Anatomy & Physiology of Heart

BY:
Mr. Anurag
lecturer
College of Nursing
DMC & H, Ludhiana
 Heart Anatomy
Heart is the center of
the cardiovascular
system
Size of heart
 Heart is hollow, cone
shaped

 weighs between 7
and 15 ounces (200
to 425 grams) and is
a little larger than
the size of your fist.
Location of heart
 Heart is located
between lungs in the
middle of chest, behind
and slightly to the left
of breastbone
(sternum).

 It rests on the
diaphragm , near the
middle of the thoracic
cavity in a space called
mediastinum.
 About 2/3rd of the
mass of heart lies in
left of the body’s
midline
 Pointed at the apex and
broadest at the base
 The heart is
 12cm long
 9cm wide (at its
broadest point)
 6cm thick
Coverings of the Heart:
 Pericardium – a double-walled sac around
the heart composed of:
 A superficial fibrous pericardium
 A deep two-layer serous pericardium
 The parietal layer lines the internal surface of
the fibrous pericardium
 The visceral layer or epicardium lines the
surface of the heart
 They are separated by the fluid-filled
pericardial cavity
Pericardial Layers of the Heart
 The pericardium:

 Protects and anchors the heart

 Prevents overfilling of the heart with
blood
 Allows for the heart to work in a
relatively friction-free environment
Heart wall
 Three layers form the heart wall:
 Outermost epicardium
 Middle myocardium : which is cardiac muscle
tissue and responsible for muscle action
 Innermost endocardium: is a thin layer of
endothelium which provides a smooth lining for
the inside of the heart and covers the valves of
the heart.
Microscopic Anatomy of Heart
Muscle
 Cardiac muscle is striated,branched,
and interconnected
 Intercalated discs anchor cardiac cells
together and allow free passage of
ions
 Heart muscle behaves as a functional
syncytium
Chambers of the Heart
Heart has 4 chambers;
 The upper chambers are
called the left and right
atria
 The lower chambers are
called the left and right
ventricles.
 A wall of muscle called
the septum separates
the left and right atria
and the left and right
ventricles.
 Thickness of the walls
 The atria are thin walled
 The left ventricle is the
largest and strongest
chamber in heart.
 The left ventricle's
chamber walls have to
push blood through the
aortic valve and into body
 Major Vessels of the Heart

 Vessels returning blood to the heart

include:
 Superior and inferior vena cava
 Right and left pulmonary veins
 Vessels conveying blood away from the
heart include:
 Pulmonary trunk, which splits into right and
left pulmonary arteries
 aorta (three branches) – brachiocephalic,
left common carotid, and subclavian arteries
External Heart: Anterior View

Figure 18.4b
Gross Anatomy of Heart:
Frontal Section

Figure 18.4e
Atria of the Heart
 Atria are the receiving chambers of
the heart

 Blood enters right atria from superior

and inferior vena cava and coronary
sinus
 Blood enters left atria from
pulmonary veins
Ventricles of the Heart
 Ventricles are the discharging chambers
of the heart
 Papillary muscles and trabeculae
carneae muscles mark ventricular walls
 Right ventricle pumps blood into the
pulmonary trunk
 Left ventricle pumps blood into the aorta
 The Heart Valves

 Valves regulate blood

flow through your
1. Atrioventricular
heart
valves
 The tricuspid
 There are four valve
valves to prevent  The bicuspid
backward flow of (mitral) valve
blood 2. Semilunar valves
 The aortic valve
 The pulmonary
valve
Atrioventricular valves

 The tricuspid valve(3

cusps) regulates blood
flow between the right
atrium and right
ventricle.
 
 The mitral
valve(bicuspid i.e 2
cusps) lets oxygen-rich
blood from your lungs
pass from the left
atrium into the left
ventricle.
 
Heart Valves

Figure 18.8a, b
 Semilunar valves

 The aortic valve opens the

way for oxygen-rich blood
to pass from the left
ventricle into the aorta,
where it is delivered to
the rest of your body.
 The pulmonary valve
controls blood flow from
the right ventricle into
the pulmonary arteries,
which carry blood to your
lungs to pick up oxygen.
 
 Each of these valves has
flaps, called leaflets that
allow the forward flow of
blood and prevent the
backward flow.
 AV valves when open
project their pointed ends
into ventricles.
 Tendon like fibrous cords
called chordae tendineae
connect to papillary muscles
Heart sounds
 When the heart's valves open and close, they
make a "lub-DUB" sound
 The first sound—the “lub”—is made by the
mitral and tricuspid valves closing at the
beginning of systole .Systole is when the
ventricles contract, or squeeze, and pump blood
out of the heart.
 The second sound—the “DUB”—is made by the
aortic and pulmonary valves closing at beginning
of diastole .Diastole is when the ventricles
relax and fill with blood pumped into them by
the atria.
 Blood flow through the heart
 heart works as a pump
 Blood delivers oxygen and nutrients to every
cell and removes the carbon dioxide and waste
products
 Blood is carried from heart to the rest of body
through a complex network of arteries,
arterioles, and capillaries.
 Blood is returned to your heart through venules
and veins.
deoxygenated blood from various parts of the
body through three veins

SVC IVC Coronary sinus

Rt atrium

Tricuspid valve

Rt ventricle

Pulmonary artery

lungs
 Lungs

pulmonary veins

Lt atrium

Bicuspid valve

Lt ventricle

Aorta

All parts of the body

Heart blood Supply
 The wall of the
heart has its own
blood supply.
 The flow of blood
though the many
vessels that pierce
the myocardium is
called the coronary
circulation.
Coronary Circulation
 Coronary circulation is the functional
blood supply to the heart muscle
itself
 Collateral routes ensure blood
delivery to heart even if major
vessels are occluded
Coronary Circulation: Arterial
Supply

Figure 18.7a
Coronary Circulation: Venous
drainage

Figure 18.7b
Post. Interventricular branch

Marginal branch
The Conduction System
The Conduction System

 Electrical impulses from heart muscle cause

heart to contract.
 This electrical signal begins in the sinoatrial
(SA) node, located at the top of the right
atrium. The SA node is sometimes called
the heart's "natural pacemaker."
 An electrical impulse from this natural
pacemaker travels through the muscle
fibers of the atria and ventricles, causing
them to contract.
The A-V Node

• The atrioventricular node periodically receives

action potentials via the junctional fibers.
• The most important function of the A-V node
is to regulate the timing of the ventricular
contraction by delaying the action potentials.
• The delayed action potentials are spread over
the ventricles to cause a contraction.
The Electrical Cycle

1. The S-A Node generates an action

potential.
2. The action potential propagates in the atria
and causes a contraction. It is also
transmitted to the AV Node.
3.The action potential is delayed at the A-V
Node.
4.The action potential is transmitted to the
ventricles and causes a contraction via
 AV Bundle branch (bundle of His)
 Rt and left bundle branch
 Purkinje fibers
 Heart beat
A heartbeat is a two-part pumping action that takes about a second.

As blood collects in the upper chambers (the right and left atria),

the heart's natural pacemaker (the SA node) sends out an electrical

signal

causes the atria to contract.

This contraction pushes blood through the tricuspid and mitral valves

to the resting ventricles.

This part of the two-part pumping phase is called diastole.

The second part of the pumping phase begins
when the ventricles are full of blood.

The electrical signals from the SA node travel

along a pathway of cells to the ventricles
,
causing them to contract.This is called systole.

As the tricuspid and mitral valves shut tight to

prevent a back flow of blood, the pulmonary
and aortic valves are pushed open.
The Electrocardiogram

• The electrocardiogram (ECG) is a

standardized way to measure and
display the electrical activity of the
heart.
• Physicians can diagnose problems
with the heart by analyzing its ECG
and comparing it to the ECG of a
healthy heart
 ECG Waves

• The P Wave: Depolarization

of the atria
• The QRS Complex:
depolarization of the
ventricles
• The T Wave: Repolarization
of the ventricles
Cardiac Cycle
 The cardiac cycle is the sequence of
events that occur when the heart
beats. There are two phases of this
cycle:
 Diastole - Ventricles are relaxed.
 Systole - Ventricles contract.
Cardiac Cycle

 The heart undergoes a constant cycle

of contractions and relaxations.
 The period of ventricular contraction
is called systole.
 The period of ventricular relaxation is
called diastole.
Events in Diastole
 Ventricles relax
 pulmonary and aortic valves close
 AV valves open
 ventricles fill (about 80% of capacity)
 atria contract (ventricles fill another
20%)
Events in Systole
 ventricles contract
 AV valves close
 aortic and pulmonary valves open
 blood is ejected

 
Regulating Cardiac Output
CO = Heart Rate x Stroke Volume
Heart Rate = Beats/minute
Stroke Volume = L/ventricular
contraction
The Cardiac Cycle –
Phase 1

Atrial Contraction:
1. Atria contract.
2. Atria empty out into the ventricles.
3. Atrial pressure drops.
4. A-V valves prepare to close.
5. Atria start filling.
The Cardiac Cycle –
Phase 2
Isovolumetric Contraction:
1. Ventricles contract.
2. Arterial valves are closed, no blood can
be ejected.
3. Volume remains constant, pressure
increases.
4. A-V valves close (First heart sound).
5. Atria continue to fill
The Cardiac Cycle –
Phase 3

Rapid Ejection:
1. Ventricular pressure continues to
increase.
2. Arterial valves open.
3. Blood is rapidly ejected from the
ventricles.
4. Atria continue to fill.
The Cardiac Cycle –
Phase 4
Reduced Ejection:
1. Ventricles start to relax.
2. Ventricular pressure starts to drop.
3. Blood is slowly ejected from the
ventricles.
4. Atria continue to fill.
The Cardiac Cycle –
Phase 5

Isovolumetric Relaxation:
1. Ventricles continue to relax.
2. Ventricular pressure continues to drop.
3. Arterial valves close(Second heart
sound).
4. Atria continue to fill.
The Cardiac Cycle –
Phase 6
Rapid Filling:
1. Atrial pressure exceeds ventricular
pressure.
2. A-V valves open.
3. Blood flows rapidly from the atria to
the ventricles.
Thank you