circulatory system循環(huán)系統(tǒng)英文

1、Logo Anatomy Contents1 Etiology 2 Diagnosis3 Treatment 4Hypertension5AnatomyThe circulatory system consists of the heart、vessels and neurohumoral adjustable devices of blood circulation. The hearta four-chambered pump. Its pumping action creates the pressure needed to push blood in the vessels to th

2、e lungs as well as to the rest of the body cells.Location of the heartThe heart lies obliquely in the mediastinum, between the lungs, inside the thoracic cavity. About 2/3 of the heart is located to the left of the midline. Shape of the heartThe heart is a hollow,four chambered muscular organ, which

3、 is approximately the size and shape of a clenched fist and weighs about 250-350g in adults.General description of the heart The heart looks like flattened and rounded pyramid that has an apex, a base,two surfaces and three borders(margins).Cardiac apex The cardiac apex is a free, cone-shaped end, w

4、hich is made up only by the left ventricle.The cardiac apex is located at the level of the left 5thintercostal space and 0.5-1cm medial to the midclavicular line. This location is an important one for clinical purposes；for auscultation as well as for palpation.LogoCardiac base The cardiac base is pr

5、imarily made up by the left atrium with a lesser contribution of the right atrium. Grooves There are three grooves on the surface of heart:the coronary sulcus, the anterior interventricular groove, the posterior interventricular groove.Chambers of the heart The heart is a four-chambered,double pump,

6、consisting of the right and left atria above and the right and left ventricles below.Right atrium From the right margin of the heart. Receives blood from the superior vena cava, inferior vena cava and coronary sinus.Right ventricle Blood from the right atrium passes thought the tricuspid valve to fi

7、ll the right ventricle.Left atrium located on the posterior aspect of the heart，receives blood from the pulmonary veinLeft ventricle The left ventricle receives the blood from the left atrium. These two chambers are separated by the bicuspid (mitral) valve. Structure of the heartStructure of the hea

8、rt wallendocardium located in the interial surface heart atrium and ventricle wall.consist of every valve of the heart. The place is easily invased by Rheumatic diseases.myocardium the majority of the heart wall,contains myocardioventricle and myocardiatrium .the former is thicker than the latter,es

9、pecially left myocardioventricle.they dont continue each other.epicardium Atrial septal ventrial septal pericardium fibrous pericardium and serous pericardium Conduction system of the heart It consists of special myocardial fibers, forms a knot or bundle, locates in the heart wall. The system has th

10、e character of generating excitement, conducting impulse and maintaining normal rhythm of the heart beat. sinuatrial node locates in the epicardial deep surface between superior vena cava and right auricle, normal heart pacemaker. atrioventricular node locates in the endocardial deep surface between

11、 coronary sinus and right atrioventricular orifice,conducts impulse from sinuatrial node into cardioventricle from . atrioventricular bundle the only important way of linking the heart atrium with ventrile. its branches.Heart VesselsArteries and Veins Ascending aorta Source, left ventricle of the he

12、art; branches:left and right coronary artery, continues as aortic arch;.Left coronary artery Source, ascending aorta; branches：anterior interventricular branches and circumflex branches.Right coronary artery Source, ascending aorta；branches：sinoatrial nodal branches, right marginal branches, posteri

13、or interventricular branches, atrioventricular nodal branches.Coronary sinus formed by union of great cardiac vein and oblique vein of left atrium; tributaries:middle cardiac vein, small cardiac vein.Pathway of blood circulationsystemic circulation left ventricle contract and eject arterial blood in

14、to aorta,pass away its branches into capillaries,exchange with substances and gases by production of different tissues or cells, then transform into vein blood and return the right atrium.pulmonary circulation right ventricle contract and eject phelbial blood into pulmonary artery,pass away its bran

15、ches into capillaries,exchange with oxygen from lung alveoluses, then transform into arterial blood and return the left atrium.Risk factors or causes for heart diseaseSmoking/intemperance High cholesterol klestrl hyperlipidemiaDiabetesObesity/mal-nutrition exercise too littleFamily history Hypertens

16、ion/hypotentionCongenital malformationPeripheral artery disease virus or bacterial infectionpoisoningAge/sexPhysiological degenerationChronic symptomscardic symptoms chest distress palpitation angina pectorispulmonary circulation cough expectoration Hemoptysis cyanosis dyspneasystemic circulation fa

17、intness abdominal distension and pain vomiting oliguria edama headache dizziness twitchingPhysiological examination the most basic examination method.the doctors get patients relative datas by their eyes，ears，noses，hands and some simple tools,such as stethoscope,thermometer,tentionmeter.1.Vital Sign

18、s heart rate , pulse, respiration, blood pressure 2.inspection Observed in patients with skin color , pay attention to whether patients with hypopnea and other symptoms. Such as angina may be cyanotic lips , and hypertension , may appear red face . Observe whether there have precardial prominence or

19、 precardial has some abnormal cardioc apex beat.(Apex beat in the left midclavicular line at the fifth intercostal space inside 0.5 cm , pulsatility range diameter of about 2.0cm.)3.palpation Touch at the apex beat , record whether the enhanced and weakened apex beat , with or without tremor , peric

20、ardial friction sensitivity .Touch the radial artery , record pulse rate , judgement if the arterial pulsation is powerful or not, including the rhythm is or not in the low ,and comparing both sides are symmetrical ,Determine whether there is pulsus paradoxus , alternating pulse or sign of capillary

21、 pulsation,etc.4、Percussion Draw the relative cardiac dullness by the percussion of chest ,in order to determine whether the increase or decrease of heart.5、auscultation Listen to the cardiechema of these valves by the stethooscope to determine if the rhythm is neat or not and the abnormal cardieche

22、ma.some important signs1.Cardiac enlargement2.Abnormal heart sounds and pulse beat3.Arrhythmia 4.abnormal breath sounds5.Pulmonary rales6.hepatomegaly7.Jugular vein distention8.lower extremity edemaLaboratory testsThe doctors use physical , chemical and biological laboratory technology to test patie

23、nts blood,fluid,secretion and tissue ,so as to obtain data and assist diagnosis and treatment.Routine conventional tests blood,urine,faece routine examinationSpecial tests 1.microbial culture: infectious heart disease 2.ASO/ESR/CRP: rheumatic heart disease 3.lipids tests : coronary atherosclerotic h

24、eart disease 4.CK/CK-MB/cTnT/cTnI : myocardial infarction and angina pectorisEquipment inspectionElectrocardiogram put the electrode onto the special regions of body surface,record out continuous curve about electricardia charges with the machine. mainly diagnose : Arrhythmia and Myocardial infarcti

25、on 24-hour Holter 24-hour ambulatory blood pressureEchocardiography move the prode onto the heart surface regions,observe the cardiography charges of computer.mainly diagnose cardiovalvularopathy.angiocardiogram胸片Selective coronary angiography-gold standardClassfication of the heart Etiology Congeni

26、tal Acquired1.Atherosclerosis2.Rheumatic3.primary hypertention4.pulmonary 5.inflectious 6.endocrinopathic7.hematopathic8.Nutritional and metabolic9.Cardiac neurosisPathological anatomy 1.Endocardium disease(endocarditis )2.Myocardosis (myocardial ischemia )Arrhythmia(tachycardia )3.pericardial disea

27、se (hydropericardium )4.Macrovascular disease (aortic stenosis )5.congenital malformation(Congenital heart disease)Pathophysiology 1.heart failure2.shock3.dysfunction of coronary circulation4.dysfunction of Papillary muscle 5.Hyperdynamic circulation6.Cardiac tamponadeDiagnosisEtiologyPathological a

28、natomyPathophysiologyeg:Rheumatic valvular heart disease1.Rheumatic heart disease2.bicuspid valve stenosis or incompetence3.heart failure4.atrial fibrillationPrevention1.stop per rest3.more movement4.lose weight5.decompression6.controll diets7.health education8.steady emotion Treatment1.

29、release symptoms(1)deal with the emergency conditions acute myocardial infarction, acute left heart failure (2)keep a balance of life sign (3)relieve pain 心痛定心痛定,硝酸甘油含化片硝酸甘油含化片 (4)swelling 速尿，螺內(nèi)酯，氫氯噻嗪速尿，螺內(nèi)酯，氫氯噻嗪2.remove etiology (1)control infection antibiotic 抗生素抗生素 NSAID非甾體類抗炎藥非甾體類抗炎藥(2)control hi

30、gh hypertention ACEI,ARB,CCB, Diuretic drugs(3)control high cholesterol 立普妥立普妥 Inhibition of platelet aggregation drugs 阿司匹林阿司匹林 氯吡格雷氯吡格雷Anticoagulant drugs 華法林華法林Thrombolytic drugs 尿激酶尿激酶(4)control high blood sugar oral medication 二甲雙胍二甲雙胍 insulin 優(yōu)泌林優(yōu)泌林3.intervention(1)Artificial pacemaker4.surgic

31、al operation(2)The percutaneous coronary artery bypass grafting5.rehabilitation-exercise(1)ensure the indications and contraindications (2)choose suitable exercise methods: medium or low intensity aerobic exercise, such as walking, jogging, swimming,tai chi chuan and so on. (3)master exercise intens

32、ity: target heart rate is often used as an evaluation index, its definition:in exercise test, by heart rate monitor machine or touching the pulse beating,we can get 60% to 80% of maximum heart rate.But if the patient cant exercise, target heart rate=170 - Age.Commonly when the patient stop motion,th

33、e doctor or theorpist touches the pulse besting immediately and lists 10 seconds (radial artery / ear artery / temporal artery), then6 represents one minute pulse rate, the result is close to the heart rate of moving exercise. (4)master exercise time: 1 to 3 hours after a meal, ready time for 10 min

34、utes, training time for 20 to 30 minutes,and finally relaxing time for 10 minutes. (5)master exercise frequency: Weekly exercise for 3 to 5 times .clinical aspect of the circulatory systermatherosclerosis The accumulation of fatty deposits within the lining of an artery is termed atherosclerosis. Th

35、is type of deposit ,called a laque, begins to form when a vessel receives tiny injuries, usually at a point of branching. A majoy risk factor for the development of atherosclerosis is dyslipidemia, abnormally high levels or imbalance in lipoproteins that are carried in the blood, especially high lev

36、els of cholesterol-containing low-density lipoproteins(LDL). Other risk factors for atherosclerosis include smoking, hypertension, poor diet, inactivity, stress, and family history. Atherosclerosis may involve any arteries,but most of its effects are seen in the cornary vessels of the heart, the aor

37、ta, the crotid arteries in the neck, and vessles in the brain.thrombosis and embolism Atherosclerosis predisposes a person to thrombosis, the formation of thrombus within a vessle. Usually the mass is a blood clot that breaks loose from the wall of a vessle, but it may also be air, fat, bacteria or other solid materials. Often a verous thrombus will travel through the heart and then lodge in an artery of the lungs, resulting in a life-threatening embolism. An thrombus from a carotid artery often blocks a cerebral vessles, causing a cereb