CARDIOVASCUL A

R SYSTEM
DR AMNA SAEED
CARDIOVASCULAR SYSTEM (C.V.S)
• Primary function of the cardiovascular system is to supply body cells with O2 and nutrients and carry away CO2 and waste
products.
• Cardiovascular system is a closed-circuit system, composed:
– Heart
– Arteries
– Capillaries
– Veins
– Blood
• We can divide the primary function of CVS into two major divisions
• Pulmonary circulation:
1). Carries blood to the lungs
2). Eliminates CO2 via the lungs and
3). returns blood to the heart
• Systemic circulation:
1). Supplies blood to the rest of the body
2). Delivers O2 to all the body
3). And carries away wastes.
 THE HEART
• The heart is a cone-shaped, hollow, muscular pump.
• Size: the adult heart has a mass of between 250-
350 gram and is about the size of a clenched fist,
around 14 cm long and 9 cm wide.
• Location: the heart lies in the mediastinal area of
thoracic cavity between the lungs.
• Surrounding structures:
- Posterior to sternum
- Medial to lungs
- Anterior to vertebral column
- On the top of diaphragm
- About 2/3 of heart lies left to midline.
BASE, APEX, AND SURFACES OF THE
HEART
• Base: is formed by left and right atria. Mostly the left atrium
found beneath the 2nd rib.
• Apex: lies in the left 5th intercostal space, Formed by the
left ventricle.
• Inferior/ diaphragmatic: liens on underside. It formed by
left and right ventricles.
• Anterior/ Sternocostal: lies just behind the sternum and
the ribs. Formed mostly by the right ventricle.
• Left/ pulmonary: formed mostly by left ventricle.
PERICARDIUM
• A sac called pericardium covers the heart. The pericardium restricts heart movements in the
thoracic cavity and prevents overfilling with blood.
• The pericardium is composed of 2 parts:
1. Fibrous pericardium: is the outer part of pericardium and it composed of tough dense
connective tissue.
2. Serous pericardium: is the inner part of pericardium and it composed of 2 subdivisions
a. A parietal layer: that lines the inner surface of the fibrous pericardium
b. Visceral layer (epicardium): that covers the outside of the heart.
c. Pericardial cavity: a thin space between the parietal and visceral layers of pericardium which
contains a serous fluid. The serous fluid lubricates the membranes and reduce prevents the friction
during heartbeat.
HEART WALL STRUCTURE

The heart wall consists of three layers:

[Link] epicardium (epi = upon or above): is the outer layer of the heart, composed mainly of
simple squamous epithelium and areolar connective tissue.
[Link] myocardium (myo= muscle): Is the middle layer of the heart wall .and, is composed of
cardiac muscle tissue. The myocardium is the thickest of the three heart wall layers.
[Link] endocardium (endon= within): is the inner layer of the heart wall and it composed of
simple squamous epithelium and a layer of areolar connective tissue. The endocardium also
covers the surface of valves and continues as the endothelium of blood vessels.
 CHAMBERS OF THE HEART
• Heart consists 4 chambers, the 2 superior chambers are known as atria (right atrium and
left atrium). The 2 inferior chambers are known as ventricles (right ventricle and left
ventricle).
• Right Atrium: it receives deoxygenated blood and passes it the right ventricle. Opening
into the right atrium:
1. Superior vena cava (blood comes from head neck, upper limbs and superior regions of
the trunk and enters into right atrium)
2. Inferior vena cava (blood comes from lower limbs, and trunk and enters into right
atrium.
3. Coronary sinus (blood comes from the heart wall and enters into right atrium).
4. Right atrioventricular opening (blood leaves right atrium and enters into right ventricle).
This opening is guarded by tricuspid valve.
• Interatrial septum forms a thin wall between the right and left atria.
• Fossa ovalis: is an oval depression in the interatrial septum. It represents a remnant of fetal
foramen ovale.
• Right Ventricle:
The right ventricle forms most of the anterior surface of
the heart. Deoxygenated blood flows into the right
ventricle from the right atrium.
Opening of the right ventricle:
1. Right aterioventricular opening (via tricuspid valve) blood
enters ventricle
2. Pulmonary trunk (blood leaves the right ventricle and
enters into pulmonary artery.
An interventricular septum forms a thick wall between the
right and left ventricles
❑ Left Atrium: oxygenated blood enters the left
atrium from the pulmonary veins.
• Opening of the left atrium:
1. Pulmonary veins (blood comes from lungs
and enters left atrium).
2. Left atrioventricular opening: blood leaves
left atrium and enter the left ventricle. this
opening is guarded by mitral (bicuspid) valve
❑ Left Ventricle: oxygenated blood flows into the
left ventricle from the left atrium. The wall of left
ventricle is 2-3 times as thick as right ventricle.
• Opening in the left ventricle:
1. Left atrioventicular opening (blood comes
from the left atrium).
2. Aortic (blood leaves left ventricle to flows
into aortic artery). It is guarded by aortic valve.
 THE VALVES:
• The valves are connective tissue flaps that lined by epithelial tissue.
• Their function is to permit the passage of the blood in one direction and prevent backflow.
• In the heart, there are 4 valves; two as Atriovanticular and two as Semilunar.
• Atrioventricular valves:
1. Right atriovantricular valve (tricuspid) is made of three cusps.
2. Left atriovantricular valve (mitral or bicuspid) is made of two cusps. The free edges of the cusps are
attached to papillary muscles through the cord like structures called cordae tendineae.
The free edges of the cusps are attached to papillary muscles through the cord like structures called cordae
tendineae.
Papillary muscles: these muscles are cone shaped which originated from the ventricular wall. There apex are
connected to cordae tendineae.
Cordae tendineae: are fine tendinous cords which are attached from papillary muscles to the border of cusps.
This attachment is to prevent the bulging of the valves into the atria during ventricles contract.
• Semilunar Valves: .
1. Aortic valve: present at the opening the
aorta in left ventricle. (has 3 cusps).
2. Pulmonary valve: present at the opening
of pulmonary trunk. (has 3 cusps)
• These valves open when ventricles contract
to allow the blood to flow from right
ventricle to pulmonary artery and from left
ventricle to aorta.
• They close when ventricle relax
• The pulmonary and aortic valves prevent back flow from the pulmonary trunk into the right
ventricle and from the aorta into the left ventricle.
• Cardiac muscle cells are joined by gap junctions that permit action potentials to be conducted
from cell to cell. ·
• The myocardium also contains specialized muscle cells that constitute the conducting system of
the heart, initiating the cardiac action potentials and speeding their spread through the heart.
• Aorta: It is the largest artery and carries oxygenated blood from the heart to the rest of the body.
• Superior Vena Cava: Deoxygenated blood from the upper parts of the body returns to the heart
through the superior vena cava.
• Inferior Vena Cava: Deoxygenated blood from the lower parts of the body returns to the heart
through the inferior vena cava.
• Pulmonary Veins: They carry oxygenated blood from the lungs back to the heart.
• Pulmonary Arteries: They carry blood from the heart to the lungs to pick up oxygen
P AT H W AY
OF BLOOD
THROUGH
THE
HEART
AND
LUNGS
CARDIAC
MUSCLE
NERVE SUPPLY TO THE HEART

• Derived from thoracic spinal cord T1-T2.

• Stimulation of the heart by sympathetic nervous system
Sympathetic: leads to increase heart rate (tachycardia), increase force of
contraction, and dilation of coronary arteries.

• branches of vagus nerve (cranial nerve X)

• Stimulation of the heart by parasympathetic nervous system
Parasympathetic: leads to: Slowing of the heart (bradycardia), reduction in the
force of contraction, and constriction of coronary arteries.
CONDUCTING SYSTEM OF THE HEART

• The heartbeat originates in a specialized cardiac muscle cells (cardiac conducting system) and
spreads via this system to all parts of the myocardium.
• Parts of conducting system:
1. Sinoatrial (SA) node is located in the posterior wall of right atrium (at the junction of the
superior vena cava with the right atrium).
[Link] (AV) node is located in the right posterior portion of interaterial septum
3. Bundle of His: located in the interventricular septum and divided into branches right and left.
4. Purkinje fibers: begin within the apex of the heart and extend through the walls of the ventricles.
This system has ability to stimulate cardiac contraction without any innervations.
ELECTRICITY AND ACTION POTENTIAL OF THE CARDIAC
MUSCLE
• Myocardial fibers have a
resting membrane potential
of approximately (-90) mV.
• At resting membrane
potential the Na+ channel
Ca++ channel are closed.
While some leakage of K+
through K+ channel.
ELECTRICITY AND ACTION POTENTIAL OF THE CARDIAC MUSCLE:

RAPID DEPOLARIZATION

• The action potential in the stimulated cardiac myocyte

is divided into 5 phases:
• - Phase 0 : rapid depolarization: occurs due to rapid
Na+ influx, so the inner membrane gradually becomes
less negative, and when the membrane potential
becomes (- 40)mV (reaches the threshold for initiating
action potential), the Ca++ influxes leads to produce
the rapidly rising phase of action potential
depolarization. The membrane potential reaches to the
+30 mV.
ELECTRICITY AND ACTION POTENTIAL OF THE CARDIAC MUSCLE:

• - Phase 1: initial rapid repolarization. It is a short phase. The membrane potential in this phase
reaches to (-10) mV. This phase occurs due to closure of Na+ channel and opening of K+
channel.
• - Phase 2: plateau. It occurs due to slow influx of Ca++.
• - Phase 3: repolarization. during this phase complete repolarization and the membrane
reaches to approximately resting value.
• - Phase 4: resting [Link] membrane potential is maintained at (- 90)mV.
• Action potential causes the release Ca++ into cytoplasm (from sarcoplasm) which causes the
muscle contraction.
• All heart cells are electrically joint one to another by intercalated disc (gap junction), so one
cardiac muscle generate action potential it just spread to the other.
• Duration of action potential is about 250 msec. at a heart rate 75 beats/ minute. The duration
of action potential decrease when heart rate increases.