Cardiovascular System:! Pulmonary circuit:!! right ventricle!!! lungs!!!! left atrium! Systemic circuit:!! left ventricle!
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1 Cardiovascular System:! Heart (Chapter 20)! Lecture Materials! for! Amy Warenda Czura, Ph.D.! Suffolk County Community College! Primary Sources for figures and content:! Eastern Campus! Marieb, E. N. Human Anatomy & Physiology 6th ed. San Francisco: Pearson Benjamin Cummings, 2004.! Martini, F. H. Fundamentals of Anatomy & Physiology 6th ed. San Francisco: Pearson Benjamin Cummings, 2004.! Cardiovascular System:! Pulmonary circuit:!! right ventricle!!! lungs!!!! left atrium! Systemic circuit:!! left ventricle!!! body!!!!! right atrium! Arteries = away from heart! Veins = toward heart! Capillaries = exchange vessels in between! Heart! -left of midline, between 2nd rib and 5th!! intercostal space, posterior to sternum, in! pericardial cavity in mediastinum! -heart is fist sized, < 1 lb, beats 100,000!! times/day moving 8000 L blood/day! -surrounded by pericardium (serous and!! fibrous layers)! -serous membranes (visceral & parietal)!! secrete pericardial fluid, reduce friction! Pericarditis = inflammation of pericardium,!! usually due to infection, causes friction! Cardiac tamponade = buildup of fluid in!! pericardial space, restricts heart movement! Four Chambers:! 2 Atria:! -superior, thin walls,!! smooth posterior walls!!!! internally,!! pectinate muscles (ridges) anteriorly! -each has expandable flap called an auricle!! lateral and superior! -left and right separated by interatrial septum! Amy Warenda Czura, Ph.D. 1 SCCC BIO132 Chapter 20 Lecture Notes
2 Left ventricle 3X thicker,!! 5X more friction while!! pumping,!! same volume as right! Left is round,!! right is crescent! External divisions:! Coronary sulcus marks division between atria! and ventricles! 2 Ventricles:! -inferior, thick walls, lined with trabeculae!! carneae (muscular ridges)! -left and right separated by interventricular!! septum! Anterior interventricular sulcus and posterior! interventricular sulcus mark division!! between ventricles! Heart Wall Layers! 1. Epicardium (thin) -!! visceral pericardium: serous membrane!! with loose CT attached to myocardium! 2. Myocardium (thick) - cardiac muscle tissue! with CT, vessels and nerves! 3. Endocardium (thin) - simple squamous!! epithelium lining with basal lamina;!! continuous with endothelium of blood!! vessels! Cardiac Muscle Tissue! -muscle cells = cardiocytes! -uses actin and myosin sliding filaments to!! contract! -rich in mitochondria, resists fatigue but!! dependent on aerobic respiration! -cells connected by intercalated discs =!! desmosomes + gap junctions! -contraction is all or none! -longer contractile phase than skeletal muscle! -fibrous skeleton of the heart (tough CT) acts!! as the tendon! Amy Warenda Czura, Ph.D. 2 SCCC BIO132 Chapter 20 Lecture Notes
3 Heart Valves (one way, prevent backflow)! Atrioventricular valves -!! between atria and! ventricles!! (flaps = cusps)!! Tricuspid valve:!!!right side, 3 cusps!! Bicuspid/Mitral valve:!!!left side, 2 cusps! -cusps attached to chordae!! tendineae from!! papillary muscles on!! ventricle wall! -contraction of papillary!! muscles prevent!! cusps opening backward during!! ventricle contraction! -cusps hang loose when!! ventricles not contracting,!! allow ventricles to fill with!! blood! Semilunar valves - between ventricles and! arteries! -3 cusps! -no chordae tendineae!! or muscles! -forced open by blood!! from ventricular!! contraction! -snap closed to prevent!! backflow! Valvular heart disease - valve function!! deteriorates to extent that heart cannot!! maintain adequate circulation!! e.g. Rheumatic fever - childhood reaction! to streptococcal infection, chronic carditis,! VHD in adult! Heart murmur - leaky valve (audible to Dr.)!! Mitral valve prolapse - murmur of left AV!!valve, cusps don t close properly, blood!!regurgitates back into left atrium! Congestive heart failure - decreased pumping! efficiency (diseased valves, damaged!! muscle), blood backs up, fluid leaks from! vessels and collects in lungs and tissues! Blood Flow Through The Heart!! (on handout)! Fetal Heart (adapted to bypass lungs)! -Foramen ovale!! in right atrium,!! ~25% of blood bypasses!! directly the left atrium,!!!! closes at birth leaving scar!! called fossa ovalis.! - Ductus arteriosus connects!! pulmonary trunk!to aorta,!! ~90% of blood bypasses!! lungs,!! closes at birth leaving the!! ligamentum arteriosum! Failure of either to close = poor oxygenation! of blood, cyanosis, blue baby syndrome! Amy Warenda Czura, Ph.D. 3 SCCC BIO132 Chapter 20 Lecture Notes
4 Coronary circulation! -heart: <1% body mass, requires 5% of blood! -too thick for diffusion! -coronary arteries originate at base of!!! ascending aorta, branch to capillary beds!! for diffusion! -blood returns via cardiac veins that empty!! into right atrium! Coronary artery disease -partial or complete! block of coronary circulation, results in!! coronary ischemia! Can lead to myocardial infarction (heart!! attack): heart tissue denied oxygen dies.! Common symptom of CAD: angina pectoralis! pain in the chest, especially during activity,! as a result of the ischemia! Coronary bypass surgery - use healthy veins!! (from legs) to create anatomoses around!! blockages!! Most people have 4 major coronary!! arteries:!! quadruple bypass! Heart Beat! -1% myocardial cells autorhythmic:!!! depolarize without neural or endocrine!! stimulation! -depolarization transmitted to other!!! myocardial cells through cardiac!!! conduction system:!! Sinoatrial (SA) node -!!!right atrium wall!!!!!!near superior!!!vena cava!! Atrioventricular!!!(AV) node -!!!inferior portion of!!!interatrial septum above tricuspid valve!! Conducting cells: AV bundle, Bundle!!!branches, and Purkinje fibers: connect!!nodes and myocardium, run down!!!interventricular septum and around apex! -cells of nodes cannot maintain resting!! membrane potential, drift to depolarization:!!!sa node action potentials/min!!!!( natural pacemaker )!!!AV node action potentials/min! -Resting rate (sinus rhythm) ~75bpm set by!! SA node + parasympathetic stimulation! Amy Warenda Czura, Ph.D. 4 SCCC BIO132 Chapter 20 Lecture Notes
5 Heartbeat Chain of Events:!! Electrical Conduction and Contraction!! (on handout)! Electrocardiogram (EKG) (Kardio- German)! -recording of electrical events of heart! (on handout)! Normal average heart rate= ~ 70-80bpm!! max = ~230bpm, but inefficient above 180! Bradycardia = heart rate slower than normal!! <60! Tachycardia = heart rate faster than normal!! >100! (Fun fact?: Lifespan theory 800 million beats)! P-wave = depolarizationwave from SA node! through atria ~80ms! QRS complex = atrial repolarization and!! ventricle depolarization ~80ms! T-wave = ventricle repolarization ~160ms! EKG used to diagnose heart problems:! - P-R longer than 200ms = damage to AV!! node or conducting cells!! Total heart block = damaged AV node, no!!impulses transmitted through, atria and!!ventricles beat independently (atria fast,!!ventricles slow)! - Large QRS = enlarged heart! - Q-T longer than 380ms = coronary ischemia! or myocardial damage! -Cardiac arrhythmias = abnormal patterns of! cardiac activity! -Fibrillation = rapid, irregular, out of phase!! contractions due to activity in areas other! than SA node: defibrillation to stop all!! activity so SA node can resume control! Normal Sinus Rhythm! SA Node Not Functional, AV Node Only! (Note No P Waves, Rate: bpm)! Heart Block: some P waves not conducted through AV node! Ventricular fibrillation! Amy Warenda Czura, Ph.D. 5 SCCC BIO132 Chapter 20 Lecture Notes
6 Cardiac Cycle! -alternating contraction and relaxation! Systole = contraction, high pressure, blood!! gets pushed to next chamber! Diastole = relaxation, low pressure, chamber! fills with blood! (on handout)! "heart rate = #cycle time, #diastole time =!! # time to fill! Atrial contraction only adds ~30% more to!! ventricles (can live with bad atria)! Heart Sounds! lubb - S1: AV valves close at start of!! ventricular systole! dupp - S2: semilunar valves close at start of! ventricular diastole! Cardiac Output! CO = amount of blood pumped by each!! ventricle in one minute, depends on heart! rate and stroke volume: CO = HR X SV! SV = amount of blood pumped by ventricle! Usually SV constant, change HR to increase!! CO as needed.! HR affected by:!!!1. autonomic nervous input!!!!sympathetic = " HR!!!!parasympathetic = # HR!!!2. hormones!!!!!3. venous return!!!!more blood return = " HR (stretch!!!!receptors activate sympathetic)!!!4. other factors (ions, bpm CO at max:! "HR = #time to fill ventricles,!! if not full = #SV and #CO! Conditioning can "SV and #HR! Fit athletes can " max CO by 700%, & #!! resting HR by 50% with same CO due to!! "SV! Heart Rate Effectors:! 1. Autonomic Innervation! -SA node, AV node and atrial myocardium!! innervated by both sympathetic (NE) and! parasympathetic (Ach) nerve fibers!! equally.! -Sympathetic dominates in ventricles.! -Cardiac centers in medulla oblongata monitor! BP and gasses to adjust HR:! A. Cardioacceleratory center -sympathetic! B. Cardioinhibitory center -parasympathetic! -Parasympathetic tone reduce rate of SA node:!! 72-80bpm female!! 64-72bpm male!! 40bpm athletes! 2. Hormones! Epinephrine, Norepinephrine, Thyroxine --all! increase HR by acting at SA node! -Beta blockers- drugs to treat hypertension,!! block $-receptors for E / NE thus!!! preventing sympathetic stimulation! Amy Warenda Czura, Ph.D. 6 SCCC BIO132 Chapter 20 Lecture Notes
7 3. Other Heart Rate Effectors:! - Caffeine: rapid depolarization of SA node,!! increases HR! - Nicotine: stimulates sympathetic neurons,!! increases HR! - Hyperkalemia: high K +, inhibits!!! repolarization, beats weak, heart can stop! - Hypokalemia: low K +, hyperpolarization,!! cells less responsive, decrease HR! - Hypercalcemia: high Ca +, muscle cells!! excitable, increase HR, can cause!!! prolonged contraction, heart seizes! - Hypocalcemia: low Ca +, contractions weak,! heart can stop! -Temperature: affects metabolic rate of!! cardiocytes!!!high temp = "HR!!!low temp = #HR! Amy Warenda Czura, Ph.D. 7 SCCC BIO132 Chapter 20 Lecture Notes
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