Cardiovascular System

Dr CHARLES A SIMANJUNTAK,
dr, SpOT(K), MPd
TOPOGRAPHY of the HEART
I. Anatomy of the Heart
A. Coverings
1. Pericardium
• fibrous pericardium
• parietal pericardium
• visceral pericardium
B. Heart wall layers
1. Epicardium – (visceral pericardium)
• protects heart
2. Myocardium – cardiac muscle
3. Endocardium – epithelial/ connective/ fibers
C. Chambers, Vessels, and Valves
1. Four chambers
• upper chambers – rt and left atria
Collects blood
• lower chambers – rt and left ventricle
pumps blood from heart
2. Arteries
• carry blood away from heart
3. Veins
• blood toward heart
 4. Valves
• AV valves
Tricuspid – rt atrium
Bicuspid or mitral - lt atrium
• Semilunar valves
Pulmonary semilunar (pulmonary trunk)
Aortic semilunar (aortic arch)
II. Pulmonary and Systemic Circulation
A. Pulmonary pathway
oxygenated blood –rt ventricle from rt atrium
myocardium (rt ventricle) contracts
 low oxygen blood through pulmonary semilunar
pulmonary trunk -> arteries -> lungs
oxygenated blood -> rt & lt pulmonary veins ->
left atrium
B. Systemic pathway
Oxygenated blood -> lt atrium to lt ventricle
Left ventricle contracts ->aortic semilunar
Aortic arch -> arteries to tissues
oxygen depleted blood from tissues ->
veins to heart -> rt atrium (vena cava)
III. Cardiac cycle and heart sounds
1. Diastole - relax
• atrial diastole – atria fill – valves closed
• ventricular diastole – ventricles fill
2. Systole - contraction
• atrial systole – contracts – blood to ventricles
• ventricular systole – closes AV valves/open semilunar

3. Sounds
Lubb - dubb
Lubb – AV close dubb – semilunar close
IV. Cardiac Conduction
A. Cardiac muscle
• sarcomeres
• contraction similar to skeletal
• intercalated disks
B. Signal conduction
• specialized cardiac cells
Undergo AP spontaneously

Sinoatrial (SA node) Atrioventricular node (AV)

pacemaker
 Signal pathway
• SA action potentials -> contraction in atrium
• AV action potentials (slower) -> bundle of HIS->
through septum -> Purkinje fibers -> contraction
C. Electrocardiography
• electrical events corresponding to mechanical
• P wave: atrial fibers depolarize
• QRS complex: ventricles depolarize
• T wave: ventricles repolarize
D. Regulation
• ANS: Sympathetic & Parasympathetic
Sympathetic: Norepinephrine
increase (Na+)
Parasympathetic: Acetylcholine
decrease (K+)
• Hormones:
Epinephrine/Norepinephrine/T3,T4
• Ions: K+/Ca2+
V. Physiology of Circulation
A. Pulse
• ejection of blood from lft ventricle (wave)
• pressure through arteries = heart beat/min
B. Blood Pressure
• pressure blood exerts on walls of arteries
• measurements: systolic pressure
peak of ventricular contraction
diastolic pressure: ventricles relaxed 120/70
C. Factors affecting pressure
• Neuronal: elevate in CO2,O2,pH
 increase in CO2 / decrease pH
-> Sympathetic norepinephrine -> vasoconstriction
• Chemicals: Histamine –(immune response)
-> vasodilation
• Temperature: cold exposure -> vasoconstriction
VASCULARIZATION to the
Heart
Scheme of the blood supply to
the heart
VASCULARIZATION TO THE
HEAD
VASCULARIZATION TO THE
CHEST & aBDOMEN
VASCULARIZATION TO THE
UPPER EXTREMITIES
VASCULARIZATION TO THE
LOWER EXTREMITIES
QUESTION

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CharlesASjuntak, FKIK-Unja 43