THE CARDIOVASCULAR SYSTEM

The heart and circulatory system make up your cardiovascular system. The heart works as a pump that pushes the blood to the organs, tissues and cells of your body. Blood delivers oxygen and nutrients to every cells and removes carbon dioxide and waste products made by those cells.

The Heart The heart weighs 7- 15 oz. (200-425 gms) and is a little larger than the size of your fist . By the end of a long life, a persons heart may have beat more than 3.5 billion times, pumping about 2,000 gallons (7,571 liters ) of blood each day

It has 4 chambers, but from the electrical point of view it can be thought of having only 2 , because the 2 atria contract together and the 2 ventricles contract together. The contraction of any muscle is associated with electrical changes and these changes can be detected by electrodes of the ECG machine attach to the surface of the body.

Superior Vena Cava One of the 2 main veins bringing deoxygenated blood from the body ( head and upper extremities) which empties into the right atrium.

Inferior Vena Cava One of the 2 main veins bringing deoxygenated blood from the body ( lower extremities) which empties into the right atrium.

Right Atrium Receives de-oxygenated blood from the body through the superior and inferior vena cava. The SA node sends an impulses that causes the cardiac muscle tissues of the atrium to contract in a coordinated wave- like manner. This contraction is associated with electrical changes called depolarization ( when normally negatively charged cells develop into a positive charge). Depolarization spreads through the atrial muscle fibers, then spreads slowly through another special area in the atrium, the atrioventricular node.

Tricuspid Valve Separates the right atrium from the right ventricle, opens to allow the deoxygenated blood to flow into the right ventricle.

Right Ventricle Receives deoxygenated blood as the right atrium contracts. The pulmonary valve is closed allowing the ventricles to fill with blood and once it is full they contract (depolarized). The electrical discharge travels rapidly, down to specialized conduction tissue: first a single pathway, the Bundle of His, which then divides in the septum between the ventricles into the right and left Bundle Branches. The left bundle branch itself divides into two. Within the mass of ventricular muscle, conduction somewhat more slowly, through the specialized tissue called Purkinje fibres.

As the ventricles contracts, the tricuspid valve closes and the pulmonary valve opens. The closure of the tricuspid valve prevents blood backflow into the right atrium and the opening of the pulmonary valve allows the blood to flow into the pulmonary artery.

Pulmonary Artery The vessel transporting deoxygenated blood from the right ventricle to the lungs for oxygenation.

Pulmonary Vein The vessel transporting oxygenated blood from the lungs to the left atrium.

Left Atrium Receives oxygenated blood from the lungs through the pulmonary vein. As the contraction triggered by the SA node progresses through the atria, the blood passes through the mitral valve into the left ventricle.

Left Ventricles Receives oxygenated blood as the left atrium contracts. The aortic valve is closed allowing the ventricles to fill with blood and once it is full they contract ( depolarized). As the left ventricle contracts the mitral valve closes ( preventing backflow of blood into the left atrium) and the aortic valve opens allowing the blood to flow into the aorta and flow throughout the body.

Aorta The largest single blood vessel in the body approximately the diameter of your thumb, which carries oxygenated blood to the various parts of the body.

Electro physiologic Properties of the Heart 1. Automaticity (pacing function) - ability of the cardiac cells to generate an electrical impulses spontaneously and repetitively. 2. Excitability - ability of the non pacemaker myocardial cells to respond to respond to an electrical impulses generated from the pacemaker cells and depolarize

3. Conductivity - ability to transmit an electrical stimulus from cell membrane. 4. Contractility - ability of the atrial and ventricular muscle cells to shorten their fiber length in electrical stimulation, generating sufficient pressure to propel/ pump blood forward.

ECG One of the most valuable and frequently used diagnostic tool to picture the cardiac electrical activities ( depolarization & repolarization)

12 Standard leads/ views/ electrical picture of the heart Standard Limb ( Bipolar ) Leads Lead 1- lateral wall - measures the difference between the left arm(-) and the right arm (+) Lead II- inferior wall - measures the difference between the left leg(+) and the right arm (-) Lead III- inferior wall - measures the difference between the left arm(-) and the left leg (+)

Unipolar Augmented Limb Leads (+) AVR - measures the difference between the heart and the right arm (+) AVL - measures the difference between the heart and the left arm (+) AVF - measures the difference between the heart and the left foot (+)

Unipolar Prtecordial/ Chest Leads V1- V6

(Module 1 & 3)