...What two factors determine the direction of blood flow through the heart? Valves and pressure gradients (Pressure is generated by contraction of cardiac muscle) List the chambers/vessels that the four valves connect: Chamber Valve Pulmonary Semilunar Aortic Semilunar Mitral (bicuspid) Tricuspid Chamber/Vessel Pulmonary Artery Aorta Pulmonary Vein Inferior/superior Vena Cava 3. Right Ventricle Left Ventricle Left Atrium Right Atrium 4. a. What are the two phases that contribute to ventricular filling? Atrial ___Systole____________ and Ventricular ________Diastole_________ b. Blood flows through the _____Mitral_____________ or ______Tricuspid_____________ valves into the ventricles. 5. 6. During Ventricular Systole, what closes the AV valves? Intraventricular pressure increases and causes ventricular contraction During Ventricular Systole, what opens the semilunar valves? Ventricles contract which causes the pressure to rise, and then the pressure of the blood forces the semilunar valves to open. 7. 8. 9. During Isovolumetric Relaxation, what closes the semilunar valves? When blood pressure in arteries is greater than blood pressure in ventricles During Isovolumetric Relaxation, what opens the AV valves? When blood pressure in ventricles is greater than blood pressure in arteries Why is hypertension hard on the heart? Hypertension is a state of constantly high blood pressure (greater than 140/90 mmhg), so this causes the heart muscles to become thicker, and...
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...diomyopathy Topic presentation on Cardiomyopathy Topic presentation on Cardiomyopathy INDEX S.N | CONTENT | PG.NO | 1 | Introduction | 5 | 2 | Definition Cardiomyopathy | 5 | 3 | Classification | 6 | 4 | Risk Factors | 7 | 5 | Clinical Manifestations | 7 | 6 | Diagnostic Evaluation | 7-9 | 7 | Dilated CardiomyopathyDefinition,Charecteristics,Types , Causes,Diagnostic Evaluation,Pathophysiology,Clinical Manifestations,Medical Management | 10-17 | 8 | Hypertrophic CardiomyopathyIncidence,Causes,Charecteristics,Clinical Manifestations,Medical And Nursing Management | 18-21 | 9 | Restrictive Cardiomyopathy-Other Names,Causes,Pathophysiology,Clinical Manifestations,Diagnostic Evaluation,Medical Management | 23-26 | 10 | Surgical management | 27-32 | 11 | Prevention | | 12 | Nursing Management,Home Care Management | 32-40 | 13 | Complications | 40-42 | 14 | Conclusion | 42 | 15 | Research Abstract | 42-43 | 16 | References | 44 | GENERAL OBJECTIVE: On completion of the course the students aquires indepth knowledge regarding cardiomyopathy and able to apply this knowledge with a positive attitude. SPECIFIC OBJECTIVE: On completion of the course the students are able to ...
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...What two factors determine the direction of blood flow through the heart? Valves and pressure gradients (Pressure is generated by contraction of cardiac muscle) List the chambers/vessels that the four valves connect: Chamber Valve Pulmonary Semilunar Aortic Semilunar Mitral (bicuspid) Tricuspid Chamber/Vessel Pulmonary Artery Aorta Pulmonary Vein Inferior/superior Vena Cava 3. Right Ventricle Left Ventricle Left Atrium Right Atrium 4. a. What are the two phases that contribute to ventricular filling? Atrial ___Systole____________ and Ventricular ________Diastole_________ b. Blood flows through the _____Mitral_____________ or ______Tricuspid_____________ valves into the ventricles. 5. 6. During Ventricular Systole, what closes the AV valves? Intraventricular pressure increases and causes ventricular contraction During Ventricular Systole, what opens the semilunar valves? Ventricles contract which causes the pressure to rise, and then the pressure of the blood forces the semilunar valves to open. 7. 8. 9. During Isovolumetric Relaxation, what closes the semilunar valves? When blood pressure in arteries is greater than blood pressure in ventricles During Isovolumetric Relaxation, what opens the AV valves? When blood pressure in ventricles is greater than blood pressure in arteries Why is hypertension hard on the heart? Hypertension is a state of constantly high blood pressure (greater than 140/90 mmhg), so this causes the heart muscles to become thicker, and...
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...two dimensional echocardiography is a widely used technique for cardiac imaging, which will provide valuable information regarding the heart’s structural relationships, chamber sizes, wall motions and valvular functions specific to pulmonary hypertension. A transducer is used to perform a two-dimensional echocardiograph and is an effective method for evaluating physiological structures and function of the heart. It provides such images of the heart through standard parasternal long axis, parasternal short axis, apical four chamber, apical two chamber and subcostal views. In patients with pulmonary hypertension, the typical findings of right ventricular pressure overload on an echo include flattening of paradoxical motion of the interventriculaar septum, enlargement of the right heart chambers and increased thickness of the right ventricular wall. The addition of Doppler Echocardiography is supplemented with TTE and records changes in frequency of sound waves. Doppler echocardiography is a method to detect the direction and velocity of moving blood within the heart. The changing frequencies are converted into an audible sound and shifted into a...
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...Case 1 (Chapter 23: Alterations in Cardiovascular Function) A.O. was an 89-year-old woman with a long history of heart failure secondary to a large left ventricular infarct. She had poor activity tolerance and required assistance with activities of daily living. Even minimal activity was associated with moderately severe dyspnea and exertional chest pain, which was relieved by rest. A.O. also exhibited marked pedal edema bilaterally. She took digitalis, furosemide (Lasix), KCl, and sublingual nitroglycerin. Discussion Questions 1.Which type of heart failure (left or right sided) is usually associated with dyspnea? What other clinical findings are likely to be present with this type of heart failure? A.O. has left sided heart failure. Other clinical findings that present with left sided heart failure are pulmonary congestion and inadequate perfusion of the systemic circulation and symptoms include orthopnea, cough, fatigue and edema and decreased urine output. Pulmonary edema and S3 gallop (3rd heart sound) is present with the physical examination, as well as high or low blood pressure. An echo can show decreased cardiac output and a chest x-ray may show an enlarged heart (Huether & McCance, 2012). 2.What compensatory mechanisms are likely to be operative in A.O. to enhance cardiac output? The cardiac output is dependent on the heart rate and stroke volume. The factors that affect heart rate are the central nervous system, autonomic nervous system, neural reflexes, atrial...
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...The Barometric Pressure (total atmospheric pressure) at sea level is 760torr. The atmosphere is 20.9% oxygen so the partial pressure of oxygen in the atmosphere is 160torr. In order for inspiration to occur (atmospheric air to enter the lungs) the diaphragm (the muscle that separates the thoracic and abdominal cavity) receives action potentials and pulls down, increasing the volume of the thoracic cavity (and the lungs). According to Boyle’s Law this increase of volume, decreases the pressure on the lungs below normal 760torr. Because of the pressure gradient between the atmosphere (high pressure=760torr) and the lungs (low pressure<760torr) air rushes into the lungs (inspiration). The tidal volume that enters the body is 500mL, 150mL of this fills the anatomical dead space (trachea and conduction bronchioles, bronchioles 1-17). The remaining 350mL enters the respiratory bronchioles (bronchioles 18-23) where gas exchange occurs. Air enters the one cell thick alveoli where partial pressure of oxygen is 100torr, there are 300 million alveoli in the lungs which creates a cross sectional area of 70m2 (where gas exchange can occur). The alveoli are in direct contact with the 1 cell thick pulmonary capillaries where erythrocytes travel one at a time, creating a diffusion length of 20 microns. The partial pressure of oxygen in the pulmonary capillaries before reaching the alveoli is 40torr. Due to the partial pressure law, oxygen diffuses from its high partial pressure in the alveoli...
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...threatening complication of left-sided congestive heart failure * When large amounts of fluid and blood accumulate in the lungs, causing the alveoli to fill up and air exchange to be nonexistent Heart failure * A syndrome that occurs from the progressive inability of heart to pump enough blood to meet body’s oxygen and nutrient needs * Causes are * Coronary artery disease * MI * Cardiomyopathy * Heart valve problems * Increased fluid Congestive heart Failure * Signs and symptoms * Fatigue, dyspnea, cardiac and respiratory rates increase, stess and anxiety Left sided heart failure * The result of the left ventricle muscle being damaged or its due to overloading * Blood backs up from the left ventricle into the LUNGS and fluid leads from the blood into the air spaces of the lungs * Hypertension the major cause behind left sided heart failure * Because hypertension causes increased pressure in the arteries causing the left ventricle to work harder * LEFT = LUNG * Signs and symptoms * Crackles * Tachycardia * Dyspnea * Tachypnea * **The patient may complain of having to be propped up in order to sleep at night ** Right sided heart failure – * Occurs because of left sided heart failure * Occurs when the right ventricle is not able to pump effectively to the lungs * Major causes * Left sided heart failure ...
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...Energy Laws Energy can be defined as the capacity to do work- but energy doesn’t just appear it must come from somewhere! The first law of thermodynamics, sometimes known as the conservation of energy, states that: Energy can be transformed (changed from one form to another), but cannot be created or destroyed. The first part of this law refers to the transformation of energy from one into another. The second form may not be of use or be capable of being measured. Forms of energy Energy can exist in several forms and chemical energy is the most common. The energy is in the chemical bond that unites atoms or molecules with each other. When a new bond is made between two atoms, energy is required for its formation and this is usually in the form of heat, although light and electrical energy can be used. When a bond is broken and atoms are released, the energy in the bond is released as well. Heat, light sound, electrical and nuclear is other forms of energy. Energy metabolism The role of energy in the body At this stage you may be wondering why there is so much emphasis on energy and be thinking that it is only concerned with muscular activity and movement. However, energy is also needed to circulate blood, lymph and tissue fluid throughout the body; it is necessary for breathing and taking in oxygen; it is necessary for making new cells and carrying out growth and repair; it is used to transmit nerve impulses so that we can respond to changes in the environment and...
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...Case Study 2 A.O. is an 89-year-old woman with a long history of systolic heart failure secondary to a large left ventricular infarct when she was in her 70s. She had poor activity tolerance and required assistance with activities of daily living. Even minimal activity was associated with moderately severe dyspnea and exertional chest pain, which was relieved by rest. A.O. also exhibited marked pedal edema bilaterally. She is being treated with digitalis, furosemide (Lasix), KCl, and sublingual nitroglycerin. Discussion Questions: 1. Which type of heart failure (left or right sided) is usually associated with dyspnea? What other clinical findings are likely to be present with left-sided heart failure? The type of heart failure usually associated with dyspnea is left-sided. Other clinical findings likely to be present with left-sided heart failure are cardiomegaly and pulmonary congestion such as orthopnea or basilar crackles. There would also be an increased heart rate and S3 heart sound while listening with a stethoscope. 2. What compensatory mechanisms are likely to be operative in A.O. to enhance cardiac output? The following compensatory mechanisms are likely to be operative to enhance cardiac output: myocardial hypertrophy due to prolonged stretch on the myocardium; baroreceptors will detect a low blood pressure and carbon monoxide levels, which would excite the sympathetic system due to an increased heart rate. During this mechanism the beta receptors will downregulate;...
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...Ectopic pregnancy, Tension Pneumothorax and Myocardial Infarction Presenting complaint, history of presenting complaint and physical findings Name: Tashaine Campbell Date: March 27, 2013 Class: Practice of Medicine An ectopic pregnancy is one in which the fertilized egg attaches itself in a place other than inside the uterus. Almost all (more than 95 percent) ectopic pregnancies occur in a fallopian tube; hence the term "tubal" pregnancy. Rarely, the egg may implant elsewhere, such as in the abdomen, ovary, or cervix. Presenting complaint: Miss Mao who is 25 years old, complains of a "sharp and stabbing abdominal pain" accompanied by dizziness and eventual loss of consciousness/syncope. She also has been experiencing bleeding. History of presenting complaint/Illness: * She suddenly experienced a sharp right pain localized to the right iliac area, intensity described as 10/10, with radiation to the tip of the right shoulder. * There was accompanying nausea, dizziness and eventual fainting/loss of consciousness. * Most commonly presents 6–8 weeks after last menstrual period. * Classic triad: Pregnant, bleeding or spotting, pelvic pain. * Rupture causes sudden increase in pain, dizziness, and anemia leading to shock and cardiovascular collapse. * Some degree of intermittent abdominal pain in the past 2 weeks, which had initially been dull, but intensity has become much sharper and episodic. * She described...
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...tissues in heart wall SA node to AV node to bundle fibers to perjunkie fibers cycle of ecg blood goes through the superior vena cava, then to right atrium, then out through pulmonary veins, into lungs, then back to left ventricle, then through left atrium out through aorta krebbs cycle glycoloysis 1. goes from glucose to 6 phosphate molecules 2. then to fructose 6 phosphate 3. f 1-6 biphosphate cardiac output = stroke volume x cardiac rate cardiac rate = stroke volume x cardiac output epinephrine mimics symphathetic nervous system binds to norepepinephrine receptor cites increase cardiac rate and force of contraction tissue in heart: epicardium myocardium endocardium systole and diastole (contraction and relaxation) lubb dupp electron transport left side more pressure than right t wave ventricular recovery qrs ventricular excitation ecg - recording of electrical activity atrial fibrillation - not fatal ventricular filbrilation -fatal cardiac output - volume of blood ejected by the left ventricle in one minute stroke volume - the volume of blood ejected by the left ventricle per contration cardiac rate - number of ventricular contactions per minute three functional correlates - allow body to function (notes from 10/26/11) functions of blood (regulates body temp, acid base balance, involved in immunity, transports oxygen from lungs to body cells, transports co2 from body cells to lungs, transports nutrients from digestive track to body cells, transports...
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... Secondary to Rheumatic Heart Disease A case Presentation A Presented to: The Faculty College of Nursing Adventist University of the Philippines In Partial fulfillment Of the Course N303 Curative and Rehabilitative Nursing Care 1st Semester By: Tha Hnem Section F Presentation Date: September, 4, 2007 I. Introduction Heart failure, also called congestive heart failure (CHF), is a life-threatening condition in which the heart can no longer pump enough blood to the rest of the body. Heart failure is almost always a chronic, long-term condition, although it can sometimes develop suddenly. Rheumatic fever and Valvular Heart Disease also contributed to Heart Failure. This condition may affect the right side, the left side, or both sides of the heart. Rheumatic heart disease refers to the cardiac manifestations of rheumatic fever, including pancarditis (myocarditis, pericarditis, and endocarditis) during the early acute phase and chronic valvular disease later. Long-term antibiotic therapy can minimize recurrence of rheumatic fever, reducing the risk of permanent cardiac damage and eventual valvular deformity. In valvular heart disease, three types of mechanical disruption can occur; stenosis, or narrowing, of the valve opening: incomplete closure of the valve; or prolepses of the valve. They can result from such disorders as endocarditis (most common), congenital defects, and inflammation, and they can lead to heart failure. When the heart valve malfunction...
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...the heart as a result of pressure differences Blood moves via mass flow which is movement of material from high to low pressure Explain the cardiac cycle and its initiation Discuss the internal factors that control heart action Refers to the sequence of contraction and relaxation of the heart chamber during one heartbeat Systole: heart muscle is contracted Diastole: heart muscle is relaxed Cardiac output is the amount of blood flowing from the heart.= Stroke volume (Volume of blood) X Number of beats in a given time (Heart Rate) 1 22-Sep-12 1. Atrial and ventricular diastole 2. Atrial systole 3. Ventricular systole •It describes how blood flows from veins to atria Both atria and ventricles are relaxed •Atria pressure lower than in veins so blood moves into atrium, which is achieved when atria muscle relaxes and the volumes in the atria increases with a corresponding lowering of pressure •Pressure begins to rise in the atria which reduces volume •As blood enters the atria, there is a higher pressure in the atria as opposed to the ventricles •Blood will flow from the atria into the ventricles pushing open the atrioventricular valves •Blood flows from the atria into the ventricles •The atria muscles contract while ventricle muscles relax •Blood pushed from atria into ventricles , atrioventricular valves open and the semilunar valves remain shut 2 22-Sep-12 •Blood flows from the ventricles into the arteries •The ventricular muscles contract and atrial...
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...Definition Heart failure occurs when abnormal cardiac function causes failure of the heart to pump blood at a rate sufficient for metabolic requirements under normal filling pressure. It is characterised clinically by breathlessness, effort intolerance, fluid retention, and poor survival. Fluid retention and the congestion related to this can often be relieved with diuretic therapy. However, diuretic therapy should generally not be used alone and, if required, should be combined with the pharmacological therapies outlined in this review. Heart failure can be caused by systolic or diastolic dysfunction, and is associated with neurohormonal changes. [1] Left ventricular systolic dysfunction (LVSD) is defined as a left ventricular ejection fraction (LVEF) below 0.40. It may be symptomatic or asymptomatic. Defining and diagnosing diastolic heart failure can be difficult. Recently proposed criteria include: (1) clinical evidence of heart failure; (2) normal or mildly abnormal left ventricular systolic function; (3) evidence of abnormal left ventricular relaxation, filling, diastolic distensibility, or diastolic stiffness; and (4) evidence of elevated N-terminal-probrain natriuretic peptide. [2] However, assessment of some of these criteria is not standardised Top of Form Search the BMJ[pic][pic] Bottom of Form • BMJ • BMJ Journals • BMJ Careers • BMJ Learning • Evidence Centre • BMJ Group [pic] [pic] [pic] [pic] [pic] [pic] Home | Log in | Athens...
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...easy second case study which, if you complete it, will be worth extra credit. Answers to the first Case Study are worth 25 points and responding to Case Study 1 is required work for the course. The extra credit, which is not required, will be worth a total of 10 points. Case 1 A.O. is an 89-year-old woman with a long history of systolic heart failure secondary to a large left ventricular infarct when she was in her 70s. She had poor activity tolerance and required assistance with activities of daily living. Even minimal activity was associated with moderately severe dyspnea and exertional chest pain, which was relieved by rest. A.O. also exhibited marked pedal edema bilaterally. She is being treated with digitalis, furosemide (Lasix), KCl, and sublingual nitroglycerin. Discussion Questions 1. Which type of heart failure (left or right sided) is usually associated with dyspnea? Left-sided heart failure is usually associated with dyspnea. What other clinical findings are likely to be present with left-sided heart failure? Other clinical findings that are likely to be present with left-sided heart failure include radiographic cardiomegaly, abnormal apical pulse and tachycardia. 2. What compensatory mechanisms are likely to be operative in A.O. to enhance cardiac output? Compensatory mechanisms that are likely to be operative in A.O. to enhance CO are: * Baroreceptors that detect a fall in BP and transmit that information to the CNS; parasympathetic system...
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