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00:08 | Alright, good morning. Here we . Nice cold day here in H |
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00:15 | . I know it's not like cold but this Houston, we've been talking |
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00:23 | parts of the cardiovascular system. We with the blood and we said what |
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00:28 | was made up of. Then we onto the pump that pumps the |
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00:33 | And so we talked about the heart all its parts and how it |
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00:37 | And today we're going to actually deal the vasculature finally. Alright. And |
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00:41 | already learned the names of these But we're gonna do we're gonna dive |
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00:45 | deep and actually understand what they right? And then we're going to |
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00:51 | from structure to dealing with blood flow blood pressure. Now, if you're |
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00:58 | aware, I think you all are you're all smart is in a |
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01:02 | We have what an exam. Oh goodness. Yeah. A week from |
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01:08 | . We have an exam. If haven't signed up, you're probably gonna |
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01:11 | stuck with a crappy time. I know if it's a crappy time, |
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01:15 | for some people it might be so sure you've signed up. Uh just |
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01:21 | that you know, um I need put this on blackboard uh casa has |
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01:27 | new makeup policy and um it's not clear how it works to me, |
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01:32 | it's very limited on how they're going allow makeup. So if you are |
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01:37 | , understand your window for making up is going to be a little bit |
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01:41 | than it has previously. All So just letting you know I'll post |
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01:45 | on blackboard that's not gonna affect like of you. But someone's gonna be |
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01:51 | got the I got the covid that can't covid and the answer is |
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01:55 | But there is a specific time that going to allow makeups. Alright. |
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02:01 | with that in mind, you got nervous look on your face like |
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02:05 | All right. With that in Let's let's do something fun. Let's |
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02:09 | about some physio or some anatomy. ? I mean that is that more |
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02:14 | ? You guys you look like you've been shot like yes, it's rainy |
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02:20 | it's cold. But just think after rain and the cold, then all |
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02:24 | water is getting absorbed in the ground all the flowers are gonna be happy |
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02:27 | about two or three weeks and it'll beautiful for like a week and it'll |
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02:31 | hot human again. There there's the I'm looking for. Okay, |
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02:36 | so this is our starting point. we said that we have three different |
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02:39 | of blood vessels, arteries, by definition are those vessels which carry |
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02:44 | from the heart. And then we're add a little bit to the end |
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02:46 | it to the capillaries. Capillaries is we're gonna spend most of our time |
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02:51 | we're dealing with the vasculature because that's all the action happens. Capillaries are |
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02:56 | , very small. They're very And this is where exchange takes |
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03:00 | And so this allows for materials to from the external environment to the cells |
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03:05 | your body and from the cells of body to the external environment. |
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03:09 | that's a really simplified version of But this is where all the action |
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03:13 | happening. All right. And then , blood from the capillaries is gonna |
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03:17 | moved back to the heart via And so, if you understand that |
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03:22 | , everything else just kind of falls place around it. All right |
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03:27 | it's always happened like that. There a general structure that we can use |
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03:33 | a model on which we build the of all the different vessels that we're |
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03:38 | be talking about. So, arteries veins and capillaries share this general |
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03:44 | Alright, now, it says arteries veins up here, and it doesn't |
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03:48 | capillaries because capillaries are coming unique in While you would say that they have |
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03:52 | 32 of those three are basically non , that we basically say there. |
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03:58 | . But you'll see that they you're in subtract based on this. All |
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04:02 | . So, we have what are the tunics and you'll see them labeled |
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04:08 | . Alright, so, tunics are three different layers. So, we |
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04:12 | a tunica in tema, a tunica and a tunica external and in |
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04:18 | What does that mean? External. and middle tunics. Now, what's |
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04:26 | is the composition of these different Alright, now you're saying, |
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04:31 | how can this possibly be interesting? , it's this structure that gives rise |
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04:38 | the functionality of the vessel that we're at. All right, So, |
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04:43 | why we're kind of interested in Because what makes an artery and artery |
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04:47 | not the fact that it just carries from the heart to the capillaries, |
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04:51 | its structure that allows it to do and similarly, with the veins and |
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04:56 | capillaries, it's this structure that allows to do the unique thing that it |
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05:01 | . Now you're gonna hear the word over and over and over again when |
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05:04 | talk and so, when you hear , what you need to be thinking |
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05:09 | helps when I turn this on is talking about the space on the inside |
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05:15 | the vessel. Alright, So, of it as the inside of the |
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05:20 | . Alright. If the vessel is pipe, the inside is the |
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05:24 | Alright? It's just the open space which the material actually travels. |
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05:28 | we're going to see two slides that exactly the same with two different |
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05:32 | So, this picture is a picture what what's red. So, it |
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05:34 | to be arteries. This picture is , so, it has to be |
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05:41 | . Alright, so, it doesn't notice how the text doesn't change. |
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05:43 | want to go back and forth. just a picture. So, this |
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05:47 | exactly true doesn't matter if you're looking the artery or the vein. |
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05:54 | This what I'm about to tell you true for both of them. All |
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05:57 | . So, the inner layer is the tunica intimacy. You can see |
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06:02 | here's the lumen. There is that inner layer. That's the intimacy that |
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06:08 | is made up of a squamous epithelium indo thallium. Alright, we've heard |
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06:14 | word already used once before. You not remember because I didn't make a |
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06:17 | deal about it. But the indo is the epithelium of the vasculature. |
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06:23 | makes up the inside of the It makes up the inside of all |
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06:26 | blood vessels. All right. it is the epithelium now underlying |
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06:31 | Or what you say is as you're outwards. So, there's little red |
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06:34 | that you see here is the sub layer. And so this is connective |
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06:40 | , its basement membrane. It basically that epithelium to the next layer, |
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06:46 | would be the tunica media. All now, the purpose of the indo |
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06:51 | is to create a a friction And it's not gonna be 100% friction |
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06:56 | , but a frictionless surface over which blood can flow. All right. |
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07:02 | , lack of a better way to it. It's a slip and slide |
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07:05 | of of the blood vessel so that blood travels down it doesn't it doesn't |
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07:10 | . It moves evenly and quickly along surface. It's not 100% frictionless. |
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07:16 | actually has some friction which is very to how blood flows in the |
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07:20 | but it's less friction e than the of your epithelium. How's that? |
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07:26 | , the tunica media is a layer smooth muscle. It's not just one |
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07:31 | , it's multiple layers. So it's you can just think of it as |
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07:35 | rings of muscle that goes around the vessel. Now, the reason we |
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07:39 | this is for the purposes of creating smaller space or a larger space through |
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07:44 | process of vessel constriction or visa Constrict means to make smaller. So |
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07:50 | make the tuna, the lumen smaller vessel constriction and invesco dilation. You'd |
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07:56 | the looming larger. Alright now, just to make sure we're on the |
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08:01 | page. So, if I made loom and smaller would I increase or |
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08:05 | the volume inside the blood vessel And if I make this, if |
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08:10 | dilate, would I increase or decrease volume increase? Right? So dilate |
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08:17 | it bigger. So that means there's space. So that means it can |
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08:21 | more blood or blood can flow. blood can flow through it similarly, |
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08:26 | I make it smaller, that's less , so less blood can flow |
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08:31 | All right. And this will become in just a moment. I want |
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08:34 | want to make sure that we understand the terms mean. Alright, so |
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08:38 | media is smooth muscle so far, easy inside is epithelium. Middle is |
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08:43 | muscle outside. What is that? primarily connective tissue and it's different types |
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08:49 | connective tissue. The purpose of which to ensure that we have something that |
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08:55 | the blood vessel from expanding too It also anchors the blood vessel where |
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08:59 | needs to be, and it protects blood vessel. All right. |
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09:03 | you might see in larger blood So, like in this particular case |
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09:07 | here, you can see there's there might even be small blood vessels |
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09:11 | the tunica. External. All Because there are cells there. And |
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09:15 | need nutrition and materials in order to . And so, you need to |
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09:20 | them with blood. So, you have a blood vessel for blood |
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09:22 | Alright. But there's much, much . Alright. And those type of |
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09:26 | vessels are called vis a vis a a vis or um And what does |
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09:31 | mean? Blood vessel? The blood ? All right. So, |
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09:38 | and a helium middle musk. I'm feeling like Popeye today. And |
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09:47 | on the outside connective tissue. All . Now, that's for an artery |
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09:54 | vein. Is it different? it's exactly the same. So, |
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09:58 | doesn't matter where you are. All have these three layers. Alright. |
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10:04 | It's construction. That is unique. right. So, let's take a |
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10:08 | at the arteries and see what we . That makes them unique. |
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10:13 | Now, arteries, as we extend from the heart and travel down |
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10:18 | the capillaries. All right. As are moving from the heart down to |
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10:21 | capillaries. The lumen of those vessels smaller and smaller and smaller. In |
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10:27 | words, you start off with big and when you get down to the |
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10:30 | , you got itsy bitsy teeny tiny . Alright. So everything is getting |
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10:34 | the further away you move from the . All right. Now, the |
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10:39 | thing has to do with the composition these tunics. Alright, As you |
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10:46 | from the heart, you're gonna see decrease in the relative amounts of the |
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10:52 | tissues or elastic fibers that are found the connective tissue. And you're going |
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10:56 | see an increase in the relative amount smooth muscle. Now, let me |
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11:00 | that into english for you. And that means if the blood vessels were |
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11:04 | same size from the top down to bottom. Right? So, they |
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11:08 | change size. What you would see that the elasticity of the blood vessel |
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11:12 | the elastic fibers are going to decrease as you move down. But as |
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11:17 | move downward, the smooth muscle is get thicker and thicker and thicker. |
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11:22 | right, because, remember this is , right, relative size or relative |
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11:27 | . Now, what's really happening is that the smooth muscles staying more or |
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11:31 | the same size? The amount of fiber is getting less and the vessel |
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11:38 | is getting smaller. So, between two things, it looks like the |
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11:41 | muscles getting bigger. That's kind of what's really going on? All |
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11:47 | So what we say with that in is that there are three different levels |
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11:52 | arteries in the body. First is we refer to as the elastic |
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11:57 | The second is going to be the artery and the last one is the |
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12:02 | artery called the arterial. See it a cute little name arterial, maybe |
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12:08 | was a princess. All right. with the elastic arteries. These are |
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12:16 | big bad boys. These are thick , they sit up here nearest the |
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12:20 | . They're sometimes referred to as conducting . The prime example of this is |
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12:25 | aorta and the branches off the aorta also these types of arteries. Alright |
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12:32 | their purpose is to serve as a reservoir and the reason they're pressure reservoirs |
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12:39 | they have lots and lots of these fibers in that tunica external. So |
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12:45 | that means is if you push fluid them, they don't resist what they |
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12:50 | is expand like a balloon and now have potential energy to drive the fluid |
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12:58 | as that elastic relaxes and the resistance the other side relaxes. So this |
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13:05 | what allows your blood to move forward your body after the heart pump because |
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13:08 | heart goes through this phase of contraction relaxation. And if the heart goes |
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13:15 | contraction relaxation. So basically pushes and relaxes. There's many periods of time |
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13:20 | blood shouldn't be moving forward in your . Right? Does that kind of |
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13:24 | sense to you? Right. these help to preserve the flow of |
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13:30 | as the blood is pushed out of heart because you basically stretch this vessel |
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13:35 | a rubber band and now that energy in the walls and it's used to |
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13:40 | the fluid forward while the heart's That's your job. Okay. |
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13:48 | what they're gonna do is as you further away from the heart, they're |
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13:51 | begin to branch and form what are the muscular arteries. Now, why |
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13:55 | their muscular arteries? What happened to how do we change from elastic, |
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13:59 | muscular? What do we lose We lose the elastin. And |
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14:05 | the muscular arteries are what you're probably familiar with. Alright, when you |
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14:10 | like the renal artery, you or a named artery. Hepatic |
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14:16 | Alright, Whenever you see like a name like that, these are the |
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14:20 | arteries. All right. These are distributing arteries. They move the blood |
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14:25 | the organs that need to get that . All right. And so, |
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14:30 | are losing that elastic nature. And , what you have is you have |
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14:36 | and because you have more muscle than have elasticity, that muscle has a |
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14:40 | effect on the flow of blood because can do two things with that |
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14:44 | I can contract the muscle or relax muscle which we called vessel constriction and |
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14:50 | . So, what I can do I can beso dilate and allow more |
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14:53 | through or I can constrict to prevent flow of blood. And what I'm |
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14:57 | here is I'm creating resistance. All . So, these are the vessels |
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15:02 | have a major role in producing resistance flow in the with regard to the |
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15:09 | themselves. Alright. So they have They have less elastin but they're still |
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15:17 | in there. They're not completely devoid it, but they have less less |
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15:21 | it. Let's see. Um and I guess the last thing I |
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15:26 | to point out here is they have they branch into the arterials. |
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15:32 | so, elastic arteries are the pressure moving down into the arteries and then |
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15:40 | into the arterials. We're now dealing resistance vessels and then we get down |
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15:45 | the arterials. Either the smallest Alright. The largest of these because |
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15:50 | multiple sizes. All right, you're have bigger arterials and then you're gonna |
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15:54 | smaller arterials. The biggest of you're gonna see have all three tunics |
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15:59 | . You're gonna see the tunica interna media tunica tunica external. They'll be |
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16:05 | identifiable connective tissue muscle in a but as the vessel gets smaller and |
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16:10 | and smaller, what ends up happening you end up losing layers of the |
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16:14 | muscle, you lose the tunica external really what you're stuck with is the |
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16:19 | in tema with just a couple of of smooth muscle around it. |
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16:23 | they're getting really, really small but speaking, they have a lot more |
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16:27 | than the ones that you're starting off those elastic arteries. All right |
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16:35 | these will always have a certain degree muscular tone to them. In other |
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16:41 | , they don't sit in a relaxed all the time. Your blood vessels |
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16:45 | always working is the way you can about it. So they kind of |
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16:48 | in the state that's in the middle completely jacked and like contracted and completely |
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16:54 | and not doing anything. They're what refer to as vezo motor tone. |
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16:59 | they sit in the middle. So means you can do things with |
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17:02 | All right. And what their job is the arterials is to determine blood |
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17:08 | into the capillaries. So, capillaries a little bit unique. They're not |
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17:14 | in like some sort of order where like artery, you don't go like |
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17:17 | big smaller, smaller, smaller than into capillary. Now, what you're |
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17:20 | is when you're dealing with capillaries, dealing with a network a a mesh |
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17:27 | vessels that are kind of spread all the place. And so what you're |
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17:31 | to do with the arterial as we're to see here is blood is being |
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17:35 | into different directions based on need. right. So the idea is |
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17:39 | oh, those cells over there saying need nutrients. Okay, I'm gonna |
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17:43 | up the blood vessel to allow blood flow into that. But I'm gonna |
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17:46 | over here because they've been saturated with and glucose. Okay. Oh well |
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17:51 | one is now telling me it needs . So I'll go ahead and open |
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17:53 | that and then I'll stop the flow blood over here. So I'm just |
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17:57 | constantly move blood to where it needs go. And that's what the arterials |
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18:00 | primarily doing. They're deciding where the goes now. They're not deciding they're |
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18:05 | told where the blood goes and who's them the cells? All right, |
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18:11 | that's one of the one of the things we're gonna see here again in |
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18:14 | a second. I know I'm kind jumping ahead. Is that the determination |
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18:19 | where blood is gonna flow in your is gonna be determined by the needs |
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18:22 | those cells and metabolic needs of the . Okay. Either we talk about |
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18:26 | today or we talk about it I can't remember now in your body |
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18:31 | now, would you guys say that at rest? You guys pretty pretty |
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18:35 | at rest? No, no All right. So what's going on |
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18:38 | your body? Is your blood is sent all over to all these different |
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18:42 | in your body? Alright. And this is kind of what it looks |
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18:45 | right now and the percentages don't matter as much as you need to memorize |
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18:50 | as into understanding the principle that we're with right now, What's happening is |
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18:55 | blood is being sent to some They're getting more blood than they actually |
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19:00 | . Right? So for example right your stomach is getting more blood than |
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19:05 | needs. Right now, it's being in blood. And why is that |
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19:09 | case? Well, because the stomach or the digestive system in general is |
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19:13 | we refer to as a bunch of organs, Their organs that are responsible |
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19:19 | moving nutrients from the external environment into body. And so what we want |
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19:25 | do is we want to supply reconditioning just because just in case we might |
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19:31 | up some extra stuff. Alright, during exercise, really what we want |
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19:36 | do is we want to make sure muscles are really the ones getting all |
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19:41 | fuel. Right? So we now a place where we can get extra |
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19:47 | right? Because right now your muscles receiving just enough blood to keep them |
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19:53 | . Right? Would you agree with ? Your muscles are not dying in |
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19:57 | body at this very moment. She's staring at me so hard. I |
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20:03 | I'm coming in with silly string. of these days and you're you're all |
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20:06 | get you're all gonna get it at least the first five rows. |
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20:09 | right? So when you begin exercising heart starts working harder. Yes. |
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20:17 | ? You start breathing harder. your blood starts flowing faster and going |
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20:22 | these organs and what you wanna do you want to deliver as much fuel |
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20:27 | necessary to allow those muscles to do job that they need to do. |
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20:34 | . And the order for that to you need to move blood from other |
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20:38 | . But if everyone was getting all blood they needed right? I mean |
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20:41 | limited to what they did, there no way you could shift blood |
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20:45 | And so reconditioning organs do is it's place to send blood first and just |
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20:52 | if you need it great if not let it pass on through. Because |
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20:57 | I can do now is I can the use of that organ or the |
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21:02 | that's being sent there and now move someplace else. So as I |
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21:05 | here's your gi tract. You're getting 24% of your blood is circulating through |
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21:09 | gi track right now. But when begin working out and running around Only |
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21:14 | 1% of your blood. Why? your gi tract doesn't need to be |
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21:19 | stuff while you're running around. But needs work? What needs to be |
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21:23 | stuff your muscles. So most of blood ends up in your muscles. |
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21:28 | provides the auction the nutrients so the can do what it needs to |
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21:32 | Now this makes a lot more sense you're being chased by a tiger. |
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21:36 | would you want to escape the No. Yes. Okay. Just |
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21:41 | making sure. All right. you wanna just just give it all |
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21:46 | that's what this allows us to So, blood flow during exercises shifts |
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21:51 | reconditioning organs to the organs of Right? So that you can do |
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21:57 | activity is that you're That makes Okay. Now, why do I |
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22:02 | this up? How do we go doing this? Well, this is |
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22:04 | function of vessel constriction and dilation, we've already mentioned. Alright, So |
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22:10 | you have this muscle, the smooth is helping to determine how blood flows |
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22:16 | you've constrict, what you're doing is reducing the volume inside that blood |
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22:21 | And what you're doing is you're restricting flow. You're creating resistance to |
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22:26 | And what do we know about fluids find the path of least |
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22:32 | Right. So, if you have blood vessels and three of them are |
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22:37 | and one is dilated. Which way the blood gonna go to the dilated |
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22:42 | ? Alright. And so this is of the ways that we shift blood |
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22:45 | the body through from reconditioning organs to . Alright, so, vessel constriction |
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22:51 | as a means to direct blood and dilation. Does the same thing. |
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22:56 | opens it up? All right all blood vessels have a certain degree |
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23:00 | tones so that you can go through process. Now, Generally speaking, |
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23:06 | we hear these terms dilation results in up. So less resistance phase of |
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23:12 | results in greater resistance. There's something that happens I'm gonna mention now that |
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23:18 | hopefully will be apparent. You guys played with hoses when you're a |
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23:23 | You know like turn on the water you see your brother or sister over |
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23:27 | and what do you wanna do? wanna soak them? So what do |
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23:29 | do? You just point the hose him? What do you do? |
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23:34 | your thumb over the top? All , now I'm having you think about |
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23:38 | because what did you accomplish did more come out of the hose? Know |
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23:44 | you did was you actually included the of the fluid through that hose by |
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23:48 | your thumb over it. But the of water that wants to pass through |
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23:52 | vessel is exactly the same. But putting your thumb over it, you |
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23:58 | a smaller opening. And so now same volume of fluid in order to |
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24:03 | past your thumb has to move faster then moving faster. It creates all |
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24:10 | velocity so that it can travel And that's why your little brother and |
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24:14 | just got soaked. Right? So you create that resistance in a blood |
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24:22 | , the volume of blood, you , it's creating resistance. That volume |
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24:26 | blood still wants to pass it. what's gonna happen to the volume of |
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24:30 | ? Is it gonna move faster or faster? And so that's one of |
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24:36 | things if I want to get blood an organ quicker I can also vaso |
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24:42 | my heart has to work harder to that blood through. But now that |
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24:46 | is moving faster and when a blood dilates what happens to the speed of |
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24:53 | blood traveling through it it slows Okay. Now this is gonna be |
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24:59 | important here because here here's the thing we think about sympathetic activity, sympathetic |
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25:05 | . One of the things that it and I'm going off the rails here |
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25:08 | a second. You probably don't have write this down. You'll probably see |
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25:11 | again on Tuesday. All right, activity acts on blood vessels in two |
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25:18 | ways on the conducting vessels, elastic muscular. It tries to create vezo |
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25:26 | . In fact it does. And what you're doing is you're including the |
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25:29 | of blood. So what happens to rate it goes faster But when you |
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25:35 | down to the capillaries and the arterials have you have different receptors and they |
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25:41 | . So what happens there blood slows ? So why do I do |
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25:48 | All right. The idea is I to get the blood to where it |
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25:50 | to go fast and then when it there I wanted to do as much |
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25:53 | as it possibly can and so I'm slow it down so that the exchange |
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25:57 | take place and then once I leave again and goes back to the heart |
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26:02 | quickly kinda cool. Huh? All now this is all a result of |
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26:09 | receptors even though you have the same again, we'll probably deal with that |
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26:14 | uh Tuesday. So we're gonna go arteries cause arteries are delivering blood to |
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26:24 | capillaries. Capillaries are where we're going see exchange take place. Now, |
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26:31 | we were to say should there be tunica external? Yes, there should |
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26:34 | but there isn't one. Okay, that's why we didn't include it in |
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26:38 | first list, you know. Does have a tunica intimacy? Yes, |
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26:42 | cells have this indie thallium. All , well, what about the tunica |
|
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26:47 | ? Well, the tunica media gets of weird and wonky. You don't |
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26:51 | a complete or full smooth muscle. you have this dispersement of muscles. |
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26:57 | little cells, we refer to them Perry sites, not parasites, |
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27:02 | Perry means the next two cells. what they're called and they're a type |
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27:07 | smooth muscle and they might be one and there might be one over |
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27:11 | So we don't really call it a media. It's just kind of cells |
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27:15 | are kind of hanging out. so the capillary while there should be |
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27:22 | three layers. They've been modified to a degree that it just looks like |
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27:26 | only have one. All right now are ridiculously small. All right. |
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27:35 | when we're talking about the red blood will show you a picture of red |
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27:38 | cells stacked up as a rule. , alright, so that's what that |
|
|
27:42 | is just basically red blood cells stacked like poker chips traveling through a |
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27:47 | And capillaries are only as big or as big as the size of a |
|
|
27:53 | blood cell. So they're really, tiny and I don't know how true |
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27:57 | is, but someone told me at point or maybe it was one of |
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27:59 | textbooks, is that there is not cell in your body. That is |
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28:03 | than 10 microns away from a blood . So, from a capillary. |
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|
28:08 | , just to kind of put that perspective, a micron is 1/1000 of |
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|
28:14 | millimeter. Okay, so, think a meter. That's about three |
|
|
28:20 | So, a millimeter. Is that tiny thing you had on your little |
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28:24 | , that you never really can And so 1,000's of that every cell |
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28:29 | your body is 10 microns away from blood vessel. A capillary. |
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28:39 | they're kind of important because this is the cells get their nutrients from. |
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|
28:47 | right, these capillaries, So they're for the material exchange between the blood |
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28:52 | either the cells themselves or from the environment. There are three basic types |
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28:59 | capillaries. The most common type. one that when you hear the word |
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29:02 | . This is what you're thinking is called A continuous capillary. |
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29:07 | And that's what you're seeing up here this corner. All right, So |
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|
29:10 | do we have here basically you have layer of epithelium outside. You may |
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29:14 | a basement membrane, you know that of serves as kind of a screen |
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29:19 | the internal, from the from the to the external side. And the |
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29:25 | way I can describe a capillary is these are a bunch of cells that |
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29:29 | connected to each other by a series leaky tight junctions, which is the |
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29:34 | weird words you'll ever hear. Right and tight. Don't go together. |
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|
29:37 | the way to picture this is imagine your hands putting them together and scooping |
|
|
29:41 | water. Alright, So with the leak between your fingers. Yeah, |
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29:46 | the water is really, really So it could leak. But if |
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|
29:49 | like scooping up water and marbles, marbles would stay in your hand and |
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|
29:52 | water would kind of drip through your . So that's kind of what a |
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|
29:56 | is like. It's leaky because the between the cells are not 100% |
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30:02 | And so very, very small things escape from the lumen to the external |
|
|
30:07 | and vice versa. And this is exchange is going to take place because |
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|
30:11 | that very nature. Alright, So have leaky tight junctions, 95%, |
|
|
30:19 | the capillaries are continuous capillaries. what we can do is we can |
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|
30:27 | a capillary even more leaky. And this is where you have finished |
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|
30:32 | . Now, finished rated capillaries are be found in places where there's going |
|
|
30:36 | be a massive amount of capillary absorption capillary filtration. An example of this |
|
|
30:42 | be the kidney, Alright. Where moving fluid from the blood into through |
|
|
30:48 | filtration system so I can get materials of the blood. Alright. And |
|
|
30:52 | here what we've done is there's a degree of permeability and part of that |
|
|
30:57 | to do with and I don't have pin up here. Um I'll just |
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|
31:01 | out, you can see here the dots that they try to draw |
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|
31:04 | So there is a natural movement of through these vacuum als that are moving |
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|
31:11 | and forth across the end of And here what we've done is we've |
|
|
31:15 | vacuums that are large enough that create in the cell. Alright, So |
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|
31:20 | like punching holes in the cell's. now you have a way for larger |
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|
31:24 | to get through the cells. So no longer depended upon the leaky |
|
|
31:27 | Now you have holes in the right? But they're still tiny |
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|
31:31 | And so it's not gonna be like big things that are gonna pass |
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|
31:35 | It's just more stuff and they're still of small. Okay, so that's |
|
|
31:40 | you're gonna see where these are Alright. More permeable, but not |
|
|
31:46 | . So and then the last one the side, you saw it, |
|
|
31:49 | gonna see these primarily in the liver the spleen here. What we've done |
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|
31:53 | we've created Swiss cheese for the most , the connective tissue uh surrounding |
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|
31:58 | The basement membrane is not complete. tight junctions are no longer tight junctions |
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|
32:03 | basically big, giant gaping holes between cells, actual blood cells can actually |
|
|
32:10 | . And we're going to see this we talk about the spleen in the |
|
|
32:12 | unit, you can actually have red cells and white blood cells fall out |
|
|
32:19 | these sinus sides. Alright, these are really really, really leaky |
|
|
32:25 | . They do not limit themselves to materials. They allow everything to move |
|
|
32:29 | and forth. All right. So discontinuous when it comes to the basement |
|
|
32:38 | . So, coming back to the , because this is again like 99% |
|
|
32:42 | them is are like this is this kind of what a network of Kapler |
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|
32:48 | look like. And over here on left hand side, this would be |
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32:51 | arterial right. And so this is direction from which blood is coming and |
|
|
32:57 | it's gonna do, it's gonna pass a blood vessel that has its capillary |
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|
33:02 | its nature. But because it doesn't a role in exchange, it's given |
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|
33:05 | special name. It's called a meta all right. So, it's not |
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|
33:11 | art artery, it's not a It's it's someplace in between. All |
|
|
33:16 | . And so this is where blood into a capillary bed and it passes |
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33:21 | and becomes a thoroughfare channel on the side. Which will then open up |
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|
33:26 | the smallest form of a vein which called a venue all and then you |
|
|
33:30 | see around like here and there, your capillary bed. So all those |
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33:36 | around here and there. Those are actual capillaries lying between the meta arterial |
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33:43 | the true capillaries are little tiny Alright. And these are basically smooth |
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|
33:48 | cells that sit there and open and in response to chemical messages to determine |
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33:54 | direction blood is gonna go. if this right now you can see |
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33:58 | these vets are open or all these open. So blood is going into |
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34:01 | capillaries and there's exchange taking place. very often you'll see when we have |
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34:07 | of this, they showed the blood purple because you're getting rid of oxygenated |
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34:12 | and you are receiving the oxy So that mixing makes it in |
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34:18 | All right now they're saying, oh , no, we're going to close |
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34:21 | those capillaries. And so now the is passing through via the meta arterial |
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34:27 | the thoroughfare channel and going to the and no exchanges taking place there. |
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|
34:31 | moving on to say another capillary Now, just to put this into |
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|
34:36 | you have and again, I think from your textbook about 60,000 miles of |
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|
34:42 | in your body. Pretty impressive. how long a mile is. I |
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|
34:51 | , I don't know how many times the Earth that is. I think |
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|
34:54 | so just you got lots of blood . We'll just put it that |
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|
34:58 | Lots of capillaries. But they're so that they only account for about 5% |
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|
35:02 | the blood of your body. So not very much, is it? |
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|
35:08 | really, really tiny. Very very . All right. So, you |
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|
35:11 | see, as I mentioned arterial is the sending blood side, the venues |
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35:19 | the receiving side. They're not they are part of the other two |
|
|
35:23 | . We've looked at the thoroughfare or , the meta arterial thoroughfare kind of |
|
|
35:28 | as the boundary between those two. then you get those capillaries there At |
|
|
35:33 | given time. Only about 10% of capillaries are open. So the way |
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|
35:37 | can think about this, if I my hand as an example, let's |
|
|
35:40 | I have five capillary beds. Can see my five capillary beds. |
|
|
35:46 | Right? So what happen is is is going into one capillary bed. |
|
|
35:50 | getting all those nutrients. And then are going wait a second. Um |
|
|
35:53 | need some. I'm actually starving. need oxygen and glucose. And so |
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|
35:57 | one says all right, I'll close off and I'll open up this |
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36:00 | These are remain closed and then I'll from there to this one to this |
|
|
36:04 | and this one and I'll just kind rotate through. And I'm now providing |
|
|
36:07 | and all the nutrients and all the I need. And I'm removing all |
|
|
36:12 | waste as I need based upon metabolic . Kind of cool. So the |
|
|
36:20 | that are surrounded by that capillary bed making the call, they're saying this |
|
|
36:25 | what I need. I'm in metabolic , provide me the nutrients and so |
|
|
36:31 | regulating the flow of blood at the level based on that metabolic need. |
|
|
36:40 | you can see how many times were and closing here. It's anywhere between |
|
|
36:43 | and 10 times a minute. So very often so it's just stuff going |
|
|
36:46 | over the place and this is referred as viso motion, you know, |
|
|
36:53 | blood to where it needs to All right, So we're gonna move |
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37:00 | to the third part of our arteries, sins. We have three |
|
|
37:06 | levels. We go into the capillaries exchange is gonna take place. Trust |
|
|
37:10 | , we're gonna talk a lot more capillaries on Tuesday. We got a |
|
|
37:13 | to talk about players because they're the kids, right? And then now |
|
|
37:19 | dealing with the third part the the veins, the venus system. All |
|
|
37:24 | now in all of these drawings, we're doing is we're putting the arteries |
|
|
37:28 | the left side, we're putting all veins on the right side. Is |
|
|
37:32 | how the body works. Is this blood receiving side? There's a blood |
|
|
37:35 | side? No, your blood vessels side by side. Alright. So |
|
|
37:41 | you look at your wrist and you see your blood vessels, there's arteries |
|
|
37:44 | veins there, right there, side side next to each other. Arteries |
|
|
37:48 | veins always run next to one But it's just kind of an easy |
|
|
37:51 | to think about it because blood is put pumped by the left side of |
|
|
37:57 | heart. Blood is being received from systemic circulation from the right side of |
|
|
38:02 | heart. And so drawing a makes it easiest to understand that concept |
|
|
38:07 | which way blood is traveling. I do this way. Okay. But |
|
|
38:12 | right next to each other. So venus system is going to extend from |
|
|
38:18 | capillaries and they go to the And as you move from the capillaries |
|
|
38:22 | the heart, the blood vessels start itsy bitsy teeny tiny and they get |
|
|
38:26 | and bigger and bigger and bigger. so when you look at their |
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|
38:29 | they're gonna tiny loom into big They're not as well defined as the |
|
|
38:35 | system in the artery system. We , oh we have the elastic we |
|
|
38:38 | the muscles, we have the arterials . We just say well there's big |
|
|
38:41 | in their small veins and we have als so we don't really classify them |
|
|
38:47 | same way because there's not so much a distinction in terms of functionality? |
|
|
38:53 | right? The veins are defined by size. Is it a great vein |
|
|
38:58 | is it a small vein that's really of how we look at it. |
|
|
39:03 | what we're gonna do is we're just work our way around the circle. |
|
|
39:05 | went from big arteries down to small , down into the capillaries. So |
|
|
39:09 | gonna start with the small veins and gonna work our way up to the |
|
|
39:12 | veins. So the smallest vein is to as a venue. All |
|
|
39:17 | so again, it's a cute little for a cute little tube. |
|
|
39:22 | what you're doing is the capillaries are up together, right joining that thoroughfare |
|
|
39:29 | um Channel and they that thoroughfare channel into a venue and that's where you |
|
|
39:35 | them. All right, They're very boring, very, very |
|
|
39:39 | So what they have is they have empathy liam, just like the capillaries |
|
|
39:43 | . And they have a couple of along with that. But as you |
|
|
39:46 | further and further on, you're gonna in that parasites kind of fill themselves |
|
|
39:51 | . They become a layer of smooth . And eventually what you'll have is |
|
|
39:54 | three tunics, by the time you're a venue you're still very very |
|
|
39:58 | But all three tunics become apparent as grow larger and larger and larger. |
|
|
40:04 | the interesting about thing about the veins starting with the venue. Als is |
|
|
40:08 | have very little tone and they produce little resistance. All right now these |
|
|
40:18 | companion vessels. As I said, and veins run side by side. |
|
|
40:22 | what you'll see is you'll see an and a venue away very close to |
|
|
40:27 | another. When we looked at this over here, you can see that |
|
|
40:30 | very, very near one another. so as a result of that, |
|
|
40:34 | communicate with each other very closely when arterial vessels dilate and blood is flowing |
|
|
40:40 | , it tells the venue I am basically I'm sending blood through this capillary |
|
|
40:46 | , be ready to receive it, causes the venue to respond. So |
|
|
40:50 | a high degree of communication that's ensuring the inflow into a capillary bed is |
|
|
40:56 | to the outflow from the capillary So you're not getting things backing up |
|
|
41:03 | , As you move on, as move from the venue of the veins |
|
|
41:08 | usually show all three tunics. But you'll see is that if you compare |
|
|
41:13 | to their companion artery that runs right right beside them, they're a lot |
|
|
41:18 | . All right. They don't have lot of muscle to them. What |
|
|
41:22 | is is that you tend to see tunica external is the layer that gets |
|
|
41:26 | and thicker and thicker. And the for this is because while the arteries |
|
|
41:32 | as a pressure of reservoir to drive forward. Vanes serve as a blood |
|
|
41:39 | . In other words, they are ones that are responsible for receiving and |
|
|
41:42 | onto blood until it's time to move forward. The way you can think |
|
|
41:48 | this is that they basically relax as receive blood. Hopefully this will make |
|
|
41:56 | in just a moment now, one the key features of of the veins |
|
|
42:00 | that they have valves. Arteries do have valves and the reason they have |
|
|
42:04 | is because they don't produce a lot pressure. It's the lowest point with |
|
|
42:09 | to the circulation. And so this that blood flows in one direction. |
|
|
42:14 | , so as we're pushing blood, passes through a valve, that pressure |
|
|
42:18 | the valve to open. And then that pressure stops, the valve closes |
|
|
42:23 | the blood tries to go back the direction and forces that blood that valve |
|
|
42:26 | close and these valves are very close each other, there are about 2-4 |
|
|
42:30 | apart and they're in all your blood your veins. So what you're doing |
|
|
42:34 | you're seeing the incremental flow of blood from one little section to another little |
|
|
42:39 | of the vein as you move Now there's a lot of reasons why |
|
|
42:43 | do this. We'll talk about that Tuesday. But I want you to |
|
|
42:46 | aware of this now. Now when valve fails, it's called valvular |
|
|
42:52 | So here you can see a valve that's working right. But when there's |
|
|
42:57 | much back pressure, the valve will and it'll allow blood to flow back |
|
|
43:03 | the other valve. And now that , which is meant to support the |
|
|
43:07 | of blood between those two valves, now supporting the volume of blood between |
|
|
43:13 | even greater like double. I'm just up a number double. And so |
|
|
43:16 | valve that area expands and and sits and is sustained and expand state until |
|
|
43:24 | valve fails and so on, and on. And that's where you get |
|
|
43:27 | veins. It's a result of valvular insufficiency. So this is the effect |
|
|
43:34 | gravity has on the blood. Where your blood want to go in your |
|
|
43:39 | down to your feet? If you long enough or sit long enough, |
|
|
43:42 | start noticing it, right? Your start going, oh, that kind |
|
|
43:45 | because gravity is constantly pulling on the in your body. How do you |
|
|
43:49 | that from happening? I move right? And when I move around |
|
|
43:54 | muscles, squeeze the blood vessels and the blood through the system. It |
|
|
43:59 | we're gonna learn about this on All right. But if gravity is |
|
|
44:05 | pulling the valves are there to serve help break up the effect of gravity |
|
|
44:11 | of pulling all five liters of I'm only pulling a little bit of |
|
|
44:15 | at a time. But if I insufficiency now I'm pulling more blood and |
|
|
44:20 | blood and more blood and this is it looks like. Now, this |
|
|
44:24 | occurs in the superficial veins. The veins are within the muscles. And |
|
|
44:28 | time you move. Believe it or you noticed that when you sit there |
|
|
44:31 | I'm looking at I'm just looking at and this is what I see, |
|
|
44:33 | see you moving your legs, you do this a lot shaking of the |
|
|
44:38 | back and forth. These are things you do in perceptively, you don't |
|
|
44:42 | notice it, but this is part your way your body creates. You're |
|
|
44:45 | your skeletal muscle as a pump system massage your blood vessels. Kind of |
|
|
44:50 | . Right? And so that helps counter the effect of gravity. |
|
|
44:55 | we'll learn more about that superficial They're not deep inside the muscles. |
|
|
45:00 | so they're more prone to doing all fun stuff. Are we ready to |
|
|
45:07 | past the ugly pictures? Okay, blood as or veins is the blood |
|
|
45:14 | . Alright, Now we saw this a couple slides back, two or |
|
|
45:19 | . If you were looking carefully, saw this already, what this is |
|
|
45:22 | you is where your blood is in body. Alright, so again, |
|
|
45:25 | just separating out arteries, we're putting this side, veins are putting on |
|
|
45:28 | side. It's like look in pulmonary . The whole thing represents about 9% |
|
|
45:33 | the blood in your body, but very much right? Most of your |
|
|
45:38 | out here in systemic circulation. So would be 91%. And if you |
|
|
45:42 | is like 7% in your heart. that means the uh about 20% is |
|
|
45:47 | your arteries, in your capillaries. means the rest of your blood resides |
|
|
45:53 | the veins. And the reason it so is as blood enters into the |
|
|
45:58 | the vein goes oh okay I see relaxes a little bit. Alright, |
|
|
46:04 | dilates as a function of it receiving . And so when that happens that |
|
|
46:11 | you now have more volume, more so more blood hangs out in the |
|
|
46:16 | . It doesn't stop moving right, still moving but it's moving slowly and |
|
|
46:22 | slowly moving back to the heart and it's like okay then pumped and then |
|
|
46:26 | put in the system. But it all that time on the venus |
|
|
46:30 | Okay. But now the tiger jumps right, tiger chases you sympathetic system |
|
|
46:38 | through the roof. Does your body more blood and circulation? Where can |
|
|
46:43 | get it? It's right there. I gotta do is squeeze my veins |
|
|
46:50 | vaso constricting my veins. I'm now the space inside the veins that pushes |
|
|
46:57 | blood to the heart. The blood all this extra blood. What does |
|
|
47:02 | heart do when it receives extra It pumps it? Right frank Starling |
|
|
47:07 | the heart pumps what it receives and that now the heart begins working harder |
|
|
47:12 | faster to move that blood because that's what it does and through sympathetic |
|
|
47:18 | Now I'm delivering more blood to those that need that more blood to do |
|
|
47:22 | job that they're supposed to do. is just where we hold it. |
|
|
47:26 | . All right. So the reconditioning are receiving the blood. But it's |
|
|
47:31 | the venus side where that blood is of hanging out and it's not |
|
|
47:36 | it's moving, it's just moving Kind of cool. All right, |
|
|
47:42 | call that. Yes. Mhm. . So, I'm not sure if |
|
|
48:00 | hearing you. Alright, So I'm try to So with regard to the |
|
|
48:05 | systemic system, she's asking about the of blood. All right. So |
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48:09 | the venus side, the movement of and we're gonna see this is what |
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48:12 | rest of this conversation is gonna About. The rest of this lecture |
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48:15 | about how do we move blood through body? So the movement of blood |
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48:19 | gonna be constant because blood moves from area of high pressure to an area |
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48:23 | low pressure. Alright, on the side we have the heart creating the |
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48:29 | , right? And then that pressure sustained because we have these elastic arteries |
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48:33 | so that's pushing the blood forward. on the venus side we don't have |
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48:37 | pump, right? Our pumps up and I've just delivered blood down to |
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48:41 | big toe, how does the blood back from my big toe back to |
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48:44 | heart. Well, the answer to question is the heart has the least |
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48:49 | of pressure. So its very nature I have more pressure on my big |
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48:54 | than I have here. So, wants to go back to my heart |
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48:57 | to overcome some stuff, but it's gonna want to do so naturally |
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49:02 | if I want to get it there , that's when I squeeze the blood |
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49:05 | and when I'm squeezing the blood what am I doing? I'm increasing |
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49:08 | pressure. Right? And so it's there faster. Alright. Did I |
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49:13 | the question? Or did I? I when it's hard for me to |
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49:16 | , it's like, I'm just gonna to kind of guess what the question |
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49:19 | All right. So, before we into all what I just described questions |
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49:27 | arteries, capillaries and veins in terms their structure, which are the Yes |
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49:40 | pulmonary that's perfectly fine. So, talked about this on like the second |
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49:45 | of class, right? So, , systemic circulation is the the circulation |
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49:52 | is responsible for providing your whole body all the blood that it needs. |
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49:57 | , pulmonary circulation is. So, we're saying is that in systemic |
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50:02 | you're receiving blood that has been oxygenated it has all the nutrients it |
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50:06 | All right, pulmonary circulation. On other one on the other hand, |
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50:10 | blood that has already used up its . And so what you're doing is |
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50:14 | re oxygenating it. And so the thing you want to do before you |
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50:17 | it off to the system is give all the oxygen it needs. And |
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50:20 | we pump first from the right side our lungs to provide the oxygen to |
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50:26 | blood so that we can then pump out to the rest of your |
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50:30 | So systemic is rest your body pulmonary your lungs. Yeah, about So |
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50:40 | gonna be internal and they're about every cm in all your blood vessels and |
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50:45 | your veins. So just you can a Just yeah, you can just |
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50:50 | a portion. You just look through just like there's one, there's |
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50:52 | there's they're literally just about 2-4 cm . Alright. And what that |
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50:58 | if you can imagine, so, have a very large blood vessel that |
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51:02 | up the internal side of your It's a large one. It has |
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51:06 | . But let's just say, here is. You know, that's the |
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51:09 | vena cava, right? It's about long. And if I cut that |
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51:13 | , you can you can see that be little valves in there and the |
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51:16 | from here to here is about what third of a meter. Just making |
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51:20 | a number. Right? And so can imagine it being about this big |
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51:24 | and it has to support all that that is being pulled by gravity. |
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51:29 | what I can do is by having valves in place, that bottom valve |
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51:32 | supports the amount of blood from that to the next valve and that volume |
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51:37 | blood doesn't have a lot of The next valve supports the next one |
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51:41 | on and so forth. So what done is I've broken it up and |
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51:43 | made it easier for the blood to because I'm no longer moving the whole |
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51:47 | which is trying to fight gravity I'm just trying to move just that |
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51:51 | bit up and then that next one to the next one that went up |
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51:53 | the next one so on and so , kinda cool. Yeah. |
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52:04 | So all right. So the question so if if you're talking about the |
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52:07 | , right? She's saying, So you're saying if there's vessel constriction |
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52:11 | creates greater pressure on the vessel so blood would move faster and up. |
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52:18 | ? And so yes. And so , you can think about it like |
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52:21 | . If I take a tube of and I squeeze on the outside. |
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52:25 | the tuba toothpaste gonna do presuming the not on, it's gonna go out |
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52:29 | and it goes out pretty fast. that's kind of the same thing is |
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52:32 | squeezing when I viso constrict, I'm the muscle to contract around that vessel |
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52:39 | it's squeezing on that vessel to propel fluid along its path of least |
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52:44 | Now it doesn't go downward like in tube of toothpaste. If I squeeze |
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52:48 | middle of a toothpaste tube of Some of it's gonna go down, |
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52:52 | of it's gonna go up right. of us who are squeezed from the |
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52:57 | of the tube know this and really hate those you squeeze in the |
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53:02 | right? This is where we find O. C. D. |
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53:05 | Alright. But the reason it can't down is because we have a valve |
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53:10 | that valve prevents the backwards flow of blood. So it basically meets |
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53:15 | That waste of the blood just wants go where there is least resistance and |
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53:19 | where why it goes upward. Good . Anyone else I've been talking to |
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53:27 | side of the room, this side room have questions now. Alright. |
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53:32 | . No. Okay so there are types of pathways. We just talked |
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53:41 | the most simple type of pathway we hey what we have when we're talking |
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53:46 | blood vessel pathways, we have an , we have a capillary, we |
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53:49 | a vein and then the heart is all that blood through it and that |
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53:52 | the most simple type of pathway and of your most of the pathways in |
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53:56 | body look like that. All And that's what you see up |
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53:59 | you can see here, I'm look here's my arteries and I go |
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54:02 | to the capillaries and out through the . Alright. So that's the most |
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54:07 | type But we also have these alternative Alright. And in these pathways, |
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54:12 | we're going to see is we're gonna more than one artery, more than |
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54:16 | vein, or more than one Alright. And it's it's it's just |
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54:24 | follow that normal thing. And so types of alternate pathways are referred to |
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54:30 | , that's plural. Anastomosis is or what we may call them is |
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54:35 | portal system. Alright. So we're gonna look at them very, very |
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54:39 | . This is how we define them it's not hard, it's just when |
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54:43 | see the word of anastomosis, that means there's more than one of whatever |
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54:47 | first word tells me. Alright, if I have an arterial anastomosis, |
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54:53 | I have is I have multiple arteries enter into a capillary system. So |
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54:57 | two or more arteries that enter into capillary system and typically we have this |
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55:04 | what we want to do is we to ensure that blood enters in to |
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55:07 | capillary system. And so this is be where there's a lot of physical |
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55:11 | or where it's very critical to get blood. So some examples up here |
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55:16 | the joints, the abdominal organs, example, the heart, the |
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55:21 | You're gonna want to have more than way to get blood into the capillaries |
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55:25 | these particular things because if you don't blood to your heart, what's gonna |
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55:30 | , you're gonna die if you don't blood to your brain, what's gonna |
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55:34 | ? You're gonna die If you don't blood, your digestive system, what |
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55:38 | you gonna do? You gonna be for a while then you're gonna |
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55:41 | All right. But it all is same thing. All right. You |
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55:47 | think about your joints right? When do this, what have I done |
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55:51 | I've pinched blood vessels, right? , I want to have another track |
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55:56 | which blood can actually get to the down in my hand, on my |
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56:01 | , right? You don't want one between two points that you know there's |
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56:08 | gonna be problems. I think of Houston traffic in Houston uh Design. |
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56:17 | there more than one way to get the University of Houston? So if |
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56:22 | water in your neighborhood, are you to get here? She she's like |
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56:27 | . It got me to trap. one of my favorite ones dr |
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56:30 | I can't come to the university There's water in my neighborhood. And |
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56:33 | like, yeah, there's water in our neighborhoods. You know, there's |
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56:36 | than one way to get here. . I know it's not always |
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56:40 | but but that's the idea is that there's traffic and you need to get |
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56:46 | or see that special someone. Are gonna find a way to make it |
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56:50 | ? Yes, because there's always another and that's what an anastomosis does. |
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56:55 | . So, that would be the , So the venous anastomosis where two |
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56:59 | more veins are draining. So these very common. You see these all |
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57:03 | over the place. So um this that blood will find its way back |
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57:09 | the heart so that you can then oxygen to it so we can get |
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57:13 | into circulation. Alright. We don't blood just hanging out for no |
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57:17 | The last one is the arteriovenous anastomosis is a very very long word that |
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57:23 | be shortened into a vascular shunt and what a vascular shunt does. It |
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57:27 | bypasses the capillaries. So the artery directly into a vein. Alright you're |
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57:34 | the system and the last one of portal system and the portal system is |
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57:39 | kind of interesting. We have them some very unique places. And so |
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57:43 | you do is the artery comes down empties into a capillary and then you |
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57:47 | a portal vein that empties into another bed before that blood then moves back |
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57:52 | the heart. So here you have capillaries. Alright so an example of |
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57:56 | would be uh blood goes to your picks up or you're not your stomach |
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58:02 | your digestive system right? Small intestines then those capillaries into into a vein |
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58:09 | then travel up to the liver which goes through its capillary system and then |
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58:14 | of the liver into systemic circulation all again. And what that does it |
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58:19 | your liver to filter through the materials you brought through the digestive system and |
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58:25 | the toxins and stuff. That would an example of a portal system. |
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58:29 | big overt one. Alright, there others, but that's an easy one |
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58:34 | kind of visualize. All right. those are our blood vessels. And |
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58:40 | I wanna do is I wanna shift and I want to kind of move |
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58:44 | Oh yes, go ahead. Uh see vascular. Oh, it's so |
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58:51 | idea is instead of doing exchange, you're doing is you're bypassing to ensure |
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58:56 | blood gets to another organ or or like that. I'm trying to I |
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59:03 | there's one that I but I'm blanking it right now and I probably should |
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59:06 | double checked before I came to but you know, lazy, so |
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59:12 | all be perfect. All right. what I wanna do is I want |
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59:15 | move away from these structures. I to deal with the question of |
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59:21 | And what we're doing is we're doing gonna feel a lot like physics. |
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59:26 | apologize for that because for those who me in A and P. |
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59:29 | did we ever do math on a ? No, so the goal here |
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59:34 | not to learn math equations so that have to do the formulas, what |
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59:39 | doing is we present the equations the so that you can understand relationships. |
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59:44 | I think this is gonna be really clear what we're gonna look at |
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59:47 | . And what we're gonna try to is we're gonna try to understand how |
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59:50 | blood actually flow? What is it that causes blood to move the way |
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59:55 | does? All right. So, three things we need to first deal |
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59:59 | . This is gonna be resistance pressure and flow, flow is dependent upon |
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60:05 | , and resistance is alright, So is blood pressure? It's basically the |
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60:10 | per unit area, right on a wall by the fluid in that |
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60:16 | Right? So, last time we here, we had a bottle like |
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60:21 | and we said inside that bottle, a fluid that fluid creates a pressure |
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60:27 | that vessel. All right now this full. But you can see there's |
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60:32 | in there, but that fluid is outward, trying to escape from this |
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60:38 | that is what blood pressure is with to a vessel. You have a |
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60:42 | , you have a fluid which is blood and it's trying to find its |
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60:46 | outward and through that. So that that force that we're talking about |
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60:50 | All right now, typically when we're about blood pressure, unless we say |
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60:54 | , what we're talking about is systemic pressure. So, we're looking at |
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60:58 | artery side and we're asking the what is the pressure on the artery |
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61:02 | of the system? Very rarely are looking at the pressure on the venus |
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61:06 | , unless we say this is venus . Okay, So if you hear |
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61:12 | pressure, it's like, oh, like when you go and get your |
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61:15 | pressure checked, what are they It's up there, systemic arterial pressure |
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61:23 | what they're checking. They're looking at blood pressure inside your arteries to make |
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61:28 | that they fit within the norm, is your heart having to work extra |
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61:33 | to overcome that pressure? All right , resistance is the opposition to blood |
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61:42 | ? Right? It's basically saying I to go that way and resistance is |
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61:47 | we're not gonna let you. All now, this is a measure and |
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61:51 | measured by it's a measure of the against the walls of the vessel. |
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61:56 | , so, right now, if were to bring a skateboard in here |
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62:01 | there's a little bit of a right? And you can imagine, |
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62:04 | , I'm not gonna use a skateboard you started at the top of this |
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62:08 | and you took a dive on that this carpet, how far would you |
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62:14 | ? Not very far. Right. ? Because the carpet has a certain |
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62:20 | of friction and when your body hits it basically grabs on and holds on |
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62:24 | you, you can't move forward right , let's take the carpet off and |
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62:30 | make it like the tile. If did the same thing, would you |
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62:36 | , would you travel a distance a bit? Yeah, not very |
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62:41 | but you'd probably slide a little bit we waxed it up, would you |
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62:45 | a little bit further? Yeah. you could do what we did when |
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62:49 | was in college because we had fun we took dish soap. Jolie has |
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62:58 | me for what? Three classes Yeah. So we took dish soap |
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63:04 | we put it on the hall of dorm and then we take a running |
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63:10 | and we throw ourselves and see how we could slide. And imagine if |
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63:16 | was soaked up and you took those steps and dove, how far would |
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63:20 | go? You're looking at me like crazy. We had fun. How |
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63:26 | do you think we could go? far? I like that answer pretty |
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63:32 | . This is where it becomes It's like, I want to see |
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63:35 | far. Alright now, I'm not you to go soap up the halls |
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63:39 | the dorm room. I'm not promoting in any way, shape or |
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63:43 | Do not sue me. Right? you see here friction prevents or resists |
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63:50 | the movement of your body. And same thing is happening with the blood |
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63:55 | . So the helium while it is the amount of friction, there's still |
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64:01 | there. And so that friction prevents flow of blood. All right now |
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64:08 | gonna be dependent on three factors which gonna deal with blood viscosity vessel length |
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64:12 | vessel radius, but we'll deal with in just a moment. Finally, |
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64:15 | flow, this is what we're interested , there's actually two different types of |
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64:18 | very often you'll see blood flow, is what we're talking about. But |
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64:21 | also see velocity of flow. Don't those two things confused. Blood flow |
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64:25 | how many mills are moving past a per minute. So if you want |
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64:30 | think about like this is like going to the highway and you're asking how |
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64:33 | cars are going by per minute per time. Right? So you can |
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64:39 | out there and you can see the zipping by at 70 miles an hour |
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64:42 | you can sit there and count them and after a minute you say, |
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64:44 | , I saw this many cars. that would be a that would be |
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64:48 | . That's a volume question. Velocity of flow is how fast is |
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64:52 | traffic moving? Well, all the are moving at roughly 70 miles an |
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64:57 | . That's a velocity. He doesn't you how many cars, it's just |
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65:00 | you the general speed like traffic this , what was the velocity of |
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65:05 | Like 10 mph, 15 mph. , that's what it felt like. |
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65:10 | no, it's raining. We've never water fall from the sky before. |
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65:18 | . So blood flow f is dependent two different things depending on the pressure |
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65:25 | is dependent on the radio. If have a higher degree of pressure, |
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65:32 | other words, if there's a so if I have high pressure over |
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65:36 | and low pressure over here, that between those two points, its |
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65:41 | I can calculate has a direct effect the flow. Now, you know |
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65:45 | intuitively because you're humans and you've lived . If I get on a flat |
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65:51 | on a skateboard, do I No, Yes, no. If |
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65:59 | put a skateboard on a flat surface I stand on the skateboard, the |
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66:03 | doesn't move. Doesn't matter how much is there? It's not gonna go |
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66:07 | . If I put a skateboard on slope that is one degree. Am |
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66:12 | gonna move? If I put it a slope at 45°, am I gonna |
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66:20 | ? AM I gonna move faster or same speed? So the steeper the |
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66:26 | , the faster I go right, flow is directly proportional to the pressure |
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66:36 | . So the more pressure I have over here, relative to over |
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66:41 | the faster the flow will be Resistance is the opposite. There's an |
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66:48 | relationship. The greater resistance, the flow I have, we can go |
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66:53 | to the example of the carpet and and the soapy floor, right? |
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66:58 | greater the resistance, the less flow have. So the carpet has more |
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67:02 | . And so when I dove on carpet, I don't move right, |
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67:07 | when I took the carpet off and down the tile, wax it up |
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67:10 | put soap all over the top of , I moved and I kept |
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67:14 | I went really fast. So resistance an inverse effect. The more |
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67:21 | the less flow, the less the more flow and the last one |
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67:25 | here demonstrates the total relationship here. I can calculate out flow if I |
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67:32 | to. If I knew what the in pressure was, if I knew |
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67:36 | the resistance was, I can relate to flow through. F equals delta |
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67:41 | . Over our Now there was a who looked at resistance. His name |
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67:49 | and he actually used those three other that resistance are made up and they |
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67:56 | up through past uh law, which you where the radius and length and |
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68:04 | also has this relationship through. And bunch of constants as well. So |
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68:09 | can look at something and say, , if I know the radius of |
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68:13 | vessel and if I increase or decrease radius, what effect does it have |
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68:17 | the flow? If I increase or the length of a vessel, what |
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68:20 | effective? It does it have on ? If I look at the viscosity |
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68:24 | the fluid flowing through that vessel and change it. What effect does it |
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68:28 | on flow as well? All of things do. And to show you |
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68:33 | , let's just look at what resistance . Alright, we said resistance is |
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68:38 | related. And we said that there's things. All right. The first |
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68:41 | is radius. Alright, radius has inverse relationship. And you know |
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68:47 | right? If you went out and a milkshake and that milkshake was |
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68:51 | they give you a straw with What type of straw do they give |
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68:55 | a big old fat straw? Because to suck on that milkshake into |
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68:59 | straw, you need a big fat to allow that stuff to flow |
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69:04 | Have you ever gotten a coffee? they give you one of those stir |
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69:07 | ? Right? Which has like a hole. Have you ever tried to |
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69:11 | coffee through one of those things? takes a lot of effort. Imagine |
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69:14 | to suck a milkshake through one of straws, imagine what type of force |
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69:19 | have to create to actually get a of milkshake to move up that straw |
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69:24 | hard. Right? So the smaller hole, the greater the resistance. |
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69:31 | ? The less flow you're going to right now imagine taking that big old |
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69:38 | straw and putting it into a nice coffee. You're gonna burn every organ |
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69:44 | your body before you even know the . All right. So, the |
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69:51 | here says it's r to the fourth . So, what that says is |
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69:55 | I double the radius. So if have a radius of one, |
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69:58 | whatever. So if I have a of one unit. If I double |
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70:02 | , then what I'm doing is I decreasing the resistance by a power of |
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70:09 | ? Not to the to the fourth . So doubling it would be one |
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70:14 | the sea is one of the fourth to the fourth, that's 2/16 1 |
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|
70:19 | . So the resistance changes 16 That makes sense. Kind of. |
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70:28 | , if you think of the it's the easy way to think about |
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70:31 | . Big straws, very little A little bit tiny straws, lots |
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70:35 | resistance. Okay, length. again, you can think about this |
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70:44 | longer the thing I have to travel the more surface I have to come |
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70:48 | contact with that's going to have a relationship to the resistance. Right, |
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70:54 | I push myself along the side, receiving that resistance. And so a |
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70:59 | vessel. I wouldn't have a lot resistance for a long time. A |
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71:02 | service. I'm gonna have a lot resistance. Lastly is viscosity, viscosity |
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71:09 | the thickness in essence. And so I have something that's really, really |
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|
71:14 | , it flows a lot easier. it doesn't it doesn't grind up or |
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71:20 | up against things all that much. if something is thick it takes it's |
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71:24 | for it to move. So these factors viscosity in in in terms of |
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|
71:31 | many red blood cells I have. it makes the blood thicker length is |
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71:35 | long the blood vessels are in your radius is what is the size? |
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71:47 | , when we treat people for high pressure, we give them drugs predominantly |
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71:52 | deal with one of these three Which factor is it? Do you |
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71:55 | it is radius? Okay, we don't give them drugs to deal |
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72:02 | length because the length of your blood is the length of your blood |
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72:05 | You're not getting any bigger or smaller soon. All right, you're viscosity |
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72:10 | change like that. But we can with is radius, right? Because |
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72:18 | can change that in a matter of . Right? If I scare you |
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72:22 | , you know, you're gonna you know, blood's gonna start pumping |
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72:27 | your body. So that's something that's to manage and manipulate. But I |
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72:31 | to point something out to you. I hope you picked it up a |
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72:35 | of seconds ago, we talked about , we said we have 60,000 miles |
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72:38 | capillaries in our body every time you a pound of weight, you're adding |
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72:45 | of miles of capillaries. So you're increasing length significantly. So, what |
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72:52 | you think would be the best way reduce blood pressure in your body to |
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72:57 | weight, Right? Because and I'm not sitting there pointing fingers. |
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73:01 | mean, I've got my my share blood blood blood blood vessels, |
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73:05 | But the idea here is we're looking quick fixes with drugs like blood pressure |
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73:12 | ? We're not dealing with the underlying , which would be length, which |
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73:16 | be a better way to deal with term management. Alright. So |
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73:21 | so the point here is what I to get to is when we look |
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73:25 | plus tools law and we look at resistance is calculated. We can see |
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73:29 | if I change the length, I'm the resistance directly. If I look |
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73:34 | the radius, I am inversely changing . I'm making as I increase |
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73:39 | I am decreasing resistance. And so I'm increasing radius I'm also increasing |
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73:46 | Alright. Those are the relationships. understanding those relationships allows me to understand |
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73:54 | relationship that you're looking at here. . And all you gotta do. |
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74:01 | no math, right? But it's I look at this and say oh |
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74:05 | I increase my length, what am really doing? Oh I'm decreasing my |
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74:11 | . That kind of makes sense. . Last little bit here. I |
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74:17 | I'm fell behind. Well we already about this blood flow is laminar. |
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74:23 | you want to go see this, down to a bayou, look at |
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74:26 | flow of the fluid in the in in the bayou. The water near |
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74:30 | edges of the bayou are going slower they're rubbing up against the shore. |
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74:33 | water in the center of the bayou moving faster because it's only resistance or |
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74:38 | is against the the concentric ring of as you move closer to the |
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74:43 | Alright. We talked about the flow uh being laminar in its nature. |
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74:48 | that's what blood should look like. doesn't look like this. This is |
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74:52 | and rarely happens in the body. there is this blood pressure gradient but |
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74:58 | say we have the highest pressure in arteries. And so this high pressure |
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75:02 | the arteries is our systolic pressure. is a result of the heart pumping |
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75:07 | out into the aorta. That pressure all that volume of blood goes into |
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75:12 | heart. Or sorry, goes into aorta causes it to expand and because |
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75:16 | is a pressure uh reservoir, that's you're gonna see the highest pressure. |
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75:25 | time that pressure drops over distance that drops. So you can see this |
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75:29 | line right here represents that pressure. average of that pressure it drops and |
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75:34 | gets smaller and smaller and smaller until get down to about zero. And |
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75:37 | that zero is is at the vena . So you can think of your |
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75:43 | circulation as being one big circles. create big pressure over here. Pressure |
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75:48 | as I come all the way back and have zero pressure here. So |
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75:52 | naturally wants it to return to the point of pressure. The lowest point |
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75:56 | pressure is not your feet. If was all the blood would end up |
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75:59 | and that's what you'd end up with giant bloody balloon feet. That's not |
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76:04 | . It comes back to the heart that's the lowest point. Notice there |
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76:10 | a difference in pressure, even in large veins relative to where the heart |
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76:14 | the blood. It's not a very steep pressure gradient but it's still a |
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76:20 | . So the flow of blood over is faster. Slow. It's it's |
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76:28 | . What about over here fast? . Because we have steep gradients. |
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76:35 | , so the blood pressure gradient serves the driving force for that flow. |
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76:41 | right, so this is just trying show you what's going on in the |
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76:45 | here. It's showing you the heart pumping, it pushes all the blood |
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76:48 | into the aorta. The aorta It stretches and so now it has |
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76:52 | forces the highest pressure in the body at that time, that high pressure |
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76:57 | a result of the systolic activity of heart. So we call it systolic |
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77:01 | . That's the high number. When measure blood pressure and then as the |
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77:07 | leaves the aorta because the resistance is . Over here, basically the blood |
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77:12 | pushed out, that pressure gets reduced , reduced and finds a low point |
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77:17 | that's just before Sicily. Again, during dia silly of the heart, |
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77:21 | low point of pressure is called the pressure. And so what we're gonna |
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77:26 | is you're going to go from the point up to the high point, |
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77:30 | going to slowly go back down that point, you're gonna go back up |
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77:32 | the high point over and over So that's systolic over diastolic or systolic |
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77:37 | diastolic systolic diastolic. And we go we measure that and we do so |
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77:41 | do. So when we measure it do so indirectly. Why don't we |
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77:46 | it directly? If I wanted to blood pressure directly, what do I |
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77:48 | to do? I'd have to go that artery and we can do |
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77:53 | That's what an A. Line is arterial line. They will take a |
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77:56 | giant needle, they'll stick it into carotid artery and it has a little |
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78:00 | on it and they can measure your pressure. Anyone want to do that |
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78:02 | you go visit the doctor. Okay good. So what we do |
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78:06 | we use something different, we use fingerprint a blood pressure cuff. I |
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78:13 | the word. I think that should be the test. If you can |
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78:16 | this, you pass meter. There go. Alright and what we're doing |
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78:25 | we're basically squeezing on an artery so is flowing through it just normally. |
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78:30 | what we're gonna do is we're gonna on it until we include the flow |
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78:33 | blood. And then what we're gonna is we're gonna listen for the sound |
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78:37 | remember blood flowing through a blood vessel no sound right? It's only when |
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78:41 | interrupted. And so the sound we're for something called a Korolkov sound. |
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78:46 | what you do is you create here can see here's the pressure going up |
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78:49 | down up and down. What we is we create enough pressure so that |
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78:52 | include the flow of blood. And we'll reduce or release the pressure. |
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78:56 | then we start listening. And when can hear your first sound, that's |
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79:00 | sound where the pressure inside the vessel greater than the pressure outside the |
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79:03 | So it makes a sound. So your systolic pressure. And then you |
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79:08 | hearing. Sh push push push push . As the pressure keeps decreasing until |
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79:15 | hear no sound. Now you've reached point where you found the low point |
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79:20 | the pressure. So the pressure inside vessel is so big that it has |
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79:24 | resistance. That would be your So what we do is we express |
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79:30 | in a value. Usually the perfect is as we said, 1 |
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79:34 | Systolic would be 1 20. Diastolic be 80. Last slide. And |
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79:40 | we're done All right now, these pressures are what we're most familiar |
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79:47 | But the body doesn't care about systolic diastolic. Alright. We physiologists |
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79:53 | well let's do some math. Let's some stuff out. We have something |
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79:56 | called a pulse pressure. That's the between the systolic and the diastolic. |
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80:00 | the pulse pressure would be if it's 20/80 it would be 1 20 minus |
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80:04 | . So pulse pressure. Is that right? It's the difference between |
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80:10 | All right? I'm trying to make . Yeah. So the pulse pressure |
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80:14 | be 40 in a healthy human. ? But if my systolic 1 60 |
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80:19 | diastolic was 1 20. What's my pressure? Has it changed? |
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80:24 | No. So, there's something nobody cares about. And this is really |
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80:28 | mean arterial pressure. And again, kind of did some math and figure |
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80:31 | out. And basically says, this is your average pressure driving things |
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80:35 | . It's roughly equivalent to your Diastolic is what, 80? |
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80:41 | And it's a third of your post . What's your post pressure? 40 |
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80:45 | by three is And they have got make you guys start memorizing these math |
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80:51 | . My kids can't do math in heads like this. Alright. 40 |
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80:55 | by 13 divided by three is 13.3 . Right. Yeah, I like |
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81:03 | . Alright, so 80 plus 13.333 93. Thank you, 93. |
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81:10 | so it's 93 is what we're looking is an average. That's what your |
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81:14 | is trying to maintain and it really a function of your cardiac output. |
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81:21 | . The further you get from the , the lower your pulse pressure and |
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81:26 | mean arterial pressure become And if your is decreased what happens to the |
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81:34 | it slows down. That's what we're for. So, that's where we're |
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81:37 | start on Tuesday we're going to then and see what our body does with |
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81:42 | this fun |
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