Cardiovascular System

Duarte Ferreira, PhD

Karolinska Institutet, Department of Physiology and Pharmacology

29th October 2019

[email protected] Blood

Tortora GJ, Principles of Anatomy and Physiology Plasma

Plasma • Mainly water

+ - • Bicarbonate pH buffer (H HCO3 )

• Plasma proteins

• Albumin

• Immunoproteins

• Antibodies

• Glucose

• Lipids Erythrocytes (Red blood cells)

Tortora GJ, Principles of Anatomy and Physiology

Tortora GJ, Principles of Anatomy and Physiology Leukocytes (white blood cells)

Tortora GJ, Principles of Anatomy and Physiology Leukocytes

Tortora GJ, Principles of Anatomy and Physiology Platelets or Thrombocyte

Wilmore, et al. Physiology of Sport and Exercise. Different blood groups

Tortora GJ, Principles of Anatomy and Physiology Different blood groups

Tortora GJ, Principles of Anatomy and Physiology Position of the heart

Tortora GJ, Principles of Anatomy and Physiology Blood flow through the heart

Tortora GJ, Principles of Anatomy and Physiology Cardiac muscle

Tortora GJ, Principles of Anatomy and Physiology Cardiac muscle

Tortora GJ, Principles of Anatomy and Physiology Action potential The electrical system of the heart

Tortora GJ, Principles of Anatomy and Physiology Pacemaker cells

Tortora GJ, Principles of Anatomy and Physiology Aktionspotential av myocyter

Tortora GJ, Principles of Anatomy and Physiology Action potential of myocytes

Tortora GJ, Principles of Anatomy and Physiology Electrocardiogram (ECG)

Tortora GJ, Principles of Anatomy and Physiology Electrocardiogram (ECG)

Tortora GJ, Principles of Anatomy and Physiology Electrocardiogram (ECG)

Tortora GJ, Principles of Anatomy and Physiology Electrocardiogram (ECG)

Tortora GJ, Principles of Anatomy and Physiology

Tortora GJ, Principles of Anatomy and Physiology Cardiac output

Cardiac output = × volume

Volume/min = Beat/min × Volume/beat

Cardiac output (CO) à The flow of blood delivered by the heart, or the total mean flow in the circulation.

Stroke volume (SV) à The output during a single heartbeat, from either the left or the right

Heart rate (HR) à The speed of the heartbeat measured by the number of contractions of the heart per minute. (Chronotropy) Cardiac output

Cardiac output = Heart rate ×

Martini & Nath. Fundamentals of Anatomy and Physiology. Pearson, 2009. and

Preload: ~ End Diastolic Volume ~ the volume of blood being returned to the right side (atrium) of the heart from the systemic circulation, before the beginning of a new contraction.

Stretch/Contraction of the cardiac muscle.

Afterload: ~ End Systolic Volume ~ the volume of blood in a ventricle at the end of contraction, or , and the beginning of filling, or

Squeeze/Resistance the left ventricle has to overcome to eject the blood. The Frank-Starling Law

“The mechanical energy set free on passage from the resting to the contracted state depends on the area of ‘chemically active surfaces,’ i.e., on the length of the fibres.” Therefore, the initial length of myocardial fibers determines the work done during the .

Boron & Boulpaep. Medical Physiology. Elsevier, 2016. The Frank-Starling Law

Boron & Boulpaep. Medical Physiology. Elsevier, 2016. Nervous system control of the heart

Boron & Boulpaep. Medical Physiology. Elsevier, 2016. Nervous system control of the heart

Boron & Boulpaep. Medical Physiology. Elsevier, 2016. PERIPHERAL CIRCULATION Blood circulation

Tortora GJ, Principles of Anatomy and Physiology Blood vessels

Tortora GJ, Principles of Anatomy and Physiology Blood vessels

Tortora GJ, Principles of Anatomy and Physiology Blood vessels

Tortora GJ, Principles of Anatomy and Physiology Pressure and flow in the peripheral circulation Mechanism promoting venous return

Tortora GJ, Principles of Anatomy and Physiology Factors that affect

Tortora GJ, Principles of Anatomy and Physiology Different measurement for blood pressure

Tortora GJ, Principles of Anatomy and Physiology Increased

Tortora GJ, Principles of Anatomy and Physiology Regulation of blood pressure

Tortora GJ, Principles of Anatomy and Physiology Capillary fluid exchange

Hydrostatic pressure gradient

Colloidosmotic pressure gradient Capillary fluid exchange

Pc pc

Pi pi

Hydrostatic pressure in the capillary, Pc

Hydrostatic pressure in the interstitium, Pi

Colloidosmotic pressure in the capillary, pc

Colloidosmotic pressure in the interstitium, pi

V = CFC * [(Pc – Pi) – (pc - pi)] Capillary solute exchange

Continuous Fenestrated Discontinuous heart bone marrow sk.muscle intestinal mucosa liver sinusoids connective tissue adipose tissue BLOOD PRESSURE REGULATION Local control of the blood flow

Wilmore, Costill & Kenney. Physiology of Sport and Exercise, Human Kinetics. Endotelial regulation of blood flow Central blood pressure regulation

Tortora GJ, Principles of Anatomy and Physiology

Boron & Boulpaep. Medical Physiology. Elsevier, 2016. Baroreceptors

Boron & Boulpaep. Medical Physiology. Elsevier, 2016. Renin--aldosteron system (RAAS) Mandatory lab Tuesday 12/11!!

Cardiovascular and Respiratory Systems Go to www.menti.com and use the room code 97 49 27

97 49 27

97 49 27