Anatomy and

Physiology

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 The Cardiovascular System
The Cardiovascular System:
The cardiovascular system is sometimes
called the blood-vascular or simply the
circulatory system.
 It consists of the heart, which is a muscular
pumping device, and
 A closed system of vessels called arteries,
veins, and capillaries.

The Heart
The heart is a hollow muscular pump that provides the force necessary
to circulate the blood to all the tissues in the body through blood
vessels.
The normal adult heart pumps about 5 liters of blood every minute
throughout life. 2
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 Layers of heart muscle

The heart comprises of three layers, epicardium, myocardium, and

endocardium surrounding the inner chambers and is enclosed in a
fourth protective layer known as the pericardium.

 Endocardium: The internal lining of all four heart chambers is the

endocardium.

 Myocardium:
 The bulk of the heart is myocardium, which is the contractile
element composed of specialized striated muscle fibres called
cardiac muscle.

 Epicardium is the outermost layer of the heart and constitutes

the visceral layer of the pericardium. It is composed of simple
squamous epithelium on the external surface.
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 Functions of the Heart

 Generates blood pressure

 Routes blood
 Heart separates pulmonary and systemic
circulation
 Ensures one-way blood flow
 Heart valves ensure one-way flow

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 Functions of the Heart

 Regulates blood supply

 Changes in contraction rate and force match
blood delivery to changing metabolic needs
 Most healthy people can increase cardiac
output by 300–500%
 Heart failure is the inability of the heart to
provide enough blood flow to maintain
normal metabolism
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 HEART ANATOMY
 The heart has four chambers.
 Two atria act as collecting
reservoirs.

 Two ventricles act as pumps.

 The heart has four valves for:

 Pumping action of the heart.
 Maintaining unidirectional
blood flow.

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 The Chambers
 Separated by
 Interatrial Septum
 Interventricular Septum

 Right Atrium
 Blood from Superior and inferior venae cavae and
the coronary sinus

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 The Chambers, cont’d
 Right Ventricle
 Receives blood from the right atrium via the right
AV valve, tricuspid valve
 Thin wall

 Left Atrium
 Receives blood from R and L Pulmonary Veins

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 The Chambers, cont’d
 Left Ventricle
 Receives blood from the Left AV valve
 Thick wall
 Pumps to body via Aortic Semilunar Valve

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 Valves of the Heart
The heart has two types of valves that keep the blood flowing in the
correct direction.
The valves between the atria and ventricles are called
atrioventricular valves (also called cuspid valves), while those at the
bases of the large vessels leaving the ventricles are called semilunar
valves.
The right atrioventricular valve is the tricuspid valve.
The left atrioventricular valve is the bicuspid, or mitral, valve.
The valve between the right ventricle and pulmonary trunk is the
pulmonary semilunar valve.
The valve between the left ventricle and the aorta is the aortic
semilunar valve.
When the ventricles contract, atrioventricular valves close to prevent
blood from flowing back into the atria. When the ventricles relax,
semilunar valves close to prevent blood from flowing back into the
ventricles. 11
Structure
Structure and
and Function
Function of
of Valves
Valves

= Mitral valve

4 sets of valves

Prevent backflow of
blood

Close passively under blood pressure

Heart sounds produced by valve closure 12

 HEART
 Deoxygenated blood returns to
the heart via the superior and
inferior vena cava, enters the
right atrium, passes into the
right ventricle, and from here it
is ejected to the pulmonary
artery.

 Oxygenated blood returning

from the lungs enters the left
atrium via the pulmonary veins,
passes into the left ventricle,
and is then ejected to the aorta.

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 Blood flow pattern through the heart
1. Blood enters right atrium via the
superior and inferior venae cavae
2. Passes tricuspid valve into right
ventricle
3. Leaves by passing pulmonary
semilunar valves into pulmonary
trunk and to the lungs to be
oxygenated
4. Returns from the lung by way of
pulmonary veins into the left atrium
5. From left atrium past bicuspid valve
into left ventricle
6. Leaves left ventricle past aortic
semilunar valves into aorta
7. Distributed to rest of the body

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 Blood Vessels
 Blood vessels are divided into a pulmonary circuit
and systemic circuit.
 Artery - vessel that carries blood away from the
heart. Usually oxygenated. Exception, pulmonary
artery.
 Vein - vessel that carries blood towards the heart.
Usually deoxygenated. Exception pulmonary veins
 Capillary - a small blood vessel that allow diffusion
of gases, nutrients and wastes between plasma and
interstitial fluid.
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 Blood Vessels
 Systemic vessels
 Transport blood through the body part from left
ventricle and back to right atrium
 Pulmonary vessels
 Transport blood from right ventricle through
lungs and back to left atrium
 Blood vessels and heart are regulated to ensure
blood pressure is high enough for blood flow to
meet metabolic needs of tissues

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 Coronary
Coronary Circulation
Circulation
Coronary arteries: first branches off the ascending aorta.

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 coronary veins coronary sinus right atrium
(inferior to opening
of inferior vena cava)

posterior view

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Actions of the heart

Four types:

1.Chronotropic action
It is the frequency of heart rate or heart beat. It is of two types:
i.Tachycardia
ii.Bradycardia

2.Inotropic action
It is the force of contraction of heart. It is of two types:
i.Positive inotropic action
ii.Negative inotropic action

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3. Dromotropic action: It is the conduction of impulse through
the heart. It is of two types:
i. Positive dromotropic action
ii. Negative dromotropic action

4. Bathmotropic action: It is the excitability of cardiac muscle.

It is of two types:
i. Positive bathmotropic action
ii. Negative bathmotropic action

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Properties of heart muscle
1. Automaticity: Also called autorhthmicity. It means that the
heart muscle can generate its own impulse at regular interval.

2. Conductivity: Impulse generated from SA node of heart transmit

to its epicardial surface through junctional tissue in it.

3. Excitability and contractility: In response to stimulus of

adequate strength and duration, heart muscle shows excitability
and responds by contraction

4. All or none law: If an adequate stimulus is supplied to heart

muscle, the heart muscle responds to its maximum. But if the
stimulus is not adequate it does not respond at all.

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5. Frank Starling law: Within the physiological limit, the greater the
length of the cardiac muscle fibre, the greater will be the force of
contraction.
6. Refractory period: It is the period during which the heart muscle is
non-responsive to external stimuli.
Refractory period of heart is 0.30 sec.
Two types – 1. Absolute RP: about 0.25 sec
2. Relative RP: about 0.05 sec
During this period, heart muscle get time for recovery by getting
nutrition and O2 supply.

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 The Heart's Electrical Conduction System
The heart is primarily made up of muscle tissue. A network of nerve
fibers coordinates the contraction and relaxation of the cardiac muscle
tissue to obtain an efficient, wave-like pumping action of the heart

 Sinoatrial node.
 Electrical pace maker.
 Atrioventricular node.
 Receives impulses originating
from SA node.
 Bundle of His
 Electrical link between atria and
ventricles.
 Purkinje fibres.
 Distribute impulses to ventricles.
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SA Node:
 The sinoatrial node (SA node) is a group of cells positioned on the
wall of the right atrium, near the entrance of the superior vena cava.
 They possess some contractile filaments, though they do not contract.
 Cells in the SA node will naturally discharge (create) impulse at about
70-80 times/minute.
 Because the sinoatrial node is responsible for the rest of the heart's
electrical activity, it is sometimes called the primary pacemaker
AV Node
 The atrioventricular node is located in the wall of the right atrium,
adjacent to the tricuspid valve.
 The impulses from the AV node will maintain a slower heart rate
(about 40-60 beats per a minute).
 The AV node delays impulses for 0.1 second before spreading to the
ventricle walls to ensure that the atria are empty completely before the
ventricles contract

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Bundle of HIS:
 The bundle of His is the band of conducting tissue radiating from
the AV node into the interventricular septum where it divides into
two branches and continues as Purkinje fibers.
 The bundle of HIS branches into the three bundle branches: the
right left anterior and left posterior bundle branches that run along
the intraventricular septum
 It takes about 0.03-0.04s for the impulse to travel from the bundle
of HIS to the ventricular muscle

Purkinje fibers:
 Purkinje fibers are located in the inner ventricular walls of the heart,
just beneath the endocardium.
 These fibers are specialized myocardial fibers that conduct an
electrical stimulus or impulse that enables the heart to contract in a
coordinated fashion.
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Heart receives visceral motor innervations via-
• Parasympathetic
• Sympathetic

• Stimulation of parasympathetic nerve causes-

- Decreased heart rate
- Reduced conductivity of bundles causing various degrees of heart
block
- Decreased force of contraction
- Reduced duration of systole
- Reduced length of refractory period
- Reduced excitability of the heart
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Stimulation of sympathetic nerve causes-
- Increased frequency of heart rate
- Increased force of contraction
- Increased excitability and irritability of heart
- Increased conductivity of myocardium and the bundle of His.

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