Chapter

The Microcirculation and the

Lymphatic System: Capillary Fluid

Exchange, Interstitial Fluid, and

Lymph Flow 181

Structure of the Microcirculation and

Capillary System 181

Flow of Blood in the Capillaries— Vasomotion 182

Average Function of the Capillary System 183

Exchange of Water, Nutrients, and Other Substances Between the Blood and Interstitial Fluid 183

Diffusion Through the Capillary Membrane 183 The Interstitium and Interstitial Fluid 184

Fluid Filtration Across Capillaries Is Determined by Hydrostatic and Colloid Osmotic Pressures, and Capillary Filtration Coefficient 185

Capillary Hydrostatic Pressure 186

Interstitial Fluid Hydrostatic Pressure 187

Plasma Colloid Osmotic Pressure 188

Interstitial Fluid Colloid Osmotic Pressure 188 Exchange of Fluid Volume Through the

Capillary Membrane 189

Starling Equilibrium for Capillary Exchange 189 Lymphatic System 190

Lymph Channels of the Body 190

Formation of Lymph 191

Rate of Lymph Flow 192

Role of the Lymphatic System in Controlling Interstitial Fluid Protein Concentration, Interstitial Fluid Volume, and Interstitial Fluid Pressure 193

CHAPTER 17 Local and Humoral Control of Blood Flow by the Tissues 195

Local Control of Blood Flow in Response to Tissue Needs 195

Mechanisms of Blood Flow Control 196

Acute Control of Local Blood Flow 196

Long-Term Blood Flow Regulation 200

Development of Collateral Circulation—A Phenomenon of Long-Term Local Blood Flow Regulation 201

Humoral Control of the Circulation 201

Vasoconstrictor Agents 201

Vasodilator Agents 202

Vascular Control by Ions and Other Chemical Factors 202

CHAPTER 18 Nervous Regulation of the Circulation, and Rapid Control of Arterial Pressure 204 Nervous Regulation of the Circulation 204

Autonomic Nervous System 204

Role of the Nervous System in Rapid Control of Arterial Pressure 208

Increase in Arterial Pressure During Muscle

Exercise and Other Types of Stress 208

Reflex Mechanisms for Maintaining Normal

Arterial Pressure 209

Central Nervous System Ischemic Response—Control of Arterial Pressure by the Brain's Vasomotor Center in Response to Diminished Brain Blood Flow 212

Special Features of Nervous Control of Arterial Pressure 213

Role of the Skeletal Nerves and Skeletal Muscles in Increasing Cardiac Output and Arterial Pressure 213

Respiratory Waves in the Arterial Pressure 214 Arterial Pressure "Vasomotor" Waves— Oscillation of Pressure Reflex Control Systems 214

CHAPTER 19 Dominant Role of the Kidney in Long-Term Regulation of Arterial Pressure and in Hypertension: The Integrated System for Pressure Control 216

Renal-Body Fluid System for Arterial Pressure Control 216

Quantitation of Pressure Diuresis as a Basis for Arterial Pressure Control 217

Chronic Hypertension (High Blood Pressure) Is Caused by Impaired Renal Fluid Excretion 220

The Renin-Angiotensin System: Its Role in Pressure Control and in Hypertension 223

Components of the Renin-Angiotensin

System 223

Types of Hypertension in Which Angiotensin Is Involved: Hypertension Caused by a Renin-Secreting Tumor or by Infusion of Angiotensin II 226

Other Types of Hypertension Caused by Combinations of Volume Loading and Vasoconstriction 227

"Primary (Essential) Hypertension" 228

Summary of the Integrated, Multifaceted System for Arterial Pressure Regulation 230

CHAPTER 20 Cardiac Output, Venous Return, and Their Regulation 232

Normal Values for Cardiac Output at

Rest and During Activity 232

Control of Cardiac Output by Venous Return—Role of the Frank-Starling Mechanism of the Heart 232

Cardiac Output Regulation Is the Sum of Blood Flow Regulation in All the Local Tissues of the Body—Tissue Metabolism Regulates Most Local Blood Flow 233

The Heart Has Limits for the Cardiac Output

That It Can Achieve 234

What Is the Role of the Nervous System in Controlling Cardiac Output? 235

Pathologically High and Pathologically Low Cardiac Outputs 236

High Cardiac Output Caused by Reduced

Total Peripheral Resistance 236

Low Cardiac Output 237

A More Quantitative Analysis of Cardiac

Output Regulation 237

Cardiac Output Curves Used in the

Quantitative Analysis 237

Venous Return Curves 238

Analysis of Cardiac Output and Right Atrial Pressure, Using Simultaneous Cardiac Output and Venous Return Curves 241

Methods for Measuring Cardiac Output 243

Pulsatile Output of the Heart as Measured by an Electromagnetic or Ultrasonic Flowmeter 243

Measurement of Cardiac Output Using the

Oxygen Fick Principle 244

Indicator Dilution Method for Measuring Cardiac Output 244

CHAPTER 21 Muscle Blood Flow and Cardiac Output During Exercise; the Coronary Circulation and Ischemic Heart Disease 246

Blood Flow in Skeletal Muscle and Blood Flow Regulation During Exercise 246

Rate of Blood Flow Through the Muscles 246

Control of Blood Flow Through the Skeletal

Muscles 247

Total Body Circulatory Readjustments During Exercise 247

Coronary Circulation 249

Physiologic Anatomy of the Coronary Blood

Supply 249

Normal Coronary Blood Flow 249

Control of Coronary Blood Flow 250

Special Features of Cardiac Muscle

Metabolism 251

Ischemic Heart Disease 252

Causes of Death After Acute Coronary

Occlusion 253

Stages of Recovery from Acute

Myocardial Infarction 254

Function of the Heart After Recovery from Myocardial Infarction 255

Pain in Coronary Heart Disease 255

Surgical Treatment of Coronary Disease 256

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Essentials of Human Physiology

Essentials of Human Physiology

This ebook provides an introductory explanation of the workings of the human body, with an effort to draw connections between the body systems and explain their interdependencies. A framework for the book is homeostasis and how the body maintains balance within each system. This is intended as a first introduction to physiology for a college-level course.

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