applied anatomy and physiology of blood circulation
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BY PB ICN NORLAILEE BINTI ABDUL HAMID
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LOCATION OF THE HEART
Rest on the diaphragm and is beneath andmostly to the left of sternum.
Apex is located in the fifth intercostal spaceon the mid clavicular line.
-the apex is able to move,when the ventriclescontract,the apex move forward and strikes
the left thoracic wall near the fifth intercostalspace.
The base lies just below the second rib and isin a relatively fixed position.
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STRUCTURE OF THE HEART
The heart is shaped like a cone with the base
superiorly and the apex inferiorly.It is about the
size of the clenched fist of is own.
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COVERING OF THE HEART
Lies inside a protective sac called thepericardium.
The pericardium is composed of an outer fibrouspericardium and inner serous pericardium.
The serous pericardium is divided into an outerparietal layer and an inner visceral layer.
Between the parietal and visceral layers is apotential space called pericardial cavity.
The pericardial cavity is filled with serouspericardial fluid.
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WALL OF THE HEART
3 layers :
1. Outer epicardium2. Middle myocardium
3. Inner endocardium
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CARDIOVASCULAR PHYSIOLOGY
Describes the flow of blood through the heart
and blood vessels,or more commonly called
the circulation of blood in the body. Divided into 2 main parts:-
a)pulmonary circulation
b)systemic circulation
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PULMONARY CIRCULATION
Pulmonary artery arises from the right
ventricle&transport deoxygenated blood to
the lungs where the blood becomesoxygenated again.
The four pulmonary veins return the
oxygenated blood to the left atrium and t left
ventricle.
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SYSTEMIC CIRCULATION
Oxygenated blood is pump from the leftventricle into the aorta.
Branches of the aorta convey blood to all tissues
and organ of the body(except the lungs).Tissue cells(oxygenated&deoxygenated blood)
returned to the heart via the superior&inferiorvena cava.
The blood flow via the tricuspid valve into theright ventricle,from where it joins the pulmonarycirculation.
Also referred to as the greater circulation.
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CARDIAC OUTPUT
Definition
The amount of blood ejected from the heart
per minute is essential equal to the amount ofvenous blood return to the right atrium fromthe peripheral circulation.
C/O=stroke volume x heart rate
Normal is 4-8L/min
Stroke volume is amount of the blood
ejaculation every beat.
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CARDIAC OUTPUT AFFECTING BY
4 FACTORS1)PRELOAD
-Amount of blood in the ventricle at the end ofdiastole or before contraction.
-It effected by venous return.
-increased preload will increased cardiac output.
2)AFTERLOAD
-The resistance in the ventricle and aortain oderto eject the stroke volume.
-When blood vessel dialate or constric,cardiacoutput decreased.
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3)CARDIAC CONTRACTILITY
-Force contract of the heart or abilitymyocardium to stretch or contract.
-It will increased by CNS stimuli and reduced bydisease of myocardium.
-If good contractility,will good cardiac output.4)HEART RATE
-The number of the time per minute ventricularcontract.
-Heart rate stimulate by sympathetic nerves.-Increased heart rate more than 150/min or less
than 50/min will reduce cardiac output.
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LOW CARDIAC OUTPUT
The heart muscle is not able to pump the proper amount ofblood to the body tissues.
The heart it beating too slowly.
The muscle of the heart arent strong enough to pumpproperly,cardiac output will be decreased.
This can occur due to:-
-damaged heart muscle
-a dysfunctional cardiac electrical system
-blood clots-high pressure in the arteries
-low amounts of blood entering the heart with each beat.
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INDICATORS OF DECREASED
CARDIAC OUTPUT Cardiac arrest
Respiratory arrest
Hypovolemic shock
Oliguria
Elevated blood urea nitrogen and creatininelevels.
Peripheral oedema in feet,ankle Neurological signs and symtoms
irratability,restlessness,confusion,anxiety,insomnia.
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REGULATION OF BLOOD FLOW
Flow of blood through the vessels of thecirculatory system is a function of thepressure in the system and the resistanceto flow caused by the blood vessels.
Pressure vessel increases-blood flow willincrease.
Resistance increases blood flow willdecrease.
Resistance effected by 3 parameters:-
-length of the vessel.-viscosity of the blood.
-radius of the vessel.
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EXTRINSIC REGULATION OF BLOOD
FLOW-refers to the control of arteriolar radius by both
the autonomic nerveous and endocrine system.
Sympathetic control of arteriolar radius
-arterioles are enervated by the sympathetic
nervous system only.
-sympathetic nerve fibers secrete
norepinephrine .binding of norepinephrine to
receptor on the smooth muscles of arteriols
causes contraction and thus leads tovasoconstriction.
The baseline amount of sympathetic stimulationand thus are slightly constricted(vessel b in
figure).
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This baseline level of constriction is call
Vascular Tone.
Vasodilation is accomplished by decreasingsympathetic stimulation belowbaseline(vessel a).
Vasoconstriction is accomplished byincreasing sympathetic stimulation above
baseline(vessel c).
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Endocrine control of arteriolar radius-composed of a variety of glands that produce
and secrete hormones.Hormones are
signalling molecules that enter the blood
stream and travel throughout the body.
-Epinephrine is a hormone that has a significant
effecton the radius of blood vessels.
-secreted by the adrenal medulla in response tosympathetic stimulation
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INTRINSIC REGULATION OF
BLOOD FLOW
-refers to local control of arteriolar radius.
-allows some organs to regulate their own
blood flow of what may be happening elsewhere in the body.
-take the form of metabolic control or
myogenic control.
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REGULATION OF BLOOD PRESSURE
Abnormally low blood pressure-inadequate
perfusion of organs.
Abnormally high blood pressure can causeheart disease,vascular disease and stroke.
Pressure in the arterial system fluctuates with
the cardiac cycle.blood pressure reaches apeak in systole and is lowest in diastole.
Mean Arterial Pressure(MAP)represents the
averange pressure in the arterial system.
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This is important because it is the difference
between MAP and the venous pressure drivesthrough the capillaries.
MAP is not simply the average of the systole anddiastolic pressures.
- Calculation MAP:a) systolic + 2(diastolic)
3
OR
b)diastolic pressure+1/3 pulse pressureNormal values:70-105mmHg
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BLOOD PRESSURE
The heart is a muscle that pumps bloodaround the body.Blood that is low in oxygenis pumped towards the lungs,where oxygensupplies are replenished.the heart pumps this
oxygen rich blood around the body to supplyour muscles and cells.
-systolic pressure-the heart contracts,whichoccurs when the left ventricle contracts.
-diastolic pressure-the blood pressurebetween heartbeats,when the heart is restingand dilating.
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HYPERTENSION
Systolic increased more than 140mmHg and
dyastolic increased more than 90mmHg and
maintain high while on resting time. 2 classification of hypertension:-
a)Primary hypertension or known as
essential hypertension.
b)secondary hypertension-more aboutdesease.
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Primary
-family history
-age
-race
-obesity-mineral intake
Secondary
-kidney disease
-endocrine disoder
-neurological disoder
-drug use
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Patophysiology
Continuoesly high pressure the artery
become thick and sclerosis,then the flow of
the blood.-heart
- kidney
- eye-endocrine
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