The Human Heart

and
Circulatory System

Angela L. Pruitt, MSN, RN, CNS

A & P: Cardiovascular
Heart Trivia
• Average human heart beats 36.5 million times/yr.
• Heart weighs about 10 ounces.
• Size of a fist.
– Blue Whale’s heart is as big as a car!
• Yawning may be due to inadequate oxygen being carried by
the cardiovascular system.
• German researchers- risk for heart attack is higher on
Monday’s.
• Women’s hearts beat faster.
• Athletes resting heart rate is 35 – 40 bpm.
• Human body blood vessels approx. 70,000 miles.
• 7% of body weight is blood.
Introduction
• CV System : heart, blood vessels
• Arteries, capillaries, veins
• Vital for supplying O2 and nutrients to tissues;
remove waste
• Pulmonary Circuit – Lungs
– Deoxygenated blood
• Systemic Circuit – remaining
– Oxygenated blood to all body cells
Structure, Size & Location
• Hollow, Cone shaped
• Muscular organ
• Two sides have separate
functions
• The size of your fist
– About 14 cm long / 9 cm
wide
• SEPTUM thick section
between the ventricles
called the
Location of Heart in Body
1. Beneath sternum in the
Mediastinum
• Lungs bilaterally; spine
posterior
2. BASE – upper right; 2nd
rib (ICS)
3. APEX – lower left; 5th rib
(ICS)
Anatomy of Heart
Pump
• Right side – lungs
• Left side - body
Systemic Circulation
– Left side sends blood at
high pressures to body
Pulmonary Circulation
– Right side sends blood
through lungs at lower
Connected to blood vessels to carry pressure
oxygen and nutrients to body cells and
remove waste products
How Does the Heart Function?
• http://video.about.com/heartdisease/How-the-Hear
t-Functions.htm
Circulation is a ONE WAY SYSTEM
ARTERIES
•oxygen-rich blood away from
your heart.
VEINS
•oxygen-poor blood back to
your heart.

PULMONARY CIRCULATION
Roles Are Switched
•pulmonary artery brings
oxygen-poor blood into your
lungs.
•pulmonary vein brings
oxygen-rich blood back to your
heart.
How does Pulmonary & Systemic
System look?
 Covering of Heart- Pericardium
Fluid filled sac, encloses heart.
Lubricate, protect, reduce
friction
Outer layer – tough fibrous
Two inner layers
• Visceral– covers heart
Pericardial sac – formed
by parietal and fibrous
pericardium
• Parietal– middle layer
• Pericardial cavity –
serous fluid to reduce
friction
What is Friction?
• RUBBING OF ONE OBJECT OR SURFACE
AGAINST ANOTHER:
PERICARDITIS
– Inflammation of the Pericardium
– Due to infection- viral or bacterial
– Cause adhesions( the layers stick
together) - FRICTION
– VERY PAINFUL
• Heard- Pericardial RUB
• Sounds like cellophane being rubbed
Three Layers of Wall of the Heart
1. Epicardium – outer, connective tissue
– Serous membrane, reduces friction
– Blood & lymph capillaries; coronary arteries
2. Myocardium – middle, muscle fibers
– Thickest layer
– Pumps blood out of heart
3. Endocardium – inner, elastic and collagen
fibers;
– contain the Purkinje fibers

MYOCARDIAL LAYERS HELPS THE HEART CONTRACT!

Layers
Four CHAMBERS of the Heart
Two Atria Two Ventricles
(upstairs) (downstairs)
• Top, thin walls • Bottom; Larger, thicker
walls
• Receive blood • Receive blood from Atria
returning to the heart • Contract to pump blood
& pumps to ventricles to body
• Low pressure • High Pressure

SEPTUM – separates right & left side; never mixes blood

Four CHAMBERS of the Heart
TWO ATRIA TWO VENTRICLES

Right Atrium (RA) Right Ventricle (RV)

• Receives from superior • Blood goes only to
& inferior vena cava lungs

Left Atrium (LA) Left Ventricle (LV)

• Smaller, thicker walls • Blood goes through
• Receives blood from aorta to vessels in
pulmonary veins entire body
Heart Valves – One Way Blood Flow
Prevents blood from backing up into the heart
ATRIOVENTRICULAR
VALVES
Separate Atria from Ventricles

• Have cusps, Chordae tendinae

attach
– Tricuspid Valve – Right
• Stops backflow from RV
into RA
– Mitral (bicuspid) - Left
• Stops backflow from LV
into LA
 Heart Valves – How Do They Work?
Chordae Tendineae
attach the cusp of AV
valve to papillary muscle

Papillary Muscles
in the inner heart wall
contract during ventricular
contraction
prevent backflow of blood
through the A-V valves.

• http://video.about.com/heartdisease/How-the-Valves-Work.htm
Semilunar Valves

– Pulmonic Valve
• Prevents return of
blood on Right side to
ventricles
• Pulmonary Artery into
RV
– Aortic Valve
• Stops backflow from
Aorta into LV

Open & Close based on

pressure changes
http://www.youtube.com/watch?v=MduG0mbW09A&feature=fvwrel
 Path of Blood Flow
• Unoxygenated blood enters the • Gas Exchange occurs to
heart (returns) to the RA via oxygenate blood
Superior & Inferior Vena Cava – High Oxygen, low CO2
– Low oxygen, high CO2 • Returns to LA via
• Enters RA ~ blood pass Pulmonary Veins
through Tricuspid valve into RV • LA, contracts~blood forced
• RV contracts, forces blood through Mitral Valve to LV
through Tricuspid into RV, then • LV contracts, closes Mitral
closes. valve ~ forces open Aortic
• Blood sent through Pulmonic Valve as blood enters
Valve, into Pulmonary Arteries Aorta
to LUNGS • Aorta sends blood to body
• Capillaries of alveoli in lungs for distribution
get rid of Co2 and pick up O2.
• Average: 60 bpm = 3600 bp hr.
• X 24hrs= 86,400 beats
• X 365 days= 31,536,000 beats
• X 17 years= 536,112,000 beats in your life
time to date without missing a beat and still
going strong.
• Name another pump that can do that?????
How does the Heart receive Blood
Supply? Coronary Arteries!!
• Openings come off the first
branch of aorta
• Delivers fresh blood to supply
the heart muscle with blood.
• Right and Left coronary
arteries branches feed heart
muscle
• Capillaries of the myocardium
have continuous blood supply,
so form collaterals as alternate
pathways for blood, should
one artery become blocked.
Low or Blocked flow of Coronary
Arteries CAUSE
• When arteries are
• Angina pectoris
obstructed, the blood flow
• Myocardial Infarction is stopped or decreased.
• Thrombus • Condition is called a
• Embolus myocardial infarction or
heart attack.
• Arrhythmia – There is no blood
• Valvular Prolapse or supply going to the
Stenosis muscles of the heart.
• Arteriosclerosis
Coronary Veins
• Cardiac veins drain blood from the heart muscle
• Carry blood to the coronary sinus,
• Empties into the right atrium.
How the Heart Pumps: Cardiac Cycle
• Hose with a one-way valve in it.
The Cardiac Cycle :
• Squeeze your hand around the hose the start of one heart beat to
it will push the blood out forcing the the start of the next
valve to open. heartbeat.
• Relax your hand, the valve will close.
Although the valve is closed the
blood still flows forward, but not as
much. The flow is still enough to
keep the blood circulating
• The act of squeezing the hand is
similar to a
– heart contraction or systole
(systolic).
– heart relaxation or diastole
(diastolic).
Cardiac Cycle
Pressure rises & falls with contraction and relaxation of A & V;
opens & closes valves

• Atria beat in unison • Ventricles contract,

followed by contraction of pressure inside increases
both ventricles, sharply, causing A-V
• the entire heart relaxes for valves to close and the
a brief moment. Aortic and Pulmonic valves
• Atria fill, pressure is open.
• Papillary muscles contract,
greater than the ventricles,
forces the A-V valves open pull on Chordae tendinae
force blood into ventricles and prevent backflow of
blood through the A-V
valves.
Heart Sounds
• “lubb – dupp” • ABNORMAL SOUNDS
• Sounds due to • Murmur
vibrations caused by – Valves are damaged,
the closing of the not closing properly
valves • Swishing sound
• Ventricular contraction • Can be benign or
– Lubb – first sound serious
• AV valves closing; • Not uncommon for
Tricuspid & Mitral Valves
• Ventricular relaxation teens and women over
40 to have murmurs.
– Dupp – second sound
• Pulmonic & Aortic Valves
snap shut
• Open heart showing heart beating
• http://www.youtube.com/watch?v=18zlNa21
6vI

• Heart sounds
• http://depts.washington.edu/physdx/audio/no
rmal.mp3
• http://www.blaufuss.org/
Conduction System
• http://video.about.com/heartdisease/Conduction-
System.htm

FUNCTIONAL SYNCYTIUM
Specialized cardiac muscle
tissue.

Mass of merging cells that

function as one unit.

When one portion is

stimulated, the resulting
impulse passes to the other
fibers of the network and the
whole section contracts as a
unit,
Self exciting and Rhythmic
Nodes of Conduction System
Sinoatrial Node – “Pacemaker” Atrioventricular Node
– Just beneath epicardium – Just beneath the endocarium
– Located near RA at opening of – Located inferior portion of
Superior Vena Cava septum that separates atria
– Reach threshold and initiate – Interatrial Septum
impulse on own; – Delay impulse transmission
• Self excitation – Allows atria to empty and
– Spreads to surrounding ventricles to fill with blood
myocardium to stimulate – Move rapidly to AV Bundle
contraction of R & L Atria at (BUNDLE OF HIS)
rate of 70 to 80 times/min – Divides into R & L
– Impulse passes to AV Node branches
• Atrioventricular Node
Nodes of Conduction System
AV Bundle (BUNDLE OF HIS) Papillary Muscles
– Divides into R & L branches – Project inward from the
– Located just beneath ventricular walls, continue
endocardium downward to apex of heart.
– Curve around and pass
Perkinje Fibers upward over lateral walls
– Halfway down Ventricular – Many small branches.
Septum – Irregular whorls allow
– Spread into the Papillary contraction with a twisting
Muscles motion to squeeze blood out
of ventricles, into aorta and
pulmonary trunk

• The heart has a firing squad. If the SA node doesn’t fire, the AV node fires.
• If the SA and AV node fail, the ventricles fire their own impulse.
What regulates or influences the
amount of blood pumped?
Cardiac Control Center: Medulla Oblongata
Parasympathetic – Inhibits or slows
Sympathetic – Excite and increases - Norepinephrine

1. Strenuous exercise Electrolytes (Ions)

– HR  1. Potassium (K+)
2. B/P Changes • High: Decrease rate & force of
–  ; Vagus Nerve contraction
3. Temperature • Low: irritates heart; V-Tach or
–  ; Hypothalmus V-Fib
2. Calcium (Ca++)
• High:  HR; prolongs heart
contraction
• Low: Slows heart action