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The Cardiovascular System: The Heart : قلب وعايى قلبى سيستم

01/31/2012

EDO 001.16

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The Heartقلب

Learning Objective: The Physical Therapy Technician will gain an understanding of the anatomy and physiology of the heart and its purpose within the body.

Estimated Time to Complete: 325 minutes.

لکچر : وقت این تکميل برای شده دقيقه ٣٢٥معین

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Lesson Overview(Insert Dari)

1. Organization

2. Function

3. The Heart

4. Vessels

5. Disorders

6. In-class assignment

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Heart(Insert Dari)

Vein (Insert Dari)

Artery (Insert Dari)

The cardiovascular system includes the heart and all the vessels that branch out from it.

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Functions of the Cardiovascular System(Insert Dari)

• Transport oxygen, nutrients and waste products through the body.

• Maintain body temperature

• Maintain fluid balance.

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The Heart(Insert Dari)

The heart acts as a pump, delivering blood containing oxygen and nutrients to tissues via blood vessels.

The heart is approximately the size of a human first and is located near the centre of the chest (slightly to the left).

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Heart(Insert Dari)

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Anatomy of the Heart(Insert Dari)

The human heart is a muscular organ consisting of 4 chambers:

(1) Left atrium

(2) Right atrium

(3) Left ventricle

(4) Right ventricle

Major vessels branching from the heart include: -Aorta-Pulmonary artery -Superior and inferior vena cava

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Anatomy of the Heart(Insert Dari) Insert Dari

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Blood Flow through the Heart(Insert Dari)

Blood enters the right side of the heart via the superior/inferior vena cava.

It then moves from the right atrium to the right ventricle and is then pumped through the pulmonary vein to the lung tissue for oxygenation.

The pulmonary artery carries the blood back to the left atrium.

The blood is then pumped into the left ventricle and out through the aorta for delivery to body tissues.

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Blood Flow through the Heart(Insert Dari)

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Pumping Action of the Heart(Insert Dari)

The muscular ventricles of the heart contract creating the pumping action which moves blood through the vessels of the body.

The muscle tissue of the heart contracts in response to nerve stimulation.

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Heart Rate and Rhythm(Insert Dari)

A heart beat is a contraction of the heart muscle.

A normal heart rate is 60-100 beats per minute.

Heart rhythm is the coordinated contraction and relaxation of the atrium and ventricles of the heart.

Cardiac cycle: atrium will contract first, followed by the ventricle. Both the atrium and ventricle relax at the same time.

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Vessels (Insert Dari)

Blood vessels circulate blood through the body.

There are three types of blood vessels:

(1) Arteries – carry blood away from the heart towards the tissues.

(2) Capillaries – which enable the exchange of fluids, nutrients and oxygen between the blood and tissues.

(3) Veins – which carry de-oxygenated blood back to the heart.

Arterial System(Insert Dari)

Venous System (Insert Dari)

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Capillaries (Insert Dari)

The smallest blood vessels of the body.

Consist of a network of small vessels between a vein and an artery.

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Veins (Insert Dari)

The veins contain valves to assist with moving the blood back to the heart from the tissues. The valves also prevent the backflow of blood.

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Regulation of Heart Rateقلب ضربان تنظيم

• Nervous control from the cardiovascular center in the medulla

• Sympathetic impulses increase heart rate and force of contraction

• parasympathetic impulses decrease heart rate.

• Baroreceptors (pressure receptors) detect change in BP and send info to the cardiovascular center

• located in the arch of the aorta and carotid arteries

• Heart rate is also affected by hormones

• epinephrine, norepinephrine, thyroid hormones

• ions (Na+, K+, Ca2+)

• age, gender, physical fitness, and temperature

در • وعائى قلبى مرکز از عصبى کنترولدماغ ميديوالى

را • قلب ضربان سيمپاتيتيک تحريکنيرومند را تقلص و ميسازد بيشتر تر

ضربان • پاراسيمپاتيتيک تحريککمترميسازد را قلب

• ) باروريسيپتورها ) فشار هاى آخذهکشف را خون فشار تغيرات

مرکز به را معلومات و نمودهميرساند وعائى . قلبى

شرائين • و ابهر قوس در واقعکاروتيد

تأثير • قلب ضربان بر نيز ها هورمونميکنند

نورايپى • نفرين، ايپى هاى هورمونتيروئيد و نفرين

•) کلسيم ) پتاسيم، سوديم، ها ايونو • جسمانى، آمادگى جنس، سن،

حرارت Iدرجۀ

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Blood Pressure(Insert Dari)

The pressure exerted on the wall of the blood vessel by the circulating blood.

During each heartbeat blood pressure varies between systolic and diastolic pressure.

Systolic pressure = pressure in the vessels when the heart muscle is contracting.

Diastolic pressure = pressure in the vessels when the heart is resting.

Blood pressure = systolic pressure

diastolic pressure

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Disorders of the Cardiovascular System

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Atrial Fibrillation (Insert Dari) Atrial fibrillation = an abnormal heart

rhythm.

Occurs when nerve impulses, which control relaxation/contraction of cardiac muscle, become uncoordinated.

Increases a patient’s risk for having a stroke.

A stroke = disruption in blood supply to the brain, resulting in a mild to severe loss of brain function.

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Hypertension (Insert Dari)

Hypertension is a high blood pressure in the arteries.

This requires the heart to work harder to move blood through the body.

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Coronary Artery DiseaseInsert Dari

Hyperlipidemia - elevated levels of lipids is the blood.

Lipid = fat molecule

Lipids can deposit in the arterial vessel wall causing a plaque to form = narrowing of the artery.

When this occurs in the arteries that supply the heart muscle tissue it is called coronary artery disease.

This results in decreased blood flow to the heart and can result in a heart attack.

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Coronary Artery DiseaseInsert Dari

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Heart Failure(Insert Dari) Occurs when the heart cannot provide

sufficient blood flow to meet the needs of the body.

This usually occurs after the heart has been damaged or weakened due to another disease such as: -Hypertension-Coronary artery disease

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Heart Failure(Insert Dari)

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Congestive Heart Failure ( احتقانىقلب ( نارسائى کفايۀ+ عدم

• Causes of CHF

• coronary artery disease, hypertension, MI, valve disorders, congenital defects

• Left side heart failure

• less effective pump so more blood remains in ventricle

• heart is overstretched & even more blood remains

• blood backs up into lungs as pulmonary edema

• suffocation & lack of oxygen to the tissues

• Right side failure

• fluid builds up in tissues as peripheral edema

قلب • احتقانى Iکفايۀ عدم اسبابفشار • ازدياد اکليلى، امراضشرائين

مرگ ) انفرکشن ميوکارديل خون، ) ها، دريچه اختالالت ، قلب Iعضلۀ

والدى نواقصقلب • چپ سمت Iکفايۀ عدمدر • بيشتر خون بوده، مؤثر کمتر پمپ

ميماند باقى بطیناتهاخون • حتى و کششده زياد قلب

ميماند بطینباقى در بيشتربه • تا ، ريوى اديماى شکل به خون

آيد پسمى ها ريهانساج • اکسيجن کمبود و نرسيدن

قلب • راست سمت Iکفايۀ عدماديماى • بشکل انساج در مايعات

ميشود جمع محيطى

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Risk Factors for Heart Diseaseامراضقلبى خطر عوامل

• Risk factors in heart disease:

• high blood cholesterol level

• high blood pressure

• cigarette smoking

• obesity & lack of regular exercise.

• Other factors include:

• diabetes mellitus

• genetic predisposition

• male gender

• high blood levels of fibrinogen

• left ventricular hypertrophy

•: قلبى امراض در خطر عواملخون • کولسترول بلند سطحخون • بلند فشارکشيدن • سگرتورزش • فقدان و چاقى

منظم• : ديگر عواملمرضشکر •

ارثى • Iزمينۀمذکر • جنسخون • فيبرينوجن بلند سطحبطینچپ • شدن کالن

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Plasma Lipids and Heart Diseaseامراضقلبى و پالزما شحميات

• Risk factor for developing heart disease is high blood cholesterol level.• promotes growth of fatty plaques • Most lipids are transported as

lipoproteins• low-density lipoproteins

(LDLs)• high-density lipoproteins

(HDLs)• very low-density lipoproteins

(VLDLs)• HDLs remove excess cholesterol

from circulation• LDLs are associated with the

formation of fatty plaques • VLDLs contribute to increased

fatty plaque formation• There are two sources of cholesterol in

the body:• in foods we ingest & formed by

liver

انکشاف • خطر عامل خون کولسترول بلند سطحميباشد قلبى امراض

ميبخشد • ارتقا را شحمى هاى پلک .رشدپروتين ) • ها پروتين ليپو بشکل شحميات اکثر

) ميکنند انتقال شحمى هاىکم • تراکم داراى هاى ليپوپروتين

) يا) ، بد low-densityکولسترولlipoproteins (LDLs)

زياد • تراکم داراى هاى ليپوپروتين ) يا) ، ، خوب high-densityکولسترول

lipoproteins (HDLs)کم • بسيار تراکم داراى هاى ليپوپروتين

very low-density lipoproteinsيا (VLDLs)

زياد • تراکم داراى هاى (HDLs)ليپوپروتينبيرون خون دوران از را اضافى کولسترول

ميکشدکم • تراکم داراى هاى با (LDLs)ليپوپروتين

دارد ارتباط شحمى هاى پلک تشکيلکم • بسيار تراکم داراى هاى ليپوپروتين

(VLDLs) هاى پلک تشکيل ازدياد Iزمينۀميسازد مساعد را شحمى

• : دارد وجود کولسترول دومنبع بدن درساخته • جگر در و ميشود گرفته غذا از

ميشود

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Desirable Levels of Blood Cholesterol for Adultsکاهالن در خون کلسترول مطلوب سطح

• TC (total cholesterol) under 200 mg/dl

• LDL under 130 mg/dl

• HDL over 40 mg/dl

• Normally, triglycerides are in the range of 10-190 mg/dl.

• Among the therapies used to reduce blood cholesterol level are exercise, diet, and drugs.

مجموعى • از ( TC)کولسترول پائينترليتر ٢٠٠ ديسى هر در گرام ملى

کم • تراکم داراى هاى ليپوپروتين(LDL )از هر ١٣٠کمتر در گرام ملى

ليتر ديسىزياد • تراکم داراى هاى ليپوپروتين

(HDL) از هر ٤٠بيشتر در گرام ملىليتر ديسى

در • ها گلسريد ترى نورمال، بصورتديسى ١٩٠-١٠حد هر در گرام ملى

ميباشد ليترکردن • کم براى هائيکه تداوى در

قرار استفاده مورد خون کولسترولادويه و غذائى رژيم ورزش، ميگيرند،

اند شامل

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Clinical Problems( کلينيکى ( سريرى هاى پرابلم

• MI = myocardial infarction

• death of area of heart muscle from lack of O2

• replaced with scar tissue

• results depend on size & location of damage

• Blood clot

• use clot dissolving drugs streptokinase or t-PA & heparin

• balloon angioplasty

• Angina pectoris----heart pain from ischemia of cardiac muscle

نرسيدن ) • اثر به قلبى عضلۀ مردن انفارکشن ميوکارديلخون( فقدان • اثر به قلب عضلۀ از ساحۀ يک مرگ

اکسيجن• ) ميگيرد ) زخم ندبه انساج را جايشدارد • بستگى اسيب محل و اندازه به نتيجهخون • علقۀتى -• يا ستريپتوکيناز خون علقۀ کنندۀ منحل ادويۀ از

اى ) کنيد( t-PAپى استفاده هيپرين وبالون • انجيوپلاستى• --- قلب عضلۀ کمخونى از قلبى درد پيکتوريس انجينا

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By-pass Graftپاس باى پيوند

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Percutaneous Transluminal Coronary Angioplastyطريق از اکليلى امتدادمجراىشريان در انجيوپالستى

جلد

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Stent in an Arteryشريان (Stent) ستنت در

Maintains patency of blood vessel نگهميدارد باز را خون رگ

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Exercise and the Heartقلب ورزشو

• Sustained exercise increases oxygen demand in muscles.

• Benefits of aerobic exercise (any activity that works large body muscles for at least 20 minutes, preferably 3-5 times per week) are;

• increased cardiac output

• increased HDL and decreased triglycerides

• improved lung function

• decreased blood pressure

• weight control.

اکسيجن • ضرورت متداوم ورزشميکند زياد را عضالت

که ) • فعاليتى هر ايروبيک ورزش فوائدافتند، بکار بدن بزرگ عضالت آن در

k :٥-٣ترجيحا ) از عبارتند هفته در بار• ) قلب ) خون خروج حاصل ازدياد

داراى • هاى ليپوپروتين ازدياد ) و ) خوب کولسترول زياد تراکم

ها گلسريد ترى شدن کمها • ريه فعاليت بهبودخون • فشار شدن کماز ) • جلوگيرى بدن وزن کنترول

چاقى(

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Venous Thromboembolism(Insert Dari)

• Thrombosis• clot (thrombus) forming in an

unbroken blood vessel• may dissolve spontaneously or

dislodge & travel• Embolus

• clot, air bubble or fat from broken bone in the blood• pulmonary embolus is found

in lungs.

ترومبوز•• ) داخل ) در ترومبوز علقه تشکيل

خون سالم هاى رگيا • و شده حل بخود خود ممکن

) کند ) سفر و شده رها کندهجريان ) • Iکنندۀ مسدود جسم امبولى

خون(از • چربى يا و هوا حباب علقه،

خون داخل در شکسته استخوانها • شش در ريوى امبولى

ميشوند يافت

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In-class Assignment(Insert Dari)

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1. The Cardiovascular System consists of the heart and blood vessels, true or false?

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1. The Cardiovascular System consists of the heart and blood vessels, true or false?

Answer: True

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2.Which of the following most correctly describes the functions of the Cardiovascular System?

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A) Transport oxygen and nutrients, control body movements, excrete waste products from the body

B) Absorb oxygen and nutrients, maintain body temperature, maintain fluid balance

C) Transport oxygen and nutrients, maintain body temperature, maintain fluid balance

D) Absorb oxygen and nutrients, control body movements, excrete waste products from the body

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2.Which of the following most correctly describes the functions of the Cardiovascular System?

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A) Transport oxygen and nutrients, control body movements, excrete waste products from the body

B) Absorb oxygen and nutrients, maintain body temperature, maintain fluid balance

C) Transport oxygen and nutrients, maintain body temperature, maintain fluid balance

D) Absorb oxygen and nutrients, control body movements, excrete waste products from the body

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3. The smallest blood vessel which allows for exchange of fluids, oxygen and nutrients from blood to tissues

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A) Arteries

B) Veins

C) Capillaries

D) Venules

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3. The smallest blood vessel which allows for exchange of fluids, oxygen and nutrients from blood to tissues

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A) Arteries

B) Veins

C) Capillaries

D) Venules

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5. Match the following disorders with their description:(Insert Dari)

A) Anemia

B) Hypertension

C) Heart Failure

D) Venous Thromboembolism

1) Inappropriate blood clotting

2) Inability of the heart to supply blood to body tissues

3) High blood pressure

4) Oxygen carrying capacity of the blood is reduced.

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5. Match the following disorders with their description:(Insert Dari)

A) Anemia (4) Oxygen carrying capacity of the blood is reduced.

B) Hypertension (3) High blood pressure

C) Heart Failure (2) Inability of the heart to supply blood to body tissues

D) Venous Thromboembolism (1) Inappropriate blood clotting

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