2
Circulatory System
1. State the meaning of the circulatory system and its
function.
2. State the functions of the cardiovascular and
lymphatic systems, and analyze associated
terminology.
3. Write the meanings of the word parts associated
with the cardiovascular and lymphatic systems, and
use them to build and analyze terms.
4. Write the names of the structures of the
cardiovascular and lymphatic systems, and define
the terms associated with these structures.
Lesson 4.1 Learning Targets
Copyright © 2018 Elsevier Inc. All rights reserved. 2
3
Cardiovascular System
5. Sequence the flow of blood from when it enters the
heart until it returns to the heart.
6. Write the names of the diagnostic tests and procedures
for assessment of the cardiovascular and lymphatic
systems when given their descriptions, or match
procedures with their descriptions.
7. Write the names of cardiovascular and lymphatic
pathologies when given their descriptions or match
pathologies with their meanings.
8. Match surgical and nonsurgical therapeutic
interventions with their descriptions, or write the names
of the interventions when given their descriptions.
Lesson 4.1 Learning Targets
Copyright © 2018 Elsevier Inc. All rights reserved. 3
Functions of the Cardiovascular System
Circulates blood throughout the body, delivering
nutrients and other essential materials to the
fluids surrounding the cells.
Removes waste products and conveys the
wastes to organs from which they are excreted.
4
Terminology: Anatomic
Pulmonary – refers to the lungs
Cardiopulmonary – refers to the heart & lungs
Copyright © 2018 Elsevier Inc. All rights reserved. 5
Copyright © 2015 by Saunders, an imprint of Elsevier Inc. 6
Heart Anatomy
divided longitudinally by the interatrial & interventricular septum
4 chambers: 2 atria & 2 ventricles
Heart Anatomy Atria
receive blood returning to the heart
right atrium: superior vena cava, inferior vena
cava and coronary sinus
left atrium: 4 pulmonary veins
Ventricles
right: pumps blood into the pulmonary trunk
left: pumps blood into the aorta then into the
body
Coronary Arteries and Heart Tissues
8
the heart is supplied by the left and right
coronary arteries & returns to the RA by the
coronary sinus & anterior cardiac veins
Gross Heart Anatomy
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(A) From Jacob S: Human anatomy: A clinically-orientated approach, St Louis, 2008, Churchill-Livingstone
Flow of Blood Through the Heart
RA→tricuspid→RV→pulmonary semilunar
valve→pulmonary trunk →
lungs→pulmonary veins→LA→bicuspid
(mitral)→LV→aortic semilunar valve→aorta
pulmonary veins- only veins to carry oxygen rich
blood
pulmonary artery – only artery to carry
deoxygenated blood
Doppler echocardiography, Doppler scanning
Cardiac MRI
Computed tomography
Positron emission tomography
Echocardiography, echocardiogram
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Mechanical or Anatomical
Diagnostic Test Terms
Echocardiography
(A) Long BW, Rollins JH, Smith BJ: Merrill's atlas of radiographic positioning procedures, ed 13, St. Louis, 2016, Mosby.(B) Hagen-Ansert SL: Textbook of diagnostic sonography, ed 75, St Louis, 20012, Mosby
Copyright © 2018 Elsevier Inc. All rights reserved. 15
Congenital Heart Defects
Ventricular septal defect
Atrial septal defect
Patent ductus arteriosus (PDA)
Coarctation of the aorta
Tetralogy of Fallot
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Combining Forms: Structures
Cardi(o) heart
Angi(o), vas(o), vascul(o) vessel
Aort(o) aorta
Arter(o), arteri(o) artery
Arteriol(o) arteriole
-ole small
Phleb(o), ven(i), ven(o) vein
Venul(o) venule
Pulmon(o) lungs
19
Mediastin(o) mediastinum
Coron(o) crown
Endocardi(o) endocardium
Myocardi(o) myocardium
Pericardi(o) pericardium
Sin(o) sinus
20
Combining Forms: Structures
Sept(o) wall/septal
Atri(o) atrium/atrial
Ventricul(o) ventricle/ventricular
Valv(o), valvul(o) valve/valval, valvar,
valvate, valvular, valvula
Copyright © 2018 Elsevier Inc. All rights reserved. 21
Combining Forms: Structures
Quick Quiz
Myocardial is the adjective form for myocardium
and pericardial is the adjective form of
pericardium, what is the adjective form for
endocardium?
A. Endocardia
B. Endocardiac
C. Endocardial
D. Endogenous
Copyright © 2018 Elsevier Inc. All rights reserved. 22
sinoatrial (SA) node- the pacemaker; determines the heart rate called sinus rhythm (right atrial wall)
atrioventricular (AV) node- impulse travels from SA node to here (inferior portion of the interatrial septum above the tricuspid valve)
atrioventricular (AV) bundle or the bundle of His- from AV node through the bundle; only electrical connection between atria and ventricles (inferior part of interatrial septum)
right and left bundle branches- extensions of the bundle of His
ventricular walls – purkinje fibers- ensure contraction of the ventricles & papillary muscles
Electrical Conduction System
Electrical Activity
Diagnostic Test Terms Electrocardiography
Holter Monitor
Chest X-ray
Stress Tests
Treadmill exercise test
Thallium stress test
Electrophysiologic Studies
Copyright © 2018 Elsevier Inc. All rights reserved. 26
Heart Rate Heart rate: number of beats per minute (bpm)
Pulse: rhythmic expansion of an artery lying
near the skin surface that can be felt with the
finger
Normal resting pulse 60–100 bpm
Bradycardia = less than 60 bpm
Tachycardia = more than 100 bpm
29
Blood Pressure Measurement
Blood pressure:
systolic/diastolic
Systolic pressure =
pressure when the
ventricles contract
Diastolic pressure =
pressure when the
ventricles relax
Sphygmomanometer
measures the pressure
30
Terminology: Anatomic
Venipuncture & phlebotomy – opening of a vein
to draw blood for analysis
Copyright © 2018 Elsevier Inc. All rights reserved. 32
Laboratory Tests
Lipids cholesterol
triglycerides
Lipoproteins low-density (LDL)
high-density (HDL)
Enzymes lactate dehydrogenase (LDH) test
creatine kinase (CK) test or creatine phosphokinase (CPK)
Copyright © 2018 Elsevier Inc. All rights reserved. 33
Blood Vessel Diagnostic Test Terms
Arteriography produces arteriography or
arteriogram
Coronary arteriography
Aortography produces an aortogram
Digital subtraction angiography (DSA)
Cardiac catheterization
Angiogram, angiography, angiocardiography
Copyright © 2018 Elsevier Inc. All rights reserved. 34
Arteriogram
From Braunwald: Heart disease: a textbook of cardiovascular medicine, ed 6, Philadelphia, 2001, Saunders.
Copyright © 2018 Elsevier Inc. All rights reserved. 35
Word Parts: Heart Pathologies
Rhythm(o), -rrhythm(o) rhythm
De- down, from, or
reversing
Scler(o), -sclerosis hard, hardening
-stenosis narrowing; stricture
Copyright © 2018 Elsevier Inc. All rights reserved. 37
Heart Pathologies
The leading cause of death in the United States is cardiovascular disease.
Cardiovascular disease is any abnormal condition characterized by dysfunction of the heart and blood vessels.
Primary cardiac diseases are those that originate in the heart: structural defects, inflammation, and infection of the heart Atriomegaly, cardiomegaly, microcardia
Congenital heart disease; congenital heart defects
Heart murmurs
Cyanosis
38
Arrhythmias
Dysrhythmia
Heart flutters, heart palpitations
Ventricular fibrillation, atrial fibrillation
Bradycardia, tachycardia
Premature ventricular contraction (PVC)
Paroxysmal atrial tachycardia (PAT)
Atrioventricular block (AVB), heart block
Asystole
39
Heart Pathologies
Myocardial infarction (MI)
Causes anoxia and infarct (damaged tissue)
Congestive heart failure (CHF)
Ischemia can cause angina pectoris (chest pain)
Cardiac insufficiency
Copyright © 2018 Elsevier Inc. All rights reserved. 40
Heart Pathologies Hemopericardium is the effusion of blood into
the pericardial space
Cardiac tamponade is compression of the heart from
fluid accumulation around the heart
Shock caused by inadequate blood flow results
in hypovolemia
Copyright © 2018 Elsevier Inc. All rights reserved. 42
Quick Quiz
Which term means any disease of cardiac muscle?
A. Myocarditis
B. Endocardiopathy
C. Cardiomyopathy
D. Pericarditis
Copyright © 2018 Elsevier Inc. All rights reserved. 43
Valvular Pathologies Valvular stenosis
Valvulitis, cardiovalvulitis
Mitral valve prolapse (MVP)
Rheumatic heart disease
Copyright © 2018 Elsevier Inc. All rights reserved. 44
Terminology: Blood Vessel
Vasomotor center
Vasodilation, vasoconstriction
Word Parts
Aneurysm(o) aneurysm
Ather(o) yellowish, fatty plaque
Embol(o) embolus
Copyright © 2018 Elsevier Inc. All rights reserved. 45
Arterial Aneurysms
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(B) From Kowalczyk N, Mace JD: Radiographic Pathology for Technologists, ed 5, 2009, Mosby.
Blood Vessel Pathologies
Coronary artery disease (CAD)
Arteriosclerotic heart disease (ASHD)
Atherosclerosis, lumen, occlusion
Sclerosis, aortosclerosis
Coronary thrombosis
Coronary occlusion
Cerebrovascular accident (CVA)
Copyright © 2018 Elsevier Inc. All rights reserved. 47
Atherosclerosis
Patton KT, Thibodeau GA: Anatomy & physiology, ed 9, St Louis, 2016, Mosby/Elsevier.
Copyright © 2018 Elsevier Inc. All rights reserved. 48
Stenosis, stricture, aortic stenosis
Aortic insufficiency (AI), aortic regurgitation
Aortitis, angiocarditis, arteritis
Angiostenosis, arteriopathy
Peripheral vascular disease (PVD)
Embolus, embolism
Angioma, hemangioma, lymphangioma
Varicose veins, hemorrhoids
Copyright © 2018 Elsevier Inc. All rights reserved. 50
Blood Vessel Pathologies
Varicose Veins
(A) From Lewis SM, Heitkemper MM, Dirksen SR, O’Brien PG, Bucher L: Medical-surgical nursing: assessment and management of clinical problems, ed 7, St Louis, 2007, Mosby.
Copyright © 2018 Elsevier Inc. All rights reserved. 51
Phlebitis, thrombophlebitis
Venous thrombosis
Phlebostasis
Copyright © 2018 Elsevier Inc. All rights reserved. 52
Blood Vessel Pathologies
Surgical and Therapeutic Interventions
Cardiopulmonary resuscitation (CPR): external
cardiac massage and respiration
Cardiac pacemaker
Cardioversion, cardioverter
Defibrillator, defibrillation
Copyright © 2018 Elsevier Inc. All rights reserved. 53
Quick Quiz
What term means surgical puncture of the
pericardium?
A. Pericardiostenosis
B. Thoracentesis
C. Pericarditis
D. Pericardiocentesis
Copyright © 2018 Elsevier Inc. All rights reserved. 56
Cardioplegia, cardioplegic solutions
Cardiopulmonary bypass, extracorporeal
Coronary artery bypass, shunt
Coronary artery bypass graft (CABG)
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Surgical and Therapeutic Interventions
Minimally invasive direct coronary artery bypass
(MIDCAB)
Off-pump coronary artery bypass (OPCAB)
Percutaneous coronary intervention (PCI)
Copyright © 2018 Elsevier Inc. All rights reserved. 60
Surgical and Therapeutic Interventions
What is the name of surgical repair of the
septum between the atria?
endarterectomy, atherectomy
laser-assisted angioplasty, excimer laser
coronary angioplasty
percutaneous transluminal coronary angioplasty
(PTCA)
intracoronary stent, stents
Copyright © 2018 Elsevier Inc. All rights reserved. 61
Surgical and Therapeutic Interventions
Atherectomy
Copyright © 2018 Elsevier Inc. All rights reserved. 62
(B) and (C) From Snopek AM: Fundamentals of special radiographic procedures, 5e, St Louis, 2006, Saunders
Intravascular thrombolysis
Sclerotherapy
Angiostomy, angiotomy
Phlebectomy, phleboplasty
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Surgical and Therapeutic Interventions
Heparin
Embolectomy
Vasodilators, nitroglycerin
Antiarrhythmic drugs
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Surgical and Therapeutic Interventions
Calcium channel blockers
Beta blockers
Digoxin
Antihypertensives, diuretics
Antilipidemics
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Surgical and Therapeutic Interventions
Functions of the Lymphatic System
Helps protect and maintain the internal fluid
environment by producing, filtering, and
conveying lymph
Absorbs and transports fats to the blood system
Serves as an important part of the immune
system
Copyright © 2018 Elsevier Inc. All rights reserved. 67
Terminology: Lymphatic System
Lymphogenous
Thoracic duct, cisterna chyli
Lymph nodes: cervical, axillary, inguinal
Copyright © 2018 Elsevier Inc. All rights reserved. 68
Word Parts: Lymphatic System
Aden(o) gland
Lymph(o) lymph, lymphatics
Lymphaden(o) lymph node
Lymphangi(o) lymph vessel
Lymphat(o) lymphatics
Adenoid(o) adenoids
Splen(o) spleen
Thym(o) thymus
Tonsill(o) tonsils
Copyright © 2018 Elsevier Inc. All rights reserved. 70
Circulation of Lymph
From Drake R, Vogl W, Mitchell A: Gray’s anatomy for students, ed 3, 2015, Churchill-Livingstone.
Copyright © 2018 Elsevier Inc. All rights reserved. 71
Diagnostic Tests and Procedures
Lymphography, lymphogram
Lymphangiography, lymphadenography
Lymph node biopsy
Blood tests of B and T lymphocytes
Copyright © 2018 Elsevier Inc. All rights reserved. 72
Pathologies Lymphedema
Lymphostasis
Lymphadenitis, lymphadenopathy
Lymphoma: Hodgkin disease, non-Hodgkin
lymphoma
Lymphatic carcinoma (metastasis)
Thymoma, thymopathy
Lymphangitis, thrombolymphangitis
Splenopathy, splenomegaly, splenorrhagia,
splenoptosis
Inflammation of the tonsils? of the adenoids?Copyright © 2018 Elsevier Inc. All rights reserved. 73
Elephantiasis
Goldstein BJ, Goldstein AO: Practical dermatology, ed 2, St Louis, 1997, Mosby.
Copyright © 2018 Elsevier Inc. All rights reserved. 74
Cervical Lymphadenitis
Lymphangitis
From Stone DR, Gorbach SL: Atlas of infectious diseases, Philadelphia, 2000, Saunders.
Copyright © 2018 Elsevier Inc. All rights reserved. 75
Surgical Interventions Lymphadenectomy
Splenectomy, splenopexy, splenorrhaphy
Thymectomy
Adenoidectomy
Tonsillectomy, tonsilloadenectomy
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Antibiotic therapy (including penicillin), hot soaks
Chemotherapy, radiotherapy, biological
therapies
Therapeutic Interventions
77
Health Care Reports, Pharmaceutics,
Abbreviations, and Review
9. Build terms using word parts to label illustrations.
10. Use word parts from this chapter to determine the meaning of terms in a health care report.
11. Spell the terms accurately.
12. Pronounce the terms correctly.
13. Recognize or use abbreviations presented in this chapter.
14. Categorize terms as anatomy, diagnostic test or procedure, pathology, surgery, or nonsurgical therapy.
15. Recognize the meanings of general pharmacology terms used in this chapter as well as the drug classes and their uses.
Lesson 4.2
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Pharmaceutics Antianginal drugs
Antiarrhythmics
Anticoagulants
Antihypertensives
Antihyperlipidemics
Antiplatelet drugs/antiaggregants
Blood flow agents
Cardiac stimulants
Hemostatics
Thrombolytics
Copyright © 2018 Elsevier Inc. All rights reserved. 78
Abbreviations: Anatomy
RA right atrium; rheumatoid arthritis
RV right ventricle
LA left atrium
LV left ventricle
SA sinoatrial
AV, A-V atrioventricular
BP blood pressure
Copyright © 2018 Elsevier Inc. All rights reserved. 79
Abbreviations: Diagnostics
mm Hg millimeters of mercury
CK (CPK) creatine kinase (formerly called creatine phosphokinase)
DSA digital subtraction angiography
LDL low-density lipoprotein
HDL high-density lipoprotein
LDH lactate dehydrogenase (enzyme elevated after MI)
TEE transesophageal echocardiogram
Copyright © 2018 Elsevier Inc. All rights reserved. 80
Abbreviations: Pathologies
AVB atrioventricular block
AI aortic insufficiency
ASHD arteriosclerotic heart disease
CAD coronary artery disease
CHF congestive heart failure
CVA cerebrovascular accident
HTN hypertension
Copyright © 2018 Elsevier Inc. All rights reserved. 81
Abbreviations: Pathologies
MI myocardial infarction
MVP mitral valve prolapse
PAT paroxysmal atrial tachycardia
PDA patent ductus arteriosus (also
posterior descending [coronary]
artery)
PVC premature ventricular contraction
Copyright © 2018 Elsevier Inc. All rights reserved. 82
Abbreviations: Therapeutics
CABG coronary artery bypass graft
CPR cardiopulmonary resuscitation
MIDCAB minimally invasive direct coronary artery bypass
OPCAB off-pump coronary artery bypass
PCI percutaneous coronary intervention
PTCA percutaneous transluminal coronary angioplasty
Copyright © 2018 Elsevier Inc. All rights reserved. 83