Blood pressure, blood flow, and resistance

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Blood pressure, blood flow, and resistance

ETP Cardiovascular System

ETP Cardiovascular System

Introduction to the cardiovascular system
Anatomy of the heart
Anatomy of the coronary circulation
Anatomy clinical correlates: Heart
Anatomy of the superior mediastinum
Anatomy of the inferior mediastinum
Anatomy clinical correlates: Mediastinum
Development of the cardiovascular system
Fetal circulation
Cardiac muscle histology
Artery and vein histology
Arteriole, venule and capillary histology
Cardiovascular system anatomy and physiology
Lymphatic system anatomy and physiology
Coronary circulation
Blood pressure, blood flow, and resistance
Pressures in the cardiovascular system
Laminar flow and Reynolds number
Resistance to blood flow
Compliance of blood vessels
Control of blood flow circulation
Microcirculation and Starling forces
Measuring cardiac output (Fick principle)
Stroke volume, ejection fraction, and cardiac output
Cardiac contractility
Frank-Starling relationship
Cardiac preload
Cardiac afterload
Law of Laplace
Cardiac and vascular function curves
Altering cardiac and vascular function curves
Cardiac cycle
Cardiac work
Pressure-volume loops
Changes in pressure-volume loops
Physiological changes during exercise
Cardiovascular changes during hemorrhage
Cardiovascular changes during postural change
Normal heart sounds
Abnormal heart sounds
Action potentials in myocytes
Action potentials in pacemaker cells
Excitability and refractory periods
Cardiac excitation-contraction coupling
Cardiac conduction system
Cardiac conduction velocity
ECG basics
ECG rate and rhythm
ECG intervals
ECG QRS transition
ECG axis
ECG normal sinus rhythm
ECG cardiac infarction and ischemia
ECG cardiac hypertrophy and enlargement
Baroreceptors
Chemoreceptors
Renin-angiotensin-aldosterone system
Arterial disease
Angina pectoris
Stable angina
Unstable angina
Myocardial infarction
Prinzmetal angina
Coronary steal syndrome
Peripheral artery disease
Subclavian steal syndrome
Aneurysms
Aortic dissection
Vasculitis
Behcet's disease
Kawasaki disease
Hypertension
Hypertensive emergency
Renal artery stenosis
Coarctation of the aorta
Cushing syndrome
Conn syndrome
Pheochromocytoma
Polycystic kidney disease
Hypotension
Orthostatic hypotension
Abetalipoproteinemia
Familial hypercholesterolemia
Hypertriglyceridemia
Hyperlipidemia
Chronic venous insufficiency
Thrombophlebitis
Deep vein thrombosis
Lymphedema
Lymphangioma
Shock
Vascular tumors
Human herpesvirus 8 (Kaposi sarcoma)
Angiosarcomas
Persistent truncus arteriosus
Transposition of the great vessels
Total anomalous pulmonary venous return
Tetralogy of Fallot
Hypoplastic left heart syndrome
Patent ductus arteriosus
Ventricular septal defect
Atrial septal defect
Atrial flutter
Atrial fibrillation
Premature atrial contraction
Atrioventricular nodal reentrant tachycardia (AVNRT)
Wolff-Parkinson-White syndrome
Ventricular tachycardia
Brugada syndrome
Premature ventricular contraction
Long QT syndrome and Torsade de pointes
Ventricular fibrillation
Atrioventricular block
Bundle branch block
Pulseless electrical activity
Tricuspid valve disease
Pulmonary valve disease
Mitral valve disease
Aortic valve disease
Dilated cardiomyopathy
Restrictive cardiomyopathy
Hypertrophic cardiomyopathy
Heart failure
Cor pulmonale
Endocarditis
Myocarditis
Rheumatic heart disease
Pericarditis and pericardial effusion
Cardiac tamponade
Dressler syndrome
Cardiac tumors
Acyanotic congenital heart defects: Pathology review
Cyanotic congenital heart defects: Pathology review
Atherosclerosis and arteriosclerosis: Pathology review
Coronary artery disease: Pathology review
Peripheral artery disease: Pathology review
Valvular heart disease: Pathology review
Cardiomyopathies: Pathology review
Heart failure: Pathology review
Supraventricular arrhythmias: Pathology review
Ventricular arrhythmias: Pathology review
Heart blocks: Pathology review
Aortic dissections and aneurysms: Pathology review
Pericardial disease: Pathology review
Endocarditis: Pathology review
Hypertension: Pathology review
Shock: Pathology review
Vasculitis: Pathology review
Cardiac and vascular tumors: Pathology review
Dyslipidemias: Pathology review
Sympatholytics: Alpha-2 agonists
Adrenergic antagonists: Presynaptic
Adrenergic antagonists: Alpha blockers
Adrenergic antagonists: Beta blockers
ACE inhibitors, ARBs and direct renin inhibitors
Thiazide and thiazide-like diuretics
Calcium channel blockers
cGMP mediated smooth muscle vasodilators
Class I antiarrhythmics: Sodium channel blockers
Class II antiarrhythmics: Beta blockers
Class III antiarrhythmics: Potassium channel blockers
Class IV antiarrhythmics: Calcium channel blockers and others
Lipid-lowering medications: Statins
Lipid-lowering medications: Fibrates
Miscellaneous lipid-lowering medications
Positive inotropic medications
Cardiomyopathies: Clinical
Congenital heart defects: Clinical
Valvular heart disease: Clinical
Infective endocarditis: Clinical
Pericardial disease: Clinical
Chest trauma: Clinical
Hypertension: Clinical
Pulmonary hypertension
Aortic aneurysms and dissections: Clinical
Raynaud phenomenon
Peripheral vascular disease: Clinical
Heart failure: Clinical
Coronary artery disease: Clinical
Deep vein thrombosis and pulmonary embolism: Pathology review
Fascia, vessels and nerves of the upper limb
Vessels and nerves of the forearm
Vessels and nerves of the hand
Anatomy of the abdominal viscera: Blood supply of the foregut, midgut and hindgut
Fascia, vessels and nerves of the lower limb
Vessels and nerves of the gluteal region and posterior thigh
Anatomy of the popliteal fossa
Ventilation
Ventilation-perfusion ratios and V/Q mismatch
Gas exchange in the lungs, blood and tissues
Oxygen binding capacity and oxygen content
Oxygen-hemoglobin dissociation curve
Carbon dioxide transport in blood
Trypanosoma cruzi (Chagas disease)
Yellow fever virus
Rickettsia rickettsii (Rocky Mountain spotted fever) and other Rickettsia species
Arteriovenous malformation
Cerebral circulation

Transcript

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Pressure is a force over an area, so with blood pressure, we’re measuring the force that the blood exerts on the surface area of the walls of the blood vessels. Differences in blood pressure throughout the body keep blood flowing from high-pressure areas, like the arteries, to low-pressure areas, like the veins. When we say “blood flow,” we’re referring to the volume of blood that flows through a vessel or an organ over some period of time. Now, the amount of blood flow from one end of a blood vessel to another is affected by the blood pressure, and by the resistance, which comes from the vessels themselves. Vasoconstriction, where the vessels constrict, decreases blood flow, and vasodilation, where the blood vessels expand, increases blood flow.

Now, blood flow is not the same thing as the velocity of blood. Blood flow is the volume of blood that moves by a point over some period of time. So let’s say this chunk of blood has a volume of 83 cm^3, and it took 1 second for this much to flow past the blue circle—this is the blood flow, represented by the variable capital Q.

Now, velocity on the other hand, is the distance traveled in a certain amount of time. So maybe in the same one second, a red blood cell at the very edge here traveled a distance of 27 cm, then it’d be moving 27 cm/s, represented by lowercase v. Even though these aren’t equal, they are related, and the last piece is area, specifically the cross-sectional area of the blood vessel, which in reality is the same as the blood cross section like this. So, based on units, since area’s going to be expressed in cm^2, we see that flow rate equals area times velocity! Alright, so for example, let’s say we want to calculate blood velocity, and we have a person’s cardiac output of 5L/min, which is average for an adult, and the diameter of their aorta, which is 2cm.

First off, using the equation for the area of a circle, (D/2)^2 x pi, we get (2 / 2)^2 x pi = 3.14 cm^2. Next, since cardiac output is the same as blood flow, we just need to convert this L/min to cubic cm per second, so there are 1000 cubic cm in a L, and 60 seconds in a minute, so multiplying those out we get 83 cubic cm per second. Then, rearranging our little formula, velocity equals flow rate divided by area, and we get about 26 cm per second! Which is also about 1 km / hr!

Going back to blood pressure, blood flow, and resistance, that relationship can be written out mathematically as well. So, to start, you have an initial, higher pressure at one end, and a final, lower pressure at the other. The difference between these, or the initial minus the final pressure, sometimes expressed as delta P, equals blood flow through that vessel multiplied by resistance. This can be also written as Q equals change in pressure over resistance. So, for example, let’s say the the blood vessel narrows, which increases the resistance, in order to keep the flow of blood to organs the same, the pressure difference has to increase, and this is typically what happens. This equation might look familiar to a similar equation, where change in voltage V equals current I times resistance R, also known as ohm’s law!

Key Takeaways

Blood pressure is the force your circulating blood exerts against the walls of your arteries. Blood flow is the movement of blood through your body, and resistance is the pushback that's against the blood flow in the circulatory system. Blood pressure, flow, and resistance are all closely related. Your blood pressure is determined by two things: the amount of blood flowing through your arteries and the diameters (widths) of those vessels. The more blood that flows through the arteries and the narrower those vessels are, the higher your blood pressure will be.

Sources

  1. "Medical Physiology" Elsevier (2016)
  2. "Physiology" Elsevier (2017)
  3. "Principles of Anatomy and Physiology" Wiley (2014)
  4. "Microcirculation: Mechanics of Blood Flow in Capillaries" Annual Review of Fluid Mechanics (1971)
  5. "Human Anatomy & Physiology" Pearson (2018)