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HEART revised 01March2016 S~ p. ~89-, Martini’s 4th: 673-705, Martini’s 5th: 654-689 Martini’s 6th: 683-716, 7th: 670-703, 8th: 681-694, 9th: 670-703, 10th: 684-720 Circulatory system is “closed,” lined with endothelium "leakage" constitutes lymph, returned via lymphatic system (see previous lecture.) Draw: 2 circuits, pulmonary & systemic: thus the two pumps of heart. (p 685) EMBRYOLOGY: future heart first pulsating tubule, pumps back to front 5th week, shaped like S, divides: anterior: aorta and pulmonary trunk posterior: superior and inferior VC By seventh week, partitions develop: four chambers result ANATOMY: occupies space between lungs, mediastinum. (P 687) Base (vessel end) behind sternum, level with 2nd intercostal space Apex (point) down to L, reaches 5th intercostal space with R ventricle resting upon diaphragm COVERINGS: pericardium: double walled sac, lined with serous membrane, folds back on self at large vessels p 689 Parietal pericardium, two layers: fibrous outer and serous inner Pericarditis, serous layers roughened, pain when rub against each other LAYERS OF THE WALLS: p 689 Epicardium visceral pericardium Myocardiun thickest, muscular layer, folds and bridges: trabeculae carnae (little beams of flesh) Endocardium connective tissue covered with squamous cells continuous with lining of blood vessels foldings of endocardium form valves (atrioventricular and semilunar valves) TO DRAW: 1) valves in a diagonal row: pulm, aortic seimi, tricuspid 2) place mitral to immediate L of tricuspid. in order: 3) draw pulmonary trunk first (front, up to R), then aorta behind p 676 4) lining of the ventricles, septum 5) lining of atria (include vena cavae) 5) papillary muscles, chordae tendonae to AV valves 6) outer muscular walls, L ventricle thicker 7) vena cavae, coronary sinus opening 8) pulmonary veins into L atrium Chambers: Atria entrance way, (also auricle) thin walls, load blood into ventricles. ventricles little belly, major pumper, R has thin wall, L thick (draw cross section) p 693 coronary sulcus where atria and ventricles join (coronary artery lies here) Vessels: Right side: superior and inferior vena cava, pulmonary trunk, divides to R & L pulm. arteries Left side: four pulmonary veins, aorta (lifting, heaving) L walls thicker, force needed is greater to circulate around body but volume pumped by two halves must be same. If not, congestive heart failure: weak L side: pulmonary edema lungs fill with fluid weak R side: systemic edema ankles swell, liver, high diastolic pressure SKELETON OF HEART: p 694: fibrous trigones: fibrous rings support valves, separates atria from ventricles, insulates. VALVES: Skeleton of the heart (fibrous trigone): tricuspid between R atrium and R ventricle pulmonary semilunar between R ventricle and pulmonary trunk bicuspid (mitral) between L atrium and L ventricle aortic semilunar between L ventricle and ascending aorta Papillary muscles connect via chordae tendineae to AV valve cusps, position valves CARDIAC CIRCULATION (P 696) Coronary vessels R and L coronary arteries exit just above aortic semilunar, circle in AV groove, form circumflex Coronary Veins coronary sinus drains into R atrium Anterior interventricular artery: “heart attack artery” FUNCTION: Automatic contraction, inherent rhythm, all or none contraction long refractory period. (no tensing of heart muscle)