Cardiovascular Physiology; Mosby's Physiology Monograph Series

by Berne & Levy

• ISBN13: 9780323011273
• ISBN10: 0323011276
• Format: Paperback
• Copyright: 2000-08-09
• Publisher: Mosby

Summary

Part of Mosby's successful monograph series, CARDIOVASCULAR PHYSIOLOGY presents fundamental concepts clearly and concisely. Students gain a solid understanding on how the cardiovascular system functions in both health and disease. Throughout, excellent illustrations and consistent pedagogical features focus student learning. In addition, the clinical commentaries help students apply what they've learned to real-life clinical situations. Gives students a solid understanding on how the system functions in both health and disease. Includes throughout, excellent illustrations and consistent pedagogical features tht focus student learning. Provides clinical commentaries to help students apply what they've learned to real-life clinical situations. Clear, accurate and up-to-the-minute coverage of the physiology of the renal system focusing on the needs of the student. Pathophysiology content throughout that serves as a bridge between normal function and disease. Integrated student-friendly tools, including learning objectives, overview boxes, key words and concepts, chapter summaries, self-study problems, clinical cases with questions and explained answers, clinical boxes and molecular boxes. Access to Student Consult®!

Table of Contents

The Circuitry	1	(6)
Summary	5	(1)
Case 1	6	(1)
Electrical Activity of the Heart	7	(48)
Cardiac Action Potentials Consist of Several Phases	7	(17)
Principal Types of Cardiac Action Potentials Are the Slow and Fast Types	8	(1)
Ionic Basis of the Resting Potential	9	(4)
The Fast Response Depends Mainly on Voltage-Dependent Sodium Channels	13	(10)
Ionic Basis of the Slow Response	23	(1)
Conduction in Cardiac Fibers Depends on Local Circuit Currents	24	(2)
Conduction of the Fast Response	24	(2)
Conduction of the Slow Response	26	(1)
Cardiac Excitability Depends on The Activation and Inactivation of Specific Currents	26	(2)
Fast Response	26	(1)
Slow Response	27	(1)
Effects of Cycle Length	27	(1)
The Heart Generates Its Own Pacemaking Activity	28	(11)
Sinoatrial Node	29	(1)
Ionic Basis of Automaticity	30	(2)
Overdrive Suppression	32	(1)
Atrial Conduction	33	(1)
Atrioventricular Conduction	33	(5)
Ventricular Conduction	38	(1)
An Impulse Can Travel Around A Reentry Loop	39	(1)
Afterdepolarizations Lead To Triggered Activity	40	(3)
Early Afterdepolarizations	41	(1)
Delayed Afterdepolarizations	42	(1)
Electrocardiography Displays The Spread of Cardiac Excitation	43	(3)
Scalar Electrocardiography	43	(3)
Dysrhythmias Occur Frequently and Constitute Important Clinical Problems	46	(5)
Altered Sinoatrial Rhythms	46	(1)
Atrioventricular Transmission Blocks	47	(1)
Premature Depolarizations	47	(1)
Ectopic Tachycardias	48	(1)
Fibrillation	49	(2)
Summary	51	(1)
Case 2	52	(3)
The Cardiac Pump	55	(30)
The Gross and Microscopic Structures of the Heart are Uniquely Designed For Optimal Function	55	(13)
Myocardial Cell	55	(5)
The Force of Cardiac Contraction Is Largely Determined by the Resting Length of the Myocardial Fibers	60	(1)
Excitation-Contraction Coupling Is Mediated Mainly by Calcium	61	(4)
Preload and Afterload Are Important in Determining Cardiac Performance	65	(3)
The Cardiac Chambers Consist of Two Atria, Two Ventricles, and Four Valves	68	(6)
Cardiac Valves	68	(5)
The Pericardium Is an Epithelized Fibrous Sac That Invests the Heart	73	(1)
The Two Major Heart Sounds Are Mainly Produced by Closure of the Cardiac Valves	73	(1)
The Sequential Contraction and Relaxation of the Atria and Ventricles Constitute the Cardiac Cycle	74	(4)
Ventricular Systole	74	(2)
Ventricular Diastole	76	(2)
The Fick Principle is Used to Determine Cardiac Output	78	(3)
The Indicator Dilution Technique Is a Useful Method for Measuring Cardiac Output	79	(2)
Summary	81	(1)
Case 3	82	(3)
Regulation of the Heartbeat	85	(30)
Heart Rate is Controlled Mainly by the Autonomic Nerves	85	(12)
Parasympathetic Pathways	86	(2)
Sympathetic Pathways	88	(2)
Higher Centers Also Influence Cardiac Performance	90	(1)
Heart Rate Can Be Regulated Via the Baroreceptor Reflex	90	(1)
The Bainbridge Reflex and Atrial Receptors Regulate Heart Rate	91	(1)
A Common Cardiac Dysrhythmia Is Induced by Respiration	92	(3)
Activation of the Chemoreceptor Reflex Affects Heart Rate	95	(1)
The Ventricular Receptor Reflexes Play a Minor Role in the Regulation of Heart Rate	95	(2)
Myocardial Performance is Regulated by Intrinsic Mechanisms	97	(7)
The Frank-Starling Mechanism Is an Important Regulator of Myocardial Contractility	98	(3)
Changes in Heart Rate Affect Contractile Force	101	(3)
Myocardial Performance is Regulated by Nervous and Humoral Factors	104	(8)
Nervous Control	109	(1)
Cardiac Performance is Also Regulated by Hormonal Substances	109	(3)
Summary	112	(1)
Case 4	113	(2)
Hemodynamics	115	(20)
Velocity of The Bloodstream Depends on Blood Flow and Vascular Area	115	(1)
Blood Flow Depends on the Pressure Gradient	116	(2)
Relationship Between Pressure and Flow Depends on the Characteristics of the Conduits	118	(4)
Resistance to Flow	122	(3)
Resistances in Series and in Parallel	124	(1)
Flow May Be Laminar or Turbulent	125	(1)
Shear Stress on the Vessel Wall	126	(1)
Rheologic Properties of Blood	127	(5)
Summary	132	(1)
Case 5	133	(2)
The Arterial System	135	(20)
The Hydraulic Filter Converts Pulsatile Flow To Steady Flow	135	(4)
Arterial Elasticity Compensates for the Intermittent Flow Delivered by the Heart	139	(2)
The Arterial Blood Pressure is Determined by Physical and Physiological Factors	141	(7)
Mean Arterial Pressure	141	(1)
Cardiac Output	142	(2)
Peripheral Resistance	144	(1)
Pulse Pressure	145	(1)
Stroke Volume	145	(1)
Arterial Compliance	146	(1)
Total Peripheral Resistance and Arterial Diastolic Pressure	147	(1)
The Pressure Curves Change in Arteries at Different Distances from The Heart	148	(1)
Blood Pressure is Measured By A Sphygmomanometer in Human Patients	149	(2)
Summary	151	(1)
Case 6	152	(3)
The Microcirculation and Lymphatics	155	(20)
Functional Anatomy	155	(4)
Arterioles Are the Stopcocks of the Circulation	155	(1)
Capillaries Permit the Exchange of Water, Solutes, and Gases	156	(2)
The Law of Laplace Explains Why Capillaries Can Withstand High Intravascular Pressures	158	(1)
The Endothelium Plays An Active Role in Regulating the Microcirculation	159	(1)
The Endothelium Plays A Passive Role in Transcapillary Exchange	160	(11)
Diffusion is the Most Important Means for Water and Solute Transfer Across the Endothelium	163	(1)
Diffusion of Lipid-insoluble Molecules Is Restricted to the Pores	164	(2)
Lipid-soluble Molecules Pass Directly Through the Lipid Membranes of the Endothelium and the Pores	166	(1)
Capillary Filtration Is Regulated by the Hydrostatic and Osmotic Forces Across the Endothelium	166	(2)
Balance of Hydrostatic And Osmotic Forces	168	(1)
The Capillary Filtration Coefficient is a Convenient Method to Estimate the Rate of Fluid Movement Across the Endothelium	169	(2)
Pinocytosis Enables Large Molecules to Cross the Endothelium	171	(1)
The Lymphatics Return the Fluid and Solutes that Escape Through the Endothelium to the Circulating Blood	171	(1)
Summary	172	(1)
Case 7-1	173	(1)
Case 7-2	174	(1)
The Peripheral Circulation and Its Control	175	(24)
Contraction and Relaxation of Arteriolar Vascular Smooth Muscle Regulate Peripheral Blood Flow	177	(3)
Intrinsic (Local) Control of Peripheral Blood Flow	180	(5)
Autoregulation and the Myogenic Mechanism Tend to Keep Blood Flow Constant in the Face of Changes in Perfusion Pressure	180	(2)
The Endothelium Actively Regulates Blood Flow	182	(1)
Tissue Metabolic Activity Is the Main Factor in the Local Regulation of Blood Flow	182	(3)
Extrinsic Control of Peripheral Blood Flow is Mediated Mainly by the Sympathetic Nervous System	185	(8)
Impulses Arising in the Medulla Descend in the Sympathetic Nerves to Increase Vascular Resistance	185	(1)
Sympathetic Nerves Regulate the Contractile State of Resistance and Capacitance Vessels	186	(1)
Parasympathetic Nervous System Only Innervates Blood Vessels in the Cranial and Sacral Regions of the Body	187	(1)
Epinephrine and Norepinephrine Are the Main Humoral Factors That Affect Vascular Resistance	187	(1)
The Vascular Reflexes Are Responsible for Rapid Adjustments of Blood Pressure	187	(4)
The Peripheral Chemoreceptors Are Stimulated by Decreases in Blood Oxygen Tension and pH and by Increases in Carbon Dioxide Tension	191	(1)
The Central Chemoreceptors Are Quite Sensitive to Changes in Paco2	192	(1)
Other Vascular Reflexes	193	(1)
Balance Between Extrinsic and Intrinsic Factors in Regulation of Peripheral Blood Flow	193	(2)
Summary	195	(1)
Case 8-1	196	(1)
Case 8-2	197	(2)
Control of Cardiac Output: Coupling of Heart and Blood Vessels	199	(28)
The Vascular Function Curve Relates Central Venous Pressure to Cardiac Output	200	(8)
Mathematical Analysis of the Vascular Function Curve	203	(2)
Venous Pressure Depends on Cardiac Output	205	(1)
Blood Volume	205	(1)
Venomotor Tone	206	(1)
Blood Reservoirs	207	(1)
Peripheral Resistance	207	(1)
Cardiac Output and Venous Return Are Closely Associated	208	(1)
The Heart and Vasculature are Coupled Functionally	208	(5)
Myocardial Contractility	210	(1)
Blood Volume	211	(1)
Peripheral Resistance	212	(1)
The Right Ventricle Regulates Not Only Pulmonary Blood Flow But Also Central Venous Pressure	213	(3)
Heart Rate Has Ambivalent Effects on Cardiac Output	216	(2)
Ancillary Factors Affect the Venous System and Cardiac Output	218	(6)
Gravity	218	(3)
Muscular Activity and Venous Valves	221	(1)
Respiratory Activity	222	(2)
Artificial Respiration	224	(1)
Summary	224	(1)
Case 9	225	(2)
Coronary Circulation	227	(14)
Functional Anatomy of Coronary Vessels	227	(2)
Coronary Blood Flow is Regulated By Physical Neural and Metabolic Factors	229	(5)
Physical Factors	229	(3)
Neural and Neurohumoral Factors	232	(1)
Metabolic Factors	232	(2)
Cardiac Oxygen Consumption is a Function of the Work Performed by the Heart	234	(1)
Cardiac Efficiency	235	(1)
Diminished Coronary Blood Flow Impairs Cardiac Function	235	(1)
Coronary Collateral Vessels Develop in Response to Impairment of Coronary Blood Flow	236	(2)
Summary	238	(2)
Case 10	240	(1)
Special Circulations	241	(30)
Cutaneous Circulation	241	(4)
Skin Blood Flow is Regulated Mainly by the Sympathetic Nervous System	241	(4)
Skin Color Depends on the Volume and Flow of Blood in the Skin and the Amount of O2 Bound to Hemoglobin	245	(1)
Skeletal Muscle Circulation	245	(2)
Regulation of Skeletal Muscle Circulation Is Achieved by Neural and Local Factors	245	(2)
Cerebral Circulation	247	(3)
Local Factors Predominate Over Neural Factors in the Regulation of Cerebral Blood Flow	248	(2)
The Pulmonary and Systemic Circulations are in Series With Each Other	250	(5)
Functional Anatomy	250	(2)
Pulmonary Hemodynamics	252	(2)
Regulation of the Pulmonary Circulation	254	(1)
The Renal Circulation Accounts for about 20% of the Cardiac Output	255	(5)
Anatomy	255	(3)
Renal Hemodynamics	258	(1)
The Renal Circulation is Regulated Mainly by Intrinsic Mechanisms	258	(2)
The Splanchnic Circulation Provides Blood Flow to the Gastrointestinal Tract Liver Spleen and Pancreas	260	(4)
Intestinal Circulation	260	(2)
Hepatic Circulation	262	(2)
Fetal Circulation	264	(4)
Several Changes Occur in the Circulatory System at Birth	267	(1)
Summary	268	(1)
Case 11-1	269	(1)
Case 11-2	270	(1)
Case 11-3	270	(1)
Interplay of Central and Peripheral Factors in the Control of the Circulation	271	(18)
Exercise	272	(6)
Mild-to-Moderate Exercise	272	(3)
Severe Exercise	275	(1)
Postexercise Recovery	276	(1)
Limits of Exercise Performance	277	(1)
Physical Training and Conditioning	277	(1)
Hemorrhage	278	(7)
Hemorrhage Evokes Compensatory and Decompensatory Effects on the Arterial Blood Pressure	278	(1)
The Compensatory Mechanisms Are Neural and Humoral	278	(4)
The Decompensatory Mechanisms Are Mainly Humoral Cardiac, and Hematological	282	(3)
The Positive and Negative Feedback Mechanisms Interact	285	(1)
Summary	285	(1)
Case 12-1	286	(1)
Case 12-2	287	(2)
Appendix: Case Study Answers	289