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Woman with a diabetes mellitus and obesity has had a myocardial infarction.
Woman with a diabetes mellitus and obesity has had a myocardial infarction.
DOWNSTREAM
INDIRECT
Obesity
Nutrition
Diabetes mellitus
(mabey) genetic predisposition
DIRECT
Overworked heart gave out
Weight of her body and the pressure that it put on her blood vessels and heart = over worked heart
Flabby left ventricle
Background
PHYSIOLOGY
Pathway of Blood
Bodily systemic circuit
Vena cava (superior/inferior)
Right atria
Tricuspid valve
right ventricle
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Valves
Atrioventricular
Prevents blood back flow into atria from ventricle
Semilunar
Pulmonary
Prevents backflow from pulumonary trunk to right ventricle
Aortic
Prevents back flow from aorta to left ventricle
Papillary muscles
Muscles that prevents the AV valves from collapsing
Heart sounds
Lub
Av valves closing
Dub
SL valves closing
Blood pressure / heart function
Regulated by TPR, and CO (HR*SV)
Short Term regulation
Increase or decrease in HR, SV, or TPR
Neural regulation
Epinephrine / Norepinephrine
Regulate TPR
Chemical regulation
Regulates chemical factors that also happen to change BP
Barcoreceptor regulation
Stretching or recession of arerial walls will activate this receptor
Regulate HR and SV
Long Term regulation
Increase or decrease in blood volume
Hormonal regulation (some of them short term)
ADH, atrial natriuretic peptide, Angeiotensin II
Heart rate
How fast the heart is beating and pushing blood out the ventricles
Stroke volume
How much blood is being push out the ventricles
EDV
The preload
How much blood in ventricle before contraction
ESV
Afterload
How much blood left in the ventricle after contraction
Cardiac output
The flow of blood through the body
Heart electrical signal pathway
SA node (sinus rhythm)
AV node (junctional rhythm)
AV bundle
Right and left branches
Purkunje fibers
ANATOMY
Cells
Pacemaker cells
Action potential w/ pacemaker potential
Na+ slowly goes in cell making more positive
Threshold reached
Ca+ rush into cell and depolarizes it
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Contractile cells
Action potential w/ plateau
Na+ floods the cell making it quickly depolarize
Ca+ then slowly continues to release causing a plateau so that heart cannot tetany
The a rapid efflux of K+ which repolarizes the cells
Tissue
Pericardium
Fiberous
Thick layer
Serous
Thin layer
Slipper
Epicardium
Outside of the heart
Myocardium
Heart Muscle
Endocardium
Inside of the heart
Cardiac Skeleton
Keeps electrical signal on track
Organ
Chambers
Atria
Right
Poor oxygen
Left
Good Oxygen
Ventricle
Right
Poor oxygen
Left
Good oxygen
Valves
AV valves
Tricuspid valve (1)
Bicuspid (mitral) valve (3)
SL valves
Pulmonary semilunar valve (2)
Aortic semilunar valve (4)
Aorta
Ascending aorta
Aortic arch
Descending aorta
Thoracic aorta
Pulmonary
Trunk
Pulmonary arteries (poor oxygen)
Lungs
Pulmonary veins (poor oxygen)
Coronary
Arteries
deliver blood directly to the heart tissue
From left atria
Good oxygen
Veins
Deliver blood from heart tissue directly to right atria
poor oxygen
Vena Cava
Take blood (poor oxygen) from body to heart
Chordae tendonae
Controls AV valves
vitals
30 Breaths per minute
125 Beats per minute
Blood Pressure 95/55
Labored breathing
Gurgling in stethoscope
papilliary muscles of left ventricle failing
Mitrial valve also failing
UPSTREAM
Failed mitrial valve
Blood will swish back into left artria
Heart have to work harder to pump more blood
Left ventricle becomes over worked
Blood pressure plummets because heart cannot sustain a large amount of BPM anything over 75 is more than normal for resting
Consequences of the failed bicuspid valve
Increased BP
Weakening of left ventricle
Flabby useless ventricle
heart failure
Myocardial infarction
scarring of heart tissue
weak heart
Problem branching into other systems
circulatory system tries to compensate with extreme vasoconstriction
Endocrine system releases hormones to keep fluid so BP and be steady
Nervous system release epi & norepi for vasoconstriction
inadequte amount of blood reaching digestive system
Body trying to keep heart alive