Anatomy and Physiology

of the Heart
Three layers of the heart
1. Epicardium
2. Endocardium
3. Endocardium
The Heart
-the heart is a small organ that weighs 300g and is
approximately the size of the fist located in the middle of
the mediastinum.
Chambers of the heart
1. Right Atrium
2. Right Ventricle
3. Left Atrium
4. Left Ventricle
Chambers of the heart
DIASTOLE
-relaxation phase
-all four chambers relax simultaneously, the ventricles fill in
preparation for contraction
-period of ventricular filling
Chambers of the heart
SYSTOLE
-contraction of of the two top chambers (atria) and two bottom
chambers (ventricles)
Valves of the heart
1. AV valves
A. Tricuspid valve
B. Bicuspid (Mitral valve)

2. Semilunar valves
A. Aortic valve
B. Pulmonic valve
Coronary Arteries
-originate from the aorta behind the cusps of the aortic
valve, in an area known as Valsalvas sinus

2 Main Coronary arteries:

A. Left Coronary artery-2 branches: Circumflex coronary
artery, Left anterior descending artery
B. Right Coronary artery
Myocardium
-It is composed of specialized cells called myocytes, which form an
interconnected network of muscle fibers.
-This cyclical pattern of myocardial contraction is controlled by the
conduction system.
Cardiac Conduction System
1. SA Node-Sinoatrial Node-triggers 6-100 beats per minute
2. AV Node- Atrioventricular node
3. Bundle of His-Right and Left Bundle Branch
4. Purkinje fibers
Cardiac Cycle
A cardiac cycle is composed of both SYSTOLE AND DIASTOLE.
ATRIAL AND VENTRICULAR DIASTOLE
-the heart chambers are relaxed:
the atrioventricular valves are open, the semilunar valves are closed
-facilitates ventricular filling
Cardiac Cycle
ATRIAL SYSTOLE
-atrial muscles contract in response to an electrical impulse initiated
by the SA node
-increases the pressure inside the atria, ejecting the remaining blood
into the ventricles
Cardiac Cycle
VENTRICULAR SYSTOLE
-the pressure inside the ventricles rapidly increases, atrioventricular
valves to close
-blood ceases to flow from the atria into the ventricles, and
regurgitation (backflow) of blood into the atria is prevented.
The rapid increase of pressure inside the right and left ventricles
forces the pulmonic and aortic valves to open, and blood is ejected
into the pulmonary artery and aorta, respectively
Cardiac Cycle
Diastole
-Relaxation and filling of the atria and ventricles

Systole
-Contraction and Emptying of the atria and ventricles
Cardiac Cycle
HEMODYNAMIC MONITORING
=Chamber pressures can be measured with the use of
special monitoring catheters and equipment.
Cardiac output

Cardiac output
-refers to the amount of blood pumped by each ventricle during a
given period.
-5 L/min
-SV x HR
-can be affected by changes in either stroke volume or heart rate
Cardiac output

Stroke volume
-the amount of blood ejected per heartbeat
-70 mL

Heart Rate
-60 to 80 bpm
Control of Heart Rate
-AUTONOMIC NERVOUS SYSTEM:
SYMPATHETIC AND PARASYMPATHETIC DIVISIONS
-SNS releases Norepinephrine which increases heart rate and the force of the contraction of the
heart.
-PNS releases acetylcholine from vagal fibres which slows the heart rate and causes slight
decrease in ventricular contractility.

Baroreceptors
-nerve cells located in the aortic arch and in both right and left internal carotid arteries
-sensitive to changes in blood pressure (BP)
Control of Stroke Volume
PRELOAD
-the degree of stretch of the ventricular cardiac muscle fibers at the end of diastole.
-the volume of blood within the ventricle at the end of diastole determines preload
AFTERLOAD
-resistance or pressure the ventricles must overcome to pump blood out
Control of Stroke Volume
Contractility
-the force generated by the contracting myocardium