Summer 2005 H.

1
Unit H: Circulatory System


Program Area: Health Occupations Education

Course Title: Medical Sciences I Number: 7221

Unit Title: Circulatory System

Suggested
Time for
Instruction: 6 class periods (90 minute classes)
12 class periods (55 minute classes)

Course Percent: 7%

Unit Evaluation: 100% Cognitive

-------------------------------------------------------------------------------

Competency: MD08. Analyze the anatomy and physiology of the circulatory
system.

Specific Objectives:

MD08.01 Describe the structure of the heart.

MD08.02 Analyze the function of the heart.

MD08.03 Analyze circulation and the blood vessels.

MD08.04 Analyze characteristics and treatment of common cardiac and
circulatory disorders.





Summer 2005 H.2
Unit H Master Outline


H Circulatory System

MD08.01 Explain the structure of the heart.
A. Size, shape and location
1. Size of closed fist
2. In thoracic cavity
3. Apex
4. Four chambers
B. Layers
1. Pericardium
2. Myocardium
3. Endocardium
4. Septum
C. Structures to and from heart
1. Superior and inferior vena cava
2. Pulmonary artery and vein
3. Aorta
D. Chambers and valves
1. Atria (atrium)
2. Ventricles (ventricle)
3. Tricuspid valve
4. Mitral (bicuspid) valve
5. Pulmonary semilunar valve
6. Aortic semilunar valve

MD08.02 Analyze the function of the heart
A. Four main functions of circulatory system
a. Pump
b. Blood transport system around body
c. Carries oxygen and nutrients to cells, carries away waster
products
d. Lymph system returns excess tissue fluid to general circulation
B. Heart
a. Ave. 72 beats per minute, 100,000 beats per day
b. Superior and inferior vena cava bring deoxygenated blood to
right atrium
c. Pulmonary artery takes blood from right ventricle to lungs
d. Pulmonary veins bring oxygenated blood from lungs to left
atrium
e. Aorta takes blood from left ventricle to rest of body
f. Four heart valves permit flow of blood in one direction
C. Pump
a. Heart is a double pump
b. Right heart = right atrium tricuspid valve right ventricle
pulmonary semilunar valve pulmonary artery lungs (for
oxygen)
c. Left heart = Lungs pulmonary veins left atrium mitral
valve left ventricle aortic semilunar valve aorta
general circulation
Summer 2005 H.3
D. Heart sounds (lubb dupp)
E. Electrical activity
1. SA (sinoatrial) node = pacemaker, sends out electrical impulses,
spreads impulse over atria and makes them contract
2. AV (atrioventricular) node = carries impulse to bundle of His
3. Bundle of His = conducting fibers in septum, divides into right
and left branches in ventricles to Purkinje fibers
4. Purkinje fibers = cause ventricles to contract

MD08.03 Analyze circulation and the blood vessels
A. Cardiopulmonary circulation carries blood from heart to lungs
1. Oxygenated and deoxygenated blood
2. Oxygen/carbon dioxide exchange
B. General circulation
1. Coronary arteries
2. Aorta
3. Systemic circulation
C. Blood vessels
1. Arteries
a. Carry oxygenated blood away from the heart to the
capillaries
b. Elastic, muscular and thick-walled
c. Transport blood under very high pressure
2. Arterioles
3. Veins
a. Carry deoxygenated blood away from capillaries to heart
b. Less elastic and muscular than arteries
c. Thin walled, collapse easily when not filled with blood
d. Superior and inferior vena cava carry blood to heart
4. Venules
5. Capillaries
a. Smallest blood vessels
b. Only seen with microscope
c. Connect arterioles and venules
e. Walls are one-cell thick, allow for selective permeability
6. Valves permit flow of blood only in direction of heart
7. Capillaries
8. Jugular vein located in neck
9. Carotid artery carries blood to brain
D. Blood pressure
1. Systolic ave = 120 (Systole is contraction phase)
2. Diastolic ave = 80 (Diastole is relaxation phase)
E. Pulse alternating expansion and contraction of an artery as blood
flows through it
1. Brachial
2. Carotid
3. Femoral
4. Pedal
5. Popliteal
6. Radial

Summer 2005 H.4
MD08.04 Discuss characteristics and treatment of common cardiac
and circulatory disorders.
A. Heart diseases
1. Symptoms
a. Arrythmia (dysrrhythmia) any change from normal heart
rate or rhythm
b. Bradycardia slow heart rate (<60)
c. Tachycardia rapid heart rate (>100)
2. Coronary artery disease
a. Angina pectoris chest pain, lack of O
2
to heart muscle,
treat with nitroglycerine
b. Edema fluid in tissues, often caused by poor circulation
3. Myocardial infarction (MI, heart attack)
a. Lack of blood supply to myocardium
b. Symps severe chest pain radiating to left shoulder, arm,
neck and jaw, nausea, diaphoresis, dyspnea
c. Rx bedrest, oxygen, medication
d. Morphine for pain
e. Anticoagulant therapy to prevent further clots from forming
f. Surgery may be necessary
4. Heart disease
a. Congestive heart failure ventricles unable to contract
effectively and blood pools in the heart, edema in lower
extremities, blood backs up in lungs
b. Endocarditis inflammation of membrane that lines heart
and covers valves
c. Myocarditis inflammation of heart muscle
d. Pericarditis inflammation of outer membrane of heart,
symptoms are chest pain, cough, dyspnea, tachycardia,
fever
d. Mitral valve prolapse valve closes imperfectly, symptoms
in response to stress include fatigue, palpitations (racing
heart) headache, chest pain, anxiety
e. Murmur defect in heart valve, causing gurgling or hissing
sound
B. Vascular diseases
1. Aneurysm ballooning of an artery, thinning and weakening
2. Arteriosclerosis arterial walls thicken and lose elasticity
3. Atherosclerosis fatty deposits form on walls of arteries and
block circulation
4. Hypertension
a. High blood pressure
b. Silent killer usually no symptoms
c. Leads to strokes, heart attacks, kidney failure
d. Higher in African-Americans and post-menopausal women
e. Risk factors smoking, overweight, stress, high fat diets,
family history
f. Treatment relaxation, low fat diet, exercise, weight loss,
medication
5. Hypotension low blood pressure, systolic <100
6. Embolism traveling blood clot
Summer 2005 H.5

7. Varicose veins
a. Swollen, distended veins
b. Heredity or due to poor posture, prolonged periods of
standing, physical exertion, age and pregnancy
c. Hemorrhoid varicose rectal vein
8. Phlebitis inflammation of lining of vein, accompanied by
clotting of blood, symptoms are edema, pain and redness
C. Diagnosis and treatment
1. Electrocardiogram electrical tracing of the heart
2. Coronary bypass healthy vein from leg removed and attached
before and after the coronary obstruction, creating an alternate
route for blood supply to the myocardium
3. AED automated external defibrillator
4. Defibrillation electrical shock to bring the heart back to a
normal rhythm
5. CPR cardiopulmonary resuscitation, used in presence of
cardiac arrest
6. Artificial pacemaker when heart has conduction (electrical
impulse) defect, demand pacemaker fires when heart rate drops
below minimum, causes heart to contract
7. Angiogram x-ray of blood vessel using dye
8. Angioplasty balloon used to open clogged vessels
9. Cardiac catheterization catheter fed into heart, dye injected, x-
rays taken as dye moves through coronary arteries
10. Heart transplant
a. To replace irreparably damaged heart
b. Problem histocompatibility
c. Rx immunosuppressants
d. Artificial hearts experimental
11. Stent tiny, expandable stainless steel tube that holds coronary
artery open to improve blood flow


Summer 2005 H.6
Unit H: Circulatory System

Competency MD08: Analyze the anatomy and physiology of the circulatory
system.

Materials/Resources

Scott, Ann Senisi and Elizabeth Fong. Body Structures & Functions. Delmar Publishers,
Latest Edition. www.DelmarAlliedhealth.com

National HOSA Handbook: Section B. Published by HOSA, Flower Mound, Texas. Current
Edition. www.hosa.org






















Teaching/Learning Indicators: The following letters are used to indicate specific
skills/areas required in the instructional activity.

R Reading SS Social Studies
W Writing S Science
M Math A The Arts
H Health professional/parent/community involvement

Summer 2005 H.7
Objective MD08.01 Describe the structure of the heart.

Teaching/Learning Activities

Cognitive S
Have students label the diagram of the heart located in the appendix (Appendix MD08.01
B). After learning about the circulation, students can then color the different structures of
the heart red or blue depending on the oxygenated or deoxygenated blood.

Teamwork S, A
Have students work in teams to produce a 3-D model of the heart following the
instructions in Make a Heart 101 (Appendix MD08.01C). Each team member must
show proof of participation. The teams will present the models to the class. Individual
teams will decide on the method to produce the models.

Before beginning the assignment, the teacher should obtain the following materials to be
used with the activity:

Latex gloves Paper cups (4 per group)
Note cards Masking tape
Markers

Critical Thinking S, A
Have students draw a heart on a plain sheet of paper. Do not give any instructions other
than to draw a heart. After the hearts are drawn, have students list all the words inside
the heart that they can think of having to do with the circulatory system. The students
must be able to explain the words to the class. It is good to require at least 5 words, but
the number can vary.

Special Needs
Each student will reach the highest level of mastery in the least restrictive environment as
recommended in the students IEP.









Summer 2005 H.8
Objective MD08.02 Analyze the function of the heart.

Teaching/Learning Activities

Critical Thinking S, M
Have students complete the worksheet Heart & Blood Math, (Appendix MD08.2A). To
be successful in this activity, the students and teacher will need to discuss why we have
a pulse, and the teacher should teach students how to take a radial pulse.

Cognitive S
As a follow up to the previous activity, discuss the transparency Blood and the Heart Fun
Facts (Appendix MD08.2B).

Employability Skills S, H, W
Invite a cardiovascular technologist to demonstrate and talk about the electrical activity of
the heart, or visit the cardiovascular department at the local hospital and observe the
cardiovascular technologist. After the presentation have students to write a summary of
their conclusions about the function of the heart, based on their experiences with this
activity.

Note: Ask the speaker if he/she has an echocardiogram to share with the class. This
shows the pumping mechanism of the heart and the structures.

Basic Skills S, W
Have students write a paper explaining the electrical activity of the heart. The paper
should be imaginative while factual. For example, SA node could be Shawn Adams who
gets a real charge out of life. The AV node could be Agnes Vernox who always gets a
charge out of other people. Assign points for creativity and realism.

Teamwork S, W
Have students divide into groups of 3-5 depending on the class size. Complete the New
Beginnings, activity. (Appendix MD08.02C)

Special Needs
Each student will reach the highest level of mastery in the least restrictive environment as
recommended in the students IEP.







Summer 2005 H.9
Objective MD08.03 Analyze the circulation and the blood vessels.

Teaching/Learning Activities

Cognitive S
Have students participate in a class discussion about blood vessels and circulation.
(Transparency Appendix MD08.03A)

Teamwork S
Have students draw note cards with the pulse sites and their locations listed. Put one
site on half the note cards and the location on the other half. Example:

Brachial Bend of the arm

Pin note cards on each students back and have him/her search for his/her mate. The
students may ask only 3 questions of each person they meet. When they find their
partner, the students should stay together until the activity is over.

Critical Thinking S
Show students how to feel pulses at various pulse sites and explain to the students what
pulses are. Have students listen to the heartbeat with a stethoscope and explain the
physiology behind the lubb dupp sound.

Technology S, A
Have students create a poster of the physiology of the blood vessels using the computer.
Students may want to try the web site: www.innerbody.com/indexbody.htm/ as an
anatomy and physiology resource.

Teamwork S, A
Have students become the different structures of the heart by making a sign to wear with
the name of their structure on it. Assign one student per structure and any remaining
students may be the blood. Assign each drop of blood a different direction to come from:
tip of nose, bottom of ear lobe, etc. The first time a drop of blood goes through the heart,
each structure holds up his/her sign to guide the way. The second time the blood goes
through, no signs are shown, but the blood may ask the structures who they are. The
third time the blood goes through, no questions are allowed. If the blood gets stuck, this
could be a good learning example of a clot, etc.

Teamwork S
Have students participate in the circulation race. (Appendix MD08.03B)

Special Needs
Each student will reach the highest level of mastery in the least restrictive environment as
recommended in the students IEP.



Summer 2005 H.10
Objective MD08.04 Analyze characteristics and treatment of common
cardiac and circulatory disorders.

Teaching/Learning Activities

Employability S, H
Invite a cardiologist to class to explain current methods used for treating heart attack
patients, such as stints, cardiac bypass, angioplasty, transplants, etc.

HOSA S, W
Using the Researched Persuasive Speaking guidelines, have students research a
disorder assigned by the teacher, and then write a paper on the assigned topic. A main
focus of the paper and speech will be to persuade people to change behavior related to
the prevention or treatment of the disease assigned.

Students will present their persuasive speech in class while classmates take notes.
When two or more students are assigned the same topic, those speeches should be
given, one after the other, to allow students to focus on one disorder at a time.

HOSA S
Using the guidelines for Biomedical Debate debate the topic Heart Transplants No
Restrictions.

Cognitive S
This exercise will be useful as a review for the entire unit on the circulatory system. Have
students play the game, Speaking Of. The game begins by the student making a
statement concerning the heart. The statement must be true and must begin with
Speaking of. For example: Speaking of the heart, it pumps 80 mL of blood with each
heartbeat. A student may jump in when he/she can make a statement using any word in
the previous sentence. For example: Speaking of each heartbeat, if you count it for 1
minute that will give you your pulse rate. The next student may pick up on pulse, heart,
beat, count, rate, etc. Use for 5-10 minutes or until you are satisfied students
understand.

NOTE: Make sure students understand how to play. Each student may be responsible
for making at least one statement. If on teams, one team member may answer for the
whole team if there is joint input.

Teamwork S
This activity is best if it is done after the Researched Persuasive Speeches have been
given.

Have one team be a host panel. Each person on the team is allowed to ask the guest
team two questions. At the end of the questions, the host panel has 30 seconds to
confer and name the diseases. Students must answer questions truthfully, but should
not volunteer any information that is not asked. If the host panel guesses correctly, the
guests go home with nothing. If the host panel does not guess correctly, each host panel
member gives each guest panel member a piece of miniature candy.



Summer 2005 H.11
Objective MD08.04 Analyze characteristics and treatment of common
cardiac and circulatory disorders.

Teaching/Learning Activities (Continued)


Teamwork S
Have students divide into four or five teams. Give them 15 minutes to write 5 questions
about the diseases they studied. Each team gets to challenge any other team in the
room with their questions. If the other team answers the question correctly and guesses
the disease, they get the point. If not, the challenging team gets the point. Teammates
who are challenged have 20 seconds to confer and then they must answer. The turn
passes to the challenged team.

Special Needs
Each student will reach the highest level of mastery in the least restrictive environment as
recommended in the students IEP.





Summer 2005 H.12
Daily Lesson Plans

Unit H: Circulatory System
Lessons: 6
Hours: 9 clock hours

Steps Lesson #1 Lesson #2 Lesson #3
Focus and
Review
Ask a set of cardio words.
See if students can figure out
the meaning using prior
learning from the terminology
unit.

Review heart illustration be
sure structures are properly
labeled.

Collect and grade math
assignment.

Ask 5-10 questions from
reading have students write
answers on scratch paper.
Have them correct their own
answers as the lesson
progresses.
Statement
of
Objectives
MD08.01 Describe the
structure of the heart.

MD08.02 Analyze the function
of the heart.

MD08.03 Analyze circulation
and the blood vessels.

Teacher
Input
Lecture using overheads
structure of circulatory system.
May also integrate some
physiology. If a heart model is
available, use it to help point
out structures.

Using overheads, finish
discussion of physiology of
heart.

Overheads Circulation and
the blood vessels.

Demonstrate pulse sites. Have
students find their own pulse.

Pass out stethoscopes. Let
students listen to heart beat.

Guided
Practice
Have students use color
pencils to identify structures of
the heart.

Have students complete the
Heart and Blood Math
worksheet.
In pairs, do New Beginnings
activity using circulatory
terminology.

In time remaining, quiz each
other on Circulatory A&P.

Have students participate in the
circulation race. (Appendix
MD08.03B)

Independent
Practice
Assignment (due in 3 days)
Make a heart model or poster.
Use any material desired. Be
creative. Show all major
structures.

Complete both written
assignments.

Homework read chapter 14
Circulation and Blood Vessels.
(Not the disorders section.)


Have students interview
someone in their family who
can give family history
information. Of parents,
grandparents or other family
is there any history of heart
disease? What is it? Prepare
one page handwritten, on
what was learned. (Give
students 2 class periods to
complete this assignment.)

Closure Use model or chart in class.
Quiz students on structures.

Have one student from each
pair read their pairs New
Beginnings story.
Review blood vessel anatomy.
Remind students of heart
model assignment due next
class period.

Materials Overheads
Handouts: Heart and Heart and
Blood Math

Overheads
Cut up slips of paper from
Beginnings stories. Be sure
to have enough so that there is
one topic per pair.

Overheads
Handout Circulation race

Summer 2005 H.13
Unit H: Circulatory System (Continued)

Steps Lesson #4 Lesson #5 Lesson #6
Focus and
Review
Quiz students on pulse sites. Collect and discuss family
cardiac history assignment.


Answer student questions
before the test.
Statement
of
Objectives
MD08.04 Analyze
characteristics and treatment of
common cardiac and
circulatory disorders.

MD08.04 Analyze
characteristics and treatment of
common cardiac and
circulatory disorders.
MD08.04 Analyze
characteristics and treatment of
common cardiac and
circulatory disorders.
Teacher
Input
Begin class with heart
model/poster presentations by
students. (This should be fun.
Display models in classroom as
appropriate.)

Using overheads, introduce
students to diseases and
disorders of circulatory system.



Allow students to present their
poems about circulatory
disorders. As each
disease/disorder is shared, the
teacher should ask questions of
the class to assure they
understand key concepts of the
disease/disorder.
TEST Circulatory System
Guided
Practice
In pairs, assign students a
disease or disorder. Have
them write a poem about their
assignment. The poem should
be 8-12 lines, and may or may
not rhyme. It should reinforce
key concepts of the
disorder/disorder being written
about.


Let students study in pairs for
the test.
Take unit test.

Grade test in class.
Independent
Practice
Finish poem. Finish family
history assignment.
Study for test.

Have students look up the
answers to the questions they
got wrong and turn in their
corrected test.


Closure Review treatments of cardiac
disorders.
Have students take a teacher-
prepared 10 question quiz on
the Circulatory System. This
will be a preview of how they
will do on tomorrows test,
unless they study.


Introduce the next unit.

Make a reading assignment.

Use remaining class time for
HOSA business/update.



Materials Overheads

Teacher-prepared preview quiz.

Test and key.

Green pens for grading tests.





Summer 2005 H.14

Unit H: Circulatory System
Terminology List


1. aorta
2. aortic semilunar valve
3. apex
4. arterioles
5. artery
6. atrium
7. Atrioventricular (AV) node
8. bicuspid/mitral
9. brachial
10. Bundle of His
11. capillaries
12. carotid
13. cardiopulmonary circulation
14. coronary arteries
15. deoxygenated
16. diastolic
17. endocardium
18. femoral
19. inferior vena cava
20. jugular
21. lubb dupp
22. myocardium
23. oxygen/carbon dioxide exchange
24. oxygenated
25. pacemaker
26. pedal
27. pericardium
28. popliteal
29. pulmonary artery
30. pulmonary semilunar valve
31. pulmonary vein
32. pulse sites
33. purkinje fibers
34. radial
35. Sinoatrial (SA) node
36. septum
37. superior vena cava
38. systemic circulation
39. systolic
40. tricuspid
41. valves
42. veins
43. ventricle
44. venules

Disorders and Related Terminology
1. AED/defibrillation
2. aneurysm
3. angina pectoris
4. angiogram
5. angioplasty
6. arrhythmias
7. arteriosclerosis
8. artificial pacemaker
9. atherosclerosis
10. bradycardia
11. cardiac catheterization
12. congestive heart failure
13. coronary artery disease
14. coronary bypass
15. CPR
16. electrocardiogram (EKG or ECG)
17. embolus (embolism)
18. endocarditis
19. heart block
20. heart transplant
21. hypertension
22. hypotension
23. mitral valve prolapse
24. murmur
25. myocardial infarction
26. myocarditis
27. palpitation
28. pericarditis
29. phlebitis
30. stent
31. tachycardia
32. varicose vein (& hemorrhoid)


Appendix MD08.01A


Summer 2005 H.15
The Heart

Label the following structures of the heart:

1. right atrium
2. left atrium
3. right ventricle
4. left ventricle
5. septum
6. mitral valve
7. tricuspid valve
8. superior vena cava
9. inferior vena cava
10. aorta
11. myocardium
12. endocardium
13. pericardium




























Appendix MD08.01B

Summer 2005 H.16

Make a Heart 101

Your assignment is to work in you assigned groups (do not
change them) and using the materials in your heart packet,
construct a heart.

You may use the finger tips of the gloves for your valves.
You may use up to four cups, but you do not have to use all
of these if you are doing something else creatively. Your heart must
have all the chambers, valves, arteries, veins, etc.

The note cards can be cut into small pieces and used as labels. Your
heart must be labeled. The tape needs to be returned to the teacher at
the end of class to be used with other classes. The most accurate and
creative heart will win a prize.

To complete this assignment you must write a group essay in which you
use your particular model to teach a person about the heart. Make sure
you make reference to the different structures and the materials you
have used to make those structures. This essay will be graded for
content, grammar, and spelling. Please use paragraphs.

Use other people in your group to proof-read your essay. You have only
this class period to complete this assignment, so do not waste time.

For maximum success, put your heart into this assignment!










Appendix MD08.01C
Summer 2005 H.17

Heart and Blood Math


FACTS: About 80 ml of blood is sent through the aorta with each contraction of
the left ventricle.

Your body contains about 5 L of blood.

Your heart weighs about one pound (10 oz.)

The adult heart is about 5 inches long and 5.5 inches wide.


QUESTIONS:

1. How much blood does your heart pump in one minute?

Pulse Amount in ml Amount in oz.

A) at rest _____ ___________ ___________

B) jump in place for 1 min. _____ ___________ ___________

C) run in place for 2 min. _____ ___________ ___________

2. Is the entire volume of blood pumped through your body in more or less than a
minute?



3. How long and how wide is the heart in centimeters? _____

4. How much does the heart weigh in grams? _____








Appendix MD08.02A

Summer 2005 H.18
BLOOD AND THE HEART FUN FACTS


An average adult human contains
about 5 liters (5.3qt) of blood.

The blood makes up about one-
thirteenth of the bodys weight.

The adult heart weighs about 280 grams (10 oz.)

At rest, the heart pumps out about 80 millimeters
(2.6 oz) of blood with each beat.

The heart beats, on average, 70 times each
minute at rest.

This means all the blood is circulated (goes
round the body once) in about one minute.

During strenuous exercise the heart can pump
six to eight times the amount of blood that it
pumps at rest.




Appendix MD08.02B
Summer 2005 H.19

New Beginnings

In a container place the slips of paper containing the New Beginnings. Have
each team to draw one new beginning out of the container. The team must take
their beginning and complete their story using ten of the anatomy terms found on the
terminology list in the appendix. Each team member must participate. Allow 20
minutes for the exercise. Terms must be used appropriately.

Examples of New Beginnings


John and Jillian were studying together when all of a sudden. . . . . .


Peter thought Chris was meeting him at the bus station. When he
walked through the door soaking wet. . . . . .


As the train careened around a steep turn. . . . . .


It was a bright and sunny day.. . . . . . . . . .


Newsflash! This is amazing!. . . . . . .


Help!. . . . . .











Appendix MD08.02C
Summer 2005 H.20
As the Blood Flows

Deoxygenated Blood from Body Tissue

Superior/inferior vena cava

Right Atrium

Tricuspid Valve opens

Right Ventricle

Pulmonic Valve Pulmonary Artery

Both Lungs

CO
2
- O
2
exchange Alveolar via Pulmonary Veins

Left Atrium

Mitral Valve Opens

Left Ventricle

Aortic Valve Opens

Aorta - Transporting Oxygenated Blood to Body
Cells


Appendix MD08.03A
Summer 2005 H.21
Circulation Race

Prepare two envelopes. One envelope will be for the artery team (pink note cards) and
one envelope for the veins team (blue notecards.)

The following terms should be written on a note card (one term per note card). Each
team should have a complete set of terms in their envelopes. (Another alternative is to
copy this page on blue paper and on pink paper, and cut out the terms below.)

Before the race starts, appoint a team captain. Have the team captain distribute the
note cards, with the term facing down so the student does not know what it is. Make
sure each team member has at least one term. Some may have more depending on the
number of students per team.

When the whistle blows, the students are to race to see who can create a circulation
circle which follows the flow of blood through the circulatory system. Students can also
race against their own times to see if they pick up speed.



Superior Vena
Cava

Inferior Vena
Cava


Right Atrium

Tricuspid
Valve


Right Ventricle

Pulmonary
Valve

Pulmonary
Artery


Lungs


CO
2
and O
2

Exchange


Pulmonary
Vein

Left Atrium

Bicuspid
(Mitral) Valve

Left Ventricle

Aortic Valve

Aorta

Arteries


Arterioles


Capillaries

Venules

Veins




Appendix MD08.03B
Summer 2005 H.22

Unit H: Circulatory System
















OVERHEAD
TRANSPARENCY
MASTERS
Summer 2005 H.23




Functions
1. Pump
2. Blood transport system around body
3. Carries O2 and nutrients to cells, carries away
waste products
4. Lymph system returns excess tissue fluid to
general circulation

Structure Circulatory system involves:
Heart
Arteries
Veins
Capillaries
Blood and lymph are part of circulatory system

Major Blood Circuits
General (Systemic) circulation
Cardiopulmonary circulation

Summer 2005 H.24




Summer 2005 H.25
The Heart
Muscular organ
Size of a closed fist
Weighs 12-13 oz
Location thoracic
cavity
APEX conical tip, lies
on diaphragm, points
left
Stethoscope
instrument used to hear
the heartbeat

Structure
Hollow, muscular, double pump that circulates
blood
At rest = 2 oz blood with each beat, 5 qts./min.,
75 gallons per hour
Ave = 72 beats per minute
100,000 beats per day
PERICARDIUM double layer of fibrous tissue
that surrounds the heart
MYOCARDIUM cardiac muscle tissue
ENDOCARDIUM smooth inner lining of heart
Summer 2005 H.26
SEPTUM partition (wall)
that separates right half
from left half

Superior vena cava and
inferior vena cava bring
deoxygenated blood to
right atrium
Pulmonary artery takes
blood away from right
ventricle to the lungs for
O
2

Pulmonary veins bring oxygenated blood
from lungs to left atrium
Aorta takes blood away from left ventricle to
rest of the body

Chambers and Valves

SEPTUM divides into R and L halves
Upper chambers RIGHT ATRIUM and LEFT
ATRIUM
Lower chambers RIGHT VENTRICLE and
LEFT VENTRICLE
Four heart valves permit flow of blood in one
direction

Summer 2005 H.27


TRICUSPID VALVE between right atrium and
right ventricle

BICUSPID (MITRAL) VALVE between left atrium
and left ventricle

Semilunar valves are located where blood leaves
the heart - PULMONARY SEMILUNAR VALVE
and AORTIC SEMILUNAR VALVE














Summer 2005 H.28
PHYSIOLOGY OF THE HEART

The heart is a double pump. When the heart
beats

Right Heart
Deoxygenated blood flows into heart from vena
cava right atrium tricuspid valve right
ventricle pulmonary semilunar valve
pulmonary artery lungs (for oxygen)

Left Heart
Oxygenated blood flows from lungs via pulmonary
veins left atrium mitral valve left ventricle
aortic semilunar valve aorta general
circulation (to deliver oxygen)


Summer 2005 H.29
Blood Supply to the Heart from CORONARY
ARTERIES

Heart Sounds = lubb dupp

Control of Heart Contractions

SA (sinoatrial) NODE = PACEMAKER
Located in right atrium
SA node sends out electrical impulse
Impulse spreads over atria, making them
contract
Travels to AV Node

AV (atrioventricular) NODE
Conducting cell group between atria and
ventricle
Carries impulse to bundle of His

BUNDLE OF HIS
Conducting fibers in septum
Divides into R and L branches to network of
branches in ventricles (Purkinje fibers)

PURKINJE FIBERS
Impulse shoots along Purkinje fibers causing
ventricles to contract
Summer 2005 H.30

ELECTROCARDIOGRAM (EKG or ECG)

Device used to record the electrical activity of the
heart.

SYSTOLE = contraction phase
DIASTOLE = relaxation phase
Baseline of EKG is flat line


P = atrial contration
QRS = ventricular contract
T = ventricular relaxation

HOLTER MONITOR 24 hour EKG

Summer 2005 H.31




CARDIOPULMONARY CIRCULATION heart
and lungs

SYSTEMIC CIRCULATION from the heart to the
tissues and cells, then back to the heart

Cardiopulmonary Circulation
As the Blood Flows Appendix MD08.03A

ARTERIOLES small arteries
VENULES small veins

Systemic Circulation
AORTA largest artery in the
body
First branch is coronary artery
Aortic arch
Many arteries branch off the
descending aorta

Summer 2005 H.32
Blood Vessels





















Summer 2005 H.33
ARTERIES
Carry oxygenated blood away from the heart to
the capillaries
Elastic, muscular and thick-walled
Transport blood under very high pressure

CAPILLARIES
Smallest blood vessels, can only be seen with
a microscope
Connect arterioles with venules
Walls are one-cell thick and extremely thin
allow for selective permeability of nutrients,
oxygen, CO
2
and metabolic wastes

VEINS
Carry deoxygenated blood away from
capillaries to the heart
Veins contain a muscular layer, but less elastic
and muscular than arteries
Thin walled veins collapse easily when not filled
with blood
VALVES permit flow of blood only in direction
of the heart
JUGULAR vein located in the neck
Summer 2005 H.34
Blood Pressure
Surge of blood when heart pumps creates
pressure against the walls of the arteries
SYSTOLIC PRESSURE measured during the
contraction phase
DIASTOLIC PRESSURE measured when the
ventricles are relaxed

Average systolic = 120
Average diastolic = 80

PULSE alternating expansion and contraction of
an artery as blood flows through it.

Pulse sites:
BRACHIAL
CAROTID
RADIAL
POPLITEAL
PEDAL


Summer 2005 H.35

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ARRHYTHMIA (or dysrrhythmia) any change
from normal heart rate or rhythm

BRADYCARDIA slow heart rate (<60 bpm)

TACHYCARDIA rapid heart rate (>100 bpm)

MURMURS indicates defect in heart valve
valves fail to close properly, causing gurgling or
hissing sound.

MITRAL VALVE PROLAPSE mitral valve closes
imperfectly symptoms occur in response to
stress, including fatigue, PALPITATIONS (heart
feels like it is racing) headache, chest pain, and
anxiety.

Infectious Diseases of the Heart
Cause = virus or bacteria
Treatment = antibiotics

PERICARDITIS inflammation of outer membrane
covering the heart symptoms are chest pain,
cough, dyspnea (difficulty breathing), tachycardia,
and fever.
Summer 2005 H.36

MYOCARDITIS inflammation of heart muscle
symptoms the same as pericarditis

ENDOCARDITIS inflammation of the membrane
that lines the heart and covers the valves, causes
rough spots in the endocardium which may lead to
the development of a thrombus

Coronary Artery Disease

ANGINA PECTORIS chest pain, caused by lack
of oxygen to heart muscle, treat with nitroglycerin
to dilate coronary arteries

MYOCARDIAL INFARCTION
MI or heart attack
Lack of blood supply to myocardium causes
damage
Due to blockage of coronary artery or blood clot
atherosclerosis plaque build-up on arterial
walls, or arteriosclerosis loss of elasticity and
thickening of wall.
Amount of damage depends on size of area
deprived of oxygen
Summer 2005 H.37
Symptoms severe chest pain radiating to left
shoulder, arm, neck and jaw. Also nausea,
diaphoresis, dyspnea.
Immediate medical care is critical
Rx bedrest, oxygen, medication
Morphine for pain, tPA to dissolve clot
Anticoagulant therapy to prevent further clots
from forming
Angioplasty and by-pass surgery may be
necessary

CONGESTIVE HEART FAILURE
Ventricles unable to contract effectively and
blood pools in the heart
Edema in lower extremities
Blood backs up into lungs
Rx drugs to strengthen heart beat (digoxin)
and diuretics to reduce fluid

Heart Surgery

ANGIOPLASTY procedure to help open clogged
vessels may also be called balloon surgery.

Summer 2005 H.38
CORONARY BY-PASS usually, a healthy vein
from the leg removed and attached before and
after the coronary obstruction, creating an
alternate route for blood supply to the
myocardium.

HEART TRANSPLANT
Why? Irreparably damaged myocardium,
valves or blood vessels, or baby/child with
congenital heart defect
Problem? Histocompatibility
Rx? Immunosuppressants
Artificial hearts? First used in 1982. What is
the current status?

PACEMAKERS
Demand pacemaker fires only when heart rate
drops below programmed minimum

STENT
Tiny, expandable stainless steel tube that holds
coronary artery open following angioplasty

CPR cardiopulmonary resuscitation, used in the
presence of cardiac arrest

Summer 2005 H.39
DEFIBRILLATION electrical shock to bring the heart
back to a normal rhythm.

AED automated external defibrillator

HEART BLOCK disturbance in electrical conductivity
of the heart beat


Disorders of the Blood Vessels

ANEURYSM ballooning of an artery, thinning
and weakening

ARTERIOSCLEROSIS arterial walls thicken,
lose elasticity

ATHEROSCLEROSIS fatty deposits form on
walls of arteries

PHLEBITIS inflammation of lining of vein,
accompanied by clotting of blood symptoms are
edema, pain and redness

EMBOLISM traveling blood clot

VARICOSE VEINS swollen, distended veins
heredity or due to posture, prolonged periods of
standing, physical exertion, age and pregnancy
Summer 2005 H.40
HEMORRHOIDS - varicose rectal veins

HYPOTENSION low blood pressure, systolic
<100

HYPERTENSION
High blood pressure
silent killer usually no symptoms
Condition leads to strokes, heart attacks, and
kidney failure
140/90 or higher
Higher in African-Americans and post-
menopausal women
Risk factors = smoking, overweight, stress, high
fat diets, family history
Treatment = relaxation, low fat diet, exercise,
weight loss, medication

Diagnostic Tests

CARDIAC CATHETERIZATION catheter fed into
heart, dye injected, x-rays taken as dye moves
through coronary arteries

ANGIOGRAM x-ray of a blood vessel using dye

ELECTROCARDIOGRAM electrical tracing of
the heart