Cardiovascular System Notes Essay Sample free essay sample

The importance of the cardiovascular system can non be overstated. This is one system that pupils often know something approximately. at least from a plumbing point of view. but they frequently don’t wholly understand the complexness of the system and the magnitude of its undertakings. An indispensable constituent of presentation of the stuff is so to sketch in item the function of the cardiovascular system and its significance to all other organic structure systems. This chapter begins with the cardinal information about the bosom by first discoursing anatomy and so traveling on to the more complex physiology. The subdivision on anatomy covers the beds of the bosom every bit good as its Chamberss. valves. and the vass through which blood moves in and out of its assorted parts. A subdivision on cardiac circulation explains the manner the bosom itself is supplied with oxygen-rich blood. The structural and mechanical features of the bosom are followed by a treatment of its alone electrical intrinsic activity. The conductivity system is outlined and relevant homeostatic instabilities are discussed. Concepts related to the electrical conductivity system of the bosom are ever hard to hold on. and cardinal presentations and activities help solidify the students’ apprehension. Following the subdivision on the bosom itself is the part of the chapter covering with the blood vass. Arteries. venas. and capillaries are compared for their structural and physiological similarities every bit good as their differences. Name callings of the major vass are given. as the path of blood is traced from its point of issue from the bosom through the aorta to all parts of the organic structure and back to the bosom via the superior and inferior vein cavae. A expression into the assorted mechanisms involved in blood force per unit area precedes a treatment of the particular circulatory paths that supply the encephalon. liver. and developing foetus. Finally. the developmental facets of circulation are con sidered. SUGGESTED LECTURE OUTLINE I. THE HEART ( pp. 362–374 )A. Anatomy of the Heart ( pp. 362–368 )1. Location and Size2. Coverings and Wall3. Chambers and Associated Great Vesselsa. Atriab. Ventriclesc. Superior and Inferior Venae Cavaed. Pulmonary Arteriese. Pulmonary Veinsf. Aorta4. Valvesa. Atrioventricular ( AV ) Valvesb. Semilunar Valves5. Cardiac Circulation6. Homeostatic Imbalancesa. Endocarditisb. Angina Pectorisc. Myocardial Infarct B. Physiology of the Heart ( pp. 368–374 )1. Intrinsic Conduction System of the Heart: Puting the Basic Rhythma. Intrinsic Conduction Systemb. Homeostatic ImbalancesI. Heart Blocktwo. Ischemiathree. Fibrillation 2. Cardiac Cycle and Heart Soundsa. Mid-to-Late Diastoleb. Ventricular Systolec. Early Diastoled. Homeostatic Imbalancesi. Mutters3. Cardiac Output ( CO )a. Regulation of Stroke Volume ( SV )B. Factors Modifying Basic Heart Rate ( HR )c. Neural ( ANS ) Controlsd. Physical Factorse. Homeostatic Imbalanacesi. Congestive Heart Failure ( CHF )two. Pulmonary EdemaII. BLOOD VESSELS ( pp. 374–395 ) A. Microscopic Anatomy of Blood Vessels ( pp. 374–377 )1. Tunics2. Structural Differences between Arteries. Veins. and Capillaries3. Homeostatic Imbalanacesa. Varicose Veinsb. Thrombophlebitisc. Pulmonary Embolism B. Gross Anatomy of Blood Vessels ( pp. 378–386 )1. Major Arteries of the Systemic Circulation ( Figure 11. 12 )a. Arterial Branches of the Ascending AortaI. Right and Left Coronary Arteriesb. Arterial Branches of the Aortic Archi. Brachiocephalic Trunktwo. Left Common Carotid Arterythree. Left Subclavian Arteryc. Arterial Branches of the Thoracic Aortai. Intercostal Arteriestwo. Bronchial Arteriesthree. Esophageal Arteriesfour. Phrenic Arteriesd. Arterial Branches of the Abdominal Aortai. Celiac Trunktwo. Superior Mesenteric Arterythree. Nephritic Arteriesfour. Gonadal Arteriesv. Lumbar Arteriessix. Inferior Mesenteric Arteryseven. Common Iliac Arteries 2. Major Veins of the Systemic Circulation ( Figure 11. 13 )a. Veins Draining into the Superior Vena CavaI. Radial and Ulnar Veinstwo. Cephalic Veinthree. Basilic Veinfour. Subclavian Veinv. Vertebral Veinsix. Internal Jugular Veinseven. Brachiocephalic Veineight. Azygos Veinb. Veins Draining into the Inferior Vena Cavai. Anterior and Posterior Tibial Veins and Fibular Veintwo. Great Saphenous Veinsthree. Common Iliac Veinsfour. Gonadal Veinsv. Renal Veinssix. Hepatic Portal Veinseven. Hepatic venas 3. Particular Circulations ( Figures 11. 14–11. 17 )a. Arterial Supply of the Brain and the Circle of Willisb. Fetal Circulationc. Hepatic Portal CirculationC. Physiology of Circulation ( pp. 387–395 ) 1. Arterial Pulsation2. Blood Pressurea. Blood Pressure GradientB. Measuring Blood Pressurec. Effectss of Assorted Factors on Blood Pressurei. Nervous Factors: The Autonomic Nervous Systemtwo. Nephritic Factors: The Kidneysthree. Temperaturefour. Chemicalsv. Dietd. Variations in Blood Pressure 3. Capillary Exchange of Gases and Foods4. Fluid Motions at Capillary BedsIII. DEVELOPMENTAL ASPECTS OF THE CARDIOVASCULAR SYSTEM ( pp. 395. 397 )A. Embryonic DevelopmentB. Congenital Heart DefectsC. ExerciseD. Coronary Artery Disease Cardinal TERMS aortaaortal archaortal semilunar valvearteriasarteriolasgo uping aortaatriaatrioventricular ( AV ) nodepremolar ( mitral ) valveblood force per unit areabrachial venabradycardiapackage subdivisionscardiac end product ( CO )cardiac venas cardiovascular systemchordae tendineaecommon carotid arteriacommon hepatic arteriacoronary arteriascoronary arteria diseasecoronary fistuladiastolic force per unit areaductus arteriosusductus venosusendocardiumvisceral pericardiumfemoral arteriafemoral vena pericardiumstomachic venagreat saphenous venabosom rate ( HR )bosom soundshepatic portal venahepatic venashigh blood force per unit areahigh blood pressurehypotension inferior vein cavainternal carotid arteriasinternal jugular venainterstitial fluid ( weave fluid )fringy arteriasaverage cubital venamediastinummyocardiumpacesetterforce per unit area pointspneumonic arteriaspneumonic circulationpneumonic semilunar valvepneumonic venaspulsation Purkinje fibresradial arteriaradial venanephritic arteriasnephritic venasright and left coronary arteriassemilunar valvessinoatrial ( SA ) nodesubclavian arteriasubclavian venasuperior vein cavasystemic circulationsystolesystolic force per unit area tachycardiathoracic aortatricuspid valvevalvesvascular systemvasoconstrictionvenasventriclescritical marks LECTURE HINTS1. Descriptively present the cardiovascular system as the great transit system of the organic structure. similar to a mail bringing system. that non merely carries the O and C dioxide people normally relate to it. but besides delivers foods. removes toxic wastes. conveys heat. and transports the myriad of endocrines that are indispensable to all regulative maps. Cardinal point: Pulling an analogy between the cardiovascular system and a mail bringing system helps pupils gestate the work of this intricate system. 2. Although the left side of the bosom generates more force per unit area than the right side. about the same volume of blood is ejected from each side per round. Ask pupils to believe about what would go on if this were non the instance. Follow up with a treatment on congestive bosom failure. Cardinal point: In CHF. blood pumped to the lungs by the right ventricle does non maintain gait with blood pumped around the system by the left ventricle. Fluid builds up in the lungs. taking to the prevailing symptom of CHF. which is take a breathing trouble. 3. Students may remember that the mean blood volume of a healthy grownup male is 5–6 litres. All blood by and large circulates wholly through the organic structure in about one minute while at remainder.Cardinal point: 5–6 liters/minute is the mean resting cardiac end product for an mean healthy grownup male.4. Compare the body’s self-acting pacesetter. the SA node. to an unreal pacesetter in map and public presentation. Describe the 1. 000. 000 or more times each hebdomad that the heart’s pacesetter fires and causes it to pump blood around the system and back once more to the bosom. Cardinal point: Students are normally rather surprised to larn that worlds have a constitutional pacesetter that is really much more efficient. longer permanent. and more versatile than an unreal one.5. Stress that the lone map of the valves of the bosom is to guarantee the one-way flow of blood. Explore with the pupils the effects of incompetent or stenosed valves. Cardinal point: This provides an chance to distinguish between the assorted types of mutters and their etiology.6. Discourse the chordae tendineae. or â€Å"heart strings. † Explain their map as similar to the corsets of an umbrella. designed to maintain the bosom valves from turning inside out under utmost force per unit area. Cardinal point: The mention to something â€Å"tugging at their bosom strings† gives pupils a concrete illustration of the manner in which anatomy. peculiarly of the bosom. has an established topographic point in our linguistic communication and literature. 7. Sketch the singular technology involved in the design of the blood vass. which allows them to absorb the force per unit area emitted from the bosom with each round and to return blood back to the bosom. normally on an acclivitous class against the changeless pull of gravitation. Cardinal point: In distinguishing between arterias. venas. and capillaries. stress that the construction of each type of vas is related to the differing sums of force per unit area they must each absorb from the bosom. every bit good as their several functions in blood conveyance. 8. A basic misconception pupils have is that arterias carry oxygenated blood and venas carry deoxygenated blood. While this is normally true. the bosom is a noteworthy exclusion. Remind pupils that arterias are defined as vass that carry blood off from the bosom and venas carry blood toward the bosom. Cardinal point: The pneumonic arterias carry deoxygenated blood from the right side of the bosom to the lungs. and the pneumonic venas return oxygenated blood to the left side of the bosom.9. Veins are more superficial and are occluded when a phlebotomist applies a compression bandage that enables venas to lift as blood is still being pumped distally through arterias running underneath the compression bandage. Cardinal point: Veins are low force per unit area vass and need less strength. support. and snap than the arterias.10. In discoursing foetal circulation. point out that all foetuss have a â€Å"hole in their bosom. † and in fact two holes. which allow circulation to be routed around the non-inflated lungs. Explain the fact that if these â€Å"holes† don’t near at or shortly after birth. so surgical closing is required. normally to rectify a PDA ( patent ductus arteriosus ) . Cardinal point: Again. this is an illustration of a lingual mention that has an existent anatomic footing. which pupils find fascinating.11. Discourse the blood supply to the bosom itself. indicating out that despite the fact that blood fills all the Chamberss of the bosom. the bosom can non nurture itself from the interior. Explain coronary arteria disease ( CAD ) and its common sequelae. the coronary arteria beltway transplant ( known as CABG and pronounced â€Å"cabbage† ) . Cardinal point: It is of import for pupils to acknowledge that the bosom must be infiltrated with its ain vascular supply in order to have the O and foods necessary for its endurance. Any obstruction in the vascular flow will take to weave harm. ensuing in a myocardial infarction or â€Å"heart onslaught. † Note the difference between unfastened bosom surgery ( valve replacing. etc. ) and unfastened thorax surgery ( CABG ) . 12. Differentiate between coronary artery disease and arterial sclerosis. indicating out that â€Å"athero† means xanthous. fatty plaque. and discourse the function of cholesterin in its development. Indicate out that there is no such thing as â€Å"good† and â€Å"bad† cholesterin. and that we really need both types within our organic structures for transit intents. Explain that it is merely a affair of ratio. or the proportion of low-density lipoids to high. Cardinal point: This is a good clip to chase away the impression of good and bad cholesterin. and alternatively to assist pupils understand that moderateness is cardinal to a healthy cardiovascular system. Indicate out that the lymphatic system dumps fats into the vena cavae instantly before blood returns to the bosom. 13. Describe the assorted methods that can be used to handle coronary artery disease ( e. g. . stents. angioplasty ) .Cardinal point: Students are by and large familiar with the construct of blocked blood vass. but are frequently incognizant of interventions other than beltway surgery. 14. Discuss Olestra. the fat replacement. and its physiological effects on the organic structure. including the blood vass.Cardinal point: Through advertisement. pupils are normally rather familiar with nutritionary replacements. such as fat and sugar replacements. but they frequently don’t understand the mechanisms at drama and the possible side effects from the usage of these replacements. 15. Discuss smoke and its cardiovascular deductions. including arteriovascular inadequacy. ischaemia. intermittent lameness with attendant leg hurting and spasms. thrombus formation. and powerlessness. Cardinal point: The impact of smoking on the cardiovascular system is so important that it is of import to integrate a treatment of the smoking-related upsets into the category presentation.16. Present information on deep vena thrombi ( DVTs ) and their incidence related to bed remainder and/or a sedentary life style. Explain their connexion to long distance travel. birth control pills. and genetic sciences. Indicate out the sarcasm that the intervention for DVTs includes bed remainder along with anticoagulant medicine. Cardinal point: This treatment helps pupils gain position on possible serious homeostatic instabilities of the venous system and their causes. 17. Discourse the correlativity of Group A streptococcic infections such as â€Å"strep throat† to rheumatic febrility and arthritic bosom disease. which can take to mitral valve harm.Cardinal point: Students are normally familiar with the unwellness described as â€Å"strep pharynx. † but frequently are incognizant of its serious branchings.18. Explain the etiology and pathology associated with high blood pressure. along with methods of bar and intervention options.Cardinal point: Since high blood pressure is one of the major hazard factors in coronary arteria disease. shot. congestive bosom failure. and kidney failure. presentation of the causative factors and current thought on bar and intervention are of import constructs for pupils to understand. Excessive salt in the diet retains more fluid within the vass and therefore additions blood force per unit area internally. as compared to external stressors that addition blood force per unit area externally. 19. Explain that the intrinsic electrical conductivity can be picked by ECG electrodes placed anyplace on the external tegument surface.Cardinal point: Electrical activity goes from the organic structure to the machine and bosom paddles placed on an exigency patient are designed to halt the bosom and hopefully enable normal autorhythmicity to take over. Explain that a savior would non desire to give a patient merely pulled out of a swimming pool several hundred Js of energy if the deck is non dry. 20. Differentiate between myocardial infarction. shot. pneumonic intercalation. and thrombi.Cardinal point: Students frequently do non recognize that these footings can all be related to one another since they refer to blockage of blood vass in different parts of the organic structure. 21. Explain the difference between an aneurism and a ruptured aneurism.Cardinal point: The media frequently does non separate between these two footings. so pupils can acquire confused as to their effects and intervention.22. Describe all of the different physical. chemical. and neurological factors that can modify bosom rate.Cardinal point: Explain to pupils that a broad assortment of factors located all over the organic structure can play a function in finding bosom rate. CLASSROOM DEMONSTRATIONS AND STUDENT ACTIVITIESClassroom Presentations:1. Film ( s ) or other media of pick.2. Show a picture of a beating bosom. ideally with bosom sounds. Stress that while the right side of the bosom is a pneumonic pump and the left side a systemic pump. both atria contract at the same clip and both ventricles contract at the same clip. 3. Use a dissectible bosom theoretical account to demo bosom construction.4. Use a dissectible human trunk theoretical account to indicate out the major arterias and venas of the organic structure.5. Show the chordae tendineae. the â€Å"heart strings. † on a cleft bosom.6. Show a chart of assorted types and classs of bosom mutters. explicating that some of them are considered nonpathological and are simply â€Å"functional† ( related to low fluid volume. etc. ) .7. Play a recording of normal and unnatural bosom sounds to attach to your presentation of valve map and malfunction. ( Interpreting Heart Sounds is available for loan from local chapters of the American Heart Association. ) 8. Show the recording of an ECG.9. Bring in a trial tubing or show images of blood in a trial tubing incorporating high fat content. Indicate out that at times the fat content is so high. you can really see drifting bunchs of fat in the specimen. 10. Have a invitee talker from the American Heart Association talk to the category about the hazard factors and taking causes of bosom disease.11. Bring in an old mechanical pacesetter and demo its arrangement on the chest wall under the tegument. Compare the heart’s ain pacesetter. the SA node. to the deep-rooted mechanical device. explicating that unreal pacesetters maintain a set pulsation rate and are non regulated by increased or reduced activity. 12. Show the usage of defibrillators. including AEDs. and explicate their map in cardiac deliverance. Besides discuss CPR as it relates to bosom map. 13. Show pictures of and depict â€Å"pitting† hydrops. Explain how fluid can make full the interstitial infinites to such a grade that an indenture will remain when the tegument is pressed with the index finger. 14. Obtain man-made beltway transplant stuff and compare it in usage and effectivity to the preferable saphenous vena.15. Describe the different symptoms of impending myocardial infarction ( bosom onslaught ) in work forces and adult females. Supply statistics demoing the addition in diagnosing of MI in adult females.16. Show a picture of a bosom operation and the importance of a perfusionist. who assists the bosom sawbones.17. Have a phlebotomist speak to the category about locations to pull blood in kids and in grownups. Have the talker explain the troubles in pulling blood when the patient is corpulent or dehydrated. and the methods they use during those state of affairss. Student Activities: 1. Show how apical and radial pulsations are taken. and have pupils pattern on each other.2. Show the location of the radial. brachial. carotid. femoral. popliteal. and pedal pulsations. Have pupils locate several of their ain and compare their rate and beat. Discourse the clinical deductions of weak or absent pulsations in the appendages. 3. Show the auscultatory method of taking blood force per unit area and supply sphygmomanometers and stethoscopes for pupils to pattern on each other.4. Ask pupils to convey in a day-to-day record of their blood force per unit area in the unsloped and supine places for a specified period of clip to chart and compare. 5. Supply simple drawings of a cleft bosom and have the pupils follow the way of blood as it flows through the assorted Chamberss. Ask them to utilize ruddy and bluish pencils to distinguish between oxygenated and deoxygenated blood. Besides ask them to label the Chamberss. valves. septa. and other distinguishing characteristics. 6. Have pupils run in topographic point or make leaping knuckleboness for 3 proceedingss. so hold them enter their radial pulsation ( indicating out that a radial pulsation is ever thumb side ) . Have them continue to take their pulsation every 30 seconds for 5 proceedingss. so graph the consequences. Indicate out that a steep diminution in the first minute or so indicates rapid recovery by the bosom. 7. Supply the pupils with a diagram of the major blood vass for labeling.8. Have pupils enter their salt intake for one hebdomad. Supply them with a chart demoing salt content in nutrients and besides reexamine the usage of nutrient labels. Have them graph their day-to-day salt consumption and compare it to the FDA bound. Discuss which foods. like milk merchandises and pickles. are surprisingly high in salt content. 9. Promote pupils to obtain CPR preparation and offer excess recognition for certification of enfranchisement during the semester.10. Have pupils plan an probe to larn more about bosom rate and bosom sounds. Have them select a job. such as the relationship of age or weight. and find its consequence on bosom rate and bosom sounds. Have them explicate a testable hypothesis and list the stairss for the probe. including the choice of appropriate equipment and engineering. They should implement the probe. record the informations in a chart. and draw decisions from that information. 11. Have pupils plan an probe to find the consequence of clip of twenty-four hours on a selected critical mark. They should explicate a testable hypothesis and list the stairss in the probe to prove this hypothesis. including the equipment and engineering that would be used. With your blessing. pupils should so implement their program utilizing their schoolmates as topics. They should enter the informations and draw decisions about the consequence of clip of twenty-four hours on the selected critical mark. 12. Have your pupils answer the undermentioned inquiry to show their apprehension of how to choose appropriate equipment and engineering: Mr. Wright is working in his garden. Suddenly he experiences tightness across his thorax and knows this is non a good mark. He uses his cell phone to name 911. and remainders until the ambulance arrives. The EMT will measure his status and put electrodes across his thorax to mensurate his bosom action. What is the name of this medical equipment? A. Electrocardiograph*B. IVC. ThermometerD. Ophthalmoscope13. Have a pupil perform an incremental stationary bike trial and record bosom rate and blood force per unit area from remainder to exhaustion. Note how systolic blood force per unit area increases at higher exercising work loads and diastolic blood force per unit area remains about the same ( of import because diastole is when the bosom is able to feed itself ) . 14. Where possible. bring pupils to a learning infirmary to detect unfastened bosom surgery and/or bosom organ transplant.15. Have pupils dissect a cow’s bosom both sagittally and transversally to detect the differences in valves. Chamberss. wall thickness. and right/left sides. Answers TO END OF CHAPTER REVIEW QUESTIONS Questions appear on pp. 399–401Multiple Choice1. vitamin D ( Figure 11. 3 )2. B ( p. 372 )3. vitamin D ( p. 368 ; Figure 11. 6 )4. a. degree Celsius ( pp. 369–371 )5. degree Celsius ( p. 370 )6. a. degree Celsius ( p. 371 )7. B ( p. 362 )8. a. degree Celsius ( p. 374 ; Figure 11. 9 )9. vitamin D ( p. 378 ; Figure 11. 12 )10. a ( Figure 11. 12 )11. B ( p. 383 )12. a. c. vitamin D ( pp. 378. 380 )13. B ( pp. 392–393 )14. a. b. degree Celsius ( p. 397 )15. degree Celsius ( pp. 372–373 )16. B ( p. 362 )17. vitamin D ( pp. 365–366 ; Figure 11. 2d )18. B ( p. 366 ; Figure 11. 2d )19. B ( pp. 363–364 ; Figure 11. 2b ) Short ANSWER ESSAY20. See Figure 11. 2. ( pp. 363–364 )21. Right atrium to right ventricle to pulmonary bole to compensate and left pneumonic arterias to pneumonic capillaries of the lungs to compensate and left pneumonic venas to left atrium of the bosom. Pulmonary circuit or pneumonic circulation. ( p. 365 ; Figure 11. 3 ) 22. The pericardiac ( serous ) fluid acts as a lubricator to diminish clash as the bosom beats. ( p. 363 )23. Systole: Time period of contraction of the bosom ( normally refers to ventricular contraction ) . Diastole: Time period of relaxation of the bosom muscular structure. Stroke volume: The sum of blood pumped out by a ventricle with each contraction. Cardiac rhythm: The clip for one complete pulse. from the beginning of one systole to the beginning of the following. ( pp. 369. 372 ) 24. The bosom has an intrinsic ability to crush ( contract ) . which is different from all other musculuss in the organic structure. Whereas the nervous system may increase or diminish its rate. the bosom continues to crush even if all nervous connexions are cut. ( p. 368 ) 25. SA node ( pacesetter ) . AV node. AV package ( package of His ) . bundle subdivisions. Purkinje fibres. ( p. 368 )26. Activity of the sympathetic nervous system ( as during physical or emotional emphasis ) . surplus or deficiency of certain critical ions. increased temperature. endocrines ( adrenaline. tetraiodothyronine ) . sudden bead in blood volume. age. gender. and exercising. ( p. 368 ) 27. Tunica intima: A individual bed of squamous epithelial tissue ; provides a smooth. friction-reducing liner for the vas. Tunica media: A in-between bed. dwelling of smooth musculus and connective tissue ( chiefly elastic fibres ) . The elastic fibres provide for stretching and so inactive kick of vass near to the bosom. which are subjected to coerce fluctuations ; the smooth musculus is activated by the sympathetic nervous system when vasoconstriction ( and increases in blood force per unit area ) is desired. Tunica externa: The outermost bed. made of hempen connective tissue ; fundamentally a protective and back uping bed. ( pp. 374–376 ) 28. Capillary walls are basically merely the adventitia intima ( endothelium plus the basement membrane ) ; therefore. they are extremely thin. ( p. 376 )29. Arteries are much closer to the pumping action of the bosom and must be able to defy the force per unit area fluctuations at such locations. Veins. on the distal side of the capillary beds of the tissues. are basically low-pressure vass that need less strength/support/ snap than make arterias. ( p. 376 ) 30. The presence of valves. the milking action of skeletal musculuss against the venas as the musculuss contract. the respiratory pump ( force per unit area alterations in the thorax during take a breathing ) . ( p. 376 )31. Pneumonic arterias carry oxygen-poor blood and pneumonic venas carry oxygen-rich blood. Umbilical arterias carry oxygen-poor blood from the foetus and the umbilical vena carries the most oxygen-rich blood to the foetus. ( pp. 365. 383–384 ) 32. Right carpus: Left ventricle to go uping aorta to aortal arch to brachiocephalic arteria to subclavian arteria to alar arteria to brachial arteria to radial ( or ulnar ) arteria to capillary web of carpus to radial ( or ulnar ) vena to brachial vena to alar vena to subclavian vena to compensate brachiocephalic venas to superior vena cava to right atrium of the bosom. Right pes: Left ventricle to go uping aorta to aortal arch to falling aorta to right common iliac arteria to external iliac arteria to femoral arteria to popliteal arteria to anterior tibial arteria to dorsalis pedis arteria to capillary web to anterior tibial vena to popliteal vena to femoral vena to external iliac vena to common iliac vena to inferior vena cava to right atrium of the bosom. ( Alternatively. the sequence between the capillary web and external iliac vena could be stated as: dorsal venous arch to great saphenous vein. ) ( Figures 11. 12–11. 13 ) 33. The hepatic portal circulation carries nutrient-rich blood from the digestive entrails to the liver for treating before the blood enters the systemic circulation. A portal circulation involves a capillary bed that is both fed and drained by venas ; the usual circulation has a capillary bed that is fed by arterias and drained by venas. ( pp. 385–386 ) 34. In a foetus. both liver and lungs are nonfunctional ( the liver comparatively so ) . The ductus venosus bypasses the liver. The ductus arteriosus and the hiatuss ovale bypass the lungs. The umbilical vena carries nutrient-rich and oxygen-rich blood to the foetus through the umbilical cord. ( pp. 383–385 ) 35. Pulsation: The alternate enlargement and kick of an arteria that occur with each pulse. ( p. 387 )36. Front of the ear: Temporal arteria. Back of articulatio genus: Popliteal arteria. ( p. 387 ; Figure 11. 18 )37. Systolic force per unit area: Pressure exerted by blood on the arterial walls during ventricular contraction. Diastolic force per unit area: Pressure exerted by blood on the arterial walls when the ventricles are loosen uping ( that is. during diastole ) . ( p. 388 ) 38. Cardiac end product is increased by increased venous return and increased bosom rate. Peripheral opposition is increased by reduced diameter of the blood vass and increased blood viscousness. ( Figure 11. 21 ) 39. Blood force per unit area is usually highest in the accumbent place and lowest instantly after standing up ; nevertheless. the sympathetic nervous system rapidly compensates in a healthy person. Very frequently an single can go hypotensive after staying still in the sitting place for an drawn-out period. ( pp. 389–390 ) 40. Intercellular clefts allow limited transition of solutes and fluid. Fenestrated capillaries allow really free transition of little solutes and fluids. Capillaries missing these alterations are comparatively impermeable. ( p. 394 ) 41. Veins that have become distorted and dilated because of unqualified valves. Inactivity ( deficiency of skeletal milking activity against the venas ) . which allows the blood to pool in the lower appendages ; increased force per unit area that restricts venous return ( as in gestation and fleshiness ) . ( p. 377. 397 ) 42. Blood flow in arterias is pulsatile because it is under a greater sum of force per unit area compared to venas. Arteries are located closer to the ventricles. so their walls must be capable of spread outing and undertaking under the alterations in force per unit area when the ventricles contract. When blood reaches the venas. the force per unit area is really low. and so alternatively of venas holding a pulsatile ability to keep force per unit area. they alternatively have valves to forestall backflow. ( pp. 387–388 ) 43. The greater the cross-sectional country in a blood vas. the faster that blood can flux through that vas. Smaller vass. like capillaries. are merely one cell midst in diameter. which slows down blood flow and allows food and gas exchange to happen. ( p. 374 ) 44. Arterioles are the blood vass that are most of import in modulating vascular opposition. These vass can compress as a consequence of activity from the sympathetic nervous system. which alters blood force per unit area. Atherosclerosis in these vass besides causes contracting due to plaque sedimentations. which besides affects blood force per unit area. ( p. 388 ) ANSWERS TO CRITICAL THINKING AND CLINICAL APPLICATION QUESTIONS 45. High blood pressure: abnormally elevated or high blood force per unit area ( by and large described as systolic force per unit area systematically over 140 millimeters Hg and diastolic force per unit area systematically over 90 millimeters Hg in younger grownups ) . ( pp. 391. 394 ) Arteriosclerosis: â€Å"hardening of the arterias. † the consequence of sedimentation of fatty-cholesterol substances and Ca salts onto the interior walls of the blood vass. Arteriosclerosis can be a direct cause of high blood pressure because it decreases the snap of the arterias ( thereby increasing peripheral opposition ) . ( p. 393 ) High blood pressure is frequently called the â€Å"silent killer† because it progresses ab initio ( and frequently over a drawn-out period ) without obvious symptoms. Three lifestyle wonts that might assist forestall cardiovascular disease are regular exercising. a diet low in concentrated fats and salt. and a lessening in emphasis. ( Discontinuing smoke would besides help. ) 46. She has pneumonic hydrops. The right side of the bosom is still directing blood to the lungs. but the left side of the bosom. the systemic pump. is non pumping blood come ining its chamber ( from the pneumonic circuit ) to the systemic circulation. As the force per unit area increases in the pneumonic vass. they become leaky. and unstable enters the tissue infinites of the lungs. ( p. 374 ) 47. Incompetence ( non stricture ) of the pneumonic semilunar valve. Incompetent valves produce laping sounds. and the pneumonic semilunar valve is heard at the superior left corner of the bosom. as indicated in this inquiry. ( pp. 371–372 ) 48. The compensatory mechanisms of Mrs. Johnson include an addition in bosom rate and an intense vasoconstriction. which allows blood in assorted blood reservoirs to be quickly added to the major circulatory channels. ( pp. 388–391 ; Figure 11. 21 ) 49. The left atrium and the posterior part of the left ventricle. ( p. 367 ; Figure 11. 2 )50. Chronically elevated due to increased blood volume. ADH promotes keeping of H2O by the kidneys. ( pp. 390–391 ; Figure 11. 21 )51. Blood flow is increased to countries of demand and decreased to countries of non-need due to bottleneck and dilation of arteriolas as blood will flux down tract of least opposition. Competition for blood flow between the GI piece of land. which needs more blood circulation for soaking up. and the skeletal musculuss. which at the same time need more blood for exercising. will do dyspepsia much more rapidly than musculus cramping. ( pp. 385. 389–390 ) 52. Standing erect for drawn-out periods enables gravitation to pool blood in lower appendages. peculiarly in the absence of musculus pump activity which increases venous return during motion. Decrease in venous return causes decreases in shot volume. doing dizziness as blood flow to encephalon is reduced. Standing in a hot environment will besides bring forth sudating. vasodilation. and a decrease of blood plasma. which farther lessenings stroke volume. ( p. 376 ) CLASSROOM DEMONSTRATIONS AND STUDENT ACTIVITIES Classroom Presentations:1. Film ( s ) or other media of pick.2. Show a picture of a beating bosom. ideally with bosom sounds. Stress that while the right side of the bosom is a pneumonic pump and the left side a systemic pump. both atria contract at the same clip and both ventricles contract at the same clip. 3. Use a dissectible bosom theoretical account to demo bosom construction.4. Use a dissectible human trunk theoretical account to indicate out the major arterias and venas of the organic structure.5. Show the chordae tendineae. the â€Å"heart strings. † on a cleft bosom.6. Show a chart of assorted types and classs of bosom mutters. explicating that some of them are considered nonpathological and are simply â€Å"functional† ( related to low fluid volume. etc. ) . 7. Play a recording of normal and unnatural bosom sounds to attach to your presentation of valve map and malfunction. ( Interpreting Heart Sounds is available for loan from local chapters of the American Heart Association. ) 8. Show the recording of an ECG.9. Bring in a trial tubing or show images of blood in a trial tubing incorporating high fat content. Indicate out that at times the fat content is so high. you can really see drifting bunchs of fat in the specimen. 10. Have a invitee talker from the American Heart Association talk to the category about the hazard factors and taking causes of bosom disease.11. Bring in an old mechanical pacesetter and demo its arrangement on the chest wall under the tegument. Compare the heart’s ain pacesetter. the SA node. to the deep-rooted mechanical device. explicating that unreal pacesetters maintain a set pulsation rate and are non regulated by increased or reduced activity. 12. Show the usage of defibrillators. including AEDs. and explicate their map in cardiac deliverance. Besides discuss CPR as it relates to bosom map.13. Show pictures of and depict â€Å"pitting† hydrops. Explain how fluid can make full the interstitial infinites to such a grade that an indenture will remain when the tegument is pressed with the index finger. 14. Obtain man-made beltway transplant stuff and compare it in usage and effectivity to the preferable saphenous vena.15. Describe the different symptoms of impending myocardial infarction ( bosom onslaught ) in work forces and adult females. Supply statistics demoing the addition in diagnosing of MI in adult females. 16. Show a picture of a bosom operation and the importance of a perfusionist. who assists the bosom sawbones.17. Have a phlebotomist speak to the category about locations to pull blood in kids and in grownups. Have the talker explain the troubles in pulling blood when the patient is corpulent or dehydrated. and the methods they use during those state of affairss. Student Activities: 1. Show how apical and radial pulsations are taken. and have pupils pattern on each other.2. Show the location of the radial. brachial. carotid. femoral. popliteal. and pedal pulsations. Have pupils locate several of their ain and compare their rate and beat. Discourse the clinical deductions of weak or absent pulsations in the appendages. 3. Show the auscultatory method of taking blood force per unit area and supply sphygmomanometers and stethoscopes for pupils to pattern on each other.4. Ask pupils to convey in a day-to-day record of their blood force per unit area in the unsloped and supine places for a specified period of clip to chart and compare.5. Supply simple drawings of a cleft bosom and have the pupils follow the way of blood as it flows through the assorted Chamberss. Ask them to utilize ruddy and bluish pencils to distinguish between oxygenated and deoxygenated blood. Besides ask them to label the Chamberss. valves. septa. and other distinguishing characteristics. 6. Have pupils run in topographic point or make leaping knuckleboness for 3 proceedingss. so hold them enter their radial pulsation ( indicating out that a radial pulsation is ever thumb side ) . Have them continue to take their pulsation every 30 seconds for 5 proceedingss. so graph the consequences. Indicate out that a steep diminution in the first minute or so indicates rapid recovery by the bosom. 7. Supply the pupils with a diagram of the major blood vass for labeling.8. Have pupils enter their salt intake for one hebdomad. Supply them with a chart demoing salt content in nutrients and besides reexamine the usage of nutrient labels. Have them graph their day-to-day salt consumption and compare it to the FDA bound. Discuss which foods. like milk merchandises and pickles. are surprisingly high in salt content. 9. Promote pupils to obtain CPR preparation and offer excess recognition for certification of enfranchisement during the semester.10. Have pupils plan an probe to larn more about bosom rate and bosom sounds. Have them select a job. such as the relationship of age or weight. and find its consequence on bosom rate and bosom sounds. Have them explicate a testable hypothesis and list the stairss for the probe. including the choice of appropriate equipment and engineering. They should implement the probe. record the informations in a chart. and draw decisions from that information. 11. Have pupils plan an probe to find the consequence of clip of twenty-four hours on a selected critical mark. They should explicate a testable hypothesis and list the stairss in the probe to prove this hypothesis. includingthe equipment and engineering that would be used. With your blessing. pupils should so implement their program utilizing their schoolmates as topics. They should enter the informations and draw decisions about the consequence of clip of twenty-four hours on the selected critical mark. 12. Have your pupils answer the undermentioned inquiry to show their apprehension of how to choose appropriate equipment and engineering: Mr. Wright is working in his garden. Suddenly he experiences tightness across his thorax and knows this is non a good mark. He uses his cell phone to name 911. and remainders until the ambulance arrives. The EMT will measure his status and put electrodes across his thorax to mensurate his bosom action. What is the name of this medical equipment? A. Electrocardiograph*B. IVC. ThermometerD. Ophthalmoscope13. Have a pupil perform an incremental stationary bike trial and record bosom rate and blood force per unit area from remainder to exhaustion. Note how systolic blood force per unit area increases at higher exercising work loads and diastolic blood force per unit area remains about the same ( of import because diastole is when the bosom is able to feed itself ) . 14. Where possible. bring pupils to a learning infirmary to detect unfastened bosom surgery and/or bosom organ transplant.15. Have pupils dissect a cow’s bosom both sagittally and transversally to detect the differences in valves. Chamberss. wall thickness. and right/left sides.