Effect of Intraabdominal Pressure on Venous Pressures of the

Leg. The pressure in the abdominal cavity of a recumbent person normally averages about +6mmHg, but it can rise to +15 to +30mmHg as a result of pregnancy, large tumors, or excessive fluid (called "ascites") in the abdominal cavity. When the intraabdominal pressure does rise, the pressure in the veins of the legs must rise above the abdominal pressure before the abdominal veins will open and allow the blood to flow from the legs to the heart. Thus, if the intra-abdominal pressure is +20 mm Hg, the lowest possible pressure in the femoral veins is also +20 mm Hg.

Effect of Gravitational Pressure on Venous Pressure

In any body of water that is exposed to air, the pressure at the surface of the water is equal to atmospheric

Figure 15-10

Effect of gravitational pressure on the venous pressures throughout the body in the standing person.

Figure 15-10

Effect of gravitational pressure on the venous pressures throughout the body in the standing person.

pressure, but the pressure rises 1 mm Hg for each 13.6 millimeters of distance below the surface. This pressure results from the weight of the water and therefore is called gravitational pressure or hydrostatic pressure.

Gravitational pressure also occurs in the vascular system of the human being because of weight of the blood in the vessels, as shown in Figure 15-10. When a person is standing, the pressure in the right atrium remains about 0 mm Hg because the heart pumps into the arteries any excess blood that attempts to accumulate at this point. However, in an adult who is standing absolutely still, the pressure in the veins of the feet is about +90mmHg simply because of the gravitational weight of the blood in the veins between the heart and the feet. The venous pressures at other levels of the body are proportionately between 0 and 90 mm Hg.

In the arm veins, the pressure at the level of the top rib is usually about +6 mm Hg because of compression of the subclavian vein as it passes over this rib. The gravitational pressure down the length of the arm then is determined by the distance below the level of this rib. Thus, if the gravitational difference between the

Deep vein

Deep vein

Figure 15-11

Venous valves of the leg

Figure 15-11

Venous valves of the leg level of the rib and the hand is +29 mm Hg, this gravitational pressure is added to the +6 mm Hg pressure caused by compression of the vein as it crosses the rib, making a total of +35 mm Hg pressure in the veins of the hand.

The neck veins of a person standing upright collapse almost completely all the way to the skull because of atmospheric pressure on the outside of the neck. This collapse causes the pressure in these veins to remain at zero along their entire extent. The reason for this is that any tendency for the pressure to rise above this level opens the veins and allows the pressure to fall back to zero because of flow of the blood. Conversely, any tendency for the neck vein pressure to fall below zero collapses the veins still more, which further increases their resistance and again returns the pressure back to zero.

The veins inside the skull, on the other hand, are in a noncollapsible chamber (the skull cavity) so that they cannot collapse. Consequently, negative pressure can exist in the dural sinuses of the head; in the standing position, the venous pressure in the sagittal sinus at the top of the brain is about -10 mm Hg because of the hydrostatic "suction" between the top of the skull and the base of the skull. Therefore, if the sagittal sinus is opened during surgery, air can be sucked immediately into the venous system; the air may even pass downward to cause air embolism in the heart, and death can ensue.

Effect of the Gravitational Factor on Arterial and Other Pressures. The gravitational factor also affects pressures in the peripheral arteries and capillaries, in addition to its effects in the veins. For instance, a standing person who has a mean arterial pressure of 100 mm Hg at the level of the heart has an arterial pressure in the feet of about 190 mm Hg. Therefore, when one states that the arterial pressure is 100 mm Hg, this generally means that this is the pressure at the gravitational level of the heart but not necessarily elsewhere in the arterial vessels.

Venous Valves and the "Venous Pump": Their Effects on Venous Pressure

Were it not for valves in the veins, the gravitational pressure effect would cause the venous pressure in the feet always to be about +90 mm Hg in a standing adult. However, every time one moves the legs, one tightens the muscles and compresses the veins in or adjacent to the muscles, and this squeezes the blood out of the veins. But the valves in the veins, shown in Figure 15-11, are arranged so that the direction of venous blood flow can be only toward the heart. Consequently, every time a person moves the legs or even tenses the leg muscles, a certain amount of venous blood is propelled toward the heart. This pumping system is known as the "venous pump" or "muscle pump," and it is efficient enough that under ordinary circumstances, the venous pressure in the feet of a walking adult remains less than +20 mm Hg.

If a person stands perfectly still, the venous pump does not work, and the venous pressures in the lower legs increase to the full gravitational value of 90 mm Hg in about 30 seconds. The pressures in the capillaries also increase greatly, causing fluid to leak from the circulatory system into the tissue spaces. As a result, the legs swell, and the blood volume diminishes. Indeed, 10 to 20 per cent of the blood volume can be lost from the circulatory system within the 15 to 30 minutes of standing absolutely still, as often occurs when a soldier is made to stand at rigid attention.

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Essentials of Human Physiology

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Responses

  • Samuli Alaja
    What is venous pressure why is it called gravitation?
    3 years ago
  • kaisa
    What Is The Gravitational Factor On Arterial?
    3 years ago
  • philipp
    Why there is negetive pressure in the dural sinusis of skull?
    3 years ago
  • Zula
    Why is hydrostatic pressure of sagittal sinuses negative?
    9 months ago
  • tomas
    Does intraabdominal pressure affect result of plr?
    29 days ago

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