ANATOMY AND PHYSIOLOGY OF THE CARDIOVASCULAR SYSTEM

THE HEART  Hollow muscular organ located in the center of the thorax, occupying the mediastinum, resting on the diaphragm.  3 LAYERS: o Endocardium-inner layer consisting of endothelial tissue, lining the inide of the heart and the valves. o Myocardium-middle layer composed of muscle fibers, responsible for the pumping action o Epicardium-exterior layer of the heart  PERICARDIUM-the thin, fibrous sac encasing the heart. a. Visceral Pericardium-adheres to the epicardium, enveloped by the parietal pericardium. b. Parietal Pericardium-tough fibrous tissue that attaches to the great vessels, diaphragm, sternum and vertebral column and supports the heart in the mediastinum. o Pericardial Space-space between the two layers normally filled with 20mL of fluid. HEART CHAMBERS  Right Atrium-receives blood returning from the superior and inferior vena cava and coronary sinus.  Right Ventricle-distributes blood to the lungs via the pulmonary artery for oxygenation.  Left Atrium-receives oxygenated blood from he lungs via the pulmonary vein.  Left Ventricle-distributes oxygenated blood to the remainder of the body via the aorta. o Ventricular walls are much thicker than the atrial walls. Diastole the relaxation phase wherein all four chambers relax simultaneously, allowing the ventricles to fill in reparation for contraction. It is commonly referred to as the Period of ventricular filling. Systole a. Atrial Systole occurs first, just at the end of the systole b. Ventricular Systole follow the atrial systole  Apical Impulse also called the Point of Maximal Impulse (PMI); pulsation created during normal ventricular contraction. HEART VALVES permit blood to flow in only one direction; composed of leaflets of fibrous tissue Atrioventricular Valves separates the atria from the ventricles a. Tricuspid Valve composed of three cusps/leaflets, separates the right atria from the right ventricle. b. Bicuspid/Mitral Valve separates the right atrium ad the right ventricle. Semilunar Valves - half-moon-like three leaflets that are closed during the diastole decreasing the pressure in the pulmonary artery and aorta. o These are forced to open during ventricular systole as blood is ejected from the ventricles into the pulmonary artery and aorta. a. Pulmonic Valve separates the right ventricle and the pulmonary artery b. Aortic valve separates the left ventricle and the aorta.

FUNCTIONS OF THE HEART CARDIAC CONDUCTION SYSTEM generates and transmits electrical impulses that stimulate contraction of the myocardium.  Automaticity ability to initiate an electrical impulse  Excitability ability to respond to an electrical impulse.  Conductivity ability to transmit an electrical impulse from one cell to another. Sinoatrial Node the primary pacemaker of the heart located at the junction of the superior vena cava and the right atrium; normally has 60-100 impulses/min. Atrioventricular Node located in the right atrial wall near the tricuspid valve; coordinates the incoming electrical impulses from the atria to the ventricles; normally 4060 impulses/min. Bundle of His - conducts impulses to the right and left ventricles. Purkinje Fibers composed of Purkinje cells, specialized to rapidly conduct the impulses through the thick walls of the ventricles. CARDIAC HEMODYNAMICS o Fluid flows from a region of higher pressure to one of lower pressure. o The pressures responsible for blood flow in the normal circulation are generated during systole and diastole.  Cardiac Cycle - During Diastole, heart chambers relax, causing AV valves to open and semilunar valves to close. - Atrial Systole increases pressure inside the atria, ejecting the remaining blood into the ventricles. -augments ventricular blood volume by 15%-25%.(atrial kick) - Ventricular Systole pressure inside the ventricles rapidly increases, forcing the AV valves to close.  Cardiac Output the amount of blood pumped by each ventricle during a given period. -normally 5 L/min in resting adult. CO=SV x HR  Stroke volume (SV) amount of blood ejected per heartbeat. o Preload degree of stretch of the ventricular cardiac muscle fibers at the end of diastole  Frank-Starling law based on the fac that, wihin limits, the greater the initial length or stretch of the cardiac muscle cells, the greater the degree of shortening occurs. o Afterload or resistance to ejection of blood from the ventricle.  Systemic Vascular Resistance the resistance of the systemic BP to left ventricular ejection.  Pulmonary Vascular Resistance the resistance of the pulmonary BP to right ventricular ejection. o Contractility the force generated by the contracting myocardium -increased contractility increases blood volume -it is enhanced by: circulating catecholamines, sympathetic neuronal activity, drugs (digoxin, dobutamine, dopamine). y Ejection Fraction percentage of the end-diastolic blood volume that is ejected with each heartbeat.

BLOOD PRESSURE - Pressure that exerts against the inner walls of the blood vessels. - The force that keeps blood circulating continuously even between heartbeats. - Pressure within the large systemic arteries near the heart.  Systolic Pressure the pressure in the arteries at he peak of ventricular contraction  Diastolic Pressure the pressure when the ventricles are relaxing.