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Cardiovascular physiology Dr.
Ahlam Kadhim
Introduction
The cardiovascular system is considered as the transport

system of the body. This system has three main components:
the heart, the blood vessels and the blood itself. The heart is the
system’s pump and the blood vessels are the ways of delivery.
Blood can be thought of as a fluid which contains the oxygen and
nutrients the body needs and carries the wastes which need to be
removed.
Figure 1 Cardiovascular physiology
Function of cardiovascular system (CVS):

1-Transfer of oxygen and nutrition to all body cells.
2- Transfer of waste product and carbon dioxide
from all body cells to kidneys and lungs for excretion.
3- Regulation of heat.
4- Distribution of hormones.
5- Aid the body for defense by immunity
Blood vessels
Blood vessels are part of the circulatory system. Blood
vessels play an important role in the transportation of blood around
Cardiovascular physiology Dr. Ahlam Kadhim
the body. There are three main types of blood

vessels: arteries, veins and capillaries.
Arteries
Arteries are the blood vessels that carry blood from the heart
to the body. It has a thicker, more muscular wall with extensive
development of elastic tissue when compared with a vein, to cope
with the extra pressure from the force of the heart’s pumping. They
are stretched during systole and recoil during diastole, to prevent
excessive rise (during systole) and excessive fall (during diastole)
of blood pressure. The volume of blood in the arteries is called the
stressed volume.figure2
figure2
Arterioles
They are the smallest branches of the arteries. Their walls
have less elastic tissue than arteries. They are the site of the
highest resistance to the blood flow.
Venules and veins

The venules collect blood from the capillaries and coalesce
to larger veins. Veins are the blood vessels that drain blood back
from the body to the heart. It has thin, flexible walls when
compared to an artery. Some veins, especially large ones, have
valves in them to prevent blood from running away from the heart
again, such as in the legs. The veins are called capacitance
vessels because they contain the largest percentage of blood in
CVS, which is about 65-75% of the circulating blood volume. The
volume of blood contained in them is called the unstressed

volume.figure3
Capillaries
Capillaries are the smallest of blood vessels. They serve to
distribute oxygenated blood from arteries to the tissues of the body
and to feed deoxygenated blood from the tissues back into the
veins. They are the site where nutrients, gases, water and solutes
exchange between the blood and tissues. Their diameter is just
sufficient to permit RBC in single file. Figure 4
Figure 4
Heart chambers and function of valves:
The heart acts as two separate pumps, right and left sides.
Each side is a pulsatile two-chamber pump that is composed of an
atrium and a ventricle. Atria are helping to move blood into
ventricles, the ventricles then supply the main pumping force that
propels the blood either through the pulmonary circulation by the
right ventricle or through the systemic circulation by the left
ventricle.
There are four valves in the heart; two are called atrioventricular
valves (mitral and tricuspid valves). These valves open during
ventricular diastole to allow blood filling the ventricles and close

during ventricular systole. Other two valves are called semilunar
valves (aortic and pulmonary valves). These valves open during
systole to allow ejecting blood from the ventricles into the aorta or
pulmonary artery and close during diastole .
Both ventricles pump the same volume of blood to systemic and
pulmonary circulation. The right ventricle pumps blood to
pulmonary circulation at low pressure. While the left ventricle
pumps blood through the systemic circulation at high pressure.
The left ventricle has a thicker wall than the right ventricle because
of the higher pressure in the systemic circulation.
About 75% of the blood flow directly through the atria into the
ventricles even before the atria contract. The atrial contraction
causes an additional 25% filling the ventricles .
Physiology of cardiac muscle
Types of cardiac muscle are : atrial, ventricular, specialized

excitatory and conductive muscle fibers. The first two types
resemble skeletal muscle with much longer duration of contraction.
The other two types contract only feebly because they contain few
contractile fibrils; instead, they produce or transmit action
potentials through the heart, providing an excitatory system that
controls the rhythmical beating of the heart.
Cardiac muscle fibers are arranged in a latticework, with the
fibers dividing, recombining, and then spreading again (figure5). It
is striated like skeletal muscle and contains typical myofibrils in the
form of actin and myosin; almost identical to those found in
skeletal muscle; these filaments lie side by side and slide during
contraction in the same manner as occurs in skeletal muscle.
Figure5 Cardiac muscle fibers

The dark areas in the above figure are called intercalated
discs; they are actually cell membranes that separate individual
cardiac muscle cells from one another. At each intercalated disc
the cell membranes fuse with one another to form permeable
communicating junctions (gap junctions) that allow rapid diffusion
of ions. Thus, ions move with ease in the intracellular fluid along
the longitudinal axes of the cardiac muscle fibers so that action
potentials travel easily from one cardiac muscle cell to the next.
Thus, the cardiac cells are so interconnected that when one cell
becomes excited, the action potential rapidly spreads to all of
them.
The atria are separated from the ventricles by fibrous tissue
that surrounds the atrioventricular (A-V) valvular openings between
the atria and ventricles. Normally, potentials are not conducted
from the atria to the ventricles directly through this fibrous tissue.
Conducting system structures are :
1-The sino-atrial node (SA node) .
2- The internodes atrial pathway .
3- The atrio-ventricular node (AV node) .
4-The bundle of His and its branches .
5- Purkinje fibers.
The SA node is the normal cardiac pacemaker, with its rate of
discharge determining the rate at which the heart beats. Impulses
generated in the SA node pass through the atrial pathways to the
AV node, through this node to the bundle of His, and through the
branches of the bundle of His via the Purkinje system to the

ventricular muscle.
Blood supply of the heart: The heart is supplied by two coronary

arteries (right and left) distal to the aortic valve. Coronary veins
drain into a single large vein, then coronary sinus, which drain into
the right atrium.
Nerve supply of the heart:The heart is innervated by both

sympathetic and parasympathetic fibers. The sympathetic fibers
innervate the SA node, AV node and muscle fibers in the atria and
ventricles. Sympathetic stimulation increases heart rate (positive
chronotropic effect), short duration delay of transmission of
impulses AV node and increases the force of contractility (positive

inotropic effect) of muscle fibers in the atriums and ventricles)
Parasympathetic fibers innervate the heart through vagus nerve.
The right vagus nerve enervates SA node to lowering the heart
rate (negative chronotropic effect) while the left vagus nerve
enervates AV node to increase duration of delay of transmission of
impulses .

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Cardiovascular physiology Dr.

The cardiovascular system is considered as the transport

Figure 1 Cardiovascular physiology

Function of cardiovascular system (CVS):

the body. There are three main types of blood

Venules and veins

volume of blood contained in them is called the unstressed

ventricular diastole to allow blood filling the ventricles and close

Types of cardiac muscle are : atrial, ventricular, specialized

Figure5 Cardiac muscle fibers

branches of the bundle of His via the Purkinje system to the

Blood supply of the heart: The heart is supplied by two coronary

Nerve supply of the heart:The heart is innervated by both

impulses AV node and increases the force of contractility (positive

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