CARDIOVASCULAR SYSTEM

1. Generating blood pressure

2. Routing blood

3. Ensuring one-way blood flow

4. Regulating blood supply

-The right side of the heart pumps blood to the lungs and back to the left side of the heart through
vessels of pulmonary circulation.
-The left side of the heart pumps blood to all other tissues of the body and back to the right side of the
heart through vessels of the systemic circulation.
SIZE, FORM, LOCATION OF THE HEART

 Shaped like a blunt cone and is approximately the size of the closed fist.

 Apex- blunt, rounded point of the heart

 Base- larger, flat part at the opposite end of the heart

 Location-thoracic cavity between the two pleural cavities that surround the lungs.

 Surrounded by the pericardial cavity.

 The heart lies obliquely in the mediastinum, with its base directed posteriorly and slightly
superiorly and its apex directed anteriorly and slightly inferiorly.
Pericardium

Two layers:
fibrous pericardium
-outer layer (tough connective tissue)
serous pericardium
-inner layer (flat epithelial cells with a thin layer of connective tissue.
Two parts:
parietal pericardium- lining the fibrous pericardium
visceral pericardium- covers the heart surface

EXTERNAL ANATOMY
Six large veins carry blood to the atria of the heart:

Superior vena cava & inferior vena cava

-carry blood from the body to the right atrium.

Pulmonary veins (4)

-carry blood from the lungs to the left atrium

Arteries (2) (great vessels/great arteries)

-carry blood away from the ventricles of the heart

Pulmonary trunk ( splits into R & L pulmonary arteries)

- Carry blood to the lungs

Aorta

-carries blood to the rest of the body

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HEART CHAMBERS & INTERNAL ANATOMY

4 CHAMBERS: RIGHT & LEFT ATRIA; RIGHT & LEFT VENTRICLES

RIGHT AND LEFT ATRIA

Right atrium receives blood from 3 major openings:

1. Superior vena cava

2. Inferior vena cava drain blood from most of the body

3. Coronary sinus – drains blood from most of the heart muscle

LEFT ATRIUM

-receives blood through the 4 pulmonary veins, which drain blood from the lungs.

Interatrial septum- separates 2 atria from each other

Heart valves

2 types:

Atrioventricular (AV) valves-located in between each atrium and ventricle

Semilunar valves-located between each ventricle and its associated great artery

Tricuspid valve – AV valve between right atrium and right ventricle

Bicuspid valve - AV valve between left atrium and left ventricle

Papillary muscles-cone-shaped, muscular pillars of each ventricle.

Chordae tendineae (heart strings)-thin, strong, connective tissue strings that attach the papillary
muscles to the AV valve cusps.

Pulmonary semilunar valve- between the right ventricle and pulmonary trunk

Aortic semilunar valve- located between the left ventricle and aorta
ROUTE OF BLOOD FLOW THROUGH THE HEART

BLOOD SUPPLY TO THE HEART

CORONARY ARTERIES

-supply blood to the wall of the heart

CARDIAC VEINS

-drain blood from the cardiac muscle

LEFT CORONARY ARTERY

3 MAJOR BRANCHES:

1. Anterior interventricular artery

2. Circumflex artery

Left marginal artery

HISTOLOGY OF THE HEART

HEART WALL

-Composed of 3 layers of tissue:

1. Epicardium

2. Myocardium

3. Endocardium

Epicardium/visceral pericardium

-thin, serous membrane forming the smooth outer surface of the heart.

-simple squamous epithelium overlying a layer of connective tissue and adipose tissue.

Myocardium

-thick, middle layer of the heart

-composed of cardiac muscle cells

-responsible for contraction of the heart chambers

Endocardium

-smooth, inner surface of the heart

-simple squamous epithelium over a layer of connective tissue

-allows blood to move easily through the heart

Cardiac Muscle

-elongated, branching cells that contain one, or occasionally two, centrally located nuclei.

-contain actin and myosin myofilaments organized to form sarcomeres, which are joined end-to-end to
form myofibrils.

-cardiac muscle cells are bound end-to-end and laterally to adjacent cells by specialized cell-to-cell
contacts called intercalated disks.

Gap junctions

-specialized cell membrane structures in the intercalated disks

-allow cytoplasm to flow freely between cells which enables action potentials to pass quickly and easily
from one cell to the next.
ELECTRICAL ACTIVITY OF THE HEART

-action potentials in the cardiac muscle take approximately 200 to 500 milliseconds to complete.
CONDUCTION SYSTEM OF THE HEART

Contraction of the atria and ventricles is coordinated by specialized cardiac muscle cells in the heart wall
that form the conduction system of the heart.

 Includes SINOATRIAL (SA) NODE, ATRIOVENTRICULAR NODE (AV) NODE, ATRIOVENTRICULAR

BUNDLE, RIGHT AND LEFT BUNDLE BRANCHES, PURKINJE FIBERS.

SINOATRIAL (SA) NODE

-located in the superior wall of the right atrium and initiates the contraction of the heart.

-action potentials originate in the SA node

ATRIOVENTRICULAR (AV) NODE

-located in the lower portion of the right atrium

-when action potentials reach the AV node, they spread slowly through it and then into the bundle of
specialized cardiac muscle called AV bundle.

AV BUNDLE

-separates the atria from the ventricles.

-divides into 2 branches of conducting tissue: left and right bundle branches.

PURKINJE FIBERS

-pass to the apex of the heart and then extend to the cardiac muscle of the ventricle walls.

CONDUCTION SYSTEM OF THE HEART

ELECTROCARDIOGRAM

Electrodes placed on the body surface and attached to a recording device can detect the small electrical
changes resulting from the action potentials in all of the cardiac muscle cells.
-normal ECG consists of a P wave, a QRS complex, T wave.

P wave

-results from depolarization of the atrial myocardium, and the beginning precedes the onset of atrial
contraction.

QRS complex

-results from depolarization of the ventricles, and the beginning precedes ventricular contraction.

T wave

-represents repolarization of the ventricles

-beginning of the T wave precedes ventricular relaxation

.
Cardiac cycle

-refers to the repetitive pumping process that begins with the onset of cardiac muscle contraction and
ends with the beginning of the next contraction.

-at the beginning of the cardiac cycle, the atria and ventricles are relaxed, the AV valves open, blood
flows into the ventricles, filling them to approximately 70% of their volume. (step 1)

ATRIAL SYSTOLE-the atria contract, forcing additional blood to flow into the ventricles to complete their
filling. Semilunar valves remain closed. (step 2)

VENTRICULAR SYSTOLE-at the beginning of ventricular systole, contraction of the ventricles pushes
blood toward the atria, causing the AV valves to close as the pressure begins to increase. (step 3)

As ventricular systole continues, the increasing pressure in the ventricles exceeds the pressure exceeds
the pressure in the pulmonary trunk and aorta, the semilunar valves are forced open, and blood is
ejected into the pulmonary trunk and aorta (step 4)

VENTRICULAR DIASTOLE-at thee beginning of ventricular diastole, the pressure in the ventricles
decreases below the pressure in the aorta and pulmonary trunk. The semilunar valves close and prevent
blood from flowing back into the ventricles. (step 5)
HEART SOUNDS

STETHOSCOPE

-originally developed to listen to the sound of the lungs and heart and is now used to listen to other
sounds of the body as well.

Two main heart sounds:

First sound: lubb

2nd sound: dupp

First sound occurs at the beginning of ventricular systole and results from closure of the AV valves

Second sound occurs at the beginning of ventricular diastole and results from closure of the semilunar
valves.
REGULATION OF HEART FUNCTION

Cardiac Output (CO)

-volume of blood pumped by either ventricle of the heart each minute.

Stroke Volume (SV)

-volume of blood pumped per ventricle each time the heart contracts

Heart Rate (HR)

-number of times the heart contracts each minute.

Formula:

CO = SV X HR

(ml/min) (ml/beat) (beats/min)

Example: In resting condition, the heart rate is approximately 72 beats/min, and stroke volume is
approximately 70mL/beat.

CO=70 mL/beat x 72 bpm

= 5040 mL/min (approx. 5 L/min)

INTRINSIC REGULATION

-Refers to mechanisms contained within the heart itself

Preload-degree to which the ventricular walls are stretched at the end of the diastole.

Venous return-the amount of blood that returns to the heart.

Afterload- pressure against which the ventricles must pump blood.

EXTRINSIC REGULATION

-refers to mechanism external to the heart, such as venous or chemical regulation.

nervous regulation: BARORECEPTOR REFLEX

-Mechanism of nervous system that plays an important role in regulating heart function.
EFFECTS OF AGING ON THE HEART

 By age 70, cardiac output decreases to approx. one-third.

 Hypertrophy

 By age 85, Cardiac output decreases 30-60%

 Connective tissue becomes less flexible, calcium deposits develop in the valves.

 Iincrease in cardiac arrhythmias

 Ccoronary artery disease and heart failure