ANATOMY & PHYSIOLOGY: LESSON 12 -

HEART
 FIST – Approximate size of the heart ENDOCARDIUM, because of its
 The shape of the heart is cone-shaped or smoothness it allows a smooth flow of the
inverted pyramid blood through the heart.
 Located in the MEDIASTINUM
OVERVIEW OF THE ANATOMY OF THE
(thoracic cavity between the 2 pleural
HEART

cavity) 6 VEINS important for the heart anatomy:

o Apex – inferior end of the heart
o Veins – valik / towards the heart
o Base – larger superior base of the heart;
o Superior vena cava -gets blood from the
points more to the RIGHT
upper part of the body and drain in the heart
o Pericardial cavity – space of the heart; made
o Inferior vena cava – carries blood from the
up of tissue called “pericardial
lower parts of the body for example in the
sac/pericardium” and these tissues will
legs and carry it towards the heart
surround the heart to anchor it to the
o 4 pulmonary veins – carries blood from the
mediastinum
lungs to the heart
The pericardium/ pericardial sac has 2 layers:
2 arteries important for the heart anatomy:
o the outer layer – called the fibrous
o Arteries – away from the heart
pericardium
o Pulmonary trunk – divides into the left and
o inner layer – called the serous pericardium
right pulmonary arteries; it carries blood
has also 2 layers the outer serous
from the heart to the lungs
pericardium is called the parietal
o Aorta – the one that carries blood from the
pericardium and the inner serous
pericardium is called the visceral heart towards the rest of the body.
pericardium also known as EPICARDIUM 4 chambers for the blood in the heart:
o there is a space in between the 2 serous
layers called the pericardial cavity. o (2) Atria - Top chambers – receiving
o The pericardial cavity is filled with fluid chambers of blood; responsible for receiving
called pericardial fluid that helps reduce and holding blood coming from the body
friction during the movement of the heart and the lungs.
o The heart has 2 atria: left and right
o Right atrium gets blood from the body
HEART WALL through the superior and inferior vena cava
o The epicardium is part of the 3 layers of the while;
heart wall and it is the outermost wall of the o Left atrium receives blood through the
heart pulmonary veins
o This layer is composed of simple squamous o If the 2 atria will contract its going to push
epithelium blood out of it and down to the next
o The MIDDLE LAYER, MYOCARDIUM chambers called the VENTRICLES
is composed of cardiac muscle cells that is o the right atrium will push blood to the right
responsible for the contraction of the heart ventricle and the left atrium will push blood
o The innermost layer makes up the smooth to the left ventricle
inner surface of the heart is called o (2) Ventricles
ANATOMY & PHYSIOLOGY: LESSON 12 -
HEART
o Ventricles are major pumping chambers of o Mitral valve will prevent back flow from the
the heart since they are responsible for left ventricle to the left atrium.
pumping blood to the lungs and to the rest of o It is called as the mitral valve since it
the body resembles the bishop’s miter.
o right ventricle, when it contracts it will push o Semilunar valves – are named this way
blood to the pulmonary arteries to give because of their shape which resembles the
blood from the heart to the lungs moon; valve in between the ventricle and
o while the left ventricle when it contracts its great blood vessels
going to push blood going to the aorta to o Pulmonary valve is between the right
push blood to the rest of the body. ventricle
o Comparing the 2 ventricles the left ventricle o In the right ventricle its going to pass
needs more power/ greater force of through the pulmonary semilunar valve
contraction since it’s going to pump blood to before the blood goes to the pulmonary
the rest of the body while the right ventricle trunk so when the ventricle contracts the
just needs to pump blood in the lungs blood will go to the pulmonary trunk
o That is why the left ventricle has a thicker o Once the blood is in the pulmonary trunk the
wall than the right ventricle and also causes pressure will be greater in the pulmonary
the left ventricle to create a greater blood trunk than the ventricle and will close the
pressure than the right side. pulmonary valve to prevent backflow of the
blood going back to the ventricle
SEPTA
o Aortic semilunar valve – valve between the
left ventricle and aorta.
Muscles in the heart
 Papillary muscles – cone shaped muscle that
are connected to the free areas of the av
valves via connective tissue strings called
CHORDAE TENDINEAE
 Chordae tendineae – heart strings
 When the ventricles contract, the papillary
o Septa – divides the atria and ventricle into
muscles will also contract to prevent the
the left and right atrium and ventricle
valves from opening by pulling the heart
o Interatrial septum – in between the two atria
strings
o Interventricular septum – in between the two  Cardiac skeleton – plate of connective tissue
ventricles made up of fibrous rings; attachment site for
Heart valves – gatekeepers of the blood flow; muscles and an electrical insulator between
allows one blood direction only and won’t allow a the four chambers of the heart
back flow. BLOOD VESSELS
 2 types: atrioventricular valves and  Deoxygenated blood coming from the upper
semilunar valves body goes through the superior vena cava and
into the right atrium
o AV VALVES (Atrioventricular valves)- in
 Next, blood coming from the lower body goes
between the atria and the ventricle; prevents
through the inferior vena cava and again
backflow from the ventricle to the atrium enters the right atrium.
o The right av valve is called the TRICUSPID  The blood in the right atrium then passes
valve it is named as tricuspid because it through the tricuspid valve and then it will
consists of 3 cusps. enter into the right ventricle
o Tricuspid valve will prevent backflow of  When the ventricle contract, the
blood from right ventricle to right atrium pulmonary semilunar valve will open
o The left av valve only consists of 2 cusps and the tricuspid valve will close.
called BICUSPID VALVE but known  The blood will then travel to the pulmonary
better as MITRAL valve trunk then to the pulmonary artery and it will
ANATOMY & PHYSIOLOGY: LESSON 12 -
HEART
go next to the lungs and there they will get the rest of the body to use up the oxygen and
oxygen that the body needs. goes back to the right side of the heart.
 After they get the oxygen, the blood will
travel through the pulmonary veins and they
will enter the left atrium.
 Once they reach the left atrium, they will pass
again through the mitral valve and it will enter
the left ventricle.
 When the ventricle contract, the mitral
valve will close and the aortic valve will
open, so the blood will flow to the aorta.
 Once in the aorta, it will go to the rest of the
body and the oxygen will be used up by the
body, this cycle goes on and on. This is the
basic flow of the blood. BLOOD SUPPLY OF THE HEART
TAKE NOTE:  The body needs a blood to function
 Two Atria simultaneously contract and Two  The heart pumps blood to the heart to the rest
Ventricles simultaneously contract of the body just like other organs in the body
that needs blood supply.
 The heart pumps blood for itself via coronary
arteries.
 These arteries originate at the base of the
aorta and it has the left and right coronary
artery.
Left Coronary Artery
 It originates from the left side of the aorta, and it
has three major branches:
a. Anterior Interventricular
b. Circumflex
c. Left Marginal Artery
CIRCULATION  These branches and the left coronary artery
 It was established that the heart is a pump, but supply most of the anterior wall of the heart and
the heart is two pumps in one, because it is the left ventricle
involved in two circulations. Right Coronary Artery
1. Pulmonary Circulation (to lungs)  Only has two branches:
which involves the right side of the heart a. Posterior Interventricular
pumping the blood to the lungs, to the left side b. Right Marginal Artery
of the heart from the right atrium to right  These branches supply most of the right
ventricle then towards the lungs. From the ventricle
lungs, to the left atrium.  There is a difference between the blood vessels
for the rest of the body and the blood vessels
2. Systemic Circulation (to body) here.
 Involves the flow of the blood from the  The artery will carry blood away from the heart,
left side of the heart to the other parts of during ventricular contraction, blood flow is
the body and then back to the right side of highest in blood vessels or arteries going
the heart. After it gets oxygen from the towards the body because it pushes blood
lungs it goes to the left atrium then left towards the vessels towards the body.
ventricle then out through the aorta, to the  These arteries have the highest blood flow
during ventricular relaxation, the heart is
supplied with blood during relaxation of the
ventricles.
Take Note:
Ventricular Relaxation is the opposite on
supplying of blood to the rest of the body.
Veins
 The veins carry blood back to the heart.
ANATOMY & PHYSIOLOGY: LESSON 12 -
HEART
 The cardiac veins will drain the blood from about the same time because the fibers are
the cardiac muscles to the coronary sinus electrically linked likewise both the ventricles
 The coronary sinus is a large vein at the will also contract at about the same time
posterior heart within the coronary sulcus because of these electrical linkages.
 From the sinus, the blood will flow to the right Four Structures in the Heart
atrium and there are also small cardiac veins (to produce spontaneous action potentials)
that will directly drain into the right atrium. a. Sinoatrial Node or SA Node
 Mostly all of the blood from the cardiac  ‘Pacemaker of the heart’ because it initiates or
muscles will drain into the right atrium via it starts the contraction of the heart
the coronary sinus or the other cardiac  It is located at the superior wall of the right
veins. atrium
ACTION  The action potentials from the SA node will
POTENTIAL then spread through

the atria to cause the atria

CORONARY ARTERY DISEASES to contract.
 Coronary Arteries will carry the blood towards b. Atrioventricular Node or AV Node
the heart muscles to supply nutrients to the  It is located at the lower part of the right
heart, but there are conditions regarding these atrium
arteries.  Once the impulses will reach the AV Node, it
a. Coronary Thrombosis will spread slowly through it.
 When there is a blood clot formed  The flow should be slow through the AV
 There is lesser blood that will go to the heart node, so that it could complete first
muscle contraction of the atria before the action
 Coronary Artery Disease or CAD potential reach the AV node
 When there is a reduced blood supply to the c. Atrioventricular Bundle or Bundle of HIS
heart.  This is located at the connective tissue
 Myocardial Infarction separating the atria from the ventricles
When there is a reduced blood supply to the d. Purkinje Fibers
heart and reduced nutrients, it could lead to  This bundle will divide into left and right
 damage of the heart tissue. Since it does not bundle branches and forms the Purkinje Fibers
receive any nutrients, it will die.  The purkinje fibers extends separating the
 This condition is commonly known as heart atria from the ventricles to the muscles of the
ventricles
 Once it reaches the purkinje fibers, this causes
the ventricles to contract.
 ‘Largest pacemakers’ or the ‘largest part of
the conduction system ’
Mnemonics: SABP
 If the SA node has problems, AV nodes will
attack. be the one to initiate the heart beats.
CONDUCTION SYSTEM  If the SA node and the AV node has problems,
 The cardiac muscle fibers contract rhythmically the bundle of HIS will initiate the contraction
because they have their own built-in conduction o Normally the heart beats 60 – 100 times per
system and this is responsible for coordinating minute, that is initiated by the SA Node.
the contractions during the cardiac cycle. o If AV node initiate, there will be lesser, it will
 The cardiac muscles have their be 40 – 60 times per minute
interconnectedness because of intercalated disks o If Bundle of HIS, it will become lesser
so both atria, the left and the right will contract
ANATOMY & PHYSIOLOGY: LESSON 12 -
HEART
o If the Purkinje Fibers, it is also lesser. surface by electrodes and its transformed

ACTION POTENTIAL

 The it has similar phases but it is not the same.

 The difference, here it starts with zero not phase
Phase Zero
 It is sodium channels open because of a
stimulus.
 When sodium channels open, sodium ions will
go inside the cell, that is why, the inside of the
cell became more positive. This is the
depolarization phase.
Phase One into 3 things by an instrument called
 Is when potassium channels open and triggers electrocardiogram, a graphic record of the
a lower or lesser positive charge inside the heart’s electrical activity.
cell. This part is the initial repolarization.  An extremely valuable tool for diagnosing a
Phase Two number of cardiac abnormalities.
 This is the phase that the other cells don't
have interaction potentials. 3 WAVES OF EKG/ECG
 ‘Plateau’ meaning they do not have a change  Depolarization- contraction
in either going negative or going positive it's  Repolarization - relaxation
because while potassium channels are still
open, calcium ion goes in and that’s also a 1. P wave
positive charged ion. There is a balance. - Electrical signal for the ATRIAL
 When the calcium channels close and DEPOLARIZATION.
potassium channels are still open, there is still - After that electrical signal, the atrias
potassium going out, it lessens because it's will contract both the left and the
getting more negative not inside the cell and right.
positively charged potassium ions. And that 2. QRS wave
is Repolarization Phase. -

 PHASE FOUR
- RESTING MEMBRANE
POTENTIAL and back to its nature
resting phase where everything is
balanced.
SUMMARY:
PHASE 0 – DEPOLARIZATION; Na
channels go open, Na goes in

PHASE 1 - INITIAL
REPOLARIZATION; K out VENTRICULAR
DEPOLARIZATION
PHASE 2 – PLATEAU; Ca going in - After that electrical signal, the
ventricle will contract.
PHASE 3- REPOLARIZATION; Na out - Atrial repolarization is very small
so its hidden between this wave
PHASE 4 – RESTING MEMBRANE
POTENTIAL and back to resting phase

EKG/ECG (ELECTROCARDIOGRAM)
 The action potential in the heart produces
electrical currents and these electrical
signals could be picked up from the bod
ANATOMY & PHYSIOLOGY: LESSON 12 -
HEART
3. T wave
- VENTRICULAR
REPOLARIZATION
- After this wave, the ventricles will relaxed

OTHER PARTS OF EKG/ECG

1. PQ/PR INTERVAL
- Time between the beginning of the
P waves and the beginning of the
QRS complex; atria contracts and
begins to relax.
2. QT INTERVAL
- Start from the beginning of the QRS
to the end of the T WAVE.
- Time needed for ventricular
depolarization and repolarization.
*insert pictures of steps for ekg/ecg
CARDIAC CYCLE
- repetitive pumping process of
cardiac muscle contractions.
 SYSTOLE – contraction of
either the atria or the
ventricles
 DIASTOLE – relaxation of
either the atria or the
ventricles
 STROKE VOLUME –
blood ejected per BEAT; 70
mL/beat
 CARDIAC OUTPUT –
blood ejected per MINUTE;
5 L/min. 2. ATRIAL
SYSTOLE/CONTRACTION

MAJOR EVENTS IN CARDIAC CYCLE

1.
ANATOMY & PHYSIOLOGY: LESSON 12 -
HEART
HEART SOUNDS
 Stethoscope – used to listen to the
sounds of the lungs and the heart

2 HEART SOUNDS

3. VENTRICULAR
SYSTOLE/CONTRACTION
1. S1- LUB
- closure of the AV valves (tricuspid & mitral
valves)
2. S2 – DUB
- Closure of the SEMILUNAR valves
(aortic & pulmonic valves)

REGULATION OF THE HEART

 STROKE VOLUME (SV) – blood
ejected per BEAT; 70 mL/beat
 CARDIAC OUTPUT (CO) – blood
ejected per MINUTE; 5 L/min.
 HEART RATE (HR) – no. of times
the heart contracts per minute; 72
beats/min; normal: 60-100 bpm

CO = SV x HR
CO = 70 mL/beat x 72 bpm
4. VENTRICULAR CO = 5040 mL/min (approx. 5 L/min)
DIASTOLE/RELAXATION
NERVOUS REGULATION:
BARORECEPTOR REFLEX
ANATOMY & PHYSIOLOGY: LESSON 12 -
HEART
EPINEPHRINE &
NOREPINEPHRINE
(SYPMPATHETIC RESPONSE)

- INCREASED HR AND SV
2. Emotions
 Excitement/anger/anxiety-

CARDIOREGULATORY
CENTER- SYMPATHETIC
 Depression –
CARDIOREGULATORY
CENTER –
PARASYMPATHETIC
BLOOD pressure INCREASES 3. Chemoreceptors in Medulla
- DECREASED PH / INCREASED
CO2 – SYMPATHETIC

4. Extracellular Ion Concentration

 EXCESS K- DECREASE
HR & SV – DEATH
 EXCESS Ca-
ARRHYTHMIC
CONTRACTION
 REDUCED Ca –
DECREASED HR & SV
5. Body Temperature
 INCREASED TEMP:
INCREASED HR
 DECREASED TEMP:
DECREASED HR

CHEMORECEPTORS REFLEX

BLOOD pressure DECREASES

CHEMICAL REGULATION
1. Exercise, Emotions, Stress
- Adrenal gland secretes
ANATOMY & PHYSIOLOGY: LESSON 12 -
HEART
BLOOD pH INCREASES
BLOOD pH DECREASES