Chapter 7

CARDIOVASCULAR SYSTEM

 Composed of:
1. Blood
2. Heart
3. Blood vessels

BLOOD

 Functions
1. for Transport of:
- oxygen from lungs to body tissues
- waste products of cellular metabolism from body tissues to the kidneys, liver,
lungs, and sweat glands for excretion
- nutrients, hormones, and enzymes throughout the body

2. for Regulation of:

- blood clotting to stop bleeding
- body temperature, mainly increasing or decreasing blood flow to the skin
- acid-base balance (pH) through the distribution of buffers, and the amount of
water and electrolytes in body fluids

3. for Protection
- against harmful microorganisms and other substances by contributing white blood
cells, proteins, and antibodies to the inflammatory and immune responses

 Properties
- average man has 5 – 6 liters of blood
- average woman has 4 – 5 liters of blood
- Red Blood Cells (RBC) make blood thicker, denser, and more viscous than water,
and flow 4 – 5x more slowly
- Hemoglobin
 a globular protein carried by the RBCs
 carries oxygen that makes the blood “oxygenated” (as in arterial
blood).
- blood is slightly alkaline (pH = 7.35 – 7.45)
- temperature of blood averages about 38*C ( 100.4*F)

 Components
1. Plasma – the liquid part of blood
2. Formed Elements – the solid part of blood
a. Red Blood Cells (RBC)/Erythrocytes
b. White Blood Cells (WBC)/Leukocytes
c. Platelets/Thrombocytes

Plasma
- made up of about 95% water, and 5% plasma and blood proteins
- provides the solvent for dissolving and transporting materials
 gases (nitrogen, CO2, O2)
 ions (Na+, Cl-, Ca2+)
  nutrients (glucose, amino acids)
 hormones
 proteins
 various wastes and lipid molecules

- plasma proteins
 most abundant of all dissolved substances in the plasma
 serves as carrier proteins

 Three (3) Types:

i. Albumin – mostly carrier proteins
ii. Globulin – some are carrier proteins; others serve as
antibodies (gamma globulins)
iii. Fibrinogen – essential for blood clotting

- blood proteins
 contribute to plasma osmotic pressure
 regulates the flow of materials and substances in and out of the
capillaries

RBC
- the most abundant cell in human blood
- about 5 billion RBCs in 1 ml of blood
- these are specialized cells that lose their nuclei and organelles during cell
differentiation; cannot divide
- shape is biconcave disk (increases surface area so that gases can move in and out
easily)
- transport O2, and CO2 (to a lesser degree) in the blood
- average life span = 120 days
 liver and spleen remove aged RBCs from circulation
- Iron contained in the hemoglobin is recycled and used to produced new RBCs in
the red bone marrow
- new RBCs are produced in the bone marrow by the Stem Cells
- Hematocrit
 the volume percentage of RBCs in the whole blood
 e.g. Hct = 46%, means that in every 100 ml of whole blood
 46 ml of rbc
 2 ml of wbc & platelets (buffy coat)
 52 ml of plasma
 normal values
male = 45 – 52%
female = 37 – 48%

- Erythropoietin
 hormone produced by the kidney when O2 level declines
 stimulates the stem cells to divide and multiply  increase RBC
production

- Hemoglobin (Hb) – oxygen-carrying globular protein

- Oxyhemoglobin (HbO) – oxygenated Hb; gives the bright red color to arterial
blood.
- Anemia
 a reduction of oxygen-carrying capacity of the blood
 causes:
i. a decrease in the number of circulating RBCs
ii. a reduction in the hemoglobin content of RBC
iii. presence of abnormal Hb in RBC

WBC
- nucleated cells
- part of the body’s protective mechanism against infection
- produced in the bone marrow
- constitute < 1% of blood volume
- most of its work is done in the tissues rather than on the circulating blood
- they arrive at the “scene” of infection by escaping or squeezing through the walls
of the capillaries (process known as Diapedesis)

- Two Basic Classification:

1. Granulocytes
a. Neutrophils
 phagocytes that destroy and engulf microorganisms and foreign
materials
 dead microorganisms and neutrophils made up the pus

b. Eosinophils
 increases during allergies, parasitic infections, and some autoimmune
diseases

c. Basophils
 contains heparin (anticoagulant), histamine (causes allergic reactions;
increases gastric acid production), and slow-reacting substance A (SRS-
A)
 gives immunity against parasites

2. Agranulocytes
a. Monocytes
 phagocytic macrophages; key part of Reticuloendothelial System
(RES)

b. Lymphocytes
 found in the body tissues (lymph nodes, spleen, thymus, tonsils, and
lymphoid tissues of GIT)
 B cells} regulates cellular immune responses that protects the
 T cells} body from its own defense system

Platelets
- formed in the bone marrow by fragmentation of huge cells known as
megakaryocytes
- they lack nuclei and organelles, thus unable to divide
- average life span = 7 – 8 days
 - responsible Hemostasis – stoppage of blood flow
 Three (3) Phases:
i. constriction of blood vessels
ii. aggregation (clumping together) of platelets
iii. blood clotting – a complicated process involving a chemical
chain reaction

 Blood Types
- Agglutinogens
 antigen on the surface of RBCs

- Hemagglutination
 clumping together of RBCs when combined with incompatible blood

- ABO Blood Grouping

Blood Type Agglutinogens Isohemagglutinin Can donate Can receive

on Erythrocytes s in Blood Plasma blood to blood from
(Antigen) (Antibody)
A A Anti-B A & AB A, O
B B Anti-A B & AB B, O
AB A, B None AB A, B, AB, & O
O none Anti-A, Anti-B A, B, AB, & O O
HEART
- pump for blood
- made up of cardiac muscles
- about the size of the clenched fist of its owner
- Function:
 receives oxygen-poor blood from the body and sends it to the lungs for
oxygenation
 pumps the newly oxygenated blood to all parts of the body, where cells can use it
for aerobic respiration

- location: mediastinum (space between the 2 lungs)

 mediastinum is located in the thoracic cavity
 slanted diagonally, with about 2/3 of its bulk is to the left of the body’s midline

- the pointed end is called the apex

- the uppermost part is called the base
- sternum is anterior to the heart.

- PERICARDIUM – a sac surrounding/covering the heart

 2 components of pericardium:

1. Visceral layer (epicardium)

 inner layer
 serous membrane
 closely attached to the heart muscles (myocardium)

2. Parietal layer
 fibrous membrane
 outer layer

 In between the two layers is the Pericardial cavity

 Pericardial cavity contains Pericardial fluid that prevents friction during
movement of the heart.
 Pericarditis – inflammation of pericardium caused by a decreased amount of
pericardial fluid

CARDIAC WALLS
- made up of three layers:

Epicardium
- the outer layer
- made up of the visceral pericardium

Myocardium
- consists of thick bundles of cardiac muscles
- it is the layer that actually contracts

Endocardium
- thin, glistening sheath of endothelium that lines the heart chambers
GREAT / MAJOR BLOOD VESSELS IN THE HEART

In general = arteries carry oxygenated blood away from the heart to the body.
Exception: pulmoray artery*

= veins carry unoxygenated blood from the body to the heart.

Exception : pulmonary vein *

1. Superior vena cava

- carries unoxygenated blood from the upper part of the body going to the heart

2. Inferior vena cava

- carries unoxygenated blood from the lower part of the body going to the heart

3. Pulmonary artery *
- carries unoxygenated blood from the heart (right ventricle) to the lungs

4. Pulmonary veins*
- carries oxygenated blood from the lungs to the heart (left atria)

5. Aorta
- carries oxygenated blood from the heart to be distributed to the whole body

FOUR CHAMBERS OF THE HEART

 The heart is divided vertically down the midline by a wall of muscle

called the septum.
 The coronary sulcus indicates the border between the atria and
ventricles

I. ATRIUM/ATRIA (Right atrium & Left atrium)

- upper chambers
- made up of thin walls and smooth, shiny inner surface
- in between them is the septum known as Fossa ovale

II. VENTRICLES (Right ventricle & Left ventricle)

- lower chambers
- made up of thicker walls
- in between the is the Interventricular septum

- Structures found in the ventricles:

 Trabeculae carnae
 coarse bundles of cardiac muscle fibers, forming ridges on the
ventricular walls
 Papillary muscles
 forms the irregular surface of the ventricles
 Chordae tendinae
 string-like structure
 attaches the free edges of atrioventricular valves to the papillary
muscles
 prevents the heart valves from turning inside out during pumping of
blood
 - Right ventricle – has opening to the pulmonary artery
- Left ventricle – has opening to the aorta
 the walls of the LEFT ventricle is 3x the thickness of the right ventricle
 Left ventricle forms the apex of the heart
 apex – located between the 5th & 6th intercostal space ( about 8cm from the
midsternal line); where the heart beat is best heard and pulsations are felt

VALVES OF THE HEART

- made up of fibrous tissue

- Function : prevent backflow of the blood during contraction
- The closure of the valves produce the Heart sounds.
- 1st heart sound (lab) – closure of the atrioventricular valves
- 2nd heart sound (dab) – closure of the semilunar valves

I. ATRIOVENTRICULAR VALVES

A. TRICUSPID VALVE
- between the right atrium & the right ventricle
- has 3 triangular flaps attached to the chordae tendinae

B. BICUSPID / MITRAL VALVE

- between the left atrium & the left ventricle
- has only 2 flaps

II. SEMILUNAR VALVES – between the ventricles & the blood vessels

A. PULMONARY semilunar valves

- found in opening from right ventricle to the pulmonary artery

B. AORTIC semilunar valve

- found in the opening from left ventricle to the aorta

NOTE: Defects in the valves of the heart causes murmur or abnormal heart sounds

BLOOD SUPPLY TO THE HEART (Coronary Circulation)

The heart muscle needs more oxygen to function. The heart pumps about 380 liters to its own
muscle tissue everyday.

 Coronary Arteries (right & left) – supply blood to the myocardium

- the first branches of the aorta
- occlusion of coronary arteries will cause chest pain
- chest pain may be a sign of Angina pectoris and Myocardial infarction
- if occlusion is not corrected will result to heart attack (Cardiac arrest)
  Cardiac Veins – drains blood from the myocardium
 several cardiac veins empty into coronary sinus  empties to the right atrium

 Blood can only flow to the myocardium if the heart is not contracting

NERVE SUPPLY TO THE HEART

The Heart is under the influence of the Autonomic Nervous System

Function: responsible for changing the rate and force of cardiac contraction
Rate – frequency of contractions
Force – intensity of contraction

Origin: Cardiac center in the Medulla of the brain

a. Parasympathetic nerves (most important is Vagus nerve)

} slows the heart rate
b. Sympathetic nerves
} increases the heart rate

INTRINSIC CONDUCTION SYSTEM

- terms : Arrythmia – absence or cessation of heartbeat

Dysrrythmia – irregular heartbeat

 The heart has specialized cardiac muscle fibers responsible for initiating and
maintaining the normal cardiac rhythm.
These specialized fibers are called Purkinje fibers.

 SINOATRIAL NODE (SA node)

- called the Pacemaker
- initiates the heart beat
- located in the right atrium
- sends impulses to the atrioventricular node

 ATRIOVENTRICULAR NODE (AVnode)

- a region of slow conductance
- ensures needed time delay between atrial and ventricular contractions.
- allows time for ventricles to fill
- sends impulse to the Bundle of His

 BUNDLE of His/Atrioventricular Bundle

- located throughout the walls of the ventricles
- give off smaller branches that terminate on specialized muscle cells  the Purkinjie
fibers
CARDIAC CYCLE

1. SYSTOLE
- the contraction of the heart
- during systole, blood from both ventricles are pumped out of the heart ( blood from
right ventricle  lungs; blood from left ventricle  to the rest of the body
- the atriovetricular valves (tricuspid & bicuspid or mitral) are CLOSE
- the semilunar valves (pulmonary & aortic) are OPEN

2. DIASTOLE
- the relaxation of the heart
- during diastole, blood from the both atria flows to the ventricles
- the atrioventricular valves are OPEN
- the semilunar valves are CLOSE

ELECTRICAL ACTIVITY IN THE HEART

 The electrical activity of the heart is reflected by the Electrocardiogram (ECG)

 Tracing:
 P wave
~ the first wave
~ represents the electrical changes occurring in the atria of the heart

 QRS complex
~ the second wave
~ represents the electrical activity taking place during ventricular contraction
(Depolarization)

 T wave
~ the third wave
~ represents the electrical activity as the ventricles relax (Repolarization)
 BLOOD FLOW THROUGH THE HEART

Unoxygenated blood from the body

Superior and inferior vena cava

Right atrium
Passes tricuspid valve
Right ventricle
Passes pulmonary SLV
Pulmonary artery

Lungs for oxygenation

Result: oxygenated blood from the lungs

Pulmonary veins (4)

Left atrium
Passes mitral valve
Left ventricle
Passes aortic SLV
Aorta

Oxygenated blood is distributed to the body

Circulation in the body

From aorta

Arteries

Capillary network
(branches of arterioles and venules)

Veins

All veins in the body empties to the

Superior & Inferior vena cava