Introduction to

Cardiovascular Physiology
Jim Pierce
Bi 145a
Lecture 14, 2010-11
Cardiovascular System
 Our Goals:
– Anatomy and Core Principles
– Cardiac Electrophysiology
– Cardiac Mechanical Function
– Vascular Function
– Integrated Picture
Cardiovascular System
 The Heart

The Pump
 (Vascular System)

The Pipes
Pulmonary Circulation
Systemic Circulation
The Heart
Mediastinum
Mediastinum, Heart
Exposed
Mediastinum without
Heart
Pericardium without
Heart
Heart, Left Lateral View
The Heart

 Components of the Heart

– Cardiac Skeleton and Valves
– Epicardium and Epicardial Vessels
– Myocardium and Penetrating Vessels
– Endocardium
– Electrical System
The Heart
Cardiac Skeleton
 The primary
skeletal
structures
surround
the Valves

 Annulus
Fibrosis
 Fibrous
Trigone
Cardiac Skeleton
Valve
Annulus

Fractured SEM Mallory’s Trichrome

Cardiac
Skeleton
Higher
Power
Cardiac Skeleton
Cardiac Valves
Cardiac Valves
Cardiac Valves
Layers of the Heart
Epicardium

Yes, That’s Fat

Epicardium
The Epicardium
supports the
coronary vasculature
Myocardium
Endocardium
Heart, Anterior View
Heart, Posterior View
Heart, Posterior Inferior
View
Cardiac Vessels,
Anteriorly
Cardiac Vessels,
Posteriorly
Right Atrium
Right Ventricle
Left Atrium and Ventricle
Left Ventricle
Artery
Vein
Aortic Arch
Thoracic
Aorta
Abdominal
Aorta
Inferior
Vena
Cava
Superior
Vena
Cava
Portal
Venous
System
Thoracic Vessels
Abdominal Vessels
Extremity Vessels
Calf Pump
Muscular Artery
Muscular Artery
Artery and Vein
Neurovascular
Bundle
Small Artery and Vein
Arterioles
Capillaries
and
Venules
Blood Vessels
Blood Flow
Cardiac Cycle

 The heart squeezing

is called Systole

 The heart relaxing

is called Diastole

 Preload
 Afterload
Valves During Systole
Valves During Diastole
Blood Transport
 One of the main roles of the blood
is Gas Transport

 The first way we can describe

“amount of gas” is by partial pressure

 pO2 = partial pressure of oxygen

 pCO2 = partial pressure of carbon dioxide
Gas Transport
 The second way we can describe
“amount of gas” is by concentration
 (Volume of gas per Liter of blood)

 CO2 = Oxygen concentration (in mL/L)

 CCO2 = Carbon dioxide concentration (in mL/L)

It’s a silly and confusing symbol to

use capital C for this purpose
Gas Transport
 Why Concentration (ml/L)?

 Tissue consumes mL of O2 / min

 Heart pumps L of blood / min

 Blood carries mL of O2 / L blood
 Thus, heart delivers mL O2 / min
Gas Transport
 Why Concentration (ml/L)?

 Tissue produces mL of CO2 / min

 Heart pumps L of blood / min

 Blood carries mL of CO2 / L blood
 Thus, heart delivers mL CO2 / min
Oxygen Transport

 Oxygen Transport (Gas Number One)

 Oxygen does not dissolve well

– One liter of plasma holds 3 ml Oxygen
– One liter of blood has 55 % plasma
– Thus, one liter of blood carries only 1.65
ml Oxygen
Oxygen Transport
 The Erythrocyte has specialized to carry
Oxygen

– Hemoglobin and Hemoglobin Allostery

– One g of Hemoglobin carries 1.34 ml Oxygen
– One dL of Blood has 14 g of Hemoglobin
– Thus, one liter of blood carries 187 ml
Oxygen
Hemoglobin
Oxygen Transport
 Hemoglobin
– Tetrameric Tertiary Structure
– Two each of alpha and beta globulins
– Each globulin has a heme group with an iron

– These irons are in the reduced state (Fe++)

– The oxygen is bound as a ligand to iron with no
electron transfer (oxygenated not oxidized)

– There is sigmoidal oxygen binding from allostery

Oxygen Transport
 Hemoglobin Saturation
– As pO2 increases, hemoglobin carries more O2
– There is a maximal carried O2
 Experimentally found to be 1.34 mL per g Hgb

– For a given concentration of hemoglobin, we can

describe the amount of oxygen carried by the
hemoglobin saturation.
– Sat Hgb % = actual carried O2 / maximal O2
Oxygen Transport
Oxygen Transport
 Concentration of Oxygen
– The total number of milliliters of oxygen
carried per liter of blood.

–CO2 = (mL dissolved O2) + (mL carried O2)

–CO2 = (.003 * pO2) + (1.34 *Hgb Sat%)

Oxygen Transport
 Saturation of Hemoglobin

CO 2 = (.003 * pO2) + (1.34 *Hgb Sat%)

Saturation % = CO2 / (1.34 *Hgb)

 Knowing saturation gives us an idea of:

– Volume of gas (see above)
– Partial pressure of gas (allosteric binding)

 That’s why we like Saturation so much

 Oxygen Transport
 Measuring Saturation of Oxygen

– Iron absorbs light

– Different ligands change iron’s absorption
– Hemoglobin absorbs light

– Different ligands change hemoglobin’s absorption.

– Different hemoglobin saturations cause
differing absorption.
Oxygen Transport
 Co-oximitery
– Beer’s Law A=BC
– Lots of Beer’s Law A=B1C1+B2C2+ …
– For each wavelength used…
we observe % absorbed

– That tells us some linear combination of the

concentrations of everything that absorbs that
wavelength.
Oxygen Transport
 Co-oximitery

– The two most common iron states in blood:

 Fe++ - Heme, H2O Ligand Bonding
 Fe++ - Heme, O2 Ligand Bonding

– Other reasonably common iron states:

 Fe++ - Heme, CO Ligand Bonding
 Fe+++ - Heme H2O Ligand Bonding
Oxygen Transport
 Co-oximitery

– One sample of blood, one concentration of Hgb

– Four amounts of each iron state

– Four wavelengths
– Four absorbances
– Four linear combinations of these four states

– One linear combination of four states = total

– Solvable for percent hemoglobin in each state.
Oxygen Transport

 Co-oximitery

– Results:
 % Saturation O2
 % Unsaturated Hgb

 % Saturation CO

 % Methemoglobin
Pulse Oximetry
Pulse Oximetry
Hemoglobin Oxygen
Association
Hemoglobin Oxygen
Association

2,3 DPG =
2,3 diphosphoglycerate
Oxygen Extraction
Oxygen Extraction
Oxygen Extraction
Carbon Dioxide Transport

 CO2 is the end product for energy

extraction from reduced carbon
(carbohydrates, fats)

 CO2 dissolves fairly easily in tissue

fluids
Carbon Dioxide Transport
 CCO2 = (dissolved CO2) + (carried CO2)

 Dissolved CO2 reacts with H2O

– This leads to production of H+ and HCO3-

 Available CO2 = (dissolved CO2) +

(carried CO2) + (accessible HCO3-)
– Not easily calculated from an equation
Carbon Dioxide Transport

 CO2 + H2O <==> H+ + HCO3-

 To shift mass to the right, we need to

hide the ion products.

 But to where???
Carbon Dioxide Transport
Carbon Dioxide Transport

 Hemoglobin can hold six times as

many protons as all other plasma
proteins combined!

 (Remember those central Histidines?)

 (with pKa’s approximately 7.0?)
Carbon Dioxide Transport

 Deoxygenated hemoglobin
allosterically holds more protons than
oxygenated hemoglobin.

 This is called the Haldane Effect

Gas Transport
 Oxygen transport and Carbon Dioxide
transport are coupled.

 As tissue burns oxygen, it produces

carbon dioxide.
 The more oxygen is removed from
hemoglobin, the more space is made in
the red cell to remove carbon dioxide.
Gas Transport
 If a tissue metabolic rate exceeds the
availability of oxygen, the cell dumps its
excess electron load on pyruvate (which
becomes lactic acid)
 Lactic acid decreases the pH of the
blood
 As pH decreases, more oxygen is forced
off the hemoglobin and made available
for the tissue
Gas Transport
 As we will see in renal physiology,
blood pH is very, very tightly
regulated.

 Thus, the red cell can compensate for

chronic pH changes by changing
intracellular concentration of 2,3 DPG
Gas Transport

 Cardiac Output = mL Blood per minute

 Concentration O2 = mL O2 per mL
Blood

 Delivery of Oxygen
= CO x C O2
Gas Transport

 We will talk more about CO2 for O2

exchange in pulmonary physiology.
The Circuit

• Pump
• Pipes
• Perfusate
Review

 The cardiovascular system:

 Circulates Blood

 Delivers Nutrients and Signals

 Removes Wastes