HEAR
T
SIZE AND LOCATION OF THE HEART
Heart is a hollow conical
muscular organ
It is situated in the middle of
the thoracic cavity (Media
sternum) above the
diaphragm
Inside the rib cage, under
and to the left of the
sternum between the lungs
SIZE AND LOCATION OF THE HEART
Size of a fist
12cm from base to apex
6cm Antero posteriorly
An adult human heart weighs 250-350 grams
Organs associated with the heart
Inferiorly – the apex rests on diaphragm
Superiorly – the great blood vessels, i.e. the aorta, superior vena
cava, pulmonary artery and pulmonary veins
Organs associated with
the heart
Laterally – the lungs – the left lung overlaps the
left side of the heart
Anteriorly – the sternum, ribs and intercostal
muscles.
Posteriorly – the esophagus, trachea, left and
right bronchus, descending aorta, inferior vena
cava and thoracic vertebrae
CHAMBERS OF THE HEART
Has four chambers
Two upper chambers called the
atrium / auricles
Two lower chambers called the
ventricles
The four chambers of the heart
are separated by means of a
partition called the septum
CHAMBERS OF THE HEART
In Atrium partition is called inter Atrial
septum
In ventricles it is called inter ventricular
septum
The atria are blood collection chambers
The ventricles are blood pumping
chambers
COVERING OF THE HEART
The heart is a large muscular organ comprised of
four different layers (from the outside to the
inside)
Pericardium
Myocardium
Endocardium
PERICARDIUM
The pericardial sac has two layers
1. Fibrous layer
2. Serous layer
The space between the two layers of
serous pericardium is Pericardial
cavity which is filled with serous
fluid
Confines heart to the mediastinum
Allows sufficient freedom of
movement.
LAYERS OF THE HEART
WALL
MYOCARDIUM: Responsible for pumping
ENDOCARDIUM: Thin layer of endothelium which is
continuous with the lining of the large blood vessels
attached to the heart.
MYOCARDIAL THICKNESS
AND FUNCTION
ATRIA : Thin walled
VENTRICLES :Thick walled
Lt ventricle is thicker than the
Rt ventricle.
MYOCARDIAL THICKNESS
AND FUNCTION
The muscle of the left ventricle is 2-3 times thicker than
that of the right
Blood is pumped out of the heart at greater pressure from
the ventricles compared to the atria
left ventricle pump blood all around the body
right ventricle pump blood only to the lungs
Higher force is needed to pump blood through the systemic
circuit compared to the pulmonary circuit
HEART VALVES
There are two types of valves in the heart
THE ATRIOVENTRICULAR VALVES (Separate the atria from the
ventricles)
Tricuspid Valve (Right Atrioventricular Valve)
Bicuspid or Mitral Valve ( Left Atrioventricular Valve)
THE SEMI LUNAR VALVE
Found at the base of the aorta and the pulmonary artery
Aortic Valve
Pulmonary Valve
HEART VALVES
Each valve has a set of flaps called leaflets or cusps
Bicuspid valve has two cusps ,flaps or leaflets
Tricuspid valves- Tricuspid, Pulmonary and Aortic
valve have three cusps
ATRIOVENTRICULAR &
SEMILUNAR VALVES
BLOOD VESSELS OF THE HEART
Aorta – It is a largest artery. It arises from left ventricle
and supplies oxygenated blood to the body tissues
(Systemic Circulation)
Pulmonary Veins - They are the blood vessels that deliver
oxygenated blood from the lungs to heart.
Two pulmonary veins enter the left side of the heart from
each lung
BLOOD VESSELS OF THE HEART
Pulmonary Artery - It is a blood vessel that carries
deoxygenated blood from right side of the heart
to the lungs (Pulmonary Circulation)
Venacavae - These are two large veins that return
deoxygenated blood from body tissues to the right
side of the heart
BLOOD VESSELS OF THE HEART
SYSTEMIC AND
PULMONARY CIRCULATION
Left side is a pump to the systemic
circulation.
Systemic circulation moves blood
between the heart and the rest of
the body.
Right side is a pump to the
pulmonary circulation
Pulmonary circulation moves blood
between the heart and the lungs.
CORONARY BLOOD
VESSELS
The coronary circulation supplies blood to heart tissue.
The right and left coronary arteries come off from ascending
aorta at the aortic sinuses.
Right Coronary Artery
Right marginal branch
Posterior interventricular branch
Left Coronary Artery
Left circumflex artery
Left anterior descending or anterior interventricular artery
CORONARY BLOOD
VESSELS
CORONARY BLOOD
VESSELS
THE CONDUCTION SYSTEM
Inherent and rhythmical
beat is due to
autorhythmic fibers of
the cardiac muscle.
These fibers have 2
important function
- Act as pace maker
- Form the
conduction system
CONDUCTION SYSTEM OF
HEART
Pathway is made up of 5
elements:
1.The Sino-atrial (SA)
node
2.The Atrio-ventricular
(AV) node
3.The bundle of His
4.The left and right
bundle branches
5.The Purkinje fibres
CONDUCTION SYSTEM OF
HEART
The SA node is the natural pacemaker of the
heart
The SA node releases electrical stimuli at a
regular rate, the rate is dictated by the needs of
the body.
Each stimulus passes through the myocardial
cells of the atria creating a wave of contraction
which spreads rapidly through both atria.
CONDUCTION SYSTEM OF
HEART
The electrical stimulus from the SA node
eventually reaches the AV node and is
delayed briefly so that the contracting atria
have enough time to pump all the blood into
the ventricles.
Once the atria are empty of blood the valves
between the atria and ventricles close.
CONDUCTION SYSTEM OF
HEART
At this point the atria begin to refill and the electrical
stimulus passes through the AV node and Bundle of
His into the Bundle branches and Purkinje
fibresventricular contraction begins pumping
blood into the pulmonary artery and the aorta.
CARDIAC CYCLE
CARDIAC CYCLE
Cardiac cycle consist of
Systole of Atrium and Ventricle
Diastole of Atrium and Ventricle
Complete cardiac diastole
ATRIAL SYSTOLE
Lasts for 0.1 sec , Atria are contracting
Atrial depolarization causes atrial systole
As atria contract pressure within atria increase
which force blood through AV valve into ventricles
It contributes a final 25ml of blood to each
ventricle
End of atrial systole is also end of ventricular
diastole
END-DIASTOLIC VOLUME IS 130 ml
VENTRICULAR SYSTOLE
Lasts for 0.3 sec
V.Systole caused by ventricular
depolarization
Pressure in ventricle increase AV
valve shuts
Isovolumetric contraction lasts for
0.05 seconds when both the
semilunar and atrioventricular
valves are closed.
VENTRICULAR SYSTOLE
The semilunar valves open when the
left ventricular pressures surpasses
aortic pressure (80 mm of mercury)
The right ventricular pressure rises
above pulmonary pressure (20 mmHg)
Semilunar valves open for 0.25 sec
VENTRICULAR SYSTOLE
The left ventricle ejects
about 70 ml into the
aorta
The right ventricle ejects
the same volume into the
pulmonary trunk.
End Systolic Volume is
60ml in each ventricle .
RELAXATION PERIOD
Both atria and ventricles are
relaxed .It lasts for 0.4 sec.
As ventricles relax pressure
decreases shuts semilunar
valves
Isovolumetric relaxation
As ventricles continue to relax
pressure falls AV valves
open ventricular filling begins
HEART SOUNDS
Produced from blood
turbulence caused by closing
of heart valves
S1 – Atrioventricular valve
closure
S2 – Semilunar Valve Closure
S3 – Rapid ventricular filling
S4 – Atrial Systole
HEART SOUNDS
S1 is described as lubb sound , soft ,long and low
pitch sound, occurs due to Atrioventricular valve
closure
S2 is described as dubb, short ,sharp and high pitched
sound , occurs due to Semilunar Valve Closure
S3 is produced due to rushing of blood into ventricles
during rapid ventricular filling, short & low pitched
S4 is produced due to vibration in atrial musculature
during atrial systole , short and low pitched
HEART SOUNDS
REGUALTION OF HEART
RATE
SA node initiates 100
beats/min if left to itself.
Tissue require different
volume of blood flow under
different conditions (ex:
exercise)
ANS and Hormones of
adrenal medulla are
important in regulating the
heart rate.
REGUALTION OF HEART
RATE
AUTONOMIC REGULATION OF
HEART RATE
Sympathetic nerve reaches the
heart via accelerator(x) nerves,
it ends at SA node, AV node and
atrial myocardium
Release noradrenaline, speeds
the rate of spontaneous
depolarization and
Increases contractility
PARASYMPATHETIC EFFECT
Parasympathetic nerve reaches the
heart via left vagus (x) nerves,it
ends at SA node,AV node and
atrial myocardium
They release acetylcholine, which
decreases the heart rate by
slowing the depolarization
CHEMICAL REGULATION OF
HEART RATE
HORMONES:
Epinephrine and Norepinephrine,
thyroid hormone also increases heart
rate
CATIONS:
Elevated k+ and Na+ decreases heart
rate, moderate increase in interstitial
ca+ levels speeds heart rate.
OTHER FACTORS IN HEART RATE
REGULATION
Age
Gender
Physical Fitness
Body Temperature
Emotional states
Autonomic (sympathetic and parasympathetic) nerve activity
Circulating hormones, e.g. adrenaline (epinephrine), thyroxine
STRUCTURE
AND
FUNCTIONS OF BLOOD
VESSELS
BODY CONTAINS THREE KINDS OF
CAPILLARIES
CONTINUOUS- LUNG, SMMOTH MUSCLE,
CONNECTIVE TISSUES
FENESTRATED- KIDNEY, SMALL
INTESTINE,BRAIN
SINUSOIDS- LIVER RED BONE MARROW, SPLEEN
AND ENDOCRINE GLANDS
BLOOD DISTRIBUTION IN THE
CARDIOVASCULAR SYSTEM
PULMONARY VESSELS - 9%
HEART – 7%
SYSTEMIC ARTERIES
AND ARTERIOLES
SYSTEMIC CAPILLARIES – 7%
- 13%
SYSTEMIC VEINS AND VENULES – 64%
HEMODYNAMIC AFFECTING
BLOOD FLOW
BLOOD PRESSURE
RESISTANCE
VENOUS RETURN
BLOOD PRESSURE
DURING SYSTEMIC CIRCULATION, BLOOD PRESSURE
FALLS AS THE DISTANCE FROM THE LEFT
VENTRICLE INCREASES
IN ARTERIOLES AND ARTERIES – 35 mm Hg
IN VENOUS END OF CAPILLARIES– 16mm Hg
WHEN BLOOD FLOW IN RT.VENTRICLE -0 mmHg
MAP = DIASTOLIC PRESSURE +
1/3 (SYS PRESSURE – DIASTOLIC
PRESSURE)
VASCULAR RESISTANCE
IT IS THE OPPOSTION TO BLOOD FLOW
DUE TO FRICTION BETWEEN BLOOD
AND THE WALLS OF BLOOD VESSELS.
VASCULAR RESISTANCE
DEPENDS ON
SIZE OF THE LUMEN-
R IS INVERSELY PROPOTIONAL TO 1/d
BLOOD VISCOSITY 4
TOTAL BLOOD VESSEL LENGTH
VENOUS RETURN
DEPENDS ON
HEART CONTRACTION
PRESSURE IN THE RT ATRIUM
BESIDES THIS
SKELETAL MUSCLE PUMP
RESPIRATORY PUMP
VELOCITY OF BLOOD
FLOW
VELOCITY IS INVERSELY PROPOTIONAL
TO CROSS SECTIONAL AREA.
VELOCITY DECREASES AS IT PROCEEDS
FROM ARTERIES,
ARTERIOLES,CAPILLAREIS
VELOCITY INCREASES AS IT PROCEEDS
FROM VENULES, VEINS.
THIS ALLOWS EXCHANGE OF MATERIALS
IN THE CAPILLARIES.
CONTROL OF BLOOD
PRESSURE AND
BLOOD FLOW
ROLE OF CARDIOVASCULAR
CENTRE
PROPRIORECEOTORS
BARORECEPTORS
CHEMORECEPTORS
NEURAL REGULATION 0F
BLOOD PRESSURE
BARORECEPTORS
CHEMORECEPTORS
BARORECEPTORS
PRESSURE SENSITIVE
LOCATED IN THE
AORTA, INTERNAL
CAROTID AND OTHER
LARGE ARTERIES.
2 IMPORTANT
BARORECEPTOR
REFLEX ARE
- CAROTID SINUS
REFLEX
- AORTIC REFLEX
CHEMORECEPTOR REFLEX
PRESENT CLOSE TO THE
- BARORECEPTORS OF CAROTID SINUS AND
ARCH OF AORTA
- THEY ARE CALLED CAROTID BODIES AND
AORTIC BODIES.
HORMONAL REGULATION
OF BLOOD PRESSURE
RENIN ANGIOTENSIN-ALDOSTERONE
MECHANISM
EPINEPHRINE AND NOR EPINEPHRINE
ANTIDIURETIC HORMONE
ATRIAL NATRIURETIC PEPTIDE
AUTOREGULATION OF
BLOOD PRESSURE
ABILTY OF TISSUE TO
AUTOMATICALLY ADJUST ITS
BLOOD FLOW TO MATCH ITS
METABLOIC DEMAND IS CALLED
AUTOREGULATION. MAINLY
DURING EXERCISE.
TWO TYPE OF STIMULI CAUSES
AUTOREGULATORY CHANGESHSICALY
- PHYSICAL CHANGE
- VASODILATING AND VASOCONSTRICTING
CHEMICALS
PHYSICAL CHANGES
WARMING AND COOLING CAUSES
VASODILATION AND VASOCONSTRICTION.
SMOOTH MUSCLE IN ARTERIOLE EXHIBIT
MYOGENIC RESPONSE
VASODILATING AND
VASOCONSTRICTING
CHEMICALS
SEVERAL CELLS RELEASE A WIDE VARIETY
OF CHEMICALS THAT ALTER THE BLOOD
VESSEL DIAMETER
VASODILATORS - K+, H+, LASCTIC ACID
AND ADENOSINE AND MAINLY NO
VASOCONSTRICTORS – THROMBAXANE A2 ,
SEROTONIN AND ENDOTHELINS
