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Cardiovascular system

Prepared by: Najah Bisat

Cardiovascular system

 Cardiovascular system: is a closed system in which the blood circulates

throughout the body.

 CVS consists of heart and blood vessels

 Heart: is a four chambered, hollow muscular organ approximately the size of your
fist
 Location:
I.Superior to diaphragm
II.Left to the midline
III.Anterior to the vertebral column
IV.posterior to the sternum

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HEART

Chapter 18, Cardiovascular System Figure 318.1

Functional anatomy of heart

1. Cardiac pumps: the heart has two pumps arranged in series:

1. Right side pump: 2. Left side pump:

 Right atrium and right  Left atrium and left
ventricle ventricle

 Separated by tricuspid valve  Separated by mitral valve

 Receives blood from
 Receives blood from
pulmonary circulation
systemic circulation and
and pumps it into
pumps it into pulmonary
systemic circulation.
circulation.

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2. Cardiac valves: there are four one way valves that allow the heart to act as a pump

I. Atrioventricular valves:

 Allow blood to flow from atria to ventricles

 Closed when the ventricles contract and prevent back flow of blood from ventricles
to atria.

1. Right AV valve: known as tricuspid valve because it made of 3 cusps.

2. Left AV valve: known as mitral valve or bicuspid valve because it made of 2

cusps.

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II. Semilunar valves:

 Open when ventricles contract to allow the blood flows from Lt ventricle to aorta and

from Rt ventricle to pulmonary artery.

 Closed when ventricles relax to prevent backflow of blood from aorta or pulmonary

trunk to ventricles.

 Both made up of 3 cusps.

1. Aortic valve: present at the opening of aorta from Lt. ventricle.

2. Pulmonary valve: present at opening of pulmonary trunk from Rt. ventricle.

Valves of heart

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Types of valves

Blood vessels

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Blood vessels: are the tubes through which the heart pumps
the blood.
1. Arteries:
 Take blood away from the heart.
 They branch to smaller and smaller arteries and arterioles
 Typically carry oxygenated blood.
 Pulmonary artery is exception.
2. Veins:
 Take blood towards the heart.
 The smaller venules join to form large veins.
 Typically carry deoxygenated blood.
 Pulmonary veins are exception.

3. Capillaries:

 Smallest and most numerous type.

 They are sites for exchange between blood and tissue fluid.

 They connect arterioles and venules.

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Cardiovascular circulation

Cardiovascular circulation

CVS is divided into 2 circuits:

1. Systemic circulation: (major circuit)

Blood flow from: Left ventricle aorta systemic arteries arterioles

capillaries venules veins vena cava Right
atrium

2. Pulmonary circulation: (smaller circuit)

Blood flows from: Right ventricle pulmonary trunk pulmonary artery

arterioles capillaries pulmonary veins Left atrium

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Left
Right ventricle
atrium
Aorta

Vena cava Systemic

arteries

Arterioles
Veins

Capillaries
Venules

Right ventricle

Left atrium
pulmonary
trunk

pulmonary
veins

pulmonary
arteries

capillaries

arterioles

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Nerve supply to heart

Cardiac plexus

Sympathetic nerves Parasympathetic nerves

From the sympathetic From left and right vagus
trunk nerves

Regulate the cardiac out put, heart rate

and contraction force of heart

Myocardium (Cardiac muscle)

 Myocardium forms the bulk of the heart and it is responsible for pumping action of
the heart.
 The cardiac muscle fibers are involuntary in nature.

 Myocardium has three types of muscle fibers:

I. Muscle fibers which form contractile unit of heart
II. Muscle fibers which form pacemaker
III. Muscle fibers which form conductive system

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I. Muscle fibers which form contractile unit of heart

 The cardiac muscle fibers have structure identical to that of skeletal muscle.

 The cardiac muscle different from skeletal muscle in that it is:

1. Involuntary

2. Branched

3. Has intercalated discs.

4. Act as a syncytium.

Intercalated disc

 The dark areas crossing the cardiac muscle fibers

 They are cell membranes that separate individual cardiac muscle cells from one
another.

 At the intercalated disc there are:

1. Gap junction: that allow rapid diffusion of ions, so the action potentials travel
easily from one cardiac muscle cell to the next.

2. Tight junction: that allow cardiac muscle to act as one unit, so stimulation of one
cardiac muscle fiber result in contraction of all the cardiac muscle.

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The cardiac muscle act as syncytium.

 Syncytium means that muscle fibers act as one unit at one time. This due to presence
of gap junction and adherence of muscle fibers.
 There are two syncytium of heart:
 Ventricular syncytium and atrial syncytium.
 Normally, potentials are not conducted from the atrial syncytium into the ventricular
syncytium directly.
 Instead, they are conducted only by way of a specialized conductive system called the
A-V bundle. This allows the atria to contract a short time before of ventricular
contraction.

II. Muscle fibers which form pacemaker

Sino-atrial Node (SA node):

 The sino-atrial node or pacemaker consists of hundreds of cells located in the right
atrial wall near the opening of the superior vena cava.
 Produces impulses for heartbeat.
 Doesn't have contractile fibers.
 Rate of impulse in SA node is ~ 60-90/min

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Conduction system of the heart

III. Muscle fibers which form conductive system

The special conductive system of the heart are:

1. Atrio-ventricular Node (AV node): The atrioventricular node is a small mass of
special cardiac muscle tissue, lies in the right atrium along the lower part of the
interatrial septum.

2. AV bundle or bundle of His: is a bundle of special cardiac muscle fibers that originate
in the AV node and extend by two branches down the two sides of the interventricular
septum.
3. Purkinje fibers: branches of His bundle (Rt and Lt fibers) to supply all fiber of
ventricles.

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Properties of cardiac muscle

1. Excitability
( non-pacemaker action potential)

2. Rhythmicity (Automaticity)
(pacemaker action potential)

3. Conductivity
(AV node, AV bundle, purkinje fibers)

4. Contractility
( All or None law and refractory period)

Excitability

 It is the ability of cardiac muscle to respond to adequate stimulus by action potential and
contraction.

 There are two types of action potential in heart muscle:

1. Ordinary myocardial ( non-pace maker) action potential ( Excitability)

2. Pace maker potential ( SA node potential) (Rhythmicity)

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I. Ordinary myocardial ( non-pace maker) action potential: occurs in muscle fibers of

atria and ventricles. Has 5 phases:

1. (Phase 0) Rapid depolarization due to rapid influx of Na⁺.

2. (Phase 1) Short rapid repolarization due to closing of Na⁺ channels and rapid efflux of
K⁺.

3. (Phase 2) Plateau due to K⁺ efflux and slow Ca⁺⁺ influx.

4. (phase 3) long rapid repolarization due to K⁺ efflux.

5. (phase 4) Stable resting membrane potential due to Na –K ATPase pump and selective
permeability of cell membrane. RMP is – 90mv.

Na⁺ influx
1 2 3
0
Ca⁺⁺
0 Rapid depolarization
20 K⁺
K⁺
10
1 Short rapid repolarization
0
Cl⁻
-10 phase phase phase phase
Ca⁺⁺
phase
K⁺ 2 Plateau
-20 0 1 2 3 4
3 Long rapid repolarization
-30
-40 4 Stable resting membrane
-50 Fast Na⁺
K⁺

-60 4
-70
K⁺
-80
-90
-100

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Ca⁺⁺ channels
 Start in phase 0 at -40.
Ca influx = K efflux  Fully active in 2 phase.
20 K⁺  Inactivated at end of
K⁺ plateau.
10  The Ca⁺⁺ is needed for
0 Cl⁻ contraction and for
-10 phase phase phase phase phase K⁺ balance the K⁺ efflux
Ca⁺⁺
-20 0 1 2 3 4
-30 Plateau
 Prolong the contraction
-40  Prolonged ARP so
-50 prevent tetanus
Fast
-60 Na⁺ K⁺
-70 Fast Na influx for fast
-80 response

-90
RMP considered phase??
-100
 Na-K ATPase pump
 Selective permeability
 Non –gated K channels still open

Rhythmicity

 It is the ability of cardiac muscle to initiates its own rhythm ( alternative

contraction and relaxation) or to beat regularly without external stimulus.

 Cardiac pacemaker: it is the part that generates the highest rhythm of impulses
and the whole heart follow it.

 Sino-atrial node (SA Node): it is the normal pace maker of the heart located in
posterior wall of Rt atrium at junction of vena cava to Rt atrium ( opening of
S.vena cava).

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Pace maker potential:

The autorythmic cells of SA node have unstable resting potential range( -55 to -60), and
action potential of Sa node has following phases:

 Phase I( Prepotential): low permeability to K⁺ and high permeability to Na⁺ and Ca⁺⁺.

 Phase II( Depolarization): when firing level reaches -40 , depolarization occur due to
influx of Ca⁺⁺ and Na⁺.

 Phase III( Repolarization): due to K⁺ efflux.

Stop Ca influx

0 4 0 3
0 1 2 4
-10

-20
k⁺
Ca⁺⁺
-30
Firing
-40

Ca⁺⁺
-50
Na⁺
-60

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Sinus rhythm: it is the spontaneous rate of SA node firing is nearly 100 impulse/minute.

But due to vagus inhibition the rhythm is 60-90 impulse/min.

 If the SA node is damaged, the AV node becomes secondary pacemaker and whole
heart follows it, this is called Nodal rhythm is ≈ 60 impulse/min.

 If the conduction between ventricles and atria damaged, the Purkinje fibers become
the tertiary pace maker and keep the person alive till he treated. The rhythm of
purkinje fibers is called Idio ventricular rhythm ≈ 25-40 impulse/min.

Nervous affect on heart rhythm:

Parasympathetic (vagus nerve) decrease rhythm rate (Bradycardia)

Sympathetic nerves increase rhythm rate ( Tachycardia)

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Conductivity

It is the ability of cardiac muscle to transmits the impulses to all muscle fibers by the
conducting system. ( mentioned before).

The conduction velocity in different parts of conduction system:

Conduction part Velocity

AV is the
SA node 0.5 m/sec
slowest part and
AV node 0.05 m/sec Purkinje fibers
Bundle of His 2 m /sec is the fastest part
Purkinje fibers 4 m/sec
Atria and ventricles 1 m/sec

The velocity of conduction depends on:

1. No. of gap junctions in the muscle fibers ( More in purkinje fibers)

2. Amplitude of phase 0 ( concentration gradient) ( fast in purkinje fibers)

Slow velocity in AV node: High velocity in Purkinje fibers:

 Delay ventricular contraction till end of  To excites the all ventricular
atrial emptying fibers at one time as one unit
 Protects ventricles during atrial damage

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