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Chapter 14

Chapter 14. Cardiovascular Physiology. About this Chapter. Blood flow pumping & distribution Anatomy and histology of the heart Mechanism of cardiac contraction Heart beat sequence–how the pump works Regulators of heart beat and volume pumped. The Heart. The Heart.

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Chapter 14

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  1. Chapter 14 Cardiovascular Physiology

  2. About this Chapter • Blood flow pumping & distribution • Anatomy and histology of the heart • Mechanism of cardiac contraction • Heart beat sequence–how the pump works • Regulators of heart beat and volume pumped

  3. The Heart

  4. The Heart

  5. Normal and Abnormal Chest X-Rays

  6. Overview of the Cardiosvascular System • Heart and Blood vessels • Products transported to sustain all cells Table 14-1: Transport in the Cardiovascular System

  7. Circulation Reviewed • Heart – "four chambered" • Right atrium & ventricle • Pulmonary circuit • Left atrium & ventricle • Systemic circuit • Blood Vessels – "closed circulation" • Arteries –from heart • Capillaries– cell exchange • Veins – to heart

  8. Circulation Reviewed Figure 14-1: Overview of circulatory system anatomy

  9. Blood Flow: Pressure Changes • Flows down a pressure gradient • Highest at the heart (driving P), decreases over distance • Hydrostatic (really hydraulic) pressure in vessels • Decreases 90% from aorta to vena cava

  10. Blood Flow: Pressure Changes Figure 14-2 : Pressure gradient in the blood vessels

  11. Some Physic of Fluid Movement: Blood Flow • Flow rate: (L/min) • Flow velocity= rate/C-S area of vessel • Resistance slows flow • Vessel diameter • Blood viscosity • Tube length Figure 14-4 c: Pressure differences of static and flowing fluid

  12. Some Physic of Fluid Movement: Blood Flow Figure 14-6: Flow rate versus velocity of flow

  13. Heart Structure • Pericardium • Chambers • Coronary vessels • Valves-(one-way-flow) • Myocardium Figure 14-7 g: ANATOMY SUMMARY: The Heart

  14. Cardiac Muscle Cells: • Autorhythmic • Myocardial • Intercalated discs • Desmosomes • Gap Junctions • Fast signals • Cell to cell • Many mitochondria • Large T tubes Figure 14-10: Cardiac muscle

  15. Mechanism of Cardiac Muscle Excitation, Contraction & Relaxation Figure 14-11: Excitation-contraction coupling and relaxation in cardiac muscle

  16. Modulation of Contraction • Graded Contraction: proportional to crossbridges formed • More [Ca++]: crossbridges, more force & speed • Autonomic n & epinephrine modulation

  17. Modulation of Contraction Figure 14-12: Modulation of cardiac contraction by catecholamines

  18. More Characteristics of Cardiac Muscle Contraction • Stretch-length relationship •  stretch,  Ca++ entering •  contraction force • Long action potential • Long refractory period • No summation • No tetanus

  19. More Characteristics of Cardiac Muscle Contraction Figure 14-13: Length-tension relationships in skeletal and cardiac muscle

  20. More Characteristics of Cardiac Muscle Contraction Figure 14-15c: Refractory periods and summation in skeletal and cardiac muscle

  21. Autorhythmic Cells: Initiation of Signals • Pacemaker membrane potential • I-f channels Na+ influx • Ca++ channels – influx, to AP • Slow K+ open – repolarization

  22. Autorhythmic Cells: Initiation of Signals Figure 14-16: Action potentials in cardiac autorhythmic cells

  23. Sympathetic and Parasympathetic • Sympathetic – speeds heart rate by  Ca++ & I-f channel flow • Parasympathetic – slows rate by  K+ efflux &  Ca++ influx Figure 14-17: Modulation of heart rate by the nervous system

  24. Coordinating the Pump: Electrical Signal Flow • AP from autorhythmic cells in sinoatrial node (SA) • Spreads via gap junctions down internodal pathways and across atrial myocardial cells (atrial contraction starts) • Pause – atrioventricular (AV) node delay • AV node to bundles of His, branches & Purkinje fibers • Right and left ventricular contraction from apex upward

  25. Coordinating the Pump: Electrical Signal Flow Figure 14-18: Electrical conduction in myocardial cells

  26. Coordinating the Pump: Electrical Signal Flow Figure 14-19a: Electrical conduction in the heart

  27. Electrocardiogram (ECG):Electrical Activity of the Heart • Einthoven's triangle • P-Wave – atria • QRS- wave – ventricles • T-wave – repolarization Figure 14-20: Einthoven’s triangle

  28. Electrocardiogram (ECG):Electrical Activity of the Heart Figure 14-21: The electrocardiogram

  29. 3. Ventricular repolarization 2. Ventriculardepolarization 1. Atrial depolarization Electrocardiography (ECG) • Measures galvanically the electric activity of the heart • Well known and traditional, first measurements byAugustus Waller using capillary electrometer (year 1887) • Very widely used method in clinical environment • Very high diagnostic value

  30. 12-Lead ECG measurement • Most widely used ECG measurement setup in clinical environment • Signal is measured non-invasively with 9 electrodes • Lots of measurement data and international reference databases • Well-known measurement and diagnosis practices • This particular method was adopted due to historical reasons, now it is already rather obsolete Goldberger augmented leads: VR, VL & VF Einthoven leads: I, II & III Precordial leads: V1-V6

  31. ECG Information Gained • (Non-invasive) • Heart Rate • Signal conduction • Heart tissue • Conditions Figure 14-24: Normal and abnormal electrocardiograms

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