heart

Page 1: The Cardiovascular System: The Heart Anatomy

Page 2: Heart Anatomy

  • Size: Approximately the size of a fist

  • Location:

    • Superior surface of the diaphragm

    • Left of the midline

    • Anterior to the vertebral column, posterior to the sternum

Page 3: Heart Anatomy Midsternal Line

  • Key anatomical landmarks include:

    • 2nd rib, sternum, diaphragm

    • Point of maximal intensity: Left lung (PMI)

    • Major vessels:

      • Aorta (a)

      • Parietal pleura (cut)

      • Pulmonary trunk

      • Right and left lungs

    • Parietal pericardium (b, anterior cut)

    • Apex of the heart

    • (c) diaphragm

Page 4: Coverings of the Heart: Anatomy

  • Pericardium: A double-walled sac surrounding the heart

    • Superficial fibrous pericardium

    • Deep two-layer serous pericardium:

      • Parietal layer (lines internal surface of fibrous pericardium)

      • Visceral layer (epicardium, lines surface of heart)

  • Pericardial cavity: Fluid-filled space between layers

Page 5: Coverings of the Heart: Physiology

  • Function of the Pericardium:

    • Protects and anchors the heart

    • Prevents overfilling with blood

    • Provides a friction-free environment for heart movement

Page 6: Pericardial Layers of the Heart

  • Fibrous pericardium

  • Parietal layer of serous pericardium

  • Myocardium

  • Pericardial cavity

  • Visceral layer of serous pericardium (epicardium)

  • Endocardium

Page 7: Heart Wall

  • Epicardium: Visceral layer of serous pericardium

  • Myocardium: Cardiac muscle layer that forms heart's bulk

  • Fibrous skeleton: Connective tissue framework

  • Endocardium: Inner layer of heart's surface

Page 8: Major Blood Vessels Returning Blood to the Heart

  • Superior and inferior venae cavae

  • Right and left pulmonary veins

  • Vessels conveying blood away:

    • Pulmonary trunk (splits into right and left pulmonary arteries)

    • Ascending aorta and its branches

      • Brachiocephalic, left common carotid, subclavian arteries

Page 9: External Heart: Major Vessels (Anterior View)

  • Coronary arteries (right and left in atrioventricular groove)

  • Marginal, circumflex, anterior interventricular arteries

  • Cardiac veins include small, anterior, and great cardiac veins

Page 10: External Heart: Anterior View

  • Key structures:

    • Brachiocephalic artery, left common carotid, left subclavian artery, aortic arch

    • Ascending aorta, left pulmonary artery and veins, circumflex artery, etc.

Page 11: Major Vessels of the Heart (Posterior View)

  • Vessels returning blood:

    • Right and left pulmonary veins, superior and inferior venae cavae

  • Vessels conveying blood away:

    • Aorta, right and left pulmonary arteries

Page 12: Posterior View of Heart Vessels

  • Right coronary artery, posterior interventricular artery

  • Major cardiac veins: great cardiac vein, coronary sinus

Page 13: External Heart: Posterior View

  • Key components:

    • Aorta, left and right pulmonary arteries, auricles of the atria, etc.

Page 14: Gross Anatomy of Heart: Frontal Section

  • Structures including aorta, pulmonary veins, mitral (bicuspid) valve, tricuspid valve, etc.

Page 15: Atria of the Heart

  • Atria serve as receiving chambers

  • Each atrium features a protruding auricle

  • Blood flow: right atrium (superior/inferior venae cavae, coronary sinus); left atrium (pulmonary veins)

Page 16: Ventricles of the Heart

  • Ventricles as discharging chambers

  • Structures: papillary muscles, trabeculae carneae

  • Blood flow: right ventricle (to pulmonary trunk); left ventricle (to aorta)

Page 17: Myocardial Thickness and Function

  • Varies by chamber function:

    • Thin-walled atria deliver blood to ventricles

    • Thicker-walled ventricles: right for pulmonary circulation, left for systemic

Page 18: Thickness of Cardiac Walls

  • Left ventricle is thicker than the right ventricle

Page 19: Atrial Septal Defect

  • A defect affecting inter-atrial septum

Page 20: Ventricular Septal Defect

  • A defect in the ventricular septum

Page 21: Pathway of Blood Through the Heart and Lungs

  • Sequence:

    • Right atrium -> tricuspid valve -> right ventricle

    • Right ventricle -> pulmonary semilunar valve -> pulmonary arteries -> lungs

    • Lungs -> pulmonary veins -> left atrium

    • Left atrium -> bicuspid valve -> left ventricle

    • Left ventricle -> aortic semilunar valve -> aorta -> systemic circulation

Page 22: Pathway of Blood Through the Heart and Lungs

  • Involves pulmonary circuit (gas exchange occurs in capillary beds of lungs)

  • Oxygen-rich from lungs to left atrium; oxygen-poor from tissues back to right atrium

Page 23: Coronary Circulation

  • Functional blood supply to the heart muscle

  • Collateral routes for blood delivery to the heart muscle

Page 24: Coronary Circulation: Arterial Supply

  • Major arteries: left and right coronary arteries

  • Anastomosis connects coronary vessels

Page 25: Coronary Circulation: Venous Supply

  • Superior vena cava, great cardiac vein, coronary sinus, small cardiac vein

Page 26: Heart Valves

  • Ensure unidirectional blood flow

  • Atrioventricular valves: between atria and ventricles, prevent backflow into atria

    • Anchored by chordae tendineae

Page 27: Heart Valves

  • Semilunar valves: prevent backflow into ventricles

    • Aortic semilunar valve: between left ventricle and aorta

    • Pulmonary semilunar valve: between right ventricle and pulmonary trunk

Page 28: Heart Valves Structure

  • Includes bicuspid (mitral), tricuspid, aortic semilunar, and pulmonary semilunar valves

Page 29: Heart Valves Function

  • Atrioventricular valve function explained

    • Allows filling and prevents backflow associated with ventricular contraction

Page 30: Atrioventricular Valve Function

  • Sequence during atrial and ventricular contraction

  • Involvement of chordae tendineae and papillary muscles in preventing valve eversion

Page 31: Semilunar Valve Function

  • Function during ventricular contraction and relaxation explained

Page 32: Mitral Valve Prolapse

  • One leaflet of the mitral valve fails to close properly

Page 33: Microscopic Anatomy of Heart Muscle

  • Properties of cardiac muscle: striated, short, branched

  • Importance of intercalated discs for connection and electrical impulse transmission between cardiac cells

Page 34: Microscopic Anatomy of Heart Muscle

  • Diagram illustrating cellular structure, including intercalated discs and mitochondria

Page 35: Cardiovascular System: The Heart Physiology

Page 36: Cardiac Muscle Contraction

  • Heart muscle is stimulated by nerves and is self-excitable

  • Contracts as a unit, with a long refractory period

  • Similar contraction mechanism to skeletal muscle

Page 37: Heart Physiology: Intrinsic Conduction System

  • Role of autorhythmic cells in generating action potentials

  • Importance of calcium influx for action potential phase

Page 38: Pacemaker and Action Potentials of the Heart

  • Detailed overview of the pacemaker potential graph, including ion movements

Page 39: Heart Physiology: Sequence of Excitation

  • SA node initiates impulses at approximately 75 beats/min

  • AV node delays impulse for coordination

Page 40: Heart Physiology: Sequence of Excitation

  • Impulse travels from atria to ventricles via AV bundle, splits into bundle branches

  • Purkinje fibers carry impulses to ventricular walls

Page 41: Heart Physiology: Sequence of Excitation

  • Overview of the conduction pathway through the heart, beginning with SA node

Page 42: Heart Excitation Related to ECG

  • Relations between SA node generation and ECG patterns explained

Page 43: Extrinsic Innervation of the Heart

  • Autonomic regulation: sympathetic (accelerating) and parasympathetic (inhibiting)-

Page 44: Electrocardiography

  • Recording of electrical activity with key waveforms: P wave, QRS complex, T wave

Page 45: Electrocardiography

  • Insights into the timing of electrical signals and heart valve closures through the ECG diagram

Page 46: Heart Sounds

  • Sounds correspond to heart valve closures:

    • "Lub" sound (AV valves close) marks ventricular systole

    • "Dup" sound (SL valves close) signifies ventricular diastole

Page 47: Cardiac Cycle

  • Definition and components of the cardiac cycle explained

    • Systole: contraction phase

    • Diastole: relaxation phase

Page 48: Phases of the Cardiac Cycle

  • Description of ventricular filling and initial atrial events

Page 49: Phases of the Cardiac Cycle

  • Description of ventricular systole, internal pressure changes and valve actions

Page 50: Phases of the Cardiac Cycle

  • Event sequence of isovolumetric relaxation explained

Page 51: Phases of the Cardiac Cycle

  • Detailed overview of each phase of the cardiac cycle demonstrated via a chart

Page 52: Cardiac Output (CO) and Reserve

  • Definition of CO: blood volume ejected by each ventricle per minute

  • Calculated as product of heart rate (HR) and stroke volume (SV)

Page 53: Cardiac Output: Example

  • Example calculation: CO = HR (75 BPM) x SV (70 ml/beat) = 5250 ml/min (5.25 L/min)

Page 54: Regulation of Stroke Volume

  • Relationship: Stroke Volume = End Diastolic Volume (EDV) - End Systolic Volume (ESV)

Page 55: Factors Affecting Stroke Volume

  • Key factors: preload, contractility, afterload

Page 56: Frank-Starling Law of the Heart

  • Preload determines stroke volume based on stretch dynamics

Page 57: Preload and Afterload

  • Diagram illustrating the concepts of preload and afterload in relation to cardiac output

Page 58: Extrinsic Factors Influencing Stroke Volume

  • Factors that positively influence contractility outlined

Page 59: Extrinsic Factors Influencing Stroke Volume

  • Factors that negatively influence contractility outlined

Page 60: Contractility and Norepinephrine

  • Mechanism of sympathetic stimulation concerning cardiac contractility explained

Page 61: Regulation of Heart Rate

  • Factors that influence heart rate, including caffeine (positive) and sedatives (negative)

Page 62: Regulation of Heart Rate: Autonomic Nervous System

  • Distinction between effects of SNS (accelerating) and PNS (slowing)

Page 63: Atrial (Bainbridge) Reflex

  • Sympathetic reflex activated by increased blood volume in the atria

Page 64: Chemical Regulation of the Heart

  • Hormones and ion concentrations' effects on heart rate regulation described

Page 65: Factors Involved in Regulation of Cardiac Output

  • Overview of physiological responses to various stimuli affecting CO

Page 66: Congestive Heart Failure (CHF)

  • Causes include coronary atherosclerosis, high blood pressure, myocardial infarcts, DCM

Page 67: Developmental Aspects of the Heart

  • Fetal heart structures bypassing pulmonary circulation explained

Page 68: Examples of Congenital Heart Defects

  • Various congenital defects with accompanying explanations

Page 69: Age-Related Changes Affecting the Heart

  • Changes include valve sclerosis, cardiac reserve decline, cardiac muscle fibrosis

Page 70: Congestive Heart Failure

  • Detailed mechanisms causing left and right heart failure described

Page 71: Coronary Artery Disease

  • Insufficient blood supply to heart muscle due to narrowed vessels, with treatment options

Page 72: Clinical Problems

  • Overview of conditions such as myocardial infarction, angina pectoris, and treatments

Page 73: By-pass Graft

  • Surgery process of grafting a vessel to bypass an obstruction

Page 74: Percutaneous Transluminal Coronary Angioplasty

  • Procedure elaborated: uses a balloon catheter to widen narrowed arteries.

Page 75: Artificial Heart

  • Information regarding advancements and function of artificial hearts.