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Professor Md.Toufiqur
Rahman
MBBS, FCPS, MD, FACC, FESC, FRCP, FSCAI,
FCCP,FAPSC, FAPSIC, FAHA,FACP,FASE
Professor and Head of Cardiology
Colonel Malek Medical College , Manikganj
.drtoufiq19711@yahoo.com
Anatomy of
Cardiovascular System
The Cardiovascular System
• A closed system of the heart and blood
vessels
– The heart pumps blood
– Blood vessels allow blood to circulate to all
parts of the body
• The function of the cardiovascular system
is to deliver oxygen and nutrients and to
remove carbon dioxide and other waste
products
Cardiovascular System-parts
• Also circulatory system
• Consists of: the heart, arteries, veins,
capillaries
Heart
• Four chamber muscular organ
• Comparable to the size of a closed fist
• Located in the mediastinum
– Behind sternum
– Between 2nd - 6th ribs
– Between T5-T8
• Apex – base of heart
– Located at the 5th
– intercostal space
Heart
External Heart Anatomy
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
Walls of the Heart
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 interventricul
– ar 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
– Btwn R atrium and ventricle
– 3 flaps of endocardium
– Connected to ventricular papillary muscle
via chordae tendinae
• Bicuspid valve
– Btwn L atrium and ventricle
– Also called mitral valve
– Two flaps of endocardium
Semilunar Valves
• Pulmonary semilunar valve
– Btwn R ventricle and pulmonary trunk
• Aorta semilunar valve
– Btwn L ventricle and aorta
Operation of Heart Valves
The Heart:
Associated Great Vessels
• Aorta - leaves left ventricle
• Pulmonary arteries - leave right ventricle
• Vena cava - enters right atrium
• Pulmonary veins (four) - enter left atrium
Coronary Circulation
• Blood in the heart chambers does not
nourish the myocardium
• The heart has its own nourishing
circulatory system
– Coronary arteries
– Cardiac veins
– Blood empties into the right atrium via the
coronary sinus
Blood Supply to the Heart
• Right and left coronary arteries
– First branches off aorta
– Right coronary artery  right marginal
artery & posterior interventricular artery
– Left coronary artery  circumflex artery
& anterior interventricular artery
– Most of the blood goes to the L ventricle
– In 50% of the population, the R coronary
artery is dominant
Anterior view
Posterior view
Blood Supply to the Heart
• Anastomosis: Connections between blood
vessels that allow for collateral circulation
• Few exist between large branches of coronary
arteries
• In presence of an obstruction in a large
artery ischemia will result to a large area of
tissue
– Myocardial infarction (MI) (aka heart attack)
• Anastomoses do exists between smaller
branches of the R and L coronary arteries
Blood Supply to the Heart
• After traveling through the capillaries
of the heart, blood empties into the R
atrium via the coronary sinus
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
Types of Blood Vessels
• Artery – carries oxygenated blood away
from the heart
– “distributors”
– Arteriole: small artery
– Precapillary sphincters: regulate the blood
flow into capillaries
Types of Blood Vessels
• Vein – carries unoxygenated blood
towards the heart
– Great ability to stretch (capacitance)
– Function as reservoirs: blood pools in the
valves then is pushed forward from the
pumping pressure
– Venules: small vein
Types of Blood Vessels
Types of Blood Vessels
• Capillaries – arterial system switches to
venous system
– “primary exchange vessels”
– Transport materials to and from the cells
– Speed of blood flow decreases to increase
contact time
– Microcirculation: blood flow between
arterioles, capillaries and venules
Types of Blood Vessels
Structure of Blood Vessels
• Tunica adventitia - outermost layer
– Fibrous connective tissue
– Holds vessels open; prevents tearing of
vessels walls during body movements
– Larger in veins than arteries
• Tunica media – middle layer
– Smooth muscle and elastic CT
– Helps vessels constrict and dilate
– Larger in arteries
Structure of Blood Vessels
• Tunica intima – innermost layer
– Composed of endothelium
– Semilunar valves present in veins
– One cell thick in capillaries
Circulatory Routes
• Systemic Circulation – blood flow from
the L ventricle to the body & back to
the R atrium
• Pulmonary Circulation – blood flow from
the R ventricle to the lungs and back to
the L atrium
Circulatory Routes
Aorta
Systemic Arteries
• Arch of aorta
• Subclavian (L and R)
• Brachiocephalic
• common carotid (L
and R)
• Axillary (L and R)
• Brachial (L and R)
• Radial
• Ulnar
• Abdominal aorta
• Common iliac
• External iliac
• Femoral
• Popliteal
• Posterior tibial
• Anterior tibial
• Dorsal pedis
The Vascular System
Systemic Veins
• Superior vena cava
• Inferior vena cava
• External jugular
• Internal jugular
• Brachiocephalic (L
and R)
• Subclavian (L and R)
• Cephalic
• axillary
• Basilic
• Median basilic
• Median cubital
• Common iliac
• External iliac
• Femoral
• Popliteal
• Great saphenous
• Small saphenous
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 btwn 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**
Fetal Circulation
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
Developmental Aspects of the
Cardiovascular System
• A simple “tube heart” develops in the
embryo and pumps by the fourth week
• The heart becomes a four-chambered
organ by the end of seven weeks
• Few structural changes occur after the
seventh week

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Anatomy of the_cardiovascular_system - dr toufiq

  • 1. Professor Md.Toufiqur Rahman MBBS, FCPS, MD, FACC, FESC, FRCP, FSCAI, FCCP,FAPSC, FAPSIC, FAHA,FACP,FASE Professor and Head of Cardiology Colonel Malek Medical College , Manikganj .drtoufiq19711@yahoo.com Anatomy of Cardiovascular System
  • 2. The Cardiovascular System • A closed system of the heart and blood vessels – The heart pumps blood – Blood vessels allow blood to circulate to all parts of the body • The function of the cardiovascular system is to deliver oxygen and nutrients and to remove carbon dioxide and other waste products
  • 3. Cardiovascular System-parts • Also circulatory system • Consists of: the heart, arteries, veins, capillaries
  • 4. Heart • Four chamber muscular organ • Comparable to the size of a closed fist • Located in the mediastinum – Behind sternum – Between 2nd - 6th ribs – Between T5-T8 • Apex – base of heart – Located at the 5th – intercostal space
  • 7. 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
  • 8. 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
  • 9. Walls of the Heart
  • 10. 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 interventricul – ar septum
  • 11.
  • 12. 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
  • 13.
  • 14. Atrioventricular Valves • Tricuspid valve – Btwn R atrium and ventricle – 3 flaps of endocardium – Connected to ventricular papillary muscle via chordae tendinae • Bicuspid valve – Btwn L atrium and ventricle – Also called mitral valve – Two flaps of endocardium
  • 15. Semilunar Valves • Pulmonary semilunar valve – Btwn R ventricle and pulmonary trunk • Aorta semilunar valve – Btwn L ventricle and aorta
  • 17. The Heart: Associated Great Vessels • Aorta - leaves left ventricle • Pulmonary arteries - leave right ventricle • Vena cava - enters right atrium • Pulmonary veins (four) - enter left atrium
  • 18. Coronary Circulation • Blood in the heart chambers does not nourish the myocardium • The heart has its own nourishing circulatory system – Coronary arteries – Cardiac veins – Blood empties into the right atrium via the coronary sinus
  • 19. Blood Supply to the Heart • Right and left coronary arteries – First branches off aorta – Right coronary artery  right marginal artery & posterior interventricular artery – Left coronary artery  circumflex artery & anterior interventricular artery – Most of the blood goes to the L ventricle – In 50% of the population, the R coronary artery is dominant
  • 21.
  • 22. Blood Supply to the Heart • Anastomosis: Connections between blood vessels that allow for collateral circulation • Few exist between large branches of coronary arteries • In presence of an obstruction in a large artery ischemia will result to a large area of tissue – Myocardial infarction (MI) (aka heart attack) • Anastomoses do exists between smaller branches of the R and L coronary arteries
  • 23. Blood Supply to the Heart • After traveling through the capillaries of the heart, blood empties into the R atrium via the coronary sinus
  • 24.
  • 25. 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
  • 26.
  • 27.
  • 28. 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
  • 29. Types of Blood Vessels • Artery – carries oxygenated blood away from the heart – “distributors” – Arteriole: small artery – Precapillary sphincters: regulate the blood flow into capillaries
  • 30. Types of Blood Vessels • Vein – carries unoxygenated blood towards the heart – Great ability to stretch (capacitance) – Function as reservoirs: blood pools in the valves then is pushed forward from the pumping pressure – Venules: small vein
  • 31. Types of Blood Vessels
  • 32. Types of Blood Vessels • Capillaries – arterial system switches to venous system – “primary exchange vessels” – Transport materials to and from the cells – Speed of blood flow decreases to increase contact time – Microcirculation: blood flow between arterioles, capillaries and venules
  • 33. Types of Blood Vessels
  • 34. Structure of Blood Vessels • Tunica adventitia - outermost layer – Fibrous connective tissue – Holds vessels open; prevents tearing of vessels walls during body movements – Larger in veins than arteries • Tunica media – middle layer – Smooth muscle and elastic CT – Helps vessels constrict and dilate – Larger in arteries
  • 35. Structure of Blood Vessels • Tunica intima – innermost layer – Composed of endothelium – Semilunar valves present in veins – One cell thick in capillaries
  • 36. Circulatory Routes • Systemic Circulation – blood flow from the L ventricle to the body & back to the R atrium • Pulmonary Circulation – blood flow from the R ventricle to the lungs and back to the L atrium
  • 37.
  • 38.
  • 39.
  • 41. Aorta
  • 42. Systemic Arteries • Arch of aorta • Subclavian (L and R) • Brachiocephalic • common carotid (L and R) • Axillary (L and R) • Brachial (L and R) • Radial • Ulnar • Abdominal aorta • Common iliac • External iliac • Femoral • Popliteal • Posterior tibial • Anterior tibial • Dorsal pedis
  • 43.
  • 45. Systemic Veins • Superior vena cava • Inferior vena cava • External jugular • Internal jugular • Brachiocephalic (L and R) • Subclavian (L and R) • Cephalic • axillary • Basilic • Median basilic • Median cubital • Common iliac • External iliac • Femoral • Popliteal • Great saphenous • Small saphenous
  • 46.
  • 47. 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 btwn the R and L atria – Allows for blood to bypass the R ventricle and pulmonary circulation
  • 48. 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**
  • 50. 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
  • 52. Developmental Aspects of the Cardiovascular System • A simple “tube heart” develops in the embryo and pumps by the fourth week • The heart becomes a four-chambered organ by the end of seven weeks • Few structural changes occur after the seventh week