Physics of Heart and Circulation
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Chapter 20 *Lecture Powerpoint the Circulatory System: Blood Vessels and Circulation
Chapter 20 *Lecture PowerPoint The Circulatory System: Blood Vessels and Circulation *See separate FlexArt PowerPoint slides for all figures and tables preinserted into PowerPoint without notes. Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. Introduction • The route taken by the blood after it leaves the heart was a point of much confusion for many centuries – Chinese emperor Huang Ti (2697–2597 BC) believed that blood flowed in a complete circuit around the body and back to the heart – Roman physician Galen (129–c. 199) thought blood flowed back and forth like air; the liver created blood out of nutrients and organs consumed it – English physician William Harvey (1578–1657) did experimentation on circulation in snakes; birth of experimental physiology – After microscope was invented, blood and capillaries were discovered by van Leeuwenhoek and Malpighi 20-2 General Anatomy of the Blood Vessels • Expected Learning Outcomes – Describe the structure of a blood vessel. – Describe the different types of arteries, capillaries, and veins. – Trace the general route usually taken by the blood from the heart and back again. – Describe some variations on this route. 20-3 General Anatomy of the Blood Vessels Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. Capillaries Artery: Tunica interna Tunica media Tunica externa Nerve Vein Figure 20.1a (a) 1 mm © The McGraw-Hill Companies, Inc./Dennis Strete, photographer • Arteries carry blood away from heart • Veins -
Radionuclear Measurement of Peripheral Hemodynamics In
RadionuclearMeasurementof Peripheral Hemodynamics in Selection of Vasodilators for Treatment of Heart Failure Yasuhiro Todo, Mitsumasa Ohyanagi, Ryu Fujisue, and Tadaaki Iwasaki Hyogo College ofMedicine, Nishinomiya, Japan Inorder to select the optimal vasodilator for the treatment of patients with congestive heart failure (CHF), the acute effects of three vasodilators (isosorbide dinitrate (ISDN) 5 mg, nifedipine 10 mg, and prazosin 1 mg) on peripheral capacitance and resistance vessels (CV and RV)were evaluated by a newly devised radionuclear technique (Study 1).Thirty-six @ patients with chronic CHF were dividedinto Group A (ejectionfraction (EF) 35%, n = 20, mean EF: 47.2 ±6.5%) and B (EF < 35%, n = 16, mean EF: 24.8 ±7.1%). ISDNproduced the strongest CVdilatation(25% in both groups). Nifedipinereduced RVtone in Groups A and B (14% and 27%, respectively),and CVtone in Group A (6%). Prazosin had the most prominent effects on both vessels in Group B. From these results, it appeared: (a) ISDN is indicated for the cases with increased CV tone, (b) nifedipine is suitable for those with @ increased RV tone, (C)in cases of increased tone in both vessels, nifedipine (when EF 35%) or prazosin (when EF < 35%) is optimal.To evaluate the validityof this assignment, 49 subjects with CHF were divided into Group 1 (n = 16, increased CV tone), Group 2 (n = 17, increased RV tone), and Group 3 (n = 16, increased CV and RV tone) in Study 2. In Group 1, the changes of all indexes were not significantly different between the subjects treated with optimal drug based on the assignment (subgroup P) and those with a non-optimaldrug (subgroup N)after 2 wk of therapy. -
Baroreflex and Cerebral Autoregulation Are Inversely
2460 NASR N et al. Circulation Journal ORIGINAL ARTICLE Official Journal of the Japanese Circulation Society http://www.j-circ.or.jp Hypertension and Circulatory Control Baroreflex and Cerebral Autoregulation Are Inversely Correlated Nathalie Nasr, MD, PhD; Marek Czosnyka, PhD; Anne Pavy-Le Traon, MD, PhD; Marc-Antoine Custaud, MD, PhD; Xiuyun Liu, BSc; Georgios V. Varsos, BSc; Vincent Larrue, MD Background: The relative stability of cerebral blood flow is maintained by the baroreflex and cerebral autoregulation (CA). We assessed the relationship between baroreflex sensitivity (BRS) and CA in patients with atherosclerotic carotid stenosis or occlusion. Methods and Results: Patients referred for assessment of atherosclerotic unilateral >50% carotid stenosis or oc- clusion were included. Ten healthy volunteers served as a reference group. BRS was measured using the sequence method. CA was quantified by the correlation coefficient (Mx) between slow oscillations in mean arterial blood pres- sure and mean cerebral blood flow velocities from transcranial Doppler. Forty-five patients (M/F: 36/9), with a me- dian age of 68 years (IQR:17) were included. Thirty-four patients had carotid stenosis, and 11 patients had carotid occlusion (asymptomatic: 31 patients; symptomatic: 14 patients). The median degree of carotid steno-occlusive disease was 90% (IQR:18). Both CA (P=0.02) and BRS (P<0.001) were impaired in patients as compared with healthy volunteers. CA and BRS were inversely and strongly correlated with each other in patients (rho=0.58, P<0.001) and in healthy volunteers (rho=0.939; P<0.001). Increasing BRS remained strongly associated with im- paired CA on multivariate analysis (P=0.004). -
Blood Vessels: Part A
Chapter 19 The Cardiovascular System: Blood Vessels: Part A Blood Vessels • Delivery system of dynamic structures that begins and ends at heart – Arteries: carry blood away from heart; oxygenated except for pulmonary circulation and umbilical vessels of fetus – Capillaries: contact tissue cells; directly serve cellular needs – Veins: carry blood toward heart Structure of Blood Vessel Walls • Lumen – Central blood-containing space • Three wall layers in arteries and veins – Tunica intima, tunica media, and tunica externa • Capillaries – Endothelium with sparse basal lamina Tunics • Tunica intima – Endothelium lines lumen of all vessels • Continuous with endocardium • Slick surface reduces friction – Subendothelial layer in vessels larger than 1 mm; connective tissue basement membrane Tunics • Tunica media – Smooth muscle and sheets of elastin – Sympathetic vasomotor nerve fibers control vasoconstriction and vasodilation of vessels • Influence blood flow and blood pressure Tunics • Tunica externa (tunica adventitia) – Collagen fibers protect and reinforce; anchor to surrounding structures – Contains nerve fibers, lymphatic vessels – Vasa vasorum of larger vessels nourishes external layer Blood Vessels • Vessels vary in length, diameter, wall thickness, tissue makeup • See figure 19.2 for interaction with lymphatic vessels Arterial System: Elastic Arteries • Large thick-walled arteries with elastin in all three tunics • Aorta and its major branches • Large lumen offers low resistance • Inactive in vasoconstriction • Act as pressure reservoirs—expand -
Lecture 18 Ocean General Circulation Modeling
Lecture 18 Ocean General Circulation Modeling 9.1 The equations of motion: Navier-Stokes The governing equations for a real fluid are the Navier-Stokes equations (con servation of linear momentum and mass mass) along with conservation of salt, conservation of heat (the first law of thermodynamics) and an equation of state. However, these equations support fast acoustic modes and involve nonlinearities in many terms that makes solving them both difficult and ex pensive and particularly ill suited for long time scale calculations. Instead we make a series of approximations to simplify the Navier-Stokes equations to yield the “primitive equations” which are the basis of most general circu lations models. In a rotating frame of reference and in the absence of sources and sinks of mass or salt the Navier-Stokes equations are @ �~v + �~v~v + 2�~ �~v + g�kˆ + p = ~ρ (9.1) t r · ^ r r · @ � + �~v = 0 (9.2) t r · @ �S + �S~v = 0 (9.3) t r · 1 @t �ζ + �ζ~v = ω (9.4) r · cpS r · F � = �(ζ; S; p) (9.5) Where � is the fluid density, ~v is the velocity, p is the pressure, S is the salinity and ζ is the potential temperature which add up to seven dependent variables. 115 12.950 Atmospheric and Oceanic Modeling, Spring '04 116 The constants are �~ the rotation vector of the sphere, g the gravitational acceleration and cp the specific heat capacity at constant pressure. ~ρ is the stress tensor and ω are non-advective heat fluxes (such as heat exchange across the sea-surface).F 9.2 Acoustic modes Notice that there is no prognostic equation for pressure, p, but there are two equations for density, �; one prognostic and one diagnostic. -
Relationship Between Vasodilatation and Cerebral Blood Flow Increase in Impaired Hemodynamics: a PET Study with the Acetazolamide Test in Cerebrovascular Disease
CLINICAL INVESTIGATIONS Relationship Between Vasodilatation and Cerebral Blood Flow Increase in Impaired Hemodynamics: A PET Study with the Acetazolamide Test in Cerebrovascular Disease Hidehiko Okazawa, MD, PhD1,2; Hiroshi Yamauchi, MD, PhD1; Hiroshi Toyoda, MD, PhD1,2; Kanji Sugimoto, MS1; Yasuhisa Fujibayashi, PhD2; and Yoshiharu Yonekura, MD, PhD2 1PET Unit, Research Institute, Shiga Medical Center, Moriyama, Japan; and 2Biomedical Imaging Research Center, Fukui Medical University, Fukui, Japan Key Words: acetazolamide; cerebrovascular disease; cerebral The changes in cerebral blood flow (CBF) and arterial-to- blood volume; vasodilatory capacity; cerebral perfusion pressure capillary blood volume (V0) induced by acetazolamide (ACZ) are expected to be parallel each other in the normal circula- J Nucl Med 2003; 44:1875–1883 tion; however, it has not been proven that the same changes in those parameters are observed in patients with cerebro- vascular disease. To investigate the relationship between changes in CBF, vasodilatory capacity, and other hemody- namic parameters, the ACZ test was performed after an The ability of autoregulation to maintain the cerebral 15O-gas PET study. Methods: Twenty-two patients with uni- blood flow (CBF), which resides in the cerebral circulation lateral major cerebral arterial occlusive disease underwent despite transient changes in systemic mean arterial blood 15 PET scans using the H2 O bolus method with the ACZ test pressure, has been shown to occur via the mechanism of 15 after the O-gas steady-state method. CBF and V0 for each arteriolar vasodilatation in the cerebral circulation (1). The subject were calculated using the 3-weighted integral vasodilatory change in the cerebral arteries is assumed for method as well as the nonlinear least-squares fitting method. -
Hemodynamic Effects of Vasodilators and Long-Term Response in Heart Failure
JACC Vol. 3, No.6 1521 June 1984:1521-30 REPORTS ON THERAPY Hemodynamic Effects of Vasodilators and Long-Term Response in Heart Failure JOSEPH A. FRANCIOSA, MD, FACC, W. BRUCE DUNKMAN, MD, FACC,* CHERYL L. LEDDY, MD* Philadelphia, Pennsylvania and Little Rock, Arkansas Hemodynamic responses to vasodilators are commonly ml/min per kg (p < 0.01), and exercise duration also assessed when starting long-term vasodilator treatment increased by 1.8 ± 3.5 minutes (p < 0.01). Changes in in patients with chronic left ventricular failure, although maximal oxygen uptake, however, did not correlate with the relation between short- and long-term responses is short-term changes in pulmonary wedge pressure (cor• not established. Thus, short- and long-term hemody• relation coefficient [r] = - 0.14), cardiac index (r = namic responses to placebo and vasodilators (isosorbide - 0.01) or systemic vascular resistance (r = - 0.20). dinitrate, minoxidil and enalapril or captopril) were Long-term hemodynamic changes also failed to correlate measured and long-term clinical efficacy was assessed with changes in exercise capacity. Baseline hemody• by changes in exercise capacity after 1 to 5 months of namics, cardiac dimensions and left ventricular ejection vasodilator administration (plus digitalis and diuretic fraction before vasodilator administration all failed to agents) in 46 patients with New York Heart Association correlate with baseline exercise capacity or with long• fun~tional class II to IV heart failure caused by cardio• term changes in exercise capacity. myopathy. There were no significant changes in hemo• Thus, hemodynamic measurements at initiation or dynamics or exercise capacity during placebo treatment. -
Effects of Vasodilation and Arterial Resistance on Cardiac Output Aliya Siddiqui Department of Biotechnology, Chaitanya P.G
& Experim l e ca n i t in a l l C Aliya, J Clinic Experiment Cardiol 2011, 2:11 C f a Journal of Clinical & Experimental o r d l DOI: 10.4172/2155-9880.1000170 i a o n l o r g u y o J Cardiology ISSN: 2155-9880 Review Article Open Access Effects of Vasodilation and Arterial Resistance on Cardiac Output Aliya Siddiqui Department of Biotechnology, Chaitanya P.G. College, Kakatiya University, Warangal, India Abstract Heart is one of the most important organs present in human body which pumps blood throughout the body using blood vessels. With each heartbeat, blood is sent throughout the body, carrying oxygen and nutrients to all the cells in body. The cardiac cycle is the sequence of events that occurs when the heart beats. Blood pressure is maximum during systole, when the heart is pushing and minimum during diastole, when the heart is relaxed. Vasodilation caused by relaxation of smooth muscle cells in arteries causes an increase in blood flow. When blood vessels dilate, the blood flow is increased due to a decrease in vascular resistance. Therefore, dilation of arteries and arterioles leads to an immediate decrease in arterial blood pressure and heart rate. Cardiac output is the amount of blood ejected by the left ventricle in one minute. Cardiac output (CO) is the volume of blood being pumped by the heart, by left ventricle in the time interval of one minute. The effects of vasodilation, how the blood quantity increases and decreases along with the blood flow and the arterial blood flow and resistance on cardiac output is discussed in this reviewArticle. -
Vortex Stretching in Incompressible and Compressible Fluids
Vortex stretching in incompressible and compressible fluids Esteban G. Tabak, Fluid Dynamics II, Spring 2002 1 Introduction The primitive form of the incompressible Euler equations is given by du P = ut + u · ∇u = −∇ + gz (1) dt ρ ∇ · u = 0 (2) representing conservation of momentum and mass respectively. Here u is the velocity vector, P the pressure, ρ the constant density, g the acceleration of gravity and z the vertical coordinate. In this form, the physical meaning of the equations is very clear and intuitive. An alternative formulation may be written in terms of the vorticity vector ω = ∇× u , (3) namely dω = ω + u · ∇ω = (ω · ∇)u (4) dt t where u is determined from ω nonlocally, through the solution of the elliptic system given by (2) and (3). A similar formulation applies to smooth isentropic compressible flows, if one replaces the vorticity ω in (4) by ω/ρ. This formulation is very convenient for many theoretical purposes, as well as for better understanding a variety of fluid phenomena. At an intuitive level, it reflects the fact that rotation is a fundamental element of fluid flow, as exem- plified by hurricanes, tornados and the swirling of water near a bathtub sink. Its derivation from the primitive form of the equations, however, often relies on complex vector identities, which render obscure the intuitive meaning of (4). My purpose here is to present a more intuitive derivation, which follows the tra- ditional physical wisdom of looking for integral principles first, and only then deriving their corresponding differential form. The integral principles associ- ated to (4) are conservation of mass, circulation–angular momentum (Kelvin’s theorem) and vortex filaments (Helmholtz’ theorem). -
Studies on Blood Viscosity During Extracorporeal Circulation
Nagoya ]. med. Sci. 31: 25-50, 1967. STUDIES ON BLOOD VISCOSITY DURING EXTRACORPOREAL CIRCULATION HrsASHI NAGASHIMA 1st Department of Surgery, Nagoya University School of Medicine (Director: Prof Yoshio Hashimoto) ABSTRACT Blood viscosity was studied during extracorporeal circulation by means of a cone in cone viscometer. This rotational viscometer provides sixteen kinds of shear rate, ranging from 0.05 to 250.2 sec-1 • Merits and demerits of the equipment were described comparing with the capillary viscometer. In experimental study it was well demonstrated that the whole blood viscosity showed the shear rate dependency at all hematocrit levels. The influence of the temperature change on the whole blood viscosity was clearly seen when hemato· crit was high and shear rate low. The plasma viscosity was 1.8 cp. at 37°C and Newtonianlike behavior was observed at the same temperature. ·In the hypothermic condition plasma showed shear rate dependency. Viscosity of 10% LMWD was over 2.2 fold as high as that of plasma. The increase of COz content resulted in a constant increase in whole blood viscosity and the increased whole blood viscosity after C02 insufflation, rapidly decreased returning to a little higher level than that in untreated group within 3 minutes. Clinical data were obtained from 27 patients who underwent hypothermic hemodilution perfusion. In the cyanotic group, w hole blood was much more viscous than in the non cyanotic. During bypass, hemodilution had greater influence upon whole blood viscosity than hypothermia, but it went inversely upon the plasma viscosity. The whole blood viscosity was more dependent on dilution rate than amount of diluent in mljkg. -
Medical Management of Advanced Heart Failure
CLINICAL CARDIOLOGY CLINICIAN’S CORNER Medical Management of Advanced Heart Failure Anju Nohria, MD Context Advanced heart failure, defined as persistence of limiting symptoms de- Eldrin Lewis, MD spite therapy with agents of proven efficacy, accounts for the majority of morbidity and mortality in heart failure. Lynne Warner Stevenson, MD Objective To review current medical therapy for advanced heart failure. EART FAILURE HAS EMERGED AS Data Sources We searched MEDLINE for all articles containing the term advanced a major health challenge, in- heart failure that were published between 1980 and 2001; EMBASE was searched from creasing in prevalence as age- 1987-1999, Best Evidence from 1991-1998, and Evidence-Based Medicine from 1995- adjusted rates of myocardial 1999. The Cochrane Library also was searched for critical reviews and meta-analyses Hinfarction and stroke decline.1 Affect- of congestive heart failure. ing 4 to 5 million people in the United Study Selection Randomized controlled trials of therapy for 150 patients or more States with more than 2 million hospi- were included if advanced heart failure was represented. Other common clinical situ- talizations each year, heart failure alone ations were addressed from smaller trials as available, trials of milder heart failure, con- accounts for 2% to 3% of the national sensus guidelines, and both published and personal clinical experience. health care budget. Developments her- Data Extraction Data quality was determined by publication in peer-reviewed lit- alded in the news media increase pub- erature or inclusion in professional society guidelines. lic expectations but focus on decreas- Data Synthesis A primary focus for care of advanced heart failure is ongoing iden- ing disease progression in mild to tification and treatment of the elevated filling pressures that cause disabling symp- moderate stages2,3 or supporting the cir- toms. -
The Influence of Negative Viscosity on Wind-Driven, Barotropic Ocean
916 JOURNAL OF PHYSICAL OCEANOGRAPHY VOLUME 30 The In¯uence of Negative Viscosity on Wind-Driven, Barotropic Ocean Circulation in a Subtropical Basin DEHAI LUO AND YAN LU Department of Atmospheric and Oceanic Sciences, Ocean University of Qingdao, Key Laboratory of Marine Science and Numerical Modeling, State Oceanic Administration, Qingdao, China (Manuscript received 3 April 1998, in ®nal form 12 May 1999) ABSTRACT In this paper, a new barotropic wind-driven circulation model is proposed to explain the enhanced transport of the western boundary current and the establishment of the recirculation gyre. In this model the harmonic Laplacian viscosity including the second-order term (the negative viscosity term) in the Prandtl mixing length theory is regarded as a tentative subgrid-scale parameterization of the boundary layer near the wall. First, for the linear Munk model with weak negative viscosity its analytical solution can be obtained with the help of a perturbation expansion method. It can be shown that the negative viscosity can result in the intensi®cation of the western boundary current. Second, the fully nonlinear model is solved numerically in some parameter space. It is found that for the ®nite Reynolds numbers the negative viscosity can strengthen both the western boundary current and the recirculation gyre in the northwest corner of the basin. The drastic increase of the mean and eddy kinetic energies can be observed in this case. In addition, the analysis of the time-mean potential vorticity indicates that the negative relative vorticity advection, the negative planetary vorticity advection, and the negative viscosity term become rather important in the western boundary layer in the presence of the negative viscosity.