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CIRCULATORY SYSTEM OBJECTIVES Discuss the location, size and position of the heart Identify the heart chambers, sounds, and valves Trace blood through the heart and compare the functions of the heart chambers OBJECTIVES List the anatomical components of the heart conduction system Discuss features of a normal electrocardiogram Explain blood vessel structure and function relationships Trace path of blood through the systemic, pulmonary, hepatic portal, and fetal systems OBJECTIVES Identify and discuss the primary factors involved in the generation and regulation of blood pressure and explain the relationships between these factors Recognize, define, spell, and pronounce the terms related to pathology, diagnostic, and treatment procedures of the system HEART Location: between the lungs in the lower portion of the mediastinum Size: triangular shaped; roughly the size of a closed fist Position: in the thoracic cavity between the sternum in front and the bodies of the thoracic vertebrae behind THE HEART HEART CHAMBER ANATOMY Divided into left and right sides Each side is subdivided to form four chambers Atria Ventricles Septum separates the chambers ATRIA Two upper chambers Receiving chambers All blood vessels coming into the heart enter here A T R I A VENTRICLES Pumping chambers of the heart Walls are thicker than walls of the atria V E N T R I C L E S HEART VALVES Control the flow of blood through the heart If a valve does not function properly, the heart cannot pump blood effectively to the body Four valves: Tricuspid Pulmonary semilunar Mitral/Bicuspid Aortic semilunar TRICUSPID VALVE Controls the opening between the right atrium and right ventricle PULMONARY SEMILUNAR VALVE Located between the right ventricle and the pulmonary artery MITRAL/ BICUSPID VALVE Located between the left atrium and left ventricle AORTIC SEMILUNAR VALVE Located between the left ventricle and the aorta VALVE FACTOIDS •Atrioventricular valves (AV): prevent backflow of blood into the atria when the ventricles contract • Chordae Tendineae: attach the AV valves to the walls of the heart V E N T R I C L E S Questions??????? Where is the tricuspid valve located? Where is the pulmonary semilunar valve located? What is the function of Chorde tendineae? SEPTUMS Interatrial septum: separates the right atrium from the left atrium Interventricular septum: separates the right ventricle from the left ventricle NOTE: the narrow tip of the heart is called the apex THE PERICARDIUM Double-walled membranous sac that encloses the heart Pericardial fluid is between the layers and prevents friction when the heart beats Pericarditis: inflammation of the pericardium WALLS OF THE HEART Epicardium: external layer of the heart and also part of the inner layer of the pericardial sac Myocardium: the middle thickest layer that consists of the cardiac muscle Endocardium: lining of the heart; forms the inner surface that comes in direct contact with blood being pumped through the heart WALLS OF THE HEART HEART ACTION Muscular pumping device for distributing blood to all parts of the body Contraction of the heart is called…….. Systole Relaxation of the heart is called……… Diastole CONTRACTION Atrial systole: atria contract, forcing blood into the ventricles Once the ventricles are filled……… Ventricular systole: ventricles contract, forcing blood from the ventricles into the body BLOOD FLOW THROUGH THE HEART Right atrium (RA) receives oxygen-poor blood through the superior and inferior vena cava Tricuspid Valve Right ventricle (RV) pumps oxygen-poor blood through the pulmonary semilunar valve and into the pulmonary artery, Which carries it to the lungs BLOOD FLOW CONTINUED The left atrium (LA) receives oxygen-rich (oxygenated) blood from the lungs through the four pulmonary veins. The blood flows out of the LA, through the………….. Mitral Valve The left ventricle (LV) receives oxygen-rich blood from the left atrium. Blood flows out of the LV through the aortic semilunar valve and into the aorta, which carries it to all parts of the body, except the lungs NOTE • The PULMONARY ARTERY is the only artery that carries unoxygenated blood • The PULMONARY VEIN is the only vein that carries oxygenated blood NOTE SYSTEMIC CIRCULATION Includes blood flow to all parts of the body except the lungs Oxygen-rich blood flows from the left ventricle into arterial circulation Oxygen-poor blood flows out of the heart and flows into the right atrium PULMONARY CIRCULATION -Flow of blood between the heart and lungs -Blood flows out of the heart from the right ventricle and through the pulmonary arteries to the lungs. - Waste material (carbon dioxide) from the body is exchanged for oxygen from the inhaled air Heart Blood Supply Coronary circulation- The delivery of oxygen, nutrient-rich arterial blood and return of oxygen poor blood Right and Left Coronary arteries supply blood to the heart muscle Cardiac veins return the blood to the right atrium thru the cardiac sinus Terminology Myocardial infarction- Occlusion of a coronary artery resulting in an infarct AKA Heart Attack Angina Pectoris- Chest pain Coronary Bypass Surgery- CABG Cardiac cycle- Complete heartbeat Terminology Stroke Volume- The amount of blood ejected from the ventricles during each beat Cardiac Output- Volume of blood pumped by by one ventricle in a minute. Heart Block- Electrical impulses are blocked from Getting to the ventricles, heart rate slows down. Could result in the need of a pacemaker Terminology Sinoatrial Node- S-A node, located right atrium Known as the Pacemaker S-A node impulse travels to A-V node Atrioventricular node- A-V node, located right atrium - Transmits impulse to the Bundle of His Bundle of His- Carry impulse to Purkinje Fibers Purkinje Fibers- Causes ventricles to contract - Simultaneously forces blood into Aorta, and pulmonary arteries HEARTBEAT •To pump blood effectively throughout the body, the contraction and relaxation (beating) of the heart must occur in exactly the correct sequence •Rate and regularity is determined by the electrical impulses from nerves Electrocardiogram Electrocardiogram- ECG record of the hearts electrical activity Depolarization- electrical activity that triggers contraction of heart muscle Repolarization- begins before relaxation phase of cardiac muscle activity P-Wave - occurs with depolarization of atria T-Wave – results from electrical activity generated by repolarization of the ventricles QRS-complex- occurs with depolarization of the ventricles Questions???????????????? Which vessels supply blood directly to the heart muscle? What is heart block? What is the difference between Cardiac output, and Stroke volume? BLOOD VESSELS Arteries: pumps arterial blood (oxygenated) Arterioles: smallest arteries that control the flow into microscopic exchange vessels…. …..Capillaries Principal Arteries of the Body Capillary beds: where the exchange of nutrients and respiratory gases occur between the blood and tissue fluid around the cells Blood exits or is drained from the capillary beds and enters the small venules which join with other venules and increase in size becoming veins. Aorta: largest artery in the body Vena Cava: returns blood to the heart after circulation via the inferior and superior vena cava STRUCTURE Arteries, veins, and capillaries differ in structure Made up of three layers Tunica adventitia Tunica media Tunica intima VESSEL LAYERS Tunica Adventitia Outermost layer Made up of connective tissue VESSEL LAYERS Tunica Media Strong middle layer layer Smooth muscle tissue Elastic tissue VESSEL LAYERS Tunica Intima Inner layer of endothelial cells Lines arteries and veins VESSEL LAYERS MUSCLE LAYER IMPORTANCE The thicker layer is meant to withstand great pressure generated by ventricular systole In arteries, the tunica media plays a critical role in maintaining blood pressure and in controlling blood distribution FUNCTIONS OF VESSELS Arteries and arterioles distribute blood from the heart to capillaries in all parts of the body By constriction or dilating, arterioles help to maintain normal arterial blood pressure Veins and venules collect blood from capillaries and return it to the heart Serve as blood reservoirs because they can hold large or small amounts of blood CAPILLARIES Function as exchange vessels Example: glucose and oxygen move out of the blood in capillaries into interstitial fluid and on into cells. Carbon dioxide and other substances move in the opposite direction into the capillaries from the cells CIRCULATION Systemic Pulmonary Systemic Circulation Blood flow from the left ventricle of the heart through blood vessels to all parts of the body and back to the right atrium Blood flows out of each organ by way of its venules and the its veins to drain eventually into the inferior or superior vena cava HEPATIC PORTAL CIRCULATION The route of blood flows through the liver Veins from the spleen, stomach, pancreas, gallbladder, and intestines do not pour their blood directly into the inferior vena cava as do the veins Blood is sent to the liver by means of the hepatic portal vein. HEPATIC PORTAL CIRCULATION Cont The blood passes through the liver and reenters the regular venous return to the heart. Blood leaves the liver by way of the hepatic veins Hepatic veins drain into the inferior vena cava PORTAL CIRCULATION Cont Blood flow in the hepatic portal circulation does not follow the typical route. Venous blood, which would ordinarily return directly to the heart, is sent instead through a second capillary bed in the liver Hepatic portal vein is located between two capillary beds—one set in the digestive organs and the other in the liver. HEPATIC PORTAL CIRCULATION FETAL CIRCULATION Circulation in the body before birth differs from circulation after birth because the fetus must secure oxygen and food from maternal blood instead of its own lungs and digestive organs Placenta: exchange of nutrients and oxygen take place UMBILICAL CORD Three vessels accomplish the oxygen, nutrient exchange and return blood to the fetal body Two umbilical arteries One umbilical vein FETAL CIRCULATION DUCTUS VENOSIS Continuation of the umbilical vein Shunts most blood from the placenta past the immature liver of the baby Empties directly into the inferior vena cava DUCTUS VENOSIS FORAMEN OVALE & DUCTUS ARTERIOSUS Shunts blood directly from the right atrium directly into the left atrium Ductus arteriosus connects the aorta and the pulmonary artery FORAMEN OVALE & DUCTUS ARTERIOSUS FETAL SHUNTING At birth, specialized fetal blood vessels and shunts must become nonfunctional When the baby is born the circulatory system is subjected to increased pressure Increased pressure results in closure of the foramen ovale and rapid collapse of the umbilical blood vessels, the ductus venosus and the ductus arteriosus BLOOD PRESSURE Best way to understand is to answer a few questions. What is Blood Pressure? It is the pressure or push of blood Where does Blood Pressure exist? In all blood vessels Highest in arteries Lower in veins PRESSURE GRADIENT List blood vessels in order according to the amount of blood pressure in them and draw a graph it would look like a hill. • Aortic blood pressure would be at the top • Vena cava pressure would be at the bottom • More precisely, the blood pressure gradient is the difference between two blood pressures SYSTEMIC PRESSURE GRADIENT The difference between the average blood in the aorta and the blood pressure at the termination of the venae cavae (where they join the right atrium of the heart) The average blood pressure in the aorta is 100 mm of mercury (mm Hg) The pressure at the termination of the venae cavae is “0” PRESSURE GRADIENT BP IS IMPORTANT When blood pressure gradient is not present • Blood does not circulate If blood does not circulate Life itself will soon cease HIGH BLOOD PRESSURE Is not a good thing for several reasons May cause rupture of one or more blood vessels -- If this happens in the brain, a stroke will occur LOW BLOOD PRESSURE Can be dangerous If arterial blood pressure falls low enough: -- Circulation and life cease -- Massive hemorrhage, which will dramatically reduce blood pressure kills in this way FACTORS THAT INFLUENCE BP Blood Volume: the larger the volume of blood in the arteries the higher the BP. The lower the volume, the lower the BP The volume of blood in the arteries is determined by how much blood the heart pumps into the arteries and how much the arterioles drain out of them FACTORS THAT INFLUENCE BP The diameter of the arterioles plays an important role in determining how much blood drains out of the arteries into the arterioles STRENGTH OF HEART CONTRACTIONS The strength and rate of the heartbeat will affect cardiac output and therefore the BP Each time the Left Ventricle contracts, it squeezes a certain volume of blood (stroke volume) into the aorta and other arteries The stronger each contraction is, the more blood it pumps into the aorta and arteries. the weaker, the less blood SUMMARY OF HEART CONTRACTIONS The strength of the heartbeat affects the blood pressure in this way: -- A stronger heartbeat increases blood pressure, and a weaker beat decreases blood pressure HEART RATE The heartbeat may also affect arterial BP Does a faster heart beat result in more blood being pumped into the aorta? NO. This is true only if the stroke volume does not decrease sharply when the heart rate increases HEART RATE More often, when the heart beats faster, each contraction of the left ventricle takes place so rapidly that it has little time full and squeezes out much less blood than usual. This decreases the arterial blood volume and therefore blood pressure decreases even though heart rate has increased BLOOD VISCOSITY To be more specific, this is how thick is the blood If blood becomes less viscous than normal blood, the blood pressure will decrease When this decrease occurs, whole blood or plasma is preferred before IV saline Saline solution is not as viscous, therefore it will not increase the viscosity of blood POLYCYTHEMIA This occurs when the number of red blood cells increase beyond the normal and the viscosity of blood it increased This condition causes an increase in BP This can occur when oxygen levels in the air decrease and the body attempts to increase its ability to attract oxygen to the blood MAIN SUPERFICIAL VEINS FLUCTUATIONS IN BLOOD PRESSURE No one’s blood pressure stays the same all the time With exercise higher BP is a good thing. Provides the body with additional oxygen \ and nutrients during this period Normal BP is about 120/80 “Normal” varies among individuals and with age VENOUS BLOOD PRESSURE Venous pressure in the right atrium is called Central Venous Pressure This pressure is important because it influences pressure that exists in large peripheral veins If heartbeat is strong then CVP is low as blood enters and leaves the heart chambers efficiently With exercise higher BP is a good thing. Provides the body with additional oxygen \ and nutrients during this period PULSE • The pulse is the alternate expansion and recoil of the blood vessel wall PULSE • Where are some land marks to take and record the Pulse? Temporal Carotid Brachial Femoral Dorsalis Pedis • Review objectives • QUESTIONS • The End