VOCABULARY DIFFERENT TYPES OF MOLECULES

1. Malacia- softening of tissue MOVE THROUGH THE CARDIOVASCULAR

2. Opia- vision SYSTEM
3. Penia- deficiency
1. Nutrients
4. Coccus- berry-shaped, spherical
- Digested food to cells
5. Ptosis- drooping; falling
2. Oxygen
6. Plegia- paralysis
- Lungs to cells
7. Ectomy- surgical removal
3. Metabolic Wastes
8. Ician- specialist
- Cells to excretory organs
9. Phobia- fear
4. Hormones
10. Rrhage- bursting forth
- Regulate body activties
5. Distributes heat to maintain body
Extra Information
temperature (constrict or dilate)
● Takotsubo cardiomyopathy (broken
heart syndrome)- a traumatizing
incident triggers the brain to THREE INTERRELATED COMPONENTS OF
distribute chemicals that weaken
THE CARDIOVASCULAR SYSTEM
heart tissue
● Congestive Heart Failure (CHF)- 1. Blood (transport vehicle)
clinical presentation of a disease not 2. Heart (pump)
a diagnosis itself 3. Blood Vessels (network of tubes)

OVERVIEW:
OTHER COMPONENTS OF THE
UNit 1: Blood
Unit 2: Cardiovascular System HEMOVASCULAR SYSTEM
1. Bone Marrow
2. Liver
3. Spleen
FUNCTION: MATERIALS TRANSPORT AND
4. Lymph System
HEAT DISTRIBUTION
- The Cardiovascular System is like a
network of highways connecting LIVER
muscles and organs through an
- Acts as a filter
extensive system of vessels that
- Produces all the procoagulants
transport blood, nutrients, and
essential to hemostasis and blood
waste.
coagulation(PROTHROMBIN and
CLOTTING FACTORS)
- critical to formation of Vitamin K
- Stores excess iron
- Produces hepcidin, a key regulator
of iron balance
SPLEEN – delivery of O2, nutrients, and
Functions can be classified as: hormones
● Hematopoietic: Able to produce – removal of CO2 and metabolic
RBCs during fetal development wastes
● Filtration
- Remove old and damaged RBCs 2. Regulation of Internal Homeostasis
from circulation – body temperature
- Removes hemoglobin from RBCs – pH
and returns iron component to the – fluid volume
bone marrow for reuse – composition of the interstitial
- Filters out bacteria, especially fluid/lymph
encapsulated organisms
● Immunologic: Contains a rich supply 3. Protection
of lymphocytes, monocytes, and – necessary for inflammation and
stored immunoglobulins repair
● Storage: Stores RBCs and – prevents blood loss by hemostasis
approximately 30% of total mass of (coagulation)
platelets – prevents infection

COMPOSITION OF BLOOD
BLOOD ● BLOOD SAMPLE
● Blood transports substances - Spin it
between body cells and the external - Separates into two parts:
environment. 1. Plasma
● A liquid connective tissue – ~55% of the volume
● A mixture: – straw colored liquid on top
1. the formed elements
- Living blood cells & platelets 2. Formed Elements
2. The plasma – the fluid matrix - ~45% of the volume
– red blood cells (99%)
– buffy coat - white blood
PHYSICAL CHARACTERISTICS OF BLOOD cells and platelets (1%)
- More viscous than water
- Temperature about 1 degree celsius
higher than oral or rectal body
temperature
- Alkaline pH (7.35 to 7.45)
- ~8% of total body weight
- 5-6 L in adult male
- 4-5 L in adult female

FUNCTIONS OF BLOOD
1. Transport and Distribution
 – Regulatory substances
• enzymes
• hormones
– Gases - O2, CO2, N2

COMPONENTS OF BLOOD
● FORMED ELEMENTS
● PLASMA 1. 99% red blood cells
1. 92% WATER 2. Living cells
2. 7% PROTEINS 3. Erythrocytes (RBC); for 02 and CO2
3. Important for osmotic balance: transport
• Albumin (60%) 4. RBC’s hemoglobin also helps buffer
–transports lipids the blood
–steroid hormones
• Fibrinogen (4%) 5. <1% WHITE BLOOD CELLS and
– blood clotting THROMBOCYTES (platelets)
• Globulins (35%) A. Leukocytes (WBC)
– many different proteins with wide • Granular leukocytes (granulocytes)
variety of functions – neutrophils
–globulin classes α, β, and γ – eosinophils
• 1% other regulatory proteins – basophils
4. 1.5% OTHER SOLUTES • Agranular leukocytes (agranulocytes)
– Waste products - carried to various organs – lymphocytes - T & B cells
for removal –monocytes--tissue
– Nutrients – glucose and other sugars, macrophages
amino acids, lipids, vitamins and minerals
– Electrolytes (ions) B. Thrombocytes (platelets)

THE HEART: FACTS
1. It is a fact that the heart, when taken
out of the body, will continue to beat.
Even when cut into parts, the
muscles in the heart will continue to
beat.
2. The heart pumps over 300 quarts of
blood an hour.
3. Heart beats about 100,000 times
every day or about 35 million beats
per year. Your heart will beat
approximately 2,700,000,000 times
in a lifetime.
4. The aorta, the largest artery in the
body, is almost the diameter of a
garden hose. Capillaries, on the
other hand, are so small that it takes
ten of them to equal the thickness of
a human hair.
5. Your body has about 5.6 liters (6
quarts) of blood.This 5.6 liters of
blood circulates through the body
three times every minute. In one
day, the blood travels a total of
19,000 km (12,000 miles)--that's four
times the distance across the US
from coast to coast.
6. Hold out your hand and make a fist.
If you're a kid, your heart is about
the same size as your fist, and if
you're an adult, it's about the same
size as two fists.
7. Give a tennis ball a good, hard
squeeze. You're using about the
same amount of force your heart
uses to pump blood out to the body.
Even at rest, the muscles of the
heart work hard--twice as hard as
the leg muscles of a person
sprinting.
8. Feel your pulse by placing two
fingers at pulse points on your neck
or wrists. The pulse you feel is blood
stopping and starting as it moves
through your arteries. As a kid, your
resting pulse might range from 90 to
120 beats per minute. As an adult,
your pulse rate slows to an average
of 72 beats per minute.
HEART ANATOMY
● As big as 2 closed fists in adults,
males have bigger anatomical hearts
● Located in the mediastinum, like a
cone on its side between the lungs
● Base - broad superior portion of
heart
● Apex - inferior end, tilts to the left,
tapers to point
GREAT BLOOD VESSELS OF THE HEART
1. Pulmonary Arteries
- Carry blood from the right ventricle
to the lungs
 - Blood is deoxygenated - Keeps your heart in its place
- Allow heart to beat without friction,
2. Pulmonary Veins room to expand and resists
- Carry blood from the lungs to the left excessive expansion
atrium
- Blood is oxygenated A. FIBROUS PERICARDIUM
- Superficial, tough, elastic
3. Superior & Inferior Vena Cava
- Carries blood from the body to the B. SEROUS PERICARDIUM
right atrium - Thinner, delicate, double
- Blood is deoxygenated layer
1. Parietal Layer
4. Aorta - Fused to the fibrous
- Carries blood from the left ventricle pericardium
to the body - Pericardial fluid,
- Blood is oxygenated Pericardial Cavity
2. Visceral Layer
- Also called the
epicardium

HEART WALL
1. Epicardium
- Outside slippery layer
- Also called the visceral
pericardium

2. Myocardium
- Muscle of heart

3. Endocardium
- Inside the heart

PERICARDIUM
- Surrounds heart
 4. Trabeculae carneae
- internal ridges in both
ventricles walls
5. Chordae tendineae
- cords connecting to the
tricuspid and mitral valves
6. Heart valves

MYOCARDIUM
● Atrial walls are the thinnest
● Right ventricle is thinner than the left
CLINICAL CORRELATION
ventricle
– pumps blood shorter distance 1. Pericarditis
● Left ventricle walls thickest – inflammation of the pericardium
● Right and left ventricles pump same
volume of Acute – sudden, no known cause; viral
● blood with each beat ● chest pain
● pericardial friction rub (creaking
sound)

Chronic – gradual, long-lasting

● pericardial fluid
accumulates—compress heart
● Cardiac tamponade -fluid in the
pericardial cavity compressing the
heart, can stop the heart beat
● cancer and tuberculosis
ENDOCARDIUM
1. Interatrial septum 2. Myocarditis
- wall that separates atria - Inflammation of the myocardium
2. Pectinate muscles
- internal ridges of ● viral infection, rheumatic fever,
myocardium in right atrium exposure to radiation or certain
and both auricles chemicals, medications
3. Interventricular septum
- wall that separates ventricles
 ● fever, fatigue, chest pain, irregular or
rapid heart beat, joint pain,
breathlessness
● mild and recover

3. Endocarditis
– inflammation of the endocardium

HEART CHAMBERS
● 4 chambers
● Right and left atria (= entry halls)
– 2 superior, posterior chambers
– receive blood returning to heart
● Right and left ventricles (= little bellies)
BLOOD FLOW IN THE HEART
– 2 inferior chambers
– pump blood into arteries
– Left ventricle is thicker, why?

PATHWAY OF BLOOD THROUGH THE

HEART
● The heart is two side-by-side pumps

1. Right side is the pump for the pulmonary

circuit
- Vessels that carry blood to and from 1. Right atrium
the lung 2. tricuspid valve
- Pulmonary circuit is a short, 3. Right ventricle
low-pressure circulation 4. pulmonary semilunar valve
5. pulmonary trunk
2. Left side is the pump for the systemic 6. pulmonary arteries
circuit 7. lungs
- Vessels that carry the blood to and 8. pulmonary veins
from all body tissues 9. left atrium
- Systemic circuit blood encounters 10. bicuspid valve
much resistance in the long 11. left ventricle
pathways 12. Aortic semilunar valve
- Anatomy of the ventricles reflects 13. aorta
these differences 14. Systemic circulation
HEART VALVES
● Ensure one-way blood flow
● Semilunar valves
- control flow into great
arteries
1. pulmonary: from right ventricle into
pulmonary trunk
2. aortic: from left ventricle into aorta
● Atrioventricular (AV) valves
1. right AV valve has 3 cusps
(tricuspid valve)
2. left AV valve has 2 cusps (mitral,
bicuspid valve)
•MNEMONICS: rat lamb
3. chordae tendineae - cords connect HEART VALVES AND CIRCULATION OF
AV valves to papillary muscles (on BLOOD
floor of ventricles)
● The valves of the heart open and
close in response to pressure
changes as the heart contracts and
relaxes

● When one set of valves is open, the

other set is closed

AV VALVE MECHANICS
● Ventricles relax, pressure drops,
semilunar valves close, AV valves
 open, blood flows from atria to
ventricles
● Ventricles contract, AV valves close
(papillary m. contract and pull on
chordae tendineae to prevent
prolapse), pressure rises, semilunar
valves open, blood flows into great
vessels

NOTE: SYSTOLE, DIASTOLE

OPERATION OF HEART VALVES

VALVE PATHOLOGY
1. Stenosis
- narrowing of heart valve
opening that restricts blood
flow;
- stiff= heart workload
increased

2. Insufficient/ Incompetent Valve

- failure of valve to close
completely backflow and
repump

3. Lup Dub Heart Sound

LOCATION OF HEART VALVES

EXAMPLES OF VALVE PATHOLOGY
1. Mitral Stenosis
- scar formation; congenital
anomaly
2. Mitral Insufficiency
● Aortic stenosis, aortic insufficiency
(aorta >> left ventricle)
● Rheumatic fever – streptococcal
infection of throat; bacteria trigger an
immune response in which
antibodies produced attack and
inflame connective tissues in joints,
heart valves (aortic, mitral)
● Can be replaced
 HEART SOUNDS
● Auscultation
– act of listening to heart sounds
● Due to vibrations in the blood
caused by valves closing and
opening
● Four sounds but only two loud
enough to hear by stethoscope (S1
and S2)

• S1 = lub = long, booming sound AV

valves closing (mitral and tricuspid)

• S2 = dub = short, sharp sound SL

valves closing (aortic and
pulmonary)

• S3 blood turbulence during

ventricular filling (relaxed)

• S4 blood turbulence during atrial

systole/ventricular filling (active)
 abnormal blood flow across the
heart valve.

● Innocent murmurs – murmurs

present without any medical or heart
conditions (childhood murmurs,
pregnancy)

Causes – Valvular heart diseases –

most common; cardiomyopathy;
septal defect

Functional causes – anemia,

hyperthyroidism

SYSTOLIC MURMURS
- Derived from increased
turbulence associated with:

1. Increased flow across normal SL

valve or into a dilated great vessel

2. Flow across an abnormal SL

valve or narrowed ventricular outflow
tract - e.g. aortic stenosis

3. Flow across an incompetent AV

valve - e.g. mitral regurgitation

4. Flow across the interventricular

septum

DIASTOLIC MURMURS
- Almost always indicate heart
disease

● Two basic types:

HEART MURMURS 1. Early decrescendo diastolic

● A heart murmur is a swishing sound murmurs
heard when there is turbulent or
 - signify regurgitant flow
through an incompetent
semilunar valve
• e.g. aortic regurgitation

2. Rumbling diastolic murmurs in

mid- or late diastole
- suggest stenosis of an AV
valve

THE HEARTBEAT
● Atria and ventricles contract in
coordinated manner
– Ensures correct blood flow
● Intercalated discs: junctions between
● 2 types of cardiac muscle cells cells anchor cardiac cells
involved: – Desmosomes prevent cells from
separating during contraction
1. Conducting system – electrical – Gap junctions allow ions to pass;
events electrically couple adjacent cells
• Control and coordinate activity of
contractile cells ● Heart muscle behaves as a
functional syncytium
2. Contractile cells – mechanical
events
• Produce powerful contractions that propel
blood

MICROSCOPIC ANATOMY OF CARDIAC

MUSCLE
● Cardiac muscle cells are striated,
short, fat, branched, and
interconnected
● Connective tissue matrix
(endomysium) connects to the
fibrous skeleton
● T tubules are wide but less
numerous; SR is simpler than in
skeletal muscle
● Numerous large mitochondria
(25–35% of cell volume)
REVIEW: ACTION POTENTIAL OF Ca2+ moves from interstitial fluid
SKELETAL MUSCLE AND NERVE into cytosol
● Ultimately triggers contraction
● Depolarization sustained due to
voltage-gated K+ channels
balancing Ca2+ inflow with K+
outflow

3. Repolarization
- recovery of resting membrane
potential
● Resembles that in other excitable
cellS
● Additional voltage-gated K+
channels open
● Outflow K+ of restores negative
resting membrane potential
CONTRACTILE MYOCARDIUM VS.
● Calcium channels closing
CONDUCTING MYOCARDIUM
Refractory period – time interval during
which second contraction cannot be
triggered
– Lasts longer than contraction itself
– Tetanus (maintained contraction) cannot
occur
Blood flow would cease

THE CONTRACTILE MYOCARDIUM

ACTION POTENTIALS AND CONTRACTION
FOR CONTRACTILE MYOCARDIUM
1. Depolarization
- contractile fibers have stable resting
membrane potential
● Voltage-gated fast Na+ channels
open – Na+ flows in
● Then deactivate and Na+ inflow
decreases

2. Plateau
- period of maintained depolarization
● Due in part to opening of
voltage-gated slow Ca2+ channels –
CONTRACTILE MYOCARDIUM VS
CONDUCTING MYOCARDIUM
THE CONDUCTING MYOCARDIUM
● Cardiac muscle tissue contracts on
its own
– Does not need hormonal or neural
stimulation
● These will change the force
– Called automaticity or autorhythmicity
● Repeatedly generate action
potentials that trigger heart
contractions
– Have unstable resting potentials called
pacemaker potentials
– Use calcium influx (rather than sodium) for
rising phase of the action potential
PACEMAKER AND ACTION POTENTIALS
OF THE CONDUCTING MYOCARDIUM
THE CONDUCTING SYSTEM
- Made up of two types of cells that do
not contract:
1. Nodal cells (responsible for
establishing rate of contraction)
2. Conducting cells (distribute the
contractile stimulus to general
myocardium)
SEQUENCE OF EXCITATION
● Sinoatrial (SA) node generates
impulses about 90-100 action
potentials per minute
● Atrioventricular (AV) node delays the
impulse approximately 0.1 second;
40-50 action potentials per minute
● Impulse passes from atria to
ventricles via the atrioventricular
bundle (bundle of His);20-40 action
potentials per minute
– AV bundle splits into two pathways
in the interventricular septum
(bundle branches)
1. Bundle branches carry the
impulse toward the apex of the heart
2. Purkinje fibers carry the impulse
to the heart apex and ventricular
walls

ELECTRICAL CONDUCTION IN HEART
- Atria contract as single unit followed
after brief delay by a synchronized
ventricular contraction
CLINICAL CLASSIFICATION OF
ARRHYTHMIAS
● Heart rate (increased/decreased)
Bradycardia – heart rate slow (<60
beats/min)
Tachycardia – heart rate fast (>100
beats/min)
● Heart rhythm (regular/irregular)
● Site of origin (supraventricular /
ventricular)
● Complexes on ECG (narrow/broad)

SINUS RHYTHM
● Sinoatrial node is cardiac
Pacemaker
● Normal sinus rhythm 60- 100
beats/min
● Cardiac arrhythmia is an abnormality
of the heart rhythm