Page 1 :
Essentials of Anatomy & Physiology, 4th Edition, Martini / Bartholomew, , 12, , The Cardiovascular, System: The Heart, , PowerPoint® Lecture Outlines, prepared by Alan Magid, Duke University, , Slides 1 to 65, , Copyright © 2007 Pearson Education, Inc., publishing as Benjamin Cummings
Page 2 :
Heart’s Place in the Circulation, Heart Pumps Blood into Two Circuits, in Sequence, • Pulmonary circuit, • To and from the lungs, , • Systemic circuit, • To and from the rest of the body, , Copyright © 2007 Pearson Education, Inc., publishing as Benjamin Cummings
Page 3 :
Heart’s Place in the Circulation, Three Kinds of Blood Vessels, • Arteries, • Carry blood away from heart and carry it to, the capillaries, , • Capillaries, • Microscopic vessels where exchange, between cells and blood takes place, , • Veins, • Receive blood from capillaries and carry it, back to the heart, Copyright © 2007 Pearson Education, Inc., publishing as Benjamin Cummings
Page 4 :
Heart’s Place in the Circulation, Two 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
Page 5 :
Heart’s Place in the Circulation, Overview of the, Cardiovascular, System, , Figure 12-1
Page 6 :
The Anatomy of the Heart, Pericardial Cavity, • Surrounds the heart, • Lined by pericardium, • Two layers, • Visceral pericardium (epicardium), • Covers heart surface, • Parietal pericardium, • Lines pericardial sac that, surrounds heart, , Copyright © 2007 Pearson Education, Inc., publishing as Benjamin Cummings
Page 7 :
The Anatomy of the Heart, The Location of the Heart in the Thoracic Cavity, , Figure 12-2
Page 8 :
The Anatomy of the Heart, Surface Features of the Heart, • Auricle—Outer portion of atrium, • Coronary sulcus—Deep groove that marks, boundary of atria and ventricles, • Anterior interventricular sulcus, • Posterior interventricular sulcus, • Mark boundary between left and right, ventricles, • Sulci contain major cardiac blood vessels, • Filled with protective fat, Copyright © 2007 Pearson Education, Inc., publishing as Benjamin Cummings
Page 9 :
The Anatomy of the Heart, The Surface, Anatomy, of the Heart, , Figure 12-3(a), 1 of 2
Page 10 :
The Anatomy of the Heart, The Surface, Anatomy, of the Heart, , Figure 12-3(a), 2 of 2
Page 11 :
The Anatomy of the Heart, The Surface, Anatomy, of the Heart, , Figure 12-3(b)
Page 12 :
The Anatomy of the Heart, The Heart Wall, • Epicardium (visceral pericardium), • Outermost layer, • Serous membrane, , • Myocardium, • Middle layer, • Thick muscle layer, , • Endocardium, • Inner lining of pumping chambers, • Continuous with endothelium, Copyright © 2007 Pearson Education, Inc., publishing as Benjamin Cummings
Page 13 :
The Anatomy of the Heart, The Heart Wall, and Cardiac, Muscle Tissue, , Figure 12-4
Page 14 :
The Anatomy of the Heart, The Heart Wall and Cardiac Muscle Tissue, , Figure 12-4(a)
Page 15 :
The Anatomy of the Heart, The Heart Wall, and Cardiac, Muscle Tissue, , Figure 12-4(b)
Page 16 :
The Anatomy of the Heart, The Heart Wall and Cardiac Muscle Tissue, , Figure 12-4(c)
Page 17 :
The Anatomy of the Heart, The Heart Wall, and Cardiac, Muscle Tissue, , Figure 12-4(d)
Page 18 :
The Anatomy of the Heart, Cardiac Muscle Cells, •, •, •, •, •, , Shorter than skeletal muscle fibers, Have single nucleus, Have striations (sarcomere organization), Depend on aerobic metabolism, Connected by intercalated discs, • Desmosomes transmit tension, • Gap junctions transmit action potential, , Copyright © 2007 Pearson Education, Inc., publishing as Benjamin Cummings
Page 19 :
The Anatomy of the Heart, Internal Anatomy and Organization, • Interatrial septum, • Separates atria, , • Interventricular septum, • Separates ventricles, , • Atrioventricular valves, • Located between atrium and ventricle, • Ensure one-way flow from atrium to, ventricle, , Copyright © 2007 Pearson Education, Inc., publishing as Benjamin Cummings
Page 20 :
The Anatomy of the Heart, Blood Flow in the Heart, • Superior and inferior venae cavae, • Large veins carry systemic blood to right, atrium, , • 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 muscles, , Copyright © 2007 Pearson Education, Inc., publishing as Benjamin Cummings
Page 21 :
The Anatomy of the Heart, Blood Flow in the Heart (cont’d), • Right ventricle pumps blood through, pulmonary semilunar valve, • Enters pulmonary trunk, • Flows to lungs through right, left pulmonary, arteries 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 or, mitral), , • Left ventricle pumps blood to aorta, • Through aortic semilunar valve to systems, Copyright © 2007 Pearson Education, Inc., publishing as Benjamin Cummings
Page 22 :
The Anatomy of the Heart, The Sectional Anatomy of the Heart, , Figure 12-5
Page 23 :
The Anatomy of the Heart, Functional Anatomy of the Heart, • Left ventricular myocardium much, thicker than right, • Reflects functional difference in load, , • Valves ensure one-way flow of blood, • Prevent backward flow (regurgitation), , • Fibrous skeleton supports valves and, muscle cells, Copyright © 2007 Pearson Education, Inc., publishing as Benjamin Cummings
Page 24 :
The Anatomy of the Heart, The Valves of the Heart, , Figure 12-6(a)
Page 25 :
The Anatomy of the Heart, The Valves of the Heart, , PLAY, , The Heart: Anatomy, , Figure 12-6(b)
Page 26 :
The Anatomy of the Heart, Key Note, The heart has four chambers, the right, atrium and ventricle with the pulmonary, circuit and left atrium and ventricle with the, systemic circuit. The left ventricle’s greater, workload makes it more massive than the, right, but the two pump equal amounts of, blood. AV valves prevent backflow from, the ventricles into the atria, and semilunar, valves prevent backflow from the outflow, vessels into the ventricles., Copyright © 2007 Pearson Education, Inc., publishing as Benjamin Cummings
Page 27 :
The Anatomy of the Heart, The Blood Supply to the Heart, • Coronary circulation meets heavy demands, of myocardium for oxygen, nutrients, • Coronary arteries (right, left) branch from, aorta base, • Anastomoses (arterial interconnections), ensure constant blood supply, • Drainage is to right atrium, • Great, middle cardiac veins drain capillaries, • Empty into coronary sinus, , Copyright © 2007 Pearson Education, Inc., publishing as Benjamin Cummings
Page 28 :
The Anatomy of the Heart, The Coronary Circulation, , Figure 12-7(a)
Page 29 :
The Anatomy of the Heart, The Coronary Circulation, , Figure 12-7(b)
Page 30 :
The Heartbeat, Heartbeat Needs two Types of Cardiac, Cells, • Contractile cells, • Provide the pumping action, , • Cells of the conducting system, • Generate and spread the action, potential, , Copyright © 2007 Pearson Education, Inc., publishing as Benjamin Cummings
Page 31 :
The Heartbeat, Differences between Cardiac and, Skeletal Muscle Cells, • Cardiac action potential has long, plateau phase, • Cardiac muscle has long, slow twitch, • Cardiac muscle has long refractory, period, • Can’t be tetanized, , Copyright © 2007 Pearson Education, Inc., publishing as Benjamin Cummings
Page 32 :
1 Rapid, , 3 Repolarization, , 2 The Plateau, , Depolarization, Cause: Na+ entry, Duration: 3-5 msec, Ends with: Closure of, voltage-regulated, sodium channels, , Cause: Ca2+ entry, Duration: ~175 msec, Ends with: Closure of, calcium channels, , Cause: K+ loss, Duration: 75 msec, Ends with: Closure of, potassium channels, , +30, , 2, , 0, mV, , 1, 3, , Stimulus, Refractory period, –90, 0, , 100, 200, Time (msec), , Copyright © 2007 Pearson Education, Inc., publishing as Benjamin Cummings, , 300, Figure 12-8(a), 1 of 5
Page 33 :
1 Rapid, Depolarization, Cause: Na+ entry, Duration: 3-5 msec, Ends with: Closure of, voltage-regulated, sodium channels, , +30, 0, mV, , 1, , Stimulus, –90, 0, , 100, 200, Time (msec), , Copyright © 2007 Pearson Education, Inc., publishing as Benjamin Cummings, , 300, Figure 12-8(a), 2 of 5
Page 34 :
1 Rapid, 2 The Plateau, , Depolarization, Cause: Na+ entry, Duration: 3-5 msec, Ends with: Closure of, voltage-regulated, sodium channels, , Cause: Ca2+ entry, Duration: ~175 msec, Ends with: Closure of, calcium channels, , +30, , 2, , 0, mV, , 1, , Stimulus, –90, 0, , 100, 200, Time (msec), , Copyright © 2007 Pearson Education, Inc., publishing as Benjamin Cummings, , 300, Figure 12-8(a), 3 of 5
Page 35 :
1 Rapid, , 3 Repolarization, , 2 The Plateau, , Depolarization, Cause: Na+ entry, Duration: 3-5 msec, Ends with: Closure of, voltage-regulated, sodium channels, , Cause: Ca2+ entry, Duration: ~175 msec, Ends with: Closure of, calcium channels, , Cause: K+ loss, Duration: 75 msec, Ends with: Closure of, potassium channels, , +30, , 2, , 0, mV, , 1, 3, , Stimulus, –90, 0, , 100, 200, Time (msec), , Copyright © 2007 Pearson Education, Inc., publishing as Benjamin Cummings, , 300, Figure 12-8(a), 4 of 5
Page 36 :
1 Rapid, , 3 Repolarization, , 2 The Plateau, , Depolarization, Cause: Na+ entry, Duration: 3-5 msec, Ends with: Closure of, voltage-regulated, sodium channels, , Cause: Ca2+ entry, Duration: ~175 msec, Ends with: Closure of, calcium channels, , Cause: K+ loss, Duration: 75 msec, Ends with: Closure of, potassium channels, , +30, , 2, , 0, mV, , 1, 3, , Stimulus, Refractory period, –90, 0, , 100, 200, Time (msec), , Copyright © 2007 Pearson Education, Inc., publishing as Benjamin Cummings, , 300, Figure 12-8(a), 5 of 5
Page 37 :
The Heartbeat, Action Potentials and, Muscle Cell, Contraction in Skeletal, and Cardiac Muscle, , Figure 12-8(b)
Page 38 :
The Heartbeat, The Conducting System, • Initiates and spreads electrical impulses, in heart, • Two types of cells, • Nodal cells, • Pacemaker cells, Reach threshold first, Set heart rate, • Conducting cells, • Distributes stimuli to myocardium, Copyright © 2007 Pearson Education, Inc., publishing as Benjamin Cummings
Page 39 :
The Heartbeat, The 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 ventricles, Copyright © 2007 Pearson Education, Inc., publishing as Benjamin Cummings
Page 40 :
The Heartbeat, The Conducting, System of the, Heart, , PLAY, , The Heart:, Conduction System, Figure 12-9(a)
Page 41 :
SA node activity and atrial, activation begin., , SA node, , Time = 0, , Stimulus spreads across the atrial, surfaces and reaches the AV node., , AV node, , Elapsed time = 50 msec, , There is a 100-msec delay at the, AV node. Atrial contraction begins. AV bundle, Bundle branches, Elapsed time = 150 msec, , The impulse travels along the interventricular, septum within the AV bundle and the bundle, branches to the Purkinje fibers., Elapsed time = 175 msec, , The impulse is distributed by Purkinje fibers, and relayed throughout the ventricular, myocardium. Atrial contraction is completed,, and ventricular contraction begins., Elapsed time = 225 msec, , Purkinje fibers, , Copyright © 2007 Pearson Education, Inc., publishing as Benjamin Cummings, , Figure 12-9(b), 1 of 6
Page 42 :
SA node activity and atrial, activation begin., , SA node, , Time = 0, , Copyright © 2007 Pearson Education, Inc., publishing as Benjamin Cummings, , Figure 12-9(b), 2 of 6
Page 43 :
SA node activity and atrial, activation begin., , SA node, , Time = 0, , Stimulus spreads across the atrial, surfaces and reaches the AV node., , AV node, , Elapsed time = 50 msec, , Copyright © 2007 Pearson Education, Inc., publishing as Benjamin Cummings, , Figure 12-9(b), 3 of 6
Page 44 :
SA node activity and atrial, activation begin., , SA node, , Time = 0, , Stimulus spreads across the atrial, surfaces and reaches the AV node., , AV node, , Elapsed time = 50 msec, , There is a 100-msec delay at the, AV node. Atrial contraction begins. AV bundle, Bundle branches, Elapsed time = 150 msec, , Copyright © 2007 Pearson Education, Inc., publishing as Benjamin Cummings, , Figure 12-9(b), 4 of 6
Page 45 :
SA node activity and atrial, activation begin., , SA node, , Time = 0, , Stimulus spreads across the atrial, surfaces and reaches the AV node., , AV node, , Elapsed time = 50 msec, , There is a 100-msec delay at the, AV node. Atrial contraction begins. AV bundle, Bundle branches, Elapsed time = 150 msec, , The impulse travels along the interventricular, septum within the AV bundle and the bundle, branches to the Purkinje fibers., Elapsed time = 175 msec, , Copyright © 2007 Pearson Education, Inc., publishing as Benjamin Cummings, , Figure 12-9(b), 5 of 6
Page 46 :
SA node activity and atrial, activation begin., , SA node, , Time = 0, , Stimulus spreads across the atrial, surfaces and reaches the AV node., , AV node, , Elapsed time = 50 msec, , There is a 100-msec delay at the, AV node. Atrial contraction begins. AV bundle, Bundle branches, Elapsed time = 150 msec, , The impulse travels along the interventricular, septum within the AV bundle and the bundle, branches to the Purkinje fibers., Elapsed time = 175 msec, , The impulse is distributed by Purkinje fibers, and relayed throughout the ventricular, myocardium. Atrial contraction is completed,, and ventricular contraction begins., Elapsed time = 225 msec, , Purkinje fibers, , Copyright © 2007 Pearson Education, Inc., publishing as Benjamin Cummings, , Figure 12-9(b), 6 of 6
Page 47 :
The Heartbeat, The Electrocardiogram (ECG or EKG), • A recording of the electrical activity of, the heart, • Three main components, • P wave, • Atrial depolarization, • QRS complex, • Ventricular depolarization, • T wave, • Ventricular repolarization, Copyright © 2007 Pearson Education, Inc., publishing as Benjamin Cummings
Page 48 :
The Heartbeat, An Electrocardiogram, , Figure 12-10
Page 49 :
The Heartbeat, Key Note, The heart rate is established by the SA, node, as modified by autonomic activity,, hormones, ions, etc. From there, the, stimulus is conducted through the atrium, to the AV node, the AV bundle, the, bundle branches, and Purkinje fibers to, the ventricular myocardium. The ECG, shows the electrical events associated, with the heartbeat., Copyright © 2007 Pearson Education, Inc., publishing as Benjamin Cummings
Page 50 :
The Heartbeat, The Cardiac Cycle, • Two phases in cardiac cycle, • Systole, • Contraction phase, • Both ventricles simultaneously, • Diastole, • Relaxation phase, , Copyright © 2007 Pearson Education, Inc., publishing as Benjamin Cummings
Page 51 :
(a) Atriole systole begins:, Atrial contraction forces, a small amount of additional, blood into relaxed ventricles., , START, , (f) Ventricular diastole—late:, All chambers are relaxed., Ventricles fill passively., , 800, msec, , 0, msec, , 100, msec, , Cardiac, cycle, , (e) Ventricular diastole—early:, As ventricles relax, pressure, in ventricles drops; blood, flows back against cusps of, semilunar valves and forces, them closed. Blood flows, into the relaxed atria., , 370, msec, , Copyright © 2007 Pearson Education, Inc., publishing as Benjamin Cummings, , (b) Atriole systole ends, atrial diastole begins, , (c) Ventricular systole—, first phase: Ventricular, contraction pushes AV, valves closed but does, not create enough pressure, to open semilunar valves., , (d) Ventricular systole—, second phase: As ventricular, pressure rises and exceeds, pressure in the arteries, the, semilunar valves open and, blood is ejected., , Figure 12-11, 1 of 6
Page 52 :
(a) Atriole systole begins:, Atrial contraction forces, a small amount of additional, blood into relaxed ventricles., , START, , 0, msec, , 100, msec, , Cardiac, cycle, , Copyright © 2007 Pearson Education, Inc., publishing as Benjamin Cummings, , Figure 12-11, 2 of 6
Page 53 :
(a) Atriole systole begins:, Atrial contraction forces, a small amount of additional, blood into relaxed ventricles., , START, , 0, msec, , Cardiac, cycle, , Copyright © 2007 Pearson Education, Inc., publishing as Benjamin Cummings, , 100, msec, , (b) Atriole systole ends, atrial diastole begins, , (c) Ventricular systole—, first phase: Ventricular, contraction pushes AV, valves closed but does, not create enough pressure, to open semilunar valves., , Figure 12-11, 3 of 6
Page 54 :
(a) Atriole systole begins:, Atrial contraction forces, a small amount of additional, blood into relaxed ventricles., , START, , 0, msec, , 100, msec, , Cardiac, cycle, , 370, msec, , Copyright © 2007 Pearson Education, Inc., publishing as Benjamin Cummings, , (b) Atriole systole ends, atrial diastole begins, , (c) Ventricular systole—, first phase: Ventricular, contraction pushes AV, valves closed but does, not create enough pressure, to open semilunar valves., , (d) Ventricular systole—, second phase: As ventricular, pressure rises and exceeds, pressure in the arteries, the, semilunar valves open and, blood is ejected., , Figure 12-11, 4 of 6
Page 55 :
(a) Atriole systole begins:, Atrial contraction forces, a small amount of additional, blood into relaxed ventricles., , START, , 0, msec, , 100, msec, , Cardiac, cycle, , (e) Ventricular diastole—early:, As ventricles relax, pressure, in ventricles drops; blood, flows back against cusps of, semilunar valves and forces, them closed. Blood flows, into the relaxed atria., , 370, msec, , Copyright © 2007 Pearson Education, Inc., publishing as Benjamin Cummings, , (b) Atriole systole ends, atrial diastole begins, , (c) Ventricular systole—, first phase: Ventricular, contraction pushes AV, valves closed but does, not create enough pressure, to open semilunar valves., , (d) Ventricular systole—, second phase: As ventricular, pressure rises and exceeds, pressure in the arteries, the, semilunar valves open and, blood is ejected., , Figure 12-11, 5 of 6
Page 56 :
(a) Atriole systole begins:, Atrial contraction forces, a small amount of additional, blood into relaxed ventricles., , START, , (f) Ventricular diastole—late:, All chambers are relaxed., Ventricles fill passively., , 800, msec, , 0, msec, , 100, msec, , Cardiac, cycle, , (e) Ventricular diastole—early:, As ventricles relax, pressure, in ventricles drops; blood, flows back against cusps of, semilunar valves and forces, them closed. Blood flows, into the relaxed atria., , 370, msec, , Copyright © 2007 Pearson Education, Inc., publishing as Benjamin Cummings, , (b) Atriole systole ends, atrial diastole begins, , (c) Ventricular systole—, first phase: Ventricular, contraction pushes AV, valves closed but does, not create enough pressure, to open semilunar valves., , (d) Ventricular systole—, second phase: As ventricular, pressure rises and exceeds, pressure in the arteries, the, semilunar valves open and, blood is ejected., , Figure 12-11, 6 of 6
Page 57 :
The Heartbeat, Heart 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 stethoscope, Copyright © 2007 Pearson Education, Inc., publishing as Benjamin Cummings
Page 58 :
Heart Dynamics, Some Essential Definitions, • Heart dynamics—Movements and, forces generated during cardiac, contraction, • Stroke volume—Amount of blood, pumped in a single beat, • Cardiac output—Amount of blood, pumped each minute, , Copyright © 2007 Pearson Education, Inc., publishing as Benjamin Cummings
Page 59 :
Heart Dynamics, Factors Controlling Cardiac Output, • Blood volume reflexes, • Autonomic innervation, • Heart rate effects, • Stroke volume effects, , • Hormones, , Copyright © 2007 Pearson Education, Inc., publishing as Benjamin Cummings
Page 60 :
Heart Dynamics, Blood 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 ventricles, Copyright © 2007 Pearson Education, Inc., publishing as Benjamin Cummings
Page 61 :
Heart Dynamics, Autonomic 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 volume, , Copyright © 2007 Pearson Education, Inc., publishing as Benjamin Cummings
Page 62 :
Heart Dynamics, Autonomic, Innervation of the, Heart, , Figure 12-12
Page 63 :
Heart Dynamics, Hormone Effects on Cardiac Output, • Adrenal medulla hormones, • Epinephrine, norepinephrine released, • Heart rate and stroke volume increased, , • Other hormones that increase output, • Thyroid hormones, • Glucagon, , Copyright © 2007 Pearson Education, Inc., publishing as Benjamin Cummings
Page 64 :
Heart Dynamics, CNS 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 sensors, Copyright © 2007 Pearson Education, Inc., publishing as Benjamin Cummings
Page 65 :
Heart Dynamics, Key Note, Cardiac output is the amount of blood, pumped by the left ventricle each minute., It is adjusted moment-to-moment by the, ANS, and by circulating hormones,, changes in blood volume and in venous, return. A healthy person can increase, cardiac output by three-fold to five-fold., , Copyright © 2007 Pearson Education, Inc., publishing as Benjamin Cummings
