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Cardiopulmonary Physical Therapy
Haneul Lee, DSc, PT
OBJECTIVE
1. Explain the principle anatomy of the cardiovascular system2. Outline the major physiology of the cardiovascular system3. Discuss the circulatory system
Delivering oxygen to active tissue
Playing an important role in
movement
Limiting factor to performing
functional activities
• One major challenges to homeostasis posed by exercise is the increased muscular demand for oxygen
• During heavy exercise, oxygen demands may increases by 15 to 25 times
Cardiovascular system
1. Transport O2 and nutrients to tissues
2. Removal of CO2 wastes from tissues
3. Regulation of body temperature
http://dokterayla.com/tag/muscles-of-respiration
Location: Apex – base of 5th intercostal space (Left)
Located in mediastinum, between lungs
Base – board superior portion of heart
Apex – inferior end
3.5 inch wide at base,
weights 10oz
http://www.tutorvista.com/content/biology/biology-ii/transportation/heart.php
Layers
1. Pericardium
2. Myocardium
3. Endocardium
http://histologyolm.stevegallik.org/node/347
Right atrium (RA): receives the blood from superior
or and inferior vena cavae. Right ventricle (RV)
:receives blood from RA and pumpsit via the pulmonary artery to lungs for oxygen
Left atrium (LA): receives oxygenated blood from the
lungs and the four pulmonary veins Left ventricle (LV)
: receives blood from the LA and pumps it via the aorta throughout the entiresystemic circulation
http://textbookofcardiology.org/wiki/Valvular_Heart_Disease
Provide one-way flow of blood
Artrioventricular valves
Tricuspid valve
Bicuspid or mitral valve
Semilunar valves
Pulmonary valve
Aortic valve
http://textbookofcardiology.org/wiki/Valvular_Heart_Disease
Begins with an action potential in the sinoartrial (SA) node, a depolarization wave is spread through both atria, to the artrioventricular (AV) node, and then, through the Punkinjecomplex, into the ventricle.
http://www.texasheart.org/HIC/Anatomy/conduct.cfm
The rhythmic pumping action of the heart
Systole : the period of ventricular contraction
Diastole : the period of ventricular relaxation
Atrial contraction occurs during the last third of diastole and completes ventricular filling
http://classes.midlandstech.edu/carterp/Courses/bio211/chap18/chap18.html
Atrial systole begins Atrial contraction forces a small amount of additional blood into ventricles
Atrial systole ends, ventricular diastole begins Pause through the AV node
Ventricular systole Ventricular contraction, AV valves close – 1st heart sound Isovolumetric ventricular contraction
Ventricular systole- 2nd phase Ventricular pressure rises and exceeds arterial trunk or aortic pressure Semilunar valves open and blood is ejected = SV
Ventricular diastole – early Ventricles relax and pressure drops below aortic pressure Blood flows into relaxed atria
Ventricular diastole-late All chambers relaxed Passive ventricular filling occurs
Arteries : arise directly from aorta near aortic valve; blood circulates to myocardium during diastole.
Right coronary artery ( RCA)
Left coronary artery (LCA)
Left anterior descending (LAD)
Circumflex (Circ)
answers.medchrome.com
Veins : parallel arterial system;
the coronary sinus receives venous blood from the heart and empties intothe right atrium.
answers.medchrome.com
Arteries Transport oxygenated blood from
areas of high pressure to lower
pressures in the body tissues.
Arterial circulation maintained by
heart pump.
Veins Transport dark, oxygenated blood
from tissues back to the heart
Lager capacity, thinner walls than
arteries, greater numbers
One-way valves to prevent backfl0w
The amount of blood ejected with each myocardial contraction; normal range is 55-100mL/beat
1. Left Ventricular End Diastolic Volume(LVEDV)
The amount of blood left in the ventricle at the end of diastole, aka preload
2. Contractility
The ability of the ventricle to contract
3. Afterload
The force the LV must generate during systole to overcome aortic pressure
to open the aortic valve
A measure of the amount of blood that is pumped out of the heart in one minute; normal rage is 4-5L/m
The amount of blood pumped out of the left ventricle as this is the ventricle that supplies blood to the muscles and organs of the body
Heart Rate (HR) * Stroke Volume(SV)
Question?Thank
you
1. National Physical Therapy Examination, O’sullivan&Siegelman, TherapyEd2. Essentials of Cardiopulmonary Physical Therapy, 3rd edition, Ellen Hillegass, Elsevi
er3. Cardiovascular and pulmonary Physical Therapy Evidence to Practice, 5th edition,
Donna Frownfelter, Elizabeth Dean, Elsevier4. Cardiopulmonary Physical Therapy Management and Case Studies, 2nd edition, W.
Darlence Reid, Frank Chung, Kylie Hill, SLACK Inc.5. Steele, Joel Dorman Hygienic Physiology (New York, NY: A. S. Barnes & Company,
1888)6. Khan Academy, www.khanacademy.org