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cardiovascularPhysiology

cardiovascularPhysiology

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Published by: Danielle on Feb 20, 2011
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01/31/2013

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THE CIRCUITRY
two pumps in series, one servicing the pulmonary circulation, the other the systemicunidirectional flow is achieved by four flap valves,a.tricuspid / pulmonaryb.mitral / aorticalthough the cardiac output is
 pulsatile
, the peripheral blood flow is continuous due to thecompliance and elastic recoil of the major arterial vesselsblood flows rapidly through the aorta (~ 50 cm/sec) and its arterial brancheslater branches become thinner and their walls contains less elastic and more smooth muscle, untilthe level of the
 arterioles
, where the muscular layer predominatesthe pressure drop from the aortic root to the arterioles is small and flow velocity remains highthe arterioles are the major resistance vessels of the arterial circuit, there being a large drop inpressure from arterioles to capillaries and a proportionate drop in flow rateflow becomes less pulsatile and more continuous, proportional to the inductance of the circuitthese characteristics of the arterioles allow control of distribution of blood flow and totalresistance of the vascular treemany capillaries arise from any given arteriole, with enormous increase in area and drop in
 resistance
 
very slow rate of flow allowing conditions for diffusion of exchangeable substancesmoving from capillaries to larger veins, area again decreases and flow velocity increasesdistribution of circulating blood volume,a.arterial bed~ 11%b.capillary bed~ 5%c.venous bed~ 67%d.pulmonary bed~ 12%e.heart~ 5%in contrast to the systemic circulation, blood in the pulmonary circulation is more equallydistributedmean pressure of the pulmonary circulation ~ 1/7
th
of systemicmean PA pressure
~ 15 mmHg
(25/8 mmHg), therefore is
 more
pulsatile than that of thesystemic circulation, with a S:D ratio of 3:1 vs. 3:2vessel walls are much thinner, with less muscle than the systemic (~ 30%)required to accept the entire CO at any given moment and not concerned with diverting bloodflow, except in
 hypoxia
PA pressure consistent with lifting blood to the apex only, thereby reducing
 RV work
resistance drop around pulmonary circuit relatively constant, c.f. the step-wise reduction in thesystemicpulmonary capillary pressures are
 hydrostatically dependent
pericapillary pressure closely approximates alveolar pressure but may be slightly less(Nunn: P ~ Atm-10 mmHg)
Cardiovascular Physiology
 
Blood Vessel Proportions
DiameterThicknessArea X/SBlood Vol.Aorta25mm2mm4.5cm
2
2 %Artery4mm1mm20cm
2
8 %Arteriole3m2m400cm
2
1 %Capillary5-7µm1µm4500cm
2
5 %Venule20µm2µm4000cm
2
54 %Vein5mm0.5mm40cm
2
Vena Cavae30mm1.5mm18cm
2
ELECTRICAL ACTIVITY
OF THE
HEARTTransmembrane Potentials
Phases of the Myocardial Action PotentialPhase 4resting potential of myocyte interior-90mVPhase 0rapid depolarisation+20mVPhase 1rapid repolarisation0 to +10mVPhase 2plateau0 to +10mVPhase 3repolarisation-95 to 90mV
 phase 0
precedes the development of fiber tensioncompletion of 
 repolarisation
coincides approximately with
 peak tension
, and the duration of contraction tends to parallel the duration of the APas the frequency of contraction increases, the duration of the AP and fiber contraction decreasetwo main types of AP are observed in the mammalian heart,1.fast responses- seen in myocardial fibers & Purkinje fibers2.slow responses- seen in the sinoatrial & atrioventricular nodes 
 fast responses
may be converted to slow responses either spontaneously, or in certainpathological conditionsa gradual shift of the resting membrane potential (V
m
) from its normal level to -60 mV willproduce
 slow responses
in (a) fibers abovethe amplitude and rate of rise (
δ
V/ 
δ
t
) of the AP are the major determinants of the
velocity
of propagation
Cardiovascular Physiology
2
 
Ionic Basis of the Resting PotentialV
m
Ion
ECF [mmol]ICF [mmol]
1
E
m
Na
+
14510
+ 70K
+
4135
- 94Ca
++
210
-4
+ 132
1
ICF concentrations are estimated
 free cytosolic
, not total intracellular
resting membrane is relatively permeable to K
+
, but not Ca
++
and Na
+
as a result there is net diffusion of K
+
from the cell along its
 chemical 
concentration gradientas K
+
diffuses from the cell protein anion A
-
remains behind causing the interior to become (-)'vethe two resulting
 forces
determining diffusion of K
+
are,1.chemical energyln[K
+
]
i
- ln[K
+
]
o
2.electrical energyE
m
.(zF/RT)
 NB:
at
equilibrium
these opposing energies must be
equal 
,therefore by rearrangement, viz.which for
 potassium
reduces to,
The Nernst Equation
where E
K
is the potassium equilibrium potentialthe measured value for E
K
(-90 to -100 mV) is close to, but slightly
 more negative
than the trueV
m
of myocardial cellstherefore, there is a net driving force for diffusion of potassium out of the cellthe driving forces for Na
+
are quite differentE
Na
~ 40 to 70 mV and the extracellular concentration is much higher, therefore
 both
electricaland chemical gradients provide a driving force for
entry
of Na
+
into the celllittle Na
+
enters due to the low resting permeability to sodium, however this ion flux is the mainreason the V
m
is more (+)'ve than E
K
this steady inward current (i
Na
) would result in depolarisation of the cell except for the activity of the membrane bound Na-K-ATP'ase pump which
 maintains
the above concentration gradients 
electrogenic pump
 E 
m
=
 RT  zF 
ln
[
+
]
i
[
+
]
o
 E 
= −
61.5log
[
+
]
i
[
+
]
o
Cardiovascular Physiology
3

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