CARDIOVASCULAR ANATOMY

dr. I Made Artawan, M.Biomed, Sp.An

FK UNDANA
2018
Component

 There is three component of

circulatory system : (3 C)

1. Blood (Content)
2. Heart (Cardiac)
3. Blood vessels (Conduit)
Heart (Cardiac)

Function of the heart :

 Generating blood pressure
 Routing blood
 Heart separates pulmonary and systemic
circulations
 Ensuring one-way blood flow
 Heart valves ensure one-way flow
 Regulating blood supply
 Changes in contraction rate and force
match blood delivery to changing
metabolic needs
Cardiac Embriology

 Develop in the middle of 3rd week after

fertilization (day 18 or 19).
 Cardiovascular system mainly develop
from splanchnic mesoderm, paraaxial
and lateral mesoderm, and neural crest
cells.
 On the cranial of embryo, the heart
develop from a group of mesoderm cells
 CARDIOGENIC AREA
Heart Anatomy

 Four chamber muscular organ

 Comparable to the size of a closed
fist
 Located in the mediastinum
 Behind sternum
 Between 2nd and 6th ribs
 Between T5-T8
 Apex – base of heart
 Located at the 5th intercostal space
 Coverings of the Heart
 Pericardium – loose fitting sac surrounding
the heart
 Fibrous pericardium – tough, loose-fitting,
inelastic
 Serous pericardium
 Parietal layer: lines the inside of the fibrous
pericardium
 Visceral layer: adheres to outside of the heart
 Pericardial space: between parietal and visceral
layer
 Filled with 10-15mL of pericardial fluid
 Decreases friction
 Walls of the Heart
 Epicardium – outer layer
 Epicardium = serous pericardium
 Myocardium – thick, contractile layer composed
of cardiac muscle cells
 Intercalated disks contain many gap junctions
 Allow cardiac muscle cells to function as a single unit
 syncytium
 Endocaridium – interior of cardiac wall
 Endothelial tissue
 Covers projections of myocardial tissue called
trabeculae
Heart Anatomy
External anatomy :
 Four chambers
2 atria
2 ventricles
 Auricles
 Major veins
Superior vena cava
Pulmonary veins
 Major arteries
Aorta
Pulmonary trunk
Chambers of the Heart

 Atria – two superior chambers

 “Receiving chambers”
 Blood from veins enters atria
 Ventricles – two inferior chambers
 “pumping chambers”
 Thick muscular walls to increase force of
pumping action
 Left > right
 Separated by interventricular septum
Valves of the Heart

 Permit blood flow in one direction

during circulation
 Atrioventricular valves (AV valves)
 Also cuspid valves
 Between atria and ventricles
 Semilunar (SL valves)
 Between R ventricle and pulmonary
arteries and L ventricle and aorta
Atrioventricular Valves

 Tricuspid valve
 Between R atrium and ventricle
 3 flaps of endocardium
 Connected to ventricular papillary muscle
via chordae tendinae
 Bicuspid valve
 Between L atrium and ventricle
 Also called mitral valve
 Two flaps of endocardium
Semilunar Valves

 Pulmonary semilunar valve

 Between R ventricle and pulmonary
trunk
 Aorta semilunar valve
 Between L ventricle and aorta
Heart skeleton

 Consists of plate of fibrous

connective tissue between atria
and ventricles
 Fibrous rings around valves to
support
 Serves as electrical insulation
between atria and ventricles
 Provides site for muscle
attachment
Cardiac muscle
 Elongated, branching cells containing
1-2 centrally located nuclei
 Contains actin and myosin
myofilaments
 Intercalated discs: Specialized cell-
cell contacts
 Desmosomes hold cells together and
gap junctions allow action potentials
 Electrically, cardiac muscle behaves
as single unit
Nerve Supply of the Heart
 The heart is innervated by sympathetic
and parasympathetic fibers of the
autonomic nervous system via the cardiac
plexuses.

 The postganglionic sympathetic fibers

terminate on the sinoatrial and the
atrioventricular nodes, cardiac muscle
fibers, and coronary arteries.
 Activation of these nerves results in
cardiac acceleration, increased force of
contraction by the cardiac muscle, and
dilatation of the coronary arteries.
Nerve Supply of the Heart
 The parasympathetic fibers reach
the cardiac plexuses in the vagus
nerves.
 Postganglionic fibers terminate on the
sinuatrial and the atrioventricular nodes
and on the coronary arteries.
 Activation of the parasympathetic
nerves results in a reduced rate and
force of contraction by the heart and a
constriction of the coronary arteries.
Blood Supply of the Heart
Right Coronary Artery
 The right coronary artery arises from the
anterior aortic sinus of the ascending
aorta.

 It descends in the right atrioventricular

groove and sends branches to the right
atrium and ventricle.

 It ends by anastomosing with the left

coronary artery in the posterior
interventricular groove.
Blood Supply of the Heart
Right Coronary Artery
 Branches :
 The right conus artery supplies the
anterior surface of the infundibulum of
the right ventricle and the upper part
of the anterior wall of the right
ventricle.

 The anterior ventricular branches are

two or three in number and supply the
anterior surface of the right ventricular.
The marginal branch is the largest, and
it follows the lower margin of the costal
surface to reach the apex.
Blood Supply of the Heart
Right Coronary Artery
 Branches :
 The posterior ventricular branches are
usually two in number and branches supply
the diaphragmatic surface of the right
ventricle.

 The posterior interventricular

(descending) artery runs toward the apex
in the posterior interventricular groove and
sends branches to the right and the left
ventricles.

 The atrial branches supply the anterior

and the lateral surfaces of the right atrium.
Blood Supply of the Heart
Left Coronary Artery
 Arises from the left posterior aortic
sinus of the ascending aorta

 Larger than the right coronary artery.

 In the atrioventricular groove, it

divides into an anterior interventricular
branch and a circumflex branch.
Blood Supply of the Heart
Left Coronary Artery
 Branches
 The anterior interventricular (descending )
branch  supplies the right and the left
ventricles.
 The circumflex artery is the same size as the
anterior interventricular artery.
 Left marginal, anterior ventricular, and posterior
ventricular branches supply the left ventricle, and
atrial branches supply the left atrium.
Coronary Circulation : Arterial Supply

Chapter 18, Cardiovascular System Figure 18.7a

32
Coronary Circulation : Venous Supply

Chapter 18, Cardiovascular System Figure 18.7b

33
Blood Flow Through the Heart
Systemic and Pulmonal Circulation
 Fetal Circulation
 Two umbilical arteries carry blood to the
placenta
 The placenta allows for exchange of oxygen
and nutrients from the mother. Maternal and
fetal blood do NOT mix.
 Umbilical vein returns oxygenated blood and
enters fetus via the umbilicus
 Foramen ovale – hole between the R and L
atria
 Allows for blood to bypass the R ventricle and
pulmonary circulation
Fetal Circulation

 Ductus arteriosus – small vessel

connecting the pulmonary artery and
the aorta
 Allows for another bypass route from the
lungs

**Most of fetal blood is a mixture of

oxygenated and deoxygenated blood**
Changes After Birth

 Umbilical vein become round ligament

 Umbilical arteries become umbilical
ligaments
 Foramen ovale closes after first few
breaths
 Full closure may take up to 9 months
 Ductus arteriosus contracts as soon as
respirations begin
 Become fibrous cord
Changes After Birth
Conduction System of the Heart

 Four structures composed of modified

cardiac muscle
 Sinoatrial Node (SA Node)
 Pacemaker of the heart
 100s of cells in the R atrium near the
opening of the superior vena cava
 Atrioventricular Node (AV Node)
 Small mass of cardiac muscle tissue
 Left lower border of R atrium
Conduction System of the Heart

 Atrioventricular Bundle
 Also Bundle of His
 Bundle of specialized cardiac muscle fibers
originating in the AV node
 Branches into R and L branches eventually
becoming Purkinje fibers
 Extend into the walls of the ventricles and
papillary muscles
Conduction System of the Heart

 Conducting System of Heart

Blood vessels (Conduit)

 Blood vessels fall into three

major classes:
 Arteries and arterioles : carry
blood away from the heart.
 Veins and venules : carry blood
to the heart.
 Capillaries : allow exchange of
nutrients, wastes and gases.
Structure of a blood vessel

 Tunica externa (adventitia) - outermost

layer made of loose connective tissue.
Serves to anchor, protect and prevent
overstretching

 Tunica media - middle layer composed of

smooth muscle; functions in dilation and
constriction of blood vessels

 Tunica interna (intima) - innermost layer

made of endothelium (s.squamous
epithelium)
Arteries
 Arteries are thick-walled, and lined with
smooth muscle.
 Arteries expand with each heart beat,
and contract afterwards, helping to move
blood.
 Arterioles branch off of arteries.
 Arterioles can constrict to direct and
control blood flow. They may, for
example, increase blood supply to the
skin to allow more heat to dissipate, or
constrict during stress to redirect blood
to the heart and muscles.
Capillaries

 Body tissues contain a vast

network of thin capillaries.
 Capillary walls are only one cell
thick, allowing exchange of
gases, nutrients, and wastes.
 Capillaries are so fine that RBCs
must line up single-file to go
through them.
Veins

 Veins have thinner walls than

arteries.
 Contraction of skeletal muscles
helps move blood up the limbs
and back to the heart.
 Valves in the veins prevents
backflow of blood.
Venules

 Venules are thin-walled

collectors of blood.

 Low pressure in the venules

allows the capillary beds to
drain into them.
TERIMA KASIH