Download 11.1 Cardiovascular Anatomy

PowerPoint® Lecture Slide Presentation
by Patty Bostwick-Taylor,
Florence-Darlington Technical College
The
Cardiovascular
System
11
PART A
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The Cardiovascular System
 A closed system of the heart and blood vessels
 The heart pumps blood
 Blood vessels allow blood to circulate to all
parts of the body
 The function of the cardiovascular system is to
deliver oxygen and nutrients and to remove
carbon dioxide and other waste products
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The Heart
 Location
 Between sternum and spine in the
mediastinum
 Orientation
 Pointed apex directed toward left hip
 Base points toward right shoulder
 About the size of your fist
 In an adult, it resembles the shape of the chest
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The Heart
Figure 11.1a–b
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The Heart
Figure 11.1c
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The Heart
Figure 11.2a
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The Heart: Coverings
 Pericardium—a double-walled sac
 Fibrous pericardium is loose and superficial
 Serous membrane is deep to the fibrous
pericardium and composed of two layers
 Visceral pericardium
 Next to heart; also known as the
epicardium
 Parietal pericardium
 Outside layer that lines the inner
surface of the fibrous pericardium
 Serous fluid fills the space between the layers
of pericardium
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8
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The Heart
Figure 11.2b
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The Heart: Heart Wall
 Three layers
 Epicardium
 Outside layer
 This layer is the visceral pericardium
 Connective tissue layer
 Myocardium
 Middle layer
 Mostly cardiac muscle
 Endocardium
 Inner layer
 Endothelium
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The Heart: Heart Wall
Figure 11.2c
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The Heart: Chambers
 Right and left side act as separate pumps
 Four chambers
 Atria
 Receiving chambers
 Right atrium
 Left atrium
 Ventricles
 Discharging chambers
 Right ventricle
 Left ventricle
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The Heart: Chambers
Figure 11.2c
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The Heart: Septa
 Interventricular septum
 Separates the two ventricles
 Interatrial septum
 Separates the two atria
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The Heart: Chambers
Figure 11.2c
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The Heart: Valves
 Allow blood to flow in only one direction to
prevent backflow
 Four valves
 Atrioventricular (AV) valves—between atria
and ventricles
 Bicuspid (mitral) valve (left side of heart)
 Tricuspid valve (right side of heart)
 Anchored in place by chordae tendinea
(heart strings”
 Open during relaxation and closed during
ventricular contraction
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The Heart: Valves
 Semilunar valves—between ventricle and
artery
 Pulmonary semilunar valve
 Aortic semilunar valve
 Closed during heart relaxation, but open
during ventricular contraction
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The Heart: Valves
Figure 11.2c
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The Heart: Valves
 Notice these valves operate opposite of one
another to force a one-way path of blood through
the heart
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Operation of the AV valves
Blood returning to
the atria, puts
pressure against
AV valves; the AV
valves are forced
open
AV valves open
Ventricles
(a)
Figure 11.5a, step 1
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Operation of the AV valves
Blood returning to
the atria, puts
pressure against
AV valves; the AV
valves are forced
open
As the ventricles
fill, AV valve flaps
hang limply into
ventricles
AV valves open
Ventricles
(a)
Figure 11.5a, step 2
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Operation of the AV valves
Blood returning to
the atria, puts
pressure against
AV valves; the AV
valves are forced
open
As the ventricles
fill, AV valve flaps
hang limply into
ventricles
AV valves open
Atria contract,
forcing additional
blood into ventricles
Ventricles
(a)
Figure 11.5a, step 3
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Ventricles contract,
forcing blood
against AV valve
flaps
(a)
Figure 11.5a, step 4
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Ventricles contract,
forcing blood
against AV valve
flaps
AV valves close
AV valves closed
(a)
Figure 11.5a, step 5
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Ventricles contract,
forcing blood
against AV valve
flaps
AV valves close
Chordae tendineae
tighten, preventing
valve flaps from
everting into atria
AV valves closed
(a)
Figure 11.5a, step 6
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Operation of the semilunar valves
Aorta
Pulmonary
trunk
As ventricles
contract and
intraventricular
pressure rises,
blood is pushed
up against
semilunar
valves, forcing
them open
Semilunar valve
open
(b)
Figure 11.5b, step 1
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Operation of the semilunar valves
Aorta
Pulmonary
trunk
As ventricles
contract and
intraventricular
pressure rises,
blood is pushed
up against
semilunar
valves, forcing
them open
Semilunar valve
open
(b)
As ventricles
relax, and
intraventricular
pressure falls,
blood flows
back from
arteries, filling
the leaflets of
semilunar
valves and
forcing them
to close
Semilunar valve
closed
Figure 11.5b, step 2
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Systemic and Pulmonary Circulations
 Although single organ, heart works as a double
pump
 Systemic circulation
 Blood flows from the left side of the heart
through the body tissues and back to the right
side of the heart
 Pulmonary circulation
 Blood flows from the right side of the heart to
the lungs and back to the left side of the heart
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Systemic and Pulmonary Circulations
Figure 11.3
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Differences in Right and Left Ventricles
 Systemic circulation carried out by left side of
heart
 Left ventricular cavity is circular
 Pulmonary circulation is carried out by the right
side of the heart
 Right ventricular cavity is crescent shaped
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Differences in Right and Left Ventricles
Figure 11.4
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The Heart: Associated Great Vessels
 Arteries
 Aorta
 Leaves left ventricle
 Pulmonary arteries
 Leave right ventricle
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The Heart: Associated Great Vessels
 Veins
 Superior and inferior venae cavae
 Enter right atrium
 Pulmonary veins (four)
 Enter left atrium
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The Heart: Associated Great Vessels
Figure 11.2c
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Blood Flow Through the Heart
 Superior and inferior venae cavae dump blood
into the right atrium
 From right atrium, through the tricuspid valve,
blood travels to the right ventricle
 From the right ventricle, blood leaves the heart as
it passes through the pulmonary semilunar valve
into the pulmonary trunk
 Pulmonary trunk splits into right and left
pulmonary arteries that carry blood to the lungs
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Blood Flow Through the Heart
 Oxygen is picked up and carbon dioxide is
dropped off by blood in the lungs
 Oxygen-rich blood returns to the heart through
the four pulmonary veins
 Blood enters the left atrium and travels through
the bicuspid valve into the left ventricle
 From the left ventricle, blood leaves the heart via
the aortic semilunar valve and aorta
 Blood from lower body empties into inferior vena
cava and to right atrium
 Blood from head and neck empties into superior
vena cava and to right atrium
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Coronary Circulation
 Blood in the heart chambers does not nourish the
myocardium
 The heart has its own nourishing circulatory
system consisting of
 Coronary arteries—branch from the aorta to
supply the heart muscle with oxygenated
blood
 Cardiac veins—drain the myocardium of blood
 Coronary sinus—a large vein on the posterior
of the heart, receives blood from cardiac veins
 Blood empties into the right atrium via the
coronary sinus
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Coronary Circulation
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Principles of Heart’s Own Blood Supply
 Both ventricles receive the blood from right and
left coronary arteries
 Each atrium, in contrast, receives blood form only
a small branch of corresponding coronary artery
 Most blood goes to myocardium of left ventricle
 There are few anasomoses (connections) between
the branches of the coronary artery
 Provide detours for arterial blood if main route
is obstructed
 Incidence of arterial anatomoses increase as
the distance from the heart increases
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Ischemic Tissue
 When blood does not reach heart muscle cells
they can’t get oxygen and become ischemic
 Deprived of oxygen
 Ischemic conditions can lead to fibrillation
 Rapid uncoordinated contraction of heart
muscle
 Myocardial infarctions (death of ischemic cells)
soon results
 Called a heart attack
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Blood Vessels: The Vascular System
 Transport blood to the tissues and back
 Carry blood away from the heart
 Arteries
 Arterioles
 Exchanges between tissues and blood
 Capillary beds
 Return blood toward the heart
 Venules
 Veins
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Echocardiography
 Noninvasive
technique to
evaluate heart and
vessels
 Uses ultrasound
beams which are
transmitted on a
monitor
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Doppler Ultrasonography
 Used to determine
velocity of blood
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Cardiac Enzyme Studies
 When a heart muscle is damaged, it releases
enzymes into the bloodstream
 Dr.’s check for these enzymes to determine if a
heart attack has taken place
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Cardiac Nuclear Scanning
 Use an IV to give a radioactive substance and
then use a gamma-ray detector over the heart
 Used to:
 Screen and monitor for new and old
myocardial infarctions
 Used in chest pain
 Evaluation of bypass surgery
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Cardiac Nuclear Scanning
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Nerve Supply of the Heart
 Autonomic nervous system regulates involuntary
systems
 Sympathetic- speeds up the heart
 Called accelerator nerves
 Parasympathetic
 Vagus fibers serve as inhibitory depressor
nerves
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Blood Vessels: The Vascular System
 Transport blood to the tissues and back
 Carry blood away from the heart
 Arteries
 Arterioles
 After birth, all arteries except the pulmonary
artery and its branches carry oxygenated
blood
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Blood Vessels: The Vascular System
 Exchanges between tissues and blood
 Capillary beds
 Return blood toward the heart
 Venules
 Veins
 All veins, except the pulmonary vein,
carries deoxygenated blood
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Blood Vessels: The Vascular System
Figure 11.9a
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Blood Vessels: Microscopic Anatomy
 Three layers (tunics)
 Tunic intima
 Endothelium
 Very thin in capillaries
 Tunic media
 Smooth muscle
 Controlled by sympathetic nervous
system
 Not present in capillaries
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Blood Vessels: Microscopic Anatomy
 Three layers (tunics)
 Tunic externa
 Mostly fibrous connective tissue
 Function to support and protect the vessel
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Blood Vessels: The Vascular System
Figure 11.9b
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Differences Between Blood Vessels
 Walls of arteries are the thickest
 Lumens of veins are larger
 Larger veins have valves to prevent backflow
 Skeletal muscle “milks” blood in veins toward the
heart
 Walls of capillaries are only one cell layer thick to
allow for exchanges between blood and tissue
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Blood Vessels: The Vascular System
Figure 11.9a
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Blood Vessels: The Vascular System
Figure 11.10
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Movement of Blood Through Vessels
 Most arterial blood is pumped by the heart
 Veins use the milking action of muscles to help
move blood
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Capillary Beds
 Capillary beds are interwoven network of
capillaries
 Capillary beds consist of two types of vessels
 Vascular shunt—vessel directly connecting an
arteriole to a venule
 True capillaries—exchange vessels
 Oxygen and nutrients cross to cells
 Carbon dioxide and metabolic waste
products cross into blood
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Capillary Beds
Figure 11.11a
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Capillary Beds
Figure 11.11b
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Major Arteries of System Circulation
 Aorta
 Largest artery in the body
 Leaves from the left ventricle of the heart
 Regions
 Ascending aorta—leaves the left ventricle
 Aortic arch—arches to the left
 Thoracic aorta—travels downward through
the thorax
 Abdominal aorta—passes through the
diaphragm into the abdominopelvic cavity
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Major Arteries of System Circulation
 Arterial branches of the ascending aorta
 Right and left coronary arteries serve the heart
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The Heart
Figure 11.2a
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Major Arteries of Systemic Circulation
 Arterial branches of the aortia arch (BCS)
 Brachiocephalic trunk splits into the
 Right common carotid artery
 Right subclavian artery
 Left common carotid artery splits into the
 Left internal and external carotid arteries
 Left subclavian artery branches into the
 Vertebral artery
 In the axilla, the subclavian artery
becomes the axillary artery  brachial
artery  radial and ulnar arteries
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Major Arteries of Systemic Circulation
 Arterial branches of the thoracic aorta
 Intercostal arteries supply the muscles of the
thorax wall
 Other branches of the thoracic aorta supply
the
 Lungs (bronchial arteries)
 Esophagus (esophageal arteries)
 Diaphragm (phrenic arteries)
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Major Arteries of Systemic Circulation
 Arterial branches of the abdominal aorta
 Celiac trunk is the first branch of the
abdominal aorta. Three branches are
 Left gastric artery (stomach)
 Splenic artery (spleen)
 Common hepatic artery (liver)
 Superior mesenteric artery supplies most of
the small intestine and first half of the large
intestine
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Major Arteries of Systemic Circulation
 Arterial branches of the abdominal aorta
 Left and right renal arteries (kidney)
 Left and right gonadal arteries
 Ovarian arteries in females serve the
ovaries
 Testicular arteries in males serve the
testes
 Lumbar arteries serve muscles of the
abdomen and trunk
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Major Arteries of Systemic Circulation
 Arterial branches of the abdominal aorta
 Inferior mesenteric artery serves the second
half of the large intestine
 Left and right common iliac arteries are the
final branches of the aorta
 Internal iliac arteries serve the pelvic
organs
 External iliac arteries enter the thigh 
femoral artery  popliteal artery 
anterior and posterior tibial arteries
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Arteries You Should Know:
 Aorta- ascending and aortic arch and definitions
of abdominal and thoracic aorta
 Common carotid artery
 Brachial artery
 Pulmonary arteries
 Coronary arteries
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Major Arteries of Systemic Circulation
Figure 11.12
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Major Veins of Systemic Circulation
 Many of the main arteries have corresponding
veins with the same name that are located
alongside or near arteries
 Deep veins found deep within the body
 Superficial veins close to the skin and many can
be seen
 Veins inside the head are called sinus veins
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Major Veins of Systemic Circulation
 Superior and inferior vena cava enter the right
atrium of the heart
 Superior vena cava drains the head and arms
 Inferior vena cava drains the lower body
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Major Veins of Systemic Circulation
 Veins draining into the superior vena cava
 Radial and ulnar veins  brachial vein 
axillary vein
 These veins drain the arms
 Cephalic vein drains the lateral aspect of the
arm and empties into the axillary vein
 Basilic vein drains the medial aspect of the
arm and empties into the brachial vein
 Basilic and cephalic veins are jointed at the
median cubital vein (elbow area)
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Major Veins of Systemic Circulation
 Veins draining into the superior vena cava
 Subclavian vein receives
 Venous blood from the arm via the axillary
vein
 Venous blood from skin and muscles via
external jugular vein
 Vertebral vein drains the posterior part of the
head
 Internal jugular vein drains the dural sinuses
of the brain
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Major Veins of Systemic Circulation
 Veins draining into the superior vena cava
 Left and right brachiocephalic veins receive
venous blood from the
 Subclavian veins
 Vertebral veins
 Internal jugular veins
 Brachiocephalic veins join to form the
superior vena cava  right atrium of heart
 Azygous vein drains the thorax
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Major Veins of Systemic Circulation
 Veins draining into the inferior vena cava
 Anterior and posterior tibial veins and fibial
veins drain the legs
 Posterior tibial vein  popliteal vein 
femoral vein  external iliac vein
 Great saphenous veins (longest veins of the
body) receive superficial drainage of the legs
 Each common iliac vein (left and right) is
formed by the union of the internal and
external iliac vein on its own side
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Major Veins of Systemic Circulation
 Veins draining into the inferior vena cava
 Right gonadal vein drains the right ovary in
females and right testicle in males
 Left gonadal vein empties into the left renal
vein
 Left and right renal veins drain the kidneys
 Hepatic portal vein drains the digestive organs
and travels through the liver before it enters
systemic circulation
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Major Veins of Systemic Circulation
 Veins draining into the inferior vena cava
 Left and right hepatic veins drain the liver
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Veins You Should Know
 Superior and Inferior Vena Cava
 Internal and external Jugular
 Great Saphenous Veins
 Longest veins in the body
 Hepatic Portal Vein
 Drains the digestive organs and travels
through the liver before it enters systemic
circulation
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Major Veins of Systemic Circulation
Figure 11.13
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Arterial Supply of the Brain
 Continuous blood flow to the brain is crucial
 Brain is supplied by two pairs of arteries
 Internal carotid arteries divide into
 Anterior and middle cerebral arteries
 These arteries supply most of the cerebrum
 Vertebral arteries join once within the skull to
form the basilar artery
 Basilar artery serves the brain stem and
cerebellum
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Arterial Supply of the Brain
 Posterior cerebral arteries form from the division
of the basilar artery
 These arteries supply the posterior cerebrum
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Circle of Willis
 Anterior and posterior blood supplies are united
by small communicating arterial branches
 Result—complete circle of connecting blood
vessels called cerebral arterial circle or circle of
Willis
 Surrounds base of brain
 Protects the brain by providing more than one
route for blood to reach brain tissue
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Arterial Supply of the Brain
Figure 11.14
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Fetal Circulation
 Fetus receives exchanges of gases, nutrients, and
wastes through the placenta
 Umbilical cord contains three vessels
 Umbilical vein—carries blood rich in nutrients
and oxygen to the fetus
 Umbilical arteries (2)—carry carbon dioxide
and debris-laden blood from fetus to placenta
 There is no mixing of fetal and maternal blood
since each flows into its own capillaries
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Fetal Circulation
 Blood flow bypasses the liver through the ductus
venosus and enters the inferior vena cava  right
atrium of heart
 Blood flow bypasses the lungs
 Blood entering right atrium is shunted directly into
the left atrium through the foramen ovale
 Ductus arteriosus connects the aorta and
pulmonary trunk (becomes ligamentum
arteriosum at birth)
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Fetal Circulation
Figure 11.15
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Changes After Birth
 Umbilical Cord is Cut
 Placenta is shed with part of the umbilical vessels
attached
 Ductus venosus becomes the ligamentum
venosum of the liver
 Foramen ovale closes after newborn takes first
breath and full circulation is established
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Hepatic Portal Circulation
 Veins of hepatic portal circulation drain
 Digestive organs
 Spleen
 Pancreas
 Hepatic portal vein carries this blood to the liver
 Liver helps maintain proper glucose, fat, and
protein concentrations in blood
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Hepatic Portal Circulation
 Major vessels of hepatic portal circulation
 Inferior and superior mesenteric veins
 Splenic vein
 Left gastric vein
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Hepatic Portal Circulation
Figure 11.16
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Hepatic Portal Circulation
Figure 11.17
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Fetal Alcohol Syndrome
 Alcohol can cross the placenta and get into
baby’s bloodstream
 Fetal Alcohol Syndrome Results In:
 Small head (microencephaly)
 Low birth rate
 Developmental disabilities
 Can lead to fetal death
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Disorders of the Pericardium
 Pericarditis
 Inflammation of the pericardium
 Visceral and parietal layers rub
 Causes severe pain and may interfere with
pumping of the heart
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Valve Disorders
 Incompetent Valves- leak and allow some blood to
flow back into the chamber
 Stenosed Valves- narrower than normal and slows
blood flow from the heart
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Valve Disorders
 Rheumatic Heart Disease- delayed inflammatory
response to strep infection
 Cardiac valves become inflamed
 Called rheumatic fever
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Valve Disorders
 Mitral Valve Prolapse
 Affects the bicuspid or mitral valve
 Mitral valve extends back into the left atrium
causing leakage of the valve
 Can be genetic or caused by rheumatic fever
 Have to take antibiotic before having dental
work to prevent inflammation of the heart
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Valve Disorders
 Aortic Regurgitation Blood goes forward into the aorta, but some
also goes backwards into the left ventricle
 Causes overload in left ventricle
 Can cause a heart attack
 Treated with valvuloplasty- surgically replace
the valve
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Disorders of the Myocardium
 Coronary Artery Disease
 Leading cause of death in the U.S.
 Has many causes
 Reduced flow of blood to the myocardial
tissue
 Can be caused by coronary thrombosis or
coronary embolism where blood flow is
blocked
 Can lead to a myocardial infarction
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Disorders of the Myocardium
 Myocardial Infarction
 Heart doesn’t get blood and causes damage to
tissue
 Recovery is possible only if a small part of the
heart is damaged.
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Disorders of the Myocardium
 Angina Pectoris
 severe chest pain that occurs when
myocardium does not get oxygen
 Coronary Bypass Surgery
 veins taken from other parts of the body to
bypass blockages in arteries
Copyright © 2009 Pearson Education, Inc., publishing as Benjamin Cummings
Heart Failure
 Inability of the heart to pump enough blood to
sustain life
 many different causes
 cardiomyopathy
 disease of the myocardial tissue that can
reduce pumping effectiveness
Copyright © 2009 Pearson Education, Inc., publishing as Benjamin Cummings
Heart Failure
 Arrhythmias can impair the pumping of the heart
 irregular heart beats
 Right sided heart failure
 not as serious
Copyright © 2009 Pearson Education, Inc., publishing as Benjamin Cummings
Heart Failure
 Congestive Heart Failure
 left sided heart failure
 more serious than right sided
 body can become congested with extra fluid
 Pulmonary edema- fluid in lungs
 Also in feet and fingers
 can lead to death
 some get heart transplants
 high degree of rejection
Copyright © 2009 Pearson Education, Inc., publishing as Benjamin Cummings
Heart Failure
 Artificial hearts may be implanted
 baboon hearts have been tried
Copyright © 2009 Pearson Education, Inc., publishing as Benjamin Cummings
Disorders of the Myocardium
 Atherosclerosis
 hardening of the arteries
 lipids build up inside the wall
 Aorta and coronary artery most susceptible
 view a normal coronary artery
 view a coronary artery with atherosclerosis
Copyright © 2009 Pearson Education, Inc., publishing as Benjamin Cummings
Disorders of Arteries
 Arteriosclerosis is end stage of disease
 fat and cholesterol build up in artery
 can be treated with vasodialators
 cause arteries to widen
 Some are suggesting taking a baby aspirin
once a day
 angioplasty- insert balloon to widen artery
 metal stents hold artery open
 bypass or replace arteries, if severe
Copyright © 2009 Pearson Education, Inc., publishing as Benjamin Cummings
Disorders of Arteries
 Aneurysm- weakening of arterial wall
 promote growth of clots
 can burst and cause severe hemorrhaging
 brain aneurysm can lead to a cerebrovascular
accident (stroke)
Copyright © 2009 Pearson Education, Inc., publishing as Benjamin Cummings
Disorders of Veins
 Varicose veins
 valves do not close properly and allow blood
to flow backwards and pool in veins
 common in people who stand for long periods
of time
Copyright © 2009 Pearson Education, Inc., publishing as Benjamin Cummings
Disorders of Veins
 Hemorrhoids
 varicose veins in the anal canal
 common during pregnancy
 advanced cases require surgical removal
Copyright © 2009 Pearson Education, Inc., publishing as Benjamin Cummings
Disorders of Veins
 Phlebitis
 vein inflammation caused by IV or catheter
 Thrombophlebitis
 vein inflammation caused by a clot
 clot can break free and cause an embolism
 can be serious
Copyright © 2009 Pearson Education, Inc., publishing as Benjamin Cummings