CIRCULATORY

SYSTEM
PREPARED BY :
ADNAN ALI
CCP STUDENT
Presentation Outline :
 Position of the heart

 Motion of the blood through the heart

 How are the Heart & Lungs connected?

 Layers of the heart

 Valves of the heart

 Pulmonary vs systemic circulation

 Coronary circulation

 Pump action of the heart

 Conduction system
POSITION OF THE HEART :
The heart is in the thoracic cavity in the
mediastinum between the lungs.It lies
obliquely, a little more towards the left, and
present a base above, and apex below.The
apex is about 9cm to the left of the midline
at the level of the 5th intercostal space, i.e.
a little below the midline and sligthly nearer
the midline.The base extends to the level of
the 2nd rib.
ANATOMICAL STRUCTURE OF THE
HEART

The heart is a hollow organ divided into four

chambers:
 Right atrium
 Right ventricle
 Left atrium
 Left ventricle
 MOTION OF THE BLOOD
THROUGH THE HEART :
 It is a simple squeeze pump that force blood
forward by squeezing in exactly the way that
abulb syringe forces out fluid when it is
compressed. The blood moves from right heart
to left by the way of the lungs.
 In other words, the right heart pulls the blood
out of the veins and pumps into the lungs. While
the left heart pulls the blood out of the lungs
and pumps it into the body`s circulation.
HOW ARE THE HEART AND LUNGS
CONNECTED ?
 Superior & inferior vena cava empties into the
right atrium. It further opens into the right
ventrictle. Then through the pulmonary artery,
the blood is carried to the lungs.
 After oxygenation it flows back into the left
atrium through two pairs pulmonary veins. It
further flows down in the left ventricle. Then
through the aorta into the entire body.
 LAYERS OF THE HEART
 The heart is surrounded by a loose protective
sac called pericardium. This sac is loose enough
to permit the heart to beat easily.
 After the pericardium, a thin, shiny, reddish-
coloured membrane from the outer surface of
the heart is seen called the epicardium.
 Under the epicardium is a thick layer of muscle
called the myocardium. The myocardium is
thickest in the left ventricle; it is thinnest in the
atria.
 Inside walls of the heart are lined with another
smooth shiny membrane called endocardium.
 VALVES OF THE HEART
 Every opening between the chambers and into the
vessels is supplied with a valve that protects
backward flow of blood;
 The tricuspid valve consists of three cusps is
located between the right atrium and right
ventricle.
 The mitral valve or bicuspid valve consists of two
cusps is located between the left atrium and left
ventricle.
 The semilunar valves are located between the right
ventricle and the pulmonary artery called
pulmonary valve, and between the left ventricle
and the aorta called the aortic valve.
 PULMONARY VS SYSTEMIC
CIRCULATION
PULMONARY
Deals with the right side of the
heart.
Deoxygenated blood enters the
right side of the heart via the
superior & inferior vena cava to
the right atrium, passing through
the tricuspid valve & into the
right ventricle; blood exits
through the pulmonary artery &
subsequently the lungs.
Thin wall structure within the
right ventricle due to projection
of blood against low resistence.
SYSTEMIC
Deals with the left side of the
heart.
Oxygenated blood enters the left
side of the heart via the four
pulmonary veins into the left atrium,
passing through the mitral valve &
into the left ventricle; blood exits
through the aortic valve into the
aorta & to the entire body.
Thick wall structure within the left
ventricle due to projection of blood
against high resistance.
 SVC & IVC RA

ENTIRE BODY RV

AORTA
A COMPLETE BLOOD PA

CIRCULATION

LV LUNGS

LA PV
 CORONARY CIRCULATION
 The coronary arteries branch off the base
of the aorta and travel a considerable
distance on the epicardial surface of the
heart. They lie embedded in the fat that
surrounds them and covers the heart. The
two main arteries are the right and left
coronary arteries. They supply both the
heart`s electrical and mechanical
structures.
Right Coronary Artery :
 After leaving the aorta, the right coronary
artery passes diagonally toward the right
side of the heart and descends in the
groove between the right atrium and the
right ventricle. Before passing around to
posterior surface of the heart, it gives of
its acute marginal branch, which descends
along the lateral side of the heart to the
apex.
Left Coronary Artery :
 After leaving the aorta, the left coronary
artery passes behind the pulmonary artery
and provides small branches to supply the
left atrium. As it leaves the area of the
pulmonary artery it branches off into two
major divisions:
 Left Anterior Descending.
 Left Circumflex.
 SUPPLY TO THE HEART
 The right coronary artery supplies:
o 55% SA node
o 90% AV node
o A portion of the bundle of his
o Posterior-inferior division of the left bundle
branch
o Posterior 1/3rd of the septum
o Right atrial and ventricular musculature
o Inferior-posterior wall of the ventricle
 Left anterior descending artery supplies :
 Anterior 2/3rd of the septum
 The right bundle branch
 Anterosuperior division of the left bundle branch
 Anterior wall of the ventricle

 Left circumflex :
 45% of the SA node
 Inferoposterior division of the left bundle branch
 Lateral wall of the left ventricle
 PUMPING ACTION OF THE HEART
 Blood is pumped through the chambers of
the heart and out through the great
vessels by a simple squeezing action of
the heart chambers. This contraction of
the heart is called systole.
 After the contraction, the heart relaxes
and allows blood to filled within the
chambers. This relaxation phase of the
heart is called diastole.
 STAGES OF A HEART BEAT
The whole cycle of a heartbeat goes through these
stages :
I. Atrial systole : The atria contract, forcing the
blood down into the ventricle.
II. Ventricular systole : The ventricles contract,
forcing the blood out of the pulmonary artery
& aorta.
III. Atrial diastole : This starts during ventricular
systole as the atria begin refilling with blood
from the great veins.
IV. Ventricular diastole : This takes place during
atrial systole as a blood from the atria fills the
ventricles.
 THE ELECTRIC CIRCUIT THAT
DRIVES THE HEART
 Electric impulses initiated within the heart are transmitted
along a network of specialized cells called the
conduction system.
 When the impulses reaches and stimulates the ventricular
muscle, myocardial contraction occurs. Each normal
heartbeat is the result of an electrical impulse that
originates in a specialized area in the wall of the right
atrium called the SA node.
 This bundle of tissues acts as the battery for the heart
and is the designated pacemaker. Other areas of the
heart also have the ability to initiate impulses,but they
assume this role only under abnormal circumstances.
SINOATRIAL OR SA NODE :
 A specialized piece of tissues that can
initiate its own impulse which has the
property of automaticity. It is located in
the posterior portion of the right atrium
near the superior vena cava. It acts as the
pacemaker of the heart. It initiates
impulses at the rate of 60-100 per minute.
ATRIAL-VENTRICULAR OR AV NODE :
 The AV node is located in the right atrium close
to the septal leaflet of the tricuspid valve. The
AV node is not usually the pacemaker, but it is
capable of initiating impulses at the rate of 40-
60 per minute if the SA node fails. The primary
function of the AV node is to relay the electrical
impulses from the atria into the ventricles in an
orderly and timely way. The impulses travel
relatively slowly through the AV node to reach
the bundle of HIS. This allows the atria to
contract and empty and ventricles to fill before
the ventricles contract.
BUNDLE OF HIS :
This bundle lies in the upper part of the interventricular
septum, connecting the AV node with the two bundle
branches.

RIGHT & LEFT BUNDLE BRANCHES

AND PURKINJEE NETWORK :
The right and left bundle branches arise from the
bundle of HIS, straddle the intervascular septum, and
travel down either side of the septum. They`re divided
into smaller and smaller branches and connect with the
purkinje network. This network also has the ability to
initiate impulses at a rate of 15-40 per minute.