Student Learning Guide

The University of the West Indies

Faculty of Medical Sciences, Mona

The
Cardiovascular
System
CVAS 2102

MB,BS Undergraduate Medical Curriculum

Year 2, Semester 1
The
Cardiovascular
System

CVAS 2102
Course Coordinator – Dr. James Mills
Section of Physiology
 The Cardiovascular System

About this course

This course covers the core knowledge of
the normal and abnormal structure and
function of the cardiovascular system that
you will be required to learn in Stage 1 of
the programme.
The course is integrated, so that whilst the
teaching of Anatomy, Physiology,
Pharmacology, Pathology and Microbiology
of the cardiovascular system is emphasized,
there is also exposure to introductory
clinical knowledge that allows an
appreciation of the clinical relevance of the
disciplines mentioned here. There is a
stepwise approach in delivering of the
lectures and case scenarios are used to
reinforce the basic sciences.

Aim of the Course

The aim of this module is to provide an
overview of the normal and abnormal
structure and function of the cardiovascular
system. It covers the essential core of
information that you are required to know
about the cardiovascular system in order to
begin your hospital based clinical training.

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The Cardiovascular System

Useful Revision
You should have already completed the
courses covering haematology and the
respiratory system. It would be useful to
review haemostasis and blood-gas exchange
in the lungs and tissues as these are related
to the heart and circulation. A brief general
reading of the relevant sections in any
standard anatomy textbook will also be
beneficial.
For this, and later study, the learning
objectives provided below will prove useful
in defining areas that need to be covered.

Core Content
Here is a list of key points which form the
core of the course. They are provided to
help you to focus on the objectives of the
course, and assist you to achieve the
expected learning outcomes.
• anatomical and physiological overview of the
CVS
• the anatomy of the heart, its valves and great
vessels
• physiological concepts – pressure, flow,
resistance, capacitance
• the cardiac cycle – electrical activity, generation
of heart sounds
• control of blood pressure and cardiac output

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 The Cardiovascular System

• structure of blood vessels

• blood pressure - systolic, diastolic, origin of
Korotkoff sounds
• capillary-tissue transfer – oedema, factors
affecting capillary permeability
• the blood-brain barrier
• review of haemostasis and thrombosis (covered
in semester 2)
• control of cardiac, cerebral, pulmonary and renal
blood flow
• cardiovascular responses – exercise, posture,
blood loss
• the injury response
• drugs affecting the cardiovascular system
• common diseases affecting the cardiovascular
system

Student Learning Objectives

On completion of this course, you should be
able to:
• Explain the structure and function of the
cardiovascular system
• Describe the gross and microscopic anatomy of
the cardiovascular system.
• Explain how structure is related to function in
the cardiovascular system
• Describe the initiation and spread of electrical
activity throughout the heart, and relate that to

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The Cardiovascular System

the genesis of the electrocardiogram in its

normal and single pathological forms
• Outline the sequence of changes in pressure and
volume in the chambers of the heart throughout
the cardiac cycle, and relate that to heart sounds,
murmurs, systolic pressure, diastolic pressure
and pulse pressure.
• Identify the intrinsic and extrinsic factors
controlling heart rate, blood pressure, stroke
volume and cardiac output.
• Explain the principles underlying measurement
of blood pressure and factors controlling it.
• Explain the relationship between cardiac output,
total peripheral resistance and mean arterial
pressure in the control of blood pressure.
• Describe the neural, humoral and renal control
of blood pressure.
• Explain the importance of coordinated control of
the cardiovascular system using the response to
exercise, shock, posture and the valsalvia
manoevre as examples.
• Describe the dominant factors controlling blood
flow in cardiac, cerebral, pulmonary, renal and
skin vascular beds.
• Outline the pharmacology, microbiology and
pathology of the cardiovascular system
• Explain the basic principles underlying
congenital heart diseases, shock, cardiac failure,
ischaemic heart disease and degenerative arterial
diseases as presented in the introductory clinical
lectures.

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 The Cardiovascular System

• Analyze case scenarios that reinforce the

relationship between the basic sciences and
clinical disciplines relevant to the cardiovascular
system.

Teaching/Learning Methods
This course is delivered by a combination of
laboratory work and formal lectures from
both clinical and basic medical sciences
teaching staff with revision tutorials and
case-based seminars where possible. Your
participation in all activities is important if
you are to gain maximum benefit from the
course.
Not all objectives will be covered in
didactic lectures or formal teaching and
students are encouraged to use the learning
objectives provided to guide their own self -
study and to participate in small group
discussion as a way of reviewing and
reinforcing your knowledge of normal
anatomy and physiology.

Assessment
On completion of the course, you will be
assessed formally by a means of a written
(Multiple Choice Question) examination
paper and an Objective Structured Practical
Examination (OSPE).

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The Cardiovascular System

Your participation in problem-oriented

learning (POL) sessions and presentations
are also considered in your overall
assessment and, commencing with the
incoming class in September 2006, your
final grade for the course will contribute to
your grade point average (GPA)
The standard and pass mark for the course
examination will be determined by the
examiners. Further details on the assessment
process can be found in the student
handbook.

Useful Resources
Books (current editions)
• Principles of Physiology, Robert M. Berneand,
Matthew N. Levy. (Mosby)
• Medical Microbiology, Murray et al.
• Robbins Basic Pathology, Kumar V, Cotran R S.
Robbins S L. (Saunders)
• Pharmacology, H. P .Rang, M. M. Dale J. M.
Ritter
• Basic Clinical Pharmacology, B. Katzung
• Last’s Anatomy - Regional and Applied. C.S.
Sinnatamby (Churchill Livingstone)
• Cunningham’s Textbook of Anatomy (Oxford
Press)

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 The Cardiovascular System

• Robbins Pathologic Basis of Disease R. Cotran,

V. Kumar and T. Collins (W.B. Saunders and
Co.)
• Human Anatomy - Marieb & Mallatt Benjamin
Cummings (Addison Wesley Longman, Inc.)

• ADAM (CDROM interactive human anatomy

software available to students in the Hopwood
Centre above the Medical Library)

Glossary of terms
Aneurysm - An abnormal localized dilatation of an
artery. Aneurysms may result from congenital
defects in the arterial wall or more commonly from
gradual weakening of the vessel from degenerative
disease which places the vessel at risk of rupturing.
Common sites for aneurysms are the abdominal
aorta and the arteries at the base of the brain.
Angina pectoris - A symptom complex resulting
from narrowing or blockage of branches of the
coronary arteries which supply blood to the heart. It
is characterized by chest pain which is brought on by
exercise or stress. During these periods, the oxygen
supply of the heart increases beyond what the
narrowed coronary arteries can deliver. Angina
should be considered a warning of more serious
conditions.

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The Cardiovascular System

Angiography - A diagnostic technique involving the

infusion of a radiopaque substance into the
bloodstream for x ray examination of specific blood
vessels.
Arteriosclerosis - A general term for the
pathological thickening and loss of elasticity of
arterial walls.
Arteriovenous malformation - A congenital
condition due to failure of proper development of
capillaries in one location so that an artery continues
directly into a vein.
Asystole - Total failure of the heart to contract
Atherosclerosis -The most common cause of
arterial disease characterized by thickening of the
tunica intima and the deposition of pinkish yellow
plaques which narrow the arterial lumen.
Predisposing factors include lack of exercise, stress,
a high cholesterol diet, high blood pressure and
smoking.
Balloon angioplasty - A procedure in which a long
catheter (tube) with an inflatable balloon
incorporated into its tip is inserted into an artery and
passed to a point of narrowing. The balloon is then
carefully inflated, stretching the arterial wall and
widening the lumen.
Bruit - A noise heard using a stethoscope which is
produced by the turbulent flow of blood in an artery.
Turbulent flow can result from stenosis (narrowing)
or localized dilatation (aneurysm). If a bruit is
pronounced, it can sometimes be experienced by the
palpating hand (see ‘thrill’ below)

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 The Cardiovascular System

Cardiac catheterization - A diagnostic procedure in

which a fine catheter (tube) is passed from an
accessible blood vessel near the body surface into
the heart. Pressure, flow and oxygen content of the
blood in different chambers can be measured and
heart structures can be visualized by x rays after
injection of radiopaque substances.
Cardiac tamponade - A condition resulting from
inability of the heart to adequately fill with blood
during diastole. This may result from constriction
from an inflamed or scarred pericardium or from the
accumulation of fluid or blood within the pericardial
sac around the heart.
Cardiomyopathy - Any disease of the myocardium
that weakens the heart’s ability to pump adequately
Cor pulmonale - A condition caused by elevated
pressure in the pulmonary vascular circulation which
results in enlargement and failure of the right
ventricle.
Dysrythmia - Any abnormal rhythm of the heart
Echocardiography - Ultrasound imaging of the
heart with measurement of blood flow through the
different chambers.
Endarterectomy - A surgical procedure to remove
atherosclerotic plaques that are blocking an artery.
Heart block - A defect in the conducting system of
the heart whereby impulses from the atria are not
transmitted correctly to the ventricles. The ventricles
continue to beat but so slowly that they may not be

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The Cardiovascular System

able to maintain adequate circulation and an

artificial pacemaker may have to be implanted.
Hypertension - High blood pressure (dependent on
age but frequently defined as greater than 90/40 mm
Hg) This may result in increased work for the heart
and increased wear and tear on arterial walls.
Myocardial infarction (heart attack) - Prolonged
blockage of a coronary artery resulting in death of
cells in an area of the wall of the heart. The effect is
sudden severe chest pain sometimes extending into
the neck or left arm. The result depends upon the
extent of infarction but death occurs almost
immediately in about 30% of cases.
Phlebitis - Inflammation of a vein most frequently
resulting from local trauma or bacterial infection
Phlebotomy - An incision made in a vein for
withdrawing blood.
Portal hypertension - Increased pressure in the
portal venous system, frequently resulting from
chronic liver disease
Thrill - A palpable sensation resulting from the
turbulent flow of blood in an artery. (see bruit)
Ventricular fibrillation - Uncoordinated
contractions of the ventricle due to crippling of the
conduction system. Random electrical impulses are
produced within the ventricular muscle such that the
ventricles are unable to pump blood. The effect,
which has been likened to a quivering bag of worms,
is equivalent to asystole and soon results in death if
not corrected rapidly.

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