ANATOMY & PHYSIOLOGY: LESSON 12 -
HEART
 FIST – Approximate size of the heart
 The shape of the heart is cone-shaped or
inverted pyramid
 Located in the MEDIASTINUM
(thoracic cavity between the 2 pleural
cavity)
o Apex – inferior end of the heart
o Base – larger superior base of the heart;
points more to the RIGHT
o Pericardial cavity – space of the heart; made
up of tissue called “pericardial
sac/pericardium” and these tissues will
surround the heart to anchor it to the
mediastinum
The pericardium/ pericardial sac has 2 layers:
o the outer layer – called the fibrous
pericardium
o inner layer – called the serous pericardium
has also 2 layers the outer serous
pericardium is called the parietal
pericardium and the inner serous
pericardium is called the visceral
pericardium also known as EPICARDIUM
o there is a space in between the 2 serous
layers called the pericardial cavity.
o The pericardial cavity is filled with fluid
called pericardial fluid that helps reduce
friction during the movement of the heart
HEART WALL
o The epicardium is part of the 3 layers of the
heart wall and it is the outermost wall of the
heart
o This layer is composed of simple squamous
epithelium
o The MIDDLE LAYER, MYOCARDIUM
is composed of cardiac muscle cells that is
responsible for the contraction of the heart
o The innermost layer makes up the smooth
inner surface of the heart is called
ENDOCARDIUM, because of its
smoothness it allows a smooth flow of the
blood through the heart.
OVERVIEW OF THE ANATOMY OF THE
HEART
6 VEINS important for the heart anatomy:
o Veins – valik / towards the heart
o Superior vena cava -gets blood from the
upper part of the body and drain in the heart
o Inferior vena cava – carries blood from the
lower parts of the body for example in the
legs and carry it towards the heart
o 4 pulmonary veins – carries blood from the
lungs to the heart
2 arteries important for the heart anatomy:
o Arteries – away from the heart
o Pulmonary trunk – divides into the left and
right pulmonary arteries; it carries blood
from the heart to the lungs
o Aorta – the one that carries blood from the
heart towards the rest of the body.
4 chambers for the blood in the heart:
o (2) Atria - Top chambers – receiving
chambers of blood; responsible for receiving
and holding blood coming from the body
and the lungs.
o The heart has 2 atria: left and right
o Right atrium gets blood from the body
through the superior and inferior vena cava
while;
o Left atrium receives blood through the
pulmonary veins
o If the 2 atria will contract its going to push
blood out of it and down to the next
chambers called the VENTRICLES
o the right atrium will push blood to the right
ventricle and the left atrium will push blood
to the left ventricle
o (2) Ventricles
ANATOMY & PHYSIOLOGY: LESSON 12 -
HEART
o Ventricles are major pumping chambers of
the heart since they are responsible for
pumping blood to the lungs and to the rest of
the body
o right ventricle, when it contracts it will push
blood to the pulmonary arteries to give
blood from the heart to the lungs
o while the left ventricle when it contracts its
going to push blood going to the aorta to
push blood to the rest of the body.
o Comparing the 2 ventricles the left ventricle
needs more power/ greater force of
contraction since it’s going to pump blood to
the rest of the body while the right ventricle
just needs to pump blood in the lungs
o That is why the left ventricle has a thicker
wall than the right ventricle and also causes
the left ventricle to create a greater blood
pressure than the right side.
SEPTA
o Septa – divides the atria and ventricle into
the left and right atrium and ventricle
o Interatrial septum – in between the two atria
o Interventricular septum – in between the two
ventricles
Heart valves – gatekeepers of the blood flow;
allows one blood direction only and won’t allow a
back flow.
 2 types: atrioventricular valves and
semilunar valves
o AV VALVES (Atrioventricular valves)- in
between the atria and the ventricle; prevents
backflow from the ventricle to the atrium
o The right av valve is called the TRICUSPID
valve it is named as tricuspid because it
consists of 3 cusps.
o Tricuspid valve will prevent backflow of
blood from right ventricle to right atrium
o The left av valve only consists of 2 cusps
called BICUSPID VALVE but known
better as MITRAL valve
o Mitral valve will prevent back flow from the
left ventricle to the left atrium.
o It is called as the mitral valve since it
resembles the bishop’s miter.
o Semilunar valves – are named this way
because of their shape which resembles the
moon; valve in between the ventricle and
great blood vessels
o Pulmonary valve is between the right
ventricle
o In the right ventricle its going to pass
through the pulmonary semilunar valve
before the blood goes to the pulmonary
trunk so when the ventricle contracts the
blood will go to the pulmonary trunk
o Once the blood is in the pulmonary trunk the
pressure will be greater in the pulmonary
trunk than the ventricle and will close the
pulmonary valve to prevent backflow of the
blood going back to the ventricle
o Aortic semilunar valve – valve between the
left ventricle and aorta.
Muscles in the heart
 Papillary muscles – cone shaped muscle that
are connected to the free areas of the av
valves via connective tissue strings called
CHORDAE TENDINEAE
 Chordae tendineae – heart strings
 When the ventricles contract, the papillary
muscles will also contract to prevent the
valves from opening by pulling the heart
strings
 Cardiac skeleton – plate of connective tissue
made up of fibrous rings; attachment site for
muscles and an electrical insulator between
the four chambers of the heart
BLOOD VESSELS
 Deoxygenated blood coming from the upper
body goes through the superior vena cava and
into the right atrium
 Next, blood coming from the lower body goes
through the inferior vena cava and again
enters the right atrium.
 The blood in the right atrium then passes
through the tricuspid valve and then it will
enter into the right ventricle
 When the ventricle contract, the
pulmonary semilunar valve will open
and the tricuspid valve will close.
 The blood will then travel to the pulmonary
trunk then to the pulmonary artery and it will
ANATOMY & PHYSIOLOGY: LESSON 12 -
HEART
go next to the lungs and there they will get the
oxygen that the body needs.
 After they get the oxygen, the blood will
travel through the pulmonary veins and they
will enter the left atrium.
 Once they reach the left atrium, they will pass
again through the mitral valve and it will enter
the left ventricle.
 When the ventricle contract, the mitral
valve will close and the aortic valve will
open, so the blood will flow to the aorta.
 Once in the aorta, it will go to the rest of the
body and the oxygen will be used up by the
body, this cycle goes on and on. This is the
basic flow of the blood.
TAKE NOTE:
 Two Atria simultaneously contract and Two
Ventricles simultaneously contract
CIRCULATION
 It was established that the heart is a pump, but
the heart is two pumps in one, because it is
involved in two circulations.
1. Pulmonary Circulation (to lungs)
which involves the right side of the heart
pumping the blood to the lungs, to the left side
of the heart from the right atrium to right
ventricle then towards the lungs. From the
lungs, to the left atrium.
2. Systemic Circulation (to body)
 Involves the flow of the blood from the
left side of the heart to the other parts of
the body and then back to the right side of
the heart. After it gets oxygen from the
lungs it goes to the left atrium then left
ventricle then out through the aorta, to the
rest of the body to use up the oxygen and
goes back to the right side of the heart.
BLOOD SUPPLY OF THE HEART
 The body needs a blood to function
 The heart pumps blood to the heart to the rest
of the body just like other organs in the body
that needs blood supply.
 The heart pumps blood for itself via coronary
arteries.
 These arteries originate at the base of the
aorta and it has the left and right coronary
artery.
Left Coronary Artery
 It originates from the left side of the aorta, and it
has three major branches:
a. Anterior Interventricular
b. Circumflex
c. Left Marginal Artery
 These branches and the left coronary artery
supply most of the anterior wall of the heart and
the left ventricle
Right Coronary Artery
 Only has two branches:
a. Posterior Interventricular
b. Right Marginal Artery
 These branches supply most of the right
ventricle
 There is a difference between the blood vessels
for the rest of the body and the blood vessels
here.
 The artery will carry blood away from the heart,
during ventricular contraction, blood flow is
highest in blood vessels or arteries going
towards the body because it pushes blood
towards the vessels towards the body.
 These arteries have the highest blood flow
during ventricular relaxation, the heart is
supplied with blood during relaxation of the
ventricles.
Take Note:
Ventricular Relaxation is the opposite on
supplying of blood to the rest of the body.
Veins
 The veins carry blood back to the heart.
ANATOMY & PHYSIOLOGY: LESSON 12 -
HEART
 The cardiac veins will drain the blood from
the cardiac muscles to the coronary sinus
 The coronary sinus is a large vein at the
posterior heart within the coronary sulcus
 From the sinus, the blood will flow to the right
atrium and there are also small cardiac veins
that will directly drain into the right atrium.
 Mostly all of the blood from the cardiac
muscles will drain into the right atrium via
the coronary sinus or the other cardiac
veins.
ACTION
POTENTIAL
CORONARY ARTERY DISEASES
 Coronary Arteries will carry the blood towards
the heart muscles to supply nutrients to the
heart, but there are conditions regarding these
arteries.
a. Coronary Thrombosis
 When there is a blood clot formed
 There is lesser blood that will go to the heart
muscle
 Coronary Artery Disease or CAD
 When there is a reduced blood supply to the
heart.
 Myocardial Infarction
When there is a reduced blood supply to the
heart and reduced nutrients, it could lead to
 damage of the heart tissue. Since it does not
receive any nutrients, it will die.
 This condition is commonly known as heart
attack.
CONDUCTION SYSTEM
 The cardiac muscle fibers contract rhythmically
because they have their own built-in conduction
system and this is responsible for coordinating
the contractions during the cardiac cycle.
 The cardiac muscles have their
interconnectedness because of intercalated disks
so both atria, the left and the right will contract
about the same time because the fibers are
electrically linked likewise both the ventricles
will also contract at about the same time
because of these electrical linkages.
Four Structures in the Heart
(to produce spontaneous action potentials)
a. Sinoatrial Node or SA Node
 ‘Pacemaker of the heart’ because it initiates or
it starts the contraction of the heart
 It is located at the superior wall of the right
atrium
 The action potentials from the SA node will
then spread through
the atria to cause the atria
to contract.
b. Atrioventricular Node or AV Node
 It is located at the lower part of the right
atrium
 Once the impulses will reach the AV Node, it
will spread slowly through it.
 The flow should be slow through the AV
node, so that it could complete first
contraction of the atria before the action
potential reach the AV node
c. Atrioventricular Bundle or Bundle of HIS
 This is located at the connective tissue
separating the atria from the ventricles
d. Purkinje Fibers
 This bundle will divide into left and right
bundle branches and forms the Purkinje Fibers
 The purkinje fibers extends separating the
atria from the ventricles to the muscles of the
ventricles
 Once it reaches the purkinje fibers, this causes
the ventricles to contract.
 ‘Largest pacemakers’ or the ‘largest part of
the conduction system ’
Mnemonics: SABP
 If the SA node has problems, AV nodes will
be the one to initiate the heart beats.
 If the SA node and the AV node has problems,
the bundle of HIS will initiate the contraction
o Normally the heart beats 60 – 100 times per
minute, that is initiated by the SA Node.
o If AV node initiate, there will be lesser, it will
be 40 – 60 times per minute
o If Bundle of HIS, it will become lesser
ANATOMY & PHYSIOLOGY: LESSON 12 -
HEART
o If the Purkinje Fibers, it is also lesser. surface by electrodes and its transformed

ACTION POTENTIAL

 The it has similar phases but it is not the same.

 The difference, here it starts with zero not phase
Phase Zero
 It is sodium channels open because of a
stimulus.
 When sodium channels open, sodium ions will
go inside the cell, that is why, the inside of the
cell became more positive. This is the
depolarization phase.
Phase One
 Is when potassium channels open and triggers
a lower or lesser positive charge inside the
cell. This part is the initial repolarization.
Phase Two
 This is the phase that the other cells don't
have interaction potentials.
 ‘Plateau’ meaning they do not have a change
in either going negative or going positive it's
because while potassium channels are still
open, calcium ion goes in and that’s also a
positive charged ion. There is a balance.
 When the calcium channels close and
potassium channels are still open, there is still
potassium going out, it lessens because it's
getting more negative not inside the cell and
positively charged potassium ions. And that
is Repolarization Phase.
into 3 things by an instrument called
electrocardiogram, a graphic record of the
heart’s electrical activity.
 An extremely valuable tool for diagnosing a
number of cardiac abnormalities.
3 WAVES OF EKG/ECG
 Depolarization- contraction
 Repolarization - relaxation
1. P wave
- Electrical signal for the ATRIAL
DEPOLARIZATION.
- After that electrical signal, the atrias
will contract both the left and the
right.
2. QRS wave
-

 PHASE FOUR
- RESTING MEMBRANE
POTENTIAL and back to its nature
resting phase where everything is
balanced.
SUMMARY:
PHASE 0 – DEPOLARIZATION; Na
channels go open, Na goes in

PHASE 1 - INITIAL
REPOLARIZATION; K out VENTRICULAR
DEPOLARIZATION
PHASE 2 – PLATEAU; Ca going in - After that electrical signal, the
ventricle will contract.
PHASE 3- REPOLARIZATION; Na out - Atrial repolarization is very small
so its hidden between this wave
PHASE 4 – RESTING MEMBRANE
POTENTIAL and back to resting phase

EKG/ECG (ELECTROCARDIOGRAM)
 The action potential in the heart produces
electrical currents and these electrical
signals could be picked up from the bod
ANATOMY & PHYSIOLOGY: LESSON 12 -
HEART
3. T wave
- VENTRICULAR
REPOLARIZATION
- After this wave, the ventricles will relaxed

OTHER PARTS OF EKG/ECG

1. PQ/PR INTERVAL
- Time between the beginning of the
P waves and the beginning of the
QRS complex; atria contracts and
begins to relax.
2. QT INTERVAL
- Start from the beginning of the QRS
to the end of the T WAVE.
- Time needed for ventricular
depolarization and repolarization.
*insert pictures of steps for ekg/ecg
CARDIAC CYCLE
- repetitive pumping process of
cardiac muscle contractions.
 SYSTOLE – contraction of
either the atria or the
ventricles
 DIASTOLE – relaxation of
either the atria or the
ventricles
 STROKE VOLUME –
blood ejected per BEAT; 70
mL/beat
 CARDIAC OUTPUT –
blood ejected per MINUTE;
5 L/min. 2. ATRIAL
SYSTOLE/CONTRACTION

MAJOR EVENTS IN CARDIAC CYCLE

1.
ANATOMY & PHYSIOLOGY: LESSON 12 -
HEART
HEART SOUNDS
 Stethoscope – used to listen to the
sounds of the lungs and the heart

2 HEART SOUNDS

3. VENTRICULAR
SYSTOLE/CONTRACTION
1. S1- LUB
- closure of the AV valves (tricuspid & mitral
valves)
2. S2 – DUB
- Closure of the SEMILUNAR valves
(aortic & pulmonic valves)

REGULATION OF THE HEART

 STROKE VOLUME (SV) – blood
ejected per BEAT; 70 mL/beat
 CARDIAC OUTPUT (CO) – blood
ejected per MINUTE; 5 L/min.
 HEART RATE (HR) – no. of times
the heart contracts per minute; 72
beats/min; normal: 60-100 bpm

CO = SV x HR
CO = 70 mL/beat x 72 bpm
4. VENTRICULAR CO = 5040 mL/min (approx. 5 L/min)
DIASTOLE/RELAXATION
NERVOUS REGULATION:
BARORECEPTOR REFLEX
ANATOMY & PHYSIOLOGY: LESSON 12 -
HEART
EPINEPHRINE &
NOREPINEPHRINE
(SYPMPATHETIC RESPONSE)

- INCREASED HR AND SV
2. Emotions
 Excitement/anger/anxiety-

CARDIOREGULATORY
CENTER- SYMPATHETIC
 Depression –
CARDIOREGULATORY
CENTER –
PARASYMPATHETIC
BLOOD pressure INCREASES 3. Chemoreceptors in Medulla
- DECREASED PH / INCREASED
CO2 – SYMPATHETIC

4. Extracellular Ion Concentration

 EXCESS K- DECREASE
HR & SV – DEATH
 EXCESS Ca-
ARRHYTHMIC
CONTRACTION
 REDUCED Ca –
DECREASED HR & SV
5. Body Temperature
 INCREASED TEMP:
INCREASED HR
 DECREASED TEMP:
DECREASED HR

CHEMORECEPTORS REFLEX

BLOOD pressure DECREASES

CHEMICAL REGULATION
1. Exercise, Emotions, Stress
- Adrenal gland secretes
ANATOMY & PHYSIOLOGY: LESSON 12 -
HEART
BLOOD pH INCREASES
BLOOD pH DECREASES