HAP Lab - FINALS

CARDIOVASCULAR SYSTEM BASE

‒ Closed pump system made up of heart, blood APEX

vessels and blood
‒ Also known as Circulatory System

FUNCTIONS OF THE HEART

THE HEART
‒ Muscular organ essential for life by pumping 1. GENERATE BLOOD PRESSURE
blood ‒ Through contractions
‒ Four-chambered, hollow, muscular organ lying
If pressure increases, flow of liquid increases.
between the lungs > Adult: at rest; pumps 5L of blood per minute

2. ROUTING BLOOD
SIZE, FORM, AND LOCATION OF THE HEART ‒ The heart separates the systematic and
pulmonary circulation
HEART ‒ Ensures the blood flowing to tissues has
‒ Shaped like a blunt cone adequate levels of O2 (oxygen)
‒ Approximately size of a closed fist
→ Larger in active adults
→ Decreases in size after approximately
age 65
‒ Weight:
→ Male: 250-390gm
→ Female: 200-275gm
► Between 2 pleural cavities at the middle
mediastinum
► The heart lies obliquely at an angle RIGHT: to the lungs
► Two-thirds of its mass (apex) is to the left of LEFT: to all other tissues of the body
the midline
3. ENSURING ONE-WAY FLOW
● APEX ‒ VALVES ensure one-way flow
‒ Blunt, rounded point
► Directed inferiorly to the left 4. REGULATING BLOOD SUPPLY
► At the 5th intercostal space, midclavicular ‒ Changes in rate and force of heart
line contraction to match blood flow to the
changing metabolic needs of tissues (rest,
● BASE exercise, changes in body position)
‒ Flat end
► Directed posteriorly, superiorly and to the
right PULMONARY CIRCULATION
► Located deep to the sternum and extends ‒ Pumps blood to the lungs (right side) back to
to the level of 2nd intercostal space the left side of the heart
‒ Carry unoxygenated blood

SYSTEMATIC CIRCULATION
‒ Pumps blood to all other tissues of the body
(left side) back to the right side of the heart
‒ Carry oxygenated blood
ANATOMY OF THE HEART
‒ Heart lies in the pericardial cavity

PERICARDIAL CAVITY
‒ Formed by pericardium or pericardial sac

PERICARDIUM
‒ Connective tissue that covers and protects the
heart
● Fibrous Pericardium PERICARDIAL FLUID
‒ Prevents overstretching of the heart ‒ Located between the visceral and parietal
‒ Provides protection and anchors it to the pericardium
mediastinum ‒ Produced by serous
‒ Help reduce friction as the heart moves within
● Serous Pericardium the pericardium
‒ Consist of flat epithelial layers w/ thin
connective tissue
○ Parietal Pericardium
‒ Lines the fibrous pericardium EXTERNAL ANATOMY OF THE HEART
○ Visceral Pericardium
‒ Also called Epicardium CORONARY SULCUS/GROOVE
‒ Inner layer that adheres tightly to ‒ Surrounds the heart
the surface of the heart ‒ Separate the atria from the ventricles

2 ADDITIONAL GROOVES
‒ Indicate the division of the R and L ventricle
● Anterior Interventrivular Sulcus
‒ Is on the anterior surface of the heart

● Posterior Interventricular Sulcus

‒ Is on the posterior surface of the heart
 2 INFERIOR CHAMBERS
‒ (Ventricles) Major pumping chambers

● Right Ventricle
‒ pumps blood into the pulmonary
trunk
‒ For smaller pulmonary circulation

● Left Ventricle
HEART CHAMBERS ‒ pumps blood into the aorta
‒ Have thicker wall
ATRIA → Thus generate greater blood
‒ Function as reservoirs by collecting blood pressure
before entering the ventricle However both ventricles pump nearly the same
blood volume
‒ For larger systematic circulation
2 SUPERIOR CHAMBERS
‒ (Atria) Receive blood from the veins INTERVENTRICULAR SEPTUM - the partition between the
ventricles

● Right Atrium receives blood from:

✓ Superior vena cava
✓ Inferior vena cava
→ Both vena cava drain blood from
most of the body
✓ Coronary sinus
→ Drains blood from most of the
heart muscle

● Left Atrium receives blood from:

✓ 4 Pulmonary veins
→ Drains blood from the lungs
INTERATRIAL SEPTUM - the partition between the 2 atria
STRUCTURES WITHIN THE VENTRICLES AV SEMILUNAR
closed open
TRABECULAE CARNAE open closed
‒ Coarse cardiomuscle fiber ridges along the Elements: Sound 1 Sound 2 [heart sounds (lub-dub)]
cardiac wall
‒ Functions probably to hold more blood SEMILUNAR VALVE
‒ Valves between the ventricle and an artery

PAPILLARY MUSCLES ● Pulmonic Valve

‒ Coned-shaped muscular pillars w/ the base ‒ Between the right ventricle and pulmonary
attached to the ventricular wall of the apices trunk
receiving the end of chordae tendinae
● Aortic Valve
‒ Between the left ventricle and the aorta
CHORDAE TEDINAE
‒ Thread (tendon)-like structures connected to
the apices of the papillary muscles and to the
cusps of the ventricular valves

Tricuspid
VALVES OF THE HEART

ATRIOVENTRICULAR (AV) VALVES

IMPORTANT NOTES
‒ Valves between the atrium and ventricle
❖ Both atria contracts at the same time, and
both ventricles contract at the same time
● Tricuspid Valve
‒ Between the right atrium and right
❖ ALL arteries carry blood AWAY from the heart
ventricle
‒ 3 cusps or flaps
❖ All arteries carry oxygenated blood EXCEPT for
● Bicuspid Valve
pulmonary vessels
‒ Between the left atrium and left ventricle
‒ 2 cusps or flaps
‒ Also known as Mitral Valve
→ ‘Mitral’ resembling a bishop’s miter
BLOOD SUPPLY TO THE HEART

TWO CORONARY ARTERIES

‒ Supply blood to the wall of the heart
‒ Its wall is thick and metabolically active ‒ Its pathways are nearly parallel to the arteries
‒ Originate at the base of the aorta ‒ Most of them drain blood into the coronary
sinus, except anterior cardiac veins
● Left Coronary Artery
‒ Supply most to the anterior wall and the
left ventricle CORONARY SINUS
○ Anterior Interventricular Artery ‒ Main venous drainage of the heart
‒ lies in the anterior interventricular ‒ Large vein located within the coronary sulcus,
sulcus at the posterior aspect
○ Circumflex Artery
‒ extends around the coronary sulcus on
the left to the posterior surface of the ANTERIOR CARDIAC VEIN
heart ‒ Drains blood DIRECTLY into the right atrium
○ Left Marginal Artery
‒ extends inferiorly along the lateral Blood flows from the coronary sinus into the right atrium.
wall of the left ventricle from the Some cardiac veins drain directly into the right atrium
circumflex artery

● Right Coronary Artery

‒ Originates at the right side of the aorta
‒ passed in the right atrioventricular sulcus to
the posterior surface of the heart
○ Posterior Interventricular Artery
‒ lies in the posterior interventricular
sulcus
○ Right Marginal Artery
‒ lies in the lateral wall of the right
ventricle

CONDUCTION SYSTEM OF THE HEART

SINOATRIAL NODE (SA NODE)

‒ Primary pacemaker of the heart
→ Initiates contraction of the heart
‒ Located at the superior wall of the right atrium,
judt to the right of the opening of superior
vena cava
VENOUS DRAINAGE OF THE HEART ‒ Has large number of Ca2+ channels
‒ 60-100 impulse per minute
CARDIAC VEINS
‒ Drain blood from the cardiac muscle
ATRIOVENTRICULAR NODE (AV NODE)
‒ Located at the lower portion of the right
atrium just above the tricuspid valve
‒ 40-60 impulses per minute

ATRIVENTRICULAR BUNDLES (AV BUNDLES) or

Bundles of His
‒ The only route for transmission of impulse
from atria into the ventricles

PURKINJE FIBERS
‒ Terminal point of conduction
‒ Ensures the ventricular contraction begins at
the apex
‒ Point where myocardial cells are stimulated -
ventricular contraction
‒ 30-40 impulses per minute

ELECTROCARDIOGRAM (ECG)
‒ Composite record of action potential produced
by all the heart muscle fibers during each
heartbeat
‒ As action potentials propagate, they generate
electrical currents that can be detected at the
surface of the body and is recorded by a
machine called electrocardiograph

NORMAL ECG TRAINING

P WAVE
‒ Represents atrial depolarization (contraction)
Ito yung contraction sa upper portion ng heart, sa base which is
caused by the SA node

QRS COMPLEX
‒ Represents rapid ventricular depolarization as
action potential spread through ventricular
contractile fibers
Contraction sa lower portion ng heart, sa apex

T WAVE
‒ Represents ventricular repolarization
(relaxation) occurs as the ventricles are
starting to relax
U WAVE DIASTOLE (RELAXATION)
‒ Represents atrial repolarization ● Atrial Diastole
Okay lang kahit hindi makita to sa cardiograph ‒ Relaxation of 2 atria

● Ventricular Diastole
PR INTERVAL ‒ Relaxation of 2 ventricles
‒ Sometimes called PQ Interval
‒ Time between the beginning of P wave and the
beginning of QRS complex
‒ Represents the time from atrial depolarization
HEART SOUNDS
to the beginning of ventricular depolarization
STETHOSCOPE
‒ Originally developed to listen to sounds of the
QT INTERVAL lungs and heart. It is now used to listen to
‒ From the beginning of QRS complex to the end other body parts.
of T wave
‒ Represents the length of time required for ATRIA AV VENTRICLE SEMILUNAR
ventricular depolarization and repolarization Relax closed Contract open
(Diastole) (Systole)
Contract open Relaxed closed
(Systole) (Diastole)
Elements: Sound 1 Sound 2 [heart sounds (lubb-dubb)]

S1 (LUBB)
‒ Has lower pitch than s2

S2 (DUBB)

BLOOD TYPING

ANTIGEN
‒ Agglutinogen
CARDIAC CYCLE ‒ Glycoproteins and glycolipids found on the
‒ The repetitive pumping process surfaces of erythrocyutes
‒ All events associated with one heartbeat
‒ Consist of alternating contraction and
relaxation of atria and ventricles forcing blood ANTIBODY
from areas of higher pressure to lower ‒ Agglutinin
pressure ‒ Proteins produced by the plasma B cells which
are stimulated by the presence of antigen#
‒ Attacker
SYSTOLE (CONTRACTION) ‒ Found in blood plasma
● Atrial Systole
‒ Contraction of the 2 atria

● Ventricular Systole
‒ Contraction of the 2 ventricles
 ANTI-B ANTIBODY
‒ Reacts w/ antigen B
❖ You do not have antibodies that react with antigens
of your own RBCs
❖ Agglutinins start to appear in the blood a few
months after birth (the reason got their presence is
not clear)
❖ Perhaps they are formed in response to bacteria
that normally inhibit gastrointestinal tract

BLOOD PLASMA
‒ Usually contains antibodies called agglutinins
that react with A or B antigen if the 2 are
mixed

BLOOD GROUPS
‒ There are at least 24 blood groups and more
than 100 antigens that can be detected on the
surface of blood cells
‒ 2 major blood groups: ABO and Rh
‒ Other blood groups: Lewis, Kell, Kidd, and
Duffy

ABO BLOOD GROUP

‒ Based on 2 glycolipid antigens called A and B

TYPE A
‒ Whose RBC’s display only antigen A

TYPE B
AGGLUTINATION
‒ Clumping of red cells
‒ only antigen B

TYPE AB
‒ Have both A and B antigen
‒ Universal recipients

TYPE O
‒ Have NEITHER antigen A nor B
‒ Universal donors

ANTI-A ANTIBODY
‒ Reacts w/ antigen A
RH BLOOD GROUP DANGERS OF BLOOD TRANSFUSION
‒ The Rh antigen called Rh factor, was first
found in the blood of the Rhesus monkey

D ANTIGEN
‒ Most important in production of antibodies

RH+
‒ Whose RBC’s have Rh antigens
Most people are Rh+; more than 99% of Filipinos

RH-
‒ Those who lack Rh antigens BLOOD PRESSURE
‒ Pressure or force exerted by the blood
‒ Measure in mmHg
‒ Because blood move in waves, there are 2
blood pressure measures:

● Systolic Pressure
‒ Pressure of blood as a result of contraction
of the ventricles (ventricular systole),
‒ The pressure of the height of the blood
wave

● Diastolic Pressure
‒ Pressure when the ventricles relax
USES OF BLOOD TYPING (ventricular diastole)
‒ Very important in medical emergency that
might require a blood transfusion or an organ
transplant
PULSE PRESSURE
‒ Performed in pregnant women and neonates
‒ Difference between systolic and diastolic
to assess for possible intrauterine exposure of
pressures
either to an incompatible blood type
‒ Normal value: 30-40mmHg
(particularly Rh factor incompatibilities)

CROSS MATCHING
‒ Necessary prior to transfusion to identify STETHOSCOPE
possible interaction of minor antigens w/ their
corresponding antibodies
SPHYGMOMANOMETER ‒ Increases cardiac output and vasoconstriction
of arterioles

RACE
‒ African American males over 35 years of age
have higher blood pressures than European
American males of the same age

GENDER
‒ After puberty, females usually have lower BP
than males of the same age
‒ due to hormonal variations
‒ After menopausal- women generally have
higher BP
BLOOD PRESSURE CATEGORIES
MEDICATIONS

OBESITY
‒ Higher pulse rate and blood pressure than
people with normal weight

DIURNAL VARIATIONS
‒ Pressure is usually lowest early in the morning,
when the metabolic rate is lowered,
‒ n rises throughout the day and peaks in the
late afternoon or early evening
FACTORS AFFECTING BLOOD PRESSURE

AGE
‒ Newborns have a mean systolic pressure of
about 75mmHg
‒ Pressure rises with age RESPIRATORY SYSTEM
‒ In older adults, elasticity of the arteries is ‒ Supply oxygen for the metabolic needs of cells
decreased. Resulting to an elevated systolic and to remove one of the waste materials of
pressure cellular metabolism (CO2)

EXERCISE
‒ Physical activity increases the cardiac output OXYGEN
and hence the blood pressure ‒ Required for the body’s cells to synthesize the
‒ 20-30 minutes of rest following exercise is chemical energy molecule
indicated before the measuring the blood
pressure

STRESS CARBON DIOXIDE

‒ Stimulates the sympathetic nervous system
‒ A by-product of the ATP production and must
be removed from the blood 2. NASAL CAVITY
Increase levels of CO2 will lower the pH of the blood ‒ A cleaning, warming, and humidifying
chamber of inspired air

3. PHARYNX
STRUCTURAL ANATOMY OF THE REPIRATION SYSTEM ‒ Commonly called the throat
‒ A shared passageway for food and air
UPPER RESPIRATORY TRACT (Upper Airway)
‒ Part of the respiratory system lying outside of 4. LARYNX
the thorax or above the sternal angle ‒ Also called the voice box
‒ Airway above the glottis or vocal cords ‒ Its rigid structure helps keep the airway
Nose Pharynx Larynx constantly open, or patent

5. TRACHEA
LOWER RESPIRATORY TRACT (Lower Airway) ‒ Commonly known as windpipe
‒ Portions of the respiratory system from ‒ An air-cleaning tube to funnel inspired air
trachea to the lungs to each lung
Trachea Primary Bronchi Lungs
6. BRONCHI
‒ Tubes that direct air into the lungs

7. LUNGS
‒ Each lung is a labyrinth of air tubes and a
complex network of air sacs called alveoli
and capillaries
‒ Airs sacs are separated by walls of
connective tissue containing both
collagenous and elastic fibers
‒ Air sac is the site of gas exchange between
air and blood

FUNCTIONS OF THE REPIRATORY SYSTEM

● GAS EXCHANGE OR RESPIRATION

‒ Respiratory system allows oxygen to enter
the blood and carbon dioxide to leave the
blood

Cardiovascular system TRANSPOSRTS oxygen FROM the

lungs TO THE BODY CELLS, and CO 2 from the body cells to
the lungs

● RESPIRATION
Seven structures that make up the Respi. System: ‒ Critical for homeostasis
1. EXTERNAL NOSE ○ Ventilation or Breathing
‒ Encloses the chamber for air inspiration
 ‒Movement of air in and out of the ●
lungs
○ External Respiration
‒ Exchange of oxygen and CO2 between
the air in the lungs and the blood
○ Gas Transport or Transport of Repiratory
Gases
‒ CO2 and oxygen travel in the blood to
and from the cells
‒ Blood as the transporting fluid
○ Internal Respiration
‒ Exchange of O2 and CO2 between the
blood and the cells

“Respiration” is also used in cellular metabolism or cellular

respiration.
→ The 2 processes are related
→ Breathing provides O2 needed in cellular respiration to
make ATP. Breathing also rids the body of potentially
toxic CO2 produced during cellular respiration

● REGULATION OF BODY pH
‒ By changing blood CO2 levels

● PRODUCTION OF CHEMICAL MEDIATORS

‒ Lungs produce enzyme called angiotensin-
covering enzyme (ACE), an important
component for blood pressure regulation

● VOICE PRODUCTION
‒ Air moving past the vocal folds make sound
and speech possible

● OLFACTION
‒ Smell

● INNATE IMMUNITY
‒ Protection against some microorganisms

FUNCTIONAL ANATOMY OF THE RESPIRATORY SYSTEM

● CONDUCTING DEAD ZONES (Dead Space)

‒ The respiratory passages from the nose to
the terminal bronchioles
‒ For passage of air

● RESPIRATORY ZONES
‒ Absorption of oxygen and removal of CO2
takes place
‒