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ANATOMY AND PHYSIOLOGY

The heart is a muscular pump that contains four chambers: right atrium, left atrium, right ventricle and left ventricle. The two small atria make up the top of the heart, and the two large ventricles make up the bottom of the heart. The right atrium pumps blood to the right ventricle, and the left atrium pumps blood to the left ventricle. A wall, called the septum, separates the right atrium and right ventricle, from the left atrium and left ventricle. Blood flows through the heart in the following manner: The right atrium receives oxygen-poor blood from the body, and then pumps the blood through the tricuspid valve and into the right ventricle. The right ventricle pumps the blood through the pulmonic valve and to the lungs, where it picks up more oxygen. The left atrium receives an oxygen-rich blood from the lungs, and then pumps the blood through the mitral valve and into the left ventricle. The left ventricle pumps blood through the aortic valve and to the rest of the body. The blood supplies oxygen to the body and the cycle starts again. Coronary Arteries The coronary arteries supply oxygen to the heart muscle. The heart has three main coronary arteries: Right coronary artery: supplies the right ventricle Left coronary artery: supplies the left ventricle Posterior circumflex artery: supplies the posterior Cardiac Conduction System

aspect

of

both

ventricles

An electrical impulse stimulates the muscle fibers in the heart to contract. The impulse spreads through the heart in a very organized manner, so that the atria contract first, followed by the ventricles. The electrical impulse proceeds in the following manner: The electrical impulse originates at the sinoatrial (SA) node, which is located in the wall of the right atrium. The SA node is the heart's natural pacemaker: it regulates the heart rate. The impulse proceeds through the atria, stimulating them to contract. After the atria are stimulated to contract, the atrioventricular (AV) node slows the electrical impulse before it proceeds to the ventricles. This pause allows the ventricles to fill with blood before they contract. The AV node is located between the atria and the ventricles. After the pause, the impulse then proceeds through the ventricles, stimulating them to contract. Parts of the Heart: Superior Vena Cava Oxygen-poor blood from the upper parts of the body returns to the heart through the superior vena cava. Right Atrium The chamber of the right atrium collects oxygen-poor blood returning from the body and then forces it through the tricuspid valve and into the right ventricle. Tricuspid Valve Controls blood flow from the R.A into the R.V Right Ventricle The chamber of the R.V collects oxygen-poor blood from the right atrium and then forces it through the pulmonary valve into the lungs. Pulmonary Valve Controls blood flow from the R.V into the pulmonary arteries. Pulmonary Arteries Carry blood from the heart to the lungs to pick up oxygen. Pulmonary Veins Carry oxygen-rich blood from the lungs back to the heart. Left Atrium Collects oxygen-rich blood returning from the lungs and then forces it through the mitral valve into the left ventricle. Mitral Valve/Bicuspid Valve Controls blood flow from the L.A into the L.V. Left Ventricle The largest and strongest chamber in the heart. The L.V a wall is only about a half inch thick, but it has enough force to push blood through the aortic valve and into the body. Aortic Valve Controls blood flow from the L.V into the aorta. Aorta This is the largest artery. It carries oxygen-rich blood from the heart to the rest of the body.

Inferior Vena Cava Oxygen-poor blood form the lower parts of the body returns to the heart through the inferior vena cava.
F. Physical Examination I. Head a. Skull Round No tenderness noted upon palpation b. c. d. e. f. Scalp Lighter in color than the complexion\ Moist No scars and lesions noted Free from lice, nits and dandruff No tenderness nor masses on palpation Hair Black in color (pt. used in dye) Evenly distributed, covers the whole scalp Thick and smooth Straight hair Face Round in shape Symmetrical No involuntary muscle movements Can move facial muscles at will Eyes Evenly placed and in line with each other None protruding Brown in color Eyebrows are white in color Eyebrows are being shaved Eyelashes are white in color Evenly distributed Turned outward Nose With nasal cannula Nose is in the midline No discharge No bone and cartilage deviation noted on palpation No tenderness on palpation Nasal septum is in the midline and not perforated

g. Mouth

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Symmetrical lips Dark red lips Dry lips With dentures Gums is pink in color Coherent speech Ears Symmetrical The upper connection of the earlobe is parallel with the outer canthus of the eyes Skin is same in color as in the complexion No discharge or lesions noted Both ears with earrings Neck Straight Symmetrical Short No visible mass The trachea is palpable Lymph nodes are not palpable Thorax Symmetrical Shallow breathing HR of 69 bpm Presence of crushing pain in the heart with pain scale of 5/10 Hands Warm to touch Symmetrical Skin is same in color No lesions and tenderness noted Feet Warm to touch Symmetrical Skin is same in color No lesions and tenderness With nail polish

Mental State Conscious Coherent Activities Complete bed rest Diet

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Low salt and low fat (LSLF)

Bladder/Bowel Intake and output Use of diapers Hygiene Oral care

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