CARDIOVASCULAR

SYSTEM
 Also called circulatory system
Consists of:
 Heart
 Blood vessels
 Lymphatics

This network brings life sustaining

oxygen and nutrients to the body’s
cell
Removes metabolic waste products
Carries hormones from one part of
the body to another
CARDIOVASCULAR
SYSTEM
HEART

Has two separate pumps

The right side pumps the blood to the lungs to

receive oxygen. (PULMONARY CIRCULATION)

The left side pumps the oxygenated blood to

the rest of the body. (SYSTEMIC
CIRCULATION)
FUNCTIONS OF THE
HEART
1. Generating blood pressure
2. Routing blood
3. Ensuring one-way blood flow
4. Regulating blood supply
SIZE FORM AND LOCATION
OF THE HEART
Shaped like blunt cone

Approximately size of a closed fist

Blunt, rounded point of the cone is apex

Larger, flat part at the opposite end of the cone is base

 The heart lies beneath
the sternum in the
mediastinum between the
second and sixth ribs.
The heart rests obliquely,
with its right side below
and almost in front of the
left. Because of its
oblique angle, the heart’s
broad part (base) is at the
upper right. And the
pointed end (apex) is at
the lower left.
WHERE THE HEART
LIES
 The apex is the point of
maximal impulse (PMI),
where the heart sounds
are the loudest.
Located deep to the left
5th intercostal space
Approximately 7-9 cm to
the left of sternum near
midclavicular line

HEART STRUCTURE
 HEART STRUCTURE
Surrounded by a sac called the pericardium
or pericardial sac, the heart has a wall made
of three layers:
myocardium
endocardium
epicardium
CARDIAC WALLS
The epicardium, the outer layer is made
up of squamous epithelial cells overlying
connective tissue.
The myocardium, the middle layer,
forms most of the heart wall. It has
striated muscle fibers that cause the heart
to contract.
The endocardium, the heart’s inner
layer, consists of endothelial tissue with
small blood vessels and bundles of
smooth muscle.
 The fibrous
Is a fibro serous sac that pericardium ,
surrounds the heart and the roots composed of though, The serous pericardium
of the great vessels. It consists of
white fibrous tissue, the thin inner portion has
the fibrous pericardium and the two layers:
serous pericardium. fits loosely around the
heart, protecting it.

the parietal layer the visceral layer

lines the inside of adheres to the
the fibrous surface of the
pericardium heart

CARDIAC WALLS: Pericardium

CARDIAC
WALLS:
Pericardium
• Between the fibrous and
serous pericardium is the
pericardial space.
• Pericardial fluid lubricates
the surfaces of the space
and allows the heart to move
easily during contraction
 2 atria
 Right and left atria (entrance
chambers) are located at the
base of the heart
2 ventricles
 Right and left ventricles( a
cavity) extend from the base
of the heart toward the apex
Coronary sulcus –separates
atria from ventricles
Anterior Interventricular
sulcus
Posterior Interventricular
sulcus

HEART CHAMBERS
 • the upper chambers, are
separated by the interatrial
septum.
•They receive blood returning
to the heart and pump blood
to the ventricles.
• The right atrium receives
blood from the superior and
inferior vena cava.
•The left atrium, which is
smaller but has thicker walls
than the right atrium, forms
the uppermost part of the
heart’s left border. It receives
blood from the two pulmonary

HEART CHAMBER: veins.

ATRIA
HEART
CHAMBER:
VENTRICLES
• Major pumping organs
▪ The right and left ventricles ,
separated by the interventricular
septum, make up the lower
chambers.
▪The ventricles receive blood from
the atria. Composed of highly
developed musculature, the
ventricles are larger and thicker
walled than the atria.
▪ The right ventricle pumps blood to
the lungs.
▪ The left ventricle, larger than the
right, pumps blood through all other
vessels of the body.
 SIX LARGE
VEINS THAT
CARRY BLOOD
TO THE HEART
♥ Superior vena cava
♥ Inferior vena cava
♥ 4 pulmonary veins
 ARTERIES THAT
CARRY BLOOD
AWAY FROM THE
HEART

♥ Pulmonary trunk
♥Aorta
♥Pulmonary
arteries
• The valves allow forward flow
of blood through the heart and
prevent backward flow.
• They open and close in
response to pressure changes
caused by ventricular
contraction and blood ejection.
• The two AV valves separate
the atria from the ventricles.
 pulmonic valve-prevents
backflow from the pulmonary
artery into the right ventricle.
 aortic valve which prevents
backflow from the aorta into
the left ventricle.
ATRIOVENTRICULAR HEART
VALVES
• VALVES BETWEEN THE ATRIA AND
VENTRICLES
• tricuspid valve- has three triangular
cusps, or leaflets
• mitral or bicuspid valve- contains two
cusps, a large anterior and smaller posterior

• The chordae tendinae attach the cusps of the AV

valves to papillary muscles in the ventricles.
• The semilunar valves has three cusps that are
shaped like half- moons.
CARDIAC
SKELTEON
♥ Fibrous rings that
surrounds the
atrioventricular & both
semilunar valves & are
continuous with the
membranous upper part
of the ventricular system
♥ Supports the bases of the
valve cusps & prevent the
valves from stretching &
becoming incompetent
BLOOD FLOW
THROUGH
THE HEART
BLOOD SUPPLY OF THE
HEART
♥Cardiac muscle in the wall of the heart is thick and metabolic
very active
♥Two coronary arteries supply blood to the wall of the heart
1. Left Coronary artery
2. Right Coronary artery
BLOOD SUPPLY
OF THE HEART:
Coronary
Circulation
Left coronary artery-
originates on left
side of aorta
3 Major Branches:
1.ant Interventricular
artery
2. left marginal
branch
3. circumflex branch
 Right coronary artery
originates in the right side
of the aorta
1. Right marginal artery
2.Posterior Interventricular
artery

BLOOD SUPPLY OF THE

HEART: Coronary
Circulation
CARDIAC MUSCLES

Striated

depends on ATP for energy

anaerobic

joined by intercalated disks that allow action

potentials to be propagated throughout the heart
ACTION POTENTIALS IN
CARDIAC MUSCLES
• Prolonged as compared to skeletal muscles
• Phases:
Depolarization- opening of voltage gated Na+ channels
Plateau phase- opened voltage gated Ca+ channels
Repolarization phase- opening the K+ channels for a
brief period
 CONDUCTION
SYSTEM OF
THE HEART

SA NODE AV NODE

BUNDLE BUNDLE
OF HIS FIBERS

PRUKINJE
FIBERS
 1. Sinoatrial (SA) node
♥pacemaker of the heart
♥located in the RA at the
upper part of the sulcus
terminalis to the R
opening of the SVC or
near the junction of RA &
SVC
♥origin of excitation
♥Produces AP that are
propagated over the Atria
to the AV node
CONDUCTION SYSTEM
OF THE HEART
CONDUCTION
SYSTEM OF
THE HEART
2. Atrioventricular (AV)
node
♥located just above the
tricuspid valve or beneath
the endocardium & R side of
the interatrial septum
♥When AP reach the AV
node, they spread slowly
through it and then into AV
bundle.
CONDUCTION
SYSTEM OF
THE HEART
3. Bundle of His or
Atrioventricular Bundle
♥Divides into L & R bundle
branches
♥They conduct AP to the
ventricles
CONDUCTION
SYSTEM OF
THE HEART
4. Purkinje fibers
♥Pass to the apex of the
heart and then extend to the
cardiac muscle of the
ventricle walls.
♥Posses the highest
conduction velocity
 • Ectopic beat results from
an Action Potential that
originated in an area of
the heart other than the
SA node.

ELECTRICAL
CONDUCTION OF THE
HEART
ELECTROCARDIOGRAM
(ECG)
♥Record of electrical events within the heart
♥Can be used to detect abnormal heart rates or
rhythms, conduction pathways, hypertrophy or
atrophy of the heart, and approximate location
of damaged cardiac muscles.
ELECTROCARDIOGRAM
(ECG )

The normal ECG consist of a:

• P wave (atrial
depolarization
• QRS complex (ventricular
depolarization)
• T wave (ventricular
repolarization)
Atrial contraction occurs
during the PQ interval, and
the ventricles contract and
relax during QT interval.
 Cardiac output (volume of blood pumped per
ventricle per minute). It is equal to the heart
rate (beats per minute) multiplied by stroke
volume, (volume of blood ejected per beat).
REGULATION
OF HEART
FUNCTION
CO= HR x SV
 INTRINSIC REGULATION OF THE
HEART
♥Refers
• to the regulation that is contained in
the heart.
♥As venous return to the heart increases, the
heart wall is stretched, and the increased
stretch of ventricular walls is called
Preload.
 CONTRACTILITY
INTRINSIC
REGULATION
OF THE
Refers to the inherent ability of the
HEART myocardium to contract normally.
Contractility is influenced by
preload. The greater the stretch
the more forceful the contraction.
INTRINSIC REGULATION OF
THE HEART
♥An increase in preload causes the cardiac
output to increase because stroke volume
increases
(Starling’s law of the heart)
♥Afterload is the pressure against which the
ventricles must pump blood.
EXTRINSIC REGULATION OF
THE HEART
♥Refers to nervous and hormonal mechanisms
♥Sympathetic stimulation:
↑ Stroke Volume and Heart Rate
♥Parasympathetic stimulation:
↓ Heart Rate
EXTRINSIC REGULATION OF
THE HEART
♥Baroreceptor reflex detects changes in BP
• causes a decrease in HR and SV in response
to a sudden increase in BP or an increase in
HR and SV in response to a sudden decrease
in BP
 Emotions influence heart function by
↑ Sympathetic stimulation of heart in
response to excitement, anxiety or
anger and by ↑ Parasympathetic
EXTRINSIC stimulation of heart in response to
depression.
REGULATION
OF THE
HEART Alterations in body fluids levels of
Carbon dioxide, pH, and ion
concentrations, as well as changes
in body temperature, influence heart
function.
EFFECTS OF AGING ON THE
HEART
♥By age 70 Cardiac output often
decreases by one-third
♥Decrease in the maximum heart rate by
30-60% by age 85 leads to a decrease in
cardiac output.
 RHEUMATIC HEART DISEASE

usually results from a prior URTI with

group A streptococcus.
CONDITIONS
AFFECTING
THE HEART may lead to permanent valve disease
and cardiac damage

Murmur S3
Joint pain
Hallmark signs and Increased temperature
greater than 100.3⁰ F
symptoms: Carditis (chest pain, heat
failure, friction rub)
 CONDITIONS AFFECTING THE HEART

ENDOCARDITIS

microorganisms usually bacteria (staphylococci) enter the blood stream and

attach to the inner lining of the heart and heart valves resulting in inflammation.

Hallmark signs and symptoms:

Osler nodes (painful Janeway lesions (painful
Petechiae on the palate,
Chills/ fever discolored raised areas lesions on palms and fatigue murmurs
beneath the finger nails
on fingers and feet) soles)
CONDITIONS
AFFECTING THE
HEART
• CORONARY HEART DISEASE
•results from atherosclerosis, the
buildup of cholesterol-laden
plaques inside the coronary
arteries. These plaques restrict
blood flow to the heart muscle,
reducing its supply of oxygen.
•Angina (chest pain) may result.
• If blood flow is entirely disrupted,
some of the tissue may die. This is
what is meant by a “heart attack.”
 ANGINA PECTORIS

Narrowing of blood vessels to the coronary

artery secondary to arteriosclerosis.

results in inadequate blood flow through

blood vessels of the heart muscle

CONDITIONS The pain or discomfort occurs when the blood

AFFECTING supply to part of the heart muscle does not
meet the hearts needs.
THE HEART
Hallmark signs:
• Chest pain lasting 3-5 minutes described as pressure,
heaviness, squeezing or tightness
• can occur at rest or after exertion, excitement or exposure to
cold
• Usually relieved by rest
• Radiating pain
• Diaphoresis
• Dyspnea
• tachycardia
 MYOCARDIAL INFARCTION

blood supply to the myocardium is interrupted

for a long period of time due to blockage of the
coronary arteries (atherosclerosis)

CONDITIONS this results in insufficient oxygen reaching

the cardiac muscles causing cardiac
AFFECTING muscles to die (necrosis)
THE HEART
MI is commonly known as heart attack

Chest pain unrelieved by

rest or nitroglycerin
Pain that radiates to arms,
Hallmark signs: jaw back or neck
Shortness of breath
Pale, cool, clammy skin
BLOOD
VESSELS
1. Arteries
2. Arterioles
3. Capillaries
4. Venules
5. Veins
BLOOD VESSELS
• ARTERIES: have thick muscular walls to accommodate the
flow of blood at high speeds and pressures
• ARTERIOLES: have thinner walls than arteries, they constrict
or dilate to control blood flow to the capillaries
• CAPILLARIES: walls are composed of only a single layer of
endothelial cells
• VENULES: gather blood from the capillaries; walls are thinner
than the arterioles
• VEINS: thinner walls than arteries but have large diameters
because of low blood pressures of venous return to the heart
CIRCULATION:
PULMONARY
CIRCULATION:
SYSTEMIC
 AORTA
• branches into vessels that supply
specific organs and areas of the
body
• Arteries that supply the upper body
with blood:
• left common carotid artery-
supplies blood to the brain
• left subclavian artery- supplies the
arms
• innominate artery- supplies the
upper chest
 • As the aorta descends
through the thorax and
abdomen, its branches
supplies the organs of the
GI and genitourinary
systems, spinal column,
and lower chest
abdominal muscles.
Which divides into:
• iliac arteries
• femoral arteries

AORTA
the heart relies on the
coronary arteries and
their branches for its
supply of oxygenated
blood

• RA, part of the LA, most CORONARY

Right coronary artery-
supplies blood: of the LV and inferior part
of the LV CIRCULATION
Left coronary artery-
divides into the • LA, most of the LV, and
anterior descending
artery and circumflex most of the
artery. It supplies interventricular septum
blood:
 Measure of the force
blood exerts against the
blood vessel wall
BP moves blood through
the vessels.
BP can be measured by
listening for Korotkoff
sounds produced as
blood flows through
arteries partially
constricted by a BP cuff

BLOOD PRESSURE
BLOOD PRESSURE
Systolic pressure —when ventricles contract, blood is
forced into the arteries, & the pressure reaches a
maximum
--pressure at which the first sound is heard

Diastolic pressure —when ventricles relax, blood

pressure in the arteries falls to a minimum value
--pressure at which sound disappears
PULSE PRESSURE
Difference between systolic pressure &
diastolic pressure
Pulse—ejection of blood from the LV into the
aorta produces a pressure wave which travels
rapidly along the arteries
https://www.youtube.com/watch?v=pMV3y8r6WOU- normal heart sounds
https://www.youtube.com/watch?v=dBwr2GZCmQM- heart sounds and heart
murmurs
https://www.youtube.com/watch?v=X9ZZ6tcxArI&t=2s- the heart part 1 crash course
https://www.youtube.com/watch?v=FLBMwcvOaEo&t=5s- heart throbs: crash course
https://www.youtube.com/watch?v=RYZ4daFwMa8- cardiac conduction system
https://www.youtube.com/watch?v=jBt5jZSWhMI- blood flow through the heart
https://www.youtube.com/watch?v=vFRkSB46bl8- Starling’s Law