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CARDIOVASCULAR SYSTEM

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Presentation on theme: "CARDIOVASCULAR SYSTEM"— Presentation transcript:

1 CARDIOVASCULAR SYSTEM
CHAPTER 15 CARDIOVASCULAR SYSTEM

2 Information 7,000L/day Beats 2.5 billion times/ lifetime
Cardiovascular system

3 HEART SIZE: 14cm X 9cm

4 HEART LOCATION

5 HEART LOCATION en.wikipedia.org

6 PULMONARY CIRCUIT invest-trial.org

7 SYSTEMIC CIRCUIT

8 PERICARDIUM en.wikipedia.org

9 PERICARDIUM

10 PERICARDIUM

11 PERICARDIUM FIBROUS PERICARDIUM PARIETAL PERICARDIUM
OUTER; TOUGH; DENSE CONNECTIVE TISSUE; FOR PROTECTION; PARIETAL PERICARDIUM INNER LINING OF FIBROUS PERICARDIUM VISCERAL PERICARDIUM COVERS THE HEART PARICARDIAL CAVITY FILLED WITH FLUID?

12 PERICARDIUM

13 HEART WALL EPICARDIUM THE VISCERAL PERICARDIUM
PROTECTS HEART (REDUCES FRICTION) CONNECTIVE TISSUE COVERED BY EPITHELIAL TISSUE; CAPILLARIES AND NERVES; MAY HAVE FAT MYOCARDIUM MIDDLE LAYER CARDIAC MUSCLE; MUSLCE FIBERS SEPARATED BY CONNECTIVE TISSUE; HAS BLOOD VESSELS; LYMPH VESSELS AND NERVES ENDOCARDIUM CONNECTIVE TISSUE COVERED BY EPITHELIAL TISSUE; ; BLOOD VESSELS; PERKINJIE FIBERS; LINES HEART CHAMBERS AND STRUCTURES

14 PERICARDIUM en.wikipedia.org

15 HEART en.wikipedia.org

16 MYOCARDIUM radiology.uchc.edu

17 INTERNAL HEART CHAMBERS en.wikipedia.org

18 PARTS ATRIA HAVE AURICLES ATRIOVENTRICULAR ORIFICE HAS A-V VALVE
ATRIOVENTRICULAR SULCHUS INTERVENTRICULAR SULCHUS TRICUSPID VALVE RIGHT SIDE BICUSPID VALVE/MITRAL VALVE LEFT SIDE CHORDAE TENDONAE PAPILLARY MUSCLES SEMI LUNAR VALVES

19

20 SKELETON OF HEART DENSE CONECTIVE TISSUE RINGS
FROM AORTA AND PULMONARY TRUNK THROUGH HEART DENSE CONNECTIVE TISSUE IN SEPTUM VALVE ATTACHMENTS; MUSCLE ATTACHMENTS; KEEP ORIFICES FROM EXPANDING

21 BLOOD FLOW

22 BLOOD SUPPLY TO HEART CORONARY ARTERIES OFF AORTA
BRANCHES TRAVEL ALONG ATRIOVENTRICULAR SULCHUS, POSTERIOR INTERVENTRICULAR SULCHUS AND ANTERIOR INTERVENTRICULAR SULCHUS MANY CAPLILLARIES TO MYOCARDIUM ANASTOMOSES BETWEEN SMALL ARTERIOLS PROVIDE ALTERNATE BLOOD FLOW ?

23 HEART ACTIONS ATRIA CONTRACT = ATRIAL SYSTOLE AS VENTRICLES RELAX = VENTRICULAR DIASTOLE THEN: VENTRICLES CONTRACT = VENTRICULAR SYSTOLE AND ATRIA RELAX = ATRIAL DIASTOLE = CARDIAC CYCLE

24 HEART SOUNDS LUBB= AV VALVES CLOSING DUBB= SEMILUNAR VALVES CLOSING
HEART MURMUR

25 CARDIAC MUSCLE

26 CARDIAC MUSCLE FIBERS INTERCALATED DISC/3D/INTERWOVEN
FUNCTIONAL SYNCYTIUM ATRIAL SYNCYTIUM VENTRICULAR SYNCYTIUM

27 HEART CONTRACTION SPECIALIZED MYOFIBRILS FOR SENDING CARDIAC IMPULSES
SA NODE: PACEMAKER BENEATH EPICARDIUM OF RT ATRIUM NEAR SUPERIOR VENA CAVA REACH THRESHOLD SPONTANEOUSLY AND BY SELF INCREASED PERMEABILITY TO SODIUM AND CALCIUM AND DECREASED PERMEABILITY TO POTASSIUM RHYTHMIC: 80 IMPULSES/MINUTE; PARASYMPATHETIC INHIBITS CONTRACTIONS TO ~70/MINUTE

28 SA NODE /hyperphysics.phy-astr.gsu.edu

29 INTERNODAL ATRIAL MUSCLE FIBERS CONDUCT IMPULSES TO DISTANT REGIONS OF ATRIA
GAP JUNCTIONS ALLOW IMPULSE TO SPREAD THROUGH MYOCARDIUM BOTH ATRIA CONTRACT ATRIA AND VENTRICLES SEPARATED BY FIBROUS SKELETON OF HEART ONLY CONDUCTION TO VENTRICLES IS THROUGH JUNCTIONAL FIBERS

30 JUNCTIONAL FIBERS TO AV NODE
INFERIOR PART OF SEPTUM UNDER ENDOCARDIUM ONLY CONNECTION BETWEEN ATRIA AND VENTRICLES JUNCTIONAL FIBERS HAVE SMALL DIAMETERS: SPEED? IMPORTANCE? IMPULSE TO AV BUNDLE/BUNDLE OF HIS LARGE FIBERS BUNDLE ENTERS INTERVENTRICULAR SEPTUM; BRANCHES TO BOTH SIDES TO LARGE PURKINJE FIBERS

31 BUNDLE OF HIS radiology.uchc.edu

32 HEART ELECTRICAL PHENOMENA
/hyperphysics.phy-astr.gsu.edu

33 PERKINJIE FIBERS

34 PURKINJE FIBERS CARRY IMPULSE THROUGH VENTRICLES FASTER THAN CELL TO CELL CONDUCTION: WHY NOT IN ATRIA? MUSCLES ARANGED IN WHORLS SO CONTRACT IN TWISTING MOTION FIBERS GO TO APEX FIRST SO APEX CONTRACTS FIRST MOVING BLOOD UP WHERE ARE THE PULMONARY ARTERY AND AORTIC OPENINGS? WHY?

35 ELECTROCARDIOGRAM ELECTRICAL CHANGES IN MUSCLE
P WAVE: SA NODE TRIGGERS IMPULSE FOR ATRIAL CONTRACTION QRS WAVES: DEPOLARIZATION OF VENTRICLES BEFORE CONTRACTION; THICKER SO MORE CHANGE T WAVE: VENTRICLE REPOLARIZATION INDICATES PROBLEMS WITH HEART PQ INTERVAL: SA NODE THROUGH AV NODE

36 HEART CONTRACTION hyperphysics.phy-astr.gsu.edu

37 REGULATION OF CARDIAC CYCLE
CONTROLLED BY PARASYMPATHETIC AND SYMPATHETIC NS EFFECTS? PARASYMPATHETIC SEND VIA VAGUS NERVES CONTINUALLY WHICH RELEASE ACETYLCHOLINE TO SA AND AV NODE TO BRAKE HEART ACTION SYMPATHETIC SEND VIA VAGUS NERVES OCCAISIONALLY TO SA AND AV NODE RELEASE EPINEPHRINE TO INCREASE CONTRACTIONS CONTROL BY BOTH ORIGINATES IN MEDULLA OBLONGATA HAS CARDIOINHIBITOR AND CARDIOACCELERATOR REFLEX CENTERS RECEIVE INFO FROM CARDIOVASCULAR SYSTEM

38 BLOOD PRESSURE EFFECT BARORECEPTORS OF AORTA AND CAROTID ARTERIES DETECT BLOOD PRESSURE CHANGES HIGHER PRESSURE STIMULATES IMPULSE TO CARDIOINHIBITOR REFLEX CENTER AND PARASYMPATHETIC NS DECREASES HEART RATE STRETCH RECEPTORS OF VENA CAVA DETECT HIGH PRESSURE SEND IMPULSE TO CARDIOACCELERATOR REFLEX CENTER AND SYMPATHETIC NS STIMULATES HEART

39 OTHER CONTROLS CEREBRUM AND HYPOTHALAMUS CAN INCREASE OR DECREASE IT
TEMPERATURE: HIGHER INCREASES IT LOWER DECREASES IT SURGERY?

40 IONS MOST IMPORTANT: K+ Ca++ K:
HIGH: DECREASES RATE & FORCE, MAY BLOCK CONDUCTION (CARDIAC ARREST) LOW: ARRHYTHMIA Ca: HOW DOES SA DIFFER FROM SKELETAL MUSCLE? SO WHERE DOES Ca COME FROM? HIGH: INCREASES CONTRACTION; TETANIC LOW: SLOWS HEART CONTRACTION

41 BLOOD VESSELS TYPES: FUNCTION?
ARTERIES; ARTERIOLES; CAPPILLARIES; VENULES; VEINS DIRECTIONS? FUNCTION?

42 ARTERIAL & VENOUS PATHWAYS

43 ARTERY & VEIN ANATOMY

44 ARTERY

45 ENDOTHELIUM SMOOTH SURFACE ? ALSO RELEASE ?
RELEASE CHEMICALS TO DILATE OR CONSTRICT BLOOD FLOW NITRIC OXIDE

46 TUNICA MEDIA ELASTIC CONNECTIVE TISSUE ?

47 TUNICA ADVENTIA/EXTERNA
ATTACHES TO TISSUE VASO VASORUM ?

48 REGULATION OF DIAMETER
SYMPATHETIC NS  VASOMOTOR FIBERS  STIMULATE SMOOTH MUSCLE TO CONTRACT: VASOCONSTRICTION INHIBITED: VASODILATION

49 BLOOD FLOW ARTERIOVENOUS SHUNTS
ARTERIES  ARTERIOLES  METARTERIOLES  CAPILLARIES ARTERIOVENOUS SHUNTS

50 ARTERIOLE

51 CAPILLARIES STRUCTURE ? FUNCTION ?
PERMEABILITY: SLITS WHERE CELLS OVERLAP/THROUGH CELLS SIZE VARIES ?

52

53 CAPILLARY BED

54

55 CAPILLARY TYPES CONTINUOUS: UNINTERRUPTED FENESTRATED
HAVE INTERCELLULAR CLEFTS BETWEEN TIGHT JUNCTIONS FENESTRATED SMALL PORES IN ENDOTHELIUM SINUSOIDAL: LARGER PORES DISCONTINUOUS SINUSOIDAL: SINUSOID, NO TIGHT JUNCTIONS

56 CONTINUOUS CAPILLARY

57 FENESTRATED CAPILLARY

58 SINUSOID CAPILLARY

59 DISCONTINUOUS SINUSOIDAL CAPILLARIES

60 BLOOD BRAIN BARRIER HOW? WHY?

61 BLOOD BRAIN BARRIER users.ahsc.arizona.edu

62 BLOOD BRAIN BARRIER

63 web.sfn.org/content

64 PRECAPILLARY SPHINCTER

65 CAPILLARY EXCHANGE DIFFUSION; LIPID SOLUBLE/INSOLUBLE FILTRATION
HYDROSTATIC PRESSURE DUE TO CONTRACTION OF VENTRICLES CLOSER TO ARTERIOLE END OF BED: FILTRATION OSMOTIC PRESSURE: DUE TO IMPERMEANT SOLUTE ONE SID EOF CELL MEMBRANE: PLASMA PROTIENS: PLASMA COLLOID OSMOTIC PRESSURE: REABSORPTION; CLOSER TO VENOUS END USUALLY MORE FLUID LEAVES THAN RETURNS (NEXT CHAPTER) WHEN WOULD MORE EXIT ?

66 CAPILLARY TRANSPORT users.ahsc.arizona.edu

67 CPPILARY TRANSPORT Figure 3 Transport mechanisms at the BBB.
1 = paracellular diffusion (sucrose), 2 = transcellular diffusion (ethanol), 3 = ion channel (K+ gated), 4 = ion-symport channel (Na+/K+/Cl- cotransporter), 5 = ion-antiport channel (Na+/H+ exchange), 6 = facilitated diffusion (Glucose via GLUT-1), 7 = active efflux pump (P-glycoprotein), 8 = active-antiport transport (Na+/K+ ATPase), 9 = receptor mediated endocytosis (transferrin & insulin)

68 VEIN

69 ARTERY vs. VEIN

70 ARTERY vs. VEIN

71 VEINS VALVES ? BLOOD RESERVOIRS: (25%)

72 ARTERIAL BLOOD PRESSURE
SYSTOLIC PRESSURE: VENTRICLES CONTRACT DIASTOLIC PRESSURE ATRIA CONTRACT ARTERIAL WALLS RECOIL AFTER BLOOD ENTERS: PULSE

73 FACTORS AFFECTING BLOOD PRESSURE
STROKE VOLUME 70 ml CARDIAC OUTPUT= STROKE VOLUME X HEART RATE IF STROKE VOLUME OR HEART RATE INCREASE BLOOD VOLUME: ~5L; 8% BODY WT PERIPHERAL RESISTANCE: BLOOD VS. WALLS: ARTERIAL RECOIL LESSENS PRESSURE/PULSE

74 VICOSITY: RESISTENCE TO FLOW OF BLOOD MOLECULES
INCREASED VISCOSITY ?

75 CONTROL OF BLOOD PRESSURE
DETERMINED BY CARDIAC OUTPUT x PERIPHERAL RESISTANCE LIMITED BY HOW MUCH RETURNS TO THE VENTRICLES USUALLY ONLY 60% IS PUMPED OUT OF VENTRICLE SO SYMPATHETIC STIMULATION CAN INCREASE MYOCARDIAL FIBERS STRETCH WHEN BLOOD ENTERS VENTRICLES MORE THEY STRETCH, HARDER THEY CONTRACT: FRANK-STARLING LAW OF THE HEART

76 PRELOAD: BLOOD ENTERING VENTRICLES AND STRETCHING FIBERS
AFTERLOAD: FORCE NEEDED TO OPEN SEMILUNAR VALVES FOR EJECTION HYPERTENSION INCREASES AFTERLOAD CARDIOINHIBITOR AND CARDIOACCELERATOR

77 THINGS THAT INCREASE HEART RATE:
EPINEPHRINE;EMOTIONS: FEAR, ANGER; EXERCISE; BODY TEMPERATURE RISE ARTERIOLE CONSTRICTION VASOMOTOR CENTER OF MEDULLA: CONTROLS VASODILATION OR CONSTRICTION BY SYMPATHETIC SYSTEM BARORECEPTORS OF AORTA SEND TO VASOMOTOR CENTER; ALSO PICKS UP PRESSURE LOSS: RELEASES EPINEPHRINE IMPORTANT CONTROL OF ARTERIOLES TO ABDOMINAL VISCERA: COULD CONTAIN MOST OF THE BLOOD OF BODY

78 CHEMICALS OF CONTROL INCREASING CO2; DECREASING O2; LOWERING pH; RELAXES SMOOTH MUSCLE  INCREASED BLOOD FLOW VASODILATORS: NITRIC OXIDE FROM ENDOTHELIAL CELLS AND BRANDYKININ FROM BLOOD VASOCONSTRICTION: ANGIOTENSIN AND ENDOTHELIN FROM ENDOTHELIUM

79 VENOUS BLOOD FLOW BLOOD PRESSURE IS LOWER
BLOOD FLOW: BLOOD PRESSURE; SKELETAL MUSCLE CONSTRICTION; RESPIRATORY MOVEMENTS; VASOCONSTRICTION VASOCONSTRICTION: LOW PRESSURE SYMPATHETIC REFLEXES STIMULATE SMOOTH MUSCLE CONTRACTION

80 CENTRAL VENOUS PRESSURE
PRESSURE IN RIGHT ATRIUM ? HIGH: INCREASES AND MORE PRESSURE IN VEINS HIGH BLOOD VOLUME OR VASOCONTRICTION INCREASES CVP HIGH CVP= EDEMA

81 PULMONARY CIRCUIT RIGHT VENTRICLE CONTRACTS WITH LESS POWER SO LESS ARTERIAL PRESSURE HELPS WITH DIFFUSION OF O2 AND CO2

82 LIFE SPAN CHANGES PLAQUE (FAT) BUILD UP ON ATERIES ?
INCREASES WITH AGE CARDIAC OUTPUT STAYS THE SAME FOR MOST DECREASES WITH THOSE HEART DISEASE CARDIAC MUSCLE DECLINES, DON’T DIVIDE: REPLACED BY FIBROUS CONNECTIVE TISSUE AND ADIPOSE TISSUE LEFT VENTRICLE 25% THICKER AT 80

83 SLOWS A LITTLE 8 ML LESS/YEAR VALVES THICKEN, BECOME MORE RIGID, MAY CALCIFY SA AND AV NODE AND BUNDLE OF HIS BECOME MORE ELASTIC SYSTOLIC BLOOD PRESSURE INCREASES: DECREASING SIZE AND ELASTICITY OF ARTERIES ARTERIES: TUNICA INTERNA THICKENS; MORE MUSCLE, MORE COLLAGEN, CALCIUM AND FAT: MORE RIGID

84 ARTERIOLES HALF THEIR ELASTICITY AT 70; DON’T RESPOND WELL TO CHANGES IN TEMPERATURE
VEINS: MORE CAOLLAGEN, MAY CALCIFY BUT NOT AS MUCH, USUALLY NOT AFFECTED OR OTHER VEINS TAKE OVER ENDOTHELIUM: LESS SMOOTH LESS CAPILLARIES EXERCISE HELPS SLOW MANY OF THESE CHANGES


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