The Circulatory System

The Heart, Blood Vessels, Blood Types

 The Closed Circulatory System
Humans have a closed circulatory system,
typical of all vertebrates, in which blood is
confined to vessels and is distinct from the
interstitial fluid.

The heart pumps blood into large vessels

that branch into smaller ones leading into the
organs.

Materials are exchanged by diffusion between

the blood and the interstitial fluid bathing the
cells.
 The Cardiovascular System

Three Major Elements

Heart, Blood Vessels, &
Blood
1. The Heart- cardiac
muscle tissue
highly interconnected
cells
four chambers
Right atrium
Right ventricle
Left atrium
Left ventricle
Superior Vena Cava Pathway of the blood
Right Atrium
Tricuspid Valve
Right Ventricle
Pulmonary Semilunar Valve
Lungs
Pulmonary Vein
Bicuspid Valve
Left Ventricle
Aortic Semilunar Valve
Aorta
To the bodies organs & cells
 Circuits

Pulmonary circuit
The blood pathway
between the right side
of the heart, to the
lungs, and back to the
left side of the heart.

Systemic circuit
The pathway between
the left and right sides
of the heart.
 The Cardiovascular System
2. Blood Vessels -A network of tubes

Arteriesarterioles move away from the heart

Elastic Fibers
Circular Smooth Muscle

Capillaries where gas exchange takes place.

One cell thick
Serves the Respiratory System

VeinsVenules moves towards the heart

Skeletal Muscles contract to force blood back
from legs
One way values
When they break - varicose veins form
 The Cardiovascular System

3. The Blood

A. Plasma

Liquid portion of the blood.

Contains clotting factors,
hormones, antibodies,
dissolved gases, nutrients
and waste
 The Cardiovascular System

The Blood

B. Erythrocytes - Red
Blood Cells

Carry hemoglobin and

oxygen. Do not have a
nucleus and live only
about 120 days.

Can not repair

themselves.
 The Cardiovascular System
The Blood

C. Leukocytes White
Blood cells

Fight infection and are

formed in the bone marrow

Five types neutrophils,

lymphocytes, eosinophils,
basophils, and monocytes.
 The Cardiovascular System
The Blood

D. Thrombocytes
Platelets.

These are cell fragment

that are formed in the
bone marrow from
magakaryocytes.

Clot Blood by sticking

together via protein
fibers called fibrin.
 Disorders of the Circulatory System
Anemia - lack of iron in the blood, low RBC count

Leukemia - white blood cells proliferate wildly,

causing anemia

Hemophilia - bleeders disease, due to lack of

fibrinogen in thrombocytes

Heart Murmur - abnormal heart beat, caused by valve

problems

Heart attack - blood vessels around the heart become

blocked with plaque, also called myocardial infarction
 Unit 9 The Heart
Cardiovascular System
The Heart
 Functions of the Heart
Generating blood pressure
Routing blood
Heart separates pulmonary and systemic
circulations
Ensuring one-way blood flow
Heart valves ensure one-way flow
Regulating blood supply
Changes in contraction rate and force match
blood delivery to changing metabolic needs
Size, Shape, Location
of the Heart
Size of a closed fist
Shape
Apex: Blunt rounded
point of cone
Base: Flat part at
opposite of end of
cone
Located in thoracic
cavity in
mediastinum
Heart Cross Section
Pericardium
 Heart Wall

Three layers of tissue

Epicardium: This serous membrane of
smooth outer surface of heart
Myocardium: Middle layer composed
of cardiac muscle cell and
responsibility for heart contracting
Endocardium: Smooth inner surface
of heart chambers
Heart Wall
External Anatomy
Four chambers
2 atria
2 ventricles
Auricles
Major veins
Superior vena
cava
Pulmonary veins
Major arteries
Aorta
Pulmonary trunk
External Anatomy
Coronary Circulation
 Heart Valves

Atrioventricular
Tricuspid
Bicuspid or mitral
Semilunar
Aortic
Pulmonary
Prevent blood from
flowing back
Heart Valves
Function of the Heart Valves
Blood Flow Through Heart
Systemic and Pulmonary
Circulation
Heart Skeleton

Consists of plate of
fibrous connective
tissue between atria
and ventricles
Fibrous rings around
valves to support
Serves as electrical
insulation between
atria and ventricles
Provides site for
muscle attachment
 Cardiac Muscle

Elongated, branching cells containing 1-2 centrally located nuclei

Contains actin and myosin myofilaments
Intercalated disks: Specialized cell-cell contacts
Desmosomes hold cells together and gap junctions allow action
potentials
Electrically, cardiac muscle behaves as single unit
Conducting System of Heart
 Electrical Properties
Resting membrane potential (RMP)
present
Action potentials
Rapid depolarization followed by rapid,
partial early repolarization. Prolonged
period of slow repolarization which is
plateau phase and a rapid final
repolarization phase
Voltage-gated channels
 Action Potentials in
Skeletal and Cardiac Muscle
SA Node Action Potential
 Refractory Period
Absolute: Cardiac muscle cell completely
insensitive to further stimulation
Relative: Cell exhibits reduced
sensitivity to additional stimulation
Long refractory period prevents tetanic
contractions
Electrocardiogram
Action potentials
through myocardium
during cardiac cycle
produces electric
currents than can be
measured
Pattern
P wave
Atria depolarization
QRS complex
Ventricle
depolarization
Atria repolarization
T wave:
Ventricle repolarization
 Cardiac Arrhythmias

Tachycardia: Heart rate in excess of

100bpm
Bradycardia: Heart rate less than 60 bpm
Sinus arrhythmia: Heart rate varies 5%
during respiratory cycle and up to 30%
during deep respiration
Premature atrial contractions:
Occasional shortened intervals between
one contraction and succeeding,
frequently occurs in healthy people
Alterations in Electrocardiogram
 Cardiac Cycle

Heart is two pumps that work together,

right and left half
Repetitive contraction (systole) and
relaxation (diastole) of heart chambers
Blood moves through circulatory system
from areas of higher to lower pressure.
Contraction of heart produces the pressure
Cardiac Cycle
Events during Cardiac Cycle
 Heart Sounds

First heart sound or lubb

Atrioventricular valves and surrounding fluid
vibrations as valves close at beginning of ventricular
systole
Second heart sound or dupp
Results from closure of aortic and pulmonary
semilunar valves at beginning of ventricular diastole,
lasts longer
Third heart sound (occasional)
Caused by turbulent blood flow into ventricles and
detected near end of first one-third of diastole
Location of Heart Valves
 Mean Arterial Pressure (MAP)
Average blood pressure in aorta
MAP=CO x PR
CO is amount of blood pumped by heart
per minute
CO=SV x HR
SV: Stroke volume of blood pumped during each
heart beat
HR: Heart rate or number of times heart beats per
minute
Cardiac reserve: Difference between CO at rest and
maximum CO
PR is total resistance against which
blood must be pumped
Factors Affecting MAP
 Regulation of the Heart
Intrinsic regulation: Results from normal
functional characteristics, not on neural or
hormonal regulation
Starlings law of the heart
Extrinsic regulation: Involves neural and
hormonal control
Parasympathetic stimulation
Supplied by vagus nerve, decreases heart rate, acetylcholine
secreted
Sympathetic stimulation
Supplied by cardiac nerves, increases heart rate and force of
contraction, epinephrine and norepinephrine released
 Heart Homeostasis
Effect of blood pressure
Baroreceptors monitor blood pressure
Effect of pH, carbon dioxide, oxygen
Chemoreceptors monitor
Effect of extracellular ion concentration
Increase or decrease in extracellular K+ decreases
heart rate
Effect of body temperature
Heart rate increases when body temperature
increases, heart rate decreases when body
temperature decreases
Baroreceptor and Chemoreceptor
Reflexes
Baroreceptor Reflex
Chemoreceptor Reflex-pH
 Effects of Aging on the Heart
Gradual changes in heart function,
minor under resting condition, more
significant during exercise
Hypertrophy of left ventricle
Maximum heart rate decreases
Increased tendency for valves to
function abnormally and arrhythmias to
occur
Increased oxygen consumption required
to pump same amount of blood
The Heart

52
The heart=a muscular double pump with 2 functions

Overview
The right side receives
oxygen-poor blood from
the body and tissues
and then pumps it to
the lungs to pick up
oxygen and dispel
carbon dioxide
Its left side receives
oxygenated blood
returning from the
lungs and pumps this
blood throughout the
body to supply oxygen
and nutrients to the
body tissues
 simplified

Cone shaped muscle

Four chambers
Two atria, two ventricles
Double pump the ventricles
Two circulations
Systemic circuit: blood vessels that
transport blood to and from all the body
tissues
Pulmonary circuit: blood vessels that
carry blood to and from the lungs
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)

 CXR
(chest x ray)

Normal male
 Chest x rays

Normal female Lateral (male)

 Starting from the outside

Pericardium
(see next slide)

Without most of pericardial layers

 Coverings of the heart: pericardium

Three layered:
(1) Fibrous pericardium
Serous pericardium of layers (2) &
(3)
(2) Parietal layer of serous pericardium
(3) Visceral layer of serous pericardium
= epicardium: on heart and is part of its
wall
(Between the layers is pericardial
cavity)
How pericardium is formed around heart
 Layers of the heart wall

Muscle of the heart with inner and outer

membrane coverings
Muscle of heart = myocardium
The layers from out to in:
Epicardium = visceral layer of serous
pericardium
Myocardium = the muscle
Endocardium lining the chambers
Layers of pericardium and heart wall
 Chambers of the heart
sides are labeled in reference to the patient facing you

Two atria
Right atrium
Left atrium
--------------------------------------------------------------------------------

Two ventricles
Right ventricle
Left ventricle
 Chambers of the heart
divided by septae:

Two atria-
divided by
interatrial septum
Right atrium
Left atrium
Two
ventricles-
divided by
interventricular
septum
Right ventricle
 Valves
three tricuspid
(cusp means flap)
one bicuspid

Tricuspid valve
RA to RV
Pulmonary or pulmonic valve
RV to pulmonary trunk (branches R and
L)
Mitral valve (the bicuspid one)
LA to LV
Aortic valve
LV to aorta
Function of AV valves
Function of semilunar valves
(Aortic and pulmonic valves)
 Pattern of flow
(simple to more detailed)

Body Body to right heart to lungs to

left heart to body
RA
Body, then via vena cavas and
RV coronary sinus to RA, to RV, then to
lungs via pulmonary arteries, then to
Lungs LA via pulmonary veins, to LV, then to
body via aorta
LA
From body via SVC, IVC & coronary
LV sinus to RA; then to RV through tricuspid
valve; to lungs through pulmonic valve
Boby and via pulmonary arteries; to LA via
pulmonary veins; to LV through mitral
valve; to body via aortic valve then aorta

LEARN THIS 70
 Chambers with embryologic changes added
fetal in pink; postnatal in blue
(see next slide)

Two atria------------divided by interatrial

septum
Fossa ovalis left over from fetal hole in septum, the foramen
ovale
Right atrium--------in fetus RA received
oxygenated blood from mom through umbilical
cord, so blood R to L through the foramen ovale
Left atrium
Two ventricles-----divided by interventricular
septum
Right ventricle-----in fetus pulmonary trunk
high resistance & ductus arteriosus shunts blood
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
ligamentum
arteriosum after
birth
 Note positions of valves
Valves open and close in response to pressure
differences
Trabeculae carnae
Note papillary muscles, chordae tendinae (heart
strings): keep valves from prolapsing (purpose of
valve = 1 way flow)
 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
more on valves
Simplified flow: print and fill in details
 Heartbeat
Definition: a single sequence of atrial contraction followed by ventricular contraction
See http://www.geocities.com/Athens/Forum/6100/1heart.html

Systole: contraction
Diastole: filling
Normal rate: 60-100
Slow: bradycardia
Fast: tachycardia
***Note: blood goes to RA, then RV, then lungs, then LA, then LV,
then body; but the fact that a given drop of blood passes through the
heart chambers sequentially does not mean that the four chambers
contract in that order; the 2 atria always contract together, followed
by the simultaneous contraction of the 2 ventricles
 Heart sounds

Called S1 and S2
S1 is the closing of AV (Mitral and Tricuspid)
valves at the start of ventricular systole
S2 is the closing of the semilunar (Aortic and
Pulmonic) valves at the end of ventricular
systole
Separation easy to hear on inspiration therefore
S2 referred to as A2 and P2
Murmurs: the sound of flow
Can be normal
Can be abnormal
 Places to auscultate

Routine places are

at right and left
sternal border and
at apex

To hear the sounds:

http://www.med.ucla.edu/wilkes/intro.html

Note that right border of heart is

formed by the RA; most of the
anterior surface by the RV; the LA
makes up the posterior surface or
base; the LV forms the apex and
dominates the inferior surface
Cardiac muscle
(microscopic)

Automaticity:
inherent rhythmicity
of the muscle itself
 EKG
(or ECG, electrocardiogram)

Electrical
depolarization is
recorded on the
body surface by up
to 12 leads
Pattern analyzed in
each lead

P wave=atrial depolarization
QRS=ventricular depolarization
T wave=ventricular repolarization
 Electrical conduction system:
specialized cardiac muscle cells that carry
impulses throughout the heart
musculature, signaling the chambers to
contract in the proper sequence

(Explanation in next slides)

 Conduction system

SA node (sinoatrial)
In wall of RA
Sets basic rate: 70-80
Is the normal pacemaker
Impulse from SA to atria
Impulse also to AV node via
internodal pathway
AV node
In interatrial septum
 Conduction continued

SA node through AV bundle (bundle

of His)
Into interventricular septum
Divides
R and L bundle branches
become subendocardial
branches (Purkinje
fibers)
Contraction begins
at apex
12 lead EKG
 Artificial
Pacemaker
 Autonomic
innervation

Sympathetic
Increases rate and
force of contractions
Parasympathetic
(branches of Vagus
n.)
Slows the heart rate

For a show on depolarization:

http://education.med.nyu.edu/courses/old/physiology/courseware/ekg_pt1/EKGseq.html
 Blood supply to the heart
(theres a lot of variation)
A: Right Coronary Artery; B: Left Main Coronary Artery; C: Left Anterior Descending (LAD, or Left
Anterior Interventricular);
D: Left Circumflex Coronary Artery; G: Marginal Artery; H: Great Cardiac Vein; I: Coronary sinus,
Anterior Cardiac Veins.
 Anterior view
L main coronary artery arises from the left side of the aorta
and has 2 branches: LAD and circumflex
R coronary artery emerges from right side of aorta
Note that the usual name for anterior
interventricular artery is the LAD (left
anterior descending)
 A lot of stuff from anterior view

Each atrium has an auricle, an ear-like flap

A lot of stuff from posterior view
 Again posterior view

Note: the coronary sinus (largest cardiac vein)

delivers blood from heart wall to RA, along with SVC & IVC)
another flow chart
Embryological development during week 4 (helps to
understand heart defects)

(day 23)

(day 28)

(day 24)

Day 22, (b) in diagram, heart starts pumping

Normal and
abnormal

Congenital (means born with)

abnormalities account for nearly half
of all deaths from birth defects
One of every 150 newborns has some
congenital heart defect
more
 See Paul Wissmans website:
main link; then Anatomy and
Physiology then Human heart:
http://homepage.smc.edu/wissmann_paul/
http://homepage.smc.edu/wissmann_paul/anato
my1/
http://homepage.smc.edu/wissmann_paul/anato
my1/1heart.html
click-on
Then from from the following list of Human
this site:
Heart Anatomy Web Sites:
1) SMC pictures of the Human Heart:
http://homepage.smc.edu/wissmann_paul/heartpics/
3) Human Heart Anatomy
7) NOVA PBS animation of Heart Cycle:
http://www.geocities.com/Athens/Forum/6100/1heart.html
 http://homepage.smc.edu/wissmann_paul/heartpics/

There are
dissections
like this
with roll
over
answers

LOOK AT
THESE!
OTHER
CARDIOVASCULAR LINKS

http://library.med.utah.edu/WebPath/CVHT
ML/CVIDX.html#2 (example upper right)
http://www.geocities.com/Athens/Forum/6
100/1heart.html (heart contraction
animation & others)
http://www.med.ucla.edu/wilkes/intro.htm
l (heart sounds)
http://education.med.nyu.edu/alexcoursew
are/physiology/ekg_pt1 (depolarization
animation)
Use to study
Functional Anatomy of
Blood Vessels
 Pulmonary
Special Circulations Circulation

Right ventricle

Pulmonary trunk

Right and left pulmonary arteries

Lobar arteries (2 left, 3 right)

Arterioles

Pulmonary capillaries

Diffusion

Venules

Veins

Pulmonary veins Functional blood supply for the lungs
comes from the aorta and through the
Left atrium bronchial arteries.
 Fetal
Special Circulations Circulation

Placenta

Umbilical vein
Liver
Ductus venosus

Inferior vena cava

Right atrium Right ventricle

Foramen ovale Pulmonary trunk


Ductus arteriosus
Left atrium

Left ventricle

Aorta

Body

Internal iliac
arteries Lower extremities
Umbilical cord is made of the umbilical vein and two
umbilical arteries. Vein carries nutrients and O2 to fetus.
Umbilical arteries Arteries carry CO2 and wastes from fetus to placenta.

Placenta
 Arterial Supply
Special Circulation of the Brain

Aortic Arch

Brachiocephalic artery
Brachiocephalic artery
Subclavian artery

Common carotid arteries Vertebral arteries

Internal carotid arteries

Basilar artery

Middle cerebral artery Posterior communicating artery Posterior cerebral arteries

Anterior cerebral artery Anterior communicating artery

Special Arterial Supply
of the Brain
Circulation
Anterior communicating
Anterior cerebral Anterior cerebral
Internal carotid Middle cerebral
Middle cerebral

Posterior
Posterior
communicating
communicating
Posterior cerebral Posterior
cerebral

Basilar

Vertebral
 Major Systemic Veins

Superior Vena Cava

Inferior Vena Cava
 Lower Limb
Major Systemic Veins

Dorsal venous arch

Great saphenous vein Dorsalis pedis vein Small saphenous vein

Anterior tibial vein

Popliteal vein Plantar Arch

Femoral vein plantar veins

External iliac vein Posterior tibial vein Fibular
(peroneal) vein
Common iliac vein

Inferior vena cava
BLOOD VESSELS
BLOOD VESSELS

Arterioles Veinules
 COMPARISON OF ARTERIES,
CAPILLARIES, & VEINS

Arteries & Arterioles Capillaries Veinules & Veins

Tunica Media
Tunica Intima

(Blood)

Tunica Adventitia
CAPILLARY BEDS
BLOOD PRESSURE
VENOUS PUMP
 VENOUS PUMP

1. Valves - formed from folds of tunica intima

prevent backflow of blood in veinules &
veins.
2. Function like semilunar valves forcing
blood to flow against gravity toward the
heart.
 VENOUS PUMP

3. Skeletal muscles pressing against walls of veins

provide force to move blood from one valve
through the next toward the heart.
4. Skeletal muscles pressing against walls of
veins provide force to move blood from one
valve through the next toward the heart.
 VARICOSE VEINS

1. Veins that are stretched, dilated &

overfilled with blood due to incompetent
valves
2. Contributing causes:
Weak valves or veins - (heredity)
Excessive weight
Excessive standing, straining
Inadequate exercise
Increased intra-pelvic pressure - pregnancy,
constipation
VARICOSE VEINS
MAJOR ARTERIES OF THE BODY
Brachiocephalic Aortic Arch
Ascending Aorta Thoracic Aorta

Abdominal Aorta
Celiac
 ARTERIES OF THE LEG

External Iliac Internal Iliac

Femoral

Popliteal (behind knee)

Anterior Tibial
Posterior Tibial (behind Tibia)
ARTERIES OF THE HEAD & NECK
 Lower Limb
Major Systemic Veins
Dorsal venous arch
Great saphenous
Dorsal venous Femoral Plantar arch
arch External iliac Plantar veins
Great saphenous Common iliac Posterior tibial
Inferior vena cava Fibular
Small saphenous
Anterior tibial
Dorsalis pedis
Dorsal venous arch Popliteal
Anterior tibial Femoral
Small saphenous
Popliteal Popliteal External iliac
Femoral Femoral Common iliac
External iliac External iliac Inferior vena
Common iliac Common iliac cava
Inferior vena cava
Inferior vena
cava
 Abdomen
Major Systemic Veins
I
N
F
Hepatic veins E Hepatic veins
R
I Left suprarenal vein
Right suprarenal vein O Renal vein
R Left gonadal vein
Right gonadal vein
V
E
N
A
Lumbar veins Lumbar veins
C
A
V
A
 Head and Neck
Major Systemic Veins

Occipital vein

Posterior arcuate vein Facial Superficial temporal vein

External jugular vein Vertebral Internal jugular vein

Subclavian vein

Brachiocephalic vein

Superior vena cava

Major Systemic Veins
Occipital vein
Posterior arcuate
vein
External jugular vein
Subclavian vein
Brachiocephalic vein
Superior vena cava
Head and Neck
Facial vein
Superficial temporal vein
Internal jugular vein
Brachiocephalic vein
Superior vena cava

Vertebral vein
Subclavian vein
Brachiocephalic vein
Superior vena cava
 Upper Limb
Major Systemic Veins
Median antibrachial vein

Ulnar vein Radial vein Basilic vein

Brachial vein

Cephalic Axillary

Subclavian
Median cubital vein
Brachiocephalic

Superior vena cava
 Upper Limb
Major Systemic Veins
Ulnar vein Basilic vein
Radial vein Brachial vein
Brachial vein Axillary vein
Axillary vein Subclavian vein
Subclavian vein
Brachiocephalic vein
Brachiocephalic
vein Superior vena cava
Superior vena cava
Cephalic vein
Axillary vein
Subclavian vein
Brachiocephalic vein
Superior vena cava
 Major Systemic Thorax

Veins
Azygos System

Posterior intercostal veins

Ascending lumbar vein

Accessory
Hemiazygos vein hemiazygos veins

Azygos vein

Superior vena cava

 Thorax
Azygos System
Major Systemic Veins

Posterior intercostal veins

Posterior intercostal
veins Ascending lumbar vein
Ascending lumbar Accessory hemiazygos
veins veins
Hemiazygos vein Azygos vein
Azygos vein Superior vena cava
Superior vena cava
 Major Systemic Hepatic Portal
System
Veins
Veins from distal large
intestine Veins from spleen

Inferior mesenteric vein Splenic vein
Veins from small intestine,
ascending and transverse
colon

Veins from Superior mesenteric vein

digestive viscera, spleen, & pancreas

Hepatic Portal vein

Veins from
Liver lesser curvature
of stomach

Hepatic veins Left gastric vein

Inferior vena cava
 Hepatic Portal
Major Systemic Veins System

Veins from distal large Veins from small intestine,

intestine ascending and transverse colon
Inferior mesenteric vein Superior mesenteric vein
Veins from digestive Veins from digestive viscera,
viscera, spleen and spleen and pancreas
pancreas Hepatic portal vein
Hepatic portal vein Liver
Liver Hepatic veins
Hepatic veins Inferior vena cava
Veins
Inferior
fromvena cava
spleen
Splenic vein Veins from lesser curvature of
Veins from digestive viscera, stomach
spleen and pancreas Left gastric vein
Hepatic portal vein Liver
Liver Hepatic veins
Hepatic veins Inferior vena cava
Inferior vena cava
Major Systemic Hepatic Portal
System
Veins