MollyCovington

PhysiologyPeriod2
April6,2015

CardiovascularStudyGuide

ParagraphQuestions:

1. Thearteryisathickmusclelayerwhichallowsthemtowithstandthepressurecausedby
thebloodasithitsthesurfaceofthearteriolewallsandisejectedfromtheheart.Avein
isathinnermusclelayerandonewayvalveswhichallowsthemtodistendwhenan
increasedamountofbloodentersthem,onewayvalvesensurebloodflowbacktothe
heart.Acapillaryisasinglelayerendotheliumandextensivebranchingsystemthat
allowsforefficientexchangeofgasandliquidmoleculesduetotheirthinstructureand
increasedsurfaceareatovolumeprovidedforbytheirextensivebranchingsystem.
2. Thecardiacoutputistheamountofbloodejectedintoaortaperminute.The
mathematicalequationtocalculatethecardiacoutputis:strokevaluexpulserate.Inthis
casetheequationwouldbe80mlx60beats/min=4800ml/min=4.8liters/min.

ClinicalInvestigation:

1.
a. Hypertensionisthetechnicaltermforhighbloodpressure.Whenapatienthas
highbloodpressure,theirarterywallsthickencausingbuildofoffattysubstances,
likecholesterolwhichthencausesplaquetosticktothesideoftheinnerwallof
theartery,whenthishappensitiscalledatherosclerosis.
b. Whenthepatientisobesetheheartworkshardertopushthebloodthroughthe
excesssurfacefatcoveringthemuscle.Ifthatobesepatientisalsosmoking
excessivetearingoccursontheinnerwallsofthearteries,plaquestartstorepair
andscabthetearingwhichnarrowsthearteries.
c. AnginaPectorisiswhenthemyocardiumisdeprivedofoxygen,yournervous
systemwillsendmessagestothebrainintheformofcrushingchestpain.This
painmaymanifestasphantompainandfeellikeitisoriginatinginthe
pectoralismajorandminor,thispainshouldneverbeignored.Ischemiaoccurs
whenthereislocalizeddecreaseinbloodflowcausingthecellsaffectedtostarve
andsuffocate.Myocardialinfarctioniswhenoxygendeprivedheartcellsand
tissuesdie,aninfarctisformed.Thepatientisreceivingcrushingchestpain
becausehisbloodcellsaremovingfasterandfasterthroughisdiseasedcoronary

artery,thebloodcellsaremovingovertheplaques.Thecellsaremovingso
quicklythattheplaquesoutermembraneiscutopen,bloodcellsquicklycloton
theopenplaque,causingthearterytobecomeevennarrower.Theflowtothe
patientheartthenbeginstoslowdown,causinghisstartingcellstosendsignalsto
hisbrain.Thispaincanbemistakenforindigestion.
d. Thecoronaryarterysuppliestheheartwithblood,ifthecoronaryarteriesare
blockedthenthepatientwillsufferlocalizedischemia.Whichthenleadstoa
heartattack.
e. IwouldrecommendCoronaryAngioplastyforthispatientbecauseitwillsenda
balloonthroughthecoronaryarterytoopenitupsoitisnotsonarrow,thenthe
heartwillbesuppliedwithoxygen.
2.
a. TheSinoatrialNodewhichistheheartsnaturalpacemaker,wheregroupsof
nervecellswheredepolarizationwavesoriginate.Depolarizationbeginsatthe
sinoatrialnodeandcontinueacrosstheentiresurfaceoftheheart.Thesinoatrial
nodeisdysfunctional,whichcausesirregularheartrhythmsthendepolarizationis
delayedandtheheartrateslows.HisEKGisirregularbecausehehasaheartbeat
thatislessthan60beatsperminute.
b. Anormalheartrateis60100beatsperminute,thispatientissufferingfrom
bradycardiabecausetheirheartrateisslowerthan60beatsperminute.
c. Bradycardiaissodangerousbecausewhenyourbiologicalpumpissluggishit
decreasesthebloodflowintothetissuesalloverthebody.Ifthelackofblood
flowisseverethebodytissueswillbegintostarveandsuffocate.Thisiscalled
Ischemia.Thiswillleadtotheoxygendeprivedcellsdyingwhichiscalledan
infarct,thisleadstomyocardialinfarctionwhichisaheartattack.
d. Iwouldrecommendapacemakersurgery
3.
a. Theheartvalvesaredamagedduringrheumaticfever,whichisuntreatedstrep
throat.Thefunctionoftheheartvalvesistomakethebloodflowintheright
direction,themitralvalveismoresignificantlyaffectedbecauseitisthemost
oxygenatedbloodsoitcanfeedthebacteriatocontinuetogrow.
b. Whentheheartsoundsareabnormalthisiscalledmitralstenosis.
c. Thesignificanceofthemitralstenosisisthenarrowingofthemitralvalvewhich
causesrestrictionsonthebloodflow.Thiscausesbloodtobackflushintothe
atria.Thiscausesthebloodtonotbeproperlyoxygenatedsothepoorly
oxygenatedbloodwillbetransportedalloverthebody.
d. Irecommendthispatientgetanartificialpigvalvetransplant.