THE CARDIOVASCULAR

SYSTEM
TERESA NYANCHAMA

1
OBJECTIVES

By the end of the learning session, the students

will be able to:
 Describe the position and structure of the

heart
 Outline the conducting system of the heart
 Describe the structure of different blood

vessels

2
The Heart

 Roughly Cone-shaped hollow

muscular organ size of the owner’s
fist.
 About 10 cm long, weighs about

225g(women) and 310g(men)

3
Position
 Located in the thoracic cavity in the
mediastinum
 Lies obliquely-directed anteriorly,

inferiorly, and to the left with a base

above and apex below
 Rests on the diaphragm, near the

midline of the thoracic cavity.

4
Position Cont’d

 Baseextends to the level of 2nd rib

 Apex lies 9cm to the left of the

midline in the 5th intercostal space

5
Relations of the heart

 Anteriorly- sternum, ribs and

intercostal muscles
 Posteriorly- oesophagus, trachea,

bronchi, descending aorta, inferior

vena cava and thoracic vertabrae

6
Relations Cont’d

 Laterally- lungs
 Superiorly- the great vessels
 Inferiorly-diaphragm

7
Position of the Heart

Figure 1
8
Pericardium
 A double-walled sac around the
heart
 composed of:
◦ A superficial fibrous pericardium
◦ A deep two-layer serous
pericardium

9
Fibrous pericardium

 Composed of tough, inelastic, dense

irregular connective tissue.
 Its open end is fused to the

connective tissues of the blood

vessels entering and leaving the
heart.

10
Serous pericardium

 Madeof two layers:

 The parietal layer-lines the
internal surface of the fibrous
pericardium
 The visceral layer or epicardium
lines the surface of the heart

11
 They are separated by pericardial cavity
filled with pericardial fluid produced by
epithelial cells-this reduces the friction
between the layers as the heart moves

12
13
Functions of pericardium

 Prevents overstretching of the heart

 Provides protection,
 Anchors the heart in the

mediastinum.
 Allows for the heart to work in a

relatively friction-free environment

14
Heart Wall

Consists of:
 Epicardium
 Myocardium
 Endocardium

15
Epicardium
 visceral layer of the serous
pericardium
 Composed of mesothelium and

delicate connective tissue

16
Myocardium
 Themiddle layer
 makes up about 95% of the heart


17
Myocardium Cont’d
 Composed of cardiac muscle tissue
supported by Fibrous skeleton of the
heart – crisscrossing, interlacing
layer of connective tissue
 Responsible for its pumping action.

18
Endocardium

 Endothelial layer of the inner

myocardial surface
 Lines the chambers and valves of the

heart

19
Endocardium Cont’d
 Continuous with the endothelial
lining of the large blood vessels
attached to the heart
 Minimizes surface friction as blood

passes through the heart and blood

vessels.

20
Heart wall

21
Functions of the Circulatory System

 Brings blood containing oxygen, nutrients,

and hormones to cells
 •Transports CO2and other wastes away

from cells
 Fights infection
 •Regulates body temperature
 •Helps stabilize pH and ionic concentration

of body fluids

22
Major Vessels of the Heart

23
Vessels returning blood to
the heart
 Superior and inferior vena cava.
 Right and left pulmonary veins

24
Vessels conveying blood away from
the heart

 Pulmonary trunk, which splits into

right and left pulmonary arteries
 Ascending aorta

25
External Heart: Anterior
View

Figure 18.4b
26
Interior of the Heart

 Heart is divided into a right and left

side by a septum (myocardium
covered by endorcardium)
 Each side is divided by an

atrioventricular valve into atrium

above and ventricle below

27
Atria

 Atriaare the receiving chambers of

the heart
 Thin walled,
 On the anterior surface of each

atrium is a wrinkled pouchlike

structure (auricle)

28
Atria Cont’d
 Deliver blood to adjacent ventricles
 Blood enters right atria from superior

and inferior vena cava and coronary

sinus

29
Atria Cont’d
 Blood enters left atria from pulmonary
veins
 Right and left atria are separated by

interatrial septum which contains an oval

depression (fossa ovalis)

30
Ventricles of the Heart
 Ventricles are the discharging
chambers of the heart
 Inside the ventricles is a series of

ridges formed by raised bundles of

cardiac muscle fibers called trabeculae
Carneae.

31
Ventricles Cont’d
 Right ventricle pumps blood into the
pulmonary trunk
 Left ventricle pumps blood into the

aorta
 Thick walled with left ventricle wall

being the thickest to supply systemic

circulation

32
Thickness of ventricles
 Right-4-5mm forms most of the anterior
surface of the heart.
 Left 10-15 mm; forms the apex of the heart

33
34
Thickness of Cardiac Walls

Myocardium of left ventricle is much thicker than the right.

35
Fibrous skeleton
 Four dense connective tissue rings that
surround the valves of the heart, fuse with
one another, and merge with the
interventricular septum.

36
 Functions:
◦ Form a structural foundation for the heart valves,
◦ prevents overstretching of the valves as blood
passes through them.
◦ serves as a point of insertion for bundles of
cardiac muscle fibers
◦ acts as an electrical insulator between the atria
and ventricles.

37
Skeleton Cont’d

38
Heart Valves
 Heartvalves ensure unidirectional
blood flow through the heart

39
Atrioventricular valves
 Liebetween the atria and the
ventricles
 Right has 3 flaps/cusps(Tricuspid)

40
 Left has 2 cusps(mitral)
 Chordae tendineae anchor AV valves to

papillary muscles(cone shaped trabeculae

Carneae muscles)

41
42
A-V Valves

43
Semilunar valves
 Aortic semilunar valve lies between
the left ventricle and the aorta
 Pulmonary semilunar valve lies

between the right ventricle and

pulmonary trunk

44
Semilunar valve

45
Heart Valves

Figure 18.8a, b
46
Interior of the heart: Anterior view

47
Pathway of Blood Through the Heart and Lungs

 Right atrium  tricuspid valve  right

ventricle
 Right ventricle  pulmonary

semilunar valve  pulmonary arteries

 lungs

48
 Lungs  pulmonary veins  left atrium
 Left atrium  bicuspid valve  left ventricle
 Left ventricle  aortic semilunar valve 

aorta
 Aorta  systemic circulation

49
 Drawa diagram illustrating the
pathway of blood through the heart

50
Coronary Circulation
 Coronary circulation is the functional
blood supply to the heart muscle
itself
 Collateral routes ensure blood

delivery to heart even if major

vessels are occluded

51
Arterial supply
 Right and left coronary arteries
supply the heart
 Branch from the aorta immediately

distal to the aortic valve

 Encircle the heart
 Receive about 5% of the blood

pumped from the heart.

52
53
Venous Drainage

 Most blood is collected into cardiac veins

that join to form coronary sinus which opens
to the right atrium
 Cardiac Veins –great, small, anterior, and

middle cardiac veins

54
55
Coronary Circulation: Venous Supply

Figure 18.7b56
BLOOD FLOW THROUGH THE
HEART

57
58
59
 deoxygenated bloodenters the atriumon the right side
of the heart.
 deoxygenated bloodcomes in from the top of the body

through the superior vena cava.

 deoxygenated bloodcomes in from the lower body

though the inferior vena cava.

60
 The right pulmonary arterytakes the
deoxygenated bloodto the right lung.
 The left pulmonary arterytakes the

deoxygenated bloodto the left lung.

 THE PULMONARY ARTERIES ARE THE ONLY

ARTERIES THAT CARRY UNOXYGENEATED

BLOOD.

61
62
 In the lungs, the carbon dioxidein the blood
diffusesinto the alveoli.
 The oxygenin the lungs diffusesinto the

blood.
 This is called gas exchange

63
 Oxygenated blood from the lungs enters the
heart through the left atrium.
 The mitral valve is closed to keep the blood

from going into the ventricle.

 The left atrium contracts. This forces the

oxygenated blood through the mitral valve

into the right ventricle

64
 Oxygenated bloodfrom the right lungreturns
to the heart through the right pulmonary
vein. Oxygenated bloodfrom the left
lungreturns to the heart through the left
pulmonary vein.
 THE PULMONARY VEINS ARE THE ONLY

VEINS THAT CARRY OXYGENATED BLOOD.

65
 While the deoxygenated blood is in the right
atrium, the tricuspid valve is closed to keep
the blood from flowing down to the ventricle.
 The atrium contracts and the tricuspid valve
opens, forcing the blood down into the
ventricle.
 The tricuspid valve closes again so that blood
cannot move back up into the atrium.
 The ventricle contracts. This forces the
deoxygenated blood through the pulmonary
valve and into the pulmonary arteries.

66
 The mitral valve closes again. This keeps
the oxygenated blood from moving back up
into the atrium.
 Oxygenated blood is forced into the aorta to

be carried to the rest of the body.

 Oxygenated blood is carried to all body cells

where oxygen diffuses into the cells and

carbon dioxide diffuses into the blood.
 Blood carrying carbon dioxide then returns

to the heart. And the cycle begins again

67
Electrical Activity of the
Heart
 Contractionofcardiacmusclecellstoejectbloo
distriggeredbyactionpotentialssweepingacro
ssthemusclecellmembranes.
 •Theheartcontracts,orbeats,rhythmicallyasa

resultofactionpotentialsthatitgeneratesbyits
elf,apropertycalledautorhythmicity.

68
69
 The physiologic characteristics of the
cardiac conduction cells account for this
coordination:
 Automaticity:abilitytoinitiateanelectricalim

pulse
 Excitability:abilitytorespondtoanelectricali

mpulse
 Conductivity:abilitytotransmitanelectricali

mpulsefromonecelltoanother

70
 There are two specialized types of cardiac
muscle cells:
 Contractile cells, which are 99% of the cardiac
muscle cells, they do the mechanical work of
pumping and do not initiate their own action
potentials.
 In contrast, the small but extremely important
remainder of the cardiac cells, the
autorhythmic cells, do not contract but
instead are specialized for initiating and
conducting the action potentials responsible for
contraction of the working cells.

71
Conducting system of the heart
 Autorhythmic cells that act as:
◦ pacemakers
◦ Conducting system

72
73
Pacemaker
 Initiate action potentials setting the rhythm of
electrical excitation that causes contraction of the
heart.

74
Conducting system
 A network of specialized cardiac muscle
fibers that provide a path for each cycle of
cardiac excitation to progress through the
heart ensuring that cardiac chambers
become stimulated to contract in a
coordinated manner,
 This makes the heart an effective pump.

75
Sinoatrial (SA) node

 small mass of specialized cells lying

in the wall of right atrium near
opening of superior vena cava.
 It normally sets the heart rate-

pacemaker- triggers the atrial

contraction.

76
Atrioventricular (AV) node
 Smallmass of neuromuscular tissue
situated in the wall of the atrial
septum near the atrioventricular
valves

77
AV Node Cont’d

 Normally merely transmits the

electrical signals but also has a
secondary pacemaker function if
there is a problem with SA node
itself.

78
AV Node Cont’d

 There is an approximately 0.1 second

delay as the impulse passes through
into the ventricles.

79
Atrioventricular bundle(AV Bundle
or Bundle of His)
 Mass of specialized fibres that
originate from the AV node.
 Crosses the fibrous ring that seperates

atria and ventricles then, at the upper

end of the ventricular septum, it
divides into right and left bundle
branches.

80
Bundle of His

 Within the ventricular myocardium

the branches break up into fine
fibres- purkinje fibres

81
Conducting System of the Heart

82
83
84
Mechanical activity of the
heart
 Ventricular filling:mid-diastole. Pressure in the
heart is low, blood returning from the circulation is
flowing passively through the atria and the open
AV valves into the ventricles, and the aortic and
pulmonary valves are closed.
 Approximately 80% of ventricular filling occurs
during this period, and the AV valve flaps begin
to drift toward the closed position.The remaining
20% is delivered to the ventricles when the
atria contract toward the end of this phase. This
stage corresponds to the TP interval on the ECG

85
 LATE VENTRICULAR DIASTOLE Late
inventricular diastole,the SA node reaches threshold
and fires.The impulse spreads throughout the atria,
which appears on the ECG as the P wave.
 •END OF VENTRICULAR DIASTOLE Ventricular
diastole ends at the onset of ventricular contraction.
By this time, atrial contraction and ventricular
filling are completed. The volume of blood in the
ventricle at the end of diastole is known as the end-
diastolic volume(EDV), which averages about
135ml.

86
 Ventricularsystole.Astheatriarelax,theventricles
begincontracting.Theirwallscloseinonthebloodinth
eirchambers,andventricularpressurerisesrapidlyan
dsharply,closingtheAVvalves.
 •Ventricularpressurecontinuestoriseandwhenitfinal
lyexceedsthepressureinthelargearteriesissuingfro
mtheventricles,theisovolumetricstageendsastheSL
valvesareforcedopenandbloodisexpelledfromtheve
ntriclesintotheaortaandpulmonarytrunk.Duringthis
ventricularejectionphase,thepressureintheaortanor
mallyreachesabout120mmHg

87
 Theamountofbloodpumpedoutofeachventricl
ewitheachcontractioniscalledthestrokevolu
me(SV).
 •TheTwavesignifiesventricularrepolarization

attheendofventricularsystole.Astheventricle
startstorelax,onrepolarization,ventricularpre
ssurefallsbelowaorticpressureandtheaorticv
alvecloses

88
 Isovolumetricrelaxation:earlydiastole.Dur
ingthisbriefphasefollowingtheTwave,thevent
riclesrelax.Becausethebloodremainingintheir
chambers,referredtoastheendsystolicvolume
(ESV),isnolongercompressed,ventricularpres
suredropsrapidly

89
 NB:Whenthebodyisatrest,onecompletecardi
accyclelasts0.8sec,with0.3secdevotedtove
ntricularsystoleand0.5sectakenupbyvent
riculardiastole.
 •Significantly,muchofventricularfillingoccurs

earlyindiastoleduringtherapidfillingphase.
 •Duringtimesofrapidheartrate,diastolelengt

hisshortenedmuchmorethansystolelengthis

90
91
Heart sounds

 Heart sounds (lub-dup) are associated with

closing of heart valves
 –First soundoccurs as AV valves close and

signifies beginning of systole (contraction)

 –Second soundoccurs when SL valves

close at the beginning of ventricular

diastole (relaxation)

92
Cardiac output and its
control
 Cardiac output (CO) is the volume of
blood pumped by each ventricle per
minute (not the total amount of blood
pumped by the heart).
 The average resting heart rate is 75 beats

per minute,established by SA node

rhythmicity; the average resting stroke
volume is 70ml per beat, producing an
average resting cardiac output is 5 min to
6L/min
93
Cardiac output

 The two determinants of cardiac output are

heart rate (beats per minute) and stroke
volume (volume of blood pumped per beat
or stroke).
 With an average resting heart rate of 75
beats per minute, an average resting
cardiac output is 5 to 6L
 CO=HR heart rate * stroke volume
 =75beats/min * 70 ml/beat
 =5250ml/min
94
 Cardiac output increases markedly in response
to special demands, such as running to catch a
bus.
 The difference between resting and maximal
CO is referred to as CARDIAC RESERVE.
 In nonathletic people, cardiac reserve is
typically four to five times resting CO(20–
25L/min), but CO in trained athletes during
competition may reach 35L/min (seven times
resting).

95
Maintaining Blood Pressure and
tissue perfusion

 Maintaining a steady flow of blood from the

heart to the toes is vital for proper organ
function.
 •But making sure a person jumping out of

bed in the morning does not keel over from

inadequate blood flow to the brain requires
the finely tuned cooperation of the heart,
blood vessels, and kidneys—all supervised
by the brain.

96
 Central among the homeostatic
mechanisms that regulate cardiovascular
dynamics are those that maintain blood
pressure, principally
 •cardiac output
 •peripheral resistance
 •blood volume.

97
 Factors determining ABP:
 Blood Pressure = Cardiac Output X

Peripheral Resistance(BP)

98
Short-term mechanisms: neural controls

 •Neural controls of peripheral resistance are

directed at two main goals:
 •Maintaining adequate MAP by altering

blood vessel diameter. Under conditions of

low blood volume, all vessels except those
supplying the heart and brain are
constricted to allow as much blood as
possible to flow to those two vital organs.

99
 Altering blood distribution to respond to
specific demands of various organs. For
example, during exercise blood is shunted
temporarily from the digestive organs to the
skeletal muscles.
 •Most neural controls operate via reflex arcs
involving baroreceptors and associated
afferent fibers, the vasomotor center of the
medulla, vasomotor fibers, and vascular
smooth muscle.

10
0
Role of the Vasomotor Center

 The neural center that oversees changes in

the diameter of blood vessels is the
vasomotor center, a cluster of neurons in
the medulla.
 This center plus the cardiac centers make

up the cardiovascular center that integrates

blood pressure control by altering cardiac
output and blood vessel diameter.

10
1
 The vasomotor center transmits impulses at
a fairly steady rate along sympathetic
efferents called vasomotor fibers, which exit
from the T1 through L2 levels of the spinal
cord and run to innervate the smooth
muscle of blood vessels, mainly arterioles.
 •As a result, the arterioles are almost

always in a state of moderate constriction,

called vasomotor tone.

10
2
Baroreceptor-initiated reflexes

 When arterial blood pressure rises, it

stretches baroreceptors, neural receptors
located in the carotid sinuses (dilations in
the internal carotid arteries, which provide
the major blood supply to the brain), in the
aortic arch, and in the walls of nearly every
large artery of the neck and thorax.

10
3
 When stretched, baroreceptors send
impulses to the vasomotor center-This
inhibits the vasomotor center, resulting in
vasodilation of not only arterioles but also
veins, and a decline in blood pressure
 •While dilation of the arterioles substantially
reduces peripheral resistance, venodilation
shifts blood to the venous reservoirs, causing
a decline in both venous return and cardiac
output

10
4
 Afferent impulses from the baroreceptors
also reach the cardiac centers, where the
impulses stimulate parasympathetic activity
and inhibit the cardioacceleratory center,
reducing heart rate and contractile force.
 •A decline in MAP initiates reflex

vasoconstriction and increases cardiac

output, causing blood pressure to rise.

10
5
 Baroreceptors protect against acute
changes in bp, e.g change in posture.
 •E.g bp falls (particularly in the head) when

one stands up after reclining.

 •Baroreceptors taking part in the carotid

sinus reflex protect the blood supply to the

brain, whereas those activated in the aortic
reflex help maintain adequate blood
pressure in the systemic circuit as a whole

10
6
Chemoreceptor-initiated reflexes

 When the oxygen content or pH of the blood

drops, chemoreceptorsin the aortic arch
and large arteries of the neck transmit
impulses to the cardio-acceleratory center,
which then increases cardiac output, and to
the vasomotor center, which causes reflex
vasoconstriction. The rise in blood pressure
that follows speeds the return of blood to
the heart and lungs

10
7
Influence of higher brain centers

 Reflexes that regulate blood pressure are

integrated in the medulla of the brain stem.
 Although the cerebral cortex and

hypothalamus are not involved in routine

controls of blood pressure, these higher
brain centers can modify arterial pressure
via relays to the medullary centers.

10
8
 For example, the fight-or-flight response
mediated by the hypothalamus has
profound effects on blood pressure.
 •The hypothalamus also mediates the

redistribution of blood flow and other

cardiovascular responses that occur during
exercise and changes in body temperature.

10
9
Hormonal Controls

 Hormones help regulate blood pressure via

changes in peripheral resistance and
changes in blood volume .
 Paracrines (local chemicals), on the other

hand, primarily serve to match the amount

of blood flow to the metabolic need of a
particular tissue.

110
 In rare instances, massive release of
paracrines can affect blood pressure.
 •During periods of stress, the adrenal gland

releases norepinephrine (NE) and

epinephrine to the blood, and both
hormones enhance the sympathetic fight-or-
flight response.

111
 NE has a vasoconstrictive action.
 Epinephrine increases cardiac output and

promotes generalized vasoconstriction

(except in skeletal and cardiac muscle,
where it generally causes vasodilation).
 Nicotine causes vasoconstriction not only by

directly stimulating ganglionic sympathetic

neurons but also by prompting release of
large amounts of epinephrine and NE.

112
Tissue perfusion

 Blood flow through body tissues, or tissue

perfusion, is involved in
 Delivery of oxygen and nutrients to, and

removal of wastes from, tissue cells

 Gas exchange in the lungs
 Absorption of nutrients from the digestive

tract
 Urine formation in the kidneys

113
Autoregulation: local regulation of blood flow

 •Autoregulation-automatic adjustment of
blood flow to each tissue in proportion to the
tissue’s requirements at any instant.
 •This process is regulated by local conditions

and is largely independent of systemic

factors.
 •The MAP is the same everywhere in the

body and homeostatic mechanisms adjust

cardiac output as needed to maintain that
constant pressure.

114
 Changes in blood flow through individual
organs are controlled intrinsically by
modifying the diameter of local arterioles
feeding the capillaries.
 •As long as the circulatory feedback

mechanisms maintains a relatively constant

MAP, local demand regulates the amount of
blood delivered to various areas.

115
 Thus, organs regulate their own blood flows
by varying the resistance of their arterioles.
 •These intrinsic control mechanisms may be

classified as metabolic or myogenic

116
Metabolic Controls

 In most tissues, declining levels of oxygen

and nutrients are the strongest stimuli for
autoregulation.
 Certain other substances released by

metabolically active tissues (such as K+,

H+, adenosine, lactic acid, and
prostaglandins) also serve as autoregulation
stimuli

117
 Many of them act directly to relax vascular
smooth muscle, but some may act by
causing the release of nitric oxide from
vascular endothelial cells.
 Nitric oxide (NO)is a powerful vasodilator
 It is quickly destroyed and its potent

vasodilator effects are very brief

118
 The endothelium also releases potent
vasoconstrictors, including the peptides
called endothelins
 Inflammatory chemicals (such as histamine,

kinins, and prostaglandins) released in

injury, infection, or allergic reactions also
cause vasodilation

119
 The net result of metabolically controlled
autoregulation is immediate vasodilation of
the arterioles serving the capillary beds of
the “needy” tissues, and therefore a
temporary increase in blood flow to the
area.
 This is accompanied by relaxation of the

precapillary sphincters, which allows blood

to surge through the true capillaries and
become available to the tissue cells
12
0
Myogenic controls

 Inadequate blood perfusion through an organ

is followed by a decline in the organ’s
metabolic rate and, if prolonged, organ death.
 Excessively high arterial pressure and tissue
perfusion can be dangerous -combination
may rupture more fragile blood vessels.
 However, vascular smooth muscles prevent
these by responding directly to increased
intravascular pressure, with increased tone,
which resists the stretch and causes
vasoconstriction

12
1
 Reduced stretch promotes vasodilation and
increases blood flow into the tissue.
 Hence, the myogenic mechanism keeps

tissue perfusion fairly constant despite most

variations in systemic pressure.
 Chemical (metabolic) and physical

(myogenic) factors determine the final

autoregulatory response of a tissue

12
2
 E.g reactive hyperemia -increased blood
flow into a tissue that occurs after the blood
supply to the area has been temporarily
blocked.
 It results from the myogenic response and

an accumulation of metabolic wastes in the

area during occlusion.

12
3
Long-term autoregulation

 If the nutrient requirements of a tissue are

greater than the short-term autoregulatory
mechanism can easily supply, a long-term
autoregulatory mechanism may evolve over
a period of weeks or months to enrich the
local blood flow still more.
 The number of blood vessels in the region

increases, and existing vessels enlarge

12
4
 This phenomenon, called angiogenesis, is
particularly common in the heart when a
coronary vessel is partially occluded.
 It occurs throughout the body in people who

live in high-altitude areas, where the air

contains less oxygen.

12
5
Nerve Supply to the Heart
 Vagus nerve-supply mainly the SA and AV
nodes and atrial muscle.

12
6
Blood vessels

12
7
Major blood vessels
 Five:
◦ Arteries and arterioles carry blood away from
heart
◦ Veins and Venules return blood to heart
◦ Capillaries site of exchange

12
8
Structure of blood vessels
 Walls consist of 3 layers:
◦ Tunica intima
◦ Tunica media
◦ Tunica externa-

12
9
Tunica interna/intima
 Forms inner lining
 In contact with blood
 Consists of :

◦ a single squamous epithelium-endothelium

◦ Basement membrane-supports the epithelial layer
◦ Internal elastic lamina-thin sheet of elastic fibers;
has variable number of window-like openings

13
0
13
1
Tunica media
 A muscular and connective tissue layer
 Varies among the different vessel types
 In most vessels, it is a relatively thick layer

comprised mainly of:

◦ smooth muscle cells which extend circularly
around the vessel
◦ substantial amounts of elastic fibers.

13
2
Tunica media cont’d
 Missing /consists only of smooth muscles in
smallest arteries
 Regulate blood flow and blood pressure and
help limit loss of blood through the injured
vessel

13
3
13
4
Tunica externa
 The outer covering of a blood vessel,
 fibrous connective tissue consisting of

elastic and collagen fibers

 Separated from tunica media by the

external elastic lamina which is part

of the tunica media.

13
5
Tunica externa Cont’d
 Contains numerous nerves and,
especially in larger vessels, tiny
blood vessels that supply the tissue
of the vessel wall(vasa vasorum)
 Also helps anchor the vessels to the

surrounding tissues

13
6
13
7
Arteries
 The wall of an artery has the three layers of
a typical blood vessel, but has a thick
muscular-to-elastic tunica media

13
8
Arteries Cont’d
 Due to their plentiful elastic fibers, arteries
normally have high compliance- their walls
stretch easily or expand without tearing in
response to a small increase in pressure.

13
9
Arteries cont’d
 Innervated by sympathetic fibers of the
autonomic nervous system innervate
stimulation of which cause contraction of
smooth muscles-vasoconstriction

14
0
Arteries Cont’d
 Additionally, when an artery or arteriole is
damaged, its smooth muscle contracts,
producing vascular spasm of the vessel-
limits blood flow and reduce blood loss.

14
1
Types of arteries
 Elastic/conducting arteries
 Muscular /distributing arteries

14
2
Elastic arteries
 largest arteries in the body,
 They have the largest diameter among

arteries, but their vessel walls are relatively

thin compared
 They help propel blood onward while the

ventricles are relaxing.

14
3
Elastic arteries Cont’d
 Include :
◦ the aorta and the
◦ pulmonary trunk, along with the aorta’s
major initial branches, such as:
 brachiocephalic,
 Subclavian
 common carotid
 common iliac arteries

14
4
Muscular arteries
 Their tunica media contains more
smooth muscle and fewer elastic
fibers than elastic arteries.
 Capable of greater vasoconstriction

and vasodilation to adjust the rate of

blood flow.

14
5
Arterioles
 Abundant microscopic vessels that regulate
the flow of blood into the capillary networks
of the body’s tissues
 have a thin tunica interna with a thin,

fenestrated internal elastic lamina that

disappears at the terminal end.

14
6
Arteriole Cont’d
 The tunica media consists of one to two
layers of smooth muscle cells having a
circular orientation in the vessel wall.
 The terminal end of the arteriole

(metarteriole) tapers toward the capillary

junction.

14
7
Arteriole Cont’d
 At the metarteriole–capillary junction, the
distal-most muscle cell forms the
precapillary sphincter which monitors the
blood flow into the capillary;

14
8
 The other muscle cells in the Arterioles play
a key role in regulating blood flow from
arteries into capillaries by regulating
resistance

14
9
Anastomosis
The union of the branches of two or more
arteries supplying the same body region
 provide alternative routes for blood to

reach a tissue or organ.

15
0
Differences between artery and veins

15
1
15
2
Capillaries
 Capillaries are the smallest and most
permeable of the blood vessels
 Made of a single layer of endothelial cells on

a very thin basement membrane.

 Link arterioles to venules

15
3
Capillaries Cont’d
 Flow of blood from metarteriole-capillaries-
post capillary venule is called
microcirculation of the body
 Number of capillaries vary with the

metabolic activity of the tissue they serve.

 Function: exchange of substances between

the blood and interstitial fluid.

15
4
Structure of capillaries
 Composed of only a single layer of
endothelial cells and a basement membrane
 Lack both a tunica media and a tunica

externa.
 at the junctions between the metarteriole

and the capillaries are rings of smooth

muscle fibers called precapillary sphincters
that control the flow of blood through the
capillaries.

15
5
15
6
Types of capillaries
 Continuous
 Fenestrated
 Sinusoids

15
7
Continous capillaries
 The plasma membranes of
endothelial cells form a continuous
tube that is interrupted only by
intercellular clefts between
neighboring endothelial cells

15
8
Continuous Cont’d
 Found in the brain, lungs, skeletal
and smooth muscle, and connective
tissues.

15
9
16
0
Fenestrated capillaries
 Theplasma membranes of the
endothelial cells in these capillaries
have many fenestrations (small
pores)

16
1
Fenestrated capillaries
Cont’d
 Found in the kidneys, villi of the
small intestine, choroid plexuses of
the ventricles in the brain, ciliary
processes of the eyes, and endocrine
glands.

16
2
16
3
Sinusoids
 wider and more winding than other
capillaries.
 Their endothelial cells may have

unusually large fenestrations.

 Have an incomplete or absent

basement membrane

16
4
Sinusoids Cont’d
 Have very large intercellular clefts
that allow proteins and in some
cases even blood cells to pass from a
tissue into the bloodstream.

16
5
Sinusoids Cont’d
 Sinusoids contain specialized lining
cells that are adapted to the function
of the tissue.
 Found in the liver, spleen, anterior

pituitary, and parathyroid glands.

16
6
16
7
Usually blood passes from the heart and
then in sequence through arteries,
arterioles, capillaries, venules, and veins
and then back to the heart.
 In some parts of the body blood passes

from one capillary network into another

through a vein called a portal vein.
 Such a circulation of blood is called a

portal system.

16
8
Venules
 Venules drain the capillary blood
 Two types:
 Post capillary
 Muscular

16
9
Post capillary
 venules that initially receive blood from
capillaries
 smallest venules
 have loosely organized intercellular

junctions thus very porous and

 function as significant sites of exchange of

nutrients and wastes and white blood cell

emigration

17
0
Muscular
 Have one or two layers of circularly
arranged smooth muscle cells-thicker wall;
pass blood into veins; act as reservoirs for
accumulating large volumes of blood

17
1
Veins
 have very thin walls relative to their total
diameter (average thickness is less than
one-tenth of the vessel diameter).
 Veins lack the internal or external elastic

laminae found in arteries

17
2
 The tunica interna of veins is thinner than
that of arteries;
 the tunica media of veins is much thinner

than in arteries, with relatively little smooth

muscle and elastic fibers.
 The tunica externa of veins is the thickest

layer and consists of collagen and elastic

fibers.

17
3
 They are distensible enough to adapt to
variations in the volume and pressure of
blood passing through them, but are not
designed to withstand high pressure
 The lumen of a vein is larger than that of a

comparable artery, and

 veins often appear collapsed (flattened)

when sectioned.

17
4
 The average blood pressure in veins is
considerably lower than in arteries.
 Many veins, especially those in the limbs,

also contain valves,

 Veins are more numerous than arteries

17
5
Types
 superficial veins-course through the
subcutaneous layer unaccompanied by
parallel arteries.
 Deep veins -travel between the skeletal

muscles; serve as the principal return

pathways
 There are connections that allow

communication between the deep and

superficial veins

17
6
Blood distribution
 Systemic veins and venules-64%
 Systemic arteries and arterioles-13%
 systemic capillaries - 7%,
 pulmonary blood vessels-9%,
 The heart - 7%.

17
7
Circulatory Routes

17
8
Circulatory Routes
 Systemic circulation
 Hepatic portal circulation
 Pulmonary circulation
 Fetal circulation

17
9
Pulmonary Circulation
 Circulation from the right ventricle of
the heart to the lungs and back to
the left atrium.

18
0
Pulmonary circulation
Cont’d
 Compared to systemic arteries, pulmonary
arteries have larger diameters, thinner
walls, and less elastic tissue- the
resistance to pulmonary blood flow is very
low, which means that less pressure is
needed to move blood through the lungs.

18
1
Pulmonary circulation
Cont’d
 Consistsof :
◦Pulmonary artery or trunk-carry
deoxygenated blood
◦Pulmonary veins-two pulmonary
veins leave each lung; carry
oxygenated blood

18
2
Systemic/General
circulation
Consists of:
◦ arteries and arterioles that carry
oxygenated blood from the left ventricle
to systemic capillaries,
◦ veins and venules that return
deoxygenated blood to the right atrium.

18
3
The Aorta
 All systemic arteries branch from the
aorta.
 Begins at the upper part of the left

ventricle
 It arches backwards and to the left

and then descends behind the heart

18
4
Aorta Cont’d
 Atthe level of the 12th thoracic
vertebrae it passes behind the
diaphragm then downwards into the
abdominal cavity

18
5
Aorta Cont’d
 At the level of 4th lumbar vertebra it
divides into right and left common
iliac arteries.
 Throughout its length it gives off

numerous branches some of which

are paired-left and right

18
6
Parts
 Ascending
 Arch
 Descending

◦ Thoracic
◦ Abdominal

18
7
Ascending Aorta
 Short section of the aorta that rises
from the heart
 About 5cm long and lies behind the

sternum.
 Branches: Coronary arteries
 Supplies the heart

18
8
18
9
19
0
 END

19
1
Arch of the aorta
 4-5 cm long
 Starts behind the manubrium of the

sternum and runs upwards,

backwards and to the left in front of
the trachea.

19
2
Arch Cont’d
 Branches

◦Brachiocephalic trunk
◦Left common carotid
◦Left subclavian

19
3
Arch of the aorta

19
4
Arch of the aorta Cont’d

19
5
Brachiocephalic
◦divides into:
 Right common carotid artery-right
side of head and neck
 Right subclavian-right upper limb

19
6
Right Subclavian
 Gives rise to two main branches:
◦ Right axillary-supply the upper limb
◦ Right vertebral –supply the brain

19
7
Vertebral artery
 The artery enters the skull through the
foramen magnum to reach the brain.
 In the brain it unites with the left vertebral

artery to form the basilar artery.

 The vertebral artery supplies the posterior

portion of the brain with blood.

19
8
Basilar artery
 The basilar artery passes along the midline
of the anterior aspect of the brain stem.
 It gives off several branches:

◦ posterior cerebral and

◦ cerebellar arteries that supply the cerebellum
and pons of the brain and the inner ear.

19
9
Common Carotid Arteries
 At the level of upper border of the
thyroid cartilage each divides into:
 Internal carotid
 External carotid

20
0
Carotid arteries Cont’d
 At the point of bifurcation are:
◦ Carotid sinuses- thin walled slight
dilations containing numerous nerve
endings(baroreceptors)
◦ Carotid bodies-two small groups of
specialized cells-chemoreceptors

20
1
External Carotid
 Externalcarotid-supply the
superficial tissues of the head and
neck.

20
2
Internal Carotid
 Internal carotid artery has no
branches in the neck and supplies
structures internal to the skull.
 The terminal branches of the internal

carotid artery are:

20
3
Internal carotid Cont’d
 Anterior cerebral artery-supplies most
of the medial surface of the cerebrum and
deep masses of gray matter within the
cerebrum, and
 Middle cerebral artery-supplies most of

the lateral surface of the cerebrum

20
4
Circle of Willis/ circulus arteriosus
 An arrangement of blood vessels at
the base of the brain near the
hypophyseal fossa.
 Formed by the union of the:

◦ Internal carotids
◦ Anterior cerebral arteries (branches of
internal carotids) and
◦ posterior cerebral arteries (branches of
basilar artery).

20
5
Circle of Willis cont’d
 Posterior communicating arteries-
connect posterior cerebral arteries with the
internal carotid arteries
 The anterior communicating arteries -

connect the anterior cerebral arteries.

20
6
Circle of Willis cont’d

20
7
Circle of Willis cont’d

20
8
Circle of Willis cont’d
 The functions of the cerebral arterial circle
are:
◦ to equalize blood pressure to the brain
◦ Provide alternate routes for blood flow to the
brain, should the arteries become damaged.

20
9
Assign
 Draw a diagram illustrating Circle of Willis

21
0
211
Venous Return from Head and
Neck
 Principal veins of the head and neck:
◦ Internal jugular
◦ External jugular, and
◦ Vertebral veins.

21
2
21
3
Circulation to the Upper
Limb
Arterial supply:
 Subclavian arteries

 Right- from brachiocephalic

 Left-from the arch of aorta

21
4
 Venous return:
◦ deep veins-located deep in the
body; usually accompany
corresponding arteries and
◦ superficial veins-located just deep
to the skin

21
5
Superficial
 The principal superficial veins that drain the
upper limbs are the:
 cephalic
 basilic veins
 Antebrachial .

21
6
21
7
Deep
 Radial
 Ulnar
 Brachial
 Axillary
 Subclavian

21
8
21
9
 Superior vena cava drains blood from
the head neck and upper limbs to the
right atrium

22
0
Thoracic Aorta
 Continuous with the arch of the aorta
from the 4th thoracic vertebra to the
level of 12th thoracic vertebra
 Gives rise to visceral and parietal

branches.

22
1
Visceral branches
 Pericardial-2 or 3 tiny branches-
pericardium
 Bronchial arteries-1 right, 2 left-

bronchial tubes, pleurae, bronchial

lymph nodes, and esophagus.

22
2
Visceral branches cont’d
 Esophageal arteries- 4 or 5 branches-
oesophagus
 Mediastinal –structures in the

mediastinum

22
3
Parietal Branches
 Posterior intercostal arteries- 9 pairs-
supply the intercostal, pectoralis major and
minor, and serratus anterior overlying
subcutaneous tissue and skin; mammary
glands; and vertebrae, meninges, and
spinal cord.

22
4
Parietal Branches Cont’d
 Subcostal-left and right- have a distribution
similar to that of the posterior intercostals
 Superior phrenic arteries- supply the

superior and posterior surfaces of the

diaphragm

22
5
Thoracic Aorta

22
6
Venous Return from the
Thoracic Cavity
 Bronchial, oesophagus and
intercostal veins and other veins
from the organs in the thoracic
cavity is drained into the azygos
system that runs on either side of
the vertebrae column

22
7
Azygos system
 Besides collecting blood from the thorax
and abdominal wall, may serve as a bypass
for the inferior vena cava that drains blood
from the lower body because:

22
8
Azygos system
Several small veins directly link the azygos
system with the inferior vena cava.
 Large veins that drain the lower limbs and

abdomen conduct blood into the azygos

system.

22
9
Azygos system cont’d
 Consists of:
◦ Azygos vein-join superior vena cava;
drains the right side of the thoracic wall,
thoracic viscera, and abdominal wall.
◦ Hemiazygos veins-terminates by joining the
azygos vein ; Generally drains the left side of
the thoracic wall, thoracic viscera, and
abdominal wall .

◦ Accessory hemiazygos-It terminates by

joining the azygos vein ;drains the left side of
the thoracic wall.

23
0
23
1
Abdominal Aorta
 Continuation of the thoracic aorta.
 Starts from the 12th thoracic

vertebra to the level of 4th lumbar

vertebra where it divides into left
and right common iliac arteries
 Gives rise to several paired and

unpaired visceral and parietal

branches

23
2
Unpaired visceral
 Arise from the anterior surface.
 Include:

◦ Celiac artery
◦ Superior mesenteric
◦ Inferior mesenteric

23
3
Celiac
 First visceral branch from the aorta inferior
to the diaphragm
 Divides into:

23
4
Celiac cont’d
◦Left gastric artery-stomach,
esophagus
◦Splenic artery-pancreas and the
spleen
◦Common hepatic artery-liver, gall
bladder, parts of the stomach,
duodenum and pancreas

23
5
Unpaired Cont’d
 Superior Mesenteric-whole of small
intestines and part of large intestines
 Inferior Mesenteric-supplies distal

half of the large intestine and part of

the rectum

23
6
Paired visceral branches
 Suprarenal arteries-adrenal glands
 Renal arteries-kidneys and adrenal

glands
 Gonadal-Testicular arteries-testis in

males; Ovarian arteries-ovaries in

females

23
7
Unpaired parietal
 Median sacral artery-arises from the
posterior surface of the abdominal aorta-
supplies the sacrum and coccyx.

23
8
Paired Parietal
 Inferior phrenic arteries-diaphragm and
adrenal (suprarenal) glands.
 Lumbar arteries-4pairs of lumbar arteries-

supply lumbar vertebrae, spinal cord and its

meninges, and the muscles and skin of the
lumbar region of the back.

23
9
24
0
Venous Return from
Abdominal Organs
 Leftand right common iliac veins join
to form the inferior vena cava-the
largest vein in the body

24
1
Venous Return Cont’d
 Paired testicular, ovarian ,renal and
adrenal veins join the inferior vena
cava
 Blood from the remaining organs in

the abdominal cavity passes through

the liver via portal circulation.

24
2
Portal Circulation
 Portalvein –formed by union of:
◦Splenic vein
◦Inferior mesenteric-rectum, pelvic
and descending colon
◦Superior mesenteric-proximal part
of large intestine
◦Gastric-stomach and distal end of
the oesophagus
◦Cystic-gall bladder

24
3
Common iliacs
 Supply the pelvis and lower limbs
 Infront of sacroiliac joint each divide

into:
 Internal iliac-Uterus (female),
prostate (male), muscles of
buttocks, and urinary bladder.
 External iliac-pass into the thigh
and become femoral artery to
supply lower limbs

24
4
Iliacs

24
5
 Venous return-both deep and
superficial veins-from common iliac
veins it drains into the inferior vena
cava.

24
6
Thank you

24
9
Functions of the Circulatory System

 Brings blood containing oxygen, nutrients,

and hormones to cells
 •Transports CO2and other wastes away

from cells

 Fights infection
 •Regulates body temperature
 •Helps stabilize pH and ionic concentration

of body fluids

25
0