Cardiovascular System Quiz

Course Information

• Course title: DPT 611 Cardiovascular Rehabilitation
• Course overview: Includes learning objectives and communication preferences.
• Assignment: FNIBBLE due by the end of week 3.

Cardiovascular Risk Factors, CV Anatomy & Physiology

• Course: DPT 611 Cardiovascular Rehabilitation
• Instructor: Lora Packel PT, PhD
• Semester: Spring 2025

Learning Objectives

• Students should be able to describe the normal cardiovascular and lymphatic system anatomy and physiology related to cardiovascular disease (CVD).
• Students should be able to identify and categorize cardiovascular disease risk factors.
• Students should be able to describe fundamental principles in exercise physiology related to the cardiovascular system.
• Students should be able to define the movement system and apply it to the examination of a mock patient with cardiovascular disease.

Cardiovascular Anatomy

• Draw the heart with valves and the branches of the aorta, excluding coronary arteries (for now).
• Do not move ahead in the presentation.

Heart - Gross Anatomy

• The base of the heart is located cranially and angled posteriorly.
• The apex is situated around the 5th intercostal space.
• About 2/3rds of the heart sits to the left of the sternum.
• Heart layers: epicardium (visceral pericardium and parietal pericardium), myocardium, and endocardium.
• Myocardial cells have automaticity (contract without stimulus), rhythmicity (beat in a pattern), and conductivity (transmit nerve impulses).

Aorta Branches

• Diagram of major branches should be studied.

Blood Flow and the Cardiac Cycle

• Work with a classmate to map and describe blood flow through the heart, prepare to present.
• Do not look ahead in the presentation.

Heart Chambers and Valves Information

• Diagram of heart chambers and valves, flow of blood through the heart.

Nervous System Influence on the Heart

• The autonomic nervous system (ANS) controls heart rate and contractility.
• The vagus nerve (parasympathetic) slows the heart rate.
• The sympathetic trunk (T1-T5) speeds up the heart rate and increases contractility (chronotropy and inotropy).
• Beta-1 receptors in the heart respond to adrenaline and noradrenaline.

Coronary Circulation

• The aortic sinuses of Valsalva give rise to the right and left coronary arteries, which feed myocardial tissue.
• The left main coronary artery divides into the left anterior descending (LAD) artery and the left circumflex (LCX) artery.

Peripheral Circulation

• Peripheral resistance impacts the heart's pumping effectiveness, increases myocardial oxygen demand, and influences blood flow to skeletal muscles (at rest and during activity).
• Oxygen uptake by muscles depends on blood flow, hemoglobin, and myoglobin.
• A-vO2 difference reflects oxygen use by tissues.

Risk Factors for Heart Disease

• Students should be familiar with common heart disease risk factors.
• Review exercise physiology information; know normative values and recommended levels.
• This material will be assessed.

Major Risk Factors for Heart Disease and Stroke

• Hypertension stages.
• High cholesterol (total cholesterol, HDL, LDL, triglycerides).
• Diabetes.
• Obesity and overweight.
• Smoking.
• Cholesterol levels (LDL, HDL, Total cholesterol, Triglycerides).
• HDL targets (40 mg/dL MEN, >50 mg/dL WOMEN).

Major Risk Factors Continued

• Physical inactivity
• Male gender (risk equals females after age 65, lower risk around age 50).
• Heredity/Race (parental/sibling history before 55 increases risk, prevalence of hypertension in blacks).
• Prevalence of obesity and smoking in specific ethnicities (Mexican-Americans, Hawaiians, Asian-Americans)
• Age (risk increases with age)

Diabetes and Heart Disease

• Pathophysiology of diabetes is to be discussed in medical management courses.
• The two types of diabetes (type I and type II).
• Both forms are associated with insulin resistance or absence.
• High blood glucose is harmful to blood vessels and nerves.
• Individuals with diabetes have a two-fold increased risk of cardiovascular diseases such as CAD, OMI, and OCVA, and heart failure.
• Those with diabetes tend to have higher blood pressure, total cholesterol, LDL, triglycerides.

Diabetes: Macrovascular Changes

• Coronary artery disease develops earlier in people with diabetes, and tends to be widespread.
• Cardiovascular autonomic neuropathy in diabetes damages autonomous nerves affecting blood vessels and the heart.
• Orthostatic hypotension (drop in blood pressure when standing), exercise intolerance, and silent myocardial infarction (heart attack without symptoms) are common associated complications of diabetes.

Contributing Risk Factors

• Stress raises blood pressure and increases myocardial oxygen demand.
• Birth control pills increase risk if older than 35, smokes or has high blood pressure.
• Alcohol intake can increase risk factors.

Intro to Simulation Lab

• Portion of students will attend the simulation lab; others will have a lecture in class on Thursday (rotate).
• A schedule, 3-minute video, simulation introduction PowerPoint, and goals for the simulation experience will be posted before the lab.