Goal of the Cardiovascular System: deliver blood to all parts of the body

Does so by using different types of tubing, attached to a pulsatile pump Elastic arteries Muscular arteries Arterioles Capillaries Venuoles Veins Distribution system broken up into areas called vascular beds Skin Digestive (splanchnic) Muscle

Blood Pressure Reflects the driving pressures produced by the ventricles Because arterial pressure is pulsatile, a single value is used to represent the overall driving pressure. This is called the mean arterial pressure. MAP = diastolic P + 1/3(systolic P-diastolic P) Why does diastolic pressure account for a greater proportion of the overall value?MAP = Q x Rarterioles Explain how these two equations are equivalent

SVR = systemic vascular resistance CO = cardiac output SV = stroke volume

Mean Arterial Blood Pressure (MAP)

average arterial blood pressure

during a cardiac cycle Perfusion pressure MAP = DP + 1/3 (SP-DP)

For a BP of 120/80, MAP is ~ 93.5 mmHg

A MAP of ~ 60 mmHg is sufficient for end organ perfusion.

What factors influence blood pressure? Blood volume Vascular resistance Autoregulation Autonomic influences

Regulation of Blood Pressure

Main coordinating center is in the medulla oblongata of the brain; medullary cardiovascular control center Reflex control of blood pressure
Baroreceptor reflex

Fight or Flight Reaction (Sudden Sympathetic Drive)

1. Skeletal muscle blood flow sympathetic cholinergic stimulation vasodilation. 2. Cutaneous blood flow sympathetic cholinergic response sweat glands. 3. Adrenal medulla sympathetic stimulation release epinephrine causes vasodilation in muscle and vasoconstriction in kidney/splanchnic Vessels. 4. Veins vasoconstriction (sympathetic)

5. Heart Increased sympathetic stimulus increased HR and contractility 6. MAP Overall output is an increase in blood pressure.

Fight or Flight Response

Fig. 24-4

sweat vasodilation

vasoconstriction Heart rate epinephrine contractility

FAINTING (Massive Parasympathetic Response)

vasovagal syncope

1. Massive vasodilation occurs removal of sympathetic tone causes a rapid fall in blood pressure. 2. Decreased Cardiac output Increased vagal output to heart causes bradycardia and decreased stroke volume

3. Decreased arterial blood pressure secondary to vasodilation and CO.

4. Cerebral blood flow reduced (> 10 seconds) fainting occurs

FAINTING (Massive Parasympathetic Response)

Emotional stress

AVP release

vasodilation

Bradycardia Decreased MAP

Reduce cerebral blood flow

Integrated Response to Massive Hemorrhage

1. Baroreceptors high pressure decreased firing result is enhanced Sympathetic output and less vagal output tachycardia, contractility, vasoconstriction re-establish MAP 2. Baroreceptors low pressure reduced VOLUME less activity of LPBs. Increased sympathetic output vasoconstriction particularly of kidney BVs Increased release of Anti-diuretic hormone/Arginine Vasopressin/Vasopressin

3. Peripheral Chemoreceptors low MAP reduces perfusion of carotid/aortic bo Local hypoxia increased firing of chemoreceptors vasoconstriction and changes in ventilation.

4. Central Chemoreceptors fall in blood pH (acidosis) increased sympathetic Output vasoconstriction

5. Adrenal medulla as a result of sympathetic stimulation increased Medullary secretion of epinephrine (a BP drop to 40 mmHg - 50 fold increase in E

Hemorrhage Venous return blood volume

SV and CO MAP

Atrial volume

LP Baroreceptors HP Baroreceptors

Central Chemoreceptors

Peripheral Chemoreceptors

Medullary Cardiovascular Control Center SYMPATHETIC RESPONSE

Hormonal response -Angiotensin/Renin -ADH release -ANP (decreased)

Heart rate Contractility

Vasoconstriction (arteriole/venous)

Substances causing contraction in vascular smooth muscle

Chemical NE (a ) Endothelin Serotonin

Physiologic role
Baroreceptor reflex Paracrine Platelet aggregation, smooth muscle contraction

Source
Sympathetic neurons Vascular endothelium Neurons, digestive tract, platelets

Type
Neural Local Local, neural

Substance P
Vasopressin

Pain, increased capillary permeability

Increase blood pressure during hemorrhage

Neurons, digestive tract

Posterior pituitary Plasma hormone endothelium

Local, neural
Hormonal Hormonal local

Angiotensin II Increase blood pressure Prostacyclin

Minimize blood loss from damaged vessels before coagulation

Substances that mediate vascular smooth muscle relaxation

Chemical
Nitric oxide Atrial natriuretic peptide Vasoactive intestinal peptide

Physiologic role
Paracrine mediator Reduce blood pressure Digestive secretion, relax smooth muscle

Source
Endothelium Atrial myocardium, brain Neurons

Type
Local Hormonal Neural, hormonal

Histamine
Epinephrine (b2)

Increase blood flow

Enhance local blood flow to skeletal muscle, heart, liver

Mast cells
Adrenal medulla

Local, systemic
Hormonal

Acetylcholine (muscarinic)
Bradykinin Adenosine

Erection of clitoris, penis

Increase blood flow via nitric oxide Enhance blood flow to match metabolism

Parasympathetic neurons
Multiple tissues Hypoxic cells

neural
Local local