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Heart Attack (Myocardial Infarction): 60-year-old Woman (Myocardial…
Heart Attack (Myocardial Infarction):
60-year-old Woman
Anatomy Of
HEART
Layers
of The Heart Wall
Epicardium (Outer Layer)
Visceral
Fat to cushion heart
Myocardium (Middle Layer)
Thickest Layer
"Muscle Heart"
Contracts
Muscle Cells
Crisscrossing CT
Circular and Spiral arrangements
Endocardium (Inner Layer)
Simple Squamous Epithelium
Endothelium
stretches as the heart pumps
thin and smooth
Valves
Semilunar Valves
Pulmonary
Valve
controls blood flow from the right ventricle into the pulmonary arteries
carry blood to your lungs to pick up oxygen
Prevents blood from flowing back into the Left Ventricle
Aortic
Valve
Prevents back-flow into the Left ventricles
opens the way for oxygen-rich blood to pass from the left ventricle into the aorta
Have 3 Semilunar Cusps
Pressures
Open
when the ventricular pressure exceeds the aortic pressure
Close
when the Ventricular Pressure drops below the aortic pressure
Atrioventricular (
AV
) Valves
Right
Tricuspid
Valve
regulates blood flow between the right atrium and right ventricle.
3 Flexible Cusps
Prevents blood from flowing back into the right atrium when the right ventricle contracts
Left
Mitral
Valve
lets oxygen-rich blood from your lungs pass from the left atrium into the left ventricle
2 Cusps
also called
"Bicuspid Valve "
Prevents blood from flowing back into the left atrium when the left ventricle contracts
Function
prevents back flow into the atria when ventricles contract
Chordae Tendinae
anchor the cusps to the papillary muscles from the ventricular walls
tiny white collagen cords
attached to each AV valve flap
Pressures
Close
when the Ventricular Pressure exceeds the Atrial Pressure
Open
When the Ventricular pressure drops below the atrial pressure
Function
Diastole
Systole
Heart Chambers
Left Side
Left Atrium
Pectinate Muscles
ONLY found in the Auricle
blood returning from the
Pulmonary Circuit
Interatrial Septum
Fossa Ovalis
a shallow depression
marks a spot from a pre-existing opening called
Foramen Ovale
existed in the Fetal Heart
4 Pulmonary Veins
enter
makes up most of the Heart's Base
transport blood from the lungs back to the Heart
Left Ventricle
Ejects blood into the
Aorta
Largest Artery in the Body
Mitral Valve
Characteristics
Thicker wall than right ventricle
Round shape
generate much more pressure
more powerful pump
pumps blood into the
Systemic Circuit
Receives Oxygenated blood from the Pulmonary Veins
Right Side
Right Atrium
Pectinate Muscles
comb-like
Crista Terminalis
C-shaped Ridges
Separate the
anterior
and
posterior
regions of the R Atrium
Receives blood returning from the
Systemic Circuit
Veins
Superior Vena Cava
Returns blood from body regions
Inferior Vena Cava
Returns blood from body areas below the diaphragm
Coronary Sinus
collects blood draining from the myocardium
Right Ventricle
Pumps blood into the
Pulmonary Trunk
Routes blood to the Lungs
Gas Exchange Occurs
Characteristics
Thinner wall than left ventricle
crescent shape
wraps around left ventricle
Receives Deoxygenated blood from Systemic Veins
Atria
Receiving
Chamber
Relatively small and are Thin- Wall Chambers
b/c they need to Contract
ONLY
minimally to push blood "downstairs" into Ventricles
Ventricles
Discharging
Chamber
"Actual Pump of the Heart"
makes up most of the Volume of the Heart
Trabeculae Carnae
"Irregular Ridges"
mark the internal walls
Papillary Muscles
Muscle Bundles
Play a Role in Valve Function
Walls are much more Massive than the Atrial Walls
Location
within Mediastinum
medially between the lungs
Behind the Sternum and above the Diaphragm
Membranes
Pericardium
Double-walled
Fibrous pericardium
protects the heart
anchors it to surrounding structures
prevents overfiling of the heart with blood
Serous Pericardium
characteristics
thin, slippery
Two -layer
forms a closed sac around the heart
filled with serous fluid
Parietal
lining internal surface of fibrous pericardium
Visceral
"epicardium"
covering
Coronary Circulation
Aorta
Arteries
Right Coronary Artery
Right Marginal Artery
Posterior Interventricular Artery
supplies the bottom portion of the left ventricle and back of the septum with blood
Left Coronary Artery
Anterior Ventricular Artery
Supplies blood to the front and bottom of the Left Ventricle and the front of the Septum
Circumflex Artery
supplies blood to the left atrium and the side and back of the Left Ventricle
Main supplier to the body
Largest Artery in the body
Veins
Coronary Sinus
all of the Cardiac Veins draining blood from the myocardium combine to form this enlarged vessel
empties into the R. Atrium
ADDITIONALLY:
Several
Anterior Coronary Veins
empty into the R. Atrium directly without utilizing the coronary sinus.
Great CV
Middle CV
Small CV
Anterior CV
Blood that already has been "used " by muscles of the heart and return it to the right atrium
Current State
History
Diabetes Mellitus II
Obesity
Blood Pressure : 95/55 mm Hg
Low blood pressure
Breathing Rate: 30 Breaths per minute
Normal breathing rate is 12-20 per min
Heart Rate: 125 bmp
heart rate is high at resting rate
Tachycardia
Heart Sounds
"Lub- Dub"
First Heart Sound- LUB
Caused by the
AV Valves Closing
point when ventricular pressure rises above atrial pressure
Mitral and Tricuspid
Beginning of
Ventricular Systole
period of contraction
Second Heart Sound- DUB
caused by the
SL Valves Closing
Beginning of
Ventricular Relaxation (Diastole)
aortic and pulmonic valves
snap SHUT!
as valves close the resulting turbulent blood Flow creates a sound
Pathway of Blood
Superior/Inferior Vena Cava
Right Atrium
Tricuspid Valve
Right Ventricle
Pulmonary Semilunar (SV) Valve
Pulmonary Trunk
Right and Left Pulmonary Arteries
Lungs
2 more items...
Pulmonary Circuit
Blood Vessels that carry blood to and from the Lungs
receives deoxygenated blood from body tissues
pumps blood to Lungs
picks up Oxygen (O2)
delivers Carbon Dioxide (CO2) for exhaling
Cardiac Output (CO)
amount of blood pumped OUT by each ventricle in 1 minute
Product of
Heart Rate
and
Stroke Volume
Heart Rate (HR)
number of beat per minute
Stroke Volume (SV)
Volume of Blood out of each ventricle per beat
End Dialostic Volume (EDV)
EDV : amount of blood that collects in a ventricle during Diastole
Preload
degree to which cardiac muscle cells are stretched just before they contract
control Stroke Volume
The Higher the Preload the Higher the Stroke volume
Relationship between preload and stroke volume is called
Frank-Starling law of the Heart
Factor:
Venous Return
amount of blood returning to the heart and distending its ventricles
Major
intrinsic factor
End Sylostic Volume (ESV)
Volume of blood remaining in a ventricle
after
it contracted
SV= EDV - ESV
Other Factors
Afterload
Is the pressure that the ventricles must overcome to eject blood
Contractility
the contractile strength achieved at a given muscle strength
CO= HR X SV
Blood Pressure
the force per unit area exerted on a vessel wall by the contained blood
Resistance
a measure of the amount of friction blood encounters as it passes through the vessels
opposition to flow
most friction is encounter in the Peripheral (Systemic) Circulation
Total Peripheral Circulation (TPR)
Factors
Blood Viscosity
Vessel Length
Vessel Diameter
Blood Flow
Volume of blood flowing through a vessel
equivalent to
Cardiac Output
Myocardial Infarction
Diagnosed?
Listen to your Heart to check for irregularities in your heartbeat
measure Blood Pressure
Run Different Tests
Electrocardiogram (EKG)
Measure hearts electrical activity
Blood Test
used to check for proteins associated with heart Damage
specifically
Troponin
Echocardiogram
helps identify areas of your Heart that aren't working properly
will be able to see the Mitral Valve failure
when one of the heart's coronary arteries is blocked suddenly or has extremely low blood flow
Symptoms
Chest Pain
heavy
Tightness
Pressure
Aching Sensation
chest
arms
neck
jaw
back
shortness of breath
Dizziness
Anxiety
Sweating
Fast Heart Rate
Risk factors:
High Blood pressure
Normal Blood Pressure: 120/80 mm Hg
damages your arteries and accelerates the buildup of plaque
Obesity
Cigarette Smoking
Physical Inactivity
Age
woman over 55 are more likely to have a Heart Attack
Diabetes
can damage blood vessels and eventually lead to Coronary Artery Disease
Effect on other Systems
Respiratory
causes irregularities in the way fluid is carried away from the lungs
fluid build up in lungs
Breathing can be impaired
The heart and lungs work together to make sure the body has Oxygen-Rich blood it needs to function properly
Nervous Systems
Sympathetic Nervous System is activated
leads to further worsening of heart failure
heart rate acceleration
increase Cardiac Contractility
Urinary
lead to kidney disease
supply and Oxygen-Rich Blood Is Reduced
causes pressure to build up in the main vein connected to the kidneys
may lead to a blockage
Complications
Heart Failure
Sudden Cardiac Arrest
Abnormal Heart Rhythms (Arrhythmias)
papilla muscle rupture
Mitral Valve Failure
valve is not closing tightly
therefore its allowing blood to flow backward in your heart
blood can't move through your heart or to the rest of the body
Indirect
Age
60 years
Woman who are older than 55 are likely to get a heart attack
Diabetes Mellitus II
higher risk for heart failure
high blood glucose
Obesity
Direct
Coronary Artery Blockage
blood to flow throughout the heart
blocked by plaque
leading to heart attack
formation of blood clot occurs
Oxygen-Rich
Oxygen-Poor