Lecture 5 (Heart)

Heart
Goals:
 You have basic knowledge about the anatomy of the heart
 You know how the blood flows through the heart
 You have basic knowledge of the conduction system of the heart and
the heart rate
-The heart is about 250 grams
Location of the heart: The heart is located in the chest cavity, specifically
in the thoracic cavity, between the lungs, slightly to the left of the center
of the chest. The heart sack is connected to the diaphragm.
Anatomy of the heart
-The heart is a hallow organ
Diastole & Systole of the heart:

 Diastole: This is the relaxation phase of the heart when it fills with
blood.
 Systole: This is the contraction phase of the heart when it pumps

blood out to the body.
The normal range for systolic blood pressure is typically considered to be

less than 120 millimeters of mercury (mm Hg). The normal range for
diastolic blood pressure is typically considered to be less than 80 mm Hg.
Atria & Ventricles:

 Atria (Atrium): The atria are the upper chambers of the heart. There
are two atria: the right atrium and the left atrium. Their main
function is to receive blood returning to the heart from the body
(right atrium) and the lungs (left atrium). When the atria contract,
they push this blood into the ventricles.
 Ventricles: The ventricles are the lower chambers of the heart,

consisting of the right ventricle and the left ventricle. Their primary
role is to pump blood out of the heart to the lungs (right ventricle)
and the rest of the body (left ventricle). The left ventricle, being
thicker and more muscular, is responsible for pumping oxygenated
blood to supply the body's organs and tissues.
Pulmonary and systemic circulation: Because it is a circulation, we can

start explaining the process from whichever point we want.
1. Blood enters to the lungs in order to bring away the carbon dioxide
and bring in the oxygen.
2. The oxygen rich blood flows further to the left atrium.
3. From the left atrium, blood flows to the left ventricle.
4. From the left ventricle it is pumped to the big artery (aorta)
5. The aorta sends the blood all the way up to the brain and down to
the lower body
6. After the blood finishes its travel through the body, being oxygen
poor, enters the right atrium.
7. From the right atrium, it flows to the right ventricle.
8. Finally, the blood from the right ventricle flows to the pulmonary
artery which then goes to the lung
9. Then the cycle repeats
Aorta: The aorta is the largest and main artery in the human body. It
originates from the left ventricle of the heart and serves as the major
channel for oxygenated blood to be pumped out of the heart and
distributed to the rest of the body.
Superior & Inferior Vena Cava:

 The superior vena cava is a large vein that carries deoxygenated
blood from the upper half of the body back to the right atrium of the
heart.
 The inferior vena cava is a major vein in the human body that carries
deoxygenated blood from the lower half of the body back to the
right atrium of the heart.
Pulmonary artery: The pulmonary artery is a major blood vessel in the

circulatory system that carries deoxygenated blood from the right
ventricle of the heart to the lungs.
How to tell the ventral and dorsal part of the heart: In the ventral part
of the heart, the inferior end is on the left side, while in the dorsal part,
the inferior end is on the right side.
Capillary: Capillaries are tiny, thin-walled blood vessels responsible for

facilitating the exchange of oxygen, nutrients, and waste products
between the blood and the body's tissues.
Arteries: Arteries are a type of blood vessel in the circulatory system

that carry blood away from the heart
Veins: Veins are a type of blood vessel in the circulatory system that
carry blood from the body's tissues and organs back to the heart.
Which ventricle ejects the biggest volume of blood? None
Stroke volume: Stroke volume refers to the amount of blood that the
heart's left ventricle ejects with each contraction or heartbeat. It
represents the volume of blood pumped out of the heart into the body's
circulatory system during one cardiac cycle. At rest it is 70ml.
Heart valves: Heart valves are specialized structures within the heart
that play a critical role in regulating the flow of blood through the four
chambers of the heart and into the major arteries. Two valves are
between the atria and ventricles (atrioventricular valves) and two valves
between the ventricles and arteries (semi-lunar valves).
Atrioventricular valves: The atrioventricular valves are between the

atria and ventricles and prevent blood from flowing back from the
ventricles to the atria. The left atrioventricular valve is called mitral or
bicuspid and the right is called tricuspid.
-Tricuspid valve in the right side of the heart - you always tri to do the
right thing.
Semi-lunar valves: The semi-lunar valves are between the ventricles and
arteries and prevent blood from flowing back from arteries to ventricles.
The left semi-lunar valve is called aortic valve and the right is called
pulmonary valve.
Electrical events in the heart
Even if we cut the nerves of the heart, the heart will still contract. The
reason behind this, are the pacemaker cells.
Pacemaker cells: Cells in the heart that spontaneously generate

impulses.
Physiology of the heart rate:

1. Sinoatrial (SA) Node: The heart's natural pacemaker, known as the
sinoatrial (SA) node, is located in the right atrium. It initiates each
heartbeat by generating electrical impulses. These impulses spread
across the atria, causing them to contract and push blood into the
ventricles.
2. Atrioventricular (AV) Node: The electrical impulses from the SA node

reach the atrioventricular (AV) node, located between the atria and
ventricles. The AV node acts as a delay, allowing the ventricles time to
fill with blood from the atria before contracting.
3. Atrioventricular (AV) bundle: The atrioventricular (AV) bundle, also

called the bundle of His, helps transmit electrical signals from the upper
chambers (atria) to the bundle branches.
4. Bundle branches: The bundle branches transmit signals from the

upper chambers (atria) to the lower chambers (ventricles).
5. Purkinje fibers: The purkinje fibers, rapidly transmit the electrical
signal down into the ventricles.
-The sinoatrial node generates on average 100 impulses/min.
-Your heart rate is determined by the sinoatrial node.
-Normal heart rate at rest 60-80 beats/min
Autonomous nervous sytem
-The nerves influence the heart beat (autonomic nervous system)
Autonomic nervous system response:

a. Sympathetic response: The sympathetic response is the body's
reaction to stress or perceived danger. It involves physiological changes
like increased heart rate.
b. Parasympathetic response: The parasympathetic response is the

body's way of promoting relaxation and normal bodily functions during
rest. It leads to effects like slower heart rate.
The heart wall is composed of three layers:

1. Epicardium (outer layer):
-The epicardium is the outermost layer of the heart wall.
-It is composed of a thin layer of connective tissue and a layer of
mesothelium (a type of epithelial tissue).
-The epicardium serves as a protective covering for the heart and
contains blood vessels, lymphatics, and nerves that supply the heart
muscle.
-It also contains a layer of fat, known as the epicardial adipose tissue,
which provides cushioning and insulation.
2. Myocardium (middle layer):

-The myocardium is the middle and thickest layer of the heart wall.
-It consists of specialized cardiac muscle cells (cardiomyocytes) that
contract rhythmically to pump blood.
-The thickness of the myocardium varies in different regions of the
heart. -It is thickest in the left ventricle, which pumps oxygenated blood
to the entire body.
-The contraction of the myocardium is responsible for the heart's
pumping action, generating the force needed to propel blood through
the circulatory system.
3. Endocardium (Inner layer):

-The endocardium is the innermost layer of the heart wall.
-It consists of a thin layer of endothelial cells that lines the chambers of
the heart and covers the heart valves.
-The smooth surface of the endocardium reduces friction as blood flows
through the heart and helps maintain proper blood flow.
-The endocardium is continuous with the inner lining of blood vessels,
ensuring a seamless transition as blood moves between the heart and
the circulatory system.
Coronary circulation: Coronary circulation is the circulation of blood

within the heart muscle itself, supplying oxygen and nutrients to the
cardiac muscle. This specialized circulation ensures that the heart has
the necessary oxygen and nutrients to function effectively. It involves
coronary arteries, veins, and the coronary sinus.
ECG (electrocardiogram): An ECG (electrocardiogram) is a test that

records the electrical activity of the heart. It's done by placing electrodes
on the skin to detect the heart's electrical signals.
P-top: The P-top on an ECG represents the electrical signal that makes
the atria (upper chambers of the heart) contract. It's the first bump on
the ECG and shows that the atria are squeezing to push blood into the
ventricles.
QRS Complex: The QRS complex is a big, spiky part of the ECG and
reflects the electrical signal traveling through the ventricles (lower
chambers of the heart). It means the ventricles are contracting to push
blood out to the body and lungs.
T-top: The T-wave is the last bump on the ECG. It indicates that the
ventricles are relaxing and getting ready for the next heartbeat.
The effects of exercise in cardiac function:

 Exercise increases your heart rate (number of heartbeats per
minute) and the amount of blood pumped with each heartbeat
(stroke volume). This raises cardiac output, which means your heart
pumps more blood to supply oxygen to your muscles during exercise.
 Your body redirects blood flow from non-essential areas (like the
digestive system) to working muscles and skin to cool down. This
redistribution helps you meet the demands of exercise.
 During exercise, systolic blood pressure (pressure when the heart
contracts) goes up to push more blood. Diastolic blood pressure
(pressure when the heart is at rest between beats) may remain
stable or slightly decrease due to widened blood vessels.

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Heart

-The heart is about 250 grams

Anatomy of the heart

-The heart is a hallow organ

Diastole & Systole of the heart:

 Systole: This is the contraction phase of the heart when it pumps

The normal range for systolic blood pressure is typically considered to be

Atria & Ventricles:

 Ventricles: The ventricles are the lower chambers of the heart,

Pulmonary and systemic circulation: Because it is a circulation, we can

Superior & Inferior Vena Cava:

Pulmonary artery: The pulmonary artery is a major blood vessel in the

Capillary: Capillaries are tiny, thin-walled blood vessels responsible for

Arteries: Arteries are a type of blood vessel in the circulatory system

Which ventricle ejects the biggest volume of blood? None

Atrioventricular valves: The atrioventricular valves are between the

Pacemaker cells: Cells in the heart that spontaneously generate

Physiology of the heart rate:

2. Atrioventricular (AV) Node: The electrical impulses from the SA node

3. Atrioventricular (AV) bundle: The atrioventricular (AV) bundle, also

4. Bundle branches: The bundle branches transmit signals from the

-The sinoatrial node generates on average 100 impulses/min.

-Your heart rate is determined by the sinoatrial node.

-Normal heart rate at rest 60-80 beats/min

Autonomous nervous sytem

-The nerves influence the heart beat (autonomic nervous system)

Autonomic nervous system response:

b. Parasympathetic response: The parasympathetic response is the

The heart wall is composed of three layers:

2. Myocardium (middle layer):

3. Endocardium (Inner layer):

Coronary circulation: Coronary circulation is the circulation of blood

ECG (electrocardiogram): An ECG (electrocardiogram) is a test that

The effects of exercise in cardiac function:

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