Anatomy Lecture #4 (Cardio) Flashcards
History of Heart Shape
The cartoon heart shape was a decorative design in the past (unclear if it symbolized love in the begining)
Had hearts in a Code of Arms image - don’t know it the hearts were asociated with love/affections
Later - have a letter that expressed love that had an upside down heart –> first indication of heart being used for love
- Upside down heart has a shape similar to real heart
- Have movement for heart to be connected to love
Victorian times –> heart was used to symbolize love (used in valtentines crads)
History of Anatomy (Galin)
Galin - observer of anatomy –> his ideas were maintained for 1700 years (was the gold standrad)
- Was good because promoted excimtment but also hindered because all of medicine used his ibservations
Galin = first to say the heart was the soul (creates connections and love)
Galin = Thought the arteries were fillied with air (because mostly saw vessles in dead animals/people where the vessels were exposed –> arteries would evacuate the blood
- No blood in arteries but had blood in veins (because veins walls are more flexible) = Galin thought this is how it is when alive
History of Anatomu (Servatus)
Servatus wrote a treatus on cataholsism + talked about anatomy + astronolmy (all together because hard to publish)
- Talked about circulatory system in Treatus
***He was burned in spain for treatus because he dissed catholism
Galin vs. Servatus
Galin = herat is the exchaneg between air and blood (No blood in arteries; blood in veins)
Servtus = thought heart is pump and blood fills both arteries and veins
- Explains pulminary circut (blood goes to the heart and body + said blood goes to lungs where there is an exchnage occuring)
Anatomy History (Harvey)
Physician in england (observer of human body)
Overall: Pushed idea of circulatory system
He put tornaque on limbs and saw the veins negorge (saw blood going into the limb (when put tornaque on saw blood can go in but it could not go out)
- Veins = superficial = blocked BUT the arteries were not blocked
- When veins engorged = saw bulbus area –> saw there are valve (first to descrive venous valves)
Left (showing Anterior to posterior)
- See corany artery on surface
- Covered with epicardial fat
Right (showing posterior to anterior)
Heart Overall
Heart = Muscilar pump
- Weighs ~1 lb
Pumpes 1.5 gallons of blood/minutes ;
Pumoes to to 5 gallons of blood/minute during excersize
Adults = have 4-5 quarts of blood
takes 1 miniues for the blood to circulate (1 minute to return to heart from extremities)
Cardiomegly
Bigger heart (heart is working harder)
Heart beats
Averrage resting heart rate = 72 (higher in women)
Means 1440 beats/min –> 104,000 beats per day –> 37,325,000 beats per year –> 2.8 billions beats over teh course of 90 years
***During meditations can get heartrate to 40-50
Reserach on nutritiant + longevity
Reserach showed that organisms with slower Hearteates live longer than organisms with higher heart rates (Numver of heart beats coorelates with longevity)
- Faster heart rates = using up heart beats in lifetime
- Want to decrease HR to increase lifespan
- Doing excersuze decreases resting HR = increases longevity
HR is a factor of mortality – resting HR = independent prediction of cardiovascular mortality
Circulatory networks
- Systemic
- Pulimary
- Portal
Systemic circulatory
Getting blood out to periphery + taking used blood from tissue to hear
Includes - Head/neack + upper limbs + body wall + pelvis + lower limb + lymph nodes
Image - blue highlighted = part of system
Pulimary Circut
Takes blood from the heart to the lungs
- Drops waste out of blood + gets oxgen
Going from heart –> lungs –> heart etc.
Portal Circut
Blood of the intestins drain through the liver –> liver has capilary netowkr –> network will bring blood (conatins nutreients) from intestine to liver to be broken down and metabolsized –> once metabolized the blood will go to the inerfior vena cava and go to the right side of the heart
- Not used arterial/venous capilaries
- Not taking oxygen out of blood BUT the liver takes some oxygen from the bloood but MOST of teh oxygen will be taken in the systemic (joins the systemic circut in the inferior vena cava)
- Blood goes to diegstive system –> gets nutrients –> metabolizes the nuerteints using the protal curcits –> stored
Function - take the blood to be metabolized
- Uses Liver + Intestinal tract
What does the Portal system affects
Affects the dosage and way that you can take certain medications
Ibeprofin
Kindey = metabolized ibeprofin
Ibeprofin = foes to the systemic circut where it is able to work THEN –> goes to the kidneys –> kidney will filter the blood
Tylanon
Metabolized in the liver
Tylonal = absorbed through the digestive –> goe sinto the portal system –> takes the tylonal form the blood to the liver –> liver metabolizes the tylonal = tylonal s metabolized fatser because it is going straight to the liver
- To get dosage = need to see how much is metabolized by the liver (not all of it will be some will go to the body and work)
Nitroglycin
Certain drugs can’t be taken orally (Ex. Nitroglycin - used for heart issue; can jump start the heart)
Nitroglycin = If goes to protal system = fully metabolized by the liver = when it is taken orally it is fully netabolized
Soution = put a tablet under tongue = oes to blood trasnmucosuly –> eventually it will be metabolized b the liver BUT not during the first pass
Remdenovear
Antiviral medication - taken via ijections or IV (rarly but sometimes transmucosuly) –> can’t take it orally because the protal system would fully metabolize it
Space in the body
There is not a lot of space in the body
- There could be some space under the liver or gut BUT it is usually filled with fat or fluid
- Lungs around heart pretty tight
Where is the heart (genrally)
Heart is located between the lungs (In the midline)
- Apex = pointed part at the bottom (points to left)
- Apex = usually at level of xyphoid process
- Base = upper part (geeat vessels come and go form the base)
In center of lungs = have media stinem - sock of tugh tissue –> goes to the diaphram (CHECK THIS)
Heart = sits on diaphram
Diaphram
Musclular floor of thoraci cavity/ roof of abdominal cavity
As breath diaphram comes up and down - big part of breathing
Heart vs Sternum
Heart = lower part of he sternum
Above the heart = have the clavicles + great vessles
- Great vessles = right behind the sternum (at the base of top of heart)
Thoracis vs. Abdomincal cavity
Thoracis cavity = seperate from abdominal cavity
Peretinium = covering of abdonmial cavity
Abdomonal + thoraci cavites = surrounded by tissue
- Only connection ebtween the 2 cavities is the hiatus (asophogus goes to the sternum) ; only communication between the abdomen and thoracic cavities
Division of thoracis cavity
Divided into three parts:
1. Left lung
2. Right lung
3. Media stinum - suspended sock of issue in which heart is housed (not tightly fixed = heart can move)
Developing CPR
William Kowheven + Knickbocker + Jude developed CPR
They noticed when they were putting electrical leeds on test subjkects the blood pressure increased –> they wanted to replicate this
- When compress chest to put electrodes on = change volume = chnage pressure in chest –> means that when press on heart = compress heart = mimics pumping of blood = made CPR
Axial section
Blue circle = heart
Black line at top = Sterum
Top circle under heart = Asophygus
To right of asphogus = thoracis aorta –> arches to the left and goes behind the heart
How to do CPR
One person doing it - 15 compressions and 2 breaths
Two people doing it - 5 compressions and 1 breath
New guidlines = can do CPR without respitory –> because have enogh oxygen in blood to keep tissue viable BUT if doing CPR for longer time = need to strat doing respirations because oxygen is being used (after 21-25 minutes)
- BUT if dorwning/if doing CPR on child/if drug iverdose = need to always do respirations
Speed of compresions = “staying alive” beat
CPR story
Rini and dad were driving to clevland –> sw cars were pulled over –> they pulled over and saw there was a guy on the ground —> the guy had. aherat attck –> rini and dad started to do CPR (rini did chest and dad did respirations) –> highw ay potrol came + ambulence came –> guy survived
- Dad had a hankerchif and put on mouth of guy
Rini now carried around kit to do respirations (got from lifeguard son)
Right vs. left side of heart
Right side of heart - gets deoxygenated blood from body
Aorta gives rise to
Vessles in aorta give rise to subclavical arteries + brachial arteries
Valves in the heart
Tricuspid (has 3 leaves) - between the Right atrium and Right ventricle
Biscupid (aka mitral valve) = between the Left Atrium and the Left ventricle
- Bishops wear and miter (looks like mitral valve)
Pulimary valcle = at the base of the pulminary trunk
- Weakest of the valves (because have less resistence in the lungs = blood is not trying to flow back = weakest)
Aortic valve (aka semilunar valvle) - Have lots of pressure going through the valve
Rini Uncle Story
Rinis uncle was a very eraly recepient of a pig heart valve –> lasted longer than expected
- He had to take antirejection meds for a while but he was weened off of them
Aortic valve
Side veiw - has leaflets = like a sack
- Curve of leaflets goes with the flow of the blood
Image - looking down wiards heart in the leaflet - have 2 openings going to the corated artery
- Corany arteries are tucked low in the aorta (inside where the valve is) - come out of level of the valve
Pericordium
Covering of the heart
Fiberous peracardium –> Serious percardium –> Visceral peracardoium (epicardium) –> myocardium –> Endocradium
Yellow lin next to SVC = frenic nerve –> goes to the diaphram = regulates breathing
- Comes from C2/C3 = high in neck
- Polio = affects the frenic nerves = kids used iron lungs
See recurent larengeal - goes under the aorta - goes to the larynx
See Ducto arelerosa
Bottom = diapgram
Line a the base of heart = fiberous peracardeium
Blood supply to the heart itself
Blood is rushing through the heart but the heart doesn’t access that blood
Heart muscles and the covering of the heart are profused by vessles on the surface of the heart
- Profused by the right coranry oartery and the left coranary artery (both come from perferastions in the aortic valve)
Right coranry –> righy marginal –> right deceding
- Right cornary comes down and comes aorund from the back goes down to an appendage by the aorta
- Sends right marginal branch and then comes down to posterior decending
Left - perferations of the aorita –> left coranary –> cicumfelx branch of left cornary (goes to back of heart) –> left marginal –> left anterior interventricular branch (Left anterior decding) –> left
- Most common plae to have coranary artery bypass (worse one to have blocked vecayse feeds the left ventrcile)
Left circumfelx
Left circumfelx = comes off the LAD - feeds the back of the heart
KNOW major branches
Back of the heart
Back of the heart = has vessles that go to the corranry sinus
On the posterior side of the heart - dumping place for venous blood
venous colection from correted = collected in veins –> veins run along with the arteries colllect into posterior surface of the heart - go to corenary sinus
- Corenary sinus = made by the covering of the heart
- Corenaru sinus = dumps blood into the right atrium
Pictre of great vessels
BIG RED = arch of aorta vessel –> turns on itself
Overview of veins and arteries in body (general layout)
Heart —> Arch of aorta –> right have brachosophalic trunk and right common corated and then furtehr divides
have subclavina and axiallary going to the radial on right
Left = same as right but common correted comes wight of the aorata and subclavial comes of seperated
Arch of aorta - goe sbehind the heart and goes down to throarci ad then adbmon arota then branch to cmoon inliac then the femeral and supply the leg
Veins go up - femeral veins runs right next to femeral nerve –> come together
- Internal Illaics come together to form infriror vena cava - dupts to right atrium
Right - Sbclavians come in and dump to sueprior vena cava to irght atriums
