CVS 2
CVS 2
CVS 2
SYSTEM
Dr. TAHMINA NAZ
BHS I
CARDIOVASCULAR SYSTEM
• the pulmonary
circulation
• the systemic circulation.
BLOOD VESSELS
Arteries & arterioles
End arteries
Capillaries
Smallest arteries
They are formed of smooth muscles
End arteries:
o Arteries with no anastomoses
CAPILLARIES AND SINUSOIDS
Capillaries:
The smallest arterioles breakup into number of minute
vessels called capillaries.
Sinusoids:
In some organs liver ,bone marrow the capillaries are
wider then normal, they are termed as sinusoids.
their walls are incomplete, thus blood flows through
them is slower and can directly come into contact with
the cells outside the walls allow faster exchange.
CAPILLARIES AND SINUSOIDS
VEINS AND VENULES
Veins:
Blood vessels that return
blood to the heart
walls are thinner
Myocardium
Endocardium
PERICARDIUM
Outermost layer.
The outer layer membrane
is called parietal
pericardium lines the
fibrous sac. The inner layer
the visceral pericardium is
adherent to the heart
muscle.
Consists of flat epithelial
cells
Secretes serous fluid
between visceral and
parietal layers and allowing
smooth muscle movement.
MYOCARDIUM
Formed of specialized,
striated cardiac muscle
Each cardiac muscle fibre
has a nucleus and
branches.
The junction of two muscle
fibre is termed as
intercalated disc.
When an impulse is initiated
it transmits rapidly causing
muscle contraction.
The myocardium is thickest
at the apex and thins out
towards the base.
ENDOCARDIUM
This lines the valves and
chambers of the heart.
It is thin, smooth
membrane that permits
smooth flow of blood
inside the heart.
It consists of flat
epithelial cells
LAYERS OF HEART
INTERIOR OF THE HEART
Heart is broadly divided into right and left side by a
septum
Each side is divided by atrioventricular valve into
upper atrium and lower ventricle.
The atrioventricular valves are formed by double
folds of endocardium strengthened by a little
fibrous tissue.
The right AV valve(tricuspid valve) has three flaps
or cusp
The left AV valve(mitral valve) has two cusp
INTERIOR OF THE HEART
The flow of blood is one way from atria to the ventricles.
Valves open when the atrial pressure exceeds the
ventricular pressure.
When the pressures exceeds in the ventricles the aortic and
pulmonary valves open
Chordae tendinea prevent the backward opening of the AV
valve in case of increase in the ventricular pressure.
INTERIOR OF THE HEART
FLOW OF BLOOD VIA HEART
Superior Vena Cava(SVA) and Inferior Vena
Cava(IVC) opens into the right atrium which
brings all the deoxygenated blood
Through the right atrioventricular(AV) valve,
this blood goes into the right ventricle.
From right ventricle blood is pumped into the
pulmonary trunk via Pulmonary artery
FLOW OF BLOOD VIA HEART
Arterial supply:
Right and left coronary arteries
These arteries receive 5% of the blood pumped to
the heart
Venous supply:
Most of the venous blood is collected into a many
cardiac veins that join to form the coronary sinus
CONDUCTING SYSTEM OF THE HEART
SA Node
Lies in the walls of right atrium near the opening of
SVC
It is termed as Pace Maker
AV Node
Lies near the AV valve.
It transmits the impulse from the atria to the
ventricles
delay; the electrical signal takes 0.1 of a second to
pass through into the ventricles. This allows the
atria to finish contracting before the ventricles start
SA Node
AV Node
CONDUCTING SYSTEM OF THE HEART
Bundle of His:
This neuromuscular
bundle originate from AV
node
It divides into right and
left bundle branches
which breakup into fine
fibers called purkinje
fibers.
.
NERVE SUPPLY TO THE HEART
It is calculated by
Cardiac output = Stroke vol x Heart rate
Venous return is the major determinant of
cardiac output.
The heart pumps out all blood returned to it.
Position of body
Muscular contraction
Respiratory pump
Heart rate (speed at which heart beats) is a major
determinant of cardiac output .
If heart rate rises, cardiac output increases, and if it
falls cardiac output falls.
Factors affecting heart rate:
Autonomic nervous system
Circulating chemicals
Position
Exercise
Emotional state
Gender
Age
Temperature
BLOOD PRESSURE
Blood pressure is the force or pressure that the
blood exerts on the walls of blood vessels.
High BP, blood vessels can be damaged,
causing clots or bleeding from sites of blood
vessel rupture.
BP too low, then blood flow through tissue
beds may be inadequate. Dangerous for
essential organs such as the heart, brain or
kidneys.
Systolic pressure: is the pressure produced
within the arterial system when the left
ventricle contracts and pushes blood into the
aorta.
In adults it is about 120 mmHg or 16 kPa.
Diastolic pressure: when the heart is resting
following the ejection of blood, the pressure
within the arteries is much lower
In an adult this is about 80 mmHg or 11 kPa
Sphygmomanometer
Blood pressure is determined by;
➢ cardiac output
➢ peripheral/arteriolar resistance
➢ Autoregulation (adjustment of blood flow and
regulation by organs)
REGULATION OF BLOOD PRESSURE
Systemic circulation
Pulmonary circulation
MAJOR BLOOD VESSELS
thoracic aorta
abdominal aorta
AORTA
External carotid
artery
EXTERNAL CAROTID ARTERY
It supplies the
superficial tissues of
head and neck it gives
of various branches
superior thyroid artery
lingual artery
facial artery
occipital artery
temporal artery
maxillary artery
INTERNAL CAROTID ARTERY
Basilar artery
VENOUS RETURN FROM HEAD & NECK
Superior sagittal
sinus
Inferior sagittal sinus
Straight sinus
Transverse sinus
Sigmoid sinus
CIRCULATION OF UPPER LIMB
Supplied by:
Right subclavian artery
Left subclavian artery
Subclavian artery
continued as:
Axilary artery
Brachial artery
Radial artery
Ulnar artery
Palmar arches
Venous return:
Deep veins follow the course of the arteries and
have the same names.
superficial veins begin in the hand and consist of
the following:
cephalic vein
basilic vein
median vein
median cubital vein.
CIRCULATION OF THORAX
• superior mesenteric
• Inferior mesenteric
INFERIOR VENA CAVA
Cardiogenic shock
Septic shock
Neurogenic shock
Anaphylactic shock
Hypovolaemic shock:
Cardiac output may fall because of low blood
volume and hence low venous return
severe haemorrhage – whole blood is lost
Anaphylactic shock
Thrombosis:
Formation of a blood clot inside a blood vessel
Factors increasing the risk of Thrombus:
Slow blood flow.. Bedrest,tumor or tight cloting
compressing vessel,sock.
Damage to blood vessel (atherosclerosis)
Increased blood coagulability
EMBOLISM
Blocking of a vessel by any mass travelling in the
blood.
This can be a thrombus or part of a thrombus
Emboli in artery travel away from heart until they
reach a narrow artery & lodge there thus blocking
the blood supply
Emboli originating in vein travel towards the heart
& then to the lungs, thus causing pulmonary
embolism
It is a common cause of stroke , myocardial
infarction and gangrenous limbs
VASCULAR
PATHOLOGIES
ATHEROMA
Plaques are patchy changes that develop in the large or
medium size arteries
It consists of cholesterol, lipids and monocytes
Initial changes show a fatty streak in the artery wall.
Mature plaques consist of accumulations of cholesterol
and other lipids, excess smooth muscle and fat-filled
monocytes (foam cells).
The plaque is covered with a rough fibrous cap
Arteries most commonly involved are those in the heart
,brain, kidney, small intestine & lower limb.
CAUSES OF ATHEROMA:
Origin is unclear.
Fatty streaks in artery wall may be the origin.
Effects:
May cause partial or complete obstruction of
the artery
Complications:
Hemorrhage
Aneurysm
Effects of atheroma:
Narrowing of an artery cause ischaemic pain in
the heart is called angina pectoris and in the
lower limbs intermittent claudication.
Occlusion of an artery like coronary artery is
occluded cause myocardial infarction. Brain
causes cerebral ischaemia and this leads to
cerebral infarction(stroke)
Complications:
Thrombosis
Infarction
Hemorrhage
Pregnancy
Increasing age
Prolong standing
Oesophageal varices
Scrotal varicocele
TUMORS
Angiomas:
Benign tumor of the blood vessel or lymph vessel
Haemangiomas:
They consist of an excessive growth of blood vessel
Capillary Haemangiomas:
Capillary growth, they are usually present at
birth,after 5 years 80% may disappear
EDEMA(OEDEMA)
Commonest Causes:
1. Myocardial Infarction (MI)
2. Pulmonary embolism
3. Cardiac arrhythmia
4. Malignant hypertension
Causes:
1. Anemia
2. Lung disease
3. Hypertension
4. Cardiac disease
RIGHT SIDE HEART FAILURE
Congenital abnormalities
Fibrosis of lungs
Stenosis: the narrowing of a valve opening,
impeding blood flow through the valve.
Acute
Chronic
Acute:all layers of the heart wall are inflamed
( pancarditis)
Fibrotic nodules develop on mitral valve cusps,
which shrink as they age, distorting the cusp
and causing stenosis and incompetence of the
valve.
Chronic rheumatic heart disease.
Inflamed tissue becomes fibrous as it heals,
and this fibrous tissue interferes with the
action of the myocardium and the heart valves.