Tuesday-2/20...GO TO CH 14...Lymphatic System and Immunity...
Monday-2/20...CW: President's Day-no school...
 
Friday-2/16...CW: Ch 12-13 Summative test-20Q = 100 pts...
***Remember blood cells are manufactured in liver, spleen, bone marrow...
***Drugs and smoking affect all systems of the body including impairing Hemoglobin and O2 in blood...
***Know what is responsible for women losing their husbands, below...
HW: always review...
Wednesday-2/14...CW: B/P lab and quiz on reading gauge of sphygmomanometer...6 Readings...
HW: Review Sheep Heart Dissection video for Thursday lab!!
https://youtu.be/xDaR-j2pwuU
***Dissection Tools You will need:
1. Safety gear-G-G-G
2. Dissection pan or improvise...
3. Dissection Probe
4. Dissection Forceps(It's not a tweezer)
5. Scalpel
6. Dissection Scissors
***Noone is above cleaning up-We all clean up 5 minutes before the bell and set-up for next period...
BE FRUGAL WITH PAPER TOWELS!

***You must identify all external structures first and then, wearing G-G-G(Gown/gloves/goggles), cut through atria and ventricles to find interventricular septum...then cut vertically NOT separating 2 halves until the end of dissection!!
Must have hands on for grade...
ALLERGY SUFFERERS MAY WEAR ONE OF MY DISPOSABLE MASKS...


***Know for Quiz...Pulse Points...
If conscious: Radial, Brachial, Popliteal, temporal...
If unconscious: Inguinal and Carotid...

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.


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


Image result for WHICH HEART ARTERY IS CALLED THE WIDOWMAKER

Related image

Thursday-2/15...CW: Dissection #1: Sheep Heart...
Must be present in class and have hands on for grade...
***Watching is not earning a grade...Completing WS is ...
***ENTER CLASSROOM ON TIME AND WEAR 3 G's...
Groups of 3-Tardies MAY NOT dissect...
***Must be prepared with procedures and safety:
***3G's: Gown, Gloves, Goggles...
NO LAB MAKE-UPS...
1 Worksheet per group...



Picture of Making the Cut




Picture of Making the Cut


Picture of A Four Bedroom House




Picture of The Pieces of the Heart
Picture of Making the Cut

Monday-2/12...CW: Make-up quizzes...
Cardiac output explanation-short video...
Explanation of EKG(ECG in England)
**Cardiac output video link...https://youtu.be/Wx1_8iTUanA
***EKG video link...https://youtu.be/4vkbywows-o
HW: Always stay ahead in text and web page...
Finish EKG video for HW..
Look at EKG for: ...normal sinus rhythm
                                 ...sinus bradycardia
                                  ...sinus tachycardia
                                  ...ventricular fibrillation(v-fib)
                                   ...asystole
***For simplicity-count from the top of QRS complex to the next ones and approximate for HR...


Image result for cardiac output


Cardiac output is the product of two variables, stroke volume and heart beat. Heartbeat is simply a count of the number of times a heart beats per minute. Stroke volume is the amount of blood circulated by the heart with each beat. The formula for this is expressed as CO = SV x HR.



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.

Tuesday-2/13...CW: Cardiac output pop quiz-3Q = 15 pts...
***EKG Tracings discussed...
***B/P spygmomanometer use explained and demo on procedure...
HW: watch '2' videos on B/P for lab grade tomorrow...
***ALL STUDENTS ARE ACCOUNTABLE FOR MAKE-UP WORK AND MUST BE COMPLETED AS SOON AS ABSENTEES RETURN...
Monday-2/12...CW: Make-up quizzes...
Cardiac output explanation-short video...
Explanation of EKG(ECG in England)
**Cardiac output video link...https://youtu.be/Wx1_8iTUanA
***EKG video link...https://youtu.be/4vkbywows-o
HW: Always stay ahead in text and web page...
Finish EKG video for HW..
Look at EKG for: ...normal sinus rhythm
                                 ...sinus bradycardia
                                  ...sinus tachycardia
                                  ...ventricular fibrillation(v-fib)
                                   ...asystole
***For simplicity-count from the top of QRS complex to the next ones and approximate for HR...


Image result for cardiac output


Cardiac output is the product of two variables, stroke volume and heart beat. Heartbeat is simply a count of the number of times a heart beats per minute. Stroke volume is the amount of blood circulated by the heart with each beat. The formula for this is expressed as CO = SV x HR.

heart


Bradycardia: HR less than 60
Tachycardia: HR greater than 100...
***Count by 10's from the crest of the wave(the point) to the next crest and approximate as paper is torn off after 15 seconds to get HR...
Image result for bradycardia and tachycardia


Asystole = Flat line = dead 

Image result for p wave asystole

Fibrillation (why you need CPR)

Image result for fibrillation

Can you guess the HR below?

is HR 58, 65, 79, or 90?

MEMORIZE: 

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 

Memorize::

Bradycardia = HR < 60

Tachycardia = HR>100 


Bradycardia below 60 bpm: 


Image result for bradycardia


Tachycardia above 100 bpm:

Image result for tachycardia

What is HR below??

Image result for tachycardia


Tuesday-2/13...CW: EKG completion on waves and tracings...
***Begin Blood pressure explanation...systolic/diastolic 
HW: Watch B/P video on performing measurements and reading SPHYGMOMANOMETER in mm Hg units...

***How to take B/P and apply cuff...
https://youtu.be/Gmic13mvsgo

WATCH VIDEOS ABOVE!!
   Great practice for in class BP quiz              

Image result for sphygmomanometer

***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)...mm Hg units...sphygmomanometer
***Hypertension affects about 20% of Americans...
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)...

Image result for steps to use sphygmomanometer with stethoscope

Image result for diastole over systole


Image result for blood pressure


Image result for high and low blood pressure

Friday-2/9...CW: Ch 13 Formative assessment including punnett squares...
HW: We are halfway through ch 13...Keep staying one step ahead: Heart dissection, Blood Pressures/Pulses/ and Stethoscope use coming up for only those who satisfy the background knowledge components...Stay Focused!!
Wednesday-2/7...CW: Pop quiz  from yesterday and Ch 13...
We will trace the flow of blood through the heart...
short video...video link from today is below...
***https://youtu.be/7XaftdE_h60
HW: continue re-reading ch 13 in text and always review notes  and webpage...

Image result for heart blood flow
Thursday-2/8...CW: Quiz 2...Heart sounds...Lubb-Dupp...
Pacemaker of the Heart...(S-A)
***Verbal Heart Blood flow quiz with 60 second time limit...All medical programs expect you to do this...
Pop quiz 2///5 Q = 25 pts...
Short video on heart sounds..
***Below is video link from today...
https://youtu.be/-4kGMI-qQ3I
HW: study-study-study for Friday quiz...review text and webpage...
***aus·cul·ta·tion
the action of listening to sounds from the heart, lungs, or other organs, typically with a stethoscope, as a part of medical diagnosis.

Image result for auscultation definition


The SA node is the heart's natural pacemaker. The SA node consists of a cluster of cells that are situated in the upper part of the wall of the right atrium (the right upper chamber of the heart). The electrical impulses are generated there. The SA node is also called the sinus node.
Image result for S-a node pacemaker of heart


Lubb-dupp...a representation of the normal heart sounds as heard through the stethoscope. The first coincides with closure of the mitral and tricuspid valves; the second with closure of the aortic and pulmonary valves.

Image result for lubb dupp

Image result for does an artificial pacemaker go into right atrium
Monday-2/5...Textbook Questions-Ch 13...Know for pop quizzes present and future...


        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).

      ***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...

       Image result for layers of the heart

      ***Pericardium and Epicardium are the same outermost layer...

***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 deprived of O2 for 4-6 minutes...you are pronounced brain-dead...that is why CPR must be initiated immediately and most people are huddled around in a crowd crying and screaming instead of performing CPR-even if they don't know how!

    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

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

     

Sub today...Punnett square review practice...
Turn them in to sub...All rules apply when I am not there...
HW: Review ch 13...check webpage...
***Pop quizzes will be frequent so you MUST stay one step ahead at all times, even if absent!!

Image result for heart valves


Image result for WHICH HEART ARTERY IS CALLED THE WIDOWMAKER

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)


***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.
Image result for chordae tendineae


Image result for heart valves
Tuesday-2/6...CW: Ch 13 Intro- The Cardiovascular system...
Short video: Link from today is below...

Key Vocabulary:
1. Cardio-Vascular
2. System Circulation
3. Pulmonary Circulation
4. Artery
5. Vein
6.Superior/Inferior Vena Cava
7. Aorta
8. Coronary Circulation
9. Atria(sing. Atrium)
10. Ventricles
11. S-A Node(Pacemaker)
12. Tricuspid valve-Bicuspid(Mitral) valve
13. Pulmonary Semi-lunar valve-Aortic valve
14. Atrio-ventricular valve
15. Pericardium-Myocardium-Endocardium
16. Myocardial Infarction(MI)
17. Apex-Base
18. Interventricular Septum
19. Chordae Tendinae
20. Papillary Muscles
21. auscultation
...To be cont'd

Video...below is link from today...
https://youtu.be/Vi1JK6IYVt8

HW: Quiz tomorrow...You MUST stay at least 1 day ahead to keep up with this extremely rigorous material...
Pop quizzes will benefit you in the long run...
Here is a sample quiz to get you ready for quizzes in class...
Are you paying attention!!

Test your knowledge with the following quiz...
Look for poor English or grammar with singular and plural Katman tips...this is NOT for turning in......




Image result for pulmonary and systemic circuits






Image result for chordae tendineae

Image result for base and apex of heart

Image result for base of heart

Image result for heart labeled

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

https://youtu.be/mUY2nWqdPxA
Below is a link to SHEEP HEART DISSECTION WALK_THROUGH!!
https://www.biologycorner.com/anatomy/circulatory/heart/heart_dissection.html




***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


Image result for heart lubb dupp

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...
https://youtu.be/-4kGMI-qQ3I

Image result for heart lubb dupp


Image result for heart lubb dupp
Image result for diastole over systole
 
 

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:
  5. https://youtu.be/m8tzO_nreb0
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:
https://youtu.be/5JDWsurkQos
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:
WE WILL NOT DO THIS IN CLASS-TOO MUCH PRESSURE CAN RESULT IN LACK OF O2 AND UNCONSCIOUSNESS
https://youtu.be/o7R28_k6i5E



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).

Image result for blood flow through the heart animation
 
 


https://youtu.be/_lgd03h3te8

CV system intro video notes.docx CV system intro video notes.docx
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