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Questions and Answers
How does high sodium intake affect the heart's physiology?
How does high sodium intake affect the heart's physiology?
High sodium intake triggers the kidneys to retain water, increasing blood volume and leading to hypertension.
What role does potassium play in cardiovascular health?
What role does potassium play in cardiovascular health?
Potassium helps maintain normal blood pressure and supports muscle contraction, balancing sodium levels in the body.
Explain the mechanism by which high sodium contributes to left ventricular hypertrophy.
Explain the mechanism by which high sodium contributes to left ventricular hypertrophy.
High sodium levels lead to increased blood volume and pressure, which cause strain on the heart, triggering left ventricular hypertrophy.
Describe the role of the renin-angiotensin-aldosterone system (RAAS) in blood pressure regulation.
Describe the role of the renin-angiotensin-aldosterone system (RAAS) in blood pressure regulation.
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What is the impact of high sodium intake on stroke risk?
What is the impact of high sodium intake on stroke risk?
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How does fluid balance impact blood pressure?
How does fluid balance impact blood pressure?
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What physiological changes occur in the heart due to chronic high sodium consumption?
What physiological changes occur in the heart due to chronic high sodium consumption?
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What is meant by capillary exchange mechanisms within the cardiovascular system?
What is meant by capillary exchange mechanisms within the cardiovascular system?
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What is the primary role of the sinoatrial (SA) node in the heart?
What is the primary role of the sinoatrial (SA) node in the heart?
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Explain the relationship between stroke volume (SV) and end diastolic volume (EDV) and end systolic volume (ESV).
Explain the relationship between stroke volume (SV) and end diastolic volume (EDV) and end systolic volume (ESV).
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What are the main phases of the cardiac cycle?
What are the main phases of the cardiac cycle?
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How does the smooth muscle in blood vessels contribute to blood pressure regulation?
How does the smooth muscle in blood vessels contribute to blood pressure regulation?
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What is the Frank-Starling law of the heart?
What is the Frank-Starling law of the heart?
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Describe how action potentials are generated in cardiac muscle cells.
Describe how action potentials are generated in cardiac muscle cells.
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What role does the atrioventricular (AV) node play in the heart's conduction system?
What role does the atrioventricular (AV) node play in the heart's conduction system?
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What factors can adversely affect stroke volume?
What factors can adversely affect stroke volume?
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What is cardiac output (CO) and how is it calculated?
What is cardiac output (CO) and how is it calculated?
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How do sympathetic and parasympathetic divisions of the autonomic nervous system affect heart rate?
How do sympathetic and parasympathetic divisions of the autonomic nervous system affect heart rate?
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What is the significance of the dicrotic notch in the aortic pressure waveform?
What is the significance of the dicrotic notch in the aortic pressure waveform?
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Define capillary exchange and its significance.
Define capillary exchange and its significance.
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How does preload affect cardiac output?
How does preload affect cardiac output?
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What physiological mechanisms are involved in the regulation of blood pressure?
What physiological mechanisms are involved in the regulation of blood pressure?
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How does the heart develop in an embryo, and when does it start pumping?
How does the heart develop in an embryo, and when does it start pumping?
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What is the significance of fetal circulation in relation to the mother's blood supply?
What is the significance of fetal circulation in relation to the mother's blood supply?
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Describe the difference in structure between veins and arteries.
Describe the difference in structure between veins and arteries.
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What role do capillaries play in the circulatory system?
What role do capillaries play in the circulatory system?
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Explain how blood pressure is affected by the autonomic nervous system.
Explain how blood pressure is affected by the autonomic nervous system.
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What happens to fetal blood circulation after birth?
What happens to fetal blood circulation after birth?
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What factors contribute to the regulation of stroke volume?
What factors contribute to the regulation of stroke volume?
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What is capillary exchange and how does it occur?
What is capillary exchange and how does it occur?
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How does blood pressure vary across the body and what are the normal ranges?
How does blood pressure vary across the body and what are the normal ranges?
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What mechanisms assist veins in the return of blood to the heart?
What mechanisms assist veins in the return of blood to the heart?
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Define the terms systolic and diastolic blood pressure.
Define the terms systolic and diastolic blood pressure.
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What are fenestrated capillaries, and where are they commonly found?
What are fenestrated capillaries, and where are they commonly found?
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How does exercise affect heart rate and cardiac output?
How does exercise affect heart rate and cardiac output?
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Why do capillaries have walls that are only one cell layer thick?
Why do capillaries have walls that are only one cell layer thick?
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Study Notes
Cardiovascular System (Heart)
- The cardiovascular system is a closed system with the heart and blood vessels.
- The heart pumps blood, and blood vessels allow blood to circulate throughout the body.
- The function of the cardiovascular system is to deliver oxygen and nutrients, and to remove carbon dioxide and other waste products.
Heart Anatomy
- Approximately the size of a fist.
- Location: superior surface of diaphragm, left of midline, anterior to the vertebral column, and posterior to the sternum.
- Coverings of the Heart:
- Pericardium - a double-walled sac around the heart
- Fibrous pericardium - superficial layer
- Serous pericardium - deep layer with parietal (internal surface) and visceral (epicardium, surface of heart) layers.
- Serous fluid fills the space between the layers of pericardium to allow for friction-free movement.
- Pericardium - a double-walled sac around the heart
Heart Wall
- Epicardium - external layer, visceral layer of serous pericardium
- Myocardium - middle layer, mostly cardiac muscle
- Endocardium - inner layer, endothelium
External Heart: Major Vessels (Anterior View)
- Vessels returning blood to the heart include:
- Superior and inferior venae cavae
- Right and left pulmonary veins
- Vessels conveying blood away from the heart include:
- Pulmonary trunk (splits into right and left pulmonary arteries)
- Ascending aorta (three branches):
- Brachiocephalic
- Left common carotid
- Left subclavian arteries
External Heart: Vessels that Supply/Drain the Heart (Anterior View)
- Arteries - right and left coronary (in atrioventricular groove), marginal, circumflex, and anterior interventricular arteries
- Veins - small cardiac, anterior cardiac, and great cardiac veins
External Heart: Major Vessels (Posterior View)
- Vessels returning blood to the heart include:
- Right and left pulmonary veins
- Superior and inferior venae cavae
- Vessels conveying blood away from the heart include:
- Aorta
- Right and left pulmonary arteries
External Heart: Vessels that Supply/Drain the Heart (Posterior View)
- Arteries - right coronary artery (in atrioventricular groove); posterior interventricular artery (in interventricular groove)
- Veins - great cardiac vein, posterior vein to left ventricle, coronary sinus, and middle cardiac vein
Atria of the Heart
- Receiving chambers of the heart
- Each atrium has a protruding auricle.
- Pectinate muscles mark atrial walls.
- Blood enters the right atria from superior and inferior venae cavae and coronary sinus.
- Blood enters left atria from pulmonary veins.
Ventricles of the Heart
- Discharging chambers of the heart.
- Papillary muscles and trabeculae carneae muscles mark ventricular walls.
- Right ventricle pumps blood into the pulmonary trunk.
- Left ventricle pumps blood into the aorta.
Heart Function to Circulate Human Blood
- The heart's function is to circulate blood by pumping it throughout the body.
Myocardial Thickness and Function
- Thickness of myocardium varies according to the function of the chamber.
- Atria are thin-walled, delivering blood to adjacent ventricles.
- Ventricle walls are thicker and stronger; the left ventricle wall is the thickest to supply systemic circulation.
Myocardial Physiology: Autorhythmic Cells (Pacemaker Cells)
- Smaller than contractile cells
- Don't contain many myofibrils.
- No organized sarcomere structure.
- Unstable membrane potentials called pacemaker potentials.
- Use calcium influx (rather than sodium) for rising phase of the action potential.
- Characteristics of pacemaker cells:
- Unstable membrane potential - "bottoms out" at -60 mV,"drifts upward" to -40 mV, forming a pacemaker potential.
- Myogenic - the upward drift allows the membrane to reach threshold potential (-40 mV) by itself. This is due to:
- Slow leakage of K+ out & faster leakage of Na+ in
- Ca2+ channels open as membrane approaches threshold
- Slow K+ channels open as membrane depolarizes, causing efflux of K+ and repolarization of membrane
- Altering Activity of Pacemaker Cells (Sympathetic activity):
- NE and E increase I₁ channel activity
- Altering Activity of Pacemaker Cells (Parasympathetic activity)
- ACh binds to muscarinic receptors & decreases Ca2+/increases K+ permeability = hyperpolarizing the membrane
- Longer time to threshold = slower rate of action potentials
Myocardial Physiology: Contractile Cells
- Special aspects
- Intercalated discs - Highly convoluted and interdigitated junctions, Joint adjacent cells with Desmosomes & fascia adherens, Allow for synticial activity—with gap junctions
- Less sarcoplasmic reticulum
- Also Ca2+ influxes from ECF reducing storage need
- Larger t-tubules
- Myocardial branching
- More mitochondria than skeletal muscle
- The action potential of a contractile cell
- Ca2+ plays major role.
- Action potential duration is longer than a typical neuronal action potential; plateau phase due to Ca2+ entry
- Phases of the Contractile Action Potential; resting membrane potential @-90 mV, depolarization, temporary repolarization, plateau phase, repolarization
- Plateau phase prevents summation due to elongated refractory period. No summation capacity= no tetanus.
Cardiac Cycle
- Sequence of events as blood enters the atria, leaves the ventricles and starts over again.
- Crucial aspects include electrical conduction pathways, synchronization, and rate regulation.
- Phases: Rest, atrial systole, isovolumetric ventricular contraction, ventricular ejection, isovolumetric ventricular relaxation, back to atrial & ventricular diastole, which is the blood flow through the heart.
- The electrical system gives rise to electrical changes which are transmitted through body fluids allowing us to record the ECG, a recording of electrical activity that maps to the cardiac cycle.
Cardiac Output (CO) and Reserve
- Cardiac Output is the amount of blood pumped by each ventricle in one minute (CO is the product of heart rate (HR) and stroke volume (SV)).
- HR is the number of heart beats per minute
- SV is the amount of blood pumped by the ventricles with each beat
- Cardiac reserve is the difference between resting and maximal CO.
Regulation of Stroke Volume
- SV=end diastolic volume (EDV)- end systolic volume (ESV) - EDV = amount of blood collected in a ventricle during diastole - ESV = amount of blood remaining in a ventricle after contraction -Factors affecting stroke volume include Preload, Contractility, and Afterload
Regulation of Heart Rate
- Positive chronotropic factors increase heart rate, for instance, caffeine.
- Negative chronotropic factors decrease heart rate, for instance, sedatives.
- Autonomic nervous system regulates heart rate via control of sympathetic and parasympathetic activation.
- Parasympathetic nervous system (PNS) stimulation is mediated by acetylcholine and opposes the SNS and lowers heart rate and causing vagal tone.
- Sympathetic nervous system (SNS) stimulation is activated by stress, anxiety, excitement, or exercise. (If vagus nerve is cut, the heart would lose its tone, increasing heart rate by 25 beats per minute) .
- Atrial (Bainbridge) reflex - a sympathetic reflex initiated by increased blood in the atria. It causes stimulation of the SA node and stimulates baroreceptors in the atria, causing increased SNS stimulation.
- Chemical regulation: Hormones epinephrine and thyroxine increase heart rate. Intra- and extracellular ion concentrations must be maintained for normal heart function.
Blood Vessels (Vascular System)
- Taking blood to the tissues and back to the heart through the arteries, arterioles, capillaries, venules, and veins.
- Three layers (tunics) make up blood vessels include tunic intima (endothelium), tunic media (smooth muscle), and tunic externa (mostly fibrous connective tissue).
- Differences between blood vessel types:
- Walls of arteries are thicker and their smooth muscle helps move blood.
- Lumens of veins are larger because their walls are thinner.
- Larger veins have valves to prevent backflow.
- Skeletal muscle pushes blood in the veins back to the heart.
- Walls of capillaries are only one cell layer thick to support exchange between blood and tissue..
Capillary Beds
- Consist of two types of vessels:
- Vascular shunt- directly connects the arteriole to a venule
- True capillaries - exchange vessels
- Oxygen and nutrients cross to cells, and carbon dioxide and metabolic waste products go into the blood.
- Diffusion at Capillary Beds
- Subtances are exchanged, such as oxygen and nutrients, via concentration gradients.
- Diffusion occurs across plasma membranes and through intercellular clefts (gaps), and through pores (fenestrations), in some capillaries.
Major Arteries and Veins (Systemic Circulation)
- Figures are available in the document provided
Arterial Supply of the Brain (Circle of Willis)
- Figures and details are available in the provided document.
Hepatic Portal Circulation
- Figures and details are available in the provided document.
Circulation to the Fetus
- Figures and details are available in the provided document.
Pulse
- Pressure wave of blood in arteries; monitored at pressure points where the pulse is easily palpated using a stethoscope.
Blood Pressure
- Measurements by health professionals are made on the pressure in large arteries;
- Systolic = pressure at the peak of ventricular contraction
- Diastolic = pressure when ventricles relax
Measuring Arterial Blood Pressure
- Measurement procedures and steps are available in the provided document.
Effects of Factors on Blood Pressure
- Neural factors - Autonomic nervous system adjustments (sympathetic division)
- Renal factors - Regulation by altering blood volume & Renin - hormonal control
- Temperature - Heat has a vasodilation effect and cold has a vasoconstricting effect; chemicals include various substances that increase/decrease blood pressure; diet is a significant factor.
Variations in Blood Pressure
- Human normal range is variable, from 140-110 mmHg systolic and 80-75 mmHg diastolic
- Hypotension = low systolic (below 110 mmHg) and often associated with illness
- Hypertension = High systolic (above 140 mmHg) and can be dangerous if chronic
Congestive Heart Failure (CHF)
- Caused by coronary artery disease, hypertension, MI, valve disorders, and congenital defects
- Left side heart failure: less effective pump; more blood in ventricle, blood back up in lungs, as pulmonary edema, suffocation and lack of oxygen to the tissues.
- Right side heart failure: fluid builds up in tissues as peripheral edema.
Heart Disease
- Various conditions including coronary artery disease, persistent high blood pressure, multiple myocardial infarctions, and dilated cardiomyopathy.
Developmental Aspects of the Heart
- A simple tube heart develops in the embryo; pumps by the fourth week.
- Heart becomes a four-chambered organ by end of seven weeks.
- Limited structural changes after seventh week.
- Fetus contains special structures bypassing pulmonary circulation to supply oxygen and nutrients to the fetus, such as the Foramen Ovale, and the Ductus Arteriousus. - Developmental abnormalities (congenital heart defects) can occur if the structures fail to fully develop as expected during fetal growth. Includes examples of ventricular septal defect, coarctation of the aorta, and tetralogy of fallot.
Age-Related Changes Affecting the Heart
- Sclerosis and thickening of valve flaps.
- Decline in cardiac reserve
- Fibrosis of cardiac muscle
- Atherosclerosis
Clinical Problems
- MI (myocardial infarction)= death of heart muscle tissue due to lack of O2 resulting in scar tissue formation.
- Blood clot: Use clot-dissolving drugs, such as streptokinase or t-PA and heparin. Balloon angioplasty
- Angina pectoris - heart pain from ischemia (lack of blood flow and oxygen) to the cardiac muscle.
Coronary Artery Disease
- Heart muscle receiving insufficient blood supply due to narrowing of coronary vessels, or atherosclerotic blockage.
- Treatment includes drugs, bypass graft, angioplasty, and stent.
Artificial Heart
- Heart valve or complete heart replacement may be needed if the heart does not function adequately or when major heart disease or damage is present. Procedures to replace valves, or even the entire heart may be done to correct the problems.
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Test your knowledge on the impact of high sodium intake on heart physiology and overall cardiovascular health. Explore the roles of potassium, the RAAS system, and fluid balance in blood pressure regulation and the risks associated with chronic high sodium consumption.