The Circulatory System

Chambers of the Heart

The internal cavity of the heart is divided into four chambers:
Right atrium
Right ventricle
Left atrium
Left ventricle
The two atria are thin-walled chambers that receive blood from the veins. The
two ventricles are thick-walled chambers that forcefully pump blood out of the
heart. Differences in thickness of the heart chamber walls are due to variations
in the amount of myocardium present, which reflects the amount of force each
chamber is required to generate.
The right atrium receives deoxygenated blood from systemic veins; the left
atrium receives oxygenated blood from the pulmonary veins.
Valves of the Heart
Pumps need a set of valves to keep the fluid flowing in one direction and the
heart is no exception. The heart has two types of valves that keep the blood
flowing in the correct direction. The valves between the atria and ventricles are
called atrioventricular valves (also called cuspid valves), while those at the
bases of the large vessels leaving the ventricles are called semilunar valves.
The right atrioventricular valve is the tricuspid valve. The left atrioventricular
valve is the bicuspid, or mitral, valve. The valve between the right ventricle and
pulmonary trunk is the pulmonary semilunar valve. The valve between the left
ventricle and the aorta is the aortic semilunar valve.
When the ventricles contract, atrioventricular valves close to prevent blood
from flowing back into the atria. When the ventricles relax, semilunar valves
close to prevent blood from flowing back into the ventricles.
The His-Purkinje System
Parts of the Electrical System
Your heart's electrical system includes three important parts:
S-A node (sinoatrial node) — known as the heart's natural pacemaker, the S-A
node has special cells that create the electricity that makes your heart beat.
A-V node (atrioventricular node) — the A-V node is the bridge between the
atria and ventricles. Electrical signals pass from the atria down to the ventricles
through the A-V node.
His-Purkinje system — the His-Purkinje system carries the electrical signals
throughout the ventricles to make them contract. The parts of the His-Purkinje
system include:
o His Bundle (the start of the system)
o Right bundle branch
o Left bundle branch
o Purkinje fibers (the end of the system).
Electrical Signals and Blood Flow
The S-A node normally produces 60-100 electrical signals per minute — this is
your heart rate, or pulse. With each pulse, signals from the S-A node follow a
natural electrical pathway through your heart walls. The movement of the
electrical signals causes your heart's chambers to contract and relax.
In a healthy heart, the chambers contract and relax in a coordinated way, or in
rhythm. When your heart beats in rhythm at a normal rate, it is called sinus
rhythm.

Electrical Signals and Blood Flow

The S-A node normally produces 60-100 electrical signals per minute — this is
your heart rate, or pulse. With each pulse, signals from the S-A node follow a
natural electrical pathway through your heart walls. The movement of the
electrical signals causes your heart's chambers to contract and relax.
In a healthy heart, the chambers contract and relax in a coordinated way, or in
rhythm. When your heart beats in rhythm at a normal rate, it is called sinus
rhythm.
The Cardiac Cycle
The cardiac cycle is the sequence of events that occurs when the heart beats.
There are two phases of the cardiac cycle. In the diastole phase, the heart
ventricles are relaxed and the heart fills with blood. In the systole phase, the
ventricles contract and pump blood to the arteries. One cardiac cycle is
completed when the heart fills with blood and the blood is pumped out of the
heart. The events of the cardiac cycle described below trace the path of the
blood as it enters the heart, is pumped to the lungs, travels back to the heart and
is pumped out to the rest of the body. It is important to note that the events that
occur in the first and second diastole phases actually happen at the same time.
The same is also true for the events of the first and second systole phases.
Cardiac Cycle: 1st Diastole Phase
During the diastole phase, the atria and ventricles are relaxed and the
atrioventricular valves are open. De-oxygenated blood from the superior and
inferior vena cavae flows into the right atrium. The open atrioventricular valves
allow blood to pass through to the ventricles. The SA node contracts triggering
the atria to contract. The right atrium empties its contents into the right
ventricle. The tricuspid valve prevents the blood from flowing back into the
right atrium.
Cardiac Cycle: 1st Systole Phase
During the systole phase, the right ventricle receives impulses from the Purkinje
fibers and contracts. The atrioventricular valves close and the semilunar valves
open. The de-oxygenated blood is pumped into the pulmonary artery. The
pulmonary valve prevents the blood from flowing back into the right ventricle.
The pulmonary artery carries the blood to the lungs. There the blood picks up
oxygen and is returned to the left atrium of the heart by the pulmonary veins.
Cardiac Cycle: 2nd Diastole Phase
In the next diastole period, the semilunar valves close and the atrioventricular
valves open. Blood from the pulmonary veins fills the left atrium. (Blood from
the vena cava is also filling the right atrium.) The SA node contracts again
triggering the atria to contract. The left atrium empties its contents into the left
ventricle. The mitral valve prevents the oxygenated blood from flowing back
into the left atrium.
During the following systole phase, the atrioventricular valves close and the
semilunar valves open. The left ventricle receives impulses from the Purkinje
fibers and contracts. Oxygenated blood is pumped into the aorta. The aortic
valve prevents the oxygenated blood from flowing back into the left ventricle.
The aorta branches out to provide oxygenated blood to all parts of the body. The
oxygen depleted blood is returned to the heart via the vena cavae.

Summary of Content:
What is the pulse?
The number of heart beats (cardiac cycle) per minute.
Factors affecting Pulse Rate, Hormones, Sympathetic Nervous System, Ion
Concentration, Exercise, Blockage of arteries, Oxygen deprivation
What is Blood Pressure?
This is the measure of systolic and diastolic pressures.
Factors Affecting Blood Pressure
Regulation of sodium and potassium by a steroid called aldosterone, The stretch
receptors in the carotid sinus, Sympathetic nervous system, Altitude
Oxygen carriage
Oxygen does dissolve in plasma but the solubility is low and decreases further
if the temperature increases. The amount that could be carried by the plasma
therefore would be completely insufficient to supply all cells.
There is a protein in the blood however that will carry 4 molecules of oxygen.
The protein is called haemoglobin (Hb) and is made up of 4 polypeptide chains,
each with a haem group. Each haem group can pick up 1 molecule of O2. The
protein, being fairly small, could pass out of the blood during ultrafiltration in
the kidneys so, to ensure that it is not lost, it is found within red blood cells.
Note: During this topic you will come across the term of partial pressure of
oxygen. It does not mean the pressure of the blood itself. Essentially it is a
measure of the concentration of oxygen. It is written in shorthand as pO2 and is
measured in kilopascals (kPa).
Inhaled air in the alveoli has a pO2 = 14kPa. The pO2 of resting tissue = 5.3kPa
(lower pO2 = lower O2concentration due to respiration) and the pO2 of active
tissues = 2.7kPa. In either case, blood arriving at the lungs has a lower pO 2 than
that in the lungs.
There is therefore a diffusion gradient and oxygen will move from the alveoli
into the blood. The O2 is then loaded onto the Hb until the blood is about 96%
saturated with oxygen. The Hb is now called oxyhaemoglobin (HbO2).
Hb + 4O2 → HbO8
Dissociation curves
The blood is then taken to tissues where the cells are respiring all the time,
using oxygen. The pO2 will be low. As the red blood cell enters this region, the
Hb will start to unload the O2, which will diffuse into the tissues and be used for
further respiration. Since much of the Hb will have unloaded the O2, a much
lower percentage of the blood will be saturated with O2.
A graph of the percentage saturation of blood with O2, i.e. the amount of
HbO2 as opposed to Hb at different pO2 is shown below. It is called an oxygen
dissociation curve:

It is S-shaped because of the behaviour of the Hb in different pO2.

The first molecule of O2 combines with an Hb and slightly distorts it. The
joining of the first is quite slow (the flatter part of the graph at the beginning)
but after the Hb has changed shape a little, it becomes easier and easier for the
second and third O2 to join. This is shown by the curve becoming steeper. It
flattens off at the top because joining the fourth O2 is more difficult.
Overall, it shows that at the higher and lower end of the partial pressures, there
isn't a great deal of change in the saturation of the Hb, but in the middle range, a
small change in the pO2 can result in a large change in the percentage saturation
of the blood.
Carbon dioxide transport
About 85% of the CO2 produced by respiration diffuses into the red blood cells
and forms carbonic acid under the control of carbonic anhydrase.
The HCO3− diffuses out of the red blood cell into the plasma. This leaves a
shortage of negatively charged ions inside the red blood cells. To compensate
for this, chloride ions move from the plasma into the red blood cells. This
restoration of the electrical charge inside the red blood cells is called the
chloride shift.
About 5% of the CO2 produced simply dissolves in the blood plasma.
Some CO2 diffuses into the red blood cells but instead of forming carbonic
acid, attaches directly onto the haemoglobin molecules to form
carbaminohaemoglobin. Since the CO2 doesn't bind to the haem groups the Hb
is still able to pick up O2 or H+.