SIZE: approx.

similar to a persons fist

hollow, cone-shaped, weighs <1lb
LOCATION: mediastinum
Between the lungs
APEX- towards the hips, rests diaphragm 5
th
ICS
BASE- towards the right shoulder, 2
nd
rib.

PERICARDIUM- the heart is enclosed by a
double sac of serous membrane.

DOUBLE SAC OF SEROUS PERICARDIUM:
Outer parietal/inner parietal
reinforced by a fibrous pericardium


WALLS(3 LAYERS)
Epicardium (visceral pericardium)- tightly hugs
the external surface of the heart and is actually
part of the heart wall.
Myocardium- muscle layer, and reinforced by
fibrous connective tissue(heart skeleton)
Endocardium- endothelium covering the
chambers of the heart.
-continous with the blood vessels
-forms the heart valves

2 ATRIA
Receiving chambers
Thin-walled, low pressure
ROLE: receive blood entering the heart
Divided by the INTERATRIAL SEPTUM
Pumping chambers
Thick-walled, high pressure
ROLE: pumps blood out the heart into the
circulation
Divided by the INTERVENTRICULAR SEPTUM
RIGHT ATRIUM(RA)
Receives blood from the rest of the body
RIGHT VENTRICLE(RV)
Forms most of the anterior surface
LEFT ATRIUM (LA)
Receives blood from the lungs
LEFT VENTRICLE (LV)
Forms the apex
RIGHT SIDE

Pulmonary circuit pump
Receives oxygen-poor blood from the veins
Superior and inferior vena cava
Pumps blood o the pulmonary trunk to pick up
oxygen
Pulmonary arteries to the lungs
LEFT SIDE

SYSTEMIC CIRCUIT PUMP
Receives oxygen-rich blood from the lungs
(pulmonary veins)
Pumps blood to the aorta to be distributed to the
body
PULMONARY CIRCULATION
FROM THE R side of the heart , to the lungs , through L
side of the heart
FUNCTION: carry blood to the lungs for gas exchange

SYSTEMIC CIRCULATION
FROM THE L side of the heart, to the body, through R side of
the heart.
FUNCTION: circulate blood to all body organs
Function: allow one-way flow of blood
through the heart

Chordae tendinae- tendinous chords that
support heart valves

ATRIOVENTRICULAR VALVES(AV VALVES)
Between the atria and ventricles
BICUSPID/MITRAL VALVE-bet. LA and LV
TRICUSPID VALVE- bet. RA and RV
Guard the bases of the 2 large arteries
leaving the heart.

PULMONARY VALVE- bet. RV and pulmonary
trunk

AORTIC VALVE- bet. LV and AORTA
Aneurysm - a localized abnormal dilation of
a blood vessel, usually an artery.
Angina Pectoris- discomfort around the
heart, caused by insufficient blood supply
to the heart.
Arrhythmia- any abnormality in the rate of
rhythm of the heartbeat. Also called
dysrhytmia.
Atherosclerosis- the development of fatty,
fibrous patches in the lining of the arteries
causing narrowing of the lumen and
hardening of the vessel wall.
Cyanosis- bluish discoloration of the skin due to lack
of oxygen.

Dyspnea- difficulty in breathing.
Embolism- obstruction of a blood vessel by a blood
clot or other matter carried in the circulation.
Fibrillation- spontaneous, quivering and ineffectual
contraction of the muscle fibers.
Infarction- localized necrosis of the tissue resulting
from a blockage or narrowing of the artery that
supplies the area.

Ischemia- local deficiency of blood supply
due to obstruction in the circulation.
Murmur-an abnormal heart sounds.
Phlebitis- an inflammation of a vein.
Stenosis- constriction or narrowing of an
opening
Stoke- sudden damage to the brain resulting
from the reduction of blood flow. Causes
include atherosclerosis, thrombosis, or
bleeding from ruptured aneurysm.

Syncope- a temporary loss of consciousness due to
inadequate blood supply to the brain.

Thrombosis- development of a blood clot within a
vessel.

Thrombus- a blood clot that forms in a vessel.
Artherectomy- removal of atheromatous
plaque from the lining of a vessel.

Commissurotomy- surgical incision of a
scarred mitral valve to increase the size of
the valve.
CABG(Coronary Artery Bypass Grafting)
-surgical creation of shunt to by pass a
blocked coronary artery.


PTCA( Percutanous Transluminal Coronary
Andioplasty)
- dilatation a blood vessel by means of a
balloon catheter inserted into the vessel and
then inflated to flatten plaque against the
artery.
AORTA- the largest artery. It receives blood
from the left ventricle and branches to all
parts of the body.
APEX- the point of cone-shaped structure.
ARTERY- a vessel that carries blood away
from the heart. Most arteries carries
oxygenated blood.
ARTERIOLE- a small artery.
ATRIUM- an entrance chamber. One of the
two upper chamber of the hearth.
Blood pressure- The force exerted by blood against
the wall of a vessel.

Capillary- One of the millions microscopic blood
vessel through which materials are exchanged
between the blood and the tissue.

Diastole- The relaxation phase of the heart cycle.

Endocardium- The tin membrain that lines the
chamber of the heart and covers the valves.
Epicarduim- The thin outermost layer of the heart.

Heart sound- The sounds produced by the heart as
it functions. Heard as the valve closes.

Myrocardium- The thick middle layer of the heart
wall composed of cardiac muscle.

Pericardium- The fibrous sac that sorrounds the
heart.

Sphygmomanometer- An instrument for determining
the arterial BP.
THE HUMAN HEART
CONDUCTION SYSTEM
Heart can contract spontaneously and
independently.
Regular and continuous contractions
2 systems regulate heart activity

AUTONOMIC NERVOUS SYSTEM
INTRINSIC CONDUCTION SYSTEM/
NODAL SYSTEM
Built into the heart tissue

Sets the basic rhythm of the heart

Special tissues in the myocardium

Causes depolarization (action
potential) in one direction

Sets basic heart rate (approximately
75 beats per minute)
INTRINSIC CONDUCTION SYSTEM

SINOATRIAL NODE (SA NODE)
pacemaker of the heart
Highest rate of depolarization that sets the pace for
heart beats
Location: wall of RA

ATRIOVENTICULAR NODE (AV NODE)
o Delays impulse briefly to allow atria to finish
contraction
o Location: right side AV septum



ATRIOVENTICULAR BUNDLE ( BUNDLE
OF HIS)
oLocation: IV septum

BUNDLE BRANCHES Purkinje fibers
(heart muscle)





CONDUCTION SYSTEM PROBLEMS
HEART BLOCK

o Anatomy: atria and ventricles separated by fibrous
skeleton
Impulse spreads from A V only through AV Node
o Cause: damage to AV node
o Effect: ventricles beat at their own rate (slower)

DAMAGE TO SA NODE

o Slower heart rate (bradycardia)
o Treatment: pacemaker

FIBRILLATION
o Cause: ischemia (lack of adequate blood supply to the
heart)
o Effect: rapid UNCOORDINATED shuddering of the heart

ELECTROCARDIOGRAPHY
AND
ELECTROCARDIOGRAM
ELECTROCARDIOGRAPHY

Electrocardiograph- machine

Electrocardiogram- reading produced by the ECG

Function: trace the flow of current through the
heart

Basis: as impulses pass through the heart, electrical
currents are generated on the surface of the body

Normal ECG has 3 waves

o P wave- atrial depolarization
o QRS complex- ventricular depolarization
o T wave ventricular repolarization


ELECTROCARDIOGRAPHY

Abnormal ECG

oDifferent shape of the waves
oDifferent timing of the waves
oCould indicate

Myocardial infract ( dead cardiac tissue)
fibrillation


CARDIAC CYCLE

Event that occur in one complete heartbeat

Involve 2 stages

o SYSTOLE (CONTRACTION)
Pumping of blood by the ventricles

o DIASTOLE (RELAXATION)
Filling of heart chambers with blood

o Normal: 75 bpm at 0.8 seconds per cycle
CARDIAC CYCLE
1. mid-late diastole
o Complete relaxation and low pressure in the heart
o Blood flows passively INTO the heart
o AV valves open, semilunar valves closed
o Atria contract to actively pump blood to the ventricles

2. ventricular systole
o Increasing pressure as ventricles contract
o Semilunar valves open, semilunar valves closed
o Atria are relaxed and filling with blood

3. early diastole
o Ventricles relax and semilunar valves closed
o Intraventicular pressure drops and AV valves open
HEART SOUNDS

Heard with a stethoscope

Described as lub dup pause lub dup

1
st
heart sound (lub)
o caused by closing of AV valves
o Longer and louder

2
nd
heart sound (dup)
o Caused by closing semilunar valves (end of systole)
o Shorter and sharper
CARDIAC OUTPUT (CO)

Amount of blood pumped by each side of the
heart in 1 minute

CO= heart rate (HR) X stroke volume (SV)

Stroke volume= volume of blood pumped by each
ventricle

Normal average CO

o Given normal SV= 70 ml/ min
o Given normal HR= 75 bpm (beats per minute)

Varies depending on demands of the body
CARDIAC OUTPUT (CO)

STROKE VOLUME

o Starlings law of the heart
The most important factor affecting SV is how much
the heart muscles are stretched just before they
contract

o Venous return- important factor stretching the heart
Amount of blood entering the heart and distending
the ventricles
Increased: slow heartbeat, exercise
Decreased: blood loss, rapid HR
CARDIAC OUTPUT (CO)

HEART RATE

o Maintains CO if SV decreases

o Controlled by the autonomic nervous system

Sympathetic stimulates SA and AV nodes
Parasympathetic (vagus nerve)- slows down the
heart

o Drugs, hormones and ions

Epinephrine- mimics effect of sympathetic NS
Thyroxine- from the thyroid gland increases HR
Low blood calcium or potassium- depress the heart

CARDIAC OUTPUT

HEART RATE

o Affected by physical factors

Age- fetus 140- 160 bpm and decreases with age

Faster in females

Heat increases heart rate (increased metabolic rate)

Exercise increases heart rate

action of skeletal muscles
Sympathetic nervous system


BLOOD VESSELS
3 Types
Microscopic anatomy
Structural differences
gross anatomy
Major arteries and veins
Special circulations
Physiology of circulation
Arterial pulse
Blood pressure
Development aspects


Forms a closed system: VASCULAR SYSTEM

Function: transports blood

3 types

Arteries- receives blood from the heart
o Carries oxygen- rich blood

Capillaries- supplies blood to every organ
o Carries a mix of oxygenated and deoxygenated blood

Veins- brings blood back to the heart
o Carries oxygen- poor blood
MICROSCOPIC ANATOMY

TUNICS/ LAYERS

o 3 layers in arteries and veins, single layer in capillaries

o TUNICA INTIMA
Inner lining
Endothelium with basement membrane

o TUNICA MEDIA
Middle layer that responds to sympathetic NS
Smooth muscle and elastic fibers

o TUNICA EXTERNA
Outer layer
Fibrous connective tissue: rich in collagen

STRUCTURAL DIFFERENCES

ARTERIES
o thicker walls, heavier tunica media

VEINS
o Thinner walls, larger lumen
o With valves that prevent backflow of blood

CAPILLARIES
o 1 layer only: tunica intima
o Microcirculation capillary beds
o Vascular shunts v.s. true capillaries
o Terminal arteriole precapillary sphincter
postcapillary venule
PATHWAY OF BLOOD

H arteries capillaries venules veinH


WHAT HELPS THE VEINS RETURN BLOOD TO
THE HEART?

Valves
Skeletal muscles
Pressure changes in the thorax
MAJOR ARTERIES

AORTA

o Largest artery in the body

o Emerges from the LV

o Different names depending on location

Ascending aorta
Arch of aorta
Thoracic aorta
Abdominal aorta

THE AORTA

ASCENDING AORTA
Left and right coronary

ARCH OF AORTA
Brachiocephalic R common carotid and R subclavian
L common carotid L internal carotid and L external
carotid
L subclavian vertebral
o Become axillary brachial radial and ulnar

THORACIC AORTA
Intercostal, brochial, esophageal, phrenic

ABDOMINAL AORTA

Celiac trunk L gastric, splenic, common
hepatic
Superior mesenteric (unpaired)
Renal
Gonadal
Lumbar
Inferior mesentric (unpaired)
L and R common iliac external and internal
iliac
o External iliac femoral popliteal A and P tibial
o Anterior tibial dorsalis pedis
MAJOR VEINS
Drain every organ in the body and returns it
to the heart
Veins are more superficial and easily seen
and palpated
Most follow the course of the arteries
Naming is similar to the arteries they
accompany
2 largest veins
SUPERIOR VENA CAVA (SVC)
o Drains the head and arms
INFERIOR VENA CAVA (IVC)
o Drains the lower body

VEINS that drain into SUPERIOIR VENA CAVA

Radial and ulnar brachial axillary
subclavian
Cephalic axillary
Basilic brachial
Cephalic and basilic median cubital (blood
removal)
Axillary and external jugular subclavian
Vertebral and internal jugular
R and L brachiocephalic SVC
Azygos SVC

VEINS that drain into INFERIOIR VENA CAVA

A and P tibial, fibular popliteal femoral
external iliac
Dorsal venous arch great saphenous femoral
External and internal iliac R and L common
iliac IVC
Cephalic and basilic median cubital (blood
removal)
R gonadal IVC
L gonadal L renal IVC
R renal IVC
Hepatic portal IVC
Hepatic IVC