cardiovasc block 10

8/12/2019 Cardiovasc Block 10

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Block 10

The Cardiovascular System

Dr Mutiara Budi Azhar SU. MMedSc

Faculty of Medicine Sriwijaya University


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Dr MBA Cardiovascular System 2

Introduction

The cardiovascular system is a transportsystem bringing nutrients to and returningwaste products from the tissues.This system is divided into two main parts:

The circulatory system , consisting of theheart, which acts as a pump, and the bloodvessels through which the blood circulates.

The lymphatic system , consisting of lymphnodes and lymph vessels, through whichcolourless lymph flows.


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Introduction (Cont. 2)

The heart pumps oxygen-rich blood via thearteries, arterioles and capillaries to the tissues.Venules and veins bring oxygen-poor blood

back to the heart, which shunts it to the lungsto be oxygenated via the pulmonarycirculation. Picture
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Carbon dioxide (CO 2) is eliminated by thelungs, and other waste products are eliminated

by the kidneys.Lymph return some substances that haveleaked from the capillaries into the tissues

back into the venous system.The exchange of nutrients and waste productsin tissues involves the capillaries.


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The circulatorysystem

The pulmonary circulationThe systemic circulation


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The right side of the heart pumps blood to thelungs ( the pulmonary system ) where gasexchange occurs (CO 2 leaves the blood andenters the lungs, and O 2 leaves the lungs and

enters the blood)The left side of the heart pumps blood into thesystemic circulation , which supply the rest ofthe body; here, tissue wastes are passed intothe blood for excretion, and the body cellsextract nutrients and O 2.


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Blood Vessels

Arteries (arteriae = aa; arteria = a)Arterioles (arteriolae; arteriola)Capillaries

Venules (venulae; venula)Veins (venae = vv; vena = v)


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The relationship between the heart and the different types of blood vessel.


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Arteries and Arterioles(Arteriae et Arteriolae)

The blood vessels that transport blood awayfrom the heart.Vary considerably in size.Their walls consists of three layers: Tunica adventitia or outer layer of fibrous tissue. Tunica media or middle layer of smooth muscle

and elastic tissue Tunica intima or inner lining of squamous

epithelium called endothelium.


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Structures of artery and vein


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Anastomoses and end arteries

Anastomoses are arteries that form a link between main arteries supplying an area (e.g.the arterial supply to the palms of the hands).What is collateral circulation?End arteries are the arteries with noanastomosis.


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Veins and Venules(Venae et Venulae)

The blood vessels that return blood at low pressure to the heart.Its wall are thinner than those of arteries (whatmake them different and why?).beban kerjalebih ringanSome veins posses valves (where the valvesabundant and where they absent, and why?)The smallest veins are called venules (venulae,

plural ; venula, singular )


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Interior of a vein


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Capillaries and Sinusoids

The smallest arterioles break up into a numberof minute vessels called capillaries.Describe the structure of a capillary wall!

What is capillary bed?Sinusoids are wider than capillaries and haveextremely thin walls separating blood from theneighbouring cells.The blood pressure is sinusoids is lower thanin capillaries and there is a slower rate of

blood flow (Why?)


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The CAPILLARY

A collection of capillaries is known as a capillary bed .



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Blood Supply

The outer layer of tissues of thick-walled blood vessels receive their blood supplyvia a network of blood vessels called vasavasorum .Vessels with thin walls and theendothelium of the others receive oxygenand nutrients by diffusion from the blood

passing through them.


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The Heart

The heart is a roughly cone-shaped hollowmuscular organ.It is about 10 cm long and is about the size ofthe owners fist. It weights about 225 g in women and isheavier in men (about 310 g)


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The Position of the Heart

Lies in the thoracic cavity in the mediastinum between the lungs.Lies obliquely, a little more to the left than theright, and presents a base ( basis ) above, and

apex below.The apex is about 9 cm to the left of themidline and the level of the 5 th intercostalspace ( spatium intercostale ), a little below thenipple and slightly nearer the midline.The base extends to the level of the 2 nd rib.


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The position of the heart in the thorax


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Organs associated with the heart

Inferiorly (identify)Superiorly (identify)

Posteriorly (identify)Laterally (identify)Anteriorly (identify)


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Organs associated with the heart


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Structure of the heart

The heart is composed of three layers of tissue: Pericardium

Myocardium Endocardium


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The pericardium

is made up of twosacs; the outer sac consist offibrous tissue andthe inner of acontinues doublelayer of serous

membrane (SeeSnell, RS. Clinical Anatomy )


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Myocardium

Composed of specialized cardiac muscle foundonly in the heart.

Not under voluntary control but, like skeletalmuscle, cross-stripes are seen on microscopicexamination.Thickest at the apex and thins out towards the

base (Why?)Each fibre (muscle cell) has a nucleus and oneor more branches.


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Cardiac muscle with fibres separated


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Interior of the Heart

The heart is divided into right and left side bythe septum ( septum interatriale and septuminterventriculare ), a partition consisting ofmyocardium covered by endocardium.After birth blood cannot cross the septum fromone side to the other.Each side is divided by an atrioventricularvalve into an upper chamber, the atrium, and alower chamber, the ventricle.


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Atrioseptal valve: normal and defective closure after birth


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Interior of the heart


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The valves

Valve (valvula = valva)Valvula atrioventriculare dextra (valvulatricuspidalis)Valvula atrioventriculare sinistra (valvula

bicuspidalis).The valves open and close passively accordingto changes in pressure in the chambers.


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The left atrioventricular valve


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Direction of blood flow through the heart


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Blood supply to the heart

Arterial supply Left and right coronary arteries

Venous drainage

Coronary sinuses Little venous channels (whats the name) (See Sobotta )


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The coronary arteries


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Conducting System of the Heart

Small groups of specializedneuromuscular cells in the myocardiumwhich initiated and conduct impulsescausing coordinated and synchronizedcontraction of the heart muscle.


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Conducting System of the Heart (Cont. 2)

SA-NodeAV-NodeAV bundle or

bundle of HissPurkinje fibres

Normally, SA- Node is thePacemaker


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Conducting System of the Heart (Cont. 3)

The heart is an intrinsic system whereby thecardiac muscle is automatically stimulated tocontract without the need for a nerve supplyfrom the brain.

However, the system can be stimulated ofdepressed by nerve impulses initiated in the

brain ( autonomic nervous system ) and

circulating chemicals including hormones .


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l


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PulseThe main

pulse points(pulse takingarteries)


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Systemic or General Circulation

Aorta: Aorta ascendence Arcus aorta Aorta descendence:

Aorta thoracalisAorta abdominalis


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The aorta and its main branches


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Arcus aorta and its branches


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Main arteries of the left side of the head and the neck


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The aorta and the main arteries of the limbs


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The venae cavae and the main veins of the limbs


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Arteries forming circulus arteriosus Willisi


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The right vertebral artery


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Veins of the left side of the head and the neck


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Venous sinuses of the brain viewed from the right


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Venous sinuses of the brain from above


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The main arteries of the right arm


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The main veins of the right arm


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The aorta and its main branches in the thorax


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The superior vena cava and the main veins of the thorax


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The abdominal aorta and its branches


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Truncus coeliacus and its branches and a. phrenica inferior

d f d h b h


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a. Mesenterica superior and a. mesenterica inferior and their branches


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Venous drainage from the abdominal organs and the formation of theportal system


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The portal vein formation and termination


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The femoral artery and its main branches


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D i


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Ductus arteriosus


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Thank you very much for your kind attention


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cardiovasc block 10

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