Chapter 1 Echo Dewitt

Heart

Driving force behind the entire CV system.

Pulmonary Circulatory System (the lungs)

Low pressure, low resistance system that exchanges blue/deoxygenated blood burdened with carbon dioxide and a low oxygen saturation of approximately 75% for red/oxygenated blood with a high oxygen saturation of 98%.

Systemic Circulatory System (the body)

high pressure, high resistance system that delivers that red/oxygenated blood to the entire body, and brings back blue/deoxygenated blood.

Left Ventricle

has thick, muscular walls that perform well in a high demand setting.

Blood Pressure

Pressure exerted by the blood on the walls of the arteries within the systemic circulatory system.

Systolic

Top number of blood pressure, pressure when the heart is contracted.

Diastolic

Bottom number of blood pressure, pressure when the heart is relaxed.

Hypotension

Low blood pressure (

Hypertension

Consistently high blood pressure

Normal Blood Pressure

120/80

Right Ventricle

Pump in right heart that has thin walls that perform best in a low demand setting.

PAP

pulmonary artery pressure

15 - 25 mmHg

Normal Systolic PAP

> 25 mmHg at rest, > 30 mmHg with exercise

Pulmonary Hypertension (value)

Pulmonary Capillary Wedge Pressure (PCWP)

the pressure when a pulmonary catheter equipped with an inflated balloon is wedged into a pulmonary arterial branch.

2 - 12 mmHg

Normal PCWP

Left Atrial Pressure

PCWP is an indirect measurement of what?

Arteries

carry blood away from the heart, relatively thick, possess an elastic quality

75%

Percent of oxygen in blood in RA

98%

Percent of oxygen in blood in LA

Thoracic Cavity

What cavity is the heart located?

Base

most superior, rotates posterior, in a rightward direction. (part of the heart)

Apex

most inferior, rotates anterior, in a leftward direction. (part of the heart)

Pericardium

loose, fluid filled, double-layered sac of elastic connective tissue that covers the heart.

Fibrous Pericardium

outer layer of the pericardium

serous pericardium

inner layer of the pericardium, comprised of two layers

Parietal layer

lines the inside of the fibrous pericardium

visceral layer

adheres to the outside of the heart

Diastole

TV and MV are open during _______.

Diastole phase

Relaxation and filling of the heart

annulus fibrosus

tough, fibrous ring that surrounds the superior edge of the valvular leaflets and anchors them between the atria and the ventricle

valvular tissue

makes up the leaflets

Chordae tendineae

cord like connections that connect the valve leaflets to the papillary muscles.

papillary muscles

anchor the valve apparatus to the ventricular walls.

Aortic valve

What valve is associated with the origin of the coronary artery system?

Systole

PV and AOV open during ____

Smaller

SL valves are _______ than AV valves. (size)

right, left, non-coronary

names for the aortic cusps.

~ 2 cm

width of the SVC

~ 7 cm

height of the SVC

1.2 - 2.1 cm

normal IVC diastolic diameter

2 - 8 mmHg

normal mean right atrial pressure (RAP)

7 - 9 cm^2

Normal TV area (TVA)

Trabeculations

crisscross muscular bands that make up the inner surface of the RV.

infundibulum

the funnel shaped portion of the RV outflow tract.

15-25 mmHg / 2- 8 mmHg

Normal RV pressure

Pulmonic Valve

Most superior position of all the valves

anterior, left posterior, right posterior

names of the PV cusps

> 2 cm^2

normal PV area (PVA)

15-25 mmHg / 4-12 mmHg

Normal PA pressure

2-12 mmHg

Normal mean LA pressure (LAP)

Thrombus

LA is prone to what

15-30%

atrial kick percentage

4-6 cm^2

Normal MV area

5x

LV pressure is ___ greater than the RV pressure.

Normal LV pressure

Sinotubular Junction

section of aorta where aortic root ends and ascending aorta begins (the waist)

Sinus of Valsalva

this is the small space located behind the aortic valve cusps.

Nodule of Arantius

small nodule in the center of the free edge of each cusp on the AOV.

1.5-2.6 cm

Normal Range of aortic cusp seperation

>2 cm^2

normal AOV area

1-1.7 m/s

Normal AOV Velocity

Normal AO (systemic) pressure

AO Isthmus

the area between the left subclavian artery and the ligamentum arteriosum

Brachiocephalic artery / innominate artery

first branch of the aortic arch

left common carotid artery

second branch of the aortic arch

left subclavian artery

Third branch of the aortic arch.

ligamentum arteriosum

This structure is a remnant of the ductus arteriosus.

ductus arteriosus

a blood vessel in a fetus that bypasses pulmonary circulation by connecting the pulmonary artery directly to the ascending aorta

isovolumetric relaxation time (IVRT)

immediately precedes diastole, all four valves are closed, the ventricular volumes remain constant while the atrial volumes change, and the ventricular pressure drops in preparation of ventricular diastole while the atrial pressure rises

75%

what percent of blood is filled in diastole

Isovolumic contraction time (IVCT)

Immediately precedes systole, all four valves are close, the ventricular volumes remain constant while the atrial volumes change, and the ventricular pressure rises in preparation of ventricular systole.

60%

O2 saturation in the coronary sinus.

coronary arteries

blood vessels that branch from the aorta and carry oxygen-rich blood to the heart muscle

contractility, chamber size, and ventricular end-diastolic pressure.

systolic and diastolic function are dependent on...

30%

how much do the walls thicken and contract during systole if normal?

Adequate coronary blood flow and oxygenation

what is contractility an indication of?

cardiac function

what is chamber size an indication of?

hyperkinesis

excessive wall movement

hypokinesis

decreased wall motion

akensis

no movement

dyskinesis

movement away from the center of the cavity

hibernation

akinetic but not infarcted

Frank-Starling Law

the more blood that enters the ventricle, the greater the force of contraction required to eject the blood.

Which valves are the semilunar valves

pulmonary and aortic valves