Cardiovascular system, kidneys & blood pressure
21 important questions on Cardiovascular system, kidneys & blood pressure
Give an overview of the heart from the cardiovascular system
- weighs ± 300g
- 2 pumps of 4 chambers
- left heart (LA, LV) or main pump
- Right heart (RA, RV) or boost pump
- CO = HR*SV
- output of each pump is ±5 L/min
- x5 during exercise
- 75-yr lifetime: 400 million L of blood
Give an overview of the the two circuits from the cardiovascular system
- The pulmonary circuit
- The systemic circuit
Blue = oxygen-poor blood
Red = oxygen-rich blood
What are the layers of the heart: (internal anatomy of the heart)
- Endocardium
- endothelium tissue
- areolar connective tissue
- Myocardium
- cardiac muscle tissue
- Epicardium (visceral pericardium)
- mesothelium tissue
- areolar connective tissue
It has 3 layers and the biggest is myocardium
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How works the conduction system and ECG
sinoatrial (SA) node
Atrioventricular (AV) node
- P wave: depolarisation of arterial myocardium
- QRS-complex: depolarisation of ventricular myocardium
- T wave: depolarisation of ventricular myocardium
3 different types of action potential
- Nerve cell
- Atrial pacemaker
- Ventricular Myocyte
The duration between hart cells and nerve cells is different, nerve cells is very short.
The resting potential of atrial pacemaker is higher than the from ventricular myocyte
Ventricular myocyte has an immediately increase.
Vessels and its circulation -->
What is the function?
Are there different types?
How many vessels are there?
Arteries = distribution system
Micro-circulation = diffusion and filtration system
Veins = collection system
number of vessels at a particular level of arborisation increase enormously from
- 1 aorta
- 10^4 small arteries
- 10^7 arterioles
- 4 x 10^10 capillaries
What are the functional consequences of the increase in area? (3)
- larger surface (more options for transfer)
- Slower speed (more time for transfer)
- Lower pressure (capillaries are fragile)
Plasma proteins vs serum proteins
- Albumin, fibrinogen and gamma-globulins (immunoglobulins) are the most abundant plasma proteins
- serum = residual fluid after clotting (plasma minus clotting factors, especially fibrinogen)
What are the primary and secondary roles of the function of the cardiovascular system?
- Distribution system for gasses and nutrients for energy production
Secondary roles
- signalling by hormones and neurotransmitters
- mediation of inflammation and host defence processes
What are the characteristics of RBC (Erythrocyte)
- Life span of 120 days
- Produced in bone marrow by a process called erythropoiesis (± 7 days)
- No nucleus or other organelles
- discoid shape provides large surface to volume ratio
- most abundant protein is hemoglobin
- ATP exclusively by glycolysis
Main tasks
- carrying O2 from the lungs to the systemic tissues
- Carrying CO2 from tissues to the lungs
- Assisting in the buffering of acids and bases
Erythropoiesis -->
Why are mitochondria removed?
EPO: erythropoietin, hormone synthesised by the kidney
They are removed because, otherwise the mitochondria are using the O2. Other cells also need the O2...
How can hemoglobin transport oxygen?
- Hemoglobin contains heme
- Heme contains iron
- Iron can bind oxygen, because it easily shifts between Fe2+ (ferrous iron) <--> Fe3+ (ferric iron)
The Bohr effect (how can hemoglobin transport oxygen)
Heme contains iron
Iron can bind oxygen
- Heme-iron binds oxygen in blood vessels in the lung
- pCO2 is low, pH is high
- Heme-iron releases oxygen in blood vessels in tissue
- pCO2 is high, pH is low (dissolved CO2 is acidic)
= Bohr effect
Mechanism: A histidine residue in global, proximal to the heme group, becomes positively charged under acid (low pH) conditions, releasing oxygen from the heme group
Cardiovascular disease has 4 type of failures
- Failure of the heart as a pump
- heart failure, arrhythmia
- Failure of the blood as an effective liquid organ
- thrombosis and embolism
- Failure of the vasculature
- as a competent container
- haemorrhage (bleeding)
- as an efficient distribution system
- atherosclerosis
- Failure of the heart and vasculature
- coronary heart disease (CHD)/ ischemic heart disease
Name 6 consequences of high blood pressure
- Stroke
- Heart failure
- Sexual dysfunction
- Vision loss
- Heart attack
- Kidney disease/failure
Usually, blood pressure refer to blood pressure of:
- large arteries in the systemic circuit
- large veins in the systemic circuit
- large arteries in the pulmonary circuit
- average pressure of large arteries in the systemic and pulmonary circuit
- large arteries in the systemic circuit
There are two responses on the regulation of blood pressure
- Baroreceptors and the autonomic nervous system
Short to longer term response
- Hormonal regulation (the RAAS system)
What is the function os baroreceptors?
baroreceptor -> nerve -> midbrain (autonomic nervous system) -->1 CO -->2 SVR
MAP = CO * SVR
What happens when the baroreceptors detects low blood pressure? And when the baroreceptors detects high blood pressure?
zie de afbeelding
What are the functions of the kidney?
- Filter plasma and excrete waste
- keep water balance
- hormone secretion: blood pressure regulation
Functional unit = nephron
RAAS (renin-angiotensin-aldosterone-system)
triggers (for low blood pressure) --> juxtaglomerular cells --> renin
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