Cardio Anatomy Flashcards
galien + heart as soul
-one of the first observes of anatomy and medicine —> word was considered gold standard for years
-talked about heart being soul —> origin of heartfelt
-initially he thought arteries were filled with air since the people were seeing vessels exposed and arteries would evacuate
origin of heart shape
-used as a decoration —> do not know if it had much to do with love or affection
-french manuscript showed someone giving their heart to someone
servetus
-created a treatus on Catholic religion and talked about anatomy as well as other topics
-executed for what he spoke about in the treatus but in it he also discussed circulation
-galien thought of the heart as exchanging chamber but servetus thought of it as a pump
pulmonary circulation
blood from the body and lungs
william harvey
-observer of human body and pushed idea of circulatory system
-suggested if you put a light turniquet on body you see veins engorge
-blood goes into the limb and can’t get out
what do venous valves do?
prevent backflow
william harvey
50 years after servetus suggested about the circulation system, william harvey saw that if you put a light tourniquet on the body you can see the veins engorge
what do venous valves do?
prevent blood backflow
stats on heart
-adults have 4-5 quarts of blood and the heart weighs ~1 lb
-takes one minute for the blood to circulate from the head to the toes and back again
-average resting heart rate is 72 (little higher in women than men)
heart rate vs longevity
-organisms with slower HR live longer than those with faster ones
-interested to see if we slow down HR can we bide time?
different elements of the circulatory system
- system
- pulmonary
- portal
systemic network
system of bringing blood out to the body and taking spent blood away
pulmonary network
part of cycle that goes from heart to lung and gets oxygen back to the heart
portal network
-intestinal tract is drained and instead of going through capillaries, it goes to the liver and is broken down, stored, or metabolized
-liver takes some of the oxygen from the blood but not all
medications and how circulation works
-kidney is where ibuprofen is metabolized —> gets filtered and can be out of system
-liver is where tylenol is metabolized —> absorbed through the intestinal tract and metabolized quickly then mostly filtered
-nitroglycerine tablets are fully metabolized in the liver —> have to be placed under the tongue otherwise they will be wiped out
-remdisivir is an anti-viral that is metabolized in the liver so it is IV-infused instead
is there a lot of space in the heart?
-not a lot of space in body —> very tightly packed with adipose tissue and blood
-heart is beneath the lungs and on the lower part of the sternum
-bulk of heart is on left side but the central part is closer to the midline
diaphragm
thin, muscular wall
discovery of CPR
-three fellows were working on electrical stimulation of the heart and noticed that when they put lead on the patient, the bp went up
-as they compressed the chest they changed the pressure in the chest —> changed bp
-before this if patient came in with chest pain they opened up the chest and through the sternum massaged the heart
right side of heart + blood circulation
-gets deoxygenated blood (spent blood from the body) and it will take it from the head and upper limbs from the superior vena cava and from the lower limbs through the inferior vena cava
-these cava dump into the right atrium
-when the atrium contracts —> pumps blood into the right ventricles
what are arteries and veins named for?
orientation and how the blood passes through
left side of heart + blood circulation
-blood exchange occurs in the alveoli of the lungs
-comes into the heart through the left pulmonary veins into the left atria
-left atria —> left ventricle —> aorta —> body
-left ventricle has a very thick muscular wall since it needs to push blood through the aorta
why are valves necessary for heart pump?
-designed to let blood go through but not regurgitate
-when heart relaxes, it creates negative pressure
tricuspid valve
located between the right atrium and right ventricle
mitral/bicuspid valve
-located between the left atrium and left ventricle
-called the mitral after the mitre, which is the headgear that the pope wears
-pulmonary veins travel through these
aortic/semilunar valve
located between the left ventricle and aorta
pulmonary valve
this is the weakest valve since the blood isn’t trying to come back
valve replacements
remove valve tissue and suture in artificial ball and ring
ball and ring technique
old method of valve replacements
doctors would stop the heart —> open the aorta —> cut diseased valve out and put replacement one in
transcatheter aortic valve replacement (TAVR)
put catheter in through leg to go to heart with inflatable balloon that held the area open and deployed the valve
aortic valve
-typically go up and leaflets are like a swallow’s nest
-look down into the heart and you see within leaflets that go to coronary arteries
fibrous pericardium
-looks like dura and is tough and makes up the mediastinum
-outer layer
serus pericardium
-consists of two layers with a pericardial cavity in between
-inside: parietal layer of it, closest to the fibrous pericardium
-outside is the visceral layer or epicardium (very close to the muscle of the heart
myocardium
heart muscle that is very close to the epicardium
endocardium
inner lining of the heart itself
serous
puts out serous fluid that cuts down on friction in the heart —> fluid in the pericardial cavity and the two layers the serous pericardium slide along nicely together
pericarditis
infection of the pericardium that can cause inflammation and add friction to the beating heart
cardiac tamponade
-could occur after trauma or surgery that did not go well
-this is when too much blood starts to build up around the heart and make it difficult to pump blood
phrenic nerve
-left side and goes down to the diaphragm
-regulates breathing from high up in the neck
-located high up in the spinal cord so injury could paralyze diaphragm
recurrent phrengeal
comes from left phrenic nerve an goes right under aorta up to the larynx
ductus artiosum
-patent connection between venous blood and arterial blood in fetus
-closes within minutes of birth
sinoatrial (SA) node
-upper medial surface of the right atrium near the superior vena cava
-generates an electrical signal that causes the upper heart chambers (atria) to contract
atrioventricular (AV) node
-located in the right atrium further down
-small structure in the heart that connects the electrical systems of the atria and ventricles
-as nerve impulses go down it causes this node to fire and the ventricles to contract
atrial fibrillation
-occurs when the firing is happening very quickly but not fully
-heart condition that causes the upper chambers of the heart to beat irregularly and rapidly
blood supply to heart
-blood rushes through the heart but the heart itself does not access it
-profused by vessels on the heart
righthand side of the blood profusion
-right coronary artery and perforation from the first branch of aorta
-right marginal artery
-posterior descending
lefthand side of the blood profusion
-perforation coming from the aorta and back around through the gap
-left coronary artery
-circumflex goes around with left marginal and anterior descending (most common place for coronary artery bypass)
aclerosis (blood clot)
-blockage of vessels
-surgically they could bypass the blockage, dacron graft, or take an internal mammary artery down distal to blockage
-non-surgically they could put catheter in there with balloon to open the blockage with a cage but may get eventual plaque buildup
otto forman
-thought about catheters in vessels
-assistant agreed to it as along as he would do it on her
-he anesthetized her arm then removed the drape and he did it on himself then went to radiology to see it
-while in radiology, he advanced the catheter and got it to his heart
blood covering the heart
veins run concurrent with arteries with some differences
coronary sinus
on the posterior side of the heart, vessels go into the coronary sinus and looks like a globby vein (similar to the sagittal sinus in the dura)
brachia cephalic trunk
-gives rise to the right subclavian and right common carotid
-remember as it connecting to the brachial plexus and the neck
left side of blood covering the heart
common carotid and left subclavian
athrosclerosis
-plaque diminishes the caliber of vessels
-most clinical is femural or carotid arteries
-if you get plaques in the blood of the brain, you have dementia changes
-test the occlusion by taking the bp of your wrist and ankles and seeing if there is a disparity
varicose veins
-veins throughout the body have valves to prevent backflow
-blood has to be pushed up
-valves can break down and blood can pool —> varicose veins
Ex. chronic drinkers have red lines on nose —> cirrhosis of the liver is blocking the portal vein and putting venous pressure
arterial venous fistula
-done for people who have to go under dialysis
-connect artery and vein and then enlarges the vein for catheter to be put in
-handles taking and putting in of blood
Ex. someone who has needed this for dialysis may have very enlarged veins
plaque buildup in neck
-procedure where they open the carotid and put in bypass shunt so the head remains perfused and scrapes out the plaque
pressure points
-way to stop bleeding for first response
-push down on the femural artery to restrict blood flow but not entirely —> better than tourniquet which would stop bleeding altogether
bypass
-bypassing blockage in artery
-use saphoneous vein (not open heart)
-internal thoracic artery line —> replacing artery with a different artery (mammary artery)
mediastinum
sock-like spot in thorax where heart sits
