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The Heart
Chapter 19
Heart Anatomy
Size and Location
• About the size of the fist and weighs less
than a pound
• Enclosed within the mediastinum, medial
cavity of the thorax
• Rests on superior surface of diaphragm
• Anterior to vertebral column and
posterior to sternum
• Lungs flank laterally and partially
obscure it
• ~ 2/3 of it lies to left
• Broad, flat base or posterior surface
Heart
Coverings
• Heart enclosed in double-wall sac
called the pericardium
• Loosely fitting superficial part of sac
is the fibrous pericardium
• The pericardium:
– Protects heart
– Anchors it to surrounding surfaces
– Prevents overfilling of the heart with
blood
Coverings (con’t)
• Deep to fibrous pericardium is the
serous pericardium, which is thin
and slippery and composed of 2
layers.
– The two layers have a film of serous
fluid between them
– Allows the hear to work in a relatively
friction-free environment
Coverings (con’t)
• Inflammation of the pericardium,
pericarditis, hinders production of
serous fluid and roughens the
surfaces.
• Creates a creaking sound that can be
hear with a stethoscope and pain
deep to the chest.
• If persists, can cause adhesions and
impede heart activity
Layers of Heart
1. Epicardium
- visceral layer of the serous pericardium
- often infiltrated with fat
2. Myocardium
- composed mainly of cardiac muscle
- forms bulk of heart
- layer that contracts
3. Endocardium
- glistening white sheet of endothelium
- lines heart chambers and covers valves
Heart
Heart Chambers
The heart has 4 chambers:
2 superior atria and
2 inferior ventricles
The internal partition that
divides the heart is the
interatrial septum when it
separates the atria and the
interventricular septum
when it separates the
ventricles.
Heart
Atria: The Receiving
Chambers
• The atrium has two basic parts:
– A smooth-walled posterior part
– An anterior part with ridged walls
• The interatrial septum has a shallow
depression called the fossa ovalis.
This marks the spot where the
foramen ovale existed in the fetal
heart.
Atria (con’t)
• Receiving chambers for blood
returning to the heart from the
circulation.
• Contract minimally to push blood
into the ventricles; therefore, they
are relatively small and thin.
Atria (con’t)
• Blood enters the right atrium
through 3 veins:
– Superior vena cava – returns blood
from body regions superior to the
diaphragm
– Inferior vena cava – returns blood from
body areas below the diaphragm, and
– Coronary sinus – collects blood from the
myocardium
Atria (con’t)
• Four pulmonary veins enter the left
atrium, which make up most of the
heart’s base.
• The pulmonary veins transport
blood from the lungs back to the
heart.
• These vessels are best seen in a
posterior view of the heart.
Ventricles: The Discharging
Chambers
• Make up most of the heart
• Right ventricle forms heart anterior
surface
• Left ventricle forms inferior surface
• When contracted, blood is propelled out of
the heart into circulation.
– Right ventricle pumps blood into pulmonary
trunk  to the lungs for gas exchange
– Left ventricle pumps blood into the aorta  to
the body’s systems
Pathway of Blood
• Heart is two side-by-side pumps
• Each side serves two different
circuits:
– Pulmonary Circuit
– Systemic Circuit
Heart
Pulmonary Circuit Pump
• Right side
• Blood returns from body, which is oxygen-
poor and carbon dioxide-rich and enters
the right atrium.
• Then, it passes into the right ventricle,
which pumps it to the lungs via the
pulmonary trunk.
• In the lungs, blood unloads the carbon
dioxide and pucks up oxygen.
• Freshly oxygenated blood is carried to the
left side of heart.
Systemic Circuit Pump
• Left side of heart
• Freshly oxygenated blood leaves lungs to
return to left atrium and passes into left
ventricle, which pumps into the aorta.
• Blood is transported via smaller arteries
to body tissues, where gases and nutrients
are exchanged.
• Blood loaded with carbon dioxide and
oxygen depleted, returns through the
systemic veins to right side of heart,
where enters venae cavae.
Pathway (con’t)
• Although equal volumes are
pumped, 2 ventricles have unequal
workloads.
– Pulmonary circuit is short and low-
pressure.
– Systemic circuit is very long and high-
pressure.
•Encounters 5x’s as much friction
•Walls are 3x’s as thick
•Cavity is nearly circular
Heart
Coronary Circulation
• Feeds the heart and is the shortest
circulation of body
• Actively delivers blood when heart
is relaxed, but are ineffective when
ventricles are contracting because:
– They’re compressed by contracting
myocardium, and
– The entrances are partly blocked by
flaps of valves.
Heart
Coronary Circulation
(con’t)
• Myocardial cells are weakened by
temporary lack of oxygen, but don’t
die.
• Complete blockage of a coronary
artery leads to tissue death and a
myocardial infarction, or heart
attack or coronary.
• Cardiac muscle is amitotic, which is
replaced by noncontractile scar
tissue.
Heart
Heart Valves
Blood flows through the heart in one
direction: from atria to ventricles.
One way traffic is enforced by heart
valves.
Valves open and close in response to
changes in blood pressure.
Heart
Atrioventricular (AV)
Valves
• Located at each atrial-ventricular
junction, preventing backflow into
the atria when the ventricles are
contracting.
• Right AV valve, the tricuspid valve,
has 3 flaps. Left AV valve, the
bicuspid valve, has 2 flaps.
• Attached to the valve flaps are tiny
white collagen cords called chordae
tendineae, or “heart strings,” anchor
flaps to heart walls.
Heart
AV Valves
• When heart is relaxed, AV flaps hang limply
into ventricular chambers below; blood
flows into atria and through open AV valves
into ventricles.
• When ventricles contract, blood is
compressed into chambers, intraventricular
pressure rises, forcing blood upwards
against valve flaps.
• Valve flap edges meet, closing valves.
• Chordae tendineae serve as guidewires to
anchor flaps in place.
Heart
Semilunar (SL) Valves
• Aortic and pulmonary SL valves guard
bases of large arteries that exit the
ventricles.
• When ventricles are contracting and
intraventricular pressure rises, the SL
valves are forced open and flaps flatten
against the arterial walls and blood rushes
by.
• When ventricles relax, blood flows back
toward the heart and closes the valves.
Heart
Cardiac Cycle
• Heart writhes in the chest when it
contracts
• Forces blood out of chambers when
it contracts and fills with blood
when it relaxes.
• Two terms are used to refer to heart
contraction/relaxation:
– Systole  contraction
– Diastole  relaxation
Cardiac Cycle (con’t)
• Includes all events associated with
the flow of blood through the heart
during one heartbeat.
• Marked by a succession of pressure
and blood volume change in heart.
• Lasts about 0.8 seconds
– Atrial systole  0.1 s
– Ventricular systole  0.3 s
– Total heart relaxation  0.4 s
(quiescent period)
Cardiac Cycle (con’t)
• Two important points:
1. Blood flow through the hear tis
controlled by pressure changes, and
2. Blood flow along a pressure gradient is
always from higher pressure to lower
pressure through any available
opening.
Heart Sounds
• Two distinguishable sound during
cardiac cycle can be heard.
• Often described as “lub-dup”, which
is associated with the closing of the
heart valves.
• Pause between lub-dup is the
quiescent period.
Murmurs
• An abnormal or unusual heart sound
• Caused by obstruction along blood
pathway
• Fairly common in young children
• Indicate valve problems (or possible
hole in heart)
• If a valve is incomplete, a swishing
sound can be heard.
Cardiac Output (CO)
• Amount of blood pumped out be
each ventricle in 1 min.
• Highly variable and increases in
response to demands
• Difference in resting and maximal
CO is called the cardiac reserve.
– Nonathletes’ reserve is 4-5x’s normal CO
– Athletes’ reserve can be 7x’s the normal
CO
Regulation of Heart Rate
• With a healthy cardiovascular system the
amount of blood pumped (stroke volume) is
relatively constant.
• When blood volume drops sharply or the
heart is weakened, stroke volume declines
and the heart maintains the CO by beating
faster.
• Also, the nervous system can affect heart
rate. Fear, anxiety, stress, etc. causes an
increase in norepinephrine, which causes the
pacemaker to fire more rapidly and the
heart beats faster.

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Heart

  • 3. Size and Location • About the size of the fist and weighs less than a pound • Enclosed within the mediastinum, medial cavity of the thorax • Rests on superior surface of diaphragm • Anterior to vertebral column and posterior to sternum • Lungs flank laterally and partially obscure it • ~ 2/3 of it lies to left • Broad, flat base or posterior surface
  • 5. Coverings • Heart enclosed in double-wall sac called the pericardium • Loosely fitting superficial part of sac is the fibrous pericardium • The pericardium: – Protects heart – Anchors it to surrounding surfaces – Prevents overfilling of the heart with blood
  • 6. Coverings (con’t) • Deep to fibrous pericardium is the serous pericardium, which is thin and slippery and composed of 2 layers. – The two layers have a film of serous fluid between them – Allows the hear to work in a relatively friction-free environment
  • 7. Coverings (con’t) • Inflammation of the pericardium, pericarditis, hinders production of serous fluid and roughens the surfaces. • Creates a creaking sound that can be hear with a stethoscope and pain deep to the chest. • If persists, can cause adhesions and impede heart activity
  • 8. Layers of Heart 1. Epicardium - visceral layer of the serous pericardium - often infiltrated with fat 2. Myocardium - composed mainly of cardiac muscle - forms bulk of heart - layer that contracts 3. Endocardium - glistening white sheet of endothelium - lines heart chambers and covers valves
  • 10. Heart Chambers The heart has 4 chambers: 2 superior atria and 2 inferior ventricles
  • 11. The internal partition that divides the heart is the interatrial septum when it separates the atria and the interventricular septum when it separates the ventricles.
  • 13. Atria: The Receiving Chambers • The atrium has two basic parts: – A smooth-walled posterior part – An anterior part with ridged walls • The interatrial septum has a shallow depression called the fossa ovalis. This marks the spot where the foramen ovale existed in the fetal heart.
  • 14. Atria (con’t) • Receiving chambers for blood returning to the heart from the circulation. • Contract minimally to push blood into the ventricles; therefore, they are relatively small and thin.
  • 15. Atria (con’t) • Blood enters the right atrium through 3 veins: – Superior vena cava – returns blood from body regions superior to the diaphragm – Inferior vena cava – returns blood from body areas below the diaphragm, and – Coronary sinus – collects blood from the myocardium
  • 16. Atria (con’t) • Four pulmonary veins enter the left atrium, which make up most of the heart’s base. • The pulmonary veins transport blood from the lungs back to the heart. • These vessels are best seen in a posterior view of the heart.
  • 17. Ventricles: The Discharging Chambers • Make up most of the heart • Right ventricle forms heart anterior surface • Left ventricle forms inferior surface • When contracted, blood is propelled out of the heart into circulation. – Right ventricle pumps blood into pulmonary trunk  to the lungs for gas exchange – Left ventricle pumps blood into the aorta  to the body’s systems
  • 19. • Heart is two side-by-side pumps • Each side serves two different circuits: – Pulmonary Circuit – Systemic Circuit
  • 21. Pulmonary Circuit Pump • Right side • Blood returns from body, which is oxygen- poor and carbon dioxide-rich and enters the right atrium. • Then, it passes into the right ventricle, which pumps it to the lungs via the pulmonary trunk. • In the lungs, blood unloads the carbon dioxide and pucks up oxygen. • Freshly oxygenated blood is carried to the left side of heart.
  • 22. Systemic Circuit Pump • Left side of heart • Freshly oxygenated blood leaves lungs to return to left atrium and passes into left ventricle, which pumps into the aorta. • Blood is transported via smaller arteries to body tissues, where gases and nutrients are exchanged. • Blood loaded with carbon dioxide and oxygen depleted, returns through the systemic veins to right side of heart, where enters venae cavae.
  • 23. Pathway (con’t) • Although equal volumes are pumped, 2 ventricles have unequal workloads. – Pulmonary circuit is short and low- pressure. – Systemic circuit is very long and high- pressure. •Encounters 5x’s as much friction •Walls are 3x’s as thick •Cavity is nearly circular
  • 25. Coronary Circulation • Feeds the heart and is the shortest circulation of body • Actively delivers blood when heart is relaxed, but are ineffective when ventricles are contracting because: – They’re compressed by contracting myocardium, and – The entrances are partly blocked by flaps of valves.
  • 27. Coronary Circulation (con’t) • Myocardial cells are weakened by temporary lack of oxygen, but don’t die. • Complete blockage of a coronary artery leads to tissue death and a myocardial infarction, or heart attack or coronary. • Cardiac muscle is amitotic, which is replaced by noncontractile scar tissue.
  • 29. Heart Valves Blood flows through the heart in one direction: from atria to ventricles. One way traffic is enforced by heart valves. Valves open and close in response to changes in blood pressure.
  • 31. Atrioventricular (AV) Valves • Located at each atrial-ventricular junction, preventing backflow into the atria when the ventricles are contracting. • Right AV valve, the tricuspid valve, has 3 flaps. Left AV valve, the bicuspid valve, has 2 flaps. • Attached to the valve flaps are tiny white collagen cords called chordae tendineae, or “heart strings,” anchor flaps to heart walls.
  • 33. AV Valves • When heart is relaxed, AV flaps hang limply into ventricular chambers below; blood flows into atria and through open AV valves into ventricles. • When ventricles contract, blood is compressed into chambers, intraventricular pressure rises, forcing blood upwards against valve flaps. • Valve flap edges meet, closing valves. • Chordae tendineae serve as guidewires to anchor flaps in place.
  • 35. Semilunar (SL) Valves • Aortic and pulmonary SL valves guard bases of large arteries that exit the ventricles. • When ventricles are contracting and intraventricular pressure rises, the SL valves are forced open and flaps flatten against the arterial walls and blood rushes by. • When ventricles relax, blood flows back toward the heart and closes the valves.
  • 37. Cardiac Cycle • Heart writhes in the chest when it contracts • Forces blood out of chambers when it contracts and fills with blood when it relaxes. • Two terms are used to refer to heart contraction/relaxation: – Systole  contraction – Diastole  relaxation
  • 38. Cardiac Cycle (con’t) • Includes all events associated with the flow of blood through the heart during one heartbeat. • Marked by a succession of pressure and blood volume change in heart. • Lasts about 0.8 seconds – Atrial systole  0.1 s – Ventricular systole  0.3 s – Total heart relaxation  0.4 s (quiescent period)
  • 39. Cardiac Cycle (con’t) • Two important points: 1. Blood flow through the hear tis controlled by pressure changes, and 2. Blood flow along a pressure gradient is always from higher pressure to lower pressure through any available opening.
  • 40. Heart Sounds • Two distinguishable sound during cardiac cycle can be heard. • Often described as “lub-dup”, which is associated with the closing of the heart valves. • Pause between lub-dup is the quiescent period.
  • 41. Murmurs • An abnormal or unusual heart sound • Caused by obstruction along blood pathway • Fairly common in young children • Indicate valve problems (or possible hole in heart) • If a valve is incomplete, a swishing sound can be heard.
  • 42. Cardiac Output (CO) • Amount of blood pumped out be each ventricle in 1 min. • Highly variable and increases in response to demands • Difference in resting and maximal CO is called the cardiac reserve. – Nonathletes’ reserve is 4-5x’s normal CO – Athletes’ reserve can be 7x’s the normal CO
  • 43. Regulation of Heart Rate • With a healthy cardiovascular system the amount of blood pumped (stroke volume) is relatively constant. • When blood volume drops sharply or the heart is weakened, stroke volume declines and the heart maintains the CO by beating faster. • Also, the nervous system can affect heart rate. Fear, anxiety, stress, etc. causes an increase in norepinephrine, which causes the pacemaker to fire more rapidly and the heart beats faster.