2Intracellular Fluid (ICF): Fluid located within the cell; cytosol Extracellular Fluid (ECF): Fluid outside of body cells; plasma and interstitial fluidInterstitial Fluid (IF): The portion of extracellular fluid that fills the microscopic spaces between the cells of tissues; tissue fluid
4Bulk FlowFiltration and reabsorption of fluids due to pressure (osmotic/hydrostatic) differencesBalance of pressures = net filtration pressure (NFP)Starling's Law of the Capillaries - movement of fluid between plasma and the interstitial fluid is in a state of near equilibrium at the arterial and venous ends of a capillary
6Blood hydrostatic pressure (BHP)= pressure of blood acting against the capillary walls forcing fluids out of capillariesInterstitial fluid hydrostatic pressure (IFHP) = pressure acting outside the capillaries pushing fluid inBlood colloid osmotic pressure (BCOP)= pressure as a result of moving fluid into capillaries due to attraction to non diffusible solutes (i.e. plasma proteins)
7Edema - filtration exceeds reabsorption resulting in increased interstitial fluid volume; causes include:Increased blood hydrostatic pressure in capillaries (cardiac failure, blood clots)Decreased concentration of plasma proteins (burns, malnutrition, kidney dis.)Increased permeability of capillariesIncreased extracellular fluid volumeBlockage of lymphatic vessels (radical mastectomy)Edema is not detectable in tissues until IF is increased 30% above normal
8Blood flows from high pressure (arterial) to low pressure (venous).Arteries-arterioles-capillaries-venules-veinsPressure: aorta: mmHgarteries:arterioles: 60-80capillaries: 20-40venules: 10-20veins: 5-10vena cava: 0-5
11Definition of TermsResistance =the opposition to flow and is a measure of the amount of friction blood encounters as it passes through vessels.Blood viscosityTotal blood vessel lengthBlood vessel diameter.
12Blood Pressure =the force per unit area exerted on a vessel wall by the blood contained within it (expressed in mm Hg).Arterial blood pressureSystolic pressureDiastolic pressurePulse pressureMean arteriole pressureCapillary blood pressureVenous blood pressure
19Maintaining BP (Long-term) Renal RegulationHigh blood pressure due to increased blood volume causes decreased reabsorption in kidneys resulting in a decrease in blood volume and a lowering of blood pressure.Renin-angiotensin II mechanism=when artery blood pressure drops, renin triggers angiotensin II production which causes vasoconstriction and increased blood pressure
20Blood flow =the volume of blood flowing through a vessel, an organ, or the entire circulation in a given period
21Blood pressure:Heart pumps blood through vessels. Blood flow is under pressure due to resistance in the systemF= PRF= blood flowP= pressureR= resistanceBlood flow is directly proportional to changes in blood pressure.Blood flow is inversely proportional to peripheral resistance.
22Systolic: Ventricles ejecting blood into the aorta Diastole:: ventricles relaxing, pressure drops in aortaDifference between the two is called pulse pressure.What is the pulse pressure on a normal BP of 120/80?40mm/Hg
23Pulse pressure is increased in conditions like arteriosclerosis. Total peripheral resistance is controlled by arterioles. BP is controlled by arterioles.
24Arteries and veins1- Tunica intima: inside layer of the vessel.in veins= valves2- Tunica media: smooth muscle is thicker in arteries and thinner in veins. Can dilate and constrict.- vasoconstriction and vasodilation3- Tunica adventitia: outer layer. Thicker in veins
28Capillaries:Extensions of the inner layer of the arteriole: endothelium (simple squamous)Continuous: skin, muscles and blood brain barrierFenestrated: openings called pores that permeable to fluid and small solutes.Found in small intestine (absorption), endocrine glands (hormone release) and kidneys (filtration of blood)Sinusoids: liver, bone marrow and spleenVery leaky.
32Vascular anatomy:Arterial:Major branches off of aorta:Aortic sinus (ascending): right and left coronary arteryArch of aorta:1- Brachiocephalic trunk which bifurcates into right subclavian a. and the right common carotid a.2- Left common carotid a.3- Left subclavian a.
34Descending aorta:Thoracic aorta lies anterior to the vertebral column and above the diaphragmBranches are: pericardial a.esophageal a.posterior intercostal a.Abdominal aorta lies below the diaphragm.Branches are: celiac a.- left gastric a.- hepatic a.- splenic a. (tortuous)
36Phrenic a.: diaphragmSuperior mesenteric a.:jejunum, ileum, cecum, ascending colon and transverse colon.Inferior mesenteric a.:descending, sigmoid colon and rectumRenal and suprarenal a.:supplies blood to the paired kidneys and adrenal glands
37Gonadal a.:Male: spermatic a. that descend through the inguinal canal to supply blood to the testes.Female: ovarian a.Middle sacral a.: long slender a. descending anterior to the lumbar vertebra and sacrum to supply blood to sacrum and coccyx.
39Abdominal aorta will bifurcate into left and right common iliac arteries. These further divide into:- internal iliac a.- external iliac a.Internal iliac a.:iliolumbar a.: ilium and back musclessuperior and inferior gluteal a.: buttocksinternal pudendal a.: external genitaliamiddle rectal a.: rectum
41External iliac a.:- main blood supply to lower limb- Between the pubis symphysis and the ASIS it becomes the femoral a.Femoral a.:- superficial circumflex iliac a.: groin- deep femoral a.: muscles of thigh and hip joint- deep geniculate a.: distal end of thighPopliteal a.: knee joint- Will bifurcate into anterior and posterior tibial a.
42Posterior a. branches into fibular a. (largest branch) Ant. tibial a. becomes dorsalis pedis a. (pedal pulse)
44Arm, head and neck.Subclavian a.:- vertebral a.: through transverseforamina into brain through foramen magnum.- becomes single basilar a. along the ventral aspect of the brainstem- basilar a. divides into two post. cerebral a.- becomes part of the Circle of Willis at base of brain
46- thyrocervical a.: thyroid and parathyroid glands pharynx and trachea. Common carotid a.: branch into internal and external carotid a.External carotid a.:- superior thyroid a.- lingual a.- facial a.- occipital a.
48Internal carotid a.:Ophthalmic a.Post. communicating a. (circle of Willis)Terminate in the anterior and middle cerebral arteries. These vessels supply blood to the motor, sensory and speech cortices of the brain.
51Arm:Subclavian a. give rise to axillary a.- humoral circumflex a.Axillary becomes brachial a. (BP)- deep brachial a. supplies tricepsAt the elbow the brachial a. divides into ulnar and radial a. (pulse).
59Clinical cornerAneurysm - a balloon-like outpocketing of an artery wall that places the artery at risk for ruptureMicroangiopathic lesion - an abnormal thickening of a capillary basement membrane due to the deposit of glycoproteinsPhlebitis - inflammation of a vein accompanied by painful throbbing and redness of the skinHypotension (low BP) and hypertension (high BP)Angiogenesis - formation of new blood vesselsClaudication - pain and lameness or limping caused by defective circulation of the blood in vessels of the limbs (Intermittant)Occlusion - the closure or obstruction of the lumen of a structure such as a blood vesselHypovolemic shock - large-scale blood loss followed by "thready" pulseWhite coat hypertension!!!