Mr Rishabh mishra

(SVM Pharmacy college, sarai sultani raniganj)

Cardiovascular System

●​ The system that fulfils the transportation needs of the body is cardiovascular system.
●​ This system is composed of the heart, blood vessels, and blood.
Main functions of the cardiovascular system are:
1.​ Distribution of 02 and nutrients to all The body cells and tissues.
2.​ Transportation of CO2 and metabolic waste products from tissues to lungs and other
excretory organs.
3.​ Distribution of water, electrolytes, and hormones throughout the body.
4.​ Thermoregulation.
●​ Blood is pumped by the heart (a muscular organ of the circulatory system).
●​ Heart consists of very strong cardiac muscle tissue and shows rhythmic contraction and
relaxation
●​ As a result of this contraction and relaxation, a force Is generated that pumps the blood
to the entire body along With nutrients and oxygen.

●​ Heart is a muscular organ, present in all vertebrates that pump blood to the whole
bodycontinuously.
●​ In humans, its size is equal to the size of a clenched fist, and average weight for
females is 250-300gm, and 300-350gm for males.
●​ Average human heart beats around 70-72 beat per minute.
Anatomy of Heart
●​ Heart is situated in the thoracic cavity, obliquely between the lungs in the mediastinum
space, just above the diaphragm.
●​ Heart is present in the midline of the body, is slightly tilted towards the left.
●​ It is a rounded cone shaped structure
●​ Heart is enclosed by a serous membrane known as pericardial sac or partial
pericardium
●​ The pericardial sac consists of two membranes:
Fibrous Pericardium : This pericardium covers the heart joining it to great vessels ( vena cava,
aorta, pulmonary vein, and artery).
 Serous Pericardium : This pericardium is a thin, delicate membrant. The outermost layer of the
heart wall (known as epicardium) and large blood vessels are continuous with this membrane.
Heart Wall
The wall of the heart is composed of three layers
Epicardium or Visceral Pericardium :This is the visceral layer of partial pericardium and forms
the outer most layer of heart.This is a transparent, thin layer and consists of specialised
epithelial tissues known as mesothelium.Pericardial cavity is a space between the epicardial
membrane of heart and the serous pericardium of pericardial sac.Fluid present in this cavity is
known as pericardial fluid and it protects the heart from friction and erosion
Myocardium : It is the thickest layer and consists of cardiac muscle tissue. Fibres of cardiac
muscle tissue are striated, involuntary, and branched. Heart contracts by the contraction of the
myocardial membrane.
Endocardium : It is the innermost and third layer of the heart wall. It consists of a thin layer of
specialised epithelial tissues (known as endothelium) which overlies a thin layer of connective
tissue. This Layer provide Smooth blood flow to heart and vessles. Endothelium also lines inner
cavities of the heart , covers valves, and forms the inner lining of blood vessels.
Chambers of Heart
The heart is composed of muscular walls and has four distinct chamber of different thickness.

1.​ The left Atrium (LA) and Right Atrium (RA) situated above the Left Ventricle and right
Ventricle (RV), Respectively, Ventricles are thick walled, large chamber performing many
function .
2.​ Heart pump blood to the lungs and other body system A system of on way Valves is
present in the heart that prevent the backflow of blood into the heart valves can be
categorized into two types
Atrioventricular (AV) Valves:
●​ These valves are present in the middle of the heart between the atria and ventricles,
and only allow blood to flow from the atria into the ventricals.
●​ The AV valve located on the right side of the heart is known as the tricuspid valve.
The AV valve on the left side of the heart is known as mitral valve or the bicuspid valve
Semilunar Valves:
●​ These are crescent moon-shaped valves, located between ventrical and arteries and
carrying blood away from the heart towards the other body parts
●​ The semilunar valve present in the right chamber of heart is known as pulmonary valve
●​ The semilunar valve present in the left chamber of the heart is known as aortic valve.
Blood vessels
1.​ The cardiovascular system is responsible for pumping of blood throughout the body and
thus transport oxygen, nutrients and hormones to different body organs and tissues and
carrying away wastes Therefore the cardiovascular system maintains homeostasis of all
other systems in the body blood vessels ( the main part cardiovascular system) form a
 closed circuit of tubules for carrying blood away from the heart to different tissues and
then bringing it back to the heart.
The blood vessels comprise the major path of the circulatory system and maintain blood
circulation in the body.
Types
Various kinds of blood vessels are discussed below in series:
1) Arteries: These are elastic vessels, carrying blood from the heart (under high pressure) to
different tissues and organs. For example,
Aorta the largest artery, carries blood out of the heart, and
Branches of the aorta, the carotid artery, the subclavian artery, the celiac trunk, the
mesenteric arteries, the renal artery, and the iliac artery.
Arterioles: They are the subdivisions of arteries. They are thinner than the arteries
Capillaries: These blood vessels have smallest diameter. They connect the arterioles (smallest
diameter arteries) to the venules (smallest diameter veins).
Veins: These blood vessels carry blood from different organs and tissues, back to the heart
(atria).
For example :
i. Large collecting vessels, such as the subclavian vein, the jugular vein, the renal vein and
the iliac vein, and
ii. Vena cava (2 large veins, carry blood into the heart).
Circulation of Blood through the Heart
With every heart beat the blood is pumped into two closed circuits, i.e., the pulmonary and the
systemic circulation.
The following four routes of blood circulation through heart have been
discussed below:
1) Systemic circulation
2) Pulmonary circulation
3) Portal circulation
4) Coronary Circulation

Systematic Circulation
1- Left side of the heart participates in
the systemic circulation and receives oxygenated blood from lungs.
From the left ventricle blood is pumped into the aorta and the backflow is guarded by the aortic
valve,
2- The arteries then divide into small diameter arterioles which further divide into systemic
capillaries. Nutrient and gaseous exchange are seen across the thin walls of the capillaries.
3- Oxygen is delivered and carbon dioxide is picked up via capillaries.
4- The deoxygenated blood then enters the systemic venules (smallest diameter blood vessel
carrying deoxygenated blood). The venules further unite to form large systemic veins.
5- They carry away the deoxygenated blood (blood rich in carbon dioxide) from the tissues.
Next,
via the systemic veins, blood enters the superior and inferior vena cava (
carrying deoxygenated blood from the upper and lower parts of the body, respectively to the
heart) and the coronary sinus (receives deoxygenated blood of the heart) and brings back the
deoxygenated blood to right atrium.

pulmonary circulation
The right side of the heart is involved in the pulmonary circulations. It receives deoxygenated
blood returning from the systemic circulation and pumped to the lungs.
The deoxygenated blood enters the right ventricle from the right atrium and the backflow is
checked by the tricuspid valve. From the right ventricle blood is pumped into the pulmonary
trunk and then, into the pulmonary arteries and the backflow is checked by the pulmonary valve.
The pulmonary circulation carey deoxygenated blood to the lungs.
The gaseous exchange takes place at the surface of alveoli and the blood gets oxygenated
(i.e., loses carbon dioxide) in the pulmonary capillaries.
The oxygen-rich blood is then carried via pulmonary veins, to left atrium from where it is
distributed to the rest of the body systems.
Portal Circulation
Blood enters the liver from two sources.
The hepatic artery supplies oxygenated blood from the abdominal aorta and the hepatic portal
vein carries deoxygenated blood from the digestive organs.
The flow of deoxygenated blood from the digestive organs to the Iiver before returning to the
heart is called hepatic portal circulation.

A vein which does not carry blood directly to the heart but forms networks of capillaries in
another or intermediate organ before reaching the heart is called a portal vein.
A portal vein together with small veins through which it receives blood is called the portal
system.
 Physiology of Heart
Heart is a hollow, muscular organ which works by changing the tension and length of muscle
fibres.
The beating of heart generates a pressure that pumps the blood.
Cardiac cells are cylindrical in shape and are arranged such that if one of the cells is
stimulated, it initiates the stimulation of the adjacent cell.
Two types of cardiac cells are generally seen:
1) Electrical cells,
2) Myocardial cells

Cardiac Cycle and Heart Sound

The alternate contraction (systole) and relaxation (diastole) of auricles and ventricles, resulting
in one heart beat is known as a cardiac cycle.
As the auricles contract (auricular systole), the ventricles relax (ventricular diastole); and as the
ventricles contract (ventricular systole), the auricles (auricular diastole) relax; and thus it is a
continuous cycle.
A systole signifies pumping out of blood from the cardiac chamber, whereas a diastole signifies
the entry of blood into a cardiac chamber.
Blood Flow in the Heart During a Cardiac Cycle
Atrial Systole : This is marked by stimulation of the SA node. A wave of contraction spreads
through the atria, and the bicuspid and tricuspid valves open up; thus pumping blood from the
atria into the ventricles.
Ventricular Systole : Next, contraction of ventricles occurs as a wave of contraction spreads
through both the ventricles. This is stimulated by AV node stimulation. The bicuspid and
tricuspid valves close and produce the first heart sound, i.e., lub (lasting for 0.I6-0.9 second)
Ventricular Diastol : As ventricles relax both semilunar valves close with a sound of dub. At this
time, pressure within the ventricles decreases continually.
Joint Diastole : Before the cycle starts again (i.e. before the atrial systole), both the atria
ventricles are relaxed and this state is known as the joint diastole.

Heartbeat
Rhythmic contraction and relaxation of the heart is known as heartbeat.
Heartbeat can be regulated by the following two mechanisms :
Nervous regulation :Sympathetic nervous system increases the heartbeat by secreting
adrenaline hormone. Parasympathetic nervous system supplying vagus nerves decreases the
heartbeat by secreting Acetylcholine (Ach).
Hormonal regulation :Thyroxine, epinephrine, and nor-epinephrine affect the heartbeat.
Thyroxine is secreted by the thyroid gland and increases the heartbeat indirectly by increasing
Basal Metabolic Rate (BMR). Epinephrine and nor-epinephrine are secreted
by the adrenal medulla. In cases of emergency, epinephrine increases the heartbeat; while
under normal conditions, nor-epinephrine increases the heartbeat.
Cardiac Output
Cardiac output is defined as the amount of blood flowing from the heart (i.e., from the left
ventricle into aorta) over a given period of time (or in one heartbeat).
Cardiac Output = Stroke Volume x Heart Rate
= 70ml x 72/min = 5040ml/min
= about 5 litre/min
Where, Stroke volume = Volume of blood pumped by heart/heartbeat).
( Heart rate =Ventricular systole/min.)
Basics of ECG (Electrocardiogram)
Electrical currents generated in the heart by the propagation of action potential can be detected
on the surface of the body as electrical signals.
These changing signals are recorded by an instrument known as an electrocardiograph.
The recordings obtained are known as electrocardiogram (ECG).
Hence, ECG is a composite record of action potentials produced by all the muscle fibres of the
heart with each heart beat.
Comparison of these records with each other and with the normal one helps in determining the
complications like-
Any abnormality in the conducting pathway,
Any enlargement in the heart,
Damage to any region of the heart, or
Any type of pain occurring in the chest.

Blood Pressure and its regulations

Blood pressure is the hydraulic pressure exerted by the blood on the blood vessels
Normal blood pressure has high systolic value and low diastole value 120mmHg/ 80mm Hg in
arteries.
Arterial blood are be of four types:
Systolic Pressure : It is the maximum L pressure or peak pressure ( 120mmHg in a healthy
adult) exerted in the arteries during the systole of the heart.It occurs at the beginning of the
cardiac cycle when the left ventricle contracts and pumps blood to the aorta.
Diastolic Pressure : It is the minimum pressure (80mmHg in a healthy adult) on the arteries It
occurs at the end of the cardiac cycle when the ventricles are in resting phase after pumping the
blood.
Pulse Pressure : It is the differential pressure of systolic and diastolic pressure It is about
4QmmHg in a healthy adult.
Apparatuses
Stethoscope:
The word stethoscope consists of two words Steth means chest and Scope means to inspect.
The stethoscope in Its present from was introduced in 1819, by Laennec, whereas, Chat
Korotkoff, in 1905 used it first time for recording the blood pressure.
It is used to hear the sounds produced in the chest and elsewhere in the body.
The stethoscope has the following three parts:
I. Chest-Piece
II. Rubber Tubing
III. Ear Frame

Sphygmomanometer
This instrument is commonly known as the BP apparatus and is used to record arterial blood
pressure in humans.
The word sphygmomanometer is derived from three Greek roots with Latin equivalents
sphygmo means pulse, manos means thin, and metron means to measure.
Nowadays various forms of BP instruments are used, but the most common one is the mercury
sphygmomanometer which consists of the following parts:
a) Mercury Manometer
b) Air Pump (Rubber Bulb)
c) Gradulated Tube
d) Armlet ( Rubber bag / Riva Rocci Cuff )