Cardiac anatomy & physiology
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Dense connective tissue. The outermost layer of the pericardiom
Coronary artery bypass surgery
- Bypass vessel blockage
- Use: small sphenous vein (leg), radial artery, or gastric flow artery.
- Up to four bypasses can be done in one surgery.
- 1. a mash tube structural that hold the blood vessel open.
- 2. Drug eluding stent (anticoagulants)
Heart attack (myocardial infarction)
Cardiac muscle die as result of circulation blockage and starvation.
A procedure that opens up clogged blood vessel
A general name of blood vessel lumen narrowing
Fatty buildup inside a blood vessel that cause coronary artery disease
Coronary artery disease
Partial or complete blockage of the blood vessel that serve the heart
Know the rout of blood flow
Right Atrium→Tricuspid Valve→Right Ventricle→Pulmonary Semilunar Valve→Pulmonary Trunk→Pulmonary Arteries→Lungs→Pulmonary Veins→Left Atrium→Mitral Valve→Left Ventricle→Aortic Semilunar Valve→Aorta→Body tissue
Inflammation of the cardiac muscle as result of bacterial or viral infection. Cause chest, pain fever, and irregular heartbeat
Inflammation of the endocardium layer of the heart wall cause the AV valves & semilunar valves to not close properly that allow back-flow of blood
List the layers that comprise the heart wall
- 1. Epicardium
- 2. Myocardium
- 3. Endocardiom
Increase fluid in the pericardium cavity, may compress and stop the heart
Inflammation of the pericardium (surfaces) cause swelling and friction
- The outermost layer of the heart wall. A mesothelium membrane (simple squamous epithelium)
- Also called Epicardium
A space that surround the heart that filled with pericardial fluid to prevent friction
Serous membrane (simple squamous epithelium) that line the inner surface of the fibrous pericardium (between the fibrous pericardium and pericardial cavity)
Which layers comprise the pericardium?
- 1. Fibrous pericardium
- 2. Parietal pericardium
- 3. Pericardial cavity
- 4. Visceral pericardium
Which blood vessels are efferent? Which are afferent?
- Arteries are efferent (blood flow away from the heart)
- Veins are afferent (blood flow toward the heart)
Which are the two circuits of blood flow?
- Systemic circuit gos to body tissue
- Pulmonary circuit gos to the lungs
Which part of the heart is the apex? Which is the base?
- The bottom pointy part is the apex
- the top wide part is the base
- A second cardiac shunt of fetus heart
- connect the the pulmonary duct to the aorta
- Bypass the lungs
- A fetal cardiac shunt, opening that connect right atrium to left atrium.
- Usually closed at birth
Name the cells type comprise the cardiac muscle
- Contractile cells: cardiac muscle cells
- Conducting cells: Form pathway that move action potential through the heart
What mechanism cause AV valves to close?
- muscles of ventricles and papillary muscle contract
- Pressure (of the blood) in the ventricle push AV valve upward and papillary muscle pull chordae tendineae taut that will prevent the AV valves from being pushed too far and open the other way
What mechanism cause AV valves to open?
Papillary muscles and muscles of the ventricle walls relaxed that cause slack of the chordae tendineae and blood flow from the atria to the ventricle
Mitral Valve collapse
- Mitral valve does not close properly usually due to swelling of the endocardium.
- As result, blood flowing back to the left atrium that decrease the blood flow to the body tissue
- Also called left atrioventricular valve (left AV Valve) or bicuspid valve
- Between the left atrium and left ventricle
- Also called right atrioventricular valve (Right AV Valve)
- Between right atrium and right ventricular
Aortic Semilunar Valve
Between the left ventricle and the aorta
Pulmonary Semilunar Valve
Between the right ventricle and pulmonary trunk
How the right atrium is different from the left atrium?
- The walls of the right atrium are thinner
- The right atrium is crescent shape (cross section view)
- The left atrium is round shape (cross section view)
Tendon stands that attach the AV valves to the ventricles papillary muscle
Which chambers are the pumping chambers?
Where is the opening of the coronary sinus located? What is its purpose?
- Right atrium
- Return of the coronary circulation blood back to the heart
A dent in the right atrium wall where foramen ovalis use to be
What is the main purpose of the right and left atria?
Collect blood from the lungs (left) and body circulation (right)
What occur during the period of ejection?
- As the ventricles continue to contract, the pressure raise and open the semilunar valves
- Pulmonary semilunar valve opens at 8 mm Hg
- Aortic semilunar valve opens at 80 mm Hg
What occur during the period of isovolumatic contraction?
- AV valves & semilunar valves are closed
- The ventricles start to contract and build up pressure
Volume of blood does not change
Name the periods of the cardiac cycle
- 1. Period of isovolumatic contraction
- 2. Period of ejection
- 3. Period of isovolumatic relaxation
- 4. Passive ventricle filling
- 5. Active ventricular filling
When atrial repolarization happen? Can we see it in EKG graph?
- During QRS wave complex
- We can't see it because the QRS wave is too big
What happen during T wave?
What happen during QRS wave complex?
What P wave represent?
depolarization of the atria
Can we live without medical intervention if the heart pace maker stops working?
- The AV node can act as the pace make if the SA node stop working
- However, the heartbeat per minute will be much slower
How many bpm can the AV node conduct by itself?
Between 40 to 60 bpm
Which conducting system structure is refered as the heart pace maker? How many bpm it can conduct by itself?
- SA Node
- Can conduct between 80 to 100 bpm by it self
What comprise the conducting system of the heart?
- 1. Sinoatrial node (SA node)
- 2. Atrioventricular node (AV node)
- 3. Antrioventricular bundle (AV bundle) or Bundle of His)
- 4.Right & left bundle brunches
- 5. Purkinje fibers
what happen during each phase of cardiac action potential?
- 1. Rapid depolarization: Na+ enter the cell via fast Na+ channels
- 2. Early repolarization: Na+ close and K+ move out the cell
- 3. plateau Phase: K+ still moving out the cell, Ca2+ move in via Ca2+ channels, and Na+ pumped out the cell
- 4. final repolorization: Ca2+ close K+ keep moving out the cell
Where is the heart located in the body?
Mediastium area (between the lungs) of the thoracic cavity
Percent of blood that pumped per cardiac cycle (heartbeat)
How sympathetic control effect the cardiac activity?
- NE & E will cause hypopolarization in the cardiac muscle
- That will require smaller stimulus and less time then normal to get to threshold of dipolarization
- As result, the heart rate will speed up
- Volume of blood pumped per minute
- SV * heart rate = CO
For example: if SV is 80 mL and HR is 70 mL bmp, CO will be 5,600 mL/min
- The volume of blood that pumped per cardiac cycle
- 120 mL - 40 mL = 80 mL
How parasympathetic control effect the cardiac activity?
- ACh will cause hyperpolorization in the cardiac muscle
- That will require a greater stimulus & time to get to threshold of dipolarization
- As result, the heart rate will slow down
S4 (heart sound)
- When atria are contracting
- Can be heard in kids and very thin people
S3 (heart sound)
When blood flow into the ventricles
S2 (heart sound)
(Dubb) When semilunar vales are closing
S1 (heart sound)
(Lubb) When AV valves closing
- The volume of blood in the ventricle at the end of period of active ventricular fillingBetween 120 mL to 130 mL
What occur during active ventricular filling?
The atria contract forcing blood into the ventricles until they finish filling
What occur during passive ventricular filling?
As the ventricles continue to relax, the ventricular pressure drop to the point that the AV valves open cause blood to flow passively into the ventricles
- Blood that left in the ventricles after period of ejection ended
- Between 50 mL to 60 mL
Fast heart rate (over 100 bpm)
Slow heart rate (under 40 bpm)
What may cause heart failure?
- Ischemic Heart Disease (dead heart muscle)
Define heart failure
When the heart cannot maintain blood flow to meet the need of the body tissue
- The amount of pressure needed to open the semilunar valves
- Increase afterload will increase ESV and decrease SV
How Contractility of the heart will effect the stroke volume (SV)?
- Contractility = Force of ventricles contraction
- Increase contractility will decrease ESV and increase SV
Starlin law of the heart
Any time that the EDV increases, it will increase the SV
- Stretch of the ventricle muscle during diastole
- As result, SA node will respond in greater stimulus that will cause more forceful contraction which increase SV
- ⇫EDV will ⇫preload cause ⇫stretch cause ⇫force of contraction ⇫VS
- Volume of blood that return to the heart from the veins.
- The grater venous return the greater EDV will be
How filling time will effect EDV?
If filling time (of the ventricles)increases, EDV increase
What occur during the period of isovolumatic relaxation?
- The ventricles begin to relax
- Blood in the pulmonary trunk & aorta start to back flow toward the ventricles and cause the semilunar valves to shut close
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