Heart
- a hollow, vaguely cone-shaped, and only
weighs about 250 to 350 grams
Location:
- rest on the diaphragm mediastinum
cavity between lungs.
- Oblique position with apex lying left to
the midline
Heart orientation
 Apex directed anteriorly, inferiorly and to
the left
 Base directed posteriorly, superiorly and to
the right
 Anterior surface deep to the sternum and
ribs
 Inferior surface rest on diaphragm
 Right border faces right lung
 Left border (pulmo border) faces left lung’
structures of the heart
Pericardium
 (peri=around); protective sac of connective
tissue
 surrounding the heart; confines it to
mediastinum
 2 parts:
i. the fibrous pericardium- tough
outer layer thin inelastic, dense
irregular connective tissue.
Anchors heart to mediastinum
ii. the serous pericardium- thinner,
more delicate divided into
a. parietal
b. visceral
o pericardial cavity- between
parietal and visceral layers
Walls of the heart:
1) Epicardium
- Epi = upon/above
- Outermost; fat to cushion heart
- Visceral layer of serous pericardium.
- Composed of mesothelium & delicate
connective tissue
2) Myocardium
 myo = muscle
 middle layer; primarily cardiac muscle
 contractility/pumping
 blood supply comes from coronary arteries
 myocardium of left ventricles are thicker
cardiac bundles of myocardium:
function to squeeze blood through
heart in the proper directions
 inferior through the atria
 superiorly through ventricles

3) Endocardium
 Endo = inner
 Stretches as heart pumps
Fibrous skeleton of heart
 Dense ct rings surround the valves, fuse
and merge with iv septum
 Supports structure for heart valves
 Insertion point for cardiac muscle bundles
 Electrical insulator betweeb atria and
ventricle to prevent direct propagation of
ap’s to ventricles
sulci of the heart
External boundaries are marked by 2 Series of
groves on the surface of heart called sulci
contain fat and coronary blood vessel
a) Coronary sulcus
Encircles heart and mark boundary
between atria and the ventricles
b) Anterior interventricular sulcus
mark boundary between ventricles
anteriorly
c) posterior interventricular sulcus
mark boundary between ventricles
posteriorly
septum
 thin Inner partition that divides heart into 2
sides creating the 4 chambers
 interatrial septum partitions the atria
 interventricular septum partitions
ventricles
Chambers of the heart
2 superior atria (low pressure) thin walled
receiving chambers for the blood coming back
to the heart after circulating
 o right atrium
 receives blood from 3 sources (SVC, IVC
and Coronary Sinus)
o left atrium
 forms most of the base of the heart
 receives blood from lungs, 4 pulmonary
veins (2 R+ 2L)
2 inferior ventricles (high pressure) thick walled
discharging chambers that push blood back out
the heart
o right ventricle
 forms most of anterior surface of the heart
o left ventricle
 myocardium of LV is thicker than thr right
Heart valves
 Each chamber has corresponding valves.
Connected to the inner walls of the heart
by tough tendons that allows valves to
close and hold the valve flaps in place (like
arm holding a door!)
 Mnemonics: (try puling my aorta)
 2 atrioventricular valves that close at the
beginning of ventricular contraction. They
prevent blood from flowing back into the
atria
a) Tricuspid valve- right side, separates
right atrium to right ventricle
b) Mitral valve- left, separates left atrium to
left ventricle
 2 semilunar valves that prevents blood from
flowing back into ventricles during
relaxation:
c) Pulmonic semilunar valve- separates
right ventricle from pulmonary artery
d) Aortic valve= left side, separates left
ventricle from aorta
Lub dub- sounds of valve opening and closing
The blood circulatory system
 delivers nutrients and oxygen to all cells in
the body. It consists of the heart and the
blood vessels running through the entire
body.
Blood vessels:
 Arteries
 carry blood away from the heart to tissues
of body
 large vessel carrying oxygen rich blood,
with exception of pulmonary arteries
 thick walled need to withstand pressure
produced when heart pushes blood into
them
 Veins
 carry it back to heart
 From capillary system blood returned to
heart via veins
 Largest vein contains one way valves that
keep blood flowing to the heart
(3 layers of artery/veins: The outer layer is tunica
Externa, the middle layer—called tunica media—
is muscle and fiber. The innermost layer, tunica
intima, is the one that comes in direct contact
with blood)
 Capillaries
 link arterioles to veins.
 Smallest blood vessel
 Important for bringing nutrients and
oxygen to tissues and absorbing co2 and
other waste products
There are 2 blood circulatory system in the
human body which are connected:
1) The systemic circulation
 provides organs, tissues and cells with
blood so that they get oxygen and other
vital substances.
 blood flows from the heart to all parts of
the body and back to the heart
2) The pulmonary circulation
 where the fresh oxygen we breathe in
enters the blood. At the same time, carbon
dioxide is released from the blood.
 blood flows from the heart to the lungs and
back to the heart
There are 14 steps in a circle of blood for easy Cardiac output calculation
illustration: Co = sv x hr
Ml/min ml/beat beats/min
1. Superior/ Inferior Vena Cava  Cardiac output is normally 5l/min and is
2. (deoxygenated blood) right atrium determined by multiplying the hr by sv
3. Tricuspid valve  Co- Cardiac output: amount blood pumped
4. right ventricle by ventricles in 1 min
5. pulmonary valve  Sv- stroke volume: amount of blood
6. pulmonic artery pumped out of a ventrical during each
7. (oxygenated blood) lungs contraction
8. pulmonary veins  Hr- heart rate: number of beats per min.
9. left atrium Control of cardiac output
10. mitral valve Factors affecting stroke volume
11. left ventricle  Preload
12. aortic valve - Volume of blood inn ventricles at the
13. aorta and coronary arteries end of diastole (end diastolic pressure)
14. body Increased in:
15. back to heart via vena cava Hypovolemia
Regurgitation of cardiac valves
Heart failure
Conduction system  Afterload
The heartbeat is generated by cardiac - Resistance left ventricle must overcome
conduction to force blood out of the heart and to circulate blood
to the rest of the body. - Increased in: hypertension,
1) Sinoatrial (sa) node vasoconstriction
2) Atrioventricular (av) node - Increased afterload = increased cardiac
3) Bundle of his workload
4) L and R bundle branch  Contractility
5) Purkinje fibers - Amount of force generated by
myocardium to eject blood into
Heart sounds circulation. Ventricular compliance and
 Each valve sound is best heard in diff. filling pressure affect the stroke volume
corners Increasing cardiac output
 Pulmo. Valve= superior left  Incre. Preload- blood returning to right
 Aortic valve= superior right atrium
 Mitral (bicuspid) = apex  Inre. Contractility
 Tricuspid= inferior right  Decre. Afterload- pressure heart pump
Co-ordination of the heartbeat against
 One complete sequence of contraction and Factors affecting heart rate
relaxation is called heartbeat  Hr affects co by causing a decrease or
 Lub is a softer sound of atria contracting increase in stroke volume
 Dub is louder sound of ventricles  Controlled by baroreceptors in aortic arch
contracting which are sensitive to changes in bp
 Parasympathetic ns stimulation= slow hr
 sympathetic ns stimulation= increase hr