Assignment on Anatomy and

Physiology of Heart

Submitted by: Submitted to:

Jayita Gayen Madam S. Poddar

INTRODUCTION

The heart is the key organ of the cardio vascular system -the body’s transport system for
blood. A muscle that contracts rhythmically and autonomously, it works in conjunction with
an extensive network of blood vessels running throughout the body. Basically, the heart is a
pump ensuring the continuous circulation of blood in the body.

An electrical system regulates the heart and uses electrical signals to contract the heart's
walls. When the walls contract, blood is pumped into the circulatory system. A system of
inlet and outlet valves in the heart chambers work to ensure that blood flows in the right
direction. The heart is vital to your health and nearly everything that goes on in the body.
Without the heart's pumping action, blood can't circulate within the body.

FUNCTIONS OF THE HEART

1. Managing blood supply: Variations in the rate and force of heart contraction match

blood flow to the changing metabolic needs of the tissues during rest, exercise, and
changes in body position.
2. Producing blood pressure: Contractions of the heart produce blood pressure, which
is needed for blood flow through the blood vessels.
3. Securing one-way blood flow: The valves of the heart secure a one-way blood flow
through the heart and blood vessels.
4. Transmitting blood: The heart separates the pulmonary and systemic circulations,
which ensures the flow of oxygenated blood to tissue

ANATOMY OF THE HEART

The cardiovascular system can be compared to a muscular pump equipped with one-way
valves and a system of large and small plumbing tubes within which the blood travels.

Heart Structure and Functions

The modest size and weight of the heart give few hints of its incredible strength.

 Weight: Approximately the size of a person’s fist, the hollow, cone-shaped heart

weighs less than a pound.
 Mediastinum: Snugly enclosed within the inferior mediastinum, the medial cavity of
the thorax, the heart is flanked on each side by the lungs.
 Apex: It’s more pointed apex is directed toward the left hip and rests on the
diaphragm, approximately at the level of the fifth intercostal space.
 Base: Its broad posterosuperior aspect, or base, from which the great vessels of the
body emerge, points toward the right shoulder and lies beneath the second rib.
 Pericardium: The heart is enclosed in a double-walled sac called the pericardium
and is the outermost layer of the heart.
  Fibrous pericardium: The loosely fitting superficial part of this sac is referred to as
the fibrous pericardium, which helps protect the heart and anchors it to surrounding
structures such as the diaphragm and sternum.
 Serous pericardium: Deep to the fibrous pericardium is the slippery, two-layer
serous pericardium, where its parietal layer lines the interior of the fibrous
pericardium.

Layers of the Heart

The heart muscle has three layers and they are as follows:

 Epicardium: The epicardium or the visceral and outermost layer is actually a part of

the heart wall.
 Myocardium: The myocardium consists of thick bundles of cardiac muscle twisted
and whirled into ringlike arrangements and it is the layer that actually contracts.
 Endocardium: The endocardium is the innermost layer of the heart and is a thin,
glistening sheet of endothelium that lines the heart chambers.

Chambers of the Heart

The heart has four hollow chambers, or cavities: two atria and two ventricles.

 Receiving chambers: The two superior atria are primarily the receiving chambers;

they play a lighter role in the pumping activity of the heart.
  Discharging chambers: The two inferior, thick-walled ventricles are the discharging
chambers, or actual pumps of the heart wherein when they contract, blood is propelled
out of the heart and into the circulation.
 Septum: The septum that divides the heart longitudinally is referred to as either
the interventricular septum or the interatrial septum, depending on which chamber it
separates.

Associated Great Vessels

The great blood vessels provide a pathway for the entire cardiac circulation to proceed.

 Superior and inferior vena cava: The heart receives relatively oxygen-poor

blood from the veins of the body through the large superior and inferior vena cava and
pumps it through the pulmonary trunk.
 Pulmonary arteries: The pulmonary trunk splits into the right and left pulmonary
arteries, which carry blood to the lungs, where oxygen is picked up and carbon
dioxide is unloaded.
 Pulmonary veins: Oxygen-rich blood drains from the lungs and is returned to the left
side of the heart through the four pulmonary veins.
 Aorta: Blood returned to the left side of the heart is pumped out of the heart into the
aorta from which the systemic arteries branch to supply essentially all body tissues.

Heart Valves

The heart is equipped with four valves, which allow blood to flow in only one direction
through the heart chambers.

 Atrioventricular valves: Atrioventricular or AV valves are located between the atrial

and ventricular chambers on each side, and they prevent backflow into the atria when
the ventricles contract.
 Bicuspid valves: The left AV valve- the bicuspid or mitral valve, consists of two
flaps, or cusps, of endocardium.
 Tricuspid valve: The right AV valve, the tricuspid valve, has three flaps.
 Semilunar valve: The second set of valves, the semilunar valves, guards the bases of
the two large arteries leaving the ventricular chambers, thus they are known as the
pulmonary and aortic semilunar valves.
Cardiac Circulation Vessels

Although the heart chambers are bathed with blood almost continuously, the blood contained
in the heart does not nourish the myocardium.

Coronary arteries: The coronary arteries branch from the base of the aorta and encircle the
heart in the coronary sulcus (atrioventricular groove) at the junction of the atria and
ventricles, and these arteries are compressed when the ventricles are contracting and fill when
the heart is relaxed.

Cardiac veins: The myocardium is drained by several cardiac veins, which empty into an
enlarged vessel on the posterior of the heart called the coronary sinus.

PHYSIOLOGY OF THE HEART

As the heart beats or contracts, the blood makes continuous round trips- into and out of the
heart, through the rest of the body, and then back to the heart- only to be sent out again.
Intrinsic Conduction System of the Heart

The spontaneous contractions of the cardiac muscle cells occur in a regular and continuous
way, giving rhythm to the heart.

The Pathway of the Conduction System

The conduction system occurs systematically through:

 SA node: The depolarization wave is initiated by the sinoatrial node.

 Atrial myocardium: The wave then successively passes through the atrial
myocardium.
 Atrioventricular node: The depolarization wave then spreads to the AV node, and
then the atria contract.
 AV bundle: It then passes rapidly through the AV bundle.
 Bundle branches and Purkinje fibres: The wave then continues on through the right
and left bundle branches, and then to the Purkinje fibers in the ventricular walls,
resulting in a contraction that ejects blood, leaving the heart.
Cardiac Cycle and Heart Sounds

In a healthy heart, the atria contract simultaneously, then, as they start to relax, contraction of
the ventricles begin.

 Systole. Systole means heart contraction.

 Diastole. Diastole means heart relaxation.
 Cardiac cycle. The term cardiac cycle refers to the events of one complete heartbeat,
during which both atria and ventricles contract and then relax.
 Length. The average heart beats approximately 75 times per minute, so the length of
the cardiac cycle is normally about 0.8 second.
 Mid-to-late diastole. The cycle starts with the heart in complete relaxation; the
pressure in the heart is low, and blood is flowing passively into and through the atria
into the ventricles from the pulmonary and systemic circulations; the semilunar valves
are closed, and the AV valves are open; then the atria contract and force the blood
remaining in their chambers into the ventricles.
 Ventricular systole. Shortly after, the ventricular contraction begins, and the
pressure within the ventricles increases rapidly, closing the AV valves; when
the intraventricular pressure is higher than the pressure in the large arteries leaving
the heart, the semilunar valves are forced open, and blood rushes through them out of
the ventricles; the atria are relaxed, and their chambers are again filling with blood.
 Early diastole. At the end of systole, the ventricles relax, the semilunar valves snap
shut, and for a moment the ventricles are completely closed chambers; the
intraventricular pressure drops and the AV valves are forced open; the ventricles
again begin refilling rapidly with blood, completing the cycle.
 First heart sound. The first heart sound, “lub”, is caused by the closing of the AV
valves.
  Second heart sound. The second heart sound, “dub”, occurs when the semilunar
valves close at the end of systole.

Cardiac Output

Cardiac output is the amount of blood pumped out by each side of the heart in one minute. It
is the product of the heart rate and the stroke volume.

 Stroke volume. Stroke volume is the volume of blood pumped out by a ventricle with

each heartbeat.
 Regulation of stroke volume. According to Starling’s law of the heart, the critical
factor controlling stroke volume is how much the cardiac muscle cells are stretched
just before they contract; the more they are stretched, the stronger the contraction
will be; and anything that increases the volume or speed of venous return also
increases stroke volume and force of contraction.
Blood Circulation Through the Heart

The right and left sides of the heart work together in achieving a smooth flowing blood
circulation.

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Entrance to the heart. Blood enters the heart through two large veins, the inferior and
superior vena cava, emptying oxygen-poor blood from the body into the right atrium
of the heart.
 Atrial contraction. As the atrium contracts, blood flows from the right atrium to the
right ventricle through the open tricuspid valve.
 Closure of the tricuspid valve. When the ventricle is full, the tricuspid valve shuts to
prevent blood from flowing backward into the atria while the ventricle contracts.
 Ventricle contraction. As the ventricle contracts, blood leaves the heart through the
pulmonic valve, into the pulmonary artery and to the lungs where it is oxygenated.
 Oxygen-rich blood circulates. The pulmonary vein empties oxygen-rich blood from
the lungs into the left atrium of the heart.
 Opening of the mitral valve. As the atrium contracts, blood flows from your left
atrium into your left ventricle through the open mitral valve.
 Prevention of backflow. When the ventricle is full, the mitral valve shuts. This
prevents blood from flowing backward into the atrium while the ventricle contracts.
 Blood flow to systemic circulation. As the ventricle contracts, blood leaves the heart
through the aortic valve.
Some common heart disease and its investigation

Heart disease describes a range of conditions that affect your heart. Heart diseases include
 Blood vessel disease, such as coronary artery disease
 Heart rhythm problems (arrhythmias)
 Heart defects you're born with (congenital heart defects)
 Heart valve disease
 Disease of the heart muscle
 Heart infection

Investigations:

 Electrocardiogram (ECG or EKG). An ECG is a quick and painless test that

records the electrical signals in your heart. It can spot abnormal heart rhythms. You
may have an ECG while you're at rest or while exercising (stress electrocardiogram).
 Holter monitoring. A Holter monitor is a portable ECG device you wear to
continuously record your heart rhythm, usually for 24 to 72 hours. Holter monitoring
is used to detect heart rhythm problems that aren't found during a regular ECG exam.
 Echocardiogram. This non-invasive exam uses sound waves to produce detailed
images of your heart's structure. It shows how your heart beats and pumps blood.
 Stress test. This type of test involves raising your heart rate with exercise or medicine
while performing heart tests and imaging to check how your heart responds.

 Cardiac catheterization. In this test, a short tube (sheath) is inserted into a vein or
artery in your leg (groin) or arm. A hollow, flexible and longer tube (guide catheter) is
then inserted into the sheath. Using X-ray images on a monitor as a guide, your doctor
carefully threads the catheter through the artery until it reaches your heart.

During cardiac catheterization, the pressures in your heart chambers can be measured,
and dye can be injected. The dye can be seen on an X-ray, which helps your doctor
see the blood flow through your heart, blood vessels and valves to check for
problems.

 Cardiac computerized tomography (CT) scan. In a cardiac CT scan, you lie on a

table inside a doughnut-shaped machine. An X-ray tube inside the machine rotates
around your body and collects images of your heart and chest.
 Cardiac magnetic resonance imaging (MRI). A cardiac MRI uses a magnetic field
and computer-generated radio waves to create detailed images of your heart.
 Pathological test:
 Lipid profile
 C reactive protein
 Plasma ceramides
 Natriuretic peptides
  Troponin T

Conclusion
The human heart is one of the most important organs responsible for sustaining life.
The human heart functions throughout a person’s lifespan. By knowing anatomy and
physiology of normal heart health personnel can understand abnormal condition and can
prevent any heart disease.
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Bibliography

 Chaurasia BD,8th edition,Cbs publisher,2020,Human Anatomy,Edition 1,201-205

 Ross& Wilson,13th edition,2018, Anatomy and physiology in health and illness, ELSEVIER,110-120
 Cardiovascular System Anatomy and Physiology, MARIANNE BELLEZA, R.N., 2021, Nurses Lab
 Module 1: Anatomy and Physiology of the Heart Page 10
 Developed by Tony Curran (Clinical Nurse Educator) and Gill Sheppard (Clinical Nurse Specialist)
Cardiology (October 2011)