3 CVS Heart

CARDIOVASCULAR SYSTEM
UNIT 3- THE HEART

1 NAB 3552 Human Anatomy B
V Nuuyoma
At the end of this session, students should be able to:
 Describe the heart under the following headings:

measurement, position, layers and relations,
chambers of the heart & exterior structures, blood
supply, venous drainage and nerve supply
 Discuss blood supply and venous drainage of the
heart
 List the components of the conducting system of
the heart
 Describe electrical control of the heart
2
INTRODUCTION: THE CARDIOVASCULAR
SYSTEM
 The cardiovascular system consists of:

 The heart
 Blood vessels
 Arteries
 Arterioles
 Capillaries and sinusoids
 Venules
 Veins
 The blood
3
THE CARDIOVASCULAR SYSTEM
4
THE HEART
5
THE HEART
 A hollow muscular organ
 It’s shaped like a blunt cone
 Slightly larger than a clenched fist
 It is about 12 cm long; 8 - 9 cm wide; and 6 cm

thick.
 Average weight:
 Males – 300 g average (range 230 – 340 g)
 Females – 250 g average
6
LOCATION OF THE HEART
7
ANATOMICAL LOCATION/POSITION OF THE
HEART
 Situated in the middle mediastinum in the

thorax (thoracic cavity).
 Lies between the two lungs and immediately
above the diaphragm
 Situated behind the sternum and adjoining
costal cartilages and left ribs
 Enclosed and held in place by the pericardium
8
COVERING LAYERS OF THE
HEART(PERICARDIUM)
 The heart is enclosed within a fibro-serous sac

called the pericardium.
 Pericardium forms the outer layer of the heart.
 Pericardium has 2 layers
 Outer fibrous layer – continuation of tunica

adventitia of great vessels
 Inner serous layer – is double layered, outer
parietal layer and an inner visceral layer or
epicardium
 The space between parietal and visceral layer is
called pericardial cavity 9
THE HEART WALL
Composed of 3 layers of tissue
Endocardium – an internal (inner) layer, is a thin
smooth glistering membrane. Made of single layered
endothelial cells. Continues with endothelium of blood
vessels.
Myocardium – a middle layer (composed of cardiac
muscle- involuntary muscles). Is the thickest layer and
forms the main mass of the heart. Responsible for
pumping action
Has muscle fibers which form contractile unit of the
heart. Some muscle fibers are modified into specialized
structure called pacemaker. Some muscle fibers form
the conduction system
Epicardium – an outer layer, is part of the 10

pericardium.
THE HEART WALL
11
CLINICAL APPLICATION
 Pericarditis
 Inflammation of the pericardium
 Myocarditis
 Inflammation of the myocardium
 Endocarditis
 Inflammation of the endocardium
12
FOUR CHAMBERS OF THE HEART
 The heart is divided into a right & left side by a
septum.
 The interior is divided into four cavities called
chambers
 2 atria – the receiving area (inflow)
 2 ventricles – the discharging chambers or

pumping out area (outflow)
13
INTERIOR OF THE HEART
14
BASE, APEX, SURFACES OF THE HEART
 The heart has:
 A base
 An apex
 Surfaces
 Sternocostal (anterior)
 Diaphragmatic (inferior)
 Pulmonary (left)
 4 borders
 Right, left, superior & inferior borders
 (study Ashalatha & Deepa (2015)

15
16
THE RIGHT ATRIUM (1)
✓ forms the right border of the heart

✓ Between the superior vena cava and inferior vena
cava
✓ Receives venous blood from vena cava veins and
coronary sinus.
 Structure
 Rt auricle – a small conical projection arising from
the left side of the right atrium
 The internal wall consist of:
➢ Sinus venarum – a smooth posterior part
➢ Musculi pectinati – a rough anterior part which
consist of muscular ridge. 17
THE RIGHT ATRIUM (2)
 Sulcus terminalis – a groove that separate the
sinus venarum and musculi pectinati externally
 Crista terminalis – a crest that separate the
sinus venarum and musculi pectinati internally
 Interatrial septum – separate the right atrium
from the left
 Fossa ovalis – an oval depression in the
interatrial septum. It’s a remnant of foramen
ovale, which closes at birth.
18
19
THE RIGHT VENTRICLE (1)
 Forms the largest part of the sternocostal surface, a

small part of diaphragmatic surface and almost the
entire inferior of the heart.
 Upper part is funnel shaped (conus arteriosus or
infundibulum), leading into the pulmonary trunk
 Receives deoxygenated blood from RA – pump to the
pulmonary trunk
20
THE RIGHT VENTRICLE (2)
 Structure
 Internally, it consist of numerous irregular

muscle bundles called papillary muscles.
 Chordae tendineae – fibrous threads that
arise from the apices of the papillary muscles
and are attached to the tricuspid valve
 Coronary sulcus – separates the right
atrium from right ventricle
 Interventricular sulcus is a groove that
separates Rt from Lt ventricle.
21
INTERIOR OF THE RIGHT VENTRICLE
22
THE LEFT ATRIUM
➢ Forms the base or posterior aspect of the heart
➢ Four pulmonary veins enter the posterior wall of
the left atrium.
➢ Externally – an appendage called left auricle
➢ Receives oxygenated from the lungs via
pulmonary veins
23
THE LEFT VENTRICLE
 It forms the apex of the heart and nearly all of its
left border, left surface and the diaphragmatic
surface.
 Twice thicker than the right ventricle
 The ascending aorta arises from the superior part

of left ventricle
 Receives blood from the LA – pump to the aorta.
24
THE VALVES OF THE HEART
 Atrioventricular (AV) valves
 Tricuspid valve (right)
 Bicuspid (mitral) valve (left)
 Semilunar (SL) valves

 Pulmonary semilunar valve (right)
 Aortic semilunar valve (left)
25
VALVES OF THE HEART
26
BLOOD FLOW THROUGH THE HEART
•Watch video
•https://youtu.be/7
XaftdE_h60
27
BLOOD FLOW THROUGH THE HEART (1)
28
COURSE OF BLOOD FLOW
 The heart pumps blood into anatomically
separate systems of blood vessels:
 The systemic circulation

 The pulmonary circulation
 The coronary circulation
29
THE SYSTEMIC CIRCULATION (1)
 Oxygenated blood is pumped by the heart (left

ventricle) into the aorta
 From aorta blood is distributed to different body
parts
 Arteries rebranched and form arterioles and
capillaries which take blood to tissues
 Capillaries have one layer of endothelial cells
 Oxygen, carbon dioxide nutrients and waste

products are exchanged in capillaries
30
THE SYSTEMIC CIRCULATION (2)
 Capillaries drain into venules

 Venules unite and form larger veins
 Superior vena cava drains venous blood from

upper part of the body
 Inferior vena cava drains venous blood from
lower part of the body
 Both veins carry deoxygenated blood to the right
atrium of the heart
 This completes systemic circulation
31
PULMONARY & SYSTEMIC CIRCULATION
32
SYSTEMIC CIRCULATION
33
SYSTEMIC CIRCULATION
34
PULMONARY CIRCULATION
 Deoxygenated blood flow from right atrium via
Atrioventricular opening
 Guarded by tricuspid valve into right ventricle
 Blood is pumped from right ventricle into

Pulmonary trunk to the lungs
 Exchange of oxygen and Carbon dioxide take
place in lungs capillaries
 Capillaries join and form venules and pulmonary
veins
35
PULMONARY CIRCULATION
 Four pulmonary veins two from each lung
carrying oxygenated blood
 Enter left atrium of the heart
 Then left ventricle via atrioventricular opening,

guarded by Bicuspid valve (mitral valve)
36
BLOOD SUPPLY OF THE HEART
 Also known as the coronary circulation
 Arterial supply
 Venous drainage
37
ARTERIAL SUPPLY OF HEART
 Left coronary artery
 Anterior interventricular branch
 Circumflex branch
 Right coronary artery

 Posterior interventricular branch
38
ARTERIAL BLOOD SUPPLY
39
VENOUS DRAINAGE OF THE HEART
 Veins of the heart
 Coronary sinus
 Receives the following tributaries:
 The great cardiac vein
 The middle cardiac vein
 The small cardiac vein
 The marginal vein
40
VENOUS DRAINAGE OF THE HEART
41
CONDUCTION SYSTEM OF THE HEART
 Consist of specialized cardiac cells
 They initiate impulses and conduct them rapidly
through the heart
 Coordinate contractions of the 4 chambers of the
heart
42
PARTS OF THE CONDUCTION SYSTEM OF
THE HEART
 The sinoatrial (SA node)

 Situated in the wall of the right atrium
 Natural pacemaker of the heart – it initiates

the impulses for contraction
 The atrioventricular (AV node)

 Located in the interatrial septum
 Impulses both atrium reach the AV node

through the intermodal fibers– conducts them
to the ventricles via the AV bundle
43
CONT….
 The AV bundle (bundle of His)
 Originates in the AV node
 It lies in the interventricular septum
 Right and left branches of AV bundle
 Many Purkinje fibers arise from each bundle
 Spread all over the ventricular myocardium
44
45
APPLIED ANATOMY
Atrial septal defect
 Foramen ovale does not close
 Oxygenated blood pass from left to right

atrium through this opening
 It overloads pulmonary system
 Causes enlargement of right atrium, right

ventricle and pulmonary trunk that
divides into right and left pulmonary
arteries.
46
CONT…..
Ischaemic Heart disease
• Inadequate blood supply to the heart,
result in retrosternal pain and
discomfort
Coronary Angiography
• Method to visualize arteries
Cardiac arrest
• Stoppage of the beating heart
47
CONT……
Angina Pectoris
• Clinical syndrome
• Characterised by sub -sternal discomfort
resulting from myocardial Ischemia
Myocardial Infarction
• sudden occlusion of a major artery
branch
48
REFERENCES
 Ashalatha, PR & Deepa, G. 2015. Text of
Anatomy & Physiology for nurses. Juta: Cape
Town
 Meiring, JH et al. 1993. Anatomy for the medical
scientific student. Van Schaik: Pretoria
 Totora, G.J. & Anagnostakos, N.P. Principles of
Anatomy and Physiology
49

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CARDIOVASCULAR SYSTEM

UNIT 3- THE HEART

 Describe the heart under the following headings:

 The cardiovascular system consists of:

 Capillaries and sinusoids

 Slightly larger than a clenched fist

 It is about 12 cm long; 8 - 9 cm wide; and 6 cm

 Females – 250 g average

 Situated in the middle mediastinum in the

 The heart is enclosed within a fibro-serous sac

 Pericardium has 2 layers

 Outer fibrous layer – continuation of tunica

Epicardium – an outer layer, is part of the 10

 2 ventricles – the discharging chambers or

 Right, left, superior & inferior borders

 (study Ashalatha & Deepa (2015)

✓ forms the right border of the heart

 Forms the largest part of the sternocostal surface, a

 Internally, it consist of numerous irregular

 The ascending aorta arises from the superior part

 Bicuspid (mitral) valve (left)

 Semilunar (SL) valves

 Aortic semilunar valve (left)

 The systemic circulation

 The coronary circulation

 Oxygenated blood is pumped by the heart (left

 Oxygen, carbon dioxide nutrients and waste

 Capillaries drain into venules

 Superior vena cava drains venous blood from

 Blood is pumped from right ventricle into

 Then left ventricle via atrioventricular opening,

 Right coronary artery

 Receives the following tributaries:

 The great cardiac vein

 The middle cardiac vein

 The small cardiac vein

 The marginal vein

 The sinoatrial (SA node)

 Natural pacemaker of the heart – it initiates

 The atrioventricular (AV node)

 Impulses both atrium reach the AV node

 It lies in the interventricular septum

 Right and left branches of AV bundle

 Many Purkinje fibers arise from each bundle

 Spread all over the ventricular myocardium

 Oxygenated blood pass from left to right

 Causes enlargement of right atrium, right

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