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The Language of Medicine

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Cardiovascular System Dr. Michael P. Gillespie * * * * * * * * * * * * * * * * * The ECG diagnoses electrical problems in the heart, such as arrhythmias. – PowerPoint PPT presentation

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Title: The Language of Medicine


1
Cardiovascular System Dr. Michael P. Gillespie
2
Chapter Goals
  • Name the parts of the heart and associated blood
    vessels and their functions in the circulation of
    blood.
  • Trace the pathway of blood through the heart.
  • Identify and describe major pathologic conditions
    affecting the heart and blood vessels.

3
Chapter Goals (contd)
  • Define combining forms that relate to the
    cardiovascular system.
  • Describe important laboratory tests and clinical
    procedures pertaining to the cardiovascular
    system, and recognize relevant abbreviations.
  • Apply your new knowledge to understand medical
    terms in their proper context, such as in medical
    reports and records.

4
Introduction
  • Cardiovascular System delivers oxygen and
    nutrients to cells of body tissue
  • Heart (muscular pump)
  • Blood vessels (fuel line and transportation
    network)

5
Blood Vessels and the Circulation of Blood
  • Arteries are the vessels that lead away from the
    heart.
  • Veins are thinner walled vessels compared to
    arteries. They move deoxygenated blood toward the
    heart from the tissues.
  • Capillaries are the smallest vessels. They form
    the point of exchange for oxygen and nutrients
    into body cells and waste products coming from
    body cells.

6
Blood Vessels
7
Blood Circulation / Systemic Circulation
8
Major Vessels
9
Anatomy of the Heart
10
Anatomy of the Heart
11
Major Valves of the Heart
  • tricuspid valve (cusps are flaps of the valves)
    between right atrium and right ventricle
  • pulmonary valve between right ventricle and
    pulmonary artery
  • mitral valve between left atrium and the left
    ventricle
  • aortic valve between left atrium and aorta

12
Pathway of Blood through the Heart
13
Heartbeat and Heart Sounds
  • Two phases of the heartbeat
  • diastole relaxation
  • systole contraction
  • The diastole-systole cardiac cycle occurs between
    70 to 80 times per minute (100,000 times per
    day).
  • The heart pumps 3 ounces of blood with each
    contraction. This means that about 5 quarts are
    pumped per minute (75 gallons an hour and about
    2000 gallons a day).

14
Heart Sounds
  • Closure of valves associated with sounds
    lubb-dubb, lubb-dubb
  • lubb closure of the tricuspid and mitral valves
    at the beginning of systole
  • dubb closure of the aortic and pulmonary valves
    at the end of systole
  • murmur abnormal heart sound caused by improper
    valve closure

15
Phases of the Heartbeat
16
Phases of the Heartbeat
17
Conduction System of the Heart
  • sinoatrial node (SA node) pacemaker of the heart
  • pacemaker origin of electrical impulse causing
    walls of the atria to contract and force blood
    into the ventricles (ending diastole)

18
Conduction System of the Heart
  • Atrioventricular node (AV node) This sends the
    excitation wave to a bundle of specialized fibers
    called atrioventricular bundle or Bundle of His.
  • Bundle of His (pronounced hiss) Helps form
    conduction myofibers that extend to ventricle
    walls and stimulate them to contract, beginning
    systole. A short rest period follows.
  • The pacemaker begins wave of excitation again.
  • ECG or EKG (electrocardiogram) The record used
    to detect electrical changes in heart muscle as
    the heart beats.

19
Conduction System of the Heart
20
Conduction System of the Heart
21
Electrocardiogram
  • P wave spread of excitation wave over the atria
    just before contraction QRS wave spread of
    excitation wave over the ventricles as the
    ventricles contract T wave electrical recovery
    and relaxation of ventricles. A heart attack
    (myocardial infarction or MI) can be recognized
    by an elevation in the S-T segment of the ECG.
    Thus, one type of MI is an S-T elevation MI or
    STEMI.

22
Electrocardiogram
23
Electrocardiogram
24
Blood Pressure
  • Blood pressure The force that blood exerts on
    arterial walls.
  • Measured using sphygmomanometer
  • Expressed as a fraction
  • systolic pressure/
  • diastolic pressure
  • example 120/80 mm Hg

25
Combining Forms and Terminology
  • angi/o vessel
  • aort/o aorta
  • arter/o artery
  • arteri/o artery
  • ather/o yellowish plaque
  • atri/o atrium

Combining Form Meaning
26
Combining Forms and Terminology
  • brachi/o arm
  • cardi/o heart
  • cholesterol/o cholesterol
  • coron/o heart
  • cyan/o blue
  • myx/o mucus

Combining Form Meaning
27
Combining Forms and Terminology
  • ox/o oxygen
  • pericardi/o pericardium
  • phleb/o vein
  • sphygm/o pulse
  • steth/o chest
  • thromb/o clot

Combining Form Meaning
28
Combining Forms and Terminology
  • valvul/o valve
  • valv/o valve
  • vas/o vessel
  • vascul/o vessel
  • ven/o, ven/i vein
  • ventricul/o ventricle

Combining Form Meaning
29
QUICK QUIZ
  • The double-layered membrane surrounding the heart
    is the ___________.
  • pericardium
  • arteriole
  • endocardium
  • endothelium

30
QUICK QUIZ
  • 2. The contraction phase of the heartbeat is
    called _________.
  • diastole
  • vena cava
  • systole
  • septum

31
Pathology the Heart and Blood Vessels
  • HEART
  • arrhythmias
  • heart block (atrioventricular block)
  • flutter
  • fibrillation

32
Pathology the Heart and Blood Vessels
  • HEART
  • congenital heart disease
  • coarctation of the aorta (CoA)
  • patent ductus arteriosus (PDA)
  • septal defects (ASD and VSD)
  • tetralogy of Fallot

33
Pathologythe Heart and Blood Vessels
  • HEART
  • congenital heart disease (CHF) The heart is
    unable to pump the required amount of blood.
  • In U.S., primarily the result of high blood
    pressure and coronary artery disease (see next
    slide)
  • Results in pulmonary edema
  • Fatal if untreated

34
Pathologythe Heart and Blood Vessels
  • HEART
  • coronary artery disease (CAD)
  • Atherosclerosis
  • thrombotic occlusion (occlusive/mural)
  • ischemia
  • necrosis
  • infarction
  • Acute Coronary Syndromes (ACS)
  • unstable angina
  • myocardial infarction (MI)

35
Pathologythe Heart and Blood Vessels
  • HEART
  • Coronary artery disease
  • Drug therapies for CAD
  • nitrates (nitroglycerin)
  • aspirin
  • beta-blockers
  • ACE inhibitors
  • calcium channel blockers
  • statins

36
Pathologythe Heart and Blood Vessels
  • HEART
  • Coronary artery disease
  • Surgical therapies for CAD
  • coronary artery bypass grafting (CABG)
  • percutaneous coronary intervention (PCI)

37
Pathologythe Heart and Blood Vessels
  • HEART
  • Other Pathologic conditions
  • endocarditis (vegetations)
  • hypertensive heart disease
  • mitral valve prolapse (MVP)
  • murmur
  • pericarditis
  • rheumatic heart disease

38
Pathologythe Heart and Blood Vessels
  • BLOOD VESSELS
  • aneurysm
  • deep vein thrombosis (DVT)
  • hypertension (HTN)
  • peripheral vascular disease (PVD)
  • Raynaud disease
  • varicose veins

39
QUICK QUIZ
  • 3. Which arrhythmia refers to rapid, random,
    inefficient and irregular contractions of the
    atria and ventricles (350 beats or more per
    minute)?
  • fibrillation
  • flutter
  • bradycardia

40
Laboratory Tests
  • BNP test
  • lipid test profile
  • lipoprotein electrophoresis
  • serum enzyme tests

41
Clinical Procedures Diagnostic
  • X-Ray
  • angiography and arteriography
  • computerized tomography angiography
  • digital subtraction angiography (DSA)
  • Electron beam computed tomography (EBCT or EBT)
  • Ultrasound Tests
  • Doppler ultrasound
  • echocardiography (ECHO)

42
Clinical Procedures Diagnostic
  • Nuclear Cardiology
  • positron emission tomography (PET) scan
  • technetium (Tc) 99m Sestamibi scan (Cardiolite)
  • Thallium-201 scan
  • Magnetic Resonance Imaging (MRI)
  • cardiac MRI

43
Clinical Procedures Diagnostic
  • Other diagnostic procedures
  • cardiac catheterization
  • electrocardiography (ECG, EKG)
  • Holter monitoring
  • stress test

44
Clinical Procedures Diagnostic
  • Identify the normal sinus rhythm and arrhythmias

45
Clinical Procedures Treatment
  • cardioversion (defibrillation)
  • endarterectomy
  • extracorporeal circulation
  • heart transplantation
  • thrombolytic therapy

46
Clinical Procedures Treatment
  • Coronary artery bypass graft (CABG) surgery. A
    Section of a vein is removed from the leg and
    anastomosed to a coronary artery to bypass an
    area of arteriosclerotic blockage. B An
    internal mammary artery is grafted to a coronary
    artery to bypass blockage.

47
Clinical Procedures Diagnostic
A Normal sinus rhythm. Notice the regularity of
the P, QRS, and T waves.
B Atrial flutter. Notice the rapid atrial rate (P
wave) compared to the slower ventricular rate
(ARS).
C Atrial fibrillation. P waves are replaced by
irregular and rapid fluctuations. There are no
effective atrial contractions.
D Ventricular tachycardia. Ventricular rate may
be as high as 250 beats per minute. The rhythm is
regular, but the atria are not contributing to
ventricular filling and blood output is poor.
48
Treatment Procedures
  • percutaneous coronary intervention (PCI)
  • includes percutaneous transluminal coronary
    angioplasty (PTCA), stent placement, laser
    angioplasty, and atherectomy

49
Abbreviations
  • LMWH
  • ICD
  • LVAD
  • ASD
  • CABG
  • ECHO
  • MVP
  • Cath
  • MR
  • PCI
  • PVC
  • HTN
  • ECG
  • LDL
  • BBB
  • CAD
  • CVP
  • Vfib
  • PDA
  • BP
  • SOB

50
QUICK QUIZ
  • 4. Which procedure involves insertion of a
    balloon-tipped catheter into a coronary artery?
  • thrombolytic therapy
  • coronary artery bypass grafting
  • percutaneous coronary intervention
  • endarterectomy

51
Review Sheet
  • COMBINING FORMS
  • angi/o ______________
  • aort/o ______________
  • arter/o ______________
  • arteri/o ______________
  • ather/o ______________
  • atri/o ______________

Combining Form Meaning
52
Review Sheet
  • COMBINING FORMS
  • angi/o vessel
  • aort/o aorta
  • arter/o artery
  • arteri/o artery
  • ather/o yellowish plaque
  • atri/o atrium

Combining Form Meaning
53
Review Sheet
  • COMBINING FORMS
  • brachi/o ______________
  • cardi/o ______________
  • cholesterol/o ______________
  • coron/o ______________
  • cyan/o ______________
  • myx/o ______________

Combining Form Meaning
54
Review Sheet
  • COMBINING FORMS
  • brachi/o arm
  • cardi/o heart
  • cholesterol/o cholesterol
  • coron/o heart
  • cyan/o blue
  • myx/o mucus

Combining Form Meaning
55
Review Sheet
  • COMBINING FORMS
  • ox/o ______________
  • pericardi/o ______________
  • phleb/o ______________
  • pulmon/o ______________
  • rrhythm/o ______________
  • sphygm/o ______________
  • steth/o ______________
  • thromb/o ______________

Combining Form Meaning
56
Review Sheet
  • COMBINING FORMS
  • ox/o oxygen
  • pericardi/o pericardium
  • phleb/o vein
  • pulmon/o long
  • rrhythm/o rhythmn
  • sphygm/o pulse
  • steth/o chest
  • thromb/o clot

Combining Form Meaning
57
Review Sheet
  • COMBINING FORMS
  • valvul/o ______________
  • valv/o ______________
  • vas/o ______________
  • vascul/o ______________
  • ven/o, ven/i ______________
  • ventricul/o ______________

Combining Form Meaning
58
Review Sheet
  • COMBINING FORMS
  • valvul/o valve
  • valv/o valve
  • vas/o vessel
  • vascul/o vessel
  • ven/o, ven/i vein
  • ventricul/o ventricle

Combining Form Meaning
59
Review Sheet
  • SUFFIXES
  • -constriction ______________
  • -dilation ______________
  • -emia ______________
  • -graphy ______________
  • -lysis ______________
  • -megaly ______________

Suffix Meaning
60
Review Sheet
  • SUFFIXES
  • -constriction narrowing
  • -dilation widening stretching expanding
  • -emia blood condition
  • -graphy process of recording
  • -lysis breakdown separation
  • destruction loosening
  • -megaly enlargement

Suffix Meaning
61
Review Sheet
  • SUFFIXES
  • -meter ______________
  • -oma ______________
  • -osis ______________
  • -plasty ______________
  • -sclerosis ______________
  • -stonosis ______________
  • -tomy ______________

Suffix Meaning
62
Review Sheet
  • SUFFIXES
  • -meter measure
  • -oma tumor mass fluid collection
  • -osis condition usually abnormal
  • -plasty surgical repair
  • -sclerosis hardening
  • -stonosis tightening structure
  • -tomy process of cutting

Suffix Meaning
63
Review Sheet
  • PREFIXES
  • a-, an ______________
  • brady- ______________
  • de- ______________
  • dys- ______________
  • endo- ______________
  • hyper- ______________

Prefix Meaning
64
Review Sheet
  • PREFIXES
  • a-, an no not without
  • brady- slow
  • de- lack of down less removal of
  • dys- bad painful difficult abnormal
  • endo- in within
  • hyper- above excessive

Prefix Meaning
65
Review Sheet
  • PREFIXES
  • hypo- ______________
  • inter- ______________
  • peri- ______________
  • tachy- ______________
  • tetra- ______________
  • tri- ______________

Prefix Meaning
66
Review Sheet
  • PREFIXES
  • hypo- deficient below under less
    than normal
  • inter- between
  • peri- surrounding
  • tachy- fast
  • tetra- four
  • tri- three

Prefix Meaning
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