III.

ANATOMY AND PHYSIOLOGY

A. The Circulatory System/Cardiovascular System
The circulatory system (cardiovascular system) pumps blood from the heart to the lungs,
supplying them with oxygen. After then, the heart sends oxygen-rich blood to the rest of the body through
arteries. In order to resume circulation, oxygen-poor blood is returned to the heart through veins. Your
circulatory system is necessary for strong muscles, organs, and tissues.

 The functions of the heart are as follows:

Managing blood supply. During rest, exercise, and changes in body posture, variations
in the rate and force of cardiac contraction match blood flow to the varying metabolic demands of
the tissues.
Producing blood pressure. The heart's contractions result in blood pressure, which is
necessary for blood to flow through the blood arteries.
Securing one-way blood flow. The heart's valves ensure that blood can only travel in
one direction through the heart and blood arteries.
Transmitting blood. The heart divides the pulmonary and systemic circulations,
ensuring that oxygenated blood is delivered to the tissues.

Weight. Approximately the size of a person’s fist, the hollow, cone-shaped heart weighs less than a
pound.
Mediastinum. Snugly enclosed within the inferior mediastinum, the medial cavity of the thorax, the heart
is flanked on each side by the lungs.
Apex. Its more pointed apex is directed toward the left hip and rests on the diaphragm, approximately at
the level of the fifth intercostal space.
Base. Its broad posterosuperior aspect, or base, from which the great vessels of the body emerge, points
toward the right shoulder and lies beneath the second rib.
Pericardium. The heart is enclosed in a double-walled sac called the pericardium which is the outermost
layer of the heart.
Fibrous pericardium. The loosely fitting superficial part of this sac is referred to as the fibrous
pericardium, which helps protect the heart and anchors it to surrounding structures such as the diaphragm
and sternum.
Serous pericardium. Deep to the fibrous pericardium is the slippery, two-layer serous pericardium,
where its parietal layer lines the interior of the fibrous pericardium.
B. LAYERS OF THE HEART
The heart muscle has three layers and they are as follows:
Epicardium. The epicardium or the visceral and outermost layer is actually a part of the heart wall. It
secretes serous fluid into the pericardial cavity to reduce friction around the heart
Myocardium. The myocardium consists of thick bundles of cardiac muscle twisted and whirled into ring-
like arrangements and it is the layer that actually contracts. It generates force necessary to circulate blood
through the body
Endocardium. The endocardium is the innermost layer of the heart and is a thin, glistening sheet of
endothelium that lines the heart chambers. It keeps the blood flowing through the heart separate from the
myocardium, or cardiac muscles
C. CHAMBERS OF THE HEART
The heart has four hollow chambers, or cavities: two atria and two ventricles.
Receiving chambers. The two superior atria are primarily the receiving chambers, they play a lighter role
in the pumping activity of the heart.
Discharging chambers. The two inferior, thick-walled ventricles are the discharging chambers, or actual
pumps of the heart wherein when they contract, blood is propelled out of the heart and into circulation.
Septum. The septum that divides the heart longitudinally is referred to as either the interventricular
septum or the interatrial septum, depending on which chamber it separates.
D. ASSOCIATED GREAT VESSELS
The great blood vessels provide a pathway for the entire cardiac circulation to proceed.
Superior and inferior vena cava. The heart receives relatively oxygen-poor blood from the veins of the
body through the large superior and inferior vena cava and pumps it through the pulmonary trunk.
Pulmonary arteries. 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.
Pulmonary veins. Oxygen-rich blood drains from the lungs and is returned to the left side of the heart
through the four pulmonary veins.
Aorta. 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.

E. HEART VALVES
The heart is equipped with four valves, which allow blood to flow in only one direction through the heart
chambers.

Atrioventricular valves. Atrioventricular or AV valves are located between the atrial and ventricular
chambers on each side, and they prevent backflow into the atria when the ventricles contract.
Bicuspid valves. The left AV valve- the bicuspid or mitral valve, consists of two flaps, or cusps, of the
endocardium.
Tricuspid valve. The right AV valve, the tricuspid valve, has three flaps.
Semilunar valve. 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.
F. CARDIAC CIRCULATION VESSELS
Although the heart chambers are bathed with blood almost continuously, the blood contained in the heart
does not nourish the myocardium.
Coronary arteries. The coronary arteries branch from the base of the aorta and encircle the heart in the
coronary sulcus (atrioventricular groove) at the junction of the atria and ventricles, and these arteries are
compressed when the ventricles are contract and fill when the heart is relaxed.
Cardiac veins. The myocardium is drained by several cardiac veins, which empty into an enlarged vessel
on the posterior of the heart called the coronary sinus.
G. BLOOD VESSELS
Blood circulates inside the blood vessels, which form a closed transport system, the so-called vascular
system.
Arteries. As the heart beats, blood is propelled into large arteries leaving the heart. They carry oxygen-
rich blood from your heart to all parts of the body, getting smaller as they get further away from the heart.
Arterioles. It then moves into successively smaller and smaller arteries and then into arterioles, which
feed the capillary beds in the tissues. As the key location of total peripheral resistance, they maintain
mean arterial pressure and tissue perfusion. They also contribute significantly to the regulation of blood
flow in an organ- or tissue-specific way by altering the diameter.
Veins. Capillary beds are drained by venules, which in turn empty into veins that finally empty into the
great veins entering the heart. Veins are used to pump much-needed blood back to the heart.

G. BLOOD CIRCULATION THROUGH THE HEART

Entrance to the heart. Blood enters the heart through two large veins, the inferior and superior vena
cava, emptying oxygen-poor blood from the body into the right atrium of the heart.
Atrial contraction. As the atrium contracts, blood flows from the right atrium to the right ventricle
through the open tricuspid valve.
Closure of the tricuspid valve. When the ventricle is full, the tricuspid valve shuts to prevent blood from
flowing backward into the atria while the ventricle contracts.
Ventricle contraction. As the ventricle contracts, blood leaves the heart through the pulmonic valve, into
the pulmonary artery, and to the lungs where it is oxygenated.
Oxygen-rich blood circulates. The pulmonary vein empties oxygen-rich blood from the lungs into the
left atrium of the heart.
Opening of the mitral valve. As the atrium contracts, blood flows from your left atrium into your left
ventricle through the open mitral valve.
Prevention of backflow. When the ventricle is full, the mitral valve shuts. This prevents blood from
flowing backward into the atrium while the ventricle contracts.
Blood flow to the systemic circulation. As the ventricle contracts, blood leaves the heart through the
aortic valve, into the aorta, and to the body.