Cardiovascular System 1.

1 Chambers and Associated Great Vessels

Four chambers of the heart
1.0 The Cardiovascular System -​ Atria (right and left)
A closed system of the heart and blood vessels ●​ Superior receiving chambers
The heart pumps blood. Blood vessels allow blood to ●​ Assist with filling the ventricles
circulate to all parts of the body. ●​ Blood enters under low pressure
Functions of the cardiovascular system from veins of the body
-​ Transport oxygen, nutrients, cell wastes, -​ Ventricles (right and left)
hormones to and from cells ●​ Inferior discharging chambers
●​ Thick-walled pumps of the heart
Anatomy of the Heart (1 of 3) ●​ During contraction, blood is
-​ Size of a human fist, weighing less than a propelled into circulation
pound
-​ Located in the thoracic cavity, between the
lungs in the inferior mediastinum (medial
section of the thoracic cavity)
Orientation
-​ Apex (pointed region) is directed toward left
hip and rests on the diaphragm
-​ Base (area where great blood vessels emerge)
points toward right shoulder

Anatomy of the Heart (2 of 3)

Coverings of the heart
-​ Pericardium—a double-walled sac
●​ Fibrous pericardium is loose and
superficial

Serous membrane is deep to the fibrous pericardium and

composed of two layers
1.​ Parietal pericardium: outside layer that lines
the inner surface of the fibrous pericardium
2.​ Visceral pericardium: next to heart; also
known as the epicardium
●​ Serous fluid fills the space between
the layers of pericardium, called the
pericardial cavity

Anatomy of the Heart (3 of 3)

Walls of the heart
-​ Epicardium
●​ Outermost layer of the heart wall;
also known as the visceral
pericardium
-​ Myocardium
●​ Middle layer composed mostly of
cardiac muscle
●​ This layer contracts
-​ Endocardium
●​ Inner layer known as endothelium
Chambers and Associated Great Vessels (2 of 5)
-​ Interatrial septum
●​ Separates the two atria
longitudinally
-​ Interventricular septum
●​ Separates the two ventricles
longitudinally

Chambers and Associated Great Vessels (3 of 5)

-​ Heart functions as a double pump
●​ Arteries carry blood away from the
heart
●​ Veins carry blood toward the heart
-​ Double pump
●​ Right side works as the pulmonary
circuit pump
●​ Left side works as the systemic
circuit pump
Chambers and Associated Great Vessels (4 of 5)
-​ Pulmonary circulation
●​ Blood flows from the right side of
the heart to the lungs and back to
the left side of the heart
●​ Blood is pumped out of right side
through the pulmonary trunk, which
splits into pulmonary arteries and
takes oxygen-poor blood to lungs
●​ Oxygen-rich blood returns to the
heart from the lungs via pulmonary
veins

Chambers and Associated Great Vessels (5 of 5)

-​ Systemic circulation
●​ Oxygen-rich blood returned to the
left side of the heart is pumped out
into the aorta
●​ Blood circulates to systemic arteries
and to all body tissues
●​ Left ventricle has thicker walls
because it pumps blood to the body
through the systemic circuit
Allow blood to flow in only one direction to prevent
-​ Oxygen-poor blood returns to the right atrium backflow
via systemic veins, which empty blood into the -​ Atrioventricular (A V) valves—between atria
superior or inferior vena cava and ventricles
●​ Left A V valve: bicuspid (mitral)
valve
●​ Right A V valve: tricuspid valve
-​ Semilunar valves—between ventricle and
artery
●​ Pulmonary semilunar valve
●​ Aortic semilunar valve
Heart Valves (2 of 2) 1.4 Physiology of the Heart
-​ A V valves Intrinsic conduction system of the heart
●​ Chordae tendineae anchor the -​ Cardiac muscle contracts spontaneously and
cusps to the walls of the ventricles can occur independently of nerve impulses
●​ Open during heart relaxation, when -​ Contractions occur in a regular and continuous
blood passively fills the chambers way
●​ Closed during ventricular ●​ Atrial cells beat 60 times per minute
contraction ●​ Ventricular cells beat 20−40 times
-​ Semilunar valves per minute
●​ Closed during heart relaxation ●​ Need a unifying control system—the
●​ Open during ventricular contraction intrinsic conduction system (nodal
●​ Valves open and close in response system)
to pressure changes in the heart
Physiology of the Heart (2 of 17)
Intrinsic conduction system of the heart
-​ Two systems regulate heart activity
●​ Autonomic nervous system
●​ Intrinsic conduction system, or the
nodal system
1.​ Sets the heart rhythm
2.​ Composed of special
nervous tissue
3.​ Ensures heart muscle
depolarization in one
direction only (atria to
ventricles)
4.​ Enforces a heart rate of
75 beats per minute

Physiology of the Heart (3 of 17)

Intrinsic conduction system of the heart
Components include:
-​ Sinoatrial (S A) node
●​ Located in the right atrium
●​ Serves as the heart’s pacemaker
-​ Atrioventricular (A V) node is at the junction
of the atria and ventricles
-​ Atrioventricular (A V) bundle (bundle of His)
and bundle branches are in the
interventricular septum
1.3 Cardiac Circulation -​ Purkinje fibers spread within the ventricle wall
Blood in the heart chambers does not nourish the muscles
myocardium

The heart has its own nourishing circulatory system

consisting of:
-​ Coronary arteries—branch from the aorta to
supply the heart muscle with oxygenated
blood
-​ On the left: anterior interventricular artery
and circumflex artery
-​ On the right: posterior interventricular artery
and marginal artery

Cardiac Circulation (2 of 2)
-​ Cardiac veins—drain the myocardium of blood
-​ Coronary sinus—a large vein on the posterior
of the heart; receives blood from cardiac veins
●​ Blood empties into the right atrium
via the coronary sinus
Physiology of the Heart (4 of 17) Isovolumetric relaxation
Intrinsic conduction system of the heart -​ Ventricular diastole begins
-​ The sinoatrial node (S A node) starts each -​ Pressure in ventricles falls below that in the
heartbeat major arteries
-​ Impulse spreads through the atria to the A V -​ Semilunar valves close to prevent blood
node backflow into the ventricles
-​ Atria contract -​ For another moment, the ventricles are
-​ At the A V node, the impulse is delayed briefly completely closed chambers
-​ Impulse travels through the A V bundle, bundle -​ When atrial pressure increases above
branches, and Purkinje fibers intraventricular pressure, the A V valves open
-​ Ventricles contract; blood is ejected from the Heart sounds
heart -​ Lub—longer, louder heart sound caused by the
closing of the A V valves
Physiology of the Heart (5 of 17) -​ Dup—short, sharp heart sound caused by the
Intrinsic conduction system of the heart closing of the semilunar valves at the end of
-​ Tachycardia—rapid heart rate, over 100 beats ventricular systole
per minute
-​ Bradycardia—slow heart rate, less than 60
beats per minutes

Physiology of the Heart (6 of 17)

Cardiac cycle and heart sounds
-​ The cardiac cycle refers to one complete
heartbeat, in which both atria and ventricles
contract and then relax
●​ Systole = contraction
●​ Diastole = relaxation
-​ Average heart rate is approximately 75 beats
per minute
-​ Cardiac cycle length is normally 0.8 second

Atrial diastole (ventricular filling)

-​ Heart is relaxed
-​ Pressure in heart is low
-​ Atrioventricular valves are open
-​ Blood flows passively into the atria and into
ventricles
-​ Semilunar valves are closed
Atrial systole
-​ Ventricles remain in diastole
-​ Atria contract
-​ Blood is forced into the ventricles to complete
ventricular filling
Isovolumetric contraction
-​ Atrial systole ends; ventricular systole begins
-​ Intraventricular pressure rises
-​ A V valves close to prevent blood backflow
into atria
-​ For a moment, the ventricles are completely
closed chambers
Ventricular systole (ejection phase)
-​ Ventricles continue to contract
-​ Intraventricular pressure now surpasses the
pressure in the major arteries leaving the
heart
-​ Semilunar valves open
-​ Blood is ejected from the ventricles
-​ Atria are relaxed and filling with blood
Physiology of the Heart (13 of 17)
Cardiac output (C O)
-​ Amount of blood pumped by each side
(ventricle) of the heart in 1 minute
-​ Product of stroke volume and heart rate
Stroke volume (S V)
-​ Volume of blood pumped by each ventricle in
one contraction (each heartbeat)
-​ About 70 milliliter of blood is pumped out of
the left ventricle with each heartbeat
Heart rate (H R)
-​ Typically 75 beats per minute

Physiology of the Heart (14 of 17)

Cardiac output is the product of the heart rate (H R) and
the stroke volume (S V)

Physiology of the Heart (15 of 17)

Regulation of stroke volume
-​ 60 percent of blood in ventricles (about 70 Blood Vessels
milliliter) is pumped with each heartbeat
-​ Starling’s law of the heart
Blood vessels form a closed vascular system that
●​ The critical factor controlling S V is
transports blood to the tissues and back to the heart.
how much cardiac muscle is
stretched, called preload
●​ The more the cardiac muscle is ●​ Vessels That Carry Blood Away from the
stretched, the stronger the Heart
contraction ○​ Arteries and arterioles
-​ Venous return is the important factor ●​ Vessels That Play a Role in Exchanges
influencing the stretch of heart muscle Between Tissues and Blood
○​ Capillary beds
Physiology of the Heart (16 of 17) ●​ Vessels That Return Blood Toward the Heart
Regulation of stroke volume ○​ Venules and veins
Two factors influence preload
-​ Amount of venous return (volume of blood Physiology of the Heart (17 of 17)
returning to the heart) Microscopic Anatomy of Blood Vessels (1 of 4)
-​ Length of time the ventricles are relaxed and Three layers (tunics) in blood vessels (except the
filling (determined by heart rate) capillaries):
Contractility is
-​ the ability of cardiac muscle tissue to generate ●​ Tunica intima: Forms a friction-reducing lining
tension (endothelium).
Afterload is ●​ Tunica media: Smooth muscle and elastic
-​ the amount of pressure the ventricles must tissue, controlled by the sympathetic nervous
overcome to eject blood system.
●​ Tunica externa: Protective outermost
Physiology of the Heart (17 of 17) covering, mostly fibrous connective tissue;
Factors Modifying Basic Heart Rate supports and protects the vessel.

●​ Neural (ANS) Controls

○​ Sympathetic nervous system
speeds heart rate.
○​ Parasympathetic nervous system,
primarily vagus nerve fibers, slows
and steadies the heart rate.
●​ Hormones and Ions
○​ Epinephrine and thyroxine speed
heart rate.
○​ Excess or lack of calcium, sodium,
and potassium ions also modify
heart activity.
●​ Physical Factors
○​ Age, gender, exercise, and body
temperature influence heart rate.
 Microscopic Anatomy of Blood Vessels (4 of 4)
Special capillary beds of the mesentery contain
precapillary sphincters and a vascular shunt:

●​ Precapillary sphincters: Regulate blood flow

through the capillary bed.
●​ Vascular shunt: Directly connects the arteriole
and venule at opposite ends of the bed.
○​ Figure 11.12a Anatomy of a
Capillary Bed
○​ Figure 11.12b Anatomy of a
Capillary Bed

Gross Anatomy of Blood Vessels (1 of 17)

Major arteries of systemic circulation:

Microscopic Anatomy of Blood Vessels (2 of 4) ●​ Aorta: Largest artery in the body, leaves the
Structural differences in arteries, veins, and capillaries: left ventricle of the heart. Sections include:
○​ Ascending aorta—leaves the left
●​ Arteries: Heavier, stronger, stretchier tunica ventricle.
media than veins to withstand pressure ○​ Aortic arch—arches to the left.
changes. ○​ Thoracic aorta—travels downward
●​ Veins: Thinner tunica media, operate under through the thorax.
low pressure, contain valves to prevent blood ○​ Abdominal aorta—passes through
backflow, and have a larger lumen than the diaphragm into the
arteries. Skeletal muscle "milks" blood in veins abdominopelvic cavity.
toward the heart.
Gross Anatomy of Blood Vessels (1 of 17)​
Major arteries of systemic circulation​
Aorta

●​ Largest artery in the body

●​ Leaves from the left ventricle of the heart

Regions

●​ Ascending aorta—leaves the left ventricle

●​ Aortic arch—arches to the left
●​ Thoracic aorta—travels downward through the
thorax
●​ Abdominal aorta—passes through the
diaphragm into the abdominopelvic cavity

Microscopic Anatomy of Blood Vessels (3 of 4)

Structural differences in arteries, veins, and capillaries:

●​ Capillaries: Only one cell layer thick (tunica

intima); allow exchanges between blood and
tissue; form networks called capillary beds.
●​ Blood flow through a capillary bed is known as
microcirculation, beginning at the terminal
arteriole.
Arterial branches of the ascending aorta Superior vena cava and inferior vena cava enter the
right atrium of the heart
●​ Right and left coronary arteries serve the
heart ●​ Superior vena cava drains the head and arms
●​ Brachiocephalic trunk splits into the: ●​ Inferior vena cava drains the lower body
○​ Right common carotid artery
○​ Right subclavian artery
●​ Left common carotid artery splits into the: Veins draining into the superior vena cava
○​ Left internal and external carotid
arteries
●​ Radial and ulnar veins drain to axillary vein
●​ Left subclavian artery branches into the:
●​ Cephalic vein drains the lateral aspect of the
○​ Vertebral artery
arm and empties into the axillary vein
●​ Basilic vein drains the medial aspect of the
In the axilla, the subclavian artery becomes the arm and empties into the brachial vein
●​ Basilic and cephalic veins are joined at the
Arterial branches of the thoracic aorta median cubital vein (elbow area)

●​ Intercostal arteries supply the muscles of the

thorax wall Veins draining into the superior vena cava
●​ Other branches of the thoracic aorta (not
illustrated) supply the:
●​ Subclavian vein receives:
○​ Lungs (bronchial arteries)
○​ Venous blood from the arm via the
○​ Esophagus (esophageal arteries)
axillary vein
○​ Diaphragm (phrenic arteries)
○​ Venous blood from skin and muscles
via external jugular vein
Arterial branches of the abdominal aorta ●​ Vertebral vein drains the posterior part of the
head
●​ Celiac trunk is the first branch of the ●​ Internal jugular vein drains the dural sinuses
abdominal aorta. Three branches are: of the brain
○​ Left gastric artery (stomach)
○​ Splenic artery (spleen)
○​ Common hepatic artery (liver) Veins draining into the superior vena cava
●​ Superior mesenteric artery supplies most of
the small intestine and first half of the large
●​ Left and right brachiocephalic veins receive
intestine
venous blood from the:
○​ Subclavian veins
○​ Vertebral veins
○​ Internal jugular veins
Arterial branches of the abdominal aorta ●​ Brachiocephalic veins join to form the superior
●​ Azygos vein drains the thorax
●​ Left and right renal arteries (kidney)
●​ Left and right gonadal arteries Veins draining into the inferior vena cava
○​ Ovarian arteries in females serve
the ovaries
●​ Anterior and posterior tibial veins and fibial
○​ Testicular arteries in males serve
veins drain the legs
the testes
●​ Posterior tibial vein drains to
●​ Lumbar arteries serve muscles of the
●​ Great saphenous veins (longest veins of the
abdomen and trunk
body) receive superficial drainage of the legs
●​ Each common iliac vein (left and right) is
formed by the union of the internal and
Arterial branches of the abdominal aorta external iliac vein on its own side

●​ Inferior mesenteric artery serves the second

half of the large intestine
●​ Left and right common iliac arteries are the
final branches of the aorta
○​ Internal iliac arteries serve the
pelvic organs
○​ External iliac arteries enter the
thigh
Gross Anatomy of Blood Vessels (13 of 17)​
Major veins of systemic circulation

Veins draining into the inferior vena cava

●​ Right gonadal vein drains the right ovary in

females and right testicle in males
●​ Left gonadal vein empties into the left renal
vein
●​ Left and right renal veins drain the kidneys
●​ Hepatic portal vein drains the digestive organs
and travels through the liver before it enters
systemic circulation
●​ Left and right hepatic veins drain the liver

Gross Anatomy of Blood Vessels (14 of 17)​

Arterial supply of the brain and the cerebral arterial circle
(circle of Willis)

●​ Internal carotid arteries divide into:

○​ Anterior and middle cerebral
arteries
●​ These arteries supply most of the cerebrum
●​ Vertebral arteries join once within the skull to
form the basilar artery
●​ Basilar artery serves the brainstem and
Gross Anatomy of Blood Vessels (17 of 17)​
cerebellum
Hepatic portal circulation

●​ Formed by veins draining the digestive organs,

spleen, and pancreas, which empty into the
Gross Anatomy of Blood Vessels (15 of 17)​ hepatic portal vein
Arterial supply of the brain and the cerebral arterial circle ●​ Hepatic portal vein carries this blood to the
(circle of Willis) liver, where it is processed before returning to
systemic circulation
●​ Posterior cerebral arteries form from the ●​ The hepatic portal vein receives blood from:
division of the basilar artery ○​ Splenic vein (receives blood from
●​ These arteries supply the posterior cerebrum inferior mesenteric vein)
○​ Superior mesenteric vein
○​ Left gastric vein

Gross Anatomy of Blood Vessels (16 of 17)​

Arterial supply of the brain and the cerebral arterial circle
(circle of Willis)

●​ Anterior and posterior blood supplies are

united by small communicating arterial
branches
●​ Result—complete circle of connecting blood
vessels called cerebral arterial circle, or circle
of Willis
Physiology of Circulation Blood Pressure Gradient
Vital Signs
●​ When the ventricles contract:
●​ Measurements of arterial pulse, blood ○​ Blood is forced into elastic arteries
pressure, respiratory rate, and body close to the heart
temperature ○​ Blood flows along a pressure
gradient (from high to low pressure)
Arterial Pulse ○​ Pressure decreases in blood vessels
as distance from the heart increases
○​ Pressure is high in the arteries,
●​ Alternate expansion and recoil of a blood
lower in the capillaries, and lowest
vessel wall (the pressure wave) that occurs as
in the veins
the heart beats
●​ Monitored at pressure points in superficial
arteries, where pulse is easily palpated
●​ Pulse averages 70 to 76 beats per minute at
rest, in a healthy person

Measuring Blood Pressure

●​ Two arterial blood pressures are measured

○​ Systolic: pressure in the arteries at
the peak of ventricular contraction
○​ Diastolic: pressure when ventricles
relax
●​ Expressed as systolic pressure over diastolic
pressure in millimeters of mercury (mm Hg)
●​ Example: Auscultatory method is an indirect
method of measuring systemic arterial blood
pressure, most often in the brachial artery

Blood Pressure (1 of 14)

Blood Pressure

●​ The pressure the blood exerts against the inner

walls of the blood vessels
●​ The force that causes blood to continue to flow
in the blood vessels
Blood Pressure (4 of 14)
Blood Pressure (8 of 14)
Effects of Various Factors on Blood Pressure
Diet
●​ Arterial blood pressure (BP) is directly related
to cardiac output and peripheral resistance ●​ It is commonly believed that a diet low in salt,
○​ Cardiac output (CO): the amount of saturated fats, and cholesterol prevents
blood pumped out of the left hypertension (high blood pressure)
ventricle per minute
○​ Peripheral resistance (PR): the
amount of friction blood encounters
as it flows through vessels

Blood Pressure (5 of 14)

Neural Factors: The Autonomic Nervous System

●​ Parasympathetic nervous system has little to

no effect on blood pressure
●​ Sympathetic nervous system promotes
vasoconstriction (narrowing of vessels), which
increases blood pressure

Blood Pressure (6 of 14) Blood Pressure (9 of 14)

Renal Factors: The Kidneys Variations in Blood Pressure

●​ Kidneys regulate blood pressure by altering ●​ Normal human range is variable

blood volume ○​ Systolic pressure ranges from 110 to
○​ If blood pressure is too high, the 140 mm Hg
kidneys release water in the urine ○​ Diastolic pressure ranges from 70 to
○​ If blood pressure is too low, the 80 mm Hg
kidneys release renin to trigger the
formation of angiotensin, a
vasoconstrictor
○​ Angiotensin stimulates the release Blood Pressure (10 of 14)
of aldosterone, enhancing sodium
(and water) reabsorption by kidneys Hypotension and Hypertension

●​ Hypotension (low blood pressure):

○​ Low systolic (below 100 mm Hg)
Blood Pressure (7 of 14) ○​ Often associated with illness
○​ Acute hypotension is a warning sign
Temperature and Chemicals for circulatory shock
●​ Hypertension (high blood pressure):
●​ Temperature: ○​ Sustained elevated arterial pressure
○​ Heat has a vasodilating effect ○​ Indicates increased peripheral
○​ Cold has a vasoconstricting effect resistance
●​ Chemicals:
○​ Various substances can cause
increases or decreases in blood
pressure
○​ Epinephrine increases heart rate
and blood pressure
Blood Pressure (11 of 14)

Capillary Exchange of Gases and Nutrients Blood Pressure (14 of 14)

●​ Interstitial fluid (tissue fluid) is found between ●​ Blood pressure is higher than osmotic pressure
cells at the arterial end of the capillary bed
●​ Substances move to and from the blood and ●​ Blood pressure is lower than osmotic pressure
tissue cells through capillary walls at the venous end of the capillary bed
●​ Exchange occurs due to concentration ●​ Fluid moves out of the capillary at the
gradients: beginning of the bed and is reclaimed at the
○​ Oxygen and nutrients leave the opposite (venule) end
blood and move into tissue cells
○​ Carbon dioxide and other wastes
exit tissue cells and enter the blood

Blood Pressure (12 of 14)

Substance Movement

●​ Substances take various routes entering or

leaving the blood:
○​ Direct diffusion through membranes
○​ Diffusion through intercellular clefts
(gaps between cells in the capillary
wall)
○​ Diffusion through pores of
fenestrated capillaries
○​ Transport via vesicles

Blood Pressure (13 of 14)

Fluid Movements at Capillary Beds

●​ Fluid movement out of or into a capillary

depends on the difference between two
pressures
○​ Blood pressure forces fluid and
solutes out of capillaries
○​ Osmotic pressure draws fluid into
capillaries
Developmental Aspects of the Cardiovascular System Developmental Aspects of the Cardiovascular System
(1 of 4) (3 of 4)

●​ In an embryo, the heart develops as a simple ●​ Shunts bypassing the lungs and liver are
tube and pumps blood by week 4 of pregnancy present in a fetus
●​ The heart becomes a four-chambered organ ●​ Blood flow bypasses the liver through the
capable of acting as a double pump over the ductus venosus and enters the inferior vena
next 3 weeks cava
●​ Blood flow bypasses the lungs:
○​ Blood entering the right atrium is
shunted directly into the left atrium
through the foramen ovale
Developmental Aspects of the Cardiovascular System
(becomes fossa ovalis at or after
(2 of 4)
birth)
○​ Ductus arteriosus connects the
Umbilical Cord
aorta and pulmonary trunk
(becomes ligamentum arteriosum
●​ Carries nutrients and oxygen from maternal at birth)
blood to fetal blood
●​ Fetal wastes move from fetal blood to
maternal blood
●​ Contains:
Developmental Aspects of the Cardiovascular System
○​ One umbilical vein, which carries
(4 of 4)
nutrient- and oxygen-rich blood to
the fetus
○​ Two umbilical arteries, which carry Age-Related Cardiovascular Issues
wastes and carbon dioxide–rich
blood from the fetus to the placenta ●​ Weakening of venous valves
●​ Varicose veins
●​ Progressive arteriosclerosis
●​ Hypertension resulting from loss of elasticity
of vessels
●​ Coronary artery disease resulting from fatty,
calcified deposits in the vessels