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Heart Anatomy: Chambers, Valves, & Structures Nursing Review — Transcript

by RegisteredNurseRN · 2,872 words · 410 segments · language en · Watch on YouTube

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0:00hey everyone it's nurse Sarah and in
0:01this video I'm going to be covering the
0:03heart's Anatomy such as the chambers the
0:05great vessels and the valves so let's
0:08get started the human heart is located
0:10in the media stanum which is the cavity
0:12between your right and left lung and
0:15it's positioned slightly left to the
0:17center of the chest and is behind the
0:19sternum now when some people try to
0:21picture the human heart they think of a
0:23heart shape like this so a nice red
0:26heart that just sits right there in the
0:27chest but in reality it's more shaped
0:30like a cone that sets in your chest
0:32upside down so the base is on the top
0:34and the pointed part is at the bottom
0:36and it's sort of sideways in there so
0:38that pointed part is known as the Apex
0:40and it's going to point more to the left
0:42side of the body and the base is the top
0:45part and it's going to be like
0:46positioned toward the right shoulder in
0:49a nursing you want to be familiar with
0:51the Bas and the Apex especially the Apex
0:54because the Apex is the place where the
0:56appical pulse is taken so this is the
0:58point of maximum impulse hence the
1:01strongest contraction and the reason you
1:03want to know where this is is because
1:05whenever we give medications like dejin
1:07we want to measure that appical pulse
1:09beforehand and appical pulse is
1:11typically located on the left side of
1:14the chest at that fifth intercostal
1:16space at the midclavicular line while on
1:18the flip side the base of the heart is
1:21located more about right behind your
1:23sternum at that second inner coal space
1:27now let's go inside the heart and look
1:29at its structure so here you're going to
1:31see an anterior view of the heart and
1:34the left and right will be flipped on
1:36your view of the screen so just remember
1:38that whenever I'm talking about the
1:40right side and the left side so the
1:42chambers include the following on the
1:44right side we have the top chamber which
1:46is the right atrium and then right below
1:48that we have the right ventricle then
1:50over here on the left side we have the
1:52left atrium which is the top chamber and
1:54then below that we have the left
1:56ventricle and all of these Chambers work
1:58beautifully together to pump blood from
2:01the right side of the heart to the left
2:03side of the heart so it goes from the
2:05right side over on the right side that
2:07blood's always going to be deoxygenated
2:09it's going to go up through a great
2:10vessel known as the pulmonary artery
2:12it's going to hit the lungs get
2:14oxygenated now it's going to go back to
2:16the left side of the heart through the
2:18pulmonary vein and it's going to enter
2:20in the left atrium and then it's going
2:22to go all the way through the left side
2:24and go up through another great vessel
2:26known as the aorta and it's going to be
2:27pumped throughout the body so let's take
2:30it chamber by chamber talk about all
2:32those neat structures inside of the
2:34heart and we're going to go in the
2:36sequence of how blood would really flow
2:38through the heart so I'm going to start
2:39on the right side here is the right
2:42atrium and this is the top chamber that
2:44receives deoxygenated blood from the
2:46superior vnea inferior vnea and the
2:49coronary sinus now the walls that make
2:52up the right atrium are thinner compared
2:55to the walls that make up the left
2:57atrium and the reason for this is
2:59because the pressure PR is lower on the
3:00right side than the pressure on the left
3:02side so this Superior vnea will drain
3:06deoxygenated blood into the r Atrium and
3:09this blood is going to come from the
3:11head the neck and the upper part of the
3:13chest and the upper extremities while
3:15the inferior vena is also going to drain
3:17deoxygenated blood to the right atrium
3:20but this blood is going to come from the
3:21lower extremities the abdomen and pelvic
3:24area and then last but not least is the
3:26coronary sinus and it opens into the
3:28right atrium and it's going to drain
3:30deoxygenated blood from The myocardium
3:32and The myocardium remember is the
3:34middle layer of the heart and it allows
3:36the heart to contract also within this
3:39chamber is the fossa ovalis which is
3:41found in the wall between the right and
3:43left atrium known as the inter atrial
3:46septum this is a passage way in the
3:48heart of a baby in utero that allows
3:50blood to bypass the lungs which are not
3:52functioning at this point until birth
3:54because remember the placenta is what
3:57oxygenates the baby's Blood In Utero
3:59therefore for after birth when the baby
4:01takes its first breath this area should
4:03SE shut leaving only an indentation in
4:06the Atria however sometimes this doesn't
4:09always happen and this can lead to a
4:11payon framan ovali which is known as a
4:13PFO and this can lead to the formation
4:16of clots which could cause a stroke now
4:18let's take a look at the inner surface
4:20of the r Atrium and it's interesting
4:22because on its anterior inner side it
4:25has these comb like ridges known as
4:28pectinate muscles and pectinate is Latin
4:31for comb and as you can see here we have
4:34a heart and it's been like peeled open
4:36and look at those pectinate muscles they
4:38do look like comb like ridges now these
4:41comb like ridges actually have a purpose
4:44they're not just there to make the heart
4:46look more interesting what they do is
4:48they help that right atrium contract
4:51blood down into the right ventricle and
4:53these muscles are found in an area known
4:56as the Oracle of the heart and the
4:59oracle is like a pouch like extension
5:02that comes off of The Atrium and both
5:04the right and left atrium have them now
5:07you may be wondering why do they term
5:09this Oracle well remember from medical
5:11terminology that the term Oracle refers
5:14to the outer ear so just use your
5:17imagination a little bit and look at
5:18these oracles with me notice they sort
5:20of look a little bit like two little
5:22flappy dog ears just hanging off on the
5:24side of each Atrium so not only do they
5:27help the Atria control ract blood down
5:30into the ventricles a little bit better
5:32but they also act as an extra space of
5:35storage for blood so if your heart has
5:37increased physical activity it can
5:40access that extra blood storage up in
5:42those little flappy ears and help
5:44maintain cardiac output also located
5:47near the pectinate muscles in the right
5:48atrium is an important Smooth Ridge
5:51called the Christa terminalis and here
5:53you can see an example of what that
5:55looks like this heart again has sort of
5:57just been peeled open so you can see it
5:59and this plays a vital role in guiding
6:01how electrical impulses travel
6:03throughout the Atria and from the SA
6:06node to the AV node so the heart can
6:08contract in a rhythmic way then as we go
6:11down through the right atrium and open
6:13into the right ventricle we encounter
6:15the tricuspid valve the tricuspid valve
6:17is lined with endocardium and remember
6:19that's the inner layer of the heart and
6:21it has three strong cusp or flaps and
6:25that's why it's called the tricuspid
6:27valve this valve is one of the two atrio
6:30ventricular valves in the heart with the
6:32other being the mitol also known as the
6:35bicuspid valve and these valves connect
6:37the Atria and ventricles together hence
6:40why we call them atrio ventricular the
6:42tricuspid valve allows blood to easily
6:44flow from the right atrium to the right
6:46ventricle but prevents the back flow of
6:49blood from The ventricle to the Atria
6:51when the ventricles contract by tightly
6:54seiling shut the right ventricle is
6:56smaller and has thinner walls compared
6:59to the left ventricle and it can have
7:01these attributes because it just has to
7:03pump deoxygenated blood up through
7:06pulmonary circulation which typically
7:08has lower pressure whereas the left
7:12ventricle has to be larger and thicker
7:15wall because it has to pump blood up
7:17throughout the whole body and it has to
7:19go against a systemic High pressured
7:22system now there are important
7:24structures on the inner surface of the
7:26right ventricle that help it contract
7:28the tabuli Carney which carne means
7:31meaty are meaty ridges on the inner
7:33surface of the ventricle that give The
7:35ventricle support so it can contract
7:37blood out properly also within this area
7:39are papillary muscles and papilla means
7:42we're talking about a protruding
7:44structure similar to like a nipple or a
7:47cone and they connect the truspa valve
7:50to the citin Denny which are strong
7:52string-like cords that create tension on
7:55the trusa valve to keep it closed and
7:57they work together with a pap muscles to
8:00help prevent collapse of the valve
8:02during ventricular contraction and make
8:05sure that blood flows in the correct
8:08direction and they do this by
8:09Contracting when the ventricles contract
8:12then right after the right ventricle you
8:14will find the pulmonic valve also known
8:16as the pulmonary valve and this valve is
8:18one of the two semi lunar valves in the
8:21heart and the reason we call them semi
8:23lunar valves is because they're made up
8:24of three cuffs that sort of look like
8:26Crescent moons and these semi lunar
8:29valves help connect the ventricles to
8:31the great vessels and are lined with
8:33endocardium which is smooth and these
8:35valves are not supported in the same way
8:37as atro ventricular valves which use the
8:40cend Deni and the papillary muscles but
8:43these valves rely on the changes of
8:45pressure in the heart for example when
8:48the ventricles contract it causes the
8:50semi lunar valves to open and blood
8:52flows into either the pulmonary artery
8:54or the aorta then when the ventricles
8:56relax pressure Falls and this causes the
8:58valves to shut so blood doesn't go back
9:01into the ventricles therefore the
9:03pulmonic valve connects the right
9:04ventricle and the pulmonary artery while
9:06the aortic valve connects the left
9:08ventricle and aorta and notice that the
9:10name of the semi lunar valve tells you
9:13which areas it connects to either
9:14ventricle so taking a little bit more of
9:16an in-depth look at the pulmonic valve
9:18we know that its goal is to really just
9:20prevent back flow of blood into that
9:23right ventricle so how it does this is
9:25It's really dependent on pressure
9:27changes within that right ventricle so
9:29when the r ventricle goes to contract
9:31that increases pressure inside that
9:33ventricle and that allows that valve to
9:36pop open so once it opens that blood is
9:39pushed up through the valve into the
9:42pulmonary artery once it leaves that
9:44drops the pressure and that droing
9:46pressure will allow that valve to close
9:49which prevents the back flow of blood
9:51into that right ventricle so now that
9:53blood has left our right ventricle we
9:54are in the pulmonary artery and the
9:56pulmonary artery sometimes is referred
9:58to as the pulmon Ary trunk now the
10:00pulmonary artery is pretty unique
10:02because it carries blood away from the
10:04heart that is
10:06deoxygenated and I know sometimes you
10:08may hear this saying that arteries
10:10always carry oxygenated blood away from
10:13the heart but yes what the pulmonary
10:15artery is an exception to that little
10:17say because it carries deoxygenated
10:19blood away from the heart now this
10:21artery starts out as one artery and then
10:24it splits into two we have the right and
10:27the left and each of those arteries feed
10:29into the right and left lung because its
10:31whole goal is to get deoxygenated blood
10:33to the lung so it can get oxygenated and
10:36the walls of the pulmonary artery are
10:38actually thinner than the other grape
10:40vessel which is found on the other side
10:41of the heart known as the aorta and the
10:44reason for that is because we want that
10:46pulmonary artery to be able to
10:48efficiently deliver blood to the lungs
10:50without high pressure because if we get
10:52high pressure going to the lungs it can
10:54damage the lungs over time now after
10:56that blood becomes oxygenated by the
10:58lungs it will return to the left side of
11:00the heart via the pulmonary veins there
11:03are four pulmonary veins with two sets
11:05coming off each lung and connecting to
11:08the left atrium and as with the
11:10pulmonary artery the pulmonary veins are
11:12unique veins because they carry
11:14oxygenated blood back to the heart
11:17specifically the left atrium whereas
11:19veins you know generally carry
11:21deoxygenated blood back to the heart and
11:23the left atrium is mainly seen on the
11:25posterior side of the heart and is
11:28slightly smaller than the Rye Atrium
11:30because it has thicker walls these
11:32thicker walls are needed because it must
11:34contract against the high pressure on
11:36this side of the heart the inside
11:39surface of the left atrium is more
11:41smooth than the right atrium and it has
11:43less pectinate muscles within its Oracle
11:46oxygenated blood will leave the left
11:48atrium and go through the second atrio
11:51ventricular valve called the mitol valve
11:53which is also known as the bicuspid
11:55valve this valve has two cusps lined
11:57with endocardium and if you need help
11:59remembering where each atrioventricular
12:02valve is located think of how the blood
12:04flows through the heart by starting on
12:06the right side and remember the phrase
12:08try before you buy like you know
12:10whenever you buy something you want to
12:11try it out before you buy it so the
12:13tricuspid valve is first and this is on
12:16the right side and the bicus valve is
12:18second on the left side and as a side
12:20note from a nursing standpoint you
12:22really want to be familiar with these
12:24heart valves particularly whenever we're
12:25talking about cases of endocarditis
12:28endocarditis can be caused by IV drug
12:31use or it can be caused by a severe
12:33infection that's got in the blood
12:35because remember your blood just flows
12:37through these valves and if you have
12:39little germs in the blood it'll stick
12:42onto these valves as they flow through
12:44and I've assisted with transesophageal
12:46Echo tees and I have seen patients in
12:49their very early 20s who have been using
12:52IV drugs and they have had extremely
12:55large vegetations on these Valves and
12:57they end up having to have heart valve
12:59replacement surgery and other procedures
13:01done so it's very serious so back to the
13:05mitro valve this valve opens to allow
13:08blood to flow from the left atrium to
13:10the left ventricle and it helps prevent
13:12blood from back flowing into that left
13:15atrium now just like with the truspa
13:18valve this valve is also connected to
13:20the cend Denny and the papillary muscles
13:23and this is so the valve can be held in
13:25place during the contractions of the
13:27left ventricle and the left ventricle is
13:29a structure that pumps oxygenated blood
13:31throughout the body because it gets it
13:33into that other great vessel known as
13:35the aorta and it is a very important
13:37chamber if we have damage to this left
13:39ventricle let's say because a patient
13:41had a my cardion farction and this
13:42ventricle just doesn't want to contract
13:44like it should the patient will enter
13:46into heart failure so separating the
13:49left ventricle from the right ventricle
13:50is a wall called the interventricular
13:52septum and as I pointed out earlier the
13:55left ventricle is much larger and has
13:57thicker walls of mardum
13:59then the right ventricle and it helps
14:01form the apex of the heart so these
14:04unique attributes of the left ventricle
14:06allows it to just easily pump against
14:08the high pressure resistance of the
14:10systemic circulation it also contains
14:13the tabuli Carney those meaty ridges the
14:16papillary muses and the citin Denny on
14:19its inner surface which work in a
14:21similar manner as we discussed with the
14:23right ventricle when blood leaves the
14:25left ventricle it passes through the
14:27second semi lunar valve called the
14:29aortic valve and this valve connects
14:31left ventricle and aorta and it works in
14:33the same manner as the pulmonary valve
14:36in regards to pressure changes based on
14:38ventricular contraction and relaxation
14:41and after blood passes through the
14:42aortic valve it's going to enter into
14:44the aorta which is going to go up
14:45through the ascending aorta and
14:47distribute oxygenated blood throughout a
14:50network of arteries that are going to
14:51Branch off and one of those important
14:54branches is going to be the right and
14:56left coronary arteries and these
14:58coronary arteries are just want to like
14:59wrap around the heart and just feed that
15:02myocardium fresh oxygenated blood so
15:05that is a walk through of the anatomy of
15:07the heart now if you'd like to learn
15:09more about that network of branches
15:11known as the coronary arteries and the
15:13layers of the heart you can access the
15:15videos in the link below and thank you
15:18so much for watching

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