Cardiovascular system contains anatomy & physiology of heart along with all types of circulations and various diseases related to this system.

1. The
Cardiovascular
System
Prepared by
Ms. Nisha S. Mhaske
M.Pharm (Q.A.T)
Lecturer, PRES’s COPD, Chincholi.
Email : nisha.mhaske@pravara.in

2. Contents
• Introduction to CVS
• Heart
• Blood vessels
• Circulation
• Heart sound
• Conduction system of heart
• Cardiac cycle of heart
• ECG
• Blood pressure
• Diseases & disorders related to heart
• References

3. Introduction to CVS
 The cardiovascular system
is transport system of body
 It comprises blood, heart
and blood vessels.
 The system supplies
nutrients and remove waste
products from various
tissue of body.

4. Functions of CVS
 Transport nutrients, hormones
 Remove waste products
 Gaseous exchange
 Immunity
 Blood vessels transport blood
◦ Carries oxygen and carbon dioxide
◦ Also carries nutrients and wastes
 Heart pumps blood through blood vessels

5. Components of CVS
Blood
Heart
Blood vessels

6. Heart
• Heart is a four chambered, hollow muscular organ
approximately the size of your fist
• Four chambers – Left & Right Ventricles
Left & Right Atria
• Made up of cardiac Tissue.
• Endocardium- lines the heart chambers
• Myocardium- muscle layer
• Pericardium- membranous outer covering
• Location:
– Superior surface of diaphragm
– Left of the midline
– Anterior to the vertebral column, posterior to the sternum

7. The Heart Wall: 3 layers
• Epicardium
• Outside layer
• This layer is the
parietal
pericardium
• Connective tissue
layer
• Myocardium
• Middle layer
• Mostly cardiac
muscle
• Endocardium
• Inner layer
• Endothelium

9. Atria
• Right Atrium (RA)-
right upper chamber-
receives blood from
body- deoxygenated
blood
• Left atrium (LA)-
left upper heart.-
receives oxygenated
blood from lungs and
sends it to the left
ventricle

10. Ventricles
• Right ventricle (RV)-
right lower chamber-
receives blood from
right atrium and sends it
to the lungs through
pulmonary artery
• Left Ventricle (LV)-
lower left chamber-
receives blood from left
atrium and sends it
through the aorta to the
body.

11. • Aorta: The main
trunk of the
systemic arteries,
carrying blood
from the left side
of the heart to the
arteries of all
limbs and organs.
• Pulmonary
Artery: carries
blood to lungs
Right
Atrium
Right
Ventricle
Left
Atrium
Left
Ventricle
Aorta
pulmonary artery

12. The Heart: Valves
• Allow blood to flow in only one direction
• Four valves
– Atrioventricular valves – between atria and
ventricles
• Bicuspid valve (left)
• Tricuspid valve (right)
– Semilunar valves between ventricle and artery
• Pulmonary semilunar valve
• Aortic semilunar valve

13. • Tricuspid valve
controls blood flow
between the right
atrium and
ventricle.
• Mitral valve /
Bicuspid valve
controls blood
movement between
the left atrium and
ventricle
Right
Atrium
Right
Ventricle
Left
Atrium
Left
Ventricle
Tricuspid
Valve
Mitral Valve

14. • Pulmonary valve
controls blood
movement from
right ventricle into
pulmonary artery
• The aortic valve
controls blood
flow from the left
ventricle to the
aorta
Right
Atrium
Right
Ventricle
Left
Atrium
Left
Ventricle
Tricuspid
Valve
Pulmonar
y valve
Mitral Valve
Aortic valve

15. Operation of Heart Valves

16. Blood vessels
Arteries(Distributing channel)
• Thick walled tubes
• Elastic Fibers
• Circular Smooth Muscle
Capillaries (microscopic vessels)
• One cell thick
• Serves the Respiratory System
Veins (draining channel)

17. Arteries
• Arteries- tubes that
carry blood away from
the heart.
• Muscular elastic walls
• Form arterioles which
form capillaries
• Carry blood and oxygen
to the body cells

18. Coronary Arteries
• Supply blood to the
heart muscle.
• The heart needs a
large amount of
blood and 5-7% of
blood flows through
the coronary arteries.

19. Difference between Artery & Vein
Points Artery vein
Direction of flow Blood Away from
Heart
Blood to Heart
Pressure Higher Lower
Walls THICKER: Tunica
media thicker than
tunica externa
THINNER: Tunica
externa thicker
than tunica media
Lumen Smaller Larger
Valves No valves Valves

21. Blood vessels
• Three layers (tunics)
– Tunic intima:
• Endothelium
– Tunic media
• Smooth muscle
• Controlled by
sympathetic
nervous system
– Tunic externa
• Mostly fibrous
connective
tissue

22. Capillaries
• Capillaries- tubes that connect
arteries and veins
• Walls only one cell thick
• Site for exchange of nutrients and
oxygen from blood cells and carbon
dioxide and wastes to the blood
Veins
• Veins- tubes that carry blood toward
the heart
• Thinner muscular walls
• Carry blood back to heart
• Cuplike valves to help move blood

23. Circulation
 Coronary circulation – the circulation of blood
within the heart.
 Pulmonary circulation – the flow of blood between
the heart and lungs.
 Systemic circulation – the flow of blood between
the heart and the cells of the body.
 Fetal Circulation

24. SYSTEMIC AND PULMONARY CIRCULATION
Pulmonary circulation
The flow of blood between
the heart and lungs.
Systemic circulation
The flow of blood between the heart and the
cells of the body.

25. Blood
Circulation

26. CORONARY CIRCULATION: ARTERIAL SUPPLY

27. Portal Circulation
Portal circulation - the
flow of blood between
two set of capillaries
before draining in
systemic veins.

28. Fetal Circulation

29. 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)

30. The Heart: Conduction System
• Group of structures that send
electrical impulses through the heart
• Sino-atrial node (SA node)
– Wall of right atrium
– Generates impulse
– Natural pacemaker
– Sends impulse to AV node
• Atrio-ventricular node (AV node)
– Between atria just above
ventricles
– Atria contract
– Sends impulse to the bundle of
His
• Bundle of His
– Between ventricles
– Two branches
– Sends impulse to
Purkinje fibers
• Purkinje fibers
– Lateral walls of
ventricles
– Ventricles contract

31. Cardiac
Conduction
System

32. The Heart’s 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
• One heartbeat = one cardiac cycle
 Atria contract and relax
 Ventricles contract and relax
• Right atrium contracts
– Tricuspid valve opens
– Blood fills right ventricle
• Right ventricle contracts
– Tricuspid valve closes
– Pulmonary semilunar valve
opens
– Blood flows into pulmonary
artery
• Left atrium contracts
– Bicuspid valve opens
– Blood fills left ventricle
• Left ventricle contracts
– Bicuspid valve closes
– Aortic semilunar valve
opens
– Blood pushed into aorta

33. Phases of the Cardiac Cycle

34. The Heart: Cardiac Output
• Cardiac output (CO) or Minute volume
– Amount of blood ejected each minute.
CO=(Stroke volume) X (Heart rate)
Cardiac output-5040 ml per minute.
• Stroke volume
– It is the amount of blood ejected from the heart at
each contraction of the ventricles.
– Stroke volume- 70 ml

35. Electrocardiogram
• In general, when muscles contract, there is change in the
electrical potential across the membrane of muscle fiber,
similarly in cardiac muscle happens same.
• As the body fluids and tissues are good conductors of
electricity, the electrical changes occurring in the contracting
myocardium can be detected by attaching electrodes to the
surface of the body.
• The pattern of electrical activity may be displayed on the
oscilloscope screen or printed out on paper. This tracing is
called as Electrocardiogram.
• The normal ECG shows 5 waves which are named as, P,Q,R,S
& T Wave.

36. • P-Wave– impulse of contraction within the atria.
• Q,R,S Wave– spread of the impulse of contraction
through the conducting tissue to the ventricular muscle.
• T Wave– relaxation of the ventricular muscle.
• Examination of ECG gives information about state of
myocardium and the conducting system within the
heart.
• ECG has diagnostic value, as variation in graph
indicates heart diseases.
• The instrument used in recording the ECG is called
electrocardiograph.

37. Electrocardiography

38. Major Arteries of Systemic Circulation

39. Major Veins of Systemic Circulation

40. Heart rate
• Heart sound- during contraction &
relaxation heart produces sound mainly
due to closing of valves (Lubb/dup)
• Heart rate is recorded by using
Stethoscope.
• Normal heart rate- 60-80 per minute.
Heart rate
Normal Abnormal
More than Normal Less than
Normal
Tachycardia Bradycardia

41. Blood pressure
• It is the force called radial pressure, exerted by blood on the walls
of the blood vessels.
• Two types of pressures
1. Systolic BP –the pressure exerted during systole (Contraction of
muscles) is called systolic blood pressure. Normal systolic BP is
120 mm of Hg.
Systolic BP may vary from 100-150 mm of Hg.
1. Diastolic BP –the pressure exerted during diastole (relaxation of
muscles) is called diastolic blood pressure. Normal diastolic BP
is from 80 mm of Hg.
Diastolic BP may vary from 60-90 mm of Hg.
• Pulse pressure –the difference between systolic & diastolic blood
pressure is called pulse pressure.

42. • Factors maintaining Blood Pressure
1. Contractile force of heart
2. Cardiac output
3. Elasticity of wall of blood vessels
4. Volume of blood circulated in the circulatory system
5. Peripheral resistance
• Factors affecting BP
1. Physiological condition –exercise
2. Emotional conditions
3. Age of the individual
4. Body weight
• Blood pressure is measured with the help of an instrument
called “Sphygmomanometer”.

43. Measuring Arterial Blood Pressure
Baroreceptors
Also help regulate blood pressure
Located in the aorta and carotid arteries

44. Pulse
• Pulse – pressure
wave of blood
• Monitored at
“pressure points”
where pulse is easily
palpated.
• Normal Pulse rate-
70-80per minute.

45. Arrhythmias Abnormal heart rhythms
Carditis Inflammation of the heart
Endocarditis Inflammation of the innermost lining of the heart, including valves
Myocarditis Inflammation of the muscular layer of the heart
Pericarditis Inflammation of the membranes that surround the heart
(pericardium)
Congestive
heart failure
Weakening of the heart over time; heart is unable to pump enough
blood to meet body’s needs
Coronary
artery disease
(CAD)
Atherosclerosis; narrowing of coronary arteries caused by
hardening of the fatty plaque deposits within the arteries
Hypertension High blood pressure; consistent resting blood pressure equal to or
greater than 140/90 mm Hg
Diseases and Disorders of the Cardiovascular System

46. Thrombophlebitis Blood clots and inflammation develop in a vein
Varicose veins Twisted, dilated veins
Myocardial infarction Heart attack; damage to cardiac muscle due to a lack of
blood supply
Murmurs Abnormal heart sounds
Angina Pectoris It means chest pain. Severe pain beneath the breast
bone, and in many cases in the left shoulder and arm. It
s due to the heart muscle being inadequately supplied
with oxygen. The commonest cause is disease
(arteriosclerosis) of the coronary arteries.
Stenosis Narrowing of valve
Hemorrhoids Rectum veins are dilated
Arteriosclerosis Hardening of the arterial walls, due to deposition of
cholesterol in blood arteries. It results in partial loss of
elasticity of the arteries. It usually results in
hypertension.

47. By-pass Graft

48. Percutaneous Transluminal Coronary Angioplasty

49. Artificial Heart

50. References
• Human Anatomy & Physiology, by Rahul Phate,
Career publications, First edition-Jan 2004, Page
no:72-95.
• Human Anatomy & Physiology, by S.B.Bhise &
A.V.Yadav, Nirali Prakashan, 25th edition-July 2013,
Page no:7.1-7.14

51. Your work is to discover
your world and then
with all your heart give
yourself to it.
~ Buddha