amali jantung 4

7/29/2019 amali jantung 4

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Lab 4: Heart sounds and vessels


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Overview

Review

Heart sounds

Blood supply to the heart Blood vessels

Veins

Portal systems

New lab website:http://isu.indstate.edu/~jowhitak/cmritzi.htm

Practical lab review: Sunday 2-5 pm


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Review

How do volume and pressure in the ventricles

change during atrial contraction?

What region of the heart controls the electrical

signal through the heart?

Which standard limb lead has a negative lead on

the right arm and a positive lead on the left arm?


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Overview Review

Heart sounds

Blood supply to the heart

Blood vessels

Veins Portal systems


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Heart sounds

lubb-dubb S1: longer and louder

S2: softer and shorter

S3: found in children and juveniles

S1 & S2 occur in conjunction with theopening and closing of valves

Actually caused by turbulence of blood


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Valvular troubles

Valvular Insufficiency:valve failure causing

backwards flow

Any defect in thevalves can lead to heartfailure

Defective valves can bereplaced with artificialvalves or with pig

valves


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Valvular Troubles (cont)

Mitral valve prolapse: tri- or bicuspid cusps bulgeback into the atrium.

Symptoms: chest pain, fatique, shortness of breath

Cause: hereditary

Valvular Stenosis: cusps of the valve are stiff andopening is constricted by scar tissue

Results from autoimmune disease Causes enlarged heart

Blood moving backwards through the valves causes aheart murmur


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Break for Dynamic Human


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muscles The endocardium prevents blood from

seeping through the heart

How is blood supplied to the myocardium

and the pericardium?

Coronary arteries originating from the aortic

arch


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Arteries in the heart

Aorta

Right Coronary Left Coronary

Marginal artery Circumflex Artery

Posterior IV Artery Anterior IV Artery

Anastomoses


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Anastomoses

Point where two

arteries join to reach a

common destination

If one artery becomes

blocked, the other can

take blood to the

appropriate destination


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Arteries of the heart


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Veins in the heart

Greater Cardiac Vein Small Cardiac Vein

Middle Cardiac Vein

Coronary Sinus

Right Atrium


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Coronary Veins


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Artherosclerosis

Contributes to over

710,000 heart attack

and stroke, andperipheral

vascular disease deaths

each year.

Fatty blockage incoronary

artery


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Artherosclerosis

Cause: Abundance of low-density lipids

and defective receptors for LDL in the

coronary arteries.LDL: cholesterol, free fatty acids and

phospholipids

Arterial cells with defective receptors will takein too much cholesterol

Results in obstruction of the arterial lumen


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Cardiac Ischemia and Infarction

Ischemia: Loss of blood flow

Infarction: Death of myocardial cells; heart attack

Cause: Artheriosclerosis blocks a cardiac artery.

The downstream region does not receive enough

oxygen causing cell death. The death of these

cells weakens the heart wall disrupting electrical

pathways leading to fibrillation.


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Break for Dynamic Human


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Overview

Review

Heart sounds Blood supply to the heart

Blood vessels

Veins Portal systems


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Blood Vessels

Arteries

Capillaries

Veins


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Structure of Blood Vessels

Tunica externa: loose

connective tissue

Tunica media: smoothmuscle, elastin,

collagen

Tunica interna:

endothelium


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Types of Arteries

Conducting (elastic)

Passively accommodate blood flow

Distributing (muscular)High smooth muscle content

Deliver blood to specific organs

ArteriolesControl blood flow

Link to capillaries


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Capillaries

Pre-capillary

sphincters

Open and closecapillary beds

of all capillaries are

ususally closed

Structure:

endothelium only


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Types of Capillaries

Continuous: uninterruptedtube

Only allow small solutes

such as glucose to enter Blood-brain barrier

Fenestrated: riddled withpores

Allow rapid passage of

small molecules Hold proteins in the vessels

Important in organs thatengage in rapid filtration


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Veins

Venules: Collect blood from capillaries

Porous

Veins:

Lower pressure than the arteries

Thinner walls (little tunica media or externa)

but larger lumensWalls expand easy and accomadate more blood

than arteries


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How does blood travel in veins?

1. Messaging action of skeletal muscle

2. Pressure gradient in the body:

Positive pressure in the abdominal cavity and

negative in the thoracic cavity draws blood up


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Venous Valves

3.Venous valves prevent

backflow

Failure of valves

results in varicose

veins


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Special Circulations: Portal

Systems Portal systems:

Blood flows between

two consecutivecapillary beds before

returning to the heart

Artery

Capillary 1

Capillary 2

Vein


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Hepatic Portal System

Connects capillaries of

the intestines to

capillaries of the liver

Delivers newly

absorbed nutrients to

the liver


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Hypothalamo-hypophyseal portal

system Connects

hypothalamus to

pituitary gland

Responsible for

transporting hormones


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Dynamic Human


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Overview

Review

Heart sounds


Blood vessels

Valves

Portal systems

Cat heart and human heart


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Cat Dissection

Finish identifying arteries and veins

Remove cat heart and dissect in half

Valves and chambers

Chordae Tendinai

Coronary Arteries

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