Questions

1. Where is the heart found?

2. How many chambers does the heart consist of? What are these chambers?

3. Why is the heart compared with the pump?

4. What blood vessels bring deoxygenated blood to the right atrium?

5. Where is the tricuspid valve located? What is its function?

6. What do the cusps of the tricuspid valve form? Does the tricuspid valve stay shut during the right ventricle contraction?

7. Where is the mitral valve located? What is its function?

8. Which of the heart chambers has the thickest walls? And why?

9. Via which valve is the blood forced into the aorta? What does this valve prevent?

10. What are septa? How are they called? What is their main function?

11. What layers of the heart wall do you know?

12. Describe the endocardium.

13. Describe the myocardium.

14. Describe the epicardium.

15. What is the pericardium?

16. What are the phases of the hearbeat? Descibe them.

17. What initiates the heartbeat? What is its origin?

18. Where is the sinoatrial node located?

19. What is the pace-maker of the heart? What does it do?

20. Where is the atrioventricular node located? What is its function?

21. What is bundle of His?

22. What does the electrical wave from the bundle of His stimulate and where does it pass to?

23. What nervous system regulates the hearbeat? What nerves?

Additional Questions. Something to Think about

1. What causes the red color of blood? (clue: hemoglobin)

2. What is the function of hemoglobin?

3. What are blood types? Why is it important to know what your blood type is? (clues: A, B, AB, O; to transfer blood; safely; to mix; donated blood; blood cells; to clump together)

4. What is Rh factor? What blood is called Rh-positive? Rh-negative? (clues: substance in red blood cells)

5. What is lymph? What is its role? (clues: clear and liquid part; to carry; everything for cells; to carry away; wastes)

6. What are lymph nodes? Where are they found? What are their functions? (clues: small structures; along lymph vessels; to form; white blood cells; to kill; disease organisms)

7. What sound is known as heart murmur? Why does it need medical attention? (clues: closing valves; sound; not to close completely; to tell the doctor; heart disease)

8. What is pulse? What is pulse rate? (clues: heartbeat; a wave of blood; to start out; to move; the number of times each minute)

9. What does the normal pulse rate average about in males and females (clues: 80 beats per minute; 72 beats per minute)

10. What may lower and increase the pulse rate?

11. What is the origin and meaning of the word “capillary”? (clues: Latin; capillus; a hair)

12. What is serum of the blood?

13. Are all parts of the body vascular?

Text 4. Osteoarthritis

The joints are among the most frequently affected parts of the body, but one condition, osteoarthritis, is responsible for the majority of these involvements.

Osteoarthritis is extremely common disabling form of arthritis. Nearly everyone who lives long enough is affected. Uncommon before age of 40 years, the prevalence of osteoarthritis in both males and females increases with age, climbing over 90 % in advanced years.

Etiology and pathogenesis remain unknown but some associations are well-based:

1. Osteoarthritis as proposed is merely a natural part of aging.

2. Gender influence. After age of 55 the knees and hands are affected more commonly in women and the hips in men. There is a tendency for the disease to appear earlier in men than in women.

3. Genetic factor.

4. Traumas to a joint (shoulders and elbows of baseball players, ankles of ballet dancers, and knees of basketball players).

5. Obesity (due to excess loading of weight-bearing joints).

How these factors cause the development of the anatomic changes characteristic of osteoarthritis remains a “black box”. But there is general agreement that the early change is the increase in the water content of the articular cartilage, suggesting some weakening of the intrinsic collagen network.

In its developmental stages, osteoarthritis is asymptomatic. Basically, it is characterized by slow progressive focal erosions and later by extensive destruction of articular cartilage. This if followed by subchondral sclerosis and formation of large bony spurs or protrusions (osteophytes) at the margins of affected joints.

When sufficiently advanced, pain (at first mild), stiffness (at first transient), and decreased mobility (most prominent in the morning on arising) become evident. The large weight-bearing joints – spine, knees, hips – and the small joints of the hands and feet are most often involved. The osteophytes may contribute to pain and disability. When osteophytes occur at the distal interphalangeal joints, they are called “Heberden’s nodes”. In women, Heberden’s nodes are early manifestation of osteoarthritis. Later this symptom is followed by flexion and lateral finger deformity. With progression, the pain on motion and disability become more marked and may be accompanied by joint crepitation with some limitation of joint mobility. Swelling of affected joints and effusion may be present or may not be present.

In great majority of cases, osteoarthritis is most often monoarticular. But it may be oligoarticular or generalized.

The standard ways of examination ( blood and urine analyses) and physical inspection are helpful in diagnosing of osteoarthritis. The diagnosis can be confirmed by X-ray, revealing narrowing of joint spaces and characteristic osteophytes. Besides, thinned and fibrillated cartilage, bony spurs and sclerosis are well-marked and observed on an X-ray film.

Regrettably, the only relief is symptomatic conservative drug therapy, pain killers, physiotherapy or replacement with an artificial joint.