Cardiovascular
System
Dr. Michael P. Gillespie
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.

2
CHAPTER GOALS (CONT’D)
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.

3
INTRODUCTION

Cardiovascular System: delivers oxygen and
nutrients to cells of body tissue
Heart (muscular pump)
 Blood vessels (fuel line and transportation network)

4
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.

5
BLOOD VESSELS
6
BLOOD CIRCULATION / SYSTEMIC
CIRCULATION
7
MAJOR VESSELS
8
ANATOMY OF THE HEART
9
ANATOMY OF THE HEART
10
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
 Bicuspid (mitral valve): between left atrium and
the left ventricle
 aortic valve: between left atrium and aorta

11
PATHWAY OF BLOOD
THROUGH THE HEART
12
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).

13
HEART SOUNDS
Closure of valves associated with sounds “lubbdubb, 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
14
PHASES OF THE HEARTBEAT
15
PHASES OF THE HEARTBEAT
16
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)
17
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.
18
CONDUCTION SYSTEM OF THE HEART
19
CONDUCTION SYSTEM OF THE HEART
20
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.
21
ELECTROCARDIOGRAM
22
ELECTROCARDIOGRAM
23
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
24
COMBINING FORMS
AND TERMINOLOGY
Combining Form
angi/o
 aort/o
 arter/o
 arteri/o
 ather/o
 atri/o

Meaning
vessel
aorta
artery
artery
yellowish plaque
atrium
25
COMBINING FORMS
AND TERMINOLOGY
Combining Form
brachi/o
 cardi/o
 cholesterol/o
 coron/o
 cyan/o
 myx/o

Meaning
arm
heart
cholesterol
heart
blue
mucus
26
COMBINING FORMS
AND TERMINOLOGY
Combining Form
ox/o
 pericardi/o
 phleb/o
 sphygm/o
 steth/o
 thromb/o

Meaning
oxygen
pericardium
vein
pulse
chest
clot
27
COMBINING FORMS
AND TERMINOLOGY
Combining Form
valvul/o
 valv/o
 vas/o
 vascul/o
 ven/o, ven/i
 ventricul/o

Meaning
valve
valve
vessel
vessel
vein
ventricle
28
QUICK QUIZ:
1. The double-layered membrane
surrounding the heart is the
___________.
A. pericardium
B. arteriole
C. endocardium
D. endothelium
29
QUICK QUIZ:
2. The contraction phase of the
heartbeat is called _________.
A. diastole
B. vena cava
C. systole
D. septum
30
PATHOLOGY:
THE HEART AND BLOOD VESSELS
HEART
arrhythmias
heart block (atrioventricular block)
flutter
fibrillation
31
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
32
PATHOLOGY:
THE 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
33
PATHOLOGY:
THE 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)
34
PATHOLOGY:
THE HEART AND BLOOD VESSELS
HEART
Coronary artery disease
Drug therapies for CAD






nitrates (nitroglycerin)
aspirin
beta-blockers
ACE inhibitors
calcium channel blockers
statins
35
PATHOLOGY:
THE HEART AND BLOOD VESSELS
HEART
Coronary artery disease
Surgical therapies for CAD


coronary artery bypass grafting (CABG)
percutaneous coronary intervention (PCI)
36
PATHOLOGY:
THE HEART AND BLOOD VESSELS
HEART
Other Pathologic conditions
endocarditis (vegetations)
 hypertensive heart disease
 mitral valve prolapse (MVP)
 murmur
 pericarditis
 rheumatic heart disease

37
PATHOLOGY:
THE HEART AND BLOOD VESSELS
BLOOD VESSELS
aneurysm
 deep vein thrombosis (DVT)
 hypertension (HTN)
 peripheral vascular disease (PVD)
 Raynaud disease
 varicose veins

38
QUICK QUIZ:
3. Which arrhythmia refers to rapid,
random, inefficient and irregular
contractions of the atria and ventricles
(350 beats or more per minute)?
A. fibrillation
B. flutter
C. bradycardia
39
LABORATORY TESTS
BNP test
 lipid test profile
 lipoprotein electrophoresis
 serum enzyme tests

40
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)
41
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
42
CLINICAL PROCEDURES:
DIAGNOSTIC
Other diagnostic procedures:




cardiac catheterization
electrocardiography (ECG, EKG)
Holter monitoring
stress test
43
CLINICAL PROCEDURES:
DIAGNOSTIC

Identify the normal sinus rhythm and arrhythmias
44
CLINICAL PROCEDURES: TREATMENT
cardioversion (defibrillation)
 endarterectomy
 extracorporeal circulation
 heart transplantation
 thrombolytic therapy

45
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.
46
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.
47
TREATMENT PROCEDURES

percutaneous
coronary intervention
(PCI)

includes:
percutaneous
transluminal coronary
angioplasty (PTCA),
stent placement, laser
angioplasty, and
atherectomy
48
ABBREVIATIONS







Cath
MR
PCI
PVC
HTN
ECG
LDL







BBB
CAD
CVP
Vfib
PDA
BP
SOB







LMWH
ICD
LVAD
ASD
CABG
ECHO
MVP
49
QUICK QUIZ:
4. Which procedure involves insertion of a
balloon-tipped catheter into a coronary
artery?
A. thrombolytic therapy
B. coronary artery bypass grafting
C. percutaneous coronary intervention
D. endarterectomy
50
REVIEW SHEET
COMBINING FORMS
Combining Form
angi/o
 aort/o
 arter/o
 arteri/o
 ather/o
 atri/o

Meaning
______________
______________
______________
______________
______________
______________
51
REVIEW SHEET
COMBINING FORMS
Combining Form
angi/o
 aort/o
 arter/o
 arteri/o
 ather/o
 atri/o

Meaning
vessel
aorta
artery
artery
yellowish plaque
atrium
52
REVIEW SHEET
COMBINING FORMS
Combining Form
Meaning
brachi/o
 cardi/o
 cholesterol/o
 coron/o
 cyan/o
 myx/o
______________
______________
______________
______________
______________
______________

53
REVIEW SHEET
COMBINING FORMS
Combining Form
Meaning
brachi/o
 cardi/o
 cholesterol/o
 coron/o
 cyan/o
 myx/o
arm
heart
cholesterol
heart
blue
mucus

54
REVIEW SHEET
COMBINING FORMS
Combining Form








ox/o
pericardi/o
phleb/o
pulmon/o
rrhythm/o
sphygm/o
steth/o
thromb/o
Meaning
______________
______________
______________
______________
______________
______________
______________
______________
55
REVIEW SHEET
COMBINING FORMS
Combining Form








ox/o
pericardi/o
phleb/o
pulmon/o
rrhythm/o
sphygm/o
steth/o
thromb/o
Meaning
oxygen
pericardium
vein
long
rhythmn
pulse
chest
clot
56
REVIEW SHEET
COMBINING FORMS
Combining Form
Meaning
valvul/o
 valv/o
 vas/o
 vascul/o
 ven/o, ven/i
 ventricul/o
______________
______________
______________
______________
______________
______________

57
REVIEW SHEET
COMBINING FORMS
Combining Form
Meaning
valvul/o
 valv/o
 vas/o
 vascul/o
 ven/o, ven/i
 ventricul/o
valve
valve
vessel
vessel
vein
ventricle

58
REVIEW SHEET
SUFFIXES
Suffix






-constriction
-dilation
-emia
-graphy
-lysis
-megaly
Meaning
______________
______________
______________
______________
______________
______________
59
REVIEW SHEET
SUFFIXES
Suffix

-constriction
-dilation
-emia
-graphy
-lysis

-megaly




Meaning
narrowing
widening; stretching; expanding
blood condition
process of recording
breakdown; separation;
destruction; loosening
enlargement
60
REVIEW SHEET
SUFFIXES
Suffix
Meaning

-meter
______________

-oma
-osis
-plasty
-sclerosis
-stonosis
-tomy
______________
______________
______________
______________
______________
______________





61
REVIEW SHEET
SUFFIXES
Suffix
Meaning

-meter
measure

-oma
-osis
-plasty
-sclerosis
-stonosis
-tomy
tumor; mass; fluid collection
condition; usually abnormal
surgical repair
hardening
tightening; structure
process of cutting





62
REVIEW SHEET
PREFIXES
Prefix
Meaning

a-, an
______________

brady-
______________

de-
______________

dys-
______________

endo-
______________

hyper-
______________
63
REVIEW SHEET
PREFIXES
Prefix
 a-,
an
Meaning
no; not; without

brady-
slow

de-
lack of; down; less; removal of

dys-
bad; painful; difficult; abnormal

endo-
in; within

hyper-
above; excessive
64
REVIEW SHEET
PREFIXES
Prefix
Meaning

hypo-
______________

inter-
______________

peri-
______________

tachy-
______________

tetra-
______________

tri-
______________
65
REVIEW SHEET
PREFIXES
Prefix
Meaning

hypo-
deficient; below; under; less
than normal

inter-
between

peri-
surrounding

tachy-
fast

tetra-
four

tri-
three
66