CVS ANATOMY (Compatibility Mode)

CIRCULATORY SYSTEM 5/14/2011
COMPONENTS
CIRCULATORY SYSTEM
• HEART
• Blood vessels
CIRCULATION OF
• Lymphatic vessels and other lymphatic organs
•BLOOD
•LYMPH
LYMPH • BLOOD
• LYMPH
Functions of circulatory system Organs of (blood) circulatory system
• Transport of
Transport of
• Heart ‐‐ pumps out blood and collects blood.
– Gas
– Nutrients • Blood vessels carry blood
– Hormones and enzymes – Artery ‐‐ away from heart
– Drugs
– Veins ‐‐ towards heart
• Defense – WBC, Immune system
• Clotting – Platelets and clotting factors – Capillaries ‐‐
C ill i microscopic network for exchange of gas
i i kf h f
• Temperature regulation – distribution of heat and heat loss
and nutrients
mechanism
drksbasnet.blogspot.com 1
Control of blood vessel diameter
• Media is thick in arteries
Three layers controls the calibre of the • Increased sympathetic tone causes vasoconstriction.
vessels • It also provides peripheral resistance
It also provides peripheral resistance
• Tunica adventitia
Tunica adventitia
• Capillary has intima only • PR depends on
– Outer layer
– Diameter
– Fibrous tissue
– Length
• Tunica media – Viscosity of blood
– Middle layer • Autoregulation
– Smooth muscle – Increased tissue activity in exercise
• Tunica intima – Following decreased blood supply
– Tissue damage e.g.. Inflammation
– Inner layer
– When circulation to vital organ is reduced critically.
– endothelium
• Pulmonary circulation • Location
– Right ventricle –
Ri ht t i l lungs –
l left
l ft – In medialtinum
In medialtinum
atrium – To the left side of the thorax
• Shape
• Systemic circulation
– Conical
– Left ventricle – tissues – right – Apex, base and surfaces (anterior,
atrium inferior and left)
• Portal circulation
Portal circulation – Size roughly equals the size of fist
– 220gms
– Alimentary canal ‐ liver
Cardiac skeleton
Structure
Three layers • Figure of 8 fibrous ring.
• Endocardium – Insulation
– Endothelial
– Inner lining – Valve attachment
• Myocardium – Muscle attachment
– Cardiac muscle
– Thick – Shape
• Pericardium
– Serous
Serous having visceral and
having visceral and
parietal layers cavity containing
serous fluid
– Fibrous forming inelastic bag
Interior of heart
Interior of heart
Right atrium Left atrium
Receives venous blood and Receives oxygenated blood
d li
delivers to right ventricle
t i ht ti l f
from lung and delivers to left
l d d li t l ft
• SVC ventricle
• IVC • 4 Openings for pulmonary veins
• Coronary sinus • AV orifice mitral valve
• AV orifice tricuspid valve
Left ventricle
g
Right ventricle • Receives blood from left atrium
• Receives blood from right atrium • Delivers blood to aorta which is
• Delivers blood to pulmonary trunk guarded by aortic valve
which is guarded by pulmonary
valve.
Right and left coronary arteries.
Right coronary artery
Right aortic sinus
Branches
Specialized •S‐A nodal
•Right marginal
Right marginal
Myocardium
M di
•Posterior IV
Components: •AV nodal
• SA node •Terminal branch
• AV node Area of supply
•Rt atrium
• AV bundle
•Rt ventricle
Rt ventricle
• Right and left bundle •SA and AV node
branches •Posterior 1/3 of IV septum
• Purkinje fibers
Heart rate
Nerve supply • ANS
From ANS • Circulating chemicals
– Catecholamine
Sympathetic T1‐4 and – Thyroxin
Parasympathetic vagus – Drugs
– Gases
nerves – Electrolytes
• Exercise
• Age
• Gender
• Emotion temperature
• Baroreceptor reflex increased stretch reduces rate
15
• Cardiac cycle‐ a series of events ECG

• 60 80/min
60‐80/min • Recording of electrical
Recording of electrical
• 0.8sec/cycle activity on the surface by
• Phases electrodes
– Atrial systole 0.1 sec • The machine is
– Ventricular systole 0.3 sec
electrocardiograph and the
recording is
– Complete cardiac diastole 0.4 sec
Complete cardiac diastole 0 4 sec
electrocardiogram
l di
• Heart sound
• Waves P Q R S T
– 1st due to the closure of AV valves
– 2nd due to closure of aprtic and pulmonary valves
Cardiac output Blood pressure
• Blood ejected per minute
j p • The force exerted by blood on the vessel wall.
The force exerted by blood on the vessel wall
• CO= SV×RATE
• Systolic during contraction
• Stroke volume amount ejected per ventricular contraction
• Stroke volume depends on • Diastolic during dialtole
– VEDV (preload) which depend on venous return • S‐D= pulse pressure
• Position • BP=CO×PR
• Muscular contraction
• Respiratory pump • PR depends on
– Atrial blood pressure which is dependent on PR (afterload) – Elasticity
– Blood volume
– Viscosity of blood
– Strength of myocardium
– Vasoconstriction
• Control of BP Pulse Factors affecting pulse

• Cardiovascular centre in medulla gathers info from
Cardiovascular centre in medulla gathers info from
– Baroreceptors
• Wave of distension and
W f di t i d • Position
P iti
• Aortic sinus elongation felt in artery • Age
• Carotid sinus
– Rate • Gender
– Chemoreceptors (in severe respiratory disruption)
• Aortic body – Rhythm
• Carotid body
• Exercise
– Volume
– Higher centre
– Tension p
• Temperature
• In emotional change
• Hypothalamus in regulating temperature causes change in vessel diameter – Symmetry • Emotion
• Output of CVC is through ANS
CVS PHYSIOLOGY
Cardiac cycle Heart rate is affected by
• Events of systole and diastole
Events of systole and diastole • ANS
• Circulating chemicals
• Stages – Adrenalin
– Atrial systole 0.1 sec – Thyroxin
– Ventricular systole 0.3 sec – Drugs
– Complete cardiac diastole 0.4 sec • Exercise
• Heart sounds • Emotional states
– 1stlub closure of AV valves • Gender F>M
– 2nd dup closure of aortic and pulmonary valves • Age children>adults
• Temperature
• 60 – 90 cycles per minute. Rate!
• Baroreceptor reflex
Stroke volume • 60‐70ml out of 110ml = 65%
• The amount of blood ejected by the left ventricle • ↑EDV‐‐↑contrac on‐‐↑SV
per contraction. 70ml. • Sympathetic system is positive ionotropic( ↑Ca++ to
• Determined by SR) and chronotropic
– EDV. SVαEDV
– PR SVα1/PR
PR SVα1/PR
– Contractility of myocardium
• Parasympathetic system is negative chronotropic – Cardiac out put
slow rate ‐‐↑EDV ‐‐
l t ↑EDV ↑contrac
↑ t on. So it can be
S it b • SV×CR
regarded as indirectly positive ionotropic. • Venous return to the heart
– Venous pressure
• Venules 10mm Hg
• Venacava 0mm
0mm Hg
Hg
– Returned by Blood volume
• Pressure difference
P diff
• Fluid movement = fluid out‐ fluid in
• Muscular contraction
• respiration • Fluid out = hydrostatic pressure + osmotic pressure
– Blood volume of tissue fluid – tissue hydrostatic pressure + plasma
osmotic pressure
• Protein in tissue = 2gm% in plasma 8%
Protein in tissue 2gm% in plasma 8%
• The difference in osmotic pressure is called oncotic
pressure
Oedema Regulation of blood volume
• ↑ arterial pressure
↑ t i l • ADH
• Venous obstruction – ↑osmolality – osmoreceptors of hypothalamus – ADH
• Leakage of plasma protein in inflammation secretion – retention of water
• Myxoedema in which there is ↑glycoprotein in • Aldosterone
tissue – ↓Pressure/volume –
↓Pressure/volume – JG cells –
JG cells – renin – angiotensinogen is
is
• ↓ Plasma protein converted into angiotensin1 – angiotensin 2
• Lymphatic obstruction (vasoconstriction) – aldosterone – sodium and water
retention.
• Stretching of artria Blood pressure
– ↑ pressure/ volume – stretching of atria –atrialnatriuritic • Pressure exerted by blood on the arterial wall
factor ANF – sodium and water excretion
• Depends on blood volume, peripheral resistance and
heart rate.
• BP α CO (rate×volume) × PR
• Volume is maintained by kidney
• Rate and PR maintained by ANS
• If BP is equal to atmospheric pressure the measurement is 0. • Atrial stretch reflex

1. Atrial stretch receptors in atria
• 100 mmHg means BP 100 mmHg > atmospheric pressure
100 mmHg means BP 100 mmHg > atmospheric pressure
2. Activated by high venous return
Controlled by 3. Tachycardia, inhibition of ADH release increasing urinary output and
• Baroreceptors like aortic and carotid sinuses increased ANF resulting in high urinary salt loss followed by water loss
• Chemoreceptors
1. Sensitive to fall in pressure
– ↑H+ , ↑PCO2 and ↓PO2 – chemoreceptors – CVC ‐‐ stroke volume and
2. Mediated by IX and X nerve heart rate increase and arteries constrict increasing blood pressure.
3. Info to vasomotor and cardiac control centres • Higher centres
g in the brain
4. Low pressure – less info ‐‐ inhibition of parasympathetic – – Emotions – hypothalamus – CVC – change in blood perssure
increased sympathetic tone – increased heart rate and – Hypothalamus – CVC – adjustment of blood vessel diameter
vasoconstriction
BP measurement Hypertension
• Principle
Principle • Secondary 5%
Secondary 5%
– Linear and turbulent flow • Primary
• Methods – Due to complex process
– Palpatory and auscultatory – Mainly PR is increased
• Instruments • Dangers
• Korotkoff sound – Vascular damage
• Pulse pressure = systolic‐ diastolic pressure – Increased afterload – CCF
– Stroke
• Mean arterial pressure (average arterial pressure during
cardiac cycle) = diastolic + 1/3 pulse pressure – Heart disease
Pulse
• Wave of elongation and distension felt in artery wall due
Wave of elongation and distension felt in artery wall due
to contraction of left ventricle ejecting 70 ml blood.
• Informations
– Rate
– Volume
– Rhythm
– Tension
– Symmetry
• Factors influencing the rate i.e. Heart rate

CVS ANATOMY (Compatibility Mode)

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CIRCULATORY SYSTEM 5/14/2011

• Cardiac cycle‐ a series of events ECG

• Control of BP Pulse Factors affecting pulse

• If BP is equal to atmospheric pressure the measurement is 0. • Atrial stretch reflex

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