Chapter 14

C a r d i o v a s c u l a r S y s t e m:

THE HEART
Carina C. Batol | Associate Professor IV | Bataan Peninsula State University
 The human cardiovascular system
consists of & muscular pump, the heart,
and a network of blood vessels that
transport blood throughout the body.
 Structure of the
heart
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• The heart is shaped like a blunt
cone. Pericardium
• It is about the size of the clenched  A protective sac that covers the heart.
 Divided into an outer parietal layer and an
fist of its owner. inner visceral layer.
• The heart is located in the center of  It surrounds the pericardial cavity
the thorax.
Pericardial cavity
Apex  Contains a small amount of pericardial
 The pointed part of the heart. fluid.
 It extends forward, downward, and to the
left.
Pericarditis
 Inflammation of the pericardium often
Base – results in a decrease in the amount of
pericardial fluid. This causes the pericardial
 The uppermost part of the heart.
layers to bind and stick to each other,
 It extends, upward, backward, and to the
forming painful adhesions that interfere
right.
with heart movements.
 Chambers of the
Heart
 The heart is a hollow organ that contains four chambers.
 Dividing the heart vertically down the middle into a right heart and a left heart is a
wall of muscle called the septum.
 At the top of each half of the heart is a chamber called an atrium. Below is another
chamber, the ventricle.
 Each atrium has a flaplike appendage of unknown function called an auricle (“little
ear’).
 The atria lead to the ventricles by way of openings called atrioventricular orifices.
 In a normal heart, blood flows the atria to the ventricles, never the other way.
  The right and left ventricles have walls that contain ridges
called trabeculae carnae, which are formed by coarse
bundles of cardiac muscle fibers.
 Both the right and left ventricles contain papillary muscles
and supportive cords called chordae tendinae, which are
attached to the free edges of the atrioventricular valves.
 Because the heart is aclosed system of chambers, when the
left and right ventricles pump almost simultaneously, Equal
amounts of blood must enter and leave the heart.

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ovascular system
  The wall of the left ventricle is thicker, however, because it must be strong
enough to supply blood to all parts of the body, whereas the right ventricle
supplies blood only to the lungs.
 The walls of the atria are thinner than the ventricular walls because less
pressure is required to pump blood only a short distance into the
ventricles.
 The coronary sulcus, encircling the heart, indicates the border between
the atria and ventricles.
 Embedded in fat within the coronary sulcus are the right and left
coronary arteries and coronary sinus.

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ovascular system
 Valves of the
HEART
The four heart valves allow blood to flow through the heart in onlY one direction; they also
prevent the backtlow of blood. The two atrioventricular valves allow blood to flow from the atria
to the ventricles, and the two semilunar valves allow
load to flow from the right ventricle to the pulmonary artery and from the left ventricle to the
aorta. A heart valve consists of flaplike folds called cusps of the endocardium reinforced by
dense connective tissue.
The two atrioventricular (AV) valves differ in structure but operate in the same way. The right
atrioventricular valve is known as the tricuspid valve of the right heart because it consists of three
cusps. The left atrioventricular valve, or bicuspid valve of left heart, has two cusps. Because the
cusps resemble a bishop’s miter, the valve is also called the mitral valve.
 The semilunar valves prevent blood in the pulmonary trunk and
aorta from flowing back into the ventricles. The left semilunar
valve is slightly larger and stronger than the right. The right
semilunar valve is in the opening between the right ventricle
and the pulmonary trunk and is called the pulmonary
semilunar valve. It allows oxygen-poor blood to enter the
pulmonary trunk on its way to the lungs from the right
ventricle. The left
semilunar valve is the aortic semilunar valve, which allows
freshly oxygenated blood to entér the aorta from the left
ventricle.

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 Great
Vessels of the

Heart
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  The largest arteries and veins of th heart form the beginnings of the pulmonary
and systemic circulations. The vessels carrying oxygen-poor blood from the heart
to the lungs are the pulmonary arteries.
 Those returning oxygen-rich blood from the lungs to the heart are the pulmonary
veins.
 Draining venous blood from the upper and lower parts of the body to the heart are
the superior vena cava and inferior vena cava, respectively.
 The artery carryinh highly oxygenated blood away from the heart is the aorta.
 It is called the ascending aorta as it extends upward from the left ventricle, the
aortic arch where it bends, and the descending aorta as it continues downward.

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Blood supply to the
heart
the heart muscle needs
more oxygen than any
other organ except the
brain.
 Coronary Circulation
-the flow of blood that supplies the heart tissue itself

 The heart pumps about 380L (100gal) to its own muscle tissue everyday, or about 5percent
of all the blood pumped by heart
 Blood is supplied to the heart by the right and left coronary arteries
 The myocardium is drained by several cardiac veins

Heart attack Angina pecroris

-When the myocardium is
-resulting myocardial
deprived by oxygen
infraction -crushing chest pain
 Physiology of the heart
2 functions:
•receives oxygen-poor blood from the body and sends
it to the lungs for a fresh supply of oxygen
•pumps the newly oxygenated blood to all parts of the
body, where body cells can use it for aerobic respiration

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 Properties of cardiac
muscle cells

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-in the atria or ventricles function as a coordinated unit in
response to physiological stimulation
- it acts this way because they are connected end to end by
intercalated disks (contain gap junctions and desmosomes)
-cardiac muscle contains a large number of mitochondria
-has abundant blood supply and high concentration of
myoglobin, a muscle protein that stores oxygen.

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 Conduction system of the heart
• The human heart functions at different rates under
different conditions.
• At rest, it beats slowly but in excitement it beats
faster than usual.
• This variation of heart rates helps the body adjust
for the difference in body requirements.
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SYNOATRIAL NODE ( SA
NODE )
: body's internal
pacemaker
: Located in the
wall of the right
atrium
: Composed of a
clump of
specialized
 •These muscle cells contract spontaneously and
rhythmically, producing a bioelectric impulse
that spreads rapidly to the SA node towards the
cardiac muscle traveling to both atria.
• Left to their devices, cardiac muscle cells
would contract independently and in disorderly
way, it creates an ineffective pumping action.
• The SA node imposes a single rhythm on all of
the atrial heart muscle cells.
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ATRIOVENTRICULAR NODE
• specialized muscle cells
• from the AV node, the impulse travels through the
ATRIOVENTRICULAR BUNDLE.

The atrioventricular bundle is divided into two branches:

B. PURKINJE FIBERS
A. BUNDLE BRANCHES
- terminate on the cardiac
- give off smaller branches
muscles in the walls of the
that terminate of
ventricles, stimulating them to
specialized muscle cells
contract.
 ELECTRICAL CAVITY IN THE HEART
 When the electrical impulse that stimulates muscle contraction
reaches a cardiac muscle cell, it causes the cell to contract.
 Normally, the outside surface of the cardiac muscle is slightly
positive; the inside surface is slightly negative.
 When the impulse arrives it causes a rapid change in the
permeability of the cardiac muscle cells plasma membrane to
sodium ions Sodium ions flow inward, changing the polarity of the
membrane and temporarily making the inside of the cell more
positive than the outside.
 This change in polarity causes the release of calcium from internal
Bataan
storage depots which in turn causes the cell to contract.
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 The shift in cardiac muscle cell polarity, or depolarization, can be detected by
surface electrodes, small metal plates connected to wires and a voltage meter.
The electrodes are placed on a person’s chest.
 The resulting reading on avoltage meter is called an electrocardlogram (ECG or,
sometimes EKG).
 For a normal person, the tracing produced on the voltage meter has three
distinct waves.
 The first wave, the P wave, represents the electrical changes occurring in the
atria of the heart.
 The second Wave, the QRS wave, is a record of the electrical activity
 taking place during ventricular contraction, and the third wave, the T wave, is a
recordingof electrical activity occurring as the ventricles relax.
 Diseases of the heart may disrupt one or more waves of the ECG.
 Cardiac Output
- The total amount of blood pumped by the ventricles each minute
Two factors:

heart rate - the number of stroke volume - the amount of

contractions the heart undergoes blood pumped by each ventricte
per minute, during each contraction.

Cardiac output varies among individuals, depending on their physical condition and
their level of activity.
Regulation of the heart rate
 The most important external influence on heart rate is the activity of the autonomic nervous system.
Heart rate is also modified by various chemicals, hormones , and ions.
 During times of physical or emotional stress, the nerves of the sympathetic division of the autonomic
nervous system stimulate the SA and AV nodes and the cardiac muscle itself. As a result, the heart
beats more rapidly.
 Parasympathetic nerves slow and steady the heart, giving it more time to rest during noncrises times.
 Various hormones and ions can have a dramatic effect on heart activity.
 Epinephrine, which mimics the effect of the sympathetic nerves, and thyroxine, both increase heart
rate.
 Electrolyte imbalances pose a real threat to the heart.
 Excesses or a lack of needed ions such as sodium and potassium also modify heart activity.
 A number of physical factors, including age, gender, exercise, and body temperature, influence heart
rate.
 Resting heart rate is fastest in the fetus (140-160 beats per
 Cardiac Cycle
 carefully regulated sequence of steps that we think of as the beating of the heart.
 The cycle includes the contraction ( systole ) of the atria and ventricles, the relaxation
(diastole) of the atria and ventricles.
FOUR STAGES OF THE CARDIAC CYCLE
• During atrial systole, both atria contract, forcing blood into the ventricles.
• During ventricular systole (0.3 secs) both ventricles contract, forcing blood out
through the pulmonary artery ( lungs ) and aorta ( to the rest of the body ) .
• During atrial diastole (0.7 secs) or relaxation of the atria, the ventricles remain
contracted and the atria begin refilling with blood from the large veins leading to the
heart from the body.
• Ventricular diastole ( 0.5 secs) or relaxation of the vetricles, begins before atrial
systole, allowing the ventricles to fill with blood from the atria.
 HEART SOUNDS
 produced with each heartbeat.
 can be amplified and recorded by placing an
electronically amplified microphone on the chest.
 The recording is called the PHONOCARDIOGRAM,
which shows the heart sounds as waves.

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 HEART DISORDERS
Heart disease or cardiovascular disease - common disorders of the heart and
blood vessels.
MYOCARDIAL INFARCTION ( Heart Disease )
; blood flows through the coronary artery is reduced for any reason
because of clotting, resulting in oxygen deprivation.

CONGESTIVE HEART FAILURE

; occurs when either ventricle fails to pump blood out of the heart as quickly as
it enters the atria or when the ventricles do not pump equal amount of blood.

VALVULAR HEART DISEASE

; abnormal heart sounds or murmurs that may indicate valvular
heart disease, in which one or more cardiac valves operate
improperly.
 CONGENITAL HEART DISEASE
; one that is present at birth, but not necessarily hereditary. Example is
Ventricular Septal Defect, where an opening occurs in the ventricular septum
that allows blood to move back and forth between ventricles.

INFECTIOUS HEART DISEASE

; severe damage to the heart valves or heart walls can become an
infectious disease. Rheumatic fever is a severe infectious disease
occuring in children, characterized by fever and painful
inflammation of the joints and may result to a permanent damage
to the heart valves. It is a hypersensitive reaction to a specific
streptococcal bacterial infection in which antibodies cause
inflammatory reactions in the joints and heart.
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 Group 5
Awa, Ron Jason
Balagtas, Angela Risen
Censon, Leila Marie
Cosme, Alyssandra Joyce
De Jesus, Ira Joie
Rivera, Psalm Robert
Sacdalan, Trisha