1

Rob Swatski
Assistant Professor of Biology
HACC York Campus
Chapter 20
Cardiovascular
System:
The Heart
20_03a
2
3
4
5
6
Heart Location: Mediastinum
7
Heart Orientation
Apex: anteriorly, inferiorly, left-side
Base: posteriorly, superiorly, right-side
Anterior surface: deep to sternum & ribs
Inferior surface: on diaphragm
Right border: faces right lung
Left border (Pulmonary border): faces left lung
8
Heart Surface Projection
Superior right point: sup border - 3
rd
right costal cartilage
Superior left point: inf border - 2
nd
left costal cartilage, 3 cm left of midline
Inferior left point: 5
th
intercostal space, 9 cm left of midline
Inferior right point: sup border - 6
th
right costal cartilage, 3 cm right of midline
9
Pericardium
Pericardium
Fibrous pericardium (outer)
- dense irregular CT
- protects & anchors heart
- prevents overstretching
Serous pericardium
(epicardium):
- thin, delicate membrane
- parietal & visceral layers
- pericardial cavity
- pericardial fluid
Pericarditis
Cardiac tamponade
10
11
Layers of the Heart Wall
Epicardium: mesothelium& CT (visceral layer of serous
pericardium)
Myocardium: cardiac muscle
Endocardium: endothelium & CT (lines chambers & valves)
12
Myocarditis & Endocarditis
endocarditis
myocarditis
13
Muscle Bundles of the Myocardium
14
Chambers & Sulci of the Heart
4 Chambers:
- 2 superior atria
- 2 inferior ventricles
Sulci: grooves on heart surface
- contain coronary BVs & adipose
Coronary sulcus
- encircles heart b/w atria & ventricles
Anterior interventricular sulcus
- ant. boundary b/w ventricles
Posterior interventricular sulcus
- post. boundary b/w ventricles
15
16
17
18
Right Atrium
Receives blood from 3 sources:
superior vena cava, inferior vena cava, & coronary sinus
Interatrial septum
Fossa ovalis: remnant of fetal foramen ovale
Tricuspid valve
- blood flows through into right ventricle
- 3 cusps of dense CT
- RAT on the Right (Right Atrioventricular, Tricuspid)
19
Right Ventricle
Forms most of ant. surface of heart
Interventricular septum
Trabeculae carneae
Papillary muscles
Chordae tendineae
Pulmonary semilunar valve
- allows blood into pulmonary trunk
Papillary Muscles &
Chordae Tendineae
20
21
22
Left Atrium
Forms most of base of heart
Receives blood from lungs through 4 pulmonary veins
- 2 right & 2 left
Bicuspid valve: blood flows through into left ventricle
- 2 cusps
- LAMB on the Left: Left Atrioventricular, Mitral, or Bicuspid
23
Left Ventricle
Forms apex of heart
Chordae tendineae, papillary muscles, & trabeculae
carneae
Aortic semilunar valve
- allows blood into ascending aorta
- openings to the coronary arteries directly above valve
24
Myocardial Thickness & Function
Thickness varies based on each chambers function:
- Atria walls are thin; Ventricle walls are thick
- Right ventricle walls are thin; Left ventricle walls are
thick
25
Fibrous Skeleton of Heart
Dense CT rings surround heart valves
- fuse together & merge with interventricular
septum
Functions of fibrous skeleton:
- valve support structure
- insertion point for cardiac muscle bundles
- electrical insulator b/w atria & ventricles
26
AV Valves OPEN
Allow blood flow from atria into ventricles
when ventricular pressure is lower than
atrial pressure
Occurs during ventricular relaxation:
- papillary muscles are relaxed
- chordae tendineae are slack
27
28
AV Valves CLOSED
Prevents backflow of blood into atria
Occurs during ventricular contraction:
- papillary muscles contract
- chordae tendineae pulled taut
- valve cusps pushed closed
29
SL Valves
SL valves OPEN during ventricular contraction
- allow blood flow into pulmonary trunk & aorta
SL valves CLOSE during ventricular relaxation
- blood fills cusps & valves close
- prevents blood from flowing backwards into
ventricles
30
31
32
33
Heart Valve Disorders
Stenosis: narrowing of valve that restricts blood flow
- repaired by balloon valvuloplasty, surgery, or valve
replacement
Insufficiency or incompetence: valve cannot close completely
Balloon
valvuloplasty
Mitral Valve Stenosis 34
35
Systemic Circulation
LEFT side of heart pumps oxygenated blood to body
Left ventricle Aorta Arteries Capillaries Organs
Venules Veins Superior/Inferior vena
cava/Coronary sinus Right atrium
36
Pulmonary Circulation
RIGHT side of heart pumps deoxygenated blood to lungs
Right atrium Right ventricle Pulmonary trunk
Pulmonary arteries Lungs Pulmonary Veins
37
38
39
40
Coronary
Circulation
Blood flow
through
myocardium
The heart
feeds itself
first
Many
anastomoses
41
Coronary Arteries
Right coronary
artery
Marginal
branch
Posterior
interventricular
branch
Left coronary
artery
Anterior
interventricular
branch (LAD)
Circumflex
branch
42
43
44
Coronary
Veins
Collect
wastes from
myocardium
Great cardiac
vein, middle
cardiac vein
Drain into
coronary
sinus
45
Cardiac
Muscle
Tissue
Striated,
branching,
shorter fibers of
heart
Intercalated
discs with gap
junctions
One central
nucleus per fiber
46
Cardiac Muscle Histology
47
Cardiac
Muscle
Tissue
Same actin &
myosin
arrangement as
skeletal muscle
Autorhythmic
Longer
contractions
(longer Ca
+2
delivery)
48
Cardiac Myofibril
49
Conduction
System
Autorhythmic
fibers
spontaneous APs
Propagate APs
through
myocardium
Sinatrial (SA)
node =
pacemaker
50
SA node
AV node
AV bundle (of
His)
Right & left
bundle branches
Purkinje fibers
Conduction System
51
52
Regulation of the
Conduction
System
Autonomic
Nervous System
(ANS)
Hormones
(epinephrine)
Modify heart
rate & strength
of contraction
They do NOT
establish the
fundamental
rhythm
53
Action
Potential
Depolarization
Plateau
Repolarization
Refractory
period
54
Physiology of Contraction
55
Role of Ions in the Action Potential
56
Electro-
cardiogram
(EKG)
Visual record of all
APs during each
cardiac cycle
(heartbeat)
Detected at
bodys surface
Diagnostic value
Detects abnormal
conduction,
enlargement, &
muscle damage
57
EKG
P wave
P-Q
interval
QRS
complex
T wave
58
59
60
61
62
Cardiac Cycle
At 75 beats/min,
1 cycle = 0.85
sec
Pressure &
volume changes
during cycle
Blood pumped
from high to low
pressure areas
63
Atrial systole
(contraction)
Atrial diastole
(relaxation)
Ventricular
systole
Ventricular
diastole
Cardiac Cycle
64
Blood
Volumes
End Diastolic
Volume (EDV)
= 130 ml
End Systolic
Volume (ESV)
= 60 ml
Stroke
Volume (SV) =
70 ml
65
SV = EDV - ESV
66
Phases of the
Cardiac Cycle
Isovolumetric
Relaxation
(all valves close)
Ventricular
Filling
(AV valves open)
Isovolumetric
Contraction
(AV valves close)
Ventricular
Ejection
(SL valves open)
67
68
69
Ventricular
Pressures
Aortic BP =
120 mmHg
Pulmonary
trunk BP = 30
mmHg
Why? How?
70
71
Heart
Sounds
Produced
when valves
close
lubb = AV
valves close
DUPP = SL
valves close
72
Heart
Sounds
73
Heart
Murmurs
Abnormal
sounds before,
b/w, or after
normal sounds
May also mask
normal sounds
Caused by valve
disorders,
increased blood
flow/volume
74
Cardiac
Output
Volume of
blood ejected
each minute
from either
ventricle
CO = Stroke
Volume (SV) x
Heart Rate
(HR)
70 ml SV x 75
beats/min =
5.25 L/min
75
Influences on
Stroke Volume
Preload
(Frank-Starling
Law of the
Heart)
Contractility
Afterload
76
Preload
The greater the
stretch, the
greater the force
of contraction
The greater the
blood volume, the
greater the force
of contraction
77
Contractility
Autonomic
Nervous
System (ANS)
Hormones
Ca
+2
or K
+
levels
78
Afterload
The back pressure
that must be
overcome
before the
semilunar valve
can open
The greater the
BP = the greater
the afterload
79
Congestive
Heart Failure
If afterload is high,
more blood remains
in the ventricles
which increases
the preload
Left ventricular
failure = pulmonary
edema
Right ventricular
failure = peripheral
edema
80
81
82
Neural
Regulation of
Heart Rate
Cardiovascular
center in medulla
oblongata
Sympathetic
impulses increase
HR & force of
contraction
Parasympathetic
impulses decrease
HR & force of
contraction
83
Nervous
System
Receptors
Baroreceptors:
monitor BP
Proprioceptors:
monitor
movements
Chemoreceptors:
monitor blood
chemistry
84
85
Biochemical
Regulation of
Heart Rate
Epinephrine,
norepinephrine,
thyroid hormones
Na
+
, K
+
, Ca
+2
Age, gender,
physical fitness,
temperature
86
High blood
cholesterol
High BP Smoking
Obesity
Lack of
regular
exercise
Family history
Male gender Diabetes
Left
ventricular
hypertrophy
Risk Factors for Heart Disease
87
Plasma Lipids
& Heart
Disease
High blood
cholesterol:
promotes plaques
High-Density
Lipoproteins
(HDLs)
Low-Density
Lipoproteins
(LDLs)
Very Low-Density
Lipoproteins
(VLDLs)
88
89
Coronary Artery Disease
(CAD)
Ischemia
Reduced blood
flow through
coronary arteries
Causes hypoxia
& weakens
cardiac muscle
Angina
Pectoris
Narrowing of
coronary arteries
Leads to reduced
blood flow, chest
pain, pressure,
discomfort
Myocardial
Infarction
Complete
obstruction of
coronary blood
flow causing heart
attack
90
91
Coronary
Artery Disease
Obstructions
Atherosclerosis
Coronary artery
spasm
Coronary artery
thrombosis
92
Atherosclerosis & Plaque Development
93
Coronary
Artery Bypass
Grafting
(CABG)
94
95
96
Congenital Heart Defects
97
Congenital Heart Defects, cont.
98
99
Arrhythmia
Irregularity in heart
rhythm due to
conduction system
defect
Bradycardia
Tachycardia
Fibrillation
100
Credits
by Rob Swatski, 2010
http://robswatskibiology.wetpaint.com
Visit my website for more Anatomy study resources!
http://www.flickr.com/photos/rswatski
Please send your comments and feedback to: rjswatsk@hacc.edu
This work bears an
Attribution-Noncommercial
Share Alike Creative
Commons license.
Images used in this work bear a
Creative Commons license and
are attributed to their original
authors.