Cardiovascular System

What is the differences between

cardiovascular system and circulatory
system?
• The cardiovascular system refers to the heart (cardio) and blood
vessels (vascular).
• The circulatory system is a more general term encompassing
the blood, blood vessels, heart, lymph, and lymph vessels.

• The cardiovascular system is part of the larger circulatory

system, which circulates fluids throughout the body.

• The circulatory system includes both the cardiovascular system

and the lymphatic system.
• The cardiovascular system moves blood throughout the body,
and the lymphatic system moves lymph, which is a clear fluid
that’s similar to the plasma in blood.
What is Heart?
• The heart is the organ that supplies blood and oxygen to all
parts of the body.
• It is about the size of a clenched fist, weighs about 10.5
ounces and is shaped like a cone.
• The heart is located in the chest cavity just posterior to the
breastbone, between the lungs and superior to the
diaphragm.
• The heart is surrounded by a fluid filled sac called
the pericardium.
• Blood is pumped away from the heart through arteries and
returns to the heart through veins.
• The major artery of the body is the aorta and the major
veins of the body are thevena cavae.
Anatomy of Heart
I. Anatomy of the Heart

A. Coverings

1. Pericardium
• fibrous pericardium
• serous pericardium

• parietal pericardium
• visceral pericardium

B. Heart wall layers

1. Epicardium – (visceral pericardium)

• protects heart
2. Myocardium – cardiac muscle

3. Endocardium – epithelial/ connective/ fibers

C. Chambers, Vessels, and Valves

1. Four chambers

• upper chambers – rt and left atria

Collects blood
• lower chambers – rt and left ventricle

pumps blood from heart

2. Arteries
• carry blood away from heart

3. Veins

• blood toward heart

 4. Valves

• AV valves

Tricuspid – rt atrium

Bicuspid or mitral - lt atrium

• Semilunar valves

Pulmonary semilunar (pulmonary trunk)

Aortic semilunar (aortic arch)

II. Pulmonary and Systemic Circulation

A. Pulmonary pathway

oxygenated blood –rt ventricle from rt atrium

myocardium (rt ventricle) contracts

 low oxygen blood through pulmonary semilunar

pulmonary trunk -> arteries -> lungs

oxygenated blood -> rt & lt pulmonary veins ->

left atrium

B. Systemic pathway

Oxygenated blood -> Lt atrium to Lt ventricle

Left ventricle contracts ->aortic semilunar

Aortic arch -> arteries to tissues

oxygen depleted blood from tissues ->

veins to heart -> rt atrium (vena cava)

 Passage of Blood Through the Heart
• Blood follows this sequence through the heart:
superior and inferior vena cava → right atrium
→ tricuspid valve → right ventricle →
pulmonary semilunar valve → pulmonary trunk
and arteries to the lungs → pulmonary veins
leaving the lungs → left atrium → bicuspid valve
→ left ventricle → aortic semilunar valve →
aorta → to the body.
Direction of blood flow through the heart
The relationship between the systemic and pulmonary circulations
Blood supply to the heart or
coronary circulation

The coronary arteries

 Blood supply to the heart
Arterial supply
 The heart is supplied with arterial
blood by the right and left coronary
arteries, which branch from the aorta
immediately distal to the aortic valve
 The coronary arteries receive about
5% of the blood pumped from the
heart, although the heart comprises
a small proportion of body weight
 This large blood supply, especially to
the left ventricle, highlights the
importance of the heart to body
function
 The coronary arteries traverse the
heart, eventually forming a vast
network of capillaries
 Blood supply to the heart –

Venous drainage

 Most of venous blood is collected

into several small veins that join to
form coronary sinus, which opens
into right atrium

 The remainder passes directly into

the heart chambers through little
venous channels
 THE CARDIAC CYCLE

What is the cardiac cycle

The cardiac cycle is the sequence of

events that occur when the heart beats
There are two phases of this cycle:

Diastole - Ventricles are relaxed

Systole - Ventricles contract
 The cardiac cycle

• Exercise increases blood flow through the heart so that the

cardiac cycle accelerates to accommodate the increased
demand for oxygen
• The normal cycle is around 0.8 seconds. This accelerates with
faster and more powerful atrial and ventricular contraction,
which is stimulated by the cardiac centre in the brain
• Heart rate:- is defined as the number of heart contractions in
each minute

# There are two distinct periods in the cardiac cycle- one of the
heart muscle relaxation (cardiac diastole), the other of
contraction (cardiac systole)
 Cardiac diastole

During cardiac diastole

• The bicuspid and tricuspid

valves are closed and the
atrium is full
• Once full with blood, the
atria forces the bicuspid and
tricuspid valves to open and
fill the ventricles
• This lasts for around 0.4
seconds at rest
 Cardiac systole
Cardiac systole

• The atria contract and send

blood via the bicuspid and
tricuspid valves into the
ventricles
• When full, these contract
causing blood to be expelled
from the heart via the semi-
lunar valves
• (the bicuspid and tricuspid
valves are closed at this time)
• This lasts around 0.4 seconds at
rest
 The Cardiac Cycle
• Heart at rest
– Blood flows from large veins into atria
– Passive flow from atria into ventricles
• Atria (R & L) contract simultaneously
– Blood forced into ventricles
• Ventricles (R & L) contract simultaneously
– Atrioventricular valves close  “lubb” sound
– Blood forced into large arteries
• Ventricles relax
– Semilunar valves close  “dub” sound
• Heart at rest
 Heart valves
• Valves are flap-like structures that allow blood to flow in
one direction
• The heart has two kinds of valves, atrioventricular and
semilunar valves
Heart sounds
• The audible sounds that can be heard from the heart are
made by the closing of the heart valves
• These sounds are referred to as the “lub-dupp” sounds
• The “lub” sound is made by the contraction of the
ventricles and the closing of the atria-ventricular valves
• The “dupp” sound is made by the semi-lunar valves
closing
Conducting system of Heart
Stimulation of the heart originates in the
cardiac centre, in the “medulla oblongata.”
The “sympathetic and parasympathetic
nervous systems” work antagonistically and
provide the stimulation for acceleration and
deceleration of the heart rate
Cardiac systole (contraction) is initiated by
the electrical cardiac impulse from the
“sinu-atrial node” (the pace-maker found in
the right atria wall)
This distributes electrical stimulus through
the “myocardial” (heart muscle) wall
between the heart chambers
where the “atrio-ventricular node”
(between the right atrium and right
ventricle) continues distribution of the
electrical signal across the ventricles
 The SA node

• In the upper part of the right atrium of the heart is a specialized bundle of
neurons known as the sino-atrial node (SA node)
• Acting as the heart's natural pacemaker, the SA node "fires" at regular intervals to
cause the heart of beat with a rhythm of about 60 to 70 beats per minute for a
healthy, resting heart
• The electrical impulse from the SA node triggers a sequence of electrical events in
the heart to control the orderly sequence of muscle contractions that pump the
blood out of the heart

The AV node

• The AV node (AV stands for atrioventricular) is an electrical relay station

between the atria (the upper) and the ventricles (the lower chambers of the
heart)
• Electrical signals from the atria must pass through the AV node to reach the
ventricles
AV node (bundle of his)

The bundle of His is located in the proximal interventicular septum

It emerges from the AV node to begin the conduction of the impulse from the AV
node to the ventricles
 Purkinje fibers

• Purkinje fibers are heart muscle tissues that are specialized to

conduct electrical impulses to ventricular cells, which induce the
lower chambers of the heart to contract
• Impulses from the upper chambers of the heart are relayed by this
node to large bundles of Purkinje fibers referred to as the Bundle
of His
• These bundles branch into smaller elements and eventually form
terminal ends that burrow into left and right ventricular chamber
muscles
• As the impulse is passed to the ventricles, the muscles contract and
pump blood
• The contraction caused by the specialized fibers begins from the
bottom of the ventricles and move upwards so that the blood leaves
the lower chambers through the pulmonary arteries and the aorta
 Signal Conduction Pathway
• SA action potentials -> contraction in atrium

• AV action potentials (slower) -> bundle of HIS->

through septum -> Purkinje fibers -> contraction

C. Electrocardiography
• electrical events corresponding to mechanical

• P wave: atrial fibers depolarize

• QRS complex: ventricles depolarize

• T wave: ventricles repolarize

Electrocardiography
 Cardiac Output (CO)
• CO is the amount of blood pumped by each
ventricle in one minute
• CO is the product of heart rate (HR) and
stroke volume (SV)
• HR is the number of heart beats per minute
• SV is the amount of blood pumped out by a
ventricle with each beat
 Cardiac Output: Example

• CO (ml/min) = HR (75 beats/min) x SV (70

ml/beat)
• CO = 5250 ml/min (5.25 L/min)
 Regulation of Stroke Volume
• SV = end diastolic volume (EDV) minus end
systolic volume (ESV)
• EDV = amount of blood collected in a ventricle
during diastole
• ESV = amount of blood remaining in a
ventricle after contraction
Factors Affecting Stroke Volume
• Preload – amount ventricles are stretched
by contained blood
• Contractility – cardiac cell contractile force
due to factors other than EDV
• Afterload – back pressure exerted by blood
in the large arteries leaving the heart
Preload and Afterload
 Regulation of Heart Rate
• Positive chronotropic factors increase heart
rate
• Negative chronotropic factors decrease heart
rate
• Autonomic nervous system
• Hormones
 Blood Pressure & its regulation
• Blood pressure is the force or pressure that the
blood exerts on the walls of the blood vessels
• BP = CO x TPR
• CO= SV x HR
• BP = Blood Pressure
• CO = Cardiac Output
• TPR = Total Peripheral Resistance
• SV = Stroke Volume
• HR = Heart rate
Control of Arterial Blood Pressure
 Control of Blood Pressure

• Short term control :

– Baroreceptors
– Chemoreceptors
– Higher centres in the brain

• Long term control:

RAAS system
Summary of the main mechanisms in blood pressure control
 Baroreceptors
• Located in walls of aortic arch and left and
right carotid sinus
• Mechanical stretch receptors
• Neuronal circuits in brainstem compare
actual value of BP provided by the
baroreceptors with the set point or optimal
value
The baroreceptor reflex
Chemoreceptor
 Nerve ending situated in the carotid and aortic bodies
 control of respiration
 Sensitive to changes in the levels of Co2 , O2 and acidity of the blood

The relationship between stimulation of chemoreceptors and arterial

blood pressure
Higher centres in the brain
 Fear
 Anxiety
 Pain
 Anger
Long term Blood pressure regulation
• Renin-angiotensin-aldosterone system (RAAS)
• Anti-diuretic harmone (ADH)
• Atrial natriuretic peptide (ANP)
harmone released by heart
sodium and water loss from the kidney
reduces blood pressure
RAAS System
Disorder of CVS
• Hypertension
• Hypotension
• Congestive heart failure
• Cardiac Arrhythmia
• Angina Pectoris
• Arteriosclerosis
• Myocardial Infarction
Hypertension
 Essential hypertension
Benign (chronic ) hypertension
Malignant ( accelerated) hypertension

 Secondary hypertension
Kidney disease
Endocrinal disorders
Heart failure
Acute heart failure
Chronic heart failure

Right-sided (congestive) heart failure

Left-sided (left ventricular) heart failure

Cardiac arrhythmia
Sinus bradycardia
Sinus tachycardia
Asystole
Fibrillation
Atrial fibrillation
Ventricular fibrillation
Heart block
 INTERACTION OF THE
CARDIVASCULAR SYSTEM WITH
OTHER BODY SYSTEM
 System involve Relationship to Cardiovascular System  Cardiovascular System’s role

Integumentary skin cell stimulation produces local clotting seals breaks in skin; removes  
changes in blood flow  toxins; provides heat 
   

Skeletal provides calcium needed for normal heart provides calcium and phosphorous for
muscle contraction; protects blood cells bone maintenance; delivers hormones and
developing in bone marrow  nutrition to bone cells 
The rib cage protects heart and thoracic
vessel.  

 
Muscular skeletal muscle contractions help move delivers oxygen and nutrients, removes
blood through veins; protects superficial carbon dioxide, lactic acid, and heat
blood vessels; muscles make up most of during muscle activity 
the heart organ   
    
 
 System involve Relationship to Cardiovascular System  Cardiovascular System’s role

Nervous controls patterns of cardivascular; certain cells in blood vessels maintain

modifies heart rate and regulates blood blood-brain barrier; helps to make
pressure  cerebrospinal fluid 
   

Endocrine adrenaline stimulates cardiac muscle, distributes hormones throughout the body;
elevating heart rate and contraction force  heart secretes hormone ANP 
   

Lymphatic defends against pathogens or toxins in The heart pumps blood carries chemical
blood; fights infections of cardiovascular regulators of the immune response
organs; returns tissue fluid to circulation 
 
 System involve Relationship to Cardiovascular System  Cardiovascular System’s role

Urinary releases hormones to elevate blood delivers blood to capillaries where

pressure and accelerate red blood cell filtration occurs; accepts fluids and solutes
production; reabsorbed during urine producton 
-removes waste products  derived from  
blood plasma in the urine
 
Reproductive estrogens may maintain healthy vessels distributes reproductive hormones;
and slow development of hardening of the provides nutrients, oxygen, and waste  
arteries with age  removal for developing fetus 
   

Respiratory provides oxygen and removes carbon transports oxygen and carbon dioxide
dioxide  between lungs and other body tissues 
   

Digestive provides nutrients; absorbs water and ions distributes digestive tract hormones;
essential to maintenance of normal blood carries nutrients, water, and ions away
volume  from sites of absorption; delivers nutrients
  and toxins to liver