Cardiac And Smooth Muscle

New updated edition first published with Cambridge University Press. This new edition includes 29 chapters on topics as diverse as pathophysiology of atherosclerosis, vascular haemodynamics, haemostasis, thrombophilia and post-amputation pain syndromes.

A version of the OpenStax text

Editions previous to this one had R.D. Keynes and David J. Aidley as primary and secondary authors.

The aim of this treatise is to summarize the current understanding of the mechanisms for blood flow control to skeletal muscle under resting conditions, how perfusion is elevated (exercise hyperemia) to meet the increased demand for oxygen and other substrates during exercise, mechanisms underlying the beneficial effects of regular physical activity on cardiovascular health, the regulation of transcapillary fluid filtration and protein flux across the microvascular exchange vessels, and the role of changes in the skeletal muscle circulation in pathologic states. Skeletal muscle is unique among organs in that its blood flow can change over a remarkably large range. Compared to blood flow at rest, muscle blood flow can increase by more than 20-fold on average during intense exercise, while perfusion of certain individual white muscles or portions of those muscles can increase by as much as 80-fold. This is compared to maximal increases of 4- to 6-fold in the coronary circulation during exercise. These increases in muscle perfusion are required to meet the enormous demands for oxygen and nutrients by the active muscles. Because of its large mass and the fact that skeletal muscles receive 25% of the cardiac output at rest, sympathetically mediated vasoconstriction in vessels supplying this tissue allows central hemodynamic variables (e.g., blood pressure) to be spared during stresses such as hypovolemic shock. Sympathetic vasoconstriction in skeletal muscle in such pathologic conditions also effectively shunts blood flow away from muscles to tissues that are more sensitive to reductions in their blood supply that might otherwise occur. Again, because of its large mass and percentage of cardiac output directed to skeletal muscle, alterations in blood vessel structure and function with chronic disease (e.g., hypertension) contribute significantly to the pathology of such disorders. Alterations in skeletal muscle vascular resistance and/or in the exchange properties of this vascular bed also modify transcapillary fluid filtration and solute movement across the microvascular barrier to influence muscle function and contribute to disease pathology. Finally, it is clear that exercise training induces an adaptive transformation to a protected phenotype in the vasculature supplying skeletal muscle and other tissues to promote overall cardiovascular health. Table of Contents: Introduction / Anatomy of Skeletal Muscle and Its Vascular Supply / Regulation of Vascular Tone in Skeletal Muscle / Exercise Hyperemia and Regulation of Tissue Oxygenation During Muscular Activity / Microvascular Fluid and Solute Exchange in Skeletal Muscle / Skeletal Muscle Circulation in Aging and Disease States: Protective Effects of Exercise / References

How is the heartbeat generated? What controls the strength of contraction of heart muscle? What are the links between cardiac structure and function? How does our understanding of skeletal and smooth muscle and non-muscle cells influence our thinking about force development in the heart? Are there important species differences in how contraction is regulated in the heart? How do the new molecular data fit together in understanding the heart beat? What goes wrong in ischemia, hypertrophy, and heart failure? This book paints a modern `portrait' of how the heart works and in this picture the author shows a close-up of the structural, biochemical, and physiological links between excitation and contraction. The author takes the reader through a series of important, interrelated topics with great clarity and continuity and also includes many useful illustrations and tables. The book starts by considering the cellular structures involved in excitation-contraction coupling and then described the characteristics of the myofilaments as the end effector of excitation-contraction coupling. A general scheme of calcium regulation is described and the possible sources and sinks of calcium are discussed in simple, but quantitative terms. The cardiac action potential and its many underlying currents are reviewed. Then the characteristics of some key calcium transport systems (calcium channels, sodium/calcium exchange and SR calcium uptake and release) are discussed in detail. This is then built into a more integrated picture of calcium regulation in succeeding chapters by detailed discussions of excitation-calcium coupling mechanisms (in skeletal, cardiac, and smooth muscle), the interplay between calcium regulatory processes, and finally mechanisms of cardiac inotropy, calcium overload, and dysfunction (e.g., ischemia, hypertrophy, and heart failure). Excitation-Contraction Coupling and Cardiac Contractile Force – Second Edition is an invaluable source of information for anyone who is interested in how the heart beat is controlled and especially suited for students of the cardiovascular system at all levels from medical/graduate students through senior investigators in related fields.

The second edition of Fundamentals of Anaesthesia builds upon the success of the first edition, and encapsulates the modern practice of anaesthesia in a single volume. Written and edited by a team of expert contributors, it provides a comprehensive but easily readable account of all of the information required by the FRCA Primary examination candidate and has been expanded to include more detail on all topics and to include new topics now covered in the examination. As with the previous edition, presentation of information is clear and concise, with the use of lists, tables, summary boxes and line illustrations where necessary to highlight important information and aid the understanding of complex topics. Great care has been taken to ensure an unrivalled consistency of style and presentation throughout.

Respiratory Muscle Training: theory and practice is the world’s first book to provide an "everything-you-need-to-know" guide to respiratory muscle training (RMT). Authored by an internationally-acclaimed expert, it is an evidence-based resource, built upon current scientific knowledge, as well as experience at the cutting-edge of respiratory training in a wide range of settings. The aim of the book is to give readers: 1) an introduction to respiratory physiology and exercise physiology, as well as training theory; 2) an understanding of how disease affects the respiratory muscles and the mechanics of breathing; 3) an insight into the disease-specific, evidence-based benefits of RMT; 4) advice on the application of RMT as a standalone treatment, and as part of a rehabilitation programme; and finally, 5) guidance on the application of functional training techniques to RMT. The book is divided into two parts – theory and practice. Part I provides readers with access to the theoretical building blocks that support practice. It explores the evidence base for RMT as well as the different methods of training respiratory muscles and their respective efficacy. Part II guides the reader through the practical implementation of the most widely validated form of RMT, namely inspiratory muscle resistance training. Finally, over 150 "Functional" RMT exercises are described, which incorporate a stability and/or postural challenge – and address specific movements that provoke dyspnoea. Respiratory Muscle Training: theory and practice is supported by a dedicated website (www.physiobreathe.com), which provides access to the latest information on RMT, as well as video clips of all exercises described in the book. Purchasers will also receive a three-month free trial of the Physiotec software platform (via www.physiotec.ca), which allows clinicians to create bespoke training programmes (including video clips) that can be printed or emailed to patients. Introductory overviews of respiratory and exercise physiology, as well as training theory Comprehensive, up-to-date review of respiratory muscle function, breathing mechanics and RMT Analysis of the interaction between disease and respiratory mechanics, as well as their independent and combined influence upon exercise tolerance Analysis of the rationale and application of RMT to over 20 clinical conditions, e.g., COPD, heart failure, obesity, mechanical ventilation Evidence-based guidance on the implementation of inspiratory muscle resistance training Over 150 functional exercises that incorporate a breathing challenge www.physiobreathe.com - access up-to-date information, video clips of exercises and a three-month free trial of Physiotec’s RMT exercise module (via www.physiotec.ca)

The Third International Symposium on Excitation-Contraction Coupling in Skeletal, Cardiac, and Smooth Muscle, organized by George Frank, C. Paul Bianchi, and Henk E. DJ. ter Keurs, was held in Banff Centre, Banff, Alberta, Canada during June 26 to June 30, 1991. The theme of these symposia has been to recognize the similarities and dissimilarities of excitation-contraction coupling in skeletal, cardiac, and smooth muscle. Cross fertilization of concepts of excitation-contraction coupling in these three types of muscle has occurred since the early studies in the late fifties and early sixties on skeletal muscle. Investigators in each field meet only at specialized symposia which exclude investigators in the other fields. The purpose of the symposia has been to bring together international investigators studying excitation-contraction coupling in skeletal, cardiac, and smooth muscle so that we may learn from each other and hence provide a more global concept of excitation-contraction. The Third International Symposia has accomplished its objective as we recognize that calcium channels of the sarcolemma and the sarcoplasmic reticulum play key essential roles in excitation-contraction coupling in all three types of muscles. In skeletal muscle the recognition that E-C coupling consists of two parallel mechanisms, one dependent upon a dihydropyridine voltage-sensitive sensors coupled to calcium release from the terminal cisternae via the ryanodine sensitive channel in the foot structure of the triad.

Easily understood, up-to-date and clinically relevant, this book provides junior anaesthetists with an essential physiology resource.