exam 2 Flashcards
compliance
ability of a vessel to adjust the BP & ↑ the V of blood that it can hold
- stretchiness in arterial walls
- compliance = ΔV/ΔP
- rigid (non-stretch) = low compliance
- stretchy = high compliance
capacitance
ability to hold/store blood
venous capacitance & compliance
- veins have capacitance
- exhibit high apparent compliance: arises from geometric changes as blood flows in (not stretchiness)
- can add V w/out ↑P
capillary compliance & capacitance
- low capacitance
- low compliance
- if V ↑ ➔ P ↑
- good for filtration (e.g. kidneys)
elastic arteries compliance & capacitance
- low capacitance ➞ not designed to store blood
- stretchy ∴ high compliance
- if we put blood into elastic arteries we ↑P ➔ pressure resevoir
what determines flow into elastic arteries
in-flow: CO
- HR
- SV
what determines flow out of elastic arteries
MAP
- elastic recoil during both systole & diastole but most important during diastole
- vasoconstriction/vasodilation in arterioles
- baroreceptor reflex: ↓ in MAP ➔ ↑ SNS activity ➔ vasoconstriction ↓ outflow ➞ maintains blood in elastic arteries ➞ maintains ↑ BP
resistance
- resistance to flow impedes movement of blood down length of pathway
- mainly related to radius
- R = 8ηℓ/𝜋r^4
- ℓ = length: as ℓ↑ R↑
- η = viscosity: as viscosity↑ R↑
- # of RBCs: as RBC↑ viscosity ↑
- e.g. erythropoietin or dehydration
- r = radius: as radius ↑ R↓
- arterioles only vessels that dramatically change radius ➞ major resistance vessels
- if r↓ by 1/2: R ↑ 16x
arteriolar vsm regulated by:
vasoconstriction:
- SNS-mediated vasoconstriction: ↑SNS activity to arterioles ➞ ↑ arteriolar R due to NE-binding to ⍺-adrenergic receptors
- vasopressin (AVP/ADH) from neurohypophysis
vasodilation:
-
SNS-mediated vasodilation: small portion of SNS neurons release ACh ➞ vasodilation
- ↑ SNS activity for same arterioles ➞ ↓ arteriolar R due to ACh binding β-adrenergic receptors on vsm in some skeletal muscle region
- only small subset of arterioles ∴ not mechanism of action - EPI ➞ binds to β2-adrenergic receptors → vasodilation
-
local metabolites: anty chemical signal factors released in immediate vicinity by tissues that influence adjacent arterioles ➞ override SNS vasoconstriction ∴ induces vasodilation
- [K]
- PCO2
- PO2
- ↓ pH: active tissue undergoes glycolytic metabolism resulting in lactic acid build-up & CO2 production
- nitric oxide = gas released by tunica intima endothelium during sheer stress causes vasodilation to other vessels to redirect bf instead of forcing it through single stressed vessel to ↓ rubbing
active hyperemia
↑bf to active tissue due to release of local metabolites causing vasodilation
- high blood flow to meet active muscles’ increased need for oxygen
reactive hyperemia
previously occluded tissue had ↓ in bf ∴ ECF has temporary ↑ in metabolites to vasodilate & bring blood back to occluded tissue
venoconstriction
when peripheral veins contract
- resistance is unchanged
- alters stretchiness of vein ➞ ↓ apparent compliance ➞ stiffer = ↑ venous P
- ↑ venous P = ↑ venous return
flow rate out of the heart is proportional to:
cumulative flow rate
stroke volume dependent on
- changes w/ activity/metabolic demand usually SNS-mediated: ↑ SNS activity ➞ ↑ SV
- venous return: blood flows passively from peripheral veins to central veins & ventricles → venous filling
- peripheral veins (7 mmHg) ➔ central veins (2 mmHg) ➔ ventricles (0 mmHg)
- EDV determines SV (frank-starling rule): volume stretches ventricular wall
- ↑ optimal overlap btwn existing thick & thin filaments
- geometric advantage ↓ distance existing btwn myosin heads & thin filaments
- Ca interaction w/ troponin ➞ ↑ Ca affinity
- EDV in ventricles is dependent on passive filling & atrial contraction (pre-load = 135mL)
CO
CO = HR x SV
- flow out of the heart
- can vary from 5-25 L/min
intrinsic property of the heart
↑ pre-load/EDV = ↑ contractile strength
- built into heart ➞ happens automatically
- dose not require any hormones, drugs, neurotransmitters
- muscle is stretched ➔ automatic greater response
venous return
de-oxygenated blood returning to central venous pool
- like a flow rate
- dependent on ΔP btwn peripheral veins & central venous pool
- SVC & IVC (large V, lots of capacitance, low P)
- RA
peripheral vein venous return mechanisms
- smooth muscle contraction in response to ↑ SNS allows us to ↑ peripheral venous P w/ no effect on radius: alters compliance ➞ stiffer
- skeletal muscle pump: muscle contracts ➞ squeezes peripheral veins ➞ ↑ venous P ➞ drives bf out to CVP
- venous valves: 1 way valves ensure 1-way flow
- cardiac suction & respiratory pump: ventricles relax ➞ V ↑ ➞ ventricle P↓ ➞ suction
- inspiration ➞ ↑ thoracic V ➞ ↓ intrapleural P ➞ SVC & IVC V↑ ➞ SVC & IVC P↓
contractility
Δ in contractile strength due to extrinsic forces
- act on muscle independently of intrinsic factors (can even act simulataneously e.g. exercise)
- SNS input to heart will ↑ contractile force
- in the atria: ↑ EDV
- in the ventricles: ↑ force of contraction ➞ ↑P ➞ ↑SV
- independent of EDV
- SNS neurons release NE ➞ binds to β-adrenergic receptors ➞ activates GPCR (Gs ⍺ subunit) ➞ PKA phosphorylates:
- L-type Ca channels ➞ ↑ Ca influx
- SERCa pumps ➞ ↑ rate of Ca removal ➞allows quick relaxation
- troponin ➞ ↑ off rate of tropomyosin ➞ allows thin filament to bind to myosin head
CO during exercise
CO ↑ due to ↑ HR & ↑ SV
- during exercise venoconstriction & skeletal muscle pump cause venous fx curve to shift ↑
- still work at CVP ≈ 1.8-2 mmHg
- ESV is smaller than normal ∴ ESP is smaller which facilitates ventricular filling
HR regulation of CO
- HR depends on:
- rate of depolarization in the SA node (during phase 4)
- duration of nodal delay in AV node
- conduction velocity in all conductive pathways
- an ↑ in HR is caused by ↑ SNS input + ↓ in PNS input
- myocytes only have sympathetic input but pacemaker & conduction pathways have both ANS & PNS
- SNS input from thoracic region
- SNS post-ganglionic neurons release NE
↑ SNS input to SA node:
- NE binds to β1-adrenergic receptors
-
activation of L-type Ca channels
- steepens phase 0
- changes threshold value: makes channels easier to open
- activation of HCN: activating β1-adrenergic receptors in SA node activates cAMP → activates HCN channel more effectively ➞ steepens phase 4 & 0
- quicker depolarization to threshold
- threshold is more electronegative
- can get to threshold much faster & can get more AP per time
↑ SNS input to AV node:
- in N region (& maybe AN region): AP becomes steeper
- faster conduction through AV node ∴ shorter AV nodal delay
↑ SNS input to conduction pathways
↑ in conduction velocity → faster impulses
↓ SNS + ↑ PNS input to pacemaker SA node
- ACh binds to muscarinic cholinergic receptors → binds K channels
- background K current hyperpolarizes → ↓ max diastolic potential (MDP becomes more electronegative)
- phase 0 & 4 are less steep (flatter)
↓ SNS + ↑ PSNS stimulation to AV node
N region becomes slower to rise → ↓ velocity of pacemaking AP through the node → ↑ AV nodal delay
change of contractility & effect on PV loop
- ↑ SNS causes ↑ in contractile strength independent of EDV
- pressure at which semilunar valves open dependent on afterload
- point D determined by pressure in aorta (MAP) not contractile force
- force of contraction (∴ P developed) has ↑ at every point during contraction
- SV ↑
- ESV ↓ (∴ ↓ ESP) w/ ↑ contractility → start diastole w/ smaller pressure → advantageous for ventricular filling
- rate of pressure development ↑ ∴ faster contractions
- rate of relaxation ↑ due to SERCa pump activation
↓ SNS + ↑ PNS stimulation to conduction pathways
slows conduction velocity → slower impulses (slower HR)
change in EDV & PV loop
- w/ an ↑ in EDV due to ↑ in venous return → larger SV
- change in SV due to change in EDV from vasoconstriction
exercise & PV loop
- during exercise we ↑ SNS output to heart
- contractility ↑
- ↑ SNS to veins → ↑ venous return → ↑ EDV
- contracting skeletal muscles ↑ venous return → ↑ EDV
- ↑ contractility + ↑ venoconstriction & venous return = ↑ EDV (venoconstriction = no change in contractility → making veins stiffer)
- ↑SV
cardiac fx curve
relates ventricular muscle stretch to the force the muscles can generate
combined cardiac & vascular fx curves
CO is matched by peripheral venous return at point A: @ 5 L/min CVP pressure = 2 mmHg
- always have to match venous return w/ CO (CO of 5 L/min = venous return of 5 L/min)
- CVP pressure must be higher than ESV in order for blood to flow
- pressure at 2 mmHg facilitates blood coming out of CVP into ventricle & also facilitates blood coming out of peripheral veins into CVP
vascular (venous) fx curve
relates amount of blood coming out of peripheral veins & pressure in venous pool
- IVC, SVC, RA
- CVPP: central venous pool pressure
- CVP acts as back-pressure → prevents venous return
- CVP influences ventricular filling → P that pushes blood into ventricles
- ventricular filling dependent on CVP pressure & ESV
- CVP — ESP
- ESP acts as back-pressure stopping CVP pool from filling
vascular fx curve: blood volume
- ↑ volume = ↑ mean systemic filling pressure
- ↓ volume = ↓ mean systolic filling pressure
- sweat
- dehydration
- hemmorrhage
vascular fx curve: vasoconstriction/vasodilation
- mean systemic venous pressure stays constant: equal amount of blood flowing in/out
- vasoconstriction: less blood coming from cap ➔ veins = slower venous return
- vasodilation: more blood flows faster
mean systemic venous pressure
avg pressure in periphery (~7 mmHg)
- peripheral P varies based on location & forces of gravity
vascular fx curve: venoconstriction
↑ SNS changes compliance ➞ stiffer walls ➞ ↑P in peripheral veins
MAP
- homeostatically regulated
- P too low: blood does not perfuse to necessary tissues → loss of O2 & nutrients for cell resp → tissue damage
- P too high: neurons & capillaries damaged (e.g. eyes)
- normotensive = 70-100 mmHg
- measured in elastic arteries
- MAP is proportional CO x TPR
TPR
total peripheral resistance
- affected by:
- Δ in SNS activity
- local metabolites
- local signal factors (i.e. histamines, N.O.)
high-pressure baroreceptors
detect BP in elastic arteries (areas of high pressure flow)
- carotid sinus: walls of carotid arteries
- aortic arch
low-pressure baroreceptors
detect BP in places that are low pressure (representative of venous side) ∴ monitor venous BP ➞ important b/c affects venous return & EDV
- sends sensory info to NTS & hypothalamus
- pulmonary artery
- jxn between veins & atria
- R & L atria
- R ventricle