powerpoint: part 2
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The HeartPart 2
Circulatory System:
Cardiac Cycle
• One complete contraction and relaxation of all 4 chambers of the heart
• Atrial systole, Ventricle diastole
• Atrial diastole, Ventricle systole
• Quiescent period
• Resistance opposes flow– great vessels have
positive blood pressure– ventricular pressure must
rise above this resistance for blood to flow into great vessels
Principles of Pressure and Flow
• Pressure causes a fluid to flow – ____________________________ - pressure difference
between two points
Heart Sounds
• ____________________ - listening to sounds made by body
• First heart sound (S1), louder and longer “_______”, occurs with closure of _______ valves
• Second heart sound (S2), softer and sharper “_______” occurs with closure of __________________ valves
• S3 - rarely heard in people > 30
Phases of Cardiac Cycle• ________________ period– all chambers relaxed– AV valves open and blood
flowing into ventricles• _____________ systole– _____ node fires, depolarize– atria contract, force
additional blood into ventricles
– ventricles now contain ____-___________________ (____) of about 130 ml of blood
___________________ of Ventricles
• Atria repolarize and relax
• Ventricles depolarize
• Ventricles contract
• Rising pressure closes AV valves - ___________________
• No ejection of blood yet (no change in volume)
Ventricular Ejection
• Pressure opens ________________ valves
• Blood ejected
• Stroke volume: amount ejected, _____ ml at rest
• SV/EDV= ejection fraction, at rest ~ ____%, during vigorous exercise as high as ____%, diseased heart < ______%
• ___________________: amount left in heart
Ventricles- Isovolumetric Relaxation
Ventricles repolarize and relax (begin to expand)
• _______________ valves close (__________ notch of aortic press. curve) - heart sound S2 occurs
• AV valves remain closed
• Ventricles expand but do not fill (no change in volume)
Ventricular Filling - 3 phases
1. Rapid ventricular filling • AV valves first
open
2. ________________• sustained lower
pressure, venous return
3. ______________ • filling completed
Major Events of Cardiac Cycle• __________ period
• __________ filling
• Isovolumetric contraction
• _______________ ejection
• _______________ relaxation
Rate of Cardiac Cycle
• Atrial systole, 0.1 sec
• Ventricular systole, 0.3 sec
• Quiescent period, 0.4 sec
• Total 0.8 sec, heart rate 75 bpm
Ventricular Volume Changes at Rest
End-systolic volume (ESV) 60 ml
Passively added to ventricle during atrial diastole +30 ml
Added by atrial systole +40 ml
End-diastolic volume (EDV) 130 ml
Stroke volume (SV) ejected by ventricular systole -70 ml
End-systolic volume (ESV) 60 ml
Both ventricles must eject same amount of blood
________________ (CO)
• Amount ejected by ventricle in 1 minute• Cardiac Output = ____________ x
________________– ~ 4 to 6L/min at rest– _____________________ CO to 21 L/min for
fit person and up to 35 L/min for world class athlete
• ____________________: difference between a persons maximum and resting CO with fitness, with disease
Heart Rate• ___________ = surge of pressure in artery– infants have HR of 120+ bpm – young adult females avg. _______ bpm– young adult males avg. ________ bpm– HR rises in the elderly
• ____________: resting adult HR above 100– stress, anxiety, drugs, heart disease or body
temp.
• _____________: resting adult HR < 60– in sleep and endurance trained athletes
Chronotropic Effects
• ____________ chronotropic agents HR
• ____________ chronotropic agents HR
• ____________ of medulla oblongata– an autonomic control center with two
neuronal pools: a cardioacceleratory center (sympathetic), and a cardioinhibitory center (parasympathetic)
Chronotropic Chemicals• _______________• Neurotransmitters - cAMP 2nd messenger– catecholamines (NE and epinephrine) • ______________________
• _______________ – caffeine inhibits cAMP breakdown– nicotine stimulates catecholamine secretion
• _______________– TH adrenergic receptors in heart,
sensitivity to sympathetic stimulation, HR
• Electrolytes– _____ has greatest effect• hyperkalemia
– myocardium less excitable, HR slow and irregular
• ______________________– cells hyperpolarized, requires increased stimulation
– ___________• ______________________
– decreases HR
• hypocalcemia – ____________________
Chronotropic Chemicals
Sympathetic Nervous System
• _______________________- center– stimulates sympathetic nerves to SA node,
AV node and myocardium– nerves secrete _________________, binds to
-adrenergic receptors in the heart(positive chronotropic effect)
– CO peaks at HR of 160 to 180 bpm– Sympathetic n.s. can HR up to 230 bpm,
(limited by refractory period of SA node), but SV and CO (less filling time)
Parasympathetic Nervous System
• Cardioinhibitory center stimulates _________ nerves
• right vagus nerve - SA node• left vagus nerve - AV node
– secretes ACH which binds to receptors• nodal cells hyperpolarized, HR slows
– vagal tone: background firing rate holds HR to sinus rhythm of 70 to 80 bpm• severed vagus nerves (intrinsic rate-100bpm)• maximum vagal stimulation HR as low as 20 bpm
Inputs to Cardiac Center
• Higher brain centers affect HR– cerebral cortex, limbic system, hypothalamus • sensory or emotional stimuli (rollercoaster, IRS audit)
• ___________________ – inform cardiac center about changes in
activity, HR before metabolic demands arise
• ________________ signal cardiac center– aorta and internal carotid arteries • pressure , signal rate drops, cardiac center HR• if pressure , signal rate rises, cardiac center HR
Inputs to Cardiac Center
• ____________________________– sensitive to blood pH, CO2 and oxygen
– aortic arch, carotid arteries and medulla oblongata
– primarily respiratory control, may influence HR
CO2 (hypercapnia) causes H+ levels, may create acidosis (pH < 7.35)
– Hypercapnia and acidosis stimulates cardiac center to HR
Stroke Volume (SV)
• Governed by three factors:1. _________________
2. contractility
3. _________________
• Example preload or contractility causes SV afterload causes SV
Preload
• _________________________________________
________________________________________• ____ preload causes ___ force of contraction– exercise venous return, stretches
myocardium ( preload) , myocytes generate more tension during contraction, CO matches venous return
• ______________________________ - SV EDV– _____________________________________• _________ they are stretched ( preload) the
______ they contract
Contractility
• Contraction force for a given preload
• ______________ inotropic agents – factors that ____ contractility• hypercalcemia, catecholamines, glucagon, digitalis
• _____________ inotropic agents – factors that ____ contractility are• hyperkalemia, hypocalcemia
Afterload
• Pressure in arteries above semilunar valves opposes opening of valves
afterload SV– any impedance in arterial circulation _____
afterload
• Continuous in afterload (____________, atherosclerosis, etc.) ________________ of myocardium, may lead it to weaken and fail
Exercise and Cardiac Output
• Proprioceptors– HR ____ at beginning of exercise due to signals from
joints, muscles
• Venous return– muscular activity ____ venous return causes ______
SV
HR and SV cause CO• Exercise produces ventricular hypertrophy– _______ allows heart to beat more slowly at rest cardiac reserve
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