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Capillary Exchange: Bulk Flow

Hydrostatic pressure
Physical force exerted by fluid on a structure E.g., blood hydrostatic pressure (HPb) force exerted per unit area by blood on wall promotes filtration from capillary E.g., interstitial fluid hydrostatic pressure (HBif) force of interstitial fluid on external blood vessel close to 0 in most tissues

Capillary Exchange: Bulk Flow

Colloid osmotic pressure
Pull of water into tissue by tissues protein concentration (colloid) E.g., blood colloid osmotic pressure (COPb) draws fluid into blood due to blood proteins promotes reabsorption, opposing hydrostatic pressure E.g., interstitial fluid colloid osmotic pressure (COPif) force drawing fluid into interstitial fluid few proteins present, so relatively low (0 to 5 mm Hg)

Capillary Exchange: Bulk Flow What is the difference between hydrostatic pressure and osmotic pressure?
Hydrostatic pressure is the force exerted by a fluid on a structure (e.g., a blood vessel). Osmotic pressure is the pull of water into an area by osmosis due to higher relative concentration of solutes.

Capillary Exchange: Net Filtration Pressure

Net filtration pressure calculation (NFP)
Net hydrostatic pressure difference between blood and interstitial fluid hydrostatic pressures Net colloid osmotic pressure difference between blood and interstitial fluid osmotic pressures

Bulk Flow at Capillaries (Figure 20.9)

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From heart Filtration Arterial end Blood hydrostatic pressure is greater than osmotic pressure. Net pressure out. Interstitial fluid Capillary Reabsorption Venous end Osmotic pressure is greater than blood hydrostatic pressure. Net pressure in.

To heart

Capillary Exchange: The Role of the Lymphatic System

Lymphatic system
Picks up excess fluid not reabsorbed at venous capillary end 15% of fluid not reabsorbed by capillary Filters fluid and returns it to venous circulation

(35 0) 35 mm Hg Net HP

(26 5) 21 mm Hg Net COP

14 mm Hg NFP out

(16 0) 16 mm Hg Net HP

(26 5) 21 mm Hg Net COP

5 mm Hg NFP in

Net HP
(HPb HPif) (35 mm Hg 0 mm Hg)

Net COP
(COPb COPif)

=
=

NFP
NFP NFP

Net HP
(HPb HPif) (16 mm Hg 0 mm Hg) 16 mm Hg

Net COP
(COPb COPif)

=
=

NFP
NFP NFP

(26 mm Hg 5 mm Hg) = 21 mm Hg

(26 mm Hg 5 mm Hg) = 21 mm Hg

Arteriole

35 mm Hg

= 14 mm Hg

= 5 mm Hg

Venule

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Capillary Exchange: The Role of the Lymphatic System If lymph vessels were nonfunctional, what would happen to the amount of interstitial fluid around the capillary bed?
This fluid would increase, potentially leading to edema.

Local Blood Flow: Degree of Vascularization and Angiogenesis

Angiogenesis
Formation of new blood vessels in tissues Helps provide adequate perfusion through anatomic changes Occurs over several weeks to months Stimulated in skeletal muscle in response to aerobic training adipose tissue with weight gain occlusion of coronary vessels, providing alternative routes for blood

Local Blood Flow: The Relationship of Local and Total Blood Flow
Total blood flow
Amount of blood transported through vasculature per time Equal to cardiac output May increase significantly with exercise If increases, more blood available to tissues If decreases, less available to tissues

Blood Pressure, Resistance, and Total Blood Flow: Blood Pressure

Blood pressure
Force per unit area of blood against vessel wall Driving force propelling blood through the vessels Change in pressure from one end to other blood pressure gradient pressure highest in arteries and lowest in veins

Blood Pressure, Resistance, and Total Blood Flow: Blood Pressure

Arterial blood pressure
Blood flow pulsatile because ventricles contracting and relaxing Systolic pressure pressure in arteries during ventricular systole highest pressure generated in arteries artery maximally stretched

Blood Pressure, Resistance, and Total Blood Flow: Blood Pressure

Arterial blood pressure (continued)
Diastolic pressure pressure in arteries during ventricular diastole lowest pressure generated in arteries artery maximally recoiled Blood pressure readings given as ratio of systolic to diastolic average adult, about 120/80 mm Hg

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Blood Pressure, Resistance, and Total Blood Flow: Blood Pressure

Arterial blood pressure (continued)
Pulse pressure additional pressure on arteries when heart contracting difference between systolic and diastolic blood pressure e.g., for blood pressure 120/80, pulse pressure 40 measures elasticity and recoil of arteries highest in arteries closest to the heart

Blood Pressure, Resistance, and Total Blood Flow: Blood Pressure

Arterial blood pressure
Pulse pressure (continued) may change temporarily with exercise with age and disease, arteries losing elasticity makes more difficult for heart to pump blood may see changes in pulse pressure pulse throbbing sensations associated with pulse pressure

Blood Pressure, Resistance, and Total Blood Flow: Blood Pressure

Arterial blood pressure (continued)
Mean arterial pressure (MAP) average of blood pressure forces on arteries MAP = diastolic pressure + 1/3 pulse pressure E.g., with blood pressure 120/80 MAP = 80 + 40/3 = 93 provides index of perfusion e.g., MAP < 60 may indicate insufficient blood flow highest in arteries closest to heart

Blood Pressure, Resistance, and Total Blood Flow: Blood Pressure

Capillary blood pressure
When blood here, pulse pressure 0 Needs to be high enough for exchange of substances Needs to be low enough not to damage vessels Arterial end about 40 mm Hg Below 20 mm Hg at venous end Accounts for filtration and reabsorption at respective ends

Blood Pressure, Resistance, and Total Blood Flow: Blood Pressure

Venous blood pressure
Venous return movement of blood from capillaries back to heart Pressure not pulsatile here 20 mm Hg in venules Almost 0 when reaches right atrium Small gradient may be insufficient to move blood when standing

Blood Pressure, Resistance, and Total Blood Flow: Blood Pressure

Venous blood pressure (continued)
Return facilitated by skeletal muscle pump and respiratory pump Skeletal muscle pump assists movement of blood within the limbs with muscle contraction, veins squeezed to help propel blood valves helping prevent backflow blood pumped more quickly back to heart during exercise with prolonged inactivity, blood pooling in the leg veins

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Skeletal muscle pump To heart

Blood Pressure, Resistance, and Total Blood Flow: Blood Pressure

Venous blood pressure (continued)
Respiratory pump assists movement of blood within thoracic cavity diaphragm contracts and flattens with inspiration abdominal cavity decreasing in volume and increasing in pressure thoracic cavity increasing in volume and decreasing in pressure blood propelled from abdominal cavity to thoracic cavity

Factors That Influence Venous Return: Skeletal Muscle Pump (Figure 20.11a)

Increased pressure opens valve

Contracted skeletal muscles

Valve closed (to prevent blood backflow) Vein

Blood flow from tissues (a)

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Blood Pressure, Resistance, and Total Blood Flow: Blood Pressure

Venous blood pressure
Respiratory pump (continued) with expiration diaphragm relaxing decreased intra-abdominal pressure helps blood move from vessels back into heart helps blood move from limbs into abdominal vessels effect increased with increased breathing rate

Respiratory pump

Thoracic cavity Abdominopelvic cavity

Factors That Influence Venous Return: Respiratory Pump (Figure 20.11b)

Inspiration Increases blood flow into thoracic veins

Expiration Increases blood flow into heart and abdominal veins

Decreased intrathoracic pressure Diaphragm contracts Blood moves superiorly Compression Increased intra-abdominal pressure

Increased intrathoracic pressure Diaphragm relaxes

Decreased intra-abdominal pressure

Release of compression

(b)

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Blood Pressure, Resistance, and Total Blood Flow: Blood Pressure

Blood pressure gradient in the systemic circulation
Mean blood pressure in arteries, 93 mm Hg Blood pressure in vena cava 0 Blood pressure gradient 93 mm Hg Driving force to move blood through vasculature increasing gradient increasing total blood flow decreasing gradient decreasing total blood flow Gradient increased by increased cardiac output

300 280 260 240 220 200 180 160 140 120 100 80 60 40 20 0

300 280 260 240 220 200 180 160 140 120

Blood Pressure (Figure 20.10)

(a) 120 Blood pressure (mm Hg) 100 93 80 60 40 20

Systolic pressure occurs when an artery is maximally stretched during ventricular contraction (systole). Stretch Systolic pressure (e.g., 120 mm Hg) Recoil Diastolic pressure (e.g., 80 mm Hg)

Diastolic pressure occurs when artery recoils no further during ventricular relaxation (diastole).

100 80 60 40 20 0

Blood flow Systolic pressure 120 mm Hg Diastolic pressure 80 mm Hg = Pulse pressure = 40 mm Hg

Systolic pressure

MAP Diastolic pressure Arterial end of capillary Venous end of capillary Pressure gradient = 93 mm Hg

(b)

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Blood Pressure, Resistance, and Total Blood Flow: Blood Pressure

Clinical View: Cerebral Edema
Excess interstitial fluid in the brain Can occur if MAP greater than 160 mm Hg Increases filtration in brain capillaries No lymph vessels here Accumulation of excess fluid

Blood Pressure, Resistance, and Total Blood Flow: Blood Pressure

Clinical View: Circulatory Shock
Insufficient blood flow to perfuse tissues Can be due to impaired heart Can be due to low venous return from hemorrhage, dehydration obstructed vein venous pooling from extensive vasodilation from bacterial toxins brainstem trauma causing loss of vasomotor tone others

Blood Pressure, Resistance, and Total Blood Flow: Resistance

Resistance
Amount of friction blood experiences traveling through vessels Due to contact between blood and vessel wall Influences and opposes total blood flow Peripheral resistance resistance of blood in blood vessels (as opposed to heart) Affected by viscosity, vessel length, lumen size

Blood Pressure, Resistance, and Total Blood Flow: Resistance

Blood viscosity
Blood resistance to its flow Greater thickness with greater viscosity Dependent on percentage of particles in fluid Blood with formed elements, proteins, platelets about 5 times more viscous than water

Blood Pressure, Resistance, and Total Blood Flow: Resistance

Blood viscosity (continued)
Change in viscosity causes change in resistance of blood flow e.g., in anemia, fewer erythrocytes blood viscosity lower, blood with less resistance e.g., in dehydration, greater percentage erythrocytes blood viscosity higher, blood with more resistance

Blood Pressure, Resistance, and Total Blood Flow: Resistance

Vessel length
Resistance increasing with length greater friction experienced by fluid shorter vessels with less resistance than longer of same diameter normally vessels maintaining same length may be increased during weight gain due to angiogenesis

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Blood Pressure, Resistance, and Total Blood Flow: Resistance

Vessel radius
The major way resistance regulated Flow fastest in the center of lumen encounters resistance from nearby vessel wall Different flow rate within vessel laminar flow As diameter increases, less blood near edges overall blood flow increases

Blood Pressure, Resistance, and Total Blood Flow: Resistance

Vessel radius (continued)
Relationship between flow and radius flow proportional to radius to the fourth F r4 e.g., radius increases 1 mm to 2 mm; change in flow 16 times greater Resistance usually regulated by arterioles vasodilation and vasoconstriction controlled by sympathetic division of ANS big changes in total resistance from small diameter change Resistance increased in atherosclerosis

Blood Pressure, Resistance, and Total Blood Flow: Resistance How is resistance defined?

Blood Pressure, Resistance, and Total Blood Flow: Resistance What three factors alter resistance? How does each affect blood flow in vessels?
Greater blood viscosity, increased vessel length, and decreased vessel radius correlate with greater resistance.

The amount of friction blood experiences as travels through blood vessels.

Blood Pressure, Resistance, and Total Blood Flow: Blood Flow, Blood Pressure Gradients, and Resistance
Resistance
Blood flow inversely related to resistance resistance increases, blood flow lessens resistance decreases, blood flow increases (if pressure gradient remains same)
Cardiac output

Factors That Influence Total Blood Flow (Figure 20.12)

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Total blood flow

Pressure gradient (established by the heart) Resistance (experienced by blood as it moves through the vessels)

Factors that increase total blood flow Vasodilation Blood flow Cardiac output

Factors that decrease total blood flow Vasoconstriction Blood flow

An increase in cardiac output causes a steeper pressure gradient

A decrease in cardiac output causes a smaller pressure gradient

mm Hg

mm Hg

Increased pressure gradient

Less resistance, which is caused by vasodilation, reduction in vessel length,or decrease in blood viscosity

Decreased pressure gradient Distance from heart

Greater resistance, which is caused by vasoconstriction, increase in vessel length, or increase in blood viscosity

Distance from heart (a) (b)