1. BIOL 2074: Anatomy & Physiology II Chapter 15 Cardiovascular System Brenda Holmes MSN/ED, RN Associate Professor Biology South Arkansas Community College Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display

3. Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. Alveolus Oxygenated blood Deoxygenated blood CO 2 CO 2 CO 2 CO 2 CO 2 CO 2 O 2 O 2 O 2 O 2 O 2 O 2 O 2 O 2 CO 2 CO 2 Right atrium Right ventricle Left atrium Left ventricle Systemic circuit delivers oxygen to all body cells and carries away wastes. Oxygenated blood pumped to all body tissues via aorta Deoxygenated blood pumped to lungs via pulmonary arteries Pulmonary circuit eliminates carbon dioxide via the lungs and oxygenates the blood. Oxygenated blood returns to heart via pulmonary veins Deoxygenated blood returns to heart via venae cavae

6. Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. Diaphragm Base of heart Apex of heart Heart Sternum

12. Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. Superior vena cava Aortic valve Right atrium Inferior vena cava (b) (c) Right ventricle Tricuspid valve Left ventricle Papillary muscle Chordae tendineae Left atrium Pulmonary trunk Aorta Superior vena cava Pulmonary valve Right atrium Inferior vena cava (a) Right ventricle Tricuspid valve Left ventricle Papillary muscle Chordae tendineae Mitral (bicuspid) valve Left atrium Pulmonary trunk Aorta Right pulmonary artery Right pulmonary veins Left pulmonary artery Left pulmonary veins Interventricular septum Right pulmonary artery Right pulmonary veins Opening of coronary sinus Left pulmonary artery Left pulmonary veins Mitral (bicuspid) valve Interventricular septum c: © The McGraw-Hill Companies, Inc.

13. Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. Right atrium Cusps of tricuspid valve Chordae tendineae Interventricular septum Papillary muscles Muscular ridges © McGraw-Hill Higher Education, Inc./University of Michigan Biomedical Communications Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. © McGraw-Hill Higher Education, Inc./University of Michigan Biomedical Communications

15. Path of Blood Through the Heart Tissue cells Tissue cells Alveolus Alveolus Left atrium Mitral valve Aortic valve Left ventricle Right atrium Tricuspid valve Pulmonary valve Inferior vena cava Right ventricle Aorta O 2 CO 2 O 2 O 2 CO 2 CO 2 O 2 CO 2 Systemic capillaries Superior vena cava Alveolar capillaries Systemic capillaries Pulmonary veins Alveolar capillaries Pulmonary artery Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.

16. Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. Tricuspid valve Right atrium Right ventricle Pulmonary trunk Pulmonary arteries Alveolar capillaries (lungs) Pulmonary veins Left atrium Left ventricle Aorta Blood to systemic circuit Pulmonary valve Mitral valve Aortic valve Venae cavae and coronary sinus Blood from systemic circuit

18. Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. Aorta Part of aorta removed Aortic valve cusps Right coronary artery Opening of left coronary artery

19. Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. Aorta Pulmonary trunk Left pulmonary artery Left pulmonary veins Left auricle Left coronary artery Great cardiac vein Left ventricle Apex of the heart Superior vena cava Right auricle Inferior vena cava Small cardiac vein Anterior cardiac vein Right ventricle (a) Left pulmonary artery Aorta Left auricle Circumflex artery Cardiac vein Left ventricle Apex of the heart Superior vena cava Left atrium Right atrium Inferior vena cava Coronary sinus Middle cardiac vein Right ventricle (b) Right pulmonary artery Right pulmonary veins Right coronary artery Anterior interventricular artery (left anterior descending artery) Left pulmonary veins Right pulmonary artery Right pulmonary veins Posterior interventricular artery

23. Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. Aortic area Pulmonary area Mitral area Tricuspid area

26. Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. Purkinje fibers Interatrial septum Left bundle branch Interventricular septum Right bundle branch Junctional fibers AV node SA node AV bundle Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. (b) Myocardial muscle fibers (a)

27. 15.1 From Science to Technology Replacing the Heart – From Transplants to Stem Cell Implants

29. Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. (b) (c) (d) (e) (f) Millivolts 0 – .5 .5 1.0 Milliseconds 0 200 400 600 Millivolts 0 – .5 .5 1.0 Milliseconds 0 200 400 600 Millivolts 0 – .5 .5 1.0 Milliseconds 0 200 400 600 P Millivolts 0 – .5 .5 1.0 Milliseconds 0 200 400 600 S Q R QRS complex (h) (g) Millivolts 0 – .5 .5 1.0 Milliseconds 0 200 400 600 Millivolts 0 – .5 .5 1.0 Milliseconds 0 200 400 600 T Millivolts 0 – .5 .5 1.0 Milliseconds 0 200 400 600 (a) Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. S Q R

30. Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. 0 +1 – 1 0 120 100 80 60 40 20 0 160 120 80 P Q S T R P Q S T R 0.3 0.6 0.9 seconds Heart sounds Electrocardiogram (ECG) Pressure changes Aortic pressure Atrial pressure Volume (mL) Millivolts Pressure (mm Hg) One cardiac cycle Atrial systole Ventricular diastole Ventricular systole Aortic semilunar valve opens AV valve closes AV valve opens Ventricular pressure Aortic semilunar valve closes Atrial diastole Ventricular diastole Ventricular systole Atrial systole Ventricular diastole Atrial diastole Ventricular volume Lubb: AV valves close Dupp: Semilunar valves close Ventricular volume

32. Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. (b) Hypothalamus Sympathetic trunk Aorta (a) Receptor Sensory or afferent neuron Central Nervous System Motor or efferent neuron Effector (muscle or gland) Carotid sinus Sensory fibers Parasympathetic vagus nerve SA node Sympathetic nerve AV node Aortic baroreceptors Common carotid artery Carotid baroreceptors Cerebrum (frontal section) Medulla (transverse section) Cardiac center Spinal cord (transverse sections)

33. 15.1 Clinical Application Arrhythmias

35. Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. Artery Lumen (a) (b) (c) Lumen Vein Valve Endothelium of tunica interna Connective tissue (elastic and collagenous fibers) Tunica media Tunica externa Endothelium of tunica interna Middle layer (tunica media) Outer layer (tunica externa) c: © The McGraw-Hill Companies, Inc./Al Telser, photographer

36. 15.2 From Science to Technology Altering Angiogenesis

38. Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. Arteriole Capillary Endothelium Smooth muscle cell Precapillary sphincter

40. Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. (c) Cell junction (b) Slit Capillary (a) Endothelial cell Nucleus of endothelial cell Endothelial cell cytoplasm Lumen of capillary Tissue fluid Tissue fluid b,c, : © Don. W. Fawcett/Visuals Unlimited

41. Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. Arteriole Capillary Venule © Don. W. Fawcett/Visuals Unlimited

42. Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. Net force at arteriolar end Outward force, including hydrostatic pressure = 35 mm Hg Inward force of osmotic pressure = 24 mm Hg Net outward pressure = 11 mm Hg Net force at venular end Outward force, including hydrostatic pressure = 16 mm Hg Inward force of osmotic pressure = 24 mm Hg Net inward pressure = 8 mm Hg Capillary Blood flow from arteriole Outward force, including hydrostatic pressure 35 mm Hg Inward force of osmotic pressure 24 mm Hg Net outward pressure 11 mm Hg Lymphatic capillary Tissue cells Outward force, including hydrostatic pressure 16 mm Hg Inward force of osmotic pressure 24 mm Hg Net inward pressure 8 mm Hg Blood flow to venule

44. Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. (a) (b) Toward heart Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. 100 90 80 70 60 50 40 30 20 10 0 Percent distribution Large veins Small veins and venules Systemic veins 60–70% Lungs 10–12% Heart 8–11% Systemic arteries 10–12% Capillaries 4–5%

48. Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. Temporal a. Carotid a. Brachial a. Radial a. Dorsalis pedis a. Posterior tibial a. Popliteal a. Femoral a. Facial a.

49. 15.2 Clinical Application Blood Vessel Disorders

50. Factors That Influence Arterial Blood Pressure Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. Blood pressure increases Blood volume increases Heart rate increases Stroke volume increases Blood viscosity increases Peripheral resistance increases

51. 15.3 Clinical Application Measurement of Arterial Blood Pressure

52. 15.4 Clinical Application Space Medicine

54. Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. Cardiac output increases Blood pressure rises Sensory impulses to cardiac center Parasympathetic impulses to heart Heart rate decreases Baroreceptors in aortic arch and carotid sinuses are stimulated Blood pressure returns toward normal SA node inhibited Rising blood pressure Sensory impulses to vasomotor center Decreased peripheral resistance Blood pressure returns toward normal Stimulation of baroreceptors in aortic arch and carotid sinuses Less frequent sympathetic impulses to arteriole walls Vasomotor center inhibited Vasodilation of arterioles

56. 15.5 Clinical Application Hypertension

58. 15.6 Clinical Application Exercise and the Cardiovascular System

60. Pulmonary Circuit Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. Left pulmonary artery Pulmonary capillaries Left pulmonary veins Left lung Aorta Right pulmonary artery Pulmonary capillaries Pulmonary trunk Right pulmonary veins Right lung Inferior vena cava Superior vena cava

61. Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. 1 3 4 2 Interstitial space Blood flow Blood flow Alveolar capillary Alveolar air Alveolar wall Capillary wall Fluid from the interstitial space enters lymphatic capillary or alveolar (blood) capillary Any excess water in alveolus is drawn out by the higher osmotic pressure of the interstitial fluid Solutes fail to enter alveoli but contribute to the osmotic pressure of the interstitial fluid Slight net outflow of fluid from capillary Lymphatic capillary Lymph flow

63. 15.7: Arterial System Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. Superficial temporal a. External carotid a. Internal carotid a. Common carotid a. Brachiocephalic a. Axillary a. Intercostal a. Suprarenal a. Brachial a. Renal a. Radial a. Common iliac a. Internal iliac a. External iliac a. Ulnar a. Deep femoral a. Popliteal a. Anterior tibial a. Fibular a. Dorsalis pedis a. Subclavian a. Aorta Coronary a. Celiac a. Superior mesenteric a. Lumbar a. Inferior mesenteric a. Gonadal a. Femoral a. Posterior tibial a. Vertebral a.

64. Principal Branches of the Aorta

65. Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. Right common carotid a. Right internal jugular v. Right subclavian a. Brachiocephalic a. Superior vena cava Right pulmonary a. Right auricle Pulmonary trunk Left common carotid a. Left subclavian a. Aortic arch Ligamentum arteriosum Left pulmonary a. Left pulmonary vv. Left auricle Brachiocephalic vv. Right pulmonary vv. Left internal jugular v.

66. Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. Hepatic a. Renal aa. Splenic a. Celiac a. (b) (a) Right gastric a. Hepatic a. Celiac a. Phrenic aa. Suprarenal a. Renal a. Middle sacral a. Gonadal a. Lumbar aa. Abdominal aorta Splenic a. Left gastric a. Common iliac aa. Superior mesenteric a. Inferior mesenteric a. Intestinal branches from superior mesenteric a. Branches from inferior mesenteric a. Common iliac aa. Abdominal aorta b: © Dr. Kent M. Van De Graaff

67. Arteries to the Brain, Head, and Neck Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. Basilar a. Basilar a. Vertebral a. Spinal cord Spinal a. Anterior cerebral a. Middle cerebral a. Posterior communicating a. Posterior cerebral a. Anterior communicating a. Internal carotid a. Pituitary gland Anterior cerebral a. Middle cerebral a.

68. Arteries to the Brain, Head, and Neck Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. Basilar a. Occipital a. Carotid sinus Subclavian a. Lingual a. Common carotid a. Brachiocephalic a. Anterior choroid a. Maxillary a. Facial a. Superior thyroid a. Superficial temporal a. Posterior auricular a. Internal carotid a. External carotid a. Thyrocervical axis Vertebral a.

69. Arteries to the Shoulder and Upper Limb Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. Right common carotid a. Right subclavian a. Anterior circumflex a. Posterior circumflex a. Axillary a. Brachial a. Radial recurrent a. Radial a. Ulnar a. Deep volar arch a. Superficial volar arch a. Digital a. Ulnar recurrent a. Deep brachial a. Principal artery of thumb

70. Arteries to the Thoracic and Abdominal Walls Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. Internal intercostal m. External intercostal m. Costal cartilage Internal thoracic a. Posterior intercostal a. Anterior intercostal aa. Sternum Thoracic aorta Vertebral body

71. Arteries to the Pelvis Inferior mesenteric a. Inferior epigastric a. Right common iliac a. Internal iliac a. External iliac a. Femoral a. Obturator a. Superior vesical a. Aorta Left common iliac a. Middle sacral a. Iliolumbar a. Superior gluteal a. Lateral sacral a. Inferior gluteal a. Internal pudendal a. Inferior vesical a. Perineal a. Inferior rectal a. Deep circumflex iliac a. Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.

72. Arteries to the Lower Limb Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. External iliac a. Deep femoral a. Lateral femoral a. Femoral a. Deep genicular a. Anterior tibial a. Posterior tibial a. Dorsalis pedis a. Medial plantar a. Anterior view Posterior view Lateral plantar a. Fibular a. Popliteal a. Right common iliac a. Deep circumflex iliac a. Superficial circumflex iliac a. Superficial pudendal a. Internal iliac a. Abdominal aorta

73. 15.8: Venous System Superior vena cava Inferior vena cava Anterior tibial vv. Small saphenous v. Posterior tibial vv. Popliteal v. Femoral v. External iliac v. Common iliac v. Ulnar vv. Radial vv. Renal v. Median cubital v. Great saphenous v. Internal iliac v. Gonadal v. Ascending lumbar v. Hepatic v. Azygos v. Subclavian v. External jugular v. Superficial temporal v. Anterior facial v. Internal jugular v. Right brachiocephalic v. Axillary v. Cephalic v. Brachial vv. Basilic v. Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.

75. Veins from the Brain, Head, and Neck Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. Venous sinuses Vertebral v. Right external jugular v. Right Subclavian v. Right axillary v. Right brachiocephalic v. Superior ophthalmic v. Anterior facial v. Right internal jugular v.

76. Veins from the Upper Limb and Shoulder Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. Superior vena cava Left brachiocephalic v. Right internal jugular v. Right external jugular v. Right subclavian v. Right brachiocephalic v. Axillary v. Brachial vv. Cephalic v. Basilic v. Median cubital v. Radial vv. Ulnar vv. Dorsal arch v.

77. Veins from the Abdominal and Thoracic Walls Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. Brachial v. Basilic v. Azygos v. Cephalic v. External jugular v. Subclavian v. Superior vena cava Axillary v. Inferior hemiazygos v. Posterior intercostal v. Superior hemiazygos v. Brachiocephalic vv. Internal jugular v.

78. Veins from the Abdominal Viscera Liver Gallbladder Pancreas Ascending colon Stomach Spleen Descending colon Rectum Hepatic portal v. Superior mesenteric v. Portion of small intestine Inferior mesenteric v. Splenic v. Right gastric v. Left gastric v. Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.

79. Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. Lungs Aorta Liver Renal capillaries Lower limb capillaries Hepatic vein Splenic artery Hepatic artery Oxygenated blood Deoxygenated blood Head and upper limb capillaries Superior vena cava Inferior vena cava Common iliac vein Trunk capillaries Renal efferent arterioles Hepatic portal vein Common iliac artery Renal afferent arterioles Mesenteric artery (to intestine)

80. Veins from the Lower Limb and Pelvis Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. Anterior view Posterior view Right common iliac v. External iliac v. Inferior vena cava Internal iliac v Femoral v. Great saphenous v. Popliteal v. Anterior tibial vv. Fibular vv. Posterior tibial vv Lateral plantar vv. Small saphenous v. Dorsalis pedis v. Medial plantar vv.

82. 15.7 Clinical Application Molecular Causes of Cardiovascular Disease

83. 15.8 Clinical Application Coronary Artery Disease