Anatomy of the

Cardiovascular System
TENTATIVE Dates:
Tuesday April 19th Chapter 18 Quiz
Wednesday April 20th Heart Anatomy Practical
Friday May 6th Project Due
Block Days (May 11th or 12th) Chapter 18/19 Test
 Cardiovascular System
Also circulatory system
Consists of: the heart, arteries, veins,
capillaries
 Heart
Four chamber muscular organ
Comparable to the size of a closed fist
Located in the mediastinum
Behind sternum
Between 2nd and 6th ribs
Between T5-T8
Apex base of heart
Located at the 5th intercostal space
Heart
 Coverings of the Heart
Pericardium loose fitting sac
surrounding the heart
Fibrous pericardium tough, loose-fitting,
inelastic
Serous pericardium
Parietal layer: lines the inside of the fibrous
pericardium
Visceral layer: adheres to outside of the heart
Pericardial space: between parietal and
visceral layer
Filled with 10-15mL of pericardial fluid
Decreases friction
 Walls of the Heart
Epicardium outer layer
Epicardium = serous pericardium
Myocardium thick, contractile layer composed
of cardiac muscle cells
Intercalated disks contain many gap junctions
Allow cardiac muscle cells to function as a single unit
syncytium
Endocaridium interior of cardiac wall
Endothelial tissue
Covers projections of myocardial tissue called
trabeculae
Walls of the
Heart
 Chambers of the Heart
Atria two superior chambers
Receiving chambers
Blood from veins enters atria
Ventricles two inferior chambers
pumping chambers
Thick muscular walls to increase force of
pumping action
Left > right
Separated by interventricular septum
 Valves of the Heart
Permit blood flow in one direction during
circulation
Atrioventricular valves (AV valves)
Also cuspid valves
Between atria and ventricles
Semilunar (SL valves)
Between R ventricle and pulmonary arteries
and L ventricle and aorta
 Atrioventricular Valves
Tricuspid valve
Btwn R atrium and ventricle
3 flaps of endocardium
Connected to ventricular papillary muscle
via chordae tendinae
Bicuspid valve
Btwn L atrium and ventricle
Also called mitral valve
Two flaps of endocardium
 Semilunar Valves
Pulmonary semilunar valve
Btwn R ventricle and pulmonary trunk
Aorta semilunar valve
Btwn L ventricle and aorta
 Chambers & Valves

Trace the blood flow through the heart

 Blood Supply to the Heart
Right and left coronary arteries
First branches off aorta
Right coronary artery right marginal
artery & posterior interventricular artery
Left coronary artery circumflex artery
& anterior interventricular artery
Most of the blood goes to the L ventricle
In 50% of the population, the R coronary
artery is dominant
 Blood Supply to the Heart
Anastomosis: Connections between blood
vessels that allow for collateral circulation
Few exist between large branches of coronary
arteries
In presence of an obstruction in a large
artery ischemia will result to a large area of
tissue
Myocardial infarction (MI) (aka heart attack)
Anastomoses do exists between smaller
branches of the R and L coronary arteries
 Blood Supply to the Heart
After traveling through the capillaries
of the heart, blood empties into the R
atrium via the coronary sinus
Conduction System of the Heart
Four structures composed of modified
cardiac muscle
Sinoatrial Node (SA Node)
Pacemaker of the heart
100s of cells in the R atrium near the
opening of the superior vena cava
Atrioventricular Node (AV Node)
Small mass of cardiac muscle tissue
Left lower border of R atrium
Conduction System of the Heart
Atrioventricular Bundle
Also Bundle of His
Bundle of specialized cardiac muscle fibers
originating in the AV node
Branches into R and L branches eventually
becoming Purkinje fibers
Extend into the walls of the ventricles and
papillary muscles
 Warm Up 4/12/11
1. The apex of the heart rests on the:
2. True/False: The epicardium and the fibrous
pericardium are the same structure.
3. What is the correct order of the layers of
the heart from outside to inside?
4. The ____________ connect the cuspid
valves to the papillary muscles.
5. What is an anastomosis?
6. What is also known as the pacemaker of the
heart?
 Types of Blood Vessels
Artery carries oxygenated blood away
from the heart
distributors
Arteriole: small artery
Precapillary sphincters: regulate the blood
flow into capillaries
 Types of Blood Vessels
Vein carries unoxygenated blood
towards the heart
Great ability to stretch (capacitance)
Function as reservoirs: blood pools in the
valves then is pushed forward from the
pumping pressure
Venules: small vein
Types of Blood Vessels
 Types of Blood Vessels
Capillaries arterial system switches to
venous system
primary exchange vessels
Transport materials to and from the cells
Speed of blood flow decreases to increase
contact time
Microcirculation: blood flow between
arterioles, capillaries and venules
Types of Blood Vessels
 Structure of Blood Vessels
Tunica adventitia - outermost layer
Fibrous connective tissue
Holds vessels open; prevents tearing of
vessels walls during body movements
Larger in veins than arteries
Tunica media middle layer
Smooth muscle and elastic CT
Helps vessels constrict and dilate
Larger in arteries
 Structure of Blood Vessels
Tunica intima innermost layer
Composed of endothelium
Semilunar valves present in veins
One cell thick in capillaries
 Circulatory Routes
Systemic Circulation blood flow from
the L ventricle to the body & back to
the R atrium
Pulmonary Circulation blood flow from
the R ventricle to the lungs and back to
the L atrium
Circulatory Routes
Aorta
 Systemic Arteries
Arch of aorta Abdominal aorta
Subclavian (L and R) Common iliac
Brachiocephalic External iliac
common carotid (L Femoral
and R) Popliteal
Axillary (L and R) Posterior tibial
Brachial (L and R) Anterior tibial
Radial Dorsal pedis
Ulnar
 Systemic Veins
Superior vena cava Basilic
Inferior vena cava Median basilic
External jugular Median cubital
Internal jugular Common iliac
Brachiocephalic (L External iliac
and R) Femoral
Subclavian (L and R) Popliteal
Cephalic Great saphenous
axillary Small saphenous
 Fetal Circulation
Two umbilical arteries carry blood to the
placenta
The placenta allows for exchange of oxygen
and nutrients from the mother. Maternal and
fetal blood do NOT mix.
Umbilical vein returns oxygenated blood and
enters fetus via the umbilicus
Foramen ovale hole btwn the R and L atria
Allows for blood to bypass the R ventricle and
pulmonary circulation
 Fetal Circulation
Ductus arteriosus small vessel
connecting the pulmonary artery and
the aorta
Allows for another bypass route from the
lungs

**Most of fetal blood is a mixture of

oxygenated and deoxygenated blood**
 Fetal
Circulation
 Changes After Birth
Umbilical vein become round ligament
Umbilical arteries become umbilical
ligaments
Foramen ovale closes after first few
breaths
Full closure may take up to 9 months
Ductus arteriosus contracts as soon as
respirations begin
Become fibrous cord
Changes After Birth
 Warm Up 4/13-14/11
1. What is the function of the precapillary
sphincters?
2. List the layers of arteries and veins from
superficial to deep. How do the layers
differ in arteries vs veins?
3. What type of tissue are capillaries composed
of?
4. What blood vessel has valves?
5. Differentiate between pulmonary and
systemic circulation.
 Warm Up 4/15
Announcements:
Warm ups due today
Chapter 18 quiz next Tuesday will finish notes on
Monday
Heart and Blood Vessel Practical next Wednesday
Warm Up:
1. Name the arteries that branch off the aorta.
2. What are the 4 divisions of the aorta?
3. True/False: During fetal circulation fetal and maternal
blood mix.
4. Explain the function of the umbilical cord during fetal
circulation.
5. Describe the foramen ovale and the ductus arteriosus.
 Warm Up 4/18/11
Announcements:
1. Chapter 18 Quiz tomorrow
2. Practical Wednesday (sheep heart and blood
vessels)
Warm Up:
1. Respectively, the right and left atrioventricular
(AV) valves are also referred to as:
2. From the L ventricle, blood flows into the:
3. The pulmonary veins carry blood to the:
4. The most abundant blood supply goes to the:
5. What type of blood vessel has valves? What type
of valves are they?
 Pericardium Disorders
Pericarditis inflammation of the heart
Causes: trauma, viral or bacteria infection, tumor
Edema causes visceral and parietal layers to rub
together = chest pain
Pus or blood build up in pericardial space
S/S
Pain with respirations or coughing, dyspnea, restlessness
Complications: Pericardial Effusion, Cardiac
Tamponade
Treatment:
Antibiotics, pain meds, antiinflammatory meds,
pericardiocentesis (Cardiac Tamponade)
Cardiac Tamponade
 Heart Valve Disorders
General Principles:
Congenital defect: decreased pumping
efficiency
Incompetent valve leak: allows backflow
into previous chamber
Stenosed valves: narrowed valve; slowing
blood from out of chamber
 Heart Valve Disorders
Mitral Valve Prolapse (MVP)
Flaps of mitral valve extend back into L
atrium causes leaking
Mostly genetic basis
1 in 20 people
S/S: most asymptomatic; chest pain,
fatigue
Treatment: valvuloplasty
Mitral Valve Prolapse
 Heart Valve Disorders
Aortic Regurgitation
Blood leaks back into L ventricle during
ejection into the aorta
Volume overload in L ventricle, hypertrophy,
dilation of L ventricle
Complications: myocaridal ischemia
Treatment: valvuloplasty
 Myocardium Disorders
Atherosclerosis
Type of arteriosclerosis
Lipids build up on the inside of vessel walls
calcify vessels hard & brittle
Risk factors: cigarette smoking, high
fat/cholesterol diet, hypertension
Atherosclerosis
 Myocardium Disorders
Myocardial Infarction
Heart Attack
Coronary thrombosis: clot
Coronary embolism: mobilized clot
Occlude coronary artery heart tissue
deprived of oxygen cell death
S/S:
Angina pectoris severe chest pain resulting
from inadequate oxygen to myocardium
Treatment: Coronary Bypass Surgery
Veins are harvested from other areas of the
body and used to bypass obstructions
 Myocardium Disorders
Congestive Heart Failure (CHF)
Left-sided Heart Failure
Inability of the L ventricle to pump blood
efficiently
Causes: myocardial infarction
S/S: decreased pumping pressure in systemic
circulation; retained fluids
Can lead to congestion in pulmonary circulation
pulmonary edema right-sided heart failure
Treatment: heart transplant
Congestive Heart Failure
 Myocardium Disorders
Coronary Artery Disease (CAD)
Leading cause of death in US
General term to describe decreased blood
flow to myocardium & associated side
effects
 Disorders of the Arteries
Arteriosclerosis
Arteries become occluded, weak and
hardened
Complications: ischemia, necrosis, gangrene
Risk factors: age, diabetes, high
fat/cholesterol diet, hypertension, smoking
Treatment: vasodilators, angioplasty, stent
placement, bypass surgery
Complications: aneurysm
Angioplasty
 Warm Up 4/25/11
Announcements:
1. Practical grades online
2. Practical & Quiz make ups today after school
3. Use next blank box on warm up sheet
Warm Up:
1. What two vessels return blood to the heart after
systemic circulation?
2. A ___________ is a small artery.
3. What procedure can open a blocked artery and
restore blood to the heart? If this doesnt work,
what is a more invasive procedure?
4. What does MONA stand for? When is this treatment
used?
5. A cardiac tamponade is the result of too much fluid in
the:
 Changes to Schedule
Project due Friday May 13th
Computer lab days:
4/28 (2nd Period)
4/29 (5th, 6th)
Block day (5/4, 5/5)
Chapter 19 Quiz 5/11 or 5/12 (block
day)
Chapter 18/19 Test Tuesday 5/17
 Disorders of Veins
Varicose Veins
Enlarged veins caused by pooling
Results in varicosities or varices (spider
veins)
Risk factors: standing for long periods
Semilunar valves widen more pooling
Treatment: compression stockings, surgical
removal
Varicose Veins
 Disorders of Veins
Phlebitis vein inflammation
Causes: irritation by IV catheter
Thrombophlebitis
Deep vein thrombosis (DVT)
Phlebitis caused by a clot
S/S
Pain, redness, swelling
Complications
Pulmonary embolism
DVT
Pulmonary Embolism
 Venous Stasis Ulcers
Result of chronic
vein insufficiency
Lack of oxygen
to peripheral
tissues
Elevate leg &
apply pressure
Irregular edges
Aching pain
 Heart Defect Project
Description of the anatomical defect(s)
Etiology (causes/origin)
Resulting circulatory problem(s)
Normal vs abnormal circulation
Perfusion
Oxygenation
Fluid balance
Associated signs/symptoms
Prevalence (Statistics)
Treatment
Medications
Surgery
Life Expectancy (with or without treatment)
Patent Ductus Arteriosus (PDA)
Atrial Septal Defect (ASD)
Ventricular Septal Defect (VSD)
Atrioventricular Septal Defect
(AVSD)
Tetralogy of Fallot (TOF)
Transposition of the Great Vessels
(TGV)
Coarcatation of the Aorta (CoA)
Ebsteins Anomaly
Pulmonary Atresia
Truncus Arteriosus
Hypoplastic Left Heart Syndrome