Department of
Anatomy
Lecture 6
Circulatory System
LECTURE OUTLINE
Describe the types of circulation in the body
Describe the size, anatomical location, structure of the heart walls and
the surrounding pericardium
Identify and describe the chambers and valves of the heart
Identify the major blood vessels to and from the heart
Describe the blood supply of the heart
Describe the conducting system and nerve supply of the heart
Describe the blood vessels (arteries, arterioles, veins, venules, capillaries,
sinusoids, end arteries and anastomosis)
Describe the lymphatic system (lymph vessels and lymph nodes)
LECTURE ILOs
1. Identify different body structures, different systems and organs
of the human body
2. Determine the structure and functions of the different systems of
the human body with reference to the clinical significance of each.
3. Relate anatomy with different subjects learned.
Circulatory
System
Types of Circulation
Systemic Circulation
Pulmonary Circulation
Portal Circulation
Types of Circulation
Systemic circulation
Pulmonary circulation
Portal circulation
THE HEART
THE HUMAN HEART
Muscular pump (double pump)
Size of a fist (Length of heart 15 cm )
Weight of heart 250 - 300 g
Number of heart beats in 70 years 3,000,000,000
Amount of blood pumped in 70 years 250,000,000 L (6.5-7 L/min)
Located in middle mediastinum (between the 2 lungs)
Base - broad superior portion of heart
Apex - inferior end, tilts to the left, tapers to point
Anatomical
location of
the heart
Division of the
Mediastinum
Location of the Heart
Anatomical location of the heart
Radiographic
Anatomy
PERICARDIUM
(FIBROUS)
PERICARDIUM (SEROUS)
PERICARDIUM
AND HEART
WALL
Heart Wall
Epicardium (visceral pericardium)
serous membrane covers heart
Myocardium
thick muscular layer
fibrous skeleton - network of collagenous and elastic fibers
provides structural support
attachment for cardiac muscle
nonconductor important in coordinating contractile activity
Endocardium
smooth inner lining
HEART
Heart
Anterior view Posterior view
HEART
CHAMBERS
AND
VALVES
Fibrous skeleton of the heart
Papillary Muscle and Chordae Tendineae
Auscultatory Areas
Auscultatory Areas
Summary
The heart lies in the middle mediastinum.
It is formed of 4 chambers (2 atria, 2 ventricles)
The right atrium is separated from the right ventricle by the tricuspid valve.
The left atrium is separated from the left ventricle by the bicuspid (mitral) valve.
The base of the heart is formed by the left atrium.
The apex of the heart is formed by the left ventricle, and directed downwards,
forward and to the left.
The wall of the right ventricle is thinner than the wall of the left ventricle.
The right ventricle contains 3 papillary muscles, while the left ventricle contains
2 papillary muscles only.
Pulmonary artery arises from the right ventricle (to the lungs, carrying
deoxygenated blood).
Aorta arises from the left ventricle (to the whole body, carrying oxygenated
blood).
Blood supply of the heart
Blood supply of the heart
Coronary Arteries
Coronary
Arteries
Coronary Arteries
The heart muscle is supplied by the right and left coronary
arteries and is drained by the cardiac veins
The coronary arteries are END ARTERIES
The right coronary artery supplies the right half of the heart
The left coronary artery supplies the left half of the heart
The inter-atrial and inter-ventricular septa are supplied from
both C.A.
The SAN (Sino Atrial Node-situated in the right atrium) is
supplied from both C.A.
The right coronary artery
It arises from the anterior aortic sinus.
It anastomoses with the terminal part of the left coronary
artery.
It gives off the following branches:
• Branch to the sinoatrial node
• The right marginal artery
• The posterior inter-ventricular artery, which is also
known as the posterior descending artery
The left coronary artery
It arises from the left posterior aortic sinus.
It anastomoses with the terminal part of the right coronary artery.
It gives off the following branches:
The circumflex branch
The anterior interventricular artery
Occlusion of a coronary artery or one of its branches causes myocardial
infarction which is cell death of the cardiac musculature due to
inadequate blood supply
Angina pectoris, coronary thrombosis and myocardial infarction
Arteriogram of Coronary Arteries
Right coronary artery Left coronary artery
Coronary disease
Complete obstruction
Partial obstruction
Myocardial infarction
Myocardial ischemia
(MI)
(Heart attack)
Angina pectoris
Normal artery obstructed artery
Coronary Arteries: Stent and CABG
Coronary Arteries: Stent and CABG
Venous
Drainage
Venous Drainage
Cardiac veins accompany the arteries.
Most of them are tributaries of THE CORONARY SINUS: a sizable vein lying in the
posterior part of the atrioventricular groove and opening into the right atrium.
Great cardiac vein accompanies the anterior interventricular artery.
Middle cardiac vein accompanies the posterior interventricular artery.
Small cardiac vein accompanies the marginal artery.
Anterior cardiac veins seen on the anterior wall of the right ventricle drain directly
into the right atrium.
Additionally there are very small veins on the various walls (venae cordis minimae)
draining directly into the cardiac cavity
Nerve Supply of The Heart
Parasympathetic nerves to the heart arise as branches of the vagus nerve in
the neck and thorax.
Parasympathetic innervation decreases heart rate and is restricted to the SA
and AV nodes and the coronary arteries.
Sympathetic fibers innervate the same structures as parasympathetic fibers.
Sympathetic innervation of the heart increases heart rate. heart rate and
strength of contraction.
Conducting
system of
the heart
ECG
The conducting system of the heart-1
The conducting system of the heart is a series of specialized cardiac
muscle cells that carries impulses throughout the heart musculature,
signaling the heart chambers to contract in the proper sequence.
It also initiates each contraction sequence, thereby setting basic heart
rate (60-80).
The impulse that signals each heartbeat begins at the sinoatrial (SA)
node.
From the SA node, impulses spread in a wave along the cardiac
muscle fibers of the atria, signaling the atria to contract.
The conducting system of the heart-1
Some of these impulses travel along an internodal pathway to the
atrioventricular (AV) node in the inferior part of the interatrial
septum, where they are delayed for a fraction of a second.
After this delay, the impulses race through the atrioventricular (AV)
bundle (formerly, bundle of His), which enters the interventricular
septum and divides into right and left bundle branches. The bundle
branches terminate in the subendocardial conducting network
(Purkinje fibers), which approach the apex of the heart and then
turn superiorly into the ventricular walls.
BLOOD
VESSELS
Arterial system
Arteries
Branches
Arterioles
Capillaries
Anastomosis
End arteries
Sinusoids
Venous system
Capillary bed
Venules
Tributaries
Large veins
Superior and Inferior VC
Right Atrium
Coronary Sinus
Lymphatic system
Lymphatic fluid
Lymphatic plexuses
Lymphatic vessels
Lymph nodes
Superficial
Deep
Lymph trunks
Thoracic duct
Right lymph trunk
Lymphatic tissues
Spleen
Thymus
tonsils
Lymphatic
system
Site and area of drainage of main groups of lymph nodes
References:
1- Susan Standring (2020). Gray's anatomy 42nd edition.
2- Gerard J. Tortora and Mark T. Neilsen: Principles of Human Anatomy
(12th edition)
