CARDIOVASCULAR SYSTEM By: Richard King

LOCATION OF THE HEART

The heart is a muscular organ containing four chambers. Its
main function is to pump blood around the circulatory system
of the lungs and the systemic circulation of the rest of the
body.

In the average day the heart beats about 108,000 times and
never rests. This is equal to 5.25 L of fluid per minute and
approximately 14,000 L per day.

This is located medially within the thoracic cavity, in a space

between the lungs known as mediastinum.
It is notable that while the majority of the heart’s mass sits
midsagittal, directly behind the sternum, the inferior heart
does deviate slightly to the left.

This deviation starts at the 24th day of gestation, in utero. The

heart initially develops as a tube, then folds on itself twice at
approximately 24 days of gestation and again at 35 days of
gestation.
 THE STRUCTURES OF THE HEART
The heart is surrounded by a membrane and layers that form
its wall. There are three distinct parts of the heart wall:
Pericardium – consists of two sublayers;
Outer fibrous pericardium - this layer prevents the overstretching
of the heart. It also provides protection to the heart and anchors
it in place.
Inner serous pericardium - a thinner, more delicate, layer that
forms a double layer around the heart.
Parietal pericardium - outer layer fused to the fibrous
pericardium.
Visceral pericardium - adheres tightly to the surface of the
heart.
Myocardium - a type of muscle only found within the heart
and is specialized in its structure and function divided into
two categories:
the majority is specialized to perform mechanical work
(contraction)
the remainder is specialized to the task of initiating and
conducting electrical impulses.
 THE HEART CHAMBERS
The heart is divided into four chambers the atria and the
ventricles. Even though the heart is referred to as a pump, it is
better to think of it as two pumps:
The right heart pump receives deoxygenated blood from the
tissues and pumps it out into the pulmonary circulation.
The left heart pump receives oxygenated blood from the
pulmonary circulation and pumps it out to the rest of the body.
Each pump of the heart is composed of one atrium and one
ventricle.
Atria - smaller chambers of the heart and lie superior to the
ventricles.
Ventricles - pumps the same amount of blood per beat but
they have very different pressures.
The right atrium receives blood
from three veins:
Superior vena cava
Inferior vena cava
Coronary sinus

The left atrium receives blood

from the lungs through the four
pulmonary veins.

Between the atria is a thin

dividing wall called interatrial
septum.
The walls of the atria are much thinner than those of the
ventricles, because the atria only need to pump the blood to
the ventricles, as opposed to the ventricles pumping the blood
around the pulmonary and systemic circulation.

Between the atria and the ventricles are two valves (the
atrioventricular (AV) valves):
the tricuspid valve – on the right pump
the bicuspid (mitral) valve – on the left pump
There are two ventricles:
The right ventricle receives
blood from the right atrium and
pumps this blood out into the
pulmonary circulation through
the pulmonary artery.
The left ventricle receives blood
from the left atrium and pumps
this blood out into the systemic
circulation via the aorta.
Between the two ventricles lies another septum, called the
interventricular septum. The septum between the left and right
pumps prevent the mixing of deoxygenated blood from the
oxygenated blood.

At the outlet of each ventricle is a valve. Both of these valves

are made up of three semilunar cusps:
The pulmonary semilunar valve lies between the right ventricle
and the pulmonary arteries.
The aortic semilunar valve lies between the left ventricle and the
aorta.
 THE BLOOD SUPPLY TO THE HEART
Because the heart is also a muscle, same as every other
muscle in the body, it also needs blood supply to function.
Blood is supplied to the majority of the heart by the coronary
arteries, with the exception of the endocardium.

The inner part of the endocardium is supplied with blood

directly from the inside of the heart chambers.

The coronary arteries come directly off the aorta just after
the aortic valve. They continuously divide into smaller
branches, forming a web of blood vessels around the heart.
As the coronary arteries are
compressed during each heart
beat, blood does not flow
through the coronary arteries at
this time.

Thus, blood flow to the

myocardium occurs during the
relaxation phase; this is the
opposite of every other part of
the body.
 BLOOD CIRCULATION
To put it simply, deoxygenated
blood returns from the body to
the right atrium and then into the
right ventricle, from where it is
pumped out to the lungs. The
oxygenated blood from the
lungs flows into the left atrium
and into the left ventricle. From
the left ventricle the blood is
then pumped into the circulation
of the body.
 CONDUCTION SYSTEM OF THE HEART
Within the heart there is a specialized network of electrical
pathways dedicated to ensuring the rapid transmission of
electrical impulses.
The cardiac conduction system include:
The sinoatrial node
The atrioventricular node
The atrioventricular bundle
The atrioventricular bundle branches
The Purkinje fibers
Normal electrical excitation/
distribution begins in the sinoatrial
(SA) node, which is located in the right
atrium, and is rapidly transmitted
across the atria by fast pathways.
This ensures that the right and left
atria are excited together and beat as
one unit.
The impulse is then transmitted to the AV
node, where further transmission is
delayed for approximately 0.1 second.

This delay ensures that the atria have

completely contracted before ventricular
contraction is initiated.
The ventricles are electrically isolated
from each other by a band of
non‐conducting fibrous tissue, and thus
the only electrical connection between
the two is the bundle of His (AV
bundle).
The impulse ‘held’ in the AV node is then transmitted
down the bundle of His to the fast pathways of the two
bundle branches.
The bundles then divide into the
smaller and smaller branches of the
Purkinje system, which transmits the
impulses to the muscles of the
ventricles, which initiate its contraction.
 BLOOD VESSELS
Blood vessels transport blood
throughout the body. There are
three major types of blood vessels:
The arteries – carry the blood away
from the heart.
The capillaries – enable the actual
exchange of water, gases, nutrients and
electrolytes between the blood and the
tissues.
The veins – carry blood from the
capillaries back towards the heart.
 STRUCTURE AND FUNCTION OF ARTERIES AND VEINS
For most of the blood vessels, the walls consist of three layers:
Tunica interna
Tunica media
Tunica externa
The tunica interna is
composed of endothelium
(simple squamous epi.) and its
basement membrane. This
layer is also lined by elastic
fibers to provide additional
flexibility and collagenous
fibers to provide additional
strength.
Arteries – most elastic tissue
Veins – very little tissue
Capillaries – no elastic layer
The tunica media is
composed largely of smooth
muscle, which enables
vasoconstriction during
contraction, or vasodilation
during relaxation and
ultimately changes the
blood flow and pressure.
Arteries – varies by the
size of the artery
Veins – thin layer
Capillaries – do not have
tunica media
The tunica externa (tunica adventitia), is a substantial sheath
of connective tissue composed primarily of collagen fibers,
which serves to anchor the blood vessel to nearby organs,
giving it support and stability:
Arteries – relatively thick
Veins – relatively thick
Capillaries – do not have tunica externa
Aside from the difference in thickness of layers of the arteries
and veins, here are some more notable differences.
Capillaries are tiny blood vessels, forming networks in most of
the organs and tissues of the body. Its walls are composed of
just a single layer of epithelium, which allows diffusion of
oxygen, water and lipids to enter the surrounding tissues.

Waste products such as carbon dioxide and urea can diffuse

back into the blood to be carried away for removal.

The lumen of capillaries can be so minute that, despite the

small size of erythrocytes, they may have to fold themselves
like a taco in order to make their way through.
 BLOOD
Blood consists of formed elements such as erythrocytes,
leucocytes and platelets.

The fluid portion of blood is called plasma, which contains

different types of proteins and other soluble molecules. And
when blood is centrifuged, the formed elements account for
45% and plasma makes up 55% of the total blood volume.

The average adult male has a blood volume of

approximately 5–6 L, and women 4–5 L, which comprises
about 7–9% of the body’s weight.
 FUNCTIONS OF THE BLOOD
Transportation: The blood is the means whereby all
nourishment and respiratory gases are transported into and
out of the cells.

Maintaining body temperature: Blood helps to maintain the

body temperature by distributing the heat produced by the
chemical activity of the cells evenly, throughout the body.

Maintaining the acid–base balance: Blood pH is maintained

by the excretion or reabsorption of hydrogen ions and
bicarbonate ions.
Regulation of fluid balance: When the blood reaches the
kidneys, excess fluid is excreted or reabsorbed to maintain
fluid balance.

Removal of waste products: The blood removes all waste

products from the tissues and cells. These waste products are
transported to the appropriate organs for excretion – lungs,
kidneys, intestine, skin and so on.

Blood clotting: By the mechanism of clotting, loss of blood

cells and body fluids is prevented.
Defense action: The blood aids in the defense of the body
against the invasion of microorganisms and their toxins due to
the phagocyte action of neutrophils and monocytes
the presence of antibodies and antitoxins
 BLOOD FORMATION
Blood cells are formed in the bone marrow through a process
called hematopoiesis.

Within the bone marrow, all blood cells originate from an

unspecialized cell called hematopoietic stem cell.

When a stem cell divides, it first becomes an immature blood

cell, then divides, matures further and ultimately becomes
mature red blood cell, white blood cell or platelet.
Plasma is a pale yellow-colored fluid, approximately 91%
water and 10% solutes, most of which are proteins. Water in
plasma is available to cells, tissues and extracellular fluid of
the body to maintain homeostasis.

Water in plasma is the liquid portion of the blood, and is

therefore the solvent, where chemical reactions between
intracellular and extracellular reactions occur.
Red blood cells are the most abundant blood cells. They are
biconcave discs and contain oxygen–carrying protein called
hemoglobin.

Young red blood cells contain a nucleus; however, the nucleus

is absent in a mature red blood cell and without any
organelles such as mitochondria, thus increasing the
oxygen‐carrying capacity of the red blood cell.
The main function of hemoglobin in the red blood cell is to
transport oxygen and carbon dioxide. As the blood flows
through the capillaries in the tissues, carbon dioxide is picked
up by the hemoglobin and oxygen is released.

As the blood reaches the lungs, carbon dioxide is released

and oxygen is picked up by the hemoglobin molecules.
Only about 20% to 25% of CO2 are released through the
lungs, some are broken down to be reused in the body:
10% of the carbon dioxide is dissolved in the plasma;
20% of the carbon dioxide combines with hemoglobin of the
red blood cell to form carbaminohemoglobin;
70% of the carbon dioxide reacts with water to form carbonic
acid, which is converted to bicarbonate and hydrogen ions:
White blood cells have nuclei and they are able to move out
of blood vessel walls into the tissues.

White blood cells are able to produce a continuous supply of

energy, unlike the red blood cells, and are able to synthesize
proteins, and thus their life span can be longer than RBCs.

There are two main types of white blood cells:

Granulocytes Agranulocytes
Neutrophils Monocytes
Eosinophils Lymphocytes
Basophils
Neutrophils are the most abundant white blood cells and
play an important role in the immune system. These cells are
the first immune cells to arrive at a site of infection and they
contain lysozymes; therefore, their main function is to protect
the body from any foreign material.

Eosinophils are phagocytes; however, they are not as active

as neutrophils. They contain lysosomal enzymes and
peroxidase in their granules, which are toxic to parasites,
resulting in the destruction of the organism.
Basophils play an important role in providing immunity
against parasites and also in the allergic response, as they
release chemical mediators that cause allergic symptoms.

Monocytes migrate into the tissue, where they develop into

macrophages and engulf pathogens or foreign proteins.
Macrophages play a vital role in immunity and inflammation
by destroying specific antigens.

Lymphocytes are not phagocytes. Two types of lymphocytes

are identified, and they are T‐ and B‐lymphocytes.
Platelets are small blood cells consisting of some cytoplasm
surrounded by a plasma membrane. They are produced in the
bone marrow from megakaryocytes and fragments of
megakaryocytes break off to form platelets.

The surface of platelets contains proteins and glycoproteins

that allow them to adhere to other proteins such as collagen in
the connective tissues.

Platelets play a vital role in blood loss by the formation of

platelet plugs, which seal the holes in the blood vessels.
The lifespan of each blood cells are as follows:
Erythrocytes – about 120 days
Leukocytes – a few hours to a few days or a few years
Platelet – about 5 –10 days

The macrophages in the spleen and liver remove old or

damaged blood cells from circulation and eventually excreted
through urine or fecal elimination.
END