Class notes
Nur 212 Cardiovascular System Notes
- Course
- NUR 212
- Institution
- Gwynedd Mercy University
This is a comprehensive and detailed note on health assessment for cardiovascular System. *Essential Study Material!!
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Assessment of the Cardiovascular System The Cardiovascular System: Structure
o Heart
Four chambers
LA, LV, RA, RV
Composed of 3 layers
Endocardium
Myocardium
Pericardium – dense, fibrous, double-walled sac
o The heart and the great vessels are located between the lungs, in the middle third of the
thoracic cage. This area is referred to as the mediastinum
o The heart extends from the second to the fifth intercostal space and from the right
border of the sternum to the left midclavicular line
o 1/3 of the heart is laying on the right side of the chest, 2/3 of the heart is lying on the
left side of the chest
o The heart is rotated so that the right side of the heart is lying anterior and the left side is
posterior
o The base of the heart is located at the top and the apex of the heart is at the bottom of
the heart pointing to the left hip
o The myocardium of the left side is thicker and bigger than the right because it has to
push blood into the aorta
Heart Chambers and Valves
o Four chambers separated by valves, whose main purpose is to prevent backflow of blood
Valves are unidirectional
Valves open and close passively in response to pressure gradients in moving
blood
o Four valves in heart
Two atrioventricular (AV) valves: tricuspid valve, mitral valve
Two semilunar valves: pulmonic valve, aortic valve
Valves
o Two AV valves separate atria and ventricles:
Tricuspid valve: right AV valve – three leaflets
Bicuspid, or mitral valve: left AV valve – two leaflets
Valves’ thin leaflets are anchored by collagenous fibers (chordae
tendineae) to papillary muscles embedded in ventricle floor
AV valves open during heart’s filling phase, or diastole, to allow ventricles to fill
with blood
During pumping phase, or systole, AV valves close to prevent regurgitation of
blood back up into atria
o SL valves are set between ventricles and arteries
Each valve has three cusps that look like half moons
Pulmonic valve: SL valve in right side of heart
Aortic valve: SL valve in left side of heart
, Open during pumping, or systole, to allow blood to be ejected from
heart
No valves are present between vena cava and right atrium, or between
pulmonary veins and left atrium
Abnormally high pressure in left side of heart gives a person symptoms
of pulmonary congestion
Abnormally high pressure in right side of heart shows in neck veins and
abdomen
Right Heart
o Deoxygenated blood
o Blood flow
Right atrium
Tricuspid valve
Right ventricle
Pulmonic valve
Lungs
Pulmonary artery is only artery that carries deoxygenated blood – carries away
from heart to the lungs
Left Heart
o Oxygenated blood
o Blood flow
Left atrium Mitral Valve Left Ventricle Aortic Valve Aorta Systemic
circulation
Coronary Arteries
o Epicardial
o Left main coronary artery (LMCA). The left main coronary artery supplies blood to the
left side of the heart muscle (the left ventricle and left atrium). The left main coronary
divides into branches
The left anterior descending artery branches off the left coronary and supplies
blood to the front of the left side of the heart
The circumflex artery branches off the left coronary artery and encircles the
heart muscle. This artery supplies blood to the outer side and back of the heart
o Right coronary artery (RCA). The right coronary artery supplies blood to the right
ventricle, the right atrium, and the SA (sinoatrial) and AV (atrioventricular) nodes, which
regulate the heart rhythm. The right coronary artery divides into smaller branches,
including the right posterior descending artery and the acute marginal artery. Together
with the left anterior descending artery, the right coronary artery helps supply blood to
the middle or septum of the heart
o Smaller branches of the coronary arteries include: obtuse marginal (OM), septal
perforations (SP), and diagonals
Cardiac Cycle
o Rhythmic flow of blood through heart
o Two phases: diastole and systole
Diastole: ventricles relax and fill with blood; this takes up 2/3 of cardiac cycle
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