I. Anatomy and Physiology:

A. Layers

1. Endocardium

2. Myocardium

3. Pericardium

B. Circulation

1. Right atrium Tricuspid Valve Right Ventricle Pulmonic Semilunar

Valve Pulmonary Arteries Lungs Pulmonary Veins Left Atrium Mitral

Valve Left Ventricle Aortic Semilunar Valve Aorta Coronary

Arteries and Vascular System Right Atrium

2. Arteries before Veins

3. Tissue Paper My Assets (Tricuspid, Pulmonic, Mitral, Aortic)

4. All valves are unidirectional unless they possess a pathology of stenosis or

regurgitation.

5. Coronary Arteries

a. Sinuses of Valsava Right and Left Coronary Arteries

b. Right Coronary Artery supplies right atrium and ventricle as well as

part of posterior left ventricle.

c. Left Coronary Artery supplies left atrium and left ventricle

* Left coronary artery Left Anterior Descending and Left

Circumflex

6. Lack of O2 ischemia hypoxia necrosis (infarction)

7. Blood flow and O2 delivery to tissues = Perfusion

8. Myocardial ischemia Chest pain (Angina)

B. Conduction System

a. SA node – primary pace maker of the heart (60-100 bpm)

b. AV node – “The gatekeeper” (40-60 bpm)

c. Bundle of His

d. Right and Left Bundle Branches

e. Purkinje Fibers – Last resort pacer (20-40 bpm)

1. Four Principle Properties

a. Automaticity – Pacing fxn or electrical induction

b. Excitability – How cardiac cells respond

d. Conductivity – Transmission of impulse

e. Contractility – Mechanical response to impulse. Associated with Ca.

* Use dobutamine to increase contractility

* Starling’s Law