Introduction to CVS

physiology

A.P. Ali A. Hadi / Al-Ameed university/ Medical

college
 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
Slide 11.1
 The Heart

 Location
 Thorax between the lungs
 Pointed apex directed toward left hip
 About the size of your fist
 Less than 1 lb.

Slide 11.2a
The Heart

Figure 11.1

Slide 11.2b
 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
Slide 11.3
 The Heart: Heart Wall
 Three layers
 Epicardium
 Outside layer
 This layer is the parietal pericardium
 Connective tissue layer
 Myocardium
 Middle layer
 Mostly cardiac muscle
 Endocardium
 Inner layer
 Endothelium
Slide 11.4
External Heart Anatomy

Figure 11.2a Slide 11.5

 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
Slide 11.6
Blood Circulation

Figure 11.3
Slide 11.7
 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
Slide 11.8
 The Heart: Valves

 Valves open as blood is pumped

through
 Held in place by chordae tendineae
(“heart strings”)
 Close to prevent backflow

Slide 11.9
 Operation of Heart Valves

Figure 11.4
Slide 11.10
Valve Pathology

Incompetent valve = backflow and repump 

Stenosis = stiff= heart workload increased 
May be replaced 
Lup Dub Heart Sound 
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
Slide 11.11
 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
Slide 11.12
 The Heart: Conduction System

 Intrinsic conduction system

(nodal system)
 Heart muscle cells contract, without nerve
impulses, in a regular, continuous way

Slide 11.13a
The Heart: Conduction System

 Special tissue sets the pace

 Sinoatrial node (right atrium)
 Pacemaker
 Atrioventricular node (junction of r&l atria
and ventricles)
 Atrioventricular bundle (Bundle of His)
 Bundle branches (right and left)
 Purkinje fibers
Slide 11.13b
Heart Contractions

Figure 11.5

Slide 11.14b
Electrocardiograms (EKG/ECG)

• Three formations
– P wave: impulse across atria
– QRS complex: spread of impulse down septum,
around ventricles in Purkinje fibers
– T wave: end of electrical activity in ventricles
Electrocardiograms (EKG/ECG)
(cont.)

Figure 8.15B, C
Pathology of the Heart

Damage to AV node = release of ventricles from 

control = slower heart beat
Slower heart beat can lead to fibrillation 
Fibrillation = lack of blood flow to the heart 
Tachycardia = more than 100 beats/min 
Bradychardia = less than 60 beats/min 
 The Heart: Cardiac Cycle

 Atria contract simultaneously

 Atria relax, then ventricles contract
 Systole = contraction
 Diastole = relaxation

Slide 11.16
 Filling of Heart Chambers –
the Cardiac Cycle

Figure 11.6

Slide 11.15
 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
Slide 11.18
.Cardiac output, cont

CO = HR x SV 
ml/min = 75 beats/min x 70 mls/beat 5250 
Norm = 5000 ml/min 
Entire blood supply passes through body once per 
.minute
.CO varies with demands of the body 
 Cardiac Output Regulation

Figure 11.7

Copyright © 2003 Pearson Education, Inc. publishing as Benjamin Cummings Slide 11.19
 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
 Changing heart rate is the most
common way to change cardiac output

Slide 11.20
 Regulation of Heart Rate
 Increased heart rate
 Sympathetic nervous system
 Crisis
 Low blood pressure
 Hormones
 Epinephrine
 Thyroxine
 Exercise
 Decreased blood volume
Slide 11.21
 The Heart: Regulation of Heart
Rate
 Decreased heart rate
 Parasympathetic nervous system
 High blood pressure or blood volume
 Dereased venous return
 In Congestive Heart Failure the heart is
worn out and pumps weakly. Digitalis
works to provide a slow, steady, but
stronger beat.
Slide 11.22
Congestive Heart Failure
(CHF)
Decline in pumping efficiency of heart 
Inadequate circulation 
Progressive, also coronary 
atherosclerosis, high blood pressure
and history of multiple Myocardial
Infarctions
Left side fails = pulmonary congestion 
and suffocation
Right side fails = peripheral congestion 
and edema
 Blood Vessels: The Vascular
System

 Taking blood to the tissues and back

 Arteries
 Arterioles
 Capillaries
 Venules
 Veins

Slide 11.23
The Vascular System

Figure 11.8b

Slide 11.24
 Blood Vessels: Anatomy
 Three layers (tunics)
 Tunic intima
 Endothelium
 Tunic media
 Smooth muscle
 Controlled by sympathetic nervous
system
 Tunic externa
 Mostly fibrous connective tissue
Slide 11.25
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
Slide 11.26
 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

Slide 11.27
Capillary Beds

 Capillary beds
consist of two
types of vessels
 Vascular shunt –
directly connects an
arteriole to a venule

Figure 11.10 Slide 11.28a

Capillary Beds

 True capillaries –
exchange vessels
 Oxygen and
nutrients cross to
cells
 Carbon dioxide
and metabolic
waste products
cross into blood

Figure 11.10 Slide 11.28b