Systemic vs. Pulmonary Circulation

What Does the Heart Do?

The heart is a pump, usually beating about 60 to 100 times per minute. With each heartbeat, the heart sends blood throughout our bodies, carrying oxygen to every cell. After delivering the oxygen, the blood returns to the heart. The heart then sends the blood to the lungs to pick up more oxygen. This cycle repeats over and over again.

What Does the Circulatory System Do?

The circulatory system is made up of blood vessels that carry blood away from and towards the heart. Arteries carry blood away from the heart and veins carry blood back to the heart.

The circulatory system carries oxygen, nutrients, and hormones to cells, and removes waste products, like carbon dioxide. These roadways travel in one direction only, to keep things going where they should.

What Are the Parts of the Heart?

The heart has four chambers — two on top and two on bottom:

· The two bottom chambers are the right ventricle and the left ventricle. These pump blood out of the heart. A wall called the interventricular septum is between the two ventricles.

· The two top chambers are the right atrium and the left atrium. They receive the blood entering the heart. A wall called the interatrial septum is between the atria.

The atria are separated from the ventricles by the atrioventricular valves:

· The tricuspid valve separates the right atrium from the right ventricle.

· The mitral valve separates the left atrium from the left ventricle.

Two valves also separate the ventricles from the large blood vessels that carry blood leaving the heart:

· The pulmonic valve is between the right ventricle and the pulmonary artery, which carries blood to the lungs.

· The aortic valve is between the left ventricle and the aorta, which carries blood to the body.

What Are the Parts of the Circulatory System?

Two pathways come from the heart:

· The pulmonary circulation is a short loop from the heart to the lungs and back again.

· The systemic circulation carries blood from the heart to all the other parts of the body and back again.

In pulmonary circulation:

· The pulmonary artery is a big artery that comes from the heart. It splits into two main branches, and brings blood from the heart to the lungs. At the lungs, the blood picks up oxygen and drops off carbon dioxide. The blood then returns to the heart through the pulmonary veins.

In systemic circulation:

· Next, blood that returns to the heart has picked up lots of oxygen from the lungs. So it can now go out to the body. The aorta is a big artery that leaves the heart carrying this oxygenated blood. Branches off of the aorta send blood to the muscles of the heart itself, as well as all other parts of the body. Like a tree, the branches gets smaller and smaller as they get farther from the aorta.

At each body part, a network of tiny blood vessels called capillaries connects the very small artery branches to very small veins. The capillaries have very thin walls, and through them, nutrients and oxygen are delivered to the cells. Waste products are brought into the capillaries.

Capillaries then lead into small veins. Small veins lead to larger and larger veins as the blood approaches the heart. Valves in the veins keep blood flowing in the correct direction. Two large veins that lead into the heart are the superior vena cava and inferior vena cava. (The terms superior and inferior don't mean that one vein is better than the other, but that they're located above and below the heart.)

Once the blood is back in the heart, it needs to re-enter the pulmonary circulation and go back to the lungs to drop off the carbon dioxide and pick up more oxygen.

How Does the Heart Beat?

The heart gets messages from the body that tell it when to pump more or less blood depending on a person's needs. For example, when we're sleeping, it pumps just enough to provide for the lower amounts of oxygen needed by our bodies at rest. But when we're exercising, the heart pumps faster so that our muscles get more oxygen and can work harder.

How the heart beats is controlled by a system of electrical signals in the heart. The sinus (or sinoatrial) node is a small area of tissue in the wall of the right atrium. It sends out an electrical signal to start the contracting (pumping) of the heart muscle. This node is called the pacemaker of the heart because it sets the rate of the heartbeat and causes the rest of the heart to contract in its rhythm.

These electrical impulses make the atria contract first. Then the impulses travel down to the atrioventricular (or AV) node, which acts as a kind of relay station. From here, the electrical signal travels through the right and left ventricles, making them contract.

One complete heartbeat is made up of two phases:

1. The first phase is called systole (SISS-tuh-lee). This is when the ventricles contract and pump blood into the aorta and pulmonary artery. During systole, the atrioventricular valves close, creating the first sound (the lub) of a heartbeat. When the atrioventricular valves close, it keeps the blood from going back up into the atria. During this time, the aortic and pulmonary valves are open to allow blood into the aorta and pulmonary artery. When the ventricles finish contracting, the aortic and pulmonary valves close to prevent blood from flowing back into the ventricles. These valves closing is what creates the second sound (the dub) of a heartbeat.

T The second phase is called diastole (die-AS-tuh-lee). This is when the atrioventricular valves open and the ventricles relax. This allows the ventricles to fill with blood from the atria, and get ready for the next heartbeat.

Comments

Vascular Catheterization - Coding

Vascular system anatomy and terminology to make reporting these procedures less challenging. A thorough understanding of the anatomy and medical terminology of the vascular system is required to accurately code arterial vessel procedures. Here’s a quick run-through of clinical information and coding guidance to show you how order affects coding. Order Matters Please refer to Appendix L of the CPT® code book for the vascular families. The aorta is the major artery. Each main vessel branching off the aorta is a first order vessel (e.g., left common carotid). First order vessels have several vessels branching off them, designated as second order vessels (e.g., right subclavian and axillary). Second order vessels have several vessels branching off them, designated as third order vessels (e.g., right internal carotid). Third order vessels have several smaller vessels branching off them, designated as beyond the third order (e.g., left deep palmar arch). Catheterization Can Ei...

CPT Quiz - 40000 Series

Quiz created by Vijayarani Sivakumar with GoConqr

Injections & Infusions Coding

Here are the three basic coding rules that you must adhere to when billing for Injection/Infusion services: Rule #1: Pay Attention to the Administration Route When you’re looking at the treatment note, you can first look for hints to proper coding by identifying the Route of Administration. the Injection/Infusion CPT® codes fall into one of three major categories: 1. Intravenous Infusions (IV) 2. Intravenous Pushes (IP) 3. Injections (Sub-Q, IM) Don’t forget: The Centers for Medicare & Medicaid Services (CMS) regulations look at the way a drug is administered only as “the physical process by which the drug enters the patient’s body” – not whether a medical professional administers the drug or supervises the administration. But the administration route hierarchy isn’t the only one you need to understand for Injection/Infusion coding — there is another hierarchy for the type of agent that works in tandem with the administration one. Rule #2: Unde...

Place Holder X

The letter " x ” serves as a placeholder when a code contains fewer than six characters and a seventh character applies. The " x ” also allows for future expansion of the codes. When reporting ICD - 10 - CM codes, coders must add a placeholder so the seventh character is in the correct position. Not every ICD-10-CM code with a seventh character has a sixth character—or even a fifth or fourth character for that matter. This frequently occurs with poisonings and injuries. The letter "x” serves as a placeholder when a code contains fewer than six characters and a seventh character applies. The "x” also allows for future expansion of the codes. When reporting ICD-10-CM codes, coders must add a placeholder so the seventh character is in the correct position. Without this placeholder to ensure characters appear in the correct positions, codes are invalid. For example, a patient presents with an accidental poisoning by an antiallergic drug. For the initial ...

Burns and Corrosions

Chemicals, such as lye or acid, can cause corrosion upon contact with a person's skin. As a professional coding specialist, you may need to code the diagnosis of a burn or corrosion. A chemical burn occurs when living tissue is exposed to a corrosive substance such as a strong acid or base. Chemical burns follow standard burn classification and may cause extensive tissue damage. Burns from a heat source are classified by depth (first, second, third, unspecified), extent, and agent. For multiple burns, sequence the highest degree burn first. Multiple burns of the same three-character category are coded to the highest degree. Non-healing burns are coded as acute burns. The extent of injury is best described using the percentage of the total body surface area (%TBSA) that is affected by a burn. The measurement of burn surface area is important during the initial management of people with burns for estimating fluid requirements and determining need for transfer to a burns service T...

Allograft vs Autograft vs Xenograft

Allo – Same species Auto – Same person Xeno – Animal (different species) An autologous transplant uses a person's own stem cells. ... In a reduced-intensity allogeneic transplant, doctors suppress the recipient's immune system enough so the donor stem cells can take root, or “engraft,” there. An autograft is a bone or tissue that is taken from a part of a person’s own body and transplanted into another. Often, surgeons will use a person’s own hamstring tendon to repair a damaged anterior cruciate ligament. Similarly, an autograft bone may be transplanted from a person’s hip to aide in a spinal fusion. Patients who undergo autograft procedures may experience increased postoperative pain from the second surgical (autograft) site. They may also require longer periods of rehabilitation. The use of allograft is advantageous because there is no second procedure required to remove and transfer a portion of the patient’s native bone or tissue. Surgical time may be...

Combination Codes

It’s one of the most important questions coders must ask while using ICD-10: Is there a single combination code that fully identifies the patient’s relevant conditions, or is it necessary to report two separate codes? The volume of combination codes in ICD-10 has increased, making it imperative for coders to be alert and aware of instances in which combination codes are applicable. Defining Combination Codes The ICD-10-CM Official Guidelines for Coding and Reporting describe combination codes as those used to classify the following: • Two diagnoses • A diagnosis with an associated secondary process (manifestation) • A diagnosis with an associated complication Coders cannot — and should not — assign multiple diagnosis codes when a single combination code clearly identifies all aspects of the patient’s diagnosis. For example, say a pati...

Complete List of Modifiers

Modifier - as the name implies a modifier will modify a service / procedure or an item under certain circumstances for appropriate reimbursement. Modifiers may add information or change the description according to the physician documentation to give more specificity for the service or procedure rendered. Appending of an appropriate modifier will effectively respond to reimbursement. Modifier are two digit codes and are categorized into two levels 1. Level I Modifiers: Normally known as CPT Modifiers and consists of two numeric digits and are updated annually by AMA - American Medical Association. 2. Level II Modifiers: Normally known as HCPCS Modifiers and consists of two digits (Alpha / Alphanumeric characters) in the sequence AA through VP. These modifiers are annually updated by CMS - Centres for Medicare and Medicaid Services. Both the above levels of Modifiers are recognized nationally. List of Level I Modifiers: Modifier -21 Prolonged Evaluation and Man...

Spleen - Anatomy

The spleen is an organ located in the upper left abdomen, and is roughly the size of a clenched fist. In the adult, the spleen functions mainly as a blood filter, removing old red blood cells. It also plays a role in both cell-mediated and humoral immune responses. The spleen in located in the upper left quadrant of the abdomen, under cover of the diaphragm and the ribcage – and therefore cannot normally be palpated on clinical examination (except when enlarged). It is an intraperitoneal organ, entirely surrounded by peritoneum (except at the splenic hilum). The spleen is connected to the stomach and kidney by parts of the greater omentum – a double fold of peritoneum that originates from the stomach: The spleen has a slightly oval shape. It is covered by a weak capsule that protects the organ whilst allowing it to expand in size. The outer surface of the spleen can be anatomically divided into two: · ...

Medical Coding Simplified

Search This Blog