Download Chapter 20

Cardiovascular System
The Heart
20-1
Functions of the Heart
• Generating blood pressure
• Routing blood
– Heart separates pulmonary and systemic
circulations
• Ensuring one-way blood flow
– Heart valves ensure one-way flow
• Regulating blood supply
– Changes in contraction rate and force match
blood delivery to changing metabolic needs
20-2
Size, Shape, Location
of the Heart
• Size of a closed fist
• Shape
– Apex: Blunt rounded
point of cone
– Base: Flat part at
opposite of end of cone
• Located in thoracic
cavity in mediastinum
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Heart Cross Section
20-4
Pericardium
20-5
Heart Wall
• Three layers of tissue
– Epicardium: This serous membrane of smooth
outer surface of heart
– Myocardium: Middle layer composed of
cardiac muscle cell and responsibility for heart
contracting
– Endocardium: Smooth inner surface of heart
chambers
20-6
Heart Wall
20-7
External Anatomy
• Four chambers
– 2 atria
– 2 ventricles
• Auricles
• Major veins
– Superior vena cava
– Pulmonary veins
• Major arteries
– Aorta
– Pulmonary trunk
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External Anatomy
20-9
Coronary Circulation
20-10
Heart Valves
• Atrioventricular
– Tricuspid
– Bicuspid or mitral
• Semilunar
– Aortic
– Pulmonary
• Prevent blood from
flowing back
20-11
Heart Valves
20-12
Function of the Heart Valves
20-13
Blood Flow Through Heart
20-14
Systemic and Pulmonary
Circulation
20-15
Heart Skeleton
• Consists of plate of
fibrous connective tissue
between atria and
ventricles
• Fibrous rings around
valves to support
• Serves as electrical
insulation between atria
and ventricles
• Provides site for muscle
attachment
20-16
Cardiac Muscle
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•
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Elongated, branching cells containing 1-2 centrally located nuclei
Contains actin and myosin myofilaments
Intercalated disks: Specialized cell-cell contacts
Desmosomes hold cells together and gap junctions allow action potentials
Electrically, cardiac muscle behaves as single unit
20-17
Conducting System of Heart
20-18
Electrical Properties
• Resting membrane potential (RMP) present
• Action potentials
– Rapid depolarization followed by rapid, partial
early repolarization. Prolonged period of slow
repolarization which is plateau phase and a
rapid final repolarization phase
– Voltage-gated channels
20-19
Action Potentials in
Skeletal and Cardiac Muscle
20-20
SA Node Action Potential
20-21
Refractory Period
• Absolute: Cardiac muscle cell completely
insensitive to further stimulation
• Relative: Cell exhibits reduced sensitivity to
additional stimulation
• Long refractory period prevents tetanic
contractions
20-22
Electrocardiogram
• Action potentials through
myocardium during
cardiac cycle produces
electric currents than can
be measured
• Pattern
– P wave
• Atria depolarization
– QRS complex
• Ventricle depolarization
• Atria repolarization
– T wave:
• Ventricle repolarization
20-23
Cardiac Arrhythmias
• Tachycardia: Heart rate in excess of 100bpm
• Bradycardia: Heart rate less than 60 bpm
• Sinus arrhythmia: Heart rate varies 5%
during respiratory cycle and up to 30%
during deep respiration
• Premature atrial contractions: Occasional
shortened intervals between one contraction
and succeeding, frequently occurs in healthy
people
20-24
Alterations in Electrocardiogram
20-25
Cardiac Cycle
• Heart is two pumps that work together, right
and left half
• Repetitive contraction (systole) and
relaxation (diastole) of heart chambers
• Blood moves through circulatory system
from areas of higher to lower pressure.
– Contraction of heart produces the pressure
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Cardiac Cycle
20-27
Events during Cardiac Cycle
20-28
Heart Sounds
• First heart sound or “lubb”
– Atrioventricular valves and surrounding fluid vibrations
as valves close at beginning of ventricular systole
• Second heart sound or “dupp”
– Results from closure of aortic and pulmonary semilunar
valves at beginning of ventricular diastole, lasts longer
• Third heart sound (occasional)
– Caused by turbulent blood flow into ventricles and
detected near end of first one-third of diastole
20-29
Location of Heart Valves
20-30
Mean Arterial Pressure (MAP)
• Average blood pressure in aorta
• MAP=CO x PR
– CO is amount of blood pumped by heart per
minute
• CO=SV x HR
– SV: Stroke volume of blood pumped during each heart beat
– HR: Heart rate or number of times heart beats per minute
• Cardiac reserve: Difference between CO at rest and
maximum CO
– PR is total resistance against which blood must be
pumped
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Factors Affecting MAP
20-32
Regulation of the Heart
• Intrinsic regulation: Results from normal
functional characteristics, not on neural or
hormonal regulation
– Starling’s law of the heart
• Extrinsic regulation: Involves neural and
hormonal control
– Parasympathetic stimulation
• Supplied by vagus nerve, decreases heart rate, acetylcholine
secreted
– Sympathetic stimulation
• Supplied by cardiac nerves, increases heart rate and force of
contraction, epinephrine and norepinephrine released
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Heart Homeostasis
• Effect of blood pressure
– Baroreceptors monitor blood pressure
• Effect of pH, carbon dioxide, oxygen
– Chemoreceptors monitor
• Effect of extracellular ion concentration
– Increase or decrease in extracellular K+ decreases heart
rate
• Effect of body temperature
– Heart rate increases when body temperature increases,
heart rate decreases when body temperature decreases
20-34
Baroreceptor and Chemoreceptor
Reflexes
20-35
Baroreceptor Reflex
20-36
Chemoreceptor Reflex-pH
20-37
Effects of Aging on the Heart
• Gradual changes in heart function, minor
under resting condition, more significant
during exercise
• Hypertrophy of left ventricle
• Maximum heart rate decreases
• Increased tendency for valves to function
abnormally and arrhythmias to occur
• Increased oxygen consumption required to
pump same amount of blood
20-38