Cardiovascular system
Learning Objectives
• Components
• Classification of blood vessels
• Types of circulation
• Related clinical aspects
Components of CVS – Heart and Blood
Heart
• 4 chambered muscular organ • Right & left atria separated
• Structurally and functionally – by Interatrial septum
divided into right & left • Right & left ventricle
• Each half – inflow (atrium) & separated by Interventricular
outflow chamber (Ventricle) septum
• Right heart – “Pulmonary • Right atrium opens into right
circulation” ventricle – Tricuspid valve
• Left heart – “Systemic • Left atrium opens into left
circulation” ventricle – Mitral valve
LA
RA MV
LV
TV
RV
Blood
• Consists of vessel of varying calibre, structure and function
• “Angeion” – Vessel
• Arteries – Carry oxygenated blood away from the heart
• Veins – Carry deoxygenated blood towards the heart
Arteries Veins
• Carry blood away from the • Carry blood towards the
heart heart
• Deep inside the body • Present superficial and deep
• Reddish in colour • Bluish in colour
• Wall – Thick • Wall – Thin
• Lumen – Narrow • Lumen – Wider
• Valves – Absent • Valves – Present
• Uses - Pulsation • Uses – I/V injections, Blood
investigations
Microscopic structure of blood vessel
• 3 layers – Tunica intima, Tunica media, Tunica adventitia
• Tunica intima – lined by squamous epithelium
ENDOTHELIUM
• Tunica media – consist of smooth muscles and elastic fibers
• Tunica adventitia – connective tissue
Classification of BV
based on calibre
Heart
Aorta SVC & IVC
Arteries (Large arteries >1 cm) Veins (Large veins >1 cm)
Medium-sized arteries 1-10 mm Medium-sized veins 1-10 mm
Arterioles <1 mm Venules <1 mm (Tributaries)
Capillaries (network of microscopic Sinusoids (In some organs,
vessels that connect arterioles and capillaries are replaced by
venules) sinusoids. Eg) Liver, Spleen)
Classification of BV
• Based on structure • Based on function
➢ Elastic artery ➢ Conductive vessels
➢ Muscular artery ➢ Distributive vessels
➢ Arteriole ➢ Resistance vessels
➢ Capillary/Sinusoid
➢ Exchange vessels
➢ Venules
➢ Capacitance / Reservoir
➢ Veins
Blood supply of Arteries Nerve supply of Arteries
• “Vasa vasorum” (a vessel • “Nervi vascularis”
supplying another vessel)
Venae Comitantes
• “Pair of veins that accompany artery”
• Helps in venous return towards the
heart by transmitted pulsation of
arteries
• Helps in counter current heat exchange
between arteries and veins
Factors that facilitate the venous return
• Gravity
• Arterial pulsation
• Contraction of muscles
• Presence of valves in veins
• Negative pressure within thorax
• Vis-a-tergo phenomenon
Venous system
• Caval system – SVC and IVC
• Portal system – 2 sets of capillaries (Hepatic portal, Renal
portal circulation)
• Azygous system – Present in thoracic cavity
• Paravertebral system of Batson – Present inside the
vertebral canal
Anastomosis
• “Pre or post capillary communication between the adjacent
vessels”
• 3 types
➢ Arterial anastomosis – Artery joins with another artery
➢ Venous anastomosis– Vein joins with another vein
➢ Arteriovenous anastomosis - Artery (arteriole )
communicates with vein (venule)
Collateral circulation
• “Circulation of blood through
anastomosis”
• Eg) Circle of Willis in brain
End arteries
• “Arteries do not anastomose with neighbouring arteries”
➢ Anatomical end arteries - Eg) Central artery of retina,
arteries of lungs, Cerebral arteries, Metaphyseal arteries of
bone
➢ Functional end arteries – Eg) Coronary arteries
➢ C/I – Necrosis
Types of Circulation
• Pulmonary circulation
• Systemic circulation
• Portal circulation
Foetal Systemic
circulation - circulation -
before after birth
birth
Clinical aspects
• Artery – used to feel for pulsation
• Veins – Used for giving medicines, fluids & withdrawing
blood for investigations
• Varicose veins – large, swollen & tortuous veins
• Phlebitis – Inflammation of vein
• Thrombophlebitis – Presence of blood clots in the vein
causing inflammation
Clinical aspects
• Angiography – Imaging technique to visualize the lumen of
the blood vessel
• Angiogram – “X-ray” image of the blood vessel
• Atherosclerosis – Narrowing of the artery due to the
formation of atheromatous plaques
• Haemangioma – Benign tumour of blood vessel
Summary
• Artery – Large artery, Muscular artery, Arterioles
• Veins – Large vein, Medium sized vein, Venules
• Capillaries / Sinusoids
• Venae commitantes
• Anastomosis
• Collateral circulation
• End arteries
Case scenario
• A 49-year-old woman who is a k/c/o breast carcinoma
presented with c/o back ache, dizziness, fatigue and loss of
appetite. She was currently on chemotherapy and
radiotherapy. Blood investigations and imaging studies have
stated it as metastasis.
1) Where would have probably got metastasized?
2) What is the mode of spread?
3) Which venous system is commonly involved in this case?
Answers
• Metastasized site - Vertebrae
• Through venous spread
• Paravertebral venous system of Batson
Thank you