SLIDES. INFLAMMATORY DISORDERS OF THE HEART (1).pptx

Disturbances in Oxygenation Components involved in OXYGENATION  Heart  Lungs  Red Blood Cells  Blood Vessels  Anatomy and Physiology Review  Heart  cone-shaped hollow muscular organ located in the mediastinum between t...

Disturbances in Oxygenation Components involved in OXYGENATION  Heart  Lungs  Red Blood Cells  Blood Vessels  Anatomy and Physiology Review  Heart  cone-shaped hollow muscular organ located in the mediastinum between the lungs  Pumps about 60ml/beat or 5L/min  Pericardium – protective covering of the  Anatomy and Physiology Review  3 layers of cardiac muscle tissue: Epicardium – outermost layer Myocardium – middle layer Endocardium – innermost layer  Anatomy and Physiology  Chambers Review  Rightatrium (0-5 mmHg)  SVC, IVC, Coronary sinus  Right Ventricle (25 mmHg)  Left atrium  Left ventricle  Valves  AV valves  Semilunar valves  Anatomy and Physiology Review  Coronary arteries  Left Coronary Artery  Left anterior descending – LV, Ventricular septum, chordae tendinae, papillary muscle, RV (lesser extent)  Circumflex coronary artery – LA, lateral & posterior surfaces of LV, portion of interventricular septum, SA node, AV node  Right Coronary Artery  RA, RV, inferior portion of LV Branching pattern of the coronary arteries varies considerably among  Anatomy and Physiology Review  Electrophysiologic Properties of the Heart  Automaticity  initiate an impulse spontaneously & repetitively  Excitability (depolarization)  respond to a stimulus  Conductivity  Transmit electrical impulses  Contractility  Contract  Refractoriness  Inability to respond until repolarization  Anatomy and Physiology Review  Conduction System of the Heart  SA node (60-100 times/min)  AV node (40-60 beats/min)  Bundle of His  R & L bundle branches  Purkinje fibers (20-40 beats/min)  Anatomy and Physiology Review  Sequence of events during cardiac cycle Systole (contraction) – emptying Diastole (relaxation) – filling  Anatomy and Physiology Review Mechanical Properties of the Heart  Cardiac Output  HR Cardiac Output = HR x  SV ANS,  endogenous cathecolamines  Parasympathetic NS (vagus nerve), beta blockers, Ca+ +-channel blockers  SV  Preload – volume of blood distending the ventricles at the end of diastole just before contraction  Afterload – resistance that the ventricles must overcome to eject blood  Contractility  Anatomy and Physiology  Vascular System Review  Anatomy and Physiology Review  Vascular System  Anatomy and Physiology  Review Vascular System: FUNCTIONS Provide conduits for blood to travel from the heart to nourish the various tissues of the body Carries cellular waste to the excretory organs Allows lymphatic flow to drain tissue fluid back into the circulation Returns blood to the heart for recirculation  Anatomy and Physiology Review  Vascular System Assessment Techniques  Assessment Techniques  History (focus: obtaining information about client’s risk factors & symptoms of cardiovascular disease)  Demographic data – age, gender, ethnic origin  Family history & genetic risk  Personal history  Diet history  Socioeconomic status  Assessment Techniques History   History  Modifiable  Modifiable cigarette cigarettesmoking smoking physical inactivity physical inactivity Obesity Obesity psychological variables psychological variables chronic diseases chronic diseases Non-modifiable risk factors Non-modifiable risk factors age, gender, ethnic background, age, gender, ethnic background, family history family history  Assessment Techniques  cigarette smoking – major risk factor for the devp’t of CAD & PVD  Obesity – strong indicator of CVD especially when abdominal obesity is present  Assessment Techniques  Physical assessment  Major symptoms cardiovascular disease (CVD)  Pain or discomfort  Dyspnea (DOE, Orthopnea, Paroxysmal Nocturnal Dyspnea)  Fatigue  Palpitations  Weight gain – best indicator of fluid retention (edema)  Syncope – transient loss of consciousness ( cerebral perfusion)   Assessment  Techniques Physical assessment  Skin color – pallor (anemia), cyanosis (late sign of decreased perfusion)   skin temperature – due to  blood flow  Clubbing of fingers – chronic tissue hypoxia  Edema  BP changes  Hypertension  Postural Hypotension  Pulse pressure (30-40mmHg)  Assessment Techniques Precordium (area over the heart) Assessment involves:  Inspection  Apical impulse  Palpation  Percussion  Auscultation  Normal heart sounds  Abnormal heart sounds  Assessment  Techniques Normal Heart Sounds S1 – closure of AV valves  Low pitch, long; best heard at the apex of the heart  Palpate the carotid pulse while listening  Marks the beginning of ventricular systole S2 – closure of semilunar valves  High pitch, short; best heard at the base of the heart  Assessment Techniques Abnormal Heart Sounds  Murmurs  Reflection of turbulence of blood flow through the normal or abnormal valves  Pericardial friction rub  Sign of inflammation, infection or infiltration  Assessment Techniques Laboratory Tests  Serum markers of myocardial damage (cardiac markers) Troponin (T=