Cardiovascular Physiology Concepts

Description:

Praised for its concise coverage, this highly accessible monograph lays a foundation for understanding the underlying concepts of normal cardiovascular function and offers a welcome alternative to a more mechanistically oriented approach or an encyclopedic physiology text. Clear explanations, ample illustrations and engaging clinical cases and problems provide the perfect guidance for self-directed learning and prepare you to excel in clinical practice. 

Table of Contents:

1 Introduction to the Cardiovascular System

THE NEED FOR A CIRCULATORY SYSTEM

THE ARRANGEMENT OF THE CARDIOVASCULAR SYSTEM

THE FUNCTIONS OF THE HEART AND BLOOD VESSELS

Heart

Vascular System

Interdependence of Circulatory and Organ Function

THE REGULATION OF CARDIAC AND VASCULAR FUNCTION

THE CONTENT OF THE FOLLOWING CHAPTERS

SUMMARY OF IMPORTANT CONCEPTS

CHAPTER 1: MULTIPLE CHOICE QUESTIONS

2 Cellular Structure and Function

CARDIAC CELL STRUCTURE AND FUNCTION

Myocytes and Sarcomeres

Excitation–Contraction Coupling

Regulation of Contraction (Inotropy)

Regulation of Relaxation (Lusitropy)

Cardiac Myocyte Metabolism

VASCULAR STRUCTURE AND FUNCTION

Vascular Smooth Muscle Cells

Vascular Endothelial Cells

SUMMARY OF IMPORTANT CONCEPTS

ANSWERS TO PROBLEMS AND CASES

SUGGESTED RESOURCES

CHAPTER 2: MULTIPLE CHOICE QUESTIONS

3 Electrical Activity of the Heart

Cell Membrane Potentials

Resting Membrane Potentials

Maintenance of Ionic Gradients

Ion Channels

Action Potentials

Arrhythmias Caused by Abnormal Action Potential Generation

Conduction of Action Potentials within the Heart

Electrical Conduction within the Heart

Regulation of Conduction Velocity

Abnormal Conduction

Tachycardia Caused by Reentry

The Electrocardiogram

ECG Tracing

Interpretation of Normal and Abnormal Cardiac Rhythms from the ECG

Volume Conductor Principles and ECG Rules of Interpretation

ECG Leads: Placement of Recording Electrodes

Electrophysiological Changes during Cardiac Ischemia

Summary of Important Concepts

ANSWERS TO PROBLEMS AND CASES

SUGGESTED RESOURCES

CHAPTER 3: MULTIPLE CHOICE QUESTIONS

4 Cardiac Function

CARDIAC ANATOMY

Functional Anatomy of the Heart

Autonomic Innervation

THE CARDIAC CYCLE

Cardiac Cycle Diagram

Phase 1. Atrial Systole

Phase 2. Isovolumetric Contraction

Phase 3. Rapid Ejection

Phase 4. Reduced Ejection

Phase 5. Isovolumetric Relaxation

Phase 6. Rapid Filling

Phase 7. Reduced Filling

Summary of Intracardiac Pressures

Ventricular Pressure–Volume Relationship

CARDIAC OUTPUT

Measurement of Cardiac Output

Influence of Heart Rate and Stroke Volume on Cardiac Output

EFFECTS OF PRELOAD ON STROKE VOLUME

Effects of Ventricular Compliance on Preload

Effects of Preload on Tension Development (Length–Tension Relationship)

Effects of Venous Return on Stroke Volume (Frank-Starling Mechanism)

Summary of Effects of Increase Preload on Cardiac Muscle Mechanics and Ventricular Function

Factors Determining Ventricular Preload

EFFECTS OF AFTERLOAD ON STROKE VOLUME

Effects of Afterload on the Velocity of Fiber Shortening (Force–Velocity Relationship)

Effects of Afterload on Frank-Starling Curves

Effects of Afterload on Pressure–Volume Loops

Summary of Effects of Increased Afterload on Cardiac Muscle Mechanics and Ventricular Function

EFFECTS OF INOTROPY ON STROKE VOLUME

Effects of Inotropy on Length-Tension Relationship

Effects of Inotropy on Force–Velocity Relationship

Effects of Inotropy on Frank-Starling Curves

Effects of Inotropy on Pressure–Volume Loops

Summary of Effects of Increased Inotropy on Cardiac Muscle Mechanics and Ventricular Function

Factors Influencing Inotropic State

Cellular Mechanisms of Inotropy

INTERDEPENDENCE OF PRELOAD, AFTERLOAD, AND INOTROPY

MYOCARDIAL OXYGEN CONSUMPTION

How Myocardial Oxygen Consumption Is Determined

Factors Influencing Myocardial Oxygen Consumption

SUMMARY OF IMPORTANT CONCEPTS

ANSWERS TO PROBLEMS AND CASES

SUGGESTED RESOURCES

CHAPTER 4: MULTIPLE CHOICE QUESTIONS

5 Vascular Function

ANATOMY AND FUNCTION

Vascular Network

Distribution of Pressures and Volumes

ARTERIAL BLOOD PRESSURE

Mean Arterial Pressure

Aortic Pulse Pressure

HEMODYNAMICS (PRESSURE, FLOW, AND RESISTANCE)

Effects of Vessel Length, Radius, and Blood Viscosity on Resistance to Blood Flow

Laminar Versus Turbulent Flow

Series and Parallel Arrangement of the Vasculature

REGULATION OF SYSTEMIC VASCULAR RESISTANCE

Calculation of Systemic Vascular Resistance

Vascular Tone

VENOUS BLOOD PRESSURE

Venous Blood Volume and Compliance

Mechanical Factors Affecting Central Venous Pressure and Venous Return

Summary of Factors Affecting Central Venous Pressure

VENOUS RETURN AND CARDIAC OUTPUT

The Balance between Venous Return and Cardiac Output

Systemic Vascular Function Curves

Cardiac Function Curves

Interactions Between Cardiac and Systemic Vascular Function Curves

SUMMARY OF IMPORTANT CONCEPTS

ANSWERS TO PROBLEMS AND CASES

SUGGESTED RESOURCES

CHAPTER 5: MULTIPLE CHOICE QUESTIONS

6 Neurohumoral Control of the Heart and Circulation

AUTONOMIC NEURAL CONTROL

Autonomic Innervation of the Heart and Vasculature

Baroreceptor Feedback Regulation of Arterial Pressure

Chemoreceptors

Other Autonomic Reflexes Affecting the Heart and Circulation

HUMORAL CONTROL

Circulating Catecholamines

Renin–Angiotensin–Aldosterone System

Natriuretic Peptides

Vasopressin (Antidiuretic Hormone)

INTEGRATION OF NEUROHUMORAL MECHANISMS

SUMMARY OF IMPORTANT CONCEPTS

ANSWERS TO PROBLEMS AND CASES

SUGGESTED RESOURCES

CHAPTER 6: MULTIPLE CHOICE QUESTIONS

7 Organ Blood Flow

DISTRIBUTION OF CARDIAC OUTPUT

LOCAL REGULATION OF BLOOD FLOW

Tissue Factors

Endothelial Factors

Smooth Muscle (Myogenic) Mechanisms

Extravascular Compression

Autoregulation of Blood Flow

Reactive and Active Hyperemia

SPECIAL CIRCULATIONS

Coronary Circulation

Cerebral Circulation

Skeletal Muscle Circulation

Cutaneous Circulation

Splanchnic Circulation

Renal Circulation

Pulmonary Circulation

Summary of Special Circulations

SUMMARY OF IMPORTANT CONCEPTS

ANSWERS TO PROBLEMS AND CASES

SUGGESTED RESOURCES

CHAPTER 7: MULTIPLE CHOICE QUESTIONS

8 Exchange Function of the Microcirculation

MECHANISMS OF EXCHANGE

Diffusion

Bulk Flow

Vesicular and Active Transport

EXCHANGE OF OXYGEN AND CARBON DIOXIDE

Oxygen Diffusion

Oxygen Delivery and Extraction

Carbon Dioxide Diffusion

TRANSCAPILLARY FLUID EXCHANGE

Physical Mechanisms Governing Fluid Exchange

Capillary Exchange Model

EDEMA FORMATION

SUMMARY OF IMPORTANT CONCEPTS

ANSWERS TO PROBLEMS AND CASES

SUGGESTED RESOURCES

CHAPTER 8: MULTIPLE CHOICE QUESTIONS

9 Cardiovascular Integration, Adaptation, and Pathophysiology

CARDIOVASCULAR RESPONSES TO EXERCISE

Mechanisms Involved in Cardiovascular Response to Exercise

Steady-State Changes in Cardiovascular Function during Exercise

Factors Influencing Cardiovascular Response to Exercise

PERIPHERAL VASCULAR DISEASE

Hemodynamics of Peripheral Artery Disease in the Leg

MATERNAL CHANGES IN CARDIOVASCULAR FUNCTION DURING PREGNANCY

FETAL CIRCULATION AND CHANGES AT BIRTH

HYPOTENSION AND SHOCK

Causes of Hypotension

Circulatory Shock

Compensatory Mechanisms during Hypotension

Decompensatory Mechanisms Following Severe and Prolonged Hypotension

Physiologic Basis for Therapeutic Intervention

HYPERTENSION

Essential (Primary) Hypertension

Secondary Hypertension

Physiologic Basis for Therapeutic Intervention

HEART FAILURE

Causes of Heart Failure

Systolic versus Diastolic Dysfunction

Systemic Compensatory Mechanisms in Heart Failure

Exercise Limitations Imposed by Heart Failure

Physiologic Basis for Therapeutic Intervention

VALVE DISEASE

Valve Stenosis

Valve Regurgitation

SUMMARY OF IMPORTANT CONCEPTS

ANSWERS TO CASES

SUGGESTED RESOURCES

CHAPTER 9: MULTIPLE CHOICE QUESTIONS

Index