The Cardiovascular System

Mr. Hunter
Anatomy and Physiology
 Anatomy and Physiology
05/06/2013

• Objectives
• SWBAT
• Understand the function and the importance of the
Cardiovascular System
• Analyze the structure of theheart
• Examine circulation function and dynamics

• Bell Ringer: What is the function of a vasomotormechanism?

 • The system that supplies our body’s
The Cardiovascular System transportation needs is the
cardiovascular system.
• Provides the replenishment of
oxygen water and nutrients to cells
• Provides a means of removal of
waste products from cells.
• Circulation of the blood is critical to
maintaining homeostasis.
The Heart
• The heart is located between the
lungs in the lower portion of the
mediastinum.
• 2/3 of the mass of the heart is
located on the left of the thoracic
cavity and 1/3 is located on theright.
• The heart is a triangular shaped
organ, shaped and sized roughly like
a closed fist.
• The apex which is the blunt pointed
, lower edge of the heart lies on the
diaphragm pointing toward the left.
• The apical heart beat is located
between the 5th and 6th rib along the
midline of the leftclavicle.
 • The heart is positioned in the
The Heart thoracic cavity between the sternum
in front and the bodies of the
thoracic vertebrae behind.
• Due toits location, the heart can be
compressed or squeezed by the
application of pressure tothe lower
body of the sternum using the heel
of the hand.
• CPRallows the temporary
maintaining of blood flow in the
event of cardiacarrest.
 • The heart is a hollow organ. A
The Heart partition divides it into right and left
sides.
• The heart contains four cavities,or
hollow chambers.
• The two upper chambers arecalled
atria. The two lower chambers are
called ventricles.
• The atria are smaller than the
ventricles and their walls a less
muscular. They are often called the
receiving chambers.
• Blood exits from the ventricles into
arteries – pulmonary and aorta. The
ventricles are referred to as
discharging chambers.
 • The wall of each heart chamber iscomposed
The Heart of cardiac muscle tissue called myocardium.
• The septum between the atrial chambersis
called the interatrial septum.
• The septum between the ventricles iscalled
the interventricular septum.
• Each heart chamber is lined by a thin layerof
smooth muscle endocardium.
• Inflammation of this layer iscalled
endocarditis.
• The covering of the heart is called the
pericardium. It consists of a parietal and
visceral layer with lubricating fluid inbetween.
• The inner layer = visceral pericardium
(epicardium) Fits like the skin of anapple.
• The outer layer = parietal pericardium.
• Fits around the heart like a loose fitting sack.
• Pericarditis = inflamed pericardium
 Review 04/15/2013
Anatomy and Physiology
Chapter 12

1. What is the name of the system that provides our body with its
transportation needs?
2. Why is adequate circulation critical tothe body?
3. Where is the heart located?
4. In which cavity and on which side is the greatest amount ofmass from
the heart located?
5. What portion of the heart lies on the diaphragm and points towards the
left?
6. Where would a doctor or nurse place a stethoscope to listen to your
apical heart beat?
7. What bony structures lie anterior and posterior to the heart?
8. What are the names of the chambers of the heart?
9. Describe myocardium, endocardium and pericardium.
 • The heart serves as a muscular
HeartAction pumping device for distributing
blood to all parts of the body.
• Pulmonary circulation and Systemic.
• Contraction of the heartis called
systole.
• Relaxation of the heartis called
diastole.
• When the heart beats, the atria
contract first (atrial systole),forcing
blood into the ventricles.
• Once filled, the two ventricles
contract (ventricular systole)and
force blood out of theheart.
 • The two valves that separate the atrial
chambers above from the ventricular
Heart Valves
chambers below are called the
atrioventricular valves (AV).
• The right AV valve is called the tricupsid
valve. It consists of three leaf-like valve
components.
• The left AV valve is called the bicupsid or
mitral valve. It consists of two leaf-like valve
components.
• Both AV valves prevent the backflow of
blood into the atria when the ventricles
contract.
• Stringlike structures called chordae
tendineae attach the AV valves to the walls
of the ventricles via papillary muscles
extending from the floor of the ventrricles.
 • The semilunar valves (SL) valves are located
between the two ventricular chambers and
Heart Valves
the arteries that carry blood away from the
heart when systoleoccurs.
• The ventricles contract at the same time like
the atria. The two SLvalves open and close
at the sametime.
• The pulmonary SLvalve is located at the
beginning of the pulmonary artery and
opens to allow blood to enter pulmonary
circulation. The valve closes to prevents
backflow of blood into the right ventricle.
• The aortic SLvalve is located at the
beginning of the aorta. The valve opens to
allow blood to enter systemic circulation.It
closes to prevent backflow of blood from
the aorta into theventricles.
 • Two distinct sounds can be heard on
Heart Sounds the anterior chestwall.
• They are described as the lub dup
sounds.
• The first lub sound is the result of
the abrupt closure of theAV valves
as the ventricles contract.
• The closure of the AV valves during
ventricular systole prevents blood
backflow into the atrialchambers.
• The second sound , dup is the
closing of both the SLvalvesduring
ventricular diastole.
 Review Anatomy and
Physiology 04/16/2013

1. What are the two circulatory paths that the heart pumps blood to?
2. What is the contraction of the heart called?
3. What is the relaxation of the heart called?
4. What is the name of the AV valve that separates the right atrium from
the right ventricle?
5. What is the name of the valve that separates the left atrium from the left
ventricle?
6. How many leaf like components does the right AV valve havein
comparison to the left AV valve?
7. What are the names of the valves located between the ventricles and the
arteries that carry blood away from theheart?
8. What function do chordae tendineaehave?
9. What are papillary muscles?
10. If you only heard the lub sound on the anterior chest wall, what
structures may be defective within theheart?
 • The heart acts as two separate
Blood Flow ThroughThe pumps.
Heart • The right side of the heartpumps
blood into the pulmonarysystem.
• The left side of the heart pumps
blood into the systemiccirculation.
• Blood enters the right atrium
through two large veins called the
vena cava. The superior and the
Inferior vena cava provides the right
atrium with blood.
• Venous blood lacks oxygen.
Therefore, veins normally transport
deoxygenated blood and arteries will
transport oxygenated blood.
 • The blood leaving the right ventricle
Blood Flow ThroughThe is deoxygenated. However it enters
Heart the pulmonary circulation via the
pulmonary arteries.
• It is returned as oxygenated blood to
the right atrium via four pulmonary
veins.
• The blood returning to the left
atrium crosses the mitral valveand
enters the ventricle during atrial
contraction.
• When the ventricles contract the left
AV valve closes and the blood is
pushed into the aortic SLvalve –into
systemic circulation.
Blood Flow Of TheHeart

•The heart must

perform a great
amount of work by
pumping through the
pulmonary and
systemic systems.
•It requires a constant
supply of oxygen and
nutrients via the
coronary circulation to
perform this task.
 • Blood flows into the heart via the right and
left coronary arteries. The location of the
Blood Flow Of TheHeart
openings to these arteries are behind the
aortic valve. The openings are called ostia
• When the aortic valve closes after
ventricular systole, blood can flow ina
retrograde manner into the coronary
arteries.

• In both coronary thrombosis and coronary

embolism, a blood clot blocks a certain
region of artery and blood cannot supply
that region of myocardial tissue with oxygen
and nutrients. The cells will become injured
and die resulting in a myocardial infarction
(MI).
• Angina Pectoris is used to describe the chest
pain resulting from a lack of oxygen to the
myocardium.
 Review Anatomy and
Physiology 04/17/2013

1. How many separate pumps does the heart actas?

2. Where does the right side of the heart pump blood into?
3. Where does the left side of the heart pump blood into?
4. What are the names of the two large veins which empty deoxygenated
blood from the superior and inferior portions of the body into the right
atrium?
5. Explain why oxygenated blood is not found in the pulmonary arteries but
it is found in the pulmonary veins.
6. What is the name of the circulation that provides oxygen and nutrients to
myocardial tissue?
7. Where are the openings of the right and left coronary arteries found?
8. What are these openings called?
9. How and when does blood flow into the right and left coronary artery?
 • The normal beating of the heartis
Cardiac Cycle regular and in a specific rhythm.
• Each complete heartbeat is called a
cardiac cycle and includes systole
and diastole (contraction and
relaxation).
• Each cycle takes about 0.8 seconds
to complete if the heart is beating at
a rate of 72 beats per minute.
• Stoke Volume (SV) = the volume of
blood ejected from the ventricles
during each beat.
• Cardiac Output (CO) = the volume
of blood pumped by one ventricle
per minute. CO= HRx SV
• Normal CO= 5 L/min
Some Normal Values
• Stroke Volume (SV) = 60 – 130 ml
• Heart rate (HR) = 60 – 100 bpm
• Cardiac Output (CO) = 4 – 8 L/min
• Systolic Pressure = 100 – 140 mmHg
• Diastolic Pressure = 60 – 90 mmHg
• Ejection Fraction (EF) = 50 – 70%
* ( percentage of blood ejected from LV) *
 • Cardiac muscle cells have an intrinsic
Conduction System ofthe property of contracting on their
Heart own.
• The rate of contraction iscontrolled
by the autonomic nervous system.
• The heart has its own conduction
system for coordinating contractions
during the cardiaccycle.
• Intercalated disks are connections
that electrically join cardiac muscle
fibers into a single unit that allows
for impulse conduction through the
entire wall of a heartchamber.
 • The structures that make of the
Conduction System ofthe conduction system of the heartare:
Heart • Sinoartrial node or pacemaker.
• Atrioventricular Node (AVnode)
• AV bundle, or bundle of His
• Purkinje fibers
• Impulse conduction starts in the SA
node.
• It spreads in all directions through
the atria. This causes atrial fibers to
contract.
• The pulse will then travel to the AV
node and to the AV bundle / bundle
of His and to the Purkinje fibers to
cause ventricular contraction.
 • Normally, therefore aventricular
Conduction System ofthe beat will follow an atrialbeat.
Heart • Myocardial infarctions, endocarditis
and other heart disorders cancause
the heart’s conduction system to
malfunction.
• Heart block occurs when impulses
cannot reach the ventricles. The
ventricles will therefore contract ata
much slower rate than normal.
• This condition may be treated by the
implantation of an artificial
pacemaker that will increase therate
of ventricular contractions to
normal.
 • Small electrical currents are
Conduction System ofthe generated by the conduction system
Heart of the heart.
• These currents can travel through
surrounding tissues to the surfaceof
the body and be transformed into
visible tracings by an
electrocardiogram – EKGor ECG
• The EKGis a graphical record of the
heart’s activity.
Electrocardiogram Waves

•The Pwave –atrial

depolarization (contraction)
•QRScomplex – Ventricular
depolarization and atrial
repolarization (relaxation)
•Twave –Ventricular
repolarization
 Anatomy andPhysiology
Review 04/25/2013

1. What is the term foreach complete heartbeat?

2. How long does it take for a cardiac cycle to complete if the heart rate is
72 beats per minute?
3. Define stroke volume and cardiacoutput.
4. What is the formula forfinding cardiac output?
5. The rate of cardiac muscle tissue is controlled by what system within the
body?
6. What are the functions ofintercalated disks?
7. List the structures that make up the conduction system of the heart.
8. Outline the path of electrical impulses through the heart including what
chambers are involved.
9. Name two cardiac abnormalities that can cause the conductionsystem to
malfunction.
10. What is heartblock and how can it be treated?
11. What is an EKGand describe three common waves or deflections.
Electrocardiogram

•Pwave – Atrial
depolarization, spreadsfrom
the RAto the LA.
Normal value =80ms
•PRSegment – Impulse does
not produce contraction, itis
traveling toward ventricles.
Normal = 50 to 120ms.
•PRInterval – The time it
takes for the impulse totravel
from the SAnode to the AV
node where it then enters the
ventricles. The normal value is
120-200 ms.
Electrocardiogram
•QRSComplex – Rapid
depolarization of right and left
ventricles. Normal Ranges = 80 to
120 ms.
•Shorter QRSvalues are found in
children and in rapid states of
heart beat – tachycardia.
•Prolonged values =hyperkalemia
or bundle branchblock.
•JPoint – Point at which QRSends
and STsegments begins.
•STsegment = ventricles are
depolarized. Normal = 80 to 120
ms above = MI
•Twave = 160 ms ventricles relax.
•U = IV septum repolarization
Electrocardiogram

•STinterval – Measured
from Jpoint to end of T
wave. Normal = 320 ms.
•Represents slow phase of
ventricular repolarization.
•QTinterval – Measured
from beginning of QRSto
end of T.Normal = up to
420 ms in heart rates of60
bpm.
•Prolonged QT = vetricular
tachyarthmias and sudden
death.
 Blood Vessels

•Arterial blood ispumped

through a series of large
distribution vessels-
arteries.
•The largest artery in the
body is the aorta.
•Arteries progressively
become smaller as they
move away from the heart
becoming arterioles.
•Arterioles control the
flow of blood into
microscopic exchange
vessels called capillaries.
Blood Vessels

•Blood enters via capillary

sphincter smooth muscle
cells. Within the capillary
beds, the exchange of
nutrients and gases occur
between blood and the
tissue fluid around the
cells.
•The blood is drained from
the capillary bed and then
enters vessels called
venules which
progressively become
larger to form veins.
•The two largest veinsthe
SVCand the IVC return
blood to the RA.
Structure of Vessels

•Arteries, veins and capillaries

differ in structure.
•Three layers are found in arteries
and veins.
•The outermost layer = tunica
externa or adventitia. It is made of
connective tissue fibers to
reinforce the walls underpressure.
•The tunica media is the smooth
muscle middle layer. It is much
thicker in arteries than in veins
and contains a thin layer of elastic
tissue. This layer is under control
of the ANSand maintains BPand
blood distribution.
Structure of Vessels

•The tunica intima lines

the arteries and veins. It is
a single layer of squamous
epithelial cells called
endothelium that linesthe
inner surface of the entire
cardiovascular system.
•The veins have one-way
valves not present in
arteries. These valves
prevent backflow of blood.
 Anatomy and Physiology
Review 04/26/2013
1. Describe the Pwave, the PRsegment and the PRinterval.
2. Where would you expect tofind shorter QRSvalues?
3. What conditions would reflect prolongedQRSvalues?
4. STsegment elevated values are an indication of what type ofcardiac
event?
5. What do U wave deflections indicate?
6. What could be the cause of a prolonged QTinterval?
7. What is the name of the largest artery in the body?
8. As arteries become smaller, what type of vessels do they become?
9. When blood leaves the capillary bed, what vessel does it travel through?
10. Name and describe the three structural layers of arteries andveins.
11. What structure is found in veins but not found in arteries?
 • Hepatic portal circulation refers to
Hepatic Portal the route of blood flow through the
Circulation liver.
• Veins from the stomach, intestines,
gallbladder and spleen do not pour
blood directly into the Inferior Vena
Cava (IVC) as do the veins from other
abdominal organs.
• Blood is funneled tothe liver by the
hepatic portal vein.
• Blood passes through the liver
before it reenters regularvenous
return to theheart.
• Blood exits the liver via hepaticveins
which drain into theIVC.
 • The diverted blood in this circulatory
Hepatic PortalCirculation path is sent through a second
capillary bed in the liver.
• Liver cells can remove high
concentrations of glucoseand
convert it to glycogen.
• Liver cells can also remove and
detoxify various poisonous
substances that may be in the blood.
• This system is another example of
helping the body maintain
homeostasis.
 • Circulation in the body beforebirth
FetalCirculation differs from circulation after birth
because the fetus must obtain
oxygen and nutrients only from
maternal blood.
• Fetal blood must be carried to the
placenta and returned to thebody of
the fetus.
• This is accomplished by three vessels
that compose the umbilicalcord.
• Two umbilical arteries
• One umbilical vein
• The umbilical artery carriesoxygen
poor blood.
• The umbilical vein carries oxygen
rich blood.
 • The ductus venosus is a continuation
FetalCirculation of the umbilicalvein.
• It serves as a shunt allowing the
blood to bypass the immatureliver
and empty directly into theIVC.
• The foramen ovale shunts blood
from the RAto the LA, bypassingthe
immature lungs.
• The ductus arteriosus connects the
aorta and the pulmonary artery.The
blood will bypass the lungs through
this route.
 Anatomy and Physiology Review
04/30/2013

1. What does hepatic portal circulation referto?

2. Veins from which organs do not pour directly into the IVC?
3. What vein funnels blood into theliver?
4. What are two functions that this system can provide for
blood traveling through its capillarybed?
5. Name the three vessels that carry blood to the placenta and
return it tofetus.
6. What is the function of the foramen ovale?
 Bell Ringer 04/30/2013
Label and Describe each wave of the EKGtrace below
Blood Pressure

• The pressure or push of bloodas

it flows through the
cardiovascular system.
• It is the highest in the arteries
and the lowest in theveins.
• The blood pressure gradient is
the difference between two
blood pressures.
• The BP for systemic circulation is
the difference of the mean BP in
the aorta and the pressure at the
termination of the venacava.
Blood Pressure
• The mean BPin the aorta is
100 mmHg and within the
termination of the vena
cava it is 0mmHg.
• The systemic BPgradient is
100 - 0 = 100 mmHg.
• The BPgradient is
responsible for keeping the
blood flowing.
• When a BPgradient is not
present, blood does not
circulate.
Blood Pressure

• Hypertension HTN – high

blood pressure can cause
the rupture of one or more
blood vessels.
• If BPis too low -
hypotension, then vital
organs will not beperfused.
Circulation would soon
cease.
• Massive hemorrhage can
kill in thisway.
Factors that Influence Blood Pressure
• Blood Volume
• Strength of Contraction
• Heart Rate
• Thickness of Blood
Blood Volume – The larger
the volume of blood inthe
arteries, the greater the
pressure that is exerted on
their walls.
• The lower the volume, the
lower the blood pressure.
Factors that Influence Blood Pressure
• Hemorrhage is a
pronounced loss of blood,
this decrease in volume
causes a decrease in BP.
• Diuretics-drugs that
promote water loss by
increasing urine output.
• These drugs are often used
to treat HTNby decreasing
blood volume.
 • The volume of blood in the arteries
Factors that Influence
Blood Pressure is determined by how much blood is
pumped into them by theheart.
• It is also determined by how much
blood is being drained from themvia
the arterioles.
• The diameter of the arterioles plays
an important role in determining
how much blood is drained fromthe
arteries.
• Heart Contractions – Strength and
rate of the heartbeat affect COand
therefore BP.
• The stronger the contraction, the
more blood is pumped into the
arteries.
 Anatomy and Physiology
Review 05/01/2013
1. What can blood pressure be defined as?
2. Where is blood pressure normally thehighest and the lowest?
3. What is a blood pressure gradient?
4. How is the systemic blood pressure gradientdetermined?
5. What is the blood pressure gradient responsiblefor?
6. What is the difference between hypertension andhypotension?
7. What affects can hypertension and hypotension have on the circulatory
system?
8. Name three factors that can influence bloodpressure.
9. How does the volume of blood in the arteries increase or decrease blood
pressure?
10. What type of drugs are commonly used to treat hypertension and how
do they work?
Factors that influence • A decrease in the heart’s output will
Blood Pressure decrease the volume of blood inthe
arteries. The decrease in arterial
blood volume decreases blood
pressure.
• A stronger heartbeat increases blood
pressure, and a weaker beat
decreases it.
• Heart Rate - The rate of the
heartbeat also may affect arterial
blood pressure.
• When the heart beats faster, more
blood enters the aorta, and
therefore the arterial bloodpressure
should increase if the SVdoes not
decrease.
Factors that influence • When a change in heart rate
Blood Pressure produces a change in blood pressure
there must also be a change in
stroke volume.
• Blood viscosity - If bloodbecomes
less viscous than normal, blood
pressure will decrease.
• If a person suffers a hemorrhage,
fluid moves into the blood from the
interstitial fluid. This dilutes the
blood and decreases blood pressure.
• Polycythemia is a condition in which
the number of red blood cells
increase to compensate for low
oxygen levels. This can cause an
increase in viscosity.
Factors That Influence • Peripheral Resistance describes any
Blood Pressure force that acts against the flow of
blood in a blood vessel.
• Tension of muscles within the walls
of blood vessels can affect PR.
• When blood vessel walls are relaxed
resistance is low.
• When blood vessel muscles are
contracted resistance is high.
• Vasomotor mechanism- adjustment
of muscle tension in vessel walls to
control blood pressure and blood
flow.
• CVP– Central Venous Pressure
should be 0 mmHg. If not,blood
flow into RAis slowed.
 Anatomy and Physiology Review
05/06/2013

1. What affect does a strong heartbeat have on blood pressure?

2. How does stroke volume affect heart rate and bloodpressure?
3. What is therelationship between blood viscosity and blood pressure?
4. What is polycythemia?
5. What can peripheral resistance be defined as?
6. When blood vessel walls are contracted, what happens to PR?
7. What is a vasomotor mechanism?
8. What is normal CVP?
9. If the CVPis above normal, what could theproblem possibly be?
 Factors of CVP

Mechanisms that keep

Venous Blood Moving Into
The Cardiovascular Circuit

3.Semilunar valves in the veins

1. Continuous beating of the that ensure continued blood
5. Changing pressure in the
heart which pumps blood flow in one direction
Chest cavity during
through the CV system 4.Contraction of skeletal
breathing can produce a
2. Adequate pressure in the muscles which squeeze veins
Pumping action in the
arteries to push blood to To produce a pumping
veins of the thorax.
And through the veins action of blood.
 Pulse Pressure

• Pulse results from anartery

expanding and then
recoiling.
• Tofeel a pulse , you must
place the fingertips overan
artery that lies near the
surface of the body and
over a bone or other firm
base.
• A pulse can provide
information about the rate,
strength and rhythm of a
heartbeat.
 Pulse Pressure

• Pulse results from anartery

expanding and then
recoiling.
• Tofeel a pulse , you must
place the fingertips overan
artery that lies near the
surface of the body and
over a bone or other firm
base.
• A pulse can provide
information about the rate,
strength and rhythm of a
heartbeat.
 Pulse Pressure

• Three pulse points are

located on each side of the
head and neck:
1. superficial temporal artery
in front of theear
2. The common carotid artery
in the neck along the edge
of the sternocleidomastoid
muscle
3. The facial artery at the
lower margin of the
mandible below the mouth
 Pulse Pressure

• Pulse points are located at

three points in the upper
limb.
1. Axilla over the axillary
artery
2. Brachial artery at thebend
of the elbow
3. Radial artery at the wrist
Most frequently
monitored pulse.
 Pulse Pressure

• Pulse points are located

on three locations in the
lower extremities.
1. Femoral artery
2. Popliteal artery – behind
and proximal to theknee
3. Dorsalis pedis artery –on
the front surface of the
foot just below the bend
of the anklejoint.
 Anatomy and Physiology
Review 05/09/2013

1. Name three mechanisms that keep venous blood moving

back through the CVcircuit into the RA.
2. What causes a pulse?
3. Tofeel a pulse, what must youdo?
4. What information can a pulse provide?
5. Name three pulse points located on each side of thehead
and neck.
6. Name three pulse points of the upperlimb.
7. Name the three pulse points of the lower extremities.
8. Where is the popliteal arterylocated?