Physiology of the
Circulatory System
Introduction
The circulatory system functions to deliver oxygen an
nutrients to tissues for growth and metabolism, and to remove metabolic wastes.
The heart pumps blood through a circuit that includes arteries, arterioles,
capillaries, venules, and veins. One important circuit is the pulmonary circuit,
where there is an exchange of gases within the alveoli of the lung. The right
side of the human heart receives deoxygenated blood from body tissues and pumps
it to the lungs. The left side of the heart receives oxygenated blood from the
lungs and pumps it to the tissues. With increased exercise, several changes
occur within the circulatory system, thus increasing the delivery of oxygen to
actively respiring muscles cells. These changes include increased heart rate,
increased blood flow to muscular tissue, decreased blood flow to non muscular
tissue, increased arterial pressure, increased body temperature and increased
breathing rate.
Blood Pressure
An important measurable aspect of the circulatory system
is blood pressure. When the ventricles of the heart contract, pressure is
increased throughout all the arteries. Arterial blood pressure is directly
dependent on the amount of blood pumped by the heart per minute and the
resistance to blood flow through the arterioles. The arterial blood pressure is
determined using a device known as a sphygmomanometer. This device
consists of an inflatable cuff connected by rubber hoses to a hand pump and to a
pressure gauge graduated in millimeters of mercury. The cuff is wrapped around
the upper arm and inflated to a pressure that will shut off the brachial artery.
The examiner listens for the sounds of blood flow in the brachial artery by
placing the bell of a stethoscope in the inside of the elbow below the
biceps.
Figure 10.1 The sphygmomanometer
At rest, the blood normally goes through the arteries so
that the blood in the central part of the artery moves faster than the blood in
the peripheral part. Under these conditions, the artery is silent when one
listens. When the sphygmomanometer cuff is inflated to a pressure above the
systolic pressure, the flow of blood is stopped and the artery is silent again.
As the pressure in the cuff gradually drops to levels between the systolic and
diastolic pressures of the artery, the blood is pushed through the compressed
walls of the artery in a turbulent flow. Under these conditions, the blood is
mixed, and the turbulence sets up vibrations in the artery that are heard as
sounds in the stethoscope. These sounds are known as the heart sounds or sounds
of Korotkoff. The sounds are divided into five phases based on the
loudness and quality of the sounds.
- Phase 1. A loud, clear tapping sound is evident
that increases in intensity as the cuff is deflated.
- Phase 2. A succession of murmurs can be heard.
Sometimes the sounds seem to disappears during this time which may be a result
of inflating or deflating the cuff too slowly.
- Phase 3. A loud, thumping sound, similar to
that in Phase 1 but less clear, replaces the murmurs.
- Phase 4. A muffled sound abruptly replaces the
thumping sounds of Phase 3.
- Phase 5. All sounds disappear.
The cuff pressure at which the first sound is heard (that
is, the beginning of Phase 1) is taken as the systolic pressure. The cuff
pressure with the muffled sound(Phase 4) disappears (the beginning of Phase 5).
is taken as the measurement of the diastolic pressure. A normal blood pressure
measurement for a given individual depends on a person's age, sex, heredity, and
environment. When these factors are taken into account, blood pressure
measurements that are chronically elevated may indicate a state deleterious to
the health of the person. This condition is called hypertension and is a major
contributing factor in heart disease and stroke.
Table 10.1: Normal Blood Pressure for Men and Women at
Different Ages
|
Systolic Pressure |
Diastolic Pressure |
Age in Years |
Men |
Women |
Men |
Women |
10 |
103 |
103 |
69 |
70 |
11 |
104 |
104 |
70 |
71 |
12 |
106 |
106 |
71 |
72 |
13 |
108 |
108 |
72 |
73 |
14 |
110 |
110 |
73 |
74 |
15 |
112 |
112 |
75 |
76 |
16 |
118 |
116 |
73 |
72 |
17 |
121 |
116 |
74 |
72 |
18 |
120 |
116 |
74 |
72 |
19 |
122 |
115 |
75 |
71 |
20-24 |
123 |
116 |
76 |
72 |
25-29 |
125 |
117 |
78 |
74 |
30-34 |
126 |
120 |
79 |
75 |
35-39 |
127 |
124 |
80 |
78 |
40-44 |
129 |
127 |
81 |
80 |
45-49 |
130 |
131 |
82 |
82 |
50-54 |
135 |
137 |
83 |
84 |
55-59 |
138 |
139 |
84 |
84 |
60-64 |
142 |
144 |
85 |
85 |
65-69 |
143 |
154 |
83 |
85 |
70-74 |
145 |
159 |
82 |
85 |
Exercise 10A: Measuring Blood Pressure
Note: These labs are ONLY for experimental, and not
diagnostic, purposes.
A sphygmomanometer (blood pressure cuff) is used to
measure blood pressure. The cuff, designed to fit around the upper arm, can be
expanded by pumping a rubber bulb connected to the cuff. The pressure gauge,
scaled in millimeters, indicates the pressure inside the cuff. A stethoscope is
used to listen to the individual's pulse. The ear pieces of the stethoscope
should be cleaned with alcohol swabs before and after each use.
Procedure
1. Work in pairs. Those who are to have their blood
pressure measured should be seated with both shirt sleeves rolled up.
2. Attach the cuff of the sphygmomanometer snugly around
the upper arm.
3. Place the stethoscope directly below the cuff in the
bend of the elbow joint.
4. Close the valve of the bulb by turning it clockwise.
Pump air into the cuff until the pressure gauge goes past 200 mm Hg.
5. Turn the valve of the bulb counterclockwise and slowly
release the air from the cuff. Listen for pulse.
6. When you first hear the heart sounds, note the
pressure on the gauge. This is the systolic pressure.
7. Continue to slowly release air and listen until the
clear thumping sound of the pulse becomes strong and then fades. When you last
hear the full heart beat, note the pressure. This is the diastolic
pressure.
8. Repeat the measurement two more times and determine
the average systolic and diastolic pressure, then record these values on the
data sheet .
9. Trade places with your partner. When your average
systolic and diastolic pressure have been determined, record these values on the
blood pressure data sheet.
Exercise 10B: A Test of Fitness
The point scores on the following tests provide an
evaluation of fitness based not only on cardiac muscular development but also on
the ability of the cardiovascular system to respond to sudden changes in demand.
Caution: Make sure that you do not attempt this exercise if strenuous
activity will aggravate a health problem. work in pairs. Determine the
fitness level for one member of the pair(Tests 1 to 5 below) and then repeat the
process for the other member of the pair.
Procedure
1. The subject should recline on a laboratory bench for
at least 5 minutes. At the end of this time, measure the systolic and diastolic
pressure and record these values below.
reclining systolic pressure ____________ mm Hg
ffffffffffreclining
diastolic pressure _______ mm Hg
2. Remain reclining for two minutes, then stand and
IMMEDIATELY repeat measurements on the same subject (arms down). Record these
values below.
standing systolic pressure ____________ mm Hg
ffffffffffstanding
diastolic pressure _______ mm Hg
3. Determine the change in systolic pressure from
reclining to standing by subtracting the standard measurement from the reclining
measurement. Assign fitness points based on Table 10.2 and record the fitness
data sheet.
Table 10.2: Changes in Systolic Pressure from
Reclining to Standing
Change (mm Hg) |
Fitness Points |
rise of 8 or more |
3 |
rise of 2-7 |
2 |
no rise |
1 |
fall of 2-5 |
0 |
fall of 6 or more |
-1 |
Cardiac Rate and Physical Fitness
During physical exertion, the cardiac rate (beats per
minute) increases. This increase can be measured as an increase in pulse rate.
Although the maximum cardiac rate is usually the same in people of the same age
group, those who are physically fit have a higher stroke volume(millimeters per
beat) then more sedentary individuals. A person who is in poor physical
condition, therefore, reaches their maximum cardiac rate at a lower work level
than a person with of comparable age who is in better shape. Maximum cardiac
rates are listed in Table 10.3. Individuals who are in good physical condition
can deliver more oxygen to their muscles before reaching maximum cardiac rate
than can those in poor condition.
Table 10.3: Maximum-Pulse Rate
Age (years) |
Maximum Pulse Rate (beats/min) |
20-29 |
190 |
30-39 |
160 |
40-49 |
150 |
50-59 |
140 |
60 and above |
130 |
Test 2: Standing Pulse Rate
Procedure
1. The subject should stand at ease for 2 minutes after
Test 1.
2. After the two minutes, determine your partner's
pulse.
3. Count the number of beats for 30 seconds and multiply
by 2. The pulse rate is the number of beats per minute. Record this on the
fitness data sheet. Assign fitness points based on Table 10.4 and record them on
the data sheet.
Pulse Rate (beats/min) |
Fitness Points |
60-70 |
3 |
71-80 |
3 |
81-90 |
2 |
91-100 |
1 |
101-110 |
1 |
111-120 |
0 |
121-130 |
0 |
131-140 |
-1 |
Test 3: Reclining Pulse Rate
Procedure
1. The subject should recline for 5 minutes on the
laboratory bench.
2. The other partner will determine the subject's resting
pulse.
3. Count the number of beats for 30 seconds and multiply
by 2. ( Note: the subject should remain reclining for the next test!) Record it
on the Data Sheet. Assign fitness points based on Table 10.5 and record them on
the fitness data sheet.
Table 10.5: Reclining Pulse Rate
Pulse Rate (beats/min) |
Fitness Points |
50-60 |
3 |
61-70 |
3 |
71-80 |
2 |
81-90 |
1 |
91-100 |
0 |
101-110 |
-1 |
Test 4: Baroreceptor Reflex (Pulse Rate Increase from
Reclining to Standing)
Procedure
1. The reclining subject should now stand up.
2. Immediately take the subject's pulse. Record this
value below. The observed increase in pulse rate is initiated by baroreceptors
(pressure receptors)in the carotid artery and in the aortic arch. When the
baroreceptors detect a drop in blood pressure they signal the medulla of the
brain to increase the heart beat, and consequently the pulse rate.
Pulse immediately upon standing =
___________________ beats per minute
3. Subtract the reclining pulse rate (recorded in Test 3)
from the pulse rate immediately upon standing (recorded in Test 4) to determine
the pulse rate increase upon standing. Assign fitness points based on Table 10.6
and record on the fitness data sheet.
Table 10.6: Pulse Increase from Reclining to
Standing
Reclining Pulse (beats/min) |
Pulse Rate Increase on Standing (# beats) |
0-10 |
11-18 |
19-26 |
27-34 |
35-43 |
hhhhhhhh |
Fitness Points |
50-60 |
3 |
3 |
2 |
1 |
0 |
61-70 |
3 |
2 |
1 |
0 |
-1 |
71-80 |
3 |
2 |
0 |
-1 |
-2 |
81-90 |
2 |
1 |
-1 |
-2 |
-3 |
91-100 |
1 |
0 |
-2 |
-3 |
-3 |
101-110 |
0 |
-1 |
-3 |
-3 |
-3 |
Test 5: Step Test- Endurance
Procedure
1. place your right foot on an 18-inch high stool. Raise your body so that
your left foot comes to rest by your right foot. Return your left foot to the
original position. Repeat these exercise five times, allowing three seconds for
each step up.
2. Immediately after the completion of the exercise, measure the pulse for 15
seconds and record below; measure again for 15 seconds and record; continue
taking the pulse and record at 60, 90, and 120 seconds.
Number of beats in the 0-to 15 second interval ____ X4= ____ beats per
minute
Number of beats in the 16-to 30 second interval ____ X4= ____ beats per
minute
Number of beats in the 31-to 60 second interval ____ X4= ____ beats per
minute
Number of beats in the 61-to 90 second interval ____ X4= ____ beats per
minute
Number of beats in the 91-to 120 second interval ____ X4= ____ beats per
minute
3. Observe the time that it takes for the pulse rate to return to
approximately the level as recorded in Test 2. Assign fitness pints based on
Table 10.7 and record them on the fitness data sheet.
Table 10.7: Time Required for Return of Pulse Rate to Standing Level
after Exercise
Time (seconds) |
Fitness Points |
0-30 |
4 |
31-60 |
3 |
61-90 |
2 |
91-120 |
1 |
121+ |
1 |
1-10 beats above standing pulse rate |
0 |
11-30 beats above standing pulse rate |
-1 |
4. Subtract your normal standing pulse rate(recorded in Test 2) from
your pulse rate immediately after exercise (the 0-to 15-second interval) to
obtain pulse rate increase. Record this on the data sheet. Assign fitness points
based on Table 10.8 and record them on the fitness data sheet.
Standing Pulse (beats/min) |
Pulse Rate Increase Immediately after Exercise
(#beats) |
0-10 |
11-20 |
21-30 |
31-40 |
41+ |
hhhhhhhh |
Fitness Points |
60-70 |
3 |
3 |
2 |
1 |
0 |
71-80 |
3 |
2 |
1 |
0 |
-1 |
81-90 |
3 |
2 |
1 |
-1 |
-2 |
91-100 |
2 |
1 |
0 |
-2 |
-3 |
101-110 |
1 |
0 |
-1 |
-3 |
-3 |
111-120 |
1 |
-1 |
-2 |
-3 |
-3 |
121-130 |
0 |
-2 |
-3 |
-3 |
-3 |
131-140 |
0 |
-3 |
-3 |
-3 |
-3 |
Data Sheet
Blood Pressure Data
Measurement |
1 |
2 |
3 |
Average |
Systolic |
ssssstttttttttttttttttttttttt |
ssttttsss |
sssss |
sssss |
Diastolic |
sssss |
stttttttttttttttttttttttttttssss |
ssssnnnnnnnnnnnnnnnns |
ssssnnnnnnnnnnnnns |
Fitness Data
|
Measurement |
Points |
Test 1. Change in systolic pressure from reclining to
standing |
rrssss mm Hg |
rrrrssss |
Test 2. Standing Pulse Ratev |
rrssss beats/min |
rrssss |
Test 3. Reclining Pulse Rate |
rrssss beats/min |
rrssss |
Test 4. Baroreceptor reflex Pulse Rate increase on
standing |
rrssss beats/min |
rrssss |
Test 5. Return of Pulse Rate to Standing after
Exercise |
rrssss seconds |
rrssss |
Pulse Rate increase immediately after exercise |
rrssss beats/min |
rrssss |
|
Total Score |
rrssss |
Total Score |
Relative Cardiac Fitness |
18-17 |
Excellent |
16-14 |
Good |
13-8 |
Fair |
7 or less |
Poor |
Topics for Discussion
1. Explain why blood pressure and heart rate differ when
measured in a reclining position and in a standing position.
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2. Explain why high blood pressure is a health
concern.
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3. Explain why an athlete must exercise harder or longer
to achieve a maximum heart rate than a person who is not as physically
fit.
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4. Research and explain why smoking causes a rise in
blood pressure.
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