AS Human Biology Module 1

Heart Structure &

Function Notes & Class
Questions
Structure of the Human Heart

The mammalian heart consists largely of cardiac muscle, a specialized tissue which is capable of
rhythmical contraction and relaxation over a long period without fatigue. Its structure is shown in
above. The muscle is richly supplied with blood vessels and also contains connective tissue which
gives strength and helps to prevent the muscle tearing.

The mammalian heart is made up of two thin-walled atria which are elastic and distend as blood
enters them. The left atrium receives oxygenated blood from the pulmonary veins while the right
atrium receives deoxygenated blood from the venae cavae. When full, the atria contract together,
forcing the remaining blood into their respective ventricles. The right ventricle then pumps blood to
the lungs. Owing to the close proximity of the lungs to the heart, the right ventricle does not need to
force blood far and is much less muscular than the left ventricle which has to pump blood to the
extremities of the body. To prevent backflow of blood into the atria when the ventricles contract,
there are valves between the atria and ventricles. On the right side of the heart these comprise three
cup-shaped flaps, the tricuspid valves. On the left side of the heart only two cup-shaped flaps are
present; these are the bicuspid or mitral valves. To prevent these valves inverting under the pressure

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of blood, they are attached to papillary muscles of the ventricular wall by fibres known as the
chordae tendinae. Blood leaving the ventricle is prevented from returning by pocket valves in the
aorta and pulmonary artery. These close when the ventricles relax.

The cardiac cycle

The cardiac cycle refers to the sequence of events which takes place during the completion of one
heartbeat. It involves repeated contraction and relaxation of the heart muscle. Contraction is called
systole and relaxation is called diastole. It occurs as follows.

1. Atrial diastole. During the time when the atria and the ventricles are both relaxed, blood
returning to the head under low pressure in the veins enters the two atria. Oxygenated blood
enters the left atrium and deoxygenated blood enters the right atrium. At first the bicuspid and
tricuspid valves are closed (fig 14.17a) but, as the atria fill with blood, pressure in them rises.
Eventually it becomes greater than that in the relaxed ventricles and the valves are pushed
open.

2. Atrial systole. When atrial diastole ends, the two atria contract simultaneously. This is
termed atrial systole and results in blood being pumped into the ventricles (fig 14.17b).

3. Ventricular systole. Almost immediately (about 0.1 to 0.2 seconds later) the ventricles
contract. This is called ventricular systole (fig 14.17c). When this occurs the pressure in the
ventricles rises and closes the atrioventricular valves, preventing blood from returning to the
atria. The pressure forces open the semi-lunar valves of the aorta and pulmonary artery and
blood enters these vessels. The closing of the atrioventricular valves during ventricular
systole produces the first head sound, described as lub.

4. Ventricular diastole. Ventricular systole ends and is followed by ventricular diastole (fig
14.17d). The high pressure developed in the aorta and pulmonary artery tends to force some
blood back towards the ventricles and this closes the semi-lunar valves of the aorta and

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 pulmonary artery. Hence backflow into the heart is prevented. The closing of the valves
causes the second heart sound, dub.

The two head sounds are therefore:

ventricular systole = lub

ventricular diastole = dub

Ventricular systole, and the elastic recoil of the arteries as blood at high pressure is forced through
them, causes a pulse. As blood gets further and further away from the heart, the pulse becomes less
and less pronounced until, in the capillaries and veins, blood flows evenly. One completer heart beat
consists of one systole and one diastole and lasts for about 0.8s.

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Graph to show pressure changes in the heart during one cardiac cycle.

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Myogenic control of the heart

When a heart is removed from a mammal and placed in a well-oxygenated salt solution at 37C it
will continue to beat rhythmically for a considerable time, without stimuli from the nervous system
or hormones. This demonstrates the myogenic nature of the stimulation of the heart, that is heart
muscle has its own built-in mechanism for bringing aboit its contraction (myo, muscle; genic,

giving rise to).

The stimulus for contraction of the heart originates in a specific region of the right atrium called the
sino-atrial node (or SAN for short). This is located near the opening of the venae cavae (fig 14.21). It
consists of a small number of cardiac muscle fibres and a few nerve endings from the autonomic
nervous system (the involuntary part of the nervous system see next section). The SAN can
stimulate the heartbeat on its own, but the rate at which it beats can be varied by stimulation from the
autonomic nervous

system.

The cells of the SAN slowly become depolarised during atrial diastole. A wave of excitation similar
to a nerve impulse passes across the muscle fibres of the heart as the action potential spreads from

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the SAN. It causes the muscle fibres to contract. The SAN is known as the pacemaker because each
wave of excitation begins here and acts as the stimulus for the next wave of excitation.

Once contraction has begun, it spreads through the walls of the atria through the network of cardiac
muscle fibres at the rate of 1 mst Both atria contract more or less simultaneously. The atrial muscle
fibres are completely separated from those of the ventricles by a layer of connective tissue called the
atrio-ventricular septum, except for a region in the right atrium called the atrio-ventricular node
(AVN) (fig 14.21).

The structure of the AVN is similar to that of the SAN and is connected to a bundle of specialised
muscle fibres, the AV bundle, which provides the only route for the transmission of the wave of
excitation from the atria to the ventricles. There is a delay of approximately 0.15s in conduction from
the SAN to the AVN, which means that atrial systole is completed before ventricular systole begins.

The AV bundle is connected to the bundle of His, a strand of modified cardiac fibres which gives
rise to finer branches known as Purkyne tissue. Impulses are conducted rapidly along the bundle at 5
ms, and spread out from there to all parts of the ventricles. Both ventricles are stimulated to contract
simultaneously. The wave of ventricular contraction begins at the bottom of the heart and spreads
upwards, squeezing blood out of the ventricles towards the arteries which pass vertically upwards out
of the heart (fig 14.21).

The electrical activity that spreads through the heart during the cardiac cycle can be detected using
electrodes placed on the skin and an instrument called an electrocardiogram (ECG). This has
medical use since certain heart defects can be detected.

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The ECG

An ECG Trace

The condition of the heart can be monitored by by studying the electrocardiogram (ECG). The ECG
gives information about the transmission of the electrical activity through the heart.

The muscular contraction of the heart is preceded by a wave of electrical activity similar to a nerve
impulse. Since body fluids are good conductors of electricity this electrical pattern or wave of
depolarization spreads through the tissues and can be detected if electrodes are placed on the skin on
opposite sides of the heart. The electrical activity can be amplified and recorded to give an ECG
trace. A typical trace of an ECG is shown in shown above (figure 14.22) . The normal ECG is
composed of a P wave, a QRS complex, and a T wave. In some people there is also a smaller U
wave, but this is not always seen.

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Each section of the ECG trace corresponds to a particular phase during the cardiac cycle, i.e. the
sequence of events taking place in one cycle of the hearts action. The P wave is produced by
depolarization of the atria, prior to atrial contraction. This is followed by the QRS complex which
indicates depolarization of the ventricles before ventricular contraction, and finally the T wave which
indicates repolarization of the ventricles, i.e. the ventricular muscle cells returning to a relaxed state.
In those cases where the U wave can be observed, it is suggested that this corresponds to the slow
repolarization of the papillary muscles which attach the heartstrings to the ventricle wall. By
altering the position of the electrodes in relationship to the heart, it is possible to monitor the
electrical activity of each individual part of the heart, and abnormalities in heart muscle function or
transmission through the heart can be detected.

Artificial pacemakers

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When there are problems with regularity of heartbeat an artificial pacemaker can be used to gain
control over the electrical activity of the heart. A pacemaker has two basic components, a pulse
generator containing a power source and one or two pacing leads, each with an electrode on its tip.

Pacemaking can be temporary or permanent. When long- term control of the heart is required, a
permanent pacemaker is implanted under the skin. The two most common modes of pacing are

1. Demand. This detects the hearts own rhythms and stimulates depolarisation of the heart
muscle, and therefore contraction, as necessary;
2. fixed rate. This fires at a predetermined rate, irrespective of the hearts own activity.

The pacemaker is a small, metal unit weighing between 30 and 130g (fig 15.16). It is powered by a
lithium battery with a life-span of up to 15 years. It is implanted in the chest under local anaesthetic.

Cardiac output
The cardiac output is a measure of the volume of blood pumped out of the ventricles per minute and
so, in effect, it is a measure of the total blood flow through the lungs and around the body The
calculation of cardiac output depends on the volume of blood pumped out of the heart during one
beat, the stroke volume, and the number of times the heart beats per minute, i.e. the heart rate.

cardiac output = stroke volume x heart rate

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Heart rate is determined simply by measuring the pulse, but the volume of blood pumped out of the
heart with each beat is not measured so easily.

Thus, the cardiac output is measured directly and, by simple calculation, the stroke volume is
determined.

If the average heart rate is 70 beats per minute and cardiac output is 5 litres per mm, what is the
average stroke volume?

cardiac output = stroke volume x heart rate

Therefore stroke volume = cardiac output/heart rate

= (5 litres per min)/(70 beats per mm)

= 5 000 ml/70 beats

= 71 ml per beat

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 Questions

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