circulation through special regions 2
TRANSCRIPT
Circulation through special regions 2
Prof. Vajira Weerasinghe
Professor of Physiology
Objectives Explain the special features of the following regional
circulations with respect to their functions; A. Coronary
B. Cutaneous
C. Cerebral
D. Skeletal muscle
E. Splanchnic (including liver)
F. Renal
Cerebral circulation Brain least tolerant of organs to ischemia Lack of blood flow for 5 seconds causes loss of
consciousness Lack of blood flow for a few minutes causes
irreversible damage
Two internal carotids Two vertebral arteries
Basilar artery Forms the Circle of Willis No crossing over from R to L (because of equal
pressure) Occlusion of vessel produces ischaemia and
infarction
Circle of Willis
General Characteristics Rest: blood flow of 50-60 ml/min/100 g (750
ml/min)(in contrast Coronary: 70-80 ml/min/100g; 250ml/min)
15% of cardiac output (in contrast Coronary: 4% of CO)
Exercise: blood flow of 750 ml/min Greatest flow goes to grey matter (100 ml/min/100 g) 35% O2 extraction at rest
Circulation is enclosed in a rigid skull Constant volume Brain tissue is incompressible Brain “floats” in a water bath of cerebrospinal fluid High capillary density (3000 - 4000/mm2) Large surface area, short diffusion distances Blood-brain barrier - tight junctions between
endothelial cells prevents circulating vasoactive substances from affecting cerebral blood flow
Local Flow Constant cerebral blood flow is maintained
under varying conditions Factors affecting the total cerebral blood flow
Arterial pressure at brain level Venous pressure at brain level Intracranial pressure Viscosity of blood Degree of active contraction/dilatation of cerebral
arterioles which is controlled by local vasodilator metabolites
Intracranial pressure (ICP) Since the brain is enclosed within the skull the volume of blood,
brain and CSF should remain constant (Monro-Kellie hypothesis)
ICP is normally 0-10 mmHg Whenever ICP increases, cerebral vessels are compressed Change in venous pressure cause a similar change in ICP Rise in venous pressure decreases CBF by compressing the
vessels thereby decreasing perfusion pressure
Autoregulation Pronounced autoregulatory capacity from 50 -
170 mmHg Both myogenic and metabolic mechanisms
involved Sympathetic nervous system activity can shift
the curve to the right