CARDIOVASCUL

AR SYSTEM
Sindhu Wisesa

Hearts position in thorax

Hearts position in thorax

In mediastinum behind sternum and pointing
left, lying on the diaphragm
It weighs 250-350 gm (about 1 pound)

Feel your heart beat at apex

(this is of a person lying down)

FIGURE 20-2(a) An anterior view of the open chest

cavity, showing the position of the heart and major
vessels relative to the lungs.

mediastinum

Posisi jantung di thorax :

Chest x rays

Lateral (male)
Normal female

Source Undetermined

Human Heart

Without most of pericardial layers

11

General Anatomy of the

Heart

Great veins and arteries at the base

Pointed tip is apex
Surrounded by pericardial sac

Figure 202c

Figure 12-3(b)

Layers of pericardium and heart

wall

15

Heart Wall

16

Cardiac
Muscle Cells

Figure 205

Relative thickness of muscular walls

LV thicker than RV because it forces blood out against more resistance;
the systemic circulation is much longer than the pulmonary circulation
Atria are thin because ventricular filling is done by gravity, requiring little
atrial effort

18

FIGURE 20-4 Layers of the Myocardium.

Cardiac muscle tissue forms concentric layers that wrap around the atria and spiral within the walls of the
ventricles.

(c) Diagrammatic views of the ventricles just before

a contraction (dilated) and just after a contraction
(contracted).

25

Cardiac Cycle

HODS - November 2006

26

Figure 12-5

 The Valves of the Heart

Figure 12-6(a)

Figure 12-6(b)

Function of AV valves

30

Function of semilunar valves

(Aortic and pulmonic valves)

31

(c) The aortic semilunar valve in the open (left) and

closed (right) positions. The individual cusps brace
one another in the closed position.

Figure 2016

Cardiac Cycle
Phases

Location of Heart Valves

Places to auscultate

36

Enlarged
Right Atrium

Source Undetermined

Source Undetermined

Enlarged
Right Ventricle

Source Undetermined

Source Undetermined

Enlarged
Right Ventricle
(lateral CXR)

Source Undetermined

Source Undetermined

Kelainan jantung (congenital)

Kelainan jantung (congenital)

Valve Stenosis and Prolapse

Figure 12-7(a)

Figure 12-7(b)

Coronary heart disease

The Conducting System

Figure 2012

Impulse Conduction
through the Heart

Figure 2013

Heart Excitation Related to

ECG
SA node generates impulse;
atrial excitation begins

SA node

Impulse delayed
at AV node

AV node

Impulse passes to
heart apex; ventricular
excitation begins

Bundle
branches

Ventricular excitation
complete

Purkinje
fibers

Figure 18.17

Autonomic
innervation

Sympathetic
Increases rate and
force of contractions

Parasympathetic
(branches of Vagus
n.)
Slows the heart rate

54

Atrial Depolarization

CORRELATION BETWEEN LOCATION OF

ISCHAEMIC, ECG AND CORONARY
ARTERY ANATOMY
LOCATION OF INFARCT/
INVOLVED
ISCHAEMIC
ANTERIOR EKSTENSIVE

ECG

I, Avl, V1-V6

ANTEROSEPTAL

V1- V3

ANTEROLATERAL

I, aVL, V4- V6

CORONARY ARTERY

LAD, LCX
LAD
LCX

INFERIOR

II, III, aVF

RCA, PDA

POSTERIOR
(POSTEROLATERAL)

V7- V9

PL

RV

V3R V5R

RCA/ RV BRANCH

Ventricle
Depolarization

0.12 second

VASCULAR SYSTEM

Circulatory
Routes overview

Macam2 type arteri & vena

Arteries & Veins

Both are comprised of 3 layers of tissue surrounding

lumen through which blood will flow: tunica interna,
tunica media & tunica externa
Structural difference between arteries & veins
primarily due to differences in pressure of blood
flowing within

Anatomy of the Heart and

Vessels

Veins and
Venules

Arteries
and
Arterioles
Tunica
Intima
Endothelial
cells

Valve

Tunica
Media
Tunica
Externa
or
Adventia

64

 In most capillaries there is more

filtration than absorption
90% the volume of fluid filtered out at the arterial
end is absorbed back into the capillary at the
venous end
the other 10% enters lymphatic vessels where it

Pembuluh darah arteri

Capillaries

Microscopic, very thin-walled

vessels comprised of endothelium
with basement membrane; allows
for filtration and reabsorption
Found in all tissues of the body
except for those that are
avascular
Usually form branching networks
(capillary beds) within tissues for
increased surface area
blood flow into capillaries may be
regulated by pre- capillary
sphincters
may have a central or
thoroughfare channel that
provides direct connection
between metarteriole (terminal
end of arteriole) & venule

Circulasi Pulmonal

Vascular Anastomoses

Arterial Anastomoses

- provide collateral supply

to some organs and tissues,

e.g., skeletal muscles

Arteriovenous Anastomoses

- thoroughfare channels

Venous Anastomoses

- most common, e.g., deep

and superficial veins in
limbs and head

Circulatory Routes Systemic circuit

Arterial blood from left ventricle into
ascending aorta
Venous return to right atrium through
SVC, IVC & coronary sinus
Left common carotid artery
Brachiocephalic
trunk
Ascending aorta
(gives off
coronary
arteries)

Left subclavian artery

Aortic arch
Thoracic (descending) aorta

Abdominal aorta
Common iliac
arteries

Circulasi Sistemik

Head and Neck Arteries

Head and Thorax Arteries

7

posterior communicating
middle cerebral artery

4
3

2
1

Cerebral Circulation

Upper Limb Arteries

Abdominal and Pelvic

Arteries

Lower Limb Arteries

Arteri Anggota Gerak

Bawah

Measuring
Heart Rate

Feeling the radial pulse

Sport Books Publisher

87

Sistem Vena

Head and Neck Veins

Thoracal Vein

Head and Thorax Vein

Upper Extrimity Vein

Hepatic Portal System

Abdominal and pelvic

veins

Lower Extremity Veins

Lower Extremity Veins

Venous Return/Valves
Assistance for venous return
skeletal muscles act as pumps

contracting muscles squeeze veins

force blood back to the heart
valves prevent back flow

respiratory pump

inhaling causes a lowered pressure

in the thoracic cavity
primarily to pull air into the lungs
helps to draw blood into thorax via
pulmonary circulation

Anatomy of the Heart and

Vessels

Venous
Return
Position (gravity)
Muscular
contraction
Breathing
Negative pressure in
thorax
Positive abdominal
pressure
99

Varicose Veins

Natural history of Atherosclerosis

Fetal Circulation
Placenta O2/CO2 &
nutrient/waste between
mom & baby
Umbilical cord (2)
umbilical arteries (baby
mom) & (1) umbilical vein
(mom baby)
Umbilical vein
(O2/nutrient rich
blood) hepatic
portal vein & ductus
venosus IVC Rt.
atrium
Rt. Atrium some blood to rt.
Ventricle, most shunts across
foramen ovale in interatrial septum
lt. atrium lt. ventricle

Fetal Circulation
Blood from Rt. Ventricle
pulmonary trunk
across ductus arteriosus
to aorta
Aorta systemic arteries
internal iliac arteries
umbilical arteries
placenta

Fetal Circulation- Changes at

Birth
Umbilical vein ligamentum
teres (round ligament)
Umbilical arteries lateral
umbilical ligaments
Ductus venosus
ligamentum venosum
Foramen ovale fossa ovalis
Ductus arteriosus
ligamentum arteriosum
Placenta delivered
(afterbirth)

Fetal
Circulation
ductus venosus
bypasses liver
3 Right Left
shunts
because
oxygenated blood
is derived from the
placenta

ductus arterious
ligametum arteriosum
foramen ovale fossa
ovalis
interventricular shunt
no remnant

In the fetus, the RA

received oxygenated
blood from mom
through umbilical
cord, so blood R to L
through the foramen
ovale: fossa ovalis is
left after it closes
The pulmonary trunk
had high resistance
(because lungs not
functioning yet) &
ductus arteriosus
shunted blood to
aorta; becomes
108
ligamentum

Flow Chart of Fetal Circulation

Terimakasih