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At less than 5 inches long and a bit more than 3 inches wide purchase cialis black online short term erectile dysfunction causes, an adult human heart weighs around 10 ounces — a couple ounces shy of a can of soda quality 800mg cialis black erectile dysfunction medication class. On the outside lies the epicardium (or visceral pericardium) order cialis black 800 mg online impotence causes, which is composed of fibroelastic connective tissue dappled with adipose tissue (fat) that fills exter- nal grooves called sulci (the singular is sulcus) discount caverta 100 mg free shipping. The larger coronary vessels and nerves are found in the adipose tissue that fills the sulci order zudena 100mg amex. Beneath the epicardium lies the myocardium 400mg levitra plus overnight delivery, which is composed of layers and bundles of cardiac muscle tissue. The endocardium, the heart’s interior lining, is composed of simple squamous endothelial cells. Epi– is the Greek term for “upon” or “on” whereas endo– comes from the Greek endon mean- ing “within. The pericardium is made up of two parts — a tough inelastic sac called the fibrous peri- cardium on the outside and a serous (or lubricated) membrane nearer the heart called the parietal pericardium. Between the serous layers of the epicardium and the parietal pericardium is the small pericardial space and its tiny amount of lubricating pericardial fluid. This watery substance prevents irritation during systole (contraction of the heart) and diastole (relaxation of the heart). Yet the proper anatomical terms for their positions refer to the atria as being “superior” (above) and the ventricles “inferior” (below). The atria Sometimes referred to as “receiving chambers” because they receive blood returning to the heart through the veins, each atrium has two parts: a principal cavity with a smooth interior surface and an auricle, a smaller, dog-ear-shaped pouch with muscular ridges inside called pectinate muscles, or musculi pectinati, that resemble the teeth of a comb. The right atrium appears slightly larger than the left and has somewhat thinner walls than the left. Its principal cavity, the sinus venarum cavarum, is between the two vena cavae and the atrioventricular (between an atrium and a ventricle) openings. The point where the right atrium’s auricle joins with its principal cavity is marked externally by the sulcus terminalis and internally by the crista terminalis. Openings into the right atrium include the following: The superior vena cava, which has no valve and returns blood from the head, thorax, and upper extremities and directs it toward the atrioventricular opening The inferior vena cava, which returns blood from the trunk and lower extremities and directs it toward the fossa ovalis in the interatrial septum, which also has no valve The coronary sinus, which opens between the inferior vena cava and the atrio- ventricular opening, returns blood from the heart, and is covered by the ineffec- tive Thebesian valve An atrioventricular opening covered by the tricuspid valve Chapter 10: Spreading the Love: The Circulatory System 167 The fossa ovalis is an oval depression in the interatrial septum that corresponds to the foramen ovale of the fetal heart. If the foramen ovale does not close at birth, it causes a condition known as “blue baby. The ventricles The heart’s ventricles are sometimes called the pumping chambers because it’s their job to receive blood from the atria and pump it back to the lungs and out into the body’s network of arteries. More force is needed to move the blood great distances, so the myocardium of the ventricles is thicker than that of either atrium, and the myocardium of the left ventricle is thicker than that of the right.