Lecture 8: Haemodynamics II Flashcards

1. Describe the structure, function & properties of arterioles 2. Discuss how the radius of arterioles is regulated. 3. Describe the structure, function & properties of veins. 4. Discuss the factors that influence venous return

1
Q

Describe the overall function of arterioles

A

 Part of microcirculation
- connect arteries to capillaries

 Major resistance vessels

  • greatest resistance to blood flow
  • largest pressure drop in vasculature ->93 mmHg to 37 mmHg
  • radius is small enough to create large enough resistance to flow
  • contribute 60% of TPR
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2
Q

List the properties of arterioles

A

Main differences from arteries:

  • Smaller radius
  • Thinner walls
  • Less elastic -> no expanding + recoiling- only in aorta
  • Rich supply of sympathetic nerve fibres
  • Thick layer of smooth muscle around vessels
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3
Q

State the functional significance of changing the radius of arterioles

A
  • Functional significance of changing the radius of arterioles -> blood flow to different regions of the body may be independently regulated
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4
Q

Describe the use of sympathetic nerve fibres in arterioles

A

-regulation of radius-via contraction of smooth muscle ->regulation of resistance ->regulation of BF

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5
Q

Explain the functional significance of arterioles

A

 Pressure differential- move blood towards organs
-> Primary resistance vessels- establish pressure differential moving the blood towards the organs
->convert the pulsatile systolic-to-diastolic pressure swings in arteries into nonfluctuating pressure present in capillaries.
 Control cardiac output distribution
 Regulate arterial blood pressure

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6
Q

Describe the relationship between vascular tone and vasodilatory capacity

A
  • Arterioles always exhibit tone
  • Basal vascular tone = some degree of smooth muscle contraction
  • > gives indication of vasodilatory capacity
  • High vascular tone = large vasodilatory capacity
  • Low vascular tone = low vasodilatory capacity
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7
Q

Explain the causes of basal vascular tone

A

 Tonic smooth muscle of arterioles produces myogenic partial contractions
->has sufficient surface-membrane voltage-gated Ca2+ channels open even at resting membrane potential -> trigger partial contraction
-> myogenic activity independent of neural or hormonal influence -> self-induced contractile activity
 Sympathetic fibres supplying most arterioles continually release norepinephrine -> further enhances vascular tone

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8
Q

Describe the variation of vascular tone in different organs of the body

A
  • Brain-> has low basal vascular tone + low vasodilatory capacity (constant+ same BF)
  • Basal vascular tone differs among organs
  • Organs that have large vasodilatory capacity ->e.g., myocardium, skeletal muscle, skin, gastrointestinal circulation= have high vascular tone
  • Organs have relatively low vasodilatory capacity ->e.g., cerebral and renal circulations= have low vascular tone
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9
Q

State how vascular tone can be controlled intrinsic and extrinsic mechanisms

A
  • Vascular tone controlled by: –intrinsic mechanism
  • > controls blood flow to local area/organ/individual capillary beds
  • extrinsic mechanisms
  • > controls systemic vascular resistance
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10
Q

State what type of control for radius is chemical factors and explain how it does so

A

 Local metabolic changes->Match blood flow to momentary metabolic needs

  • Decrease in O2=
  • increase in CO2 =Generated as byproduct with more oxidative phosphorylation
  • increase in acid=more carbonic acid generated from increased CO2, + lactic acid (lactate) accumulates when glycolysis pathway used for ATP production
  • increase in K+= repeated AP that outpace the Na+ K+ pump ability to restore resting membrane potential ->more K+ in interstitial fluid
  • Increase in osmlarity= concentration of osmotically active solutes – >increases during elevated cellular metabolism
  • increase adenosine release= concentration of osmotically active solutes – >increases during elevated cellular metabolism
  • Active hyperemia= active increase in blood flow

 Endothelial-derived vasoactive paracrines
- do not act directly on smooth muscle
- endothelial cells release chemical mediators
- act on arteriolar endothelial cells
- respond to changes in cell environment
->reduction in O2
->physical changes: increase in frictional force of blood as it flows over surface of vessel lining
• nitric oxide = NO = small, highly reactive short-lived gas molecule
- numerous functions of NO as signalling molecule in physiological and pathological processes.
- Vasodilation-> increases conc. of intracellular 2nd messenger cyclic GMP in smooth muscle
-> activation of enzyme that reduces phosphorylation of myosin (necessary for cross bridge cycline)
=causing smooth muscle relaxation
- Released in response to local metabolic changes-> to further enhance vasodilation in area
- Plays role in regulating mean arterial pressure

• Endothelin

  • Released from endothelial cells
  • Potent vasoconstrictor

 Histamine induces vasodilation

  • Important in certain pathological conditions
  • synthesized & stored in mast cells in many tissues & circulating WBCs
  • When tissues are injured/damaged histamine is released
  • Promotes arteriolar smooth muscle relaxation
  • Increased blood flow, redness, swelling –> signs of inflammatory response
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11
Q

State what type of control for radius is physical factors and explain how it does so

A
  • Myogenic response
  • Shear stress
  • Heat

 Myogenic response ( inherent property of smooth muscle)

  •  blood flow >  blood pressure >  stretch
  • mechanically gated cation channels open
  • small depolarisation
  • opens surface-membrane voltage-gated Ca2+ channels
  •  cytosylic Ca2+
  • contraction of smooth muscle
  • Vasoconstriction >  radius >  resistance >
  •  blood flow
  • Important for regulation of hypertension
  • Myogenic response works simultaneously with local chemical mechanisms ->return blood flow to normal within minutes
  • Skeletal muscle doesn’t have myogenic response
  • Myogenic response important in:
  • brain
  • kidney
  • heart
    = Purpose = keep blood flow constant = autoregulation -> no hormonal/ neural control
     Shear stress
  • Release of NO -> response to increased shear stress of blood flow
  • Endothelial cells shed due to friction
	Temperature 
Heat:
-	↑ blood flow
-	useful therapeutic agent
->remove waste+ increase travel of hormones + circulation 
  • Cold
  • ↓ blood flow
  • useful therapeutic agent
  • > reduce swelling
  • counteracts histamine-induced vasodilation
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12
Q

Derive MAP=CO x TPR

A
F=deltaP/R
F=CO
delta pressure= MAP
R=TPR
CO=MAP/TPR
MAP=CO/TPR
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13
Q

Explain how neural controls can be used to affect TPR

A

 Sympathetic system

  • Controlled by cardiovascular control centre in brain stem
  • Innervation of smooth muscle of arterioles
  •  sympathetic activity
  • > vasoconstriction of systemic arterioles
  • >  TPR
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14
Q

Explain how TPR for brain is controlled using neural control

A
  • Except brain-> BP remains constant
  • Cerebral vessels controlled by local mechanisms ->maintains constant bf
    =support constant level of brain metabolic activity
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15
Q

Explain how blood can be redistributed to vital organs

A
  • Joint activity of systemic and local controls-> allow redistribution of blood
  • To increase BF to vital organs-> local metabolic factors released to cause vasodilation of arterioles of those organs
    = increase CO to vital organs + increase TPR+ MAP
  • Exercise
  • NA + adrenaline= chemical mediators
    ->Noradrenaline (NA), (neurotransmitter +hormone), released from sympathetic nerve endings (NT) & adrenal medulla (hormone)
    ->NA binds with α adrenergic receptors on arteriolar smooth muscle
    = general vasoconstriction in all systems through Phosphatidyl inositol triphosphate signaling system
  • Noradrenaline is the primary extrinsic factor affecting TPR and MAP
  • Adrenaline is a hormone produced by the adrenal glands
    + acts as a neurotransmitter for nerve cells
  • Adrenaline weakly binds the α adrenergic receptor
    + strongly binds β adrenergic receptors in the arteriolar smooth muscle in the heart and skeletal muscles
    = local vasodilation
    = the local effect of adrenaline in heart and skeletal muscle overrides the systemic effect of noradrenaline (and to a smaller extent adrenaline)
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16
Q

Explain how hormonal controls can be used to affect TPR

A
  • When NA + adrenaline released from adrenal medulla= hormone
  • When from synapse= NT
  • Adrenaline release only as hormone for local arteriole control
  • Vasopressin (vasoconstriction)
  • > Posterior pituitary gland
  • > Maintain water balance via kidney water retention
  • Angiotensin II (vasoconstriction)
  • > Renin-angiotensin-aldosterone system (RAAS)
  • > Regulation of body salt and water balance in kidneys
  • Both promote systemic vasoconstriction of blood vessels= important for haemorrhage when need to maintain BP
17
Q

List the properties of veins

A
  • Large radius =less loss due to friction
    = little resistance to BF-> lower pressure gradient required for BF
  • Small amount of smooth muscle
  • Thin walls -> high compliance
  • Blood reservoir – capacitance vessels
    -> 60% of total blood volume (TBV) in systemic veins at rest
  • Has valves
  • Venous flow is dependent on the pressure gradient between veins & right atrium
18
Q

Explain the function of valves

A
  • prevent backflow
  • temporarily supports column of blood
  • unidirectional BF -> towards heart only
19
Q

Define venous return

A
  • Venous return = volume of blood/min entering atrium from veins
20
Q

Describe how venous return affects BF to organs

A

-decrease VR > decrease end- diastolic volume > decrease SV > decrease CO > decrease BF to organs

21
Q

List the factors that affect venous return

A
  • blood volume
  • respiratory pump
  • skeletal muscle pump
  • sympathetic vasoconstriction activity
  • pressure imparted to blood by cardiac contraction
  • cardiac suction effect
  • venous valves
22
Q

Explain these factors affect venous return

A

Factor= Cardiac suction effect
- Pressure gradient between central veins (high) & atria (low) drive blood back to heart
 venous pressure ->  driving force for venous return
= CVP influences venous return
- CVP increased with heart failure/congestive heart failure, heart congested/overfilled
->overfilled/congested heart because: ventricular muscle not contracting forcefully enough
= can’t eject all blood
= reduced CO

Factor=sympathetic vasoconstrictor activity:
- Venomotor tone: Smooth muscle in walls of veins innervated by sympathetic NS (a adrenergic receptors)
- Norepinephrine stimulates contraction of smooth muscle =venous constriction
->Increases central venous pressure
->Decreases venous compliance
=Increases venous return
Factor= Skeletal muscle pump
- Many of the large peripheral veins lie between skeletal muscles
Skeletal muscle contracts ->compression of the veins:
 venous capacity
 venous pressure
= Essentially squeezing fluid in veins towards heart

-	Exercise:
muscle activity 	
 blood pushed out of veins 
 blood to heart
= Increase in venous return 

Factor=Respiratory pump
- Inspiration
 Pressure in thoracic cavity
- Pressure in chest cavity ~ 5 mmHg less than atmospheric P -> pressure gradient between atmosphere + thoracic cavity
- Blood from lower regions of body at higher pressure
Because lower region blood-> has external pressure of atmospheric
= pressure gradient exists between lower veins & chest veins
- Blood squeezed from lower veins  chest veins
 CVP
=  venous return