Pressures in the cardiovascular system

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Pressures in the cardiovascular system

MSNV 699: Pathophysiology

MSNV 699: Pathophysiology

Cardiovascular system anatomy and physiology
Normal heart sounds
Abnormal heart sounds
Blood pressure, blood flow, and resistance
Measuring cardiac output (Fick principle)
Pressures in the cardiovascular system
Baroreceptors
Chemoreceptors
Renin-angiotensin-aldosterone system
Cardiac contractility
Cardiac conduction system
Myocardial infarction
Angina pectoris
Aortic dissection
Aneurysms
Tricuspid valve disease
Mitral valve disease
Pulmonary valve disease
Aortic valve disease
Hypertrophic cardiomyopathy
Skin anatomy and physiology
Wound healing
Hair, skin and nails
Atopic dermatitis
Psoriasis
Lichen planus
Vitiligo
Albinism
Burns
Actinic keratosis
Skin cancer
Endocrine system anatomy and physiology
Thyroid hormones
Cortisol
Synthesis of adrenocortical hormones
Calcitonin
Parathyroid hormone
Vitamin D
Cushing syndrome
Diabetes mellitus
Hyperparathyroidism
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Toxic multinodular goiter
Graves disease
Thyroid cancer
Pheochromocytoma
Neuroblastoma
Gastrointestinal system anatomy and physiology
Pancreatic secretion
Liver anatomy and physiology
Bile secretion and enterohepatic circulation
Carbohydrates and sugars
Proteins
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Prebiotics and probiotics
Vitamins and minerals
Barrett esophagus
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Colorectal polyps
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Gallstones
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Alcohol-associated liver disease
Hemochromatosis
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Portal hypertension
Hirschsprung disease
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Blood components
Coagulation (secondary hemostasis)
Clot retraction and fibrinolysis
Platelet plug formation (primary hemostasis)
Role of Vitamin K in coagulation
Iron deficiency anemia
Alpha-thalassemia
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Von Willebrand disease
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Polycythemia vera (NORD)
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Skeletal system anatomy and physiology
Cartilage structure and growth
Bone remodeling and repair
Fibrous, cartilage, and synovial joints
Rheumatoid arthritis
Gout
Systemic lupus erythematosus
Raynaud phenomenon
Amyloidosis
Scleroderma
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Rotator cuff tear
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Sprained ankle
Compartment syndrome
Bone tumors
Developmental dysplasia of the hip
Nervous system anatomy and physiology
Anatomy and physiology of the eye
Anatomy and physiology of the ear
Neuron action potential
Sympathetic nervous system
Parasympathetic nervous system
Adrenergic receptors
Cholinergic receptors
Cerebellum
Optic pathways and visual fields
Cranial nerves
Brachial plexus
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Renal system anatomy and physiology
Movement of water between body compartments
Renal clearance
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Glomerular filtration
Proximal convoluted tubule
Loop of Henle
Potassium homeostasis
Phosphate, calcium and magnesium homeostasis
Sodium homeostasis
The role of the kidney in acid-base balance
Diabetic nephropathy
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Estrogen and progesterone
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Oxytocin and prolactin
Pregnancy
Anatomy and physiology of the female reproductive system
Anatomy and physiology of the male reproductive system
Testosterone
Development of the reproductive system
Puberty and Tanner staging
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Uterine fibroid
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Respiratory system anatomy and physiology
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Retropharyngeal and peritonsillar abscesses
Pulmonary hypertension
Lung cancer
Mesothelioma
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Transcript

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When we talk about pressures in the cardiovascular system, we’re talking about blood pressure. Pressures in different parts of the cardiovascular system aren’t equal and these differences in pressures keep the blood moving from high pressure areas leaving the heart like the arteries to low pressure areas like the veins.

Actually, the pressure curve looks a little more like this, and fluctuates in the arteries depending on part of the cardiac cycle it’s in, with these peaks being systole, and these low points being diastole -That being said, this original line is the average of these fluctuations, or the mean arterial pressure. Now, since systole takes up about a third of a single cardiac cycle, and diastole takes up the remaining 2/3 of the cycle, we can calculate the mean arterial pressure at any time by the equation:

                            MAP = (⅓) SBP + (⅔) DBP

Which after distributing we get:

                            MAP = DBP + (⅓) PP

Now, looking at these fluctuations on the arterial side, there’s a couple important things to notice. First of all, on the downswing of the curve, there’s a sharp sharp pressure drop followed by a rise again forming what’s called the dicrotic notch or incisura. As blood is ejected out into the aorta, pressure rises quickly, and then as a tiny amount of blood flows back into the ventricle, and causes the valve to snap shut and the pressure to fall. That snapping shut of the valve causes it to recoil back, which causes a brief increase in pressure of aorta, and then finally the pressure falls as the aorta settles and the heart relaxes.

A second interesting thing to notice is that the pulse pressure in the large arteries downstream of the aorta is larger than those in the aorta themselves!That’s because the pressure from blood travels a bit faster than blood itself. To understand that idea - think of the molecules and cells in the blood like Newton’s cradle, and while they move together, they bump into each other and transmit that pressure wave faster than the group can move as a whole, meaning that the pressure wave actually increases the pressure downstream. Also, the pressure waves bounce off the branch points in the arteries, which causes them to reflect back and increase the pressure in the arteries even more.

Key Takeaways

In the human body, the heart is the pump, the arteries are pressure reservoirs and conduits, the arterioles are resistance vessels that control distribution, the capillaries are exchange sites, and the veins are conduits and blood reservoirs. Due to the varying degrees of compliance and resistance, blood pressures are not equal throughout the cardiovascular system. The mean arterial pressure falls as blood moves away from the heart to the periphery. This is because as blood flows downstream through many blood vessels, each of those vessels offers a bit of resistance, which adds up and reduces the blood pressure.

Sources

  1. "Medical Physiology" Elsevier (2016)
  2. "Physiology" Elsevier (2017)
  3. "Human Anatomy & Physiology" Pearson (2018)
  4. "Principles of Anatomy and Physiology" Wiley (2014)