Cardiovascular System

Lecture 13

Supplies the raw materials for metabolism and establishes the environment of the extracellular fluid

CARDIOVASCULAR SYSTEM
Blood serves as medium of transport Blood Vessels tubes that carry blood
Pulmonary Circulation Systemic Circulation

Heart two side-by-side pumps that move blood through the vessels
Right pump powers the pulmonary circulation Left pump powers the systemic circulation

Pulmonary Circulatory System

Right Heart pumps deoxygenated blood to the lungs Blood becomes oxygenated and unloads CO2 Oxygenated blood is returned to the Left Heart

Right Lung

Left Lung

Systemic Circulatory System

Oxygenated blood is pumped from the Left Heart

Oxygenated blood is circulated to the tissues O2 is unloaded and CO2 is picked up Blood is returned to the Right Heart

Anterior View of the Heart

Right Pump
To Right Lung To Left Lung

Superior Vena Cava

Pulmonary Artery Pulmonary Semilunar Valve

Right Atrium
Right Atrioventricular Valve Inferior Vena Cava Right Ventricle

Aorta

Left Pump

Pulmonary Veins (4) Left Atrium Aortic Semilunar Valve Left Atrioventricular Valve (mitral)

Left Ventricle Why is the wall of the left ventricle so much thicker than the right?

Cardiac Cycle
The heart beats in a rhythmic pattern at a rate of about 70 beats per minute
Resting <60 bpm = bradycardia Resting >100 bpm = tachycardia

Each cycle consists of two stages:

The filling stage of the cardiac cycle is called diastole The contraction (emptying) stage of the cardiac cycle is called systole

Cardiac Cycle
The cycle is regulated by the operation of an internal electrical conduction system Heart rate can be increased or decreased by the action of the:
Autonomic Nervous System (ANS)
Parasympathetic branch SLOWS heart rate Sympathetic branch INCREASES heart rate

Hormones
Adrenalin (epinephrine)speeds the heart rate Thyroid hormones (T3 and T4)speeds the heart rate

Cardiac Cycle animation

Electrical Conduction System Organizes the Cardiac Cycle

Sinoatrial (SA) node is the pacemaker

AV node
AV Bundle Purkinje Fibers Purkinje Fibers

Electrocardiogram (ECG)
Recording of electrical changes during a cardiac cycle P wave = SA node triggers impulse, atria are stimulated QRS wave = ventricles are stimulated

T wave = heart relaxes

Abnormalities: Ventricular fibrillation = uncoordinated contraction of ventricles Need to be defibrillated

Blood Vessels
Arteries and arterioles
Carry blood away from the heart

Capillaries
Tiniest vessels; thin, allows diffusion Exchange of materials between blood & body cells

Venules and veins

Return blood to the heart Valves prevent backflow of blood

Stitched end-to-end, the blood vessels would be 60,000 miles long

Arterial Circulation
The hollow interior of all blood vessels is called the lumen Arteries Thick-walled, muscular vessels Carry blood away from the heart Elasticexpand and contract with heart beat We feel expansion as a pulse

Pulse Points
Pulse points feel pulsing of blood in arteries close to skin Used to determine heart rate

Arterial Circulation
Arterioles
smallest arterial vessels prime controllers of blood pressure

In certain organs, arterioles control blood flow by using precapillary sphincters

Vasocontrictionclose sphincters Vasodilationopen sphincters

Organs include skin, GI tract, muscles)

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Capillary Perfusion

Venous Circulation
Veins are thin walled vessels that serve to carry blood back to the heart They also function as a reservoir for blood volume

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To deal with increased demands for blood:

The heart rate increases Some capillary beds dilate to increase blood flow

Some capillary beds constrict to reduce blood flow

Measuring Blood Pressure

Systolic Pressure = Pressure in the large arteries while the ventricles are contracting

Diastolic Pressure = pressure in the large arteries while the ventricles are filling
Measured in mm Hg

110-130

60-80

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Hypotension
Can be OK in athletes May indicate serous problems in others Systolic pressure < 90 mm Hg Diastolic pressure < 60 mm Hg Causes
Heart disease Medication Infection Dehydration Severe blood loss Severe allergic reaction (anaphylactic shock)

Hypotension
Symptomsrelated to low oxygen in brain
Dizziness or lightheadedness Fainting (syncope) Lack of concentration Blurred vision Nausea Cold, clammy, pale skin--vasoconstriction

May lead to SHOCKlife threatening, may cause organ failure

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Hypertension
High blood pressure

Systolic

140 and/or diastolic

90

Affects ~20% of Americans Forces heart to work harder, can lead to major health problems

Causes: genetic predisposition, obesity, arteriosclerosis, smoking, stress

Treatment: lifestyle changes and medication
Silent killer because seldom causes warning symptoms

Arteriosclerosis
Known as hardening of the arteries Lining of the walls accumulates fatty tissue called plaquerestricts blood flow Risk factors include:
High LDL cholesterol in blood Hypertension Diabetes Obesity Inactivity Genetics/family history

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 http://www.youtube.com/watch?v=fLonh7ZesKs&feature =related

Aneurysm
Abnormal widening or ballooning of blood vessels

Vessel may rupture with massive bleeding, can be fatal; can compress nearby nerves
Causes: congenital, hypertension, atherosclerosis Treatments: reduce risk factors, surgical excision (excellent prognosis), replace with plastic tube

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Stroke
Interruption of blood supply to the brain Lack of O2 causes:
Tissue death

Loss of brain function

Paralysis Death possible

Symptoms include:
Changes in vision, speech, comprehension Weakness Loss of sensation

Loss of consciousness

Causes of Stroke
Hemorrhagic stroke (20%) bleeding, trauma, ruptured aneurysm Ischemic stroke (80%)stoppage of blood flow to brain region
Thrombotic strokeblood clot forms in brain (thrombus) and blocks flow of blood
Embolic strokeblood clot travels to the brain (embolus) and blocks flow of blood

TIA (transient ischemic attack)temporary loss of blood flow to the brain, reversible

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Embolic Stroke

The heart muscle (myocardium) is nourished by coronary circulation Coronary arteries are the first to emerge from the aorta

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Heart Disease
Coronary artery disease Cardiac muscle suffers ischemiareduced blood flow Blockage causes pain angina If completely blocked, may result in heart attack (myocardial infarction) If large vessel, heart may stop beating

Angioplasty and stenting video

http://www.youtube.com/wat ch?v=gvRtP3wl_AY&NR=1

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Coronary Bypass
Surgeon grafts segments of another blood vessel to bypass an obstructed Grafted veins carry coronary artery
blocked vessels

arterial blood

New approaches:
tissue engineeringuse stem cells to grow new heart muscle

Heart Transplants
Congestive heart failure = heart no longer able to pump blood adequately
If irreparable require heart transplant >2000 transplants performed yearly in US; ~70% survival rate Problems: lack of donor organs, host rejection of foreign organ

Alternatives: artificial hearts (temporary), xenotransplants (organs from other species)

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Preventing Cardiovascular Disease

Avoid: Smoking nicotine increases blood pressure, heart has to pump harder Drug abuse stimulants can cause heart attacks, excessive alcohol can destroy heart Obesity more strain on heart, hypertension Do: Eat healthy diet low in saturated fats and cholesterol, get antioxidants, fruits & vegetables Exercise keeps weight under control, minimizes stress, reduces hypertension

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