Lab 5: Blood and Heart Instructor Slides

Learning Objectives:

Activity 1: blood histology

- Identify and sketch the cell types found in blood

Activity 2: blood typing

- Investigate two systems to classify human blood
types (ABO, and Rh factors)

Activity 3: Anatomy of the heart

- Identify and diagram the physical structures of
the heart to understand how this organ functions
in pumping blood
 Activity I. Histology of Blood/Circulatory System
Fold a piece of blank copy paper in quadrants and sketch the 7 different types of
blood cells listed below. Include the name of the cell type and any prominent
features (Nucleus/no nucleus, organelles ect) You can use the blood smears
from prepared microscope slides and/or Blood Images found here. Be sure to
include at least 1 representative cell from each cell type.

I. Red blood cells:

Erythrocytes: Function to deliver oxygen and remove carbon dioxide.
1) Draw and label a red blood cell

II. White blood cells:

I. Leukocytes: Function in the immune system- White blood cells
A. Granular Leukocytes: filled with “grains” or organelles that hold
enzymes or histamines. Important in allergic reactions.
Draw and label these granular leukocytes
2) eosinophil
3) basophil
B. Non-Granular Leukocytes: Natural killer and T cells function to
destroy cells our own cells when they are infected by viruses or
tumors
Draw and label these non-granular leukocytes
4) Monocyte
5) Lymphocyte
C. Thrombocytes: help form blood clots
Draw and label megakaryoblast cells and the platelets that are
created by these cells and function to clot blood
6) Megakaryoblasts
7) Platelets

Upload one single image on canvas (with all 7 cells) to include with your
submission of today’s lab.

Human blood smear, Giemsa stain, 86X scan from hematopathology normals collection Virtual
Slide
Activity II. Simulated ABO and Rh Blood Typing

OVERVIEW

Our genes control what types of sugars and proteins are on the surface of our blood
cells. We inherit either A,B, or O (no) sugars from each parent. We Inherit Rh proteins
from each parent as well. Whichever gene is passed down from our parents determines
which sugars and proteins are on the surface of our blood cells. Our immune system
recognizes the proteins and sugars found on the surface of blood cells. Our immune
system treats any cell that does not match our blood “type” as an invader and destroys
the cell. The purpose of this lab is to perform an ABO & Rh blood typing procedure
using simulated blood. This activity will help you to investigate and discuss the
significance of ABO & Rh blood types and how we can use these blood types in
healthcare and forensics.

SAFETY PRECAUTIONS
lab specific safety:
WARD'S Simulated Blood does NOT need to be refrigerated and has an indefinite shelf
life. All simulated blood components in this lab activity are biohazard free and can be
discarded in the garbage can.

Vocabulary Guide
● Agglutinogens (antigens): substances found on the surface of erythrocytes.
● Agglutinins (antibodies): antibodies found in the plasma of blood. Erythrocytes:
red blood cells.
● Leukocytes: white blood cells.
● Plasma: fluid of the blood where red blood cells are suspended.
● Antisera: serum that contains antibodies for one or more antigens.
● Process of agglutination: the clumping of red blood cells as a result of a
reaction to a specific antibody.
● Blood Transfusion: the transfer of whole blood from one individual to another.
● Hemoglobin: is a protein in the blood, primarily responsible for carrying oxygen
from the lungs to the tissues of the body and carbon dioxide from the tissues of
the body to the lungs.
● Gene: is a unit that one organism inherits from a parent organism and is the
determining factor of a specific phenotype of an organism.
● Genetic code: is the sequence of nucleotides in DNA or RNA that determines
the specific protein synthesis.
● Allele: a pair of genes located on a specific site of a specific chromosome
● Genotype: the genetic makeup of an organism.
● Phenotype: the expression of a specific trait in an organism.
● Sensitization: to make reactive to an antigen.
● Hemolysis: the destruction of red blood cells and the release of hemoglobin.
Erythroblastosis fetalis: is a blood disorder found in human fetuses and infants
in which the mother's antibodies attack the developing baby's red blood cells.
If a woman who is Rh- is pregnant with a fetus that inherited Rh factors from its
biological father the mother’s immune system may attack the fetus. This attack gets
worse over time. Often there is very little response until late in the first pregnancy but in
subsequent pregnancies the immune response will be more aggressive resulting in
damage to the fetal cells known as Erythroblastosis fetalis. This blood disorder can
lead to birth defects or death.

BACKGROUND

Around 1900, Karl Landsteiner discovered that there are at least four different kinds
of human blood, determined by the presence or absence of specific agglutinogens
(antigens) on the surface of red blood cells(erythrocytes). These antigens have been
designated as A and B. Agglutinins (antibodies) against foreign antigens A or B
begin to build up in the blood plasma shortly after birth, the levels peak at about eight
to ten years of age, and the antibodies remain, in declining amounts, throughout the
rest of a person's life. The stimulus for antibody production is not clear; however, it
has been proposed that antibody production is initiated by minute amounts of A and
B antigens that may enter the body through food, bacteria, or other means.
Blood type is determined by Agglutinogens (shown in green or blue in the figure
above). An individual is either A type, B type or O type based on what specific
glycoproteins (biomolecule with both sugar and protein) they have on the surface of
their blood cells (O type individuals are missing these agglutinogens).

Humans normally produce antibodies, also known as Agglutinins: (Shown in blue

above) to attack cells with antigens that are not on their own erythrocytes. If cells
with foreign antigens are found, our immune system will destroy them through the
process of Agglutination. For example, a person with A antigens will produce anti-B
antibodies. If cells with B antigens are found they will be destroyed. A person with B
antigens has anti-A antibodies; a person with neither A nor B antigens has both anti-
A and anti-B antibodies; and a person with both A and B antigens has neither anti-A
nor anti-B antibodies. Blood type is based on the antigens, not the antibodies, a
person possesses.

A agglutinogens, is the most common blood type in the United States and is found
in 34% % of the population. Type B is next in frequency, and is found in 9% of the
population. The frequencies at which type AB occurs is 3% O type is most rare at
1%.
ABO SYSTEM PROCESS OF AGGLUTINATION

There is a simple test performed with antisera containing high levels of anti-A and
anti-B agglutinins to determine blood type. Several drops of each kind of antiserum
are added to separate samples of blood. If agglutination (clumping) occurs only in
the suspension to which the anti-A serum was added, the blood type is A. If
agglutination occurs only in the anti-B mixture, the blood type is B. Agglutination in
both samples indicates that the blood type is AB. The absence of agglutination in
any sample indicates that the blood type is O.

Importance of Blood Typing

As noted in Figure 1, people can receive transfusions of certain blood types,
depending on the type of blood they have. If incompatible blood types are mixed,
erythrocyte destruction, agglutination and other problems can occur. For instance, if
a person with type B blood is transfused with blood type A, the recipient's anti-A
antibodies will attack the incoming type A erythrocytes. The type A erythrocytes will
be agglutinated, and hemoglobin will be released into the plasma. In addition,
incoming anti-B antibodies of the type A blood may also attack the type B
erythrocytes of the recipient, with similar results. This problem may not be serious,
unless a large amount of blood is transfused.
The ABO blood groups and other inherited antigen characteristics of red blood
cells are often used in medico-legal situations involving identification of disputed
paternity. A comparison of the blood groups of mother, child, and alleged father
may exclude the man as a possible parent. Blood typing cannot prove that an
individual is the father of a child; it merely indicates whether or not he possibly
could be. For example, a child with a blood type of AB, whose mother is type A,
could not have a man whose blood type is O as a father.

THE GENETICS OF BLOOD TYPES

The human blood types (A, B, AB, and O) are inherited by multiple alleles, which
occurs when three or more genes occupy a single locus on a chromosome.
Gene lA codes for the synthesis of antigen (agglutinogen) A, gene P codes for
the production of antigen B on the red blood cells, and gene i does not produce
any antigens. The phenotypes listed in the table below are produced by the
combinations of the three different alleles: I, P, and i. When genes P and I are
present in an individual, both are fully expressed. Both P and I are dominant
over i so the genotype of an individual with blood type O must be ii.

Rh System
In the period between 1900 and 1940, a great deal of research was done to
discover the presence of other antigens in human red blood cells. In 1940,
Landsteiner and Wiener reported that rabbit sera containing antibodies for the
red blood cells of the Rhesus monkey would agglutinate the red blood cells of
5% of Caucasians. These antigens, six in all, were designated as the Rh
(Rhesus) factor, and they were given the letters C, c, D, d, E, and e by Fischer
and Race. Of these six antigens, the D factor is found in 85.9% of Caucasians,
94% of African Americans, and 99% of Asians. An individual who possesses
these antigens is designated Rh+; an individual who lacks them is designated
Rh-
The genetics of the Rh blood group system is complicated by the fact that more
than one antigen can be identified by the presence of a given Rh gene. Initially,
the Rh phenotype was thought to be determined by a single pair of alleles.
However, there are at least eight alleles for the Rh factor. To simplify matters,
consider one allele: Rh+ is dominant over Rh-; therefore, a person with an
 Rh+/Rh-or Rh+/Rh+ genotype has Rh+ blood.

The anti-Rh antibodies of the system are not normally present in the plasma, but
anti-Rh antibodies can be produced upon exposure and sensitization to Rh
antigens. Sensitization can occur when Rh+ blood is transfused into an Rh-
recipient, or when an Rh- mother carries a fetus who is Rh+. In the latter case,
some of the fetal Rh antigens may enter the mother's circulation and sensitize her
so that she begins to produce anti-Rh antibodies against the fetal antigens. In
most cases, sensitization to the Rh antigens takes place toward the end of
pregnancy, but because it takes some time to build up the anti-Rh antibodies, the
first Rh+ child carried by a previously unsensitized mother is usually unaffected.
However, if an Rh- mother, or a mother previously sensitized by a blood
transfusion or a previous Rh+ pregnancy, carries an Rh+ fetus, maternal anti-Rh
antibodies may enter the fetus' circulation, causing the agglutination and
hemolysis of fetal erythrocytes and results in a condition known as erythroblastosis
fetalis (hemolytic disease of the newborn). To treat an infant in a severe case, the
infant's Rh+ blood is removed and replaced with Rh- blood from an unsensitized
donor to reduce the level of anti-Rh antibodies.

Blood Components
The formed elements in blood include erythrocytes, or red blood cells (RBCS;
various types of leukocytes, or white blood cells (WBCs); and platelets.

Erythrocytes are circular, biconcave disks of 5 to 8 micrometers. Their chief

function is to transport oxygen O,) and carbon dioxide (CO,). The transport of O,
and CO, depends largely on the hemoglobin present in the erythrocytes. The
biconcave shape is also related to the erythrocytes’ function of transporting gasses,
in that it provides an increased surface area through which gasses can diffuse.

The number of circulating RBCs is closely related to the blood's oxygen-carrying

capacity. Any changes in the RBC count may be significant. RBC counts are
routinely made to diagnose and evaluate the course of various diseases.

Leukocytes range in size from approximately 9 to 25 micrometers and function

primarily to control various disease conditions. Leukocytes can move against the
current of the bloodstream through amoeboid movement, and pass through the
blood vessel walls to enter the tissues. The total WBC count normally varies from
5,000 to 10,000/mm. Certain infectious diseases are accompanied by an increase in
WBCs.If the number exceeds 10,000/mm, the person has an acute infection. If it
drops below 5,000/mm, the person may have a condition such as measles or
chickenpox. The percentage of the different types of leukocytes present in the blood
may also change in particular diseases, this number is important for diagnostic
purposes and is called a differential count.
Procedure
1. Label each blood typing slide:
Slide #1:Mr. Smith
Slide #2: Mr. Jones
Slide #3: Mr. Green
Slide #4: Ms. Brown

2. Place three to four drops of Mr. Smith's blood in each of the A, B,

and Rh wells of Slide #1.
3. Place three to four drops of Mr. Jones's blood in each of the A, B,
and Rh wells of Slide # 2.
4. Place three to four drops of Mr. Green's blood in each of the A, B,
and Rh wells of Slide #3.
5. Place three to four drops of Ms. Brown's blood in each of the A, B,
and Rh wells of Slide #4
6. Place three to four drops of the simulated anti-A serum in each A
well on the four slides.
7. Place three to four drops of the simulated anti-B serum in each B
well on the four slides.
8. Place three to four drops of the simulated anti-Rh serum in each Rh
well on the four slides.
9. Obtain three toothpicks per blood typing slide. Stir each well with a
separate clean toothpick for30 seconds. To avoid splattering the
simulated blood, do not press too hard on the typing tray.
10. Observe each slide and record your observations in Table 1 of the
Analysis section. To confirm agglutination try reading text through the mixed
sample. If you cannot read the text, assume you have a positive agglutination
reaction.
11. Based on the agglutination, determine and record in table 1, the blood type
(including the Rh factor) for each slide.
12.Clean up and dispose of materials according to your teachers instructions.
RESULTS AND ANALYSIS
TABLE 1
Anti- A Serum Anti-B Serum Anti-Rh Serum Blood Type

Slide #1 Light red liquid Darker red liquid Light red liquid A-Type
Mr. Smith with agglutination but with with agglutination
agglutination

Darker red liquid Light red liquid Darker red liquid B-type
Slide #2
but with no with agglutination but with no
Mr. Jones agglutination agglutination

Dark red liquid Light red liquid Light red liquid AB-Type
Slide #3
with agglutination with no with agglutination
Mr. Green agglutination

Darker red liquid Darker red liquid Darker red liquid O-Type
Slide #4
but with no but with no but with no
Ms. Brown
agglutination agglutination agglutination

ASSESSMENT
1. Record his/her name here:
Mr. Smith
b. Using the information shown in Figure 1 and the data recorded in Table 1, what
agglutinogens are present on the patient's RBCs?
A agglutinogens are present
c.What AB0 agglutinin(s) is/are found in this patient's plasma?
Anti-B
d. What is this patient's blood type?
A-type
e. If this patient needed a transfusion, what blood type(s) could this patient safely
receive?
O and A type blood
f.What blood types) could safely receive this patient's blood?
A and AB
2. Record his/her name here:
Mr. Jones
 b. Using the information shown in Figure 1 and the data recorded in Table 1,
what agglutinogens are present on the patient's RBCs?
B
c.What AB0 agglutinin(s) is/are found in this patient's plasma?
Anti-A
d. What is this patient's blood type?
A-type
e. If this patient needed a transfusion, what blood type(s) could this patient safely
receive?
O and B type blood
f.What blood types) could safely receive this patient's blood?
B and AB type blood

3. Record his/her name here:

Mr. Green
b. Using the information shown in Figure 1 and the data recorded in Table 1,
what agglutinogens are present on the patient's RBCs?
A and B
c.What AB0 agglutinin(s) is/are found in this patient's plasma?
Neither Anti-A nor Anti-B
d. What is this patient's blood type?
AB Blood type
e. If this patient needed a transfusion, what blood type(s) could this patient safely
receive?
O, A, B, and AB
f.What blood types) could safely receive this patient's blood?
Only AB

4. Record his/her name here:

Ms. Brown
b. Using the information shown in Figure 1 and the data recorded in Table 1,
what agglutinogens are present on the patient's RBCs?
Neither A nor B
c.What AB0 agglutinin(s) is/are found in this patient's plasma?
Both Anti-A nor Anti-B
 d. What is this patient's blood type?
O type
e. If this patient needed a transfusion, what blood type(s) could this patient safely
receive?
Only O
f.What blood types) could safely receive this patient's blood?
O, A, B, and AB

5. Below is a diagram representing the blood type analysis of a new patient (patient X).
From the information obtained from the slide, fill out the medical technologist's report.

Medical Technologist's Report

Med Tech Name:

Cristian Camacho
Patient Name:
patient X A type
ABO Type:
Anti-B
Rh Type:
Positive

3.Compare and contrast agglutinogens and agglutinins. (at least two similarities and
two differences)
Agglutinogens are antigens present on the surface of red blood cells;Agglutinins are
antibodies found in the plasma (liquid portion) of blood
Agglutinogens are responsible for triggering immune responses; produced by the
immune system in response to exposure
Agglutinogens and agglutinins are both related to the immune response
5. Reflect on your everyday life and what you have learned about from the news. list
at least three situations where blood typing could be used.
1 Crime scenes

2 Blood transfusion

3 Giving Blood

6.
a. Define erythroblastosis fetalis.
a blood disorder that occurs when the blood types of a mother and baby are
incompatible

b. Describe the sequence of events that result in this condition.

After a mother gives birth for the first time her immune system is forever changed
towards fetuses so their white blood cells attack the fetus and can lead to this
condition.
Activity III. Anatomy of the Heart

**** Before you begin***

Important!!!
- ONE Person’s hands on the mat at a time. Give each other space.

- Use the skewers and other tools to safely (and systematically) explore.

- Slice across and away from your body!!! Like you are slicing a hamburger bun or a
bagel not down the middle like cutting cake

Slice so that the words on the blade are towards the mat not towards the ceiling.
Take turns dissecting. Always communicate before

Learning outcomes of the lab exercises:

1. To describe the location of the heart
2. To name and locate the major anatomical areas and structures of the heart when
provided with an appropriate model, diagram, or dissected sheep heart, and to
explain the function of each
3. To trace the pathway of blood through the heart, and list the names of each of the
structures blood has to go through to travel throughout the body.
4. To explain why the heart is called a double pump, and to compare the pulmonary
and systemic circuits
5. To follow the blood supply of the heart, name and identify the blood vessels
involved, and to discuss the consequences of the blockage of these vessels
6. Review the histology of cardiac muscle and associated diseases

“There is no single better word to describe the function of the heart other than “pump,”
since its contraction develops the pressure that ejects blood into the major vessels: the
aorta and pulmonary trunk. From these vessels, the blood is distributed to the
remainder of the body. Although the connotation of the term “pump” suggests a
mechanical device made of steel and plastic, the anatomical structure is a living,
sophisticated muscle.”

General Considerations
Identify the following on a human heart diagram and a sheep heart specimen.
A. Surfaces and Borders
1. Apex - formed by the left ventricle, lies at the level of the fifth
intercostal space, midclavicular line
2. Base (posterior surface) - formed by the atria, mainly the left atrium
 B. Surface Markings
1. left and right atrioventricular grooves (or coronary sulcus)
2. anterior interventricular sulcus
3. posterior interventricular sulcus
I. Chambers
Identify the following on heart diagram and sheep heart:

A. right atrium and its associated structures

1) pectinate muscles (musculi pectinati)
2) right auricle
3) openings of the superior vena cava and inferior vena cava
B. interatrial septum
C. left atrium and its associated structure
1) left auricle
D. right ventricle and its associated structures
1) trabeculae carneae
2) papillary muscles
3) chordae tendineae
4) right atrioventricular valve
5) pulmonary semilunar valve
E. interventricular septum
F. left ventricle and its associated structures
1) trabeculae carneae
2) papillary muscles
3) chordae tendineae
4) left atrioventricular valve
5) aortic semilunar valve
G. right atrioventricular valve (tricuspid)
H. left atrioventricular valve (bicuspid or mitral)
I. aortic and semilunar valves
II. Great Vessels
Identify the following on a human heart diagram and a sheep heart specimen:

A. systemic pump - vessels associated with the systemic circulation:

1) ascending aorta
2) aortic arch
3) brachiocephalic artery
4) left common carotid artery
5) left subclavian artery
B. pulmonary pump - vessels associated with the pulmonary circulation:
1) superior vena cava
2) inferior vena cava
3) pulmonary trunk
4) pulmonary arteries (right & left)
5) pulmonary veins (right & left)

III. Heart Blood Supply - Coronaries

A. Coronary Arteries - The right and left coronary arteries arise from the ascending
aorta, just above the ventricle. The coronary arteries supply blood to the
myocardium.
1) left coronary artery and its branches - arises from the left side of the aorta, and
as it passes behind the pulmonary trunk, bifurcates into two main branches
a) anterior interventricular artery (located in the left anterior interventricular
sulcus)
b) circumflex artery
2) right coronary and its branches - arises from the right side of aorta and runs in
 the right atrioventricular groove
a) posterior interventricular artery
b) marginal artery
c)
B. Cardiac Veins - the three cardiac veins drain into the coronary sinus.
1) great cardiac vein
2) middle cardiac vein
3) small cardiac vein
Heart Anatomy Word Bank

You must be able to identify the following structures on a paper figure, a sheep heart,
and/or plastic heart model(s) for the lab quiz.

Aorta Left subclavian artery

Aortic semilunar valve Left ventricle
Apex Middle cardiac vein
Base Papillary muscles
Bicuspid valve Pectinate muscles
Brachiocephalic trunk Pulmonary arteries (R/L)
Chordae tendineae Pulmonary semilunar valve
Circumflex artery Pulmonary trunk
Coronary sinus Pulmonary veins
Great cardiac vein Right atrium
Inferior vena cava Right Coronary artery
Interventricular septum Right ventricle
Left atrium Superior vena cava
Left anterior interventricular artery Trabeculae carneae
Left common carotid artery Tricuspid valve

Heart Labeling
 Word Bank
Aorta Left atrium
Apex Left ventricle
Pulmonary trunk Right atrium
Right ventricle Right coronary artery
Left interventricular coronary artery Circumflex artery
 1

2
6
3
7

4
8

9
5

10

Heart Labeling

Word Bank
Aortic semilunar valve Bicuspid/mitral atrioventricular valve
Chordae tendineae Inferior vena cava
Papillary muscle Pulmonary semilunar valve
Superior vena cava Tricuspid atrioventricular valve
 1

4 8

DISSECTION OF THE SHEEP HEART

Human hearts are not readily available for student dissection. Sheep hearts
are similar in size, have most of the same parts, and have the same general
conformations as human hearts. At all times compare structures of the sheep
heart with those of the human heart (utilize models). Directions are given with
the heart in the anatomic position.

1. Locate the following structures and regions on the model and diagrams of
the human heart: anterior (ventral) longitudinal sulcus, apex, aorta, aortic
semilunar valve, base, bicuspid (mitral) valve, chordae tendineae, inferior
vena cava, left atrium and auricle, left ventricle, ligamentum arteriosum,
papillary muscle, pulmonary artery, pulmonary semilunar valve, pulmonary
vein, right atrium and auricle, right ventricle, superior vena cava, tricuspid
valve.

2. The pericardium (the fibroserous membrane surrounding the heart) has

been removed from the sheep heart.

3. The epicardium (the visceral layer of the pericardium) is adherent to the

myocardium (muscle) of the heart. The innermost layer of the heart, the
endocardium, will be visible only after the heart is opened.

4. Determine the ventral surface of the sheep heart. Distinguish the right
and left sides of the heart, the ventral and dorsal sides of the heart, and the
base (superior) and apex (inferior) regions of the heart. Determine location of
the heart if it were sitting in its correct anatomic position within yourself.

5. Locate the pulmonary artery on the ventral surface of the heart. This
artery emerges from the superior (base) ventral surface of the heart, medial to
the left auricle. The auricles are the earlike outpocketings of the atria, the
upper (receiving) chambers of the heart. Locate the right and left auricles.

6. Note the anterior (ventral) longitudinal sulcus which superficially marks the
separation of the right and left ventricles. Coronary blood vessels are in
the sulcus.

7. Compare the thickness of the wall of the right ventricle with that of the left
ventricle by pressing against the wall of each ventricle.

OBSERVE CAREFULLY ALL INCISIONS MADE BY YOUR INSTRUCTOR

DURING DEMONSTRATION OF PROPER DISSECTION OF THE HEART.

8. Using great care, make an incision through the ventral wall of the
pulmonary artery. Continue the cut through the ventral wall of the right
ventricle parallel to and about one-half inch to the right of the anterior
longitudinal sulcus. Do not cut so deeply that you cut into the dorsal surface
of either the pulmonary artery or right ventricle. Continue the incision, keeping
parallel to the anterior longitudinal sulcus, to the interventricular septum that
separates the right and left ventricles.

9. Open the pulmonary artery and note the three flaps (cusps) of the
pulmonary semilunar valve. Generally, the incision has been made through
one of these flaps.

10. Examine the dorsal surface of the heart and find the opening of the
superior vena cava into the right auricle. Make a longitudinal incision
through the lateral wall of the superior vena cava toward the ending point of
your initial incision. Continue down through the lateral surface of the right
atrium and right ventricle to the point of juncture with the first incision.

11. Spread open the right atrium and ventricle. Note the absence of a valve at
the entrance of the superior vena cava into the right atrium.

12. Observe the internal structure of the right auricle. The muscle visible in
the interior of the auricle is called the pectinate muscle.

13. Locate the opening of the inferior vena cava on the dorsal side of the
right atrium near the atrioventricular junction. Locate the opening of the
coronary sinus just inferior to the inferior vena cava. The coronary sinus
drains most veins of the wall of the heart. Gently insert a metal probe into this
opening and find the vessel on the dorsal surface of the heart.

14. Locate the interatrial septum, the wall that separates the two atria. Find
the fossa ovalis, a depression in the interatrial septum. Prior to birth, there
was an opening here (the foramen ovale) that permitted blood to move freely
between the left and right atria. Normally, this firmly closes with the first
breath the baby takes, thus preventing mixing of oxygenated blood coming
from the lungs with deoxygenated blood from the various organs of the body.
Since the lungs were non-functional prior to birth, not much blood was sent
into the pulmonary (right heart) circuit; most moved through the foramen ovale
to be pumped in the systemic (left heart) circuit to the developing organs of the
body.

15. Examine the tricuspid valve between the right atrium and right ventricle.
Note that it has three flaps (cusps). Locate the papillary muscles (elevations
of muscle) in the wall of the right ventricle. String-like structures called
chordae tendineae attach the free edges of the flaps of the tricuspid valve to
the papillary muscles. This arrangement prevents eversion of the flaps back
into the atrium during the powerful contraction of the ventricle.

16. Locate the moderator band crossing the lumen of the right ventricle from
the ventral to its medial wall. This structure is believed to prevent over-
distension of the ventricle when it fills with blood. The moderator band
generally is not found in the human heart.

17. Four pulmonary veins enter the left atrium. However, the heart has
usually been cut so that they are no longer intact. What is seen instead is an
opening into the superior surface of the left atrium. From this opening, make a
longitudinal incision through the lateral wall of the left atrium and the left
ventricle all the way to the apex of the heart (the apex is formed by the left
ventricle).
18. Spread open the left side of the heart and compare the wall thickness of
the left ventricle with that of the right. Observe the bicuspid (mitral) valve
and note that it has only two flaps rather than three. Determine whether the
left ventricle has a moderator band, chordae tendineae, and papillary
muscles.
19. Insert a finger up the midline of the left ventricle into the aorta. Cut along
this line and through the wall of the aorta. Find the three flaps (cusps) of the
aortic semilunar valve. Behind two of these flaps, find the openings of the
two coronary arteries.

20. Return to the external surface of the heart, relocate the thick-wall aorta
and determine whether its first branch, the brachiocephalic artery, is
present. This vessel later branches into the subclavian and common carotid
arteries, which supply the arms and head. In humans, three large blood
vessels branch from the aortic arch.
 Activity: Complete the Story of Blood Flow through the Heart

10 Aorta 1 Vena Cava

11 Aortic Semilunar Valve 12 Left Ventricle
5 Pulmonary Semilunar Valve 2 Right Atrium
4 Right Ventricle 6 Pulmonary Trunk/Arteries
7 Pulmonary Veins 9 Left Atrium
3 Tricuspid Atrioventricular Valve 8 Bicuspid/Mitral Atrioventricular Valve

After being used by the major organs of the body, deoxygenated blood is transported

back to the right side of the heart by two large veins known as the _(1)_ and enters the

_(2)_, quickly passing by the open _(3)_ valve, where blood then enters and fills the

_(4)_ chamber. After filling, the cardiomyocytes contract, produce force on the blood

and push open the _(5)_ valve and allow blood to exit into the _(6)_. Blood now enters

the circulation of the lung for gas exchange to occur. Once oxygenated, blood returns to

the heart from the by way of four large vessels called the _(7)_, blood then moves into

the _(8)_, and past the open _(9)_ valve filling the _(10)_ chamber. From here,

oxygenated blood is pushed past the _(11)_ valve and into the _(12)_ where blood is

pumped into the systemic circuit.

 Matching Exercise
Match the cardiovascular structure to its proper description.

Valve of the heart consisting of two cusps

1. _H__ Left ventricle [A] attached by chordae tendineae, present
between the left atrium and left ventricle
Receiving chamber of the heart that moves
2. __L___ Right ventricle [B]
deoxygenated blood from the vena cava

Outgrowths of cardiac muscle that help secure

3. _F___ Left atrium [C]
atrioventricular valves in place
Largest vessels of the body that move
4. __B__ Right atrium [D]
deoxygenated blood into the right atrium

5. _J___ Pulmonary trunk [E] Shared wall between the right and left atria

Receiving chamber of the heart that moves

6. _D___ Vena Cava [F]
oxygenated blood from the pulmonary veins
Valve of the heart consisting of three cusps
7. __N__ Aorta [G] attached by chordae tendineae, present
between the right atrium and right ventricle
Pumping chamber of the heart that moves
8. __A__ Bicuspid/Mitral [H]
oxygenated blood into the aorta
Valve of the heart consisting of three cusps,
9. __G__ Tricuspid [I] present between the right ventricle and
pulmonary trunk
Vessel that moves deoxygenated blood from
10. _M___ Aortic semilunar [J]
the right ventricle to the lungs.
Shared wall between the right and left
11. __I__ Pulmonary Semilunar [K]
ventricles

Pumping chamber of the heart that moves

12. __Q__ Pulmonary veins [L]
deoxygenated blood into the pulmonary trunk

Valve of the heart consisting of three cusps,

13. __K__ Interventricular septum [M]
present between the left ventricle and aorta
 Largest vessel of the body that moves
14. _E___ Interatrial septum [N] oxygenated blood from the left ventricle to
systemic circulation
Vessels that carry oxygenated blood from the
15. __C__ Papillary muscles [O]
lungs back to the left atrium of the heart

Problem Solving Activity

For each response,

[1st] State whether you are ACCEPTING or REJECTING that statement.

[2nd] Write a detailed explanation WHY you ACCEPT or REJECT ALL of the choices.
Each choice should be considered individually and an argument should be written for
accepting or rejecting it. Since the problem has one best answer, there should be one
argument for acceptance and four for rejection.

PROBLEM #1:

A person enters the hospital because of pulmonic valve incompetence (pulmonary

semilunar valve murmur). As a result of this condition, where is excessive blood most
likely to accumulate?

[A.] The left atrium.

Reject, the left atrium plays no role in the incompetence of the pulmonic valve.

[B.] The right atrium.

Reject, blood does not flow through the right atrium

[C.] The left ventricle.

 Reject

[D.] The right ventricle.

Accept, the pulmonary semilunar valve sits between right ventricle and pulmonary
trunk

[E.] The pulmonary artery.

Accept, due to the murmur and incompetence, excessive blood is there.

PROBLEM #2:

A middle-aged woman is admitted to the coronary care unit with a diagnosis of left
ventricular failure resulting from a myocardial infarction. Her history indicates that she
was aroused in the middle of the night by severe chest pain. Her skin is pale and cold.

[A.] Her systemic circuit was not affected by the MI.

Reject, the systemic circuit was affected because it is the function of the heart that
was affected by the heart attack.

[B.] This MI could not have been caused by an embolism.

Reject, the blood clot could be blocking off the flow.

[C.] A symptom likely would be moist sounds heard over lower regions of both
lungs.