Heart

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What is the heart?
-Muscular organ
-Function is to pump blood to two different circulations
-A four chamber pump
-2/3 of the heart sits on the left side of the body
How many chambers are there in the heart?
Four
What are the two upper chambers of the heart?
Left and right atrium
What are the two lower chambers of the heart?
Left and right ventricles
What carries blood away from the heart?
Arteries
What carries blood to the heart?
Veins
What is systemic circulation?
-Blood supply from the heart to the rest of the body
-The left side of the heart
What is the pulmonary circulation?
-Blood supply from the heart to the lungs
-The right side of the heart
What does the left side of the heart carry?
Oxygenated blood
What does the right side of the heart carry?
Deoxygenated blood
What is the mediastinum?
Where is it found?
-The cavity within the thoracic region that the heart sits
-The middle of the right and left lung
-Lungs sit on either side of it
Where is the heart located?
-Sitting posterior to the sternum
-Within the thoracic wall
-Mediastinum
What is the apex of the heart? Where is it located?
-Surface projection of the major vessels & heart
-Pointed portion of the heart
-Posterior to the 5th intercostal space
What is base of the heart?
-Blunt rounded portion of the heart
-Consisting mainly of the left atrium
What is the Sternal Angle?
-Elevation between the manubrium and the body of the sternum.
-AKA Manubriosternal joint (joint between manubrium and sternum) or Angle of Louis
-Serves as a guide to the second rib and the location of inter-coastal spaces
Landmarks of the sternal angle?
-Intervertebral disk between T4 and T5 vertebrae
-Arch of the aorta
-Carina of the trachea (Where the trachea splits. Bifurcation of the trachea, right and left bronchus)
What are the parts of the aorta?
-Ascending Aorta
-Arch
-Descending Aorta
What does the superior vena cava supply blood to? (Deoxygenated Blood)
-Head
-Neck
-Thorax
-Upper extremities
What does the inferior vena cava supply blood to? (Deoxygenated Blood)
-Pelvis
-Abdomen
-Perineum (Inferior to the pelvis)
-Lower extremities
What does the ascending aorta supply oxygenated blood to?
Out to the body
What does the pulmonary trunk (Artery) supply deoxygenated blood to?
Away from the (right ventricle) heart to the lungs
What does the pulmonary veins supply oxygenated blood to?
From the lungs to the left atrium (Heart)
What is the coronary sinus?
Main vessel that carries venous blood from the heart muscle to the right atrium (Deoxygenated blood)
What is the pericardium?
-Double layer sac that the heart sits in
-Can be considered three layer sac because of the breakdown of serous pericardium
What are the layers of the pericardium?
-The fibrous pericardium (Outer Layer)
-Serous pericardium (Inner Layer)
further divides into:
-Parietal pericardium (close to the fibrous layer)
-Visceral pericardium (close to the heart)
What is between the parietal pericardium and visceral pericardium?
-The pericardial cavity filled with pericardial fluid
-It also acts as a shock absorber to reduce friction with the movement of the heart
What are the walls of the heart? Out to In
-Epicardium (Visceral Pericardium)
-Myocardium (Muscle Layer)
-Endocardium (Lines the chambers)
What is the auricle?
The reservoir for excess blood
What is the coronary sulcus anteriorly?
-Anterior atrio-ventricular sulcus
-Divides the right atrium and right ventricle
What is the anterior inter-ventricular sulcus?
Divides the right ventricle and left ventricle anteriorly
What is the coronary sulcus posteriorly?
-Posterior atrio-ventricular sulcus
-Divides the left atrium and left ventricle
What is the posterior inter-ventricular sulcus?
Divides the right ventricle and left ventricle posteriorly
What do the coronary arteries branch from?
The ascending aorta
What are the branches of the right coronary artery?
-SA nodal Artery
-Marginal Artery
-Porterior inter-ventricular artery (PAD)
What are the branches of the left coronary artery?
-Circumflex Artery
-Anterior inter-ventricular artery (LAD)
Which artery is the widow maker? (Commonly clotted in heart attacks)?
Anterior inter-ventricular artery (LAD)
What houses the posterior inter-ventricular artery? (PAD)
Posterior inter-ventricular sulcus
What houses the anterior inter-ventricular artery? (LAD)
Anterior inter-ventricular sulcus
What houses the right coronary artery?
Anterior atrio-ventricular sulcus
What houses the circumflex artery?
Posterior atrio-ventricular sulcus
What are the four cardiac veins?
-Anterior cardiac vein
-Small cardiac vein
-Great cardiac vein
-Middle cardiac vein
What is the function of the cardiac veins?
Venous drainage of the musculature of the heart that drain into the coronary sinus and enter the right atrium BESIDES the anterior cardiac vein which drains directly into the right atrium
What artery runs next to the small cardiac vein?
Right Marginal Artery
What artery runs next to the great cardiac vein?
Anterior inter-ventricular artery (LAD)
What artery runs next to the middle cardiac vein?
Posterior inter-ventricular artery (PAD)
What are the internal structures of the right atrium?
-Opening for SVC, IVC and coronary sinus
-Pectinate muscles (Wall of the heart)
-Crista Terminalis
-Fossa Ovalis (Located in interatrial septum)
-Cusps of Tricuspid Valve
Where is the pectinate muscle only found?
Atrium
What is the fossa ovalis?
-Depression
-Fetal reminant that closes upon birth
What are the internal structures of the right ventricle?
-Papillary muscles (3)
-Moderator band (connects inter-ventricular septum to papillary muscle)
-Chordae tendinae (connect to papillary muscle)
-Pulmonary Semilunar Valve
What is the moderator band?
-Speeds up impulse
-Located only in the right ventricle
What are the internal structures of the left atria?
-Openings for pulmonary veins
-Pectinate muscles
-Bicuspid Valve (AKA Mitral valve or Left Atrio-ventricular valve)
What are the internal structures of the left ventricle?
-Chordae tendinae
-Papillary muscles (2)
What is the conus arteriosus?
Where there pulmonary trunk originates
What valve separates the right atrium and the right ventricle?
Tricuspid valve (Right Atrio-ventricular valve)
What valve separates the right ventricle from the lungs?
Pulmonary semilunar valve
What valve separates the left atrium and the left ventricle?
Bicuspid valve (AKA Mitral valve or Left Atrio-ventricular valve)
What separates the left ventricle from the ascending aorta?
Aortic semilunar valve
Which wall of the heart is thicker and why?
The left ventricle's wall is thicker than the right because the left ventricle supplies the pressure for systemic blood (to deliver blood to the systemic circulation) while the right ventricle supplies the pressure for pulmonary blood flow
What is the blood route to the heart?
1. Deoxygenated blood enters the right atrium from Superior Vena Cava and Inferior Vena Cava and Coronary Sinus
2. Goes through tricuspid valve (Right Atrio-ventricular valve) into right ventricle
3. Blood goes from the right ventricle through the pulmonary semilunar valve to the pulmonary trunk
4. Blood goes through the right and left pulmonary arteries and into the lungs
5. Oxygenated blood enters left atrium via pulmonary veins
6. Blood goes through the bicuspid valve and enters the left ventricle
7. Blood goes from the left ventricle through the aortic semilunar valve to the ascending aorta
8. Out to systemic circulation as oxygenated blood through the ascending aorta
What maintains blood flow in one direction?
Valves between the atria and ventricles and in the pulmonary trunk and aorta (Opening and closing of valves)
Systole
Means contraction of the ventricles
What occurs during systole?
Atrio-ventricular Valves (AV) shut Aortic & Pulmonary valves (semilunar) are open (Blood goes to vessels)
Diastole
Means relaxation of the ventricles
What occurs during diastole?
Atrio-ventricular Valves (AV) open and Aortic & Pulmonary (semilunar) shut (Blood goes into coronary arteries)
True/False? The pulmonic valve contains openings for the coronary arteries?
-False
-Only the aortic valve contains openings for the coronary arteries
What are the landmarks of valve sounds?
-Aortic
Right second inter-coastal space close to sternum
-Pulmonic
Left second inter-coastal space close to sternum
-Tricuspid
Left fifth inter-coastal space close to sternum
-Mitral
Left fifth inter-coastal space at the apex point
What is the conducting system of the heart?
-Sequence of impulse in the heart
-The way Action Potential travels
-SA Node -->AV Node-->AV Bundle-->Right and Left Bundle Branches-->Apex Area of Heart
-Via the purkinjie fibers which make up the terminal part of the heart conducting system
What does the conducting system of the heart do?
-Ensures that ventricular contraction of the heart begins in the apex area of the heart and from there a wave of cardiac muscle contraction spreads to the base of the heart
-The heart is most efficient in expelling blood when the wave of contraction spreads from the apex to the base of the heart