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Date: 10.08.2017

Two Hearts, One Mind (2001)

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Photograph of a human heart Computer generated animation of a beating human heart Location and shape Real-time MRI of the human heart The human heart is in the middle of the thorax , with its apex pointing to the left.

A double-membraned sac called the pericardium surrounds the heart and attaches to the mediastinum. The upper part of the heart is located at the level of the third costal cartilage. Because the heart is between the lungs , the left lung is smaller than the right lung and has a cardiac notch in its border to accommodate the heart.

The atria open into the ventricles via the atrioventricular valves, present in the atrioventricular septum. This distinction is visible also on the surface of the heart as the coronary sulcus. Similarly, the left atrium and the left ventricle together are sometimes referred to as the left heart. It forms the atrioventricular septum which separates the atria from the ventricles, and the fibrous rings which serve as bases for the four heart valves. The interatrial septum separates the atria and the interventricular septum separates the ventricles.

Heart valves With the atria and major vessels removed, all four valves are clearly visible. The white arrows show the normal direction of blood flow. Frontal section showing papillary muscles attached to the tricuspid valve on the right and to the mitral valve on the left via chordae tendineae.

One valve lies between each atrium and ventricle, and one valve rests at the exit of each ventricle. Between the right atrium and the right ventricle is the tricuspid valve. The tricuspid valve has three cusps, [20] which connect to chordae tendinae and three papillary muscles named the anterior, posterior, and septal muscles, after their relative positions. It is also known as the bicuspid valve due to its having two cusps, an anterior and a posterior cusp.

These cusps are also attached via chordae tendinae to two papillary muscles projecting from the ventricular wall. These muscles prevent the valves from falling too far back when they close. As the heart chambers contract, so do the papillary muscles. This creates tension on the chordae tendineae, helping to hold the cusps of the atrioventricular valves in place and preventing them from being blown back into the atria. The pulmonary valve is located at the base of the pulmonary artery.

This has three cusps which are not attached to any papillary muscles. When the ventricle relaxes blood flows back into the ventricle from the artery and this flow of blood fills the pocket-like valve, pressing against the cusps which close to seal the valve.

The semilunar aortic valve is at the base of the aorta and also is not attached to papillary muscles. This too has three cusps which close with the pressure of the blood flowing back from the aorta.

A small amount of blood from the coronary circulation also drains into the right atrium via the coronary sinus , which is immediately above and to the middle of the opening of the inferior vena cava. In addition to these muscular ridges, a band of cardiac muscle, also covered by endocardium, known as the moderator band reinforces the thin walls of the right ventricle and plays a crucial role in cardiac conduction.

It arises from the lower part of the interventricular septum and crosses the interior space of the right ventricle to connect with the inferior papillary muscle. The pulmonary trunk branches into the left and right pulmonary arteries that carry the blood to each lung.

The pulmonary valve lies between the right heart and the pulmonary trunk. The left atrium has an outpouching called the left atrial appendage.

Like the right atrium, the left atrium is lined by pectinate muscles. Like the right ventricle, the left also has trabeculae carneae , but there is no moderator band. The left ventricle pumps blood to the body through the aortic valve and into the aorta. Two small openings above the aortic valve carry blood to the heart itself, the left main coronary artery and the right coronary artery. Cardiac muscle Layers of the heart wall, including visceral and parietal pericardium.

The heart wall is made up of three layers: These are surrounded by a double-membraned sac called the pericardium. The innermost layer of the heart is called the endocardium. It is made up of a lining of simple squamous epithelium , and covers heart chambers and valves.

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It is continuous with the endothelium of the veins and arteries of the heart, and is joined to the myocardium with a thin layer of connective tissue. The cardiac muscle pattern is elegant and complex, as the muscle cells swirl and spiral around the chambers of the heart, with the outer muscles forming a figure 8 pattern around the atria and around the bases of the great vessels and the inner muscles forming a figure 8 around the two ventricles and proceeding toward the apex.

This complex swirling pattern allows the heart to pump blood more effectively. These contractile cells are connected by intercalated discs which allow a rapid response to impulses of action potential from the pacemaker cells. The intercalated discs allow the cells to act as a syncytium and enable the contractions that pump blood through the heart and into the major arteries.

They are generally much smaller than the contractile cells and have few myofibrils which gives them limited contractibility. Their function is similar in many respects to neurons. The tough outer surface of the pericardium is called the fibrous membrane. This is lined by a double inner membrane called the serous membrane that produces pericardial fluid to lubricate the surface of the heart.

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Coronary circulation Heart tissue, like all cells in the body, needs to be supplied with oxygen , nutrients and a way of removing metabolic wastes. This is achieved by the coronary circulation , which includes arteries , veins , and lymphatic vessels.

These are the left main coronary artery and the right coronary artery. The left main coronary artery splits shortly after leaving the aorta into two vessels, the left anterior descending and the left circumflex artery. The left anterior descending artery supplies heart tissue and the front, outer side, and the septum of the left ventricle. It does this by branching into smaller arteries — diagonal and septal branches.

The left circumflex supplies the back and underneath of the left ventricle. The right coronary artery supplies the right atrium, right ventricle, and lower posterior sections of the left ventricle. The right coronary artery runs in a groove at the back of the heart and the left anterior descending artery runs in a groove at the front. There is significant variation between people in the anatomy of the arteries that supply the heart [29] The arteries divide at their furtherst reaches into smaller branches that join together at the edges of each arterial distribution.

It receives blood from the great cardiac vein receiving the left atrium and both ventricles , the posterior cardiac vein draining the back of the left ventricle , the middle cardiac vein draining the bottom of the left and right ventricles , and small cardiac veins.

These vessels then travel into the atrioventricular groove, and receive a third vessel which drains the section of the left ventricle sitting on the diaphragm.

The left vessel joins with this third vessel, and travels along the pulmonary artery and left atrium, ending in the inferior tracheobronchial node. The right vessel travels along the right atrium and the part of the right ventricle sitting on the diaphragm. It usually then travels in front of the ascending aorta and then ends in a brachiocephalic node.

These nerves act to influence, but not control, the heart rate. Sympathetic nerves also influence the force of heart contraction. The vagus nerve of the parasympathetic nervous system acts to decrease the heart rate, and nerves from the sympathetic trunk act to increase the heart rate. The ventricles are more richly innervated by sympathetic fibers than parasympathetic fibers.

Sympathetic stimulation causes the release of the neurotransmitter norepinephrine also known as noradrenaline at the neuromuscular junction of the cardiac nerves. This shortens the repolarization period, thus speeding the rate of depolarization and contraction, which results in an increased heart rate.

It opens chemical or ligand-gated sodium and calcium ion channels, allowing an influx of positively charged ions. Heart development and Human embryogenesis Development of the human heart during the first eight weeks top and the formation of the heart chambers bottom.

In this figure, the blue and red colors represent blood inflow and outflow not venous and arterial blood. This early start is crucial for subsequent embryonic and prenatal development. The heart derives from splanchnopleuric mesenchyme in the neural plate which forms the cardiogenic region. Two endocardial tubes form here that fuse to form a primitive heart tube known as the tubular heart. This places the chambers and major vessels into the correct alignment for the developed heart.

Further development will include the septa and valves formation and remodelling of the heart chambers. By the end of the fifth week the septa are complete and the heart valves are completed by the ninth week.

The foramen ovale allowed blood in the fetal heart to pass directly from the right atrium to the left atrium, allowing some blood to bypass the lungs.

Within seconds after birth, a flap of tissue known as the septum primum that previously acted as a valve closes the foramen ovale and establishes the typical cardiac circulation pattern. A depression in the surface of the right atrium remains where the foramen ovale once walls, called the fossa ovalis. The embryonic heart rate then accelerates and reaches a peak rate of — bpm early in the early 7th week early 9th week after the LMP. There is no difference in female and male heart rates before birth.