Blood Flow and Pressure

Exchange

Outline

Overview of circulation
Components of the Vascular system
Medical physics of blood flow
Vascular distensibility and
compliance
Arterial damping of pressure pulses
Veins as reservoirs of blood
Capillary exchange

Learning Objectives
Know each component of the vascular
system.
Understand blood flow using Ohms and
Poiseuilles laws.
Know how vascular distensibility allows
arteries to dampen pressure pulses and
veins to act as reservoirs.
Know how hydrostatic and colloid osmotic
forces determine the flow of fluid in the
capillaries.

Components of the Vascular System

- Blood Vessels
Closed circulatory
system
Arteries
Arterioles
Capillaries
Venules
Veins
3 tunics
Lumen

Tunica interna
Endothelium
Connective tissue

Tunica media

Smooth muscle
Elastin
Vasoconstriction
Vasodilation

Tunica externa

Collagen fibers
Nerve fibers
Lymphatic vessels
Elastin fibers

Comparison of Veins and Arteries

Arteries:

Veins:

Histological Structure of Blood Vessels

Arteries
Away from the
heart
Thick, muscular
walls
Very elastic
Arterioles
Diameter varies in
response to neural
stimuli and local
chemical
influences.

Capillaries
Consist of a single
tunica interna
Gas, nutrient, and
waste exchange
Brain capillaries
Blood-brain barrier
Capillary beds
Precapillary sphincter
Shunting of blood
Digestion

Venous System
Toward the heart
Venulesporousfree
movement of fluids
and white blood cells.
Veins
3 tunicsbut thin
Venous valves
Varicose veins
Incompetent valves
hemorrhoids

Maintenance of Blood
Pressure
Neural control
Shunting and
vasoconstriction.

Vasomotor center
Baroreceptors
Carotid and aorta

Chemoreceptors
Higher brain centers
Hormones
Catecholoamines
Atrial natrietic peptide
ADH

Alcohol
Histamineother
vasodilators

Hypertension
30% of people over
50
Damages arteries
Causes heart
failure, vascular
disease, renal
failure, stroke, and
blindness.
Enlargement falled
by hypertrophy of
the myocardium

Contributing
factors:
Diet (sodium,
saturated fat,
cholesterol)
Obesity
Age
Race
Heredity
Stress
Smokingnicotine
is a vasoconstrictor.

Atherosclerosis
Damage to the tunica
interna
Viral
Bacterial
Hypertension

Reinjury
Inflammation
LDLsbad
cholesterol
Foam cells
Fatty streak stage

Arteriosclerosis
Hypertension
Stroke
Heart attack
Coronary bypass
Angioplasty
tPAtissue
plasminogen activator
Clot buster
HDLremoves
cholesterol from
vessel walls.

Arteries
Aortalargest artery

Ascending
Descending
Right and left coronary arteries
Common carotid arteriesbranch to form
internal and external carotids
Externalsupply tissues of the head except the brain
and orbits.
Internalsupply the orbits and most of the cerebrum.

Vertebral arteriesbranch to the cervical

spinal cord, neck, cerebellum, pons, and inner
ear.

Arteries to Know
Know the arteries on the proceeding
chart plus:
Arteries of the armbrachial, radial,
ulnar
Arteries of the legfemoral, popliteal,
anterior tibial, posterior tibial
Be able to identify these arteries on a
diagram. Also know the locations
served by these arteries.

Veins
Dural sinusesveins of the brain drain into
these enlarged chambers and drain to the
internal jugular veins.
External jugular veinssuperficial head
structures.
Vertebral veinscervical vertebrae and
neck muscles.
Brachiocephalicmammary glands and
first 2 or 3 intercostal spaces.

Veins to Know
Know the veins on the preceding chart
plus:
The veins of the armscephalic, axillary,
brachial, radial, ulnar.
The veins of the legsexternal iliac, femoral,
popliteal, anterior tibial, posterior tibial, great
saphenous vein, hepatic portal vein.
The great saphenous vein is a superficial vein.
Connect with many of the deep veins of the
legs and thighs.
Be able to identify these veins on a diagram.
Also know the locations served by these
arteries.

Overview of
Circulatory
System:
Arteries +
Veins and
Everything in
Between

Function of
Circulatory System:
To carry nutrients and
hormones to tissues
and wastes products
away from tissues.

Basic Circulatory Function

Rate of blood flow to tissues changes based on
need.
- e.g., during exercise, blood flow to skeletal
muscle increases.
- In most tissues, blood flow increases in
proportion to the metabolism of that tissue.
Cardiac output is mainly controlled by venous
return.
Generally, arterial pressure is controlled
independently of local blood flow or cardiac
output control.

of the
AortaParts
receives
blood
Vasculature
from left
ventricle.
Arteries transport
under high pressure,
strong vascular walls.
Arterioles control
conduits, last branch
of arterial system,
strong muscular walls
that can strongly
constrict or dilate.
Capillaries exchange
substances through
pores.
Venules collect
blood from
capillaries.
Veins low pressure,
transport blood back
to the heart,

Blood Volume and

Vasculature CrossSectional Area

Cross-sectional
Aorta
Small Arteries
Arterioles
Capillaries
Venules
Small Veins
Venae Cavae

area (cm2)
2.5
20
40
2500
250
80
8

Normal Blood Pressures in

Vasculature

Ohms Law Applied to Blood

Flow

Blood Pressure
BP is the force exerted by the blood
against the vessel wall.
- Typically measured as mm Hg.
- E.g., 100 mm Hg is the force needed to
push a column of Hg to a level of 100 mm.

Resistance
Resistance is the impediment to blood
flow.
Not measured directly, but determined
from pressure and flow measurements.
- If P = 1 mm Hg and F = 1 ml/sec, then R = 1
PRU (peripheral resistance unit).
- In the adult systemic circulatory system, P =
100 mm Hg, and F = 100 ml/sec; so R = 1 PRU.
- In the pulmonary system, P = 14 mm Hg and
F = 100 ml/sec; so R = 0.14 PRU.

Conductance
Conductance is the opposite of
resistance:
Conductance = 1/resistance
Conductance may be easier to
conceptualize than resistance and is
sometimes easier to use in
calculating the total resistance of
parallel vessels.

Vessel Diameter and Blood Flow

Changes in Resistance

Laminar Flow

Poiseuilles Law

Turbulant Flow

Adding Resistance in Series and

Parallel

Effect of Viscosity on Resistance

and Blood Flow

Summary of Blood Flow

Physics

Vascular Distensibility
Vascular distensibility is the ability
of the vascular system to
expand with increased pressure,
which
- Increases blood blow as pressure
increases.
- In arteries, averages out pulses.
- Allows veins to act as reservoirs

Calculate Distensibility
Fractional increase in volume per rise in
pressure:

Vascular = Increase in Volume

Distensibility Incr in P x orig Vol
If 1mm Hg increases a vessel from
10mm to 11mm, the distensibility
would be 0.1 per mm Hg or 10%
per mm Hg.

Distensibility of Arteries and

Veins
Artery walls are much stronger than
those of veins and thus, much less
distensible.
The larger distensibility of veins
allows them to act as blood
reservoirs.

Vascular Compliance
The quantity of blood that can be
stored in a particular portion of the
vasculature for a rise in pressure:
Vascular compliance = Increase in
volume
Increase in
pressure
Compliance = distensibility x vol

Arterial and Venous VolumePressure Curves

Damping of Pulse Pressure in

Arterial System

Athersclerosis Arteries become

less Compliant

Can Veins
distend to
hold large
amounts of blood.
Contraction of
skeletal muscles
can constrict the
veins and propel
blood to the heart
and increase
cardiac output.
The contractioninduced
constriction and
the valves
prevent the
venous pressure
from building up
on the feet of

Veins as Blood Reservoirs

> 60% of blood in the circulatory system is in
the veins.
When blood is lost, sympathetic stimulation
causes veins to constrict and make up for the
lost blood.
Conversely, veins can distend to hold excess
blood if too much is given during a
transfusion.

The Distribution of Blood

Blood Volume

Distribution of H2O
within the body:
Intracellular
compartment:
2/3 of total body H2O
within the cells.

Extracellular
compartment:
1/3 total body H2O.
80% interstitial fluid.
20% blood plasma.

Maintained by constant
balance between H2O
loss and gain.

Capillaries
Exchange nutrients and waste with
tissues.
~ 10 billion capillaries with 500
700 m2 total surface area in whole
body.

Capillaries are Porous

The exchange of water-soluble
nutrients and waste between
blood plasma and interstitial fluid
occurs by diffusion through pores
in the capillary walls.
Lipid-soluble substances pass
directly through the capillary wall
(e.g., O2 and CO2).

Capillary Structure

Capillary Exchange
Diffusion:
Filtration:
Reabsorption:

Capillary Exchange

Molecular Weight and Capillary

Porosity

Colloid Osmotic Pressure

Starling force=(Pc + if) - (Pif +
p)
Pc
Hydrostatic pressure in the capillary.

if
Colloid osmotic pressure of the interstitial
fluid.

Pif
Hydrostatic pressure in the interstitial fluid.

Cardiac Output (CO)

Recall the Frank-Starling Mechanism?

Volume of blood
pumped/min. by
each ventricle.
Pumping ability of
the heart is a
function of the
beats/ min. and
the volume of
blood ejected per
beat.

CO = SV x HR
Total blood volume
= about 5.5 liters.

Each ventricle
pumps the
equivalent of the
total blood volume/
min.

Forces Determining the Flow of

Substances in the Capillary

Forces at Arterial End of

Capillary

Forces at Venous End of

Capillary

Mean Capillary Forces