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The Heart

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The Cardiovascular System 1

Figure 12.1
The heart is a muscular organ that is
essential for life because it pumps blood
through the body.
The heart is a member organ of the
cardiovascular system, which consists of
the heart, blood vessels, and blood.
The heart of a healthy adult, at rest,
pumps approximately 5 liters (L) of blood
per minute.
For most people, the heart continues to
pump at approximately that rate for more
than 75 years.
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The Cardiovascular System 2

The heart is a member organ of the

cardiovascular system, which consists of
the heart, blood vessels, and blood.
The heart is actually two pumps in one,
with the heart’s right side pumping to the
lungs and back to the left side of the
heart through vessels of the pulmonary
circulation.
The left side of the heart pumps blood to
all other tissues of the body and back to
the right side of the heart through vessels Figure 12.2
of the systemic circulation.
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Functions & Characteristics of the Heart

1. Generates blood pressure
2. Routes blood
3. Ensures one-way blood flow
4. Regulates blood supply
Size: size of a fist and weighs less
than 1 lb.
Location: between lungs in thoracic
cavity
Orientation: apex (bottom) towards
left side Figure 12.3
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Pericardia
Pericardium:
double-layered sac that
anchors and protects heart
Parietal pericardium:
membrane around heart’s
cavity
Visceral pericardium:
membrane on heart’s
surface
Pericardial cavity:
space around heart Figure 12.4
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Heart External Anatomy 1

A coronary sulcus extends

around the heart, separating the
atria from the ventricles.
Two grooves, or sulci, which
indicate the division between
the right and left ventricles,
extend inferiorly from the
coronary sulcus.
The anterior interventricular
sulcus extends inferiorly from
the coronary sulcus on the
anterior surface of the heart.
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 Surface Anatomy of the Heart 1
9

Figure 12.5a
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Heart External Anatomy 2

The posterior interventricular sulcus

extends inferiorly from the coronary
sulcus on the posterior surface of the
heart.
The superior vena cava and inferior
vena cava carry blood from the body
to the right atrium, and four
pulmonary veins carry blood from the
lungs to the left atrium.
Two arteries, often called the great
vessels or great arteries, carry blood
away from the ventricles of the heart.
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Heart External Anatomy 3

The pulmonary trunk, arising

from the right ventricle, splits
into the right and left
pulmonary arteries, which
carry blood to the lungs.
The aorta arising from the left
ventricle, carries blood to the
rest of the body.

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Surface Anatomy of the Heart 2

Figure 12.5c
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Heart Chambers
Four Chambers:
• left atrium (LA)
• right atrium (RA)
• left ventricle (LV)
• right ventricle (RV)
Coronary sulcus:
• separates atria from ventricles

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The Atria
Superior chambers
Holding chambers
Small, thin walled
Contract minimally to push
blood into ventricles
Interatrial septum:
• separates right and left atria

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Ventricles
Inferior chambers
Pumping chambers
Thick, strong walled
Contract forcefully to propel
blood out of heart
Interventricular septum:
• separates right and left
ventricles
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Internal Anatomy of the Heart

Figure 12.6
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Heart Valves

Valves between the atria and

ventricles
Tricuspid valve:
• AV valve between RA and RV
• 3 cusps
Bicuspid valve (mitral):
• AV valve between LA and LV
• 2 cusps
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Heart Valves 2

Figure 12.8
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Heart Valves 1

Figure 12.7
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Valvular Control
Each ventricle contains cone-shaped,
muscular pillars called papillary muscles.

These muscles are attached by strong,

connective tissue strings called chordae
tendineae to the free margins of the
cusps of the atrioventricular valves.

When the ventricles contract, the

papillary muscles contract and prevent
the valves from opening into the atria by
pulling on the chordae tendineae
attached to the valve cusps.

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Semilunar Heart Valves

The semilunar valves have three
half-moon shaped cusps, and are
valves between the pulmonary
trunk and aorta.
Pulmonary valve:
• between RV and pulmonary
trunk
Aortic valve:
• between LV and aorta

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Cardiac Skeleton 1

A plate of connective tissue,

sometimes called the cardiac
skeleton, or fibrous skeleton,
consists mainly of fibrous rings that
surround the atrioventricular and
semilunar valves and give them solid
support.
This connective tissue plate also
serves as electrical insulation
between the atria and the ventricles
and provides a rigid attachment site
for cardiac muscle.
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Blood Flow through Heart 1

1. RA
2. Tricuspid valve
3. RV
4. Pulmonary semilunar valve
5. Pulmonary trunk
6. Pulmonary arteries
7. Lungs
8. Pulmonary veins
9. LA
10. Bicuspid valve
11. LV
12. Aortic semilunar valve
13. Aorta
14. Body
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Blood Supply to the Heart 1

Coronary arteries:
• supply blood to heart wall
• originate from base of
aorta (above aortic
semilunar valve)
Left coronary artery:
• has 3 branches
• supply blood to anterior
heart wall and left ventricle
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Blood Supply to the Heart 2

Right coronary artery:

• originates on right side of aorta
• supply blood to right ventricle

Cardiac veins:
• drain blood from the cardiac
muscle
• parallel to the coronary arteries
• most drain blood into the coronary
sinus
• from the coronary sinus into the
right atrium
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Heart Wall

Epicardium:
• surface of heart (outside)
Myocardium:
• thick, middle layer
composed of cardiac
muscle
Endocardium:
• smooth, inner surface
Figure 12.12
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Cardiac Muscle
1 centrally located nucleus
Branching cells
Rich in mitochondria
Striated (actin and myosin)
Ca2+ and ATP used for
contractions
Intercalated disks connect
cells
Figure 12.12
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Cardiac Muscle Action Potentials 1

Changes in membrane channels’

permeability are responsible for
producing action potentials and is called
pacemaker potential.
1. Depolarization phase:
• Na+ channels open
• Ca2+ channels open
2. Plateau phase:
• Na+ channels close
• Some K+ channels open
• Ca2+ channels remain open
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Cardiac Muscle Action Potentials 2

3. Repolarization phase:
• K+ channels are open
• Ca2+ channels close
Plateau phase prolongs action
potential by keeping Ca2+ channels
open.
In skeletal muscle action potentials
take 2 msec, in cardiac muscle they
take 200-500 msec.

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Conduction System of Heart 1

Contraction of the atria and ventricles is

coordinated by specialized cardiac
muscle cells in the heart wall that form
the conduction system of the heart.
All the cells of the conduction system
can produce spontaneous action
potentials.
The conduction system of the heart
includes the sinoatrial node,
atrioventricular node, atrioventricular
bundle, right and left bundle branches,
and Purkinje fibers.
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Conduction System of Heart 2

Sinoatrial node (SA node):

• in RA
• where action potential originates
• functions as pacemaker
• large number of Ca2+ channels

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Conduction System of Heart 3

Atrioventricular node (AV node):

• located in the lower portion of the
right atrium
• action potentials from SA node
sent to this node
• action potentials spread slowly
through it
• slow rate of action potential
conduction allows the atria to
complete their contraction before
action potentials are delivered to
the ventricles
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Conduction System of Heart 4

Atrioventricular
bundle:
• action potentials from
AV node travel to AV
bundle
• AV bundle divides into a
left and right bundle
branches

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Conduction System of Heart 4

Purkinje Fibers
• at the tips of the left and right
bundle branches, are Purkinje
fibers
• Purkinje fibers pass to the apex of
the heart and then extend to the
cardiac muscle of the ventricle
walls
• action potentials are rapidly
delivered to all the cardiac muscle
of the ventricles
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Conduction System of the Heart

Figure 12.15
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Electrocardiogram (EKG)

ECG (EKG)
• record of electrical events in
heart
• diagnoses cardiac
abnormalities
• uses electrodes
• contains P wave, QRS complex,
T wave

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Electrocardiogram
Components of ECG/EKG

P wave:
• depolarization of atria
QRS complex:
• depolarization of ventricles
• contains Q, R, S waves
T wave:
• repolarization of ventricles

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Cardiac Cycle 1

The cardiac cycle is a

summative description of all
the events that occur during
one single heartbeat.
The heart is a two sided
pump, with the atria being
primers for pumps and the
ventricles being the actual
pumps.

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Heart Chamber
Contractions
Cardiac muscle contractions
produce pressure changes
within heart chambers.
Pressure changes are
responsible for blood
movement.
Blood moves from areas of
high to low pressure.
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Cardiac Cycle 2

Atrial systole:
• contraction of atria
Ventricular systole:
• contraction of ventricles
Atrial diastole:
• relaxation of atria
Ventricular diastole:
• relaxation of ventricles
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Cardiac
Cycle 3

Figure 12.17

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Events of
the Cardiac
Cycle

Figure 12.18
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Heart Sounds Heart Valve Locations

Heart sounds are produced due to the
closure of heart valves.
A stethoscope is used to hear heart
sounds

The first heart sound makes a ‘lubb’

sound. The second heart sound makes
a ‘dupp’ sound.

The first heart sound is due to the

closure of the atrioventricular valves.
The second heart sound is due to the
closure of the semilunar valves.
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Regulation of Heart Function 1

Stroke Volume:
• volume of blood pumped per
ventricle per contraction
• 70 milliliters/beat
Heart Rate:
• number of heart beats in 1 min.
• 72 beats/min.

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Regulation of Heart Function 2

Cardiac Output:
• volume of blood pumped by a
ventricle in 1 min.
• 5 Liters/min.
Cardiac output equals stroke
volume multiplied times heart
rate
CO = SV x HR

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Intrinsic Regulation of the Heart 1

Intrinsic regulation refers to the

mechanisms contained within the heart
itself that control cardiac output.
Venous return:
• the amount of blood that returns to heart
Preload:
• the degree ventricular walls are stretched
at end of diastole
Venous return, preload, and stroke
volume are related to each other
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Intrinsic Regulation of the Heart 2

Starlings Law of the Heart:

• relationship between preload and stroke
• volume
• influences cardiac output
• Example - exercise increases venous
return, preload, stroke volume, and
cardiac output
After load:
• pressure against which ventricles must
pump blood
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Extrinsic Regulation of Heart

Extrinsic regulation refers to mechanisms
external to the heart, such as either
nervous or chemical regulation.
Nervous system control of the heart occurs
through the sympathetic and
parasympathetic divisions of the autonomic
nervous system. influences of heart activity
are carried through the autonomic nervous
system.
Both sympathetic and parasympathetic
nerve fibers innervate the SA node.
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Baroreceptor Reflex 1

The baroreceptor reflex is a

mechanism of the nervous
system that plays an important
role in regulating heart function.
Baroreceptors:
• monitor blood pressure in the
aorta and carotid arteries
• changes in blood pressure
cause changes in
• frequency of action potentials
• involves the medulla
oblongata

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Chemoreceptor Reflex 1

The chemoreceptor
reflex involves
chemical regulation
Chemoreceptor
of the heart.
Reflex—pH
Chemicals can affect
heart rate and stroke
volume.

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Chemoreceptor Reflex 2

Chemical actions:
• epinephrine and norepinephrine from
the adrenal medulla can increase
heart rate and stroke volume
• excitement, anxiety, and anger can Chemoreceptor
increase cardiac output Reflex—pH
• depression can decrease cardiac
output
• medulla oblongata has
chemoreceptors for changes in pH
and CO2
• K+, Ca2+, and Na+ affect cardiac
function
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Summary of Extrinsic Regulation

Figure 12.22
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Heart Disease
Coronary Artery Disease
• due to decrease blood supply to the
heart
• coronary arteries are narrowed for
some reason
Myocardial Infarction (heart attack)
• due to closure of one or more
coronary arteries
• area(s) of cardiac muscle lacking
adequate blood supply die, and
scars (infarct)
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Heart Procedures
Angioplasty: procedure opens blocked blood vessels
Stent: structures inserted to keep vessels open
Bypass: procedure reroutes blood away from blocked arteries

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