Mar 31 - cardiovascular

Mar 31 - cardiovascular - Objectives Review important...

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Unformatted text preview: Objectives Review important concepts of cardiovascular anatomy: layers of the heart, valves, electrical conducting system Review important concepts of cardiovascular physiology: mechanical function, hemodynamics, regulation of cardiac output and blood flow Review components of the systemic circulation and blood vessels Discuss disorders of arterial function: artherosclerosis, peripheral arterial disorders, aneurysms and dissections Discuss disorders of venous function: varicose veins and venous thrombosis Discuss cor onar y hear t disease: chr onic and acute Discuss pericardial, myocardial, endocardial, and valvular disorders Layers of the Heart Coronary Arteries Conduction System Cardiac Action Potential Electrocardiogram (EKG or ECG) Mechanical Functions The heart’s job is to pump blood throughout the circulatory system Cardiac muscle is similar to skeletal, with addition of intercalated disks Atria and ventricles must be coordinated and healthy to achieve ideal blood flow and circulation Pulmonary circulation: smaller volume, low pressure Systemic circulation: larger volume, high pressure Volume and Pressure One influences the other I n the systemic circulation: -pressure is highest in the arteries, lowest in the veins-volume is lowest in the arteries, highest in the veins Veins are extremely compliant, so they are able to expand and store large volumes of blood The whole circulatory system is closed, but blood can shift between systemic and pulmonary systems and between central and peripheral Pressure, Resistance, and Flow Blood flow (cardiac output) = pressure/resistance-higher pressure means more blood flow-higher resistance means less blood flow Resistance is affected by radius of the vessel and blood viscosity (Poiseulle’s equation) I deally, blood flow is laminar , not turbulent Laplace law: P = T/r Intraluminal pressure Wall tension Vessel radius Cardiac Cycle During systole, AV valves are closed, semilunar valves open, and ventricles eject their blood into the pulmonary arteries and aorta During diastole, semilunar valves are closed, AV valves open, and atria drop blood down into ventricles At end of diastole, there is an “atrial kick” End Diastolic Volume (EDV) = volume in ventricles at end of diastole End Systolic Volume (ESV) = volume at end of systole Stroke Volume (SV) = EDV-ESV usually ~ 70 mL Ejection fraction (EF) = SV/EDV usually ~ 60-70% Measures of Cardiac Performance Cardiac output (CO) = SV x HR, measured in L/min-varies greatly with metabolic demands, activity-anywhere from 4 to 8 L/min Preload = EDV, “volume work” or “prestretch”-to a limit, higher preloads cause a stronger contraction (due to arrangement of muscle fibers) Afterload = pressure that LV must overcome to pump blood into aorta “pressure work” (blood pressure) Contractility = increased strength of contraction independent of preload Control of Cardiovascular...
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Mar 31 - cardiovascular - Objectives Review important...

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