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CARDIOVASCULAR SYSTEM, Study Guides, Projects, Research of Anatomy

Saint Paul University Philipinnes (SPUP)Anatomy

NURSING NOTES CARDIOVASCULAR SYSTEM NOTES COMPLETE NOTES

Typology: Study Guides, Projects, Research

2023/2024

Available from 06/24/2026

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CARDIOVASCULAR SYSTEM
The heart is a muscular organ that is essential for life
because it pumps blood through the body. It is capable
of doing many things in a millisecond. It is also
independent to the Nervous System.
The heart, blood vessels, and the blood make up the
Cardiovascular System. The heart (of a healthy
adult) pumps approximately 5L of blood per minute.
For most people, the heart continues to pump at
approximately for more than 75 years.
The right side of the heart pumps blood to the lungs
and back to the left side of the heart through vessels of
the Pulmonary Circulation. The left side of the heart
pumps blood to all other tissues of the body and back
to the right side of the heart through the vessels of the
Systematic Circulation.
When we are asleep, blood pumping is slow.
There is a little to minimal back flow that happens
inside the heart.
Systolic Pressure (contraction)
— first sound we hear from the heart
Diastolic Pressure (relaxation)
— second sound we hear from the heart
Alveoli — site of oxygenation and gas exchange
Capillaries — from the heart; carries deoxygenated
blood
Arteries — brings oxygenated blood; carry blood
away from the heart
Veins — brings deoxygenated blood; carry blood
toward the heart
Valves — gates; leaflike
HEART
location: middle mediastinum
weight: 300-400 grams
shape: blunt cone
size: (approximately) closed fist
right side: relieves blood from systemic
circulation, they pump blood to the
lungs
left side: relieves blood from the lungs, they
pump blood to the systemic circulation
RLLS (right to the lungs; left to the system
through the aorta)
FUNCTIONS OF THE HEART
• Generating blood pressure.
• Routing blood.
• Ensuring one-way blood flow.
• Regulating blood supply.
The Cardiovascular System pumps approximately
5L of blood per minute.
Base — the larger, flat
part at the opposite end
of the heart
Apex — the blunt
rounded point of the
heart
Intercostal Space — spaces between rib cages
Base — located deep to the sternum and extends to
the level of the second intercostal space
(left)
Apex — directed to the left
— two thirds of the heart’s mass lies to the left
of the midline of the sternum
— deep to the fifth intercostal space (left) near
the midclavicular line which is a
perpendicular line that extends down from
the middle of the clavicle
The heart, trachea, esophagus, and associated
structures form a midline partition called the
Mediastinum.
The heart oxygenates itself through the coronary
arteries.
Pericardial Cavity
— cavity that surrounds the heart
— where the heart lies
— filled with pericardial fluid
— formed by the pericardium
Pericardium
• house of the heart
• also called pericardial sac, which surrounds
or envelopes the heart and anchors it within
the mediastinum
• 2 Layers of the Pericardium
➢ Fibrous Pericardium
– outer layer; composed of tough,
fibrous connective tissue
➢ Serous Pericardium
– inner layer; consists of flat
epithelial cells with a thin layer
of connective tissue
– composed of two parts:
1. Parietal Pericardium
which lines the fibrous
pericardium.
2. Visceral Pericardium or
epicardium, covers the
heart surface.
STRUCTURE
• Atrium (singular) / Atria (left and right
atrium)
- where the blood enters first
- Right and Left Atria are located at the
base of the heart
- Right Atrium receives blood from the
three major openings:
1. Superior Vena Cava
2. Inferior Vena Cava
3. Coronary Sinus
pf3
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CARDIOVASCULAR SYSTEM

The heart is a muscular organ that is essential for life because it pumps blood through the body. It is capable of doing many things in a millisecond. It is also independent to the Nervous System. The heart , blood vessels , and the blood make up the Cardiovascular System. The heart (of a healthy adult) pumps approximately 5L of blood per minute. For most people, the heart continues to pump at approximately for more than 75 years. The right side of the heart pumps blood to the lungs and back to the left side of the heart through vessels of the Pulmonary Circulation. The left side of the heart pumps blood to all other tissues of the body and back to the right side of the heart through the vessels of the Systematic Circulation. When we are asleep, blood pumping is slow. There is a little to minimal back flow that happens inside the heart. Systolic Pressure (contraction) — first sound we hear from the heart Diastolic Pressure (relaxation) — second sound we hear from the heart Alveoli — site of oxygenation and gas exchange Capillaries — from the heart; carries deoxygenated blood Arteries — brings oxygenated blood; carry blood away from the heart Veins — brings deoxygenated blood; carry blood toward the heart Valves — gates; leaflike

HEART

location: middle mediastinum

weight: 300 - 400 grams

shape: blunt cone

size: ( approximately) closed fist

right side : relieves blood from systemic

circulation , they pump blood to the

lungs

left side : relieves blood from the lungs , they

pump blood to the systemic circulation

RLLS ( right to the lungs ; left to the system

through the aorta )

FUNCTIONS OF THE HEART

  • Generating blood pressure.
  • Routing blood.
  • Ensuring one-way blood flow.
  • Regulating blood supply. The Cardiovascular System pumps approximately 5L of blood per minute. Base — the larger, flat part at the opposite end of the heart Apex — the blunt rounded point of the heart Intercostal Space — spaces between rib cages Base — located deep to the sternum and extends to the level of the second intercostal space (left) Apex — directed to the left — two thirds of the heart’s mass lies to the left of the midline of the sternum — deep to the fifth intercostal space (left) near the midclavicular line which is a perpendicular line that extends down from the middle of the clavicle The heart, trachea, esophagus, and associated structures form a midline partition called the Mediastinum. The heart oxygenates itself through the coronary arteries. Pericardial Cavity — cavity that surrounds the heart — where the heart lies — filled with pericardial fluid — formed by the pericardium Pericardium
  • house of the heart
  • also called pericardial sac , which surrounds or envelopes the heart and anchors it within the mediastinum
  • 2 Layers of the Pericardium ➢ Fibrous Pericardium
  • outer layer; composed of tough, fibrous connective tissue ➢ Serous Pericardium
  • inner layer; consists of flat epithelial cells with a thin layer of connective tissue
  • composed of two parts :
  1. Parietal Pericardium which lines the fibrous pericardium.
  2. Visceral Pericardium or epicardium , covers the heart surface. STRUCTURE
  • Atrium (singular) / Atria (left and right atrium)
  • where the blood enters first
  • Right and Left Atria are located at the base of the heart
  • Right Atrium receives blood from the three major openings:
  1. Superior Vena Cava
  2. Inferior Vena Cava
  3. Coronary Sinus
  • drains blood from most of the heart muscle
  • the two atria are separated from each other by a partition called the interatrial septum
  • Ventricle
  • major pumping chambers of the heart
  • ejects blood into the arteries and force it to flow through the circulatory system
  • Right and Left Ventricles extend from the base of the heart toward the apex
  • the Right Ventricle pumps blood into the pulmonary trunk
  • the Left Ventricle pumps blood into the aorta; has a thicker wall
  • the two ventricles are separated from each other by the muscular interventricular septum
  • Vein
  • carries blood to the atria
  • Valves ( AV and Semilunar)
  • four valves; two are prominent
  • gates which opens and closes; maintains the one-way flow of blood through the heart chambers
  1. Atrioventricular (AV) Valves are found between each atrium and ventricle. o when the ventricles relax, the higher pressure in the atria forces the AV valves to open and blood flows from the atria into the ventricles o when the ventricles contract, blood flows toward the atria and causes the AV valves to close o TRICUSPID VALVE
  • between the right atrium and the right ventricle
  • composed of three cusps or flaps of tissue o BICUSPID VALVE
  • also called mitral valve because it resembles a bishop’s miter, a two-pointed hat
  • between the left atrium and left ventricle
  • composed of two cusps
  • allow blood to flow from the atria into the ventricles but prevent it from flowing back into the atria
  1. Semilunar Valves are gated channels to / for the pulmonary and systemic circulations. o located between each ventricle and its associated great artery o PULMONARY SEMILUNAR VALVE
  • located between the right ventricle and the pulmonary trunk
  • to the lungs o AORTIC SEMILUNAR VALVE
  • located between the left ventricle and aorta
  • throughout the whole body
  • Conduction System
  • Artery
  • blood flows from the ventricles through large arteries called the great vessels or great arteries Coronary Sulcus – extends around the heart, separates the atria from the ventricles
  1. Anterior Interventricular Sulcus
  2. Posterior Interventricular Sulcus Superior Vena Cava and Inferior Vena Cava — carry blood from the body to the right atrium (4) Pulmonary Veins — carry blood from the lungs to the left atrium Pulmonary Trunk — arising from the right ventricle, splits into the right and left pulmonary arteries (which carry blood to the lungs) Aorta — arising from the left ventricle, carries blood to the rest of the body Papillary Muscles — cone-shaped muscular pillars contained in each ventricle — these muscles are attached by a thin, strong, connective tissue strings called chordae tendinae (heart strings)
  • helps the valve to close and open properly — when ventricles contract, the papillary muscles contract and prevent the valves from opening into the atria by pulling on the chordae tendinae attached to the valve cusps Cardiac Skeleton — also called fibrous skeleton , gives structure to the valves — also serves as electrical insulation between the atria and the ventricles and provides a rigid attachment site for cardiac muscle Blood Flow Through the Heart Blood exits through the aorta (which branches out). Coronary Arteries and Cardiac Veins — provide pathway for blood through the heart wall — CORONARY ARTERIES - originate from the base of the aorta, just above the aortic semilunar valve - branches from the aorta which oxygenates the heart during ventricular relaxation
  • 2 Coronary Arteries I. Left Coronary Artery
  • on the left side of the aorta
  • 3 Major Branches
  1. Anterior Interventricular Artery lies in the anterior interventricular sulcus.

e. PURKINJE FIBERS

  • pass to the apex of the heart and then extend to the cardiac muscle of the ventricle walls
  • contraction of the ventricles
  • ensures that ventricular contractions begin at the apex and then spread up the ventricular walls The coordinated contraction of the ventricles depends on the conduction of action potentials by the conduction system. Ectopic Beat — when action potentials originate in an area of the heart other than the SA node; may cause very small portions of the heart to contract rapidly and independently of all other areas Fibrillation — reduces the output of the heart to only a few milliliters of blood per minute when it occurs in the ventricles Defibrillation — a technique to stop the process of fibrillation where health professionals apply a strong electrical shock (causes simultaneous depolarization of all muscle fibers) to the chest region Cardiac Conductive System Properties: • automaticity • excitatory
  • conductivity • contractility Depolarization : influx of Na+^ into the cell that allows K+^ to exit the cell ( electrical activation ) Repolarization : influx of K+^ into the cell that allows Na+^ to exit (heart is relaxed or the resting state ) Normal Cardiac Cycle:
  1. Systole — period of contraction
  2. Diastole — period of relaxation Events in the Cardiac Conductive System
  3. MID TO LATE VENTRICULAR DIASTOLE ( relaxation )
  • ventricular filling
  • AV valve is OPEN while the SL valve is CLOSED
  • the pressure is LOW in the chambers but HIGH in your pulmonary arteries and aorta
  1. VENTRICULAR SYSTOLE ( contraction )
  • blood is ejected from the heart
  • AV valve is CLOSED while the SL valve is OPEN
  • pressure is HIGH in both chambers and pulmonary arteries and aorta
  1. ISOVOLUMETRIC RELAXATION
  • early ventricular diastole
  • pressure in ventricles becomes LESS
  • SL valves starts to close with small back flow
  • volume of valve remains the same Electrocardiogram
  • also called ECG or EKG
  • the record of electrical events
  • Electrodes — attached to a recording device, can detect the small electrical changes resulting from the action potentials in all of the cardiac muscle cells
  • consists of:
  1. P WAVE
  • results from depolarization of the atrial myocardium
  • its beginning precedes the onset of atrial contraction
  1. QRS COMPLEX
  • consists of three individual waves: Q , R , and S waves
  • results from depolarization of the ventricles
  • its beginning precedes ventricular contraction
  1. T WAVE
  • represents repolarization of the ventricles
  • its beginning precedes ventricular relaxation A wave representing repolarization of the atria cannot be seen because it occurs during the QRS Complex. PQ Interval — commonly called PR Interval because the Q wave is very small — the time between the beginning of the P Wave and the beginning of the QRS Complex — during the PQ Interval, the atria contract and begin to relax — at the end of PQ Interval, the ventricles begin to depolarize QT Interval — extends from the beginning of the QRS Complex to the end of the T Wave — represents the length of time required for ventricular depolarization and repolarization ABNORMAL HEART RHYTHMS Conditions Symptoms Tachycardia heart rate in excess of 100 bpm Bradycardia heart rate is less than 60 bpm Sinus Arrhythmia heart rate varies as much as 5% during respiratory cycle and up to 30% during deep respiration Paroxysmal Atrial Tachycardia sudden increase in heart rate to 150-250 bpm for a few secs or even several hrs Atrial Flutter as many as 300 P Waves / min and 125 QRS Complex / min Atrial Fibrillation no P Waves, normal QRS Complex and T Waves, irregular timing Ventricular Tachycardia frequently causes fibrillation Atrium — primer pump because they complete the filling of the ventricles with blood

Ventricle — power pump because they produce the major force that causes blood to flow through the pulmonary and systemic circulations Cardiac Cycle — repetitive pumping process that begins with the onset of cardiac muscle contraction and ends with the beginning of the next contraction Atrial Systole refers to the contraction of the two atria. Ventricular Systole refers to the contraction of the two ventricles. Atrial Diastole refers to the relaxation of the two atria. Ventricular Diastole refers to the relaxation of the two ventricles. At the beginning of the cardiac cycle, the atria and ventricles are relaxed , the AV Valves are open and the SL Valves are closed. Point of Maximal Impulse (PMI)

  • location of the intersection of the midclavicular line and the 5th^ intercostal space
  • pulsation created during normal ventricular contraction
  • it is also the location at which the cardiac impulse can be best palpated on the chest wall HEART SOUNDS Stethoscope — developed to listen to the sounds of the lungs and the heart and is now used to listen to other sounds of the body as well Auscultation / Auscultate — when we actually listen to any sound of the body through the stethoscope The valves usually do not make sounds when they open. APTB: where the heart sounds can be best heard Aortic Auscultation / Aortic Semilunar Valve — right sternal border 2nd^ intercostal space Pulmonic Auscultation / Pulmonary Semilunar Valve — right sternal border 2 nd^ intercostal space Tricuspid Valve — left sternal border 4 th- 5 th intercostal space Bicuspid Valve — left sternal border 5th^ intercostal space lubb — also called S — first heart sound; has lower pitch — occurs at the beginning of ventricular systole — results from the closure of the AV valves dubb / dupp — also called S — second heart sound — occurs at the beginning of ventricular diastole — results from the closure of the semilunar valves Incompetent Valve — a heart valve that does not close completely Characteristics of Sounds Rate : Bradycardia / Tachycardia Rhythm : Regular, Irregular, Regularly Irregular Pitch : High, Medium, Low Intensity : Soft to Loud, 1- 6 Duration : Short, Long Timing : Systolic, Diastolic, or Both Quality : Blowing, Trembling, Sharp, Snappy Location : sites where sounds are heard and radiates best ( APTB ) **Variations in S1 and S
  • Normal S
  • Accentuated S1** (louder than usual) - Diminished S1 ( dubb is much louder) - Normal Split S1 (problem with hearing abnormal sound with systolic and diastolic) **- Abnormal Split S
  • Normal S 2
  • Accentuated S 2
  • Diminished S2** (does not imply that S1 is louder) **- Normal Split S
  • Abnormal Split S** The increased filling of the left ventricle gradually causes it to hypertrophy and can lead to heart failure. The increased pressure in the pulmonary veins can cause edema in the lungs. Abnormal heart sounds called murmurs are usually a result of faulty valves. When the opening of a valve is narrowed, or stenosed , a swishing sound precedes closure of the stenosed valve. ABNORMAL HEART SOUNDS — develop during systole / diastole — when structural / functional problems are present — these sounds are called S3 / S4 gallops , opening snaps , systolic clicks , and **murmurs
  • Gallop** — produced by the addition of a 3rd^ or 4th^ heart sound; are very low-frequency sounds — are heard with the bell of the stethoscope placed very lightly against the chest — S3 and S4 gallop sounds are heard during diastole , caused by the vibration of the ventricle and surrounding structures as blood meets resistance during ventricular filling

o people suffering from hypertension have an increased afterload because their aortic pressure is elevated during contraction of the ventricles o Vascular Pressure , Pulmonary Pressure , and Valve Damages Extrinsic Regulation of the Heart — involves neural and hormonal control — mechanisms external to the heart — neural regulation of the heart results from sympathetic and parasympathetic reflexes, and the major hormonal regulation comes from epinephrine and norepinephrine secreted by the adrenal medulla Nervous Regulation: Baroceptor Reflex — the autonomic nervous system influences the pumping action of the heart and thereby affects cardiac output by altering both heart rate and stroke volume — stimulation by sympathetic nerve fibers causes the heart rate and the stroke volume to increase — stimulation by parasympathetic nerve fibers causes the heart rate to decrease Baroreceptor Reflex — a mechanism of the nervous system that plays an important role in regulating heart function Baroreceptors — stretch receptors that monitor blood pressure in the aorta and in the wall of the internal carotid arteries , which carry blood to the brain Cardioregulatory Center — within the medulla oblongata; receives and integrates action potentials from the baroreceptors — controls the action potential frequency in sympathetic and parasympathetic nerve fibers that extend from the brain and spinal cord to the heart Epinephrine and norepinephrine , released from the adrenal gland , increase the stroke volume and heart rate. Chemical Regulation: Chemoreceptor Reflex — epinephrine and small amounts of norepinephrine released from the adrenal medulla in response to exercise, emotional excitement, or stress also influence the heart’s function — epinephrine and norepinephrine bind to receptor proteins on cardiac muscle and cause increased heart rate and stroke volume — excitement , anxiety , or anger can affect the cardioregulatory center, resulting in increased sympathetic stimulation of the heart and increased cardiac output — depression , on the other hand, can increase parasympathetic stimulation of the heart, causing a slight reduction in cardiac output The medulla oblongata of the brain also contains chemoreceptors that are sensitive to changes in pH and CO2 levels. An excess of extracellular K+^ causes the heart rate and stroke volume to decrease. If the extracellular K+^ concentration increases further, normal conduction of action potentials through cardiac muscle is blocked, and death can result. An excess of extracellular Ca2+^ causes the heart to contract arrhythmically (changes in heart tracing). Reduced extracellular Ca2+^ causes both the heart rate and stroke volume to decrease. How heart rate is regulated in body: intrinsic regulation controlled by SV and AV Node. SA Valves generates nerve impulses with nueral stimulation average 100bpm. Parasympathetic – via vagus nerve (decreases force); slows the heart rate; dilates vessel and it will go down; pressure will decrease Sympathetic – sympathetic cardiac nerve ; increases heart rate; narrows vessel HR – absence of vagal tone Baroreflex – homeostasis of blood pressure Nucleus Tractus Solitarii (NTS) – receives projection BLOOD filled: 100mL ejected: 60mL PH 7.35–7.45 ( neutral ) Above – alkaline / alkalinity Below – acidic / acidity EFFECTS OF AGING AGING ON THE HEART

  • By the age of 70, a person’s cardiac output has probably decreased by approximately one-third.
  • Hypertrophy (enlargement) of the left ventricle is a commone age-related change. Because the left ventricle is enlarged, its ability to pump out blood is reduced, which can cause an increase in left atrial pressure and lead to increased pulmonary edema.
  • By age 85, the cardiac output has decreased by 30– 60%.
  • The aortic semilunar valve may become stenosed or incompetent.
  • Coronary artery disease and heart failure are also age-related.
  • Regular aerobic exercise improves the heart’s functional capacity at all ages.