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4/25/16 Chapter 18 – The Heart “Do What do we already know? you love me with all your heart?” “My heart doesn’t love you at all. It’s a chunk of muscle that pumps blood” What is the heart? • If you had only one word to describe the heart? – Pump • Two words? – Pumping Muscle • Three words? – Chambered Pumping Muscle Big Idea: Function • Why does your heart pump?? Transport! • • • • • • Nutrients O2, CO2 Waste Heat Hormones Immune Cells But more on that LATER… BI: Size & Shape (Gross Anatomy) • Size: – Double fist (adult) , fist (child) BI: Location (Gross Anatomy) • Location: – Not where you put your hand • Mass: – 250-350 grams (<1#) • Shape: – Cone shaped (heart shaped!) 1 4/25/16 Location • • • • • • • • • Medial anterior portion of chest 5 in long Between 2nd-5th ribs Behind the sternum Between the lungs Base à R shoulder Apex à L Hip Sits on diaphragm Point of Maximal Intensity – Apex contacts chest wall – Can best feel heartbeat – Around left nipple Location • • • • • • • • • Medial anterior portion of chest 5 in long Between 2nd-5th ribs Behind the sternum Between the lungs Base à R shoulder Apex à L Hip Sits on diaphragm Point of Maximal Intensity – Apex contacts chest wall – Can best feel heartbeat – Around left nipple Location • Mediastinum Cavity BI: Coverings (Gross Anatomy) Pericardium • Think back!! • Peri= • Cardi = • Double-walled sac • Keeps things friction-free Coverings Pericardium • Double-walled sac • Keeps things friction -free Ø Fibrous Pericardium attaches & anchors Ø Serous Pericardium slippery liner Coverings Pericardium • Double-walled sac • Keeps things friction -free Ø Fibrous Pericardium attaches & anchors Ø Serous Pericardium slippery liner • Parietal Layer (Serous) lines fibrous pericardium • Parietal Layer (Serous) lines fibrous pericardium • Pericardial Cavity serous fluid • Pericardial Cavity serous fluid • Visceral Layer (Serous) lines outside of heart = pericardium • Visceral Layer (Serous) lines outside of heart = pericardium Peri = around Cardi = heart 2 4/25/16 BI: Heart Wall (Gross Anatomy) Ø Epicardium Epi = upon; Cardi = heart • = visceral pericardium! Ø Myocardium Myo = muscle • What kind of muscle?? • Bulk of heart • Bundles of muscle are arranged in spiral and circular patterns Review / Draw It Pericardium Ø Fibrous Pericardium Ø Serous Pericardium • Parietal Layer Ø Epicardium Heart Wall Ø Myocardium Ø Endocardium • Pericardial Cavity • Visceral Layer Ø Endocardium Endo = inside • Squamous Epithelial & Connective Tissue • Lines • All heart chambers • Continuous with lining of all veins/arteries coming in and out of the heart …Review… • What cavity is the heart located in? – Mediastinum • What is the covering of the heart called? – Pericardium • What are the three layers/components of the visceral serous pericardium? …Review… • What layer of the pericardium functions to attach and anchor? – Fibrous Pericardium • What is the point of maximal intensity and where is it located? – Parietal Layer, Pericardial Cavity, Visceral Layer What is the heart? • A blood-pumping muscle – How does a garden waterfall work? • A pump creates pressure to move the water – How does a hair spray can work? • Fluids move from high pressure to low pressure The Heart • The heart creates and maintains a pressure gradient – High hydrostatic pressure to move blood out of the heart – Low hydrostatic pressure to allow blood into the heart • Chambers, valves, veins and arteries all work together to create and maintain the pressure gradient 3 4/25/16 Big Idea: Internal Heart Structure Internal Heart Structure • Heart chambers are separated by 4 valves • Divided into 2 parts by an inner septum • 4 chambers • Atrium = top 2 – Mitral (bicuspid) • L At / L Vt – Tricuspid – Low pressure – Thin walls – Receiving chambers • R At / R Vt – Pulmonary Semilunar • R Vt / Pulmonary Artery • Ventricle = bottom 2 – Aortic semilunar – High pressure – Thick walls – Discharging chambers Valves • Allow blood to enter but not exit chambers Ø Atrioventricular Valves Mitral & Tricusupid Ø Semilunar Valves Pulmonary & Aortic Semilunar Valves Ø Aortic Semilunar & Pulmonary Semilunar • Guard bases of the aorta and pulmonary trunk • Prevent backflow • Three cusps that look like crescent moons • L Vt / Aorta Atrioventricular Valves Ø Tricuspid Valve • Right side • Three cusps Ø Mitral (Bicuspid) Valve • Left side • Two cusps Ø Cusp • Flaps of endocardium reinforced by connective tissue Ø Chordae Tendineae • “heart strings” • Anchor cusps to the papillary muscles Valves Ø “Lub” = closure of mitral & tricuspid valves Ø “Dub” = closure of aortic & pulmonary semilunar valves 4 4/25/16 Valves: All About the Pressure • “Lub” = closure of mitral & tricuspid valves – Close to build up pressure when ventricles contract to pump blood out of the heart – Systole = high pressure caused by ventricle contraction Valves: All About the Pressure • “Dub” = closure of aortic & pulmonary semilunar valves – Close at the start of diastole – Diastole = ventricles relaxing to receive next gush of blood from the L & R atria Valves Ø Note • No valves guard entrances from vena cava or pulmonary veins Which brings us to… The Internal Heart Internal Heart Structure: Details • Interatrial Septum – Fossa Ovalis Location of fetal heart foramen ovale Internal Heart Structure: Details • Ventricles – Trabeculae Carneae: Irregular ridges of muscle – Papillary Muscles: Valve function, attach to chordae tendineae – Massive Myocardium • Right Atrium Pectin = comb – Pectinate Muscles • Found on anterior wall • Posterior wall is smooth • No distinguishing features in L At 5 4/25/16 Big Idea: Blood Movement 1. Right Ventricle 2. Pulmonary Semilunar Valve 3. Pulmonary Trunk 4. R/L Pulmonary Arteries* 5. R/L Lungs 6. Lung Capillaries 7. Pulmonary Veins* 8. Left Atrium <Contracts> (creates pressure) 1. 2. 3. 4. 5. 6. 7. 8. Right Ventricle Pulmonary Semilunar Valve Pulmonary Trunk R/L Pulmonary Arteries* R/L Lungs Lung Capillaries Pulmonary Veins* Left Atrium <Contracts> (creates pressure) Blood Movement: Systemic Circuit 1. Superior & Inferior 2. 3. 4. 5. 6. 7. Aortic Semilunar Valve Aorta* Arteries Capillaries Veins Vena Cava 8. Right Atrium Superior & Inferior 8. Right Atrium <Contracts> (creates pressure) 9. Tricuspid Valve 10. Right Ventricle Left Ventricle <Contracts> (creates pressure) Aortic Semilunar Valve Aorta* Arteries Capillaries Veins Vena Cava <Contracts> (creates pressure) *Aorta is about the size of a garden hose! Largest artery in the body Systemic & Pulmonary Circuits • Removes CO2 from the blood and replenishes O2 Systemic Circuit 1. Left Ventricle 2. 3. 4. 5. 6. 7. Ø Carbaminohemoglobin becomes oxyhemoglobin <Relaxed> (lower pressure) *Pulmonary arteries are the the only only place place you you *Pulmonary veins are willwill find deoxygenated blood in in aanvein artery find oxygenated blood <Contracts> (creates pressure) Ø Right side of heart is the pump Ø O2 needs to get where? 9. Mitral Valve 10. Left Ventricle 9. Mitral Valve 10. Left Ventricle <Relaxed> (lower pressure) Pulmonary Circuit Ø Left side of heart is the pump Ø High pressure circulation Ø 5x more friction/resistance to blood flow than pulmonary circuit Ø Left ventricle wall 3x thicker than right and has larger chamber 9. Tricuspid Valve 10. Right Ventricle Blood Movement: Details • Right atrium receives • Left atrium receives blood from three veins: blood from four 1. Superior vena cava pulmonary arteries 2. Inferior vena cava 3. Coronary Sinus… 6 4/25/16 Congestive Heart Failure 1. 2. 3. Left Ventricle Aortic Semilunar Valve Aorta* • LV can’t pump blood out to body • It backs up and leaks into the lungs • Eventually backs up into the lungs • Lungs are “congested” Big Idea: Coronary Circulation • Myocardium is too thick for blood diffusion – Coronary Arteries – Cardiac Veins BUT WAIT… Where does the heart get blood?? Coronary Arteries • Right and left coronary arteries – Come from the base of the aorta – Encircle heart – Lie in coronary sulcus Cardiac Veins • Cardiac Veins – Join together at coronary sinus – Empty into right atrium Which brings us to… The External Heart 7 4/25/16 Big Idea: External Anatomy • • • • • • • • R/L Atria R/L Ventricles R/L Coronary Sulcus R/L Coronary Arteries Coronary Sinus posterior Pulmonary Trunk R/L Pulmonary Arteries Aortic Arch External Anatomy • • • • • • • • R/L Atria R/L Ventricles R/L Coronary Sulcus R/L Coronary Arteries Coronary Sinus posterior Pulmonary Trunk R/L Pulmonary Arteries Aortic Arch – Brachiocephalic – Left common carotid – Left subclavian – Brachiocephalic – Left common carotid – Left subclavian • Pulmonary Arteries • Sup/Inf Vena Cava • Pulmonary Arteries • Sup/Inf Vena Cava Coronary Sinus • • • • • • • • R/L Atria R/L Ventricles R/L Coronary Sulcus R/L Coronary Arteries Coronary Sinus posterior Pulmonary Trunk R/L Pulmonary Arteries Aortic Arch External Anatomy • Auricles “Little Ears” – Small appendages that slightly increase atrial volume – Brachiocephalic – Left common carotid – Left subclavian • Pulmonary Arteries • Sup/Inf Vena Cava That was all gross anatomy. Now we move on to Microscopic Anatomy Think CELLULAR! 8