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By the end of this section, you will be able to:
  • Describe the location and position of the heart within the body cavity
  • Describe the internal and external anatomy of the heart
  • Identify the tissue layers of the heart
  • Relate the structure of the heart to its function as a pump
  • Compare systemic circulation to pulmonary circulation
  • Identify the veins and arteries of the coronary circulation system
  • Trace the pathway of oxygenated and deoxygenated blood thorough the chambers of the heart

The vital importance of the heart is obvious. If one assumes an average rate of contraction of 75 contractions per minute, a human heart would contract approximately 108,000 times in one day, more than 39 million times in one year, and nearly 3 billion times during a 75-year lifespan. Each of the major pumping chambers of the heart ejects approximately 70 mL blood per contraction in a resting adult. This would be equal to 5.25 liters of fluid per minute and approximately 14,000 liters per day. Over one year, that would equal 10,000,000 liters or 2.6 million gallons of blood sent through roughly 60,000 miles of vessels. In order to understand how that happens, it is necessary to understand the anatomy and physiology of the heart.

Location of the heart

The human heart is located within the thoracic cavity, medially between the lungs in the space known as the mediastinum. [link] shows the position of the heart within the thoracic cavity. Within the mediastinum, the heart is separated from the other mediastinal structures by a tough membrane known as the pericardium, or pericardial sac, and sits in its own space called the pericardial cavity    . The dorsal surface of the heart lies near the bodies of the vertebrae, and its anterior surface sits deep to the sternum and costal cartilages. The great veins, the superior and inferior venae cavae, and the great arteries, the aorta and pulmonary trunk, are attached to the superior surface of the heart, called the base. The base of the heart is located at the level of the third costal cartilage, as seen in [link] . The inferior tip of the heart, the apex, lies just to the left of the sternum between the junction of the fourth and fifth ribs near their articulation with the costal cartilages. The right side of the heart is deflected anteriorly, and the left side is deflected posteriorly. It is important to remember the position and orientation of the heart when placing a stethoscope on the chest of a patient and listening for heart sounds, and also when looking at images taken from a midsagittal perspective. The slight deviation of the apex to the left is reflected in a depression in the medial surface of the inferior lobe of the left lung, called the cardiac notch    .

Position of the heart in the thorax

This diagram shows the location of the heart in the thorax.
The heart is located within the thoracic cavity, medially between the lungs in the mediastinum. It is about the size of a fist, is broad at the top, and tapers toward the base.

Everyday connection

Cpr

The position of the heart in the torso between the vertebrae and sternum (see [link] for the position of the heart within the thorax) allows for individuals to apply an emergency technique known as cardiopulmonary resuscitation (CPR) if the heart of a patient should stop. By applying pressure with the flat portion of one hand on the sternum in the area between the line at T4 and T9 ( [link] ), it is possible to manually compress the blood within the heart enough to push some of the blood within it into the pulmonary and systemic circuits. This is particularly critical for the brain, as irreversible damage and death of neurons occur within minutes of loss of blood flow. Current standards call for compression of the chest at least 5 cm deep and at a rate of 100 compressions per minute, a rate equal to the beat in “Staying Alive,” recorded in 1977 by the Bee Gees. If you are unfamiliar with this song, a version is available on www.youtube.com. At this stage, the emphasis is on performing high-quality chest compressions, rather than providing artificial respiration. CPR is generally performed until the patient regains spontaneous contraction or is declared dead by an experienced healthcare professional.

When performed by untrained or overzealous individuals, CPR can result in broken ribs or a broken sternum, and can inflict additional severe damage on the patient. It is also possible, if the hands are placed too low on the sternum, to manually drive the xiphoid process into the liver, a consequence that may prove fatal for the patient. Proper training is essential. This proven life-sustaining technique is so valuable that virtually all medical personnel as well as concerned members of the public should be certified and routinely recertified in its application. CPR courses are offered at a variety of locations, including colleges, hospitals, the American Red Cross, and some commercial companies. They normally include practice of the compression technique on a mannequin.

Cpr technique

The top panel shows a schematic of a person performing CPR and demarcates the region in the chest where the compression must be performed. The bottom panel shows a photo of a person performing CPR on a dummy.
If the heart should stop, CPR can maintain the flow of blood until the heart resumes beating. By applying pressure to the sternum, the blood within the heart will be squeezed out of the heart and into the circulation. Proper positioning of the hands on the sternum to perform CPR would be between the lines at T4 and T9.

Questions & Answers

Rheumatoid arthritis affects
Jessica Reply
what is oedema
Nantumbwe Reply
i want abook about physiology including the vitamins
Belal
fluid retention in the body. (also spelt as edema) e.g. fluid retention in the lungs is called Pulmonary Edema). It can also happen as a result of Injury manifested as swelling.
Arif
can you give me an example of a tissue composed of few related types of cells
Theresa Reply
What is LMx1600
Mae Reply
the skeletal system includes all of the bones
All Reply
what is the bone not contain red bone marrow in medulla
Duha Reply
To know the part of human body
Sarah Reply
Anatomy refers to as structure of human body
Sarah
so is the macroscopic and microscopic the types of anatomy
Gloria Reply
is microscopic and macroscopic a type of anatomy
Gloria
yes
Maxine
yes
Yabsra
yes
Sarah
Please can someone explain three glands in endocrine system?
josh
.
Robin
can someone explain disease and the category
gege
type 2 is controled by diet
Chloe Reply
Diet and life style
Paias
Diet how? maybe eating food containing less sugar?
BTS
we must eat protein food to check our diet
Sarah
type 2 diabetes cannot be controlled by insulin so therefore your diet should be well balanced especially you shouldn't eat foods with high sugar level or stopping sugar at all so that the sugar content needed by your body will be provided by the balanced diet taken
Enada
what is hypotension
regina Reply
hypotension is when the blood pressure is less than 60/50
Mursal
hypo means low so it implies low blood pressure
Isaac
ok
Mursal
what is mild DKA
Mursal
mild diabetic ketoacidosis is when there is high level of sugar in the blood and the ketone bodies build up in the body ,is a type 1 which can lead to type 2
Isaac
what is the normal range for blood pressure?
BTS
120 over 80
Danielle
low blood pressure; opposite of high blood pressure which is hypertension
Regina
what if your a type 2 diabetic and you have no way to get meds due to no insurance what is some good over the counter medications to take?
Ashley
type 2 diabets is controlled by diet not meds.type 1 is contolled by insulin.
Chloe
type 1 diabets cant be controlled type 2 can be controlled.type 1 is worse than type 2 diabets.
Chloe
type 2 is purely a lifestyle disease, eat healthy, fresh, natural unprocessed real foods.
Danielle
sometime , we already eat diabetic diet than the results of blood sugar level not turn good , what is the reason ?
Muhammad
What is a "diabetic diet" though? Be specific. Juvenile diabetes and/or Type 1 diabetes is something that one can be born with, this needs medical diagnosis and intervention.
Danielle
what i mean by diabetic diet is we take fiber-rich food like vegetables,nut and also fish.
Muhammad
ok, no cause a doctor told me I needed metformin and my suger won't go under 300
Ashley
what is the difference between plasma and serum
Gloria Reply
Plasma contains fibrinogen while serum doesn't
Kateregga
plasma ----- fibrinogen = serum
Sneha
serum is blood plasma without fibrinogen or other clotting factors While blood plasma contains dissolved protein like fibrinogen,globulin, and albumin), glucose, clotting factors,mineral ions like Na2+,Cl-1,hormones and carbon dioxide
Prince
In what time stomach empty it's content in to doudemun? what is chyme?
Sneha Reply
write the chemical and mechanical digestion which occurs in stomach?
Sneha
Does absorption take place in stomach? what are absorption in the stomach by which cell?
Sneha
Chemical digestion---Mixtures of the food with the gastric acid Mechanical digestion--- churning of the food in the stomach making it become more involved into chyme
Mercy
absorption takes place in the small intestine because of the presence of the villi
Enada
name the muscles supplied redina nerve
Appu Reply
mechanism of hormone releasing by gland
said Reply
why is muscle tissue not considered to be a type of connective tissue?
Ezel Reply
A Skeletal muscles consist of numerous muscles cells called Muscle Fibers . Three layers of connective tissues surrounded these fibers to make the muscles tissues
Manisha
that's wny connective tissues is not considered as muscles fibers
Manisha
there are 4 types of tissues : epithelial, connective tissue, nervous tissue and muscle tissue, each one has its own properties. The main function of connective tissue is nutrition, it supplies nutrientes to epithelial tissues that are responsible for protection.
Ariete
Muscle tissue has properties that allow movement, the function here is movement and not nutrition like connective tissue.
Ariete
In what time stomach empty it's content in to doudemun?
Sneha
write the chemical and mechanical digestion which occurs in stomach?
Sneha
Does absorption take place in stomach? what are absorption in the stomach by which cell?
Sneha
Does absorption take place in stomach? what are the absorption in the stomach by which cell?
Sneha
mechanism of hormone controlling releasing by gland
said
please can someone explain renin angiotensin aldosteron system for me
okolie

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Source:  OpenStax, Anatomy & Physiology. OpenStax CNX. Feb 04, 2016 Download for free at http://legacy.cnx.org/content/col11496/1.8
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