March 2, 2024

1
CARDIOVASCULAR
PHYSIOLOGY :
THE CIRCULATION
 March 2, 2024

2 FUNCTION OF CIRCULATION

• Transport oxygen, nutrients to the body tissues

• Transport waste products away
• Conduct hormones from one part of the body to another
• Maintain an appropriate environment in all the tissue fluids
of the body for optimal survival and function of the cells.
 March 2, 2024

3 FUNCTIONAL PARTS OF
CIRCULATION
• Arteries
• Arterioles
• Capillaries
• Venules
• Veins
 March 2, 2024

4 ARTERIES

• Transport blood under high pressure to the tissues.

• Therefore they have strong vascular walls, and blood flows
at a high velocity in the arteries.
 March 2, 2024

5 ARTERIOLES

• Last small branches of the arterial system;

• Act as control conduits through which blood is released into
the capillaries.
• Has a strong muscular wall that can close the arteriole
completely or can, by relaxing, dilate it several fold:
altering blood flow in each tissue bed in response to the
need of the tissue.
 March 2, 2024

6 CAPILLARIES

• Site of exchange: oxygen, carbon dioxide, fluid, nutrients,

electrolytes, hormones, and other substances between the
blood and the interstitial fluid.
• As such capillary walls are very thin and have numerous
minute capillary pores permeable to water and other small
molecular substances.
 March 2, 2024

7 VEINS

• Transport blood from the venules back to the heart

• Pressure in the venous system is very low-have thin walls & valves to
prevent backflow of blood
• Also:
• Serve as a major reservoir of extra blood
• Propel blood forward-venous/skeletal pump
• Help to regulate cardiac output
 March 2, 2024

8 DISTRIBUTION OF BLOOD
 March 2, 2024

9 VESSEL DIAMETER WITH

VELOCITIES
 March 2, 2024

10 VELOCITY

• Because the same volume of blood must flow through each

segment of the circulation each minute, the velocity of
blood flow is inversely proportional to vascular cross-
sectional area & vessel diameter.
 March 2, 2024

11 PRINCIPLES UNDERLYING
CIRCULATORY FUNCTION
• The rate of blood flow to each tissue of the body is almost
always precisely controlled in relation to the tissue need.
• The cardiac output is controlled mainly by the sum of all
the local tissue flows.
 March 2, 2024

12 PRINCIPLES CONT’D

• In general the arterial pressure is controlled independently

of either local blood flow control or cardiac output control
• At any time the pressure falls significantly below the
normal level of about 100 mm Hg, within seconds a
barrage of nervous reflexes elicits a series of
circulatory changes to raise the pressure back toward
normal i.e. increase in force contraction, constriction of
arterioles, contraction of veins
 March 2, 2024

13 BLOOD FLOW THROUGH A

BLOOD VESSEL
• Depends on:
• Pressure difference of the blood between the two ends
of the vessel(pressure gradient)
• Vascular resistance-impediment to blood flow through
the vessel
 March 2, 2024

14

• The blood flow is directly proportional to the pressure

difference but inversely proportional to the resistance
 BLOOD FLOW

Two flow patterns recognized:

1. Laminar:- silent and occurs in:
• Normal arteries, arterioles, Venules and veins
• Silent up to a ‘critical pressure’ above which, it becomes turbulent.
2. Turbulent flow –noisy, occurs mainly in the ventricles
 March 2, 2024

16 LAMINAR FLOW

• The flow of blood in straight blood vessels, is normally

laminar:
• Characterized by concentric layers of blood moving in parallel
down the length of a blood vessel.
• An infinitely thin layer of blood in contact with the wall of the
vessel does not move. The next has a low velocity, the next a
higher velocity, and so forth,
• Velocity is greatest in the center of the stream
 March 2, 2024

17 TURBULENT FLOW

• Blood flowing in all directions and continually mixing within

the vessel
• Occurs above critical velocity (velocity at which the liquid
changes from streamlined to turbulent)
• Blood in the vessel with low velocity moves in straight
parallel lines. When velocity hits its limit, it begins to create
patterns.
• Turbulent flow creates sounds.
 March 2, 2024

18 RESISTANCE OF FLOW

• The impediment to blood flow in a vessel

• Determined by:
• Radius of blood vessels
• Viscosity of blood
 March 2, 2024

19 RESISTANCE CONT’D

• The small arteries and arterioles-resistance vessels because they

are the principal site of the peripheral resistance often with very
small lumen diameters when relaxed
• In the systemic circulation, about two thirds of the total systemic
resistance to blood flow is arteriolar resistance in the small
arteries & arterioles
• As such arterioles responding to nervous signals or local tissue
chemical signals, by altering their diameter either can turn off
almost completely the blood flow to the tissue or cause a vast
increase in flow.
 March 2, 2024

20 RESISTANCE AND CAPACITANCE

• Veins –capacitance vessels with low resistance-hold a large

amount of blood - A large amount of blood can be added to
the venous system before the veins become distended to the
point where further increments in volume produce a large
rise in venous pressure
 March 2, 2024

21 HEMATOCRIT AND BLOOD

VISCOSITY
• The viscosity of normal blood is x3 that of water.
• Viscosity is dependent on:
• Hematocrit
• Composition of plasma-plasma proteins -mainly
immunoglobulins
 March 2, 2024

22 HEMATOCRIT

• Increased Viscosity→↓blood flow

• The large numbers of suspended red cells make the
viscosity of normal blood three times as great as the
viscosity of blood.
• Viscosity of blood increases drastically as the haematocrit
increases as in polycythemia
• The hematocrit of men averages about 42 %, while that of
women averages about 38 %.
 March 2, 2024

23 EFFECT OF PRESSURE ON TISSUE

BLOOD FLOW
• Increase in arterial pressure increase blood flow through the
various tissues of the body.
• This is because Increase in arterial pressure:
• Increases the force that pushes blood through the
vessels
• Distends the vessels at the same time, which decreases
vascular resistance.
 March 2, 2024

24 PULSE PRESSURE

• The difference between systolic and diastolic pressure (Average=30 -40

mmHg)
• In the healthy young adult during each cardiac cycle the:
• Systolic pressure rises to 120 mm Hg.
• Diastolic pressure falls to 80/70 mm Hg.
 March 2, 2024

25

• Pressure is highest in the aorta and in the brachial and other

large arteries
• Falls rapidly in the small arteries and arterioles-Bernoulli
principle
 March 2, 2024

26 BERNOULLI'S PRINCIPLE

• The greater the velocity of flow in a vessel, the lower the

lateral pressure distending its walls.
• When a vessel is narrowed, the velocity of flow in the
narrowed portion increases and the distending pressure
decreases
 March 2, 2024

27 FACTORS AFFECTING PULSE

PRESSURE
• Stroke volume output of the heart
• Compliance (total distensibility) of the arterial tree.

• Gravity
 March 2, 2024

28 STROKE VOLUME

• Increase in stroke volume increases arterial pressure

• Stroke volume is affected by:- dehydration, ↓EF, Valve
incompetence, ↓ venous return & preload etc.
 March 2, 2024

29 COMPLIANCE/DISTENSIBILITY

• The less is the compliance-the greater is the pulse pressure

• Arterial Compliance is affected by:- atherosclerosis, aneurisms (a
ballooning & weakened area in an artery) vasodilators, vasoconstrictors
• Vasoconstrictors
• Norepinephrine and Epinephrine
• Angiotensin II, etc.
• Vasodilators
• Bradykinin, Histamine from basophils and mast cells etc.
• ANP from atrial muscles
 March 2, 2024

30 GRAVITY
• Both venous & arterial pressures are affected by gravity
• Gravity causes pressure to increase, thus the pressure in any vessel below heart
level is increased and that in any vessel above heart level is decreased by the
effect of gravity
• Magnitude of gravitational effect is 0.77 mm Hg/cm of vertical distance above or
below heart.
• I.e.., Above heart level – Pressure decreases by 0.77 mm Hg for each centimeter.
• Below heart level – Pressure increases by 0.77 mm Hg for each centimeter.

• Mean pressure in large artery in head (adult human) in upright position – 62 mm

Hg while Mean pressure in large artery in leg in upright position – 105 mm Hg.
• Mean pressure in vessels In lying down position at all levels – Same (Due to nil
effect by gravity).
 March 2, 2024

31 BLOOD PRESSURE

• The force exerted by the blood against any unit area of the vessel
wall.
• Depends on cardiac output and peripheral resistance
• Young adults in the sitting position at rest is approximately 120/80
mm Hg
• BP=𝐶𝑎𝑟𝑑𝑖𝑎𝑐 𝑂𝑢𝑡𝑝𝑢𝑡 (CO) 𝑥 𝑃𝑒𝑟𝑖𝑝ℎ𝑒𝑟𝑎𝑙 𝑅𝑒𝑠𝑖𝑠𝑡𝑎𝑛𝑐𝑒 (PVR)
• 𝐶𝑎𝑟𝑑𝑖𝑎𝑐 𝑂𝑢𝑡𝑝𝑢𝑡=𝑆𝑡𝑟𝑜𝑘𝑒 𝑉𝑜𝑙𝑢𝑚𝑒 (SV) 𝑥 𝐻𝑒𝑎𝑟𝑡 𝑅𝑎𝑡𝑒 (HR)
• 𝑆𝑡𝑟𝑜𝑘𝑒 𝑉𝑜𝑙𝑢𝑚𝑒=𝐸𝑛𝑑 𝐷𝑖𝑎𝑠𝑡𝑜𝑙𝑖𝑐 𝑉𝑜𝑙𝑢𝑚𝑒 −𝐸𝑛𝑑 𝑆𝑦𝑠𝑡𝑜𝑙𝑖𝑐 𝑉𝑜𝑙𝑢𝑚𝑒
• Thus, BP= (SV X HR) X PVR
 FACTOR AFFECTING BP

1. Preload- It is the End diastolic volume- Frank-Sterling Forces

2. Afterload-Resistance of pumping blood
3. ANS-sympathetic ↑BP, parasympatic ↓BP
4. Temperature:- ↑venous capacitance → ↓ venous return → ↓BP
5. Age: stiffness of arteries increases↓ arterial compliance → ↑ resistance → ↑BP
6. Health-atherosclerosis →↓arterial compliance→ ↑BP
7. Emotion/Stress - increases the cardiac output and peripheral resistance
(catecholamine's)
8. Metabolic rate - ↑Tissue metabolism→ ↑blood flow
9. Etc.
 AUTOREGULATION OF BLOOD FLOW
DURING CHANGES IN ARTERIAL BP
• Autoregulation:
• Is the return to normal tissue blood flow during increase in systemic arterial pressure.
• Two theories explain the physiology of autoregulation:-

a) Myogenic Theory
• ↑ arterial blood pressure cause smooth muscles of arterioles to be stretched & sensing by
receptors
• Stretching smooth muscle make them to contract and reduce blood flow.
• Occur in absence of neural and hormonal input maintaining a constant blood flow.
b. Metabolic Theory
↑ Metabolic rate such as exercising muscle increases rate of blood flow because vasodilators
are being released this is known as Active Hyperemia
 REGULATION OF BP

• Bp is regulated in a range of 100-139/60-89 mmHg.

• There are two main mechanism:-
1. Immediate regulation: Atrial and Peripheral Baroreceptors
2. Long term Regulation: RAAS system (Role of the kidney in BP
regulation)
 March 2, 2024

35 THANK YOU

• Read on the:
• Invasive Method of taking BP measuring
• Non-invasive/ Ausculatory Method of taking BP
measuring