THE CARDIOVASCULAR SYSTEM
A closed system of the heart and blood vessels
The heart pumps blood
Blood vessels allow blood to circulate to all parts of the body
The function of the cardiovascular system is to deliver oxygen and nutrients and to remove carbon dioxide and other waste products.
The Heart
Location
Thorax between the lungs
Pointed apex directed toward left hip
About the size of your fist
Less than 1 lb
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THE CARDIOVASCULAR SYSTEM
The Heart contd..
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THE HEART: COVERINGS
Pericardium – a double serous membrane
Visceral pericardium
Next to heart
Parietal pericardium
Outside layer
Serous fluid fills the space between the layers of pericardium.
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THE HEART: HEART WALL
Three layers
Epicardium
Outside layer
This layer is the parietal pericardium
Connective tissue layer
Myocardium
Middle layer
Mostly cardiac muscle
Endocardium
Inner layer
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Endothelium
EXTERNAL HEART ANATOMY
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THE HEART: CHAMBERS
Right and left side act as separate pumps
Four chambers
Atria
Receiving chambers
Right atrium
Left atrium
Ventricles
Discharging chambers
Right ventricle
Left ventricle
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THE HEART: CHAMBERS
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THE HEART: VALVES
Allow blood to flow in only one direction
Four valves
Atrioventricular valves – between atria and ventricles
Bicuspid valve (left)
Tricuspid valve (right)
Semilunar valves between ventricle and artery
Pulmonary semilunar valve
Aortic semilunar valve
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THE HEART: VALVES
Valves open as blood is pumped through
Held in place by chordae tendineae (“heart strings”)
Close to prevent backflow.
Table 1: The heart valves
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OPERATION OF HEART VALVES
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VALVE PATHOLOGY
Incompetent valve = backflow and repump
Stenosis = stiff= heart workload increased
May be replaced
Lup Dub Heart Sound
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THE HEART: ASSOCIATED GREAT VESSELS
Aorta
Leaves left ventricle
Pulmonary arteries
Leave right ventricle
Vena cava
Enters right atrium
Pulmonary veins (four)
Enter left atrium
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CORONARY CIRCULATION
Blood in the heart chambers does not nourish the myocardium.
The heart has its own nourishing circulatory system.
Coronary arteries
Cardiac veins
Blood empties into the right atrium via the coronary sinus.
Cardiac Pathology
Rapid heart beat
= Inadequate blood
= Angina Pectoris
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THE HEART: CONDUCTION SYSTEM
Intrinsic conduction system (nodal system)
Heart muscle cells contract, without nerve impulses, in a regular, continuous way
Special tissue sets the pace
Sinoatrial node (right atrium)
Pacemaker
Atrioventricular node (junction of r&l atria and ventricles)
Atrioventricular bundle (Bundle of His)
Bundle branches (right and left)
Purkinje fibers
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HEART CONTRACTIONS
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THE HEART: CONDUCTION SYSTEM
Electrocardiograms (EKG/ECG)
Three formations
P wave: impulse across atria
QRS complex: spread of impulse down septum, around ventricles in Purkinje fibers
T wave: end of electrical activity in ventricles.
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THE HEART: CONDUCTION SYSTEM
Electrocardiograms (EKG/ECG) contd…
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THE HEART: CONDUCTION SYSTEM
Pathology of the Heart
Damage to AV node = release of ventricles from control = slower heart beat
Slower heart beat can lead to fibrillation
Fibrillation = lack of blood flow to the heart
Tachycardia = more than 100 beats/min
Bradychardia = less than 60 beats/min
The Heart: Cardiac Cycle
Atria contract simultaneously
Atria relax, then ventricles contract
Systole = contraction
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Diastole = relaxation
FILLING OF HEART CHAMBERS – THE CARDIAC CYCLE
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THE HEART: CARDIAC OUTPUT
Cardiac output (CO)
Amount of blood pumped by each side of the heart in one minute
CO = (heart rate [HR]) x (stroke volume [SV])
Stroke volume
Volume of blood pumped by each ventricle in one contraction
CO = HR x SV
5250 ml/min = 75 beats/min x 70 mls/beat
Norm = 5000 ml/min
Entire blood supply passes through body once per minute.
CO varies with demands of the body.
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THE HEART: CARDIAC OUTPUT
Cardiac Output Regulation
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