CARDIOVASCULA

R SYSTEM
Departemen Fisiologi
Fakultas Kedokteran
Universitas Sumatera
Utara
Dr. Poland Room 3-007, Sanger Hall, Phone: 8289557

CARDIOVASCULAR
SYSTEM
heart, which serves as a pump
for the
blood,
blood vessels, which transport
blood throughout the body.
a continuous and closed
circuit,

Functions of the Cardio-Vascular

System
Delivery of O2, Glucose and other
nutrients to active tissues.
Transport of metabolites and other
substances to and from storage
sites.
Transport of hormones, antibodies
and other substances to site of
t
r
action.
po

s
n
Tra

Dr Peter K. McFawn Department of Physiology Queens University

Botterell Hall 4th floor

HEART
heart consists of two separate

pumps; right and left side

right side; pumps blood to the
lungs through the pulmonary
gas exchange, uptake of oxygen
and elimination of carbon dioxide
can take place

left side; pumps blood to the rest

of the tissues of the body through

the systemic circulation oxygen
and nutrients are delivered to the
tissues to sustain their activities
and carbon dioxide and other
metabolic waste products are
removed from the tissues

BLOOD VESSELS
arterial system, arteries and arterioles,
carry blood away from heart and toward
tissues.
arterioles deliver blood to the capillaries
where exchange of substances between
blood and tissues takes place.
From capillaries, blood flows into the
vessels of the venous system, veins and
venules, which carry blood back to the
heart.

BASIC PHYSICS OF BLOOD FLOW

To function mechanically as a
pump, the heart must have:
Receiving chambers ; atria
Delivery chambers; ventricles
Valves; ensure the one-way, or
forward, flow of the blood

Cardiac output (CO); amount of blood

from each ventricle pumped/minute
depends on volume of bood ejected per
minute (stroke volume, SV) and number
of heart beats per minute (heart beat,
HR)
CO = SV x HR

Systole; phase
of cardiac cycle
during which
ventricle cells
are contracting
Diastole; when
ventricle cells
relax

Conducting System of the Heart

Inter- nodal Tracts
SA Node
AV Node

Left Bundle
Branch
Anterior Superior Fascicle

Bundle of HIS

Posterior Inferior Fascicle

Septal Depolarization Fibers

Purkinjie Fibers

Right Bundle
Branch

 Diastolic Filling

Autonomic Neural
Influences
Adrenergic sympathetic nerve
fibers release norepinephrine on
cardiac cells which interacts with
1 adrenergic receptors to
increase heart rate, action
potential conduction velocity, force
of contraction and rates of
contraction and relaxation.
increase cardiac pumping

 Cholinergic parasympathetic nerve fibers

travel to heart via vagus nerve and innervate
SA node, AV node, and atrial muscle. When
active, release acetylcholine which interacts
with muscarinic receptors on cardiac
muscle cells to decrease heart rate (SA
node) and action potential conduction
velocity (AV node), force of contraction of
atrial (not ventricular) muscle cells.

The Circulatory System

2 main divisions
Pulmonary circulation (heart lungs)
Pulmonary artery: deoxygenated blood from the heart to
the lungs
Pulmonary vein: oxygenated blood from the lungs to the
heart

Systemic circulation: (Heart rest of the body)

Aorta: feeds oxygenated (arterial) blood to the body
Venae cavae: returns deoxygenated (venous) blood from
the body

PULMONARY
CIRCULATION
1. LOW RESISTANCE
2. LOW PRESSURE
(25/10 mmHg)

SYSTEMIC
CIRCULATION
1. HIGH RESISTANCE
2. HIGH PRESSURE
(120/80 mmHg)
PARALLEL
SUBCIRCUITS
UNIDIRECTIONAL
FLOW

CAPACITY VESSELS

THE SYSTEMIC
CIRCULATION
1. HIGH RESISTANCE
2. HIGH PRESSURE
(120/80 mmHg)

THE PULMONARY
CIRCULATION
1. LOW RESISTANCE
2. LOW PRESSURE
(25/10 mmHg)

NORMAL

VALVES
Atrioventricular

(AV) valves; between

the atria and the ventricles:
Right side: tricuspid valve
Left side: bicuspid valve (mitral valve)
Semilunar valves; separate the
ventricles from their associated
arteries.
Right side: pulmonary valve
Left side: aortic valve

ATRIOVENTRICULAR VALVE
When

ventricles contract, the

pressure within them increases
substantially, creating a pressure
gradient for blood flow from ventricles
back into the atria where the pressure
is very low.

Closure

of the AV valves prevents this

potential backward flow of blood.

 When

ventricles are stimulated to

contract, the papillary muscles also
contract, pulling downward on chordae
tendinae
In this way, the flaps of valves are not
pushed open into the atria, but instead
are held in place in the closed position.
Blood is now forced to continue its
forward progression and move from
ventricles into their respective arteries

SEMILUNAR VALVES

These

valves prevent backward flow

of blood from the pulmonary artery
or the aorta into their preceding
ventricles when the ventricles relax.

HEART SOUNDS
Two sounds are normally heard through a stethoscope

during each cardiac cycle.

First sound, a low, slightly prolonged lub caused
by vibrations set up by sudden closure of AV valves at
start of ventricular systole. Duration 0,15 s and
frequency 25 to 40 Hz.
Second sound, a shorter, high-pitched dup caused
by vibrations associated with closure of aortic and
pulmonary valves just after the end of ventricular
systole. Duration 0,12 s and frequency 50 Hz.

Third sound, a soft, low-pitched, is heard about

one third of the way through diastole in many

normal young individuals. It coincides with period
of rapid ventricular filling and is probably due to
vibrations set up by the inrush of blood.
Fourth sound can sometimes be heard
immediately before first sound when atrial pressure
is high or ventricle is stiff in conditions such as
ventricular hypertrophy. It is due to ventricular
filling and is rarely heard in normal adults.

MURMUR
Blood normally flows in a laminar

fashion; that is, layers of fluid slide

smoothly over each other (lamina
means layer). Laminar flow does
not produce any sound up to a critical
velocity; above this velocity and
beyond an obstruction, blood flow is
turbulent and creates sounds.
Blood flow speeds up when an artery
or a heart valve is narrowed.

Murmurs (abnormal heart sounds) are

usually (but not always) associated with

cardiac disease.
Murmurs not involving heart pathology, socalled functional murmurs, are more
common in young people (and some
elderly people) with perfectly healthy
hearts, probably because their heart walls
are relatively thin and vibrate with rushing
blood.
Systolic murmurs are also heard in anemic
patients as a result of the low viscosity of

HEART MURMUR
Heart murmurs can be either systolic or

diastolic.
During systole, while left ventricle is
contracting, aortic valve is open and the
mitral valve is closed.
Turbulent flow can occur either because
of an incompetent mitral valve, leading
to regurgitation of blood back into the
atrium, or from a narrowed aortic valve.

HEART MURMUR
In diastole, the situation is

reversed, with filling of the left

ventricle through an open mitral
valve while the aortic valve is
closed.
Turbulent flow occurs when there
is narrowing of the mitral valve or
incompetence of the aortic valve.

Thank You

Let it
beat!