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CORONARY CIRCULATION
ARTERIAL SUPPLY
z Right atrium
z Major portion of right ventricle
z Interventricular septum (posterior part)
z Most of the conducting system of the heart
TWO BRANCHES
• ANTERIOR DESCENDING ARTERY
Runs in interventricular groove
• LEFT CIRCUMFLEX ARTERY
Runs in A-V groove
SUPPLY
z Whole left atrium
z Most of left ventricle.
z Interventricular septum, (anterior part).
z Small part of right ventricle near anterior interventricular septum.
z Part of left branch of bundle of his
POINTS TO REMEMBER
z Normal coronary blood flow is 250 ml /min.
z O2 consumption of myocardium at rest is 25ml/min.
z 80% coronary blood flow occurs during diastole whereas only 20% CBF
occurs during systole.
AORTA LV RV LV RV
SYSTOLE 120 122 25 -1 95
DIASTOLE 80 0 0 80 80
NOTE
1. Pressure difference between aorta and left ventricle is very small during systole,
therefore there is no blood flow in subendocardial portion of LV during systole.
2. 80% blood flow occurs during diastole
3. Subendocardial portion of LV is prone to MI.
4. All conditions that leads to high LV pressure leads to more chances of MI, as
coronary perfusion is severely compressed during systole.
5. CCF, increase in venous pressure? Decrease aortic diastolic pressure, effective
coronary perfusion pressure decreases.
CHEMICAL FACTORS
NEURAL FACTORS
• Alpha- adrenergic receptors----vasoconstriction
• Beta- adrenergic receptors----vasodilatation
CEREBRAL CIRCULATION
BLOOD SUPPLY
Arterial supply
z Clear, colorless
z Specific gravity 1005- 1008
z Protein – 20-30 mg%
z Lymphocytes – 0-4
z Glucose less than plasma
z Volume 150 ml
z Normal CSF pressure 130 mm Hg H2O
CSF PLASMA
Na 146 150
K 3.0 4.6
Ca 2.2 4.7
HCO3 25 24.8
CSF is formed by choroid plexus in ventricles and blood vessels of meningeal and
ependymeal lining of ventricles. Absorbed by arachnoid villi into dural sinuses and
spinal veins.
LATERAL VENTRCILES
↓ FORAMEN OF MONRO
THIRD VENTRICLE
↓ AQUDUCT OF SYLVIUS
CISTERNA MAGNA
↓
SUBARACHNOID SPACE
FUNCTIONS OF CSF
• Supports the delicate brain.
• Acts as buffer.
• Removal of waste product from brain.
FUNCTION OF BBB
NOTE
z Highly permeable to water, O2,CO2 SULPHA DRUGS
z Slightly permeable to H, Na, K HCO3 Mg
z Impermeable to gold, urea, bile salts
NOTE
Four areas where substances in the blood can act and cause changes in brain
functions without entering BBB are :
1. The posterior pituitary
2. The area postrema
3. The organosum vasculosum
4. Subfornical organs
PULMONARY CIRCULATION
FEATURES
It consists of
1. Pulmonary trunk
2. Pulmonary arterioles
3. Pulmonary capillaries
4. Pulmonary venules and veins
Pulmonary trunk
Divided into
Right pulmonary artery
Left pulmonary artery
Pulmonary arterioles
Pulmonary artery is
1. Very distensible
2. Low pressure system
3. Resistance to blood flow is low. Therefore work done by right ventricle to
pump blood is less than that of left ventricle.
Nerve supply
Vascular Reflexes
HYPOXIA
SPLANCHNIC CIRCULATION
Drainage of blood from liver, GIT, spleen and pancreas. The blood from GIT, spleen
and pancreas drains via portal veins to the liver (Portal circulation) and from the
liver via hepatic veins to the inferior vena cava.
INTESTINAL CIRCULATION
HEPATIC CIRCULATION
80% of blood supply to the liver is through the portal vein.
20% of blood supply to the liver is through the hepatic artery.
NERVE SUPPLY
Innervated by vasoconstrictor sympathetic nerves.
Fall in Arterial BP
↓
Stimulation of sympathetic nerves
↓
Constriction of hepatic, mesenteric arterioles and venules
↓
Capacitance vessels constricts
↓
Blood flow is directed towards the heart