Anatomy of the cardiovascular system
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Anatomy of the Cardiovascular System. Cardiovascular System. Also circulatory system Consists of: the heart , arteries , veins , capil laries. Heart. Four chamber muscular organ Comparable to the size of a closed fist Located in the mediastinum. Heart. Coverings of the Heart.

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Cardiovascular system
Cardiovascular System

  • Also circulatory system

  • Consists of: the heart, arteries, veins, capillaries


Heart
Heart

  • Four chamber muscular organ

  • Comparable to the size of a closed fist

  • Located in the mediastinum



Coverings of the heart
Coverings of the Heart

  • Pericardium – loose fitting sac surrounding the heart

    • Fibrous pericardium – tough, loose-fitting, inelastic

    • Serous pericardium

      • Parietal layer: lines the inside of the fibrous pericardium

      • Visceral layer: adheres to outside of the heart

    • Pericardial space: between parietal and visceral layer

      • Filled with 10-15mL of pericardial fluid

      • Decreases friction


Walls of the heart
Walls of the Heart

  • Epicardium – outer layer

    • Epicardium = serous pericardium

  • Myocardium – thick, contractile layer composed of cardiac muscle cells

  • Endocaridium – interior of cardiac wall



Chambers of the heart
Chambers of the Heart

  • Atria – two superior chambers

    • “Receiving chambers”

    • Blood from veins enters atria

  • Ventricles – two inferior chambers

    • “pumping chambers”

    • Separated by interventricular septum


Valves of the heart
Valves of the Heart

  • Permit blood flow in one direction during circulation

  • Atrioventricular valves (AV valves)

    • Also cuspid valves

    • Between atria and ventricles

  • Semilunar (SL valves)

    • Between ventricles and vessles


Chambers valves
Chambers & Valves

Trace the blood flow through the heart


Blood supply to the heart
Blood Supply to the Heart

  • After traveling through the capillaries of the heart, blood empties into the R atrium via the coronary sinus


Conduction system of the heart
Conduction System of the Heart

  • Four structures composed of modified cardiac muscle

  • Sinoatrial Node (SA Node)

    • Pacemaker of the heart

    • 100s of cells in the R atrium near the opening of the superior vena cava

  • Atrioventricular Node (AV Node)

    • Left lower border of R atrium


Conduction system of the heart1
Conduction System of the Heart

  • Atrioventricular Bundle

    • Also Bundle of His

    • Bundle of specialized cardiac muscle fibers originating in the AV node

    • Branches into R and L branches eventually becoming Purkinje fibers

    • Extend into the walls of the ventricles and papillary muscles


Types of blood vessels
Types of Blood Vessels

  • Artery – carries oxygenated blood away from the heart

    • Arteriole: small artery

    • Precapillary sphincters: regulate the blood flow into capillaries


Types of blood vessels1
Types of Blood Vessels

  • Vein – carries unoxygenated blood towards the heart

    • Great ability to stretch (capacitance)

    • Function as reservoirs: blood pools in the valves then is pushed forward from the pumping pressure

    • Venules: small vein



Types of blood vessels3
Types of Blood Vessels

  • Capillaries – arterial system switches to venous system

    • “primary exchange vessels”

    • Transport materials to and from the cells

    • Speed of blood flow decreases to increase contact time



Structure of blood vessels
Structure of Blood Vessels

  • Tunica adventitia - outermost layer

    • Fibrous connective tissue

    • Holds vessels open; prevents tearing of vessels walls during body movements

    • Larger in veins than arteries

  • Tunica media – middle layer

    • Smooth muscle and elastic CT

    • Helps vessels constrict and dilate

    • Larger in arteries


Structure of blood vessels1
Structure of Blood Vessels

  • Tunica intima – innermost layer

    • Composed of endothelium

    • Semilunar valves present in veins

    • One cell thick in capillaries


Circulatory routes
Circulatory Routes

  • Systemic Circulation – blood flow from the L ventricle to the body & back to the R atrium

  • Pulmonary Circulation – blood flow from the R ventricle to the lungs and back to the L atrium




Systemic arteries

Arch of aorta

Subclavian (L and R)

Brachiocephalic

common carotid (L and R)

Axillary (L and R)

Brachial (L and R)

Radial

Ulnar

Abdominal aorta

Common iliac

External iliac

Femoral

Popliteal

Posterior tibial

Anterior tibial

Dorsal pedis

Systemic Arteries


Systemic veins

Superior vena cava

Inferior vena cava

External jugular

Internal jugular

Brachiocephalic (L and R)

Subclavian (L and R)

Cephalic

axillary

Basilic

Median basilic

Median cubital

Common iliac

External iliac

Femoral

Popliteal

Great saphenous

Small saphenous

Systemic Veins


Fetal circulation
Fetal Circulation

  • Two umbilical arteries carry blood to the placenta

  • The placenta allows for exchange of oxygen and nutrients from the mother. Maternal and fetal blood do NOT mix.

  • Umbilical vein returns oxygenated blood and enters fetus via the umbilicus

  • Foramen ovale – hole btwn the R and L atria

    • Allows for blood to bypass the R ventricle and pulmonary circulation


Changes after birth
Changes After Birth

  • Umbilical vein become round ligament

  • Umbilical arteries become umbilical ligaments

  • Foramen ovale closes after first few breaths

    • Full closure may take up to 9 months

  • Ductus arteriosus contracts as soon as respirations begin

    • Become fibrous cord


Pericardium disorders
Pericardium Disorders

  • Pericarditis – inflammation of the heart

    • Causes: trauma, viral or bacteria infection, tumor

    • Edema causes visceral and parietal layers to rub together = chest pain

    • Pus or blood build up in pericardial space

    • S/S

      • Pain with respirations or coughing, dyspnea, restlessness

    • Complications: Pericardial Effusion, Cardiac Tamponade

    • Treatment:

      • Antibiotics, pain meds, antiinflammatory meds, pericardiocentesis (Cardiac Tamponade)



Heart valve disorders
Heart Valve Disorders

  • General Principles:

    • Congenital defect: decreased pumping efficiency

    • Incompetent valve leak: allows backflow into previous chamber

    • Stenosed valves: narrowed valve; slowing blood from out of chamber


Heart valve disorders1
Heart Valve Disorders

  • Mitral Valve Prolapse (MVP)

    • Flaps of mitral valve extend back into L atrium causes leaking

    • Mostly genetic basis

    • 1 in 20 people

    • S/S: most asymptomatic; chest pain, fatigue

    • Treatment: valvuloplasty



Heart valve disorders2
Heart Valve Disorders

  • Aortic Regurgitation

    • Blood leaks back into L ventricle during ejection into the aorta

    • Volume overload in L ventricle, hypertrophy, dilation of L ventricle

    • Complications: myocaridal ischemia

    • Treatment: valvuloplasty


Myocardium disorders
Myocardium Disorders

  • Atherosclerosis

    • Type of arteriosclerosis

    • Lipids build up on the inside of vessel walls  calcify  vessels hard & brittle

    • Risk factors: cigarette smoking, high fat/cholesterol diet, hypertension



Myocardium disorders1
Myocardium Disorders

  • Myocardial Infarction

    • “Heart Attack”

    • Coronary thrombosis: clot

    • Coronary embolism: mobilized clot

    • Occlude coronary artery  heart tissue deprived of oxygen  cell death

    • S/S:

      • Angina pectoris – severe chest pain resulting from inadequate oxygen to myocardium

    • Treatment: Coronary Bypass Surgery

      • Veins are harvested from other areas of the body and used to bypass obstructions


Myocardium disorders2
Myocardium Disorders

  • Congestive Heart Failure (CHF)

    • “Left-sided Heart Failure”

    • Inability of the L ventricle to pump blood efficiently

    • Causes: myocardial infarction

    • S/S: decreased pumping pressure in systemic circulation; retained fluids

      • Can lead to congestion in pulmonary circulation  pulmonary edema  right-sided heart failure

    • Treatment: heart transplant



Myocardium disorders3
Myocardium Disorders

  • Coronary Artery Disease (CAD)

    • Leading cause of death in US

    • General term to describe decreased blood flow to myocardium & associated side effects


Disorders of the arteries
Disorders of the Arteries

  • Arteriosclerosis

    • Arteries become occluded, weak and hardened

    • Complications: ischemia, necrosis, gangrene

    • Risk factors: age, diabetes, high fat/cholesterol diet, hypertension, smoking

    • Treatment: vasodilators, angioplasty, stent placement, bypass surgery

    • Complications: aneurysm



Disorders of veins
Disorders of Veins

  • Varicose Veins

    • Enlarged veins caused by pooling

    • Results in varicosities or varices (“spider veins”)

    • Risk factors: standing for long periods

      • Semilunar valves widen  more pooling

    • Treatment: compression stockings, surgical removal



Disorders of veins1
Disorders of Veins

  • Phlebitis – vein inflammation

    • Causes: irritation by IV catheter

  • Thrombophlebitis

    • Deep vein thrombosis (DVT)

    • Phlebitis caused by a clot

    • S/S

      • Pain, redness, swelling

    • Complications

      • Pulmonary embolism




Venous stasis ulcers
Venous Stasis Ulcers

  • Result of chronic vein insufficiency

  • Lack of oxygen to peripheral tissues

  • Elevate leg & apply pressure

  • Irregular edges

  • “Aching” pain













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