CARDIOVASCULAR SYSTEM 2.

The inferior and superior venae cavae

enter the right atrium. The four pulmonary
Functions of the Heart
veins enter the left atrium.
1. The heart generates blood pressure.
3. The pulmonary trunk exits the right
2. The heart routes blood through the ventricle, and the aorta exits the left
systemic and pulmonary ventricle.
circulations. Heart Chambers and Internal Anatomy
3. The heart’s pumping action and its valves 1. There are four chambers in the heart. The
ensure a one-way flow left and right atria receive blood from veins
of blood through the heart and blood vessels. and function mainly as reservoirs.
Contraction of the atria complete ventricular
4. The heart helps regulate blood supply to filling.
tissues.
2. The atria are separated internally from
Size, Form, and Location of the Heart each other by the interatrial septum.
The heart is approximately the size of a 3. The ventricles are the main pumping
closed fist and is located in the chambers of the heart. The right ventricle
pericardial cavity. pumps blood into the pulmonary trunk, and
the left ventricle, which has a thicker wall,
Anatomy of the Heart pumps blood into the aorta.
Pericardium 4. The ventricles are separated internally by
1. The pericardium is a sac consisting of the interventricular septum.
fibrous and serous pericardia. The fibrous Heart Valves
pericardium is lined by the parietal
pericardium. 1. The heart valves ensure one-way flow of
blood.
2. The outer surface of the heart is lined by
the visceral pericardium (epicardium). 2. The tricuspid valve (three cusps)
separates the right atrium and the right
3. Between the visceral and parietal ventricle, and the bicuspid valve (two cusps)
pericardia is the pericardial cavity, which is separates the left atrium and the left
filled with pericardial fluid. ventricle.
External Anatomy 3. The papillary muscles attach by the
1. The atria are separated externally from the chordae tendineae to the cusps of the
ventricles by the coronary sulcus. The right tricuspid and bicuspid valves and adjust
and left ventricles are separated externally tension on the valves.
by the interventricular sulci. 4. The aorta and pulmonary trunk are
separated from the ventricles by the
semilunar valves.
5. The skeleton of the heart is a plate of The heart wall consists of the outer
fibrous connective tissue that separates the epicardium, the middle myocardium, and the
atria from the ventricles, acts as an electrical inner endocardium.
barrier between the atria and ventricles, and
Cardiac Muscle
supports the heart valves.
1. Cardiac muscle is striated; it depends on
Route of Blood Flow Through the Heart
ATP for energy and on aerobic metabolism.
1. The left and right sides of the heart can be
2. Cardiac muscle cells are joined by
considered separate pumps.
intercalated disks that allow
2. Blood flows from the systemic vessels to
action potentials to be propagated
the right atrium and from the right atrium to
throughout the heart.
the right ventricle. From the right ventricle,
blood flows to the pulmonary trunk and Electrical Activity of the Heart
from the pulmonary trunk to the lungs. From Action Potentials in Cardiac Muscle
the lungs, blood flows through the
pulmonary veins to the left atrium, and from 1. Action potentials in cardiac muscle are
the left atrium, blood flows to the left prolonged compared to
ventricle. From the left ventricle, blood those in skeletal muscle and have a
flows into the aorta and then through the depolarization phase, a plateau phase, and a
systemic vessels. repolarization phase.
Blood Supply to the Heart 2. The depolarization is due mainly to
1. The left and right coronary arteries opening of the voltage gated Na+ channels,
originate from the base of the aorta and and the plateau phase is due to opened
supply the heart. voltage-gated Ca2+ channels. Repolarization
2. The left coronary artery has three major at the end of the plateau phase is due to the
branches: the anterior interventricular, the opening of K+ channels for a brief period.
circumflex, and the left marginal arteries. 3. The prolonged action potential in cardiac
3. The right coronary artery has two major muscle ensures that contraction and
branches: the posterior interventricular and relaxation occur and prevents tetany.
the right marginal arteries. 4. The SA node located in the upper wall of
4. Blood returns from heart tissue through the right atrium is the normal pacemaker of
cardiac veins to the coronary sinus and into the heart, and cells of the SA node have
the right atrium. Small cardiac veins also more voltage-gated Ca2+ channels than do
return blood directly to the right atrium. other areas of the heart.

Histology of the Heart Conduction System of the Heart

Heart Wall 1. The conduction system of the heart is

made up of specialized cardiac muscle cells.
2. The SA node produces action potentials 2. During atrial systole, the atria contract
that are propagated over the atria to the AV and complete filling of the ventricles.
node.
3. During ventricular systole, the AV valves
3. The AV node and the atrioventricular close, pressure increases in the ventricles,
bundle conduct action potentials to the the semilunar valves are forced open, and
ventricles. blood flows into the aorta and pulmonary
trunk.
4. The right and left bundle branches
conduct action potentials 4. At the beginning of ventricular diastole,
pressure in the ventricles decreases. The
from the atrioventricular bundle through
semilunar valves close to prevent backflow
Purkinje fibers to the ventricular muscle.
of blood from the aorta and pulmonary trunk
5. An ectopic beat results from an action into the ventricles.
potential that originates in an area of the
5. When the pressure in the ventricles is low
heart other than the SA node.
enough, the AV valves open, and blood
Electrocardiogram flows from the atria into the ventricles.
1. An ECG is a record of electrical events Heart Sounds
within the heart.
1. The first heart sound results from closure
2. An ECG can be used to detect abnormal of the AV valves.
heart rates or rhythms,
The second heart sound results from closure
abnormal conduction pathways, hypertrophy of the semilunar valves.
or atrophy of the heart, and the approximate
2. Abnormal heart sounds, called murmurs,
location of damaged cardiac muscle.
can result from incompetent (leaky) valves
3. A normal ECG consists of a P wave or stenosed (narrowed) valves.
(atrial depolarization), a QRS complex
Regulation of Heart Function
(ventricular depolarization), and a T wave
(ventricular repolarization). Cardiac output (volume of blood pumped
per ventricle per minute) is equal to the
4. Atrial contraction occurs during the PQ
stroke volume (volume of blood ejected per
interval, and the ventricles contract and
beat) times the heart rate (beats per minute).
relax during the QT interval.
Intrinsic Regulation of the Heart
Cardiac Cycle
1. Intrinsic regulation refers to regulation
1. Atrial systole is contraction of the atria,
mechanisms contained within the heart.
and ventricular systole is contraction of the
ventricles. Atrial diastole is relaxation 2. As venous return to the heart increases,
the heart wall is stretched, and the increased
of the atria, and ventricular diastole is
stretch of the ventricular walls is called
relaxation of the ventricles.
preload.
3. A greater preload causes the cardiac 3. Decrease in the maximum heart rate of
output to increase because stroke volume 30–60% by age 85 leads to decreased
increases (Starling’s law of the heart). cardiac output.
4. Afterload is the pressure against which 4. The aortic semilunar valve can become
the ventricles must pump blood. stenotic or incompetent.
Extrinsic Regulation of the Heart 5. Coronary artery disease and congestive
heart failure can develop.
1. Extrinsic regulation refers to nervous and
chemical mechanisms. 6. Aerobic exercise improves the functional
capacity of the heart at all ages.
2. Sympathetic stimulation increases stroke
volume and heart rate; parasympathetic
stimulation decreases heart rate.
3. The baroreceptor reflex detects changes in
blood pressure. If blood pressure increases
suddenly, the reflex causes a decrease in
heart rate and stroke volume; if blood
pressure decreases suddenly, the reflex
causes an increase in heart rate and stroke
volume.
4. Emotions influence heart function by
increasing sympathetic stimulation of the
heart in response to exercise, excitement,
anxiety, or anger and by increasing
parasympathetic stimulation in response to
depression.
5. Alterations in body fluid levels of CO2,
pH, and ion concentrations, as well as
changes in body temperature, influence heart
function.
Effects of Aging on the Heart
The following age-related changes are
common:
1. By age 70, cardiac output has often
decreased by one-third.
2. Hypertrophy of the left ventricle can
cause pulmonary edema.