lymphatic system, a subsystem of the circulatory system in the vertebrate body that consists of a complex network of vessels, tissues, and organs. The lymphatic system helps maintain fluid balance in the body by collecting excess fluid and particulate matter from tissues and depositing them in the bloodstream

1. THE CIRCULATORY
AND
LYMPHATIC SYSTEM
Dr. Pallavi Pathania
Associate professor

3. INDEX
S.NO. CONTENT
1
2
3
4
5
6
7
8
Structure of blood components, blood vessels (Arterial
and venous system)
Position of heart relative to the associated structures
Chambers and layers of the heart
Heart valves, coronary arteries
Nerve and blood supply to the heart
Lymphatic tissue
Veins used for IV Injections
Application and implication in nursing

4. INTRODUCTION
The circulatory system is
an organ system that
permits blood to circulate
and transport nutrients such
as amino acid and
electrolytes , Oxygen,
carbon dioxide, hormones
and blood cells in the body
to provide nourishment and
help in fighting disease
,stablishing temperature ,
pH and maintain
homeostasis.

7. INTERESTING FACTS

8. 1. A human heart is roughly the size of a large fist.
2. The heart weighs between 9 and 12 ounces (250 and 350 grams).
3. The heart beats about 100,000 times per day (about three billion beats in a lifetime).
4. An adult heart beats about 60 to 80 times per minute.
5. New-borns hearts beat faster than adult hearts, about 70 -190 beats per minute.
6. The heart pumps about 6 quarts (5.7 litres) of blood throughout the body.
7. The heart is located in the center of the chest, usually pointing slightly left.
8. Your heart is located in your chest and is well protected by your rib cage.
9. Every day, the heart creates enough energy to drive a truck 20 miles. In a lifetime, that is equivalent to
driving to the moon and back.
10. Because the heart has its own electrical impulse, it can continue to beat even when separated from the
body, as long as it has an adequate supply of oxygen.

9. 11. The “thump-thump” of a heartbeat is the sound made by the four valves of the heart closing.
12. The heart begins beating at four weeks after conception and does not stop until death.
13. A woman’s heart typically beats faster than a man’s. The heart of an average man beats approximately 70 times a minute,
whereas the average woman has a heart rate of 78 beats per minute.
14. Grab a tennis ball and squeeze it tightly: that’s how hard the beating heart works to pump blood.
15. During an average lifetime, the heart will pump nearly 1.5 million barrels of blood—enough to fill 200 train tank cars.
16. French physician Rene Laennec (1781-1826) invented the stethoscope when he felt it was inappropriate to place his ear on his
large- buxomed female patients' chests.
17. In 1903, physiologist Willem Einthoven (1860-1927) invented the electrocardiograph, which measures electric current in the
heart.
18.In 1929, German surgeon Werner Forssmann (1904-1979) examined the inside of his own heart by threading a catheter into his
arm vein and pushing it 20 inches and into his heart, inventing cardiac catheterization, a now common procedure.
19. On December 3, 1967, Dr. Christiaan Barnard (1922-2001) of South Africa transplanted a human heart into the body of Louis
Washansky. Although the recipient lived only 18 days, it is considered the first successful heart transplant.
20. “Atrium” is Latin for “entrance hall,” and “ventricle” is Latin for “little belly”.

10. 21. A normal hear valve is about the size of a half dollar.
22. The first hear pacemakers plugged into a wall socket.
23. Happiness (Laughing) and a strong sense of emotional vitality help lower risk of heart disease.
24. The number of hear attacks peaks on Christmas Day, followed by December 26th and New Years.
25. The blue whale has the Largest hear–weighing over 1,500 pounds.
26. You control your heart health through diet, exercise and managing stress.
27. Heart cancer is very rare , because heart cells stop dividing early in life.
28. Every cell in the body gets blood from the heart, except for the corneas.

11. CIRCULATORY SYSTEM
ORGAN/COMPONENTS PRIMARY FUNCTION
BLOOD Transport oxygen, carbon dioxide and blood cells, delivers nutrients and
hormones, remove waste products, assists in temperature regulation and
defence against disease
BLOOD VESSELS Distribute blood around the body
ARTERIES Carry blood heart to capillaries
CAPILLARIES Permit diffusion between blood and interstitial fluids
VEINS Return blood from capillaries to the heart
Heart Propels blood, maintains blood pressure

12. BLOOD

14. INTRODUCTION
Blood, fluid that transports oxygen and
nutrients to the cells and carries
away carbon dioxide and other waste
products. Technically, blood is a transport
liquid pumped by the heart (or an
equivalent structure) to all parts of the
body, after which it is returned to the heart
to repeat the process.

15. DEFINITION
Blood is a body fluid in humans and other animals that delivers
necessary substances such as nutrients and oxygen to
the cells and transports metabolic waste products away from those
same cells.
Blood is a special type of fluid connective tissue derived from
mesoderm.
The branch of science concerned with the study of blood,
blood-forming tissues, and the disorders associated with them
is called haematology.
(Gk: haeme – blood and logos - study)

16. CONT..
• The average human has 5 liters of blood(Average Blood Volume is 4 to 6 liters).
• It carries vital substances to all parts of the body
• Blood is the only fluid tissue.
• Blood is a complex connective tissue in which living cells, the formed elements,
are suspended in the nonliving fluid called plasma.

17. PROPERTIES OF BLOOD
Content Properties
Colour Bright red in arteries & dark red in veins
Mass 8 % of the body mass
PH Slightly alkaline (pH = 7.35 – 7.45)
Taste Salty
Temperature
38° C (100.4° F)
Volume 5 – 6 litre

19. COMPOSTION OF BLOOD
55% Plasma (fluid matrix of water, salts, proteins, etc.)
45% Cellular elements:
• Red Blood Cells (RBCs): 5-6 million RBCs/ml of
blood. Contain hemoglobin which transport oxygen and
CO2.
• White Blood Cells (WBCs): 5,000-10,000 WBCs/ml
of blood.

20. CONT..
Play an essential role in immunity and defense. Include:
1. Lymphocytes: T cells and B cells
2. Macrophages: (phagocytes)
3. Granulocytes: Neutrophils, basophils, and
eosinophils.
• Platelets: Cellular fragments, 250,000- 400,000/ml of
blood.
Important in blood clotting

21. PLASMA
• Plasma is a pale yellow colored liquid component of a blood that holds the cellular
elements of blood in suspension

23. CONT..

24. PLASMA PROTEINS
• Constitute 7-9% of plasma
• Three types of plasma proteins: albumins,
globulins, & fibrinogen.
• Albumin accounts for 60-80, plasma protein
made by the liver, Creates colloid osmotic
pressure that draws H20 from interstitial fluid
into capillaries to maintain blood volume &
pressure.

25. COMPONENTS OF PLASMA
• 90% of plasma is water:
• other substances in plasma: salts (electrolytes), nutrients , gases, hormones,
plasma proteins, various wastes and products of cell metabolism.
• Plasma proteins:
• Constitute 7-9% of plasma.
• Provide the colloid osmotic pressure needed to draw H2O from interstitial fluid to
capillaries.

26. CONT…
• Globulins carry lipids
• alpha globulin: Transport lipids and fat soluble vitamins.
• beta globulin: Transport lipids and fat soluble vitamins.
• gamma globulin: Antibodies that function in immunity.
• Gamma globulins are antibodies
• Fibrinogen Constitutes 4% of plasma proteins. Important clotting factor.
Converted into fibrin during the clotting process.

27. HEMATOPOSIS

28. RBCs/ ERYTHROCYTES
• Red blood cell, also called erythrocyte, cellular
component of blood, millions of which in the
circulation of vertebrates give the blood its
characteristic colour and carry oxygen from the
lungs to the tissues.
• The mature human red blood cell is small, round,
and biconcave; it appears dumbbell-shaped in
profile.

30. COMPONENTS OF RBCs
• Anucleate - they lack a nucleus
• Filled with hemoglobin which carries oxygen
• Biconcave discs = greater surface area for gas exchange.
• Half-life ~ 120 days.
• Contain 280 million hemoglobin with 4 heme chains (contain iron).

32. RBC (RED BLOOD CELLS)
• Shape -Circular biconcave non-nucleated
• Diameter= 7-8um
• Thickness=2.5 um
• Colour =Red (haemoglobin pigment)
• Count = Adult male = 5.4 million RBCs/μL
Adult female = 4.8 million RBCs/μL
• Life span=120 days

33. ERYTHROPOIESIS
The production of RBCs is known as erythropoiesis
• Adult- Red bone marrow of long bones (hip bone, breast bone & ribs)
• Child(up to 5 year)-Bone marrow of all the bones
• Foetus-Liver & spleen
• Increase in number of RBCs is known as polycythaemia
• Decrease in number of RBCs is known as erythropenia

34. CONT..

35. FUNCTIONS OF RBCs
• Transport of oxygen from lungs to tissues
• Transport of carbon dioxide from tissues to lungs
• Regulate acid base balance

36. DISODERS RELATED TO RBCs
• Aplastic anemia
• Iron-deficiency anemia
• Sickle cell anemia
• Hemolytic anemia

37. WHITE BLOOD CELLS(WBCs) / LEUKOCYTES
• White blood cells (WBCs), also
called leukocytes or leucocytes, are the cells of
the immune system that are involved in protecting the
body against both infectious disease and foreign invaders.
• All white blood cells are produced and derived
from multipotent cells in the bone marrow known
as hematopoietic stem cells. Leukocytes are found
throughout the body, including the blood and lymphatic
system.

40. COMPONENTS
• Complete cells (nuclei, mitochondria and organelles)
• Almost invisible, so named after stains.
• Neutrophils are the most abundant WBC, accounts
for 50 – 70% of WBCs.

41. CONT…
• Involved in immune function. Crucial for defense.
• Positive chemotaxis: they respond to chemical signals and move toward damage
or threats.
• Body increases amount in response to infection

42. WHITE BLOOD CELLS
• Shape-Amoeboid nucleated
• Size-12 – 15 μm
• Colour-Colourless & translucent
• Count-5000 – 10000 WBCs/μL
• Life span-10-13 days

43. LEUCOPOIESIS
• The production of WBCs is known as leucopoiesis
Adult Liver, spleen, tonsils, bone marrow
Foetus Liver, spleen

44. TYPES Of WBCs

45. GRANULAR WBCs

46. AGRANULAR WBCs

47. DISODERS RELATED TO WBCS
• Neutropenia
• Leukaemia
• Leukopenia
• Leucocytosis

48. PLATELETS
• Platelets, also called thrombocytes , are a
component of blood whose function (along with
the coagulation factors) is to react to bleeding from
blood vessel injury by clumping, thereby initiating
a blood clot.
• Platelets have no cell nucleus: they are fragments
of cytoplasm that are derived from
the megakaryocytes of the bone marrow which then
enter the circulation

50. COMPONENTS
• Derived from ruptured multinucleate cells (megakaryocytes)
• Smallest of formed elements.
• Are fragments of megakaryocytes.
• Lack nuclei.
• Normal platelet count = 300,000/mm3
• Survive 5-9 days

51. CONT….
• Have amoeboid movement.
• Important in blood clotting:
a. Constitute most of the mass of the clot.
b. Release serotonin to reduce blood flow to area.
c. Secrete growth factors
d. Maintain the integrity of blood vessel wall.

52. PLATELETS

53. THROMBOPOIESIS

54. FUNCTIONS
• The functions of platelets are primarily related to haemostasis.
• Serotonin released by platelets contributes to the vasoconstriction observed
immediately after vascular injury
• Platelets aggregates to plug the vascular integrity
• Contractile proteins of the platelets brings about clot retraction
• It has growth factors which stimulates mitosis in vascular wall thus repair the
damage of vessels walls

55. BLOOD INVESTIGATION FORM

56. BLOOD CLOTTING

57. PROCESS OF BLOOD CLOTTING

58. WOUND HEALING
• Cutaneous wound healing is the process by which
the skin repairs itself after damage. It is important
in restoring normal function to the tissue.
• There are two main types of healing, primary
intention and secondary intention. In both types, there
are four stages which occur; hemostasis, inflammation,
proliferation, and remodeling.

59. WOUND HEALING PROCESS

60. WOUND HEALING PROCESS

61. ANTICOAGULANT

62. BLOOD GROUPING
• There are 4 main blood groups (types of blood) – A, B, AB and O. Your blood
group is determined by the genes you inherit from your parents.

63. CONT…
• Antibodies and antigens
• Blood is made up of red blood cells, white blood cells and
platelets in a liquid called plasma. Your blood group is
identified by antibodies and antigens in the blood.
• Antibodies are proteins found in plasma. They're part of your
body's natural defenses. They recognize foreign substances,
such as germs, and alert your immune system, which
destroys them.
• Antigens are protein molecules found on the surface of red
blood cells.

64. CONT…
The ABO system
There are 4 main blood groups defined by the ABO system:
• blood group A – has A antigens on the red blood cells with anti-B antibodies in
the plasma
• blood group B – has B antigens with anti-A antibodies in the plasma
• blood group O – has no antigens, but both anti-A and anti-B antibodies in the
plasma
• blood group AB – has both A and B antigens, but no antibodies
• Blood group O is the most common blood group. Almost half of the UK
population (48%) has blood group O.

65. CONT…

66. CONT…
• The universal red cell donor has Type O negative blood.
• The universal plasma donor has Type AB blood.

68. BLOOD VESSELS

69. INTRODUCTION
• The blood vessels are the components of the circulatory
system that transport blood throughout the human
body. These vessels transport blood cells, nutrients, and
oxygen to the tissues of the body. They also take waste
and carbon dioxide away from the tissues. Blood
vessels are needed to sustain life, because all of the
body's tissues rely on their functionality

70. DEFINITION
• Blood vessel, a vessel in the human or animal
body in which blood circulates. The vessels that
carry blood away from the heart are
called arteries, and their very small branches
are arterioles. Very small branches that collect the
blood from the various organs and parts are
called venules, and they unite to form veins,
which return the blood to the heart.

71. TYPES OF BLOOD VESSELS
1. Arteries & Arterioles
2. Veins & Venules
3. Capillaries

77. CONT…
1.Arteries & Arterioles
• built to withstand the greatest pressure of the system
a. strong resilient walls,
b. thick layers of connective tissues
c. more muscular than veins

78. CONT…
• Arteries and arterioles typically contain ~25% of all blood in circulation (15% in
arteries; 10% in arterioles )
• Pressure is variable MAP ~ 93 varies from 100 – 40 mmHg
• Most organs receive blood from >1 arterial branch provides alternate pathways

79. CONT…
Veins & Venules
• Generally have a greater diameter than arteries but thinner walls,
flaccid
• Three layer are all thinner than in arteries tunica adventitia is
thickest of three
• But not as elastic as arteries
• Little smooth muscle

80. CONT…
• 70% of all blood is in veins & venules (~60% in veins, ~10% in venules)
• low pressure:
• 12 – 8 mmHg venules
• 6 – 1 mmHg veins larger veins near 0

81. CONT…
3. Capillaries:
• Actual site of exchange of materials the rest is just pumps and plumbing
• Consist of only a single layer of squamous epithelium= endothelial layer (=tunica
intima)

82. CONT…
• Arranged into capillary beds = functional units of circulatory system
• Capillaries are extremely abundant in almost every tissue of the body
• Only 5% of blood at any one time is in capillaries

83. MEMBRANE OF VESSELS
walls of arteries and veins consist of three layers:
a. Tunica Externa
b. Tunica Media
c. Tunica Interna

84. CONT…
a. Tunica Externa (= T. adventitia)
• outer loose connective tissue
• anchors the vessel and provides passage for small
nerves, lymphatic vessels and smaller blood
vessels

85. CONT…
b. Tunica Media
• middle, made mainly of smooth muscle with some
elastic tissue and collagen fibers strengthens vessel
walls
• prevent high pressure from rupturing them allows
vasodilation and vasoconstriction
• usually the thickest layer, especially in arteries

86. CONT…
c. Tunica Interna (=T. Intima)
• inner endothelium
• exposed to blood when damaged or inflamed induce
platelets or
• WBC’s to adhere
• may lead to plaque build up and atherosclerosis

87. AORTA
• The aorta is the main and largest artery in the human
body originating from the left ventricle of the heart and
extending down to the abdomen, where it splits into two
smaller arteries (the common iliac arteries). The aorta
distributes oxygenated blood to all parts of the body
through the systemic circulation

88. CONT…
• part of the aorta is by anatomical compartment, where
the
• 1. Thoracic aorta (or thoracic portion of the aorta) runs
from the heart to the diaphragm.
• 2. Abdominal aorta (or abdominal portion of the aorta)
from the diaphragm to the aortic bifurcation

89. THORACIC AORTA
• This part of the aorta lies above the diaphragm ana is described into 3 parts :
• Ascending aorta
• Arch of the aorta
• Descending aorta in the thorax

90. CONT..
• ASCENDING AROTA
• It is a portion of the aorta commencing at the upper part of the
base of the left ventricle, on a level with the lower border of the
third costal cartilage behind the left half of the sternum
• Right and left coronary arties are branches of ascending aorta.

91. CONT..
• ARCH OF AORTA
• The aortic arch is the connection between the ascending and descending aorta, and
its central part is formed by the left 4th aortic arch during early development
• Three branches arises from upper aspect :
• Brachiocephalic artery or trunk
• Left common carotid artery
• Left subclavian artery

92. CONT..
• DESENDING AROTA
• The descending aorta is the part of the aorta, the largest artery
in the body, that runs down through the chest and the
abdomen. The descending aorta starts after the arch of the
aorta and ends by splitting into two great arteries (the
common iliac arteries) that go to the legs.

93. ABDOMINALAROTA
• The abdominal aorta, is the final section of the aorta. It
begins at the diaphragm as a continuation of the thoracic
aorta and runs down to where the aorta ends (by splitting into
the two leg arteries)or right/left common iliac artery. The
abdominal aorta supplies oxygenated blood to all of the
abdominal and pelvic organs and the legs.

94. VENAE CAVAE
• The venae cavae from the Latin for "hollow veins", singular
"vena cava" are two large veins (venous trunks) that return
deoxygenated blood from the body into the heart. In humans
there are the superior vena cava and the inferior vena cava and
both empty into the right atrium. They are located slightly off-
center, toward the right side of the body.

95. CONT…
• The superior vena cava (SVC) is the superior of the two venae
cave, the great venous trunks that return
deoxygenated blood from the systemic circulation to the right
atrium of the heart.
• It is a large-diameter (24 mm) short length vein that receives
venous return from the upper half of the body, above
the diaphragm

96. CONT…
• The inferior vena cava (or IVC) is a large vein that carries
the deoxygenated blood from the lower and middle body into
the right atrium of the heart.
• Its walls are rigid and it has valves so the blood does not
flow down via gravity. It is formed by the joining of the right
and the left common iliac veins, usually at the level of the
fifth lumbar vertebra.

97. VASCULAR SYSTEM
• Provide conduits for blood to travel from the heart to nourish the body.
• Carry cellular wastes to the excretory organs.
• Return blood to the heart for recirculation.

98. ARTIAL SYSTEM
• Delivers blood to various tissues for nourishment
• Transport of cellular wastes
• Contribute to thermal regulation

99. CONT…
Arteries of the
Thoracic
Region
Vessel Description
Visceral branches A group of arterial branches of the thoracic aorta; supplies blood to the viscera (i.e., organs) of the thorax
Bronchial artery
Systemic branch from the aorta that provides oxygenated blood to the lungs; this blood supply is in addition to the
pulmonary circuit that brings blood for oxygenation
Pericardial artery Branch of the thoracic aorta; supplies blood to the pericardium
Esophageal artery Branch of the thoracic aorta; supplies blood to the esophagus
Mediastinal artery Branch of the thoracic aorta; supplies blood to the mediastinum
Parietal branches
Also called somatic branches, a group of arterial branches of the thoracic aorta; include those that supply blood to the
thoracic wall, vertebral column, and the superior surface of the diaphragm
Intercostal artery Branch of the thoracic aorta; supplies blood to the muscles of the thoracic cavity and vertebral column
Superior phrenic
artery
Branch of the thoracic aorta; supplies blood to the superior surface of the diaphragm

100. CONT…
Aortic Arch Branches
and Brain Circulation
Vessel Description
Brachiocephalic artery
Single vessel located on the right side of the body; the first vessel branching from the aortic arch; gives rise to the right
subclavian artery and the right common carotid artery; supplies blood to the head, neck, upper limb, and wall of the thoracic
region
Subclavian artery
The right subclavian artery arises from the brachiocephalic artery while the left subclavian artery arises from the aortic arch;
gives rise to the internal thoracic, vertebral, and thyrocervical arteries; supplies blood to the arms, chest, shoulders, back, and
central nervous system
Internal thoracic artery
Also called the mammary artery; arises from the subclavian artery; supplies blood to the thymus, pericardium of the heart,
and anterior chest wall
Vertebral artery
Arises from the subclavian artery and passes through the vertebral foramen through the foramen magnum to the brain; joins
with the internal carotid artery to form the arterial circle; supplies blood to the brain and spinal cord
Thyrocervical artery Arises from the subclavian artery; supplies blood to the thyroid, the cervical region, the upper back, and shoulder
Common carotid artery
The right common carotid artery arises from the brachiocephalic artery and the left common carotid artery arises from the
aortic arch; each gives rise to the external and internal carotid arteries; supplies the respective sides of the head and neck
External carotid artery
Arises from the common carotid artery; supplies blood to numerous structures within the face, lower jaw, neck, esophagus,
and larynx
Internal carotid artery
Arises from the common carotid artery and begins with the carotid sinus; goes through the carotid canal of the temporal bone
to the base of the brain; combines with the branches of the vertebral artery, forming the arterial circle; supplies blood to the
brain

101. CONT…

102. VENOUS SYSTEM
• Series of veins located adjacent to arterial system
• Veins collect blood from the capillaries & terminal
arterioles
• Acts as reservoir for blood

103. CONT…
Major Veins of the Head and Neck
Vessel Description
Internal
jugular vein
Parallel to the common carotid artery, which is more or less its counterpart, and
passes through the jugular foramen and canal; primarily drains blood from the
brain, receives the superficial facial vein, and empties into the subclavian vein
Temporal vein Drains blood from the temporal region and flows into the external jugular vein
Maxillary
vein
Drains blood from the maxillary region and flows into the external jugular vein
External
jugular vein
Drains blood from the more superficial portions of the head, scalp, and cranial
regions, and leads to the subclavian vein

104. CONT…
Veins of the
Thoracic Region
Vessel Description
Superior vena cava
Large systemic vein; drains blood from most areas superior to the diaphragm; empties into the right
atrium
Subclavian vein
Located deep in the thoracic cavity; formed by the axillary vein as it enters the thoracic cavity from
the axillary region; drains the axillary and smaller local veins near the scapular region and leads to
the brachiocephalic vein
Brachiocephalic veins
Pair of veins that form from a fusion of the external and internal jugular veins and the subclavian
vein; subclavian, external and internal jugulars, vertebral, and internal thoracic veins flow into it;
drain the upper thoracic region and lead to the superior vena cava
Vertebral vein
Arises from the base of the brain and the cervical region of the spinal cord; passes through the
intervertebral foramina in the cervical vertebrae; drains smaller veins from the cranium, spinal cord,
and vertebrae, and leads to the brachiocephalic vein; counterpart of the vertebral artery
Internal thoracic veins
Also called internal mammary veins; drain the anterior surface of the chest wall and lead to the
brachiocephalic vein
Intercostal vein Drains the muscles of the thoracic wall and leads to the azygos vein
Esophageal vein Drains the inferior portions of the esophagus and leads to the azygos vein
Bronchial vein Drains the systemic circulation from the lungs and leads to the azygos vein

105. CONT…

108. PROCESS OF BLOOD FLOW
Heart
Arteries
Arterioles
Capillaries
Venules
Veins

109. DEFINTION
• The circulatory system, sometimes called the cardiovascular
system, consists of the heart, blood vessels, and blood.
• It transports oxygen, hormones and nutrients to all the cells in
the body
• The circulatory system is composed with the heart, arteries,
capillaries, and veins. This remarkable system transports
oxygenated blood from the lungs and heart throughout the body
via the arteries

110. HEART

111. Women's hearts and arteries are smaller than men's.

112. LOCATION AND SURFACE PROJECTION
• Apex- lower, cone shaped
• Base- border, superior portion
• The heart is the hollow, cone shaped about the size of closed fist
• It lies in the mediastinum between the lungs and rests upon the
diaphragm
• Two- third of its mass lies to left of the midline

113. POSTION OF HEART
• Normally located in the middle and slightly to the
left side of the thoracic
• The apex is about 9 cm to the left of the midline at
the level of the 5th intercostal space and the base
extends to the levels of the 2nd rib .
• Weighs about 325 gm is males and about 275 gm
in females.

114. LAYERS OF HEART WALLS

115. CONT…
• PERICARDUIM – membrane (sac)that surrounds and protects the heart by the
help of two layers.
a. Fibrous pericardium- superficial layer, tough, inelastic, prevents
overstretching, provide protection and anchors the heart in place.
b. Serous pericardium-
1. partial layer-fused to the fibrous pericardium
2. visceral layer- or epicardium adheres to the heart itself
c. Pericardial cavity –present between two layer is filled with pericardial fluids
which reduce friction

116. CONT…

117. CONT…
• EPICARDUIM is the layer immediately outside of the heart muscle proper (the
myocardium). The epicardium is largely made of connective tissue and functions
as a protective layer

118. CONT…
MYOCARDUIM
The myocardium of the left ventricle is the thickest,
as this ventricle is responsible for generating the
power needed to pump oxygenated blood from the
heart to the rest of the body

119. CONT…
ENDOCARDUIM
• Endocardium (endo-cardium) is the thin inner layer of the
heart wall. This layer lines the inner heart chambers,
covers heart valves, and is continuous with the endothelium
of large blood vessels.
• The endocardium of heart atria consists of smooth
muscle, as well as elastic fibers.

120. CHAMBERS OF HEART
Four chambers
• Right Atrium
• Right Ventricle
• Left atrium
• Left ventricle

121. CONT…
RIGHT ATRIUM
• Receives venous blood from whole of the body via the superior vena cava(SVC)
at its upper end and inferior vena cava (IVC) at its lower end.
• It pumps into Right ventricle (RV)through the tricuspid valve during the
ventricular diastole.
• RIGHT VENRTICLE
• Triangular shaped or crescent shaped
• Opens into pulmonary artery through pulmonary valve
• Most anterior chamber

122. CONT…
LEFT ATRIUM
• Posterior most chamber
• Receives oxygenated blood from pulmonary veins
• Pulmonary veins open into LA from the posterior wall
• RIGHT VENRTICLE
• chambers and is responsible for pumping oxygenated blood to tissues all over the
body

123. VALVES OF HEART
• There are also 4 one-way valves that direct flow of blood through the heart in one
direction

124. CONT…
2 Atrioventricular (AV) valves
• Bicuspid (Mitral) valve - separates left atrium
and ventricle, consists of two flaps of tissues
• Tricuspid valve – separates right atrium and
ventricle - consists of three flaps of tissue
( prevent backflow (eversion) keeps valves pointed
in direction of flow )

125. CONT…
2 Semilunar valves
• at beginning of arteries leaving the ventricles
Aortic SL valve- at beginning of aorta
Pulmonary SL valve-at beginning of pulmonary trunk

127. SYSMATIC CIRCULATION/PULMONARY
CIRCULATION

128. PULMONARY CIRCULATION
• Transports oxygen-poor blood from the right ventricle to the lungs where blood
picks up a new oxygen supply.

129. SYSTEMATIC CIRCULATION
• It returns oxygen rich blood and nutrients to the left atrium and is pumped out all
over the body It also picks up carbon dioxide and other waste products.

130. CORONARY CIRCUALTION
• Coronary arteries supply blood to the heart
muscle. Like all other tissues in the body, the
heart muscle needs oxygen-rich blood to
function. Also, oxygen-depleted blood must be
carried away. The coronary arteries wrap around
the outside of the heart. Small branches divide
into the heart muscle to bring it blood.

131. CONT…
• Left main coronary artery (LMCA)-supplies blood to the
left side of the heart muscle (the left ventricle and left atrium).
The left main coronary divides into branches:
• The left anterior descending artery branches off the left
coronary artery and supplies blood to the front of the left side
of the heart.
• The circumflex artery branches off the left coronary artery and
encircles the heart muscle. This artery supplies blood to the
outer side and back of the heart.

132. CONT…
• Right coronary artery (RCA)-supplies blood to
the right ventricle, the right atrium, and the SA
(sinoatrial) and AV (atrioventricular) nodes,
which regulate the heart rhythm.
• The right coronary artery divides into smaller
branches, including the right posterior descending
artery and the acute marginal artery.
• Together with the left anterior descending artery,
the right coronary artery helps supply blood to the
middle or septum of the heart.

133. CARDIC CONDUCTION SYSTEM

134. The heart conduction system is the
network of nodes, cells and signals
that controls your heartbeat. Each
time your heart beats, electrical signals
travel through your heart. These signals
cause different parts of your heart to
expand and contract.
The cardiac conduction system is
a network of specialized cardiac muscle
cells that initiate and transmit the
electrical impulses responsible for the
coordinated contractions of each
cardiac cycle.

135. CONT…
• To pump blood throughout the body, the
muscles of the heart must be
coordinated perfectly — squeezing the
blood in the right direction, at the right
time, at the right pressure. The heart’s
activity is coordinated by electrical
impulses.

136. CONT…
• Electrical signals arising in the SA node
(located in the right atrium) stimulate the atria
to contract.
• The sinoatrial (SA) node or sinus node is the
heart's natural pacemaker. It's a small mass of
specialized cells in the top of the right atrium
(upper chamber of the heart). It produces the
electrical impulses that cause your heart to
beat. These are called demand pacemakers
• Then the signals travel to the atrioventricular
node (AV node), which is located in
the interatrial septum.

137. CONT…
• After a delay, the electrical signal diverges and is conducted
through the left and right bundle of His to the
respective Purkinje fibers for each side of the heart, as well
as to the endocardium at the apex of the heart, then finally to
the ventricular epicardium; causing its contraction.
• These signals are generated rhythmically, which in turn
results in the coordinated rhythmic contraction and relaxation
of the heart.

138. CARDIC CYCLE
• The cardiac cycle is the performance of the human heart from the ending of one
heartbeat to the beginning of the next. It consists of two periods: one during which
the heart muscle relaxes and refills with blood, called diastole following a period
of robust contraction and pumping of blood, dubbed systole

140. CARDIC OUTPUT
• The cardiac output is the amount of the blood ejected from each
ventricle every minutes.
• The amount of expelled by each contraction of each ventricles
is the stroke volume
cardiac output = stroke volume x heart rate
• For a resting adult
CO = 70mL/beat x75beats/min
= 5250 mL/min
= 5.25 L/min

141. Cardiac auscultation
• Produced from blood turbulence caused by closing of the heart valves
• S1 – atrioventricular valve closure LUB
• S2 – semilunar valve closure DUB
• S3 – rapid ventricular filling
• S4 – atrial systole

142. ECG

143. Key facts
• Pulmonary arteries
• Right ventricle -> pulmonary trunk -> right and left pulmonary arteries
Purpose: deliver deoxygenated blood to the respective lung
• Pulmonary veins
• Lung capillaries -> 4 pulmonary veins (2 from each lung) -> left atrium
Purpose: deliver oxygenated blood to the left ventricle which will distribute
it to the body
• Hormones of Heart : The heart produces two major hormones, A- and B-
type natriuretic peptides (ANP and BNP), which are synthesized and
secreted in response to increased workload of the heart. Their main
function is to alleviate cardiac load by decreasing the amount of
extracellular fluid and lowering the blood pressure.

146. The lymphatic system
The lymphatic system, or lymphoid
system, is an organ system in vertebrates
that is part of the circulatory system and
the immune system. It is made up of a
large network of lymph, lymphatic
vessels, lymph nodes, lymphatic or
lymphoid organs, and lymphoid tissues.
The vessels carry a clear fluid
called lymph (the Latin
word lympha refers to the deity of fresh
water, "Lympha“ towards the heart.

148. The lymphatic system is a network of tissues and
organs that help rid the body of toxins, waste and
other unwanted materials.
The primary function of the lymphatic system is to
transport lymph, a fluid containing infection-
fighting white blood cells, throughout the body.
The lymphatic system primarily consists of
lymphatic vessels, which are similar to the veins
and capillaries of the circulatory system. The
vessels are connected to lymph nodes, where the
lymph is filtered. The tonsils, adenoids, spleen and
thymus are all part of the lymphatic system.

149. Lymphatic circulation
The lymphatic system can be thought of as a drainage
system needed because, as blood circulates through the
body, blood plasma leaks into tissues through the thin
walls of the capillaries. The portion of blood plasma that
escapes is called interstitial or extracellular fluid, and it
contains oxygen, glucose, amino acids, and other nutrients
needed by tissue cells. Although most of this fluid seeps
immediately back into the bloodstream, a percentage of it,
along with the particulate matter, is left behind. The
lymphatic system removes this fluid and these materials
from tissues, returning them via the lymphatic vessels to
the bloodstream, and thus prevents a fluid imbalance that
would result in the organism’s death.

150. The fluid and proteins within the tissues begin their journey back to the
bloodstream by passing into tiny lymphatic capillaries that infuse almost
every tissue of the body. Only a few regions, including the epidermis of
the skin, the mucous membranes, the bone marrow, and the central nervous
system, are free of lymphatic capillaries, whereas regions such as
the lungs, gut, genitourinary system, and dermis of the skin are densely
packed with these vessels. Once within the lymphatic system, the
extracellular fluid, which is now called lymph, drains into larger vessels called
the lymphatics. These vessels converge to form one of two large vessels
called lymphatic trunks, which are connected to veins at the base of the
neck. One of these trunks, the right lymphatic duct, drains the upper right
portion of the body, returning lymph to the bloodstream via the right
subclavian vein. The other trunk, the thoracic duct, drains the rest of the
body into the left subclavian vein. Lymph is transported along the system of
vessels by muscle contractions, and valves prevent lymph from flowing
backward. The lymphatic vessels are punctuated at intervals by small masses
of lymph tissue, called lymph nodes, that remove foreign materials such as
infectious microorganisms from the lymph filtering through them.

151. l

152. Role in immunity
• In addition to serving as a drainage network, the lymphatic system
helps protect the body against infection by producing white blood
cells called lymphocytes, which help rid the body of disease-causing
microorganisms. The organs and tissues of the lymphatic system are
the major sites of production, differentiation, and proliferation of two
types of lymphocytes—the T lymphocytes and B lymphocytes, also
called T cells and B cells. Although lymphocytes are distributed
throughout the body, it is within the lymphatic system that they are
most likely to encounter foreign microorganisms.