Cardiovascular System pericardial fluid that reduces friction

between the two membranes.

THE HEART o Thin delicate membrane
Part I: The Heart and Blood Vessels o Contains parietal layer-outer layer,
pericardial cavity with pericardial fluid,
 The cardiovascular system consists of the blood, and visceral layer (epicardium)
heart, and blood vessels.
 The heart is the pump that circulates the blood
through an estimated 60,000 miles of blood
vessels.
 The study of the normal heart and diseases
associated with it is known as cardiology.

HEART LOCATION

2/3 of the heart’s mass is on the left to the middle

Missing: anatomical description

HEART ORIENTATION
 Fibrous pericardium
 Apex - directed anteriorly, inferiorly and to the o Dense irregular connective tissue
left o Protects and anchors the heart, prevents
 Base - directed posteriorly, superiorly and to the over stretching
right
 Anterior surface - deep to the sternum and ribs LAYERS OF HEART WALL
 Inferior surface - rests on the diaphragm
 Right border - faces right lung  Epicardium – visceral layer of serous pericardium
 Left border - faces left lung  Myocardium – cardiac muscle layer is the bulk of
the heart
 Endocardium – chamber lining and valves

MUSCLE BUNDLES OF THE MYOCARDIUM

PERICARDIUM
- Encloses and holds the heart in place
- Consists of an outer fibrous pericardium and
inner serous pericardium (epicardium) CHAMBERS AND SULCI OF THE HEART

 Serous pericardium  Four chambers:

o Composed of a parietal layer and visceral o 2 upper atria
layer o 2 lower ventricles
o Between the parietal and visceral layers of * atrium – welcoming area
the serous pericardium is the pericardial  Sulci – grooves on surface of heart containing
cavity, a potential space filled with coronary blood vessels and fat
 o Coronary sulcus – encircles heart and - Bicuspid valve: blood passes through into left
marks the boundary between the atria ventricle
and the ventricles o Has two cusps
o Anterior interventricular sulcus – marks o Mnemonic LAMB (Left Atrioventricular,
the boundary between the ventricles Mitral, or Bicuspid valve)
anteriorly
o Posterior interventricular sulcus – marks Left Ventricle
the boundary between the ventricles - Forms the apex of the heart
posteriorly - Chordae tendineae anchor biscuspid valve to
papillary muscles (also has trabeculae carneae like
right ventricle)
- Most powerful chamber because it has thickest
myocardia and pumps greatest amount of blood
- Aortic semilunar valve:
o Blood passes through valve into the
ascending aorta
o Just above valve are the openings to the
coronary arteries

MYOCARDIAL THICKNESS AND FUNCTION

The thickness of the myocardium of the four

chambers varies according to the function of each
chamber.
 The atria walls are thin because they deliver
blood only to the ventricles
Right Atrium  The ventricle walls are thicker because they pump
- Receives blood from 3 sources: superior vena blood greater distances
cava, inferior vena cava, coronary sinus  The right ventricle walls are thinner than the left
- Interatrial septum partitions the atria because they pump blood into the lungs, which
*it’s the one that divides the right and left atrium are nearby and offer very little resistance to blood
- Fossa ovalis is a remnant of the fetal foramen flow
ovale (foramen ovale – open; fossa ovalis –  The left ventricle walls are thicker because they
closed) pump blood through the body where the
- Tricuspid valve resistance to blood flow is greater
o Blood flows through into right ventricle
o Has three cusps composed of dense FIBROUS SKELETON OF HEART
connective tissue covered by
endocardium Dense CT rings surround the valves of the heart,
o Allow unidirectional flow fuse and merge with the interventricular septum

Right Ventricle  Support structure for heart valves

- Forms most of anterior surface of the heart  Insertion point for cardiac muscle bundles
- Papillary muscles are cone-shaped trabeculae
 Electrical insulator between atria and ventricles
carneae (raised bundles of cardiac muscles)
o Prevents direct propagation of action
- Chordae tendineae: cords between valve cusps
potential to ventricles
and papillary muscles
- Interventricular septum: partitions ventricles
ATRIOVENTRICULAR VALVES OPEN
- Pulmonary semilunar valve: blood flows into
pulmonary trunk
A-V valves open and allow blood to flow from
atria into ventricles when ventricular pressure is lower
Left Atrium
than atrial pressure
- Forms most of the base of the heart
 occurs when ventricles are relaxed, chordae
- Receives blood from lungs – 4 pulmonary veins (2
tendineae are slack, and papillary muscles are
right + 2 left)
relaxed
 Open:
1. Blood returning to the heart fills the atria, putting
pressure against atrioventricular valves;
atroiventricular valves forced open
2. As ventricles fill, atrioventricular valves flaps hang
limply into ventricles
3. Atria contract, forcing additional blood into
ventricles
ATRIOVENTRICULAR VALVES CLOSE Closed:
1. Ventricles contract, forcing blood against
A-V valves close preventing backflow of blood into atrioventricular valve cusps
atria 2. Atrioventricular valves close
 occurs when ventricles contract, pushing valve 3. Papillary muscles contract and chordae tendineae
cusps closed, chordae tendineae are pulled taut tighten, preventing valve flaps from everting into
and papillary muscles contract to pull cords and atria
prevent cusps from everting
SEMILUNAR VALVE FUNCTION

Open:
[MISSING SLIDE] As ventricles contract and intraventricular
pressure rises, blood is pushed up against semilunar
HEART VALVE DISORDERS valves, forcing them to open.

 Stenosis is a narrowing of a heart valve which Closed:

restricts blood flow As ventricles relax and intraventricular pressure
 Insufficiency or incompetence is a failure of a falls, blood flows back from arteries filling the cusps of
valve to close completely semilunar valves and forcing them to close.
 Stenosed valves may be repaired by balloon
valvuloplasty, surgical repair, or valve BLOOD CIRCULATION
replacement
-Two closed circuits, the systemic and pulmonic
ATRIVENTRICULAR VALVE FUNCTION
Systemic circulation
 Left side of heart pumps blood through body
 Left ventricle pumps oxygenated blood into aorta
 Aorta branches into many arteries that travel to
organs
 Arteries branch into many arterioles in tissue
*arteries create the pulse
 Arterioles branch into thin-walled capillaries for
exchange of gases and nutrients
 Deoxygenated blood begins its return in venules
 Venules merge into veins and return to right
*hypoxia- low oxygen
 *heart doesn’t regenerate CORONARY VEINS

Pulmonic circulation  Collects “wastes” from cardiac muscle

 Right side of heart pumps deoxygenated blood to  Drains into a large sinus on posterior surface of
lungs heart called the coronary sinus
 Right ventricle pumps blood to pulmonary trunk  Coronary sinus empties into right atrium
 Pulmonary trunk branches into pulmonary
arteries HISTOLOGY OF CARDIAC MUSCLES
 Pulmonary arteries carry blood to lungs for  Compared to skeletal muscle fibers, cardiac
exchange of gases muscle fibers are:
 Oxygenated blood returns to heart in pulmonary o Shorter in length
veins o Larger in diameter
o Squarish rather than circular in transverse
section
o Exhibit branching
 Fibers within the networks are connected by
intercalated discs which consist of desmosomes
and gap jucntions
 Cardiac muscles have the same arrangement of
actin and myosin, and the same bands, zones, and
Z discs as skeletal muscles
 They have less sarcoplasmic reticulum than
skeletal muscles and require Ca+2 from
extracellular fluid for contraction

CORONARY CIRCULATION

-Coronary circulation is blood supply to the heart

-Heart as a very active muscle needs a lot of O2
-When the heart relaxes, high pressure of blood in aorta
pushes blood into coronary vessels
*Coronary Circulation - perfusion to the heart muscles
Anastomoses – connections between arteries supplying
blood to the same region, provide alternate routes if one
artery becomes occluded
Autorhythmic Cells:
CORONARY ARTERIES
The Conduction System
Branches off aorta above aortic semilunar valve
 Cardiac muscle cells are autorhythmic cells
 Left Coronary Artery
because they are self-excitable. They repeatedly
o Circumflex branch
generate spontaneous action potentials that
o Anterior interventricular artery
trigger heart contractions.
 Left Coronary Artery
 These cells act as a pacemaker to set the rhythm
o Marginal branch
for the entire heart.
o Posterior interventricular artery

 They form the conduction system, the route for

propagating action potential through heart
CONDUCTION SYSTEM OF HEART *K+ and Ca++maintains the plateau
*Na+initiates depolarization

ATP PRODUCTION IN CARDIAC MUSCLE

 Cardiac muscle relies on aerobic cellular

respiration for ATP production
 Cardiac muscle also produces some ATP from
creatine phosphate
 The presence of creatine kinase (CK) in the blood
indicates injury of cardiac muscle usullay caused
by myocardial infarction

ELECTROCARDIOGRAM

RHYTHM OF CONDUCTION SYSTEM

 SA node fires spontaneously 60-100 times per

minute
*SA node- initiates impulse
 AV node fires at 40-50 times per minute
o If both nodes are suppressed, fibers in
ventricles by themselves fire only 20-40
times per minute
o Artificial pacemaker is needed if pace is
too slow
o Extra beats forming at other sites are
called ectopic pacemakers

TIMING OF ATRIAL AND VENTRICULAR EXCITATION  EKG – action potentials of all active cells can be
detected and recorded
 SA node sets pace since it is the fastest  P wave – atrial depolarization
 In 50 msec excitation spreads through both atria  P to Q interval – conduction time from atrial to
and down to AV node ventricular excitation
 100 msec delay at AV node due to smaller  QRS complex – ventricular depolarization
diameter fibers- allows atria to fully contract filling
 T wave – ventricular repolarization
ventricles before ventricles contract
 In 50 msec excitation spreads through both THE CARDIAC CYCLE
ventricles simultaneously
-The rhythmic pumping action of the heart
PHYSIOLOGY OF CONTRACTION
 Phases:
o Systole – the period at which the
ventricles are contracting
o Diastole – the period at which ventricles
are relaxed and filled with blood
o Pang-apat na sound yung diastole

 At 75 beats/min, one cycle requires 0.8 sec.

o systole (contraction) and diastole
(relaxation) of both atria, plus the systole
and diastole of both ventricles
 End diastolic volume (EDV)
 o volume in ventricle at end of diastole, HEART SOUNDS
about 130ml
 End systolic volume (ESV)  The sound of a heartbeat comes primarily from
o volume in ventricle at end of systole, the turbulence in blood flow caused by the closure
about 60ml of the valves, not from the contraction of the
 Stroke volume (SV) heart muscle.
o the volume ejected per beat from each  The first heart sound (lubb) is created by blood
ventricle, about 70ml turbulence associated with the closing of the
 SV = EDV – ESV atrioventricular valves soon after ventricular
systole begins.
Phases of Cardiac Cycle  The second heart sound (dubb) represents the
closing of the semilunar valves close to the end of
the ventricular systole.
 Auscultation – the act of listening to the beat of
your heart
 AV closue – loudest sa apex
 SV closure – base

CARDIAC OUTPUT

Cardiac Output – Measure used to determine efficiency of

cardiac performance

 Amount of blood the heart pumps each minute

 Varies with body size & metabolic needs
 Increased in stress & physical activity
1. Atrial systole – atria contract, AV valves open,  Decreased in sleep & rest
semilunar valves closed  Average: 3.5 – 8L/min
2. Early ventricular systole – atria relax, ventricles
contract, AV valves forced closed, semilunar CO = SV X HR
valves still closed
3. Late ventricular systole – atria relax, ventricles REGULATION OF CARDIAC OUTPUT
contract, AV valves remain closed, semilunar
valves forced open
4. Early ventricular diastole – atria and ventricles
relax, AV valves and semilunar valves closed, atria
begin passively filling with blood
5. Late ventricular diastole – atria and ventricles
relax, atria passively fill with blood as AV valves
open, semilunar valves closed

VENTRICULAR PRESSURES

 Blood pressure in aorta is 120 mm Hg

 Blood pressure in pulmonary trunk is 30 mm Hg
 Differences in ventricle wall thickness allows the
heart to push the same amount of blood with
more force from the left ventricle CARDIAC PERFORMANC REGULATION
 The volume of blood ejected from each ventricle
is 70 mL (stroke volume) Cardiac Reserve
 Maximum percentage of increase in cardiac
 Why do stroke volumes need to be the same? output that can be achieved above the normal
So they can pump with the same strength resting level
 N: 300-400%
 Dependent on:
 o Preload
o Afterload
o Cardiac contractility REGULATION OF HEART RATE
o Heart Rate
Nervous control from the cardiovascular center in the
PRELOAD: EFFECT OF STRETCHING medulla

 Determined by the stretch and volume it can  Sympathetic impulses increase heart rate and
contain force of contraction
 Predload is directly proportional to EDV  Parasympathetic impulses decrease heart rate.
 EDV – determined by the length of diastole and  Baroreceptors (pressure receptors) detect change
the venous return in BP and send info to the cardiovascular center
 Represents the amount of blood that the heart o located in the arch of the aorta and
must pump with each beat carotid arteries
 more blood = more force of contraction results
 Determined by venous return to the heart & Heart rate is also affected by hormones
stretch of the muscle fibers
 Frank-Starling mechanism  epinephrine, norepinephrine, thyroid hormones
 ions (Na+, K+, Ca2+)
AFTERLOAD  age, gender, physical fitness, and temperature

 The pressure that the heart must generate to

move blood into the aorta
 High blood pressure creates high afterload
 Sources of afterload:
o L Heart: Systemic arterial BP
o R Heart: Pulmonary arterial pressure
 High BP creates high afterload

CONTRACTILITY

 The ability of the heart to change its force of

contraction without changing its resting length

 Myocardial contractility, the strength of

contraction at any given preload, is affected by AUTONOMIC REGULATION OF THE HEART
positive and negative inotropic agents.
 Nervous control of the cardiovascular system
stems from the cardiovascular center in the
 Influenced by number of calcium ions available in medulla oblongata.
the contractile process
 SNS stimulation: + inotropic effect by increasing  Proprioceptors, baroreceptors, and
Ca+ available chemoreceptors monitor factors that influence
the heart rate.
HEART RATE
 Sympathetic impulses increase heart rate and
 Determines the frequency with which blood is force of contraction; parasympathetic impulses
ejected from the heart decrease heart rate.

↑HR = ↑CO
CHEMICAL REGULATION OF THE HEART RATE
↑ ↑ HR —> ↓time spent in diastole, less time to fill
ventricles BUT same time in systole  Heart rate affected by hormones (epinephrine,
norepinephrine, thyroid hormones).
EFFECT: ↑ SV but ↓ CO
  Cations (Na+, K+, Ca+2) also affect heart rate.

 Other factors such as age, gender, physical fitness,

and temperature also affect heart rate.

REVIEW OF CARDIAC OUTPUT

FACTORS INVOLVED IN REGULATION OF CARDIAC OUTPUT

*SA node can trigger a heartbeat/rate from 60-100