Friday lecture 11/13 end of CH 21 the heart

Test has been moved up to the Monday before Thanksgiving.
Practical will no longer be a ‘moving around’ thing, but rather, we’ll have it entirely on slides on the power point, so make sure you know those.

KNOW:
4 chambers of the heart
directionality of flow (top to bottom up, top to bottom out)
Coronary sinus
Superior vena cava
Inferior vena cava
Widowmaker (coronary artery)
* left marginal branch of LCA – know this from multiple angles/images
Aorta
Ascending arch
Arch of aorta
Descending aorta
Pulmonary veins
Interventricular sulcus
Coronary sulcus
Orient and identify posterior and anterior heart
Chordae tendinae
Papillary muscles

NEW:
Conus arteriosus – high smooth area at the top of the R ventricle just before the pulmonary semilunar valve
*coronary arteries are the first to get oxygenated blood from the heart. These are what need to be bypassed whent hey get clogged.
L ventricle
Thicker
Extra thickness to force blood around systemic circuit
Know trabeculae carnae
Papillary muscles
Chordae tendinae
Ventricles/differences
R:
thinner
AV valve has three cusps
L:
thicker
AV valve has two cusps

Coronary arteries, slide 45
Circulation to the muscle of the heart (myocardium)
2 branches off the ascending aorta
KNOW
L coronary and R coronary artieries
Circumflex artery
Anterior interventricular artery
Right coronary artery

Slides 48-50
Left coronary artery
KNOW: Two main branches
Anterior interventricular
Circumflex artery

Right coronary artery
KNOW: two main branches
Posterior interventricular artery
Right marginal

Venous drainage of myocardium
Slide 52
Great cardiac
Middle cardiac
Small cardiac

Valve cycles know slide 53 for practical
(What is contracting?)
know “systole”
atria are contracting on this slide
semilunar valves are shut while AV are open

Know slide 54
Difference between ventricular and atrial systole
V systole/A systole

http://www.youtube.com/watch?v=D3ZDJgFDdk0

Autorhythmic
Cardiac muscles are conncted by gap junctions known as intercalated discs - contract as single unit
KNOW the cycle of conduction – slide 60 and 61
SA Node
down to
AV node
Know bundle branches and Purkinje fibers

P wave – when SA node goes off, before it hits the AV node
QRS complex – depolarization – ventricular – after AV node goes off
T wave is when the whole heart repolarizes

Slide 64 – purkinje fibers
Also “bundle of his”

Slide 67 and 68 – know coordinated sequence of heart chamber contractions/cardiac cycle
SA generates an impulse
Atria contract (systole) while Ventricles relax (diastole)
Impulse to AV node then to ventricles
Ventricles contract (systole) while atria relax (diastole)

Normal rhythm vs too fast or slow
Too fast = tachycardia
Too slow = brachycardia

Additional innervation to the heart outside of autorhythmic cells
Also innervated by divisions of the ANS – sympathetic ( makes it contract more quickly, fight or flight, etc, starts with neurons in T1-T5) and parasympathetic (make it contract slower, less forcefully - off medulla oblongata via left and right vagus nerves)

Anatomical components of both divisions make up the coronary plexus

**Sympathetics increase rate and force of contractions
**Parasympathetics, decreases rate but has no effect on contractions

Aging:
Nothing gets better – some issues and what is affected
Murmurs, sounds caused by changes in valves - VALVES
Hypertrophy, enlargement of the heart - MYOCARDIUM
Decreased conduction/electrical abnormalities – NERVES
Lifestyle caused issues, diet/exercises - VESSELS