CARDIOLOGY ❣
introduction
key function
anatomy 
circulation and oxygenation
cardiac output
fick principle
cardiac myocytes 
pericardium
conduction system 
chamber
heart valves
coronary circulation
blood vessels
transport
control system
body temperature regulation
reproduction
hydraulic mechanism
genital erection
semilunar valve
ECG
pumping chamber
right venticle
left ventricle
contractile reservoir
right atrium
left atrium
pulmonary circulation
arteries
veins
arterial pressure
blood volume
blood flow
systemic circulation
arteries
veins
arterial pressure
blood volume
blood flow
oxygenated TO heart
deoxygenated FROM heart
5-6 L/min
5-6L/ min
deoxygenated TO heart
oxygenated FROM heart
10% of total blood flow
high
low
90% of total blood
systemic blood flow = pulmonary blood flow
CO = HR * SV (stroked volume)
definition
Ca O2
Cv O2
V O2 (ml O2/min)
fick equation
V O2= CO (Ca O2 - Cv O2)
= concentration of venous O2
100 ml O2/min
= concentration of arterial O2
200 ml O2/ L blood
rate of O2 uptake from lung capillaries
250 ml O2/ L blood
nucleas
fiber
carcolmma
sarcomere
fibrile
capillary
intercalated disk
increase pressure in RV
pumps blood into pulmonary artery
pulmonary circulation arterial pressure mean 9-18
increase pressure in the left ventricle #
pumps blood into the aorta
systemic circulation arterial pressure (BP, mean 70-100)
adipose tissue
outer fibrous layer
outer parietal layer
pericardial cavity filled with pericardial fluid
epicardium
inner visceral layer
anatomy
sinoatrial node/ sinus node/ SA node
atrioventricular node (AV node)
his-purkinjie system
his bundle
right bundle branch
left bundle branch
purkinjie fibers
process
electrical activation of the heart
generate electrical force across the heart
can be measured at surface of the body
P wave
atrial depolarization
QRS complex
ventricular depolarization
T wave
ventricular repolarization
location
function
right heart
left heart
atrioventricular valves
location
function
right heart
left heart
mitral valve
tricuspid valve
separate ventricle and atrium
prevent blood back flowing from ventricle -> atrium
aorta
pulmonic artery
separate ventricle and great artery
prevent back flow from artery -> ventricle
opening or closing
open pressure A > pressure B
close pressure A < pressure B
heart sound
basic
vein
pulmonary system: oxygenated blood
systemic circulation: deoxygenated blood
artery
systemic circulation: oxygenated blood
vibration of valve leaflets and blood when valve closing
LUB S1
closing of AV valve
DUB S2
close of semilunar valve
ABNORMALITIES
valvular stenosis
valvular regurgitation/ valvular insufficiency/ incompetence
valve not opening fully
heart develops high pressure in proximal valve
mitral stenosis
tricuspid stenosis
aortic stenosis
pulmonic stenosis
valve not closing fully
blood leaks backward
pulmonic regurgitation
aortic regurgitation
mitral regurgitation
tricuspid regurgitation
structure
left coronary artery
left anterior descending coronary artery (anteriod interventricular artery)
right coronary artery
coronary artery disease
aortic sinus
collect 90% of blood from coronary veins
O2 concentration is much lower than in veins from other organs
most common type of cardiovascular disease
artherosclerosis
coronary arteries become
build up of lipid plaques
hardened
narrowed
impaired blood flow
angina pectoris
myocardial infarction/ heart attack
chest pain
due to transient O2 supply-demand imbalance
tissue necrosis
due to severe impairment O2 supply
pulmonary system: deoxygenated blood
windkessel effect
aorta
muscular conduit artery
arteriole *
blood
RBC erythrocyte
WBC leukocyte
platelet
blood clotting
hemoglobin
increase O2-carrying capacity in arterial blood
component of immune system
defend body against
infection
foreign material
neutrophils
esinophils
basophils
lymphocytes
monocytes
most concentrated
least concentrated
wall layers
tunica intima
tunica media
tunica adventitia
sheet of epithelial cells
underlying connective tissue
exception: capillaries only have an intima
layer of smooth muscle cells
sheath of connective tissue
tethers vessel to surrounding tissue
capillary *
vascular ressistance
general resistance equation
continuity equation
venule*
vein #
vena cava
elastic fiber
stretch
when blood is pumped into aorta
allow aorta to accommodate stroke volume
recoil
when aortic valve close
keep arterial pressure high enough to push blood to organs
deliver to organ
ex: coronary artery
regulation BP
control distribution of cardiac output to different organs
response to smooth muscle constriction/ relaxation
pressure = QR
delta P= pressure gradient
Q blood flow
R vascular resistance
can be applied to pulmonary/ systemic circulation
O2 and nutrients exchanged for CO2 and other metabolic waste product
small molecules
flow = velocity * cross sectional area
Q = v * A
large capacitance
majority of blood volume in supine person at rest
contraction/relaxation of SM in media = change storage capacity
adjustable reservoirs for blood
determine volume of blood in a vessel with a given vascular pressure
compliance
determine change in volume produced by a change in vascular pressure
PERIPHERAL microcirculation
ARTERIES
small arteries
arterioles
capillaries
venules and veins
capacitance vessels
large capacity
important in regulating blood return to heart
contraction/relaxation of SM
change in capacitance
exchange vessels
O2
solute exchange
metabolic waste CO2
intima layer
diffusion of gas, solute
resistance vessel
regulation of blood pressure
control distribution of CO
prominent media
contraction/relaxation of SM
change in vascular resistance
conduit or feed vessel
deliver blood to organ
large arteries
elastic artery
stretch when blood pumped into aorta
recoil when aortic valve closed
maintain pressure for perfusion of organs
accommodate preload
DETERMINANTS OF PULSE PRESSURE
stroke volume
common cause of acute changes in PP
exercise
arterial compliance
chronic change in PP
increase age = increase PP
inotropic state
drug-induced
⬆ IS = faster ejection = ⬆ PP
direct effect on beta 1 receptor
main site of resistance
systemic SVR
organ VR
⬆ arteriole resistance = ⬆ blood pressure = ⬇ hydraulic pressure
change in cross-sectional profile
high compliance over normal range of venous pressure
high capacitance function
- 60-70% of blood volume at rest
gravity
transfer of blood volume to veins in lower body
orthostatic hypotension
regulate CO
increase sympathetic tone = increase venous return
#
pump
SKM pump = increase venous return
response in exercise
respiration pump
= increase venous return during inspiration
decrease venous return during expiration
modulation of Frank-Starling equation
hemorrhage
severe dehydration
posture = supine -> upright
neural tone
muscle compression
respiration
concentration gradient ---> passive diffusion across capillary wall
Fick stuffs
law of diffusion
lipophilic solute
lipophobic solutes
small pore
large pore
entire capillary surface
Js = PS*deltaC
principle
quantifies total solute exchange
Vs = Q * ( Cas - Cvs)
small lipophobic solute
large lipophobic
increase Q = increase exchange
increase Q = no increase in exchnage
fluid exchange
ultrafiltration
filtration pressure gradient ----> passive
ultrafiltration across capillary wall
starling equation
Jv - Lp S (( Pc - Pi ) - sigma (pi o - pi i))
net filtration
occur in well-perfused capillaries
filtration fraction < 0.1%
higher in glomerular capillaries in kidney
lymphatics: filtered fluid enter here and returned to circulation
convective transport of solutes
slower than diffusion for most solute (except protein)
important in glomerular capillaries
lymphatics
function
preservation of fluid balance
defense function
nutritional function
typical return = 4 L of fluid/day to circulation
structure
initial lymphatics
ICC orientation
couple lymph flow to Jv
collecting lymphatics
wall contain SM
pumping mechanism
extrinsic propulsion
tissue movement push lymph from initial - collective lymphatics
intrinsic propulsion
SM contraction pushes lymph from collecting lymphatics - veins
major sources of lymph
liver
GI after meal
SKM during exercise
PERIPHERAL CIRCULATION control
vascular control
regulation of vascular resistance
contraction/ relaxation of SM
regulation of venous capacitance
contraction/relaxation of SM
organ Q = BP / organ VR
determinant of venous return
preload
cardiac output
determinant
CO
click to edit