Heart – Anatomical Position

• The heart:
– Sits near the anterior chest wall, directly posterior to the sternum – Lies slightly to the left of the midline – Sits at an angle to the longitudinal axis of the body – Is rotated towards the left side – Surrounded by the pericardium in the anterior of the mediastinum
• Mediastinum separates the 2 pleural cavities and also contains the esophagus, trachea, and thymus.

Pericardium
• • • Serous membrane lining the pericardial cavity Analogous to a fist in a balloon Subdivided into visceral and parietal pericardium
– Visceral layer (brown arrow) is the outer layer of the heart itself – a.k.a. the epicardium – Parietal layer (red arrow) lines the inner portion of the pericardial sac and is deep to a meshwork of collagen fibers that stabilize the position of the heart

Pericardium • Space btwn the visceral & parietal layers is the pericardial cavity. . – Normally contains 10-20mL of pericardial fluid secreted by the membranes • A variety of pathogens may infect the pericardium. • Pericardial irritation and inflammation results in an  in pericardial fluid production which limits the movement of the heart. causing pericarditis. Known as cardiac tamponade.

blood vessels. • Continuous with the endothelium of blood vessels . and nerves – Endocardium • Simple squamous epithelium that lines the internal spaces of the heart and covers the valves.The Heart Wall • 3 distinct layers: – Epicardium • Visceral pericardium • Consists of an exposed mesothelium underlain by a layer of loose connective tissue – Myocardium • Muscular wall of the heart • Contains cardiac muscle tissue.

General Heart Anatomy • Blood vessels can be divided into a pulmonary circuit (between the heart and the gas exchange surfaces of the lungs) and a systemic circuit (between the heart and the rest of the body) • Heart contains 4 muscular chambers. 2 associated with each circuit – Right atrium receives deO2 blood from the systemic circuit and passes it to the right ventricle which discharges it into the pulmonary circuit. – Left atrium receives O2 blood from the pulmonary circuit and passes it to the left ventricle which discharges it into the systemic circuit .

while the LV forms the apex and inferoposterior aspect. .• The 2 atria are superior to the ventricles and mostly posterior • Each atrium has a small earlike extension called an auricle which slightly  its volume • The ventricles are inferior to the atria. The RV constitutes most of the anterior aspect of the heart.

• LV is 2-4x as thick as the RV because of its large workload.• Atria have thin flaccid walls corresponding to their light workload. Why is it light? • Right and left atria are separated by the interatrial septum. • The thick interventricular septum separates the LV and RV. • Both ventricles exhibit internal muscular ridges known as trabeculae carneae S E P T U M LV RV . • RA and both auricles exhibit internal ridges of myocardium called pectinate muscles.

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. • Found btwn each atria and each ventricle and btwn each ventricle and its great artery • Each consists of 2-3 flaps of connective tissue covered by endothelium • Atrioventricular Valves – Tricuspid Valve  Btwn RA and RV – Bicuspid Valve  Btwn LA and LV. These function to prevent the valves from bulging (prolapsing) into the atria. mitral valve – Stringlike chordae tendineae connect the valve flaps to conical papillary muscles found on the ventricular floor. A.a.Valves • Necessary to ensure oneway flow.k.

. the mitral valve is open as blood flows from the left atrium into the left ventricle. Notice how the chordae tendineae and papillary muscles are relaxed.Here.

Now. What are the chordae tendineae and papillary muscles doing now? . the mitral valve is closed as blood flows from the left ventricle into the aorta.

Valves • Semilunar Valves: • Pulmonary Semilunar Valve – Prevents backflow of blood from pulmonary artery into RV • Aortic semilunar valve – Prevents backflow of blood from aorta into LV .

Blood Flow back to the Heart • Blood high in CO2 and low in O2 arrives at the RA from 3 vessels: – Superior Vena Cava • Drains head. pelvis. and legs – Coronary Sinus • Drains coronary circulation . upper torso. and arms – Inferior Vena Cava • Drains abdomen.

Blood Flow back to the Heart • Blood high in O2 and low in CO2 arrives at the LA from 4 blood vessels – Right superior and right inferior pulmonary veins – Left superior and left inferior pulmonary veins .

Basic Pathway of Blood Flow CS SVC IVC Right Atrium Tricuspid Valve Right Ventricle Pulmonary Semilunar Valve Systemic Capillaries Pulmonary Trunk Aorta Aortic Semilunar Valve Left Ventricle Pulmonary Arteries Pulmonary Capillaries Bicuspid Valve Left Atrium Pulmonary Veins .

and veins – the coronary circulation • 5% of circulating blood is delivered to the heart • After the aorta emerges from the LV it gives off 2 branches. so it has its own network of arteries.a. Temporary and reversible ischemia produces a sense of pain known as angina pectoris.k. heart attack or coronary) . Prolonged coronary blockage can lead to myocardial cell death . the left & right coronary arteries • The coronary circulation has many anastomoses – where 2 arteries come together and combine their blood flow. capillaries. – What is the advantage to this? • Blockage of coronary arteries causes ischemia – a loss of blood flow..Coronary Circulation • Why does the heart require a prodigious amt of O2 and nutrients? • Cardiac muscle is not nourished to any extent by the blood flowing thru its chambers.a myocardial infarction (a.

it enters coronary veins which combine to form the coronary sinus which empties into the RA .• After blood passes thru the coronary capillaries.

• Locations: – Sinoatrial Node → Adjacent to the SVC opening in the RA – Atrioventricular Node → Near the right AV valve at the bottom of the interatrial septum – Atrioventricular Bundle → Inferior interatrial septum – Right & Left Bundle Branches → Interventricular septum – Purkinje Fibers → Distributed throughout the LV and RV .Cardiac Conduction System • Autorhythmic cardiac myocytes have the ability to spontaneously depolarize to threshold and fire action potentials.

the heartbeat originates at the SA node. • How will the atrial contractile cells respond to depolarization? . it is known as the heart’s pacemaker and its rhythm (sinus rhythm) determines heart rate.Intrinsic Control of the Heart Rate • Without input from any other cell. For this reason. • The depolarization begun in SA node cells spreads via gap junctions throughout the atria and via the internodal pathway to the AV node.

Why is this important? • The impulse travels on to the L&R bundle branches and onward to the Purkinje fibers which begin at the heart apex and extend upward thru the ventricles • How do the ventricles respond to depolarization? • What is significant about the fact that the Purkinje fibers begin at the apex and course upwards? .Intrinsic Control of the Heart Rate • At the AV node. The AV bundle is the ONLY electrical connection btwn the atria and the ventricles. the impulse is delayed momentarily to allow the atria to complete their contraction before the ventricles contract • From the AV node. the impulse travels to the AV bundle.

. A region of the heart becomes hyperexcitable and generates impulses faster than the SA node. premature ventricular contraction (PVC)) before the SA node initiates the next contraction • Heart Block → Any damage to the AV node. Can very in severity.g. Why are fibrillating ventricles useless as pumps? • Ectopic Focus → An abnormal pacemaker. Can also lead to premature contractions or extrasystole (e. Interferes with the transmission of impulses to the ventricles.Conduction Pathologies • Arrhythmia → Irregular heart rhythm • Fibrillation → Condition of rapid and out-of-phase contractions. .

the cardiac cycle can be divided into 2 phases: – Systole  contraction – Diastole  relaxation • A basic principle that governs the movement of blood thru the heart is that blood will flow from one chamber to the next only if the pressure in the 1st chamber exceeds the pressure in the 2nd .Cardiac Cycle • Period btwn the start of one heartbeat and the beginning of the next • For any one chamber in the heart.

Valve Pathology • Murmur Abnormal heart sound due to a malfunctioning heart valve • Valvular Stenosis Valve cusps become stiffened and the opening is constricted by scar tissue. How would this effect the workload of the heart? • Mitral Valve Prolapse insufficiency in which one or both mitral valve flaps bulge into the atrium during ventricular systole .

• What do you suppose happens to CO during exercise? .Cardiac Output • Volume of blood ejected by each ventricle in 1 minute • Cardiac Output = Heart Rate (beats/minute) x Stroke Volume (mL/beat) CO=(HR)(SV) • Suppose Tim’s heart rate was 60bpm. What is Tim’s CO? • Cardiac output varies with the body’s state of activity. his ESV was 50mL and his EDV was 140mL.

Heart Rate • Tachycardia is a persistent resting HR >100bpm • Bradycardia is a persistent resting HR <60bpm .

Baroreceptor Reflex • Baroreceptors are pressure sensitive neurons in the aortic arch and carotid sinus. – Why are they found in these 2 locations? • They respond to decreased BP by decreasing cardioinhibitory activity and by increasing both cardioacceleratory activity and the vasoconstrictor center (all in the medulla oblongata) – How would they respond to increased BP? • What type of control is demonstrated by this reflex? .