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Heart outline pulmonary & systemic circulation

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Presentation on theme: "Heart outline pulmonary & systemic circulation"— Presentation transcript:

1 Heart outline pulmonary & systemic circulation
location of heart in thorax pericardium external anatomy of heart internal anatomy of heart coronary circulation CAD, angina and heart attacks heart valves conduction system of heart EKG’s

2 Pulmonary circuit Systemic circuit
artery vein artery vein CO2 O2 Systemic circuit

3 CPR, xyphoid process Auscultating the heart….where? Press down 4-5 cm

4 T9

5 Looking at left side of heart
Looking at right side of heart


7 Pericardial cavity For you only – already did

8 Visceral pericardium Myocardium Endocardium
Fibrous pericardium Parietal pericardium Visceral pericardium Myocardium Endocardium Cardiomyopathy: heart muscle disease Extrinsic (mostly coronary art issues – lack of oxygen to muscle) Intrinsic (drug & alcohol toxicity, hep C, genetic) Genetic issues: thickened, stiff or spongy muscle – young athletes with heart failure Hypertrophic cardiomyopathy… Epicardium = visceral pericardium + adipose cardiomyopathy

9 Pericarditis = inflammation of the pericardium
Inflammation: infection, cancer, trauma, radiation, auto-immune, no cause Symptoms: chest pain, fever, increased heart rate, none Constrictive pericarditis: severe pericarditis, pericardium sticks together, heart can’t expand – breath shortness, tired, edema… Pericarditis = inflammation of the pericardium peri = ? cardi = ? -itis = inflammation

10 Fibrous skeleton: collagen & elastic fibers between chambers & around valves
structural support prevents valves from being overly distended anchors myocardium electrical “insulator” between atria and ventricles

11 Superior vena cava PV Inferior vena cava Anterior View aorta
Pulmonary artery PV Right atrium LA Right ventricle LV Inferior vena cava Anterior View

12 Left atrium RA Use model Left ventricle RV Posterior view

13 Chambers of the Heart 4 chambers 2 upper atria (atria = entry hall)
(auricle = little ear) 2 lower ventricles (ventricles = little bellies) Auricle

14 Right atrium SVC Coronary Sinus (opening) Pectinate muscle
PFO – 15% of adults, can get bigger Fossa ovalis IVC Right AV orifice

15 Right ventricle Pulmonary valve Trabeculae carneae Tricuspid valve
Papillary muscle with tendinous cords

16 Left ventricle Aortic valve Mitral (bicuspid) valve Papillary muscles
with chordae tendineae Trabeculae carneae Thrombi form on walls of left ventricle with certain types of heart disease – stroke or VA

17 Right atrium & ventricle
Left atrium & ventricle

18 Coronary circulation Deep to epicardium
Symp and para innervation (sym dilates)

19 Coronary circulation RCA Coronary sinus LCA (Under auricle) RCA
L & R coronary artery = directly off aorta just distal to aortic valves Coronary sinus = drains into right atrium


21 Coronary sinus R & L coronary arteries Aortic valve

22 Fig. 20.12 Coronary artery disease (CAD)
narrowing of coronary arteries leading cause of death in US Atherosclerosis fatty plaque on arterial walls

23 By-pass Graft

24 Myocardial infarction (MI)
dead tissue areas in myocardium caused by interruption of blood flow cardiac muscles cells don’t regenerate replaced by scar tissue scarred or ischemic cardiac muscle can’t pump or conduct electrical impulses arrhythmias (ventricular fibrillation) Angina pectoris (chest pain)

25 Referred pain: Organ & skin pain fibers travel to the spinal cord together Organ pain misinterpreted as skin pain (referred pain)

26 Aortic valve (semilunar valve) Pulmonary valve (semilunar valve) Bicuspid or Mitral valve Tricuspid valve

27 Atrioventricular (AV) valves
Semilunar valves aortic & pulmonary valves each has 3 cusps (no tendinous cords) close when pressure in ventricles falls Atrioventricular (AV) valves tricuspid and bicuspid (Mitral) tricuspid = 3 cusps, bicuspid = 2 connected to papillary muscle via tendinous cords close when pressure in ventricles increases

28 Cardiac Cycle = 1 heartbeat
Diastole = relaxation Systole = contraction

29 Atrioventricular Valves Open
Ventricles = diastole Atria = systole (atrial pressure > ventricle pressure)

30 Atrioventricular Valves Close
Ventricles = systole Atria = diastole Ventricle pressure > atrial pressure A-V valves close preventing backflow of blood into atria

31 What are the ventricles doing in A?
Valve Function Review A B TP slide What are the ventricles doing in A? Is blood flowing into the coronary arteries in A or B?

32 Murmurs – any abnormal heart sound
Stenosis – narrowing of valve orifice Congenital, rheumatic fever Mitral most common (aortic) Insufficiency or regurgitation – incomplete closure of valve Many causes (MI, RF, HF, prolapse) Aortic and mitral most common Prolapse: most common valve disease CT diseases or genetic Rheumatic fever - strepA Stenosis – mitral = rheumatic fever, aortic = congenital, RF, calcification disease of elderly Causes LV hypertrophy, LV failure (angina, dyspnea) insufficiency (blood regurgitates – murmur): mitral = MI, RF, HF, prolapse Nodules can form on valve, scar and shorten, CT or PM get diseased (AIDS and anti-parkinson drugs cause valve diseases) Pulmonary and tricuspid valves: uncommon stenosis>regurgitation (tricuspid w/RF)

33 Cardiac Cycle = 1 heartbeat
How does the heart beat? Cardiac Cycle = 1 heartbeat

34 Conduction System of Heart
SA node – AV node – AV bundle of His (between ventricles) – Purkinje fibers How does your heart rate change? Nervous control (ANS) hormones drugs Need to coordinate contractions SA node: 100/min ANS innervated (para keeps it slower) AV node: ANS innervated Ventricles can beat on own (20-30/min – too slow) AV node can be an ectopic focus Most ectopic foci beat too slowly to sustain life Beta blockers – block sym response during MI Heart block: electrical signals blocked Bundle branch block or total heart block Ectopic focus Arrhythmia: irregular heart beat Fibrillations: uncoordinated contractions

35 EKG = electrocardiogram
Recording electrical currents in heart P wave atrial contraction P to Q interval time for impulse to travel from SA node to AV node QRS complex ventricular contraction T wave ventricular relaxation

36 Heart failure Impairment of the heart to fill or pump
a sufficient amount of blood through the body right side peripheral edema ascites jugular venous distention left side dyspnea (shortness of breath) orthopnea pulmonary edema

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