Lab 3 Heart Sounds, Valve Problems and Blood Flow

Total Page：16

File Type：pdf, Size：1020Kb

Lab 3 Heart Sounds, Valve Problems and Blood Flow MDufilho 1 Heart Sound Lub-dup, lub-dup, lub-dup • Lub – lower pitch • Dup – higher pitch • Normal heart sounds -Animated Normal S1 S2 MDufilho 2 Figure 18.20 Areas of the thoracic surface where the sounds of individual valves can best be detected. Aortic valve sounds heard in 2nd intercostal space at right sternal margin Pulmonary valve sounds heard in 2nd intercostal space at left sternal margin Mitral valve sounds heard over heart apex (in 5th intercostal space) in line with middle of clavicle Tricuspid valve sounds typically heard in right sternal margin of 5th MDufilho intercostal space 3 Figure 18.5e – Heart Valves Aorta Left pulmonary artery Superior vena cava Right pulmonary artery Left atrium Left pulmonary veins Pulmonary trunk Right atrium Mitral (bicuspid) valve Right pulmonary veins Fossa ovalis Aortic valve Pectinate muscles Pulmonary valve Tricuspid valve Right ventricle Left ventricle Chordae tendineae Papillary muscle Interventricular septum Trabeculae carneae Epicardium Inferior vena cava Myocardium Endocardium Frontal section MDufilho 4 (not in text) Valve Prolapse MDufilho 5 (not in text) Valve Prolapse MDufilho 6 (not in text) Valvular Stenosis MDufilho 7 (not in text) Valvular Stenosis Heart Sounds S3 S4 Murmurs MDufilho 8 Figure 18.5b Blood Supply to the Myocardium Left common carotid artery Brachiocephalic trunk Left subclavian artery Superior vena cava Aortic arch Ligamentum arteriosum Right pulmonary artery Left pulmonary artery Ascending aorta Left pulmonary veins Pulmonary trunk Auricle of left atrium Right pulmonary veins Circumflex artery Right atrium Right coronary artery Left coronary artery (in coronary sulcus) (in coronary sulcus) Anterior cardiac vein Left ventricle Right ventricle Right marginal artery Great cardiac vein Anterior interventricular Small cardiac vein artery (in anterior Inferior vena cava interventricular sulcus) Apex Anterior view MDufilho 9 Figure 18.5d Blood Supply to the Myocardium Aorta Superior vena cava Left pulmonary artery Right pulmonary artery Right pulmonary veins Left pulmonary veins Auricle of left atrium Right atrium Left atrium Inferior vena cava Great cardiac vein Coronary sinus Right coronary artery Posterior vein of (in coronary sulcus) left ventricle Posterior interventricular Left ventricle artery (in posterior interventricular sulcus) Middle cardiac vein Right ventricle Apex Posterior surface view MDufilho 10 Figure 18.10 Coronary circulation. Aorta Superior Pulmonary vena cava trunk Left atrium Anastomosis (junction of vessels) Left coronary Right artery atrium Circumflex Right coronary artery artery Left Right ventricle ventricle Anterior Right interventricular marginal Posterior artery artery interventricular artery The major coronary arteries Superior vena cava Anterior Great cardiac cardiac veins vein Coronary sinus Small cardiac vein Middle cardiac vein MDufilho 11 The major cardiac veins Video on Atherosclerosis MDufilho 12 Figure UN 19.1 Consequences and Prevention • Ischemia • Hypoxia • Mycardial Infarction • Prevention of Atherosclerosis • Anastomoses • Pop's Angioplasty and Stent Installation... MDufilho 13 Coronary Bypass Surgery MDufilho 14 .

Copy Link

Recommended publications

CT Cardiac Anatomy
CT cardiac anatomy M.Todorova Tokuda Hospital Sofia 1 MDCT vs US 2 Position of the heart • Position in the thoracic cavity • Cardiac apex • Cardiac base 3 Systematic approach Cardiac CT • Right atrium • Aorta • Right ventricle • Coronaries • PA • Cardiac Veins • PV • Valves • Left atrium • Pericardium • Left ventricle 4 Right atrium 5 Right atrium • RA appendage – Pectinate muscles >2mm – 20 sc.cm normal size on 4 ch.view • Crista terminalis • Sulcus terminalis • Coronary sinus • Thebesian valve • Eustachian valve • Internal septum • Fossa ovalis 6 Tricuspid valve • Tricuspid valve- separates RA from RV • Trileflet valve- anterior,posterior, septal • Structure- leflet,annulus,commi ssures 7 Right ventricle 8 RV-anatomy inflow tract 4 chamber view outflow tract 9 Volumetric parameters of RV • Normal quantitative RV Values • EF = 61+/-6 • End diastolic volume = 173+/-39 • End systolic volume = 69+/-22 • Strike volume = 104+/=21 • Mass = 35-45 10 RV-anatomic structure • Tricuspid valve • RV wall • Pulmonary valve • Intrventricular septum • Anterior longitudinal sulcus • Posterior longitudinal sulcus • Moderator band 11 • Interventricular septum – Separates ventricles – Thin wall – Convexity toward the right ventricle – Muscular ventricular septum – Membrannous ventricular septum • Anterior and posterior longitudinal sulcus – Ventricles separeted externally by grooves – Anterior longitudinal sulcus – Posterior longitudinal sulcus – Moderator band 12 Pulmonary valve • Three leaflet • Semilunar morphology 13 PA anatomy 14 Left atrium and pulmonary veins 15 • Pulmonry veins – Two inferior and two superior into either side of LA 16 LA - anatomy • LA • LA appendage – Arises from the superiorlateral aspect of the LA – Projects anteriorly over the proximal LCX artery – Pectinate muscles >1mm 17 Mitral valve • represent inflow tract of LV • bicuspid • fibrous ring mitral valve-annulus • triangular leaflets 18 Left ventricle 19 LV - anatomy • Inflow tract • Outflow tract • Chordae tendinae • Papillary muscles 20 LV wall Normal Anterior MI LV papillary muscles Ferencik et al.
[Show full text]
Mediastinal Mass and Superior Vena Cava Obstruction Masquadering As Lung Carcinoma -A Case Report
Case Report Int J Pul & Res Sci Volume 2 Issue 1 - August 2017 Copyright © All rights are reserved by Surya Kant DOI: 10.19080/IJOPRS.2017.02.555580 Mediastinal Mass and Superior Vena Cava Obstruction Masquadering as Lung Carcinoma -A Case Report Jyoti Bajpai1 and Surya Kant1* King George Medical University, India Submission: March 15, 2017; Published: August 02, 2017 *Corresponding author: Surya Kant, King George Medical University, Lucknow, India, Tel: ; Email: Abstract Pulmonary tuberculosis has different types of radiological presentations. Mediastinal mass with superior vena cava obstruction mostly points out towards malignancy. We are reporting a case 40 years old a male alcoholic, smoker, with known case of diabetes mellitus presented with a mediastinal mass with effusion and cavitating lesions as a case of pulmonary tuberculosis. Sputum cytology and bronchoscopy biopsy suggestive of tuberculosis. Four drug anti tubercular therapy started and patient got relieved in his symptoms after one month. Keywords: Pulmonary tuberculosis; Mediastinal mass; Superior vena cava obstruction; Endobronchial biopsy Introduction limits. On general examination his neck veins were prominent Pulmonary tuberculosis is a greatest health problem of the world. Around 9.6 million cases of tuberculosis are reported superior vena cava obstruction. CXR suggestive of right sided worldwide annually [1]. Pulmonary tuberculosis shows different and facial swelling were seen. These findings were indicative of intrathoracic mass with effusion with mediastinal mass with left radiological presentations, pretending all the other pathological sided reticulonodular lesions with cavitating mass in (Figure 1). Different type of bacterial and fungal infection, bronchogenic formations of the lung and clinical difficulties for diagnosis [2].
[Show full text]
Prep for Practical II
Images for Practical II BSC 2086L "Endocrine" A A B C A. Hypothalamus B. Pineal Gland (Body) C. Pituitary Gland "Endocrine" 1.Thyroid 2.Adrenal Gland 3.Pancreas "The Pancreas" "The Adrenal Glands" "The Ovary" "The Testes" Erythrocyte Neutrophil Eosinophil Basophil Lymphocyte Monocyte Platelet Figure 29-3 Photomicrograph of a human blood smear stained with Wright’s stain (765). Eosinophil Lymphocyte Monocyte Platelets Neutrophils Erythrocytes "Blood Typing" "Heart Coronal" 1.Right Atrium 3 4 2.Superior Vena Cava 5 2 3.Aortic Arch 6 4.Pulmonary Trunk 1 5.Left Atrium 12 9 6.Bicuspid Valve 10 7.Interventricular Septum 11 8.Apex of The Heart 9. Chordae tendineae 10.Papillary Muscle 7 11.Tricuspid Valve 12. Fossa Ovalis "Heart Coronal Section" Coronal Section of the Heart to show valves 1. Bicuspid 2. Pulmonary Semilunar 3. Tricuspid 4. Aortic Semilunar 5. Left Ventricle 6. Right Ventricle "Heart Coronal" 1.Pulmonary trunk 2.Right Atrium 3.Tricuspid Valve 4.Pulmonary Semilunar Valve 5.Myocardium 6.Interventricular Septum 7.Trabeculae Carneae 8.Papillary Muscle 9.Chordae Tendineae 10.Bicuspid Valve "Heart Anterior" 1. Brachiocephalic Artery 2. Left Common Carotid Artery 3. Ligamentum Arteriosum 4. Left Coronary Artery 5. Circumflex Artery 6. Great Cardiac Vein 7. Myocardium 8. Apex of The Heart 9. Pericardium (Visceral) 10. Right Coronary Artery 11. Auricle of Right Atrium 12. Pulmonary Trunk 13. Superior Vena Cava 14. Aortic Arch 15. Brachiocephalic vein "Heart Posterolateral" 1. Left Brachiocephalic vein 2. Right Brachiocephalic vein 3. Brachiocephalic Artery 4. Left Common Carotid Artery 5. Left Subclavian Artery 6. Aortic Arch 7.
[Show full text]
Physiology of Heart Unit-4 (ZOOA-CC4-9-TH)
Physiology of Heart Unit-4 (ZOOA-CC4-9-TH) Coronary Circulation: The heart muscle, like every other organ or tissue in your body, needs oxygen-rich blood to survive. Blood is supplied to the heart by its own vascular system, called coronary circulation. The aorta (the main blood supplier to the body) branches off into two main coronary blood vessels (also called arteries). These coronary arteries branch off into smaller arteries, which supply oxygen-rich blood to the entire heart muscle. The right coronary artery supplies blood mainly to the right side of the heart. The right side of the heart is smaller because it pumps blood only to the lungs. The left coronary artery, which branches into the left anterior descending artery and the circumflex artery, supplies blood to the left side of the heart. The left side of the heart is larger and more muscular because it pumps blood to the rest of the body. Coronary circulation is the circulation of blood in the blood vessels that supply the heart muscle (myocardium). Coronary arteries supply oxygenated blood to the heart muscle, and cardiac veins drain away the blood once it has been deoxygenated. Because the rest of the body, and most especially the brain, needs a steady supply of oxygenated blood that is free of all but the slightest interruptions, the heart is required to function continuously. Therefore its circulation is of major importance not only to its own tissues but to the entire body and even the level of consciousness of the brain from moment to moment.
[Show full text]
4B. the Heart (Cor) 1
Henry Gray (1821–1865). Anatomy of the Human Body. 1918. 4b. The Heart (Cor) 1 The heart is a hollow muscular organ of a somewhat conical form; it lies between the lungs in the middle mediastinum and is enclosed in the pericardium (Fig. 490). It is placed obliquely in the chest behind the body of the sternum and adjoining parts of the rib cartilages, and projects farther into the left than into the right half of the thoracic cavity, so that about one-third of it is situated on the right and two-thirds on the left of the median plane. Size.—The heart, in the adult, measures about 12 cm. in length, 8 to 9 cm. in breadth at the 2 broadest part, and 6 cm. in thickness. Its weight, in the male, varies from 280 to 340 grams; in the female, from 230 to 280 grams. The heart continues to increase in weight and size up to an advanced period of life; this increase is more marked in men than in women. Component Parts.—As has already been stated (page 497), the heart is subdivided by 3 septa into right and left halves, and a constriction subdivides each half of the organ into two cavities, the upper cavity being called the atrium, the lower the ventricle. The heart therefore consists of four chambers, viz., right and left atria, and right and left ventricles. The division of the heart into four cavities is indicated on its surface by grooves. The atria 4 are separated from the ventricles by the coronary sulcus (auriculoventricular groove); this contains the trunks of the nutrient vessels of the heart, and is deficient in front, where it is crossed by the root of the pulmonary artery.
[Show full text]
Anomalous Middle Cardiac Vein Draining Into the Left Atrium
IMAGES IN THIS ISSUE Cardiovascular Disorders http://dx.doi.org/10.3346/jkms.2016.31.8.1179 • J Korean Med Sci 2016; 31: 1179-1180 Anomalous Middle Cardiac Vein Draining into the Left Atrium Jihyun Sohn,1 Young Soo Lee,2 Seung Pyo Hong,2 and Sung Hee Mun3 1Department of Cardiology, Kyungpook National University Hospital, Daegu, Korea; 2Department of Cardiology, Catholic University of Daegu, Daegu, Korea; 3Department of Radiology, Catholic University of Daegu, Daegu, Korea RV LV RA LA A B C LA CS RA PVLV LA MCV MCV LV D E Fig. 1. Cardiac computed tomography demonstrates the middle cardiac vein draining into the left atrium (yellow arrows). (A-C) Axial serial scan images of cardiac computed to- mography after contrast dye injection. (D) The 3-dimensional volume rendering image of cardiac computed tomography. (E) The curved planar reformation image of cardiac computed tomography. A 67-year-old woman was admitted for radiofrequency catheter oxygen supplement. Her electrocardiogram, chest X-ray, and ablation (RFCA) of paroxysmal atrial fibrillation. She had un- echocardiogram were within normal limits. She underwent derwent patch closure of atrial septal defect 7 years before. Her cardiac computed tomography for the left atrial reconstruction arterial blood oxygen saturation level was 94.6% without any before the RFCA. It revealed abnormal drainage of the middle © 2016 The Korean Academy of Medical Sciences. pISSN 1011-8934 This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
[Show full text]
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.
[Show full text]
Abnormally Enlarged Singular Thebesian Vein in Right Atrium
Open Access Case Report DOI: 10.7759/cureus.16300 Abnormally Enlarged Singular Thebesian Vein in Right Atrium Dilip Kumar 1 , Amit Malviya 2 , Bishwajeet Saikia 3 , Bhupen Barman 4 , Anunay Gupta 5 1. Cardiology, Medica Institute of Cardiac Sciences, Kolkata, IND 2. Cardiology, North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences, Shillong, IND 3. Anatomy, North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences, Shillong, IND 4. Internal Medicine, North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences, Shillong, IND 5. Cardiology, Vardhman Mahavir Medical College (VMMC) and Safdarjung Hospital, New Delhi, IND Corresponding author: Amit Malviya, [email protected] Abstract Thebesian veins in the heart are subendocardial venoluminal channels and are usually less than 0.5 mm in diameter. The system of TV either opens a venous (venoluminal) or an arterial (arterioluminal) channel directly into the lumen of the cardiac chambers or via some intervening spaces (venosinusoidal/ arteriosinusoidal) termed as sinusoids. Enlarged thebesian veins are reported in patients with congenital heart disease and usually, multiple veins are enlarged. Very few reports of such abnormal enlargement are there in the absence of congenital heart disease, but in all such cases, they are multiple and in association with coronary artery microfistule. We report a very rare case of a singular thebesian vein in the right atrium, which was abnormally enlarged. It is important to recognize because it can be confused with other cardiac structures like coronary sinus during diagnostic or therapeutic catheterization and can lead to cardiac injury and complications if it is attempted to cannulate it or pass the guidewires.
[Show full text]
Anatomy of the Heart
Anatomy of the Heart DR. SAEED VOHRA DR. SANAA AL-SHAARAWI OBJECTIVES • At the end of the lecture, the student should be able to : • Describe the shape of heart regarding : apex, base, sternocostal and diaphragmatic surfaces. • Describe the interior of heart chambers : right atrium, right ventricle, left atrium and left ventricle. • List the orifices of the heart : • Right atrioventricular (Tricuspid) orifice. • Pulmonary orifice. • Left atrioventricular (Mitral) orifice. • Aortic orifice. • Describe the innervation of the heart • Briefly describe the conduction system of the Heart The Heart • It lies in the middle mediastinum. • It is surrounded by a fibroserous sac called pericardium which is differentiated into an outer fibrous layer (Fibrous pericardium) & inner serous sac (Serous pericardium). • The Heart is somewhat pyramidal in shape, having: • Apex • Sterno-costal (anterior surface) • Base (posterior surface). • Diaphragmatic (inferior surface) • It consists of 4 chambers, 2 atria (right& left) & 2 ventricles (right& left) Apex of the heart • Directed downwards, forwards and to the left. • It is formed by the left ventricle. • Lies at the level of left 5th intercostal space 3.5 inch from midline. Note that the base of the heart is called the base because the heart is pyramid shaped; the base lies opposite the apex. The heart does not rest on its base; it rests on its diaphragmatic (inferior) surface Sterno-costal (anterior)surface • Divided by coronary (atrio- This surface is formed mainly ventricular) groove into : by the right atrium and the right . Atrial part, formed mainly by ventricle right atrium. Ventricular part , the right 2/3 is formed by right ventricle, while the left l1/3 is formed by left ventricle.
[Show full text]
The Biomechanical Puncture Study of the Fossa Ovalis in Human and Porcine Hearts Daniel S
The Biomechanical Puncture Study of the Fossa Ovalis in Human and Porcine Hearts Daniel S. Balto, Steven A. Howard, BMEn., Paul A. Iaizzo, Ph.D.2 Departments of Biomedical Engineering1 and Surgery2 University of Minnesota, Minneapolis, MN 55455 Introduction Apparatus Conclusion Approximately 1 in 4 humans on this earth is born with a congenital heart •The apparatus designed for this study was great for initial testing of the defect that involves the failure of the complete formation of the fossa ovalis tissue properties of the fossa ovalis of large mammalian hearts, either of membrane between the left and right atria1. This defect, better known as a PFO research animals or of human donor hearts. However, physiological or Patent Fossa Ovalis is an opening in the fossa ovalis membrane that results properties weren’t really observed in the testing and so that is a starting from the failure of the fetal structures (septum primum and septum secundum) point for advancing the quality of this research. The ability for the system to from closing together at the moment of birth2. The opening can be classified in have interchangeable depression, puncture, and dilation devices adds to the a variety of ways, but the most common are “shunts” which cause blood to flexibility of the current setup. The visualization of the inside of the heart flow from one atria to the other. A shunt that results in the blood flowing from adds a new dimension to this research as well since it is able to visualize all the left to right atria will cause the blood pressure to increase in the right side cardiac structures under ~10 mmHg of pressure.
[Show full text]
Premature Obliteration of the Foramen Ovale by G
PREMATURE OBLITERATION OF THE FORAMEN OVALE BY G. AUSTIN GRESHAM From the Department of Pathology, University of Cambridge Received August 16, 1955 Obliteration of the foramen ovale occurring during intrauterine life is a rare condition. It throws some light on the mechanism of development of endocardial fibroelastosis and also upon the factors concerned in determining the size of the aorta and of the cardiac chambers. CASE HISTORY The patient was the second child of a mother (aet. 21) whose previous obstetric history was normal. Apart from two periods of rather rapid gain of weight for which no cause could be found, the pregnancy was uneventful. The child was eleven days postmature; labour was induced with an enema and lasted forty-five minutes. The infant cried lustily but was cyanosed: the heart was clinically normal. Abnormalities were present in all four limbs. The left radius and ulna were absent and rudimentary digits were present on the skin over the distal end of the limb. Terminal phalanges were absent in the fingers of the right hand, and four toes were present on each foot with a rudimentary fifth digit on the left foot. Cyanosis and dyspniea became more intense and the child died three hours after birth despite the use of oxygen. NECROPSY The body was that of a full-term male infant (weight 3430 g.). The limbs were abnormal as previously described. The lips were blue-black in colour. On the septal wall of the right atrium a hemispherical grey-white area (10x 12 x 4 mm. deep) with a central dimple filled in the usual site of the fossa ovalis (Fig.
[Show full text]
Cardiology Self Learning Package
Cardiology Self Learning Package Module 1: Anatomy and Physiology of the Module 1: Anatomy and Physiology of the Heart Heart. Page 1 Developed by Tony Curran (Clinical Nurse Educator) and Gill Sheppard (Clinical Nurse Specialist) Cardiology (October 2011) CONTENT Introduction…………………………………………………………………………………Page 3 How to use the ECG Self Learning package………………………………………….Page 4 Overview of the Heart…………………………………………………...…………..…….Page 5 Location, Size and Shape of the Heart…………………………………………………Page 5 The Chambers of the Heart…………….………………………………………..……….Page 7 The Circulation System……………………………………….………………..…………Page 8 The Heart Valve Anatomy………………………….…………………………..…………Page 9 Coronary Arteries…………………………………………….……………………..……Page 10 Coronary Veins…………………………………………………………………..……….Page 11 Cardiac Muscle Tissue……………………………………………………………..……Page 12 The Conduction System………………………………………………………………...Page 13 Cardiac Cycle……………………………………………………………………………..Page 15 References…………………………………………………………………………………Page 18 Module Questions………………………………………………………………………..Page 19 Module Evaluation Form………………………………………………………………..Page 22 [Module 1: Anatomy and Physiology of the Heart Page 2 Developed by Tony Curran (Clinical Nurse Educator) and Gill Sheppard (Clinical Nurse Specialist) Cardiology (October 2011) INTRODUCTION Welcome to Module 1: Anatomy and Physiology of the Heart. This self leaning package is designed to as tool to assist nurse in understanding the hearts structure and how the heart works. The goal of this module is to review: Location , size and shape of the heart The chambers of the heart The circulation system of the heart The heart’s valve anatomy Coronary arteries and veins Cardiac muscle tissue The conduction system The cardiac cycle This module will form the foundation of your cardiac knowledge and enable you to understand workings of the heart that will assist you in completing other modules. Learning outcomes form this module are: To state the position of the heart, the size and shape.
[Show full text]