ANATOMY AND PHYSIOLOGY

YEAR 1
PREPARED BY: JAVIER, INO ZUII

UNIT 9: THE CARDIOVASCULAR SYSTEM

THE HEART PERICARDIUM

● Pericardial sac, double-layered, closed sac that surrounds the
heart
● Contains fibrous connective tissue
● Consists of:
o Fibrous pericardium
o Serous pericardium
▪ Parietal pericardium
▪ Visceral pericardium (epicardium)
● Can accommodate changes in heart size by gradually
enlarging

FUNCTIONS OF THE HEART

● Generating blood pressure
● Routing blood
o Heart separates pulmonary and systemic
circulations
● Ensuring one-way blood flow
o Heart valves ensure one-way flow
● Regulating blood supply
o Changes in contraction rate and force match blood
delivery to changing metabolic needs HEART WALL
● Three layers of tissue
SIZE, SHAPE, LOCATION OF THE HEART o Epicardium: This serous membrane of smooth
● The heart lies in the thoracic cavity between the lungs and outer surface of heart
sternum o Myocardium: Middle layer composed of cardiac
muscle cell and responsibility for heart contracting
● Size of a closed fist o Endocardium: Smooth inner surface of heart
● Shape chambers.
o Apex: Blunt rounded point of cone
o Base: Flat part at opposite of end of cone

EXTERNAL ANATOMY
● Four chambers
o 2 atria
o 2 ventricles
HEART CROSS SECTION ● Auricles
● Major veins
o Superior vena cava
o Pulmonary veins
● Major arteries
o Aorta
o Pulmonary trunk

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 CORONARY CIRCULATION CONDUCTING SYSTEM OF HEART

HEART VALVES ELECTRICAL PROPERTIES

● Atrioventricular ● Resting membrane potential (RMP) present
o Tricuspid
● Action potentials
o Bicuspid or mitral
o Rapid depolarization followed by rapid, partial early
● Semilunar repolarization. Prolonged period of slow
o Aortic repolarization which is plateau phase and a rapid
o Pulmonary final repolarization phase
● Prevent blood from flowing back o Voltage-gated channelss

FUNCTION HEART VALVES ACTION POTENTIALS IN SKELETAL

AND CARDIAC MUSCLE

SA NODE ACTION POTENTIAL

HEART SKELETON
● Consists of plate of
fibrous connective
tissue between atria
and ventricles
● Fibrous rings
around valves to
support
● Serves as electrical
insulation between
atria and ventricles
● Provides site for
muscle attachment

CARDIAC MUSCLE
● Elongated, branching cells containing 1-2 centrally located
nuclei REFRACTORY PERIOD
● Contains actin and myosin myofilaments ● Absolute: Cardiac muscle cell completely insensitive to
● Intercalated disks: Specialized cell-cell contacts further stimulation
● Desmosomes hold cells together and gap junctions allow ● Relative: Cell exhibits reduced sensitivity to additional
action potentials stimulation
● Electrically, cardiac muscle behaves as single unit ● Long refractory period prevents tetanic contractions
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 ELECTROCARDIOGRAM EVENTS DURING CARDIAC CYCLE
● Action potentials through myocardium during cardiac cycle
produces electric currents than can be measured
● Pattern
o P wave
▪ Atria depolarization
o QRS complex
▪ Ventricle depolarization
▪ Atria repolarization
o T wave:
▪ Ventricle repolarization

CARDIAC ARRHYTHMIAS
● Tachycardia: Heart rate in excess of 100bpm
● Bradycardia: Heart rate less than 60 bpm
● Sinus arrhythmia: Heart rate varies 5% during respiratory
cycle and up to 30% during deep respiration
● Premature atrial contractions: Occasional shortened
intervals between one contraction and succeeding, frequently
occurs in healthy people
HEART SOUNDS
● First heart sound or “lubb”
o Atrioventricular valves and surrounding fluid
vibrations as valves close at beginning of ventricular
systole
● Second heart sound or “dupp”
o Results from closure of aortic and pulmonary
semilunar valves at beginning of ventricular diastole,
lasts longer
● Third heart sound (occasional)
o Caused by turbulent blood flow into ventricles and
detected near end of first one-third of diastole
LOCATION OF HEART VALVES

ALTERATIONS IN ELECTROCARDIOGRAM

MEAN ARTERIAL PRESSURE (MAP)

● Average blood pressure in aorta
CARDIAC CYCLE ● MAP=CO x PR
o CO is amount of blood pumped by heart per minute
● Heart is two pumps that work together, right and left half
▪ CO=SV x HR
● Repetitive contraction (systole) and relaxation (diastole) of
heart chambers ● SV: Stroke volume of blood
pumped during each heart beat
● Blood moves through circulatory system from areas of higher
to lower pressure. ● HR: Heart rate or number of
o Contraction of heart produces the pressure times heart beats per minute
▪ Cardiac reserve: Difference between CO
at rest and maximum CO
o PR is total resistance against which blood must be
pumped

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 FACTORS AFFECTING MAP BARORECEPTOR REFLEX

REGULATION OF THE HEART

● Intrinsic regulation: Results from normal functional CHEMORECEPTOR REFLEX-pH
characteristics, not on neural or hormonal regulation
o Starling’s law of the heart
● Extrinsic regulation: Involves neural and hormonal control
o Parasympathetic stimulation
▪ Supplied by vagus nerve, decreases heart
rate, acetylcholine secreted
o Sympathetic stimulation
▪ Supplied by cardiac nerves, increases
heart rate and force of contraction,
epinephrine and norepinephrine released

HEART HOMEOSTASIS
● Effect of blood pressure
o Baroreceptors monitor blood pressure
● Effect of pH, carbon dioxide, oxygen
o Chemoreceptors monitor
● Effect of extracellular ion concentration
o Increase or decrease in extracellular K+ decreases
heart rate
● Effect of body temperature
o Heart rate increases when body temperature
increases, heart rate decreases when body EFFECTS OF AGING ON THE HEART
temperature decreases ● Gradual changes in heart function, minor under resting
condition, more significant during exercise
BARORECEPTOR AND CHEMORECEPTOR REFLEXES
● Hypertrophy of left ventricle
● Maximum heart rate decreases
● Increased tendency for valves to function abnormally and
arrhythmias to occur
● Increased oxygen consumption required to pump same
amount of blood