TOPIC 5: THE

CARDIOVASCULAR
SYSTEM The Heart

Definition  Generating Blood

The Cardiovascular System Pressure
 responsible for delivering blood  Routing blood
to different parts of the body Heart separates pulmonary and
Organs: systemic circulation
 Heart: Pumping device  Ensuring one-way blood flow
 Blood vessels Heart valves ensure one-way flow
 Veins  Regulating blood supply
 Arteries Changes in contraction rate and
 Capillaries force match blood delivery to
changing metabolic needs

The Heart

 Size of a closed fist

 Shape
 Apex: Blunt rounded point
 Base: Flat part at opposite of
end of cone
 Located in thoracic cavity in
Mediastinum

The Heart

 Consists of plate of fibrous

connective tissue between atria
and ventricles
 Fibrous rings around valves to
support
Serves as electrical insulation
between atria and ventricles
 Provides site for muscle
Attachment
Cardiac Muscle
 Elongated, branching cells
containing 1-2 centrally located
nuclei
 Contains actin and myosin
myofilaments
 Intercalated disks: Specialized cell-
cellcontacts
 Desmosomes hold cells together and
gap junctions allow action potentials
 Electrically, cardiac muscle behaves
assingle unit
Heart Wall
 Three layers of tissue
 Epicardium: This serous
membrane of smooth outer
surface of heart
 Myocardium: Middle layer
composed of cardiac muscle
cell and responsibility for
heart contracting
 Endocardium: Smooth inner
surface of heart chambers

Heart Wall
Size, Shape, Locationof theHeart

Heart Wall
Heart Cross Section  Atrioventricular
 Tricuspid
 Bicuspid or mitral
 Semilunar
 Aortic
 Pulmonary
 Prevent blood from flowing
back
 Heart Chambers
 Atria

Right - Receives blood from 3 veins

(superior vena cava, the inferior vena
cava and the coronary sinus)
Left - forms most of the base of the heart
and receives blood from the
lungs through four pulmonary veins
External Anatomy
 Four chambers  Ventricles
 2 atria
 2 ventricles Right - receives blood from the right
 Auricles atrium and pumps this blood out
 Major veins into the pulmonary circulation (the
 Superior vena cava lungs).
 Pulmonary veins Left - receives blood from the left atrium
 Major arteries and pumps this blood out into
 Aorta the systemic circulation (the rest of the
 Pulmonary trunk body) via the aorta.

Blood Circulation through the heart

 The right heart pump receives

deoxygenated blood (blood that has
given up
some of its oxygen to the cells) from the
tissues and pumps it out into the
pulmonary circulation (the lungs).

 The left heart pump receives

oxygenated blood from the
pulmonary
circulation and pumps it out to the rest
of the body (the systemic
circulation).
Blood Circulation through the heart
SystemicandPulmonary Circulation

Conducting
System of the
Heart Electric Pathways
Blood Circulation through the heart
 Within the heart there is a
specialized network of electrical
pathways
dedicated to ensuring the rapid
transmission of electrical impulses.
 This ensures that the myocardium is
excited rapidly in response to an
initiating impulse so that the chambers
contract and relax in the right
order and the different pairs of chambers
(atria and ventricles)
contract at the same time.
Blood Circulation through the heart
 Once the impulse has been ‘held’ in
the AV node it is then transmitted
down the bundle of His (AV bundle) to
the fast pathways of the two
bundle branches (one bundle branch per
ventricle). The bundles then
divide into the smaller and smaller
branches of the Purkinje system,
which transmits the impulses to the
muscles of the ventricles
Cardiac Cycle
 Blood moves through circulatory
system from areas of higher to
lower
pressure.
 Contraction of heart produces the
pressure
 Systole: the contraction of a heart
chamber (atrium or ventricle).
 Diastole: the relaxation of a heart
chamber (atrium or ventricle)
Electrocardiogram
 the electrical activity that stimulates
this mechanical action can be seen
by the use of an ECG
 an electrical tracing produced by
attaching electrodes to the patient’
skin and generated by an ECG machine

Heart Sounds
 First heart sound or
“lubb”
 Atrioventricular valves and
surrounding fluid vibrations
 as valves close at beginning of
ventricular systole
 Second heart sound or
“dupp
 ”Results from closure of aortic and
pulmonary semilunar valves at
beginning of ventricular diastole, lasts
longer
 Third heart sound (occasional)
 Caused by turbulent blood flow into
ventricles and detected near end
of first one-third of diastole
FACTORS AFFECTING CARDIAC
OUTPUT
 Stroke Volume
 Preload
 Force of contraction
 Afterload
 Heart Rate
 autonomic nervous system activity;
hormone activity
 Stroke Volume
 Preload
 The force the cardiac muscle fibers
contract with during systole is
affected by the amount of stretch they
are subjected to (the greater
the stretch, the greater the force).
 The stretch of the cardiac muscle is
directly related to the amount of
blood in the ventricle at the end of
diastole
 dependent on the volume of blood
returned to the heart via the veins
(venous return)
 venous return is related to the force
of contraction of the ventricles
Force of Contraction
 Hormones, such as adrenaline,
glucagon and thyroxine, all increase
the
force of contraction.
 Sympathetic nervous system
activity increases the force of
contraction
through the action of noradrenaline.
 Contractility can be reduced by
acidaemia (excess hydrogen ions in
the
blood) and high potassium levels in the
blood
Stroke Volume
 Afterload
 refers to the pressure in the arteries
leading from the ventricles
(aorta or pulmonary arteries) that the
ventricle must overcome in
order to eject blood.
 80 mmHg in the aorta and 8 mmHg
in the pulmonary arteries.
Heart Rate
 Autonomic nervous system activity
 nonadrenaline
 leads to the excitation of the SA
node and an increase in its
production of action potentials and thus
an increase in heart rate.
 Hormone activity
 Adrenaline – from the adrenal
medulla. Adrenaline has the same
effect as noradrenaline released by the
sympathetic nervous system.
 Thyroxine – from the thyroid gland.
Released in large quantities,  Parasympathetic stimulation
thyroxine has the effect of increasing the Supplied by vagus nerve, decreases
heart rate heart rate, acetylcholine
secreted
Baroreceptor
And Chemoreceptor  Sympathetic stimulation
Reflexes Supplied by cardiac nerves,
increases heart rate and force of
contraction, epinephrine and
norepinephrine released

SUMMARY: Aging effects on Heart

 Gradual changes in heart function,

minor under resting condition, more
significant during exercise
 Hypertrophy of left ventricle
 Maximum heart rate decreases
Baroreceptor  Increased tendency for valves to
 cardiovascular centre of the medulla function abnormally and
oblongata arrhythmias to occur
 cardioinhibitory centre directly  Increased oxygen consumption
controls parasympathetic required to pump same amount of
outflow to the heart: Increase outflow, blood.
reduce heart rate
 Vasomotor centre Cardiac Arrhythmias
 Presser Area: moderated by nerves  Tachycardia: Heart rate in excess of
transmitting impulses 100bpm
 Depressor Area  Bradycardia: Heart rate less than 60
bpm
 Sinus arrhythmia: Heart rate varies
5% during respiratory cycle and up
to
30% during deep respiration
 Premature atrial contractions:
Occasional shortened intervals
between one contraction and
succeeding, frequently occurs in
SUMMARY: HEART healthy people
REGULATION

 Intrinsic regulation: Results from

normal functional characteristics,
not on
neural or hormonal regulation (Starling
’
s law of the heart)
 Extrinsic regulation: Involves neural
and hormonal control
TOPIC 5: THE Platelets
CIRCULATION  small blood cells consisting of some
cytoplasm surrounded by a
BLOOD  plasma membrane
The Cardiovascular System  megakaryocytes
 Remove macrophage
 Red blood cells  Platelets plug
 White blood cells
 Platelets HAOEMOSTASIS &
 Plasma COAGULATION

Function of the blood  Haemostasis is a sequence of

 The Cardiovascular System responses that stops bleeding
 Transport of gases, nutrients, and and can prevent haemorrhage from
waste products smaller blood vessels
 Transport of processed molecules  Vasoconstriction
 Transport of regulatory molecules  Platelet Aggregation
 Maintenance of body temperature  Coagulation
 Protection against foreign
substances Blood clotting
 Clot formation  Thromboplastinogenase is an
enzyme released by the blood
BLOOD platelets and combines with
antihaemophilic factor to
 Red blood cells convert the plasma protein
 Erythrocytes thromboplastinogen into
 Haemoglobin thromboplastin.
 Bone Marrow  Thromboplastin combines with
 Erythroblast calcium ions to convert the
inactive plasma protein prothrombin into
thrombin.
 Thrombin acts as a catalyst to
convert the soluble plasma
protein fibrinogen into insoluble plasma
protein fibrin.
 The fibrin threads trap blood cells to
form a clot.
 Once the clot is formed, the healing
BLOOD of the damaged blood vessel takes
 White blood cells place, which restores the integrity of
 granulocytes (contain granules in the blood vessel.
the cytoplasm)
 neutrophils Blood Grouping
 eosinophils TERMS TO REMEMBER:
 basophils;
 agranulocytes (despite the name  Transfusion – transfer of blood or
contain a few granules in the blood components from one
cytoplasm) individual to another.
 monocytes  Infusion- introduction of a fluid
 Lymphocytes other than blood
 Donor – person who gives blood
 Recipient – person who receives
blood
 Transfusion reactions – caused by
antigens and antibodies, resulting
-Clumping, rupture, clotting
within blood vessel
Blood Typing
Capillaries
 Capillary wall consists mostly of
endothelial cells
 Types classified by
diameter/permeability
 Continuous
 Do not have fenestrae
 Fenestrated (Have pores)
 Sinusoidal
-Large diameter with large fenestrae

Diagnostic Blood Tests

 Blood typing
 Cross match Cap
 CBC illary Network
 Differential WBCount  Blood flows from arterioles through
 Platelet count metarterioles, then through capillary
 Prothrombin time network
 Blood Chemistry  Venules drain network
 Smooth muscle in arterioles,
BLOOD VESSELS metarterioles, precapillary sphincters
 Arteries regulates blood flow
 Veins
 Cappilaries

Blood Vessel Structure

 Arteries
 Elastic, muscular, arterioles
 Capillaries
 Blood flows from arterioles to
capillaries
Structure of Arteries and Veins
 Most of exchange between blood
 Three layers except for capillaries
and interstitial spaces occurs across
and venules
the walls
 Tunica intima
 Blood flows from capillaries to
-Endothelium
venous system
 Tunica media
 Veins
-Vasoconstriction & Vasodilation
 Venules, small veins, medium or
 Tunica adventitia
large veins
-Merges with connective tissue
surrounding blood vessels
Structure of Arteries and Veins  Venules and small veins
 Tubes of endothelium on delicate
basement membrane
 Medium and large veins

 Valves
 Allow blood to flow toward heart
but not in opposite direction

 Atriovenous anastomoses

 Allow blood to flow from arterioles

to small veins without passing
through
capillaries

Blood Vessel Comparison

Structure of Arteries
 Elastic or conducting arteries
 Largest diameters, pressure high
and fluctuates
 Muscular or medium arteries
 Smooth muscle allows vessels to
regulate blood supply by
constricting or dilating
 Arterioles Peripheral Circulation and
 Transport blood from small arteries Regulation
to capillaries

Aging of the Arteries

 Arteriosclerosis
 General term for degeneration
changes in arteries making them
less elastic
 Atherosclerosis
 Deposition of plaque on walls
 Systemic vessels
 Transport blood through most all
body parts from left ventricle and
back to right atrium
 Pulmonary vessels
 Transport blood from right ventricle
through lungs and back to left
atrium
 Blood vessels and heart regulated to
ensure blood pressure is high
Structure of Veins
 enough for blood flow to meet
metabolic needs of tissues

Peripheral Circulatory System

The Circulation
 Moves blood to and from the lungs
 Pulmonary trunk
 Arises from right ventricle
Pulmonary arteries
 Branches of pulmonary trunk which Arteries of the Brain
project to lungs
 Pulmonary veins
 Exit each lung and enter left atrium

Systemic Circulation: Arteries

 Aorta
 From which all arteries are derived
either directly or indirectly
 Parts
 Ascending, descending, thoracic,
abdominal Head and Thorax Major Arteries
 Coronary arteries
 Supply the heart
Branches of
the Aorta

Arteries of Upper Limp and Shoulder

Major Arteries

Head and Neck Arteries

 Systemic Circulation: Veins
 Return blood from body to right
atrium
 Major veins
 Coronary sinus (heart)
 Superior vena cava (head, neck,
thorax, upper limbs)
 Inferior vena cava (abdomen, pelvis,
lower limbs)
 Types of veins
 Superficial, deep, sinuses
Major Veins
Arteries of Abdomen and Pelvis

Veins of Neck and Head

Arteries of Pelvis and Lower Limb

Arteries of Lower Limb Head and Thorax Vein

Veins of Should and Upper Limb

 Veins of Pelvis and Lower Limb

Veins of Thorax Veins of Lower Limb

Blood Pressure Measurement

Veins of Abdomen and Pelvis Dynamics of Blood Circulation

Interrelationships between
 Pressure  Cardiovascular System
 Flow  Cardiac Output
 Resistance  Circulating Volume
 Control mechanisms that regulate  Peripheral Resistance
blood pressure  Blood Viscosity
 Blood flow through vessels  Hydrostatic Pressure

Blood Pressure Control of arterial blood pressure

 Measure of force exerted by blood The Circulation
against the wall  Baroreceptors
 Blood moves through vessels  Chemoreceptors
because of blood pressure  Circulating Hormones
 Measured by listening for Korotkoff  The Renin-angiotensin system
sounds produced by turbulent flow  The hypothalamus
in arteries as pressure released from
blood pressure cuff
 Neuronal regulation
through the autonomic nervous
system
 Hormonal regulation
adrenaline, noradrenaline, renin and
others
 Autoregulation through the renin‐
angiotensin system

Laminar and Turbulent Flow

 Laminar flow
 Streamlined
 Outermost layer moving slowest
and center moving fastest
 Turbulent flow
 Interrupted
 Rate of flow exceeds critical
velocity
 Fluid passes a constriction, sharp
turn, rough surface

 Physiological factors regulating

blood pressure