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The apex beat (lat. ictus cordis), also called the apical impulse, [1] is the pulse felt at the point of maximum impulse (PMI), which is the point on the precordium farthest outwards (laterally) and downwards (inferiorly) from the sternum at which the cardiac impulse can be felt.
Anatomically, this means that the heart is on the left with the pulmonary atrium on the right and the systemic atrium on the left along with the cardiac apex. Right-sided organs are the liver , the gall bladder and a trilobed lung as well as the inferior vena cava , while left-sided organs are the stomach , single spleen , a bilobed lung, and ...
Although the ventricular stimulus originates from the AV node in the wall separating the atria and ventricles, the Bundle of His conducts the signal to the apex. Depolarization propagates through cardiac muscle very rapidly. Cells of the ventricles contract nearly simultaneously. The action potentials of cardiac muscle are unusually sustained.
It first passes at posterior to the pulmonary artery, then passes anteriorward between that pulmonary artery and the left atrium to reach the anterior interventricular sulcus, along which it descends to the notch of cardiac apex. In 78% of cases, it reaches the apex of the heart. [citation needed]
It is best heard at the cardiac apex with the patient in the left lateral decubitus position and holding their breath. The combined presence of S3 and S4 is a quadruple gallop, also known as the "Hello-Goodbye" gallop. At rapid heart rates, S3 and S4 may merge to produce a summation gallop, sometimes referred to as S7. [1]
The heart is a muscular organ situated in the mediastinum.It consists of four chambers, four valves, two main arteries (the coronary arteries), and the conduction system. The left and right sides of the heart have different functions: the right side receives de-oxygenated blood through the superior and inferior venae cavae and pumps blood to the lungs through the pulmonary artery, and the left ...
The anterior interventricular sulcus and posterior interventricular sulcus extend from the base of the ventricular portion to a notch, the notch of cardiac apex, (or incisura apicis cordis) on the acute margin of the heart just to the right of the apex.
The left ventricle is longer and more conical in shape than the right, and on transverse section its concavity presents an oval or nearly circular outline. It forms a small part of the sternocostal surface and a considerable part of the diaphragmatic surface of the heart; it also forms the apex of the heart.