The Heart: Anatomy, Physiology and Exercise Physiology
The impact of anatomy on medicine was first recognised by Andreas Vesalius during the 16th century [1] and from birth to death, the heart is the most talked about organ of the human body. It is the centre of attraction for people from many lifestyles, suc
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The Heart: Anatomy, Physiology and Exercise Physiology
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Syed Shah, Gopinath Gnanasegaran, Jeanette Sundberg-Cohon, and John R Buscombe
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Contents
1.1 1.2 1.2.1 1.2.2 1.2.3 1.2.4 1.2.5 1.2.6 1.3 1.3.1 1.3.2 1.3.3 1.3.4 1.3.5 1.3.6 1.3.7 1.3.8 1.4 1.4.1 1.4.2 1.5
Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . Anatomy of the Heart . . . . . . . . . . . . . . . . . . . Chamber and Valves . . . . . . . . . . . . . . . . . . . . Cardiac Cell and Cardiac Muscle . . . . . . . . . Coronary Arteries and Cardiac Veins . . . . . . Venous Circulation . . . . . . . . . . . . . . . . . . . . . Nerve Supply of the Heart . . . . . . . . . . . . . . . Conduction System of the Heart . . . . . . . . . . Physiology of the Heart . . . . . . . . . . . . . . . . . Circulatory System: Systemic and Pulmonary Circulation . . . . . . . . . . . . . . Conduction System of the Heart (Excitation Sequence) . . . . . . . . . . . . . . . . . . . Action Potential (AP) . . . . . . . . . . . . . . . . . . . Mechanism of Excitation and Contraction Coupling of Cardiac Myocytes . . . . . . . . . . . Autonomic Nervous System and Heart . . . . . Cardiac Cycle . . . . . . . . . . . . . . . . . . . . . . . . . Physiology of Coronary Circulation . . . . . . . Coronary Collaterals . . . . . . . . . . . . . . . . . . . . Exercise Physiology . . . . . . . . . . . . . . . . . . . . . Gender and Exercise Performance . . . . . . . . Age and Exercise Performance . . . . . . . . . . . Conclusion . . . . . . . . . . . . . . . . . . . . . . . . . . . . References . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Introduction
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The impact of anatomy on medicine was first recognised by Andreas Vesalius during the 16th century [1] and from birth to death, the heart is the most talked about organ of the human body. It is the centre of attraction for people from many lifestyles, such as philosophers, artists, poets and physicians/surgeons. The heart is one of the most efficient organs in the human body and heart disease is one of the commonest causes of morbidity and mortality in both developing and developed countries. Understanding the anatomy and pathophysiology is very important and challenging. With innovative changes in the imaging world, the perception of these has changed radically and applied anatomy and physiology plays an important role in understanding structure and function. 1.2
Anatomy of the Heart
The heart is located in the chest, directly above the diaphragm in the region of the thorax called mediastinum, specifically the middle mediastinum. The normal human heart varies with height and weight (Table 1.1). The tip (apex) of the heart is pointed forward, downward, and toward the left. The (inferior) diaphragmatic surface lies directly on the diaphragm. The heart lies in a double walled fibroserous sac called the pericardial sac, which is divided into (a) fibrous pericardium, and (b) serous pericar
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