Download Circulation and Atherosclerosis

Circulation and Atherosclerosis
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Fig. 42-7
Pulmonary artery
Aorta
Pulmonary
artery
Right
atrium
Left
atrium
Semilunar
valve
Semilunar
valve
Atrioventricular
valve
Atrioventricular
valve
Right
ventricle
Left
ventricle
The Mammalian Heart: A Closer Look
• A closer look at the mammalian heart provides a better
understanding of double circulation
• The heart contracts and relaxes in a rhythmic cycle called
the cardiac cycle
• The contraction, or pumping, phase is called systole
• The relaxation, or filling, phase is called diastole
• The heart rate, also called the pulse, is the number of
beats per minute
• The stroke volume is the amount of blood pumped in a
single contraction
• The cardiac output is the volume of blood pumped into
the systemic circulation per minute and depends on both
the heart rate and stroke volume
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• Four valves prevent backflow of blood in the heart
• The atrioventricular (AV) valves separate each atrium and
ventricle
• The semilunar valves control blood flow to the aorta and the
pulmonary artery
• The “lub-dup” sound of a heart beat is caused by the recoil of
blood against the AV valves (lub) then against the semilunar
(dup) valves
• Backflow of blood through a defective valve causes a heart
murmur
Fig. 42-8-1
Semilunar
valves
closed
AV
valves
open
0.4 sec
1 Atrial and
ventricular
diastole
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Fig. 42-8-2
2 Atrial systole;
ventricular
diastole
Semilunar
valves
closed
0.1 sec
AV
valves
open
0.4 sec
1 Atrial and
ventricular
diastole
Fig. 42-8
2 Atrial systole;
ventricular
diastole
Semilunar
valves
closed
0.1 sec
AV
valves
open
1 Atrial and
ventricular
diastole
0.4 sec
Semilunar
valves
open
0.3 sec
AV valves
closed
3 Ventricular systole;
atrial diastole
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Fig. 42-6
Superior
vena cava
Capillaries of
head and
forelimbs
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Pulmonary
artery
Pulmonary
artery
Capillaries
of right lung
Aorta
9
3
Capillaries
of left lung
3
2
4
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Pulmonary
vein
Right atrium
1
Pulmonary
vein
5
Left atrium
10
Right ventricle
Left ventricle
Inferior
vena cava
Aorta
8
國立交通大學生物科技學系 陳文亮老師
Capillaries of
abdominal organs
and hind limbs
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Internal View of the Heart
Mammalian Circulation
• Blood begins its flow with the right ventricle pumping blood
to the lungs
• In the lungs, the blood loads O2 and unloads CO2
• Oxygen-rich blood from the lungs enters the heart at the left
atrium and is pumped through the aorta to the body tissues
by the left ventricle
• The aorta provides blood to the heart through the coronary
arteries
• Blood returns to the heart through the superior vena cava
(blood from head, neck, and forelimbs) and inferior vena
cava (blood from trunk and hind limbs)
• The superior vena cava and inferior vena cava flow into the
right atrium
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Transport in Humans
• Blood returning to heart from systemic circuit
– Enters right atrium
– Right atrium pumps through tricuspid valve to right ventricle
– Right ventricle pumps blood through pulmonary valve to the
pulmonary circuit
• Blood returning to heart from pulmonary circuit
– Enters left atrium
– Left atrium pumps through mitral valve to left ventricle
– Left ventricle pumps blood through aortic valve to the
systemic circuit
• Oxygen-poor blood never mixes with oxygen-rich
blood (in humans)
Maintaining the Heart’s Rhythmic Beat
• Some cardiac muscle cells are self-excitable, meaning they
contract without any signal from the nervous system
• The sinoatrial (SA) node, or pacemaker, sets the rate and
timing at which cardiac muscle cells contract
• Impulses from the SA node travel to the atrioventricular
(AV) node
• At the AV node, the impulses are delayed and then travel to
the Purkinje fibers that make the ventricles contract
• Impulses that travel during the cardiac cycle can be recorded
as an electrocardiogram (ECG or EKG)
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Fig. 42-9-1
1 Pacemaker
generates wave of
signals to contract.
SA node
(pacemaker)
ECG
Fig. 42-9-2
2 Signals are
delayed at
AV node.
AV
node
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Fig. 42-9-3
3 Signals pass
to heart apex.
Bundle
branches
Heart
apex
Fig. 42-9-4
4 Signals spread
throughout
ventricles.
Purkinje
fibers
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Fig. 42-9-5
1 Pacemaker
generates wave of
signals to contract.
SA node
(pacemaker)
2 Signals are
delayed at
AV node.
AV
node
3 Signals pass
to heart apex.
Bundle
branches
Heart
apex
4 Signals spread
throughout
ventricles.
Purkinje
fibers
ECG
Conduction System of the Heart
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Fig. 42-10
Artery
Vein
SEM
Valve
100 µm
Basal lamina
Endothelium
Smooth
muscle
Connective
tissue
Endothelium
Capillary
Smooth
muscle
Connective
tissue
Artery
Vein
Capillary
15 µm
Red blood cell
Venule
LM
Arteriole
Blood Vessel Structure and Function
• The epithelial layer that lines blood vessels is
called the endothelium
• Capillaries have thin walls, the endothelium plus
its basement membrane, to facilitate the exchange
of materials
• Arteries and veins have an endothelium, smooth
muscle, and connective tissue
• Arteries have thicker walls than veins to
accommodate the high pressure of blood pumped
from the heart
• In the thinner-walled veins, blood flows back to the
heart mainly as a result of muscle action
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Blood Flow Velocity
• Physical laws governing movement of fluids
through pipes affect blood flow and blood pressure
• Velocity of blood flow is slowest in the capillary
beds, as a result of the high resistance and large
total cross-sectional area
• Blood flow in capillaries is necessarily slow for
exchange of materials
Capillary Exchange
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Capillary Bed
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人類的泌尿系統(urinary system)
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人類的排泄系統---腎臟
腎臟的構造
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人類的排泄系統---腎元（nephron）
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Substance
Description
Glucose
If glucose is not
reabsorbed by the
reabsorption
kidney, it appears
(almost 100%) via
in the urine, in a
sodium-glucose
condition known
transport proteins[2]
as glucosuria. This
(apical) and GLUT
is associated with
(basolateral).
diabetes
[1]
mellitus. .
Oligopeptides,
proteins, and
amino acids
Urea
Sodium
Chloride
Water
All are reabsorbed
nearly
completely.[3]
Regulation of
osmolality. Varies
with ADH[4][5]
Uses Na-H
antiport, Naglucose symport,
sodium ion
channels (minor)[6]
Usually follows
sodium. Active
(transcellular) and
passive
(paracellular)[6]
Proximal tubule
reabsorption
Loop of Henle
-
Distal tubule
Collecting duct
-
-
-
-
reabsorption in
medullary
collecting ducts
reabsorption (5%,
reabsorption (25%,
reabsorption (5%, principal cells),
reabsorption (65%, thick ascending,
sodium-chloride
stimulated by
isosmotic)
Na-K-2Cl
symporter)
aldosterone via
symporter)
ENaC
reabsorption (50%)
secretion
via passive
transport
reabsorption
reabsorption (thin
reabsorption
ascending, thick
(sodium-chloride
ascending, Na-Ksymporter)
2Cl symporter)
Uses aquaporin
absorbed
reabsorption
water channels.
osmotically along
(descending)
See also diuretic. with solutes
國立交通大學生物科技學系 陳文亮老師
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-
-
reabsorption
(regulated by ADH,
via arginine
vasopressin
receptor 2)
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Bicarbonate
Helps maintain acidreabsorption (80-90%) [8]
base balance. [7]
reabsorption (thick
ascending) [9]
Protons
Uses vacuolar
H+ATPase
-
-
-
reabsorption
(intercalated cells,
via band 3 and
pendrin)
secretion
(intercalated cells)
Potassium
Varies upon dietary
reabsorption (65%)
needs.
reabsorption (20%,
thick ascending,
Na-K-2Cl
symporter)
secretion
(common, via
Na+/K+-ATPase,
increased by
aldosterone), or
reabsorption (rare,
hydrogen
potassium ATPase)
Calcium
Uses calcium
ATPase, sodiumreabsorption
calcium exchanger
reabsorption (thick
ascending) via
passive transport
-
Magnesium
Calcium and
magnesium
compete, and an
reabsorption
excess of one can
lead to excretion of
the other.
reabsorption (thick
reabsorption ascending)
Phosphate
Excreted as
titratable acid.
Carboxylate
reabsorption (85%) via
sodium/phosphate
cotransporter[2]. Inhibited by
parathyroid hormone.
-
-
reabsorption (100%[10]) via
carboxylate transporters.
-
-
Capillary Exchange
• Capillaries very narrow – Tiny RBCs must go
through single file
• Wall of capillaries very thin to facilitate diffusion of
nutrients, gasses and wastes
– Oxygen and nutrients exit a capillary near the
arterial end
– Carbon dioxide and waste molecules enter a
capillary near the venous end
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External Heart Anatomy
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LDL: Low-density lipoprotein
HDL: High-density lipoprotein
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Treatment
1) Stenting
• a stent is introduced into a blood vessel on a balloon
catheter and advanced into the blocked area of the artery
• the balloon is then inflated and causes the stent to
expand until it fits the inner wall of the vessel, conforming
to contours as needed
• the balloon is then deflated and drawn back
•The stent stays in place permanently, holding the vessel
open and improving the flow of blood.
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Treatment
2) Angioplasty
• a balloon catheter is passed through the guiding catheter to the
area near the narrowing. A guide wire inside the balloon catheter is
then advanced through the artery until the tip is beyond the
narrowing.
• the angioplasty catheter is moved over the guide wire until the
balloon is within the narrowed segment.
• balloon is inflated, compressing the plaque against the artery wall
• once plaque has been compressed and the artery has been
sufficiently opened, the balloon catheter will be deflated and
removed.
Treatment
3) Bypass surgery
• healthy
blood vessel is removed from leg, arm or chest
• blood vessel is used to create new blood flow path in your heart
• the “bypass graft” enables blood to reach your heart by flowing
around (bypassing)
the blocked portion
of
the
diseased
artery. The increased
blood flow reduces
angina and the risk
of heart attack.
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低升糖對飲食的影響
脂肪儲存區
脂肪消耗區
疲勞/飢餓
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BCDAE CADAB BCECA ECDCD CADCB CABAC ECDAE BEAED ABBBE
DDABA DEDAC BDAAC DCAAD ECADB CDDBB BBDDA ADABD CAABC
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