heart anatomy and physiology.pdf
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Transcript of heart anatomy and physiology.pdf
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1Rob SwatskiAssistant Professor of Biology
HACC York Campus
Chapter 20
Cardiovascular System: The Heart
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20_03a
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6Heart Location: Mediastinum
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7Heart OrientationApex: anteriorly, inferiorly, left-sideBase: posteriorly, superiorly, right-side
Anterior surface: deep to sternum & ribs
Inferior surface: on diaphragm
Right border: faces right lung
Left border (Pulmonary border): faces left lung
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8Heart Surface Projection
Superior right point: sup border - 3rd right costal cartilage
Superior left point: inf border - 2nd left costal cartilage, 3 cm left of midline
Inferior left point: 5th intercostal space, 9 cm left of midline
Inferior right point: sup border - 6th right costal cartilage, 3 cm right of midline
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9Pericardium Pericardium
Fibrous pericardium (outer)- dense irregular CT- protects & anchors heart- prevents overstretching
Serous pericardium (epicardium):- thin, delicate membrane- parietal & visceral layers- pericardial cavity - pericardial fluid
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Pericarditis
Cardiac tamponade
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Layers of the Heart WallEpicardium: mesothelium & CT (visceral layer of serous
pericardium)
Myocardium: cardiac muscle
Endocardium: endothelium & CT (lines chambers & valves)
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Myocarditis & Endocarditis
endocarditis
myocarditis
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Muscle Bundles of the Myocardium
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Chambers & Sulci of the Heart
4 Chambers: - 2 superior atria
- 2 inferior ventricles
Sulci: grooves on heart surface- contain coronary BVs & adipose
Coronary sulcus- encircles heart b/w atria & ventricles
Anterior interventricular sulcus- ant. boundary b/w ventricles
Posterior interventricular sulcus- post. boundary b/w ventricles
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Right Atrium
Receives blood from 3 sources:superior vena cava, inferior vena cava, & coronary sinus
Interatrial septum
Fossa ovalis: remnant of fetal foramen ovale
Tricuspid valve
- blood flows through into right ventricle
- 3 cusps of dense CT
- RAT on the Right (Right Atrioventricular, Tricuspid)
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Right Ventricle
Forms most of ant. surface of heart
Interventricular septum
Trabeculae carneae
Papillary muscles
Chordae tendineae
Pulmonary semilunar valve
- allows blood into pulmonary trunk
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Papillary Muscles & Chordae Tendineae
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Left Atrium
Forms most of base of heart
Receives blood from lungs through 4 pulmonary veins- 2 right & 2 left
Bicuspid valve: blood flows through into left ventricle- 2 cusps- LAMB on the Left: Left Atrioventricular, Mitral, or Bicuspid
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Left Ventricle
Forms apex of heart
Chordae tendineae, papillary muscles, & trabeculaecarneae
Aortic semilunar valve- allows blood into ascending aorta- openings to the coronary arteries directly above valve
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Myocardial Thickness & FunctionThickness varies based on each chambers function:
- Atria walls are thin; Ventricle walls are thick- Right ventricle walls are thin; Left ventricle walls are
thick
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Fibrous Skeleton of Heart
Dense CT rings surround heart valves- fuse together & merge with interventricular
septum
Functions of fibrous skeleton: - valve support structure
- insertion point for cardiac muscle bundles- electrical insulator b/w atria & ventricles
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AV Valves OPEN
Allow blood flow from atria into ventricles when ventricular pressure is lower than
atrial pressure
Occurs during ventricular relaxation:- papillary muscles are relaxed- chordae tendineae are slack
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AV Valves CLOSED
Prevents backflow of blood into atria
Occurs during ventricular contraction:- papillary muscles contract
- chordae tendineae pulled taut- valve cusps pushed closed
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SL Valves
SL valves OPEN during ventricular contraction- allow blood flow into pulmonary trunk & aorta
SL valves CLOSE during ventricular relaxation- blood fills cusps & valves close
- prevents blood from flowing backwards into ventricles
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Heart Valve DisordersStenosis: narrowing of valve that restricts blood flow- repaired by balloon valvuloplasty, surgery, or valve
replacement
Insufficiency or incompetence: valve cannot close completely
Balloon valvuloplasty
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Mitral Valve Stenosis 34
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Systemic Circulation
LEFT side of heart pumps oxygenated blood to body
Left ventricle Aorta Arteries Capillaries Organs Venules Veins Superior/Inferior vena
cava/Coronary sinus Right atrium
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Pulmonary Circulation
RIGHT side of heart pumps deoxygenated blood to lungs
Right atrium Right ventricle Pulmonary trunk Pulmonary arteries Lungs Pulmonary Veins
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Coronary Circulation
Blood flow through
myocardium
The heart feeds itself
first
Many anastomoses
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Coronary Arteries
Right coronary artery
Marginal branch
Posterior interventricular
branch
Left coronary artery
Anterior interventricular
branch (LAD)
Circumflex branch
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Coronary Veins
Collect wastes from myocardium
Great cardiac vein, middle cardiac vein
Drain into coronary
sinus
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Cardiac Muscle Tissue
Striated, branching,
shorter fibers of heart
Intercalated discs with gap
junctions
One central nucleus per fiber
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Cardiac Muscle Histology
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Cardiac Muscle Tissue
Same actin & myosin
arrangement as skeletal muscle
Autorhythmic
Longer contractions (longer Ca+2
delivery)
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Cardiac Myofibril
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Conduction System
Autorhythmicfibers
spontaneous APs
Propagate APs through
myocardium
Sinatrial (SA) node =
pacemaker
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SA node
AV node
AV bundle (of His)
Right & left bundle branches
Purkinje fibers
Conduction System
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Regulation of the Conduction
System
Autonomic Nervous System
(ANS)
Hormones(epinephrine)
Modify heart rate & strength of contraction
They do NOT establish the fundamental
rhythm
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Action Potential
Depolarization
Plateau
Repolarization
Refractory period
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Physiology of Contraction
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Role of Ions in the Action Potential
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Electro-cardiogram
(EKG)
Visual record of allAPs during each
cardiac cycle (heartbeat)
Detected at bodys surface
Diagnostic value
Detects abnormal conduction,
enlargement, & muscle damage
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EKG
P wave
P-Q interval
QRS complex
T wave
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Cardiac Cycle
At 75 beats/min, 1 cycle = 0.85
sec
Pressure & volume changes
during cycle
Blood pumped from high to lowpressure areas
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Atrial systole (contraction)
Atrial diastole (relaxation)
Ventricular systole
Ventricular diastole
Cardiac Cycle
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Blood Volumes
End Diastolic Volume (EDV)
= 130 ml
End Systolic Volume (ESV)
= 60 ml
Stroke Volume (SV) =
70 ml
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SV = EDV - ESV
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Phases of the Cardiac Cycle
IsovolumetricRelaxation
(all valves close)
Ventricular Filling
(AV valves open)
IsovolumetricContraction
(AV valves close)
Ventricular Ejection
(SL valves open)
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Ventricular Pressures
Aortic BP = 120 mmHg
Pulmonary trunk BP = 30
mmHg
Why? How?
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Heart Sounds
Produced when valves
close
lubb = AV valves close
DUPP = SL valves close
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Heart Sounds
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Heart Murmurs
Abnormal sounds before, b/w, or after
normal sounds
May also mask normal sounds
Caused by valve disorders,
increased blood flow/volume
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Cardiac Output
Volume of blood ejected each minute from either
ventricle
CO = Stroke Volume (SV) x
Heart Rate (HR)
70 ml SV x 75 beats/min = 5.25 L/min
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Influences on Stroke Volume
Preload (Frank-Starling
Law of the Heart)
Contractility
Afterload
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Preload
The greater the stretch, the
greater the force of contraction
The greater the blood volume, the greater the force
of contraction
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Contractility
Autonomic Nervous
System (ANS)
Hormones
Ca+2 or K+
levels
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Afterload
The back pressure that must be overcome
before the semilunar valve
can open
The greater the BP = the greater
the afterload
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Congestive Heart Failure
If afterload is high, more blood remains
in the ventricles
which increasesthe preload
Left ventricular failure = pulmonary
edema
Right ventricular failure = peripheral
edema
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Neural Regulation of
Heart Rate
Cardiovascular center in medulla
oblongata
Sympatheticimpulses increase
HR & force of contraction
Parasympathetic impulses decrease
HR & force of contraction
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Nervous System
Receptors
Baroreceptors: monitor BP
Proprioceptors: monitor
movements
Chemoreceptors: monitor blood
chemistry
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Biochemical Regulation of
Heart Rate
Epinephrine, norepinephrine,
thyroid hormones
Na+, K+, Ca+2
Age, gender, physical fitness,
temperature
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High blood cholesterol
High BP Smoking
ObesityLack of regular exercise
Family history
Male gender DiabetesLeft
ventricular hypertrophy
Risk Factors for Heart Disease
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Plasma Lipids & Heart Disease
High blood cholesterol:
promotes plaques
High-Density Lipoproteins
(HDLs)
Low-Density Lipoproteins
(LDLs)
Very Low-Density Lipoproteins
(VLDLs)
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Coronary Artery Disease (CAD)
Ischemia
Reduced blood flow through
coronary arteries
Causes hypoxia & weakens
cardiac muscle
Angina Pectoris
Narrowing of coronary arteries
Leads to reduced blood flow, chest
pain, pressure, discomfort
Myocardial Infarction
Complete obstruction of coronary blood
flow causing heart attack
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Coronary Artery Disease Obstructions
Atherosclerosis
Coronary artery spasm
Coronary artery thrombosis
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Atherosclerosis & Plaque Development
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Coronary Artery Bypass Grafting (CABG)
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Congenital Heart Defects
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Congenital Heart Defects, cont.
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Arrhythmia
Irregularity in heart rhythm due to
conduction system defect
Bradycardia
Tachycardia
Fibrillation
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Credits
by Rob Swatski, 2010
http://robswatskibiology.wetpaint.com
Visit my website for more Anatomy study resources!
http://www.flickr.com/photos/rswatski
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