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The Heart Part 1 Slides by Vince Austin and W. Rose. figures from Marieb & Hoehn 8th and 9th eds. Portions copyright Pearson Education Heart Anatomy • Approximately the size of a fist • Location • In the mediastinum between second rib and fifth intercostal space • On the superior surface of diaphragm • Two-thirds to the left of the midsternal line • Anterior to the vertebral column, posterior to the sternum • Enclosed in pericardium, a double-walled sac PLAY Animation: Rotatable heart Copyright © 2010 Pearson Education, Inc. Superior vena cava Aorta Parietal pleura (cut) Pulmonary trunk Left lung Pericardium (cut) Diaphragm Apex of heart (c) Copyright © 2010 Pearson Education, Inc. Figure 18.1c Pericardium Two layers Parietal layer (“pericardium”) a clear fibrous “bag” protecting & anchoring heart. Limits filling beyond a certain volume. Visceral layer (epicardium) on external surface of the heart Very thin layer of fluid between the layers decreases friction Layers of the heart wall • Epicardium (visceral pericardium) • Myocardium (muscle) • Endocardium (inner lining) http://dev.biologists.org/content/139/18/3277/F1.large.jpg Cardiac Chambers: 2 ventricles, 2 atria Two atria • Separated internally by interatrial septum • Coronary sulcus (atrioventricular groove) encircles junction of atria and ventricles • Auricles increase atrial volume Two ventricles • Separated by interventricular septum • Anterior & posterior interventricular sulci on external surface suggest location of septum inside Brachiocephalic trunk Superior vena cava Right pulmonary artery Ascending aorta Pulmonary trunk Right pulmonary veins Right atrium Right coronary artery (in coronary sulcus) Anterior cardiac vein Right ventricle Right marginal artery Small cardiac vein Inferior vena cava (b) Anterior view Copyright © 2010 Pearson Education, Inc. Left common carotid artery Left subclavian artery Aortic arch Ligamentum arteriosum Left pulmonary artery Left pulmonary veins Auricle of left atrium Circumflex artery Left coronary artery (in coronary sulcus) Left ventricle Great cardiac vein Anterior interventricular artery (in anterior interventricular sulcus) Apex Figure 18.4b Atria: The Receiving Chambers Vessels entering right atrium • Superior vena cava • Inferior vena cava • Coronary sinus Vessels entering left atrium • Right and left pulmonary veins Ventricles: The Discharging Chambers Walls are ridged by trabeculae carneae Papillary muscles project into the ventricular cavities Pulmonary trunk leaves right ventricle Aorta leaves left ventricle Aorta Superior vena cava Right pulmonary artery Pulmonary trunk Right atrium Right pulmonary veins Fossa ovalis Pectinate muscles Tricuspid valve Right ventricle Chordae tendineae Trabeculae carneae Inferior vena cava Left pulmonary artery Left atrium Left pulmonary veins Mitral (bicuspid) valve Aortic valve Pulmonary valve Left ventricle Papillary muscle Interventricular septum Epicardium Myocardium Endocardium (e) Frontal section Copyright © 2010 Pearson Education, Inc. Figure 18.4e Pathway of Blood Through the Heart The heart is two side-by-side pumps Right side pumps blood to & through pulmonary (lung) arteries & veins Left side pumps blood to & through systemic arteries & veins (everything but lungs) Pulmonary Circuit Pulmonary arteries Venae cavae Capillary beds of lungs where gas exchange occurs Pulmonary veins Aorta and branches Left atrium Left ventricle Right atrium Right ventricle Oxygen-rich, CO2-poor blood Oxygen-poor, CO2-rich blood Copyright © 2010 Pearson Education, Inc. Heart Systemic Circuit Capillary beds of all body tissues where gas exchange occurs Figure 18.5 Blood pathway through right side of heart Systemic veins Right atrium tricuspid valve right ventricle Right ventricle pulmonary (semilunar) valve pulmonary trunk pulmonary arteries lung capillaries Blood pathway through left side of heart Pulmonary veins Left atrium mitral valve left ventricle Left ventricle aortic (semilunar) valve ascending aorta systemic arteries systemic capillaries Pathway of Blood Through the Heart • Equal volumes of blood are pumped to the pulmonary and systemic circuits • Pulmonary circuit is a short, low-pressure circulation • Systemic circuit blood encounters much resistance in the long pathways • Anatomy of the ventricles reflects these differences Copyright © 2010 Pearson Education, Inc. Left ventricle Right ventricle Interventricular septum Copyright © 2010 Pearson Education, Inc. Figure 18.6 Coronary Circulation • The functional blood supply to the heart muscle itself • Arterial supply varies considerably and contains many anastomoses (junctions) among branches • Collateral routes provide additional routes for blood delivery Copyright © 2010 Pearson Education, Inc. Coronary Circulation • Arteries • Right and left coronary (in atrioventricular groove), marginal, circumflex, and anterior interventricular arteries • Veins • Small cardiac, anterior cardiac, and great cardiac veins Copyright © 2010 Pearson Education, Inc. Superior vena cava Anastomosis (junction of vessels) Right atrium Aorta Pulmonary trunk Left atrium Left coronary artery Circumflex artery Right coronary Left artery ventricle Right ventricle Anterior Right interventricular marginal Posterior artery artery interventricular artery Major coronary arteries Copyright © 2010 Pearson Education, Inc. Figure 18.7a Superior vena cava Anterior cardiac veins Great cardiac vein Coronary Sinus (on the back wall, drains into RA) Small cardiac vein Middle cardiac vein Major cardiac veins Copyright © 2010 Pearson Education, Inc. Figure 18.7b Aorta Left pulmonary artery Superior vena cava Left pulmonary veins Auricle of left atrium Left atrium Great cardiac vein Right pulmonary veins Posterior vein of left ventricle Left ventricle Apex Copyright © 2010 Pearson Education, Inc. Right pulmonary artery Right atrium Inferior vena cava Coronary sinus Right coronary artery (in coronary sulcus) Posterior interventricular artery (in posterior interventricular sulcus) Middle cardiac vein Right ventricle (d) Posterior surface view Figure 18.4d Homeostatic Imbalances • Angina pectoris • Thoracic pain caused by temporarily inadequate blood flow to the myocardium • Cells are weakened • Myocardial infarction (heart attack) • Prolonged coronary artery blockage • Dead muscle cells are replaced with noncontractile scar tissue Copyright © 2010 Pearson Education, Inc. Heart Valves • Ensure unidirectional blood flow through the heart • Atrioventricular (AV) valves • Prevent backflow into the atria when ventricles contract • Tricuspid valve (right) • Mitral valve (left) • Chordae tendineae anchor AV valve cusps to papillary muscles Copyright © 2010 Pearson Education, Inc. Heart Valves • Semilunar (SL) valves • Prevent backflow into the ventricles when ventricles relax • Aortic semilunar valve • Pulmonary semilunar valve Copyright © 2010 Pearson Education, Inc. Myocardium Pulmonary valve Aortic valve Tricuspid Area of cutaway (right atrioventricular) Mitral valve valve Tricuspid valve Mitral (left atrioventricular) valve Aortic valve Myocardium Tricuspid (right atrioventricular) valve Mitral (left atrioventricular) valve Aortic valve Pulmonary valve Fibrous skeleton (a) Copyright © 2010 Pearson Education, Inc. Pulmonary valve Aortic valve Area of cutaway (b) Pulmonary valve Mitral valve Tricuspid valve Anterior Figure 18.8a Opening of inferior vena cava Tricuspid valve Mitral valve Chordae tendineae Myocardium of right ventricle Myocardium of left ventricle Papillary muscles (d) Copyright © 2010 Pearson Education, Inc. Interventricular septum Pulmonary valve Aortic valve Area of cutaway Mitral valve Tricuspid valve Figure 18.8d Cardiac MRI of a preserved human heart. Short axis view at the level of the valves. The short axis view is a plane perpendicular to a line from the apex of the heart along the interventricular septum to the approximate middle of the base of the heart. “This short axis slice of the specimen beautifully shows the annulus of the mitral valve. Additionally, the left circumflex artery can be seen curving around heart above the mitral annulus and the left anterior descending artery diving down into the myocardium adjacent to the pulmonary valve annulus.” Note how the mitral, aortic, and tricuspid valves share parts of their annuli. Source: Atlas of Human Cardiac Anatomy, heart 0053, http://www.vhlab.umn.edu/atlas/cardiac-mri/short-axis-valve/index.shtml, retrieved 20150228. 1 Blood returning to the Direction of blood flow heart fills atria, putting pressure against atrioventricular valves; atrioventricular valves are forced open. Atrium Cusp of atrioventricular valve (open) 2 As ventricles fill, atrioventricular valve flaps hang limply into ventricles. Chordae tendineae 3 Atria contract, forcing additional blood into ventricles. Ventricle Papillary muscle (a) AV valves open; atrial pressure greater than ventricular pressure Atrium 1 Ventricles contract, forcing blood against atrioventricular valve cusps. 2 Atrioventricular valves close. 3 Papillary muscles contract and chordae tendineae tighten, preventing valve flaps from everting into atria. Cusps of atrioventricular valve (closed) Blood in ventricle (b) AV valves closed; atrial pressure less than ventricular pressure Copyright © 2010 Pearson Education, Inc. Figure 18.9 Aorta Pulmonary trunk As ventricles contract and intraventricular pressure rises, blood is pushed up against semilunar valves, forcing them open. (a) Semilunar valves open As ventricles relax and intraventricular pressure falls, blood flows back from arteries, filling the cusps of semilunar valves and forcing them to close. (b) Semilunar valves closed Copyright © 2010 Pearson Education, Inc. Figure 18.10 Microscopic Anatomy of Cardiac Muscle • Cardiac muscle cells are striated, short, fat, branched, and interconnected • Connective tissue matrix (endomysium) connects to the fibrous skeleton • T tubules are wide but less numerous; SR is simpler than in skeletal muscle • Numerous large mitochondria (25–35% of cell volume) – these cells need energy & never rest! Copyright © 2010 Pearson Education, Inc. Nucleus Intercalated discs Gap junctions Cardiac muscle cell Desmosomes (a) Copyright © 2010 Pearson Education, Inc. Figure 18.11a Microscopic Anatomy of Cardiac Muscle • Intercalated discs: junctions between cells anchor cardiac cells • Desmosomes prevent cells from separating during contraction • Gap junctions allow ions to pass; electrically couple adjacent cells • Heart muscle behaves as a functional syncytium Copyright © 2010 Pearson Education, Inc. Cardiac muscle cell Mitochondrion Intercalated disc Nucleus T tubule Mitochondrion Sarcoplasmic reticulum Z disc Nucleus Sarcolemma (b) Copyright © 2010 Pearson Education, Inc. I band A band I band Figure 18.11b