Circulation Flashcards
What is % CO through the liver
27%
What is % CO through the kidney
22%
What is % CO through the muscle
15%
What is % CO through the brain
14%
What is % CO through the skin
6%
What is % CO through the bone
5%
What is % CO through the heart
4%
What is % CO through the rest of the system
3.5%
What is % CO through the bronchi
2%
What is % CO through the thyroid
1%
What is % CO through the adrenal
0.5%
Describe the arteries
Low resistance
Elastic
Cushion systole
Maintain blood flow to organs during diastole
Describe arterioles
Principal site of resistance to vascular flow
Determined by local, neural and hormonal factors
Major role in determining arterial pressure
Major role in distributing flow to tissue/organs
What is myogenic tone
Vascular smooth muscle is never completely relaxed
Describe capillaries
Slow flow
Flow determined by
- arteriolar resistance
- no. of open pre-capillary sphincters
Describe veins
Compliant
Low resistance conduits
Capacitance vessels
Up to 70% of blood flow but only 10mmHg
Valves aid venous return against gravity
Define CO
HR x SV
Define BP (MAP)
CO x TPR (total peripheral resistance)
Define pulse pressure
Systolic - diastolic pressure
Define mean arterial pressure
Diastolic pressure + 1/3PP
What governs flow
Ohm’s law
Poiseuille’s law
Describe Frank-Starling Mechanism
SV increases as end-diastolic volume increases
Due to length-tension (L-T) relationship of muscle
Increase EDV = increase stretch = increase force of contraction
Cardiac muscle at rest is NOT at its optimal length
Increase VR = Increase EDV = Increase SV = Increase CO
Define blood pressure
Pressure of blood within and against the arteries
When is blood pressure highest
When ventricles contract - systole
100-150mmHg
When is blood pressure lowest
When ventricles relax - diastole
60-90mmHg
Not 0 due to aortic valve and aortic elasticity
Define mean arterial pressure
D + 1/3(S-D)
What artery is used to measure BP
Brachial artery
What are the components of BP control
Autoregulation
Local mediators
Humoral factors
Baroreceptors
Central (neural) control
Describe myogenic autoregulation
Stretch of vascular smooth muscle
Contraction until diameter is normalised or slightly reduced
What organs have good autoregulation
Renal
Cerebral
Coronary
What organs have moderate autoregulation
Skeletal muscle
Splanchnic
What organ has poor autoregulation
Cutaneous
Local humoral factors - what are the vasoconstrictors
Endithelin-1
Internal blood pressure (myogenic contraction)
Local humoral factors - what are vasodilators
Hypoxia
Adenosine
Bradykinin
NO
K+, CO2, H+
Tissue breakdown products
Is NO a vasodilator or vasoconstrictor
Vasodilator
Circulating hormonal factors - vasoconstrictors
Epinephrine (skin)
Angiotensin II
Vasopressin
Circulating hormonal factors - vasodilators
Epinephrine (muscle)
ANP
Describe intrinsic and extrinsic control
Intrinsic control dominates to maintain BF to vital organs
Skin - BF vasoconstrictor response to temp (extrinsic)
Skeletal muscle - Dual effects. Rest vasoconstrictor (extrinsic) tone dominant, exercise intrinsic mechanisms predominate
Local control - endothelium
Essential for control of circulation
Uses NO, prostacyclin, endothelin
Is prostacyclin a vasodilator or vasoconstrictor
Vasodilator
Is endothelin a vasodilator or vasoconstrictor
Vasoconstrictor
Describe baroreceptors
Pressure sensing
Firing rate is proportional to MAP and PP - integrated by the medulla
Increased BP = Increased firing = Increased PNS/Decreased SNS = Decreased CO/TRP = Decreased BP
Vice versa
What is the location of baroreceptors
Primary (arterial)
- carotid sinus
- aortic arch
Secondary
- veins
- myocardium
- pulmonary vessels
Afferent - glossopharyngeal
Efferent - sympathetic and Vagus
What does arterial baroreceptors play a key role in
Short term regulation of BP
- minute to minute control
- response to exercise
- haemorrhage
If arterial pressure deviates from norm for more than a few days adapt to a new baseline pressure
What is the major factor in long-term BP control
Blood volume
Describe cardiopulmonary baroreceptors
Atria, ventricles, PA
Stimulation - decrease vasoconstriction = decrease BP
Decrease in angiotensin, aldosterone and vasopressin = fluid loss
Play an important role in blood volume regulation
Describe the central neural control loop
Baroreceptors signal to brain stem
Either + or - sympathetic = + or - vasoconstrictors
Effects HR, SV, vessel diameter
BP + or -
Describe arterial baroreceptors affect on central control
Increase arterial pressure = increased baroreceptor firing
- decreased sympathetic outflow to heart, arteries and veins
- increased sympathetic outflow to heart
Describe the role of central chemoreceptors
Increase PaCO2 = vasoconstriction - increase peripheral resistance, increase BP
Decrease PaCO2 = decrease medullary tonic activity, Decrease BP
Similar changes with pH
PaO2 less effect on medulla
- decreased = vasoconstriction
- serve decrease = general depression
What is the effect of PaO2 mainly by
Peripheral chemoreceptors
What is the short term control of BP
Baroreceptors
What is the long term control of BP
Volume of blood
Na+, H20, RAAS, ADH
Describe the minute by minute feedback loop
Blood pressure
Baroreceptor discharge
Sympathetic and Parasympathetic outflow
Vasomotor tone and CO
What is the location of chemoreceptors
Peripheral
- carotid body
- aortic body
Central
- medulla oblongata
Define cushings syndrome
Clinical manifestation of pathological hypercortisolism from any cause
What circulation do both lungs have
Bronchial and pulmonary
What is the bronchial circulation
Supplied O2 and nutrients to meet metabolic needs
What are the adaptations of the pulmonary circulation
Low pressure - mean arterial pressure 5-15mmHg
Low resistance
What is the mean arterial pressure of the systemic circualtion
93mmHg
What are extrinsic controls of cardiovascular system
Neural
Hormonal
Reflex
Chemical regulatory mechanisms
What do extrinsic factors control
Regulate HR
Myocardial contractility
Vascular smooth muscle maintain CO, blood flow distribution and arterial blood pressure
What is the role of intrinsic factors of control
Vary stroke volume by affecting the myocardial contractility
Can change the sarcomere length or independent of the cell length change using other agents
Define Ohm’s Law
Pressure gradient/resistance
Define Poiseuille’s equation
Flow = radius to the power of 4
What is the cushings phenomenon
NS response to increased intracranial pressure leads to
Increased BP
Irregular breathing
Brachy cardia
What are the constituents of plasma
91.5% water
7% proteins
Describe plasma proteins
Carrier proteins e.g. albumin, globulin
Immunoglobulins
Clotting factors