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BASICS OF THE HEART. Katee Beaudry MS 2 – Penn State University College of Medicine kmatthews@hmc.psu.edu. Learning Objectives. To understand the basic anatomy of the heart. To understand blood flow through the heart and lungs. To understand the basic physiology of the heart.

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Basics of the heart

BASICS OF THE HEART

Katee Beaudry

MS 2 – Penn State University College of Medicine

kmatthews@hmc.psu.edu


Learning objectives
Learning Objectives

  • To understand the basic anatomy of the heart.

  • To understand blood flow through the heart and lungs.

  • To understand the basic physiology of the heart.

  • To understand the basics of heart murmurs.


Vocabulary
Vocabulary

  • Oxygenated blood – blood that has a lot of oxygen in it.

  • Deoxygenated blood – blood that does not have a lot of oxygen in it.

  • Systole – contraction

  • Diastole – relaxation

  • Arteries – carry oxygenated blood to tissues

  • Veins – carry deoxygenated blood from tissues

  • EXCEPTION – the pulmonary circulation



Right atrium
Right Atrium

  • Blood from the upper extremities and head empties into the right atrium through the Superior Vena Cava (SVC).

  • Blood from the lower extremities and abdomen empties into the right atrium through the Inferior Vena Cava (IVC).

  • Blood passes through the tricuspid valve to enter the right ventricle.


Right ventricle
Right Ventricle

  • Blood enters the right ventricle through the tricuspid valve.

  • Blood leaves the right ventricle through the pulmonary semi-lunar valve and enters the pulmonary trunk


Pulmonary circulation
Pulmonary Circulation

  • The pulmonary trunk splits into the left and right pulmonary arteries.

  • These carry deoxygenated blood to the lungs.

  • The blood then passes through pulmonary capillaries, where the blood is oxygenated.

  • Oxygenated blood is carried back to the heart by 4 pulmonary veins.


Left atrium
Left Atrium

  • Oxygenated blood from the lungs enters the left ventricle via the pulmonary veins.

  • Blood passes through the bicuspid valve and enters the left ventricle.


Left ventricle
Left Ventricle

  • Once oxygenated blood passes through the bicuspid valve it enters the left ventricle.

  • Oxygenated blood leaves the left ventricle through the aortic semi-lunar valve and enters the aorta.

  • The aorta takes oxygenated blood to the rest of the body.


Blood flow review
Blood Flow Review

  • SVC and IVC to right atrium.

  • Tricuspid valve

  • Right ventricle

  • Pulmonary semi-lunar valve

  • Pulmonary Trunk

  • Pulmonary arteries

  • Pulmonary capillaries

  • Pulmonary veins

  • Left atrium

  • Bicuspid valve

  • Left ventricle

  • Aortic semi-lunar valve

  • Aorta


Heart wall and pericardium

HEART WALL

Endocardium – in contact with blood

Myocardium – heart muscle (cardiac muscle)

Epicardium – most outer layer

PERICARDIUM

Sac surrounding the heart.

Visceral (on the heart) and parietal layers

Secretes pericardial fluid to lubricate the heart.

Heart Wall and Pericardium


Septa
Septa

  • Septa separate the right and left sides of the heart to make sure that oxygenated and deoxygenated blood do not mix.

  • Atrial Septum – separates the right and left atria (contains the fossa ovalis).

  • Ventricular Septum – separates the right and left ventricles.


Heart valves
Heart Valves

  • Review:

    • Tricuspid valve – between the right atrium and right ventricle.

    • Pulmonary semi-lunar valve – between the right ventricle and pulmonary trunk.

    • Bicuspid valve – between the left atrium and left ventricle.

    • Aortic semi-lunar valve – between the left ventricle and aorta


Function of heart valves
Function of Heart Valves

  • Valves prevent the backflow of blood in the heart.

  • The AV valves prevent blood from moving from the ventricles back into the atria.

  • The semi-lunar valves prevent blood from moving from arteries (aorta and pulmonary trunk) back into the ventricle.


1 st heart sound
1st Heart Sound

  • 1st Heart Sound – referred to as “Lubb”

    • This sound occurs during ventricular systole (contraction).

      • The ventricles contract (generating pressure in the ventricles), which pushes open the semi-lunar valves.

      • When the ventricles contract, the AV (tricuspid and bicuspid) valves close due to the increased pressure in the ventricles as opposed to the atria.

      • The closing of the AV valves results in blood hitting them, causing the first heart sound.


2 nd heart sound
2nd Heart Sound

  • 2nd Heart Sound – referred to as “Dupp”

    • This sound occurs during ventricular diastole (relaxation).

    • When the ventricles relax, the pressure in the arteries is greater than that in the ventricles, and the semi-lunar valves close.

    • When the semi-lunar valves close, blood hits them causing the characteristic “Dupp” sound.


Murmurs
Murmurs

  • Murmurs are “extra” heart sounds heard.

  • They are due to insufficiencies in the heart valves causing leakage of blood.

  • There are two types of murmurs:

    • Sysolic murmurs

    • Diastolic murmurs


Systolic murmurs
Systolic Murmurs

  • These murmurs occur during ventricular contraction.

  • The AV (tricuspid or bicuspid) valves are leaky and SOME blood flows backward, from the ventricles to the atria.

  • Lubb swooooosh Dupp


Diastolic murmurs
Diastolic Murmurs

  • These “extra” heart sounds occur during ventricular relaxation.

  • The semi-lunar valves are leaky and allow SOME blood to flow backwards, from the artery (aorta or pulmonary trunk) back into the ventricle.

  • Lubb Dupp Swooooooosh


Cardiac physiology
Cardiac Physiology

  • The job of the heart is to move blood through the body.

  • Moves deoxygenated blood to the lungs to pick up oxygen and pushes oxygenated blood to the rest of the body tissues.


Cardiac pathology
Cardiac Pathology

  • If there is a problem involving blood flow through the heart, less oxygen will get to the tissues that desperately need it.

  • The cardiovascular system will respond by increasing the pulse, blood pressure, respiratory rate, etc.

  • The individual will feel tired, have a lack of energy and will be short of breath with minimal exertion.


Clinical pearl

How to listen to someones heart….

All People Take Money

A – aortic semi-lunar valve

P – Pulmonic semi-lunar valve

T – tricuspid valve

M – mitral (bicuspid) valve

Clinical Pearl!


So how well do you know the heart
So, How Well Do You Know the Heart?

  • What artery carries deoxygenated blood?

  • What structures separate the right and left sides of the heart?

  • When blood leaves the right side of the heart, where does it go?

  • What causes a heart murmur?

  • What does a systolic murmur sound like?


References
References

  • Lilly, L.S. Pathophysiology of heart disease. Lippincott Williams & Wolters Kluwer Business, 2007. P.39-43.

  • Martini, F.H. Fundamentals of anatomy and physiology. Pearson Benjamin Cummings. 2004. P. 682-716.