27-1

The Cardiovascular System

PowerPoint® presentation to accompany:

Medical Assisting
Third Edition

Booth, Whicker, Wyman, Pugh, Thompson

© 2009 The McGraw-Hill Companies, Inc. All rights reserved

 27-2

Learning Outcomes
27.1 Describe the structure of the heart and the
function of each part.

27.2 Trace the flow of blood through the heart.

27.3 List the most common heart sounds and what

events produce them.

27.4 Explain how heart rate is controlled by the

electrical conduction system of the heart.

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Learning Outcomes (cont.)

27.5 List the different types of blood vessels and
describe the functions of each.
27.6 Define blood pressure and tell how it is
controlled.
27.7 Trace the flow of blood through the pulmonary
and systemic circulation.
27.8 List the major arteries and veins of the body and
describe their locations.

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Learning Outcomes (cont.)

27.9 List and describe the components of blood.
27.10 Give the functions of red blood cells, the different
types of white blood cells, and platelets.
27.11 List the substances normally found in plasma.
27.12 Explain how bleeding is controlled.
27.13 Explain the differences among blood types A, B,
AB, and O.

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Learning Outcomes (cont.)

27.14 Explain the difference between Rh-positive blood
and Rh-negative blood.
27.15 Explain the importance of blood typing and tell
which blood types are compatible.
27.16 Describe the causes, signs and symptoms, and
treatments of various diseases and disorders of
the cardiovascular system.

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Introduction
 The cardiovascular system consists of heart and
blood vessels

 Sends blood to
 Lungs for oxygen
 Digestive system for nutrients

 CV system also circulates waste products to

certain organ systems for removal from the blood

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The Heart: Structures

 Cone-shaped organ
about the size of a
loose fist
 In the mediastinum
 Extends from the level
of the second rib to
about the level of the
sixth rib
 Slightly left of the
midline
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The Heart: Structures (cont.)

 Heart is bordered:
 Laterally by the lungs
 Posteriorly by the vertebral
column
 Anteriorly by the sternum

 Rests on the diaphragm

inferiorly

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The Heart: Structures (cont.)

 Heart coverings
Click for Larger View
 Pericardium
 Heart walls:
 Covers the heart and
 Epicardium
large blood vessels
 Outermost layer
attached to the heart
 Fat to cushion heart
 Visceral pericardium
 Myocardium
 Innermost layer
 Middle layer
 Directly on the heart  Primarily cardiac muscle
 Parietal pericardium
 Endocardium
 Layer on top of the  Innermost layer
visceral pericardium  Thin and smooth
 Stretches as the heart
pumps

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The Heart: Structures (cont.)

 Four chambers
 Two atria  Two ventricles
 Upper chambers  Lower chambers
 Left and right  Left and right
 Separated by  Separated by
interatrial septum interventricular
septum
 Atrioventricular septum separates the atria
Click for
from the ventricles View of
Heart

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The Heart: Structures (cont.)

 Tricuspid valve – prevents blood from flowing back
into the right atrium when the right ventricle
contracts
 Bicuspid valve – prevents blood from flowing back
into the left atrium when the left ventricle contracts
 Pulmonary valve – prevents blood from flowing
back into the right ventricle
 Aortic valve – prevents blood from flowing back Click for
View of
into the left ventricle Heart

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The Heart: Blood Flow

Oxygenated
Deoxygenated blood out to
blood in from Oxygenated body
body blood in lungs

Deoxygenated
blood out
to lungs

Atria Contract Ventricles Contract

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The Heart: Blood Flow (cont.)

Right Tricuspid Right Pulmonary

Atrium Valve Ventricle Valve

Body Lungs

Aortic Left Left Pulmonary

Bicuspid
Semilunar Semilunar
Ventricle Valve Atrium
Valve Valve

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The Heart: Cardiac Cycle
 One heartbeat = one cardiac cycle
 Atria contract and relax
 Ventricles contract and relax
 Right atrium contracts
 Tricuspid valve opens
 Blood fills right ventricle
 Right ventricle contracts
 Tricuspid valve closes
 Pulmonary semilunar valve
opens
 Blood flows into pulmonary
artery
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 Left atrium contracts
 Bicuspid valve opens
 Blood fills left ventricle
 Left ventricle contracts
 Bicuspid valve closes
 Aortic semilunar valve
opens
 Blood pushed into aorta
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The Heart: Cardiac Cycle (cont.)

 Influenced by
 Exercise
 Parasympathetic nerves
 Sympathetic nerves
 Cardiac control center
 Body temperature
 Potassium ions
 Calcium ions

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The Heart: Heart Sounds

 One cardiac cycle – two heart sounds (lubb
and dubb) when valves in the heart snap shut
 Lubb – First sound
 When the ventricles contract, the tricuspid and
bicuspid valves snap shut
 Dubb – Second sound
 When the atria contract and the pulmonary and aortic
valves snap shut

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The Heart: Cardiac Conduction System

 Group of structures that send electrical impulses through the heart

 Sinoatrial node (SA node)  Bundle of His

 Wall of right atrium  Between ventricles
 Generates impulse  Two branches
 Natural pacemaker  Sends impulse to Purkinje
 Sends impulse to AV node fibers

 Atrioventricular node (AV  Purkinje fibers

node)  Lateral walls of ventricles
 Between atria just above ventricles  Ventricles contract
 Atria contract Link to
 Sends impulse to the bundle of His Diagram

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Apply Your Knowledge

Match the following: ANSWER:
C Tricuspid valve
__ A. Two branches; sends impulse to Purkinje fibers

__
F Bicuspid valve B. Covering of the heart and aorta

__
B Pericardium C. Between the right atrium and the right ventricle

__
E SA node D. In the lateral walls of ventricles

__
A Bundle of His E. Natural pacemaker

D Purkinje fibers
__ F. Between the left atrium and the left ventricle

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Blood Vessels: Arteries and Arterioles

 Strongest of the  Arterioles
blood vessels  Small branches of
arteries
 Carry blood away
from the heart  Aorta
 Takes blood from the
 Under high pressure heart to the body
 Vasoconstriction  Coronary arteries
 Vasodilation  Supply blood to heart
muscle

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Blood Vessels: Veins and Venules

 Blood under no pressure in  Venules
veins  Small vessels formed when
 Does not move very easily capillaries merge

 Skeletal muscle contractions  Superior and inferior vena

help move blood cava
 Sympathetic nervous system  Largest veins
also influences pressure
 Carry blood into right atrium
 Valves prevent backflow

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Blood Vessels: Capillaries

 Branches of arterioles
 Smallest type of blood vessel
 Connect arterioles to venules
 Only about one cell layer thick
 Oxygen and nutrients can pass out of a capillary into
a body cell
 Carbon dioxide and other waste products pass out of
a body cell into a capillary

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Apply Your Knowledge

How do arteries control blood pressure?

ANSWER: The muscular walls of arteries can constrict to

increase blood pressure or dilate to decrease blood
pressure.

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Blood Pressure
 Force blood exerts on the inner walls of blood vessels
 Highest in arteries
 Lowest in veins

 Systolic pressure
 Ventricles contract
 Blood pressure is at its greatest in the arteries

 Diastolic pressure
 Ventricles relax
 Blood pressure in arteries is at its lowest

 Reported as the systolic number over the diastolic number

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Blood Pressure (cont.)

 Control is based mainly on the amount of blood pumped out
of the heart
 The amount of blood entering should equal the amount
pumped from the heart
 Starling's law of the heart
 Blood entering the left ventricle stretches the wall of the ventricle
 The more the wall is stretched
 The harder it will contract and
 tTe more blood it will pump out

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Blood Pressure (cont.)

 Baroreceptors
 Also help regulate blood pressure
 Located in the aorta and carotid arteries
 High blood pressure in aorta  message to
cardiac center in brain  decreases heart rate
 lowers blood pressure
 Low blood pressure in aorta  message to
cardiac center in the brain  increases heart rate
 increases blood pressure

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Apply Your Knowledge

What is the difference between the systolic pressure
and diastolic pressure?
ANSWER: Systolic pressure is the result of the
contraction of the ventricles increasing the pressure in
the arteries. Diastolic pressure is the result of the
relaxation of the ventricles lowering the pressure in the
arteries.

Good Answer!
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Circulation
 Pulmonary circuit
right atrium  right ventricle  pulmonary artery
trunk  pulmonary arteries  lungs 
pulmonary veins  heart (left atrium)

 Systemic circuit
left atrium  left ventricle  aorta  arteries 
arterioles  capillaries  venules  veins 
vena cava  heart (right atrium)

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Circulation (cont.)
 Arterial system
 Carry oxygen-rich blood
away from the heart

 Pulmonary arteries carry

oxygen-poor blood

 Paired – left and right

artery of the same name

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Circulation (cont.)
 Venous system  Hepatic portal system
 Carries oxygen-  Collection of veins
poor blood toward carrying blood to the
the heart liver
 Except pulmonary
veins
 Most large veins
have the same
names as the
arteries they are
next to Click for Larger View

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Apply Your Knowledge

Do pulmonary arteries carry blood with high levels of
oxygen or low levels of oxygen?

ARTERIES: Pulmonary arteries carry oxygen-poor blood.

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 27-35

Blood
 A type of connective
tissue Average-sized adult has
4 to 6 liters of blood
 Red blood cells
(erythrocytes) Amount depends on:
 White blood cells  Size of person

(leukocytes)  Amount of adipose tissue

 Platelets – cell  Concentrations of ions

fragments  Females have less than
 Plasma – fluid part of males
blood

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Blood Components
 Hematocrit
 The percentage of red blood
cells
 Normal is about 45%

 White cells and

platelets = 1%

 Plasma = 55%

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Blood Components: Red Blood Cells

 Erythrocytes
 Transport oxygen throughout the body
 Small biconcave-shaped cells
 Hemoglobin is a pigment in RBCs
 Oxyhemoglobin carries oxygen; bright red
 Deoxyhemoglobin does not carry oxygen; darker red
 Carries carbon dioxide, so also called carboxyhemoglobin
 Anemia – low RBC count
 Erythropoietin – regulates production of RBCs

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Blood Components: Red Blood Cells (cont.)

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Blood Components: White Blood Cells

 Granulocytes
 Neutrophils (55%) –destroy bacteria, viruses, and toxins in
the bloodstream (phagocytes)
 Eosinophils (3%) – get rid of parasitic infections such as
worm infections
 Basophils (1%) – control inflammation and allergic
reactions
 Agranulocytes
 Monocytes (8%) – destroy bacteria, viruses, and toxins in
blood
 Lymphocytes (33%) – provide immunity for the body

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Blood Components: White Blood Cells (cont.)

 WBC count normally 5000 to 10,000 cells per
cubic millimeter of blood
 Leukocytosis
 Elevated WBC count
 Usually due to infection
 Leukopenia
 Low WBC count
 Some viral infections and other conditions

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Blood Components: Platelets

 Fragments of cells found in the bloodstream
 Also called thrombocytes
 Important in the clotting process of blood
 Normal count
 130,000 to 360,000 platelets per cubic
millimeter of blood

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Blood Components: Plasma
 Liquid portion of blood
composed mostly of water
 Proteins
 Albumins
 Smallest plasma proteins
 Pull water in to help
maintain blood pressure
 Globulins – transport lipids
and fat-soluble vitamins
 Fibrinogen – needed for
blood clotting
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 Nutrients
 Amino acids
 Glucose
 Nucleotides
 Lipids from the digestive
tract
 Gases – oxygen, carbon
dioxide, and nitrogen
 Electrolytes
 Waste products
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Blood: Bleeding Control

 Hemostasis – the control
of bleeding
 Three processes of
hemostasis
 Blood vessel spasm
 Platelet plug formation
 Blood coagulation

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Platelet plug
formation:

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Blood Types
 Types are distinguished
by antigen and
antibodies

 Agglutination
 Clumping of red blood
cells
 Antigens on surface of
RBCs bind to
antibodies in plasma

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Blood Types (cont.)

Blood Type Antigen Antibody Blood That Can
Present Present Be Received
A A B A and O

B B A B and O

AB AB None A, B, AB, and O

O None A and B O

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Blood Types (cont.)

 Rh antigen – protein on  Rh-positive blood is
RBCs given to Rh-negative
person
 Rh-positive  Antibodies form

 RBCs contain the

Rh antigen  If Rh-negative person
receives more Rh-
 Rh-negative positive blood
 RBCs do not contain  Antibodies bind to the
the Rh antigen donor cells
 Agglutination occurs

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Apply Your Knowledge

True or False: ANSWER:
__
F Hematocrit is the percentage of WBCs in the blood. RBCs
__
T Neutrophils destroy bacteria, viruses, and toxins in the bloodstream.
__
T Platelets are important to the clotting process. pulls water into
__
F Albumin is a small plasma protein that pushes water out of the bloodstream.
__
T Hemostasis is the control of bleeding.
can receive any type of blood
__
F A person with type AB blood can only receive type AB blood.
__
T Blood should be matched for Rh factor.

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 27-49

Chest Pain
 Cardiac  Non-cardiac
 Myocardial infarction
 Angina
 Pericarditis
 Coronary spasm
Take all complaints of
chest pain seriously!
 Heartburn
 Panic attacks
 Pleurisy
 Costochondritis
 Pulmonary embolism
 Sore muscles
 Broken ribs

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 27-50

Chest Pain (cont.)

 Determine cause
 Electrocardiogram
 Stress tests
 Blood tests
 Chest x-ray
 Nuclear scan
 Coronary
catheterization
 Echocardiogram
 Endoscopy

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Diseases and Disorders of the

Cardiovascular System
Disease Description
Anemia The blood does not have enough red blood cells
or hemoglobin to carry an adequate amount of
oxygen to the body’s cells
Aneurysm A ballooned, weakened arterial wall
Arrhythmias Abnormal heart rhythms
Carditis Inflammation of the heart
Endocarditis Inflammation of the innermost lining of the
heart, including valves

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Diseases and Disorders of the

Cardiovascular System (cont.)
Disease Description
Myocarditis Inflammation of the muscular layer of the heart
Pericarditis Inflammation of the membranes that surround
the heart (pericardium)
Congestive Weakening of the heart over time; heart is
Heart Failure unable to pump enough blood to meet body’s
needs
Coronary Artery Atherosclerosis; narrowing of coronary arteries
Disease (CAD) caused by hardening of the fatty plaque deposits
within the arteries
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Diseases and Disorders of the

Cardiovascular System (cont.)
Disease Description
Hypertension High blood pressure; consistent resting blood
pressure equal to or greater than 140/90 mm Hg
Leukemia Bone marrow produces a large number of
abnormal WBCs
Murmurs Abnormal heart sounds
Myocardial Heart attack; damage to cardiac muscle due to a
Infarction lack of blood supply

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 27-54

Diseases and Disorders of the

Cardiovascular System (cont.)
Disease Description
Sickle Cell Abnormal hemoglobin causes RBCs to change
Anemia to a sickle shape; abnormal cells stick in
capillaries
Thalassemia Inherited form of anemia; defective hemoglobin
chain causes, small, pale, and short-lived RBCs
Thrombophlebitis Blood clots and inflammation develops in a vein

Varicose Veins Twisted, dilated veins

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Apply Your Knowledge

The doctor has told your patient she has anemia. How
would you explain this to the her?
ANSWER: Anemia is a condition in which a person does not
have enough red blood cells or hemoglobin in the blood to
carry an adequate amount of oxygen to body cells.

Bravo!
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In Summary
 Cardiovascular system
 Transport system for body
 Heart, arteries, veins, and capillaries
 Blood
 Transport medium
 RBCs, WBCs, platelets, plasma
 Medical assistant
 Assists patients in understanding prevention and
treatments for cardiovascular problems

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 27-57

End of Chapter

Your work is to
discover your
world and then
with all your
heart give
yourself to it.
~ Buddha

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