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Venous system Tom Horváth M.D. Ph.D.

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Page 1: Venous systemVenous system Tom Horváth M.D. Ph.D. Topics 1.Structural aspects 2.Hemodynamic functions 3.Pressure-diameter behavior 4.Central venous pressure & vascular function The

Venoussystem

TomHorváthM.D.Ph.D.

Page 2: Venous systemVenous system Tom Horváth M.D. Ph.D. Topics 1.Structural aspects 2.Hemodynamic functions 3.Pressure-diameter behavior 4.Central venous pressure & vascular function The

Topics

1. Structuralaspects2. Hemodynamicfunctions3. Pressure-diameterbehavior4. Centralvenouspressure&vascularfunction

Page 3: Venous systemVenous system Tom Horváth M.D. Ph.D. Topics 1.Structural aspects 2.Hemodynamic functions 3.Pressure-diameter behavior 4.Central venous pressure & vascular function The

Thecirculatorysystem

pulmonaryveins

systemicveins

Page 4: Venous systemVenous system Tom Horváth M.D. Ph.D. Topics 1.Structural aspects 2.Hemodynamic functions 3.Pressure-diameter behavior 4.Central venous pressure & vascular function The

Pressuredistribution

Page 5: Venous systemVenous system Tom Horváth M.D. Ph.D. Topics 1.Structural aspects 2.Hemodynamic functions 3.Pressure-diameter behavior 4.Central venous pressure & vascular function The

Distribution of total blood volume

veins64

arteries13

pulmonarycirculation

9

capillaries7

heart7

Totalbloodvolume~5.5Liter

Venousbloodvolume~3.52Liter

Page 6: Venous systemVenous system Tom Horváth M.D. Ph.D. Topics 1.Structural aspects 2.Hemodynamic functions 3.Pressure-diameter behavior 4.Central venous pressure & vascular function The

Hemodynamicfunctionsoftheveins

• Conduitfunction– channelbloodtowardtheheart

• Flowrectification(anti-gravitationalfunctions)– venousvalves– musclepump– abdominalpump

• Capacityfunction– bloodstorage(60-70%)

• spleen~150ml• liver~200-300ml• abdominallargeveins~300ml

Page 7: Venous systemVenous system Tom Horváth M.D. Ph.D. Topics 1.Structural aspects 2.Hemodynamic functions 3.Pressure-diameter behavior 4.Central venous pressure & vascular function The

Structuralaspects– arteriesvs.veins

Page 8: Venous systemVenous system Tom Horváth M.D. Ph.D. Topics 1.Structural aspects 2.Hemodynamic functions 3.Pressure-diameter behavior 4.Central venous pressure & vascular function The

Structuralaspects– arteriesvs.veinsII.

Page 9: Venous systemVenous system Tom Horváth M.D. Ph.D. Topics 1.Structural aspects 2.Hemodynamic functions 3.Pressure-diameter behavior 4.Central venous pressure & vascular function The

Arteriesandveinsunderpressure

COMPLIANCE:DV/DP

DISTENSIBILITY:DV/(DP× V0)

Page 10: Venous systemVenous system Tom Horváth M.D. Ph.D. Topics 1.Structural aspects 2.Hemodynamic functions 3.Pressure-diameter behavior 4.Central venous pressure & vascular function The

Flowrectification– valves– I.

Page 11: Venous systemVenous system Tom Horváth M.D. Ph.D. Topics 1.Structural aspects 2.Hemodynamic functions 3.Pressure-diameter behavior 4.Central venous pressure & vascular function The

Flowrectification– musclepump– II.

Page 12: Venous systemVenous system Tom Horváth M.D. Ph.D. Topics 1.Structural aspects 2.Hemodynamic functions 3.Pressure-diameter behavior 4.Central venous pressure & vascular function The

Flowrectification– thoraco-abdominalpump– III.

INSPIRATIONbloodflowsrapidlytowardthechest

EXPIRATIONbloodflowsslowstowardthechest

Page 13: Venous systemVenous system Tom Horváth M.D. Ph.D. Topics 1.Structural aspects 2.Hemodynamic functions 3.Pressure-diameter behavior 4.Central venous pressure & vascular function The

Centralvenouspressure

• Visafronte(fromthefront~RA)

• Visatergo(fromtheback~LV)

Page 14: Venous systemVenous system Tom Horváth M.D. Ph.D. Topics 1.Structural aspects 2.Hemodynamic functions 3.Pressure-diameter behavior 4.Central venous pressure & vascular function The

ThevascularfunctioncurveI.

Page 15: Venous systemVenous system Tom Horváth M.D. Ph.D. Topics 1.Structural aspects 2.Hemodynamic functions 3.Pressure-diameter behavior 4.Central venous pressure & vascular function The

Conceptof“deadpressure”a.k.a.meancirculatorypressure

• Q=5l/min• Pa =102mmHg• Pv =2mmHg• Ph =Pa - Pv =100mmHg• TPR=Ph/Q=20mmHgmin/l• C=DV/DP• Ca/Cv =1/19

Page 16: Venous systemVenous system Tom Horváth M.D. Ph.D. Topics 1.Structural aspects 2.Hemodynamic functions 3.Pressure-diameter behavior 4.Central venous pressure & vascular function The

ThevascularfunctioncurveII.

Page 17: Venous systemVenous system Tom Horváth M.D. Ph.D. Topics 1.Structural aspects 2.Hemodynamic functions 3.Pressure-diameter behavior 4.Central venous pressure & vascular function The

ThevascularfunctioncurveIII.