cardiovascular - part 1
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CARDIOVASCULAR
SYSTEM
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The
cardiovascular
system iscomposed of:
• Heart
• Blood vessels
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The Heart• The heart is the focal point of the
cardiovascular system.• It supplies the driving force for the
movement of blood.
• The heart functions as a pump, activelyforcing blood out of its chambers andpassively relaxing to allow the nextquantity of blood to enter.
• The heart is cone-shaped, pointing downand to the left, and is located left of center of the chest between the lungs.
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Sternal Angle -
angle formed bythe junction of the
manubrium and
the body of thesternum. This is
also called the
manubriosternal joint or Angle of
Louis.
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Sternum
- is a flat, dagger
shaped bone located in
the middle of the chest.
Along with the ribs, thesternum forms the rib
cage that protects the
heart, lungs, and major blood vessels from
damage
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3 PARTS OF STERNUM:
•Manubrium - also called the "handle", islocated at the top of the sternum and moves
slightly. It is connected to the first two ribs
• Body - also called the "blade" or the
"gladiolus", is located in the middle of thesternum and connects the third to seventh ribs
directly and the eighth through tenth ribs
indirectly.
• Xiphoid Process - also called the "tip", is
located on the bottom of the sternum. It is
often cartilaginous (cartilage), but does
become bony in later years.
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• The ribs are thin, flat, curved bones thatform a protective cage around the organs
in the upper body.• They are comprised 24 bones arranged in
12 pairs.
• 1 – 7 bones are called True Ribs
• These bones are connected to the spine
(the backbone) in back. In the front, thetrue ribs are connected directly to thebreastbone or sternum by a strips of cartilage called the costal cartilage.
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• Ribs 8 – 10 are called False ribs.
• These bones are slightly shorter than
the true ribs and are connected to thespine in back. However, instead of being attached directly to the sternum in
front, the false ribs are attached to thelowest true rib.
• 11 – 12 rib bones are called Floating
ribs.• They are attached to the spine at theback, but are not connected to anythingin the front.
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PURPOSE:
• They protect the heart and lungs from
injuries and shocks that might damagethem.
• Ribs also protect parts of the stomach,
spleen, and kidneys.• The ribs help you to breathe. As you
inhale, the muscles in between the ribs
lift the rib cage up, allowing the lungs toexpand. When you exhale, the rib cagemoves down again, squeezing the air out of your lungs.
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Intercostal space (ICS)• space between two ribs• Since there are 12 ribs on each side, there
are 11 intercostal spaces.
Importance of intercostal space
• Intercostal spaces are important accesspoints in medicine, for example:• access for surgical procedures, e.g. resection
of (part of) the lung (pneumonectomy), or
insertion of a chest tube• penetrating trauma of the thorax• for percussion and auscultation of underlying
structures, e.g. sites for heart auscultation,
percussion in Traube’s space.
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MIDCLAVICULAR LINE:
• A vertical line crossing through the
clavicle.
• It is useful for evaluating
hepatomegaly and identifying heartsounds, as well as finding the
gallbladder.
• It is the usual reference point for clinical assessment of liver size and
localization of the cardiac apex beat.
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JUGULAR VEINS:
• Veins that bring deoxygenated blood from thehead back to the heart via the superior vena cava.
Two sets of jugular veins:
• The internal jugular vein is formed by theanastomisi of blood from the sigmoid sinus of thedura mater and the common facial vein. The
internal jugular runs with the common carotidartery and vagus nerve inside the carotid sheath.
• It provides venous drainage for the contents of theskull.
• The external jugular runs superficially to SCM.
• Both connect to the brachocephalic veins, theexternal jugular joining more laterally than theinternal.
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CAROTID ARTERIES:
• Common carotid artery supplies the
head and neck with oxygenated blood• Divides in the neck to form the external
and internal carotid arteries
• The common carotid artery is a pairedstructure, meaning that there are two inthe body, one for each half.
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• The left and right common carotid arteries
follow the same course with the exception
of their origin.• The right common carotid originates in the
neck from the brachiocephalic trunk.
• The left arises from the aortic arch in thethoracic region.
• The left common carotid artery can be
thought of as having two parts: a thoracic(chest) part and a cervical (neck) part. The
right common carotid originates in or close
to the neck, so it lacks a thoracic portion.
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PULSE SITES:
• Carotid
• Brachial
• Radial
• Ulnar • Femoral
• Popliteal
• Apical
• Dorsalis Pedus
• Posterior Tibial
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MEDIASTINUM:• Movable partition that extends superiorly to
the thoracic inlet and the root of the neck and
inferiorly to the diaphragm.• A non-delineated group of structures in the
thorax (chest), surrounded by looseconnective tissue.
• It is the central compartment of the thoraciccavity.
• It contains the heart, the great vessels of theheart, esophagus, trachea, phrenic nerve,
vagus nerve, thoracic duct, thymus, andlymph nodes of the central chest.• It extends from the sternum in front to the
vertebral column behind, and contains all the
thoracic viscera except the lungs.
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FOR THE PURPOSE OF DESCRIPTIONIT IS DIVIDED INTO 2 PARTS:
3. SUPERIOR MEDIASTINUM
– an upper portion, above the upper level of the pericardium.
• superior limit at the superior thoracicopening and its inferior limit at theplane from the sternal angle to the
disc of T4-T5 (Plane of Ludwig)• Bounded in front by the manubrium
sterni and behind by the first 4
thoracic vertebrae.
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2. INFERIOR MEDIASTINUM - below the
upper level of the pericardium. This
lower portion is again subdivided intothree parts:
– that in front of the pericardium, the
anterior mediastinum; – that containing the pericardium and
its contents, the middle mediastinum
; – and that behind the pericardium, the
posterior mediastinum.
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• It is surrounded by the body of the
sternum anteriorly, the lungs laterally
and the lower 8 thoracis vertebraeposteriorly.
• It is continuous with the loose
connective tissue of the neck, andextends inferiorly onto the diaphragm.
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SUPERIOR
MEDIASTINUM:
• Thymus
• Large veins
• Large arteries
• Trachea
• Esophagus and
thoracic duct
• Sympathetic trunk
INFERIOR
MEDIASTINUM
• Thymus• Hart within the
pericardium with
phrenic nerve
• Esophagus and
thoracic duct
• Descending aorta
• Sympathetic trunk