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Circulation and Atherosclerosis 國立交通大學生物科技學系 陳文亮老師 1 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 國立交通大學生物科技學系 陳文亮老師 2 • 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 國立交通大學生物科技學系 陳文亮老師 3 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 國立交通大學生物科技學系 陳文亮老師 4 Fig. 42-6 Superior vena cava Capillaries of head and forelimbs 7 Pulmonary artery Pulmonary artery Capillaries of right lung Aorta 9 3 Capillaries of left lung 3 2 4 11 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 5 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 國立交通大學生物科技學系 陳文亮老師 6 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) 國立交通大學生物科技學系 陳文亮老師 7 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 國立交通大學生物科技學系 陳文亮老師 8 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 國立交通大學生物科技學系 陳文亮老師 9 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 國立交通大學生物科技學系 陳文亮老師 10 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 國立交通大學生物科技學系 陳文亮老師 11 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 國立交通大學生物科技學系 陳文亮老師 12 Capillary Bed 國立交通大學生物科技學系 陳文亮老師 13 國立交通大學生物科技學系 陳文亮老師 14 人類的泌尿系統(urinary system) 30 國立交通大學生物科技學系 陳文亮老師 15 人類的排泄系統---腎臟 腎臟的構造 31 人類的排泄系統---腎元(nephron) 32 國立交通大學生物科技學系 陳文亮老師 16 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 - - - reabsorption (regulated by ADH, via arginine vasopressin receptor 2) 17 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 國立交通大學生物科技學系 陳文亮老師 18 External Heart Anatomy 國立交通大學生物科技學系 陳文亮老師 19 LDL: Low-density lipoprotein HDL: High-density lipoprotein 國立交通大學生物科技學系 陳文亮老師 20 國立交通大學生物科技學系 陳文亮老師 21 國立交通大學生物科技學系 陳文亮老師 22 國立交通大學生物科技學系 陳文亮老師 23 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. 國立交通大學生物科技學系 陳文亮老師 24 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. 國立交通大學生物科技學系 陳文亮老師 25 國立交通大學生物科技學系 陳文亮老師 26 國立交通大學生物科技學系 陳文亮老師 27 低升糖對飲食的影響 脂肪儲存區 脂肪消耗區 疲勞/飢餓 國立交通大學生物科技學系 陳文亮老師 28 BCDAE CADAB BCECA ECDCD CADCB CABAC ECDAE BEAED ABBBE DDABA DEDAC BDAAC DCAAD ECADB CDDBB BBDDA ADABD CAABC 國立交通大學生物科技學系 陳文亮老師 29