Blood flow and it’s

measurement
 CARDIAC OUTPUT

 Amount of blood ejected from the ventricles per

minute
 Measure of the pumping ability of the heart
 Cardiac Output = Cardiac Rate X Stroke volume
(beats/min) (ml/beat)
 Average resting cardiac output:
 5.6 L/min for human male, 4.9 L/min for a female
 STROKE VOLUME
 The amount of blood ejected from the ventricles is
about 2/3 of the volume prior to contraction,
referred to as Stroke Volume
 SV=EDV-ESV
 Volume of blood pumped from one ventricle of the
heart with each beat
 Stroke volume is regulated by three parameters:
 End Diastolic Volume (EDV)
 Contractibility
 Total peripheral resistance, R  P
Q
 Stroke volume is directly proportional to EDV, since an
increase in volume of blood in ventricles prior to
contraction results in an increase in ejection volume.

 Stroke volume is also directly proportional to

contractibility, since a more forceful ejection results in a
more complete emptying of the ventricles.

 Total peripheral resistance is inversely proportional to

Stroke Volume, since higher resistance or increase in
arteriole pressure results in less blood entering the aorta.
 Regulation of Blood Flow

 Constriction and dilation of blood vessel regulates blood flow

to tissues and cells.
 Sympathetic nerve stimulation causes vaso-constriction in
viscera and skin and vaso-dilation in skeletal muscle.
 Myogenic regulation in cerebral artery causes dilation of
vessels in response to a decrease in blood pressure and
vice-versa.
 Metabolic regulation in skeletal and cardiac muscle vessel
promotes vaso-dilation based on local conditions such as O 2
and CO2 concentrations, tissue pH and the release of
Adinosine.
 Factors which promote blood flow:
 Pumping action of heart
 Skeletal muscle pump
 Respiratory activity
Factors which impede blood flow:
1. Endothelium
2. Atherosclerotic plaque
3. Muscle spasm
4. High blood pressure
5. Branching of blood vessels
6. Polycythemia
 Regulation in Blood Pressure
 Blood pressure is regulated by changes in cardiac
rate, blood volume and total peripheral resistance, all
of which are controlled by Sympatho-adrenal system.
 If cardiac output falls for some reason, peripheral
vasoconstriction can maintain arterial pressure by
keeping blood in the arterial system.
 On the other hand, cardiac output can increase three
to fourfold (as in exercise) and MAP may not increase
at all because peripheral vasodilation occurs, so that
TPR falls to one third to one fourth of pre-exercise
levels.
RENIN-ANGIOTENSIN SYSTEM
 RENIN-ANGIOTENSIN
Mechanism
 When blood volume is low, the kidneys secrete renin.
 Renin stimulates the production of angiotensin which
causes blood vessels to constrict, resulting in increased
blood pressure.
 Angiotensin also stimulates the secretion of the hormone
aldosterone from the adrenal cortex which causes the
tubules of the kidneys to increase the re-absorption of
sodium and water.
 This increases the volume of fluid in the body, which also
increases blood pressure.
 Measurement of Heart Activity
 Cardiac rate and heart sounds are simplest
measurement of heart activity.
 The pulse can be measured using finger and a
watch.
 Stethoscope can be used to hear sounds
associated with the opening and closing of the
semi-lunar and atrio-ventricular valves.
 ECG can be used to measure the electrical
signals associated with motions of the heart.
Synus Rhythm
 ECG

 The shape of the ECG can be used to

determine forcefulness of ventricular ejection.
 During QRS wave, the ventricle contracts to
eject blood to the aorta.
 A malformed QRS wave indicates abnormality
in ventricles. e.g. unusually large ventricles
will produce a stronger ejection force and
resulting enlarged R spike.
 This information can be used to infer blood
pressure and thus provides some information
on flow of blood.
 Blood Pressure (BP)
 BP levels in various chambers of heart and
arteries indicates the health of cardio-
vascular system.
 Measurement:
 direct (invasive)
 indirect (non-invasive)
 Non-invasive measurement of BP
 Auscultatory methods
 With the use of stethoscope and
sphygmomanometer:
 The systolic pressure sounds are produced by turbulent
flow through the partially constricted vibrating artery

 Oscillometric methods
 Similar to auscultatory method, but with a
pressure sensor and electronic display
 Invasive measurement of BP
(Direct measurement)
 Arterial BP is most accurately measured invasively
through an arterial line.
 Done by placing an intravascular cannula needle in an artery
(usually brachial, radial, femoral or dorsalis pedis).

 The cannula must be connected to a sterile, fluid-

filled system, which is connected to an electronic
pressure transducer.

 The advantage of this system is that pressure is

constantly monitored beat-by-beat, and a waveform
(a graph of pressure against time) can be displayed.
 Invasive ..
 For invasive measurement of BP, BP sensor systems are
divided into two categories, depending on where the
sensor is placed:

 Extra-vascular sensors: measure pressure to an

external sensor via a liquid filled catheter

 Intra-vascular sensors: incorporate a sensor into the

tip of a catheter inserted into the vascular system
 Measurement of BLOOD FLOW
1. INDICATOR DILUTION METHOD
2. ELECTROMAGNETIC FLOW METERS
3. ULTRASONIC FLOW METERS
 INDICATOR DILUTION METHOD
 An indicator is inserted into the blood flow and the
rate at which 1 liter is carried downstream is
measured.
 Colored dyes and cold saline are common
indicators.
 A known amount of dye (or salt) per unit time is
added to a flow stream. After complete mixing,
the concentration is measured. The dilution rate
equals the flow rate.
 Types: continuous infusion, rapid injection
 ELECTROMAGNETIC FLOW METERS
 Inductional instrument designed by Faraday's law of eletromagnetic
induction to measure inner-tube conductive media's flow of volume
 Faraday's Law states that the voltage induced across any conductor
as it moves at right angles through a magnetic field is proportional
to the velocity of that conductor.
 Faraday's Formula: E is proportional to v x B x L
(E = The voltage generated in a conductor, v = The velocity of the
conductor, B = The magnetic field strength, L = The length of the
conductor)
# A magnetic field is applied to the metering tube, which results in
a potential difference proportional to the flow velocity perpendicular
to the flux lines
 ULTRASONIC FLOW METERS

 Non intrusive device that

measure volumetric flow
 Measures the velocity of any
liquid or gas through a pipe
using ultrasonic transducers
 Affected by temp, density and
viscosity of flowing medium
 Types:
 Transmission(transit time)

 Reflection (Doppler)

 Open-channel flow meters

Transit time
 A pair of transducers, each having its own transmitter
and receiver, are placed on the pipe wall, one on the
upstream and the other on the downstream.
 Time of flight of an ultrasound pulse sent in the flow
direction and opposite to it is measured.
 Time difference-> avg velocity of the fluid
L L
td  , tu 
c  v cos  c  v cos 
L tu  t d
v
2 sin  tu t d
 Doppler Open Channel
 Measure the flow of liquids that
 Recent innovation are open to the atmosphere
 Use of Doppler shift that results  Level measurement (head) is
from the reflection of an ultrasonic used in combination of velocity
beam off sonically reflective measurement, and a flow
materials computer using the equation of
 Ultrasonic beam is passed through open channel flow to calculate
the tissues, bouncing it off a the flow rate
reflective plate, then reversing the  By measuring the time from
direction of the beam and repeating transmission of an ultrasonic
the measurement pulse to receipt of an echo, the
 The difference between two water level is accurately
frequencies of the transmitted measured
beams gives the measure of the
volume flow