CARDIOVASCULAR SYSTEM

Introduction to cardiovascular system

The cardiovascular system is made up of two sections connected to each other; the “cardio” and the
vascular.

“Cardio” referring to the heart, and “vascular” referring to the network of blood vessels.

The heart pumps blood and circulate all through the blood vessels, while the blood vessels are
network of vessels of different sizes through which blood flows.

THE HEART

Introduction

The heart is the organ that pumps blood to every part of the human body. The heart beats
around 100,000 times a day, pumping approximately 5 liters of blood throughout the body (British
Heart Foundation, 2024).. The pumping action ensures constant circulation of blood and this action
starts from human development at 4 weeks old (a month). This delivers oxygen and nutrient-rich
blood to tissues and organs and carries away waste products.

Learning Objectives

At the end of the teaching, the student should be able to:

1. Define the heart

2. Draw and label the diagram of the heart showing the structure and blood flow through the
heart
3. Describe the structure of the heart
4. Describe the blood flow through the heart
5. Draw and label the Conducting system of the heart
6. Describe the Cardiac Cycle using a diagram
General Learning Point on Description of an Organ in Anatomy

In description of an organ in Anatomy, you are expected to write on the following sub
headings and more depending on the organ:

 Definition of the organ

 Position
 Size
 Weight
 Shape
 Colour
 Organs in relation or association
 Gross structure
 Microscopic Structure
 Blood supply
 Nerve supply

Description of the Heart

Definition of the Heart – The heart is a hollow muscular organ. It works like a pump sending
blood around the body. It collects deoxygenated blood from all parts of the body, carries it
to the lungs for oxygenated and releases carbon dioxide through the respiratory tract. Then, it
transports the oxygenated blood from the lungs and distributes it to all the body parts.
An adult heart beats about 60 to 80 times per minute and 100,000 times per day (Scallon &
Sanders, 2020).

Position – It is situated in the thoracic cavity, in the media-sternum

It is slightly tilted to the left of center of the thoracic cage.
The apex is 9cm to the left of the midline at the level of the fifth intercostals space.
The base extends to the level of the second rib

Size - about the size of the owner’s closed fist.

Shape– Cone shape

Weight – Average of about 225g in women and is heavier in men about 310g
Organs in relation –
Inferiorly – The apex rest on central tendon of the diaphragm
Superiorly – The great blood vessels – Superior vena cava, aorta, pulmonary artery and pulmonary
veins
Anteriorly – The sternum, ribs and intercostals muscles
Posteriorly – The oesophagus, trachea, left and right bronchus, descending airta, inferior vena cava
and thoracic vertebrae
Laterally – The lungs (Ross & Wilson, 2014).

GROSS STRUCTURE OF THE HEART

Walls/Layers of the heart - The heart wall consists of three layers enveloped by the layer called
Epicardium.

1. Pericardium - the outermost layer of the heart. It is made up of two sacs.

First, the outer sac of fibrous tissue and an inner layer of a double serous membrane.
2. Myocardium - the muscular middle layer of the wall of the heart and has excitable
tissue that aids the conducting system.
3. Endocardium – This layer lines the chambers and the valves of the heart. It is a thin,
smooth, glistening membrane that helps smooth flow of blood within the heart.

INTERIOR OF THE HEART –

 Chambers of the heart

 Valves of the heart
 Cordae tendineae
 Papillary muscles

Chambers of the Heart

The heart is subdivided into right and left halves by a septum. After birth, blood cannot cross
the septum from one side of the heart to another.
Each half is further divided into the upper cavity called the atrium, the lower the ventricle
by a constriction band. The heart therefore consists of four chambers:
 right atrium
 right ventricle
 left atrium
 left ventricle

The Valves of the Heart

The valves of the heart maintain one-directional flow of the blood and prevent the back flow
in the opposite direction. There are four valves in the heart, a pair of atrioventricular valves
and a pair of semilunar valves.
- Atrioventricular Valves
 1. Tricuspid valve (Right side of the heart)
2. Mitral valve/Bicuspid valve (Left side of the heart)
- Semilunar valves which are located in the outflow tracts of the ventricles
1. Pulmonary valve (Right side of the heart)
2. Aortic valve (Left side the heart).
The valves are prevented from opening upward into the atria by tendinous cords, called
chordae tendineae, which extend from the inferior surface of the cusps to little projections of
myocardium into the ventricles, covered with endothelium, called papillary muscles.

Cordae tendineae – These are strong, fibrous connections between the valves and the papillary
muscle. It prevents the valves from opening upwards into the atria

Papillary muscle – These are projections of the myocardium into the ventricles that gives support
to the cordae tendanea.

Blood Supply to the heart

The coronary arteries provide the main blood supply to the heart. The coronary arteries also
supply the myocardium with oxygen to allow for the contraction of the heart and thus causing
circulation of the blood throughout the body.

Venous Drainage
Just like the coronary arteries, there are coronary veins that drain the myocardium of deoxygenated
blood.
Nervous Supply - The nervous supply is through sympathetic and parasympathetic nerves.
Functions of the Heart
The heart is the most crucial organ of the circulatory system.
 It is predominantly responsible for pumping blood to all parts of the body.
 The valves of the heart ensure one way flow of blood to all parts of the body.
 Circulates nutrients to all parts of the body.
 Pumps deoxygenated blood to the lungs for purification.
 The pumping action helps in circulating hormones to necessary organs.
 The rate and force of contractions changes to meet the metabolic needs of the tissues, which
vary depending on conditions such as rest, exercise and changes in body position.
THE STRUCTURE OF THE HEART
THE FLOW OF BLOOD THROUGH THE HEART

Learning Objectives
The students should understand that there are two pathways of blood flow

 Blood flow to the lungs and back to the heart (Pulmonary Circulation)

 Blood flow to the whole body (Systemic Circulation)

Blood flow to the lungs and back to the heart (Pulmonary Circulation)

 Deoxygenated blood first enters the right atrium from the superior and inferior vena cava.
 It then flows through the right atrioventricular valve (tricuspid valve) into the right
ventricle.
 The blood then moves through the pulmonary valve into the pulmonary artery (the only
artery that carries deoxygenated blood).
 The pulmonary artery divides into two right pulmonary arteries, and two left pulmonary
arteries, and carries the deoxygenated blood to the right and left lungs where it takes up
oxygen.
 Oxygenated blood returns to the heart through two right and two left pulmonary veins (the
only veins carrying oxygenated blood) into the left atrium.
 From the left atrium the blood then moved through the left atrioventricular vave (bicuspid
or mitral valve) into the left ventricle.
 The left ventricle then pumps the oxygenated blood through the aortic valve into the aorta.
 From the aorta, the blood is transported through the network of blood vessels, delivering
oxygen and nutrients to tissues
 The veins take carbon dioxide and wastes from tissues (deoxygenated blood)
 The deoxygenated blood returns to the heart via the superior and inferior vena cava, and
the cycle begins again.
Note - From this sequence of events, it can be seen that blood passes from the right side of the heart
through the lungs (pulmonary circulation). However, it should be noted that both atria contract at
the same time and this is followed by simultaneous contraction of both vehicles.
THE FLOW OF BLOOD THROUGH THE HEART
THE CIRCULATION OF BLOOD THROUGH THE SYSTEMIC AND PULMONARY
SYSTEM

PULMONARY AND SYSTEMIC CIRCULATION

SYSTEMIC OR GENERAL CIRCULATION

The systemic circulation is the flow of oxygenated blood from the left ventricle to all the body
tissues, and the flow of venous or deoxygenated blood from the body tissues back to the right
atrium of the heart through the superior and the inferior vena cavae.

The oxygenated blood leaves the left ventricle of the heart flowing through the ascending aorta
to the arch of the aorta. Arising from the arch of the aorta are three arteries called the left
Subclavian artery, the left Common Carotid artery and the Brachio-cephalic artery. The Brachio-
cehalic artery divides to form the right common carotid artery and the right subclavian artery.

The right and left subclavian arteries supply oxygenated blood to right and left upper limbs while
the right and left common carotid arteries supply oxygenated blood to the neck and head. The
remaining part of the oxygenated blood in the arch of the aorta flows down through the descending
aorta into the Thoracic aorta to supply oxygenated blood to the walls of the thoracic cavity and the
organs within the thoracic cavity. The Thoracic aorta passes through the Aortic opening of the
diaphragm to enter the abdominal aorta.

The Abdominal aorta gives off branches and supply oxygenated blood to all the abdominal walls
and abdominal organs. At the level of the 4th Lumbar vertebra, the abdominal aorta divides into the
right and left common iliac arteries. Each Common iliac artery divides into the right and left
external and internal iliac arteries. The right and left internal iliac arteries supply oxygenated blood
to the organs within the pelvis including the reproductive organs. The right and left external iliac
arteries supply oxygenated to the right and left lower limbs.

The deoxygenated blood or venous blood from the head, neck, upper limbs flow finally the
superior vena cava into the right atrium, while the deoxygenated blood from the lower limbs, pelvic
region and abdominal organs flows through the inferior to the right atrium and later into the right
ventricle of the heart.
THE SYSTEMIC OR GENERAL CIRCULATION (ARTERIAL BLOOD FLOW)
VENUOUS BLOOD FLOW
THE PORTAL CIRCULATION

This is the circulation of blood rich in oxygen and food nutrients from the organs of the digestive
tract and the spleen through the hepatic artery and the portal vein to the liver and later through the
hepatic veins and the inferior vena cava to the right atrium of the heart.

The oxygenated blood from the abdominal aorta flows through the hepatic artery to the liver.

The blood that is rich in food nutrients also leaves the organs along the digestive tract and the
spleen through the portal vein to the liver.

When these two blood vessels enter the liver, they subdivide until they form the sinusoids within
the liver. Metabolism of food nutrients including their regular supplies to other parts of the body
takes place within the liver.

The deoxygenated blood leaves the liver through the hepatic veins into the inferior vena cava which
finally empties this blood into the right atrium of the heart.
PORTAL CIRCULATION
 Portal Circulation

Reading Materials

Ross & Wilson (2014). Anatomy and Physiology for Health and Illness, 14th Edition

Scallon & Sanders (2020). Essentials of Anatomy and Physiology, 5th Edition, Davis company
Philadelphia