Key Points

• The heart is an example of a reciprocating pump.

• During diastole, the semilunar valves (aortic on the left and pulmonic on the right) are closed and systemic and pulmonary venous blood flows through the respective atria and fills the relaxed ventricles. The ventricular pressure is essentially venous pressure.

• During systole, the atrioventricular (mitral on the left and tricuspid on the right) valves are closed and the contracting heart ejects blood through the semilunar valves. Left ventricular pressure is essentially aortic pressure.

• The beating heart normally makes four sounds. Two are audible and two are usually inaudible, requiring instrumentation to appreciate. The heart may make other sounds, including murmurs or clicks.

• The mechanics of the ventricle are best analyzed by the pressure-volume plot on which an ejection loop can be drawn.

• The force with which the ventricle contracts is proportional to its filling (Frank-Starling relationship).

Essential Medical Physiology, Third Edition

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