Chapter 15

The Cardiovascular System: The Heart

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Location of the Heart

Thoracic cavity between two lungs

~2/3 to left of midline

surrounded by pericardium: Fibrous pericardium

Inelastic and anchors heart in place

Inside is serous pericardium - double layer around heart

Parietal layer fused to fibrous pericardium Inner visceral layer adheres tightly to heart Filled with pericardial fluid - reduces friction during beat.
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Position of the Heart

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Position of the Heart

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Heart Wall

Epicardium - outer layer Myocardium - cardiac muscle

Two separate networks via gap junctions in intercalated discs - atrial & ventricular Networks- contract as a unit lines inside of myocardium

Endocardium - Squamous epithelium

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Pericardium

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Cardiac Muscle Fibers

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Cardiac Muscle Tissue

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Chambers of the Heart

4 chambers 2 upper chambers = Atria

Between is interatrial septum Contains fossa ovalis - remnant of foramen ovalis Between is interventricular septum Atria thinnest Right ventricle pumps to lungs & thinner than left
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2 lower chambers = ventricles

Wall thickness depends on work load

Structure of the Heart

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Structure of the Heart

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Structure of the Heart

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Great Vessels Of Heart-Right

Superior & inferior Vena Cavae Delivers deoxygenated blood to R. atrium from body Coronary sinus drains heart muscle veins R. Atrium R. Ventricle pumps through Pulmonary Trunk R & L pulmonary arteries lungs

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Great Vessels Of Heart-Left

Pulmonary Veins from lungs

oxygenated blood

L. atrium Left ventricle ascending aorta body Between pulmonary trunk & aortic arch is ligamentum arteriosum fetal ductus arteriosum remnant

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Posterior View of Heart

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Anterior View of Frontal Section

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Valves

Designed to prevent back flow in response to pressure changes Atrioventricular (AV) valves

Between atria and ventricles

Right = tricuspid valve (3 cusps) Left = bicuspid or mitral valve Semilunar valves near origin of aorta & pulmonary trunk Aortic & pulmonary valves respectively
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Atrioventricular Valves: Bicuspid Valves

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Atrioventricular Valves: Superior View

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Blood Flow Through Heart

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Blood Flow

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Blood Supply Of Heart

Blood flow through vessels in myocardium = coronary circulation Left & right coronary arteries

branch from aorta branch to carry blood throughout muscle

Deoxygenated blood collected by coronary sinus (posterior) Empties into right atrium

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Conduction System

1% of cardiac muscle generate action potentials= Pacemaker & Conduction system Normally begins at sinoatrial (SA) node Atria & atria contract AV node - slows AV bundle (Bundle of His) bundle branches Purkinje fibers apex and up- then ventricles contract
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Pacemaker

Depolarize spontaneously sinoatrial node ~100times /min also AV node ~40-60 times/min in ventricle ~20-35 /min Fastest one run runs the heart = pacemaker Normally the sinoatrial node

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Frontal plane

Left atrium Right Right atrium atrium 1 SINOATRIAL (SA) NODE 2 ATRIOVENTRICULAR (AV) NODE 3 ATRIOVENTRICULAR (AV) BUNDLE (BUNDLE OF HIS) 4 RIGHT AND LEFT BUNDLE BRANCHES Right Right ventricle ventricle 5 PURKINJE FIBERS
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Left ventricle

Electrocardiogram

Recording of currents from cardiac conduction on skin = electrocardiogram (EKG or ECG) P wave = atrial depolarization

Contraction begins right after peak Repolarization is masked in QRS

Contraction of ventricle

QRS complex = Ventricular depolarization

T-wave = ventricular repolarization

Just after ventricles relax

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ECG

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Cardiac Cycle

after T-wave ventricular diastole

Ventricular pressure drops below atrial & AV valves open ventricular filling occurs Finishes filling ventricle (`25%)
Pressure pushes AV valves closed Pushes semilunar valves open and ejection occurs Ejection until ventricle relaxes enough for arterial pressure to close semilunar valves
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After P-wave atrial systole

After QRS ventricular systole

Action Potential

Review muscle Heart has addition of External Ca2+ Creates a plateau Prolonged depolarized period Can not go into tetanus

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Cardiac Cycle

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Flow Terms

Cardiac Output (CO) = liters/min pumped Heart Rate (HR) = beats/minute (bpm) Stroke volume (SV) = volume/beat CO = HR x SV

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Controls - Stroke Volume (S.V.)

Degree of stretch = Frank-Starling law

Increase diastolic Volume increases strength of contraction increased S.V. Increased venous return increased S.V.

increased sympathetic activity High back pressure in artery decreased S.V.

Slows semilunar valve opening

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Controls- Heart Rate

Pacemaker adjusted by nerves

Cardiovascular center in Medulla

Via vagus nerve

parasympathetic- ACh slows

Sympathetic - norepinephrine speeds Sensory input for control:

baroreceptors (aortic arch & carotid sinus)B.P. Chemoreceptors- O2, CO2, pH

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Other Controls

Hormones: Epinephrine & norepinephrine increase H.R. Thyroid hormones stimulate H.R. Called tachycardia Ions + + Increased Na or K decrease H.R. & contraction force Increased Ca2+ increases H.R. & contraction force
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Autonomic Nervous System Regulation of Heart Rate

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Exercise and the Heart

Aerobic exercise (longer than 20 min) strengthens cardiovascular system Well trained athlete doubles maximum C.O. Resting C.O. about the same but resting H.R. decreased

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End of Chapter 15
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