CARDIOVASCULAR THE HEART: HEART WALL

SYSTEM Epicardium ● Outside layer

● This layer is
Prof: Mr. Red Steven Nillo, RMT
the parietal
pericardium
● Connective
DEFINITION tissue layer

● A closed system of the heart and blood Myocardium ● Middle layer

vessels ● Mostly cardiac
★ The heart pumps blood muscle
★ Blood vessels allow blood to
circulate to all parts of the body Endocardium ● Inner layer
● Endothelium
● The function of the cardiovascular system is
to deliver oxygen and nutrients and to
remove carbon dioxide and other waste
products.

THE HEART

THE HEART: CHAMBERS

★ Right and left side act as separate pumps

★ Four chambers

Atria ● Upper
chambers on
★ Location: each side of
● Thorax between the lungs the heart
● Pointed apex directed toward left ● Receiving
hip chambers
● Right atrium
★ About the size of your fist and left atrium
● Less than 1
Ventricle ● Lower
THE HEART: COVERINGS chambers
● Pumping or
★ Pericardium - a double serous delivering
membrane chambers
● Right and left
Visceral pericardium Next to heart ventricle

Parietal pericardium Outside layer

Serous fluid It fills the space

between the layers of
pericardium
 ★ Atrioventricular (AV) valves
● between atria and
ventricles
● valves at the entrance to
the ventricles
Bicuspid valve (left)
Tricuspid valve (right)

★ Semilunar valves
● between ventricle and
artery
● valves that exit the
ventricles
Pulmonary semilunar
valve
Aortic semilunar valve

● Valves open as blood is pumped through

● Held in place by chordae tendineae (“heart
strings”)
● Close to prevent backflow

OPERATION OF HEART VALVES

FUNCTION

Right atrium ● Receives deoxygenated

blood from the body via both
the Superior vena cava
and Inferior vena cava and
pumps into the right
ventricle

Right ventricle ● Receives blood from the

right atrium and pumps into
the pulmonary artery,
which carries it to the lungs
to the oxygenated

Left atrium ● Receives oxygenated blood VALVE PATHOLOGY

from the lungs via the
pulmonary veins and ★ Incompetent valve = backflow and repump
pumps it into the left
ventricle
★ Stenosis = stiff = heart workload increased
★ May be replaces
Left ventricle ● Receives blood from the left ★ Lup Dub Heart Sound (Kortkoff sounds)
atrium and pumps into the
aorta
● The cell walls of the left
ventricle are nearly three (3) THE HEART: ASSOCIATED GREAT VESSELS
times as thick as those of
the right ventricle owing to
the force required to pump Aorta Leaves left ventricle
the blood into the arterial
system
Pulmonary arteries Leave right ventricle

Vena cava Enters right atrium

THE HEART: VALVES
Pulmonary veins Enter left atrium
● Allow blood to flow in ONLY one direction (four)
● Four (4) valves
 ❖ QRS complex: spread of impulse
CORONARY CIRCULATION down septum, around ventricles in
● Blood in the heart chambers does not Purkinje fibers
nourish the myocardium ❖ T wave: end of electrical activity in
● The heart has its own nourishing circulatory ventricles
system
★ Coronary arteries
★ Cardiac veins
★ Blood empties into the right atrium
via the coronary sinus

CARDIAC PATHOLOGY
★ Rapid heart beat
= inadequate blood
= Angina Pectoris

THE HEART: CONDUCTION SYSTEM

★ Intrinsic conduction system (nodal
system)
● Heart muscle cells contract, without
nerve impulses, in a regular
continuous way
● Special tissue sets the pace
Sinoatrial (SA) node
(right atrium)
● Pacemaker
Atrioventricular node
(junction of right and left
atria and ventricles)
Atrioventricular bundle
(bundle of HIS)
Bundle branches (right
and left)
Purkinje fibers
HEART CONTRACTIONS
PATHOLOGY OF THE HEART
★ 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
THE HEART: CARDIAC CYCLE
★ Atria contract simultaneously
★ Atria relax, then ventricles contract

★ Systole: contraction
★ Diastole: relaxation

THE HEART: CARDIAC OUTPUT

ELECTROCARDIOGRAMS (EKG/ECG)
★ Cardiac Output (CO)
➔ Three (3) formations ● Amount of blood pumped by each
❖ P wave: impulse across atria side of the heart in one minute
● CO = (heart rate [HR] x (stroke
volume [SV])
 Stroke volume
VASCULAR SYSTEM
★
● Volume of blood pumped by each
ventricle in one contraction

● Normal = 5000 ml/min

BLOOD VESSELS
● Taking blood to the tissues and back
● Contribute to homeostasis
● They also play an important role in adjusting
the velocity and volume of the blood flow
● Blood circulates inside the blood vessels,
which form a CLOSED TRANSPORT
SYSTEM

5 MAIN TYPES OF BLOOD VESSELS

Arteries ● carry blood away from

the heart to other organs

REGULATION OF HEART RATE

★ Increased heart rate
● Sympathetic nervous system
➢ Crisis
➢ Low blood pressure
● Hormones
➢ Epinephrine
➢ Thyroxine
● Exercise
● Decreased blood volume

★ Decreased heart rate

● Parasympathetic nervous system
● High blood pressure of blood
volume
● Decreased venous return
● In Congestive Heart Failure (CHF)
the heart is worn out and pumps
weakly. Digitalis works to provide a
slow, steady, but stronger beat.
Arterioles ● are products of smaller
CONGESTIVE HEART FAILURE (CHF) medium-sized arteries
● as the arterioles enter a
● Decline in pumping efficiency of heart tissue, they branch into
● Inadequate circulation numerous tiny vessels
● Progressive, also coronary called capillaries
atherosclerosis, high blood pressure and
history of multiple myocardial infarctions Capillaries ● numerous tiny vessels
● Left side fails = pulmonary congestion and branched on the
arterioles
suffocation
● the thin walls of
● Right side fails = peripheral congestion and capillaries allow the
edema exchange of substances
between the blood and
body tissues
 BLOOD VESSELS: ANATOMY
● Three (3) layers
★ Tunica intima (interna)
➢ endothelium
➢ forms the inner lining of
blood vessel and is in
direct contact with the
blood as it flows through
the lumen
★ Tunica media
➢ smooth muscle
Venules ● small veins formed from ➢ controlled by sympathetic
group of capillaries within nervous system
a tissue ➢ such a decrease in the
diameter of the lumen of a
Veins ● larger blood vessels that blood vessel is called
convey blood from the vasoconstriction;
tissues back to the heart increase in the lumen
diameter is called
vasodilation

★ Tunica externa
➢ outer covering of the blood
vessel
➢ mostly fibrous connective
tissue
➢ contains numerous nerves

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 of

thick to allow for exchanges between blood and
tissue
 DIFFUSION OF CAPILLARY BEDS
MOVEMENT OF BLOOD THROUGH VESSELS
● Most arterial blood is pumped by the heart
● Veins use the milking action of muscles to
help move blood

VITAL SIGNS

Arterial pulse
CAPILLARY BEDS Blood pressure (BP)
Respiratory rate
● Capillary beds consist of two (2) types of
vessels Body temperature
★ Vascular shunt - directly connects All indicate the efficiency of the system
an arteriole to a venule
★ True capillaries - exchange
vessels
❖ Oxygen and nutrients PULSE
cross to cells
❖ Carbon dioxide and ● Pulse - pressure wave of blood
metabolic waste products ● Monitored at “pressure points” where pulse
cross into blood is easily palpated
 ➢ 140-110 mm Hg systolic
BLOOD PRESSURE ➢ 80-75 mm Hg diastolic
● Usually refers to the pressure in arteries
generated by the left ventricle during systole ★ Hypotension
and the pressure remaining in the arteries ➢ Low systolic (below 110
when the ventricle is in diastole mm Hg)
● Measurements by health professionals are ➢ Often associated with
made on the pressure in large arteries illness
★ Systolic - pressure at the peak of
ventricular contraction ★ Hypertension
★ Diastolic - pressure when ➢ High systolic (above 140
ventricles relax mm Hg)
● Pressure in blood vessels decreases as the ➢ Can be dangerous if it is
distance away from the heart increases chronic
● Sphygmomanometer - device used to
measure blood pressure SHOCK AND HOMEOSTASIS
● Shock is a failure of the cardiovascular
system to deliver enough O2 and nutrients to
meet cellular metabolic needs. The causes
of shock are many and varied, but all are
characterized by inadequate blood flow to
body tissues.

TYPES OF SHOCK
(1) hypovolemic shock due to decreased
blood volume
(2) cardiogenic shock due to poor heart
BLOOD PRESSURE: EFFECT OF FACTORS function
(3) vascular shock due to inappropriate
vasodilation
Neural factors ● Autonomic nervous
(4) obstructive shock due to obstruction of
system
blood flow
adjustments
(sympathetic
division)
PULMONARY CIRCULATION
Renal factors ● Regulation by
altering blood ● Carries deoxygenated blood from the
volume right ventricle to the air sacs (alveoli)
● Renin - hormonal within the lungs and returns oxygenated
control blood from the air sacs to the left atrium

Temperature ● Heat has a

vasodilation effect
● Cold has a
vasoconstricting
effect

Chemicals ● Various substances

can cause
increases or
decreases

Diet

VARIATIONS IN BLOOD PRESSURE

● Human normal range is variable
★ Normal
 SYSTEMIC CIRCULATION
● Carries oxygen and nutrients to body
tissues and removes carbon dioxide and
other wastes and heat from the tissues
● All systemic arteries branch from the aorta.
Deoxygenated blood returns to the heart
through the systemic veins
● All veins of the systemic circulation drain into
the superior vena cava, inferior vena cava,
or coronary sinus, which in turn empty into
the right atrium.