CARDIOVASCULAR

SYSTEM

Cvs
 OBJECTIVES
• Anatomy of the Heart
• Conducting systems
• ECG
• Cardiac cycle
• Control of cardiac out put and blood pressure

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ANATOMY OF THE HEART
Cardiovascular system is a system of organs that
include the heart, blood vessels and blood which
circulated through the entire body of human or
other vertebrate.
Main anatomy consist heart which is a muscular
pumping devices and closed system of vessels
called arteries, veins and capillaries. This make up
two circulatory system.
• Pulmonary circulation
Loop from right heart taking deoxygenated blood
to the lung where it is oxygenated and returned to
the left heart.
 Systemic circulation
Loop the delivery oxygenated blood from
left heart to the rest of the body and
return deoxygenated blood back to the
right heart via large veins (vena cava).
 Location of the heart
 Superior surface of diaphragm
 Left of the midline
 Anterior to the vertebral column, posterior to the sternum
 Responsibilities of cardiovascular system

 Pumping blood to the body

tissues and cells
 Supplying oxygen and nutrients
to tissues and cells
 Removing carbon dioxide and
other waste products of
metabolism from tissues and
cells
Coverings of the Heart
Pericardium is a fluid filled sac that
encloses the heart and great vessels.
Divided into two main layer:
 Fibrous pericardium: this is outer most layer and
made up of connective tissue that prevent heart from expanding
too much
 Serous pericardium: this is a inner layer of
pericardium and produced pericardial fluid that lubricate your
heart as it beats. This made of two layer
 Parietal layer this is outer layer that attached to
your fibrous pericardium and there is no space
 between them.
Visceral layer is inner most layer and directly cover your
heart and the roots of greet vessels. The portion that cover the
heart is also know as your pericardium. Pericardial cavity is
the space between two layer of serous pericardial fluid.
The Function of the Pericardium:
Protects the heart from infection
Prevents overfilling of the heart with blood
Allows for the heart to work in a relatively
friction-free environment
 Major Vessels of the
Heart
 Vessels returning blood to the heart include:

1. Superior and inferior venae

cavae
2. Right and left pulmonary veins
 Vessels conveying blood away from the heart include:

1. Pulmonary trunk, which splits

into right and left pulmonary
arteries
2. Ascending aorta (three
branches) –
a. Brachiocephalic
Vessels that Supply/Drain the
Heart

Arteries – right and left coronary (in atrioventricular groove),
marginal, circumflex, and anterior interventricular arteries
 Veins – small cardiac, anterior cardiac, and great cardiac veins
posterior vein to left ventricle, coronary sinus, and middle cardiac
vein
Gross Anatomy of Heart:
Heart Valves
 Heart valves ensure unidirectional blood
flow through the heart.this include the
following valve:
• Atrioventricular (AV) valves lie between
the atria and the ventricles
• AV valves prevent backflow into the atria when ventricles contract

• Semilunar valves prevent backflow of

blood into the ventricles
• Aortic semilunar valve lies between the left
ventricle and the aorta
• Pulmonary semilunar valve lies between
the right ventricle and pulmonary trunk
Pathway of Blood Through the Heart and
Lungs
 Right atrium  tricuspid valve  right ventricle
 Right ventricle  pulmonary semilunar valve 
pulmonary arteries  lungs
 Lungs  pulmonary veins  left atrium
 Left atrium  bicuspid valve  left ventricle
 Left ventricle  aortic semilunar valve  aorta
 Aorta  systemic circulation
 Conduction System of the Heart
The heart has its own electrical system called conduction
system.this system send electrical signal throughout the heart that
determine the timing of the heart beat in a coordinated,rhythmic
pattern.this impulses of the heart are generated by a clump of
special tissue called the sinus node.This sinus node generate
new electrical impulse and spread through the heart at right atrium
and left atrium.After two atrium stimulated and contract and
pumping blood into the right and left ventricles.Then spread to AV
node which located between atrium and ventricles.AV node slows
down the spread of electrical impulse to allow left and right atrium
to contracting.From AV node the impulse spread into fiber called
His Bundle and distribute the impulse rapidl to the right and left
ventricle stimulate them and contracting in coordinated way.With
this contraction blood pumped from right ventricle to the lung,and
from left ventricle through out the body.
 Electrocardiograp
hy
ECG is a first line test used to obtained valuable
information about your heart health by measuring the
electrical activity of the heart.it can be detect heart
attack, heart rhythm problem and other heart
condition.
ECG involve of the uses of electrode attached to your
chest, arm and legs. And detect electrical signal
produced by heart and show your
heart rate, heart rhythm and electrical
waveforms.
 Interval refer to the duration of time that include
one segment and one wave or more.
 PR interval the time take from electrical signal
to travel from the atria to the ventricles.
 QT interval the time take for the ventricles to
contract and relax. Should be in normal limit

 Wave form: A normal ECG wave form include;

 P wave the electrical activity that cause the
atrial to contract.
 QRS complex the electrical activity that
cause the ventricles to contract.
 T wave this represent the ventricles returning
to their resting state
 Rhythm: A normal ECG is
described as regular without
extra beats.
 The cardiac cycle

• Is the period from the END of one cardiac

contraction to the END of the next contraction
• One cardiac cycle is reflected by ELECTRICAL
& MECHANICAL changes
• At rest, the healthy adult heart is likely to
beat at a rate of 60–80 beats per minute
(b.p.m.)
• During each heartbeat, or cardiac cycle the
heart contracts (systole) and then relaxes
(diastole).
 Stages of the cardiac
cycle
• Each cycle lasts about 0.8 of a second
and consists of:
1. atrial systole – contraction of the atria
2. ventricular systole – contraction of the
ventricles
3. complete cardiac diastole – relaxation
of the atria and ventricles.
 CARDIAC OUTPUT
• The cardiac output (CO) can be defined as
the amount of blood ejected or pumped out of the heart
per min.
• Cardiac output is expressed in litres per minute (L/min)
• Cardiac output = volume ×Heart rate.
• 70 X 75 = about 5000ml per min or 5l.
• Factors affecting cardiac volume:
 VEDV (ventricular end-diastolic volume – preload)
 Venous return
 position of the body
 skeletal muscle pump
 respiratory pump
 • Strength of myocardial contraction
 • Blood volume
Cardiac output is influenced by
• Afterload which is an expression of the
resistance which a ventricle must overcome to
eject the cardiac volume.
Factors that affect Afterload:
• The resistance in the aorta
• The peripheral resistance
• The mass of blood in the aorta
• The viscosity of the blood
• If heart rate rises, cardiac output increases, and
if it falls, cardiac output falls too;
• The heart rate is a major determinant of cardiac
output.
The main factors affecting heart rate
• Gender
• Autonomic activity
• Age
• Circulating hormones
• Activity and exercise
• Temperature
• The baroreceptor reflex
• Emotional states
• There are four heart sounds, each
corresponding to a particular event in
the cardiac cycle
• Heart sounds are associated with
closing of heart valves
First sound occurs as AV(atrialventricular
valves) close and signifies beginning of
systole (contraction)
Second sound occurs when SL valves
(aortic and pulmonary semilunar valves)
close at the beginning of ventricular
diastole (relaxation)
 Blood pressure

• Blood pressure is the force or pressure

that the blood pushing against the walls
of blood vessels.
• Blood pressure is determined by cardiac
output and peripheral resistance
NOTE. Blood pressure=Cardiac output X Peripheral
resistance
Blood pressure is higher when you heart is beats and
pumping the blood
Normal blood pressure for healthy adult is generally considered to be around :
SYSTOLIC PRESURE :120mmHg
DIASTOLIC PESSURE: 80mmHg
• Systolic pressure: This is pressure in the arteries when the heart contract
{during a heart beat} and pumps blood out.
• Diastolic pressure: This is pressure in the arteries when the heart is at rest .
IMPORTANCE
• High blood pressure [hypertension]:
Chronic high blood pressure forces the heart to work herder, can damage blood
vessels, and increases the risk of heart desease,strock and kidney problems.
• Low blood pressure[hypotension]:
Low blood pressure can lead to insufficient blood to flow to organs.
HOW BLOOD PRESURE WORKS:
• Heart function: The heart act as pump, driving blood into the large arteries
with each contraction .This create systolic pressure.
• Arteries and vessels: The arteries which are elastic, expand and contract in
response to the force of the blood, helping maintain pressure. The smaller blood
vessels like arterioles and capillaries regulate blood flow by increasing or
decreasing resistance which impacts blood pressure .
ANESTHESIA ON BLOOD PRESSURE
Blood pressure during anaesthesia is a critical factor
because anaesthesia affects both cardiovascular
system and the body ability to regulate blood
pressure. Anaesthesia can cause significant changes
in blood pressure, depending on the type of
anaesthesia, the patient health and the specific
surgical procedures.
 References
• Gray's Anatomy: The Anatomical Basis of Clinical
Practice (40th ed.), Churchill-Livingstone, Elsevier,
2008, ISBN 978-0-443-06684-9
• Ross and Wilson Anatomy and Physiology in Health
and Illness 12th Edition
• Essentials of Anatomy and Physiology. Front Cover.
Valerie C. Scanlon, Tina Sanders. F.A. Davis Company,
2007 - Medical - 603 pages.
• Snell’s Clinical Anatomy by Regions 10th Edition