( England...Electrokardiograms-in U.S)...

Bradycardia: HR less than 60
Tachycardia: HR greater than 100...
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Asystole = Flat line = dead 

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Fibrillation (why you need CPR)

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Can you guess the HR below?

is HR 58, 65, 79, or 90


P wave = Atrial Depolarization

QRS complex = Ventricular Depolarization

T wave = Ventricular Repolarization 

SIMPLE EXPLANATION: Has to do with electrical picture of the heart... 

    Depolarization and Repolarization

      1.  Cardiac cells at rest are considered polarized, meaning no electrical activity takes place

      2.  The cell membrane of the cardiac muscle cell separates different concentrations of ions, such as sodium, potassium, and calcium.  This is called the resting potential

      3.  Electrical impulses are generated by automaticity of specialized cardiac cells

      4.  Once an electrical cell generates an electrical impulse, this electrical impulse causes the ions to cross the cell membrane and causes the action potential, also calleddepolarization

      5.  The movement of ions across the cell membrane through sodium, potassium and calcium channels, is the drive that causes contraction of the cardiac cells/muscle

      6.  Depolarization with corresponding contraction of myocardial muscle moves as a wave through the heart

      7.  Repolarization is the return of the ions to their previous resting state, which corresponds with relaxation of the myocardial muscle

      8.  Depolarization and repolarization are electrical activities which cause muscular activity

      9.  The action potential curve shows the electrical changes in the myocardial cell during the depolarization – repolarization cycle

      10.  This electrical activity is what is detected on ECG, not the muscular activity


Bradycardia = HR < 60

Tachycardia = HR>100 

Bradycardia below 60 bpm: 

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Tachycardia above 100 bpm:

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What is HR below??

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***1 valve replaced = single bypass, 2 = double, 3 = triple, 4 = quadruple...

***M I = myocardial infarction = heart attack.....

***Heart murmur = leaking valve that sounds like a hum or soft vibration...

***CPR = cardiopulmonary resuscitation


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Below is a link to watch on What is B/P...Watch it!

***Quiz Facts:
Hyprtension: High B/P
Hypotension: Low B/P
B?P must be in form of fraction: Systolic/Diastolic...Contraction(pumping, squeezing)/resting, filling) Hg units...sphygmomanometer
Ethnicity: African Americans have highest Hypertension compared with caucasians, Asians, Islanders, etc...
***Lowest O2 in body is in vena cavae(plural)...
***Ventricles pump blood furthest so they are muscular(L Ventricle thickest systemically)...
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Heart sounds-1st = Lubb...2nd = Dupp...
Heart sounds = closing of valves...but which ones??? We will learn today... short video today....
Blood pressure Intro...

***Below is heart sounds video link from today...

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Hypertension vs Hypotension...
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Friday-2/17...Ch 12-13 Summative assessment-25Q = 100 pts...

***Heart Jigsaw Puzzle Game...

heart blood flow chart health education/information   blood flow through the heart. what

Related image

***The LAD typically supplies 45-55% of the left ventricle (LV) and is therefore considered the most critical vessel in terms of myocardial blood 


The aorta (the main blood supplier to the body) branches off into two main coronary blood vessels (also called arteries). These coronary arteries branch off into smaller arteries, which supply oxygen-rich blood to the entire heart muscle. The right coronary artery supplies blood mainly to the right side of the heart.
***Coronary circulation is Heart circulation
There are 2 Pulmonary arteries and 4 Pulmonary veins(2 to each lung)

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***Thchordae tendineae, or heart strings, are cord-like tendons that connect the papillary muscles to the tricuspid valve and the mitral valve in the heart.They keep the valve closed preventing backflow of blood.#18 in bottom blue picture...

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Blood flow through the heart video link:

Test your knowledge with the following quiz...
Look for poor English or grammar with singular and plural...

Radial Artery:                    Wrist

Brachial Artery:                 Inner Elbow

Popliteal Artery:                Behind Knee

Posterior Tibial Artery:    Ankle

Dorsalis Pedis Artery:     Foot

Femoral Artery:                Groin

Carotid Artery:                   Neck

Facial Artery:                     Face

Temporal Artery:              Side Forehead

Of course the heart rate can also be taken by listening to a patient’s heart using a stethoscope and counting the number of beats per second. Generally a nurse might counts a patients pulse over 15 seconds, measure via a nurses fob watch, and multiply that result by a factor of four to establish the patient’s heart rate over 1 minute. Though if the pulse seems irregular it is prudent to listen to count the pulse for a fill 1 minute period.

How do I check the pulse on my wrist?
  1. Place your index and middle fingers on the inside of your wrist, below your thumb.
  2. Use a watch with a second hand and count your pulse for 60 seconds.
  3. Write down your pulse rate, the date, time, and which side was used to take the pulse.
  4. Video how to take radial pulse:
How to take Brachial Pulse:
It is vital to find the correct location of the brachial artery when taking a blood pressure. To find the brachial artery, turn the palm face up and follow the line of the pinky upwards just past the crook of the elbow
Brachial pulse video link:
How to find Carotid Pulse:
To check your pulse over your carotid artery, place your index and middle fingers on your neck to the side of your windpipe. When you feel your pulse, look at your watch and count the number of beats in 10 seconds. Multiply this number by 6 to get your heart rate per minute.
Carotid pulse video link:

Ch 13-CV System-Vocab-MEMORIZE THESE!

1.             Pulmonary/Systemic          

2.             Aorta      Pericardium-Myocardium-Endocardium

3.             Atria-Ventricles

4.             Septum

5.             Bicuspid(Mitral) valve        

6.             Tricuspid valve

7.             Pulmonary Semilunar/Aortic valve

8.             Chordae Tendineae

9.             Systole/Diastole

10.          Coronary arteries

11.          Cardiac Cycle

12.          Angina/Myocardial Infarction(MI)

13.          Sinoatrial(SA) Node = Pacemaker

14.          A-V node-A-V bundle(Bundle of His)

15.          Purkinje Fibers

16.          Lubb-Dupp

17.          Electrocardiogram(Canada)-EKG in U.S.

18.          P-QRS-T waves

19.          Arteries-Veins-Capillaries

20.          Stroke Volume-Cardiac Output = SV x HR

Textbook Questions-Ch 13-w/e 2/17/17

         1.       Name the Cardiovascular Structures. (p. 340-341).

        2.       Distinguish between the heart coverings and wall of heart (p.341-342).

       3.       Identify and locate structures and functions of heart (p. 342-344).

       4.       Trace flow of blood through the heart (p. 345-346)

       5.       Discuss Cardiac cycle and cardiac output (p. 346-348).

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 Anatomy of the Heart Definitions The heart is the size of your fist and it is located on the left side of your chest. The heart is divided into four chambers. Right Atrium The right atrium receives de-oxygenated blood from the body through the superior vena cava (head and upper body) and inferior vena cava (legs and lower torso). Right Ventricle The right ventricle receives de-oxygenated blood as the right atrium contracts. Left Atrium The left atrium receives oxygenated blood from the lungs through the pulmonary vein. Left Ventricle The left ventricle receives oxygenated blood as the left atrium contracts. The blood passes through the mitral valve into the left ventricle
 List of Blood Flow Through the Heart 1. From the body through the veins – BLUE (dirty blood – deoxygenated blood) 2. Enters through superior and inferior vena cava 3. Right Atrium 4. Through the Tricuspid Valve 5. Into Right Ventricle 6. Through Pulmonary Valve 7. Into Pulmonary Artery 8. Out to Lungs – changes to RED (clean blood – oxygenated blood) 9. Back to heart via Pulmonary Vein 10. Into Left Atrium 11. Through Bicuspid Valve 12. Into Left Ventricle 13. Through Aortic Valve 14. Into Aorta 15. Back to body via Arteries


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***The Heart sits in a space called the MEDIASTINUM, and is slightly LEFT of MIDLINE in the THORAX...It is about the size of a fist-the larger the fist, the larger the heart...
***The top(superior) of the heart is called the BASE, and the bottom(inferior) of the heart is called the APEX...(You would think it would be base at the bottom like a microscope but REMEMBER THIS).
***CPR: Cardiopulmonary Resuscitation...If brain is deoprived of O2 for 4-6 are pronounce brain-dead...that is why CPR must be initiated immediately and most people are huddled around in a criowd crying and screaming instead od performing CPR-even if they don't know how!

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***Normal Heart Rate (HR) is 80 bpm(beats/minute...Which would have faster HR and WHY: a mouse or a human??
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Cardiac Output and Blood Pressure

Read this page to refresh (or learn) why blood pressure is such an important measure for trainers to understand and take accurate measurements of.

Cardiac output and blood pressure are two important measures of the health and function of the cardiovascular system.  You need to understand these measures as a fitness professional in order to design and deliver safe, effective exercise sessions, and in the case of blood pressure, be able to conduct and interpret blood pressure measurements for your clients.

Cardiac output

Cardiac output (known as ‘Q’) is a measure of the amount of blood that is pumped out of the heart in one minute.

‘Q’ specifically refers to 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.

Cardiac output is made up of two components, heart rate (HR) and stroke volume (SV). 

personal training taking pulseHeart rate (HR) refers to the number of times the heart beats every minute (bpm).

This can be easily measured through the use of heart rate monitors or taking ones pulse (counting the ‘pulses’ at the radial artery for example over a one minute period). 

personal training heart rateHeart rates increase as the intensity of activity increases, as shown in the adjacent picture.  This is because the working muscles demand more energy, so the heart beats increasingly faster in order to deliver the nutrients and O2 needed to meet these increased energy demands.

The normal resting heart rate range for an adult is between 60-100 bpm.  However when a resting heart rate is greater than 100bpm it is called ‘tachycardia’ and when it’s below 60bpm it is called ‘bradycardia’.

These can both indicate possible heart conditions or complications and if you notice these in a personal training client of your's you should advise your client to have a medical check.  The exception to this is that bradycardia may be present in extremely fit (international level multisport, triathlon, ironman etc) individuals and not something to be concerned about.

Stroke volume (SV) refers to the quantity of blood pumped out of the left ventricle with every heart beat.  The exact volumes are not easily measured, so they are often estimated based on what we know about stroke volume and the factors that it affects such as blood pressure which we can measure.

The equation for cardiac output is:

***Memorize this!!    HR x SV = Q.  Therefore to calculate Q we must first establish HR and SV.  An example at rest is shown below.

HR  (70BPM) x SV (70ml) = 4900ml/min or 4.9 litres per minute

An increase in HR, SV or both will increase someones Q.  SV on the whole does not fluctuate too much, with only relatively small increases with exercise.  HR on the other hand increases quite dramatically and thus is the biggest influencer of increasing somesones Q.

Increases in Q with exercise are vital, as it is essentially your CV system trying to meet the demands of the body for the supply of oxygen rich blood and the removal of waste.

However it is highly unlikely that you will ever have to measure a client’s Q, but because Q affects blood pressure, which you will measure, its important that you know what HR & SV are and how they along with Q influence blood pressure.

Blood pressure

personal training blood pressure diagramBlood pressure (BP) is a measure of the force being exerted on the walls of arteries as blood is pumped out of the heart. 

BP measurements are usually taken on the upper arm with a ‘sphygmomanometer’ and a stethoscope as pictured on the adjacent diagram. 

The sphygmomanometer consists of an inflatable cuff with a pressure gauge.

When inflated the cuff blocks the flow of blood to the arm below the cuff.  As the cuff is allowed to slowly deflate, the measurer listens through the stethoscope to sounds as the artery opens and allows blood flow to continue again.

The measurer is listening for two specific sounds as the blood flows through the artery, as shown on the below image.

The first sound heard as the artery opens enough for the first pumps of blood to come through is known as the ‘systolic’ pressure.  This measures the force the heart has to pump against to get the blood to flow around the body. 

personal training blood pressure readings

The second sound recorded is known as the ‘diastolic’ pressure.  This measure is recorded at the point where the measurer stops hearing the ‘pump’; essentially it measures the pressure in the arteries as the heart relaxes.

The systolic number is placed over the diastolic number and is always the higher of the two numbers. For example blood pressure of 110 (systolic) and 70 (diastolic) is read as 110/70mmHg.  The measurement of blood pressure is expressed in millimetres of mercury (mmHg).

personal training high blood pressure High blood pressure at rest is an indicator that the cardiovascular system is in a less than ideal state of health. 

High blood pressure (known as ‘hypertension) occurs when systolic blood pressure readings consistently exceed 140mmHg and or diastolic readings exceed 90mmHg. 

‘Normal’, healthy BP is regarded as 120/80mmHg or thereabouts. 

BP is also used as a ‘risk factor’ for many diseases and illnesses, such as heart disease.  Doctors and fitness professionals alike use blood pressure to screen for potential problems before making judgements as to what exercise a person can safely take part in.

A person’s BP is determined by the following three factors;

1.      Cardiac output (as we have already discussed)

2.      Blood viscosity (the thickness of the blood)

3.      Total peripheral resistance ‘TPR’ (the resistance the blood encounters on its voyage within the blood vessels)

Cardiac output

Cardiac output as you know is made up of heart rate and stroke volume.  At rest these are relatively constant however with exercise the heart beats faster and more blood is pumped out with each beat.  These factors both contribute to a rise in BP, as would any other factor that caused the heart to speed up.

Changes in the volume of blood within the cardiovascular system will also affect BP.  If a person was severely dehydrated or lost a large quantity of blood through a wound there would be less blood for the heart to pump, thereby reducing cardiac output and BP.

If the volume of blood increased (waste products not being removed to the kidneys due to kidney failure for example) then there would be a greater quantity of blood within the system increasing the pressure within.  Think about putting more air into an already inflated balloon and you’ll get the picture!

Blood viscosity

personal training blood vesselThe thicker (or more ‘viscous’) blood is, the harder the heart has to work to pump it around the body and consequently more pressure is created within the vessels. 

Blood can thicken for many reasons but the main ones are a lack of water and or a high glucose (blood sugar) concentration. 

For diabetics, if they don’t control their blood sugar levels these can quickly become high and cause problems with high blood pressure.  Low hydration levels can also result in thick blood and therefore higher blood pressure. 

This is why it is important to always remain well hydrated, as it helps to reduce the pressure within the blood vessels and therefore the load on the heart to pump the blood.  For this reason people with a history of heart problems are often prescribed medications to keep their blood thin.