UNIVERSITY OF GOCE DELCEV STIP

FACULTY OF MEDICINE

Proffesor: Dragan Donev

Made by: Viktorija Talevska

CONTENT:

INTRODUCTION..3 STRUCTURE...4 FUNCTION.....6 HEART CONDITIONS...7 THE CIRCULATION OF BLOOD....8 CONCLUSION....10

Introduction
The heart is a myogenic muscular organ found in all animals with a circulatory system (including all vertebrates), which pumps bloodthroughout the blood vessels by repeated, rhythmic contractions. The term cardiac (as in cardiology) means "related to the heart" and comes from the Greek , kardia, for "heart". The vertebrate heart is principally composed of cardiac muscle and connective tissue. Cardiac muscle is an involuntary striated muscle tissue found only in this organ and responsible for the ability of the heart to pump blood. The average human heart, beating at 72 beats per minute, will beat approximately 2.5 billion times during an average 66 year lifespan. It weighs approximately 250 to 300 grams (9 to 11 oz) in females and 300 to 350 grams (11 to 12 oz) in males. In invertebrates that possess a circulatory system, the heart is typically a tube or small sac and pumps fluid that contains water and nutrients such as proteins, fats, and sugars. In insects, the "heart" is often called the dorsal tube and insect "blood" is almost always not oxygenated since they usually respirate (breathe) directly from their body surfaces (internal and external) to air. However, the hearts of some otherarthropods (including spiders and crustaceans such as crabs and shrimp) and some other animals pump hemolymph, which contains thecopper-based protein hemocyanin as an oxygen transporter similar to the ironbased hemoglobin in red blood cells found in vertebrates.

Structure
The structure of the heart varies among the different branches of the animal kingdom. (See Circulatory system.) Cephalopods have two "gill hearts" and one "systemic heart". In vertebrates, the heart lies in the anterior part of the body cavity, dorsal to the gut. It is always surrounded by a pericardium, which is usually a distinct structure, but may be continuous with the peritoneum in jawless and cartilaginous fish. Hagfishes, uniquely among vertebrates, also possess a second heart-like structure in the tail.

The human heart has a mass of between 250 and 350 grams and is about the size of a fist. It is located anterior to the vertebral column and posterior to the sternum. It is enclosed in a double-walled sac called the pericardium. The superficial part of this sac is called the fibrous pericardium. This sac protects the heart, anchors its surrounding structures, and prevents overfilling of the heart with blood. The outer wall of the human heart is composed of three layers. The outer layer is called the epicardium, or visceral pericardium since it is also the inner wall of the pericardium. The middle layer is called the myocardium and is composed of cardiac muscle which contracts. The inner layer is called the endocardium and is in contact with the blood that the heart pumps. Also, it merges with the inner lining (endothelium) of blood vessels and covers heart valves. The human heart has four chambers, two superior atria and two inferior ventricles. The atria are the receiving chambers and the ventricles are the discharging chambers. The pathway of blood through the human heart consists of a pulmonary circuit and a systemic circuit. Deoxygenated blood flows through the heart in one direction, entering through the superior vena cava into the right atrium and is pumped through the tricuspid valve into the right ventricle before being pumped out through the pulmonary valve to the pulmonary arteries into the lungs. It returns from the lungs through the pulmonary veins to the left atrium where it is pumped through the mitral valve into the left ventricle before leaving through the aortic valve to the aorta.

Function
In mammals, the function of the right side of the heart (see right heart) is to collect de-oxygenated blood, in the right atrium, from the body (via superior and inferior vena cavae) and pump it, through the tricuspid valve, via the right ventricle, into the lungs (pulmonary circulation) so that carbon dioxide can be dropped off and oxygen picked up (gas exchange). This happens through the passive process of diffusion. The left side (see left heart) collects oxygenated blood from thelungs into the left atrium. From the left atrium the blood moves to the left ventricle, through the bicuspid valve, which pumps it out to the body (via the aorta). On both sides, the lower ventricles are thicker and stronger than the upper atria. The muscle wall surrounding the left ventricle is thicker than the wall surrounding the right ventricle due to the higher force needed to pump the blood through the systemic circulation. Starting in the right atrium, the blood flows through the tricuspid valve to the right ventricle. Here, it is pumped out the pulmonary semilunar valve and travels through the pulmonary artery to the lungs. From there, oxygenated blood flows back through the pulmonary vein to the left atrium. It then travels through themitral valve to the left ventricle, from where it is pumped through the aortic semilunar valve to the aorta. The aorta forks and the blood is divided between major arteries which supply the upper and lower body. The blood travels in the arteries to the smaller arterioles and then, finally, to the tiny capillaries which feed each cell. The (relatively) deoxygenated blood then travels to the venules, which coalesce into veins, then to the inferior and superior venae cavae and finally back to the right atrium where the process began. The heart is effectively a syncytium, a meshwork of cardiac muscle cells interconnected by contiguous cytoplasmic bridges. This relates to electrical stimulation of one cell spreading to neighboring cells. Some cardiac cells are self-excitable, contracting without any signal from the nervous system, even if removed from the heart and placed in culture. Each of these cells have their own intrinsic contraction rhythm. A region of the human heart called the sinoatrial (SA) node, or pacemaker, sets the rate and timing at which all cardiac muscle cells contract. The SA node generates electrical impulses, much like those produced by nerve cells. Because cardiac muscle cells are electrically coupled by inter-calated disks between adjacent cells, impulses from the SA node spread rapidly through the walls of the artria, causing both artria to contract in unison. The impulses also pass to another region of specialized cardiac muscle tissue, a relay point called theatrioventricular node, located in the wall between the right atrium and the right ventricle. Here, the impulses are delayed for about 0.1s before spreading to the walls of the ventricle. The delay ensures that the artria empty completely before the ventricles contract. Specialized muscle fibers called Purkinje fibers then conduct the signals to the apex of the heart along and throughout the ventricular walls. The Purkinje fibres form conducting pathways called bundle branches. This entire cycle, a single heart beat, lasts about 0.8 seconds. The impulses generated during the heart cycle produce electrical currents, which are conducted through body fluids to the skin, where they can be detected by electrodes and recorded as an electrocardiogram (ECG or EKG).
6

Heart Conditions

Coronary artery disease: Over the years, cholesterol plaques can narrow the arteries supplying blood to the heart. The narrowed arteries are at higher risk for complete blockage from a sudden blood clot (this blockage is called a heart attack). Stable angina pectoris: Narrowed coronary arteries cause predictable chest pain or discomfort with exertion. The blockages prevent the heart from receiving the extra oxygen needed for strenuous activity. Symptoms typically get better with rest. Unstable angina pectoris: Chest pain or discomfort that is new, worsening, or occurs at rest. This is an emergency situation as it can precede a heart attack, serious abnormal heart rhythm, or cardiac arrest. Myocardial infarction (heart attack): A coronary artery is suddenly blocked. Starved of oxygen, part of the heart muscle dies. Arrhythmia (dysrhythmia): An abnormal heart rhythm due to changes in the conduction of electrical impulses through the heart. Some arrhythmias are benign, but others are life-threatening. Congestive heart failure: The heart is either too weak or too stiff to effectively pump blood through the body. Shortness of breath and leg swelling are common symptoms. Cardiomyopathy: A disease of heart muscle in which the heart is abnormally enlarged, thickened, and/or stiffened. As a result, the heart's ability to pump blood is weakened. Myocarditis: Inflammation of the heart muscle, most often due to a viral infection. Pericarditis: Inflammation of the lining of the heart (pericardium). Viral infections, kidney failure, and autoimmune conditions are common causes. Pericardial effusion: Fluid between the lining of the heart (pericardium) and the heart itself. Often, this is due to pericarditis. Atrial fibrillation: Abnormal electrical impulses in the atria cause an irregular heartbeat. Atrial fibrillation is one of the most common arrhythmias. Pulmonary embolism: Typically a blood clot travels through the heart to the lungs. Heart valve disease: There are four heart valves, and each can develop problems. If severe, valve disease can cause congestive heart failure. Heart murmur: An abnormal sound heard when listening to the heart with a stethoscope. Some heart murmurs are benign; others suggest heart disease. Endocarditis: Inflammation of the inner lining or heart valves of the heart. Usually, endocarditis is due to a serious infection of the heart valves. Mitral valve prolapse: The mitral valve is forced backward slightly after blood has passed through the valve. Sudden cardiac death: Death caused by a sudden loss of heart function (cardiac arrest). Cardiac arrest: Sudden loss of heart function.

The Circulation of Blood

The human circulatory system is really a two-part system whose purpose is to bring oxygen-bearing blood to all the tissues of the body. When the heart contracts it pushes the blood out into two major loops or cycles. In the systemic loop, the blood circulates into the bodys systems, bringing oxygen to all its organs, structures and tissues and collecting carbon dioxide waste. In the pulmonary loop, the blood circulates to and from the lungs, to release the carbon dioxide and pick up new oxygen. The systemic cycle is controlled by the left side of the heart, the pulmonary cycle by the right side of the heart. Lets look at what happens during each cycle:

The systemic loop begins when the oxygen-rich blood coming from the lungs enters the upper left chamber of the heart, the left atrium. As the chamber fills, it presses open the mitral valve and the blood flows down into the left ventricle. When the ventricles contract during a heartbeat, the blood on the left side is forced into the aorta. This largest artery of the body is an inch wide. The blood leaving the aorta brings oxygen to all the bodys cells through the network of ever smaller arteries and capillaries. The used blood from the body returns to the heart through the network of veins. All of the blood from the body is eventually collected into the two largest veins: the superior vena cava, which receives blood from the upper body, and the inferior vena cava, which receives blood from the lower body region. Both venae cavae empty the blood into the right atrium of the heart.

From here the blood begins its journey through the pulmonary cycle. From the right atrium the blood descends into the right ventricle through the tricuspid valve. When the ventricle contracts, the blood is pushed into the pulmonary artery that branches into two main parts: one going to the left lung, one to the right lung. The fresh, oxygen-rich blood returns to the left atrium of the heart through the pulmonary veins.

Although the circulatory system is made up of two cycles, both happen at the same time. The contraction of the heart muscle starts in the two atria, which push the blood into the ventricles. Then the walls of the ventricles squeeze together and force the blood out into the arteries: the aorta to the body and the pulmonary artery to the lungs. Afterwards, the heart muscle relaxes, allowing blood to flow in from the veins and fill the atria again. In healthy people the normal (resting) heart rate is about 72 beats per minute, but it can go much higher during strenuous exercise. Scientists have estimated that it takes about 30 seconds for a given portion of the blood to complete the entire cycle: from lungs to heart to body, back to the heart and out to the lungs.

Conclusion
The center of the circulatory system is the heart, which is the main pumping mechanism. The heart is made of muscle. The heart is shaped something like a cone, with a pointed bottom and a round top. It is hollow so that it can fill up with blood. An adults heart is about the size of a large orange and weighs a little less than a pound. The heart is in the middle of the chest. It fits snugly between the two lungs. It is held in place by the blood vessels that carry the blood to and from its chambers. The heart is tipped somewhat so that there is a little more of it on the left side than on the right. The pointed tip at the bottom of the heart touches the front wall of the chest. Every time the heart beats it goes thump against the chest wall. You can feel the thumps if you press there with your hand. You can also listen to them with your ear.

10

Used Literature:
http://www.meds.com/immunotherapy/conclusion.html http://www.medicalnewstoday.com http://en.wikipedia.org

11