Download عرض تقديمي من PowerPoint

Vascular Physiology
Arterial
Venous
Physiology
Systemic
Regulation
Tissue
Capillary
Pulmonary
Overview
Arteries
Structure
Perfusion
System
System
of
Blood
Dynamics
ofPelvis
Head
the
Upper
of
Circulation
Blood
Systemic
Circulation
Blood
Abdomen
thorax
Pressure
and
and
Limb
Vessels
Pressure
Neck
Leg
Circulation
wall
and
Walls
Thorax
Three
layers:Tunica
intera:Inner
most
layer, endoRenal
regulation
of
blood
pressure
1.
R.
Abd.
Blood
subclavian
aorta
flow-volume
gives
changes
Suprarenal
per
to
axillary
unit
arteries:
time
artery
(ml/min)
Adrenal
gl.s,
Gases
&
nutrients
diffuse
from
capillary
to
interArterial
Blood
flow
blood
is
velocity
through
precisely
pressure:
individual
distributed
organs
to
body
is
intrinsicaltissue:
Venous
4.
Osmotic
Baroreceptors:
return:
pressure:
Venous
Net
movement
pressure
is
of
too
water
low
for
from
an
Aorta
Common
and
iliac
Major
divides
Arteries
into
of
two
Systemic
branches
Circulation
thelium
(simple
squamous)
&
some
larger
vessels
a.
Thoracic
Adrenal
aorta
medulla
(above
hormones
the
diaphragm)
Long-term
mechanisms
for
BP
regulation
Classification
2.
d.
e.
Net
R.
1.
Venodilation
Endothelium-derived
Angiotensin
Muscular
Internal
common
filtration
thoracic
carotid
arteries-distributing
pressure
based
II:
shifts
Mediated
artery:
artery
on
Bd
(NFP):
size
factors:
to
off
venous
(off
and
by
subclavian
Reflects
release
R
function
Endothelin
arteries:
brachiocephalic)
reservoirs:
of
interaction
renin
artery
Distal
(VC),
by
to
1.Thoracoacromial:
Superior
Blood
pressure-force
mesenteric
Superior
artery
per
(gives
unit
shoulder&pectoral
area
br.s
(mm
that
Hg)
supply
region
5.
Hydrostatic
Abdominal
Chemoreceptors
artery
pressure
lies
(HP):
below
Force
level
exerted
of
the
diaphragm
by
fluid
stitial
fluid:
Water-soluble
solutes
pass
through
Pulmonary
Direct
action
trunk,
of
the
rt.
and
kidney
lt.
pulmonary
arteries,
1.
ly
At
Factors
Inversely
controlled
rest
affecting
proportionate
(i.e.,
autoregulation):
arterial
to
pr.:
cross-sectional
Stretching
Diameter
of
area
of
of
Types
Sequence
Capillary
R.
a.
b.
Common
Splenic:
Internal
of
capillary
of
beds
blood
carotid:
hepatic:
Bd
movement
pressure
Gives
through
branches
capillary
to
stomach,
bed
adequate
area
Detect
of
low
changes
return,
to
high
need
in
solute
art.
functional
BP:
conc.
Pr.
which
sensitive
modifications:
is
relatively
mechanoCapacitance
Circle
of
vessels
Willis
vessels
Aortic
1.
Internal
arch
iliac:
Pelvis
&
visceral
organs
(bladder,
Factors
a.
R.
Regulation
Brachiocephalic
that
enhance
of
blood
artery
CO
vessel
branches
diameter
off
aortic
arch
have
subendothelium
(loose
CT
&
BM),
Tunica
i.
Parietal
NE
and
branches
EPI
(nicotine
is
a
monoamine
agonist)
Background
BP
Neural
=
CO
control
X
PR
of
blood
pressure
2.
Kidney
controls
Bd
vol.
by
regulating
water
loss
1.
elastic
Venous
JGA
prostaglandin-derived
between
R.
a.
Anterior
Elastic
external
of
arteries,
kidney
return
hydrostatic
(conducting)
intercostal
&
internal
decreases
tubule.
deliver
&
When
art.s:
carotid
growth
arteries:
Bd
osmotic
&
to
CO
Bd
specific
arteries
factor“PDGF”
pressures
declines
Thick-walled,
amount
organs,
entering
thick
(VC)
near
Chemical
Femoral
artery
control
becomes
of
blood
popliteal
pressure
artery:
Knee
3.
mesenteric
Resistance-opposition
Lateral
thoracic:
organs
(Intestinal:
Lateral
to
flow;
chest
Large
generally
wall
intestine,
&
breast
encounagainst
Respond
Inferior
vessel
phrenic
to
wall.
changes
arteries:
In
capillary
in
O2
Diaphragm
and
bed
CO2
HP
is
the
same
c.
Antidiuretic
hormone
(ADH)
clefts
&
fenestrations
while
lipid-soluble
diffuse
a.
lobar
Alters
arteries
rate
of
(3
fluid
in
rt
filtration
lung
&
2
from
in
lt),
Bd
arterioles,
stream
to
3.
Changes
associated
with
dias.:
Semilunar
valve
arteries
bv
arterioles
Brain:
to
be
near
filled:
13%
feeding
Ht
It
(compliance
is
a
fastest
given
organ
in
vessels
&
distensibility)
is
controlled
with
smallest
by
&
it
1.
small
Terminal
Continuous:
40
Sends
Capillaries
Enters
mm
intestine
branches
the
Hg
arteriole
skull
entering
act
&
Uninterrupted
as
pancreas
to
and
networks-capillary
stomach
services
(after
and
endothelial
the
giving
pancreas
brain
beds
off
cells,
gastroa.
receptors
high
Respiratory
in
capillary
when
pump
BP
Bd
rises,
(high
(abdominal
receptors
concentration
pr.
are
squeeze
stretched
of
plasma
local
Veins
Venules:
R.
and
act
L.
8
as
posterior
100
reservoirs:
µm,
communicating
properties
Large
lumens
vary
arteries
with
&
low
size
BP
Factors
influences
blood
pressure
rectum,
Coronary
uterus&vagina(prostate&
arteries
ductus
deferens)
b.
1.
Reduce
Vasomotor
subclavian
parasym.
fibers
artery
(sym.
control
Efferents,
(HR
increases)
innervate
sm
media:
Middle
layer,
circularly
arranged
smooth
2.
ii.
Visceral
NE
is
a
branches
vasoconstrictor
Short-term
Heart
Cardiac
pumping
output
mechanisms
is
generates
directly
blood
related
flow
to
Bd
vol.
3.
Blood
volume
affects
CO
via:
a.
Venous
pressure
heart,
media
f.
,kidney
At
From
nitrous
Baroreceptors
Costocervical
arterial
external
largest
layer
tubule
oxide
end:
(more
diameter,
is
“NO”
carotid
NFP
too
trunk
also
smooth
low;
=
(fast
send
artery:
gives
(HPc
more
renin
acting
efferent
muscle)
rise
elastic,
Hpif)
releases
to
local
signals
&
the
large
0.3
(OPc
VD)
first
&
catalyzes
to
1.0
lumen
two
card.
OPif)
cm
1.
region
&
divides:
tered
Ileocolic:
Subscapular:
in
the
Appendix,
systemic
Scapula,
circuit
colon
latissimus
&
(peripheral
R.
&
dorsi
middle
&
resistance:
thorax
colic:
wall
concentrations
as
2.
Celiac
capillary
trunk:
BP
and
that
Three
pH
forces
branches
fluid
through
capillary
i.
Posterior
pituitary
hormone
through
PM
of
capillary
epithelial
cells
kidney
capillaries,
tubules
venules,
(High
pulmonary
BP
increases
veins
filtrate
(2
per
entering
lung),
closes,
aorta
recoils
&
Pr.
is
maintained
by
vol.
cross-sectional
Intrinsic
Heart
Bd
forced
4%
control
into
area
mechanisms
arteries
“aorta
has
near
a
Ht
cross-sectional
incomplete
2.
duodenal
b.
20
Microcirculation:
Metateriole:
Opthalmic:
Splenic
mm
Hg
artery,
terminates
tight
exiting
eyes,
True
junctions
common
orbits,
Arteriole
capillaries
in
the
hepatic
(intercellular
forehead
spleen
to
branch
venule
becomes
&
nose
off
clefts)
(Prehepatic
veins,
proteins).
Located
backflow
Capillary
in
carotid
is
prevented
colloid
sinuses,
osmotic
by
aortic
valves,
pr.
arch
(OPc)
Bd
&
is
walls
forced
=
26
of
(little
allows
connect
muscle
walls
posterior
to
&
thin
thin
cerebral
externa)
arteries
with
R.
and
L.
1.
Cardiac
output
2.
&
Brachiocephalic:
br.s
to
gluteal
muscles
a.
R.
&
common
external
carotid
genitalia
(i.
R.
of
Increase
R.
blood
vertebral
v.‘primarily
sym.
artery
Activity:
arterioles’&
Increases
release
contractility
NE:
VC)
of
muscle,
chemical
&
nervous
control
of
deg.
of
contAbdominal
iii.
EPI
increase
aorta
CO
(below
by
increasing
diaphragm)
2.
Nervous
Pr.
BP
results
is
directly
control
when
related
flow
of
peripheral
to
opposed
CO,
BV
by
resistance
and
resistance
PR
b.
Venous
return,
c.Hg
EDV
&
d.(35
Stroke
volume
(dampen
3.
centers
the
f.
=
1.
posterior
35
Inflammatory
Arterioles:
Superior
conversion
25
in
=
BP
intercostals
medulla:
10
thyroid:Supplies
changes
Determine
mm
of
chemicals
angiotensinogen
Inhibit
associated
arteries
flow
(VD):
sym.
thyroid
into
with
NS,
Histamine,
capillary
to
Ht
stimulate
&
angiotensin
contraction
larynx
beds,
etc.
II
Levels
Post.
tibial
of
O2
artery
and
CO2
which
gives
peroneal
artery:
PR):
4.
Transverse
Ant.
Sources
&
post.
colon),
circumflex
of
resistance
Paired
arteries:
renal
(Bd
Deltoid&shoulder
viscosity
arteries:Kidneys
“thickness
joint
on
b.
wall:
a.
Common
Located
Greater
in
hepatic
carotid
at
arterial
and
end
aortic
arch
mm
Hg)
and
&
carotid
lower
ii.
Increases
BP
by
increasing
water
reabsorption
Forces
responsible
for
direction
&
amount
of
fluid
tubules
which
drain
greater
into
than
left
can
atrium
be
processed,
fluid
leaves
reducing
volume
(DP:
70
80
mm
Hg)
2.
c.
area
1.
Kidney:
Changes
Metabolic
(2.5
cm2)
20%
associated
controls:
&
an
average
with
Levels
sys.:
velocity
of
nutrients,
Aorta
of
is
40-50
stretched
particulcm/s,
capillary
Venous
3.
artery
Lt
Fenestrated:
Parts
R.
gastroepiploic
internal
which
blood
of
sphincter
abranches
capillary
branches
carotid
pressure
Endothelial
controls
branches:
divides
bed:
off
topr.
cells
Bd
R
to
Supplies
gastroepiploic:
flow
form
have
into
oval
stomach
capillary
pores
toward
all
mm
large
Hg.
the
Interstitial
vessels
Ht,
chest
osmotic
cavity
pressure
Decreases,
(OPif)
thoracic
=
0.1
anterior
Venous
Veins:
cerebral
Formed
valves:
from
Prevent
arteries
venules,
backflow
thinner
(folds
walls
of
and
2.
Peripheral
resistance
internal
External
carotid
iliac:
&
Enters
ii.
R.
external
thigh
becomes
carotid)
femoral
&
b.
R.
art.
Ht
c.
3.
Vasomotor
Basilar
(reduces
artery
ESV
tone
(R+L
&
(tonic
increases
vertebrals)
vasoconstriction)
SV)
&
releases
Epi
raction
(sym.
NS)
&
change
in
dia.
(VC
&
VD),
b.
1.
Atrial
Parietal
natriuretic
peptide
(ANP)
CO
a.
Alter
Bd
=
flows
Stroke
blood
along
volume
distribution
a
pr.
X
gradient
HR
from
higher
to
BP
change
parallels
change
in
Bd
vol.:
a.
High
,4.
mostly
parasym.
which
(increase
At
2.
3.
passive
The
Lingual:
Venous
II
thoracic
smooth
accommodation
causes
capillary
NS
end:
Supplies
to
muscle
aorta
NFP
VC
decrease
permeability)
of
tongue
=
gives
systemic
&
(HPc
10
HR
results
rise
µm
&
Hpif)
to
arterioles
contractile
in
0.3
the
smooth
cm
next
(OPc
&
nine
flow
force
OPif)
of
Lateral
Blood-borne
muscles
chemicals
of
leg
related
Enters
each
side
arm,
to
of
formed
body,
axillary
elements”,
Gonadal
changes
arteries:
total
to
brachial
bv
(Testicular
length
artery
‘longer
or
sinus
at
b.
Splenic
venous
end
(17
mmHg).
HPc
is
opposed
by
interiii.
At
high
conc.,
causes
vasoconstriction
crossing
capillary
walls:
Hydrostatic
&
osmotic
body
as
urine,
Bd
vol.
decreases
&
therefore
BP
4.
Pulse
pressure
(PP):
SP
minus
DP
by
d.
capillaries
arly
Abdominal
Bd
oxygen,
leaving
have
act
organs:
lt
a
ven.
as
total
autoregulation
(kinetic
24%
cross-sectional
energy)
stimuli
area
Bd
of
moves
4500
(fenestrations)
3.
1.
a.
Supplies
c.
L.
Thoroughfare
Vascular
Relatively
R.
gastric
ant.
stomach),
cerebral
shunt:
artery:
steady
to
channel:
permit
artery:
Connects
then
throughout
Stomach
hepatic
greater
Capillaries
Medial
arteriole
&
inferior
cardiac
splits
permeability
surface
rejoin
with
into
cycle
esophagus
of
right
venule
brain
&
5veins
mm
Stretching
expand
Hg.
Net
increase
&
osmotic
Bd
enters
signal
pressure
rt
to
atrium
vasomotor
≈
25
mm
Hg
center:
less
interna)
2.
Anterior
muscle
communicating
than
arteries,
little
artery
muscle
connects
in
media
R.
and
3.
Blood
volume
subclavian
a.
Deep
femoral
(i.
R.
artery:
vertebral
Posterior
&
ii.
R.
thigh
axillary)
into
4.
R.
Bd
and
stream
L.
posterior
from
adrenal
cerebral
med.
arteries:
(increases
Supply
HR)
Tunica
externa:
Made
of&
collagen
fibers,
function
2.
i.
Visceral
Atrial
peptide
branches
hormone
lower
b.
Alter
pr.
blood
(highest
vessel
in
aorta
diameter
&
lowest
in
rt
atrium)
vol.
increases
BP
(kidney
responds
by
eliminating
blood
4.
increases
g.
=
3.
pairs:
17
Alcohol:
Respond
Capillaries:
Facial:
‘1.0
25
Posterior
=
BP.
Supplies
-8
Reduces
to
2.5
Angiotensin
mm
acute
Smallest
cm’
intercostal
Hg
skin
changes
BP,
blood
inhibits
II
muscles
spaces
also
in
vessels
BP:
ADH
causes
&
of
Carotid
deep
anterior
(8
release
release
10
muscles
sinus
µm),
face
of
2.
Anterior
tibial
artery:
Extensor
muscles
vessel
1.Deep
ovarian),
greater
brachial
Inferior
resistance’
artery:
mesenteric
Triceps
&
bv
artery:
dia.
brachii
‘flow
Gives
(post.
inversely
br.s
arm)
to
stitial
c.
L.
Primarily
gastric
fluid
HP
artery
involved
(Hpif)
in
which
control
is
assumed
of
respiratory
to
be
zero
rate
Pressures
(forces
oppose)
b.
Indirect
renal
mechanisms
(renin-angiotensin
5.
Mean
arterial
pressure
(MAP)=DP+
1/3
PP
toward
cm2
2.
During
Myogenic
and
periphery
a
exercise:
very
controls:
slow
because
flow
Excessive
(0.03
peripheral
cm/s)”
or
inadequate
Pr.
is
lower
BP
3.
4.
left
Gradient
Sinusoidal:
Post-capillary
True
R.
branches:Supplies
middle
capillaries
from
cerebral
Modified,
venule
venules
artery:
liver
leaky
to
vena
Lateral
capillaries
cava
parts
(20
(large
mm
of
HG
b.
Inhibits
Muscular
vasomotor
pump
‘more
center
important’
causes
VD
(contraction
of
(mostly
L.
anterior
elastin)
cerebral
&
externa
arteriors
is
thickest
wall
layer
3.
L.
Branches
common
to
carotid:
Lateral
a.
&
L.
medial
internal
circumflex
carotid
&
b.
L.
occipital
Increase
and
activity
inferior
of
temporal
resp.
&
muscular
lobes
of
brain
pumps:
(protection,
reinforcement
&
anchor
to
surround.
ii.
R.
Reduces
BP
iliac
by
antagonizing
aldosterone
4
3.
Vasomotor
center
water
to
reduce
vol.)
&
b.
Low
vol.
decreases
BP
(,
tunica
reflex
aldosterone
(increases
4.
of
Occipital:
back,
protects
interna
vertebral
loss
from
Supplies
of
only
Bd
water
adrenal
supply
columns
&
posterior
exchange
in
to
cortex
urine)
&
brain
spinal
scalp
of
which
&
&
materials
increases
cord
aortic
increases
reflex
VD
related
2.
supply
Brachial
distal
to
dia.;
artery:
part
larger
of
Ant.
colon
dia.
flexor
less
(L.
colic,
resistance
muscles
sigmoidal
of
(1/r
arm
)’.
aa
and
(interstitial
depth
fluid
is
withdrawn
by
lymphatic
tissue).
mechanism,
aldosterone
also
cause
release
of
ADH
than
a.
can
Skin,
damage
aortic
muscles
Pr.
or
(SP:
cause
and
120
heart
death
mm
increase
of
Hg)
an
organ,
such
BP
molecules
‘60
temporal
from
aorta
and
can
parietal
pass
to
arterioles’)
through)
lobes
skeletal
d.
Arteriole
muscle
dilation
surrounding
reduces
peripheral
veins
compress
resistance
vein,
external
arteries:
carotid
Head
&
neck
of
femur
Increases
venous
return
(increases
EDV
&
SV)
tissue),accessory
tissues(nerve
fi.,
lymphatic
v., ela4.
iii.
L.
Increases
common
water
iliac
excretion
from
kidney
kidney
reabsorbs
water
to
increase
vol.)
maintains
absorption
(skin)
5.
Maxillary:
by
depressing
supply
of
Supplies
water
to
by
systemic
vasomotor
upper
kidney
&
circuit
tubules
center
lower
jaw
In
3.
sup.
Radial
humans,
rectal
artery:
aa),
dia.
Lumbar
is
Lateral
the
greatest
arteries:
muscles
source
Post.
of
forearm
of
abdominal
resistance
Net
effective
HP
is
equal
to
HPc
(=HPc
Hpif)
which
promotes
water
reabsorption
by
kidney
b.
changes
Other
stimulate
tissues
either
myogenic
remain
responses
same
or
decrease
backflow
is
prevented
by
valves
so
Bd
moves
in
4.
L.
subclavian:
a.
L.
vertebral
&
b.
L.
axillary
stic
network&
tiny
Bdv
within
layer-vasa
vasorum)
6.
Superficial
temporal:
Supplies
most
of scalp
Blood
4.
wall,
Ulnar
Median
Flow
artery:
(F)
sacral,
=
Medial
∆P/PR
R.
muscles
&
L.
common
of
forearm
iliacs
Home
Exit
direction
of
Ht
BASIM ZWAIN LECTURE NOTES
Vascular Physiology
Arteries
Veins
MajorofVeins
Abdomen
Head
Upper
Pelvis
of Pelvis
ofand
and
the
Limbs
and
Neck
Systemic
Lower
Leg
and Limbs
Thorax
Circulation
Hepatic
portal
system
Other
veins
draining
inferior
vena
cava
Azygous
system
drains
thoracic
tissues:
Post.which
interAnt. & post. tibial
vv into
joins
to form
popliteal
Sup.
Inferior
Drainage
Superficial
vena
vena
of
cava
drainage
blood
cava
pours
from
runs
of
into
upper
brain
from
R
atrium.
junction
limb
It
of
is
common
a
union
of
1.
Multiple
hepatic
vv
from
liver
to
inf.
vena
cava
Lumbar
veins:
R.
&
L.
ascending
lumbar
veins
costals,
hemiazygous
vv
becomeshemiazygous
femoral vein&toaccessory
become external
iliac joins
L
iliac
1.
&
Most
Median
R
veins
brachiocephalic
veins
to
v.
of
R.
drain
forearm
atrium.
into
veins.
It
lies
dural
receives:
between
(meningial)
ulna
&
sinuses
radius
2.
Cystic
veins
drain
gall
bladder
&
join
hepatic
vv
Gonadal
veins:
R:
ovariaries
or
testes
on
right
drain
into
azygous
v.
that
drains
to
sup.
vena
cava
Deep
veins
of
face
drain
into
inferior
jugulars
internal iliac to form common iliac
R.
1.
a.
(connects
Superior
Hepatic
brachiocephalic
veins
sagittal
either
(R.
to
vein
and
basilic
receives:
L.)
or
cephalic
vv)
Hepatic
portal
v
drains
digestive
viscera:
side
of
body
(directly
into
vena
cava),
L:
ovariaries
Deep
drainage
of upper limb
1.
Facial
Saphenous
veins
1.
b.
2.
R.
Cephalic
Straight
internal
suprarenal
vein
jugular
joins
vein
vein
with
axillary
vein
Superior
mesenteric
or
testes
on
left
side
of
body
(into
L.
renal
vein)
1.
Distal
vvMedial
of temporal
armaspects
drain into
ulnar
&
radial
vv
2. Great:
Superficial
a.
of leg,
longest
v empties
2.
c.
3.
Cavernous
R.
Renal
Basilic
vertebral
veins
vein
joins
(R.
vein
and
with
L.)
brachial
vein
Inferior
mesenteric:
Large
intestine
& rectum
&
3.
Suprarenal:
R:
right
adrenal
gland
(directly
into
2.
Ulnar
&
radial
vv
unite
to
form
brachial
vein
into femoral v
3.
d.
4.
R.
Median
Transverse
subclavian
gonadal
cubital
vein
vein
v.
connects
receives
basilic
R.
external
&
cephalic
jugular
vv
joins
splenic
vena
cava),
L:
left
adrenal
gland
(into
left
renal
3.
Brachial v. enters
shoulder
becomes
v.v)v
b.Small:Deep
fascia of
calf, empties
intoaxillary
popliteal
*Left
5.
2.
Lumbar
Most
side
Bd
corresponds
veins
from
used
brain
to
obtain
drains
to
right
blood
into
side
samples)
internal
jugulars
3.
Splenic:
Spleen,
parts
of
stomach
&
pancreas
4.(commonly
Renal
veins:
Drain
kidneys
At level of first rib, it becomes subclavian v. &
joins superior
mesenteric
Common
iliacs join
to form inferior vena cava
Exit
BASIM ZWAIN LECTURE NOTES
Home
Vascular Physiology