Introduction to Human Physiology--AP 151 Lecture Outline--CARDIOVASCULAR PHYSIOLOGY I.

Physical Laws Governing Blood Flow, Blood Volume, Blood Pressure, and Resistance A. Blood Flow – the volume of blood flowing through a vessel, or organ, or the entire circulation in a given period of time (ml/min). 1. If entire circulation, then blood flow = cardiac output 2. Fluid flow is directly related to a pressure gradient (∆P = P1 – P2); F ∝ ΔP 3. Flow is laminar through long, smooth-walled tubes. 4. Flow is turbulent through vessel constrictions, or over rough surfaces. B. Blood Pressure – the force blood exerts against the blood vessel walls; expressed in mm Hg C. Resistance – the opposition to flow 1. Blood flow encounters friction from vessel walls and blood cell collisions 2. Most friction encountered in peripheral circulation; therefore, aka Peripheral resistance 3. Increased resistance ------> decreased blood flow a. Flow ∝ 1/R :(i.e., Flow is inversely proportional to resistance)   As resistance increases, flow decreases As resistance decreases, flow increases

4. Three (3) parameters determine resistance for fluid flowing through a vessel a. Vessel length (L) – longer vessels have greater resistance than shorter vessels b. Fluid viscosity ( n ) – thicker fluids have greater resistance than thinner fluids c. Vessel radius (r) – changes more often than length or viscosity    As radius increases, resistance decreases As radius decreases, resistance decreases. In humans, R ∝ 1/r4 ; i.e., resistance varies inversely with the fourth power of the vessel radius (one-half the diameter). • Reducing the radius increases the resistance 16 times and therefore decreases flow through the vessel 16 fold •  Doubling the radius decreases resistance 16 times and therefore increases flow through the vessel 16 fold. Therefore, blood vessel radius becomes main determinant in resistance • • Vasoconstriction----->increased resistance-----> decreased flow Vasodilation--->decreased resistance-----> increased flow F = ΔP / R , where ∆P = P1 – P2 and R is the resistance

D. Relationship between Flow, Pressure, and Resistance 1. Shown by the formula:

a. When ΔP increases, flow increases and when ΔP decreases, flow decreases. b. When R (peripheral resistance) increases, flow decreases; if R decreases, flow ↑

II. Physiology of Systemic Circulation A. Cross-sectional area of blood vessels 1. Velocity of blood flow is affected by total cross-sectional area of the blood vessel a. Aorta = 5 cm2 vs. Capillaries = 2500 cm2 b. Therefore, blood flow is slowest in capillaries (0.3 mm/sec) and fastest in aorta (33 cm/sec B. Pressures and Resistances in the Various Portions of the Systemic Circulation (see Fig. 21.33) 1. Pressure of the blood falls from from 100 mm Hg in aorta to 0 mm Hg at right atrium 2. This decrease in arterial pressure in each segment of the systemic circulation is directly proportional to the vascular resistance in the segment (aorta, arterioles, capillaries, venules, vena cavae). C. Capillary Exchange and Regulation of Interstitial Fluid Volume 1. Forces affecting fluid movement across capillary walls a. Capillary hydrostatic pressure – moves fluid outward through capillary membrane b. Interstitial fluid pressure – moves fluid inward through the capillary membrane c. Plasma colloid osmotic pressure – causes osmosis of fluid inward through the membrane d. Interstitial fluid colloid osmotic pressure –causes osmosis of fluid outward thru membrane 2. Net filtration pressure (NFP) = Net hydrostatic pressure – Net osmotic pressure a. Net hydrostatic pressure = CHP – IFP ( a - b above) b. Net osmotic pressure = PCOP - ICOP ( c – d above) III. Control of Blood Flow in Tissues A. Local regulation of blood flow through the tissues 1. Autoregulation – the automatic adjustment of blood flow to each tissue in proportion to the tissue’s requirements at any instant a. Metabolic controls- declining levels of nutrients and oxygen stimulate vasodilation b. Myogenic controls – physical changes in vessels ( increasing or decreasing BP leads to a change in the vessel diameter) that deep tissue perfusion fairly constant   ↑ Intravascular pressure causes vasoconstriction ↓ Intravascular pressure causes vasodilation

B. Nervous and hormonal regulation of local circulation 1. Vasomotor tone via sympathetic regulation as controlled by the medullary vasomotor center a. Vasomotor tone – partial constriction of peripheral vessels due to sympathetic innervation • • Vasocontriction – due to an increase in vasomotor tone Vasodilation – due to a decrease in vasomotor tone

b. Symp. fibers release NE that binds to α-adrenergic receptors on vascular smooth muscle

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c. Hormones EPI and NE also cause vasoconstriction; in skeletal muscle EP binds to β-adrenergic receptors causing vasodilation IV. Regulation of Mean Arterial Pressure A. What is mean arterial pressure (MAP)? The average pressure tending to push blood through the systemic circulatory system. B. Measurement of blood pressure 1. Systolic pressure – pressure blood exerts on vessel during ventricular contraction 2. Diastolic pressure 3. Pulse pressure = Systolic pressure - Diastolic pressure a. MAP = Diastolic pressure + 1/3 Pulse pressure C. Short-term regulation of blood pressure: 1. Baroreceptor Reflexes a. Role of the ‘vasomotor center’ – a cluster of sympathetic neurons in the medulla 1) Baroreceptor reflexes – a mechanoreceptor; see Fig. 21.37   Stretch receptors located in the aortic arch and carotid sinus respond to changes in arterial pressure ↑ in pressure causes walls of these arteries to stretch & ↑ frequency of action potentials along sensory nerves; o o o  o o o   results in decreased sympathetic stimulation of blood vessels (vasodilation) increased parasympathetic stimulation of heart (↓ heart rate) blood pressure decreases (see Fig. 21.40) Increased sympathetic stimulation of blood vessels (vasoconstriction) Increased sympathetic stimulation of heart (↑ heart rate and strength) Blood pressure increases e.g. 120-75 = 45 (pulse press

↓ in pressure causes a decrease in the frequency of action potentials

Sensory fibers from baroreceptors ascend via vagus and glossopharyngeal nerves to vasomotor centers of medulla Reflex is more sensitive to decreases in pressure than to increases, and more sensitive to sudden changes in pressure than to more gradual changes

2. Adrenal Medullary Mechanism a. Activated when stimuli result in a substantial increase in sympathetic stimulation of heart and blood vessels (Fig. 21.38, Fig. 21.39) b. Results in release of epinephrine (EPI) and some norepinephrine (NE) c. Effects same as sympathetic stimulation d. Short term and reapid-acting

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C. Short-term regulation of blood pressure (continued) 3. Chemoreceptor reflexes a. Changes in oxygen content, levels of CO2, or pH of the blood D. Long-term mechanisms of regulation of peripheral resistance (blood pressure) 1. Renal regulation a. Counteracts fluctuations in blood pressure by altering blood volume rather than per. resis. b. Direct renal mechanism 1) Alters blood volume c. Indirect renal mechanism 1) Uses the rennin-angiotensin mechanism    ↓ in BP leads to renin secretion which stimulates production of Angiotensin II. Angiotensin-II increases blood pressure and thus increases rate of blood delivery to the kidneys. Renin also stimulates secretion of aldosterone from adrenal cortex • • Increases Na+ reabsorption which promotes water reabsorption Movement of Na+ and water into blood raises blood volume and BP

2. ADH (Antidiuretic hormone) mechanism 3. Atrial Natriuretic Mechanism 4. Stress-Relaxation response V. Venous blood pressure – 1. Changes very little during cardiac cycle; ΔP in veins is only about 20 mm Hg; 60 in art. 2. Venous pressure is too low to promote adequate venous return 3. 2 structural modifications that assist venous return a. Respiratory pump – pressure changes in ventral body cavity b. Muscular pump – “milking” of veins during contraction of muscles

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VI. Blood Flow in Special Areas A. Blood flow to the skeletal muscles 1. Skeletal arterioles have high vascular resistance due to alpha-adrenergic sympathetic stimulation. Produces relatively low blood flow 2. Sympathetic cholinergic fibers stimulate vasodilation as part of fight-or-flight 3. Stimulation of beta-adrenergic fibers by hormone epinephrine also vasodilates 4. Increased blood flow during exercise due largely to intrinsic metabolic control a. Latter may increase blood flow to 85% of total blood flow during exercise B. Blood flow to the Brain 1. Cerebral blood flow NOT normally influenced by sympathetic nerve activity a. Becomes active only when MAP rises to about 200 mmHg 2. Regulated almost exclusively by local control mechanisms (‘autoregulation”) a. Myogenic regulation • ↓ BP → Vasodilation and ↑ BP → Vasoconstriction (Maintains constant flo ↑ Carbon dioxide (due to hypoventilation) → Vasodilation (and vice versa b. Metabolic regulation • C. Blood flow to the heart 1. Coronary arterioles contain both alpha and beta adrenergic receptors which promote vasoconstriction and vasodilation, respectively 2. Most vasodilation is due to intrinsic metabolic control

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