Heart Cardiovasc Chap12

Because learning changes everything.
Chapter 12
Heart
Lecture Outline
Seeley’s ESSENTIALS OF
ANATOMY & PHYSIOLOGY
Eleventh Edition
Cinnamon VanPutte
Jennifer Regan
Andrew Russo
Copyright 2022 © McGraw Hill LLC. All rights reserved. No reproduction or distribution without the prior written consent of McGraw Hill LLC.
The Cardiovascular System 1
• The heart is a muscular organ that is essential for life

because it pumps blood through the body.
• The heart is a member organ of the cardiovascular
system, which consists of the heart, blood vessels, and
blood.
• The heart of a healthy adult, at rest, pumps approximately
5 liters (L) of blood per minute.
• For most people, the heart continues to pump at
approximately that rate for more than 75 years.
Figure 12.1
Access the text alternative for slide images
• The heart is actually two pumps in one, with the heart’s

right side pumping blood to the lungs and back to the left
side of the heart through vessels of the pulmonary
circulation.
• The left side of the heart pumps blood to all other tissues
of the body and back to the right side of the heart through
vessels of the systemic circulation.
The Circulatory System
Figure 12.2
Functions of the Heart
1. Generates blood pressure
2. Routes blood
3. Ensures one-way blood flow
4. Regulates blood supply
Heart Characteristics
Size:
• size of a fist and weighs less
than 1 lb.
Location:
• between lungs in thoracic
cavity
Orientation:
• apex (bottom) towards left side
Figure 12.3
Access the text alternative for slide images.
Pericardia
Pericardium:
• double-layered sac that
anchors and protects heart
Parietal pericardium:
• membrane around heart’s
cavity
Visceral pericardium:
• membrane on heart’s surface
Pericardial cavity:
• space around heart
Figure 12.4
Heart External Anatomy 1
• A coronary sulcus extends around the heart, separating

the atria from the ventricles.
• Two grooves, or sulci, which indicate the division between
the right and left ventricles, extend inferiorly from the
coronary sulcus.
• The anterior interventricular sulcus extends inferiorly
from the coronary sulcus on the anterior surface of the
heart.
• The posterior interventricular sulcus extends inferiorly

from the coronary sulcus on the posterior surface of the
heart.
• The superior vena cava and inferior vena cava carry

blood from the body to the right atrium, and four
pulmonary veins carry blood from the lungs to the left
atrium.
• Two arteries, often called the great vessels or great

arteries, carry blood away from the ventricles of the heart.
• The pulmonary trunk, arising from the right ventricle,

splits into the right and left pulmonary arteries, which carry
blood to the lungs.
• The aorta arising from the left ventricle, carries blood to
the rest of the body.
Surface Anatomy of the Heart 1
Figure 12.5a
Surface Anatomy of the Heart 2
Figure 12.5c
Heart Chambers
Four Chambers:
• left atrium (LA)
• right atrium (RA)
• left ventricle (LV)
• right ventricle (RV)
Coronary sulcus:
• separates atria from ventricles
The Atria
Superior chambers
Receive blood from veins
Small, thin walled
Contract minimally to push blood into ventricles
Interatrial septum:
• separates right and left atria
Ventricles
Inferior chambers
Pump blood out of heart to arteries
Thick, strong walled
Contract forcefully to propel blood out of heart
Interventricular septum:
• separates right and left ventricles
Atrioventricular Heart Valves
Valves between the atria and ventricles
Tricuspid valve:
• AV valve between RA and RV
• 3 cusps
Bicuspid valve (mitral):

• AV valve between LA and LV
• 2 cusps
Control of Heart Valves
• Each ventricle contains cone-shaped, muscular pillars

called papillary muscles.
• These muscles are attached by strong, connective tissue
strings called chordae tendineae to the free margins of
the cusps of the atrioventricular valves.
• When the ventricles contract, the papillary muscles
contract and prevent the valves from opening into the atria
by pulling on the chordae tendineae attached to the valve
cusps.
Semilunar Heart Valves
The semilunar valves have three half-moon shaped cusps,

and are valves between the ventricles and the arteries.
Pulmonary valve:
• between RV and pulmonary trunk
Aortic valve:
• between LV and aorta
Internal Anatomy of the Heart
Figure 12.6
Heart Valves 1
(a) ©VideoSurgery/Science Source; (b) ©Oktay Ortakcioglu/iStock/360/Getty Images RF
Figure 12.7
Heart Valves 2
Figure 12.8
Cardiac Skeleton 1
• A plate of connective tissue, sometimes called the cardiac

skeleton, or fibrous skeleton, consists mainly of fibrous
rings that surround the atrioventricular and semilunar
valves and give them solid support.
• This connective tissue plate also serves as electrical
insulation between the atria and the ventricles and
provides a rigid attachment site for cardiac muscle.
Cardiac Skeleton 2
Figure 12.9
Blood Flow through Heart 1
1. Right Atrium
2. Tricuspid valve
3. Right Ventricle
4. Pulmonary semilunar valve
5. Pulmonary trunk
6. Pulmonary arteries
7. Lungs
8. Pulmonary veins
9. Left Atrium
10. Bicuspid valve
11. Left Ventricle
12. Aortic semilunar valve
13. Aorta
14. Body
Blood Flow through Heart 2
Figure 12.10
Blood Supply to the Heart 1
Coronary arteries:
• supply blood to heart wall
• originate from base of aorta (above aortic semilunar valve)
Left coronary artery:

• has 3 branches
• supplies blood to anterior heart wall and left ventricle
Right coronary artery:

• originates on right side of aorta
• supplies blood to right ventricle
Cardiac veins:
• drain blood from the cardiac muscle
• parallel to the coronary arteries
• most drain blood into the coronary sinus
• from the coronary sinus into the right atrium
Figure 12.11
Heart Wall
Epicardium:
• surface of heart (outside)
Myocardium:
• thick, middle layer composed
of cardiac muscle
Endocardium:
• smooth, inner surface
Figure 12.12
Cardiac Muscle
• One centrally located

nucleus
• Branching cells
• Rich in mitochondria
• Striated (actin and myosin)
• Ca2+ and ATP used for
contractions
• Intercalated disks connect
(b) ©Ed Reschke
cells
Figure 12.13
Stimulation of the Heart 1
Movement of blood through the heart is determined by a

coordinated sequence of cardiac muscle contractions. Atria
contract first, followed by ventricles.
1. The heart is at rest and all chambers are relaxed.
2. Cardiac muscle cells in the atrial wall are stimulated as
action potentials spread across the atrial wall and towards
the ventricles.
3. Cardiac muscle cells in the atrial wall contract, pushing

blood into the ventricles.
4. Cardiac muscle cells in the ventricular wall are stimulated

as action potentials spread across the ventricular wall
from the apex of the heart towards its base.
5. Cardiac muscle cells in the ventricular wall contract,

pushing blood into the great arteries.
Figure 12.14
Figure 12.14
Cardiac Muscle Action Potentials 1
Changes in membrane permeability are responsible for

producing action potentials and called pacemaker
potential.
1. Depolarization phase:
• Na+ channels open
• Ca2+ channels open
2. Plateau phase:
• Na+ channels close
• Some K+ channels open
• Ca2+ channels remain open
Cardiac Muscle Action Potentials 2
3. Repolarization phase:
• K+ channels are open
• Ca2+ channels close
Plateau phase prolongs action potential by keeping Ca2+

channels open.
In skeletal muscle action potentials take 2 msec, in cardiac

muscle they take 200 to 500 msec.
Action Potentials in Skeletal and Cardiac Muscle
Figure 12.15
Conduction System of Heart 1
• Contraction of the atria and ventricles is coordinated by

specialized cardiac muscle cells in the heart wall that form
the conduction system of the heart.
• All the cells of the conduction system can produce

spontaneous action potentials.
• The conduction system of the heart includes the sinoatrial

node, atrioventricular node, atrioventricular bundle,
right and left bundle branches, and Purkinje fibers.
Sinoatrial node (SA node):

• in RA
• where action potential originates
• functions as pacemaker
• large number of Ca2+ channels
Atrioventricular node (AV node):

• located in the lower portion of the right atrium
• action potentials from SA node sent to this node
• action potentials spread slowly through it
• slow rate of action potential conduction allows the atria to

complete their contraction before action potentials are
delivered to the ventricles
Atrioventricular bundle:
• action potentials from AV node travel by the AV bundle to
the ventricles
• AV bundle divides into a left and right bundle branches to
left and right ventricles
Purkinje Fibers
• at the tips of the left and right bundle branches, are
Purkinje fibers
• Purkinje fibers pass to the apex of the heart and then
extend to the cardiac muscle of the ventricle walls
• action potentials are rapidly delivered to all the cardiac
muscle of the ventricles
Action Potential Path through Heart
1. SA node
2. AV node (atrioventricular)
3. AV bundle
4. Right and Left Bundle branches
5. Purkinje fibers
Conduction System of the Heart
Figure 12.16
Electrocardiogram (EKG)
ECG (EKG)
• record of electrical events in heart
• diagnoses cardiac abnormalities
• uses electrodes
• contains P wave, QRS complex, T wave
Components of ECG/EKG
P wave:
• depolarization of atria
QRS complex:
• depolarization of ventricles
• contains Q, R, S waves
T wave:
• repolarization of ventricles
Electrocardiogram
Figure 12.17
Cardiac Cycle 1
• The cardiac cycle is a summative description of all the

events that occur during one single heartbeat.
• The heart is a two sided pump, with the atria being primers
for pumps and the ventricles being the actual pumps.
Heart Chamber Contractions
• Cardiac muscle contractions produce pressure changes

within heart chambers.
• Pressure changes are responsible for blood movement.
• Blood moves from areas of high to low pressure.
Cardiac Cycle 2
Atrial systole:
• contraction of atria
Ventricular systole:
• contraction of ventricles
Atrial diastole:
• relaxation of atria
Ventricular diastole:
• relaxation of ventricles
Cardiac Cycle 3
Figure 12.18
Events of the Cardiac Cycle
Figure 12.19
Heart Sounds
• Heart sounds are produced due to the closure of heart

valves.
• A stethoscope is used to hear heart sounds
• The first heart sound makes a ‘lubb’ sound.
• The second heart sound makes a ‘dupp’ sound.
• The first heart sound is due to the closure of the
atrioventricular valves.
• The second heart sound is due to the closure of the
semilunar valves.
Heart Valve Locations
©Juice Images/Alamy RF Figure 12.20

Regulation of Heart Function 1
Stroke Volume:
• volume of blood pumped per ventricle per contraction
• 70 milliliters/beat
Heart Rate:
• number of heart beats in 1 min.
• 72 beats/min.
Regulation of Heart Function 2
Cardiac Output:
• volume of blood pumped by a ventricle in 1 min.
• 5 Liters/min.
Cardiac output equals stroke volume times heart rate
CO = SV × HR
Intrinsic Regulation of the Heart 1
Intrinsic regulation refers to the mechanisms contained within

the heart itself that control cardiac output.
Venous return:
• the amount of blood that returns to heart
Preload:
• the degree ventricular walls are stretched at end of diastole
Venous return, preload, and stroke volume are related to each

other
Intrinsic Regulation of the Heart 2
Starlings Law of the Heart:

• relationship between preload and stroke
• volume
• influences cardiac output
• Example - exercise increases venous return, preload,
stroke volume, and cardiac output
After load:
• pressure against which ventricles must pump blood
Extrinsic Regulation of Heart
• Extrinsic regulation refers to mechanisms external to the

heart, such as either nervous or chemical regulation.
• Nervous system control of the heart occurs through the

sympathetic and parasympathetic divisions of the
autonomic nervous system. Influences of heart activity are
carried through the autonomic nervous system.
• Both sympathetic and parasympathetic nerve fibers

innervate the SA node.
Baroreceptor Reflex 1
The baroreceptor reflex is a mechanism of the nervous

system that plays an important role in regulating heart
function.
Baroreceptors:
• monitor blood pressure in the aorta and carotid arteries
• changes in blood pressure cause changes in frequency of
action potentials
• involves the medulla oblongata
Baroreceptor Reflex 2
Figure 12.21
Chemoreceptor Reflex 1
• The chemoreceptor reflex involves chemical regulation of

the heart function.
• Chemicals can affect heart rate and stroke volume.
Chemoreceptor Reflex 2
Chemical actions:
• epinephrine and norepinephrine from the adrenal medulla

can increase heart rate and stroke volume excitement,
anxiety, and anger can increase cardiac output
• depression can decrease cardiac output
• medulla oblongata has chemoreceptors for changes in pH

and CO2
• K+, Ca2+, and Na+ affect cardiac function
Chemoreceptor Reflex—pH
Figure 12.22
Summary of Extrinsic Regulation
Figure 12.23
Heart Disease
Coronary Artery Disease
• decreases blood supply to the heart
• coronary arteries are narrowed for some reason
Myocardial Infarction (heart attack)
• due to closure of one or more coronary arteries
• area(s) of cardiac muscle lacking adequate blood supply

die, and scars (infarct)
Heart Procedures
Angioplasty:
• procedure opens blocked blood vessels
Stent:
• structures inserted to keep vessels open
Bypass:
• procedure reroutes blood away from blocked arteries
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Because learning changes everything.

• The heart is a muscular organ that is essential for life

• The heart is actually two pumps in one, with the heart’s

1. Generates blood pressure

3. Ensures one-way blood flow

4. Regulates blood supply

• A coronary sulcus extends around the heart, separating

• The posterior interventricular sulcus extends inferiorly

• The superior vena cava and inferior vena cava carry

• Two arteries, often called the great vessels or great

• The pulmonary trunk, arising from the right ventricle,

• right atrium (RA)

• left ventricle (LV)

• right ventricle (RV)

Receive blood from veins

Small, thin walled

Contract minimally to push blood into ventricles

Valves between the atria and ventricles

Bicuspid valve (mitral):

• Each ventricle contains cone-shaped, muscular pillars

The semilunar valves have three half-moon shaped cusps,

(a) ©VideoSurgery/Science Source; (b) ©Oktay Ortakcioglu/iStock/360/Getty Images RF

• A plate of connective tissue, sometimes called the cardiac

• originate from base of aorta (above aortic semilunar valve)

Left coronary artery:

• supplies blood to anterior heart wall and left ventricle

Right coronary artery:

• One centrally located

Movement of blood through the heart is determined by a

3. Cardiac muscle cells in the atrial wall contract, pushing

4. Cardiac muscle cells in the ventricular wall are stimulated

5. Cardiac muscle cells in the ventricular wall contract,

Changes in membrane permeability are responsible for

• Ca2+ channels open

• Some K+ channels open

• Ca2+ channels remain open

• Ca2+ channels close

Plateau phase prolongs action potential by keeping Ca2+

In skeletal muscle action potentials take 2 msec, in cardiac

• Contraction of the atria and ventricles is coordinated by

• All the cells of the conduction system can produce

• The conduction system of the heart includes the sinoatrial

Sinoatrial node (SA node):

Atrioventricular node (AV node):

• action potentials from SA node sent to this node

• action potentials spread slowly through it

• slow rate of action potential conduction allows the atria to

4. Right and Left Bundle branches

• diagnoses cardiac abnormalities

• contains P wave, QRS complex, T wave

• The cardiac cycle is a summative description of all the

• Cardiac muscle contractions produce pressure changes

• Blood moves from areas of high to low pressure.

• Heart sounds are produced due to the closure of heart

©Juice Images/Alamy RF Figure 12.20

• volume of blood pumped by a ventricle in 1 min.

Cardiac output equals stroke volume times heart rate

Intrinsic regulation refers to the mechanisms contained within

Venous return, preload, and stroke volume are related to each

Starlings Law of the Heart:

• Extrinsic regulation refers to mechanisms external to the

• Nervous system control of the heart occurs through the

• Both sympathetic and parasympathetic nerve fibers