Key Takeaways

  • The heart has 4 chambers: right atrium, right ventricle, left atrium, left ventricle; the left ventricle is the thickest
  • Blood flow: body → vena cava → RA → RV → pulmonary artery → lungs → pulmonary veins → LA → LV → aorta → body
  • Arteries carry blood AWAY from the heart (thick walls, high pressure); veins carry blood TO the heart (thinner walls, valves)
  • The cardiac conduction system: SA node → AV node → Bundle of His → bundle branches → Purkinje fibers
  • Normal adult blood pressure is below 120/80 mmHg; hypertension is 130/80 or higher
  • The respiratory system consists of upper (nose, pharynx, larynx) and lower (trachea, bronchi, lungs, alveoli) airways
  • Gas exchange occurs in the alveoli by diffusion — O2 enters the blood, CO2 exits into the alveoli
  • Breathing is controlled by the medulla oblongata and is primarily driven by CO2 levels in the blood
Last updated: February 2026

Cardiovascular & Respiratory Systems

The cardiovascular and respiratory systems work together to deliver oxygen to every cell in the body and remove carbon dioxide. Dysfunction of either system is life-threatening.


The Heart

The heart is a muscular pump about the size of a fist, located in the mediastinum (center of the chest, slightly left).

Four Chambers

ChamberFunctionReceives FromSends To
Right Atrium (RA)Receives deoxygenated bloodSuperior/inferior vena cavaRight ventricle
Right Ventricle (RV)Pumps blood to lungsRight atriumPulmonary arteries
Left Atrium (LA)Receives oxygenated bloodPulmonary veinsLeft ventricle
Left Ventricle (LV)Pumps blood to bodyLeft atriumAorta

The left ventricle has the thickest walls because it must generate enough pressure to pump blood throughout the entire body.

Four Heart Valves

ValveLocationFunction
TricuspidBetween RA and RVPrevents backflow to RA
Pulmonary (pulmonic)Between RV and pulmonary arteryPrevents backflow to RV
Mitral (bicuspid)Between LA and LVPrevents backflow to LA
AorticBetween LV and aortaPrevents backflow to LV

Blood Flow Pathway

Deoxygenated blood: Body → Vena Cava → RA → Tricuspid Valve → RV → Pulmonary Valve → Pulmonary Arteries → Lungs

Oxygenated blood: Lungs → Pulmonary Veins → LA → Mitral Valve → LV → Aortic Valve → Aorta → Body

Cardiac Conduction System

The heart's electrical system controls the heartbeat:

  1. SA node (sinoatrial) — "pacemaker" in the right atrium, sets the rate (~60-100 bpm)
  2. AV node (atrioventricular) — delays the signal briefly to allow atrial emptying
  3. Bundle of His — conducts signal from atria to ventricles
  4. Bundle branches (left and right) — carry signal down the interventricular septum
  5. Purkinje fibers — distribute signal throughout the ventricles, triggering contraction

Blood Vessels

VesselFunctionWall ThicknessPressure
ArteriesCarry blood AWAY from heartThick, muscularHigh
ArteriolesSmall arteries, regulate blood flowModerateModerate
CapillariesGas/nutrient exchangeOne cell thickLow
VenulesSmall veins, collect bloodThinLow
VeinsCarry blood TO the heartThin, contain valvesLow

Key exception: Pulmonary arteries carry DEoxygenated blood; pulmonary veins carry oxygenated blood.

Blood Pressure

  • Systolic (top number): Pressure during ventricular contraction
  • Diastolic (bottom number): Pressure during ventricular relaxation
  • Normal adult: < 120/80 mmHg
  • Hypertension (Stage 1): 130-139 / 80-89 mmHg
  • Hypertension (Stage 2): ≥ 140/90 mmHg

Cardiac Output

Cardiac output (CO) is the volume of blood pumped by the heart per minute:

CO = Stroke Volume (SV) x Heart Rate (HR)

TermDefinitionNormal Value
Stroke volumeBlood ejected per heartbeat~70 mL/beat
Heart rateBeats per minute60-100 bpm
Cardiac outputVolume per minute~5 L/min (70 mL x 72 bpm)

Factors that increase cardiac output:

  • Exercise, fever, anxiety, anemia, pregnancy
  • Sympathetic nervous system activation (epinephrine)

Factors that decrease cardiac output:

  • Heart failure, myocardial infarction, bradycardia
  • Parasympathetic nervous system activation (vagus nerve)

Clinical significance: Adequate cardiac output ensures sufficient oxygen delivery to all tissues. Heart failure occurs when the heart cannot pump enough blood to meet the body's metabolic demands.


Respiratory System

Upper Respiratory Tract

  • Nose/Nasal cavity — warms, humidifies, filters air
  • Pharynx — shared airway and food passage
  • Larynx — voice box, contains vocal cords and epiglottis

Lower Respiratory Tract

  • Trachea — windpipe, supported by C-shaped cartilage rings
  • Bronchi — left and right main bronchi branch from trachea
  • Bronchioles — smaller airways, no cartilage
  • Alveoli — tiny air sacs where gas exchange occurs (~300 million)

Gas Exchange

Gas exchange occurs in the alveoli through diffusion:

  • O2 moves from alveoli (high concentration) → blood (low concentration)
  • CO2 moves from blood (high concentration) → alveoli (low concentration)

Mechanics of Breathing

PhaseDiaphragmPressureAir Flow
InhalationContracts (flattens)Intrathoracic pressure decreasesAir rushes IN
ExhalationRelaxes (domes up)Intrathoracic pressure increasesAir pushed OUT

Breathing is controlled by the medulla oblongata in the brainstem, primarily driven by CO2 levels in the blood (not O2 levels). High CO2 stimulates increased respiratory rate.


Lung Volumes

VolumeDefinitionNormal Adult Value
Tidal volume (TV)Air in a normal breath~500 mL
Inspiratory reserveExtra air that can be inhaled beyond tidal~3,100 mL
Expiratory reserveExtra air that can be exhaled beyond tidal~1,200 mL
Residual volumeAir remaining after maximal exhalation~1,200 mL
Vital capacityMaximum air exhaled after maximum inhalation (TV + IRV + ERV)~4,800 mL
Total lung capacityAll air the lungs can hold~6,000 mL

Vital Signs — Normal Adult Ranges

Vital SignNormal RangeAbnormal Terms
Heart rate60-100 bpmTachycardia (>100), Bradycardia (<60)
Respiratory rate12-20 breaths/minTachypnea (>20), Bradypnea (<12), Apnea (0)
Blood pressure<120/80 mmHgHypertension (≥130/80), Hypotension (<90/60)
Temperature97.8-99.1°F (36.5-37.3°C)Hypothermia (<95°F), Fever (>100.4°F / 38°C)
Oxygen saturation (SpO2)95-100%Hypoxemia (<90%)

Blood Types — Clinical Significance

Blood type compatibility is critical for safe transfusions:

Transfusion reactions occur when the recipient's antibodies attack donor red blood cells:

  • Type A blood has Anti-B antibodies → reacts against Type B blood
  • Type B blood has Anti-A antibodies → reacts against Type A blood
  • Type O blood has both Anti-A and Anti-B → reacts against A, B, and AB
  • Type AB blood has NO antibodies → does not react against any type

In emergencies when blood type is unknown, Type O negative packed RBCs are given because they lack all major antigens.


Cardiac Output

Cardiac output (CO) is the volume of blood pumped by the heart per minute:

CO = Heart Rate (HR) x Stroke Volume (SV)

  • Stroke volume = amount of blood ejected per heartbeat (~70 mL)
  • Normal cardiac output = 70 bpm x 70 mL = ~4,900 mL/min (~5 L/min)
  • Cardiac output must match the body's metabolic demands
  • During exercise, both HR and SV increase, raising CO to 15-25 L/min

Factors that affect cardiac output:

  • Preload — amount of blood filling the ventricles (more stretch = stronger contraction)
  • Afterload — resistance the heart must pump against (higher BP = more work)
  • Contractility — strength of ventricular contraction

Blood Vessel Anatomy — Detailed

LayerNameDescription
InnerTunica intimaSmooth endothelium; in direct contact with blood
MiddleTunica mediaSmooth muscle and elastic tissue; controls vessel diameter
OuterTunica adventitiaConnective tissue; provides structural support

Arteriosclerosis = hardening and thickening of arterial walls Atherosclerosis = plaque buildup inside arteries (a type of arteriosclerosis)

  • Risk factors: high cholesterol, hypertension, smoking, diabetes, obesity
  • Can lead to heart attack (MI), stroke (CVA), or peripheral vascular disease
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Blood Flow Through the Heart
Test Your Knowledge

Which chamber of the heart has the thickest wall?

A
B
C
D
Test Your Knowledge

What is the "pacemaker" of the heart called?

A
B
C
D
Test Your Knowledge

Pulmonary arteries are unique because they:

A
B
C
D
Test Your KnowledgeOrdering

Arrange the cardiac conduction pathway in the correct order.

Arrange the items in the correct order

1
Purkinje fibers
2
AV node
3
Bundle of His
4
SA node
5
Bundle branches
Test Your Knowledge

Gas exchange in the lungs occurs primarily by which process?

A
B
C
D
Test Your KnowledgeFill in the Blank

Breathing is primarily controlled by the _____ oblongata in the brainstem.

Type your answer below