Normal functional capacity of the heart:
   approx. 100,000 heartbeats/day
   approx. 2,760,000,000 heartbeats/lifetime
   approx. 4,000 gallons (15,000 liters) blood pumped/day
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I. Cardiac Anatomy:
    A. Located in mediastinum of thoracic cavity
    B. Pericardium -
      1. fibrous pericardium (dense irreg. ct)
      2. serous pericardium
            a. parietal layer
            b. visceral layer (aka epicardium)
                i. pericardial cavity
                ii. pericardial fluid
      3. pericarditis
    C. Heart wall -
      1. epicardium (aka visceral layer of serous pericardium)
      2. myocardium (cardiac muscle tissue)
            a. review cardiac muscle tissue from BIO 201…
                i. intercalated discs
                ii. gap junctions
                iii. desmosomes
      3. endocardium
            a. endothelium
                i. continuous with vascular endothelium

II. Internal Structures of the Heart :
    A. R & L Atria
      1. interatrial septum
            a. fossa ovalis
    B. R & L Ventricles
      1. Interventricular septum
    C. Atrioventricular valves (R & L AVs)
      1. tricuspid
      2. bicuspid (mitral)
      3. chordae tendinae
      4. papillary muscles
    D. Semilunar valves
      1. pulmonary semilunar
      2. aortic semilunar
   E. Disorders of valves
      1. rheumatic fever
      2. stenosis
 Check out some excellent Cardiovascular Pathology images from UofU

III. Major Blood Vessels of the Heart:
    A. Coronary vessels
      1. Left coronary artery
            a. ANterior interventricular branch
            b. Circumflex branch
            c. mneumonic = "LANCe"
      2. RIght coronary artery
            a. Posterior interventricular branch
            b. Marginal branch
            c. mneumonic = "RIPM"
      3. coronary sinus
            a. great cardiac vein
            b. middle cardiac vein
      4. Coronary artery disease.
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            a. atherosclerosis
                i. risk factors (8)
                ii. athersclerotic plaque
                iii. thrombus and embolism
                    aa. heparin (enhances antithrombin III)
                    bb. coumadin (warfarin) (blocks synth. of II, VII, IX X)
                iv. angioplasty
                v. coronary artery bypass grafting
            b. ischemia
            c. angina pectoris
            d. myocardial infarction (MI)
            e. anastomoses
    B. Superior & inferior vena cava
    C. Pulmonary trunk
      1. R & L pulmonary arteries
    D. Ascending aorta
      1. Brachiocephalic trunk
            a. right common carotid artery
            b. right subclavian artery
      2. left Common carotid artery
      3. left Subclavian artery
      4. mneumonic = "ABC'S"
      5. ligamentum arteriosum (ductus arteriosus)

IV. Blood Flow Through the Heart:
    A. starting from right atrium, identify all chambers, valves, and major blood vessels along the pathway to return back to the right atrium.
    B. compare/contrast fetal and adult blood flow

V. Electrical Conduction System of the Heart:
    A. Sinoatrial (SA) node
      1. location in right atrial myocardium
      2. major pacemaker function
      3. regulated by autonomic nervous system
    B. Atrioventricular (AV) node
      1. sole electrical connection between atria and ventricles
      2. 100 msec delay in conduction
      3. also regulated by autonomic nervous system
   C. AV bundle (bundle of His)
   D. Conduction fibers (Purkinje fibers)

VI. Electrocardiogram (ECG):
   A. Basic ECG waves
      1. P wave
      2. QRS complex
      3. T wave    
   B. ECG interpretation
      1. size and timing of waves
      2. know significance of enlarged waves
      3. significance of long PR interval
      4. significance of elevated & depressed ST segment
      5. arrhythmias
            a. AV block
            b. fibrillation

VII. Cardiac Cycle:
    A. Basic Terminology
      1. systole
      2. diastole
      3. normal sinus rhythm (60-100beats/min; avg=75)
      4. tachycardia (higher than normal HR)
      5. bradycardia (lower than normal HR)
   B. Phases of cardiac cycle
      1. relaxation phase
            a. T wave intiates
            b. occurs at end of heartbeat
            c. all chambers in diastole
            d. ventricular pressure falls below atrial pressure
            e. ventricles begin to fill…
      2. ventricular filling
            a. SA node fires (P wave begins)
            b. atrial systole follows
            c. end-diastolic volume (EDV) (~ 20-30ml) pushed into vents
      3. ventricular systole
            a. AV node sends impulse to conduction fibers (QRS waves)
            b. ventricular ejection (~ 70ml ejected ("stroke volume"))
            c. blood remaining in vents (ESV) (~60 ml)
    C. Stroke volume
      1. SV = EDV - ESV
      2. three major factors regulate SV
            a. preload ("stretch" on vents before contraction)
                i) Starling's law (rubber band notion)
            b. contractility ("force" of contraction)
            c. afterload (pressure in aorta & pulm. trunk)
    D. Cardiac output
      1. CO (ml/min) = SV(ml/beat) x HR(beat/min)
            a. total amount ejected from right or left ventricle in one minute
      2. cardiac reserve (CR) = ratio of CO_max : CO_rest
            a. average CR ~ 4-5
    E. Auscultation (listening to heart sounds)
      1. Lubb sound
            a. blood turbulence from closure of AVs
      2. Dubb sound
            b. blood turbulence from closure of semilunar valves

VIII. Regulation of Heart:
    A. Autonomic Innervation
      1. Medullary Cardiovascular Center (CV)
            a. cardioacceleratory center (sympathetic)
            b. cardioinhibitory center (parasympathetic)
                i. vagus nerve to SA and AV node
            c. action of norepinephrine & acetylcholine
                ii. beta adrenergic receptors on cardiac fibers
                    aa. use of "beta-blockers" to control hypertension
      2. Baroreceptors
            a. carotid sinus reflex
                i) maintains BP in brain
            b. aortic reflex
                ii) maintians BP for general body system
    B. Hormonal Regulation of Blood Pressure
      1. kidneys
            a. renin production
      2. hypothalamus
            a. ADH production
      3. adrenals
            a. aldosterone production

This is only a general outline. There is much that has been discussed and presented in lecture that is not included in this outline. All material discussed in lecture is test-material whether or not it is included in this outline.