Cardiology - Relationship of conduction system, ventricular contraction and ECG

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  • Опубликовано: 2 окт 2024

Комментарии • 181

  • @patbrewer5245
    @patbrewer5245 7 лет назад +104

    LOL - "I hope this isn't too confusing" I've been a cardiac nurse for 15 years and this is the clearest explanation I have ever received!! Thank you:)

    • @fareshejazi2297
      @fareshejazi2297 3 года назад +6

      mate if you dont understand it after 15 years of working then i dont think it is the explantion fault

    • @sleepydog9968
      @sleepydog9968 2 года назад +1

      @@fareshejazi2297 perhaps 'pat brewer' meant that, through 15 years of lectures/classes, this video had the clearest explanation (compared to pat's lecturer/textbook explanations)

    • @khairunisayunus2920
      @khairunisayunus2920 Год назад

      I agree, I watched a ninja nerd video before this and couldn't even last 5 minutes without being confused...

  • @YoureInSilico
    @YoureInSilico 10 лет назад +91

    You gave me hope, then you took it away. There is no next video on this topic.

  • @abod505site
    @abod505site 3 года назад

    You are the Godfather of modern medicine

  • @ashwinshaun9061
    @ashwinshaun9061 10 лет назад +40

    I just got back from my physiology finals...and i ACED it...all thanks to you...thank you man :D

  • @oe1195
    @oe1195 10 лет назад +42

    Adding onto his notes in more specificity:
    The unstable membrane potential for which these pacemaker fibers start is known as a pacemaker potential since the fibers never truly rest at a constant value. This would be the beginning of his stage 4 at about -60mV. These pacemaker fibers contain channels known as I-funny channels, that are different from other excitatory tissues in that they allow Na ions and K ions to both pass. When these channels open at negative values, they allow for a greater influx of Na+ than an efflux of K+. This influx of Na+ slowly begins to depolarize the fibers, which can be seen in his slow incline along phase 4. As the fibers become more inside positive, the I-funny channels slowly start to close. It is at this point, right before the sudden inclination, that a specific set of Ca2+ channels open, allows Ca2+ to move into the fibers and continues to make the auto-rhythmic fibers more inside positive. When the pacemaker potential reaches threshold, a different group of Ca2+ channels open, allowing a sudden rush of Ca2+ into the cell and creating the steep 0 phase. The steep depolarization due to Ca2+ is a key characteristic of pacemaker cells. In other cells, the steep depolarization phase is due to a net influx of Na+. At the peak, these Ca2+ channels close, and slow K+ channels open. The rapid efflux of K+ is responsible for repolarization (his phase 3). This phase is similar to other excitatory cells. Similarly, the small "under shoot" at the end of the steep decline signifies the closure of K+ channels. Among other things, the time it takes for depolarization of pacemaker cells determines the heart rate.

    • @sleepydog9968
      @sleepydog9968 2 года назад

      thank you, sir!

    • @boansikofibadu5328
      @boansikofibadu5328 2 года назад

      Thanks

    • @bbmtge
      @bbmtge Год назад +1

      You added very little, repeated some of what was explained and somehow felt an urge to waste your time.

  • @TropicalChris
    @TropicalChris 8 лет назад +63

    You got me through my freshman semester of PA school...now you're getting me through my sophomore semester. You rock, man! Thanks!

    • @tenapreseanski3925
      @tenapreseanski3925 8 лет назад

      +Crist Gord hi guys, the best results that I have ever had was by using the Anatomy Blueprint Pro (just google it) definately the no.1 course that I've followed.

    • @TropicalChris
      @TropicalChris 8 лет назад

      +Lucian Lucian SPAM

    • @TropicalChris
      @TropicalChris 8 лет назад

      +Tena Preseđanski SPAM

    • @TropicalChris
      @TropicalChris 8 лет назад

      +Tena Preseđanski SPAM!!!

    • @MaximillianRed
      @MaximillianRed 8 лет назад

      Whats PA school?

  • @LaChuletaDeOsler
    @LaChuletaDeOsler 10 лет назад +39

    this is by far the best ecg and heart function explanation in history.

  • @iabaca
    @iabaca 10 лет назад +2

    im really frikkin annoyed now. these videos do a great job explaining how the heart works and what each organelle does but!!!!! for the SA node...calcium rushes in yes? then it slows/stops. then potassium rushes out okay. depolarisation and repolarisation. then what? how does the sequence start again? we are left with the inside of the node having a large amount of calcium and the outside a large amount of potassium.... is there a pump that reverts it all back to normal? or does the next action potential start with POTASSIUM rushing in instead of calcium. this shit is NEVER explained and it confuses the shit out of me. please can someone help.

    • @JustPiichi
      @JustPiichi 10 лет назад +1

      Yes, ions are always brought back to where they originated from by "ATPase pumps"

    • @iabaca
      @iabaca 10 лет назад

      okay thanks. atleast somene explains. but damn these pumps must be fast to do this in a fraction of a second

    • @wangtang55
      @wangtang55 10 лет назад +1

      iabaca Hey mate just saw this and I'm sure you're well past caring (6 months ago). Anyway, it's a bit of a misconception that the ions actually 'rush out' - e.g. potassium ions - to massive degree. What's happening is a change in the open or closed state of the channels. So there actually isn't a huge amount of potassium efflux from the cell - it's just that a lot of potassium channels open, and that changes the driving force or potential - i.e. it becomes more permeable. You're right, it doesn't really make sense that huge amounts of this stuff rushes in and out of the cell all of the time - and for the most part, it doesn't! The other thing that helps think about that is that the extracellular fluid around the cells contains a certain make-up of ions - this isn't constantly changing in massive waves, rather, it stays fairly constant, otherwise it could potentially affect the other cells (if there was a sudden increase in extracellular potassium then all the surrounding cells would have their membrane potential changed, by this logic.
      However, in cardiac cells the main driver of calcium potential changes (or rather, the degree of calcium channel opening) actually comes from within the SR calcium storage, rather than the extracellular calcium concentration.
      Just in case you never had this resolved! This website provides a better worded explanation of what I tried to say: www.austincc.edu/emeyerth/mempot1.htm

  • @dakotarogers4246
    @dakotarogers4246 7 лет назад +20

    This channel is getting me through Anatomy and Physiology. Bless your soul!

  • @hyatt9011
    @hyatt9011 5 лет назад

    thank you so much for this video and the image of your notes, so helpful!

  • @rramnarine8919
    @rramnarine8919 4 года назад +5

    Armando, I am truly grateful for your videos. Your videos have help breakdown complexing subjects into bite size clear information. You have an amazing way of teaching the material and thanks to your videos I made it through my Pathophysiology course. Thank you again for taking the time to help me and so many who struggle with reading words on a textbook. Thank you again and God bless !

  • @bunCbunn
    @bunCbunn 7 лет назад +1

    Cmiiw : SA node -> AV node -> Bundle of Hiss -> Purkinjae Fibers
    Location,
    SA : Crista Terminalis - Atrium Dextra Posterior
    AV : Trigonum Koch - near A-V Valve
    Bundle of Hiss : Interventriculare Ceptum
    Purkinjae Fibers : spread in Miocard Ventricle

  • @bliss_feeder
    @bliss_feeder 4 года назад

    Need videos on heart failure, CAD, rheumatic fever, IHD

  • @vjpillay
    @vjpillay 10 лет назад +1

    I wonder what
    sort of student are you and if you have got qualification which is verified by those who are well qualified in this subject not necessarily a doctor or a professor ?

  • @fahads2878
    @fahads2878 6 лет назад +1

    What's the relation between the first and second graph?

  • @mryoonyan8933
    @mryoonyan8933 9 лет назад +1

    diastole should rightly pronouns as di-as-to-le or as di-as-tole. please let me know.

    • @jacquelynalderson1215
      @jacquelynalderson1215 3 года назад

      He mispronounced "systole" and "diastole". It should have sounded like "sis-TOE-lee" and "die-ASS-toe-lee". I came to the comments section to see if anyone else noticed that and you were the only one!

  • @MrEritito7
    @MrEritito7 10 лет назад +5

    I'm so happy I saw this video !!! I'm very grateful, thanks so much it was excellent an so are you. Life will multiply you good actions !!!

  • @blueberry11051
    @blueberry11051 11 лет назад

    Thank you very much for this vid.

  • @hanachase
    @hanachase 8 лет назад +5

    I'm just in awe. lol. such skill going on here. thanks for the video!

  • @sheilavergara9283
    @sheilavergara9283 4 года назад +2

    you are amazing!! my college professor is no where as clear as you are. it took 2 classes to cover this subject and you did it in less than 30 min.

  • @farisalshboul998
    @farisalshboul998 10 лет назад +16

    very very very very ......... Great work , u have a genius creative mind (prefrontal cortex :P ) that connects all things together in a simple way ,,, I really love this way of looking at things
    thanks very much man , u are a hero :D

  • @Edumacation95
    @Edumacation95 9 лет назад +2

    great vid, keep em coming, just please make sure everything youre writing/saying is correct by reviewing your work

  • @mightylogic6808
    @mightylogic6808 8 лет назад +1

    May i know what reference book/s you are using kind sir?

  • @lavemrai6880
    @lavemrai6880 4 года назад +1

    After the T wave, you said the ventricles start filling but your wrote "arterial diastole" i am bit confused :/
    HALP!

    • @muskansood6363
      @muskansood6363 4 года назад

      Did you get your answer. I'm confused too!

    • @lavemrai6880
      @lavemrai6880 4 года назад

      @@muskansood6363 i think he wanted to write ventricular diastole and was just a typo

    • @lavemrai6880
      @lavemrai6880 4 года назад

      @@muskansood6363 i think he wanted to write ventricular diastole and was just a typo

  • @RichardAdetoye
    @RichardAdetoye 9 лет назад +1

    ok...one question right,,,for the ventricle graph..first depolarization means filling the with positive charge..so how is phase0 systolic when there is rapid depolarization....could you kindly explain that as soon as possible

  • @clairedeguzman1000
    @clairedeguzman1000 9 лет назад +1

    Mr. Richard Adetoye, there's no reply option to your comment so I'll just answer you question here. When you mean systolic, there is contraction of ventricular muscles to push the blood from the ventricles to the pulmonary artery or to the aorta. Depolarization means making the membrane potential to become more positive to make muscle contraction possible. Phase 0 means depolarization of the ventricular muscles thus is part of the systolic phase. Hope this helps.

  • @vivianwang2539
    @vivianwang2539 11 лет назад +1

    if you look into the period of the cardiac cycle, there is about 0.3 sec when four chambers are all relaxed and waiting for blood coming into the atrium.I think that area should be shown longer. thank you!

  • @maureenhirzel8
    @maureenhirzel8 6 лет назад +1

    you have saved so many lives with your videos i hope you know that!

  • @magdolenelzway8892
    @magdolenelzway8892 8 лет назад +1

    thaaaanx it made alot of sense now..ive been looking for the video next to this one but i couldnt find it could u please tell me how to find it..many thanx

  • @wry1007
    @wry1007 3 года назад

    Did you make th video explaining whats going on with the heart (visually) when looking at the ECG?

  • @ploikMUH
    @ploikMUH 11 лет назад +1

    Hi, good catch when you said atrial diastole instead of ventricular diastole. But if you want to add in, the S4 sound should be heard right before the QRS complex. Also when you drew the cardiac myocyte action potential on top of the EKG, shouldn't phase 3 include the T wave instead of ending at the T wave, since the T wave represents ventricular repolarization.

  • @threekerr1345
    @threekerr1345 3 года назад

    Is the bundle of his the same structure as bachman bundle, or is it different? Thank you!

  • @behishtaamir3631
    @behishtaamir3631 2 года назад

    I can’t explain my feelings for ur explanations!
    Just can tell you u are gorgeous ✨

  • @fortunecookiesmiles
    @fortunecookiesmiles 10 лет назад +5

    I love you man

  • @muhammadsulaiman6023
    @muhammadsulaiman6023 4 года назад

    I request that please during delivery of your lecture you are too fast.so please reduce your speed

  • @s.papadatos6711
    @s.papadatos6711 4 года назад +1

    Diastole doesnt mean filling... it means expanding in Hellenic. Furthermore, systole means contraction, also in Hellenic language (Greek)

  • @faryalhuma9522
    @faryalhuma9522 3 года назад

    I love you so much man....keep impressing me Armando 💖

  • @summitscenes
    @summitscenes 9 месяцев назад

    Watched whole videos from the top of Himalaya to ease through the medical exams.bravo

  • @asishreddy7729
    @asishreddy7729 9 лет назад +1

    Okay i have a conceptual doubt, you said that in SA node, repolarisation by efflux of Potassium is followed by depolarization of the next Action Potential Cycle. But how do the Calcium ions which entered the cell in the previous cycle go out? Thats a necessary step before the next cycle begins isn't it? Please help me with this i always struggle at this part. :(

  • @danielmajor7886
    @danielmajor7886 2 года назад

    This is probably a minor and inconsequential point, but at ~8:50, Armando mentions phase 0 (the steep upward curve) and states that the influx of sodium is the contraction of the ventricles. While this phase of the action potential is the depolarization of the membrane, the voltage-gated influx of calcium (Ca) ions (via the L-type channels) starts at about -40 mV and is more prolonged than sodium influx (lasting throughout phase 2). The Ca ions which influx during this phase trigger a massive release of Ca ion storage from the sarcoplasmic reticulum, which is responsible for ventricular contraction. Therefore, I believe it would be more precise to say contraction of the ventricles happen during phase 2. Source: Pathophysiology of Heart Disease, L. Lilly.

  • @karnapriya4568
    @karnapriya4568 9 лет назад +7

    hey man great video. I just have a quick note about the SA node phases. In phase 4, it is true that the L and T types open up channels but they do so after it reaches -40 mV. From -55 to -40 mV is produced by something called a funny channel which is activated by negative membrane potential and this channel bring in Na +. Just wanted to add detail but great video, love your stuff please keep doing what youre doing!

    • @Datboigioo
      @Datboigioo 7 лет назад

      Yes you're right

    • @shafiakhan5023
      @shafiakhan5023 5 лет назад

      Yes that's true there are funny channels envolve here

  • @SereneStudio
    @SereneStudio 7 лет назад

    What's the difference between spontaneous depolarization and depolarization on the first graph,?

  • @lysol5555
    @lysol5555 9 лет назад +1

    so does R correspond to the first heart sound, and T the second heart sound?

  • @benteteigstad5199
    @benteteigstad5199 10 лет назад

    Just one question, in the explanation about the cardiac muscle cell contraction, you say that Na+ stop moving in in phase 1, but then in phase 3 you say both Calcium AND sodium stop moving in, how can the sodium influx stop twice ?

  • @teboulshira9194
    @teboulshira9194 Год назад

    you can't imagine how thankful I am... my exam is tomorrow and I was crying cause I didn't understand it till I found your video and it appears clear like water... thanks you so so much!!!!!!❤❤❤❤❤❤❤❤❤❤❤

  • @robertheinrichs4273
    @robertheinrichs4273 8 лет назад +1

    I enjoy watching the VERY informative videos. Do you have one about the pericardium anatomy?

  • @manishasingh7520
    @manishasingh7520 6 лет назад

    The videos are just amazing and so to the point..also Please post some detailed videos on CARDIAC ARRTHYMIAS and ANGINA PECTORIS..and if it has already been made..please provide the link..unable to find it..

  • @FrankMoreiraV
    @FrankMoreiraV 9 лет назад

    what if we translate your videos to other languages so they can be available on the captions of the video??? :D

  • @richie3008
    @richie3008 8 лет назад +1

    This is the first time this has made sense to me - many thanks!

  • @ceraoconnor4956
    @ceraoconnor4956 7 лет назад +3

    Beautiful artwork!

  • @jomarsmith707
    @jomarsmith707 6 лет назад

    I graduated school because of the videos on RUclips just write notes and study these examples I am a licensed EKG Technician

  • @TomoMomoDomo
    @TomoMomoDomo 3 года назад

    Been struggling to understand this for my A&P exam.
    Im so happy i found your channel again.
    Subbed so i never lose it again xD

  • @abhishekbhatta2071
    @abhishekbhatta2071 10 лет назад

    grt diagram it explain and cover all ...bt u can even make it simplier..

  • @anevanielonthetree
    @anevanielonthetree 8 лет назад

    So much clearer than the school lecturer. Did not understand anything before watching your videos.

  • @drastichaudhari
    @drastichaudhari 6 лет назад

    Where is the video for the cardiac cycle???

  • @frontierfootbal
    @frontierfootbal 9 лет назад +2

    where do you teach? I love your videos , you are very good.

    • @rebbecakhan5262
      @rebbecakhan5262 9 лет назад +1

      +zachy pembleton lmao i guess he's ganna have two new students

  • @mahlakabano7486
    @mahlakabano7486 4 года назад

    Armando gets zero hate comments. Whoever comes here goes away with clear concepts.amazing teacher.thank you sir ♥️

  • @srionkareyeenthospitalamba3172
    @srionkareyeenthospitalamba3172 6 лет назад

    Very nice videos; kindly make a video on EKG also.
    Thanks.

  • @annas9942
    @annas9942 3 года назад

    Very nice video. Especially lining up ECG with contractile cycles (systole/diastole)

  • @shrabonishee5942
    @shrabonishee5942 4 года назад

    Thank you so much for helping students like me. Only searching for good teacher 🙂

  • @jbny63
    @jbny63 4 года назад

    You don’t say where blood goes when it leaves heart,two exits?

  • @user-ji2ck5mq9v
    @user-ji2ck5mq9v 8 лет назад +1

    I think you are so skilled

  • @saronazh5331
    @saronazh5331 10 лет назад

    thanks for all those videos you make ...they helped me a lot .. perfect as a study guide

  • @rahisha5732
    @rahisha5732 4 года назад

    What what that by which u erased the marker

  • @bpoole99251
    @bpoole99251 9 лет назад

    Ok... so.maybe I am getting confused between skeletal and cardiac. But wouldn't a repolarization involve an influx of potassium? He says eflux but this doesn't make sense to me cause the whole purpose of membrane potential is offsetting balance between sodium and potassium and a continued eflux of potassium would never allow the membrane to reach resting membrane potential. Thanks

    • @intrepidusferox9493
      @intrepidusferox9493 9 лет назад

      Hey sorry if I'm wrong but what I think is this: Depolarization --> 3 Na influx & 2 K outflux, thus the inner side of the cell membrane becomes more positive resulting in depolarization.
      Repolarisation means that the inner side of the cell membrane has to become more negative. So we have to pump extra positive charge out of the cell, this way we get a negative inner side of the cell membrane.
      Thus the Na-K pump pumps 2K out of the cell...K efflux. Hole it helps. :-)

    • @intrepidusferox9493
      @intrepidusferox9493 9 лет назад

      *Hope. The Na-K pump only pumps Na out of the cell and K into the cell. It's a one way pump. Search: Na-K pump conformations. Being in a particular shape of the pump E1 or E2 creates specific affinities to either K or Na. I think, please google and tell me if I'm wrong, that on the inside it can only pump Na inside and K outside.

    • @clairedeguzman1000
      @clairedeguzman1000 9 лет назад

      I'm not sure if I get you question right, but when you say repolarization, you are making the inside of the cell more negatively charged. For you to be able to do this, Ca2+ and Na+ channels should be closed to prevent further increase of positive ions within the cell, and also, there must be a K+ eflux so that positive ions will move out of the cell making it more negative thus repolarizing it.

  • @phuhuynh6763
    @phuhuynh6763 10 лет назад +1

    Your lectures are amazing!!!!

  • @vishalmaan1936
    @vishalmaan1936 6 лет назад

    Sir
    When are you uploading Next Video on this topic..??

  • @avilashmandal151
    @avilashmandal151 11 лет назад

    thanx for providing the image...And for everthing else.. :)

  • @pakhtun7639
    @pakhtun7639 5 лет назад

    K+ efflux is by voltage gated or leak channels?

  • @Datboigioo
    @Datboigioo 7 лет назад

    Thank you for this amazing video but i want to point out about the action potential of the SA node, the action potential peak reaches +10 not 0, otherwise there will be potential difference between the charges if it stops at 0

  • @iratepeople455
    @iratepeople455 8 лет назад +2

    the "HAWT" LOLZ!

  • @jessmcd5148
    @jessmcd5148 3 года назад

    This man's vids saves me in Physiology. Thank you so much.

  • @hebasaradileep
    @hebasaradileep 5 лет назад

    What's the mechanics behind calcium in systolic arrest?

  • @new_light-xq6cd
    @new_light-xq6cd 6 лет назад

    Ucan draw!!&U know the material 😋 thankU 4 sharing💖

  • @vjpillay
    @vjpillay 10 лет назад

    How calcium blockers affect the normal function of heart?

  • @yadiali4572
    @yadiali4572 8 лет назад

    I'm watching most of your videos are really helpful thank you so much

  • @ElderWrath
    @ElderWrath 11 лет назад +1

    Thank you so much for doing these man! Absolutely fantastic as a study guide!

  • @loveliveallthetime
    @loveliveallthetime 11 лет назад

    i hope you're not busy, but i really need the "NEXT" video as soon as possible. Thank you so much for all your other videos, you're really great!

  • @lram8330
    @lram8330 8 лет назад +2

    GRACIAS

  • @MaroonGoone
    @MaroonGoone 8 лет назад

    Nice vid thanks man, m trying to relearn all this stuff

  • @victorgaliana8941
    @victorgaliana8941 5 лет назад

    This video is really well done and explained, thank you very much my friend

  • @juancontrerasjfc
    @juancontrerasjfc 10 лет назад

    Congrats for such a good vid, nice electrocardiographic correlation!

  • @bw_11
    @bw_11 4 года назад

    Sir u r amazing... Love from India!!!!

  • @madjetheronier1065
    @madjetheronier1065 8 лет назад

    your videos really helped.I have a question now, what is the blood flow from the coronary sinus to the femoral artery? thanks in advance

  • @TransformChantel
    @TransformChantel 11 лет назад

    this is good armando

  • @drsahaja562
    @drsahaja562 7 лет назад

    very very helpful ! thanks for d tutorial !

  • @omidhabibi5470
    @omidhabibi5470 3 года назад

    WHY ITS SO CONFUSING

  • @rovergzz
    @rovergzz 7 лет назад

    God Bless you I ThanksGod tour Life

  • @xxAnonymousPhantomxx
    @xxAnonymousPhantomxx 8 лет назад

    Thank you a lot. This makes clear all the confusion I got with books.

  • @luckystarwellnongbri2179
    @luckystarwellnongbri2179 7 лет назад

    can you make a video on cardiac cycle please

  • @mosbahmaryd5959
    @mosbahmaryd5959 9 лет назад

    There is something not clear to be , when you draw a digram of ECG how it can be the distend from P wave to R represent atrial systole ( ventricular diastole ) and the distend from the T wave to P wave atrial systole also. Please if you can make it more explanation to me . Thank you

    • @JohnCitizenCitizen
      @JohnCitizenCitizen 9 лет назад +1

      Mosbah Maryd The atria are in diastole most of the time - atrial systole only occurs during the PR interval.
      Action potentials fire first which causes the muscle to contract. We start with the heart relaxed, with the atria and ventricles in diastole, both full of blood.
      The action potential spreads across the atria (P wave) then there is a small amount of time, about 0.2 seconds, before the action potential reaches the ventricle muscle cells (QRS). This small amount of time is called PR interval, and during this time the atria contract, squeezing their blood into the ventricles (atrial systole), and then relax (atrial diastole) and repolarise. The atrial repolarisation can't be seen on an EEG because the action potential (QRS) reaching the ventricles is so much stronger.
      During the time between S and T, the ventricles contract (ventricle systole) and pump blood into the lungs/body. Ventricles then relax (diastole) and repolarise. The T wave is ventricular muscle cells becoming more negative so they are ready to contract again for the next heart beat. The entire heart is resting in diastole during the time between T and the next P.

    • @kausikraj4220
      @kausikraj4220 8 лет назад

      Mosbah Maryd

  • @SaadAli-qv9nf
    @SaadAli-qv9nf 3 года назад

    Thank you so much

  • @parinyafon
    @parinyafon 9 лет назад +1

    thank you

  • @SerpilBorazan
    @SerpilBorazan 5 лет назад

    Thank you soooo much🙏🏻

  • @cikookie
    @cikookie 4 года назад

    Your hand is amazing

  • @rogermulumba-lutumba8094
    @rogermulumba-lutumba8094 11 лет назад

    Good! But can you also tell us about "Renal vascularization"?

  • @alexholdsworth6940
    @alexholdsworth6940 11 лет назад

    great video, thank you for taking the time to post this material it has been very helpful.

  • @lilijanet1291
    @lilijanet1291 Год назад

    The greatest!

  • @amalia7070
    @amalia7070 5 лет назад

    Pleases make a next video to this

  • @sanwalram1792
    @sanwalram1792 6 лет назад

    How to left atrium contract???