CIRCULATORY

RESPONSES TO
EXERCISE
ORGANIZATION OF THE CIRCULATORY SYSTEM & structure of the Heart
Myocardium

 The wall of the heart is composed of three layers

(I) an outer layer called the epicardium,

(2) a muscular middle layer, the myocardium , and
(3) an inner layer known as the endocardium.
LAYERS OF HEART
Myocardium

 It is the myocardium, or heart muscle, that is responsible for contracting and

forcing blood out of the heart.
 The myocardium receives its blood supply via the right and left coronary arteries
These vessel,s branch off the aorta and encircle the heart.
 The coronary veins run alongside the arteries and drain all coronary blood into a
larger vein called the coronary sinus, which deposits blood into the right atrium .
Cardiac Cycle
 cardiac cycle lasts 0.8 second, with 0.5 second spent in diastole and remaining 0.3
second dedicated to systole
ARTERIAL BLOOD PRESSURE

 Force exerted by blood against the arterial walls.

 Difference between systolic and diastolic blood pressure is called the
pulse pressure.
 Average pressure during a cardiac cycle is called mean arterial pressure.
 Mean arterial pressure = DBP + .33 (pulse pressure)= 93mmHg.
Hypertension
 Blood pressure above 140/90 mmHg
 Primary (essential) hypertension
Cause unknown
90% cases of hypertension
 Secondary hypertension
result of some other disease process
 Risk factor for:
– Left ventricular hypertrophy
– Atherosclerosis and heart attack
– Kidney damage
– Stroke
Factors that Influence Arterial
Blood Pressure

 Determinants of mean arterial pressure

– Cardiac output
– Total vascular resistance
REGULATION OF BLOOD
PRESSURE
 Short-term regulation
– Sympathetic nervous system
– Baroreceptors in aorta and carotid arteries
 Increase in BP = decreased SNS activity
 Decrease in BP = increased SNS activity
• Long-term regulation
– Kidneys
Via control of blood volume
 Increase in arterial pressure
 receptors send impulses to the cardiovascular control center,
 decreasing sympathetic activity
 Reduction in sympathetic activity
 lower cardiac output
 reduce vascular resistance,
 lowers blood pressure
 Decrease in blood pressure
 reduction of baroreceptor activity to the brain.
 increasing sym pathetic outflow
 raises blood pressure back to normal
Regulation of Stroke Volume
Regulation of Stroke Volume
Stroke volume, at rest or during exercise, is regulated by three variables

( I) the end-diastolic volume (EDV), which is the volume of blood in the ventricles at
the end of diastole;

(2) the average aortic blood pressure; and

(3) the strength of ventricular contraction

CARDIAC OUTPUT
 Cardiac output (0) is the product of the heart rate(HR) and the stroke
volume (SV).

Q =HR x SV .
Regulation of Heart Rate

 Blood supply changes in accordance with changing oxygen demand.

 Parasympathetic and sympathetic nervous systems influence heart rate.
 Parasympathetic fibers to the heart arise from neurons in cardiovascular
control centre in medulla oblongata and make up portion of vagus nerve.
 Act on SA and AV and release acetylcholine this decreases their activity by
hyperpolarization. This decreases heart rate.
 At rest the vagus nerves carry impulses to the SA and AV nodes.
 This is parasympathetic tone.
 Changes in parasympathetic activity can cause heart rate to increase or decrease.
 Decrease in parasympathetic tone to the heart can elevate heart rate,
 Increase in parasympathetic activity causes a slowing of heart rate.
 Initial increase in heart rate during exercise is 100 beats per minute due
to withdrawal of parasympathetic tone.
 At higher work rates, stimulation of SA and AV nodes by the
sympathetic nervous system is responsible for increases in heart rate.
 Sympathetic fibers reach the heart by means of the cardiac accelerator
nerves innervating both the SA node and the ventricles.
 Endings of these fibers release norepinephrine which act on beta
receptors in the heart and cause an increase in heart rate and myocardial
contraction .
Electrical Activity of the Heart
Electrical Activity of the Heart
 SA node serves as the pacemaker for the heart.
 Spontaneous electrical activity occurs due to a decay of the resting membrane
potential via inward diffusion of sodium during diastole.
 atrial­mediated depolarization of the AV node is delayed by approximately 0.10
second.
 This time delay is important because it allows atrial contraction to empty atrial
blood into the ventricles prior to ventricular depolarization and contraction.
 Bundle branches --- parkinji fibers.
Conduction system of the Heart
 ECG

 Electrical changes that occur in the myocardium during the cardiac cycle
is called an electrocardiogram (ECG).
 ECG during exercise is often used in the diagnosis of coronary artery
disease.
 P wave represents the depolarization of the atria.
 QRS complex represents the depolarization of the ventricles.0.10 second
following the P wave.
 T wave is ventricular repolarization
 Atrial repolarization occurs at the same time as the QRS complex.
 QRS at the beginning of systole.
 T at the beginning of diastole.
Diagnostic Use of the ECG During
Exercise:
 Graded exercise test to evaluate cardiac function
– Observe ECG during exercise
– Also observe changes in blood pressure
 Atherosclerosis
– Fatty plaque that narrows coronary arteries
– Reduces blood flow to myocardium
Myocardial ischemia
 S-T segment depression
– Suggests myocardial ischemia
To be continued