The Cardiovascular System

1
The Cardiovascular System Lecture 3
of the Course Medical English for Sophomore
Medical Students of Taipei Medical
University School of Medicine Taipei Medical
University
Winston W. Shen, M.D. Professor and
Chairman Department of Psychiatry Taipei Medical
University College of Medicine and
Chief, Department of Psychiatry TMU-Wan Fang
Medical Center Taipei, TAIWAN E-mail address
Shenwinw_at_gmail.com
2
The Schedule for the Course Medical English
Version of 3/4/07 (Part 1 of 2)

• Week 1 (March 1) The Digestive System
• Week 2 (March 8) The Respiratory System
• Week 3 (March 15) The Cardiovascular System
• Week 4 (March 22) The Musculoskeletal System
• (Turning in a 400-word essay on My Visit
  to the Clinic or My Visit
• to the Hospital (in double-line space
  hard copy)
• Week 5 (March 29) The Central Nervous System
  
• Week 6 (April 5) The Urinary System
• Week 7 (April 12) The Reproductive System
• Week 8 (April 19) The First Examination
• Week 9 (April 26) Medical Records
• (Turning in a 400-word essay on My Favorite
  Book (in double line
• space hard copy)

3
The Schedule for the Course Medical English
Version of 3/4/07 (Part 2 of 2)

• Week 10 (May 3) Scientific Papers
• Week 11 (May 10) Hematology
• Week 12 (May 17) Infectious diseases
• Week 13 (May 24) The Second Examination
• Week 14 (May 31) Endocrinology
• (Turning in a 400-word essay on How to Be a
  Good Physician (in double line
• space hard copy)
• Week 15 (June 7) Immunology
• Week 16 (June 14) Oncology
• Week 17 (June 21) No Class
• Week 18 (June 28) Final (The Third)
  Examination

4
The Heart (Gr. das Herz Fr. le coeur)
The hollow muscular organ that is the center of
the circulatory system. The heart pumps
blood throughout the intricate system of blood
vessels in the body.
Origin bef. 900 ME herte, OE heorte c. D
hart, G Herz, ON hjarta, Goth hairto akin to
L cor (see cordial, courage) Gk kardía (see
cardio-)
Heart specialist cardiologist Cordially
yours, encouragement cor pulmonale
www.mywebpages.comcast.net
A peer review journal (A refereed journal)
5
A.or.ta n. pl. -tas, -tae   Anatomy. the main
trunk of the arterial system, conveying blood
from the left ventricle of the heart to all of
the body except the lungs. (Gk aort, the great
artery, lit., something hung, carried akin to
aeírein to lift, carry)
Left common carotid a. Left subclavical a.
Atrium
Brachiocephalic a.
n.   pl. atria (a'tre-?)
or atriums Architecture A
rectangular court, as A usually
skylighted central area, often containing plants,
in some modern buildings, especially of a public
or commercial nature. The open area in the center
of an ancient Roman house. The forecourt of a
building, such as an early Christian church,
enclosed on three or four sides with porticoes.
Anatomy A body cavity or chamber, especially
either of the upper chambers of the heart that
receives blood from the veins and forces it
into a ventricle. Also called auricle
Superior vena cava
Ventricle
1. Zoology. any of various hollow organs
or parts in an animal body. 2. Anatomy. a.
either of the two lower chambers on each
side of the heart that receive blood from
the atria and in turn force it into the
arteries. b. one of a series of connecting
cavities of the brain
www.mywebpages.comcast.net
L. ventriculus belly
Inferior vena cava (Pl. venae cavae)(L. vena,
vein L. cava, hollow)
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Cardiac Conduction

1. Pacemaker impulse generation
2. AV node impulse conduction
3. AV bundle impulse conduction
4. Purkinje fiber impulse conduction

SA Sinoatrial
Atrioventricular AV
Purkinje fibers (or Purkyne tissue) are located
in the inner ventricular walls of the heart, just
beneath the endocardium. These fibers are
specialized myocardial fibers that conduct an
electrical stimulus or impulse that enables the
heart to contract in a coordinated fashion
poorkinyay (17871869) Histologist and
physiologist, born in Libochovice, NW Czech
Republic. He graduated in 1818 with a thesis on
vision, which gained him the friendship and
support of Göthe. Helped by this, he became
professor in Wroclaw, Poland (formerly Breslau,
Prussia) and later at Prague. An early user of
the improved compound microscope, he discovered a
number of new and important microscopic
anatomical structures, some of which are named
after him. He was also a very early user of the
microtome for cutting sections.
Image courtesy of Carolina Biological Supply
7
http//upload.wikimedia.org/wikipedia/commons/0/0
b/ECG_Principle_fast.gif
8
Electrocardiograph or
Electrocardiogam (ECG or EKG)
R
P- wave
T-wave
Q
S
Repolarization
depolarization
QT-interval
QRS interval
9
Myo.cardium
Between the layers of endocardium, and epicardium
e.g. myocarditis myocardial infarction
Bicuspid (not shown) Tricuspid valve, L
tricuspid- (s. of tricuspis) having
three points.
Striatal muscle
http//www.med.yale.edu/intmed/cardio/imaging/anat
omy/specimen_ant/index.html
10
Cardiac Arrhythmia
Gk. Arrhythmía a rhythm ia

• Sinus Tachycardia
• Sinus Bradycardia
• Type 1 second degree heart block
• Type 2 Second degree heart block
• Arial flutter
• Parosysmal atrial tachycardia
• Atrial fibrillation
• Ectopic beats (Gk. ek-, away from, out of see
  ecto- topos, place.
• Ventricular fibrillation

(refers to a heart rate of more than 100 beats
per minute) (describes a rate of less than 60
beats per minute)
(also known as Mobitz I heart block or
Wenckebach phenomenon)
(also known as Mobitz II heart Block is almost
always a disease of the distal conduction system
His-Purkinje System)
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Treatments of A.rrhyth.mia

• Holter monitering
• Antiarrythmic agents (digitalis, ß-blockers,
  calcium channel blockers)
• Cardioversion
• Defibrillation
• Implantable cardioverter defibillator (ICD)
• Cardiac pacing
• Radiofrequency ablation
• Cryoablation

12
Samples of Words with a Prefix De
Meaning to Negate
de.bate v. to discuss or argue
formally de.cay v. to decompose rot (Gr. de,
down cadere, fall down ) de.code v. to
convert from code to plain text de.generate v.
to deteriorate or decay De.hydrate v. to
remove water from de.grade v. to debase,
corrupt de.lete v. to strike out
omit De.mote v. to lower in rank de.note
v. to indicate plainly de.part v. to
leave de.pict v. to represent in a
picture de.sert v. to abandon de.valuate
v. to lower the value de.vise v. to plan
(L. de-visus, of dividere, to divide)
13
Samples of Words with a De
Which Is not a Prefix
Deb.it n. an item of debt, e.g. a debit
card dé.bris n. a scattered remains
(Old French debrisier, to break to pieces) dé.cor
n. the decorative style of a room dé.but
n. the first public appearance (Old
French de- see de-) but, goal, target from
Old French butte) de.i.ty n. a god de.sert
n. a dry and barren region Del.i.ca.tes.sen
n. a shop that sells cooked food (Gr.
Delikatessen, from pl. of Delikatesse, delicacy
Fr. délicatesse L. delicatus, pleasing)
De.mo.cra.cy n. government by the people (Gk.
demos, people
kratein, to rule)
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Polymorphic Ventricular Tachycardia
(F. Torsade de pointes)

• n. a French term that literally means the
  twisting of the points.
• 1. a twisted cord.
• any ornamental twist, as of velvet.
• F. twisted fringe, equiv. to tors twisted (see
  torse) -ade ade

15
Types of Vessels
Veins
Arteries
Aorta, the largest artery, carries
blood out of the heart
Venae cavae, two largest veins carry
blood to the heart
Branches of the aorta Carotid artery (Gk
karotídes neck arteries, equiv. to
karot(ikós) soporific (kár(os) stupor
-otikos -otic) -ides -id1 so
called by Galen, who found that their
compression causes stupor)
Subclavian artery Celiac artery Mesenteric
artery (Gr. meso- enterion, diminutive
of enteron, intestine) Renal
artery Iliac artery
Collecting veins to venae cavae
Subclavian vein Jugular vein (L. jugularis,
from L. jugulum, collarbone,
throat, neck) Renal vein Iliac vein
www.phoenix5.org/.../graphics/bloodvessels.gif
Venules
Arterioles
Capillaries
(the smallest blood vessels L
capillaris pertaining to hair)
parenteral (out of intestine)
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Layers of an Artery
Endothelium
a type of epithelium composed of a single layer
of smooth, thin cells that lines the heart,
blood vessels, lymphatics, and serous cavities.
Muscle layer
Adventitia
Latin adventicius, foreign see adventitious
www.med.cmu.ac.th
17
Types of Stroke
(Cerebrovascular Accident, CVA)

• Embolic stroke

L. embolismus, from Gk. embolismos, from
emballein, to insert see emblem.

• Thrombolic stroke

New Latin thrombosis, from Gk. a clotting, from
thrombousthai, to clot, from thrombos, clot.
On auscultation, bruit (spreading sound) can be
heard on the skin of thrombotic site.

• Hemorrhagic stroke

From obsolete hemoragie, emorogie, from Middle
English emorogie, from Old French emoragie, from
L. haemorrhagia, from Gk. haimorrhagia haimo-,
hemo- -rrhagia, -rrhagia.
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Arteriosclerosis
Origin 13501400 ME lt ML lt Gk. skl rosis
hardening.
See scler-, -osis
degenerative changes in the arteries,
characterized by thickening of the vessel walls
and accumulation of calcium with consequent loss
of elasticity and lessened blood flow.
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Arteries of the Brain
www2.mhsi.us/images/ed_stroke.jpg
20
Digitalis is a Medication for the Heart

• Digitalis, an example of a cardio-active
• or cardio-tonic drug, in other words a
  steroid
• which has the ability to exert a specific and
• powerful action on the cardiac muscle in
• animals, and has been used in the treatment
• of heart conditions ever since its discovery
• in 1775.

Digitalis purpurea Common foxglove 240 x 320
pixels - 19k - jpg en.wikipedia.org
(L. digitalis, of a finger (from the
finger- shaped corollas of foxglove), from
digitus, finger see digit.
(e.g. L. intestinum duodenum digitorum,
intestine of twelve fingerbreadths) A digital
clock digital transmission analog transmission
Digitalis is a cardioglucoside.
21
Ten Commandments to Write Better English
1. Thou shalt always use correct grammar
Original version Further researches are
needed to clarify the issue. Revision
Further research are needed to clarify the
issue.
N.B. (nota bene, to note well) one research,
two research one deer, two deer
22
Ten Commandments to Write Better English
2. Thou shalt use simpler sentences
Original text A 10-year-old girl
was diagnosed with acute lymphoblastic
leukemia in May 2004 and remitted after
receiving induction chemotherapy. Original
text A 10-year-old girl was diagnosed with
acute lymphoblastic leukemia in May 2004.
She was in in good remission after having
received chemotherapy.
23
Ten Commandments to Write Better English
3. Thou shalt vary your
writing.
Original version Curses come home to roost like
chicken. Revision Curses, like chicken, come
home to roost.
24
Ten Commandments to Write Better English
4. Thou shalt use more active voice.
Original version Comparison of means
of bone mass density z score of continuous
variables of two groups were performed
using two-tailed student t tests.
Revision We compared means of bone mass
density z score of continuous variables of
two groups with two-tailed student t tests.
25
Ten Commandments to Write Better English
5. Thou shalt avoid redundancies
Original version The patient developed conscious
changes in mental status such as disorientation,
lethargy, confusion and obtundation
Revision The patient developed disorientation,
lethargy, confusion and obtundation.
26
Ten Commandments to Write Better English
6. Thou shalt avoid using Latinate words
Original version The patient obviously
demonstrated the exacerbation of psychotic
symptoms after receiving disulfiram therapy.
Revision The patient obviously showed the
worsened psychotic symptoms after receiving
disulfiram therapy.
27
Ten Commandments to Write Better English
7. Thou shalt use strong verbs
Original text These results are in agreement
with those in the studies of rat model of spinal
cord injury. Revision These results agree
with those in the studies of rat model of spinal
cord injury.
28
Ten Commandments to Write Better English
8. Thou shalt use the parallel construction
Original text The causes in
malabsorptions of cobalamin (vitamin B12)
deficiency consist of inadequate production of
intrinsic factor, disorder of terminal ileum,
and competing for cobalamin.
Revision The causes in malabsorptions of
cobalamin (vitamin B12) deficiency consist of
decreased intrinsic factor, the presence of
disorder of terminal ileum, and the competition
for cobalamin.
29
Ten Commandments to Write Better English
9. Thou shalt avoid using empty phrases.
Original text There were no any
complications noted when she was discharged
with normal liver function. Revision
She did not have any complications when she was
discharged with normal liver function.
30
Ten Commandments to Write Better English
10. Thou shalt be specific in using words.
Original text The professor has
improved the department during his
10-year tenure in the department.
Revision The professor has improved the
department during his 10-year employment in
the department.
1. the holding or possessing of anything the
tenure of an office. 2. the holding of
property, esp. real property, of a superior in
return for services to be rendered. 3. the
period or term of holding something. 4. status
granted to an employee, usually after a
probationary period, indicating that the
position or employment is permanent.
Random House Unabridged Dictionary, Random House,
Inc. 2006.
31
Exercises II
Choosing the Most Appropriate Answers

• Yeman is (A) a Caribbean, (A) a Baltic, (C) a
  Mediterranean, or (D) an Arabian country.
• 5. The term, euphoria means (A) being elated,
  (B) being depressed, (C) being defeated, or (D)
  being confused.
• 6. On auscultation of a person who is lying in
  bed quietly, we can hear (A) râles, (B) bruit,
  (C) murmur, or (D) tapping sounds.