Cardiovascular system

DR K S RATHORE
Cardiovascular system
 Introduction
• Cardiovascular system includes heart and blood
vessels.
• Heart pumps blood into the blood vessels. Blood vessels
circulate the blood throughout the body.
• Blood transports nutrients and oxygen to the tissues and
removes carbon dioxide and waste products from the
tissues.
 Cardiovascular system of mammals

Systemic circulation
General Plan
Pulmonary circulation

RV RA
LV LA

System of vessels that carry blood

The force for movement of blood is provided by heart
Two major loops of flow : systemic circulation and pulmonary circulation

Components • 4 chambered heart

• Arteries
• Capillaries
• Veins
 Morphology of heart

• The average adult human heart is about 12 cm from base to

apex, 8 – 9 cm wide at its broadest transverse diameter and
6 cm anteroposterior.

• The weight of the heart is about 300 g in males and 250 g in

females
• Double layered pericardial layer containing fluid allow
contractile motion of the heart without friction
• The atrium myocardium is electrically separate from the
ventricular myocardium by fibrous tissue
 HEART

• Heart is a muscular organ that pumps blood throughout

the circulatory system.
• It is situated in between two lungs in the mediastinum.
• It is made up of four chambers, two atria and two
ventricles.
• The musculature of ventricles is thicker than that of atria.
• Force of contraction of heart depends upon the muscles
 RIGHT SIDE OF THE HEART

• Two chambers, right atrium and right ventricle.

• Right atrium is a thin walled and low pressure chamber.
• Right atrium receives venous (deoxygenated) blood via
two large veins
• Superior vena cava that returns venous blood from the
head, neck and upper limbs
• Inferior vena cava that returns venous blood from lower
parts of the body
• Right atrium communicates with right ventricle through
tricuspid valve.
• Wall of right ventricle is thick.
• Venous blood from the right atrium enters the right
ventricle through this valve.
• From the right ventricle, pulmonary artery arises.
• It carries the venous blood from right ventricle to lungs.
In the lungs, the deoxygenated blood is oxygenated.
 LEFT SIDE OF THE HEART

• Left side of the heart has two chambers, left atrium and
left ventricle.
• Left atrium is a thin walled and low pressure chamber.
• It receives oxygenated blood from the lungs through
pulmonary veins.
• his is the only exception in the body, where an artery
carries venous blood and vein carries the arterial blood.
• Blood from left atrium enters the left ventricle through
mitral valve (bicuspid valve). Wall of the left ventricle is
very thick.
• Left ventricle pumps the arterial blood to different parts
of the body through systemic aorta
 SEPTA OF THE HEART

. Right and left atria are separated from one another by a

fibrous septum called interatrial septum.
• Right and left ventricles are separated from one another
by interventricular septum.
• The upper part of this septum is a membranous
structure, whereas the lower part of it is muscular in
nature.
 LAYERS OF WALL OF THE
HEART
• Heart is made up of three layers of
tissues:
• 1. Outer pericardium
2. Middle myocardium
3. Inner endocardium.
 VALVES OF THE HEART

• Four valves in human heart.

• Two valves are in between atria and the ventricles called
atrioventricular valves.
• Other two are the semilunar valves, placed at the
opening of blood vessels arising from ventricles, namely
systemic aorta and pulmonary artery.
• Valves of the heart permit the flow of blood through heart
in only one direction.
 Atrioventricular Valves

• Left atrioventricular valve is otherwise known as mitral valve

or bicuspid valve.
• Right atrioventricular valve is known as tricuspid valve and it
is formed by three cusps.
• Cusps of the valves are attached to papillary muscles
• Papillary muscles arise from inner surface of the ventricles.
• Papillary muscles play an important role in closure of the
cusps and in preventing the back flow of blood from ventricle
to atria during ventricular contraction .
• Atrioventricular valves open only towards ventricles and
prevent the backflow of blood into atria.
 Semilunar Valves

• Semilunar valves are present at the openings of

systemic aorta and pulmonary artery and are known as
aortic valve and pulmonary valve respectively.
• Because of the half moon shape, these two valves are
called semilunar valves.
• Semilunar valves are made up of three flaps.
• Semilunar valves open only towards the aorta and
pulmonary artery and prevent the backflow of blood into
the ventricles
 ACTIONS OF THE HEART

• Actions of the heart are classified into four types:

• 1. Chronotropic action
2. Inotropic action
3. Dromotropic action
• 4. Bathmotropic action.
CHRONOTROPIC ACTION
• Chronotropic action is the frequency of heartbeat or
heart rate.
• It is of two types:
1. Tachycardia or increase in heart rate
2. Bradycardia or decrease in heart rate.
 INOTROPIC ACTION

• Force of contraction of heart is called inotropic action. It is of

two types:
• i. Positive inotropic action or increase in the force of
contraction
• ii. Negative inotropic action or decrease in the force of
contraction
DROMOTROPIC ACTION
• Dromotropic action is the conduction of impulse through heart.
• It is of two types:
• i. Positive dromotropic action or increase in the velocity of
conduction
• ii. Negative dromotropic action or decrease in the velocity of
conduction.
 BATHMOTROPIC ACTION

• Bathmotropic action is the excitability of cardiac muscle.

It is also of two types:
• i. Positive bathmotropic action or increase in the
excitability of cardiac muscle
• ii. Negative bathmotropic action or decrease in the
excitability of cardiac muscle.
 BLOOD VESSELS
• Vessels of circulatory system are the aorta, arteries, arterioles, capillaries,
venules, veins and vena cava.

Smooth muscle
Blood vessel Diameter Thickness of the wall Elastic tissue Fibrous tissue
fibers

Aorta 25 mm 2 mm More Less More

Artery 4 mm 1 mm More More Moderate

Arteriole 30 μ 6μ Moderate More Moderate

Terminal arteriole 10 μ 2μ Less More Moderate

Capillary 8μ 0.5 μ Absent Absent Moderate

Venule 20 μ 1μ Absent Absent Less

Vein 5 MM 0.5MM Less More Moderate

Vena cava 30 mm 1.5 mm Less More More

 DIVISIONS OF CIRCULATION
• Blood flows through two divisions of circulatory system:
• 1. Systemic circulation
2. Pulmonary circulation.
• Systemic circulation is otherwise known as greater
circulation Blood pumped from left ventricle passes
through a series of blood vessels, arterial system and
reaches the tissues.
• Exchange of various substances between blood and the
tissues occurs at the capillaries.
• After exchange of materials, blood enters the venous
system and returns to right atrium of the heart. From
right atrium, blood enters the right ventricle.
 PULMONARY CIRCULATION

• Pulmonary circulation is otherwise called lesser

circulation. Blood is pumped from right ventricle to
lungs through pulmonary artery. Exchange of gases
occurs between blood and alveoli of the lungs at
pulmonary capillaries. Oxygenated blood returns to left
atrium through the pulmonary veins.
• Thus, left side of the heart contains oxygenated or
arterial blood and the right side of the heart contains
deoxygenated or venous blood.
 Properties of cardiac muscle
• EXCITABILITY

• RHYTHMICITY

• CONDUCTIVITY

• CONTRACTILITY
 Cardiac cycle
• Cardiac cycle is defined as the succession of (sequence of)
coordinated events taking place in the heart during each beat.
• Each heartbeat consists of two major periods called systole and
diastole. During systole, heart contracts and pumps the blood
through arteries.
• During diastole, heart relaxes and blood is filled in the heart. All
these changes are repeated during every heartbeat, in a cyclic
manner.
 EVENTS OF CARDIAC CYCLE

• Events of cardiac cycle are classified into two:

• 1. Atrial events
2. Ventricular events.
• ATRIAL EVENTS
• 1. Atrial systole = 0.11 (0.1) sec
• 2. Atrial diastole = 0.69 (0.7) sec
• VENTRICULAR EVENTS
• 1. Ventricular systole = 0.27 (0.3) sec
• 2. Ventricular diastole = 0.53 (0.5) sec.
 ATRIAL SYSTOLE

• Atrial systole is also known as last rapid filling phase

or pre systole. It is usually considered as the last phase
of ventricular diastole. Its duration is 0.11 second.
• Pressure and Volume Changes
• During atrial systole, the intra atrial pressure increases.
Intraventricular pressure and ventricular volume also
increase but slightly.
• Fourth Heart Sound
• Contraction of atrial musculature causes the production
of fourth heart sound.
•
 ATRIAL DIASTOLE

• After atrial systole, the atrial diastole starts. Simultane

ously, ventricular systole also starts. Atrial diastole lasts
for about 0.7 sec
• This long atrial diastole is necessary because, this is the
period during which atrial filling takes place. Right atrium
receives deoxygenated blood from all over the body
through superior and inferior vena cava. Left atrium
receives oxygenated blood from lungs through
pulmonary veins.
Atrial and ventricular events of cardiac cycle
 ISOMETRIC CONTRACTION PERIOD

• Isometric contraction period in cardiac cycle is the first phase of

ventricular systole.
• It lasts for 0.05 second. Isometric contraction is the type of muscular
contraction characterized by increase in tension, without any change
in the length of muscle fibers.
• Isometric contraction of ventricular muscle is also called
isovolumetric contraction.
• Immediately after atrial systole, the atrioventricular valves are closed
due to increase in ventricular pressure.
• First Heart Sound
• Closure of atrioventricular valves at the beginning of this phase
produces first heart sound.
 EJECTION PERIOD

• Due to the opening of semilunar valves and isotonic contraction of

ventricles, blood is ejected out of both the ventricles. Hence, this period is
called ejection period. Duration of this period is 0.22 second
 Functional features of the heart

1. Pump the blood

2. Maintain unidirectional flow
3. Generate high pressure
4. Separation of pulmonary circulation
5. Modify the function as per specific requirements of circulation
 Functional Organization of the heart
to systemic circulation

pulmonary circulation
Left atrium

Right atrium
Left ventricle

from systemic circulation

Right V entricle

Heart as a set of two functional pumps

Figure 2. Heart as a set of two functional pumps
Right pump

Components
Right atrium and Right ventricle

Input : vena cava

Output : pulmonary artery

Valves :
Vena cava and Right atrium
Right atrium and Right ventricle
Right ventricle and pulmonary artery

Thickness of right ventricle wall : 3 -5 mm

Pressure generated : 25 mmHg during systole
Left pump

Components
left atrium and left ventricle

Input : Pulmonary vein

Output : Aorta

Valves :
Pulmonary vein and Left atrium
Left atrium and Left ventricle
Left ventricle and Aorta

Thickness of ventricle wall : 9 mm

Pressure generated : 120 mmHg during systole
 left atrium

P
Right atrium
A M left ventricle

T
Right ventricle

Fig. 6 Relative Relative

positionposition of different
of different chambers
chambers andheart
of the valvesand position
of the valves. T: tricuspid, M: mitral, A: aortic, P: pulmonary.
Distribution of blood in circulation
 Functional aspects of cardiovascular
system
• Changing metabolic needs

• Integration with other systems

• Safety margin or physiologic reserve

• Pathology resulting in diseases

 Functional aspects of cardiovascular
system
• Intermittent cardiac output but continuous
flow to tissues

• Dampening of pulsatile arterial flow at

capillary level

• Inverse Relation of cross-sectional area with

velocity of blood flow
Pressures in circulatory system
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