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Cardiovascular Physiology Conc

Cardiovascular Physiology Conc

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1
Introduction to the CardiovascularSystem
LEARNING OBJECTIVESUnderstanding the concepts presented in this chapter will enable the student to:1.Explain why large organisms require a circulatory system, while single-cell and small multi-cellular organisms do not.2.Describe the series and parallel arrangement of the cardiac chambers, pulmonary circula-tion, and major organs of the systemic circulation.3.Describe the pathways for the flow of blood through the heart chambers and large vesselsassociated with the heart.4.Describe, in general terms, the primary functions of the heart and vasculature.5.Explain how the autonomic nerves and kidneys serve as a negative feedback system forthe control of arterial blood pressure.
1
 
THE NEED FOR A CIRCULATORYSYSTEM
All living cells require metabolic substrates(e.g., oxygen, amino acids, glucose) and amechanism by which they can remove by-products of metabolism (e.g., carbon dioxide,lactic acid). Single-cell organisms exchangethese substances directly with their environ-ment through diffusion and cellular transportsystems. In contrast, most cells of large organ-isms have limited or no exchange capacity  with their environment because their cells arenot in contact with the outside environment.Nevertheless, exchange with the outside envi-ronment must occur for the cells to function.To accomplish this necessary exchange, largeorganisms have a sophisticated system of blood vessels that transports metabolic sub-stances between cells and blood, and betweenblood and environment. The smallest of theseblood vessels, capillaries, are in close proxim-ity to all cells in the body, thereby permittingexchange to occur. For example, each cell inskeletal muscle is surrounded by two or morecapillaries. This arrangement of capillariesaround cells ensures that exchange can occurbetween blood and surrounding cells.Exchange between blood and the outsideenvironment occurs in several different or-gans: lungs, gastrointestinal tract, kidneys andskin. As blood passes through the lungs, oxy-gen and carbon dioxide are exchanged be-tween the blood in the pulmonary capillariesand the gases found within the lung alveoli.Oxygen-enriched blood is then transported tothe organs where the oxygen diffuses from theblood into the surrounding cells. At the sametime, carbon dioxide, a metabolic waste prod-uct, diffuses from the tissue cells into theblood and is transported to the lungs, whereexchange occurs between blood and alveolargases.Blood passing through the intestine picksup glucose, amino acids, fatty acids, and otheringested substances that have been trans-ported from the intestinal lumen into theblood in the intestinal wall by the cells liningthe intestine. The blood then delivers thesesubstances to organs such as the liver for ad-ditional metabolic processing and to cellsthroughout the body as an energy source.Some of the waste products of these cells aretaken up by the blood and transported toother organs for metabolic processing and fi-nal elimination through either the gastroin-testinal tract or the kidneys.Cells require a proper balance of water andelectrolytes (e.g., sodium, potassium, and cal-cium) to function. The circulation transportsingested water and electrolytes from the in-testine to cells throughout the body, includingthose of the kidneys, where excessive amountsof water and electrolytes can be eliminated inthe urine.The skin also serves as a site for exchangeof water and electrolytes (through sweating),and for exchange of heat, which is a major by-product of cellular metabolism that must beremoved from the body. Increasing blood flowthrough the skin enhances heat loss from thebody, while decreasing blood flow diminishesheat loss.In summary, the ultimate purpose for thecardiovascular system is to facilitate exchangeof gases, fluid, electrolytes, large moleculesand heat between cells and the outside envi-ronment. The heart and vasculature ensurethat adequate blood flow is delivered to or-gans so that this exchange can take place.
THE ARRANGEMENT OF THECARDIOVASCULAR SYSTEM
The cardiovascular system has two primary components: the heart and blood vessels. Athird component, the lymphatic system, doesnot contain blood, but nonetheless serves animportant exchange function in conjunction with blood vessels.The heart can be viewed functionally as twopumps with the pulmonary and systemic circu-lations situated between the two pumps (Fig.1-1). The
pulmonary circulation
is the bloodflow within the lungs that is involved in the ex-change of gases between the blood and alveoli.The
systemic circulation
is comprised of allthe blood vessels within and outside of organsexcluding the lungs. The right side of the heartcomprises the right atrium and the right ventri-cle. The
right atrium
receives venous bloodfrom the systemic circulation and the
right
2
CHAPTER 1
 
ventricle
pumps it into the pulmonary circula-tion where oxygen and carbon dioxide are ex-changed between the blood and alveolar gases.The left side of the heart comprises the leftatrium and the left ventricle. The blood leavingthe lungs enters the
left atrium
by way of thepulmonary veins. Blood then flows from theleft atrium into the left ventricle. The
left ven-tricle
ejects the blood into the
aorta,
 whichthen distributes the blood to all the organs viathe arterial system. Within the organs, the vas-culature branches into smaller and smaller ves-sels, eventually forming capillaries, which arethe primary site of exchange. Blood flow fromthe capillaries enters veins, which return bloodflow to the right atrium via large systemic veins(the superior and inferior vena cava).As blood flows through organs, some of thefluid, along with electrolytes and smallamounts of protein, leaves the circulation andenters the tissue interstitium (a processtermed fluid filtration). The
lymphatic ves-sels,
 which are closely associated with smallblood vessels within the tissue, collect the ex-cess fluid that filters from the vasculature andtransport it back into the venous circulation by  way of lymphatic ducts that empty into large veins (subclavian veins) above the right atrium.It is important to note the overall arrange-ment of the cardiovascular system. First, theright and left sides of the heart, which are sep-arated by the pulmonary and systemic circula-tions, are
in series
 with each other (see Fig.1-1). Therefore, all of the blood that is pumpedfrom the right ventricle enters into the pul-monary circulation and then into the left side of the heart from where it is pumped into the sys-temic circulation before returning to the heart.This in-series relationship of the two sides of the heart and the pulmonary and systemic cir-culations requires that the output (volume of blood ejected per unit time) of each side of theheart closely matches the output of the other sothat there are no major blood volume shifts be-tween the pulmonary and systemic circulations.Second, most of the major organ systems of thebody receive their blood from the aorta, andthe blood leaving these organs enters into the venous system (superior and inferior vena cava)that returns the blood to the heart. Therefore,the circulations of most major organ systemsare
in parallel
as shown in Figure 1-2. Onemajor exception is the liver, which receives alarge fraction of its blood supply from the ve-nous circulation of the intestinal tract thatdrains into the hepatic portal system to supply the liver. The liver also receives blood from theaorta via the hepatic artery. Therefore, most of the liver circulation is in series with the intesti-nal circulation, while some of the liver circula-tion is in parallel with the intestinal circulation.This parallel arrangement has significanthemodynamic implications as described inChapter 5. Briefly,
 the parallel arrangement of 
INTRODUCTION TO THE CARDIOVASCULAR SYSTEM
3
RALARVLVAoPAPulmonaryCirculationSystemic Circulation
FIGURE 1-1
Overview of the cardiovascular system. The right side of the heart, pulmonary circulation, left side of theheart, and systemic circulation are arranged in series.
RA,
right atrium;
RV,
right ventricle;
PA,
pulmonary artery;
 Ao,
aorta;
LA,
left atrium;
LV,
left ventricle.

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