1. CARDIOVASCULAR SYSTEM THE HEART Chapter 18

2. Physical Characteristics Located in the mediastinum between the lungs and behind the sternum About the size of a clenched fist Shaped like an inverted cone Apex vs. Base

4. Coverings and Layers Covering Around the Heart –Pericardium Fibrous pericardium Serous pericardium –Parietal layer –Visceral layer (epicardium) –Serous fluid Walls of the Heart –Epicardium –Myocardium –Endocardium

5. Chambers Atria –Right atrium –Left atrium –Interatrial septum –Fossa ovalis Ventricles –Right ventricle –Left ventricle –Interventricular septum

6. Differences between the Ventricles

8. Valves Atrioventricular valves –Tricuspid –Bicuspid (mitral) Semilunar valves –Pulmonary semilunar –Aortic semilunar Associated Structures –Chordae tendineae –Papillary muscles

9. Valves

10. AV Valves

11. Semilunar Valves

12. Heart Valve Video Heart Valve Video

13. Microscopic Anatomy

15. Blood Flow Pulmonary Circuit Systemic Circuit Coronary Circuit Venous Drainage Blood Flow Animation

16. Pulmonary vs. Systemic

17. Pulmonary Circulation Superior and inferior vena cava and coronary sinus Right atrium Tricuspid Right Ventricle Pulmonary semilunar Pulmonary arteries Lungs

18. Systemic Circulation Pulmonary veins Left atrium Bicuspid valve Left ventricle Aortic semilunar Systemic aorta Coronary artery

19. Coronary Circulation Left coronary artery –Anterior interventricular artery –Circumflex artery Right coronary artery –Posterior interventricular artery –Marginal artery Arterial anatomoses

20. Posterior View

21. Venous Drainage Superior vena cava Inferior vena cava Great cardiac vein Small cardiac vein Middle cardiac vein Coronary sinus

22. Posterior View

24. Anastomoses of Coronary Circulation

25. Cardiac Conduction Systems

26. Intrinsic Cardiac Conduction System Animation Intrinsic Cardiac Conduction System Animation

27. Extrinsic Cardiac Conduction System Autonomic Innervation –Sympathetic nervous system –Parasympathetic nervous system

28. Cardiac Physiology EKG Heart Sounds Cardiac Cycle

29. Electrocardiograph

30. EKG and Conduction

31. EKG Animation EKG Animation

32. Abnormal ECG

33. Heart Sounds Auscultate Stethoscope Lub-dup, pause, lub-dup, pause, etc Lub= AV valves closing Dup=Semilunar valves closing

34. Cardiac Cycle Animation Cardiac Cycle Animation

35. Cardiac Output Cardiac output (CO) = the amount of blood pumped by each ventricle per minute –CO = SV X HR –SV=“stroke volume” or the amount of blood pumped by a ventricle in a single beat –HR=“heart rate” or number of beats per minute

36. Factors Affecting SV

38. Contractility Positive Inotropic Agents - Sympathetic NS - Digitalis - Glucagon (pancreas) - Epinephrine - Hypercalcemia Negative Inotropic Agents - Hyperkalemia - Hypocalcemia - Cardiac hypoxia - Cardiac hypercapnia

39. Factors Affecting HR Autonomic nervous system Hormones: epinephrine and thyroxine Age, gender, fitness, emotional state Body temperature Ion concentrations in body fluids Blood pressure

40. Homeostasis

41. Cardiac Disorders Valve disorders –Heart murmur Stenosis Incompetent valve Mitral valve prolapse –Rheumatic fever or Streptococcus infection –Sclerosis and thickening of valve flaps Arrhythmias –Tachycardia –Bradycardia –Fibrillation –Heart block

42. Cardiac Disorders Other related heart problems –Ischemia and hypoxia –Angina pectoralis –Myocardial infarction –Heart palpitation –Asystole –Myocarditis –Endocarditis –Cardiac tamponade –Pericarditis –Congenital defects –Congestive heart failure