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Copyright 2004 Pearson Education, Inc., publishing as Benjamin Cummings
Human Anatomy & Physiology, Sixth Edit ion
Elaine N. Marieb
PowerPointLecture Slides prepared by Vince Austin, University of Kentucky
The Cardiovascular System:
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Copyright 2004 Pearson Education, Inc., publishing as Benjamin Cummings
Heart Anatomy
Figure 18.1
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Copyright 2004 Pearson Education, Inc., publishing as Benjamin Cummings
Pericardial Layers of the Heart
Figure 18.2
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Copyright 2004 Pearson Education, Inc., publishing as Benjamin Cummings
External Heart: Anterior View
Figure 18.4b
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Copyright 2004 Pearson Education, Inc., publishing as Benjamin Cummings
Gross Anatomy of Heart: Frontal Section
Figure 18.4e
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Pathway of Blood Through the Heart and Lungs
Figure 18.5
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Coronary Circulation: Arterial Supply
Figure 18.7a
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Coronary Circulation: Venous Supply
Figure 18.7b
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Heart Valves
Heart valves ensure unidirectional blood flow
through the heart
Atrioventricular (AV) valves lie between the atria
and the ventricles
AV valves prevent backflow into the atria when
ventricles contract
Chordae tendineae anchor AV valves to papillary
muscles
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Heart Valves
Aortic semilunar valve lies between the left
ventricle and the aorta
Pulmonary semilunar valve lies between the right
ventricle and pulmonary trunk
Semilunar valves prevent backflow of blood into theventricles
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Heart Valves
Figure 18.8c, d
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Copyright 2004 Pearson Education, Inc., publishing as Benjamin Cummings
Atrioventricular Valve Function
Figure 18.9
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Copyright 2004 Pearson Education, Inc., publishing as Benjamin Cummings
Semilunar Valve Function
Figure 18.10
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Copyright 2004 Pearson Education, Inc., publishing as Benjamin Cummings
Microscopic Anatomy of Heart Muscle
Cardiac muscle is striated, short, fat, branched, andinterconnected
The connective tissue endomysium acts as both
tendon and insertion
Intercalated discs anchor cardiac cells together and
allow free passage of ions
Heart muscle behaves as a functional syncytium
I nterActive Physiology:
Cardiovascular System: Anatomy Review: The HeartPLAY
http://localhost/var/www/apps/conversion/Animations/InterActive_Physiology/systems/heartrev.htmlhttp://localhost/var/www/apps/conversion/Animations/InterActive_Physiology/systems/heartrev.html8/12/2019 FL-K24 Cardiovascular System
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Microscopic Anatomy of Heart Muscle
Figure 18.11
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Copyright 2004 Pearson Education, Inc., publishing as Benjamin Cummings
Cardiac Muscle Contraction
Heart muscle:
Is stimulated by nerves and is self-excitable
(automaticity)
Contracts as a unit
Has a long (250 ms) absolute refractory period
Cardiac muscle contraction is similar to skeletal
muscle contraction
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Copyright 2004 Pearson Education, Inc., publishing as Benjamin Cummings
Heart Physiology: Intrinsic Conduction System
Autorhythmic cells:
Initiate action potentials
Have unstable resting potentials called pacemakerpotentials
Use calcium influx (rather than sodium) for rising
phase of the action potential
I nterActive Physiology:
Cardiovascular System: Cardiac Action PotentialPLAY
http://localhost/var/www/apps/conversion/Animations/InterActive_Physiology/systems/actnpot.htmlhttp://localhost/var/www/apps/conversion/Animations/InterActive_Physiology/systems/actnpot.html8/12/2019 FL-K24 Cardiovascular System
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Pacemaker and Action Potentials of the Heart
Figure 18.13
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Copyright 2004 Pearson Education, Inc., publishing as Benjamin Cummings
Heart Physiology: Sequence of Excitation
Sinoatrial (SA) node generates impulses about 75
times/minute
Atrioventricular (AV) node delays the impulse
approximately 0.1 second
Impulse passes from atria to ventricles via theatrioventricular bundle (bundle of His)
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Copyright 2004 Pearson Education, Inc., publishing as Benjamin Cummings
Heart Physiology: Sequence of Excitation
AV bundle splits into two pathways in the
interventricular septum (bundle branches)
Bundle branches carry the impulse toward the apex
of the heart
Purkinje fibers carry the impulse to the heart apex
and ventricular walls
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Heart Physiology: Sequence of Excitation
Figure 18.14a
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Heart Excitation Related to ECG
Figure 18.17
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Copyright 2004 Pearson Education, Inc., publishing as Benjamin Cummings
Extrinsic Innervation of the Heart
Heart is stimulated
by the sympathetic
cardioacceleratory
center
Heart is inhibited by
the parasympathetic
cardioinhibitorycenter
Figure 18.15
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Copyright 2004 Pearson Education, Inc., publishing as Benjamin Cummings
Heart Sounds
Heart sounds (lub-dup) are associated with closing
of heart valves
First sound occurs as AV valves close and signifies
beginning of systole
Second sound occurs when SL valves close at the
beginning of ventricular diastole
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Ph f h C di C l
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Copyright 2004 Pearson Education, Inc., publishing as Benjamin Cummings
Phases of the Cardiac Cycle
Ventricular filling mid-to-late diastole
Heart blood pressure is low as blood enters atria
and flows into ventricles
AV valves are open, then atrial systole occurs
Ph f th C di C l
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Copyright 2004 Pearson Education, Inc., publishing as Benjamin Cummings
Phases of the Cardiac Cycle
Ventricular systole
Atria relax
Rising ventricular pressure results in closing of AVvalves
Isovolumetric contraction phase
Ventricular ejection phase opens semilunar valves
Ph f th C di C l
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Copyright 2004 Pearson Education, Inc., publishing as Benjamin Cummings
Phases of the Cardiac Cycle
Isovolumetric relaxation early diastole
Ventricles relax
Backflow of blood in aorta and pulmonary trunkcloses semilunar valves
Dicrotic notch brief rise in aortic pressure caused
by backflow of blood rebounding off semilunarvalves
I nterActive Physiology:
Cardiovascular System: Cardiac CyclePLAY
Ph f th C di C l
http://localhost/var/www/apps/conversion/Animations/InterActive_Physiology/systems/cardcycl.htmlhttp://localhost/var/www/apps/conversion/Animations/InterActive_Physiology/systems/cardcycl.html8/12/2019 FL-K24 Cardiovascular System
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Copyright 2004 Pearson Education, Inc., publishing as Benjamin Cummings
Phases of the Cardiac Cycle
Figure 18.20
C di O t t (CO) d R
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Copyright 2004 Pearson Education, Inc., publishing as Benjamin Cummings
Cardiac Output (CO) and Reserve
CO 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 out by a
ventricle with each beat
Cardiac reserve is the difference between resting
and maximal CO
C di O t t E l
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Copyright 2004 Pearson Education, Inc., publishing as Benjamin Cummings
Cardiac Output: Example
CO (ml/min) = HR (75 beats/min) x SV (70 ml/beat)
CO = 5250 ml/min (5.25 L/min)
R l ti f St k V l
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Copyright 2004 Pearson Education, Inc., publishing as Benjamin Cummings
Regulation of Stroke Volume
SV = end diastolic volume (EDV) minus end
systolic volume (ESV)
EDV = amount of blood collected in a ventricle
during diastole
ESV = amount of blood remaining in a ventricle
after contraction
F t Aff ti St k V l
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Copyright 2004 Pearson Education, Inc., publishing as Benjamin Cummings
Factors Affecting Stroke Volume
Preload amount ventricles are stretched by
contained blood
Contractility cardiac cell contractile force due to
factors other than EDV
Afterload back pressure exerted by blood in the
large arteries leaving the heart
Frank Starling La of the Heart
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Copyright 2004 Pearson Education, Inc., publishing as Benjamin Cummings
Frank-Starling Law of the Heart
Preload, or degree of stretch, of cardiac muscle cellsbefore they contract is the critical factor controlling
stroke volume
Slow heartbeat and exercise increase venous return
to the heart, increasing SV
Blood loss and extremely rapid heartbeat decrease
SV
Preload and Afterload
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Copyright 2004 Pearson Education, Inc., publishing as Benjamin Cummings
Preload and Afterload
Figure 18.21
Extrinsic Factors Influencing Stroke Volume
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Copyright 2004 Pearson Education, Inc., publishing as Benjamin Cummings
Extrinsic Factors Influencing Stroke Volume
Contractility is the increase in contractile strength,
independent of stretch and EDV
Increase in contractility comes from:
Increased sympathetic stimuli
Certain hormones
Ca2+and some drugs
Extrinsic Factors Influencing Stroke Volume
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Copyright 2004 Pearson Education, Inc., publishing as Benjamin Cummings
Extrinsic Factors Influencing Stroke Volume
Agents/factors that decrease contractility include:
Acidosis
Increased extracellular K+
Calcium channel blockers
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Regulation of Heart Rate
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Copyright 2004 Pearson Education, Inc., publishing as Benjamin Cummings
Regulation of Heart Rate
Positive chronotropic factors increase heart rate
Negative chronotropic factors decrease heart rate
Regulation of Heart Rate: Autonomic Nervous
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Copyright 2004 Pearson Education, Inc., publishing as Benjamin Cummings
Sympathetic nervous system (SNS) stimulation is
activated by stress, anxiety, excitement, or exercise
Parasympathetic nervous system (PNS) stimulation
is mediated by acetylcholine and opposes the SNS
PNS dominates the autonomic stimulation, slowingheart rate and causing vagal tone
Regulation of Heart Rate: Autonomic Nervous
System
Atrial (Bainbridge) Reflex
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Copyright 2004 Pearson Education, Inc., publishing as Benjamin Cummings
Atrial (Bainbridge) Reflex
Atrial (Bainbridge) reflex a sympathetic reflex
initiated by increased blood in the atria
Causes stimulation of the SA node
Stimulates baroreceptors in the atria, causing
increased SNS stimulation
Chemical Regulation of the Heart
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Chemical Regulation of the Heart
The hormones epinephrine and thyroxine increase
heart rate Intra- and extracellular ion concentrations must be
maintained for normal heart function
I nterActive Physiology:
Cardiovascular System: Cardiac OutputPLAY
http://localhost/var/www/apps/conversion/Animations/InterActive_Physiology/systems/cardoutp.htmlhttp://localhost/var/www/apps/conversion/Animations/InterActive_Physiology/systems/cardoutp.html8/12/2019 FL-K24 Cardiovascular System
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BLOOD PRESSURE
Tekanan yang dibentuk oleh darah terhadap
dinding pembuluh darah
Sistole: pada saat jantung kontraksi
Diastole: pada saat jantung relaksasi
Tekanan Darah = Cardiac Output x Total
Peripheral Resistance
ESH 2003 & JNC VII(2003)
JNC 7
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ESH 2003 & JNC VII(2003)ESH-ESC 2003
BP Classification
BP BP JNC VII(2003)
Bp Classification
Optimal 110
Isolated Systolic
Hypertension
Isolated Systolic
Hypertension> 140 < 90
ESC 2003
JNC 7
2003
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Capillaries
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Capillary Beds
SlideCopyright 2003 Pearson Education, Inc. publishing as Benjamin Cummings
Capillary bedsconsist of two
types of vesselsVascular shunt
directly connects an
arteriole to a venule
Figure 11.10
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Capillary Beds
SlideCopyright 2003 Pearson Education, Inc. publishing as Benjamin Cummings
True capillaries exchange vessels
Oxygen and
nutrients cross tocells
Carbon dioxide
and metabolicwaste productscross into blood
Figure 11.10
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Diffusion at Capillary Beds
SlideCopyright 2003 Pearson Education, Inc. publishing as Benjamin Cummings
Figure 11.20
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