THE CARDIOVASCULAR SYSTEM

Dr.Ngakan Made Rai Widjaja,drh.,MS

Department of Basic Veterinary Science Faculty of Veterinary Medicine Airlangga University

Basic Design and Function Of the Cardiovascular System The cardiovascular system consists of the heart and the many vessels through which blood flow

When

the

erythrocyte

is

pumped out of th l ft side d t f the left id of the heart, it enters the p aorta and passes into the systemic circulation

The systemic circulation is a subdivision of the cardiovascular system consisting of all vessels associated with all organs (other than the parts of the lungs where exchange of gases: O2 & CO2) takes place.

When blood returns from the systemic circulation, it enters the right side of the heart. The right side of the heart pumps blood bl d into i t the th pulmonary circulation.

The pulmonary circulation consists of vessels associated with the parts of the lungs where the exchange of gases takes place.

From the pulmonary circulation, blood reenters the heart on the left side, and from here it is pumped out into the systemic circulation to begin the loop again.

If the right side of the heart cannot pump an adequate amount of blood into the pulmonary circulation, the left side of the heart will not receive enough blood to maintain flow into the systemic circulation.

Figure 1: General design of cardiovascular system illustrating the systemic and pulmonary circulations. Pulmonary circulation is shown in black. (Reprinted with permission from Reece W.O. Physiology of Domestic Animals. 2nd ed. Baltimore: Williams & Wilkins, 1997).

Blood

flows

through

the

vessels of the cardiovascular system because of a driving force g generated by y the

contraction of the heart.

Blood flow from a point

of high mean pressure to a point of low mean pressure.

In the systemic circulation, mean blood pressure is higher in the arteries than in the capillaries and higher in the capillaries than in the veins, from which blood , reenters the right side of the heart.

The driving force of blood pressure is necessary to overcome the vascular resistance provided by the blood vessels. vessels

The resistance (R) to flow through a single tube depends on the length (L) of the tube, the radius (r ) of the tube, and the character of fluid flowing flo ing through thro gh the tube t be

(viscosity,).

The resistance increases with the length of the tube, decreases as the radius of the tube increases, and increases with the viscosity of the fluid.

The radius have the largest effect ( (as shown in the following g formula: Poiseuille)

8L R= 4 r

The vessels on the arterial side of the circulation just before the capillaries is an arteriole have the greatest combined resistance.

Branching of vessels tends to lower resistance, and the of extensive branching

capillaries in their networks is responsible for a relatively low resistance at this point (in spite of the small diameter of an individual capillary).

Transports is the ultimate function of the cardiovascular system.

Blood is the transport medium; the heart provides the force for g blood ( , (i.e., p p pump moving function) around the circulation; and vessels provide a path for the movement and permit exchange between blood and interstitial fluids (at the level of the capillaries).

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The rate of transport and exchange is usually determined by the rate of blood flow through the capillaries. capillaries

Cardiac Cycle The cardiac cycle is one complete of cardiac contraction and relaxation (heartbeat).

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Diastole

(dilation,

from

Gr.

dia,apart; stello, place or put) refers to the relaxation of a chamber of the heart just prior to t and d i d during th filli the filling of th t f that chamber.

Systole (contraction, from Gr. syn,together; stello, place) refers to the contraction of a chamber of the heart that drives di blood bl d out t of f the th chamber.

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Figure 2: Timing of various events of the cardiac cycle. (Reprinted with permission from porth C M. Pathophysiology. 5th ed Philadelphia Lippincott Williams & Wilkins, 1998)

Two distinc heart sounds can be heard during each cardiac cycle in all domestic species, and these are typically described as lub (first sound, or S1) and dub (second sound, or S2).

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These sounds (S1 & S2) are used clinically to divide the cardiac cycle into systole and diastole.

The first sound marks the beginning of systole, and the second sound marks the beginning of diastole.

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Systole As the ventricles begin their contraction, contraction blood pressure increases in them. Almost immediately the pressure within each ventricle exceeds d the th pressure differences force the A-V valves closed.

The first heart sound (S1) is associated with closure of the i ht d l ft th right and left A-V valves

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The isovolumetric contraction p period is the period of systole p y during which all valves are closed (during it the volume of each ventricle remains constant).

When ventricular exceed semilunar those valves

pressures in their to

respective arterial vessels, the open permit ejection of blood (rapid ejection phase of systole).

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 When the blood pressure in the aorta and pulmonary vessels are greater than the pressure in their associated ventricles, differences the pressure the close

semilunar valves.

Closure of the aortic and pulmonary valves is associated with the second heart sound (S2). S2 is used to mark the end of systole and the beginning of diastole.

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Stroke volume (SV) is the volume of blood ejected from each ventricle during a single cardiac cycle.

Normally the stroke volumes for the right and left ventricles are th same. the If these are not equal, blood tends to accumulate in either the systemic or pulmonary circulation.

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Diastole At the beginning of diastole diastole, both the semilunar and A-V valves are closed, so the initial phase is termed isovolumetric relaxation.

When blood

ventricular pressure blood

relaxation exeeds pressures,

reaches the point that atrial ventricular

the pressure differences open the A-V valves.

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While the A-V valves are closed during systole and early diastole, g y y blood continues to flow into the right and left atria from the systemic and pulmonary circulation, respectively.

The accumulation of blood within the atria increases atrial blood pressure. When the A-V valves open, much of the accumulated blood flows rapidly into ventricles. Most ventricular filling occurs during this periode prior to any atrial contraction.

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Blood continues to flow into the atria throughout diastole, and because the A-V valves are AV open, blood flows directly through the atria into the ventricles. So slow heart rates provide a long period for ventricular filling.

Atrial contraction (atrial systole) occurs during ventricular diastole, forcing , g an additional volume of blood into the ventricles, but this amount is relatively small ( ll (perhaps 15 %) h compared to the volume already in the ventricles.

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The end-diastolic volume (EDV) is the volume of blood in each ventricle at the end of diastole

During systole each ventricle ejects only a percentage of its EDV, typically 40-60%. The percentage of EDV that is g ejected is the ejection fraction.

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Heart Sounds and Murmurs Third and fourth heart sounds may be heard in some normal horses and cattle with relatively slow heart rate. The third sound is associated with the rapid ventricular filling phase after the initial i iti l opening of th A V valves. i f the A-V l The fourth sound is associated with atrial contractions.

Heart murmur is a general term for any abnormal heart sound.

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Murmurs may occur when a valve fails to close completely (valvular insufficiency) and blood flow goes in the wrong direction at the wrong time. Murmurs may also occur when a valve fails to open completely p p y (valvular stenosis) and blood is forced through a smaller than normal opening.

Electrical Activity of the Heart In the heart, the initial action potential occurs spontaneously in a specialized group of myocardial cells found in the sinoatrial (SA) node of the heart, from p which the action potential is propagated around the heart to bring about contraction of all cardiac muscle cells.

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Sinoatrial Node and Heart Rate A unique feature of the electrical activity of SA node cells is that the y resting membrane potential is unstable. This instability permits SA node cells t d ll to depolarize spontaneously t l i t l to threshold, where an action potential is generated.

The

SA

node

is

termed

the

pacemaker of the heart because each action potential that spontaneously develops propagated stimulate myocardial contraction. in the around action cells SA the node heart in is to all a

potential and

produce

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Both SA node node.

sympathetic

and

parasympathetic nerves innervate the

By their action on cells in the SA node, symphatetic nerves increase the rate of spontaneous action potential and parasymphatetic nerves reduce the rate.

This heart

is

the

means stimulation and

by

which

symphatetic rate

increases

parasymphatetic

stimulation reduces heart rate. Parasymphatetic nerves continuously inhibit the SA node in the heart of a resting animal, and this constant inhibition is responsible for the resting heart rate.

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During

light

exercise the

or

with

excitement,

parasymphatetic

inhibition is reduced first to permits an p increase in heart rate. With greater excitement or more intense stimulation exercise, increase, symphatetic further

increasing heart rate.

Highly animals, relatively

trained such high as

athletic racing have levels of

thoroughbreds,

parasymphatetic stimulation h t ti ti l ti to their hearts at rest.

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Atrioventricular Node and Other Specialized Conductive Cells in the Heart The atrioventricular node (A-V

node) and the common bundle, or , y bundle of His, are also myocardial cells specialized for conducting action potentials.

The A-V node is in the intraatrial septum, and the common b ndle e tends bundle extends from the A-V node into the ventricle through the fibrous connective tissue of the cardiac skeleton.

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The common bundle divides into several branches that rapidly propagate action potentials throughout the ventricle. The individual cells that make up these branches are the Purkinje fibers.

Figure 3. Impulse generation and conduction system of the mammalian heart

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Cells of the A-V node are specialized to conduct action potentials more slowly than other myocardial cells. This characteristic allow enough time for the atria to depolarize completely and contract before action potentials spread into the ventricles to stimulate their contraction.

The slow conduction through the A-V node is A-V node delay. delay

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Electrocardiography and Arrhythmias Electrocardiography is the recording of electrical activity on the surface of the body that reflects the electrical activity in the heart. The lead is a specific combination of sites where the recording electrodes are placed on the body. An electrocardiogram recording. is the actual

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The P wave is associated with atrial depolarization. The QRS complex is associated with ventricular depolarization. The T wave is associated with ventricular repolarization. The period between the P and Q waves is associated with A-V node delay.

Arrhythmia is a general term for any abnormality y y in cardiac electrical activity, including rate, rhythm, and the propagation of d th ti f action potentials around the heart.

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