Thibodeau: Anatomy and Physiology, 5/e
Chapter 18 - Anatomy of the Cardiovascular System
A brief reflection on the reason for referring to the cardiovascular system as the circulatory system
quickly puts this system into perspective and highlights its vital role in homeostasis. Now that students
have gained an understanding of the role of blood, they will come to this chapter with more interest in
examining just how the blood is pumped by the heart around a closed circle, or circuit of vessels, as it
passes again and again through the various "circulations" of the body.
Chapter 18 begins with a focus on the location, structure, and function of the heart, before moving
on to the blood vessels, their circulatory routes, and systemic circulation, as well as hepatic portal
circulation. An understanding of the anatomy of the cardiovascular system will aid in comprehension of its
physiology, which will be the focus of Chapter 19.
Objectives
After students have completed this chapter, they should be able to:
1.
List the primary organs of the cardiovascular system and relate each organ or group of organs to
the movement and/or direction of blood flow in the system.
2.
Discuss the location, size, and position of the heart in the thoracic cavity.
3.
Describe the structure of the pericardium and the function of each pericardial layer.
4.
List and discuss the three layers of the heart wall, the heart cavities, and the valves.
5.
Trace blood through the heart.
6.
Trace blood through the coronary circulation.
7.
List the anatomical components of the heart conduction system.
8.
List, locate, and compare the primary coats or layers of tissue found in major arteries and veins.
9.
Correlate structure of arteries, arterioles, veins, venules, and capillaries with their function.
10.
List anatomical components of microcirculation and discuss the reservoir function of veins.
11.
Trace the path of blood flow as it leaves the right side of the heart until it returns to the left side of
the heart (pulmonary circulation).
12.
Trace blood from the heart to various locations of the body and return the blood to the heart.
13.
Identify the unusual anatomical characteristics of the hepatic portal circulation.
14.
List and discuss the function of the six structures characteristic of the fetal circulation.
15.
Discuss changes that occur in the vascular system at birth.
Lecture Outline
I.
Introduction (p. 556)
A.
II.
Components
1.
Heart
2.
Blood vessels
Heart (p. 556)
A.
Location of the heart (Fig. 18-1)
Copyright © 2003 Mosby, Inc. All Rights Reserved.
Chapter 18 - Anatomy of the Cardiovascular System
B.
Size and shape of the heart (Fig. 18-2)
C.
Coverings of the heart
1.
2.
D.
2
Structure of the heart coverings (Figs. 18-3, 18-4)
a.
Fibrous pericardium
b.
Serous pericardium
1)
Visceral serous pericardium (epicardium)
2)
Parietal serous pericardium
Function of the heart coverings
Structure of the heart (p. 559)
1.
2.
Wall of the heart (Fig. 18-4)
a.
Epicardium
b.
Myocardium (Fig. 18-5)
c.
Endocardium
Chambers of the heart (Figs. 18-6, 18-7)
a.
b.
3.
4.
Atria
1)
Blood enters via veins.
2)
Blood leaves to ventricles.
3)
Auricle is an external flap of the atrium.
Ventricles
Valves of the heart (Figs. 18-6, 18-7, 18-8, 18-9)
a.
Atrioventricular valves (p. 561)
b.
Semilunar valves
c.
Skeleton of the heart (Fig. 18-8)
d.
Surface projection
e.
Blood flow through the heart (Fig. 18-7)
Blood supply of heart tissue (Fig. 18-10)
a.
b.
Right and left coronary arteries
1)
Arise from aorta behind two flaps of aortic semilunar
valves
2)
Few anastomoses between arteries
Cardiac veins
1)
5.
Most drain into the coronary sinus, which drains into
the right atrium
Conduction system of the heart (Fig. 18-11)
a.
Sinoatrial node (SA node)
b.
Atrioventricular node (AV node)
c.
Atrioventricular bundle (AV bundle)
Copyright © 2003 Mosby, Inc. All Rights Reserved.
Chapter 18 - Anatomy of the Cardiovascular System
6.
III.
d.
Right and left atrioventricular bundle branches
e.
Purkinje fibers
Nerve supply of the heart (Fig. 14-17; Table 14-8)
a.
Sympathetic fibers
b.
Parasympathetic fibers (vagus nerve)
Blood Vessels (p. 566)
A.
B.
Types of blood vessels
1.
Artery
2.
Arterioles
3.
Vein
4.
Venules
5.
Sinuses
6.
Capillaries or sinusoids
Structure of blood vessels (Fig. 18-12, Table 18-1)
1.
2.
3.
C.
Outer layer (tunica adventitia)
a.
Made of fibrous connective tissue attached to surrounding
tissue
b.
Thickest layer in veins
Middle layer (tunica media)
a.
Circular smooth muscle and elastic connective tissue
b.
Usually thicker in arteries than veins
c.
Allows for vasoconstriction and vasodilation
Inner layer (tunica intima)
a.
Endothelium (simple squamous epithelium) continuous with
endocardium
b.
Forms valves in veins
c.
Only layer of the capillaries
Functions of blood vessels (p. 567)
1.
Functions of capillaries (Fig. 18-13)
a.
2.
Functions of arteries
a.
3.
IV.
The site of all material exchange
Regulate where the blood flow increases or decreases
Functions of veins (Fig. 18-14)
a.
Collectors for returning blood to heart
b.
Reservoirs for blood
Major Blood Vessels (p. 569)
A.
Circulatory routes (Fig. 18-15)
Copyright © 2003 Mosby, Inc. All Rights Reserved.
3
Chapter 18 - Anatomy of the Cardiovascular System
1.
Pulmonary circulation
2.
Systemic circulation
a.
b.
c.
d.
V.
VI.
1)
Aorta (Fig. 18-17)
2)
Major branches of the aortic arch (Fig. 18-17)
3)
Arteries of the head and neck (Figs. 18-18, 18-19)
4)
Arteries of the trunk (Fig. 18-17)
5)
Arteries of the upper extremity (Fig. 18-20)
6)
Arteries of the lower extremity (Fig. 18-21)
Systemic veins (Table 18-3; Fig. 18-22)
1)
Veins of the head and neck (Fig. 18-23)
2)
Veins of the upper extremity (Fig. 18-24)
3)
Veins of the thorax (Fig. 18-25)
4)
Veins of the abdomen (Fig. 18-26)
5)
Blood flow through the body (Fig. 18-27)
6)
Hepatic portal circulation (Fig. 18-28)
7)
Veins of the lower extremity (Fig. 18-29)
Fetal circulation (Figs. 18-30, 18-31)
1)
Two umbilical arteries
2)
Placenta
3)
Umbilical vein
4)
Ductus venosus
5)
Foramen ovale
6)
Ductus arteriosus
Changes in circulation at birth (Fig. 18-32)
Cycle of Life: Cardiovascular Anatomy (p. 584)
A.
Profound changes at birth
B.
Maintenance during childhood, adolescence, and adulthood
C.
Degeneration during late adulthood
The Big Picture: Cardiovascular Anatomy and the Whole Body (p. 584)
A.
B.
VII.
Systemic arteries (Table 18-2; Fig. 18-16)
Network of transport pipes for the blood
1.
Heart
2.
Major arteries and veins
3.
Arterioles, venules, and capillaries
Visualization of blood flow through the system
Mechanisms of Disease: Disorders of the Cardiovascular System (p. 584)
Copyright © 2003 Mosby, Inc. All Rights Reserved.
4
Chapter 18 - Anatomy of the Cardiovascular System
A.
B.
C.
Disorders involving the pericardium
1.
Pericarditis
2.
Cardiac tamponade
Disorders involving heart valves
1.
Incompetent valves
2.
Stenosed valves
3.
Rheumatic heart disease
4.
Mitral valve prolapse (Fig 18-33)
5.
Aortic regurgitation
Disorders involving the myocardium
1.
Coronary artery disease (Fig. 18-35)
a.
Myocardial infarction
b.
Atherosclerosis
c.
Angina pectoris
1)
2.
D.
Congestive heart failure
Disorders involving the blood vessels
1.
Disorders of arteries
a.
2.
Arteriosclerosis
1)
Ischemia, necrosis, and gangrene
2)
Angioplasty (Fig. 18-36)
b.
Aneurysm
c.
Cerebrovascular accident (CVA)
Disorders of veins
a.
Varicose veins (varices) (Fig. 18-37)
1)
E.
Frequent treatment—coronary bypass surgery (Fig.
18-34)
Hemorrhoids (piles)
b.
Phlebitis
c.
Thrombophlebitis and pulmonary embolism
Heart medications
1.
Anticoagulants
2.
Beta-adrenergic blockers
3.
Calcium channel blockers
4.
Digitalis
5.
Nitroglycerin
6.
Tissue plasminogen activator (TPA)
Copyright © 2003 Mosby, Inc. All Rights Reserved.
5