Heart -larger in physically active adults ; decrease size after age 65

- a muscular organ that essential for life because it pumps • Location

blood through the body
- located in thoracic cavity between two pleural cavities
- member organ of cardiovascular system which is consist of surround lungs
heart, blood vessels, and blood.
• Orientation
- the heart of a healthy adult, at rest, pumpd approximately 5 L
- apex - blunt, rounded point of the heart
of blood per minute
- base - larger, flat part opposite end of the heart
Picture
-apex (bottom) toward left side
-heart lies oblique in the mediastinum; base directed posterior
and slightly superiorly ; apex directed anteriorly and slightly
inferiorly ; apex directed to the left - 2/3 of heart mass lies at
the left of the midline of sternum ; base of the heart is located
deep to the sternum and extends to level of the intercostal
slace ; apex is deep to the left fifth intercostal space (7-9cm) to
left of the sternum near clavicular line, perpendicular line that
extends down from a a middle of the clavicle

mediastinum - heart, trachea and esophagus and the

associated structure in midline partition
pericardial cavity - spaces around heart

Cardiovascular system
-the heart is two pumps in one, the right side pumping to lungs Cardiopulmonary resuscitation (CPR)
and back to the left side of the heart through vessels to - an emergency procedure that maintains blood flow in the
pulmonary circulation body if a persons heart stops
-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 of
tge systemic circulation

Picture

Anatomy of the heart

-heart lies in pericardial cavity

Functions of heart • Pericardium

• Generates blood pressure -double layered sac that anchors the heart and protects the
heart ; consist of two layers
• Routing blood
- fibrous pericardium - outer layer is tough, fibrous connective
• Ensures one-way blood flow tissue
• Regulates blood supply -serous pericardium - inner layer consist of flat epithelial cells
Characteristic of Heart with a thin layer of connective tissue

• Size • Parietal Pericardium

-size of a fist and weighs less than 1 lb ; shapedlike blunt cone - part lining of the fibrous pericardium
-membrane around heart cavity
• Visceral pericardium
-membrane on hearts surface ; part covering the heart surface
• Pericardial cavity
-spaces between heart filled with thin layer of pericardial fluid
• Pericardial Fluid
- produced by serous pericardium ; helps reduce friction as the
heart moves with pericardium

Heart Chambers and Internal Anatomy

• Four Chambers
-Left atrium (LA)
-Right atrium (RA)
-Left Ventricle (LV)
-Right Ventricle (RV)
External Heart Anatomy
• Coronary sulcus
• right and left atria are located at the base of heart
-separate atria from ventricles
• right and left ventricle extend from base of the heart toward
apex
• The Atria
• Coronary sulcus - extends around the heart, separating the
atria from the ventricles ; two grooves or sulci indiciate the - blood enters the atria of the heart through veins
divisuon between right and left ventricles, extend inferiorly from
coronary sulcus. - its function as the reservoirs, where vlood returning from
veins collects before it enters the ventricles
• Anterior interventricular sulcus - extends inferiorly from sulcus
on the anterior surface of the heart -small, thin walled

• Posterior interventricular sulcus - extends inferiorly from the -it contracts minimally to push blood into ventricles
coronary sulcus on thr posterior surface of the heart. -superior chamber ; holding chamber
• Superior and inferior vena cava - carry blood from the body to
the right atrium
Right atrium
• Pulmonary veins carry blood from the lungs to the left atrium
-receive blood from superior vena cava, inferior vena cava,
• Great vessels or great arteries (two arteries) - carry blood coronary sinus
away from the ventricles of the heart
Superior vena cava / inferior vena cava - drains blood from
• Pulmonary trunk - arising from right ventricle, splits into the most of the body.
right and left pulmonary arteries, which carry blood to the
lungs. Left atrium

• Aorta - arising from left ventricle, carries blood to the rest of -receive blood through 4 pulmonary veins, drains blood from
the body lungs

Pictures Interatrial septum - a partition where two atria are seperated

from each other

• The Ventricles
-inferior chamber; pumping chamber; thick, strong walled
-contractd forcefully to propel blood out of the heart
-eject blood into the arteries and force it to flow through
circulatory system
-atria open ventricles and each ventricle has one large outflow -have three half-moon shaped cusps and are valves between
route pulmonary trunk and aorta
Right ventricle
-pumps blood into the pulmonary trunk Pulmonary Semilunar Valve
Left ventricle -located between RV and pulmonary trunk
-pumps blood into the aorta
Aortic Semilunar Valve
Interventricular septum - separate the left and right ventricles -located between LV and aorta

Pictures

Heart Valves
-one way flow of blood through the heart chambers is
maintaine by heart valves
-two types: atrioventricular & semilunar valves
1. Atrioventricular (AV) valve
-located between each atrium and ventricle
-allow blood flow from atria into ventricles but prevent it from
Cardiac skeleton or Fibrous skeleton
flowing back to the atria
-plate of connective tissue, consist of mainly fibrous rings that
Tricuspid Valve
surroundnthe atrioventricular and semilunar valves and give
-the AV valve between RA and RV ; has 3 cusps them solid support
Bicuspid Valve or Mitral Valve -serves as electrical insulation between atria and ventricles
and provides a rigid attachment site for cardiac muscle
-the AV valve between LA and LV ; has two cusps
-resembles bishops miter, two pointed hat
Picture

Valvular Control
• Papillary muscle - cone-shaped, muscular pillars that
ventricle contains
• Chordae tendineae - strong, connective tissue strings
attached to thr papillary muscles to the free margins of cusps
of the AV valves
• When ventricles contracts the papillary muscle contract and
preveny valves from opening into tge atria by pulling on the
chordae tendineae attachrd to the valve cusps

2. Semilunar Valve
- located between each ventricle and associated with great
artery
Blood Flow Left marginal artery - extends inferiorly along lateral wall of the
left ventricle from circumflec artery
1. Right Atrium (RA)
2. Tricuspid Valve
• Right coronary artery
3. Right Ventricle (RV)
-originates on right side of aorta
4. Pulmonary semilunar valve
-supply blood to right ventricle
5. Pulmonary trunk
6. Pulmonary arteries
Right marginal artery - extends inferiorly along lateral wall of
7. Lungs
right ventricle
8. Pulmonary veins
9. Left Atrium (LA) • Cardiac Veins
10. Bicuspid Valve
-drain blood from cardiac muscle
11. Left Ventricle (LV)
-parallrl to coronary arteries
12. Aortic Semilunar Valve
-mostly drain blood into the coronary sinus - large vein located
13. Aorta within the coronary sulcus on posterior aspect of heart

14. Body -blood flows from coronary sinus to right atrium

Figure Pictures

Heart Wall
-composed of 3 layers of tissue

• Epicardium / visceral pericardium

-a thin, serous membrane forming the outer surface

Blood supply to the Heart -outer surface of heart

• Coronary Arteries -consist of squamos epithelium overlying a layer of connective

tissue and adipose tissue
-supplies blood to heart wall
• Myocardium
-originate from base of aorta (above semilunar valve)
-a thick, middle layer composed of cardiac muscle
• Left Coronary artery
-responsible for contraction of heart chambers
-originates on left side of aorta
• Endocardium
-has three branches: anterior interventricular artery, circumflex
artery, left marginal artery -smooth, inner surface of heart chamber ; consist of simple
squamoud epithelium over a layer of connective tissue
-responsible for allowing blood to move easily to heart
Anterior interventricular artery - lies at anterior interventricular
sulcus
Circumflex artery - extends around the coronary sulcus on the Trabeculae carneae - ridges and column of cardiac muscle
left of the posterior surface of the heart that modified the surfaces of interior salls of ventricles

Picture
Cardiac Muscle
-elongated, branching cells that contain one or two, centrally
located nuclei
- contain actin and myosin myofilaments responsible for
muscle contraction (striated)
-rich in mitochondria
-Ca 2+ and ATP used for contractions
Intercalated disks
-connect cells ; cell-to-cell contacts
Gap junction
-specialized membrane in intercalated disk
Electrical Activity of Heart
• Action Potential of Cardiac Muscle
-exhibit depolarization and repolarization
-approx. 200 to 500 ms to complete
-can spread from one cell to adjacent cell through gap junction
at intercalated disks.
Pacemaker potential - are responsible for producing action
potential when changes in membrane channels permeability
happens
1. Depolarization phase
-Na+ channels open, increase permeability of cell membrane
Na+ ; can diffuse to cell ; stimulate opening of Ca channel
-Ca2+ channels open ; begins diffusing unto cell ;
2. Plateau Phase
-Na+ channel close
-Some K+ channels open
-Ca2+ channels remain open
-Plateau phase prolongs action potential by keeping Ca2+
channels open.
3. Repolarization
-K+ channels are open
-Ca2+ channels close
Refractory period - exhibit by action potentials in cardiac
muscle ; ensures a rhythm of contraction and relaxation for
cardiac muscle.
Picture
• Conduction System of the Heart
-contraction of atria and ventricles is coordinated by
specialized cardiac muscle in the heart wall
-can produce spontaneous action potentials
-includes sinoatrial node, atrioventricular node, atrioventicular
bundle, right and left bundle branches, Purkinje fibers
> Sinoatrial Node (SA Node)
- function as heart's pacemaker ; located in the superior wall of
right atrium and initiate the contraction of the heart
-action potential originate here
-produce action potentials at a faster rate than othrr areas of
the heart and has large number of Ca2+ channels
>Atrioventricular Node (AV Node)
-located lower portiin of the right atrium
-action potentials from SA node sent to this node ; action >P wave
potential spread slowly through it
-from depolarization of atrial myocardium
-slow rate of action potential conduction allows the atria to
>QRS Complex
complete their contraction before action potentials are
delivered to the ventricles -from depolarization of ventricles
>Antrioventicular bundles -consist of Q, R, S waves
- bundle of specialized cardiac muscle >T wave
-action potentials from AV node travel to AV bundle ; divides -represents repolarization of ventricles
left and right bundle branches
>Purkinje Fibers
Figures
-at the tips of the left and right bundle branches
-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 ventricle

Action potentials path through heart

1. SA Node
2. AV Node
3. AV Bundle
4. Right and Left Bundle branches
5 Purkinje Fibers

Pictures

Ectopic beat - when action potentials originate in an area of the

heart other than the SA Node
Fibrillation - when ectopic beats may cause very small portion
of the heart to contract rapidly and independently of all other
areas; reduces the output of the heart to only a few milliliters of
blood per minute when it occurs in the ventricles.

Electrocardiograph (ECG or EKG)

-record of electrical events in heart
-can diagnose cardiac abnormalities
-uses electrodes ; placed on the body surface and attached to
a recordung device can detect the small electrical changes
-it contains P wave, QRS Complex, T wave
• Cardiac Cycle
-repititive pumping process that begins with the onset of
cardiac muscle contraction
-summative description of all events that occurr during one
single heartbeat
-heart is two sided pump, with the atria being primers for pumls
and the ventricles being the actual pumps
-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
1. Atrial Systole
-contraction of atria, forcing additional bloof to glow into the
ventricles ro complete their filling. Semilunar valve remains
closed.
2. Ventricular Systole
-contraction of ventricles pushes blood toward the atria,
causing the AV valves to close as the pressure begins to
increase
-increasing pressure in the ventricled exceeds the prrssure in
the pulmonary trunk and aorta, demilunar valvrs are forced
open and blood is ejected into the pulmonary trunk and aorta
3. Atrial diastole
- relaxation of atria
4. Ventricular Diastole
-relaxation of ventricles
-pressyre in the ventricles decreases below the pressure
ofnthe aorta and pulmonary trunk. Semilunar valves closes
and prevent blood from flowing back into the ventricles.
Pictures
• Heart Sounds
-produce due to closure of heart valves
-Stethoscope - used to heart heart sounds
-Lubb sound - first heart sound makes ; due to closure of
atrioventricular valves
-Dupp sound - second heart sound makes ; due to the closure
of semilunar valves
Regulation of Heart Function
• Cardiac output (CO) -volume of blood pumped by either
ventricle of the heart each minute
• Stroke Volume (SV) - volume of blood pumped per ventriclr
each time the heart contracts ; 70 milliliters/beat
• Heart Rate (HR) - number of heart beat in 1 min ; 72
beats/min
Cadiac Output
-volume of blood pumpes by a ventricle in 1 min
-5 liters/min
-cardiac output equals stroke voluke multiplied times heart rate
| CO = SV × HR
Intrinsic Regulation of Heart
• Intrinsic Regulation -refers to the mechanism contained within
the heart itself that control cardiac output
• Preload - degree ventricular walls are stretched at end of
diastole
• Venous return - amount of blood that returns to the heart ; if
venous return increases, heart fills to a greater volume and
stretches the cardiac muscle fibers, producing an increased
preload.
• Starlings Law of the Heart - relationship between preload and
stroke volume ; influences cardiac output ; ex: exercise
increases venous return, preload, stroke volume, cardiac
outout
• After load - pressure against which thr ventricled must pump
blood.
Extrinsic Regulation of the Heart
- refers to mechanism external to the heart, such as
nervousbor chemicak regulation
• Baroreceptor Reflex : Nervous Regulation
-mechanism of the nervous system, plays an important role in
regulating heart function
- Baroreceptor -stretch receptor that monitor blood pressure in
the aorta and wall of the internal carotid arteries which carry
blood to the brain ; involves medulla oblongata
Figure

• Chemoreceptor Reflex : Chemical Regulation

-involves chemical regulation of the heart
-chemicals can affect heart rate and stroke volume
Chemical actions
-epinephrine and norepinephrine from the adrenal medulla can
increase heart rate and stroke volyme
-excitement, anxiety, anger can increase cardiac output
-depression can decrease cardiac output
-medulla oblongata has chemoreceptor for changes in pH and
CO2
-K+ Ca2+, Na+ affect cardiac function

Figures

Heart Disease
• Coronary Artert Disease - due to decrease blood supply to
the heart ; narrowed for some reason
• Myocardial Infarction (Heart attack) - due to closure of one or
more coronary arteries ; areas of cardial muscle lacking
adequate blood supply die and scars (infarct)
Heart Procedure
• Angioplasty - procedures when blocked blood vessels
• Stent - structures inserted to keep vessels open
• Bypass - procedure reroutes blood away from blocked
arteries