lOMoARcPSD|26582732
Lomoarcpsd|26582732
Alterations in Cardiovascular Function and Perfusion
2025-2026
Anatomy & Physiology
The Apex of the heart, or point of maximum
impulse (PMI), is located at the fifth
Intercostal space at the midclavicular line
onthe left.
Heart is composed of 3 layers:
• Endocardium – inner most layer.
Endothelial tissue that lines heart and valves.
• Myocardium – middle layer. Muscle fibers & thickets layer of heart.
Epicardium – outer layer. Serous layer that protects the heart.
Pericardium is a fibrous sac that surrounds the heart. The parietal pericardium
surrounds the visceral pericardium &
attaches to the great vessels, diaphragm,
sternum, vertebral column, anchoring to
thorax.
4 Heart Chambers: atria receive blood
returning from the body & lungs. Ventricles
receive blood from atria & pump it to the
lungs & rest of the body. Septum separates
left and right.
• Right atrium -
• Right ventricle – only pumps blood to the lungs
• Left atrium.
• Left ventricle – thickest wall because it pumps blood to whole body *needs more
force*
Deoxygenated blood from head & neck superior vena cava right atrium
Downloaded by NELSON KIIRU ()
, lOMoARcPSD|26582732
Deoxygenated blood from rest of body inferior vena cava right atrium
Right atrium right ventricle pulmonary arteries lungs oxygenation back to heart by
veins
Left atrium left ventricle pumps blood to entire body.
4 Heart Valves: composed of fibrous tissue that form leaflets that open & close as blood
flows.
o Atrioventricular (AV) valves = mitral & tricuspid
o Separate the atria from the ventricles. O Tricuspid – deoxygenated
blood moves from R atrium to R ventricle during diastole. O Systole occurs
when R ventricle contracts, causing blood flow upward toward pulmonary valve
& tricuspid closes. O Semilunar valves = pulmonic & aortic o Separate the
right ventricle from the pulmonary artery and the left ventricle from the aorta.
Vascular System:
Arteries High-pressure blood is
transported from the heart
to the arteries and arterioles
Arterioles Join arteries & capillaries
Veins Act as a reservoir of blood &
carries low-pressure blood
to the heart from venules.
Venules Joins capillaries & veins.
Capillaries Permits gas exchange, the
transfer of nutrients, &
removal of waste between
blood & the fluid of tissues.
Fun ction s of the H ear t:
Own conduction system that creates electrical impulses. Dysrhythmias can occur in the
normal conduction pathway.
• Impulses start in the sinoatrial (SA) node in the
Right Atrium – natural pacemaker that sets the
hearts rate & rhythm.
Downloaded by NELSON KIIRU ()
, lOMoARcPSD|26582732
• Atrioventricular (AV) node -allows the
impulses to fully contract & empty blood
into the ventricles.
• Bundle of His – divides into R/L bundle branch in the interventricular septum
allowing conduction impulse to R/L ventricles.
• Purkinje fibers – reaches terminal point & ventricular contraction occurs.
Contraction phase – systole
Relaxation phase – diastole
Car diac Output: total amount of blood that is ejected from the one ventricle of the
heart in L/min. (healthy adult 5-6L/min)
Stroke volume x Heart Rate = Cardiac output
Can affect cardiac output:
• Vasoconstriction
• Compliance of arteries
• Arterial pressure
• Afterload
Heart Sounds: “lub-dub”
S1 – first heart sound heard & indicates closure of mitral & tricuspid valves
S2- closure of the aortic & pulmonic valves.
S3/S4 – abnormal heart sounds gallop, lub, after heart sounds 1 or 2.
Murmurs – turbulent blood flow through valves. “whooshing” sound.
Pericardial friction rub – abnormal over left sternal border, from inflammation,
infiltration of pericardial sac. “grating” sound.
Car diac Rhythm s:
Downloaded by NELSON KIIRU ()
Lomoarcpsd|26582732
Alterations in Cardiovascular Function and Perfusion
2025-2026
Anatomy & Physiology
The Apex of the heart, or point of maximum
impulse (PMI), is located at the fifth
Intercostal space at the midclavicular line
onthe left.
Heart is composed of 3 layers:
• Endocardium – inner most layer.
Endothelial tissue that lines heart and valves.
• Myocardium – middle layer. Muscle fibers & thickets layer of heart.
Epicardium – outer layer. Serous layer that protects the heart.
Pericardium is a fibrous sac that surrounds the heart. The parietal pericardium
surrounds the visceral pericardium &
attaches to the great vessels, diaphragm,
sternum, vertebral column, anchoring to
thorax.
4 Heart Chambers: atria receive blood
returning from the body & lungs. Ventricles
receive blood from atria & pump it to the
lungs & rest of the body. Septum separates
left and right.
• Right atrium -
• Right ventricle – only pumps blood to the lungs
• Left atrium.
• Left ventricle – thickest wall because it pumps blood to whole body *needs more
force*
Deoxygenated blood from head & neck superior vena cava right atrium
Downloaded by NELSON KIIRU ()
, lOMoARcPSD|26582732
Deoxygenated blood from rest of body inferior vena cava right atrium
Right atrium right ventricle pulmonary arteries lungs oxygenation back to heart by
veins
Left atrium left ventricle pumps blood to entire body.
4 Heart Valves: composed of fibrous tissue that form leaflets that open & close as blood
flows.
o Atrioventricular (AV) valves = mitral & tricuspid
o Separate the atria from the ventricles. O Tricuspid – deoxygenated
blood moves from R atrium to R ventricle during diastole. O Systole occurs
when R ventricle contracts, causing blood flow upward toward pulmonary valve
& tricuspid closes. O Semilunar valves = pulmonic & aortic o Separate the
right ventricle from the pulmonary artery and the left ventricle from the aorta.
Vascular System:
Arteries High-pressure blood is
transported from the heart
to the arteries and arterioles
Arterioles Join arteries & capillaries
Veins Act as a reservoir of blood &
carries low-pressure blood
to the heart from venules.
Venules Joins capillaries & veins.
Capillaries Permits gas exchange, the
transfer of nutrients, &
removal of waste between
blood & the fluid of tissues.
Fun ction s of the H ear t:
Own conduction system that creates electrical impulses. Dysrhythmias can occur in the
normal conduction pathway.
• Impulses start in the sinoatrial (SA) node in the
Right Atrium – natural pacemaker that sets the
hearts rate & rhythm.
Downloaded by NELSON KIIRU ()
, lOMoARcPSD|26582732
• Atrioventricular (AV) node -allows the
impulses to fully contract & empty blood
into the ventricles.
• Bundle of His – divides into R/L bundle branch in the interventricular septum
allowing conduction impulse to R/L ventricles.
• Purkinje fibers – reaches terminal point & ventricular contraction occurs.
Contraction phase – systole
Relaxation phase – diastole
Car diac Output: total amount of blood that is ejected from the one ventricle of the
heart in L/min. (healthy adult 5-6L/min)
Stroke volume x Heart Rate = Cardiac output
Can affect cardiac output:
• Vasoconstriction
• Compliance of arteries
• Arterial pressure
• Afterload
Heart Sounds: “lub-dub”
S1 – first heart sound heard & indicates closure of mitral & tricuspid valves
S2- closure of the aortic & pulmonic valves.
S3/S4 – abnormal heart sounds gallop, lub, after heart sounds 1 or 2.
Murmurs – turbulent blood flow through valves. “whooshing” sound.
Pericardial friction rub – abnormal over left sternal border, from inflammation,
infiltration of pericardial sac. “grating” sound.
Car diac Rhythm s:
Downloaded by NELSON KIIRU ()
