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Cardiology and Lymphatics

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1 Cardiology and Lymphatics
Chapter 27 Cardiology and Lymphatics

2

3 Learning Objectives Identify key structures of the cardiovascular and lymphatic systems Describe the electrical conduction system of the heart Discuss the roles played by the cardiovascular and the lymphatic systems Define and spell terms related to the cardiovascular and lymphatic systems

4 Learning Objectives Define the role of the medical assistant in the cardiology office Identify common cardiovascular and lymphatic disorders List commonly used word elements related to the cardiovascular and lymphatic systems

5 Learning Objectives Give at least 10 examples of how new cardiology-related terms may be created by combining prefixes, suffixes, and combining forms Describe physical examination techniques used to evaluate the cardiovascular and lymphatic systems

6 Learning Objectives List and describe types of cardiovascular testing done in or out of the cardiology office Demonstrate the performance of an electrocardiogram (ECG)

7 Structures of the Heart
Epicardium Myocardium Endocardium Atrium Ventricles Septum

8 Circulatory System Arteries (carry oxygenated blood)
Veins (carry deoxygenated blood) Major arteries: aorta, pulmonary arteries Major veins: pulmonary veins and superior and inferior vena cava Capillaries

9 Circulatory System Structures of the circulatory system

10 Heart Hollow, muscular organ Generates its own contractions
Enclosed in pericardial sac, pericardial fluid Two-sided pump

11 Conduction System of Heart
SA node AV node Bundle of His Purkinje fibers

12 Cardiac Cycle Contraction and relaxation of heart Systole Diastole
0.8 seconds Blood pressure Written as 110/72 Systole—highest pressure of contraction Diastole—relaxation of heart, condition of vessels away from heart

13 Circulatory System Aorta—largest artery carries blood away from the heart; thick, muscular walls; high pressure, blood is rich in oxygen Veins—less oxygenated blood, less pressure, valves prevent backflow Capillaries—microscopic vessels, place where exchange of oxygenated blood and deoxygenated takes place

14 Lymphatic System Lymphatic vessels parallel arteries, veins, capillaries Lymph fluid in lymphatic vessels Muscle contractions move lymph through body, no pump Lymph nodes and glands Immunity

15 Structures of Lymphatic System
Lymph—fluid, watery substance, excess fluid in tissues Interstitial fluid—lymph in tissue spaces Lymphatic vessels—vessels that carry lymph Lymph nodes—tonsils, adenoids Nodes found throughout body but higher concentrations are found in groin, neck, and axilla

16 Lymph Glands Thymus—produces T lymphocytes, shrinks in size with age
Spleen—rich blood supply, produces white blood cells and antibodies, can survive without spleen

17 Common Diseases and Disorders
Hypertension (high blood pressure)— consistent blood pressure >140/90, secondary and primary hypertension, known as the silent killer, treatment includes modifying risk factors and medication

18 Coronary Artery Diseases
CAD—lumen of arteries become narrow due to deposits of fat on artery walls Treatment includes lifestyle modifications, medications, angioplasty

19 Myocardial Infarction
MI (heart attack)— death of heart muscle Life-threatening emergency Aggressive treatment includes medications, hospitalization, respiratory support

20 Heart Failure Congestive heart failure—inability of heart to pump blood effectively Left-sided heart failure, right-sided heart failure Treatment—medications including diuretics, antihypertensives, and digoxin

21 Aneurysm Abnormal dilation in vessel wall usually due to weakness
Treatment includes “watchful waiting” and surgery

22 Common Diseases and Disorders
Atrial fibrillation—common type of heart arrhythmia, atria do not contract regularly Treatment—medications, cardioversion, and possible ablation Varicose veins—enlarged, dilated superficial veins, mostly legs, treatment includes rest, elevation, support hose, ligation

23 Common Diseases and Disorders
Deep vein thrombosis (DVT)—blood clot in deep vein, usually legs, treatment includes medication, rest, elevation, warm compresses Shock—inadequate perfusion and oxygenation due to low blood pressure, varying degrees of shock, treatment includes quick diagnosis, medications

24 Common Diseases and Disorders
Anemia—decreased amount of red blood cells, treatment depends on underlying cause and may include supplements Leukemia—malignancy of blood and blood-forming tissues, different types, treatment varies according to type of leukemia

25 Common Diseases and Disorders
Hodgkin disease (lymphoma)—malignancy of lymph system, treatment may include chemotherapy, radiation, and possibly bone marrow transplantation Non-Hodgkin lymphoma—group of malignancies, treatment may include radiation, chemotherapy, and bone marrow transplantation

26 AIDS Acquired immune deficiency syndrome— late-stage infection of HIV which progressively weakens immune system Treatment includes medications and general measure to improve immune system Currently there is no cure and no vaccine to prevent AIDS

27 Medical Specialty Cardiology—medical specialty that focuses on the study and treatment of disorders of the cardiovascular system Cardiologist—medical doctor specializing in the diagnosis and treatment of patients with cardiovascular disorders

28 Assisting With Examination
Medical assistant prepares patient for exam Checks vital signs Obtains health history, may include family history, risk factors for CAD, new or unusual symptoms Assists patient as necessary Assists physician as necessary

29 Electrocardiography ECG—noninvasive procedure
Electrocardiograph— machine to record electrical heart activity Electrocardiogram—written record of electrical heart activity

30 Electrocardiograph paper
Paper is heat and pressure sensitive Vertical and horizontal lines 1 mm each Bold vertical and horizontal lines 5 mm each

31 Standardization ECG machine must be standardized or calibrated
Correct standardization is 10 mm vertical deflection, 2 mm horizontal

32 Leads and Electrodes Placed on patient’s arms, legs, and chest
Color-coded wires assure correct placement Leads record electrical activity between positive and negative electrodes

33 Preparing the Patient Make patient as comfortable as possible
Instruct patient to undress to the waist, properly gown/drape Position patient in supine or semi-Fowler position Record medications and vital signs Assure patient that the procedure is painless

34 Rhythm Interpretation
P wave—atrial depolarization Q,R,S complex—ventricular depolarization ST segment—no electrical activity T wave—ventricular repolarization

35 Waveforms ECG waves include: P wave Q,R,S complex ST segment T wave

36 Artifacts Distracting and irrelevant marks on ECG
If present, may have to repeat ECG Causes include somatic tremor, wandering baseline, AC interference, and interrupting baseline

37 Somatic Tremor Small, irregular, jagged peaks Fuzzy appearance
Caused by muscle movement Comfort patient, keep patient still, encourage to not talk

38 Wandering Baseline Entire tracing strays from baseline
Patient movement, faulty connections Keep patient still, clean electrodes, check connections

39 Alternating Current (AC) Interference
Series of short spikes Electrical currents Ground ECG machine with three-prong cord in outlet, avoid crossing lead wires, unplug nearby equipment

40 Interrupted Baseline Large, irregular fluctuations
Patient movement, broken lead wires Keep patient still, replace lead wires

41 Artificial Cardiac Pacemaker
Device that delivers electrical impulses to stimulate heartbeat Used when natural heartbeat is too slow or irregular Implanted under patient’s skin Physician sets pacemaker’s pace

42 Implantable Cardioverter Defibrillator
Slightly larger than pacemaker Some devices are combination pacemaker and defibrillator Used in patients with life-threatening arrhythmias When patient is in life-threatening rhythm, the device delivers an electrical shock to restore normal sinus rhythm

43 Cardiac Stress Test Evaluates heart’s response to physical exercise
Patient walks on treadmill or is given IV medication to stimulate response During test heart rate, BP is monitored and any symptoms are noted Constant monitoring is important

44 Holter Monitoring Portable device monitors patient’s heart for 24- or 48-hour period Used when patient has irregular heartbeat or symptoms are intermittent Electrodes are placed on patient’s chest; the monitor is placed in a small pouch Patient records activities in a journal

45 Holter Monitoring Patient returns to clinic where recording from monitor is downloaded

46 Event Recorder “King of Hearts”
Small, portable monitor, placed around the patient’s neck or in shirt pocket Electrodes on patient’s chest are activated when symptoms occur

47 Discussion Identify structures of the heart
List functions of the heart List organs of the lymphatic system Discuss conduction system of the heart and an artificial pacemaker Identify sites for electrode placement in electrocardiogram

48 Credits


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