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assessing cardiovascular system:LICH


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what is known as the lifeline of the body
cardiovascular system
primary function of cs
acts as transport system: 1.delivers red bld cells and nutrients, metabolites and hormones to every cell.
2. transports waste for detox and excretion.
primary function of white bld cells
fight infection
what is leading health prob in US
cardiovascular disease
the cardiovascular system is a_____ system consisting of ________ and _______.
closed, heart and bld vesselss
how long is the network of bld vessels
60000 miles
what are the 2 main networks of the circulatory system?
pulmonary circulation and systemic circulation. (coronary circulation is part of systemic circ and supplies heat itself)
describe pulmonary circulation
1. unoxegenated bld enters rt and lt pulm art. 2.flows pulm arterioles to lung capi.(gas exchange) 3.oxegenated bld enters pulm venules lead to pulm veins. carried back to left atrium through rt and lt pulm veins.
what does arterial system do
supplies oxygen to every cell in body
what does venous system do
returns unoxygenated bld to heart
what is the systemic circualation path
O2 bld flow into lt atrium from Pcircuit atrium pumps to lt vent pumps through aorta to arterial systemic circ.3. aorta-->small arterioles-->system capil. linked to art and ven syst.(gas exchange)unoxegen bld flow through venules--veins-- sup inf vena cava rt atr.
what keeps heart oxygenated
coronary circulation
what does cor circ consist of?
rt lt and cor sinus and cardiac veins.
the first branches off the aorta are called
left and right coronary arteries
where do cardiac veins drain
cardiac sinus which drains into rt atrium
what effects sound of heart
movement and pressure of bld, activity of electrical conduction system, and movement of valves
2 phases in cardiac cycle
systolic- contraction or emptying
diastollic- resting or filling
ventricular diastole
pressure decrease below atria- mitral and tricuspid valves open to fill-
atrial kick-
atria contract to complete fill; responsible for 25% of total bld vol in ventr.
ventricular systole
pressure higher than atria closes valves; contraction--pressure opens aortic and pulmonic valves flow into systemic and pulmonic systems
what is stroke volume
amt of bld ejected form heart with each contraction. responds to pre-load(end of diastole) and afterload(end of systole)and contractiliy
cardiac output
amt of bld ejected each min.= stroke vol x heart rate.
_____is the major regulator of cardiac output
heart rate: internal pacemaker, ANS, and external factors.
T/F: increase in afterload = decrease in stroke volume
Positive intotropes and Neg inotropes
increase force of contraction and decrease "
what happens in contractility is increased
oxygen requirements are increased
which side of the heart is slightly "ahead" in normal heart?
what are layers of the heart
enodcardium, myocardium, epicardium and pericardium
what are the structures of right side of heart
atrium ventricle, tricuspid valve, pulm semilunar valve, main pulmonary artery and pulmonary veins
what are the structures of left side of heart
l atrium and ventricle, mitral or bicuspid valve, aortic valve, interventricular septum
cardiac electrical conduction system-
resonsible for initiating and maintaining rhythm of the heart
SA- sinoatrial node:
what is it, how many bpm, how
pacemaker of heart in right atrium near sup vena cava
60-100 bpm
passes through atria=contract
AV- atrioventricular node:
where, bpm, path
base of rt atrium; 40 60 bpm;
AV node to bundle of His--split right and left bundle--follows septum turn to purkinje fibers=ventricles contract.
bundle of his pacemaker=
20-40 bpm
bachmans bundle
stimulates left atrium- branch of SA node
S1 heart sounds caused by
closure of mitral and tricuspid valves; .02 sec
dub, end of systole
lub, beginning of systole
where listen for S1
apex or L lat sternal border w/ diaphragm of steth
Accentuated S1 caused by
anemia, hyperthyroidism and exercize. mitral and tricuspid stenosis; louder
Diminished S1 caused by
thick chest walls, emphysema, first degree heart block
why would emphysema or thick chest walls cause diminished S1
greater distance to traverse from myocardium to chest wall
why would heart block dimish s1
delay in conduction b/w atrial contraction and vent contar allows more time for valve to close
very irregular s1
complete heart block or atrial fibrilation.
normal split s1
can hear left closure and right closure very clearly; mitral is louder
widely split s1 caused by
RBBB,PVC,Ventricular tachychardia
dub, closure of aortic and pulmonic valves
Accentuated S2
exersize; A2- systemic hypertension, P2- pulmonary hypertension
Diminished S2
thick chest wall and chronic lung disease; A2 cacific aortic stenosis and P2 pulmonic stenosis
Split S2
respiration variation:
inspiration: blub A2 than P2
expiration single dub
why the respiration variation?
1.neg intra thoracic pressure=
2.increased bld return to rt side
3.rt vent contraction time ups
during inspiration the cardiac rate ------- to accomodate ------in venous return.
widely abnormal split caused by:
reversed or paradoxical split
P2 before A2 delayed contraction of left ventricle- blockagein left hearts elec nerve conduc sys.
atrial septal defect
fixed widely split S2, unaffected by respiration. split .04-.07 sec.
early ejection click
high pitched, short .03-.08 after S1 aortic and pulmonic valve. aorval-base and apex, pulm heard left sternal border 2nd and 3rd interspace
midsystolic ejection click
high pitch short MVP .14 after S1 apex or medial wide transmitt over precordium
opening snap
diastolic short high pitched .05-.14 after S2 mitral stenossi heard near apex patient in left lateral position midlate dias murmur of mitral stenosis
normal heart sound 3
after s2 soft low pitch filling sound of ventricle
S3 gallop
rapid, hemodynamic filling and failing of noncompliant ventricle= CHF; lilt of canter present- left lat sternal border
S4 gallop
atrial kick heard if ventricular resistance.08 sec before S1, HTN, MI, CAD, left sternal border or apex
what is murmur
series of audlible prolonged sounds turbulence created in system
causes of murmur 5
1.increased flow 2 flow through constricted valve(aortic stenosis)3 flow into dilated bld vessel(whoosh)4backflow through incompetent valve 5.shunting
how is murmur characterized (8)
quality, frequency, intensity,duration, configuration, placement in cycle, location, and radiation of sound
continuous murmur
patent ductus arteriousus.
crescendos in late systole decrescendos through diastole heard in infraclavicular area and second left interspace
venous hum
neck and sup vena cava low pitched normal in kids glowing rough or musical heard over right internal jusgular fv3ein in supra clavicular area. light pressure; benign
friction rub
pericardial rub high pitched scrathcg leathery inflamation of parietal and visceral latyers pericardiitis MI accute. pain third interspace left sternal border.
T/F pressure in venous system is higher than in arterial system.
what is dicrotic notch
in normal systole positve wave on decent- aortic valve closing
what is the flow of blood in venous system regualated by
1.pressure gradient for venous return
2.resistance to bld flw
3.venous pumps
pressure gradient affected by:
right arterial pressure and venous pressuer
resistance to bld flow affects
venous return
venous pumps include
skeletal muscle pum and resiratory pump

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