FUNCTIONAL ANATOMY OF THE HEART

Average normal adult heart weighs about 250-300 gm in

.females and 300-350 gm in males

Normal wall-thickness of right ventricle is 0.3 to 0.5 and that

.of the left ventricle 1.3 to 1.5 cm

.Hypertrophy- is greater weight or ventricular thickness

.Dilatation- is the enlarged chamber size

.Cardiomegaly- is the increased weight or size of the heart

: Valves

Four cardiac valves respond passively to pressure and flow

.changes within the heart

Aortic and pulmonary valves are three in number and

.semilumar

Atrioventriclular valves are mitral (two) and tricuspid

(three) and are loose flaps connected to the ventricular wall
by a number of delicate chordae tendineae attached to
.papillary muscles

Function of the cardiac valves depends on the coordinated

actions of cusps, chordae tendineae, papillary muscles and
.ventricular walls

Heart muscle has the ability to increase its output many fold,
as demand requires and consists of cardiac myocytes having
.structural and functional subunits

.Cardiac myocyte consists of myofibrils

Amount of contraction of myofibrils is proportional to the

.(length of the myofibrils within limits (2 to 2.2 microns
Contraction power is diminished if the length is less than 2
.(or more than 2.2 microns (Starling law of Heart

:Conducting system

.This consists of specialized myocytes

The heartbeat originates in the sinoatrial node (pacemaker

of the heart), located at the junction of the right atrial
appendage with the opening of the superior vena cava and
passes to AV node, located at the junction of the medial wall
.of the right atrium with the interventricular septum

From AV node impulse passes through the common bundle

(bundle of His), which is divided into left and right bundle
branches and extends along interventricular septum to the
.apex of the ventricles

Apex of the ventricles is the region that is first stimulated to

.contract

The bundle of His is the only electrical connection between

.atria and the ventricles

:Blood supply

Blood is supplied to the heart by the right and left coronary

.arteries and their branches

Intramyocardial blood flow occurs during diastole, when the

pressure of the aortic root is high and the microcirculation is
.not compressed by the cardiac contraction

The epicardial (outside surface of heart) portion of each

artery fills and dilate during systole and narrows during
.diastole
The areas of heart supplied by the three coronary arteries
:are as follows

Left anterior descending branch supplies anterior wall of .1

left ventricle and adjacent area of anterior right ventricle
and anterior two-thirds of the interventricular septum
.((accept the apical region

Left circumflex branch supplies lateral wall of the left .2

.ventricle

Right coronary artery supplies remainder of the right .3

ventricle, posterior region of left ventricle and posterior
.third of the interventricular septum

Thus occlusion of the right as well as the left coronary artery

.and their major branches can cause left ventricular damage

Functionally the right and left coronary arteries behave as

end-arteries, although anatomically there are numerous
intercoronary anastomoses in most normal hearts (called
(collaterals

The Heart's Electrical System

Did you know that your heart has an electrical system? It's a bit
like the electrical wiring in your home. The heart's electrical system
creates the signals that tell your heart when to beat. And your
heartbeat is what pumps blood throughout your body. The heart's
electrical system is also called the cardiac conduction system.
You may know that the heart is a four-chambered muscle, about
the size of your fist. The two upper chambers are the right and left
atria, and the two lower — and larger — chambers are the right
and left ventricles

Parts of the Electrical System

Your heart's electrical system ../includes three important parts
• S-A node (sinoatrial node) — Known as the heart's natural pacemaker.
The S-A node initiates each heartbeat.
• A-V node (atrioventricular node) — The bridge between the atria and
ventricles. Electrical signals are passed from the atria down to the ventricles
through the A-V node.
• His-Purkinje system — Carries the electrical signals throughout the
ventricles. The His-Purkinje system consists of the following parts:
o His Bundle (the start of the system)
o Right bundle branch
o Left bundle branch
o Purkinje fibers (the end of the system)

The Path of an Electrical Signal

A system of electrical pathways in your heart
connects one part to another — the S-A node to the A-
V node, for instance. This movement of the signals
causes your heart to contract (or beat) and relax. The
number of electrical signals controls the speed of
your heartbeat. The more signals passing through the
heart, the faster the heartbeat.
Usually 60-100 signals per minute travel these
pathways. That means a heart rate of 60-100 beats per
minute. Your doctor or nurse may check your heart
rate by checking your pulse.
You can see the steps in the electrical system
pathway below. You can also play an animation that
shows the pathway in action

STEP 1. The S-A node (natural pacemaker)

creates an electrical signal.

STEP 2. The electrical signal follows natural

electrical pathways through both atria. The
movement of electricity causes the atria to
contract, which helps push blood into the
ventricles.

STEP 3. The electrical signal reaches the A-V

node (electrical bridge). There, the signal
pauses to give the ventricles time to fill with
blood.

STEP 4. The electrical signal spreads

through the His-Purkinje system. The
movement of electricity causes the ventricles
to contract and push blood out to your lungs
and body.

Note that the atria contract a fraction of a second

before the ventricles do. After your heart contracts, it
relaxes for a moment before the process begins
again.
When working right, your conduction system
automatically responds to your body's changing need
for oxygen:
• When you climb stairs, carry heavy
groceries, or take a walk, you need more oxygen;
therefore, your heart beats at a faster heart rate.
• When you are sitting or sleeping, you need
less oxygen; therefore, your heart beats at a
slower rate.
Your conduction system senses your need for oxygen
and responds with the proper heart rate.