2.2 Cardiovascular & Respiratory Systems

Key Takeaways

  • The heart has four chambers: right atrium (receives deoxygenated blood), right ventricle (pumps to lungs), left atrium (receives oxygenated blood), left ventricle (pumps to body)
  • Cardiac conduction pathway: SA node → AV node → Bundle of His → bundle branches → Purkinje fibers
  • Normal adult vital signs: HR 60-100 bpm, BP <120/80 mmHg, RR 12-20/min, O2 sat 95-100%
  • The respiratory system exchanges O2 and CO2 at the alveolar-capillary membrane in the lungs through diffusion
  • Blood flow: right atrium → right ventricle → pulmonary arteries → lungs → pulmonary veins → left atrium → left ventricle → aorta → body
  • Arteries carry blood AWAY from the heart (oxygenated, except pulmonary arteries); veins carry blood TO the heart (deoxygenated, except pulmonary veins)
Last updated: March 2026

Cardiovascular & Respiratory Systems

The cardiovascular and respiratory systems work together to deliver oxygen to every cell and remove carbon dioxide waste. These systems are heavily tested on the CCMA exam, particularly in relation to vital signs, EKG testing, and clinical assessment.


Cardiovascular System

Heart Anatomy:

  • 4 chambers: Right atrium (RA), right ventricle (RV), left atrium (LA), left ventricle (LV)
  • 4 valves: Tricuspid (RA→RV), pulmonary (RV→pulmonary artery), mitral/bicuspid (LA→LV), aortic (LV→aorta)
  • 3 layers: Epicardium (outer), myocardium (muscle), endocardium (inner lining)
  • Pericardium: Protective sac surrounding the heart

Blood Flow Through the Heart:

  1. Deoxygenated blood enters the right atrium via the superior and inferior vena cava
  2. Blood flows through the tricuspid valve into the right ventricle
  3. Right ventricle pumps blood through the pulmonary valve into the pulmonary arteries
  4. Blood travels to the lungs for gas exchange (CO2 released, O2 absorbed)
  5. Oxygenated blood returns via pulmonary veins to the left atrium
  6. Blood flows through the mitral (bicuspid) valve into the left ventricle
  7. Left ventricle pumps blood through the aortic valve into the aorta
  8. Oxygenated blood is distributed throughout the body

Cardiac Conduction System (Electrical Pathway):

  1. SA node (sinoatrial node) — "Natural pacemaker," fires 60-100 times/min
  2. AV node (atrioventricular node) — Delays impulse briefly to allow atrial contraction
  3. Bundle of His — Conducts impulse from atria to ventricles
  4. Right and left bundle branches — Divide to supply each ventricle
  5. Purkinje fibers — Distribute impulse throughout ventricular muscle, causing contraction

Blood Vessels:

Vessel TypeFunctionWall ThicknessDirection
ArteriesCarry blood away from heartThick, muscular, elasticAway from heart
ArteriolesSmall arteries; regulate blood pressureMediumAway from heart
CapillariesGas/nutrient exchange with tissuesOne cell thickConnect arterioles to venules
VenulesSmall veins; collect blood from capillariesThinToward heart
VeinsReturn blood to heart; contain valvesThinner than arteriesToward heart

Key Cardiovascular Terms:

  • Systole — Contraction phase of the heart (ventricles pumping)
  • Diastole — Relaxation phase of the heart (ventricles filling)
  • Cardiac output — Amount of blood pumped per minute (~5 L/min at rest)
  • Blood pressure — Force of blood against arterial walls (systolic/diastolic)
  • Tachycardia — Heart rate > 100 bpm
  • Bradycardia — Heart rate < 60 bpm
  • Hypertension — Blood pressure ≥ 130/80 mmHg (per AHA guidelines)
  • Hypotension — Blood pressure < 90/60 mmHg

Respiratory System

Structures of the Respiratory System:

StructureLocationFunction
Nose/nasal cavityUpper airwayWarms, moistens, filters inhaled air
Pharynx (throat)Upper airwayPassageway for air and food
Larynx (voice box)Upper airwaySound production, protects airway (epiglottis)
Trachea (windpipe)Lower airwayConducts air to bronchi; supported by C-shaped cartilage rings
BronchiLower airwayTwo main branches (right and left) that enter each lung
BronchiolesLower airwaySmaller branches that lead to alveoli
AlveoliLower airwayTiny air sacs where gas exchange occurs (300 million in lungs)
DiaphragmBelow lungsPrimary muscle of respiration; contracts during inhalation

Gas Exchange (Respiration):

  • External respiration — Gas exchange between alveoli and blood in pulmonary capillaries
    • O2 moves from alveoli → blood (diffusion)
    • CO2 moves from blood → alveoli (diffusion)
  • Internal respiration — Gas exchange between blood and body tissues
    • O2 moves from blood → cells
    • CO2 moves from cells → blood

Normal Respiratory Values:

ParameterNormal Adult Value
Respiratory rate12-20 breaths/minute
Tidal volume~500 mL per breath
SpO2 (pulse oximetry)95-100%

Key Respiratory Terms:

  • Dyspnea — Difficulty breathing
  • Apnea — Absence of breathing
  • Tachypnea — Rapid breathing (>20/min in adults)
  • Bradypnea — Slow breathing (<12/min in adults)
  • Hypoxia — Insufficient oxygen reaching tissues
  • Hypoxemia — Low oxygen in the blood
  • Hypercapnia — Elevated CO2 in the blood
  • Cyanosis — Bluish discoloration from low oxygen
  • Orthopnea — Difficulty breathing when lying flat

Common Respiratory Conditions:

  • Asthma — Chronic inflammation with bronchospasm; triggers include allergens, exercise, cold air
  • COPD — Chronic obstructive pulmonary disease (emphysema + chronic bronchitis); often caused by smoking
  • Pneumonia — Infection of lung tissue (bacterial, viral, fungal)
  • Tuberculosis (TB) — Bacterial infection (Mycobacterium tuberculosis); airborne transmission
  • Pulmonary embolism — Blood clot in pulmonary artery; medical emergency
Test Your Knowledge

What is the correct sequence of cardiac conduction from the natural pacemaker to the ventricles?

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Test Your Knowledge

Where in the respiratory system does gas exchange (O2 and CO2) primarily occur?

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B
C
D
Test Your Knowledge

Pulmonary arteries are unique because they carry:

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B
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D