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Circulation, Cardiac Cycle and
        Heart Sounds
                                 1
The circulatory system




The circulatory system consists of two major sub-circuits, the systemic
circulation and the pulmonary circulation.                                2
The circulatory system

                         The Heart:
                         Four chambered double pump.

                         Blood vessels:
                         Carry Blood from the heart to the
                         vital organs and back.

                         Arteries carry blood away
                         from the heart and branch to
                         form the arterioles. They all
                         carry oxygenated blood
                         except the pulmonary arteries.

                         Veins return blood to the heart
                         and start as venules. They all
                         carry deoxygenated blood
                         except the pulmonary veins.

                         Blood capillaries are found as a
                         network Between arteries and
                         veins.                             3
Human and animal hearts




Which one is a human heart?




                              4
Exterior structure of the heart




   • Inflow ports consisted of the superior and inferior vena cava and
        pulmonary veins.
   • Outflow ports mainly the aorta, and pulmonary arteries.
                                                                         5
Structure of the heart (interior view)

                                     • Atria (right atrium and left
                                       atrium)

                                     • Ventricles (right ventricle and
                                       left ventricle)


                                         Right and left heart sides are
                                         normally completely separate.

                                         Right atrium and left ventricles
                                         open in the corresponding
                                         ventricles by a valve.




                                                                      6
Atrioventricular valves   The atria are connected to the ventricles
                          by atrioventricular valves.

                          Tricuspid valve on the right side.

                          Bicuspid valve (mitral valve) on the lefty
                          side

                          The valves are passively operated by the
                          difference in blood pressure between the
                          heart champers.

                          The papillary muscles are connected to the
                          valves by tendons called Chordae tendinae
                          which help to keep them in place.


                          There are other valves, called semilunar
                          valves at the entrance of the aorta and
                          the pulmonary artery. They are one
                          way valves!.
                                                                  7
Blood vessels




Arteries have muscular walls and smaller lumen.

Veins have thinner walls and bigger lumen.

Blood capillaries are single layer of endothelial cells.

Arteries are high pressure vessels while veins have lower pressure and blood
flow is helped by valves to go back to the heart.
Generalized look at the blood vessels




                                        9
Histology of the blood vessels
                                           Both arteries and veins are
     Artery             Vein               composed of three coats
                                           (layers), tunica externa
              Tunica                       (tunica adventitia), tunica
              interna                      media and tunica interna
                               Valve
                                           (intima).
              Elastin


              Tunica
              media                        Tunica interna consists of
                                           three parts. Elastic tissue
              Tunica
                                           fibers, the basement
              externa                      membrane and the inner
                                           endothelium.
              Serosa
                                           The blood capillary is single cell
                                           thick which is endothelium.




                               Capillary

                                                                         10
Cardiac cycle

Cardiac cycle is a repeated pattern of contraction and relaxation. The phase of
contraction is systole and relaxation is diastole.

Average heart rate (beat per minutes) is ~ 75 B/min cardiac cycle lasts
about 0.8 sec.
                                                          0.5 sec     0.3 sec
                                                          diastole    systole


                                       Even before contraction of atria, the
                                       ventricles are filled with blood by up to
                                       80%, the remaining 20% enter the
                                       ventricles after contraction of atria.




                                                                             11
States of heart during cardiac cycle


                          When the ventricles fill up with blood this
                          is called end diastolic volume (EDV).

                          The ventricle contract during systole to
                          eject two third of the amount it contains
                          (stroke volume (SV)).

                          Stroke volume (SV): volume of blood ejected
                          during one cardiac cycle.
                          The one third left is the end-systolic volume
                          (ESV).




                                                                      12
-Right Atrium = RA
Heart and Circulation                                   -Left Atrium = LA
                                                        -Right Ventricle = RV
                                                        -Left Ventricle = LV
1- Venous blood containing CO2 returns from body tissues to RA
             Tricuspid valve
2- From RA                       RV

             Pulmonary artery
3- From RV                       Lungs
                Pulmonary vein
4- From Lungs                      LA

5- From LA   Bicuspid valve       LV
                   Aorta
6- From LV                         Body
Pressure changes during cardiac Cycle

-Ventricles are filled with blood (e.g. 120 ml) and ventricular muscle contracts without
-change in length this is called isovolumic contraction:
   Isovolumetric     No change   Increase in
   contraction       in volume   intraventricular
                                 pressure


  Intraventricular
  pressure           >   Aortic
                         pressure     Ejection



 Ejection            Volume and pressure decrease


            Isovolumic relaxation

The pressure produced by the left ventricle
during systole is about 120 mmHg and during
diastole is about 80 mmHg. The blood pressure
is represented by systole/diastole = 120/80.
Heart Sounds
- The valves between atria and ventricles are called atrio-ventricular (AV) valves
-and the valves between right ventricles and pulmonary artery + left ventricle and
-aorta are called semilunar valves.

- Closing of the AV valves and semilunar
valves produces sounds that can be heard
by stethoscope. These sounds are called
heart sounds. They sound like “lub-dub”.

- First sound (“lub”) is produced by closure
of AV valves. Second heat sound (“dub”) is
produced by closure of semilunar valves




                                                     lub       dub
The cardiac cycle




                    16

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dr fawziy 8 lecture 20/2/2013

  • 1. Circulation, Cardiac Cycle and Heart Sounds 1
  • 2. The circulatory system The circulatory system consists of two major sub-circuits, the systemic circulation and the pulmonary circulation. 2
  • 3. The circulatory system The Heart: Four chambered double pump. Blood vessels: Carry Blood from the heart to the vital organs and back. Arteries carry blood away from the heart and branch to form the arterioles. They all carry oxygenated blood except the pulmonary arteries. Veins return blood to the heart and start as venules. They all carry deoxygenated blood except the pulmonary veins. Blood capillaries are found as a network Between arteries and veins. 3
  • 4. Human and animal hearts Which one is a human heart? 4
  • 5. Exterior structure of the heart • Inflow ports consisted of the superior and inferior vena cava and pulmonary veins. • Outflow ports mainly the aorta, and pulmonary arteries. 5
  • 6. Structure of the heart (interior view) • Atria (right atrium and left atrium) • Ventricles (right ventricle and left ventricle) Right and left heart sides are normally completely separate. Right atrium and left ventricles open in the corresponding ventricles by a valve. 6
  • 7. Atrioventricular valves The atria are connected to the ventricles by atrioventricular valves. Tricuspid valve on the right side. Bicuspid valve (mitral valve) on the lefty side The valves are passively operated by the difference in blood pressure between the heart champers. The papillary muscles are connected to the valves by tendons called Chordae tendinae which help to keep them in place. There are other valves, called semilunar valves at the entrance of the aorta and the pulmonary artery. They are one way valves!. 7
  • 8. Blood vessels Arteries have muscular walls and smaller lumen. Veins have thinner walls and bigger lumen. Blood capillaries are single layer of endothelial cells. Arteries are high pressure vessels while veins have lower pressure and blood flow is helped by valves to go back to the heart.
  • 9. Generalized look at the blood vessels 9
  • 10. Histology of the blood vessels Both arteries and veins are Artery Vein composed of three coats (layers), tunica externa Tunica (tunica adventitia), tunica interna media and tunica interna Valve (intima). Elastin Tunica media Tunica interna consists of three parts. Elastic tissue Tunica fibers, the basement externa membrane and the inner endothelium. Serosa The blood capillary is single cell thick which is endothelium. Capillary 10
  • 11. Cardiac cycle Cardiac cycle is a repeated pattern of contraction and relaxation. The phase of contraction is systole and relaxation is diastole. Average heart rate (beat per minutes) is ~ 75 B/min cardiac cycle lasts about 0.8 sec. 0.5 sec 0.3 sec diastole systole Even before contraction of atria, the ventricles are filled with blood by up to 80%, the remaining 20% enter the ventricles after contraction of atria. 11
  • 12. States of heart during cardiac cycle When the ventricles fill up with blood this is called end diastolic volume (EDV). The ventricle contract during systole to eject two third of the amount it contains (stroke volume (SV)). Stroke volume (SV): volume of blood ejected during one cardiac cycle. The one third left is the end-systolic volume (ESV). 12
  • 13. -Right Atrium = RA Heart and Circulation -Left Atrium = LA -Right Ventricle = RV -Left Ventricle = LV 1- Venous blood containing CO2 returns from body tissues to RA Tricuspid valve 2- From RA RV Pulmonary artery 3- From RV Lungs Pulmonary vein 4- From Lungs LA 5- From LA Bicuspid valve LV Aorta 6- From LV Body
  • 14. Pressure changes during cardiac Cycle -Ventricles are filled with blood (e.g. 120 ml) and ventricular muscle contracts without -change in length this is called isovolumic contraction: Isovolumetric No change Increase in contraction in volume intraventricular pressure Intraventricular pressure > Aortic pressure Ejection Ejection Volume and pressure decrease Isovolumic relaxation The pressure produced by the left ventricle during systole is about 120 mmHg and during diastole is about 80 mmHg. The blood pressure is represented by systole/diastole = 120/80.
  • 15. Heart Sounds - The valves between atria and ventricles are called atrio-ventricular (AV) valves -and the valves between right ventricles and pulmonary artery + left ventricle and -aorta are called semilunar valves. - Closing of the AV valves and semilunar valves produces sounds that can be heard by stethoscope. These sounds are called heart sounds. They sound like “lub-dub”. - First sound (“lub”) is produced by closure of AV valves. Second heat sound (“dub”) is produced by closure of semilunar valves lub dub