CARDIAC CYCLE

Various events occur in the heart during on beat. These events are repeated in a cyclic
manner. This cyclic repetition of events is called cardiac cycle.

Duration of cardiac cycle 0.8 sec

z ATRIAL SYSTOLE 0.1 sec

z VENTICULAR SYSTOLE 0.3 sec
z VENTICULAR DIASTOLE 0.5sec
z ATRIAL DIASTOLE 0.7 sec

1. ATRIAL SYSTOLE DURATION 0.1 SEC

• Contraction of the atrium and atrial pressure rises.
• Expulsion of blood into ventricles.

2. VENTRICULAR SYSTOLE DURATION 0.3 sec

i. ISOVOLUMETRIC CONTRACTION
ii. RAPID EJECTION
iii. SLOW EJECTION

I. ISOVOLUMETRIC CONTRACTION
• Atrial systole ceases and pressure in atrium and ventricle falls.
• Ventricular contraction starts and then ventricular pressure rises above
atrial pressure, AV valve closes
• FIRST HEART SOUND occurs with closure of AV valve
• Isovolumetric contraction – ventricles are closed and pressure is rising
in ventricles. No emptying.
• Ventricular systole – Left ventricle pressure rises above aorta pressure 80
mm hg and RV ventricle pressure rises above pulmonary artery pressure 10
mm Hg, aortic and pulmonary valves open.

II. RAPID EJECTION

• Opening of semilunar valves.
• Ejection of blood from ventricles to aorta and pulmonary artery.
 III. SLOW EJECTION
• Ventricular pressure declines.
• Ejection of blood slows down.

3. VENTRICULAR DIASTOLE DURATION 0.5 seconds

z Ventricular pressure drops after ventricular systole ends.

z Closure of semilunar valves causes second heart sound.

I. Isovolumetric relaxation
• After closure of semilunar valves, ventricular pressure drops rapidly.
• NO CHANGE in ventricular volume.
• ENDS as ventricular pressure falls below atrial pressure.

II. Rapid filling phase

• AV valves open.
• Rapid Ventricular filling occurs.
• Slow ventricular filling.
• Last Rapid ventricular filling due to atrial systole.

4. ATRIAL DIASTOLE DURATION 0.7 seconds

• Atrial relaxation.
• Venous return fills the right atrium.

NOTE
RA systole precedes LA systole.
RV contraction starts after LV contraction.
DIAGRAM AND GRAPH
 mmHg
Pulmonary artery 25/10

Aorta 120/80
Left atrium 5
Left ventricle 120/0
Right ventricle 25/0

NOTE
Atrial systole starts after P wave.
Ventricular systole starts near the end of R WAVE.

JUGULAR VENOUS PRESSURE (JVP)

Right atrial pressure changes are transmitted to the jugular veins in the neck
producing, characteristic waves.
z A wave due to atrial systole.
z C wave during isovolumetric contraction, there is bulge in right atrium due
to tricuspid valve.
z V wave rise in atrial pressure before tricuspid valve opens.

APPLIED
CANNON WAVES – GIANT a waves – seen in complete heart block
TR --GIANT c waves

HEART SOUNDS

1. FIRST HEART SOUND

 Occurs with closure of AV valves
Denotes onset of ventricular systole.
Low pitched.
Loud sound.
Coincide with R wave of ECG.

2. SECOND HEART SOUND

Occurs with closure of semilunar valves.

Signifies onset of ventricular diastole.
High pitched.
Sharp sound.
Coincide with T wave of ECG.

3. THIRD HEART SOUND

Occurs during rapid filling phase of the ventricles

Low pitched
Duration 0.1 sec

4. FOURTH HEART SOUND

Occurs due to atrial systole

Low frequency

Vessels

Type of blood vessels

Type
1. Wind Kessel vessels
2. Resistance vessels
3. Precapillary sphincters
4. Exchange vessels
5. Capacitance vessels
Features
eg. Aorta, major arteries ,have a lot of
elastic tissue ;show elastic recoil effect
eg. Arteries, have some elastic tissue.
Have lot of smooth muscle
No innervation ,respond to local
metabolites
Capillaries. No innervations.
Controlled by precapillary sphincters
Veins. Have some innervations
 6. Shunt vessels A-V anastomoses. They have thick
muscular wall very richly innervated

NOTE- 1. Cross sectional area area: is minimum for aorta and maximum for capillaries.
2. % of blood volume: is maximum in capacitance vessels and minimum in
arterioles.

Capillaries
3 Types
a) Continous eg. Brain, skin
b) Fenestrated eg. GIT , glomeruli of kidney, endocrine
glands, circum ventricular organs
c) Discontinous (Sinusoids) eg. Liver , bone marrow

The least permeability of capillaries is that is the brain.

Pericytes:

These are associated with capillaries and post capillary venules. They are similar to the
mesangial cells in the renal glomeruli.
I. They are contractile
II. They release vasoactive agents
III. They synthesise and release constituents o bone marrow and extracellular matrix.
One of their functions is to regulate the flow through the junction between the
endothelial cells , especially during inflammation.

BIOPHYSICAL PRINCIPLES

1. F= P/R (WHERE F= flow, P = effective perfusion pressure,R = resistance)

R=P/F
If P is expressed in mm Hg and flow is expressed in ml/sec , then resistance will be
expressed in 'R' units.

Flow can be laminar or turbulent

Laminar flow Turbulent flow

a) Eletcro magnetic flow meters a) Fick method
b) Doppler flow meter b) Indicator method
c)More efficient (less energy consumption) c) Plethysmography
The probability of turbulence in a given flo can be determined by Reynold's number.
Re= PDV/n
(where Re = Reynold number, P= Density of fluid, D = diameter of the vessel, V =
velocity of the flow and n = Viscosity)
More the Reynold number , more the chances of the turbulence.
If D is measured in cms, Vin cm/sec, n in poises,
then Re is < 2000 there is usually no turbulence ; if Re is > 3000, turbulence is almost
always there.

2. Average velocity of flow

V= Q/A (Where V = velocity , Q = Quantity/amount of fluid and A = area)

So, if area is more, velocity is less. Therefore the flow is least in the capillaries
(maximum cross sectional area) and maximum in the aorta (least cross sectional
area)