Cardiovascular System

HLTAAP002

• Obtain information about physical health status

• Check physical health status
• Identify variations from normal physical health status
• Assess client health status
• Plan action to address health status

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At the end of this session you will have a
basic understanding of:

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The Cardiovascular System
A closed system of the heart and blood vessels
◦ The heart pumps blood
◦ Blood vessels allow blood to circulate to all parts of the
body
The function of the cardiovascular system is to deliver
oxygen and nutrients and to remove carbon dioxide and
other waste products

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 The Heart
• Location
– Thorax
between
the
lungs
• About the
size of your
fist
The heart: Coverings
Pericardium – a double serous membrane
◦ Visceral pericardium
◦ Next to heart
◦ Parietal pericardium
◦ Outside layer
Serous fluid fills the space between the layers of
pericardium

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The Heart: Heart Wall
Three layers
◦ Epicardium
◦ Outside layer
◦ This layer is the parietal pericardium
◦ Connective tissue layer
◦ Myocardium
◦ Middle layer
◦ Mostly cardiac muscle
◦ Endocardium
◦ Inner layer
◦ Endothelium

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External Heart Anatomy

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 The Heart: Chambers
Right and left side act as separate
pumps
Four chambers
• Atria
• Receiving chambers
Right atrium
Left atrium
• Ventricles
• Discharging chambers
Right ventricle
Left ventricle

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Blood Circulation

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 Blood Flow
Right Heart

(deoxygenated)

Body Lungs

Left Heart

(oxygenated)
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The Heart: Valves
Allow blood to flow in only one direction
Four valves
◦ Atrioventricular valves – between atria and ventricles
◦ Bicuspid valve (left)
◦ Tricuspid valve (right)
◦ Semilunar valves between ventricle and artery
◦ Pulmonary semilunar valve
◦ Aortic semilunar valve

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The Heart: Valves
Valves open as blood is pumped through
Held in place by chordae tendineae (“heart strings”)
Close to prevent backflow

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Operation of Heart Valves
 The Heart: Associated Great
Vessels
Aorta
◦ Leaves left ventricle
Pulmonary arteries
◦ Leave right ventricle
Vena cava
◦ Enters right atrium
Pulmonary veins (four)
◦ Enter left atrium

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CARDIOVASCUALAR SYSTEM VERSION 1.1 15
Coronary Circulation
Blood in the heart chambers does not nourish the myocardium
The heart has its own nourishing circulatory system
◦ Coronary arteries
◦ Cardiac veins
◦ Blood empties into the right atrium via the coronary sinus

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The Heart: Conduction
System
Intrinsic conduction system
(nodal system)
◦ Heart muscle cells contract, without nerve impulses, in a regular, continuous
way

Special tissue sets the pace

◦ Sinoatrial node
◦ Pacemaker
◦ Atrioventricular node
◦ Atrioventricular bundle
◦ Bundle branches
◦ Purkinje fibers

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 Heart Contractions
Contraction
is initiated
by the
sinoatrial
node
The Heart: Cardiac Cycle
The Heart: Cardiac Cycle
Atria contract simultaneously
Atria relax, then ventricles contract
Systole = contraction
Diastole = relaxation
The Heart: Cardiac Output
Cardiac output (CO)
◦ Amount of blood pumped by each side of the heart in
one minute
◦ CO = (heart rate [HR]) x (stroke volume [SV])
Stroke volume
◦ Volume of blood pumped by each ventricle in one
contraction

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 The Heart: Regulation of Heart
Rate
Stroke volume usually remains relatively constant
◦ Starling’s law of the heart – the more that the cardiac
muscle is stretched, the stronger the contraction
Changing heart rate is the most common way to change
cardiac output

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The Heart: Regulation of
Heart Rate
INCREASED HEART RATE DECREASED HEART RATE
◦ Sympathetic nervous system ◦ Parasympathetic nervous system
◦ Crisis ◦ High blood pressure or blood
◦ Low blood pressure volume
◦ Decreased venous return
◦ Hormones
◦ Epinephrine
◦ Thyroxine
◦ Exercise
◦ Decreased blood volume

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 Blood Vessels: The Vascular
System
Taking blood to the tissues and back
◦ Arteries
◦ Arterioles
◦ Capillaries
◦ Venules
◦ Veins

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The Vascular System

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Blood Vessels: Anatomy
Three layers (tunics)
◦ Tunic intima
◦ Endothelium
◦ Tunic media
◦ Smooth muscle
◦ Controlled by sympathetic nervous system
◦ Tunic externa
◦ Mostly fibrous connective tissue

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Differences Between Blood
Vessel Types
Walls of arteries are the thickest
Lumens of veins are larger
Veins have valves to prevent backflow
Skeletal muscle “milks” blood in veins toward the heart
Walls of capillaries are only one cell layer thick to allow
for exchanges between blood and tissue

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Movement of Blood Through
Vessels
Most arterial blood is
pumped by the heart

Veins use the milking action

of muscles to help move
blood

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Capillary Beds
True capillaries – exchange vessels
◦ Oxygen and nutrients cross to cells
◦ Carbon dioxide and metabolic waste
products cross into blood

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Capillary Exchange
Substances exchanged due to concentration gradients (Diffusion)
◦ Oxygen and nutrients leave the blood
◦ Carbon dioxide and other wastes leave the cells

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Major Arteries of Systemic
Circulation

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Major Veins of Systemic
Circulation

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Average blood volume of an adult
5-6 litres
Blood volume makes up 6 to 10 percent of body weight
Averages 8% of body weight

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Pulse
Pulse – pressure wave of
blood
Monitored at “pressure
points” where pulse is easily
palpated

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Blood Pressure
Measurements by health professionals are made on the
pressure in large arteries
◦ Systolic – pressure at the peak of ventricular contraction
◦ Diastolic – pressure when ventricles relax
Pressure in blood vessels decreases as the distance away
from the heart increases

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Measuring Arterial Blood
Pressure

ELAINE N. MARIEB
ESSENTIALS OF HUMAN ANATOMY & PHYSIOLOGY 35
Blood Pressure: Effects of
factors
Neural factors
◦ Autonomic nervous system (sympathetic division)
Renal factors
◦ Regulation by altering blood volume
◦ Renin – hormonal control
Temperature
◦ Heat has a vasodilation effect
◦ Cold has a vasoconstricting effect
Chemicals
◦ Various substances can cause increases or decreases
Diet

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Variations in Blood Pressure
Human normal range is variable
◦ Normal
◦ 140–110 mm Hg systolic
◦ 80–75 mm Hg diastolic
◦ Hypotension
◦ Low systolic (below 110 mm HG)
◦ Often associated with illness
◦ Hypertension
◦ High systolic (above 140 mm HG)
◦ Can be dangerous if it is chronic

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Age Related Changes
more prominent arteries in head, neck and extremities
valves become thicker and more rigid
stroke volume decreases by 1% per year
less elasticity of vessels
less efficient oxygen utilisation
aorta becomes dilated and elongated
cardiac output decreases.

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Clinical Disorders with blood
vessels
Varicose veins
Atherosclerosis
Hypotension
Orthostatic hypotension
Chronic hypotension
Acute hypotension
Shock

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Varicose Veins

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Congestive Cardiac Failure (CCF)

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Conduction disorders
Atrial fibrillation

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Coronary Artery Disease
Angina

Myocardial Infarction

Hypertension

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Angina

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Myocardial Infarction

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Postural Hypotension
When the body moves from a lying to standing or sitting
to standing position and is unable to equalise the blood
pressure quickly
This is common in elderly people
When sitting or standing an elderly client, allow them time
for their BP to stabilise

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Hypertension
High Blood Pressure

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Common Signs and
Symptoms
Blood pressure changes
Irregular pulse rates
Pain
Light headed
Fatigue
Oedema
Skin changes such as coldness
Ulceration
Easy bruising
Peripheral oedema
Ascities
Cyanosis
Poor pulses
Postural Hypotensions
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Common Tests related to the
circulatory System
Electrocardiogram – a graphic recording of the electrical
activity of the heart

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Doppler's
An ultrasound technique used to study moving
substances or structures such as blood

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 Chest X Ray

Useful to see the

structure of the heart.
In particular it is used
to see if the heart has
enlarged, indicating
cardiovascular stress

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Echocardiogram:
A non – invasive procedure for studying the structure and
motion of the heart

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Responsibilities of health care worker

• History
• Vital Observation: TPR,BP, O2 Sats
• Complete fluid balance chart
• Daily weight if client needs it
• Assist with oxygen therapy within scope of practice
• Assist with activities of daily living
• Application of antithrombotic stockings
• Pain assessment
• Assist with comfort
• Report and sign of chest pain
• Report any changes

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MEDICAL TERMINOLOGY

Medical Terminology
Word Parts
Cardi
Meaning
heart
Angi-,angio Vessel, vascular
Aor-,aorto- Aorta, aortic
Apic-,apici-,apico- Apex, apical
Arterio-,arteri Artery, arterial
Athero Fatty, gruel like, atheroma
Atrio- Atrium
Automat-,automato Automatic, spontaneous
Brady Slow
Cardi-, cardio- Heart, cardiac
Chord-,chordo Cord
Isch-,ischo- Stoppage, obstruction
Phleb-,phlebo Vein, venous
Sphygm-,sphygmo- Pulse
Tachy- Rapid, quick, accelerated
Vas,casi-,vaso- Vessel, vascular
Veni-,veno- veins