Download - Cardiology
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Cardiology
• The medical specialty that studies the anatomy and physiology of the cardiovascular system and uses diagnostic tests, medical and surgical procedures, and drugs to treat cardiovascular diseases.
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Figure 5-1 Cardiovascular system
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The Cardiovascular System
• A continuous, circular body system that includes the heart and the vascular structures (blood vessels such as arteries, capillaries, and veins)
• Moves blood throughout the body and transports oxygen, carbon dioxide, nutrients, and wastes in the blood
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Anatomy of the Cardiovascular System
• Heart– A muscular organ that contracts at least once
every second to pump blood through the body – Has an extensive electrical system that initiates
and coordinates its contractions
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Figure 5-2 Surface of the heart
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Anatomy of the Cardiovascular System (cont’d)
• Heart Chambers– The heart contains four chambers, two on the top
and two on the bottom.– Each small upper chamber is an atrium.– Each large lower chamber is a ventricle.– The septum, a center wall, divides the heart into
right and left halves.– The inferior tip of the heart is the apex.
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Figure 5-3 Chambers and valves of the heart
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Anatomy of the Cardiovascular System (cont’d)
• Four valves control the flow of blood through the heart:– Tricuspid – Pulmonary – Mitral – Aortic
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Figure 5-4 Aortic valve
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Anatomy of the Cardiovascular System (cont’d)
• Heart Muscle – Mycardium — composed of cardiac muscle – Responds to electrical impulses generated by a
node within the heart itself – Contracts in a coordinated way to pump blood – Thickest on the left side of the heart
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Table 5-1 Layers and Membranes of the Heart
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Figure 5-5 Layers and membranes of the heart
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Anatomy of the Cardiovascular System (cont’d)
• Thoracic Cavity – Contains the lungs and the mediastinum, an
irregularly shaped central area between the lungs
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Anatomy of the Cardiovascular System (cont’d)
• Mediastinum– Contains the heart and parts of the great vessels
(aorta, superior vena cava, inferior vena cava pulmonary arteries and veins), as well as the thymus, trachea, and the esophagus
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Figure 5-6 Mediastinum
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Anatomy of the Cardiovascular System (cont’d)
• Blood Vessels– Vascular channels through which blood circulates
in the body– Have a central opening or lumen through which
the blood flows – Lined with endothelium, a smooth inner layer that
promotes the flow of blood
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Anatomy of the Cardiovascular System (cont’d)
• There are three kinds of blood vessels in the body, each performing a different function:– Arteries– Capillaries– Veins
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Anatomy of the Cardiovascular System (cont’d)
• Arteries – Large blood vessels– Smaller branches of an artery are arterioles
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Anatomy of the Cardiovascular System (cont’d)
• All arteries share some important characteristics and functions:– They carry blood away from the heart to the body.– They carry bright red blood that has a high level of
oxygen.– Most arteries lie deep beneath the skin.– All arteries have smooth muscle in their walls.– Exception: pulmonary arteries
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Figure 5-7 Vasoconstriction and vasodilation
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Anatomy of the Cardiovascular System (cont’d)
• Capillaries– Smallest blood vessels in the body– The lumen of a capillary is so small that blood
cells must pass through in single file.
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Anatomy of the Cardiovascular System (cont’d)
• Veins– Capillaries combine to form small veins known as
venules, which then combine to form the largest veins.
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Anatomy of the Cardiovascular System (cont’d)
• All veins share some important characteristics and functions:– They carry blood from the body back to the heart.– They carry dark red-purple blood with a low level
of oxygen.– Exception: pulmonary arteries
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Anatomy of the Cardiovascular System (cont’d)
• All veins share some important characteristics and functions:– The largest veins have valves that keep the blood
flowing in one direction―toward the heart.– Many veins are near the surface of the body and
can be seen just under the skin as bluish, sometimes bulging lines.
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Figure 5-8 Valves in a vein
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Anatomy of the Cardiovascular System (cont’d)
• Aorta– Largest artery in the body – Receives blood from the left ventricle of the heart
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Figure 5-9 Arteries and veins around the heart
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Figure 5-10 Arteries in the body
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Anatomy of the Cardiovascular System (cont’d)
• Arteries– Coronary artery– Carotid artery– Subclavian artery – Axillary artery (armpit)– Brachial artery (upper arm)– Radial artery (thumb side of the lower arm)– Ulnar artery (little finger side of the lower arm)
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Anatomy of the Cardiovascular System (cont’d)
• Thoracic Aorta and Arterial Branches– The thoracic aorta travels inferiorly through the
thoracic cavity.– It branches into arteries that bring blood to the
esophagus, muscles between the ribs, diaphragm, upper spinal cord, and the back.
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Anatomy of the Cardiovascular System (cont’d)
• Abdominal Aorta and Arterial Branches– Brings oxygenated blood to the stomach, liver,
pancreas, spleen, gallbladder, small and large intestines, adrenal glands, kidneys, ovaries, testes, and the lower spinal cord
– Abdominal aorta ends where right and left iliac arteries begin
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Anatomy of the Cardiovascular System (cont’d)
• Abdominal Aorta and Arterial Branches – Iliac artery– Femoral artery (upper leg)– Popliteal artery (near the knee joint)– Tibial artery (front and back of the lower leg)– Peroneal artery (little toe side of the lower leg)
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Anatomy of the Cardiovascular System (cont’d)
• Two major veins of the body– Superior vena cava– Inferior vena cava
• Other major veins– Jugular vein– Portal vein– Saphenous and femoral veins
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Anatomy of the Cardiovascular System (cont’d)
• The Circulatory System– The cardiovascular system or circulatory system
circulates blood through the blood vessels.– Systemic circulation includes the arteries,
capillaries, and veins everywhere in the body, except in the lungs.
– Pulmonary circulation includes the arteries, capillaries, and veins going to, within, and coming from the lungs.
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Figure 5-11 Circulation of the blood
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Physiology of a Heartbeat
• Heart contracts and relaxes in a regular rhythm coordinated by the conduction system• Actually, med terms kids make my heartbeat – Sinoatrial node (SA node), or pacemaker of the
heart, initiates the electrical impulse that begins each heartbeat
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Physiology of a Heartbeat (cont’d)
• Heart contracts and relaxes in a regular rhythm coordinated by the conduction system – Atrioventricular node (AV node) receives the
impulse to contract from the SA node– Purkinje fibers, a network of nerves, cause both
ventricles to contract simultaneously
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Figure 5-12 Conduction system of the heart
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Physiology of a Heartbeat (cont’d)
• Two Heartbeat Phases– Systole (contraction)– Diastole (resting period)
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Figure 5-13 Exercise increases the heart rateJohn Garrett © Dorling Kindersley
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Diseases and Conditions
• Myocardium– Acute coronary syndrome– Angina pectoris– Cardiomegaly– Cardiomyopathy– Congestive heart failure (CHF)– Myocardial infarction (MI)
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Figure 5-14 Peripheral edemaAntonia Reeve/Photo Researchers, Inc.l
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Diseases and Conditions (cont’d)
• Heart Valves and Layers of the Heart– Endocarditis– Mitral valve prolapse (MVP)– Murmur– Pericarditis– Rheumatic heart disease
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Figure 5-15 Vegetation on the mitral valveAbrahas/Custom Medical Stock Photo, Inc.
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Diseases and Conditions (cont’d)
• Conduction System– Arrhythmia– Bradycardia– Fibrillation– Flutter– Heart block
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Figure 5-16 Arrhythmias on an EKG tracing
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Diseases and Conditions (cont’d)
• Conduction System– Premature contraction– Sick sinus syndrome– Tachycardia– Asystole– Palpitation
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Diseases and Conditions (cont’d)
• Blood Vessels– Aneurysm– Arteriosclerosis– Bruit– Coronary artery disease (CAD)– Hyperlipidemia– Hypertension (HTN)– Hypotension– Peripheral artery disease (PAD)
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Figure 5-27 An aneurysm(b) Michael English, M.D./Custom Medical Stock Photo, Inc.
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Figure 5-18 Mild atheromatous plaqueSIU BioMed/Custom Medical Stock Photo, Inc.
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Figure 5-19 Severe atherosclerotic plaque in an arteryC. Abrahams, M.D./Custom Medical Stock Photo, Inc.
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Diseases and Conditions (cont’d)
• Blood Vessels – Peripheral vascular disease (PVD)– Phlebitis– Raynaud’s disease– Varicose veins
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Figure 5-23 Severe varicose veins in the leg
SPL/Photo Researchers, Inc.
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Laboratory and Diagnostic Procedures
• Blood Tests– Cardiac enzymes– C-reactive protein (CRP)– Homocysteine – Lipid profile – Troponin
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Laboratory and Diagnostic Procedures (cont’d)
• Diagnostic Heart Procedures– Cardiac catheterization – Cardiac exercise stress test– Electrocardiography (ECG, EKG) – Electrophysiologic study (EPS)
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Figure 5-22 ElectrocardiographyJupiter Images – PictureArts Corporation/Brand X Pictures-Royalty Free
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Figure 5-23 An EKG tracing
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Laboratory and Diagnostic Procedures (cont’d)
• Diagnostic Heart Procedures – Holter monitor– Pharmacologic stress test– Telemetry
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Figure 5-21 Treadmill exercise stress testFotopic/Miles Simons/Phototake NYC
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Laboratory and Diagnostic Procedures (cont’d)
• Radiology and Nuclear Medicine Procedures– Angiography – Echocardiography
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Figure 5-24 EchocardiogramCustom Medical Stock Photo, Inc.
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Figure 5-25 Doppler ultrasonographyMatt Meadows/Science Photo Library/Photo Researchers, Inc.
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Medical and Surgical Procedures
• Medical Procedures– Auscultation– Cardioversion – Sclerotherapy– Vital signs
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Figure 5-26 DefibrillationPearson Education/PH College
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Figure 5-27 Pulse points
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Figure 5-28 Carotid pulse
Michal Heron/Pearson Education/PH College
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Figure 5-29 Measuring the blood pressure
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Medical and Surgical Procedures (cont’d)
• Surgical Procedures– Aneurysmectomy – Cardiopulmonary bypass – Carotid endarterectomy
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Medical and Surgical Procedures (cont’d)
• Surgical Procedures– Coronary artery bypass graft (CABG)– Heart transplantation – Pacemaker insertion
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Figure 5-30 Open heart surgery
F. Schussler/PhotoDisc/Getty Images
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Figure 5-31 Pacemaker(left) English/Custom Medical Stock Photo, Inc. (right) Alvis Upitis/Jupiter Images-PictureArts
Corporation/Brand X Pictures-Royalty Free
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Medical and Surgical Procedures (cont’d)
• Surgical Procedures (cont’d)– Percutaneous transluminal coronary angioplasty
(PTCA) – Pericardiocentesis – Valve replacement– Valvoplasty– Radiofrequency catheter ablation
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Figure 5-32 Balloon angioplasty
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Figure 5-33 Stent
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Figure 5-34 Valve replacement surgeryCustom Medical Stock Photo, Inc.