Anatomy of the heart

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  • The heart, located in the mediastinum, is the central structure of the cardiovascular system. It is protected by the bony structures of the sternum anteriorly, the spinal column posteriorly, and the rib cage. Clinical Tip:The cone-shaped heart has its tip (apex) just above the diaphragm to the left of the midline. This is why we may think of the heart as being on the left side, since the strongest beat can be heard or felt here.

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  • Upon completion of this lesson, the successful participant will be able to: Describe the size, shape, location, and orientation of the heart in the thorax; name the coverings of the heart; describe the structure and function of each of the three layers of the heart wall; describe the structure and functions of the four heart chambers; name each chamber and provide the name and general route of its associated great vessel(s);...

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  • After completing this chapter, students will be able to: Describe the structural and functional properties of cardiac muscle, and explain how it differs from skeletal muscle; briefly describe the events of cardiac muscle cell contraction; name the components of the conduction system of the heart, and trace the conduction pathway;...

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  • Electrocardiograms (ECGs) are the graphic representation of body surface potential differences generated by the electrical activity of the heart. Bipolar limb leads, augmentedunipolar limb leads and precordial leads have been used routinely for recording the ECG, which remains an essential part of the cardiac examination, even after the advent of cardiac catheterization, angiocardiography, echocardiography and many other sophisticated diagnostic modalities.

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  • Heart failure is the end stage of all diseases of the heart and is a major cause of morbidity and mortality. It is estimated to account for about 5% of admissions to hospital medical wards, with over 100 000 annual admissions in the United Kingdom. The overall prevalence of heart failure is 3 20 per 1000 population, although this exceeds 100 per 1000 in those aged 65 years and over. The annual incidence of heart failure is 1 5 per 1000, and the relative incidence doubles for each decade of life after the age of 45 years.

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  • Understanding the concepts presented in this chapter will enable the student to: 1. Describe the basic anatomy of the heart, including the names of venous and arterial vessels entering and leaving the heart, cardiac chambers, and heart valves; trace the flow of blood through the heart. 2. Describe how each of the following changes during the cardiac cycle:

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  • Calculate the Nernst equilibrium potential for sodium, potassium, and calcium ions given their intracellular and extracellular concentrations. 3. Describe how changing the concentrations of sodium, potassium, and calcium ions inside and outside the cell affect the resting membrane potential in cardiac cells. 4. Explain why the resting potential is near the equilibrium potential for potassium and the peak of an action potential approaches the equilibrium potential for sodium. 5.

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  • Medicine is, fortunately, constantly evolving. Imaging diagnosis is no exception. Technical improvements guarantee further developments in diagnosis. Computed tomography (CT) and magnetic resonance imaging (MRI) have attained a recognized value in the diagnosis of the heart, which is continuing to increase. For this reason, we have now provided a separate chapter on diagnostic imaging of the heart. We have placed sectional CT images next to MR images of the heart to facilitate classification. We have limited ourselves to scans which are presently recognized as standard.

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  • Medicine is, fortunately, constantly evolving. Imaging diagnosis is no exception. Technical improvements guarantee further developments in diagnosis. Computed tomography (CT) and magnetic resonance imaging (MRI) have attained a recognized value in the diagnosis of the heart, which is continuing to increase. For this reason, we have now provided a separate chapter on diagnostic imaging of the heart. We have placed sectional CT images next to MR images of the heart to facilitate classification. We have limited ourselves to scans which are presently recognized as standard.

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  • The present second edition of the Color Atlas of Pharmacology goes to print six years after the first edition. Numerous revisions were needed, highlighting the dramatic continuing progress in the drug sciences. In particular, it appeared necessary to include novel therapeutic principles, such as the inhibitors of platelet aggregation from the group of integrin GPIIB/IIIA antagonists, the inhibitors of viral protease, or the non-nucleoside inhibitors of reverse transcriptase. Moreover, the re-evaluation and expanded use of conventional drugs, e.g.

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  • The electrocardiogram (ECG), introduced into clinical practice more than 100 years ago by Einthoven, constitutes a lineal recording of the heart’s electrical activity that occurs successively over time. An atrial depolarisation wave (P wave), a ventricular depolarisation wave (QRS complex) and a ventricular repolarisation wave (T wave) are successively recorded for each cardiac cycle (Figures 1A–C). As these different waves are recorded from different sites (leads) the morphology varies (Figure 2).Nevertheless, the sequence is always P–QRS–T.

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  • We have compiled and written this textbook to highlight the clinical indications and applications of cardiac magnetic resonance imaging (MRI). Over the past few decades, MRI has become an essential element of decision making for many medical specialties. However, though cardiovascular diseases are a major cause of morbidity and mortality throughout the world, MRI of the heart and great vessels has experienced relatively slow acceptance.

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  • Perioperative critical care cardiology (PCCC) includes the cardiovascular management of patients with any underlying diseases or imposed conditions (whether natural or iatrogenic) that involve or affect the heart–including, acute or chronic mechanical heart failure (HF). This can result from ischemic heart disease, diabetes mellitus, uncontrolled hypertension, arrhythmias that compromise heart function, circulatory shock, or dilated or obstructive cardiomyopathy. Patients needing therapy for HF are especially challenging to clinicians involved their perioperative care....

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  • The diagnosis and successful management of congenital heart disease represents one of the greatest triumphs of cardiovascular medicine and surgery in the 20th century. As a consequence, the number of adults with congenital heart disease – both with repaired and unrepaired lesions – has grown rapidly, and is now approaching one million in North America. Similar increases have occurred in Western Europe. The care of adults with congenital heart disease represents a major challenge.

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  • The inflammatory process both reduces collagen synthesis by inhibiting the smooth muscle cell and causes its death by apoptosis. Macrophages also produce a wide range of metalloproteinases capable of degrading all the components of the connective tissue matrix, including collagen. These metalloproteinases are secreted into the tissues in an inactive form and then activated by plasmin. Metalloproteinase production by macrophages is upregulated by inflammatory cytokines such as TNFá.

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  • Organ damage and the resultant inflammatory responses initiate a series of repair processes, including stem cell proliferation, migration, and differentiation, often in combination with angiogenesis and remodeling of the extracellular matrix. Endogenous stem cells in tissues such as liver and skin have a remarkable ability to regenerate the organs, whereas heart and brain have a much more limited capability for self-repair. Under rare circumstances, circulating stem cells may contribute to regenerative responses by migrating into a tissue and differentiating into organ-specific cell types.

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  • Physicians once found it convenient to think of cardiac arrhythmias as a sort of “itch” of the heart and of antiarrhythmic drugs as a soothing balm that, applied in sufficient quantities, would relieve the itch. During the past several decades, however, pioneering work has revealed many of the complexities of cardiac arrhythmias and of the drugs used to treat them. To the dismay of most reasonable people, the old, convenient viewpoint finally proved utterly false.

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  • Children rarely present with the symptoms classically associated with heart disease in adults (chest pain, shortness of breath, swollen ankles) – rather they present with a variety of symptoms such as failure to thrive, frequent chest infections, or unexplained ‘funny turns’. A careful history and examination is key, as are special investigations such as CXR, ECG and pulse oximetry. An echocardiogram is the gold standard investigation required to confirm the diagnosis.

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  • Chapter 22 provides knowledge of cardiology. After completing this chapter, students will be able to: Identify risk factors and prevention strategies associated with cardiovascular disease, describe the normal anatomy and physiology of the heart.

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  • Why study chemistry in an anatomy and physiology course? The answer is simple. Your entire body is made up of chemicals, thousands of them, continuously interacting with one another at an incredible pace. Although it is possible to study anatomy without much reference to chemistry, chemical reactions underlie all physiological processes—movement, digestion, the pumping of your heart, and even your thoughts. This chapter presents the basic chemistry and biochemistry (the chemistry of living material) you need to understand body functions.

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