Physiology

I. CELL, MEMBRANE, MUSCLE, and NERVE PHYSIOLOGY

Differences between SKELETAL, CARDIAC, and SMOOTH MUSCLES

SKELETAL CARDIAC SMOOTH
Single small, closely packed
Fibers Single multinucleated cells Aligned cells, branching
fusiform cell
Cells Cylindrical Cylindrical Fusiform
Striations Present Present Absent
Location of Nuclei Peripheral Central Central
Absent, caveolae may be
T Tubules Center of triads at A-I junction In diads at Z-discs
functionally similar
Well-developed, with 2 Less well-developed, one
terminal cisterns per small terminal cistern per
Sarcoplasmic Reticulum Irregular smooth ER
sarcomere in triads with T sarcomere in diad with T-
tubule tubule
Very well organized Intercalated discs joining cell
Gap junctions, caveolae,
Specialized Structures sarcomeres, SR, and with many adherent and gap
dense bodies
transverse tubule system junctions
Troponin C binds to Ca2+, Troponin C binds to Ca2+, Actin-myosin binding occurs
moving tropomyosin and moving tropomyosin and with myosin phosphorylation
Contraction
exposing actin for myosin exposing actin for myosin by MLCK triggered when
binding binding calmodulin binds Ca2+
Endomysium, perimysium, Endomysium, subendocardial Endomysium and less-
Connective Tissue
and epimysium and subpericardial CT layers organized CT sheaths
BV, digestive and respiratory
Major Location Skeletal muscles Heart
tracts, uterus, bladder
Key Function Voluntary Automatic Involuntary
Efferent Innervation Motor Autonomic Autonomic
Contraction All or None All or None Partial, slow
Response to Increased Load Hypertrophy Hypertrophy Hypertrophy
Capacity for Regeneration Limited Very Poor Good

II. CARDIOVASCULAR PHYSIOLOGY

Difference between SYSTEMIC and PULMONARY CIRCULATION

Systemic Circulation Pulmonary Circulation
- supplies all organs except the lungs - circulation to the lungs
- also known as the "greater circulation"
- high resistance; high pressure circulation - also known as "lesser circulation"
- has a pressure of 70-120 mmHg - low resistance; low pressure circulation
- vessels are less dilatable, causing more resistance - has a pressure of 4-25 mmHg
- vessels are very dilatable, causing little resistance

Difference between ATRIA and VENTRICLES

Atria
- thin walled with fair
amount of elasticity and
distensibility so that when
filled with blood, there will - effective pump
be only a slight increase in
pressure
- low pressure chambers,
low resistance
- primer pump; not an
effective pump but serves
Ventricles
- thick walled; greater force of contraction
- less distensible than the atria that is why there is greater pressure when filled with blood
- high pressure, high resistance
Differences between the Left and Right Ventricles:
Thickness: L > R
Force: L > R
Pressure: L > R
Work: L > R
Stroke Volume: L = R
 only as a primer pump that
will help push blood
towards the ventricle
- has a lesser force of
contraction
- no significant difference
between right and left
Cardiac Output: L = R
Heart Rate: L = R
Blood Flow: L = R
Left Ventricle: has to overcome aortic pressure (SYSTEMIC pressure), therefore has to overcome
HIGH afterload
Right Ventricle: has to overcome pulmonic pressure (PULMONARY pressure), therefore has to
overcome LOW afterload

Differences between the Cardiac Valves

ATRIOVENTRICULAR A. Tricuspid Valve
- prevents backflow of blood from the ventricle to the atria - prevents backflow of blood from right ventricle to right atrium
- opens due to pressure gradient B. Mitral Valve/Bicuspid Valve
- thinner than semilunar valve therefore a lesser pressure - prevents backflow of blood from the left ventricle to the left
can open and close the valve atrium
SEMILUNAR A. Pulmonary Valve
- half moon shaped - prevents the backflow of blood from the pulmonary arteries to
- located in the major vessels (pulmonary vessels and aorta) the right ventricle
- a greater pressure is needed to open and close the valve B. Aortic Valve
- thicker than the AV valves - prevents the backflow of blood from the aorta to the left
- prevents the backflow of blood from the aorta or ventricle
pulmonary to the ventricles
- no chordae tendinae

The Electrical Activity of the Heart

- occurs in the CONTRACTILE cardiac tissues: ATRIA, - occurs in ELECTRICAL cardiac tissue: SA NODE, AV NODE
VENTRICULES, BUNDLE OF HIS, and PURKINJE Fibers - also known as the SLOW RESPONSE
- also known as the FAST RESPONSE - unstable
- stable - less amplitude
- greater amplitude - slowly depolarizing (pacemaker potential)
- increased conduction velocity - more sensitive to conduction block
- RMP: -90mV - RMP: -60 mV
Phase 0: DEPOLARIZATION fast sodium channels open Phase 0
Phase 1: INITIAL REPOLATIZATION fast sodium channels close Phase 1: not as prominent
Phase 2: PLATEAU calcium channels open and fast potassium Phase 2: absent
channels close Phase 3
Phase 3: RAPID REPOLARIZATION calcium channels close and Phase 4: due to calcium influx
slow potassium channels open
Phase 4: RESTING MEMBRANE POTENTIAL
The Cardiac Cycle and the Volume-Pressure Curves
EVENTS DURING DIASTOLE EVENTS DURING SYSTOLE
Phase IV: PERIOD OF ISOVOLUMIC RELAXATION Phase II: PERIOD OF ISOVOLUMIC CONTRACTION
- the aortic valve closes and the ventricular pressure falls back - the volume of the ventricle does not change because all valves
to the diastolic pressure level are closed
- decrease in intraventricular pressure without any change in - pressure inside the ventricle increases to equal the pressure in
volume; period of lowest pressure and volume the aorta, at a pressure value of about 80 mm Hg
- the ventricle returns to its starting point, with about 50
milliliters of blood left in the ventricle and at an atrial pressure Phase III: PERIOD OF EJECTION
of 2 to 3 mmHg - the systolic pressure rises even higher because of still more
contraction of the ventricle
Phase I: PERIOD OF FILLING - the volume of the ventricle decreases because the aortic valve
- begins at a ventricular volume of about 50 milliliters and a has now opened and blood flows out of the ventricle into the
diastolic pressure of 2 to 3 mm Hg aorta
- amount of blood that remains in the ventricle after the A. Rapid Ejection
previous heartbeat, 50 milliliters, is called the end-systolic B. Slow Ejection
volume
- as venous blood flows into the ventricle from the left atrium, a wave: occurs with the rise in pressure caused by atrial
the ventricular volume normally increases to about 120 contraction
milliliters, called the end-diastolic volume, an increase of 70 c wave: is caused by impact of the common carotid artery with
milliliters the adjacent jugular vein and to some extent by the abrupt
- volume increasing to 120 milliliters and the diastolic pressure closure of the tricuspid valve in early ventricular systole
rising to about 5 to 7 mm Hg v wave: reflects the rise in pressure associated with atrial filling
- divided into:
A. Rapid Ventricular Filling
- 70% of blood
- passive process
- 3rd heart sound
B. Slow Ventricular Filling
- 30% of blood
- also known as diastasis
- atrial systole will complete ventricular filling, hence is an
active process