dr. S. Wulandari, M.

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Hemodynamics
Describes the physical factors governing blood flow

within the circulatory system Pressure Flow Resistance

Blood Velocity

Q = VA

V = Q/A

Blood Flow
Blood flow : the quantity of blood that passes a given

point in the circulation in a given period of time ml/mnt, L/mnt Determined by :

Pressure gradient

Force that pushes the blood through the vessel

Vascular resistance

The impediment to blood flow through the vessel as a result of friction between the flowing blood and the intravascular endothelium all along the inside of the vessel

Organs blood flow is determined by changes in

resistance

Ohms Law
Q=P R
Q : Blood Flow
P : Pressure Difference (P1 P2) R : Resistance

 Blood flow in the total

circulation Cardiac output (CO) CO : the amount of blood pumped into the aorta by the heart each minute Blood flow within each organ changes with body activities

Laminar Blood Flow

Streamline Each layer remaining the same distance from vessel wall Parabolic velocity Most portion of the blood stays in the centre of the

vessel

Turbulen Blood Flow

Causes : High velocity Obstruction Sharp turn Rough surface Disorderly Greater resistance

Reynolds number
the measure of the tendency for turbulence to occur
Re : reynolds number
v : mean velocity (cm/s) d : diameter (cm) : density : viscosity (poise)

POISEUILLEs LAW

r P1 P2 Q 8 L
4
Q = debit / flow rate (m/s) = blood viscosity (Poiseuille/Pa.s) r = radius of the vessel(m) P1/P2 = pressure (N/m = Pa) L = length of the vessel (m)

Applied only to single vessel

Resistance to Blood Flow

r 4 P 1 P 2 Q 8 L
Pressure = Q Flow Rate =

Flow Rate =

Pressure Resistance

Resistance = 8L / r 4

Pressure = Flow Rate x Resistance

Total Peripheral Vascular Resistance & Total Pulmonary Vascular Resistance

Circulatory Blood Flow rate ~ CO ( 100 ml/s)
Total Peripheral Resistance : the resistance of the

entire systemic circulation 1 PRU Total Pulmonary Resistance : 1/7 systemic circulation
vasodilation resistance decreases vasoconstriction resistance increases

Series & Parallel Vessels

Series Vessels Arteries, arterioles, cappilaries, venules & vein are collectively arranged in series Flow through each vessel is the same The total resistance to blood flow is equal to the sum of the resistances of each vessel Parallel vessel Permits each tissue to regulate its own blood flow the total resistance is far less than the resistance of any single blood vessel

 The total parallel resistance is less than single lowest

resistance Changing the resistance of a small number of parallel vessel will have little effect on total resistance

Blood Conductance
Conductance is a measure of the blood flow through a vessel for a given pressure difference.

Blood Viscosity & Hematocrit

The greater the viscosity, the less the flow in a

vessel Water viscosity= 10-3 Pa s (20) Blood viscosity= 3-4 x 10-3 Pa s Hematocrit >>> Blood viscosity >>> Temperature <<< blood viscosity >>> Flow <<< blood viscosity >>>

Polisitemia vera

Vessels Diameter
The most important factor determining resistance to flow
Q ~ r4

Blood Pressure
Pressure >>> Flow >>> an increase in arterial pressure not only increases the

force that pushes blood through the vessels but also distends the vessels at the same time, which decreases vascular resistance.

P = Q 8L / r

Tekanan Darah : - Berbanding lurus dengan V (curah jantung) - Berbanding lurus dengan tahanan (perifer) dipengaruhi oleh tonus dan elastisitas arteri - Berbanding lurus (viskositas darah) dipengaruhi oleh volume darah - Berbanding lurus dengan L (panjang pembuluh) - Berbanding terbalik dengan r (jari-jari/ diameter pembuluh)

METODE PENGUKURAN TEKANAN DARAH

Diukur dengan Sphygmomanometer Spygmomanometer terdiri dari : 1. Manometer 2. Pressure cuff Tipe Spygmomanometer : 1. Manometer air raksa tekanan = tinggi kolom air raksa 2. Manometer aneroid tekanan menyebabkan jarum bergerak ke angka

TEKANAN ZAT CAIR

PA PB = g ( hA hB ) hA & hB (+) jika diukur ke bawah PA = PA + PO PB = PB + PO PA & PB = tekanan mutlak zat cair PO = tekanan atmosfer PA & PB = selisih tekanan mutlak & tekanan atmosfer
Metode Pengukuran Tekanan : Menentukan tinggi kolom cairan yang memproduksi tekanan yang setara dengan tekanan yang diukur Manometer (tabung bentuk U yang terisi cairan, biasanya air raksa/air)

Arteries and blood pressure

Pressure reservoir
Arterial walls are able to

expand and recoil because of the pressure of elastic fibers in the arterial wall Systolic pressure: maximum pressure occurring during systole Diastolic pressure: pressure during diastole

Arterial blood pressure

Figure 14.8

Blood pressure values: what do they mean?

Pulse pressure:

PP = SP-DP
Mean arterial blood pressure =

MAP
MAP = Pdias 1/3 (Psys Pdias) MAP = (CO x SVR) + CVP

LAJU ENDAP DARAH (LED)

2r v g 0 9
v = kecepatan endap/sedimentasi r = jari-jari benda = viskositas g = percepatan gravitasi = massa jenis benda 0 = massa jenis zat cair
2

Referensi
Guyton, A.C., John E. Hall., 2006. Textbook of

Medical Physiology.11th ed. Elsevier Inc.Philadelphia, Pennsylvania. Klabunde, R.E. 2011. Cardiovascular physiology concepts. 2nd ed. Lippincott Wiliams & Wilkins. Cameron, John R., 2006. Fisika Tubuh Manusia; Alih bahasa, Brahm U. Pendit. Ed.2-Jakarta. EGC. Gabriel J.F. 1996. Fisika Kedokteran. 7th ed. Jakarta. Penerbit Buku Kedokteran EGC.

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