Lecture Outline: The Cardiovascular System, Perfusion, and Circulation
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    - Introduction to the Cardiovascular System
        
            - Relationship to Circulatory System
                
                    - Cardiovascular system: heart and vessels
- Circulatory system: heart, vessels, and blood
 
- Location of the Heart
                
                    - Between the two lungs, in the mediastinum
- Situated diagonally, apex points to lower left
- More to the left of the midline, making the left lung smaller
 
- Membranes Surrounding the Heart
                
                    - Pericardium (serous membrane)
                        
                            - Features two layers with pericardial fluid between them
- Allows for slippage and movement without abrasion
 
- Pericardium Layers
                        
                            - Parietal layer (more superficial)
- Visceral layer (in direct contact with heart)
                                
                                    - Also called epicardium (part of heart wall)
 
- Fibrous layer (superficial to serous pericardium)
 
 
 
- Heart Anatomy and Function
        
            - Heart as a Pump: Two Pumps in One
                
                    - Four chambers: two atria (superior), two ventricles (inferior)
                        
                            - Right atrium and right ventricle
- Left atrium and left ventricle
 
- Blood does not mix between right and left sides
 
- Heart Wall Layers (from superficial to deep)
                
                    - Epicardium (visceral layer of serous pericardium)
- Myocardium (thickest, cardiac muscle tissue)
- Endocardium (inner lining, in direct contact with blood)
 
- Atria vs. Ventricles (Wall Thickness)
                
                    - Atria are much thinner-walled and less muscular (pump to adjacent ventricles)
- Ventricles are much thicker-walled and more muscular (pump blood through longer distances)
- Left ventricle is much thicker than right ventricle
                        
                            - Pumps blood to the systemic circuit (rest of body)
- Right ventricle pumps blood to the pulmonary circuit (lungs)
 
 
- Heart Valves: Ensure One-Way Blood Flow
                
                    - Atrioventricular (AV) Valves
                        
                            - Located between an atrium and a ventricle
- Open downward (inferiorly)
- Anchored by chordae tendineae to ventricular wall (prevent backward flow)
- Types:
                                
                                    - Right AV valve (Tricuspid valve): between right atrium and right ventricle (3 cusps)
- Left AV valve (Bicuspid valve): between left atrium and left ventricle (2 cusps)
 
 
- Semilunar Valves (half-moon shaped)
                        
                            - Located between a ventricle and its major artery
- Open upward (superiorly)
- No chordae tendineae
- Types:
                                
                                    - Right semilunar valve (Pulmonary semilunar valve): between right ventricle and pulmonary trunk
- Left semilunar valve (Aortic semilunar valve): between left ventricle and aorta
 
 
 
 
- Blood Flow Circuits
        
            - Pulmonary Circuit
                
                    - Involves the right side of the heart
- Deoxygenated blood from body enters right atrium, then right ventricle
- Right ventricle pumps blood through pulmonary semilunar valve into pulmonary trunk
- Pulmonary trunk splits into pulmonary arteries, then arterioles, then capillaries in lungs
- Gas exchange in lung capillaries: CO2 released, O2 picked up (blood becomes oxygenated)
- Oxygenated blood returns to heart via venules, then larger veins, then pulmonary veins
- Pulmonary veins empty into the left atrium
 
- Systemic Circuit
                
                    - Involves the left side of the heart
- Oxygenated blood from lungs enters left atrium, then left ventricle
- Left ventricle pumps blood through aortic semilunar valve into the aorta
- Aorta branches into arteries, then arterioles, then capillaries throughout the body
- Gas exchange in body capillaries: O2 delivered to cells, CO2 picked up (blood becomes deoxygenated)
- Deoxygenated blood returns to heart via venules, then larger veins
- Superior Vena Cava (from upper body) and Inferior Vena Cava (from lower body) empty into the right atrium
 
- Coronary Circuit (Blood supply to the heart muscle itself)
                
                    - Heart muscle (myocardium) is too thick for direct diffusion of oxygen from blood in chambers
- Coronary arteries branch off the aorta, deliver oxygenated blood to heart muscle
- Coronary veins drain deoxygenated blood from heart muscle, dump into the right atrium
 
 
- Electrical System of the Heart
        
            - Composed of specialized excitable tissues
- Generates and transmits action potentials for rhythmic beating
- Components and Sequence of Operation:
                
                    - Sinoatrial (SA) Node
                        
                            - "Pacemaker of the heart"
- Located in the right atrium
- Creates initial action potentials, causing both atria to contract almost simultaneously
 
- Atrioventricular (AV) Node
                        
                            - Located near the junction of atrium and ventricle
- Transmits signal from SA node to ventricles
- Delays signal to allow atria to fully empty into ventricles
 
- Atrioventricular (AV) Bundle
                        
                            - Located in the interventricular septum
- Rapidly transmits signal after AV node delay
 
- Bundle Branches (two major branches, one for each ventricle)
                        
                            - Send signals down toward the apex of the heart
 
- Purkinje Fibers
                        
                            - Distribute signals to muscle cells in ventricular walls
- Ensure ventricles contract from bottom upward, efficiently ejecting blood
 
 
 
- Cardiac Cycle (One cycle of the pump)
        
            - Diastole (Relaxation)
                
                    - Atrial Diastole: All four chambers relaxed, blood passively enters atria and spills into ventricles
 
- Systole (Contraction)
                
                    - Atrial Systole: Only atria contract, squeezing remaining blood into ventricles
- Ventricular Systole: Ventricles contract
                        
                            - Isovolumetric Contraction: Initial phase, pressure builds, volume doesn't change
- Ejection Phase: Pressure opens semilunar valves, blood is forced into major arteries, ventricular volume decreases
 
 
- Isovolumetric Relaxation: Ventricles relax, ending the cycle
 
- Blood Vessels (Beyond the Heart)
        
            - Categories of Blood Vessels
                
                    - Arteries: Carry blood away from the heart
                        
                            - Much thicker, more muscular walls than veins
- Can vasoconstrict (decrease diameter) or vasodilate (increase diameter) to adjust blood flow
- Do not have internal valves
- Three layers (tunics): tunica intima, tunica media (thickest), tunica externa
 
- Arterioles: Smaller arteries
- Capillaries: Smallest blood vessels
                        
                            - Site of gas exchange between blood and tissues
- Walls are one cell thick (endothelium)
- No tunics (layers)
- Blood pressure is continuous (zero pulse pressure)
 
- Venules: Small veins
- Veins: Carry blood toward the heart
                        
                            - Much thinner, less muscular walls than arteries
- Have internal valves to prevent backflow due to lower pressure
- Skeletal muscle contractions squeeze veins, acting as a pump to push blood toward heart
- Three tunics: tunica intima, tunica media (thinner), tunica externa
 
 
- Control of Blood Flow to Tissues (Perfusion)
                
                    - Capillary beds: Network of capillaries
- Pre-capillary sphincters: Rings of muscle at capillary branch points
                        
                            - Contract to shut off blood flow to specific capillaries
- Relax to allow perfusion (blood flow through tissue)
 
- Vascular shunt: Direct connection from arteriole to venule, bypassing capillary bed when sphincters are contracted
- Not all tissues are perfused at once to prevent drastic blood pressure drop (shock)
 
- Blood Flow to the Brain
                
                    - Brain requires continuous supply of oxygen and glucose
- Supplied by carotid arteries
- Circle of Willis: Circular arterial arrangement at base of brain
                        
                            - Provides collateral circulation; helps maintain blood flow if one carotid artery is blocked
 
 
 
- Blood Pressure Dynamics
        
            - Highest in the aorta (first artery from left ventricle)
- Systolic pressure: Pressure during ventricular contraction
- Diastolic pressure: Pressure during ventricular relaxation
- Pulse pressure: Systolic pressure minus diastolic pressure (height of pressure curve)
                
                    - High in arteries, decreases further from heart
- Zero in capillaries (continuous flow needed for gas exchange)
- Lowest in veins (requires valves and muscle pumps to return blood to heart)
 
 
- Portal Systems
        
            - Definition: Two capillary beds in series before blood returns to the heart
- Hepatic Portal System (Liver)
                
                    - First capillary bed: surrounds digestive system (e.g., small intestine, stomach)
                        
                            - Absorbs nutrients and toxins
 
- Blood collects into veins (e.g., hepatic portal vein) which then branch
- Second capillary bed: surrounds liver cells (hepatocytes)
                        
                            - Liver processes nutrients and removes toxins
 
- Blood then returns to the heart via other veins
 
 
- Major Arteries and Veins (General Overview)
        
            - Arteries (carrying blood away from heart)
                
                    - Aorta: Main artery from left ventricle
                        
                            - Aortic arch: U-turn portion
- Ascending aorta, Descending aorta
- Branches supply lower appendages (iliac arteries), kidneys (renal arteries), and upper body (subclavian, axillary, brachial, radial, ulnar arteries)
 
- Pulmonary arteries: From right ventricle to lungs (carry deoxygenated blood)
 
- Veins (carrying blood toward heart)
                
                    - Superior Vena Cava (SVC): Collects deoxygenated blood from upper body
- Inferior Vena Cava (IVC): Collects deoxygenated blood from lower body
- Both SVC and IVC empty into the right atrium
- Pulmonary veins: From lungs to left atrium (carry oxygenated blood)
- Other veins often named similarly to arteries (e.g., brachial vein, subclavian veins)