CIRCULATION !

VEINS
◦ Conduits for transport of blood from venules
Functions back to the heart
◦ Transport nutrients to body tissues ◦ Very low pressure; thin walls
◦ Transport waste products away ◦ Muscular, can contract or expand
◦ Conduct hormones ◦ Serve as major reservoir for extra blood
◦ Maintain appropriate environment in all the
tissue fluids
Distribution of blood in the different parts of the
◦ ! for optimal survival and function of the cell
Circulation

! “Rate of blood flow is controlled in response to

tissue need for nutrients”
! Heart & circulation are controlled to provide
necessary cardiac output and arterial pressure to
cause the needed tissue blood flow
! Systemic circulation
“greater or peripheral circulation”
! Pulmonary circulation

FUNCTIONAL PARTS OF THE CIRCULATION

! ARTERIES
◦ Transport blood under high pressure to the
tissues
◦ Strong vascular walls
◦ High velocity blood flow

! ARTERIOLES
◦ Last small branches of arterial system
◦ Control conduits through which blood is
released into capillaries Cross Sectional Areas of Vessels
◦ Strong muscle walls; can close completely or
VESSEL CROSS SECTIONAL
dilate severalfold AREA

AORTA 2.5
! CAPILLARIES
◦ Exchange fluids, nutrients, electrolytes, SMALL ARTERIES 20
hormones and other substances between blood
ARTERIOLES 40
& interstitial fluid
◦ Thin walls with numerous minute capillary CAPILLARIES 2500
pores, permeable to water and other small
molecular substances. VENULES 250
◦
SMALL VEINS 80
! VENULES
VENA CAVA 8
◦ Collect blood from capillaries
◦ Coalesce into progressively larger veins
 VELOCITY OF BLOOD FLOW INTERRELATIONSHIPS AMONG PRESSURE,
FLOW AND RESISTANCE
! Same volume of blood must flow through each
segment of the circulation each minute
! Velocity of blood flow is inversely proportional to
the vascular cross-sectional area:
v = F/A
! Under resting conditions, Velocity in:
◦ Aorta: about 33 cm/sec
◦ Capillaries: 0.3 mm/sec.
◦ However, because the capillaries have a typical
length of only 0.3 to 1 millimeter, the blood
remains in the capillaries for only 1 to 3
seconds. Q = Blood Flow
∆P = Pressure difference between 2 ends of vessel
NORMAL BLOOD PRESSURES IN THE DIFFERENT (P - P )
1 2
PARTS OF CIRCULATION
R = Resistance to flow

Other algebraic form:

ΔP = Q x R

R = ΔP
Q

BLOOD FLOW

! Quantity of blood that passes a given point in the

BASIC PRINCIPLES OF CIRCULATORY FUNCTION
1. The rate of blood flow to each tissue is almost
always precisely controlled in relation to tissue
needs.
Local blood flow + Nervous + Hormones
2. The cardiac output is controlled mainly by the
sum of all the local tissue flows.
Heart acts as an “automaton”
circulation in a given time.
! Expressed in:
◦ mL/min
◦ Liters/min
◦ mL/second
! Normally, 5000ml/min
! “Cardiac Output”: amount of blood pumped into the
aorta by the heart each minute
LAMINAR FLOW OF BLOOD IN BLOOD VESSELS

3. Arterial pressure is controlled independently of ! Laminar flow or streamline flow

either local blood flow control or cardiac output ◦ “Streamlines”
control. ◦ Each layer of blood remaining the same distance
from the vessel wall.
Nervous System Regulation + Renal System Regulation ◦ Centralmost portion of the blood stays at the
CENTER of the vessels.
 ! Blood flow with much greater resistance
! Eddy currents add tremendously to overall friction
! Tendency for turbulent flow:
! Turbulent flow
- Reynolds number
- blood flowing in all direction
- continually mixing

TENDENCY TO TURBULENCE: REYNOLD’S

NUMBER
PARABOLIC VELOCITY PROFILE DURING
LAMINAR FLOW
Re= v.d.p

! Velocity of flow in the center of the vessel is far

greater than that toward the outer edges η

• When Reynolds’ number rises above 200 to 400,

turbulent flow will occur at some branches of vessels
but will die out along the smooth portions of the
vessels.
• However, when Reynolds’ number rises above
approximately 2000, turbulence will usually occur
even in a straight, smooth vessel.

BLOOD PRESSURE
A, Two fluids (one dyed red, and the other clear) before
flow begins ! Force exerted by the blood against any unit area of
B, The same fluids 1 second after flow begins the vessel wall.
C, Turbulent flow, with elements of the fluid moving in a ! mmHg (millimeters of Mercury)
disorderly pattern ◦ Eg.50 mmHg
CAUSE OF PARABOLIC PROFILE ! cmH 0
2

! Mercury manometer – standard reference

! Adherence to vessel wall of outermost layer
! Fluid molecules slips over one another layer by layer 1mmHg = 1.36 cm water pressure
! Each layer toward the center flows progressively
more rapidly than the outer layers RESISTANCE TO BLOOD FLOW

• When the rate of blood flow becomes too great,

• When it passes by an obstruction in a vessel,
• When it makes a sharp turn, or
• When it passes over a rough surface.

! Disorderly
Resistance= pressure gradient
! Forming whorls in the blood – eddy currents blood flow
Eg. P – P = 1 mmHg ! ml/sec/mmHg
1 2
Blood flow = 1 mL/sec ! Reciprocal of Resistance
C= 1/ R
Resistance = 1 PRU (Peripheral Resistance Unit) ! Increases in proportion to the fourth power of the
diameter
! Total Peripheral Vascular Resistance
! Conductance ∝ Diameter4
- Blood flow = CO (100 ml/sec)
- Δ P = (arteries – veins) 100 mmHg
POISEUILLE’S LAW
- Total Peripheral resistance =100/100
! Velocity of blood flow is directly proportional to the
= 1 PRU diameter of the vessel
F= π Pr4
! Total Pulmonary Vascular Resistance
8ηl
- PA (16 mmHg)- LA (2 mmHg)= 14
- 14 mmHg ÷ 100 ml/sec
IMPORTANCE OF THE VESSEL DIAMETER
= 0.14 PRU “FOURTH POWER LAW” IN DETERMINING
ARTERIOLAR RESISTANCE
CONDUCTANCE
! Measure of blood flow for a given pressure ! A fourfold increase in vessel diameter can increase
difference the flow as much as 256-fold.
! ml/sec/mmHg ! Thus, this fourth power law makes it possible for the
! Reciprocal of Resistance arterioles, responding with only small changes in
diameter to nervous signals or local tissue chemical
C= 1/ R signals, either to turn off almost completely the
blood flow to the tissue or at the other extreme to
EFFECT OF VESSEL DIAMETER ON BLOOD cause a vast increase in flow.
FLOW
RESISTANCE TO BLOOD FLOW IN SERIES

! Blood flows from high pressure to low pressure

! Arteries → arterioles → capillaries → venules
! Flow in each vessel is the same
! Total Resistance = sum of individual resistances in
each vessel
! R Total = R1 + R2 + R3 + R4 …

A, Demonstration of the effect of vessel diameter on blood

flow.
B, Concentric rings of blood flowing at different velocities;
the farther away from the vessel wall, the faster the flow.

CONDUCTANCE
! Measure of blood flow for a given pressure
difference
 RESISTANCE IN PARALLEL VASCULAR ! What makes blood viscous?
CIRCUITS Mainly the large number of suspended red cells in the
blood, each exert frictional drag against adjacent
cells & against the wall
! Parallel arrangement permits each tissue to regulate
its own blood flow independently of flow to other
tissues EFFECTS OF VISCOSITY ON BLOOD FLOW
! 1 1+ 1 + 1 + 1 + 1 …
η = viscosity of blood (Normal = 3)
R TOTAL R1 R2 R3 R4
! Determined by pressure gradient and its own • Hematocrit – % of blood that is cells
resistance normally 40%

F= π Pr4
8ηl

Hematocrits in a healthy (normal) person and in

patients with anemia and polycythemia

! Many parallel blood vessels, however, make it easier

for blood to flow through the circuit because each
HEMATOCRI
parallel vessel provides another pathway, or
conductance, for blood flow.
! The total conductance (C ) for blood flow is the
total
sum of the conductance of each parallel pathway:
C = C +C + C +C
total 1 2 3 4

! Therefore, amputation of a limb or surgical removal

of a kidney also removes a parallel circuit and
reduces the total vascular conductance and total
blood flow (i.e., cardiac output) while increasing
total peripheral vascular resistance.
! 1 1+ 1 + 1 + 1 + 1 …
EFFECT OF HEMATOCRIT ON BLOOD
R TOTAL R1 R2 R3 R4 VISCOSITY

C = C +C + C +C
total 1 2 3 4

EFFECT OF BLOOD HEMATOCRIT AND BLOOD

VISCOSITY ON VASCULAR RESISTANCE AND
BLOOD FLOW

! The greater the Viscosity, the less the flow if all other
factors are constant
! Viscosity of normal blood is about 3 x the viscosity
of water
 EFFECT OF ARTERIAL PRESSURE ON BLOOD Vascular Compliance = Increase in volume
FLOW Increase in pressure
! Compliance is equal to DISTENSIBILITY times
volume

VOLUME PRESSURE CURVES

Effect of arterial pressure on blood flow through a blood

vessel at different degrees of vascular tone caused by
increased or decreased sympathetic stimulation of the
vessel.
VASCULAR DISTENSIBILITY AND FUNCTIONS OF
“Volume-pressure curves” of the systemic arterial and venous systems, showing
the effects of stimulation or inhibition of the sympathetic nerves to the circulatory
system

THE ARTERIAL AND VENOUS SYSTEM

DELAYED COMPLIANCE (STRESS RELAXATION)
VASCULAR DISTENSIBILITY
! All blood vessels are distensible
! Increase pressure ! vessel dilatation
! decrease intravascular resistance
! increased blood flow
! Veins are the most distensible; reservoir function
! Normally expressed as fractional increase in volume
for each mm Hg increase in pressure
OF VESSELS
! A vessel exposed to increased volume
at first exhibits a large increase in pressure
( elastic distention)
! But progressive delayed stretching of smooth muscle
in the vessel wall allows the pressure to return back
towards normal (stress-relaxation)
DELAYED COMPLIANCE OF VESSELS

! If 1 mm Hg causes a vessel that originally contained

10 mm of blood to increase its volume by 1 mL, the
distensibility would be 0.1 per mm Hg, or 10 per
cent per mm Hg.
! Veins are eight times more distensible than arteries.

VASCULAR COMPLIANCE (VASCULAR

CAPACITANCE)
! Total quantity of blood that can be stored in a given
portion of the circulation
Effect on the intravascular pressure of injecting a volume of blood into a venous
! Different from DISTENSIBILITY
segment and later removing the excess blood, demonstrating the principle of
delayed compliance.
 Arterial Pressure Pulsation In general, the greater
the compliance of each
vascular segment, the
slower the velocity,
which explains the slow
transmission in the
aorta and the much
faster transmission in
the much less compliant
small distal arteries.

Progressive stages in
transmission of the pressure pulse along the aorta.

DAMPING
1. Resistance
2. Compliance
Pressure pulse contour recorded from the ascending aorta

! Systolic pressure – pressure at the top of the pulse Changes in the pulse
(120 mmHg) pressure contour as
! Diastolic pressure – lowest point of each pulse (80 the pulse wave
mmHg) travelstoward the
! Difference between the two pressures smaller vessels
- Pulse Pressure (40 mmHg) The degree of damping is
almost directly proportional
to the product of resistance
Pulse Pressure times compliance.

! Major factors that affect pulse pressure

1. Stroke volume output
2. Compliance of arterial tree
3. Character of ejection from heart BP Measurement: Auscultatory Method
! The greater the Stroke Volume, the greater the amount of
blood that must be accommodated in the arterial tree with
each beat, the greater the pulse pressure.
! Pulse Pressure = Stroke Volume___
Arterial Compliance Auscultatory
method for
Aortic pressure pulse contours in arteriosclerosis, aortic stenosis,
patent ductus arteriosus, and aortic regurgitation. measuring systolic
and diastolic
arterial pressures.

! Korotkoff sounds
- believed to be caused mainly by blood jetting through the
partly occluded vessels
- the jet causes turbulence in the vessel beyond the cuff and
this sets up the vibrations heard through the stethoscope
 RIGHT ATRIAL PRESSURE

Normal RA Pressure= -3 to -5 to 0 mmHg

= atmospheric pressure
! INCREASED in:
1. Heart failure
2. After massive blood transfusion

Mean Arterial Pressure

!Average of the arterial pressures measured millisecond
by millisecond over a period of time. Compression
!During normal heart rate: points that tend
to collapse the
◦ Nearer to the diastolic pressure
veins entering
!High heart rate:
the thorax.
◦ More closely approximated as the average of the
systolic and diastolic pressures

VEINS AND THEIR FUNCTIONS

- Reservoir : constrict or dilate, and
thereby store blood EFFECT OF HIGH RIGHT ATRIAL PRESSURE ON
- venous pump – can propel blood forward PERIPHERAL VENOUS PRESSURE

- help regulate cardiac output

! When RA pressure > 0 mmHg
→ blood backs up into the larger veins
VENOUS PRESSURES
→ veins enlarges
! Right Atrial (RA) Pressure: → collapsed points open when RA pressure
◦ blood from all systemic veins flows into the RA > +4 to + 6 mmHg
of the heart
◦ ! Central Venous P° EFFECT OF INTRA ABDOMINAL PRESSURE ON
◦ Regulated by a balance between VENOUS PRESSURE OF THE LEGS
1. Ability of the heart to pump blood out
of RA & RV into the lungs ! Intraabdominal pressure: Averages +6 mmHg
2. Tendency of blood to flow from the ! Pregnancy, Large Tumors, Abdominal Obesity,
peripheral veins into the RA Ascitis:
! ↑ RA pressure ◦ → 15 to 30 mmHg
- weak heart pumping ! When intraabdominal pressure increases, venous
- increased venous return pressures of the legs must rise above the
intraabdominal pressures before abdominal veins
! Factors that increase venous return will open and allow blood to flow from the legs to
the heart
1. Increased blood volume
2. Increased large vessel tone →
increased peripheral venous return
3. Dilatation of arterioles
 EFFECT OF GRAVITATIONAL PRESSURE ON ! ↑ Venous pressures in the leg → ↑ size of the veins
VENOUS PRESSURE → destroys function of the valves

CLINICAL ESTIMATION OF VENOUS PRESSURE

! Estimated by simply observing the distention of the
! occurs in peripheral veins
the vascular – neck veins
system of
the human ! When RA pressure becomes increased
being → 10 mmHg- the lower veins of the neck begin to
because of protrude
weight of
the blood in → 15 mmHg – essentially all veins in the neck become
the vessels. distended

DIRECT MEASURE OF VENOUS PRESSURE AND

RA PRESSURE
! Insert a needle into a vein and connect to a pressure
recorder → venous pressure
! RA pressure – insert a catheter through the
peripheral vein and into the RA ( central venous
catheters)
VENOUS VALVES AND “VENOUS PUMPS” !

! Every time one moves the legs, one tightens the
muscles and compresses the veins and squeezes the
blood out of the veins
! Venous valves are arranged so that the direction of
the blood flow can only be toward the heart
- “venous pump” or “muscle pump”
REFERENCE LEVEL FOR PRESSURE
MEASUREMENT
! Point in the circulation at which the gravitational
pressure factors caused by the changes in body
position, do not affect the pressure measurement by
more than 1-2 mmHg
! Near or at the level
of the tricuspid valve
! Reason for lack of gravitational effect
- Heart acts a feedback regulator of pressure at the
tricuspid valve
◦ ⇑ pressure at TV ⇒ ⇑ RV filling ⇒ heart pump
more blood ⇒ ⇓ TV pressure back to normal

! Venous valve incompetence causes “Varicose Veins”

! Veins have been overstretched by excess venous
pressure lasting weeks or months ( pregnancy,
frequent prolonged standing)
BLOOD RESERVOIR FUNCTION OF THE VEINS ◦ capillaries are so permeable that whole blood
including RBCs oozes through the capillary wall
into the trabecular mesh – Red Pulp
! Islands of WBC
◦ ( manufacture lymphoid cells)– White Pulp

! > 60% of all blood is in the veins

! Very compliant
! Reservoir function

SPECIFIC BLOOD RESERVOIRS

! Spleen
! Liver
! Large abdominal veins
! Venous plexus beneath the skin

Heart & lungs – must also be considered as blood

reservoir

Functional structure
of the spleen
! 2 areas for storing blood
◦ Venous sinuses
◦ Pulp
! Splenic pulp