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Cardiovascular Physiology
Cardiovascular Physiology
S. I. OGUNGBEMI
DEPARTMENT OF PHYSIOLOGY
UNIVERSITY OF LAGOS
Cardiovascular System
INTRODUCTION
• Cardiovascular system (CVS: aka circulatory system)
consists of the heart and blood vessels.
The Heart
• The heart is a muscular pump with 4 chambers.
• The chambers are 2 atria and 2 ventricles.
• The ventricles are the pumps arranged in series.
• These pumps maintain continuous blood flow and
blood perfusion round the body.
The Pump
The Heart
• The 2 pumps are left ventricle (LV) which pumps blood to
systemic circulation and right ventricle (RV) which
pumps blood to pulmonary circulation.
• Endocardium
– It is the inner lining of the heart.
– It continues with the endothelium (i.e. the lining of
the blood vessels).
• Myocardium
– It is the muscular layer of the heart.
– It is made up of conductive and contractile cardiac
tissues.
• Epicardium
– It is a serous layer that function as the visceral layer
of the pericardium.
• Pericardium
– It is the conical sac within which the heart lies.
– It consists of inner serous pericardium and outer
fibrous pericardium.
– Inner serous pericardium composed of visceral
(attaching the heart) and parietal (attaching the fibrous
sac) layers.
• These 2 layers allows the heart to beat in the mediastinum
with minimum friction.
• They are the 1st branches to the heart just above the
aorta.
• Conductive Tissue
• The bundle of His divides into the right and left bundle
branches.
• Purkinje fibres branch off from the main bundle and supply
the myocardium.
• Bundle branches and their smaller branches constitute a
fast conduction pathway through which excitation
impulses are rapidly spread throughout the heart.
Evidence
• κ = extension constant
Note
• Excess Ca²⁺ will make the heart to stop working at systole
(i.e. cardiac arrest at systole).
Absolute Refractoriness
• A second excitation cannot cause the cardial myocytes to
depolarise or contract while the first excitation in process.
Repolarisation Phase
• At the peak of the pacemaker AP following the brief
plateau of ICa²⁺, there is opening of K⁺ channels.
Artificial Pacemaker
• a = augmented; V = voltage
• The augmented leads increase the size of the potential by
50% without any change in configuration from the non-
augmented records ie aV = ³/₂ of unaugmented lead.
Cardiac Vector
• An approximate mean QRS vector (electrical axis of the
heart) is often plotted by using the average QRS voltage in
each lead.
• Approximation is done by recording net difference btw the
positive and negative peaks of the QRS complex.
o Heart Rate
• Heart rate (HR) is calculated as 25 ÷ RR interval × 60
• 1st degree heart block is due to prolong nodal delay (PR >
0.20 s prolong nodal delay) with P wave : QRS = 1 : 1
Arterial Pulse
• The blood pumped into aorta during systole moves the
• Blood in the aorta forward and set up a wave that travels
along the arteries.
• This pressure expands the arterial wall as it travels and the
expansion is palpable as the pulse.
• The pulse wave travels at 4 m/s in aorta, 8 m/s in large
arteries, 16 m/s in the small arteries of young adults.
• Wave velocity is much higher than blood flow velocity.
• The pulse is felt at the wrist about 0.1 s after the peak
systolic ejection into the aorta.
• The pulse wave moves faster with advancing age, as the
arteries become more rigid.
• Pulse strength is always determined by pulse pressure.
Heart Sound
• There 4 heart sounds
Septal Defects
– Congenital interventricular septal defects produces
systolic murmurs as as blood flow from left to right
ventricle.
– Interatrial septal defects also can produce soft murmurs.