circulatorysystem循环系统英文资料课件.pptx

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1、Logo Anatomy Contents1 Etiology 2 Diagnosis3 Treatment 4Hypertension5AnatomyThecirculatorysystemconsistsofthe heart、vessels and neurohumoral adjustable devices of blood circulation.The hearta four-chambered pump.Its pumping action creates the pressure needed to push blood in the vessels to the lungs

2、 as well as to the rest of the body cells.Location of the heartThe heart lies obliquely in the mediastinum,between the lungs,inside the thoracic cavity.About 2/3 of the heart is located to the left of the midline.Shape of the heartThe heart is a hollow,four chambered muscular organ,which is approxim

3、ately the size and shape of a clenched fist and weighs about 250-350g in adults.GeneraldescriptionoftheheartTheheartlookslikeflattenedandroundedpyramidthathasanapex,abase,twosurfacesandthreeborders(margins).CardiacapexThecardiacapexisafree,cone-shapedend,whichismadeuponlybytheleftventricle.Thecardia

4、capexislocatedattheleveloftheleft5thintercostalspaceand0.5-1cmmedialtothemidclavicularline.Thislocationisanimportantoneforclinicalpurposes；forauscultationaswellasforpalpation.LogoCardiacbaseThecardiacbaseisprimarilymadeupbytheleftatriumwithalessercontributionoftherightatrium.GroovesTherearethreegroo

5、vesonthesurfaceofheart:thecoronarysulcus,theanteriorinterventriculargroove,theposteriorinterventriculargroove.Chambers of the heart Theheartisafour-chambered,doublepump,consistingoftherightandleftatriaaboveandtherightandleftventriclesbelow.RightatriumFromtherightmarginoftheheart.Receivesbloodfromthe

6、superiorvenacava,inferiorvenacavaandcoronarysinus.RightventricleBloodfromtherightatriumpassesthoughtthetricuspidvalvetofilltherightventricle.Leftatriumlocatedontheposterioraspectoftheheart，receivesbloodfromthepulmonaryveinLeftventricleTheleftventriclereceivesthebloodfromtheleftatrium.Thesetwochamber

7、sareseparatedbythebicuspid(mitral)valve.Structure of the heartStructureoftheheartwallendocardiumlocatedintheinterialsurfaceheartatriumandventriclewall.consistofeveryvalveoftheheart.TheplaceiseasilyinvasedbyRheumaticdiseases.myocardiumthemajorityoftheheartwall,containsmyocardioventricleandmyocardiatr

8、ium.theformeristhickerthanthelatter,especiallyleftmyocardioventricle.theydontcontinueeachother.epicardiumAtrialseptalventrialseptalpericardiumfibrouspericardiumandserouspericardiumConductionsystemoftheheartItconsistsofspecialmyocardialfibers,formsaknotorbundle,locatesintheheartwall.Thesystemhasthech

9、aracterofgeneratingexcitement,conductingimpulseandmaintainingnormalrhythmoftheheartbeat.sinuatrialnodelocatesintheepicardialdeepsurfacebetweensuperiorvenacavaandrightauricle,normalheartpacemaker.atrioventricularnodelocatesintheendocardialdeepsurfacebetweencoronarysinusandrightatrioventricularorifice

10、,conductsimpulsefromsinuatrialnodeintocardioventriclefrom.atrioventricularbundletheonlyimportantwayoflinkingtheheartatriumwithventrile.itsbranches.Heart VesselsArteries and Veins AscendingaortaSource,leftventricleoftheheart;branches:leftandrightcoronaryartery,continuesasaorticarch;.Leftcoronaryarter

11、ySource,ascendingaorta;branches：anteriorinterventricularbranchesandcircumflexbranches.RightcoronaryarterySource,ascendingaorta；branches：sinoatrialnodalbranches,rightmarginalbranches,posteriorinterventricularbranches,atrioventricularnodalbranches.Coronarysinusformedbyunionofgreatcardiacveinandoblique

12、veinofleftatrium;tributaries:middlecardiacvein,smallcardiacvein.Pathwayofbloodcirculationsystemiccirculation leftventriclecontractandejectarterialbloodintoaorta,passawayitsbranchesintocapillaries,exchangewithsubstancesandgasesbyproductionofdifferenttissuesorcells,thentransformintoveinbloodandreturnt

13、herightatrium.pulmonarycirculationrightventriclecontractandejectphelbialbloodintopulmonaryartery,passawayitsbranchesintocapillaries,exchangewithoxygenfromlungalveoluses,thentransformintoarterialbloodandreturntheleftatrium.RiskfactorsorcausesforheartdiseaseSmoking/intemperance High cholesterol klestr

14、l hyperlipidemiaDiabetesObesity/mal-nutrition exercise too littleFamily history Hypertension/hypotentionCongenital malformationPeripheral artery disease virus or bacterial infectionpoisoningAge/sexPhysiological degenerationChronicsymptomscardicsymptoms chest distress palpitation angina pectorispulmo

15、narycirculation cough expectoration Hemoptysis cyanosis dyspneasystemiccirculation faintness abdominal distension and pain vomiting oliguria edama headache dizziness twitchingPhysiologicalexaminationthemostbasicexaminationmethod.thedoctorsgetpatientsrelativedatasbytheireyes，ears，noses，handsandsomesi

16、mpletools,suchasstethoscope,thermometer,tentionmeter.1.VitalSignsheartrate,pulse,respiration,bloodpressure2.inspection Observedinpatientswithskincolor,payattentiontowhetherpatientswithhypopneaandothersymptoms.Suchasanginamaybecyanoticlips,andhypertension,mayappearredface.Observewhethertherehavepreca

17、rdialprominenceorprecardialhassomeabnormalcardiocapexbeat.(Apexbeatintheleftmidclavicularlineatthefifthintercostalspaceinside0.5cm,pulsatilityrangediameterofabout2.0cm.)3.palpationTouchattheapexbeat,recordwhethertheenhancedandweakenedapexbeat,withorwithouttremor,pericardialfrictionsensitivity.Toucht

18、heradialartery,recordpulserate,judgementifthearterialpulsationispowerfulornot,includingtherhythmisornotinthelow,andcomparingbothsidesaresymmetrical,Determinewhetherthereispulsusparadoxus,alternatingpulseorsignofcapillarypulsation,etc.4、PercussionDrawtherelativecardiacdullnessbythepercussionofchest,i

19、nordertodeterminewhethertheincreaseordecreaseofheart.5、auscultation Listentothecardiechemaofthesevalvesbythestethooscopetodetermineiftherhythmisneatornotandtheabnormalcardiechema.someimportantsigns1.Cardiacenlargement2.Abnormalheartsoundsandpulsebeat3.Arrhythmia4.abnormalbreathsounds5.Pulmonaryrales

20、6.hepatomegaly7.Jugularveindistention8.lowerextremityedemaLaboratorytestsThedoctorsusephysical,chemicalandbiologicallaboratorytechnologytotestpatientsblood,fluid,secretionandtissue,soastoobtaindataandassistdiagnosisandtreatment.Routineconventionaltestsblood,urine,faeceroutineexaminationSpecialtests1

21、.microbialculture:infectiousheart disease2.ASO/ESR/CRP:rheumaticheartdisease3.lipidstests:coronary atherosclerotic heart disease4.CK/CK-MB/cTnT/cTnI:myocardialinfarctionandanginapectorisEquipment inspectionElectrocardiogram puttheelectrodeontothespecialregionsofbodysurface,recordoutcontinuouscurveab

22、outelectricardiachargeswiththemachine.mainlydiagnose:ArrhythmiaandMyocardialinfarction24-hour Holter 24-hour ambulatory blood pressureEchocardiography movetheprodeontotheheartsurfaceregions,observethecardiographychargesofcomputer.mainlydiagnosecardiovalvularopathy.angiocardiogram胸片Selective coronary

23、 angiography-gold standardClassficationoftheheartEtiology Congenital Acquired1.Atherosclerosis2.Rheumatic3.primaryhypertention4.pulmonary5.inflectious 6.endocrinopathic7.hematopathic8.Nutritional and metabolic9.Cardiac neurosisPathologicalanatomy1.Endocardiumdisease(endocarditis)2.Myocardosis(myocar

24、dialischemia)Arrhythmia(tachycardia)3.pericardialdisease(hydropericardium)4.Macrovasculardisease(aorticstenosis)5.congenitalmalformation(Congenitalheartdisease)Pathophysiology1.heartfailure2.shock3.dysfunctionofcoronary circulation4.dysfunction of Papillary muscle 5.Hyperdynamic circulation6.Cardiac

25、 tamponadeDiagnosisEtiologyPathological anatomyPathophysiologyeg:Rheumaticvalvularheartdisease1.Rheumaticheartdisease2.bicuspid valve stenosis or incompetence3.heart failure4.atrial fibrillationPrevention1.stopsmoking2.properrest3.moremovement4.loseweight5.decompression6.controlldiets7.healtheducati

26、on8.steadyemotionTreatment1.releasesymptoms(1)dealwiththeemergencyconditionsacutemyocardialinfarction,acuteleftheartfailure(2)keepabalanceoflifesign(3)relievepain心痛定心痛定,硝酸甘油含化片硝酸甘油含化片(4)swelling速尿，螺内酯，氢氯噻嗪速尿，螺内酯，氢氯噻嗪2.removeetiology(1)controlinfectionantibiotic抗生素抗生素NSAID非甾体类抗炎药非甾体类抗炎药(2)controlhigh

27、hypertentionACEI,ARB,CCB,Diureticdrugs(3)controlhighcholesterol立普妥立普妥Inhibitionofplateletaggregationdrugs阿司匹林阿司匹林氯吡格雷氯吡格雷Anticoagulantdrugs华法林华法林Thrombolyticdrugs尿激酶尿激酶(4)controlhighbloodsugaroralmedication二甲双胍二甲双胍insulin优泌林优泌林3.intervention(1)Artificialpacemaker4.surgicaloperation(2)Thepercutaneous

28、coronaryarterybypassgrafting5.rehabilitation-exercise(1)ensuretheindicationsandcontraindications (2)choose suitable exercise methods:medium or low intensity aerobic exercise,such as walking,jogging,swimming,tai chi chuan and so on.(3)master exercise intensity:target heart rate is often used as an ev

29、aluation index,its definition:in exercise test,by heart rate monitor machine or touching the pulse beating,we can get 60%to 80%of maximum heart rate.But if the patient cant exercise,target heart rate=170-Age.Commonly when the patient stop motion,the doctor or theorpist touches the pulse besting imme

30、diately and lists 10 seconds(radial artery/ear artery/temporal artery),then6 represents one minute pulse rate,the result is close to the heart rate of moving exercise.(4)master exercise time:1 to 3 hours after a meal,ready time for 10 minutes,training time for 20 to 30 minutes,and finally relaxing t

31、ime for 10 minutes.(5)master exercise frequency:Weekly exercise for 3 to 5 times.clinical aspect of the circulatory systermatherosclerosis The accumulation of fatty deposits within the lining of an artery is termed atherosclerosis.This type of deposit,called a laque,begins to form when a vessel rece

32、ives tiny injuries,usually at a point of branching.A majoy risk factor for the development of atherosclerosis is dyslipidemia,abnormally high levels or imbalance in lipoproteins that are carried in the blood,especially high levels of cholesterol-containing low-density lipoproteins(LDL).Other risk fa

33、ctors for atherosclerosis include smoking,hypertension,poor diet,inactivity,stress,and family history.Atherosclerosis may involve any arteries,but most of its effects are seen in the cornary vessels of the heart,the aorta,the crotid arteries in the neck,and vessles in the brain.thrombosis and emboli

34、sm Atherosclerosis predisposes a person to thrombosis,the formation of thrombus within a vessle.Usually the mass is a blood clot that breaks loose from the wall of a vessle,but it may also be air,fat,bacteria or other solid materials.Often a verous thrombus will travel through the heart and then lod

35、ge in an artery of the lungs,resulting in a life-threatening embolism.An thrombus from a carotid artery often blocks a cerebral vessles,causing a cerebrovascular accident(CVA),commonly called stoke.Aneurysm An arterial wall weakened by atherosclerosis,malformation,injury or other causes may balloon

36、out,forming an aneurysm.Rupture of a cerebral artery is another cause of stroke.The abdominal aorta and carotid arteries are also common sites of aneurysm.Hypertension(primary)definitionaclinicalsyndromeofunexplainedarterialpressureincreasedasthemaincharacteristics,easilycausethetargetorgansdamage,m

37、ainlyincludeheart,vessel,brain,kidneyandretinal Standard Systolic pressure140mmHg and/or Diastolic pressure 90mmHgcoronary artery disease(CAD)CAD,which results from atherosclerosis of the vessles that supply blood to the heart muscle,is a leading cause of death in industrialized countries.An early s

38、ign of CAD is the type of cheat pain known as angia pectoris,which is a feeling of constriction around the heart or pain that may radiate to the left arm or shoulder,usually brought on by exertion.Often there is anxiety,diaphoresis and dyspnea.arrhythmia arrhythmia is any irregularity of heart rhythm such as a higher or lower thanavarage heart rate,extra beats or an alteration in the pattern of the beat.Bradycardia and tachycardia are the 2 basic types.LogoLogoThankyou