Chapter 13:

The Heart

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Taylor: Memmler’s Structure and Function of the Human Body

Circulation and the Heart

Circulation
• Continuous one-way circuit of the blood vessels
• Propelled by heart

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Taylor: Memmler’s Structure and Function of the Human Body

Location of the Heart

• Between the lungs
• Left of the midline of the body
• In mediastinum
• Apex pointed toward left

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Taylor: Memmler’s Structure and Function of the Human Body

The heart in position in the thorax (anterior view).  

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Taylor: Memmler’s Structure and Function of the Human Body

Structure of the Heart

Three tissue layers

• Endocardium lines heart’s interior
• Myocardium is thickest layer; the heart muscle
• Epicardium is thin outermost layer

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Taylor: Memmler’s Structure and Function of the Human Body

The Pericardium
The sac that encloses the heart
• Fibrous pericardium holds heart in place
• Serous membrane
– Parietal layer
– Pericardial cavity
– Visceral layer (epicardium)

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Taylor: Memmler’s Structure and Function of the Human Body

Special Features of the Myocardium

Cardiac muscles
• Are lightly striated (striped)
• Have single nucleus cells
• Are controlled involuntarily
• Have intercalated disks
– Modified plasma membranes
• Have branching muscle fibers

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Taylor: Memmler’s Structure and Function of the Human Body

Double pump
Divisions
• of the
Right side pumps Heart
blood low in oxygen to the lungs
– Pulmonary circuit
• Left side pumps oxygenated blood to remainder of body
– Systemic circuit

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Taylor: Memmler’s Structure and Function of the Human Body

Four Chambers
• Right atrium
– Receives low-oxygen blood returning from body tissue
through superior vena cava and inferior vena cava
• Left atrium
– Receives high-oxygen blood from lungs
• Right ventricle
– Pumps blood from right atrium to lungs
• Left ventricle
– Pumps oxygenated blood to body

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Taylor: Memmler’s Structure and Function of the Human Body

Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins

Taylor: Memmler’s Structure and Function of the Human Body

The
heart
and
great
vessels
.

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Taylor: Memmler’s Structure and Function of the Human Body

Four Valves
• Atrioventricular valves
– Entrance valves
– Right atrioventricular (AV) valve (tricuspid valve)
– Left atrioventricular (AV) valve (bicuspid valve)
• Attached by threads (chordae tendinae) to papillary
muscles
• Semilunar valves
– Exit valves
– Pulmonary valve
– Aortic valve

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Taylor: Memmler’s Structure and Function of the Human Body

Pathway
of blood
through
the
heart.

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Taylor: Memmler’s Structure and Function of the Human Body

Blood Supply to the Myocardium

Coronary circulation-own blood supply
• Right coronary artery
• Left coronary artery
• These arteries are the first to branch off from the aorta
• After passing through capillaries in the myocardium, blood
drains into a system of cardiac veins that bring blood back to
the R atrium
• Coronary sinus
– Dilated vein that opens into the R atrium near IVC
– Blood colllects here

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Taylor: Memmler’s Structure and Function of the Human Body

Blood vessels that supply the myocardium. Coronary

arteries and cardiac veins are shown. (A) Anterior
view. (B) Posterior view.
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Taylor: Memmler’s Structure and Function of the Human Body

Function of the Heart

Left and right sides of heart work together in cardiac cycle
(heartbeat)
• Systole (active phase, contraction)
• Diastole (resting phase)

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Taylor: Memmler’s Structure and Function of the Human Body

The cardiac cycle.

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Taylor: Memmler’s Structure and Function of the Human Body

Cardiac Output
Calculating cardiac output
• Cardiac output (CO)
• Stroke volume (SV)
• Heart rate (HR)
• CO = HR 3 SV

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Taylor: Memmler’s Structure and Function of the Human Body

The Heart’s Conduction System

Electrical energy stimulates heart muscle
• Nodes
– Sinoatrial (SA) node (pacemaker)
– Atrioventricular (AV) node
• Specialized fibers
– Atrioventricular bundle (bundle of His)
– Purkinje fibers (conduction myofibers)
• Intercalated disks

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Taylor: Memmler’s Structure and Function of the Human Body

The Conduction Pathway

Sinus rhythm
• Sinoatrial (SA) node
• Atria
• Atrioventricular (AV) node
• Internodal pathways
• Bundle of His
• Bundle branches and Purkinje fibers
• Ventricles

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Taylor: Memmler’s Structure and Function of the Human Body

Conduction
system of
the heart.

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Taylor: Memmler’s Structure and Function of the Human Body

Control of the Heart Rate

Influences that allow heart to meet changing needs rapidly
• Autonomic nervous system (ANS)
• Sympathetic nervous system
• Parasympathetic system
– Cranial nerve X

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Taylor: Memmler’s Structure and Function of the Human Body

Variations in Heart Rates

• Bradycardia
• Tachycardia
• Sinus arrhythmia
• Premature beat (extrasystole)

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Taylor: Memmler’s Structure and Function of the Human Body

Heart Sounds
• Lub
• Dup
• Murmurs
– Organic
– Functional

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Taylor: Memmler’s Structure and Function of the Human Body

The Heart in the Elderly

How the heart can age
• Heart shrinks
• Decreased contraction strength
• Valves become less flexible
• Murmur develops
• Cardiac output decreases
• Abnormal rhythms
• Heart block

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Taylor: Memmler’s Structure and Function of the Human Body

Maintaining Heart Health

• Risk factors that cannot be • Risk factors that can be modified
modified
– Smoking
– Age
– Physical inactivity
– Gender
– Weight
– Heredity
– Diet
– Body type
– Blood pressure
– Diabetes
– Gout

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Taylor: Memmler’s Structure and Function of the Human Body

Heart Studies
• Stethoscope
• Electrocardiograph (ECG or EKG)
– Electrodes
• Catheterization
– Fluoroscope
• Echocardiography (ultrasound cardiography)
– Oscilloscope

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Taylor: Memmler’s Structure and Function of the Human Body

Figure 13-12 Coronary angiography.

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Taylor: Memmler’s Structure and Function of the Human Body

Normal ECG
tracing.

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