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The
Cardiovascular System
& Cardiovascular Emergencies
*
Supplies oxygenated blood to
all cells in the body!!
*
Components
Heart pumps bloodVessels Arteries carry blood away from the heart and veins carry blood back to the heartBlood fluid that carries nutrients essential to cell function*
The Heart
Located in the thoracic cavity2nd intercostal space at right sternal border5th intercostal space at left midclavicular lineabout size of your clenched fistIn mediastinum*
The Heart
4 chambers2 sided - divided by septum2 upper called atria2 lower called ventriclessurrounded by pericardiumsystem of one way valves*
Path of blood flow (Systemic circulation)
left ventricleaortaarteries, arterioles, capillaries, etc ...Vena cava (superior and inferior)Right atrium*
Path of blood flow (Pulmonary circulation)
right ventriclepulmonary arterylung ( pulmonary capillaries)Pulmonary veinsLeft atrium*
The Circulatory System
*
Note that text on graphic may be difficult to read.
Blood Flow Through the Heart
*
The Heart
Electrical Systemindependentstimulates contractions of heartnormally initiated in right atrium if initiated from other areas = abnormal*
Electrical Conduction
Sinoatrial (SA) nodeAtrioventricular nodeBundle of His(AV bundle)
Bundle branchesPurkinje fibers*
Vessels
ArteriesArteriolesCapillariesVeiniolesVeins*
Vessels
Vasoconstriction
Effect on Blood Pressure?
Vasodilation
Effect on Blood Pressure?
*
Major Arteries and Veins
Aorta
Pulmonary
Carotid
Femoral
Brachial
Radial
Superior vena cava Inferior vena cava PulmonaryLook Up in TEXT!
*
coronary arteries Supply blood to heart muscle itself
The two maincoronary arteries have
openings immediately
above the aortic valve
at the beginning of the
aorta where the
pressures are highest
*
Blood
Liquid Portion - PlasmaSolid PortionRed blood cellsWhite blood cellsPlatelets*
Blood
Plasma - transports solids
It is basically a salt solution
*
Blood
Red Blood cells - carry oxygen
AKA - Erythrocytes
Hemoglobin is the substance that
combines with oxygen in a red blood cell
*
Blood
White Blood cells - fight infection
AKA Leukocytes
almost all blood cells (red or white) are made in the bone marrow.
*
Blood
Platelets are essential for formation of blood clots. They perform coagulation.
AKA - thrombocytes
*
average amount of blood
in an adult is 4-6 liters.
*
note
Systemic Vs pulmonary circulationPulmonary arteryPulmonary veinCoronary arteriesPericardiumMyocardium*
*
You getPerfusion
Definition Adequate flow of blood through body tissue or organs to meet the needs of the cell.*
Cardiovascular Emergencies
*
Abnormal Heart Conditions
Angina PectorisMyocardial InfarctionCongestive Heart Failure*
Angina Pectoris
Decreased blood flow to heart muscle results in ischemia- lack of oxygenCauses mild to moderate painPain may radiateUsually lasts 3-8 minutes (rarely longer than 15 mins)IT GOES AWAY with no permanent damage to heart muscle Can be difficult to differentiate from heart attack*
Acute Myocardial Infarction
decreased flow of blood to the myocardium leading to death of tissuemay not be provokedmoderate to severe painCan last between 30 minutes and several hoursMay not go away with rest, O2 or nitroglycerinImmediate transport is essential*
AMI
Signs and SymptomsSudden onset of weakness, nausea, and diaphoresisChest pain or discomfortdyspneairregular pulsePain in lower jaw, arms, or backSudden faintingPulmonary edemaSudden deathFeeling of impending doom*
there are always exceptions ...
Referred painAtypical painNo pain*
Congestive Heart Failure
Causesdiseased heart valves and damaged ventriclesChronic hypertensionobstructive pulmonary disease (emphysema, chronic bronchitis)often a complication of an MI*
CHF
Heart tries to compensate.Increased heart rateEnlarged left ventricleThe heart can not efficiently pump the amount of fluid in the body and CHF develops Fluid backs up into lungs or body as heart fails to pump*
Signs & Symptoms of CHF
Pedal edemaJVD Ascites*
Critical CHF & Pulmonary Edema
dyspnearales & audible ralespink frothy sputumtachycardiacyanosisanxiety, restlessness*
Vascular emergencies
Atherosclerosis & arteriosclerosisThrombusEmbolusAneurysm*
Athero/arterio -sclerosis
build up of fatty deposits & calciumcauses narrowing of the lumencan create rough inner surface that can lead to clot*
Athero/arterio -sclerosis
Results in: restricted blood flowhigh blood pressureAMI*
Thrombus
formation of clot and debris in vessels from plaquecan become large enough to occlude vesselpartial blockage = distal reduction of O2complete blockage = distal tissue death*
Embolus
a thrombus that breaks off from vessel wall.flows through blood vesselsmay partially or completely occlude smaller arteryocclusion will result in decreased oxygen to tissue or tissue death*
Aneurysm
is a ballooning out of a weakened section of an arteryPossibility of rupture*
Ruptured aneurysm
Is a bursting of an aneurysmcan result in rapid, life threatening internal bleeding*
Abdominal Aortic Aneurysm (AAA)
Signs & SymptomsTearing abdominal or back painPulsating mass in midline of abdomenUnequal femoral pulsesSyncope*
AAA Treatment
Rapid transportHigh flow O2Treat for shock*
Other Considerations
other causes of chest painpacemakersdefibrillator implantsCABG coronary artery bypass graft*
RX for all
High flow oxygen(ventilate patient if needed!)
Position of comfortRapid transport*
medications
LasixDigoxinLanoxinInderalNTG = nitroglycerin*
Cerebral Vascular Accidents
AKA
Stroke
Brain Attack
*
CVA - Cerebral Vascular Accidents
sudden change in neurological status caused by interference with blood supply to brainobstructivehemorragic*
CVA signs & symptoms
hypertensionaltered mental statushemiparesis & hemiparalysisheadache, blurred visionone sided facial droopaphasiaincontinence*
Transient Iscemic Attack
TIAsAKA mini-strokecan have symptoms of CVAtemporary*
The end
Questions?
*
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