Things to Know:

- Pericardium (functions, layers: fibrous, serous, parietal, visceral(epicardium

), pericardial cavity/fluid)
- Myocardium
- Endocardium
- Vessels (superior and inferior venae cavae, right and left pulmonary veins(fro
m the lungs/poorly oxegenated)) towards the heart
- Vessels (pulmonary trunk/ R+L arteries, ascending aorta) away from the heart
- Vessels that supply/drain the heart (arteries-right & left coronary, veins)
-Atria: three recieving chambers of the heart
-Ventricles: discharging chambers of the heart
-Heart valves: ensure unidirectional blood flow throughout heart
-Atrioventricular valves prevent backflow into the atria when ventricles contrac
t
-Semilunar valves prevent backflow of blood into the ventricles
-Cardiac muscle (striated, short, fat, branced, and interconnected)
-Connective tissue: endomysium
-Intercalated discs anchor cardiac cells together and allow ion passage
***Know blood flow in & out (what it passes through)
right side: Blood enters the heart through two large veins, the inferior and sup
erior vena cava, emptying oxygen-poor blood from the body into the right atrium.
Blood flows from your right atrium into your right ventricle through the open tr
icuspid valve. When the ventricles are full, the tricuspid valve shuts.
This prevents blood from flowing backward into the atria while the ventricles co
ntract (squeeze).
Blood leaves the heart through the pulmonic valve, into the pulmonary artery and
to the lungs.
Entering heart: Venae Cavae---Right Atrium---Tricuspid valve---RIght Ventricle-
--Pulmonary Semilunar Valve---Pulmonary Artery---Lungs
left side: The pulmonary vein empties oxygen-rich blood, from the lungs into the
left atrium.
Blood flows from your left atrium into your left ventricle through the open mitr
al valve. When the ventricles are full, the mitral valve shuts.
This prevents blood from flowing backward into the atria while the ventricles co
ntract (squeeze).
Blood leaves the heart through the aortic valve, into the aorta and to the body.
Leaving heart: Lungs---Pulmonary Vein---Left Atrium---Biscupid Valve---Left Vent
ricle---Aortic Semilunar Valve---Aorta---Body (systemic circulation)
This pattern is repeated, causing blood to flow continuously to the heart, lungs
and body.
Pulmonary circuit: low pressure system (lungs & heart)
Systemic circuit: high pressure system (heart & body)
which veins/arteries etc. have high Oxygen or CO2
-Heart muscle is stimulated by nerves and is self-excitable, contracts as a unit
Conduction System
-Autorhythmic cells: initiate action potentials, have unstable resting potential
s (pacemaker potentials), use calcium influx instead of sodium
-Sequence of Excitation
Extrinsic Innervation
-Heart is stimulated by the sympathetic cardioacceleratory center
-Heart is inhibited by the parasympathetic cardioinhibitory center
Electrocardiography
Cardiac Cycle
Systole: contraction of heart muscle
-atria relax, AV close, SL open, ventricular ejection phase, blood is sent to bo
dy
Diastole: relaxation of heart muscle
-early diastole: ventricles relax, SL close
-late diastole: blood pressure is low, blood enters atria and ventricles, AV val
ves are open
Heart Sounds
-first sound (lub) occurs as AV (atrioventricular) valve closes and signified be
ginning of systole
-second sound (dub) occurs when SL(semilunar) valve closes at the beginning of v
entricular diastole
Cardiac Output- the amount of blood pumped by each ventricle in one minute (the
product of heart rate and stroke volume)
Heart Rate- # of heart beats per minute (60-70 beats per minute) beats/min
Stroke Volume- amount of blood pumped out by a ventricle with each beat mL/beat
Cardiac Reserve- difference between resting and maximal CO
CO=HRxSV cardiac output=heart rate x stroke volume
CO ml/min
ischemia- lack of blood flow
factors affecting stroke volume:
*preload- venous return, amount ventricles are stretched by contained blood
*contractility- cardiac cell contractile force
*afterload- back pressure exerted by blood in large arteries leaving the heart
frank-starling law of the heart=
the greater the volume of blood entering the heart during diastole (end-diastoli
c volume),
the greater the volume of blood ejected during systolic contraction (stroke volu
me) and vice-versa.

*know phases of the cardiac cycle, what is happening during each phase on an ecg
most important intrinsic factor: preload, or degree of stretch of cardiac muscle
s before contraction is critical factor controlling stroke volume
slow heartbeat and exercise increase venous return to the heart, increasing SV
most important extrinsic factor: contractility, because the increase comes from:
increased sympathetic stimuli (epinephrine, norepinephrine) certain hormones (gl
ucagon, thyroid hormones, thyroxine), Ca2+ and some drugs(+inotropes) (-inotrope
s inhibit contractility)
factors that decrease contractility- acidosis(lowers Ph-normal is 7.4), increase
d K+, calcium channel blockers
inotrope- increase or decrease contractility
chronotrope- increase or decrease heart rate
know where oxegenated vs. deoxegenated blood flows
tricuspid valve: between right atrium and ventricle
pulmonary valve: right ventricle and pulmonary artery
mitral valve: left atrium and left ventricle
aortic valve: left ventricle and aorta
"Your heart uses its four valves to ensure your blood flows only in one directio
n. Healthy valves open and close in coordination with the pumping action of your
heart's atria and ventricles.
Each valve has a set of flaps called leaflets or cusps. These seal or open the v
alves. This allows pumped blood to pass through the chambers and into your blood
vessels without backing up or flowing backward.
Oxygen-poor blood from the vena cavae fills your heart's right atrium. The atriu
m contracts (atrial systole). The tricuspid valve located between the right atri
um and ventricle opens for a short time and then shuts. This allows blood to ent
er into the right ventricle without flowing back into the right atrium.
When your heart's right ventricle fills with blood, it contracts (ventricular sy
stole). The pulmonary valve located between your right ventricle and pulmonary a
rtery opens and closes quickly.
This allows blood to enter into your pulmonary arteries without flowing back int
o the right ventricle. This is important because the right ventricle begins to r
efill with more blood through the tricuspid valve. Blood travels through the pul
monary arteries to your lungs to pick up oxygen.
Oxygen-rich blood returns from the lungs to your heart's left atrium through the
pulmonary veins. As your heart's left atrium fills with blood, it contracts. Th
is event also is called atrial systole.
The mitral valve located between the left atrium and left ventricle opens and cl
oses quickly. This allows blood to pass from the left atrium into the left ventr
icle without flowing backward.
As the left ventricle fills with blood, it contracts. This event also is called
ventricular systole. The aortic valve located between the left ventricle and aor
ta opens and closes quickly. This allows blood to flow into the aorta. The aorta
is the main artery that carries blood from your heart to the rest of your body.

The aortic valve closes quickly to prevent blood from flowing back into the left
ventricle, which is already filling up with new blood."
Causes of congestive heart failure:
coronary atherosclerosis
persistent high blood pressure
multiple myocardial infarcts
dilated cardiomyopathy (DCM)
lumen- an opening
Three major types of blood vessels: arteries, which carry blood away from the he
art
capillaries, which enable the exchange of water and chemicals between the blood
and tissues
veins, which carry blood from the capillaries back to the heart.
arteries and veins have same internal structure: 3 tunic layers
tunica intima, tunica media (largest), and tunica adventitia
capillaries are just a later of endothelium.
arterial vs. venous blood vessels (arterial- away, venous- towards)
lungs oxegenate the blood.
Blood pressure (BP) is the pressure exerted by circulating blood upon the walls
of blood vessels.
factors that influence BP:
-heart rate (rate of pumping) higher rate, higher pressure
-blood volume (amount of blood present in the body)
-resistance in blood vessels (higher resistance, higher pressure) size of arteri
es (vasoconstrictors vs. vasodilators)
-viscosity (thickness of fluid)
capillaries: smaller the ions, quicker the diffusion, higher the pressure gradie
nt, faster diffusion.
capillary hydrostatic pressure:
net filtration pressure:
osmotic pressure: force sucking fluid in (high concentration of solutes: hyperos
molar, less water, more concentrated, want to suck in water)
hypercapnea: high CO2 in blood, pH is going to be high
pre-capillary sphincters
how BP is regulated by the body:
Brain- produces neurotransmitters, like catecholamines, to increase HR and incre
ase contraction of blood vessels
Kidneys: produce renin when BP is low, angiotensin, causing vessels to tighten.
kidneys can also absorb salt or sodium from your urine, increasing amount of fl
uid in body & BP.
if too much fluid, kidneys will flush water and sodium out through urine to lowe
r fluid in body, lower BP.
low pH: acidotic
know pulmonary system vs. systemic system. which has lower pressure? where do th
ey lead? oxegenated blood?
know main arteries and veins of the body
arteries: away from the heart, almost always oxegenated blood (xcept pulmonary)
veins: towards the heart, de-oxegenated (xcept pulmonary)
KNOW:
ascending aorta (aortic arch)
right common carotid artery
brachiocephalic artery
right subclavian artery
vertebral artery
axillary artery
brachial artery
radial & ulnar arteries
KNOW: