Essentials of cardiovascular physiology

224 Pages·1987·21.641 MB·English

by  Harvey V Sparks, Thom W Rooke

Essentials of
Cardiovascular
Physiology
Essentials of
Cardie
PhyS
University of Minnesota Press D Minneapolis
Harvey V. Sparks, Jr., M.D.
Professor and Chairman
Department of Physiology
Michigan State University
and
Thom W. Rooke, M.D.
Fellow, Mayo Graduate School of Medicine
Mayo Clinic/Mayo Foundation
Stanley J. Sarnoff Fellow
for Research in Cardiovascular Science
vascular
iology
Original illustrations by
ROBERT R. LORENZ
Editorial preparation of manuscript by
JULIANNE O. ROOKE
Copyright © 1987 by the
University of Minnesota
All rights reserved. No part of this
publication may be reproduced,
stored in a retrieval system, or
transmitted, in any form or by any
means, electronic, mechanical,
photocopying, recording, or
otherwise, without the prior
written permission of the
publisher.
Published by the University of
Minnesota Press, 2037 University
Avenue Southeast, Minneapolis
MN 55414.
Published simultaneously in
Canada by Fitzhenry & Whiteside
Limited, Markham.
Printed in the United States of
America.
Library of Congress
Cataloging-in-Publication Data
Sparks, Harvey V., 1938-
Essentials of cardiovascular
physiology.
Includes bibliographies and
index.
1. Cardiovascular system.
I. Rooke, Thorn W.
II. Title. [DNLM: 1. Cardiovascular
System—physiology.
WG 102 S736e]
QP102.S684 1987 612.186-7011
ISBN 0-8166-1472-5
ISBN 0-8166-1473-3 (pbk.)
The University of Minnesota is an
equal-opportunity educator and
employer.
Publication of this book was
assisted by a grant from the
McKnight Foundation to the
University of Minnesota Press's
program in the health sciences.
To Barbara and Julie
This page intentionally left blank
Contents
Preface xv
Acknowledgments xvii
Chapter 1 Once Around the Circulation 3
Systemic and Pulmonary Circulation 3
Transport 5
Blood 7
Hemostasis 8
Suggested Readings 10
Chapter 2 Electrical Activity of the Heart 11
Ionic Basis for Electrical Activity 11
Membrane Potential of Cardiac Cells 11
Molecular Basis of Cation Movements Across
Cardiac Cell Membranes 13
Refractory Period 15
Ionic Basis for the Cardiac Membrane Potential 16
Membrane Changes in Ventricular Cells 17
Membrane Changes in Nodal Cells 19
Propagation of Electrical Activity 21
Conduction of the Action Potential 21
The Electrocardiogram 24
In terpretation of the Electrocardiogram 35
Change in Mass 39
Abnormal Dipoles 39
Suggested Readings 41
Chapter 3 The Heart as a Pump 43
Molecular Basis of Cardiac Muscle Contraction 43
Excitation-Contraction Coupling 46
The Contraction of Isolated Cardiac Muscle 48
Length-Tension Relationship 50
Preload and Afterload 52
Force-Velocity Relationship 52
Contractility 52
The Cardiac Cycle 56
Cardiac Output 59
Factors Influencing Cardiac Output 59
Summary of Determinants of Cardiac Output 71
Measurement of Cardiac Output 71
Energetics of Cardiac Function 77
Suggested Readings 78
Chapter 4 Systemic Circulation 79
Pressure-Flow Relationship 79
Mean Arterial Pressure 85
P u Ise Pressure 87
Normal Range of Arterial Pressure 89
Determinants of Blood Pressure 90
Measurement of Arterial Pressure 94
Total Peripheral Resistance 95
Blood Volume 99
Suggested Readings 103
Chapter 5 Neural and Hormonal Control of the Circulation 105
Autonomic Control 105
Functional Anatomy 105
Neurotransmitters 108
Norepinephrine 108
Adrenergic Receptors 111
Alpha-adrenergic Receptors 111
Beta-adrenergic Receptors 112
Acetylcholine 113
CNS Areas Involved in Control of the
Cardiovascular System 115
Spinal 115
Medullary 116
Cortical 116
Neurotransmitters in the CNS 117
Reflex Behavior of the Cardiovascular System 117
Baroreceptor Reflex 117
Volume Receptor Reflex 120
Chemoreceptor Reflex 122
Other Reflexes 122
Corticohypothalamic Cardiovascular Patterns 123
Hormonal Control System 125
Adrenal Medulla 125
Vasopressin 126
Renin-Angiotensin-Aldosterone System 126
Erythropoietin 128
Atrial Natriuretic Peptide 128
Suggested Readings 128
Chapter 6 Regulation of Flow and Exchange 131
Functional Anatomy 131 Functional Anatomy 131
Endothelial Cells 133 Endothelial Cells 133
Vascular Smooth Muscle 135
Exchange Across the Capillary Wall 136
Diffusional Exchange 138
Capillary Filtration and Reabsorption 141
The Lymphatic System 148
Edema 149
Suggested Readings 153
Chapter 7 Regulation of Blood Flow 155
The Pulmonary Circulation 155
Skeletal Muscle Blood Flow 160
Cutaneous Blood Flow 163
Cerebral Blood Flow 167
Splanchnic Blood Flow 169
Renal Blood Flow 170
Coronary Blood Flow 171
Suggested Readings 175
Chapter 8 Integrated Cardiovascular Responses 177
Cardiac Output, Venous Return,
and Central Blood Volume 177
The Cardiovascular Response to Standing 178
Reflexes 180
Muscle and Respiratory Pumps 181
Constriction of Arterioles 184
Long-Term Adjustments 185
Exercise 190
Suggested Readings 195
Index 199