Medicină I – Seminarul 10

THE CARDIOVASCULAR SYSTEM

Elaine N. Marieb
Essentials of Human Anatomy and Physiology
Benjamin/Cummings Publishing Company, 1997, pp. 314 - 320, 350 - 351

The circulatory system has two major subdivisions – the cardiovascular system and the
lymphatic system. The cardiovascular system can be compared to a muscular pump equipped with
one-way valves and a system of large and small plumbing tubes within which the blood travels.
The relative size and weight of the heart give few hints of its incredible strength.
Approximately the size of a person’s fist, the hollow, cone-shaped heart weights less than a pound.
The heart is located within the body thorax and is flanked on each side by the lungs. Its more
pointed apex is directed toward the left hip and rests on the diaphragm, approximately at the level
of the fifth intercostal space. (This is exactly where one would place a stethoscope to count the heart
rate for an apical pulse). Its broader posterosuperior aspect, or base, from which the great vessels of
the body emerge, points toward the right shoulder and lies beneath the second rib.

cardiovascular system - sistem cardiovascular, aparat cardiovascular

lymphatic system (syn.) absorbent system - sistem limfatic
pump – pompă
muscular pump - pompă musculară
one-way valve - valvă unisens, valvă unidirecţională
hollow - gol, supt, cav; prăbuşit, înfundat
flank (syn.) latus (pl. latera) (syn.) lateral abdominal region - flanc, regiune abdominală
laterală, regiunea laterală a abdomenului
apex (pl. apices) - apex, vârf
aspect - aspect, latură; poziţie; privire
base (syn.) basis (pl. bases) - bază, temelie, punct de plecare

The heart is enclosed by a double sac of serous membrane, the pericardium. The thin
visceral pericardium, or epicardium, tightly hugs the external surface of the heart and is actually
part of the heart wall. It is continuous at the heart apex with the loosely applied parietal
pericardium, which is reinforced on its superficial face by dense connective tissue. This fibrous
layer helps protect the heart and anchors it to surrounding structures, such as the diaphragm and
sternum. A slippery lubricating fluid (serous fluid) is produced by the serous pericardial
membranes. This fluid allows the heart to beat easily in a relatively frictionless environment as the
pericardial layers slide smoothly across each other.

pericardium (pl. pericardia) (syn.) heart sac (syn.) capsule of heart (syn.) capsula
cordis - pericard, sac pericardic, pericard fibros
pericardial (syn.) pericardiac - pericardic
epicardium (syn.) visceral layer of serous pericardium - epicard, lama viscerală a
pericardului seros
epicardial – epicardiac
wall (syn.) paries (pl. parietes) - perete, sept; membrană
to slide - a aluneca, a culisa

Inflammation of the pericardium, pericarditis, often results in a decrease in the amount of

serous fluid. This cause the pericardial layers to bind and stick to each other, forming painful
adhesions that interfere with heart movements.
 The heart walls are composed of three layers: the outer epicardium, the myocardium, and the
innermost endocardium. The myocardium consists of thick bundles of cardiac muscle twisted and
whorled into ringlike arrangements. It is the layer that actually contracts. The myocardium is
reinforced internally by a dense, fibrous connective tissue network called the “skeleton of the
heart”. The endocardium is a thin, glistening sheet of endothelium that lines the heart chambers. It
is continuous with the linings of the blood vessels leaving and entering the heart.

pericarditis – pericardită
endocardium (pl. endocardia) – endocard
myocardium (pl. myocardia) (syn.) muscle of heart (syn.) cardiac muscle - miocard,
muşchi cardiac
myocardial (syn.) myocardiac - miocardic
bundle - fascicul, legătură, mănunchi
twisted - strâmb, răsucit
whorl – spiră
glistening – strălucitor
endothelium (pl. endothelia) – endoteliu

The heart has four hollow chambers or cavities – two atria and two ventricles. Each of
these chambers is lined with endocardium, which helps blood flow smoothly through the heart. The
superior atria are primarily receiving chambers. As a rule, they are not important in the pumping
activity of the heart. Blood flows into the atria under low pressure from the veins of the body and
then continues on to fill the ventricles below. The inferior, thick-walled ventricles are the
discharging chambers, or actual pumps of the heart. When they contract, blood is propelled out of
the heart and into the circulation. The heart is somewhat twisted; the right ventricle forms most of
its anterior surface, whereas the left ventricle forms its apex. The septum that divides the heart
longitudinally is referred to as the interventricular or interatrial septum, depending on which
chamber it divides and separates.

chamber - cameră, spaţiu; compartiment

atrium (pl. atria) – atriu
ventricle (syn.) ventriculus (pl. ventriculi) - ventricul
to line - a acoperi, a căptuşi; a linia
pressure - presiune, compresiune, tensiune; strângere
discharge - excreţie, scurgere, golire, secreţie, supuraţie, descărcare; ieşire din spital
to discharge - a emite, a scoate; a descărca;
interatrial septum (syn.) septum interatriale (syn.) interauricular septum – sept
interatrial al inimii, sept interauricular

Although it is a single organ, the heart functions as a double pump. The right side works as
the pulmonary circuit pump. It receives oxygen-poor blood from the veins of the body through the
large superior and inferior venae cavae and pumps it out through the pulmonary trunk. The
pulmonary trunk splits into the right and left pulmonary arteries, which carry blood to the lungs,
where oxygen is picked up and carbon dioxide is unloaded. Oxygen-rich blood drains from the
lungs and is returned to the left side of the heart through the four pulmonary veins. The circulation
just described, from the right side of the heart to the lungs and back to the left side of the heart, is
called the pulmonary circulation. Its only function is to carry blood to the lungs for gas exchange
and then return it to the heart.

pulmonary trunk (syn.) truncus pulmonalis - trunchi pulmonar

pulmonary arteries (syn.) arteriae pulmonales - artere pulmonare
pulmonary veins (syn.) venae pulmonales - vene pulmonare
circulation - circulaţie, circuit
 blood circulation - circulaţie sangvină
lesser circulation (syn.) pulmonary circulation - circulaţie mică, circulaţie pulmonară

Blood returned to the left side of the heart is pumped out of the heart into the aorta, from
which the systemic arteries branch to supply essentially all body tissues. Oxygen-poor blood
circulates from the tissues through systemic veins, which return the blood to the right atrium
through the superior and inferior venae cavae, as mentioned earlier. This second circuit, from the
left side of the heart through the body tissues and back to the right side of the heart, is called the
systemic circulation. It supplies oxygen- and nutrient-rich blood to all body organs. Because the
left ventricle is the systemic pump that must pump blood over a much longer pathway through the
body, its walls are substantially thicker than those of the right ventricle and it is a much more
powerful pump.

aorta (pl. aortae) (syn.) arteria aorta – aortă

branch (syn.) ramus (pl. rami) - ramură, ramificaţie
supply - aprovizionare, livrare; rezervă
blood supply - irigaţie, vascularizaţie
nerve supply (syn.) innervation - inervaţie, inervare
to supply - a aproviziona; a livra, a furniza
oxygen-rich/enriched blood - sânge oxigenat
deoxygenated blood (syn.) oxygen-poor blood - sânge neoxigenat
to oxygenate - a oxigena; a oxida
oxygenation – oxigenare
greater circulation (syn.) systemic circulation - circulaţie generală, circulaţie mare,
circulaţie sistemică

Valves
The heart is equipped with four valves that allow blood to flow in only one direction
through the heart chambers – from the atria through the ventricles and out the great arteries leaving
the heart. The atrioventricular or AV valves are located between the atrial and ventricular
chambers on each side. The AV valves prevent backflow into the atria when the ventricles contract.
The left AV valve – the bicuspid or mitral valve – consists of two cusps, or flaps, of endocardium.
The right AV valve, the tricuspid valve, has three cusps. Tiny white cords, the chordae tendineae
– literally, “heart strings” – anchor the cusps to the walls of the ventricles. When the heart is relaxed
and blood is passively filling its chambers, the AV-valve flaps hang limply into the ventricles. As
the ventricles contract, they press on the blood in their chambers, and the intraventricular pressure
begins to rise. This causes the AV-valve flaps to be forced upward, closing the valves. At this point
the chordae tendineae are working to anchor the flaps in a closed position. If the flaps were
unanchored, they would blow upward into the atria like an umbrella being turned inside out by a
gusty wind. In this manner, the AV valves prevent backflow into the atria when the ventricles are
contracting.

valve (syn.) valva (pl. valvae) – valvă

atrioventricular (AV) valves - valve atrioventriculare
bicuspid valve (syn.) valvula bicuspidalis (syn.) left atrioventricular (AV) valve (syn.)
valva atrioventricularis sinistra (syn.) mitral valve (syn.) valva mitralis - valvă
bicuspidă, valvă atrioventriculară stângă, valvă mitrală
tricuspid valve (syn.) right atrioventricular (AV) valve (syn.) valva atrioventricularis
dextra (syn.) valva tricuspidalis (syn.) valvula tricuspidalis - valvă tricuspidă, valvă
atrioventriculară dreaptă
cusp - cuspid; cuspidă, valvă
flap - lambou; clapă, clapetă
 chorda (pl. chordae) (syn.) cord - cordon, coardă
heart strings (syn.) tendinous cords (syn.) chordae tendinae cordis - cordaje tendinoase
gusty - cu rafale, impetuos

The second set of valves, the semilunar valves, guards the bases of the two large arteries
leaving the ventricular chambers. Thus, they are known as the pulmonary and aortic semilunar
valves. Each semilunar valve has three cusps that fit tightly together when the valves are closed.
When the ventricles are contracting and forcing blood out of the heart, the cusps are forced open
and flattened against the walls of the arteries by the tremendous force of rushing blood. Then, when
the ventricles relax, the blood begins to flow backward toward the heart and the cusps fill with
blood, closing the valves. This prevents arterial blood from reentering the heart.

semilunar valve (syn.) valvula semilunaris - valvulă semilunară

flow - flux, circulaţie, scurgere, curent, debit, volum
to flow - a curge, a circula, a se vărsa; a se scurge

Each set of valves operates at a different time. The AV valves are open during heart
relaxation and closed when the ventricles contract. As they open and close in response to pressure
changes in the heart, the valves force blood to continually move forward in its journey through the
heart.
Heart valves are basically simple devices, and the heart – like any mechanical pump – can
function with “leaky” valves as long as the damage is not too great. However, severe valve
deformities can seriously hamper cardiac function. For example, an incompetent valve forces the
heart to pump and repump the same blood because the valve does not close properly and blood
backflows. In valvular stenosis, the valve flaps become stiff, often because of repeated bacterial
infection of the endocardium (endocarditis). This compels the heart to contract more forcibly than
normal. In each case, the heart’s workload increases, and ultimately the heart weakens and may fail.
Under such conditions, the faulty valve is replace with a synthetic valve or a valve taken from a pig
heart.

leaky - neetanş, permeabil; care curge, cu fisuri

leakage - scurgere, curgere; crăpătură, fisură
to hamper - a împiedica, a îngreuna
endocarditis - endocardită
to compel - a obliga, a constrânge
workload - normă de muncă; sarcină de lucru
fault - defect, imperfecţiune; greşeală, eroare
faulty - defect, defectuos, imperfect, stricat; eronat, greşit

Although the heart chambers are bathed with blood almost continuously, the blood
contained in the heart does not nourish the myocardium. The blood supply that oxygenates and
nourishes the heart is provided by the right and left coronary arteries. The coronary arteries branch
from the base of the aorta and encircle the heart in the atrioventricular groove at the junction of the
atria and ventricles. The coronary arteries and their major branches (the anterior interventricular and
circumflex arteries on the left, and the posterior interventricular and marginal arteries on the right)
are compressed when the ventricles are contracting and fill when the heart is relaxed. The
myocardium is drained by several cardiac veins, which empty into the coronary sinus, which in
turn empties into the right atrium.

atrioventricular (AV) groove (syn.) atrioventricular (AV) sulcus (syn.) coronary sulcus
(syn.) sulcus coronarius - şanţ atrioventricular, şanţ coronar
cardiac veins (syn.) venae cordis (syn.) veins of heart - venele inimii, vene cardiace
 left anterior descending artery (syn.) anterior interventricular artery - artera
interventriculară anterioară
posterior interventricular artery (syn.) posterior descending coronary artery - artera
interventriculară posterioară
sinus (pl. sinus, sinuses) – sinus
coronary sinus (syn.) sinus coronarius - sinus coronar

When the heart beats at a very rapid rate, the myocardium may receive an inadequate blood
supply because the relaxation periods (when the blood is able to flow to the heart tissue) are
shortened. Situations in which the myocardium is deprived of oxygen often result in crushing chest
pain called angina pectoris. This pain is a warning that should never be ignored because, if angina
is prolonged, the ischemic heart cells may die, forming an infarct. The resulting myocardial
infarction is commonly called a “heart attack” or “coronary”.

rate - rată, proporţie, procentaj; viteză, rapiditate, debit; intensitate; coeficient

to shorten – a simplifica, a reduce, a micşora; a prescurta
angina pectoris (syn.) breast pang (syn.) heart stroke - angină pectorală
to warn - a preveni, a avertiza, a pune în gardă
warning - înştiinţare; prevenire, avertizare, avertisment
infarction - infarctizare; infarct
myocardial infarction (MI) (syn.) heart attack - infarct miocardic, atac de cord

Blood vessels
Blood circulates inside the blood vessels, which form a closed transport system. The idea
that blood circulates or “makes rounds” through the body is only about 300 years old. The ancient
Greeks believed that blood moved through the body like an ocean tide, first moving out from the
heart and then ebbing back to it in the same vessels to get rid of its impurities in the lungs. It was
not until the seventeenth century that William Harvey, an English physician, proved that blood did,
in fact, move in circles. In 1628, the English physician William Harvey (1578–1657) published his
pioneering work On the Motion of the Heart and Blood in Animals. Not only did this brilliant
research establish proof of the continuous circulation of blood within contained vessels, it also
provided a classic example of the scientific method of investigation. Like Vesalius, Harvey was
severely criticized for his departure from Galenic philosophy. The controversy over circulation of
the blood raged for 20 years, until other anatomists finally repeated Harvey’s experiments and
concurred with his findings.

ebb – reflux
to concur (with) – a fi de acord cu
finding - descoperire, dezvăluire, revelaţie
findings - constatări

Like a system of roads, the circulatory system has its freeways, secondary roads, and alleys.
As the heart beats, blood is propelled into the large arteries leaving the heart. It then moves into
successively smaller and smaller arteries and then into the arterioles, which feed the capillary beds
in the tissues. Capillary beds are drained by venules, which in turn empty into veins that finally
empty into the great veins entering the heart. Thus arteries, which carry blood away from the heart,
and veins, which drain the tissues and return the blood to the heart, are simply conducting vessels -
the freeways and secondary roads. Only the tiny hairlike capillaries, which extend and branch
through the tissues and connect the smallest arteries (arterioles) to the smallest veins (venules),
directly serve the needs of the body cells. The capillaries are the alleys that intimately intertwine
among the body cells. It is only through their walls that exchanges between the tissue cells and the
blood can occur.
 capillary bed - pat capilar
drain - dren, tub de dren
to drain - a drena, a evacua, a vida, a elimina fluidul dintr-o cavitate
drainage - drenaj, drenare
to extend - a întinde, a prelungi, a lungi; a extinde
extension - extensie, deflectare, extensiune; amploare, volum
to intertwine - a se împleti, a se răsuci

Except for capillaries, blood vessels are composed of three tunics: the tunica intima forms a
friction-reducing lining for the vessel; the tunica media is the bulky middle layer of muscle and
elastic tissue; the tunica externa is the protective, outermost connective tissue layer. Capillary
walls are formed of the intima only.
Artery walls are thick and strong to withstand pressure fluctuations. They expand and recoil
as the heart beats. Vein walls are thinner, their lumina are larger, and they are equipped with valves.
These modifications reflect the low pressure nature of veins.
Blood pressure is the pressure that blood exerts on the walls of the blood vessels. It is the
force that causes blood to continue to flow in the blood vessels. It is high in the arteries, lower in the
capillaries, and lowest in the veins. Blood is forced along a descending pressure gradient. Both
systolic and diastolic pressures are recorded.

tunica (pl. tunicae) (syn.) tunic - tunică, înveliş, căptuşeală, membrană

tunica intima vasorum (syn.) intima – intima
tunica media (syn.) media - tunica medie, medie
tunica externa (syn.) extima - tunică externă
to fluctuate - a fluctua, a oscila, a varia; a se ondula
fluctuation - fluctuaţie, oscilaţie, variaţie, schimbare
recoil - recul, ricoşare
to recoil - a ricoşa, a sări înapoi
lumen (pl. lumina, lumens) – lumen
luminal (syn.) luminalis – luminal
fluctuant - fluctuant, oscilant
gradient - gradient; pantă