Podcast
Questions and Answers
Which of the following accurately describes the function of the cardiovascular system?
Which of the following accurately describes the function of the cardiovascular system?
- To facilitate gas exchange in the lungs and transport oxygen to tissues.
- To pump oxygenated blood into systemic circulation and deoxygenated blood into pulmonary circulation. (correct)
- To regulate hormone production and facilitate communication between different organs.
- To filter waste products from the blood and maintain fluid balance.
Which of the following is a key difference between the systemic and pulmonary circulations?
Which of the following is a key difference between the systemic and pulmonary circulations?
- The systemic circulation delivers blood to the lungs, while the pulmonary circulation delivers blood to the rest of the body.
- The systemic circulation is a closed loop, while the pulmonary circulation is an open system.
- The systemic circulation carries deoxygenated blood, while the pulmonary circulation carries oxygenated blood.
- The systemic circulation involves the left side of the heart, while the pulmonary circulation involves the right side. (correct)
If a patient's heart is located more towards the right side of their midline than normal, which condition might they have?
If a patient's heart is located more towards the right side of their midline than normal, which condition might they have?
- Left ventricular hypertrophy
- Dextrocardia (correct)
- Atrial septal defect
- Mitral stenosis
What is the functional significance of the left ventricle having a thicker myocardial wall compared to the right ventricle?
What is the functional significance of the left ventricle having a thicker myocardial wall compared to the right ventricle?
Which chambers of the heart receive blood from the venae cavae and pulmonary veins, respectively?
Which chambers of the heart receive blood from the venae cavae and pulmonary veins, respectively?
What would be the immediate consequence of damage to the chordae tendineae?
What would be the immediate consequence of damage to the chordae tendineae?
Which of the following sequences correctly describes the layers of the pericardium, from the outermost to the innermost layer?
Which of the following sequences correctly describes the layers of the pericardium, from the outermost to the innermost layer?
Which layer of the heart wall is responsible for the heart's contractile function?
Which layer of the heart wall is responsible for the heart's contractile function?
Which vessel is NOT one of the three major branches arising directly from the ascending aorta?
Which vessel is NOT one of the three major branches arising directly from the ascending aorta?
After a blood clot forms in the left circumflex artery, which region of the heart is most likely to experience ischemia first?
After a blood clot forms in the left circumflex artery, which region of the heart is most likely to experience ischemia first?
During ventricular contraction, which of the following coronary arteries primarily receives blood flow?
During ventricular contraction, which of the following coronary arteries primarily receives blood flow?
What is the primary consequence of myocardial ischemia on cardiac muscle contraction?
What is the primary consequence of myocardial ischemia on cardiac muscle contraction?
What is the functional significance of cardiac muscle being 'self-excitable' or displaying 'automaticity'?
What is the functional significance of cardiac muscle being 'self-excitable' or displaying 'automaticity'?
Which of the following represents the correct sequence of the heart's electrical conduction system?
Which of the following represents the correct sequence of the heart's electrical conduction system?
What is the key function of the atrioventricular (AV) node in the cardiac conduction system?
What is the key function of the atrioventricular (AV) node in the cardiac conduction system?
In the cardiac conduction system, what role do the Purkinje fibers play?
In the cardiac conduction system, what role do the Purkinje fibers play?
In a healthy heart, what is the effect of parasympathetic stimulation on the SA node?
In a healthy heart, what is the effect of parasympathetic stimulation on the SA node?
What does the P wave in an electrocardiogram (ECG) represent?
What does the P wave in an electrocardiogram (ECG) represent?
What does the QRS complex in an ECG primarily indicate?
What does the QRS complex in an ECG primarily indicate?
What cardiac event does the T wave in an ECG represent?
What cardiac event does the T wave in an ECG represent?
What does the ST segment of an ECG represent?
What does the ST segment of an ECG represent?
Which of the following best describes the normal sequence of events in the spread of a cardiac impulse?
Which of the following best describes the normal sequence of events in the spread of a cardiac impulse?
What is indicated by a prolonged Q-T interval on an ECG?
What is indicated by a prolonged Q-T interval on an ECG?
Under normal conditions, what range of heart rate would be considered normal sinus rhythm?
Under normal conditions, what range of heart rate would be considered normal sinus rhythm?
In the context of ECG interpretation, what does the term 'sinus arrhythmia' refer to?
In the context of ECG interpretation, what does the term 'sinus arrhythmia' refer to?
What ECG finding is most indicative of ST elevation myocardial infarction (STEMI)?
What ECG finding is most indicative of ST elevation myocardial infarction (STEMI)?
Which of the following is true about a cardiac muscle?
Which of the following is true about a cardiac muscle?
The heart is composed of how many chambers?
The heart is composed of how many chambers?
Which ventricle pumps deoxygenated blood into the pulmonary artery?
Which ventricle pumps deoxygenated blood into the pulmonary artery?
Which ventricle pumps oxygenated blood into the aorta?
Which ventricle pumps oxygenated blood into the aorta?
Atria are the __________ chambers of the heart.
Atria are the __________ chambers of the heart.
Ventricles are the __________ chambers of the heart.
Ventricles are the __________ chambers of the heart.
Electrical conduction system of the heart is regulated by...
Electrical conduction system of the heart is regulated by...
When interpreting the ECG , what are you interpreting?
When interpreting the ECG , what are you interpreting?
If a patient has a slight irregularity in heart rhythm that is still initiated by the SA node, what is this typically classified as?
If a patient has a slight irregularity in heart rhythm that is still initiated by the SA node, what is this typically classified as?
The heart can be regulated externally by what?
The heart can be regulated externally by what?
The heart can be inhibited by what?
The heart can be inhibited by what?
The heart can be stimulated by what?
The heart can be stimulated by what?
Select the correct description of what The electrocardiogram (ECG) is.
Select the correct description of what The electrocardiogram (ECG) is.
A patient is diagnosed with a heart condition causing a decrease in the elasticity of the arterial walls. How would this most directly impact the systemic circulation?
A patient is diagnosed with a heart condition causing a decrease in the elasticity of the arterial walls. How would this most directly impact the systemic circulation?
If a thrombus (blood clot) formed in the anterior cardiac vein, which area of the heart would be most immediately affected due to impaired drainage?
If a thrombus (blood clot) formed in the anterior cardiac vein, which area of the heart would be most immediately affected due to impaired drainage?
A doctor observes that a patient's atrioventricular node is only able to transmit action potentials at half its normal rate. What effect would this have on the ECG?
A doctor observes that a patient's atrioventricular node is only able to transmit action potentials at half its normal rate. What effect would this have on the ECG?
During a period of intense exercise, the sympathetic nervous system's influence on the heart would result in which of the following changes to the cardiac cycle?
During a period of intense exercise, the sympathetic nervous system's influence on the heart would result in which of the following changes to the cardiac cycle?
If a patient's ECG shows a heart rate of 110 beats per minute with normal P waves, QRS complexes, and T waves, but the R-R intervals are noticeably irregular, which condition is most likely?
If a patient's ECG shows a heart rate of 110 beats per minute with normal P waves, QRS complexes, and T waves, but the R-R intervals are noticeably irregular, which condition is most likely?
The ______ system can be anatomically subdivided into the heart and the blood vessels.
The ______ system can be anatomically subdivided into the heart and the blood vessels.
The heart's main function is to pump oxygenated blood into systemic circulation and deoxygenated blood into ______ circulation.
The heart's main function is to pump oxygenated blood into systemic circulation and deoxygenated blood into ______ circulation.
The ______ circulation involves vessels carrying blood between the heart and the lungs, where the blood is oxygenated.
The ______ circulation involves vessels carrying blood between the heart and the lungs, where the blood is oxygenated.
______ circulation involves vessels carrying blood between the heart and other body systems, delivering oxygen and nutrients.
______ circulation involves vessels carrying blood between the heart and other body systems, delivering oxygen and nutrients.
The heart is located anterior to the vertebral column and ______ to the sternum.
The heart is located anterior to the vertebral column and ______ to the sternum.
The heart is composed of ______ chambers: two atria and two ventricles.
The heart is composed of ______ chambers: two atria and two ventricles.
The ______ ventricular wall is thicker than that of the right ventricle because it needs to pump blood into the systemic circulation.
The ______ ventricular wall is thicker than that of the right ventricle because it needs to pump blood into the systemic circulation.
______ are the receiving chambers of the heart.
______ are the receiving chambers of the heart.
______ are the discharging chambers of the heart.
______ are the discharging chambers of the heart.
Blood enters the right atrium from the superior and inferior ______.
Blood enters the right atrium from the superior and inferior ______.
Blood enters the left atrium from the ______ veins.
Blood enters the left atrium from the ______ veins.
The right ventricle pumps deoxygenated blood into the ______ artery.
The right ventricle pumps deoxygenated blood into the ______ artery.
The left ventricle pumps oxygenated blood into the ______.
The left ventricle pumps oxygenated blood into the ______.
The ______ is a double-walled sac around the heart, composed of a fibrous pericardium and a serous pericardium.
The ______ is a double-walled sac around the heart, composed of a fibrous pericardium and a serous pericardium.
The ______ is the cardiac muscle layer forming the bulk of the heart.
The ______ is the cardiac muscle layer forming the bulk of the heart.
The ______ is the endothelial layer of the inner myocardial surface.
The ______ is the endothelial layer of the inner myocardial surface.
The ______ is the visceral layer of the serous pericardium.
The ______ is the visceral layer of the serous pericardium.
The superior and inferior ______ return blood to the heart.
The superior and inferior ______ return blood to the heart.
The ascending aorta branches into the brachiocephalic artery, left common carotid, and left ______ arteries.
The ascending aorta branches into the brachiocephalic artery, left common carotid, and left ______ arteries.
The right and left ______ veins return blood to the heart from the lungs.
The right and left ______ veins return blood to the heart from the lungs.
The heart's arteries include the right and left ______ arteries, which supply blood to the heart muscle itself.
The heart's arteries include the right and left ______ arteries, which supply blood to the heart muscle itself.
The great ______ vein, along with the small and anterior cardiac veins, helps drain blood from the heart.
The great ______ vein, along with the small and anterior cardiac veins, helps drain blood from the heart.
______ veins run alongside the coronary arteries and collect deoxygenated blood.
______ veins run alongside the coronary arteries and collect deoxygenated blood.
Interruption of blood flow for only a few seconds damages the ______.
Interruption of blood flow for only a few seconds damages the ______.
Heart muscle is stimulated by nerves and is ______ (automaticity).
Heart muscle is stimulated by nerves and is ______ (automaticity).
______ cells differentiate from other cardiomyocytes to have this specialist function in the heart.
______ cells differentiate from other cardiomyocytes to have this specialist function in the heart.
The cardiac action potential includes rapid depolarization due to Na+ inflow, a plateau due to Ca2+ inflow and K+ outflow, and ______ due to closure of Ca2+ channels and K+ outflow.
The cardiac action potential includes rapid depolarization due to Na+ inflow, a plateau due to Ca2+ inflow and K+ outflow, and ______ due to closure of Ca2+ channels and K+ outflow.
The heart has a natural pacemaker from where action potentials originate: the ______ node, also known as the natural pacemaker.
The heart has a natural pacemaker from where action potentials originate: the ______ node, also known as the natural pacemaker.
The action potential is delayed at the ______ node, allowing the atria to be excited before the ventricles.
The action potential is delayed at the ______ node, allowing the atria to be excited before the ventricles.
The sympathetic cardioacceleratory center ______ the heart rate by increasing SA node firing.
The sympathetic cardioacceleratory center ______ the heart rate by increasing SA node firing.
The parasympathetic cardioinhibitory center ______ the heart rate by decreasing SA node firing.
The parasympathetic cardioinhibitory center ______ the heart rate by decreasing SA node firing.
The ______ is a body surface recording of the overall cardiac electrical activity with time.
The ______ is a body surface recording of the overall cardiac electrical activity with time.
In an ECG reading, each ______ complex is preceded by a P wave if the heart is in normal sinus rhythm.
In an ECG reading, each ______ complex is preceded by a P wave if the heart is in normal sinus rhythm.
In an ECG reading, a regular ______ interval is indicative of normal sinus rhythm.
In an ECG reading, a regular ______ interval is indicative of normal sinus rhythm.
The impulse originates at the sino-atrial node and invades the ______, triggering atrial depolarization detectable on ECG.
The impulse originates at the sino-atrial node and invades the ______, triggering atrial depolarization detectable on ECG.
The impulse is delayed at the atrio-______ node (AVN) before spreading down the bundle of His.
The impulse is delayed at the atrio-______ node (AVN) before spreading down the bundle of His.
Atrial ______ generates a P wave on the ECG.
Atrial ______ generates a P wave on the ECG.
Ventricles ______ generates a QRS complex on the ECG.
Ventricles ______ generates a QRS complex on the ECG.
Ventricles uniformly depolarised generate a ______ segment on the ECG.
Ventricles uniformly depolarised generate a ______ segment on the ECG.
Ventricles repolarise, generating a ______ wave on the ECG.
Ventricles repolarise, generating a ______ wave on the ECG.
The heart's main function is to pump oxygenated blood into ______ circulation (to all body organs) and deoxygenated blood into pulmonary circulation (to the lungs).
The heart's main function is to pump oxygenated blood into ______ circulation (to all body organs) and deoxygenated blood into pulmonary circulation (to the lungs).
Blood enters the right atrium from the superior and inferior ______, and it enters the left atrium from pulmonary veins.
Blood enters the right atrium from the superior and inferior ______, and it enters the left atrium from pulmonary veins.
The heart is composed of four chambers: two atria, the left (LA) and right (RA), and two ventricles, the left (LV) and right ______.
The heart is composed of four chambers: two atria, the left (LA) and right (RA), and two ventricles, the left (LV) and right ______.
The ______ are present to aid unidirectional flow of blood.
The ______ are present to aid unidirectional flow of blood.
On an ECG, atrial depolarisation generates a ______ wave.
On an ECG, atrial depolarisation generates a ______ wave.
Flashcards
Circulatory System Arrangement
Circulatory System Arrangement
The arrangement of the circulatory system which includes systemic and pulmonary circuits.
Anatomy of the Heart
Anatomy of the Heart
The heart is an organ that pumps blood throughout the body.
Blood Flow and Cardiac Valves
Blood Flow and Cardiac Valves
The flow of blood through the heart and the function of the heart valves.
Different Blood Vessels
Different Blood Vessels
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Coronary Circulation
Coronary Circulation
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Electrical Conduction System
Electrical Conduction System
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ECG
ECG
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Cardiovascular System
Cardiovascular System
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Heart's Main Function
Heart's Main Function
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Blood Vessels' Role
Blood Vessels' Role
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Systemic Circulation
Systemic Circulation
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Pulmonary Circulation
Pulmonary Circulation
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Location of the Heart
Location of the Heart
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Heart Chambers
Heart Chambers
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Heart Valves
Heart Valves
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The Atria
The Atria
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The Ventricles
The Ventricles
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The Right Atrium
The Right Atrium
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The Right Ventricle
The Right Ventricle
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Left Atrium
Left Atrium
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Left Ventricle
Left Ventricle
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Pericardium
Pericardium
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Epicardium
Epicardium
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Myocardium
Myocardium
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Endocardium
Endocardium
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Vessels returning blood to the heart
Vessels returning blood to the heart
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Vessels conveying blood away from the heart
Vessels conveying blood away from the heart
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Arteries of the heart
Arteries of the heart
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Veins blood drainage
Veins blood drainage
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Blood flow through coronary arteries
Blood flow through coronary arteries
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Myocardial Intolerance
Myocardial Intolerance
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Cardiac Muscle
Cardiac Muscle
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AV Node Role
AV Node Role
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The Cardiac cycle
The Cardiac cycle
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Cardiac Conduction System Function
Cardiac Conduction System Function
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Electrical Action
Electrical Action
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Heart action potentials
Heart action potentials
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electrocardiogram (ECG)
electrocardiogram (ECG)
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Sinus Arrhythmias
Sinus Arrhythmias
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Myocardial Infarction
Myocardial Infarction
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Cardiac Impulse
Cardiac Impulse
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Ventricles
Ventricles
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P to R value
P to R value
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Normal QRS width
Normal QRS width
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Q-T interval is normal
Q-T interval is normal
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Blood Vessel Divisions
Blood Vessel Divisions
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Heart Weight
Heart Weight
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What are Atria?
What are Atria?
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What are Ventricles?
What are Ventricles?
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What is Pericardium?
What is Pericardium?
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External Heart Arteries
External Heart Arteries
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Right Heart Arteries
Right Heart Arteries
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Myocardial Ischemia
Myocardial Ischemia
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Refractory Period
Refractory Period
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Sinoatrial Node
Sinoatrial Node
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Cardiac Conduction
Cardiac Conduction
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The Heart Pacemaker
The Heart Pacemaker
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What rhythm on ECG
What rhythm on ECG
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What do the rhythm do?
What do the rhythm do?
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Impulse Origination
Impulse Origination
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Ventricular Action
Ventricular Action
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Study Notes
Cardiac Physiology: Anatomy of the Circulatory System and Heart
- The lectures are assessed via practical report and final examination (MCQ).
- There are practicals and lecture bites.
- Reading includes Tortora & Derrickson Ch 20, The Cardiovascular System: The Heart.
Learning Objectives
- The arrangement of the circulatory system: systemic and pulmonary circulations
- The anatomy of the heart
- Description of blood flow through the heart and cardiac valves
- The structure and function of different blood vessel types
- Coronary circulation
- Electrical conduction system of the heart
- ECG
The Circulatory System
- The cardiovascular system subdivides into the heart and the blood vessels
- The main function of the heart is to pump oxygenated blood into systemic circulation (to all body organs) and deoxygenated blood into pulmonary circulation (to the lungs).
- Blood vessels are the distribution system, divided into arterial and venous.
- The arterial system carries oxygenated blood.
- The venous system carries deoxygenated blood.
Systemic vs. Pulmonary Circulation
- Systemic circulation involves arterial and venous systems
- Blood from the left ventricle circulates around the body and back to the heart through the right ventricle
- The circuit carries blood between the heart and other body systems
- Pulmonary circulation involves blood pumped from the right ventricle into the pulmonary artery to the lungs and gets oxygenated.
- It is a closed loop of vessels carrying blood between heart and lungs.
Anatomy of the Heart
- The heart is approximately the size of a fist and located in the superior surface of diaphragm and left of the midline.
- It is anterior to the vertebral column and posterior to the sternum.
Heart Chambers
- The heart normally weighs about 300g in an adult and is composed of 4 chambers
- The two atria are left (LA) and right (RA)
- The two ventricles are left (LV) and right (RV)
- The left ventricular wall (myocardium) is thicker and more muscular than that of the right ventricle.
- Heart valves aid the unidirectional flow of blood.
Atria of the Heart
- The atria are the receiving chambers of the heart
- Blood enters the right atrium from the superior and inferior venae cavae
- Blood enters the left atrium from pulmonary veins.
Ventricles of the Heart
- Ventricles are the discharging chambers of the heart
- The right ventricle pumps deoxygenated blood into the pulmonary artery.
- The left ventricle pumps oxygenated blood into the aorta.
Coverings of the Heart: Anatomy
- The pericardium is a double-walled sac around the heart:
- A superficial fibrous pericardium
- A deep two-layer serous pericardium
- Parietal layer lines the internal surface of the fibrous pericardium
Heart Wall Layers
- Epicardium is a visceral layer of the serous pericardium.
- Myocardium is a cardiac muscle layer forming the bulk of the heart.
- Endocardium is an endothelial layer of the inner myocardial surface.
External Heart: Major Vessels (Anterior View)
- Vessels returning blood to the heart:
- Superior and inferior venae cavae
- Right and left pulmonary veins
- Vessels conveying blood away from the heart:
- Pulmonary trunk splits into right and left pulmonary arteries
- Ascending aorta which branches into brachiocephalic, left common carotid and subclavian arteries
External Heart: Major Vessels (Posterior View)
- Vessels returning blood to the heart:
- Right and left pulmonary veins
- Superior and inferior venae cavae
- Vessels conveying blood away from the heart:
- Aorta
- Right and left pulmonary arteries
External Heart: Vessels Supply/Drain the Heart (Anterior View)
- Arteries:
- Right and left coronary (in atrioventricular groove), marginal, circumflex, and anterior interventricular arteries
- Veins:
- Small cardiac, anterior cardiac, and great cardiac veins
External Heart: Vessels Supply/Drain the Heart (Posterior View)
- Arteries
- Right coronary artery (in atrioventricular groove) and the posterior interventricular artery (in interventricular groove)
- Veins
- Great cardiac vein, posterior vein to left ventricle, coronary sinus, and middle cardiac vein
Coronary Circulation
- Most of the blood flow through the coronary arteries occurs when the heart is relaxed.
- The contraction of the heart closes the arteries during this time.
Myocardial Ischemia
- The myocardium is intolerant to ischaemia.
- Interruption of blood flow for only a few seconds damages the myocardium
- Crushing pain/tightness with exertion
Cardiac Muscle Contraction
- The heart muscle is stimulated by nerves and is self-excitable (automaticity)
- It contracts as a unit with a long (250 ms) absolute refractory period
- The conduction system of the heart located in the right atrial wall acts as the heart's pacemaker
Cardiac Circulation (Anatomy)
- Pacemaker cells differentiate from other cardiomyocytes to have this specialist function.
Cardiac Action Potential
- The action potential includes phases of rapid depolarisation, plateau, and repolarization.
- Rapid depolarisation is due to Na+ inflow when voltage-gated fast Na+ channels open
- Plateau is maintained due to Ca2+ inflow when voltage-gated slow Ca2+ channels open
- Repolarization is due to closure of Ca2+ channels and K+ outflow when additional voltage-gated K+ channels open.
- Na+ channels open leading to rapid depolarisation
- Ca2+ and K+ channels open leading to maintained depolarisation.
- Ca2+ channels close and K+ channels open leading to repolarisation.
The Conduction System of the Heart and Action Potential (AP)
- The cardiac conduction system regulates the heart rate and rhythm
- The heart has a natural pacemaker where APs originate as the sinoatrial (SA) node, the natural pacemaker.
- AP propagates across the atria, depolarising and exciting the atrial myocardium.
- The AP reaches the atrioventricular (AV) node and the electrical connection between atria and ventricles.
- AP is delayed at the AV node, allowing the atria to be excited/contract before the ventricles
- The AP propagates rapidly down the bundle of His.
- The AP next propagates rapidly down the left and right bundle branches (of His).
- Purkinje fibers then rapidly disperse impulses throughout the myocardium leading to ventricular myocardium being depolarised at nearly the same time.
Autonomic Control: Extrinsic Innervation
- Usually, there are 75-80 AP generated per minute which can be regulated externally.
- The heart is stimulated by the sympathetic cardioacceleratory centre.
- The heart is inhibited by the parasympathetic cardioinhibitory centre.
- The nervous system cannot elicit cardiac action potentials; this only happens via the SA node
Recording the Cardiac Electrical Signal: ECG
- The electrocardiogram (ECG) records the overall cardiac electrical activity
- It is not a direct recording of actual electrical activity of heart
Key Aspects of ECG Reading
- Each QRS complex is preceded by a P wave and the RR interval.
Spread of Cardiac Impulse
- The impulse originates at the sino-atrial node and invades the atria to generate a 'P wave'
- The impulse is delayed at the atrio-ventricular node (AVN)
- Ventricles invaded by impulse and depolarised generating a QRS complex
- Ventricles are uniformly depolarised as ST segment
- Ventricles repolarise as T wave
ECG Intervals
- P-R interval = 0.12 - 0.20 sec
- QRS width = 0.08 - 0.12 sec
- Q-T interval = 0.35 - 0.43 sec
ECG Heart Rate Measurement
- R-R interval measures heart rate (HR).
- Measure the distance between the peaks of consecutive QRS complexes at a known recording speed.
- Heart rate = 1/R-R interval; normal range is 55-75 beats/minute.
ECG: Sinus Arrythmias
- Arrhythmia, Bradycardia and Tachycardia
ECG Reading
- ST depression OR ST elevation
Future work
- Cardiac output (Volume)
- Blood pressure
- Autonomic control of the heart (stress, exercise)
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