the circular system, AKA the cardiovascular system has three major components:
heart (pump)
blood vessels (pipes)
blood (fluid)
tissue that generates electrical impulses that are conducted rapidly to other cells of the heart
conductive tissue
tissue that allows the heart muscle to contract when stimulated by the electrical impulses from the conduction system
contractile tissue
conductive cells in three areas of the heart where electrical impulses are created automatically, independent of the automatic nervous system of the body.
automaticity
pacemaker site in the upper portion of the right atrium. known as the primary pacemaker of the heart, generates the impulse that triggers the rest of the heart to contract.
sinoatrial node SA
secondary pace maker located at the crux, the point where the walls that separate the upper and lower chambers and the left and right sides of the heart all cross.
atrioventricular (AV) node - only creates impulse if the sinoatrial node fails.
pacemaker site that is widely distributed in the conduction system of the ventricles. these fibers deliver the impulse to the working cells of the heart.
purkinje fibers - if both pacemaker sites fail, the purkinje network can also initiate an impulse to maintain some ventricular contraction.
although the hear initiates electrical impulses on its own, the overall heart rate and force of contraction can be influenced by the ___________.
automatic nervous system - the sympathetic branch
the largest veins within the body
inferior/superior vena cava
some pulmonary (lung) diseases, such as emphysema, pulmonary vessels are compressed or narrowed. increased pressure makes it more difficult for the _______ to pump blood out. high pressure over time leads to weakening and eventual failure called ________.
right ventrical
right-sided or right ventricular heart failure
high aortic pressure (hypertension) the _______ will begin to weaken and fail. or if there is a blockage of the coronary (heart) artery. this may lead to __________
CHF
left-sided or left ventricular heart failure
the first two arteries that originate off the aorta. they branch off from the base of the aorta and are responsible for supplying the heart with a rich supply of oxygenated blood.
coronary arteries
________ is that part of blood which is similar in composition with plasma but exclude clotting factors of blood. Fibrinogen is a protein that is involved in blood coagulation.
Serum
the formed elements in the liquid portion of the blood; the serum:
red/white blood cells and platelets
the blood clot that is formed by platelets is called a _____.
thrombus
disk-shaped elements in the blood that are fragments of cells from the bone marrow
platelets
a protein responsible for activating the formation of a clot
thrombin
strands that are responsible for making the clot stronger
fibrin
a thrombus may form within a coronary artery at a site where _______ (a fatty deposit) as built up.
plaque
simultaneous atria contraction as a result of electrical impulse
atrial systole
simultaneous ventricle contraction
ventricular systole
cardiac rhythm abnormality called _____.
dysrhythmia
the first electrical component of mechanical contraction in which electrical charges of the heart muscle change from a positive to negative and cause heart muscle contraction
depolarization
the second electrical component of mechanical contration in which electrical charges of the heart muscle return to a positive charge and cause relaxation of the heart muscle.
repolarization
this is the first waveform of the EKG and represents the depolarization (contraction) of the atria
P wave
this is the second waveform and represents the depolarization (contraction) of the ventricles and the main contraction of the heart
QRS complex
this is the third waveform and represents the repolarization (relaxation) of the ventricles
T wave
uncoordinated firing of electrical ventricular impulses called _________
premature ventricular complexes (PVCs)
shows up on EKG as steep peaks and valleys that are very close together
V-Tach
shows up on EKG as small, uneven, disorganized peaks and valleys.
V-Fib
amount of pressure exerted against the arterial wall during circulation
BP
the chief result of inadequate circulation is a state of profound depression of cell perfusion, called _______.
SHOCK - hypoperfusion
hypoperfusion (shock) can result from:
low blood volume
insufficient pumping action
or dilated vessels
a condition that causes the smallest of arterial structures to become stiff and less elastic.
arteriosclerosis - “hardening of the arteries”
a disease of the arteries characterized by the deposition of plaques of fatty material on their inner walls.
atherosclerosis
a buildup of fatty deposits on the inside of the oronary blood vessels. narrowing of the coronary blood vessel increases the amount of blood flow to the distal heart muscle
Coronary Artery Disease (CAD)
a group of signs and symptoms resulting from any of a variety of conditions that can affect the heart in which the coronary arteries are narrowed or occluded by fat deposits, clots, or spasm.
acute coronary syndrome (ACS)
two conditions that are part of any acute coronary syndrome are _____ _______ and ______ _______.
unstable angina and myocardial infarction
cardiac cell hypoxia - a state in which there is inadequate delivery of oxygen to the heart muscle
myocardial ischemia
myo - heart
cardio - heart
ischemia - deficient supply of oxygenated blood
a condition marked by severe pain in the chest, often also spreading to the shoulders, arms, and neck, caused by an inadequate blood supply to the heart
(literally means, “pain in the chest”) commonly associated with coronary artery disease
angina pectoris
generally, ______ occurs during periods of stress, either physical or emotional. once the stress is relieved or removed or the Pt rests, the pain will usually go away.
angina pectoris
pain usually felt under the sternum and may radiate to the jaw, down the arm, to the back, or to the epigastrium (upper center region of the abdomen.) pain usually lasts from 2-15 min. - usually Rx nitro
angina pectoris
signs/symptoms:
steady discomfort, usually located in the center of chest but may be more diffuse throughout the front of the chest.
discomfort that is usually described as pressure, tightness, aching, crushing, or heavy
discomfort that may radiate to the shoulders, arms, neck, jaw, back, or epigastric region (upper center abdm)
cool, clammy
anxiety
dyspnea
diaphoresis
n/v
complaint of indigestion
complaint of indigestion
angina pectoris
occurs when a portion of the heart muscle dies because of the lack of an adequate supply of oxygenated blood.
acute myocardial infarction (AMI)
“heart attack”
infarction definition
death of tissue
medications called _____ and _____ agents, commonly referred to as “clot busters” may possibly dissolve the clot, reopen the coronary artery, and restore perfusion to the ischemic heart muscle.
fibrinolytics and antiplatelet
S/S: chest discomfort radiating to jaw, arms, shoulders, and back anxiety dyspnea sense of impending doom diaphoresis n/v light-headedness or dizziness weakness
AMI
occurs when a weakened section of the aortic wall, usually resulting from atherosclerosis, begin to dilate and balloon outward from the pressure exerted by the blood flowing through the vessel. may exist for a long time with no symptoms or signs that the Pt is aware of, then rupture suddenly, causing rapid and fatal internal bleeding.
aortic aneurysm
occurs when there is a tear in the inner lining of the aorta and blood enters the opening and causes seperation of the layers of the aortic wall.
dissection
restoration of blood to an area of tissue that was once ischemic from low blood flow or occlusion of a vessel is called ______.
reperfusion.
S/S:
normal to high BP
inspiratory rales
no JVD or peripheral edema
left ventricular failure
S/S:
JVD
peripheral edema
clear breath sounds
right ventricular failure
medical diagnosis that refers to the condition in which there is a buildup of fluid in the body resulting from the pump failure of the heart.
CHF
S/S: dyspnea tachycardia difficulty breathing supine sudden waking at night fatigue on any type of exertion anxiety tachypnea diaphoresis legs, feet, arms, hands dangling pale, cool, clammy chest discomfort cyanosis agitation and restlessness edema crackles/rales JVD distended, soft, spongy abdm
CHF
diuretic medication that is used to reduce the amount of fluid in the body
“water pill” - as referred to by the Pt
a severe, accelerated episode with a systolic pressure greater than 160 mmHg and/or a diastolic blood pressure greater than 94 mmHg.
hypertension
S/S: strong, bounding pulse skin that may be warm, dry, or moist severe headache ringing in the ears N/V elevated BP resp distress chest pain seizures focal neural deficits indications of organ dysfunction (stroke, heart attack, pulmonary edema) possible nose bleed
hypertensive emergency
potent vasodilator that works in seconds to relax the muscles of the blood vessel walls. dilates arteries, increasing the blood flow through the coronary arteries and O2 supply to the heart muscle and decreasing the workload of the heart
nitroglycerin
represents the time it takes the hearts electrical impulses to travel from the atria to the ventricles
from the beginning of the P wave to the beginning of the QRS complex
PR interval (as referred to as the PRI)