Anatomy & Physiology of Cardiovascular

System
 Location of the Heart
– Lies in the pericardial cavity in mediastinum, a
space in the middle of thoracic cavity

– behind the body of the sternum between the

points of attachment of ribs two through six

– Approximately 2/3rd of its mass is to the left of the

midline of the body, and 1/3rd is to the right

– Posteriorly the heart rests on the bodies of

vertebrae T5-T8

– Between 2nd and 6th ribs

 Location of the Heart
– Apex lies on the diaphragm, pointing to the left

– Base lies just below the second rib

– Boundaries of the heart are clinically important as

an aid in diagnosing heart disorders
 Size & Shape of the Heart

– At birth, is transverse and appears large in

proportion to the diameter of the chest cavity

– Between puberty and 25 years of age the

heart attains its adult shape and weight

– In an adult, the shape of the heart tends to

resemble that of the chest
Divisions of Pericardium and Layers of Heart wall

3
4
 Structure of Heart: Wall of the Heart

• Endocardium is the inner layer and is consists

of endothelial tissue that lines the inner surface
of the heart and the cardiac valves.

• The myocardium is the middle layer and is

composed of muscle fibers that enable the heart
to pump.

• Epicardium is the outer layer, is tightly adherent

to the heart and the base of the great vessels.
The Heart Wall and Cardiac Muscle Cells
• Cardiac muscle cells are
involuntary, striated,
branched
• Each fiber is connected
to the others by
intercalated discs.
• The intercalated disc has
following structures
– gap junctions allow action
potentials to pass from
fiber to fiber
– desmosomes (“spot
welds”) to prevent cardiac
fibers from separating
during contractions
 Structure of Heart: Surface Projection
• External landmarks
– Atrioventricular grooves separate atria from ventricles
– Anterior/posterior interventricular sulcus separates right
and left ventricles
– Coronary vessels run in these grooves
 Structure of Heart: Chambers
Chambers: heart is divided into four cavities
with the right and left chambers separated by
the septum
• Atria
– Two superior chambers known as receiving chambers
because they receive blood from veins
– Atria alternately contract and relax to receive blood and
then push it into ventricles
– Myocardial wall of each atrium is not very thick because
little pressure is needed to move blood such a small
distance
– Auricle: earlike flap protruding from each atrium
Structure of Heart: Chambers
 Chambers: Right Atrium
• Receives deoxygenated blood by 3 large veins
– Superior vena cava (precaval) from head,
forelimbs and upper part of chest

– Inferior vena cava (post caval) from lower part

of trunk and hind limbs

– Coronary sinus from wall of heart

• Valve of Eustachius – opening of IVC
• Valve of Thebesius – opening of coronary sinus
 Chambers: Right Atrium

• Opens in Right ventricles – right atrioventricular

aperture guarded by atrioventricular valve –
tricuspid valve – formed of 3 flaps called cusps
• Function of valve: Regulates unidirectional flow of
blood from RA to RV but prevents the back flow
with the help of Chordae tendineae
• Chordae tendineae - number of whitish, elastic
threads which extends from tricuspid valve to the
wall of right ventricle.
• Opening and closing of valves occur as a result of
pressure differences.
 Chambers: Left Atrium
• Left atrium receives oxygenated blood from lungs
by 4 pulmonary veins (two from each lungs)
• These have no valve
• Opens in Left ventricles – left atrioventricular
aperture guarded by atrioventricular valve –
bicuspid valve (mitral valve)– formed of 2 flaps
called cusps
• Function of valve: Regulates unidirectional flow of
blood from LA to LV but prevents the back flow with
the help of Chordae tendineae similar to those in
right ventricle.
• Opening and closing of valves occur as a result of
pressure differences.
 Chambers: Ventricles
– Two lower chambers known as pumping
chambers because they push blood into the
large network of vessels

– Ventricular myocardium is thicker than the

myocardium of the atria because great force
must be generated to pump the blood a large
distance
 Chambers: Ventricles

• Both ventricles (Right & left) – thick walled

• Left ventricle –
• Myocardium of left
ventricle is thicker than
the right because it
must push blood much
further
• Three times thicker
than right
 Chambers: Ventricles
• Both ventricles are rough walled and have
ridges and grooves
• Ridges 2 types
• trabeculae carneae – low network of ridges found
in ventricular walls giving it the spongy appearance
• Papillary muscles or musculi papillares (act as
anchors) – well developed ridges – to which the
chordae tendineae are attached
• Chordae tendineae and papillary muscles prevent
the AV valves from everting and flipping into the
atria when the ventricles contract
• Interventricular septum – separates 2 ventricle
placed obliquely towards right side – prevents
mixing of blood
 Right and Left Ventricles
• From right ventricle, the pulmonary arch or
pulmonary artery originates and carries
deoxygenated blood to the lungs
• From left ventricle, the aortic arch (aorta)
originates – carried oxygenated blood to various
body parts.
• At the base of pulmonary and aortic arches,
there is valve called pulmonary and aortic valve
• Each valve is formed of 3 semilunar valves –
allow blood to enter the great artery from ventricle,
but prevent back flow of blood into ventricle.
Structure of Heart: Valves of the Heart

– Valves of the heart: mechanical devices

that permit the flow of blood in one
direction only
• Atrioventricular (AV) valves: prevent blood
from flowing back into the atria from the
ventricles when the ventricles contract
– Tricuspid valve (right AV valve): guards the
right atrioventricular orifice; free edges of three
flaps of endocardium are attached to papillary
muscles by chordae tendineae
– Bicuspid, or mitral, valve (left AV valve): similar
in structure to tricuspid valve except has only
two flaps
Function of the Atrioventricular Valves
 Structure of Heart: Valves of the Heart

• Semilunar valves: half-moon–shaped flaps

growing out from the lining of the pulmonary
artery and aorta; prevent blood from flowing
back into the ventricles from the aorta and
pulmonary artery
– Pulmonary valve: valve at entrance of the
pulmonary artery
– Aortic valve: valve at entrance of the aorta
 BLOOD VESSELS
• Blood is carried in a closed system of vessels that begins
and ends at the heart
• 5 Classes of Blood Vessels
1. Arteries:
– carry blood away from heart
2. Arterioles:
– Are smallest branches of arteries
3. Capillaries:
– are smallest blood vessels
– location of exchange between blood and
interstitial fluid
4. Venules:
– collect blood from capillaries
5. Veins:
– return blood to heart
 CIRCULATION
– Coronary circulation – the circulation of
blood within the heart.
– Pulmonary circulation – the flow of blood
between the heart and lungs.
– Systemic circulation – the flow of blood
between the heart and the cells of the
body.
– Fetal Circulation
Filling of Heart Chambers –
the Cardiac Cycle
 The Heart: Cardiac Output

 Cardiac output (CO)

 Amount of blood pumped by each side of
the heart in one minute
 CO = (heart rate [HR]) x (stroke volume
[SV])
 Stroke volume
 Volume of blood pumped by each ventricle
in one contraction
 Conducting System (‫ )إجراء النظام‬of the Heart

• Inherent and rhythmical

beat is due to autorhythmic
fibers of the cardiac
muscle.
• These fibers have 2
important function
- Act as pace maker
- Form the conduction
system
Conducting System (‫ )إجراء النظام‬of the Heart
• Four structures composed of modified cardiac
muscle
1. Sinoatrial Node (SA Node)
– Pacemaker of the heart
– Initiates heart beat
– 100s of cells in the Right atrium near the
opening of the superior vena cava

2. Atrioventricular Node (AV Node)

– Small mass of cardiac muscle tissue
– Left lower border of Right atrium
Conducting System (‫ )إجراء النظام‬of the Heart

• Atrioventricular Bundle
– Also Bundle of His
– Bundle of specialized cardiac muscle fibers
originating in the AV node
– Branches into Right and Left branches
eventually becoming Purkinje fibers
– Extend into the walls of the ventricles and
papillary muscles
Conducting System (‫ )إجراء النظام‬of the Heart
Purkinjee fibers
– Atrioventricular Bundle Branches
into Right and Left branches
eventually becoming Purkinje
fibers
– Specialized cardiac muscle
fibers that are involved in
conduction system of the heart
and are found in the
endocardium
– Extend into the walls of the
ventricles and papillary muscles
– The last conducting tissue in the
process of cardiac conduction
sequence is the Purkinjee fibers
Conducting System (‫ )إجراء النظام‬of the Heart