HEMODINAMIK

Muhammad Yusuf Fathoni

Yudhish
Resi
HEMODYNAMIC
 physical factors governing blood flow within the
circulatory system
FLOW
 Blood flow through an organ is determined by the
pressure gradient (P) driving the flow divided by
the resistance (R) to flow
 The pressure gradient (or perfusion pressure)
driving flow through an organ is the arterial
minus the venous pressure.
 Blood flow through organs (as well as through
the entire systemic circulation) is determined
largely by changes in resistance
FLOW
RESISTANCE
 Three factors determine the resistance (R) to
blood flow within a single vessel: vessel length
(L), blood viscosity () and diameter/radius (r)
 Vessel radius is the most important factor
determining resistance to flow.
 a change in radius alters resistance inversely to
the fourth power of the radius
POISEUILLE’S EQUATION
 This equation describes how flow is related to
perfusion pressure, radius, length, and viscosity.
 In the body, however, flow does not conform
precisely to this relationship becasuse the
equation assumes the following:
 (1) the vessels are long, straight, rigid tubes;

 (2) the blood behaves as a Newtonian fluid in

which viscosity is constant and independent of
flow
 (3) the blood is flowing under steady laminar flow
conditions
SERIES AND PARALLEL ARRANGEMENT OF
THE VASCULATURE

 Poiseuille’s equation only applyed to single vessel

 a single arteriole within the kidney were
constricted by 50%, although the resistance of
that single vessel would increase sixteen-fold, the
vascular resistance for the entire renal
circulation would not increase sixteen-fold
 The change in overall renal resistance would be
immeasurable
PARALLEL ARRANGEMENT OF ORGANS AND
CIRCULATION
 parallel vessels decrease
total vascular resistance
 the total resistance of a
network of parallel
resistances is less than
the resistance of the
single lowest resistance
 when many parallel
vessels exist, changing
the resistance of a small
number of these vessels
will have little effect on
total resistance
 Within an organ, the vascular arrangement is a
combination of series and parallel elements
 the artery, arterioles, capillaries, venules, and
vein are in series with each other
 Within each of theseries segments, many parallel
components may exist
 For an in-series resistance network, the total
resistance (RT) equals the sum of the individual
segmental resistances.
 The resistance of each segment
relative to
 the total resistance of all the
segments determines how
changing the resistance of one
segment affects total resistance
 changes in large artery
resistance have little effect on
total resistance, whereas
changes in small artery and
arteriolar resistances greatly
affect total resistance
 The above analysis explains
why the radius of a large,
distributing artery must be
decreased by more than 60% or
70% to have a significant effect
on organ blood flow. This is
referred to as a “critical”
stenosis
SYSTEMIC VASCULAR RESISTANCE
 is the resistance to blood flow offered by all of the
systemic vasculature, excluding the pulmonary
vasculature
 Systemic vascular resistance (SVR) can be
calculated if cardiac output (CO), mean arterial
pressure (MAP), and central venous pressure
(CVP) are known.
 its value is not determined by either of these
variables
 Systemic vascular resistance is determined by
vascular diameters, length, anatomical
arrangement of vessels, and blood viscosity.
VASCULAR TONE
 A state of partially constricted resistance vessels
 Generated by smooth muscle contraction within
walls of blood vessel
 Extrinsic and intrinsic mechanisms determine
the degree of smooth muscle activation
 Extrinsic mechanisms, such as sympathetic
nerves and circulating hormones
 intrinsic mechanisms include endothelial-derived
factors, smooth muscle myogenic tone, locally
produced hormones, and tissue metabolites
CVP
 The blood pressure in the thoracic vena cava near
the right atrium
 it determines the filling pressure of the right
ventricle, and thereby determines ventricular
stroke volume through the Frank-Starling
mechanism
 Several factors influence central venous pressure:

 cardiac output, respiratory activity, contraction

of skeletal muscle, sympathetic vasoconstrictor
tone, and gravitational forces.
THANK YOU