The circulatory system
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1 Introduction to Physiology (Course # 72336) 1 הלב עקרונות בסיסיים (הכנה למעבדת לב) Adi Mizrahi mizrahia@cc.huji.ac.il Textbook Chapter 12 2 The circulatory system To the heart Away from the heart 3 L 2.5 L ~ 70 Beats/min (24/7) Within reach of almost every cell in the body ~5.5 Liter THE SYSTEMIC AND PULMONARY CIRCULATION 3 או... 1
2 4 Hemodynamics - Pressure, Flow, and Resistance 5 F = flow P R R= 8L r 4 Blood flows from regions of high pressure to low pressure Resistance and flow 6 F = P R R= 8L r 4 2
3 THE HEART 7 THE HEART 8 THE HEART 9 3
4 10 THE CARDIAC CYCLE 11 Systole Diastole Mid/late-diastole THE CARDIAC CYCLE 1= Ventricular filling 2= Isovolumetric ventricular contraction 3= ventricular ejection 4= Isovolumetric ventricular relaxation 4
5 Early Systole 1= Ventricular filling 2= Isovolumetric ventricular contraction 3= ventricular ejection 4= Isovolumetric ventricular relaxation Systole 1= Ventricular filling 2= Isovolumetric ventricular contraction 3= ventricular ejection 4= Isovolumetric ventricular relaxation Early Diastole 1= Ventricular filling 2= Isovolumetric ventricular contraction 3= ventricular ejection 4= Isovolumetric ventricular relaxation Stroke volume 5
6 HEART SOUNDS 16 AV Aorta-V valve Sounds: valve Where / who? 17 Cardiac Output = HR X SV Liters/min beats/min Liters/beat Resting Well trained athlete 18 5 lit/min 35 lit/min Cardiac Output = HR X SV 6
7 19 The inherent (autonomous) rhythm of the heart s pacemaker is ~100 beats/min Which is under neuronal and hormonal control Sympathetic stimulation Parasympathetic stimulation So why does our heart beat at 70 beats/min? Autonomic nervous system 20 The inherent (autonomous) rhythm of the heart s pacemaker is ~100 beats/min Sympathetic stimulation Parasympathetic stimulation Only 70 because under normal conditions parasympathetic rules 21 The SA node is the normal pacemaker of the heart! 7
8 22 23 Epinephrine acts on beta-adrenergic receptors of the SA node to accelerate heart rate Epinephrine HR 24 8
9 25 Stroke volume is affected by: 1. End diastolic volume (preload). 2. Sympathetic input to the ventricles. 3. Afterload. END DIASTOLIC VOLUME (PRELOAD) 26 Stroke volume Skeletal muscle Heart muscle Starling s law of the heart The higher the end diastolic volume The stronger is the contraction THE SYMPATHETIC NERVES (and epinephrine) 27 Stroke volume Epinephrine and norepinephrine change the contractility of the heart s muscle Ejection fraction= SV/EDV Independent of the end diastolic volume!!! 9
10 THE SYMPATHETIC NERVES (and epinephrine) 28 Stroke volume Epinephrine and norepinephrine shorten the duration of cardiac cycle 29 Stroke volume is affected by: 1. End diastolic volume (preload). 2. Sympathetic input to the ventricles. 3. Afterload. לסיכום Cardiac output 10
11 Pressure in the vessels 31 Blood vessels are structurally and functionally different 32 Pressure Size Resistance arteries low arterioles high veins low Number Composition Endothelium - common Smooth muscle Connective tissue variable ARTERIES They have thick walls and lots of elastic tissue. Large diameter (low resistance). Act as blood reservoir for maintaining flow
12 ARTERIES Blood pressure in a vessel is determined by: Volume of blood Compliance ( stretchability ) Compliance = volume / pressure 34 ARTERIES Input does not equal output (that s why arteries stretch during systole ) Output exceeds input (that s why arteries relax during diastole) הלב עקרונות בסיסיים (הכנה למעבדה ( ARTERIES Pulse Pressure is determined by: SV, speed of SV ejection and contractility of the artery PP Pulse Pressure (PP) = P sys P dia Mean Arterial Pressure (MAP) = P dia + 1/3 (PP) 36 12
13 ARTERIOLES Determine the relative blood flow into organs Main factor in determining the MAP 37 ARTERIOLES Determine the relative blood flow into organs The arterioles diameters determine the flow into the organs (by changing their resistance) flow F = P R 38 ARTERIOLES Determine MAP MAP (Mean Arterial Pressure) CO = X (Cardiac Output) TPR (Total Peripheral resistance) 39 13
14 הלב עקרונות בסיסיים (הכנה למעבדה ( ARTERIOLES Determine MAP When things are calm Inflow = outflow But when priorities change הלב עקרונות בסיסיים (הכנה למעבדה ( ARTERIOLES P F = R Determine MAP 41 הלב עקרונות בסיסיים (הכנה למעבדה ( ARTERIOLES Determine MAP P F = R TPR a TPR b TPR a =TPR b =1/r 1 +1/r 2 +1/r 3 +1/r 4 +1/r 5 14
15 הלב עקרונות בסיסיים (הכנה למעבדה ( ARTERIOLES Determine MAP F = P R P = F X R MAP = CO X TPR 43 MAP = CO X TPR??? = CO X??? equal??? = CO X??? 44 15
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