Cardiovascular system overview

Randa Mostafa Head, Basic Medical Sciences Department Prof of Medical Physiology Ext. 7204
E mail: Mostafaranda@sharjah.ac.ae

Feel free to make notes, but dont try and copy everything I show and say you wont have time. I would rather that you just listen. If you have a question please catch my attention I am more than happy to stop. The recommended course textbooks cover my lectures well. If you need a copy of this presentation, then you can get it from the black board.

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MAIN FUNCTIONS OF THE CIRCULATORY SYSTEM

Transport and distribute essential substances to the tissues. Remove metabolic byproducts. Adjustment of oxygen and nutrient supply in different physiologic states. Regulation of body temperature.

The system has two major divisions: A pulmonary circuit : which carried blood to the lungs for gas exchange and returns it to the heart. A systemic circuit : which supplies blood to every organ of the body.

The right side of the heart serves the pulmonary circuit

The left side serves the systemic circuit.

The heart is enclosed in a double-walled sac called the pericardium. The outer wall, called the parietal pericardium (pericardial sac). has a tough, superficial fibrous layer of dense irregular connective tissue and a deep, thin

serous layer.

The serous layer turns inward at the base of the heart and forms the visceral pericardium (epicardium) covering the heart surface .

The pericardium

The pericardial sac is anchored by ligaments to the diaphragm below and the sternum anterior to it. Between the parietal and visceral membranes is a space called the pericardial cavity . It contains 5 to 30 mL of pericardial fluid.

The pericardial fluid lubricates the membranes and allows the heart to beat almost without friction.

Pathophysiology : Pericardial disease manifest itself by the accumulation of fluid in the pericardial space (pericardial effusion) and /or inflammation of the pericardium (pericarditis).
The pericardial cavity can fill with up to 2 litters of serous fluid (hydropericardium ) or blood (hemopericardium) that prevent normal diastolic filling and thereby reduces cardiac output.

COLLECTING

PUMP

TUBULES

THE MAIN CIRCUIT

DISTRIBUTING

TUBULES

THIN VESSELS

There are 3 primary blood vessel types: 1. Arteries : which carry blood away from the heart. 2. Veins : which carry blood towards the heart. 3. Capillaries : tiny blood vessels that function in the exchange of gases, nutrients, and wastes between the blood and the interstitial fluid.

The walls of both arteries and veins have 3 layers that surround the lumen: 1. Tunica externa Outermost layer. Made primarily of loose connective tissue. Anchors the blood vessel to the surrounding tissue. 2. Tunica Media Consists primarily of smooth muscle and is responsible for vasoconstriction and vasodilatation. Usually the thickest layer in arteries. 3. Tunica Interna (Endothelium) Acts as a selectively permeable barrier to blood solutes. Secretes vasoconstrictors and vasodilators. Provides a smooth surface that repels blood cells and platelets.

They are constructed to withstand surges of blood pressure associated with ventricular systole. They're more muscular than veins and appear relatively round in tissue sections. They retain their round shape even when empty. There are 3 basic categories of arteries

Conducting (or Elastic) Arteries

Distributing (or Muscular) Arteries Arterioles

1. Conducting (or Elastic) Arteries

The largest
oExamples include the aorta, pulmonary arteries, and the common carotid arteries.

Their tunica media contains a great deal of elastic tissue. The elastic tissue allows for expansion during ventricular systole and recoil during ventricular diastole. This helps create continuous flow from a discontinuous pump.

Conducting arteries expand during ventricular systole to receive blood, and recoil during diastole: *Their expansion takes some of the pressure off the blood so that smaller arteries downstream are subjected to less systolic stress . * Their recoil between heart beats prevents t he blood pressure from dropping too low while the heart is relaxing and refilling. Lessen the fluctuations in blood pressure

2. Distributing (or Muscular) Arteries * Smaller branches ,distribute blood to individual organs. *They have 25-40 layers of smooth muscle cells constituting about three quarters of the wall thickness. * Examples include the brachial, femoral, and splenic arteries

3. Arterioles Smallest of the three. They are heavily innervated . The primary points at which the body controls the relative amounts of blood directed to specific organs.

Linking the arterioles to the capillaries are short vessels known as metarterioles. metarterioles Part of their wall surrounded by smooth muscle

These muscle cells form precapillary sphincters which encircle the entrance to a capillary bed.

These sphincters regulate how much blood will flow through particular capillary beds.

Arterial sense organs: Certain major arteries above the heart have sensory structures in their walls that monitor blood pressure and chemistry. They transmit information to the brain stem that is used to regulate the heart beat, vasomotion and respiration.

The sensory receptors are of three kinds 1. Carotid sinuses. These are baroreceptors (pressure sensors) that respond to changes in blood pressure. * Thin tunica media * An abundance of glossopharyngeal nerve fibers in the tunica externa.

The carotid sinuses are located in the wall of the internal carotid artery

A rise in blood pressure stretches the thin media and stimulates the nerve fibers which transmits signals to the vasomotor and cardiac centers of the brainstem, which responds by lowerin the heart rate and dilating the blood vessels, thereby lowering the blood pressure.

2. Carotid bodies: located near the branch of the common carotid arteries. They are chemoreceptors that monitor changes in blood composition. They primarily transmit signals to the brainstem respiratory centers, which adjust breathing to stabilize the blood pH and its CO2 and O2 levels

3. Aortic bodies: These are one to three chemoreceptors located in the aortic arch They are structurally similar to the carotid bodies and have the same function.

Capillaries
There are approximately 1 billion of them in the human body. Capillaries are organized into groups of 10-100 in capillary beds There are 3 separate types of capillaries: 1. Continuous Capillaries 2. Fenestrated Capillaries

3. Sinusoidal Capillaries

1. Continuous Capillaries

Most common. Abundant in skin and muscle. muscle

Endothelial cells are joined by tight junctions. but contain intercellular clefts through which small molecules (e.g., glucose, but not albumin) can pass. Cerebral capillaries lack these clefts and have far more numerous tight junctions forming the blood brain barrier which helps protect the delicate brain tissue from blood-borne toxins and pathogens.

Some continues capillaries exhibit cells called pericytes that lie external to the endothelium Pericytes are contractile, have elongated tendrils that wrap around the capillary

It thought that they contract and regulate blood flow through the capillaries. They also can differentiate into endothelial and smooth muscle cells and thus contribute to vessel growth and repair.

2. Fenestrated capillaries These pores allow for the rapid passage of molecules, even proteins , through the capillary wall.

Similar to continuous capillaries but some of the endothelial cells has filtration pores fenestrations.

Found in sites of active absorption (small intestine), secretion (endocrine organs) and capillary filtration (kidneys).

3. Sinusoidal Capillaries Highly modified, extremely leaky, fenestrated capillaries

Contain irregularly shaped lumen and large intercellular clefts Found in locales where large stuff needs to exit/enter the bloodstream. bloodstream Such sites include bone marrow (for passage of nascent blood cells), lymphoid organs (for easy entry/exit by WBCs) and the liver (for large plasma proteins, e.g., albumin).

In the liver and the spleen , the endothelium is intimately associated with macrophages. In these locations the sinusoids are twisty and tortuous, conformed to the shape of the surrounding tissue. . The twistiness makes blood flow extra slowly which gives time for splenic and hepatic macrophages to monitor and assess its contents.

Just by looking at this image, can you identify the different capillary types?

Veins
The capacitance vessels of the cardiovascular system because : They are relatively thin-walled and flaccid. Expand easily to accommodate an increased volume of blood. At rest, about 54% of the blood is found in the systemic veins as compared with only 11% in the systemic arteries

Being distant from the ventricles of the heart, they are subjected to relatively low blood pressure. In large arteries, blood pressure averages 90 to 100 mm Hg (millimeters of mercury) and surges to 120 mm Hg during systole, whereas in veins it averages about 10 mm Hg. Considering the relatively low pressure in the veins. how blood is forced through them to get back to the heart????

It's a combination of 3 separate things: things 1.Skeletal Muscle Pump . 2. Respiratory Pump . 3. Venous Valves

It's a combination of 3 separate things: 1.Skeletal Muscle Pump . 2. Respiratory Pump . 3. Venous Valves

1. Skeletal Muscle Pump :- the contraction/relaxation cycles of skeletal muscles squeeze the veins forcing the contained blood towards the heart.

2. Respiratory Pump : as we inhale, our thoracic cavity expands while our abdominal cavity compresses. pressure within veins of the thoracic cavity drops. Meanwhile, pressure in the abdominal veins increases. This combination results in increased blood flow towards that heart.

3. Venous Valves: - one-way valves (similar to the semilunars of the heart) made of flaps of endothelium are found in medium veins (mostly in the legs and the arms) where they help prevent backflow.

Pathophysiology: varicose veins: In people who stand for long periods, blood tends to pool in the lower limbs and stretch the veins. This is especially true of superficial veins, which are not surrounded by supportive tissue. Stretching pulls the cusps of the venous valves farther apart until the valves become incompetent to prevent the backflow of blood

As the veins become further distended, their walls grow weak and they develop into varicose veins with irregular dilations and twisted pathways.