Pathophysiology

Challenge 2010
propound

Lecture Notes
Lecture Title : CVS Prof name : Dr.Mostafa Shihebat Done by : Hebah Ramadneh

Introduction for the cardiovascular system (cvs)

First of all the doctor talk about the exam, so get the exam because the makeup will be essay and difficult and he said that there is review in Thursday lecture.

The heart :
Heart: it's a vital organ in our body , it receive deoxygenated blood from all over the body , then the blood will pump to the lung by pulmonary artery to be oxygenated then return to the heart by pulmonary vein . then blood go all over the body.

note

1. Pulmonary artery : the only artery that carry deoxygenated blood . 2. Pulmonary vein : the only vein that carry oxygenated blood .

Anatomy of the heart :

-it composed by 4 chamber , 2 right and left aurum and 2
right and left ventricles . -right side of the heart separate from left side by fibrous tissue (NO opining except in the feral life there is opining in the atrium called fosse oval it should be closed after birth ) If it still ,it will be pathological state , and called foramin ovali And there is another opening in the left pulmonary artery and aorta which called inductus arteriorus and it must be closed . -ventricle and atrium are separate by fibrous tissue .

So, the impulse transmit in the heart by conductive system not direct between atrium and ventricle .except in rare situation called muscular bridge which return the impulse again to the atrium .

The location of the heart :

-its extend between second inter costal space to the fifth inter
costal space (base: above and the apex :below) On the apex there is appoint called (PMI) , (PMI) : point of maximum intensity .

Cardiomegaly : its enlargement of the heart so the (PMI) will

be in sixth or seventh intercotal space. -the heart locate in the thoracic cavity in the mediastinum.

Papillary muscle cordial tendinae:

Its attached to the valves , its prevent plugging of the valves to atrium, during ventricular contraction . -the rupture of the papillary muscle lead to back flow of blood to the atrium and reduce the output of the heart.

Atrial sensation :

the atrium contract as one unite because the impuls originat from SA node and the leaky of ions . so when action potential start in one cell it will spread all over the atrium . very quickly.

Conductive system of the heart :

SA node. AV bundle . Purkinje fibers

 Blood vessels :

1-artery 2-artiriol 3-cappilaries 4-vein 5- venules

Each one of these blood resells has its own anatomical structure to do its function.

- Artery: condensing the blood to the body - Arteriol: control blood pressure - capillaries: exchange gases and nutrient between blood vessel and enter serial space. - vein: conduct blood to the heart .

note

:vein has Avery important function its reservoir of the blood .

 Specific feature of the

heart:
1-Contractility 2-Conductivity 3- excitability 4- rethmisity

Contractility :

its the contraction in the heart its different

from contraction of skeletal and smooth muscle

because in the cardiac muscle contraction we have platen because in skeletal and smooth and cardiac muscle we have facer sodium channel but in cardiac muscle we have addition slow Ca-Na channel which responsible for platen . Platen: the rest period between contraction the atrium and ventricle not together because of plateau .

Excitability :

the heart is self excited that mean that the action potential and the impulse is enitiaten in the heart itself from the base maker of the heart

(SA node)

What is the role of the brain in cvs ?

- The heart isn't work under the direct control of the brain . but it effect by sympathetic and parasympathetic system (autonomic nerves system (ANS)) so if the patient has brain death the heart may being working.

The innervated of the heart

-Its innervated by sympathetic and parasympathetic nerve .
-The atrium innervated by parasympathetic nerve (vagus nerve)which effect the heart rate (parasympathetic stimulation decrease the heart rate) -The ventricle innervated by sympathetic nerve (the stimulation of sympathetic system decrease the heart rate and decrease the cardiac output.

* Sympathetic nerve come from T1-L2

note

The heart effect by hormones mainly adrenaline and noradrenalin , which secret by adrenal gland .they case central vasodilatation and peripheral vasoconstriction . Sympathetic system innervated the left ventricle more than other part because it can increase the cardiac output . The heart has receptor for Sympathetic and parasympathetic .they are alpha 2 ,peta1 , but alpha 1 in blood vessel and beta 2 in the lung .

B1:increase heart rate and contractility. B2:broncho dilication . Alpha1:vasoconstriction . Alpha 2 : vasodilication .

Why vein effect by sympathetic nerve more than other blood vessel ? -because the vein is reservoir of blood because
Sympathetic innervations we need more blood.

ECG:
electro cardiogram reflect the action potential of the heart . use of diagnosis most decease in the heart.

The wisdom of the day:

It does not matter how much fatigue effort for others, but it is important that you see the joy in their eyes when they see your creativity

DONE BY : HEBAH RAED RAMADNEH

GOOD LUCK