KierraMcComb

Period2
4/5/16

CardiovascularSystemUnit6StudyGuide

ParagraphQuestions:
1).
Thearterieshaveathickmusclelayerthatallowsthemtowithstandthepressurecausedby
thebloodasithitsthesurfaceofthearteriolewallsandisejectedfromtheheart.Theveins
haveathinnermusclelayerandonewayvalves.Itallowsthemtodistendwhenanincreased
amountofbloodentersthem,onewayvalvesensurebloodflowbacktotheheart.Capillaries
haveasinglelayerofendotheliumandextensivebranchingsystem.Thisallowsforefficient
exchangeofgasandliquidmoleculesduetotheirthinstructureandincreasedsurfaceareato
volumeprovidedforbytheirextensivebranchingsystem.

2).
Cardiacoutputistheamountofbloodejectedintotheaortaperminute.Itisdeterminedby
theamountofbloodpercontraction(strokevolume)andthenumberofbeatsperminute(pulse
rate).
COiscalculatedby80ml(strokevolume)X60beats/min(pulserate)whichequals4,800
ml/minor4.8liters/min.Forceofcontractionisdeterminedbythelengthofthecardiacmuscle
cellswhichcanbeincreasedwithregularexercise.

Clinical1
a).
Hypertensionmeansthatyouhavehighbloodpressure.Normalbloodpressureis120/70
andthispatienthas140/90.Ifhypertensiongoesuntreatedfora1015yearperiod,itcanlead
toextensivearterialdamageandatherosclerosis.Atherosclerosisiswhenthearterywalls
thickenandhasabuildupoffattysubstanceslikecholesterol.Plaquestickstotheinsideofthe
innerwallofthearteryasthearterytriestorepair.
b).
Highbloodpressurewillcausethispatienttohaveatherosclerosisbecausethewallsare
rippingandtearingandthepatientislyingdownwhichcausesextensiveplaque.Becausethe
patientisoverweight,thehearthastoworkhardertopushthebloodthroughtheexcesssurface
fatcoveringtheheartmusclewhichworkstheheartharderandthencausesmoretearing.The
patientisaheavysmokerwhichmeansthenicotinecausesexcessivetearingontheinnerwalls
ofthearteries.It'srepairedbyextensiveplaquelikescabformationswhichnarrowsthearteries.
c).
Anginapectorisiswhenthemyocardiumisdeprivedofoxygen.Yournervoussystemwill
thensendmessagestothebrainintheformofcrushingchestpain.Ischemiaisalocalized
decreaseinbloodflowwhichwillstarveandsuffocatethecellsaffected.Myocardialinfarction
occurswhenthereisadecreaseinbloodflowtoalocalizedareaofthemyocardium,starving
andsuffocatingtheheartcells,whichleadstoaheartattack.Thepatienthasacloggedartery
withmeansthereisadecreaseofbloodflowtothemyocardiumwhichcausestheheartattack
becausetheheartoverworksitselfwhichwillcausefibrillation.

d).
Themyocardiumistheheartmuscle.Coronaryarteriessupplythemyocardiumwithblood.If
coronaryarteriesareblockedtheheartmusclecansufferlocalizedischemiaandcauseaheart
attack.
e).
Iwouldrecommendacoronaryangioplastyballoonangioplastystentbecauseitopensup
thecloggedarteriesandislessinvasivethanotherprocedures.Thecoronaryangioplastystarts
withinsertingacatheterupanarteryinthegroinorarm.Thenathinflexiblewireispassed
throughtheblockedartery.Asecondsmallercatheteristheninsertedoverthewireandasmall
balloonwilltheninflatetoreopenthearteryandflattentheblockageintothearterywall.Usually
astentwillbeplacedtoholdopenthearterytopreventnarrowing.

Clinical2
a)
.Thesinoatrialnodeisthespecificpartoftheheartthatisdamaged.Itistheheart'snatural
pacemaker.Ifthesinoatrialnodeisdysfunctional,youwillhaveirregularheartrhythms,
depolarizationwillbedelayedandheartratewillslowdown.AnEKGorECGmeasurestheflow
ofelectricalcurrentacrosstheheart.Thepatient'sECGisirregularbecausehisheartrateis
slowerthanaverage.
b)
.Bradycardiameanstheheartrateisabnormallyslow.Anormalheartrateisusually60100
beatsperminute.Thepatientissufferingfrombradycardiabecausethereheartrateislessthan
60beatsperminute.
c).
Whenyourheartissluggish,itdecreasesbloodflowtoallthetissuesinyourbody.Ifitis
reallyseverethenyourtissueswillbegintostarveandsuffocate.Bradycardiaisdangerous
becauseifyourheartisnotabletopumpbloodefficientlytoyourtissuesthenischemiaoccurs.
Ifischemiaoccursthenmyocardialinfarctionwilloccurandthepatientwillsufferaheartattack
becausetheheartoverworksitselfandgoesintofibrillation.
d)
.Thispatientneedsapermanentpacemakersurgicallyimplanted.Thiswillallowhisheart
ratetobenormalduetothenewpacemakersincethepatientswasdamaged.Apacemakerisa
smalldevicethat'splacedinthechesttohelpcontroltheabnormalheartrhythms.Ituses
electricalpulsestopromptthehearttobeatatanormalrate.Duringsurgery,asmallincisionwill
bemadebeneaththecollarbone.Thepacemakersleadswillbeinsertedintothesubclavian
veinandthreadedtotheheart.Apulsegeneratorwillbeplacedinasmallpouchandinserted
undertheskinbeneaththecollarbone.

Clinical3
a).
RheumaticfeveriscausedbyuntreatedstreptococcalA.Itthendamagestheheartvalves.
Thepurposeofyourheartvalvesistokeepbloodflowingintheproperdirection.Ifvalvesget
damaged,bloodwillbackflushintobloodpoolsatthebottomoftheventricles.Theleftsideof
theheartwhichisthemitralvalve,isunderalotofpressuresothereismoreinfectionpushedin
andmorerippingandtearingduetothehigherpressureoccurring.Backflushedpooledbloodin
theventriclescauseexcessivestrainontheventricularwallsandmakesthewallsstretchedout
andflabby.Morebloodwouldpoolinthebottomoftheheartwhichcouldcausecongestive
heartfailure.
b).
Whentheheartsoundsareabnormal,thisiscalledaheartmurmur.Restrictedbloodflow
acrossaheartvalvewillcauseanabnormalsound.

c).
Mitralstenosisisthenarrowingofthemitralvalves.Arestrictionofbloodflowkeepsthe
mitralvalvesfromclosingproperlywhennecessary.Becausethemitralvalveispartiallyopen
duringventricularcontraction,bloodwillbackflushintotheatria.Ifitisextremethebloodwill
notbeproperlyoxygenatedandpoorlyoxygenatedbloodwillbetransportedsystemicallyinto
thebodytissues.Thisiswhythepatienthasseverefatigue.
d).
Thebesttreatmentforthispatientwouldbeavalvereplacement.Avalvereplacementwould
allowproperbloodflowthroughthevalvesandallowthevalvestoopenandshutwhenneeded.
Aheartvalvesurgerywillremovethedamagedvalvebyopeningupyourchestandheart.A
newartificialvalvewillthenbesewnintoplace.