Review of ANATOMY and

PHYSIOLOGY
HEART
 Layers
• Endocardium- endothelial tissue, inner lining
• Myocardium- composed of muscle fibers,
pumping action!!
• Epicardium- outer layer

*Pericardium: Fibrous membrane; for anchoring

the heart in place
– Visceral: adheres to epicardium
– Parietal: Adheres to vessels, diaphragm, sternum
 Heart Valves
• Permits one way flow of valves
• Composed of fibrous tissue

1. AV valve
- Tricuspid – 3 leaflets
- Mitral – 2 leaflets
2. Semu-Lunar Valves:
- 3 half-moon shaped leaflets
a. Pulmonic semi-lunar valve(Pulmonary)
b. Aortic semi-lunar valve(Aorta)
 Heart Blood Supply
A. Coronary artery
• Supplies blood to heart
• Originated from the Aorta
• Relaxed: supply is greater (70%)
• Exercise: supply is greater in skeletal
muscles (70%)
• Greatest blood flow to heart: diastole
B. Coronary Vein:
• Collects blood from the heart
• Coronary Sinus- posteriorly of Right Atrium
 Conduction
Characteristics:
1. Automaticity
2. Excitability
3. Conductivity
Conduction Pathway:
a. SA node- fastest pace(60-100)
b. AV node- pauses after stimulation 40-60
c. Bundle of His
d. L & R Bundle Branches- L posterior &
anterior
e. Purkinje Fibers
 Cardiac Conduction
• Cardiac electrical activity is the result of
the movement of across the cell
membrane
A. Depolarization
1. Na Channels open
2. K channels close
3. Ca starts to open slowly
B. Early Repolarization
1. Na channels close
2. some K channles open
3. Ca channels open

C. Final Repolarization
1. Ca channels close
2. K channels open
*Refractory Period
• Same length with action potential
• Prevents tetanic contractions
 Cardiac Cycle
1. Ventricles contract, AV valves close (1st sound),
pressure exceeds semi-lunar valves, blood is
ejected out
2. Ventricles relax, pressure in atria increases,
pressure exceeds ventricles, AV valves open,
blood is ejected to ventricles (70%), Semi-lunar
Valves Close(2nd sound)
3. Atria contract to finish ventricular filling (atrial
kick)
4. Pressure increase in ventricles (start of another
cycle)
 Heart Rate
Cardiac Output
- Amount of blood pumped by each ventricle
in a given period (5L/min)
- CO= SV x PR

Stroke Volume
- Amount pumped per beat (70mL)
Baroreceptors
- Aortic arch & internal carotid
- Sensitive to BP changes (para/sympa)

Stroke Volume Factors:

• Pre-Load- degree of stretch is greatest &
ventricular filling volume is highest
• After-Load- resistance to ejection from ventricles
• Contractility- pumping force by myocardium