Transcript Valves of the Heart

Introduction




Cattle are phlegmatic animals and rarely
undertake strenuous exercise.
As a result, signs of cardiac disease may not
be recognised until the disease is at an
advanced stage.
Affected calves may show signs of poor
growth and, in advanced cases, heart failure.
In mild cases there may be no external signs
and the cardiovascular abnormality is only
detected during a careful clinical examination.
Applied anatomy
The cardiovascular system is sometimes
called the circulatory system. It consists
of the heart, which is a muscular
pumping device, and a closed system of
vessels called arteries, veins, and
capillaries.




R & L atrium receive blood from vein
Ventricle pump blood out of the heart
R.A receives deoxygenated blood from
vein.
L.A receives oxygenated blood from
pulmonary veins.
Valves of the Heart








The heart has two types of valves that keep the blood flowing in the
correct direction.
The valves between the atria and ventricles are called atrioventricular
valves, while those at the bases of the large vessels leaving the
ventricles are called semilunar valves.
The right atrioventricular valve is the tricuspid valve.
The left atrioventricular valve is the bicuspid, or mitral, valve.
The valve between the right ventricle and pulmonary trunk is the
pulmonary semilunar valve.
The valve between the left ventricle and the aorta is the aortic
semilunar valve.
When the ventricles contract, atrioventricular valves close to prevent
blood from flowing back into the atria.
When the ventricles relax, semilunar valves close to prevent blood from
flowing back into the ventricles.
Pathway of blood through heart
Both atria contract at the same time and both
ventricle contract at the same time
Heart work as two pump R & L
Pathway of blood through heart include three
circulation:
1.
Pulmonary circulation
2.
Systemic circulation
3.
Coronary circulation
Pulmonary circulation
The Pulmonary circulation is the portion
of the cardiovascular system which
Transports oxygen depleted blood away
from the heart to the lungs and returns
oxygenated blood back to the heart.



Oxygen deprived blood from the vena cava enters
the R A of the heart and flows through the the
tricuspid valve into the right ventricle, from which it is
pumped through the pulmonary semilunar valve into
the pulmonary arteries which go to the lungs.
Pulmonary veins return the oxygen-rich blood to the
heart, where it enters the left atrium before flowing
through the mitral valve into the left ventricle.
Then, oxygen-rich blood from the left ventricle is
pumped out via the aorta, and on to the rest of the
body.
Systemic circulation


Systemic circulation is the portion of the
cardiovascular system which transports
oxygenated blood away from the heart, to
the rest of the body, and returns oxygendepleted blood back to the heart.
Systemic circulation is much longer than
pulmonary circulation, transporting blood to
every part of the body.
Coronary circulation


The coronary circulatory system
provides a blood supply to the heart.
It provides oxygenated blood to the
heart , through R & L coronary artry
Examination of the cardiovascular system





Anatomy of the heart
Manifestation of CVS
Disorders of the heart
Clinical examination of the heart
Special methode of examination
Anatomy of the heart

Deviated toword the left side of the
median plain of the body opposite to
the 3-6th intercostal space at the left
side.
Aorta
A.vena cava
L.A
Pul. artery
R. V
L.V
Position of the pulmonary (P), aortic (A) and bicuspid or mitral (B)
heart valves.The stethoscope is advanced under
the triceps muscle to get as close to the valves as possible
Manifestation of CVS















Lethargy
Poor appetite (anorexia)
Cough & Epistaxis
syncope
Weakness
Difficult breathing (dyspnea)
Distended abdomen (especially if the right heart is diseased) called ascites
odema
Pale or bluish colored gums (cyanosis).
tachycardia
Decreased heart rate (brachycardia)
A heart murmur during auscultation with the stethoscope
Cool extremities
Reduced mental capacity
Jugular vein pulsation
Dist.Abdomen
Ascites
Distended
J.v
Brisket odema
Submandibular
odema
Disorders of the heart
Tachycardia
Bradycardia
Heart block
Tachycardia

1.
2.
3.
4.
5.
6.
Tachycardia means increase in the heart
rate. Which occurred in the following
conditions:
Febrile conditions
Cardiac hypertrophy
Myocardial diseases
Hypotension
Excitement, fair and pain
Anemia.
Bradycardia
Bradycardia means that decreasing in the heart
rate as in case of :1.
Hypoglycemia
2.
Hypocalcemia
3.
Jaundice
4.
Congestive H.F.
5.
Hydropericardium
6.
Haemopericardium
7.
Perior to death
Hart block
Detected by E.C.G
Heart block means that defecte or delaying or inhibition
or interruption in the conduction of contractile
impulse from pacemaker to the ventricle
Types of heart block:
1.
Sinoatrial heart block.
2.
Atrioventincular heart block.
3.
Branch bundle heart block.
Physical Examination Of The Heart




Inspection
Palpation
Percussion
Auscultation
Inspection
Inspection : is of low value in large ruminants
1-Inspection occurred by observation of the so called “Apex beat”
causing movement of the chest
2-Apex beat can be observed in normal animal with:
•
Narrow chest
•
Thin wall of chest
•
Short coat
•
Good conditioned animal
3-Apex beat appeared clear in the following cases:

sever exercise.

Fever

Hemolytic anemia (sever)

Cardiac hypertrophy or dilatation
Palpation
1-Palpation of cardiac area detect the strength
and extent of the cardiac impulse
it’s occurred by placing the palm of the hand
over the cardiac area and slight pressure is
applied to compress the chest wall.
2-Cardiac impulse is palpable on left side only in
large animal and it may be week or absent in:
valvular insufficiency or stenosis
Percussion
Percussion of the cardiac area provide “Dull sound” because
it’s gas free organ
Abnormalities Of Percussion:
Increase of area of cardiac dullness
1.
Cardiac hypertrophy or dilatation
2.
Hydro or haemopericardium.
3.
Pericarditis especially in late stage
4.
Neoplasm
Decrease of area of cardiac dullness
1.
Pneumothorax
2.
Hydrothrax
3.
Pulmonary emphysema

Auscultation
chest piece of the stethoscope should pressed
firmly against the chest wall on the left side
in the 3-6th intercostals space beneath and
above the point of elbow joint.
Normal Heart Sounds:-Lubb dupp sound
 LUBB sound (Systolic sound ) Originated
from contraction of the ventricles and closure
of atrioventricular valve
 DUPP sound(Diastolic sound )Originated
from the closure of semilunar valves (aortic
and pulmonary)
Abnormal Heart Sounds By Auscultation
Murmurs
(I) Endocardial Murmurs
It’s arises within the heart usually as a result of
vulvular insufficiency or stenosis.
Systolic murmurs :during systoles due to
imperfect closure of the atrioventricular valve
(Bicuspid & tricuspid valve).
Diastolic murmurs :during diastole due to
imperfect closure of semilunar valves.
(II) Pericardial Murmurs
1- Frictional sound

Ex: pericarditis in early stage or in pleurisy.
2- Muffled sound


Occurred when the pericardial sac conations sufficient amount
of fluid so that the heart sound become faint and muffled be
heart sound as came from a far distance.
Ex: Heme- or hydropericardium.
3- Tinkling sound


indicate the presence of gas on the surface of fluid.
Gas production result from the presence of certain bacteria
which are introduced following the entry of a foreign body in
case of traumatic pericarditis.
Special Methods Of Examination Of The Heart
1.
2.
3.
4.
5.
Angiocrdiography.
Phonocardiography.
Electrocardiograph E.C.G.
Radiography.
Pain test.
Pain test
it is a specific test for confirmation the diagnosis of traumatic
pericarditis

Walking on down hill
Upward give no signs, Downward the animal show the signs of
pain or reluctant to walk.

Pinching of weather
the animal show the signs of pain.

Turning the animal in acute angle
it shows the signs of pain.

Side stick method
by raising the animal and suddenly release of the animal we found
the grunting sound
IN traumatic pericarditis
auscultation of the heart according to the stage of the
disease as the following:1-1st stage  frictional sound due to roughness
and dryness of pericardial layer.
2-2nd stage  dribbling sound when sufficient fluid
present in the pericardial sac.
3-3rd stage  splashing or tinkling sound due to
presence of gas in pericardial sac due to anaerobic
microorganisms which enter with the foreign body.
4-4th.Stage  Muffled sound due to organization of
the exudates in the pericardial sac.
Electrocardiograph


1.
2.
3.
The ECG is of limited value in cattle but can
be used to confirm abnormalities of rhythm.
Athree-lead system is used:The right arm (RA) lead attached to the
thoracic wall over the base of the heart.
The left arm (LA) lead is attached over the
cardiac apex.
The neutral (N) lead is attached to the skin
over the withers.
ECG
R A lead
N lead
L A lead
The right arm (RA) lead is placed on the neck, the left arm (LA) lead is placed on
the chest wall just above the sternum, and the neutral (N) lead is placed on the
wither
Ultrasonographic (US) evaluation
This is useful to detect abnormalities around
the heart and some details of its internal
structure.
 Evidence of fluid within the pericardial sac
may be seen as a black non-echogenic area
surrounding the heart.
 If the contents of the pericardial sac are
purulent, flacks of hyperechogenic material
may be seen.
Diagram of an ultrasonographic scan of an animal suffering from
pericarditis showing the presence of a pericardial effusion
Body wall
Tricuspid
valve
Pericardial effusion
Wall of left ventricle
Pericardiocentesis
This technique is used to collect and assess
pericardial fluid.
The needle is inserted through the chest wall
into the pericardial sac and fluid is allowed
to flow or is aspirated using a syringe.
Local anaesthetic is injected into the skin and
muscle layers of the space between the 5th
and 6th ribs.
Pericardiocentesis from an animal suffering
from pericarditis
Chest drain
5th rib
QUESTIONS