Cardiovascular

Heart & CV system anatomy & function


Blood vessels structure & function

Mechanisms of action & control

Transmission of an electrical impulse

Cardiovascular system & exercise

Blood pressure regulation

Components of CV system


Heart

  • Establishes pressure gradient needed for blood to flow to tissues

Blood vessels

  • Passageway for blood

Blood

  • Materials dissolved or suspended and transported

Major blood vessels


Aorta

  • Largest artery in the body
  • Leaves heart at left ventricle
  • Carries oxygenated blood to the body

Vena cava

  • Major vein, returns deoxygenated blood from the body to the right auricle

Pulmonary artery

  • Carries deoxygenated blood from right ventricle to the lungs for oxygenation

Pulmonary vein

  • Carries oxygenated blood from lungs to left atrium

3 kinds of blood vessels


  1. Arteries
  • Carries blood away from heart
  • Thick strong walls
  • Narrow lumen, varies with heartbeat


  1. Capillaries
  • Gradually join up to form veins
  • Thin, one cell thick
  • Very narrow lumen


  1. Veins
  • Carries blood towards the heart
  • Thin walls
  • Valves to prevent back flow

Heart


  • Size of large fist
  • 280-340g in men
  • Located thoracic cavity

Pericardium


  • Thin sac enclosing the heart
  • Holds heart in position whilst allowing movement for contraction

Fibrous pericardium

  • Prevents over stretching
  • Tough, inelastic
  • Attaches to diaphragm
  • Top fused to connective tissue of blood vessels entering and leaving the heart


Serous pericardium

  • Reduces friction between layers of serous pericardium as the heart moves
  • Thinner, more delicate membrane
  • Forms double layer around heart
  • Outer layer fixed to fibrous layer
  • Inner layer fixed to heart surface
  • Pericardial fluid in the middle

Chamber of the heart

  • Atria
  • Ventricles
  • Auricles - Wrinkled pouch-like structures, slightly increases the capacity of the atrium
  • Sulcus - Grooves which hold blood vessels and fat

Blood flow through the heart


  1. Blood enters right atrium from superior and inferior vena cava
  2. Blood flows from right atrium through tricuspid valve to right ventricle
  3. Contraction of right ventricle causes pulmonary valve to open
  4. Blood flows though pulmonary valve to pulmonary artery
  5. Blood flows to lungs, unloads CO2 and take up O2
  6. Blood returns to heart via pulmonary vein and enters left atrium
  7. flows from left atrium though bicuspid valve to left ventricle
  8. Contraction of left ventricle causes aortic valve to open
  9. Flows though aortic valve to aorta and to the body organs and tissues
  10. Unloads O2 and takes up CO2
  11. Deoxygenated blood returns to heart via superior and inferior vena cava

Cardiac conduction system


Group of specialised cardiac muscle cells in the walls of the heart that send signals to the heart muscle causing it to contract


  • Sinoatrial node (SA) is natural pacemaker, starts the sequence by causing the atrial muscles to contract
  • Signal travels to the atrioventricular (AV) node, down through purkinje fibres, causing ventricles to contract
  • The signal creates an electrical current that can be seen on a graph called an electrocardiogram (ECG)

Cardiac Output


Volume of blood ejected from a ventricle every minute


Calculated by Stroke volume (SV) (volume of blood expelled with each beat) multiplied by heart rate (number of beats)


e.g
Heart beat 72bpm
Stroke volume 70ml


72 x 70 = 5040ml/min


5040 / 1000


= 5.04L/min

Heart beat regulation


  1. Autonomic nervous system
  2. Hormonal control

Autonomic regulation of heart rate


Medulla oblongata contains the cardiovascular centre

2 Nerves link the cardiovascular centre in the medulla oblongata to the SA nodes of the heart


  1. Accelerator nerve (Sympathetic NS)
  • When stimulated releases neurotransmitter at the SA node to increase heart rate
  1. Vagus nerve (parasympathetic NS)
  • When stimulated releases neurotransmitter at the SA node to decrease heart rate

Cardiovascular centre receives input from 4 main receptor groups


  1. Pressure receptors in heart (baroreceptors)
  • Found in carotid arteries and arch of the aorta
  1. Chemoreceptors in heart (detects CO2 and O2 levels, and changes in pH)
  • Found in carotid arteries and arch of the aorta
  1. Thermo receptors in muscles


  2. Stretch receptors in muscles

Hormonal control


Adrenal medulla produces adrenaline (and noradrenaline)

  • Secreted from adrenal glands
  • Increases heart rate by increasing frequency of impulses released from the SA node
  • Increases force of contraction

Thyroid hormone (thyroxine) increases heart rate

  • Hyperthyroidism give tachycardia (heart rate exceeding normal)(heart rate over 100)

Cations controlling heart rate


K+, Ca2+ and Na+ have a big effect of cardiac function


  • Elevated blood K+ and Na+ decrease heart rate and contraction
  • Excess Na+ blocks Ca2+ inflow during cardiac action potentials, decreasing the force of contraction, excess K+ blocks generation of action potentials
  • A moderate increase in intestinal Ca2+ levels speeds heart rate and strengthens the heart beat

If you have low potassium levels you may have a heart problem e.g irregular heart beat


High potassium levels, heart muscle activity may be reduced


Ions need ions for action potential, imbalance of ions can therefore alter effectiveness of the heart


Elevated K+ and Na+ blood levels decrease heart rate and contractibility

Sympathetic NS activity increases heart rate


Parasympathetic NS decreases heart rate

ECG electrical activity


P-wave

  • Activation of the atria

QRS complex

  • Activation of ventricles

T-wave

  • Recovery wave

Exercise makes the heart work harder and increases cardiac output


Proprioceptors (sensory receptors)

  • In muscles, tendons, joints inform cardiovascular centre that movement has increased

Chemoreceptors

  • Located in aorta and carotid arteries detect decrease in blood pH due to increase of lactic acid and CO2

Baroreceptors

  • Detect low blood pressure because of vasodilation in skeletal muscles

How the heart ages


  • Heart shrinks
  • Decreased contraction strength
  • Valves become less flexible
  • Cardiac output decreases
  • Abnormal rhythms

Decreased blood pressure and volume


Endocrine mechanism

  • ADH, angiotensin II, aldosterone, EPO released
  • Increases blood volume

Neural mechanism

  • Baroreceptors, chemoreceptors stimulated
  • Cardiovascular centres stimulated
  • General sympathetic activation, release norepinephrine and epinephrine
  • Cardiac output increases
  • Peripheral vasoconstriction increases blood pressure
  • Decreases venous reserve

Nervous system controlling blood pressure


Regulates blood pressure via negative feedback loops


Baroreceptor reflex

  • Responds to stretch of artery wall
  • Feed info to the brainstem cardiovascular centre

Baroreflex


Drop in blood pressure

  • Drop in blood pressure detected by baroreceptor
  • Decrease parasympathetic activity to sinoatrial (SA) node
  • Increases heart rate = increased stroke volume = increased blood pressure

Increase in blood pressure

  • Increase in blood pressure detected by baroreceptor
  • Increased parasympathetic activity to SA node
  • Decreases heart rate = Decreased stroke volume = Decreased blood pressure

Hormonal regulation of blood pressure


Renin-angiotensin-aldosterone (RAA) system


  • Controls blood pressure by regulating the volume of blood in the body
  • Renin is an enzyme that hydrolyses angiotensinogen (liver) into angiotensin I
  • Angiotensin-converting enzyme converts angiotensin I into angiotensin II (a vasoconstrictor, elevates blood pressure)
  • Elevation of renin causes blood pressure increase

Electrical activity of myocardium


P wave

  • SA nodes fire, atria depolarise and contract, atrial systole begins 100 milliseconds after SA signal

QRS complex

  • Ventricular depolarisation complex shape of spike due to different thickness and shape of the two ventricals

ST segment

  • Ventricular systole plateau in myocardial action potential

T wave

  • Ventricular repolarisation and relaxation

Limitation of baroreflex


  • Can responds to increase/decrease of atrial pressure, but most important role is responding to reductions/increases in arterial pressure


  • Long term regulation of arterial pressure requires activation of other mechanisms (hormonal and renal) to maintain normal blood pressure because baroreceptors adapt to sustained changes in arterial pressure

High blood pressure


Diagnosing Hypertension
Blood pressure measure in clinical setting


Stage 1 - 140/90 mmHg +
Stage 2 - 160/100 mmHg +
Severe hypertension - Systolic 160 mmHg or diastolic 110 mmHg

Long term consequences of hypertension

  • Stroke
  • Blood vessel damage (arteriosclerosis)
  • Heart attack or failure
  • Kidney failure