HAP- I (Class Notes for B. Sc. MLT) DR.

CHANCHAL KUMAR MISHRA

HUMAN ANATOMY AND PHYSIOLOGY- I (THEORY)

DR. CHANCHAL KUMAR MISHRA
Assistant Professor, BIT Mesra

MODULE- 5: Cardiovascular system

________________________________________________________________

Introduction
The circulatory system, also called the cardiovascular system or the vascular
system, is an organ system that permits blood to circulate and
transport nutrients (such as amino acids and electrolytes), oxygen, carbon
dioxide, hormones, and blood cells to and from the cells in the body to provide
nourishment and help in fighting diseases, stabilize temperature and pH, and
maintain homeostasis.
[1] https://en.wikipedia.org/wiki/Circulatory_system

The circulatory system of the blood is seen as having two components, a systemic
circulation and a pulmonary circulation.
[2] "How does the blood circulatory system work?". PubMed Health. 1 August 2016.

The vital importance of the heart is obvious. If one assumes an average rate of
contraction of 75 contractions per minute, a human heart would contract
approximately 108,000 times in one day, more than 39 million times in one year,
and nearly 3 billion times during a 75-year lifespan. Each of the major pumping
chambers of the heart ejects approximately 70 mL blood per contraction in a
resting adult. This would be equal to 5.25 liters of fluid per minute and
approximately 14,000 liters per day. Over one year, that would equal 10,000,000
liters or 2.6 million gallons of blood sent through roughly 60,000 miles of vessels.
In order to understand how that happens, it is necessary to understand the anatomy
and physiology of the heart.

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HAP- I (Class Notes for B. Sc. MLT) DR. CHANCHAL KUMAR MISHRA

Heart shape, size and positions

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 ounces). The heart of a well-trained athlete, especially one
specializing in aerobic sports, can be considerably larger than this. Cardiac muscle
responds to exercise in a manner similar to that of skeletal muscle. That is, exercise
results in the addition of protein myofilaments that increase the size of the
individual cells without increasing their numbers, a concept called hypertrophy.
Hearts of athletes can pump blood more effectively at lower rates than those of
non-athletes. Enlarged hearts are not always a result of exercise; they can result
from pathologies, such as hypertrophic cardiomyopathy.
The human heart is situated in the middle mediastinum, at the level
of thoracic vertebrae T5-T8. A double-membraned sac called
the pericardium surrounds the heart and attaches to the mediastinum.

[3] Dorland's (2012). Dorland's Illustrated Medical Dictionary (32nd ed.). Elsevier.
1461. ISBN 978-1-4160-6257-8.

The back surface of the heart lies near the vertebral column, and the front surface
sits behind the sternum and rib cartilages. The upper part of the heart is the
attachment point for several large blood vessels – the venae
cavae, aorta and pulmonary trunk. The upper part of the heart is located at the level
of the third costal cartilage. The lower tip of the heart, the apex, lies to the left of
the sternum (8 to 9 cm from the midsternal line) between the junction of the fourth
and fifth ribs near their articulation with the costal cartilages.

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HAP- I (Class Notes for B. Sc. MLT) DR. CHANCHAL KUMAR MISHRA

[4] Betts, J. Gordon (2013). Anatomy & physiology. pp. 787–846. ISBN 978-1-938168-
13-0. Retrieved 11 August2014.
[5] https://en.wikipedia.org/wiki/Heart

Anatomy of human heart

Figure 5.1: Anatomical structure of human heart

The heart is a muscular organ situated in the chest just behind and slightly toward
the left of the breastbone. It roughly measures the size of a closed fist. The heart
works all the time, pumping blood through the network of blood vessels called the
arteries and veins. The heart and its blood vessels are known as the cardiovascular
system
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HAP- I (Class Notes for B. Sc. MLT) DR. CHANCHAL KUMAR MISHRA

The heart has four chambers. The upper two chambers are called the atria, whereas
the lower two chambers are known as the ventricles. The right atrium and right
ventricle are referred to as the right heart, whereas the left atrium and left
ventricle are referred to as the left heart. The various chambers of the heart are
separated by partitions, each of which is called a septum.

 The right atrium receives deoxygenated blood from the body and pumps it
to the right ventricle.
 The right ventricle gets blood from the right atrium and pumps it to
the lungs to load it with oxygen.
 The left atrium receives oxygenated blood from the lungs and pumps it to
the left ventricle.
 The left ventricle is the strongest chamber of the heart. It pumps oxygen-rich
blood to the rest of the body.

The flow of blood into the heart, within the heart chambers and from the heart is
guarded by the four valves present in the heart. The heart gets its nutrients and
oxygen via the coronary arteries that run along the surface of the heart. It is also
richly supplied by a web of nerve tissue that facilitates the rhythmic heartbeat. The
heart is enclosed within a fluid-filled sac called the pericardium. The pericardium
is a protective covering that produces fluid, which lubricates the heart and prevents
friction between the heart and the surrounding organs.
Blood vessels and blood supply
Blood from the heart is pumped throughout the body using blood vessels. Arteries
carry blood away from the heart and into capillaries, providing oxygen (and other
nutrients) to tissue and cells. Once oxygen is removed, the blood travels back to
the lungs, where it is re-oxygenated and returned by veins to the heart.

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HAP- I (Class Notes for B. Sc. MLT) DR. CHANCHAL KUMAR MISHRA

Figure 5.2: Flow of blood in human heart

The main artery of the systemic circuit is the aorta which branches out into other
arteries, carrying blood to different parts of the body.

[6]file:///C:/The%20circulatory%20system%20review%20(article)%20_%20Khan%20Academy.
html

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HAP- I (Class Notes for B. Sc. MLT) DR. CHANCHAL KUMAR MISHRA

Nerve vessels supply to the heart

The spice of life is at the root of cardiac pain. Normally, we do not think of the
heart as a sensory organ, but it possesses a rich supply of
heterogeneous nerve endings that communicate the mechanical and chemical
state of the heart to the brain via both the vagus nerves and the spinal cord.
The main control of the heart resides with the medulla oblongata. There is
an area called the cardio-acceleratory centre, or pressor centre, in the upper part
of the medulla oblongata, and an area called the cardio inhibitory centre,
or depressor centre, in the lower part. Together they are called the cardio
regulatory centre, since they interact to control heart rate, etc.
The nervous supply to the heart is autonomic, consisting of both sympathetic and
parasympathetic parts. The sympathetic fibers arise from the pressor centre, while
the parasympathetic fibers arise in the depressor centre.
The sympathetic nervous system acts on the sinoatrial node, speeding up
the de-polarization rate, and therefore increasing the heart rate.
The parasympathetic system works in reverse in order to slow the heart rate
down. The heart itself has a natural pacemaker, the sinoatrial node, which does not
need a nervous supply to function. If you sever all the nerves to the heart, then it
will continue to beat. In fact, it will beat faster than normal, since there is
normally a parasympathetic supply slowing the heart down.
The sympathetic fibers, arising from the superior, middle, and inferior cervical
ganglia (but originating in the medulla oblongata), and the parasympathetic fibres,
which originate in the medulla oblongata, and pass down by way of the vagus
nerve, join in the cardiac plexus (which has superficial and deep parts). From here
they enter the heart.
T2, T3, and T4 are intercostal nerves. The sensory component of the
sympathetic supply to the heart passes to the same sensory root as these, hence
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HAP- I (Class Notes for B. Sc. MLT) DR. CHANCHAL KUMAR MISHRA

feeling a band of pain across the chest when having a heart attack. T1 is dragged
into the upper limb, hence the referred pain in the arm during a heart attack. The
pain is more usually felt in the left arm (since the heart is more to the left than the
right), but it is not impossible to get pain in the right arm during a heart attack.
[7] https://www.liverpool.ac.uk/~trh/local_html/heartdisease/nerve_supply_to_the_heart.htm

Pulmonary circulation through the Heart- Position of arteries and veins

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. There are two distinct but
linked circuits in the human circulation called the pulmonary and systemic circuits.
Although both circuits transport blood and everything it carries, we can initially
view the circuits from the point of view of gases.
The pulmonary circuit transports blood to and from the lungs, where it
picks up oxygen and delivers carbon dioxide for exhalation. The systemic circuit
transports oxygenated blood to virtually all of the tissues of the body and returns
relatively deoxygenated blood and carbon dioxide to the heart to be sent back to
the pulmonary circulation.
The right ventricle pumps deoxygenated blood into the pulmonary trunk, which
leads toward the lungs and bifurcates into the left and right pulmonary arteries.
These vessels in turn branch many times before reaching the pulmonary
capillaries, where gas exchange occurs: Carbon dioxide exits the blood and
oxygen enters. The pulmonary trunk arteries and their branches are the only
arteries in the post-natal body that carry relatively deoxygenated blood. Highly
oxygenated blood returning from the pulmonary capillaries in the lungs passes
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HAP- I (Class Notes for B. Sc. MLT) DR. CHANCHAL KUMAR MISHRA

through a series of vessels that join together to form the pulmonary veins—the
only post-natal veins in the body that carry highly oxygenated blood. The
pulmonary veins conduct blood into the left atrium, which pumps the blood into
the left ventricle, which in turn pumps oxygenated blood into the aorta and on to
the many branches of the systemic circuit. Eventually, these vessels will lead to the
systemic capillaries, where exchange with the tissue fluid and cells of the body
occurs. In this case, oxygen and nutrients exit the systemic capillaries to be used by
the cells in their metabolic processes, and carbon dioxide and waste products will
enter the blood.
The blood exiting the systemic capillaries is lower in oxygen concentration than
when it entered. The capillaries will ultimately unite to form venules, joining to
form ever-larger veins, eventually flowing into the two major systemic veins,
the superior vena cava and the inferior vena cava, which return blood to the right
atrium. The blood in the superior and inferior vena cava flows into the right atrium,
which pumps blood into the right ventricle. This process of blood circulation
continues as long as the individual remains alive. Understanding the flow of blood
through the pulmonary and systemic circuits is critical to all health professions.
[8] https://courses.lumenlearning.com/suny-ap2/chapter/heart-anatomy/
[9] https://en.wikipedia.org/wiki/Circulatory_system

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HAP- I (Class Notes for B. Sc. MLT) DR. CHANCHAL KUMAR MISHRA

Most important functions of the human heart are:

 Pumping oxygenated blood to the other body parts.
 Pumping hormones and other vital substances to different parts of the body.
 Receiving deoxygenated blood and carrying metabolic waste products from
the body and pumping it to the lungs for oxygenation.
 Maintaining blood pressure
[10] https://www.medicinenet.com/what_are_the_four_main_functions_of_the_heart/article.htm

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HAP- I (Class Notes for B. Sc. MLT) DR. CHANCHAL KUMAR MISHRA

Glossary
Aorta: Major artery that carries blood to the systemic circulatory system.
Aortic valve (also, aortic semilunar valve): Valve located at the base of the aorta.
Atrio-ventricular septum:
Cardiac septum located between the atria and ventricles; atrio-ventricular
valves are located here.
Atrio-ventricular valves:
One-way valves located between the atria and ventricles; the valve on the
right is called the tricuspid valve, and the one on the left is the mitral or
bicuspid valve
Atrium (plural = atria):
Upper chamber of heart or receiving chamber of the heart that pumps blood
into the lower chambers just prior to their contraction; the right atrium
receives blood from the systemic circuit that flows into the right ventricle;
the left atrium receives blood from the pulmonary circuit that flows into the
left ventricle
Auricle: extension of an atrium visible on the superior surface of the heart
Bicuspid valve (also, mitral valve or left atrio-ventricular valve):
Valve located between the left atrium and ventricle; consists of two flaps of
tissue
Capillary: Small blood vessels that allows nutrient exchange
Cardiomyocyte: muscle cell of the heart
Coronary arteries:
Branches of the ascending aorta that supply blood to the heart; the left
coronary artery feeds the left side of the heart, the left atrium and ventricle,
and the interventricular septum; the right coronary artery feeds the right
atrium, portions of both ventricles, and the heart conduction system
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HAP- I (Class Notes for B. Sc. MLT) DR. CHANCHAL KUMAR MISHRA

Coronary sinus:
Large, thin-walled vein on the posterior surface of the heart that lies within
the atrio-ventricular sulcus and drains the heart myocardium directly into the
right atrium
Coronary veins:
Vessels that drain the heart and generally parallel the large surface arteries
Endocardium:
Innermost layer of the heart lining the heart chambers and heart valves;
composed of endothelium reinforced with a thin layer of connective tissue
that binds to the myocardium
Endothelium:
Layer of smooth, simple squamous epithelium that lines the endocardium
and blood vessels
Epicardium: Innermost layer of the serous pericardium and the outermost layer of
the heart wall
Inferior vena cava:
Large systemic vein that returns blood to the heart from the inferior portion
of the body
Inter-atrial septum:
Cardiac septum located between the two atria; contains the fossa ovalis after
birth
Inter ventricular septum: Cardiac septum located between the two ventricles.
Left atrio-ventricular valve (also, mitral valve or bicuspid valve):
Valve located between the left atrium and ventricle; consists of two flaps of
tissue.

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HAP- I (Class Notes for B. Sc. MLT) DR. CHANCHAL KUMAR MISHRA

Marginal arteries:
Branches of the right coronary artery that supply blood to the superficial portions
of the right ventricle
Mitral valve (also, left atrio-ventricular valve or bicuspid valve): Valve located
between the left atrium and ventricle; consists of two flaps of tissue.
Myocardium:
Thickest layer of the heart composed of cardiac muscle cells built upon a
framework of primarily collagenous fibers and blood vessels that supply it
and the nervous fibers that help to regulate it
Pericardium (also, pericardial sac):
Membrane that separates the heart from other mediastinal structures;
consists of two distinct, fused sub layers: the fibrous pericardium and the
parietal pericardium
Pulmonary: Related to the lungs
Pulmonary arteries: Left and right branches of the pulmonary trunk that carry
deoxygenated blood from the heart to each of the lungs
Pulmonary capillaries:
Capillaries surrounding the alveoli of the lungs where gas exchange occurs:
carbon dioxide exits the blood and oxygen enters
Pulmonary trunk:
Large arterial vessel that carries blood ejected from the right ventricle;
divides into the left and right pulmonary arteries
Pulmonary valve (also, pulmonary semilunar valve, the pulmonic valve, or the
right semi-lunar valve):
Valve at the base of the pulmonary trunk that prevents backflow of blood
into the right ventricle; consists of three flaps

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HAP- I (Class Notes for B. Sc. MLT) DR. CHANCHAL KUMAR MISHRA

Pulmonary veins:
Veins that carry highly oxygenated blood into the left atrium, which pumps
the blood into the left ventricle, which in turn pumps oxygenated blood into
the aorta and to the many branches of the systemic circuit
Right atrio-ventricular valve (also, tricuspid valve):
Valve located between the right atrium and ventricle; consists of three flaps
of tissue.
Semi-lunar valves:
Valves located at the base of the pulmonary trunk and at the base of the aorta
Septum (plural = septa): Walls or partitions that divide the heart into chambers
Superior vena cava: Large systemic vein that returns blood to the heart from the
superior portion of the body.
Tricuspid valve:
Term used most often in clinical settings for the right atrio-ventricular valve.
Valve: In the cardiovascular system, a specialized structure located within the
heart or vessels that ensures one-way flow of blood
Vein: Blood vessels that moves blood toward the heart
Ventricle: Lower chamber of heart or one of the primary pumping chambers of the
heart located in the lower portion of the heart; the left ventricle is the major
pumping chamber on the lower left side of the heart that ejects blood into the
systemic circuit via the aorta and receives blood from the left atrium; the
right ventricle is the major pumping chamber on the lower right side of the
heart that ejects blood into the pulmonary circuit via the pulmonary trunk
and receives blood from the right atrium.
[11] https://courses.lumenlearning.com/suny-ap2/chapter/heart-anatomy/

[12]file:///C:/Users/Chanchal/Desktop/The%20circulatory%20system%20review%20(arti
cle)%20_%20Khan%20Academy.html

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HAP- I (Class Notes for B. Sc. MLT) DR. CHANCHAL KUMAR MISHRA

ASSIGNMENT:
1. How to define Circulatory system?
2. Draw the structure and label the human heart with their shape, size and
position.
3. Explain the anatomy of human heart in details.
4. How blood vessels and blood supply in human heart?
5. How nerve vessels supply in to the heart?
6. Explain the pulmonary circulation through the heart and role of arteries and
veins.
7. Write the functions of:
a) Atrio-ventricular valves
b) Atrium
c) Coronary arteries
d) Inferior vena cava
e) Superior vena cava
8. Write the role of:
a) Valve
b) Bicuspid valve
c) Pulmonary valve
d) Tricuspid valve
9. Define Vein and Arteries.
10. Explain in details about human heart and related diseases.

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