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Pitt NUR 0013 - The heart

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NUR 0013 1st Edition Lecture 7 Outline of Current Lecture I. Anatomy and Blood flowa. General Considerationsi. Pulmonaryii. Systemicb. Hearti. General ii. Layers of the Heart iii. Chambersiv. Ventriclesv. ValvesCurrent LectureI. Anatomy and Blood FlowA. General Considerations Cardiovascular System - heart, blood vessels, and blood Heart is a double pump that pushes blood through 2 circuits at once.  Pulmonary – carries blood to and from the lungs . The right side of the heart receives oxygen- poor blood from the body ts and then pumps this blood to the lungs to pick up oxygen and dispel carbon dioxide. Systemic – carries blood to and from the all body ts. The left side of the heart receives the oxygenated blood returning from the lings and pumps this blood throughout the body to supply oxygen and nutrients to body tissue.  The circulatory system serves to bring fresh gases and nutrients to the tissues and to remove wastes from tissues, also important in transporting substances (e.g. hormones,antibodies).B. Heart – General Info, External Anatomy1. General Located in the middle mediastinum. These notes represent a detailed interpretation of the professor’s lecture. GradeBuddy is best used as a supplement to your own notes, not as a substitute. Usually about the size of a clenched fist.  Can increase to about double its size (athletes, pathology). Cone shaped, inferior narrow end is the apex, vessels exit the superior base. Muscle cells are bigger than skeletal muscle cells so they need less blood. Normal BP of 120/80 necessary to force blood through vessels and effect cellular exchange of gases, wastes, and nutrients.2. Pericardium - doubled walled sac that surrounds the heart Fibrous - tough CT outer covering, attached to the diaphragm by a central tendon. Serous –Outer parietal layer and inner visceral layer (epicardium). Secretes serous fluid, which allows the heart to beat in an almost frictionless environment. Inflammation of the pericardium is called pericarditis.3. Layers of the Heart Epicardium – single layer of epithelial cells, same as visceral pericardium. Myocardium – involuntary cardiac muscle cells  Endocardium – innermost lining of simple squamous cells, continuous with endothelium of blood vessels.C. Chambers and Vessels.1. Chambers and Valves 2 atria (mention auricles), 2 ventricles atria and ventricles anchored to the fibrous skeleton.  Atrioventricular groove  Anterior interventricular and posterior ventricular sulci Atria - 2 Right atrium- receiving chambers from the pulmonary circuit.  Left atrium -  Fossa ovalis – a small depression between the right and left atria. Was the foramen ovale in the fetus. Contraction is weak.Ventricles - 2 Right takes up much of the anterior surface. Left makes up most inferior and posterior portions. Trabeculae carnae -  Papillary muscles -  Right ventricle pumps into –  Left ventricle pumps into -- Fibrous Skeleton Tough fibrous connective tissue fibers that provide an anchor for cardiac muscle cells. Tend to be thicker in areas around great vessels and valve regions. Limits the spread of AP’s within the heart.Valves Atrioventricular valves  Tricuspid - right side Bicuspid (mitral) -left side Each flap attached to ventricle wall by chordae tendinae, which is a strong collagen-like cord that attaches from the valve to the papillary muscle. AV valves are open when ventricles are at rest. They close when ventricles fill with blood.  The papillary muscles contract just before the ventricles do, and the tension they exert on the chordae tendinae keep the valves closed throughout ventricular contraction (see ppt slide). Semilunar valves  Pulmonary – RV to pulmonary trunk Aortic – LV to aorta Blood flowing out forces them open and then blood falling back on their upturnedumbrella-like flaps causes them to close.2. Blood Flow through the Heart Right SideIVC, SVC, Coronary Sinus  Right atrium  Tricuspid valve  Right ventricle  Pulmonary semilunar valve  Pulmonary trunk/arteries ↓ Lungs (pulmonary capillaries)↓ Left SidePulmonary veins  Left atrium  Bicuspid valve  Left ventricle  Aortic semilunar valve  Aorta. Remember that even though blood flow through the heart is presented in a sequence, both sides pump at the same time and they pump approximately the same amount of blood with each beat. The cardiovascular system is a closed system; there is roughly the same amount of blood in each circuit all the


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