Scorebuilders Ch. 6 – CARDIAC, VASCULAR, AND PULMONARY SYSTEM SYSTEM ANATOMY & PHYSIOLOGY OF THE CARDIOVASCULAR SYSTEM Cross section of the anterior of the heart showing the chambers and valves.
Cardiac Conduction System ______. Each cardiac The cardiac conduction system includes the __________ (____) ______ and __________ (____) ______.
myocyte has an intrinsic ability to ____________________ ____________________ and ____________________ ____________________ electrical impulses from cell to cell without nerve stimulation.
The _____ __________ __________ is the normal pacemaker of the t he heart.
Innervation of the Heart ____________________ and ____________________. ____________________. The sympathetic influence is achieved by release of ____________________
Sympathetic nerves stimulate the t he chambers to beat _______________ _______________ and with greater _______________ force of contraction.
The parasympathetic influence is ac hieved via ____________________ ____________________ release from the __________ nerve. Parasympathetic nerves _______________ the heart rate primarily through their influence on the _____ _________. _________.
Anterior surface of the heart showing the great vessels and coronary arteries.
Coronary Veins
The coronary venous circulation includes: _______________ _____________, __________ ________, and _____________ _________.
The great cardiac vein, along with the small and middle cardiac veins, drain into the ______________ _________, emptying into the _____________ _____________.
Neural Reflexes and Circulatory Control
Baroreceptor reflex are mechanoreceptors that detect changes in ______________.
What are the reflexes known as that maintain blood pressure? _________________
What type of activation leads to increased blood pressure? ____________________
Which type of activation decreases blood pressure? _____________________
When signals are sent to the medulla’s cardiovascular center t hat inhibit parasympathetic activity leading to
increased heart rate, what is this reflex known as? __________________
What reflex reacts to changes in pH status and blood oxygen tension? _________________________
The________________ maneuver increases intrathoracic pressure by forced expiration against a closed glottis.
Cardiac Cycle Write the correct term or definition.
The contraction of the right and left atria pushing blood into the ventricles. ______________________
Atrial diastole: ___________________________________________________________________________________ _______________________________________________________________________________________________
Contraction of the right and left ventricles pushing blood into the pulmonary arteries and aorta. _________________
Ventricular diastole: ______________________________________________________________________________ _______________________________________________________________________________________________
Tension in the ventricular wall at the e nd of diastole. It reflects the venous filling pressure t hat fills the left ventricle during diastole: ______________
The forces that impede blood flow out of the heart, especially peripheral vasculature pressure, aorta compliance, and the mass and blood viscosity. ______________________
Stroke Volume (SV): ______________________________________________________________________________ _______________________________________________________________________________________________ Normal SV ranges from _____ to _____ L/min depending on age, sex, and activity.
Cardiac Output (CO): ______________________________________________________________________________ _______________________________________________________________________________________________ Normal CO adult male at rest: _____ L/min. Women produce ____ CO than males. During exercise, it can ↑ to ______
Venous return o
The amount of blood that returns to the _______ atrium each minute
o
Venous return must be ___ CO when averaged over time because the cardio system is closed loop.
A. More
B. Less
C. Equal
Blood and Components of Blood
______ Leukocytes
A. Blood Platelets
______ Erythrocytes
B. Red Blood Cells
______ Thrombocytes
C. White Blood Cells
Normal blood volume of an adult is between _____ and _____ L. Woman have _____ than men.
Blood cells and platelets are suspended in this liquid component: ______________. It is important in regulating __________ _____________ and ____________________________.
What enables red blood cells to bind with oxygen and have its red color? ___________________
What is the term used to describe a high red blood cell count, increased blood thickness? ______________________ o
What is a pt in risk of with increased blood cell count? __________or ____________ ______________
A low number in blood platelets, termed ______________________, increases the risk of ______________________ and _________________ _________________. A high number, termed ____________________________, increases the risk of ___________________, which may result in a ________________ or ______________ _______________.
A low number of white blood cells, termed ________________, increases the risk of ________________. An abnormal amount of white blood cells, termed ________________, can indicate _____________ or _____________.
What type of WBC protects the body against infection by ingesting bacteria and debris? _______________________
Lymphocytes consists of: o
T-Lymphocytes: ______________________________________________________________________ ____________________________________________________________________________________ ____________________________________________________________________________________
o
B-Lymphocytes: ______________________________________________________________________ ____________________________________________________________________________________
Monocytes: _____________________________________________________________________________________ _______________________________________________________________________________________________
What WBC kills parasites, destroy cancer cells, and are involved in allergic responses? _________________________
Basophils: ______________________________________________________________________________________
ANATOMY & PHYSIOLOGY OF THE RESPIRATORY SYSTEM Ribs 1-7 are called: ___________________; Ribs 8-10: _________________; Ribs 11-12:_________________
What are the three principle muscles of respiration? o
______________________, ______________________,______________________
The upper respiratory tract consists of the: o
______________________, ______________________,______________________
The right lung has ______ lobes. The left lung has _____ lobes.
There are _____ bronchopulmonary segments in the right lung and _____ segments in the left lung.
The right lung’s main bronchus gives rise to the superior, middle, and inferior ____________ _______________.
The left lung’s main bronchus divides into the superior _____________ ______________ corresponding to t he upper
and lower lobes.
Oxygen diffuses across the _______________________ __________________ into the RBC in lung capillaries where it combines with ___________________ to be transported back to the heart. Carbon dioxide diffuses in what direction – Same or Opposite?
The membranous serous sac that covers the lungs is called ______________ _________________. Under abnormal circumstances, the pleural space may contain air – termed __________________________, blood – termed _______________________, pus or increased amounts of serous fluid, which compress the lung and cause _______________________ ________________________.
The pulmonary circulation returns oxygenate d blood from the lungs to the ____ atrium via the ___________ ______.
Oxygen is physically dissolved in the _________ __________, and chemically combines with _________________ in RBCs. Carbon dioxide is physically dissolved in __________.
Diagram of the human lungs.
Total Volume
Total Volume
ERV
=
RV
=
IRV
=
IC
=
FRC
=
TV
=
VC
=
TLC
=
Lung Volumes and Capacities
Anatomic dead space volume (VD)
Expiratory reserve volume (ERV)
Forced expiratory volume (FEV)
Forced vital capacity (FVC)
Functional residual capacity (FRC)
Inspiratory capacity (IC)
Inspiratory reserve volume (IRV)
Minute volume ventilation (VE)
Peak expiratory flow (PEF)
Residual volume (RV)
Tidal volume (TV)
Total lung capacity (TLC)
Vital capcity (VC)
* Classification determined by higher BP category
CLASSIFICATION OF HTN IN ADULTS BP Classification
SBP mm Hg*
Normal Prehypertensive Stage 1 HTN Srage 2 HTN
Arterial Blood Gas (ABG)
Mean range of adult normal ABG values: pH PaCO2 PaO2 HCO3 SaO2 Acidemia Alkalemia Hypoxemia
Hypoxia
Angina Pain Scale Rating Description
1 2 3 4 Ankle-Brachial Index (ABI) Interpretation > 1.30
1.0 – 1.30 0.8 – 0.99 0.4 – 0.79 < 0.4
DBP mm Hg*
This chart and the following chart is on page 218 of Scorebuilders.
HEMATOCRIT REFERENCE VALUES IN CLINICAL CHEMISTRY Conventional Units Serum Cholesterol
Total
LDL Cholesterol
HDL Cholesterol
Triglyceride
SI Units
REFERENCE VALUES IN HEMATOLOGY Conventional Units Erythrocytes
Adult Males
Adult Females
Leukocytes
Total
Platelet count
Partial Thromboplastin Time (PTT)
Hematocrit
Adult Males
Adult Females
Hemoglobin
Adult Males
Adult Females
SI units
ARTERIAL BLOOD PRESSURE Korotkoff Sounds
Phase I Phase II Phase III Phase IV Phase V
ARTERIAL BLOOD PRESSURE INTERPRETATION Children (ages 3-17)
Normal BP Prehypertension Stage 1 HTN Stage 2 HTN Adults
SBP Normal BP Prehypertension Stage 1 HTN Stage 2 HTN
Auscultation of Heart Sounds Area
Aortic Area Pulmonic Area Mitral Area Tricuspid Area
Ausculatory area
DBP
Auscultation of Heart Sounds Interpretation S1 (lub)
S2 (dub)
S3
S4
Adult BMI
Borg Dyspnea Scale
0 0.5 1 2 3 4 5 6 7 8 9 10
ECG Waveforms and Intervals
P wave
PR interval
QRS Complex
QT interval
ST segment
T wave
Classification
Sinus Node Rhythms
Normal sinus rhythm
Sinus bradycardia
Sinus tachycardia
Sinus arrhythmia
Sinus arrest
Pulse Points of Selected Peripheral Arteries Artery
Carotid
Brachial
Radial
Ulnar
Femoral
Popliteal
Posterior tibial
Dorsalis pedis
Pulse Point
PULSE CHARACTERIZATION Characterize the heart rate
Normal infant Normal child Normal adult Bradycardia Tachycardia Characterize the volume or amplitude of the pulse
3+ 2+ 1 0
Original RPE Scale
Revised RPE Scale
Respiratory Rate
Newborn 1 year 10 years Adult Respiratory Rhytm
Normal COPD
Common Breathing Patterns
Apnea
Biot’s
Bradypnea
Cheyne-Stokes (periodic)
Eupnea
Hyperpnea
Hypopnea
Tachypnea
TARGET HEART RATE Method 1 – Percent of maximum heart rate (HRmax)
Lower THR = Upper THR = Method 2 – Heart rate reserve (HRR) or Karvonen formula
Lower THR = Upper THR = HRmax= HRest=
Postural Drainage Positioning Apical segments
Right and Left upper lobes Posterior segment Right Upper Lobe Posterior segment Left Upper Lobe Lingula Left Upper Lobe Anterior segments Right and Left Upper Lobes Right middle lobe
Superior segments Left and Right Lower Lobes Anterior basal segments Left and Right Lower Lobes Posterior basal segments Left and Right Lower Lobes Lateral basal segments Lower Lobes
