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Weekly Overview

Week Three

Overview

In Week Two, you will learn the basic function and structure of the cardiovascular system, along with some common terminology used. The heart, blood vessels, and blood are the main components of the cardiovascular system. The continuous flow of blood is needed to sustain life, and the heart is the main organ that causes blood to circulate. Arteries carry blood away from the heart, whereas the veins carry blood toward the heart from other body parts. Pulmonary circulation is the circulation of blood from the heart to the lungs. Systemic circulation is the circulation of blood from the heart to body tissues and back. Blood is considered a main tissue of the human body that is responsible for transporting gases, protecting the body against infections, and regulating pH and water levels.

There are different diseases that can affect the cardiovascular system, and medical testing is performed to assess body functions and disease processes. To assign the correct diagnosis and procedure codes, and to process accurate claims, you must first be able to read and comprehend medical documentation that contains anatomy and physiology terms related to the cardiovascular system.

What you will cover

1. Cardiovascular System

The heart, blood vessels, and blood are the main components of the cardiovascular system. The continuous flow of blood is needed to sustain life, and the heart is the main organ that causes blood to circulate. Arteries carry blood away from the heart, whereas the veins carry blood towards the heart from other body parts. Pulmonary circulation is the circulation of blood from the heart to the lungs. Systemic circulation is the circulation of blood from the heart to body tissues and back. Blood is considered a main tissue of the human body that is responsible for transporting gases, protecting the body against infections, and regulating pH and water levels

a. Identify common medical terms for the cardiovascular system.

1) Atrium: two small upper chambers of the heart

2) Septum: the wall that divides the two atria

3) Ventricles: two lower chambers of the heart

4) Myocardium: the middle layer of the heart wall composed of cardiac muscle

5) Atrioventricular: the valves between each atrium and ventricle on the same side (right or left)

6) Veins: Blood is transported back to the heart through vessels. The smallest veins are called venules.

7) Arteries: Vessels that carry blood away from the heart; smaller vessels are called arterioles. The smallest vessels are capillaries. This is where the exchange of gas, nutrients, and waste occur in the cells.

8) Systole: contraction of the heart muscle during the cardiac cycle (movement or pumping of the heart)

9) Diastole: relaxation phase of the cardiac cycle (movement or pumping of the heart)

10) Plasma: straw-like liquid that comprises about 55% of blood volume (water, nutrients, salt, carbon dioxide, and oxygen)

11) White blood cells: Types of white blood cell include neutrophils, eosinophils, and basophils. White blood cells help fight infections by destroying invading bacteria; they also help fighting cancers.

12) Red blood cells: cells created by the bone marrow, containing iron (hemoglobin) and that aid in transporting oxygen from the lungs to the cells in the body

13) Platelets: thrombocytes that aid in the blood’s ability to clot

14) Albumin: Protein found in the blood that aids in the repair of tissue and growth; albumin originate in the liver.

15) Stenosis: an abnormal narrowing of a passage

b. Identify the structure and function of the cardiovascular and circulatory system.

1) Structure: The major components of the cardiovascular system include the heart (pumps blood through the system), blood (a connective tissue that is a fluid component), and blood vessels (transport the blood to and from the body’s cells). Pulmonary circulation includes circulation to the lungs, whereas the systemic circulation includes the body tissues.

a) Chambers in the heart

1) Four chambers

2) Names of four chambers: Right and left atrium; right and left ventricle

b) Types of blood vessels

1) Capillaries: The smallest arteries are capillaries. This is where the exchange of gas, nutrients, and waste occur in the cells.

2) Venules: the smallest veins

3) Veins: vessels that bring blood back to the heart

4) Arteries: vessels that carry blood away from the heart

c) Blood composition: Adults have approximately 4–5 liters of blood, making up approximately 8% of total body weight. Due to the high levels oxygen, arteries are brighter in color than veins. Blood composition includes plasma, platelets, red blood cells, white blood cells, amino acids, gases, and electrolytes.

d) Circulation (pulmonary and systemic)

1) Pulmonary: the complete circuit of blood traveling from the heart to the lungs

2) Systemic: circulation of oxygenated blood away from the heart to the body and the return of deoxygenated blood back to the heart

2) Function of blood

a) Transport: gases (oxygen and carbon dioxide), nutrients, waste products from the kidneys and liver, and hormones; regulates body temperature

b) Protection: White blood cells destroy microorganisms and cancer cells. Antibodies destroy pathogens. Platelet factors help prevent blood clot formation.

c) Regulation: Blood regulates the body’s pH levels and helps maintain water balance.

c. Describe major diseases that affect the cardiovascular system.

1) Pump issues (heart failure)

a) CHF (congestive heart failure): This a condition where the heart does not pump the blood adequately. It can be caused by narrowing arteries, high blood pressure, obesity, enlarges heart.

b) CHF right-sided heart failure: Fluid will back up into the legs, feet, and abdomen, causing swelling.

c) CHF left-sided heart failure results in fluid backing up in the lungs, causing shortness of breath.

2) Valvular insufficiency: There are several causes for valvular insufficiency. The most common series is aortic stenosis. The valve narrows, reducing the amount of blood that can be pumped to the body by the ventricle. The heart has to work harder to pump blood, resulting in muscle damage and weakness to the heart.

3) Vessel problems

a) Arteriosclerosis: hardening of the arteries and a condition in which plaque builds up on the arteries, resulting in narrowing

b) Atherosclerosis (interchanged with arthrosclerosis): condition in which plaque builds up in the inner lining of the blood vessel

c) Myocardial infarct: occurs when blood flow is restricted through one or more coronary arteries, resulting in a lack of oxygen to the heart and causing tissue death; referred to as a heart attack

d) Angina: chest pain; discomfort in the chest that occurs when the heart is not receiving adequate oxygenated blood (not a heart attack)

4) Aneurysm: localized weakness in a blood vessel wall that can result in bulging or rupture; can be life threatening

5) Hypertension: This is high blood pressure. Blood pressure is the result of blood being pumped by the heart using the arteries. The force is a measurement that provides your blood pressure reading. High blood pressure causes the heart to work harder to pump blood, which causes the heart muscle to overcompensate by thickening the walls. Thick walls can cause the heart to be too weak to effectively pump blood.

6) Blood issues and disorders

a) Anemia: less than normal amount of red blood cells, resulting in decreased oxygen in the body

b) Thrombocytopenia-:fewer than normal circulating platelets, which can lead to excessive bleeding

c) Hemophilia: a condition that prohibits clotting, resulting in increased bleeding time after an injury, possible internal bleeding, or joint issues

d) Leukemia: A higher than normal amount of white blood cells is produced. This may be due to a bone cancer

e) Embolus: This is a blood clot. An abnormal blood clot could restrict blood flow to the heart, lungs, or brain.

d. Describe major laboratory and diagnostic tests used to assess cardiovascular diseases.

1) Plasma: Plasma blood tests can determine inflammation, cancers, and electrolyte issues.

2) White blood cells: Blood tests can determine white blood cell counts to assess for infection, disease process, and cancers.

3) Red blood cells: Blood tests can determine red blood cell counts to assess for the anemia disease process.

4) Platelets blood tests can determine platelet counts to assess for,clotting issues and disease process.

5) Blood types: Assess a patient’s blood type (A, B, AB, or O). Rh testing will assess Rh negative or Rh positive blood for blood types.

6) Blood clotting: Blood tests can determine coagulation issues to assess for disease process.

7) EKG or ECG (electrocardiogram) testing: The test checks for electrical activity problems in the heart.

8) Cardiac enzymes: a blood test that measures proteins and enzymes in the blood, which can indicate levels of damage to the heart muscle (heart attack)

9) Cardiac stress test: testing performed to assess how the heart works under physical stress, such as walking, bike riding, or running. Testing is performed in a stress test department. Patients are connected to heart monitors while they exercise, and heart activity is monitored.

10) Chest X-ray: noninvasive testing that produces an image of the chest, including the heart, lungs, vessels, and bones to assess for any abnormality

11) Angiogram, arteriogram, and venogram: X-ray tests that can monitor the blood flow within arteries to assess for any narrowing or blockage

12) Vital signs are clinical measurements that include a patient’s temperature, heart rate, respiratory rate, and blood pressure. The measurements are used to help detect abnormalities. There are normal range parameters, and if a value is too high or too low, it could be an indication of disease process.

e. Describe the main health care providers for the cardiovascular department.

1) Cardiovascular

a) Cardiologists specialize in disorders of the heart and the circulatory system. Cardiology is the study, diagnosis, and treatment of conditions pertaining to the heart or the circulatory system.

b) Vascular surgeon: a physician who specializes in the surgical treatment of diseases that affects the vascular system

c) Cardiac surgeon: a physician who specializes in the surgical treatment of diseases that affect the heart

d) Cardiothoracic surgeon: a physician who specializes in surgical treatment of organs in the chest

Note. The section below represents material covered in HCS/235. This information could be reinforced as you discuss the major providers of each system.

2) Other providers

a) The attending physician or staff physician is responsible for diagnosing the patient and directing the care of the patient. The attending physician generally has more experience and has completed all resident and fellowship requirements and will oversee the care of the patient. They will generally consult with specialists and manage the ongoing treatment of the patient.

b) The resident physician is in training as a physician and consults with the staff or attending physician before rendering a final diagnosis. The resident physician will order treatment and examine the patient, but will consult with the attending physician.

c) The fellow physician is a physician in training in a specialty after completing residency requirements.

d) Registered nurse: Graduate nurses from associate, bachelors, masters, or doctorate program are legally authorized to practice after passing a state board exam. The registered nurse is responsible for carrying out physician orders, administering medications, performing treatment and procedures, and developing a patient care plan. Registered nurses may obtain additional licensure to practice as a nurse practitioner working directly with physicians in primary patient care.

e) Licensed practical nurse (LPN): The LPN works under the supervision of a registered nurse. The LPN can administered medications and some IV medications, depending on state laws, and performs treatments. The LPN receives 12–18 months of training and is also required to take a state board examination.

f) Nursing assistant and nurse’s aide: The nursing assistant or nurse’s aid works under the direct supervision of a registered nurse or licensed practical nurse performing personal care to patients such as dressing, bathing, helping with ambulation and exercises, and checking vital signs. Certified nursing assistant programs are generally 8–12 weeks in length.

g) Medical assistant: The medical assistant performs medical, administrative, and clinical tests and may perform some basic functions in billing and coding after receiving training. The medical assistant program is generally 9–24 months, and there are certificate examinations to include the certified clinical medical assistant (CCMA) or the certified medical assistant (CMA). The medical assistant generally works in physician offices or outpatient facilities.

h) Medical administrative assistant: The medical administrative assistant assists in performing office tasks and some basic medical billing and coding after receiving training. The tasks do not include patient care.

i) Medical billing and coding specialists: The biller and coders are responsible for billing and coding patient claims for all services rendered in a variety of health care settings in the medical records, coding, and billing departments. The biller and coder must demonstrate knowledge in coding, medical terminology, and anatomy and physiology.

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