1. Heart Anatomy Approximately the size of your fist Location
Superior surface of diaphragm
Left of the midline
Anterior to the vertebral column, posterior to the sternum

2. Heart Anatomy
Figure 18.1

3. Coverings of the Heart: Anatomy
Pericardium – a double-walled sac around the heart composed of:
A superficial fibrous pericardium
A deep two-layer serous pericardium
The parietal layer lines the internal surface of the fibrous pericardium
The visceral layer or epicardium lines the surface of the heart
They are separated by the fluid-filled pericardial cavity

5. Coverings of the Heart: Physiology
The pericardium:
Protects and anchors the heart
Prevents overfilling of the heart with blood
Allows for the heart to work in a relatively friction-free environment

6. Pericardial Layers of the Heart
Figure 18.2

7. Heart Wall Epicardium – visceral layer of the serous pericardium
Myocardium – cardiac muscle layer forming the bulk of the heart
Fibrous skeleton of the heart – crisscrossing, interlacing layer of connective tissue
Endocardium – endothelial layer of the inner myocardial surface

9. Cardiac Muscle Bundles
Figure 18.3

10. External Heart: Major Vessels of the Heart (Anterior View)
Vessels returning blood to the heart include:
Superior and inferior venae cava
Right and left pulmonary veins
Vessels conveying blood away from the heart:
Pulmonary trunk, which splits into right and left pulmonary arteries
Ascending aorta (three branches)

12. interventricular artery (in posterior interventricular sulcus)
(d)
Superior
vena cava
Right
pulmonary artery
pulmonary veins
Right atrium
Right coronary
artery (in coronary
sulcus)
Right ventricle
Coronary sinus
Middle cardiac vein
Left
Left atrium
Auricle
of left atrium
Left ventricle
Posterior vein
of left ventricle
Posterior
interventricular artery
(in posterior
interventricular sulcus)
Great cardiac vein
Apex
Inferior
Aorta
Figure 18.4d

13. Aorta Superior vena cava Left Right pulmonary artery pulmonary artery
Left atrium
Pulmonary trunk
Left
pulmonary veins
Right atrium
Right
pulmonary veins
Mitral
(bicuspid) valve
Fossa
ovalis
Aortic
valve
Pectinate
muscles
Pulmonary
valve
Tricuspid
valve
Left ventricle
Papillary
muscle
Right ventricle
Chordae
tendineae
Interventricular
septum
Myocardium
Trabeculae
carneae
Visceral
pericardium
Inferior
vena cava
Endocardium
(e)
Figure 18.4e

14. Atria of the Heart Atria are the receiving chambers of the heart
Each atrium has a protruding auricle
Pectinate muscles mark atrial walls
Blood enters right atria from superior and inferior venae cavae and coronary sinus
Blood enters left atria from pulmonary veins

15. Ventricles of the Heart
Ventricles are the discharging chambers of the heart
Papillary muscles and trabeculae carneae muscles mark ventricular walls
Right ventricle pumps blood into the pulmonary trunk
Left ventricle pumps blood into the aorta

16. Right and Left Ventricles
Figure 18.6

17. Pathway of Blood Through the Heart and Lungs
Right atrium  tricuspid valve  right ventricle
Right ventricle  pulmonary semilunar valve  pulmonary arteries  lungs
Lungs  pulmonary veins  left atrium
Left atrium  bicuspid valve  left ventricle
Left ventricle  aortic semilunar valve  aorta
Aorta  systemic circulation

19.
Figure 18.5

20. Coronary Circulation
Coronary circulation is the functional blood supply to the heart muscle itself
Collateral routes ensure blood delivery to heart even if major vessels are occluded

21. Coronary Circulation: Arterial Supply
Figure 18.7a

22. Coronary Circulation: Venous Supply
Figure 18.7b

23. Heart Valves
Heart valves ensure unidirectional blood flow through the heart
Atrioventricular (AV) valves lie between the atria and the ventricles
AV valves prevent backflow into the atria when ventricles contract
Chordae tendineae anchor AV valves to papillary muscles

24. Heart Valves
Aortic semilunar valve lies between the left ventricle and the aorta
Pulmonary semilunar valve lies between the right ventricle and pulmonary trunk
Semilunar valves prevent backflow of blood into the ventricles

25. Heart Valves
Figure 18.8a, b

26. Heart Valves
Figure 18.8c, d

28. Atrioventricular Valve Function
Figure 18.9

29. Semilunar Valve Function
Figure 18.10

30. Microscopic Anatomy of Heart Muscle
Cardiac muscle is striated, short, fat, branched, and interconnected
The connective tissue endomysium acts as both tendon and insertion
Intercalated discs anchor cardiac cells together and allow free passage of ions
Heart muscle behaves as a functional syncytium

31. Microscopic Anatomy of Cardiac Muscle
Figure 18.11

32. Cardiac Muscle Contraction
Heart muscle:
Is stimulated by nerves and is self-excitable (automaticity)
Contracts as a unit
Cardiac muscle contraction is similar to skeletal muscle contraction

33. Heart Physiology: Intrinsic Conduction System
Autorhythmic cells:
Initiate action potentials
Have unstable resting potentials called pacemaker potentials
Use calcium influx (rather than sodium) for rising phase of the action potential

34. Pacemaker and Action Potentials of the Heart
Figure 18.13

35. Heart Physiology: Sequence of Excitation
Sinoatrial (SA) node generates impulses about 75 times/minute
Atrioventricular (AV) node delays the impulse approximately 0.1 second
Impulse passes from atria to ventricles via the atrioventricular bundle (bundle of His)

36. Heart Physiology: Sequence of Excitation
AV bundle splits into two pathways in the interventricular septum (bundle branches)
Bundle branches carry the impulse toward the apex of the heart
Purkinje fibers carry the impulse to the heart apex and ventricular walls

38. Cardiac Intrinsic Conduction
Figure 18.14a

39. Heart Excitation Related to ECG
SA node generates impulse;
atrial excitation begins
Impulse delayed
at AV node
Impulse passes to
heart apex; ventricular
excitation begins
Ventricular excitation
complete
SA node
AV node
Bundle
branches
Purkinje
fibers
Figure 18.17

40. Heart Excitation Related to ECG
SA node generates impulse;
atrial excitation begins
SA node
Figure 18.17

41. Heart Excitation Related to ECG
Impulse delayed
at AV node
AV node
Figure 18.17

42. Heart Excitation Related to ECG
Impulse passes to
heart apex; ventricular
excitation begins
Bundle
branches
Figure 18.17

43. Heart Excitation Related to ECG
Ventricular excitation
complete
Purkinje
fibers
Figure 18.17

44. Heart Excitation Related to ECG
SA node generates impulse;
atrial excitation begins
Impulse delayed
at AV node
Impulse passes to
heart apex; ventricular
excitation begins
Ventricular excitation
complete
SA node
AV node
Bundle
branches
Purkinje
fibers
Figure 18.17

45. Extrinsic Innervation of the Heart
Heart is stimulated by the sympathetic cardioacceleratory center
Heart is inhibited by the parasympathetic cardioinhibitory center
Figure 18.15

46. Electrocardiography
Electrical activity is recorded by electrocardiogram (ECG)
P wave corresponds to depolarization of SA node
QRS complex corresponds to ventricular depolarization (contracting)
T wave corresponds to ventricular repolarization (go back to normal state)
PLAY
InterActive Physiology ®:
Intrinsic Conduction System, pages 3–6

47. Heart Sounds
Figure 18.19

48. Electrocardiography
Figure 18.16

49. Heart Sounds
Heart sounds (lub-dup) are associated with closing of heart valves
First sound occurs as AV valves close and signifies beginning of systole
Second sound occurs when SL valves close at the beginning of ventricular diastole

50. Atrial fibrillation
Ventricular fibrillation
Ventricular tachycardia

51. Cardiac Cycle
Cardiac cycle refers to all events associated with blood flow through the heart
Systole – contraction of heart muscle
Diastole – relaxation of heart muscle

52. Phases of the Cardiac Cycle
Ventricular filling – mid-to-late diastole
Heart blood pressure is low as blood enters atria and flows into ventricles
AV valves are open, then atrial systole occurs

53. Phases of the Cardiac Cycle
Ventricular systole
Atria relax
Rising ventricular pressure results in closing of AV valves
Ventricular ejection phase opens semilunar valves

54. Phases of the Cardiac Cycle
Isovolumetric relaxation – early diastole
Ventricles relax
PLAY
InterActive Physiology ®: Cardiac Cycle, pages 3–18

55. Figure 18.20

56. Examples of Congenital Heart Defects
Figure 18.25

57. Age-Related Changes Affecting the Heart
Sclerosis and thickening of valve flaps
Decline in cardiac reserve
Fibrosis of cardiac muscle
Atherosclerosis