The document describes the anatomy and structure of the cardiovascular system, including the heart and blood vessels. It details the layers that make up the heart walls and pericardium. It explains the coronary circulation that supplies blood to the heart muscle and lists the major arteries and veins involved in systemic and pulmonary circulation. Key anatomical features like heart valves and chambers are defined along with common congenital defects. Microscopic views of heart muscle and blood vessels are provided.

1. 1
The Cardiovascular System:
The Heart
Anatomy

2. 2
Heart Anatomy
 Approximately the size of your fist
 Location
 Superior surface of diaphragm
 Left of the midline
 Anterior to the vertebral column, posterior to the
sternum

3. 3
Heart Anatomy

4. 4
Coverings of the Heart: Anatomy
 Pericardium – a double-walled sac around the
heart composed of:
1. A superficial fibrous pericardium
2. A deep two-layer serous pericardium
a. The parietal layer lines the internal surface of
the fibrous pericardium
b. The visceral layer or epicardium lines the
surface of the heart
 They are separated by the fluid-filled
pericardial cavity

5. Chapter 18, Cardiovascular System 5
Coverings of the Heart: Physiology
 The Function of the Pericardium:
 Protects and anchors the heart
 Prevents overfilling of the heart with blood
 Allows for the heart to work in a relatively friction-
free environment

6. 6
Pericardial Layers of the Heart

7. 7
Heart Wall
 Epicardium – visceral layer of the serous
pericardium
 Myocardium – cardiac muscle layer forming the
bulk of the heart
 Fibrous skeleton of the heart – crisscrossing,
interlacing layer of connective tissue
 Endocardium – endothelial layer of the inner
myocardial surface

8. Chapter 18, Cardiovascular System 8
 Vessels returning blood to the heart include:
1. Superior and inferior venae cavae
2. Right and left pulmonary veins
 Vessels conveying blood away from the heart include:
1. Pulmonary trunk, which splits into right and left
pulmonary arteries
2. Ascending aorta (three branches) –
a. Brachiocephalic
b. Left common carotid
c. Subclavian arteries
External Heart: Major Vessels of the Heart
(Anterior View)

9. Chapter 18, Cardiovascular System 9
 Arteries – right and left coronary (in
atrioventricular groove), marginal, circumflex, and
anterior interventricular arteries
 Veins – small cardiac, anterior cardiac, and great
cardiac veins
External Heart: Vessels that Supply/Drain the
Heart (Anterior View)

10. Chapter 18, Cardiovascular System 10
External Heart: Anterior View
Figure 18.4b

11. Chapter 18, Cardiovascular System 11
 Vessels returning blood to the heart include:
1. Right and left pulmonary veins
2. Superior and inferior venae cavae
 Vessels conveying blood away from the heart
include:
1. Aorta
2. Right and left pulmonary arteries
External Heart: Major Vessels of the Heart
(Posterior View)

12. Chapter 18, Cardiovascular System 12
 Arteries – right coronary artery (in atrioventricular
groove) and the posterior interventricular artery (in
interventricular groove)
 Veins – great cardiac vein, posterior vein to left
ventricle, coronary sinus, and middle cardiac vein
External Heart: Vessels that Supply/Drain the
Heart (Posterior View)

13. Chapter 18, Cardiovascular System 13
External Heart: Posterior View
Figure 18.4d

14. Chapter 18, Cardiovascular System 14
Gross Anatomy of Heart: Frontal Section
Figure 18.4e

15. Chapter 18, Cardiovascular System 15
Atria of the Heart
 Atria are the receiving chambers of the heart
 Each atrium has a protruding auricle
 Pectinate muscles mark atrial walls
 Blood enters right atria from superior and inferior
venae cavae and coronary sinus
 Blood enters left atria from pulmonary veins

16. Chapter 18, Cardiovascular System 16
Ventricles of the Heart
 Ventricles are the discharging chambers of the heart
 Papillary muscles and trabeculae carneae muscles
mark ventricular walls
 Right ventricle pumps blood into the pulmonary
trunk
 Left ventricle pumps blood into the aorta

17. Chapter 18, Cardiovascular System 17
Myocardial Thickness and Function
Thickness of myocardium varies according to the function of the
chamber
Atria are thin walled, deliver blood to adjacent ventricles
Ventricle walls are much thicker and stronger
 right ventricle supplies blood to the lungs (little flow resistance)
 left ventricle wall is the thickest to supply systemic circulation

18. Chapter 18, Cardiovascular System 18
Thickness of Cardiac Walls
Myocardium of left ventricle is much thicker than the right.

19. Chapter 18, Cardiovascular System 19
Atrial Septal Defect

20. Chapter 18, Cardiovascular System 20
Ventricular Septal Defect

21. Chapter 18, Cardiovascular System 21
Pathway of Blood Through the Heart and
Lungs
 Right atrium  tricuspid valve  right ventricle
 Right ventricle  pulmonary semilunar valve 
pulmonary arteries  lungs
 Lungs  pulmonary veins  left atrium
 Left atrium  bicuspid valve  left ventricle
 Left ventricle  aortic semilunar valve  aorta
 Aorta  systemic circulation

22. Chapter 18, Cardiovascular System 22
Pathway of Blood Through the Heart and
Lungs
Figure 18.5

23. Chapter 18, Cardiovascular System 23
Coronary Circulation
 Coronary circulation is the functional blood supply
to the heart muscle itself
 Collateral routes ensure blood delivery to heart
even if major vessels are occluded

24. Chapter 18, Cardiovascular System 24
Coronary Circulation: Arterial Supply
Figure 18.7a

25. Chapter 18, Cardiovascular System 25
Coronary Circulation: Venous Supply
Figure 18.7b

26. Chapter 18, Cardiovascular System 26
Heart Valves
 Heart valves ensure unidirectional blood flow
through the heart
 Atrioventricular (AV) valves lie between the atria
and the ventricles
 AV valves prevent backflow into the atria when
ventricles contract
 Chordae tendineae anchor AV valves to papillary
muscles

27. Chapter 18, Cardiovascular System 27
Heart Valves
 Semilunar valves prevent backflow of blood into the
ventricles
 Aortic semilunar valve lies between the left
ventricle and the aorta
 Pulmonary semilunar valve lies between the right
ventricle and pulmonary trunk

28. Chapter 18, Cardiovascular System 28
Heart Valves
Figure 18.8a, b

29. Chapter 18, Cardiovascular System 29
Heart Valves
Figure 18.8c, d

30. Chapter 18, Cardiovascular System 30
Atrioventricular Valve Function
Figure 18.9

31. Chapter 18, Cardiovascular System 31
Semilunar Valve Function
Figure 18.10

32. Chapter 18, Cardiovascular System 32
Mitral Valve Prolapse

33. Chapter 18, Cardiovascular System 33
Microscopic Anatomy of Heart Muscle
 Cardiac muscle is striated, short, fat, branched, and
interconnected
 The connective tissue endomysium acts as both
tendon and insertion
 Intercalated discs anchor cardiac cells together and
allow free passage of ions
 Heart muscle behaves as a functional syncytium
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34. Chapter 18, Cardiovascular System 34
Microscopic Anatomy of Heart Muscle
Figure 18.11

35. Vascular System - the Blood Vessels
 Arteries, veins, and capillaries comprise the vascular
system.
 Arteries and veins run parallel throughout the body with
a web-like network of capillaries connecting them.
 Arteries use vessel size, controlled by the sympathetic
nervous system, to move blood by pressure.
 Veins use one-way valves controlled by muscle
contractions.

37. Arteries
 Arteries are strong, elastic vessels adapted for carrying
blood away from the heart at relatively high pumping
pressure. Arteries divide into progressively thinner
tubes and eventually become fine branches called
arterioles. Blood in arteries is oxygen-rich, with the
exception of the pulmonary artery, which carries blood
to the lungs to be oxygenated.
 The aorta is the largest artery in the body, the main
artery for systemic circulation. The major branches of
the aorta (aortic arch, ascending aorta, descending aorta)
supply blood to the head, abdomen, and extremities. Of
special importance are the right and left coronary
arteries, that supply blood to the heart itself.

38. Arteries
 The main arteries which branch off the aorta and take
blood to specific parts of the body are:
 Carotid arteries, which take blood to the neck and head
 Coronary arteries, which provide blood supply to the
heart itself
 Hepatic artery, which takes blood to the liver with
branches going to the stomach
 Mesenteric artery, which takes blood to the intestines
 Renal arteries, which takes blood to the kidneys
 Femoral arteries, which take blood to the legs

39. Capillaries
 The arterioles branch into the microscopic capillaries, or
capillary beds, which lie bathed in interstitial fluid, or
lymph, produced by the lymphatic system. Capillaries
are the points of exchange between the blood and
surrounding tissues. Materials cross in and out of the
capillaries by passing through or between the cells that
line the capillary. The extensive network of capillaries is
estimated at between 50,000 and 60,000 miles long.1
 Microscopic--one cell layer thick
 Network
 Bathed in extracellular matrix of areolar tissue
 Entire goal of C-V system is to get blood into capillaries
where diffusion takes place

40. Veins
 Blood leaving the capillary beds flows into a series of
progressively larger vessels, called venules, which in
turn unite to form veins. Veins are responsible for
returning blood to the heart after the blood and the
body cells exchange gases, nutrients, and wastes.
Pressure in veins is low, so veins depend on nearby
muscular contractions to move blood along. Veins have
valves that prevent back-flow of blood.
 Blood in veins is oxygen-poor, with the exception of the
pulmonary veins, which carry oxygenated blood from
the lungs back to the heart. The major veins, like their
companion arteries, often take the name of the organ
served. The exceptions are the superior vena cava and
the inferior vena cava, which collect body from all parts
of the body (except from the lungs) and channel it back
to the heart.

41. Artery/Vein Tissues
 Arteries and veins have the same three tissue layers, but
the proportions of these layers differ. The innermost is
the intima; next comes the media; and the outermost is
the adventitia. Arteries have thick media to absorb the
pressure waves created by the heart's pumping. The
smooth-muscle media walls expand when pressure
surges, then snap back to push the blood forward when
the heart rests. Valves in the arteries prevent back-
flow. As blood enters the capillaries, the pressure falls
off. By the time blood reaches the veins, there is little
pressure. Thus, a thick media is no longer needed.
Surrounding muscles act to squeeze the blood along
veins. As with arteries, valves are again used to ensure
flow in the right direction.

42. LAYERS OF VEINS& ARTERIES
 Tunica externa.
 Outermost layer
 Contain elastin and collagen
 Strengthens, Anchors
 Tunica media
 Middle layer
 Circular Smooth Muscle
 Vaso-constriction/dilation
 Tunica intima
 Innermost layer
 Endothelium
 Minimize friction
 Lumen

44. DIFFERENCES BTWN VEINS
AND ARTERIES
Arteries (aa.) Veins (vv.)
Direction
of flow
Blood Away from
Heart
Blood to Heart
Pressure Higher Lower

45. DIFFERENCES BTWN VEINS
AND ARTERIES
Walls THICKER:
Tunica media
thicker than
tunica externa
THINNER:
Tunica externa
thicker than
tunica media
Lumen Smaller Larger
Valves No valves Valves (see
next)

47. REVIEW
 Describe the location of Heart in Chest
 What Does C-V System do?
 Describe how the heart works.
 Describe the layers of veins & arteries.
 List five differences between arteries and veins.
 Name the five great vessels

48. 48
The Cardiovascular System:
The Heart
Physiology

49. Chapter 18, Cardiovascular System 49
Cardiac Muscle Contraction
 Heart muscle:
 Is stimulated by nerves and is self-excitable
(automaticity)
 Contracts as a unit
 Has a long (250 ms) absolute refractory period
 Cardiac muscle contraction is similar to skeletal
muscle contraction

50. Chapter 18, Cardiovascular System 50
Heart Physiology: Intrinsic Conduction
System
 Autorhythmic cells:
 Initiate action potentials
 Have unstable resting potentials called pacemaker
potentials
 Use calcium influx (rather than sodium) for rising
phase of the action potential

51. Chapter 18, Cardiovascular System 51
Pacemaker and Action Potentials of the Heart
Figure 18.13

52. Chapter 18, Cardiovascular System 52
Heart Physiology: Sequence of Excitation
 Sinoatrial (SA) node generates impulses about 75
times/minute
 Atrioventricular (AV) node delays the impulse
approximately 0.1 second

53. Chapter 18, Cardiovascular System 53
Heart Physiology: Sequence of Excitation
 Impulse passes from atria to ventricles via the
atrioventricular bundle (bundle of His)
 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

54. Chapter 18, Cardiovascular System 54
Heart Physiology: Sequence of Excitation
Figure 18.14a

55. Chapter 18, Cardiovascular System 55
Heart Excitation Related to ECG
Figure 18.17

56. Chapter 18, Cardiovascular System 56
Extrinsic Innervation of the Heart
 Heart is stimulated
by the sympathetic
cardioacceleratory
center
 Heart is inhibited by
the parasympathetic
cardioinhibitory
center
Figure 18.15

57. Chapter 18, Cardiovascular System 57
Electrocardiography
 Electrical activity is recorded by electrocardiogram
(ECG)
 P wave corresponds to depolarization of SA node
 QRS complex corresponds to ventricular
depolarization
 T wave corresponds to ventricular repolarization
 Atrial repolarization record is masked by the larger
QRS complex
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58. Chapter 18, Cardiovascular System 58
Electrocardiography
Figure 18.16

59. Chapter 18, Cardiovascular System 59
Heart Sounds
 Heart sounds (lub-dup) are associated with closing
of heart valves
 First sound occurs as AV valves close and signifies
beginning of systole (contraction)
 Second sound occurs when SL valves close at the
beginning of ventricular diastole (relaxation)

60. Chapter 18, Cardiovascular System 60
Cardiac Cycle
 Cardiac cycle refers to all events associated with
blood flow through the heart
 Systole – contraction of heart muscle
 Diastole – relaxation of heart muscle

61. Chapter 18, Cardiovascular System 61
Phases of the Cardiac Cycle
 Ventricular filling – mid-to-late diastole
 Heart blood pressure is low as blood enters atria
(passively) and flows into ventricles
 AV valves are open, then atrial systole occurs

62. Chapter 18, Cardiovascular System 62
Phases of the Cardiac Cycle
 Ventricular systole (contraction)
 Atria relax
 Rising ventricular pressure results in closing of AV
valves
 Isovolumetric contraction phase
 Ventricular ejection phase opens semilunar valves

63. Chapter 18, Cardiovascular System 63
Phases of the Cardiac Cycle
 Isovolumetric relaxation – early diastole
 Ventricles relax
 Backflow of blood in aorta and pulmonary trunk
closes semilunar valves
 Dicrotic notch – brief rise in aortic pressure caused
by backflow of blood rebounding off semilunar
valves
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64. Chapter 18, Cardiovascular System 64
Phases of the Cardiac Cycle
Figure 18.20

65. Chapter 18, Cardiovascular System 65
Cardiac Output (CO) and Reserve
 Cardiac Output is the amount of blood pumped by
each ventricle in one minute
 CO is the product of heart rate (HR) and stroke
volume (SV)
 HR is the number of heart beats per minute
 SV is the amount of blood pumped out by a
ventricle with each beat
 Cardiac reserve is the difference between resting
and maximal CO

66. Chapter 18, Cardiovascular System 66
Cardiac Output: Example
 CO (ml/min) = HR (75 beats/min) x SV (70 ml/beat)
 CO = 5250 ml/min (5.25 L/min)

67. Chapter 18, Cardiovascular System 67
Regulation of Stroke Volume
 SV = end diastolic volume (EDV) minus end
systolic volume (ESV)
 EDV = amount of blood collected in a ventricle
during diastole
 ESV = amount of blood remaining in a ventricle
after contraction

68. Chapter 18, Cardiovascular System 68
Factors Affecting Stroke Volume
 Preload – amount ventricles are stretched by
contained blood
 Contractility – cardiac cell contractile force due to
factors other than EDV
 Afterload – back pressure exerted by blood in the
large arteries leaving the heart

69. Chapter 18, Cardiovascular System 69
Frank-Starling Law of the Heart
 Preload, or degree of stretch, of cardiac muscle cells
before they contract is the critical factor controlling
stroke volume
 Slow heartbeat and exercise increase venous return
to the heart, increasing SV
 Blood loss and extremely rapid heartbeat decrease
SV

70. Chapter 18, Cardiovascular System 70
Preload and Afterload
Figure 18.21

71. Chapter 18, Cardiovascular System 71
Extrinsic Factors Influencing Stroke Volume
 Contractility is the increase in contractile strength,
independent of stretch and EDV
 Increase in contractility comes from:
 Increased sympathetic stimuli
 Certain hormones
 Ca2+ and some drugs

72. Chapter 18, Cardiovascular System 72
Extrinsic Factors Influencing Stroke Volume
 Agents/factors that decrease contractility include:
 Acidosis
 Increased extracellular K+
 Calcium channel blockers

73. Chapter 18, Cardiovascular System 73
Contractility and Norepinephrine
 Sympathetic
stimulation
releases
norepinephrine
and initiates a
cyclic AMP
second-
messenger
system
Figure 18.22

74. Chapter 18, Cardiovascular System 74
Regulation of Heart Rate
 Positive chronotropic factors increase heart rate
 Caffeine
 Negative chronotropic factors decrease heart rate
 Sedatives

75. Chapter 18, Cardiovascular System 75
 Sympathetic nervous system (SNS) stimulation is activated
by stress, anxiety, excitement, or exercise
 Parasympathetic nervous system (PNS) stimulation is
mediated by acetylcholine and opposes the SNS
 PNS dominates the autonomic stimulation, slowing heart
rate and causing vagal tone
 If the Vagus Nerve was cut, the heart would lose its tone.
Thus, increasing the heart rate by 25 beats per minute.
Regulation of Heart Rate: Autonomic Nervous
System

76. Chapter 18, Cardiovascular System 76
Atrial (Bainbridge) Reflex
 Atrial (Bainbridge) reflex – a sympathetic reflex
initiated by increased blood in the atria
 Causes stimulation of the SA node
 Stimulates baroreceptors in the atria, causing
increased SNS stimulation

77. Chapter 18, Cardiovascular System 77
Chemical Regulation of the Heart
 The hormones epinephrine and thyroxine increase
heart rate
 Intra- and extracellular ion concentrations must be
maintained for normal heart function
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78. Chapter 18, Cardiovascular System 78
Factors Involved in Regulation of Cardiac
Output
Figure 18.23

79. Chapter 18, Cardiovascular System 79
Congestive Heart Failure (CHF)
 Congestive heart failure (CHF) is caused by:
 Coronary atherosclerosis
 Persistent high blood pressure
 Multiple myocardial infarcts
 Dilated cardiomyopathy (DCM) – main pumping
chambers of the heart are dilated and contract
poorly

80. Chapter 18, Cardiovascular System 80
Developmental Aspects of the Heart
Figure 18.24

81. Chapter 18, Cardiovascular System 81
Developmental Aspects of the Heart
 Fetal heart structures that bypass pulmonary
circulation
 Foramen ovale connects the two atria
 Ductus arteriosus connects pulmonary trunk and
the aorta

82. Chapter 18, Cardiovascular System 82
Figure 18.25
Examples of Congenital Heart Defects

83. Chapter 18, Cardiovascular System 83
Age-Related Changes Affecting the Heart
 Sclerosis and thickening of valve flaps
 Decline in cardiac reserve
 Fibrosis of cardiac muscle
 Atherosclerosis

84. Chapter 18, Cardiovascular System 84
Congestive Heart Failure
 Causes of CHF
 coronary artery disease, hypertension, MI, valve disorders,
congenital defects
 Left side heart failure
 less effective pump so more blood remains in ventricle
 heart is overstretched & even more blood remains
 blood backs up into lungs as pulmonary edema
 suffocation & lack of oxygen to the tissues
 Right side failure
 fluid builds up in tissues as peripheral edema

85. Chapter 18, Cardiovascular System 85
Coronary Artery Disease
 Heart muscle receiving
insufficient blood supply
 narrowing of vessels---
atherosclerosis, artery
spasm or clot
 atherosclerosis--smooth
muscle & fatty deposits in
walls of arteries
 Treatment
 drugs, bypass graft,
angioplasty, stent

86. Chapter 18, Cardiovascular System 86
Clinical Problems
 MI = myocardial infarction
 death of area of heart muscle from lack of O2
 replaced with scar tissue
 results depend on size & location of damage
 Blood clot
 use clot dissolving drugs streptokinase or t-PA & heparin
 balloon angioplasty
 Angina pectoris
 heart pain from ischemia (lack of blood flow and oxygen )
of cardiac muscle

87. Chapter 18, Cardiovascular System 87
By-pass Graft

88. Chapter 18, Cardiovascular System 88
Percutaneous Transluminal Coronary
Angioplasty

89. Chapter 18, Cardiovascular System 89
Artificial Heart