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Introduction
1. Cardiopulmonary system
1.1 Physiology of cardiac system
1.2 Cardiac pathologies
1.3 Cardiac rehabilitation
1.4 Electrocaradiograms
1.5 Cardiac exercise testing
2. Pulmonary system
3. Neuromuscular system
4. Pediatrics
5. Musculoskeletal system
6. Other system
7. Non-systems
Wrapping up
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1.1 Physiology of cardiac system
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1. Cardiopulmonary system

Physiology of cardiac system

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Anatomy

The heart is a muscle that works to provide oxygen and nutrients to both the lungs and the body system while removing carbon dioxide and waste products.

The heart consists of:

  • External walls
  • Blood filled chambers
  • Valves which allow blood to flow through the chambers
  • Blood vessels that carry blood to the other structures
  • Electrical signaling conduction system

The three walls of heart are:

  • Endocardium; innermost layer
  • Myocardium: muscular middle layer
  • Epicardium: outermost layer

Chambers of heart:

  • Right atrium
  • Right ventricle
  • Left atrium
  • Left ventricle

Valves of heart:

  • Atrioventricular valves:
    • Tricuspid valve: lies between right atrium and right ventricle
    • Mitral valve: lies between left atrium and left ventricle
  • Semilunar valves:
    • Aortic valve: oxygenated blood flows from left ventricle to aorta
    • Pulmonary valve: de-oxygenated blood

Blood vessels:

  • Arteries: carry oxygenated blood
  • Veins: carry de-oxygenated blood
  • Capillaries: small blood vessels for exchange of de-oxygenated and oxygenated blood

Major coronary arteries:

  • Left coronary artery: divides into circumflex artery and left anterior descending artery
  • Circumflex artery: supplies blood to the left atrium and back of left ventricle
  • Left anterior descending artery: supplies blood to the font and bottom of the left ventricle
  • Right coronary artery: supplies blood to the right atrium, right ventricle, bottom portion of left ventricle

Image #1

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https://achievable-public-assets.s3.amazonaws.com/products/usmle-step-1/uncategorized/n021.jpg

Chambers of the heart

The heart is separated into four chambers that work to ensure blood flow occurs in the right direction. The left and right side of the heart work separately to ensure blood reaches either the lungs or body system. The left side of the heart pumps blood directly to the lungs providing oxygen to the blood while the right side of heart receives blood that has been pumped throughout the entire body and is deoxygenated.

Image #5

alt_text

https://open.oregonstate.education/aandp/chapter/19-3-cardiac-cycle/

Definitions
Aorta
Transports oxygenated blood from heart to peripheral systems
Right atrium
Receives de-oxygenated blood from the body system and then pumps to the right ventricle
Right ventricle
Receives blood from the right atrium and pumps deoxygenated blood the the lungs via the pulmonary arteries
Left atrium
Received oxygenated blood from the lungs and pumps to the left ventricle
Left ventricle
Receives oxygenated blood from the left atrium and then pushes to peripheral system
Superior vena cava
Large vein that carries deoxygenated blood from head, chest, arm, and neck
Inferior vena cava:
Large vein that carries deoxygenated blood from feet, legs, and abdomen

Blood flow through the heart: step-by-step

  1. Deoxygenated blood returns to the heart Blood lacking oxygen returns from the body to the heart through two large veins:
    • Superior vena cava: brings blood from the upper body.
    • Inferior vena cava: brings blood from the lower body.
  2. Right atrium The deoxygenated blood enters the right atrium, the heart’s upper right chamber.
  3. Right ventricle Blood flows from the right atrium into the right ventricle, the lower right chamber.
  4. Pulmonary arteries to the lungs The right ventricle pumps the blood through the pulmonary arteries to the lungs. *(Note: Despite being called arteries, these carry deoxygenated blood.)
  5. Lungs oxygenate the blood In the lungs, carbon dioxide is exchanged for oxygen. The now oxygen-rich blood is ready to return to the heart.
  6. Left atrium Oxygenated blood returns to the heart via the pulmonary veins into the left atrium, the upper left chamber.
  7. Left ventricle Blood moves from the left atrium into the left ventricle, the lower left chamber.
  8. Aorta to the body The left ventricle pumps the oxygen-rich blood into the aorta, the body’s main artery, which distributes it throughout the body.

Image #2

alt_text

https://open.oregonstate.education/aandp/chapter/19-1-heart-anatomy/

Electrical signals in the heart

Electrical signals within the heart act as a pacemaker to the heart by assisting with controlling heart rate, coordinating the heart chambers (atria and ventricles), adapt to the changing needs to the body, and ensure appropriate circulation.

Image #3

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https://achievable-public-assets.s3.amazonaws.com/products/usmle-step-1/anatomy/heart-electrical-activity.jpeg

Definitions
Sinoatrial node
Bundle of electrically charged cardiomyocytes that cause blood to move from superior vena cava to right atrium- pacemaker of heart
Atrioventricular bundle
Bundle of electrically charged cardiomyocytes that causes blood to move from atrium to ventricle
Purkinje fibers
Specialized electrical charged fibers that work with greater efficiency to cause contraction of the right and left ventricles
Bundle of his
Electrically charged fibers that carry signals through the central components of heart to assist with maintaining consistent contractility of heart by sending signals from AV node to Purkinje fibers

Crucial factors of cardiac function

The amount of blood pumped with each heart beat is crucial to maintaining vitality of the lungs and peripheral system. The principles that are important in this process are afterload and preload. If there is dysfunction in either of these components, then the individual may experience stroke, myocardial infarction, or death.

Definitions
Preload
Amount of blood in ventricles at the end of diastole
Afterload
Pressure that that the heart must overcome to pump blood to the lungs and peripheral system
Stroke volume
Amount of blood pumped out by ventricle at end of each contraction
Cardiac output
Heart rate multiplied by stroke volume to determine the how much blood is pumped from ventricles in liters by minute
Diastole
Relaxation of atrium and ventricles
Systole
Contraction of atrium and ventricle

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