HEART PHYSIOLOGY

Nabila Alifah Zahra Perkasa

1610211096
 DEFINITION

A cardiovascular system is a series of tubes

(the blood vessels) filled with fluid (blood)
and connected to a pump (the heart)
 THE NEED FOR A CIRCULATORY SYSTEM

• All living cells require metabolic substrates (e.g. oxygen, amino acids,
glucose) and a mechanism by which they can remove byproducts of
metabolism (e.g. carbon dioxide, lactic acid)
• To accomplish this necessary exchange, large organisms have a
sophisticated system of blood vessels that facilitates the exchange of
substances between cells and blood and between blood and
environment
• Exchange between blood and the outside environment occurs in
several different organs: lungs, GI tract, kidneys, and skin
 COMPONENTS

• Heart
Serves as the pump that imparts pressure to the blood to establish the
pressure gradient needed for blood to flow to the tissues
• Blood vessels
Serves as the passageways through which blood is directed and distributed
from the heart to all parts of the body and subsequently returned to the
heart
• Blood
The transport medium within which materials being transported long
distances in the body are dissolved or suspended
• The heart is divided by a central wall (septum) into left and right halves.
• Each half functions as an independent pump that consists of an atrium
and a ventricle
• The atrium receives blood returning to the heart from the blood
vessels. The ventricle pumps blood out into the blood vessels
• The right side of the heart receives blood from the tissues and sends it
to the lungs for oxygenation. The left side of heart receive the newly
oxygenated blood from the lungs and pumps it to tissues throughout
the body
• From the right atrium, blood flows into the right ventricle of the heart. From there it is
pumped through the pulmonary arteries to the lungs where it is oxygenated. From the
lungs, blood travels to the left side of the heart (left atrium) through the pulmonary
veins. The blood vessels that go from the right ventricle to the lungs and back to the left
atrium are known as the pulmonary circulation
• Blood from the lungs enters the heart at left atrium and passes into the left ventricle. Blood
pumped out at the left ventricles enters the large artery known as aorta. The aorta branches
into a series of smaller arteries and oxygen left the blood and diffused into the tissues. After
leaving the capillaries, blood flows into the venous side of circulation. The veins from the
upper part of he body join to form superior vena cava. Those from the lower part of the
body form inferior vena cava. The two vena cavae empty into the right atrium. The blood
vessels that carry blood from the left side of the heart to the tissues and back to the right
side of the heart are known as systemic circulation
 WHY DOES BLOOD FLOW?

• Liquids and gases flow down pressure gradients from regions of

higher pressure to regions of lower pressure
• Blood can flow in the cardiovascular system only if one region
develops higher pressure than other regions
• In humans, the heart creates high pressure when it contracts. Blood
flows out of the heart (the region of highest pressure). As blood
moves through the system, pressure is lost because of friction
between the fluid and the blood vessel walls
 PRESSURE

• Pressure in a fluid is the force exerted by the fluid on its container.

• In the heart and blood vessels, pressure is commonly measured in
millimeters of mercury
• If fluid is not moving, the pressure it exerts is called hydrostatic
pressure and force is exerted equally in all directions
• In a system in which fluid is flowing, pressure falls over distance as
energy loss because of friction
 PRESSURE

• In human heart, pressure created by the contracting

muscle is transferred to the blood.
• When the walls of a fluid-filled container expand, the
pressure exerted on the fluid decreases. For this reason,
when the heart relaxes and expands, pressure in fluid filled
chambers falls
 RESISTANCE

• Blood flowing through blood vessels encounters friction

from the walls of the vessels and from cells within the
blood rubbing against one another as they flow
• If resistance increases, flow decreases
• The resistance to fluid flow offered by a tube increases as
the length of the tube increases and the viscosity of the
fluid increases. But resistance decreases as the tube’s radius
increases
 HEART VALVES

• Two sets of heart valves ensure this one way flow: one set
(atrioventricular valves) between the atria and the ventricles, and the
second set (semilunar valve) between the ventricles and the arteries
• They serve the same function: preventing the backward flow of blood
• The opening between each atrium and its ventricle is guarded by an
atrioventricular valve
• The AV valve is formed from the thin flaps of tissues joined at the base
to a connective tissue ring. The flaps are slightly thickened at the edge
and connect on the ventricular side to collagenous tendons, the
chordae tendinae
 HEART VALVES

• Most of the chordae fasten to the edges of the valve flaps. The opposite ends of the
chordae are tethered to moundlike extensions of ventricular muscle (papillary
muscle). This muscle provide stability for the chordae, but they cannot actively open
and close the AV valves.
• The two AV valves are not identical. The valve that separates the right atrium and
the right ventricle has three flaps and is called the tricuspid valve. The valve
between the left atrium and the left ventricle has only two flaps and is called
bicuspid valve or mitral valve
• The semilunar valve separate the ventricles from the major arteries. The aortic
valve is between the left ventricle and the aorta, and the pulmonary valve lies
between the right ventricle and the pulmonary trunk
 CARDIAC MUSCLE

• The bulk of the heart is composed of cardiac muscle cells or

myocardium
• These cells account for a unique property: its ability to contract
without any outside signal. The heart can contract without a
connection to other parts of the body because the signal for
contraction is myogenic (originating within the muscle itself)
• The signal for myocardial contraction comes not from the nervous
system, but from specialized myocardial cells known as autorhythmic
cells.
 CARDIAC MUSCLE: CONTRACTILE
MYOCARDIUM

• The main difference between the action potential of the myocardial

contractile cell and those of skeletal muscle fibers and neurons is that the
myocardial cell has a longer action potential due to Ca entry
• The longer myocardial action potential helps prevent the sustained
contraction called tetanus. Prevention of tetanus in the heart is important
because cardiac muscle must relax between contractions so the ventricles
can fill with blood
• In cardiac muscle, the long action potential means the refractory period and
the contraction end almost simultaneously. By the time a second action
potential can take place, the myocardial cell has almost completely relaxed.
Consequently, no summation occurs
 CARDIAC MUSCLE: AUTORHYTHMIC
MYOCARDIUM

• Ability to generate action potentials spontaneously in the absence of input

from the nervous system
• This ability results from their unstable membrane potential (pacemaker
potential) which starts at -60mV and slowly drifts upward toward
threshold. Whenever a pacemaker potential depolarizes to threshold, the
autorythmic cell fires an action potential
• The autorhythmic cells contain channels that are different from he
channels of other excitable tissues
• The speen with which pacemaker cells depolarize determines the rate at
which the heart contracts (the heart rate)
 THE HEART AS A PUMP

• Individual myocardial cells must depolarize and contract in a

coordinated fashion if the heart is to create enough force to circulate
the blood
• Electrical communication in the heart begins with an action potential in
an autorhythmic cell. The depolarization spreads rapidly to adjacent
cells through gap junctions
• The depolarization begins in the sinoatrial node (SA node),
autorhythmic cells in the right atrium that serves as the main
pacemaker of the heart. A branched intermodal pathway connects the
SA node to the atrioventricular node (AV node)
 THE HEART AS A PUMP

• From the AV node, the depolarization moves into the ventricles. Purkinje fibers
specialized conducting cells, transmit electrical signals very rapidly down the AV
bundle in the ventricular septum
• AV bundle fibers divide into left and right bundle branches. The bundle branch
fibers continue downward to the apex of the heart, where they divide into smaller
Purkinje fibers that spread outward among the contractile cells
• If electrical signals from the atria were conducted directly into the ventricles, the
ventricles would start contracting at the top. Then blood would be squeezed
downward and become trapped in the bottom of the ventricles
 ELECTROCARDIOGRAM

• Physiologists discovered that they could place electrodes on the skin’s surface
and record the electrical activity of the heart. It is possible to use surface
electrodes to record internal activity because salt solutions are good conductors
of electricity.
• These recordings, called electrocardiograms show the summed electrical activity
generated by all cells of the heart
• An ECG is not the same as a single action potential. An action potential is one
electrical event in an single cell, recorded using an intracellular electrode. The
ECG is an extracellular recording that represents the sum of multiple action
potentials taking place in many heart muscle cells.
 ELECTROCARDIOGRAM

• There are two major components of an ECG: waves and segments.

• Waves appear as deflections above or below the baseline. Segments are sections of
baseline between two waves. Intervals are combinations of waves and segments.
• Three major waves can be seen on a normal ECG recorded from lead I.
• The first wave is the P wave, which corresponds to depolarization of the atria.
• The next trio of waves, the QRS complex, represents the progressive wave of
ventricular depolarization
• The final wave, the T wave, represents the repolarization of the ventricles
• Atrial repolarization is not represented by a special wave but is incorporated into the
QRS complex
 ELECTROCARDIOGRAM

• Because depolarization initiates muscle contraction, the electrical events (waves) of an ECG can be
associated with contraction or relaxation
• The cardiac cycle (contraction relaxation cycle) begins with both atria and ventricles at rest
• The ECG begins with atrial depolarization. Atrial contraction starts during the latter part of the P wave
and continues during the P-R segment. During the P-R segment, the electrical signal is sowing down as
it passes through the AV node and AV bundle
• Ventricular contraction begins just after the Q wave and continues through T wave. The ventricles are
repolarizing during the T wave, which is followed by ventricular relaxation. During the T-P segment the
heart is electrically quiet
 ELECTROCARDIOGRAM

• An ECG is an electrical “view” of a 3D object. This is one reason we

use multiple leads to assess heart function. The leads of an ECG
provide different electrical “views” and give information about different
regions of the heart
• An ECG provides information on the heart rate and rhythm,
conduction velocity, and even the condition of tissues in the heart.
• Heart rate is normally timed either from the beginning of one P wave
to the beginning of the next P wave.
CARDIAC CYCLE
 REFERENCES

• Cardiovascular Physiology Concepts

• Silverthorn Human Physiology Integrated Approach 7th edition
• Sherwood Human Physiology From Cells to System 7th edition