Oral Pathology

Cardiovascular
Physiology
OMER MOHAMMEG
Chambers of the heart
2 Atria:
■ Thin-walled chambers.
■ Receive blood returning to the heart.
2 Ventricles:
■ Thicker, muscular walls.
■ Pump blood from the heart.
■ It pumps same volume of blood in a given period of time.
 Atria & ventricles are separated by fibrous ring which isolated to electrical
impulses.
Chambers of the Heart
Cardiovascular physiology:
The function of cardiovascular system CVS is
perfusion of tissues with blood.
 The left ventricle pumps the oxygenated
blood into the aorta to systemic arteries to
the tissues.
 The tissues extract O from blood in the
2
capillaries
 Then deoxygenated blood returns from the
tissues to the right atrium, then flow to the
right ventricle.
The heart
The heart actually consists of two separate pumps. The
right side of the heart pumps blood to the lungs through
the pulmonary circulation so that gas exchange (uptake of
oxygen and elimination of carbon dioxide) can take place.
Function of valves
 The cardiac valves allow the blood to flow in one direction only (from atria to
ventricles and from ventricles to aorta or pulmonary artery).
 Cardiac valves open and close passively, according to pressure gradient.
Function of valves
 The cardiac valves allow the blood to flow in one direction only (from atria to
ventricles and from ventricles to aorta or pulmonary artery).
 Cardiac valves open and close passively, according to pressure gradient.
The cardiac cycle
 The normal heart rate is about 75 beat/min.

 Each beat is regarded as one cardiac cycle.
 Each cycle takes about 0.8 s.
 Phases :-
The cardiac cycle is studied in three phases:
 Atrial systole (0.1 s).
 Ventricular systole (0.3 s).
 Atrial (0.7 s) & ventricular diastole (0.5 s)
Cardiac Cycle
 Systole: in which the chambers contract and eject the blood
 Diastole: in which the chambers relax allowing blood to fill them

Events that occur during the cardiac cycle
 During late diastole, the four chambers are relaxed, and the atrioventricular valves
(mitral and tricuspid) are open, while the aortic and pulmonary valves are closed.
 Blood from the right atrium flows to the right ventricle (period of
ventricular filling ).
 The atrioventricular (AV) valves are opened so blood is allowed to flow.
 Just before the end of diastole, atrial systole takes place.
 70% of the ventricular filling occurs spontaneously/ passively due to
the difference in pressure between the atrium and ventricle.
 So atrial systole (atrial contraction) provides the remaining 30% of the
ventricular filling.
 Filling is rapid at the beginning then it becomes slower.
 The end diastolic volume is the volume of blood in each ventricle at the end of
diastole and it is 120—130ml.
Events during ventricular systole
 When the ventricles start contraction this leads to an increase in the

intraventricular pressure.
 Blood flow from the ventricle to the atrium and this leads to the closure of the AV
(atrioventricular) valves causing the first heart sound (lub).
 When the pressure in the left ventricle reaches 80 mmHg this causes
opening of the aortic valve because this pressure is equal to the diastolic
pressure in the aorta.
 At the same time the pressure in the right ventricle reaches 10 mmHg and
this leads to opening of the pulmonary valve, and this equals the diastolic
pressure in the pulmonary artery.
 So both semilunar valves are opened by these pressures (No sound).
 This is the start of the ejection phase, which is rapid at first then it slows
down.
 Volume of blood in the ventricles will decrease and pressure is still rising.
 The maximum pressure reached in the left ventricle is 120 mmHg, and in
the right ventricle is 25 mmHg.
 Late in systole the pressure in the aorta exceeds that of the left ventricle,
but momentum keeps the blood moving forward.
 The amount of blood ejected by each ventricle per beat is called the stroke
volume (SV), which is used as an index of ventricular function.
 It is usually 70 to 90 ml of blood.
 The amount of blood remains at each ventricle at the end of systole is
called the end systolic volume and it is 50 ml, and it is the minimum
amount of blood that remains in the ventricles.
Important Volumes
 The volume of blood in the ventricles at the end of filling (End of Diastole)=End
Diastolic volume (EDV) = 120-130 ml.
 The volume of blood ejected by each ventricle during one beat (stroke)= Stroke
volume (SV) = 70 ml.
 The volume of blood found in the ventricles at the end of systole = End Systolic
volume (ESV) = 120 -70 = 50 ml.
 Percentage of EDV ejected in each beat = Ejection fraction =

SV/EDV = 65%.
Heart sounds
 First heart sound (S1)

 caused by closure of AV valves
 Indicate start of ventricular systole
 low pitched (lub)
 more prolonged than S2
 duration (0.15s)
 heard by stethoscope at the apex of the heart .
 Second heart sound (S2):
 caused by closure of semilunar valves
 Indicate start of ventricular diastole
 high pitched (dup)
 shorter than S1
 heard by stethoscope at the base of the heart
 duration (0.12s)
Murmurs
 abnormal sounds heard over the heart.
 Causes:
 Due to diseases of heart valves
1. Stenosis
 narrowing
2. Regurgitation (insufficiency)
 backward flow
 Can be systolic or diastolic murmurs.

Murmurs
Types of murmurs State of valves dieases
Diastolic Mitral stenosis
Systolic Mitral incompetence
Systolic Aortic stenosis
Diastolic Aortic incompetence

Oral Pathology

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Cardiovascular

 The normal heart rate is about 75 beat/min.

 Diastole: in which the chambers relax allowing blood to fill them

 When the ventricles start contraction this leads to an increase in the

 Percentage of EDV ejected in each beat = Ejection fraction =

 First heart sound (S1)

Diastolic Mitral stenosis

Systolic Mitral incompetence

Systolic Aortic stenosis

Diastolic Aortic incompetence

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