Dr. I Gusti Ayu Widianti, M.

Biomed
Anatomy Department, Faculty of Medicine
Udayana University
Cardiovascular system
Circulatory System

 The heart (cor)

 System of blood vessel
 System of lymphatics
The relevance of the System
The three biggest killers
 Cardiovascular disorders
 Malignancy
 Cerebrovascular Disease (Stroke)
Dr. Paul White’s clarion challenge:

“Heart disease before 80 is our fault, not God’s or

Nature’s will”
 The heart: Coronary artery disease
→ ischemic heart disease
→ myocardial infarction
 The blood vessels: → atherosclerosis
→ hypertension
varicose vein
The general design

 Two major components:

 The heart and system of blood vessels
 Major functions:
 Transport of oxygen and nutrients
 Transport of CO2 and waste products
 Two major divisions
 Major or systemic circulation
 Lesser or pulmonary circulation
 Lungs
Deoxygenated blood Pulmonary Oxygenated blood
circulation
RV LA
Heart
RA LV

Deoxygenated blood Systemic circulation Oxygenated blood

(CO2 & waste products) (O2 & nutrients)

Whole body

RA=right atrium, LA=left atrium, RV=right ventricle, LV=left ventricle

 The site of exchange

Cell

Arteriole Venule

Capillary Capillary
 The Heart
 A four-chamber, powerful, muscular pump
Divided into two halves: left heart & right heart.

 Left heart: left atrium & left ventricle

Receives oxygenated blood (“arterial blood“) from
the lungs
Distributes it to the whole body.

 Right heart: right atrium & right ventricle

Receives deoxygenated blood (“venous blood”)
from the whole body, sends it to the lungs.

 The walls of the left ventricle is the thickest.

MIDDLE MEDIASTINUM
• Boundaries:
left and right pleural cavities,
diaphragm,
anterior and posterior leaves of fibrous pericardium, and
superior aspect of the left and right pulmonary arteries

• Contents:
Heart and pericardium
Roots of the great vessels
Arch of azygos vein
Main bronchi
 HEART

The wall consist of three layers:

• Epicardium
• Myocardium
• Endocardium

The fibrous skeleton of the heart

 PERICARDIUM

 Double-walled fibroserous sac, encloses the

heart and the roots of its great vessels
 Pericardial cavity:
The potential space between the opposing
layers of the parietal and visceral of serous
pericardium
Cardiac tamponade
 EXTERNAL HEART STRUCTURE

Boundaries
• Apex of the heart apex beat
• Base of the heart----the heart’s posterior
aspect
• Four surfaces of the heart
• Four borders of the heart
 External heart structure
(continued)
Divisions:
• Four chambers:
right and left atria
right and left ventricles
• The right atrium superior & inferior vena cava
coronary sinus
• The right ventricle the largest portion of the
anterior (sternocostal) surface
 The circulation
Vena cava Heart Aorta

Veins Arteries
Circulation
Venules Arterioles

Capillaries

Venules=very small veins; arterioles=very small arteries

 The Conduction System
Sinoatrial node (sinus node)

Conduction through the atrial wall

A-V node (atrioventricular node)

A-V bundle (bundle of His)

Purkinje fibers

Right & left branches

Heart rate
 Number of heart beats per minute
 Classification of heart rate
Normal heart rate; 60 – 100/minute
Bradycardia:  60 beats per minute
Bradyarrhythmia
Tachycardia: 100 beats per minute
Tachyarrhythmia
Determining the heart rate

Two most common sites:

 In the side of the neck: carotid pulse by
palpating the common carotid artery
 At the wrist: radial pulse by palpating the
radial artery
 Normal and optimal:  120/80 (adults)
 Abnormal high: Hypertension
 Systolic Hypertension (wide pulse pressure)
 Decreased compliance
 Increased stroke volume
 Systolic and diastolic hypertension: Increased peripheral
vascular resistance
 The myocardium: Heart failure
 The Conducting system: Arrhythmias
 The coronary artery system:
Ischemic heart disease, myocardial
infarction
 The great vessels of the heart: Aortic
aneurysm, etc
THE LYMPHATIC SYSTEM
 Lymphatic plexuses
 Lymphatics
 Lymph nodes
 Aggregations of lymphoid tissue
 Circulating lymphocytes
 DRAINAGE OF TISSUE FLUID, COLLECTION
OF LYMPH PLASMA AND TRANSPORT OF
LYMPH TO THE VENOUS SYSTEM
 ABSORPTION AND TRANSPORT OF FAT
FROM THE INTESTINE.
 FORMATION OF A DEFENCE MECHANISM
 The ground plan of lymphatic
drainage
 Right lymphatic duct (ductus lymphaticus
dexter):
The right halves of head, neck and thorax,
and the right upper limb
 Left lymphatic duct = The thoracic duct
(ductus lymphaticus sinister):
The remainder of the body
 Both duct eventually open into the
corresponding subclavian veins (venous
angles)