Pathophysiology course (BMED8121/6793)
|
|
- Dominick Hudson
- 6 years ago
- Views:
Transcription
1 Pathophysiology course (BMED8121/6793) Sam Dudley, MD, PhD Associate Professor of Medicine and Physiology Office: VA room 2A167 Tel:
2 Overview of the CV system Purposes Distribute metabolites and O 2 Collect wastes and CO 2 Thermoregulation Hormone distribution Components Heart the driving force Arteries distribution channels Veins - collection channels Capillaries exchange points
3 Parallel and series design RA LA RV LV Organ 1 Organ 2 Organ 3 A given volume of blood passes through a single organ Blood entering an organ has uniform composition Perfusion pressure is the same for each organ Blood flow to each organ can be controlled independently
4 Cardiac anatomy The myocardial syncytium All atrial cells are coupled, all ventricular cells are coupled, the AV node links the two Connections between cells are known as intercalated disks Electrical activation leads to contraction (EC coupling)
5 Cardiac cellular anatomy Basic unit is a sarcomere (Z line to Z line) Think filaments of myosin in the A band Thin filaments of actin in the I band Sarcoplasmic reticulum Holds Ca 2+ Forms cisternae Approximation to T tubules (sacrolemmal invaginations) known as a dyad
6 Review of Cardiac Electrophysiology
7 Ca 2+ induced Ca 2+ release Ca 2+ K + Na + Ca 2+ ATP ATP SARCOLEMMA Ca 2+ RyR2 Ca 2+ Ca 2+ RyR2 SARCOPLASMIC RETICULUM ATP Ca 2+ SARCOMERE Ca 2+ enters from sacrolemmal Ca 2+ channels, diffuses to the SR Ca 2+ release channel (ryanodine receptor), and causes a large Ca 2+ release. SR Ca 2+ release raises intracellular Ca 2+ from 10-7 M to 10-5 M, enough to cause Ca 2+ binding to troponin, displacing tropomyosin, causing actin-myosin cross bridge cycling
8 The sliding filament hypothesis
9 Sliding filaments 2
10 Length-tension (Frank-Starling Effect) Length of a fiber determines force generation The major determinate of length in the heart is chamber volume The ascending limb results from lengthdependent changes in EC coupling The descending limb derives mostly from the number of thick and thin filament cross bridge interactions
11 Pressure-volume loops Determinants of cardiac output (stroke volume x heart rate) Preload or ventricular end diastolic volume Afterload or Aortic pressure Contractility or modulation of active force generation (ESPVR, inotropy) Ventricular compliance (EDPVR, lusitropy) Heart rate ESV= end systolic volume; EDV = end-diastolic volume; SV = stroke volume
12 Myocardial work Most myocardial work is potential work W = PdV Myocardial O 2 consumption is a function of myocardial wall tension, contractility, and heart rate The law of Laplace: T = Pr/ 2 where T is tension, P is pressure, and r is the radius. Larger ventricles have higher wall tension and O 2 utilization to produce the same pressure as smaller ones
13 The Idea of Heart Failure RH LH Vasoconstriction Fluid retention Right heart failure Left heart failure
14 The Effect of Heart Failure Pressure (mm Hg) ESPVR Volume (ml) Inotropy Acute HF Chronic HF EDPVR
15 Conceptualizing Treatment for Pressure (mm Hg) Heart Failure Volume (ml) ESPVR changes by inotropy afterload EDPVR
16 Coupling the heart and vasculature Vascular function curve CO = Pms Pra R( 1+ cv / ca ) Where P ms, P ra, R, c v, and c a are the mean systemic pressure, right atria pressure, total peripheral resistance, arterial and venous capacitance, respectively. Cardiac function curve Normal equilibrium
17 The Vicious Cycle of Heart Hypertrophy Energy Starvation Failure Cell death Apoptosis Fetal gene activation Inflammation Injury Systolic dysfunction Increased Load Neurohormonal activation RAAS, SNS, ET, AVP, bradykinin
18 Epidemiology of HF in the US Patients in US (millions) Year 1. American Heart Association. Heart and Stroke Statistics Update. 2. Croft JB et al. J Am Geriatr Soc 1997;45: National Heart, Lung, and Blood Institute. Congestive Heart Failure Data Fact Sheet. Available at: million patients 1 ; estimated 10 million in Incidence: about 550,000 new cases each year 1 Prevalence is 2% in persons aged 40 to 59 years, progressively increasing to 10% for those aged 70 years and older 3 52,000 deaths each year 1 Sudden cardiac death is 6 to 9 times higher in the heart failure population 1
19 Etiology of Heart Failure
20 Diagnosis Modalities Physical examination Chest X ray Echocardiography Bioimpedance MRI CT (Electron beam and Multidetector-row) Nuclear scintigraphy Cardiac catheterization
21 Chest X ray No temporal information No quantification Requires radiation No valvular/coronary information Two dimensional
22 Echocardiography
23 Limitations to Echocardiography Two dimensional Views limited by anatomy Image quality frequently poor Improved signal to noise ratios Improved contrast Limited quantitative information Need better contrast agents for flow Need higher resolution images Acoustic shadowing
24 Magnetic Resonance Need for more rapid acquisition Breathing artifacts Better contrast agents Higher spatial resolution Thinner slices 3D Reconstruction
25 Complications of Heart Failure Progressive pump dysfunction End organ underperfusion Pulmonary and systemic congestion Sudden death
26
27 Options for Pump Dysfunction When Medications Fail Left ventricular reconstruction/left ventricular resection Biventricular pacing (BiV) Left ventricular assist devices (LVAD) Cell/tissue replacement therapy Cardiac transplant
28 Biventricular pacing
29
30 Problems with BiV Pacing Not all people benefit Technical insertion failures Not all people have wide QRS Optimum intervals and pacing sites unknown Diaphragmatic pacing Frequent premature beats alter timing
31 LVADs Pulsatile vs. nonpulsatile Centrifugal, axial flow, pneumatic pumps Extracorporeal (short term) vs. implantable (longer term) Bleeding, hemolysis, DIC, embolism (air or thrombotic), battery life, bulk, mechanical failure, cost, infection, surgery Valvular/coronary disease/arrhythmias/con-genital defects limit use
32 Cardiac Cell Transplantation
33 Cell replacement therapy
34
35 Unresolved issues Arrhythmogenicity Automaticity Slow Conduction/Reentry Triggered activity Immunogenicity Mechanism of improved function contraction, remodeling How does cell therapy compare to engineered replacement tissue? Best source of cells adult, fetal, embryonic, tissue, species, differentiated, undifferentiated Best route of application injection, mobilization, IC, IV Timing of application How does homing occur? Which types of cells are necessary?
36 Cardiac transplantation Limited donors Infection Rejection Renal failure Tumors Accelerated Vascular Disease
37 Sudden Death in HF
38 Risk Predictors for Sudden Death Left ventricular dysfunction Frequent premature ventricular contractions Nonsustained ventricular tachycardia Inducible ventricular tachycardia on programmed electrical stimulation Abnormal signal averaged ECG (presence of late potentials) Reduced heart rate variability Presence of T wave alternans Increased QT segment dispersion
39 A Link between Contraction and Ca 2+ Sudden Death K + Na + Ca 2+ I ti I Cl ATP ATP SARCOLEMMA Ca 2+ RyR2 Ca 2+ Ca 2+ RyR2 SARCOPLASMIC RETICULUM ATP Ca 2+ SARCOMERE
40 Studying lethal RyR -/- using embryonic stem cells Undifferentiated mouse RyR +/+ /RyR -/- ESCs ESCs in hanging drops 2 days Embryoid bodies (EBs) Suspending EBs 5 days Plating EBs Day 7 Enzymatic isolation Electrophysiological study Spontaneously beating EBs Single cardiomyocytes Action potential morphology and triggered arrhythmias: EADs/DADs > Day Day
41 Early afterdepolarizations were more common in RyR -/- ESC-derived cardiomyocytes RyR +/+ Vm (mv) Control 1 µm BayK mm [TEA] o Vm (mv) µm BayK mm [TEA] o EAD Vm (mv) Washout ms ms ms RyR -/- Vm (mv) ms EADs EADs Vm (mv) ms EADs
42 Delayed afterdepolarizations were more common in RyR -/- ESC-derived cardiomyocytes RyR +/+ +/ mm [Ca 2+ ] mm [Ca 2+ o ] o Vm (mv) ms Vm (mv) ms DADs RyR -/ Vm (mv) ms DADs DAD
43 Finding (Mapping) Arrhythmias Contact vs. noncontact Baskets vs. single electrodes No integration of mapping and imaging Difficulty interpreting activation patterns and electrograms Cannot measure full thickness of myocardium Map resolution/accurate anatomical display
44 Implanted Cardiac Defibrillators (ICDs) Battery life Inappropriate shocks Limited event recording Infection/bleeding/perforation/unstable leads/pneumothorax/erosion Lead failure/dislodgement Pain Incessant VT/VF EM interference
45 ICD in action
46 Future Challenges for the Bioengineer Develop cellular/nanotechnology solutions Will require more knowledge of pathogenesis Implement tissue engineering solutions Improve biomedical imaging More noninvasive solutions Integrate with therapy Molecular imaging Need better bioinformatics risk predictive models
47 References 1. Katz A.M., Physiology of the Heart, Lippincott Williams & Wilkins, New York, Berne and Levy, Cardiovascular Physiology, 7 th Edition, Mosby, St. Louis, 1996.
Chapter 13 The Cardiovascular System: Cardiac Function
Chapter 13 The Cardiovascular System: Cardiac Function Overview of the Cardiovascular System The Path of Blood Flow through the Heart and Vasculature Anatomy of the Heart Electrical Activity of the Heart
More informationElectrical Conduction
Sinoatrial (SA) node Electrical Conduction Sets the pace of the heartbeat at 70 bpm AV node (50 bpm) and Purkinje fibers (25 40 bpm) can act as pacemakers under some conditions Internodal pathway from
More informationPrinciples of Biomedical Systems & Devices. Lecture 8: Cardiovascular Dynamics Dr. Maria Tahamont
Principles of Biomedical Systems & Devices Lecture 8: Cardiovascular Dynamics Dr. Maria Tahamont Review of Cardiac Anatomy Four chambers Two atria-receive blood from the vena cave and pulmonary veins Two
More informationDuring exercise the heart rate is 190 bpm and the stroke volume is 115 ml/beat. What is the cardiac output?
The Cardiovascular System Part III: Heart Outline of class lecture After studying part I of this chapter you should be able to: 1. Be able to calculate cardiac output (CO) be able to define heart rate
More information*Generating blood pressure *Routing blood: separates. *Ensuring one-way blood. *Regulating blood supply *Changes in contraction
*Generating blood pressure *Routing blood: separates pulmonary and systemic circulations *Ensuring one-way blood flow: valves *Regulating blood supply *Changes in contraction rate and force match blood
More informationHeart Pump and Cardiac Cycle. Faisal I. Mohammed, MD, PhD
Heart Pump and Cardiac Cycle Faisal I. Mohammed, MD, PhD 1 Objectives To understand the volume, mechanical, pressure and electrical changes during the cardiac cycle To understand the inter-relationship
More informationOutline. Pathophysiology: Heart Failure. Heart Failure. Heart Failure: Definitions. Etiologies. Etiologies
Outline Pathophysiology: Mat Maurer, MD Irving Assistant Professor of Medicine Definitions and Classifications Epidemiology Muscle and Chamber Function Pathophysiology : Definitions An inability of the
More informationPhysiology sheet #2. The heart composed of 3 layers that line its lumen and cover it from out side, these layers are :
Physiology sheet #2 * We will talk in this lecture about cardiac muscle physiology, the mechanism and the energy sources of their contraction and intracellular calcium homeostasis. # Slide 4 : The heart
More informationThe Cardiovascular System
Chapter 18 Part A The Cardiovascular System 1/19/16 1 Annie Leibovitz/Contact Press Images Similarities of Cardiac and Skeletal Muscle RMP Ion concentration Deploarization Action Potential Repolarization
More informationTHE CARDIOVASCULAR SYSTEM. Heart 2
THE CARDIOVASCULAR SYSTEM Heart 2 PROPERTIES OF CARDIAC MUSCLE Cardiac muscle Striated Short Wide Branched Interconnected Skeletal muscle Striated Long Narrow Cylindrical PROPERTIES OF CARDIAC MUSCLE Intercalated
More informationCardiovascular Physiology. Heart Physiology. Introduction. The heart. Electrophysiology of the heart
Cardiovascular Physiology Heart Physiology Introduction The cardiovascular system consists of the heart and two vascular systems, the systemic and pulmonary circulations. The heart pumps blood through
More informationAge-related changes in cardiovascular system. Dr. Rehab Gwada
Age-related changes in cardiovascular system Dr. Rehab Gwada Objectives explain the main structural and functional changes in cardiovascular system associated with normal aging Introduction aging results
More informationPathophysiology: Heart Failure
Pathophysiology: Heart Failure Mat Maurer, MD Irving Assistant Professor of Medicine Outline Definitions and Classifications Epidemiology Muscle and Chamber Function Pathophysiology Heart Failure: Definitions
More information(D) (E) (F) 6. The extrasystolic beat would produce (A) increased pulse pressure because contractility. is increased. increased
Review Test 1. A 53-year-old woman is found, by arteriography, to have 5% narrowing of her left renal artery. What is the expected change in blood flow through the stenotic artery? Decrease to 1 2 Decrease
More informationBIOL 219 Spring Chapters 14&15 Cardiovascular System
1 BIOL 219 Spring 2013 Chapters 14&15 Cardiovascular System Outline: Components of the CV system Heart anatomy Layers of the heart wall Pericardium Heart chambers, valves, blood vessels, septum Atrioventricular
More informationThe Circulatory System. The Heart, Blood Vessels, Blood Types
The Circulatory System The Heart, Blood Vessels, Blood Types The Closed Circulatory System Humans have a closed circulatory system, typical of all vertebrates, in which blood is confined to vessels and
More informationCardiac MRI in ACHD What We. ACHD Patients
Cardiac MRI in ACHD What We Have Learned to Apply to ACHD Patients Faris Al Mousily, MBChB, FAAC, FACC Consultant, Pediatric Cardiology, KFSH&RC/Jeddah Adjunct Faculty, Division of Pediatric Cardiology
More informationCardiac Output MCQ. Professor of Cardiovascular Physiology. Cairo University 2007
Cardiac Output MCQ Abdel Moniem Ibrahim Ahmed, MD Professor of Cardiovascular Physiology Cairo University 2007 90- Guided by Ohm's law when : a- Cardiac output = 5.6 L/min. b- Systolic and diastolic BP
More informationAnS SI 214 Practice Exam 2 Nervous, Muscle, Cardiovascular
AnS SI 214 Practice Exam 2 Nervous, Muscle, Cardiovascular Select the best answer choice in the questions below. 1) On the electrocardiogram, repolarization of the atria is represented by the: A) P wave
More informationOutline. Electrical Activity of the Human Heart. What is the Heart? The Heart as a Pump. Anatomy of the Heart. The Hard Work
Electrical Activity of the Human Heart Oguz Poroy, PhD Assistant Professor Department of Biomedical Engineering The University of Iowa Outline Basic Facts about the Heart Heart Chambers and Heart s The
More informationADVANCED ASSESSMENT Cardiovascular System
ONTARIO BASE HOSPITAL GROUP QUIT ADVANCED ASSESSMENT Cardiovascular System 2007 Ontario Base Hospital Group ADVANCED ASSESSMENT Cardiovascular System AUTHORS Mike Muir AEMCA, ACP, BHSc Paramedic Program
More informationMyocardial Infarction: Left Ventricular Failure
CARDIOVASCULAR PHYSIOLOGY 93 Case 17 Myocardial Infarction: Left Ventricular Failure Marvin Zimmerman is a 52-year-old construction manager who is significantly overweight. Despite his physician's repeated
More informationBio 449 Fall Exam points total
Name: Exam 2 100 points total Multiple choice. As with any test, choose the best answer in each case. Each question is 3 points. Comments are provided in italic for questions that too many people missed!
More informationQUIZ/TEST REVIEW NOTES SECTION 1 CARDIAC MYOCYTE PHYSIOLOGY [CARDIOLOGY]
QUIZ/TEST REVIEW NOTES SECTION 1 CARDIAC MYOCYTE PHYSIOLOGY [CARDIOLOGY] Learning Objectives: Describe the ionic basis of action potentials in cardiac contractile and autorhythmic cells Explain the relationship
More informationCardiac physiology. b. myocardium -- cardiac muscle and fibrous skeleton of heart
I. Heart anatomy -- general gross. A. Size/orientation - base/apex B. Coverings D. Chambers 1. parietal pericardium 2. visceral pericardium 3. Layers of heart wall a. epicardium Cardiac physiology b. myocardium
More informationCollin County Community College
Collin County Community College BIOL. 2402 Anatomy & Physiology WEEK 5 The Heart 1 The Heart Beat and the EKG 2 1 The Heart Beat and the EKG P-wave = Atrial depolarization QRS-wave = Ventricular depolarization
More informationAnatomy Review: The Heart Graphics are used with permission of A.D.A.M. Software, Inc. and Benjamin/Cummings Publishing Co.
Anatomy Review: The Heart Graphics are used with permission of A.D.A.M. Software, Inc. and Benjamin/Cummings Publishing Co. Anatomy Views Label the diagrams of the heart below: Interactive Physiology Study
More informationTHE CARDIOVASCULAR SYSTEM
THE CARDIOVASCULAR SYSTEM AND RESPONSES TO EXERCISE Mr. S. Kelly PSK 4U North Grenville DHS THE HEART: A REVIEW Cardiac muscle = myocardium Heart divided into two sides, 4 chambers (L & R) RS: pulmonary
More information11/10/2014. Muscular pump Two atria Two ventricles. In mediastinum of thoracic cavity 2/3 of heart's mass lies left of midline of sternum
It beats over 100,000 times a day to pump over 1,800 gallons of blood per day through over 60,000 miles of blood vessels. During the average lifetime, the heart pumps nearly 3 billion times, delivering
More informationCardiovascular system
BIO 301 Human Physiology Cardiovascular system The Cardiovascular System: consists of the heart plus all the blood vessels transports blood to all parts of the body in two 'circulations': pulmonary (lungs)
More informationCardiology. Objectives. Chapter
1:44 M age 1121 Chapter Cardiology Objectives art 1: Cardiovascular natomy and hysiology, ECG Monitoring, and Dysrhythmia nalysis (begins on p. 1127) fter reading art 1 of this chapter, you should be able
More informationCardiovascular Physiology
chapter 3 Cardiovascular Physiology I. CIRCUITRY OF THE CARDIOVASCULAR SYSTEM (FIGURE 3-1) A. Cardiac output of the left heart equals cardiac output of the right heart. Cardiac output from the left side
More informationCardiovascular Nursing Practice: A Comprehensive Resource Manual and Study Guide for Clinical Nurses 2 nd Edition
Cardiovascular Nursing Practice: A Comprehensive Resource Manual and Study Guide for Clinical Nurses 2 nd Edition Table of Contents Volume 1 Chapter 1: Cardiovascular Anatomy and Physiology Basic Cardiac
More informationGeneral Cardiovascular Magnetic Resonance Imaging
2 General Cardiovascular Magnetic Resonance Imaging 19 Peter G. Danias, Cardiovascular MRI: 150 Multiple-Choice Questions and Answers Humana Press 2008 20 Cardiovascular MRI: 150 Multiple-Choice Questions
More informationCardiac Properties MCQ
Cardiac Properties MCQ Abdel Moniem Ibrahim Ahmed, MD Professor of Cardiovascular Physiology Cairo University 2007 1- Cardiac Valves: a- Prevent backflow of blood from the ventricles to the atria during
More informationIP: Regulation of Cardiac Output
ANP 1105D Winter 2013 Assignment 9: The Heart, part 2: Chap... Assignment 9: The Heart, part 2: Chapter 18 Signed in as Alex Sokolowski Help Close Resources Due: 11:59pm on Monday, March 25, 2013 Note:
More informationIntroduction. Cardiac Imaging Modalities MRI. Overview. MRI (Continued) MRI (Continued) Arnaud Bistoquet 12/19/03
Introduction Cardiac Imaging Modalities Arnaud Bistoquet 12/19/03 Coronary heart disease: the vessels that supply oxygen-carrying blood to the heart, become narrowed and unable to carry a normal amount
More informationBUSINESS. Articles? Grades Midterm Review session
BUSINESS Articles? Grades Midterm Review session REVIEW Cardiac cells Myogenic cells Properties of contractile cells CONDUCTION SYSTEM OF THE HEART Conduction pathway SA node (pacemaker) atrial depolarization
More informationBIPN100 F15 Human Physiology I (Kristan) Problem set #5 p. 1
BIPN100 F15 Human Physiology I (Kristan) Problem set #5 p. 1 1. Dantrolene has the same effect on smooth muscles as it has on skeletal muscle: it relaxes them by blocking the release of Ca ++ from the
More informationPHYSIOLOGY MeQ'S (Morgan) All the following statements related to blood volume are correct except for: 5 A. Blood volume is about 5 litres. B.
PHYSIOLOGY MeQ'S (Morgan) Chapter 5 All the following statements related to capillary Starling's forces are correct except for: 1 A. Hydrostatic pressure at arterial end is greater than at venous end.
More informationLeft atrial function. Aliakbar Arvandi MD
In the clinic Left atrial function Abstract The left atrium (LA) is a left posterior cardiac chamber which is located adjacent to the esophagus. It is separated from the right atrium by the inter-atrial
More informationSkeletal Muscle and the Molecular Basis of Contraction. Lanny Shulman, O.D., Ph.D. University of Houston College of Optometry
Skeletal Muscle and the Molecular Basis of Contraction Lanny Shulman, O.D., Ph.D. University of Houston College of Optometry Like neurons, all muscle cells can be excited chemically, electrically, and
More informationThe Cardiovascular System
The Cardiovascular System The Cardiovascular System A closed system of the heart and blood vessels The heart pumps blood Blood vessels allow blood to circulate to all parts of the body The function of
More informationHeart Failure. Cardiac Anatomy. Functions of the Heart. Cardiac Cycle/Hemodynamics. Determinants of Cardiac Output. Cardiac Output
Cardiac Anatomy Heart Failure Professor Qing ZHANG Department of Cardiology, West China Hospital www.blaufuss.org Cardiac Cycle/Hemodynamics Functions of the Heart Essential functions of the heart to cover
More informationSkeletal muscle in the light of its structure
Mechanism of contraction of Skeletal muscle in the light of its structure By Dr. Mudassar Ali Roomi (MBBS, M. Phil) Muscle Tissue Skeletal Muscle Cardiac Muscle Smooth Muscle Skeletal Muscle Long cylindrical
More informationP215 SPRING 2019: CIRCULATORY SYSTEM Chaps 13, 14 & 15: pp , , , I. Major Functions of the Circulatory System
P215 SPRING 2019: CIRCULATORY SYSTEM Chaps 13, 14 & 15: pp 360-390, 395-404, 410-428 433-438, 441-445 I. Major Functions of the Circulatory System 1. 2. 3. 4. II. Structure of the Heart 1. atria 2. ventricles
More informationChapter 9, Part 2. Cardiocirculatory Adjustments to Exercise
Chapter 9, Part 2 Cardiocirculatory Adjustments to Exercise Electrical Activity of the Heart Contraction of the heart depends on electrical stimulation of the myocardium Impulse is initiated in the right
More informationPhysiology of the heart I.
Physiology of the heart I. Features of the cardiac muscle The cardiac cycle Theheart as a pump Cardiac sounds (Learning objectives 35-36) prof. Gyula Sáry Cardiovascular physiology Cardiac function, pumping
More informationHeart. Structure Physiology of blood pressure and heartbeat
Heart Structure Physiology of blood pressure and heartbeat Location and Anatomy Location and Anatomy Pericardial cavity: surrounds, isolates, and anchors heart Parietal pericardium lined with serous membrane
More informationPrinciples of Anatomy and Physiology
Principles of Anatomy and Physiology 14 th Edition CHAPTER 20 The Cardiovascular System: The Heart Introduction The purpose of the chapter is to: 1. Learn about the components of the cardiovascular system
More information10/23/2017. Muscular pump Two atria Two ventricles. In mediastinum of thoracic cavity 2/3 of heart's mass lies left of midline of sternum
It beats over 100,000 times a day to pump over 1,800 gallons of blood per day through over 60,000 miles of blood vessels. During the average lifetime, the heart pumps nearly 3 billion times, delivering
More informationCardiac Output (C.O.) Regulation of Cardiac Output
Cardiac Output (C.O.) Is the volume of the blood pumped by each ventricle per minute (5 Litre) Stroke volume: Is the volume of the blood pumped by each ventricle per beat. Stroke volume = End diastolic
More informationNewer pacemakers also can monitor your blood temperature, breathing, and other factors and adjust your heart rate to changes in your activity.
Pacemakers & Defibrillators A pacemaker system consists of a battery, a computerized generator and wires with sensors called electrodes on one end. The battery powers the generator, and both are surrounded
More informationPathophysiology: Heart Failure. Objectives
Pathophysiology: Heart Failure Mat Maurer, MD Irving Assistant Professor of Clinical Medicine Objectives At the conclusion of this seminar, learner will be able to: 1. Define heart failure as a clinical
More informationCardiovascular System
Cardiovascular System The Heart Cardiovascular System The Heart Overview What does the heart do? By timed muscular contractions creates pressure gradients blood moves then from high pressure to low pressure
More informationCardiac Imaging Tests
Cardiac Imaging Tests http://www.medpagetoday.com/upload/2010/11/15/23347.jpg Standard imaging tests include echocardiography, chest x-ray, CT, MRI, and various radionuclide techniques. Standard CT and
More informationIndex of subjects. effect on ventricular tachycardia 30 treatment with 101, 116 boosterpump 80 Brockenbrough phenomenon 55, 125
145 Index of subjects A accessory pathways 3 amiodarone 4, 5, 6, 23, 30, 97, 102 angina pectoris 4, 24, 1l0, 137, 139, 140 angulation, of cavity 73, 74 aorta aortic flow velocity 2 aortic insufficiency
More informationPractice Exercises for the Cardiovascular System
Practice Exercises for the Cardiovascular System On the diagram below, color the oxygen-rich blood red and the oxygen-poor blood blue. Label the parts: Continued on the next page... Label the parts on
More informationDepartment of medical physiology 7 th week and 8 th week
Department of medical physiology 7 th week and 8 th week Semester: winter Study program: Dental medicine Lecture: RNDr. Soňa Grešová, PhD. Department of medical physiology Faculty of Medicine PJŠU Cardiovascular
More informationChapter 12: Cardiovascular Physiology System Overview
Chapter 12: Cardiovascular Physiology System Overview Components of the cardiovascular system: Heart Vascular system Blood Figure 12-1 Plasma includes water, ions, proteins, nutrients, hormones, wastes,
More informationCRC 431 ECG Basics. Bill Pruitt, MBA, RRT, CPFT, AE-C
CRC 431 ECG Basics Bill Pruitt, MBA, RRT, CPFT, AE-C Resources White s 5 th ed. Ch 6 Electrocardiography Einthoven s Triangle Chest leads and limb leads Egan s 10 th ed. Ch 17 Interpreting the Electrocardiogram
More informationCor pulmonale. Dr hamid reza javadi
1 Cor pulmonale Dr hamid reza javadi 2 Definition Cor pulmonale ;pulmonary heart disease; is defined as dilation and hypertrophy of the right ventricle (RV) in response to diseases of the pulmonary vasculature
More informationMechanics of Cath Lab Support Devices
Mechanics of Cath Lab Support Devices Issam D. Moussa, MD Professor of Medicine Mayo Clinic College of Medicine Chair, Division of Cardiovascular Diseases Mayo Clinic Jacksonville, Florida DISCLOSURE Presenter:
More informationSIKLUS JANTUNG. Rahmatina B. Herman
SIKLUS JANTUNG Rahmatina B. Herman The Cardiac Cycle Definition: The cardiac events that occur from the beginning of one heartbeat to the beginning of the next The cardiac cycle consists of: - Diastole
More informationEXAM II Animal Physiology ZOO 428 Fall 2006
V Eq EXAM II Animal Physiology ZOO 428 Fall 2006 = RT X o. ln( [ zf [ X ) RT p K[K o pna[na o pcl[cl i V = m ln i F pk[k i pna[na i pcl[cl o I = g(v m V eq. ) Q = C m V m Q Driving Force = V m V eq. 10
More informationFor more information about how to cite these materials visit
Author(s): Louis D Alecy, D.M.D., Ph.D., 2009 License: Unless otherwise noted, this material is made available under the terms of the Creative Commons Attribution Non-commercial Share Alike 3.0 License:
More informationChapter 20: Cardiovascular System: The Heart
Chapter 20: Cardiovascular System: The Heart I. Functions of the Heart A. List and describe the four functions of the heart: 1. 2. 3. 4. II. Size, Shape, and Location of the Heart A. Size and Shape 1.
More informationAbout This Chapter. Skeletal muscle Mechanics of body movement Smooth muscle Cardiac muscle Pearson Education, Inc.
About This Chapter Skeletal muscle Mechanics of body movement Smooth muscle Cardiac muscle Skeletal Muscle Usually attached to bones by tendons Origin: closest to the trunk or to more stationary bone Insertion:
More informationCirculation. Blood Pressure and Antihypertensive Medications. Venous Return. Arterial flow. Regulation of Cardiac Output.
Circulation Blood Pressure and Antihypertensive Medications Two systems Pulmonary (low pressure) Systemic (high pressure) Aorta 120 mmhg Large arteries 110 mmhg Arterioles 40 mmhg Arteriolar capillaries
More informationObjectives of the lecture:
Yesterday s lecture was an introduction for the cardiovascular system. Today we will talk about the cardiac muscle physiology because if you know how the cardiac muscle works you will know as a generalization
More informationCARDIOVASCULAR SYSTEM Worksheet
CARDIOVASCULAR SYSTEM Worksheet NAME Section A: Blood Basics http://www.psbc.org/hematology/01_index.htm Although blood appears to be red liquid it is actually composed of yellowish liquid called plasma
More informationCirculation: Chapter 25. Cardiac Output. The Mammalian Heart Fig Right side of the heart
Circulation: Chapter 25 1. Limits of Diffusion A. Small organisms use diffusion B. rapid over small distances 2. Most animals have circulatory systems A. Blood B. Pump (Heart) or propulsive structures
More informationStructure of the striated muscle general properties
Structure of the striated muscle general properties Structure of the striated muscle membrane systems 1. Myofibrillum (contractile proteins) 2. Sarcoplasmic reticulum (SR) longitudinal tubule 3. SR terminal
More informationCardiac Implanted Electronic Devices Pacemakers, Defibrillators, Cardiac Resynchronization Devices, Loop Recorders, etc.
Cardiac Implanted Electronic Devices Pacemakers, Defibrillators, Cardiac Resynchronization Devices, Loop Recorders, etc. The Miracle of Living February 21, 2018 Matthew Ostrom MD,FACC,FHRS Division of
More informationMechanics of Cath Lab Support Devices
Mechanics of Cath Lab Support Devices Issam D. Moussa, MD Chief Medical Officer First Coast Cardiovascular Institute, Jacksonville, FL Professor of Medicine, UCF, Orlando, FL None DISCLOSURE Percutaneous
More informationCirculatory system. Terminology. Ventricles and resistance. Pressure gradients move blood through the heart and vessels.
Circulatory system Pressure gradients move blood through the heart and vessels. Pulmonary circulation vs. systemic circulation (to pulmonary circuit) liver head and arms heart aorta diaphragm (from pulmonary
More informationClinical Cardiac Electrophysiology
Clinical Cardiac Electrophysiology Certification Examination Blueprint Purpose of the exam The exam is designed to evaluate the knowledge, diagnostic reasoning, and clinical judgment skills expected of
More informationCirculation. Sinoatrial (SA) Node. Atrioventricular (AV) Node. Cardiac Conduction System. Cardiac Conduction System. Linked to the nervous system
Circulation Cardiac Conduction System AHS A H S Your body resembles a large roadmap. There are routes or arteries that take you downtown to the heart of the city and veins that take you to the outskirts
More informationMuscle Cells & Muscle Fiber Contractions. Packet #8
Muscle Cells & Muscle Fiber Contractions Packet #8 Skeletal muscle is attached to bones and is responsible for movement. Introduction Introduction II Skeletal muscle is composed of bundles of muscle fibers
More informationChapter 7 The Muscular System. Mosby items and derived items 2012 by Mosby, Inc., an affiliate of Elsevier Inc. 1
Chapter 7 The Muscular System Mosby items and derived items 2012 by Mosby, Inc., an affiliate of Elsevier Inc. 1 INTRODUCTION A. Muscular tissue enables the body and its parts to move 1. Three types of
More informationIn Vivo Animal Models of Heart Disease. Why Animal Models of Disease? Timothy A Hacker, PhD Department of Medicine University of Wisconsin-Madison
In Vivo Animal Models of Heart Disease Timothy A Hacker, PhD Department of Medicine University of Wisconsin-Madison Why Animal Models of Disease? Heart Failure (HF) Leading cause of morbidity and mortality
More informationCARDIOVASCULAR SYSTEM
CARDIOVASCULAR SYSTEM Overview Heart and Vessels 2 Major Divisions Pulmonary Circuit Systemic Circuit Closed and Continuous Loop Location Aorta Superior vena cava Right lung Pulmonary trunk Base of heart
More informationCadiovascular System-1. Faisal I. Mohammed, MD, PhD
Cadiovascular System-1 Faisal I. Mohammed, MD, PhD 1 Textbook: University of Jordan School of Medicine. Cardiovascular Physiology Medical Students Fall 2017-2018 Textbook of Medical Physiology By: Arthur
More informationBiology November 2009 Exam Three FORM W KEY
Biology 251 3 November 2009 Exam Three FORM W KEY PRINT YOUR NAME AND ID NUMBER in the space that is provided on the answer sheet, and then blacken the letter boxes below the corresponding letters of your
More information2
1 2 Although the term "cardiomyopathy" could theoretically apply to almost any disease affecting the heart, it is usually reserved for "severe myocardial disease leading to heart failure".cardiomyopathy
More informationCirculatory System. Functions and Components of the Circulatory System. Chapter 13 Outline. Chapter 13
Circulatory System Chapter 13 Chapter 13 Outline Functions and Components of the Circulatory System Composition of Blood Structure of the Heart Cardiac Cycle and Heart Sounds Electrical Activity of the
More informationCh 12: Muscles sarcolemma, t-tubules, sarcoplasmic reticulum, myofibrils, myofilaments, sarcomere...
Ch 12: Muscles Review micro-anatomy of muscle tissue Terminology examples: sarcolemma, t-tubules, sarcoplasmic reticulum, myofibrils, myofilaments, sarcomere... SLOs Differentiate levels of muscle structure:
More informationCirculatory system ( 循环系统 )
Circulatory system ( 循环系统 ) Circulatory system: heart + blood vessels Function: nutrient transportation and metabolites returning Blood: carrier Heart: pump Blood vessels: route, substance communications
More informationTOPIC : Cardiogenic Shock
University of Ferrara Department of Morphology, Surgery and Experimental Medicine. Section of Anaesthesia and Intensive Care Medicine TOPIC : Cardiogenic Shock What is shock? Shock is a condition of inadequate
More informationCardiac arrhythmias. Janusz Witowski. Department of Pathophysiology Poznan University of Medical Sciences. J. Witowski
Cardiac arrhythmias Janusz Witowski Department of Pathophysiology Poznan University of Medical Sciences A 68-year old man presents to the emergency department late one evening complaining of increasing
More informationGIGA - In Silico Medicine, University of Liege, Belgium, 2
S. Kosta 1,*, A. Pironet 1, J.A. Negroni 2, E.C. Lascano 2, P.C. Dauby 1 1 GIGA - In Silico Medicine, University of Liege, Belgium, 2 Department of Comparative Cellular and Molecular Biology, Favaloro
More informationHow does the heart pump? From sarcomere to ejection volume
How does the heart pump? From sarcomere to ejection volume Piet Claus Cardiovascular Imaging and Dynamics Department of Cardiovascular Diseases University Leuven, Leuven, Belgium Course on deformation
More informationThe Heart. C h a p t e r. PowerPoint Lecture Slides prepared by Jason LaPres Lone Star College - North Harris
C h a p t e r 20 The Heart PowerPoint Lecture Slides prepared by Jason LaPres Lone Star College - North Harris Copyright 2009 Pearson Education, Inc., publishing as Pearson Benjamin Cummings Introduction
More informationCopyright 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. Normal Cardiac Anatomy
Mosby,, an affiliate of Elsevier Normal Cardiac Anatomy Impaired cardiac pumping Results in vasoconstriction & fluid retention Characterized by ventricular dysfunction, reduced exercise tolerance, diminished
More informationMake you feel better Make you live longer
Drugs and Devices for Women with Heart Disease Sharonne N. Hayes MD, FACC Director, Women s Heart Clinic Mayo Clinic Rochester, MN CP986192-1 CP1045209-2 Goals of Medical Treatments for Heart Disease Make
More informationIB TOPIC 6.2 THE BLOOD SYSTEM
IB TOPIC 6.2 THE BLOOD SYSTEM THE BLOOD SYSTEM TERMS TO KNOW circulation ventricle artery vein 6.2.U1 - Arteries convey blood at high pressure from the ventricles to the tissues of the body Circulation
More informationThe Pathophysiology of Cardiogenic Shock Knowledge Gaps & Opportunities
The Pathophysiology of Cardiogenic Shock Knowledge Gaps & Opportunities Navin K. Kapur, MD, FACC, FSCAI, FAHA Associate Professor, Department of Medicine Interventional Cardiology & Advanced Heart Failure
More informationHuman Anatomy and Physiology II Laboratory Cardiovascular Physiology
Human Anatomy and Physiology II Laboratory Cardiovascular Physiology 1 This lab involves two exercises: 1) Conduction System of the Heart and Electrocardiography and 2) Human Cardiovascular Physiology:
More informationCh. 12 The Circulatory System. The heart. The heart is a double pump. A quick note on arteries vs. veins. = the muscular pump of the CV system
Ch. 12 The Circulatory System The heart A.k.a. the cardiovascular system Blood was discussed in Ch. 11 Focus of Ch. 12: heart and blood vessels = the muscular pump of the CV system ~ 100,000 heartbeats/day!
More information