Cardiac Anatomy

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Brad Bass
ASN,RN
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Included In This Lesson

Study Tools For Cardiac Anatomy

Cardiac Valves Blood Flow (Mnemonic)
Coronary Blood Flow Worksheet (Cheatsheet)
Coronary Blood Flow Worksheet – Answers (Cheatsheet)
Heart Wall Layers (Image)
Pericardium (Image)
Cardiovascular Circulation (Image)
Vascular System (Image)
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Outline

Overview

Understanding cardiac anatomy helps to better understand cardiovascular physiology.

Nursing Points

General

  1. The heart is a pump
  2. Muscular tissue called myocardium
  3. Made up of 4 chambers
  4. Houses 4 valves
  5. Covered in coronary arteries
  6. Cardiac Blood Flow

Nursing Concepts

  1. Anatomy
    1. Location
      1. Between lungs
      2. Mostly left of midline
    2. Size
      1. Approx. size of fist
    3. Layers
      1. Endocardium – inner layer
      2. Myocardium – muscle layer
      3. Epicardium – outermost layer
      4. Pericardium
        1. Sac around heart
        2. Visceral – touches heart tissue (SAME as Epicardium)
        3. Parietal – outer layer of sac
        4. Layer of fluid in between
    4. Four Chambers
      1. Right Atrium
      2. Right Ventricle
      3. Left Atrium
      4. Left Ventricle
    5. Valves (“Toilet Paper My A**”)
      1. Tricuspid (three leaflets)
      2. Pulmonic
      3. Mitral (two leaflets)
      4. Aortic
      5. **Papillary muscles hold valves in place
    6. Vasculature – in order from heart, through tissues, back to heart
      1. Arteries – take blood away from heart
      2. Arterioles – tiny arteries
      3. Capillaries – within tissues
      4. Venules – tiny veins
      5. Veins – carry blood to the heart
  2. Blood Flow
    1. Pulmonary Vein = oxygenated
    2. Pulmonary Artery = deoxygenated
    3. Order of Flow:
      1. IVC/SVC
      2. Right Atrium
      3. Tricuspid Valve
      4. Right Ventricle
      5. Pulmonic Valve
      6. Pulmonary Artery
      7. Lungs
      8. Pulmonary Vein
      9. Left Atrium
      10. Mitral Valve
      11. Left Ventricle
      12. Aortic Valve
      13. Aorta
      14. Body
      15. Back to IVC/SVC
  3. Electrical Basics (see EKG Course)
    1. SA node
      1. In Right atrium
      2. “Packemaker”
      3. 60-100 bpm
    2. AV node
      1. In Septum
      2. Backup “pacemaker”
      3. Delays to allow filling of ventricles
      4. Escape rhythm 40-60 bpm
    3. Bundle of His & Purkinje fibers
      1. In ventricles
      2. Spread signal to whole muscle
      3. Escape rhythm 30-40 bpm

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Transcript

Hey guys, my name is Brad and welcome to nursing.com. And in today’s lesson, what we’re going to be doing is we’re going to discuss the anatomy of the heart. Without further ado. Let’s dive in. 

So, let’s first discuss the function of the heart. What does the heart do, right? The heart is the pump. It is the pump of the body. It’s responsible for pumping all of our freshly oxygenated blood to all of the tissues of our body. And it’s also responsible for pumping deoxygenated blood back up to the lungs to be reoxygenated. I like to think about it like the water pump for our house, right? The water pump for the house is the pump for the house. And it’s responsible for providing fresh water to all of the sinks and toilets and bathtubs in the home. The heart operates much in the same way. It is the pump responsible for providing fresh blood to all of the tissues of the body. 

So, the first thing I’d like to discuss with cardiac anatomy is the myocardium. And the myocardium is the actual muscle of the heart itself, right? Myo being muscle. And cardium referring to the heart. So, as we can see here with this diagram on the right, we have the myocardium, right? This is that thick muscle of the heart, right? This thing is strong enough to pump blood against the gravity, to get blood up and perfuse the tissues of the brain. It’s also responsible for pumping blood to the rest of the body. Now, this myocardium, this heart itself, is actually housed in a protective sack called the pericardium, which is comprised of a parietal pericardium, as well as a visceral pericardium, same thing with the peritoneal cavity, same thing with the lungs. You have a pleural cavity that houses and protects the lungs, same thing with the heart. 

And, so whenever we’re discussing cardiac anatomy, we’re pretty much looking at four chambers and four valves. What I’m going to do here is draw a little, a little heart, if you will. We have a much better visual over here, so be sure to reference that. But we have two atria and two ventricles. And in between the atria and ventricles, we have two atrioventricular valves. Now coming off of this left ventricle, remember anatomically speaking, that’s the left and that’s the right. Coming off of this left ventricle we have a valve that we’re going to pass through and coming off of this right ventricle, we have another valve that we’re going to pass through. And we’re going to discuss that a little bit more in detail over here. So the four chambers of the heart that we have, right, we have two atria – right atria, left atria – as well as a right ventricle and a left ventricle. Make sure you’re referencing our supplemental image over here. 

Also, now the four valves that our blood is going to flow through. It’s important to understand the way in which blood flows through the heart and through the rest of the body, right? So deoxygenated blood is going to be carried by our inferior and superior vena cava. And this is going to carry all of our deoxygenated blood returning from all the tissues of our body, back up to be deposited in our right atrium. Blood is going to be passed from our right atria down into our right ventricle via the tricuspid valve. Now, once in the right ventricle, blood is going to be ejected out through one of our two semilunar valves. This is the pulmonic semilunar valve. So as the right ventricle squeezes and ejects blood is going to pass through that pulmonic semilunar valve and go up into the lungs to be oxygenated carried via the pulmonary arteries.  Fun fact, this is the only time in the body where deoxygenated blood is carried by an artery. Blood goes up to the lungs, it gets nice and reoxygenated.  Fresh oxygenated blood, then returning back into that left atrium via the pulmonary veins. Again, the only time that veins carry oxygenated blood in the body, in that pulmonary vasculature. Blood then passes from our left atrium into our left ventricle via our bicuspid valve, also known as the mitral valve. These two terms are used interchangeably. Now, once the blood is in that left ventricle and the left ventricle contracts, blood then is ejected through our second semilunar valve, our aortic semilunar valve, but then goes into our aorta and to go to the rest of the tissues of our body and provide freshly oxygenated blood. 

Now, one other thing to note here with the cardiac anatomy, that was kind of the cardiac flow, but one of the things to note with the cardiac anatomy is we actually have these little things down here. Not really visualized that well in this image, but they’re papillary muscles and connected to these papillary muscles are these little web-like tethers called chordae tendineae And the entire idea of this chordae tendineae is as this right ventricle and as this left ventricle contract, blood is supposed to be ejected through our pulmonic and our aortic semilunar valves and our tricuspid and bicuspid valves close preventing blood from being retrograde, pushed into a backup into our atria. These chordae tendineae act as tethers preventing that valve from prolapsing, from retrograde flow prolapsing back into the atria. And instead of blood being pumped backwards through the heart, this actually allows full valve closure so that blood can be pumped out forward. 

And finally, I thought it was important to mention the coronary vasculature, the actual heart vessels themselves. In nursing school, you’re not likely to be tested on all of these intricate vessels that feed into the heart itself. And no, this image over here on the right is not completely inclusive of all of the coronary vasculature, but I thought it was important to propose this concept to you. We know that the heart is a pump. We know that the heart is responsible for pumping freshly oxygenated blood to all of the tissues of the body, but let’s not forget also that the heart is responsible for pumping blood to itself, right? All of these nice, fine, spider-like coronary vessels that cover and web up over top of the heart, they also pump freshly oxygenated blood to the pump itself. Remember, should the pump cease to receive freshly oxygenated blood, the pump ceases to pump. So, as it’s equally, if not more important, that the heart receives nice blood, nice blood flow, equally as important as its job of pumping blood to the rest of the body. 

And so to summarize some of our key points regarding cardiac anatomy, remember the heart is a pump. It is made of that nice myocardium, myo – muscle, cardium – heart, that is strong enough to pump blood against gravity, to our brain, as well as to all the rest of the tissues of our body. The heart is a pump. It’s comprised of four chambers: left atrium, right atrium, left ventricle and right ventricle. And also recalling that there are four valves, two atrioventricular valves, the tricuspid valve, which passes blood from the right atrium to the right ventricle, as well as the bicuspid valve also known as the mitral valve pumping blood from the left atrium to the left ventricle. And then there are two semilunar valves as well. The pulmonic semilunar valve, which allows passage of blood from the right ventricle up to the lungs to be oxygenated. And then the aortic semilunar valve, which allows passage of blood from the left ventricle up to the aorta, and then to the rest of the body. Also recalling the cardiac blood flow, the way in which blood flows throughout the body, throughout the heart and throughout that pulmonary vasculature. And then also recalling that there are that spiderweb-like arrangements of coronary vessels that actually feed blood to the pump itself.

 I hope that this video will help. I hope that you enjoyed it. Go out there and be your best selves today, guys. And as always, happy nursing.

 

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Concepts Covered:

  • Cardiac Disorders
  • Cardiovascular
  • Circulatory System
  • Emergency Care of the Cardiac Patient
  • Shock
  • Shock
  • Disorders of Pancreas
  • Endocrine
  • EENT Disorders
  • Adult
  • Medication Administration
  • Acute & Chronic Renal Disorders
  • Respiratory Emergencies
  • Newborn Complications
  • Disorders of the Adrenal Gland
  • Disorders of the Thyroid & Parathyroid Glands
  • Immunological Disorders
  • Musculoskeletal Trauma
  • Hematologic Disorders
  • Vascular Disorders
  • Microbiology
  • Respiratory Disorders
  • Depressive Disorders
  • Oncology Disorders
  • Noninfectious Respiratory Disorder
  • Nervous System
  • Central Nervous System Disorders – Brain
  • Substance Abuse Disorders
  • Intraoperative Nursing
  • Emergency Care of the Trauma Patient
  • Integumentary Disorders
  • Integumentary Disorders
  • Urinary System
  • Liver & Gallbladder Disorders
  • Eating Disorders
  • Pregnancy Risks
  • Cardiovascular Disorders
  • Terminology
  • Disorders of Thermoregulation
  • Basics of NCLEX
  • Multisystem
  • Upper GI Disorders
  • Studying
  • Neurological Emergencies
  • Postpartum Complications
  • Infectious Respiratory Disorder
  • Renal Disorders
  • Communication
  • Perioperative Nursing Roles
  • Oncologic Disorders
  • Musculoskeletal Disorders
  • Prenatal Concepts
  • Muscular System
  • Proteins
  • Sexually Transmitted Infections
  • Peripheral Nervous System Disorders
  • Disorders of the Posterior Pituitary Gland

Study Plan Lessons

02.02 Cardiomyopathy for CCRN Review
02.03 Swan-Ganz Catheters for CCRN Review
02.04 Pulmonary Artery Wedge Pressure (PAWP) for CCRN Review
02.08 Cardiac Catheterization & Acute Coronary Syndrome for CCRN Review
02.14 Shock Stages for CCRN Review
02.16 Cardiogenic Shock for CCRN Review
02.17 Septic Shock for CCRN Review
03.03 Hypoglycemia for CCRN Review
06.05 Wide Complex Tachycardia for CCRN Review
ACE (angiotensin-converting enzyme) Inhibitors
Acetaminophen (Tylenol) Nursing Considerations
ACLS (Advanced cardiac life support) Drugs
Acute Coronary Syndrome (ACS)
Acute Coronary Syndrome for Certified Emergency Nursing (CEN)
Acute Inflammatory Disease (Myocarditis, Endocarditis, Pericarditis) for Progressive Care Certified Nurse (PCCN)
Acute Kidney Injury Case Study (60 min)
Acute Respiratory Distress Syndrome (ARDS) for Progressive Care Certified Nurse (PCCN)
Addicted Newborn
Adenosine (Adenocard) Nursing Considerations
Adrenal and Thyroid Disorder Emergencies for Certified Emergency Nursing (CEN)
Advanced Cardiovascular Life Support (ACLS)
Allergic Reactions and Anaphylaxis for Certified Emergency Nursing (CEN)
Amputation for Certified Emergency Nursing (CEN)
Anemia for Progressive Care Certified Nurse (PCCN)
Aneurysm and Dissection for Certified Emergency Nursing (CEN)
Angiotensin Receptor Blockers
Anti Tumor Antibiotics
Anti-Infective – Antifungals
Anti-Infective – Fluoroquinolones
Antidepressants
Antidepressants
Antineoplastics
Arterial Pressure Monitoring
Aspiration for Certified Emergency Nursing (CEN)
Atrial Dysrhythmias for Progressive Care Certified Nurse (PCCN)
Atrial Fibrillation (A Fib)
Atrial Flutter
Autonomic Nervous System (ANS)
AV Blocks Dysrhythmias for Progressive Care Certified Nurse (PCCN)
AVPU Mnemonic (The AVPU Scale)
Benzodiazepines
Blood Flow Through The Heart
Blood Pressure (BP) Control
Blood Salvage Transfusion Anticipation for Certified Perioperative Nurse (CNOR)
Blunt Thoracic Trauma
Body System Assessments
Brain Natriuretic Peptide (BNP) Lab Values
Bronchodilators
Burns for Certified Emergency Nursing (CEN)
Calcium Acetate (PhosLo) Nursing Considerations
Calcium and Magnesium Imbalance for Certified Emergency Nursing (CEN)
Calcium Carbonate (Tums) Nursing Considerations
Calcium Channel Blockers
Calcium-Ca (Hypercalcemia, Hypocalcemia)
Cardiac (Heart) Disease in Pregnancy
Cardiac (Heart) Enzymes
Cardiac (Heart) Physiology
Cardiac A&P Module Intro
Cardiac Anatomy
Cardiac Arrest Nursing Interventions for Certified Perioperative Nurse (CNOR)
Cardiac Course Introduction
Cardiac Cycle
Cardiac Glycosides
Cardiac Labs – What and When to Use Them – Live Tutoring Archive
Cardiac Labs – What and When to Use Them 2 – Live Tutoring Archive
Cardiac Stress Test
Cardiac Surgery (Post-ICU Care) for Progressive Care Certified Nurse (PCCN)
Cardiac Tamponade for Progressive Care Certified Nurse (PCCN)
Cardiac Terminology
Cardiac Valves Blood Flow Nursing Mnemonic (Toilet Paper my Ass)
Cardiac/Vascular Catheterization (Diagnostic, Interventional) for Progressive Care Certified Nurse (PCCN)
Cardiogenic Shock and Obstructive Shock for Certified Emergency Nursing (CEN)
Cardiogenic Shock For PCCN for Progressive Care Certified Nurse (PCCN)
Cardiomyopathies (Dilated, Hypertrophic, Restrictive) for Progressive Care Certified Nurse (PCCN)
Cardiopulmonary Arrest
Cardiopulmonary Arrest for Certified Emergency Nursing (CEN)
Cardiovascular Trauma for Certified Emergency Nursing (CEN)
Cerebral Metabolism
Chemotherapy Patients
Cirrhosis for Certified Emergency Nursing (CEN)
Cold Temperature-related Emergencies for Certified Emergency Nursing (CEN)
Congenital Heart Defects (CHD)
Congestive Heart Failure (CHF) Labs
Congestive Heart Failure Concept Map
Coronary Artery Disease Concept Map
Creatine Phosphokinase (CPK) Lab Values
Critical Thinking
Cushing’s Syndrome Case Study (60 min)
Day in the Life of a Med-surg Nurse
Day in the Life of a NICU Nurse
Defects of Decreased Pulmonary Blood Flow
Defects of Increased Pulmonary Blood Flow
Digoxin (Lanoxin) Nursing Considerations
Disease Specific Medications
Diuretics (Loop, Potassium Sparing, Thiazide, Furosemide/Lasix)
Dobutamine (Dobutrex) Nursing Considerations
Dopamine (Inotropin) Nursing Considerations
Dysrhythmia Emergencies
Dysrhythmias for Certified Emergency Nursing (CEN)
Dysrhythmias Labs
Echocardiogram (Cardiac Echo)
Electrical A&P of the Heart
Electrical Activity in the Heart
Electrolyte Imbalances for Progressive Care Certified Nurse (PCCN)
Electrolytes Involved in Cardiac (Heart) Conduction
Endocarditis Case Study (45 min)
Endocarditis for Certified Emergency Nursing (CEN)
Envenomation Emergencies for Certified Emergency Nursing (CEN)
Epinephrine (EpiPen) Nursing Considerations
Flight Nurse
General Anesthesia
GERD (Gastroesophageal Reflux Disease)
Goal Setting
Heart (Cardiac) and Great Vessels Assessment
Heart (Cardiac) Failure Module Intro
Heart (Cardiac) Failure Therapeutic Management
Heart (Cardiac) Sound Locations and Auscultation
Heart (Heart) Failure Exacerbation
Heart Failure (Acute Exacerbations, Chronic) for Progressive Care Certified Nurse (PCCN)
Heart Failure Case Study (45 min)
Heart Failure for Certified Emergency Nursing (CEN)
Heart Sounds Nursing Mnemonic (APE To Man – All People Enjoy Time Magazine)
Heat Temperature-related Emergencies for Certified Emergency Nursing (CEN)
Hemodynamics
Hemorrhagic Fevers for Certified Emergency Nursing (CEN)
Hiatal Hernia
Hydrocodone-Acetaminophen (Vicodin, Lortab) Nursing Considerations
Hyperemesis Gravidarum for Certified Emergency Nursing (CEN)
Hyperkalemia – Management Nursing Mnemonic (AIRED)
Hyperkalemia – Signs and Symptoms Nursing Mnemonic (Murder)
Hypertension (Uncontrolled) and Hypertensive Crisis for Progressive Care Certified Nurse (PCCN)
Hypertensive Crisis Case Study (45 min)
Hyperthyroidism Case Study (75 min)
Hypokalemia – Signs and Symptoms Nursing Mnemonic (6 L’s)
Hypoparathyroidism
Hypovolemic and Distributive Shock for Certified Emergency Nursing (CEN)
Hypovolemic Shock Case Study (OB sim) (60 min)
Influenza for Certified Emergency Nursing (CEN)
Intake and Output (I&O)
Interdisciplinary Team Participation for Certified Perioperative Nurse (CNOR)
Intraoperative Positioning
Invoicing Process
Lactate Dehydrogenase (LDH) Lab Values
Leukemia
Lorazepam (Ativan) Nursing Considerations
Lung Cancer
Magnesium-Mg (Hypomagnesemia, Hypermagnesemia)
Malignant Hyperthermia
Marfan Syndrome
Maternal Risk Factors
Meds for Postpartum Hemorrhage (PPH)
Meds for PPH (postpartum hemorrhage)
MI Surgical Intervention
Midazolam (Versed) Nursing Considerations
Minimally-Invasive Cardiac Surgery (Non-Sternal Approach) for Progressive Care Certified Nurse (PCCN)
Mixed (Cardiac) Heart Defects
Muscle Anatomy (anatomy and physiology)
Muscle Cytology
Musculoskeletal Terminology
Myocardial Infarction (MI) Case Study (45 min)
Myoglobin (MB) Lab Values
Neurogenic Shock for Certified Emergency Nursing (CEN)
Newborn Physical Exam
Noncardiac Pulmonary Edema for Certified Emergency Nursing (CEN)
Norepinephrine (Levophed) Nursing Considerations
Nursing Care and Pathophysiology for Anaphylaxis
Nursing Care and Pathophysiology for Cardiogenic Shock
Nursing Care and Pathophysiology for Cushings Syndrome
Nursing Care and Pathophysiology for Gonorrhea (STI)
Nursing Care and Pathophysiology for Heart Failure (CHF)
Nursing Care and Pathophysiology for Hyperthyroidism
Nursing Care and Pathophysiology for Hypothyroidism
Nursing Care and Pathophysiology for Hypovolemic Shock
Nursing Care and Pathophysiology for Ischemic Stroke (CVA)
Nursing Care and Pathophysiology for Myasthenia Gravis
Nursing Care and Pathophysiology for Pneumothorax & Hemothorax
Nursing Care and Pathophysiology for Pulmonary Edema
Nursing Care and Pathophysiology for SIADH (Syndrome of Inappropriate antidiuretic Hormone Secretion)
Nursing Care and Pathophysiology for Valve Disorders
Nursing Care and Pathophysiology of Acute Kidney (Renal) Injury (AKI)
Nursing Care and Pathophysiology of Angina
Nursing Care and Pathophysiology of Chronic Kidney (Renal) Disease (CKD)
Nursing Care and Pathophysiology of Coronary Artery Disease (CAD)
Nursing Care and Pathophysiology of Endocarditis and Pericarditis
Nursing Care and Pathophysiology of Hypertension (HTN)
Nursing Care and Pathophysiology of Myocardial Infarction (MI)
Nursing Care and Pathophysiology of Myocarditis