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

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.