| 00:08 | Okay, today, we got a of ground to cover, Right? |
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| 00:12 | gonna start here with homeostasis from we're gonna start talking about the blood |
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| 00:17 | . Hey, more stasis seems like very, very complex, but it's |
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| 00:21 | pretty straightforward. All right. They're be four basic steps that you're gonna |
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| 00:24 | looking at here. And if you know homeostasis, if I don't if |
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| 00:28 | picture doesn't make it clear, this your way your body's way of making |
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| 00:31 | band aid. Alright. You're basically you all agree your blood is kind |
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| 00:35 | important to you? Yeah, You wanna you don't wanna lose your |
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| 00:38 | So, yeah. So, so band AIDS were existed, your body |
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| 00:42 | figured out how to make its own aids. And that's what we're |
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| 00:44 | And we're gonna create blood clots So, there's four basic processes. |
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| 00:48 | first is gonna be the process of or constriction. All right, |
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| 00:53 | it's gonna be resulting. What we're do is we're gonna apply pressure and |
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| 00:57 | we're gonna see the formation of the plug itself, and then we're going |
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| 01:00 | see the clotting of the blood in area. So, if you pin |
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| 01:06 | , how many of you guys have gotten trained for cpr and stuff like |
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| 01:09 | . Okay, So, you guys how to include the flow of |
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| 01:13 | Right? So, notice how everything just said here matches very much what |
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| 01:17 | said when you got trained in Cpr and first aid, really? It's |
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| 01:21 | first day that we're looking at Alright. So, your body is |
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| 01:24 | that automatically. and and and does simply And so what we're gonna do |
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| 01:29 | we're gonna kind of just focus on matter if you've if you've cut on |
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| 01:32 | surface of the skin or if you've internally. The idea here is I've |
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| 01:36 | a blood vessel some way. That's I've completely cut through it or just |
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| 01:41 | of shared it. So, I've it a little bit like, what |
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| 01:44 | seeing here. So, it doesn't which way you're looking at it. |
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| 01:46 | right. The first thing that's gonna is what is called the vascular |
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| 01:51 | which is just one of the coolest in physiology. Right. I |
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| 01:54 | it gives you this image of like , but really? What's going on |
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| 01:58 | Is that when you when you cut a blood vessel, what it's gonna |
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| 02:03 | ? And so the way that I'm here is that if you cut it |
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| 02:06 | half. Alright. So, what's happen is I've cut this blood vessel |
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| 02:10 | . And so those two open ends gonna allow blood to come through |
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| 02:13 | What they'll naturally do as a function that damage is they actually squeeze |
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| 02:19 | So instead of having an open like this, they squeeze on themselves |
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| 02:22 | this. All right. And what that does is it includes the |
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| 02:25 | of blood through that vessel. That's what the little picture down here |
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| 02:29 | the bottom is trying to demonstrate to , is this vascular spasm. |
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| 02:34 | the smaller the blood vessel, the it is to do the work because |
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| 02:37 | less pressure in the vessel. And it's able to include and blood doesn't |
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| 02:41 | pushing through. But you can imagine I get bigger and bigger and bigger |
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| 02:45 | , it's much much more difficult to the flow of blood, especially in |
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| 02:49 | artery that has say has a lot pressure driving the blood through it. |
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| 02:54 | , so that is uh it's advantageous you're talking about small things, blood |
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| 02:59 | will naturally try to include the flow blood going through them when damage has |
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| 03:03 | done to that blood vessel. All now this vascular spasm will be promoted |
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| 03:10 | and over and over again in each step by the materials that are being |
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| 03:14 | by the platelets and the surrounding Alright, so this is not just |
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| 03:18 | one time thing, it is being . And then what we're doing is |
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| 03:21 | reinforcing it again and reinforcing again by actions that are going on along the |
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| 03:27 | . So, the second thing that's happen, you're gonna see an increase |
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| 03:30 | tissue pressure and this is just a of a decrease in the trans mural |
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| 03:34 | . If I have blood pressure. , remember what trans mural pressure is |
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| 03:39 | difference between the pressures between two points are two points inside and outside. |
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| 03:46 | not hard. Right. So, kind of tells you it's between the |
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| 03:50 | . And so what happens if if including the flow of blood or blood |
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| 03:54 | leaking out? What's happening to the inside the inside the blood vessel? |
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| 03:58 | going down, Right? And so pressure on the outside, even if |
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| 04:01 | stays the same with the pressure on inside is going down relatively speaking, |
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| 04:05 | pressure on the outside is increased. that reinforces that spasm. Alright, |
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| 04:10 | that's kind of what's going on So there is a there is a |
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| 04:14 | on the radius and the amount of going on. But the way that |
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| 04:17 | can think about this second step is really what the body's doing is applying |
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| 04:21 | to the wound. Right? I this picture. This is actually from |
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| 04:26 | of those uh um you know the the practice emergencies, you know? |
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| 04:33 | that's not real blood, that's red . Okay, so those are the |
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| 04:37 | two steps and so far, that's very similar to what you see in |
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| 04:40 | aid. Right? I'm going to try to close the clued the flow |
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| 04:45 | blood, basically stop the flow of pressure to the wound to keep to |
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| 04:49 | that that flow doesn't take place. , everything else that's going to happen |
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| 04:53 | is a function of the structure of of the blood vessel and what what |
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| 05:00 | up the blood vessel and the platelets we described as a very last bit |
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| 05:03 | class, right? So they're gonna three steps in the formation of the |
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| 05:07 | plug. They're all A's adhesion activation aggregation. Alright. And so really |
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| 05:13 | I wanna do is I want to a picture here, and I think |
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| 05:15 | is a really good picture. platelets naturally don't adhere to the inside |
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| 05:21 | blood vessels. Alright. In essence cells, the epithelium of the of |
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| 05:25 | of the blood vessel produces a chemical that says, I don't want you |
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| 05:31 | around here. Go away. So, the way I like to |
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| 05:34 | that I think of platelets as teenagers the the uh the thallium as basically |
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| 05:39 | men like me and they're yelling all time. Stay off my lawn. |
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| 05:44 | . So, you can automatically see this is naturally going on. Now |
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| 05:47 | molecule that is is different types of Cyclones. Those process Cyclones are being |
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| 05:52 | and saying you stay away and the vessels and the And play let's |
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| 05:55 | okay, sure, fine. what happens is that you get adhesion |
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| 06:01 | there is something other than a helium in that location. All right. |
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| 06:08 | we're gonna see this. And just , let's see, do I have |
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| 06:10 | up here yet? No. So about when when you have a bloody |
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| 06:15 | or bleeding takes place. Does it long for the blood to to |
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| 06:20 | No. Right. The reason it and doesn't stay in the liquid is |
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| 06:24 | it comes across a foreign surface, that it's no longer being told to |
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| 06:30 | aggregate. All right. So like blood hits the floor, there is |
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| 06:36 | there's no process. I climbed on floor saying I don't want you to |
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| 06:40 | , right? When it gets on surface of my skin, there's no |
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| 06:44 | saying I don't want you to So, the idea here is that |
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| 06:47 | platelets are responding now to that foreign . In other words, they recognize |
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| 06:51 | have receptors on their surface that recognize foreign surface. All right now they're |
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| 06:58 | or being uh in response to sheer . And so in essence, what's |
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| 07:03 | is that as they slow down there able to come into contact with the |
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| 07:08 | and because there's no signal that hey, don't congregate here, don't |
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| 07:13 | here. They do. All So that's where you get the |
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| 07:16 | All right now, this is a injury. And then we're also going |
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| 07:19 | see here in just a moment that actual signals. And so the receptors |
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| 07:25 | what are on those platelets is what's it to recognize where it needs to |
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| 07:30 | to. So one of the things circulating in the blood is this material |
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| 07:35 | Von Wilburn Factor. Von Wilburn factor says, hey, hey, |
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| 07:39 | I need you to start adhering in area. Alright. And that's gonna |
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| 07:43 | activated through a whole series stuff. really it's other factors like collagen. |
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| 07:48 | right here you can see here, got a blood vessel popped open |
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| 07:52 | you can see the collagen and that tissue, or at least that's the |
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| 07:56 | tissue. So you can imagine there's there, and now we have something |
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| 07:59 | foreign and that platelet comes into contact that and says, oh, this |
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| 08:03 | a good place to hang out. like my neighbor's house, right? |
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| 08:09 | when teenagers started aggregating at a neighbor's , what happens at a party? |
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| 08:16 | so from the adhesion, the teenagers out, that's where we get |
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| 08:22 | Alright, what are we gonna We're getting it on our phones, |
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| 08:25 | gonna get on all social media and gonna call all our friends, |
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| 08:29 | we know everyone, we think we all our friends who've ever we've made |
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| 08:32 | with and we're gonna invite them to party, you guys do that, |
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| 08:38 | ? What a sad generation. That's we did parties of 200 300, |
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| 08:44 | people, cops showing up people jumping fences. You've seen those movies, |
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| 08:52 | ? Those are based on real We did. That kind of |
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| 08:56 | I'm not encouraging it in you. just saying, maybe think about, |
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| 09:00 | know, getting out a little bit . Alright, so what we're gonna |
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| 09:05 | is we're gonna see the activation of platelets, and really what they're doing |
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| 09:08 | is they're releasing those contents of those . So we're releasing the dense Granules |
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| 09:12 | the alpha Granules and so what we're is factor right. Clotting factor |
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| 09:18 | which we're gonna learn about the second some fibrinogen. What we're doing is |
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| 09:21 | releasing materials to promote this activity. releasing signaling molecules to tell them, |
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| 09:28 | , this is the place to hang . And so what we're gonna do |
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| 09:32 | we're gonna start changing the way the behave. Not only are we able |
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| 09:38 | recognize, but we're gonna actually change they're doing in the blood. And |
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| 09:42 | we're gonna see these morphological changes. of skeletal changes. Now, remember |
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| 09:46 | is the platelet do you remember? said very briefly when we're leaving |
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| 09:50 | what was the platelet 40? It's piece of torn off. It's a |
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| 09:55 | carrier site. This big giant cell basically has these little pieces going |
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| 09:59 | like so and you're sharing them off in that context of your sharing stuff |
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| 10:04 | your sharing of acting and my assassin all these little tiny components. So |
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| 10:09 | within the platelets, you have all mechanisms to change the shape, the |
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| 10:12 | of skeleton, is there? It's not a real cell. It's just |
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| 10:16 | bit of a cell. So that's changes that we're gonna be making is |
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| 10:19 | gonna affect what's already there. So we get that aggregation, everyone's coming |
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| 10:24 | the party. The signal has been all right. And what we want |
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| 10:27 | do is we're going to get them aggregate and to jam up and fill |
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| 10:32 | that space that needs filling up. , so again, this is like |
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| 10:36 | right. The party we can have 15 people, you know this this |
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| 10:39 | how all the movies go. You have four friends over. That's |
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| 10:42 | And you know, you invite four and they invite four friends. They |
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| 10:45 | four friends and someone then gets on media and you have 400 friends. |
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| 10:50 | ? So that's what's going on is all showing up here. All |
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| 10:54 | So, we're gonna see an amplification so these are all gonna be amplified |
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| 10:58 | a series of those signaling molecules, ? ADP for example, uh from |
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| 11:03 | alpha two or a two. Excuse , are going to bring them all |
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| 11:06 | and now they're being activated. So they're doing is they're bridging with each |
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| 11:09 | . They're attaching to each other and doing those confirmation all changes. And |
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| 11:13 | they're doing is they're stretching themselves kind of like foam, filling up |
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| 11:16 | crack right there, changing their And their jamming themselves in there. |
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| 11:20 | what they're doing is they're sealing the and when doing so they're preventing the |
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| 11:26 | of the plasma. All right. not just the red blood cells and |
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| 11:29 | other stuff. It's literally the fluid come through because you basically stacked a |
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| 11:33 | bunch of sandbags into the hole and can pass through it. All |
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| 11:38 | And then that act into mice. what they do is they kind of |
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| 11:41 | on each other and that tightens and and tightens the dam that you've |
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| 11:46 | So, that's what the aggregation All right? So what is |
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| 11:51 | The coagulation cascade? All right. gonna have to learn this at some |
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| 11:54 | in your life. And it's it's of like the most worst thing |
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| 11:58 | Alright. We're not gonna go through the steps which is good. |
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| 12:02 | But what I want you to see is we have two basic pathways. |
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| 12:05 | that's intrinsic, one that's extrinsic. then we have a common pathway. |
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| 12:09 | all linked to each other. When hear the word intrinsic. What does |
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| 12:12 | mean? Say again. Inside of . Extrinsic means outside. Alright. |
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| 12:20 | . And then So, what this us then is that when we're dealing |
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| 12:24 | this pathway of coagulation intrinsic pathway refers what is available already in the blood |
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| 12:32 | can cause coagulation. So, we can take a drop of your |
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| 12:35 | and we can put it on the or on the floor, whatever. |
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| 12:38 | without anything else, it will naturally . It will it will coagulate, |
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| 12:44 | ? You do not need to send signal from the tile or from the |
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| 12:47 | to say coagulate. Because everything that need to cause coagulation already exists. |
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| 12:54 | right. So, that's one pathway we have what is called the extrinsic |
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| 12:58 | . The extrinsic pathway says the tissue . That becomes damaged, sends a |
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| 13:02 | to the blood that says, damage has occurred here. Do something |
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| 13:06 | do something now. Alright, So what these present and then then then |
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| 13:13 | have a common pathway shared between So that while the initiation may be |
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| 13:18 | , the ultimate pathway itself is the what's going to ultimately happen here. |
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| 13:25 | . In looking at this. I'm gonna go back here. You can |
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| 13:27 | here there's a whole bunch of roman numerals, right? This is the |
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| 13:32 | that sucks about the pathway. And this is why we don't spend |
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| 13:36 | time memorizing anything. First off, roman numerals are the result of the |
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| 13:41 | in which these molecules were discovered. , you can already see the |
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| 13:47 | Right. So, it's not like one turns on number two, which |
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| 13:51 | on number three, which turns on four. You can see here, |
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| 13:54 | know, 12 is turning on number , which is turning on number |
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| 13:59 | Right? And if you have those numbers, that means there's some low |
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| 14:02 | 12 and three. That's not being . Right? So, this is |
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| 14:06 | nightmare thing to kind of remember, you can't just go OK, |
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| 14:09 | One turns into turns on three. right. So, we're not gonna |
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| 14:12 | about that at some point. You take a class where you have to |
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| 14:17 | those things. All right. And apologize for the idiots who named it |
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| 14:21 | way? Okay, But what I you to understand is the why, |
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| 14:27 | , why are we doing these two ? And then ultimately let's get down |
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| 14:29 | the common pathway, and then let's what's going on in the common |
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| 14:33 | Alright. So, intrinsic everything you is in the blood. The reason |
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| 14:37 | do this or has this is that Probably a more ancient pathway. It's |
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| 14:42 | one that's been around for a It takes a little bit of |
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| 14:45 | So, think about like that scab you picked at, right? Let's |
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| 14:49 | we had a cut and we get scab right? And what we do |
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| 14:51 | pick at it and it starts and we're like, 00ops, I |
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| 14:54 | up the blood vessels. I don't why we always blowing it, but |
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| 14:59 | do right? Maybe it speeds it . It doesn't right? But what |
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| 15:03 | doing here is we're going through these steps. So, A. Turns |
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| 15:07 | B. Turns on C. Turns D. Turns on E. So |
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| 15:10 | so forth, down this pathway. because you have all these different |
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| 15:13 | it takes a little bit longer. , So this is initiated by damage |
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| 15:19 | the vessel wall and it's initiated by platelets, that's the intrinsic pathway, |
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| 15:25 | ? So, like I said, could put a drop of blood on |
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| 15:27 | table and you'll naturally get that Alright, The extrinsic pathway, on |
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| 15:32 | other hand is dependent upon the tissue that's been damaged. Alright, So |
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| 15:38 | what happens is that tissue goes, ! Something terrible has happened to |
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| 15:41 | I've been stabbed with a shiv, ? And maybe I actually haven't even |
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| 15:46 | that blood vessel just yet. But happens, the tissue says, you |
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| 15:49 | , damage has occurred. I need to include the outflow of blood. |
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| 15:54 | so what I'm gonna do is I'm you blood start dealing with the issue |
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| 15:57 | down. So this is a very process, takes about 15 seconds to |
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| 16:01 | this. Alright, so this is outside of the vessel, inside the |
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| 16:07 | , outside the vessel. Alright. so what it does is just ignores |
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| 16:11 | those steps. In essence, it its own signaling molecule to initiate the |
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| 16:16 | pathway. Whereas here, it's basically bunch of dominoes to initiate the common |
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| 16:21 | . That's a better way to think it. All right now, once |
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| 16:26 | initiate this pathway, it will continue until the actual Claude is completed and |
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| 16:30 | . Alright. And so why we these systems? Well, basically you |
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| 16:34 | these it's basically a backup system is can kind of think about it like |
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| 16:37 | way really. The extrinsic is there it means I can get a quick |
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| 16:41 | like I'm hoping for but I have that's probably been around for a longer |
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| 16:44 | of time and I'm not gonna get of something that works. I can |
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| 16:48 | it as a, as a way back up what I'm doing right |
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| 16:52 | All right, now, everything that turn on, you're gonna want to |
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| 16:56 | off, right? So for when I have time, I should |
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| 17:02 | go back here. So for example I'm, when I'm accumulating platelets, |
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| 17:08 | I want a platelets to keep on till the end of time? |
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| 17:12 | because that will eventually fill up the vessel equals bad. Right? |
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| 17:15 | you can imagine the end of helium releasing signals at the same time that |
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| 17:21 | platelets are releasing signals and saying, , stop aggregating. This is why |
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| 17:25 | say it's the old man's screaming. the ones calling the cops about the |
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| 17:30 | , right? The neighbors are being , quit coming onto my yard, |
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| 17:35 | your beer cups over there, your cups. Really right. And the |
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| 17:41 | thing is kind of going on here everything that we're gonna turn on. |
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| 17:44 | something there immediately trying to turn it because we don't want this to go |
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| 17:48 | of control. You don't want your your blood to go through this process |
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| 17:51 | just become solidified. You're there to a band aid to solve a short |
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| 17:57 | problem. Right? And so that's we have all this stuff. All |
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| 18:02 | . So what I wanna do is want to focus here on the, |
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| 18:04 | the common pathway and I try to code this so that you can kind |
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| 18:07 | just follow along even though it doesn't any color over there. Alright, |
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| 18:11 | the first thing is the formation of pro from an activator here, it's |
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| 18:15 | growth remains right. And in essence it is, it's the active form |
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| 18:19 | 10. It's the active form of , it's some calcium. And what |
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| 18:23 | doing is we're bringing in pro thrombin in the plasma membrane or plasma, |
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| 18:29 | a plasma protein. You know, clotting factors are all plasma proteins that |
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| 18:34 | exist, they're there and what we're is we're just trying to bring everything |
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| 18:38 | in its activated form to kickstart everything once you bring all that then plus |
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| 18:43 | calcium. Then what you're gonna be to do is you're able to create |
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| 18:47 | enzyme that breaks down pro thrombin, plasma protein and turns it into its |
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| 18:52 | form, thrombin, that's all it . So what's thrombin thrombin is an |
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| 19:00 | that takes vibrant region which is another protein and it converts it into |
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| 19:07 | So what you have is you have inactive form that can't do anything circulating |
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| 19:11 | blood at all times. And now you've done is you've activated and now |
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| 19:14 | able to do stuff. So what fiber, well fiber and basically is |
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| 19:20 | fiber that helps to reinforce and create clot where the platelets have been aggregating |
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| 19:26 | have been congregating. Aggregating is a word. Right? So you got |
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| 19:31 | platelets in there going, okay, filling up this space. And now |
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| 19:34 | I wanna do is I want to that with a whole bunch of fibers |
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| 19:37 | create a tough material that basically protects environment from the external environment. |
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| 19:45 | Think about what a scab looks Alright, it's basically all those platelets |
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| 19:49 | it's basically cross linked with a whole of fibers. Alright, so you |
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| 19:53 | this mesh and then the factor that that is factor 13. And you |
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| 19:57 | see here, I'm here's the activated and I'm taking those fibers and creating |
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| 20:03 | stable form of that. That's all steps. So, basically create an |
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| 20:08 | . So I can activate one This is now new enzyme that can |
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| 20:12 | the next protein which are loosely And then what I'm doing is I'm |
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| 20:17 | stabilize it with another active protein. there's the steps, so thrombin really |
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| 20:25 | like the key factor in this whole and what I've done that kind of |
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| 20:30 | out again just so and can they a really good job of highlighting of |
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| 20:33 | the different places, thrombin is Right? It is an enzyme that |
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| 20:38 | is its own production. It's an that catalyze is the activation of factor |
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| 20:43 | into into its active form. It's uh catalyze is the the active or |
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| 20:49 | inactive form of seven to become the form in the intrinsic pathway. |
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| 20:54 | It's activating factor 13. So, essence, it's basically turning on everything |
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| 21:00 | reinforcing this activity. So while you it kind of going on a little |
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| 21:04 | , the more you get, the and faster the system goes, it's |
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| 21:08 | positive feedback mechanism, right? So really kind of saying, let's make |
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| 21:12 | clot as fast as we can, then on top of that it acts |
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| 21:16 | other things, it acts on those epithelial cells. Remember, get off |
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| 21:19 | lawn, I got the platelets accumulating , let's keep that going. But |
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| 21:23 | , by the way, let's make that the platelets are, are forming |
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| 21:26 | the right place. So let's tell endothelial cells to start releasing more and |
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| 21:30 | of those inhibitory factors like nitric oxide prostaglandin, basically saying, stop, |
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| 21:37 | come here, you stay wherever you're . But at the same time, |
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| 21:40 | me act on the platelets and hey, keep doing what you're |
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| 21:43 | So you see what we've got here we've got a system that's saying, |
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| 21:46 | , focus, focus, stay away the areas you're not supposed to |
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| 21:50 | and I'm just gonna keep pushing the forward. Alright, And what am |
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| 21:54 | doing in the platelets? I'm activating von Wilburn factor, I'm forced into |
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| 21:59 | to become released, so on and forth the other thing that does, |
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| 22:04 | gonna do with this here in a and it tells tissue to help produce |
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| 22:09 | . This is T. P. . Is tissue plasma an activator and |
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| 22:12 | on another slide. So, if don't see it in a second, |
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| 22:15 | mean, you don't need to have right here. All right. |
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| 22:20 | obviously this is a system that can out of control very quickly. |
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| 22:26 | And so, for every system that have that can go out of |
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| 22:30 | Actually, every system we have we something that regulates it. And I |
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| 22:33 | this was a really good way to of see because it's a very well |
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| 22:37 | system, but you can see how it is. Alright, so, |
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| 22:42 | got these peregrine factors, like I , prostaglandin, nitric oxide. What |
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| 22:45 | doing is you're telling the endothelial cells this stuff so that the platelets aren't |
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| 22:50 | out of control and and filling out basically limited to the place where they've |
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| 22:54 | activated in our aggregating. All But then we have some anti coagulant |
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| 23:02 | means stop the process. All So, we have a tissue factor |
|
| 23:06 | basically prevents the activation of factor Whereas factor 10. Or remember it |
|
| 23:11 | make that common pathway. So, , on blocking here saying stop making |
|
| 23:15 | thrombin. All right. So, have a break on our gas |
|
| 23:21 | We have anti thrombin three. What it do? It's another brake on |
|
| 23:25 | gas pedal, thrombin modeling. Not are we going to press on the |
|
| 23:29 | , but we're gonna actually take out engine that's driving all this stuff so |
|
| 23:34 | bind up thrombin and we move it and destroy it. All right? |
|
| 23:39 | lastly, we have a couple of called protein C. And S. |
|
| 23:42 | what they do is they bind to a modeling and inactivate other factors like |
|
| 23:48 | five and factor seven or sorry, eight. So, for everything that |
|
| 23:54 | turned on, we have something that's , Whoa, slow down. Slow |
|
| 23:57 | , slow down. That's the Now, let's go back to our |
|
| 24:05 | scab. Honestly, let's we're friends , right? Are we friends? |
|
| 24:12 | ? Okay. Got a couple of looking down like I'm not gonna look |
|
| 24:15 | in the eye. All right. be honest here. How many guys |
|
| 24:19 | to play with your scabs? it's fun, isn't it? |
|
| 24:23 | You get that bleeding going, pick, pick, pick, |
|
| 24:26 | look, I gotta go. You like it now picking at it, |
|
| 24:32 | ? Right. And it's really sad it finally goes away, right? |
|
| 24:35 | we go take a shower and part the scab disappears and then you |
|
| 24:39 | you come back and you know, can pick at it for a little |
|
| 24:41 | , but the next time you take shower a little bit more disappears, |
|
| 24:44 | ? It's like man, my it's slowly dissolving, Right? But |
|
| 24:50 | an indicator that this is not a solution, right? The purpose of |
|
| 24:56 | scab is to serve as a temporary while the underlying tissue repairs itself. |
|
| 25:04 | ? So, so it's meant to . And it's picking at It doesn't |
|
| 25:09 | right now? I'm not asking acting your parent is saying stop picking because |
|
| 25:13 | do the same thing. Right? like, oh, I'm gonna just |
|
| 25:16 | at it. Mosquito bites are like I hate them. But they're also |
|
| 25:22 | toy for me, right? Get bleeding. Let that scab comes pick |
|
| 25:26 | it for a little while. All . So, the process of breaking |
|
| 25:34 | that band aid, right? That begins the moment that you begin building |
|
| 25:40 | . Alright, so the process of a clot is called fiber analysis. |
|
| 25:47 | right. So what we're gonna do in the blood. We have this |
|
| 25:51 | there goes finally we have this material plasminogen. Alright, So it's another |
|
| 25:55 | all it is is just another um just so sad how fast is |
|
| 26:01 | It's just another plasma protein. And its job is is to become when |
|
| 26:07 | becomes activated, it's activated by these . Either the one that said the |
|
| 26:11 | or one that's in circulation. And it will do is that it activates |
|
| 26:16 | and plasma serves as a scissor to fiber in. So you created all |
|
| 26:20 | cross links, you made fiber and nice and tight. And it's doing |
|
| 26:24 | job. And now what you have you are going to start breaking it |
|
| 26:27 | the moment that you make it it's that the rate at which it breaks |
|
| 26:30 | . It's fairly slow, relatively Right. So, think about how |
|
| 26:34 | a scab sits around you have it for quite a while, don't |
|
| 26:38 | The bigger the scab, the longer sticks around the purpose of the scab |
|
| 26:42 | the tissue underlying. And so what doing is you don't want it to |
|
| 26:47 | around but you want it to be long enough. So the plan has |
|
| 26:49 | sitting there going clip, clip clip it's working to break that down as |
|
| 26:56 | goes along. Which is why when shower and you start scrubbing at this |
|
| 27:01 | , you're getting rid of the parts you don't need anymore. It's being |
|
| 27:05 | down as it goes along. Now are regulators of the regulators and their |
|
| 27:10 | regulators regulators. And this is just to show you that the rate at |
|
| 27:13 | I make plasma is gonna be regulated other proteins as well. And that's |
|
| 27:17 | I'm trying to show you there. don't think I'm gonna ask you specifically |
|
| 27:20 | names of those proteins and stuff. just mean. Right, I don't |
|
| 27:27 | be too harsh. Alright, so gonna stop there and we'll ask you |
|
| 27:36 | questions. What do we know or do we need to know? What |
|
| 27:40 | I not explain? Well, what you concerned about regarding? Homeostasis does |
|
| 27:45 | up pretty well, does it make ? three heads nodding. four heads |
|
| 27:52 | . All right. Yes, both of you? Mhm. |
|
| 28:05 | Like, I don't understand. It's pressure inside. Right. So, |
|
| 28:12 | , imagine though where the flow of is. If I've included the flow |
|
| 28:15 | blood, then the pressure in that inside that blood vessels a lot |
|
| 28:19 | Right? That's why it's basically you're longer flowing through. So, there's |
|
| 28:24 | pressure where that flow should be. the idea you might have greater pressure |
|
| 28:29 | the back side than you normally but it's not enough to push the |
|
| 28:33 | through relative to the strength of the . That's constricting. So the trans |
|
| 28:38 | pressure is simply that outer pressure reinforcing initial vascular spasm. Okay, |
|
| 28:51 | definitely quiet. I like that. means we understand it. Ready for |
|
| 28:56 | easy, easy stuff. Blood vessels easy. I It's all easy if |
|
| 29:07 | look at it and say it's What have you just done? You've |
|
| 29:11 | it hard. Alright. If it's it's easy and it feels hard and |
|
| 29:16 | say I've got to figure out how it easy? So, it's a |
|
| 29:20 | trick. Now there's stuff that's I mean, organic chemistry, it |
|
| 29:27 | fun compared to this. Oh my . Yeah. We're going to start |
|
| 29:34 | argument. Maybe even a fistfight and not even talking to me being |
|
| 29:38 | I mean, Yeah. Alright. what I wanna do is this is |
|
| 29:44 | that we've kind of already seen. . We talked about a little bit |
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| 29:47 | this already, right That there is organization to the blood vessels that from |
|
| 29:52 | heart we go from from the heart arteries, from arteries we go down |
|
| 30:00 | arterial. That's good. I mean was going for the big one but |
|
| 30:04 | to capillaries, capillaries to veins and the small ones are venues. So |
|
| 30:10 | artery capillary vein, that's all you to remember right? That's that's the |
|
| 30:14 | in which blood is flowing. We're moving away from the heart and |
|
| 30:20 | back towards the heart. The capillaries the site of exchange and that's really |
|
| 30:23 | this is trying to show you is there are arteries, capillaries and |
|
| 30:26 | Arteries carry blood away from the Capillaries are the site of exchange veins |
|
| 30:30 | where where returning blood back to the . Now obviously we don't have one |
|
| 30:36 | fits all that arteries get smaller and and smaller as they go. Veins |
|
| 30:41 | off really, really small about the of capillary and get bigger and bigger |
|
| 30:44 | bigger as they return back towards the . Alright, so we have names |
|
| 30:49 | those different levels right? The first of artery that you should be familiar |
|
| 30:55 | is the elastic artery. Alright, arteries like your aorta. Alright, |
|
| 30:59 | aorta is not just a little tube comes out of your heart. It |
|
| 31:02 | travels the length of your thoracic cavity your abdomen. Alright. And from |
|
| 31:08 | you get branches off of them. that's where you're gonna start getting named |
|
| 31:12 | named arteries. But this aorta is example of an elastic artery and this |
|
| 31:18 | as a pressure reservoir. Now why I need a pressure reservoir? What |
|
| 31:23 | the two states of the heart Sicilian ? Or if you want to be |
|
| 31:29 | in plain english contraction and relaxation. there's a period of time where I'm |
|
| 31:35 | blood and moving blood forward. And there's a period of time when I'm |
|
| 31:38 | . But do your does your tissue blood all the time? Yeah. |
|
| 31:44 | . It would suck if you don't blood. Right. And so here |
|
| 31:48 | we need to do is we need create an environment that is going to |
|
| 31:51 | for blood to continue while the heart relaxing. So we call this a |
|
| 31:56 | reservoir. Because when blood is ejected the aorta or into an elastic |
|
| 32:03 | it expands. And now you have energy that is going to be used |
|
| 32:08 | into kinetic energy that is going to push the blood back out during the |
|
| 32:12 | of diastolic. Does that make Right. So basically you can think |
|
| 32:18 | why is it elastic and has a bunch of elastic tissue in it? |
|
| 32:21 | when you put pressure inside there that elastic tissue expands that word. And |
|
| 32:26 | when you remove that pressure, it's gonna squeeze on its own and return |
|
| 32:31 | to its original position while pushing the forward. Now the elastic arteries empty |
|
| 32:37 | into what are called the muscular arteries hear what you're doing is you're sending |
|
| 32:42 | blood to the different organs. They're arteries there. The named arteries of |
|
| 32:46 | , like renal artery, would be example of a distributing artery. |
|
| 32:50 | And they get smaller and smaller as go. All right, when we're |
|
| 32:54 | about blood pressure, typically, this what we're talking about is we're talking |
|
| 32:57 | these structures because they're primarily muscular and the ones that are responsible for vessel |
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| 33:02 | and dilation. They're the ones that all the pressure in the blood vessels |
|
| 33:08 | there. Resistance vessels for the most . And then finally, we get |
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| 33:12 | to the last little bit. These the arterials and they are also resistance |
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| 33:16 | , but they're the ones that regulate flow of blood into the capillaries. |
|
| 33:20 | right, So, the itsy bitsy structures the capillaries side of exchange. |
|
| 33:27 | , So, you can think up , when I see artery think transport |
|
| 33:31 | is not going into the interstitial fluid it gets into a capillary fluid from |
|
| 33:35 | interstitial fluid doesn't go into the blood the plasma unless you're in a |
|
| 33:40 | Alright. So, we primarily see where we're going to exchange material between |
|
| 33:45 | blood and the cells, or we're materials from the blood to the external |
|
| 33:49 | , which is the air. the veins is where we're gonna collect |
|
| 33:54 | after exchanges taking place. So we really, really small ones. They |
|
| 33:57 | off small and they get bigger and and bigger. And what we're doing |
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| 34:00 | we're moving towards the blood vessel or the heart. They don't have the |
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| 34:04 | degrees of structure. So we just break it down as tiny and |
|
| 34:08 | So vineyards and veins. All right when we get to the big |
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| 34:12 | the big veins here, what we're do is we're gonna see that they |
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| 34:17 | fairly easily as a result of the pressure or the outward pressure of the |
|
| 34:21 | . All right. So what happens is as blood enters into them they |
|
| 34:26 | , oh well this is kind of . I'm going to relax. And |
|
| 34:30 | you can actually hold more blood in than a normal vessel because of that |
|
| 34:34 | pressure. And so we think of as blood reservoirs. Yes ma'am. |
|
| 34:53 | the degree of constriction and relaxation or is a function of the sympathetic |
|
| 35:00 | So at any given time your body body is trying to maintain a specific |
|
| 35:04 | of blood pressure. Right? And you're you're we we do not have |
|
| 35:09 | parasympathetic innovation or if there is parasympathetic of the blood vessel it's very very |
|
| 35:14 | . So it's primarily sympathetic. So it's how much sympathetic activity are you |
|
| 35:19 | ? And so really what you're asking question is that that not you're |
|
| 35:22 | But they're asking is am I delivering blood needed to keep the cells alive |
|
| 35:27 | this particular area. And so what gonna do is they're going to do |
|
| 35:31 | degrees of construction, constriction and relaxation upon the needs of the tissue surrounding |
|
| 35:37 | . Does that make sense? so let's let's do an example |
|
| 35:42 | Okay. No, no. So resistance changes as a function of the |
|
| 35:52 | of constriction of relaxation. Right? remember diameter, really? Radius has |
|
| 35:57 | huge impact on on resistance. To the art of the fourth power |
|
| 36:03 | over r to the fourth power is inverse of resistance. So as I |
|
| 36:09 | the radius, I'm really dropping the significantly. But where I constrict then |
|
| 36:15 | increasing the degree of resistance significantly. right, So, do we understand |
|
| 36:23 | concept of blood reservoir? This idea basically this is where blood is always |
|
| 36:28 | be in circulation. It does not moving if it stops moving, bad |
|
| 36:31 | happen. All right. So it slow down to quite a bit, |
|
| 36:35 | it still moves. Alright, when stops moving, then those heavy formed |
|
| 36:39 | kind of drop out and you gotta things. And that's not good. |
|
| 36:44 | when we say blood reservoir, it's a pool of blood sitting around doing |
|
| 36:47 | . It's slow moving blood. It's a bayou, right? If you |
|
| 36:51 | look at the water in the bayou doesn't look like it's moving? But |
|
| 36:54 | moving it's just doing it slower. . Yeah. So where so the |
|
| 37:08 | cava basically. So wherever you have artery typically speaking and none of these |
|
| 37:13 | are all over the show. That's speaking artery and veins run side by |
|
| 37:16 | to it with each other. So wherever the A. R. Is |
|
| 37:19 | , that's where you're gonna see the vena cava as it's being formed is |
|
| 37:23 | up alongside it. Superior vena cava down um from the superior portions above |
|
| 37:29 | above. The heart is responsible for the blood returning back from the head |
|
| 37:33 | region. Right? But they basically right outside the right side, right |
|
| 37:38 | the right atrium. Right? But idea is that whenever you see an |
|
| 37:42 | just think there's a vein right beside and vice versa. All right. |
|
| 37:46 | so we're just we're since we're not the anatomy, we're just presuming these |
|
| 37:50 | things. Now, you'll see this right up here. And this is |
|
| 37:53 | a really good point is that whenever talk about in physiology we kind of |
|
| 37:57 | make it a loop. Right? so the reason we draw it like |
|
| 38:01 | loop is so that you can envision leaving the heart traveling through the systemic |
|
| 38:05 | and returning back, right? But two structures are side by side is |
|
| 38:11 | I want you to envision how it is. All right. So this |
|
| 38:15 | how we envision it as a loop though they are side by side. |
|
| 38:21 | , blood vessels have all the same . It's just when something is |
|
| 38:26 | we just call it. You have of that component, right? And |
|
| 38:30 | , what I want to show you is that the inner layer of all |
|
| 38:32 | blood vessels are filled with an epithelium in to Thalia. Alright. It's |
|
| 38:38 | a special word we use for the for its capital for for the the |
|
| 38:43 | tissue that lines the inner circle or inner inner part of the tube. |
|
| 38:48 | what we can do is we can ask questions about connective tissue and smooth |
|
| 38:52 | . So, we have elastic connective , have fibrous connective tissue and smooth |
|
| 38:57 | . And depending upon which vessel you're at, you're gonna see varying |
|
| 39:01 | So, for example, over here's the aorta, which is an |
|
| 39:05 | artery. It has right there, and lots of elastic fibers. It |
|
| 39:10 | has really fibers, fibers as And that's to ensure that you don't |
|
| 39:15 | expanding the balloon until it pops You want to have something that serves |
|
| 39:19 | a point of resistance. And that's the fibers does. But notice, |
|
| 39:24 | speaking how much smooth muscle it Alright, now, this is a |
|
| 39:29 | large vessel. Right? And when you're talking about a vessel like |
|
| 39:32 | size, What you're looking at is vessel that has a uh lumen. |
|
| 39:38 | about that big. Alright. What talking about, say, a muscular |
|
| 39:43 | a muscular artery. You know, might have a vessel that's like that |
|
| 39:47 | . All right. But if I it the same size relative, you |
|
| 39:51 | , to to that size, you'd that the muscle is much much thicker |
|
| 39:55 | in the elastic one. And that's what this is trying to show |
|
| 39:57 | , is relative concentrations, even though thicknesses are very, very different, |
|
| 40:04 | ? And the sizes are very So, depending on what you're looking |
|
| 40:08 | , you're gonna see varying concentrations of different types of tissues. They all |
|
| 40:13 | enough helium. Right? But look a capillary, Does it have elastic |
|
| 40:18 | tissue? Does it have muscular? it have fibrous? No. |
|
| 40:23 | basically, what is a capillary? a little Itsy bitsy, teeny tiny |
|
| 40:26 | made up of epithelium. Right. about a blood vessel? Well, |
|
| 40:31 | has some elasticity have to if it itself to stretch outward, but it |
|
| 40:36 | have the same amount as, that elastic artery does. Alright, |
|
| 40:42 | , varying concentrations, depending depending upon location and its role in the movement |
|
| 40:48 | blood from one point to the So, if we remember those rules |
|
| 40:51 | we learned at the beginning, elastic artery, muscular artery arterials? |
|
| 40:55 | can kind of see where do I to see these things. I don't |
|
| 40:59 | to see a lot of elasticity in smaller arteries. I expect to see |
|
| 41:02 | muscle, right? When I'm over in the vineyards. What do I |
|
| 41:07 | ? I expect to see muscle and so much elasticity, but I do |
|
| 41:13 | them not to pop. So arteries functions move the blood from the heart |
|
| 41:24 | the tissues. Secondly, we're talking big arteries pressure reservoirs, that's just |
|
| 41:32 | keep the blood always flowing when we down to the small enough structures. |
|
| 41:37 | have your arterials, but you can see some of the muscular arteries kind |
|
| 41:40 | fall in this line when I get to the small vessels. Now, |
|
| 41:43 | dealing with resistance and that has to with radius. All right, |
|
| 41:49 | What we're gonna see and you've seen chart before where you saw the systolic |
|
| 41:53 | diastolic systolic diastolic got smaller and smaller smaller until ultimately what's gonna happen is |
|
| 41:58 | resistance becomes great enough. So, can't see the differences between systolic and |
|
| 42:03 | . In other words, it prevents pulse, it'll um appearance of that |
|
| 42:09 | gradient and instead, what you end as you end up with a smooth |
|
| 42:14 | . Now, each of the arterials be adjusted independently of each other. |
|
| 42:21 | right, I'll we're gonna we'll see in just a second when we look |
|
| 42:29 | blood flow during exercise. Alright, they're gonna do is they're going to |
|
| 42:36 | what the heart is pumping out to tissues that need it. Alright, |
|
| 42:41 | , we're not gonna saturate every tissue the time with all more blood than |
|
| 42:46 | needs. We're gonna send blood to it needs to go is a way |
|
| 42:50 | kind of think about this. And , you're constantly constricting and relaxing blood |
|
| 42:55 | to ensure that blood is going where needs to go. Now, what |
|
| 42:59 | end up happening is you'll end up into a region like what we're looking |
|
| 43:02 | . So, here, you can your little tiny arterial, you can |
|
| 43:04 | the smooth muscle that plays that role creating that resistance and then what this |
|
| 43:08 | . It represents a capillary bed and the opposite side, is that |
|
| 43:13 | All right. So, you can arterial blood goes in the capillaries and |
|
| 43:16 | it goes via the venue. but entering into the capillary bed is |
|
| 43:20 | structure that's referred to as a meta . It's not an artery and it's |
|
| 43:25 | a capillary, it sits in Alright, at the openings of these |
|
| 43:30 | arterials, you're gonna see a capillary , right? Really at the point |
|
| 43:36 | where the capillaries are, blood flows in. And so these sphincters serve |
|
| 43:40 | determine where the blood is actually going go. Now, just to give |
|
| 43:45 | you a sense of how many blood you have and how many miles and |
|
| 43:49 | and miles of blood vessels you have that there is not a cell in |
|
| 43:52 | body that is more than 10 microns from a blood vessel from a source |
|
| 43:58 | of of the auction or or or know, glucose or whatever it needs |
|
| 44:04 | blood. All right. So, got a lot of blood vessels is |
|
| 44:08 | I'm trying to get at. But any given time you're not feeding every |
|
| 44:12 | solitary capillary, all that blood you're distributing where the blood needs to |
|
| 44:18 | So, it's these capillary sphincters that see going into these capillaries that determines |
|
| 44:24 | the blood is going to actually Now, just to be clear these |
|
| 44:29 | vessel constriction and dilation referred to narrowing enlarging the blood vessels. Just so |
|
| 44:35 | you can picture constrict, make smaller , make bigger. Alright, every |
|
| 44:40 | vessel you have already has a certain of tone to it, meaning that |
|
| 44:44 | not completely open and it's not completely . It's it's someplace in the |
|
| 44:49 | They're regulated through the sympathetic system. , if I increase sympathetic activity, |
|
| 44:55 | gonna cause constriction. Right? And I'm gonna get vessel constriction. If |
|
| 45:01 | decrease sympathetic activity, that's going to in dilation. So, what I'm |
|
| 45:07 | is I'm basically saying, okay, to its natural tone. Which direction |
|
| 45:11 | I want to go? All So this is what is regulating that |
|
| 45:22 | . Now, what this picture is to show you is where I am |
|
| 45:26 | rest versus what I am when I'm or what you are doing, maybe |
|
| 45:31 | what I'm doing. Maybe what you're . Okay. So, when I |
|
| 45:35 | to exercise, my heart beats right? And it beats harder. |
|
| 45:42 | the amount of blood that's circulating through body is actually going up. |
|
| 45:47 | So we we see that for in given minute if I increase my heart |
|
| 45:52 | , what happens to my cardiac it goes up. If I beat |
|
| 45:56 | , what happens to my stroke Cardiac output goes up. Alright, |
|
| 46:00 | that's why we looked at that formula there at the very front end of |
|
| 46:04 | the stuff that we're talking about. right, So where does that blood |
|
| 46:09 | from? I mean, I've got finite amount of blood. Well, |
|
| 46:12 | where the blood reservoirs become important. right now again, remember blood vessels |
|
| 46:17 | right next to each other, but kind of separating them out. |
|
| 46:20 | I'm just gonna say, pretend this your artery side and pretend this is |
|
| 46:24 | your venue all side of venus Right? So during normal activity, |
|
| 46:30 | got more blood hanging out on the side than I have on the artery |
|
| 46:36 | . Right? Why? Well, the veins can relax and so when |
|
| 46:41 | veins relaxed, they basically hold more , blood still moves towards the heart |
|
| 46:45 | it but it just moves slower through heart and because of frank starling the |
|
| 46:49 | pumps, just what whatever you give . And so I'm pushing out and |
|
| 46:52 | 80 mils and then that 80 mils over here and it's like slows |
|
| 46:57 | it's not gonna come rushing out like does when I'm squeezing it out of |
|
| 47:01 | ventricles, it slows down. But blood because I've expanded outward, that |
|
| 47:06 | still returns back to the blood. just arriving slower. Does that make |
|
| 47:11 | ? It's like a river and a a river has water flowing through |
|
| 47:16 | But it's a thin channel. So in a river moves fast. |
|
| 47:21 | But then I come out to a , the bayou is wide. It |
|
| 47:26 | receives the same amount of blood, the blood. Let's hope not. |
|
| 47:32 | It receives the same amount of But the water moving through the bayou |
|
| 47:36 | , even though it's the same volume was coming in is moving slower. |
|
| 47:42 | ? Same volume. Different speed. . Yeah. Also it's all based |
|
| 47:53 | . So the large ones are. , so again, where does that |
|
| 47:57 | does that dividing line between small and ? It's there someplace. All |
|
| 48:03 | But I'm not gonna say that was large one and that one, even |
|
| 48:06 | it's a micron smaller, smaller. I don't want to play that |
|
| 48:09 | All right. But what you what I want you to think about |
|
| 48:11 | that it's just it basically it it kind of relaxes when it gets more |
|
| 48:17 | . All right, So when I , what is the autonomic response sympathetic |
|
| 48:24 | parasympathetic, sympathetic? Right? So activity doesn't make my heart do beats |
|
| 48:32 | and faster. And how does sympathetic blood vessels typically constricts them. |
|
| 48:40 | we're going to learn something new. little bit of nuance in that in |
|
| 48:42 | a second here. But I want to just generally speaking. Makes my |
|
| 48:46 | get tight. So, you're saying resistance. So blood moves faster through |
|
| 48:51 | . All right. And then on venus side, I also get vezo |
|
| 48:56 | . So, what am I I'm squeezing the blood vessel so, |
|
| 49:00 | not able to hold as much So, what is it doing I'm |
|
| 49:05 | started with the P ended with Pre load. I'm pushing more blood |
|
| 49:10 | to the heart frank. Starling no problem. I'll just push it |
|
| 49:13 | on the front end. And that's you get that going through. |
|
| 49:16 | now we have more blood circulating through I'm no longer holding blood over on |
|
| 49:21 | venus side. I'm circulating it faster the system. Alright, alright, |
|
| 49:26 | , where's it gonna go? the other aspect of our bodies is |
|
| 49:31 | we have what are called conditioning A conditioning organ is an organ |
|
| 49:36 | under normal restful conditions, receives more than it ever needs. All |
|
| 49:42 | In other words, it serves as place to say, yeah, just |
|
| 49:45 | it there. All right, Because we need it, we know where |
|
| 49:48 | can get it. All right. so, that's what these conditioning I |
|
| 49:52 | . Reconditioning organs are all right. so, you can see up here |
|
| 49:56 | they're trying to show you a couple these, like, the kidney kidneys |
|
| 49:59 | reconditioning organ, Alright, I can our blood to the kidney. It's |
|
| 50:03 | big deal. I'm just filtering stuff of the blood. Not a |
|
| 50:06 | If I need to. If I that blood, I know where to |
|
| 50:09 | it. I can send it away the kidney and send it to where |
|
| 50:12 | needs to go. Um, skeletal , obviously, not a reconditioning |
|
| 50:17 | right? I want to give the muscle as much blood as it needs |
|
| 50:21 | order to perform its function. Skin one. It's not a reconditioning. |
|
| 50:27 | , just, kind of, trying decide, uh, show you here |
|
| 50:30 | that blood is actually going. when I begin exercising, look what |
|
| 50:35 | , OO, there's abdominal, There gets 1300, the amount of |
|
| 50:39 | going into those reconditioning organs drops But I'm not losing blood, because |
|
| 50:46 | my kidneys need to work hard while exercising? No. All they're doing |
|
| 50:51 | just going through going, Yeah, don't need that. You don't need |
|
| 50:53 | . You don't You do need You don't need that. So, |
|
| 50:55 | rate at which it's working is stays or less constant. But when I'm |
|
| 51:01 | from a bear, do my skeletal need more blood. So, imagine |
|
| 51:06 | we're giving every organ all the blood needed. You know, I |
|
| 51:11 | you know, this flat thing. , if I needed to run away |
|
| 51:13 | a bear, there's no place to more blood, no oxygen, no |
|
| 51:18 | . Your now lunch. Right? that's where you're gonna see these increases |
|
| 51:24 | those where the activity is needed. so this is a function of modifying |
|
| 51:30 | amount of blood being held in the , Alright? And that is |
|
| 51:37 | I squeeze the tube. Now the thing that you need to kind of |
|
| 51:44 | is that when blood is leaving the , what we're dealing with is a |
|
| 51:48 | of blood per per unit time. ? And so if I am constricting |
|
| 51:55 | , let's say I constrict one I don't want blood to go to |
|
| 51:57 | kidney. Then what that also means that I have to compensate for that |
|
| 52:03 | amount of blood. Right? here would be an example of |
|
| 52:06 | I'm sending to the kidney and to to the digestive system, over the |
|
| 52:10 | muscle, over to the brain, ? So if I'm sending a leader |
|
| 52:15 | minute to all those different structures, that means my total flow over here |
|
| 52:20 | match what's leaving the heart, But if I constrict to one of |
|
| 52:26 | structures, that means the other ones to make up for it because I'm |
|
| 52:30 | changing how much blood is leaving the . So when we talk about regulating |
|
| 52:38 | structures, this is what we're talking is like, oh, it's not |
|
| 52:41 | be this. Well, everyone, open up. It's I'm gonna open |
|
| 52:46 | here, I'm gonna close up there I'm actually shunting where blood actually needs |
|
| 52:50 | go. So each individual arterial is upon its specific resistance, which I |
|
| 52:58 | regulate independent of the other ones. this is gonna be more or less |
|
| 53:02 | on the needs of the system that trying to provide perfusion to When you |
|
| 53:13 | capillaries. There are three basic types capillaries. Easy one. This one |
|
| 53:17 | easy, is the continuous one. is one you're familiar with when you |
|
| 53:22 | of a capillary. This is what think about. All right. So |
|
| 53:25 | taking your hands putting them together, into a bucket with a bunch of |
|
| 53:29 | with water. And you take your in there and you scoop marbles and |
|
| 53:33 | pull it out. Water is gonna between the fingers in your hands. |
|
| 53:39 | , marble stay. So this is a capillary works is basically a bunch |
|
| 53:45 | leaky tight junctions. So materials can of escape in between the cells. |
|
| 53:49 | the big things are too big to so they stay inside the blood |
|
| 53:53 | And so the reason these capillaries can as a point of exchange is because |
|
| 53:57 | can allow things to escape back and between these two is the most common |
|
| 54:02 | . They're all over the place. right in some places we're gonna see |
|
| 54:08 | are called finished rated. And what we've done is we're modifying that |
|
| 54:13 | model. All right, we're gonna it leaky here. And so |
|
| 54:17 | what we've done trying to find my is what we're doing is we're putting |
|
| 54:24 | uh administrations. In other words, creating gaps in the cells. Were |
|
| 54:29 | vesicles where two vesicles come together and form a complete channel inside the |
|
| 54:35 | And that's what the administration's do. so this is where you're gonna want |
|
| 54:38 | move more materials in and out of of the blood vessel. Alright, |
|
| 54:43 | the kidneys are an example where this where you're going to see these and |
|
| 54:47 | you'll see things like the sinus And these are really weird. This |
|
| 54:51 | basically we don't have any connective tissue it. So there's nothing serving as |
|
| 54:55 | of as a screen or great. cells themselves look like cheese or swiss |
|
| 55:00 | . So, they got big, gaping holes. The cells themselves can |
|
| 55:03 | be separated from each other. So don't even have like they're not tight |
|
| 55:07 | this or loose like this. you can have lots of big |
|
| 55:10 | The liver in the spleen is where gonna see a lot of this and |
|
| 55:13 | spleen in particular, um is a where we're gonna recycle red blood |
|
| 55:18 | And so what you wanna do is want to send them through these capillaries |
|
| 55:21 | basically kind of tear the red blood apart and then kind of create this |
|
| 55:25 | area. So all that stuff can of flush out. So you see |
|
| 55:29 | quite often in there. So they're very very leaky. So you can |
|
| 55:33 | of normal leaky, really leaky. are very very specific where they're |
|
| 55:39 | These are very specific. These are . And so what we're doing is |
|
| 55:43 | allowing exchange to take place. When talking about exchange, we're talking about |
|
| 55:48 | things your body wants things your body to get rid of right between the |
|
| 55:53 | and the blood. How do I these things around? So, capillaries |
|
| 55:56 | the side of exchange. All Um and what we're doing is we |
|
| 56:01 | very very thin walls are very very . We've kind of showed you that |
|
| 56:04 | when we looked at the red blood about those rulers being formed lots and |
|
| 56:08 | of branching. All right. And I mentioned about 10 microns apart between |
|
| 56:12 | cell and it's a source of of . And I love this graph right |
|
| 56:17 | from your textbook because it shows you relative cross section in terms of area |
|
| 56:22 | your blood vessels in these different Right? So you can see what |
|
| 56:26 | cross section your blood vessels. When you get down to the |
|
| 56:32 | the amount of area that you see incredibly high. All right. |
|
| 56:38 | let's put this into perspective for a . All right. Remember when I |
|
| 56:42 | describing a river there's a small channel which fluid flows quickly through. |
|
| 56:49 | So that would be like what you over there where it says four |
|
| 56:51 | that would be like your aorta. order is pretty big, right? |
|
| 56:55 | you only got one right? And you keep dividing and dividing and dividing |
|
| 57:00 | dividing eventually you get down a whole of little tiny. Itsy bitsy tiny |
|
| 57:03 | like this. But there are so capillaries that if you do the cross |
|
| 57:08 | now you have this massive um area can accommodate that volume. So the |
|
| 57:15 | through the capillaries does what goes way , right? If I'm going faster |
|
| 57:23 | aorta, which is big but doesn't a lot of surface area, a |
|
| 57:27 | of area inside. If I got lot of itsy bitsy tiny areas, |
|
| 57:30 | they sum up to a greater area the original, then the flow |
|
| 57:35 | that has to be very slow. this is advantageous. Why do I |
|
| 57:40 | to have things going slow in a More time for exchange. Right? |
|
| 57:47 | about you driving through a drive through going through at 60 mph. You |
|
| 57:51 | you're gonna get what you need? , I mean, maybe the top |
|
| 57:55 | at Taco Bell might be able to it through your window as you're going |
|
| 57:58 | odds are pretty good. That's not happen, right? But if you |
|
| 58:02 | slow down have that conversation with that person. Alright. You know, |
|
| 58:07 | on, we're gonna flirt with the who you know, it's like |
|
| 58:10 | you're gonna get more sauce. So things slow down and that's what |
|
| 58:17 | shows you. It shows you the of flow between these two different |
|
| 58:20 | Now I want to be clear we're talking about velocity versus quantity, |
|
| 58:27 | ? So when we've been talking about , we've been talking about quantity leaders |
|
| 58:31 | per millimeter, right, velocities speed help you visualize this, pick yourself |
|
| 58:37 | the highway, right? You're going miles an hour and you have a |
|
| 58:42 | of cars around you, right? say there's four cars around you and |
|
| 58:45 | going 60 miles an hour. You're about velocity, right, quantity is |
|
| 58:49 | four. Right? But you can or you can keep the quantity the |
|
| 58:54 | and you can all slow down, ? Like think about the 59-88 |
|
| 58:59 | right? You know what I'm talking ? It's like everyone gets down to |
|
| 59:03 | mph all trying to get in front each other. Right? The other |
|
| 59:07 | you can look at it, This you sit on the side of the |
|
| 59:09 | , you count the number of cars by in a minute, right? |
|
| 59:12 | would be volume or velocity volume. right. But now you're using a |
|
| 59:18 | and you're trying to see how fast going. That's velocity. Okay, |
|
| 59:23 | those two things are very different, ? One is how fast millimeters per |
|
| 59:29 | versus how many per millimeter. Alright . So we've been focusing here at |
|
| 59:37 | rate. That's that F. In formula F. Equals delta P. |
|
| 59:41 | our so that blood flow through the depending upon the amount of resistance in |
|
| 59:50 | arterial is greater. The resistance the , the less blood is gonna find |
|
| 59:55 | into the capillaries. This is all controlled. Alright. Number of open |
|
| 60:01 | . If I have an area that's need of material oxygen and glucose. |
|
| 60:06 | I'm going to open up those Blood flows into those areas and then |
|
| 60:11 | that area with oxygen and glucose. I've got all the oxygen glucose I |
|
| 60:16 | . Well let me close up those and let me send the oxygen glucose |
|
| 60:19 | another area. Think about it like . If your hand was a series |
|
| 60:23 | capillary beds. Alright. Each of represents a capillary bed. I'm gonna |
|
| 60:27 | oxygen glucose to this area for a while the other ones don't get |
|
| 60:31 | And then once I've saturated I'm just close that Kapler and go to the |
|
| 60:34 | one and saturate that one. And I'm gonna saturate this one, then |
|
| 60:37 | gonna saturate that and I'm just rotating the blood is actually going at any |
|
| 60:42 | time to ensure that everyone is getting they need and how do I know |
|
| 60:46 | they need? Well the cells are tell me right, they play an |
|
| 60:50 | role in communicating to the surrounding epithelium they need their nutrients when their oxygen |
|
| 60:58 | . So local factors play a major based on metabolic need, sympathetic |
|
| 61:04 | Does that as well? Right, activity increases in response to metabolic |
|
| 61:12 | That kind of makes sense. So about when you're running right, you're |
|
| 61:17 | . What color do you turn write? Why? Well, you're |
|
| 61:23 | heating up and you need to remove heat. And so what's happening is |
|
| 61:26 | opening up all your capillaries to get blood up to the surface. That's |
|
| 61:30 | sympathetic response. And what you're trying do is you're trying to shut off |
|
| 61:34 | . But similarly that heat is also of metabolic activity. Remember our cells |
|
| 61:40 | not particularly efficient of using their So as they burn through their |
|
| 61:44 | they produce heat. So that is indicator of metabolic activity. So that's |
|
| 61:48 | open up the capillaries as well. gonna draw an oxygen glucose. |
|
| 61:54 | so the cells themselves tell the blood um oxygen glucose, please. I'm |
|
| 62:03 | show you this except in a second further. How we doing on |
|
| 62:08 | All right, we're cruising, We're catch up. I like this. |
|
| 62:11 | right. So the vineyards, they go from capital to the vineyard. |
|
| 62:16 | basically we saw that picture right, is your venue. You're basically exiting |
|
| 62:21 | that way. So there's a lot communication going on between the two |
|
| 62:25 | So if this is saying, I'm sending blood into this capillary |
|
| 62:29 | the venus side basically dilates to say go ahead. And it creates that |
|
| 62:34 | gradient so that blood flows through back the venue. Als right? So |
|
| 62:38 | two sides are talking to each so you're you're making sure that you |
|
| 62:42 | enough pressure difference. So blood flows the right direction is what I'm trying |
|
| 62:45 | get out. And when you get the veins now you have very little |
|
| 62:48 | to flow, right? You're not . And what's happening is that the |
|
| 62:54 | vessel itself actually relaxes as it fills . So because it has um no |
|
| 63:00 | or less elasticity um basically what it is when blood comes in and |
|
| 63:05 | oh alright, I'm feeling I'm feeling pressure inside here. So when I |
|
| 63:09 | that pressure, I'm just gonna relax little bit more like bad pantyhose, |
|
| 63:14 | ? You ever had bad pantyhose put foot and they just, they never |
|
| 63:18 | back, they just keep relaxing All right, I'm gonna talk to |
|
| 63:21 | guys guys that pair of underwear, haven't thrown away, that band, |
|
| 63:26 | , that pair of socks that you on and it just stays super stretched |
|
| 63:30 | now, you know what I'm talking ? See you throw all your old |
|
| 63:34 | away, don't you? Okay? a result blood is going to spend |
|
| 63:39 | time in the veins. Why I greater volume, more space, more |
|
| 63:44 | can sit in there and go hey like it in here and as a |
|
| 63:47 | of there being more space blood flows . Just like what we said, |
|
| 63:52 | like a bayou, it's wide. can accommodate and slow things down. |
|
| 63:57 | that's what's going on. Now. know I showed you the picture that's |
|
| 64:06 | around, right, showed you arteries to capillaries and then we're coming back |
|
| 64:10 | again. All right. But it's not your feet, it's |
|
| 64:14 | You have arteries and veins and capillaries all these different structures, right? |
|
| 64:19 | have near the heart. You have far away from the heart. But |
|
| 64:23 | we Wanna do is we want to that blood vessels overcome the effect of |
|
| 64:28 | . Gravity has an effect on on fluids. It's gonna pull it |
|
| 64:33 | And so all our veins have these way valves and they're about 2-4 cm |
|
| 64:38 | . So like about this far And so what that does is it |
|
| 64:41 | up that column of blood from the down to the lowest structures in your |
|
| 64:46 | . And so this ensures that as accumulates in the blood vessels that it's |
|
| 64:51 | popping down and keeps going down and and down. Instead, it's just |
|
| 64:54 | small volume of blood and that doesn't a lot of mass. And so |
|
| 64:58 | easy to propel forward through a couple those different mechanisms that we've described but |
|
| 65:04 | can fail. And so this is they're trying to show you and this |
|
| 65:06 | what a varicose vein is. It's the valve fails. And so instead |
|
| 65:10 | having a valve and a valve or the other one I guess right |
|
| 65:15 | Right. A valve and a what happens is is now if that |
|
| 65:19 | fails instead of having something that's like big now you have something that that's |
|
| 65:22 | and a valve that's only capable of a smaller volume. This valve is |
|
| 65:28 | going to fail and what ends up is you get um you get blood |
|
| 65:34 | inappropriately in these areas which causes an expansion that remains expanded. And so |
|
| 65:41 | what that varicose vein is all So you get this swelling and enlargement |
|
| 65:45 | I've tried to find the ugliest pictures could just so that you can see |
|
| 65:48 | things to look forward to. Um this typically occurs primarily in the superficial |
|
| 65:55 | . It's not gonna slow blood getting to the heart. I mean I |
|
| 65:59 | maybe if all of your veins did would be bad but for the most |
|
| 66:02 | they're mostly just cosmetically ugly. Yeah far as I know. No I |
|
| 66:10 | not and that's been asked me before I've looked maybe they can now I |
|
| 66:15 | usually what they do like with spider which is a similar thing. It's |
|
| 66:20 | at the surfaces are opened up really tiny uh really really microscopic veins |
|
| 66:27 | they'll go fill them up with silicone that you basically included. So, |
|
| 66:31 | blood has to find a different but for something like this, you |
|
| 66:35 | repair that as far as I So, Yeah. Yeah. |
|
| 66:47 | So, capillaries are about exchange. for some math. I like |
|
| 66:56 | All right. Alright. Exchange occurs through Transito sis. All right. |
|
| 67:05 | we're gonna do? We're gonna move from the blood vessels between the cells |
|
| 67:09 | back out again. Alright. There certain things that are too big for |
|
| 67:13 | . So, what we're gonna do we're gonna use um carry mated carrier |
|
| 67:17 | exocet psychosis. So, that form Transito sis All right, So, |
|
| 67:22 | would be trans cellular. Alright, , Transito sis between the cells. |
|
| 67:26 | cellular is through the cell. Um Did I get that right? |
|
| 67:34 | no, I got him flipped translated the cells. Trans psychosis is through |
|
| 67:39 | cell. Okay. Sorry. So you are, the easier it is |
|
| 67:45 | get between the cells. So lipid primarily. Um Yeah, gasses will |
|
| 67:57 | through easily. Um You can create small pores, which is what I |
|
| 68:02 | talking about. They already exist because helium is is so small that you |
|
| 68:08 | get to vesicles side by side, actually create a narrow passage. And |
|
| 68:13 | with regard to the thinnest rated those where they are. You have more |
|
| 68:16 | them and they're so they're more But everything you learned about diffusion is |
|
| 68:22 | here? Okay, so just think all the things, all the rules |
|
| 68:25 | you learned about diffusion and the effects they that diffusion has on the movement |
|
| 68:29 | materials. Now when we're talking about nutrients to the cells, you'll often |
|
| 68:39 | materials moving from the blood to the . But remember we have interstitial |
|
| 68:43 | So really what we're talking about is moving from the plasma into the interstitial |
|
| 68:48 | and from the interstitial fluid to the and vice versa. So it's not |
|
| 68:53 | , it's indirect. Alright. And to move those materials, what we're |
|
| 68:58 | do is we're gonna follow some basic that we've already learned. We can |
|
| 69:02 | at individual salutes and ask the what is the the flow? What |
|
| 69:07 | how is this diffusing is what is concentration gradients through which these materials are |
|
| 69:12 | be flowing? Or we're gonna ask big question. Which direction are things |
|
| 69:15 | generally speaking for all the things. so that is the individual. So |
|
| 69:20 | would be a concentration gradient, you're moving down your concentration gradients. So |
|
| 69:24 | my concentration is high there and low , I'm moving into the cells vice |
|
| 69:28 | . If I have lots inside the . A little over here, I'm |
|
| 69:31 | move out of the cells through the fluid and into the plasma. When |
|
| 69:36 | talking about bulk flow? I'm talking ? How are things moving? Generally |
|
| 69:42 | . So what is the fluid and does it contain? In which direction |
|
| 69:45 | it going? So on the arterial , am I moving from the blood |
|
| 69:50 | the cells are moving from the cells the blood. They go caterpillar on |
|
| 69:54 | arterial side of the capillary. Which do you think? I'm going from |
|
| 70:00 | blood to the cells and then from venue inside my materials are moving generally |
|
| 70:04 | , from cells to the blood. right. So you can see we |
|
| 70:09 | this general bulk flow. Does that mean that that that's gonna be 100% |
|
| 70:13 | . No. For each individual. you you can look at each |
|
| 70:16 | But as a general thing you can of as blood comes in through the |
|
| 70:21 | into the capillary material is gonna flow the plasma into the interstitial fluid as |
|
| 70:28 | unit. And then as I go the venue all side I'm gonna move |
|
| 70:33 | a unit, primarily from the interstitial back into that capillary. Now to |
|
| 70:41 | which is flowing in which direction. need to understand what are the driving |
|
| 70:45 | ? What are the pressures that are and therefore pressures? Right to our |
|
| 70:51 | , to our colloidal osmotic pressures. , so hydrostatic pressure is what type |
|
| 70:57 | pressure? It's the fluid, writes fluids pressure. What is the colorado |
|
| 71:03 | pressure? What's what causes that All right. And so we just |
|
| 71:08 | to think we have two compartments inside capillary. Outside the capillary. |
|
| 71:12 | you can think interstitial fluid and capillary . So, I have one that's |
|
| 71:17 | for the capillary one. That's colloidal for the capillary for the interstitial |
|
| 71:22 | Similar one hydrostatic pressure. One interstitial pressure. Or uh colored osmotic |
|
| 71:30 | Alright, so, what I'm gonna ? I'm gonna break this down for |
|
| 71:33 | . All right? So inside the , right, the hydrostatic pressure is |
|
| 71:38 | the pressure of the fluid of the inside and so on the arterial |
|
| 71:41 | you can go into measure and it's 35 millimeters of mercury. All |
|
| 71:45 | And then on the ventral side because the resistance inside that blood vessel. |
|
| 71:49 | pressure is about 15 millimeters of So, you can see the difference |
|
| 71:52 | . Right. I mean, you kind of see yeah, blood is |
|
| 71:55 | flow from the arterial side of the inside, Right? Because that difference |
|
| 72:00 | pressure in terms of the colloidal osmotic . The amount of plasma protein that |
|
| 72:06 | inside the capillary is going to be or less constant. So we can |
|
| 72:11 | and measure out that and it comes to about roughly 25 mm of |
|
| 72:15 | Alright, so this is the pressure draws fluid regardless if I'm on the |
|
| 72:19 | side or on the ventral side into capillary. This pressure out here is |
|
| 72:26 | driving fluid out of the capillary. ? Because this is relative to atmospheric |
|
| 72:33 | here. The interstitial fluid also has hydrostatic pressure. Remember we're talking about |
|
| 72:38 | mural this is the other half of trans mural pressure. This is one |
|
| 72:41 | . This is the other half. it's asking the question, what is |
|
| 72:44 | ? Well, if I go and it out, it's about negative |
|
| 72:49 | Right? It's very low. It's we just call it zero for our |
|
| 72:52 | . It makes our lives easy. ? So relative to atmospheric pressure it's |
|
| 72:56 | nothing. And you can really kind visualize it if I take a needle |
|
| 73:00 | poke you and um don't actually hit blood vessel. Is water gonna leak |
|
| 73:06 | of your body? Are you a character? I remember when you like |
|
| 73:11 | all the bullet holes in the water out. That doesn't happen to |
|
| 73:13 | right? Because the pressure inside your is roughly the same pressure as the |
|
| 73:18 | of your body. So the hydrostatic doesn't really exist differently than the atmospheric |
|
| 73:24 | . And then finally, if you at the colloidal osmotic pressure in the |
|
| 73:27 | fluid. Do you have any plasma there? What do you think are |
|
| 73:33 | plasma proteins in the interstitial fluid? , if they were what would we |
|
| 73:37 | them interstitial fluid parties. That's where name plaza protocol. It's in the |
|
| 73:44 | . And so if you look at , you'd see that there are none |
|
| 73:48 | . And so if there are then you have no colloids. Osmotic |
|
| 73:53 | . So it's roughly equal to So we have four pressures. Two |
|
| 73:56 | them are close to zero. If zero. And then we have two |
|
| 74:02 | actually have a value that we can . And all we gotta do now |
|
| 74:05 | just ask the question, what do pressures do? Right? This pushes |
|
| 74:12 | out or fluid out. This pulse in this push pushes fluid into the |
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| 74:18 | . This pulls fluid back out of capillary. And all we gotta do |
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| 74:21 | is just do a little bit of and everyone loves math. I'm gonna |
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| 74:28 | it easy for you. I'm gonna you the formula that the book talks |
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| 74:31 | . But I'm gonna show you another right? There is another way to |
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| 74:34 | it. All right. And basically says, what is the pressure out |
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| 74:38 | what's the pressure in? And so can just plug those things in, |
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| 74:43 | ? one minus the other and then the pressure out versus the pressure |
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| 74:48 | Which is that right there. And can give you the form that will |
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| 74:51 | you whether the pressure is driving things pulling things out. Now, when |
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| 74:56 | learned this stuff, this is the that I learned is to put all |
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| 74:59 | pressures out versus all the pressures So, it's just the same |
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| 75:03 | I'm just moving the characters and and doing some rearrangement. What's that's the |
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| 75:10 | community property. Do you remember that ? Way back in 6th grade when |
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| 75:14 | learned those definitions, I can't remember one it is distributive. I think |
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| 75:18 | distributed property. All right. But essence, you can do the same |
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| 75:22 | . And what happens is if you the math and throw those numbers in |
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| 75:25 | we showed you the 35 and the and 15 and the zero and the |
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| 75:29 | and put them in the places. you find is if the pressure is |
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| 75:32 | positive number, then what that's telling that that particular location, then the |
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| 75:37 | flow is gonna be filtration or the flow. Its outward flow. So |
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| 75:41 | filtration. If that number comes, negative after you throw that, then |
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| 75:45 | says the flow is not outward. it's towards the capillary, inward. |
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| 75:50 | so, what you have is that kinda makes sense. I'm just |
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| 75:54 | flip to this slide. So you kind of see it. So over |
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| 75:57 | is where I have that 35 right here is where I'd have that |
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| 76:03 | And then we remember what we're doing we're dealing with that 25 ka |
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| 76:06 | So 35 minus 25 is what? . So that would be a positive |
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| 76:11 | . What's 15 minus 25 negative Yeah. And so you can see |
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| 76:17 | , I've got a positive 10 versus negative 10. So on this |
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| 76:20 | what I see is I see that fluid is being pushed out of the |
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| 76:24 | into the interstitial space And then there's point of transition. And then now |
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| 76:28 | I'm doing is I'm pulling fluid back the capillary and so you can see |
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| 76:33 | flowing out and then I'm flowing back and then then off to the vineyards |
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| 76:38 | go and it's this movement, this flow that allows me to have exchange |
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| 76:42 | place. So on the artery I'm carrying oxygen glucose and I'm delivering |
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| 76:47 | to the cells. I'm also carrying dioxide and other waste. But for |
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| 76:51 | most part oxygen glucose. And then get all those things exchange and |
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| 76:55 | And now I've got a lot of dioxide and a lot of waste product |
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| 76:58 | now the blood naturally flows back out the capillary or into the capillaries and |
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| 77:03 | out through the venue als So, where exchange occurs. That kinda makes |
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| 77:11 | . I'm looking at her eyebrows, eyebrows are doing this, see it's |
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| 77:16 | frustration. Look, I'm gonna try see where I'm at. All |
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| 77:22 | So, I'm gonna answer it. gonna try to explain and I'm gonna |
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| 77:25 | this last slide and then we'll be . We'll deal with lymphatic and the |
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| 77:28 | stuff before we do respiration and I respiration it's really easy. All |
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| 77:38 | So, what we're saying here is we compare and look at those |
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| 77:43 | you know, along the line. we're going to see is that the |
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| 77:48 | nearest the artery because of the collide . The differences between them because of |
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| 77:54 | differences in the hydrostatic pressures. We're to see a positive pressure that pushes |
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| 77:59 | out of the blood and into that space. And as that blood is |
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| 78:04 | then the pressure is going to be . Would you agree with that? |
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| 78:08 | if I remove something then there's So that means there's less pressure and |
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| 78:12 | over the length of the capillary as move towards the venus side is I'm |
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| 78:17 | less and less and less pressure until a point when the pressure on the |
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| 78:23 | of the capillary is less than the on the outside in the interstitial |
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| 78:28 | And at that point now the flow fluid reverses itself. It's no longer |
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| 78:34 | to escape the capillary is now being back into the capillary and it's bringing |
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| 78:38 | it those materials that need to be from that area. And so that |
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| 78:44 | is gonna become bigger and bigger and partly because the blood in the veins |
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| 78:48 | the venus side in the venue is away. And if there's no pressure |
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| 78:52 | the vein then the fluid from or there's no blood inside the vein then |
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| 78:57 | going to be replaced by the blood the cap player which creates kind of |
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| 79:00 | negative pressure. And so that's why drawing blood faster and faster away. |
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| 79:08 | I'm gonna point this out here first then deal with that next slide. |
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| 79:12 | then we'll come back under any under normal circumstances, the amount of |
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| 79:18 | that's filtered filters the stuff that's leaving capillary. There's more filtered than that's |
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| 79:24 | . That said in english means more is leaving the capital than is |
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| 79:29 | More plasma is leaving the capital than returning. So we need to have |
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| 79:33 | mechanism to fix that problem. And what the lymphatic system is about. |
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| 79:38 | plays a role in the immune but it plays an important role in |
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| 79:41 | blood back and this is kind of the circulation looks like. So we |
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| 79:46 | three loops. We have the cardiac . That's that first look loop, |
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| 79:50 | ? So basically what we're doing is pumping about five liters per minute. |
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| 79:53 | as you're sitting here for the last and 20 minutes is you can just |
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| 79:57 | that number. That's what, 80 , multiplied by five. That's how |
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| 80:03 | blood you pumped In this 11 class day. That's about 7200 L per |
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| 80:10 | . Your heart is a very active . Then we have the trans vascular |
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| 80:14 | , that's what's being pumped across the . Alright, so here, what |
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| 80:18 | doing is that's about 20 liters that been filtered. In other words, |
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| 80:21 | can go out and go into the space and then what comes back in |
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| 80:25 | the reabsorbed, you get about 18. So if you're five liters |
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| 80:29 | blood over the course of of a , Well really not of a day |
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| 80:36 | you're basically losing two L of two liters of fluid. Now of |
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| 80:42 | , you imagine your blood is getting and thicker and thicker. So what |
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| 80:45 | gotta do is you gotta fix that . And so that's what this third |
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| 80:48 | , the lymphatic loop. The thing gonna talk about first thing on Tuesday |
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| 80:52 | is it says wait a second um that two leaders need to go back |
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| 80:57 | here. So what we're gonna do we're gonna catch that and we're gonna |
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| 81:00 | it back and so that's what we're to deal with lymphatic system. Did |
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| 81:08 | help you on that last |
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