Anatomy and Physiology

This document discusses heart murmurs, atrial fibrillation, uterine prolapse, and other topics related to anatomy and physiology. It also covers the causes and mechanisms of these conditions.

Running head: ANOTOMY AND PHYSIOLOGY
Anatomy and Physiology
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Heart Murmur and its Causes
A heart murmur is a sound produced by turbulent blood flow within the heart. Its
occurrence may indicate the presences of structural abnormalities in the heart chamber, heart
valve or it may be due to abnormal connection between two parts of the heart (Sun et al., 2015).
However, there are instances in which it is considered normal because they can also occur in a
healthy heart. For example, the benign flow murmur which occurs when there is rapid blood
flow within the heart and the innocent murmur that is produced by a healthy heart (Sun et al.,
2015). Some of the causes of heart murmurs include congenital heart disorders, aortic
regurgitation, mitral regurgitation, mitral or aortic stenosis and damage of the cardiac muscle.
Other causes include anemia, stress, and hyperthyroidism.
Atrial Fibrillation and the heart conducting system
It is the term used to describe rapid and uncoordinated muscular twitching of the atrial
wall, which is mainly caused the damage of the electrical heart system resulting from the
cardiovascular conditions. The heart conducting system pathway is made up of five elements
which include the sino-atrial (SA) node, the atrioventricular (AV) node, the bundle of His, he left
and right bundle branches and the Purkinje fibres (van Weerd & Christoffels, 2016). The SA
which is located at the point where the superior vena cava enters the heart in the upper section of
the right atrium discharges the electrical impulses at a consistent rate depending on the needs of
the body (van Weerd & Christoffels, 2016). The stimuli then move across the myocardial cells of
the atria which results in development of wave of contraction that can spread quickly through
both of the atria.
The impulses from the SA will finally reach the AV node, which is found near the
opening of the coronary sinus and within the atrioventricular septum. At this point, the stimuli

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are delayed to allow the contracting atria to empty all the blood with its chambers to the
ventricles (van Weerd & Christoffels, 2016). Once the blood has been emptied, the valves that lie
between the atria and the ventricle close, which then allows the atria to refill. The stimulus wave
then passes to the bundle of His which serves the purpose of transmittion of the stimulus to the
Purkinje fibres of the ventricles (van Weerd & Christoffels, 2016). The Purkinje fibres are
located in the subendocardial surface in the walls of the ventricles, and they can transfer the
action potentials of the heart from the bundle of His to the myocardium surrounding the
ventricles
In a healthy heart, the impulses produced by the SA always travel throughout the atria
which then allows it to discharged blood into the ventricles. However, the transmission of the
electrical impulse can become uncoordinated due to abnormal triggering impulses or structural
changes of the heart (Hall, 2015). For example, triggers arising due to premature beats in the
pulmonary vein can result in rapid discharge of impulses which might not allow proper
transmission to the whole atria uniformly and therefore, resulting in fibrillation. On the other
hand, the contraction of the ventricular muscles occurs after the electrical impulses from the SA
trigger it (Tse, 2016). This causes them to propel blood either to the rest of the body or to the
lungs. However in the cases where automaticity of the impulses are impaired for example due to
scarring, the process becomes disrupted and thus, causing tachycardia
Causes of Rheumatic Fever and its Relationship with Heart Murmur
Rheumatic fever is an inflammatory condition that occurs as a complication of inadequate
treatment of scarlet fever or infection of the throat caused by group A streptococcus bacteria.
This inflammation can occur in the joints, central nervous system, heart or the skin with the
possibility of lasting for months (Carapetis et al., 2016). In severe cases, the condition can result

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in permanent damage to the heart with critical areas such as the mitral valve is the most
commonly affected (Carapetis et al., 2016). Due to that, development of valve stenosis, valve
regurgitation, and destruction of the heart muscles may occur which then puts an individual at
risk for experiencing turbulence in blood flow as presented by the client in the case report.
Anatomy of the mitral valve
The mitral valve is found between the left ventricle and the left atrium. It has various
structures which include the leaflets (projects involved in closing of the valve), commissures
(region in which both the anterior and posterior chambers join), chordae tendinae (it is a
connective structure and attaches papillary muscles to leaflets), zone of coaptation and mitral
annulus (Hoffman & Fullerton, 2018). This feature allows it to controls the movement of blood
between the two chambers which are exclusively involved in handling of oxygenated blood.
Support structures of the uterus
The female reproductive systems contains ligaments which provide support of the
internal genital organs on the wall of the pelvis. The ligaments supporting the uterus are divided
into three based on where they conferred in the uterus, which includes; the inferior aspect, the
middle aspect, and the superior aspect (Mahre et al., 2016). Firstly, the round ligament
commences from the uterine horns, passes through the inguinal canal and is attached to the labia
majora. Secondly, cardinal ligaments which are also present in the uterus and they are found
along the inferior border. This ligaments on the lateral pelvic wall offer a great attachment
occurring at the level of the ischial spines. Other supporting structures include the pubocervical
and uterosacral ligaments which are bilateral and holds the cervix to the posterior surface of the
pubic symphysis and sacrum respectively (Mahre et al., 2016). They not only work to provide
support for the uterus but also holding it in place.

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Causes of uterine prolapse
Pregnancy is one of the leading causes of uterus prolapse. This is because pregnancy
results in weakening of the pelvic muscles and tissues which are usually involved in providing
support and holding with within the pelvic cavity (Barber, 2016). Besides, conditions that
increase abdominal pressure is also another cause. These conditions include chronic coughing,
accumulation of fluid in the abdomen, tumors or excessive straining. This weakens the pelvic
muscles and support structures and thus, can result in uterine prolapse.
Types and the Anatomical Mechanism of Pelvic Prolapse in Females
Different kinds of prolapses can occur either independently or with other organs in
female pelvis. Some of them include; cystocele which occurs when supporting structures
between the wall of the vagina and the bladder weaken and thus section of the bladder protrudes
into the vagina and urethrocele that occurs when the vaginal wall is pushed by the urethra
leading to bulging into the vagina (Barber, 2016). Others include uterine prolapse that occurs
when cervix and the uterus protrude into the vagina and rectocele which occurs due to
weakening of tissues supporting vagina and rectum causing rectum to push into vaginal wall.
Urethral Sphincter
Both the external and internal urethral sphincter offer muscle control for urine flow. The
internal sphincter surrounds the opening of the bladder leading to the urethra, and it undergoes
relaxation to allow for the flow of urine (Bertrand et al., 2016). It is also involuntary as opposed
to the external sphincter which is voluntary and surrounds the urethra outside the bladder.
Mechanism of Stress Incontinence
During the incidents of stress incontinence, a rise in pressure within the abdominal cavity
is present, for example, sneezing, coughing or lifting something. This increases pressure within

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the bladder which becomes more than the urethral resistance to urine flow (Kirchin et al., 2017).
At this point then, urine is released though it stops when the force applied on the bladder
reduces.
References

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