ANATOMY AND PHYSIOLOGY

THE HEART:
The heart weighs between 7 and 15 ounces (200 to 425 grams) and is a little larger than the size
of the fist. By the end of a long life, a person's heart may have beat (expanded and contracted)
more than 3.5 billion times. In fact, each day, the average heart beats 100,000 times, pumping
about 2,000 gallons (7,571 liters) of blood.

The heart is located between the lungs in the middle of the chest, behind and slightly to
the left of the breastbone (sternum). A double-layered membrane called the pericardium
surrounds the heart like a sac. The outer layer of the pericardium surrounds the roots of the
heart's major blood vessels and is attached by ligaments to the spinal column, diaphragm, and
other parts of the body. The inner layer of the pericardium is attached to the heart muscle. A
coating of fluid separates the two layers of membrane, letting the heart move as it beats, yet still
be attached to the body.

The heart has 4 chambers. The upper chambers are called the left and right atria, and the
lower chambers are called the left and right ventricles. A wall of muscle called the septum
separates the left and right atria and the left and right ventricles. The left ventricle is the largest
and strongest chamber in the heart. The left ventricle's chamber walls are only about a half-inch
thick, but they have enough force to push blood through the aortic valve and into the body.
Four types of valves regulate blood flow through the heart:

• The tricuspid valve regulates blood flow between the right atrium and right ventricle.

• The pulmonary valve controls blood flow from the right ventricle into the pulmonary
arteries, which carry blood to the lungs to pick up oxygen.

• The mitral valve lets oxygen-rich blood from the lungs pass from the left atrium into the
left ventricle.

• The aortic valve opens the way for oxygen-rich blood to pass from the left ventricle into
the aorta, the body's largest artery, where it is delivered to the rest of the body.

Coronary Arteries

Because the heart is composed primarily of cardiac muscle tissue that continuously contracts and
relaxes, it must have a constant supply of oxygen and nutrients. The coronary arteries are the
network of blood vessels that carry oxygen- and nutrient-rich blood to the cardiac muscle tissue.

The blood leaving the left ventricle exits through the aorta, the body’s main artery. Two coronary
arteries, referred to as the "left" and "right" coronary arteries, emerge from the beginning of the
aorta, near the top of the heart.

The initial segment of the left coronary artery is called the left main coronary. This blood vessel
is approximately the width of a soda straw and is less than an inch long. It branches into two
slightly smaller arteries: the left anterior descending coronary artery and the left circumflex
coronary artery. The left anterior descending coronary artery is embedded in the surface of the
front side of the heart. The left circumflex coronary artery circles around the left side of the heart
and is embedded in the surface of the back of the heart.

Just like branches on a tree, the coronary arteries branch into progressively smaller vessels. The
larger vessels travel along the surface of the heart; however, the smaller branches penetrate the
heart muscle. The smallest branches, called capillaries, are so narrow that the red blood cells
must travel in single file. In the capillaries, the red blood cells provide oxygen and nutrients to
the cardiac muscle tissue and bond with carbon dioxide and other metabolic waste products,
taking them away from the heart for disposal through the lungs, kidneys and liver.

When cholesterol plaque accumulates to the point of blocking the flow of blood through a
coronary artery, the cardiac muscle tissue fed by the coronary artery beyond the point of the
blockage is deprived of oxygen and nutrients. This area of cardiac muscle tissue ceases to
function properly. The condition when a coronary artery becomes blocked causing damage to the
cardiac muscle tissue it serves is called a myocardial infarction or heart attack.

Physiology
 The heart and circulatory system make up the cardiovascular system. The heart works as
a pump that pushes blood to the organs, tissues, and cells of the body. Blood delivers oxygen and
nutrients to every cell and removes the carbon dioxide and waste products made by those cells.
Blood is carried from the heart to the rest of the body through a complex network of arteries,
arterioles, and capillaries. Blood is returned to the heart through venules and veins. If all the
vessels of this network in the body were laid end-to-end, they would extend for about 60,000
miles (more than 96,500 kilometers), which is far enough to circle the earth more than twice.

The one-way circulatory system carries blood to all parts of the body. This process of blood flow
within the body is called circulation. Arteries carry oxygen-rich blood away from the heart,
and veins carry oxygen-poor blood back to the heart.

In pulmonary circulation, though, the roles are switched. It is the pulmonary artery that brings
oxygen-poor blood into the lungs and the pulmonary vein that brings oxygen-rich blood back to
the heart.

Twenty major arteries make a path through the tissues, where they branch into smaller
vessels called arterioles. Arterioles further branch into capillaries, the true deliverers of oxygen
and nutrients to the cells. Most capillaries are thinner than a hair. In fact, many are so tiny, only
one blood cell can move through them at a time. Once the capillaries deliver oxygen and
nutrients and pick up carbon dioxide and other waste, they move the blood back through wider
vessels called venules. Venules eventually join to form veins, which deliver the blood back to the
heart to pick up oxygen.

BLOOD

Blood serves as a vehicle for distributing body heat and for transporting nutrients, respiratory
gases, and other substances throughout the body.
Blood is a sticky opaque fluid with a characteristic metallic taste. Blood is heavier than water
and about five times thicker, or more viscous, largely because of its formed elements.
Blood is slightly alkaline, with pH between 7.35 and 7.45. Its temperature 38 degree Celsius is
always slightly higher than body temperature.
Blood from the body flows:

• to the Superior and Inferior Vena Cava,

• then to the Right Atrium
• through the Tricuspid Valve
• to the Right Ventricle
• through the Pulmonic Valve
• to the Pulmonary Artery
• to the Lungs

The blood picks up oxygen in the lungs, and then flows from the lungs:

• to the Pulmonary Veins

• to the Left Atrium
• through the Mitral valve
• to the Left Ventricle
• through the Aortic Valve
• to the Aorta
• to the body
Physiology:
Circulatory system

Blood is circulated around the body through blood vessels by the pumping action of the heart. In
humans, blood is pumped from the strong left ventricle of the heart through arteries to peripheral
tissues and returns to the right atrium of the heart through veins. It then enters the right ventricle
and is pumped through the pulmonary artery to the lungs and returns to the left atrium through
the pulmonary veins. Blood then enters the left ventricle to be circulated again. Arterial blood
carries oxygen from inhaled air to all of the cells of the body, and venous blood carries carbon
dioxide, a waste product of metabolism by cells, to the lungs to be exhaled. However, one
exception includes pulmonary arteries, which contain the most deoxygenated blood in the body,
while the pulmonary veins contain oxygenated blood.

Additional return flow may be generated by the movement of skeletal muscles, which can
compress veins and push blood through the valves in veins toward the right atrium.