INTRODUCTION TO HUMAN PHYSIOLOGY
Cardiovascular System I
Dr Janelle Bryan
Week 4: 15th February, 2024
WE WILL DISCUSS…
General Overview of the Cardiovascular System
The Heart
Vascular System
Cardiac Muscle
Electrocardiogram (ECG)
THE HEART AND CIRCULATORY SYSTEM- HOW THEY WORK
source: https://www.youtube.com/watch?v=CWFyxn0qDEU
CARDIOVASCULAR SYSTEM
heart
blood vessels
arteries (distributing system)
capillaries (exchange system)
veins (collecting system)
COMPONENTS OF THE CARDIOVASCULAR SYSTEM
CIRCULATORY SYSTEM
FUNCTION OF
THE CARDIOVASCULAR SYSTEM
Main Function: Transportation
blood = transport vehicle
heart = pump
blood vessels = network of tubes
transports blood to and from different tissues and organs
supplies oxygen, nutrients, and other vital substances
removes carbon dioxide and waste products from tissues
to lungs, kidneys, and other organs for excretion from the
body
CIRCULATORY SYSTEM DESIGN
double circulation loop
Pulmonary Circuit
blood between heart and lungs
Systemic Circuit
blood between heart and organ
systems
CIRCULATORY SYSTEM DESIGN
THE HEART
ANATOMY OF THE HEART
muscular organ
myocardium- cardiac muscle (heart muscle)
muscular tissue of the heart, middle layer of the heart wall
~ size of a fist
located in mediastinum (central compartment of the thoracic cavity)
⅔ of heart left of midline
ANATOMY OF THE HEART
4 chambers
2 atria: right and left
2 ventricles: right and left
double pump
atria, receiving chambers: receive blood
ventricles, pumping chambers: pump blood out
septum: muscular wall between right and left sides of heart
valves: prevent backward flow of blood
atrioventricular (AV) valves
tricuspid: right
mitral / bicuspid: left
semilunar valves
pulmonary: right
aortic: left
GROSS ANATOMY OF THE HEART
EXTERNAL FEATURES
GROSS ANATOMY OF THE HEART
INTERNAL FEATURES
THE HEART
COMPARISON BETWEEN VENTRICLES
right ventricle
pulmonary circuit
lower pressures
left ventricle
systemic circuit
3x thicker
more powerful pump
higher pressures
HEART VALVES
HEART VALVES
chordae tendineae: anchor valve flaps in their closed position
HEART VALVES
Atrioventricular Valves
open: atrial pressure > ventricular pressure
close: ventricular pressure > atrial pressure
at beginning of ventricular systole (contraction)
produces 1st heart sound
“lub”
generated by the vibration of the blood and ventricular wall
louder, longer, more resonant than 2nd heart sound
Semilunar Valves
open: ventricular pressure > aorta and pulmonary trunk pressure
close: aorta and pulmonary trunk pressure > ventricular pressure
at beginning of ventricular diastole (relaxation)
produces 2nd heart sound
“dub”
generated by vibration of blood and aorta
aortic valve closes slightly before pulmonary valve
HEART VALVES
HEART SOUNDS
NORMAL HEART SOUNDS
source: https://depts.washington.edu/physdx/audio/normal.mp3
PATHWAY OF BLOOD THROUGH THE HEART
PATHWAY OF BLOOD THROUGH THE HEART
VASCULAR SYSTEM
blood circulates inside a closed circulatory system
(transport system)
types of blood vessels:
arteries
arterioles
capillaries
venules
veins
VASCULAR SYSTEM
Arteries
oxygenated blood from (away) the heart to the tissues
exception:
pulmonary artery: deoxygenated blood from right ventricle to lungs
thicker walls
withstand high pressure
16-18% blood volume
Capillaries
smallest of the body’s blood vessels
connect arterioles and venules
exchange of water, oxygen, carbon dioxide and many other
nutrients and waste substances between blood and
surrounding tissues
thin walls, no muscle, one cell layer thick
5-7% blood volume
VASCULAR SYSTEM
Veins
deoxygenated blood to the heart from the tissues
exception:
pulmonary vein: oxygenated blood from lungs to left atrium
umbilical vein: oxygenated blood from placenta to foetus
thinner walls
low pressure
large lumen
50-70% blood volume
• Valves
• prevent backward flow of blood
• skeletal muscles enhance venous return
CARDIAC MUSCLE
Functions:
produce powerful contractions that pump blood out
the heart
generate impulses (action potential) for contraction
of the heart
conduct impulses from their site of origin to other
parts of the heart
HISTOLOGICAL PROPERTIES OF CARDIAC MUSCLE
cardiac muscle cells:
short, branched, interconnected (unlike skeletal muscle)
striated (contain actin and myosin arranged in sarcomeres)
generally one (may have 2) central nucleus in each cell
large numbers of mitochondria (high resistance to fatigue) and
abundant reserves of myoglobin (O2 binding protein in muscle)
HISTOLOGICAL PROPERTIES OF CARDIAC MUSCLE
intercalated discs
specialised structures which connect cardiac cells to each
other
2 types of junctions within intercalated discs:
gap junctions
link intercalated discs
electrical synapses which allow action potentials to spread from one
cell to adjacent cells
desmosomes
secure intercalated discs to convey force of contraction
FUNCTIONAL CHARACTERISTICS OF CARDIAC MUSCLE
functions as a syncytium (single functional unit)
one cardiac cell undergoes an action potential (AP)
electrical impulse spreads to all other cells joined by gap junctions
cells become excited and contract as a single functional syncytium
atrial syncytium and ventricular syncytium
involuntarily (unconsciously) controlled
can spontaneously depolarise
contracts without neural stimulation
TYPES OF CARDIAC MUSCLE CELLS
Contractile Muscle Fibres Specialised Muscle Fibres
(~99%) (conducting cells) (~1%)
atrial muscle fibres Excitatory & Conductive Muscle Fibres
ventricular muscle fibres (autorhythmic)
Sinoatrial (SA) node
produce powerful Atrioventricular (AV) node
contractions that pump Bundle of His
blood Bundle branches
contract similarly to Purkinje fibres
skeletal muscle
much longer duration of
initiate the heart beat
contraction
automatic rhythmic discharge
(AP)
help spread the impulse (AP)
rapidly throughout the heart
few contractile fibrils (very weak
contraction)
BLOOD SUPPLY TO THE HEART:
CORONARY CIRCULATION
coronary arteries supply blood to the heart muscle
arise from base of the aorta
venous blood empties into the right atrium
during maximal exertion, blood supply to the heart may
increase to 9x that of resting level
Coronary Arteries Coronary Veins
CARDIAC MUSCLE METABOLISM
ATP from aerobic metabolism
rich in mitochondria
fatty acids- preferred fuel (~70%)
glucose- least preferred
ketone bodies and lactate used under stress when energy
demand high
~1% energy from anaerobic metabolism
can ↑ to 10% under moderate hypoxia
creatine phosphate pool is small (as in skeletal muscle)
pumps insufficiently in ischaemic conditions
contractions quickly cease (within 30s) when cardiac muscle
completely deprived of O2 from occlusion of a coronary
blood vessel
PROPERTIES OF CARDIAC MUSCLE
Rhythmicity (autorhythmicity / automaticity)
Excitability
Conductivity
Contractility
Rhythmicity (Autorhythmicity /Automaticity)
ability of cardiac muscle to initiate its beat continuously and
regularly without external stimulation
myogenic in origin ie. not neurogenic
contract regularly independent of nerve supply
inherent spontaneous rhythmicity
due to specialised excitatory and conductive system of the
heart
initiated by sinoatrial node
possesses greatest rhythmicity
initiates the heartbeat
pacemaker of the heart
fastest rate of generating action potential
Rhythmicity (Autorhythmicity /Automaticity)
Autorhythmic Fibres
Functions:
act as a pacemaker
set the rhythm of electrical excitation
form the conductive system
provide a path for each cycle of cardiac excitation to progress
through the heart
Location of Autorhythmic Fibres
Sinoatrial node
specialised region in
posterior wall of right
atrium near opening of
superior vena cava (SVC)
Atrioventricular node
small bundle of
specialised cardiac
cells located at base of
right atrium near
septum
Location of Autorhythmic Fibres
Bundle of His
(atrioventricular bundle)
• cells originate at AV node
• enters interventricular
septum
• divides into right and left
bundle branches
• travels down septum
• curves around tip of
ventricular chambers
• travels back towards
atria along outer walls
Purkinje Fibres
• small, terminal fibres
that extend from Bundle
of His and spread
throughout ventricular
myocardium
Normal and Latent Pacemakers of the Heart
Normal Pacemaker
Sinoatrial (SA) node
Latent Pacemakers
can take over (at a slower rate), should SA node fail
Atrioventricular AV node
Bundle of His
Purkinje fibers
Firing Rate of SA Node and Latent Pacemakers
EXCITABILITY
ability of cardiac muscle to respond to a stimulus of
adequate strength and duration by generating an
action potential (AP) followed by a mechanical
contraction
AP initiated by SA node travels along conductive
pathway excites atrial and ventricular muscle fibres
mechanical response consists of systole (contraction)
and diastole (relaxation)
CONDUCTIVITY
ability of cardiac muscle to conduct cardiac impulses
initiated in the SA node and transmitted in a specialised
conducting system formed from specialised muscle fibres
Conducting System composed of:
SA node, internodal pathway, AV node, Bundle of His &
Purkinje Fibres
CONDUCTIVITY
HOW THE CARDIAC CYCLE IS PRODUCED
BY ELECTRICAL IMPULSES IN THE HEART
source: https://www.youtube.com/watch?v=fZT9vlbL2uA
THE CONDUCTING SYSTEM OF THE HEART
CONTRACTILITY
ability of cardiac muscle to convert chemical energy into
mechanical form of energy
Excitation-Contraction Coupling in Cardiac Contractile Cells
ELECTROCARDIOGRAM (ECG)
recording of electrical activity of the heart via electrodes
placed on body surface
electrical activity- depolarisation and repolarisation of cardiac muscle
Principle:
body fluids are good conductors
when cardiac impulses pass through the heart, electrical
currents spread into tissues surrounding the heart and to
surface of the body
ECG ELECTRODES
ELECTRODE PLACEMENT
GENESIS OF A NORMAL ECG
P wave: atrial depolarisation
QRS complex: ventricular depolarisation (atria repolarising simultaneously)
T wave: ventricular repolarisation
PR interval: impulse propagation through the AV node, AV bundle and bundle
branches
ST segment: ventricles contracting and emptying, all regions of the
ventricles are depolarised, no potential differences recorded
12 LEAD ECG
normal heart rate: 60-100 beats/min
sinus bradycardia: slower than normal heart rate
slower than 60 beats/minute
sinus tachycardia: faster than normal heart rate
faster than 100 beats/minute
ECG
Resting ECG
ECG
Exercise Stress Testing & Cardiopulmonary Exercise Testing
The Cardiovascular System and…
Sports
Exercise
Exercise Physiology
* physiological changes, responses, and adaptations
* oxygen demands and cardiac output
* blood flow / supply to tissues
* physiological hypertrophy (“athlete’s heart”)
beneficial contractile effects
* pre-participation screening (medicals)
The Cardiovascular System and…
Sports
Exercise
Exercise Physiology
* diseases in the athlete-
risk factors, symptoms, sudden death, Hypertrophic
Cardiomyopathy (HCM) / Hypertrophic Obstructive
Cardiomyopathy (HOCM) , congenital heart disease,
atherosclerosis, Myocardial Infarction (MI), abnormal heart
rhythm
* exercise stress testing & cardiopulmonary exercise testing
LABEL THE HEART DIAGRAM
PATHWAY OF BLOOD THROUGH THE HEART
PATHWAY OF BLOOD THROUGH THE HEART
WE DISCUSSED…
General Overview of the Cardiovascular System
The Heart
Vascular System
Cardiac Muscle
Electrocardiogram (ECG)
