Lecture 16: Cardiovascular System

The Heart as a Pump

The Right and Left Hearts are Connected in Series, but are Folded Together to Form a
Single Unit

The right heart pumps blood only to the lungs; its output is low pressure (25 mm Hg)
The left heart pumps blood to the rest of the body; its output is high pressure (120 mm
Hg)
Because the 2 hearts are attached they beat in synchrony
The 2 atria receive the incoming blood- they pump extra blood into the ventricles
The 2 ventricles produce enough pressure to push blood through the pulmonary and
systemic circulations

The right side of the heart has been colored blue to indicate deoxygenated blood; the red
color of the left side indicates oxygenated blood that has come from the lung.
There are no valves where the vena cavae and join the right atrium or where the
pulmonary veins enter the left atrium. Pressures in the atria are small and valves are not
needed.

Pressure Causes Valves to Open and Close in the Heart Cycle

The heart has 2 sets of valves:

o AV valves: between atria and ventricles
Flap type
Chorda tendinae & papillary muscles keep them from being pushed too
far
Left heart: bicuspid or mitral (2 flaps)
Right heart: tricuspid: (3 flaps)
o Semilunar valves: where arteries leave heart
Blood caught in the 3 cusps pushes them closed
Right heart: pulmonary semilunar
Left heart: aortic semilunar
o Leaks in valves -> murmurs
o Usually there are no valves where veins enter the atria
Not needed, low pressure
Exception is a valve between the inferior vena cava and right atrium, but
this is missing in many adults
When the heart contracts pressure builds up, forcing the valves to close
o Muscles are not required to close the valves
Valves in the cardiac cycle:
AV Valves:
Right: Tricuspid
Left: Mitral
Filling of ventricle Open
Building up
Closed
pressure
Expelling blood
Closed
Event

Semilunar Valves:
Right: Pulmonary
Left: Aortic
Closed
Closed
Open

Opening and closing of valves depends upon the pressures on opposite sides
o Example: aortic valve
o Closed during filling and building up of pressure in the left ventricle because
pressure in the aorta is higher than pressure in the ventricle
o When pressure in the left ventricle becomes higher than pressure in the aorta the
aortic valve opens and blood is expelled from the heart

Heart Sounds are Produced by the Closing of the Valves

Normal heart sounds are produced when valves snap closed: LUB-DUP
LUB = closing of AV valves: beginning of systole
DUP = closing of semilunar valves: end of systole
Abnormal valve sounds:
o Leakage of valve -> swishing sound (murmur)
o Narrowing of valve (stenosis) -> high pitched sound

The Cardiac Output is the Product of Heart Rate and Stroke Volume

Normally about 5 liters/min

The cardiac output per minute (CO) is the product of the size of a single output, the
stroke volume (SV), and the heat rate (HR) in beats/minute:
o CO = HR X SV
o = 70 beats/min X .07 liters/beat = 5 liters/min
If the SV is constant, doubling the HR will double the CO

Heart Rate Can be Increased From About 70 to 200 Beats/Minute

Resting heart rate is about 60-80 beats/min (lower in athletes because they have large
stroke volumes)
The HR can be increased about 3 times in exercise
Above about 200 beats/min the heart would not have time to fill properly- therefore
nature limits the rate
Rate is controlled by the autonomic nervous system

Stroke Volume is Controlled by Sarcomere Length

When the venous return of blood to the heart increases the heart beats more forcefully
and puts out more blood: Frank- Starling's law of the heart
Can be explained by sarcomere length:
o Cardiac muscle is like skeletal muscle: there is an optimum length for the
sarcomeres
o At rest heart sarcomeres are too short to give maximum tension
o Filling heart to a greater volume stretches sarcomeres- they become more
efficient and contract more strongly
o More input -> sarcomeres stretch -> stronger contraction -> more output
Mechanism allows SV to increase about 1.5 to 2X.

Blood Pressure is Caused by Cardiac Contraction

Blood pressure at the output of the left heart alternates between a high pressure (systole)
and a lower pressure (diastole)
Systole:
o When the heart beats (systole) the pressure in the arteries leaving the heart rises
to about 120 millimeters of mercury (mm Hg)
Diastole:
o Between beats (diastole) the arterial pressure drops to about 80 mm Hg
o The diastolic pressure does not drop to 0 because the arterial walls are elastic
o A force due to wall elasticity pushes on the arterial blood between beats
o The 80 mm Hg diastolic pressure keeps the blood flowing between beats
Blood pressure is reported as systolic pressure over diastolic pressure
o Example: 120/80

Systemic Blood Pressure Depends Upon Cardiac Output and Resistance to Flow

The more blood pumped into the arteries the higher the pressure

Pressure also goes up if there is more resistance to flow- this occurs when large numbers
of arterioles constrict
The body changes both CO and resistance to adjust blood pressure
The higher the blood pressure the more work the heart must do to pump blood

Blood Pressure is Regulated by Reflexes and the Kidney

Blood pressure must be closely regulated

o If too low circulation will be poor;
o If too high there is danger of arterial damage or hemorrhage
Short term regulation (seconds -> minutes): baroreceptor reflex
o Example:
If you are lying down and suddenly stand up the pressure in the aorta will
fall as blood flows to the lower limbs.
The baroreceptor reflex will cause the heart to speed up and increase its
stroke volume.
This raises the cardiac output and the blood pressure will go up
o Components of the reflex:
Pressure is measured by sensors in the arch of the aorta and in the carotid
sinus (the carotids are the major arteries supplying blood to the brain)
The control center is in the medulla of the brain
Two nerves control the heart rate:
Vagus nerve: slows the heart
Accelerator nerve: speeds it up
Long term regulation (days -> years) is mainly by the kidney
o Kidney regulates the salt and water content of the body, and these substances
control the blood pressure
The more fluid in the blood vessels the higher the pressure
o Salt:
Sodium retention is controlled by the Na pump
The hormone aldosterone increases Na pump activity in the kidney
The hormones renin and angiotensin control the amount of aldosterone
secreted into the blood
o Water:
If Na is retained the blood osmotic pressure rises and this causes water to
be retained also- by osmosis in the kidney
Water reabsorption in the kidney requires water channels in the kidney
tubules
The water channels are controlled by the antidiuretic hormone (ADH)
If ADH is present at high concentrations there will be much water
reabsorbed and the blood pressure will rise