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Anatomy of the Heart
Pericardium : The outer Layer
Myocardium : The middle layer/heart muscle
Endocardium : The innermost layer
Right Atrium : Right upper chamber
Left Atrium : Left upper chamber
Right Ventricle : Right lower chamber
Left Ventricle : Left lower chamber
Tricuspid Valve : Between the RA and the RV
Mitral Valve : Bicuspid valve located between the LA
and the LV
Pulmonary Semilunar Valve : Between the RV and the
Lungs
Aortic Semilunar Valve : Between the LV and the Aorta
Physiology of blood flow through the Heart
SVC : Drains blood from the head, upper extremities
and chest to the RA
IVC : Drains blood from the lower extremities and
pelvis and abdomen to the RA
PA : Brings blood from the RV to the Lungs
PV : Brings blood from the Lungs to the LA
Aorta : Largest artery bringing the blood from the LV
to the rest of the body
Coronary Arteries : Supply blood to the heart tissue
Coronary veins : Drain blood from the heart into the
coronary sinus which
drains into the right
atrium
Anatomy & Physiology of the Conduction System of the Heart
SA : Pacemaker in the upper wall of RA initiating the heartbeat
AV node : Under the endocardium of the RA sending impulses from the SA node to the Bundle of His
Bundle of His : AV bundle sending impulses from the AV node to the Purkinje fibers through the RBB and the LBB
RBB + LBB : In the septum
Purkinje Fibers : Within the walls of the ventricles causing the ventricles to contract
Cardiac cycle
During relaxation/diastole the chambers fill up with
blood
During contraction/systole the chambers forcefully
move the blood out
During diastole the RA receives blood from the SVC
+ the LA receives blood from the PV. At the same
time the Ventricles are in systole. The RV ejects the
blood into the PA and the LV ejects the blood into the
Aorta
Heart sounds
Closure of the A-V valves produces the 1st heart sound
Closure of the Semilunar valves produces the 2nd heart
sound
Anatomy of the Arteries
Elastic tubes that expand with pressure (during
contraction of the heart). Composed of the tunica
externa/adventitia, tunica media and the tunica intima
Arterioles - Capillaries - Venules
Arterioles : Tunica adventitia, media and intima
Capillaries : Endothelium
Venules : Tunica adventitia, media and intima
Veins
Thin-walled vessels with low pressure. Contain valves
preventing backflow of blood. Composed of tunica
externa/adventitia, tunica media and tunica intima
Venipuncture/phlebotomy : Incision of a vein to draw
blood for examination
Physiology of the blood vessels circulation
Arteries : Carry the blood away from the aorta
Arterioles : Smaller vessels carrying the blood away from the arteries to the capillaries
Capillaries : Smallest vessels where the nutrients and oxygen leave the blood and go into the cells. The waste products and carbon dioxide from the cells pass through the capillaries into the bloodstream
Venules : Larger than the capillaries but as small as the arterioles carrying the blood filled with waste products away. Also carry the blood filled with nutrients from the small intestine to the hepatic vein. Carry the blood filtered though the kidneys to the hepatic vein
Veins : Larger than the venules carrying the blood from the upper part of the body to the SVC and from the lower part of the body to the IVC
Obtaining a pulse
Radial Artery : Lateral wrist + proximal to the thumb
Apex of the heart : 5th intercostal space
Brachial Artery : Antecubital space of the elbow or
between the biceps and triceps muscle
Carotid artery : Lateral neck
Temporal Artery : Temple
Femoral Artery : Inguinal
Popliteal Artery : Posteromedial (knee)
Dorsalis Pedis Artery : Upper surface of the foot
Anterior Tibial Artery : Medial side of the ankle
Blood Pressure
Determined by the force exerted by the blood on the
walls of the arteries, the amount of blood pumped, the
size and the flexibility of the arteries
Measured in the arm (brachial artery) using the
sphygmomanometer
1st korotkoff sounds and last korotkoff sounds heard
through the stethoscope
N° BP : 120/80 mmHg
Pulmonary Circulation
Heart
Pulmonary Artery
Pulmonary arterioles
Pulmonary capillaries
Pulmonary venules
Pulmonary vein
Blood
Composed of cells : -Erythrocytes/RBC
(45%) Male (4.3-5.9 million/mm³)
Female (3.5-5.5 million/mm³)
-Leukocytes/WBC
(4500-11,000/mm³)
-Thrombocytes/Platelets/clotting
cells (150,000-400,000/mm³)
and of plasma : -Fluid Portion
(55%)
Erythrocyte : Biconcave. No nuclei. Made up of
Hemoglobin (protein & iron). Hb Carries oxygen
from the lungs to the cells and carbon dioxide from
the cells to the lungs. Produced in the bone marrow
Leucocyte : Larger. Contains a nucleus. Has to be
stained to be seen. Fight infection. Categorized as
granulocyte or agranulocyte.
Granulocytes : Basophils, Eosinophils and
Neutrophils have granules in their cytoplasm
Basophils Eosinophils Neutrophils
Agranulocytes : Monocytes and Lymphocytes T and
B do not have granules in their cytoplasm
Monocytes Lymphocytes
Thrombocytes : Smaller than the RBC and WBC.
Control the loss of blood by congregating to form a
clot (coagulation) at the site of injury
Functions of the blood
Transportation : -Oxygen from the lungs to the cells
-Carbon dioxide from the cells to the lungs
-Nutrients from the digestive tract to the
cells
-Hormones from the endocrine glands
to the cells of each organ
-Waste materials from the cells to the liver
to be excreted in the feces through the bile and to the
kidney to be eliminated in the urine
Regulation : -Body Temperature
(vasodilation vs vasoconstriction)
-Water and salt balance
-pH balance
-Blood loss with coagulation
Defense : -Neutrophils and Monocytes phagocyte
(destroy the germ)
-Lymphocytes B secrete antibodies that
attach to the germ before it is phagocytized
-Lymphocytes T attack directly the germ
Blood Types
Type A : Type A antigen on the RBC and anti-B
antibody in the plasma
Type B : Type B antigen on the RBC and anti-A
antibody in the plasma
Type AB : Both A and B antigens on the RBC and no
anti-A or anti-B antibodies in the plasma
Type O : No A or B antigens on the RBC but anti-A
and anti-B antibody in the plasma
The Rhesus Factor/Rh+ : Antigen on the RBC.
Pregnant woman without the antigen(Rh-) whose
fetus’ RBC has the antigen(Rh+) will develop
antibodies against the antigen. During the next
pregnancy the antibodies will attack the RBC of the
fetus and the fetus will become anemic and may die
In general, Rh negative blood is given to Rh-negative
patients, and Rh positive blood or Rh negative blood
may be given to Rh positive patients.
The universal red cell donor has Type O negative
blood type
The universal plasma donor has Type AB positive
blood type.
The lymphatic System
Lymphatic vessels : Transport excess fluids away
from the interstitial space (in-between the cells) into
the bloodstream. Contain valves that prevent
backflow which leads to edema
Lymphatic nodes : Filter out and trap bacteria,
viruses, cancer cells, destroyed pathogens and
unwanted substances
Common disorders associated with the circulatory System
Iron-deficiency Anemia : Low iron level leading to
low hemoglobin production
Pernicious Anemia (Vit-deficiency Anemia) : Lack of
secretion of intrinsic factor from the stomach causing
vitamin B12 not to be absorbed. Leads to macrocytic
anemia and glossitis (swollen red tongue), neuropathy
etc..
Hemolytic Anemia : Premature destruction of RBCs
by antibodies produced by the immune system
Sickle cell Anemia : Hemoglobin S disease with a
sickle-shaped RBC in people of African origins
Aplastic Anemia : Failure of the bone marrow to
produce the blood cells. The bone marrow is replaced
with fat cells
Aneurysm : Abnormal widening of a portion of an
artery because of weakness in the vessel wall
Atherosclerosis : Buildup of plaque(fatty acids) in the
wall of the artery. May lead to the narrowing of the
lumen and hardening (arteriosclerosis) of the vessel.
Leading cause of coronary artery disease(CAD)
Cerebrovascular accident : Stroke resulting from a
complete interruption of blood flow to the brain by a clot
(Thrombotic/Embolic Stroke) or a ruptured blood vessel
(Hemorrhagic Stroke)
Cardiac Tamponade : Congestion of the heart muscle
and restriction of heart movement caused by blood or
fluid trapped in the pericardial sac
Cardiogenic Shock : Collapse of the cardiovascular
system resulting from vasodilation and fluid shifting
away from the heart
Pericarditis : Inflammation of the pericardium
Myocarditis : Inflammation of the myocardium
Endocarditis : Inflammation of the endocardium
Cor Pulmonale : Lung disease blocking the flow of
blood from the right ventricle to the lungs. Results in
an enlargement of the RV
Myocardial Infarction : Infarction/death of heart
tissue because of severe reduction or absence of
supply of blood to an area of the myocardium
Hemophilia : Hereditary deficiency of clotting factors
most frequently in male
Pre-Hypertension : BP from 120/80 – 139/89
Hypertension : BP>140/90
Hypotension : BP <90/60
Transfusion Reaction : When the blood type
transfused to a patient is incompatible with the
patient’s blood type causing an agglutination of the
patient’s RBC
Mitral Stenosis : Mitral valve disease/calcification
causing the valve to narrow not able to open up
sufficiently when blood enters the RV
Mitral Valve Prolapse : Mitral valve is above its
normal location between the atrium and the ventricle
causing the leaflets to go all the way into the atrium
rather than get close to each other horizontally at the
end of the ventricular contraction
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