The Cardiovascular System- The Heart

Vessels of The Cardiovascular System

 Arteries Efferent vessels
o Carry blood Away
 Capillaries
 Veins Afferent vessels
o Return blood

Pericardial Layers of The Heart

 Visceral Pericardium (inner layer covers the heart)
 Pericardial Cavity (filled with fluid)
 Parietal Pericardium (outer layer)

Muscle Layers of The Heart

 Epicardium
 Myocardium
o Contains muscle tissue; intercalated discs
 Help ↑ the efficiency of contraction
 Endocardium

External Boundaries (Sulci)

 Anterior Interventricular Sulcus
o Front between ventricles
 Posterior Interventricular Sulcus
o Back between ventricles
 Coronary Sulcus
o Separates the Atrium from the Ventricles

Internal Boundaries (Septum)

 Interatrial Septum
o Between atrium
 Interventricular Septum
o Between ventricles

Parts of the Heart

Base location of major vessels
Apex bottom tip
 Chambers divided into:
o Right and Left
o Top  Atrium (receives blood)
o Bottom  Ventricles (ejects blood)

Chambers of the Heart

 Right Atrium
o Receives ALL blood from the Systemic Circuit (deoxygenated blood)
 Superior Vena Cava drains blood from the upper body
 Inferior Vena Cava drains blood from the lower body
 Coronary Sinus drains blood from the heart (myocardium)
 Left Atrium

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 o Receives ALL blood from the Pulmonary Circuit (oxygenated blood)
 Right Ventricle
o Pumps the deoxygenated blood to the lungs
 Left Ventricle
o Pumps the oxygenated blood to the rest of the body

Valves ALL valves are one-way valves and their purpose is to prevent backflow or regurgitation
 Atrioventricular Valves (AV valves)
o 2 AV valves; one on the right side and one on the left side of the heart
 Right (Tricuspid Valve)
 Right Atrium  Tricuspid Valve  Right Ventricle
 Left (Bicuspid or Mitral Valve)
 Left Atrium  Bicuspid Valve  Left Ventricle
 Semilunar Valves
o 2 Semilunar valves; one on the right side and one on the left side of the heart
 Right (Pulmonary Valve)
 Right Ventricle  Pulmonary Valve  Pulmonary Trunk
 Left (Aortic Valve)
 Left Ventricle  Aortic Valve  Aorta
Circuits of the Body
 Systemic Circuit (Body) carries blood between the Heart and Body
o Body (deoxygenated blood)  Right Atrium  Right Ventricle  Lungs  Left Atrium
(oxygenated)  Left Ventricle  Aorta  Body

 Pulmonary Circuit (Lungs) carries blood between the Heart and Lungs
o Right Ventricle (deoxygenated blood)  Pulmonary Trunk  Left and Right Pulmonary
Arteries  Right and Left Lungs (oxygenated blood)  Right and Left Pulmonary Veins 
Left Atrium

2
  Coronary Circuit (Heart) carries blood between the Myocardium and Heart

Base of Heart Base of Heart

Posterior Circumflex Artery

Interventricular Right Coronary and Anterior Left Coronary
Artery and Artery Interventricular Artery
Marginal Artery Artery

Right Atrium and Interventricular

Parts of both Septum, Left
Ventricles Atrium, & Left
Ventricle

o Drains blood from the Great Cardiac Vein and Middle Cardiac Vein  Coronary Capillaries 
Coronary Sinus Right Atrium

Cardiac Cells
 Contractile Cells 99%
 Nodal Cells determine contraction rate
o SA Node (R. atrium) cardiac pacemaker
o AV Node (R. atrium) can take over, but at a slower rate (40-60 bpm)
 Conducting Cells distribute stimuli through the myocardium
o AV Bundle Branches
o Left and Right Branches Does NOT need neural or
o Purkinje Fibers hormonal stimuli
 Automaticity heart can beat on its own.
o Normal HR 70-80 bpm
o Bradycardia < 60 bpm
o Tachycardia > 100 bpm

Action Potential causes the muscle to contract (pass AP flow through gap junctions)
 Skeletal Muscle faster action potential (tetany)
 Cardiac Muscle slower action potential (no tetany because of longer AP), increase refractory period
limits the number of contractions
Too much 1. Na+ Influx rapid depolarization (changes the cell from – to +)
can cause 2. Ca2+ Influx and K+ Efflux plateau (slow Ca2+ at first then rapid) the K+ is self-excitatory
tetany and 3. K+ Efflux repolarization
even
 Until this happens another contraction can NOT occur
death


3
 If it doesn’t work, then causes atrial
The Conducting System fibrillation
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SA Node If this pathway is
Atria contract blocked, then the
Depolarization &
Repolarization
ventricles will beat
slower

Purkinje Fibers AV Node

Ventricular Ventricular
Repolarization Depolarization

Right and Left AV Bundle

Bundle Branches Branch

ECG/EKG
 P wave  PR Interval beginning of atrial systole to
o Atrial Depolarization beginning of ventricular systole
 Rapid Na+ influx o Extended time indicates damage to
 QRS Complex (problems in the atria)
o Ventricular Depolarization  Conducting Pathways
 Rapid Na+ influx  AV Node
o Atrial Repolarization  QT Interval
 Rapid K+ efflux o Extended time indicates (problems in
 T Wave the ventricles; depolarization)
o Ventricular Repolarization  Conducting problems
 Rapid K+ efflux  Myocardial damage
 Coronary ischemia

Cardio dynamics movements and forces generated during cardiac contractions

 Stroke Volume (SV) blood ejected by a ventricle (mL/beat)
 Cardiac Output (CO) blood ejected by the left ventricle (mL/min)

4
 o Highly regulated
o CO = HR x SV Cardiac Output = Heart Rate x Stroke Volume
 Direct relationship between
o Venous Return
o Blood ejected during contractions
 Volume Reflexes 1 adjusts (HR) and 1 adjusts (SV)  Adjusts the Cardiac Output
o Atrial Reflex (venous return)
 Adjusts HR in response to increase in venous return
 Increases HR
o Frank-Starling Principle (venous return and filling time)
 SV depends on venous return and filling time
 “more in” = “more out”
o Preload = end diastolic volume

The Cardiac Cycle end diastolic volume is the amount of blood in the ventricles after atrial systole
[Link]
 Pressure
o Pressure flows from HIGH to low
o Increase in pressure in one chamber causes blood to flow into another chamber with lower
pressure
 Systole (contraction) ejection of blood
 Diastole (relaxation) filling of blood
o Atrial Systole
 Blood is going from atria to ventricles
 Atria contract
 AV valves open
o Atrial Diastole
 Atria relax
 AV valves are close (S1)
 Semilunar valves are still closed
o Ventricular Systole
 Blood is going from ventricles into the pulmonary or systemic circuit
 Ventricles contract
 Blood is ejected
 Semilunar valves open
o Ventricular Diastole
 Early Phase
 Both valves are closed
o Semilunar valves close (S2)
 Ventricle pressure
 When atrial pressure is higher than ventricular pressure the AV valves open
 Relaxes- filling occurs
 Increase in Ventricles semilunar valves open

Heart Sounds
 S1 “lubb” AV valves close
 S2 “dubb” Semilunar valves close
 S3 and S4 can be faintly heard (chambers filling with blood)

Autonomic Innervation of the Heart primarily effects SA Node

 Pacemaker Cells

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  Heart has dual innervation
o Parasympathetic (Rest and Digest)
 Controlled by Cardioinhibitory Center
 Medulla Oblongata
o Vagus nerve (Acetylcholine)
 Decreases HR
o Sympathetic (Fight or Flight)
 Controlled by Cardioaccelatory Center
 Medulla Oblongata
o Fibers that extend from
 Cervical ganglia
 Upper thoracic ganglia
 Increases HR

Heart Rate (HR) Stroke Volume (SV)

Parasympathetic Parasympathetic
 Vagus nerve  releases ACh  ↓ HR  Release of ACh  ↓ contractions  ↓ SV
Sympathetic Sympathetic
 Releases NE  ↑ HR  Release of NE and E  ↑ contractions  ↑ SV

Disease/Abnormalities
 Valvular Heart Disease valve function deteriorates
 Coronary Artery Disease obstruction of coronary circulation
 Tachycardia increase heart rate >100 bpm
 MI or Chest Pains caused by obstruction of coronary vessels
 Sinus Bradycardia slow heartrate origination at SA Node
 Cardiac Tamponade pericardial sac fills with fluid decreasing cardiac output