Scorebuilders Ch.

6 CARDIAC, VASCULAR, AND PULMONARY SYSTEM ANATOMY & PHYSIOLOGY OF THE CARDIOVASCULAR SYSTEM Cross section of the anterior of the heart showing the chambers and valves.

Cardiac Conduction System The cardiac conduction system includes the __________ (____) ______ and __________ (____) ______. Each cardiac myocyte has an intrinsic ability to ____________________ and ____________________ electrical impulses from cell to cell without nerve stimulation. The _____ __________ is the normal pacemaker of the heart. Innervation of the Heart The sympathetic influence is achieved by release of ____________________ and ____________________. Sympathetic nerves stimulate the chambers to beat _______________ and with greater _______________ force of contraction. The parasympathetic influence is achieved via ____________________ release from the __________ nerve. Parasympathetic nerves _______________ the heart rate primarily through their influence on the _____ _________.

Anterior surface of the heart showing the great vessels and coronary arteries.

Coronary Veins The coronary venous circulation includes: _______________ _____________, __________ ________, and _____________ _________. The great cardiac vein, along with the small and middle cardiac veins, drain into the ______________ _________, emptying into the _____________ _____________.

Neural Reflexes and Circulatory Control Baroreceptor reflex are mechanoreceptors that detect changes in ______________. What are the reflexes known as that maintain blood pressure? _________________ What type of activation leads to increased blood pressure? ____________________ Which type of activation decreases blood pressure? _____________________ When signals are sent to the medullas cardiovascular center that inhibit parasympathetic activity leading to increased heart rate, what is this reflex known as? __________________ What reflex reacts to changes in pH status and blood oxygen tension? _________________________ The________________ maneuver increases intrathoracic pressure by forced expiration against a closed glottis.

Cardiac Cycle Write the correct term or definition. The contraction of the right and left atria pushing blood into the ventricles. ______________________ Atrial diastole: ___________________________________________________________________________________ _______________________________________________________________________________________________ Contraction of the right and left ventricles pushing blood into the pulmonary arteries and aorta. _________________ Ventricular diastole: ______________________________________________________________________________ _______________________________________________________________________________________________ Tension in the ventricular wall at the end of diastole. It reflects the venous filling pressure that fills the left ventricle during diastole: ______________ The forces that impede blood flow out of the heart, especially peripheral vasculature pressure, aorta compliance, and the mass and blood viscosity. ______________________ Stroke Volume (SV): ______________________________________________________________________________ _______________________________________________________________________________________________ Normal SV ranges from _____ to _____ L/min depending on age, sex, and activity. Cardiac Output (CO): ______________________________________________________________________________ _______________________________________________________________________________________________ Normal CO adult male at rest: _____ L/min. Women produce ____ CO than males. During exercise, it can to ______ Venous return o o The amount of blood that returns to the _______ atrium each minute Venous return must be ___ CO when averaged over time because the cardio system is closed loop. A. More B. Less C. Equal

Blood and Components of Blood ______ Leukocytes ______ Erythrocytes ______ Thrombocytes A. Blood Platelets B. Red Blood Cells C. White Blood Cells

Normal blood volume of an adult is between _____ and _____ L. Woman have _____ than men. Blood cells and platelets are suspended in this liquid component: ______________. It is important in regulating __________ _____________ and ____________________________. What enables red blood cells to bind with oxygen and have its red color? ___________________ What is the term used to describe a high red blood cell count, increased blood thickness? ______________________ o What is a pt in risk of with increased blood cell count? __________or ____________ ______________ A low number in blood platelets, termed ______________________, increases the risk of ______________________ and _________________ _________________. A high number, termed ____________________________, increases the risk of ___________________, which may result in a ________________ or ______________ _______________.

 A low number of white blood cells, termed ________________, increases the risk of ________________. An abnormal amount of white blood cells, termed ________________, can indicate _____________ or _____________. What type of WBC protects the body against infection by ingesting bacteria and debris? _______________________ Lymphocytes consists of: o T-Lymphocytes: ______________________________________________________________________ ____________________________________________________________________________________ ____________________________________________________________________________________ o B-Lymphocytes: ______________________________________________________________________ ____________________________________________________________________________________ Monocytes: _____________________________________________________________________________________ _______________________________________________________________________________________________ What WBC kills parasites, destroy cancer cells, and are involved in allergic responses? _________________________ Basophils: ______________________________________________________________________________________

ANATOMY & PHYSIOLOGY OF THE RESPIRATORY SYSTEM Ribs 1-7 are called: ___________________; Ribs 8-10: _________________; Ribs 11-12:_________________ What are the three principle muscles of respiration? o ______________________, ______________________,______________________ The upper respiratory tract consists of the: o ______________________, ______________________,______________________ The right lung has ______ lobes. The left lung has _____ lobes. There are _____ bronchopulmonary segments in the right lung and _____ segments in the left lung. The right lungs main bronchus gives rise to the superior, middle, and inferior ____________ _______________. The left lungs main bronchus divides into the superior _____________ ______________ corresponding to the upper and lower lobes. Oxygen diffuses across the _______________________ __________________ into the RBC in lung capillaries where it combines with ___________________ to be transported back to the heart. Carbon dioxide diffuses in what direction Same or Opposite? The membranous serous sac that covers the lungs is called ______________ _________________. Under abnormal circumstances, the pleural space may contain air termed __________________________, blood termed _______________________, pus or increased amounts of serous fluid, which compress the lung and cause _______________________ ________________________. The pulmonary circulation returns oxygenated blood from the lungs to the ____ atrium via the ___________ ______. Oxygen is physically dissolved in the _________ __________, and chemically combines with _________________ in RBCs. Carbon dioxide is physically dissolved in __________.

Diagram of the human lungs.

Total Volume ERV = IRV FRC VC = = = RV IC TV = = =

Total Volume

TLC =

Lung Volumes and Capacities Anatomic dead space volume (VD)

Expiratory reserve volume (ERV)

Forced expiratory volume (FEV)

Forced vital capacity (FVC)

Functional residual capacity (FRC)

Inspiratory capacity (IC)

Inspiratory reserve volume (IRV)

Minute volume ventilation (VE)

Peak expiratory flow (PEF)

Residual volume (RV)

Tidal volume (TV)

Total lung capacity (TLC)

Vital capcity (VC)

CLASSIFICATION OF HTN IN ADULTS BP Classification Normal Prehypertensive Stage 1 HTN Srage 2 HTN Arterial Blood Gas (ABG) Mean range of adult normal ABG values: pH PaCO2 PaO2 HCO3 SaO2 Acidemia Alkalemia Hypoxemia Hypoxia SBP mm Hg*

* Classification determined by higher BP category DBP mm Hg*

Angina Pain Scale Rating Description 1 2 3 4 Ankle-Brachial Index (ABI) Interpretation > 1.30 1.0 1.30 0.8 0.99 0.4 0.79 < 0.4

This chart and the following chart is on page 218 of Scorebuilders. HEMATOCRIT REFERENCE VALUES IN CLINICAL CHEMISTRY Conventional Units Serum Cholesterol Total SI Units

LDL Cholesterol

HDL Cholesterol

Triglyceride

REFERENCE VALUES IN HEMATOLOGY Conventional Units Erythrocytes Adult Males SI units

Adult Females

Leukocytes Total

Platelet count

Partial Thromboplastin Time (PTT)

Hematocrit Adult Males

Adult Females

Hemoglobin Adult Males

Adult Females

ARTERIAL BLOOD PRESSURE Korotkoff Sounds Phase I Phase II Phase III Phase IV Phase V

ARTERIAL BLOOD PRESSURE INTERPRETATION Children (ages 3-17) Normal BP Prehypertension Stage 1 HTN Stage 2 HTN Adults SBP Normal BP Prehypertension Stage 1 HTN Stage 2 HTN DBP

Auscultation of Heart Sounds Area Aortic Area Pulmonic Area Mitral Area Tricuspid Area Ausculatory area

Auscultation of Heart Sounds Interpretation S1 (lub)

S2 (dub)

S3

S4

Adult BMI

Classification

Borg Dyspnea Scale 0 0.5 1 2 3 4 5 6 7 8 9 10 ECG Waveforms and Intervals P wave

PR interval

QRS Complex

QT interval

ST segment

T wave

Sinus Node Rhythms Normal sinus rhythm

Sinus bradycardia

Sinus tachycardia

Sinus arrhythmia

Sinus arrest

Pulse Points of Selected Peripheral Arteries Artery Carotid Pulse Point

Brachial

Radial

Ulnar

Femoral

Popliteal

Posterior tibial

Dorsalis pedis

PULSE CHARACTERIZATION Characterize the heart rate Normal infant Normal child Normal adult Bradycardia Tachycardia Characterize the volume or amplitude of the pulse 3+ 2+ 1 0 Original RPE Scale Revised RPE Scale

Respiratory Rate Newborn 1 year 10 years Adult Respiratory Rhytm Normal COPD

Common Breathing Patterns Apnea

Biots

Bradypnea

Cheyne-Stokes (periodic)

Eupnea

Hyperpnea

Hypopnea

Tachypnea

TARGET HEART RATE Method 1 Percent of maximum heart rate (HRmax) Lower THR = Upper THR = Method 2 Heart rate reserve (HRR) or Karvonen formula Lower THR = Upper THR = HRmax= HRest=

Postural Drainage Positioning Apical segments Right and Left upper lobes Posterior segment Right Upper Lobe Posterior segment Left Upper Lobe Lingula Left Upper Lobe Anterior segments Right and Left Upper Lobes Right middle lobe

Superior segments Left and Right Lower Lobes Anterior basal segments Left and Right Lower Lobes Posterior basal segments Left and Right Lower Lobes Lateral basal segments Lower Lobes