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HEART

Ajeng Diantini
Heart
Function:
As a pump
Maintain constant circulation of blood throughout the
body
Its action consists of a series of events known as cardiac
cycle
During each heartbeat or cardiac cycle, the heart
contracts and then relaxes.
- period of contraction = systole
- period of relaxation = diastole
CARDIOVASCULAR SYSTEM


PULMONARY CIRCULATION AND SYSTEMIC CIRCULATION

Cardiac cycle
Normal : 60-80/minutes
Taking 74, each cycle lasts about 0.8 second and
consist of:
- atrial systole
- ventricular systole
- complete cardiac diastole: relaxation of the atria and
ventricles.


Stages of cardiac cycle
For convenience: the cycle starts when atria are filling
- Superior and inferior vena cava transport deoxygenated
blood into right atrium, at the same time:
- pulmonary veins convey oxygenated blood into the left
atrium.
- atrioventricular valves open, blood flows through to the
ventricles.
SA node triggers a wave of contraction that spreads over
the myocardium of both atria, emptying the atria and
completing ventricular filling (atrial systole 0.1 second)
Cardiac cycle
Wave of contraction reach AV node emit an
impulse which quickly spreads to the ventricular muscle
via the AV bundle, the bundle branches, and Purkinje
fibres.


both ventricles pumping the blood into the pulmonary
artery and aorta.
Pressure in ventricular contraction > pressure in aorta

AV valves close.
(ventricular systole 0.3 second)
Cardiac cycle
Complete cardiac diastole : atria and ventricles are
relaxed (0.4 seconds).
During this time, myocardium recovers until it is able to
contract again, and the atria refill in preparation for the
next cycle.




Heart sound
Lub dup
- Lub: is fairly loud and is due to the closure of the atrio -
ventricular valves (ventricular systole).

- dup: is softer, and is due to the closure of the aortic and
pulmonary valves ( atrial systole).

Electrical changes
Body fluids and tissues are good conductors of electricity
Electrical activity within the heart can be detected by attaching
electrodes to the surface of the body.
Apparatus used is an electrocardiograph and the tracing is an
electrocardiogram (ECG).
Normal tracing: five waves, named: P,Q,R,S,T
P= impulse from SA node, sweeps over the atria.
QRS complex= very rapid spread of the impulse from the
AV node through the AV bundle and
the Purkinje fibres and the electrical
activity of the ventricular muscle.
ECG originates from the SA node, and is known an sinus rhythm
(60-100 beats/minute).
Faster heart rate : tachycardia
Slower heart rate : bradycardia
By Examining pattern of waves, time interval between cycles,and parts
of cycles state of myocardium and cardiac conduction system.
CARDIAC OUTPUT

the amount of blood ejected from the heart.
Stroke volume : the amount expelled by each contraction of the
ventricles.

Cardiac output = stroke volume x heart rate


In healthy adults, at rest:
Stroke volume: 70 ml, if heart rate 72/min, CO is 5 L/min
Exercise : 25 L/min
Athletes : 35 L/min
This increase is called : cardiac reserve
Cardiac output

STROKE VOLUME

CARDIAC OUTPUT
Factors affecting stroke volume:
VEDV (ventricular end diastolic volume)= preload
VEDV > myocardial contraction >

Venous return: major determinant of CO
- position of the body
- skeletal muscle pump
- respiratory pump

Strength of myocardial contraction
- increased stimulation of the sympathetic nerves innervating the heart.
- hormon : adrenaline, noradrenaline, thyroxine

Blood volume, is kept constant by kidney.


Factors affecting heart rate:
Autonomic nerve stimulation
Circulating chemicals
Emotional states
Gender
Age
Body temperature
Baroreceptor reflex