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Size, Shape, Location 2/3 lie to left of midsternal line 2/3 lie to left of midsternal line Points toward right shoulder and left hip (apex, PMI) Points toward right shoulder and left hip (apex, PMI)
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Advanced BiologyAdvanced BiologyHeartHeart
Size, Shape, LocationSize, Shape, LocationFistFistHollow, cone shapedHollow, cone shapedMediastinum, Rests on Mediastinum, Rests on
diaphragm, posterior to diaphragm, posterior to sternum, Lungs on each sternum, Lungs on each sideside
Size, Shape, LocationSize, Shape, Location2/3 lie to left of midsternal 2/3 lie to left of midsternal
linelinePoints toward right Points toward right
shoulder and left hip shoulder and left hip (apex, PMI)(apex, PMI)
Structure/Function 4 Structure/Function 4 ChambersChambers
2 Superior Atria2 Superior Atria2 Inferior Ventricles2 Inferior VentriclesDivided by Divided by
interatrial/interventricular interatrial/interventricular septumseptum
Structure/Function 4 Structure/Function 4 ChambersChambers
Most Mass in Right and Left Most Mass in Right and Left Ventricles; pumping chambersVentricles; pumping chambers
Right= Forms most of the Right= Forms most of the anterior surfaceanterior surface
Left= Forms inferoposterior Left= Forms inferoposterior aspect. Much more muscular!aspect. Much more muscular!
Structure/Function 4 Structure/Function 4 ChambersChambers
Posterior Atrial walls are Posterior Atrial walls are smoothsmooth
Anterior Atrial walls are rigid Anterior Atrial walls are rigid with bundles of muscle tissuewith bundles of muscle tissue
Atria are the Receiving Atria are the Receiving chambers; thin walledchambers; thin walled
Pathway of BloodPathway of BloodBlood Flow through chambersBlood Flow through chambersRight Atrium – Superior Vena Right Atrium – Superior Vena
Cava, Inferior Vena Cava, Cava, Inferior Vena Cava, Coronary SinusCoronary Sinus
Left Atrium – 4 Pulmonary Left Atrium – 4 Pulmonary veins pump blood backveins pump blood back
Pathway of BloodPathway of BloodRight Ventricle – pumps Right Ventricle – pumps
blood to pulmonary trunk blood to pulmonary trunk (goes to lungs)(goes to lungs)
Left Ventricle – pumps Left Ventricle – pumps blood to Aorta, then out to blood to Aorta, then out to bodybody
Pathway of BloodPathway of BloodValves – Atrioventricular Valves – Atrioventricular
(AV)(AV)Right – TricuspidRight – TricuspidLeft – BicuspidLeft – BicuspidSemilunar valves in Semilunar valves in
pulmonary trunk/aortapulmonary trunk/aorta
Pathway of BloodPathway of BloodPulmonary Circuit – Pulmonary Circuit –
Pulmonary veins have Pulmonary veins have blood with oxygenblood with oxygen
Pulmonary arteries have Pulmonary arteries have blood without oxygenblood without oxygen
Pathway of BloodPathway of BloodSystemic Circuit – Arteries Systemic Circuit – Arteries
have blood with oxygenhave blood with oxygenVeins have blood without Veins have blood without
oxygenoxygenSee page 662See page 662
Major BranchesMajor BranchesCoronary Circulation – Coronary Circulation –
supply blood to the heartsupply blood to the heartLeft Coronary – runs to left Left Coronary – runs to left
side and divides into two side and divides into two partsparts
Major BranchesMajor BranchesAnterior Interventricular Anterior Interventricular
arteryarterySupplies blood to Supplies blood to
interventricular septum interventricular septum and anterior walls of and anterior walls of ventriclesventricles
Major BranchesMajor BranchesCircumflex arteryCircumflex arterySupplies blood to the left Supplies blood to the left
atrium and posterior wall atrium and posterior wall of left ventricleof left ventricle
Major BranchesMajor BranchesRight Coronary – Runs to Right Coronary – Runs to
the right and also divides the right and also divides into two partsinto two parts
Major BranchesMajor BranchesMarginal Artery – lateral part Marginal Artery – lateral part
of right side of heart (atrium)of right side of heart (atrium)Posterior interventricular Posterior interventricular
artery – Runs to the apex, artery – Runs to the apex, supplies posterior ventricle supplies posterior ventricle wallswalls
Major BranchesMajor BranchesCardiac Veins – 1 major, 3 Cardiac Veins – 1 major, 3
minor that dump intominor that dump intoCoronary Sinus – empties Coronary Sinus – empties
blood into the right blood into the right atrium.atrium.
Located on Posterior sideLocated on Posterior side
Major BranchesMajor BranchesGreat Cardiac Vein – Found in Great Cardiac Vein – Found in
the anterior interventricular the anterior interventricular sulcus (groove)sulcus (groove)
Middle Cardiac Vein – In Middle Cardiac Vein – In posterior interventricular posterior interventricular sulcussulcus
Major BranchesMajor BranchesSmall Cardiac Vein – runs Small Cardiac Vein – runs
along heart’s right inferior along heart’s right inferior marginmargin
Several other anterior Several other anterior cardiac veins empty cardiac veins empty directly into Right Atriumdirectly into Right Atrium
Problems?Problems?Myocardial Infarction (MI) – Myocardial Infarction (MI) –
Heart Attack.Heart Attack.Blockage to coronary Blockage to coronary
arteries reduces blood flowarteries reduces blood flowDamage to the Left Damage to the Left
Ventricle is the most seriousVentricle is the most serious
Conduction SystemConduction SystemIntrinsic Cardiac Intrinsic Cardiac
Conduction System – Non-Conduction System – Non-contractile cells that contractile cells that initiate and distribute initiate and distribute impulsesimpulses
Conduction SystemConduction SystemSinoatrial Node (SA) – In Sinoatrial Node (SA) – In
right atriaright atriaHeart’s Natural PacemakerHeart’s Natural PacemakerAtrioventricular Node (AV) Atrioventricular Node (AV)
– In interatrial septum – In interatrial septum above tricuspid valveabove tricuspid valve
Conduction SystemConduction SystemAtrioventricular Bundle Atrioventricular Bundle
(bundle of His) – electrical (bundle of His) – electrical connection between atria and connection between atria and ventricleventricle
Bundle Branches – Run down Bundle Branches – Run down interventricular septum to interventricular septum to apexapex
Conduction SystemConduction SystemPurkinje Fibers – Purkinje Fibers – penetrate apex, run penetrate apex, run superiorly up ventricle superiorly up ventricle wallswalls
Like milking a cowLike milking a cow
ECGECGElectrocardiographElectrocardiographWaves includeWaves includeP – SA node sends first P – SA node sends first
impulseimpulse
ECGECGQRS – Ventricular QRS – Ventricular
depolarizationdepolarizationPrecedes ventricular Precedes ventricular
contractioncontractionT – Ventricular T – Ventricular
RepolarizationRepolarization
ECGECGIntervalsIntervalsP-R (P-Q) – Beginning of P-R (P-Q) – Beginning of
atrial excitation and atrial excitation and ventricular contractionventricular contraction
Q-T – Action potential Q-T – Action potential through Heartthrough Heart
Cardiac CycleCardiac CycleSystole – Contraction of Systole – Contraction of
ventricles or atriaventricles or atriaDiastole – Relaxation of Diastole – Relaxation of
ventricles or atriaventricles or atria
Cardiac CycleCardiac CycleSystolic Pressure – Systolic Pressure –
Ventricular contraction Ventricular contraction 120mmHg120mmHg
Diastolic Pressure – Diastolic Pressure – Ventricular refilling 80mmHgVentricular refilling 80mmHg
Hypertension – High BPHypertension – High BPHypotension – Low BPHypotension – Low BP
Heart SoundsHeart SoundsLub-dupLub-dupLub – AV valves close Lub – AV valves close
(systole)(systole)Dup – SL valves close Dup – SL valves close
(diastole)(diastole)
Heart SoundsHeart SoundsMurmurs – obstructions in Murmurs – obstructions in
BVBVThin walled vibrationsThin walled vibrations
Cardiac OutputCardiac OutputCO = amount of blood pumped CO = amount of blood pumped
by each ventricle in 1 minuteby each ventricle in 1 minuteCO = HR x SV (stroke volume)CO = HR x SV (stroke volume)SV = Volume of blood pumped SV = Volume of blood pumped
out by ventricle (Force of out by ventricle (Force of contraction)contraction)
Cardiac OutputCardiac OutputCO = 75 bpm x 70mLpbCO = 75 bpm x 70mLpbCO = 5250 mL/minCO = 5250 mL/min
Developmental Developmental AspectsAspects
Heart pumps by 23Heart pumps by 23rdrd day day1-2 days later, chambers 1-2 days later, chambers
start to formstart to formChambers are:Chambers are:
Developmental Developmental AspectsAspects
Sinus venosus – receives Sinus venosus – receives all venous blood, becomes all venous blood, becomes Rt. Atrium & Coronary Rt. Atrium & Coronary Sinus, SA nodeSinus, SA node
Atrium – becomes muscle Atrium – becomes muscle ridged parts of atriumridged parts of atrium
Developmental Developmental AspectsAspects
Ventricle – Becomes left Ventricle – Becomes left ventricleventricle
Bulbus cordis – Gives rise Bulbus cordis – Gives rise to the pulmonary trunk, to the pulmonary trunk, first part of the aorta, first part of the aorta, most of the right ventriclemost of the right ventricle
Age Related ChangesAge Related ChangesSclerosis – Thickening of Sclerosis – Thickening of
valve flapsvalve flapsDecline in Cardiac Reserve Decline in Cardiac Reserve
– Heart is less able to – Heart is less able to adjust to changesadjust to changes
Age Related ChangesAge Related ChangesFibrosis of cardiac muscle – Fibrosis of cardiac muscle –
Scarred nodes, increase in Scarred nodes, increase in arrhythmiasarrhythmias
Atherosclerosis – acclerated Atherosclerosis – acclerated by inactivity, smoking, by inactivity, smoking, stress. CV diseasestress. CV disease