Dont worry about failures,

worry about the chances you

miss when you dont even
try.
[PHYSIOLOGY
LECTURE DR. MANALO]
THE HEART

15, 2013

SA node- fires at a rate of 60-100 bpm

(normal heart rate)

Heart-pumps 35 million times/year

MVo2 (Myocardial Oxygen Consumption)
3 phasic parameters:
1. Heart Rate
2. Contractility
3. Wall Tension
* stiffness, contraction, heart
rate= Oxygen Consumption
*slower heart rate = longer life span
Physical strenuous activity = gradually makes
heart rate slower
HEART VALVES (4):
(2) AV (atrioventricular) valves:
1. Mitral/Bicuspid - located between the
LEFT atrium and the LEFT ventricle; has 2
leaflets/cusps
2. Tricuspid- between the RIGHT atrium and
the RIGHT ventricle; has 3 leaflets/cusps

ATRIAL
CHAMBERS (PRIMER
PUMPS) - thinner wall and translucent
VENTRICULAR (BOOSTER PUMPS) - MORE
IMPORTANT, thicker wall and more muscular

(2) Semilunar valves:

1. Aortic - located in the aorta; valve that
protects the aorta and assures a good
cardiac output
2. Pulmonic - guards the pulmonary artery
(one of the 2 arteries that carries
unoxygenated blood); located at the right
side of the heart

LEFT SIDE of the heart- OXYGENATED blood

- PRESSURE ADAPTED CHAMBERS
- thicker chambers (3x thicker)
(AV septum part of Left ventricle)
RIGHT SIDE of the heart- UNOXYGENATED
blood
- VOLUME ADAPTED CHAMBERS
- bigger chambers

CARDIAC CYCLE:
S1- coincides with the carotid pulse; lubb
- represents the closure of the AV valves
(should open up silently; otherwise
abnormal)

4 INTRINSIC PROPERTIES OF THE HEART:

1. Conductivity- ability to conduct
electrical impulses to the entire
structure of the heart
2. Automaticity- no need for impulse;
ability to spontaneously fire and
depolarize; different from the skeletal
muscles
3. Rhythmicity- ability to depolarize at a
fixed rate (via the SA node)
4. Excitability- ability to depolarize on
its own

S2- represents the closure of the

Semilunar valves
- during inspiration-split into:
a. aortic component
b. pulmonic component
*split happens due to the delayed closure
of the pulmonic valve due to an in the
negativity of thoracic pressure causing a in
venous return to the right side of the heart
(normal)

*Phase 4: curvilinear, reaches threshold

(peaks)
Phase 0: depolarization

S1-S2 (SYSTOLIC TIME) - shorter

S2- next S1 (DIASTOLIC TIME) - wider
1

Dont worry about failures,

worry about the chances you
miss when you dont even
try.
[PHYSIOLOGY
LECTURE DR. MANALO]

15, 2013

*SYSTOLE AND DIASTOLE- determines

ventricular pace/activity
ventricular diastole- favorably wider to
assure the filling up of the ventricles and
improved coronary blood flow; better
stroke volume; Cardiac Output; coronary
artery perfusion
- coronary arteries are filled up to supply
blood to the heart muscle

1. 2 ear
pieces
2. Tubing25
inches
in
length
3. Chest
piece-

*Angina Pectoris- diastolic time, filling up

= ISCHEMIA
*Tachycardia- constant systolic time,
shortened diastolic time, blood flow,
coronary perfusion
* Cardiac drugs- slow down the heart rate,
Oxygen Consumption, coronary perfusion

consisting of a bell and a diaphragm

BELL- conical segment; used to detect low
pitch sounds
-should be applied to the chest wall
lightly
*pressing hard produces the diaphragm
effect- tension, makes skin taut; cuts off
low pitch sounds leading to abnormal
sounds/results

Conditions that affect the heart valves: (most

common to most rare)
1. MITRAL
2. AORTIC
3. TRICUSPID
4. PULMONIC

DIAPHRAGM- flattened segment; used to

detect high pitch sounds
-should be applied with pressure to
the chest wall
* pressure produces the double
diaphragm effect- intensifies high pitch
sounds

*Rheumatic Heart Disease- may be mitral,

aortic, or both
AUSCULTATION: to be able to hear cardiac
events
- Only maneuver to appreciate heart
sounds
1. Direct- first and most primitive
maneuver; used by Egyptians; use
ears to hear heart sounds directly on
the chest wall
2. Indirect- use of a stethoscope
(introduced by a French physician:
Rene Laennec)

*Most important part is in between the 2 ear

pieces
HEART SOUNDS:
1. Transients
a. S1
b. S2
normal/abnor
c. S3
d. S4
e. CLICKS- common in tall and slim
females (8 females: 1 male)=
MITRAL VALVE PROLAPSE
(MVP)/Barlows Syndrome:
- pathognomonic Sign: MidSystolic Click (lub-click-dub)
which becomes louder on lateral
recumbent position
- NORMAL, mitral valve is large
causing palpitations
* palpitations - least important symptom;
conscious awareness of your heart beat

STETHOSCOPE: parts:

Dont worry about failures,

worry about the chances you
miss when you dont even
try.
[PHYSIOLOGY
LECTURE DR. MANALO]
f.

OPENING SNAPS- ABNORMAL MITRAL STENOSIS

15, 2013

4. S4- due to Atrial Contraction/Atrial

Kick
* 85% of the ventricle is filled with blood;
atrial contraction is required to push
blood inside from the atrium towards the
ventricles to achieve 100% filling

NORMAL HEART SOUNDS: (4)

1. S1- CLOSURE of the AV valve
-semilunar valve slightly opens
* as myocardium contracts, ejects
blood out, closure of the semilunar
valve

* S3+S4= normal until age 18; >18 y/o=

abnormal; gallop; may indicate HEART
FAILURE

2. S2- CLOSURE of the Semilunar valve

- AV silently opens
3. S3- sound of blood hitting the ventricle
due to pressure gradient of the
atrium and the ventricle (PHASE OF
RAPID FILLING OF THE VENTRICLE)
*rapid ventricular filling- blood flow,
volume, pressure

Note takers:
Albon, Irish
Belmes, Stefanie
Banizal, Sigrid