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Circulation 2/27 Types of circulatory systems • diffusion is slow – circulation (bulk flow) for the distribution of oxygen and nutritients • other solutions also exist – trachea in insects, intense enteric system in parasites, etc. • open circulation – low pressure, slow flow – slow way of living – exception – insects, because of the tracheal system • closed circulation – high pressure, fast flow, fast regulation – active life – e.g. difference between snails and cephalopods; vertebrates and invertebrates in general • further development: separated circuits in vertebrates for the body and lungs – high pressure would cause filtration in lungs 3/27 Circulatory system of mammals Eckert: Animal Physiology, W.H.Freeman and Co., N.Y.,2000, Fig. 12-3. 4/27 Human heart Berne and Levy, Mosby Year Book Inc, 1993, Fig. 24-10 5/27 Valves in the heart Berne and Levy, Mosby Year Book Inc, 1993, Fig. 24-11 6/27 Electrical activity of the heart • • • • • • • • • vertebrate heart is miogenic – see Aztec rituals principal pacemaker: sinoatrial node 2x8 mm, built up by modified muscle cells AP is followed by slow hypopolarization – hyperpolarization induced mixed channels (Na+, Ca++) and K+ inactivation NA and ACh changes the pacemaker potential in different directions through cAMP effecting the hyperpolarization induced channel in the atrium – rudimentary conduction system AV-node, 22x10x3 mm, in the interatrial septum bundle of His, bundle branches (Tawara), Purkinje fibers SA, AV nodes 0.02-0.1 m/s, muscle cell 0.3-1 m/s, specialized fibers 1-4 m/s (70-80 vs. 10-15 ) 7/27 Electrocardiogram • fibers in the atria and in the ventricles are activated in synchrony • high-amplitude signal • vector and scalar ECG • Einthoven triangle • diagnostic importance infarction, angina • mean electrical axis • arrhythmias – premature depolarization extrasystole, compensatory pause – fibrillation - atrial, ventricular (soap operas) Eckert: Animal Physiology, W.H.Freeman and Co., N.Y.,2000, Fig. 12-8. Cardiac cycle 8/27 Berne and Levy, Mosby Year Book Inc, 1993, Fig. 24-13 9/27 Regulation of cardiac output I. • cardiac output = heart rate x stroke volume • frequency is regulated mainly by the autonomic nervous system • stroke volume depends on the myocardial performance that in turns depends on intrinsic and extrinsic factors • heart rate at rest is about 70/minute • during sleep it is less by 10-20, in children and small animals it can be much higher (hummingbird) • emotional excitation, exercise: 120-150 • parasympathetic inhibition dominates in rest from the vagal nerves – ganglion on the surface or in the wall of the heart • asymmetric: right - SA, left - AV • acting through muscarinic receptors • beat-to-beat regulation – fast elimination 10/27 Regulation of cardiac output II. • sympathetic innervation: lower 1-2 cervical, upper 5-6 dorsal segments • relay in stellate ganglion • beta adrenergic effect through cAMP positive chronotropic, inotropic, dromotropic, batmotropic effects • slow effect, slow elimination • asymmetric innervation: right - frequency, left – strength of contraction • other effects: – baroceptor reflex – respiratory sinus arrhythmia: rate increases during inspiration, decreases during expiration – explanation: vagal activity increases during expiration (asthma), filling of the heart (preload) increases frequency Myocardial performance 11/27 • intrinsic factors: Starling´s law of the heart, or the Frank-Starling mechanism - 1914 • myocardial performance increases with preload to a certain extent • length of skeletal muscles is optimal at rest, length of heart muscles is optimal when stretched • increased preload: – first the heart cannot pump out the increased venous volume – end systolic volume increases – larger end-diastolic volume – stronger contraction – new equilibrium, increased volume is pumped out • increased peripheral resistance: – first the heart cannot pump out the same volume against the increased resistance – end systolic volume increases – larger end-diastolic volume – stronger contraction – new equilibrium, increased volume is pumped out • extrinsic factors: most important: sympathetic effect – strength of contraction increases Hemodynamics 12/27 • circulation cannot be described by simple physical rules: those apply for homogenous fluids flowing by laminar flow in rigid tubes • it is worth to examine those rules as we don’t have any other choice • basic principles: – v - linear velocity (cm/s) – Q - flow (cm3/s) – v = Q / A – linear velocity depends on the cross sectional area – Q = P / R – analogous to Ohm’s law P * * r4 Q = ---------8 * * l 8 * * l R = -------- * r4 • arterioles have high resistance because of the small „r” • relations between viscosity and hematocrit • turbulent and laminar flow – measurement of blood pressure The arterial system 13/27 • large volume, distensible wall, terminated by a large resistance - “Windkessel” • punctured tire, Scotch pipe, etc. • small variation in pressure, continuous flow • decreases the workload of the heart – heart should pump stroke volume in 1/6 time • terms: systolic/diastolic pressure, pulse pressure, mean arterial pressure • mean arterial pressure depends on the blood volume in the arterial system and on the distensibility of the walls of the arteries • pulse pressure depends on stroke volume and compliance • heart copes with increased venous return and peripheral pressure through the arterial system Microcirculation I. 14/27 • in most tissues cells are less than 3-4-cells distance from the nearest capillary • length 1 mm, diameter 3-10 • arteriole - metarteriole - precapillary sphincter - capillary - pericytes • arteriovenous anastomosis (shunt) • nutritional and non-nutritional circulation (thermoregulation) – rat’s tail, rabbit’s ear, etc. • growth of capillaries depends on demand – babies born before term are put into incubators – upon removal, lens are invaded by capillaries - blindness • capillary permeability depends on location (function) • easy penetration for lipid soluble substances • for hydrophilic ones it depends on capillary type Microcirculation II. 15/27 • continuous capillary – continuous basal membrane, gaps of 4 nm, 7 nm pinocytotic vesicles – muscle, nervous tissue, lung, connective tissue, exocrine glands • fenestrated capillary – continuous basal membrane, pores – everything can penetrate, except proteins and blood cells – kidney, gut, endocrine glands • sinusoidal capillary – large paracellular gaps crossing through the basal membrane – liver, bone marrow, lymph nodes, adrenal cortex • hydrostatic pressure difference - filtration (2% out, 85% back) – exchange of materials • filtration - reabsorption – Starling’s hypothesis • edema: gravidity, tight socks, heart failure, starving, inflammation, elephantiasis , Regulation of peripheral circulation 16/27 • central and local regulation – location-, and time-dependent • target: arteriole, metarteriole, sphincter muscles • sympathetic innervation in most cases • strong, long-term contraction without Nachannels – single-unit smooth muscle • local regulation – basal miogenic tone – metabolic regulation - adenosine • external regulation: sympathetic vasoconstriction • parasympathetic effect e.g. on saliva glands, possibly artifact (bradykinin) • humoral effect: NA in low concentration dilates ( -adrenergic), in high concentration contracts (-adrenergic) vessels Venous system 17/27 • veins have thin-walls and large volume – capacity vessels • maximal pressure is about 11 mmHg, but contains half of the blood volume • effect of gravitation: U-shaped tube, pressure difference is the same standing and laying – hydrostatic pressure is huge at the turn • role of the muscle pump and the valves • effect of inspiration – Valsalva's maneuver; in trumpet players - pressure can be around 100400 mmHg • thrombus and embolus • venomotor tone – standing in attention, fighter pilots, circulatory shock, returning of astronauts • jumping out of bed - 3-800 ml displaced into legs – cardiac output decreases by 2 l Coupling of heart and vessels I. 18/27 • balance of blood flow: pumped volume = volume flowing through the periphery • pumped volume is influenced by: heart beat, contractility of heart, preload, afterload • the last two are coupling factors – influenced by both the heart and the vessels • two important relationships should be considered • cardiac function curve – Starling’s law – vessels can be replaced by tubes • vascular function curves – increase of cardiac output decreases central venous pressure – heart can be replaced by a pump • blood is moved by the difference of mean arterial pressure and central venous pressure • these pressure values depend on blood volume and compliance in the respective systems 19/27 Coupling of heart and vessels II. • circulation stops: mean circulatory pressure, when heart restarts it pumps blood from the venous into the arterial system • the two function curves act against each other – moving water in a circular channel • equilibrium is reached – many phenomena, such as heart failure can be explained by this • in case of physical exercise, bleeding, veins contract – internal infusion • sympathetic effect – cardiac function curve is shifted upward • increase in peripheral resistance shifts both curves downward – balance depends on several factors Coronary circulation I. 20/27 • heart cannot accumulate oxygen dept, as it never stops – it is always aerobic • at rest consumption is 8-10 ml/100g/min O2, that is 25-30 ml/min for a 300 g male heart • total consumption is 250 ml/min, this is 12% of that • the stopped heart (dog) has a consumption of 2 ml/100g/min O2 • O2 extraction is very high: venous blood has a saturation of about 25% (20 mmHg) • during physical exercise blood flow can only increase from 180-240 ml/min to 900-1200 ml/min • many mitochondria, scarce mioglobin and glycogen • utilizes everything: glucose, lactate, fatty acids, ketone bodies, amino acids Coronary circulation II. 21/27 • coronary arteries – surround the heart • very good blood supply, 8-10 times as many open capillaries than in the functioning skeletal muscle – almost one capillary/muscle cell • hypertrophy can deteriorate nutrition • end-artery system: almost no overlap – fast occlusion, <10% blood, slow – anastomosis • myocardial infarct - necrosis • blood supply of left ventricle stops during systole • heart rate – systole/diastole ratio! • autoregulation is crucial (between 60-180 mmHg), basal miogenic tone, metabolic regulation (adenosine, NO) • NA – indirect vasodilatation, direct (weak) vasoconstriction – coronary constriction, emotional excitation, increased O2 need – death can occur Cerebral circulation 22/27 • high O2 (3-4 ml/100g/min) and glucose need • irreversible damage after 3-6 minutes • mass is 2% of bodyweight, circulation 15%, O2 consumption 25% • circle of Willis – right and left a. carotis and a. vertebralis – moderate contralateral circulation • specialty: closed space – constant blood flow • local differences, measurement: 85Kr, 133Xe, PET • tumor, bleeding, edema – severe consequences • autoregulation very strong between 60-160 mmHg - mechanism unknown • metabolic regulation: adenosine, NO, CO2, K+ • no sympathetic tone at rest • 3 compartments: intracellular, interstitial, liquor • interstitial fluid and liquor: low protein content, compared to plasma lower K+ , higher NaCl • blood-brain, blood-liquor barrier, circumventricular windows Splanchnic circulation 23/27 • gastrointestinal tract, liver, spleen, pancreas • blood flow 25 % of total, strongly variable • 18 % of total blood volume (1 l) – blood store, half can be released into circulation • the liver (1.5 kg) uses 20% of total O2 consumption • a. hepatica, hepatic portal vein - portal circulation – effectiveness of pills and suppositories • some local regulation (functional hyperemia after meals), increase is only 50 % • strong central regulation by the sympathetic nervous system – splanchnic vasoconstriction compensates for vasodilatation in muscles during exercise, peripheral resistance and blood pressure stable – constriction of veins provides internal transfusion • in some animals the spleen is a blood store Skeletal muscle circulation 24/27 • 40-50% of body mass (young man), 20 % of circulation • strong exercise: circulation 20 l, muscles get 80% • at rest: central regulation, during exercise: metabolic - K+, adenosine (?), H+ • on blood vessels not only 1 adrenoreceptors, but 2 as well – more sensitive for adrenalin dilatation • main effect still constriction • stimulation of the limbic system, hypothalamus, cortex – in some species dilatation - cholinergic sympathetic fibers • role: preparation for exercise, simulated death • redistribution of blood flow during exercise – overall vasoconstriction (resistance), venous contraction (volume) – percentages change, but increase of cardiac output more important Skin circulation 25/27 • typical non-nutritional blood flow • 100 ml/min would be sufficient, but 3-500 ml/min flows • serving thermoregulation: thermal exchange and evaporation • at apical parts (fingers, nose, ears, etc.): surface-to-volume ratio large - arteriovenous anastomosis toward the venous plexus – if open, intense flow, more heat loss • strong central regulation: sympathetic innervation, 1 receptor - constriction • dilatation is achieved by a decrease in this tone • sweat glands receive sympathetic cholinergic innervation - bradykinin - dilatation • psychical reactions on the head, neck, upper part of the chest: embarrassment, anger flushing; fear, anxiety, sorrow - paling; military test Central regulation I. 26/27 • regulator neurons are in the medulla (formerly: pressor and depressor centers) – that is why any increase in brain volume can be fatal • input: reflex zones, direct CO2, H+ effect • output: vagal nerve and the sympathetic nervous system – tonic activity at rest: slow heart beat, vasoconstriction in muscle, skin, intestines • chemo-, and mechanoreceptors – information for the control of breathing and for the long-term regulation • part of the receptors found in compact zones, they induce circumscribed reflexes • receptors in the high-pressure system (baroceptors): carotid and aortic sinuses – „buffer nerves” carry the information to the n. tractus solitarius (belongs to the caudal cell group) Central regulation II. 27/27 • receptors of the low-pressure system (atrial volume receptors): at the orifice of the v. cavae and the v. pulmonalis, as well as at the tip of the ventricles • activated by volume increase, effect similar to baroceptor effect, but long-term responses more important – production of ADH and aldosterone decreases • special receptor group in the atrium: Bainbridge - reflex – filling increase, frequency increase – one factor in sinus arrhythmia • chemoreceptors: glomus caroticum and aorticum activated by CO2 increase and O2 decrease (below 60 mmHg) – latter is more important as CO2 acts also directly in the medulla – heart frequency decreases, vasoconstriction • „sleeping pill” for native people (and biology students): pressing the sinus caroticum End of text Conduction system of the heart Berne and Levy, Mosby Year Book Inc, 1993, Fig. 23-25 Heart-lung preparation Berne and Levy, Mosby Year Book Inc, 1993, Fig. 25-16 Cross sectional area and velocity Eckert: Animal Physiology, W.H.Freeman and Co., N.Y.,2000, Fig. 12-24. Pressure changes Eckert: Animal Physiology, W.H.Freeman and Co., N.Y.,2000, Fig. 12-26. Windkessel function Eckert: Animal Physiology, W.H.Freeman and Co., N.Y.,2000, Fig. 12-28. Effect of increased venous return Berne and Levy, Mosby Year Book Inc, 1993, Fig. 27-10 Effect of increased resistance Berne and Levy, Mosby Year Book Inc, 1993, Fig. 27-13 Microcirculation Eckert: Animal Physiology, W.H.Freeman and Co., N.Y.,2000, Fig. 12-36. Types of capillaries Eckert: Animal Physiology, W.H.Freeman and Co., N.Y.,2000, Fig. 12-36. Starling’s hypothesis Eckert: Animal Physiology, W.H.Freeman and Co., N.Y.,2000, Fig. 12-39. Effect of blood volume changes Berne and Levy, Mosby Year Book Inc, 1993, Fig. 30-6 Effect of resistance changes Berne and Levy, Mosby Year Book Inc, 1993, Fig. 30-7 Model of the circulatory system Berne and Levy, Mosby Year Book Inc, 1993, Fig. 30-2 Coupling between the heart and the vasculature Berne and Levy, Mosby Year Book Inc, 1993, Fig. 30-12 Effect of sympathetic tone Berne and Levy, Mosby Year Book Inc, 1993, Fig. 30-9 Autonomic nervous system Eckert: Animal Physiology, W.H.Freeman and Co., N.Y.,2000, Fig. 11-15. Spinal nerves Kiss-Szentagothai, Medicina, 1964, Fig. III-90 Regulation of circulation rostro-ventrolateral neurons caudal neurons preganglionic vagal neurons primary afferents sympathetic preganglionic neurons reflexogenic zones sympathetic postganglionic neurons heart Fonyo, Medicina, 1997, Fig. 23-2 vessels adrenal medulla Carotid sinus Berne and Levy, Mosby Year Book Inc, 1993, Fig. 29-8 Autonomic nervous system I. • peripheral and central nervous system - PNSCNS • CNS: brain + spinal chord • PNS: nerves + ganglia (sensory and vegetative) + (enteric nervous system) • afferent and efferent, somatic and vegetative • afferent: similar organization – primary afferent neuron outside of the CNS • efferent: location of motoneurons, outflow, peripheral relaying, transmitter, target • there are two divisions of the autonomic nervous system: sympathetic and parasympathetic • vegetative fibers in spinal nerves • not every organ is innervated by both divisions, effect is not everywhere antagonistic • sympathetic: general effects • parasympathetic: localized effects Autonomic nervous system II. • preganglionic fibers (B-fibers) – sympathetic and parasympathetic: ACh binding to neuronal nicotinic ACh receptors - ionotropic, opening of Na+-K+ mixed channel - antagonist: e.g. hexamethonium • postganglionic fibers (C-fibers) – parasympathetic: ACh binding to muscarinic ACh receptors - IP3 increase, and opening (direct effect) or closing (indirect effect) of K+-channels antagonist: atropine, agonist: carbachol – sympathetic: 90% NE, 10% ACh (salivary gland, sweat gland, vasodilatation in skeletal muscles) • 1 - IP3 increase - Ca++ release from internal stores – contraction in smooth muscles, e.g. vessels, sphincters in the intestines, iris radial muscle - NE > Adr • 2 - cAMP decrease – mostly autoreceptor • 1 - cAMP increase - Ca++ - in the heart - chrono-, and inotropic effect - NE = Adr • 2 - cAMP increase - Ca++ pump - relaxation in smooth muscles, e.g. bronchioles, skeletal muscle vessels - Adr >> NE • - agonist: phenylephrine, antagonist: phenoxybenzamine • - agonist: isoprotenerol, antagonist: propanolol Elephantiasis I. Elephantiasis II.