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Cardiovascular Anatomy
(adapted from another slideshow on slideshare.com)
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The Capillary Beds
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The Cardiovascular System
Heart – the pump
Vasculature – the conduits
Pulmonary circuit
Systemic circuit
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The Vasculature A closed system of vessels that moves blood around the bodyA closed system of vessels that moves blood around the body
Arterial vessels: aorta, arteries, arterioles (vascular resistance)Arterial vessels: aorta, arteries, arterioles (vascular resistance) Carry blood away from the heart to the:Carry blood away from the heart to the:
Capillary bedsCapillary beds
Venous vessels: venules, veins, venae cavae Venous vessels: venules, veins, venae cavae
Carry blood toward the heartCarry blood toward the heart
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3 layers of an artery
1. Adventitia: tough covering.2. Media: muscle and elastic membrane3. Intima: delicate inner lining.
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The Heart
A 4-chambered organ located in the middle mediastinum
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CABG video 1:26ff
Cardiac bypass surgery.
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Functional Purpose of the Heart
Four Chamber pump that provides blood supply to: Systemic circulation left
heart Pulmonary circulation right
heart
Right and left atria: receiving chambers
Right and left ventricles: pumping chambers
Suspended at the base by the great vessels
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Heart WallEpicardium
Outer layer, inner visceral layer of pericardium
Myocardium Middle muscle
layer, interlacing bundles of fiber
Endocardium Inside of the heart,
covers valves
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Myocardium
specialized musclePerforms the work of
the heartMakes up the
majority of the mass
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Heart Wall
Figure 20.4
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Cardiac Chambers
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Right Atrium (RA)
Receives blood from the body or systemic venous circulation
Forms the right cardiac border
Receives blood from vena cava (SVC & IVC) and coronary sinus
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Right Ventricle (RV)
Provides blood flow to the pulmonary circuit
Low pressure pump <35 mmHg
Crescent-shaped wraps around the LV
Most anterior heart structure
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Left Atrium (LA)Receives blood from
the lungs (oxygenated)
Smooth walled except appendage
Most posterior cardiac chamber
Receive blood through right and left pulmonary veins
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Left Ventricle (LV)
Provides blood flow to the systemic circuit
High pressure pump >100 mmHg
Egg shaped (ellipse)
Forms the left cardiac border
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Structural Differences between the Left and Right Ventricles
Figure 20.7a-c
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Cardiac TissuesAnnuli fibrosi
Non-conducting fibrous connective tissue
Referred to as the skeleton
Forms support for the valves tissue (annulus)
Separates the atria and ventricles and ventricles and great vessels
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Valves of the Heart
Figure 20.8a
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Atrioventricular: Mitral and Tricuspid
Separate the atria and their respective ventricles
Tricuspid, Bicuspid
Attached at the base to the annulus and at the tips to the papillary muscles via chordae tendinea
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Semilunar: Aortic and PulmonicSeparate the
ventricles and their respective arteries
Three cusp, attached at the base to the annulus
Pressure sensitive valve, opening and closing activated by change in pressure
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Coronary ArteriesSupplies blood supply
to the heartTwo primary arteries
from the aortaLeft
Left Main Left Anterior Descending Circumflex
Right Right Posterior Descending
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Heart Casts - Muscle Removed
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Left MainLAD
DiagonalSeptal perforators
Circumflex
Left atrial branch
Obtuse Marginal
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Right Coronary ArteryRA, RV, Inferior LV, SA Node, AV NodeConus branch (RVOT)Sinus node branch (SA node, RA)RV BranchesAcute Marginal branches (RV)AV nodal artery (AV node, IAS)Posterior descending artery (inferior IVS)Left ventricular branch-PLA’s (inferior LV)
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Conus branch
Sinus node branch
Acute Marginal Posterior descending artery
Left ventricular branch
RV branch
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RAO
Circumflex LAD
DiagonalSeptal
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LAD
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Evolution of fibrous plaque
LDLMonocyte
endothelium
Cell adhesion factors
Foam Cells
1
1. LDL enters 2. & Oxidizes
3. Monocytes adhere & 4. cross intima become macrophages
macrophage
5. Macrophages Eat Fat become Foam cells
6. muscle cells multiply & 7. enter intima
8. Muscle cells die & harden plaque -Calcium develops
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Fuster V, et al. Fuster V, et al. N Eng J MedN Eng J Med 1992;326:311-318. 2. Photos courtesy of Boehringer Ingleheim International GmbH, by Lennart 1992;326:311-318. 2. Photos courtesy of Boehringer Ingleheim International GmbH, by Lennart Nilsson Nilsson
Braunwald E, et al. 2002 http://www.acc.org/clinical/guidelines/unstable/unstable.pdfBraunwald E, et al. 2002 http://www.acc.org/clinical/guidelines/unstable/unstable.pdf
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Coronary Artery Disease
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Aortic valveNormal aortic valve
area is 2.5 to 4.0 cm2
Diseased aortic valve. Narrowed opening.