Chapter 11Cardiovascular System

• The major function of the cardiovascular system is transportation.

• The blood is the transport vehicle.• It carries oxygen, nutrients, cell wastes, hormones,

and many other substances vital for body homeostasis to and from cells.

• The force to move the blood throughout the body is provided by the beating heart.

The Cardiovascular System consists of:1. Blood (transport vehicle)

2. Heart (pump)

3. Blood vessels (network of tubes)

Location and Size of the Heart• The heart is the size of a fist• The heart is located between the two lungs• A double sac called the pericardium surrounds the

heart.

• Lubricating fluid is found in between the two layers of the sac. This fluid allows the heart to beat easily in a frictionless environment.

The walls of the heart are made of 3 layers:1. Epicardium – outer layer

2. Myocardium – layer that contracts

3. Endocardium – lines the chambers and goes into the blood vessels

• The heart has four chambers or cavities.• The two atria are located at the superior or top of the

heart and the two ventricles are located at the inferior or bottom of the heart.

Blood flow through the heart

Pulmonary Circulation• Happens on the Right side of the heart• It pumps blood with no oxygen to the lungs• When in the lungs blood picks up oxygen – becomes

oxygen rich

The Steps:1. Oxygen poor blood enter the superior and inferior

vena cava

2. Blood goes into the right atrium then right ventricle

3. Blood is them pumped to the pulmonary trunk which branches into pulmonary arteries

4. Blood goes to the lungs and picks up oxygen

5. Blood leaves the lungs in the pulmonary veins and goes to the left atrium

Systemic Circulation• Left side: pumps blood with oxygen to the body cells

and back to the heart

The Steps:1. Blood enters the left atrium then goes to the left

ventricle

2. Blood is then pumped to the body cells through the aorta

3. Blood travels from the aorta to arteries, smaller arteries, capillaries (losses oxygen) then to the veins and then to the superior and inferior vena cava

Cardiac Circulation• The blood in the heart does not nourish the

myocardium. The blood supply that nourishes the heart is provided by the right and left coronary arteries which branch from the aorta.

Physiology of the Heart• 6 quarts pushed through 1000X• Heart pumps 6000 quarts a day• Cardiac muscle cells can and do contract

spontaneously and independently. These contractions occur in a regular and continuous way.

• The muscles in the different parts of the heart have different rhythms.

• The heart has a unifying control system that coordinates its movement.

The Two Controlling Systems1. The autonomic nervous system (automatic) acts like:

the brakes and accelerators to increase or decrease heart rate

2. Intrinsic conduction system or nodal system

- causes the heart to depolarize in one direction (from atria to ventricle)

- enforces a contraction rate of 75 beats/min

• SA node starts each heartbeat and is known as the pacemaker.

Cardiac Cycle and Heart Sounds

• In a healthy heart the atria contract simultaneously• Systole – heart contraction• Diastole – heart relaxation

The Cardiac Cycle refers to:• The events of one complete heart beat during which

both atria and ventricles contract and then relax.

• The average heart beats 75 beats/min.• The cardiac cycle lasts for .8 sec.

Heart Sounds• When using a stethoscope, you can hear 2 distinct

sounds during each cardiac cycle. These heart sounds are often described as lub and dub.

• The first heart sound is made when: the AV valve closes - Lub

• The second heart sound is made when: the semilunar valves close at the end of systole - Dub

• The average heart rate is faster in females than males.• Females – 72-80 beats per minute• Males – 64-72 bpm

Cardiovascular System: Blood Vessels

• Blood circulates inside the blood vessels which is a closed transport system, the so called vascular system.

The Path of Blood:• Arteries carry blood away from the heart (oxygen)• Veins carry blood to the heart (no oxygen)• From the heart blood is propelled into: arteries

smaller arteries arterioles capillary beds venules veins great veins

Microscopic Anatomy of Blood Vessels

• The walls of blood vessels have 3 coats or tunics1. Tunica intima decreases friction

2. Tunica media changes diameter of blood vessels

3. Tunica externa function: support and protect blood vessels

• The walls of arteries are usually thicker than the walls of veins

• Artery walls must be strong and stretchy enough to take these continuous changes in pressure

• Veins have thinner walls because they do not have to take the pressure

• However, they are modified: to ensure the amount returning to the heart equals what is being pumped

Modifications1. Valves to prevent backflow

2. Muscles milk veins and move blood to the heart

3. Breathing also helps

Location of Arteries and Veins in the body

• Arteries are generally located in deep, well protected body areas.

• Many veins are more superficial and some are easily seen and palpated on the body surface.

• Most deep veins follow the course of the major arteries.

Hepatic Portal Vein• Delivers blood to the liver from the digestive organs

Fetal Circulation• Since the lungs and digestive system are not yet

functioning in a fetus, all nutrient, excretory and gas exchange occur through the placenta.

• Nutrients and oxygen move from the mother’s blood into the fetal blood and fetal wastes move in the opposite direction.

Physiology of Circulation• A good indication of the efficiency of a person’s

circulatory system can be obtained by taking arterial pulse and blood pressure.

• Vital Signs: arterial pulse, blood pressure, respiratory rate, body temperature

Arterial Pulse• Pulse: alternating expansion and recoiling of an artery

that occurs with each ventricular beat• Average pulse is a person at rest: 70-76 BPM

Pressure Points• Areas where you can feel your pulse• These points can also be compressed to stop blood

flow into distal tissue during hemorrhage

Blood Pressure• Pressure the blood exerts against the inner wall of the

blood vessels and it is the force that keeps the blood circulation

Blood Pressure Gradient• Blood flows along a pressure gradient (from high to

low)• If a vein is cut the blood flows evenly from the wound• If an artery is cut the blood comes out in rapid spurts

Measuring Blood Pressure• Because the heart alternately contracts and relaxes the

off-and-on flow of blood into the arteries causes the blood pressure to rise and fall during each beat.

There are two arterial blood pressure measurements that are usually made:

1. Systolic Pressure – pressure in the arteries at the peak of ventricular contraction (first number)

2. Diastolic Pressure – pressure when the ventricles are relaxing (second number)

• Blood pressure is reported in mmHg• Millimeters of mercury• Average 120/80 mmHg

Effects of Various Factors on BP

Peripheral Resistance• Amount of friction encountered by the blood as it

flows through blood vessels

1. Nervous System• Can cause vasoconstriction (narrowing of blood

vessels – pressure increases

2. Kidneys• Role in blood pressure is alternating blood volume

3. Temperature• Cold – vasoconstricting effect• Heat vasodilating effect

4. Chemicals• Epinephrine – increases heart rate and blood pressure• Nicotine – increase blood pressure by

vasoconstriction• Alcohol and Histamine – vasodilation – decreases

blood pressure

5. Diet• Hypertension (high blood pressure)• Prevented by a diet low in salt, saturated fat and

cholesterol

Variations in Blood Pressure• Normal adults systolic blood pressure varies between

110-140 mmHg• Normal adults diastolic blood pressure varies between

75-80 mmHg• Hypotension – low blood pressure• Hypertension – high blood pressure

Diseases of the Cardiovascular System

Coronary Artery Disease• When the supply of blood to the heart muscle is

restricted • Oxygen and nutrients cannot reach the muscle• Extent of the symptoms depends on the location,

severity and speed of onset

Artherosclerosis• Narrowing and stiffening of the arteries due to fatty

deposits (atheroma)• Begins with abnormally high levels of fats and

cholesterol in the blood• Begin to accumulate at areas of microscopic damage

• Fatty deposits accumulate and form plaques• Plaques narrow the space for blood to flow• Causes turbulence and blood flows over and makes

blood more likely to clot• Major risk factors – smoking, diet high in saturated

fats, lack of exercise and excess weight

Angina• Chest pain that comes on with exertion and relieved

with rest• Sign the heart muscle is not getting enough oxygen• Arterial narrowing from atherosclerosis causes

Heart Attack (Myocardial Infarction)• Area of cardiac muscle is deprived of blood due to a

blockage in the artery• Result of coronary artery disease due to

atherosclerosis and subsequent formation of a clot• Blood flow must be restored as fast as possible• Usually occurs suddenly with little or no warning

Angioplasty• Procedure to widen a section of artery• Carried out to treat severe angina or after a heart

attack

Structural Disorders

Congenital Heart Defects• Present from birth• May be due to a fault during early embryo development

Valve Disorders• Effect the efficient functioning of the heart valves• Two Main Types

1. Stenosis – valve outlet is too narrow and restricts blood flow – valve outlet is stiffened and cannot open fully

2. Incompetence – valve does not close fully, allowing backflow of blood

Heart Murmurs• Unusual heart sounds produced by turbulent blood

flow – may be due to a defect

Aneurysm• Abnormal swelling of a weakened arterial wall that

makes the wall bulge out like a balloon

Arrhythmia• Abnormal heart rate or rhythm that is caused by a

disturbance in the electrical system that controls the way a heart muscle contracts

• Can be slow, fast or erratic

Sinus Tachycardia• Regular but rapid heart rate more than 100 bmp• Fever, exercise, caffeine, great stress

Atrial Fibrillation• Extremely weak, disordered, weak contractions with a

rate as high as 500 BPM• Blockage at an AV node can cause

Ventricular Tachycardia• Very fast contractions by the ventricles• Can be caused by damaged heart muscle – heart

attack – impulses have trouble passing through the scarred heart muscle so they recirculate

The End