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Understanding the Cardiovascular System Chapter 4 Refers to Heart – Lung Functioning

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Chapter 4 Refers to Heart Lung Functioning Sub-Components of the Cardio-respiratory System Heart Blood Blood Vessels Lungs Function of Cardio-Respiratory Systems ... – PowerPoint PPT presentation

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Title: Understanding the Cardiovascular System Chapter 4 Refers to Heart – Lung Functioning


1
Understanding the Cardiovascular SystemChapter
4Refers to Heart Lung Functioning
2
Sub-Components of the Cardio-respiratory System
  • Heart
  • Blood
  • Blood Vessels
  • Lungs

3
Function of Cardio-Respiratory Systems
  • Primarily to
  • Transport and exchange gases(O2 and CO2)
  • Deliver nutrients to cells
  • Deliver hormones and nutrients
  • Removes waste
  • Balance fluids
  • Temperature regulation

4
Anatomical Considerations of the Heart
  • Size of a closed fist
  • Located in the mediastium of the chest cavity

5
Basics Of Heart Anatomy
  • It is a four chambered structure
  • Two upper chambers atria or atrium
  • Two lower chambers ventricles
  • It is divided into right and left sides by
    muscular tissue known as the septum

6
Basics Of Heart Anatomy 2
  • By being divided into right and left sides, the
    heart is able to serve two systems
  • Pulmonary
  • Systemic
  • Explanation of basic blood flow

7
Cardiovascular Disease
  • 60-70 million Americans have one or more forms of
    CVD

8
Cardiovascular Disease
  • 1 million deaths each year
  • 330 billion dollars

9
Cardiovascular Disease
  • Cardiovascular disease (CVD) is the number one
    cause of death in the United States.

10
Cardiovascular Disease
  • 2600 Americans die each day from CVD
  • 1 death every 33 seconds
  • Claims more lives each year than the next 7
    causes of death combined (AHA 99)

11
Forms of Cardiovascular Disease(Often
preventable and lifestyle related)
  • Coronary artery disease (CAD or CVD)
  • Hypertension (high blood pressure)
  • Cerebral vascular accidents (strokes)
  • Angina pectoris
  • Peripheral vascular disease
  • Valve disease
  • Rheumatic heart disease
  • Congenital heart disease
  • Congestive heart failure

12
Coronary Artery Disease (CAD)
  • Primary form of heart disease
  • May be caused by a variety of conditions, however
    most cases are associated with
  • Waxy plaque build-up in the arteries
  • Atherosclerosis

13
Clear Coronary Arteries
14
Cardiovascular Disease
  • Has anyone in your family had bypass surgery?
  • Blocked arteries?
  • Plaque build-up
  • Related to high cholesterol levels sustained over
    time
  • Occurs, primarily, in vessels closest to the heart

15
Cardiovascular Procedures
  • Angioplasty
  • Roto-Blade
  • Stints
  • Keyhole Surgery
  • Radiation
  • Bypass Surgery (7 yr.average)

16
CAD Post-Op Patient
  • What behavioral and dietary changes are
    suggested for the patient?

17
Can One Be FIT But Not Healthy?
  • Personal profile example
  • Run 3 miles daily
  • Lift weights
  • Stretching exercises
  • Smokes, stress, excessive alcohol, fatty foods,
    drugs, etc.

18
Jim Fixx
  • 36 years old, 215 pounds
  • 2 pack a day smoker
  • No regular exercise
  • Family history of heart disease
  • father had a heart attack at 35, died at 43
  • Began to exercise at age 36
  • Ran 60-80 miles per week
  • Was FIT but not HEALTHY

19
Coronary Risk Factors
  • Primary Risk Factors Factors that have been
    definitively associated with or directly cause
    coronary artery disease.
  • Secondary Risk Factors Factors believed to
    contribute to or advance the severity of
    atheroschlerosis and CAD.

20
Primary Risk Factors (Alterable)
  • Smoking
  • Hypertension (high blood pressure)
  • High serum cholesterol (hyperlipidemia)
  • Physical inactivity
  • Diabetes mellitus
  • Obesity
  • (drug use)

21
Secondary Risk Factors
  • Stress
  • Age
  • Gender (male vs. female)
  • Family history

22
Are Arkansans at Risk for these Health Problems?
  • ?

23
Arkansas Stats from the Center for Disease
Control/Mortality Rates
  • Males 2 in deaths from CAD
  • Males 2 in deaths from lung cancer
  • Males and Females 1 in deaths from stroke

24
Additional Ark. Stats
  • 1/3 of deaths in AR related to CVD (l998)
  • 90 of adults report no vigorous activity
  • 36 do not engage in any physical activity
  • Arkansans are gaining weight 3 times faster than
    the rest of the nation
  • 40 AR youths carry excessive weight

25
Examining CAD Risk Factors (Primary followed by
Secondary)
26
Smoking 1
  • The single most important, preventable cause of
    illness and early death

27
Smoking 2
  • 400,000 related deaths per year
  • gt50 billion
  • Cancer, heart disease, respiratory diseases
    (emphysema)
  • Cigarette smoking and passive smoke inhalation
    are highly related to CAD.

28
Smoking 3
  • Smokers have a 70 greater level of coronary risk
    than nonsmokers.
  • Magnitude of risk is related to number of
    cigarettes smoked.
  • Pipe, cigar, pot
  • Personal economics of smoking

29
Secondary Smoke
  • 53,000 annual deaths
  • For each pack of cigarettes smoked, the non
    smoker, sharing the same air, will inhale the
    equivalent of 3 to 5 cigarettes.

30
Smokeless Tobacco
  • Chewing tobacco
  • Overheads

31
Smoking Benefits??
  • Injures the inner lining of the arteries
  • Increases the risk of blood clotting
  • Increases the risk of heart attack
  • Increases risk of sudden death
  • Allows for consumption of 63 cancer causing
    chemicals

32
Smoking Benefits 2 ???
  • 87 of lung cancer caused by smoking
  • Most emphysema and chronic bronchitis caused by
    smoking
  • Lowers HDL cholesterol
  • Increases facial wrinkles
  • Increases risk of many other diseases
  • Reduces length of life by as much as 17 years
  • Depends on amount smoked and years smoked
  • Stop smoking
  • Heart disease risk drops in a matter of months
  • Cancer risk drops slowly and may take 10 years

33
Hypertension / High Blood Pressure
  • Blood Pressure
  • The driving force that moves blood throughout
    the body.
  • The pressure exerted by the blood on the walls of
    the arteries.

34
Blood Pressure
  • 120/80 or less is optimal
  • 120-139/80-89 is Pre-hypertension
  • 140-159/90-99 is stage 1
  • 160/100 or higher is stage 2

35
Systolic Blood Pressure 120/80
  • The highest pressure or value
  • Occurs during heart contraction phase
    (ventricular contraction)

36
Diastolic Blood Pressure 120/80
  • The lowest pressure or value
  • Occurs during heart relaxation phase (resting or
    refilling stage of the contraction)

37
Hypertension (High Blood Pressure)
  • A silent killer
  • 140/90 considered mild stage of hypertension
  • Which is more problematic? 140/80 or 130/95
  • Potentially leads to stroke
  • Causes the heart muscle to overwork

38
Hypertension 2
  • Related to stroke / aneurysms
  • Hypertension may be the result of another health
    problem

39
Factors Affecting Blood Pressure
  • Hypertensive medications
  • Time of day
  • Full bladder content
  • Body posture
  • Recent intake of caffeine
  • Nicotine
  • Alcohol
  • Recent strenuous activity

40
Impact of Hypertension
  • 25 or 50 million Americans are hypertensive
  • 67 are not treated
  • 1/2 are unaware of the complication

41
Factors Contributing To Hypertension
  • Age
  • Race
  • Sodium sensitivity
  • Chronic alcohol abuse
  • Oral contraceptives
  • Sedentary living

42
Lifestyle Interventions to Maintain or Lower
Blood Pressure
  • Body weight reduction or maintenance
  • Smoking cessation

43
How To Lower Blood Pressure
  • Aerobic exercise
  • Reduce stress
  • Reduce cholesterol, sodium, high fat diet
    (saturated)
  • Medications

44
Hyperlipidema / High Serum Cholesterol
  • Definition of Cholesterol
  • A type of lipid (fat) found in animal tissues
  • This fat (Lipid) is insoluble in blood
  • It binds to proteins (lipoproteins) in order to
    be transported in the body

45
Cholesterol 3 basic facts
  • Provides for basic functions of the metabolic
    process
  • Is manufactured in the liver non-essential
  • The body makes additional cholesterol (LDL) from
    saturated fats

46
What Is So Bad About Having High Cholesterol
Levels??
  • High levels lead to a waxy, plaque build-up in
    the arteries, especially those near the heart.
  • The result can be increased risk of Coronary
    Artery Disease (CAD)

47
More About Plaque
  • Affects all of us
  • May begin as early as 10 years of age
  • May be genetic
  • Medications??

48
Types of Lipoproteins / Types of Cholesterol
  • LDL
  • HDL
  • VLDL

49
LDL
  • Low density lipoproteins (BAD)
  • enhances plaque build up in the arteries
  • increases with a diet high in saturated and
    trans-fatty acids (hydrogenated products)
  • Undesirable, increases risk of CAD

50
HDL
  • High density lipoproteins (GOOD)
  • Offers protection from CAD
  • May remove plaque from the arteries
  • Aerobic activity will raise HDL level
  • Can be raised by consuming small amounts of
    alcohol daily

51
VLDL
  • Very low density lipoproteins (VLDL)
  • undesirable and are associated with increase risk
    of CAD

52
Cholesterol Information
  • Dietary Cholesterol
  • Refers to foods high in cholesterol
  • Example
  • Shrimp
  • High in cholesterol
  • Low in fat

53
Cholesterol Information
  • Saturated fats
  • Can significantly raise LDL levels (bad
    cholesterol) and total serum cholesterol levels
  • Found in animal sources and by products

54
Cholesterol Information
  • Plants are NEVER sources of cholesterol, but can
    be sources of saturated fat.
  • Examples
  • Tropical oils (palm, coconut)
  • Examples of sources Movie popcorn, commercially
    baked goods
  • Ingestion of dietary cholesterol

55
Serum Cholesterol Levels
  • Desirable below 200
  • Borderline high 200-239
  • Risk for CVD 240 or gt
  • Some guidelines call for desirable to be 170

56
High Serum Cholesterol 2
  • If your cholesterol is 250, your risk of heart
    attack is twice that of 200
  • If your cholesterol is 300, your risk of heart
    attack is four times that of 200

57
Understanding Total Serum Cholesterol Values
  • Knowing an individuals total cholesterol is not
    always adequate when determining coronary risk

58
Understanding Cholesterol Ratios
  • Determine the ratio of total cholesterol to HDLs
  • Formula TC/HDL
  • Example Male, TC 190, HDL 34 (5.4)
  • 190 divided by 34 5.4
  • Values equal to or greater than 5.0 for men and
    4.5 for women are associated with risk.
  • 6.0 increased risk
  • 4.0 low risk
  • Usually, if HDL is less than 35, heart attack
    risk is indicated

59
Cholesterol Value Examples
  • Male
  • TC 210 HDL 32
  • Divide 210 by 32 6.56
  • 6.56 1 ratio
  • Ratio is gt5.0
  • Increased risk of CAD
  • Male
  • TC 220 HDL 49
  • Divide 220 by 49 4.49
  • 4.49 1 ratio
  • Ratio is lt5.0
  • Low risk of CAD

60
Cholesterol Value Examples
  • Female
  • TC 195 HDL 36
  • Divide 195 by 36 5.42
  • 5.42 1 ratio
  • Ratio is gt4.5
  • Increased risk of CAD
  • Female
  • TC 195 HDL 40
  • Divide 195 by 40 4.9
  • 4.9 1 ratio
  • Ratio is gt 4.5
  • Increased risk of CAD

61
Cholesterol Value Actual Example
  • Female
  • TC 207 HDL 74
  • 207 divided by 74 2.8
  • 2.8 1 ratio
  • lt 4.5
  • Very low risk CAD

62
How To Control Or Lower Cholesterol
  • Avoid saturated fats
  • fats from animal sources
  • red meats
  • animal fats
  • animal by-products

63
Controlling Cholesterol 2
  • Avoid dietary cholesterol
  • Exercise
  • Consume a low fat diet (20 or less)
  • Watch egg consumption
  • Limit red meats (fewer than 3 times per week)
  • Avoid commercially baked goods (tropical oils and
    trans-fatty acids/hydrogenation)
  • Use skim milk

64
Controlling Cholesterol 3
  • Eat fish 2-3 times per week
  • Bake, broil, steam
  • Remove excess fat (soup, chili)
  • Is ground turkey better?

65
Controlling Cholesterol 4
  • Avoid fatty sauces (fettuccini alfredo)
  • Substitute in recipes
  • Egg whites for eggs
  • Applesauce for oil in cakes
  • Salsa instead of butter for baked potatoes
  • Are there substitutions you make?
  • Maintain proper body weight

66
Take Care Of Your Kitchen Disposal
67
Physical Inactivity
  • Physical activity levels and CAD are strongly
    inversely related.

68
Physical Inactivity 2
  • Sedentary individuals have
  • 2-3 times greater risk of CAD than active
    individuals.
  • Twice the risk of fatal heart attacks

69
Physical Activity
  • Physical activity is argumentably be the single
    best method of controlling or reducing CAD.
  • Collateralization

70
Physical Activity 2
  • Increases strength of the heart
  • Helps to establish and maintain normal blood
    pressure.
  • Helps to control obesity due to increase in
    caloric expenditure

71
Physical Activity 2
  • Raises HDL levels, while lowering LDL,
    triglyceride and total cholesterol levels.
  • Decreases resting heart rates
  • Helps to manage stress levels

72
Physical Activity 3
  • Increases resting and exercising stroke volumes
  • Amount of blood pumped by the heart in a single
    beat
  • Reduces the risk of diabetes

73
Diabetes Mellitus
  • Arkansas ranks 11th in the prevalence of diabetes
  • New trends
  • Increased cases of Type 2 diabetes children
  • Increase in adults in the 30s.

74
Diabetes Mellitus
  • A condition in which glucose is unable to enter
    the cells
  • A disease associated with problems in controlling
    blood glucose or blood sugar
  • The disease results when the pancreas has
    problems producing insulin or the body can no
    longer use insulin properly
  • Insulin is the taxi that carries sugar from the
    blood to the cells

75
Blood Sugar Levels
  • Normal blood sugar levels 65-110
  • Hyperglycemia
  • High levels of blood sugar
  • When sugar levels remain high, over time, it
    damages the walls of the vessels
  • Leads to impairment of the circulatory system
  • Affects functioning of most organs
  • Problems healing (small cuts, amputations)
  • Blindness

76
Hypoglycemia
  • Low levels of blood sugar
  • It is appropriate to give sugar to the diabetic
    in a hypoglycemic emergency
  • Some may experience hypoglycemia but are not
    diabetic
  • protein is often recommended

77
Types of Diabetes
  • Type I insulin dependent or juvenile onset
  • Type II maturity or adult onset, usually
    non-insulin dependent
  • Gestational onset

78
Diabetes Mellitus Adult Onset
  • The pancreas does not produce enough insulin or
    has just forgotten how
  • Directly related to obesity
  • 90 of all cases are Type II

79
Adult Onset 2
  • An 20 increase in body weight doubles the
    chances of developing diabetes
  • Example
  • Appropriate weight 160
  • 20 weight gain 192

80
How To Avoid Adult Onset Diabetes
  • Control cholesterol
  • Control weight
  • Control blood pressure
  • Exercise regularly (aerobic)
  • Diabetics must plan for meals, insulin
    injections, and exercise

81
Obesity
  • 64 Americans are overweight
  • 25 obese
  • 60 Arkansans at unhealthy weight
  • 37 obese
  • Arkansas 77 increase in obesity from 1991 to
    2000
  • 117 billion spent on obesity-related illnesses

82
Obesity 2
  • 38 Arkansas school children overweight
  • Young adult obesity can shorten life span by 5 to
    20 years

83
Obesity Is Related To
  • High cholesterol
  • Hypertension / stroke
  • Elevated LDL levels
  • Lower HDL levels
  • Physical Inactivity
  • Diabetes
  • Obesity is also related to joint problems

84
Obesity Fat Distribution
  • Apples Android Obesity
  • Fat distributed in upper body
  • Higher risk of CAD, strokes, diabetes
  • Pears Gynoid Obesity
  • Fat is distributed in the hips and legs

85
Other Diseases Associated With Obesity
  • Renal disease
  • Gallbladder disease
  • Pulmonary disease
  • Degenerative arthritis
  • Psychological problems
  • Some cancers
  • Post menopausal obese women 5 times more likely
    to develop uterine cancer
  • Problems administering anesthesia

86
What Constitutes Obesity?
  • BMI gt 25
  • gt 20 lbs overweight
  • Body fat percentages
  • Men gt 20 (25)
  • Women gt 25 (30)

87
Secondary Risk Factors (Not alterable)
  • Stress (secondary but is alterable to some
    degree)
  • Age
  • Gender
  • Family History

88
Stress
  • Unmanaged stress is related to CAD.
  • Type A personality is related to CAD.

89
Age
  • Men 45 and over
  • Women 55 and over

90
Family History Primary or Secondary?
  • The risk is greater when
  • Father or other first degree relative has a MI or
    sudden death prior to 55
  • Mother or another female family member has a MI
    or sudden death prior to 65
  • Family history of diabetes, hypertension

91
Gender
  • Men have a greater history of CAD earlier in
    life.
  • CAD is a disease of equal opportunity

92
New Information Homocysteine Levels
  • An amino acid (level becomes too high)
  • Causes heart disease (sudden blockage)
  • Birth defects
  • Testing is involved and expensive
  • Consume folic acid
  • Vegetables, fruits, vitamins E, C, B- complex and
    selenium

93
New Information
  • High triglyceride levels are associated with
    increase in CAD (fall 2000)

94
New Information
  • Blood tests for C-Reactive Protein
  • Presence of protein indicated inflamed arteries
  • Inflammation may cause plaque to break away
    (plaque rupture)
  • Prescribe an antibiotic??

95
Discuss Prescription
  • Page one
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