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Chap. 19– The Heart (Cardiology)

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  1. Chap. 19– The Heart (Cardiology)

  2. Chap. 19 (Heart) Study Guide Critically read Chapter 19 pp. 719-739 before 19.5 “Blood Flow” section Comprehend Terminology (those in bold) Study-- Figure questions, Think About It questions, and Before You Go On (section-ending) questions Do Testing Your Recall— 1, 2, 4-8, 11-19 Do True or False– 1-4, 7, 9-10 Do Testing Your Comprehension-- #1 2

  3. What are you going to do with your heart? • “The best and most beautiful things in the world cannot be seen or even touched—they must be felt with the heart.” --Hellen Keller • “Happiness comes only when we push our brains and hearts to the farthest reaches of which we are capable.” --Leo C. Rosten

  4. I. Overview of cardiovascular system

  5. § Introduction • The circulatory system— • Three component: the pump, the passageway, and the transport medium • What are they respectively? • The pump-- • The passageway-- • The transport medium--

  6. § Two circuits in the cardiovascular system (1) • Pulmonary circulation— • Function? • The route? • R. ventricle  Pulmonary arteries  Lungs  Pulmonary veins  L. atrium Figure 19.1

  7. Lungs Pulmonary circulation Pulmonary capillaries Pulmonary veins Pulmonary arteries = O2-poor blood = O2-rich blood Right side of heart

  8. § Two circuits in the cardiovascular system (2) • Systemic circulation— • Functions? • The route? (Students work on it.) • Starts which chamber of the heart?Major vessels? Destinations?Two major veins?Ends at which chamber of the heart? Fig. 19.1

  9. Systemic circulation Left side of heart = O2-poor blood = O2-rich blood Systemic veins Systemic arteries Systemic capillaries Organ systems

  10. II. Gross anatomy of the heart

  11. § Shape and size of the heart • Base – broad superior portion • Apex - inferior end (a blunt point) • 3.5 in. wide at base, 5 in. from base to apex, and 2.5 in. anterior to posterior • weighs 10 oz (300 gram; size of your fist) Fig. 19.2

  12. Aorta Superior vena cava Base of heart Apex of heart Next Topic Diaphragm

  13. § Heart Position (1)

  14. § Heart Position (2)

  15. § Heart Position (3)

  16. § Pericardial sac (pericardium) -1 • Def. the double-walled, membranous covering that encloses the heart • Function– Friction free • Peircardial fluid— Figure x Cardiac Disorders here (Table 19.3): • Pericarditis– inflammation here • Pericardial effusion– fluid in pericardial cavity • Cardiac tamponade– accumulation of fluid here

  17. Figure x Pericardial cavity Heart

  18. § Pericardial sac (pericardium) - 2 • Parietal pericardium– 2 SUBLAYERS • A-outer, tough/fibrous layer (CT) + B-deep thin serous layer– turns inward . . . forms #2 below • Visceral pericardium (a.k.a. epicardium of heart wall) • INNER, thin, smooth, moist serous layer • covers heart surface • Pericardial cavity: between 1 + 2 above • filled with ____________________ Fig. 19.3

  19. Functions? 3 1 2

  20. § Heart Wall (from outermost layer) • Epicardium(a.k.a. visceral pericardium) • serous membrane covers heart • Myocardium • thick muscular layer • fibrous skeleton - network of collagenous and elastic fibers (special section for this one) • Endocardium - smooth inner lining • What type of epi.? Simple _________ epi. • Continuous with endothelium cells . . . Fig. 19.3

  21. 2 3 1

  22. § Fibrous skeleton of the heart (1) • What is it? Four CT rings fuse with . . . • Structure details– Four fibrous rings, surrounds the 4 valves; in sheets of tissue that interconnect these rings • Location? In the walls between … Figure 19.8

  23. (Rear) Fibrous skeleton including fibrous rings Right AV valve Left AV valve Aortic valve Pulmonary semilunar valve Ventricular myocardium (Front)

  24. § Fibrous skeleton of the heart (2) Functions– • 1. Structure support-- firm base of the heart valves and openings of great vessels • 2. It anchors the cardiac muscle • 3. An electrical insulator: • Separate the atria from the ventricles and direct A.P. to specific pathways

  25. Checkpoint Questions • Does most of the heart lie to the right or left of the median plane? • Name, in order, the three layers of the heart wall beginning with the outermost layer.

  26. § Heart Chambers • 4 chambers— • A. right and left ATRIA • auricles? Ear-like structures . . . • B. right and left VENTRICLES • 3 sulci (grooves)— on the surface • Largely fat and coronary blood vessels • A. Atrioventricular (coronary) sulcus- • B+C. Anterior and posterior interventricular sulci Figure 19.5 a+b

  27. Coronary sulcus? Anterior view

  28. Posterior view

  29. § Heart Chambers – Internal (Fig. 19.7) • Interatrial septum • wall that separates atria • Pectinate muscles • internal ridges of myocardium in right atrium and both auricles; (@ absorber) • Interventricular septum • wall that separates ventricles • Trabeculae carneae • internal ridges in both ventricles (@ absorber) Wave/sound absorber

  30. Checkpoint Questions • Which heart chamber has the thickest walls? What is the significance of this structural difference? • Do the atrial pectinate muscles more nearly resemble the ventricular papillary muscles or the trabeculae carneae?

  31. § Heart valves (1) • Two atrioventricular (AV) valves— • A. Right AV valve– also called the tricuspid valve • B. Left AV valve– also called . . . • Function-- blood from the atria to ventricles . . . Figure 19.8 (a,b)

  32. Aorta Pulmonary artery Superior vena cava Pulmonary valve Pulmonary veins Left atrium Pulmonary veins Left AV valve Right atrium Aortic valve Chordae tendineae Right AV valve Papillary muscle Left ventricle Right ventricle Interventricular septum Inferior vena cava Superior views of these valves – next slide

  33. Right AV valve Left AV valve Aortic/pulmonary valve

  34. Heart valves (2) • Chordae tendineae— • Structure– • Fibrous cords anchor the cusps to the ventricle walls via papillary muscles • Function– • Prevent valves from being _________ Figure 19.7, 19.8

  35. Right atrium Chordae tendineae Right AV valve Direction of backflow of blood Septum Right ventricle Papillary muscle

  36. Right AV valve seen from within the right ventricle

  37. § Heart valves (3) • Semilunar valves include: One ______ valve and one __________ valve • Where are they located respectively? • Major arteries leave the ventricles • How to prevent them from everting? • Anatomical structure— leakproof “seam” • Function– (of all valves) • Ensure unidirectional flow of blood Figure 19.7 and Fig. Z

  38. Next slide Aorta Pulmonary artery Superior vena cava Pulmonary valve Pulmonary veins Left atrium Pulmonary veins Left AV valve Right atrium Aortic valve Chordae tendineae Right AV valve Papillary muscle Left ventricle Right ventricle Interventricular septum Inferior vena cava

  39. (Pulmonary trunk or Aorta) Direction of backflow of blood Leakproof “seam” Aortic valve (Right or Left Ventricle)

  40. § Valve Mechanics (Fig. 19.9, 19.19) Ventricles filling & isovolumetric contraction • AV valves open (semilunar valves close); blood flows from atria to ventricles (v. fillings) • AV valves open/closed (circle one)—S1 • ventricle pressurecontinuestorise • Momentarily before ventricle ejection Ventricles ejection & isovolumetric relaxation • semilunar valves open (AV valves close); • ventricle ejection; ventricle pressuredrops • semilunar valves open/closed (circle one)—S2 • Isovolumetric relaxation

  41. Operation of Atrioventricular Valves S1

  42. Operation of Semilunar Valves S2

  43. Before You Go On (p. 730) • Reminder: Remember to go over each question of Before You Go On in the text. • P. 730– Trace the flow of blood through the heart, naming each chamber, valve, and the great vessels in order (from the superior vena cava to the aorta). Do it yourself. Fig. 19.9 is a great figure to help you with this. \

  44. Figure 19.10 Fig. 19.9 Pathway of blood flow through the heart

  45. III. The Coronary Circulation

  46. § Coronary arteries Right C.A. Left C.A.

  47. § Coronary Arterial Supply • 1. Left coronary artery (LCA)– 2 branches • 1A--anterior interventricular branch • supplies blood to interventricular septum and anterior walls of both ventricles • 1B--circumflex branch (Fig. 19.10 a+b) • passes around left side of heart in coronary sulcus, supplies left atrium and posterior wall of left ventricle; it gives off a left marginal branch (1C) • 2. Right coronary artery (RCA)– 2 branches • 2A--right marginal branch • supplies lateral side of R atrium and ventricle • 2B--posterior interventricular branch • supplies posterior walls of ventricles

  48. 1B 2A 1A

  49. 1B 1C 2A 2B