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Anatomy and Physiology of the Heart

Anatomy of the Heart
The essential function of the heart is to pump blood to various parts of the body. The
mammalian heart has four chambers: right and left atria and right and left ventricles. The two
atria act as collecting reservoirs for blood returning to the heart while the two ventricles act as
pumps to eject the blood to the body. As in any pumping system, the heart comes complete
with valves to prevent the back flow of blood. Deoxygenated blood returns to the heart via the
major veins (superior and inferior vena cava), enters the right atrium, passes into the right
ventricle, and from there is ejected to the pulmonary artery on the way to the lungs.
Oxygenated blood returning from the lungs enters the left atrium via the pulmonary veins,
passes into the left ventricle, and is then ejected to the aorta. In the frontal view of the heart
shown below, the right atrium is in blue, the left atrium in yellow, the right ventricle in purple,
and the left ventricle in red. The chambers are semi-transparent so that the valves, drawn in
white, can be seen.

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The view below shows the detail of the valves in the right half of the heart seen from obliquely
beneath. The large valve in the foreground is the tricuspid valve that prevents backflow from
the right ventricle to the right atrium. The small round valve you see near the top is the
pulmonary valve, where the pulmonary artery comes out of the right ventricle (you are looking
at it almost straight up into the pulmonary artery).
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The view below shows the detail of the valves in the left half of the heart. You are looking
obliquely at the top of the large mitral valve in the foreground through the semi-transparent
atrial and ventricular walls. The mitral valve prevents the backflow of blood from the left
ventricle to the left atrium. Behind the mitral valve, you can see a circular valve in an end-on
view. That is the aortic valve, where the aorta comes out of the left ventricle. In the
background, the tricuspid valve can be seen.

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The inner edge of the tricuspid and the mitral valves end in filamentous connective tissue
(chordae tendineae). These are attached to small columns of muscle (papillary muscles) arising
out of the inner surface of the ventricles. As the pressure builds in the ventricles, the valves
snap shut, and the papillary muscles prevent the valves from blowing into the atrium and
opening.

Pumping Action of the Heart

The pumping action starts with the simultaneous contraction of the two atria. This contraction
serves to give an added push to get the blood into the ventricles at the end of the slow-filling
portion of the pumping cycle called "diastole." Shortly after that, the ventricles contract,
marking the beginning of "systole." The aortic and pulmonary valves open and blood is
forcibly ejected from the ventricles, while the mitral and tricuspid valves close to prevent
backflow. At the same time, the atria start to fill with blood again. After a while, the ventricles
relax, the aortic and pulmonary valves close, and the mitral and tricuspid valves open and the
ventricles start to fill with blood again, marking the end of systole and the beginning of
diastole. It should be noted that even though equal volumes are ejected from the right and the
left heart, the left ventricle generates a much higher pressure than does the right ventricle.

Electrical Activity of the Heart

When vertebrate muscles are excited, an electrical signal (called an "action potential") is
produced and spreads to the rest of the muscle cell, causing an increase in the level of calcium
ions inside the cell. The calcium ions bind and interact with molecules associated with the cell's
contractile machinery, the end result being a mechanical contraction. Even though the heart is a
specialized muscle, this fundamental principle still applies.

One thing that distinguishes the heart from other muscles is that the heart muscle is a
"syncytium," meaning a meshwork of muscle cells interconnected by contiguous cytoplasmic
bridges. Thus, an electrical excitation occurring in one cell can spread to neighboring cells.
Another defining characteristic is the presence of pacemaker cells. These are specialized
muscle cells that can generate action potentials rhythmically.

Under normal circumstances, a wave of electrical excitation originates in the pacemaker cells in
the sinoatrial (S-A) node, located on top of the right atrium. Specialized muscle fibers transmit
this excitation throughout the atria and initiate a coordinated contraction of the atrial walls.
Meanwhile, some of these fibers excite a group of cells located at the border of the left atrium
and ventricle known as the atrioventricular (A-V) node. The A-V node is responsible for
spreading the excitation throughout the two ventricles and causing a coordinated ventricular
contraction.

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