o

- B 5

Chapter 18 T
The Cardiovascular System: The Heart
Heart Location
• Approximately the size of adult fist
• Located on the superior surface of diaphragm, left of the midline, anterior to
the vertebral column and posterior to the sternum

Heart Covering
• Enclosed and held by pericardium
• Pericardium has 2 parts
o Fibrous pericardium
▪ Outer thicker layer of fibrous tissue
o Serous pericardium
▪ Inner layer of thin, delicate tissue
▪ Divided into parietal (outer) and visceral (inner) layers
▪ The space between the parietal and visceral layers is the
pericardial cavity that contains pericardial fluid
*GAP JUNCTION :

Microscopic Heart Muscle Anatomy wider

• Cardiac muscles are striated, short, fat, branched, and interconnected
• Connective tissue endomysium acts as both tendon and insertion
-

• Intercalated discs connect cardiac cells together and allow free passage of
GAP - ions (calcium to allow for contraction)
• Entire heart muscle behaves as a single unit (called functional syncytium)

(CalcineSection)
JUNCT A CARDIAC MUSCLES BRANCH OUT
Cardiac Muscle Contraction
• Heart muscle are stimulated by nerves and they are also self-excitable
(automaticity) (SA + AV Nodes)
• Muscles contracts as a unit
• Cardiac muscle contraction is similar to skeletal muscle contraction
Calcium needed , activ + mosin fillments cance
Heart Wall contractor (sliding
• Two layers of tissues
o Myocardium
▪ Cardiac muscle
▪ Many layers, involuntary
o Endocardium (inside the heart)
 ▪ Thin layer of fibrous connective tissues
▪ Lines heart muscles and heart valves S

did
to mitiga
ate
pericardialcrity
I

(Outer)

(within)
(Abore)

↑
-

-inferior
Heart Chambers Cardin
a Superior -
• Heart has 4 chambers – Rt. atrium, Lt. atrium, Rt. ventricle and Lt. ventricle
• Two atria are separated by interatrial septum
• Two ventricles are separated by interventricular septum
Left :
o
oxygenated
Right De-oxygenated
:
• Ventricular wall is thicker than the atrial wall
• Lt. ventricular wall is thicker than the Rt. ventricular wall Blood
• Pectinate muscles – comb like muscle projections on the inner wall of the
atria that provide rigidity to the atrial wall
(tiny) values to
• Papillary muscles – finger like muscle projections inside the ventricles Asupportclose very
• Trabeculae carneae – irregular muscular columns projected from the inner lightlyblood
to

surface of the right ventricle of the heart ↓ also left miningifthecame

prevent
I• Fossatovalis is an oval depression on the septal wall of the Rt. Atrium way

&
Pover ovale is an opening in the interatrial septum of the fetal heart – that
• Foramen
corresponds to the site of fossa ovalis
* Fetal heart connection between RA + It a trium
:

after the Fetal stage

A pluge
 heart
Arterie Away from the
*
:

Blood
Vains : Towards the heart

Major Vessels and Blood Flow Through the heart (7)

o Rt. Atrium receives deoxygenated blood through:
▪ Superior Vena Cava – from the upper body
D-Deoxygenated blood
only
-
▪ Inferior Vena Cava – from the lower body
▪ Coronary Sinus – from heart muscles (Deoxygenated blood from Heart
o Rt. Atrium then delivers deoxygenated blood to the Rt. Ventricle
o Rt. Ventricle delivers deoxygenated blood to the Pulmonary Trunk 4- #S
o Pulmonary Trunk is divided into Lt. and Rt. Pulmonary Arteries that
delivers blood to the Lt. and Rt. Lungs for oxygenation S

o Oxygenated blood from the lungs is delivered to the Lt. Atrium

through Pulmonary Veins G loxygenated blood into It vent )
.

o Lt. Atrium delivers oxygenated blood to the Lt. Ventricle

7
o Lt. Ventricle pumps oxygenated blood into the Aorta that is divided
into major arteries to deliver oxygenated blood to major organs
 Red Oxygenated
:

Blue Deoxygenated
:

Upper Body
Vein

semilana blo

Tod

>
- or bicuspid

&wall
M

-
-
flow of
oxy
blood from
flow of afric to
de-oxy
blood Lower Body vont
atria
from Vein
vent
.

to

Avalve is fibrous tissue Mitral & fricuspid

are
both
"
Atrioventricular
Pathway of Blood through the Heart and Lungs volves
• Right atrium → tricuspid valve → right ventricle
• Right ventricle → pulmonary semilunar valve → pulmonary arteries → lungs
• Lungs → pulmonary veins → left atrium
• Left atrium → bicuspid valve → left ventricle
• Left ventricle → aortic semilunar valve → aorta
• Aorta → systemic circulation

• Valves of the Heart

o Two Atrioventricular Valves (Tricuspid and Bicuspid/Mitral)
o Two Semilunar Valves (Aortic and Pulmonary)
o Valves have a lining of Endocardium

o Tricuspid Valve
▪ Located between the Rt. Atrium and the Rt. Ventricle
▪ Consists of 3 flaps
▪ Flaps are fibrous tissue structures that grow from heart muscles
▪ Valves are connected to the Papillary Muscles of the Rt.
ventricle by Chordae Tendineae (fibrous tissue)
▪ Chordae Tendineae and Papillary Muscles keep the valve in
functional position

o Bicuspid Valve
▪ Also known as the Mitral valve
▪ Located between the Lt. Atrium and the Lt. Ventricle
▪ Consists of 2 flaps
▪ Valves are connected to the Papillary Muscles of the Lt.
ventricle by Chordae Tendineae

o Pulmonary Semilunar Valve

▪ Located between the Rt. Ventricle and the Pulmonary Trunk
▪ Consists of 3 flaps
▪ Attached to the wall of the Pulmonary Trunk
▪ It opens inside the Pulmonary Trunk
▪ Permits deoxygenated blood to flow in one direction only

o Aortic Semilunar Valve

▪ Located between the Lt. Ventricle and the Aorta
▪ Consists of 3 flaps
▪ Attached to the wall of the Aorta
▪ It opens inside the Aorta
▪ Permits oxygenated blood to flow in one direction only
 • Blood Supply to Heart Muscles
o Oxygenated blood is supplied by Rt. and Lt. Coronary Arteries

o Lt. Coronary is divided into:

▪ Anterior Interventricular Branch – that supply blood to the wall
of the Lt. Ventricle
▪ Circumflex Branch – that supply blood to the wall of the Lt.
Atrium and Lt. Ventricle

o Rt. Coronary is divided into:

▪ Posterior Interventricular Branch – that supply blood to the wall
no
major of the Rt. Ventricle
to ▪ Marginal Branch – that supply blood to the wall of the Rt.
supply Ventricle

Rt atrium byo The wall of the Rt. Atrium receives blood supply through some minor
branches from Rt. Coronary

minerenches
3
• Blood Collection from Heart Muscles
o Deoxygenated blood is collected by Coronary Sinus
o Coronary Sinus id divided into:
▪ Great Cardiac Vein – that the anterior part of the heart wall
▪ Middle Cardiac Vein – that drains posterior part of the heart
wall

Nodes of the Heart

• Sinoatrial Node (SA Node)
o A mass of cells in the Rt Atrium under the opening of the Superior
Vena Cava
o Sends impulses to the atrial muscles for atrial contractions
o Also stimulates the AV Node
o SA is the Pace Maker because it starts the cardiac cycle
de
• Atrioventricular Node (AV Node)
o When stimulated by the SA Node, Av Node sends impulses to the
muscles of ventricles – this causes ventricular contraction
 o Impulses are sent by a bundle of nerve fibers called the Bundle of His
(Atrioventricular Bundle)

70 % of blood
atria
will cross from
to vent

product na SAnode sends

stor self
to
signal
AV afrioventricular
:

VA node
node
for
signal
ventricular
contraction
SA sino-atrial
:
node

produce signal for

atrial contraction
Al bundle bundle of HIS
:

↓ AV mode to fibers to
signals for AV contract
Cardiac Cycle vent to
.

• Cardiac cycle refers to all events associated with blood flow through the
dias tole
systole
heart When atria contract, ventricles relax
• When ventriclessystolen
diastole
contract, atria relax
• Systole is the phase of contraction
• Diastole is the phase of relaxation
• A complete cardiac cycle is the systole and diastole of the atria and the
ventricles

Atrial Systole
• 70% of atrial blood will flow to the ventricles when the atrioventricular
valves are open
• 30% of atrial blood will flow under atrial contraction

Ventriclar Filling
• Ventricles receive atrial blood
 contract
Ventricular Systole
• Atrioventricular valves close
• Ventricles start to contract -all
a
MValvloat
pressure
volume be
.

• First 0.05 sec is the Isovolumetric Contraction Period

same

• Semilunar valves open up and blood is ejected into the pulmonary trunk and
aorta – This is the ejection period (0.25 sec)
• Ventricles only pump ½ of its blood content – called stroke volume
relax
Ventricular Diastole
• Pressure drops
• Semilunar valves close
• Takes 0.05 sec
• This is the Isovolumetric Relaxation

Timing
• 75 heart beats per minute aug .

• 1 heart beat is 1 cardiac cycle

• Each cycle takes about 0.8 sec – divided into 0.1 + 0.3 + 0.4 sec

First 0.1 sec

• Atria Contract systale
• Ventricles relax diastol
• Atrioventricular valves open and semilunar valves close

Next 0.3 sec

• Ventricles contract systile
• Atria relax diastole
• Semillunar valves open
• Atrioventricular valves close

Final 0.4 sec 50 % of Car. Gale

• All chambers relax

Heart Sound
• Lubb and Dupp
 • Lubb is louder and longer than the Dupp
• Lubb is created when the atrioventricular valves close
• Dupp is created when the semilunar valves close

Cardiac Output

X • Average 5250 ml/min (5.25 L/min)

• 60 – 90 ml/heart beat

Regulation of Stroke Volume

• Stroke volume = Diastolic volume – Systolic volume
X • Diastolic volume = amount of blood collected in a ventricle during diastole
• Systolic volume = amount of blood remaining in a ventricle after contraction

Factors Affecting Stroke Volume

• Preload – amount ventricles are stretched by contained blood

E
• Contractility – cardiac cell contractile force
• Afterload – back pressure exerted by blood in the large arteries leaving the
heart

Frank-Starling Law of the Heart

• Preload, or degree of stretch, of cardiac muscle cells before they contract is
the critical factor controlling stroke volume
• Slow heartbeat and exercise increase venous return to the heart, increasing
SV
• Blood loss and extremely rapid heartbeat decrease Stroke volume, Preload
and Afterload

Factors Influencing Stroke Volume

• Increase in contractility may due to increased sympathetic stimuli caused by
certain hormones (norepinephrine), Ca2+, drugs, etc.
• Decrease in contractility may be due to acidosis, increased extracellular
calcium, calcium channel blockers, etc.

Regulation of Heart Rate

• Heart rate is controlled by Autonomic Nervous System (Sympathetic and
Parasympathetic)
• Sympathetic nervous system (SNS) stimulation is activated by stress,
anxiety, excitement, exercise, etc.
·
• Parasympathetic nervous system (PNS) stimulation is mediated by enzyme
acetylcholine
• The hormones epinephrine and thyroxine increase heart rate
• Intra- and extracellular ion concentrations must be maintained for normal
heart function

Bainbridge Reflex
• Bainbridge (atrial) reflex – a sympathetic reflex initiated by increased blood
in the atria
• Causes stimulation of the SA node
• That stimulates baroreceptors in the atria, causing increased sympathetic
stimulation

Factors Involved in Regulation of Cardiac Output

• Hypocalcemia – reduced ionic calcium depresses the heart
• Hypercalcemia – dramatically increases heart irritability and leads to
convulsive contractions
• Hypernatremia (high blood sodium level) – blocks heart contraction by
inhibiting calcium ion transport
• Hyperkalemia (high blood potassium level) – leads to heart block and
cardiac arrest
• Tachycardia – heart rate over 100 beats/min
• Bradycardia – heart rate less than 60 beats/min

Congestive Heart Failure

May caused by:
• Coronary atherosclerosis,
• Increased blood pressure in aorta
• Myocardial infarction
• Dilated cardiomyopathy (enlargement and thickening of cardiac muscle,
associated with rigidity)

Age-Related Changes Affecting the Heart

• Sclerosis and thickening of valves
• Decline in cardiac reserve
• Fibrosis of cardiac muscle
• Atherosclerosis (plaques of fatty material on the inner walls)
Electrocardiography

X
• Electrical activity is recorded by electrocardiogram (ECG)
• P wave corresponds to depolarization of SA node
• QRS complex corresponds to ventricular depolarization
• T wave corresponds to ventricular repolarization
• Atrial repolarization record is masked by the larger QRS complex

Heart stimulation is also regulated by the cardioacceleratory and cardioinhibitory

centers located in the medulla oblongata.