Woman with a diabetes mellitus and obesity has had a myocardial infarction.

DOWNSTREAM

INDIRECT

Background

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PHYSIOLOGY

ANATOMY

Cells

Tissue

Organ

Pacemaker cells

Contractile cells

Action potential w/ pacemaker potential

Action potential w/ plateau

Na+ slowly goes in cell making more positive

Na+ floods the cell making it quickly depolarize

Threshold reached

Ca+ rush into cell and depolarizes it

Reaches max membrane voltage

Cell closes Ca+ channel and K+ leaves cell quickly

K+ leaving the cell= repolarization

Ca+ then slowly continues to release causing a plateau so that heart cannot tetany

The a rapid efflux of K+ which repolarizes the cells

Pericardium

Fiberous

Thick layer

Serous

Thin layer

Slipper

Epicardium

Myocardium

Endocardium

Inside of the heart

Cardiac Skeleton

Keeps electrical signal on track

Heart Muscle

Outside of the heart

Chambers

Valves

Aorta

Pulmonary

Coronary

Trunk

Arteries

Veins

Atria

Ventricle

Right

Ascending aorta

Aortic arch

Descending aorta

Thoracic aorta

Pulmonary arteries (poor oxygen)

Lungs

Pulmonary veins (poor oxygen)

deliver blood directly to the heart tissue

From left atria

Vena Cava

Take blood (poor oxygen) from body to heart

Good oxygen

Deliver blood from heart tissue directly to right atria

poor oxygen

Right

Left

Poor oxygen

Left

Good Oxygen

Poor oxygen

Good oxygen

AV valves

SL valves

Tricuspid valve (1)

Bicuspid (mitral) valve (3)

Pulmonary semilunar valve (2)

Aortic semilunar valve (4)

Pathway of Blood

vitals

30 Breaths per minute

125 Beats per minute

Blood Pressure 95/55

Labored breathing

Gurgling in stethoscope

papilliary muscles of left ventricle failing

Mitrial valve also failing

Valves

Papillary muscles

Heart sounds

Blood pressure / heart function

Heart rate

Stroke volume

Cardiac output

Bodily systemic circuit

Vena cava (superior/inferior)

Right atria

Tricuspid valve

Heart electrical signal pathway

right ventricle

Pulmonary semilunar valve

Pulmonary artieries

Lungs

Pulmonary veins

Left atria

Bicuspid (mitral) valve

Left Ventricle

Aorta

Bracheocephallic trunk

Left corotid

Left Subclavian

Right subclavian artery

Right corotid

Deliver blood to upper extremities

Descending aorta

Delivers blood to lower extremities

How fast the heart is beating and pushing blood out the ventricles

How much blood is being push out the ventricles

EDV

ESV

The preload

How much blood in ventricle before contraction

Afterload

How much blood left in the ventricle after contraction

The flow of blood through the body

Regulated by TPR, and CO (HR*SV)

Short Term regulation

Long Term regulation

Increase or decrease in HR, SV, or TPR

Increase or decrease in blood volume

Neural regulation

Hormonal regulation (some of them short term)

Chemical regulation

Barcoreceptor regulation

Epinephrine / Norepinephrine

ADH, atrial natriuretic peptide, Angeiotensin II

Regulate TPR

Regulates chemical factors that also happen to change BP

Stretching or recession of arerial walls will activate this receptor

Regulate HR and SV

Lub

Dub

Av valves closing

SL valves closing

Chordae tendonae

Controls AV valves

Muscles that prevents the AV valves from collapsing

Atrioventricular

Semilunar

Prevents blood back flow into atria from ventricle

Pulmonary

Aortic

Prevents back flow from aorta to left ventricle

Prevents backflow from pulumonary trunk to right ventricle

SA node (sinus rhythm)

AV node (junctional rhythm)

AV bundle

Right and left branches

Purkunje fibers

Obesity

Diabetes mellitus

DIRECT

Overworked heart gave out

Weight of her body and the pressure that it put on her blood vessels and heart = over worked heart

Nutrition

(mabey) genetic predisposition

UPSTREAM

Flabby left ventricle

Failed mitrial valve

Blood will swish back into left artria

Consequences of the failed bicuspid valve

Problem branching into other systems

circulatory system tries to compensate with extreme vasoconstriction

Increased BP

Heart have to work harder to pump more blood

Left ventricle becomes over worked

Blood pressure plummets because heart cannot sustain a large amount of BPM anything over 75 is more than normal for resting

Weakening of left ventricle

Flabby useless ventricle

heart failure

Myocardial infarction

scarring of heart tissue

weak heart

Endocrine system releases hormones to keep fluid so BP and be steady

Nervous system release epi & norepi for vasoconstriction

inadequte amount of blood reaching digestive system

Body trying to keep heart alive