Page 1664 - Saunders Comprehensive Review For NCLEX-RN

CHAPTER 52

Cardiovascular Problems

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Priority Concepts
Health Promotion; Perfusion

I. Anatomy and Physiology
A. Heart and heart wall layers
1. The heart is located in the left side of the mediastinum.
2. The heart consists of 3 layers.
a. The epicardium is the outermost layer
of the heart.
b. The myocardium is the middle layer
and is the actual contracting muscle of
the heart.
c. The endocardium is the innermost layer
and lines the inner chambers and heart
valves.
B. Pericardial sac
1. Encases and protects the heart from trauma and
infection
2. Has 2 layers
a. The parietal pericardium is the tough,
fibrous outer membrane that attaches
anteriorly to the lower half of the
sternum, posteriorly to the thoracic
vertebrae, and inferiorly to the
diaphragm.
b. The visceral pericardium is the thin,
inner layer that closely adheres to the
heart.
3. The pericardial space is between the parietal and
visceral layers; it holds 5 to 20 mL of pericardial fluid,
lubricates the pericardial surfaces, and cushions the
heart.
C. There are 4 heart chambers.
1. The right atrium receives deoxygenated blood from
the body via the superior and inferior vena cava.
2. The right ventricle receives blood from the right
atrium and pumps it to the lungs via the pulmonary

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