SYSTEM
Review of Ana-Phy
FUNCTIONS
– Primary function: transportation of hormones,
nutrients, wastes, respiratory gases, vitamins,
minerals, enzymes, water, leukocytes, antibodies,
and buffers
MEDICAL-SURGICAL
NURSING
Prepared by:
Cherry Ann G. Garcia, RN
BLOOD
HEART
HEART
Functions:
Pumps blood throughout the
body
Routes blood
Ensures one-way blood flow
Regulates blood supply
HEART
Location: in mediastinum
Structure:
Pericardium – covering of the heart
Heart wall: myocardium – cardiac
muscle cells; endocardium –
endothelial inner lining
4 Cavities: Left and Right Atria; Left
and Right Ventricles
Valves: Tricuspid valve, Mitral valve,
Aortic valve, Pulmonic Valve
HEART
Arrange the following to form the correct path of the blood
through different organs starting with the superior and
inferior vena cava
SUPERIOR
VENA CAVA
INFERIOR
VENA CAVA
HEART
BLOOD CIRCULATION
SUPERIOR
VENA CAVA RIGHT TRICUSPID RIGHT
INFERIOR ATRIUM VALVE VENTRICLE
VENA CAVA
PULMONARY PULMONIC
LUNGS VALVE
PULMONARY ARTERY
VEIN
SYSTEMIC AORTA
CIRCULATION
Memory Tip
TRIGHT
Tricuspid on the Right
MITRALEFT
Mitral on the Left
Conduction System of
the Heart
INTERNODAL
SA NODE PATHWAY
AV NODE
Pathway of Depolarization
BLOOD
Plasma Formed Elements
Liquid/ Water portion of A. ERYTHROCYTES – red blood
the blood cells; lives for 120 days
principal component:
HEMOGLOBIN – O2 carrier of
ALBUMIN – major the blood
plasma protein
B. LEUKOCYTES – white blood
cells
- antibody synthesis
- phagocytosis
C. THROMBOCYTES – platelets
- blood coagulation
BLOOD VESSELS
• Transport system of the circulatory
system
• 3 major types:
Arteries
Veins
Capillaries
ANGINA PECTORIS
• Angere - to choke
• Myocardial oxygen
demand exceeds
supply during
periods of increased
activity, exercise,
or stressful event
Angina Pectoris
• During stress, the
myocardium demands
more O2
• Coronary arteries
would normally
dilate to supply
more blood and O2
• In Angina Pectoris,
the coronary
arteries are unable
to dilate
sufficiently to
increase perfusion
Symptoms -Angina Pectoris
• Great anxiety/Fear
• Fixation of the body
• Pale, ashen, or livid face
• Dyspnea (SOB) may be
associated
Symptoms -Angina Pectoris
• Nausea
• Diaphoresis
• BP usually up during
attack
• Dysrhythmia may be
present
Forms of Angina Pectoris
• Stable Angina
– Occurs with exercise
– Predictable
– Relieved by rest or
Nitroglycerin
Forms of Angina Pectoris
• Unstable Angina
– More frequent/severe
– Can occur during rest
– May indicate impending MI
– Requires immediate
treatment and transport
to appropriate facility
PAIN ASSESSMENT
(PQRST)
P – Position/Provocation
Q – Quality/Quantity
R – Radiation/Relief
S – Severity/Symptoms
T – Timing
ISCHEMIC HEART DISEASES
MYOCARDIAL INFARCTION
Inadequate perfusion
of myocardium
– Death of myocardium
•Infarct
– Damage to myocardium
•Ischemia
Acute Myocardial Infarction
CLINICAL FINDINGS
For MI:
Increased Cardiac troponin T within 21 days
Elevated CPK-MB for 4-6 hrs after pain, peak at
24 hours and goes back to normal after 72 hours
Elevated myoglobin for 1-3 hrs and goes back to
normal after 12 hours
ECG: presence of Q wave
Elevated temperature and WBC
ISCHEMIC HEART DISEASES
INTERVENTIONS
Angina:
Nitroglycerin
O2
Pulse oximeter
Vital signs monitoring
MI:
ASA administration on the way to the hospital
Analgesics: morphine sulfate
O2
Thrombolytic therapy within 6 hours of MI; anticoagulants
Cardiac monitoring
NPO on the first 24 hours
Complete bed rest
Acquired Valvular Disorders
HOW?
Acquired Valvular Disorders
INTERVENTIONS
• Commissurotomy – surgical
opening to separate the leaflets
Inflammatory Diseases of the
Heart
PERICARDITIS
DEFINITION
Causes of CHF:
Coronary Artery Disease
Chronic hypertension (high blood
pressure)
AMI
Valvular heart disease
Congestive Heart Failure
Usually begins with left-sided failure.
– Left ventricle fails
– Blood “stacks up” in lungs
– High pressure in capillary beds
– Fluid forced out of capillaries into alveoli
Congestive Heart Failure
Right-sided failure most commonly
caused by Left-sided failure. Blood
“backs up” into systemic circulation
– Distended neck veins
– Fluid in abdominal cavity
– Pedal edema
HEART FAILURE
LEFT-SIDED HF RIGHT-SIDED HF
(PULMONARY) (CIRCULATORY
CONGESTION)
Crackles, Cheyne- Bloating
Stokes respiration Pitting edema
Orthopnea Ascites
Paroxysmal nocturnal Jugular vein distention
dyspnea Ankle edema (1st sign of
Frothy, blood-tinged RHF)
sputum Hepatomegaly
Cyanosis
HEART FAILURE
INTERVENTIONS
(ADD 02)
Assume semi-recumbent position
Daily weight, abdominal girth, intake and
output and V/S monitoring; diuretics therapy
Decrease cardiac workload; Digoxin
O2 therapy
Vascular Diseases
Thromboangiitis Obliterans
Impairment in the peripheral circulation
due to inflammatory occlusions of the
arteries
Occurs in male smokers
Vascular Diseases
RAYNAUD’S DISEASE
THROMBOPHLEBITIS
Venous stasis
DEFINITION
Risk Factors
■ Atherosclerosis, trauma, congenital
weakness, infection, inflammation
■ HTN, smoking
Types of ANEURYSM
Dissecting Saccular
Aneurysm
False aneurysm aneurysm
Fusiform
Normal artery True aneurysm aneurysm
(A) Normal artery
(B) False aneurysm—actually a pulsating hematoma. The
clot and connective tissue are outside the arterial wall.
(C) True aneurysm. One, two, or all three layers of the artery
may be involved.
(D) Fusiform aneurysm—symmetric, spindle-shaped
expansion of entire circumference of involved vessel.
(E) Saccular aneurysm—a bulbous protrusion of one side of
the arterial wall.
(F) Dissecting aneurysm—this usually is a hematoma that
splits the layers of the arterial wall.
ANEURYSMS
DEFINITION
Management
• Secure airway
• High concentration O
2
• Rapid transport
• Definitive treatment:
• PERICARDIOCENTESIS
Types of Shock and Their Causes
Cardiogenic Shock
Pump failure
Heart’s output depends on
How often it beats (heart rate)
How hard it beats (contractility)
Main Problem:
• Decreased oxygen carrying capacity
of the blood. The condition is usually
associated with:
• nutritional deficiency of iron.
• increased milk intake in infants
• females
Iron Deficiency Anemia
Manifestations:
• Easy fatigability
• Poor sucking (infants)
• Chubby but pale babies (milk babies)
• Dyspnea on exertion
• Pallor
• Fatigue
• Irritability
• Tachycardia
• Spoon shaped, brittle nails
Iron Deficiency Anemia
Interventions:
• Instruct the client to have frequent
rest periods.
• Increase iron in the diet (organ
meat, egg yolk).
• Milk (breast or cow’s) is a poor
source of iron.
• Administer oral iron supplements
as ordered.
Pernicious Anemia
Main Problem:
• Reduced Vitamin B12 absorption
due to the absence of the intrinsic
factor, related to:
• gastrectomy
• atrophy of gastric mucosa in
elderly clients.
Pernicious Anemia
Manifestations:
• Fatigue
• Beefy red tongue or glossitis
• Pallor
• Paresthesia
• Weakness
• Sore mouth
• (+) Romberg’s test
Pernicious Anemia
Diagnostics:
• Growth retardation
• Dyspnea on exertion
• Joint swelling
• Aching bones
• Generalized pain
• Leg ulcers
Sickle Cell Anemia
Interventions:
Two types:
• Alpha - thalassemia alpha chains of
hemoglobin are affected
• Beta thalassemia beta chains of
hemoglobin are affected
Thalassemia
Manifestations:
• Initial: fatigue/shortness of breath
• Other manifestations:
• jaundice
• splenomegaly
• hepatomegaly
• hemosiderosis accumulation of iron
in the tissues
Thalassemia
Interventions: