Cardiovascular System

Dr CHARLES A SIMANJUNTAK,
dr, SpOT(K), MPd

TOPOGRAPHY of the HEART

I. Anatomy of the Heart

A. Coverings
1. Pericardium
fibrous pericardium
parietal pericardium
visceral pericardium
B. Heart wall layers
1. Epicardium (visceral pericardium)
protects heart
2. Myocardium cardiac muscle
3. Endocardium epithelial/ connective/ fibers

C. Chambers, Vessels, and Valves

1. Four chambers
upper chambers rt and left atria
Collects blood
lower chambers rt and left ventricle
pumps blood from heart
2. Arteries
carry blood away from heart
3. Veins
blood toward heart

4. Valves
AV valves
Tricuspid rt atrium
Bicuspid or mitral - lt atrium
Semilunar valves
Pulmonary semilunar (pulmonary trunk)
Aortic semilunar (aortic arch)
II. Pulmonary and Systemic Circulation
A. Pulmonary pathway
oxygenated blood rt ventricle from rt atrium
myocardium (rt ventricle) contracts

low oxygen blood through pulmonary semilunar

pulmonary trunk -> arteries -> lungs
oxygenated blood -> rt & lt pulmonary veins ->
left atrium
B. Systemic pathway
Oxygenated blood -> lt atrium to lt ventricle
Left ventricle contracts ->aortic semilunar
Aortic arch -> arteries to tissues
oxygen depleted blood from tissues ->
veins to heart -> rt atrium (vena cava)

III. Cardiac cycle and heart sounds

1. Diastole - relax
atrial diastole atria fill valves closed
ventricular diastole ventricles fill
2. Systole - contraction
atrial systole contracts blood to ventricles
ventricular systole closes AV valves/open semilunar
3. Sounds
Lubb - dubb
Lubb AV close

dubb semilunar close

IV. Cardiac Conduction

A. Cardiac muscle
sarcomeres
contraction similar to skeletal
intercalated disks
B. Signal conduction
specialized cardiac cells
Undergo AP spontaneously
Sinoatrial (SA node)
pacemaker

Atrioventricular node (AV)

Signal pathway
SA action potentials -> contraction in atrium
AV action potentials (slower) -> bundle of HIS->
through septum -> Purkinje fibers -> contraction
C. Electrocardiography
electrical events corresponding to mechanical
P wave: atrial fibers depolarize
QRS complex: ventricles depolarize
T wave: ventricles repolarize

D. Regulation
ANS: Sympathetic & Parasympathetic
Sympathetic: Norepinephrine
increase (Na+)
Parasympathetic: Acetylcholine
decrease (K+)
Hormones:
Epinephrine/Norepinephrine/T3,T4
Ions: K+/Ca2+

V. Physiology of Circulation
A. Pulse
ejection of blood from lft ventricle (wave)
pressure through arteries = heart beat/min
B. Blood Pressure
pressure blood exerts on walls of arteries
measurements: systolic pressure
peak of ventricular contraction
diastolic pressure: ventricles relaxed 120/70
C. Factors affecting pressure
Neuronal:

elevate in CO2,O2,pH

increase in CO2 / decrease pH

-> Sympathetic norepinephrine -> vasoconstriction
Chemicals: Histamine (immune response)
-> vasodilation
Temperature: cold exposure -> vasoconstriction

VASCULARIZATION to the
Heart

Scheme of the blood supply to

the heart

VASCULARIZATION TO THE
HEAD

VASCULARIZATION TO THE
CHEST & aBDOMEN

VASCULARIZATION TO THE
UPPER EXTREMITIES

VASCULARIZATION TO THE
LOWER EXTREMITIES

QUESTION

?
CharlesASjuntak, FKIK-Unja

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