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{{Merge to|Total peripheral resistance|discuss=Talk:Total peripheral resistance#Merger proposal|date=September 2012}}
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'''Total peripheral resistance''' (TPR) is the sum of the resistance of all peripheral vasculature in the systemic circulation. Vasculature throughout the entire body is two separate circuits - the systemic circulation and the pulmonary circulation. TPR should not be confused with Pulmonary Vascular Resistance (PVR), which is the resistance in the pulmonary circulation.<ref name="test">[[Total peripheral resistance]], additional text..</ref>


Change in pressure that occurs in the aorta and large arteries is very little. About 70% of pressure drop occurs in small arteries and arterioles. Thus, small arteries and arterioles are the main regulators of [[Total peripheral resistance]].
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The significance of smooth muscle in the control TPR is major. While contracting and relaxing, the smooth muscles that line the walls of vessels alter the radius therefore influencing flow of blood through them.   
 
The role of each factor in Poiseuille’s law:
 
:'''R = 8Lη/Πr^4'''
 
Blood viscosity, vessel length and radius influence on resistance. Increase in viscosity, oxygen-carrying capacity supply by the greater number of red blood cells is offset by the increase in resistance to flow. The correct balance between enough red blood cells for oxygen carriage and negative effect of additional red blood cells on the resistance to blood flow. Length of vessels does not change significantly therefore does not determine the resistance. Vessel radius is major factor in determining the changes in TPR. Small changes in radius cause large changes in resistance because resistance is proportional to r^4.
 
==Analysis of Total Peripheral Flow Resistance==
Blood vessels provide resistance to the flow of blood because of friction between moving blood and the wall of the vessel.<ref>"Cardiac Output and Blood Pressure". biosbcc. Retrieved 7 April 2011</ref>
 
:Using the generalized [[Bernoulli's equation]] below for pressure and flow in blood vessels,
 
:<small><math>P_1-P_2=\tfrac12\rho[(\text{velocity at station} 2)^2-(\text{velocity at station} 1)^2] +\gamma [(\text{height at station} 2)-(\text{height at station} 1)] +\
(\text{rate of change of kinetic energy of the blood between stations 2 and 1}) +\ (\text{integrated frictional loss between station 2 and 1})</math></small> {{pad|3em}} '''(Eqn. 1)'''
 
:''Velocities of two stations equal by putting station 1 in the aorta at aortic valve and station 2 in the vena cava at the right atrium.''
: ''Height of these two are the same.''
:''Measurements of average pressure and flow over a period of time over several cycles of oscillation will average out to zero because the rate of change kinetic energy of the blood in this segment oscillates on the positive and negative side equally.''
 
:Thus the above equation becomes
 
:'''Average pressure at aortic valve - average pressure at right atrium = integrated friction loss.''' {{pad|3em}} '''(Eqn. 2)'''
 
:Also often written as
 
:'''Systemic arterial pressure = (flow)(resistance)''' {{pad|3em}} '''(Eqn. 3)'''
 
:''Systemic arterial pressure = pressure difference between aortic valve and the vena cava at the right atrium.''
:''Flow = [[Cardiac output]]''
:''Resistance = [[Total peripheral resistance]]''
:Or
 
:'''Pressure at aortic valve - pressure at right atrium = (cardiac output)(total peripheral vascular resistance)''' {{pad|3em}} '''(Eqn. 4)'''
 
:The billions of capillary blood vessels have millions of pathways to integrate to obtain equation 2 and 3. No matter which path of integration is used the final result is the same difference of pressure at the aortic valve and right atrium.
 
==References==
{{Reflist}}
{{cite web|title=Cardiac Output and Blood Pressure|url=http://www.biosbcc.net/doohan/sample/htm/COandMAPhtm.htm|publisher=biosbcc|accessdate=7 April 2011}}
 
{{cite book|last=Fung|first=Y. C.|title=Biomechanics : circulation|year=1997|publisher=Springer-Verlag|location=New York, N.Y.|isbn=0-387-94384-6|pages=10–11|edition=2nd ed.}}
 
{{cite book|last=Sparks|first=Harvey V.|title=Essentials of cardiovascular physiology|year=1987|publisher=University of Minnesota Press|location=Minneapolis|isbn=0-8166-1473-3|pages=95–98|coauthors=Jr., , Lorenz, Thom W. Rooke ; original illustrations by Robert R.}}
 
[[Category:Angiology]]

Latest revision as of 17:28, 25 October 2014

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