1. The Cardiovascular System

2. Learning goals I can identify the 4 chambers of the heart.
I can compare and contrast the 4 chambers in anatomy and function.
I can identify the great vessels that enter and leave the heart.
I can trace the flow of blood through the heart and circulatory system.
I can compare the oxygenation state of blood at different points in the circulatory system.

3. The Cardiovascular System
A closed system of the heart and blood vessels
The heart pumps blood
Blood vessels allow blood to circulate to all parts of the body
The function of the cardiovascular system is to deliver oxygen and nutrients and to remove carbon dioxide and other waste products

4. The Heart Location About the size of your fist
Thorax between the lungs
Pointed apex directed toward left hip
About the size of your fist

5. The Heart
Figure 11.1

6. The Heart: Coverings Pericardium – a double serous membrane
Visceral pericardium
Next to heart
Parietal pericardium
Outside layer
Serous fluid fills the space between the layers of pericardium

7. The Heart: Heart Wall Three layers Epicardium Myocardium Endocardium
Outside layer
This layer is the visceral pericardium
Connective tissue layer
Myocardium
Middle layer
Mostly cardiac muscle
Endocardium
Inner layer
Endothelium

8. External Heart Anatomy
Aorta
Superior Vena Cava
Pulmonary Artery
Pulmonary Veins
Pulmonary Veins
Left Atrium
Right Atrium
Right Coronary Artery
Left Coronary Artery
Right Ventricle
Left Ventricle
Inferior Vena Cava
Apex

9. The Heart: Chambers Right and left side act as separate pumps
Four chambers
Atria
Receiving chambers
Right atrium
Left atrium
Ventricles
Discharging chambers
Right ventricle
Left ventricle
Figure 11.2c

10. Blood Circulation
Figure 11.3

11. The Heart: Valves Allow blood to flow in only one direction
Four valves
Atrioventricular valves – between atria and ventricles
Bicuspid valve (left)
Tricuspid valve (right)
Semilunar valves between ventricle and artery
Pulmonary semilunar valve
Aortic semilunar valve

12. The Heart: Valves Valves open as blood is pumped through
Held in place by chordae tendineae (“heart strings”)
Close to prevent backflow

13. Operation of Heart Valves
Figure 11.4

14. Operation of Heart Valves

15. Operation of Heart Valves

16. Operation of Heart Valves

17. The Heart: Associated Great Vessels
Aorta
Leaves left ventricle
Pulmonary arteries
Leave right ventricle
Vena cava
Enters right atrium
Pulmonary veins (four)
Enter left atrium

18. Coronary Circulation
Blood in the heart chambers does not nourish the myocardium
The heart has its own nourishing circulatory system
Coronary arteries
Cardiac veins
Blood empties into the right atrium via the coronary sinus

19. The Heart: Conduction System
Intrinsic conduction system (nodal system)
Heart muscle cells contract, without nerve impulses, in a regular, continuous way

20. The Heart: Conduction System
Special tissue sets the pace
Sinoatrial node
Pacemaker
Atrioventricular node
Atrioventricular bundle
Bundle branches
Purkinje fibers

21. Heart Contractions Contraction is initiated by the sinoatrial node
Sequential stimulation occurs at other autorhythmic cells

22. Heart Contractions
Figure 11.5

23. The Heart: Cardiac Cycle
Atria contract simultaneously
Atria relax, then ventricles contract
Systole = ventricular contraction
Diastole = ventricular relaxation

24. The Heart: Cardiac Cycle
Cardiac cycle – events of one complete heart beat
Mid-to-late diastole – blood flows into ventricles
Ventricular systole – blood pressure builds before ventricle contracts, pushing out blood
Early diastole – atria finish re-filling, ventricular pressure is low

25. Filling of Heart Chambers – the Cardiac Cycle
Figure 11.6

26. The Heart: Cardiac Output
Cardiac output (CO)
Amount of blood pumped by each side of the heart in one minute
CO = (heart rate [HR]) x (stroke volume [SV])
Stroke volume
Volume of blood pumped by each ventricle in one contraction

27. The Heart: Regulation of Heart Rate
Stroke volume usually remains relatively constant
Starling’s law of the heart – the more that the cardiac muscle is stretched, the stronger the contraction
Increased/Decreased venous return
Changing heart rate is the most common way to change cardiac output

28. The Heart: Regulation of Heart Rate
Increased heart rate
Sympathetic nervous system
Crisis
Low blood pressure
Hormones
Epinephrine
Thyroxine
Exercise

29. The Heart: Regulation of Heart Rate
Decreased heart rate
Parasympathetic nervous system
High blood pressure or blood volume

31. Cardiac Output Regulation
Figure 11.7

32. 75 b/min*70ml/b= 5250ml/min
75b/m*80ml/b= CO

33. Blood Vessels: The Vascular System
Taking blood to the tissues and back
Arteries
Arterioles
Capillaries
Venules
Veins
Figure 11.8a

34. The Vascular System
Figure 11.8b

35. Blood Vessels: Anatomy
Three layers (tunics)
Tunic intima
Endothelium
Tunic media
Smooth muscle
Controlled by sympathetic nervous system
Tunic externa
Mostly fibrous connective tissue

36. Differences Between Blood Vessel Types
Walls of arteries are the thickest
Lumens of veins are larger
Skeletal muscle “milks” blood in veins toward the heart
Walls of capillaries are only one cell layer thick to allow for exchanges between blood and tissue

37. Movement of Blood Through Vessels
Most arterial blood is pumped by the heart
Veins use the milking action of muscles to help move blood
Figure 11.9

38. Capillary Beds Capillary beds consist of two types of vessels
Vascular shunt – directly connects an arteriole to a venule
Figure 11.10

39. Capillary Beds True capillaries – exchange vessels
Oxygen and nutrients cross to cells
Carbon dioxide and metabolic waste products cross into blood
Figure 11.10

40. Major Arteries of Systemic Circulation
Figure 11.11

41. Major Veins of Systemic Circulation
Figure 11.12

42. Arterial Supply of the Brain
Figure 11.13

43. Hepatic Portal Circulation
Figure 11.14

44. Circulation to the Fetus
Figure 11.15

45. Pulse Pulse – pressure wave of blood
Monitored at “pressure points” where pulse is easily palpated
Figure 11.16

46. Blood Pressure
Measurements by health professionals are made on the pressure in large arteries
Systolic – pressure at the peak of ventricular contraction
Diastolic – pressure when ventricles relax
Pressure in blood vessels decreases as the distance away from the heart increases

47. Measuring Arterial Blood Pressure
Figure 11.18

48. Comparison of Blood Pressures in Different Vessels
Figure 11.17

49. Blood Pressure: Effects of Factors
Neural factors
Autonomic nervous system adjustments (sympathetic division)
Renal factors
Regulation by altering blood volume
Renin – hormonal control

50. Blood Pressure: Effects of Factors
Temperature
Heat has a vasodilation effect
Cold has a vasoconstricting effect
Chemicals
Various substances can cause increases or decreases
Diet

51. Variations in Blood Pressure
Human normal range is variable
Normal
140–110 mm Hg systolic
80–75 mm Hg diastolic
Hypotension
Low systolic (below 110 mm HG)
Often associated with illness
Hypertension
High systolic (above 140 mm HG)
High diastolic (above 90 mm HG)
Can be dangerous if it is chronic

52. Factors Determining Blood Pressure
Figure 11.19

53. Capillary Exchange Substances exchanged due to concentration gradients
Oxygen and nutrients leave the blood
Carbon dioxide and other wastes leave the cells

54. Diffusion at Capillary Beds
Figure 11.20

55. Capillary Exchange: Mechanisms
Direct diffusion across plasma membranes
Endocytosis or exocytosis
Some capillaries have gaps (intercellular clefts)
Plasma membrane not joined by tight junctions
Fenestrations of some capillaries
Fenestrations = pores

56. Developmental Aspects of the Cardiovascular System
A simple “tube heart” develops in the embryo and pumps by the fourth week
The heart becomes a four-chambered organ by the end of seven weeks
Few structural changes occur after the seventh week

57. Atrial septal defect (ASD)
An ASD is a hole in the part of the septum that separates the atria
Oxygen-rich blood flows from the L. atrium into the R. atrium
instead of flowing into the left ventricle
Few, if any, symptoms
About ½ of ASDs close on their own
Medium & large ASDs -repaired with surgery

58. Atrial septal defect (ASD)

59. Ventricular Septal Defect (VSD)
Hole in the wall separating the ventricles
May cause higher pressure in the heart or reduced oxygen to the body
Large VSDs allow a lot of blood to flow from the left ventricle to the right ventricle.
Left side of the heart must work harder
Increases blood pressure in the right side of the heart and the lungs.

60. Ventricular Septal Defect (VSD)

61. Ventricular Septal Defect (VSD)
Heart’s extra workload can cause heart failure and poor growth.
If the hole isn't closed, high blood pressure can scar the arteries in the lungs.
Open-heart surgery to repair VSDs.

62. Patent Ductus Arteriosus (PDA)
An unclosed hole in the aorta.
Fetus's blood does not need to go to lungs to get oxygenated.
Ductus arteriosus allows the blood to skip the circulation to the lungs
At birth, the blood must receive oxygen in the lungs and this hole is supposed to close.

63. Patent Ductus Arteriosus (PDA)

64. Patent Ductus Arteriosus (PDA)
A heart murmur might be the only sign of PDA.
Other symptoms: shortness of breath, poor feeding and growth, tiring easily, and sweating with exertion.
PDA is treated with medicines, catheter-based procedures, and surgery.
Small PDAs often close without treatment.

65. Tetralogy of Fallot Complex defect involving four problems
Pulmonary valve stenosis (narrowing)
A large VSD
An overriding aorta
aorta between the left and right ventricles, directly over the VSD.
oxygen-poor blood from R. ventricle flows directly into the aorta instead of into the pulmonary artery.
Right ventricular hypertrophy
muscle of R. ventricle is thicker than usual because it has to work harder than normal.

66. Tetralogy of Fallot

67. Babies and children have episodes of cyanosis
Older children tire during exercise and might faint.
Surgical repair in infancy now to prevent these problems.
Need lifelong medical care from a specialist to make sure they stay as healthy as possible.

68. External Heart Anatomy
Figure 11.2a