PHYSIOLOGY

OF
CIRCULATORY SYSTEM

Dr Ebtehal El-Demerdash
Assist. Prof. of Pharmacology & Toxicology
Faculty of Pharmacy, Ain Shams University
 CVS consists of:
- HEART
- BV
- BLOOD
It is a closed system inside which
blood circulates “CIRCULATORY
SYSTEM”
The Cardiovascular
System
Major function is transportation
Blood is the vehicle (Rides on
vessels)
Oxygen, nutrients, wastes,
hormones, etc. are the passengers
FORCE OF HEART
General function of circulatory
system

Respiratory
Nutritional
Excretory
Endocrinal
Body temperature regulation

Homeostasis
Heart Anatomy
❶ location Located within mediastinum, the medial cavity of the
thorax

❷ heart muscle = myocardium

✦ atrial mass
✦ ventricular mass
Heart Coverage
Enclosed by Pericardium
3 Layers
 Outer-Epicardium
 (thin cover)
 Middle-Myocardium
 (thick, ringlike, contractile)
 Inner-Endocardium
 (thin sheet between
chambers)
Functions of Atria and
Ventricles
The Atria:
- Blood receptacles
- Pump action
- Venous return sensor
- Endocrinal function
The Ventricles
- The true pump
Four Valves
Atrio ventricular
valves (A-V):
- The Right A-V
valve; Tricuspide
valve
- The Left A-V
valve; Mitral valve

Semilunar Valves:
- The Pulmonic
Valve
- The ortic Vlave
Circulation of Blood

We have two circulations

Systemic & Pulmonary
Definitions
Systole: contraction of cardiac muscle

Diastole: relaxation of cardiac muscle

Heart beat: a systole + a diastole

Heart rate (HR): number of heart beats/min (~

75beats/min)

Tachycardia: ↑ HR above 100beats/min

Bradycardia: ↓ HR below 60beats/min

Cardiac output (CO): total volume of blood pumped

by each ventricle/min
Ventricular Volumes
THE END-DIASTOLIC VOLUME(EDS):
Volume of blood in the ventricle at the end of diastole
THE END-SYSTOLIC VOLUME (ESV):
Volume of blood in the ventricle at the end of systole
THE STROKE VOLUME (SV):
Volume of blood pumped by the ventricle per beat
SV = EDV (135ml) – ESV (65ml) = 70ml
CO = SV x HR = 70 x 70 ~ 5L/min
THE DIASTOLIC FILLING VOLUME (DFV):
Volume of blood which flows from the atrium into the
ventricles during diastole
The Conducting System
The Nodal System
 Sinoatrial Node (S-A node) 1
 Atrioventricular Node (A-V
node) 3

The Internodal System

 Anterior, Middle & Posterior 2
 Bachmann`s bundle 7

The Purkinje System

 Atrioventricular bundle (bundle
of His) 4
 Right & left bundle branch 5
 Purkinje fibers 6
Properties of Cardiac
Muscle

Autorhythmicity Excitability

Conductivity Contractility
Autorhythmicity
Automaticity:
Ability of the heart to beat independent
of extrinsic stimuli
Rhythmicity:
Ability of the heart to beat in regular
cycle
Autorhythmicity:
Ability of the heart to beat regularly
independent on extrinsic stimuli
Pacemaker
SA-node AV-node
Primary pacemaker Secondary pacemaker
105 impulse/min 45-60 impulse/min
Sinus rhythm Nodal rhythm

Purkinje System
Inhibitory vagal Tertiary pacemaker
tone
25-40 impulse/min
Idioventricular rhythm
Pacemaker Potential

Ectopic foci
Factors Affecting
Autorhythmicity

Chronotropism:
An influence on the heart rate
Physiological Factors:
- Nervous - Physical
- Mechanical - Chemical
Non-Physiological Factors:
Excitability

Excitability:
Ability of the heart to respond to
stimuli

Bathmotropism:
An influence on myocardial
excitability
Contractile myocardium action
potential

Phase 0: rapid depolarization

due to rapid Na+ influx
Phase 1: early partial
repolarization due to CL- influx
and limited K+ efflux
Phase 2: plateau prolonged
depolarization due to Ca2+ influx
through slow Ca channels
(depolarizing Ca2+)
Phase 3: repolarization due to
K+ efflux without Ca2+ influx
Phase 4: complete
repolarization by Na+/K+ pump
Inward going Rectefication
 The absolute refractory
period (ARP):
The ventricles can not respond to
any stimuli
The relative refractory
period (RRP):
The ventricles can respond to
strong stimuli

Supernormal phase of
excitability (SNP):
The heart respond to weaker
stimuli
Arrhythmia: abnormal rate or
rhythm of heart beats
Factors Affecting
Excitability
Physiological Factors:
- HR
- Nerve supply
Non-Physiological Factors:
- Ischemia & hypoxia
- Drugs & chemicals
Conductivity
Conductivity:
Transmission of impulses between
cardiac muscle fibers

Dromotropism:
An influence on the conductivity
Charatcters of A-V node
Very slow conductivity:
so the artia finish their systole
before starting the ventricular
systole

Long absolute refractory

period:
limits the number of impulses
that reach the ventricles (230
impulse/min)

Heart block:
failure of conduction of impulses
from S-A node down to the
ventricles
Types of Heart Block
Sinoatrial block (SA block)
 No P-wave
Atrioventricular block (AV
block)
 1st degree (prolonged AV
conduction) so PR interval is
long
 2nd degree (regular & irregular)
 3rd degree
Bundle-branch block
 Right or left
Physiological 2nd degree heart
block
Contractility
Contractility:
Ability of the myocardial muscle to
change the potential energy of the food
to mechanical energy

Ionotropism:
An influence on the contractility
Types of Ca2+ transport across the
sarcolemma

Transient (T-type) Ca channels:

 They are present in the nodal and conducting system
only
 They are activated (open) at a threshold membrane

potential of – 60 mV and deactivated rapidly (close)

 They are not affected by β-stmiulant and Ca channel

blockers

Long lasting (L-type) Ca channels:

 They are present in all myocardial cells
 They are activated at threshold membrane potential
of – 45 mV and deactivated slowly
 They are activated by β-stmiulant and blocked by Ca
channel blockers
Types of Ca2+ transport across the sarcolemma
(cont.)

Ca pump:
 This is one-way pump found in the sarcolemma and
pumps Ca2+ out of the myocardial cells
 It is an ATPase that gets the energy for pumping by

hydrolysis of ATP
 It has high affinity but low capacity of Ca2+ transport

Na+/Ca2+ exchanger:
 This is an antiport carrier in the sarcolemma
 It exchanges Na+ at one side with Ca2+ on the other
 The direction depends on ion concentration on both
sides
Mechanism of Contraction
Two types of proteins
Relaxation Proteins:
 Troponin
 Tropomyocin

Contraction proteins:
 Actin
 Myosin
Regulation of CO

Two factors:
Extrinsic System:
This is done through autonomic
nervous system + Hormones + drugs
Intrinsic system:
 This is done by a mechanism inherent
to cardiac muscle
Extrinsic control of the
heart
The nervous system
exerts influence upon
the heart’s rate and
force of contraction
primarily via the
cardiac centers of the
medulla oblongata.
They are the:
– Cardioacceleratory
center
– Cardioinhibitory
center
ANS Control of Heart
Cardiac Parasympathetic Sympathetic
Properties (Vagal)
Supplies the atria, SA Supplies all
node, AV node & AV cardiac tissue
bundle but not the including the
ventricles ventricles
Rhythmicity Slowing due to Acceleration due
depression of SA to ↑ of SA node
Excitability node
↓ ↑

AV conduction ↓ (heart block) ↑

Contractility Depressed in atria Stimulated in atria

and ventricles
Rate of O2 ↓ ↑
consumption
Hormones & Drugs affecting
CO
Catecholamines (adrenaline &
noradrenaline): They have +ve inotropic effect by
increasing the permeability of sarcolemma to Ca2+ i.e.
↑SV ↑ CO
Digitalis (cardiac glycosides): They have +ve
inotropic effect by inhibiting Na/K pump i.e. ↑SV ↑CO
Toxins: Cardiotoxins weaken myocardial contractility
by direct action on the contractile muscle e.g. diphtheria
toxins. Cardiotoxin of snake venom damage the
sarcoplasmic reticulum and decrease its Ca storing and
releasing capacity
Intrinsic factors affecting
CO
Preload
Afterload
What is the
Electrocardiogram?
Electrocardiogram (ECG)

P: atrial depolarization (atrial systole)

QRS: ventricular depolarization (ventricular systole)
T: ventricular repolarization (ventricular diastole)
PR interval: represents the rate of A-V conduction
QS interval: represents the duration of ventricular
systole