Cardiovascular
System
Heart’s Functions
• Generating blood pressure
• Routing blood
• Ensuring one-way blood flow
• Regulating blood supply
Heart
• shaped like a blunt cone and is
approximately the size of a closed fist*
• located in the thoracic cavity between
the two pleural cavities**
• surrounded by a pericardial cavity
formed by the pericardium or
pericardial sac***
• fibrous pericardium (tough, fibrous
connective tissue outer layer); serous
pericardium (inner layer of flat
epithelial cells with a thin layer of
connective tissue)*
Heart Layers and Borders
• three layers of heart walls
- epicardium: outer layer
(visceral serous pericardium)
- myocardium: middle layer; the
thickest and composed mostly of
cardiac muscle*
- endocardium: inner layer;
made of simple squamous
epithelium; covers the heart
valves and continuous with the
inner lining of the great vessels
• borders: right edge of the
sternum to left midclavicular line
(horizontal); 2nd to 5th
intercostal spaces (vertical)
Heart Chambers and Valves
Heart Chambers and Valves
Blood Flow through the Heart
Pulmonary and Systemic Circulations
Cardiac Circulation
• two coronary arteries that originate from the
base of the aorta just above the aortic semilunar
valves supply blood to the wall of the heart
• left coronary artery
- branches: anterior interventricular arteries,
circumflex artery and left marginal artery
- supplies the anterior ventricular walls and the
laterodorsal part of the left side of the heart
• right coronary artery
- branches: posterior interventricular artery and
right marginal artery
- supplies the posterior surface of the ventricles
and the lateral aspect of the right side of the
heart
• the myocardium is drained by several cardiac
veins which empty into the coronary sinus* then
into right atrium**
Action Potentials in Cardiac Muscle
• Depolarization phase
- Na channels open
- K channels close
- Ca channels begin to open
• Early repolarization and plateau
phases
- Na channels close
- some K channels open, causing
early repolarization
- Ca channels are open,
producing the plateau by slowing
further repolarization
• Final repolarization phase
- Ca channels close
- many K channels open
Conduction System
• the conduction system of the heart is
made up of specialized cardiac muscle
cells*
• the sinoatrial (SA) node produces action
potentials that are propagated over the
atria to the atrioventricular (AV) node
• the AV node and AV bundle conduct
action potentials to the ventricles
• the right and left bundle branches
conduct action potentials from the AV
bundle through Purkinje fibers to the
ventricular muscle
• an ectopic beat results from an action
potential that originates in an area of the
heart other than SA node
Electrocardiogram
• the ECG is a record of electrical
events within the heart
• the ECG can be used to detect
abnormal heart rates or
rhythms, conduction pathways,
hyperthrophy or atrophy of the
heart, and the approximate
location of damaged cardiac
muscle
• the normal ECG consists of P
wave, a QRS complex and a T
wave
Cardiac Cycle
• refers to the repetitive pumping process that begins with the
onset of cardiac muscle contraction and ends with the
beginning of the next contraction*
• atrial systole refers to contraction of two atria; ventricular
systole refers to the contraction of the two ventricles; atrial
diastole refers to the relaxation of the two atria and
ventricular diastole refers to the relaxation of the two
ventricles
• cardiac muscle contraction results to pressure changes
within the heart that are responsible for blood movement
Heart Sounds
• first heart sound (lubb) results from the
closure of the AV valves at the
beginning of systole
• second heart sound (dupp) results from
the closure of the semilunar valves at
the end of systole
• murmurs are abnormal heart sounds
and result from incompetent (leaky)
valves or stenosed (narrowed) valves
Intrinsic Regulation of the Heart
• refers to the regulation that is contained in the heart
• Preload: the degree to which the ventricular walls are
stretched at the end of diastole
• Starling’s law of the heart: the relationship between
preload and stroke volume*
• Afterload: pressure against which the ventricles must
pump blood
Extrinsic Regulation of the Heart
• refers to the nervous and hormonal mechanisms
• sympathetic stimulation increases stroke volume and heart rate;
parasympathetic stimulation decreases heart rate
• baroreceptor* reflex detects changes in blood pressure and causes a
decrease in heart rate and stroke volume in response to a sudden increase
in blood pressure or an increase in heart rate and stroke volume in
response to sudden decrease in blood pressure
• emotions influence heart function by increasing sympathetic stimulation of
the heart in response to exercise, excitement, anxiety or anger and by
increasing parasympathetic stimulation in response to depression
• alterations in body fluid levels of carbon dioxide, pH and ion concentrations,
as well as changes in body temperature, influence heart function**
Blood Vessels
and Circulation
General Features
1. Blood is pumped from the heart
through elastic arteries, muscular
arteries and arterioles to
capillaries.
2. Blood returns to the heart from the
capillaries through venules, small
veins and large veins.
3. Except for capillaries and venules,
blood vessels have three layers
a. tunica intima: consists of
endothelium, basement membrane
and connective tissue
b. tunica media: contains circular
smooth muscle and elastic fibers
c. tunica adventitia: connective tissue
Arteries
1. Large elastic arteries have
many elastic fibers but little
smooth muscles in their walls*
2. Muscular arteries have much
smooth muscle and some
elastic fibers and undergo
vasodilation and
vasoconstriction**
3. Arterioles are the smallest
arteries and have smooth
muscles and few elastic fibers
and undergo vasodilation and
vasoconstriction *
Capillaries
1. consist of only endothelium
and are surrounded by a
basement membrane and
loose connective tissue
2. nutrient and waste product
exchange is the principal
function
3. blood is supplied to capillaries
by arterioles; precapillary
sphincters regulate blood flow
through capillary networks
Veins
1. venules are endothelium
surrounded by a basement
membrane
2. small veins are venules covered
with a layer of smooth muscle
and a layer of connective tissue
3. medium-sized and large veins
contain less smooth muscle and
elastic fibers of the same size
4. valves prevent the backflow of
blood in the veins
Blood Vessels of the Pulmonary Circulation
• Pulmonary circulation
moves blood to and
from the lungs
• Pulmonary trunk carries
oxygen-poor blood from
the heart to the lungs
• Pulmonary veins carry
oxygen-rich blood from
the lungs to the left
atrium of the heart
Blood Vessels of the Systemic Circulation: Arteries
• Aorta
- leaves the LV to form the
ascending aorta, aortic arch and
descending aorta, which consists of
the thoracic and abdominal aorta*
• Arteries of the Head and Neck
- the brachiocephalic, left common
carotid and left subclavian arteries
branch from the aortic arch supply
the head and the upper limbs
- the common carotid arteries and
vertebral arteries supply the head;
the common carotid arteries divide
to form the external carotids (supply
the face and mouth) and the internal
carotids (supply the brain)
Blood Vessels of the Systemic Circulation: Arteries
• Arteries of the Upper Limbs
- the subclavian artery continues as the
axillary artery and then as the brachial
artery, which branches to form the
radial and ulnar arteries
• The Thoracic Aorta and Its Branches
- the thoracic aorta has visceral
branches, which supply the thoracic
organs* and parietal branches which
supply the thoracic wall**
• The Abdominal Aorta and Its
Branches
- the abdominal aorta has visceral
branches, which supply the abdominal
organs*** and parietal branches who
supply the abdominal wall*
Blood Vessels of the Systemic Circulation: Arteries
• Arteries of the Pelvis
- the common iliac arteries
supply the pelvis
• Arteries of the Lower
Limbs
- the common iliac arteries
give rise to the external iliac
arteries and the external iliac
artery continues as the
femoral artery and then as
the popliteal artery in the
leg; the popliteal artery
divides to form the anterior
and posterior tibial arteries
Blood Vessels of the Systemic Circulation: Veins
• The superior vena cava drains the head, neck,
thorax and upper limbs; the inferior vena cava
drains the abdomen, pelvis and lower limbs
• Veins of the Head and Neck
- right and left brachiocephalic veins drain the head,
neck and upper extremities and unite to form the
superior vena cava
- internal jugular veins drain the dural sinuses of the
brain and receive blood from the head and neck
- vertebral veins drain the posterior aspect of the
head and neck
- subclavian veins receive venous blood from the
upper limb
- external jugular vein, returning venous drainage of
the extracranial tissues of the head and neck joins
the subclavian vein near its origin
• Veins of the Upper Limbs
- the deep veins are the brachial, axillary and
subclavian; the superficial veins are the basilic,
cephalic and median cubital
Blood Vessels of the Systemic Circulation: Veins
• Veins of the Thorax
- the left and right brachiocephalic
veins and the azygos veins return
blood to the superior vena cava*
• Veins of the Abdomen and Pelvis
- posterior abdominal wall veins join
the azygos veins
- veins from the kidneys, adrenal
glands and gonads directly enter the
inferior vena cava
- veins from the stomach, intestines,
spleen and pancreas connect with
the hepatic portal vein which
transports blood to the liver for
processing; the hepatic veins from
the liver join the inferior vena cava
Blood Vessels of the Systemic Circulation: Veins
• Veins of the Lower Limbs
- anterior and posterior tibial veins serve
the calf and foot
- the anterior tibial vein is a continuation
of the dorsalis pedis vein of the foot
- the posterior tibial vein is formed by the
union of the medial and lateral plantar
veins and ascends deep in the calf
muscles; joins with the fibular vein at the
knee to produce the popliteal vein, which
crosses the back of the knee
- the popliteal vein becomes the femoral
vein in the thigh which in turn becomes
the external iliac vein in the inguinal
region
- the great saphenous vein, a superficial
vein is the longest vein in the body
Fetal Circulation
• fetal blood travels through the
umbilical cord (umbilical vein and
umbilical arteries)*
• oxygenated blood flows superiorly
toward the fetal heart, some
perfuse the liver but most are
shunted through the immature liver
to the IVC via the ductus venosus -
carries blood to the RA of the heart
• some of the blood entering the RA
move into the LA through the
foramen ovale**
• blood that does not enter the RV
and is pumped out of the
pulmonary trunk encounters a
second shunt, the ductus
arteriosus***
Portal Circulation
• the blood in the hepatic portal
system has been drained from the
digestive tract organs
• the liver processes and stores
some of the various nutrients
before they are released into
general circulation
• the hepatic portal vein is formed by
the union of the splenic vein, which
drains the spleen, pancreas,
stomach and the large intestine via
the inferior mesenteric vein
• superior mesenteric vein drains the
small intestine and proximal colon
• the large gastric vein drains the
lesser curvature of the stomach
and empties directly into the
hepatic portal vein
Arterial Supply of the Brain
and the Cerebral Arterial Circle*
• the brain is supplied by internal
carotid arteries and the vertebral
arteries
• internal carotid arteries divide into
anterior and middle cerebral
arteries
• internal carotid arteries contribute
to the cerebral arterial circle by
helping to form a posterior
communicating artery on each
side
• the circle is completed by the
anterior communicating artery
• vertebral arteries unite to form
the single basilar artery
• posterior cerebral arteries supply
the posterior part of the cerebrum
Blood Pressure
