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Physiology of the Heart
The work of the heart is to pump blood to the lungs through pulmonary circulation and to the rest of the body through systemic circulation. This is accomplished by systematic contraction and relaxation of the cardiac muscle in the myocardium.
An effective cycle for productive pumping of blood requires that the heart be synchronized accurately. Both atria need to contract simultaneously, followed by contraction of both ventricles. Specialized cardiac muscle cells that make up the conduction system of the heart coordinate contraction of the chambers.
The conduction system includes several components. The first part of the conduction system is the sinoatrial node . Without any neural stimulation, the sinoatrial node rhythmically initiates impulses 70 to 80 times per minute. Because it establishes the basic rhythm of the heartbeat, it is called the pacemaker of the heart. Other parts of the conduction system
include the atrioventricular node, atrioventricular bundle, bundle branches, and conduction myofibers. All these components coordinate the contraction and relaxation of the heart chambers.
The cardiac cycle refers to the alternating contraction and relaxation of the myocardium in the walls of the heart chambers, coordinated by the conduction system, during one heartbeat. Systole is the contraction phase of the cardiac cycle, and diastole is the relaxation phase. At a normal heart rate, one cardiac cycle lasts for 0.8 second.
The sounds associated with the heartbeat are due to vibrations in the tissues and blood caused by closure of the valves. Abnormal heart sounds are called murmurs.
The sinoatrial node, acting alone, produces a constant rhythmic heart rate. Regulating factors are reliant on the atrioventricular node to increase or decrease the heart rate to adjust cardiac output to meet the changing needs of the body. Most changes in the heart rate are mediated through the cardiac center in the medulla oblongata of the brain. The center has both sympathetic and parasympathetic components that adjust the heart rate to meet the changing needs of the body.
Peripheral factors such as emotions, ion concentrations, and body temperature may affect heart rate. These are usually mediated through the cardiac center.