Angelyka J.

Cabalo

2APH 2016-2017

CHAPTER 12 HEART
CARDIOVASCULAR SYSTEM
- heart, blood vessels and blood
HEART
- muscular organ that is essential for
life because it pumps blood
through the body
- at rest : 5 L of blood per minute
- PULMONARY CIRCULATION : right
side pumps blood to the lungs then
back to the left side
- SYSTEMIC CIRCULATION : left side
pumps blood to all other tissues of
the body
- Shaped like a blunt cone / size of a
closed fist
- Larger in physically active adults
- Decreases in size by age 65
- APEX : blunt, rounded point and
directed to the left
- BASE : larger, flat part at the
opposite end of the heart
- Surrounded by pericardial cavity
- Lies obliquely in the MEDIASTINUM
- CARDIOPULMONARY
RESUSCITATION (CPR) : emergency
procedure that maintains blood
flow in the body if a persons heart
stops
- Found 2-5th intercostal space (7-9
cm to the left of the sternum)
FUNCTIONS :
~ Generating blood pressure
~ Routing blood
~ Ensuring one way blood flow
~ Regulating blood supply
ANATOMY :
PERICARDIAL CAVITY
- formed by pericardium or
pericardial sac ( tissue that
surrounds the heart and anchor it
w/in the mediastinum )
~ Fibrous Pericardium
- tough, fibrous connective tissue
outer layer
~ Serous Pericardium
- thin layer of connective tissue
- PARIETAL PERICARDIUM : lines the
fibrous pericardium
- VISCERAL PERICARDIUM :
epicardium ; covering the heart
~ Pericardial Fluid
- reduce friction
- between parietal and visceral
CHAMBERS

~
-

Right and Left Atria

base of the heart
receive blood from veins
as reservoirs
forces blood into the ventricles to
complete ventricular filling
- RIGHT : superior and inferior vena
cava and coronary sinus
- LEFT : four pulmonary veins
- Separated by INTERATRIAL SEPTUM
~ Right and Left Ventricles
- from base to apex
- major pumping chambers
- eject blood into the arteries
- RIGHT : into pulmonary trunk
- LEFT : into the aorta ; its wall is
thicker ; contracts more forcefully ;
generates a greater blood pressure
(120mmHg)
- Separated by INTERVENTRICULAR
SEPTUM
HEART VALVES
~ Atrioventricular (AV) Valves
- TRICUSPID VALVE : right
- BICUSPID / MITRAL VALVE : left
- They allow blood to flow from atria
into the ventricles and prevent it
from flowing back into the atria
~ Semilunar Valves
- AORTIC : aorta
- PULMONARY : pulmonary trunk
- Blocking blood flow back into
ventricles
** PAPILLARY MUSCLES : cone-shaped
muscular pillars
** CHORDAE TENDINEAE : thin, strong,
connective tissue strings
** CARDIAC SKELETON : surround the AV
and semilunar valves and serve as
electrical insulation between atria and
ventricles
ROUTE OF BLOOD FLOW (Figure 12.10)
- both atria and ventricle contract at
the same time
BLOOD SUPPLY
CORONARY ARTERIES
- supply blood to the wall of the
heart
- gives up 70% of its oxygen
- blood glow is greatest when
ventricles are relaxed
LEFT CORONARY ARTERY
- anterior wall and left ventricle
- from left side of the aorta
~ anterior interventricular artery
~ circumflex artery
~ left marginal artery
RIGHT CORONARY ARTERY
- right ventricle

- from right side of the aorta

~ posterior interventricular artery
~ right marginal artery
CARDIAC VEINS
- drain blood from the cardiac
muscle
- nearly parallel to the coronary
arteries
- CORONARY SINUS : large vein in
coronary sulcus ; blood flows to
right atrium
HEART WALL
~ Epicardium
- visceral pericardium
~ Myocardium
- thick middle layer
- cardiac muscle cells
- for contraction of the heart
chambers
~ Endocardium
- smooth inner surface of the heart
- allows blood to move easily
through the heart
** TRABECULAE CARNEAE : ridges and
columns of cardiac muscle
CARDIAC MUSCLE
- its cells are elongated, branching
cells
- contain actin and myosin
myofilaments
- relies on calcium and ATP for
contraction
- rich in mitochondria
- cannot develop a significant
oxygen deficit
- bound end to end and laterally to
adjacent cells by INTERCALATED
DISKS
- GAP JUNCTIONS : allow cytoplasm
to flow freely between cells
ACTION POTENTIALS
- 200-500 ms to complete
~ DEPOLARIZATION PHASE
~ PLATEAU PHASE : slow
repolarization ; result from slow
diffusion of calcium
~ REPOLARIZATION PHASE : rapid
~ REFRACTORY PERIOD : lasts as long
as plateau phase and prevents
tetanic contractions thus ensuring
a rhythm
- Can contract w/o neural stimulation
CONDUCTION SYSTEM OF THE HEART
- contraction of the atria and
ventricles and can produce
spontaneous action potentials
~ Sinoatrial (SA) Node
- hearts pacemaker

initiates the contraction of the

heart
- produces action potentials at a
faster rate
- has a larger number of calcium
channels
~ Atrioventricular (AV) node
- forms AV bundle
- slow rate of action potential allows
the atria to complete their
contraction
- branches into left and right bundle
branches and forms Purkinje fibers
** ECTOPIC BEAT : when action potentials
originate other than the SA node
ELECTROCARDIOGRAM (ECG)
- action potentials produce electrical
currents
- these are records of electrical
events
- can reveal abnormal heart rates or
rhythms
~ P wave
- depolarization of atrial myocardium
- onset of atrial contaction
~ QRS complex
- depolarization of ventricles
- precedes ventricular contraction
~ T wave
- repolarization of the ventricles
- precedes ventricular relaxation
CARDIAC CYCLE
- repetitive pumping process that
begins w/ the onset of cardiac
muscle contraction and ends w/ the
beginning of the next contraction
- primer pump : atria
- power pump : ventricle
~ Atrial and Ventricular Systole
- contraction
~ Atrial and Ventricular Diastole
- relaxation
HEART SOUNDS
- STETHOSCOPE : listen to the
sounds of the lungs and hearts and
other sounds in the body
- First : lubb : ventricular systole &
closure of AV valves
- Second : dupp : ventricular diastole
& closure of semilunar valves
- MURMURS : abnormal heart sounds
- STENOSED : opening of a valve is
narrow
REGULATION
Cardiac Output (CO)
- volume of blood pumped by either
ventricle per minute
- slightly more than 5 L/min

Stroke Volume (SV)

- volume of blood pumped per
ventricle each contraction
- 70 ml/beat
Heart Rate (HR)
- number of times the heart
contracts per minute
- 72 beats/min
CO = SV x HR
~ Intrinsic
- mechanisms w/ the heart
- VENOUS RETURN : amt of blood
that returns to the heart
- PRELOAD : degree to which the
ventricular walls are stretched at
the end of diastole
- STARLINGS LAR OF THE HEART :
relationship between preload &
stroke volume
- AFTERLOAD : pressure against
which the ventricles must pump
blood
~ Extrinsic

mechanisms external to the heart

BARORECEPTOR REFLEX
mechanism of the nervous system
baroreceptors : stretch receptors
that monitor blood pressure in the
aorta and internal carotid arteries
CARDIOREGULATORY CENTER :
receives and integrates action
potentials from the baroreceptors
Sympathetic stimulation,
epinephrine & norepinephrine =
increase SV and HR
CHEMORECEPTOR REFLEX
chemoreceptors : sensitive to
changes in pH and CO2 levels
decrease in pH, increase in CO2 =
increase SV and HR
excess extracellular K and reduced
extracellular Ca = decrease SV and
HR
elevated body temp = increase HR