1. Circulatory System Cardiovascular system function:
Three basic components
Heart
Blood vessels
Blood
Cardiovascular system function:
Transport oxygen
Nutrients
Cell wastes
Hormones via the blood

2. Cone shape
Muscular pump
250 – 300 g
Size of a person’s fist

3. Location Mediastinum Superior surface of diaphragm
Anterior to the vertebral column
Posterior to the sternum
Apex is directed toward the left, rests on the diaphragm, at about the fifth intercostals space

4. Pericardium

5. Pericardium : The pericardium: A superficial fibrous pericardium
A deep two-layer serous pericardium
The parietal layer
The visceral layer
They are separated by the fluid-filled pericardial cavity
The pericardium:
Protects
Prevents overfilling
Allows for the heart to work in a relatively friction-free environment

6. Heart Wall Epicardium – visceral layer of the serous pericardium
Myocardium
Endocardium

8. Anatomical position surface Borders Base Apex Sternocostal
Diapgragmatic
Pulmonary R &L
Borders
Left
Right
Inferior
superior
Base
Apex

9. Four hollow chambers: 2 atria – receiving chambers
divided by the interatrial septum
2 ventricles – discharging chambers
divided by the interventricular septum

10. Atria
Septum
Ventricles

12. Anterior Inter ventricular sulcus
Sternocostal surface
Left Atrium
Left
Ventricle
Right Atrium
Sinus coronary sulcus
Anterior Inter ventricular sulcus
Right Ventricle

13. posterior Inter ventricular sulcus
Diaphragmatic surface
Left
Ventricle
posterior Inter ventricular sulcus
Coronary
Sulcus

14. Right atrium Ineratrial septum Fossa ovalis Right auricle
Superior Vena Cava
inferior Vena Cava
Coronary sinus
Right atrioventricular foramen

15. Pectinate
Muscle
Fovea
Ovalis

16. Blood Enters The Right Atrium Via Three Veins
Superior
vena
cava
Superior vena cava
Inferior vena cava
Coronary sinus
Coronary
sinus
Inferior
vena cava

17. Right ventricle Right ventricle: Papillary muscles Papillary muscles
Chorda tendineae
Tricuspid valves
Pulmonary artery
Right ventricle:
Papillary muscles
Chorda tendineae
Tricuspid valves
Pulmonary artery
Trabeculae
carneae

18. Chordae
tendoneae
Papillary
muscles

19. Left atrium
Left auricle
Left atrioventricular foramen
Aorta foramen

20. Blood enters the left atrium via four veins
Right and left pulmonary veins
Right
Pulmonary
veins
Left
pulmonary
veins

21. Left ventricle Left ventricle Papillary muscles Chorda tendineae
bicuspid valves
Aorta
Papillary muscles
Chorda tendineae
Bicuspid valves
Aorta

22. Radiographic Landmarks

23. Major Vessels of the Heart
Vessels returning blood to the heart include:
Superior venae cavae
inferior venae cavae
Right and left pulmonary veins
Vessels conveying blood away from the heart include:
Pulmonary trunk
Ascending aorta

24. Valves of the Heart Atrioventricular valves Semilunar valves
Right AV (Tricuspid)
Left AV (Bicuspid)
Pulmonary valve
Aortic valve

25. Pulmonary
semilunar valve
Right AV
(tricuspid)
valve
Aortic
semilunar valve
Chordai
tendineae
Papillary
muscle
Left AV
(bicuspid)
valve

26. Pathway of Blood

27. Circulatory System
Pulmonary circulation
Systemic circulation

28. Pathway of Blood Through the Heart and Lungs
RA  tricuspid valve  RV
RV  pulmonary semilunar valve  pulmonary arteries  lungs
Lungs  pulmonary veins  LA
LA  bicuspid valve  LV
LV  aortic semilunar valve  aorta
Aorta  systemic circulation

29. Pulmonary Circulation

30. Systemic Circulation

31. Intrinsic conduction system
( Nodal system )

32. Two systems act to regulate heart activity:
Extrinsic conduction system
2. Intrinsic conduction system = or nodal system
Setting the basic rhythm
Sinoatrial (SA) node :
located in right atrium
pacemaker of the heart
Atrioventricular (AV) node :
at junction of atria and ventricles
Atrioventricular (AV) Bundle (Bundle of his)
Bundle branches
Purkinje fibers

34. Bundle of His
SA Node
Internodal Pathways
Bundle Branches
Purkinje Fibers
AV Node

36. Regulation of Heart Rate
Increased heart rate
Sympathetic nervous system thoracic N – 1- 4
Low blood pressure
Hormones
Epinephrine
Thyroxine
Exercise
Decreased blood volume
Decreased heart rate
Parasympathetic vagus N
High blood pressure or blood volume

37. Heart Sounds

38. Murmurs = abnormal heart sounds
Lub dup
Lub – closing of AV valves ( systole )
Dup – closing of semilunar valves (diastole )
Murmurs = abnormal heart sounds

39. Cardiac Cycle Systole : lup
Rising ventricular pressure results in closing of AV valves
Atria relax
Diastole : dup
relaxation of heart muscle

40. Blood Vessels

41. Capillary Beds
Figure 19.4a

42. Blood Pressure (BP) Systemic pressure:
Force wall of a blood vessel by its contained blood
Expressed in millimeters of mercury (mm Hg)
in large arteries near the heart
Systemic pressure:
Is highest in the aorta
Declines throughout the length of the pathway
Is 0 mm Hg in the right atrium

43. Measuring Blood Pressure
first sound heard = systolic pressure
Second sound heard = diastolic pressure
Systole = contraction
Diastole = relaxation

44. Blood Pressure: Effects of Factors
Normal
140–110 mm Hg systolic
80–75 mm Hg diastolic
Hypotension
Low systolic (below 110 mm HG)
Hypertension
High systolic (above 140 mm HG)
Neural factors (sympathetic division)
Renal factors ( Renin )
Temperature
Heat has a vasodilation effect
Cold has a vasoconstricting effect
Chemicals
Various substances can cause increases or decreases
Diet

45. Cardiovascular Disease

46. Types Of Cardiovascular Disease
Atherosclerosis ----(Plaque )
Coronary heart disease (CHD) ---Myocardial infarction (MI) or heart attack
Chest pain (angina pectoris)
Ischemia
Irregular heartbeat (arrhythmia)
Tachycardia = more than 100 beats/min
Bradycardia = less than 60 beats/min
Congestive heart failure (CHF)
heart muscle is unable to keep blood circulating normally
Congenital heart disease
Stroke--- Myocardial infarction (MI)
Embolism: blockage of blood vessels

47. Common Blood Vessel Disorders

48. Angioplasty Versus Bypass Surgery
Coronary bypass surgery

49. Inflammation of pericardial sac
Pericarditis
Inflammation of pericardial sac
Clinical Manifestations of Pericarditis
Chest pain
Dyspnea
Chills
Fever
Pain –Substernal, over heart, can radiate, intense sharp grating pain that increases with deep inspiration, coughing, lying flat. Relieved by sitting up, leaning forward
Pericardial rub produced from the inflamed pericardial and epicardial layers rubbing together with movement. Can be intermittent.
Pericardial effusion – abnormal amount of pericardial fluid, if develops gradual as much as 400 ml can accumulate before there is an effect, but if it is rapid, not time to adjust and will see effects with as little as 100ml. It can impede functioning of heart – cardiac tamponade. Signs of pericardial effusion – dyspnea as tissue becomes depressed, distant heart sounds, tachycardia. As it progresses, tamponade can occur – cardiac output falls, BP falls, restlessness, confusion, tachycardia, paradoxical pulse – drop in SBP of more than 10 mmHg with inspiration.

50. Clinical Manifestations of Mitral Stenosis
Cough
Frequent respiratory infections
Weakness, fatigue
Diastolic murmur
Murmur heard best at the apex of the heart-low pitch rumbling

51. Varicose Veins