UNIT 5

MAINTENANCE OF THE BODY_THE CARDIOVASCULAR

SYSTEM
The cardiovascular system_heart
• The heart is a muscular organ located in the thoracic
cavity, specifically in the mediastinum, between the
lungs.
• It is roughly the size of a fist in humans, size of an
adult head in cows and the largest in blue whale.
• The heart pumps blood throughout the body via two
circuits:
• Pulmonary circulation (to the lungs)
• Systemic circulation (to the rest of the body)
Learning outcomes
• Identify and describe the structural components of the heart,
including the chambers, valves, and layers of the heart wall.
• Understand the flow of blood through the heart and the role of
the valves in ensuring one-way circulation.
• Describe the electrical conduction system of the heart and its
role in coordinating the heartbeat.
• Trace the pathway of electrical impulses through the heart,
from the SA node to the Purkinje fibers.
• Interpret the basic components of an ECG waveform, including
the P wave, QRS complex, and T wave.
• Describe the cardiac cycle
Layers surrounding the heart
The Pericardium
• The heart is enclosed in a double-layered sac called the
pericardium, which protects the heart and anchors it within the
thoracic cavity.
Pericardial layers:
• Fibrous pericardium: The tough, outer layer that prevents
overexpansion and provides protection.
• Serous pericardium: A thinner, inner layer divided into:
• Parietal layer (lines the inner surface of the fibrous pericardium)
• Visceral layer (epicardium) (adheres directly to the surface of the heart)
• Between these layers is the pericardial cavity, which contains
pericardial fluid to reduce friction during heartbeats.
Layers of the Heart Wall
• The heart wall is made up of three layers, each with distinct functions:
1. Epicardium:
• The outermost layer of the heart. It is the same as the visceral layer of the
pericardium.
• Functions as a protective layer and contains coronary blood vessels that supply
the heart muscle.
2. Myocardium:
• The thick, middle muscular layer. Composed of cardiac muscle fibers, which are
responsible for the heart's pumping action.
• The thickest layer, particularly in the left ventricle, which pumps blood to the
entire body. The myocardium has intercalated discs that allow for synchronized
contractions of the heart muscle.
3. Endocardium:
• The innermost layer. Made of endothelial tissue, lining the heart chambers and
valves.
• Provides a smooth surface to minimize resistance to blood flow.
 Chambers of the Heart
• The heart has four chambers:
1. Atria (upper chambers):
Right atrium:
• Receives deoxygenated blood from the superior vena cava, inferior vena cava, and
coronary sinus.
Left atrium:
• Receives oxygenated blood from the pulmonary veins (from the lungs).
2. Ventricles (lower chambers):
Right ventricle:
Pumps deoxygenated blood into the pulmonary trunk, which carries it to the lungs for
oxygenation.
Left ventricle:
• Pumps oxygenated blood into the aorta, which distributes it throughout the body.
• The left ventricle has a much thicker myocardium than the right because it needs to
generate more force to pump blood to the entire body.
 Heart Valves
• There are four valves in the heart, which ensure unidirectional blood flow and
prevent backflow:
1. Atrioventricular (AV) valves:
Tricuspid valve:
• Located between the right atrium and right ventricle. It has three cusps.
Bicuspid (mitral) valve:
• Located between the left atrium and left ventricle. It has two cusps.
• Chordae tendineae (thin bands of fibrous tissue) anchor the AV valves to papillary
muscles on the walls of the ventricles, preventing the valves from inverting during
ventricular contraction.
2. Semilunar valves:
Pulmonary valve:
• Located between the right ventricle and the pulmonary trunk.
Aortic valve:
• Located between the left ventricle and the aorta.
Systemic and Pulmonary Circuits
• The cardiovascular system consists of two major circuits
responsible for the transport of blood throughout the
body:
1. Pulmonary circuit: Carries deoxygenated blood from the
heart to the lungs for gas exchange and returns oxygenated
blood to the heart.
2. Systemic circuit: Distributes oxygenated blood from the
heart to all body tissues and returns deoxygenated blood
back to the heart.
 Pulmonary Circuit
• The pulmonary circuit is responsible for gas exchange in the lungs. It delivers
deoxygenated blood to the lungs to receive oxygen and release carbon dioxide.
Pathway:
1. Right ventricle: Blood is pumped from the right ventricle through the
pulmonary valve into the pulmonary trunk.
2. Pulmonary arteries: The pulmonary trunk divides into the right and left
pulmonary arteries, which carry deoxygenated blood to the lungs.
3. Lungs: In the lungs, blood flows through the capillary networks surrounding
the alveoli, where gas exchange occurs:
• Oxygen is absorbed into the blood. Carbon dioxide is expelled from the blood into the
lungs to be exhaled.
• Pulmonary veins: Oxygenated blood returns from the lungs to the left atrium of the heart
through the pulmonary veins.
Low pressure circuit: The pulmonary circulation operates under lower pressure
compared to the systemic circuit, ensuring delicate lung tissue is not damaged.
 Systemic Circuit
• The systemic circuit delivers oxygenated blood to all body tissues and
organs and returns deoxygenated blood to the heart for re-oxygenation.
Pathway:
1. Left ventricle: Blood is pumped from the left ventricle through the
aortic valve into the aorta.
2. Aorta and systemic arteries: The aorta branches into major arteries
that carry oxygen-rich blood to various parts of the body, including the
brain, organs, and muscles.
3. Capillaries: At the tissue level, blood flows through capillary networks
where oxygen and nutrients are exchanged for carbon dioxide and waste
products.
4. Systemic veins: Deoxygenated blood is collected by veins and returned
to the heart through the superior and inferior vena cavae, which empty
into the right atrium.
Coronary Circulation
• The heart muscle (myocardium) receives its own blood
supply through the coronary arteries.
• The right coronary artery and left coronary artery
branch from the base of the aorta and provide
oxygenated blood to the heart.
• The cardiac veins collect deoxygenated blood from the
myocardium and drain it into the coronary sinus,
which empties into the right atrium.
 Electrical Conduction System
• The heart has its own intrinsic electrical system that coordinates
contraction:
1. Sinoatrial (SA) node: The pacemaker of the heart, located in the
right atrium, initiates the electrical impulse.
2. Atrioventricular (AV) node: Receives the impulse from the SA node
and delays it slightly to allow the atria to finish contracting before the
ventricles contract.
3. Bundle of His: Transmits the impulse from the AV node to the
ventricles.
4. Right and left bundle branches: Carry the impulse down the
interventricular septum.
5. Purkinje fibers: Spread the impulse throughout the ventricles,
ensuring a coordinated contraction of the ventricular myocardium.
Electrocardiogram (ECG or EKG)
• An electrocardiogram (ECG) is a diagnostic tool used to
record the electrical activity of the heart.
• It provides a graphical representation of the electrical
impulses as they travel through the heart.
• The ECG helps in diagnosing various heart conditions,
including arrhythmias, heart attacks, and electrolyte
imbalances.
Components of an ECG Waveform
• The ECG consists of distinct waves and intervals that correspond to
the phases of the cardiac cycle:
1. P Wave: Represents atrial depolarization (the electrical activity
associated with atrial contraction).The P wave indicates that the
SA node has fired, and the atria have contracted.
2. QRS Complex: Represents ventricular depolarization (the
electrical activity associated with ventricular contraction). The QRS
complex is larger than the P wave because the ventricles have
more muscle mass than the atria.
3. T Wave: Represents ventricular repolarization (the electrical
resetting of the ventricles in preparation for the next
contraction).The T wave indicates the recovery phase of the
ventricles.
Components of an ECG Waveform
4. PR Interval: The time between the start of the P wave and the
beginning of the QRS complex. Represents the time it takes for the
electrical impulse to travel from the SA node through the AV node. A
prolonged PR interval may indicate a block in the conduction system
(e.g., AV block).
5. ST Segment: The flat section between the end of the QRS
complex and the start of the T wave. Represents the time between
ventricular depolarization and the start of repolarization. Changes in
the ST segment can indicate ischemia (lack of blood flow) or
infarction (heart attack).
6. QT Interval: Represents the time for both ventricular
depolarization and repolarization. A prolonged QT interval can
increase the risk of arrhythmias.
The cardiac cycle
• A single cardiac cycle refers to the complete sequence
of events in one heartbeat, including the contraction
and relaxation of the heart chambers.
• The atria and ventricles alternatively contract and relax,
forcing blood from areas of high pressure to areas of low
pressure.
• When a heart rate is 75 beats/minute, the cardiac cycle
last 0.8 sec
• This cycle is essential for maintaining effective blood
circulation throughout the body.
Phases of the Cardiac Cycle
1. Atrial Systole
• The cardiac cycle begins with atrial systole, where the atria
contract (last 0.1 sec).
• Electrical impulses from the sinoatrial (SA) node trigger the
contraction of the atria (P wave in ECG).
• Atrial pressure increases, forcing the atrioventricular (AV)
valves (mitral and tricuspid) to open.
• Blood flows from the atria into the ventricles. The amount of
blood in ventricles at the relaxation period (diastole) is call
end diastolic volume (EDV) (about 130ml).
• The QRS complex in the ECG marks the onset of ventricular
depolarization
Phases of the Cardiac Cycle
2. Ventricular Systole
• Following atrial systole, the ventricles begin to contract,
leading to ventricular systole.
• The impulse spreads from the SA node through the
atrioventricular (AV) node and down the Bundle of His and
Purkinje fibers, causing ventricular contraction.
• Ventricular pressure rises rapidly as the ventricles contract.
• The increased pressure closes the AV valves to prevent
backflow into the atria.
• For about 0.05 sec, both the SL and AV valves are closed. This
period is called isovolumetric contraction.
Phases of the Cardiac Cycle
2. Ventricular systole
• Continued contraction of the ventricles causes pressure
inside the chamber to rise sharply
• When left ventricular pressure surpasses aortic pressure at
about 80 mmHg and the right ventricular pressure rises
above the pulmonary trunk (20 mmHg), both SL valves open
• The period when the SL valves are open is ventricular
ejection and last about 0.25 sec
• The pressure in the left ventricle rises to about 120 mmHg
and pressure in the right to about 25-30 mmHg
Phases of the Cardiac Cycle
2. Ventricular systole
• The left ventricle ejects 70 ml of blood into the aorta
and right ventricle ejects the same volume into the
pulmonary trunk.
• The volume remaining in in each ventricle at the end of
systole, about 60 ml is the end systolic volume (ESV)
• Stroke volume is the volume of blood ejected per
heartbeat from each ventricle, which is = EDV-ESV (130
mL-60 mL = 70 mL
Phases of the Cardiac Cycle
3. Ventricular Filling
• As the ventricles continue to relax, they begin to fill with
blood, marking the start of ventricular filling.
• The pressure in the atria becomes greater than that in the
ventricles, causing the AV valves to open.
• Blood flows passively from the atria into the ventricles.
• As the ventricles fill, the atria also contract (due to the SA
node's pacing), contributing additional blood to the ventricles.
• The cycle concludes with the ventricles being filled with blood
to a maximum volume, known as the end-diastolic volume
(EDV).