heart surface anatomy

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heart surface anatomy
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name these

• right atrium
• left atrium
• right ventricle
• left ventricle

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the heart

• 1. Innominate (brachiocephalic) artery
• 2. Aortic arch
• 3. Ligamentum arteriosum
• 4. Superior vena cava
• 5. Right atrium
• 6. Right coronary artery
• 7. Right atrium
• 8. Inferior vena cava
• 9. Apex of heart
• 10. Right ventricle
• 11. Left coronary artery
• 12. Left ventricle
• 13. Left atrium
• 14. Pulmonary trunk
• 15. Left subclavian artery
• 16. Left common carotid artery

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posterior heart

• 1. Left common carotid a.
• 2. Left subclavian a.
• 3. Aortic arch
• 4. Left pulmonary artery
• 5. Left pulmonary veins
• 6. Cut edge of pericardium
• 7. Left atrium
• 8. Inferior vena cava
• 9. Right atrium
• 10. Right pulmonary veins
• 11. Right pulmonary artery
• 12. Superior vena cava
• 13. Innominate (brachiocephalic) artery

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heart dissection

• Superior and inferior vena cava into right atrium
• Rt ventricle and pulmonary artery
• Pulmonary veins and Lt atrium
• Lt ventricle

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name the part with

• Interventricular septum
• Interventricular sulcus
• Left atrioventricular valve
• Ligamentum arteriosum
• Papillary muscle
• Pectinate muscles
• Pulmonary trunk
• Pulmonary valve
• Pulmonary vein
• Right atrioventricular valve
• Septomarginal trabeculum
• Superior vena cava

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and this is

• bicuspid valve
• tricuspid valve
• pulmonary semilunar valve
• aortic semilunar valve

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CT of heart

• Right atrium
• Right ventricle
• Left ventricle
• Left atrium
• Descending aorta

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impulse-conducting system

• 1.  Sinus node (sinoatrial node)
• 2. Atrioventricular node
• 3. Right atrium
• 4. Right ventricle
• 5. Left ventricle
• 6. Bundle of His (atrioventricular)
• 6a. Right branch
• 6b. Left Branch
• 7. Left atrium

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blood
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blood functions

• Blood performs two major functions
• transport through the body of
• oxygen and carbon dioxide
• food molecules (glucose, lipids, amino acids)
• Ions (e.g., Na, Ca2, HCO3-)
• wastes (e.g., urea)
• hormones
• heat
• defense of the body against infections and other
  foreign materials. All the WBCs participate in
  these defenses.

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blood is a liquid tissue

• Suspended in the watery plasma are seven types
  of cells and cell fragments.
• red blood cells (RBCs) or erythrocytes
• platelets or thrombocytes
• five kinds of white blood cells (WBCs) or
  leukocytes
• Three kinds of granulocytes
• neutrophils
• eosinophils
• basophils
• Two kinds of leukocytes without granules in their
  cytoplasm
• lymphocytes
• monocytes

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blood

• If one takes a sample of blood, treats it with an
  agent to prevent clotting, and spins it in a
  centrifuge,
• the red cells settle to the bottom
• the white cells settle on top of them forming the
  "buffy coat".

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spun blood

• When you spin blood in a centrifuge, the red
  cells go to the bottom of the container, and the
  white cells and platelets to the middle, leaving
  the yellowish plasma at the top.

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Plasma is the straw-colored liquid in which the
blood cells are suspended.

• Composition of blood plasma
• Component- Percent
• Water92
• Proteins 6-8
• Salts 0.8
• Lipids 0.6
• Glucose (blood sugar) 0.1

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plasma

• Plasma transports materials needed by cells and
  materials that must be removed from cells
• various ions (Na, Ca2, HCO3-, etc.
• glucose and traces of other sugars
• amino acids
• other organic acids
• cholesterol and other lipids
• hormones
• urea and other wastes

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red blood cells (erythrocytes)the most numerous
type in the blood and are responsible for the
transport of oxygen and carbon dioxide

• Women average about 4.8 million of these cells
  per cubic millimeter (mm3 which is the same as a
  microliter µl) of blood).
• Men average about 5.4 x 106 per µl.
• These values can vary over quite a range
  depending on such factors as health, and
  altitude. (Peruvians living at 18,000 feet may
  have as many as 8.3 x 106 RBCs per µl.)

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whole blood

• 1. Plasma 50
• 1a. Water 90 (45 )
• 1b. Proteins 8 (4 )
• 1c. Organic acids 1 (0.5 )
• 1d. Salts 1 (0.5 )
• 2. Blood cells 45
• 2a. Erythrocytes 44
• 2b. Leukocytes platelets 1

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white blood cells

• are much less numerous than red (the ratio
  between the two is around 1700),
• have nuclei,
• participate in protecting the body from
  infection,
• consist of lymphocytes and monocytes with
  relatively clear cytoplasm, and three types of
  granulocytes, whose cytoplasm is filled with
  granules.

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Lymphocytes

• After neutrophils, lymphocytes are the most
  numerous of the circulating leukocytes. The
  normal range count is 1000 - 4800/µL. Their life
  span may vary from several days to a lifetime (as
  for memory lymphocytes). Lymphocytes 1) can move
  back and forth between the vessels and the
  extravascular tissues, 2) are capable of
  reverting to blast-like cells, and 3) when so
  transformed, can multiply as the immunologic need
  arises.

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lymphocytes

• Each of the white blood cell types has a task
  in helping the body fight infections. The
  lymphocytes help create antibodies that attack
  the invaders and mark them for destruction by the
  neutrophils, monocytes and macrophages.

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monocytes

• largest cell type seen in blood smears, and
  constitute 5 to 8 of total leukocytes. Their
  nuclei are not multilobular like granulocytes,
  but may be deeply indented or U-shaped

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monocytes

• The normal range for the monocyte count is
  200 - 950 /µL.

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neutrophils- the most abundant WBC

• Neutrophils squeeze through the capillary
  walls and into infected tissue where they kill
  the invaders (e.g., bacteria) and then engulf the
  remnants by phagocytosis.

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eosinophils

• The number of eosinophils in the blood is
  normally quite low (0 - 450/µl). However, their
  numbers increase sharply in certain diseases,
  especially infections by parasitic worms.
  Eosinophils are cytotoxic, releasing the contents
  of their granules on the invader.

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basophils

• The number of basophils also increases during
  infection. Basophils leave the blood and
  accumulate at the site of infection or other
  inflammation. There they discharge the contents
  of their granules, releasing a variety of
  mediators such as histamine, serotonin
• prostaglandins, and leukotrienes

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basophils

• increase blood flow to the area and in other
  ways add to the inflammatory process. The
  mediators released by basophils also play an
  important part in some allergic responses such as
  hay fever and to insect stings.

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blood cells

• 3. Erythrocytes (red blood cells)
• 4. Thrombocytes (platelets)
• 5. Leukocytes (white blood cells)
• 5a. Neutrophil (granulocyte)
• 5b. Eosinophil (granulocytes)
• 5c. Basophil (granulocyte)
• 5d. Monocyte
• 5e. Small lymphocyte
• 5f. Large lymphocyte

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platelets

• Blood normally contains 150,000 to 450,000
  per microliter (µl). If this value should drop
  much below 50,000/µl, there is a danger of
  uncontrolled bleeding. This is because of the
  essential role that platelets have in blood
  clotting. Look for the ts, platelet beside each.

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blood types
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ABOs of blood

The table shows the four ABO phenotypes ("blood
groups") present in the human population and the
genotypes that give rise to them.
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wrong transfused blood

• Human red blood cells before (left) and after
  (right) adding serum containing anti-A
  antibodies. The agglutination reaction reveals
  the presence of the A antigen on the surface of
  the cells.

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Are you positive or negative?
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Rh factor

• This protein is also present in the blood of
  some people. Other people, however, do not have
  the protein. The presence of the protein, or lack
  of it, is referred to as the Rh (for Rhesus)
  factor. If your blood does contain the protein,
  your blood is said to be Rh positive (Rh). If
  your blood does not contain the protein, your
  blood is said to be Rh negative (Rh-).

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blood type and Rh factor

• This Rh factor is connected to your blood
  type. For example, your blood may be AB which
  means that you have type AB blood with a positive
  Rh factor. Or, you might have O- blood which
  means that you have type O blood with a negative
  Rh factor.

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mother and fetus Rh factor

• It is particularly important for expectant
  mothers to know their blood's Rh factor.
  Occasionally, a baby will inherit an Rh positive
  blood type from its father while the mother has
  an Rh negative blood type. The baby's life could
  be in great danger if the mother's Rh negative
  blood attacks the baby's Rh positive blood. If
  this happens, an exchange transfusion may save
  the baby's life. The baby's blood can be
  exchanged for new blood that matches the
  mother's.

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blood flow
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blood vessels

• arteries
• arterioles
• capillaries
• venules
• veins

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diagram of capillary network

• 1. Arteries
• 2. Arterioles
• 3. Capillaries
• 4. Venules
• 5. Veins

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arteries

• heart pumps blood out through one main artery
  called the dorsal aorta which divides and
  branches out into many smaller arteries so that
  each region of your body has its own system of
  arteries supplying it with fresh, oxygen-rich
  blood
• arteries are tough on the outside and smooth on
  the inside, have actually three layers an outer
  layer of tissue, a muscular middle, and an inner
  layer of epithelial cells

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artery and vein

• 1. Lumen
• 2. Tunica initima
• 3. Endothelium of tunica initima
• 4. Internal elastic membrane
• 5. Tunica media
• 6. Smooth muscle cells of tunica media
• 7. External elastic membrane
• 8. Tunica adventitia
• 9. Longituduinal cells of adventitia
• 10. Fibre lattice of adventitia
• 11. Vasa vasorum
• 12. Valves

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capillaries

• are very thin and fragile. The capillaries are
  actually only one epithelial cell thick
• so thin that blood cells can only pass through
  them in single file
• exchange of oxygen and carbon dioxide takes place
  through the thin capillary wall
• red blood cells inside the capillary release
  their oxygen which passes through the wall and
  into the surrounding tissue
• tissue releases its waste products, like carbon
  dioxide, which passes through the wall and into
  the red blood cells

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veins

• veins are similar to arteries but, because they
  transport blood at a lower pressure, they are not
  as strong as arteries
• like arteries, veins have three layers an outer
  layer of tissue, muscle in the middle, and a
  smooth inner layer of epithelial cells
• the layers are thinner, containing less tissue.
  Veins receive blood from the capillaries after
  the exchange of oxygen and carbon dioxide has
  taken place
• veins transport waste-rich blood back to the
  lungs and heart.
• valves located inside the veins prevent the
  backflow of blood

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circulation

• 1. Heart and arms
• 2. Superior vena cava
• 3. Lungs
• 4. Right atrium
• 5. Right ventricle
• 6. Liver
• 7. Portal vein
• 8. Inferior vena cava
• 9. Kidneys
• 10. Legs
• 11. Intestines
• 12. Abdominal aorta
• 13. Left ventricle
• 14. Left atrium
• 15. Pulmonary veins
• 16. Pulmonary artery

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path of circulation

• 1. 2 10 sup/inf vena cava
• 2. 7 Rt atrium
• 3. 8 Rt AV valve (tricuspid)
• 4. 9 Rt ventricle
• 5. 6 Rt SL (semilunar) valve
• 6. 4,3,18 Pulmonary arteries
• 7. lungs
• 8. 5, 17 Pulmonary veins
• 9. 16 Lt atrium
• 10. 14 Lt AV valve (bicuspid)
• 11. 13 Lt ventricle
• 12. 15 Lt SL (semilunar) valve
• 13. 1 aorta

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blood pressure heart beatslub dub

• lub
• Diastole (relaxation of heart muscle)
• top number of B.P.
• 100/80

• dub
• Systole (contraction of the heart muscle)
• bottom number of B.P.
• 100/80

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heart valves from above

• 1. Tricuspid (right atrioventricular) valve
• 2. Aortic valve (Lt SL)
• 3. Pulmonary valve (Lt SL)
• 4. Mitral (bicuspid or left atrioventricular)
  valve

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pulmonary circulation

• pulmonary circulation is the movement of blood
  from the heart, to the lungs, and back to the
  heart again

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name these vessels
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name these vessels

• 1. Internal jugular vein
• 2. Common carotid artery
• 3. Subclavian vein and artery
• 4. Brachial artery
• 5. Cephalic vein
• 6. Basilic vein
• 7. Inferior vena cava
• 8. Radial artery
• 9. Ulnar artery
• 10. Common iliac artery and vein
• 11. Femoral artery
• 12. Great saphenous vein
• 13. Aorta
• 14. Heart
• 15. Femoral vein

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just arteries

• name these

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just arteries

• 1. Common carotid artery
• 2. Subclavian artery
• 3. Axillary artery
• 4. Brachial artery
• 5. Ulnar artery
• 6. Radial artery
• 7. Deep and superficial palmar arches
• 8. Femoral artery
• 9. Anterior tibial artery
• 10. Posterior tibial artery
• 11. Common iliac artery
• 12. Aorta
• 12a. Abdominal aorta
• 12b. Thoracic aorta
• 12c. Aortic arch
• 13. Brachiocephalic trunk (innominate artery)

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just veins

• name these

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just veins

• 1. External jugular vein
• 2. Internal jugular vein
• 3. Subclavian vein
• 4. Brachial vein
• 5. Ulnar vein
• 6. Radial vein
• 7. Femoral vein
• 8. Great saphenous vein
• 9. Popliteal vein
• 10. Anterior tibial vein
• 11. Posterior tibial vein
• 12. Small saphenous vein
• 13. External iliac vein
• 14. Internal iliac vein
• 15. Common iliac vein
• 16. Inferior vena cava
• 17. Superior vena cava
• 18. Brachiocephalic (innominate) vein

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arteries and pressure points

• 1. Temporal artery
• 2. Facial artery
• 3. Subclavian artery
• 4. Axillary artery (use pad)
• 5. Brachial artery (digital pressure or
  tourniquet)
• 6. Radial artery
• 7. Ulnar artery
• 8. Popliteal artery (use pad behind knee)
• 9. Anterior tibial artery
• 10. Posterior tibial artery
• 11. Femoral artery
• 11a. Femoral artery (use tourniquet)
• 12. Common carotid artery

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portal system

• 1. Inferior vena cava
• 2. Right hepatic vein
• 3. Portal vein
• 3a. left branch
• 3b. right branch
• 6. Renal veins
• 8. Superior mesenteric vein
• 9. Common iliac veins
• 10. Superior rectal vein
• 11. Inferior mesenteric vein
• 13. Pancreatic veins
• 15. Splenic vein
• 16. Short gastric veins
• 17. Right gastric vein
• 18. Left gastric vein
• 20. Left hepatic vein

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red bone marrow sites

• Blood is made in the bone marrowAll of the
  cells in the blood, red blood cells, all types of
  white blood cells, and platelets are made in the
  bone marrow. This happens primarily in the flat
  bones in your body such as the skull, the
  sternum, and the pelvis.

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blood clot
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blood related problems

• Anemia--Anemia is a shortage of RBCs and/or the
  amount of hemoglobin in them. Anemia has many
  causes. One of the most common is an inadequate
  intake of iron in the diet.
• A deficiency of a clotting factor can lead to
  uncontrolled bleeding. von Willebrand disease
  (the most common) and hemophilia

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malformed RBCs

• Sickle cell anemia is an inherited condition
  which results in some erythrocytes being
  malformed. The gene for this condition causes the
  hemoglobin to be incorrectly formed, which in
  turn causes some erythrocytes to take on a
  crescent shape. These cells are not able to carry
  adequate amounts of oxygen to cells.

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references

• The University of Michigan Medical School
  www.med.umich.edu/.../M1/anatomy/
  html/thorax/heart.html