1.

08 THE CARDIOVASCULAR SYSTEM, THE HEART & THE

BLOOD VESSELS ANPH111
Dr. Ma. Luisa Crisostomo || October 2022
Transcribers: Kathleen Venus

OUTLINE ventricular systole

I. CARDIOVASCULAR SYSTEM: AN Vessels that deliver
OVERVIEW Coronary arteries oxygenated blood to the
II. STRUCTURES myocardium
III. CIRCUITS OF THE HEART Large transverse vein on the
IV. BLOOD FLOW Coronary sinus heart’s posterior that returns
V. BLOOD SUPPLY blood to the right atrium
VI. CARDIAC CYCLE The period of cardiac muscle
Diastole
VII. CARDIAC CYCLE relaxation
VIII. HEART SOUNDS Record of the electrical
IX. REGULATION OF HEART FUNCTION Electrocardiogram (ECG)
currents in the heart
X. BLOOD VESSELS The endothelial membrane
XI. ARTERIES Endocardium that lines the chambers of
XII. PULSE the heart
XIII. BLOOD PRESSURE The serous membrane on
XIV. VEINS Epicardium the surface of the
myocardium
TERMINOLOGIES Space between the lungs
Heart valve that prevents Mediastinum
and beneath the sternum
Aortic valve backflow from the aorta to The valve that regulates
the left ventricle Mitral valve blood flow between the left
Pointed end of the heart, the atrium and left ventricle
Apex location of the point of The middle layer of the heart
maximum impulse Myocardium wall; composed of cardiac
Group of pacemaker cells in muscle
the interatrial septum that Space between the visceral
Atrioventricular (AV) node
relays impulses from the and parietal layers of the
atria to the ventricles Pericardial cavity serous pericardium that
The upper chamber of each contains a small amount of
Atrium
half of the heart serous fluid
The unique ability of the The membranous
cardiac muscle to contract fibroserous sac enclosing
Automaticity Pericardium
without nervous the heart and the bases of
stimulation the great vessels
Pressure sensors in the The amount of tension, or
aorta and carotid arteries stretch, in the ventricular
Baroreceptors that detect changes in Preload
muscle just before it
blood pressure; also called contracts
press receptors Sensors in muscles and
Broadest part of the heart; joints that signal the cardiac
Proprioceptors
Base where great vessels enter center of changes in physical
and leave activity
The series of events that Heart valve that prevents
occur from the beginning of Pulmonary valve backflow from the pulmonary
Cardiac cycle
one heartbeat to the artery to the right ventricle
beginning of the next Nerve-like processes that
The amount of blood extend from the bundle
Cardiac output pumped by the heart in 1 branches to the
minute Purkinje fiber
ventricular myocardium; form
Sensors in the aortic arch, the last part of the cardiac
carotid arteries, and medulla conduction system
Chemoreceptors
that detect increased levels Term applied to the heart’s
of carbon dioxide, decreased Rhythmicity
ability to beat regularly
levels of oxygen, and The two valves that regulate
decreases in pH flow between the ventricles
Tendinous cords that Semilunar valves
and the great
connect the edges of the AV arteries
Chordae tendineae valves to the papillary The heart’s primary
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muscles to prevent inversion Sinoatrial node pacemaker, where normal

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of the valve during cardiac impulses arise

[ANPH111] 1.08 THE CARDIOVASCULAR SYSTEM, THE HEART, AND THE BLOOD VESSELS – Dr. Ma. Luisa Crisostomo
The amount of blood ejected C. HEART LAYERS
Stroke volume • Epicardium:
by the heart with each beat
Contraction of the chambers surface of
Systole heart
of the heart
(outside), the
The right atrioventricular visceral layer
valve, which regulates flow of the serous
Tricuspid valve
between the right pericardium
atrium and right ventricle • Myocardium:
The two lower chambers of thick, middle
Ventricles layer
the heart
composed of
cardiac muscle
I. CARDIOVASCULAR SYSTEM: AN OVERVIEW • Endocardium
A. FUNCTIONS : smooth, inner surface; inner layer of the endothelium
1. Regulates blood supply D. CARDIAC MUSCLE
2. Generates blood pressure • 1 centrally located nucleus
3. Routes blood • Branching cells
4. Ensures 1-way blood flow • Rich in mitochondria
II. STRUCTURES • Striated (actin and myosin)
• Ca2+ and ATP used for contractions
A. HEART CHARACTERISTICS
• Intercalated disks connect cells
• Is a four-chambered, hollow, muscular organ lying
between the lungs in the middle.
• The heart is shaped like an inverted cone, with its
apex pointed downward and to the left base upwards
and to the right
• Size: Size of a fist and weighs less than 1lb
• Location: Between lungs in thoracic cavity
• Orientation: Apex (bottom) towards left side

E. CHAMBERS AND BLOOD VESSELS

• 4 Chambers
o left atrium (LA)
▪ Base of the heart
▪ Quadrilateral in shape
▪ Interior of the chamber is smooth
except in its auricular portion where
the musculi pectinati are found
▪ Blood leaves the left atrium via the
left atrioventricular orifice or mitral
orifice
B. HEART COVERINGS o right atrium (RA)
• Pericardium: Double-layered sac that anchors and ▪ Receives venous blood from:
protects heart • Superior vena cava
• Parietal Pericardium: membrane around heart’s • Inferior vena cava
cavity • Anterior cardiac veins
• Visceral pericardium: membrane on heart’s surface • Vena cordis minimae
• Pericardial cavity: space around heart • The coronary sinus
o left ventricle (LV)
▪ Apex of heart
▪ Cavity is longer and narrower than
the right and the walls are 3x thicker
than the right ventricle
▪ The lower anterior part forms the of
the heart which is at the level of the
o right ventricle (RV)
▪ Chamber of the heart receiving
venous blood from right atrium and
ejecting this to the pulmonary
arteries
Coronary Sulcus: separates atria from ventricles
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[ANPH111] 1.08 THE CARDIOVASCULAR SYSTEM, THE HEART, AND THE BLOOD VESSELS – Dr. Ma. Luisa Crisostomo

F. ATRIA
• Upper portion; Holding chambers
• Small, thin walled, contract minimally to push blood
into ventricles
• Interatrial septum: separates right and left atria

G. VENTRICLES
• Lower portion; Pumping chambers
• Thick, strong walled, contract forcefully to propel blood
out of heart
• Interventricular septum: separates right and left
ventricles

H. VALVES
• structures that ensure 1-way blood flow
• Atrioventricular valves (AV): between atria and
ventricles
o Tricuspid valve: AV valve between RA and
RV; 3 cusps
o Bicuspid valve (mitral): AV valve between
LA and LV; 2 cusps
• Semilunar valves:
o Pulmonary: base of pulmonary trunk
o Aortic: base of aorta
o Chordae tendineae: attached to AV valve
flaps ; support valves
What happens when Bicuspid Valve is Open?
• Blood flows from LA into LV.
• Aortic semilunar valve is closed.
• Tension on chordae tendineae is low.

What happens when Bicuspid Valve is Closed?
• Blood flows from LV into aorta.
• Aortic semilunar valve is open
• Tension on chordae tendineae is high.
III. CIRCUITS OF THE HEART
A. PULMONARY CIRCUIT
Right side of heart: Pulmonary Circuit
• carries blood from heart to lungs
• blood is O2 poor, CO2 rich

• Right Atrium: receives blood from 3 places: superior

and inferior vena cava and coronary sinus
o Superior vena cava: drains blood above
diaphragm (head, neck, thorax, upper limbs)
o Inferior vena cava: drains blood below
diaphragm (abdominopelvic cavity and lower
limbs)
o coronary sinus: drains blood from
myocardium
• Right Ventricle: opens into pulmonary trunk
o Pulmonary trunk: splits into right and left
pulmonary arteries
o Pulmonary arteries: carry blood away from
heart to lungs

B. SYSTEMIC CIRCUIT
Left side of heart: Systemic Circuit
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• carries blood from heart to body

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• blood is O2 rich, CO2 poor

[ANPH111] 1.08 THE CARDIOVASCULAR SYSTEM, THE HEART, AND THE BLOOD VESSELS – Dr. Ma. Luisa Crisostomo
• Left Atrium: 4 openings (pulmonary veins) that V. BLOOD SUPPLY
receive blood from lungs o Coronary Arteries
• Left Ventricle: o supply blood to heart wall
o opens into aorta o originate from base of aorta (above aortic
o thicker, contracts more forcefully, higher semilunar valve)
blood pressure than right ventricle has to get o Left Coronary Artery
to body o has 3 branches
o Aorta: carries blood from Left Ventricle to o supply blood to anterior heart wall and left
o body ventricle
o Right Coronary Artery
o originates on right side of aorta
o supply blood to right ventricle

VI. ACTION POTENTIAL IN CARDIAC MUSCLE

Changes in membrane channels’ permeability are responsible
for producing action potentials and is called pacemaker
potential.

1. Depolarization phase:
• Na+ channels open
• Ca2+ channels open
2. Plateau Phase:
• Na+ channels close
• Some K+ channels open
• Ca2+ channels remain open
3. Repolarization phase:
• K+ channels are open
• Ca2+ channels close
o Plateau phase prolongs action potential by keeping
Ca2+ channels open.
IV. BLOOD FLOW\ o In skeletal muscle action potentials take 2 msec, in
cardiac muscle they take 200-500 msec.

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[ANPH111] 1.08 THE CARDIOVASCULAR SYSTEM, THE HEART, AND THE BLOOD VESSELS – Dr. Ma. Luisa Crisostomo
A. CONDUCTION SYSTEM
• contraction of atria and ventricles by cardiac muscle
cells
• Sinoatrial node (SA node):
o in RA
o where action potential originates
o functions as pacemaker
o large number of Ca2+ channels

Path of Action Potential through Heart

1. SA node
2. 2. AV node (atrioventricular)
3. 3. AV bundle
4. 4. Right and Left Bundle branches
5. 5. Purkinje fibers

VIII. HEART SOUNDS

o S1 – first heart closure of the AV valves
B. ELECTROCARDIOGRAM o S2 – Closure of the semilunar valves
• record of o S3 – Ventricular Gallop
electrical events S4 – Atrial Gallop
in heart o Stethoscope is used to hear lung and heart sounds
• diagnoses o First sound is lubb, second is dupp
cardiac o Sounds result from opening and closing valves
abnormalities o Murmurs are due to faulty valves
• uses electrodes
• contains P wave,
QRS complex, T
wave
Components of
ECG/EKG
• P wave:
depolarization of
atria
• QRS complex:
o depolarization of ventricles
o contains Q, R, S waves
• T wave: repolarization of ventricles

VII. CARDIAC CYCLE

o Heart is 2 side by side pumps: right and left
o Atria: primers for pumps
o Ventricles: power pumps
o Cardiac Cycle: repetitive pumping action which
includes contraction and relaxation IX. REGULATION OF HEART FUNCTION
o Cardiac muscle contractions produce o Stroke Volume:
pressure changes within heart chambers. o volume of blood pumped per ventricle per
o Pressure changes are responsible for blood contraction
movement. o 70 ml/beat
o Blood moves from areas of high to low o Heart Rate:
pressure. o number of heart beats in 1 min.
o Atrial systole: contraction of atria o 72 beats/min.
o Ventricular systole: contraction of ventricles o Cardiac Output:
o Atrial diastole: relaxation of atria o volume of blood pumped by a ventricle in 1
o Ventricular diastole: relaxation of ventricles min.
o Cardiac output is the product of the heart rate
(HR) and the stroke volume (SV)
o CO = HR × SV
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o CO = HR (75 beats/min) × SV (70 ml/beat)

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o CO = 5250 ml/min = 5.25 L/min

[ANPH111] 1.08 THE CARDIOVASCULAR SYSTEM, THE HEART, AND THE BLOOD VESSELS – Dr. Ma. Luisa Crisostomo
A. REGULATION OFSTROKE VOLUME
• 60 percent of blood in ventricles (about 70 ml) is
pumped with each heartbeat
• Starling’s law of the heart
o The critical factor controlling SV is how much
cardiac muscle is stretched
o The more the cardiac muscle is stretched, the
stronger the contraction
• Venous return is the important factor influencing the
stretch of heart muscle
B. INTRINSIC REGULATION
• What is it? mechanisms contained within heart
• Venous return: amount of blood that returns to heart
• Preload: degree ventricular walls are stretched at end
of diastole
• Venous return, preload and stroke volume are
related to each other
• Starlings Law of the Heart: relationship between
preload and stroke volume influences cardiac output
(Ex. Exercise increases venous return, preload, stroke
volume, and cardiac output)
• After load: pressure against which ventricles must
pump blood
C. EXTRINSIC REGULATION
• What is it? mechanisms external to heart
• nervous or chemical regulation
i. NERVOUS REGULATION: BAROCEPTOR REFLEX
▪ mechanism of nervous system which regulates heart
function
▪ keeps heart rate and stroke volume in normal range
▪ baroreceptors monitor blood pressure in aorta and
carotid
▪ arteries (carry blood to brain)
▪ changes in blood pressure cause changes in
frequency of
▪ action potentials involves medulla oblongata
ii. CHEMICAL REGULATION: CHEMORECEPTOR REFLEX
▪ What is it?
o chemicals can affect heart rate and stroke
volume
o epinephrine and norepinephrine from adrenal
medulla can increase heart rate and stroke
volume
o excitement, anxiety, anger can increase
cardiac output
o depression can decrease cardiac output
o medulla oblongata has chemoreceptors for
changes in pH and CO2
o K+, Ca2+, and Na+ affect cardiac function
iii. FACTORS MODIFYING BASIC HEART RATE
1. Neural (ANS) control
• Sympathetic nervous system speeds heart
rate
• Parasympathetic nervous system, primarily
vagus nerve fibers, slow and steady the heart
rate
2. Hormones and ions
• Epinephrine and thyroxine speed heart rate
• Excess or lack of calcium, sodium, and
potassium ions also modify heart activity
3. Physical factors
• Age, gender, exercise, body temperature
influence heart rate
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[ANPH111] 1.08 THE CARDIOVASCULAR SYSTEM, THE HEART, AND THE BLOOD VESSELS – Dr. Ma. Luisa Crisostomo
X. BLOOD VESSELS A. AORTA
There are two systems of blood vessels: • The main arterial trunk of the systemic circulation
• Pulmonary Vessels divided into:
o transport blood from the right o Ascending Aorta
ventricle, through the lungs, and o Aortic Arch
back to the left atrium. o Descending Aorta
• Systemic Vessels ▪ Thoracic Aorta
o transport blood from the left ▪ Abdominal Aorta
ventricle, through all parts of the i. ASCENDING AORTA
body, and back to the right atrium ▪ It passes superiorly from the heart
There are three types of Blood Vessels: ▪ Approximately 5 cm long
• Arteries ▪ Has two arteries branching from it:
• Veins ▪ Right Coronary Artery
• Capillaries ▪ Left Coronary Artery
ii. AORTIC ARCH
Differences Arteries Veins ▪ Three major arteries branch from the aortic arch and
Carries blood away Carries blood carry blood to the head and upper limbs
Function ▪ Arteries of the Head and Neck
from heart toward heart
Unoxygenated A. Brachiocephalic Artery
Oxygenated except This short artery branches at the level of
Character of blood except pulmonary
pulmonary artery the clavicle to form the right common
vein
Thinner Thinnest carotid artery and the right subclavian
Thicker Thickest artery
Thickness of wall wall (tunica
wall (tunica media) i. Right Common Carotid Artery
adventitia)
The right common carotid
Usually rounded
Lumen Usually collapsed artery transports blood to
smaller
the right side of the head
Superficially
Location Deeply located and neck
located
ii. Right Subclavian Artery
Blow flow when the right subclavian artery
In spurts Flows freely
injured transports blood to the right
Presence of valves - - upper limb
B. Left Common Carotid Artery
XI. ARTERIES transports blood to the left side of the
head and neck
C. Left Subclavian Artery
which transports blood to the left upper
limb.
iii. DESCENDING AORTA
▪ The descending aorta is the longest part of the aorta
and it extends through the thorax in the left side of the
mediastinum and through the abdomen to the superior
margin of the pelvis.
1. Thoracic Aorta
o is the portion of the descending aorta located
in the thorax. It has several branches that
supply various structures between the aortic
arch and the diaphragm
2. Abdominal Aorta
o is the part of the descending aorta that
extends from the diaphragm to the point at
which the aorta divides into the two common
iliac artery
o The abdominal aorta has several branches
that supply the abdominal wall and organs.
Its terminal branches, the common iliac
arteries, supply blood to the pelvis and lower
limbs
• Visceral
A. Paired:
1. Middle Suprarenal – supplies suprarenal gland
2. Renal – supplies kidney
3. Testicular or ovarian – supplies gonads
B. Single
1. Coeliac – supplies foregut
2. Superior Mesentric – Supplies Midgut
3. Inferior Mesentric – Supplies Hindgut
• Parietal
A. Paired
1. Inferior Phrenic – Supplies lower diaphragm
2. Lumbar – Supplies posterior abdominal wall
Common iliac – Terminal branch
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3.
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B. Single
1. Median Sacral
[ANPH111] 1.08 THE CARDIOVASCULAR SYSTEM, THE HEART, AND THE BLOOD VESSELS – Dr. Ma. Luisa Crisostomo
B. ARTERIES OF THE HEAD AND NECK A. COMMON SITES OF PULSES
1. Common Carotid Arteries 1. Superficial temporal artery
- common carotid arteries extend superiorly, without 2. Facial Artery
branching, along each side of the neck, from their 3. Femoral Artery
base to the inferior angle of the mandible. At this point, 4. Popliteal Artery
each common carotid artery branches into internal and 5. Radial Artery
external carotid arteries 6. Dorsalis Pedis
a. External Carotid Artery 7. Carotid Artery
b. Internal Carotid Artery

XIII. BLOOD PRESSURE

o Force exerted by the blood pushing against the blood
vessels walls that circulated through out the body

C. ARTERIES OF THE LOWER LIMB

1. Femoral Artery
- Becomes the popliteal artery that divides into:
a. Anterior Tibial Artery
- continues as dorsalis pedis
b. Posterior Tibial Artery
- divides into medial and lateral plantar arteries

XIV. VEINS

XII. PULSE
o A travelling pressure that cause an alternating
expansion and recoil of the elastic arteries
o Normally 70 – 80 beats per minute
o Tachycardia - > 100
o Bradycardia – below 60
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[ANPH111] 1.08 THE CARDIOVASCULAR SYSTEM, THE HEART, AND THE BLOOD VESSELS – Dr. Ma. Luisa Crisostomo
A. VEINS DRAINING THE HEART
1. Cardiac veins
- transport blood from the walls of the heart and return
it through the coronary sinus to the right atrium.

B. VEINS OF THE HEAD AND NECK

1. External jugular veins
- are the more superficial of the two sets, and they
drain blood primarily from the posterior head and neck
- The external jugular vein drains into the subclavian
vein
2. Internal jugular veins
- are much larger and deeper than the external
jugular veins.
- internal jugular veins drain blood from the cranial
cavity and the anterior head, face, and neck.

C. PULMONARY CIRCULATION

D. PORTAL CIRCULATION
• Blood from the intestines will pass through the
circulation on the way to the liver
• Food nutrients that had been absorbed in the small
intestines – intestinal veins – superior mesenteric
veins – joins splenic vein to form portal vein liver
• The portal vein is one of 2 main blood supplies of the
liver. These cavities absorb food nutrients
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