Cardiovascular

Cardiac Cycle and Heart Sounds

Cardiac Cycle refers to one complete
heartbeat.
The heart is actually 2 pumps situated
side by side, so a complete cycle consists
of contractions of both atria and both
ventricles.
The average resting heart rate is
approximately 75 beats per minute

Cardiac Cycle and Heart Sounds

Resting heart rate will vary with degree of
physical conditioning as well as with
disease states
The familiar lub-dub associated with the
function of the heart are known as heart
sounds.
The heart sounds are made by the heart
valves snapping closed under contractile
pressure.

Heart Sounds and Cardiac Output

The lub is caused by the closure of the
AV valves
The dub is caused by the closure of the
semi-lunar valve.
Cardiac output (CO) is the amount of
blood pumped out of each side of the
heart ( meaning the ventricles ) in one
minute

Heart Sounds and Cardiac Output

The value of CO is calculated as the
product of the Heart Rate ( HR) multiplied
by the Stroke Volume (SV)
SV generally increases as the force of the
ventricular contractions increases.
CO = HR x SV
CO = 75 beats per min x 70mls per beat
CO = 5250 ml/min

Heart Sounds and Cardiac Output

Generally speaking, blood starting in the
heart should complete a circuit of the body
and arrive back in the heart in one minute.
According to Starlings Law of the heart,
stroke volume is influenced by the amount
of stretching force applied to the muscle
cells of the heart.
The more the cells are stretched, the great
the contraction will be

Starlings Law of the Heart

A healthy, efficient heart only pumps about
60% of the volume of blood in the
ventricles.
Venous return is critical to the amount of
stretching the heart undergoes.
If one side of the heart begins to pump
more blood than the other, the increase in
venous return to the opposite ventricle will
force it to pump a larger volume of blood.

Starlings Law of the Heart

This helps prevent back ups and
increased pressures in the system.
Anything that increases the volume or
speed of venous return will also increase
the SV and CO.
The squeezing actions of skeletal muscles
on veins also plays a major role in
increasing venous return.

Muscular Pump

Regulation of Heart Rate

Coronary contraction does not depend on
stimulus from the nervous system,
because the heart has its own intrinsic
pacemakers ( SA and AV nodes)
HOWEVERheart rate can be
temporarily influenced by stimulus from
the autonomic nerves.

Regulation of Heart Rate

Sympathetic nerves can act to increase or
decrease the heart by stimulating the SA
or AV nodes.
Parasympathetic nerves act to decrease
the heart rate
Being excited or startled can cause a rapid
increase in heart rate.
Heart rate can also be influenced by
hormones

Regulation of Heart Rate

Epinephrine and Thyroxine mimic the
effects of the sympathetic nerves.
Ion concentrations also has a rofound
influence on the heart.
Decreased Ca+ will depress the heart rate
Excessive Ca+ will cause prolonged
contractions, and possibly stop the heart
from beating.

CHF and Blood Vessels

When the pumping efficiency of the heart
is depressed so that circulation is
inadequate to meet tissues needs,
congestive heart failure (CHF) results.
CHF is usually a progressive condition,
and in most cases reflects diminished
coronary circulation by coronary
atherosclerosis

CHF and Blood Vessels

Each side of the heart can fail
independently
If the left side fails, pulmonary congestion
will occur.
The right side continues to pump blood,
but the left side is unable to push
oxygenated blood into systemic circulation

CHF and Blood Vessels

The blood vessels of the lungs become
swollen with blood, and the increased
pressure forces fluids to leak from
circulation and into the lung tissue,
resulting in pulmonary edema.
Suffocation will result if this condition is
untreated.

CHF and Blood Vessels

If the right heart fails, blood is not moved
out of the systemic circulation, and
peripheral congestion will occur.
This results in edema in distal parts of the
body, such as the feet, ankles and hands.
Failure of one side of the heart places
increased strain on the opposite side of
the hearteventually leading to whole
heart failure

Blood Vessels
Blood circulates through the body within
the vasculature.
In decreasing size order, vessels carrying
blood away from the heart are, arteries,
arterioles, capillary beds.
In increasing size order, vessels carrying
blood back towards the heart from the
capillary beds are, venules, and veins

Blood Vessels
The walls of most blood vessels consist of
three layers called tunics.
The innermost layer is called the tunica
intima.
Tunica intima consists of a thin layer of
closely fitted endothelial cells.
It is very smooth, to allow for smooth flow
of blood

Blood Vessels
The tunica media is the middle layer of
tissue, and is primarily smooth muscle
tissue and elastic connective tissue.
This smooth muscle is controlled by the
sympathetic nervous system, which
changes the diameter of the blood vessels

Blood Vessels
The tunica externa is the outer-most layer,
and is mostly fibrous connective tissue
that supports and protects the vessel.
The walls of arteries are usually thicker
than those of the veins.
Veins are subject to less pressure than
ateries, but move blood against gravity.
Veins contain one way valves to prevent
backflow of blood