Anaphy Cardio XII
Anaphy Cardio XII
Anaphy Cardio XII
Section: BSN – 1H
CHAPTER Xll
TITLE: THE HUMAN HEART AND ITS VASCULAR SYSTEM
The major structures of the cardiovascular system, the heart and the blood vessels,
play a vital role in human physiology. The major function of the cardiovascular system is
transportation. Using blood as the transport vehicle, the system carries nutrients, gases,
wastes, antibodies, electrolytes, and many other substances to and from the body cells. Its
propulsive force is the contracting heart.
There are four chambers in the heart. The upper chambers, the atrium is separated by
the interatrial septum, and the two lower chambers, the ventricles are divided by
interventricular Septum. Each atrium opens into the ventricles on the same side through an
atrioventricular valve, folds of fibrous tissue that ensure one-way flow of blood from the atria
into the ventricles. The two atria have relatively thin muscular wall and are highly expandable
So when the atrium is not filled with blood, its outer portion deflates into a lumpy wrinkled
flap called auricle. The coronary sulcus, a deep groove usually filled with substantial amounts
of fat, marks the border between the atria and the ventricles. Shallower depressions, the
anterior interventricular sulcus and posterior interventricular sulcus mark the boundary
between the left and right ventricles.
The great veins and arteries of the circulatory system are connected to the superior
end of the heart at the base. The inferior pointed tip of the heart is the apex.
The heart is surrounded by the pericardial cavity. The lining of the pericardial cavity is
a serous membrane called pericardium. The pericardium can be subdivided into the visceral
pericardium and the parietal pericardium. The visceral pericardium or epicardium covers the
outer surface of the heart, whereas, the parietal pericardium lines the inner surface of the
pericardial sac, which surrounds the heart.
The heart lies near the anterior chest wall, directly behind the sternum. It is enclosed
by the mediastinum, the connective tissue mass that divides the thoracic cavity into two
pleural cavities and also contains the thymus and trachea.
The right atrium receives blood from the systemic circuit through the large veins,
the superior vena cava and inferior vena cava. The superior vena cava delivers blood from
the head, neck, upper limbs and chest. The inferior vena cava comes from the rest of the
trunk, the viscera and the lower limbs. The cardiac veins of the heart return venous blood
to the coronary sinus, which opens into the right atrium slightly below the connection with
the inferior vena cava.
Blood travels from the right atrium into the right ventricle through a broad opening
bounded by three flaps of fibrous tissue.
Blood leaving the right ventricle flows into the pulmonary trunk, the start of the
pulmonary circuit. The pulmonary semilunar valve guards the entrance of this efferent trunk.
Within the pulmonary trunk, blood flows into the lefty and right pulmonary arteries. These
vessels branch repeatedly in the lungs before supplying the capillaries where gas exchange
Occurs. From these respiratory capillaries, oxygenated blood moves into the left and right
pulmonary veins, which delivers it to the left atrium. The left atrium has an external auricle
and a valve, the atrioventricular valve or bicuspid valve. The blood leaving the left ventricle
passes though the aortic semilunar valve into the aorta, the start of the systemic circuit.
Blood flows through a network of blood vessels that extends between the heart and
peripheral tissues. Blood vessels are subdivided into pulmonary circuit, which carries blood to
and from the exchange surfaces of the lungs, and a systemic circuit, which transport blood to
and from the rest of the body. Each circuit begins and ends at the heart, and blood travels
through this circuit in sequence.
In the heart's normal pattern of activity, each contraction follows a precise
sequence. The atria contracts first, followed by the ventricles. Cardiac contractions are
coordinated by the heart's conducting system, a network of specialized cardiac muscle cells
that initiates and distributes electrical impulses. The network is made up of two types of
cardiac muscle cells that do not contract (1) nodal cells, which are responsible for
establishing the rate of cardiac contraction and are located at the sinoatrial node (SA) and
atrioventricular nodes (AV); and (2) conducting cells include the AV bundle, the bundles
branches, and the Purkinjie fibers.
Blood has a unique composition. It is a fluid connective tissue consisting of a matrix
called plasma and several formed elements. Plasma contains dissolved proteins rather than
the network of insoluble fibers like those in loose connective tissue or cartilage. Because Of
those proteins in, plasma is highly denser than water. Formed elements are blood cells and
cell fragments (platelets) suspended in the plasma. Red blood cells (RBC) or erythrocytes
transport Oxygen and carbon dioxide. The less numerous white blood cells (WBC), or
leukocytes, function as part of the body's defense mechanism. Platelets are small, membrane
enclosed packets of cytoplasm that contains enzymes and factors important to blood clotting.
Together the plasma and formed elements constitute whole blood. The volume of
whole blood varies from 5 to 6 liters in the cardiovascular system an adult, and from4 to 5
liters in that of an adult woman. Whole blood components may be separated, or fractionated
for analytical or clinical purposes.
In the procedure for ABO blood typing, single drop of blood is mixed with different
antisera, solutions that contain antibodies. One drop of blood is mixed with anti-A serum,
which contains anti-A antibodies that will agglutinate (clump together) red blood cells that
possess A antigen. Another drop is mixed with anti-B serum, which contains anti-B
anti9bodies that will agglutinate red blood cells that possess B antigens. If the red blood cells
agglutinate only when mixed with anti-A serum, the blood type is A. If the red blood cells
agglutinate only when mixed with anti-B serum, the blood type is B. The blood type is AB if
both drops agglutinate: if neither agglutinate, the blood type is type O.
OBJECTIVES:
. Illustrate the parts of the heart including its membranes.
2. Identify the function of the heart.
3. Discuss the Cardiac Cycle.
4. Justify the cardiac conduction pathways
5. Identify the controlling system of blood vessels.
6. Distinguish the structures involved in the pulmonary and systemic circulation.
7. Discuss the pathway of pulmonary, systemic and hepatic circulation.
8. Compare the fetal circulation from the adult circulation.
9. Identify changes in levels of blood components in association to a health problem.
(CBC result interpretation)
ACTIVITIES:
l. Parts Of the heart. Complete the following statements by inserting your answers in the
blanks.
The heart is a cone-shaped muscular organ located within the (1). Its apex rests on
the (2), and its base is at the level of the (3) rib. The Coronary arteries that nourish
the myocardium arise from the (4). The coronary sinus empties into the (5). Relative to the
roles of the heart chambers, the (6) are receiving chambers, whereas the (7) are
discharging chambers. The membrane that lines the heart and also forms the valve flaps is
called the The outermost layer of the heart is called the (9). The fluid that fills the
pericardial sac acts to decrease (10) during heart activity. The heart muscle tissue called (11)
Answer Box
1. Thorax 2. Diaphragm
3. Second 4. Aorta
5. Right atrium 6. Atria
7. Ventricles 8. Endocardium
9. Epicardium 10. Friction
11. Cardiac muscle
ll. The heart is called a double pump because it serves two circulations. Trace the flow of
blood through both the pulmonary and systemic circulations by writing an essay beginning
from the right atrium, depicting the whole flow of blood circulation according to the image
below. Note specifically the oxygenated and unoxygenated blood in the circulation. Finally,
identify the various regions of the circulation shown in the same figure by labelling them
using the key choices.
Key Choices (Numbers: 2, 4, 8-11, 13) Key Choices (Numbers: 1, 3,5-7, 12)
A. Liver Circulation H. Kidney
B. Circulation to up r limbs l. Pulmonary Trunk
C. Renal Circulation J. Aorta
D. Pulmonary Circulation K. Brain
E. Circulation to lower limbs L. Pulmonary Arteries
F. Circulation to the brain and tissues of the M. Pulmonary Vein
head
G. Digestive tract Circulation
Answer box
1. K 2. F
3. J 4. B
5. L 6. I
7. M 8. D
9. Heart 10. G
11. C 12. E
13. A 14. H
Answer
Blood from the body is returned to the right atrium by veins and venules. Blood is pumped
into the pulmonary trunk after its passage from the right atrium to the right ventricle. In
the right and left pulmonary arteries, which bring deoxygenated blood to the lungs, the
pulmonary trunk splits. Carbon dioxide is released into the lung capillaries, and the blood
takes up oxygen. Blood, now rich in oxygen, runs from the left atrium of each lung. Blood
flows to the left ventricle from the left atrium, then the left ventricle pumps blood into the
aorta, which distributes the oxygenated blood to the whole body through its branches.
Blood returns through the venous system to the heart, and the cycle goes on.
III. The events of one complete heartbeat are referred to as the cardiac cycle. Complete the
following statements that describe these events. Insert your answers in the answer box
provided.
The contraction of the ventricles is referred to as (1), and the period of ventricular relaxation
is called (2). The monosyllables describing heart sounds during the cardiac cycle are (3). The
first heart sound is a result of closure of the (4) valves; closure of the (5) valves Causes the
second heart sound. The heart chambers that have just been filled when you hear the first
heart sound are the (6) and the chambers that have just emptied are the (7). Immediately
after the second heart sound, the (8) are filling with blood, and the (9) are empty. Abnormal
heart sounds, or (10), usually indicate valve problems.
Answer box
1. Systole 2. Diastole
3. Lub-dub 4. Atrioventricular
5. Semilunar 6. Ventricles
7. Atria 8. Atria
9. Ventricles 10. Murmurs
IV. Follow the instructions to complete this activity. Refer to Figure 11-4.
A. Draw arrows to indicate the direction of blood flow through the heart. Draw the pathway
of the oxygen rich blood with red arrows, and trace the pathway of oxygen poor blood
with blue arrows.
A. Identify
each of the
elements of the
intrinsic conduction
system (numbers
1-5 On the image) by
inserting the
appropriate terms in the blanks on the left of the image. Then, indicate with green arrows the
pathway that impulses take through this system.
B. Correctly identify each of the heart valves (number 6-9 on the image) by inserting the
appropriate terms in the blanks left of the image, and draw in and identify by name the
cordlike structures that anchor the flaps of the atrioventricular (AV) valves.
Answer box Figure 11—4
V. Heart Conduction System. Trace the conduction pathway Of the heart and identify the
elements involve in the conduction system. Write your answer in the box provided.
Answer box:
Answer box:
Conduction
pathway of the
heart.
1. The action potentials originate in sinoatrial (SA) node and travel across to the wall of the
atrium (arrows) from the sinoatrial (SA) node to atrioventricular (AV) node.
2. The action potentials pass through the AV node and along the atrioventricular (AV) bundle,
which extends from the AV node, through the fibrous skeleton, into the interventricular
septum.
3. AV bundle divides into the right and left bundle branches and action potentials descend to
the apex of each ventricle along the bundle branches.
4. Action potentials are carried by the Purkinje fibers from bundle branches to ventricular walls.
V. FETAL CIRCULATION
A. Identify the structures unique in the fetus and from where this structure receives and
will deliver the blood.
Fetal structure Receives blood Delivers blood to Structure after birth
from
1. Placenta Umbilical arteries Umbilical veins Grow too deeply into the
uterine wall
4. Foramen ovale Right atrium Left atrium The tissue usually grows
together and closes the hole
B. Identify the parts in the fetal circulation together with the fetal structures.
Key Choices Answer
A. Umbilical Vein 10 Fetal Circulation
B. Placenta 1
C. Right Atrium 8
D. Umbilical 14
Arteries
E. Ductus 11
Arteriosus
F. Superior Vena 4
Cava
G. Foramen Ovale 5
H. Inferior Vena 9
Cava
l. Left Atrium 13
J. Descending Aorta 2
K. Pulmonary Trunk 6
L. Pulmonary Veins 12
M. Aorta 7
N. Ductus Venosus 3
C. Discuss briefly using your Own words what happens in the following neonatal
congenital heart defects particularly in the circulation of blood.
1. Patent Ductus Arteriosus – it is where the blood flows away from the lungs before
birth. It is referred to as a patent ductus arteriosus if the connection remains open.
The irregular opening allows the baby's lungs and heart to circulate too much blood.
Untreated, the blood pressure in the lungs of the baby could rise (pulmonary
hypertension) and the heart of the baby may swell and weaken.
2. Atrial septal defect – it is where the oxygen-rich blood to flow into the oxygen-poor
blood chambers of the heart.
3. Tetralogy of Fallot – the aorta is moved slightly to the right and is directly above the
ventricular septal defect. In this location, the aorta receives blood from the right and
left ventricles, combining the oxygen-poor blood from the right ventricle with the
oxygen-rich blood from the left ventricle.
4. Coarctation Of the Aorta – a contraction, or constriction, of a part of the aorta. The
condition forces the heart to pump more blood through the aorta and into the rest of
the body.
5. Transposition of the Great Arteries – or D-TGA is a birth defect of the heart in which
the two major arteries transporting blood from the heart (away from the heart)– the
main pulmonary artery and the aorta – are switched in place or "transposed."
VI. BLOOD VESSELS
Activity: Identify the blood vessels for each of the body region as depicted. Write your
answers On the box provided.
1. Answer box
1. Celiac trunk
2. Superior mesenteric artery
3. Inferior mesenteric artery
4. Left common iliac artery
5. Median sacral artery
6. Left internal iliac artery
7. Left external iliac artery
8. Lumbar arteries
9. Gonadal arteries (testicular or ovarian)
10. Renal arteries
11. Suprarenal arteries
12. Inferior phrenic arteries
5. Answer box
6. Answer box
1. Facial vein
2. Lingual vein
3. Superior thyroid vein
4. Internal jugular vein
5. Left brachiocephalic vein
6. Superior vena cava
7. Inferior vena cava
8. Brachial veins
9. Basilic vein
8.
10. Azygos vein
11. Axillary vein
1. Coronary sinus
12. Cephalic vein
13. Right
2. Great brachiocephalic
cardiac vein vein
14. Subclavian vein
3. Small cardiac vein
15. External jugular vein
4. Middle cardiac vein vein
16. Retromandibular Answer
17. Superficial temporal vein box
9. Answer box
Vlll. Essay. Compare the fetal circulation from that of an adult circulation focusing on
their major differences
Answer
There is a distinct distinction between the fetal circulation system and adult
circulation. This complex mechanism allows the fetus to obtain from the placenta
oxygenated blood and nutrients. It consists of the placenta blood vessels and the
umbilical cord, comprising two umbilical arteries and one umbilical vein. Via a shunt
known as the arteriosus ductus, fetal drainage bypasses the lungs; the ductus venosus
also bypass the liver, and blood can migrate through the foramen ovale from the right
atrium to the left atrium. There are between 110 and 160 peats per minute in the
usual fetal heart rate. Fetuses have diminished ventricular filling and decreased
contractility as compared with adults. Upon birth, fetal circulation undergoes a rapid
transformation to accommodate extra-uterine life. Detailed evidence is now provided
by human knowledge of fetal circulation derived from fetal sheep, but ultrasound and
magnetic resonance imaging (MRI) during the fetal phase. There are distinct variations
in fetal circulation that can lead to childhood or adult diseases if not properly
developed. In humans, fetal circulation is markedly different from circulation. In the
fetus, the placenta, which lies outside the body cavity, is the primary filtration source
for plasma vein
1. Cephalic nutrients and waste. In adults, the flow happens exclusively within the
body. In the human fetus, embryonic circulation is the circulation of blood into the
2. Externalsystem.
coronary jugular It
vein
is well known that people's blood supply varies. It produces a
3. Basilic veincardiovascular system as the embryo grows into the fetus, which
functioning
4. Superficial with
cooperates temporalthevein
mother's structure. There are adaptive physiological
modifications
5. Dorsal plexus that transform the mutual mechanism into an independent one for the
vein
fetus during
6. Great birth. vein
saphenous
7. Dorsal metacarpal vein
8. Cephalic vein
9. Basilic vein