BY: DR FATIMA ZEHRA

© COPY RIGHT INTELLECTUAL PROPERTY

OF DR FATIMA ZEHRA, SENIOR LECTURER,
DEPARTMENT OF PHYSIOLOGY, BUMDC
 At the end of the lecture the students should
be able to:
 Describe the design and function of the
circulatory system and how it responds
during exercise
 Identify the effects of ANS on circulatory
system during exercise (regulation of CVS)
Respiratory & Circulatory System
act as a coupled unit

Respiratory System adds O2 &

removes CO2 from blood

Circulatory System delivers

oxygenated blood & nutrients to
tissues
It is a closed loop that circulates
blood to body tissues

Arteries & veins are continuous with

each other through smaller vessels

Blood travels away from heart

through arteries

Blood returns to heart through veins

Arteries branch into microscopic
vessels called arterioles

Arterioles open into beds of

smaller vessels called capillaries

Blood passes from capillaries to

venous vessels called venules
Heart is divided into 4
chambers & 2 pumps

Right atrium & right

ventricle form right pump

Left atrium & left

ventricle form left pump
Heart contains 4 one-way valves

Right & left AV valves connect

atria with right & left ventricles

Right & left Semi-lunar valves

prevent backflow of blood from
arteries into ventricles
Tricuspid valve (Right AV Valve)
and Bicuspid valve (Left AV
Valve)

Pulmonary Semilunar valve

(Right Ventricle) and Aortic
Semilunar valve (Left Ventricle)
Deoxygenated blood is pumped to right
heart from lungs

This is called pulmonary circuit and

delivers blood to pulmonary circulation

Oxygenated blood travels from left

heart to body tissues

This is called systemic circuit & delivers

blood to systemic circulation
An outer layer called
epicardium

A muscular layer
called myocardium

An inner layer called

endocardium
Myocardium receives blood supply
from right & left coronary arteries

Coronary veins run alongside

arteries

Coronary veins drain into coronary

sinus
HEART
ATTACK
When coronary blood flow is disrupted
or blocked for several minutes

Permanent damage to the heart occurs

Death of cardiac muscle cells occurs

This is called heart attack or MI

A mild heart attack damages a small

portion, while major destroys a large
number
SR. CARDIAC MUSCLE SKELETAL MUSCLE
NO.
1. Involuntary Voluntary
2. Muscle fibers shorter Muscle fibers longer
3. Connected in a tight series Not connected in a tight series
4. Muscle fibers interconnected Muscle fibers not
by intercalated discs interconnected by intercalated
discs
5. Acts as a functional Does not act as a functional
syncitium and heart fibers syncitium
contract as a unit
6. Muscle fibers aerobic with Aerobic & anaerobic
large number of
mitochondria
It refers to the repeating pattern of
contraction & relaxation of heart

The contraction phase is called

systole

The relaxation phase is called diastole

Atrial contraction occurs during

ventricular diastole

Atrial relaxation occurs during

ventricular systole
Total duration of cardiac cycle lasts
0.8 seconds

Diastole lasts 0.5 seconds

Systole lasts 0.3 seconds

If the H/R increases, a reduction in

systole & diastole occurs

Reduction in diastole is more than

systole
During diastole 70% of blood flows into
ventricles, without atrial contraction

During atrial contraction, 30% of atrial

blood passes into ventricles

The ventricles contract increasing the

pressure, causing AV Valve closure

When ventricular pressure exceeds

pressure of aorta and pulmonary artery

This causes opening of semilunar valves

First heart sound is produced by
closure of AV Valves

Second heart sound is produced

by closure of Semilunar Valves
Blood exerts pressure
greatest in arteries

Normal blood pressure is

120/80 mmHg

The larger number is systolic

blood pressure

The smaller number is

diastolic blood pressure
The difference between systolic &
diastolic BP is called pulse pressure

Average pressure during cardiac cycle

is called mean arterial pressure

This determines the rate of blood

through systemic circulation

Time spent in systole is 33% of cardiac

cycle during rest

During maximal exercise, systole

accounts for 66% of cardiac cycle time
These are: CO & TPR

CO is the amount of blood

pumped from the heart

TPR is the sum of resistance to

blood flow by all systemic vessels

MAP= CO × TPR
Short term by Sympathetic
Nervous System and Baroreceptors

Long term through renal regulation

RAAS and ADH

BP above 140/90 is
considered as HTN

There are 2 types: Primary &

Secondary

In Primary HTN, cause is

unknown

In Secondary HTN, cause is

2ndry to another disease
SA node serves as pacemaker of heart

SA node fires wave of depolarization

in atria

This causes atrial contraction

AV node connects atria with ventricles

through right & left bundle branches

These branch into purkinje fibers

A recording of electrical changes that
occur in myocardium during cardiac cycle

Analysis of ECG during exercise is

diagnostic of CAD

P wave represents depolarization of atria

QRS represents depolarization of

ventricles

T wave represents ventricular

repolarization
QRS complex occurs at
beginning of systole

T wave occurs at
beginning of diastole
CO is the product of H/R &
Stroke Volume

Stroke Volume is the amount of

blood pumped per heartbeat

During exercise there is an

increase in CO
This is by Sympathetic &
Parasympathetic

Sympathetic stimulates SA & AV Node

by cardiac accelerator nerves

This increases H/R and force of

myocardial contraction

Parasympathetic inhibits SA & AV node

by vagus nerve

This decreases H/R and force of

myocardial contraction
Balance between parasympathetic
& sympathetic is maintained

By Cardiovascular Control Center

in medulla oblongata

Increase in body temperature

results in increase in heart rate

Decrease in body temperature

results in lowering of heart rate
It is regulated by EDV in
ventricles at end of diastole

Average aortic blood

pressure

Strength of ventricular
contraction
Venoconstriction-
Constriction of veins

Muscle pump-Pumping
action of skeletal muscles

Respiratory pump-Pumping
action of respiratory system
Metabolic need for oxygen in
skeletal muscle increases

This is achieved by increased CO

A redistribution of blood flow from

inactive organs to skeletal muscle
Increased CO through SV & H/R

In an untrained or moderately trained

individual

SV remains at a workload of 40% to

50% vO2 maximum

At greater workload, increase in CO

achieved by rise in H/R

CO decreases after 30 years of age

vO2 represents amount of O2 taken
from 100ml of blood

By tissues during one trip around

systemic circuit

Increase in vO2 is due to increase in

O2 taken up

This is used for oxidative production

of ATP by skeletal muscle
Increased O2 demand by skeletal
muscles

This leads to decreased blood flow to

inactive organs

These are liver, kidneys & GIT

At rest 15% to 20% of CO is directed

towards skeletal muscle

During maximal exercise this

increases between 80 to 85% of CO
Blood supply to brain is decreased

Absolute blood flow to brain is

increased

Total CO that reaches myocardium

is the same as that during rest

Total coronary blood flow is

increased
There is vasoconstriction due to
sympathetic stimulation

There is low blood flow to muscles at

rest

There is an initial skeletal muscle

vasodilation during exercise

This is due to intrinsic metabolic

control

This blood flow is called

autoregulation
Blood delivery to contracting skeletal
muscles increases 15 to 20 times

Arteriole vasodilation is combined with

recruitment of capillaries

During a low intensity exercise a small

number of motor units are recruited

During a high intensity exercise a large

number of motor units are recruited
H/R & BP at O2 intake are
higher during arm work

They are comparatively lower

in leg work

Exercise in hot, humid weather

results in higher heart rates

Cool environment leads to

lower heart rates
Emotionally charged atmosphere
results in higher H/R & BP

In comparison with psychologically

neutral environment
In the beginning, there is a rapid
increase in H/R, SV & CO

If work rate is constant, steady state

rise in H/R, SV & CO is reached
Recovery from short term,
low intensity exercise is rapid

H/R, SV & CO all decrease

rapidly

Recovery from long term

exercise is slower
Increase in CO during incremental
exercise

This is achieved through decrease

in vascular resistance to flow

Increase in mean arterial BP

Increase in exercise intensity,
increases H/R & systolic BP

This increases workload on heart by

500% over rest

Increased metabolic demand on heart

during exercise is estimated by DP

Double product=H/R × Systolic BP

H/R & BP are higher during arm
work as compared to leg work

This is because of greater flow

rate to heart during arm work

Isometric exercise increases

H/R (muscle length same)

Increase in BP is due to a
vasoconstriction in BP
CHRONOTROPIC
•Change in H/R in SA Node

DROMOTROPIC
•Change in conduction
velocity in AV Node
Negative Chronotropic
•Decreased H/R, SA Node
firing
Positive Chronotropic
•Increased H/R, SA Node
firing
Negative Dromotropic
• Decreased conduction velocity in
AV Node and AP from atria to
ventricles, increased PR Interval
Positive Dromotropic
• Increased conduction velocity in
AV Node and AP from atria to
ventricles, decreased PR Interval
Positive Chronotropic
• Increased H/R, rate of Phase-4
Depolarization, Na+ influx (slow
depolarization)
Positive Dromotropic
• Increased conduction velocity in AV
Node and AP from atria to ventricles,
decreased PR Interval, Ca++ influx
(inward current)
Negative Chronotropic
• Decreased H/R, rate of Phase 4
Depolarization, AP and inward Na+
current
Negative Dromotropic
• Decreased conduction velocity in AV
Node, increased PR Interval,
decreased Ca++ inward, increased K+
outward
1. Heart rate Increases Increased Sympathetic activity

2. Venous Return Increases Sympathetic induced venous

venoconstriction

3. Stroke Volume Increases Increased Venous Return

4. Cardiac Output Increases Increased Heart Rate and Stroke

Volume
5. Blood flow to active skeletal Increases Local arteriolar vasodilation
muscles and heart muscle
6. Blood flow to the brain Unchanged Constant cerebral blood flow

7. Blood flow to the skin Increases Hypothalamus induced vasodilation of

skin arterioles

8. Blood flow to the Digestive System, Decreases Sympathetic arteriolar

kidneys and other organs vasoconstriction

9. Total Peripheral Resistance Decreases Resistance in skeletal muscles

decreases
10. Mean Arterial Blood Pressure Increases (modest) Increased Cardiac Output
 Exercise Physiology by Scott K Powers