The cardiovascular system week 4 penny

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Running Head: THE CARDIOVASCULAR SYSTEM 1 The Cardiovascular System Penny Rudni Chamberlain University

THE CARDIOVASCULAR SYSTEM 2 The Cardiovascular System The circulatory system consists of the heart which pumps blood throughout the body in a closed system of blood vessels. The heart is composed of the myocardium or cardiac muscles whose primary function is to pump blood throughout the body. The heart’s main function is facilitating the transportation of water, nutrients, wastes, gases, and chemical signals throughout the body. As a hollow organ, the heart is muscular in nature, with is size like a fist. The cardiac muscles which pump blood through the blood vessels repeatedly are involuntary. This is because the cardiac muscles are self-exciting meaning that they have the electrical conduction system that allows them to contract and therefore pump blood throughout the body. On the other hand, the skeletal muscles requires reflex or conscious nervous stimuli. Although the rhythmic contractions of the heart occur spontaneously, the heart rate or frequency can be changed by hormonal or nervous influences. The Physiology The myocardium is the heart’s muscular tissue. The myocardium has specialized cardiac muscle cells with abilities that cannot be found in any other tissue throughout the body. Just like other muscles, the myocardium can contract, but these contractions could also occur without electricity (Burggren, & Bagatto, 2020). The cardiac muscles are supplied with blood by the coronary arteries. The blockage or obstruction of these arteries could cause heart attacks leading to the lack of oxygen to the heart muscles. The inability of the heart to contract properly is known as heart failure. Heart failure could be caused by several reasons which generally lead to edema, fluid retention, a shortened life expectancy, decreased quality of life and renal insufficiency. There is a thick sac that surrounds the heart referred to as the pericardium. This

THE CARDIOVASCULAR SYSTEM 3 membranous sac does not only protects the heart but also lubricates it as it pumps blood throughout the body. The heart has two atria and two ventricles. The ventricles are larger and stronger compared to the atria which have thin walls and are much smaller. The atria are located on either side of the heart. The right atrium contains poorly oxygenated blood while the left atrium contains oxygenated blood (Burggren, & Bagatto, 2020). Poorly oxygenated blood gets to the right atrium through the superior and inferior vena cava while oxygenated blood gets to the left atrium receives its blood via the right and left pulmonary veins. The ventricles are the thick- walled chambers located both on the right and left sides of the heart. The right ventricle pumps blood to the pulmonary circulation of the lungs while the left ventricle pumps blood out of the heart to the rest of the body through the aorta. Ventricles are thicker than the atria for the development or creation of higher pressure for pumping blood out of the heart (Burggren, & Bagatto, 2020). Comparing the right and left ventricles, the left ventricle is thicker than the right ventricle because the left ventricle pumps blood throughout the body while the right ventricle pumps blood to the lungs. The septum is the thick wall that separates the ventricles or lower chambers of the heart from one another. This is because it is important that the oxygenated blood and the deoxygenated blood not mix at the heart as this could create complications. Additionally, valves are important organs of the heart. The heart has two atrioventricular valves which ensure that blood only flows in one direction (Tanaka et al., 2018). That is blood flows from the atria to the ventricles and not the other way round. The heart also has two semilunar valves which are present in arteries to prevent the backflow of blood, especially into the ventricles. In a heartbeat, the sound heard during this process is the sound of the heart valves shutting after the passage of blood. The right

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THE CARDIOVASCULAR SYSTEM 4 atrioventricular valve is referred to as the tricuspid valve and is located between the right atrium and the right ventricle. This valve allows blood to flow into the right ventricle when the heart is relaxed which is referred to as diastole. At the beginning of the contraction of the heart, blood is pushed into the ventricles then the ventricles begin contracting as blood pressure inside the heart rises. This is referred to as systole. The tricuspid valve shuts when the ventricular pressure exceeds the pressure in the atrium. The atrioventricular valve on the left is known as the bicuspid valve, whose function is preventing blood in the left ventricle from flowing into the left atrium. The valve is required to withstand the pressure located on the left side of the heart. This is because it has two cusps instead of three like the right atrioventricular valve. The other two valves are the aortic and pulmonary semilunar valves that prevent the backflow of blood into the aorta and the pulmonary artery respectively. Subjective Data with Relevant Health History Questions Consultation with a patient suspected to have cardiovascular-related problems requires one have good communication skills. This is because patients with cardiovascular can present with a wide range of symptoms. These symptoms include dyspnea, chest pain, syncope, palpitation, fatigue, and edema (Cotter, 2018). During the subjective data collection process one has to always make the interview patient-centered. Some of the relevant communication skills during this process include demonstrating empathy while responding to the patient’s cues (Narula et al., 2018). Listening actively is also another important skill required to effectively communicate with the patient. An appropriate level of eye contact is important as this would help the patient be more honest, as this helps establish a rapport with the patient thus promoting effective communication. During the collection of subjective data, the patient would be asked several questions, for instance, if they have ever been treated for high blood pressure, or have

THE CARDIOVASCULAR SYSTEM 5 been diagnosed with hypertension. The patients would be asked if they are diabetic, if they have high blood cholesterol levels, or if they smoke. If they smoke how much do they smoke. During the interview, it is also important for the patient’s family to be known as some of the cardiovascular diseases are genetically induced (Cotter, 2018). Therefore, during the interview, the patient would also be asked about their family’s history with heart conditions. Some of these questions include asking if they have anyone in their family who has had a stroke or heart attack and at age. They would also be asked if anyone in their family has been diagnosed with a heart or artery disease. Another question would be if anyone in their family has undergone a bypass or undergone a procedure that had to remove blockages on their arteries. Objective Data with Relevant Health History Questions In medicine, if a diagnosis is or a patient's symptoms are not documented, then they did not exist. It is due to this reason that a patient’s data or information needs to be documented. Documentation of the patient’s information is also important as it helps in the continuity of care. During taking of a patient’s subjective data, a medical practitioner needs to use certain skills (Cotter, 2018). Some of the important skills required to successfully evaluate the patient include skills of palpation, auscultation, and inspection of different body organs. Some of the important objective data to be documented during the patient’s exam include their general observation. General, the patient should appear oriented, alert, and awake. The patient should not appear in distress, hydrated, well developed, nourished, and of the stated age (Cotter, 2018). The patient’s skin should be dry, warm, intact without lesions or rashes. The patient’s skin color should also appropriately match her ethnicity. Nailbeds should have no cyanosis or clubbing. The head of the patient should be atraumatic without palpable or visible masses, scarring, or depression. The patient’s hair has normal texture and distrusted evenly. The patient’s eye has a visual acuity of

THE CARDIOVASCULAR SYSTEM 6 20/20 without corrective lenses (Cotter, 2018). The conjunctivae are clear without hemorrhage or excaudate. The patient has an intact EOM, PERRELA and the sclera is non-icteric. The optic disc, vessels, and fundi appear clear. The eyelids are normal in appearance without lesions or swelling and have no signs of nystagmus. Ears appear normal with no tenderness or swelling in both the ear canal and the external ear (Narula et al., 2018). The patient has clear ear canal without discharging with the tympanic membrane having a normal appearance. The patient also has intact hearing with good acuity to whispered voice. Patients should have a moist and pink nasal mucosa while the nares are patent bilaterally. The patient’s throat has good detention and is moist with a pink oral mucosa. The tongue appears normal without lesions as well as good symmetrical movements (Cotter, 2018). The patient’s pharynx appears normal and has no buccal nodules or lesions without tonsillar excaudate and swelling. The patient’s neck is supple without adenopathy. The thyroid gland is normal as it has no masses while the trachea is midline. No JVD carotid pulse is +2 bilaterally without bruit. The patient’s cardiovascular system appears normal as the external chest has no thrills, heaves, or lifts and appears normal. PMI is not visible and is palpated in the 5 th intercostal space at the midclavicular line. The patient’s vitals indicate that he has a normal heart rate and rhythm (Narula et al., 2018). The patient has no gallops, murmurs or ribs on auscultation as well as normal intensity of s1 and s2. The patient’s respiratory system should be normal with the chest being without deformity and symmetric chest walls. The patient should have no sign of trauma, non-tender chest walls, with no sign of respiratory distress (Cotter, 2018). The lung sounds are clear in all the patient’s lobes bilaterally without ronchi, rales, or wheezes. The patient has a symmetric, soft, and non-tender abdomen without distention. The abdomen has no visible scars or lesions while the aorta is midline without bruit or visible pulsation (Paneni et al., 2017). The

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THE CARDIOVASCULAR SYSTEM 7 umbilicus has no herniation and is midline. Additionally, the patient has normal bowel sounds in all four quadrants. The patient’s extremities are atraumatic both low and upper without tenderness or deformity. There is no erythema or swelling and the patient has a full range of motion in all joints. Muscle strength is normal with normal tendon function as well. Neurologically, the patient is awake, oriented to person, time, place, and is alert. Should have normal speech, motor function, and muscle strength (Cotter, 2018). The patient should have an appropriate mood and affect. The patient should have good insights and judgment with no auditory or visual hallucinations. Techniques of Physical Examination One of the most important procedures during the diagnosis of a patient with cardiovascular-related problems is the physical examination. This is because the context of the physical examination focusing on the cardiovascular system is established during the patient’s medical history. Additionally, information on the physical exam or the objective data is obtained from observing the patient’s gestures, habits speech, manipulation of their features and extremities (Tanaka et al., 2018). Some of the important techniques necessary to appropriately assess a patient with a cardiovascular-related problem include inspection, palpation, and auscultation. The inspection involves assessing the patient’s medical history and their body as well. This is important as it helps one assess the patient’s chief complaint and determine if they have any allergic history (Paneni et al., 2017). Additionally, the patient is inspected throughout the body where in most cases they are asked to undress, sit upright as the nurse inspects the thorax from the front. This helps the nurse to determine any defects with the patient’s skin movement, chest among other vital organs. This does not only occur from the front but also the patient's back (Tanaka et al., 2018). In most cases, an inspection of the patient’s body involves

THE CARDIOVASCULAR SYSTEM 8 studying symmetry of the thorax even eyes, face, neck, and gross deformities of the skin. Auscultation is another technique used during the physical examination. This technique involves listening to areas of the body using a stethoscope. In this case, during the exam, the stethoscope could be used to listen to bowel sounds, heart and lung sounds. The sounds heard from the stethoscope would be classified based on their pitch, duration, quality, and intensity (Tanaka et al., 2018). On the other hand, palpation is when an assessment is done by placing fingers on the body to determine if there is swelling, areas of pain, and masses. Palpation can either be light or deep. The patient’s response must be recorded during palpation as this might indicate areas where the patient is in pain. The Use of Different Physical Exam Techniques Different physical assessment skills would be used for patients of all ages. For infant pediatrics, they should be examined physically through inspection, light palpation, and auscultation (Paneni et al., 2017). On the other hand, for pregnant women, palpation, and auscultation is the most appropriate for physical examination. Physical assessment for geriatric patients should involve inspection, auscultation, and palpation. This is because, for geriatric patients, visible medical complications such as edema could be recognized through visual examination while other symptoms such as irregular heart rates could be determined through auscultations. On the other hand, palpations would help determine other complications such as cardiac abnormalities. One Major Disease One major disease that might significantly impact the cardiovascular system is myocardial infarction. Myocardial infarction occurs when there is decreased blood flow to a part of the heart causing damage to the heart muscles. Also known as heart failure, this condition is

THE CARDIOVASCULAR SYSTEM 9 usually caused as a result of the buildup of cholesterol or fats around the coronary artery (Lockhart & Sun, 2020). As a result, the heart fails to supply itself with adequate blood causing heart failure. Some of the major symptoms of a heart attack include shortness of breath, cold sweat, fatigue, and sudden dizziness or lightheadedness. Patients with cardiovascular diseases exhibit several symptoms. In this case, in the case of cardiovascular disease, the patient might experience chest pain either on the left side or central, shortness of breath, palpitations or fast breathing, fluid retention in body tissues or edema, and syncope which is the rapid onset of loss of consciousness (Lockhart & Sun, 2020). The patient might also experience muscle pain, systemic symptoms such as fatigue, fever among others. In conclusion, the cardiovascular system which is also referred to as the circulatory system consists of the heart and blood vessels. The heart is the muscular organ responsible for pumping blood throughout the body’s closed systems of vessels. The circulatory system is important as it helps circulate oxygen, nutrients, get rid of wastes, gases as well as the transportation of chemical signals. In case of cardiovascular-related problems, a patient’s objective and subjective data should be obtained. When examining to acquire the subjective data, questions to be asked would include asking the patient if they have a family member or themselves have a heart problem. For the objective data, a physical examination would be done to assess the patients’ vitals among other signs. Important physical assessment skills used during the assessment include auscultation, inspection, and palpations. One major disease that could significantly affect the patient’s cardiovascular system is myocardial infarction.

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THE CARDIOVASCULAR SYSTEM 10 References Burggren, W. W., & Bagatto, B. (2020). Cardiovascular anatomy and physiology. In Fish larval physiology (pp. 119-161). CRC Press. Tanaka, A., Tomiyama, H., Maruhashi, T., Matsuzawa, Y., Miyoshi, T., Kabutoya, T., ... & Physiological Diagnosis Criteria for Vascular Failure Committee. (2018). Physiological diagnostic criteria for vascular failure. Hypertension, 72(5), 1060-1071. Paneni, F., Diaz Cañestro, C., Libby, P., Lüscher, T. F., & Camici, G. G. (2017). The aging cardiovascular system: understanding it at the cellular and clinical levels. Journal of the American College of Cardiology, 69(15), 1952-1967. Cotter, L. (2018). Taking a history and the examination of the cardiovascular system. Medicine, 46(8), 437-442. Narula, J., Chandrashekhar, Y., & Braunwald, E. (2018). Time to add a fifth pillar to bedside physical examination: inspection, palpation, percussion, auscultation, and insonation. JAMA cardiology, 3(4), 346-350. Lockhart, P. B., & Sun, Y. P. (2020). Diseases of the cardiovascular system. Burket's Oral Medicine, 505-552.

The cardiovascular system week 4 penny

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