Cardiovascular System

I. Introduction
A. The cardiovascular system includes the heart and blood vessels.
B. Without blood circulation, the tissues lack oxygen and nutrients and waste accumulates.
II. Structure of the Heart
A. Size and Location o the !eart
". An average size o an adult heart is generally "# cm long and $ cm wide.
%. The heart is bounded laterally by the lungs, anteriorly by the sternum, and &osteriorly by the vertebral
column.
'. The base o the heart lies beneath the second rib.
#. The a&ex o the heart is at the level o ith intercostal s&ace.
B. (overings o the !eart
". The &ericardium is a covering that enclosed the heart and the &roximal ends o the large blood vessels to
which it attaches.
%. The ibrous &ericardium is the outer ibrous layer o the &ericardium.
'. The visceral &ericardium is a serous membrane that is attached to the surace o the heart.
#. The &arietal &ericardium is a serous membrane that lines the ibrous layer o the &ericardium.
). The &ericardial cavity is the s&ace between the visceral &ericardium and &arietal &ericardium.
*. Serous luid reduces riction between the &ericardial membranes as the heart moves.
(. Wall o the !eart
". The three layers o the heart wall are endocardium, myocardium, and &ericardium.
%. The e&icardium is com&osed o a serous membrane that consists o connective tissue covered by e&ithelium,
and it includes blood ca&illaries, lym&h ca&illaries, and nerve ibers.
'. The middle layer is the myocardium.
#. The myocardium is com&osed o cardiac muscle tissue.
). The inner layer is the endocardium.
*. The endocardium consists o e&ithelium and connective tissue that contains manly elastic and collagenous
ibers. +t also contains blood vessels and ,urkin-e ibers.
.. The endocardium o the heart is continuous with the inner lining o the blood vessels attached to the heart.
/. !eart (hambers and 0alves
". The two u&&er chambers o the heart are the right atrium and the let atrium.
%. The two lower chambers o the heart are the right ventricle and the let ventricle.
'. Auricles are small, earlike &ro-ections o the atria.
#. The interatrial se&tum se&arates the right and let atrium.
). The interventricular se&tum se&arates the right and let ventricles.
*. An atrioventricular oriice is an o&ening between an atrium and a ventricle.
.. An atrioventricular oriice is &rotected by an A10 valve.
2. The atrioventricular sulcus is located between the atria and ventricles.
$. The right atrium receives blood rom the su&erior and inerior vena cavae and the coronary sinus.
"3. The tricus&id valve is located between the right atrium and right ventricle and unctions to &revent the back
low o blood into the right atrium.
"". (hordae tendinae are ibrous strings and unction to &revent cus&s o A10 valves rom swinging back into
atria.
"%. ,a&illary muscles are located in ventricular walls and contract when the ventricles contract.
"'. The right ventricle receives blood rom the right atrium.
"#. The right ventricle &um&s blood into the &ulmonary trunk.
"). The &ulmonary trunk divides into &ulmonary arteries.
"*. ,ulmonary arteries deliver blood to the lungs.
".. The &ulmonary valve is located between the right ventricle and &ulmonary trunk and o&ens when the right
ventricle contracts.
"2. ,ulmonary veins carry blood rom the lungs to the let atrium.
"$. Blood &asses rom the let atrium into the let ventricle.
%3. The mitral valve is located between the let atrium and let ventricle and unctions to &revent the back low
o blood into the let atrium.
%". The let ventricle &um&s blood into the aorta.
%%. The aortic valve is located between the let ventricle and aorta and o&ens when the let ventricle contracts.
%'. The tricus&id and mitral valves are also called A10 valves because they are &ositioned between atria and
ventricles.
%#. The &ulmonary and aortic valves are also called semilunar valves
because o their structures.
4. Skeleton o the !eart
". The skeleton o the heart is com&osed o rings o dense connective tissue and other masses o connective
tissue in the interventricular se&tum.
%. The skeleton o the heart &rovides attachments or the heart valves and or muscle ibers.
5. ,ath o Blood Through the !eart
". Blood that is low in oxygen and rich in carbon dioxide enter the right atrium o the heart through venae cavae
and the coronary sinus.
%. As the right atrium contracts, blood &asses into the right ventricle.
'. When the right ventricle contracts, blood moves into the &ulmonary trunk.
#. 5rom the &ulmonary arteries blood enters the lungs.
). The blood loses carbon dioxide in the lungs and &icks u& oxygen.
*. 5reshly oxygenated blood returns to the heart through &ulmonary veins.
.. The &ulmonary veins deliver blood to the let atrium.
2. When the let atrium contracts, blood &asses into the let ventricle.
$. When the let ventricle contracts, blood &asses into the aorta.
6. Blood Su&&ly to the !eart
". The irst two branches o the aorta are the let and right coronary arteries.
%. (oronary arteries su&&ly blood to the tissues o the heart.
'. The circumlex artery is located in the atrioventricular groove between the let atrium and let ventricle and
su&&lies blood to the walls o the let atrium and let ventricle.
#. The anterior interventricular artery is located in the anterior interventricular groove and su&&lies blood to
walls o both ventricles.
). The &osterior interventricular artery is located the &osterior interventricular groove and su&&lies the &osterior
walls o both ventricles.
*. The marginal artery is located along the lower border o the heart and su&&lies blood to the wall o the right
atrium and right ventricle.
.. Blood low in coronary arteries is &oorest during ventricular contraction because the contracting myocardium
intereres with blood low and the o&enings o the coronary arteries are &artially blocked by cus&s o the aortic
valve.
2. (ardiac veins drain blood that &asses through the ca&illaries o the myocardium.
$. The coronary sinus is an enlarged vein on the &osterior surace o the heart.
III. Heart Actions
A. +ntroduction
". Atrial systole is atrial contraction.
%. 0entricular diastole is ventricular relaxation.
'. Atrial diastole is atrial relaxation.
#. 0entricular systole is ventricular contraction.
). When the atria o the heart contract, the ventricles relax.
*. When the ventricles o the heart contract, the atria relax.
B. (ardiac (ycle
". /uring a cardiac cycle, the &ressure within the heart chambers rises and alls.
%. The &ressure in the ventricles is low during ventricular diastole.
'. /uring diastole, the A10 valves are o&en.
#. About .37 o the blood lows &assively rom the atria into ventricles and the remaining blood is &ushed into
the ventricles when the atria contract.
). As ventricles contract, the A10 valves sna& shut.
*. When the &ressure in the atria is lower than venous &ressure, blood lows rom the veins into atria.
.. /uring ventricular systole, ventricular &ressure increases and the &ulmonary valves o&en.
2. As blood lows out o the ventricles, ventricular &ressure decreases.
$. The semilunar valves close when the &ressure in the ventricles is lower than &ressure in the aorta and
&ulmonary trunk.
(. !eart Sounds
". !eart sounds are &roduced by the movement o blood through the heart and by the o&ening and closing o
heart valve.
%. The irst heart sound is lubb and occurs during ventricular contraction.
when the A10 valves sna& shut.
'. The second heart sound is du&& and occurs during ventricular relaxation when the &ulmonary valves sna&
shut.
#. A murmur is an abnormal heart sound.
/. (ardiac 8uscle 5ibers
". A unctional syncytium is a mass o merging cells that act as a unit.
%. Two syncytiums o the heart are in the atrial walls and the ventricular walls.
'. The atrial syncytium and ventricular syncytium are connected by ibers o the cardiac conduction system.
4. (ardiac (onduction System
". The cardiac conduction system consists o an S1A node, atrial syncytium, -unctional ibers, A10 node, A10
bundle, bundle branches, ,urkin-e ibers, and a ventricular syncytium.
%. The S1A node is located in the wall o the right atrium and initiates one im&ulse ater another.
'. The S1A node is called the &acemaker because it generates the heart9s rhythmic contractions.
#. As a cardiac im&ulse travels rom the S1A node into the atrial syncytium, it goes rom cell to cell via ga&
-unctions.
). (onducting ibers deliver im&ulses rom the S1A node to the A10 node.
*. The A10 node is located in the inerior &art o the interatrial se&tum and &rovides the only normal
conduction &athway between the atrial and ventricular syncytiums.
.. +m&ulses are delayed as they move through the A10 node because this allows time or atria to contract.
2. 5rom the A10 node, im&ulses &ass to the A10 bundle.
$. The A10 bundle is located in the su&erior &art o the interventricular se&tum and gives rise to bundle
branches.
"3. ,urkin-e ibers carry im&ulses to distant regions o the ventricular myocardium.
"". The ventricular myocardium contracts as a unctioning unit.
"%. ,urkin-e ibers are located in the inerior &ortion o the interventricular se&tum, &a&illary muscles, and in the
ventricular walls.
"'. The ventricular walls contract with a twisting motion because the muscle ibers in the ventricular walls orm
irregular whorls. The twisting motion &roduces a &ushing motion.
"#. (ontraction o the ventricles begins at the a&ex o the heart and &ushes blood su&eriorly toward the aortic
and &ulmonary semilunar valve.
IV. Blood Vessels
A. +ntroduction
". Blood vessels orm a closed circuit o tubes that carries blood rom the heart to cells and back again.
%. 5ive ty&es o blood vessels are arteries, arterioles, ca&illaries, venules, and vein.
'. Arteries conduct blood away rom the heart and to arterioles.
#. 0enules and veins conduct blood rom ca&illaries and to the heart.
). The ca&illaries are sites o exchange o substances between the blood and the body cells.
B. Arteries and Arterioles
". Arteries are strong, elastic vessels that are ada&ted or carrying the blood away rom the heart under high
&ressure.
%. Arteries give rise to arterioles.
'. The three layers o the wall o an artery are the endothelium, tunica media, and tunica adventitia.
#. The inner layer o an artery is called endothelium and unctions to &rovide a smooth surace or blood low
and &revents blood clotting.
). The middle layer o an artery is called the tunica media and is com&osed o smooth muscle ibers.
*. The outer layer is the tunica adventitia and consists o connective tissues with collagenous and elastic ibers.
.. The vasa vasorum o an artery is a series o blood vessels that su&&ly the wall o large arteries.
2. The sym&athetic nervous system innervates smooth muscle in arteries and arterioles.
$. 0asomotor ibers stimulate smooth muscle cells to contract, decreasing the diameter o the vessel.
"3. 0asoconstriction is the contraction o smooth muscle cells in blood vessel walls.
"". 0asodilation is the relaxation o smooth muscle cells in the walls o blood vessels and occurs when the
blood vessel diameter increases.
"%.(hanges in the diameters o arteries and arterioles greatly inluence blood low and &ressure.
"'. The wall o a very small arteriole consists o an endothelium and some smooth muscle cells and connective
tissue.
"#. 8etarterioles are branches o arterioles and hel& regulate blood low to an area.
"). Arteriovenous shunts are connections between arterioles and venous &athways.
(. (a&illaries
". +ntroduction
a. The smallest diameter blood vessels are ca&illaries.
b. (a&illaries connect arterioles to venules.
c. The wall o a ca&illary consists o endothelium.
%. (a&illary ,ermeability
a. The most &ermeable ca&illaries are located in the liver, s&leen, and red bone marrow.
b. ,rotective and tight ca&illaries are located brain.
'. (a&illary Arrangement
a. The higher a tissue9s rate o metabolism, the denser its ca&illary networks.
b. Tissues richly su&&lied with ca&illaries are muscle and nervous tissues.
c. Tissues that lack ca&illaries are cartilage and e&ithelial tissues.
d. /uring exercise, blood is directed to ca&illary networks o skeletal muscle and it by&asses some o
the ca&illary networks o the digestive tract.
#. :egulation o (a&illary Blood 5low
a. ,reca&illary s&hincters are located at the o&ening o ca&illaries and their unction is control the low
o blood into a ca&illary.
b. When cells have low concentrations o oxygen, &reca&illary s&hincters relax and blood low
increases.
). 4xchanges in the (a&illaries
a. The vital unction o exchanging gases, nutrients, and metabolic by1&roducts between the blood and
the tissue luid surrounding body cells occurs in the ca&illaries.
b. Biochemicals move through ca&illary walls by diusion, iltration, and osmosis.
c. /iusion is the most im&ortant means o transer.
d. ;xygen and nutrients diuse out o the ca&illary walls into surrounding cells because they are in a
lower concentration in surrounding cells.
e. (arbon dioxide and other wastes diuse into the ca&illary blood because they are in a lower
concentration in the ca&illary blood.
. ,lasma &roteins generally remain in the blood because they are too big to cross through ca&illary
walls.
g. +n iltration, hydrostatic &ressure orces molecules through a membrane.
h. +n the ca&illaries, the orce or iltration is &rovided by blood &ressure.
i. Blood &ressure is greater at the arteriole end o the ca&illary.
-. (olloid osmotic &ressure is osmotic &ressure and is created by &lasma &roteins in the blood o
ca&illaries.
k. At the arteriolar end o the ca&illary, iltration &redominates.
l. At the venular end o the ca&illary, osmotic &ressure &redominates.
/. 0enules and 0eins
". 0enules are blood vessels that continue rom ca&illaries and merge to orm veins.
%. The middle layer o the wall o a vein is very thin and &oorly develo&ed com&ared to that o an artery.
'. The unction o valves in veins is kee& blood lowing toward the heart.
#. 0eins also unction as blood reservoirs.