1. ASNSS’s S.B.SHIRKOLI HOMOEOPATHIC
MEDICAL COLLEGE , SANKESHWAR.
SHRI DURADUNDEESHWAR HOMOEOPATHIC
HOSPITAL
Topic name –Physiology of Heart
Presented by
Dr. Hem Shah & Dr. Zainab Kankanwadi

2. OVERVIEW
1. Introduction to physiology
2. Introduction to cardio vascular system
3. Functions of Heart
4. Layers of the heart
5. Heart circulation
6. Cardiac cycle
7. Heart Sounds
8. Cardiac output
9. Cardiac Rhythmia
10. Blood Pressure
11. Conclusion

3. INTRODUCTION TO PHYSIOLOGY
• It is the study of how human body works in health and disease.
• It describe the physics and chemistry behind basic body function.
• It help us to understand what happens in a healthy body in everyone’s life and what
goes wrong when someone gets sick.

4. INTRODUCTION TO CIRCULATORY SYSTEM
Circulatory system
Heart Blood vessel

5. HEART
It is a muscular organ that pumps blood
through out the circulatory system.
Heart is having four chamber.
1. Two atrium :-
- Right atrium
- Left atrium
2. Two ventricles:-
- Right ventricle
- Left ventricle
BLOOD VESSELS
• Artery.
• Capillaries.
• Vein.

6. FUNCTIONS OF HEART
• Pumping oxygenated blood.
• Pumping hormones.
• Removes metabolic waste product.
• Maintaining of blood pressure.
• Maintaining of heart rate & rhythm.

7. LAYERS OF THE HEART
There are 3 layers of heart :-
1. Outer Pericardium
2. Middle Myocardium
3. Inner Endocardium

8. 1. Outer Pericardium
Outer
pericardium
Fibrous
pericardium
Serous
pericardium
Parietal Visceral

9. A. Fibrous Pericardium
• Outer most layer of heart.
• Maintain shape & size.
• Protect the heart from over stretching.
• Protect from infection.
B. Serous Pericardium
• Secrets small amount of fluid ( 20 – 60 ml ).
• This fluid prevent friction & allows free movement of heart.

10. Pericardial sac
• Help in repairing of tissue.
• Cardiac tamponade ( Increase in fluid ).
2. Myocardium
• Muscular contraction & relaxation of heart.
• Maintain heart rate & rhythmicity.
• Myocardium is made up of 2 types of cell.
a) Nodal cells – Conductivity of heart, Maintain rhythm, HR, Blood volume.
b) Cardio myocytes – Contraction & relaxation of heart.

11. 3. Endocardium
• Keeps the blood flowing throughout the heart.
• Provide protection to the valves & heart chamber.

12. HEART CIRCULATION

13. CARDIAC CYCLE

14. HEART SOUNDS
 INTRODUCTION
Heart sounds are sounds produced by the mechanical activities of the heart during each
cardiac cycle.
They are due to movements of
• Blood flow through the chambers of the heart.
• Cardiac muscle.
• Valves of the heart.
These are heard by placing the ear over the chest or by using stethoscope or
microphone.

15.  HEART SOUNDS
• S1 - "LUBB" caused by the closing of the AV valves.
• S2 - "DUBB" caused by the closing of semilunar valves.
• S3 -Associated with blood flowing into the ventricles.
• S4 -Associated with atrial contraction.
Four heart sounds can be recorded by phonocardiography, but normally only the first
and the second heart sounds, are audible through stethoscope.

16. WHERE TO AUSCULTATE ?

17. NORMAL AND ABNORMAL HEART SOUNDS

18. CARDIAC OUTPUT
It is the amount of blood pumped out by each ventricle in one
minute.
Cardiac
Output
Heart Rate
Contractility Preload Afterload
Stroke
Volume

19. CARDIAC RHYTHM
• Normal cardiac rhythmia
Heart rate 60 – 100 beats / min.
Every heart rate is orginating from S.A node.
Cardiac impulse should propogate through normal conduction pathway.
Normal velocity

20. Normal conduction pathway.
S.A node Atria Depolarization to AV Bundle of Hiss
Bundle of branches Purkinje system Final fiber

22. BLOOD PRESSURE
 It is the lateral pressure exerted by circulating blood upon the valve of blood vessel.
There are two types of Blood Pressure :-
1. Systolic Blood Pressure :-
Maximum pressure exerted by blood on vessel wall during contraction of heart chamber.
Normal Range - 90 to 120 mm of Hg.
2. Diastolic Blood Pressure :-
Minimum pressure exerted by blood on vessel wall during relaxation of heart chamber.
Normal Range - 60 to 80 mm of Hg.

23. .
BLOOD PRESSURE
CATEGORY
SYSTOLIC
(mm of hg)
DIASTOLIC
(mm of hg)
NORMAL Less than 120 and Less than 80
ELEVATED 120-129 and Less than 80
STAGE 1
HIGH BLOOD PRESSURE
(HYPERTENSION)
130-139 or 80-89
STAGE 2
HIGH BLOOD PRESSURE
(HYPERTENSION)
140 or Higher or 90 or Higher
HYPERTENSIVE CRISIS
(consult your doctor
immediately)
Higher than
180
or/and Higher than 120

24. • Determinates of blood pressure are:-
1. Heart rate
HR
CO
BP

25. 2. Arterial elastic constant stiffness of the arterial system which progressively
from birth until death
in arterial elastic constant pressure during systole
BP

26. 3. Arterial blood volume -
Total blood SBP DBP volume
4. Hemorrhage -
Blood volume BP

27. Factors affecting arterial blood pressure
1. Age : with the age
2. Gender : Before menopause females have high BP compare to males of same age group.
After menopause female have less BP compare to males of same age group.
3. Temperature : Hot climate - BP
Cold climate BP
4. Emotions : emotion sympathetic actions - BP
5. Effect of meals : After meals - for 1 hour.
6. Effect of gravity : on standing -
7. Sleep : during sleep - upto 15 – 20 mm of Hg.

28. 9. Effect of posture change : Immediate effect on standing BP.
10. Body built : In obese – slightly
11. During pregnancy :

29. CONCLUSION
Normal Increase Decrease
Heart Rate 72-80 beats/min More than100 beats/min
TACHYCARDIA
Less than 60 beats/min
BRADYCARDIA
Blood Pressure 120/80 MM of hg More than 140/100 mm of
hg
HYPERTENSION
Less than 100/80 mm of
hg
HYPOTENSION
Oxygen Saturation More or equal to 95 %
HYPEROXIA
Less than 90 %
HYPOXIA
Cardiac Output 4.0-8.0 ltr/min More than
4.0-8.0 ltr/min
Increase of Blood
Pressure
Less than
4.0-8.0 ltr/min
Decrease of Blood
Pressure

30. THANK YOU