Transcript Chapter 33
Exercise 37
Human cardiovascular
physiology
Cardiac cycle
Concepts to memorize:
The two atria contract simultaneously
The two ventricles contract
simultaneously
Diastole
The
relaxation period
Systole
The
contraction period
Steps of the cardiac cycle
The heart is in diastole
Heart pressure is low
The blood flows passively from the
pulmonary and systemic system into
the atria
The AV valves open
The blood flows into the ventricles
The atria contracts to force the residual
blood into the ventricles
Cardiac cycle
The ventricular pressure increases
The ventricular systole begins
The atria are in diastole and begin to
be filled
The AV valves close
The semilunar valves open
The blood flows into the aorta and the
pulmonary arteries
Cardiac cycle
The pressure in the aorta and
pulmonary arteries increase
The semilunar valves close
The ventricles relax
The cardiac sounds
(lub-dup pause)
First heart sound (S1- lub)
Represents the closing of the AV
valves
It happens at the beginning of the
systole
Second heart sound (S2- dup)
It represents the closing of the
semilunar valves
It happens at the end of the systole
The cardiac sounds
Murmurs
It represents a turbulent blood flow
It is found when blood flows through
narrow openings (stenosis)
Also found when there is backflow of
blood (regurgitation) because of
defected valves (insufficiency)
Cardiac cycle
Auscultation of the mitral valve
Over the 5th intercostal space
In line with the middle of the clavicle
Auscultation of the tricuspid valve
Over the sternum
Cardiac cycle
Auscultation of the pulmonary valve
Over the 2nd intercostal space
At left sternal margin
Auscultation of the aortic valve
Over the 2nd intercostal space
At the right sternal margin
The pulse
It is palpation of the pressure wave that
travels along the arteries
The pressure wave causes the
expansion of the arterial wall
Parameters detected by the pulse
palpation:
Pulse rate
It is the same as the heart rate
Normal: 60-100 bpm
The pulse
Pulse rhythm
Pulse amplitude
Superficial pulse points
Common carotid artery
Temporal artery
Facial artery
Brachial artery
Radial artery
The pulse
Femoral artery
Popliteal artery
Posterior tibial artery
Dorsalis pedis artery
The blood pressure
It is the pressure that the blood causes
to the wall of the vessels
It is reported in millimeters of mercury
(mm Hg)
Arterial pressure:
Systolic pressure
Reflects the pressure in the arteries
during ventricular ejection
It is the first reading
normal:120 mm Hg
The blood pressure
Diastolic pressure
Reflects the pressure in the arteries
during ventricular relaxation
It is the second reading
Normal: 80 mm Hg
The blood pressure
Sounds of Korotkoff
Indicates the resumption of blood
flow into the forearm when the
pressure to occlude the artery is
gradually released
First sound heard is the systolic
pressure
The disappearance of the Korotkoff
indicates the diastolic pressure
The blood pressure
Venous pressure
Normal: 30-90 mm Hg
They are affected by muscle activity,
deep pressure, breathing, etc
The blood pressure
Pulse Pressure (PP)
Systolic pressure – diastolic pressure
Mean arterial pressure (MAP)
MAP=diastolic pressure+PP/3
Effects of various factors on
blood pressure
BP=CO * PR
Factors that increase PR:
Constriction of arteries
Increased blood viscosity
Increased blood volume
Hardening of the arteries walls
Effects of various factors on
blood pressure
Factors that increase BP:
Age
Weight
Drugs
Exercise
Emotions, etc
Skin color
It indicates local circulatory dynamics
Factors that influence skin color
Oxygen supply (cyanosis)
Temperature (cold, warm)
Hormones (thyroid hormones)
Autonomic nervous system
• Fight or flight reaction
Collateral blood flow
Electrocardiogram (ECG)
Conduction of impulses through the heart
Generation of electrical impulses
Detection of the electrical impulses on the body’s
surface
Electrocardiograph
The electrocardiogram (ECG)
Deflection waves
The P wave accompanies the depolarization of
the atria
• First wave, small and precedes atrial
contraction
The electrocardiogram (ECG)
The
QRS complex appears as the
ventricles depolarize
• Second wave, large and precedes
ventricular contraction
The T wave indicates ventricular
repolarization; third wave
An Electrocardiogram
The electrocardiogram
(ECG)
Intervals- Always include at least one wave
PR interval (PQ)
• From the beginning of P wave to the start of
QRS
• Represents atrial depolarization and
conduction through AV node
QT interval
• From the Q wave to the end of T wave
• Ventricular depolarization, contraction and
repolarization
The electrocardiogram
(ECG)
ST
interval
• From the end of the QRS to the end of the T
wave
• Represents the spread of impulse to the
ventricles (ventricular contraction) +
ventricular repolarization
An Electrocardiogram
The electrocardiogram
(ECG)
Segments
From the end of one wave to the start of the
next one
ST segment
• From the end of QRS to the beginning of T
wave
• Represents the spread of the impulse to the
ventricles (ventricular contraction)
The electrocardiogram
(ECG)
PR
segment
• From the end of P wave to the beginning of
QRS complex
• Represents the spread of the impulse to the
atria (atrial contraction)
An Electrocardiogram
The electrocardiogram
(ECG) abnormalities
Tachycardia
HR above 100 bpm
Bradycardia
HR below 60 bpm
Fibrillation
Uncoordinated heart contractions