PH 131 Cardiovascular System || Bumanglag, Cabero, Cahanding, Caisido, Carino

PH 131 Cardiovascular System

Lecturer: Dr. Perla S. Macaraeg Date of Lecture: July 18, 2011

Transcribed by: Bumanglag, Cabero, Cahanding, Caisido, Carino

Gas, nutrient, and waste exchange occur across their thin walls (endothelium) D. The Veins 1. same three layers only less muscle 2. uphill against gravity 3. valves 4. vascular or venous sinus - no smooth muscle Venules are small veins that drain blood from the capillaries and then join to form a vein. The walls of veins and venules have the same 3 layers as arteries, but they are much thinner. Thinner walls allow veins to expand to a greater extent. Veins often have valves which allow blood to flow only toward the heart when open and prevent the backward flow of blood when closed. **Thicker walls: Arteries (+ thick tunica media) Veins thick tunica adventitia + valves preventing backflow (convolutions) Features of the Cardiovascular System The surge of blood entering the arteries causes their elastic walls to stretch and then recoil. This alternating stretching and recoiling of an arterial wall can be felt as a pulse in any artery that runs close to the bodys surface. Pulse can be felt by placing several fingers on the radial artery which lies near the outer border of the palm side of a wrist. A carotid artery, on either side of the trachea in the neck, is another accessible location for feeling the pulse. Normally the pulse rate indicates the rate of heartbeat because the arterial walls pulse whenever the left ventricle contracts. When these muscle fibers are contracted, the vessel is constricted. When they are relaxed, the vessel is dilated. Arteriole constriction or dilation affects blood pressure. C. The Capillaries -endothelium site of nutrient/gas/waste exchange -metarteriole and capillary sphincters -"vasomotion" intermittent blood flow Arterioles branch into capillaries. Capillaries are extremely narrow, microscopic blood vessels with a wall formed of one layer of simple squamous cells (endothelium) Capillary beds (networks of many capillaries) are present in all regions of the body. Blood pressure is the pressure of blood against the wall of a blood vessel. A sphygmomanometer which has a pressure cuff is used to measure blood pressure in the brachial artery of the arm. Systolic pressure is the highest arterial pressure reached during ejection of blood from the heart. Diastolic pressure is the lowest arterial pressure that occurs while the heart ventricles are relaxing. The pulse rate is usually 6080 beats per minute. Blood Flow

Cardiovascular System Heart and Blood Vessels I. The Blood Vessels A. The cardiovascular system has 3 types of blood vessels: 1. Arteries (and arterioles) which carry blood away from the heart to the capillaries. 2. The capillaries which permit exchange of nutrients, wastes, and gases with the tissues. 3. Veins (and venules) which return blood from the capillaries to the heart. B. The Arteries The arterial wall has 3 layers which are thick and resilient. 1) outer coat (tunica externa/adventitia) a) elastic & collagen fibers 2) middle coat (tunica media) a) usually thickest b) elastic fibers (elastin) & smooth muscle c) smooth muscle has sympathetic innervation -vasoconstriction & vasodilation 3) inner coat (tunica interna/intima) a) endothelium & basment membrane (intimate with blood cells) 4) large arteries (conducting) a) more elastic fibers, thinner b) "pressure reservoir" 5) medium arteries (distributing) a) more smooth muscle, thicker b) most vasodynamic 6) arterioles a) regulate blood into capillaries The strong walls of an artery give it support when blood enters under pressure. Divide into smaller arterioles small arteries just visible to the naked eye.

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PH 131 Cardiovascular System || Bumanglag, Cabero, Cahanding, Caisido, Carino

Normal resting blood pressure for a young adult is 120mm mercury (Hg) over 80 mm Hg or 120/80. The higher number is the systolic pressure and the lower number is the diastolic pressure. Blood pressure varies throughout the body. It is highest in the aorta and lowest in the vena cava. nated blood and not all veins carry deoxygenated blood. Since blood in the pulmonary arteries is oxygen poor and blood in the pulmonary veins is oxygen rich they serve as the exception. C. The Systemic Circuit -The aorta (artery) and vena cava (veins) are the main pathways for blood in the systemic circuit. Both systolic and diastolic pressure decrease with distance from the -The superior vena cava collects blood from the head, chest, and arms while left ventricle. the inferior vena cava collects blood from the lower body regions. Blood pressure is minimal in venules and veins. -Transport of oxygenated blood moves from left ventricle through aorta out to all Instead of blood pressure, venous return is dependent on skeletal tissues. muscle contraction, the presence of valves in veins, and respiratory -Deoxygenated blood returns from all tissues via vena cava. -The coronary arteries serve the heart muscle itself and are the first movements. branches off the - Pressure exerted on the vascular walls; taken quite far away from aorta. the <3; results when blood flow is met by resistance from the vessel -Coronary arteries lie on the external surface of the heart, where they divide into walls arterioles. Blood cells travelling @ the center = faster -Coronary veins collect deoxygenated blood from capillaries and Cells bumping @ inner wall = resistance = slower travel empty into the right Smaller space = greater resistance = increase in BP atrium. Thick blood/ Sticky plasma = stick on walls, obstruction = raises BP! - Important indicator of cardiovascular health - Pumping pressure of heart expressed as mm Hg PHYSIOLOGY OF THE HEART Parts: **The pulse you feel is actually a pressure wave which travels from the heart throughout the arteries; Pulse pressure = Systolic pressure Diastolic pressure; Tis the throb that you feel! a. Systolic BP (Systoleh) pressure exerted when ventricles contract (more powerful) b. Diastolic BP (Diastoleh) pressure exerted as ventricles relax

The Cardiovascular Pathways A. The cardiovascular system has 2 major circular pathways: The pulmonary circuit which circulates blood through the lungs and the systemic circuit which serves the needs of the body tissues. B. The Pulmonary Circuit Deoxygenated blood from the body collects in the right atrium and then passes into the right ventricle, which pumps it to pulmonary trunk. Pulmonary trunk divides into right and left pulmonary arteries to carry blood to each lung. In the pulmonary capillaries of the lungs, carbon dioxide is unloaded and oxygen is picked up by blood. Oxygenated blood from lungs is returned through pulmonary veins to left atrium. Carries deox. blood Superior vena cava Pulmonary artery Right atrium Right ventricle Carries oxygenated blood Aorta Pulmonary vein Left atrium Left ventricle *Left ventricle has thicker walls than the right due to the pressure caused by the presence of oxygen in the blood it contains. *Blood pathway: S. VENA CAVA -> TRICUSPID VALVE -> R. ATRIUM -> SEMILUNAR VALVE -> R. VENTRICLE -> P. ARTERY -> LUNGS -> P. VEIN -> L. ATRIUM -> BICUSPID/MITRAL VALVE Not all -> L. VENTRICLE -> SEMILUNAR VALVE -> AORTA -> BODY arterie s carry oxyge

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PH 131 Cardiovascular System || Bumanglag, Cabero, Cahanding, Caisido, Carino

Passage of Blood through the Heart Heart A. The heart is a cone-shaped, muscular organ about the size of a fist. B. It is located between the lungs directly behind the sternum (breast bone) and is tilted so the apex (pointed end) is directed left. C. Myocardium is the major portion of the heart consisting of cardiac muscle tissue. D. Heart lies within a pericardium sac that contains pericardial fluid which provides cushioning. E. Endocardium lines inner surface of the heart. F. Internal wall called the septum separates heart into right and left halves. G. Heart has 2 upper, thin-walled atria and 2 lower, thick-walled ventricles. Atria receive blood from the venous portion of the cardiovascular system. Atria are much smaller and weaker than muscular ventricles, but hold the same volume of blood. Ventricles pump blood into arterial portion of cardiovascular system. H. Heart valves direct flow of blood and prevent backward movement. Valves are supported by strong, fibrous tendons attached to muscular projections of ventricular walls. They support the valves and prevent them from inverting when the heart contracts. Atrioventricular valves occur between atria and ventricles and prevent back flow of blood from ventricle to atrium. Right atrioventricular or tricuspid valve on right side of heart consists of 3 cusps or flaps. Left atrioventricular or bicuspid (mitral) valve on left side of heart consists of 2 cusps or flaps. Semilunar valves have flaps that resemble half-moons and are located between the ventricles and their attached vessels. The pulmonary semilunar valve lies between the right ventricle and the pulmonary trunk. The aortic semilunar valve lies between the left ventricle and the aorta. *Unique to the heart is its AUTORHYTHMICITY (independently beat on its own; has its own system ran by its parts without the need of nerves or hormones) I. The heart is a double pump serving the lungs and the body circulations simultaneously. J. Since the left ventricle has the harder job of pumping blood throughout the body, its walls are thicker than those of the right ventricle. A. Oxygen-poor (deoxygenated) blood enters right atrium from both superior and inferior vena cava. B. Right atrium sends blood through right atrioventricular valve (tricuspid valve) to right ventricle. C. Right ventricle sends blood through pulmonary semilunar valve into pulmonary trunk. The pulmonary trunk divides into two pulmonary arteries that go to the lungs. D. Oxygen-rich (oxygenated) blood returns from lungs through pulmonary veins and is delivered to the left atrium. E. Left atrium sends blood through left atrioventricular valve (bicuspid or mitral valve) to left ventricle. F. Left ventricle sends blood through aortic semilunar valve into the aorta to the body proper through arteries. G. Oxygen-poor blood never mixes with oxygen-rich blood. H. Blood must go through the lungs in order to pass from the right side to the left side of the heart.

CONDUCTION SYSTEM

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PH 131 Cardiovascular System || Bumanglag, Cabero, Cahanding, Caisido, Carino

CARDIOINHIBITORY CENTER cardioinhibitory center of the medulla -> parasympathetic impulses -> Vagus nerve (a.k.a. brake 1. SinoAtrial NODE initiates heartbeat and controls its pace (70- of the heart) -> Ach -> decrease SA node pace 75 beats/min); below the atrial pericardium at its junction with the s. vena cava ; has intrinsic rhythm (w/o stimulation from brain or spinal CARDIOACCELERATOR CENTER cardioaccelerator center of cord via nerve signals or hormones, initiates own impulse at reg. the medulla -> sympathetic impulses -> sympathetic fibers (middle, superior, inferior cardiac nerves) -> norepinephrine -> increases SA intervals) node pace 2. INTERNODAL PATHWAY muscles of both atria contracts CARDIAC PRESSOREFLEXES baroreceptors (notice change in 3. AtrioVentricular NODE conduction slows down to allow pressure) in cardiovascular regions (aorta&carotid sinuses) -> afferent nerve fibers -> medullary control centers -> parasym or complete contraction of atria sympathetic outflow 4. AtrioVentricular BUNDLE bundle of His ; conduction increases *CAROTID SINUS REFLEX carotid sinus baroreceptors -> afferent fibers -> carotid sinus nerve (of Hering) -> 5. BUNDLE BRANCHES glossopharyngeal nerve -> cardioinhibitory center -> parasym 6. PURKINJE FIBERS conduction terminates ; conduct fibers of outflow both ventricles almost simultaneously *AORTIC REFLEX aortic baroreceptors -> afferent *Abnormal/Ectopic pacemakers they assume the role of the SA fibers -> aortic nerve -> vagus nerve -> cardioinhibitory center -> parasym outflow node if it fails to function normally; yields lower heart rate *Impulse pathway: *Artificial pacemakers attached inside the cardiovascular system FACTORS AFFECTING HEART RATE such as catheters ; sends electrical impulse *Emotions decrease (grief) or increase (anger) heart rate; through the influence of the cerebrum via the hypothalamus ELECTROCARDIOGRAM *Exercise increase heart rate *Blood temperature high temp: stimulates skin heat receptors, therefore increases HR; low temp: stimulates skin cold receptors, therefore decreases HR *Pain from visceral organs increases HR

The Heartbeat Each heartbeat is called a cardiac cycle. The heart contracts or beats about 70 times a minute. Each heartbeat lasts about 0.85 seconds. *Graphic record of hearts ACTION CURRENTS, not contractions (it A normal adult heart rate at rest can vary from 60 to 80 beats per precedes this) minute. *Parts: The heartbeat consists of phases: Systole refers to contraction of P-WAVE depolarization of atria (makes the system more positive heart chambers and Diastole is relaxation of heart chambers. due to influx of Na+) Atria contract first while ventricles relax (0.15 sec), then ventricles contract while T-WAVE - repolarization/relaxation of the ventricles (back to atria relax (0.30 sec), then all chambers rest (0.40 sec). original negativity of the system; K+ exits) When the heart beats, the familiar lub-dup sound is heard as valves of the heart close. ***The intervals between these represents heart rate QRS-COMPLEX depolarization of the ventricles CONTROL OF HEART RATE ANS CONTROL: Lub is caused by vibrations occurring when the atrioventricular valves close due to ventricular contraction.

*Parasympathetic inhibitory; lowers heart rate with Ach released Dup is heard when the semilunar valves close due to back pressure of blood by the Vagus nerve in the arteries. *Sympathetic stimulatory; increases heart rate with norepinephrine released by accelerator nerves

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PH 131 Cardiovascular System || Bumanglag, Cabero, Cahanding, Caisido, Carino

A heart murmur is often due to ineffective valves, which allow blood to pass back into the atria after the atrioventricular valves have closed Rhythmical contraction of the atria and ventricles is due to the intrinsic conduction system of the heart. SA (Sinoatrial) node is found in the upper dorsal wall of the right atrium. It initiates the heartbeat by sending out an excitatory impulse every 0.85 seconds that cause atria to contract. It is called the pacemaker because it serves to keep the heartbeat regular. AV (Atrioventricular) node is found at the base of the right atrium very near the septum. When stimulated by impulses from SA node, it sends out impulses through septum to cause ventricles to contract. An electrocardiogram (ECG) is a recording of the electrical changes that occur in myocardium during a cardiac cycle. An abnormality called ventricular fibrillation can be detected using an ECG. Ventricular fibrillation is the most common cause of sudden cardiac death in seemingly healthy individuals over the age of 35. Causes uncoordinated contraction of the ventricles. Can be caused by injury or drug overdose.

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