40.Neural (extrinsic) regulation of cardiac performance, sympathetci and parasympathetic effects.

Humoral factors affecting cardiac performance.

The cardiac system is self-regulating. It is nearly impossible to consciously increase or decrease
contraction rate due to its involuntary operation. The large number of influential factors affecting
cardiac performance combine in a complex manner, thus providing the ability to adapt quickly and
efficiently to the needs of the body. This is accomplished by two pathways. The intrinsic pathway
represents the alterations occurring within the myocardial cells which do or do not depend on a
change in the initial myocardial fiber length. The extrinsic pathway occurs primarily through neural
and humoral adaptations. These discrete interrelated biological interactions indicate that regulating
any certain physiological control pathway is not easy.
( I ) Nervous regulation:
The heart rate is regulated by two center present in the medulla oblongata:
Cardiac.Activation.Center which is connected with the sympathetic nervous system and
Cardiac.Inhibition.Center which is connected with the vagus nerve i.e. parasympathetic nervous
system.
At rest , the human heart pumps about 5 L of blood each minute. This volume is called cardiac
output (C.O.). During exercise ventricles pump as much as 4-7 times this amount. The two basic
means by which the volume pumped by the heart is regulated are:
Intrinsic regulation of pumping in response to changes in volume of blood flowing into the heart,
and Extrinsic regulation of pumping: a. reflex control of the heart by the autonomic nervous system.
b. humoral control of the heart function by hormones ions or other metabolites.2. Extrinsic
Regulation a. Reflex Control by ANS .The heart is well supplied with both sympathetic and
parasympathetic nerves. These nerves affect the cardiac pumping in two ways: 1. by changing the
heart rate , and 2. by changing the strength of contraction
Sympathetic nerves to the heart increase the cardiac rate and the force of cardiac contraction.
Parasympathetic (cholinergic vagal cardiac fibers) decrease heart rate.
In humans, in whom both sympathetic and parasympathetic systems are blocked (by drugs),
the heart rate is approximately 100 beats per minute.
b. Humoral Control
Ions:
An excess of potassium - the heart becomes extremely dilated and flaccid and slows the heart rate.
Very large quantities can block conduction through the AV node.
An excess of calcium - effects almost exactly opposite of these of potassium ions, causing the heart
to go into spastic contraction. An excess of sodium ions depresses cardiac function, an effect similar
to that of potassium ions.
Hormones and metabolites:- The hormones adrenaline and noradrenaline stimulate the heart rate
and the strength of cardiac contraction. - Thyroid hormones (T3 and T4) increase the heart rate. -
Some metabolites as the lactic acid also increase the strength of cardiac muscle contractions.
41 functional characteristics of the blood vessels.Hemodynamic principles characteristics of the
vessels and blood. Hemodynamic indices.Volume and linear velocity of the blood flow in differenct
parts of the vascular system and determining factors.
The most important feature of the circulation: It is a continuous circuit. So, if a given amount of
blood is pumped by the heart, the same amount must also flow through each subdivision of the
circulation.two major subdivisions: the systemic circulation, and the pulmonary circulation.
Systemic circulation - blood pressure normally about 120 mmHg - high pressure circuit. Pulmonary
circulation - blood pressure - about 20 mmHg - low pressure circuit.
The Systemic circulation,
Because the systemic circulation supplies all the tissue of the body except the lungs with blood
flow, it is frequently called the greater circulation or peripheral circulation. It consists of: arteries,
arterioles, capillaries, venules, and veins.
The function of the arteries is to transport the blood under high pressure to the tissues. The arteries
have strong vascular walls , and blood flows rapidly in the arteries. The large arteries are elastic .
They stretch at the pulse of blood from the heart enters the arterial tree. Then they recoil to a
smaller size as the blood flows out of the arteries between heartbeats. The elastic properties of the
arteries are important for two reasons:
1. This prevents the pressure from rising extremely high when the blood is pumped by ventricular
contraction.
2. The elasticity maintains a high arterial pressure between heartbeats blood can continue to flow
through the tissues without interruption.
Arterioles are smallest branches of the arterial system are called arterioles. They act as control
valves through which blood is released into the capillaries. They have a strong muscular wall
that is capable of closing the arteriole completely or of allowing it to be dilated several fold, thus
having the capability of vastly altering the blood flow to the capillaries.
The arterioles are intensively innervated by the sympathetic nervous system and, when stimulated
constrict powerfully. Furthermore, many local factors in the tissues (oxygen concentration, carbon
dioxide, H+) can directly affect the degree of constriction of the arterioles.
Capillaries, the function of the capillaries is to exchange fluid, nutrients, electrolytes, hormones and
other substances between the blood and tissues . For this role, the capillary walls are very thin and
are permeable to small molecular substances .
They are approximately 10 billion capillaries in the peripheral tissues. These together have more
than 500 square meters of surface area . The average functional capillary blood pressure is about
17 mm Hg , whereas the pressure in the tissue fluid is near zero or even less than zero.
The venules collect blood from the capillaries . They gradually are passing into progressively
larger veins.
The Veins function as conduits for transport of blood from the tissues back to the heart and from
lungs back to the heart again. Since the pressure in the veins is very low , the venous walls
are thin . Even so, they are muscular, and this allows them to contract or expand and thereby
act as a reservoir for extra blood . Blood from all the systemic veins flows into the right
atrium, therefore the pressure in the right atrium is frequently called the central venous
pressure .
Hemodynamics is the study of interrelationships among flow, pressure, resistance and other basic
physical principles of a blood circulation.
Properties of Cardiovascular System that Affect Blood Flow
Pulsatile Flow, Contraction/relaxation of the heart - Pressure changes from the heart beat.
2. Blood Vessels , Closed network of tubes - Elastic conduits - Highly branched -
Decreasing diameter - Enormous surface area (ie, in capillaries)
3. 3. Blood Liquid and cellular component - Non-Newtonian fluid - Viscosity affects
flow

Hemodynamics, Poiseuille's Law

Many properties of blood flow relate to this equation: Flow (Q) = P/R = r4

Where r = radius of the blood vessel, P = pressure difference along the vessel, l = length
of the vessel,viscosity of the blood and = a proportionality constant.
Flow (Q) is primarily driven by a pressure gradient. That is Parterial > Pvenous or Psystole >
Pdiastole. If length and viscosity are considered constant, then Flow (Q) is directly
proportional to the radius of a vessel.