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S1 Secretion Reabsorption Filtration S2 Circulatory System Circulates • • • • • Nutrients: glucose, amino acids, fatty acids, ketones, etc Wastes: Hormones: bound & free Gases: CO2 and O2 Formed Elements: Cells and Cell Fragments – Erythrocytes, Leukocytes, Thrombocytes = Platelets Other roles of the Cardiovascular System Thermoregulation Blood Clotting Reproduction (ex: penile erection) S3 Blood volume ~ 5 liters Figure 12.01 Serum = plasma – clotting factors Entering and Exiting the blood Components…… EPO and “The Scoop on Tissie” Discontinuous capillaries in bone marrow, spleen, & liver permit erythrocytes to enter and exit blood. Formed elements Hct = percentage of blood volume occupied by RBCs Anemia Blood doping & erythropoietin (hormone that stimulates erythrocyte production in bone marrow) to increase hematocrit S4 Fig. 12.02 Arteries..away from heart Veins..return to heart Resting Cardiac Output = 5L/min for each side! When left heart can’t pump all the blood it receives from pulmonary circuit (due to high aortic pressure and/or damage to left ventricle) blood accumulates in pulmonary circuit. This is congestive heart failure. Symptom: shortness of breath. Regional blood flow determined by arteries and arterioles. S5 Figure 12.04 CO = 5L/min for each circuit Up to 35 L/min in strenuous exercise S6 Pulmonary circuit CO = 5 liters/min Arterial Blood Pressure Systemic Circuit Exchange Vessels What’s missing? CO = 5 liters/min Recall Portal Systems! Resistance Vessels Microcirculation Capacitance vessels S7 Pulmonary circuit Pressure gradients makes fluids move. Moving fluids flow, but flow is limited by resistance. Resistance creates pressure. Systemic Circuit Arterioles establish Mean Arterial Pressure S8 Radius of arterioles regulates Q to organs F=Q=ΔP/R Flow = Pressure gradient/Resistance from Ohm’s Law (V=IR) Double radius … 16x flow R= 8Lη/πr4 Half radius….1/16th flow Q= ΔP πr4 8Lη Poiseulle’s equation Smooth muscles determine radius S 14 Mean Arterial Pressure = Cardiac Output x Total Peripheral Resistance MAP = CO x TPR MAP = (HR x SV) x TPR S1 Cardiac Output = Heart Rate X Stroke Volume What regulates heart rate? What regulates Stroke Volume? CO = HR x SV 5L/min = 72 beat/min x 70 ml/beat The Cardiac Cycle animation Problems with valves: Heart murmurs ≠ heart sounds ….Stenosis (narrowing) →Heart Murmurs (turbulent flow past a constriction) Figure 12.07 note: origin of neonatal heat murmurs (foramen ovale) ….Prolapse (eversion) allows backflow (also generates murmurs) S4 Tricuspid Heart sounds produced by valve closings Semilunar Valves Bicuspid =Mitral Animation S3 Cardiac Myofiber action potential Plateau phase Figure 12.13 Long refractory period prevents summation in cardiac myofibers Cardiac Myofiber S4 Figure 12.11 S5 SA node cells do not have stable resting membrane potential, spontaneously produce AP, are Pacemaker cells S5 Cardiac Pacemaker action potential Figure 12.14 Ectopic Pacemaker Pacemaker Cells in Conducting System: SA Node and Bundle of His Locations other than SA Node These cells set the rhythm & control Heart Rate. S 15 Figure 12.22 Intrinsic Rate = 100 beat/min 2 effects of Parasymp: hyperpolarization & slower depolarization S6 Figure 12.23 NE Beta-adrenergic receptors Effect of “Beta blockers” EPI ACh mAChR Effect of atropine S7 What prevents the AP from being conducted from ventricles back to atria? Fibrous connective tissue between atria and ventricles prevents the conduction of action potential. Only route is via AV node, bundle of His, bundle branches, Purkinje fibers, and to ventriclular myofibers. S8 “Sis-toe-lee” 1st Heart Sound = Closure of Atrioventricular (AV) valves at beginning of Ventricular Systole “die-ass-toe-lee” 2nd Heart Sound = Closure of Semilunar valves at beginning of Ventricular Diastole S9 Figure 12.20 Systolic Diastolic Atrial Fibrillation Stroke Volume Ejection Fraction = SV/EDV Ventricular Fibrillation & Defibrillation Animation S 10 Events are same for Cardiac Cycle for Right Side of Heart; only difference is lower systolic pressures in right atrium and right ventricle. S1 So far, we’ve dealt with the factors that control Cardiac Output by changing heart rate. 3 CO = HR x SV 2 + sympathetic - parasympathetic 1 5L/min = 72 beat/min x 70 ml/beat 35L/min = ? beat/min x ? ml/beat S2 Figure 12.20 Stroke Volume Animation S3 Frank-Starling Law of the Heart Does not depend on hormones or nerves Assures that the heart adjusts its output based on VENOUS RETURN Ventricular Function Curve Ways to enhance Venous Return: 1) muscle contractions 2) “respiratory pump” 3) venoconstriction FS LoH = SV is proportional to EDV ↑VR→ ↑EDV → ↑SV S4 Length-tension “curve” for Cardiac muscle Fig. 09.21 High EDV Low EDV Overinflation of ventricles leads to less effective pumping S5 Overinflation of ventricles results in reduction in stroke volume Treatments? …..diuretics S6 NE from Symp postganglionics & EPI from Adrenal medulla acting via B-adrenergic receptors on cardiac myofibers. Contractility Increase Ejection Fraction Note: cardiac myofibers NOT innervated by parasympathetic division S7 3 Effects of Sympathetic Stimulation 1: Increase rate of contraction 2: Increase peak tension 3: Decrease twitch duration Why should the contraction be shorter? Afterload is analogous to trying to pump more air into a tire that is already fully inflated (heart contracting to overcome diastolic pressure.) S9 High blood pressure increases the workload of the heart….. Cardiac hypertrophy….increase chance of irregular conduction of AP through heart Hypertrophic cardiomyopathy S8 Summary: Control of Stroke Volume FS LoH • End diastolic volume (preload) • Contractility (strength of ventricular contraction due to adrenergic stimulation) • Pressure in arteries that must be overcome = Afterload S 11 Factors that control Cardiac Output by changing heart rate and stroke volume. Afterload (MAP) CO = HR x SV EDV (FSLoH) + sympathetic - parasympathetic contractility 5L/min = 72 beat/min x 70 ml/beat 35L/min = ? beat/min x ? ml/beat Summary of Factors that Regulate Cardiac Output S 12 Fig. 12.28 Even persons with heart transplants can adjust CO in the absence of innervation of heart. S 13 Heart is pump that generates pressure gradient. Blood flows through vessels, which have resistance. Arterioles have greatest resistance and create “backpressure” in the arteries and aorta. Mean Arterial Pressure = diastolic +1/3(systolic – diastolic) = 70 + 1/3(120-70) = 70 + 17 = 87 mm Hg