1. W ARM -U P 1. What is the pacemaker? Where is it located? 2. List the parts of the intrinsic conduction system of the heart. 3. Draw and label the 3 waves of a typical EKG tracing. What is happening at each wave? 4. What causes the heart sounds (lub-dub)?

2. W ARM -U P 1. Compare arteries, capillaries, & veins. 1. Imagine you are a red blood cell. List the pathway you would travel through the body in a complete circuit starting at a pinky toe. 2. Explain how blood pressure is measured.

3. W ARM -U P 1. What is hypertension? What are possible causes? 2. What is atherosclerosis? 3. What can you do to prevent atherosclerosis? 4. What treatment options are available for patients with coronary atherosclerosis?

4. B LOOD V ESSELS & C IRCULATION

5. Vascular System: blood circulates inside closed transport systems Types of Blood Vessels: Arteries (takes blood away from heart) Arterioles Capillary beds Venules Veins (return blood back to heart)

6. A NATOMY OF B LOOD V ESSELS Three coats (tunics): 1. Tunica intima: endothelium lines the interior of vessels; decreases friction as blood flows 2. Tunica media: smooth muscle & elastic tissue (dilates & constricts vessels) 3. Tunica externa: fibrous connective tissue on outside supports and protects vessels

8. Arteries Capillaries Veins Blood away from heart Thicker walls Withstand high pressure Walls 1-cell thick Exchange gases between blood and tissue cells Blood back to heart Thinner walls Low pressure Large lumen Valves Valves: prevent blood backflow Skeletal muscles enhance venous return

9. V ERICOSE V EINS People stand for long periods of time  inactivity or pressure on veins Blood pools in feet and legs Valves weaken  veins become twisted & dilated Treatment: compression stockings, exercise, laser treatment, surgery

10. V ITAL S IGNS Pulse: expansion & recoil of an artery with each beat of left ventricle Pressure points (eg. carotid artery, radial artery) Normal resting: 70-76 beats/min

11. V ITAL S IGNS Blood pressure: pressure of blood on inner walls of blood vessels Systolic presure: peak of ventricular contraction Diastolic pressure: ventricles relaxed Written: Systolic/Diastolic Normal: (120 mm Hg)/(70 mm Hg) or 120/70

12. M EASURING B LOOD P RESSURE

14. U SING A SPHYGMOMANOMETER Wrap cuff around upper arm Place stethoscope on brachial artery Inflate cuff to 180 mm Hg Slowly release air  listen for whooshing sounds in brachial artery ( Korotkoff sounds ) Systolic: when sound begin to appear Diastolic: when sounds disappear

15. YouTube: How to Measure Blood Pressure

16. H OMEOSTATIC I MBALANCES Hypertension: high blood pressure (>140/90) Circulatory shock: acute hypotension Blood loss Atherosclerosis – artery walls thicken due to fatty deposits (plaques)

17. S TENT VS. B YPASS S URGERY

19. C ONGESTIVE H EART F AILURE Progressive weakening of heart Low heart efficiency  circulation inadequate to meet tissue needs Caused by: Coronary atherosclerosis Persistent high blood pressure Multiple heart attacks – scar tissue