Cardiovascular System

and the beat goes on

Heart: Location & Size

The size of a persons fist
Weighs less than one pound Located in the thorax The apex points toward the left hip and rests on the diaphragm at the level of the 5th rib The base points toward the right shoulder at the level of the 2nd rib

Heart Coverings and Walls

Enclosed in a double layered membrane called the pericardium
visceral pericardium (epicardium) forms part of the wall of the heart

parietal pericardium loose membrane composed of dense connective tissue

Walls of the heart three layers

Epicardium connective tissue Myocardium heart muscle Endocardium layer of endothelium that lines the chambers

Heart chambers
Heart has four hollow chambers
2 receiving chambers the left and right atria
2 pumping chambers the left and right ventricles

The left and right chambers are separated by a septum interatrial or interventricular septum

Heart works as a double pump

Right side pumps blood to the lungs Left side pumps blood to the body

Heart: Associated Great Vessels

Superior and Inferior venae cavae bring oxygen poor blood from the body to the right atrium Pulmonary Trunk and arteries carries oxygen poor blood to the lungs Pulmonary Veins bring oxygen rich blood to the left atrium Aorta carries oxygen rich blood to the body

Pulmonary Circulation
Carries blood to the lungs for gas exchange
Pathway - right atrium to right ventricle to pulmonary arteries to lungs to pulmonary veins to

left atrium

Systemic Circulation
Carries oxygen rich blood to the body and oxygen poor blood to the heart
Pathway left atrium to left ventricle to aorta to body to venae cavae to right atrium

Heart Valves
The heart has four valves They keep blood flowing in one direction Atrioventricular (AV) valves located between the atria and the ventricles
Left AV valve called the mitral valve (bicuspid valve)
Right AV valve called the tricuspid valve

Semilunar valves located between the ventricles and the great vessels
Pulmonary semilunar valve Aortic semilunar valve

Cardiac Circulation
The blood pumped by the heart does not feed the myocardium Coronary arteries carry oxygen rich blood to the myocardium Coronary veins carry oxygen poor blood from the myocardium

Coronary artery disease

Angina pectoris Myocardial infarction Coronary by-pass surgery

Heart Physiology
Pumps about 6000 quarts of blood a day Beats about 100,800 times a day (70 bpm X 60 minutes X 24 hours) Myocardial cells contract spontaneously Contraction is regulated by the autonomic nervous system as well as by nerves in the heart itself

Regulation of Heart Beat

Autonomic nervous system acts to speed up and slow down the heart rate Intrinsic Conduction System , or Nodal System
Built into the heart tissue
Causes heart muscle depolarization to occur only from atria to ventricle -Produces a coordinated beat with a contraction rate of about 75 BPM

Intrinsic Conduction System

Sinoatrial Node
Located in the right atrium It starts each heart beat and sets the rate Called the pacemaker

Atrioventricular Node
Located at the junction of the atria and ventricles - Relays the impulse to the ventricles

The AV bundle (bundle of His)

Right and left bundle branches Purkinjie fibers

Conduction Pathway
SA node to atria to the AV node

AV node to AV bundles to bundle branches to purkinje fibers

Atria contract before ventricles Ventricles contract from the apex toward the atria

Produces coordinated contractions

Disorders of regulation
Heart block 1st, 2nd, 3rd degree Fibrillation Bradycardia Tachycardia

Cardiac Cycle
Diastole muscle relaxes and chamber fills

Systole muscle contracts and blood is ejected

Cardiac cycle refers to events of one complete heartbeat

3 stages
mid-to-late diastole

Ventricular systole Early diastole

Mid-to-Late Diastole
Heart is in complete relaxation Atria are filled Ventricles empty AV valves open Blood flows passively from atria into the ventricles Atria then contract and pump blood into the ventricles

Ventricular Systole
Ventricles contract ejecting blood into the great vessels

Semilunar valves open

AV valves are closed

Atria are relaxed and the chambers are filling with blood

Early Diastole
Ventricles relax Atria are filled All valves are closed for an instant AV valves open and blood begins to flow passively into the ventricles

Heart Sounds
2 heart sounds are heard
lub dup pause lub dup

lub is the sound of the AV valves closing dup is the sound of the semilunar valves closing Abnormal sounds
Murmurs indicate leaky valves or narrow valves
Split sounds heart enlargement

Cardiac Output
Stroke Volume the amount of blood ejected by a ventricle with each contraction about 70 ml per beat Cardiac Output the total amount of blood pumped out by the heart in one minute about 5250 ml per minute

Regulation of cardiac output heart rate and stroke volume

Regulation of Stroke Volume

Stretching of heart muscle cells
The more they stretch the greater the stroke volume
Stretch is regulated by venous return - Venous return affected by heart rate and exercise

Congestive Heart Failure

Heart muscle weakens causes may be antherosclerosis, high blood pressure, or multiple myocardial infarcts Cardiac output cannot keep up with venous return

Heart swells to increase output (increases filling)

Reaches a point where the swelling is so great that output is further weakened
Left side failure Right side failure Generalized failure

Blood Vessels
Blood travels away from the heart in arteries and arterioles

Blood travels back to the heart in venules and vein

Capillary beds are sites of gas exchange and nutrient waste diffusion

Microscopic Anatomy of Blood Vessels

Blood vessels consist of three layers tunica intima, tunica media, tunica externa Tunica intima
Lines the lumen (the space inside a hollow organ)
Composed of thin layer of endothelium resting on connective tissue Function is to decrease friction as blood flows through the vessel

Tunica media
Composed of smooth muscle and elastic tissue Contraction alter the diameter of the vessel

Tunica externa
Composed of fibrous connective tissue Function is to support and protect the vessel

Differences in arteries, veins, capillaries

Arteries Thicker and more elastic walls
Tunica media is thicker Allows vessel to withstand the higher pressure of arterial blood

veins

Thin walls Valves to prevent backflow Relay on skeletal muscle to propel blood

capillaries Only consist of the tunica interna

Walls are one cell thick Function exchange of nutrients, wastes, &gases

Physiology of Circulation
Vital signs pulse, blood pressure, respiratory rate, body temperature Pulse pressure wave that travels through the arterial system with each ventricular contraction Normal pulse averages 70 76 beats per minute Influenced by activity, posture, and emotions

Pressure points points where the pulse can be felt

These are the same area that can be compressed to stop blood flow to the extremities

Blood Pressure

The pressure the blood exerts on the inner walls of the arteries
The pressure is highest in the larger arteries and lessens as the blood enters smaller arteries

Blood pressure is usually measured using the brachial artery in the arm

Blood Pressure Measurements

Two measurements are usually made - one measures the pressure when the heart contracts - one measures the pressure when the heart has relaxed

Systolic pressure measures the pressure

when the heart is in systole (contraction); this represents the higher number in the measurement

Diastolic pressure measures the pressure when

the heart is in diastole (relaxed); this represents the Lower number in the measurement

Factors that affect blood pressure

Many factors can affect blood pressure age, weight, Exercise, body position; they either effect cardiac output or peripheral resistance

Cardiac output amount of blood pumped by the heart

In one minute

Peripheral resistance the amount of friction

Encountered by blood as it circulates

Factors that affect peripheral resistance

Arteriosclerosis fatty deposits in arteries

Reduce elasticity Reduce the diameter of blood vessels

Neural factors sympathetic nerves cause

tiny arterioles to contract (called vasoconstriction) This raises blood pressure

Renal factors
Kidneys regulate fluid balance; this affects blood volume and blood pressure Kidneys release and enzyme renin that causes the formation of another chemical angiotensin II. Angiotensin II causes vasoconstriction as well as the release of aldosterone (raises blood volume)

Variations in blood pressure

Hypotension systemic pressure below 100 mm Hg Hypertension blood pressure higher than 140/90