AnaPhy - Heart <3

@paulynecarlyle on ig :P

- The heart, trachea, esophagus, and associated

FUNCTIONS OF THE HEART structures form a midline partition, the
mediastinum.
1.​ Generating blood pressure. - The heart is surround by its own cavity, the
2.​ Routing Blood. pericardial cavity.
3.​ Ensuring one-way blood flow. - The heart lies obliquely in the mediastinum, with
4.​ Regulating blood supply. its base directed upward and posteriorly and its
apex downward, forward, and to the left, positioned
mostly left of the sternum.
- Health professionals must know the heart’s
location and shape in the thoracic cavity to
properly use tools (stethoscope, ECG leads) and
perform lifesaving procedures like
cardiopulmonary resuscitation (CPR), which
keeps blood flowing when the heart stops.

SIZE, FORM, AND LOCATION OF THE HEART

- Adult heart is shaped like a blunt cone and is

approximately the size of a closed fist.
ANATOMY OF THE HEART
- Physically active adults has larger heart than i
nless active but otherwise healthy adults.
1. Pericardium
- The blunt, rounded point of the heart is the apex
Location: The heart lies in the pericardial cavity,
and the larger, flat part at the opposite end of the
surrounded by the pericardium (pericardial sac).
heart is the base.
Function: Anchors the heart in the mediastinum
- Heart is located in the thoracic cavity between
and reduces friction during heart movement.
the two pleural cavities that surround the lungs.
Layers of Pericardium:

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 ●​ Fibrous Pericardium – outer, tough - The right and left ventricles extend from the base
connective tissue layer. of the heart toward the apex.
●​ Serous Pericardium – inner layer of flat - A coronary sulcus extends around the heart.
epithelial cells with connective tissue. - The anterior interventricular sulcus extends
○​ Parietal Pericardium – lines fibrous inferiorly from the coronary sulcus on the anterior
pericardium. surface of the heart.
○​ Visceral Pericardium (Epicardium) - The posterior interventricular sulcus extends
– covers the heart surface. inferiorly from the coronary sulcus on the posterior
surface of the heart.
Pericardial Cavity: Space between parietal and
visceral pericardium.​
Pericardial Fluid: Thin layer of fluid in the cavity,
reduces friction as the heart beats.

- Six large veins carry blood to the heart

●​ Superior & Inferior vena cava
- Carry blood from the body to the right
atrium.
●​ Four pulmonary veins: (R & L)
- Carry blood from the lungs to the left
atrium.
●​ Two arteries:
2. External Anatomy
1.​ Pulmonary trunk → right & left pulmonary
- The right and left atria are located at the base of
arteries which carry blood to the lungs.
the heart.

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 2.​ Aorta → from left ventricle carries blood to
the rest of the body. 4. Heart Valves

3. Heart Chambers and Internal Anatomy ●​ Maintain one-way blood flow through the
Right and Left Atria heart
General Function: ●​ Prevent backflow of blood between
1.​ Receive blood from veins chambers
2.​ Serve as reservoirs for blood before it
enters ventricles Atrioventricular Valves (AV)
3.​ Atrial contraction → completes ventricular -​ Located between left and right atria and
●​ Right Atrium ventricles.
Openings: ​ Right AV Valve
- Superior vena cava → drains blood from -​ Has three cusps and it is call the tricuspid
upper body valve.
- Inferior vena cava → drains blood from Left AV Valve
lower body -​ Has two cusps and is called the bicuspid
- Coronary sinus → drains blood from valve or mitral valve.
heart muscle
●​ Left Atrium
Openings:
- Four pulmonary veins → carry
oxygenated blood from lungs
- Right and left atria divided by interatrial septum.​

Right and Left Ventricles

​ General Function:
​ 1. Major pumping chambers
2. Eject blood into arteries → circulate
through body/lungs​
3. Each ventricle has one outflow route Support Structures
(superior, near midline) Function: Prevent valves from opening backward
●​ Right Ventricle into atria during contraction
- Pumps blood into pulmonary trunk (to ●​ Papillary Muscles - cone-shaped
lungs) muscles in ventricles
- Lower pressure (~1/5 of left ventricle) ●​ Chordae Tendieae - strong “heart
- Moves blood through pulmonary strings” attached to AV valve cusps.
circulation
●​ Left Ventricle Aortic and Seminular Valves
​ - Pumps blood into aorta (to body) - Located at bases of aorta and pulmonary trunk
- Thicker wall → contracts more forcefully - Each has three half-moon (pocket-like) cusps
- Pressure: ~120 mm Hg - Open when ventricles contract (high pressure
- Moves blood through systemic circulation inside ventricles)
- Right & left ventricles divided by interventricular - Close when ventricles relax (blood backflow fills
septum cusps and seals valves)
- Both ventricles pump equal blood volume despite ●​ Aortic semilunar valve - between LV and
pressure differences aorta

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 ●​ Pulmonary semilunar valve - between RV
and pulmonary trunk

5. Route of Blood Flow Through the Heart

Key Concept: Both atria contract together, and

both ventricles contract together.

Right Side (Deoxygenated Blood)

1.​ Blood enters Right Atrium

○​ From superior & inferior vena
cava (systemic circulation)
○​ From coronary sinus (heart
muscle)
2.​ Flows into Right Ventricle
○​ Through tricuspid valve (AV valve)
while ventricle relaxes
3.​ Right Atrium contracts → completes
ventricular filling
4.​ Right Ventricle contracts
○​ Tricuspid valve closes (prevents
backflow)
○​ Pulmonary semilunar valve opens
Cardiac Skeleton → blood enters pulmonary trunk
- Fibrous rings of connective tissue around AV and 5.​ Pulmonary trunk branches into right & left
semilunar valves pulmonary arteries → carry blood to lungs
- Provides structural support and electrical 6.​ In lungs: CO₂ released, O₂ picked up
insulation between atria and ventricles
- Serves as attachment site for cardiac muscle Left Side (Oxygenated Blood)

7.​ Blood returns to Left Atrium

○​ Through four pulmonary veins
8.​ Flows into Left Ventricle
○​ Through bicuspid (mitral) valve
while ventricle relaxes
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 9.​ Left Atrium contracts → completes interventricular sulcus;
ventricular filling supplies anterior wall.
10.​Left Ventricle contracts ■​ Circumflex artery – extends
○​ Bicuspid valve closes around coronary sulcus to
○​ Aortic semilunar valve opens → posterior side of heart.
blood enters aorta ■​ Left marginal artery – runs
11.​Aorta distributes blood throughout the down left ventricle’s lateral
body (systemic circulation) wall.
12.​As LV relaxes → aortic semilunar valve ○​ Supplies: anterior heart wall & most
closes (prevents backflow) of left ventricle.​

●​ Right Coronary Artery (RCA)

○​ Origin: Right side of aorta.
○​ Branches:
■​ Posterior interventricular
artery – in posterior
interventricular sulcus.
■​ Right marginal artery –
runs down right ventricle’s
lateral wall.
○​ Supplies: most of right ventricle
​
wall.​

●​ Oxygen Usage
○​ Coronary arteries deliver ~70% of O₂
at rest (vs. ~25% in skeletal muscle).
○​ During exercise, cardiac O₂
extraction cannot increase much →
blood flow rate must rise.
○​ Coronary blood flow is greatest
during ventricular relaxation
Blood Supply to the Heart (diastole).

Coronary Arteries

Function: Supply oxygen and nutrients to cardiac

muscle.​
Origin: Both arise from the base of the aorta, just
above the aortic semilunar valve.

●​ Left Coronary Artery (LCA)

○​ Origin: Left side of aorta.
○​ Branches:
■​ Anterior interventricular
artery – in anterior

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 ●​ Trabeculae Carneae
- Ridges and columns of cardiac muscle found on
the interior walls of the ventricles.
Function: Help prevent suction that could occur
during contraction by reducing smooth surface
tension inside ventricles.
- Smaller muscular ridges are also found in parts of
the atria.

2. Cardiac Muscle
Structure:
-​ Cells are elongated, branching, with 1–2
HISTOLOGY OF THE HEART central nuclei.
-​ Contain actin and myosin myofilaments
1.​ Heart Wall arranged in sarcomeres → gives a
- Composed of 3 Layers striated appearance.
1.​ Epicardium -​ Striations are less regular than in skeletal
-​ Also called visceral pericardium. muscle.
-​ Thin, serous membrane forming the smooth
outer surface of the heart.
2.​ Myocardium
-​ Thick middle layer of the heart.
-​ Composed of cardiac muscle cells.
-​ Responsible for contraction of the heart
chambers.
3.​ Endocardium
-​ Smooth inner surface of the heart
chambers.
-​ Allows blood to move easily through the
heart.
Energy & Oxygen Use
-​ Heart valves are formed by folds of
endocardium.
●​ Requires Ca²⁺ and ATP for contraction.
●​ Calcium ions enter during action potentials
to trigger contraction.
●​ Rich in mitochondria → produces ATP
rapidly.
●​ Has an extensive capillary network for O₂
supply.
●​ Cannot tolerate oxygen deficit →
prevents fatigue or failure.

Muscle Organization

●​ Fibers form spiral bundles → contraction

shortens & twists heart chambers for
efficient pumping.
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 ●​ Cells connected by intercalated discs → ○​ Has many Ca²⁺ channels, allowing it
prevent separation during contraction.​ to depolarize quickly.
Gap junctions in discs allow rapid action ○​ Calcium channel blockers slow the
potential spread between cells. heart rate by delaying
depolarization.
ELECTRICAL ACTIVITY OF THE HEART 2.​ Atrioventricular (AV) Node
○​ Located in the lower right atrium.
●​ Depolarization:
○​ Slows down the signal → gives atria
○​ Sodium (Na⁺) channels open → Na⁺
time to finish contracting before
rushes in → cell becomes positive.
ventricles start.
●​ Plateau Phase:
3.​ Atrioventricular (AV) Bundle / Bundle of
○​ Calcium (Ca²⁺) enters the cell →
His
keeps it positive longer.
○​ Connects the AV node to the
○​ Few potassium (K⁺) ions leave →
ventricles.​
balance keeps the charge steady.
Passes through the fibrous cardiac
●​ Repolarization:
skeleton (separates atria and
○​ Calcium channels close, more
ventricles).
potassium goes out → cell becomes
4.​ Right and Left Bundle Branches
negative again (resting).
○​ Run along the interventricular
septum.
○​ Carry the action potential toward the
apex (bottom) of the heart.
5.​ Purkinje Fibers
○​ Spread throughout the ventricular
walls.
○​ Conduct impulses very fast →
cause ventricles to contract together.

1. Conduction System of the Heart

- Unlike skeletal muscle, the heart can contract on

its own (no nerve signal needed).
- Special cardiac cells make up the conduction
system that controls heartbeat rhythm.

Parts of the Conduction System

1.​ Sinoatrial (SA) Node

○​ Located in the upper right atrium.
○​ Known as the pacemaker of the
heart.
○​ Starts the action potential that
spreads across both atria → causes
atrial contraction.

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Electrocardiogram
- An electrocardiogram (ECG or EKG) records
the electrical activity of the heart. CARDIAC CYCLE
- Electrodes on the body detect small electrical - The cardiac cycle is one complete heartbeat —
changes from cardiac muscle action potentials. from the start of one contraction to the start of the
next.
Purpose: - Includes contraction (systole) and relaxation
- Used to monitor heart rate and rhythm. (diastole) of both atria and ventricles.
- Helps detect abnormalities, such as blocks,
arrhythmias, or damaged heart tissue. Heart as Two Pumps:
- It’s painless, quick, and non-surgical. ●​ Atria → “Primer pumps” that fill the
ventricles with blood.
Waves of a Normal ECG ●​ Ventricles → “Power pumps” that push
blood into pulmonary and systemic
●​ P wave → Atrial depolarization (atria
circulation.
contract).
●​ QRS complex → Ventricular depolarization
Main Phases of the Cardiac Cycle
(ventricles contract).
○​ Hides atrial repolarization (not seen). 1.​ Atrial Systole (Atria contract)
●​ T wave → Ventricular repolarization ○​ Atria contract and push extra blood
(ventricles relax). into ventricles (complete filling).
○​ AV valves open, semilunar valves
Intervals closed.
○​ Ventricles now 100% filled.​
●​ PQ (PR) interval
○​ From start of P wave to start of
2.​ Ventricular Systole (Ventricles contract)
QRS.
○​ Pressure in ventricles rises.
○​ Atria contract → ventricles begin to
○​ AV valves close → first heart sound
depolarize.
“lub.”
●​ QT interval
○​ When pressure is high enough,
○​ From start of QRS complex to end
semilunar valves open, and blood
of T wave.
is pumped into:
○​ Time for ventricles to depolarize
■​ Pulmonary trunk (right
and repolarize.
ventricle)
○​ Abnormal values may indicate heart
rhythm problems.
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 ■​ Aorta (left ventricle)​ ●​ First heart sound (S1 “lub”) → AV valves
closing.
3.​ Ventricular Diastole (Ventricles relax) ●​ Second heart sound (S2 “dup”) →
○​ Ventricles relax; pressure drops. Semilunar valves closing.
○​ Semilunar valves close → second ●​ Ventricular systole occurs between S1
heart sound “dup.” and S2.
○​ When ventricular pressure is lower ●​ Ventricular diastole occurs between S2
than atrial pressure, AV valves and the next S1.
open → blood flows into ventricles
again. HEART SOUNDS
Stethoscope
●​ Device used to listen to heart and lung
sounds.
●​ Specific spots on the chest give the best
heart sound clarity.

Normal Heart Sounds

●​ Two main sounds:

○​ First sound (S₁) – “Lubb”
■​ Lower pitch
■​ Caused by closure of AV
valves (tricuspid &
bicuspid)
■​ Marks the start of
ventricular systole
(contraction)
○​ Second sound (S₂) – “Dupp”
■​ Higher pitch
■​ Caused by closure of
semilunar valves (aortic &
pulmonary)
■​ Marks the start of
ventricular diastole
(relaxation)
●​ Timing:
○​ Ventricular systole → between S₁
and S₂
○​ Ventricular diastole → between S₂
and next S₁
○​ Diastole lasts longer than systole.
Additional Notes:
Abnormal Heart Sounds (Murmurs)
●​ Systole = contraction; Diastole =
relaxation. ●​ Murmur → abnormal swishing sound
●​ Blood always moves from high → low caused by faulty valves.
pressure.
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 ●​ Incompetent valve → doesn’t close Intrinsic Regulation (Inside the Heart)
properly → blood leaks → swishing after
valve closes. ●​ Controlled by the heart’s own
○​ Example: Incompetent bicuspid mechanisms.
valve → swish after first heart ●​ Starling’s Law of the Heart:
sound. ○​ The more cardiac muscle is
●​ Stenosed valve → valve opening stretched, the stronger it
narrowed → swishing before valve closes. contracts.
○​ Example: Stenosed bicuspid valve ○​ More blood returning → greater
→ swish before first heart sound. stretch → stronger contraction → ↑
stroke volume → ↑ cardiac output.​

●​ Venous Return:
○​ Amount of blood returning to the
heart.
○​ Increased venous return → ↑
preload → ↑ CO.
○​ Decreased venous return → ↓
preload → ↓ CO.​

●​ Preload:
○​ Degree of stretch of ventricular walls
at end of diastole.​

●​ Afterload:
REGULATION OF THE HEART
○​ Pressure the ventricles must
overcome to eject blood.
Cardiac Measurements
○​ High afterload (ex: hypertension)
●​ Cardiac Output (CO): amount of blood → heart works harder → risk of
pumped per minute heart failure.
○​ Formula: CO = SV × HR ○​ Low afterload (low BP) → easier
○​ Stroke Volume (SV): blood pumped for heart to pump.
per beat (~70 mL/beat) ○​ Afterload affects CO less than
○​ Heart Rate (HR): beats per minute preload.
(~72 bpm)
Extrinsic Regulation of the Heart
○​ Normal CO: ≈ 5 L/min at rest
●​ Athletes: - Refers to external controls of heart function —
○​ Higher SV, lower HR at rest mainly nervous and chemical mechanisms.​
(stronger heart)
●​ During Exercise:
○​ HR ↑ (up to 190 bpm), SV ↑ (≈115 Nervous Regulation – Baroreceptor Reflex
mL/beat)
○​ CO ↑ up to ~22 L/min ●​ Autonomic Nervous System (ANS):
○​ Sympathetic nerves → ↑ Heart rate
& ↑ Stroke volume

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 ○​ Parasympathetic nerves → ↓ Heart
rate Nervous
Condition Effect on
●​ Baroreceptors (Pressure sensors): Response Heart Result
○​ Located in the aorta and carotid
arteries.
↓ BP
○​ Detect changes in blood pressure
↑ Blood ↑ Parasyma thetic, ↓ HR &
by sensing stretch in vessel walls. Pressure ↓ SV
↓ Sympathetc
○​ Send signals to the medulla
oblongata (cardioregulatory center).
↓ Parasympathetic, ↑ BP
↑ Sympathetic
Cardioregulatory Center (in Medulla Oblongata) ↓ Blood ↑ HR & ↑
Pressure SV

●​ Receives signals from baroreceptors.

●​ Controls the sympathetic and
parasympathetic output to the heart.
●​ Also affects adrenal gland → releases
epinephrine & norepinephrine → further
increases HR & SV.

Responses to Blood Pressure Changes

●​ When BP Increases:
○​ Baroreceptors → more stretch →
more signals to medulla
○​ Medulla response: ↑
Parasympathetic, ↓ Sympathetic
○​ Result: ↓ HR, ↓ Stroke Volume, ↓
BP​

●​ When BP Decreases:
○​ Baroreceptors → less stretch →
fewer signals to medulla
○​ Medulla response: ↓ Chemical Regulation: Chemoreceptor Reflex
Parasympathetic, ↑ Sympathetic
○​ Result: ↑ HR, ↑ Stroke Volume, ↑ - Epinephrine and norepinephrine (from the
BP​ adrenal gland) are released during exercise,
○​ If BP drops severely → adrenal excitement, or stress.
medulla releases epinephrine & - These hormones increase heart rate and stroke
norepinephrine → boosts HR & volume by acting on the heart.
contraction strength - Emotions like anxiety or anger speed up the
heart, while depression can slow it down.
- Chemoreceptors in the medulla oblongata
sense changes in pH and CO₂ levels:
- If CO₂ increases (causing low pH), the body
increases sympathetic activity, making the heart
beat faster to bring in more oxygen.

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Summary of Extrinsic Regulation ​
- Baroreceptors (in the aorta and carotid arteries)
detect blood pressure changes.
- Chemoreceptors detect O₂, CO₂, and pH
changes.
- These signals go to the cardioregulatory center
in the medulla oblongata.
- The medulla adjusts heart activity by:

●​ Increasing sympathetic signals → heart

beats faster and stronger.
●​ Increasing parasympathetic signals →
heart beats slower.

- Adrenal glands release epinephrine and

norepinephrine, which also increase heart rate
and stroke volume.

Other Factors Affecting Heart Function

●​ Too much K⁺ (potassium) → weak

heartbeat or heart stops.
●​ Too much Ca²⁺ (calcium) → heart
contracts too strongly.
●​ Too little Ca²⁺ → weak heartbeat.
●​ High body temperature → faster heart
rate.
●​ Low body temperature → slower heart
rate.

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