The%20Blood%20System

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The Blood System

• 6.2 and D.4

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The Transport System

• Also known as the Circulatory System or the
  Cardiovascular System
• The system responsible for the circulation of
  blood throughout the body.

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Blood

• About 8 of the human body is blood.
• Depending on the size of the individual, the
  human body contains an average of 4 L - 5 L of
  blood
• Blood consists of
• Plasma 50-55
• Cells 45-50

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PLASMA

• Protein rich liquid
• 90 water
• Contains dissolved solutes Na, K, Ca2, Cl-,
  HCO-
• Also contains nutrients, respiratory gases,
  metabolic waste materials, hormones, and proteins
  (fibrinogen, globulins, albumins)

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Plasma

• Plasma proteins
• Control blood pH
• ALBUMINS Control water balance (the amount of
  water that enters and leaves the blood stream)
• GLOBULINS Transport insoluble lipids,
  cholesterol, fat-soluble vitamins, minerals
• Antibodies (immunoglobulins) guard against
  foreign microorganisms
• FIBRINOGEN involved in blood clotting

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Cellular Components of Blood

• Consist of
• ERYTHROCYTES red blood cells
• LEUCOCYTES white blood cells
• THROMBOCYTES platelets
• They are constantly being replaced.
• New ones are formed from pluripotent stem cells
  in bone marrow
• These cells are initially the same but can
  specialize into specific ones

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Red Blood Cells (rbc)

• Also called erythrocytes
• Represent 90 of blood cells
• 1 mm3 of blood contains 5-6 x 106 rbc!!!
• Shape biconcave disk
  thinner at the
  center than
  the edges (increases surface
  area)

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RBC

• FUNCTION deliver O2 and some CO2
• A single rbc contains 250 million molecules of
  hemoglobin!
• Hemoglobin is a protein with an iron atom (at its
  heme groups) that binds to gases (O2 and CO2)
• Anemia low rbc or low hemoglobin, therefore
  cannot deliver as much O2 to the body
• Usually caused by lack of iron in diet
• Results in a lack of energy (because O2 needed
  to make ATP)

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Hemoglobin
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DID YOU KNOW???

• RBCs live only 120 days are removed by liver
  and spleen when they die
• Between 2 -3 million are produced each second to
  replace lost ones
• Mammalian RBC lack nuclei (they have one when
  they are developing but it breaks down and
  disappears when it is mature and released into
  bloodstream)
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Remember.Blood Types?

• There are 4 main blood types (8 if you consider
  Rh factors) in the ABO Blood grouping system
• Types A, B, AB, and O
• Antigens determine what blood type you have

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Blood Type Antigens

• Most cells (including blood cells) have cell
  markers called ANTIGENS which are proteins that
  extend from the cell surface.
• Type A blood has A antigens Type AB has A
  and B antigens Type O does not have any
  antigens positive blood has the Rh Factor,
  negative blood does not
• Antigens help identify the cells as self or
  not-self
• If the immune system identifies foreign antigens
  on a cell in your body, an immune response will
  occur

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• This includes the production of antibodies that
  will adhere to the foreign antigens, thereby
  marking the cell as foreign and flagging them for
  removal
• With blood cells, this causes a clumping of blood
  cells called agglutination that can be life
  threatening

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• So that means, you cannot receive a blood
  donation from a blood type with foreign
  antigens.
• Type AB is the universal acceptor these
  individuals can receive blood from any blood type
  because they recognize all antigens
• Type O- is the universal donor these
  individuals can donate blood to everyone because
  they lack antigens

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Type A Type B Type AB Type O
Has protein marker A Has protein marker B Has both protein marker A and B Does not have these protein markers
42 of population 10 of population 3 of population 45 of population
Can receive Type A and O Can receive Type B and O Can receive Types A, B, and O Can receive only O
Can donate to Type A and Type AB Can donate to Type B and type AB Can only donate to Type AB Can donate to Types A, B, AB, and O
  Population O O- A A- B B- AB AB-
Canada 33, 487, 208 39 7 36 6 7.6 1.4 2.5 0.5
based on 2010 data from Stats Canada
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DID YOU KNOW?

•  
• RBC can have other antigens on its membranes
  (other than A,B, and ) that affect
  compatibility, so there are other blood grouping
  systems
• There are 30 grouping systems!
• The AB Blood Grouping System is the most
  important blood grouping system (greater
  diversity in the presence or absence of these
  antigens)

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White Blood Cells (wbc)

• Also called leukocytes
• 5000 10000 in a mm3 of blood
• lt 1 of blood cells are WBC
• These cells protect the body from harmful
  bacterial, viruses and other foreign invaders
• Unlike RBC, WBC have a nucleus

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WBC

• 70 are phagocytes
• Nonspecific ingest foreign invaders and antigens
• 30 are lymphocytes
• Produce antibodies that target specific foreign
  invaders

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Phagocytosis
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Platelets

• Also known as thrombocytes
• 150 000 - 450 000 mm3
• Have no nuclei
• Involved in blood clotting
• Are actually small pieces that have broken off
  from cells in bone marrow

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Platelets

• Blood vessels are normally smooth
• If they are broken, the rough edges will break
  platelets
• The broken platelets release chemicals (clotting
  factors) which help platelets stick together to
  form a plug
• With the aide of fibrinogen, platelets form a
  clot which clogs the tear in the blood vessel and
  prevents the loss of blood cells

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Function of Circulatory System

• The function of the circulatory system is to
  transport materials throughout the body via
  blood.
• This includes
• Oxygen
• Carbon dioxide
• Nutrients (eg glucose)
• Hormones (eg insulin)
• Antibodies
• Waste products
• Heat

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The Heart

• The heart is a specialized organ that pumps blood
  though the body
• Location it is situated just below the sternum
  (breastbone)
• Structure the heart is enclosed in a sac, the
  pericardium, a two layered wall.
• The space between the two walls is a lubricating
  fluid that allows the walls of the heart to move
  as the heart beats without friction from other
  organs.

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• Heart is composed mostly of cardiac muscle a
  muscle type that is exclusive to the heart only
  and has the ability to contract and relax quickly
• The heart has 4 chambers Left atrium, Right
  atrium, Left ventricle, Right ventricle

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Atria

• The atria are collection chambers responsible
  for receiving blood
• Right atrium receives blood from body
• Left atrium receives blood from lungs
• Cardiac muscle that lines the walls of atria is
  thin because the atria responsible for pumping
  blood a short distance (only to the ventricles)

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Ventricles

• Ventricles have a larger space and have thicker
  muscular walls that are much more powerful than
  the atria.
• These thicker walls (especially left ventricle)
  pump blood out to body organs (pump blood much
  further than atria)
• Why are the walls of the left ventricle thicker
  than that of the right ventricle?

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• The left and right side of the heart are
  separated by the septum
• This keeps oxygenated and deoxygenated blood
  separated from each other
• The pumping action of the heart is synchronized
  (happen at the same time on right and left side)

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HEART VALVES

• Blood flows one-way (always in the same
  direction) with the help of valves that prevent
  blood from flowing backwards
• Note there are two types of valves
• atrioventricular valves (AV valves)
• separate atria from ventricles
• prevent blood from flowing from the ventricles
  back to the atria
• semilunar valves
• separate ventricles from arteries
• prevent blood from flowing from arteries back
  into ventricles

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Double Circulation

• Humans have 2 separate circulations
• The PULMONARY SYSTEM/CIRCUIT refers to the path
  of blood flow through the right side of the heart
  to the lungs and then the left side of the heart.
  
• (see Flow of Blood handout)
• The SYSTEMIC SYSTEM/CIRCUIT - the path blood
  takes throughout body through the blood vessels
• Heart ? aorta ? arteries ? arterioles ?
• capillaries ? venules ? veins ? vena cava
  ? heart

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Blood Vessels

• Blood is circulated throughout the body by the
  contraction of the heart and via 3 types of blood
  vessels
• 1. Arteries
• 2. Veins
• 3. Capillaries

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Arteries

• Transport blood away from the heart to the organs
• Carry oxygenated blood (except for the pulmonary
  artery)
• Each organ of the body is supplied with blood by
  one or more artery.
• Ex Renal artery supplies the kidneys with
  blood
• At the organs, the arteries branch into smaller
  arteries known as arterioles

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Arteries

• The largest artery in the body is the aorta
• Like all body organs, the heart also needs food
  (glucose) and oxygen to work
• The arteries that transport blood with food and
  oxygen to the heart are the coronary arteries.

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Coronary Arteries
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Arteries

• They receive blood from the ventricles at high
  pressure so they have thick, muscular, elastic
  walls

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• TUNICA EXTERNA tough outer layer
• TUNICA MEDIA contains smooth muscle and elastic
  fibers made of elastin
• TUNICA INTIMA the smooth lining of the lumen

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Arteries and your Pulse

• When the ventricles contracts (squeezes in) it
  pushes blood into the arteries.
• The high pressure blood pushes the walls of the
  arteries outward, expanding the lumen of the
  artery so it can accommodate for the increased
  blood volume and pressure.
• It is able to do this because of the elastin
  fibers in the elastic arterial walls.

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Arteries and your Pulse

• This expansion is what you feel when you feel
  your pulse.
• When the heart relaxes, the artery walls recoil
  and squeeze the blood in the lumen, and pushing
  it further along the blood vessels, away from the
  heart.
• When blood is at its highest pressure in the
  arteries, it is known as systolic pressure
• When blood is at its lowest pressure in the
  arteries, it is known as diastolic pressure

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Vasoconstriction Vasodilation

• Circular muscles in the tunica media can affect
  the size of the lumen.
• During vasoconstriction, the muscles contract to
  narrow the size of the lumen and increase blood
  pressure in the arteries.
• Arterioles in particular are able vasoconstrict
  and dilate due to nervous signals and hormones.

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Capillaries

• Small numerous blood vessels in the tissues
• The walls of the capillaries are permeable which
  allow materials to move in and out.
• The walls of capillaries are very thin - only 1
  cell thick to allow for diffusion of materials
  (such as respiratory gases, and glucose) from the
  blood vessels to the cells and vice versa
• Move blood at low speed
• Contain blood at moderate pressure

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Veins

• Transport blood back toward the heart
• Carry deoxygenated blood (except the pulmonary
  veins)
• Move blood at moderate speeds and at low pressure
  so walls are thin (compared to the arteries) and
  thus have less muscle and elastic fibers.
• Because they often move blood against gravity,
  they have valves to prevent blood from flowing
  back.

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How does blood get back to the heart?

• Veins contain one-way valves that allow blood to
  flow in one direction only.
• These veins are sandwiched in between skeletal
  muscles.
• As muscles contract, veins are squeezed and blood
  is forced through the vein in one direction back
  to the heart.
• When the muscles relax, the blood would fall back
  down, however, the venous valves prevent that.

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Venous Valves
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Veins

• Just as each organ is supplied blood by one or
  more artery, each part of the body is served by
  one or more veins.
• Ex Renal Vein takes deoxygenated blood away from
  the kidneys, back to the heart.
• Venules are small veins.
• Deoxygenated blood flows from the capillaries to
  the venules to the veins.

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Comparing Blood Vessels
ARTERY CAPILLARY VEIN
Size Thick walls with narrow lumens Thin walls (1 cells thick) and lumens around 10µm in diameter Relatively thin walls with variable but often wide lumens
Wall Composition 3 layers Tunica externa, media, intima (plus sublayers) Only 1 layer (tunica intima) 3 layers Tunica externa, media, intima
Muscles and Elastic fibres in the wall abundant none Small amounts
Valve none none present
Blood Speed Pressure Carry blood at high speeds and high pressure Carry blood at low speeds and low pressure Cary blood at moderate speeds and low pressure
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Heart Rate

• Heart rate the number of times a heart beats
  each minute (measure by taking a pulse)
• During a single heart beat, or cardiac cycle, the
  heart is pumping twice - 2 contractions (both
  atria contract simultaneously and then both
  ventricles contract simultaneously)
• The contractions are caused by special cardiac
  muscle cells within wall of the right atrium

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Myogenic Muscle Contraction

• Cardiac muscle (heart tissue) is a myogenic
  muscle it spontaneously contracts and releases
  without nervous system control.
• It does not need the brain to control it!
• The electrical impulses (action potentials)that
  generate heart contractions originate from a
  specific region of the right atrium the
  Sino-Atrial Node (SA node).

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Sino Atrial Node

• The SA node generates an electrical signal that
  rapidly spreads throughout the walls of the atria
• The signal is eventually passed on to ventricles
  through specialized fibres
• Because of this, the SA node is also known as the
  pacemaker.

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• Systole (Systolic phase) contraction phase
• Diastole (Diastolic phase) relaxation phase

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Cardiac Cycle

• The SA node sends out an electrical signal to
  both atria, causing them both to contract
  simultaneously.
• This causes blood to be pushed out of the atria
  and fill up the ventricles.
• During this time, the atrioventricular valve are
  open and the semilunar valves are closed

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Cardiac Cycle

• Within the right atrium is another area called
  the Atrioventricular node (AV node).
• The AV node receives the electrical signal from
  the SA node, and passes the signal down special
  heart muscle tissue in the septum known as the
  Bundle of His and AV bundle branches.

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Cardiac Cycle

• When the impulse reaches the apex of the heart,
  the impulse is sent to the Purkinje fibres in the
  walls of the ventricles.
• This causes both ventricles to simultaneously
  contract.
• As the ventricles contract, blood is pushed out
  of them into the arteries.
• During this time, the AV valves are closed and
  the semilunar valves are open

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AV Node Ventricular Systole

• There is 0.12 second delay from when the AV node
  receives the electrical signal, to when it causes
  the ventricles to contract.
• This is because the AV node cells take longer to
  be excited than the SA node cells.
• This allows the atria to contract to fill up the
  ventricles and the AV valves to close before
  ventricular systole.

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ECG (Electrocardiogram)
QRS contraction of the ventricles (caused by the
Purkinje Fibers)
P contraction of the atria (caused by SA node)
The electrical signals generated by the cardiac
muscle can be detected and quantified using an
ECG.
T ventricular diastole heart is prepping for
next contraction
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Heart Beat

• Using a stethoscope, you can hear the
  characteristic heart sounds lub-dub, lub-dub,
  lub-dub
• The lub sound is made by the closing of the
  atrioventricular valves (ventricular systole)
• The dub sound is made by the closing of the
  semilunar valves (ventricular diastole).

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• See p 686 (Fig4), p 688 (Fig 6)

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Heart Rate Control

• While the heart is myogenic, the brain and
  hormones can influence the frequency of heart
  beats.
• WHY?
• During times of increased body activity (such as
  exercise), heart rate needs to increase to need
  demand for O2 by body cells and release
  accumulated CO2.

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Heart Rate Control

• The region of the brain known as the medulla
  contains the cardiovascular centre which can
  monitor body conditions and adjust heart rate
  accordingly.
• Low blood pressure, low O2 concentration and low
  blood pH will result in the medulla increasing
  heart rate. (The opposite will decrease heart
  rate)
• A nerve from the medulla to the SA node initiates
  an increases in heart rate (as much as 3x as
  normal) a second nerve can decrease heart rate

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Heart Rate Control

• Hormones such as epinephrine (also known as
  adrenaline) can also affect frequency by causing
  the SA node to increase the frequency of
  generating its electrical signals
• You release epinephrine during vigorous physical
  activity, moment of danger and excitement.

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Did You Know?

• Regular Adult Heart Rate 60-100 bpm
• However professional athletes can have heart
  rates as low as 40 bpm

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Heart Conditions and Procedures
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Blood Pressure
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Measuring Blood Pressure

• With an instrument called a sphygmomanometer
  (sphygmomanometer)
• The cuff is inflated until blood flow to the
  brachial artery is stopped.
• When the cuff deflates, sensors detect vibrations
  of the blood flowing through the artery

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Measuring Blood Pressure

• The first reading is the systolic pressure
  (pressure when the heart contracts)
• The second reading is the diastolic pressure
  (pressure when the heart is relaxed)

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• Normal blood pressure is 120/80 (120 over 80)
• The normal range is
• Systolic 110-130
• Diastolic 75-85
• Blood pressure decreases as it flows away from
  the heart

Systolic Diastolic
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Factors that affect Blood Pressure

• Diameter of blood vessels
• Level of physical activity
• Temperature
• Body position
• Diet high sodium diets
• Stress
• Age bld vessels lose elasticity with age
• Medications
• Smoking
• Inherited Conditions
• See page 690-691

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HYPERTENSION

• consistently high blood pressure
• Can be caused by a variety of factors (as
  mentioned)
• Ex Diet high in sodium
• Excess sodium (salt) in your diet means more salt
  in your blood stream. This causes water excess
  water to enter your blood stream (water
  retention) to dilute the salt concentration. This
  also increases blood volume and therefore blood
  pressure

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Hypertension

• Ex Smoking
• Cigarettes can cause a build up of tar on
  alveolar surfaces, reducing gas exchange. To
  compensate for this, the heart rate and blood
  pressure increase to pump more blood to the lungs
  so to pick up oxygen.

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Hypertension

• Hypertension is dangerous because it forces the
  heart to work harder to pump blood around the
  body.
• It can result in ruptured blood vessels in organs
• It can be reduced by adjusting ones lifestyle
  (proper diet, losing weight, regular exercise)
• Medications work by dilating blood vessels or by
  reducing water retention

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Arteriosclerosis

• the hardening of the arteries
• Over time, too much pressure can cause the
  arteries to lose elasticity and harden
• Can happen in any artery
• Sometimes, bacteria can cause damage to the
  artery walls and cause deposition of calcium on
  the walls which harden them

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• Since arteriosclerosis occurs within the body
  where it cannot be seen, it is not always
  recognized early or easily.
• Some signs and symptoms
• high blood pressure as arteries harden
• Poor circulation in fingers and toes
• Recurrent kidney infections
• Heart attacks (in advanced cases)

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• Arteriosclerosis actually describes several
  disease of the cardiovascular system
• Atherosclerosis
• Coronary Heart Disease (CHD)

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Atherosclerosis

• Hardening of the artery walls caused by a build
  up of plaque (fat, cholesterol, calcium) in the
  artery walls

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Atherosclerosis

• The plaque narrows the passage of blood- creates
  a clog!
• Dangerous because it can cut off blood flow to an
  organ
• Atherosclerosis can occur in any artery in the
  body

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Coronary Heart Disease (CHD)

• (sometimes referred to as coronary artery
  disease)
• When atherosclerosis occurs in the coronary
  arteries (which provide the heart organ with
  blood)
• Many factors contribute to CAD, including
• High bld pressure, high cholesterol, being
  overweight, smoking, physical activity, gender,
  age, genetics

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CAD Cholesterol

• Cholesterol in a major risk factor for CAD
• Remember, cholesterol is important in cell
  membranes.
• Cholesterol is made by our liver and also
  obtained from the foods we eat (animal products
  i.e. meat, eggs, etc)

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CAD and Cholesterol

• Lipoproteins are special carriers that transport
  cholesterol in the blood
• There are 2 types
• LDL low-density lipoprotein bad cholesterol
• Contributes to the build-up of plaque on artery
  walls
• HDL high-density lipoprotein good cholesterol
• Bring cholesterol back to liver to be removed
  from body

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ANGINA

• chest pain or discomfort due to CAD
• Pain is created when the heart muscle doesnt get
  as much blood as it needs because of a blockage
  in a coronary artery
• Often triggered by physical activity
• Treated with nitroglycerin causes vasodilation
  to increase blood flow.

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Heart Attack / Myocardial Infarction

• death of an area of the heart muscle due to
  oxygen deprivation
• If the plaque that builds up in a coronary artery
  ruptures, a blood clot will form at the rupture
  site
• The clot reduces blood flow, causing the coronary
  arteries to narrow and less blood and O2 to reach
  the heart

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Heart Attack

• After 20-40 minutes, heart cells will start dying
  (b/c of oxygen deprivation) and will continue to
  die for the next few hours if not treated
• Can be fatal if a large area of the heart is
  affected or if it interferes with the cardiac
  cycle

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Heart Attack

• After 20-40 minutes, heart cells will start dying
  (b/c of oxygen deprivation) and will continue to
  die for the next few hours if not treated
• Can be fatal if a large area of the heart is
  affected or if it interferes with the cardiac
  cycle

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Heart Attack SYMPTOMS

• Usually occurs suddenly but there are warning
  symptoms
• Chest pain
• Difficulty breathing
• Pain in the arm, back , jaw
• Nausea and vomiting
• Tingling in the left arm
• Heartburn and indigestion
• Dizziness
• Often, these symptoms are confused with digestive
  problems

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Treating Coronary Heart Disease

• Lifestyle changes
• Regular exercise
• Healthier diet
• Quit smoking
• Medications to reduce buildup of plaque in
  arteries
• Procedures angioplasty, bypass surgery

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Angioplasty

• Opening of a blocked artery by inflating a small
  balloon at the point of the blockage.
• An expandable mesh tube called da stent may be
  placed at the site of the blockage to ensure that
  the artery remains open.
• A laser could also be used to vaporize the plaque

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Bypass Surgery

• Surgery that reroutes or bypasses blood around
  clogged coronary arteries to improve blood flow
  and oxygen to the heart muscles.
• In the procedure, blood vessels from another part
  of the body (usually a vein from the leg) is
  removed and the grafted to the coronary arteries
  to provide an alternate route for blood to travel

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Bypass Surgery
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Stroke

• Caused when a blood vessel leading to the brain
  is blocked is damaged preventing blood and O2
  from getting to the brain.
• The brains cells begin to die because of oxygen
  deprivation

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Stroke - CAUSES

• 1) Atherosclerosis in the arteries of the brain
  or neck
• 2) blood clot in a blood vessel in the brain
  (cerebral thrombosis) (Thrombosis clot)
• 3) A travelling blood clot (embolus)
• 4) a weak spot in a blood vessel may break
  (cerebral hemorrhage) (Hemorrhage rapid loss of
  blood)

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Stroke

• The effects of a stroke depend on the location of
  the obstruction and how much brain tissue is
  affected.
• Can cause paralysis, vision problems, memory
  loss, difficulty speaking, cognitive
  difficulties, loss of balance

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DID YOU KNOW???

• One side of the brain controls the opposite side
  of the body.
• If a stroke occurs in the right side of the
  brain, the right side of the face and the left
  side of the body will be affected.

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Thrombophlebitis

• a small blood clot that form on the wall of a
  vein causing it to swell
• Often occurs in leg veins close to the skin
• The area is marked by redness, tenderness, pain
  and hardness

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• May result from infection or injury (which causes
  the clotting), immobility (prompting blood to
  pool and clot), wearing a cast
• Smoking and birth control pills also increase
  chances
• Treatments propping up limb, medicines to reduce
  pain and swelling, antibiotics

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Heart Murmur

• Caused by faulty heart valves.
• If one of the valves does not close properly,
  then blood will flow backwards into the chamber
  it just came from
• The backwards flow of blood will make a hissing
  sound when heard a stethoscope is used.

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Heart Murmur

• A normal heart beat lub-dub
• If you hear
• lub-dub-hiss one of the semilunar valves are
  malfunctioning
• lub-hiss-dub one of the atrioventricular
  valves are malfunctioning.

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Heart Murmur

• Usually, heart murmurs are not very serious and
  do not require treatment.
• If a valve was completely damaged, then surgery
  could be performed and an artificial valve could
  be sewn in to replace a faulty one.

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Varicose Veins

• Caused by faulty venous valves.
• As a result, blood pools in area in the veins and
  has difficulty returning to the heart for
  recirculation

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Varicose Veins -Treatments

• Elevating legs (so that blood can return to the
  heart without)
• Compression Stockings create a pressure
  gradient
• Exercise increase skeletal muscle contraction
  and heart rate to help push blood past faulty
  valve back to the heart.
• Surgery

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