Essentials of Anatomy & Physiology, 4th Edition

Martini / Bartholomew

12 The Cardiovascular
System: The Heart

PowerPoint® Lecture Outlines

prepared by Alan Magid, Duke University

Slides 1 to 65

Copyright © 2007 Pearson Education, Inc., publishing as Benjamin Cummings

 Cardiovascular system

The primary function of the cardiovascular

system is to supply blood to body tissues.
• This event provides nutrients and oxygen
to cells for metabolism.
• It also transport waste to site of removal
from the body e.g. lungs and kidneys.
• The transport carries hormones to target
sites.
• It is also involved in homeostasis.
Types of circulatory systems

The circulatory system of an

animal may be of the following
types:
• Open circulatory system
• Closed circulatory system
Organisms that have a closed
circulatory system may
experience single or double
circulation.
Types of circulatory systems

• Open and closed circulatory system

Types of circulatory systems

• Single and double circulation

Heart’s Place in the Circulation

Heart Pumps Blood into Two Circuits

in Sequence
• Pulmonary circuit
• To and from the lungs
• Systemic circuit
• To and from the rest of the body

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 Heart’s Place in the Circulation
Overview of the
Cardiovascular
System

Figure 12-1
Heart’s Place in the Circulation
Three Kinds of Blood Vessels
• Arteries
• Carry blood away from heart and carry it to
the capillaries
• Capillaries
• Microscopic vessels where exchange
between cells and blood takes place
• Veins
• Receive blood from capillaries and carry it
back to the heart

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Heart’s Place in the Circulation
Two Sets of Pumping Chambers in Heart
• Right atrium
• Receives systemic blood
• Right ventricle
• Pumps blood to lungs (pulmonary)
• Left atrium
• Receives blood from lungs
• Left ventricle
• Pumps blood to organ systems (systemic)

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The Anatomy of the Heart
Pericardial Cavity
• Surrounds the heart
• Lined by pericardium
• Two layers
• Visceral pericardium (epicardium)
• Covers heart surface
• Parietal pericardium
• Lines pericardial sac that
surrounds heart

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The Anatomy of the Heart
The Location of the Heart in the Thoracic Cavity

Figure 12-2
The Anatomy of the Heart
Surface Features of the Heart
• Auricle—Outer portion of atrium
• Coronary sulcus—Deep groove that marks
boundary of atria and ventricles
• Anterior interventricular sulcus
• Posterior interventricular sulcus
• Mark boundary between left and right
ventricles
• Sulci contain major cardiac blood vessels
• Filled with protective fat
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 The Anatomy of the Heart
The Surface
Anatomy
of the Heart

Figure 12-3(a)
1 of 2
 The Anatomy of the Heart
The Surface
Anatomy
of the Heart

Figure 12-3(b)
 The Anatomy of the Heart
The Surface
Anatomy
of the Heart

Figure 12-3(a)
2 of 2
The Anatomy of the Heart
The Heart Wall
• Epicardium (visceral pericardium)
• Outermost layer
• Serous membrane
• Myocardium
• Middle layer
• Thick muscle layer
• Endocardium
• Inner lining of pumping chambers
• Continuous with endothelium

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The Anatomy of the Heart
The Heart Wall and Cardiac Muscle Tissue

Figure 12-4(a)
The Anatomy of the Heart
Internal Anatomy and Organization
• Interatrial septum
• Separates atria
• Interventricular septum
• Separates ventricles
• Atrioventricular valves
• Located between atrium and ventricle
• Ensure one-way flow from atrium to
ventricle

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The Anatomy of the Heart
The Sectional Anatomy of the Heart

Figure 12-5
The Anatomy of the Heart
Blood Flow in the Heart
• Superior and inferior venae cavae
• Large veins carry systemic blood to right
atrium
• Right atrium sends blood to right ventricle
• Flows through right AV valve
• Bounded by three cusps (tricuspid valve)
• Cusps anchored by chordae tendinae
• Chordae attached to papillary muscles

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The Anatomy of the Heart
The Valves of the Heart

Figure 12-6(a)
The Anatomy of the Heart
The Valves of the Heart

PLAY The Heart: Anatomy Figure 12-6(b)

The Anatomy of the Heart
Blood Flow in the Heart (cont’d)
• Right ventricle pumps blood through
pulmonary semilunar valve
• Enters pulmonary trunk
• Flows to lungs through right, left pulmonary
arteries where it picks up oxygen
• Pulmonary veins carry blood to left atrium
• Left atrium sends blood to left ventricle
• Enters through left AV valve (bicuspid or
mitral)
• Left ventricle pumps blood to aorta
• Through aortic semilunar valve to systems
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The Anatomy of the Heart
The Sectional Anatomy of the Heart

Figure 12-5
The Anatomy of the Heart
Functional Anatomy of the Heart
• Left ventricular myocardium much
thicker than right
• Reflects functional difference in load
• Valves ensure one-way flow of blood
• Prevent backward flow (regurgitation)
• Fibrous skeleton supports valves and
muscle cells

Copyright © 2007 Pearson Education, Inc., publishing as Benjamin Cummings

The Anatomy of the Heart
Key Note
The heart has four chambers, the right
atrium and ventricle with the pulmonary
circuit and left atrium and ventricle with the
systemic circuit. The left ventricle’s greater
workload makes it more massive than the
right, but the two pump equal amounts of
blood. AV valves prevent backflow from
the ventricles into the atria, and semilunar
valves prevent backflow from the outflow
vessels into the ventricles.
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Heart beating
The Anatomy of the Heart
The Blood Supply to the Heart
• Coronary circulation meets heavy demands
of myocardium for oxygen, nutrients
• Coronary arteries (right, left) branch from
aorta base
• Anastomoses (arterial interconnections)
ensure constant blood supply
• Drainage is to right atrium
• Great, middle cardiac veins drain capillaries
• Empty into coronary sinus

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The Anatomy of the Heart
The Coronary Circulation

Figure 12-7(a)
The Anatomy of the Heart
The Coronary Circulation

Figure 12-7(b)
The Anatomy of the Heart
Cardiac Muscle Cells
• Shorter than skeletal muscle fibers
• Have single nucleus
• Have striations (sarcomere organization)
• Depend on aerobic metabolism
• Contraction of cardiac muscle is
involuntary.
• Connected by intercalated discs

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The Anatomy of the Heart
The Heart Wall
and Cardiac
Muscle Tissue

Figure 12-4(d)
The Anatomy of the Heart
Cardiac Muscle Cells
• Some cardiac muscle cells contract
without nervous stimulation.
• The intercalated discs found only in
cardiac muscles allow for rapid
movements of ions and low to electrical
resistance
• These consists of
• Desmosomes transmit tension
• Gap junctions transmit action potential
Copyright © 2007 Pearson Education, Inc., publishing as Benjamin Cummings
The Anatomy of the Heart
The Heart Wall and Cardiac Muscle Tissue

Figure 12-4(c)
The Anatomy of the Heart
• Connected by intercalated discs
• Desmosomes intercellular junctions with strong
adhesion. They maintain the mechanical integrity
of tissues.

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The Anatomy of the Heart
• Connected by intercalated discs
• Gap junctions are specialized intercellular
connections that connects the cytoplasm of two
cells
The Heartbeat
Heartbeat Needs two Types of Cardiac
Cells
• Contractile cells
• Provide the pumping action
• Cells of the conducting system
• Generate and spread the action
potential

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The Heartbeat
The Conducting System
• Heart is self-exciting
• Pacemaker cells establish heart rate
• Normal pacemaker is sinoatrial (SA)
node
• This is a special group of cells found in the
wall of the right atrium.
• The SA node initiates action potential
(impulse) rhythmically.
• Electric charges flow freely between cells
of the heart because of gap junctions.
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The Heartbeat
The Conducting System
• Impulse spreads rapidly from the SA
node across atria.
• As a result the atria undergo systole,
they contract simultaneously as if it
were one cell.
• The impulse reaches the atrioventricular
(AV) node and flows to the AV bundle
and bundle branches.
• It then reaches the ventricles via
Purkinje fibers.
Copyright © 2007 Pearson Education, Inc., publishing as Benjamin Cummings
The Heartbeat
The Conducting
System of the
Heart

PLAY The Heart:

Conduction System
Figure 12-9(a)
The Heartbeat
The Conducting System
• Stimulated ventricles undergo systole
• This snaps the atrioventricular valves
shut and opens the semilunar valves.
• After the ventricles are emptied, the
semilunar valves close.
• The ventricles begin diastole, the
atrioventricular valves open and
ventricles start filling with blood.
• Finally, all four chambers are in diastole
and filling.
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The Heartbeat
The Delay in contraction
• There are mechanisms in place to
stagger contraction of atria and
ventricles.
• This ensures atrial contraction and
emptying before ventricular systole.
• A 0.12s delay between signal arrival at
the AV and ventricular contraction.
• The cells of the AV node takes longer to
get excited than the cells of the SA node.
• AV node cells have fewer gap junctions
and more non conductive tissues.
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 SA node activity and atrial SA node
activation begin.

Time = 0

Stimulus spreads across the atrial

surfaces and reaches the AV node. AV node

Elapsed time = 50 msec

There is a 100-msec delay at the

AV node. Atrial contraction begins. AV bundle

Bundle branches
Elapsed time = 150 msec

The impulse travels along the interventricular

septum within the AV bundle and the bundle
branches to the Purkinje fibers.

Elapsed time = 175 msec

The impulse is distributed by Purkinje fibers

and relayed throughout the ventricular
myocardium. Atrial contraction is completed,
and ventricular contraction begins.
Elapsed time = 225 msec Purkinje fibers

Figure 12-9(b)
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The Heartbeat

Heart Sounds
• Generated by closing of valves
• Two main heart sounds
• First sound (lub)
• Closing of AV valve
• Second sound (dup)
• Closing of aortic valve
• Indicate start/stop of systole
• Heard with stethoscope

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Heart sound
The Heartbeat
News Flash
• Different heart abnormalities could be
detected through heartbeats.
• Stethoscope was invented in the 19th
century by Rene Laennec.
• Doctors had to place their ears on the
chest of patients
• A challenge with obese patients
• Bathing was not a social norm
• Issue of modesty with female patients

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 The Heartbeat

ECG trace
• The signals received
by the cardiac muscles
can be detected and
quantified by the
electrocardiogram
(ECG or EKG).

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The Heartbeat
The Electrocardiogram (ECG or EKG)
• A recording of the electrical activity of
the heart
• Three main components
• P wave
• Atrial depolarization (systole)
• QRS complex
• Ventricular depolarization (systole)
• T wave
• Ventricular repolarization (diastole)

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The Heartbeat
An Electrocardiogram

Figure 12-10
The Heartbeat
ECG trace
• Analysis can be performed
on the EKG signal e.g. the
times between
• P and Q (P - Q), QRS and
Q to the end of T (Q - T)
intervals.
• Specialists can use
changes in size of peaks
and lengths of intervals to
detect heart pathology.
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video
The Heartbeat
Artificial Pacemakers
• In instances of
• blocked signal conduction
pathway
• too slow heartbeat
• fault in the conduction system (SA
node)
• Artificial pacemakers are surgically
fitted to maintain rhythmic nature of
heartbeats.
• It usually stimulates ventricles
when heartbeat is not detected.
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Artificial pacemaker
The Heartbeat

Use of a Defibrillator
• Fibrillation is the twitching of the
heart muscles due to rapid and
chaotic contraction of individual
cardiac cells.
• Cardiac arrest occurs when blood
supply to the heart tissues become
reduced.
• This affects the cardiac cycle in a
number of ways e.g. ventricular
fibrillation.
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The Heartbeat
Use of a Defibrillator

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The Heartbeat
Use of a Defibrillator
• When first responders reach the
scene where a victim is not
breathing, the defibrillator is used.
• The two paddle are placed on the
chest in a diagonal line with the heart
in between.
• The device first detects whether
fibrillation is happening and if it is, an
electric discharge is given off to
restore a normal heart rhythm.

Copyright © 2007 Pearson Education, Inc., publishing as Benjamin Cummings

The Heartbeat
Key Note
The heart rate is established by the SA
node, as modified by autonomic activity,
hormones, ions, etc. From there, the
stimulus is conducted through the atrium
to the AV node, the AV bundle, the
bundle branches, and Purkinje fibers to
the ventricular myocardium. The ECG
shows the electrical events associated
with the heartbeat.

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The Heartbeat
The Cardiac Cycle
This describes the repeating sequence
of actions in the heart which result in
pumping of blood to the lungs and other
body parts.
• Two phases of cardiac cycle
• Systole
• Contraction phase
• Diastole
• Relaxation phase

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Cardiac cycle
Cardiac cycle
 (a) Atrial systole begins:
Atrial contraction forces
START a small amount of additional
blood into relaxed ventricles.

(f) Ventricular diastole—late:

All chambers are relaxed. (b) Atrial systole ends
0
Ventricles fill passively. 800 100 atrial diastole begins
msec
msec msec

(c) Ventricular systole—

Cardiac first phase: Ventricular
cycle contraction pushes AV
valves closed but does
not create enough pressure
to open semilunar valves.

370
(e) Ventricular diastole—early: msec (d) Ventricular systole—
As ventricles relax, pressure second phase: As ventricular
in ventricles drops; blood pressure rises and exceeds
flows back against cusps of pressure in the arteries, the
semilunar valves and forces semilunar valves open and
them closed. Blood flows blood is ejected.
into the relaxed atria.

Figure 12-11
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Heart Dynamics

Some Essential Definitions

• Heart dynamics—Movements and
forces generated during cardiac
contraction
• Stroke volume—Amount of blood
pumped in a single beat
• Cardiac output—Amount of blood
pumped each minute

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Heart Dynamics
Hormone Effects on Cardiac Output
• Adrenal medulla hormones
• Epinephrine, norepinephrine released
• Heart rate and stroke volume increased
• Other hormones that increase output
• Thyroid hormones
• Glucagon

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Heart Dynamics
CNS Control of the Heart
• Basic control in medulla oblongata
• Cardioacceleratory center
• Activation of sympathetic neurons
• Cardioinhibitory center
• Governing of parasympathetic neurons
• Other inputs
• Blood pressure sensors
• Oxygen, carbon dioxide sensors

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Heart Dynamics
Key Note
Cardiac output is the amount of blood
pumped by the left ventricle each minute.
It is adjusted moment-to-moment by the
ANS, and by circulating hormones,
changes in blood volume and in venous
return. A healthy person can increase
cardiac output by three-fold to five-fold.

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