Beruflich Dokumente
Kultur Dokumente
Physiology 2016
-Special circulations-
o Pulmonary Circulation
o Coronary Circulation
o Splanchnic Circulation
o Renal circulation
o Cutaneous circulation
o Skeletal muscle circulation
o Cerebral circulation
1
Characteristics of the Pulmonary Circulation
mean arterial pressure of pulmonary circulation is lower than that of systemic circulation
low pressure
viscosity length
8 l
Remember that resistance toR = r4
Flow = (Input pressure - Output pressure)/ R radius
2
Pulmonary blood vessels are much more compliant than systemic
blood vessels. Also the system has a remarkable ability to promote
a decrease in resistance as the blood pressure rises.
Recruitment: opening up closed capillaries which receive little or no blood
flow (as pressure rises) lowers the overall resistance
Distension: vasodilation
Ventilation
Alveolar ventilation, VA
VA = (VT - VD) x resp. rate
= (0.5 - 0.15) x 12 = 4.2 L/min
Perfusion
Cardiac output = C.O. = Q
Q = stroke vol. x heart rate
= (0.086) x 70 = 6.0 L/min
VA
= ventilation/perfusion ~ 0.8
Q
3
Hypoxic pulmonary vasoconstriction is a physiological phenomenon in which pulmonary arteries constrict in the
presence of hypoxia (low oxygen levels) without hypercapnia (high carbon dioxide levels), redirecting blood flow
to alveoli with a higher oxygen content.
The process might at first seem illogical, as low oxygen levels should theoretically lead to increased blood flow to
the lungs to receive increased gaseous exchange. However, it is explained by the fact that constriction leads to
redistribution of bloodflow to better-ventilated areas of the lung, which increases the total area involved in gaseous
exchange.
This improves ventilation/perfusion ratio and arterial oxygenation, but is less helpful in the case of long-term
whole-body hypoxia. This is seen in COPD, at altitude, and in heart failure.
Lets assume that there is a blockage of one
alveolar region
VA
<< 0.8 VA
~ 0.8
Q
Q
without hypercapnia
When PO2 within the alveoli decreases there is a decrease in blood
flow to that alveolus
This is called hypoxic vasoconstriction
4
CoronaryCirculation
Thecoronaryflowrateis215ml/min.(4%ofCO),andistightly
coupledtooxygendemand.Thisisnecessarybecausethehearthas
averyhighbasaloxygenconsumption.Underrestingconditions,
coronarybloodflowremainsconstantbetweenmeanarterial
pressuresof60140mmHg.
Flowiscontrolledalmostentirelybylocalmetabolicfactors
(Hypoxia&adenosine).
Exhibitsautoregulation: local control of coronary blood flow
o ac vehyperemia:myocardialcontrac lityOdemand
compensatoryvasodila on=owandO
o reactivehyperemia:mechanicalcompressionduringsystolewill
produceocclusionreac vehyperemiabloodowandO2
deliveryandtorepaytheO2debtthatwasincurredduringthe
compression.
CoronaryCirculation
Roleofautonomicnervoussystemoncoronarybloodflow
isdirectandindirect.
Indirecteffects>Directeffects
Direct:SympatheticNervousSysteminduces
Vasoconstrictionorvasodilatation.Thus Coronary
BloodFlow.
Indirect:
o SympatheticNervousSysteminduces HeartRate&
Contractility.Thus Oxygenconsumption& adenosine
andcausesVasodilatation.
o ParasympatheticNervoussystemdecreaseshartRateand
thus Oxygenconsumption& adenosineandcauses
Vasoconstriction.
5
SplanchnicCirculation
internal organs
Referstothebloodcirculationtothegut,spleen,pancreas
andliver.Specialdesign:Aportalveinthroughwhichthe
bloodfromthegut,spleenandpancreasgoestotheliver.
o Hormonalcontrol:Cholecystokinin,vasoactiveintestinal
peptide,gastrinandsecretinarepeptidehormones,which
regulatethemotorandsecretoryactivitiesoftheGItract.
Thesehormonesinducevasodilatationinthesplanchnic
circulation.
oMetabolitecontrol:LowO2andadenosineinduced
Vasodilatation.
oNeuralcontrol:sympatheticstimulationofalpha1
adrenoceptorsinducesvasoconstriction(importantin
haemorrhage)
Renalcirculation
o Thiscirculationistightlyautoregulatedsothatflowremains
constantevenwhenrenalperfusionpressurechanges.
o Renalautoregulationisindependentofsympatheticinnervation,
anditisretainedevenwhenthekidneyisdenervated(e.g.,ina
transplantedkidney).
o Autoregulationofrenalbloodflowwithinthearterialpressure
rangeof75 160mmHg.
o Autoregulationispresumedtooccurfromacombinationofthe
myogenicpropertiesandtubuloglomerularfeedback(renin
angiotensinconstrictionoftheafferentarteriolesinresponsetoan
increaseinsodiumchlorideconcentrationintheearlydistaltubule).
6
Cutaneouscirculation
Primaryfunction:Constantbodytemperature.Minorfunction:Oxygen
andnutrientsupplyduetorelativelysmallrequirement.
o Sympatheticinnervation:hasatonicinfluence(alphareceptors)to
alterbloodflowtotheskinforregulationofbodytemperature
(duringexercise,sympathetics areinhibitedresultinginvasodilation ,
thusheatdissipation). intense ex. > opp.
o Localvasodilatormetaboliteshavelittleeffectoncutaneous blood
flow.
o Localproductionofbradykinin insweatglandsandnoncholinergic&
nonadrenergic neuroninducevasodilatation.
o Vasoactive substancessuchashistamine(producedfollowingskin
trauma)induceatripleresponse:aredline,aredflare,andawheal
Thewhealislocaledemaandresultsfromhistaminicactionsthat
vasodilate arteriolesandvasoconstrict veins.Together,thesetwo
effectsproduceincreasedcapillarypressure,increasedfiltration,and
localedema.
Cerebralcirculation
ControlledalmostentirelybylocalmetabolitesCO2(orH+).
Vasodila onofthecerebralarteriolesbloodowtoassistin
removaloftheexcessCO2. constant blood flow
Exhibitsautoregulationandactiveandreactivehyperemia
1.Flowcontrolledbymetabolites
2.Vasodilationoccursinresponseto
increasedCO2 inarterialblood
7
L6
SKELETALMUSCLECIRCULATION
Skeletalmusclecirculationiscontrolledbothbylocal
metabolites&sympatheticinnervation.
Regulationisdifferentatrestandduringactivity.
Regulationofbloodflowatrest
Atrest,bloodflowisregulatedprimarilybyitssympathetic
innervation (1&2receptors).
8
Regulationofbloodflowduringexercise
DuringExercise,demandforO2inskeletalmusclevaries
withtheactivitylevel,and,accordingly,bloodflowis
increasedordecreasedtodeliversufficientO2tomeet
demand.Bloodflowiscontroledprimarilybylocal
metabolites.
Eachofthephenomenaoflocalcontrolisexhibited:
o autoregulation.
o activeandreactivehyperemia.
o Localvasodilatorsubstances(Lactate,adenosine,
andK+).
o Mechanicalcompressionofthebloodvesselsin
skeletalmusclebriefperiodsofocclusionreac ve
hyperemiawilloccur,whichincreasesbloodflowandO2
deliverytorepaytheO2debt.
The End