Anatomy & Physiology

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ANATOMY AND PHYSIOLOGY OF THE CARDIOVASCULAR SYSTEM The respiratory and cardiovascular systems are closely linked and dependent on one another to deliver oxygen to the tissues of the body. Alterations in function of either system can affect the other and lead to tissue hypoxia, or lack of oxygen. The heart and the blood vessels make up the cardiovascular system. Together with blood, it is the major transport system of the body, bringing oxygen and nutrients to the cells and removing wastes for disposal. The heart serves as the system pump, moving blood through the vessels to the tissues.

THE HEART The heart is a hollow, coneshaped organ about the size of a fist. It is located in the mediastinum between the lungs and underlying the sternum. It is enclosed by a double layer of fibroserous membrane, called pericardium. The parietal, or outermost pericardium serves to protect the heart and anchor it to surrounding structures. The visceral pericardium adheres to the surface of the heart, forming the hearts outermost later, the epicardium. The heart wall contains two additional layers; the myocardium, cardiac muscle cells that form the bulk of the heart and contract with each beat, and the endocardium, which lines the inside of the hearts chambers and great vessels (Marieb, 2006) Four hollow chambers within the heart, two upper atria and two lower ventricles, are separated longitudinally by the interventricular septum, forming two parallel pumps. The atria and ventricle s are separated from one another by the atrioventricular (AV) valves, the tricuspid valve on the right and the bicuspid or mitral valve on the left. The ventricles, in t urn, are separated from the great vessels (the pulmonary arteries and aorta) by the semilunar valves (named for their crescent moon shape): the pulmonic valve on the right and the aortic valve on the left. The valves serve to direct the flow of blood, allowing or to move from the atria to the ventricles, and the ventricle tp the great vessels, but preventing backflow. Deoxygenated blood from the veins enters the right side of the heart thought the superior and inferior venae cavae. From there, it flows into the right ventricle, which pumps it through the pulmonary artery into the lungs for gas exchange at the alveolar/ capillary membrane. Freshly oxygenated blood returns to the left atrium via the pulmonary veins. From here, the blood enters the left ventricle to be pumped out to the systemic circulation through the aorta (Kozier & Erbs, 2007).

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CIRCULATION AND BLOOD VESSELS Your heart and blood vessels make up your overall blood circulatory system. Your blood circulatory system is made up of four subsystems (National Institute of Health, 2009). I. ARTERIAL CIRCULATION Arterial circulation is the part of your overall blood circulatory system that involves arteries, like the aorta and pulmonary arteries. Arteries are blood vessels that carry blood away from your heart. Healthy arteries are strong and elastic. They become narrow between beats of the heart, and they help keep your blood pressure consistent. This helps blood circulate efficiently through your body. Arteries branch into smaller blood vessels called arterioles. Arteries and arterioles have strong, flexible walls that allow them to adjust the amount and rate of blood flowing to various parts of your body. II. VENOUS CIRCULATION Venous circulation is the part of your overall blood circulatory system that involves veins, like the vena cavae and pulmonary veins. Veins are blood vessels that carry blood to your heart. Veins have thinner walls than arteries. Veins can widen as the amount of blood passing through them increases. III. CAPILLARY CIRCULATION Capillary circulation is the part of your overall blood circulatory system where oxygen, nutrients, and waste pass between your blood and parts of your body. Capillaries connect the arterial and venous circulatory subsystems. Capillaries are very small blood vessels. The importance of capillaries lies in their very thin walls. Unlike arteries and veins, capillary walls are thin enough that oxygen and nutrients in your blood can pass through the walls to the parts of your body that need them to work normally. Capillaries' thin walls also allow waste products like carbon dioxide to pass from your body's organs and tissues into the blood, where it's taken away to your lungs. IV. PULMONARY CIRCULATION Pulmonary circulation is the movement of blood from the heart to the lungs and back to the heart again. Pulmonary circulation includes both arterial and venous circulation. Blood without oxygen is pumped to the lungs from the heart (arterial circulation). Oxygenrich blood moves from the lungs to the heart through the pulmonary veins (venous circulation). Pulmonary circulation also includes capillary circulation. Oxygen you breathe in from the air passes through your lungs into your blood through the many capillaries in the lungs. Oxygenrich blood moves through your pulmonary veins to the left side of your heart and out of the aorta to the rest of your body. Capillaries in the lungs also remove carbon dioxide from your blood so that your lungs can breathe the carbon dioxide out into the air.

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ELECTRICAL CONDUCTION SYSTEM OF THE HEART

The heart is a muscle that works continuously, much like a pump. Each beat of your heart us set in motion by an electrical signal from within your heart muscle. The electrical activity is recorded by an electrocardiogram, known as an EKG or ECG. Each beat of your heart begins with an electrical signal from the sinoatrial node, also known as the SA node The SA node is located in your hearts right atrium. When your hearts right atrium is full with blood the electrical signal spreads across the cells of your hearts right and left aria. The signal causes the atria to contract, or squeeze. This pumps blood through the open valves from the atria into both ventricles. The P wave on the EKG, marks the contraction of your hearts atria. The signal arrives at the atrioventricular (AV) node near the ventricles. Here it is slowed for an instant to allow your hearts right and left ventricular to fill with blood. On an EKG, this interval is represented by the start of the line segment between the P and Q wave. The signal is released and moves next to the bundle of His located in your hearts ventricles. From the bundle of His, the signal fibers divide into left and right bundle braches, which run through your hearts septum. On t he EKG, this is represented by the Q wave. The signal leaves the left and right bundle branches through the Purkinje fibers that connect directly to the cells in the walls of your hearts ventricles. The signal spreads quickly across your hearts ventricles. As the signal spreads across the cells of the ventricle walls, both ventricles contract, but not at exactly the same moment. The left ventricle of your heart contracts an instant before the right ventricle. On an EKG, the R wave marks the contraction of your hearts left ventricle. The S wave marks the contraction of your hearts right ventricle. The contraction of your hearts right ventricle pushes blood through the pulmonary valve to your lungs. The contraction of your hearts left ventricle pushes blood through the aortic valve to the rest of your body. As the signal passes, the walls of your hearts ventricles relax and await the next signal. On the RKG, the T wave marks the point at which your hearts ventricles are relaxing. This process continues over and over (National Institute of Health, 2009).

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