Chapter 7: Cardiovascular System

Angi/o

Vessel

Aort/o

Aorta

Arter/o, arteri/o

Artery

Arteriol/o

Arteriole

Atri/o

Atrium

Cardi/o

Heart

-ectomy

Surgical removal

End/o

In, within

Hyper-

Over, excess, increased, abnormally high

Hypo-

Under, below, decreased, abnormally low

My/o

Muscle

-otomy

Surgical opening

peri-

Around

Phleb/o

Vein

-plegia

Paralysis

Valv/o, valv/o

Valve

Vas/o, vascul/o

Vessel, duct

Ven/o, ven/i

Vein

Ventricul/o

Cavity, ventricle

Apex of the heart

The bottom portion of the heart that comes to a blunt point and points toward the left hip.

Three layers of the heart

Epicardium (outer layer), myocardium (middle main muscle layer), and endocardium (inner lining layer).

Myocardium thickness difference

The left side of the heart is thicker due to the need for higher pressure on contraction to distribute its contents outward to the body.

Pericardial fluid

Fluid found between the two linings of the pericardial sac (usually 10 to 30 mL) that lubricates the heart's surface and facilitates movement during pumping.

Congestive heart failure (CHF)

A common, chronic condition in older adults usually resulting from increased demands on the heart muscle over time or injury from a myocardial infarction.

Left-sided CHF mechanism

The left ventricle does not pump blood out to the body effectively, leading to a backup of blood into the left atrium and increased pressure in pulmonary veins, causing pulmonary edema (fluid buildup in lungs).

Systolic heart failure

A type of left-sided heart failure occurring when the left ventricle cannot contract (squeeze) hard enough, reducing the volume of blood pumped into circulation.

Diastolic heart failure

A type of left-sided heart failure occurring when the muscle in the left ventricle becomes stiff and cannot completely fill with blood between beats.

Right-sided CHF mechanism

Occurs when the right ventricle has difficulty pumping blood to the lungs to pick up oxygen, causing blood to back up in the systemic veins and resulting in edema in the abdomen, liver, and lower extremities.

Pericarditis

Inflammation of the thin double-layered sac (pericardium) that surrounds the heart, usually due to a viral infection in 80-90% of cases, causing friction and pain.

Pericardial effusion

An excessive buildup of fluid around the heart between the serous and fibrous layers of the pericardial sac, which can range from 10 mL to 2 liters.

Cardiac tamponade

Compression of the heart caused by excess fluid in the pericardial sac (pericardial effusion) that prevents the heart from beating effectively.

Pericardiocentesis

A surgical procedure done to drain excess fluid out of the pericardial cavity.

Pericardial window

A surgical opening created by cutting a section out of the pericardium to allow repeat fluid accumulation to drain into the chest cavity.

Pericardial metastasis

Cancer cells that have broken off from a main tumor (often lung, breast, lymphatic cancer, or melanoma) and spread to the pericardial sac surrounding the heart; carries a very poor prognosis.

Endocarditis

Inflammation of the inner lining of the heart and valves, usually due to an infection from bacteria, fungi, or other organisms.

Hypercholesterolemia

High levels of cholesterol in the bloodstream, which is the leading cause of coronary artery atherosclerosis and other vascular diseases.

Annulus

A ring of fibrous tissue that holds the leaflets of a heart valve in place.

Annuloplasty

Surgical reconstruction of a valvular annulus that has become worn down or misshapen over the course of a lifetime.

Atrioventricular (AV) valves

Inlet valves situated between the atria and the ventricles; includes the tricuspid valve on the right (three leaflets) and the mitral/bicuspid valve on the left (two leaflets).

Semilunar valves

Outlet valves that open during ventricular systole; includes the pulmonary valve on the right side and the aortic valve on the left side.

Chordae tendineae

String-like tendons (heart strings) linking the papillary muscles of the ventricles to the inlet valves to support them and prevent inversion/prolapse during contraction.

Valvular stenosis

A narrowing in the opening of a heart valve, causing the heart to beat harder to push blood through the smaller opening.

Valvular prolapse

A condition, most often found in the mitral valve, where the flaps of the valve are floppy and balloon back into the atrium during contraction.

Valvular regurgitation

The backflow of blood through a heart valve in the wrong direction; also referred to as valvular insufficiency.

Hypertensive renal disease

Prolonged high blood pressure taking a toll on the kidneys, causing the network of filtering tubules to break down and leading to hypertensive renal failure.

Hypertensive heart disease

Thickening of the muscle fibers in the left ventricle over time to help the heart push against high systemic blood pressure, resulting in a variety of CHF.

Right coronary artery (RCA) origin

Originates from the right coronary sinus in the ascending aorta, which allows blood to circulate without occlusion while the aortic valve is open.

Non-coronary sinus

The third aortic sinus where no coronary artery originates.

Left main coronary artery branches

Branches into two slightly smaller arteries: the left anterior descending (LAD) coronary artery and the left circumflex coronary (LCX) artery.

Angina pectoris

A hallmark of coronary artery disease characterized by pain in the left side of the chest, often radiating to the jaw and down the left arm; also known as stable angina.

Unstable angina

Unexpected chest pain that occurs during rest, is unpredictable, changes in frequency, and may get worse over time.

Variant angina (Prinzmetal's)

A type of angina that usually occurs while a patient is resting, specifically during the night or early morning, and typically occurs in younger patients with pre-existing heart conditions.

Microvascular angina

Chest pain brought about by spasms within the walls of the heart's smallest coronary arteries; pain may be more severe and last longer than other anginas.

Coronary artery disease (CAD)

The buildup of plaque (chiefly made of cholesterol) in the walls of the coronary arteries, leading to narrowing of the lumen (atherosclerosis).

Coronary artery stenosis

The narrowing of a coronary artery, usually due to the buildup of cholesterol and other debris along its internal walls.

Myocardial ischemia

Loss of blood flow and oxygen to the muscle of the heart, resulting in tissue damage; a major blockage can ultimately lead to a full MI.

Ischemic cardiomyopathy (ICM)

A disease condition of the heart muscle resulting from a prolonged period of oxygen and blood flow deprivation, causing irreversible damage and less effective functioning.

Myocardial infarction (MI)

An acute, life-threatening heart attack that occurs when blood flowing to the heart muscle is suddenly cut off, causing tissue damage.

STEMI (ST-elevated MI)

A serious type of MI associated with a total occlusion of a coronary artery; the EKG shows an elevated ST wave.

NSTEMI (Non-ST-elevated MI)

A type of MI usually associated with partial blockage and less heart muscle damage; the EKG shows a depressed or inverted (upside down) ST wave.

Oxygenation path through the right side of the heart

Oxygen-deficient blood enters the right atrium via the vena cavae -> passes tricuspid valve -> enters right ventricle -> pushed through pulmonary valve -> enters pulmonary artery -> travels to lungs.

Oxygenation path through the left side of the heart

Oxygen-rich blood returns from lungs via pulmonary veins -> enters left atrium -> passes mitral valve -> enters left ventricle -> pushed through aortic valve -> enters aorta -> distributed to body.

Sinoatrial (SA) node

The natural pacemaker of the heart located in the right atrium by the superior vena cava; generates electrical impulses between 60-100 times per minute.

Atrioventricular (AV) node

Located lower in the septal wall of the right atrium; receives, focuses, and slows down the impulse to allow time for the atria to fill with blood before ventricles contract.

Bundle of His & Purkinje fibers

The impulse travels from the AV node to the bundle of His, splits into right and left bundle branches, and reaches Purkinje fibers deep in the ventricular muscle to signal contraction.

Blood vessel classifications

Arteries (carry oxygen-rich blood away from the heart) -> arterioles -> capillaries (single cell layer bed where oxygen/nutrient exchange occurs) -> venules -> veins (carry deoxygenated blood back).

Osmosis in capillary beds

The principle where things pass from areas of higher to lower concentration, creating an osmotic gradient that causes excess fluids and cellular waste to flow back into the venous side.

Artery Layers

An artery has three layers: a tough outer layer of tissue, a strong and elastic muscular middle layer, and a very smooth inner layer of epithelial cells to withstand the heart's pumping pressure.

Vein Layers

Like arteries, veins have three layers (outer tissue, middle muscle, smooth inner epithelial cells), but their vascular layers are thinner and contain less tissue because they transport blood at a lower pressure.

Venous Systems of extremities

Veins found in the legs and arms belong to either a deep system located deep in tissues or a superficial system located just beneath the skin.

Vein Valves

Gates made of two leaflets attached to the vein wall that normally permit only unidirectional flow against gravity back to the heart.

Vein Valve Function during Muscle Contraction

During muscle contraction in an extremity, increased pressure opens the valve's leaflets and blood is pushed uphill; upon relaxation, pressure drops and leaflets immediately close to keep blood upstream.

Capillary Structure

Very thin and fragile vessels that are the width of a single epithelial cell, forcing blood cells to pass through only in single file.

Capillary Function

The site where the exchange of oxygen and carbon dioxide takes place through the thin capillary wall.

Subclavian Artery

Supplies blood to the upper extremities.

Subclavian Veins

Drains blood from the upper extremities; commonly used as points of entry for catheters to provide access to the bloodstream.

Greater Saphenous Vein

The longest vein in the human body; a superficial vein (closer to the skin) that is often used for coronary artery bypass grafting.

Five Circulatory Pathways

The five distinct pathways found in the human body are Systemic, Coronary, Pulmonary, Portal, and Lymphatic.

Systemic Circulation

Provides circulation throughout the entire body except for the heart and lungs; moves approximately five liters of blood continually using the heart's pumping force.

Coronary Circulation

Refers to the specific blood flow loop found within the tissues of the heart.

Pulmonary Circulation

A closed circuit running from the right ventricle to the pulmonary artery, through the lungs (exchanging O2 and CO2 in the capillary bed), and back to the left atrium via the pulmonary vein.

Portal Circulation

Found in the liver; consists of arterial blood from hepatic arteries to nourish cells and the portal vein carrying venous blood from digestive organs to be filtered before joining general circulation.

Liver Filtration Functions

Hepatic cells filter blood to neutralize bacteria from the gut, filter nutrients to make proteins/hormones/clotting factors, and break down drugs/chemicals (e.g., breaking down 1 oz of alcohol).

Lymphatic Pathway Function

A network of vessels and nodes running parallel to systemic circulation to filter excess fluid (lymph) and return it to main circulation; integral to the body's immune system.

Lymph Nodes

Kidney bean-shaped organs (average adult has 400 to 450) that filter bacteria, viruses, and foreign particles, housing T cells, B cells, and other immune sentinels that swell near infection sites.

Right Lymphatic Duct

The smaller of the two lymphatic ducts; collects lymph from the upper-right quadrant of the body (right side of head/neck, right upper extremity, right side of thorax) and deposits it into the subclavian vein.

Thoracic Duct

The larger lymphatic duct; drains lymph from the remainder of the body (everything except the upper-right quadrant) and deposits it into the subclavian vein.

Aneurysm

A weakening of the arterial wall that can leak or rupture, causing serious to fatal events.

Thrombus

A blood clot that forms in response to injury in a blood vessel; the disease process is called thrombosis.

Arterial vs. Venous Thrombus

An arterial thrombus forms in an artery (such as the heart or brain); a venous thrombus occurs in a vein.

Deep Vein Thrombosis (DVT)

The most common form of venous thrombosis, occurring specifically in the deep veins of the leg.

Mural Thrombus

A blood clot usually found in an artery, especially the aorta, that is attached to the wall of the artery and frequently associated with an aneurysm.

Laminar Thrombus

A blood clot that forms slowly over time with distinct layers of clotting factors, fibrin, platelets, and other cellular debris.

Varicose Veins

Also called varicosities; swollen, enlarged veins usually showing up in the legs due to weak or damaged vein walls and valves.

Lymphadenopathy

Refers specifically to swollen lymph nodes.

Transcutaneous Approach

Application of a device or monitor directly onto the skin to measure or alter heart rhythm (e.g., EKG, echocardiography, cardioversion).

Transesophageal Approach

An approach taken through the esophagus, such as placing a transesophageal echocardiography (TEE) probe in the back of the throat to monitor EKG and heart pressures.

Percutaneous

Puncturing the skin to gain access to a body cavity or organ with a small catheter or probe (per = through, cutaneous = skin).