The Circulatory System

Femi Otulaja, PhD

The Circulatory System
The Circulatory System
 Let’s talk about the circulatory system
• What is the circulatory system?
– It is an essential organ system that
circulates blood and lymph through the
body,
– It is also called the CARDIOVASCULAR
SYSTEM – cardia (heart); vasculum
(vessels)
– It consists of the pulmonary circulation
and the systemic circulation
– It helps the body maintain homeostasis
• What makes up the circulatory
system?
– It is made up of the heart, blood vessels
(arteries, veins & capillaries), blood,
lymph, and the lymphatic vessels and
glands
 Cardiovascular System
• The heart, its blood vessels and the blood are collectively called the
cardiovascular system
• Heart (cardia)
– Provides the power (pressure) to move blood to lungs (pulmonary circulation)
and the rest of the body (systemic circulation)
• 2 Atria or auricles
• 4 Valves (2 atrioventricular (AV) & 2 semilunar valves)
• 2 Ventricles
• Vessels (vascular) system
– Pipelines through which blood flow through the body. Their different
structures reflect their functions
• Artery  arteriole  capillary
• Capillary
• Vein  venule  capillary
• Blood (the fluid tissue)
– Plasma (transports nutrients and wastes)
– Red Blood Cells (Erythrocytes)
• Carry Oxygen & Carbon dioxide)
– White Blood Cells (Leukocytes)
• Fights infection
– Platelets
• Blood clotting
 The Vascular (Vessels) System
• Three major types
– Arteries
• Thick-walled vessels that transport blood away from
the heart under high pressure.
– Capillaries
• Network of microscopic, single-cell thick vessel involved
in the exchange of gases and nutrients
– Veins
• Thin-walled vessels that stores and return blood to the
heart; has valves.
 Let’s talk about the heart
• What is the heart?
– The cone-shaped muscular, life-giving pumping organ of body
located in the cardiac cavity surrounded by the cardiac notch of
the left lung in the thoracic cavity
– It is located between the lungs and underneath the sternum
– It is surrounded by the pericardium
– It provides the power to move blood throughout the body by its
pumping action and has its own circulatory system
– It is slightly larger than the fist
• What does the heart do?
• What are the different parts of the heart?
• What does each part of the heart do?
• What do veins have that arteries do not have
• What are the main veins and arteries associated
with the heart?
 Let’s talk about the heart
• What is the heart?
– The cone-shaped muscular, life-giving pumping organ of body
located in the cardiac cavity surrounded by the cardiac notch of the
left lung in the thoracic cavity
– It is located between the lungs and underneath the sternum
– It is enclosed in a tough fibrous sac called the pericardium; which
anchors the heart & prevent it from overfilling
– Between the heart and the pericardium is the pericardial cavity
filled with lubricating fluid that reduced friction & allowing the
heart & pericardium to glide against each other as the heart
contracts
– It provides the power to move blood throughout the body by its
pumping action and has its own circulatory system
– It is slightly larger than your fist; the heart pumps about 75 time per
minute (at about 70 years of age, you heart must have beat 2.8
billion times)
– The heart rate, under normal condition, is controlled by the brain
but the heart can beat on its own.
Structures of the heart
 Let’s talk about the heart
• What does the heart do?
– The heart continuously pumps blood to and receives
blood from the rest of the body
• What are the different parts of the heart?
– The heart is made of four (4) separate chambers
– Right atrium
– Right Ventricle
– Left atrium
– Left ventricle
– The septum –
• separates the left side from the right side
 The heart

cardiomyocytes
 What are the different parts of the heart?
• Right atrium
– Receives deoxygenated blood
from the body through the
inferior & superior vena cava
– The atrium in thin compared with
the ventricle
– Right atrium contracts to
discharge its content into the right
ventricle through the tricuspid
valve – atrioventricular (AV) valve
• Right ventricle
– Receive deoxygenated blood from
the atrium and sends it to the
lungs through the pulmonary
arteries with the semilunar valves
preventing flow back
• Left atrium
– Receives oxygenated blood
from the lungs through the
pulmonary veins
– discharges the blood into the
muscular left ventricle
through the Mitral or
bicuspid valve -
atrioventricular (AV) valve
• Left ventricle
– More muscular than the right
ventricle and the right & left
atrium
– Receive oxygenated blood
from the left atrium and
contracts to push the blood
through the Aortic semilunar
valve and the Aorta to the
rest of the body
Blood flow through the heart
Blood flow through the heart
 Let’s talk about the heart valves
• What are the four valves of the heart and what do they do?
– There are four valves in the heart at the exit of each chamber.
– They enforce the one-way flow of blood through the heart
– There are two atrioventricular valves and two semilunar valves
• The atrioventricular valve – are anchored to
The inside of the walls of the heart by chordae
tendineae as a continuation of the papillary
muscles
• Valves prevent blood from flowing back to the atria
– Tricuspid (three cups/flaps) between the right
atrium and right ventricles
– Mitral or bicuspid (two cups/flaps) valve between
the left atrium and left ventricle

• The semilunar valves – prevent blood from flowing back to the heart
– Pulmonary semilunar (half-moon) valve (three cusps or flaps) in the pulmonary
artery prevents deoxygenated blood from flowing back to the right ventricle

– Aortic semilunar (half-moon) valve (three cusps or flaps) in the aorta prevents
oxygenated blood from flowing back to the left ventricle
 the main vessels of the heart
• What are the main veins and arteries associated with the
heart?
– Vena cava –
• Superior vena cava brings deoxygenated blood from the upper parts of
the body
• Inferior vena cava brings deoxygenated blood from the lower parts of
the body
– Aorta
• Ascending aorta – supplies oxygenated blood to the upper parts of the
body
• Descending aorta – supplies oxygenated blood to the lower parts of
the body
– Pulmonary artery
• Carry dexoygenated blood to the lungs from the heart
– Pulmonary vein
• Return oxygenated blood from the lungs to the heart
– Coronary vessels
• Supply blood to the heart itself
Main Vessels of the Circulatory System
Main Vessels of the Circulatory System
 The Pulmonary Circuit – Re-oxygenation of Blood
Process of releasing CO2 and uptake of Oxygen in the lungs
– Blood returns from _____________ circulation into the
right chambers of the heart loaded with _____________
– From the right _____, blood passes to the right __________
through the ___________ valve. From the _______
___________ the _____________ blood passes through the
____________ valve into the ___________artery which
goes to the ___________
– The pulmonary trunk divides into two, namely, the _______
& _______ pulmonary _________ (2 each of both sides of
the heart)
– In the ____________, the ____________ blood exchanges
________ ___________ for ____________ and travels back
to the _________ through the ________ & ______
pulmonary _________
– The pulmonary _________ empty their ___________ blood
into the _________ _________.
– The left ________ contracts and pumps __________ blood
through the ___________ valve into the left
_____________.
– The ________ ventricle with its _______ wall contracts and
pumps ___________ _________ to the _______________
going past the ______________ into the _______________
circuit.
Deoxygenated blood comes into the right side of the heart must pass
through the lungs before returning to the left side of the heart and
then to the systemic circuit
 Let’s talk about the Systemic Circuit
• The Systemic Circuit
When blood enters the left ventricle, the systemic circuit begins the
process of taking blood to the rest of the body

– The ________ _______________ pumps the

________________ blood through the ______________
_____________________ valves into the
___________________, the __________________ artery in
the body
– From the ___________________,
______________________ blood travels through the many
branches of the ______________, ________________ and
the capillaries.
– In the ___________________ bed ____________________
and nutrients in the blood are exchanged for
__________________ and waste products from the tissues.
– From the ________________________ blood flows into the
venules and the ________________ to the superior and
inferior _________ ____________ back to the right
____________

Deoxygenated blood in the right chambers of the heart do not mix

with oxygenated blood in the left chambers of the heart.
More commonly, arteries and veins serve the same region of the body
 Let’s talk about the Systemic Circuit
• The heart’s own Coronary circulation
– For the heart to do its hard work of pumping blood to the body, it requires a lot
more ______________ and _____________.
– The heart requires nearly one-twentieth (1/20) of the total blood flow of the
body when at rest.
– The heart is continually filled with blood; however, the ____________________
is too thick for _______________________ and ___________________ to
diffuse through. So, it has to have its own _____________________.
– The heart has its own blood ___________________ called the
______________ arteries.
– The coronary ______________ branches directly from the _________________
just above the ____________________________ valves and winds around the
heart surface. They end up inside the myocardium where cardiac
_____________ collect deoxygenated _________________ from the
_________________ in the heart muscle and return it back into the right
____________________
The coronary arteries are very small in diameter and often become
partially or completely blocked, as a result of atherosclerosis,
which leads to serious health problem requiring bypass surgery –
sometimes double or triple bypass surgery.

Sometimes babies are born with heart defects ex. where the ventricles are
connected to the wrong vessels, ex the right ventricle send blood to the aorta
and the left ventricle to the pulmonary trunk. What is the problem with this
arrangement? Or an atrial septal defect (ASD), an abnormal hole between the
two atrial chambers, or a ventricular septal defect (VSD), an abnormal hole
between the two ventricles, will allow blood to circulate between the two
sides of the heart. a patent ductus arteriosus (PDA) that doesn't close normally
after birth. The PDA is a connection between the aorta and pulmonary arteries
that exists while a baby is in the womb and doesn't use its lungs. The PDA
usually closes shortly after birth. Symptoms include: Bluish colored skin
(cyanosis), Shortness of breath, Poor weight gain, and Poor feeding.
 Let’s talk about the circulatory system
• The circulatory system is made
up of two _________ – two
circulation patterns
– ____________ circuit, which
serve the _____________
– ____________ circuit, which
serves the rest of the _________
(head, torso, limbs, internal
organs including heart and lungs)
• Each circuit has its own blood
_________ and carry ________
types of ________
Coronary Vessels of the heart
Main Vessels of the heart itself
Let’s think & talk about the circulatory system
• What are the main parts of the circulatory
system?
– The Heart (kardia or cardia)
– The Vessels (vasculum) (3 main types)
• Arteries
• Veins
• Capillaries
– The Blood
– The Lymphatic system
– The Lymph

Note: The circulatory system contain 3 or 5 or 7 main parts

Let’s think & talk about the circulatory system
• What does the
circulatory system do?
– It is responsible for
transporting materials
throughout the entire
body –to and from the
cells.
– It transports nutrients,
water, and oxygen to
billions of body cells
and carries away
wastes such as carbon
dioxide that body cells
produce
 Structure of the Vessels
Vein
Artery
Capillary
Outer layer:
Connective
Outer layer: tissue
Connective Middle layer:
tissue Smooth muscle
Endothelium with elastic
fibers

Elastic layer

flattened,
squamous
epithelial cells
of capillary
Middle layer:
endothelium
Smooth muscle
with elastic Elastic layer
fibers Inner layer:
Inner layer: endothelium of
endothelium of flattened,
flattened, squamous
squamous epithelial cells
epithelial cells

http://www.aviva.co.uk/health-insurance/home-of-health/medical-centre/medical-encyclopedia/entry/structure-and-function-the-blood-vessels/
 Let’s think & talk about the arteries
• What are arteries?
– They are thick-walled vessels
that are part of the circulatory
system built to withstand high
pressure
• What do arteries do?
– They transport (carry
away)oxygenated blood from
the heart to the rest of the
body under high pressure -
(**Exception Pulmonary
arteries carry deoxygenated
blood to the lungs under low
pressure)
 Let’s think & talk about the arteries
• What are arteries made of?
– They are made of three distinctive layers
surrounding the lumen (hollow interior of
the vessel)
• Outer layer of connective tissue – supportive
layer, mostly collagen fibers, anchors arteries
to surrounding tissues and protect against
injury
• Middle layer of smooth muscle (stiffens the
vessel) interwoven with elastic connective
tissue (thickest layer that stretches to help it
withstand the high pressure from the
heartbeat)
• Thin inner layer of flattened, squamous
epithelial cell – creates a slick surface for
smooth blood flow and to keep friction to
minimum
Being under constant pressure make
arteries prone to injury - aneurysm
 Let’s think & talk about the arterioles
• What are arterioles
– As arteries become smaller arterioles (0.3 mm or less), they end up as
capillaries where gas, nutrients, water and waste exchanges take place

• What are arterioles made of?

– Capillaries do not have outer connective tissue
– The smooth muscle layer is not thick
– It has the inner endothelium (epithelium)

• What do the arterioles do?

– They transport and store blood
– They also contain precapillary sphincters (smooth muscle) that regulate
(serve as gates) amount of blood released to the capillaries
• Vasoconstriction – constriction of arterioles and the sphincter reduces their
diameter & amount of blood flow to the capillaries
• Vasodilation – arterioles and precapillary sphincters increase their diameter to
increase blood flow to the capillaries

• Factors that cause vasoconstriction or vasodilation include, nerves,

hormones, condition of the surrounding tissue and emotions
 Arterioles and Precapillary Sphincters
• Arteries eventually become arterioles (little arteries. 0.3
millimeters wide or less).
• Arterioles are simpler in structure as the pressure reaching
them are considerably much less
• Lack outermost connective tissue & the smooth muscle is
not that thick
• 3 functions - transport & store blood but also regulate
amount of blood reaching each capillary by contracting and
relaxing the band of smooth muscle around the entrance to
the capillary – the precapillary sphincter at the point where
the capillary joins the arteriole
• The precapillary sphincter alters the diameter of the
arteriole lumen to serve as a gate to control blood flow into
the capillary
• The contraction of the precapillary sphincter is called
vasoconstriction and the relaxation is called vasodilation
 Arterioles and Precapillary Sphincters
• Internal and external factors can the vasoconstriction and
vasodilation, ex. nerves impulses, hormones, local
environment (cold day vasoconstriction to reduce heat loss;
hot weather vasodilation to speed heat loss and cooling),
emotions as in sexual arousal caused by vasodilation

http://antranik.org/blood-vessels/ http://slideplayer.com/slide/6975284/
 Capillaries
• Smallest blood vessels connecting between arterioles and venules
• Capillaries are thin-walled vessels, one-cell thick single squamous
epithelial cell), averaging 1/100 of a millimeter; about the size of
one RBC. RBCs have to pass through in single file or squeeze
through
• Site of exchange of substances (O2, CO2,nutrients and wastes) with
the surrounding tissues – walls are porous
• Capillary beds (extensive networks of capillaries) are found in all
areas of the body except cornea of the eyes (no body vessels);
hence why you bleed when you cut anywhere on the body
• The single squamous cells lining the capillaries are separated by
narrow slits and microscopic pores that allow exchange of fluid and
other materials between blood and the interstitial fluid; yet small
enough not to allow RBC and most plasma protein through (keep
them in the capillary) while allowing white blood cells (WBC,
leukocytes) to squeeze through into the tissue space.
• Are the only blood vessels that can exchange materials with the
interstitial fluid.
 Let’s think & talk about the capillaries
• What are capillaries
– Arterioles (0.3 mm or less), they end up as capillaries where
gas, nutrients, water and waste exchanges take place

• What are capillaries made of?

– Capillaries are thin-walled vessels about 1/100th of a
millimeter in diameter – slightly wider than a RBC that passes
through one at a time
– Capillary walls consist of a single layer of squamous epithelial
cells with microscopic pores in between cells separated by
narrow slits
– Capillary beds are extensive networks of capillaries

• What do the capillaries do?

– Walls of capillaries are porous to allow exchange of oxygen,
carbon dioxide, nutrients and waste products
– They function as biological strainers that permit exchange of
substances with the interstitial fluid that are mostly
re/absorbed by diffusion
 Capillary Exchanges
• At the beginning of a capillary, fluid is filtered out of the
vessel into interstitial fluid, accompanied by O2, nutrients &
raw materials needed by the cell.
• Filtered fluid is essentially like plasma except it contain very
little amount of plasma protein, which are too large to be
filtered. Filtration is driven by blood pressure from the
heart
• Wastes (CO2 and urea) diffuse out of the cells back into the
blood by reabsorption in the last half of the capillary before
in joins the venule. The force of reabsorption is the
presence of protein in the blood, not the interstitial fluid.
• So, water, by osmosis, diffuse from area of high water
concentration (interstitial fluid) to an area of low water
concentration (blood plasma); but the pressure-induced
filtration allows small amount of filtered fluid to remain in
the interstitial space as excess interstitial fluid
 Capillaries Exchange

http://medicalpicturesinfo.com/capillary-pictures/

http://www.as.wvu.edu/~rbrundage/chapter10b/sld004.htm
 Let’s think & talk about the veins
• What are veins?
– They are thin-walled vessels that are part of
the circulatory system
– They are NOT built to withstand high
pressure
• What do veins do?
– They transport (carry back) deoxygenated
blood from the rest of the body back to the
heart
– **Exception Pulmonary veins that carry
oxygenated blood from the lungs back to
the heart
– They store (blood volume reservoir, nearly
2/3 of the blood in the body is in the veins)
– They contain valves that prevent blood from
flowing back
– They are highly distensible (stretch) to
accommodate large volume of blood at low
pressures
Being able to stretch can lead to problem;
because they push blood against gravity, blood
tend to accumulate in the legs – varicose veins
 Let’s think & talk about the arteries
• What are veins made of?
– They are made of three distinctive
layers surrounding the lumen
(hollow interior of the vessel). The
two outer layers are much thinner
but the lumen is larger compared
to the arteries;
• Outer layer of connective tissue
supportive layer, mostly collagen
fibers, anchors arteries to
surrounding tissues and protect
against injury
• Middle layer of smooth muscle
(stiffens the vessel) interwoven with
elastic connective tissue (thickest
layer that stretches to help it
withstand the high pressure from
the heartbeat)
• Thin inner layer of flattened,
squamous epithelial cell – creates a
slick surface for smooth blood flow
and to keep friction to minimum
 Let’s think & talk about the arteries
• The anatomical differences between
arteries and veins reflect their functions.
As blood moves CVS, blood pressure
becomes lower and lower to the point
where the veins do not need much
pressure or thick walls to move blood only
the contraction of the surrounding skeletal
muscles.
• Three mechanisms assist veins in returning
blood to the heart
– Contractions of the skeletal muscles as we
move around
– One-way valves inside the veins that prevent
backflow of blood – blood flow in one
direction to the heart
– Movement associated with breathing –
pressure changes in the thoracic and
abdominal cavities as we breath (respiratory
pump)
 http://www.78stepshealth.us/human-physiology/veins.html

Veins
• Veins return blood to the heart through
venules (little veins) and increasingly larger
veins; the largest being the Vena Cava
• Walls of veins consist of three layers like the
artery but with the outer and middle layers
that are not as thick.
• Veins have larger diameter lumen than arteries
and most also valves that opens passively to
allow only one direction blood flow to the
heart and closes to prevent blood from flowing
backward; once blood has been pushed
towards the heart by skeletal muscle or by
drained by gravity, it cannot drain back again.
• 3 ways blood is moved in the veins. 1) The
opening and closing of venous valves is strictly
dependent on differences in blood pressure on
either side. The pressure in the veins is about
1/10th that in the arteries.
http://www.aviva.co.uk/health-insurance/home-of-health/medical-centre/medical-encyclopedia/entry/structure-and-function-the-blood-vessels/
 Veins http://www.78stepshealth.us/human-physiology/veins.html

• 2) Skeletal muscles squeeze veins – veins pass through my

skeletal muscles. As we move and the muscles contract
and relax, they press against veins & collapse them,
pushing blood toward the heart. Walking improves the
return of blood to your heart & prevent fluid accumulation
in your legs and increase blood flow and supply energy to
your leg muscles.
• 3) Pressures associated with breathing push blood toward
the heart – pressure changes in the thoracic and
abdominal cavities during breathing assists blood flow.
When we inhale, abdominal pressure increases and
squeezes abdominal veins. At the same time, pressure
within the thoracic cavity decreases, dilating the veins. The
result is to push blood from the abdomen into the chest
and toward the heart – this effect is known as the
“respiratory pump.
• When a person’s vein expands too much with blood, the
valves may no longer work properly and blood pool in the
veins resulting in varicose veins
http://www.aviva.co.uk/health-insurance/home-of-health/medical-centre/medical-encyclopedia/entry/structure-and-function-the-blood-vessels/
 Differences in Blood Vessels
Arteries Capillaries Veins
Transport blood away Connect arterioles to Transport blood to the
from the heart venules heart

Transport oxygenated Acts as the sites for Transport deoxygenated

blood (except the exchange of substances blood (except the
pulmonary artery) within the cells pulmonary vein)
Thinnest walls, one cell
Thick muscular wall thickness Thinner walls

No valves except
semilunar valves at the No valves Valves present to prevent
base of the aorta and backflow of blood
pulmonary artery
Blood flows in pulses No pulses, pressure No pulses, blood flows
under high pressure lower them arteries but under lower pressure
from heart beats higher than veins than arteries
 Let’s talk about the Cardiac Cycle
• The heart’s contraction is pulsatile instead of
continuous – distinct and separate pulses
– Complete cardiac cycle involves _____________
of the _______ atria, which forces
_______________ into the two
____________________ followed by the
___________________ of the two
__________________ which pumps
_______________ into the pulmonary
__________ and the ___________ followed by
the relaxation of the entire _____________.
– The period of contraction is referred to as the
________________ and the period of relaxation
is referred to as the _________________. The
entire sequence of ______________________
and ______________________ is called the
_________________ cycle.
– The cardiac cycle consist of _____________ steps
 Let’s talk about the Cardiac Cycle
• The cardiac cycle consist of three steps
– Atrial systole
– Ventricular systole
– Diastole
• Atrial systole
– Filled with blood that entered the ventricles and atria from previous
diastole, contraction begins with the atria.
– both atria contract, raising blood pressure in the atria with a ‘kick’ that
fills the two ventricles to capacity
– Atrial systole also momentarily stops further inflow from the veins
– Both atrioventricular valves are still open while both semilunar valves
are still closed.
– Lasts 0.1 second

• Ventricular systole
– Contractions that begins in the atria spreads to the ventricles which
both contracts simultaneously
– Rising ventricular pressure as a result of contraction from the
ventricles causes the two atrioventricular (AV) valves to close,
preventing blood flow back to the atria and veins.
– The atria relax allowing them to be filled with blood
– Pressure in the ventricles continue to rise until it is greater than the
pressure in the arteries; at this point the pulmonary and aortic
semilunar valves open at the same time and blood is ejected into the
aorta and the pulmonary trunk. With each ventricular systole, 60% of
the blood in each ventricle is forcefully ejected
– Lasts 0.3 second
 Let’s talk about the Cardiac Cycle
• The cardiac cycle consist of three steps
– Atrial systole
– Ventricular systole
– Diastole

• Diastole
– Both atria and ventricles are relaxed throughout diastole
– Pressure within the ventricles begin to fall. As soon as the
ventricular pressures fall below arterial pressures during early
diastole, the pulmonary and semilunar valves close to prevent
backflow of arterial blood.
– Once blood pressure fall below the pressure in the veins, the
atrioventricular valves open and blood begins to flow passively
into the heart.
– The heart relaxes in diastole
– Lasts 0.8 second

A complete cardiac cycle lasts 0.8 second. This cycle is repeated

from before birth till death without ever stopping.
As the burst of blood enters the arteries, the walls of the arteries
stretch to accommodate the extra volume and arterial pressure
rises. Arteries recoil passively as blood passes through to the
capillaries where the exchange gases.
One can fill this cycle of rapid expansion and recoil in the wall of
the arteries as the PULSE. One can feel the pulse in the wrist (radial
artery) below the thumb.
Let’s talk about the Cardiac Cycle
Cardiac Conduction System
 Let’s talk about the Cardiac Conduction System
• The cardiac conduction system
– The coordinated sequence of the cardiac cycle is due to
the cardiac conduction system
– This group of specialized cardiac muscle cells initiate and
distribute electrical impulses throughout the heart
– Consist of four structures
• Sinoatrial (SA) node
• Atrioventricular (AV) node
• Atrioventricular (AV) bundle and its two branches
• Purkinje fibers
• Sinoatrial (SA) node
– A small mass of cardiac muscle cells located at the
junction of the right atrium & superior vena cava
– They initiate electrical signals spontaneously &
repetitively without need for stimulation from
other cardiac cells and the impulses travel from
cell to cell generating waves of contraction
– This electrical transmission is made possible by
gap junctions between adjacent cells.
– Called the cardiac pacemaker because it initiates
heartbeat
 Let’s talk about the Cardiac Conduction System
• The cardiac conduction system
– The coordinated sequence of the cardiac cycle is due to
the cardiac conduction system
– This group of specialized cardiac muscle cells initiate and
distribute electrical impulses throughout the heart
– Consist of four structures
• Sinoatrial (SA) node
• Atrioventricular (AV) node
• Atrioventricular (AV) bundle and its two branches
• Purkinje fibers
• Atrioventricular (VA) node
– Electrical impulse from the SA node traveling across the
atria reaches the AV node
– Located between the atria & ventricles (this cardiac
muscle fiber is smaller in diameter and causing a slight
delay of approx. 0.1 second that slows the rate of
impulse travel
– The delay allows atria time to contract and empty their
blood into the ventricles before ventricular contraction
– The electrical charge from AV node spreads to a group of
conducting fibers in the septum of the between the tow
ventricles – the AV bundle and the Purkinje fibers
• Atrioventricular bundle
• Purkinje fibers
 Let’s talk about the Cardiac conduction system
• The cardiac conduction system
– The coordinated sequence of the cardiac cycle is due
to the cardiac conduction system
– This group of specialized cardiac muscle cells initiate
and distribute electrical impulses throughout the heart
– Consist of four structures
• Sinoatrial (SA) node
• Atrioventricular (AV) node
• Atrioventricular (AV) bundle and its two
branches
• Purkinje fibers
• Atrioventricular (AV) bundle & Purkinje fibers
– The fibers of the AV bundle extends to the smaller
fibers of the Purkinje fibers.
– They carry the impulse to all the myocardium of the
ventricle
– The electrical impulse travels down the septum to the
lower parts of the ventricle and then spread rapidly
upward through the Purkinje fibers allowing the lower
part of the ventricle to contract before the upper part.
– This lower-to-upper squeezing motion pushes blood
upwards into the pulmonary trunk and the aorta
 What does electrocardiogram (EKG or ECG) indicate

• The human body is mostly water &

water conducts electric activities
well. This allows electrical activity
of the heart to be measured as
week difference in voltage on the
surface of the skin.
• An electrocardiogram or EKG is a
record of electrical impulses in the
cardia conduction system.
Electrodes placed on the skin of
the chest, wrists and ankle
transmit heart’s electrical impulses
which are recorded as continuous
lines on a screen or moving graph
The Cardiac Conduction System
 What does electrocardiogram (EKG or ECG) indicate
• A healthy heart produces three
characteristic patterns of voltage changes
– P wave
• Represents electrical impulses
traveling along the atria
– QRST complex
• Represents the spread of the
electrical impulse down the
septum and around the two
ventricles in the Purkinje fibers –
occurs before the ventricles start
to contract
– T wave
• The result of the end of the
electrical activity in the ventricles –
when the ventricles relax
 What does electrocardiogram (EKG or ECG) indicate
• An unhealthy heart caused by wrong
cardiac conduction system or damage to
the heart muscle produce abnormal EKG
– Arrhythmia
• Produces characteristic EKG tracing
• Less life-threatening
• May require artificial pacemaker – surgically
implanted under the skin of the chest

– Ventricular fibrillation
• Rapid irregular ventricular contraction
• Fatal if not treated
• Treated by “cardioversion” – applying a strong
electrical current to the chest to eliminate the
abnormal fibrillation and restore normal
pattern
Measuring Blood Pressure
 Measuring blood pressure
• Blood pressure is the force that blood exerts on the wall of
a blood vessel due to pumping action of the heart.
• BP is not the same in all blood vessels
– Highest pressure of the cycle is the systolic pressure – pressure
reach during ventricular systole when the ventricles contract to
eject blood from the heart
– Lowest pressure is the diastolic pressure – occurs during
ventricular diastole when the ventricles are relaxing
– Arteries store energy generated by the heart during systole,
which are used during diastole to supply blood to the tissues
– Maintenance of arterial blood pressure is important to drive
throughout the body and back to the heart
– The difference in the blood pressure of (arteries, capillaries and
veins keep blood moving throughout the body)
 Measuring blood pressure
• From a clinical view, BP gives
valuable clues about the relative
amount of blood in the vessels
– The condition or stiffness of the
arteries to withstand pressure
– The overall efficiency of the
CVS (CardioVascular System)
• BP is measured in mm Hg
with a sphygmomanometer;
the procedure yields two numbers
as systolic/diastolic pressures;
These represent the high & low points of
blood pressure during the cardiac cycle
a young person – 120/80 mm Hg
• BP increase is a consequence of
age-related stiffness of the arteries
 Hypertension
• When BP is higher than normal, it is called
hypertension. When BP is lower than normal, it
is called hypotension
• Hypertension
– A significant risk factor to cardiovascular disease
Since the greater the pressure, the greater the strain
on the CVS as blood vessels react by becoming
hardened and scarred which limit the capacity to
stretch during systole; also put greater strain on the
heart as the pressure at which it has to pump
increases
– Called “the silent killer” because it has no
symptoms; If untreated, it increases the risk of heart
attack, heart failure, stroke kidney failure &
possible damage to tissues inside the eyes
• Hypotension
– When BP falls below normal. Generally a problem
if it reduces blood flow to the brain, causing
Dizziness and fainting
 Cardiovascular System Regulation
The overall regulation of the CVS is achieved by nerves, hormones, and local factors
coupled to metabolism
• Baroreceptors
– Pressure receptors are on the large arteries (aorta, two carotid arteries)
• When blood pressure rises, arterial blood vessels stretch passively
• Baroreceptors send signals via nerves to the cardiovascular center in the
brain
• The cardiovascular center in the medulla oblongata responds by sending
signals via nerves to the heart and blood vessels to lower heart rate and
the force of contraction – this reduces cardiac output (amount of blood
the heart pumps to the aorta), causes vasodilation in the arteries
(increase arteriole diameter and blood flow to the tissues)
• Net effect is to return arterial pressure to normal
• The opposite is sequence occurs when arterial blood pressure falls below
normal
All day long, when you sit, stand, get excited run to the bus, your blood
pressure fluctuates up or down and often quickly come back within normal
range by a negative feedback loop initiated by the baroreceptors
 Cardiovascular System Regulation
The overall regulation of the CVS is achieved by nerves, hormones, and local factors
coupled to metabolism
• Nerves and hormones
– These adjust cardiac output (amount of blood pumped into the aorta in one minute; heart rate
(# of heart beat/minute) multiplied by stroke volume (volume of blood pumped out with each
heart beat)
• Cardiovascular center in the medulla oblongata responds to signals from baroreceptor and
from receptors in the muscles and joints and areas of the brain involved with emotions
• The cardiovascular center responds to these signal input by sending signal to the heart
through the sympathetic nerves in the blood vessels (stimulates the heart to beat faster;
help maintain blood pressure by controlling blood vessels diameter) and parasympathetic
nerves (causes the heart to beat more slowly)
• Two hormones, Epinephrine (adrenaline) and norepinephrine (noradrenaline) are secreted
by the adrenal glands on the kidneys stimulate the heart also. Most blood vessels are
under constant state of partial constriction by the sympathetic nerves; increased activity
further constricts blood vessels and raise blood pressure. Most blood vessels do not have
parasympathetic nerves, so its activation has little effect on overall blood vessel diameter.

• Local requirements
– When particular tissue is metabolically active, such as when contracting it consume oxygen and
nutrients and raise production of carbon dioxide and other wastes; these cause the precapillary
sphincter within the tissue to dilate to increase blood flow into that particular tissue.
Oxygen/Oxyhemoglobin Dissociation Curve

• The normal ODC is the relationship between

the amount of O2 dissolved in the blood and
the amount of O2 attached to the hemoglobin.
• It is the S-shaped (sigmoidal) curve that shows
the partial pressures of oxygen (pO2) in
relation to the % saturation of haemoglobin.
At 50 % saturation (indicated on the curve by
p50), half of the haemoglobin binding sites
contain oxygen molecules.
 Importance of ODC
• In its most simple form, the oxyhemoglobin
dissociation curve describes the relation
between the partial pressure of oxygen (x axis)
and the oxygen saturation (y axis).
• Hemoglobin's affinity for oxygen increases as
successive molecules of oxygen bind.
• It is determined by what is called "haemoglobin
affinity for oxygen"; that is, how readily
hemoglobin acquires and releases oxygen
molecules into the fluid that surrounds it.
 Oxygen/Oxyhemoglobin Dissociation Curve

• Oxygen can be
measured in two forms:
– Partial atmospheric
pressure of O2 (PaO2)
– Oxygen saturation
(SaO2).
• It is a calculated
estimates of oxygen
saturation (SpO2): an
indirect SaO2.
 Oxygen/Oxyhemoglobin Dissociation Curve
• At high PO2, as in the
pulmonary capillaries,
haemoglobin is nearly 100
% saturated. This point is
shown by the red arrow.
• At low PO2, as in exercising
muscles, haemoglobin
saturation is much lower
and oxygen is released. This
point is shown by the blue
arrow.
• The dissociation curve is
sigmoidal in shape because
binding of the 1st O2
molecule increases the
affinity of haemoglobin for
O2, making it easier for the http://www.diatronic.co.uk/nds/webpub/dissociation_curve.htm

next O2 molecule to bind.

 Can you draw the ODC?
• What you need to know to draw ODC
– Three main points to indicate the curves
• Arterial point: pO2 100 mmHg with SaO2 = 97.5%
• Mixed venous: pO2 40 mmHg with SaO2 = 75%
• P50: PO2 26.6 or 28.8 mmHg with SaO2 = 50%

– Four other simple points to remember

• pO2 0 mmHg, SO2 0% - the origin
• pO2 10 mmHg, SO2 10% - beginning point of sigmoid shape
• pO2 60 mmHg, SO2 91% - the ‘ICU’ point
• pO2 150 mmHg, SO2 98.8% - shows flat upper part of ODC

– The ‘ICU’ point is the point on the curve that separates the
steep lower part from the flat upper part. It is the lowest
acceptable pO2 in an ICU patient – marked desaturation
occurs at pO2 values below this point
 Oxyhemoglobin Dissociation Curve (ODC) Arterial point

Mixed venous point

Standard Conditions
Temp = 37C
pH = 7.40
Bohr Effect = 0

P50 Partial pressure of Oxygen

http://biology-forums.com/index.php?action=gallery;sa=view;id=1235
 What is the Arterial Point?
• It is the partial pressure of oxygen in arterial
blood (PaO2), the portion of total blood gas
pressure, exerted by oxygen.
• It is lower than normal in patients with
asthma, obstructive lung disease, or certain
blood diseases and in healthy individuals
during vigorous exercise.
• The normal PaO2 in arterial blood is 95-100
mmHg and the SaO2 is about 97.5%.
 What is the Mixed Venous Point?
• Mixed venous oxygen saturation (SvO2) is the
percentage of oxygen bound to hemoglobin in
blood returning to the right side of the heart.
– Reflects the amount of oxygen "left over" after
the tissues remove what they need.
– It is used to help us to recognize when a patient's
body is extracting more oxygen than normally.
– The pO2 40 mmHg and hemoglobin saturation is
75% (SaO2 = 75%)
 What is meant by P50?
• It is the partial pressure of oxygen at which 50%
of haemoglobin is bound to oxygen (hemoglobin
is 50% saturated)
• The normal P50 is typically 26.7 mmHg in a
healthy adult
• Shifting the curve to the left or right has little
effect on the SO2 in the normal range where the
curve is fairly horizontal; a much greater effect is
seen for values on the steeper part of the curve.
 Factors Affecting Standard ODC
Control Factors Decrease Increase

Temperature Left shift Right shift

2,3-BPG Left shift Right shift

p(CO2) Left shift Right shift

pH (Bohr Effect), H+ Right shift (acidosis) Left shift (alkalosis)

Note:

Left shift: high O2 affinity

Right shift: low (decreased) O2 affinity – P50 is

higher

Fetal hemoglobin has higher O2 affinity than

adult hemoglobin; primarily due to much-
reduced affinity to 2,3-diphosphoglycerate.
 Factors affecting ODC
Shifts the curve to the right Shifts the curve to the left
• Decreased PO2 • Increased PO2

• Increased blood PCO2 • Decreased blood PCO2

•
• Increased blood H+ conc • Decreased blood H+ conc

• Increased blood temperature • Decreased blood temperature

• Increased conc of 2,3-DPG • Decreased conc of 2,3-DPG

(2,3-BPG) (2,3-BPG)
 The Bohr Effect
• This physiological phenomenon was 1st described
by the Danish physiologist in 1904 by Christian
Bohr, stating the “oxygen binding affinity of Hb in
inversely related (proportional) to the conc. of
CO2 & H+ conc.
– At tissue level – increased pCO2 conc. & lower pH
causes HB to release more O2 (H+ conc) - shifts the
curve to the left
– In the lungs, decreased pCO2 conc. & higher pH causes
Hb to hold on to more O2 (H+ conc) - shifts the curve
to the left
• So Bohr’s Effect (BE) facilitates:
– O2 release from Hb at the tissue level
– O2 uptake by Hb in the lungs
http://www.showme.com/sh/?h=aF40xRg
 The Bohr Effect

http://www.normalbreathing.com/CO2-bohr-effect.php
 Haldane Effect
• Refers to the fact that more CO2 is carried in deoxygenated blood
than in oxygenated blood at any given pCO2
• Describes how oxygen concentrations determine Hb’s affinity for
CO2
• The Haldane Effect results from the fact that deoxygenated Hb has
a higher affinity (~3.5 x) for CO2 than does oxyhemoglobin.
– because it is a better proton acceptor than oxygenated hemoglobin.
• Therefore, when hemoglobin is deoxygenated (i.e., at tissues) there
is a right shift of the carbonic acid-bicarbonate buffer equation to
produce H+ which in turn increases the amount of CO2 which can
be carried by the blood back to the lungs to be exhaled.
• Then, with oxygenation at the lungs CO2 dissociates more readily
from hemoglobin.
CO2 + H2O ⇆ H2CO3 ⇆ H+ + H+CO3-
• The following is the general equation of the Haldane Effect
H+ + HbO2 ←→ H+Hb + O2
 Bohr & Haldane Effects
• The Haldane Effect (along with the Bohr Effect)
facilitates the release of O2 at the tissues and the
uptake of O2 at the lungs. This is represented by a
right shift of the oxyhemoglobin dissociation
curve and a left shift of the oxyhemoglobin
dissociation curve respectively.
• The Haldane effect allows for approximately 50%
of the CO2 excreted by the lungs and is
physiologically much more important than its
reciprocal counterpart, the Bohr effect (the effect
of carbon dioxide on oxygen transport).
https://www.openanesthesia.org/haldane_effect/
 ODC for fetal Hemoglobin
• Fetal hemoglobin (HbF) is structurally different from normal adult
hemoglobin (HbA), giving HbF a higher affinity for oxygen than HbA.
• HbF is composed of two alpha and two gamma chains whereas HbA
is composed of two alpha and two beta chains.
• The fetal dissociation curve is shifted to the left relative to the curve
for the normal adult because of these structural differences.
• Typically, fetal arterial oxygen pressures are lower than adult
arterial oxygen pressures. Hence, higher affinity to bind oxygen is
required at lower levels of partial pressure in the fetus to allow
diffusion of oxygen across the placenta.
• At the placenta, a higher conc of 2,3-BPG is formed, & 2,3-BPG
binds readily to beta chains rather than to alpha chains. So, 2,3-BPG
binds more strongly to adult hemoglobin, causing HbA to release
more oxygen for uptake by the fetus, whose HbF is unaffected by
the 2,3-BPG. HbF then delivers that bound oxygen to tissues that
have even lower partial pressures where oxygen can be released.
http://slideplayer.com/slide/1710921/
ODC for fetal Hemoglobin

https://en.wikipedia.org/wiki/Oxygen%E2%80%93hemoglobin_dissociation_curve
 Myoglobin
• The heme-containing oxygen binding protein in the
skeletal muscles
• Role is to store oxygen in the muscles
• Needs to have P50 that is less than hemoglobin so it
can take up O2 from hemoglobin
• Needs to be able to load and unload O2 in the range of
PO2 values that occur within the cell
• Difference in curves is from difference in structure as it
contain a single globin chain compared to four chain in
hemoglobin
• Its ODC is a rectangular hyperbola - the curve is steep
lower part and flat upper part
 Myoglobin

https://www.studyblue.com/notes/note/n/exercise-physiology-test-2/deck/4288716
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n_dioxide_transport_role_of_myoglobin_storage_of_oxygen_structure_of_hemoglobin_torr_transport_of_of_respiratory_gases_types_of_hemoglobin_t_page
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