生理学——血管生理ppt课件

1、左左Blood distribution Volume （）systemic83% Arteries 11% capillary5%-10% veins60%-70%pulmonary12%Heart5%泊肃叶定律 Poiseuilles lawQ=r48L(P1P2)LrP1P2 单位时间液体的流量 Q 与管道两端的压力差 P1P2 以及管道半径r的4次方成正比，与管道的长度 L 成反比。Q=Kr4L(P1P2)血流量 容积速度ml/min L/minQ = P/ RP1P2Q = P/ RQ:心输出量R:总外周阻力P:PAP右心房Q = PA/ RQ:5000ml/min自动脉：20cm/

2、s毛细血管：0.03cm/s层流: 液体每个质点的流动方向都一致，与血管的长轴平行；但各层质点的流速不一样。湍流 每个质点的流动方向不一致。Re=VD轴流轴流 axial flow 温度温度血液粘滞度血液粘滞度 微动脉直径0.20.3mm 血管口径 血液粘滞度Fahraeus-Lindqvist效应外周阻力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 体循环平均充盈压：mean circulatory filling pressure) 构成血压的根本要素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. 下降下降动脉脉搏arterial pulse： 在每个心动周期中，随着心脏的舒缩活动，动脉内的压力和容积发生周期性变化而导致动脉管壁发生周期性动摇，称动脉脉搏。它是以波的方式沿血管壁传布的，称脉搏波。 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.动脉脉搏是由左心室射血引起的自动脉 35m/s大动脉 710m/s小动脉 1535m/s3.动脉脉搏的传播速度直立不动 90mmHg步行 25mmHg运动

7、回心血量添加数升运动后的整理活动 吸气时 胸膜腔负压 回右心血量 右心输出量 肺血管容积 肺贮留血 回左心血量 左心输出量 呼气时迂回通路交换通路营养通路直捷通路thoroughfarechannel动静脉短路arteriovenousshunt3040mmHg1015mmHg动脉端静脉端V= Q / S0.30.7mm/s阿提洛尔Norepinephrine1 adrenergic receptorG Adenyl cyclaseCa2+ATPcAMPSarcoplasmic reticulumCa2+thresholdpotentialabNa+IfCa2+acetylcholine M

8、receptorG Adenyl cyclaseCa2+ATPcAMPSarcoplasmic reticulumCa2+Ca2+K+最大复极电位最大复极电位thresholdpotentialK+IK-AChCa2+AChK+AChCa2+Otto Loewi, 1873-1961, Germany 奥托奥托 洛伊洛伊, 德裔美籍药理学家德裔美籍药理学家 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舒张parasympatheticvasodilator fiberAChM脑、唾液腺、脑、唾液腺、胃肠道的外分泌腺、胃肠道的外分泌腺、外生殖器等外生殖器等舒张舒张轴突反射 axon reflex降钙素基因相关肽 calcitonin gene-related peptide CGRP汗腺颌下腺交感神经元交感神经元副交感神经元副交感神经元ACh

13、血管活性肠肽vasoactive intestinal polypeptide,VIP颈动脉窦压力感受性反射肾上腺素 心率 传导收缩力心脏(1)心输出量血管皮肤 腹腔内脏血管()收缩骨骼肌 肝脏血管(2)舒张外周阻力变化不大去甲肾上腺素血管平滑肌()收缩外周阻力norepinephrinearterial blood pressure heart ratenorepinephrine血浆晶体浸透压下丘脑浸透压感受器下丘脑视上核室旁核 VP(ADH)血压血容量低氧损伤性刺激BP肾远曲小管集合管水重吸收尿量 肾脏调理肾体液控制系统细胞外液量血量血压VP 肾素血管紧张素醛固酮系统 肾排水、排钠血管收

14、缩 细胞外液量血压1998年诺贝尔生理年诺贝尔生理学或医学奖主角学或医学奖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奖评选委员会在Karolinska学院宣布1998年诺贝尔生理学或医学奖同时授予Robert F Furchgott，Louis J Ignarro和Ferid Murad ($978,000)获奖题目：Nitric oxide as a signaling molecule in thecardiovascular system1998年年诺贝尔生理学或医学奖诺贝尔生理

15、学或医学奖The 1998 Nobel Prize in Physiology or MedicineDepartment of Physiology, The University of Hong KongLouis J. Louis J. IgnarroIgnarroFeridFerid MuradMuradRobert F. Robert F. FurchgottFurchgott诺贝尔生理学或医学奖诺贝尔生理学或医学奖Nobel Prize in Physiology or Medicine“sandwich experiment done by Furchgott动脉血压调理神经调理

16、体液调理肾体液控制系统快速、短期调理调理阻力血管口径，心脏活动长期调理调理细胞外液量动脉血压调理血压的快速、短期调理减压反射等血压的长期调理肾脏调理RASADH心房钠尿肽n等容收缩期n射血期n舒张期n 舒张压n 舒张期长短n体外反搏动安装：n在舒张期定时定量地压迫下肢，添加外周阻力和舒张压，以添加冠脉血流量。 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