Cardiopulmonary Physical Therapy

Haneul Lee, DSc, PT

OBJECTIVE

1. Explain the principle anatomy of the cardiovascular system2. Outline the major physiology of the cardiovascular system3. Discuss the circulatory system

Delivering oxygen to active tissue

Playing an important role in

movement

Limiting factor to performing

functional activities

• One major challenges to homeostasis posed by exercise is the increased muscular demand for oxygen

• During heavy exercise, oxygen demands may increases by 15 to 25 times

Cardiovascular system

1. Transport O2 and nutrients to tissues

2. Removal of CO2 wastes from tissues

3. Regulation of body temperature

http://dokterayla.com/tag/muscles-of-respiration

Location: Apex – base of 5th intercostal space (Left)

Located in mediastinum, between lungs

Base – board superior portion of heart

Apex – inferior end

3.5 inch wide at base,

weights 10oz

http://www.tutorvista.com/content/biology/biology-ii/transportation/heart.php

Layers

1. Pericardium

2. Myocardium

3. Endocardium

http://histologyolm.stevegallik.org/node/347

Right atrium (RA): receives the blood from superior

or and inferior vena cavae. Right ventricle (RV)

:receives blood from RA and pumpsit via the pulmonary artery to lungs for oxygen

Left atrium (LA): receives oxygenated blood from the

lungs and the four pulmonary veins Left ventricle (LV)

: receives blood from the LA and pumps it via the aorta throughout the entiresystemic circulation

http://textbookofcardiology.org/wiki/Valvular_Heart_Disease

Provide one-way flow of blood

Artrioventricular valves

Tricuspid valve

Bicuspid or mitral valve

Semilunar valves

Pulmonary valve

Aortic valve

http://textbookofcardiology.org/wiki/Valvular_Heart_Disease

Begins with an action potential in the sinoartrial (SA) node, a depolarization wave is spread through both atria, to the artrioventricular (AV) node, and then, through the Punkinjecomplex, into the ventricle.

http://www.texasheart.org/HIC/Anatomy/conduct.cfm

The rhythmic pumping action of the heart

Systole : the period of ventricular contraction

Diastole : the period of ventricular relaxation

Atrial contraction occurs during the last third of diastole and completes ventricular filling

http://classes.midlandstech.edu/carterp/Courses/bio211/chap18/chap18.html

Atrial systole begins Atrial contraction forces a small amount of additional blood into ventricles

Atrial systole ends, ventricular diastole begins Pause through the AV node

Ventricular systole Ventricular contraction, AV valves close – 1st heart sound Isovolumetric ventricular contraction

Ventricular systole- 2nd phase Ventricular pressure rises and exceeds arterial trunk or aortic pressure Semilunar valves open and blood is ejected = SV

Ventricular diastole – early Ventricles relax and pressure drops below aortic pressure Blood flows into relaxed atria

Ventricular diastole-late All chambers relaxed Passive ventricular filling occurs

Arteries : arise directly from aorta near aortic valve; blood circulates to myocardium during diastole.

Right coronary artery ( RCA)

Left coronary artery (LCA)

Left anterior descending (LAD)

Circumflex (Circ)

answers.medchrome.com

Veins : parallel arterial system;

the coronary sinus receives venous blood from the heart and empties intothe right atrium.

answers.medchrome.com

Arteries Transport oxygenated blood from

areas of high pressure to lower

pressures in the body tissues.

Arterial circulation maintained by

heart pump.

Veins Transport dark, oxygenated blood

from tissues back to the heart

Lager capacity, thinner walls than

arteries, greater numbers

One-way valves to prevent backfl0w

The amount of blood ejected with each myocardial contraction; normal range is 55-100mL/beat

1. Left Ventricular End Diastolic Volume(LVEDV)

The amount of blood left in the ventricle at the end of diastole, aka preload

2. Contractility

The ability of the ventricle to contract

3. Afterload

The force the LV must generate during systole to overcome aortic pressure

to open the aortic valve

A measure of the amount of blood that is pumped out of the heart in one minute; normal rage is 4-5L/m

The amount of blood pumped out of the left ventricle as this is the ventricle that supplies blood to the muscles and organs of the body

Heart Rate (HR) * Stroke Volume(SV)

Question?Thank

you

1. National Physical Therapy Examination, O’sullivan&Siegelman, TherapyEd2. Essentials of Cardiopulmonary Physical Therapy, 3rd edition, Ellen Hillegass, Elsevi

er3. Cardiovascular and pulmonary Physical Therapy Evidence to Practice, 5th edition,

Donna Frownfelter, Elizabeth Dean, Elsevier4. Cardiopulmonary Physical Therapy Management and Case Studies, 2nd edition, W.

Darlence Reid, Frank Chung, Kylie Hill, SLACK Inc.5. Steele, Joel Dorman Hygienic Physiology (New York, NY: A. S. Barnes & Company,

1888)6. Khan Academy, www.khanacademy.org