B.

PHARM 1ST SEMESTER

SUBJECT –HUMAN ANATOMY AND PHYSIOLOGY
UNIT 5

CARDIOVASCULAR SYSTEM
 The cardiovascular system is a closed system if the heart and blood vessels. The heart
pumps blood through a closed system of blood vessels. Blood vessels allow blood to
circulate to all parts of the body.
 The function of the cardiovascular system is to deliver oxygen and nutrients to the body
tissues and remove carbon dioxide and wastes products.

Location,shape and size of the heart

 The human heart is located within the thoracic cavity, medially between the lungs in the space
known as the mediastinum.
 A typical heart is approximately the size of your fist: 12 cm (5 in) in length, 8 cm (3.5 in) wide,
and 6 cm (2.5 in) in thickness. Given the size difference between most members of the sexes,
 the weight of a female heart is approximately 250–300 grams (9 to 11 ounces), and the weight
of a male heart is approximately 300–350 grams (11 to 12 ounce

Chambers of the heart-

 The human heart consists of four chambers:

 The left side and the right side each have one atrium and one ventricle. Each of the upper
chambers, the right atrium (plural = atria) and the left atrium, acts as a receiving chamber and
contracts to push blood into the lower chambers, the right ventricle and the left ventricle.
 The ventricles serve as the primary pumping chambers of the heart, propelling blood to the lungs
or to the rest of the body.

Membranes-

 The membrane that directly surrounds the heart and defines the pericardial cavity is called
the pericardium or pericardial sac.
 the wall of the heart is composed of three layers of unequal thickness. From superficial to deep,
these are the epicardium, the myocardium, and the endocardium

1-Epicardium. The epicardium is the outermost layer of the heart wall and is just another name for the
visceral layer of the pericardium. Thus, the epicardium is a thin layer of serous membrane that helps to
lubricate and protect the outside of the heart.

2-Myocardium. The myocardium is the muscular middle layer of the heart wall that contains the cardiac
muscle tissue. Myocardium makes up the majority of the thickness and mass of the heart wall and is the
part of the heart responsible for pumping blood.

3-Endocardium. The endocardium is very smooth and is responsible for keeping blood from sticking to
the inside of the heart and forming potentially deadly blood clots.

Chambers of the heart-

 The heart contains 4 chambers: the right atrium, left atrium, right ventricle, and left ventricle.
 The atria are smaller than the ventricles and have thinner, less muscular walls than the ventricles.
 The atria act as receiving chambers for blood, so they are connected to the veins that carry blood to the
heart.
 The ventricles are the larger, stronger pumping chambers that send blood out of the heart.
 The ventricles are connected to the arteries that carry blood away from the heart.

Valves of the heart-

 To prevent blood from flowing backwards or “regurgitating” back into the heart, a system of one-way
valves are present in the heart.
 The heart valves can be broken down into two types: atrioventricular and semilunar valves.
 The AV valve on the right side of the heart is called the tricuspid valve because it is made of three cusps
(flaps) that separate to allow blood to pass through and connect to block regurgitation of blood.
 The AV valve on the left side of the heart is called the mitral valve or the bicuspid valve because it has
two cusps. The AV valves are attached on the ventricular side to tough strings called chordae tendineae.

The semilunar valves, so named for the crescent moon shape of their cusps, are located between the
ventricles and the arteries that carry blood away from the heart.
 The semilunar valve on the right side of the heart is the pulmonary valve, so named because it prevents
the backflow of blood from the pulmonary trunk into the right ventricle. The semilunar valve on the left
side of the heart is the aortic valve

Conduction System-

 The heart is able to both set its own rhythm and to conduct the signals necessary to maintain and
coordinate this rhythm throughout its structures.
 About 1% of the cardiac muscle cells in the heart are responsible for forming the conduction system that
sets the pace for the rest of the cardiac muscle cells.

 The conduction system starts with the pacemaker of the heart—a small bundle of cells known as the
sinoatrial (SA) node.

 The SA node is located in the wall of the right atrium inferior to the superior vena cava. The SA node is
responsible for setting the pace of the heart as a whole and directly signals the atria to contract.

 The signal from the SA node is picked up by another mass of conductive tissue known as the
atrioventricular (AV) node.

 The AV node is located in the right atrium in the inferior portion of the interatrial septum. The AV node
picks up the signal sent by the SA node and transmits it through the atrioventricular (AV) bundle.

 The AV bundle is a strand of conductive tissue that runs through the interatrial septum and into the
interventricular septum.

 The AV bundle splits into left and right branches in the interventricular septum and continues running
through the septum until they reach the apex of the heart.

 Branching off from the left and right bundle branches are many Purkinje fibers that carry the signal to
the walls of the ventricles, stimulating the cardiac muscle cells to contract in a coordinated manner to
efficiently pump blood out of the heart.

Coronary systole and diastole-

 At any given time the chambers of the heart may found in one of two states:

 Systole. During systole, cardiac muscle tissue is contracting to push blood out of the chamber.
 Diastole. During diastole, the cardiac muscle cells relax to allow the chamber to fill with blood.
 Blood pressure increases in the major arteries during ventricular systole and decreases during
ventricular diastole.
 This leads to the 2 numbers associated with blood pressure—systolic blood pressure is the higher
number and diastolic blood pressure is the lower number. For example, a blood pressure of 120/80
describes the systolic pressure (120) and the diastolic pressure (80).

Cardiac Cycle-

The cardiac cycle includes all of the events that take place during one heartbeat. There are 3 phases to the
cardiac cycle: atrial systole, ventricular systole, and relaxation.

 Atrial systole: During the atrial systole phase of the cardiac cycle, the atria contract and push
blood into the ventricles.
 To facilitate this filling, the AV valves stay open and the semilunar valves stay closed to
keep arterial blood from re-entering the heart.
 The atria are much smaller than the ventricles, so they only fill about 25% of the ventricles
during this phase. The ventricles remain in diastole during this phase.
 Ventricular systole: During ventricular systole, the ventricles contract to push blood into the
aorta and pulmonary trunk.
 The pressure of the ventricles forces the semilunar valves to open and the AV valves to
close.
 This arrangement of valves allows for blood flow from the ventricles into the arteries.
 The cardiac muscles of the atria repolarize and enter the state of diastole during this phase.
 Relaxation phase: During the relaxation phase, all 4 chambers of the heart are in diastole as
blood pours into the heart from the veins.
 The ventricles fill to about 75% capacity during this phase and will be completely filled only
after the atria enter systole.
 The cardiac muscle cells of the ventricles repolarize during this phase to prepare for the next
round of depolarization and contraction.
 During this phase, the AV valves open to allow blood to flow freely into the ventricles while
the semilunar valves close to prevent the regurgitation of blood from the great arteries into the
ventricles.

Blood flow through heart-

 Deoxygenated blood returning from the body first enters the heart from the superior and inferior vena
cava.

 The blood enters the right atrium and is pumped through the tricuspid valve into the right ventricle.

 From the right ventricle, the blood is pumped through the pulmonary semilunar valve into
the pulmonary trunk.

 The pulmonary trunk carries blood to the lungs where it releases carbon dioxide and absorbs oxygen.

 The blood in the lungs returns to the heart through the pulmonary veins. From the pulmonary veins,
blood enters the heart again in the left atrium.

 The left atrium contracts to pump blood through the bicuspid (mitral) valve into the left ventricle.

 The left ventricle pumps blood through the aortic semilunar valve into the aorta.

 From the aorta, blood enters into systemic circulation throughout the body tissues until it returns to the
heart via the vena cava and the cycle repeats.

ECG-

The electrocardiogram (also known as an EKG or ECG) is a non-invasive device that measures and
monitors the electrical activity of the heart through the skin. The EKG produces a distinctive waveform in
response to the electrical changes taking place within the heart.
 The first part of the wave, called the P wave, is a small increase in voltage of about 0.1 mV that
corresponds to the depolarization of the atria during atrial systole.

 The next part of the EKG wave is the QRS complex which features a small drop in voltage (Q) a large
voltage peak (R) and another small drop in voltage (S).

 The QRS complex corresponds to the depolarization of the ventricles during ventricular systole. The
atria also repolarize during the QRS complex, but have almost no effect on the EKG because they are so
much smaller than the ventricles.

 The final part of the EKG wave is the T wave, a small peak that follows the QRS complex. The T wave
represents the ventricular repolarization during the relaxation phase of the cardiac cycle.

 Variations in the waveform and distance between the waves of the EKG can be used clinically to
diagnose the effects of heart attacks, congenital heart problems, and electrolyte imbalances.

Heart sounds-

 The sounds of a normal heartbeat are known as “lubb” and “dupp” and are caused by blood pushing on
the valves of the heart.

 The “lubb” sound comes first in the heartbeat and is the longer of the two heart sounds. The “lubb”
sound is produced by the closing of the AV valves at the beginning of ventricular systole.

 The shorter, sharper “dupp” sound is similarly caused by the closing of the semilunar valves at the end
of ventricular systole.

 During a normal heartbeat, these sounds repeat in a regular pattern of lubb-dupp-pause. Any additional
sounds such as liquid rushing or gurgling indicate a structure problem in the heart.

 The most likely causes of these extraneous sounds are defects in the atrial or ventricular septum or
leakage in the valves.

Cardiac output-
 Cardiac output (CO) is the volume of blood being pumped by the heart in one minute. The equation
used to find cardiac output is: CO = Stroke Volume x Heart Rate

 Stroke volume is the amount of blood pumped into the aorta during each ventricular systole, usually
measured in milliliters.

 Heart rate is the number of heartbeats per minute.

 The average heart can push around 5 to 5.5 liters per minute at rest.

Types of blood circulation-

The 3 types of blood circulation are as follows:

1. The systemic circulation: Ittakes oxygenated blood from the left ventricle through the aorta to
all parts of the body, including some lung tissue (not to air sacs) and returns the deoxygenated
blood to the right atrium.

2. Pulmonary circulation: It collects blood from the veins of the pancreas, spleen, stomach,
intestines, and gallbladder and directs it into the hepatic portal vein of the liver before it returns to
the heart.

3. Portal circulation: It takes deoxygenated blood from the right ventricle to the air sacs of the
lungs and returns oxygenated blood from the lungs to the left atrium.
BLOOD PRESSURE

Hydrostatic pressure created by the heart forces blood to move through the arteries. Systolic
blood pressure, the pressure measured during contraction of the ventricles, averages about 110
mm Hg in arteries of the systemic circulation (for healthy, young adults). The diastolic blood
pressure, measured during ventricle relaxation, is about 75 mm Hg in these arteries. As blood
travels through the arterial system, resistance from the walls of the blood vessels reduces the
pressure and velocity of the blood (see Figure 1). Blood pressure drops sharply in the arterioles
and falls to between 40 and 20 mm Hg in the capillaries. Blood pressure descends further in the
venules and approaches zero in the veins.
Figure 1. As blood travels through the arterial system, resistance from the walls of the blood
vessels reduces the pressure and velocity of the blood.

Because blood pressure is so low in venules and veins, two mechanisms assist the return of blood
to the heart (venous return):

 The muscular pump arises from contractions of skeletal muscles surrounding the veins.
The contractions squeeze the veins, forcing the blood to move forward, the only direction
it can move when valves in the veins close to prevent backflow.
 The respiratory pump is created by the expansion and contraction of the lungs during
breathing. During inspiration (inhaling), pressure in the abdominal region increases while
pressure in the thoracic cavity decreases. These pressures act upon the veins passing
through these regions. As a result, blood flows toward the heart as it moves from regions
of higher pressure (the abdomen) to those of lower pressure (the chest and right atrium).
When the pressures are reversed during expiration (exhaling), backflow in the veins is
prevented by valves.

PULSE

Pulse is your heart rate, or the number of times your heart beats in one minute. Pulse rates vary
from person to person. Your pulse is lower when you are at rest and increases when you exercise
(more oxygen-rich blood is needed by the body when you exercise). Knowing how to take your
pulse can help you evaluate your exercise program.
How to take your pulse

1. Place the tips of your index, second and third fingers on the palm side of your other wrist
below the base of the thumb. Or, place the tips of your index and second fingers on your
lower neck on either side of your windpipe.
2. Press lightly with your fingers until you feel the blood pulsing beneath your fingers. You
may need to move your fingers around slightly up or down until you feel the pulsing.
3. Use a watch with a second hand, or look at a clock with a second hand.
4. Count the beats you feel for 10 seconds. Multiply this number by six to get your heart
rate (pulse) per minute.

Count your pulse: _____ beats in 10 seconds x 6 = _____ beats/minute

normal pulse

Normal heart rates at rest:

 Children (ages 6 - 15) 70 – 100 beats per minute

 Adults (age 18 and over) 60 – 100 beats per minute