生理學(xué)——血管生理ppt課件

1、左左Blood distribution Volume （）systemic83% Arteries 11% capillary5%-10% veins60%-70%pulmonary12%Heart5%泊肅葉定律 Poiseuilles lawQ=r48L(P1P2)LrP1P2 單位時間液體的流量 Q 與管道兩端的壓力差 P1P2 以及管道半徑r的4次方成正比，與管道的長度 L 成反比。Q=Kr4L(P1P2)血流量 容積速度ml/min L/minQ = P/ RP1P2Q = P/ RQ:心輸出量R:總外周阻力P:PAP右心房Q = PA/ RQ:5000ml/min自動脈：20cm/

2、s毛細(xì)血管：0.03cm/s層流: 液體每個質(zhì)點(diǎn)的流動方向都一致，與血管的長軸平行；但各層質(zhì)點(diǎn)的流速不一樣。湍流 每個質(zhì)點(diǎn)的流動方向不一致。Re=VD軸流軸流 axial flow 溫度溫度血液粘滯度血液粘滯度 微動脈直徑0.20.3mm 血管口徑 血液粘滯度Fahraeus-Lindqvist效應(yīng)外周阻力PeripheralresistanceThinking: Why is total arteriolar resistance higher than total capillary resistance?Arteriolar radius capillary radiusNumber o

3、f arterioles number of capillaries帕帕Pa kPammHgcmH2O1mmHg=1.36cmH2O1mmHg=0.133KPa =133Pa1Pa=1N/m2 1mmHg=1333dyn/cm2 體循環(huán)平均充盈壓：mean circulatory filling pressure) 構(gòu)成血壓的根本要素Systemic and Pulmonary MAP Systemic MAP 80 + (120-80)/3 = 93.3 mmHg (100 mmHg) Pulmonary MAP 8 + (22-8)/3 = 12.7 mmHg (15 mmHg) In 1

4、711 Hales began his studies on blood pressure. True to his mechanistic views, he carefully measured the blood pressure of three horses and produced the first recorded estimates of blood pressure. Furthermore, he studied the pulse rates of various-sized animals and measured the hearts capacity to pum

5、p blood through the pulmonary veins. Hales also studied the effects of heat, cold, and various drugs on the blood vessels and experimented with animal reflex. 下降下降動脈脈搏arterial pulse： 在每個心動周期中，隨著心臟的舒縮活動，動脈內(nèi)的壓力和容積發(fā)生周期性變化而導(dǎo)致動脈管壁發(fā)生周期性動搖，稱動脈脈搏。它是以波的方式沿血管壁傳布的，稱脈搏波。 The blood forced into the aorta during s

6、ystole not only moves the blood in the vessels forward but also sets up a pressure wave that travels along the arteries.The pressure wave expands the arterial walls as it travels ,and the expansion is palpable as the pulse.動脈脈搏是由左心室射血引起的自動脈 35m/s大動脈 710m/s小動脈 1535m/s3.動脈脈搏的傳播速度直立不動 90mmHg步行 25mmHg運(yùn)動

7、回心血量添加數(shù)升運(yùn)動后的整理活動 吸氣時 胸膜腔負(fù)壓 回右心血量 右心輸出量 肺血管容積 肺貯留血 回左心血量 左心輸出量 呼氣時迂回通路交換通路營養(yǎng)通路直捷通路thoroughfarechannel動靜脈短路arteriovenousshunt3040mmHg1015mmHg動脈端靜脈端V= Q / S0.30.7mm/s阿提洛爾Norepinephrine1 adrenergic receptorG Adenyl cyclaseCa2+ATPcAMPSarcoplasmic reticulumCa2+thresholdpotentialabNa+IfCa2+acetylcholine M

8、receptorG Adenyl cyclaseCa2+ATPcAMPSarcoplasmic reticulumCa2+Ca2+K+最大復(fù)極電位最大復(fù)極電位thresholdpotentialK+IK-AChCa2+AChK+AChCa2+Otto Loewi, 1873-1961, Germany 奧托奧托 洛伊洛伊, 德裔美籍藥理學(xué)家德裔美籍藥理學(xué)家 Sir Henry Hallett Dale 1875-1968 United Kingdom The Nobel Prize in Physiology or Medicine 1936for their discoveries rela

9、ting to chemical transmission of nerve impulsesThe night before Easter Sunday of that year I awoke, turned on the light, and jotted down a few notes on a tiny slip of thin paper. Then I felt asleep again. It occurred to me at six oclock in the morning that I had written down something most important

10、, but I was unable to decipher the scrawl. The next night, at three oclock, the idea returned. It was the design ofan experiment to determine whether or not the hypothesis of chemical transmission that I had uttered seventeen years ago was correct. I got up immediately, went to the laboratory, and p

11、erformed a simple experiment on a frog heart according to the nocturnal design. .Discovery of neurotransmittersThese results unequivocally proved that the nerves do not influence the heart directly but liberate from their terminals specific chemical substances which, in their turn, cause the well-kn

12、own modifications of the function of the heart characteristic of the stimulation of the heart.Sympatheticvasodilator fiberAChM舒張parasympatheticvasodilator fiberAChM腦、唾液腺、腦、唾液腺、胃腸道的外分泌腺、胃腸道的外分泌腺、外生殖器等外生殖器等舒張舒張軸突反射 axon reflex降鈣素基因相關(guān)肽 calcitonin gene-related peptide CGRP汗腺頜下腺交感神經(jīng)元交感神經(jīng)元副交感神經(jīng)元副交感神經(jīng)元ACh

13、血管活性腸肽vasoactive intestinal polypeptide,VIP頸動脈竇壓力感受性反射腎上腺素 心率 傳導(dǎo)收縮力心臟(1)心輸出量血管皮膚 腹腔內(nèi)臟血管()收縮骨骼肌 肝臟血管(2)舒張外周阻力變化不大去甲腎上腺素血管平滑肌()收縮外周阻力norepinephrinearterial blood pressure heart ratenorepinephrine血漿晶體浸透壓下丘腦浸透壓感受器下丘腦視上核室旁核 VP(ADH)血壓血容量低氧損傷性刺激BP腎遠(yuǎn)曲小管集合管水重吸收尿量 腎臟調(diào)理腎體液控制系統(tǒng)細(xì)胞外液量血量血壓VP 腎素血管緊張素醛固酮系統(tǒng) 腎排水、排鈉血管收

14、縮 細(xì)胞外液量血壓1998年諾貝爾生理年諾貝爾生理學(xué)或醫(yī)學(xué)獎主角學(xué)或醫(yī)學(xué)獎主角信息分子信息分子NO Nitric oxide as a signaling molecule1998年10月12日11:30 a.m. Nobel獎評選委員會在Karolinska學(xué)院宣布1998年諾貝爾生理學(xué)或醫(yī)學(xué)獎同時授予Robert F Furchgott，Louis J Ignarro和Ferid Murad ($978,000)獲獎題目：Nitric oxide as a signaling molecule in thecardiovascular system1998年年諾貝爾生理學(xué)或醫(yī)學(xué)獎諾貝爾生理

15、學(xué)或醫(yī)學(xué)獎The 1998 Nobel Prize in Physiology or MedicineDepartment of Physiology, The University of Hong KongLouis J. Louis J. IgnarroIgnarroFeridFerid MuradMuradRobert F. Robert F. FurchgottFurchgott諾貝爾生理學(xué)或醫(yī)學(xué)獎諾貝爾生理學(xué)或醫(yī)學(xué)獎Nobel Prize in Physiology or Medicine“sandwich experiment done by Furchgott動脈血壓調(diào)理神經(jīng)調(diào)理

16、體液調(diào)理腎體液控制系統(tǒng)快速、短期調(diào)理調(diào)理阻力血管口徑，心臟活動長期調(diào)理調(diào)理細(xì)胞外液量動脈血壓調(diào)理血壓的快速、短期調(diào)理減壓反射等血壓的長期調(diào)理腎臟調(diào)理RASADH心房鈉尿肽n等容收縮期n射血期n舒張期n 舒張壓n 舒張期長短n體外反搏動安裝：n在舒張期定時定量地壓迫下肢，添加外周阻力和舒張壓，以添加冠脈血流量。 o Phasic nature of CBF During systole, The myocardial vessels are compressed and tends to collapse, mainly in the left ventricle, where the intr

17、aventricular pressure reaches large values. The result is a reduced CBF, even though systemic arterial pressure is highest during this period. Systolic compressional forces are greater in the subendocardial layers than in the epicardial ones. Therefore the subendocardial layer is more prone to ischemic damage. During diastole there is a high flow to the left ventricle and this compensates for the relatively lack of flow during systole. Tachycardia reduces diastole period and consequently the CBF. Myocardial oxygen consumption (M