Presenter : Dr.

ILENE PEARCE DENNIS MEDICAL OFFICER KSA HEALTH DEPT

Define terms Introduce systems relevant to course Cardiovascular Endocrine Skeletal immune system Overview of the anatomy of relevant systems Physiology of Cardiovascular and Endocrine systems

DEFINITION- THE BRANCH OF SCIENCE DEALING WITH THE STRUCTURE OF ORGANISMS DIFFERENT TYPES OF ANATOMY APPLIED ANATOMY (DIAGNOSIS) COMPARATIVE (DIFFERENT ANIMALS) DESCRIPTIVE ( INDIVIDUAL PARTS) GROSS OR MACROSCOPIC

DIFFERENT TYPES OF ANATOMY CONT, MICROSCOPIC PATHOLOGICAL (ABNORMAL ,DISEASED) SECTIONAL (TRANSVERSE, SAGITTAL, CORONAL, OBLIQUE) SURFACE ANATOMY

DEFINITION- PHYSIS,LOGOS THE SCIENCE OF THE FUNCTIONS OF THE LIVING ORGANISM AND ITS COMPONENTS AND OF THE CHEMICAL AND PHYSICAL PROCESSES INVOLVED

DIFFERENT TYPES OF PHYSIOLOGY CELL COMPARATIVE

DIFFERENT TYPES OF PHYSIOLOGY CONT. PATHOLOGIC (EXPLAINS PATHOLOGICAL EVENTS) SPECIAL (ORGANS AND SYSTEMS)

ANATOMY APPLIED (RELATED TO DIAGNOSIS/TREATMENT )

PATHOLOGICAL(EVIDENCE OF DISEASE/SUFFERING)

PHYSIOLOGY SPECIAL (SYSTEM /ORGAN INVOLVED) PATHOLOGICAL

HYPERTENSION

CARDIOVASCULAR ENDOCRINE GASTROINTESTINAL ENDOCRINE GASTROINTESTINAL GASTROINTESTINAL

DIABETES

HYPERCHOLESTEROL

OSTEOARTHRITIS

SKELETAL SYSTEM

HIV/ AIDS

IMMUNOLOGICAL SYSTEM

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ANATOMY- heart , arteries , veins

CARDIOVASCULAR SYSTEM

PhysiologyHeart rate heart rhythm Blood Pressure

HEART RATE Definition no. of heart beats per minute Heart Rate can be normal or abnormal Normal Heart Rate= 60- 100 beats per minute Abnormal Heart Rate= < 60 b.p.m. OR > 100 b.p.m. Rate determined by either Sino-atrial node (main pace maker), Atrio-ventricular node ,or nearby site

HEART RHYTHM DEFINITION- the dominant beat of the heart Represents the movement of electricity from the top chambers to the bottom chambers Rhythm can be regular (SINUS) from pacemaker Regular heart rhythm is a lub dub Rhythm can be irregular (SICK SINUS,ECTOPIC,AV BLOCK) from site other than pace maker Irregular heart rhythm is any rhythm aside from lub-dub, eg.lub dub dub of heart failure

HEART SOUNDS LUB sound is made when blood from ventricles hit against valves separating upper and lower heart chambers snapping them shut (CONTRACTION, SYSTOLIC ) DUB sound is made when lower chambers relax and the outlet valves of the heart (pulmonary and aortic) slam shut.

BLOOD PRESSURE DEFINITION- the tension exerted by blood against the arterial walls Formula Definition Blood Pressure= Cardiac output* Vsl Resistance

Heart rate

Stroke vol.

AUSCULTATORY METHOD OF BLOOD PRESSURE MEASUREMENT

PALPATION METHOD OF BLOOD PRESSURE MEASUREMENT

Uses blood pressure machine (sphygmomanometer) and stethoscope Inflated cuff occludes Brachial artery at medial arm Cuff pressure released until first gush of blood escapes (systolic BP / top number) When sound of pulsing blood just disappears (diastolic BP / bottom number)

Uses sphygmomanometer but not stethoscope Inflated cuff occludes brachial artery at medial arm Cuff pressure is released while radial pulse is felt At first sound record Systolic Add 2- 5 mmHg When sound disappears record value as diastolic

BP READING

ASSESSMENT

< 120 / 80 120 139 / 80 89 140 159 / 90 99 160 179 / 100 119 > 180 / 120

NORMAL BP PRE HYPERTENSION STAGE 1 HYPERTENSION STAGE 2 HYPERTENSION STAGE 2

AGE Newborn to 6 weeks * Infant (6 weeks to 6 months) *

Normal BP Systolic 50 - 70 Systolic 70 - 95

Toddler ( 1 to 3 years) *
Young Children ( 3 to 6 years) Older Children (10 to 14 years) Adults

Systolic 80 - 100
Systolic 80 - 110 Systolic 90 - 120 Systolic 90 - 120 Diastolic 80 or less

(Mosbys Critical Care Nursing Reference, 2002; Perry & Potter, 2006)

(* BP is often not taken on children less than 3 years of age)

FACTORS DETERMINING BP RECALL FORMULAE : BP = CARDIAC OUTPUT * PERIPHERAL VASCULAR RESISTANCE CARDIAC OUTPUT = HEART RATE * STROKE VOLUME

STROKE VOLUME

PRE LOAD amt of blood in heart prior to contraction AFTER LOAD sum of all forces opposing ejection of blood from ventricle HEART MUSCLE CONTRACTILITY -

Affected by time taken to fill ventricle and how much blood is in veins If forces are high , stroke volume will be low and vice versa Affected by nervous system and hormones

HEART RATE

NEURAL CONTROL

BRAIN (Medulla Oblongata, Cerebral Cortex)

ENDOCRINE hormones and chemicals

Pressure, position, stretch and chemical sensors in aorta, carotid sinus, atria Chemicals include oxygen, carbon dioxide, lactic acid, hydrogen ions Info. Travels via nerves in neck to brain. Sympathetic stimulation causes arterial constriction Para sympathetic stimulation causes arterial dilatation Epinephrine, nor epinephrine, thyroid hormones,

HEART RATE

ENDOCRINE CONTROLlong term control

Hormones include Renin aldosterone anti- diuretic hormone epinephrine Nor- epinephrine Atrial Natriuretic peptide

HEART RATE Continued

Age Gender Physical fitness Body temperature

PERIPHERAL VASCULAR RESISTANCE

Functions Warms air Extract pollutants via sneeze reflex, hairs Transfer air to exchange membrane in lung (interstitium)

Hypothalamus Anterior Pituitary Posterior Pituitary Thyroid gland Adrenal Cortex Pancreas islets of Langerhans

LOCATION : behind stomach SHAPE : head ,neck, body, tail

LOCATION IN BODY

PANCREAS

ISLET CELLS scattered throughout secreting cells of Pancreas

Alpha cells to outside Beta cells to centre Delta cells intersperse Secretes glucagon Secretes insulin Secretes somatostatin

GLUCAGON

Hormone that converts glycogen ( stored glucose) into glucose units thereby increasing glucose levels in blood
Hormone that binds to cell membranes of most body cells and leads to increased uptake of glucose from blood into cells for energy use

INSULIN

INSULIN

Affects carbohydrate, fat and protein metabolism

encourages the synthesis and storage of glycogen, fats and proteins from excess glucose hence decreasing glucose levels in the blood