Anatomy & Physiology of the Cardiovascular System PDF

NOTES: Heart -a fist-sized, muscular organ located in the mediastinum between the lungs Ana...

NOTES: Heart -a fist-sized, muscular organ located in the mediastinum between the lungs Anatomy & -pumps 4.5-5.7L per minute (60mL per beat) -first organ to receive oxygen-rich blood Physiology of the -has mechanical and electrical properties CARDIOVASCULAR -heart rhythm is controlled by the medulla oblongata SYSTEM -heart rate is affected by the autonomic nervous system (sympathetic [catecholamines] and parasympathetic [vagus nerve]) stimulation ** Baroreceptors- detect pressure ** Peripheral chemoreceptors- detect hypoxemia Mechanical Properties of the Heart -to maintain PERFUSION to the various body tissues - Cardiac Cycle: systole (contraction) & diastole (relaxation) BP= cardiac output (CO) x total peripheral resistance (TPR) heart rate (HR) x stroke volume (SV) preload (blood returning to the heart and stretch) afterload (pressure/resistance ventricles must overcome) contractility …..expressed as: BP= Systolic / Diastolic Mean Arterial Pressure (MAP)= (1 x systolic) + (2 x diastolic) 3 -Heart Sounds: S1- closure of AV valves (lub) S2- closure of semilunar valves (dub) S3- ventricular gallop (lub-du-dub) *volume overload normal: females -Class: inflow, outflow Syndrome -Cause: atherosclerosis (MOST COMMON), SYPHILIS, -Cause: atherosclerosis -prolonged venous Marfan’s syndrome, Ehlers-Danlos syndrome, blunt Stages I: Asymptomatic hypertension and trauma Stages II: Claudication valvular damage Types: fusiform, saccular (Berry), mycotic aneurysms (due Stages III: Rest Pain resulting in edema stasis to infection) Stages IV: Necrosis/Gangrene and decreased tissue -Location: Abdominal Aortic Aneurysm (AAA), thoracic -S&sx: rest pain (felt at toes, foot arches, perfusion AA, cerebral aneurysm forefeet, heels calves, ankles), loss of hair; dry, -Risks: Standing/sitting -S&sx: asymptomatic, abdominal/flank/back pain (dull, scaly, dusky, pale, or mottled skin; thickened for long periods, obesity, boring, gnawing), pulsation (upper abdomen), bruit, toenails; cold and gray-blue (cyanotic) or DVTs symptoms from compression of other organs (esp TAA), darkened, dependent rubor, muscle atrophy, -S&sx: venous stasis, thrashing toes Dx: MR angiography (MRA), CTA, Doppler UTZ, swelling, and cellulitis, -Complication: Rupture (SEVERE PAIN radiating to the segmental systolic blood pressure stasis dermatitis groin, buttocks, legs; hematomas) →shock measurements, ankle-brachial index (ABI), (hemosiderin staining) -Dx: CT scan w/ contrast (STANDARD), UTZ -Complication: venous -Mgt: exercise tolerance testing, plethysmography ulcers (over malleolus of manage HTN (main cause for RUPTURE) Mgt: exercise (collateral circulation), positioning inner ankle) monitor growth (dependent), promoting vasodilation (providing -Dx: Duplex elective or emergency (aneurysmectomy, warmth, avoid crossing legs & restrictive cloth; ultrasonography endovascular stent grafts [may result to spinal cord avoid stress, caffeine, nicotine), drug therapy, -Mgt: Elevate ischemia complication]) prevent burns, ensure adequate hydration, extremities 15-20mins wound care, activity restrictions, pain management. percutaneous transluminal coronary angioplasty above the level of the (PTCA), atherectomy, arterial revascularization heart, graduated (bypass; WOF blockage), neurovascular checks compression stockings (6Ps: pulse, pain, pallor, paresthesia, paralysis, (worn day & evening) poikilothermy), foot care Buerger’s Disease and do not roll them (Thromboangitis obliterans) down, report if too tight, Venous Thromboembolism Raynaud’s Phenomenon avoid crossing legs, avoid -inflammation & occlusive thrombosis -frequently occurs in the deep veins of the lower extremities restrictive clothing, Aortic Dissection -intermittent arteriolar -affects medium and small arteries and veins Thrombophlebitis ("Deep Vein Thrombosis" most common type) dressings (damp-to-dry), -a.k.a dissecting hematoma vasoconstriction (vasospasm) -Main cause: Smoking Phlebothrombosis Unna boot -sudden tear in the aortic intima -S&sx: coldness, numbness, -more common in men and age