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Chapter 25Chapter 25
Circulatory Circulatory SystemSystem
3/ 14/ 2011 online
Two Circulatory SystemsTwo Circulatory Systems
Blood-vascular System- Blood-vascular System- major major portion- transports bloodportion- transports blood Consists of heart, arteries, capillaries Consists of heart, arteries, capillaries
and veinsand veins
Lymphatic System- Lymphatic System- minor portion minor portion – – collects fluid from tissue spaces, filters collects fluid from tissue spaces, filters
through lymph systemthrough lymph system
Two SystemsTwo Systems make up make up Circulatory SystemCirculatory System
Both carry oxygen and nutrients to Both carry oxygen and nutrients to tissues in continuous, endless uni-tissues in continuous, endless uni-directiondirection
Both transport waste products to organs of excretion- what are those 4 organs? Skin Lungs Liver kidneys
Heart has 2 circulation routes Heart has 2 circulation routes branching off it:branching off it:
Systemic (arterial circuit)- Systemic (arterial circuit)- carries oxygenatedcarries oxygenated bloodblood to to organs and tissuesorgans and tissues
PulmonaryPulmonary –carries blood to lungs –carries blood to lungs for carbon dioxide exchange and re-for carbon dioxide exchange and re-oxygenation of bloodoxygenation of blood
Pulmonary, systemic, and portal circulation
red = oxygenated blue = deoxygenated purple -nutrient-rich
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Systemic Systemic CirculationCirculation
Pumps blood to Pumps blood to organsorgans
Pulmonary CirculationPulmonary Circulation
Takes returning Takes returning bloodblood to to lungs to exchange carbon lungs to exchange carbon dioxide for oxygendioxide for oxygen
Carries Carries oxygenated oxygenated bloodblood from lungs to from lungs to heartheart
These are only veinsThese are only veins in post-fetal human body in post-fetal human body carrying oxygenated (red) carrying oxygenated (red) bloodblood
Portal SystemPortal System
Venous drainage Venous drainage from abdominal from abdominal organs to liver-organs to liver-
Filtered -Filtered -
Back to inferior vena Back to inferior vena cavacava
Liver has 2 blood Liver has 2 blood supplies!supplies!
Anatomy: HeartAnatomy: Heart 4 chambers 4 chambers
2 atria2 atria 2 ventricles2 ventricles
MyocardiumMyocardium - - muscular wall of heartmuscular wall of heart EndocardiumEndocardium -membrane lining interior of heart -membrane lining interior of heart
Pericardial sac- Pericardial sac- double-walled membrane double-walled membrane enclosing heartenclosing heart exterior wall is fibrousexterior wall is fibrous thin inner wall- thin inner wall- EpicardiumEpicardium - covers heart - covers heart
Great Vessels of Great Vessels of Heart Heart DeoxygenatedDeoxygenated//OxygenatedOxygenated Blood Flow Blood Flow
Pulmonary artery- vessel Pulmonary artery- vessel carrying venous blood to carrying venous blood to lungslungs
Aorta- carry oxygenated Aorta- carry oxygenated blood for systemic blood for systemic circulationcirculation
Vena CavaVena Cava Inferior and Superior - return of Inferior and Superior - return of
venous blood to heartvenous blood to heart
Pulmonary Veins- Pulmonary Veins- carry carry oxygenated blood to left oxygenated blood to left artriumartrium
Anatomy: HeartAnatomy: Heart
Right side of heart-Right side of heart- handles venous, or handles venous, or deoxygenated deoxygenated bloodblood
Left side of heart-Left side of heart- handles arterial, or handles arterial, or oxygenated bloodoxygenated blood
Function of ChambersFunction of Chambers
Atria act as Atria act as receiving chambersreceiving chambers Right atrium Right atrium
receives venous blood receives venous blood from superior and from superior and inferior vena cavaeinferior vena cavae
Left atrium Left atrium receives receives oxygenated blood from oxygenated blood from right and left right and left pulmonary veinspulmonary veins
Ventricles act as distributers Ventricles act as distributers of bloodof blood
Left ventricle pumps blood into aorta and systemic cirulation
Right ventricle pumps blood into pulmonary circulation
Heart ValvesHeart Valves Right Right
atrioventricular (AV)atrioventricular (AV) valve or valve or tricuspid tricuspid valve valve controls opening controls opening
between right atrium between right atrium and right ventricleand right ventricle
Left AV valve or Left AV valve or mitral valvemitral valve controls opening controls opening
between left atrium between left atrium and left ventricleand left ventricle
Coronary arteriesCoronary arteries supply blood supply blood to to myocardiummyocardium (muscular wall of (muscular wall of
heart)heart)
Right Coronary artery
Left Coronary artery
Coronary sinus
Myocardial infarctionMyocardial infarction ( (MIMI)) Commonly known Commonly known
as a as a heart attackheart attack
interruption of blood interruption of blood supply to part of supply to part of heart, causing some heart, causing some heart cells to dieheart cells to die
most commonly due most commonly due to occlusion to occlusion (blockage) of a (blockage) of a coronary arterycoronary artery
CABG (CABG (Coronary Artery Bypass Graft)
Surgery called revascularization to improve blood flow to heart in people with severe coronary artery disease (CAD)
CAD - occurs when coronary arteries become blocked due to buildup (plaque) on inside of blood vessels.
If severe enough:chest pain (angina), shortness of breath, possible heart attack and death
Healthy artery or vein grafted, to blocked artery bypassing blocked portion -new passage routes oxygen-rich blood around blockage to heart muscle
Replacing vessel will take over role previously performed by piece removed
Up to 4 major blocked coronary arteries can be bypassed during 1 surgery.
Blood -Vascular SystemBlood -Vascular System Radiological StudiesRadiological Studies
Exam of vascular structures using Exam of vascular structures using contrast mediumcontrast medium
ArteriographyArteriography - exam of arteries- exam of arteries
VenographyVenography - exam of veins - exam of veins
Angiography
IndicationsIndications Claudication –
leg pain and cramping
Stenosis - narrowing of vessel
Occlusion – blockage of a vessel
Aneurysm – weakened area of artery
“ballooning”
Suspected tumors
Anatomic variances
Contrast dye is injected Contrast dye is injected
Automatic injector is most commonly Automatic injector is most commonly usedused Manual injection is done rarelyManual injection is done rarely
Injectors are programmed to coincide Injectors are programmed to coincide with imaging sequencewith imaging sequence
Rapid film changers are rarely seenRapid film changers are rarely seen
Digital subtractionDigital subtraction -instantly -instantly “subtracts” “subtracts” overlying bony overlying bony structuresstructures
better better visualization of visualization of contrast-filled contrast-filled vascular structuresvascular structures
Digital EquipmentDigital Equipment
EquipmentEquipment
CatheterizationCatheterization
CatheterCatheter - - small, flexible tube small, flexible tube inserted into vessel through which inserted into vessel through which contrast is introducedcontrast is introduced
Femoral artery most commonFemoral artery most common introduction siteintroduction site Radial Radial BrachialBrachial AxillaryAxillary Jugular Jugular Subclavian Subclavian
Possible Possible Complications!Complications! Bleeding at puncture siteBleeding at puncture site Allergic reaction to Allergic reaction to
contrastcontrast Nerve, vessel, or tissue Nerve, vessel, or tissue
damagedamage StrokeStroke Heart attackHeart attack DeathDeath
VenographyVenography
IndicationsIndications For For VenographyVenography
Deep vein thrombosis: Deep vein thrombosis: Formation of Formation of blood clot inside blood vesselblood clot inside blood vessel
When blood vessel injured:When blood vessel injured: body forms blood clot to prevent loss of bloodbody forms blood clot to prevent loss of blood
If too much clotting & clot breaks freeIf too much clotting & clot breaks free
travelstravels in bloodstream – blocks blood vessel - in bloodstream – blocks blood vessel - obstructs circulation obstructs circulation (embolism)(embolism)
If goes toIf goes to lungslungs - can rupture pulmonary artery, - can rupture pulmonary artery, causing causing deathdeath
Other IndicationsOther Indications for for VenographyVenography
Venous obstruction Venous obstruction
Recurrent varicose veinsRecurrent varicose veins
Swollen legs of unknown etiologySwollen legs of unknown etiology
Varicose ulcersVaricose ulcers
Venous malformationsVenous malformations
Main Veins of Upper Main Veins of Upper ExtremityExtremity
Cephalic veinCephalic vein Basilic veinBasilic vein Subclavian veinSubclavian vein
Injection usually in median cubital
Injection usually in median cubital
Peripheral VenographyPeripheral Venography Examines superficial and deep Examines superficial and deep
veins of extremitiesveins of extremities Less common today-replaced by Less common today-replaced by
advances in ultrasoundadvances in ultrasound
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AP of entire AP of entire extremityextremity
Lateral of entire Lateral of entire extremityextremity
Lower-Limb Venogram
CentralCentral Venography Venography
Superior venacavogramSuperior venacavogram performed by accessing performed by accessing axillary or subclavian veinaxillary or subclavian vein
Inferior Inferior venacavogramvenacavogram performed by accessing performed by accessing femoral vein and placing femoral vein and placing catheter in common iliac catheter in common iliac vein or inferior aspect of vein or inferior aspect of inferior vena cavainferior vena cava