Cardiovascular System (CVS)

STRUCTURE OF THE HEART:

4 chambers:
Two atria: receive venous blood.
Two ventricles: eject blood into arteries.
Right ventricle pumps blood to the lungs, where the
blood becomes oxygenated.
Left ventricle pumps oxygenated blood to the entire
body.

The right atrium and ventricle (called the right pump)

are separated from the left atrium and ventricle (the
left pump) by a muscular wall, or septum (prevents
mixture of the blood from the two sides of the heart).
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Cardiovascular System (CVS)
Pulmonary and Systemic Circulations:
Pulmonary circulation
Blood with low oxygen content and with high carbon dioxide content returns to the right
atrium then to the right ventricle then to the lungs through pulmonary trunk and
pulmonary arteries.

Gas exchange occurs between the lung capillaries and the air sacs (alveoli) of the lungs.

Oxygenated blood that returns to the left atrium by pulmonary veins.

Systemic circulation
Oxygenated blood leave the left atrium to the left ventricle then its pumped through the
aorta to all of the organ systems.

***Aorta: a very large, elastic artery, the aorta ascends for a short distance, makes a U-turn,
and then descends through the thoracic (chest) and abdominal cavities. Arterial branches
from the aorta supply oxygen-rich blood to all of the organ systems.

Material exchange occurs and the low oxygenated blood returns into two large veins —the
superior and inferior venae cavae —that return the oxygen-poor blood to the right atrium.

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chapter 13 4
Cardiovascular System (CVS)
Atrioventricular and Semilunar Valves
adjacent myocardial cells are joined together mechanically
and electrically by intercalated discs.

the atria and ventricles are separated into two functional units
by a connective tissue called fibrous skeleton.

In the fibrous skeleton is one-way atrioventricular (AV)

valves. located between:
➢ the right atrium and right ventricle (called the tricuspid
valve- has three flaps).
➢ the left atrium and left ventricle (called the bicuspid valve
or mitral valve- has two flaps).
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The heart valves
Cardiovascular System (CVS)
The AV valves:
Allow blood to flow from the atria to the ventricles,
They prevent the backflow of blood into the atria.
Opening and closing occur based on the pressure differences
between the atria and ventricles.

- AV open when the pressure in the atria exceed that in the

ventricles (When the ventricles are relaxed, the venous
return of blood to the atria causes the pressure in the
atria to exceed that in the ventricles. The AV valves
therefore open, allowing blood to enter the ventricles).

- AV closed when the pressure in the intraventricular

pressure rises above the pressure in the atria.
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Cardiovascular System (CVS)
Papillary muscles and chordae tendineae
Papillary muscles present within the ventricles.
are connected to the AV valve flaps by strong tendinous cords called the
chordae tendineae.
Contraction of both papillary muscles and ventricles occurs at the same
time; serves to keep the valve flaps tightly closed.
The high pressure produced by contraction of the ventricles could push the
valve flaps too much and evert them. This is normally prevented by
contraction of the papillary muscles within the ventricles.

The semilunar valves

One-way valves
are located at the origin of the pulmonary artery and aorta.
Open: during ventricular contraction (allowing blood to enter the
pulmonary and systemic circulations).
Closed (snap shut): during ventricular relaxation (when the pressure in the
arteries is greater than the pressure in the ventricles, the semilunar valves
snap shut, thus preventing the backflow of blood into the ventricles).
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Cardiovascular System (CVS)
Heart Sounds
Two normal sounds resulted from closing of the AV and semilunar
valves, respectively.
These sounds are often verbalized as “lub-dub”

First sound (S1, lub):

produced by closing of the AV valves during isovolumetric
contraction of the ventricles.
heard when the ventricles contract at systole (at the beginning of
ventricular contraction).

Second sound (S2, dub):

produced by closing of the semilunar valves when the pressure in
the ventricles falls below the pressure in the arteries.
heard when the ventricles relax at the beginning of diastole (end
of ventricular systole). chapter 13 9
Cardiovascular System (CVS)
Heart Murmurs
abnormal heart sounds produced by abnormal patterns of blood flow in the
heart caused by defective heart valves (incompetent Valves- do not work
properly).
Small defects in heart valves: produce detectable murmurs but do not
seriously compromise the pumping ability of the heart.
Larger defects in heart valves: may have dangerous consequences and thus
may require surgical correction.

Causes of incompetent AV valves or defective heart valves are:

1. Damage to the papillary muscles.
2. Congenital such as Septal defects — holes in the septum between the
right and left sides of the heart (blood will pass from the left [higher
pressure] to the right side that may lead to pulmonary hypertension
and edema).
3. Associated with rheumatic fever (rheumatic endocarditis): the valves
become damaged by antibodies made in response to an infection
caused by streptococcus bacteria (the bacteria that produce strep
throat).
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Cardiovascular System (CVS)
Mitral stenosis: a valvular heart disease associated
with rheumatic fever.

The mitral valve becomes thickened and calcified

(impair the blood flow from the left atrium to the left
ventricle).

Might cause pulmonary hypertension: if the blood

accumulated in the left atrium it might cause a rise in
left atrial and pulmonary vein pressure.
As a result: To compensate for the increased pulmonary
pressure, the right ventricle grows thicker and
stronger.
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Cardiovascular System (CVS)
CARDIAC CYCLE:
Refers to the repeating pattern of contraction (systole) and
relaxation (diastole) of the heart.
Both ventricles and atria can contract and relax but the terms
systole and diastole are mainly used for the ventricles.

The heart has two-step pumping action:

Atria-ventricles: The two atria fill with blood and then
contract simultaneously [Atrial contraction occurs toward the
end of diastole].
0.1-0.2 second later,
Ventricles-arteries: simultaneous contraction of both
ventricles [the atria are relaxed], which sends blood through
the pulmonary and systemic circulations.
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Cardiovascular System (CVS)
1. the venous return blood to the atria (when both the atria and
ventricles are relaxed).
2. The returned blood will cause to buildup pressure in the atria
and the AV valves to open and blood to flow from atria to
ventricles.
***by the action of this pressure, ventricles are about 80% filled
with blood.
3. Then contraction of the atria occurs: adds the final 20% to the
end-diastolic volume (the total volume of blood in the ventricles
at the end of diastole).
4. When ventricles are filled, contraction of the ventricles in
systole occurs and ejects about two thirds of the blood they
contain (an amount called the stroke volume)

***one-third of the initial amount left in the ventricles as the end-

systolic volume. The ventricles then fill with blood during the next
cycle. chapter 13 13
At an average cardiac rate of 75 beats per minute, each cycle lasts
0.8 second (0.5 second is spent in diastole, and systole takes 0.3
second).

Contraction of the atria occurs in the last 0.1 second of ventricular

diastole.
Relaxation of the atria occurs during ventricular systole.
Pressure changes during the Cardiac
Cycle:
When the heart is in diastole, the
pressure in the systemic arteries
averages about 80 mmHg (millimeters
of mercury).

These events in the cardiac cycle then

occur:
1. Isovolumetric contraction phase
As the ventricles begin their
contraction, the intraventricular
pressure rises, causing the AV valves
to snap shut (S1).
At this time, the ventricles are neither
being filled with blood (because the AV
valves are closed) nor ejecting blood
(because the intraventricular pressure
has not risen sufficiently to open the
semilunar valves).

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2. Ejection phase:
When the pressure in the
left ventricle becomes
greater than the pressure
in the aorta, the phase of
ejection begins as the
semilunar valves open.

The pressure in the left

ventricle and aorta rises
to about 120 mmHg
when ejection begins and
the ventricular volume
decreases.
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3. Isovolumetric relaxation
phase:
As the pressure in the ventricles
falls below the pressure in the
arteries, the back pressure
causes the semilunar valves to
snap shut (S2).
The pressure in the aorta falls to
80 mmHg, while pressure in the
left ventricle falls to 0 mmHg.

During isovolumetric relaxation,

the AV and semilunar valves are
closed. This phase lasts until the
pressure in the ventricles falls
below the pressure in the atria.
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4. Rapid filling phase:
When the pressure in
the ventricles falls
below the pressure in
the atria, the AV valves
open and a phase of
rapid filling of the
ventricles occurs.

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5. Atrial contraction (atrial
systole) delivers the final
amount of blood into the
ventricles immediately prior to
the next phase of isovolumetric
contraction of the ventricles.

Similar events occur in the right

ventricle and pulmonary
circulation, but the pressures
are lower.
The maximum pressure
produced at systole in the right
ventricle is 25 mmHg, which
falls to a low of 8 mmHg at
diastole.
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