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The Heart

I. Layers of the heart (have drawing page 820, new book)


A. outer-visceral pericardium (thin layer of epithelium)
B. middle-myocardium
C. inner-endocardium
D. In addition, there is a parietal paricardium. This is a sac that surrounds the heart.
II. Blood flow through heart and body
A. Superior/inferior Vena Cava
1. Blood is low in oxygen
B. From right atrium blood passes, through tricuspid valve
1. valves keep blood flowing in one direction, and prevents back flow
2. papillary muscles help support valve
C. To the right ventricle
D. Out past pulmonary semi-lunar valve
E. Into pulmonary arteries
F. To lungs (pick up O2, let off CO2)
G. From lungs enters pulmonary veins
H. Both sets of veins enter heart in left atrium
I. Through the bicuspid valve (mitral valve)
1. mitral valve most frequently replaced valve in the heart. Why?
J. To left ventricle
K. Exits ventricle through Aortic semi-lunar valve
L. To aorta
M. From the aorta to the major arteries, arterioles, capillaries, venules and the veins of
the body.
N. Back to the vena cavas
III. Cardiac Cycle
A. Atrial diastole
1. Both atria are relaxed and fill with blood
a) atrioventricular valves are open and the semi-lunar valves are closed
B. Atrial systole
1. atria contract forcing the blood into the ventricles
C. Ventricular diastole
1. ventricles are relaxed and filling with blood
D. Ventricular systole
1. ventricles are contracting
2. blood is being forced into the aorta and pulmonary arteries
3. the semi-lunar valves are open and the atrioventricular valves are closed
IV. Regulation of Heart Rate
A. Cardiac Output (CO)
1. the amount of blood the heart pumps in 1 minute
2. CO=stroke volume (SV) x heart rate (HR) example 70 mL of blood/beat x 70
beats/min. = 4900 mL/min.
B. Starling's Law of the Heart
1. the longer the filling time, the greater the force of the contraction therefore the
greater the stroke volume (this is why athletes have lower resting heart rates)
V. Control Centers for Heart Rate (found in the medulla)
A. 2 centers
1. cardioacceleratory center
a) has a sympathetic nerve that connects to the SA node of the heart
b) cardioaccelerator nerve
2. cardioinhibitory center
a) has a parasympathetic nerve that connects to the SA node of the heart
(Vagus nerve)

VI. Factors effecting heart rate


A. Blood Pressure (BP)
1. As blood pressure in the arteries goes up, what should happen to heart rate?
B. Chemical Factors
1. Carbon dioxide (increases HR), adrenaline (epinephrine) (increases HR), Calcium
(increases HR) Na+ and K+ (decrease)
C. Other factors
1. sex (females are higher than males), age (older the slower), aerobic exercise:
acutely raises but lowers resting HR, and temperature (what do you think?)
VII. Cardiovascular Disease (CVD)
A. U.S. 1 million deaths/year
B. Coronary heart disease (56%)
1. Causes by a slow build up of fatty plaque (atherosclerosis) along the walls of the
coronary blood vessels which reduces blood flow to heart causing the death of
heart tissue
2. diagnosis
a) outward symptoms of a heart attack: pain in chest and left arm, cyanosis
of lips, nausea, dizziness, shortness of breath and cold sweat
b) Exercise ECG
c) Angiogram: insert catheter in artery of pelvis and work it into aorta, they
then inject dye and take an X-ray of the heart, the dye will show where
blockage occurs in the blood vessels
3. Treatment
a) bypass surgery: remove a vein from the leg and use it to bypass a
blockage in heart vessel (to do this you stop heart and put patient on a
heart lung machine)
b) angioplasty: insertion of a catheter containing a balloon, through the
artery, blow up balloon and vessel stretches and plaque are pressed
against artery wall.
C. Stroke 20%
1. the interruption of blood flow to the brain
2. causes: clot, atherosclerosis (no outward symptoms) or aneurysm (broken
artery)
VIII. Risk Factors: age, sex, genetics, diets high in fat (hyperlipidemia), high blood pressure,
smoking, stress, alcohol (intake), obesity, inactivity
IX. Benefits of Exercise
A. Normalizes BP
B. Promotes bradycardia
1. heart pumps more blood per beat
2. more efficient
C. Increases the number of RBC's
D. Increased caloric output
E. Decreases LDL's and increased HDL's
1. HDL's high density lipoproteins contain more protein than fat and HDL's are
able to remove LDL's from blood stream
2. LDL's low density lipoproteins higher proportions of fat and tend to accumulate
along the walls of the arteries of the body, and heart in cerebral arteries.