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Howley
Chapter
Circulatory Adaptations to
Exercise
Chapter 9
Objectives
1
Chapter 9
Objectives
Chapter 9
Outline
Organization of the Hemodynamics Circulatory Responses
Circulatory System Physical Characteristics to Exercise
Structure of the Heart of Blood Emotional Influence
Pulmonary and Systemic Relationships Among Transition From Rest to
Circuits Pressure, Resistance, Exercise
and Flow Recovery From Exercise
Heart: Myocardium
and Cardiac Cycle Sources of Vascular Incremental Exercise
Resistance
Myocardium Arm Versus Leg Exercise
Cardiac Cycle
Changes in Oxygen Intermittent Exercise
Delivery to Muscle Prolonged Exercise
Arterial Blood Pressure
During Exercise
Factors That Influence Regulation of
Changes in Cardiac
Arterial Blood Pressure
Output During Exercise Cardiovascular
Electrical Activity of the Adjustments to
Heart Changes in Arterial-Mixed
Venous O2 Content Exercise
Cardiac Output During Exercise
Regulation of Heart Rate Redistribution of Blood
Regulation of Stroke Flow During Exercise
Volume Regulation of Local Blood
Flow During Exercise
Copyright ©2009 The McGraw-Hill Companies, Inc. All Rights Reserved.
2
Chapter 9 Organization of the Circulatory System
• Heart
– Creates pressure to pump blood
• Arteries and arterioles
– Carry blood away from the heart
• Capillaries
– Exchange of O2, CO2, and nutrients with tissues
• Veins and venules
– Carry blood toward the heart
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Chapter 9 Organization of the Circulatory System
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Chapter 9 Organization of the Circulatory System
Pulmonary and
Systemic Circulations
In Summary
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Chapter 9 Heart: Myocardium and Cardiac Cycle
Myocardium
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Chapter 9 Heart: Myocardium and Cardiac Cycle
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Chapter 9 Heart: Myocardium and Cardiac Cycle
• Systole
– Contraction phase
– Ejection of blood
~2/3 blood is ejected from ventricles per beat
• Diastole
– Relaxation phase
– Filling with blood
• At rest, diastole longer than systole
• During exercise, both systole and diastole are
shorter
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Chapter 9 Heart: Myocardium and Cardiac Cycle
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Chapter 9 Heart: Myocardium and Cardiac Cycle
• Expressed as systolic/diastolic
– Normal is 120/80 mmHg
• Systolic pressure
– Pressure generated during ventricular contraction
• Diastolic pressure
– Pressure in the arteries during cardiac relaxation
• Pulse pressure
– Difference between systolic and diastolic
• Mean arterial pressure (MAP)
– Average pressure in the arteries
MAP = DBP + 0.33(SBP – DBP)
Copyright ©2009 The McGraw-Hill Companies, Inc. All Rights Reserved.
10
Chapter 9 Heart: Myocardium and Cardiac Cycle
Hypertension
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Chapter 9 Heart: Myocardium and Cardiac Cycle
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Chapter 9 Heart: Myocardium and Cardiac Cycle
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Chapter 9 Heart: Myocardium and Cardiac Cycle
Electrocardiogram (ECG)
Normal Electrocardiogram
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Chapter 9 Heart: Myocardium and Cardiac Cycle
A Closer Look 9.2
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
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Chapter 9 Heart: Myocardium and Cardiac Cycle
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Chapter 9 Heart: Myocardium and Cardiac Cycle
In Summary
In Summary
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Chapter 9 Cardiac Output
Cardiac Output
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Chapter 9 Cardiac Output
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Chapter 9 Cardiac Output
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Chapter 9 Cardiac Output
End-Diastolic Volume
• Frank-Starling mechanism
– Greater EDV results in a more forceful contraction
Due to stretch of ventricles
• Dependent on venous return
• Venous return increased by:
– Venoconstriction
Via SNS
– Skeletal muscle pump
Rhythmic skeletal muscle contractions force blood in the
extremities toward the heart
One-way valves in veins prevent backflow of blood
– Respiratory pump
Changes in thoracic pressure pull blood toward heart
Copyright ©2009 The McGraw-Hill Companies, Inc. All Rights Reserved.
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Chapter 9 Cardiac Output
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Chapter 9 Cardiac Output
In Summary
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Chapter 9 Cardiac Output
In Summary
Chapter 9 Hemodynamics
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Chapter 9 Hemodynamics
Hematocrit
Chapter 9 Hemodynamics
Pressure
Blood flow =
Resistance
• Pressure
– Proportional to the difference between MAP and
right atrial pressure ( Pressure)
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Chapter 9 Hemodynamics
Chapter 9 Hemodynamics
Hemodynamics
• Resistance
– Depends upon:
Length of the vessel
Viscosity of the blood
Radius of the vessel
Length x viscosity
Resistance =
Radius4
• Sources of vascular resistance
– MAP decreases throughout the systemic circulation
– Largest drop occurs across the arterioles
Arterioles are called “resistance vessels”
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Chapter 9 Hemodynamics
Chapter 9 Hemodynamics
In Summary
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Chapter 9 Changes in Oxygen Delivery to Muscle During Exercise
– Increased SV
Increase, then plateau at ~40% VO2 max
No plateau in highly trained subjects
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Chapter 9 Changes in Oxygen Delivery to Muscle During Exercise
Changes in
Cardiovascular
Variables During
Exercise
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Chapter 9 Changes in Oxygen Delivery to Muscle During Exercise
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Chapter 9 Changes in Oxygen Delivery to Muscle During Exercise
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Chapter 9 Changes in Oxygen Delivery to Muscle During Exercise
In Summary
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Chapter 9 Changes in Oxygen Delivery to Muscle During Exercise
In Summary
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Chapter 9 Circulatory Responses to Exercise
Transition
From Rest to
Exercise to
Recovery
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Chapter 9 Circulatory Responses to Exercise
Incremental Exercise
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Chapter 9 Circulatory Responses to Exercise
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Chapter 9 Circulatory Responses to Exercise
Intermittent Exercise
Prolonged Exercise
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Chapter 9 Circulatory Responses to Exercise
In Summary
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Chapter 9 Regulation of Cardiovascular Adjustments to Exercise
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Chapter 9 Regulation of Cardiovascular Adjustments to Exercise
Chapter 9
Study Questions
40
Chapter 9
Study Questions
41