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The Heart and Circulation Cardiovascular System = Heart, Blood and Vessels Lymphatic System = Lymph nodes, Organs and Vessels Functions of Heart and Cardiovascular System • Cardiovascular System – Bulk flow of blood – Exchange with tissue • Heart – Right side receives oxygen-poor blood from body tissues and pumps the blood to the lungs – Left side receives the oxygenated blood from the lungs and pumps the blood throughout the body Location of Heart in Chest • • • • • • • Oblique Position Apex = Left of Midline (5th ICS), Anterior to rest of heart Base (posterior surface) sits on vertebral column Superior Right = 3rd Costal Cartilage, 1” right midsternum Superior Left = 2nd Costal Cartilage, 1” left midsternum Inferior Right = 6th Costal Cartilage, 1” right midsternum Inferior Left = 5th Intercostal Space at Midclavicular line Pg 155 Cardiac Conduction • Intrinsic system initiating and coordinating contraction of heart muscle – Sinoatrial node (where SVC enters RA) – Atrioventricular node (in atrioventricular septum) – AV Bundle (in IV septum then splits) – Purkinje fibers (throughout LV) • Cardiac Plexus (external innervation) – Vagus (parasympathetic) – Sympathetic trunk pg 178 Pericardium • Pericardium (3 layers) • 1) Outer-fibrous pericardium – Serous pericardium • 2) parietal • 3) visceral (epicardium) • Pericardial Cavity – between layers of serous pericardium – serous fluid – lubricate heart while beating pg 178 External Features of Heart • • • • • • • Interventricular sulcus Coronal/Coronary sulcus Auricles of atria Apex Base Coronary vessels Ligamentum Arteriosum Pg 158 The Great Vessels and major branches Aorta (from Left Ventricle) • Ascending – Coronary arteries • Aortic Arch – Brachiocephalic trunk – Left Common Carotid – Left Subclavian • Descending (Thoracic/Abdominal) – Many small branches to organs Pulmonary Trunk (from Rt Ventricle) - -2 Pulmonary Arteries into lungs Inferior/Superior Vena Cava - Coronary sinus Pg 180 Layers of Heart • Epicardium (most superficial) – Visceral serosa • Myocardium (middle layer) – Cardiac muscle – Contracts • Endocardium (inner) – Endothelium on CT – Lines the heart – Creates the valves Fibrous Skeleton of Heart • • • • • Insertion for cardiac muscle Anchors valve cusps Prevents valves from opening too much Block electrical impulses from atria to ventricles Contains AV node Pg 170 Heart Chambers • 2 receiving chambers: – Right atria – Left atria • 2 pumping chambers: – Right ventricle – Left ventricle Right Heart Chambers: Pulmonary Pump • Right Atrium (forms most of base of heart) pg 163, 165 – Receives O2-poor blood from body via IVC, SVC, Coronary sinus – Ventral wall (w/Pectinate muscles) and dorsal wall (no pectinate muscles) separated by crista terminalis – Fossa Ovalis- on interatrial septum, remnant of Foramen Ovale • Right Ventricle – – – – Receives O2-poor blood from right atrium through tricuspid valve Pumps blood to lungs via Pulmonary Semilunar Valve in pulmonary trunk Trabeculae Carnae- muscle ridges along ventral surface Chordae Tendinae-fibrous cords running between AV valve cusps and papilary muscles – Papillary Muscles (3)-cone-shaped muscles within ventricles to which chordae tendinae are anchored – Moderator Band (septomarginal trabeucla)-muscular band connecting anterior papillary muscle to interventricular septum Left Heart Chambers: Systemic Pump • Left Atrium – Receives O2-rich blood from 4 Pulmonary Veins – Pectinate Muscles line only auricle • Left Ventricle (forms apex of heart) – Receives blood from Left Atrium via bicuspid valve – Pumps blood into aorta via Aortic Semilunar Valve to body – Same structures as Rt Ventricle: Trabeculae carnae, Papillary muscles (2), Chordae tendinae – No Moderator band Heart Valves: Lub*-Dub** • *Tricuspid Valve: Right AV valve – – – – – 3 Cusps (flaps) made of endocardium and CT Cusps anchored in Rt. Ventricle by Chordae Tendinae Chordae Tendinae prevent inversion of cusps into atrium Flow of blood pushes cusps open When ventricle is in diastole (relaxed), cusps hang limp in ventricle – Ventricular contraction increases pressure and forces cusps closed • *Bicuspid (Mitral) Valve: Left AV valve – 2 cusps anchored in Left Ventricle by chordae tendinae – Functions same as Rt. AV valve • They close together pg 165 Semilunar Valves (the dub) • Semilunar valves: prevents backflow in large arteries • Pulmonary Semilunar Valve – Right Ventricle and Pulmonary Trunk • Aortic Semilunar Valve – Left Ventricle and Aorta • Made of 3 Cusps – As blood rushes past the cusps are flattened – As it settles they’re pushed down (valve closed) pg 165 Flow of Blood • O2-poor blood (S+I VC, Coronary Sinus) enters Rt Atrium • Travels through Tricuspid Valve into Rt Ventricle • Pumped out through Pulmonary Semilunar Valve into Pulmonary trunk (branches into Pulmonary Arteries) and to lungs • After circulating through lungs, O2-rich blood returns to the heart through 4 Pulmonary veins • The O2-rich blood enters the Left Atrium • Travels through Bicuspid/Mitral Valve into Left Ventricle • Pumped out through Aortic Semilunar Valve into Aorta to be distributed to rest of body by descending aorta and branches of aortic arch Cardiovascular Flow of Blood • HeartArteries(conducting-distributing) ArteriolesCapillaries of tissues • At Capillaries O2 is delivered and CO2 picked up • CapillariesVenulesVeinsHeart Circuits • Pulmonary Circuit – Vessels carrying blood to and from lungs – Pulmonary arteries and veins • Systemic Circuit – Vessels carrying blood to and from the rest of the body – All other vessels Blood Flow to Supply the Heart Muscle • Heart wall too thick for diffusion of nutrients • Rt and Lft Coronary Arteries – – – – Branch from Ascending Aorta Have multiple branches along heart Sit in Coronary Sulcus Coronary Heart Disease • Cardiac Veins – Coronary Sinus (largest) – Many branches feed into sinus – Sits in Coronary Sulcus pg 171 Blood Vessels • Powered by the heart! • Carry blood to and from the heart • 3 main types: – Arteries • Carry blood away from heart • arterioles – Capillaries – Veins • Carry blood toward heart • Venules Anatomy of Arteries and Veins • Tunica externa – Outermost layer – CT w/elastin and collagen – Protects, Strengthens, Anchors • Tunica media – – – – Middle layer Circular Smooth Muscle Collagen & Elastic Fibers Vaso-constriction/dilation • Tunica intima – Innermost layer – Endothelium – Minimize friction • Lumen Vessels of Cardiovascular System: Arteries • • • • Carry blood AWAY from heart Systemic Circuit: carry O2 blood Pulmonary Circuit: carry de-O2 blood Walls thicker than Veins – Tunica media > Tunica externa • 3 Types – Conducting (elastic) • large, elastin, high pressure – Distributing (muscular) • medium size, to organs – Arterioles • smallest Capillaries • • • • • Smallest BV Usually 1 RBC thick 1 layer endothelial cell thick surrounded by basal lamina Deliver O2 and nutrients to cells and remove waste Capillary Beds: networks of capillaries – Regulating amount of blood going to cells throughout tissues – Supply tissues and organs that otherwise have poor capillary circulation • Epithelium, cartilage has no capillaries Vessels of Cardiovascular System: Veins • • • • Carry blood from capillaries INTO the heart Systemic Circuit: O2 poor blood Pulmonary Circuit: O2 –rich blood Pressure in Veins less than that in arteries – Thinner walls than arteries (tunica externa > tunica media, less elastin) – Larger lumen than arteries – Contain valves (made of T. intima) – Normal movement, Muscular contraction push blood through • Venules- smallest veins Cardiovascular Blood Flow • Portal System: Special vascular circulation where blood goes through 2 capillary beds before returning to the heart to achieve 2nd function – (eg) Hepatic Portal System: aids digestion by picking up digestive nutrients from stomach + intestines and delivers to liver for processing/storage – Pick-up occurs at capillaries of stomach and intestine – Via Hepatic Portal Vein goes to capillaries of liver – Via Hepatic Vein blood goes back to heart Vascular Anastomoses • Vessels unite and connect • Arteriole Anastomoses – Communication between arteries – Joints, Abdominal Organs, Brain, Heart • Venous Anastomoses – Communication between veins – More common – (eg) back of hand • Vaso Vasorum – Tiny arteries, veins, capillaries in tunica externa of vessels to nourish them (outer half) pg 726 Fetal Circulation • All major vessels in place by third month • 2 main differences: – 1. Fetus must supply blood to placenta – 2. Lungs do not need much blood because respiratory organ is the placenta 1. Blood to Placenta • Umbilical vessels – Run in umbilical cord – 2 umbilical arteries • Carry blood (little oxygen and waste) to placenta – 1 umbilical vein • Returns this blood (with oxygen and nutrients) to fetus and to portal vein (to liver) • Ductus venosus – Shunt that puts blood to hepatic veins, IVC, and RA from placenta – Too much blood for liver to handle – Results in highly O2 blood going to heart 2. Bypassing the Lungs: Foramen Ovale • • • • Becomes Fossa Ovalis Hole in the inter-atrial septum Allows blood to flow from RA to LA Bypasses the RV – Would usually bring blood to lungs pg 163 2. Bypassing the Lungs: Ductus Arteriosus • Becomes Ligamentum arteriosum • Carries blood from pulmonary trunk to aortic arch – Empties distal to coronary arteries • This enables the heart and brain to receive the most highly oxygenated blood • Bypasses the lungs pg 186 First Breath!! • Lungs inflate – Ductus arteriosus constricts and closes • Oxygenated blood begins pouring into LA for first time – Raises the pressure within the LA – This pushes the 2 flaps of foramen ovale together and closes it