The Tell Tale Heart ( ANNOTATED )

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m Look at the left-hand diagram. Make a long cut down through the aorta and the left ventricle to the tip of the heart (‘apex’), as shown in the diagram. The position of the blood vessels on the surface will help you to make this cut in the right place. Identify the coronary artery that supplies the heart muscle itself with blood. During a complete cardiac diastole, blood from the superior and inferior vena cava slowly flows into the auricles. The pressure in the ventricles then decreases and eventually becomes lower than the atrial pressure. The AV (auriculo-ventricular) valves then open, and blood from the atria starts entering into the relaxing ventricles. A complete cardiac diastole takes only 0.4 seconds. Your sinoatrial node is sometimes called your heart’s natural pacemaker. It sends the electrical impulses that start the heartbeat. The SA node is in the upper part of your heart’s right atrium. It is at the edge of your atrium near your superior vena cava (vein that brings oxygen-poor blood from your body to your heart). The heart is a hollow muscular organ that lies in the middle of the chest cavity. It is enclosed in the pericardium, which protects the heart and facilitates its pumping action.

The left ventricle is responsible for pumping blood to the whole body. Oxygenated blood is pumped to the whole body through the aorta. Which chamber receives deoxygenated blood from the body? Right Heart Function: Therefore, the goal of the right side of the heart is to deliver deoxygenated blood from the body to the lungs to become oxygenated. I had then, as you remember, just returned to London after a lot of Indian Ocean, Pacific, China Seas -- a regular dose of the East -- six years or so, and I was loafing about, hindering you fellows in your work and invading your homes, just as though I had got a heavenly mission to civilize you. It was very fine for a time, but after a bit I did get tired of resting. Then I began to look for a ship -- I should think the hardest work on earth. But the ships wouldn't even look at me. And I got tired of that game, too

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The right atrium contracts pushing blood through the right atrioventricular valve into the right ventricle. The right ventricle then contracts passing the blood into the pulmonary trunk via the pulmonary valve to reach the lungs Another contradiction central to the story involves the tension between the narrator’s capacities for love and hate. Poe explores here a psychological mystery—that people sometimes harm those whom they love or need in their lives. Poe examines this paradox half a century before Sigmund Freud made it a leading concept in his theories of the mind. Poe’s narrator loves the old man. He is not greedy for the old man’s wealth, nor vengeful because of any slight. The narrator thus eliminates motives that might normally inspire such a violent murder. As he proclaims his own sanity, the narrator fixates on the old man’s vulture-eye. He reduces the old man to the pale blue of his eye in obsessive fashion. He wants to separate the man from his “Evil Eye” so he can spare the man the burden of guilt that he attributes to the eye itself. The narrator fails to see that the eye is the “I” of the old man, an inherent part of his identity that cannot be isolated as the narrator perversely imagines. d Ensure first aid kit for cuts is available in the teaching room. Investigation 1 Looking at the outside of the heart Pulmonary veins (-> left atrium), superior and inferior vena cavae (-> right atrium), aorta (left ventricle ->), pulmonary artery (right ventricle ->)

One thing more remained to do -- say good-bye to my excellent aunt. I found her triumphant. I had a cup of tea -- the last decent cup of tea for many days -- and in a room that most soothingly looked just as you would expect a lady's drawing-room to look, we had a long quiet chat by the fireside. In the course of these confidences it became quite plain to me I had been represented to the wife of the high dignitary, and goodness knows to how many more people besides, as an exceptional and gifted creature -- a piece of good fortune for the Company -- a man you don't get hold of every day. Good heavens! and I was going to take charge of a two-penny-half-penny river-steamboat with a penny whistle attached! It appeared, however, I was also one of the Workers, with a capital -- you know. Something like an emissary of light, something like a lower sort of apostle. There had been a lot of such rot let loose in print and talk just about that time, and the excellent woman, living right in the rush of all that humbug, got carried off her feet. She talked about 'weaning those ignorant millions from their horrid ways,' till, upon my word, she made me quite uncomfortable. I ventured to hint that the Company was run for profitWith your fingers or probes in the aorta and the pulmonary trunk you should notice that they criss-cross each other, with the pulmonary trunk in the front.

The heart muscle can contract by itself, without the stimulation of a nerve. This is called myogenic muscle contraction. The region that initiates each contraction is found in the wall of the right atrium and is called the pacemaker. Every time the pacemaker sends out a signal, a heartbeat results. The pacemaker is under the influence of nerves and adrenaline. One nerve carries messages from the medulla of the brain to the pacemaker and speeds up the beating of the heart. Another nerve carries messages from the medulla of the brain to the pacemaker and slows down the beating of the heart. Finally, adrenaline (epinephrine) is carried by the blood and once it reaches the pacemaker it signals it to increase the beating of the heart. Sternocostal (right ventricle), diaphragmatic (mostly right ventricle, portion of left ventricle), pulmonary (cardiac impression) surfaces Ventricular systole is where the ventricles chambers contract and forces the blood up and out of the heart and into the arteries The arteries carry the blood rich in oxygen from the heart to different parts of the body. The pulmonary artery, being an exception, carries deoxygenated blood to the lungs for purification. Ventricular systole: During ventricular systole, the ventricles contract to push blood into the aorta and pulmonary trunk. The pressure of the ventricles forces the semilunar valves to open and the AV valves to close. This arrangement of valves allows for blood flow from the ventricles into the arteries. The cardiac muscles of the atria repolarize and enter the state of diastole during this phase.It had become so pitch dark that we listeners could hardly see one another. For a long time already he, sitting apart, had been no more to us than a voice. There was not a word from anybody. The others might have been asleep, but I was awake. I listened, I listened on the watch for the sentence, for the word, that would give me the clue to the faint uneasiness inspired by this narrative that seemed to shape itself without human lips in the heavy night-air of the river. Now when I was a little chap I had a passion for maps. I would look for hours at South America, or Africa, or Australia, and lose myself in all the glories of exploration. At that time there were many blank spaces on the earth , and when I saw one that looked particularly inviting on a map (but they all look that) I would put my finger on it and say, 'When I grow up I will go there.' The North Pole was one of these places, I remember. Well, I haven't been there yet, and shall not try now. The glamour's off. Other places were scattered about the hemispheres. I have been in some of them, and . . . well, we won't talk about that. But there was one yet -- the biggest, the most blank, so to speak -- that I had a hankering after. Leipsic J, Abbara S, Achenbach S et al. SCCT Guidelines for the Interpretation and Reporting of Coronary CT Angiography: A Report of the Society of Cardiovascular Computed Tomography Guidelines Committee. J Cardiovasc Comput Tomogr. 2014;8(5):342-58. doi:10.1016/j.jcct.2014.07.003 - Pubmed Cardiac output (CO) is the volume of blood being pumped by the heart in one minute. The equation used to find cardiac output is: CO = Stroke Volume x Heart Rate