ANATOMY AND

PHYSIOLOGY II
UNIT 1: METABOLISM IN MAINTENACE OF THE BODY AND
SYSTEMS
1.1
CARDIOVASCULAR
SYSTEM
MRS DEBORAH M. MWANGO
INTRODUCTION
•The cardiovascular system consists of two components,
namely, the heart (a powerful pump) which pumps blood
to all parts of the body, and the blood vessels through
which the blood flows, taking oxygen and nutrients to all
body cells and removing wastes products .
CONT…
A functional cardiovascular system is vital for survival
because without blood circulation, tissues lack a supply
of oxygen and nutrients, and wastes products
accumulate. Under such conditions the cells soon begin
irreversible changes, which quickly leads to death.
General Objective
• To equip students with knowledge of basic principles
of anatomy and physiology of the Cardiovascular
system
Specific objectives
At the end of this unit, students should be able to;
• Describe the structure and function of the heart
• Discuss the blood vessels
• Describe cell respiration
• Describe systemic circulation
• Describe Pulmonary circulation
• Describe Portal circulation
THE HEART
•It is a hollow, cone-shaped, muscular organ about the size
of a fist.
•It is about 14cm long, 9cm wide. It weighs about;
- 280grames to 340grames in men
- 230grames to 280grames in women
Position
•The heart is located in the thoracic cavity between the lungs within the
mediastinum. The base, which is the widest part of the heart is superior
to the apex (the pointed tip) which rests on the diaphragm.

•The heart is on a slant, that is, the base is directed toward the right
shoulder, and the apex points to the left hip. The base is deep to the
second rib, and the apex is at the level of the fifth intercostal space.
Organs associated with the Heart.
•Inferiorly – Diaphragm
•Superiorly – Aorta, Superior vena cava, pulmonary artery and
pulmonary vein
•Posteriorly – Oesophagus, Trachea, left and right bronchi,
descending aorta, inferior vena cava and Thoracic vertebrae
•Anteriorly – Sternum, ribs and intercostal muscles
•Laterally - Lungs
Structure of the Heart
•The Heart wall
• The heart wall is composed of three layers of tissue,
namely pericardium, myocardium and endocardium.
Pericardium
•This is the outermost layer and is made up of 2 sacs. The
outer sac known as the Fibrous pericardium consists of
fibrous tissue and the inner sac known as the serous
pericardium is made up of a continuous double layer of
serous membrane.
CONT…
• The outer fibrous sac is continuous with the tunica
adventitia of the great blood vessels above and is adherent
to the diaphragm below. Its inelastic, fibrous nature
prevents overdistension of the heart.
CONT…
• The serous pericardium is a membrane formed by a single layer of
endothelial cells, folded over itself so that it forms a double
membrane around the heart, with an enclosed space in between the
layers. The outer layer is called parietal pericardium and the inner
layer is called visceral pericardium which is adherent to the heart
muscle.
CONT…
•The serous membrane consists of epithelial cells which
secrete a serous fluid into the space between the visceral
and parietal layers (pericardial cavity) which allows smooth
movement between them as the heart beats.
Myocardium
•The myocardium is composed of specialized cardiac muscle found only
in the heart. It is not under voluntary control but, like skeletal muscle,
cross-stripes are seen on microscopic examination.

•Each fibre (cell) has a nucleus and one or more branches. The ends of
the cells and their branches are in very close contact with the ends
and branches of adjacent cells.
CONT…
•Because of the end-to-end continuity of the fibres, each
one does not need to have a separate nerve supply. When
an impulse is initiated it spreads from cell to cell via the
branches and intercalated discs over the whole 'sheet' of
muscle, causing contraction.
CONT…
• The myocardium is thickest at the apex and thins out towards the
base. This reflects the amount of work each chamber contributes to
the pumping of blood.

• The wall of the left ventricle is thicker than the right because it has to
pump blood around the body, whereas the right ventricle pumps
blood under low pressure, only to the lungs.
Endocardium
• This lines the chambers of the heart. It is a thin smooth membrane
to ensure smooth flow of blood through the heart. It consists of
flattened epithelial cells and is continuous with the endothelial lining
of the blood vessels.
Internal structures of the Heart
• The heart is divided into a right and left side by the septum,
a partition consisting of myocardium covered by
endocardium. Each side is divided by an atrioventricular
valve into an upper chamber, the atrium, and a lower
chamber, the ventricle.
CONT…
•The atrioventricular valves are formed by double folds of
endocardium strengthened by a little fibrous tissue. The right
atrioventricular valve (tricuspid valve) has three flaps or cusps and
the left atrioventricular valve (mitral valve) has two cusps.

•Flow of blood in the heart is one-way! Blood enters the heart via the
Atria and passes into the Ventricles below.
CONT…
• The valves between the atria and ventricles open and close
passively according to changes in pressure in the chambers.
They open when the pressure in the atria is greater than
that in the ventricles.
CONT…
•During ventricular systole (contraction), the pressure in the
ventricles rises above that in the atria and the valves snap
shut preventing backward flow of blood.
CONT…
•The valves are prevented from opening upwards into the
atria by tendinous cords, called chordae tendineae, which
extend from the inferior surface of the cusps to little
projections of myocardium covered with endothelium,
called papillary muscles.
Functions of the heart
• Keeps oxygen-poor blood separate from oxygen-rich blood

• Keeps the blood flowing in one direction, that is, blood flows away
from and then back to the heart in each circuit

• Creates blood pressure, which moves the blood through the circuits

• Regulates the blood supply based on the current needs of the body.
Flow of blood through
the Heart
CONT…
•The two largest veins of the body, the superior and inferior venae
cavae, empty their contents into the right atrium. This blood
passes via the right atrioventricular valve into the right ventricle,
and from there it is pumped into the pulmonary artery or trunk
(the only artery in the body which carries deoxygenated blood).
CONT…
•The opening of the pulmonary artery is guarded by the
pulmonary valve, formed by three semilunar cusps. This
valve prevents the back flow of blood into the right ventricle
when the ventricular muscle relaxes.
CONT…
• After leaving the heart the pulmonary artery divides into
left and right pulmonary arteries, which carry the venous
blood to the lungs where exchange of gases takes place:
carbon dioxide is excreted and oxygen is absorbed.
CONT…
• Two pulmonary veins from each lung carry oxygenated
blood back to the left atrium. Blood then passes through the
left atrioventricular valve into the left ventricle, and from
there it is pumped into the aorta, the first artery of the
general circulation.
CONT…
• The opening of the aorta is guarded by the aortic valve,
formed by three semilunar cusps, which prevents blood
flowing back into the left ventricle at the end of each
contraction.
CONT…
•In summary, blood passes from the right to the left side of
the heart via the lungs or pulmonary circulation.

•Note that both atria contract at the same time and this is
followed by the simultaneous contraction of both ventricles.
Blood supply to the heart ( the Coronary
Circulation)
•Arterial Supply

•The heart is supplied with arterial blood by the right and

left coronary arteries, which branch from the aorta
immediately distal to the aortic valve.
CONT…
The coronary arteries receive about 5% of the blood
pumped from the heart, although the size of the heart is
relatively small in size. This large blood supply of which most
goes to the left ventricle, highlights the importance of the
heart to the body function.
CONT…
• The coronary arteries branch throughout the heart,
forming a vast network of capillaries.
CONT…
•Venous Drainage

•Most of the venous blood is collected into a number of

cardiac veins that join to form the coronary sinus, which
opens into the right atrium. The remainder passes directly
into the heart chambers through little venous channels.
That’s it for today!!!!!!!!!!!!
Assignment:
Read on the following;
1. Cardiac conducting system
2. Cardiac cycle
Cardiac conducting
system
MRS DEBORAH M. MWANGO
Introduction
• The heart generates its own electrical impulses and

beats independently of the nervous or hormonal

control. This means that the heart is not reliant on

external mechanism to initiate each heartbeat.

Cont…
• The heart muscle is supplied by both the sympathetic and
parasympathetic nerve fibres which increase and decrease
the heart rate.

• It also responds to a number of circulating hormones

including adrenaline, epinephrine and thyroxine.
Cont…
•Small groups of specialized neuromuscular cells in the
myocardium initiate and conduct impulses, causing
coordinated and synchronized contraction of the heart
muscle.
Sinoatrial Node
•The sinoatrial node (SA node) is a mass of specialized cells that lie in
the wall of the right atrium near the opening of the superior vena
cava.

• The sinoatrial cells generate regular impulses due to their nature of

being electronically unstable. This instability leads them to discharge
regularly, usually between 60 and 90 times a minute.
Cont…
• The SA node discharges faster than any other part of
the heart. It sets the heart rate, hence is called the
‘pace maker of the heart’.

•Firing of the SA node triggers atrial contraction.

 Atrioventricular node
• The atrioventricular node (AV node) is a small mass

of neuromuscular tissue that is situated in the wall of

the atrial septum near the atrioventricular valves.
CONT…
• It normally transmits the electrical signals from the atria into
the ventricles.

• There is a delay of 0.1 seconds in electrical signal transmission

as the signal passes through into the ventricles. This allows the
atria to finish contracting before the ventricles start.
CONT…
•The AV node also has a secondary pacemaker function and
takes over this role if there is a problem with the SA node
itself or with the transmission of impulses from the atria.

• Its intrinsic firing rate is slower than that set by the SA node
(40 to 60 beats per minute)
Atrioventricular Bundle
• The atrioventricular bundle (AV bundle or Bundle of His) is a
mass of specialized fibres that originates from the AV node.

• It passes through the fibrous ring that separates atria and

ventricles then, at the upper end of the ventricular septum,
it divides into right and left bundle branches.
Cont…
• Within the ventricular myocardium the branches break up into fine
fibres called Purkinje fibres.

• The AV bundle, bundle branches and Purkinje fibres transmit electrical

impulses from the AV node to the apex of the myocardium, where the
wave of ventricular contraction begins; it then sweeps upwards and
outwards, pumping blood into the pulmonary artery and the aorta.
Nerve supply to the heart
• The heart is influenced by sympathetic and parasympathetic nerves
originating in the cardiovascular centre in the medulla oblongata.

• The vagus nerve (parasympathetic) supplies mainly the SA and AV nodes

and atrial muscle. This reduces the rate of SA node firing, decreasing the
rate and force of the heartbeat.

• Sympathetic nerves supply the SA and AV nodes and the myocardium and
this increases the rate and force of the heartbeat.
Factors affecting heart rate
• Autonomic nervous system - As described above, the rate
at which the heart beats is a balance of sympathetic and
parasympathetic activity and this is the most important
factor in determining heart rate.
CONT…
• Circulating chemicals - The hormones adrenaline and
noradrenaline, secreted by the adrenal medulla, have the same
effect as sympathetic stimulation, i.e. they increase the heart rate.
Other hormones including thyroxine increase heart rate by their
metabolic effect. Some drugs, dissolved gases and electrolytes in the
blood may either increase or decrease the heart rate.
CONT…
• Position - When the person is upright, the heart rate is
usually faster than when lying down.

• Exercise - Active muscles need more blood than resting

muscles and this is achieved by an increased heart rate and
selective vasodilatation.
CONT…
•Emotional states - During excitement, fear or anxiety the
heart rate is increased. Other effects mediated by the
sympathetic nervous system may be present.
CONT…
•Gender - The heart rate is faster in women than men.

• Age - In babies and small children the heart rate is more

rapid than in older children and adults.
 Heart Sounds
• There are four heart sounds, each corresponding to a
particular event in the cardiac cycle.

•The first two are the most distinguished and through the
stethoscope sound like ‘Lub-Dup’.
Cont…
•The first sound, ‘Lub’ is fairly loud and is due to the closure of the
atrioventricular valves. It corresponds to the start of a ventricular
systole.

•The second sound, ‘Dup’, is softer and is due to the closure of the
aortic and pulmonary valves. It corresponds with the ventricular
diastole.
Assignment
Read and write notes on the following:
1. Cardiac output
2. Stroke volume
3. Venous return