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Understanding the Cardiovascular System: Anatomy, Function, and Assessment of the Heart

This comprehensive overview of the cardiovascular system focuses on the structure and function of the heart, located in the thoracic cavity between the lungs. It outlines the heart's role as a double pump, the circulation of oxygenated and deoxygenated blood, the cardiac cycle, and the conduction system. Additionally, it discusses cardiac assessment, vital signs, and diagnostic tests necessary for evaluating heart health. Learn about blood flow dynamics, heart sounds, and factors affecting cardiac output.

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Understanding the Cardiovascular System: Anatomy, Function, and Assessment of the Heart

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  1. The Cardiovascular System Chapters 15-18

  2. The Heart • Location: • Thoracic cavity • Behind sternum • Between the lungs

  3. The Heart: • Protective sac • PERICARDIUM • Layers of heart tissue • Epicardium • Myocardium • Endocardium

  4. The Heart • Function • Double pump • Right  • Receives blood from the body (pumps blood to) • Lungs • Left  • Receives blood from the lungs  • body

  5. The Heart: Blood flow • Inferior & Superior Vena cava  • Right Atrium  • Tricuspid valve • Right Ventricle  • Pulmonary valve • Pulmonary Arteries  • Pulmonary arterioles  • Pulmonary capillaries  • Pulmonary venules  • Pulmonary veins 

  6. The Heart: Blood flow • Pulmonary veins  • Left Atrium  • Bicuspid (mitral) valve  • Left ventricle  • Aorta  • Aortic Valve • (body) • Arteries • Capillaries  • Vein 

  7. The Heart: Blood flow • Veins  • Inferior & Superior Vena cava  • Right Atrium  • Tricuspid valve • Right Ventricle  • Pulmonary Arteries  • Pulmonary arterioles  • Pulmonary capillaries  • Pulmonary venules  • Pulmonary veins 

  8. Heart Beat • Lub-dub; lub-dub • First sound • S1 (lub) • “AV valves” close • (valves between the atriums & ventricles) • Tricuspid • Bicuspid • Second sound • S2 (dub) • “semilunar valves” close • Aortic valve • Pulmonary valve

  9. Conduction System • Cardiac muscle does not need the nervous system to generate an electrical impulse

  10. Cardiac Cycle • Contraction & relaxation of the heart = • One heart beat • Diastole • Ventricles relax • Systole • Ventricles contact

  11. Normal Heart Rate • 70-90 / minute • > tachycardia • < bradycardia

  12. Cardiac output • Stroke Volume (SV) • Amount of blood pushed from the heart with each heart beat (ventricle contraction) • @ 70 mL • Cardiac Output (CO) • Amount of blood pumped by the ventricles in 1 minute • CO = HR (pulse) x SV • @4-8 L/min

  13. Peripheral Vascular System • Network of blood vessels that carry blood to peripheral tissues and then return it to the heart • Arteries • carry blood away from the heart • Capillaries • Veins • carry blood towards the heart

  14. Arteries & Veins • Aorta  • Arteries  • Arterioles • Capillaries • Venules • Veins  • Superior & Inferior Vena Cava

  15. Capillaries • Where Oxygen & nutrients are exchanges • Very permeable

  16. Blood vessel structure • Inner layer • Slick surface • Middle layer • Smooth muscle • Out layer • Protection

  17. Blood Vessel Structure • Smooth muscle function • Constriction • Narrowing • Dilation • Widening

  18. Blood Vessel Structure • Veins have something Arteries don’t have! • Valves

  19. Blood Pressure (BP) • Force exerted by blood against the walls of the arteries • SYSTOLIC • Pressure exerted when the heart contracts • DYASTOLIC • Pressure when the heart is filling

  20. Blood Pressure (BP) • Optimal Blood Pressure • <120 / 80

  21. Blood • Oxygenated • Blood that is carrying oxygen • Deoxygenated • Blood that is not carrying oxygen • Carrying CO2

  22. Oxygenated &Deoxygenated • Inferior & Superior Vena cava  • Right Atrium  • Tricuspid valve • Right Ventricle  • Pulmonary valve • Pulmonary Arteries  • Pulmonary arterioles  • Pulmonary capillaries  • Pulmonary venules  • Pulmonary veins 

  23. Oxygenated & Deoxygenated • Pulmonary veins  • Left Atrium  • Bicuspid (mitral) valve  • Left ventricle  • Aorta  • Aortic Valve • (body) • Arteries • Capillaries  • Vein 

  24. The Heart: Blood flow • Veins  • Inferior & Superior Vena cava  • Right Atrium  • Tricuspid valve • Right Ventricle  • Pulmonary Arteries  • Pulmonary arterioles  • Pulmonary capillaries  • Pulmonary venules  • Pulmonary veins 

  25. Small Group Questions • Fill in the chart. • Describe blood flow through the heart & body. • Where is oxygenated blood and deoxygenated blood found?

  26. Cardiac Assessment • Health History • Chest pain • Breathing problems • Short of breath • Changes in energy levels • Medication • Life style • Alcohol intake • Exercise • Smoking • Illicit drugs

  27. Cardiac Assessment • Skin Color • Pallor • Pale • Cyanosis • Blue

  28. Cardiac Assessment • Vital Signs • Peripheral pulses • Capillary refill • Edema? • Auscultate the heart

  29. Diagnostic Tests • Lipid profile • Cholesterol • Triglycerides • High-density lipoproteins (HDL’s) • Low-density lipoproteins (LDL’s) • Assess risk for atherosclerosis & coronary heart disease

  30. Diagnostic Tests • Serum Cardiac Markers (Cardiac enzymes) • Creatinephosphokinase • CK-MB • cTnT • cTn1 • Heart muscle cells that are dead or damaged release these proteins. • Increased levels = heart damage

  31. Diagnostic Test • Electrocardiogram (ECG) • Record of the electricity of the heart

  32. Imaging Techniques • CT scan • 3-D X-ray machine

  33. Imaging Techniques • MRI scan • Magnetic resonance imaging

  34. MRI: Rules • No METAL in the room with the machine • Assess for • Metal implants • Claustraphobia • http://www.youtube.com/watch?v=7g5UVrOt2CI • http://www.youtube.com/watch?v=6BBx8BwLhqg&NR=1

  35. Imaging Techniques • Angiography • INVASIVE • Insertion into an artery • X-rays + fluoroscopy

  36. Imaging Techniques • Angiography • INVASIVE • Risks – • Bleeding • Clot  • Assess: • Insertion site • Pedal pulses

  37. WARNING: Angiography • Closely monitory the client, the insertion site, the extremity after the procedure. Immediately report evidence of bleeding, pain or a pale pulseless extremity to the charge nurse & physician

  38. Coronary Heart Disease • AKA • Coronary Artery Disease • Definition • Narrowing of the arteries that supply blood to the heart muscles

  39. Arteriosclerosis & Atherosclerosis Arteriosclerosis Atherosclerosis Plaque buildup in the arteries #1 cause of CHD • Arteries that are • Thick • Non-elactic

  40. CHD: Risk Factors Changeable Non-changeable Age Gender Race Heredity • Smoking • Obesity • Physical inactivity • High fat diet • High blood pressure • Hypertension / HTN • High blood lipids • Hyperlipidemia • Diabetes Mellitus

  41. Atherosclerosis: Pathophysiology • Narrow arteries  • i blood flow  • ISCHEMIA • Not enough blood or oxygen for their metabolic needs • Infarction • Tissue death

  42. S&S of atherosclerosis • No symptoms until 75% of the lumen is occluded • Symptoms are due to ISCHEMIA

  43. Atherosclerosis: IDT Interventions • Quit smoking • Diet • Low fat • Exercise • Control BP • Control DM

  44. Atherosclerosis: IDT Interventions • Medications • Cholesterol-Lowering Drugs • Statins • Lipitor • Lescol • Mevacor • Pravachol • Crestor • Zocor • Nursing Implications • Monitor serum lipid levels • Assess liver

  45. Angina Pectoris • “Chest pain when there is a temporary imbalance between myocardial blood supply and demand”. • Chest pain due to i blood/ oxygen to the heart muscle

  46. Angina Pectoris: S&S • Pain • Chest • Radiating to • Neck • Shoulder • Arm • Jaw • Tight, squeezing, heavy • Shortness of Breath (SOB)

  47. IDT: Angina Pectoris • WARNING!!!!

  48. IDT: Angina Pectoris • Medications • Nitrates • Beta Blockers • Calcium Channel blockers

  49. Nitrates • Action: • Dilate blood vessels  • h blood flow to the heart • E.G. • Nitroglycerin • Route • Sub-lingual • Patches • Ointment

  50. Beta-Blockers • Decrease workload of the heart • Nrs Implications • Take BP & pulse before • Hold if <50/min

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