Overview of the Circulation: Medical Physics of Pressure, Flow and Resistance Physical Characteristics of the Circulation • Functional Parts

of the Circulation o Arteries: transport blood under high pressure to the tissues (strong vascular walls, high velocity bloodflow) o Arterioles: small branches of the arterial system; act as control conduits through which blood is released into the capillaries (strong muscular wall that can close or dilate  alteration of bloodflow in response to needs of tissue) o Capillaries: exchange fluid, nutrients, electrolytes, hormones and other substances between the blood and interstitial fluid (very thin walls, numerous minute capillary pores) o Venules: collect blood from capillaries (coalesce into larger veins) o Veins: conduits for transport of blood from the venules back to the heart; major reservoir of extra blood (pressure is low  venous walls are thin but muscular= controllable reservoir) • Volumes of Blood in the Different Parts of the Circulation • Cross-Sectional Areas and Velocities of Blood Flow • Pressures in Various Portions of the Circulation Basic Theory of Circulatory Function 1. The rate of blood flow to each tissue of the body is almost always precisely controlled in relation to tissue need 2. Cardiac output is controlled mainly by the sum of all the local tissue flows. 3. In general, the arterial pressure is controlled independently of either local blood flow control or cardiac output control. Interrelationships Among Pressure, Flow and Resistance • Blood Flow o The quantity of blood that passes a given point in the circulation in a given period of time o Cardiac output: overall blood flow in the total circulation; amount of blood pumped into the aorta by the heart each minute o Methods for Measuring Blood flow  Electromagnetic flowmeter  Ultrasonic Doppler flowmeter o Laminar Flow of Blood in Vessels o Parabolic Velocity Profile During Laminar flow  The fluid molecules touching the wall barely move because of adherence to the vessel wall. The next layer of molecules slips over these; the third layer over the second, etc. Therefore, the fluid in the vessel can move rapidly because the many layers of slipping molecules exist between the middle of the vessel and the vessel wall o Turbulent Flow of Blood Under Some Conditions • Blood Pressure o Standard Units of Pressure  mm Hg  Blood pressure= force exerted by the blood against any unit area of the vessel wall  Centimeters of water: one mm Hg= 1.36 cm water pressure o High-fidelity Methods for Measuring Blood Pressure • Resistance to Blood Flow o Units of resistance  Resistance must be calculated from measurements of blood flow and pressure difference  Peripheral resistance unit: pressure difference between two points is 1 mm Hg and the flow is 1 ml/sec  resistance is 1 PRU  CGS units o Total peripheral Vascular Resistance and Total Pulmonary Vascular Resistance o Conductance of Blood in a Vessel and its Relation to Resistance  Conductance: measure of the blood flow through a vessel for a given pressure difference  C = 1/resistance o Very Slight Changes in Diameter of a Vessel can Change its Conductance Tremendously!

 Conductance of the vessel increases in proportion to the fourth power of the diameter o Poiseuille’s Law  The diameter of a blood vessel plays by far the greatest role of all factors in determining the rate of blood flow through a vessel. o Importance of the Vessel Diameter “Fourth Power Law” in Determining Arteriolar Resistance  Fourth power law makes it possible for the arterioles either to turn off almost completely the blood flow to a tissue or at the other extreme to cause a vast increase in flow. o Resistance to Blood Flow in Series and Parallel Vascular Circuits  Arteries, arterioles, capillaries, venules and veins are collectively arranged in series (flow through each blood vessel is the same and the total resistance to blood flow is equal to the sum of the resistances of each vessel)  Blood vessels branch extensively to form parallel circuits (total resistance to flow is expressed as 1/Rtotal= 1/R1+1/R2…  Many parallel vessels make it easier for blood to flow through because each parallel vessel provides another pathway (conductance) for blood flow. o Effect of Blood Hematocrit and Blood Viscosity on Vascular Resistance and Blood Flow o Hematocrit: % of blood that is cells o Effect of Hematocrit on Blood Viscosity Effects of Pressure on Vascular Resistance and Tissue Blood Flow o An increase in arterial pressure not only increases the force that pushes blood through the vessels but also distends the vessels at the same time, which decreases vascular resistance (greater pressure increases the flow in two ways)