BL OO D FL OW IN T HE HE AR T DURI NG A CARDIA C CY CLE AND THE

HEART SOU ND S
Cardiac cycle refers to all the events which occur during one heart beat i.e. its contraction and
relaxation. The successive stages are as follows :

(i) Atrial Systole : As SA node is stimulated a wave of contraction spreads through atria and the
blood is forced into ventricles as bicuspid and tricuspid valves are open.
(ii) Ventricular systole : A wave of contraction spreads through both ventricles stimulated by AV
node contraction of ventricles result in closure of biscuspid and tricuspid valves producing first
heart sound, lubb. (It lasts for 0.16-0.90 sec) Due to contraction of ventricles blood flows into
pulmonary artery from right ventricle & dorsal aorta from left-ventricle.
(iii) Ventricular diastole : As ventricles relax both semilunar valves close resulting in second heart
sound, dupp (it lasts for only 0.10 second). Pressure within ventricles keeps decreasing when
this pressure decreases below the atrial pressure both bicuspid & tricuspid valve open and blood
flows again into ventricles.
(iv) Joint Diastole : Before the atrial systole again starts, a time comes when both atria and
ventricles are in a relaxed state. At this state blood flows into atria from superior and inferior
vena cava and from atria to ventricles also. But semilunar valve remain closed. So blood does not
flow into the aortic arch and pulmonary aorta.
 Heart Beat
The rhythmic contraction and relaxation of the cardiac chamber is known as heart beat.
The beat of a heart may originate in one of the two ways. Neurogenically or myogenically.
RE GU LATIO N OF HEA RT B EAT
Heart beat is at a fixed rate due to inherent property of the fibres of SA node but it can also be
controlled by nervous & hormonal mechanisms. Centre of heart beat regulation is medulla
oblongata.
(i) Nervous regulation
Sympathetic nervous system having accelerator nerves increases the heart beat by secreting
adrenaline hormone.
Parasympathetic nervous system supplying with vagus nerves decreases the heart beat by secreting
acetylcholine (Ach).
(ii) Hormonal Regulation
Thyroxine : Secreted by thyroid gland increases heart beat indirectly by increasing basal metabolic
rate which requires more oxygen.
Epinephrine and nor-epinephrine secreted by adrenal medulla, also have a role in regulation.
Epinephrine increases heart beat in emergency.
Nor-epinephrine increases heart beat under normal condition.
COUR SE OF CIR CULA TIO N OF BL OOD
Physiology of blood circulation was first described by Sir William Harvey.
Human heart is completely divided into four chambers due to which there is no inter-mixing of
oxygenated and deoxygenated blood.
Blood that returns from various parts of the body is collected in the right auricle. It passes into
right ventricle from where it pumped into pulmonary aorta. Which takes the blood to lungs for
oxygenation.
Oxygenated blood returns to left auricle through pulmonary veins and is carried to left ventricle
which distributes it to different body parts through dorsal aorta.
So to complete one circulation blood goes twice through the heart and this type of circulation is
called double circulation.
Circulation of blood from heart to lungs and back into heart is called pulmonary circulation. while
circulation to and from body parts is called systemic circulation.
It can be schematically represented as follows :
COR ONAR Y CIR CULA TI ON
Coronary circulation is accomplished by the coronary arteries.
Coronary arteries arise from a branch of the aorta.
The coronary veins formed on the myocardium ultimately pour into the superior vena cava, that
reaches the blood to the right auricle.
PORT AL CIR CULA TI ON
It is constituted by a portal vein and the system of capillaries to which the portal vein supplies blood.
Hepatic portal vein returns blood from the intestine and breaks into a second system of capillaries in
the liver.
Hypophyseal portal vein arising from hypothalamus breaks into a second system of capillaries in the
anterior pituitary.
HEART SOU ND S
Heart sound are of two types which occurs due to the closure of cuspid valves and semilunar valves
& are respectively called “lubb” & ‘dupp’.
Heart sounds give valuable information about working of valves. So any damage of these valves
(either bicuspid/tricuspid or semilunar valves) effects the quality of sound. This is called heart
murmur.
Heart murmurs are caused by turbulent blood flow through a narrowed valve or by changes in the
direction of the blood flow.
Heart beat/heart sound are measured or listened by means of instrument called stethoscope.

BL OO D PRE SS UR E
It is the arterial pressure of blood exerted on the wall of arteries with each heart beat. It is measured
from the brachial artery in the elbow pit.
 The blood pressure can be measured by sphygmomanometer.
It has first measured by S. Hales.
Blood pressure is expressed as.
Normal B.P. has high systolic value & low diastolic value i.e. 120 mm Hg/80 mm Hg in arteries.
B.P. In arterioles = 85/60 mm Hg.
In capillaries = 30/10 mm Hg
in vein = 10/0 mm Hg
Hypertension : means high blood pressure. It has systolic value more than 140 mm Hg and diastolic
more than 90 mm Hg.
Hypotension : means low blood pressure with systolic below 110 mm Hg and diastolic below
70 mm Hg.
CARDI AC OU TP UT
The amount of blood flowing from the heart (i.e. from the left ventricle into aorta) over a given
period of time is known as cardiac output.
Cardiac output = stroke volume (the volume of blood pumped by heart/heart beat) ×
Heart rate (ventricular systole/min)
70 ml × 72 /min = 5040 ml/min.
= about 5 litre/min.
PACEM AK ER
SA node controls the heart beat & hence, it is the natural pace maker of the heart.
An artificial pacemaker is an electronic device, which regularly sends a small amount of electrical
charge for maintaining the rhythmicity of the heart.
It is implanted subcutaneously in the upper thoracic region which has connection with the heart.
In patients having the symptoms of ventricular escape (stokes - Adams syndrome), in which the
atrial impulse suddenly fails to be transmitted to the ventricle, which may last for few seconds to few
hours even, the artificial pacemaker is connected to the right ventricle for controlling its rhythm.
The pacemaker consists of pulse generator containing cell, to produce electricals impulse, that lead
in the form of wire and an electrode connected to the portion of the heart when impulse is to be
transmitted.
PUL SE
It is wave of distension felt in the arteries with each heart beat. It is counted from radial artery of
wrist. Normal pulse rate ranges 70-90 per minute. 72/min in man & 80/min in women.
Pulse rate in children is more rapid than adult.
It is more rapid in female then in the male.
When any strong emotion is experienced the pulse rate is increased for e.g. anger, excitement etc.
Exercise increases the rate of pulse.
HEART RATE
It is pulse per minute
Heart rate increased by
Increase in blood pressure in the vena cava.
Increase in blood CO2 concentration.
Decrease in blood pH
Increase in body temperature (core temperature)
Increase in hormone adrenaline.
Decrease in hormone thyroxin (increase in BMR)
Increase in the nervous input from pain receptors.
Heart rate decreased by
Increase in blood pressure in aorta and large arteries.
Decrease in blood CO2 concentration.
Increase in blood pH.
Decrease in body temperature (core temperature).
Decrease in adrenaline.
Increase in thyroxine.