Lecture #5

Reading Chapter 10 pages 339-344 and Chapter 11 pages 360-368

Blood Pg 340 and 341

The River of Life Classified as connective tissue!! Blood contains living blood cells suspended in a nonliving fluid called plasma. Approximately 45% of the blood volume is occupied by erythrocytes, red blood cells. This percent is known as the_____________. _______ makes up the remaining 55% of blood volume.

- What is the average blood volume in a healthy male? - In a healthy female?

Plasma Leukocytes & Platelets Erythrocytes

Is blood heavier or thinner than water? Is blood thicker or thinner than water?

Blood Quiz
Blood accounts for about _________% of our total body weight? The colour of blood varies from scarlet to dull red depending upon _____________________ ______________________________________? Scarlet Red = _________________ Dull Red = ___________________

Erythrocytes (RBCs)
RBCs are shaped like jelly donuts with depressed centres. RBCs contain large quantities of hemoglobin, which is an iron bearing protein that carries the respiratory gases (O2 and CO2). Hemoglobin picks up oxygen in capillary beds of the lungs and releases it to tissue cells across other capillaries throughout the body.

Erythrocytes
RBCs wear out in every _______ days. When worn out, they are eliminated by what organs?

 Hemoglobin is made of 4 chains of protein, each bound to a red heme group. Each heme group is able to bind one molecule of oxygen, so this means that a hemoglobin molecule can transport 4 molecules of oxygen. Since each RBC contains 250 million hemoglobin molecules, then each RBC can carry approximately 1 billion molecules of oxygen!

Anemia
Means lacking blood . A decrease in oxygen carrying ability of the blood. May be the result of
1) 2) 3)

Sickle Cell Anemia

- RBC is sickle shaped - Interferes with oxygen delivery - African descent

Heart Anatomy
The human heart is about the size of a fist and weighs between 250350g. It extends from the 2nd rib to the diaphragm. 2/3 of the heart lies to the left of the midsternal line. Its apex points inferiorly towards the left hip.

 The cardiac muscle layer that forms the bulk of the heart is called the myocardium. It is the layer of the heart that actually contracts. The pericardium is the layer that encloses the double walled sac of the heart.

Heart Chambers and Vessels

The heart has four chambers, two atria (superior) and two ventricles (inferior). Walls, called septums divide the atria and the the ventricles.

Atria
The 2 atria are receiving chambers for blood returning to the heart from the circulation. The atria are relatively small and thin walled since they only need to be strong enough to push blood down into the ventricles.

Blood enters the right atrium via three veins:

1. Superior vena cava returns blood from body regions superior to the diaphragm 2. Inferior vena cava returns blood from body regions inferior to the diaphragm 3. Coronary sinus collects blood draining from the myocardium itself

Ventricles
The two ventricles make up most of the mass of the heart. The ventricles are the actual pumps of the heart and have much more muscular walls that the atria.

Ventricles
When the ventricles contract, blood is propelled out of the ventricles into the circulation. The right ventricle pumps blood into the pulmonary trunk, which takes blood to the lungs where gas exchange takes place. The left ventricle pumps blood into the aorta, which is the largest artery in the body and it takes blood to the rest of the body.

Pathway of Blood through the Heart

Blood vessels that carry blood to and from the ________ are referred to as the pulmonary circuit. Blood vessels that carry blood to and from all ____________are referred to as the systemic circuit. The right side of the heart is the pulmonary circuit pump.

Blood returning from its trip around the body is oxygen poor and carbon dioxide rich. This blood enters the right atrium and passes into the right ventricle. The right ventricle pumps this blood to the lungs via the pulmonary trunk.

 In the lungs, the blood unloads the carbon dioxide and picks up oxygen. The freshly oxygenated blood is carried by the pulmonary veins back to the left atrium. Note: Veins usually carry blood that is low in oxygen back to the heart, but pulmonary veins carry oxygen rich blood.

 The left side of the heart is the systemic circuit pump. From the left atrium, the oxygen rich blood passes into the left ventricle. The left ventricle pumps this blood into the aorta. From there the blood is transported in smaller arteries to body tissues where gases and nutrients are exchanged across the capillary walls.

 Then the blood, once again low in oxygen and high in carbon dioxide, returns through systemic veins to the right side of the heart. It enters the right atrium through the superior or inferior vena cava. The whole cycle continually repeats.

The Heart: Valves

Allow blood to flow in only one direction Four valves
Atrioventricular valves between atria and ventricles
Bicuspid valve (left) Tricuspid valve (right)

Semilunar valves between ventricle and artery

Pulmonary semilunar valve Aortic semilunar valve

Cardiac Output
Cardiac Output: The amount of blood pumped out by each ventricle in 1 minute. It is the product of Heart Rate x Stroke Volume. Stroke volume: volume of blood pumped out by a ventricle with each heartbeat.

Cardiac Output
CO = HR (75 beats/min) x SV (70ml/beat) = 5250ml/min. The normal adult blood volume is about ________________ so the entire blood supply passes through the body once each minute.

Cardiovascular Disease
CVD: disease of the heart (cardio) and blood vessels (vascular)
Heart disease the #1 killer of Canadians Teens and young adults are developing changes associated with CAD
Why?

Prevalence of Cardiovascular Disease

Statistics seen below are taken from:
www.phac-aspc.gc.ca/ccdpc-cpcmc/topics/cvd-heartstroke_e.html

Heart disease and stroke killed nearly 79,000 Cdn s in 1999 8 in 10 Cdn s possess one risk factor for CVD disease, while 11% have 3+ risk factors

http://www.youtube.com/watch?v=nEBDUhuRb8g UK 2008 MASCOT RACE FOR THE HEART

Risk Factors You CAN Control

1. Physical inactivity 2. Hypertension 3. High blood lipid levels 4. Diabetes Mellitus 5. Obesity 6. Smoking

Modifiable

QUIZ
Smoking a) b) c) d) Doesn t increase your risk of heart attack Doubles your risk of heart attack Triples your risk of heart attack Makes your breath smell great

QUIZ

1 year after quitting smoking, your risk of heart disease is decreased by: a) b) c) d) e) 10% 25% 40% 50% Not decreased as all

QUIZ

Active AND 2nd hand smoke accelerates the rate of arteries become clogged. a) True b) False

QUIZ

Smoking contains this many chemicals: a) b) c) d) >400 >300 >200 >100

QUIZ

Smoking contains this many known carcinogens: a) b) c) d) >5 >10 >20 >30

MORE Controllable Risk Factors

7) High levels of homocysteine bacteria originating in the oral cavity or caused by some B vitamins. Chronic stress can lead to unhealthy habits I.e. smoking, poor diet, underactivity, drug use, lack of sleep Female sex hormones (estrogen/progest) protect women from CV disease until menopause

8)

9)

10) Too much alcohol can lead to elevated BP, heart failure or
stroke

QUIZ
What is the definition of drinking in moderation ? 1) 2) 3) 4) 1 drink per day for women and 2 for men? 2 drinks per day for women and 4 for men? 2 drinks per day for women and 3 for men? 1 litre vodka per day for women and 2 for men?

Risk Factors You Can t Control 1. Increasing Age

Nonmodifiable

2. Heredity

3. Male Gender

QUIZ
What % of people die from heart disease at age 65 and older?

1) 2) 3) 4)

40% 65% 85% 90%

QUIZ
African Americans have: a) b) c) d) 2 times the rate of severe HTN as caucasians? 3 times the rate of severe HTN as caucasians? 4 times the rate of severe HTN as caucasians? Have the same rate of severe HTN as caucasians?

Recipe for Prevention?

1. Physical activity
Reduces body weight Reduces blood pressure Reduces LDL s (bad cholesterol) and total cholesterol Increases HDL s (good cholesterol) Increases insulin sensitivity

2. Heart-healthy nutrition
Balanced, low-fat diet, rich with fruits and vegetables

Forms of CV disease
6 major forms of CV disease:
Coronary artery disease CAD = CHD Hypertensive Disease/Hypertension (HTN) Stroke (CVA) Congenital heart disease Rheumatic heart disease: Damage to heart from strep infection or from rheumatic fever Congestive heart failure (CHF): Heart unable to pump out all blood that returns to it leading to dangerous fluid build up in the veins

Coronary Artery Disease

WHAT IS IT: Damage to coronary arteries that supply blood to the heart muscle WHAT DOES IT CAUSE: Reduction of blood (containing oxygen and nutrients) to areas of the heart will often lead to angina, SOB on exertion or MI. WHAT CAUSES CAD: Atherosclerosis (cholesterol & lipid plaque deposition in arteries) causes arteries to narrow

ANGINA PECTORIS
Angina caused by CAD Chest pain that is a WARNING SIGN of impending MI. Pain is due to lack of oxygen reaching the heart Symptoms: pressure or discomfort that radiates to throat, jaw, back or arms; mild indigestion to severe pain in chest.

ANGINA PECTORIS
Occurs with exercise, emotional stress Treatment: goes away with rest and/or nitroglycerin within 3-5 minutes. The greater the blockage, the greater the pain.

ANGINA vs MI
Angina: Chest pain that occurs when heart doesn t get enough blood and O2 r/t CAD. Most common #1 sign of HD for women. MI: A complete blockage in CA cuts off blood supply to the heart. The heart muscle is damaged and if part of it dies, it doesn t pump well. Most common #1 sign of HD in men. What happens if women have MI as their 1st symptom of HD?

Hypertension Silent Killer!

1/3 of people with HTN are often unaware that they have the condition cannot feel their blood pressure rise High BP causes arteries & arterioles to become less elastic which decreases dilation under stress. WHAT CAUSES HTN: Atherosclerosis & Arteriosclerosis Those who are aware often don t take measures to control it => diet, decrease in alcohol consumption, physical activity, relaxation, drugs 1 in 5 Canadian adults have HTN

Hypertension Silent Killer

Average blood pressure for healthy adults is 120/80 mm Hg Systolic pressure blood pressure against the vessel walls when the heart contracts Diastolic pressure blood pressure against the walls when the heart relaxes (between heartbeats) Hypertension is a consistently elevated blood pressure of over 140/90 mmHg.

Prehypertension Hypertension Hypertension Stage 1 Stage 2 Systolic 120 - 139 140 - 159 160 or more Diastolic 80 - 89 90 - 99 100 or more

STROKE
WHAT IS IT? If an artery supplying blood to the brain bursts or becomes blocked and part of the brain is permanently damaged, this is called a stroke.

WHAT CAUSES STROKE? Atherosclerosis

STROKE
RISK FACTORS YOU CAN CHANGE: Smoking, smoking and the pill + >35yr, physical inactivity, DM, CAD, hypercholesterolemia, alcohol abuse, overweight, stress, homocysteine levels.

STROKE
Possible debility occurring from stroke:  Can affect everything we say, do and think  Can affect ability to move and coordinate movement.  Can affect ability to think, remember, understand, plan, reason or problem solve.  Can affect ability to communicate, read, write.  Can affect personality, emotions, behaviour.

Signs of stroke
Sudden weakness or numbness in face, arm or leg of one side of body. Temporary loss of speech/trouble in speaking/understanding speech Temporary loss of vision often in one eye. Dizziness, unsteadiness, falls. TIAs are warning signs days/wks/mths before more severe event.

Heart Attack See pg. 222

WHAT IS A HEART ATTACK? When the blood supply to the heart is slowed or stopped because of a blockage, a heart attack occurs. __________________, the narrowing of coronary arteries due to plaque buildup causes >90% of MIs. The length of time the blood supply is cut off determines the amount of heart damage.

Am I Having a Heart Attack?

Tight ache, heavy, squeezing pain/discomfort in center of chest Chest pain that radiates to shoulder, arm, neck, back, jaw Anxiety Sweating/cold, clammy skin Nausea/vomiting Shortness of breath Dizziness, fainting, loss of consciousness

DASH
Diet plan created after Dietary Approaches to Stop Hypertension studies were completed. The DASH study found that a diet low in sodium & fat & high in fruits, veg, & low-fat dairy reduced BP.

Other Heart Health Tips

Eat a healthy diet with reduced sat fat and cholesterol Add oats and fibre (25-35g/day) to your diet Replace butter/lard/shortening with soft nonhydrogenated margarine Stop smoking Watch your weight Monitor BP