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Cardiovascular System I
WEEK 1
Review Structures
Base
Apex
Atria
STRUCTURE = small, wrinkled, protruding appendages called auricles (increase atrial volume)
FUNCTION = receiving chambers for blood returning to the heart from the circulation
Small and thin=walled chambers because they need to contract minimally to push blood to the
ventricles
Blood enters the right atrium through THREE veins
o Superior vena cava: returns blood from body regions superior to the diaphragm
o Inferior vena cava: returns blood from body areas below the diaphragm
o Coronary sinus: collects blood draining from the myocardium
Blood enters the left atrium though FOUR pulmonary veins
o Makes up most of the hearts base
o Transport blood from the lungs back to the heart
o Seen in the posterior view of the heart
Ventricles
STRUCTURE
FUNCTION
Thick walls = ventricles contract and propel blood out of the heart into the circulation
Right ventricle
o Pumps blood into the pulmonary trunk
Sends blood to the lungs where gas exchange occurs
Left ventricle
o Pumps blood into the aorta
Largest artery in the body – pumps the blood to the rest of the body
Pericardium
STRUCTURE
FUNCTION (4)
Fibrous pericardium
o Protects the heart (cushion)
o Anchors it to surrounding structures
o Prevents overfilling of the heart with blood
Prevents from overfilling or stretching – can overcompensate but it wont do it
quickly
o Prevents friction
The serous membrane (lubricated by the fluid in the parietal layer) glides
smoothly past one another and allows the heart to work in a relatively friction
free environment
Wall Layers
STRUCTURE
FUNCTION
FUNCTION (2)
STRUCTURE
FUNCTION
STRUCTURE
FUNCTION
A-V Valves OPEN and allow blood to flow from atria into ventricles when ventricular pressure is
lower than atrial pressure
o Occurs when ventricles are relaxed chordae tendineae are slack and papillary muscles
are relaxed
A-V Valves CLOSE preventing backflow of blood into atria
o Occurs when ventricles contract, pushing valve cusps closed, chordae tendineae are
pulled taut and papillary muscles contract to pull cords and prevent cusps from everting
Directional Flow
Coronary circulation: the functional blood supply of the heart and the shortest circulation in
the body
o How the heart gets nourishment and removes waste
Coronary veins
o After passing through the myocardium the venous blood is collected in the cardiac veins
The paths roughly follow those of the coronary arteries
o The veins join to form an enlarged vessel called the coronary sinus
Coronary sinus: empties blood into right atrium
Found on the posterior aspect of the heart
o Coronary sinus has three large tributaries:
Great cardiac vein – in the anterior interventricular sulcus
Middle cardiac vein – in the
posterior interventricular
sulcus
Small cardiac vein – running
along hearts right inferior
margin
Blood Flow
Cardiac Cycle
- Right side of the heart receives oxygen poor blood from body tissues
o Flows through the superior vena cava and inferior vena cava into the right atrium
o Flows through the tricuspid valve into the right ventricle
- Then pumps the blood to the lungs to pick up oxygen and dispel CO2
o Travels through the pulmonary semi lunar valve to the pulmonary truck
o Splits off into the pulmonary arteries to the lungs
- The left side of the heart receives the oxygenated blood returning from the lings
o Travels back into the left atrium through the 4 pulmonary veins
o The blood fills the left atrium and into the left ventricle after pushing through the
mitral valve
- Then pumps the blood throughout the body to supply oxygen to body tissues
o Blood fills the left ventricle and then passes through the aortic semilunar valve to
the aorta
o The blood is pumped through the aorta to the body
Cardiac cycle: describes the mechanical events associated with blood flow through the heart;
includes ALL events associated with the blood flow through the heart during one complete
heartbeat
o One complete heartbeat = arterial systole and diastole followed by ventricular systole
and diastole
EDV: end diastolic volume
o Occurs in ventricle after heart has filled (120mL)
o Maximum volume of blood the ventricles will contain in a cycle
ESV: end systolic volume
o After ejection of blood (50mL)
o Blood that is remaining in the chambers after ejection
Stroke Volume: difference between EDV and ESV EDV – EDS = SV
o Volume ejected from each ventricle, each beat
MAIN EVENTS
Ventricular Pressures
Complete Cardiac Cycle – ECD and Heart Sounds
Cardia Output
Stroke volume and heart rate are regulated to alter cardiac output
CO = SV x HR
o CO = cardiac output
UNITS: L/min
o SV = stroke volume
UNITS: mL/beats
The volume of blood pumped out by one ventricle with each beat
Correlates with the forced of ventricular contraction
o HR = heart rate
UNITS: beats/min
Why? – gives us an idea of the supply and demand on a persons cardiac system
Preload: the degree to which cardiac muscle cells are stretched just before they contract
o Controls stroke volume
Stretch required on ventricles to accept volume of pressure
Pressure to fill decreases after each time – similar to blowing
up a balloon for the first time
Effects on Preload
PRELOAD STRETCH
CONTRACTILITY
Contractility: Cardiac cell contractile force due to factors other than EDV
Inotropic state of the myocardium – normal
o Ability for myocardium to contract
Ability of cardiac muscle to shorten when electrically stimulated
AFTERLOAD
AFTERLOAD CONTRACTION
Decreases afterload:
o Diuretics
o Vasodilators
Fiber Proteins Actin, myosin; troponin Actin, myosin; Actin, myosin; troponin
and tropomyosin tropomyosin and tropomyosin
- Catecholamines
- Digoxin
- Increased afterload
- stress
The basic contractile unit of muscle fibres – basic unit of muscle contraction
o Very carefully arranged
Contain two types of myofilaments = actin and myosin
Cardiac sarcomeres branch in a variety of areas
Rich blood supply
Within each sarcomere there is a significant number of mitochondria
o Reflection of the energy output required
The muscle fibers have T-tubules and
some sarcoplasmic reticulum
Arranged differently than skeletal
muscle fibers and this is important
because:
o Much of the calcium that enters the sarcoplasm during contractions enters from outside
the cell through the t-tubules rather than from storage
line
Myofilaments form a geometric pattern in which each myosin filament interacts with 6 actin
filaments
One myosin molecule contains 2 rod segments and a 2 sided head unit
o Myosin head has limited range of motion
o Binding sites to ATP and actin
Actin filament consists of double chain of actin molecules and regulatory proteins – tropomyosin
and troponin
T-Tubules
Arrangement
Cardiac muscle fibres are very carefully arranged in many rod-like myofibrils
The sarcomere organization has several different names
o M line – thick filaments linked by accessory proteins myosin
o Z disks actin
o H zone
o A band – thick and thin filaments overlap
o I band – thin filaments only
Relationship between actin and myosin arrangements
Thin filament pulls them closer together and muscle contracts H zone shortens
Cardiac Markers
CK (Creatine Kinase) – enzyme in muscle cell; can be released, when this happens there is
Mean the muscle damage
same o Used in Canada and US
thing
CPK (Creatine Phosphokinase)
o Used in Europe
o Enzymes in muscle – damage when released
Heart muscle is stimulated by nerves and is self-excitable (automaticity) Can generate its
own impulse
Contracts as a unit (atria contract together and ventricles contract together)
Has a 250ms absolute refractory period (LONG!)
Autorhythmic cells:
o Initiate action potentials
o Have unstable resting potentials called pacemaker potentials
o Use calcium influx (rather than sodium) for rising phase of the action potential
o Approx. 1% cardiomyocytes have capacity to generate impulses
Pacemaker Stimulation
Epinephrine
o Increase heart rate, increases slope
o Increase time to get to action potential by changing the slow of pacemaker potential
Acetylcholine
o Decreases slope
o Takes longer to reach threshold therefore slow down
Manipulating threshold manipulates HR
Electrical Pathway
Sinoatrial (SA) node – “ruling pacemaker” regulates heart rate
o 60-100 bpm is normal
Atrioventricular (AV) node delays the impulse approximately 0.1 second
o Can rake over if the SA node stops working but only goes 40-60
Bundle of His = Atrioventricular Bundle
o After electrical impulse is sent from the sinoatrial (SA) node to the atrioventricular (AV)
node, the bundle of his quickly transmits the impulse to the left and right bundle
branches and into the ventricles
Resulting in a synchronized contraction pf the ventricles
o Located under the AV node
o Bundle branches split into 2 pathways going to each ventricle
Purkinje Fibres or Network (Subendocardial conducting network)
o Completes the pathway through the interventricular septum
o Penetrates the heart apex, and then turns superiorly into the ventricular walls.
The electrical currents generated in and transmitted through the heart spread throughout the
body and can be detected with a device called an electrocardiograph.
An electrocardiogram (ECG) is a graphic record of heart activity. An ECG is a composite of all
the action potentials generated by nodal and contractile cells at a given time.
P WAVE
- This is an example of a normal P wave, reflecting normal SA node firing and if the SA node fired
at a rate between 60 to 100bpm then this part of the rhythm would be considered normal sinus
rhythm.
What electrical activity is taking place:
PHYSIOLOGY OF CONTRACTION
PR INTERVAL
-
- Reflects the normal delay from the SA node to the AV node
- If the SA node fired at a rate between 60 to 100 then this part of the rhythm would be
considered normal sinus rhythm
PR INTERVAL
Some level of blockage between the atria and when the electrical activity goes down into the ventricles
On the ECG – a longer day between the first P wave and the QRS complex
HEART BLOCK – 2nd Degree
When you are looking at an ECG you are normally looking for abnormal electrical condition that occurs
in any areas of cardiac muscle damage
o Don’t have to know for purpose of course
NORMAL
INFRACTION
INJURY
ISCHEMIA