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Heart Surgery
Heart Surgery- A surgery in which the chest wall
is surgically opened and heart is exposed.
Surgery can be performed on the heart
muscles, valves and the great arteries. This can
be done through open, or closed heart surgery
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Cardiovascular Assessment & Diagnosis
Case scenario
Mr. Zee aged 69 years was being observed at the A/E dept with c/o coughing, dizziness/fainting, dyspnea, palpitation, indigestion, haziness.
Recently, he had a syncope episode at the work place and was treated and discharged on
medication.
He says sometimes he gets both chest pains and abdominal pains with associated indigestion
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Introduction to ECG(Electrophysiology)
The electrocardiogram is the graphical representation of the electrical activity of the heart
• It records the electrical activity of atrial ventricular cells in form of specific waveforms and complexes.
• The first ECG was introduced by Willem Einthoven, a Dutch physiologist, in the early 1900s
• ECG is an important diagnostic method in cardiac conditions.
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Introduction to ECG (Basic Electrocardiogram)
Indications For ECG Monitoring
Indicated for:-
• To monitor a patient’s heart rate and rhythm
• Evaluate the effects of disease or injury on heart function
• Evaluate pacemaker function
• Evaluate the response to medications
• Obtain a baseline recording before, during, and after a medical procedure
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Junctional Rhythms ( Electrophysiology)
The (AVN) Atrial Ventricular Node is a group of specialized cells located in the lower part of the right atrium above the tricuspid valve base. Its function is to Delay, Relay and Filter impulses as they pass through the Ventricles.
The nodal cells have pacemaker properties and can pace the heart at a rate of 40-60b/min. Rhythms coming from the AV junction are called .Junctional dysrhythmias. The electrical impulse must travel backward
( Retrograde) to activate the atria.
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KENYA JUNIOR SCHOOL ASSESMENT
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Pre technical comprehensive rationalised exam
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Sinus Mechanisms
A normal heartbeat results from an electrical impulse that originates from the hearts primary pace maker-(SA node)
• The Normal sinus rhythm records the hearts electrical impulse that starts in the SAN spreading through the normal conduction pathway.
• The SAN dominates other areas that may pace the heart slower and abnormally.
All other rhythms will be compared to the Normal Sinus
Rhythm
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Ventricular Rhythms
The ventricles (purkinje fibres) may assume the function of pacing the heart, they pace at a slower rate 20-40b/min which cannot sustain the body's perfusion requirements. Rhythms originating from the ventricles are called ventricular arrhythmias because they originate in the ventricles.
Ventricular arrhythmias occur when:-
a) The SAN fails to initiate an impulse
b) The AVN does not pick to pace
c) There is an irritable foci in the ventricular muscle
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Sickle cell Crisis
Sickle cell disease (SCD)
• A group of hereditary disorders in which the normal adult hemoglobin (hemoglobin A) is partly or completely replaced by abnormal sickle hemoglobin (HgbS).
• The most common genetic hematologic condition in children
• Transmitted by autosomal recessive pattern of inheritance.
• Patient with this condition is homozygous for the sickle cell gene, i.e. both genes are abnormal.
• The basic defect responsible for the sickling of
erythrocytes is contained in the globin fraction of hemoglobin
• The mode of transmission is hereditary
• The gene that determines the production of HgbS is situated on an autosome.
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Treatment modalities for hematological disorders
These are therapies aimed at preventing, alleviating the underlying cause or treating the hematological disorder
• They include
1. Nutritional therapy: meal management to ensure rich sources of iron, vitamin K, vitamin B9.
2. Supplements: administration of folate, iron sulfate.
3. Treatment of underlying cause: antimalarial, deworming, ulcer treatment
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Valvular heart disease
Outline
1. Review the role of valves in cardiac cycle
2. Define valvular heart disease
3. Identify types of VHD
4. Explain the assessment and diagnostic tests
5. Describe the management of patient with VHD
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Assessment and diagnostic evaluation of patient with haematological disorder
History taking
1. Nutrition: feeding habits; typical meal – to determine deficiencies
2. use of prescription and over-the-counter medications: most hematological conditions can result from herbs, or certain medications.
3. Prior chemotherapy or radiotherapy
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Disseminated intravascular coagulation (DIC)
It is a condition of combine platelet and coagulation factor disorder.
• It is characterized by widespread coagulation and bleeding in the vascular compartment.
• DIC occurs secondary to inappropriate systemic activation of normal clotting mechanisms.
• It is associated with underlying disease manifested as uncontrolled activation of coagulation and fibrinolysis.
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Circulatory Shock
3 elements ensures adequate tissue perfusion
1. Functioning pump (myocardial contractility)
2. Rate of Myocardial contraction
3. Adequate volume of blood (preload)
4. Normal vascular tone, SVR (Afterload)
• In order for adequate tissue perfusion to occur, cardiac output must be sufficient to deliver nutrient- and oxygen rich blood to the tissues.
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Hematologic emergencies (Disorders of haemostasis)
Disorders of hemostasis – hypercoagulability
states
Disorders occurring due to imbalance between procoagulants and anticoagulants.
Pro-coagulant factors:
Platelets
clotting factors
Ca2 PLUS
molecules released by damaged tissues
Anticoagulant factors
Protein C
Plasmin
Antithrombin III
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Leukemia
A group of malignant diseases of the bone marrow and lymphatic system.
• Characterized by an unrestricted proliferation of immature white blood cells in the blood-forming tissues of the body.
• Classified as malignant because the leukemic cells demonstrate the neoplastic properties of solid cancers.
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Febrile Neutropenia
A leukocyte and the most numerous of the white blood cells, accounting for 50–70% of the WBC population.
• Range 1,500 to 8,000/mm3
• Are about twice as large as erythrocytes.
• Also called polymorphonuclear neutrophils
• Chemically attracted to sites of inflammation
and are active phagocytes
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KENYA JUNIOR SCHOOL EDUCATION ASSESMENT
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CHRISTIAN RELIGIOUS EDUCATION (CRE) COMPREHENSIVE EXAM
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KCSE 2017 MATHEMATICS PP1,PP2 QUESTIONS & ANSWERS
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Download a copy of KCSE 2017 MATHEMATICS PP1,PP2 QUESTIONS with comprehensive KNEC Marking Schemes, This is instrumental in aiding your revision for your fourth coming examinations.
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JSS GRADE 9 AGRICULTURE LESSON NOTES
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This integrated learning area combines agricultural science with home science principles, introduced to students at the upper primary level. It provides learners with a comprehensive understanding of how to conserve natural resources, improve food production and maintain good hygiene both personally and in their communities.
60 Pages
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