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Structure and Function of the Cardiovascular and Lymphatic Systems Chapter 22 Elsevier items and derived items © 2008 by Mosby, Inc., an affiliate of Elsevier Inc. Some material was previously published. Circulatory System Heart • Right heart Pulmonary circulation – Pumps blood through the lungs Left heart • Systemic circulation Pumps blood through the body Elsevier items and derived items © 2008 by Mosby, Inc., an affiliate of Elsevier Inc. Some material was previously published. Circulatory System Elsevier items and derived items © 2008 by Mosby, Inc., an affiliate of Elsevier Inc. Some material was previously published. Capillaries & RBCs Elsevier items and derived items © 2008 by Mosby, Inc., an affiliate of Elsevier Inc. Some material was previously published. Circulatory System Heart Mediastinum Heart wall • Pericardium Parietal and visceral Pericardial cavity and fluid • Myocardium • Endocardium Elsevier items and derived items © 2008 by Mosby, Inc., an affiliate of Elsevier Inc. Some material was previously published. Wall of the heart Elsevier items and derived items © 2008 by Mosby, Inc., an affiliate of Elsevier Inc. Some material was previously published. The Chambers of the Heart Right atrium Left atrium Right ventricle Left ventricle Elsevier items and derived items © 2008 by Mosby, Inc., an affiliate of Elsevier Inc. Some material was previously published. The Chambers of the Heart Elsevier items and derived items © 2008 by Mosby, Inc., an affiliate of Elsevier Inc. Some material was previously published. The Valves of the Heart Atrioventricular valves Tricuspid valve Mitral valve Semilunar valves Pulmonic semilunar valve Aortic semilunar valve Elsevier items and derived items © 2008 by Mosby, Inc., an affiliate of Elsevier Inc. Some material was previously published. The Valves of the Heart Elsevier items and derived items © 2008 by Mosby, Inc., an affiliate of Elsevier Inc. Some material was previously published. The Great Vessels Superior and inferior venae cavae Pulmonary artery (trunk) Right and left pulmonary arteries Pulmonary veins Aorta Elsevier items and derived items © 2008 by Mosby, Inc., an affiliate of Elsevier Inc. Some material was previously published. Blood Flow Cardiac cycle Diastole Systole Phases of the cardiac cycle Elsevier items and derived items © 2008 by Mosby, Inc., an affiliate of Elsevier Inc. Some material was previously published. Blood Flow and Cardiac Cycle Elsevier items and derived items © 2008 by Mosby, Inc., an affiliate of Elsevier Inc. Some material was previously published. Cardiac Cycle Phases Elsevier items and derived items © 2008 by Mosby, Inc., an affiliate of Elsevier Inc. Some material was previously published. Elsevier items and derived items © 2008 by Mosby, Inc., an affiliate of Elsevier Inc. Some material was previously published. Normal Intracardiac Pressures Elsevier items and derived items © 2008 by Mosby, Inc., an affiliate of Elsevier Inc. Some material was previously published. The Coronary Vessels Right coronary artery Conus Right marginal branch Posterior descending branch Left coronary artery Left anterior descending artery Circumflex artery Elsevier items and derived items © 2008 by Mosby, Inc., an affiliate of Elsevier Inc. Some material was previously published. The Coronary Vessels Collateral arteries Coronary capillaries Coronary veins Coronary sinus Great cardiac vein Posterior vein of the left ventricle Coronary lymphatic vessels Elsevier items and derived items © 2008 by Mosby, Inc., an affiliate of Elsevier Inc. Some material was previously published. The Coronary Vessels Elsevier items and derived items © 2008 by Mosby, Inc., an affiliate of Elsevier Inc. Some material was previously published. Vasculature of Heart review Box 22-1 Elsevier items and derived items © 2008 by Mosby, Inc., an affiliate of Elsevier Inc. Some material was previously published. Structures That Control Heart Action Cardiac action potentials Conduction system Sinoatrial node (SA) • Intranodal pathways • Bachmann bundle Atrioventricular node (AV) Bundle of His (AV bundle) Right and left bundle branches Purkinje fibers Elsevier items and derived items © 2008 by Mosby, Inc., an affiliate of Elsevier Inc. Some material was previously published. Conduction System of the Heart Elsevier items and derived items © 2008 by Mosby, Inc., an affiliate of Elsevier Inc. Some material was previously published. Structures That Control Heart Action Propagation of cardiac action potentials Membrane potential Depolarization Repolarization Refractory period Electrocardiogram Automaticity Rhythmicity Elsevier items and derived items © 2008 by Mosby, Inc., an affiliate of Elsevier Inc. Some material was previously published. Electrocardiogram Elsevier items and derived items © 2008 by Mosby, Inc., an affiliate of Elsevier Inc. Some material was previously published. Structures That Control Heart Action Cardiac innervation Sympathetic nerves Parasympathetic nerves Adrenergic receptor function Beta-adrenergic receptors Norepinephrine or epinephrine Elsevier items and derived items © 2008 by Mosby, Inc., an affiliate of Elsevier Inc. Some material was previously published. Autonomic Innervation Elsevier items and derived items © 2008 by Mosby, Inc., an affiliate of Elsevier Inc. Some material was previously published. Myocardial Cells Nearly identical to skeletal muscle cells Sarcomeres Intercalated disks Actin, myosin, and the troponintropomyosin complex Troponin T, I, and C Myocardial metabolism Myocardial oxygen consumption Elsevier items and derived items © 2008 by Mosby, Inc., an affiliate of Elsevier Inc. Some material was previously published. Myocardial Contraction and Relaxation Myosin Cross bridge theory of muscle contraction Excitation-contraction coupling Calcium channel L-type T-type Troponin Tropomyosin Elsevier items and derived items © 2008 by Mosby, Inc., an affiliate of Elsevier Inc. Some material was previously published. Cardiac Muscle Fiber Elsevier items and derived items © 2008 by Mosby, Inc., an affiliate of Elsevier Inc. Some material was previously published. Myocardial Contraction and Relaxation Elsevier items and derived items © 2008 by Mosby, Inc., an affiliate of Elsevier Inc. Some material was previously published. Myocardial Contraction & Relaxation Elsevier items and derived items © 2008 by Mosby, Inc., an affiliate of Elsevier Inc. Some material was previously published. Myocardial Contraction and Relaxation Elsevier items and derived items © 2008 by Mosby, Inc., an affiliate of Elsevier Inc. Some material was previously published. Cardiac Performance Cardiac output Preload • Left ventricular end-diastolic volume • Laplace law • Frank-Starling law of the heart Afterload • Load muscle must move after it starts to contract Elsevier items and derived items © 2008 by Mosby, Inc., an affiliate of Elsevier Inc. Some material was previously published. Cardiac Performance Elsevier items and derived items © 2008 by Mosby, Inc., an affiliate of Elsevier Inc. Some material was previously published. Cardiac Performance Heart rate Cardiovascular control center • Cardioexcitatory and cardioinhibitory centers Neural reflexes • Bainbridge and baroreceptor reflexes Atrial receptors Hormones and biochemicals Elsevier items and derived items © 2008 by Mosby, Inc., an affiliate of Elsevier Inc. Some material was previously published. Cardiac Performance Myocardial contractility Stroke volume Inotropic agents Oxygen and carbon dioxide levels Cardiac output Volume of blood flowing through either the systemic or pulmonary circuit in liters per minute Elsevier items and derived items © 2008 by Mosby, Inc., an affiliate of Elsevier Inc. Some material was previously published. Cardiac Output Elsevier items and derived items © 2008 by Mosby, Inc., an affiliate of Elsevier Inc. Some material was previously published. Systemic Circulation Arteries Arterioles Capillaries Venules Veins Elsevier items and derived items © 2008 by Mosby, Inc., an affiliate of Elsevier Inc. Some material was previously published. Structure of Blood Vessels Lumen Tunica intima ( endothelium) Tunica media Tunica externa (adventitia) Elsevier items and derived items © 2008 by Mosby, Inc., an affiliate of Elsevier Inc. Some material was previously published. Elsevier items and derived items © 2008 by Mosby, Inc., an affiliate of Elsevier Inc. Some material was previously published. Elsevier items and derived items © 2008 by Mosby, Inc., an affiliate of Elsevier Inc. Some material was previously published. Elsevier items and derived items © 2008 by Mosby, Inc., an affiliate of Elsevier Inc. Some material was previously published. Structure of Blood Vessels Elsevier items and derived items © 2008 by Mosby, Inc., an affiliate of Elsevier Inc. Some material was previously published. Muscle Pump Elsevier items and derived items © 2008 by Mosby, Inc., an affiliate of Elsevier Inc. Some material was previously published. Factors Affecting Blood Flow Poiseuille law Pressure Force exerted on a liquid per unit area Resistance Opposition to force Diameter and length of the blood vessels contribute to resistance Elsevier items and derived items © 2008 by Mosby, Inc., an affiliate of Elsevier Inc. Some material was previously published. Factors Affecting Blood Flow Neural control of total peripheral resistance Change in diameter of the vessels Baroreceptors Arterial chemoreceptors Elsevier items and derived items © 2008 by Mosby, Inc., an affiliate of Elsevier Inc. Some material was previously published. Elsevier items and derived items © 2008 by Mosby, Inc., an affiliate of Elsevier Inc. Some material was previously published. Factors Affecting Blood Flow Velocity Laminar vs. turbulent flow Vascular compliance Elsevier items and derived items © 2008 by Mosby, Inc., an affiliate of Elsevier Inc. Some material was previously published. Laminar vs. Turbulent Flow Elsevier items and derived items © 2008 by Mosby, Inc., an affiliate of Elsevier Inc. Some material was previously published. Regulation of Blood Pressure Arterial pressure Mean arterial pressure (MAP) Effects of cardiac output Effects of total peripheral resistance Effect of hyperemia Effects of hormones • Epinephrine and norepinephrine • Antidiuretic hormone, renin-angiotensin system, and natriuretic peptides Elsevier items and derived items © 2008 by Mosby, Inc., an affiliate of Elsevier Inc. Some material was previously published. Regulation of Blood Pressure Elsevier items and derived items © 2008 by Mosby, Inc., an affiliate of Elsevier Inc. Some material was previously published. Elsevier items and derived items © 2008 by Mosby, Inc., an affiliate of Elsevier Inc. Some material was previously published. Plasma Volume & 3 Hormones Elsevier items and derived items © 2008 by Mosby, Inc., an affiliate of Elsevier Inc. Some material was previously published. Elsevier items and derived items © 2008 by Mosby, Inc., an affiliate of Elsevier Inc. Some material was previously published. Regulation of Coronary Circulation Coronary perfusion pressure Autoregulation Autonomic regulation Elsevier items and derived items © 2008 by Mosby, Inc., an affiliate of Elsevier Inc. Some material was previously published. Lymphatic System Special vascular system that picks up excess fluid and returns it to the bloodstream Lymphatic fluid Lymphatic veins and venules Right lymphatic duct Thoracic duct Afferent and efferent lymphatic vessels Elsevier items and derived items © 2008 by Mosby, Inc., an affiliate of Elsevier Inc. Some material was previously published. Elsevier items and derived items © 2008 by Mosby, Inc., an affiliate of Elsevier Inc. Some material was previously published. Lymphatic System Elsevier items and derived items © 2008 by Mosby, Inc., an affiliate of Elsevier Inc. Some material was previously published.