Anatomy exam

The Heart Defined

A muscular 'double' pump

The heart composition

cardiac muscle tissue

heart shape

cone

heart size

size of fist

Heart weight

250-350 grams

Base

superior portion of the heart

apex

5th & 6th, inferior to the left nipple

Largest organ of the mediastinum

located between the lungs

Two atria

receives from pulmonary and systemic circuits and pumps into ventricles

Two ventricles

receives from atria and pumps to pulmonary and systemic circuits

interventricular septum

partition between the right and left ventricles

interatrial septum

partition between the right and left atria

coronary sulcus

separates atria from ventricles

anterior interventricular sulcus

marks the boundary between the ventricles anteriorly

posterior interventricular sulcus

marks the boundary between the ventricles posteriorly

right atrium

Receives deoxygenated blood from the body

left atrium

receives oxygenated blood from the lungs

right ventricle

pumps oxygen poor blood to the lungs

left ventricle

receives oxygen-rich blood from the left atrium

right coronary artery

supplies right atrium and most of right ventricle

left coronary artery

supplies blood to the left ventricle, left atrium, and interventricular septum

anterior interventricular artery

supplies blood to the interventricular septum and anterior walls of both ventricles

posterior interventricular artery

runs to the heart apex and supplies the posterior ventricular walls

right side of heart

pumps deoxygenated blood to the lungs

left side of heart

receives oxygenated blood from the lungs and pumps it to the body

right pulmonary veins

bring oxygen-rich blood from the right lung to the left atrium

left pulmonary artery

carries poor oxygenated blood from the right ventricle to the left lung.

right pulmonary artery

takes blood from the right ventricle to the right lung

left pulmonary veins

bring oxygen-rich blood from the left lung to the left atrium

superior vena cava

receives blood from the head and arms and chest and empties into the right atrium of the heart

inferior vena cava

carries blood from lower regions of the body to right atrium

Aorta

The large arterial trunk that carries blood from the heart to be distributed by branch arteries through the body.

pulmonary circuit

carries blood to the lungs for gas exchange and returns it to the heart

systemic circuit

Circuit of blood that carries blood between the heart and the rest of the body.

pulmonary valve

valve positioned between the right ventricle and the pulmonary artery

tricuspid valve

valve between the right atrium and the right ventricle

mitral valve

valve between the left atrium and the left ventricle; bicuspid valve

chordae tendineae

"heart strings" are tiny white collagenic cords that anchor the cusps to the ventricular walls. They originate from the papillary muscles.

left atria location

left posterior aspect of heart

left atria receives blood from

4 pulmonary veins

left atria sends blood to

left ventricle

left atria muscular wall

1/8 inch think

left atria externally

left auricle (appendage) - remnant of embryonic development

right ventricle wall

1/4 inch thick

right and left ventricle internal structures

papillary muscle and chordae tendineae

left ventricle wall

3/4 inch thick

atrioventricular (AV) valves location

between atria and ventricles

Atrioventricular valve right side

tricuspid valve

Atrioventricular valve left side

bicuspid valve

AV node (atrioventricular node)

region of the heart between the right atrium and right ventricle from which electrical impulses spread to the ventricles during a heartbeat

aortic semilunar valve

located between the left ventricle and the aorta

pulmonary semilunar valve

heart valve opening from the right ventricle to the pulmonary artery

aortic and pulmonary semilunar valves composition

Endocardium with connective tissue core

fibrous skeleton

Dense connective tissue that forms a structural foundation, point of insertion for muscle bundles, and electrical insulator between atria and ventricles

AV valve purpose

prevent regurgitation of ventricle blood

AV valve operation

pressure gradient

chordae tendineae attaches to

3 papillary muscles (tricuspid)

2 papillary muscles (bicuspid)

Flaps of heart valves

semilunar valve purpose

prevent regurgitation into the ventricle

semilunar valve operates

pressure gradient

semilunar valves space behind valves prevents sticking to walls of arteries

pulmonary and aortic sinus

Pathway of blood through the heart

Superior & Inferior Vena Cava \> R Atrium \> Tricuspid Valve \> R Ventricle \> Pulmonary Semilunar Valve \> Pulmonary Trunk \> Pulmonary Artery \> Lungs \> Pulmonary Veins \> L Atrium \> Bicuspid Valve \> L Ventricle \> Aortic Semilunar Valve \> Aorta \> Systemic Circulation

oxygen poor blood

enters the heart from the body and goes out to the lungs

oxygen rich blood

enters the heart from the lungs and goes out to the body

"Lub"

AV valves closing, beginning of systole

"Dup"

semilunar valves closing, beginning of ventricular diastole

heart murmur

abnormal heart sounds are most often indicative of valve problems

Resting heart rate typically

60-80 bpm

Resting heart rate conditioned

< 60 bpm \= good cardio shape

resting heart rate tachycardia

\>100 bpm

resting heart rate bradycardia

heart rate slower than 60 bpm

Systole

cardiac muscle contraction, emptying of heart chambers

Diastole

cardiac muscle relaxation, filling of the heart chambers

manually measure HR

Radial Artery

Carotid Artery

Korotkoff sounds

series of sounds that correspond to changes in blood flow through an artery as pressure is released

Bell

the bell of the stethoscope is the cup shaped part at the end of the tubing, usually opposite to the diaphragm

Diaphragm

the diaphragm is the flat part at the end of the tubing, with the thin plastic "drum-like" covering

Tubing

tubing transmits sound from the bell or diaphragm to the earpieces

earpieces

they should angle slightly forward for the best fit

How to take BP

-client should be sitting down, both feet on floor. wrap cuff around arm, find artery. find preliminary palpatory systolic pressure, find brachial pulse, close valve on the bulb, pump up cuff until you no longer feel brachial pulse. note pressure. position stethoscope directly on skin, BP(pump cuff 30mm over palpable systolic pr, decrease valve slowly, identify systolic pressure(1st sound) and diastolic pressure(last)

Reasons for altered readings

stress, caffeine, smoking, medication, hydration status, last exercise bout, ambient temperature

heart valve incompetence

Valve can no longer prevent backflow

heart valve incompetence causes

Chordae tendineae too long

papillary muscle doesn't contract correctly

Bacterial infection

heart valve stenosis

cusps or flaps of heart valve are too stiff and unable to open fully, making it difficult for blood to flow through; condition may affect any of heart valves but most often affects mitral valve

heart valve stenosis causes

Rheumatic fever, calcium deposits with age, viral infection, congenital formation

The respiratory system

A system of organs, functioning in the process of gas exchange between the body and the environment, consisting especially of the nose, nasal passages, nasopharynx, larynx, trachea, bronchi, and lungs.

The circulatory system

(aka cardiovascular system) This system works as the transportation highway for the body. It consists of the heart, blood, and blood vessels. It transports substances such as oxygen, carbon dioxide, and nutrients in the body.

pulmonary ventilation

movement of air into and out of the lungs

external respiration

O2 and CO2 exchange between lungs and blood

transport

O2 and CO2 in blood

internal respiration

O2 and CO2 exchange between systemic blood vessels and tissues

respiratory zone

site of gas exchange

respiratory zone structures

respiratory bronchioles, alveolar ducts, alveolar sacs, alveoli

conducting zone

conduits to gas exchange sites

Includes all other respiratory structures

respiratory muscles

diaphragm and other muscles that promote ventilation

alveoli purpose

site of gas exchange with blood

Alveoli structure

* Thin epithelial layer
* Rich capillary network
* Spherical
* Internal surface is covered with a layer of fluid

left lung (2 lobes)

separated by an oblique fissure (has a cardiac notch)

right lung (3 lobes)

Seperated. by oblique and horizontal fissures

Lobules are the smallest subdivisions

served by bronchioles and their branches

root

site of vascular and bronchial attachment to mediastinum