Basic heart

1.Fibrous pericardium
Layers of the heart wall 2.Parietal layer of serous
pericardium
3.Pericardial cavity
4.Epicardium (visceral
layer of serous
pericardium)
5.Myocardium (cardiac
muscle)
6.Endocardium – a layer of
simple squamous
epithelial tissue
 Heart Chambers
Heart (anterior View) 1. Atria – receive blood
2. Ventricles – pump blood
out
External features
3. Auricles – “ear-like flaps”
4. Sulci – grooves
1. Coronary sulcus
2. Anterior interventricular
sulcus (with anterior
interventricular artery and
great cardiac vein)
3. Posterior interventricular
sulcus
5. Apex
6. Base
 1. Posterior inteventricular
Heart (posterior view) sulcus
Blood vessels associated
with heart
2. Superior vena cava
3. Inferior vena cava
4. Aorta
5. Pulmonary trunk –
branches to pulmonary
arteries
6. Pulmonary veins
7. Coronary sinus
8. Middle cardiac vein
 1. Pectinate muscle
Heart (internal view) 2. Interatrial septum
1. Fossa ovalis
3. Valves
1. Tricuspid valve
2. Bicuspid (mitral) valve
3. Pulmonary Valve
4. Aortic valve
4. Interventricular septum
5. Papillary muscle
6. Trabeculae carnae
7. Ligamentum arteriosum
Notice how left ventricle
has thicker outside wall.
Blood Flow
Through The Heart
• Base
• Apex
• Anterior interventricular sulcus (groove)
• L and R atria (atrium = singular)
• L and R ventricles
• L and R auricle
• Superior Vena Cava
• Ascending aorta
• Aortic arch
• Brachiocephalic trunk
• L Common Carotid A.
• L Subclavian A.
• Pulmonary Trunk
• L and R Pulmonary A. (blue)
• L Pulmonary V. (red)
• Anterior interventricular artery (L Anterior Descending
Coronary Artery)
• Great Cardiac Vein
• Ligamentum arteriosum
• L and R Pulmonary Arteries
(blue)
• L and R Pulmonary Veins (red)
• Ligamentum arteriosum
• Opening of Inferior Vena Cava
• Coronary sinus
• Coronary sulcus (groove)
• Posterior Interventricular
Sulcus
• Middle cardiac vein
• Posterior interventricular artery
• Pectinate muscle
• Left ventricle
• Right ventricle
• Valves
• Pulmonary valve
• Aortic valve
• Tricuspid valve
• Bicuspid (mitral) valve
• Chordae tendinea
• Papillary muscle
• Interventricular septum
• Layers of the heart
• Epicardium
• Myocardium
• endocardium
• Fossa ovalis
• Pulmonary valve
• Superior Vena Cava
• Ascending aorta
• Arch of aorta
• Right coronary artery
• Right marginal artery
• Chordae tendinea
• 1. left ventricle
• 2. right ventricle
• 3. left auricle (of left atrium)
• 4. same as 3 (this tag is the
auricle; the intent was for 3 to
tag the left atrium but it would
depend on the question that is
asked.)
• 5. Interventricular sulcus (with
fat)
• 6. apex of heart
• 7. right auricle (of right atrium)
• A. left atrium
• B. Chordae tendinea of bicuspid
valve
• C. Papillary muscle
• D. Wall of left ventricle
• E. Trabeculae Carnae
• F. Apex
• G. Interventricular septum
• H. Right atrium
• I. Aortic valve
• 1. Bicuspid (mitral) valve
• 2. Right ventricle
• 3. left atrium
• 4. interventricular septum
• 5. papillary muscle
• 6. Chordae tendinea of bicuspid valve
• 7. Left ventricle (once again this
would be determined by the
question)
• 8. apex
• 9. Trabeculae carnae in right ventricle
• 10. Aortic valve
Heart Physiology
Cardiac Conduction
System
Cardiac conduction • 1. SA node – located in the wall of the right
atrium; the “pacemaker”; cells
system spontaneously depolarize and the action
potential spreads quickly through both atria
(see the purple arrows)
• 2. AV node – located in the interatrial
septum; provides resistance to the
movement of the action potential allowing
the atria time to push blood into ventricles
• 3. Bundle of His (AV Bundle) – in the
membranous interventricular septum;
action potential enters ventricles here
• 4. right and left bundle branches – located
in muscular interventricular septum
• 5. purkinje fibers – continue from apex
through outer walls of ventricles
• 3,4, and 5 collectively depolarize the ventricles
Electrocardiogram
(ECG or EKG)
 • P wave = atrial depolarization
Standard ECG Tracing • QRS complex = ventricular
depolarization
• S-T segment = ventricular systole
• Elevation often associated with
myocardial infarcts (heart attacks)
• T wave = ventricular repolarization
• P-Q interval – time from beginning
of atrial depolarization to beginning
ventricular depolarization (SA node
through AV node)
• Extended in AV Block
• Q-T interval – time from beginning
of ventricular depolarization to end
of ventricular repolarization
Phases of ECG
 • The P wave respresents
atrial deplorization
P wave • Begins when the SA node
depolarizes
• As the action potential
spreads over the atrial
muscle, the atrial muscle
depolarizes.
• The depolarization of atrial
muscle then produces the
p wave on the ECG.
Baseline Segment after the p wave
• This segment is at baseline so there
is not depolarization or
repolarization of cardiac muscle
occurring. Instead the atrial muscle
is fully depolarized.
• The action potential is actually
within the AV node and forcing it’s
way through.
• Since this delays entry of the action
potential into the ventricles it
allows the atria time to move blood
into the ventricles below.
QRS Complex • After the action potential moves through
the AV Node and enters the bundle of his
the depolarization of the Ventricles
begins.
• Since the ventricles are depolarizing, we
should see a change in the ECG and we
do. That change is the QRS complex.
• The QRS complex represents ventricular
depolarization.
• The atrial are repolarizing at the same
time (notice how they are red). However,
there is no signal on the ECG for atrial
repolarization. This is due to the signal
from the ventricles masking the signal
from the atria (it’s because of the muscle
difference).
S-T Segment
• The S-T segment represents
ventricular systole
• Notice how the ECG is at
baseline. This is because there
is no depolarization or
repolarization occurring (no
electrical changes).
• The ventricles are fully
depolarized and in full systole
ejecting blood out of the heart.
T Wave
• T wave represents ventricular
repolarization
Diastolic Phase

• Brief (.2 second)

period of time where
all 4 chambers are in
diastole prior to the
beginning of the next
heart beat
Cardiac Output
Cardiac Output (CO)
• The volume of blood ejected from a ventricle per minute
• It is important that the cardiac output be high enough to meet
your body’s metabolic demands
• These demands can change
• If your metabolic demands increase, then CO must increase also
• To do this, the body will utilize it’s cardiac reserve
• The difference between your CO at rest and your Maximal CO
• CO = Stroke Volume x Heart Rate (SV x HR)
Stroke Volume (SV)
• Defined as the amount of blood ejected from the ventricles per beat
• Calculated by substracting end-systolic volume (ESV) from end-
diastolic Volume (EDV)
• SV = EDV – ESV; (ejection fraction – 70%)
• Can be changed by manipulating:
• Preload – this is essentially EDV; it is the amount of blood in the ventricle before
contraction hence the term “pre”load
• Contractility – the force of the contraction; stronger contractions push out more
blood (think like squeezing a ketchup bottle really hard)
• Afterload – this is the force holding the semilunar (sl) valves closed; if you’re
going to eject blood you have to open the exit doors of the heart, i.e the sl
valves
• The afterload is caused by your (diastolic) blood pressure
Heart rate (HR)
• Heart rate is the number of times per minute that the heart
beats (measured in beats/minute)
• Can increase if necessary (like when you’re more active)
• The nervous system, endocrine system, and a few other outside
influences can cause this to occur
• Can decrease when necessary also (like after you’re done
working out and your heart rate comes down)
• The nervous and endocrine systems are involved in this effort as
well
Cardiac Output