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 .