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Chapter-7 | Cardiovascular
system
 ● Anatomy and Physiology of heart
 ● Blood vessels and circulation (Pulmonary, coronary and systemic
circulation)
 ● Cardiac cycle and Heart sounds, Basics of ECG
 ● Blood pressure and its regulation

Cardiovascular system:
 The cardiovascular system consists of the blood, the heart and blood vessels.
 The heart beats about 100,0000 times every day.
 Which adds up to about 35 million beats in a year and approximately 2.5
billion times in an average lifetime.

Anatomy of heart:
 The heart is located in the mediastinum about two thirds of its mass is to the
left of the midline.
 It apex is the pointed inferior part its base is the broad superior part.
 The heart shape is relatively small roughly the same size (but not the same
shape) as our closed fist.
 It is about Long-12cm & Wide- 9cm
 Its Broadest point and 6cm thick with an average mass of 250g in adult
female and 300g in adult males.
 The heart chambers include two superior chambers the right and left atria
and two inferior chambers the right and heart include the auricles (Flaps of
each atrium that slightly increase their volume)

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 The coronary sulcus between the atria and ventricles and the anterior and
posterior sulci between the ventricles on the anterior and posterior surfaces
of the heart respectively.
 The right atrium receive blood from the superior vena cava, inferior vena
cava and coronary sinus. It is separated internally from the left atrium by the
interatrial septum which contains the fassa ovalis. Blood exits the right
atrium through the tricuspid value.
 The right ventricle receives blood from the right atrium. It is separated
internally from the left ventricle by the interventricular septum and pumps
blood through the pulmonary valve into the pulmonary trunk.
 Oxygenated blood enters the left atrium from the pulmonary veins and exits
through the bicuspid (mitral) valve.
 The left ventricle pumps oxygenated blood through the aortic valve into the
aorta.
 The thikness of the myocardium of the four chambers varies according to the
chamber's function. The left ventricle with the highest work load has the
thickest wall.
 The fibrous skeleton of the heart is dense connective tissue that surrounds
and supports the values of the heart.

Chambers of the Heart:-

The heart has four chambers.

1. Right Atrium
2. Left Atrium
3. Right Ventricle
4. Left Ventricle

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Blood vessels:
 A vessel in the human or animal body in which blood circulates.
 They help deliver oxygen to vital organs and tissues, and also remove waste
products.
 The vessels that carry blood away from the heart are called arterioles.
 Your body contains about 60000 miles of blood vessels.

There are three types of blood vessels:-

1. Arteries: they carry blood away from your heart.

2. Veins: They carry blood back toward your heart.

3. Capillaries: The smallest blood vessels, connect arteries and veins.

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Pulmonary Circulations/ Systemic Circulations:

 The left side of the heart pumps oxygenated blood into the Systemic
Circulations to all tissue of the body except the air sacs (alveoli) of the
lungs.
 The right side of the heart pumps deoxygenated blood into the pulmonary
circulation to the air sacs (alveoli) of the lungs.

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Coronary Circulation:
 Nutrients are not able to diffuse quickly enough from blood in the chambers
of the heart to supply all the layers of cells that make up the heart wall.
 For this reason the myocardium has its own network of blood vessels.
 The coronary arteries branch from the ascending aorta and encircle the heart
like a crown encircles the head.
 The right and left coronary arteries deliver blood to the heart. The coronary
veins drain blood from the heart into the coronary sinus.

Cardiac cycle:
 A single cardiac cycle includes all the events associated with one
heartbeat/min 72-75.
 A cardiac cycle lasts 0.8 sec.
 A cardiac cycle consists of systole and diastole of the atria plus systole and
diastole of the ventricles.
 There are typical changes in pressure and blood flow during the cardiac
cycle in large veins such as the vena cava.
 Such oscillations in pressure and flow may, at times, be transmitted to more
peripheral vessels.
 There are three positive pressure waves (a, c, v) in the central veins
corresponding to changes in pressure changes in the atria. Thea wave is
caused by atrial contraction at end diastole.

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Heart sounds:
 The sound of the heart beat comes primarily from blood turbulence caused
by the closing of the heart values. Smoothly flowing blood is silent.
 There are four heart sounds but in a normal heart only the first and second
heart sounds (S1 and S2) are loud enough to be heard through a stethoscope.
 The timing of heart sounds relative to other event in the cardiac cycle.
 The first sound (S1) which can be described as a Lubb sound is louder and a
bit longer than second sound.
 S1 is caused by blood turbulence associated with closure of the AV values
soon after ventricular systole begins.
 The second sound (S2) which is shorter and not as loud as the first sound can
be described as a Dupp sound.

Basics of ECG (Electrocardiogram) :-

 They generate electrical currents that can be detected at the surface of the
body. An ECG is recording of these electrical signals.

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 The ECG is a composite record of action potentials produced by all the heart
muscle fibers during each heart beat.
 There are two ways to learn ECG interpretation — Pattern recognition (the
most common) and understanding the exact electrical vectors recorded by an
ECG as they relate to cardiac electrophysiology — and most people learn a
combination of both.

Blood pressure and its regulation

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Blood pressure:
 Blood pressure is the pressure of blood pushing against the walls
of your arteries. Arteries carry blood from your heart to other parts
of your body.
 Your blood pressure normally rises and falls throughout the day.
 Blood pressure is determined both by the amount of blood your
heart pumps and the amount of resistance to blood flow in your
arteries.
 The more blood your heart pumps and the narrower your arteries,
the higher your blood pressure.
 A blood pressure reading is given in millimeters of mercury (mm
Hg). It has two numbers.
 Systolic pressure. The first, or upper, number measures the
pressure in your arteries when your heart beats.
 Diastolic pressure. The second, or lower, number measures
the pressure in your arteries between beats.

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