Heart 4

Physiology of cardiovascular system IV
Circulation through special regions
Parameters of regional blood supply in resting

conditions
Oxygen
Organ or Intensity of Oxygen
extraction from
tissue blood supply consumption
(ml/min/100g) mlO2/min/100g the blood
%
Skeletal
2.7 0.18 34
muscle
Cardiac
87 11.0 65
muscle
Brain 54 3.7 34
Skin 13 0.38 15
Kidney 420 6.8 8
2
Regional blood flow
Coronary blood vessels
4
Pulsation of coronary flow (one beat)
5
Coronary circulation
• More intense oxygen consumption ( 8 – 10 ml O2/min . 100 g ) and high ability
to extract oxygen( Arterio-venous difference; A-V difference can reach) 13 -16 ml
O2/ 100 ml blood (100 ml arterial blood contains 20 ml O2) .
• Myogenic blood flow stabilization uncouples coronary flow from the mean
arterial pressure from 60- 200 mm Hg.
• Active hyperemia (coronary blood supply meet the demands of oxygen use)
produced by local vasodilatatory substances :Adenosine, ATP, NO.
• Activation of sympathetic nervous system:

– short vasoconstriction (adrenergic α1 – reception), with a following
– pronounced vasodilatation, because β2 activation causes positive inotropic
effect, what can increase release of vasodilatatory metabolites.
.
• Activation of parasympathetic nervous system initiates direct cholinergic
vasodilatation, though it is limited by decreased concentration of
vasodilatatory metabolites during reduced activity.
6
Cerebral blood flow
• Cerebral blood supply is very intensive (35 – 55 ml blood / min . 100 g) because
of high metabolic rate . (Oxygen consumption is 20% of total use.
• Pronounced regional variations of blood flow – depending on local metabolic

activity; main metabolic vasodilators : ATP, lactate, NO
• Total blood supply :

– Myogenic autostabilization of the flow – independently from mean arterial
pressure;
– depends on pH, pO2 and pCO2.
7
Independence of cerebral blood flow from arterial pressure and
dependence of cerebral blood flow from pCO2 and pO2 in arterial
blood
100
8
9
Positron emission tomography (PET)
• Nuclear medicine imaging technique which produces a three-dimensional

image or map of functional processes in the body. The system detects pairs of
gamma rays emitted indirectly by a positron-emitting radionuclide (tracer),
which is introduced into the body on a biologically active molecule. Images of
tracer concentration in 3-dimensional space within the body are then
reconstructed by computer analysis.
10
Skeletal muscle blood flow
• Capillarization of skeletal muscle depends on number of slow aerobic fibers

and physical training
• 20 % of Total peripheral resistance of the body are produced by skeletal

muscle blood vessels.
• Skeletal muscle blood flow may vary from 1- 4 ml/min.kg to 50 – 100 ml/min.kg;
Active and reactive hyperemia are produced by vasodilatatory metabolites
• At rest, arterioles of skeletal muscle exhibit substantial contractile tone, partly

due to the weak sympathetic efferentation (α1 un α2 – reception) .
• Increased activity of sympathetic nervous system (stress situations) activates

B2 – adrenoreceptors, what cause sympathetic vasodilatation
11
Active and reactive hyperemia in skeletal muscle
Active hyperemia Reactive hyperemia
Muscle contractions Time (s)
12
PET Transaxial image of muscle
Blood flow in muscle,

ml/min.100 g
Static exercise
Dynamic exercise
Muscle blood flow during static and dynamic exercise
13
Skin
Epiderma
Derma
14
Cutaneous blood flow
• During daily activity , cutaneous blood vessels exhibit substantial contractile

tone due to the high sympathetic efferentation.
• To increase heat conduction from the body to surrounding, so called “active

vasodilatation” in the glabrous skin can dilate arterioles and precappilary
sphincters (sympathetic cholinergic dilatation)
• Local responses are caused by local signals (paracrine) (cytokines,

inflammatory factors, Calcitonin gene related peptide (CGRP), substance P,
NO)
• The reason for local response could be secretion of norepinephrine from

sensory nerve endings (axon reflex)
15
Cutaneous blood and lymphatic vessels
Arterial cappilaries – red,

venous cappilaries – blue.
Lymphatic vessels – yellow.
Skobe M., Detmar M.

16 vessels.
Structure and function of cutaneous blood
Journal of Investigative Dermatology, 2000
Reactions of cutaneous blood vessels
Systemic reflectory responses Local responses respond

(thermoregulation of the body) to the local temperature changes
Type C sensory Sympathetic

afferent fiber adrenergic fiber
to
to
Acetilcholine + CGRP, NO
norepinephrine substance P
cotransmitters NA
α1, α2
NO ?
early phase Late phase
Sympathetic
Sympathetic cholinergic Local vasodilatation Local adrenergic
adrenergic
vasodilatation vasoconstriction
vasoconstriction
(only glabrous skin)
17
Renal blood flow
• Kidneys is richly supplied with blood for nutritive function and to provide
adequate filtration rate.
• The total renal blood flow is independent from mean arterial pressure.
• Provided by flow Autoregulation mechanisms:
1) myogenic autoregulation , when pressure is increased the walls of

afferent arterioles constrict.
2) paracrine mechanism, when pressure is decreased JGA cells secrete
renin, which produces AT II, that
constricts efferent arteriole.
18
Structure of kidney
19
Formation of urine
20
Hidrostatic pressure in nephrone and
blood vessels
Proximal tubul
18 mm Hg st.
Eferent arteriole 18 mm Hg st.
21
Miogenic and paracrine regulation provides:
blood flow in renal artery,
pressure in glomerulus,
filtration rate of primary urine
independent from arterial pressure
50 100 150
Arterial pressure mmHg
22
a
Myogenic
regulation of
renal arterioles
Perfusion (arterial) pressure
a) 80 mmHg
b) 180 mm Hg
b
23
Structure of JGA
24
Structure of JGA
(glomerulus)
Macula densa
Distal tubule
25
Flow autostabilization
26
Skin blood flow measurement technique
Our technique of venous occlusion plethysmography depends upon

occluding the venous outflow of the forearm briefly
and recording the increase in circumference that follows
as the incoming blood causes the forearm to swell slightly.
Of course this measures the flow in all the vasculatures
of the forearm, but it is only the cutaneous vasculature
that is influenced by these thermal reflexes.
Consequently, the changes in forearm blood flow (FBF)
that occur in response to thermal stimuli, can be interpreted
as due to changes in skin blood flow. 27

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Physiology of cardiovascular system IV

Circulation through special regions

Parameters of regional blood supply in resting

Kidney 420 6.8 8

• Activation of sympathetic nervous system:

• Pronounced regional variations of blood flow – depending on local metabolic

• Total blood supply :

• Nuclear medicine imaging technique which produces a three-dimensional

• Capillarization of skeletal muscle depends on number of slow aerobic fibers

• 20 % of Total peripheral resistance of the body are produced by skeletal

• At rest, arterioles of skeletal muscle exhibit substantial contractile tone, partly

• Increased activity of sympathetic nervous system (stress situations) activates

Active hyperemia Reactive hyperemia

Muscle contractions Time (s)

Blood flow in muscle,

Muscle blood flow during static and dynamic exercise

• During daily activity , cutaneous blood vessels exhibit substantial contractile

• To increase heat conduction from the body to surrounding, so called “active

• Local responses are caused by local signals (paracrine) (cytokines,

• The reason for local response could be secretion of norepinephrine from

Arterial cappilaries – red,

Lymphatic vessels – yellow.

Skobe M., Detmar M.

Systemic reflectory responses Local responses respond

Type C sensory Sympathetic

early phase Late phase

1) myogenic autoregulation , when pressure is increased the walls of

Eferent arteriole 18 mm Hg st.

Our technique of venous occlusion plethysmography depends upon

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