1. Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Chapter 14: The Heart and Heart Disease

2. Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Cohen: Memmler’s The Human Body in Health and Disease Location of the Heart In mediastinum Apex pointed toward Circulation and the Heart The circulatory system is.

3. Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Cohen: Memmler’s The Human Body in Health and Disease Figure 14-1 The heart in position in the thorax (anterior view). Why is the left lung smaller than the right lung?

4. Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Cohen: Memmler’s The Human Body in Health and Disease Structure of the Heart Learning Outcomes 1.Describe the three tissue layers of the heart wall. 2.Describe the location and structure of the pericardium and cite its functions.

5. Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Cohen: Memmler’s The Human Body in Health and Disease Structure of the Heart Tissue Layers of the Heart Wall Endocardium Myocardium Epicardium

6. Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Cohen: Memmler’s The Human Body in Health and Disease Figure 14-2 Layers of the heart wall and pericardium. Which layer of the heart wall is the thickest?

7. Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Cohen: Memmler’s The Human Body in Health and Disease Structure of the Heart _________________________ The sac that encloses the heart –_____________________________________ –Serous pericardium Parietal layer fused to fibrous pericardium Visceral layer (epicardium) fused to myocardium –_____________________ is the pace between serous layers

8. Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Cohen: Memmler’s The Human Body in Health and Disease Structure of the Heart Special Features of the _____________ Composed of _____________________ –Are lightly striated (striped) –Have single nucleus cells –Are controlled ________________ –Have intercalated disks –Have branching muscle fibers

9. Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Cohen: Memmler’s The Human Body in Health and Disease Figure 14-3 Cardiac muscle tissue viewed under the microscope (x540).

10. Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Cohen: Memmler’s The Human Body in Health and Disease Structure of the Heart Learning Outcomes 3.Compare the functions of the right and left chambers of the heart. 4.Name the valves at the entrance and exit of each ventricle and identify the function of each. 5.Briefly describe blood circulation through the myocardium.

11. Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Cohen: Memmler’s The Human Body in Health and Disease Structure of the Heart Divisions of the Heart Double pump – Right side pumps __________________________________________ – Left side pumps __________________________________________

12. Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Cohen: Memmler’s The Human Body in Health and Disease Structure of the Heart Four Chambers Right atrium Left atrium Right ventricle Left ventricle

13. Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Cohen: Memmler’s The Human Body in Health and Disease Figure 14-4 The heart and great vessels. Which heart chamber has the thickest wall?

14. Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Cohen: Memmler’s The Human Body in Health and Disease Structure of the Heart Four Valves Atrioventricular valves –________________________ Right atrioventricular (AV) valve (___________ valve) Left atrioventricular (AV) valve (__________ valve) Semilunar valves –Exit valves

15. Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Cohen: Memmler’s The Human Body in Health and Disease Figure 14-5 Heart valves (superior view from anterior, atria removed). How many cusps does the right AV valve have? The left?

16. Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Cohen: Memmler’s The Human Body in Health and Disease Structure of the Heart Blood Supply to the Myocardium Coronary arteries –Right coronary artery –Left coronary artery Cardiac veins

17. Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Cohen: Memmler’s The Human Body in Health and Disease Figure 14-6 Blood vessels that supply _____________________ What is the largest cardiac vein and where does it lead?

18. Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Cohen: Memmler’s The Human Body in Health and Disease Figure 14-7 Opening of coronary arteries in the aortic valve (anterior view).

19. Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Cohen: Memmler’s The Human Body in Health and Disease Heart Function Learning Outcomes 6.Briefly describe the cardiac cycle 7.Name and locate the components of the heart’s conduction system. 8.List and define several terms that describe variations in heart rates. 9.Explain what produces each of the two normal heart sounds and identify the usual cause of a murmur.

20. Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Cohen: Memmler’s The Human Body in Health and Disease Heart Function Cardiac Cycle Series of event occurring in the heart during one heartbeat – –

21. Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Cohen: Memmler’s The Human Body in Health and Disease Figure 14-8 The cardiac cycle. When the ventricles contract, what valves close? What valves open?

22. Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Cohen: Memmler’s The Human Body in Health and Disease Heart Function Cardiac Output (CO) ____________________________________________ Calculation of cardiac output –Stroke volume (SV): The volume of blood pumped by the heart per heartbeat –Heart rate (HR): The number of heartbeats per minute CO = SV x HR CO = mL/min

23. Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Cohen: Memmler’s The Human Body in Health and Disease Heart Function The Heart’s Conduction System Components – –Internodal pathways – – –

24. Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Cohen: Memmler’s The Human Body in Health and Disease Figure 14-9 Conduction system of the heart. What parts of the conduction system do the internodal pathways connect?

25. Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Cohen: Memmler’s The Human Body in Health and Disease Heart Function Although the SA node sets the heart’s pace, the nervous and endocrine systems can influence the heart and allow it to adapt rapidly to changing needs. –Autonomic nervous system (ANS) –Endocrine system Thyroxine speeds heart up

26. Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Cohen: Memmler’s The Human Body in Health and Disease Figure 14-10 Autonomic nervous system (ANS) regulation of the heart. Which cranial nerve carries parasympathetic impulses to the heart?

27. Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Cohen: Memmler’s The Human Body in Health and Disease Heart Function Variations in Heart Rates Premature beat (extrasystole)

28. Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Cohen: Memmler’s The Human Body in Health and Disease Heart Function Normal and Abnormal Heart Sounds Normal –Lub –Dup Abnormal –Organic murmur –Functional

29. Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Cohen: Memmler’s The Human Body in Health and Disease Heart Disease Learning Outcome 11. Describe several common types of heart disease.

30. Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Cohen: Memmler’s The Human Body in Health and Disease Heart Disease Classifications of Heart Disease Inflammatory heart disease – – – Congenital heart disease – –Patent ductus arteriosus – –Coarctation of the aorta –Tetralogy of Fallot

31. Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Cohen: Memmler’s The Human Body in Health and Disease Figure 14-11 Congenital heart defects.

32. Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Cohen: Memmler’s The Human Body in Health and Disease Heart Disease Classification of Heart Disease Rheumatic heart disease Coronary artery disease – – –Angina pectoris

33. Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Cohen: Memmler’s The Human Body in Health and Disease Figure 14-12 Coronary atherosclerosis.

34. Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Cohen: Memmler’s The Human Body in Health and Disease Figure 14-13 Myocardial infarction (MI).

35. Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Cohen: Memmler’s The Human Body in Health and Disease Heart Disease Classification of Heart Disease Abnormalities of heart rhythm (arrhythmia) – –Heart block

36. Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Cohen: Memmler’s The Human Body in Health and Disease Heart Disease Classification of Heart Disease – –Heart chambers enlarge –Blood backs up into lungs – –Fluid accumulates in lungs, liver, abdomen, legs

37. Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Cohen: Memmler’s The Human Body in Health and Disease Heart Studies Learning Outcome 14.Briefly describe methods used to study the heart.

38. Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Cohen: Memmler’s The Human Body in Health and Disease Heart Studies Methods of Studying the Heart –Electrodes –Fluoroscope – –Coronary computed tomography angiography Echocardiography

39. Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Cohen: Memmler’s The Human Body in Health and Disease Figure 14-14 Normal electrocardiography (ECG) tracing. What is the length of the cardiac cycle shown in this diagram?

40. Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Cohen: Memmler’s The Human Body in Health and Disease Figure 14-15 Coronary angiography.

41. Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Cohen: Memmler’s The Human Body in Health and Disease Treatment of Heart Disease Learning Outcome 15.Describe several approaches to the treatment of heart disease.

42. Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Cohen: Memmler’s The Human Body in Health and Disease Treatment of Heart Disease Medications –Statins –Anticoagulants –Digitalis –Nitroglycerin –Beta adrenergic blockers –Antiarrhythmic agents –Slow calcium-channel blockers

43. Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Cohen: Memmler’s The Human Body in Health and Disease Treatment of Heart Disease Heart surgery – –Angioplasty –Coronary atherectomy –Cardiac ablation – –

44. Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Cohen: Memmler’s The Human Body in Health and Disease Figure 14-16 Placement of an artificial pacemaker.

45. Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Cohen: Memmler’s The Human Body in Health and Disease Figure 14-17 Coronary artery bypass graft (CABG).

46. Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Cohen: Memmler’s The Human Body in Health and Disease Figure 14-18 Percutaneous transluminal coronary angioplasty (PTCA).

47. Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Cohen: Memmler’s The Human Body in Health and Disease Figure 14-19 Arterial stent.