Greatest Hits Test 2 11 15 12 16 17 13 18 14 10/3 9/19 9/23 10/5 10/7 9/28 18 14 10/12 9/30 Selected slides to study for Test 2. The numbers on the slide are a guide to when we covered the material in lecture. If you print these out, please print them as handouts to conserve paper. (When you select print, select handouts. You can print up to 9 slides on a page). BIO 232 Fall 2016

The Heart as a Pump Stroke Volume Cardiac Output Cardiac Reserve 11

The Two Circulations 11 Volumes in R/L ventricles are equal Volumes in the two circulations are NOT 11

Stroke Volume End Diastolic Volume (EDV) End Systolic Volume (ESV) 11

Cardiac Output (CO) CO= HR x SV 11

Cardiac Reserve COMax - CORest = COReserve 11

Cardiac Reserve COMax - CORest = COReserve 11

Resting Heart Rate Decreases from Birth 140-160 ♂ 64-72 ♀ 72-80 11

11 Tachycardia (100 or more beats/min) Bradycardia (60 or less Miguel Indurain 11 A Bradycardia Sufferer

Heart Rate Control Parasympathetic (Vagal Tone) Sympathetic Adrenal 11

Changing Stroke Volume Increasing/Decreasing EDV Increasing/Decreasing ESV 11

Factors that Alter EDV and ESV Preload Contractility Afterload 11

Preload: Heart “Stretchiness” Affects EDV Cardiac muscle stretches as heart fills 11

Frank-Starling Law of the Heart The volume of blood ejected from a ventricle during systole (contraction) depends on the volume present in the ventricle at the end of diastole (relaxation) 11

Venous Return and Preload Blood returning to heart from veins Slow heart rate Exercise Very fast heart rate Blood Loss 11

Contractility increases SV Contractile strength at a given muscle length More Ca++ Less Ca++ 11

Afterload Decreases Stroke Volume Pressure in aorta decreases the amount of blood that can leave the left ventricle 120mmHg 80mmHg 120mmHg 100mmHg 11

Blood Vessel Layers Tunica intima Tunica media Tunica externa 12

Tunica intima Endothelium Subendothelium 12

Tunica media Largest layer Smooth Muscle Elastin 12

Smooth Muscle Non-Straited Involuntary 12

Tunica media Vasoconstriction Vasodilation Vasomotor nerve fibers 12

Tunica externa (Adventitia) Collagen fibers Nerve fibers Vasa vasarum 12

Arterial System 12 Elastic (Conducting) 1cm-2.5cm Muscular (Distributing) 0.3mm-1cm Arterioles 10um- 0.3mm Diameters for lumens 12

Elastic (Conducting) Arteries Fire Hose Very elastic Conduct blood with little resistance 12

Compliance/Distensibility Pressure waves Decreases pressure in smaller vessels 12

Muscular (Distributing) Arteries Carry blood to organs Smallest named arteries Less elastin, more smooth muscle 12

Arterioles Largest 3 layers Smallest 2 layers Change diameter 13

Capillaries Smallest vessel Tunica intima 13

Continuous Capillaries Endothelial cells Tight junctions Blood Brain Barrier 13

Fenestrated Capillaries Pores More material in and out of blood SI Kidney Endocrine glands 13

Sinusoidal Capillaries Very large fenestrated pores Big intercellular clefts Liver Bone marrow 13

Capillary Beds: Closed Terminal Arterioles Metarterioles + Thoroughfare channel Vascular Shunt Postcapillary venule 13

Capillary Beds: Open 13 Precapillary sphincters OPEN due to LOCAL FACTORS True capillaries 13

Venous System Venules Veins Superior Vena Cava Inferior Vena Cava 13

Systemic Venous System Large Lumen Thin walls Less smooth muscle Less elastin Holds ~65% of blood 13

Venous Valves 13

Venous Blood Pressure 13 No pulse Very low pressure Blood is pushed back up to the heart 13 38

The Muscular Pump Muscle contraction drives blood to heart 13 39

The Respiratory Pump 13 40

Flow Requires Pressure Differences Blood Flow Difference in Pressure 14

Pressure is measured in mmHg Pressure= Force Area mmHg 14

Pressures across the Vascular System Systolic Diastolic Pulse Pressure 14 43

Resistance Opposes Blood Flow Friction of blood moving through vessels Peripheral Resistance (Systemic Circulation) Flow = ∆P R 14 (Will be printed on test) 44

One Equation to Rule them All (HR) (EDV-ESV) (R) = Δ P 14 (Will be printed on test) 45

Resistance: Vessel Diameter Laminar Flow Fourth power rule 15 46

Resistance: Vessel Diameter Resistance low in conducting vessels Resistance in small arteries changes quickly 15 47

Resistance: Turbulence Rapid changes in vessel size Protrusions 15 48

Resistance: Viscosity Thickness of blood Polycythemia Anemia 15 49

Baroreceptors 15 Detect Pressure Aortic Reflex Carotid Sinus Reflex Syncope 15

Short Term Neuronal Controls Cardiac Inhibitory Center + Cardiac Excitatory Center Vasomotor Center Cardiovascular Center 15

Vasomotor Tone Vasomotor Fibers Arterioles 15

Short Term Hormonal Controls Norepinephrine and Epinephrine Atrial Natriuretic Peptide Angiotensin II 15

Norepinephrine and Epinephrine Vasodilation skeletal and cardiac muscle Vasoconstriction other organs CO 15

Atrial Natriuretic Peptide Myocardial cells of atria Vasodilation Decreases blood volume 15

Angiotensin II 15 Secreted by kidney if blood volume is low Vasoconstriction Increases Blood Volume 15

Long Term Control of Blood Pressure Blood Volume changes CO! More blood, more pressure Less blood, less pressure Renal 16

Direct Renal Mechanisms Less blood  More H2O returned to blood More blood  Less H2O returned to blood 16

A Very Brief Overview of Kidney Function 16

Renin/ Angiotensin II 16 Renin Angiotensin II Angiotensin I Angiotensin Converting Enzyme Angiotensin II 16

Angiotensin II Aldosterone increase Na reuptake 16

Atrial Natriuretic Peptide High Blood Pressure Blocks Aldosterone More Na and water leave as urine 16

Circulatory Shock Low blood pressure caused by unfilled vessels or abnormal circulation Hypovolemic Shock 16 63

Circulatory Shock Vascular Shock Anaphylactic Shock Septic 16 64

Hypotension 16 Low Blood Pressure Orthostatic Hypotension Chronic Hypotension 16 65

Hypertension 16 High Blood Pressure (140/90) Transient- exercise, fever, anger ~30% of 50+ year olds “The Silent Killer” 16 66

Lung Anatomy Apex Base 17

Pleurae surround Each Lung Parietal pleura Pleural cavity Visceral pleura 17

Pulmonary Ventilation Inspiration Expiration 17

Respiration Depends on Pressure and Flow Change in volume Change in pressure in lungs Change in air flow 17

Quiet Inspiration Changes Lung Volume Diaphragm External intercostals 17 How does this lead to air flow into the lungs?

Muscle of Quiet Expiration Diaphragm External intercostals 17 How does this lead to air flow out of the lungs?

Muscles of Forced Inspiration Diaphragm External intercostals Sternocleido-mastoid Scalenes Pec Minor 17 How does this lead to increased air flow into the lungs?

Muscles of Forced Expiration Diaphragm External intercostals Internal intercostals Abdominal muscles 17 How does this lead to increased air flow out of the lungs?

Know Tidal Volume, Inspiratory and Expiratory Reserve Volumes and Residual Volume 17

Capacities (Adding Volumes) Vital Capacity Total Lung Capacity 17

18 FVC and FEV Forced Vital Capacity Forced Expiratory Volume

FVC and FEV Obstructive Disorders Restrictive Disorders 18

Restrictive Disorders What would FVC and FEV look like? Reduction in lung capacities VLC, TLC, etc. Decrease in compliance “stretchiness” What would FVC and FEV look like? 18 79

Structural Changes and Compliance Fibrosis Costal ossification Weakness of inspirational muscles 18 80

Obstructive Disorders What would FVC and FEV look like? Lung volume unchanged but air flow is restricted Minute ventilation What would FVC and FEV look like? 18 81