Essentials Of Anatomy & Physiology, 4th Edition Martini .
Essentials of Anatomy & Physiology, 4th EditionMartini / Bartholomew12The CardiovascularSystem: The HeartPowerPoint Lecture Outlinesprepared by Alan Magid, Duke UniversitySlides 1 to 65Copyright 2007 Pearson Education, Inc., publishing as Benjamin Cummings
Heart’s Place in the CirculationHeart Pumps Blood into Two Circuitsin Sequence Pulmonary circuit To and from the lungs Systemic circuit To and from the rest of the bodyCopyright 2007 Pearson Education, Inc., publishing as Benjamin Cummings
Heart’s Place in the CirculationThree Kinds of Blood Vessels Arteries Carry blood away from heart and carry it tothe capillaries Capillaries Microscopic vessels where exchangebetween cells and blood takes place Veins Receive blood from capillaries and carry itback to the heartCopyright 2007 Pearson Education, Inc., publishing as Benjamin Cummings
Heart’s Place in the CirculationTwo Sets of Pumping Chambers in Heart Right atrium Receives systemic blood Right ventricle Pumps blood to lungs (pulmonary) Left atrium Receives blood from lungs Left ventricle Pumps blood to organ systems (systemic)Copyright 2007 Pearson Education, Inc., publishing as Benjamin Cummings
Heart’s Place in the CirculationOverview of theCardiovascularSystemFigure 12-1
The Anatomy of the HeartPericardial Cavity Surrounds the heart Lined by pericardium Two layers Visceral pericardium (epicardium) Covers heart surface Parietal pericardium Lines pericardial sac thatsurrounds heartCopyright 2007 Pearson Education, Inc., publishing as Benjamin Cummings
The Anatomy of the HeartThe Location of the Heart in the Thoracic CavityFigure 12-2
The Anatomy of the HeartSurface Features of the Heart Auricle—Outer portion of atrium Coronary sulcus—Deep groove that marksboundary of atria and ventricles Anterior interventricular sulcus Posterior interventricular sulcus Mark boundary between left and rightventricles Sulci contain major cardiac blood vessels Filled with protective fatCopyright 2007 Pearson Education, Inc., publishing as Benjamin Cummings
The Anatomy of the HeartThe SurfaceAnatomyof the HeartFigure 12-3(a)1 of 2
The Anatomy of the HeartThe SurfaceAnatomyof the HeartFigure 12-3(a)2 of 2
The Anatomy of the HeartThe SurfaceAnatomyof the HeartFigure 12-3(b)
The Anatomy of the HeartThe Heart Wall Epicardium (visceral pericardium) Outermost layer Serous membrane Myocardium Middle layer Thick muscle layer Endocardium Inner lining of pumping chambers Continuous with endotheliumCopyright 2007 Pearson Education, Inc., publishing as Benjamin Cummings
The Anatomy of the HeartThe Heart Walland CardiacMuscle TissueFigure 12-4
The Anatomy of the HeartThe Heart Wall and Cardiac Muscle TissueFigure 12-4(a)
The Anatomy of the HeartThe Heart Walland CardiacMuscle TissueFigure 12-4(b)
The Anatomy of the HeartThe Heart Wall and Cardiac Muscle TissueFigure 12-4(c)
The Anatomy of the HeartThe Heart Walland CardiacMuscle TissueFigure 12-4(d)
The Anatomy of the HeartCardiac Muscle Cells Shorter than skeletal muscle fibersHave single nucleusHave striations (sarcomere organization)Depend on aerobic metabolismConnected by intercalated discs Desmosomes transmit tension Gap junctions transmit action potentialCopyright 2007 Pearson Education, Inc., publishing as Benjamin Cummings
The Anatomy of the HeartInternal Anatomy and Organization Interatrial septum Separates atria Interventricular septum Separates ventricles Atrioventricular valves Located between atrium and ventricle Ensure one-way flow from atrium toventricleCopyright 2007 Pearson Education, Inc., publishing as Benjamin Cummings
The Anatomy of the HeartBlood Flow in the Heart Superior and inferior venae cavae Large veins carry systemic blood to rightatrium Right atrium sends blood to right ventricle Flows through right AV valve Bounded by three cusps (tricuspid valve) Cusps anchored by chordae tendinae Chordae attached to papillary musclesCopyright 2007 Pearson Education, Inc., publishing as Benjamin Cummings
The Anatomy of the HeartBlood Flow in the Heart (cont’d) Right ventricle pumps blood throughpulmonary semilunar valve Enters pulmonary trunk Flows to lungs through right, left pulmonaryarteries where it picks up oxygen Pulmonary veins carry blood to left atrium Left atrium sends blood to left ventricle Enters through left AV valve (bicuspid ormitral) Left ventricle pumps blood to aorta Through aortic semilunar valve to systemsCopyright 2007 Pearson Education, Inc., publishing as Benjamin Cummings
The Anatomy of the HeartThe Sectional Anatomy of the HeartFigure 12-5
The Anatomy of the HeartFunctional Anatomy of the Heart Left ventricular myocardium muchthicker than right Reflects functional difference in load Valves ensure one-way flow of blood Prevent backward flow (regurgitation) Fibrous skeleton supports valves andmuscle cellsCopyright 2007 Pearson Education, Inc., publishing as Benjamin Cummings
The Anatomy of the HeartThe Valves of the HeartFigure 12-6(a)
The Anatomy of the HeartThe Valves of the HeartPLAYThe Heart: AnatomyFigure 12-6(b)
The Anatomy of the HeartKey NoteThe heart has four chambers, the rightatrium and ventricle with the pulmonarycircuit and left atrium and ventricle with thesystemic circuit. The left ventricle’s greaterworkload makes it more massive than theright, but the two pump equal amounts ofblood. AV valves prevent backflow fromthe ventricles into the atria, and semilunarvalves prevent backflow from the outflowvessels into the ventricles.Copyright 2007 Pearson Education, Inc., publishing as Benjamin Cummings
The Anatomy of the HeartThe Blood Supply to the Heart Coronary circulation meets heavy demandsof myocardium for oxygen, nutrients Coronary arteries (right, left) branch fromaorta base Anastomoses (arterial interconnections)ensure constant blood supply Drainage is to right atrium Great, middle cardiac veins drain capillaries Empty into coronary sinusCopyright 2007 Pearson Education, Inc., publishing as Benjamin Cummings
The Anatomy of the HeartThe Coronary CirculationFigure 12-7(a)
The Anatomy of the HeartThe Coronary CirculationFigure 12-7(b)
The HeartbeatHeartbeat Needs two Types of CardiacCells Contractile cells Provide the pumping action Cells of the conducting system Generate and spread the actionpotentialCopyright 2007 Pearson Education, Inc., publishing as Benjamin Cummings
The HeartbeatDifferences between Cardiac andSkeletal Muscle Cells Cardiac action potential has longplateau phase Cardiac muscle has long, slow twitch Cardiac muscle has long refractoryperiod Can’t be tetanizedCopyright 2007 Pearson Education, Inc., publishing as Benjamin Cummings
1 Rapid3 Repolarization2 The PlateauDepolarizationCause: Na entryDuration: 3-5 msecEnds with: Closure ofvoltage-regulatedsodium channelsCause: Ca2 entryDuration: 175 msecEnds with: Closure ofcalcium channelsCause: K lossDuration: 75 msecEnds with: Closure ofpotassium channels 3020mV13StimulusRefractory period–900100200Time (msec)Copyright 2007 Pearson Education, Inc., publishing as Benjamin Cummings300Figure 12-8(a)1 of 5
1 RapidDepolarizationCause: Na entryDuration: 3-5 msecEnds with: Closure ofvoltage-regulatedsodium channels 300mV1Stimulus–900100200Time (msec)Copyright 2007 Pearson Education, Inc., publishing as Benjamin Cummings300Figure 12-8(a)2 of 5
1 Rapid2 The PlateauDepolarizationCause: Na entryDuration: 3-5 msecEnds with: Closure ofvoltage-regulatedsodium channelsCause: Ca2 entryDuration: 175 msecEnds with: Closure ofcalcium channels 3020mV1Stimulus–900100200Time (msec)Copyright 2007 Pearson Education, Inc., publishing as Benjamin Cummings300Figure 12-8(a)3 of 5
1 Rapid3 Repolarization2 The PlateauDepolarizationCause: Na entryDuration: 3-5 msecEnds with: Closure ofvoltage-regulatedsodium channelsCause: Ca2 entryDuration: 175 msecEnds with: Closure ofcalcium channelsCause: K lossDuration: 75 msecEnds with: Closure ofpotassium channels 3020mV13Stimulus–900100200Time (msec)Copyright 2007 Pearson Education, Inc., publishing as Benjamin Cummings300Figure 12-8(a)4 of 5
1 Rapid3 Repolarization2 The PlateauDepolarizationCause: Na entryDuration: 3-5 msecEnds with: Closure ofvoltage-regulatedsodium channelsCause: Ca2 entryDuration: 175 msecEnds with: Closure ofcalcium channelsCause: K lossDuration: 75 msecEnds with: Closure ofpotassium channels 3020mV13StimulusRefractory period–900100200Time (msec)Copyright 2007 Pearson Education, Inc., publishing as Benjamin Cummings300Figure 12-8(a)5 of 5
The HeartbeatAction Potentials andMuscle CellContraction in Skeletaland Cardiac MuscleFigure 12-8(b)
The HeartbeatThe Conducting System Initiates and spreads electrical impulsesin heart Two types of cells Nodal cells Pacemaker cellsReach threshold firstSet heart rate Conducting cells Distributes stimuli to myocardiumCopyright 2007 Pearson Education, Inc., publishing as Benjamin Cummings
The HeartbeatThe Conducting System (cont’d) Heart is self-exciting Pacemaker cells establish heart rate Normal pacemaker is sinoatrial (SA)node Impulse spreads from SA node: Across atria To atrioventricular (AV) node To AV bundle and bundle branches Via Purkinje fibers to ventriclesCopyright 2007 Pearson Education, Inc., publishing as Benjamin Cummings
The HeartbeatThe ConductingSystem of theHeartPLAYThe Heart:Conduction SystemFigure 12-9(a)
SA node activity and atrialactivation begin.SA nodeTime 0Stimulus spreads across the atrialsurfaces and reaches the AV node.AV nodeElapsed time 50 msecThere is a 100-msec delay at theAV node. Atrial contraction begins. AV bundleBundle branchesElapsed time 150 msecThe impulse travels along the interventricularseptum within the AV bundle and the bundlebranches to the Purkinje fibers.Elapsed time 175 msecThe impulse is distributed by Purkinje fibersand relayed throughout the ventricularmyocardium. Atrial contraction is completed,and ventricular contraction begins.Elapsed time 225 msecPurkinje fibersCopyright 2007 Pearson Education, Inc., publishing as Benjamin CummingsFigure 12-9(b)1 of 6
SA node activity and atrialactivation begin.SA nodeTime 0Copyright 2007 Pearson Education, Inc., publishing as Benjamin CummingsFigure 12-9(b)2 of 6
SA node activity and atrialactivation begin.SA nodeTime 0Stimulus spreads across the atrialsurfaces and reaches the AV node.AV nodeElapsed time 50 msecCopyright 2007 Pearson Education, Inc., publishing as Benjamin CummingsFigure 12-9(b)3 of 6
SA node activity and atrialactivation begin.SA nodeTime 0Stimulus spreads across the atrialsurfaces and reaches the AV node.AV nodeElapsed time 50 msecThere is a 100-msec delay at theAV node. Atrial contraction begins. AV bundleBundle branchesElapsed time 150 msecCopyright 2007 Pearson Education, Inc., publishing as Benjamin CummingsFigure 12-9(b)4 of 6
SA node activity and atrialactivation begin.SA nodeTime 0Stimulus spreads across the atrialsurfaces and reaches the AV node.AV nodeElapsed time 50 msecThere is a 100-msec delay at theAV node. Atrial contraction begins. AV bundleBundle branchesElapsed time 150 msecThe impulse travels along the interventricularseptum within the AV bundle and the bundlebranches to the Purkinje fibers.Elapsed time 175 msecCopyright 2007 Pearson Education, Inc., publishing as Benjamin CummingsFigure 12-9(b)5 of 6
SA node activity and atrialactivation begin.SA nodeTime 0Stimulus spreads across the atrialsurfaces and reaches the AV node.AV nodeElapsed time 50 msecThere is a 100-msec delay at theAV node. Atrial contraction begins. AV bundleBundle branchesElapsed time 150 msecThe impulse travels along the interventricularseptum within the AV bundle and the bundlebranches to the Purkinje fibers.Elapsed time 175 msecThe impulse is distributed by Purkinje fibersand relayed throughout the ventricularmyocardium. Atrial contraction is completed,and ventricular contraction begins.Elapsed time 225 msecPurkinje fibersCopyright 2007 Pearson Education, Inc., publishing as Benjamin CummingsFigure 12-9(b)6 of 6
The HeartbeatThe Electrocardiogram (ECG or EKG) A recording of the electrical activity ofthe heart Three main components P wave Atrial depolarization QRS complex Ventricular depolarization T wave Ventricular repolarizationCopyright 2007 Pearson Education, Inc., publishing as Benjamin Cummings
The HeartbeatAn ElectrocardiogramFigure 12-10
The HeartbeatKey NoteThe heart rate is established by the SAnode, as modified by autonomic activity,hormones, ions, etc. From there, thestimulus is conducted through the atriumto the AV node, the AV bundle, thebundle branches, and Purkinje fibers tothe ventricular myocardium. The ECGshows the electrical events associatedwith the heartbeat.Copyright 2007 Pearson Education, Inc., publishing as Benjamin Cummings
The HeartbeatThe Cardiac Cycle Two phases in cardiac cycle Systole Contraction phase Both ventricles simultaneously Diastole Relaxation phaseCopyright 2007 Pearson Education, Inc., publishing as Benjamin Cummings
(a) Atriole systole begins:Atrial contraction forcesa small amount of additionalblood into relaxed ventricles.START(f) Ventricular diastole—late:All chambers are relaxed.Ventricles fill passively.800msec0msec100msecCardiaccycle(e) Ventricular diastole—early:As ventricles relax, pressurein ventricles drops; bloodflows back against cusps ofsemilunar valves and forcesthem closed. Blood flowsinto the relaxed atria.370msecCopyright 2007 Pearson Education, Inc., publishing as Benjamin Cummings(b) Atriole systole endsatrial diastole begins(c) Ventricular systole—first phase: Ventricularcontraction pushes AVvalves closed but doesnot create enough pressureto open semilunar valves.(d) Ventricular systole—second phase: As ventricularpressure rises and exceedspressure in the arteries, thesemilunar valves open andblood is ejected.Figure 12-111 of 6
(a) Atriole systole begins:Atrial contraction forcesa small amount of additionalblood into relaxed ventricles.START0msec100msecCardiaccycleCopyright 2007 Pearson Education, Inc., publishing as Benjamin CummingsFigure 12-112 of 6
(a) Atriole systole begins:Atrial contraction forcesa small amount of additionalblood into relaxed ventricles.START0msecCardiaccycleCopyright 2007 Pearson Education, Inc., publishing as Benjamin Cummings100msec(b) Atriole systole endsatrial diastole begins(c) Ventricular systole—first phase: Ventricularcontraction pushes AVvalves closed but doesnot create enough pressureto open semilunar valves.Figure 12-113 of 6
(a) Atriole systole begins:Atrial contraction forcesa small amount of additionalblood into relaxed yright 2007 Pearson Education, Inc., publishing as Benjamin Cummings(b) Atriole systole endsatrial diastole begins(c) Ventricular systole—first phase: Ventricularcontraction pushes AVvalves closed but doesnot create enough pressureto open semilunar valves.(d) Ventricular systole—second phase: As ventricularpressure rises and exceedspressure in the arteries, thesemilunar valves open andblood is ejected.Figure 12-114 of 6
(a) Atriole systole begins:Atrial contraction forcesa small amount of additionalblood into relaxed ventricles.START0msec100msecCardiaccycle(e) Ventricular diastole—early:As ventricles relax, pressurein ventricles drops; bloodflows back against cusps ofsemilunar valves and forcesthem closed. Blood flowsinto the relaxed atria.370msecCopyright 2007 Pearson Education, Inc., publishing as Benjamin Cummings(b) Atriole systole endsatrial diastole begins(c) Ventricular systole—first phase: Ventricularcontraction pushes AVvalves closed but doesnot create enough pressureto open semilunar valves.(d) Ventricular systole—second phase: As ventricularpressure rises and exceedspressure in the arteries, thesemilunar valves open andblood is ejected.Figure 12-115 of 6
(a) Atriole systole begins:Atrial contraction forcesa small amount of additionalblood into relaxed ventricles.START(f) Ventricular diastole—late:All chambers are relaxed.Ventricles fill passively.800msec0msec100msecCardiaccycle(e) Ventricular diastole—early:As ventricles relax, pressurein ventricles drops; bloodflows back against cusps ofsemilunar valves and forcesthem closed. Blood flowsinto the relaxed atria.370msecCopyright 2007 Pearson Education, Inc., publishing as Benjamin Cummings(b) Atriole systole endsatrial diastole begins(c) Ventricular systole—first phase: Ventricularcontraction pushes AVvalves closed but doesnot create enough pressureto open semilunar valves.(d) Ventricular systole—second phase: As ventricularpressure rises and exceedspressure in the arteries, thesemilunar valves open andblood is ejected.Figure 12-116 of 6
The HeartbeatHeart Sounds Generated by closing of valves Two main heart sounds First sound (lubb) Closing of AV valve Second sound (dupp) Closing of aortic valve Indicate start/stop of systole Heard with stethoscopeCopyright 2007 Pearson Education, Inc., publishing as Benjamin Cummings
Heart DynamicsSome Essential Definitions Heart dynamics—Movements andforces generated during cardiaccontraction Stroke volume—Amount of bloodpumped in a single beat Cardiac output—Amount of bloodpumped each minuteCopyright 2007 Pearson Education, Inc., publishing as Benjamin Cummings
Heart DynamicsFactors Controlling Cardiac Output Blood volume reflexes Autonomic innervation Heart rate effects Stroke volume effects HormonesCopyright 2007 Pearson Education, Inc., publishing as Benjamin Cummings
Heart DynamicsBlood Volume Reflexes Stimulated by changes in venous return VR is amount of blood entering heart Atrial reflex Speeds up heart rate Triggered by stretching wall of right atrium Frank-Starling principle Increases ventricular output Triggered by stretching wall of ventriclesCopyright 2007 Pearson Education, Inc., publishing as Benjamin Cummings
Heart DynamicsAutonomic Control of the Heart Parasympathetic innervation Releases acetylcholine (ACh) Lowers heart rate and stroke volume Sympathetic innervation Releases norepinephrine (NE) Raises heart rate and stroke volumeCopyright 2007 Pearson Education, Inc., publishing as Benjamin Cummings
Heart DynamicsAutonomicInnervation of theHeartFigure 12-12
Heart DynamicsHormone Effects on Cardiac Output Adrenal medulla hormones Epinephrine, norepinephrine released Heart rate and stroke volume increased Other hormones that increase output Thyroid hormones GlucagonCopyright 2007 Pearson Education, Inc., publishing as Benjamin Cummings
Heart DynamicsCNS Control of the Heart Basic control in medulla oblongata Cardioacceleratory center Activation of sympathetic neurons Cardioinhibitory center Governing of parasympathetic neurons Other inputs Higher centers Blood pressure sensors Oxygen, carbon dioxide sensorsCopyright 2007 Pearson Education, Inc., publishing as Benjamin Cummings
Heart DynamicsKey NoteCardiac output is the amount of bloodpumped by the left ventricle each minute.It is adjusted moment-to-moment by theANS, and by circulating hormones,changes in blood volume and in venousreturn. A healthy person can increasecardiac output by three-fold to five-fold.Copyright 2007 Pearson Education, Inc., publishing as Benjamin Cummings
Essentials of Anatomy & Physiology, 4th Edition Martini / Bartholomew . The Anatomy of the Heart The Valves of the Heart PLAY The Heart: Anatomy Figure 12-6(b) The Anatomy of the Heart Key Note The heart has four ch
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Cambridge IGCSE and O Level Accounting 1.4 The statement of financial position The accounting equation may be shown in the form of a statement of financial posi
