The Language of Medicine 13th Edition PDF

The Language of Medicine 13th edition Davi-Ellen Chabner 1  Chapter 11 Cardiovascular System 2  Chapter Goals (Slide 1 of 2) Name the parts of the heart and associated blood vessels and their functions in the circulatio...

The Language of Medicine 13th edition Davi-Ellen Chabner 1  Chapter 11 Cardiovascular System 2  Chapter Goals (Slide 1 of 2) Name the parts of the heart and associated blood vessels and their functions in the circulation of blood. Trace the pathway of blood through the heart. Identify and describe major pathologic conditions affecting the heart and blood vessels. 3  Chapter Goals (Slide 2 of 2) Define combining forms that relate to the cardiovascular system. Describe important laboratory tests and clinical procedures pertaining to the cardiovascular system and recognize relevant abbreviations. Apply your new knowledge to understand medical terms in their proper context, such as in medical reports and records. 4 Chapter 11 Lesson 11.1 5  Introduction Cardiovascular system: delivers oxygen and nutrients to cells of body tissue Heart (muscular pump) Blood vessels (fuel line and transportation network) 6  Blood Vessels and the Circulation of Blood Arteries are the vessels that lead away from the heart. Veins have thinner walls than arteries and move deoxygenated blood toward the heart from the tissues. Capillaries are the smallest vessels. They form the point of exchange for oxygen and nutrients into body cells and waste products coming from body cells. 7 Blood Vessels 8 Blood Circulation/Systemic Circulation 9 The Aorta and Arteries 10  Anatomy of the Heart Anatomical structures of the heart include:  Superior vena cava  Inferior vena cava  Right atrium  Tricuspid valve  Right ventricle  Pulmonary valve  Pulmonary artery  Pulmonary veins  Left atrium  Mitral valve  Left ventricle  Aortic valve  Aorta 11  Major Valves of the Heart Tricuspid valve (cusps are flaps of the valves): between the right atrium and right ventricle Pulmonary valve: between the right ventricle and pulmonary artery Mitral valve: between the left atrium and left ventricle Aortic valve: between the left atrium and aorta 12 Pathway of Blood through the Heart 13  Heartbeat Two phases of the heartbeat: Diastole: relaxation Systole: contraction The diastole-systole cardiac cycle occurs between 70 to 80 times per minute (100,000 times per day). The heart pumps 3 ounces of blood with each contraction. This means that about 5 quarts are pumped per minute (75 gallons an hour and about 2000 gallons a day). 14  Heart Sounds Closure of valves associated with sounds “lubb- dubb, lubb-dubb” lubb: closure of the tricuspid and mitral valves at the beginning of systole dubb: closure of the aortic and pulmonary valves at the end of systole murmur: an abnormal heart sound caused by improper valve closure 15 Phases of the Heartbeat 16  Conduction System of the Heart (slide 1 of 2) Sinoatrial node (SA node): the pacemaker of the heart Pacemaker: origin of electrical impulse causing walls of the atria to contract and force blood into the ventricles (ending diastole) 17  Conduction System of the Heart (slide 2 of 2) Atrioventricular node (AV node): This sends the excitation wave to a bundle of specialized fibers called the atrioventricular bundle or Bundle of His. Bundle of His (pronounced “hiss”): Helps form conduction myofibers that extend to ventricle walls and stimulate them to contract, beginning systole. A short rest period follows. The pacemaker begins wave of excitation again. ECG or EKG (electrocardiogram): The record used to detect electrical changes in heart muscle as the heart beats. 18  Electrocardiogram (slide 1 of 3) P wave = spread of excitation wave over the atria just before contraction QRS wave = spread of excitation wave over the ventricles as the ventricles contract; T wave = electrical recovery and relaxation of ventricles. A heart attack (myocardial infarction or MI) can be recognized by an elevation in the S-T segment of the ECG. Thus, one type of MI is an S-T elevation MI or STEMI 19 Electrocardiogram (slide 2 of 3) 20 Electrocardiogram (slide 3 of 3) 21  Blood Pressure Blood pressure: The force that blood exerts on arterial walls Measured using a sphygmomanometer Expressed as a fraction: systolic pressure/diastolic pressure Example: 120/80 mm Hg 22 Vocabulary (Slide 1 of 22) Term aorta apex of the heart arteriole artery 23  Vocabulary (Slide 2 of 22) Term Meaning/Definition aorta The largest artery in the body apex of the heart The lower tip of the heart arteriole A small artery artery The largest type of blood vessel; carries blood away from the heart to all parts of the body 24 Vocabulary (Slide 3 of 22) Term atrioventricular bundle (bundle of His) atrioventricular node (AV node) atrium (plural: atria) 25  Vocabulary (Slide 4 of 22) Term Meaning/Definition atrioventricular Specialized muscle fibers connecting the bundle (bundle of atria with the ventricles and transmitting His) electrical impulses between them atrioventricular Specialized tissue in the wall between atria; node (AV node) electrical impulses pass from pacemaker through AV node and bundle of His toward ventricles atrium (plural: One of two upper chambers of the heart atria) 26 Vocabulary (Slide 5 of 22) Term capillary carbon dioxide (CO2) coronary arteries deoxygenated blood 27  Vocabulary (Slide 6 of 22) Term Meaning/Definition capillary The smallest blood vessel carbon dioxide Waste gas released by body cells, (CO2) transported via veins to the heart, and then to lungs for exhalation coronary arteries Blood vessels that branch from the aorta and carry oxygen-rich blood to the heart muscle deoxygenated Oxygen-poor blood blood 28 Vocabulary (Slide 7 of 22) Term diastole electrocardiogram endocardium endothelium 29  Vocabulary (Slide 8 of 22) Term Meaning/Definition diastole Relaxation phase of the heartbeat electrocardiogram Record of the electricity flowing through the heart endocardium Inner lining of the heart endothelium Innermost lining of blood vessels 30 Vocabulary (Slide 9 of 22) Term mitral valve murmur myocardium normal sinus rhythm 31  Vocabulary (Slide 10 of 22) Term Meaning/Definition mitral valve Valve between the left atrium and left ventricle; bicuspid valve murmur Abnormal swishing sound caused by improper closure of heart valves myocardium Muscular, middle layer of the heart normal sinus Heart rhythm originating in sinoatrial node rhythm with resting rate of 60-100 beats/min 32 Vocabulary (Slide 11 of 22) Term oxygen pacemaker (sinoatrial node) pericardium pulmonary artery 33  Vocabulary (Slide 12 of 22) Term Meaning/Definition oxygen Gas carried by the blood from the lungs to the heart to be pumped via arteries to all body cells pacemaker Specialized nervous tissue in the right (sinoatrial node) atrium that begins the heartbeat pericardium Double-layered membrane surrounding the heart pulmonary artery Artery carrying oxygen-poor blood from the heart to the lungs 34 Vocabulary (Slide 13 of 22) Term pulmonary circulation pulmonary valve pulmonary vein 35  Vocabulary (Slide 14 of 22) Term Meaning/Definition pulmonary Flow of blood from the heart to the lungs circulation and back to the heart pulmonary valve Valve positioned between the right ventricle and the pulmonary artery pulmonary vein Carries oxygenated blood from the lungs to the left atrium of the heart 36 Vocabulary (Slide 15 of 22) Term pulse septum (plural: septa) sinoatrial node (SA node) 37  Vocabulary (Slide 16 of 22) Term Meaning/Definition pulse The beat of the heart as felt through the walls of the arteries septum (plural: A partition or wall dividing a cavity, such as septa) that between the right and left atria and right and left ventricles sinoatrial node (SA The pacemaker of the heart node) 38 Vocabulary (Slide 17 of 22) Term sphygmomanometer systemic circulation systole tricuspid valve 39  Vocabulary (Slide 18 of 22) Term Meaning/Definition sphygmomanometer An instrument to measure blood pressure systemic circulation Flow of blood from body tissue to the heart and back systole The contraction phase of the heartbeat tricuspid valve Located between the right atrium and right ventricle; has three leaflets or cusps 40 Vocabulary (Slide 19 of 22) Term valve vein 41  Vocabulary (Slide 20 of 22) Term Meaning/Definition valve A structure in veins or in the heart that temporarily closes an opening so blood flows in only one direction vein A thin-walled vessel that carries blood from body tissues and lungs back to the heart; contains valves to prevent the backflow of blood 42 Vocabulary (Slide 21 of 22) Term vena cava (plural: venae cavae) ventricle venule 43  Vocabulary (Slide 22 of 22) Term Meaning/Definition vena cava (plural: The largest vein in the body; superior and venae cavae) inferior venae cavae return blood to the right atrium of heart ventricle One of two lower chambers of the heart venule A small vein 44 Combining Forms and Terminology (Slide 1 of 4) Combining Form Meaning angi/o vessel aort/o aorta arter/o artery arteri/o artery ather/o yellowish plaque atri/o atrium 45 Combining Forms and Terminology (Slide 2 of 4) Combining Form Meaning brachi/o arm cardi/o heart cholesterol/o cholesterol coron/o heart cyan/o blue myx/o mucus 46 Combining Forms and Terminology (Slide 3 of 4) Combining Form Meaning ox/o oxygen pericardi/o pericardium phleb/o vein sphygm/o pulse steth/o chest thromb/o clot 47 Combining Forms and Terminology (Slide 4 of 4) Combining Form Meaning valvul/o valve valv/o valve vas/o vessel vascul/o vessel ven/o, ven/i vein ventricul/o ventricle 48  QUICK QUIZ (Slide 1 of 4) 1. The double-layered membrane surrounding the heart is the: A. pericardium B. arteriole C. endocardium D. endothelium 49  QUICK QUIZ (Slide 2 of 4) 2. The contraction phase of the heartbeat is called: A. diastole B. vena cava C. systole D. septum 50  Chapter 11 Cardiovascular System Lesson 11.2 51  Pathology: Heart (Slide 1 of 7) Heart Arrhythmias Heart block (atrioventricular block) Flutter Fibrillation 52  Pathology: Heart (Slide 2 of 7) Heart Congenital heart disease Coarctation of the aorta (CoA) Patent ductus arteriosus (PDA) Septal defects (ASD and VSD) Tetralogy of Fallot 53  Pathology:Heart ( Slide 3 of 7) Heart Congestive heart disease (CHF): The heart is unable to pump the required amount of blood. In the U.S., primarily the result of high blood pressure and coronary artery disease (see next slide) Results in pulmonary edema Fatal if untreated 54  Pathology: Heart (Slide 4 of 7) Heart Coronary artery disease (CAD) Atherosclerosis Thrombotic occlusion (occlusive/mural) Ischemia Necrosis Infarction Acute Coronary Syndromes (ACS) Unstable angina Myocardial infarction (MI) 55  Pathology: Heart (Slide 5 of 7) Heart Coronary artery disease (CAD) Drug therapies for CAD Nitrates (nitroglycerin) Aspirin Beta-blockers ACE inhibitors Calcium channel blockers Statins 56  Pathology: Heart (Slide 6 of 7) Heart Coronary artery disease (CAD) Surgical therapies for CAD Coronary artery bypass grafting (CABG) Percutaneous coronary intervention (PCI) 57  Pathology: Heart (Slide 7 of 7) Heart Other pathologic conditions Endocarditis (vegetations) Hypertensive heart disease Mitral valve prolapse (MVP) Murmur Pericarditis Rheumatic heart disease 58  Pathology: Blood Vessels Blood vessels Aneurysm Deep vein thrombosis (DVT) Hypertension (HTN) Peripheral vascular disease (PVD) Raynaud’s disease Varicose veins 59  QUICK QUIZ (Slide 3 of 4) 3. Which arrhythmia refers to rapid, random, inefficient, and irregular contractions of the atria and ventricles (350 beats or more per minute)? A. Fibrillation B. Flutter C. Bradycardia 60 Chapter 11 Lesson 11.3 61  Laboratory Tests BNP test Cardia biomarkers Lipid test profile Lipoprotein electrophoresis 62  Clinical Procedures: Diagnostic (Slide 1 of 3) X-ray  Angiography and arteriography  Computerized tomography angiography  Digital subtraction angiography (DSA)  Electron beam computed tomography (EBCT or EBT) Ultrasound tests  Doppler ultrasound  Echocardiography (ECHO) 63  Clinical Procedures: Diagnostic (Slide 2 of 3) Nuclear cardiology  Positron emission tomography (PET) scan  Technetium TC 99m scan  Thallium-201 scan Magnetic resonance imaging (MRI)  Cardiac MRI 64  Clinical Procedures: Diagnostic (Slide 3 of 3) Other diagnostic procedures  Cardiac catheterization  Electrocardiography (ECG, EKG)  Holter monitoring  Stress test 65  Clinical Procedures: Treatment (Slide 1 of 2) Cardioversion (defibrillation) Endarterectomy Extracorporeal circulation Heart transplantation Thrombolytic therapy Transcatheter aortic valve replacement (TAVR) 66  Clinical Procedures: Treatment (Slide 2 of 2) Coronary artery bypass graft (CABG) surgery 1, A section of a vein is removed from the leg and anastomosed to a coronary artery to bypass an area of arteriosclerotic blockage. 2, An internal mammary artery is grafted to a coronary artery to bypass blockage. 67  Treatment Procedures Percutaneous coronary intervention (PCI)  Includes: percutaneous transluminal coronary angioplasty (PTCA), stent placement, laser angioplasty, and atherectomy 68  Abbreviations (Slide 1 of 9) Abbreviation Meaning AAA Abdominal aortic aneurysm ACE inhibitor Angiotensin-converting enzyme inhibitor ACLS Advanced cardiac life support ACS Acute coronary syndrome ADP Adenosine diphosphate AED Automatic external defibrillator AF, a-fib Atrial fibrillation AICD Automatic implantable cardioverter-defibrillator AMI Acute myocardial infarction ARVD Arrhythmogenic right ventricular dysplasia ARB angiotension II receptor blocker AS Aortic stenosis ASD Atrial septal defect 69  Abbreviations (Slide 2 of 9) Abbreviation Meaning AV, A-V Atrioventricular AVR Aortic valve replacement BBB Bundle branch block BNP Brain natriuretic peptide BP Blood pressure CABG Coronary artery bypass grafting CAD Coronary artery disease CCU Coronary care unit Cath Catheterization CHF Congestive heart failure CK Creatinine kinase CoA Coarctation of the aorta 70  Abbreviations (Slide 3 of 9) Abbreviation Meaning CPR Cardiopulmonary resuscitation CRT Cardiac resynchronization therapy CTNI or cTnI; Cardiac troponin-I and cardiac troponin-T CTNT or cTnT DES Drug-eluting stent DSA Digital subtraction angiography DVT Deep vein thrombosis ECMO Extracorporeal membrane oxygenation ECG; also EKG Electrocardiography ECHO Echocardiography EF Ejection fraction EPS Electrophysiology study 71  Abbreviations (Slide 4 of 9) Abbreviation Meaning ETT Exercise tolerance test ETT-MIBI Exercise tolerance test combined with a radioactive tracer (sestamibi) scan EVAR Endovascular aneurysm repair FFR Fractional flow reserve HDL High-density lipoprotein hsCRP High sensitivity C-reactive protein HTN Hypertension (high blood pressure) IABP Intra-aortic balloon pump 72  Abbreviations (Slide 5 of 9) Abbreviation Meaning ICD Implantable cardioverter-defibrillator IVUS Intravascular ultrasound LAD Left anterior descending (coronary artery) LDL Low-density lipoprotein LMWH Low-molecular-weight heparin LV Left ventricle LVAD Left ventricular assist device 73  Abbreviations (Slide 6 of 9) Abbreviation Meaning LVH Left ventricular hypertrophy MI Myocardial infarction MUGA Multiple-gated acquisition scan MVP Mitral valve prolapse NSR Normal sinus rhythm NSTEMI Non-ST elevation myocardial infarction 74  Abbreviations (Slide 7 of 9) Abbreviation Meaning NT-proBNP N-terminal pro-peptide of BNP PAC Premature atrial contraction PCI Percutaneous coronary intervention PDA Patent ductus arteriosus; posterior descending artery PE Pulmonary embolus PVC Premature ventricular contraction SA, S-A node Sinoatrial node 75  Abbreviations (Slide 8 of 9) Abbreviation Meaning SCD Sudden cardiac death SOB Shortness of breath SPECT Single photon emission computed tomography STEMI ST elevation myocardial infarction SVT Supraventricular tachycardia TAVR Transcatheter aortic valve replacement TEE Transesophageal echocardiography TEVAR Thoracic endovascular aneurysm repair 76  Abbreviations (Slide 9 of 9) Abbreviation Meaning TGA Transposition of the great arteries tPA Tissue-type plasminogen activator UA Unstable angina VF Ventricular fibrillation VSD Ventricular septal defect VT Ventricular tachycardia WPW Wolff-Parkinson-White syndrome 77  QUICK QUIZ (Slide 4 of 4) 4. Which procedure involves insertion of a balloon-tipped catheter into a coronary artery? A. Thrombolytic therapy B. Coronary artery bypass grafting C. Percutaneous coronary intervention D. Endarterectomy 78 Review Sheet – Combining Forms (Slide 1 of 8) Combining Form aneurysm/o angi/o aort/o arter/o arteri/o ather/o atri/o 79  Review Sheet – Combining Forms (Slide 2 of 8) Combining Form Meaning aneurysm/o aneurysm angi/o vessel aort/o aorta arter/o artery arteri/o artery ather/o yellowish plaque atri/o atrium 80 Review Sheet – Combining Forms (Slide 3 of 8) Combining Form axill/o brachi/o cardi/o cholesterol/o coron/o cyan/o isch/o my/o myx/o 81  Review Sheet – Combining Forms (Slide 4 of 8) Combining Form Meaning axill/o armpit brachi/o arm cardi/o heart cholesterol/o cholesterol coron/o heart cyan/o blue isch/o to hold back my/o muscle myx/o mucus 82 Review Sheet – Combining Forms (Slide 5 of 8) Combining Form ox/o pericardi/o phleb/o pulmon/o rrhythm/o sphygm/o steth/o thromb/o 83  Review Sheet – Combining Forms (Slide 6 of 8) Combining Form Meaning ox/o oxygen pericardi/o pericardium phleb/o vein pulmon/o long rrhythm/o rhythm sphygm/o pulse steth/o chest thromb/o clot 84 Review Sheet – Combining Forms (Slide 7 of 8) Combining Form valvul/o valv/o vas/o vascul/o ven/o, ven/i ventricul/o 85  Review Sheet – Combining Forms (Slide 8 of 8) Combining Form Meaning valvul/o valve valv/o valve vas/o vessel vascul/o vessel ven/o, ven/i vein ventricul/o ventricle 86 Review Sheet – Suffixes (Slide 1 of 4) Suffix -constriction -dilation -emia -graphy -lysis -megaly 87 Review Sheet – Suffixes (Slide 2 of 4) Suffix Meaning -constriction narrowing -dilation widening; stretching; expanding -emia blood condition -graphy process of recording -lysis breakdown; separation; destruction; loosening -megaly enlargement 88 Review Sheet – Suffixes (Slide 3 of 4) Suffix -meter -oma -osis -plasty -sclerosis -stenosis -tomy 89 Review Sheet – Suffixes (Slide 4 of 4) Suffix Meaning -meter measure -oma tumor; mass; fluid collection -osis condition; usually abnormal -plasty surgical repair -sclerosis hardening -stenosis tightening; structure -tomy process of cutting 90 Review Sheet – Prefixes (Slide 1 of 4) Prefix a-, an brady- de- dys- endo- hyper- 91 Review Sheet – Prefixes (Slide 2 of 4) Prefix Meaning a-, an no; not; without brady- slow de- lack of; down; less; removal of dys- bad; painful; difficult; abnormal endo- in; within hyper- above; excessive 92 Review Sheet – Prefixes (Slide 3 of 4) Prefix hypo- inter- peri- tachy- tetra- tri- 93 Review Sheet – Prefixes (Slide 4 of 4) Prefix Meaning hypo- deficient; below; under; less than normal inter- between peri- surrounding tachy- fast tetra- four tri- three 94