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the position of the heart in the body
a cone-shaped organ approximately the size of a fist, is located within the mediastinum, or medial cavity, of the thorax.
the membranes that surround
it and line it
from deep to superficial
visceral pericardium: is closely applied to the heart muscle
parietal pericardium: lines the internal surface of the fibrous pericardium
fibrous pericardium: dense connective layer protects the heart, anchors it to surroundings structures, and prevents overfilling of the heart with blood
endocardium: a glistening white sheet of endothelium (squamous epithelium) resting on a thin connective tissue layer
myocardium: is composed of cardiac muscle and forms the bulk of the heart.
epicardium: visceral layer of the serous pericardium
abnormal conditions associated with these membranes and possible causes of these conditions
pericarditis: inflammation of the pericardium, causing painful adhesions between the serous pericardial layers.
know the major vessels that connect the heart to the pulmonary and systemic circulatory systems and know what type of blood flows through these vessels.
Pulmonary circulatory systems: pulmonary arteries (deoxygenated blood) and pulmonary veins (oxygenated blood)
Systemic circulatory systmes: superior and inferior venae cavae (deoxygenated blood), aorta (oxygenated blood)
to prevent the heart from overexpanding when blood volume increases
LEFT: to collect oxygenated blood as it leaves the lungs and moves the blood into the left ventricle
RIGHT: to collect deoxygenated blood from the bloodstream and moves it into the heart's right ventricle
RIGHT: to receive blood from the right atrium and pumps it to the main pulmonary artery
LEFT: to receive blood from the left atrium and pumps it to the aorta
to supply oxygenated blood to the head, neck and arm regions of the body
left subclavian artery
to supply oxygenated blood to the arms
to route blood to the lungs to be oxygenated.
superior vena cavas
to bring deoxygenated blood from the head, neck, arm and chest regions of the body to the right atrium
inferior vena cava
to bring deoxygenated blood from the lower body regions (legs, back, abdomen and pelvis) to the right
to deliver oxygen rich blood from the lungs to the left atrium
SL valve (aortic and
pulmonary semilunar valve)
to prevent backflow from the arteries into the ventricles
AV valve (bicuspid and tricuspid valve)
to prevent backflow into the atria when the ventricles are contracting
to anchor the cusps to the ventricular walls
to divde the heart longitudinally
to prevent prolapse of anterior and posterior cusps of mitral valve during systole
to convey the right branch of the atrioventricular bundle of the conducting system
to help prevent suction that would occur with a smooth surface and to help bind the heart's muscle tissue together
to increase force of the atrial contraction without increasing heart mass
to allow the passage of a large quantity of blood from the right ventricle to around the lungs filled with fluids
to receive the blood from the myocardium and facilitate the movement of the blood into the right atrium
a shallow depression that marks the spot
autorhythmic cardiac cells (Sinoatrial node)
Location: in the right atrial wall, just inferior to the entrance of the superior vena cava
Function: to set the rate of contraction for the heart and spontaneously contracts and generates nerve impulses that travel throughout the heart wall causing both atria to contract
Location: beneath the endocardium, which is the innermost layer of the heart
Function: to relay cardiac impulses to the ventricular cells causing the ventricles to contract
sinoatrial (SA) node
Location: in the right atrium just inferior to the entrance to the superior vena cava
Function: to guard the bases of the two large arteries leaving the ventricular chambers.
conductive fiber systems of the heart
- 1. SA node pacemaker generates impulses and brings nodal cells to threshold (-40 mv)
- 2. It spreads via gap junctions through atrial muscle to AV node
- 3. The impulses delay for 0.1 sec at AV node
- 4. The AV bundle connects the atria to the ventricles.
- 5. The bundle branches conduct the impulses through the interventricular septum.
- 6. Rapid spread through bundles & Purkinje fibers through ventricles
- 7. The Purkinje fibers depolarize the contractile cells of both ventricle.
- P wave: 0.08 to 0.10 s
- P-R interval: 0.12 to 0.20 s
A longer than normal intervals indicate conduction problems in the atria (for example, due to ischemia) or a partial AV heart block. A shorter than normal interval suggests that the depolarization did not originate in the SA node.
QRS complex: 0.06 to 0.1s
If the QRS complex is prolonged (>0.1s), conduction is impaired within the ventricles. A wider Q wave is suggestive of myocardial infarction.
from the beginning of ventricular depolarization through repolarization
QT interval: 0.31 to 0.41s
Normal range: 70b/min. Interval can shortern when heart rate rises. A QT interval can also be shorter in hypercalcemia (elevated blood Ca2+ levels)
lines the lumen of a vessel, is a single thin layer of endothelium (squamous cells underlain by a scant basal lamina) that is continous with the endocardium of the heart.
Its cells fit closely together, forming an extremely smooth blood vessel lining that helps decrease resistance to blood flow.
the more bulky middle coat and is composed primarily of smooth muscle and elastin. The smooth muscle, under the control of the sympathetic nervous system, plays an active rolse in regulating the diameter of blood vessels, which in turn alters peripheral resistance and blood pressure.
the outermost tunic, is composed of areolar or fibrous connective tissue. Its function is basically supportive and protective.
valves do not close tightly
sounds are heard in 2nd intercostal space at right sternal margin
sounds are heard in 2nd intercostal space at left sternal margin
sounds are heard over heart apex, in 5th intercostal space in line with middle of clavicle
sounds are typically heard in right sternal margin of 5th intercostal space; variations include over sternum or over left sternal margin in 5th intercostal space
Know where on the body various superficial pulse points are located
- 1. superficial temporal artery
- 2. facial artery
- 3. common carotid artery
- 4. brachial artery
- 5. radial artery
- 6. femoral artery
- 7. popliteal artery
- 8. posterior tibial artery
- 9. dorsalis pedis artery
difference between systolic and diastolic pressure
systolic (120) - diastolic (80)
mean arterial pressure
the average arterial pressure during a singlecardiac cycle
MAP = diastolic pressure + (pulse pressure/3)
Understand the uses of the apical-radial pulse measurements in diagnosis
Know normal diastolic and systolic blood pressures and why they are measured at the brachial artery
diastolic (80) and systolic (120). Because it's the main supplier of blood to the arm and hand
the colorless fluid part of blood
one of the red blood cells, white blood cells, or blood platelets as contrasted with the fluid portion of the blood
sacs of hemoglobin molecules that transport the bulk of the oxygen carried in the blood (and a small percentage of the carbon dioxide)
part of the body's nonspecific defenses and the immune system
one of the tiny colorless disk-shaped bodies of the blood that assist in blood clotting
the passage of blood cells through the intact walls of the capillaries, typically accompanying inflammation
A crawling-like type of movement in which the cell forms temporary cytoplasmic projections
solvent for carrying other substances; absorbs heat
Na+, K+, Ca2+, Mg2+, Cl-, Bicarbonate
osmotic balance, pH buffering, regulation of membrane permeability
osmotic balance, pH buffering, clotting of blood, defense (antibodies) and lipid transport
substances transported by blood
nutrients (glucose, fatty acids, amino acids, vitamins), waste products of metabolism (urea, uric acid), respiratory gases (O2 and CO2), hormones
4-6 million, transport oxygen and help transport carbon dioxide
leukocytes (WBCs), NLMEB
4,800-10,800, defense and immunity
150,000-400,000, blood clotting
Understand the significance and know the normal range of blood plasma pH
Normal blood pH: 7.35-7.45
what pathological conditions might be associated with pH values outside the normal range.
- Hormone concerns
- Cardiovascular weakness
- Weight gain/loss
- Bladder and kidney concerns.
- Immune deficiencyAcceleration of free radical damage.
- Structural system weakness, including brittle bones, hip fractures and joint discomfort
- Stressed liver function
- Low energy
- Slow digestion and elimination
- Yeast/fungal overgrowth.
- Tumor growth
Know the physical characteristics and components of plasma
More than 100 different substances are dissolved or suspended in plasma, which is 90% water. These included nutrients, gases, hormones, various wastes and metabolities, many types of proteins and electrolytes.
- is routinely determined when anemia is suspected.
- WOMEN: 42.0 + or - 5
- MEN: 47.0 + or - 5
- Destruction of red blood cells
- Nutritional deficiencies of iron, folate, vitamin B12, and vitamin B6
- Congenital heart disease
- Failure of the right side of the heart (cor pulmonale)
- DehydrationAbnormal increase in red blood cells (erythrocytosis)
- Low blood oxygen levels (hypoxia)
- Scarring or thickening of the lungs (pulmonary fibrosis)
- Bone marrow disease that causes abnormal increase in RBCs (polycythemia vera)