CHAPTER 11: CARDIOVASCULAR SYSTEM

The Cardiovascular System

 A closed system of the heart and blood vessels
 The heart pumps blood
 Blood vessels allow blood to circulate to all parts of the body
 Functions:
 To deliver oxygen and nutrients to cells and tissues
 To remove carbon dioxide and other waste products from cells and tissues

The Heart
 Location: thorax between the lungs in the inferior mediastinum
 Orientation:
 Pointed apex directed toward left hip
 Base points toward right shoulder
 About the size of your fist
 Coverings:
 Pericardium – a double walled sac
o Fibrous pericardium is loose and superficial
o Serous membrane is deep to the fibrous pericardium and composed of two layers
 Visceral pericardium – next to heart; also known as the epicardium
 Parietal pericardium – outside layer that lines the inner surface of the fibrous
pericardium
o Serous fluid fills the space between the layers of pericardium
 Heart Wall
 Three layers:
o Epicardium: outside layer; this layer is the visceral pericardium; and a connective tissue
layer
o Myocardium: middle layer; and mostly cardiac muscle
o Endocardium: inner layer; and endothelium
 Chambers:
 Right and left side act as separate pumps
 Four chambers:
o Atria – receiving chambers
 Right atrium and left atrium
o Ventricles – discharging chambers
 Right ventricle and left ventricle
 Septa
 Intraventricular septum: separates the two ventricles
 Interatrial septum: separates the two atria
 The Heart’s Role in Blood Circulation
 Systemic Circulation
o Blood flows from the left side of the heart through the body tissues and back to the right side
of the heart
 Pulmonary Circulation
o Blood flows from the right side of the heart to the lungs and back to the left side of the heart
 Valves
 Allow blood flow in only one direction to prevent backflow
 Four valves
o Atrioventricular (AV) valves - between atria and ventricles
 Anchored in place by chordae tendineae (“heart strings”)
  Open during heart relaxation and closed during ventricular contraction
 Bicuspid (mitral) valve – left side of the heart
 Tricuspid valve – right side of the heart
o Semilunar valves – between ventricle and artery
 Closed during heart relaxation but open during ventricular contraction
 Pulmonary semilunar valve
 Aortic semilunar valve
 Notice these valves operate opposite of one another to force a one-way path of blood through the heart
 Cardiac Circulation
 Blood in the heart chambers does not nourish the myocardium
 The heart has its own nourishing circulatory system consisting of:
o Coronary arteries – branch from the aorta to supply the heart muscle with oxygenated blood
o Cardiac veins – drain the myocardium of blood
o Coronary sinus – a large vein on the posterior of the heart, receives blood from cardiac veins
 Blood empties into the right atrium via the coronary sinus
 Associated Great Vessels
 Arteries
o Aorta – leave left ventricle
o Pulmonary arteries – leave right ventricle
 Veins
o Superior and inferior vena cava – enter right atrium
o Pulmonary vein (4) – enter left atrium
 Blood Flow through the Heart
 Superior and inferior vena cava dump blood into the right atrium
 From the right atrium, through the tricuspid valve, blood travels to the right ventricle
 From the right ventricle, blood leaves the heart as it passes through the pulmonary semilunar valve
into the pulmonary trunk
 Pulmonary trunk splits into right and left pulmonary arteries that carry blood to the lungs
 Oxygen is picked up and carbon dioxide is dropped off by blood in the lungs
 Oxygen-rich blood returns to the heart through the four pulmonary veins
 Blood enters the left atrium and travels through the bicuspid valve into the left ventricle
 From the left ventricle, blood leaves the heart via the aortic semilunar valve and aorta
 Conduction System
 Intrinsic conduction system (nodal system)
o Heart muscle cells contract, without nerve impulses, in a regular, continuous way
 Special tissue sets the pace
o Sinoatrial node (SA node) – the “pacemaker”; is in the right atrium
o Atrioventricular node (AV node) – is at the junction of the atria and ventricles
o Atrioventricular bundle (AV bundle) – bundle of His; is in the interventricular septum
o Bundle branches are in the interventricular septum
o Purkinje fibers spread within the ventricle wall muscles
 Heart Contractions
 Contraction is initiated by the sinoatrial node (SA node)
 Sequential stimulation occurs at other autorhythmic cells
 Force cardiac muscle depolarization in one direction – from atria to ventricles
 Once SA node starts the heartbeat
o Impulse spreads to the AV node
o Then the atria contract
 At the AV node, the impulse passes through the AV bundle, bundle branches, and Purkinje fibers
 Blood is ejected from the ventricles to the aorta and pulmonary trunk as the ventricles contract
Homeostatic Imbalance
 o Heart Block – damaged AV node releases them from control of the SA node; results is in a
slower rate as ventricles contract at their own rate
o Ischemia – lack of adequate oxygen supply to heart muscle
o Fibrillation – a rapid, uncoordinated shuddering of the heart muscle
o Tachycardia – rapid heart rate over 100 beats per minute
o Bradycardia – slow heart rate less than 60 per minutes
 Cardiac Cycle and Heart Sounds
 Atria contract simultaneously
 Atria relax, then ventricles contract
 Systole = contraction
 Diastole = relaxation
 Cardiac Output
 Cardiac output (CO)
o Amount of blood pumped by each side (ventricle) of the heart in one minute
 Stroke volume (SV)
o Volume of blood pumped by each ventricle in one contraction (each heartbeat)
o Usually remains relatively constant
o About 70 mL of blood is pumped out of the left ventricle with each heartbeat
 Heart rate (HR)
o Typically 75 beats per minute

Formula: CO = HR x SV
Example: CO = HR (75 beats/ min) x SV (70 mL/ beat)
CO = 5250 mL/min

 Starling’s law of the heart – the more the cardiac muscle is stretched, the stronger the contraction
 Changing heart rate is the most common way to change cardiac output
 Regulation of the Heart Rate
 Increased heart rate
o Sympathetic nervous system: crisis / low blood pressure
o Hormones: epinephrine / thyroxine
o Exercise
o Decreased blood volume
 Decreased heart rate
o Parasympathetic nervous system
o High blood pressure or blood volume
o Decreased venous return

The Blood Vessels

 The Vascular System
 Transport blood to the tissues and back
o Carry blood away from the heart: arteries and arterioles
o Exchanges between tissues and blood: capillary beds
o Return blood toward the heart: venules and veins
 Structural Differences among Blood Vessels
 Arteries have a thicker tunica media than veins
 Capillaries are only one cell layer (tunica intima) to allow for exchanges between blood and tissue
 Veins have a thinner tunica media than arteries
o Veins also have valves to prevent backflow of blood
o Lumen of veins are larger than arteries
 Venous Aids for the Return of Blood to the Heart
  Veins
o Have a thinner tunica media
o Operate under low pressure
o Have a larger lumen than arteries
 To assist in the movement of blood back to the heart:
o Larger veins have valves to prevent backflow
o Skeletal muscle “milks” blood in veins toward the heart
 Movement of Blood through Vessels
 Most arterial blood is pumped by the heart
 Veins use the milking action of muscles to help move blood
 Capillary Beds
 Capillary beds consist of two types of vessels
o Vascular shunt – vessel directly connecting an arteriole to a venule
o True capillaries – exchange vessels
 Oxygen and nutrients ross to cells
 Carbon dioxide and metabolic waste products cross into blood
 Major Arteries of System Circulation
 Aorta
o Largest artery in the body
o Leaves from the left ventricle of the heart
o Regions:
 Ascending aorta – leaves the left ventricle
 Arterial branches of the ascending aorta
 Right and left coronary arteries serve the heart
 Aortic arch – arches to the left
 Arterial branches of the aortic arch (BCS)
 Brachiocephalic trunk splits into the
 Right common carotid artery
 Right subclavian artery
 Left common carotid artery splits into the
 Left internal and external carotid arteries
 Left subclavian artery branches into the
 Vertebral artery
 In the axilla, the subclavian artery becomes the axillary
artery → brachial artery → radial and ulnar arteries
 Thoracic aorta – travels downward through the thorax
 Arterial branches of the thoracic aorta
 Intercostal arteries supply the muscles of the thoracic wall
 Other branches of the thoracic aorta supply the
 Lungs (bronchial arteries)
 Esophagus (esophageal arteries)
 Diaphragm (phrenic arteries)
 Abdominal aorta – passes through the diaphragm into the abdominopelvic cavity
 Arterial branches of the abdominal aorta
 Celiac trunk is the first branch of the abdominal aorta. Three
branches are:
 Left gastric artery (stomach)
 Splenic artery (spleen)
 Common hepatic artery (liver)
 Superior mesenteric artery supplies most of the small intestine and
first half of the large intestine
 Inferior mesenteric artery serves the second half of the large intestine
  Left and right common iliac arteries are the final branches of the
aorta
 Internal iliac arteries serve the pelvic organs
 External iliac arteries enter the thigh → femoral artery →
popliteal artery → anterior and posterior tibial arteries
 Major Veins of Systemic Circulation
 Superior and Inferior Vena Cava
o Enter the right atrium of the heart
o Superior vena cava - drains the head and arms
 Veins draining into the superior vena cava
 Radial and ulnar veins → brachial vein → axillary vein
 These veins drain the arms
 Cephalic vein drains the lateral aspect of the arm and empties into the axillary
vein
 Basilic vein drains the medial aspect of the arm and empties into the brachial
vein
 Basilic and cephalic veins are jointed at the median cubital vein (elbow area)
o Inferior vena cava - drains the lower body
 Arterial Supply of the Brain
 Internal carotid arteries divide into
o Anterior and middle cerebral arteries
o These arteries supply most of the cerebrum
 Vertebral arteries join once within the skull to form the basilar artery
o Basilar artery serves the brain stem and cerebellum
 Posterior cerebral arteries form from the division of the basilar artery
o These arteries supply the posterior cerebrum
 Hepatic Portal Circulation
 Veins of hepatic portal circulation drain
o Digestive organs
o Spleen
o Pancreas
 Hepatic portal vein carries this blood to the liver
 Liver helps maintain proper glucose, fat, and protein concentrations in blood
 Major vessels of hepatic portal circulation
o Inferior and superior mesenteric veins
o Splenic vein
o Left gastric vein

Pulse
 Pressure wave of blood
 Monitored at “pressure points” in arteries where pulse is easily palpated
 Pulse averages 70 to 76 beats per minute at rest

Blood Pressure
 Measurements by health professionals are made on the pressure in large arteries
 Systolic – pressure at the peak of ventricular contraction
 Diastolic – pressure when ventricles relax
 White systolic pressure first and diastolic last (120/80 mm Hg)
 Pressure in blood vessels decreases as distance from the heart increases
Effects of Factors
 Blood Pressure (BP) is affected by age, weight, time of day, exercise, body position, emotional state
 o Cardiac output (CO) is the amount of blood pumped out of the left ventricle per minute
o Peripheral Resistance (PR) or the amount of friction blood encounters as it flows through
vessels
 Narrowing of blood vessels and increased blood volume increases PR
o Formula: BP = CO x PR
 Neural factors: autonomic nervous system adjustments (sympathetic division)
 Renal factors
o Regulation by altering blood volume
o Renin – hormonal control
 Temperature
o Heat has a vasodilating effect
o Cold has a vasocontricting effect
 Chemicals: various substances can cause increases or decreases
 Diet
Variations in Blood Pressure
 Normal range of blood pressure
o 140 to 110 mm Hg systolic
o 80 to 75 mm Hg diastolic
 Hypotension
o Low systolic (below 110 mm Hg)
o Often associated with illness
 Hypertension
o High systolic (above 140 mm Hg)
o Can be dangerous if it is chronic

Developmental Aspects of the Cardiovascular System

 Aging problems associated with the cardiovascular system include:
 Venous valves weaken
 Varicose veins
 Progressive atherosclerosis
 Loss of elasticity of vessels leads to hypertension
 Coronary artery disease results from vessels filled with fatty, calcified deposits