B4-098 Cardiovascular Hemodynamics Flashcards
the heart provides a constant
pressure head
the goal of the cardiovascuar system is to maintain
mean arterial pressure
allows for perfusion
The cardiovascular system consists of two pumps arranged in
series
the systemic organs are arranged in
parallel circuits
allos same blood composition to each organ with independent flow
the systemic organs are arranged in
parallel circuits
allos same blood composition to each organ with independent flow
- high pressure
- left heart to organ systems
systemic circulation
- low pressure
- includes capillaries to right side of heart
pulmonary circulation
the pressure gradient amoung all organ systems
remains the same
differences in blood flow between organs are due to
differences in vascular resistance of each organ
portal special circulatory systems
3
- hepatic portal system
- renal portal system
- hypothalmic-pituitary portal system
main factors of hemodynamics
6
- blood flow
- resistance
- viscosity
- blood velocity
- blood pressure
- compliance
driven by a difference in pressure and opposed by the resistance of the vessels
blood flow
displacement of fluid per unit time
blood flow
amount of blood delivered by the heart into circulation
cardiac output
cardiac output during a single heartbeat
stroke volume
CO=
SV * HR
at rest, cardiac output for an individual is about
5 L/min
cardiac output can be increased by
increasing stroke volume or heart rate
factors that increase stroke volume
- preload: filling of the ventricle
- inotropic state: force of contraction
factors that decrease stroke volume
afterload: resistance to ejection of blood
blockage
factors that alter heart rate
- heart’s pacemaker activity
- extrinsic factors
measures the sound reflected by RBCs in movement
ultrasound
measures the change in electromagnetic force exerted by the moving blood in an electrial field
electromagnetic
involves the use of radioactive microspheres, injected on a vessel and collected downstream
reference sample method
measures regional blood flow
Implications of Poiseulle’s Law
Flow is […] proportional to the pressure difference between 2 points
directly
Implications of Poiseulle’s Law
Flow is […] proportional to the fourth power of the vessel radius
inversely
Implications of Poiseulle’s Law
Flow is […] proportional to the viscosity of blood
inversely
Implications of Poiseulle’s Law
Flow is […] proportional to the length of the vessel
inversely
if a vessel radius decreases by a factor of 2, resistance increases by a factor of
16
to the fourth power
inversely proportional to vessel radius to the fourth power
resistance
changes in the radius of arterioles are the major influences on
TPR
blood viscosity is determined by
hematocrit
erythrocyte concentration
two factors that affect resistance
- vascular radius
- blood viscosity
- site of greatest vascular resistance
- major component of TPR
arterioles
arteriolar dilation or constriction will affect the
TPR
expresses degress of slipperiness between layers
viscosity
organized in concentric layers of fluid moving down the length of a vessel
laminar flow
when flow become disorganized it is called
turbulent flow
factors that determine if flow is laminar:
- blood velocity
- blood viscosity
critical velocity
when flow changes from laminar to turbulent
- measure of velocity and viscosity
- increases when blood reaches critical velocity
reynolds number
in anemia, viscosity is
decreased
in polycythemia vera, viscosity is
increased
turbulent flow in the heart creates
murmurs
turbulent flow in the vessels creates
bruits
intense turbulence may be detected as mechanical vibrations
thrills
refers to the rate of displacement of blood within vessels with respect to time
blood velocity
inversely related to the cross sectional area of all vessels of a particular segment of the CV system
blood velocity
have lowest velocity to facillitate solute exchange
capillaries
3 components of blood pressure
- driving pressure
- transmural pressure
- hydrostatic pressure
- difference in pressure between two point along the circulatory system
- generated by the pumping action of the heart
- allows blood to flow
driving pressure
- change in pressure inside and outside a vessel along radial axis
- influences vessel diameter and vascular resistance
transmural pressure
- the change in pressure that exists between two points of a different height
- depends on gravity
hydrostatic pressure
standing causes […] in the legs, and […] venous return to the heart
pooling
decreases
standing reduces
SV and CO
vessel with highest pressure
aorta
vessel with lowest pressure
cava vein
atria
increases blood flow and pressure downstream
arteriolar dilation
decreases blood flow and pressure downstream
arteriolar constriction
highest and results from blood ejected when the heart contracts
systolic pressure
lowest and occurs when heart relaxes and blood returns to heart via veins
diastolic pressure
- difference between systolic and diastolic pressures
- depends on SV and arterial compliance
pulse pressure
average arterial pressure over time
MAP
very low because compliance allows it to hold large volumes of blood
venous pressure
pulsatile during cardiac cycle and dependent on systolic pressure
arterial pressure
MAP in large systemic arteries
95 mmHg
MAP=
CO x TPR
(HR x SV) x TPR
arterial pressure rises when
inflow is greater than outflow
systole
arterial pressure falls when
inflow is less than outflow
diastole
- determines how quickly blood volume in the arterial system increases
- influences peak systolic pressure
ejection rate
rise in arterial pressure during ejection is directly proportional to the volume of blood added by the heart to the arterial system
stroke volume
determinants of arterial systolic pressure
3
- ejection rate
- stroke volume
- arterial compliance
vessels with higher compliance maintain
reduced blood pressure
determinants of arterial diastolic pressure
- rate of runoff
- runoff time
how fast blood flows from the arterial system to the venous system
rate of runoff
runoff occuring during diastole
ventricular filling
runoff time
major determinant of runoff time is
heart rate
length of diastole decreases as heart rate increases
ways to measure blood pressure
- directly with a catheter
- indirectly with sphygomanometer
distensibility of blood vessels
compliance
high compliance
veins
low compliance
arteries
[…] results in decreased arterial compliance, which leads to increased arterial systolic pressure
aging
causes reduced arterial compliance, leading to increased blood pressure due to hardening of arteries
arteriosclerosis
starling’s law
venous return to the right heart will decrease with standing, so:
* reduce end diastolic volume
* decrease stroke volume
* reduce cardiac output
- results in increased pressure within peripheral veins without a change in resistance
- increases venous return to the heart
venoconstriction
[…] increase in blood volume within the arteries will increase arterial pressure significantly
small
low compliance
[…] increase in blood volume within the arteries will increase arterial pressure significantly
small
low compliance
[…] increases in venous blood produce a small increase in venous pressure
large
high compliance
[…] increases in venous blood produce a small increase in venous pressure
large
high compliance
the majority of blood is within
the systemic veins (60%)
main regions that can contribute to blood redistribution following blood loss
veins and venules
factors that contribute to venous return
- skeletal muscle pump
- respiratory pump
- venous valves
contraction of skeletal muscles compresses veins in the legs, forcing blood toward heart
skeletal muscle pump
when skeletal muscles relax […] prevents the backward flow of blood
venous valves
effect of inspiration on right ventricle
- increased intrathoracic volume
- decreased intrathoracic pressure
- decreased right atrial pressure
- increased pressure gradient between peripheral veins and right atrium
- increased blood flow to right atrium
- increased EDV of right ventricle
- increasd stroke volume
effect of inspiration on left ventricle
- increased intrathoracic volume
- decreased intrathoracic pressure
- distension of pulmonary veins
- decreased pressure in pumonary veins
- pooling of blood in pulmonary veins
- decreased blood flow to left atrium
- decreased EDV of left ventricle
- decreased stroke volume
expiration decreases
- filling of right ventricle
- right ventricular stroke volume
expiration increases
filling of left heart
left ventricular stroke volume
inspiration [….] pressure in the pulmonary veins
reduces
decreases venous return to the left heart
inspiration
increases venous return to the left heart
expiration
increases right ventricular preload
inspiration
increases venous return to the right heart
inspiration
decreases venous return to the right heart
expiration
decreases SV from right ventricle
expiration
decreases pulse pressure in pulmonary arteries
expiration
why is blood flow slowest through the capillaries?
the cross sectional area of all capillaries is greater than other vessels
flow divided by a cross sectional area =
velocity
have the highest total cross sectional area and lowest flow velocity
capillaries
pulse pressure is […] proportional to SV and […] proportional to arterial compliance
directly; inversely
index of ventricular contractility
ejection fraction
SV/EDV=
ejection fraction
EDV-ESV=
stroke volume
systolic blood pressure - diastolic blood pressure =
pulse pressure
CO * TPR =
MAP