NCM112j - Disturbances in Oxygenation Cardio System, Peripheral Vascular, Fluid and Electrolytes
Module 1: Overview of Anatomy and Physiology of the Heart
The Cardiovascular System contains pericardial fluid that
Functions: lubricates the lining of the heart
The heart pumps blood consists of two layers:
Blood vessels allow blood to circulate 1. Visceral pericardium-
to all parts of the body. adheres to the epicardium.
Cardiovascular system is to deliver 2. Parietal pericardium - supports
oxygen and nutrients and to remove the heart in the mediastinum
carbon dioxide and other waste
products.
THE HEART
Hollow, muscular organ
Weighs approximately 300 g
Occupies the space between the
lungs (mediastinum) and rests on the
diaphragm.
The heart pumps blood to the tissues
supplying them with oxygen and
other nutrients.
TWO CHAMBERS OF THE HEART
Location of the heart 1. UPPER
The heart : Atrium
Occupies the space between the Collecting/ receiving chamber
lungs (mediastinum : space in the 2. LOWER
chest that holds the heart , it’s the Ventricles
middle section of the thoracic cavity Pumping / contracting chamber
bet the left and right pleural cavities
which hold the lungs. ) and rests on
Pumping action of the Heart
the diaphragm.
• is accomplished by the rhythmic
relaxation and contraction.
3 LAYERS OF THE HEART
Systole - refers to the events in the
1. Endocardium – lines the inside of
heart during contraction of the two top
the heart and valves
chambers (atria) and two bottom
2. Myocardium _ is made up of
chambers (ventricles)
fibers, is responsible for the
Diastole - characterized by relaxation
contraction.
of the four chambers simultaneously,
3. Epicardium – exterior layer of the
which allows the ventricles to fill in
heart in which the pericardium can
preparation for contraction.
be found.
- Outermost
MYOCARDIAL THICKNESS AND
- External coronary arteries are located
FUNCTION
ATRIA: THIN WALLED
Pericardium
VENTRICLES: THICK WALLED
thin layer of fibrous tissue
LT VENTRICLE IS THICKER THAN
THE RT VENTRICLE.
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NCM112j - Disturbances in Oxygenation Cardio System, Peripheral Vascular, Fluid and Electrolytes
Module 1: Overview of Anatomy and Physiology of the Heart
Bicuspid / mitral valve: Located
between the Left Atrium and Left
Ventricle
Functions of the heart Valves:
prevents backflow of blood.
Acts as one- way inlets of blood on
Heart Valves one side of the ventricle and one-way
outlets of blood on the other side of a
ventricle.
Valves are flaps located on each side
of the 2 ventricles (lower chambers
of the heart.
Coronary Arteries
2 types of cardiac valves:
1. Atrioventricular
Tricuspid (right side of the heart)
Bicuspid or mitral (left side of the
heart)
2. Semilunar
Aortic valve: between the left
ventricle and the aorta supply blood to the myocardium
Pulmonic valve: located between (heart muscle).
right ventricle and pulmonary artery CA blood flow to the myocardium
Valves open during ventricular systole occurs during diastole.
and close during ventricular diastole During diastole blood enters the CA
(ventricles relax). which is called diastolic filling.
Prevent blood from flowing back work continuously (as opposed to
other muscles of the body, which are
Heart Valves often at rest), the heart muscle has a
1. AV valves: very high requirement for oxygen and
close at the beginning of ventricular nutrients and therefore requires a
contraction and prevent blood from very reliable, continuous supply of
flowing back into the atria from blood.
ventricles, these valves open when
ventricles relax. Coronary arteries
Tricuspid valve: located between 1. right main Coronary artery
Right atrium and Right Ventricle. supplies;
- right atrium
- inferior portion of the left ventricle
- post portion of septal wall
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NCM112j - Disturbances in Oxygenation Cardio System, Peripheral Vascular, Fluid and Electrolytes
Module 1: Overview of Anatomy and Physiology of the Heart
- SA / AV nodes
2. Left main Coronary artery (2
branches)
- Left anterior descending artery
(supplies blood to anterior wall of
LV)
- Circumflex artery (supplies blood
Left atrium and Lateral and
posterior surfaces of LV.
The Blood supply of the heart comes
from the Coronary arteries.
1. Right coronary artery: right
atrium, inferior wall (right ventricle)
2. Left coronary artery
- circumflex: lateral wall (left vent)
- anterior descending - anterior surf
(left vent)
The venous drainage of the heart
1. Cardiac veins
Coronary arteries originate from the aorta. 2. Coronary sinus
2 main coronary arteries: Left coronary
artery (LCA) and Right Coronary Artery SYSTEMIC AND PULMONARY
(RCA) CIRCULATION
LCA divides into two branches : 1. LEFT SIDE IS A PUMP TO THE
Circumflex coronary artery and the Left SYSTEMIC CIRCULATION.
anterior descending artery ( LADA) RIGHT SIDE IS A PUMP TO THE
RCA supplies the right atrium right PULMONARY CIRCULATION.
ventricle, portion of the septum , SA
node, AV node and inferior portion of the Systemic and Pulmonary
left ventricle. Circulation
CCA supplies the ff: Left atrium, posterior Pulmonary Circulation
lateral surface of the ventricle. moves blood between the heart and
LADA supplies the anterior wall of the left the lungs. It transports deoxygenated
ventricle, the anterior intervertebral blood to the lungs to absorb oxygen
septum, anterior papillary and apex of the and release carbon dioxide. The
heart. oxygenated blood then flows back to
the heart.
Blood Supply Systemic Circulation
moves blood between the heart and
the rest of the body.
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NCM112j - Disturbances in Oxygenation Cardio System, Peripheral Vascular, Fluid and Electrolytes
Module 1: Overview of Anatomy and Physiology of the Heart
Electrophysiologic Properties of the
Heart (Cardiac Cells) 1. SA node: normal pacemaker of the
1. AUTOMATICITY (Rhythm): ability heart. (location: junction of SVC and
to initiate an electrical impulse right Atrium
2. EXCITABILITY (response): ability 2. function: pacemaker of the heart
to respond to an electrical impulse initiates 60- 100 beats per minute
3. CONDUCTIVITY (Electrical 3. AV node: Location: interatrial
impulse): ability to transmit an septum, delays impulse to allow
electrical impulse from one cell to ventricular filling of 0.8 milliseconds
another. 4. Bundle of HIS: Location:
4. CONTRACTILITY (chemical Interventricular septum, branches
energy into mechanical work): out into right main bunble and left
ability of cardiac cells to respond to main bundle branch
an impulse by contracting 5. Purkinje fibers: Located walls of
5. Refractoriness: no stimulation ventricles, fastest conduction is 20 to
contraction : Inability of the cardiac 40 beats/min, can function as a
cells to response to a new stimulus backup pacemaker if other
while it is still in contraction in pacemakers fail.
response to previous stimulus). SA node triggers electrical
impulses at a rate of 60- 100
THE CONDUCTION SYSTEM bpm. Atria is then depolarized, and
Is a network of nodes impulse is transmitted via the
INHERENT AND RHYTHMICAL BEAT internodal tracts into the AV node the
IS DUE TO AUTORHYTHMIC FIBERS impulse is delayed in the av node
OF THE CARDIAC MUSCLE. which enables atrial contraction to
THESE FIBERS HAVE 2 IMPORTANT complete before the ventricles are
FUNCTIONS stimulated to contract. The electrical
1. ACT AS PACEMAKER (generates impulses then transmitted into the
electrical signal that causes the atria bundle of his and into the purkinje
to contract) which controls the fibers.
heartbeat.
2. FORM THE CONDUCTION SYSTEM Heart Sounds
Conducting cells carry the electrical 1. First heart sound (S1)
signals. heard as the AV close and heard
loudest at the apex of the heart
Conduction System of Heart 2. Second heart sound (S2)
heard when semilunar valves close
and heard the loudest at the base of
the heart
3. Third heart sound (S3)
Heard if ventricular compliance is
decrease, ventricular wall vibrate
such as in CHF.
Normal in individuals younger than
30 years old
4. Fourth heart sound (S4)
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NCM112j - Disturbances in Oxygenation Cardio System, Peripheral Vascular, Fluid and Electrolytes
Module 1: Overview of Anatomy and Physiology of the Heart
Resistance to ventricular filling Degree of myocardial stretch at the
(cardiac hypertrophy) end of diastole and just before
contraction Determined by the
amount of blood returning to the
heart from venous and pulmonary
system
STARLING’S LAW
The more the heart is filled during
diastole the more forcefully it
contracts.
AFTERLOAD
Pressure or resistance that the
ventricles must overcome to eject
blood through the semilunar valves.
Directly proportional to the BP and
diameter of blood vessels.
CONTRACTILITY
Force generated by the contracting
myocardium.
Enhanced by sympathetic activity and
Mechanical Properties of the Heart
medicatios; 3D’s ( digoxin, dopamine,
1. Cardiac Output (CO)
dobutamine)
Amount of blood(liters) pumped by
each side of the heart in one minute
Cardiac Cycle
5L /min
the performance of the human heart
During exercise (may Increase
from the beginning of one heartbeat
fourfold to 20 L/min
to the beginning of the next.
CO = Heart rate [HR]) x Stroke
It consists of two periods:
volume [SV])
- one during which the heart muscle
2. Stroke Volume
relaxes and refills with blood, called
Volume of blood pumped/ ejected by
diastole,
each ventricle in one contraction
- following a period of robust
(systole)
contraction and pumping of blood,
called systole.
Heartbeat (Pulse Rate)
After emptying, the heart relaxes and
Contraction of the atria and the
expands to receive another influx of
ventricles.
blood returning from the lungs and
Number of times the ventricles
other systems of the body, before
contract each minute ü60 - 100
again contracting to pump blood to
beats/min
the lungs and those systems.
controlled by the ANS
Stroke Volume
Amount of blood ejected by the left
ventricle during each systole
Preload
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NCM112j - Disturbances in Oxygenation Cardio System, Peripheral Vascular, Fluid and Electrolytes
Module 1: Overview of Anatomy and Physiology of the Heart
Baroreceptors are specialized nerve
cells located in the aortic arch and in
both right and left internal carotid
arteries. The baroreceptors are
sensitive to changes in blood
pressure.
ATRIAL SYSTOLE Normally Decrease water intake,
LASTS FOR 0.1 SEC increases Blood osmolality
ATRIAL DEPOLARIZATION CAUSES (concentration of dissolved particles
ATRIAL SYSTOLE in the blood)
Atrial systole: both atria contract Stim. Pituitary gland to release ADH
and force the blood from the atria ADH receptor site (Kidneys)---
into the ventricles. Action: Increased reabsorption of
IT CONTRIBUTES A FINAL 25mL OF H2O, decrease urine volume/output
BLOOD TO EACH VENTRICLE ----returns blood osmolality to normal
END OF ATRIAL SYSTOLE IS ALSO
END OF VENTRICULAR DIASTOLE ADH: vasopressin
END-DIASTOLIC VOLUME IS 130 mL. Release triggered by osmoreceptors
(thirst center-hypothalamus)
Fluid volume excess -- decreased
ADH
Fluid volume deficit -- increased ADH
VENTRICULAR SYSTOLE
LASTS FOR 0.3 SEC
both ventricles contract, blood is
forced to the lungs via the pulmonary
trunk, and the rest of the body via Baroreceptor Reflex:
the aorta. Respond to a fall in arterial blood
IT IS CAUSED BY VENTRICULAR pressure
DEPOLARIZATION Located in the atrial walls, vena cava,
ISOVOLUMETRIC CONTRACTION aortic arch and carotid sinus
LASTS FOR 0.05 SECONDS WHEN Constricts afferent arterioles of the
BOTH THE SEMILUNAR AND kidney resulting in retention of fluid
ATRIOVENTRICULAR VLAVES ARE
CLOSED.
Regulation Blood Volume
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NCM112j - Disturbances in Oxygenation Cardio System, Peripheral Vascular, Fluid and Electrolytes
Module 1: Overview of Anatomy and Physiology of the Heart
