Full transcript
0:00within your heart you have what's called
0:02an electrical system this is the
0:04electrical conductivity that's happening
0:07within your heart cells it triggers the
0:09heart cells to initiate that beat or the
0:12pulse that we were practicing and
0:14measuring in our past lesson
0:16it's called a heart rate and the heart
0:18rate is what gives us our beats per
0:20minute
0:21an average adult beat per minute or
0:24pulse would be anywhere from 60 to 100
0:27beats per minute meaning that if we were
0:30to obtain a patient's pulse remember we
0:33have two ways we can do this if it's a
0:35nice regular strong pulse we can pulsate
0:39that pulse for 30 seconds multiply that
0:42number by two that would give us our
0:45results
0:46if it's a thready inconsistent pulse
0:49hard to feel then we're going to palpate
0:51that pulse for a full one minute and
0:54we're going to document that number as
0:56what we have no additional math required
0:58there in any case where we'd like for
1:01our patients to fall in normal range
1:03would be anywhere from 60 beats to 100
1:06beats per minute and that's at rest
1:09meaning no exercise nothing intense
1:12happening just at rest
1:14uh if you want to know where your
1:17exercising rate should be it should be
1:19double what your resting heart rate is
1:21so if your resting heart rate Falls at a
1:2460 you're exercising you want to learn
1:26how to burn fat then you should be
1:27doubling that number at about 120.
1:31so we have the term heart rate which is
1:33our beats per minute and then we also
1:35have the term heart rhythm and the heart
1:38rhythm is the synchronized action in
1:40which your heart is pumping it's pumping
1:42the blood through the valves through the
1:44chambers of the heart we're able to
1:47regulate that on what's called an ECG or
1:50an EKG
1:51electrocardiogram in the electrical
1:54conductivity of the heart it all starts
1:57with what's called this SA node or
1:59sinoatrio node
2:01cyanoatrial node is located in the
2:04atrium of the heart what it does
2:07involuntarily is it creates the impulse
2:11for the heart cells to contract and
2:13relax as that happens what's occurring
2:17is one cardiac cycle it cannot be done
2:20without the electrical impulse that is
2:23said throughout the cardiac cells so the
2:25SA node is referred to as the body's
2:28natural pacemaker of the heart
2:31there are circumstances where that essay
2:34note could be faulty uh and when that
2:37does occur those will be our patients
2:39that have pacemakers put in place the
2:42pacemaker could be the primary action of
2:45the cardiac cycle or it could be put in
2:48place as a backup method to help an
2:51individual who may have an essay note
2:54that tends to not beat on a regular
2:57basis
2:59now going down in the electrical system
3:02of the heart the next system we have is
3:04called the AV node
3:06typically what happens is if the sa note
3:09the sinoatria note is defective for
3:12whatever reason the AV node is our
3:15backup method it sits in the ventricles
3:18so if that first impulse in the atrium
3:21does not trigger then we can expect to
3:23see the trigger occur within the AV node
3:26as that trigger in the AV node uh sends
3:30out its impulses it's then going to
3:32speak to the ventricles allowing the
3:35ventricles to work its part throughout
3:37the cardiac cycle and hopefully get the
3:40heart rhythm back on track
3:42because the initial occurrence happened
3:45in the AV node if we were to do a
3:48readout on this on an EKG machine we
3:51could expect to see some abnormalities
3:53in the patient's Rhythm and that is
3:56because the initial conductivity of the
3:58heart should be happening within the
4:01atrium in the SA node AV node is simply
4:04a backup
4:05in any case whether it occurs in the SA
4:07node or the AV node as it sends out that
4:10electrical pulse maker um it's going to
4:13send out that activity all throughout
4:16the heart and the entire heart Embraces
4:18that it sends signals through What's
4:21called the bundle of His
4:23to the bundle of branches and then the
4:26purkinje fibers
4:28all of that works hand in hand and
4:30allowing the contraction and the
4:33relaxation of the heart uh that equates
4:36to one heartbeat or one what we call
4:39cardiac cycle
4:41now here is where the sinoatrial node is
4:44located here in the atrium and moving
4:47our way down we have the AV node or the
4:50atrial ventricular note this would be
4:52the backup method
4:55once the natural pacemaker sends out
4:58that cardiac trigger it's going to send
5:00the impulse out to the cardiac cells it
5:03tells the cells that now they need to
5:05contract and they need to relax that's
5:07what's occurring here throughout the
5:09heart
5:11and what we see is the one cardiac cycle
5:14which is really just a heartbeat the
5:17bundle of His located in between the two
5:19ventricles
5:21also receives the impulse or the
5:25electrical charge and it sends it out
5:27even further through the purkinje fibers
5:30the purkinje fibers then receive further
5:33communication and that signals those
5:35ventricles to contract
5:38and allow for the conductivity to
5:40continue which again is one cardiac
5:43cycle
5:44two terms here within the cardiac cycle
5:46you have systole or diastolic or
5:49systolic or diastolic
5:52just remembering from when we were
5:53learning blood pressure remember
5:55systolic would be our top number
5:57diastolic would be our bottom number in
6:00acquiring a patient's blood pressure
6:01reading
6:02and what we're monitoring is the
6:05Contracting and the relaxation of the
6:08heart
6:09so systolic is going to be when the
6:11heart is Contracting our top number
6:14diastolic when the heart is refilling
6:17it's a period of relaxation and the
6:19heart is filling again with the blood
6:21and so if you have a heart that's
6:23overworked or you've got cardiac cells
6:26that are damaged then what we're going
6:28to expect to see another thing with
6:31blockage within the heart we're going to
6:32expect to see a higher systolic number
6:35high blood pressure the heart is working
6:38harder it's pumping it's Contracting
6:40it's relaxing in higher numbers it's
6:43working harder to do the job to get that
6:45blood to go through those valves as it
6:47should not what we want on a regular
6:50basis our heart has the ability to
6:53sustain but we don't want it to overwork
6:56day to day this could cause conditions
6:58of an enlarged heart and overworked
7:01heart and could definitely put a patient
7:03at risk for a heart attack