1 Dr. abbas Foroutan Cardiac Mechanics Heart Physiology Heart as a pump Oct.2005 By: Dr. Abbas Foroutan Shaheed Beheshti Univ. Med. Sci.

2 Dr. abbas Foroutan Cardiac Mechanics Part 1 Anatomy

3 Dr. abbas Foroutan Cardiac Mechanics Heart

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8 Dr. abbas Foroutan Cardiac Mechanics Part 2 Cardiac Cycle

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18 Dr. abbas Foroutan Cardiac Mechanics Animation\echo\1-Echo3-n.swf Animation\echo\1-Echo3-n.swf Animation\echo\1-Echo3-n.swf

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20 Dr. abbas Foroutan Cardiac Mechanics Cardiac Output CO = SV * HR CO = SV * HR Preload Preload Contractility Contractility Afterload Afterload HR HR

21 Dr. abbas Foroutan Cardiac Mechanics Part 3 Preload Frank – Starling Law

22 Dr. abbas Foroutan Cardiac Mechanics No spatial summation No spatial summation No Time domain summation (no tetanus) No Time domain summation (no tetanus)

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30 Dr. abbas Foroutan Cardiac Mechanics P1 P2 Q Blood Flow Q = P1 – P2 * Ca

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39 Dr. abbas Foroutan Cardiac Mechanics Laplac Law T= P* r/2h

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44 Dr. abbas Foroutan Cardiac Mechanics Part 4 Contractility

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59 Dr. abbas Foroutan Cardiac Mechanics Blood volumeVenous tone

60 Dr. abbas Foroutan Cardiac Mechanics Part 6 Heart rate

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70 Dr. abbas Foroutan Cardiac Mechanics Part 6 Exercise

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76 Dr. abbas Foroutan Cardiac Mechanics CARDIOVASCULAR CHANGES DURING EXERCISE  Cardiac output  Cardiac output  heart rate (  sympathetic adrenergic and  parasympathetic activity)  heart rate (  sympathetic adrenergic and  parasympathetic activity)  stroke volume (  CVP; inotropy; lusitropy)  stroke volume (  CVP; inotropy; lusitropy)  Mean arterial pressure and pulse pressure  Mean arterial pressure and pulse pressure CO increases more than SVR decrease CO increases more than SVR decrease  stroke volume increases pulse pressure  stroke volume increases pulse pressure  Central venous pressure  Central venous pressure Venous constriction (  sympathetic adrenergic activity) Venous constriction (  sympathetic adrenergic activity) Muscle pump activity Muscle pump activity Abdominothoracic pump Abdominothoracic pump  Systemic vascular resistance  Systemic vascular resistance Metabolic vasodilation in active muscle and heart Metabolic vasodilation in active muscle and heart Cutaneous vasodilation (  sympathetic adrenergic activity) Cutaneous vasodilation (  sympathetic adrenergic activity) Vasoconstriction in splanchnic, nonactive muscle, and renal circulation Vasoconstriction in splanchnic, nonactive muscle, and renal circulation (  sympathetic adrenergic activity) (  sympathetic adrenergic activity) CVP, central venous pressure; CO, cardiac output; SVR, systemic vascular resistance

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83 Dr. abbas Foroutan Cardiac Mechanics Return of blood to the heart through veins from the extremities occurs by low ∆P, but also, as in lymphatics, by one-way valves, "milking action" of skeletal muscles, and — within the torso — by lowered thoracic pressure each time the diaphragm is lowered (no valves within torso).