Overview of Cardiovascular
Nancy Long Sieber, Ph.D.
September 19, 2011
http://www.flickr.com/photos/glockoma/398476805/in/set-72157594209628957/
Fig. 12.01
Blood Cells
Abnormal Blood Counts• Too many red blood cells and platelets: polycythemia
vera, certain blood cancers
• Too few red blood cells: anemia, due to insuffient iron in the diet, hemolysis, chemotherapy
• Too many white blood cells: leukemia and other other blood cancers
• Too few white blood cells: AIDS, other immune deficiencies, chemotherapy
Fluid Spaces
• Intravascular (first space)
• Interstitial (second space)
• “Third space” - interstitial spaces that expand as the result of injury or disease. Eg: swelling at site of surgical incision, edema in abdominal cavity.
Fig. 12.47
Elephantiasis: The swelling results from blocked
lymphatic vessels
The distribution of blood flow at rest and during exercise.
Note how blood conditioning organs (the kidneys and abdominal organs) are able to withstand a significant reduction in blood flow during exercise.
The vascular system
Arteries Low resistance conduits Highly elastic
Arterioles Major site where total peripheral resistance (TPR) is controlledControl of blood flow to organs and tissues
Capillaries and venulesExchange of nutrients, waste, and fluid between the blood and interstitiumLargest cross-sectional area and slowest flow
VeinsLow resistance conduits that return blood to the heartBlood storage reservoir – can be mobilized as needed
The Skeletal Muscle Pump
http://www.nlm.nih.gov/medlineplus/ency/imagepages/18072.htm
An Aortic Aneurysm
http://www.vascularweb.org/graphics/northpoint_graphics_jpg/Varicose_02_Base_300.jpg
Varicose Veins
Fig. 12.06
Cardiac Muscle
http://content.answers.com/main/content/img/oxford/Oxford_Body/019852403x.cardiac-muscle.1.jpg
Normal ECG (a), partial AV block(b) complete AV block (c)
Atrial Fibrillation
http://www.lhsc.on.ca/uwodoc/media/fib2.gif
Two normal beats, followed by ventricular fibrillation
http://noodle.med.yale.edu/~staib/bme355/ecg/vfib.jpg
Hypothermia can lead to a characteristic Osborn (or “J”) wave at the end of the QRS complex.
A 12-lead ECG obtained at core body temperature of 85°F. Note Osborn waves, an extra deflection at end of QRS complex (arrows).
From: Circulation June 27, 2000 vol. 101 no. 25 e233-e244
Electrolyte imbalances can interfere with the cardiac rhythm, potentially
leading to cardiac arrest.
Examples:
• Eating disorders and other types of malnutrition.
• Hyponatremia – can result from over consumption of water.
• People who are on antidiuretic drugs may also develop levels of K+ that are too high or too low.
Heart Sounds
http://www.nlm.nih.gov/medlineplus/ency/images/ency/fullsize/19613.jpg
http://connection.lww.com/Products/taylor5e/documents/Ch25/jpg/25_039.jpg
Heart SoundsS1 and S2 are normal S3 and S4 are abnormal
Extra Diastolic Sounds: S3
• S3 is produced by the tensing of the chordae tendineae, which occurs during rapid filling and expansion of the ventricles.
• Common in children and young adults – the flexible ventricles of young people can expand rapidly.
• In middle-aged or older adults often indicates excessive volume in the ventricles, which usually indicates heart failure.
www.mvprolapse.com/mvp.html
Extra Diastolic Sounds: S4
• Produced by the left or right venticle contracting against a stiffened ventricle
• Usually indicates a loss of compliance of the ventricle due to ventricular hypertrophy or myocardial ischemia
The heart murmur associated with mitral valve prolapse
Mitral valve prolapse causes a late systolic murmur
Mitral valve prolapse is an example of valve insufficiency. Abnormally shaped valve leaflets are pushed into the left atrium during late systole.
http://www.nlm.nih.gov/medlineplus/ency/images/ency/fullsize/18148.jpg
Mitral Valve Prolapse
http://www.abcbodybuilding.com/magazine03/wrench/tensionlevels2.jpg
The length-tension relationship
Children with Kwashiorkor
http://www.cs.stedwards.edu/chem/Chemistry/CHEM43/CHEM43/Leukotr/Kwashiorkor.GIF