CARDIOVASCULAR SYSTEM

dr. RIDWAN RAHMAN SALEH

 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
• The function of the cardiovascular system is to
deliver oxygen and nutrients and to remove carbon
dioxide and other waste products
 The Heart

• Location
– Thorax between the
lungs
– Pointed apex
directed toward left
hip
• About the size of
your fist
 The Heart: Coverings

• Pericardium – a double serous membrane

– Visceral pericardium - Next to heart
– Parietal pericardium - Outside layer
• Serous fluid fills the space between the layers of
pericardium
 The Heart Wall: 3 layers
• Epicardium
• Outside layer
• This layer is the parietal pericardium
• Connective tissue layer
• Myocardium
• Middle layer
• Mostly cardiac muscle
• Endocardium
• Inner layer
• Endothelium
External Heart Anatomy

Figure 11.2a
 The Heart: Chambers
• Right and left side act as
separate pumps
• Four chambers
– Atria
• Receiving chambers
– Right atrium
– Left atrium
– Ventricles
• Discharging chambers
– Right ventricle
– Left ventricle

Figure 11.2c
 Blood
Circulation

Figure 11.3
 The Heart: Valves

• Allow blood to flow in only one direction

• Four valves
– Atrioventricular valves – between atria and
ventricles
• Bicuspid valve (left)
• Tricuspid valve (right)
– Semilunar valves between ventricle and artery
• Pulmonary semilunar valve
• Aortic semilunar valve
 The Heart: Valves

• Valves open as blood is pumped through

• Held in place by chordae tendineae (“heart strings”)
• Close to prevent backflow
Operation of Heart Valves

Figure 11.4
 The Heart:
Associated Great Vessels

• Aorta - leaves left ventricle

• Pulmonary arteries - leave right ventricle
• Vena cava - enters right atrium
• Pulmonary veins (four) - enter left atrium
 Coronary Circulation

• Blood in the heart chambers does not nourish the

myocardium
• The heart has its own nourishing circulatory system
– Coronary arteries
– Cardiac veins
– Blood empties into the right atrium via the
coronary sinus
 The Heart: Conduction System
• Intrinsic conduction system
(nodal system)
– Heart muscle cells contract, without nerve
impulses, in a regular, continuous way
• Special tissue sets the pace
• Sinoatrial node (SA) - Pacemaker
• Atrioventricular node (AV)
• Atrioventricular bundle
• Bundle branches
• Purkinje fibers
 The Heart’s Cardiac Cycle

• Atria contract simultaneously

• Atria relax, then ventricles contract
• Systole = contraction
• Diastole = relaxation
 Heart Contractions

• Contraction is initiated by the sinoatrial node

• Sequential stimulation occurs at other autorhythmic cells
Filling of Heart Chambers – the Cardiac Cycle

Figure 11.6
 The Heart: Cardiac Cycle

• Cardiac cycle – events of one complete heart beat

– Mid-to-late diastole – blood flows into ventricles
– Ventricular systole – blood pressure builds before
ventricle contracts, pushing out blood
– Early diastole – atria finish re-filling, ventricular
pressure is low
 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
Cardiac Output Regulation

Figure 11.7
 Regulation of Heart Rate

• Stroke volume usually remains relatively constant

– Starling’s law of the heart – the more that the
cardiac muscle is stretched, the stronger the
contraction
• Changing heart rate is the most common way to
change cardiac output
Regulation of Heart Rate

• Increased heart rate

– Sympathetic nervous system
• Activated in a Crisis
• Low blood pressure
– Hormones
• Epinephrine
• Thyroxine
– Exercise
– Decreased blood volume
 Regulation of Heart Rate

• Decreased heart rate

– Parasympathetic nervous system
– High blood pressure or blood volume
– Decreased venous return
Blood Vessels: The Vascular System

• Taking blood to the tissues and back

– Arteries
– Arterioles
– Capillaries
– Venules
– Veins

Figure 11.8a
The Vascular System

Figure 11.8b
 Blood Vessels: Anatomy

• Three layers (tunics)

– Tunic intima:
• Endothelium
– Tunic media
• Smooth muscle
• Controlled by sympathetic nervous system
– Tunic externa
• Mostly fibrous connective tissue
 Differences Between Blood Vessel Types

• Walls of arteries are the thickest

• Lumens of veins are larger
• Skeletal muscle “milks” blood in veins toward the
heart
• Walls of capillaries are only one cell layer thick to
allow for exchanges between blood and tissue
 Movement of Blood Through Vessels

• Most arterial blood is

pumped by the heart
• Veins use the milking action
of muscles to help move
blood

Figure 11.9
 Capillary Beds

• Capillary beds consist of

two types of vessels
– Vascular shunt –
directly connects an
arteriole to a venule

Figure 11.10
 Capillary Beds

• True capillaries –
exchange vessels
• Oxygen and nutrients
cross to cells
• Carbon dioxide and
metabolic waste
products cross into
blood

Figure 11.10
Diffusion at Capillary Beds

Figure 11.20
Major Arteries of Systemic Circulation

Figure 11.11
Major Veins of Systemic Circulation

Figure 11.12
Arterial Supply of the Brain

Figure 11.13
Hepatic Portal Circulation

Figure 11.14
Circulation to the Fetus

Figure 11.15
 Pulse

• Pulse – pressure
wave of blood
• Monitored at
“pressure points”
where pulse is easily
palpated

Figure 11.16
 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
• Pressure in blood vessels decreases as the distance
away from the heart increases
Measuring Arterial Blood Pressure

Figure 11.18
 Blood Pressure: Effects of Factors

• Neural factors
– Autonomic nervous system adjustments
(sympathetic division)
• Renal factors
– Regulation by altering blood volume
– Renin – hormonal control
 Blood Pressure: Effects of Factors

• Temperature
– Heat has a vasodilation effect
– Cold has a vasoconstricting effect
• Chemicals
– Various substances can cause increases or
decreases
• Diet
 Variations in Blood Pressure
• Human normal range is variable
– Normal
• 140–110 mm Hg systolic
• 80–75 mm Hg diastolic
– Hypotension
• Low systolic (below 110 mm HG)
• Often associated with illness
– Hypertension
• High systolic (above 140 mm HG)
• Can be dangerous if it is chronic
 Capillary Exchange

• Substances exchanged due to concentration

gradients
– Oxygen and nutrients leave the blood
– Carbon dioxide and other wastes leave the cells
 Capillary Exchange: Mechanisms

• Direct diffusion across plasma membranes

• Endocytosis or exocytosis
• Some capillaries have gaps (intercellular clefts)
– Plasma membrane not joined by tight junctions
• Fenestrations of some capillaries
– Fenestrations = pores
 Developmental Aspects of the Cardiovascular System

• A simple “tube heart” develops in the embryo and

pumps by the fourth week
• The heart becomes a four-chambered organ by the
end of seven weeks
• Few structural changes occur after the seventh week