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The Cardiovascular System

PowerPoint presentation to accompany:

Medical Assisting
Third Edition

Booth, Whicker, Wyman, Pugh, Thompson

2009 The McGraw-Hill Companies, Inc. All rights reserved

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Learning Outcomes
27.1 Describe the structure of the heart and the function of each part. 27.2 Trace the flow of blood through the heart. 27.3 List the most common heart sounds and what events produce them. 27.4 Explain how heart rate is controlled by the electrical conduction system of the heart.
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Learning Outcomes (cont.)

27.5 List the different types of blood vessels and describe the functions of each.

27.6 Define blood pressure and tell how it is controlled.

27.7 Trace the flow of blood through the pulmonary and systemic circulation. 27.8 List the major arteries and veins of the body and describe their locations.
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Learning Outcomes (cont.)

27.9 List and describe the components of blood. 27.10 Give the functions of red blood cells, the different types of white blood cells, and platelets. 27.11 List the substances normally found in plasma. 27.12 Explain how bleeding is controlled. 27.13 Explain the differences among blood types A, B, AB, and O.

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Learning Outcomes (cont.)

27.14 Explain the difference between Rh-positive blood and Rh-negative blood.

27.15 Explain the importance of blood typing and tell which blood types are compatible.
27.16 Describe the causes, signs and symptoms, and treatments of various diseases and disorders of the cardiovascular system.

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Introduction

The cardiovascular system consists of heart and blood vessels Sends blood to

Lungs for oxygen Digestive system for nutrients

CV system also circulates waste products to certain organ systems for removal from the blood
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The Heart: Structures

Cone-shaped organ about the size of a loose fist In the mediastinum Extends from the level of the second rib to about the level of the sixth rib Slightly left of the midline
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The Heart: Structures (cont.)

Heart is bordered:

Laterally by the lungs Posteriorly by the vertebral column Anteriorly by the sternum

Rests on the diaphragm inferiorly

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The Heart: Structures (cont.)

Heart coverings

Pericardium

Click for Larger View

Covers the heart and large blood vessels attached to the heart Visceral pericardium

Heart walls:

Epicardium

Outermost layer Fat to cushion heart Middle layer Primarily cardiac muscle Innermost layer Thin and smooth Stretches as the heart pumps

Innermost layer

Myocardium

Directly on the heart

Parietal pericardium

Layer on top of the visceral pericardium

Endocardium

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The Heart: Structures (cont.)

Four chambers Two atria

Two ventricles

Upper chambers Left and right Separated by interatrial septum

Lower chambers Left and right Separated by interventricular septum

Click for View of Heart

Atrioventricular septum separates the atria from the ventricles

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The Heart: Structures (cont.)

Tricuspid valve prevents blood from flowing back into the right atrium when the right ventricle contracts Bicuspid valve prevents blood from flowing back into the left atrium when the left ventricle contracts Pulmonary valve prevents blood from flowing back into the right ventricle Aortic valve prevents blood from flowing back Click for View of into the left ventricle Heart
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The Heart: Blood Flow

Deoxygenated blood in from body
Oxygenated blood in lungs Oxygenated blood out to body

Deoxygenated blood out to lungs Atria Contract Ventricles Contract

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The Heart: Blood Flow (cont.)

Right Atrium
Tricuspid Valve

Right Ventricle

Pulmonary Valve

Body

Lungs

Aortic Semilunar Valve

Left Ventricle

Bicuspid Valve

Left Atrium

Pulmonary Semilunar Valve

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The Heart: Cardiac Cycle

One heartbeat = one cardiac cycle

Atria contract and relax Ventricles contract and relax

Right atrium contracts

Left atrium contracts

Tricuspid valve opens Blood fills right ventricle

Bicuspid valve opens Blood fills left ventricle

Bicuspid valve closes Aortic semilunar valve opens Blood pushed into aorta

Right ventricle contracts

Left ventricle contracts

Tricuspid valve closes Pulmonary semilunar valve opens Blood flows into pulmonary artery

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The Heart: Cardiac Cycle (cont.)

Influenced by

Exercise Parasympathetic nerves Sympathetic nerves Cardiac control center Body temperature Potassium ions Calcium ions
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The Heart: Heart Sounds

One cardiac cycle two heart sounds (lubb and dubb) when valves in the heart snap shut

Lubb First sound

When the ventricles contract, the tricuspid and bicuspid valves snap shut

Dubb Second sound

When the atria contract and the pulmonary and aortic valves snap shut

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The Heart: Cardiac Conduction System

Group of structures that send electrical impulses through the heart Sinoatrial node (SA node)

Bundle of His

Wall of right atrium Generates impulse Natural pacemaker Sends impulse to AV node

Between ventricles Two branches Sends impulse to Purkinje fibers

Atrioventricular node (AV node)

Purkinje fibers

Between atria just above ventricles Atria contract Sends impulse to the bundle of His

Lateral walls of ventricles Ventricles contract

Link to Diagram

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Apply Your Knowledge

Match the following:
C Tricuspid valve __ __ F Bicuspid valve

ANSWER:
A. Two branches; sends impulse to Purkinje fibers B. Covering of the heart and aorta

__ B Pericardium
__ E SA node __ A Bundle of His D Purkinje fibers __

C. Between the right atrium and the right ventricle

D. In the lateral walls of ventricles E. Natural pacemaker F. Between the left atrium and the left ventricle

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Blood Vessels: Arteries and Arterioles

Strongest of the blood vessels Carry blood away from the heart Under high pressure

Arterioles

Small branches of arteries Takes blood from the heart to the body Supply blood to heart muscle

Aorta

Vasoconstriction Vasodilation

Coronary arteries

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Blood Vessels: Veins and Venules

Blood under no pressure in veins

Venules

Does not move very easily Skeletal muscle contractions help move blood Sympathetic nervous system also influences pressure

Small vessels formed when capillaries merge

Superior and inferior vena cava

Largest veins Carry blood into right atrium

Valves prevent backflow

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Blood Vessels: Capillaries

Branches of arterioles Smallest type of blood vessel Connect arterioles to venules Only about one cell layer thick

Oxygen and nutrients can pass out of a capillary into a body cell
Carbon dioxide and other waste products pass out of a body cell into a capillary
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Apply Your Knowledge

How do arteries control blood pressure?
ANSWER: The muscular walls of arteries can constrict to increase blood pressure or dilate to decrease blood pressure.

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Blood Pressure

Force blood exerts on the inner walls of blood vessels

Highest in arteries Lowest in veins

Systolic pressure

Ventricles contract Blood pressure is at its greatest in the arteries

Diastolic pressure

Ventricles relax Blood pressure in arteries is at its lowest

Reported as the systolic number over the diastolic number

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Blood Pressure (cont.)

Control is based mainly on the amount of blood pumped out of the heart The amount of blood entering should equal the amount pumped from the heart Starling's law of the heart

Blood entering the left ventricle stretches the wall of the ventricle The more the wall is stretched

The harder it will contract and tTe more blood it will pump out

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Blood Pressure (cont.)

Baroreceptors

Also help regulate blood pressure

Located in the aorta and carotid arteries

High blood pressure in aorta message to cardiac center in brain decreases heart rate lowers blood pressure Low blood pressure in aorta message to cardiac center in the brain increases heart rate increases blood pressure
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Apply Your Knowledge

What is the difference between the systolic pressure and diastolic pressure?
ANSWER: Systolic pressure is the result of the contraction of the ventricles increasing the pressure in the arteries. Diastolic pressure is the result of the relaxation of the ventricles lowering the pressure in the arteries.

Good Answer!
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Circulation

Pulmonary circuit
right atrium right ventricle pulmonary artery trunk pulmonary arteries lungs pulmonary veins heart (left atrium)

Systemic circuit
left atrium left ventricle aorta arteries arterioles capillaries venules veins vena cava heart (right atrium)
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Circulation (cont.)

Arterial system

Carry oxygen-rich blood away from the heart

Pulmonary arteries carry oxygen-poor blood

Paired left and right artery of the same name

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Circulation (cont.)

Venous system

Hepatic portal system

Carries oxygenpoor blood toward the heart

Collection of veins carrying blood to the liver

Except pulmonary veins

Most large veins have the same names as the arteries they are next to

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Apply Your Knowledge

Do pulmonary arteries carry blood with high levels of oxygen or low levels of oxygen?
ARTERIES: Pulmonary arteries carry oxygen-poor blood.

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Blood

A type of connective tissue

Red blood cells (erythrocytes) White blood cells (leukocytes) Platelets cell fragments Plasma fluid part of blood

Average-sized adult has 4 to 6 liters of blood

Amount depends on: Size of person Amount of adipose tissue Concentrations of ions Females have less than males

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Blood Components

Hematocrit

The percentage of red blood cells Normal is about 45%

White cells and platelets = 1%

Plasma = 55%
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Blood Components: Red Blood Cells

Erythrocytes Transport oxygen throughout the body Small biconcave-shaped cells Hemoglobin is a pigment in RBCs

Oxyhemoglobin carries oxygen; bright red Deoxyhemoglobin does not carry oxygen; darker red

Carries carbon dioxide, so also called carboxyhemoglobin

Anemia low RBC count

Erythropoietin regulates production of RBCs

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Blood Components: Red Blood Cells (cont.)

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Blood Components: White Blood Cells

Granulocytes

Neutrophils (55%) destroy bacteria, viruses, and toxins in the bloodstream (phagocytes) Eosinophils (3%) get rid of parasitic infections such as worm infections Basophils (1%) control inflammation and allergic reactions

Agranulocytes

Monocytes (8%) destroy bacteria, viruses, and toxins in blood Lymphocytes (33%) provide immunity for the body
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Blood Components: White Blood Cells (cont.)

WBC count normally 5000 to 10,000 cells per cubic millimeter of blood

Leukocytosis

Elevated WBC count Usually due to infection Low WBC count Some viral infections and other conditions

Leukopenia

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Blood Components: Platelets

Fragments of cells found in the bloodstream Also called thrombocytes Important in the clotting process of blood Normal count

130,000 to 360,000 platelets per cubic millimeter of blood

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Blood Components: Plasma

Liquid portion of blood composed mostly of water Proteins

Nutrients

Albumins

Smallest plasma proteins Pull water in to help maintain blood pressure

Amino acids Glucose Nucleotides Lipids from the digestive tract

Globulins transport lipids and fat-soluble vitamins Fibrinogen needed for blood clotting

Gases oxygen, carbon dioxide, and nitrogen Electrolytes Waste products

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Blood: Bleeding Control

Hemostasis the control of bleeding

Three processes of hemostasis

Blood vessel spasm Platelet plug formation Blood coagulation

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Platelet plug formation:

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Blood Types

Types are distinguished by antigen and antibodies Agglutination

Clumping of red blood cells Antigens on surface of RBCs bind to antibodies in plasma
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Blood Types (cont.)

Blood Type Antigen Present Antibody Present Blood That Can Be Received

A B

A B

B A

A and O B and O

AB O

AB None

None A and B

A, B, AB, and O O

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Blood Types (cont.)

Rh antigen protein on RBCs Rh-positive

Rh-positive blood is
given to Rh-negative person Antibodies form

RBCs contain the Rh antigen

Rh-negative

If Rh-negative person receives more Rhpositive blood

RBCs do not contain the Rh antigen

Antibodies bind to the donor cells Agglutination occurs

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Apply Your Knowledge

True or False: ANSWER: RBCs __ F Hematocrit is the percentage of WBCs in the blood. __ T Neutrophils destroy bacteria, viruses, and toxins in the bloodstream. __ T Platelets are important to the clotting process. pulls water into __ F Albumin is a small plasma protein that pushes water out of the bloodstream. __ T Hemostasis is the control of bleeding.
can receive any type of blood

__ F A person with type AB blood can only receive type AB blood.

__ T Blood should be matched for Rh factor.

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Chest Pain

Cardiac

Non-cardiac

Myocardial infarction Angina Pericarditis Coronary spasm

Take all complaints of chest pain seriously!

Heartburn Panic attacks Pleurisy Costochondritis Pulmonary embolism Sore muscles Broken ribs

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Chest Pain (cont.)

Determine cause

Electrocardiogram Stress tests Blood tests Chest x-ray Nuclear scan Coronary catheterization Echocardiogram Endoscopy
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Diseases and Disorders of the Cardiovascular System

Disease
Anemia

Description
The blood does not have enough red blood cells or hemoglobin to carry an adequate amount of oxygen to the bodys cells A ballooned, weakened arterial wall

Aneurysm

Arrhythmias
Carditis Endocarditis

Abnormal heart rhythms

Inflammation of the heart Inflammation of the innermost lining of the heart, including valves
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Diseases and Disorders of the Cardiovascular System (cont.)

Disease
Myocarditis
Pericarditis Congestive Heart Failure

Description
Inflammation of the muscular layer of the heart
Inflammation of the membranes that surround the heart (pericardium) Weakening of the heart over time; heart is unable to pump enough blood to meet bodys needs

Coronary Artery Atherosclerosis; narrowing of coronary arteries Disease (CAD) caused by hardening of the fatty plaque deposits within the arteries
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Diseases and Disorders of the Cardiovascular System (cont.)

Disease
Hypertension
Leukemia Murmurs Myocardial Infarction

Description
High blood pressure; consistent resting blood pressure equal to or greater than 140/90 mm Hg
Bone marrow produces a large number of abnormal WBCs Abnormal heart sounds Heart attack; damage to cardiac muscle due to a lack of blood supply

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Diseases and Disorders of the Cardiovascular System (cont.)

Disease
Sickle Cell Anemia Thalassemia

Description
Abnormal hemoglobin causes RBCs to change to a sickle shape; abnormal cells stick in capillaries Inherited form of anemia; defective hemoglobin chain causes, small, pale, and short-lived RBCs

Thrombophlebitis Blood clots and inflammation develops in a vein

Varicose Veins

Twisted, dilated veins

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Apply Your Knowledge

The doctor has told your patient she has anemia. How would you explain this to the her?
ANSWER: Anemia is a condition in which a person does not have enough red blood cells or hemoglobin in the blood to carry an adequate amount of oxygen to body cells.

Bravo!
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In Summary

Cardiovascular system

Transport system for body Heart, arteries, veins, and capillaries Transport medium RBCs, WBCs, platelets, plasma Assists patients in understanding prevention and treatments for cardiovascular problems
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Blood

Medical assistant

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End of Chapter

Your work is to discover your world and then with all your heart give yourself to it.
~ Buddha

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