Scorebuilders Ch. 6 – CARDIAC, VASCULAR, AND PULMONARY SYSTEM A N A T O M Y & P H Y S I O L O G Y O F T H E C A R D I O V A S C U L A R S Y S T E M Cross section of the anterior of the heart showing the chambers and valves.

Cardiac Conduction System

The cardiac conduction system includes the __________ (____) ______ and __________ (____) ______. Each cardiac

myocyte has an intrinsic ability to ____________________ and ____________________ electrical impulses from cell

to cell without nerve stimulation.

The _____ __________ is the normal pacemaker of the heart.

Innervation of the Heart

The sympathetic influence is achieved by release of ____________________ and ____________________.

Sympathetic nerves stimulate the chambers to beat _______________ and with greater _______________ force of

contraction.

The parasympathetic influence is achieved via ____________________ release from the __________ nerve.

Parasympathetic nerves _______________ the heart rate primarily through their influence on the _____ _________.

Anterior surface of the heart showing the great vessels and coronary arteries.

Coronary Veins

The coronary venous circulation includes: _______________ _____________, __________ ________, and

_____________ _________.

The great cardiac vein, along with the small and middle cardiac veins, drain into the ______________ _________,

emptying into the _____________ _____________.

Neural Reflexes and Circulatory Control

Baroreceptor reflex are mechanoreceptors that detect changes in ______________.

What are the reflexes known as that maintain blood pressure? _________________

What type of activation leads to increased blood pressure? ____________________

Which type of activation decreases blood pressure? _____________________

When signals are sent to the medulla’s cardiovascular center that inhibit parasympathetic activity leading to

increased heart rate, what is this reflex known as? __________________

What reflex reacts to changes in pH status and blood oxygen tension? _________________________

The________________ maneuver increases intrathoracic pressure by forced expiration against a closed glottis.

Cardiac Cycle Write the correct term or definition.

The contraction of the right and left atria pushing blood into the ventricles. ______________________

Atrial diastole: ___________________________________________________________________________________

_______________________________________________________________________________________________

Contraction of the right and left ventricles pushing blood into the pulmonary arteries and aorta. _________________

Ventricular diastole: ______________________________________________________________________________

_______________________________________________________________________________________________

Tension in the ventricular wall at the end of diastole. It reflects the venous filling pressure that fills the left ventricle

during diastole: ______________

The forces that impede blood flow out of the heart, especially peripheral vasculature pressure, aorta compliance,

and the mass and blood viscosity. ______________________

Stroke Volume (SV): ______________________________________________________________________________

_______________________________________________________________________________________________

Normal SV ranges from _____ to _____ L/min depending on age, sex, and activity.

Cardiac Output (CO): ______________________________________________________________________________

_______________________________________________________________________________________________

Normal CO adult male at rest: _____ L/min. Women produce ____ CO than males. During exercise, it can ↑ to ______

Venous return

o The amount of blood that returns to the _______ atrium each minute

o Venous return must be ___ CO when averaged over time because the cardio system is closed loop.

A. More B. Less C. Equal

Blood and Components of Blood

______ Leukocytes A. Blood Platelets

______ Erythrocytes B. Red Blood Cells

______ Thrombocytes C. White Blood Cells

Normal blood volume of an adult is between _____ and _____ L. Woman have _____ than men.

Blood cells and platelets are suspended in this liquid component: ______________. It is important in regulating

__________ _____________ and ____________________________.

What enables red blood cells to bind with oxygen and have its red color? ___________________

What is the term used to describe a high red blood cell count, increased blood thickness? ______________________

o What is a pt in risk of with increased blood cell count? __________or ____________ ______________

A low number in blood platelets, termed ______________________, increases the risk of ______________________

and _________________ _________________. A high number, termed ____________________________, increases

the risk of ___________________, which may result in a ________________ or ______________ _______________.

A low number of white blood cells, termed ________________, increases the risk of ________________. An

abnormal amount of white blood cells, termed ________________, can indicate _____________ or _____________.

What type of WBC protects the body against infection by ingesting bacteria and debris? _______________________

Lymphocytes consists of:

o T-Lymphocytes: ______________________________________________________________________

____________________________________________________________________________________

____________________________________________________________________________________

o B-Lymphocytes: ______________________________________________________________________

____________________________________________________________________________________

Monocytes: _____________________________________________________________________________________

_______________________________________________________________________________________________

What WBC kills parasites, destroy cancer cells, and are involved in allergic responses? _________________________

Basophils: ______________________________________________________________________________________

A N A T O M Y & P H Y S I O L O G Y O F T H E R E S P I R A T O R Y S Y S T E M

Ribs 1-7 are called: ___________________; Ribs 8-10: _________________; Ribs 11-12:_________________

What are the three principle muscles of respiration?

o ______________________, ______________________,______________________

The upper respiratory tract consists of the:

o ______________________, ______________________,______________________

The right lung has ______ lobes. The left lung has _____ lobes.

There are _____ bronchopulmonary segments in the right lung and _____ segments in the left lung.

The right lung’s main bronchus gives rise to the superior, middle, and inferior ____________ _______________.

The left lung’s main bronchus divides into the superior _____________ ______________ corresponding to the upper

and lower lobes.

Oxygen diffuses across the _______________________ __________________ into the RBC in lung capillaries where

it combines with ___________________ to be transported back to the heart. Carbon dioxide diffuses in what

direction – Same or Opposite?

The membranous serous sac that covers the lungs is called ______________ _________________. Under abnormal

circumstances, the pleural space may contain air – termed __________________________, blood – termed

_______________________, pus or increased amounts of serous fluid, which compress the lung and cause

_______________________ ________________________.

The pulmonary circulation returns oxygenated blood from the lungs to the ____ atrium via the ___________ ______.

Oxygen is physically dissolved in the _________ __________, and chemically combines with _________________ in

RBCs. Carbon dioxide is physically dissolved in __________.

Diagram of the human lungs.

Total Volume Total Volume

ERV = RV =

IRV = IC =

FRC = TV =

VC = TLC =

Lung Volumes and Capacities

Anatomic dead space volume (VD)

Expiratory reserve volume (ERV)

Forced expiratory volume (FEV)

Forced vital capacity (FVC)

Functional residual capacity (FRC)

Inspiratory capacity (IC)

Inspiratory reserve volume (IRV)

Minute volume ventilation (VE)

Peak expiratory flow (PEF)

Residual volume (RV)

Tidal volume (TV)

Total lung capacity (TLC)

Vital capcity (VC)

CLASSIFICATION OF HTN IN ADULTS * Classification determined by higher BP category

BP Classification SBP mm Hg* DBP mm Hg*

Normal

Prehypertensive

Stage 1 HTN

Srage 2 HTN

Arterial Blood Gas (ABG)

Mean range of adult normal ABG values:

pH

PaCO2

PaO2

HCO3

SaO2

Acidemia

Alkalemia

Hypoxemia

Hypoxia

Angina Pain Scale

Rating Description

1

2

3

4

Ankle-Brachial Index (ABI) Interpretation

> 1.30

1.0 – 1.30

0.8 – 0.99

0.4 – 0.79

< 0.4

This chart and the following chart is on page 218 of Scorebuilders.

HEMATOCRIT REFERENCE VALUES IN CLINICAL CHEMISTRY

Conventional Units SI Units

Serum Cholesterol

Total

LDL Cholesterol

HDL Cholesterol

Triglyceride

REFERENCE VALUES IN HEMATOLOGY

Conventional Units SI units

Erythrocytes

Adult Males

Adult Females

Leukocytes

Total

Platelet count

Partial Thromboplastin Time (PTT)

Hematocrit

Adult Males

Adult Females

Hemoglobin

Adult Males

Adult Females

ARTERIAL BLOOD PRESSURE

Korotkoff Sounds

Phase I

Phase II

Phase III

Phase IV

Phase V

ARTERIAL BLOOD PRESSURE INTERPRETATION

Children (ages 3-17)

Normal BP

Prehypertension

Stage 1 HTN

Stage 2 HTN

Adults

SBP DBP

Normal BP

Prehypertension

Stage 1 HTN

Stage 2 HTN

Auscultation of Heart Sounds

Area Ausculatory area

Aortic Area

Pulmonic Area

Mitral Area

Tricuspid Area

Auscultation of Heart Sounds Interpretation

S1 (lub)

S2 (dub)

S3

S4

Adult BMI Classification

Borg Dyspnea Scale

0

0.5

1

2

3

4

5

6

7

8

9

10

ECG Waveforms and Intervals

P wave

PR interval

QRS Complex

QT interval

ST segment

T wave

Sinus Node Rhythms

Normal sinus rhythm

Sinus bradycardia

Sinus tachycardia

Sinus arrhythmia

Sinus arrest

Pulse Points of Selected Peripheral Arteries

Artery Pulse Point

Carotid

Brachial

Radial

Ulnar

Femoral

Popliteal

Posterior tibial

Dorsalis pedis

PULSE CHARACTERIZATION

Characterize the heart rate

Normal infant

Normal child

Normal adult

Bradycardia

Tachycardia

Characterize the volume or amplitude of the pulse

3+

2+

1

0

Original RPE Scale Revised RPE Scale

Respiratory Rate

Newborn

1 year

10 years

Adult

Respiratory Rhytm

Normal

COPD

Common Breathing Patterns

Apnea

Biot’s

Bradypnea

Cheyne-Stokes (periodic)

Eupnea

Hyperpnea

Hypopnea

Tachypnea

TARGET HEART RATE

Method 1 – Percent of maximum heart rate (HRmax)

Lower THR =

Upper THR =

Method 2 – Heart rate reserve (HRR) or Karvonen formula

Lower THR =

Upper THR =

HRmax=

HRest=

Postural Drainage Positioning

Apical segments

Right and Left upper lobes

Posterior segment

Right Upper Lobe

Posterior segment

Left Upper Lobe

Lingula

Left Upper Lobe

Anterior segments

Right and Left Upper Lobes

Right middle lobe

Superior segments

Left and Right Lower Lobes

Anterior basal segments

Left and Right Lower Lobes

Posterior basal segments

Left and Right Lower Lobes

Lateral basal segments

Lower Lobes