PHYSIOLOGY OF CARDIOVASCULAR

SYSTEM

By Addise.A(Bsc in public heaith)

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OUTLINES
Introduction
Components of Cardiovascular system
Cardiac valves
Cardiac muscles
Specialized excitatory and conductive
system of the Heart
Cardiac cycle and Heart sounds
Electrophysiology of the Heart
Cardiac output and its regulation
Capillary exchange
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LEARNING OBJECTIVES
At the end of teaching/learning activities, students are
expected to:
Identify functional structure of the cardiovascular
system
Describe electro physiology of the myocardium &
ECG
Describe pumping function of the heart chambers,
cardiac cycle
Explain cardiac output and its regulation
Explain blood pressure and its regulation
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INTRODUCTION
The primary function of the cardiovascular system is to deliver
blood to the tissues, which provides essential nutrients to the
cells for metabolism and removes waste products from the
cells

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COMPONENTS OF THE CVS
The Heart: central pump
Systemic arteries
Arterioles & pre capillary sphincters:
act as control valves to regulate local flow
Capillaries: one cell layer thick
exchange between tissue (cells) & blood
Venules:
collect blood from capillaries
Systemic veins:
return blood to heart/dynamic storage

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DIVISION OF THE CIRCULATION
In the CVS, blood passes through two (double)
circulations:
1. Systemic circulation

2. Pulmonary circulation
Systemic circulation:
Starts in the LV→ Aorta → Systemic arteries
→Systemic capillaries →Veins →SVC & IVC →ends in
RA
Pulmonary circulation:
Starts in the RV→trunk →Pulmonary arteries → 6
Pathway of Blood Through the Heart and
Lungs

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HEART
Heart is the hollow, muscular organ that plays a central
pumping role
Composed of 4-chambers:
2 atria and
2 ventricles
Has 4 valves:
2 AV valves (TCV &BCV) and
2 SLV (PV &AV)

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Cardiac Valves
 Responsible for the unidirectional flow of blood
through the heart
 Atrioventricular vs semilunar valves

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Cardiac muscle
It is composed of 3 types of cardiac muscles
1. The atrial muscle
2. The ventricular muscle
3. The specialized excitatory and conductive muscle fibres
(Autorhythmic Cells)

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SPECIALISED EXCITATORY AND CONDUCTIVE
MUSCLE
Pacemaker Tissue of the Heart
 The SA node in the right atrium is the primary
pacemaker of the heart.
The AV node located b/n rt atrium and rt ventricle is
the secondary pacemaker.
Specialized Conductive Tissue of the Heart
Consists of Purkinje fibers ramifying over the sub-
endocardial surfaces of both ventricles.

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It is comprised of the following components:
1. Sino-atrial node (SA-node): AP generation
2. Internodal pathways
3. AV-node
4. Atrioventricular bundle (bundle of His)
5. Purkinje fibers

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ELECTRICAL ACTIVITY OF CARDIAC CELLS
Excitability
Trans-membrane potentials

 Resting membrane potential (rmp)

 Action potential (AP)
1. A fast channel that accounts for the early influx of Na+

2. A slow channel that permits Ca++ and some sodium to

move down its concentration and electrical gradients into

the cell
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ELECTROPHYSIOLOGY OF THE HEART
Phases and ionic basis of myocardial action potential
It has the following phases
Phase-0: Rapid depolarization
Caused by rapid Na-influx
Phase-1: Early brief repolarization
Caused by K+ efflux
Phase-2: The plateau (prolonged depolarization)
Caused by Ca2+influx via L-channels
Phase-3: Repolarization
Caused by K+ efflux
Phase-4: complete repolarization
RMP - Na+-K+-ATPase

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FUNDAMENTALS OF
ELECTROCARDIOGRAPHY
ECG is the electrical activity of the heart that is conducted
through the body fluid and recorded from the surface of the
body using highly sensitive electrodes

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P wave-SA node initiates atrial depolarization
PR interval- isoelectric line which is between the onset of
atrial depolarization and the onset of ventricular
depolarization
 QT INTERVAL-includes the QRS complex, the ST segment,
and the T wave.
ST segment- an isoelectric portion of the QT
T wave - repolarization of ventricles

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APPLICATION OF ECG
 anatomical orientation of the heart,
 heart rate determination
 relative size of heart chambers,
 a variety of disturbances of rhythm and conduction
arrhythmia and conduction block
 extent, location and progress of ischaemic damage
(myocardial infarction)
 hypertrophy
 pericarditis and myocarditis

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CARDIAC CYCLE
 A single cardiac cycle is comprised of
- Atrial systole and atrial astole
-Ventricular diastole + ventricular systole
1. Atrial systole -atrial contraction producing S4
2. Atrial diastole- the period during which atrial filling takes
place. Later part of atrial diastole coincides with ventricular
diastole
3. Venticular Protodiastole-S2
4. Rapid filling phase-S3
5. Ventricular systole-S1

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CARDIAC OUTPUT (CO)
CARDIAC OUTPUT (CO)- the amount of blood pumped by each
ventricle in one minute
CO=SVXHR
o SV= EDV-ESV
ejection fraction x EDV

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Regulation of Pumping Activity of the Heart
There are two types of regulatory mechanisms:
1. The Intrinsic Auto-regulatory Mechanisms (The Frank Starling
Mechanism)
 “Within physiological limits, the contractile force of the heart

is proportional to the amount of the blood enters the heart”.

2. The Extrinsic Regulatory Mechanisms
 Sympathetic, parasympathetic stimulation

 Catecholamine

 Electrolytes (Ca2+, K+)

 Drugs: Cardiac glycosides, xanthenes

 Hormones: AD, Glucagon, T3/T4

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THE STRUCTURE OF ARTERIES AND VEINS
 Arteries and veins resemble each other in that their walls contain
three coats.
The inner coat (vascular endothelium, tunica intima) consists of a
single layer of endothelial cells
The middle coat (tunica media) contains primarily smooth muscle
and elastic tissue fibers.
The outer coat (tunica adventitia, adventitious coat) embeds the
vessel in its surroundings and consists mainly of connective tissue.
 Arteries are distinguished by an especially well developed muscle
coat, which contains a varying amount of elastic fiber according to its
site (predominantly elastic and predominantly muscular arteries).

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FUNCTIONAL CLASSIFICATION OF BLOOD VESSELS
 Elastic vessels
 Resistance vessels
 Exchange vessels
 Capacitance vessels (big to small veins)

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ARTERIAL BLOOD PRESSURE (BP
ABP- the pressure in the wall of arteries.
 BP is conventionally written as systolic (peak, ejection

pressure)/ diastolic (minimum, filling pressure) blood

pressure
 BP=COXTPR,

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REGULATION OF ABP
A. Short-term controlling mechanisms
CNS ischemic response
Baroreceptor reflex
Chemoreceptor reflex
Atrial stretch reflex
Stress relaxation and reverse stress relaxation
Capillary fluid shift
Hormonal mechanisms: Vasopressin (ADH)
B. Long-term controlling mechanisms
The renal mechanism
The Renin-angiotensin-aldosterone system
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CAPILLARIES
 Necessary for exchange of gases, nutrients, and wastes
 No smooth muscle, no innervations
 Blood flow controlled by pre-capillary sphincter muscles via metabolic
regulation
 Capillaries exchange

 There are two forces that determine the direction of flow of fluid through the

capillaries
 The capillary colloid osmotic pressure (25 mm Hg)

 The capillary hydrostatic pressure (32mmHg

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THANK YOU!!!

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REFERENCES
1.Guyton and Hall text book of Medical physiology,12th
edition

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