LAYERS:

1. Epicardium
- Work horse (it pumps blood 24 hrs.) - Visceral epicardium
- Relaxation: when it receives blood - inner layer of the fibrous sac
pericardium
Right Side: Oxygenated blood from the
- outer layer of the heart
body
- serous membrane that surrounds
Left Side: oxygenated blood from the myocardium
lungs 2. Myocardium (heart muscle)
- Consist of thick bundles of cardiac
- Propels blood through the 50,000 muscle
miles of blood vessels in the body - Wasted into ring like arrangement
- Beats approx. 100,000 times each day - Layer of the heart that actually
- Pumps blood – 7,000-7,400 L/day contracts
- Contraction – 2.5 billion times in an - Reinforce by a dense fibrous
average lifetime. connective tissue → “skeleton of the
NORMAL RESTING HEART AVERAGE heart”
RATE - Makes up the 4 chambers of the
Neonate 120-160 CPM 140 CPM heart
1 y/o 80-160 CPM 120 CPM 3. Endocardium
3 y/o 80-120 CPM 110 CPM - Is a thin, glistening sheath of
6 y/o 70-115 CPM 100 CPM endothelium that lines the heart’s
chambers
10 y/o 70-110 CPM 90 CPM
- Innermost
14 y/o 60-110 CPM 85-90 CPM - Continuous with the lining of the
Adult 60-100 CPM 72 CPM blood vessel

CHAMBERS OF THE HEART

STRUCTURE OF THE HEART
- Blunt cone shape
- 12 cm long, 9 cm wide (5 in x 3.5 in)
- Adult Male: 250 g – 390 g (310g)
- Adult Female: 200 g – 275 g (255g)
- Accounts for the 5% of the body
weight
- Center of thorax – inside the
mediastinum
- slanted diagonally to the left side
- apex- pointed end
- base- upper part
- covered with a protective sac called
PERICARDIUM
• a membrane
• protective sac that surrounds
the pericardial cavity; which
contains small amount of
pericardial fluid
- Enclosed space/compartment/cavity
a. Interventricular Septum
- Divides the heart vertically into right
and left
b. Auricle
- An ear shaped muscular part that
sticks out from the surface of each
upper chamber atrium of the heart
1. Atria
- Upper chambers of the heart that
receives blood from the veins and
pumps it to the ventricles
2. Ventricles
- Lower chambers that receives blood
from the atria and contract to force
blood out of the heart into arteries

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VALVES b. Descending
- Downward aorta
- Allows blood to flow in the direction
- Extends downward
and prevents the backflow of the
blood
• Coronary Arteries - 1st branch of
aorta
1. Atrioventricular Valves
• Myocardium – several cardiac veins
- This is the 2 valves that allow blood to
• Brachiocephalic Artery
flow from atria to the ventricles
• Left Common Carotid Artery
a. Tricuspid Valve
• Left Subclavian Artery
- Right AV
-supplies O2 and products
- 3 flaps that prevents backflow
b. Bicuspid/Mitral Valve
❖ Blood is supplied to the heart by the
- Left AV
right and left coronary arteries which
- One-way valve between the left
are the first branches of the aorta
atrium/ventricle
FUNCTIONS OF THE HEART
2. Semilunar Valve
- Prevents backflow of blood in the 1. Receives oxygen-poor blood from the
pulmonary trunk and aorta from body and sends it to the lungs for a
flowing back into the ventricles fresh supply of O2
a. Pulmonary Semilunar Valve 2. Pumps newly oxygenated blood to all
(Pulmonic valve) parts of the body, where body cells
- Allows O2-poor blood to enter the can use it for aerobic respiration
pulmonary trunk on its way to the
lungs from the right ventricle ▪ Left Atrium and Ventricle
b. Aortic Semilunar Valve - Receives oxygenated blood from the
- Allows oxygenated blood to enter the lungs via pulmonary veins to be
aorta from the left ventricle delivered to the body
Valves involved: Mitral valve and
GREAT VALVES aortic valve
▪ Right Atrium and Ventricle
1. Pulmonary Arteries
- Receives deoxygenated blood from
- Carries o2-poor blood from the heart
the body to the lungs for fresh supply
to the lungs
of oxygen
2. Pulmonary Veins
Valves involved: Tricuspid and
- Returns o2-rich blood from the lungs
pulmonary valve
to the heart
3. Superior and Interior Vena Cava
PROPERTIES OF CARDIAC MUSCLE
- Drains venous blood from the upper
CELLS
and lower part of the body to the
1. Cardiac muscle cells function as a
heart
coordinated unit in response to
- Drains oxygen poor blood going to
physiological stimulation
the right atria
2. Contains mitochondria which
4. Aorta
provides constant ATP for the
- An artery that carry highly
contraction of the hardworking
oxygenated blood away from the
heart muscle
heart
3. Abundant blood and a high
a. Ascending
concentration of myoglobin
- Upward aorta
- Extends upward from the left
ventricle to the aortic arch where it
bends
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CONDUCTION SYSTEM depolarization after ventricular
contraction
- Transmission of electrical impulses to
be able for the heart to contract
❖ Attaching electrodes to the skin and
recording activity can visualize
2 TYPES OF MUSCLE
electrical activity of the heart by
1. Myocardial (Muscle Cell)
electrocardiograph
- Responsible for the heart pumping
action
ELECTROCARDIOGRAM
2. Electrical Cells
- ECG/EKG Machine
- generating and conducting electrical
current that stimulates the muscle
1. Depolarization
cells to contract
- Loss of electrical charges on the
surface of the cell membrane that
A. Sinoatrial (SA) node
results or create nerve impulses
- Internal pacemaker located in the
- Rapid enabling nerve impulse
walls of right atrium
- (+) wave on the heart muscle
- Composed of clump of specialized
- Process of electrical discharge
cardiac muscle cell
- Enables the heart to contract
• Pacemaker
2. Repolarization
- sends out rhythmic electrical
- Restoration of the normal electrical
impulses to regulate the heart beat
polarity of a nerve or muscle after
- imposes a single rhythm on
- muscle contraction
all the atrial muscle cells
ELECTROCARDIOGRAPH
❖ Depolarizes- 70-80 times/min
▪ P wave: Atrial Depolarization
causing the atria to contract
-transmission of electrical
B. Atrioventricular (AV) Node
impulses from the SA node
- Delays the impulse from the atria
throughout the atrial myocardium
while the ventricles fill
▪ QRS Complex: Ventricular
- Lowe interatrial septum
Depolarization
C. Bundle of His
-electrical impulses spread
- Arises to the AV node and conducts
throughout the ventricular
impulses to the bundle branch
myocardium
system
▪ T wave: ventricular Repolarization
a. Right Bundle Branch
-activity occurring as ventricle
- Transmit impulses down the right
relax
side of the interventricular septum
towards the right ventricular
IMPORTANCE OF ECG RESULT
myocardium
1. Diagnosis of the client
b. Left Bundle Branch
1. Anterior portion transmit the CARDIAC OUPUT
impulses to the anterior
endocardial surface of the left - Total amount of blood pump by the
ventricle ventricles each minute
2. Posterior portion transmit the
impulses over the posterior and 2 FACTORS
inferior endocardial surfaces 1. Heart Rate
D. Purkinje Fibers -number of contractions the
- Transmit the impulses to the heart undergoes per minute
ventricles and provide for Ex: 60-80 bpm
Cardiac output= stroke volume

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 (60-80) x pulse rate (hear rate) - Lubb and Dupp
Cardiac output= 70 ml x 70 bmp - The recording of the heart sound is
Cardiac output= 4900 ml per minute called PHONOCARDIOGRAM which
(approx. 5L) shows heart sound as waves

LUBB
2. Stroke Volume
-amount of blood pumped by - When blood is push out from the
each ventricle during contraction heart into the body
- Occurs during ventricular contraction
CARDIAC CYCLE - when the atrioventricular valves are
1. Systole closing
- Contraction of the atria and ventricle
during which blood id pumped to Dubb
the arteries - reloading of the heart with more
- Higher pressure than diastole blood and ready to be push out
- contraction - pulmonary/aortic valve are closing
2. Diastole
- Rhythmic expansion of the chambers NORMAL RANGE OF BLOOD PRESSURE IN
of the heart at each heart beat THE BODY
- Relaxation
SYSTOLIC DIASTOLIC AVERAGE
4 STAGES New
65-90 30-60 80/46 mm/Hg
born
1. Atrial Systole
Infant 65-115 42-80 90/61 mm/Hg
- Both atria contract, forcing blood into
the ventricles 3 y/o 76-112 46-84 99/65 mm/Hg
2. Ventricular Systole (.3 sec) 6 y/0 85-115 48-64 100/56 mm/Hg
- Both ventricles contract forcing the
10 y/o 93-125 46-68 118/61 mm/Hg
blood out through the pulmonary
artery to the lungs and aorta to rest 14 y/o 99-137 51-71 118/61 mm/Hg
of the body Adult 100-140 60-90 120/80 mm/Hg
o EDV
Elderly 100-160 60-90 130/80 mm/Hg
- End diastolic volume
- Amount of blood in the ventricles
right before ventricular contraction ➢ 140 – hypertension
3. Atrial Diastole (.7 sec) ➢ 130 – prehypertension
- Relaxation of the atria
- Ventricles remain contracted and the Oxygenated Blood
atria begins to fill with blood from the Lungs→ pulmonary veins→ atrium→ mitral
large veins leading to the heart from valve→ left ventricle→ aortic valve→ aorta→
- the body body (cells/tissue)
4. Ventricular Diastole (.5 sec)
- Relaxation of the ventricle before the Deoxygenated Blood
atrial systole allowing ventricles fill Superior/inferior vena cava→ right atrium→
with blood from atria tricuspid valve→ right ventricle→
o ESV pulmonary valve→ pulmonary arteries→
- End systolic volume lungs
- Amount of blood left at the ventricle
right after ventricular contraction

HEART SOUNDS

- First and second sound

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