CHAPTER 4

THE CARDIOVASCULAR SYSTEM

  Weight of the heart 300g
 Work: 75/min, 10000
beats /day
 35 million beats /year, 2.5
billion beats/life
 70ml/beat, 7200 l/day

The work of the heart in one life is equivalent to

lifting 30 tons to the Mount Everest

The busy and hard working heart!

 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.
 Humoral communication.
Systemic and Pulmonary Circulation
A. Heart location in the chest
B. Heart Chambers
B. Heart Chambers
 1. Right Heart
 receives venous blood from
systemic circulation
 via superior and inferior
vena cava into right atrium
pumps blood to pulmonary circulation from right
ventricle
 2. Left Heart
receives oxygenated blood from pulmonary
circulation
pumps blood into systemic circulation
 C. Heart Valves
 1. Atrioventricular
 tricuspid--between RA
and RV; three leaflets
 mitral--between LA and
LV; two leaflets
 2. Semilunar
 pulmonic--three leaflets
 aortic--three leaflets
 Heart Valves

 Prevent backward regurgitation

 Provide low resistance to forward flow

 Section 1 The Heart as a Pump

 I Cardiac Cycle
 The period from the end of one heart
contraction to the end of the next
 Cardiac Cycle

 Diastole is
longer than
systole

 The sequence
of systole and
diastole
 Heart Sounds

The sounds heard over the cardiac

region produced by the functioning of
the heart.
 Heart Sounds
 S1- first sound
 Atrioventricular valves and surrounding fluid vibrations as valves
close at beginning of ventricular systole
 S2- second sound
 closure of aortic and pulmonary semilunar
valves at beginning of ventricular diastole
 S3- third sound
 vibrations of the ventricular walls when
suddenly distended by the rush of blood from the
atria
II Cardiac Output
 Stroke Volume – The volume pumped by the
heart with each beat,
 = end diastole volume – end systole volume, about
70 ml

 Ejection Fraction – Stroke volume accounts for

the percentage of the end diastolic volume,
 = stroke volume / end diastole volume X 100%,
normal range, 55-65%
 II Cardiac Output
 3. Minute Volume, or Cardiac Output – the
volume of the blood pumped by one ventricle in
one minute
 = stroke volume X heart rate.
 It varies with sex, age, and exercise
 4. Cardiac Index, the cardiac output per square
meter of body surface area.
 the normalized data for different size individuals,
 the normal range is about 3.0 – 3.5 L/min/m2
Determinants of Cardiac Output (CO)

Contractility

Stroke
Preload Volume Afterload

Heart Rate

Cardiac
Output
 Definitions
 Preload
amount of stretch on the ventricular myocardium
prior to contraction
 Afterload
the arterial pressure that a ventricle must
overcome while it contracts during ejection
impedance to ventricular ejection
Definitions

 Contractility
 myocardium’s intrinsic ability to
efficiently contract and empty the
ventricle
 (independent of preload & afterload)
Action of Sympathetic Stimulation
 Sympathetic nerve
stimulation increases
cardiac contractility.
 At rest the heart is under
sympathetic tone.
 Noradrenaline enhances
calcium entry into
cardiac cells.
 Parasympathetic
stimulation has little
affect on contractility
due to the innervation
pattern of the heart.