PHYL2001: Physiology of Human Body Systems Cardiac Output and Blood Pressure Dr Peter McFawn Room: G.01 Anatomy Building Ph: 6488 3341 email: peter.mcfawn@uwa.edu.au 2019 Lecture Outline Blood Overall design of the circulatory system Vascular compartments Arterial Blood Pressure Cardiac output Cardiac Function Curve Aims I List and define the compartments of the cardiovascular system. Define Heart Rate, Stroke Volume, Cardiac Output and Venous Return. Know typical values for Heart Rate, Stroke Volume and Cardiac Output. List the variables which alter cardiac output and make calculations from CO=HRxSV. Explain the interaction among venous return and cardiac output for the left and right heart. Aims II Define TBW, ECF, ICF, IF, Plasma and Blood. Calculate TBW, ECF, IF and blood volume. Know typical values for blood volume and PCV. Describe the systemic and pulmonary circulations and explain the difference between them Describe the Frank-Starling law of the heart and sketch the cardiac function curve. Define Systolic, Diastolic, Mean and Pulse Pressure for the systemic arterial system. Know typical values for systemic arterial systolic, diastolic, mean and pulse pressure. Calculate mean and pulse pressure from systolic and diastolic pressure. Functions of the Cardiovascular System Delivery of O2, Glucose and other nutrients to active tissues. Removal of CO2, Lactate and other waste products from active tissues. Transport of metabolites and other substances to and from storage sites. Transport of hormones, antibodies and other substances to site of action. Moves blood to transport stuff in the blood Fluids Total Body Water (TBW) 60% of body weight (males) is water (~50% females) Fluid inside cells is intracellular fluid (ICF) Fluid outside cells is extracellular fluid (ECF) Two thirds of total body water (TBW) is in ICF One third of TBW is in ECF ECF found in solid organs is interstitial fluid (IF) Plasma, lymph and IF are all part of ECF Blood Fluid in the blood vessels and chambers of the heart 6 – 8% of body mass A 70 kg person has about 5 L of blood 55% plasma (fluid) Serum is fluid from clotted blood 45% cells (packed cell volume 0.45) erythrocytes (red blood cells) leukocytes (white blood cells) platelets Cells of the Blood • Red blood cells – gas transport • White blood cells – immune response • Platelets – Blood clotting • All are from haematopoietic stem cells in bone marrow Outline of the Circulation Arteries and Veins Arteries accept blood from the ventricles of the heart. Arterioles are small arteries; control flow. Microcirculation connects arterioles to venules, includes direct connections (metarterioles etc), capillaries. Capillaries are where exchange occurs Venules are small veins; collect blood from microcirculation Veins deliver blood to the atria of the heart; blood storage vessels. Systemic versus Pulmonary Pulmonary circulation from the right side of the heart. Gains O2 from the lungs. Systemic circulation is all the rest. Delivers O2 to the body. Comes from the left side of the heart. The systemic and pulmonary circulations are in Series with each other. Berne & Levy Principles of Physiology Ch 15 Systemic versus Pulmonary Systemic arteries have oxygenated blood. Systemic veins have deoxygenated blood. Pulmonary arteries have deoxygenated blood Pulmonary Veins have oxygenated blood. Berne & Levy Ch 15 Some Numbers Diastole: Relaxation of the heart. Systole: Contraction of the heart Diastolic pressure: 80 mmHg lowest systemic arterial pressure, during diastole. Systolic pressure: 120 mmHg highest systemic arterial pressure, during systole. Blood pressure Systemic arterial pressure as: systolic/diastolic e.g. 120/80 mmHg Some (more) Numbers Pulse Pressure: 40mmHg the difference between systolic and diastolic pressure. Mean arterial pressure: 90-95 mmHg the arterial pressure averaged over the cardiac cycle. 1 Pa Pd + ( Ps - Pd ) 3 Pressure and Flow Flow(Q) requires a pressure difference. Blood flows from high to low pressure. Flow through the vascular system is produced by the arterial to venous blood pressure. Rhoades & Pflanzer Human Physiology 2nd Ed Ch 18 Cardiac Output How Much Blood Does the Heart Pump? Cardiac output is the amount of blood the heart pumps each minute. About 5 l/min at rest Cardiac Output Volume pumped each minute depends on: The number of strokes – heart rate The volume per stroke – stroke volume Even More Numbers Heart Rate: 70 beats/min number of contractions per unit time. Stroke Volume: 70-80 ml volume pumped by a ventricle in one contraction. Cardiac Output: 5-5.5 l/min flow rate out of one side of the heart, volume pumped per unit time. Cardiac Output = Heart Rate x Stroke Volume Venous return: flow rate into the heart. 5-5.5 l/min Ventricular Volumes End diastolic volume ~130 ml End systolic volume ~50 ml Stroke volume ~80 ml Ejection fraction ~0.65 or 65% Flow Through Regions Connected in Series Rhoades & Pflanzer 2nd Ed Ch 18 Flow in =flow out Q =5 l/min Q =5 l/min Flow in =flow out Blood Volume is abbreviated as: Q Blood Flow is abbreviated as: Q Intrinsic Control of Cardiac Output Venous return controls stroke volume Cardiac Function Curve Increasing venous return increases the ventricular end diastolic volume and stretches the ventricles. Stretching muscle cells increases the pressure they can generate. Increasing pressure increases stroke volume. Frank-Starling Law “Within physiological limits the heart pumps all the blood it receives.” Increased venous return stretches the ventricles and increases force production until cardiac out put matches venous return. Summary Arteries, microcirculation and veins. Systemic versus Pulmonary Circulation. Systemic arterial pressure and an equation. Cardiac output, venous return, blood flow and another equation. Cardiac function curves and the Frank-Starling Law. Lots of numbers and definitions.