ANATOMY OF CARDIOVASCULAR SYSTEM

AND BLOOD
 LEARNING OUTCOMES

By the end of this lecture you should be able to:

◾ Describe the cells of the blood & the basis of the ABO
system √
◾ Describe the anatomy of the thorax √
◾ Outline the subdivisions of the mediastinum √
◾ Define & distinguish between the pulmonary & systemic
circuits
◾ Describe the gross anatomy of the heart & its four chambers

◾ Outline the structure & function of the valves of the heart

◾ Describe the arterial blood supply to the heart

 OVERVIEW OF CARDIOVASCULAR SYSTEM

◾ cardiovascular system
◾ heart & blood vessels

◾ circulatory system
◾ heart, blood vessels & blood
◾ lymphatic system - lymphatic tissues, channels &
nodes
 PULMONARY & SYSTEMIC CIRCUITS
◾ major divisions of circulatory system

◾ pulmonary circuit: right side of heart

◾ carries blood to lungs for gas exchange & back to heart

◾ systemic circuit: left side of heart

◾ supplies oxygenated blood to all tissues of body & returns it to

heart
 PULMONARY & SYSTEMIC CIRCUITS

◾ Pulmonary

◾ oxygen-poor blood arrives from inferior & superior venae

cavae
◾ blood sent to lungs via pulmonary trunk

◾ Systemic

◾ fully oxygenated blood arrives from lungs via pulmonary veins

◾ blood sent to all organs of the body via aorta

Pulmonary circuit

A rtery Vein

Venous Arterialised blood

blood Low High O 2
O 2 High Low
CO2 CO2

Vei A rtery
n

Systemic circuit
 HISTOLOGY OF THE BLO O D
VESSELS
Arteries & veins:
 same basic
histological structure
 same three layers:
 tunica intima -
innermost
 tunica media -
middle
 tunica adventitia -
outer

 structural variations
related to function

 arteries: transport blood

 under high pressure
veins: transport bloodaway
at
from
lower heart
pressure towards heart
.
 LEARNING OUTCOMES

By the end of this lecture you should be able to:

◾ Describe the cells of the blood & the basis of the ABO system
√
◾ Describe the anatomy of the thorax √
◾ Outline the anatomy & subdivisions of the mediastinum √
◾ Define & distinguish between the pulmonary & systemic circuits
√
◾ Describe the gross anatomy of the heart & its four chambers

◾ Outline the structure & function of the valves of the heart

◾ Describe the arterial blood supply to the heart

 A N ATOMY OF THE HEART
 central organ in systemic & pulmonary circulations
 hollow, four-chambered fibromuscular pump
 base, apex, surfaces & borders
 general orientation: atria to right of & posterior to, the respective
ventricles
POSITION OF HEART IN THORACIC
C AVITY
HEART LOCATION
 THE PERICARDIUM

◾ membranes that enclose the heart

◾ allow heart to beat without friction & to expand
◾ resist excessive expansion
◾ anchored to diaphragm inferiorly, sternum anteriorly & roots of great
vessels
 THE PERICARDIUM

Three layers
(i) outer fibrous pericardium
 outer collagenous, inelastic sac
 fused to central tendon of diaphragm & adventitia of great vessels
 attached by ‘ligaments’ to sternum (variable)
 securely ‘anchors’ heart within thorax

(ii)parietal serous pericardium

◾ lines the fibrous pericardium & reflects on to surface of the heart as
the…

(iii)visceral serous pericardium (epicardium)

 THE PERICARDIUM

Javad.abbas
 PERICARDIAL CAVITY
 ‘space’ between parietal serous & visceral
serous layers
 small amount serous fluid (50 ml)
 intrapericardial pressure either (– ve) or
zero
 closed space - fluid results in
increased pressure
 can result in cardiac tamponade
 [right atrium - decreased venous return
- decreased cardiac output -
hypotension, circulatory collapse]
 PERICARDIUM

Fibrous Pericardium Serous (Visceral) Pericardium

 STRUCTURE OF THE HEART
◾ three layers: epicardium, myocardium & endocardium

(i) epicardium (visceral pericardium)

◾ serous membrane covering heart
◾ adipose tissue thick layer in some places
◾ coronary blood vessels travel through this layer

(ii)myocardium
◾ layer of cardiac muscle
◾ spirals around heart which produces wringing motion

(iii)endocardium
◾ smooth inner lining of heart and blood vessels
◾ covers heart valve surfaces & is continuous with endothelium of blood
vessels
 HEART STRUCTURE

Epicardium

Myocardium

Endocardiu
m

Photos © McGraw-Hill Education

SPIRAL ORIENTATION OF MYOCARDIUM
 FIBROUS SKELETO N OF THE HEART

 contracting muscles need fixed point

(fulcrum) around which they
contract

 fibro-collagenous connective
tissue

 attachment for musculature -

chambers structurally &
functionally separate
 almost stationary when cardiac
muscle
contracts
 helps keep valves open
 important in timing & coordination
 of contractile
electrical activity
insulation between atria &
 CHAMBERS OF THE HEART
◾ Four chambers
◾ right & left atria
◾ superior in position
◾ receive blood returning to heart
◾ auricles (seen on surface) - extensions of
chamber
◾ right & left ventricles
◾ inferior in position
◾ pump blood into
aorta &
pulmonary trunk
 CHAMBERS OF THE
HEART

Right Left
atrium atrium

Right Left
ventricle ventricle
 CHAMBERS OF THE HEART

Right Left
atrium atrium

Right Left
ventricle
CHAMBERS OF THE HEART

Interatrial
septum

Interventricular
Septum
 ATRIA

 thin-walled

 walls smooth & rough (muscular) parts

 openings for veins – venae cavae, pulmonary veins

 receive venous blood from systemic (RA) & pulmonary circulations

(LA)

 blood reservoir – weak pump

 FEATURES OF THE RIGHT
ATRIUM
 musculi pectinati

 crista terminalis (sulcus

terminalis)

 limbus fossa ovalis

 fossa ovalis

cusps of tricuspid valve

Openings for:

 superior & inferior

vena cavae

 coronary sinus
 FEATURES OF THE LEFT
ATRIUM
 openings of 4 pulmonary
veins
 cusps of bicuspid valve
 roughened auricle
 FEATURES OF THE
VENTRICLES
 thick muscular chambers - cardiac muscle
 receive blood from atria via AV openings
 pump blood into systemic (LV) & pulmonary (RV)
circulation
 FEATURES OF THE
 VENTRICLES
trabeculae carneae
 valve cusps
 chordae tendinae
 papillary muscles
 aortic/pulmonary
opening
CHAMBERS OF THE
HEART
HEART A N ATOMY:THE GREAT
VESSELS
Pulmonary Ascending
trunk aorta

Superior vena
cava

Inferior vena
 LEARNING OUTCOMES

By the end of this lecture you should be able to:

◾ Describe the cells of the blood & the basis of the ABO system
√
◾ Describe the anatomy of the thorax √
◾ Outline the anatomy & subdivisions of the mediastinum √
◾ Define & distinguish between the pulmonary & systemic circuits
√
◾ Describe the gross anatomy of the heart & its four chambers √

◾ Outline the structure & function of the valves of the heart

◾ Describe the arterial blood supply to the heart

 HEART VALVES

 valves control direction of flow through heart

 allow flow in one direction only
 prevent backflow of blood into chambers

 open & close ± 3 billion times in normal life

span

Two

types of valves
(i) atrioventricular
 (ii)semilunar
 HEART VALVES

Atrioventricular (AV) valves

 collagenous tissue lined with endothelium

 control blood flow from atria to ventricles

 right AV valve has three cusps (tricuspid valve)

 left AV valve has two cusps (mitral or bicuspid

valve)
 ATRIOVENTRICULAR VALVES

Tricuspi Bicuspid
d (Mitral)
 HEART
Atrioventricular (AV) valvesVALVES
 chordae tendinae – attach to valves

 prevent AV valves from flipping back into atria when ventricles contract

 each papillary muscle has 2-3 attachments to heart wall - distribute

physical stress, coordinate timing of electrical conduction & provide
redundancy
 HEART VALVES
Semilunar valves
 connective tissue lined with endothelium

 control flow into aorta & pulmonary trunk

◾ pulmonary semilunar valve - between right ventricle & pulmonary
trunk
◾ aortic semilunar valve - between left ventricle & aorta
SEMILUNAR VALVES

Pulmonar Aorti
y c
HEART
VALVES
 BLOOD FLO W THROUGH THE CHAMBERS

In a typical cycle
◾ following ventricular contraction, the ventricles relax
◾ pressure inside the ventricles drops
◾ semilunar valves close as blood flows back into ventricles from great
vessels
◾ AV valves open
◾ blood flows from atria to ventricles

Ventricles contract
◾ AV valves close as blood attempts to back up into the atria
◾ pressure rises inside of the ventricles
◾ semilunar valves open & blood flows into great vessels
BLOOD FLO W THROUGH
CHAMBERS
1) Blood enters right atrium from superior
and inferior venae cavae.

2) Blood in right atrium flows through right

AV valve into right ventricle.

3) Contraction of right ventricle forces

pulmonary valve open.

4) Blood flows through pulmonary valve

into pulmonary trunk.

5) Blood is distributed by right and left

pulmonary arteries to the lungs, where it
unloads CO2 and loads O2.

6) Blood returns from lungs via pulmonary

veins
to left atrium.

7) Blood in left atrium flows through left AV

valve into left ventricle.

8) Contraction of left ventricle (simultaneous

with step 3) forces aortic valve open.

9) Blood flows through aortic valve into ascending

aorta.

10) Blood in aorta is distributed to every

organ in the body, where it unloads O2
and loads CO2

11) Blood returns to right atrium via venae

cavae.
 BLOOD FLO W THROUGH CH AMBERS

 opening & closing of all heart valves passive

 close when backward pressure gradient pushes blood back

 open when forward pressure gradient pushes blood forwards

 i.e. opening & closing due to pressure differences b/w chambers

 flimsy AV valves don’t require too much pressure to close

 semilunar valves have fibrous nodules in centre – stronger back pressure

for
short duration
 LEARNING OUTCOMES

By the end of this lecture you should be able to:

◾ Describe the cells of the blood & the basis of the ABO system
√
◾ Describe the anatomy of the thorax √
◾ Outline the anatomy & subdivisions of the mediastinum √
◾ Define & distinguish between the pulmonary & systemic circuits
√
◾ Describe the gross anatomy of the heart & its four chambers √

◾ Outline the structure & function of the valves of the heart √

◾ Describe the arterial blood supply to the heart

 CORONARY CIRCULATION
◾ 5% of blood pumped by heart is distributed to heart
tissue
◾ flows through right & left coronary arteries

◾ 250 mL of blood per minute

◾ needs abundant O2 & nutrients

 CORONARY CIRCULATION

◾ Left coronary artery (LCA) – branch of ascending aorta

◾ anterior interventricular artery

◾ supplies both ventricles & anterior 2/3 of the interventricular

septum

◾ circumflex branch

◾ passes posteriorly in coronary sulcus

◾ left marginal branch

◾ ends on posterior aspect of heart

◾ supplies left atrium & posterior wall of left ventricle

 CORONARY CIRCULATION

◾ Right coronary artery (RCA) - branch of ascending

aorta
◾ supplies right atrium & sinoatrial node (pacemaker)

◾ right marginal branch

◾ supplies lateral aspect of right atrium & ventricle

◾ posterior interventricular branch

◾ supplies posterior walls of ventricles

 CORONARY CIRCULATION

(a) Anterior view (b) Posterior view

Figure
19.10a,b
 CORONARY CIRCULATION

◾ flow through coronary arteries is greatest when heart relaxes

◾ contraction of myocardium compresses arteries & obstructs blood flow

◾ opening of aortic valve during ventricular systole covers openings to

coronary
arteries, blocking blood flow into them
◾ during ventricular diastole, blood in aorta surges back towards heart &
into openings of coronary arteries
 VENOUS DRAINAGE OF THE HEART

◾ 5-10% of venous blood drains directly into heart chambers (mostly right
atrium)
by way of small veins

◾ most deoxygenated blood returns to right atrium by way of coronary sinus

◾ coronary sinus receives blood from the great, middle & small cardiac veins

◾ coronary sinus - large vein in coronary sulcus on posterior side of heart

◾ empties into right atrium
VENOUS DRAINAGE O F THE
HEART

Coronary
sinus
 ANGINA & HEART ATTACK

◾ angina pectoris - chest pain from partial obstruction of coronary blood

flow
◾ pain caused by ischemia of cardiac muscle

◾ obstruction partially blocks blood flow

◾ myocardium shifts to anaerobic fermentation, producing lactate & thus

stimulating pain
 ANGINA & HEART ATTACK

◾ myocardial infarction (MI) - death of myocardium resulting from long-

term obstruction of coronary circulation
◾ atheroma (blood clot or fatty deposit) often obstructs coronary
arteries
◾ cardiac muscle downstream of the blockage dies
◾ heavy pressure or squeezing pain radiating into left upper limb [arm]
◾ some painless heart attacks may disrupt electrical conduction
pathways,
leading to fibrillation & cardiac arrest
◾ silent heart attacks occur in diabetics & elderly
◾ MI responsible for ± 27% of all deaths in the U.S.
ABDOMINAL AO RTIC
ANEURYSM C TA:
ANTERIOR
ATHEROSCLEROTIC DISEASES