HEMODYNAMICS

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 HEMODYNAMICS

Hemodynamics is the study of the relationship between flow,

pressure and resistance and other physical principles of blood
circulation
 Blood vessels: types, histology

 Blood flow: types

 Blood pressure & regulation

 Microcirculation

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Blood vessels: Classification
1. Elastic vessels :
 Example: Aorta, big arteries
 Pressure resistant components
 High ability of recoiling

2. Resistance vessels

Example: small arteries and arterioles

 High muscular component
 Develop high resistance
 Regulate blood flow
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 Blood vessels: Classification...

3. Exchange vessels: Example, capillaries

 Thin enough for exchange
 3 types: continuous, Sinusoid capillaries and fenestrated capillaries

4. Capacitance vessels (big to small veins)

 Very high capacity of distension
 Can accommodate large volume of blood (65% of blood
volume)

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 Blood vessel functions: overview
Strong and elastic arteries
Arterioles control blood flow
and pressure

Capillaries: thin and

with large area for
diffusional exchange

 Veins: compliant, large, low resistance

 veins have valves & assure blood return to the heart5
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Fig. Major types of blood vessels found within the circulation 6
 Arteries
 More muscular.
 Able to resist high blood pressure (resistance vessels)
 Contain elastic cartilage and smooth muscle, This allows the
arteries walls to contract and relax to send blood to all parts of
the body.
 Divided into three categories by size.
 Conducting(elastic/large)arteries-Able to expand/recoil.
-eg. Aorta, pulmonary arteries, common carotids.
 Distributing (muscular, medium) arteries
- Distribute blood to specific organs.
- eg. brachial, renal, and splenic arteries etc
 Arterioles – smallest arteries; lead to capillary beds.
 Control flow into capillary beds via vasodilation and constriction
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 Veins
Carry blood back to the heart (deoxygenated blood
except pulmonary vein which carries oxygenated blood
from lungs to heart).
 Capacitance vessels (blood (volume) reservoirs) that contain 65% of the blood
supply.

 Thinner and less muscular than arteries.

 Have some smooth muscle- contracts to help sent the blood back to the heart

 Less elastic than arteries

 Have valves – prevent back flow of blood during venous return.

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 CAPILLARIES
 Necessary for exchange of gases, nutrients, and wastes
Oxygen and nutrient delivery (upload) to tissues
Pick up CO2 and nitrogenous waste from the tissue.

 Blood flow is slow and continuous

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 Types of capillary
1.Continuous capillaries
 Have tight junctions (distance between endothelial is 5-30nm)
 Found mainly in brain (blood -brain barrier)
 are low permeable to ions and most hydrophilic molecules
2. Fenestrated capillaries-
 Found in organs that transport lots of water bowels (glomerular
capillaries of kidney, pancreas and salivary glands)
 Fenestrate keep plasma proteins back 
3.Sinusoid capillaries -have broad openings between endothelial cells
 Found in tissues bathed in plasma (liver, spleen, and bone marrow)

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 Capillary Exchange
 Depends on the following pressure:
The capillary hyderostatic pressure (Pc), which tends to force fluid
outward through the capillary membrane. Pc = 35mm Hg

The interstitial hydrostatic pressure (Pif), which tends to force

inward movement of fluid through the capillary membrane. Pif=0

The capillary plasma colloid osmotic pressure (cp), which tends to

cause osmosis of fluid inward through the capillary membrane. cp =
28 mm Hg

The interstitial fluid colloid osmotic pressure (if), which tends to

cause osmosis of fluid outward through the capillary membrane. if =
3mm Hg
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 Capillary Exchange….

 Pressure-driven movement of fluid and solutes from blood

capillaries into interstitial fluid is called filtration.
 Pressure-driven movement from interstitial fluid into blood
capillaries is called reabsorption.
 The net filtration pressure (NFP), which indicates the direction
of fluid movement, is calculated as follows:
NFP = (Pc + ifP ) - (cP + Pif)
Pressures that Pressures that
promote filtration promote reabsorption

If NFP is positive = filtration

If NFP is negative = reabsorption
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 Blood flow rate (Q)
Blood flow (Q) is the amount of blood that moves to a particular
organ in a given time (Q= volume/time)
Total blood flow is equal to CO; 5-6 L/min
Q is determined by 2 factors
1. Pressure difference b/n 2 ends of the vessel
i.e., the force that pushes blood through vessels
2. Resistance of flow, hindrance to flow through vessels
Q = ΔP/R Where Q = Blood flow
ΔP = Change in pressure
R = Resistance
Ohms Law: states that Q is directly proportional to the ΔP but
inversely proportional to resistance (R).
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 Vascular resistance

 Poiseuille's Law: Vascular resistance is directly proportional to the length of the

vessel and viscosity of blood, but inversely proportional to the 4th power of radius
of the vessel. Where, R = Resistance
R = 8l/r 4
l = Length
Q= Pr4
 = Viscosity
8l
 = Circle constant (3.14)
r = Radius

Factors affecting viscosity of blood

 Hematocrit: polycythemia = ↑Viscosity = ↑PR

Anemia = ↓Viscosity = ↓PR

PR=Peripheral resistance
 Plasma protein concentration
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 Velocity of blood flow (V)
 Velocity is a measure of how fast blood flows past a point.
 Measured with Ultrasonic Doppler flow Meters or Electromagnetic Flow
Meter
Velocity of blood flow through a tube equals the flow rate divided by the
tubes cross-sectional area.
Pr4
V = Q/A A= r2 Q= 8l
v = Pr2 /8l

 Velocity (v) of Q is directly proportional to the pressure difference (P)

and diameter of the vessels, but inversely related to the viscosity of blood
and length of the blood vessel

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 Types of Blood Flow
There are two types of blood flow inside the vessels
1. Laminar flow
2. Turbulent flow

1. Laminar blood flow also called streamline flow

Blood flows in a steady rate through long smooth vessels
Blood cells move in a straight line
Blood cells at the centre of the vessel move faster
Laminar flow is silent
2. Turbulent flow
Blood flows in all directions in a vessel, continuously mixed
Turbulent blood flow produces sound
Occurs at blood vessels with high elastic content and during
high velocity
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 Regulation of blood flow
 Each organ can control the rate of BF based on the degree of
requirement of O2, nutrients and removal of wastes.
 Two types of regulation
A. Intrinsic Regulation of Blood Flow (Autoregulation)
 It is localized regulation of vascular resistance and blood flow.
 Includes - Myogenic
- Metabolic
B. Extrinsic Regulation of Blood Flow
 Extrinsic regulation refers to control by the autonomic nervous
system and endocrine system (hormonal) 20
 A. Intrinsic Regulation of Blood Flow
i. Myogenic Control Mechanisms
• Stretching of small blood vessels at high pressure causes the smooth
muscle of the vessel wall to contract.
• Conversely, at low pressures, the muscles relax.

 Blood flow will maintain as required.

ii. Metabolic Control Mechanisms
 Local vasodilation within an organ can occur as a result of
metabolism
 Chemicals that promote vasodilation include:
• O2 , CO2 concentrations, pH (due to CO2, lactic acid, etc.),
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release of adenosine or K+ from the tissue cells.
 B. Extrinsic Regulation of Blood Flow
• Includes

autonomic nervous system (Sympathetic and parasympathetic)

Endocrine system (hormonal)

norepinephrine and epinephrine.

Angiotensin II.

Vasopressin (ADH)

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 Arterial blood pressure-ABP

 BP is a force exerted by the blood on the wall of the blood

vessels

 Has 2 components: systolic and diastolic pressure

 Expressed as : BP=systolic/diastolic

 Normal Ps: 90 – 130 mm Hg (120 mm Hg)

Pd: 60 – 90 mm Hg (80 mm Hg)

Normal adult BP=120/80

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 Variations in ABP
1. Age: ABP rises as age increases, New born: 70/50, infants:
90/60, children: 100/70, Adults: 120/80 and old age (>60
yrs.): 150/90
2. Time of the day: ↓morning, ↑evening
3. Body wt.: ABP higher by 10-15 mm Hg in obese
4. Gravity: every 1 cm distance below the level of the heart
increases pressure by 0.77 mm Hg
5. Exercise: increases ABP by 40 – 50 mm Hg
6. Emotion: increases ABP by 10 – 30 mm Hg
7. Deep sleep: decreases ABP by 20 mm Hg

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Pulse pressure-

up and down fluctuation of

arterial pressure.
Ppulse = Ps-Pd
where;
Ps = systolic pressure

Pd= diastolic pressure

. it is about ~ 40mmHg
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 Mean arterial pressure(MAP)

MAP is average BP over a cardiac cycle.

Mainly determined by CO, and total peripheral vascular
resistance (TPVR)
MAP= CO X TPVR
MAP also ~ Pd + 1/3 (Ps-Pd.)
 it is about 93-100 mmHg
where;
Ps = systolic pressure
Pd= diastolic pressure

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Blood Pressure Measurement

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 Regulation of blood pressure

General considerations:

•  blood volume   blood pressure

•  blood volume   blood pressure

• diameter of blood vessel  resistance   blood pressure

• diameter of blood vessel  resistance  blood pressure.

• salt intake   H2O retention  blood pressure.

 Regulation of blood pressure

 Two types

A. Short-term controlling mechanisms

 Baroreceptor reflex

 Chemoreceptor reflex

 CNS ischemic reflex

 Atrial stretch reflex

 Hormonal mechanisms: AD, NAD, Vasopressin (ADH),etc

B. Long-term controlling mechanisms

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
 The Baroreceptor Reflex

Baroreceptors are stretch-sensitive mechanoreceptors which are

located on:
• walls of the carotid bodies
• Aortic arch
• Wall of large thoracic arteries and
• Wall of cervical arteries.
Regulate arterial pressure by increasing firing when stretched
(high pressure) and conversely, slowing firing when relaxed
(low pressure

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Regulation of Blood Pressure

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Figure The baroreceptor reflex: the response to increased blood pressure
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 Chemoreceptor reflex

At low O2 or high CO2 or H+ (as occurs during low pressure

because of blood flow), chemoreceptors are stimulated.

Chemoreceptors excite the vasomotor center, which elevates

the arterial pressure.

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Chemorecepter

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 B. Hormonal control of blood pressure

a) Angiotensin II  ↑ BP

b) Aldosterone  ↑ BP

c) Atrial natriuretic peptide  ↓ BP

d) Antidiruetic hormone (ADH)  ↑ BP

e) Epinephrine and Norepinephrine  ↑ BP

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Hormonal control of BP- (Decreased Blood Pressure)

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Hormonal control –(Increased Blood Pressure)

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Renin-Angiotension-Aldosterone system (RAAS)

The kidneys control the level of H2O and NaCl in the body,
thus controlling the volume of the extracellular fluid and
blood.

By controlling blood volume, the kidneys control arterial

pressure.

Increased arterial pressure results in increased renal output of

H2O (pressure diuresis) and salt (pressure natiuresis).

It is long-term control system

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RAAS….

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