Advanced Cardiac Anatomy
Advanced Cardiac Anatomy
Information Covered:
Anatomy of the Cardiovascular System
A. Location
- Layers
- Myocardium
- Endocardium
- Pericardium
- visceral (epicardium)
- parietal
- pericardial fluid
- Chambers
- Atria
- Ventricles
- Valves
- Atrioventricular (AV) valves
- tricuspid (right)
- mitral (left)
- Semilunar valves
- pulmonic (right)
- aortic (left)
- Atrioventricular (AV) valves
- Papillary muscles
- Chordae tendineae
- Myocardial blood supply
- Arteries
- Left coronary artery
- Arteries
a) Anterior descending artery (LAD)
i) distribution to the conduction system
ii) distribution to the left and right ventricles
b) Circumflex artery
i) distribution to the conduction system
ii) distribution to the left ventricle
iii) distribution to the left atrium
ii. Right coronary artery
a) Posterior descending artery
i) distribution to the conduction system
ii) distribution to left and right ventricles
b) Marginal artery
i) distribution to the conduction system
ii) distribution to the right ventricle
iii) distribution to the right atrium
b. Veins
- Coronary sinus
- Great cardiac vein
7. Conduction system
- Sinoatrial node
- Atrioventricular node
- Atrioventricular bundle (Bundle of His)
- Bundle branches
- left anterior fascicle
- left posterior fascicle
- right
- Purkinje network
- Internodal and interatrial pathways
- Atrioventricular node
- Left Atrium (Bachmann’s bundle)
- Middle internodal tract (Wenckebach’s tract)
- Posterior internodal tract (Thorel’s tract)
- Anatomical tracts that bypass the atrioventricular node
i. considered possible conduction routes that account for anomalous atrioventricular conduction (Wolff-Parkinson- White syndrome, Lown-Ganong-Levine syndrome)
a) James fibers
b) Mahaim fibers
c) Accessory bundle of Kent
8. Vascular system
- Aorta
- ascending
- thoracic
- abdominal
- Arteries
- Arterioles
- Capillaries
- Venules
- Veins
- Vena cava
- Superior
- inferior
II. Physiology
- Cardiac cycle
- Consists of systole and diastole of atria and ventricles
- Cycle occurs in about 0.8 seconds and 70-80 cycles/minute average
- Events that occur in 1 cardiac cycle:
a. Atrial systole
- AV valves open and SL valves closed
- ventricles relaxed
- preceded by P wave on ECG
b. Isovolumetric contraction
- between start of ventricular systole and opening of SL valves
- ventricular volume remains constant
- onset coincides with R wave on ECG
- first heart sound heart (S1)
a) caused by ventricles contracting and closure of cuspid valves
b) “lubb” sound
- c. Ejection -- Initial, shorter, rapid ejection followed by longer phase
of reduced ejection
- Residual volume of blood remains in ventricles following ejection phase
- Residual volume increases in states of heart failure
- d. Isovolumetric relaxation
- period between closure of SL valves and opening of AV valves
- ventricles are relaxing
- second heart sound heard during this phase (S2)
a) caused by closure of SL valves
b) “dubb” sound
- e. Rapid ventricular filling f. Reduced ventricular filling (diastasis)
- Cardiac output
1. Heart rate X stroke volume
- Starling’s law
- Contractility
Content Creator: Bridget Kammerzelt
CAPCE Course Number: 20-EMTP-F3-7201
Total CE Hours: 1
Level: Advanced
NJ Course Number: 1932943604367
EMT-CE uses the NEMSES guidelines as the foundation for every course outline.