ARTERIAL & VENOUS SYSTEM

Dr. MRS. Chhaya Saraf

LEARNING ISSUES
Understand

the importance of arterial distension and recoil Describe the mechanisms of peripheral arterial pulsations Arterial system & functions Venous system & functions

Anatomy

WALLS OF BLOOD VESSELS

Circular Smooth Muscle Vaso-constriction/dilation Elastin and collagen Strengthens, Anchors

Endothelium Minimize friction Sympathetic stimulation(alpha receptors) Noradrenaline causes vasoconstriction Sympathetic inhibition Vasodilatation Vasomotor tone-Even at rest sympathetic tone is there

WINDKESSEL EFFECT

VASCULAR DISTENSIBILITY
Fractional increase in volume per 1 mmHg pressure rise Dilatation
P
Increased Blood flow

Distensibility allows blood vessels to accommodate pulsatile output & also smooth flow to tissues Veins are 6-10 times more distensible

VASCULAR COMPLIANCE/CAPACITANCE

Total quantity of blood stored per 1 mmHg pressure rise Compliance = Distensibility x volume In veins compliance is 24 times more than arteries (8x3)

VOLUME PRESSURE CURVE

More pressure change after small volume change

Increased sympathetic tone increases pressure Helps in shifting blood e.g. hemorrhage

Small pressure change after large volume change

DELAYED COMPLIANCESTRESS RELAXATION

Transfusion Stress relaxation of muscle

Hemorrhage
Readjustment of muscle

Increased volume initially increases the pressure but later on it comes to normal due to stretch

VENOUS SYSTEM

Main features

Compliant Compressible Extremity veins have Valves

Mean peripheral venous pressure

4-6 mmHg

Central Venous Pressure(RAP)

~ 0-4 mmHg Cardiac pumping VR Increased RAP opens collapsed veins

PERIPHERAL VENOUS PRESSURE

Venoconstriction by sympathetic stimulation maintains the circulation & shifts a blood Specific reservoirs Spleen Liver Large abdominal veins Venous plexus beneath the skin

HYDROSTATIC PRESSURE AND VENOUS PRESSURE

Role

of gravity

For every 13.6 mm distance there is 1 mm Hg pressure increase It is seen in veins as well as arteries so arterial pressure in legs is 100+90=190mmHg

SKELETAL MUSCLE PUMP VENOUS PUMP

Incompetence & destruction of valves - varicose veins

NORMAL ARTERIAL PRESSURE PULSATIONS AT AORTIC ROOT

Dicrotic notch & wave

Pressure pulsations reduces to zero in capillaries d/to distensibility & resistance in arteries

DETERMINANTS OF PULSE PRESSURE

PULSE PRESSURE

= STROKE VOLUME
COMPLIANCE(DISTENSIBILITY)

In old age due to non compliant arteries PP is increased

Systolic pressure

Pulse pressure Diastolic pressure

ABNORMAL PRESSURE PULSE WAVE

PRESSURE PULSE PROPAGATION

Damping during propagation
Last curves show decrease in intensity due to change in Resistance & Compliance of peripheral vessels pulse wave is not seen in capillaries.

MAIN STUDY MATERIAL

GUYTON 15TH CHAPTER

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