1. Carotid artery Jugular vein Aorta Pulmonary trunk Heart
Fig. 12.1
Copyright © McGraw-Hill Education. Permission required for reproduction or display.
Carotid artery
Jugular vein
Aorta
Pulmonary trunk
Heart
Brachial artery
Inferior
vena cava
Femoral
artery
and vein

2. CO2 O2 Tissue capillaries Circulation to tissues of head Lung CO2
Fig. 12.2
Copyright © McGraw-Hill Education. Permission required for reproduction or display.
CO2 O2
Tissue
capillaries
Circulation to
tissues of head
Lung
CO2
Pulmonary
circulation
(to lungs)
Lung
capillaries O2
Systemic
circulation
(to body)
Left side
of heart
Right side of heart
Circulation to
tissues of
lower body
Tissue
capillaries
CO2 O2

3. Fig. 12.3 Larynx Trachea Rib Superior vena cava Aortic arch Right lung
Copyright © McGraw-Hill Education. Permission required for reproduction or display.
Larynx
Trachea
Rib
Superior vena cava
Aortic arch
Right lung
Pulmonary trunk
Left atrium
Right atrium
Left lung
Midclavicular
line
Right ventricle
Left ventricle
2nd intercostal
space
Rib
Apex of heart
Visceral pleura
Sternum
Parietal pleura
Pleural cavity
Apex of heart
Diaphragm
5th intercostal
space
Anterior view
(a)
(b)

4. Fig
Copyright © McGraw-Hill Education. Permission required for reproduction or display.
Aortic arch
Superior
vena cava
Left pulmonary artery
Branches of left
pulmonary arteries
Branches of
right pulmonary
arteries 4 4 8
Pulmonary trunk 5
Pulmonary veins
Aortic semilunar
valve 5
Pulmonary
veins
Left atrium 3 6
Pulmonary semilunar
valve 7
Bicuspid valve 1
Right atrium
Left ventricle
Tricuspid valve 2
Interventricular septum
Right ventricle
Inferior
vena cava
(a) 1 2 3 4
Superior and
inferior vena
cava
Right
atrium
Tricuspid
valve
Right
ventricle
Pulmonary
semilunar
valve
Pulmonary
trunk
Pulmonary
arteries
Coronary sinus
Cardiac veins
Body tissues
(systemic
circulation)
Heart tissue
(coronary
circulation)
Lung tissue
(pulmonary
circulation)
Coronary
arteries
Aortic
semilunar
valve
Left
ventricle
Left
atrium
Pulmonary
veins
Aorta
Bicuspid
valve 8 7 6 5
(b)

5. Right pulmonary artery
Fig. 12.5b
Copyright © McGraw-Hill Education. Permission required for reproduction or display.
Aorta
Superior vena cava
Left pulmonary artery
Right pulmonary artery
Left pulmonary veins
Right pulmonary veins
Left atrium
Right atrium
Great cardiac vein
Inferior vena cava
Coronary sinus
Right coronary artery
Left Ventricle
Small cardiac vein
Posterior interventricular artery
(in posterior interventricular sulcus)
Middle cardiac vein
(in posterior inter-
Ventricular sulcus)
Right ventricle
Apex
(c)
Posterior view

6. Fig. 12.13 Striations Branching muscle fibers Intercalated disks
Copyright © McGraw-Hill Education. Permission required for reproduction or display.
Striations
Branching
muscle fibers
Intercalated disks
Nucleus of cardiac
muscle cell
T tubule
Sarcoplasmic
reticulum
LM 400x
(b)
Sarcomere
T tubule
Myofilbrils
Sarcoplasmic
reticulum
Mitochondrion
Sarcolemma
(cell membrane)
Connective tissue
(a)
Sarcomere
Nucleus of
cardiac muscle
cell
Mitochondrion
Myofibrils
(c)
b: ©Ed Reschke

7. Fig. 12.11 Aortic arch Aortic arch Superior vena cava Pulmonary trunk
Copyright © McGraw-Hill Education. Permission required for reproduction or display.
Aortic arch
Aortic arch
Superior
vena cava
Pulmonary
trunk
Aortic
semilunar
valve
Superior
vena cava
Pulmonary
trunk
Left coronary
artery
Left atrium
Left atrium
Right
atrium
Circumflex
artery
Right
coronary
artery
Posterior vein
of left ventricle
Left marginal
artery
Right
atrium
Into
right
atrium
Anterior
interventricular
artery
Coronary
sinus
Posterior
interventricular
artery
Middle
cardiac vein
Great
cardiac
vein
Right
marginal
artery
Small
cardiac
vein
Left ventricle
Left
ventricle
Right ventricle
Right ventricle
(a)
Anterior view
(b)
Anterior view

8. Fig
Copyright © McGraw-Hill Education. Permission required for reproduction or display.
Skeletal Muscle
Cardiac Muscle
Repolarization
phase
Plateau 2
phase 1
(mV)
(mV) 2 1
Repolarization
phase 3
Depolarization
phase
Depolarization
phase
–85
–85 1 2 1 2
500
Time (ms)
Time (ms) 3
Tension
Tension 4 1 2 1 2
500
Time (ms)
Time (ms)
(a) 1
Depolarization phase
(b) 1
Depolarization phase •
Na+ channels open. •
Na+ channels open. •
K+ channels begin to open. •
Ca+ channels open. 2
Repolarization phase 2
Plateau phase •
Na+ channels close. •
Na+ channels close. •
K+ channels continue to open, causing
repolarization. •
Some K+ channels open, causing
repolarization. •
K+ channels close at the end of
repolarization and return the membrane
potential to its resting value. •
Ca2+ channels are open, producing the
plateau by slowing further repolarization. 3
Repolarization phase 3
Refractory period effect on tension •
Ca2+ channels close. •
Maximum tension is obtained after the
refractory period (purple shaded area)
is completed allowing for increased
tension with additional stimulation. •
Many K+ channels open. 4
Refractory period effect on tension •
Cardiac muscle contracts and relaxes almost
completely during the refractory period (purple
shaded area).

9. Pulmonary semilunar valve Cardiac skeleton Aortic semilunar valve
Fig. 12.9
Copyright © McGraw-Hill Education. Permission required for reproduction or display.
Pulmonary semilunar valve
Cardiac skeleton
Aortic
semilunar valve
Bicuspid
valve
Tricuspid
valve
Cardiac muscle
of the right
ventricle
Cardiac muscle
of the left ventricle
Posterior view

10. Fig. 12.15 Sinoatrial (SA) node 1
Copyright © McGraw-Hill Education. Permission required for reproduction or display.
Sinoatrial
(SA) node 1
Action potentials originate in the sinoatrial (SA) node
and travel across the wall of the atrium (arrows) from
the SA node to the atrioventricular (AV) node.
Left atrium
Atrioventricular
(AV) node 1 2
Action potentials pass through the AV node and
along the atrioventricular (AV) bundle, which extends
from the AV node, through the fibrous skeleton, into
the interventricular septum. 2 3
The AV bundle divides into right and left bundle branches,
and action potentials descend to the apex of each ventricle
along the bundle branches.
Left ventricle 3
Atrioventricular
(AV) bundle 4
Action potentials are carried by the Purkinje fibers
from the bundle branches to the ventricular walls.
Right and left
bundle branches 4
Purkinje
fibers
Apex

11. QRS complex R (mV) T wave P wave Q S PQ interval QT interval
Fig
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QRS complex R
(mV)
T wave
P wave Q S
PQ interval
QT interval
Time (seconds)

12. Aortic semilunar valve Left pulmonary veins Right pulmonary veins
Fig. 12.6
Copyright © McGraw-Hill Education. Permission required for reproduction or display.
Aortic arch
Superior vena cava
Left pulmonary artery
Pulmonary trunk
Branches of right
pulmonary artery
Right pulmonary veins
Aortic semilunar valve
Left pulmonary veins
Right pulmonary veins
Left atrium
Pulmonary
semilunar valve
Bicuspid (mitral) valve
Right atrium
Coronary sinus
Left ventricle
Chordae tendineae
Tricuspid valve
Papillary muscles
Interventricular septum
Right ventricle
Inferior vena cava
Anterior view

13. Fig. 12.7 Bicuspid valve Tricuspid valve Pulmonary trunk Chordae
Copyright © McGraw-Hill Education. Permission required for reproduction or display.
Bicuspid
valve
Tricuspid
valve
Pulmonary
trunk
Chordae
tendineae
Pulmonary
semilunar
valve
Papillary
muscles
Aorta
Aortic semilunar
valve
Left
ventricle
Right
ventricle
Tricuspid valve
Bicuspid valve
Right atrium
Anterior view
Superior view
(a)
(b)
a: ©VideoSurgery/Science Source; b: ©Oktay Ortakcioglu/iStock/360/Getty Images RF

14. Fig. 12.8 Pulmonary veins Pulmonary veins Left atrium Aorta
Copyright © McGraw-Hill Education. Permission required for reproduction or display.
Pulmonary veins
Pulmonary veins
Left atrium
Aorta
Left atrium
Aorta
Bicuspid valve
(open)
Bicuspid valve
(closed)
Aortic semilunar
valve (open)
Aortic semilunar
valve (closed)
Chordae tendineae
(tension low)
Chordae tendineae
(tension high)
Papillary muscle
(relaxed)
Papillary muscle
(contracted)
Cardiac muscle
(relaxed)
Cardiac muscle
(contracted)
Left ventricle
(relaxed)
Left ventricle
(contracted)
(a)
Anterior view
(b)
Anterior view

15. Fig
Copyright © McGraw-Hill Education. Permission required for reproduction or display.
Semilunar
valves closed
Semilunar
valves closed
AV valves
opened
AV valves
opened 1
The atria and ventricles are relaxed.
AV valves open, and blood flows into
the ventricles. The ventricles fill to
approximately 70% of their volume. 2
The atria contract and complete
ventricular filling.
Semilunar
valves closed
Semilunar
valves closed
AV valves
closed
AV valves
closed 5
At the beginning of ventricular
diastole, the ventricles relax, and the
semilunar valves close (the second
heart sound). 3
Contraction of the ventricles causes
pressure in the ventricles to increase.
Almost immediately, the AV valves
close (the first heart sound). The
pressure in the ventricles continues
to increase.
Semilunar
valves opened
AV valves
closed 4
Continued ventricular contraction
causes the pressure in the ventricles
to exceed the pressure in the pulmonary
trunk and aorta. As a result, the
semilunar valves are forced open,
and blood is ejected into the
pulmonary trunk and aorta.

16. ©Jose Luis Pelaez Inc/Blend Images LLC RF
Fig
Copyright © McGraw-Hill Education. Permission required for reproduction or display.
Pulmonary
semilunar
valve
Aortic
semilunar
valve
Bicuspid
valve
Tricuspid
valve
Outline
of heart
©Jose Luis Pelaez Inc/Blend Images LLC RF

17. Fig. 12.22 1 Sensory neurons (green) carry
Copyright © McGraw-Hill Education. Permission required for reproduction or display. 1
Sensory neurons (green) carry
action potentials from baroreceptors
to the cardioregulatory center.
Chemoreceptors in the medulla
oblongata influence the
cardioregulatory center.
Cardioregulatory center and
chemoreceptors in medulla oblongata
Sensory nerve
fibers
Baroreceptors
in wall of internal
carotid artery 2
The cardioregulatory center controls
the frequency of action potentials in
the parasympathetic neurons (red )
extending to the heart. The
parasympathetic neurons decrease
the heart rate. 1
Carotid body
chemoreceptors
Sensory
nerve
fibers
Baroreceptors
in aorta 3
The cardioregulatory center controls
the frequency of action potentials in
the sympathetic neurons (blue)
extending to the heart. The
sympathetic neurons increase the
heart rate and the stroke volume. 2
Parasympathetic nerve fibers 3
SA node
Sympathetic nerve fibers 4
The cardioregulatory center
influences the frequency of action
potentials in the sympathetic
neurons (blue) extending to the
adrenal medulla. The sympathetic
neurons increase the secretion of
epinephrine and some
norepinephrine into the general
circulation. Epinephrine and
norepinephrine increase the heart
rate and stroke volume.
Heart
Sympathetic
nerve fibers to
adrenal gland 4
Circulation
Adrenal medulla
Epinephrine and norepinephrine

18. Fig
Copyright © McGraw-Hill Education. Permission required for reproduction or display. 3 4
Actions
Reactions
Baroreceptors in the carotid arteries
and aorta detect an increase in blood
pressure.
Effectors Respond:
The SA node and cardiac
muscle decrease activity and
heart rate and stroke volume
decrease.
The cardioregulatory center in the
brain decreases sympathetic
stimulation of the heart and adrenal
medulla and increases
parasympathetic stimulation of the
heart. 5
Homeostasis Disturbed:
Blood pressure increases.
Homeostasis Restored:
Blood pressure decreases. 2
Blood pressure
(normal range) 1
Start here
Blood pressure
(normal range) 6
Homeostasis Disturbed:
Blood pressure decreases.
Homeostasis Restored:
Blood pressure increases.
Actions
Reactions
Baroreceptors in the carotid arteries
and aorta detect a decrease in blood
pressure.
Effectors Respond:
The SA node and cardiac
muscle increase activity
and heart rate and stroke
volume increase.
The cardioregulatory center in the
brain increases sympathetic
stimulation of the heart and adrenal
medulla and decreases
parasympathetic stimulation of the
heart.

19. Fig
Copyright © McGraw-Hill Education. Permission required for reproduction or display. 3 4
Actions
Reactions
Chemoreceptors in the medulla
oblongata detect an increase in
blood pH (often caused by a
decrease in blood CO2). Control
centers in the brain decrease
stimulation of the heart and adrenal
medulla.
Effectors Respond:
The SA node and cardiac
muscle decrease activity and
heart rate and stroke volume
decrease. 5
Homeostasis Restored:
Blood pH decreases. 2
Homeostasis Disturbed:
Blood pH increases.
(normal range)
Blood pH 1
Start here
(normal range)
Blood pH 6
Homeostasis Disturbed:
Blood pH decreases.
Homeostasis Restored:
Blood pH increases.
Actions
Reactions
Chemoreceptors in the medulla
oblongata detect a decrease in blood
pH (often caused by an increase in
blood CO2). Control centers in the
brain increase stimulation of the
heart and adrenal medulla.
Effectors Respond:
The SA node and cardiac
muscle increase activity and
heart rate and stroke volume
increase, increasing blood flow
to the lungs.

20. (left): ©Hank Morgan/Science Source; (right): ©SPL/Science Source
Fig. 12A
Copyright © McGraw-Hill Education. Permission required for reproduction or display.
Occluded coronary
artery
(left): ©Hank Morgan/Science Source; (right): ©SPL/Science Source

21. Myocardial Infarctions
Page 345
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MUSCULAR
Skeletal muscle activity is reduced
because of lack of blood flow to the brain
and because blood is shunted from blood
vessels that supply skeletal muscles to
those that supply the heart and brain.
URINARY
NERVOUS
Pallor of the skin results from intense
vasoconstriction of peripheral blood
vessels, including those in the skin.
Decreased blood flow to the brain, decreased
blood pressure, and pain due to ischemia of
heart muscle result in increased sympathetic
and parasympathetic stimulation of the
heart. Loss of consciousness occurs when the blood flow to the brain decreases so that not enough O2 is available to maintain normal
brain function, especially in the reticular
activating system.
Myocardial
Infarctions
URINARY
Blood flow to the kidney decreases
dramatically in response to sympathetic
stimulation. If the kidney becomes
ischemic, the kidney tubules can be
damaged, resulting in acute renal
failure and reduced urine production.
increased blood urea nitrogen,
increased blood levels of K+, and edema
are indications that the kidneys cannot
eliminate waste products and excess
water. If damage is not too great, the
period of reduced urine production
may last up to 3 weeks; then the rate
of urine production slowly returns to
normal as the kidney tubules heal.
Symptoms
Chest pain that radiates down left arm
ENDOCRINE
Tightness and pressure in chest
Difficulty breathing
When blood pressure becomes
low, antidiuretic hormone (ADH) is
released from the posterior pituitary
gland, and renin, released from
the kidney, activates the renin angiotensin-aldosterone mechanism.
ADH, secreted in large amounts, and
angiotensin II cause vasoconstriction
of peripheral blood vessels. ADH and
aldosterone act on the kidneys to
retain water and ions. increased blood
volume increases venous return, which
results in increased stroke volume and
blood pressure unless damage to the
heart is very severe.
Nausea and vomiting
Dizziness and fatigue
Treatment
Restore blood flow to cardiac muscle
Medication to reduce blood clotting
(aspirin) and increase blood flow (t-Pa)
Supplemental O2 to restore normal
O2 to heart tissue
Prevention and control of
hypertension
DIGESTIVE
Intense sympathetic stimulation
reduces blood flow to the digestive
system to very low levels, which
often results in nausea and vomiting.
Angioplasty or bypass surgery
LYMPHATIC AND IMMUNE
RESPIRATORY
White blood cells, including
macrophages, move to the area of
cardiac muscle damage and phagocytize
any dead cardiac muscle cells.
Decreased blood pressure results in decreased blood flow to the lungs. the decrease in gas exchange
leads to increased blood co2 levels, acidosis, and decreased blood O2 levels. Initially, respiration
becomes deep and labored because of the elevated CO2 levels, decreased blood pH, and depressed
O2 levels. If the blood O2 levels decrease too much, the person loses consciousness. Pulmonary
edema can result when the pumping effectiveness of the left ventricle is substantially reduced..