Circulation 1: Hemodynamics Flashcards
What is the function of …
- arterial side
- venous side
- global control
- local control
arterial side- control pressure
venous side- control volume
global control- sympathetic
local control- dep. on metabolic demand
Clinically the central venous pressure is used to monitor blood volume very carefully. Why?
If someone is bleeding internally would you see a change in arterial pressure or venous pressure?
bc its v sensitive to blood volume
see a change in venous pressure immediately and no change at all in arterial pressure. why? bc arterial pressure is regulated by baroreceptor reflex. and you need to lose a large volume of fluid before you start to see changes in arterial pressure. on other side of system, venous system not regulated at all. big bag of fluid. not strong regulation bc holds volume. arterial side maintains pressure. volume side-venous. has low pressure under normal conditions (between 2-5) and small changes in volume cause dramatic changes in pressure bc not regulated. thats what central venous line is for- measure pressure… give transfusion, is pressure going back up? bc that pressure pushes blood into heart.
What is a main job of the circulatory system?
maintain arterial bp.
that bp is designed to perfuse and bring O to tissues.
There is not enough blood in the circulatory system to perfuse all organs at the same moment. How does the circulatory system compensate?
circulatory system designed to distribute blood to organs that need blood at moment. little blood to GI unless eating. little blood to skeletal while sitting. blood to brain… most of blood to 3 vital organs (brain, pulmonary system and heart) , 25 percent to kidneys all the time… brain needs constant O. even 5 sec without it and you’d pass out. v dep. on O. as far as body those are only 3 that need to be perfused all the time
so during hypo-volumic shock. bleeding, the sympathetic baroreceptor reflex closes blood flow to kidneys, splanchin region, skin, and shunts blood to 3 vital organs.
What is Poiseuille’s Law? Describe it and provide the equation.
Describes how blood flow is regulated
-applies to steady laminar flow of Newtonian fluids through uniform cylindrical tubes.
(CV system is composed of branching, elastic tubes of varying diameter and a non-Newtonian fluid (blood)
-analogous to Ohm’s Law
Law: F= P/R (change in pressure over Resistance)
- Flow is directly proportional to pressure gradient
- Flow inversely proportional to resistance
F= (P1-P2) pi r^4/(8L x viscosity)
Blood flow is directly proportional to the pressure gradient.
Blood flow is directly proportional to the vessel radius to the fourth power.
Blood flow is inversely proportional to vessel length and blood viscosity.
Resistance is directly proportional to the vessel length and blood viscosity.
Resistance is inversely proportional to vessel radius to the fourth power.
The most important determinants of blood flow in the cardiovascular system are the pressure gradient and radius to the fourth power. The pressure gradients are generally held constant by feedback mechanisms (baroreceptors). Therefore, small changes in arteriolar radius can cause large changes in blood flow to a tissue or organ because flow and radius are related by the fourth power.
What is flow equal to?
flow equal to pressure generated across cardiovascular system.
flow L to R, generates pressure gradient- blood flowing forward.
related to pi r^4 …r is the radius of the vessel
What is the significance of r^4?
means that blood flow is related to the 4th power of radius of vessel which means that very small decreases in radius cause very large decrease in blood flow.
if vessel diameter increases 2 times. blood flow goes up r^4… 2^4… 16. so blood flow goes up 16x for increased diameter of only 2x.
Describe resistance and the relationship between resistance and radius.
Resistance is inversely related to r^4. as radius goes up, resistance goes down by the same factor.
R= 8/viscosity x Lviscosity/r^4
Resistance is related to the L of the tube… as blood flows across circulatory system the tube is long, longer blood flows across tube the more resistance it encounters. one of reasons bp drops over distance
Describe how length of system is related to bp.
as blood flows across circulatory system the tube is long, longer blood flows across tube the more resistance it encounters. one of reasons bp drops over distance. L of system - resistance is high. as blood flows arterial side, capillaries to venous side, that L affects resistance of system or det. resistance of system. one reason bp drops, losing E against that resistance
What is viscosity?
viscosity directly related to resistance. higher viscosity, higher resistance. viscosity =(internal frictional resistance of fluid flowing across itself) …
=internal frictional resistance between adjacent layers of a fluid
Why does the L ventricle generate so much more pressure than the R side even though the CO is the same?
pressure generated by L ventricle high even tho CO same bc of resistance… same CO generated by R ventricle but pressure low bc resistance low
Describe shear stress and shear rate and its relationship to viscosity. How do they relate to each other (Provide equations for viscosity and shear rate)
shear stress= resistance to movement between laminae (pressure)
shear rate= relative velocities between laminae (velocity of blood flow)
viscosity= shear stress/shear rate (pressure/velocity of fluid thru system)
shear rate (V)= shear stress (P)/viscosity
Describe the parabolic profile of velocity.
If viscosity is very low how will that affect the parabolic profile?
In a blood vessel the shearing laminae of blood are concentric cylinders that move with different velocities. The inner most cylinder moves with the highest velocity, while the outermost cylinder moves at the slowest velocity. As a result, the velocity profile is a parabola with the maximum velocity at the central axis.
The lower the viscosity, the sharper the parabolic profile.
if blood flow moving faster bc of viscosity, would stick out every further bc internal axial flow even faster compared to flow against wall. lower viscosity means lower internal frictional resistance so velocity of flow faster
Describe the layers of laminar flow in a blood vessel.
velocity of blood flow not uniform throughout cross sectional area of tube. faster is axial flow (right in middle) layer 5. slowest is against the wall of vessel (Layer 0,1)… fluid right up against wall is at 0 velocity not moving at all. v thin. as you go more and more axially further from that resistance at wall, fluid flow increases and creates parabolic profile. this is referred to as laminar flow. in terms of viscosity - each diff concentric layers flowing across e/o bc flowing at diff velocities.
What would happen if all the layers went at the same velocity?
What if shear rate goes up? What causes it?
if same velocity there’d be no viscosity bc no frictional resistance except at wall. internal frictional resistance is diff concentric layers flowing across e/o.
look at eq. if shear rate goes up, no sig. change in pressure causing it then thats a decrease in viscosity. if shear rate goes up, velocity of flow increases but not bc of increase in pressure, shear stress constant then fraction goes down and thats decrease in viscosity. if shear rate goes down and pressure didnt change then viscosity has gone up.
What are the units of viscosity?
poise (dyne sec/cm2)
Describe Newtonian vs non-Newtonian fluids.
a) Newtonian fluid - a fluid whose viscosity remains constant over a range of shear rates and shear stress. Homogeneous fluid. Ex. water or plasma.
(if increase velocity of fluid flow, pressure goes up same as shear stress. shear rate goes up together. so fraction stays same. no change in viscosity if increase velocity of water flow. homogenous fluid. therefore viscosity doesn’t change as flow rate changes)
b) non-Newtonian fluid - a fluid whose viscosity changes over a range of shear rates and shear stress. Non-homogenous fluid
Ex. whole blood (RBC, WBC, proteins).
(has components in it, main component in blood that makes it non-homogenous with plasma is RBC, proteins. as result they interact w each other and don’t behave as newtonian fluid. as shear rate goes up, as velocity goes up, viscosity comes down by inherent interactions or lack of interactions between these molecules. bc of interactions of RBC proteins and WBC, as shear rate goes up (velocity of blood flow increases) viscosity comes down …blood flow slows down, more chances to interact w each other and viscosity goes up.)
As velocity of blood flow increases, viscosity decreases due to less interactions between components.
Discuss the effect of hematocrit on viscosity.
Draw graph.
What would low or high hematocrit mean? Clinical ex.
Slide 6.
Relative viscosity increases progressively as hematocrit increases. as hematocrit increases viscosity increases…not linear relationship. has dramatic effect at higher hematocrit. so can change viscosity of blood by changing number of RBC. interaction w diff components.
This effect can be significant.
a) anemia - low hematocrit - relatively low viscosity
b) polycythemia - high hematocrit - relatively high viscosity.
Increased erythropoietin (high altitude). Multiple myeloma.
normal range-35-50%
What is the normal range of hematocrit?
35-50%
What is blood doping?
take out couple units of blood, store, then go out and exercise at high altitude (increase RBC by acclimating to high altitude)… 2-3 months. takes months for RBC to regenerate… get normal content right. then right before compete put blood back into system and now you have a lot more RBC than before. increases O carrying capacity. more O to tissues. improves performance. increases viscosity… more difficult for heart to pump fluid around system… strong athlete the extra resistance wont make much diff. but if older person it could
Why might you hear the blood flow of someone with anemia?
low viscosity, velocity of blood flow changes in body and hear it as murmurs.
What is axial streaming? What are the implications for this?
tendency of RBC to accumulate in axial laminae at high shear rates
tendency of RBC to accumulate in axial lamina. what happens is blood vessel…laminar blood flow and parabolic function, center axial lamina fastest, as go into smaller vessels (less than 200 microns), RBC line up in the middle…thats axial streaming. RBC more confined to fastest lamina and now have situation where most periphery of vessel is plasma-rep. much lower internal resistance. this mechanism offsets what we just talked about- as blood flow slows, viscosity should go up. but because small diameter reduces viscosity, the net effect is that viscosity ins decreasing as gets into smaller and smaller vessels-easier for heart to push blood through smaller vessels.
Describe viscosity and velocity as blood travels through arterial system to capillaries to veins.
As blood travels down arterial system, reduce pressure on system and reduce velocity of blood flow in system. Blood slower and slower as goes to capillaries, means viscosity of blood going up. but as blood flows into smaller tubes, rel. viscosity comes down due to axial streaming.
normal decrease in blood flow, or decrease in blood velocity which would raise viscosity is offset by decrease in diameter of these vessels. and net effect is decrease in viscosity in peripheral vessels.
What is plasma skimming?
Draw graph
tendency of smaller vessels to contain relatively more plasma and less red blood cells due to axial streaming.
(As blood flow slows down from larger to smaller vessels, the viscosity should increase, but it doesn’t in small vessels (200 microns or less), because of axial streaming)
if small vessel branching into even smaller vessel- bc of axial streaming (RBC confided to axial lamina) less RBC go into smaller vessels and its more plasma… as tube diameter goes down, hematocrit goes down bc more plasma goes into smaller vessels
Slide 8.