11/8/12 Path of blood flow through the CVS Cardiovascular system = closed system Flow through systemic and pulmonary circuits are in series Flow within systemic (and pulmonary) circuit is in parallel Parallel flow (below) allows independent regulation of blood flow to organs Physical laws governing blood flow Pressure Gradients in the Cardiovascular System Resistance in the Cardiovascular System Flow = ΔP/R = pressure gradient/resistance Pressure is force exerted by blood Flow occurs from high pressure to low pressure Heart creates pressure gradient for bulk flow of blood A gradient must exist throughout circulatory system to maintain blood flow 1 11/8/12 Pressure gradient across pulmonary circuit Pressure gradient = pressure in pulmonary arteries minus pressure in pulmonary veins just before they empty into left atrium Pulmonary arterial pressure = 15 mm Hg Pulmonary venous pressure = 0 mm Hg Pressure gradient = 15 – 0 = 15 mm Hg Pressure gradient across systemic circuit Pressure gradient = pressure in aorta minus pressure in vena cava just before it empties into right atrium Pressure in aorta = mean arterial pressure (MAP) = 90 mm Hg Pressure in vena cava = central venous pressure (CVP) = 0 mm Hg Pressure gradient = MAP – CVP = 90 – 0 = 90 mm Hg Resistance in the Cardiovascular System Systemic circuit: high P, high R; Pulmonary circuit: low P, low R Effect of Resistance on Flow Remember Flow = ΔP/R For any given pressure, the lower the resistance, the greater the flow Factors affecting resistance to flow: Poiseuille’s Law R= length x viscosity radius4 Length of vessel (normally doesn’t change) Viscosity of fluid (normally doesn’t change) Radius of vessel: Arterioles (and small arteries) - can regulate radius RADIUS IS THE MOST IMPORTANT FACTOR 2 11/8/12 Regulate blood flow by regulating radius Radius dependent on contraction state of smooth muscle in arteriole wall Vasoconstriction: increased contraction (decreased radius) Vasodilation: decreased contraction (increased radius) Functions of Varying Arteriole Radius Controlling blood flow to individual capillary beds Regulating mean arterial pressure The combined resistance of all blood vessels is termed TPR: total peripheral resistance. Regional changes in vasodilation and vasoconstriction can change TPR Control of blood flow distribution to organs Regulation of blood flow to organs based on need (eg to skeletal muscles during exercise) Regulated by varying radius (and therefore resistance) Organ blood flow = MAP / organ resistance ie driving force for blood flow resistance to flow in that organ For any given P gradient, blood flow changes when resistance changes 3 11/8/12 Factors that influence vasodilation and vasoconstriction Autonomic nerves (sympathetic constricts) Hormones (eg adrenaline constricts) Metabolism (eg. decreased O2 causes dilation) These factors therefore influence blood flow Blood pressure: Mean Arterial Pressure MAP = driving force for blood flow F = ΔP/R Regulating MAP critical to normal function MAP < normal Hypotension Inadequate blood flow to tissues MAP > normal Hypertension (scholarship topic this year) Stress on heart and walls of blood vessels 4 11/8/12 Regulation of MAP Flow = pressure gradient resistance CO = MAP TPR Therefore MAP=CO x TPR = HR x SV x TPR This means that MAP is completely determined by HR, SV & TPR Short- and long-term regulation of MAP Short-term regulation Seconds to minutes Involves heart &blood vessels Primarily neuronal control Long-term regulation Minutes to days Regulate blood volume Involves kidneys Primarily hormonal control This is a classic example of the different modes of action of the 2 key regulatory systems (nervous & endocrine systems) Short-Term Regulation of MAP The baroreceptor reflex: A negative feedback loop that helps maintain normal blood pressure Baroreceptors = stretch receptors (mechanoreceptos) Arterial baroreceptors High pressure baroreceptors Sinoaortic baroreceptors Location Carotid sinus Aortic arch 5 11/8/12 Cardiovascular Control Centre Medulla oblongata Integration center for blood pressure regulation Output Sympathetic nerves Parasympathetic nerves Sympathetic: SA node (increase HR) Ventricles (increase contractility) Arterioles (increase resistance) Veins (increase venomotor tone) Parasympathetic: SA node (decrease HR) Major neural pathways in the control of cardiovascular function Baroreceptor Reflex in response to a decrease in MAP Components of Baroreceptor Reflex Detectors = baroreceptors Afferents = nerves Integration center = cardiovascular control center Efferents = autonomic nervous system Effectors = heart, arterioles, veins 6 11/8/12 Physiology Research Focus: hypertension (scholarship topic 2012/13) Hypertension and diabetes are frequent comorbidities Factors associated with hypertension Serious problem in developed countries, increasing problem in developing countries Figures taken from scholarship special reading journal articles Physiology Research Focus: hypertension (scholarship topic 2012/13) Drugs & medical devices are in development. We can only develop effective treatments if we understand the Physiology underlying the disease Figures taken from scholarship special reading journal articles 7
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