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3/18/12

Regulation of blood flow


By Dr. Doaa samy
3/18/12

Cardiovascular regulatory mechanisms

1- Altering the cardiac properties that affect the cardiac output 2- regulation of blood flow by changing the diameter of the arterioles (the resistant vessels)
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Regulation of blood flow


local regulation
systemic regulation

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Objectives: n By the end of this lecture the students should be able to: n 1. List the local regulatory component of regional blood flow. n 2. Explain the importance of Laplace law in myogenic autoregulation n 3. List the examples of metabolic autoregualtion. n 4. Describe the mechanism of each. n 5. Outline the substances secreted from the vascular endothelium.
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Local regulation of blood flow

1- Autoregulation

I- Local regulation of blood flow

2-Endothelial mediated

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Local regulation

1- Autoregulation

It is the capacity of tissues to regulate their own blood flow. Most vascular beds have an intrinsic capacity to compensate for moderate changes in perfusion pressure by changing the vascular resistance, so that blood flow remains relatively constant.

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Local regulation

1- Autoregulation

a)Myogenic autoregulation

b)Metabolic autoregulation

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Local autoregulation

a)Myogenic autoregulation

Myogenic regulation is the intrinsic contractile response of vascular smooth muscle to stretch. As the pressure rises, the blood vessels are distended and the vascular smooth muscle fibers contract.

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Local autoregulation

a)Myogenic autoregulation

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Local autoregulation

a)Myogenic autoregulation

Laplace law states that:

Vessel wall tension distending pressure X the radius of the vessel.

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Local regulation

b)Metabolic autoregulation

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Local autoregulation

b)Metabolic autoregulation

decrease in oxygen tension and acidosis Increase in CO2tension, its action is most pronounced in skin and brain. Rise in temperature in active tissues. K+ and lactate in skeletal muscle. Histamine in injured tissues. Adenosine in cardiac muscle
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Examples of vasodilators

Local autoregulation

b)Metabolic autoregulation

Short term Last for minutes 1- reactive hyperaemia 2- active hyperaemia


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Long term Last for days or years

Local autoregulation

b)Metabolic autoregulation

Short term Last for minutes 1- reactive hyperaemia

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Local autoregulation

b)Metabolic autoregulation

Short term Last for minutes 2- Active hyperaemia

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Local autoregulation

b)Metabolic autoregulation

Long term Last for days or years


If the tissue metabolism of certain area or its local blood supply is changed (increased or decreased) , the local blood flow is readjusted over a period of weeks or months.
e.g. 1- chronic hyper or hypotension 2- hyperthyroidism or hypothyriodism

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Local autoregulation

b)Metabolic autoregulation

Long term Last for days or years In young persons, this degree of readjustment is usually very exact; in old persons it is only partial. The underlying mechanisms of increased blood flow include

increased tissue vascularity and the development of collaterals 3/18/12 (angiogenesis).

Local regulation

2- Endothelial mediated

prostacycli n

Thromboxane A2

inhibits platelet aggregation promotes 3/18/12 vasodilatation.

Released from platelets promotes platelet aggregation vasoconstriction.

Local regulation

2- Endothelial mediated

EDRF (nitric oxide)

promotes vasodilatation. essential for maintaining normal arterial blood pressure.


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Local regulation

2- Endothelial mediated

Endothelins

Three Endothelins are identified (1, 2, and 3). Endothelin-1, produced by endothelial cells, is one of the most potent vasoconstrictors. Veins are more sensitive than arteries. It acts as a paracrine factor. 3/18/12

systemic regulation of blood flow


Objectives: n 1. Outline the effects of circulating hormones in blood flow regulation. n 2. Describe the role of vasoconstrictor hormones in regulation of blood flow. n 3. Describe the role of vasodilator hormones in regulation of blood flow. n 4. Outline the nervous regulation of the blood flow
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II- systemic regulation of blood flow


systemic regulation of blood flow

nervous regulation

Hormonal regulation

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II- systemic regulation of blood flow


Hormonal regulation

a)Vasoconstrictors b)Vasodilators 1- epinephrine and 1- kinins norepinephrine 2- atrial natriuretic 2- vasopressin peptide 3- renin- angiotensin II
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2- systemic regulation of blood flow a) Hormonal control


Epinephrine Norepinephrine

Sympathetic stimulation

These hormones can reach some parts of the circulation that have no sympathetic 3/18/12 nervous supply at all, including the very minute vessels such as the metarterioles.

Epinephrine

Norepinephrine

Heart ++++ Blood vessels


Skin ,GIT Skeletal ms Coronary Liver constrict dilate dilate dilate

Heart + Blood vessels


Constrict most of the blood vessels

Blood pressure no effect

Blood pressure increased Reflex bradycardia

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2- systemic regulation of blood flow a) Hormonal control


Renin-Ang II system

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Renin-AngiotensinAldosterone Mechanism
Decreased extracellular fluid volume

Increased 3/18/12 BP

2- systemic regulation of blood flow Vasopressin a) Hormonal control


(ADH) Ang II stimulation of atrial B receptors is reduced (e.g. hypovolemia).

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Vasopressin (ADH) Mechanism

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2- systemic regulation of blood flow a) Hormonal control


Atrial Natriuretic Peptide

ECF volume increase and atrial walls stretch vasodilatation

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2- systemic regulation of blood flow a- Hormonal control


kinins (Bradykinin and Lysylbradykinin)
Action of kinins 1- They relax vascular smooth muscles via EDRF: lowering blood pressure. 2- They increase capillary permeability and attract leucocytes. 3- They are responsible for the increase in blood flow in certain tissues when they are actively secreting e.g. sweat glands, salivary glands and exocrine portion of pancreas. 3/18/12

2- systemic regulation of blood flow a- Hormonal control


kinins (Bradykinin and Lysylbradykinin)
Action of kinins

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2- systemic regulation of blood flow b- Nervous control Innervation of the blood vessels

1- sympathetic adrenergic nerve fibers (vasomotor tone) 2- sympathetic cholinergic nerve fibers 3- parasympathetic cholinergic nerves 3/18/12

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Heart rate

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(C.C., hypothalamus, limbic system and respiratory centers) Atrial stretch receptors

Heart rate modification

Increased temperature

Cardiovascula r centers

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Adrenaline

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1- direct stimulatory effect on the vasomotor area

2- indirect effect through chemoreceptors stimulation of respiratory center and increased ventilation

3- direct stimulatory effect of hypoxia on the heart

4- hypoxia stimulates the suprarenal gland to secrete epinephrine


Causes of tachycardia in moderate hypoxia or hypercapnea

Hypoxia hypercapnia

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tachycardia

DOAA SAMY 3/18/12