Anatomy of

The Cardiovascular System

1
 Cardiovascular System
• The cardiovascular (cardio- heart, vascular-
blood vessels) system is divided into two main
parts for descriptive purposes
• The heart whose pumping action ensures
constant circulation of blood
• The blood vessels which form a lengthy
network of in which the blood flows
• The heart pumps blood into two anatomically
separate system of blood vessels:
Sunday, March 31, 2024 2
 Cardiovascular System…
• Pulmonary circulation- the right side of the heart
pumps blood into the lungs where gas exchange
occurs, i.e. the blood collects oxygen from the
airsacs and excess carbon dioxide diffuses into the
airsacs for exhalation
• Systemic circulation- the left side of the heart
pumps blood into the systemic circulation, which
supplies blood to the rest parts of the body
• Here, the tissue wastes are passed into blood for
excretion and body cells extract nutrients and
oxygen
Sunday, March 31, 2024 3
 The Heart
• The heart is cone-shaped hollow muscular
organ, its about 10cm long and is about the
size of the owner’s fist, weighs about 225g in
women and is more heavier in men about
310g
• The heart lies in the thoracic cavity in the
mediastinum (space between the two lungs)
• It lies obliquely, a little more to the left than
the right, have a base above and an apex
below
Sunday, March 31, 2024 4
 Heart Location
• Approximately the size of your fist
• Location
– Within the middle mediastinum
– Superior surface of diaphragm
– Left of the midline
– Anterior to the vertebral column,
posterior to the sternum
5
Heart Location

6
External Heart: Anterior View

7
External Heart: Posterior View

8
 Heart Walls
• The heart wall is composed of three layers of tissue:
• Pericardium- is the outermost layer and is made up of
two sacs
• Outer sac fibrous pericardium, consists of fibrous
tissue and the inner serous pericardium, continuous
double layer of serous membrane, secrets serous fluid
called pericardial fluid which allows smooth
movement when the heart beats
• Myocardium- is composed of specialized cardiac
muscle found only in the heart
• It is striated, not under voluntary control, each fiber
has a nucleus and one or more branches
Sunday, March 31, 2024 9
 Heart Walls…
• The Function of the Pericardium:
– Protects and anchors the heart
– Prevents overfilling of the heart with
blood
– Allows for the heart to work in a
relatively friction-free environment

10
 Heart Muscle
• The ends of the cells and branches are in very close
contacts within the ends and branches of adjacent
cells, forming “joints” (intercalated discs)
• This arrangement makes an impulse which is
initiated to spread from cell to cell via the
intercalated discs over the whole “sheet” of
muscle causing contractions
• The sheet arrangement of myocardium enables the
atria and ventricles to contract in a coordinated
and efficient manner

Sunday, March 31, 2024 11

Microscopic Anatomy of Heart Muscle

12
Figure 18.11
 Heart Wall…
• Endocardium- lines the chambers and valves
of the heart
• It is a thin smooth membrane to ensure
smooth flow of blood through the heart

Sunday, March 31, 2024 13

Layers of the Heart Wall

14
 Major Vessels of the Heart
• Vessels returning blood to the heart
include:
1. Superior and inferior venae cavae
2. Right and left pulmonary veins
• Vessels conveying blood away from the
heart include:
1. Pulmonary trunk, which splits into right
and left pulmonary arteries
Chapter 18, Cardiovascular System 15
 Major Vessels of the Heart…
2. Ascending aorta (three branches) –
a. Brachiocephalic
b. Left common carotid
c. Subclavian arteries
• Vessels returning blood to the heart include:
1. Right and left pulmonary veins
2. Superior and inferior venae cavae

Sunday, March 31, 2024 16

 Vessels that Supply/Drain the Heart
(Anterior View
• Arteries – right and left coronary (in
atrioventricular groove), marginal,
circumflex, and anterior interventricular
arteries
• Veins – small cardiac, anterior cardiac,
and great cardiac veins

17
Vessels Supplying the Heart

Figure 18.4b
18
 Vessels that Supply/Drain the Heart
(Posterior View)
• Arteries – right coronary artery (in
atrioventricular groove) and the
posterior interventricular artery (in
interventricular groove)
• Veins – great cardiac vein, posterior vein
to left ventricle, coronary sinus, and
middle cardiac vein

19
Vessels Draining the Heart

Figure 18.4b
20
 Flow of Blood Through the Heart
• The two largest veins of the body superior and
inferior vena cavae empty their contents into the
right atrium
• This blood passes to the right ventricle via right
atrioventricular valve, from where it is pumped into
the pulmonary artery (only artery carrying
deoxygenated blood) via pulmonary valve
• The right and left pulmonary arteries from each
lung carry the venous blood to the lungs where
exchange of gases occur; carbon dioxide is excreted
and oxygen is absorbed
Sunday, March 31, 2024 21
Flow of Blood Through the Heart…
• The pulmonary veins (only veins carrying
oxygenated blood) from each lung carry the
oxygenated blood back to the left atrium
• Blood then passes to the left ventricle via left
atrioventricular valve, and the it is pumped
into the aorta, via the aortic valve to the other
body systems

Sunday, March 31, 2024 22

 Pathway of Blood Through the Heart and
Lungs
• Right atrium  tricuspid valve  right ventricle
• Right ventricle  pulmonary semilunar valve 
pulmonary arteries  lungs
• Lungs  pulmonary veins  left atrium
• Left atrium  bicuspid valve  left ventricle
• Left ventricle  aortic semilunar valve  aorta
• Aorta  systemic circulation

23
Pathway of Blood Through the Heart and Lungs

Figure 18.5
24
 Atria of the Heart
• Atria are the receiving chambers of the
heart
• Each atrium has a protruding auricle
• Pectinate muscles mark atrial walls
• Blood enters right atria from superior and
inferior venae cavae and coronary sinus
• Blood enters left atria from pulmonary
veins

25
 Ventricles of the Heart
• Ventricles are the discharging chambers of the
heart
• Papillary muscles and trabeculae carneae
muscles mark ventricular walls
• Right ventricle pumps blood into the pulmonary
trunk
• Left ventricle pumps blood into the aorta

26
 Thickness of Heart Chambers
• Thickness of myocardium varies according to
the function of the chamber
• Atria are thin walled, deliver blood to
adjacent ventricles
• Ventricle walls are much thicker and stronger
right ventricle supplies blood to the lungs
(little flow resistance) left ventricle wall is the
thickest to supply systemic circulation

Sunday, March 31, 2024 27

Myocardial Thickness and Function

28
 Thickness of Cardiac Walls

Myocardium of left ventricle is much thicker than the

right.
29
 Heart Valves
• Heart valves ensure unidirectional blood flow
through the heart
• Atrioventricular (AV) valves lie between the
atria and the ventricles
– AV valves prevent backflow into the atria
when ventricles contract
• Chordae tendineae anchor AV valves to papillary
muscles

30
 Heart Valves
• Normal heart contains four valves that regulate
blood flow into and out of the heart
• The aortic and pulmonary valves are known as
semilunar valves, whereas the tricuspid and
mitral valve are known as atrioventricular valves
• All these valves are trileaflet with the exception
of the mitral valve which have two leaflets
(bicuspid)

31
 Heart Valves....
• Cardiac valves are sorrounded by fibrous tissue
forming partial or complete valvular rings or annuli
• These annuli joins the fibrous skeleton of the heart
to anchor and support the valvular structures
• Aortic semilunar valve lies between the left
ventricle and the ascending aorta
• Pulmonary semilunar valve lies between the right
ventricle and pulmonary trunk. It prevents
regurgitation of deoxygenated blood from
pulmonary artery back to the right ventricle. It is a
semilunar valve with three cusps
32
 Heart Valves…
• Semilunar valves prevent backflow of blood into
the ventricles
• Tricuspid valve is made up of three valve
leaflets- the annulus, the supporting chordae
tendinae and the papillary muscles . It is located
between the right atrium and right ventricle
• Mitral valve- connects the left atrium and the
left ventricle. Mitral valve opens during diastole
to allow blood to flow from LA to LV

33
 Heart Valves…
• Any congenital or acquired disorder of
individual component can disturb the finely
coordinated mechanisms of the mitral valve
and result in incompetent valve

34
Heart Valves…

35
Heart Valves…

36
Atrioventricular Valve Function

Figure 18.9
37
Semilunar Valve Function

Figure 18.10
38
 Blood Vessels
• Blood vessels vary in structure, size and function.
These are:
• Arteries and arterioles- are vessels that transport
blood away from the heart
• They vary considerably in size and their walls consist
of three layers of tissue;
– Tunica adventitia or outer layer of fibrous tissue
– Tunic media or middle layer of a smooth muscle and
elastic tissue
– Tunica intima or inner lining of squamous epithelium
called endothelium
Sunday, March 31, 2024 39
 Blood Vessels…
• The amount of muscular and elastic tissue varies in
the arteries depending upon their size and function
• In the large arteries, including the aorta (elastic
arteries), the tunica media contains more elastic
tissue and less smooth muscle
• This allows the vessel wall to stretch, absorbing the
pressure wave generated by the heart as it beats
• These proportions gradually change as the arteries
branch many times and become smaller until the
arterioles (the smallest arteries)

Sunday, March 31, 2024 40

 Blood Vessels….
• The tunica media of arterioles consists almost
entirely of smooth muscle
• This enables their diameter to be precisely
controlled, which regulates the pressure within
them
• Arteries have thicker walls than veins to
withstand the high pressure of arterial blood
• Capillaries and Sinusoids- the smallest
arterioles break up into a number of minute
vessels called capillaries
Sunday, March 31, 2024 41
 Blood Vessels….
• Capillary wall consists of a single layer of endothelial
cell sitting on a very thin basement membrane,
through which water and other small molecules can
pass
• The capillaries form a vast network of tiny vessels that
link the smallest arterioles to the smallest venules
• The capillary bed is the site of exchange of substances
between blood and the tissue fluid, which bathes the
body cells
• With the exception of the cells on the skin surface and
in the cornea of the eye, every body cell lies close to a
capillary
Sunday, March 31, 2024 42
 Blood Vessels….
• Veins and Venules- veins return blood at low
pressure to the heart
• The walls of the veins are thinner than arteries but
have the same three layers of tissue
• They are thinner because there is less muscle and
elastic tissue in the tunica media, as veins carry blood
at a lower pressure than arteries
• Some veins posses valves, which prevent backflow of
blood, ensuring that it flows towards the heart
• The valves are formed by a fold of tunica intima and
strengthened by connective tissue
Sunday, March 31, 2024 43
 Blood Vessels….
• Valves are abundant in the veins of the limbs
especially lower limbs where blood must
travel a considerable distance against gravity
when the individual is standing
• They are absent in very small and very large
veins in the thorax and abdomen
• Valves are assisted in maintaining one-way
flow by skeletal muscles surrounding the veins
• The smallest veins are called venules

Sunday, March 31, 2024 44

 Blood Vessels….
• At any one time, about two thirds of the
body’s blood is in the venous system
• This allows the vascular system to absorb (to
an extent) sudden changes in blood volume,
such as haemorrhage; the veins can constrict,
helping to prevent a sudden fall in blood
pressure

Sunday, March 31, 2024 45

 Blood
• Blood is a fluid connective tissue, which
circulates constantly around the body,
allowing constant communication between
tissues distant from each other
• Blood makes up about 7% of body weight
(about 5.6 liters in a 70kg man)
• Blood transport oxygen, nutrients, hormones,
heat, protective substances and clotting
factors
Sunday, March 31, 2024 46
 Functions of Blood
• Carries/transports oxygen from the lungs to all body
parts and carbon dioxide from all the body tissues to
the lungs
• Carries nutrients substances from the digestive system
and hormones from the endocrine glands to all the
tissues
• Protects the body against diseases (immunological
functions) done by white blood cells, antibodies and
anti-toxins
• Transports waste products from tissues to the kidney
(urea, uric acid) for excretion
• Regulatory functions- regulates body temperature
Sunday, March 31, 2024 47
 Blood Cells
• There are three types of blood cells:
• Erythrocytes (red blood cells)- the most abundant
type of blood cell (99% of all blood cells)
• Their main function is gas transport mainly oxygen
and some carbon dioxide
• Their shape, biconcave increases their surface area
for gas exchange
• Platelets (Thrombocytes)- their cytoplasm is packed
with granules containing substances that promote
blood clotting causing heamostasis (cessation of
bleeding)
Sunday, March 31, 2024 48
 Blood Cells…
• Leukocytes (white blood cells) have an
important function in defense and immunity
• They detect foreign or abnormal (antigenic)
material and destroy it
• They are two main types of white blood cells:
Granulocytes (polymorphonuclear
leukocytes)- neutrophils, eosinophils and
basophils
• Agranulocytes- monocytes and lymphocytes
Sunday, March 31, 2024 49
 Plasma
• Blood is composed of a clear, straw-coloured,
watery fluid called plasma in which several
different types of cells are suspended
• Plasma constitute 55% of the blood volume
and 45% of the cell
• Blood cells and plasma can be separated by
centrifugation (spinning) or by gravity when
blood is allowed to stand the cells are heavier
than plasma thus they sink to the bottom

Sunday, March 31, 2024 50

 Constituents of Plasma
• The constituents of plasma are water (90-92%),
dissolved and suspended substances including:
• Plasma proteins (albumins, globulins & clotting
factors). Plasma viscosity (thickness) is due to plasma
proteins mainly albumin and fibrinogen
• Inorganic salts/electrolytes- calcium, sodium,
phosphate. The pH of blood is maintained between
7.35-7.45 (slightly alkaline) by an ongoing buffering
system
• Nutrients- products of digestion e.g. glucose, amino
acids, fatty acids and glycerol are absorbed from the
alimentary tract
Sunday, March 31, 2024 51
 Constituents of Plasma….
• Waste products- urea, creatinine and uric acid are waste
products of protein metabolism
• They are formed in the liver and carried in blood to the
kidneys for excretion
• Carbon dioxide from tissue metabolism is transported to
the lungs for excretion
• Hormones- chemical messagers synthesized by endocrine
glands pass directly from the endocrine cells into the
blood, which transport them to their target organs
• Gases- oxygen, carbon dioxide and nitrogen are
transported round the body dissolved in plasma
• Oxygen and carbon dioxide are also transported in
combination with haemoglobin in red blood cells
Sunday, March 31, 2024 52
 Blood Grouping
• The surface of red blood cells carries a range of different
proteins called antigens
• These antigens can stimulate an immune response if transferred
from one individual (the donor) into the bloodstream of an
incompatible individual
• These antigens, which are inherited determine the individual’s
blood group
• Individuals can make antibodies to these antigens, but not to
their own type of antigen
• If an individual is transfused with blood of the same group i.e.
possessing the same antigens on surface of red cells, their
immune system will not recognize them as foreign and will not
reject them (compatible)
Sunday, March 31, 2024 53
 Blood Grouping…
• However, if they are given blood from an individual
of a different blood type i.e. with a different type of
antigen on red cells, their immune system will
generate antibodies to the foreign antigens and
destroy the transfused cells
• This is the basis of the transfusion reaction; the two
blood types (donor & recipient) are incompatible
• There are many different collections of red cell
surface antigens, but the most important for the
sake of blood transfusion are the ABO system and
the Rhesus system

Sunday, March 31, 2024 54

 The ABO System
• About 55% of the population has either A-type
antigens (blood group A), B-type antigens (blood group
B) or both A-type & B-type antigens (blood group AB)
• The remaining 45% have neither A nor B type antigens
(blood group O)
• The corresponding antibodies are called anti-A and
anti-B
• Blood group A individuals cannot make anti-A abs
(therefore do not have these antibodies in their
plasma), since otherwise a reaction to their own cells
would occur; they can however make anti-B
Sunday, March 31, 2024 55
 The ABO System…
• Blood group AB individuals make neither anti-A nor anti-
B antibodies, and blood group O individuals make both
anti-A and anti-B antibodies
• Because blood group AB people make neither anti-A nor
anti-B antibodies, they are referred to as universal
recipients
• This means that transfusion of either type A, B AB, or O is
likely to be safe
• Blood group O people have neither A nor B antigens on
their red cell membranes, thus their blood can be safely
transfused into A, B, AB and O blood types, thus blood
group O individuals are referred to as universal donors
Sunday, March 31, 2024 56
 The ABO System…
• The ABO system is not the only thing to be
considered during transfusion because other
antigen systems on donor/recipient cells may
be incompatible and cause a transfusion
reaction
• For this reason, prior to transfusion, blood
grouping and cross-matching is required to
ensure that there is no reaction between
donor and recipient bloods

Sunday, March 31, 2024 57

 The Rhesus System
• The red blood cell membrane antigen important in
blood grouping is the Rhesus (Rh) antigen or
Rhesus factor
• About 85% of people have this antigen thus they
are Rhesus positive (Rh₊) and do not therefore
make anti-Rhesus antibodies
• The remaining 15% of people have no Rhesus
antigen thus they are Rhesus negative (Rh₋)
• Rhesus negative individuals are capable of making
anti-Rhesus antibodies in case of an incompatible
blood transfusion
Sunday, March 31, 2024 58
 Homeostasis
• When a blood vessel is damaged, loss of blood is stopped
and healing occurs in a series of overlapping processes, in
which platelets play a vital role. These processes are:
1. Vasoconstriction- when platelets come into contact with
a damaged blood vessel, their surface becomes sticky
and adhere to the damaged wall
They then release serotonin (5-hydroxytryptamine)
which constricts (narrows) the vessel, reducing or
stopping blood flow through it
Other chemicals that causes vasoconstriction e.g.
thromboxanes are released by the damaged vessel itself

Sunday, March 31, 2024 59

 Homeostasis…
2. Platelet plug formation- the adherent platelets
clump to each other and release other substances
including adenosine diphosphate (ADP) which
attracts more platelets to the site
Passing platelets stick to those already at the
damaged vessel and they too release their
chemicals
This is a positive feedback mechanism by which
many platelets rapidly arrive at the site of
injury/damage and quickly form a temporary seal-
the platelet plug
Sunday, March 31, 2024 60
 Homeostasis…
3. Coagulation (Blood clotting)- this involves clotting
factors (named I-XIII) activate each other,
eventually resulting in formation of prothrombin
activator which is the first step in the final common
pathway
Prothrombin activates the enzyme thrombin,
which converts inactive fibrinogen to insoluble
threads of fibrin
As clotting proceeds, the platelet plug is
progressively stabilized by increasing amounts of
fibrin laid down
Sunday, March 31, 2024 61
 Homeostasis…
• The blood clot traps blood cells and other
plasma proteins including plasminogen which
eventually destroy the clot
• After some time, the clot shrinks (retracts)
pulling the edges of the damaged vessel
together, reducing blood loss and closing off
the hole in the vessel wall

Sunday, March 31, 2024 62

 Homeostasis…
4. Fibrinolysis- after the clot has formed, the
process of removing it and healing the
damaged vessel begins
The breakdown of the clot is called fibrinolysis
Plasminogen is converted to the enzyme
plasmin, which breaks down fibrin to soluble
products that are treated as waste materials
and removed by phagocytosis
As the clot is removed, the healing process
restores the integrity of the blood vessel wall
Sunday, March 31, 2024 63
 Blood Pressure
• Blood pressure is the force or pressure that
the blood exerts on the wall of blood vessels
• Systemic arterial blood pressure maintains
the essential flow of blood into and out of the
organs of the body
• Keeping blood pressure within normal limits is
important, because if it becomes too high,
blood vessels can be damaged, causing clots
or bleeding from sites of blood vessel rupture

Sunday, March 31, 2024 64

 Blood Pressure…
• If it falls too low, then blood flow through tissue
beds may be inadequate and dangerous for
essential organs such as heart, kidneys or brain
• The systemic arterial blood pressure (arterial blood
pressure) is the result of the discharge of blood
from the left ventricle into the aorta
Systolic and Diastolic Pressures
• When the left ventricle contracts and pushes blood
into the aorta, the pressure produced within the
arterial system is called systolic blood pressure, in
adults it is about 120mmHg
Sunday, March 31, 2024 65
 Blood Pressure…
• in complete cardiac diastole when the heart is
resting following the ejection of blood, the
pressure within the arteries is much lower and
is called diastolic blood pressure, in an adult it
is about 80mmHg
• The difference between the systolic and
diastolic pressure is the pulse pressure
• Arterial blood pressure is measured using a
Sphygmomanometer
Sunday, March 31, 2024 66
 Factors Affecting Blood Pressure
• Blood pressure is determined by cardiac output and
peripheral resistance (BP= PR X CO)
• Cardiac output is the amount of blood the heart pumps
through the circulatory system in a minute. The
amount of blood put out by the left ventricle in one
contraction is called stroke volume
• The stroke volume and the heart rate (heart beats per
minute) determines the cardiac output
• An increase in cardiac output raises both systolic and
diastolic pressure and increase in stroke volume
increases systolic pressure more than diastolic pressure
Sunday, March 31, 2024 67
 Factors Affecting Blood Pressure…
• Peripheral resistance (arteriolar resistance)-
constriction and dilation of the arterioles are
the main determinants of peripheral
resistance
• Vasoconstriction causes blood pressure to rise
and vasodilation causes it to fall
• When elastic tissue in the tunica media is
replaced by fibrous tissue as part of ageing
process, blood pressure rises
Sunday, March 31, 2024 68
 Autoregulation
• Systemic blood pressure continually rises and falls
according to level of activity, body position etc
• However, the body organs are capable of adjusting
blood flow and blood pressure in their own local
vessels independent of systemic blood pressure
• This property is called autoregulation and it protects
the body tissues against swings in systemic pressures
• It is important in the kidneys, which can be damaged
by increased pressure in their delicate glomerular
capillary beds, in brain, which is very sensitive to even
slight increases in levels of cellular wastes
Sunday, March 31, 2024 69
Artificial Heart

70
.

71