How Your Heart Works
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Chapter 20 *Lecture Powerpoint the Circulatory System: Blood Vessels and Circulation
Chapter 20 *Lecture PowerPoint The Circulatory System: Blood Vessels and Circulation *See separate FlexArt PowerPoint slides for all figures and tables preinserted into PowerPoint without notes. Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. Introduction • The route taken by the blood after it leaves the heart was a point of much confusion for many centuries – Chinese emperor Huang Ti (2697–2597 BC) believed that blood flowed in a complete circuit around the body and back to the heart – Roman physician Galen (129–c. 199) thought blood flowed back and forth like air; the liver created blood out of nutrients and organs consumed it – English physician William Harvey (1578–1657) did experimentation on circulation in snakes; birth of experimental physiology – After microscope was invented, blood and capillaries were discovered by van Leeuwenhoek and Malpighi 20-2 General Anatomy of the Blood Vessels • Expected Learning Outcomes – Describe the structure of a blood vessel. – Describe the different types of arteries, capillaries, and veins. – Trace the general route usually taken by the blood from the heart and back again. – Describe some variations on this route. 20-3 General Anatomy of the Blood Vessels Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. Capillaries Artery: Tunica interna Tunica media Tunica externa Nerve Vein Figure 20.1a (a) 1 mm © The McGraw-Hill Companies, Inc./Dennis Strete, photographer • Arteries carry blood away from heart • Veins -
The Ventricles
Guest Editorial Evolution of the Ventricles Solomon Victor, FRCS, FRCP We studied the evolution of ventricles by macroscopic examination of the hearts of Vijaya M. Nayak, MS marine cartilaginous and bony fish, and by angiocardiography and gross examination of Raveen Rajasingh, MPhil the hearts of air-breathing freshwater fish, frogs, turtles, snakes, and crocodiles. A right-sided, thin-walled ventricular lumen is seen in the fish, frog, turtle, and snake. In fish, there is external symmetry of the ventricle, internal asymmetry, and a thick- walled left ventricle with a small inlet chamber. In animals such as frogs, turtles, and snakes, the left ventricle exists as a small-cavitied contractile sponge. The high pressure generated by this spongy left ventricle, the direction of the jet, the ventriculoarterial ori- entation, and the bulbar spiral valve in the frog help to separate the systemic and pul- monary circulations. In the crocodile, the right aorta is connected to the left ventricle, and there is a complete interventricular septum and an improved left ventricular lumen when compared with turtles and snakes. The heart is housed in a rigid pericardial cavity in the shark, possibly to protect it from changing underwater pressure. The pericardial cavity in various species permits move- ments of the heart-which vary depending on the ventriculoarterial orientation and need for the ventricle to generate torque or spin on the ejected blood- that favor run-off into the appropriate arteries and their branches. In the lower species, it is not clear whether the spongy myocardium contributes to myocardial oxygenation. In human beings, spongy myocardium constitutes a rare form of congenital heart disease. -
Severe Aortic Stenosis and the Valve Replacement Procedure
Severe Aortic Stenosis and the Valve Replacement Procedure A Guide for Patients and their Families If you’ve been diagnosed with severe aortic stenosis, you probably have a lot of questions and concerns. The information in this booklet will help you learn more about your heart, severe aortic stenosis, and treatment options. Your heart team will recommend which treatment option is best for you. Please talk with them about any questions you have. Table of Contents 4 About Your Heart 5 What Is Severe Aortic Stenosis? 5 What Causes Severe Aortic Stenosis? 7 What Are the Symptoms of Severe Aortic Stenosis? 8 Treatment Options for Severe Aortic Stenosis 10 Before a TAVR Procedure 12 What Are the Risks of TAVR? 2 3 About Your Heart What Is Severe See the difference between healthy and The heart is a muscle about the size of your fist. It is a pump that works nonstop to Aortic Stenosis? diseased valves send oxygen-rich blood throughout your entire body. The heart is made up of four The aortic valve is made up of two or three chambers and four valves. The contractions (heartbeats) of the four chambers push Healthy Valve the blood through the valves and out to your body. tissue flaps, called leaflets. Healthy valves open at every heart contraction, allowing blood to flow forward to the next chamber, and then close tightly to prevent blood from backing Pulmonic controls the flow of Aortic controls the flow of blood up. Blood flows in one direction only. This is Valve blood to the lungs Valve out of your heart to the important for a healthy heart. -
Pulmonary Valve Guideline
Pulmonary Valve What the Nurse Caring for a Patient with CHD Needs to Know Catherine Baxter, MSN, RN, CPNP-AC Nurse Practitioner, Pediatric Cardiac Surgery, Levine Children’s Hospital, Charlotte, NC Misty Ellis, MSN, CPNP-PC/AC Pediatric Cardiac Intensive Care Nurse Practitioner University of Louisville, Kosair Children’s Hospital Victoria Winter RN, MSN, CNS, CCRN Clinical Nurse IV, Adjunct Professor, Children’s Hospital Los Angeles and Azusa Pacific University School of Nursing Louise Callow, MSN, RN, CPNP Pediatric Cardiac Surgery Nurse Practitioner, University of Michigan, CS Mott Children’s Hospital Mary Rummell, MN, RN, CPNP, CNS, FAHA Clinical Nurse Specialist, Pediatric Cardiology/Cardiac Services, Oregon Health & Science University (Retired) Embryology Occurrence: o Defects of cardiac valves are the most common subtype of cardiac malformations o Account for 25% to 30% of all congenital heart defects o Most costly and relevant CHD o Wide spectrum of congenital defects in pulmonary valve Development of the heart valves occurs during the fourth to eighth weeks of gestation- after tubular heart looping o Walls of the tubular heart consist of an outer lining of myocardium and an inner lining of endocardial cells o Cardiac jelly, extensive extracellular matrix (ECM), separates the two layers o Cardiac jelly expands to form cardiac cushions at the sites of future valves . Outflow track (OT) valves = aortic and pulmonic valves Final valves derived from endothelial-mesenchymal cells with neural crest cells from the brachial arches Valves (Semilunar) have 3 equal cusp-shaped leaflets Aortic valve incorporates coronary arteries . Atrioventricular (AV) valves = mitral and tricuspid Final valves derived entirely from endocardial cushion tissue Leaflet formed without a cusp 1 Two leaflets associated with left ventricle (mitral) Three leaflets associated with right ventricle (tricuspid) Coordinated by complex interplay of: o Genetics o Signaling pathways that regulate cell apoptosis and proliferation o Environmental factors . -
Of the Pediatric Mediastinum
MRI of the Pediatric Mediastinum Dianna M. E. Bardo, MD Director of Body MR & Co-Director of the 3D Innovation Lab Disclosures Consultant & Speakers Bureau – honoraria Koninklijke Philips Healthcare N V Author – royalties Thieme Publishing Springer Publishing Mediastinum - Anatomy Superior Mediastinum thoracic inlet to thoracic plane thoracic plane to diaphragm Inferior Mediastinum lateral – pleural surface anterior – sternum posterior – vertebral bodies Mediastinum - Anatomy Anterior T4 Mediastinum pericardium to sternum Middle Mediastinum pericardial sac Posterior Mediastinum vertebral bodies to pericardium lateral – pleural surface superior – thoracic inlet inferior - diaphragm Mediastinum – MR Challenges Motion Cardiac ECG – gating/triggering Breathing Respiratory navigation Artifacts Intubation – LMA Surgical / Interventional materials Mediastinum – MR Sequences ECG gated/triggered sequences SSFP – black blood SE – IR – GRE Non- ECG gated/triggered sequences mDIXON (W, F, IP, OP), eTHRIVE, turbo SE, STIR, DWI Respiratory – triggered, radially acquired T2W MultiVane, BLADE, PROPELLER Mediastinum – MR Sequences MRA / MRV REACT – non Gd enhanced Gd enhanced sequences THRIVE, mDIXON, mDIXON XD Mediastinum – Contents Superior Mediastinum PVT Left BATTLE: Phrenic nerve Vagus nerve Structures at the level of the sternal angle Thoracic duct Left recurrent laryngeal nerve (not the right) CLAPTRAP Brachiocephalic veins Cardiac plexus Aortic arch (and its 3 branches) Ligamentum arteriosum Thymus Aortic arch (inner concavity) Trachea Pulmonary -
PERCEVAL SUTURELESS AORTIC HEART VALVE Instructions for Use
HVV_LS-850-0002 Rev X03 PERCEVAL SUTURELESS AORTIC HEART VALVE Instructions for Use CAUTION: Federal Law (USA) restricts the device to sale by or on the order of a physician. SYMBOLS CAUTION: SEE MANUAL FOR INSTRUCTIONS/WARNINGS CONTENTS STERILIZED USING ASEPTIC PROCESSING TECHNIQUE USE BY STORE BETWEEN 5°C AND 25°C SINGLE USE ONLY DO NOT RESTERILIZE CATALOGUE NUMBER SERIAL NUMBER SIZE MANUFACTURER QUANTITY INCLUDED IN PACKAGE DO NOT USE IF PACKAGE IS DAMAGED THIS WAY UP MR CONDITIONAL 1. DESCRIPTION Perceval is a bioprosthetic valve designed to replace a diseased native or a malfunctioning prosthetic aortic valve via open heart surgery, with the unique characteristic of allowing sutureless positioning and anchoring at the implant site. The choice of materials and configuration ensures the device biocompatibility and hemocompatibility. The Perceval prosthesis consists of a tissue component made from bovine pericardium and a self-expandable Nitinol stent, which has the dual role of supporting the valve and fixing it in place. Perceval tissue heart valve is supplied unmounted. Prior to implantation the prosthesis diameter is reduced to a suitable size for loading it on the holder. The valve is then positioned and released in the aortic root, where the stent design and its ability to apply a radial force to the annulus allow stable anchoring of the device. 2. AVAILABLE MODELS The Perceval aortic model is available in four sizes: size S, size M, size L, and size XL. The prosthesis height is 31.0, 33.0, 35.5, and 37.5 mm, respectively. Each size is suitable for a range of aortic annuli and sinotubular junction (STJ) diameters. -
Your Pulse and Target Heart Rate
Skip to main content ×Close Menu We use cookies to improve your experience on our website. By closing this banner or interacting with our site, you acknowledge and agree to this. Legal Notices MobileClose Menu Find A Doctor Your Visit Pay a Bill Log in to MyGillette Learn more about MyGillette Patient Education Patient Services and Resources Your Rights and Medical Records Understanding Costs, Insurance and the Gillette Assistance Programs Services to Support Your Family Interpreter Services International Patients Parent Resources and Support Prepare for Your Visit Prepare for Clinic Visits and Tests Prepare for Surgery Take a Hospital Tour Transfer Your Medical Records Transportation and Accommodations Ways to Prepare and Comfort Your Child During Your Visit or Hospital Stay Commitment to a Safe and Healing Environment Our Hospital Units Your Hospital Room St. Paul Campus Amenities and Activities Visit or Contact a Patient Conditions & Care All Conditions Cerebral Palsy Neuromuscular Disorders Scoliosis Craniosynostosis Brain Injury All Tests & Treatments Shunt Surgery for Hydrocephalus Gait and Motion Analysis Selective Dorsal Rhizotomy (SDR) Gillette Craniocap© Orthosis Botulinum Toxin and Phenol (Injected Spasticity Medications) All Specialties & Services Orthopedics Rehabilitation Services Craniofacial and Plastic Surgery Neurology Neurosurgery Virtual Visits Pediatric Expert Consults Virtual Rehab Therapy Sleep Medicine Virtual Care Get Involved Advocating for Your Family Community Health United Cerebral Palsy of MN Donors & Supporters -
Vessels and Circulation
CARDIOVASCULAR SYSTEM OUTLINE 23.1 Anatomy of Blood Vessels 684 23.1a Blood Vessel Tunics 684 23.1b Arteries 685 23.1c Capillaries 688 23 23.1d Veins 689 23.2 Blood Pressure 691 23.3 Systemic Circulation 692 Vessels and 23.3a General Arterial Flow Out of the Heart 693 23.3b General Venous Return to the Heart 693 23.3c Blood Flow Through the Head and Neck 693 23.3d Blood Flow Through the Thoracic and Abdominal Walls 697 23.3e Blood Flow Through the Thoracic Organs 700 Circulation 23.3f Blood Flow Through the Gastrointestinal Tract 701 23.3g Blood Flow Through the Posterior Abdominal Organs, Pelvis, and Perineum 705 23.3h Blood Flow Through the Upper Limb 705 23.3i Blood Flow Through the Lower Limb 709 23.4 Pulmonary Circulation 712 23.5 Review of Heart, Systemic, and Pulmonary Circulation 714 23.6 Aging and the Cardiovascular System 715 23.7 Blood Vessel Development 716 23.7a Artery Development 716 23.7b Vein Development 717 23.7c Comparison of Fetal and Postnatal Circulation 718 MODULE 9: CARDIOVASCULAR SYSTEM mck78097_ch23_683-723.indd 683 2/14/11 4:31 PM 684 Chapter Twenty-Three Vessels and Circulation lood vessels are analogous to highways—they are an efficient larger as they merge and come closer to the heart. The site where B mode of transport for oxygen, carbon dioxide, nutrients, hor- two or more arteries (or two or more veins) converge to supply the mones, and waste products to and from body tissues. The heart is same body region is called an anastomosis (ă-nas ′tō -mō′ sis; pl., the mechanical pump that propels the blood through the vessels. -
Thoracic Aorta
GUIDELINES AND STANDARDS Multimodality Imaging of Diseases of the Thoracic Aorta in Adults: From the American Society of Echocardiography and the European Association of Cardiovascular Imaging Endorsed by the Society of Cardiovascular Computed Tomography and Society for Cardiovascular Magnetic Resonance Steven A. Goldstein, MD, Co-Chair, Arturo Evangelista, MD, FESC, Co-Chair, Suhny Abbara, MD, Andrew Arai, MD, Federico M. Asch, MD, FASE, Luigi P. Badano, MD, PhD, FESC, Michael A. Bolen, MD, Heidi M. Connolly, MD, Hug Cuellar-Calabria, MD, Martin Czerny, MD, Richard B. Devereux, MD, Raimund A. Erbel, MD, FASE, FESC, Rossella Fattori, MD, Eric M. Isselbacher, MD, Joseph M. Lindsay, MD, Marti McCulloch, MBA, RDCS, FASE, Hector I. Michelena, MD, FASE, Christoph A. Nienaber, MD, FESC, Jae K. Oh, MD, FASE, Mauro Pepi, MD, FESC, Allen J. Taylor, MD, Jonathan W. Weinsaft, MD, Jose Luis Zamorano, MD, FESC, FASE, Contributing Editors: Harry Dietz, MD, Kim Eagle, MD, John Elefteriades, MD, Guillaume Jondeau, MD, PhD, FESC, Herve Rousseau, MD, PhD, and Marc Schepens, MD, Washington, District of Columbia; Barcelona and Madrid, Spain; Dallas and Houston, Texas; Bethesda and Baltimore, Maryland; Padua, Pesaro, and Milan, Italy; Cleveland, Ohio; Rochester, Minnesota; Zurich, Switzerland; New York, New York; Essen and Rostock, Germany; Boston, Massachusetts; Ann Arbor, Michigan; New Haven, Connecticut; Paris and Toulouse, France; and Brugge, Belgium (J Am Soc Echocardiogr 2015;28:119-82.) TABLE OF CONTENTS Preamble 121 B. How to Measure the Aorta 124 I. Anatomy and Physiology of the Aorta 121 1. Interface, Definitions, and Timing of Aortic Measure- A. The Normal Aorta and Reference Values 121 ments 124 1. -
Cardiovascular System ANS 215 Physiology and Anatomy of Domesticated Animals
Cardiovascular System ANS 215 Physiology and Anatomy of Domesticated Animals I. Structure and Function A. Heart is a cone-shaped, hollow, muscular structure located in the thorax. B. Larger arteries and veins are continuous with the heart as its base. 1. Base is directed upward (dorsal) and forward (cranial). 2. Opposite end of the cone is known as the apex C. Membrane around the heart is known as the pericardium 1. Membrane next to hear fuses with the heart muscle and is called the visceral pericardium or epicardium 2. outer membrane is parietal pericardium 3. apex is free 4. Inflammation of the pericardium is called pericarditis. a. increase in fluid in pericardium b. traumatic pericarditis (hardware) disease in cattle 1 Left view of bovine thorax and abdomen showing location of the heart relative to the stomach. Foreign objects (nails, wire), sometimes ingested by cattle, accumulate in the reticulum ( one of the bovine forestomachs). Contraction of the reticulum can force pointed objects through the reticulum wall and the diaphragm, causing final penetration of the pericardium and subsequent inflammation (pericarditis). 2 D. Myocardium 1. Muscular part of the heart which forms the walls for the chambers 2. Heart chambers (4) divided into left and right side of the heart a. Each side has an atrium and ventricle. b. Each atrium has an extension known as the auricle. c. Atria receive blood from veins and ventricles receive blood from atria. Computer image of a cross sectional view of the heart at the ventricular level showing the chordae tendinae and the relative thickness of the myocardium. -
The Heart Institute
The Heart Institute Division of Cardiology 4650 Sunset Blvd., #34, Los Angeles, CA 90027 Phone: 323-361-2461 Fax: 323-361-1513 The Heart Institute at Children’s Hospital Los Angeles is CHLA.org/CARDIOLOGY one of the top-ranked pediatric heart programs in the Division of nation—with a long history of exceptional and innovative Cardiothoracic Surgery 4650 Sunset Blvd., #66 care for the most complex pediatric cardiac conditions. Los Angeles, CA 90027 Phone: 323-361-4148 Fax: 323-361-3668 We treat patients from fetus to adulthood and serve as CHLA.org/CTSurgery a major tertiary referral center for all forms of congenital Referrals Phone: 888-631-2452 and acquired heart disease. Fax: 323-361-8988 Email: [email protected] Physician Portal: https://myCHLA.CHLA.org We offer an integrated inpatient and outpatient Our Cardiothoracic Intensive Care Unit (CTICU) complement of services that brings together experts was the first of its kind on the West Coast, using in cardiology, cardiothoracic surgery, cardiothoracic innovative treatments including extracorporeal transplant, cardiothoracic intensive care and membrane oxygenation (ECMO) and ventricular cardiovascular acute care in a centrally located, assist services. state-of-the-art healing environment. With fewer steps to navigate, our patients and families receive care Our two state-of-the-art catheterization laboratories that is more streamlined and less stressful. use the latest technology to provide accurate cardiac data while reducing radiation. Our programmatic emphasis on high-complexity surgeries in neonates has produced outcomes that are among the best in the country, as shown in the most recent Society of Thoracic Surgeons report. -
Blood Vessels
BLOOD VESSELS Blood vessels are how blood travels through the body. Whole blood is a fluid made up of red blood cells (erythrocytes), white blood cells (leukocytes), platelets (thrombocytes), and plasma. It supplies the body with oxygen. SUPERIOR AORTA (AORTIC ARCH) VEINS & VENA CAVA ARTERIES There are two basic types of blood vessels: veins and arteries. Veins carry blood back to the heart and arteries carry blood from the heart out to the rest of the body. Factoid! The smallest blood vessel is five micrometers wide. To put into perspective how small that is, a strand of hair is 17 micrometers wide! 2 BASIC (ARTERY) BLOOD VESSEL TUNICA EXTERNA TUNICA MEDIA (ELASTIC MEMBRANE) STRUCTURE TUNICA MEDIA (SMOOTH MUSCLE) Blood vessels have walls composed of TUNICA INTIMA three layers. (SUBENDOTHELIAL LAYER) The tunica externa is the outermost layer, primarily composed of stretchy collagen fibers. It also contains nerves. The tunica media is the middle layer. It contains smooth muscle and elastic fiber. TUNICA INTIMA (ELASTIC The tunica intima is the innermost layer. MEMBRANE) It contains endothelial cells, which TUNICA INTIMA manage substances passing in and out (ENDOTHELIUM) of the bloodstream. 3 VEINS Blood carries CO2 and waste into venules (super tiny veins). The venules empty into larger veins and these eventually empty into the heart. The walls of veins are not as thick as those of arteries. Some veins have flaps of tissue called valves in order to prevent backflow. Factoid! Valves are found mainly in veins of the limbs where gravity and blood pressure VALVE combine to make venous return more 4 difficult.