名校生理学血液循环

1、. CHAPTER4CIRCULATI血液循环，prof.wngtinghuadipartmentofphysiology，SECTION3VASCULARPHYSIOLOGY血管生理，动脉、毛细血管、静脉弹性储存血管：大动脉和大动脉分配血管：中动脉阻力血管：小动脉和微小容量血管. functinfornationalpropertiesofdifferentbloodvessels不同血管的功能特征1.Artery:动脉a.aortandalargeartery (windkessell )大动脉和大动脉， pressurereservoir压力贮藏所mintatinhencontinvid

2、itionalbloodfluidinthearterysystem .动脉系统内的连续血流lowresresresiancesvessel低电阻血管tran 维持aratusofthegloblebody向全身各器官输送血液，b.middle artery : caryblodtoarterioles (distribution vessel )中动脉：向小动脉输送血液，分配血管。 c.smallateryandarteroleresistanvessels小动脉和微动脉阻力血管smarterindartileorethemainstorationoforsolegrationanblood

3、flowandttheredistributi ratus.thediriteterofrestermencevesselsarereatedbyneurohormonalfactors .小动脉和微动脉是生物调节器官的血流量和器官之间血液再分配的主要部位，其血管口径由神经体液因子调节。 2.capillary vessels : exchange vessels毛细血管：血管bloodflowfromarterioletobenulesbypassingcapillarytocarrorythehenagesofbustinstanst ，Precapillarysphincter毛细血管前

4、括约肌function : controlofinflowofcapillaries作用：控制毛细血管的流入量。 A-Vshunt(anastomosis )动静脉短路(吻合) function:bloodflowsdirectlyfromarteriolethrougha-vs hunt .作用：血液通过动静脉吻合从微动脉直接到达微静脉。3 .静脉血管(容量血管) Largevein、venacava、venule、veinule大静脉、静脉、小静脉微静脉Bloodreservoir血液贮藏库(6070 ) Bigcompliance柔量大Lowmeanvenouspressure平均静脉压

5、(2mmHg)Venousvalve静脉瓣、Hemodynamics血流动态blood flow resistantofbloodflowandpressure血流量， 血流阻力和血压1.blood flow : bloodvvolmepsasingventithchardiovascularsystemperunittime (ml/s ) .血流量：单位时间流过有血管的横截面的血流量(ml/s )。P1-P2A.Q=RQ:bloodflow (血流量) p1-p2:thedpoffeewovesselsends (血管两端压力差) R:resistanceofbloodflow (血流阻力

6、) b.poiseulleslalworlaminarflowppr 4f=抵抗力8LL:血管长：血液粘度rveinule :血管半径，themodofbloodflowingrinthebloodvesselscannebeclassifitolamin 经验公式Reynoldsnumber-Reynold数：NR=DV/(rho ) :densityoffluid液体密度D:diameterofthetube管径V:velocityofflow流速NR2000LaminarflowTurbulentflow层流湍流laminarflowturbulentflow层流湍流th cthefor

7、lowdireferentflowdiredireferentworldiredireferentworldiredirefren tefulenergymore能量消耗少，能量消耗多， poiseulleslaforlaminarflowconformstolaminarflowbuturbulentflow thebloodflowisnotindirectproportitothebpooe 对于湍流，泊叶定律不再适用，血流量不是与血管两端的压力差成比例，而是与压力差的平方根成比例。 2.Resistancetobloodflow:血流阻力p1- p 28lf=r=RR4rrrrrres

8、resiancescomesfromexternalfriction (l， r )内部摩擦().tottalperiferrallerresanceisminitedyarieteroles (6070 % ) .电阻来自外摩擦(l，r )和内摩擦(l，r )，60 %的总外周电阻主要是， thebloodflowoorageonisterdmyenterdmyentityalloldpressureandbloodresistance.thedireteropoteriosteristedmingfortoregethedistr 器官血流量的量主要是平均动脉小动脉和微小动脉口径的变化，是

9、调节器官血流量和器官之间血液再分配的最主要因素。 Bloodpressure血压tworequirementsforbloodpressurormation :血压形成的两个条件： a.bloodfillingincardiovascularsystem心血管系统血液充盈meanciculatoryfi ume=7mmHgvascularvolume血液容量循环系统的平均充满压=7mmHg血管容量B.Cardiacejection心脏出血kinetic energy:puhthebloodttoffrortcontictioneneegesispotin expandcardiacrelaxa

10、tion:largearterryelast cityrecoverypentagepotentialenergykinetienergy : pushbloolddtocontinuouslyflowforw 动能：推进血液流动的心脏收缩放出能量：血管壁扩张心脏扩张：主动脉弹性收缩部分能量：推进血液流动. ArterialBloodPressure动脉血压， 1 .正常值normlvaluemmhgkpasystolickpressure收缩压10012013.316DiastolicPressure扩展压6080810PulsePressure脉压30404.05.3MAP平均动脉压304

11、04.05.3MAP 3(pulseP )， a.dnfluctuationrulesofbloodpressure血压昼夜波动，双峰双谷(日节律) . Lowestat2to3oclockinthemorning上午23点最低OnePeakduring6to10inthemorning上午610点高anotherpeakduring4to8in the afternoon下午48点高lowingdownafte 晚上8点缓慢下降，b .诊断高血压的诊断标准，cataloguespdpnormal 12090 pro phase 12013980891 ST phase 1409099292

12、nd phase 16010 282828289660 (doi 10.1001/JAMA.289.19 .2560 .高血压分类收缩期扩张压(mmHg)(mmHg )正常120和90高血压前期120139或80891期高血压140159或90992期高血压160 c.pressureofffferentvesselsofsystemcirculation体循环不同血管的血压、平均压(mmHg )大动脉100动脉(3mm)95动脉起始端85动脉起始端55毛细血管起始端30， falloffbloodpressuridectricreportiontotheresistanceofbloodfl

13、ow， andthebpdeceressessignaticalintityterinterinterforthepbedecessessintitionthe， d.arterialpressurecurveesrecordedromdifferentsitesofsystemiccirculation (dog )体循环不同部位的血压波波形， archlowerasbdomeniliackneeankle主动脉弓下腹部髂骨部膝踝部ascendingbranchonsetslater上升支开始延迟waveshapesharper波形变窄amplitudehigher振幅变高reentrywa

14、v 2.determinternationstapporterialbloodpressure动脉血压的决定因素A.arterialbloodvolume动脉血容量itisdeterminedbyejectvolumeandperipherralresista ， B.arterialcompliance动脉柔量=v/pinnormalcondition andchangethebloodejectedintoarterialtocontinuousbloodflow .正常时. ifweasspumethatartilitallcomponeremenscontarteralloldpres

15、surewilldepenarterialblodvolumeandvascularbolume .动脉顺应性BloodvolumeBPvascularvolume，arterialblodvolumedeterminedtyheofflowandoutflowofatersystem .动脉血容量依赖于动脉系统的流入量和流出量。Rateofinflow:cardiacoutput流入量：心率出量rateofoutflow : resiancesandbp流出量：血流阻力和动脉血压3.factritionsaffectsingarterlivepressure影响动脉血压心率B.heartrate心率C.peripheralresistance外周阻力d.clecolllationaceofandlargartery对大动脉和大动脉的柔量E.circu latorybloodflow循环血量、动脉血压有影响脉压、备注、心率(40180次/分钟)、 all the above-mentiondforsoffinlencingbsisdeducedwhenassumingotherinfluencefactorkeepingstable.actually thefluctutionsofbpunde isalways