TOPIC 9.

CARDIOVASCULAR
SYSTEM
Msc. Omar Torres Soto
 Anatomy and Physiology of the Cardiovascular System
The cardiovascular system consists of:

Blood Vessels Heart Blood

 Blood Vessels
The cardiovascular system consists of three types of blood vessels that transport blood:

Capillaries. Which allow gas,

nutrient and waste exchange
to take place with the tissues.

Veins (and venules). Arteries (and arterioles).

which return blood which carry blood away
from the capillaries from the heart to the
to the heart. capillaries.
 The Arteries
The walls of the arteries have three layers:

The Inner layer (endothelium).

Consists of simple squamous
epithelium with an underlying
connective tissue basement
membrane.

The middle layer.

Consists of a thick layer of
smooth muscle that regulates
blood pressure.

The outer layer.

Consists of connective tissue.
 Arterioles
Is a small-diameter blood vessel in the
microcirculation that extends and
branches out from an artery and leads
to capillaries.

An Arteriole can:
Vasoconstrict (decrease diameter).
Vasodilate (Increase diameter).

Precapillary sphincter:
Controls blood flow to capillary beds.

Blood flow in the arteries and arterioles is

due to blood pressure caused by the
pumping of the heart.
 The Capillaries
Capillaries join arterioles to venules.
They are extremely narrow and
have thin walls that are composed
of a single layer of endothelium Venules Arterioles
with a basement membrane.

Capillaries facilitate exchange of:

• Wastes.
• Nutrients.
• Gases and hormones between
blood and body cells.
Capillaries
Capillaries are important in maintaining homeostasis because:

• They exchange substances between the blood and the tissues.

• Oxygen and nutrients diffuse out of the capillaries and into the tissue fluid that surrounds
the cells (also called interstitial fluid).
• Wastes, such as carbon dioxide, diffuse into the capillaries.

Homeostasis absolutely
dependents on capillary exchange.
 Capillary exchange
is the exchange of materials between
the blood and the interstitial fluid.

Two forces control the movement

of fluid through the capillary wall:

• Osmotic pressure: Which is created

by plasma proteins and salts, and
tends to pull water from the tissues
into the capillary.

• Blood pressure, which tends to cause

water to move from the blood into
the tissue fluid.
Any excess tissue fluid is collected by the lymphatic capillaries and becomes lymph.

The excess water and solutes that filter out

of the capillary are picked up by the lymph
vessels and returned to the circulation.
 The Veins
Veins and venules (small veins) take blood
from the capillaries back to the heart.

• Veins also have valves that cause

the blood to flow in one direction,
and avoid the backflow of blood.

• Blood flow in the veins is due to the

contraction of skeletal muscles near
veins, and the presence of valves in
the veins that prevent the back flow
of blood.

• Blood pressure in the veins is low.

 Blood Pressure
Pressure that is exerted by the blood upon the
walls of the blood vessels and especially arteries.

• Systolic pressure is the pressure of blood on

the walls of the arteries during ventricular
systole.

• Diastolic pressure is the pressure on the

walls of the arteries during ventricular
systole.
• Blood pressure can be measured with a
sphygmomanometer. It is expressed in
millimeters of mercury (mm Hg).

• A blood pressure reading consists of the systolic

and diastolic pressures, for example 120/80.

• Pulse: The rhythmic dilation of an artery that

results from beating of the heart.
It can be used to determine heart rate, which is
the number of times the heart beats per minute.
 Heart
The heart is a cone-shaped, muscular organ about
the size of a fist that is responsible for pumping
blood though the cardiovascular system.

• Pericardium: a thick, serous membrane that

secretes a small amount of liquid for lubrication.

• The pericardial sac has two layers, a serous layer

and a fibrous layer. It encloses the pericardial cavity
which contains pericardial fluid.

• The pericardium fixes the heart to the mediastinum,

gives protection against infection and provides the
lubrication for the heart.
• Myocardium: Most of the heart is made up of this
cardiac muscle.

• The inner surface of the heart is lined with endocardium,

a membrane composed of connective tissue and a layer
of simple squamous epithelium called endothelium
Internally, the heart is divided into right and
left hand sides by the septum, and then
further divided into four chambers:

• two upper chambers called atrium.

• two lower chambers called ventricles.
• The valves between the atria and ventricles are called the
atrioventricular or AV valves.

• The right AV valve is called the tricuspid valve because it

has three flaps.

• The function of the tricuspid valve is to prevent back flow of

blood from the right ventricle into the right atrium.

• The left AV valve is called the bicuspid or mitral valve

because it has two flaps.

• These valves are supported by the chordae tendineae,

which are strong fibrous strings that attach the ends of the
valves to the ventricles.
 CONTROL OF HEARTBEAT

Heartbeat can be controlled by two mechanisms:

• Intrinsic control
• Extrinsic control
 Intrinsic control of heartbeat
The rhythmic contraction of the atria and ventricles is due to
the intrinsic (or internal) conduction system of the heart,
which is possible because of :

• Nodal tissue. A unique type of cardiac muscle that

has both nervous and muscular characteristics.

• The SA (sinotrial) node is found in the upper back Sinotrial Node

(SAN)
wall of the right atrium.
HIS bundle

• The AV (atrioventricular) node is found in the base

Atrioventricular Node
of the right atrium, close to the septum. (AVN)

• His bundle is a collection of heart muscle cells

specialized for electrical conduction.

• The Purkinje fibres are specialized conducting

fibers composed of electrically excitable cells. Purkinje fibers
PF
 Extrinsic control of heartbeat

Heartbeat is initiated by intrinsic control, but it can

be regulated by extrinsic (or external) control by
the nervous system and hormones.

A cardiac control center in the medulla oblongata of

the brain can alter the heartbeat through the
autonomic portion of the nervous system.
The autonomic system has two subdivisions:

• The parasympathetic division, which functions during rest.

• The sympathetic division, which works in response to

increased activity or stress.

• The parasympathetic division decreases SA and AV nodal

activity when we are at rest

• The sympathetic division increases the nodal activity when

we are active or under stress.

• The hormones epinephrine and norepinephrine, which are

released by the adrenal medulla of the adrenal glands, also
stimulate the heart.
 Electrocardiogram

• An electrocardiogram (ECG) is a recording of the electrical

changes that occur in the myocardium during a cardiac
cycle.

• Electrodes are placed on or near the chest that are

connected by wires to an instrument that detects and
records the electrical changes that takes place in the
myocardium.
 Path of blood through the heart

1. Blood from the right atrium is sent through the tricuspid

Aorta
valve to the right ventricle.
Pulmonary
Artery
2. The right ventricle sends blood through the pulmonary
semilunar valve into the pulmonary trunk and then through Left Atrium
the two pulmonary arteries to the lungs. Right Atrium

3. Blood leaves the lungs through the four pulmonary veins to Mitral Valve
reach the left atrium. Tricuspid Valve

4. From the left atrium, blood is sent through the mitral valve
to the left ventricle.
Pulmonary Valve
5. The left ventricle sends blood through the aortic semilunar
valve into the aorta to the rest of the body. Right Ventricle
Left Ventricle
 The blood

Blood is an extracellular fluid that delivers vital substances such

as nutrients and oxygen to the cells, and transports metabolic
wastes products away form these same cells.

When it reaches the lungs, gas exchange occur resulting in

oxygenated blood. This oxygenated blood is transported back
to the heart and then to the rest of the body to oxygenate the
tissues. Blood contains many substances that maintain body
functions.
 COMPOSITION OF BLOOD

When blood is collected in a test tube and prevented from

clotting by adding an anticoagulant, it separates into three
layers:

• The top layer, which represents about 55% of the blood, is

the plasma.

• The thin middle layer, which represents less than 1 % of

blood, consists of leucocytes or white blood cells and
platelets.

• The bottom layer, which represents about 45% of blood,

contains the erythrocytes or red blood cells.
• Red blood cells or erythrocytes. The red blood
cells are shaped like biconcave disks that lack a
nucleus. This form gives them the flexibility to
travel through the blood vessels and increases
their surface area for diffusion of gasses.

• White blood cells or leukocytes. Their function is

to fight infection and aid in the development of
immunity, the ability of the body to resist disease.

• Platelets or thrombocytes. Platelets are involved

in the process of blood clotting or coagulation,
which occurs when a blood vessel is damaged.
 Vascular Pathways
Pulmonary circuit

The pulmonary circuit begins in the right atrium where blood

collects from all regions of the body.

• The arterioles take blood to the pulmonary capillaries,

where gas exchange occurs.

• Blood then passes through the pulmonary venules, which

lead to the four pulmonary veins (two from each lung) that
enter the left atrium.

• Since blood in the pulmonary arteries is oxygen-poor but

the blood in the pulmonary veins is oxygen rich, it is not
correct to say that all arteries carry oxygen rich blood and all
veins carry oxygen deficient blood.
 Systemic circuit
• The systemic circuit includes the major arteries and veins of the
body. The superior and the inferior vena cava are the largest veins in
the body.

• The superior vena cava collects blood from the head, the chest, and
the arms, and the inferior vena cava collects blood from the lower
body regions.

• The aorta is the largest artery in the systemic circuit and carries
oxygenated blood from the left ventricle to the body.

• The aorta and the vena cave serve as the primary pathways for
blood in the systemic circuit.

 The path of systemic blood to any organ in the body begins in the
left ventricle, which pumps blood into the aorta, and from there,
the blood travels to the major arteries that reach the tissues of the
body.
• The coronary arteries feed the heart muscle.

• The coronary arteries are the first branches off of the aorta;
they branch into arterioles and then capillaries that feed the
heart muscle.

• Since the coronary arteries have a very small diameter, they

are susceptible to becoming clogged.

• The coronary capillaries join to form venules that join to

form the coronary veins, and then the coronary sinus that
empties into the right atrium.
 Disorders of the Cardiovascular System

Disorders of the cardiovascular system are diseases that affect the

cardiovascular system and they include :

• Atherosclerosis.
• Hypertension, stroke.
• Heart attack.
• Aneurysm.
 Atherosclerosis

Atherosclerosis is an accumulation of fatty

materials, mainly cholesterol, beneath the inner
linings of arteries, forming deposits called
plaque.
 Hypertension

• Is high blood pressure. It is present when the systolic blood

pressure is 140 or greater, or the diastolic pressure is 90 or
greater.

• Hypertension is called the silent killer because it may not be

detected until a stroke or heart attack occurs.
 Stroke

• A stroke or cerebrovascular accident usually results when a

small cranial arteriole bursts or is blocked by an embolus.
Lack of oxygen causes a portion of the brain to die, resulting
in paralysis or death.

• A person sometimes feels numbness in the hands or face,

difficulty in speaking, or temporary blindness in one eye as a
warning that a stroke is coming.
 Heart attack

• A heart attack, also called a myocardial infarction

(MI), occurs when a portion of the heart muscle dies
due to lack of oxygen.

• When a coronary artery becomes partially blocked,

the person will suffer angina pectoris, or chest pain
that is characterized by a squeezing or burning
sensation.
 Aneurysm

• An aneurism is the ballooning of a blood

vessel, usually affecting the abdominal
artery or the arteries leading to the brain.
 How to prevent cardiovascular diseases

• Maintaining a healthy diet is very important for reducing

the risk of cardiovascular disease.

• People who exercise are less likely to have cardiovascular

disease. Exercise not only helps keep weight under control,
but it also helps reduce stress and hypertension.

• When blood levels of LDL are high, and HDL are low, plaque
accumulates on the wall of the arteries.

• LDL levels rise when people eat foods high in saturated fats
such as red meat, cream, and butter, and foods containing
trans-fats such as margarines, commercially baked good,
and deep-fried foods.