NSCA CPT Chapter 2 - Cardiorespiratory System and Gas Exchange

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Chapter Objectives:

  • Discuss the anatomical and physiological characteristics of the cardiovascular system.
  • Discuss the electrical conduction system of the heart and the basic electrocardiogram.
  • Discuss mechanisms that control blood circulation in the body.
  • Describe the anatomical and physiological characteristics of the respiratory system.
  • Go into detail about the exchange of gases between the lungs and the blood.
  • Know the mechanisms for controlling respiration.

Cardiovascular Anatomy and Physiology

The cardiovascular system transports nutrients and removes metabolic waste products while helping maintain the environment for all bodily functions. Blood transports oxygen from the lungs to tissues for cellular metabolism and transports carbon dioxide from the tissues to the lungs, where CO2 is then removed from the body.

Oxygen Transport

Oxygen dissolves into the blood and is also carried by hemoglobin.

Hemoglobin oxygen transportation is the largest percentage, so the book focuses on oxygen transport.

Each gram of hemoglobin can carry about 1.39 mL of oxygen. There are about 15 grams of hemoglobin for every 100 mL of blood.

Oxygen Hemoglobin Dissociation Curve

This curve illustrates the saturation of hemoglobin at various partial pressures.

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Factors Influencing the Oxygen Hemoglobin Curve

A core body temperature decrease shifts the curve left. An increase moves the curve to the right.

Arterial blood acidity is another factor, like core body temperature, that causes shifts.

Cardiac Morphology

The heart is made up of cardiac muscle.

The heart has four chambers: the right and left atrium and the right and left ventricles.

The heart has a pacemaker of its own and therefore beats automatically.

The electrical conduction system starts with the SA node, which acts as the main intrinsic pacemaker.

The electrical impulse from the SA node spreads across the atrium to the atrioventricular node.

Next, it moves to the left and right bundle branches and into the Purkinje fibers.

The Purkinje fibers surround the ventricles. The impulses cause contractions of the heart in an order that causes the circulatory system to work.

Electrocardiogram

This is a way to record the heart’s electrical activity at the body’s surface using 10 – 12 electrodes on the chest.

In clinical settings, ECGs are taken in incremental exercise tests to see what the heart does under stress.

Circulation

The circulation system is made of arteries that carry blood away from the heart and into the tissues and organs of the body and then back through the veins, reaching the heart again.

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Veins have one-way valves that help with the return of blood.

Total peripheral resistance is the resistance of the entire systemic circulation. When blood vessels constrict, the peripheral resistance increases, whereas the dilation of vessels causes a decrease.

Cardiac Cycle

This is the start of one heartbeat, to the start of the next one.

Relaxation periods are the diastole, and the contraction periods are the systole.

Systolic blood pressure is the pressure put on the arterial walls as the blood is forced from ventricular contractions.

Rate pressure product (RPP) is the estimate of work on the heart.

Diastolic blood pressure is the pressure exerted on the arterial walls when there is a time of relaxation and no forceful ejection of blood.

Mean Arterial Pressure is the mean blood pressure in the cardiac cycle.

Cardiac Output

Defined as the total amount of blood the heart pumps within a minute.

Stroke volume is the amount of blood ejected with each heartbeat.

End diastolic volume is the blood volume in the ventricles after filling them.

Respiratory System

The main function is the basic exchange of both oxygen and carbon dioxide.

Structure

Air passes in the nose and the air is warmed, humidified, and purified. The lungs then distribute air through the trachea, bronchi, and bronchioles.

Inspiration is active and it uses the diaphragm and external intercostal muscles.

While exercising, we use other muscles besides those to assist with the need for more air.

Lung volumes

Spirometry is a method for examining static lung volumes.

Gas Exchange

The Alveolus has many capillaries that cover it. Capillaries are the smallest blood vessel unit. They are the site where gas exchange happens.

Diffusion is the movement of gas across a cell membrane.

Diffusion happens along a concentration gradient.

Gases move from high to low concentration.

Oxygen Uptake

This is the amount of oxygen used by the body’s tissues. It is also known as oxygen consumption.

Maximal oxygen uptake or VO2 max is the highest amount of oxygen that will be used at a cellular level for the whole body. VO2 max correlates highly with the degree of physical conditioning and is also the most accepted measure of cardio fitness.

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