Module 4: CARDIOVASCULAR SYSTEM

1. Heart: Size, form, and location

 Shaped like a blunt cone, approximately the size of a closed fist.
 Located in the thoracic cavity in between the two pleural cavities.
 Together with the trachea and the esophagus, forms a midline partition called the
mediastinal cavity or mediastinum.

2. Anatomy of the Heart

a. Pericardium
 The heart is surrounded and enclosed within the pericardial cavity.
 The pericardium is made up of two layers
1. Fibrous pericardium: A tough, fibrous connective outer tissue layer
2. Serous pericardium: Inner layer of flat epithelial cells and connective
tissue. The portion of the serous pericardium lining the fibrous
pericardium is the parietal pericardium while the part covering directly
the heart surface is the visceral pericardium or epicardium.
 Pericardial fluid fills the space between the visceral and parietal pericardium
which reduces friction as the heart moves within the pericardial sac.

b. External Anatomy
 Left and right atria – located superiorly at the base of the heart.
 Left and right ventricles – located inferiorly and extend from the base of
the heart towards the apex.
 Coronary sulcus – extends around the heart and separates the atria from
the ventricles.
- Anterior interventricular sulcus – extends inferiorly from the coronary
sulcus on the anterior surface and indicates the division between the
right and left ventricles; where the anterior interventricular artery and
the great cardiac vein are located.
- Posterior interventricular sulcus - extends inferiorly from the coronary
sulcus on the posterior surface of the heart; where the posterior
interventricular artery and the middle cardiac vein are located.

c. Blood Supply
1. Superior vena cava: Carries unoxygenated blood from the head and neck
to the right atrium.
2. Inferior vena cava: Carries unoxygenated blood from the lower part of the
body to the right atrium.
3. Four pulmonary veins: Carries oxygenated blood from the lungs to the
left atrium.
4. Pulmonary trunk: Arises from the right ventricle and divides into the left
and right pulmonary arteries and carries unoxygenated blood to the lungs
for gas exchange.
5. Aorta: Arises from the left ventricle and carries oxygenated blood to the
rest of the body via the systemic circulation.
d. Heart Chambers
 The atria of the heart receive blood from the veins.
Example: The right atrium receives unoxygenated blood from the tissues
via the systemic veins to the superior and inferior vena
cava.
The left atrium receives oxygenated blood from the lungs via
the four pulmonary veins.

- Functions primarily as reservoirs where blood returning to the

heart from the superior and inferior vena cava collects before it
enters the ventricles.
- The right atrium has 3 major openings: superior vena cave, inferior
vena cava, and the coronary sinus which drains blood from the
heart muscles.
- Interatrial septum is a partition which separates the right and left
atria.

 The right and left ventricles are the major pumping chambers of the heart
wherein the wall of the left ventricle is thicker than the right.
- Eject blood into the arteries.
- The right ventricle pumps blood into the pulmonary trunk, while
the left ventricle pumps blood into the systemic circulation via the
aorta.
- The interventricular septum is a muscular partition which separates
the right and left ventricles.

e. Heart Valves
 Prevents blood from flowing back (one direction flow)

 Atrioventricular Valves: Located between:

1. Right atrium and right ventricle – Tricuspid valve which has three
cusps.
2. Left atrium and left ventricle – Bicuspid valve which has two
cusps (Mitral valve).

The walls of the ventricles contain papillary muscles attached by a

thin, strong connective tissue string called chordae tendinae which are
attached to the margins of the atrioventricular valves.

 Semilunar Valves: Half-moon shaped valves in the aortic and

pulmonary trunk which are forced open during ventricular contraction
and closes during ventricular relaxation blocking the return of blood
into the ventricles.
 f. Route of Blood Flow through the heart
* Please refer to Figure 12.10 on page 329 in the Essentials of Anatomy and
Physiology 6th Edition by Seeley, Stephens, and Tate.

Coronary Circulation
Blood supply to the heart wall is supplied by the two coronary arteries. The
coronary arteries originate from the base of the aorta.

The left coronary artery which lies in the anterior interventricular sulcus gives
off three major branches supplying most of the anterior wall of the heart and
the left ventricle.
a. Anterior interventricular artery.
b. Left circumflex artery which extends from the coronary sulcus on the
left to the posterior surface of the heart.
c. Left marginal artery.

The right coronary artery extends around the coronary sulcus on the right to
the posterior side of the heart and supplies the right ventricle. Its branches
are:
a. Posterior interventricular artery which lies in the posterior
interventricular sulcus.
b. Right marginal artery.

g. Heart Wall
 Made of 3 layers: Epicardium, myocardium, and endocardium.
 Epicardium: Visceral pericardium; a thin serous membrane
forming the smooth outer surface of the heart.
- Made up of simple squamous epithelium on top of a
layer of loose connective tissue.
 Myocardium: The thick middle layer of the heart made up of
cardiac muscle cells.
 Endocardium: Inner surface of the cardiac chambers and made up
of simple squamous epithelium over a layer of
connective tissue.

3. Conduction System of the Heart

 Sinoatrial (SA) node: Functions as the pacemaker of the heart. It is located in the
superior wall of the right atrium and initiates the contraction of the heart.

Action potentials originate in the SA node and spreads over the right and
left atria causing them to contract.

 Atrioventricular node: Second pacemaker (ectopic) of the heart which is located

in the lower portion of the right atrium. When action potential reaches the
AV node, they spread slowly through it to the atrioventricular bundle
which divides into two branches of conducting tissues called the left and
right bundle branches to the tips called the Purkinje fibers.