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00:01 Alright, I guess we can go and get started here. Um you're

00:05 at the distribution for the second exam students, you look at this

00:09 what was me? I look at and said this is the best exam

00:12 I've seen in like four years. I'm, I'm ecstatic about this.

00:17 average was about a 68, that year's was 62. So just to

00:22 you a sense of, of this was really, really good standard

00:27 15. It means it's getting tighter tighter, which is also a good

00:31 . You can see max great great. But again, that's just

00:34 exam. How much is an exam ? 18%? I mean it's barely

00:41 . I mean it is right. mean that's less than the fifth of

00:44 grade, right? I mean, need to put things into perspective.

00:50 is putting those two to the examine the second exam against each other

00:54 you can really see now how there's this massive shift over to the

00:58 That's a good thing. That means guys are changing habits and you guys

01:03 improving as a group. That is . I looked at, I didn't

01:06 at everyone's great, but you as I put them in, I

01:08 like, oh wow, I can a lot of people have gone up

01:11 then I saw the graph, I like, yeah, it's represented

01:13 so good on you and if you the wrong direction, don't feel

01:17 It's still, we got, we lots of grades in front of us

01:21 so this I guess it helps if actually turn this on. That's that's

01:26 problem sit there. Why is it working? Okay so this right

01:31 So if I had to give you grade today this is what would be

01:33 on. So the A. Starts 90 The B. Start at about

01:38 A. Half C. Start about D. Start about 50. But

01:42 is how much of your grade is ? Remember none of this includes any

01:45 credit. So you know throw your credit on top and you can kind

01:49 see where you where you lie And so what happens on the 24th

01:55 draft is due. And so that be Haftar grade and then 11

01:59 What's that date? Third exam. so so that's exam three so you

02:05 see right now you you've got a of great in front of you have

02:08 than half of your grades still sitting front of you. So if you're

02:11 at your grade right now and you're , don't panicking is what leads to

02:16 . What you need to do is need to analyze and ask the question

02:20 why am I not getting the grade I want? What is going

02:23 How is it different? We'll go there first and up here. Yeah

02:34 are you happy with your grade? then you're at def con what?

02:41 cannot remember the five or the I can't remember. They talked about

02:49 on Big Bang Theory. So someone go back and watch the episode.

02:53 ? So in essence if you find satisfied then you should not be like

02:58 . I mean you should be panicking you should be like okay, I

03:00 I'm doing everything the way I should doing it. Are there areas in

03:04 you need to improve? Maybe? . So try to identify those areas

03:08 work for it if there are, know, if you're if you're finding

03:12 like there's nothing else I can do I'm at the highest grade I can

03:17 get then you know, keep it , do what you keep doing.

03:25 . Yeah. So I don't Plus and minus at this point.

03:28 mean with 45% of your grade, do I want to do extra work

03:31 I have so much more to do many emails from the other class and

03:35 I'm not you know, they're freshmen you gotta forgive them but they're like

03:39 extra credit is not on on blackboard . I'm like because it takes me

03:43 day to do that stuff and I want to do it right now.

03:46 mean do you it's not gonna I'm not gonna do anything until the

03:50 of the semester and why would I to do it now when I can

03:53 around and watch youtube or something? know? Well right now this is

04:01 after 40% 5% of your grade. is what what it would be like

04:04 I had to give you a grade day and send you on your

04:06 This is what you how you kind use it, right? And then

04:11 you also you can add in your credit, right? Like I

04:14 and then you can use that to of say, well, alright,

04:17 just gonna use the number. Let's you you average out to an 85

04:20 you getting a B plus right now 85? Yeah, but if you

04:24 your extra credit in then what's that do? It might get my pop

04:29 over. Okay. That was the . Alright. So do we understand

04:35 ? A lot of people don't understand . How many you got?

04:39 here's a better question. How many took stats? How many guys wasted

04:43 time with Cal 3? I'm looking the biology. Yeah. You'll never

04:48 calculus again, except for mathematical The rest of y'all, you

04:52 stats is where it's at. And you understood your f distributions, if

04:57 understood what a distribution was and how works, you understand this. And

05:02 it's just basically telling you, Relative to everybody else. This is

05:05 I stand and that's how I determine . That's where I got those numbers

05:09 do use using standard air of mean can figure out where those boundaries are

05:14 be. The truth is is that in the class is like a

05:17 But am I gonna be mean and nope unless you got a 98 you're

05:20 a I'm not chemistry right? This biology. The standard is if you

05:25 meet the 90th%ile right now. So the curve goes this way we keep

05:29 the actual values that the university established A. B. C.

05:33 S. If we move this way we use the curve values.

05:42 Right so yeah so so hold So for example the reason I say

05:48 all right so my wife has a account. My other kids have Microsoft

05:53 . They go onto my computer. use their stupid account. So when

05:56 log in sometimes it's going I don't who you are why you trying to

05:59 into the U. H. So that's number one. If you

06:02 you have multiple accounts Microsoft accounts that's one. Okay now go ahead.

06:07 it let us like because I'm not was like Unless if you are not

06:19 into office 365 it won't let you because the way that the way that

06:25 works is you have to have the that I set it up is you

06:29 to have your university access right? why. Yeah. Yeah Don't worry

06:38 that at the end of the semester you look at your extra credit I

06:42 post it on blackboard. Remember I'm not gonna do it today cause I'm

06:45 . Um But I do post that you can double check it,

06:49 And if you're saying wait a I know I did this you can

06:52 you can just email me and I'll it up because I can find

06:55 I'll tell you the reason it's so is that it doesn't alphabetize you by

07:01 last name. It alphabetize you by first name. So I have to

07:07 through and I have to reorganize every solitary person from their first name to

07:14 last name. Yeah it's a So I spent all day doing that

07:19 is why I wait till the last . Yeah. No that becomes available

07:25 thursday after the last exam is So I will basically as that exam

07:31 being taken that's when I usually will it up and I'll make all the

07:34 the exams viewable and at the same that opens I think the extra credit

07:40 at six p.m. So that's just kind a standard thing just at the end

07:43 the. Yeah that's it. Well don't know I'll have to take a

07:53 . There might be stuff that's residual previous semesters. That just this is

07:57 of the reasons why we hate Oh, by the way, if

07:59 haven't heard we are switching away from next semester. Yeah. I think

08:04 going to canvas. It hasn't been . And I know six and one

08:09 doesn't know the other. You're they're bad. We'll just put it that

08:13 . They are all bad. We're ready to move on. Are

08:19 done with this stuff? Let's talk calibrations. Alright. So we all

08:24 a paper. I want to know opinion. What do you think?

08:30 paper ever read? Okay. So didn't like the we didn't like the

08:39 . How was the content? What what What? Go ahead. It

08:45 like Really? Okay, terrible What other what other comments? Anyone

08:50 think it was a good paper. I'm not I'm not I'm not asking

08:54 to mock you anyone think that? yeah, there's a pretty good

08:57 I enjoyed it. Anyone. No . Are you guys just too scared

09:02 admit it? No. So this a garbage paper. How was the

09:07 ? Did they, did they cover topic or did it feel like they

09:10 faking it to make it faking it making it. All right. Any

09:16 anything else? You language? I heard past tense. Language grammar

09:23 grammar. Alright. So generally speaking paper. All right. Here's the

09:30 how many of you guys marked it and gave it a good score the

09:34 time you read it. And then you went back and saw your your

09:37 score, it was like in the . All right. Why? Why

09:43 you market well, Oh, I trying to be nice. I I

09:51 want to get the bad grade I want I feel bad for the

09:54 . Did you feel bad for Yeah. So your pity, your

09:58 for this person was I'm going to the standards and I'm gonna allow this

10:03 to have a better score. Even this is a garbage paper. This

10:08 this was a true student paper. . Yeah. This this would not

10:12 of you. Right. Obviously. but this was what a student actually

10:17 in as a first draft the first they did it. All right.

10:23 someone in this class is going to in a paper like that and I'm

10:27 doing that to say it's to show that we're not all up to speed

10:33 it comes to writing in college. just some of us is english how

10:39 english second language. Look at I mean, raise your hands

10:43 I mean, you should be You can speak more languages than I

10:47 . Right. I cannot speak two . I grew up on the

10:50 I should be able to speak two . I know how to ask where

10:54 bathroom is and I know how to a beer. The two most important

10:57 . That's about it, right? rest of Y'all have to change,

11:04 know, language in your brains as communicating. And part of the problem

11:09 you're writing in English, technically writing you're still trying to do that translation

11:15 doesn't always come across well. But you can't become a better writer

11:20 no one is telling you that you to make correction. Does that make

11:25 ? So, our job here again not about grades. If you,

11:29 you approach these assignments, these writing , how do I get a better

11:33 ? You are gonna fail miserably. right. You've got to approach this

11:39 a true peer, as someone who helping somebody along. So if you

11:44 a bad paper, you need to it and explain to that person why

11:48 not that good of a paper. need to deal with the grammar.

11:52 need to deal with the subject matter how they're not explaining. Well,

11:55 need to deal with, hey, writing in past tense, you're using

12:00 person, you're using all these things you need to account for that.

12:04 mean, you need to score them . See the thing is, is

12:07 this the grade for this. If just turn anything in. If you

12:11 , if you turn something in at point, the lowest grade you're gonna

12:15 is a 50. Alright. So worst is is that you're the the

12:21 passing grade that exists. All So everything else right now is gravy

12:26 this point. So, what we're to do is we're trying to learn

12:28 to be better writers. Because how papers are we doing one? But

12:33 doing how many revisions? 12 to ? Right. We're doing this one

12:37 then we revise it. Right? along the way, In theory,

12:40 guys have been putting together your you've written an outline to your

12:45 right? You've written an introduction. already done some of the many first

12:51 . And in theory those of you have been reviewing those have actually looked

12:55 that and said, hey, you're all the right steps or No.

12:59 really not notice. Did you guys and see what your grades were for

13:02 all those assignments posted them yesterday? are your grades? What are they

13:08 Loud? 100. If you turn the assignment and you did your peer

13:13 100. Other three points. The exercise here is learn how to

13:20 a reviewer to help other people become writers. And in the process do

13:26 become a better writer? Yeah. you're becoming a better writer as

13:30 That's what our job here is is become a better communicator because it doesn't

13:34 what you go and it doesn't matter you're planning on medicine doesn't matter planning

13:37 science. Doesn't matter if you're managing Mcdonald's you will have to write

13:43 it is the name of the you have to account for whatever you're

13:47 to someone. My poor wife, told you she's a physical therapist every

13:52 . She sees two or three patients then she comes home and she writes

13:56 for 3-4 hours. That is her , right? And those notes are

14:01 used by her or other therapists to with whatever the process is.

14:07 Yes sir. No, no. this is again, there's a turn

14:15 in. So historically I know they've their software so I don't know what

14:20 is like, but historically when you see the feedback in the top right

14:24 in that little blue bar that says it in. There's these two little

14:28 arrows that are basically the greater than than signs that are in a color

14:33 , that is slightly darker than the color blue that you're looking at.

14:37 takes a miracle to actually find those , but they should be there and

14:41 should allow you to be able to forward and backwards through those particular

14:45 Is that alright? That's that's how done it historically. And it was

14:50 another a student who actually said, yeah, here it is because I

14:53 get to to, I can actually and see each and everyone's reviews.

14:58 ? So that's the way it should there. So if you log in

15:00 see that, let me know and anyone else has better advice than what

15:04 just gave. I appreciate that because don't get the student view for this

15:08 . Alright, so we have another to read. It's not gonna be

15:12 very long paper. None of these very long. Did it take a

15:15 of time to read that paper? you happy when you read that

15:18 No sea when it makes you feel , it's not a good paper.

15:23 that's that's just a general rule. this is why you don't want one

15:27 grading everybody because it's like the third is always gonna be the bad paper

15:31 from there after everyone's getting bad I'm just even with the rubric it's

15:35 like screw you all and they go that this is the Angry Ta

15:41 So on thursday we have another you have to read the paper,

15:45 the calibration, you have two times go through it and determine what sort

15:50 writing is it? Bad writing is good writing. Give it a fair

15:54 because you're gonna be doing this for actual first draft and you'll do it

16:00 for your actual second draft. So how to be a better reviewer.

16:05 pity the writers write. Help help them become better writers. All

16:12 . Yes thursday before class. So basically, if you read it tonight

16:17 did it twice tonight, you'd be . But it's I think like literally

16:23 after class. You can see the paper. Yeah I think it's that

16:28 after class. I wanted to get this one first. Yeah. Well

16:35 might look all the same to Yeah. Yeah. Oh that's another

16:41 number. The last question each of . You'll see that comment one you

16:47 to follow the directions, make sure get the number of words in there

16:51 doesn't count the assignment for you. I had to change some grades to

16:54 you guys points back that were taken from you. Yeah this is the

17:01 class assignment. Actually the grade that got on the calibration is the thing

17:06 is us discussing it. Alright so we can all be on the same

17:10 . Yeah. Well no I mean . All right. You want me

17:16 break it down for you real Give me give me I know this

17:20 seconds. I have the review. did my my own. Alright.

17:28 the abstract. I said he actually a pretty good job. Or she

17:31 for the purpose listing of the purpose him a 11 oh one oh one

17:38 one oh 11111 11111111 oh here's the um paper conforms to the instructions on

17:50 . So they form out of the correctly. Gave them a two.

17:53 They didn't do charts or figures. whenever they didn't do one and I

17:57 think it's necessary just give them the of three for that. Um um

18:02 thing if a figure was used, I just gave him three because they

18:05 use one, then 112 composition flows a predictable logical sequence. So it

18:11 better than crap, It was just crap. And then a one.

18:16 and if you look at my notes , basically I have a one and

18:19 what would be an alternately acceptable And so every place where I said

18:23 a one, the acceptable answer was , it was a two and where

18:26 was a to the acceptable answer was one. So if the total number

18:33 points this person would have earned was 54.5 or sorry, 32 out of

18:37 and 10 total points. Which comes to 54.5. So not a great

18:42 . Really, really a bad, bad paper, you know? So

18:47 the next paper, look at judge it fairly, look at and

18:52 is it good is as bad as mediocre. It sits in the

18:55 whatever for each of those things. then what we'll do is we'll kind

18:58 go over it again, just kind like what we did here, we're

19:01 gonna go over through everything. I want to kind of get a general

19:03 of what the paper was like. , sir. Three, maybe you

19:10 get a middle paper? You just know if we're calibrating. What do

19:15 think? Probably a middle and a Alright, ironic. As in then

19:27 a bad paper, Right? I , bad is bad. You

19:31 we don't know what the intent of author is other than what they've kind

19:35 presented to us and so we have take it at face value.

19:44 Mm. Okay. So all So you're asking how does how are

19:50 graded? So this all falls into paper category and really what it

19:53 It's kind of a it's it's a to make sure that everybody's on the

19:57 page. And so you can kind think of it more as a penalty

20:00 than adding points to All right. is not a great way to think

20:03 it, but it's an easier way think about it. All right.

20:07 , generally speaking, what I'm asking can we all be within 80 I

20:11 20 points of each other. In other words, can we be

20:14 correct or accurate with one another. what I'm looking for. I don't

20:18 the person to come in If you're everyone fives all the way down,

20:22 not doing your job and I'm gonna gonna penalize you for that on the

20:25 paper, Right? So, the here is can we all just kind

20:29 work together? So we have three , each of those calibrations, I'm

20:33 take your top two. So if missed a calibration, guess what?

20:36 was your zero. You get to the other. Alright. And what

20:40 looking for is we're now looking for well recalibrating. So if you get

20:44 80th%ile, then I start removing points your paper. How many points?

20:49 if you get like a seven year , I'll give you like .25 points

20:53 your paper Cruel. Just I'm you know, and then like the

20:59 is like .5 points and then one and that's when it increases. So

21:04 you're like scoring like in the 20% your never calibrating, then you're actually

21:08 get some real points taken off. as long as you're getting near and

21:13 the only people I see getting points off the people who don't do

21:17 So because you're gonna figure it this isn't hard, right?

21:21 And then yeah, I answered Yeah, I take the top

21:29 the top two. So and how chances do you have on each one

21:33 ? So really it's like for each you can you can go, oh

21:37 , I was way off. So me let me try to fix

21:40 And then what I do is I the top two of those and I've

21:44 I've had students, you know who I'm just a tough grader and you

21:48 , they're just not calibrating well. so there's gonna be a small penalty

21:53 their own paper to kind of remind , hey, you need to get

21:57 board. Don't be a tough I've had weak graders. It's like

22:00 need to get on board so that all kind of looking at this through

22:05 same lens. Okay, okay with . All right. Just some

22:11 So, um because your papers do what, like the 24th today is

22:16 11th, so like almost two right? Um So you've already done

22:21 lot of work. And so at point, really what you're gonna do

22:24 you're kind of going through the revision stages and I know your students,

22:28 not gonna, you're gonna wait till the weekend before to do anything,

22:32 but let's pretend together that you're working a regular basis on this. So

22:37 off, just make sure you understand sourcing works and what its purposes,

22:40 giving credits to others. These are ideas that other people have the results

22:45 they that they found in their And really even in your Acknowledgments you

22:49 , you don't have to put an , but if you have someone like

22:52 your paper, you know, it'd like, I want to acknowledge that

22:55 roommate looked over my paper and help , you know, kind of looked

23:00 my formatting and stuff like that. that is okay to do. That's

23:04 collaboration. That's not against the rules you are giving them credit for

23:08 That that second I All right. Things that you don't need to anything

23:14 a general knowledge and general rule for knowledge stuff that can be finding a

23:17 science textbook. Alright, so if not specialized knowledge it's general knowledge.

23:23 you don't need to look at it any sort of analysis you do.

23:27 if you know group A figured this group big figured that out. And

23:31 took those two things and you talk what that means. Your analysis of

23:35 it means doesn't need to be sourced the what A. And B.

23:39 those results need to be sourced? I need to remind you you need

23:44 be using primary sources. Don't trust sources. You know because they make

23:50 . All the times you can use sources but really keep moving back as

23:55 you can back to the primary Um So this is a literature

23:59 So you need to be reviewing the itself. That's that's the idea.

24:03 And so here this is primarily where see the secondary sources primarily in your

24:08 to give background. Alright so that's the sources. Are you guys using

24:13 are you finding his Otero easy to . Yeah. Is it like are

24:16 like this is the best ever. you wish you No, no,

24:20 , no. The freshman. Okay. All right. Some of

24:23 want to use figures, some of won't. That's okay. Right?

24:27 are the author. You get to whether or not a figure needs to

24:30 into your paper. If you choose use a figure, you can use

24:33 else's figure. That's that is okay this. Cause you don't need to

24:37 up with something yourself. All But if you do just make sure

24:41 reference where you got the figure from the figure legend. All right.

24:45 then use your own words to describe in the figure. That's that's the

24:48 thing here. All right. So figures shouldn't be like so complex that

24:53 one will understand it unless they have PhD make sure it's easy to understand

24:57 interpret. And so what you're doing you're pointing out the things you want

25:00 point out in that All right. if you do use that, don't

25:03 like more than two at the You know, if you can if

25:07 can I mean if you have to the third one, that's fine.

25:10 don't think like I've got to get figures in here because that's going to

25:13 not the goal. Alright. So yourself to that. And lastly revising

25:18 is the hardest thing for young writers novice writers is revising every time you

25:23 pen to paper? You have given , right? And the last thing

25:28 want to do is you want to your own baby. Alright. I

25:32 , this is this. It really explain. But the truth is you

25:36 to actually go through and you need read with that critical eye and look

25:41 something. If you've written something that help toss it. I mean,

25:44 you have to save it, put on a different document and then,

25:47 know, print it up and put on your wall. That's a good

25:50 . You can look at it, beautiful. I've looked at what I've

25:52 birth to, but if it's not here, get rid of that.

25:56 right. So, um if you know how to write, use

26:00 we have some examples of small literature on blackboard, you can use that

26:05 of as a way to see how I supposed to be structuring this?

26:08 a good way to do that. other people look at your stuff.

26:13 give you written comments. The person is not helpful is the person looks

26:17 something you've written goes, oh that's really nice. Alright, that's

26:21 not helpful. You need to hear criticism, even if it's, you

26:25 , slightly negative, you know, like you wanna hear the positive as

26:28 as the negative. So you want get that person who can be that

26:32 you. All right. Um If to writing right, avoid jargon,

26:38 figurative language. Alright. We're trying express an idea crisp and clean,

26:44 through it so that you can move . We never right in the first

26:48 in the sciences, technical writing, do not exist. The data

26:52 Alright. It will be shown that data demonstrates that. So you're always

26:58 from that narrative, that third right? Last thing I would point

27:03 is don't try to write smart, know? Right. Well,

27:07 So remember don't try to use language you're not used to using. I

27:12 you're gonna have to kind of dive the science a little bit but don't

27:16 $10 words when a $1 word is fine. Okay, don't try to

27:20 above your level because when you try write smart, you sound ignorant.

27:24 give you the example. Have you watched the news where they have like

27:28 and they get the newscaster out there they're interviewing the the eyewitnesses and that

27:32 person always shows up and then they're , you know, they realize they're

27:36 camera and they know that they don't smart, so they start using words

27:39 they don't really understand what they Yeah. And then everyone's just sitting

27:43 going, please just just get them the camera. Alright. Don't be

27:47 person. All right. It's okay use normal language to explain things.

27:52 don't have to try to craft something sounds smarter. Just explain. That's

27:59 goal of writing is to be communicative your own language. Alright. So

28:04 to do that. Go. We'll here then the mark. Yeah.

28:11 go here. First. Collective. passive is what you really want to

28:17 right. And that's that that goes everything you've been trained to do,

28:21 ? All your honor students, What they tell you? Gotta write active

28:26 science? No, no, We're passive because we're not involved.

28:31 not there. It's this stuff doing . Yeah. Past passive voice.

28:40 . Yeah. When you read the notice that they don't they don't say

28:43 or we I mean every now and you'll say we you'll see a We

28:47 we discovered that it's usually in an or in the last sentence or the

28:52 paragraph of a conclusion. But generally , that is that's in poor

29:00 That's exactly right. The data demonstrates it was shown that all those icky

29:05 that make you know, you feel saying. Yeah. All right.

29:14 all this stuff off. Let's get some some fun stuff as I've

29:19 the way you write here is you use the exact number of words you

29:22 in order to express your ideas. ? The sweet spot is around.

29:27 did I say? About 5000 5000 . 9000 top top limit. That's

29:35 good is about 8000 bottom limit is about 2500. Alright. You probably

29:42 probably not using enough words at You're probably using way too many at

29:46 8000. But I'm not gonna tell not to. I've had people turn

29:51 smaller papers. I've had people turn really long papers. But remember which

29:56 of you guys wants to read the plus page paper? So, anyone

30:01 to read that 1500 page paper? . You think you're going to learn

30:06 from it? Yeah, maybe bullet . All right. Alright. With

30:13 in mind. Let's see how much I wasted. Look, I wasted

30:15 total of 30 minutes here. All . What we're doing is we're moving

30:20 um into the respiratory and cardiovascular These two areas I think are are

30:26 approachable, because we can kind of it a little bit easier.

30:32 And so, we're gonna start first circulatory system, and then we're gonna

30:35 on that with the respiratory system. , first off with the circulatory

30:39 Three main areas. We're gonna deal the heart. The blood vessels,

30:43 the blood. And that's it how break down. All right, this

30:46 . So, the heart that's a . What's its job to do is

30:50 supposed to create pressure to drive blood the blood vessels. So, what

30:54 blood? Jump down? This is medium through which we transport materials through

30:59 body. So, we're talking about sorts of signaling molecules, all sorts

31:03 nutrients. We're talking about water. talking about gasses, both waste and

31:08 that we're actually using. Um And is how we move materials from one

31:13 to another that are at some distance . And then the path through which

31:17 gonna pass are gonna be through these vessels. But we refer refer to

31:21 collectively as the bachelor chair. All , so you're gonna see the word

31:25 when you see per fuse. That simply the delivery of blood per

31:29 per gram of tissue. So it a it is a unit measurement.

31:33 so perfusion deals with blood and the of that blood. So this belongs

31:42 a different lecture. But I can't about the heart if I'm not talking

31:44 this. This vasculature. So this a generic vascular lecture or a

31:49 We have three basic types of blood . We have arteries. Capillaries and

31:53 , arteries always always always carry blood from the heart. That's that's definition

31:58 ain't always always always carries blood towards heart. And then in between

32:03 the place where you have material exchange the interstitial fluid and the plasma of

32:08 blood is going to be through the . Alright. And so what we're

32:12 here you can say capillaries are vessels exchange. I'm exchanging materials from the

32:18 and the external environment. So the would be that external environment and then

32:23 other places between the blood and the . So the vascular church serves as

32:28 of that middleman between the external environment the cells themselves. And that's what

32:32 gonna address this when we get to respiratory system. So, the heart

32:39 a four chambered organ. It has basic features that we need to carry

32:45 or worry about. First, it's two pump strung us to pump

32:49 structure, structure. All right, has some great vessels that at some

32:55 in your life, you're gonna have memorize all the names of everything.

32:58 today, that's not gonna be the . But we're gonna have to deal

33:01 some great vessels that are responsible for blood to that pump. And then

33:06 responsible for pumping the blood away from heart through these large vessels. And

33:10 there are two pairs of valves that gonna be looking at. And so

33:13 we're gonna do is we're gonna start the pump structure. Alright. And

33:17 to pump structure is responsible for two circulations in our bodies. Now,

33:23 all animals have this to pump If you take the comparative anatomy class

33:27 the spring, you'll get to learn other heart structures for other different types

33:32 vertebrates. But for us and for purposes to circulatory systems. If we

33:37 to circulatory systems, we have 22 pumps. So one pump is responsible

33:45 your entire body except for the respiratory . So we call that the systemic

33:50 and then the pump that's responsible for . So the pulmonary system is that

33:56 pump? All right. Now, two pumps are gonna be working in

34:00 . Um when I had more time I didn't, I guess talk

34:05 I guess I would actually pull students and I demonstrate this. But I

34:08 you to envision this. You guys play ring around the rosy when your

34:12 much younger. So when you play around the rosie, everyone's holding hands

34:16 as one group, as you, one person moves, all people have

34:20 move because you're in a large chain . Would you agree with me on

34:23 ? Right. So, if one stops moving, the whole chain

34:27 doesn't it? Right. And so is why these two chains work

34:31 These two pumps work together. Because the pulmonary and the systemic circulation is

34:37 big giant chain with the pump in center to ensure that that movement

34:42 Now, we have two chambers on . If you look at the

34:45 you can see, oh, I draw this out real quick just so

34:50 don't know. You'll just have to with me please. So, let

34:53 see here. First thing I gotta . No, that's not the right

34:58 . Uh screen. White screen. . All right. So, I'm

35:05 draw this. You need to learn to draw a heart. Okay.

35:13 has four chambers. You see how works. Alright, so over here

35:21 is your right hand side. That's left hand side. Why is

35:25 Because I'm a cadaver on the This is my right hand. So

35:29 looking at the cadaver? Alright, the top chambers are atria. The

35:35 two chambers are ventricles. You see that works? Right? So we

35:40 the right atrium and the right left atrium, left ventricle.

35:44 systemic circulation serves the right atrium blood back into the systemic circulation exits via

35:54 left ventricle. So you can imagine kind of the pathway it's gonna follow

35:58 . Alright, so that's the Alright. Blood from the right atrium

36:04 pushed to the right ventricle from the ventricle. You're serving pulmonary circulation.

36:10 I should put down here, I systemic up here. This is

36:14 Alright. And then blood coming from pulmonary circulation goes to the left

36:21 Now, this is a very terrible drawing. What we all agree.

36:26 doesn't follow the actual anatomy very Right. If you've if you've ever

36:31 heart anatomy, that's actually the case , I'm going to go back to

36:36 um white screen. Alright, so can see this here. No,

36:44 did something with my Okay, It's up here. Alright. So here

36:51 can see we have blood vessels that serving the right atrium blood is pushed

36:57 the right ventricle. This is deoxygenated . It's coming from the system so

37:03 has used up its oxygen and now needs to be re oxygenated. The

37:08 are the pushing uh chambers. They all the musculature, they're the ones

37:14 stuff out. So from the right were driving fluid or blood out into

37:20 lungs. So we're profuse ng the so that it can become oxygenated,

37:25 then the blood returning from the lungs into the left atrium which is hiding

37:30 that blood vessel. And then the pushes the blood in the ventricle and

37:34 that left ventricle is responsible for pushing blood back out into systemic circulation.

37:41 , so the superior chambers there, receiving chambers, the atria receiving

37:45 The ventricles are the pushing chambers now regulate which direction blood flows inside the

37:55 . We have a series of The purpose of the valves are to

38:00 or block back flow into the direction from which you want to go.

38:05 if I'm moving from the atrium to ventricle with my ventricle squeezes, I

38:09 want blood going back into the I wanted to go out of the

38:13 right? So I need to put valve between the atrium and the ventricle

38:17 prevent that backflow. They serve as block or a damn there one way

38:22 from one chamber to the next. , I want to have a damn

38:28 the ventricle and the circulation because I'm create all this flow out into that

38:33 with that volume of blood leaving it's be pressure. And that pressure is

38:37 want to drive fluid back into the . So I want to have that

38:42 there to prevent that from happening. what we have here is we have

38:46 HBO ventricular valves A. V. between the atrium and the ventricle.

38:52 I'm gonna have to semi lunar Name for their shape. All

38:56 And so their names were gonna stick right and left A. V.

38:59 it's not an anatomy class, it's to learn it that way and then

39:02 back later and learn their actual Trikus. But what do you think

39:06 called? Strike 33 cups bicuspid And then it also has another

39:12 So the left has another name which is the shape of a bishop's

39:17 miter is what that's called. That's it's called a mitral valve. But

39:21 gonna keep it simple on test. just use left and right.

39:24 V. The other two are named the semi lunar valve. Sit between

39:29 ventricle and that blood or the blood . So it's named after the blood

39:36 are going into So the pulmonary valve in the pulmonary, remember blood leaving

39:41 artery is sort of leading the heart in an artery. So it's named

39:45 the pulmonary artery, collectively referred to the pulmonary trunk and the aortic valve

39:51 between the ventricle and the aorta. blood leaving into the systemic circulation is

39:56 the aortic valve as a backstop. valve is a backstop between the pulmonary

40:02 and the right ventricle. Alright, left, right. So you just

40:08 to remember which the direction of blood is. Now we don't have valves

40:13 the veins that are serving the two because the pressure in that atrium is

40:20 going to be very high. Blood moving along its pressure gradient. So

40:25 flows from the veins into the When the atria contract they actually squeeze

40:31 sides of their those chambers which actually the flow of blood backwards into the

40:36 . So you don't need them. right? So if you want to

40:42 what this kinda looks like, this what the flow of blood is.

40:45 right? And so the way to this and you can do this on

40:48 exam, you can be your own sheet, right? We always start

40:51 our right hand side. If you remember your right hand side, this

40:53 the side you make pledges with right you I solemnly swear right or I

40:59 allegiance to the flag or you know brother, whatever. Right? It's

41:05 with our right hands. Alright, this is the side that you start

41:09 . Yeah question. Are you raising right hand? Okay raising the right

41:13 . Excellent. Alright so if you forget, just gotta raise my right

41:17 . Alright? So we go from vena cava, which you don't need

41:20 know its name, but that's the that feeds the right atrium. You

41:24 into the right atrium. Blood moves the right atrium into the right

41:29 When the right ventricle contracts, it's push blood into the pulmonary system.

41:33 the pulmonary arteries and pulmonary capillaries where get the gas exchange taking place so

41:38 oxygen poor blood becomes oxygen rich So the blood arriving back to the

41:43 is via the pulmonary veins from the veins you go into the left

41:48 blood gets pushed from the left atrium the right or sorry left to the

41:52 ventricle. Excuse me? So right, pulmonary left, left,

41:59 then out into systemic circulation. You out via the aorta from the

42:04 You go through a whole bunch of arteries down to the capillaries where gas

42:09 takes place. You now have oxygen blood blood becomes oxygen poor blood and

42:14 you return back to the right side a series of veins that ultimately become

42:20 vena cava. And the vena cava into the right atrium. So you

42:25 the circle and eventually you're going to all the names of these things.

42:29 today we don't need to learn the of the arteries and the veins.

42:33 . When you take your anatomy That's where you get to learn all

42:36 things? And here's a secret They're after the structures there in So,

42:41 not really that hard. Alright. is a couple of portal veins that

42:48 of screw things up, Right? , I mean, I'm trying to

42:51 you here, there's a portal vein the digestive tract and liver, so

42:55 blood goes directly from the digestive track the liver, so, it can

42:59 processed. That's just an example of portal vein. But there's some others

43:03 there, but we're not gonna worry them so much right now.

43:07 if you understand that basic following, if you look at it's a vis

43:10 vis a vis, right? Art atrium, ventricle artery vein. If

43:16 ignore the capillaries, then back to atrium to the ventricles, arteries,

43:20 , atrium, ventricle artery, atrium ventricle arteries, veins a vis

43:25 vis a vis make life easy for . Alright? So, what we're

43:31 do is we're gonna move away from generic basic anatomy and we're gonna come

43:36 and we're gonna start dealing with the of the function of the heart.

43:40 . So, what is it trying do? Well, we're trying to

43:43 pressure to drive blood forward. what is blood flow? Will blood

43:48 is dependent upon two things? Pressure in the body, as well as

43:54 . All right. So, what the pressure gradients. Just the difference

43:57 two points in a vessel and that in that vessel. So, here

44:02 an example of the vessel. We the pressure on that side, measure

44:05 pressure on that side. The difference those two pressures is your pressure gradient

44:09 P. All right. So just everywhere else, wherever you have a

44:13 , you always move from an area high to an area of low.

44:16 we're going from an area of high to an area of low pressure.

44:20 , the way you can think about in the body is I'm gonna create

44:22 highest pressure in my heart, I'm just used to systemic side for

44:26 purposes. So, I create the pressure in my ventricle to create the

44:31 pressure in the aorta. And then means over on the vena cava must

44:35 my lowest pressure. Right? in order for blood to come all

44:40 way back around, that has to the lowest pressure in the body.

44:44 kind of cool. Alright, you can think of your whole vasculature

44:48 being a pressure gradient from the aorta to the Vienna Kaveh. Or

44:52 if you want to do it, can say from the left ventricle all

44:56 way back to the right atrium. the other way to look at

44:59 All right. So, it's that that is responsible for creating that

45:03 And the other thing is there's a occurrence of a pressure dropping along this

45:10 of the resistance in that blood vessel . In other words, because the

45:16 is moving along the side of the , what you're doing is you're actually

45:20 dragged from the side of the vessels that's friction. And so your blood

45:25 is dropping along the direct along length of that drag. This is I

45:32 you guys just aren't having as much as I did when I was in

45:35 . So like when my freshman we got a whole bunch of dish

45:38 and we added it to water and spread it along the floor of our

45:41 room or dorm, our dorm And then there might have been a

45:45 bit of beer involved. But um we do is we try to see

45:48 far we could slide. Right? so why did we use the soapy

45:54 to reduce friction? Right. Because all ran out here right now up

45:57 stairs or up this hallway and jumped there onto that that hall. How

46:02 would we slide? Not very, there's a lot of friction there that

46:07 actually wax the floors, which actually that friction. But if we soak

46:11 bad boy up, I'm willing to we could probably hit that wall on

46:15 other side. You know, just . Right? And so that's kind

46:20 the same thing that we're dealing with , we've got to remember there is

46:24 in these blood vessels that's slowing everything . That's part of the resistance.

46:30 , there are three different kinds of differences in a blood vessel. We

46:34 to think about the driving pressure the . All right. And And rightly

46:39 , because when we think about the of these materials, that is the

46:43 . The driving pressure is what is along the longitudinal axis, right?

46:48 this is the longitudinal axis, this , right along the blood vessel.

46:54 , So, when we think about , that could be the difference between

46:56 arterial and venus in. So, you look at a blood vessel,

46:59 say, which is coming from the , it's this side, the one

47:02 nearest the heart, and the venus is the one that's furthest away from

47:06 heart, or the one that's going towards the heart. So, we

47:09 can measure the difference between those pressures . And that would be the driving

47:15 . But there's also a trans mural . Trans mural pressure. When you

47:19 that, it should be what you're at is the pressure inside the vessel

47:23 the pressure outside the vessel. so, the difference between those two

47:28 is that trans mural mural pressure and job is to govern vessel diameter.

47:34 , if I have a lot of on the outside here relative to the

47:38 there. What's gonna happen to that vessel? It's gonna constrict And when

47:42 constrict, I've reduced the space in . So, I've actually increased the

47:47 on the inside as well. That's going to have an impact on

47:51 flow of blood. All right. diameter Has a direct relationship to resistance

48:00 we'll deal with in just a And then lastly, we have hydrostatic

48:03 . The hydrostatic pressure is simply the that gravity has on the fluid inside

48:09 blood vessel. Now, in this example, they're trying to show you

48:12 is the direction gravity is straight But we have a blood vessel that's

48:16 45°. So, we have to figure Kassian and all that stuff to actually

48:20 it out. And we don't do kind of math stuff here.

48:25 For those of you who love Right. But really what? It's

48:29 the effect of gravity of blood. , gravity has what effect on blood

48:32 pulls it which direction downward. And so you have to the pressure

48:37 you're dealing with is trying to be , you're trying to overcome that hydrostatic

48:41 . So, if we're gonna be if if we could if we could

48:44 a hole in your toe, blood basically try to drive itself outward because

48:49 probably less pressure outside as a result all that. Yeah, you'd still

48:58 a hydrostatic, which direction would hydrostatic be still towards the ground and it

49:04 be nice, it would be towards . Yeah. So hydrostatic. So

49:10 you see the word hydrostatic, just the pressure of the fluid inside a

49:15 as being acted upon by gravity. every every container I'm stealing her

49:22 So this has a hydrostatic pressure. direction is that hydrostatic pressure downward?

49:27 water is trying desperately to escape from vessel. But the sides of the

49:31 are are stronger than the actual pressure . So the water stays in the

49:35 the container. Right? But there's I poked a hole in here,

49:38 water come out? Yeah. That's function of the hydrostatic pressure. Trans

49:43 would be across the wall. So here we have atmospheric pressure inside there

49:49 have the pressure of the fluid inside container as a result. That's really

49:52 hydrostatic pressure. The pressure between the between those two would be trans

49:57 Now when we're talking about the we're really talking about interstitial fluid versus

50:02 pressure of the plasma on the So we're dealing two fluids.

50:07 So if I increase the amount of on the outside then I'm increasing the

50:13 of pressure on the outside. Which have an effect on the pressure on

50:17 inside because it would cause the blood to squeeze. So what we do

50:22 we're reducing um diameter and thus we're resistance. Yeah. Oh we're gonna

50:33 into the slow so much more? . Yes sir. Yes. Which

50:45 know which direction the blood is it expand or is it gonna contract?

50:49 . And that's presuming of course that vessel itself is is malleable and that

50:54 not acting against the pressure inward or which the blood vessels actually do.

51:00 we'll get to that the pressure that heart produces to drive the blood

51:07 All right so I know you guys math, physiologists love math. So

51:13 we are cardiac output. What is output? It's simply the flow of

51:17 delivered by the heart. So it's be dependent on heart rate and stroke

51:21 . So cardiac output equals heart time stroke volume. If I double

51:24 heart rate, what happens to cardiac ? If I double stroke volume?

51:28 does cardiac output do? Good. guys understand math? Excellent. That's

51:32 we need to go here and then just shows you how it's measured.

51:36 measuring leaders per minute. Right? heart rate is beats per minute,

51:40 volume is leaders per beat. And we can just do a nice little

51:44 . And that's how we get our . So cardiac output is always leaders

51:48 minute more math. Oh my There's just so much math. You

51:56 have to do math on the What do you think? Oh no

52:01 don't do math. We don't do . What we're doing here is we're

52:04 at relationships. Right. So we know there's a relationship if I increase

52:08 rate, what happens to cardiac If I increase stroke volume? What

52:13 increases, right? If I want maintain cardiac output, increase stroke

52:17 what happens to heart rate goes Right? Cardiac output stays the

52:22 But SB goes up HR has to down, right? To maintain a

52:27 . That makes sense. Yeah. it sounded tricky because you weren't looking

52:31 the numbers as they're moving in front you, right? But that's what

52:35 trying to accomplish here is to kind visualize the relationships between these things.

52:41 , stroke volume is the amount of being pumped per beat. Right?

52:48 then heart rate is beats per Yeah. Okay. So, what

52:53 have here is we have what resistance what this whole slide deals with.

52:57 ? So resistance is the hindrance or of blood flow due to friction.

53:02 , again, picture me sliding across floor on my belly with no

53:06 Right? Its opposition. There's an relationship between resistance and flow.

53:13 Trying to slide on the floor with soap. I have increased resistance.

53:17 I have less flow. And that's to turn a blood vessel as well

53:21 I increased resistance in a blood I'm decreasing the flow through that blood

53:26 . Check. That's what that one . Alright, now, resistance is

53:32 by three different factors the radius of vessel. All right. This is

53:37 inverse relationship being shown here, the length, which is a direct relationship

53:43 there. And viscosity. Which is determined by the number of circulating red

53:47 cells. Now, if you look at the vessel radius, notice here

53:51 it's this incredibly unique relationship. So time I double the radius of a

53:58 , what happens to my resistance? I double it in size, what

54:05 it it reduces by a factor of ? Right? So, as the

54:10 . So the opposite is true. time I shrink it by you

54:14 if I shrink by half, So I'm reducing it by half.

54:18 going to happen to the resistance? goes up 16 fold. All

54:23 Now, if you want to envision , I want you to think for

54:25 moment about a milkshake straw. What milk shake straw look like? Big

54:30 thick big hole. So you can all that milkshake into your body nice

54:33 fast. Right? All right, , I want you to think of

54:36 stirring straw that you get with your right? A little bit. It's

54:40 teeny tiny thing, like So, want you to try to imagine sucking

54:45 milkshake through one of those coffee You're gonna create so much pressure that

54:50 probably gonna be like a cartoon and suck your face into the straw,

54:54 ? Yeah. You've all watched bugs . You know what I'm talking about

54:58 , reverse that drink hot coffee with milkshake straw. You're gonna get your

55:04 fast. Yeah. You're gonna burn organ in your body as you pull

55:09 that coffee in. So you can of see the dramatic relationships right between

55:16 diameter or the radius and resistance. . Now the thing is in your

55:24 , we don't really change length all much. Right? Once your your

55:28 , you are your size and the of blood vessels you have, and

55:31 length of those blood vessels don't really by all that much. Okay,

55:36 on a daily basis, you don't miles and miles of new blood

55:40 Okay, With regard to viscosity, is determined by the number of circulating

55:45 blood cells. The more red blood you have, the thicker your blood

55:48 , the less flow you're going to that kind of makes sense,

55:51 That's viscosity. So, you're not the number of red blood cells on

55:54 day to day basis. That's not that you really muck with all that

55:58 . So, the way that we blood pressure for the most part is

56:02 through radius. Right? So, a day to day, minute by

56:06 , second by second, your blood can change their radius, thus changing

56:11 . And it has such a huge . So, that's why we use

56:16 as a way of management. I have no, I've asked this

56:20 , how many of you guys are pharmacy 12. Alright. I'm gonna

56:27 you to a question if you don't the answer, That's okay. You're

56:30 pharmacists? All right. So, is the first drug we treat blood

56:37 ? What's what do you what is usually use? There's What's that?

56:42 ? No, no, that's too . I mean, like I'm talking

56:45 chronic, oh, you're giving name . I want classes ace inhibitors.

56:55 have another one, beta blockers, ? And there's another one. That's

57:01 arbs. Yeah. And again, pharmacists, you're naming drugs and you

57:08 went above my head. So just to be clear, you're you're you're

57:12 ahead of me. All right. of these things are responsible for regulating

57:18 blood pressure through changing of the Alright. That's that's how they work

57:24 that's an easy thing to manipulate the thing. But the more useful thing

57:29 manipulate would be length. Alright? , for every pound of weight you

57:34 , you actually grow miles and miles capillaries and we're gonna see here a

57:38 bit later that that's where most of resistance in your body comes from greater

57:42 . More miles. You have the resistance, greater resistance to higher blood

57:46 . So, what do we want really do get people lose weight is

57:50 the better approach. Yeah. When lose weight, you those blood vessels

57:55 disappear. And the reason we have those blood vessels As maybe I'll just

58:00 here is every cell in your body a couple of microns away from a

58:05 vessel from a capillary. Alright. those cells would die. So,

58:10 have to make new blood vessels to the nutrients to keep those cells

58:15 But you have no need for those . You don't need those blood

58:19 So the optimum way to treat high pressure would be to encourage a change

58:25 lifestyle and a loss of weight. . These No. So, what

58:40 what they're doing is they are actually a couple of different things. Um

58:44 actually managing how well the heart, efficiency of the heart, you're also

58:50 when the blood vessels are constricting and under uh you know, oxygen and

58:55 conditions, all that stuff. So there's ways that our body manages on

59:00 minute by minute, second by second to ensure that all our blood vessels

59:04 getting the auction and stuff they that they need, and the fuel

59:08 they need. But what they're not doing is you're not changing this.

59:12 not changing that. You're always focused and you're just doing it in a

59:16 efficient manner, right? Because you about what is an athlete do.

59:20 training all the time to teach his how to respond to the conditions,

59:24 do we call it, conditioning. ? So that's that's kind of what

59:29 doing there. All right, we can take all these different factors

59:33 we can put them together into an ? Right? Sorry, math geeks

59:37 really digging this right now and that is called law and law basically.

59:43 show you the relationships of all these things with regard to being able to

59:47 out resistance. Now, you're not to calculate anything. I'm not gonna

59:51 you do any math here. But you can see here if I

59:56 this equation, I can see the . So if I increase my

60:01 my resistance go up. If I length of blood vessels, my resistance

60:05 up. And if I increase my , my resistance goes down. It

60:10 shows you all those relationships. these two terms you should be familiar

60:14 constriction. That's when a blood vessel smaller. Constricts. Visa dilation is

60:19 you dilate that blood vessel, it in radius versus decreases back to blood

60:27 . We said there's a relationship. flow is dependent upon pressure gradients,

60:30 dependent on resistance. So, the of hydrodynamics is written out like

60:37 So here you have flow dependent upon correlates to the pressure gradient divided by

60:43 resistance. And if you want to in then you can just throw all

60:50 numbers in there as well. And can see there's the pressure gradient,

60:53 ? And then all the other stuff just the resistance flipped over. So

60:57 that's the full uh calculation. And it just shows you what happens if

61:02 increase the length, it's going to flow, right? Why is it

61:07 decrease flow? What was the Because remember I have more blood vessel

61:13 rub up against. And so that a direct effect on resistance. Just

61:18 an example. All right now, flow, if you're not familiar flow

61:23 any sort of fluid is what we say as is laminar. And what

61:27 means basically just travels in concentric rings visualize this. You could go down

61:32 the bayou and watch and presuming that size of the bayou were smooth and

61:37 . You would see that at the of the bayou that that's where the

61:42 water is. But as you move and further inward to the middle of

61:45 canal or the middle of the that's where the fastest water is

61:49 You can even test as you can take a stick and throw in the

61:52 of the bayou and one at the the shore. And you'd see that

61:55 stick in the middle travels faster. the reason for this would be why

62:00 you think friction, right? The near the shore is rubbing up against

62:04 shore. So it has more resistance it slows down and then that next

62:09 in has less friction and so on so on until you finally get in

62:12 middle where you have the least amount friction. Now there's always gonna be

62:15 there, but the water in the has the least amount of friction,

62:20 only being rubbing up against the slower that's next to it. And so

62:25 what's going on inside a blood So as you move inward, the

62:32 max velocity is going to be faster the V. Not, which is

62:37 velocity at the wall of a blood . So this is just trying to

62:42 that frictional loss that's occurring. Now you listen to blood flowing in this

62:49 or fluid at at flowing like it doesn't make any sort of

62:54 right? Fluid is not running into other, all the molecules are moving

62:57 the same direction in orderly fashion. if you listen in on a,

63:02 a pipe, for example, or a blood vessel, you shouldn't hear

63:06 . But if something disrupts that laminar , then what you end up with

63:11 noise. So you're gonna get turbulent . Now, I lived in an

63:17 downstairs, I was on the first . So I always heard when anyone

63:21 flush the toilet or anything, And you could hear the water in

63:25 walls, not actually the walls, in the pipes in the walls,

63:28 ? Because I lived in an apartment was like 40 years old and you

63:32 , there was just stuff in that that we just don't want to talk

63:35 . And so when that water came , it was all the way

63:39 But if you live in a new , you might hear them flush

63:42 but you don't hear the rushing water the walls because those pipes are still

63:47 . You got laminar flow alright in theory, this would be true

63:54 every velocity, but there is a velocity for everything where you see this

63:58 loss of kinetic energy. What you think about this is like, think

64:02 being in your car, have you tried to see how fast your car

64:05 ? I'm look at the guys, guys have all done this ladies,

64:08 know you're like law abiding, so you might speed because you're late,

64:13 know, but the guys, we getting our cars and it's like,

64:15 know, that speedometer says 140 I if I can hit 100 and

64:19 So what you do is you press the gas and you'll start going,

64:22 hit like 90. It's like, isn't too bad. And you get

64:25 like 100 and five and all of sudden your car starts cavett ating

64:30 It starts shaking and that's when you , oh, the engine may be

64:34 to go that fast, but the is not designed to do that.

64:37 what you say is that's like, finding my critical velocity when the chaos

64:42 coming. And so everything is basically can get this lost kinetic energy and

64:48 starts becoming disrupted. That's when you that turbulent flow and that's what you're

64:52 over. The surface of your car the turbulent flow of the air around

64:57 . All right. At what It's just once you the velocity of

65:04 of that fluid starts uh passing that velocity. And so instead of flowing

65:10 , what happens is they start veering that straight path and start running into

65:15 other. All right. So, pressure. What is it?

65:21 it's a pulse. It'll pressure. was like, wait a second.

65:26 , it's post style because this is pump activity. The heart, what

65:29 your heart do? It contracts, , contracts, relaxes. And so

65:33 means it creates this massive pressure and pressure is lost and the massive pressure

65:38 lost, That massive pressure. That pressure is referred to as the systolic

65:44 . Alright, so that's the pressure being exerted on the arteries when the

65:49 is ejected from the heart. in the aorta, that's where we

65:52 see that peak of systolic pressure. pressure refers to the pressure when the

65:58 is at rest. So systolic is the heart is completely contracted. Diastolic

66:02 the heart is sitting there not pumping out, it's at rest.

66:06 so this would be the minimum And so you can see over here

66:10 this little graph up here that's systolic there. That's diastolic in the

66:15 So, we're going from very, high pressure and low pressure, very

66:18 pressure and low pressure over and over . All right. But in the

66:23 we're not doing the high in the , because there's always gonna be a

66:26 bit of blood inside the arteries. in the aorta, what I'm doing

66:31 I'm pushing blood into a container that has blood in it. So it

66:35 has a starting pressure and then it out to its highest point. That

66:39 be systolic pressure. And then that serves as the driving force to push

66:44 out of the aorta. And so aorta shrinks back down and gets to

66:48 minimum pressure with blood still in That's the diastolic pressure. Now,

66:53 guys have learned this stuff. When go to the doctor's office,

66:57 you've heard systolic and diastolic. What the normal systolic and diastolic. The

67:01 ideal one for for you 1 All right, So what you're doing

67:07 you're just basically say in millimeters of , that high point of pressure should

67:11 ideally 100 and 2020 millimeters of And then when all that when the

67:16 at rest, that low pressure should at 80 millimeters of mercury. Now

67:20 can actually calculate the mean pressure. the difference between those two. That's

67:24 pulse pressure. So between systolic and 80 between 100 20 and 80.

67:30 the difference, 40? That's your pressure. Then we have what is

67:35 the mean arterial pressure. And this the average pressure driving blood forward.

67:39 can see here it's this little line then kind of slopes downward like so

67:45 is roughly equivalent to the diastolic So 80 plus a third of the

67:50 pressure, one third of the pulse would be one third times 40 which

67:56 13. Thank you man, you're a calculator today. I love

68:00 Alright, so 80 plus 13 is . So the driving pressure, the

68:06 arterial pressure is about 93 mm of . Now, why can we calculate

68:11 out? Is the heart actually is body actually trying to figure out what

68:15 map is? No, it doesn't less. This is a bunch of

68:19 geek ng out, trying to figure numbers, bunch of physiologists sitting there

68:23 , okay, we'll figure this stuff . And so what they did is

68:26 say, look, let's look at cardiac cycle which is the cycle moving

68:30 systolic through diastolic back to the beginning systolic again, your heart spends about

68:34 thirds of its cycle in diastolic. at rest. So think about

68:39 Just think about your heart right thump, thump, thump,

68:44 thump, thump. Right, that blank space there is your heart at

68:50 . The thump, thump. Is systolic part. Alright. Or it's

68:54 really. But we'll use that for now. So then. So if

68:57 spending most of your time in that's why they say it's kind of

69:00 the pressure and then pulse pressure. that high pressure plus the stuff in

69:07 . All right now, the further get away from the heart, you

69:10 see right here, you can see both the pulse pressure decreases as well

69:15 the map decreases so blood flows because decreases right? We have a high

69:24 of pressure and we have a low and flow is a result of going

69:28 an area of high pressure to an of low pressure. And you have

69:31 look over here at our graph, what's over here at zero right

69:36 right left ventricle, right atrium. gotta check all right now. The

69:46 we measure blood pressure as we do indirectly. We use everyone say the

69:51 with the single mama mama. bingo. Blood pressure cuff is what

69:56 say. I think that should be like everyone should have an oral exam

70:01 the M cat and you should be to say this word single man nanometer

70:06 momentum. It's a blood pressure And the way that this works is

70:13 you are taking that cup and you're it around the upper arm. So

70:19 you're trying to occlude the flow of through the brachial artery. All

70:26 And so what you do is you wrap that cup and you start putting

70:30 whole bunch of pressure in what you're is you're squeezing that um that artery

70:37 . And so what you can do you imagine I'm increasing pressure until I'm

70:41 the systolic. Once I close I start releasing the air out of that

70:47 . And now I'm going to just listening. So as I start decreasing

70:52 pressure in the cuff, eventually the inside the cuff is going to fall

70:55 the systolic pressure. Not so much that I don't get anything, but

71:01 will hear that pressure hit that high as it's allowing a little bit of

71:08 to squirt through that blood that that . So I'm gonna Trish Trish

71:15 Because remember turbulent flow makes sound so are called the karate cough sounds and

71:20 listening for when they start and then the pressure inside that cup falls below

71:25 diastolic pressure, you'll no longer make . The flow of blood is no

71:29 included. So you listen for the when they stop hearing the noise.

71:33 those two points is really what you that systolic and diastolic Alright? And

71:39 gonna expressed as systolic over diastolic 120 80 or whatever horrible numbers you end

71:45 with um that's my life, And so that's how we measure it

71:52 you can measure it directly. You here work in an operating room.

71:56 you, have you ever anyone Um You can do what is called

71:59 arterial line. And basically what you is you take a needle with a

72:04 on it and that gauge is threaded the crowded artery, down into the

72:09 and it measures the blood pressure directly . That's an A line or an

72:14 . Or a. Or a. decline. All right. So how

72:20 we get the heart to pump? heart? Doesn't need a signal from

72:26 nervous system to do what it Alright. It does so through its

72:30 conduction system and this is something that developed very early on during development.

72:36 . So you'll see these cells start and then they are they're governing the

72:42 contract. I'll activity of the So there's four areas where you're gonna

72:47 the managers, the areas that are these contractions. We have sino atrial

72:54 that's found in this unique region, in the upper right atrium, near

72:59 vena cava. We have the node basically sits at the crossroads. Remember

73:03 I drew the cross sits right smack the middle of that septum between the

73:08 and two ventricles. So right in middle. All right, so that's

73:11 V. Node. Um You have bundle of hiss that goes right down

73:15 center of the septum between the two and then at the bottom of that

73:19 of the heart. Those those branches the bundle of hiss, then spread

73:24 across the uh the walls of the . And these are gonna be the

73:28 fiber. Typically when you see um uh demonstrated in um um uh in

73:37 sort of anatomy, it's gonna be . These are not nerves. These

73:42 muscle cells. All right. They pacemaker cells. They produce their own

73:48 potentials. And so you'll see them . They're being drawn as black with

73:53 around them because they're self conducting. , so these are not nerves.

73:58 are actual muscle cells. So, started the essay note. The note

74:02 has per kenji fibers. There we . So of all of these,

74:10 each have their own pace. I always, somebody email me. Just

74:15 me an email right now. If have it open and say fix your

74:19 because I can see here that my is not in the right place.

74:22 I keep forgetting to do that every I moved the picture slightly. Um

74:27 here, every one of these different are pacemaker cells that have their own

74:33 pace. They're separate from each But the one that actually sets the

74:37 is gonna be the s. A . And so this is it.

74:39 not the blue circle. Blue circle be sitting right over there. So

74:43 like if you had four engines on train, it's the one in the

74:48 that's determining the rate at which everyone's . So once the s a note

74:53 , it tells all the other ones to fire in what sequence.

74:57 So if you damage the essay, . Then the next one that's fastest

75:00 line is gonna be responsible. That's necessarily the A. V.

75:03 Alright. So they're all connected to other. But it's the one the

75:08 . A note first and then after it's the next fastest. So once

75:12 S a note actually produces its all the ones are gonna respond in

75:17 to that. And I just wanted show you what we're looking at

75:20 A series of cells that are connected electrical synapse. So, when you

75:25 of the synapses here, I want to think about that. Now,

75:30 we have here is we are looking rhythmic beating, right? The

75:34 thump, thump, thump. There's rhythm to it. And this is

75:37 result of two different muscle cells. first of that pacemaker cell or that

75:42 arrhythmic sell or what is also called nodal sell. All right,

75:46 this is what you're gonna find in essay. The A. V.

75:48 bundle of hiss and purr kenji fibers those different areas are gonna be these

75:53 , they make up about 1% of cells of the heart. So they're

75:57 that numerous. Alright. They're specialized unique in that they produce their own

76:03 and they tell the contract I'll cells to do. So the contract I'll

76:09 . When you think of these these more like the skeletal muscles that you

76:13 we've already learned about. They do actual work of creating that contraction which

76:18 in the pump and they are dependent the auto rhythmic cells or the pacemaker

76:24 for their action potential. So the one produces the action potential. The

76:29 ones respond to it. Now you thought you were done with action

76:35 didn't you? You're like oh we're not gonna talk about these types

76:40 cells produce some very interesting looking action . All right. And you can

76:44 here's the action potential. It's kind the same looking kind of But you

76:49 see there's actually a different type of . We don't we were starting off

76:52 different parts. We don't have this curve. You know? It doesn't

76:56 up like this. There's this this thing and this is the result of

77:01 different ions and different four different types currents that are being created here.

77:06 , again, what do you do look at the different points where changes

77:09 place? And you can ask the , what's going on here? So

77:12 three ions, sodium potassium, we know those things but we're adding in

77:16 on top of it this time. . And what we have is we

77:22 these channels that are called funny All right. That's the I.

77:27 . Sorry. So, they created is called a funny current. We

77:30 a channel that is a voltage gated channel. We have a channel that's

77:35 voltage gated calcium channel. And then have a channel a current that is

77:39 upon potassium. So that's the the channel. And in writing all this

77:45 out or saying all this stuff, it's you can think of it as

77:49 a little bit easier than how it's presented. So the way that you

77:53 think about this is that these funny are always kind of open.

77:57 And what they're doing is they're allowing deep polarization to occur. And as

78:02 polarization is occurring, what you're doing you're starting to recruit these voltage gated

78:07 channels. So this sound any different what we've already learned now. The

78:11 here is that we just have the or the funny channels open right there

78:15 . Alright. And so we see slow climb and then when we get

78:19 this point right here, that's when open up all the sodium channels.

78:23 , and I should also mention that this time. You're also recruiting in

78:27 of the calcium channels. Alright. there's two different types of channels.

78:30 the L. Type and T. . The L. Types are the

78:33 ones. The T types are the ones. I think I may have

78:36 those flipped camera. But basically what doing is you're opening up some of

78:42 fast ones and then those results in slow ones opening up. So you

78:46 up getting this massive deep polarization as result of sodium and calcium coming

78:51 So you can kind of say here mostly sodium but here it's mostly calcium

78:56 then those channels slam shut and then you're gonna see re polarization. This

79:01 when you open up the potassium channels then down here that's when the potassium

79:05 closed. Funny channels are still open so you repeat this process.

79:12 So what do you see you see cell that naturally depot de polarizes and

79:17 back to rest naturally d polarizes and back down to rest. How we

79:27 , I'm gonna do this one and you guys can go okay because I

79:30 you to compare and contrast these are contract I'll cells in the action potential

79:34 contract I'll cells these are even Alright, look what we have here

79:38 have rising phase a plateau phase and phase. All right. The way

79:43 can break these things down is rapid phase is a function of the opening

79:47 sodium channels. Alright, The plateau is a function of open calcium

79:53 The falling phase is the function of potassium channels and closing the other

79:58 So at each different. So here I'm going up that sodium channels opening

80:04 then calcium channels are opening along the . But then here at the top

80:07 sodium channels close, the calcium channels open. That's why it just stays

80:14 . And then the calcium channels the potassium channels open. So then

80:18 fall. And then down here, when the potassium channels close. So

80:22 two different action potentials, you're sitting going, well, why do I

80:25 to know this? Is this just he wants me to learn because he's

80:28 and wants me to learn all the shapes. No, because the way

80:32 our heart works is dependent upon these different channels, how their actual potential

80:38 , and the types of contractions that result in. And when we come

80:42 after we talk about the calibration, see how this all comes together.

80:48 . See there's stuff there's promise. see there's stuff alright, we're

80:54 Alright. Today's Tuesday. Right? wanted to be thursday too.

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