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60 year old woman, history of DM ll has experienced a myocardial…

- - - - no valves inbetween major veins and atria
      - two atrioventricular (AV) valves
        
        mitral valve
        
        left AV valve
        
        made up of three cusps
        
        tricuspid valve
        
        right AV valve
        
        made up of three cusps
        
        these valves prevent backflow into atria when ventericles contract
      - open and close
        
        in response to pressure changes
      - ensure one direcation flow of blood through heart
      - two semilunar (SL) valves
        
        pulmonary valve
        
        right SL valve
        
        between RV and PT
        
        aortic valve
        
        left SL valve
        
        between left ventrical and aorta
        
        prevent backflow from major artieries back to ventricles
        
        each has 3 cusps resemble half moons
    - - hold valve flaps in closed position
      - prevent flaps from everting back into atria
  - - - S1
        
        closing of AV valves at beginning of ventricular systole
      - S2
        
        closing of SL valves at beginning of ventricular dastole
      - pause between lub dub indicates relaxation
  - - - right ventricle
      - pulmonary semilunar valve
      - tricuspid valve
      - pulmonary trunk
      - right atrium
      - pulmonary arteries
      - enter into 3 ways
        
        inferior vena cava
        
        coronary sinus
        
        superior vena cava
      - Lungs
    - - enters four pulmonary veins
      - left atrium
      - mitral valve
      - left ventricle
      - aortic semilunar valve
      - aorta
      - systemic circulation
  - - - receveiving chambers
        
        right atrium
        
        recieves blood returning from systemic circuit
        
        from veins
        
        left atrium
        
        recieves blood returning from pulmonary circuit
        
        from veins
      - pumping chambers
        
        right ventricle
        
        pumps blood through pulmonary circuit
        
        from arteries
        
        left ventricle
        
        pumps blood through systemic circuit
        
        from arteries
    - - right side
        
        recieves oxygen poor blood from tissues
        
        known as pulmonary circuit
      - left side
        
        recieves oxygenated blood from lungs
        
        known as systemic circuit
    - - mediasternum
        
        between 2nd rib and 5th rib
        
        intercoastal space
      - 2/3 of heart to left of midsternal line
      - base (posterier surface)
        
        leans to right shoulder
      - apex
        
        points toward left hip
      - apical impulse
        
        palpated between 5th and 6th ribs, below left nipple
  - - - volume of blood pumped out by one ventricle
        
        with each beat
      - correlates with force of constraction
    - - amount of blood pumped by each ventricle
        
        in one minute
      - equals HR x SV
    - - speed of the heart beat
        
        measured by the # of contractions of heart per minute
- - - - insulin deficency
  - - - doesnt produce insulin
      - or resists insulin
- - - - due to lack of oxygen
  - - - MI may cause pressure build up in main vein connected to kidneys
        
        may lead to blockage
    - - sympathetic nervous system is activated
        
        vagal activity occurs
      - can futher worsen heart failure
    - - breathing problems will occur over time
      - fluid gets put into lungs sacs where doesnt belong
      - trouble breathing
      - tachycardia
  - - - blood can flow back into left atria
    - - heard with a stethoscope
      - irregular sound of heart