CARDIOVASCULAR SYSTEM

HAPP111 | FINALS | 1ST SEMESTER

THE CARDIOVASCULAR SYSTEM THE HEART: HEART WALL

★ A closed system of the heart and blood Heart wall has three layers
vessels ★ Epicardium
★ The heart pumps blood ○ Outside layer
★ Blood vessels allow blood to circulate ○ This layer is the parietal
to all parts of the body pericardium
★ Delivers oxygen and nutrients and to ○ Connective tissue layer
remove carbon dioxide and other ★ Myocardium
waste products
○ Middle layer
○ Mostly cardiac muscle
★ Endocardium
○ Inner layer
○ Endothelium

★ LOCATION:
○ Thorax between the lungs
○ Pointed apex directed toward
left hip
★ Size of the human fist
EXTERNAL HEART ANATOMY
THE HEART: COVERINGS

★ PERICARDIUM: A double serous

membrane
○ Visceral pericardium - Next to
heart
○ Parietal pericardium - Outside
layer
★ SEROUS FLUID: Fills the space
between the layers of pericardium
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THE HEART: CHAMBERS
★ Right and left side act as separate
pumps
★ FOUR CHAMBERS:
○ Atria - receiving chambers
■ Right atrium
■ Left atrium
○ Ventricles - discharging
chambers
■ Right ventricle
■ Left ventricle
BLOOD CIRCULATION
THE HEART: VALVES
★ Allow blood to flow in only one
direction
★ FOUR VALVES:
○ Atrioventricular valves –
between atria and ventricles
■ Bicuspid valve (left)
■ Tricuspid valve
(right)
○ Semilunar valves - between
ventricle and artery
■ Pulmonary semilunar
valve
■ Aortic semilunar
valve
OPERATION OF HEART VALVES
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VALVE PATHOLOGY THE HEART: CONDUCTION SYSTEM

★ Incompetent valve = backflow and ★ Intrinsic conduction system (nodal

repump system)
★ Stenosis = stiff= heart workload ★ Heart muscle cells contract, without
increased nerve impulses, in a regular,
★ May be replaced continuous way
★ Lub Dub Heart Sound ○ Special tissue sets the pace
■ Sinoatrial node (right
THE HEART: ASSOCIATED GREAT VESSELS atrium) “Pacemaker”
■ Atrioventricular node
(junction of right and
★ Aorta - Leaves left ventricle left atria and
★ Pulmonary arteries - Leave right ventricles)
ventricle
■ Atrioventricular
★ Vena cava - Enters right atrium
bundle (Bundle of
★ Pulmonary veins (four) - Enter left
His)
atrium
■ Bundle branches
(right and left)
CORONARY CIRCULATION ■ Purkinje fibers

★ Blood in the heart chambers does not

nourish the myocardium
★ The heart has its own nourishing
circulatory system
○ Coronary arteries
○ Cardiac veins
★ Blood empties into the right atrium via
the coronary sinus
★

CARDIAC PATHOLOGY

★ Rapid heart beat

○ Inadequate blood
○ Angina Pectoris (sharp
tingling pain)
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ELECTROCARDIOGRAMS (EKG/ECG) FILLING OF HEART CHAMBERS –

CARDIAC CYCLE

★ Three formations
○ P wave: impulse across atria
○ QRS complex: spread of
impulse down septum, around
ventricles in Purkinje fibers
○ T wave: end of electrical
activity in ventricle
THE HEART: CARDIAC OUTPUT

★ Cardiac output (CO)

○ Amount of blood pumped by
each side of the heart in one
minute
○ CO = (heart rate [HR]) x
(stroke volume [SV])
★ Stroke volume
○ Volume of blood pumped by
each ventricle in one
contraction

PATHOLOGY OF THE HEART

THE HEART: CARDIAC OUTPUT

★ Damage to AV node = release of

ventricles from control = slower heart
beat
★ Slower heart beat can lead to
fibrillation
★ Fibrillation = lack of blood flow to the
heart
★ Tachycardia = more than 100
beats/min
★ Bradycardia = less than 60 beats/min
CO = HR x SV
5250 ml/min = 75 beats/min x 70 mls/beat
Norm = 5000 ml/min
Entire blood supply passes through the body
once per minute.
CO varies with demands of the body.

THE HEART: CARDIAC CYCLE

★ Atria contract simultaneously

★ Atria relax, then ventricles contract
★ Systole = contraction
★ Diastole = relaxation
CARDIOVASCULAR SYSTEM
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★ Right side fails = peripheral congestion

THE HEART: REGULATION OF HEART RATE
and edema

★ Stroke volume usually remains

VASCULAR SYSTEM
relatively constant
★ Starling’s law of the heart – the more
that the cardiac muscle is stretched,
BLOOD VESSELS: THE VASCULAR SYSTEM
the stronger the contraction
★ Changing heart rate is the most
common way to change cardiac output ★ Taking blood to the tissues and back
★ Increased heart rate ○ Arteries
○ Sympathetic nervous system ○ Arterioles (small arteries)
■ Crisis ○ Capillaries
■ Low blood pressure ○ Venules (small veins)
○ Hormones ○ Veins
■ Epinephrine
■ Thyroxine
○ Exercise
○ Decreased blood volume
★ Decreased heart rate
○ Parasympathetic nervous
system
○ High blood pressure or blood
volume
○ Decreased venous return
○ In Congestive Heart Failure
the heart is worn out and
pumps weakly. Digitalis (drug) BLOOD VESSELS: ANATOMY
works to provide a slow,
steady, but stronger beat.
Three layers (Tunics/Tunica)
★ Tunic intima
CONGESTIVE HEART FAILURE (CHF) ○ Endothelium
★ Tunic media
★ Decline in pumping efficiency of heart ○ Smooth muscle
★ Inadequate circulation ○ Controlled by sympathetic
★ Progressive, also coronary nervous system
atherosclerosis, high blood pressure ★ Tunic externa
and history of multiple Myocardial ○ Mostly fibrous connective
Infarctions tissue
★ Left side fails = pulmonary congestion
and suffocation
CARDIOVASCULAR SYSTEM
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DIFFERENCES BETWEEN BLOOD VESSEL

TYPES

★ Walls of arteries are the thickest

★ Lumens of veins are larger
★ Skeletal muscle “milks” blood in veins
toward the heart
★ Walls of capillaries are only one cell
layer thick to allow for exchanges
between blood and tissue

MOVEMENT OF BLOOD THROUGH VESSELS

★ Most arterial blood is pumped by the

heart
★ Veins use the milking action of muscles
to help move blood DIFFUSION AT CAPILLARY BEDS

CAPILLARY BEDS

★ Capillary beds consist of two types of

vessels
○ Vascular shunt – directly
connects an arteriole to a
venule VITAL SIGNS
○ True capillaries – exchange
vessels
★ Arterial pulse
■ Oxygen and nutrients
★ Blood pressure
cross to cells
★ Respiratory Rate
■ Carbon dioxide and
★ Body Temperature
metabolic waste
★ All indicate the efficiency of the
products cross into
system
blood
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PULSE MEASURING ARTERIAL BLOOD PRESSURE

★ Pulse – pressure wave of blood

★ Monitored at “pressure points” where
pulse is easily palpated

BLOOD PRESSURE

★ Measurements by health professionals

are made on the pressure in large
arteries
○ Systolic – pressure at the
peak of ventricular
contraction
BLOOD PRESSURE: EFFECTS OF FACTORS
○ Diastolic – pressure when
ventricles relax
★ Pressure in blood vessels decreases as
the distance away from the heart
increases
★ Neural factors
○ Autonomic nervous system
adjustments (sympathetic
division)
★ Renal factors
○ Regulation by altering blood
volume
○ Renin – hormonal control
★ Temperature
○ Heat has a vasodilation effect
○ Cold has a vasoconstricting
effect
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★ Chemicals
PULMONARY CIRCULATION
○ Various substances can cause
increases or decreases
★ Diet ★ The pulmonary circulation carries
deoxygenated blood from the right
ventricle to the air sacs (alveoli) within
VARIATIONS IN BLOOD PRESSURE
the lungs and returns oxygenated
blood from the air sacs to the left
★ Human normal range is variable atrium
○ Normal
■ 140–110 mm Hg SYSTEMIC CIRCULATION
systolic
■ 80–75 mm Hg
★ The systemic circulation carries
diastolic
oxygen and nutrients to body tissues
○ Hypotension
and removes carbon dioxide and other
■ Low systolic (below
wastes and heat from the tissues.
110 mm HG)
■ Often associated
with illness PATHWAY OF SYSTEMIC CIRCULATION
○ Hypertension
■ High systolic (above I. Oxygen-rich blood from the lungs
140 mm HG) leaves the pulmonary circulation when
■ Can be dangerous if it enters the left atrium through the
it is chronic pulmonary vein.
II. The blood is then pumped through the
CIRCULATORY ROUTES mitral valve into the left ventricle.
III. From the left ventricle, blood is
pumped through the aortic valve and
★ There are two basic postnatal (after
into the aorta.
birth) routes for blood flow;
IV. The aorta arches and branches into
★ Pulmonary circulation - when blood
major arteries to the upper body
returns to the heart from the systemic
before passing through the diaphragm,
route, it is pumped out of the right
where it branches further into arteries
ventricle through the pulmonary
which supply the lower parts of the
circulation to the lungs.
body.
★ Systemic circulation - carries oxygen
V. The arteries branch into smaller
and nutrients to body tissues and
arteries, arterioles, and finally
removes carbon dioxide and other
capillaries.
wastes and heat from the tissues.
CARDIOVASCULAR SYSTEM
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THE HEPATIC PORTAL CIRCULATION

★ Hepatic portal circulation - carries

venous blood from the gastrointestinal
organs and spleen to the liver.
★ Portal vein - vein that carries blood
from one capillary network to another
★ Hepatic portal vein - receives blood
from capillaries of gastrointestinal
organs and the spleen and delivers it
to the sinusoids of the liver.
★ Superior mesenteric vein - drains
blood from the small intestine and
portions of the large intestine,
stomach, and pancreas
★ Splenic vein - drains blood from the
stomach, pancreas, and portions of the
large intestine.
★ Inferior mesenteric vein - which passes
into the splenic vein, drains portions of
the large intestine
★ Right and left gastric veins- which
open directly into the hepatic portal
vein, drain the stomach.
★ Cystic vein - which also opens into the
hepatic portal vein, drains the
gallbladder.
★ Hepatic portal vein - the liver is
receiving nutrient-rich but
deoxygenated blood.
★ Hepatic artery, the liver also receiving
oxygenated blood ,a branch of the
celiac trunk.
★ Sinusoids - the oxygenated blood
mixes with the deoxygenated blood.
Eventually, blood leaves the sinusoids
of the liver through the hepatic veins,
which drain into the inferior vena cava.