The Heart

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Included In This Lesson

Study Tools For The Heart

Heart Beating (Image)
Cardiovascular Circulation (Image)
Vascular System (Image)
Cardiac Anatomy (Image)
Circulatory System (Image)
Lymphatic Circulation (Image)
Coronary Blood Flow Worksheet (Cheatsheet)
Coronary Blood Flow Worksheet – Answers (Cheatsheet)
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Outline

Overview

  1. The Heart
    1. Muscular pump
    2. Circulates blood throughout the body

Nursing Points

General

  1. Location
    1. Mediastinum — space between lungs
      1. From sternum to vertebral column
    2. Base — top of atria — 2nd pair of ribs
    3. Apex — point
      1. Left ventricle
      2. 5th intercostal space
      3. Midclavicular line
  2. Structure
    1. Wall
      1. Endocardium — innermost layer
        1. Composed of simple squamous endothelium
        2. Smooth to prevent clotting
        3. Serous membrane
      2. Myocardium — “cardiac muscle”
      3. Epicardium OR “visceral pericardium”
        1. Serous membrane
        2. Releases fluid @ outer surface of heart
    2. Pericardial sac
      1. Parietal pericardium
        1. WFCT
      2. Pericardial space
        1. Between pericardial sac and outer surface of heart
      3. Pericardial fluid
        1. In space from epicardium
      4. FUNCTION
        1. Reduce friction between the beating heart and other structures in the mediastinum
    3. Chambers (4)
      1. Atria — upper (left and right)
        1. Separated by interatrial septum
        2. Connected to left and right ventricles by atrioventricular (AV) orifices
          1. Right = tricuspid valve
            1. 3 flaps
          2. Left = bicuspid valve (mitral valve)
            1. 2 flaps
        3. Right atrium connected to superior and inferior vena cavae
          1. Deoxygenated blood dumps into Right Atrium
        4. Left atrium connects to 4 pulmonary veins (2 left and 2 right)
          1. Oxygenated blood dumps into Left Atrium
      2. Ventricles — lower, larger, more muscular
        1. Separated by interventricular septum
        2. Contains papillary muscles and chordae tendineae which control AV valves (tricuspid, mitral)
        3. Pulmonary artery exits RV
          1. Deoxygenated blood goes to lungs
        4. Aorta exits LV
          1. Oxygenated blood goes to body
        5. Semilunar valves where vessels exit the ventricles
          1. Pulmonic valve (Pulmonary Artery)
          2. Aortic valve (Aorta)
References
Betts, J.G., et al. (2017). _Anatomy and physiology_. Houston, TX: OpenStax, Rice University. Retrieved from https://openstax.org/details/books/anatomy-and-physiology?Book%20details

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Transcript

In this lesson we’re going to take a look at the heart and the general structure and function of it.

The first thing that we need to look at is that we need to look at the functions of the heart.The hearts primary function is to act as a muscular pump, and circulate blood throughout the entire body

So let’s take a look at the hearts location.

Inside the chest, there’s an area just to the left of midline, and it’s essentially a cavity. And it’s called the mediastinum. It’s an actual space between the right and left lung lobes. it extends from the sternum all the way to the vertebral column and it goes basically from the top side of the trachea all the way down to the xiphoid process.

Now looking at the location of the heart, the base is actually in the second intercostal space, again just to the left of midline. When I say intercostal, I’m talking about the space in between the Ribs. The apex of the heart is located at the fifth intercostal space, right along the midclavicular line. When I say midclavicular line, you can see the clavicle right here. I want you to divide it in half, and go straight down until the get to the space in between the fourth and fifth ribs. That’s where the apex of the heart is.
In terms of structure, the heart is a big giant muscle.

The heart is made up of three different layers, the endocardium, The myocardium, and epicardium. Let’s look at these more in-depth.There’s a great lesson on cardiac muscle tissue and muscle contractility, so I encourage you to check those out

When we’re talking about the endocardium, we’re talking about the innermost wall of the heart.

It’s composed of simple squamous Endothelium, and it is smooth. And the reason it smooth is because it helps prevent clotting. The other thing is that it has a serous membrane along the inside.

The myocardium, is the thick middle layer. It is essentially known as the heart muscle and it has the main squeeze every time the heart contracts.

The epicardium, is the most outer layer of the heart. It’s covered by something called the visceral pericardium, and it actually releases fluid to the outside of the heart.

That leads me to my next point, which is the pericardial Sac. Now imagining that the outside of the heart continues to produce fluid inside the chest, well it’s got to go somewhere right. Well around the heart is something called the pericardial sac and it’s responsibility is to reduce friction between the beating heart and other tissues. Imagine your beating heart every time it beats rubbing up against other tissues. This also helps to reduce some of the shock anytime that that any sort of impact comes in and hits the chest.

The pericardial sac actually has a little bit of a fluid in it called the pericardial fluid. And this pericardial fluid is found in the space between the visceral and parietal pericardium. The parietal pericardium is the outermost layer of the pericardium. So you have any epicardium which is an outside wall of the heart, or commonly known as the visceral pericardium, and then you have the parietal pericardium which is the outside layer. Now let’s get to the bulk of the heart.

The heart is divided up into four chambers. You have two on top, and two on bottom. The two on top or call the atria, or Atrium which is singular. And then you have each ventricle. The heart is also divided into a right and a left side.

Starting with the atria, these are your upper chambers. You have a right side in the left side, and they are connected to each ventricle. So the right atria is connected to the right ventricle and the left atrium is connected to the left ventricle. The atria are separated by something called the interatrial septum. So now that we’ve got something that separates the atria, we have to have something that separates the ventricles right?

Well each atria and each ventricle are separated by something called valves. These valves act like doorways that allow blood to go from one chamber, the door was open, and then the blood goes into another. In the right side of the heart you have something called the tricuspid valve. In the left side you have something called the bicuspid or mitral valve. Most people call it the mitral valve, but you also need to know that is called bicuspid. Another reason that the tricuspid valve is called tricuspid, is because it has three flaps. The bicuspid valve on the other hand only has two.

So how does blood get from the body to the atria? Wall on the right side, blood is delivered to the right atrium from the superior and inferior vena cava. On the left side, you have the left atrium which receives blood from the four pulmonary veins. There are two on each side.

Now the ventricles are the lower chambers of the heart. You have a right and left ventricle, and they force blood out of the heart to wherever they’re going. The right ventricle forces blood out of the heart into the lungs, and then the left ventricle forces blood out of the heart into the rest of the body. The important thing to know here is at the left ventricle is the power house for the pump.

Similar to the separation between the atria and the ventricles, there are valves that separate the ventricles to the outside of the heart. These are called semilunar valves. On the right side, coming from the right ventricle to the lungs it’s called the pulmonic valve. On the left side, going from the left ventricle to the aorta, it’s called the aortic valve. So what we’re talking about blood flow we have blood that goes from the right ventricle, and it exits via the pulmonary artery to the lungs and it’s going to go through that pulmonic valve.

On the left side is going to exit via the aorta going through the aortic valve.

Okay so let’s recap.

We were talking about the heart, you have to remember that the heart is a pump. It’s one primary responsibility is to circulate blood throughout the body.

The heart consists of four chambers, two atria and two ventricles. There’s two on the right and two on the left of each side. The atria are on top, and the ventricles are on the bottom.

All of the chambers are separated by valves. The tricuspid in the mitral separate the atria from the ventricles. And the similar valves separate the ventricles from the outside of the heart.

The heart is located just to the left of midline with the base starting at the second intercostal space, and the apex of the heart going to the 5th intercostal space, right along that midclavicular line.

We’re talking about structure the heart, the heart consists of three layers. There’s the endocardium, which is the Innermost layer, you have The myocardium which is the thick middle layer of the heart, and then you have the epicardium which creates the visceral pericardium.

That’s it for the lesson on the heart. Be sure to check out all the other resources attached to this lesson. Now go out and be your best self today, and as always happy nursing

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Concepts Covered:

  • Cardiac Disorders
  • Musculoskeletal Trauma
  • Integumentary Disorders
  • Neurologic and Cognitive Disorders
  • Oncology Disorders
  • EENT Disorders
  • Respiratory Disorders
  • Gastrointestinal Disorders
  • Hematologic Disorders
  • Communication
  • Test Taking Strategies
  • Pregnancy Risks
  • Fundamentals of Emergency Nursing
  • Concepts of Mental Health
  • Basics of NCLEX
  • Prioritization
  • Emotions and Motivation
  • Tissues and Glands
  • Skeletal System
  • Muscular System
  • Nervous System
  • Sensory System
  • Circulatory System
  • Hematologic System
  • Respiratory System
  • Digestive System
  • Urinary System
  • Endocrine System
  • Reproductive System
  • Labor Complications
  • Disorders of Pancreas
  • Eating Disorders
  • Neurological Emergencies
  • Noninfectious Respiratory Disorder
  • Vascular Disorders
  • Upper GI Disorders
  • Lower GI Disorders
  • Liver & Gallbladder Disorders
  • Urinary Disorders
  • Sexually Transmitted Infections
  • Female Reproductive Disorders
  • Renal Disorders
  • Integumentary Disorders
  • Integumentary Important Points
  • Immunological Disorders
  • Shock
  • Endocrine and Metabolic Disorders
  • Musculoskeletal Disorders
  • Musculoskeletal Disorders
  • Neurological Trauma
  • Central Nervous System Disorders – Brain
  • Central Nervous System Disorders – Spinal Cord
  • Peripheral Nervous System Disorders
  • Emergency Care of the Neurological Patient
  • Respiratory Emergencies
  • Infectious Respiratory Disorder
  • Oncologic Disorders
  • Studying
  • Cardiovascular Disorders
  • Basic
  • Adult
  • Pediatric
  • Neonatal
  • Emergency Care of the Trauma Patient
  • Emergency Care of the Cardiac Patient
  • Emergency Care of the Respiratory Patient

Study Plan Lessons

The 5-Minute Assessment (Physical assessment)
General Assessment (Physical assessment)
Integumentary (Skin) Assessment
Neuro Assessment
Head/Neck Assessment
EENT Assessment
Heart (Cardiac) and Great Vessels Assessment
Thorax and Lungs Assessment
Abdomen (Abdominal) Assessment
Lymphatic Assessment
Peripheral Vascular Assessment
Musculoskeletal Assessment
Genitourinary (GU) Assessment
Communicating with Patients
SATA
Absolute Words
Nursing Process
What do you want me to know?
Duplicate Facts
Repeating Words
Denying Feelings
NCLEX® Question Traps
Opposites
Same
Priority
Acute vs Chronic
Hierarchy of O2 Delivery
Nutrition Assessments
Abuse
Therapeutic Communication
Nurse-Patient Relationship
Thinking Like a Nurse
Critical Thinking
Prioritization
Triage
Maslow’s Hierarchy of Needs in Nursing
Overview of the Nursing Process
Skin Structure & Function
Skeletal Anatomy
Bone Structure
Development of Bones
Joints
Muscle Anatomy (anatomy and physiology)
Muscle Cytology
Skeletal Muscle
Muscle Contraction
Muscle Physiology
Nervous System Anatomy
Membrane Potentials
Nerve Transmission
Autonomic Nervous System (ANS)
Spinal Cord
Cranial Nerves
Sensory Basics
Intro to Circulatory System
The Heart
Cardiac Cycle
Electrical Activity in the Heart
Cardiac (Heart) Physiology
Blood Vessels
Blood Pressure (BP) Control
Blood Plasma
Blood Grouping
Vessels & Fluid
Respiratory Structure & Function
Breathing Movements
Breathing Control
Respiratory Functions of Blood
Digestive System Anatomy
Mouth & Oropharynx
Esophagus
Stomach Video
Small Intestine
Large Intestine
Liver & Gallbladder
Urinary System Anatomy (Anatomy and Physiology)
Renal (Kidney) Structure & Function
Renin Angiotensin Aldosterone System (RAAS)
Formation & Excretion of Urine
Renal (Kidney) Fluid & Electrolyte Balance
Renal (Kidney) Acid-Base Balance
Pituitary Gland
Thyroid Gland
Adrenal Gland
Pancreas
Male Reproductive Anatomy (Anatomy and Physiology)
Female Reproductive Anatomy (Anatomy and Physiology)
Epithelial (Skin) Tissues
Types of Epithelial (Skin) Tissue
Glands
Connective Tissues
Membranes
Fluid Compartments
Fluid Pressures
Fluid Shifts (Ascites) (Pleural Effusion)
Isotonic Solutions (IV solutions)
Hypotonic Solutions (IV solutions)
Hypertonic Solutions (IV solutions)
Potassium-K (Hyperkalemia, Hypokalemia)
Sodium-Na (Hypernatremia, Hyponatremia)
Calcium-Ca (Hypercalcemia, Hypocalcemia)
Chloride-Cl (Hyperchloremia, Hypochloremia)
Magnesium-Mg (Hypomagnesemia, Hypermagnesemia)
Phosphorus-Phos
Heart (Cardiac) Sound Locations and Auscultation
Nursing Care and Pathophysiology for Heart Failure (CHF)
Nursing Care and Pathophysiology of Myocardial Infarction (MI)
Nursing Care and Pathophysiology of Diabetes Mellitus (DM)
Nursing Care and Pathophysiology for Hemorrhagic Stroke (CVA)
Nursing Care and Pathophysiology of COPD (Chronic Obstructive Pulmonary Disease)
Nursing Care and Pathophysiology for Arterial Disorders
Nursing Care and Pathophysiology for Aortic Aneurysm
Venous Disorders (Chronic venous insufficiency, Deep venous thrombosis/DVT)
Nursing Care and Pathophysiology of Coronary Artery Disease (CAD)
GERD (Gastroesophageal Reflux Disease)
Nursing Care and Pathophysiology for Pancreatitis
Nursing Care and Pathophysiology for Diverticulosis – Diverticulitis
Nursing Care and Pathophysiology for Hemorrhoids
Nursing Care and Pathophysiology for Appendicitis
Nursing Care and Pathophysiology for Cholecystitis
Nursing Care and Pathophysiology for Hepatitis (Liver Disease)
Nursing Care and Pathophysiology for Cirrhosis (Liver Disease, Hepatic encephalopathy, Portal Hypertension, Esophageal Varices)
Nursing Care and Pathophysiology of Urinary Tract Infection (UTI)
Nursing Care and Pathophysiology of BPH (Benign Prostatic Hyperplasia)
Nursing Care and Pathophysiology for Syphilis (STI)
Nursing Care and Pathophysiology for Herpes Simplex (HSV, STI)
Nursing Care and Pathophysiology for Menopause
Nursing Care and Pathophysiology of Glomerulonephritis
Pressure Ulcers/Pressure injuries (Braden scale)
Nursing Care and Pathophysiology for Herpes Zoster – Shingles
Skin Cancer
Integumentary (Skin) Important Points
Nursing Care and Pathophysiology for Anaphylaxis
Nursing Care and Pathophysiology for Acquired Immune Deficiency Syndrome (AIDS)
Breast Cancer
Diabetes Management
Nursing Care and Pathophysiology for Sepsis
Fluid Volume Deficit
Fluid Volume Overload
Nursing Care and Pathophysiology for Rheumatoid Arthritis (RA)
Nursing Care and Pathophysiology of Osteoarthritis (OA)
Nursing Care and Pathophysiology of Osteoporosis
Nursing Care and Pathophysiology for Compartment Syndrome
Fractures
Casting & Splinting
Impulse Transmission
Cerebral Metabolism
Blood Brain Barrier (BBB)
Levels of Consciousness (LOC)
Routine Neuro Assessments
Adjunct Neuro Assessments
Brain Death v. Comatose
Intracranial Pressure ICP
Nursing Care and Pathophysiology for Multiple Sclerosis (MS)
Nursing Care and Pathophysiology for Myasthenia Gravis
Nursing Care and Pathophysiology for Parkinsons
Miscellaneous Nerve Disorders
Tension and Cluster Headaches
Migraines
Nursing Care and Pathophysiology for Ischemic Stroke (CVA)
Stroke Assessment (CVA)
Stroke Therapeutic Management (CVA)
Stroke Nursing Care (CVA)
Seizure Causes (Epilepsy, Generalized)
Seizure Assessment
Seizure Therapeutic Management
Nursing Care and Pathophysiology for Seizure
Neurological Fractures
Spinal Cord Injury
Nursing Care and Pathophysiology for Meningitis
Nursing Care and Pathophysiology for Asthma
Nursing Care and Pathophysiology of Acute Respiratory Distress Syndrome (ARDS)
Nursing Care and Pathophysiology for Pulmonary Edema
Nursing Care and Pathophysiology for Influenza (Flu)
Nursing Care and Pathophysiology for Tuberculosis (TB)
Nursing Care and Pathophysiology of Pneumonia
Isolation Precautions (MRSA, C. Difficile, Meningitis, Pertussis, Tuberculosis, Neutropenia)
Coronavirus (COVID-19) Nursing Care and General Information
Artificial Airways
Airway Suctioning
Nursing Care and Pathophysiology for Pneumothorax & Hemothorax
Nursing Care and Pathophysiology for Pulmonary Embolism
Lung Sounds
Alveoli & Atelectasis
Gas Exchange
Wound Care – Assessment
Aortic Aneurysm – Management Nursing Mnemonic (CRAM)
Aortic Aneurysm – Thoracic signs Nursing Mnemonic (PEE BADS)
Bacterial Endocarditis – Symptoms Nursing Mnemonic (Be Joan Of Arc)
Cardiac Valves Blood Flow Nursing Mnemonic (Toilet Paper my Ass)
Circulatory Checks (5 P’s) Nursing Mnemonic (The 5 P’s)
Coronary Arteries – Location Nursing Mnemonic (I have a RIGHT to CAMP if you LEFT off the AC)
Cor Pulmonale – Signs & Symptoms Nursing Mnemonic (Please Read His Text)
CHF Treatment Nursing Mnemonic (UNLOAD FAST)
Cyanotic Defects Nursing Mnemonic (The 4 T’s)
Heart Failure-Left-Sided Nursing Mnemonic (CHOP)
Heart Failure-Origin Nursing Mnemonic (Left – Lung|Right – Rest)
Heart Failure – Right Sided Nursing Mnemonic (HEAD)
Heart Sounds Nursing Mnemonic (APE To Man – All People Enjoy Time Magazine)
Hypertension- Complications Nursing Mnemonic (The 4 C’s)
Hypertension – Nursing care Nursing Mnemonic (DIURETIC)
Increase MAP Nursing Mnemonic (VAK)
Murmur locations Nursing Mnemonic (hARD ASS MRS. MSD)
Shock – Signs and symptoms Nursing Mnemonic (TV SPARC CUBE)
Vascular Disease – Deep Vein Thrombosis Nursing Mnemonic (HIS Leg Might Fall off)
Vascular disease – Raynaud’s symptoms Nursing Mnemonic (COLD HAND)
Digestion & Absorption
Nutrition-related Diseases
CPR-BLS (Basic Life Support)
Advanced Cardiovascular Life Support (ACLS)
Pediatric Advanced Life Support (PALS)
Neonatal Resuscitation Program (NRP)
Prioritizing Assessments
Triage in the ER
Critical Incident Management
Aggressive & Violent Patients
Legal & Ethical Issues in ER
EMTALA & Transfers
Trauma Survey
Blunt Thoracic Trauma
Penetrating Thoracic Trauma
Blunt Abdominal Trauma
Penetrating Abdominal Trauma
Crush Injuries
Head Trauma & Traumatic Brain Injury
Massive Transfusion Protocol
Acute Coronary Syndrome (ACS)
Aneurysm & Dissection
Cardiopulmonary Arrest
Dysrhythmia Emergencies
Heart (Heart) Failure Exacerbation
Hypertensive Emergency
Arterial Pressure Monitoring
Rapid Sequence Intubation
Pulmonary Embolism
Acute Respiratory Distress
Ventilator Settings
Acute Confusion
Intracranial Hemorrhage
Increased Intracranial Pressure
Stroke (CVA) Management in the ER
Seizure Management in the ER
Sodium and Potassium Imbalance for Certified Emergency Nursing (CEN)