CARDIOVASCULAR SYSTEM

.
ANATOMY OF HEART:
Location of Heart:
• The heart is roughly the same size as ones closed fist.
• About 12 cm long, 9 cm wide at its broadest point,
and 6 cm thick.
• Average mass of heart is 250 g in adult females and
300 g in adult males.
• Rests on the diaphragm, near the midline of the
thoracic cavity.
• Lies in the mediastinum (an anatomical region that
extends from the sternum to the vertebral column,
the first rib to the diaphragm, and between the
lungs).
Apex:
• The pointed apex is formed by the tip of the
left ventricle (a lower chamber of the heart)
and rests on the diaphragm.
• It is directed anteriorly, inferiorly, and to the
left.
Base:
• The base of the heart is its posterior surface.
• It is formed by the atria (upper chambers) of
the heart, mostly the left atrium
Surfaces and Borders of Heart:
• The anterior surface is deep to the sternum
and ribs.
• The inferior surface is the part of the heart
between the apex and right border and rests
mostly on the diaphragm.
• The right border faces the right lung and
extends from the inferior surface to the base.
• The left border, also called the pulmonary
border, faces the left lung and extends from
the base to the apex.
 :Pericardium:
• The membrane that surrounds and
protects the heart.

Parts of Pericardium:

(1) Fibrous pericardium

(2) Serous pericardium
1. Fibrous pericardium:
• The superficial fibrous pericardium is composed
of tough, inelastic, dense irregular connective
tissue.
• The fibrous pericardium prevents overstretching
of the heart, provides protection, and anchors
the heart in the mediastinum.
2. Serous pericardium:
The deeper serous pericardium is a thinner
membrane forming a double layer around the
heart.
-----The outer parietal layer of the serous
pericardium is fused to the fibrous pericardium.
-----The inner visceral layer of the serous
pericardium, also called the epicardium, is one
of the layers of the heart wall and adheres
tightly to the surface of the heart.
Pericardial fluid:
Between the parietal and visceral layers of
the serous pericardium is a slippery secretion
of the pericardial cells, known as pericardial
fluid that reduces friction between the layers
of the serous pericardium as the heart
moves.
Pericardial cavity:
The space that contains the few milliliters of
pericardial fluid is called the pericardial
cavity.
 :Layers of the heart wall:

The wall of the heart consists of three layers:

1. Epicardium (external layer)
2. Myocardium (middle layer)
3. Endocardium (inner layer)
1. Epicardium:
• The outermost epicardium, the thin,
transparent outer layer of the heart wall, is
also called the visceral layer of the serous
pericardium.
• It is composed of mesothelium and
delicate connective tissue that imparts a
smooth, slippery texture to the outermost
surface of the heart.
2. Myocardium:
• The middle myocardium, which is cardiac
muscle tissue, makes up about 95% of the
heart and is responsible for its pumping
action.
• The cardiac muscle fibers swirl diagonally
around the heart in bundles.
3. Endocardium:
• The innermost endocardium is a thin layer
of endothelium overlying a thin layer of
connective tissue.
• It provides a smooth lining for the chambers
of the heart and covers the valves of the
heart.
• The endocardium is continuous with the
endothelial lining of the large blood vessels
attached to the heart, and it minimizes
surface friction as blood passes through the
heart and blood vessels.
 :Chambers of the heart:

The heart has four chambers i.e:

1. Right atrium
2. Right ventricle
3. Left atrium
4. Left ventricle
Auricle:
• On the anterior surface of each atrium is a
wrinkled pouch like structure called an
auricle.
• Each auricle slightly increases the capacity of
an atrium so that it can hold a greater volume
of blood.
Sulci:
• A series of grooves on the surface of the
heart, that contain coronary blood vessels
and a variable amount of fat.
• Each sulcus marks the external boundary
between two chambers of the heart.
❖ Coronary sulcus:
• The deep coronary sulcus encircles most of
the heart and marks the external boundary
between the superior atria and inferior
ventricles.
❖ Anterior interventricular sulcus:
A shallow groove on the anterior surface of the
heart that marks the external boundary between the
right and left ventricles.
❖ Posterior interventricular sulcus:
This sulcus continues around to the posterior
surface of the heart as the posterior interventricular
sulcus, which marks the external boundary between
the ventricles on the posterior aspect of the heart.
1. Right Atrium:
• Forms the right border of the heart.
• The right atrium is about 2–3 mm in
average thickness.
• Receives blood from three veins: i.e
✔ superior vena cava,
✔ inferior vena cava
✔ coronary sinus.
• The posterior wall of the right atrium is
smooth; the anterior wall is rough due to
the presence of muscular ridges called
pectinate muscles, which also extend into
the auricle.
• Between the right atrium and left atrium
is a thin partition called the interatrial
septum.
A prominent feature of this septum is an
oval depression called the fossa ovalis,
the remnant of the foramen ovale, an
opening in the interatrial septum of the
fetal heart that normally closes soon
after birth.
• Blood passes from the right atrium into the
right ventricle through a valve that is called the
tricuspid valve because it consists of three
leaflets or cusps.
• It is also called the right atrioventricular valve.
• The valves of the heart are composed of dense
connective tissue covered by endocardium.
 2. Right ventricle:
•About 4–5 mm in average thickness.
•The inside of the right ventricle contains
a series of ridges formed by raised
bundles of cardiac muscle fibers called
trabeculae carneae.
• Some of the trabeculae carneae convey
part of the conduction system of the
heart
• The cusps of the tricuspid valve are connected to
tendonlike cords, the chordae tendineae, which in
turn are connected to coneshaped trabeculae
carneae called papillary muscles.
• The right ventricle is separated from the left
ventricle by a partition called the interventricular
septum.
• Blood passes from the right ventricle
through the pulmonary valve (pulmonary
semilunar valve) into a large artery called
the pulmonary trunk, which divides into
right and left pulmonary arteries.
 3. Left Atrium:
• About the same thickness as the right atrium.
• Forms most of the base of the heart.
• Receives blood from the lungs through four
pulmonary veins.
• Has a smooth posterior wall like right atrium.
• Blood passes from the left atrium into the left
ventricle through the bicuspid (mitral) valve
having two cusps.
• It is also called the left atrioventricular valve.
 4. Left Ventricle:
• Thickest chamber of the heart, averaging
10–15 mm.
• Forms the apex of the heart.
• Like the right ventricle, the left ventricle
contains trabeculae carneae and has
chordae tendinae that anchor the cusps of
the bicuspid valve to papillary muscles.
• Blood passes from the left ventricle through
the aortic valve (aortic semilunar valve) into
the ascending aorta.
• Some of the blood in the aorta flows into the
coronary arteries, which branch from the
ascending aorta and carry blood to the heart
wall.
• The remainder of the blood passes into the
arch of the aorta and descending aorta
(thoracic aorta and abdominal aorta). Branches
of the arch of the aorta and descending aorta
carry blood throughout the body.
• During fetal life, a temporary blood vessel,
called the ductus arteriosus, shunts blood
from the pulmonary trunk into the aorta.
Hence, only a small amount of blood
enters the nonfunctioning fetal lungs.
• The ductus arteriosus normally closes
shortly after birth, leaving a remnant
known as the ligamentum arteriosum,
which connects the arch of the aorta and
pulmonary trunk.
PATHWAY OF BLOOD THROUGH THE HEART:

• Blood (deoxygenated) coming from body

regions superior to the diaphragm (excluding
the heart wall) enters the right atrium via the
superior vena cava (SVC).
• Blood returning from body regions inferior to
the diaphragm enters via the inferior vena
cava (IVC).
• Blood draining from the heart wall itself is
collected by and enters through the coronary
sinus.
• The blood passes from the right atrium
through the tricuspid valve to the right
ventricle, propelled by gravity and the
contraction of the right atrium.
• Then, the right ventricle contracts,
propelling the blood through the
pulmonary semilunar valve into the
pulmonary trunk and to the lungs
through the pulmonary circuit for
oxygenation.
• The freshly oxygenated blood returns via
the four pulmonary veins to the left atrium
and passes through the mitral valve to the
left ventricle, propelled by gravity and the
contraction of the left atrium.
• The left ventricle then contracts and propels
the blood through the aortic semilunar valve
into the aorta and its branches.
• After delivering oxygen and nutrients to the
body tissues through the systemic capillaries,
the oxygen-poor blood returns through the
systemic veins to the right atrium and the
whole cycle repeats continuously.
 :BLOOD SUPPLY TO THE HEART:

• Although the heart is filled with blood, the heart

walls are too thick to obtain much nutrition by
diffusion from this contained blood.
• Instead, blood supply to the muscular walls and
tissues of the heart is delivered by:
✔ The right coronary artery
✔The left coronary artery
• These systemic arteries arise from the base of the
aorta and run in the coronary sulcus.
 1. Left coronary artery: The left coronary artery
arises from the left side of the aorta, passes
posterior to the pulmonary trunk, then divides
into two branches:
✔anterior interventricular artery
✔circumflex artery
❖ The anterior interventricular artery
descends in the anterior interventricular
sulcus toward the apex of the heart, sending
branches into the interventricular septum and
onto the anterior walls of both ventricles.
❖ The circumflex artery follows the coronary
sulcus posteriorly and supplies the left atrium
and the posterior part of the left ventricle.
 2. Right coronary artery:
• The right coronary artery emerges from
the right side of the aorta and descends in
the coronary sulcus on the anterior surface
of the heart, between the right atrium and
right ventricle.
• At the inferior border of the heart, it
branches to form the marginal artery.
• Continuing into the posterior part of the
coronary sulcus, the right coronary
artery gives off a large branch called the
posterior interventricular artery in the
posterior interventricular sulcus
• Cardiac veins, which carry deoxygenated
blood from the heart wall into the right
atrium, also occupy the sulci on the heart
surface.
• The largest of these veins, the coronary
sinus, occupies the posterior part of the
coronary sulcus and returns almost all the
venous blood from the heart to the right
atrium.
 Three large tributaries drain into the
coronary sinus:
✔ The great cardiac vein in the anterior
interventricular sulcus.
✔The middle cardiac vein in the posterior
interventricular sulcus.
✔The small cardiac vein running along the
heart’s inferior right margin.
• The anterior surface of the right ventricle
contains several horizontal anterior cardiac
veins that empty directly into the right
atrium.
STRUCTURE OF BLOOD VESSEL WALLS:
The walls of all blood vessels, except the very
smallest, are composed of three distinct
layers, or tunics.

tunica intima
tunica media
tunica externa
1. Tunica intima:
• The innermost tunic of a vessel wall
which is in “intimate” contact with the
blood in the lumen.
• This tunic contains the endothelium,
the simple squamous epithelium that
lines the lumen of all vessels. The flat
endothelial cells form a smooth surface
that minimizes the friction of blood
moving across them.
In vessels larger than about 1 mm in
diameter, a thin layer of loose connective
tissue, the subendothelial layer, lies just
external to the endothelium.
 2. Tunica media:
• Also called middle tunic, consists primarily of
circularly arranged sheets of smooth muscle
fibers, between which lie circular sheets of
elastin and collagen fibrils.
• Contraction of the smooth muscle cells
decreases the diameter of the vessel, a
process called vasoconstriction. Relaxation of
the smooth muscle cells, a process called
vasodilation, increases the vessel’s diameter.
• The elastin and collagen contribute elasticity
and strength for resisting the blood pressure
that each heartbeat exerts on the vessel
wall.
• In arteries, which function to maintain blood
pressure, the tunica media is the
thickest layer.
 3. Tunica externa:
• The outermost layer of the vessel wall,
also called tunica adventitia.
• Made up of a layer of connective tissue
that contains many collagen and elastic
fibers.
• The tunica externa protects the vessel,
further strengthens its wall, and anchors
the vessel to surrounding structures.
TYPES OF BLOOD VESSELS:

Arteries
Capillaries
Veins
ARTERIES:

• Arteries are vessels that carry blood away

from the heart.
• The passage of blood through the arteries
proceeds from elastic arteries, to muscular
arteries, to arterioles.
 1. Elastic Arteries:
• The largest arteries near the heart—the aorta and
its major branches with diameters ranging from
2.5 cm to 1 cm.
• The elastic arteries are sometimes called
conducting arteries because these large arteries
conduct blood between the heart and the medium
sized muscular
arteries.
• More elastin occurs in the walls of these
arteries that dampens the surges of blood
pressure resulting from the rhythmic
contractions
of the heart.
• When the heart forces blood into the
arteries, the elastic elements in these
vessels expand in response to increased
blood pressure.
• When the heart relaxes, the elastic
elements recoil, propelling the blood
onward.
 2. Muscular Arteries:
• Also called distributing arteries lie distal to
the elastic arteries and supply groups of
organs, individual organs, and parts of organs.
• They range in diameter from about 1 cm to 0.3
mm.
• They are called “muscular” because their
tunica media is thicker.
• By actively changing the diameter of the
artery, this muscular layer regulates the
amount of blood flowing to the organ
supplied according to the specific needs of
that organ.
• Concentric sheets of elastin occur within
the tunica media of muscular arteries but
less abundant and less thick as compared to
elastic fibres.
• A unique feature of muscular arteries is
that thick sheets of elastin lie on each
side of the smooth muscle of the tunica
media:
------A wavy internal elastic membrane
forms the outer layer of the tunica intima.
------ And an external elastic membrane
forms the outer layer of the tunica media.
• The elastin help withstand the pressure
of blood in vessels.
 3. Arterioles:
• Arterioles are the smallest arteries, with
diameters ranging from about 0.3 mm to 10 μm.
• Their tunica media contains only one or two
layers of smooth muscle cells.
• Larger arterioles have all three tunics plus
an internal elastic network in the tunica
intima.
• Smaller arterioles, which lead into the
capillary beds, are little more than a single
layer of smooth muscle cells spiraling
around an underlying endothelium.
 3. Capillaries:
• Are the smallest blood vessels, with a diameter
of 8–10 μm.
• Composed of only a single layer of endothelial
cells surrounded by a basement membrane.
•Capillaries deliver to the interstitial fluid /
tissue fluid, the oxygen and nutrients cells
need, and they remove the carbondioxide
and nitrogenous wastes that cells deposit
into this fluid.
• In the lungs, oxygen enters the blood (and
carbon dioxide leaves it) through capillaries.
• Capillaries in the small intestine receive
digested nutrients.
• Capillaries in the endocrine glands pick up
hormones.
• Capillaries in the kidneys remove nitrogenous
wastes from the body.