Ana cardiovascular systemlec

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Transcript of Ana cardiovascular systemlec

  • THE HEARTPresented by: Fe M. Compas, RN, MAN

  • HEARTA 4 chambered, hollow, muscular organLies between the lungs and within the middle mediastinumAbout the size of the fist

  • HEARTShaped like an inverted cone

    - base - upward, backward and to the right

    - apex- downward, forward and to the left- pulsation felt 2-3 fingerbreadths below the nipple

  • COVERING OF THE HEARTPERICARDIUM

    fibro-serous covering

    Parietal Pericardium

    Visceral Pericardium

    - EPICARDIUM- outermost wall of the heart

  • COVERING OF THE HEART

  • WALLS OF THE HEARTEPICARDIUM or VISCERAL PERICARDIUM

    - outermost layer

    MYOCARDIUM

    - middle muscular layer- contracts rhythmically and spontaneously through the conduction system of the heart

    ENDOCARDIUM

    - innermost layer

  • MAJOR BLOOD VESSELS ATTACHED TO THE HEARTSUPERIOR VENA CAVA

    - drains blood from the upper part of the body to the right side of the heartINFERIOR VENA CAVA

    - drains blood from the lower part of the body to the right side of the heartPULMONARY TRUNK

    - brings unoxygenated blood from the right side of the heart to the lungs for oxygenationPULMONARY VEINS

    - brings oxygenated blood from the lungs to the left side of the heartAORTA

    - brings oxygenated blood from the left side of the heart to the whole body

  • CHAMBERS OF THE HEART :ATRIARIGHT ATRIUM (RA)

    - larger that the left- thinner wall- portal of entry to 3 veins- superior vena cava- inferior vena cava- coronary sinusLEFT ATRIUM (LA)

    - thicker wall- portal of entry to 4 pulmonary veinsINTERATRIAL SEPTUM

    - septum (wall) that separates the right and left atrium

    FOSSA OVALIS

    - located in the septum- represents the foramen ovale - opening between the 2 atria during fetal life

  • MM EspinoCHAMBERS OF THE HEART :VENTRICLESRIGHT VENTRICLE (RV)

    - wall thinner than left ventricle - receives blood from the right atrium- pumps blood to the lungs through the pulmonary trunk

    LEFT VENTRICLE (LV)

    - very thick walled- receives blood from the left atrium- pumps blood to the whole body through the aorta

    INTERVENTRICULAR SEPTUM

    MM Espino

  • VALVES OF THE HEARTPURPOSE :

    - prevent backflow or reflux of blood between chambers

    ATRIOVENTRICULAR (AV) VALVESSEMILUNAR VALVES (SL) VALVES

  • VALVES OF THE HEARTAtrioventricular (AV) ValvesTRICUSPID VALVE

    - guards opening or orifice between RV and RABICUSPID or MITRAL VALVE

    - guards orifice between LV and LASemilunar (SL) ValvesPULMONARY or PULMONIC VALVE

    - guards opening between RV and Pulmonary Trunk

    AORTIC VALVE

    - guards opening between LV and Aorta

  • FUNCTION OF THE HEARTPump blood

    Right ventricle

    - pumps blood to the pulmonary circulatory systemLeft ventricle

    - pumps blood to the whole body

  • MM Espino

    MM Espino

  • MM Espino

    MM Espino

  • CONDUCTION SYSTEM OF THE HEARTSINO-ATRIAL (SA) NODEATRIO-VENTRICULAR (AV) NODEBUNDLE OF HIS or AV BUNDLEPURKINJE FIBERS

  • CONDUCTION SYSTEM OF THE HEARTSINO-ATRIAL (SA) NODEPosterior wall of the RA at the junction of the SVC and the RACardiac PACEMAKER

    - initiates the heartbeat

    ATRIO-VENTRICULAR (AV) NODERight side of the inter-atrial septum

    BUNDLE OF HIS or AV BUNDLEGoes down the right side of the interventricular septumDivides into right and left branches

    PURKINJE FIBERSConducting fibers of the right and left Bundle branchesExtend over the undersurface of the endocardium

  • CONDUCTION SYSTEM OF THE HEARTElectrical activity accompanies the spread of excitation over the heart

    ELECTROCARDIOGRAM (ECG or EKG)

    - instrument used to record the electrical activity of the heart using electrodes placed on the anterior chest wall

  • MM EspinoECGP wave

    - atrial depolarization

    QRS complex

    - ventricular depolarization

    P-R interval

    - atrioventricular interval

    T wave

    - ventricular repolarization

    MM Espino

  • CARDIAC CYCLEAtrial depolarization

    - initiates atrial contraction which forces blood into the ventricles

    Atrial relaxation

    - AV valves begin to close

    Ventricular depolarization

    - initiates ventricular contraction- closure of the AV valves - first heart sound (S1 or lubb)Increase in ventricular pressureSL valves opens

    Ejection period

    Ventricular relaxation

    - pressure within ventricle falls- closure of the SL valves- second heart sound (S2 or dubb)

    Atrial depolarization

  • HEART RATEObtained by placing the stethoscope between the 5th and 6th ICS MCL

    - area just below the left nipple

    1 heart beat=lubb and dubb

    60 100 bpm

  • Factors Affecting Heart RateSize of the body

    - the smaller the body, the higher the rate- mouse=1,000/min- elephant =30/min- man=60 80/minAge

    - fetal life=120 160- newborn=120 140- young children =100 120- adults=60 - 80Body position

    - 5 10 beats/min more when standing erect

  • Factors Affecting Heart RateIncreased heart rate with

    - acute bleeding- muscular activity- emotional excitement- eating and right after a meal- warm baths or hot drinks- during ovulation

  • MM EspinoREGULATION OF HEART RATENervous regulation

    - parasympathetic vs sympathetic stimulation- aortic reflex - stimulated when BP is high- carotid sinus reflex- stimulated when BP is highChemical regulation

    - aortic and carotid sinus reflex- O2 or CO2 increases heart rate, vis-a-visMechanical regulation

    - Starlings Law of the Heart- flow of blood into heart distends myocardium HR

    MM Espino

  • MM EspinoBLOOD PRESSURESYSTOLIC PRESSURE

    - the pressure that develops in the large arteries during each left ventricular contractions- 120 mmHg

    DIASTOLIC PRESSURE

    - the pressure in the arterial system between heart beats- 80 mmHg

    Normal Blood Pressure = 120/80 mmHg

    MM Espino

  • BLOOD PRESSUREBLOOD PRESSURE Equivalent to cardiac output and total peripheral resistance

    CARDIAC OUTPUTVolume of blood pumped out of the ventricles in 1 minute

    Stroke Volume XHeart Rate60 70 mlX60 80

  • BLOOD PRESSUREFactors contributing to Cardiac Output

    Venous returnForce of cardiac contractionHeart rate

  • BLOOD SUPPLY OF THE HEARTThe heart also needs blood supply for its nourishment

    RIGHT CORONARY ARTERY

    - RA (SA node)- RV- inferior surface of the interventricular septum- inferior surfaces of the LVLEFT CORONARY ARTERY

    - Left anterior descending artery & Left circumflex artery - superior 2/3 of the interventricular septum- superior and lateral surfaces of the LV