MASCULAR SYSTEM: THE BLOOD VESSELS and HEMODYNAMICS

Anatomy of Blood Vessels

A. Blood vessels form a closed system of tubes that carry blood away from the heart,
transport it to the tissues of the body, and then return it to the heart.
1. Arteres carry blood a!ay from t"e "eart to the tissues.
2. Arteroles are small arteries that connect to capillaries.
3. Ca#llares are the site of substance exchange between the blood and cells of body
tissues.
4. Ven$les connect capillaries to larger veins.
. Vens convey blood from the tissues %a&' to!ard t"e "eart.
!. Vasa (asor$m are small blood vessels that supply blood to the cells of the walls of the arteries
and veins.
B. Arteries
1. "he wall of an artery consists of three layers
a. "unica interna
b. "unica media
c. "unica externa
2. "he functional properties of arteries
a. Elast&ty##the elastic nature of the tunica interna and media allows arteries to accept
blood
under great pressure from the contraction of the ventricles and to send it on through the
system.
b. &ontra&tlty##smooth muscle of the tunica media allows arteries to increase or
decrease lumen si$e and to limit bleeding from wounds
3. "ypes of arteries
a. Elast& arteres
%1& large arteries with more elastic fibers and less smooth muscle
%2& capable of receiving blood under pressure and to propel it onward
%3& also called conducting arteries because they conduct blood from the heart to medium
si$ed muscular arteries
%4& "hey function as a pressure reservoir
b. M$s&$lar arteres
%1& have a large amount of smooth muscle in their walls
%2& distribute blood to various parts of the body
'. Arterioles
1. "hrough (aso&onstr&ton %decrease in the si$e of the lumen of a blood vessel& and
(asodlaton %increase in blood vessel lumen si$e&, arterioles assume an important role in
regulating blood flow from arteries into capillaries and in altering arterial blood pressure.
(. 'apillaries
1. M&ro&r&$laton is the flow of blood through the capillaries.
2. 'apillaries are found near almost every cell in the body, but their distribution varies
with
the metabolic activity of the tissue.
3. 'apillaries are the only blood vessels which allow for the exchange of nutrients and wastes
between blood and tissue cells via interstitial cells.
4. 'apillary walls consist of an endot"el$m %a simple s)uamous epithelium with its basement
membrane&
. 'apillaries branch to form an extensive capillary networ* throughout the tissue. "his
networ* increases the surface area allowing a rapid exchange of large )uantities of
materials.
a. "he flow of blood through capillaries is regulated by blood vessels with smooth muscle in their
walls.
b. +ings of smooth muscle fibers called #re&a#llary s#"n&ters regulate the blood flow.
c. "ypes of capillaries are continuous, fenestrated, sinusoids, and erectile tissue.
!. ,aterials can cross the blood capillary walls through nter&ell$lar &lefts, via pinocytic
vesicles, directly across the endothelial membrane, and through fenestratons.
-. .enules are small vessels that are formed from the union of several capillaries/
venules merge to form veins.

Vens
1. Vens consist of the same three tunics as arteries but have a thinner tunica interna and
media
and a thic*er tunica externa/ they have less elastic tissue and smooth muscle and are
therefore thinner#walled than arteries. "hey contain (al(es to prevent the bac* flow of
blood.
2. Vas&$lar )(eno$s* sn$ses are veins with very thin walls with no smooth muscle to
alter
their diameters. %Superior sagittal sinus of the brain and the coronary sinus of the heart.&
3. 0ea* valves can lead to varicose veins.
1. Anastomoses %singular2 anastomosis/ verb2 to anastomose&
1. Anastomoses are the union of the branches of two or more arteries supplying the same
region.
2. "hey provide alternate routes for blood to reach a tissue or organ.
3. "he collateral circulation is the alternate flow of blood to a body part through an
anastomosis.
4. Arteries that do not anastomose are *nown as end arteres. 3cclusion of an end artery
interrupts the blood supply to a whole segment of an organ, producing necrosis %death& of
that
segment.
4. Blood (istribution
1. At rest, the largest portion of the blood is in systemic veins and venules, collectively
called
%lood reser(ors.
a. "hey store blood and, through venous vasoconstriction, can move blood to other parts
of
the body if the need arises.
b. 5n cases of hemorrhage, when blood pressure and volume decrease, vasoconstriction of
veins in venous reservoirs helps to compensate for the blood loss.
2. "he principle reservoirs are the veins of the abdominal organs %liver and spleen& and
s*in.
II+ 'apillary exchange
A. 6ubstances enter and leave capillaries by diffusion, trancytosis, and bul* flow
%filtration and
absorption, a*a 7reabsorption7&
B. "he most important method of capillary exchange is sm#le dff$son.
1. 6ubstances such as oxygen, carbon dioxide, glucose, amino acids, hormones, and others
diffuse down their concentration gradients.
2. All plasma solutes, except large proteins, pass freely across most capillary walls.
3. "he prime exception of diffusion of water#soluble materials across capillary walls is in
the brain where the blood#brain barrier exists.
'. 6ome materials cross the capillary membrane by trans&ytoss, the enclosing of
substances
within tiny vesicles that enter cells by endo&ytoss.
(. B$l' flo!2 filtration and reabsorption
1. Bul* flow is important for regulation of the relative volumes of blood and interstitial
fluid.
2. "he movement of water and dissolved substances %except proteins& through capillaries
is dependent upon hydrostatic and osmotic pressures.
3. Edema is an abnormal increase of interstitial fluid. -dema may be caused by2
a. 5ncreased blood hydrostatic pressure in capillaries due to an increase in venous
pressure
b. (ecreased concentration of plasma proteins that lower blood colloid osmotic pressure
c. 5ncreased permeability of capillaries
d. 5ncreased extracellular fluid volume as a result of fluid retention
e. Bloc*age of lymphatic vessels postoperatively or due to filarial worm infection
III+ 4emodynamics2 8hysiology of 'irculation
A. "he distribution of cardiac output to various tissues depends on the interplay of the
pressure
difference that drives the blood flow and the resistance to blood flow.
B. .elocity of Blood ,lo! %,&
1. Blood flo! is the volume of blood that flows through any tissue in a give period of
time.
2. "he velocity of blood flow is inversely related to the cross#sectional area of blood
vessels/
blood flows most slowly where cross#sectional area is greatest.
3. Blood flow decreases from the aorta to arteries to capillaries and increases as it returns to
the heart.
. '. .olume of blood flow
1. Blood flow is determined by blood pressure and resistance."heir mathematical relationship
expression
is2 , - B./R %9low is directly proportional to Blood 8ressure/ inversely proportional to
+esistance&
2. Blood flows from regions of higher to lower pressure/ the higher the resistance the lower the
blood flow.



(. Blood .ress$re %B.& is the pressure exerted on the walls of a blood vessel/ in clinical use,
B8 refers to pressure in arteries.
1. Carda& o$t#$t %CO& e)uals mean arteral %lood #ress$re %MAB.& divided by
total resstan&e %R&. %At one time, this was referred to as 7peripheral resistance7.&
2. 9actors which affect blood pressure2
a. 'ardiac output
b. "otal blood volume
c. Blood viscosity
d. +esistance %vessel lumen si$e and smoothness&
e. -lasticity of arteries
3. As blood leaves the aorta and flows through systemic circulation, its pressure
progressively
falls to : mm 4g by the time it reaches the right atrium.
-. Resstan&e refers to the opposition to blood flow as a result of friction between blood
and the
walls of the blood vessels.
1. +esistance depends on2
a. Blood viscosity
b. Blood vessel length
c. Blood vessel radius ; ,athematical relationship of +esistance to vessel radius is2 R - 0/r
1
2. System& (as&$lar resstan&e refers to all of the vascular resistances offered by
systemic
blood vessels/ most resistance is in arterioles, capillaries, and venules due to their small
diameters.
9. .enous return
1. .enous return is aided by increasing the magnitude of the pressure gradient between the
venules and the right atrium.
2. Blood return to the heart is maintained by several factors2
a. 6*eletal muscle contraction
b. .alves in veins
c. 8ressure changes associated with breathing

Control of %lood #ress$re and %lood flo!
A. 'ardiovascular 'enter
1. "he cardiovascular center %'.& is a group of neurons in the medulla that regulates the
heart rate, contractility, and blood vessel diameter.
2. "he '. receives input from higher brain regions and sensory receptors %baroreceptors and
chemoreceptors&
3. 3utput form the '. flows along sympathetic and parasympathetic fibers.
a. 6ympathetic impulses along the cardioaccelerator nerves increase heart rate
and contractility .
b. 8arasympathetic impulses along bilateral .agus %<& nerves decrease heart rate.
c. "he 6ympathetic (ivision also continually sends impulses to smooth muscle in blood
vessel
walls via vasomotor nerves. "his creates and maintains (asomotor tone.
B. =eural +egulation of Blood 8ressure
1. Barore&e#tors are important pressure#sensitive sensory neurons that monitor
stretching
of the walls of blood vessels and the atria.
a. "he &arda& sn$s refle2 is concerned with maintaining normal blood pressure in the brain
and is initiated by baroreceptors in the wall of the carotid sinus.
b. "he aort& refle2 is concerned with general systemic blood pressure and is initiated by
baroreceptors in the wall of the arch of the aorta or attached to the arch.
c. 5f blood pressure falls, the baroreceptor reflexes accelerate heart rate, increase force of
contraction, and promote vasoconstriction.
2. +eceptors sensitive to chemicals are called &"emore&e#tors.
a. "hese receptors are located close to the baroreceptors of the carotid sinus and arch of the aorta
b. "hey monitor blood levels of oxygen, carbon dioxide, and hydrogen ion concentration.
'. 4ormonal +egulation
1. 4ormones which affect blood pressure and blood flow
a. Angiotensin 55 %. -pinephrine &. =orepinephrine
d. Antidiuretic 4ormone %A(4& e. atrial natriuretic peptide

2. "hese hormones affect blood pressure and blood flow by2
a. Altering cardiac output
b. 'hanging systemic vascular resistance
c. Ad>usting the total blood volume
(. ?ocal +egulation of Blood 8ressure
1. A$tore3$laton is the ability of a tissue to automatically ad>ust its own blood flow to
match its metabolic demand for supply of oxygen and nutrients and the removal of
wastes.
2. 5n most body tissues, oxygen is the principal, though not direct, stimulus for
autoregulation.
V+ 6hoc* and 4omeostasis .
A. S"o&' is an inade)uate cardiac output that results in failure of the cadiovascular
system to
deliver ade)uate amounts of oxygen and nutrients to meet the metabolic needs of body
cells.
As a result, cellular membranes dysfunction, cellular metabolism is abnormal, and
cellular
death may eventually occur without proper treatment.
B. "ypes of 6hoc*
1. Hy#o(olem& s"o&' is due to decreased blood volume.
2. Cardo3en& s"o&' is due to poor heart function.
3. Vas&$lar s"o&' is due to inappropriate vasodilation.
4. O%str$&t(e s"o&' is due to obstruction of blood flow.
'. 4omeostatic responses to shoc* include2
1. Activation of the +enin#Angiotensin#Aldosterone system
2. 6ecretion of A(4
3. Activation of the sympathetic division of the A=6
4. +elease of local vasodilators
(. 6igns and symptoms of shoc*2
1. 'lammy, cool, pale s*in
2. "achycardia
3. 0ea*, rapid pulse
4. 6weating
. 4ypotension %systemic pressure less than @: mm 4g&
!. Altered mental status
A. (ecreased urinary output
B. "hirst
@. Acidosis
VI+ 'hec*ing circulation
A. 8ulse
1. .$lse is the alternate expansion and elastic recoil of an artery wall with each heartbeat.
2. A normal resting pulse %heart& rate is between A: to B: beats per minute.
a. Ta&"y&arda means a rapid resting heart or pulse rate %C1:: beatsDmin&
b. Brady&arda indicates a slow resting heart or pulse rate E !: beatsDmin&
B. ,easurement of Blood 8ressure
1. Blood #ress$re is the pressure exerted by blood on the wall of an artery when the left
ventricle undergoes systole and then diastole. 5t is measured by the use of
a s#"y3momanometer,
usually in one of the brachial arteries.
a. Systol& %lood #ress$re is the force of blood recorded during ventricular contraction.
b. Dastol& %lood #ress$re is the force of blood recorded during ventricular relaxation.
c. 4orot'off so$nds are the various sounds that are heard while ta*ing blood pressure.
d. "he normal blood pressure of a young adult male is 12:DB: mm 4g %B#1: mm 4g less
in
a young adult female&.
2. .$lse #ress$re is the difference between systolic and diastolic pressure. %88F68#(8&
5t
normally is about 4: mm 4g and provides information about the condition of the arteries.
VII+ 'irculatory +outes
A. 6ystemic 'irculation
1. "he system& &r&$laton ta*es oxygenated blood from the left ventricle through the
aorta to
all parts of the body and returns the deoxygenated blood to the right atrium.






a. "he aorta is divided into the ascending aorta, arch of the aorta, and the descending
aorta.
b. -ach section gives off arteries that branch to supply the whole body.
2. Blood returns to the heart through the systemic veins. All the veins of the systemic
circulation flow into the superior and inferior venae cavae or the coronary sinus, which in turn,
empty into the right atrium.
B. 4epatic 8ortal 6ystem
1. "he "e#at& #ortal &r&$laton collects blood from the veins of the pancreas, spleen,
stomach, intestines, and gallbladder and directs it into the hepatic portal vein of the liver
before it returns to the heart.
2. A portal system carries blood between two capillary networ*s, in this case from
capillaries
of the gastrointestinal tract to sinusoids of the liver.
3. "his circulation enables nutrient utili$ation and blood detoxification by the liver.
'. 8ulmonary 'irculation
1. "he #$lmonary &r&$laton ta*es deoxygenated blood from the right ventricle to the
air
sacs of the lungs and returns oxygenated blood from the lungs to the left atrium.
2. "he pulmonary and systemic circulations differ from each other in the following2
a. Blood in the pulmonary circulation is not pumped as far as in the systemic circulation.
b. 8ulmonary arteries have a larger diameter, thinner walls, and less elastic tissue
c. ?ess pressure is needed to move the blood through the lungs.
d. =ormal pulmonary capillary hydrostatic pressure is lower than systemic capillary
hydrostatic pressure
(. 9etal 'irculation
1. "he fetal &r&$laton involves the exchange of materials between the fetus and mother.
2. "he fetus derives its oxygen and nutrients and eliminates its carbon dioxide and wastes
through the maternal blood supply by means of the #la&enta.
3. Blood passes from the fetus to the placenta via two umbilical arteries and returns from
the placenta via a single umbilical vein.
4. At birth, when pulmonary, digestive, and liver functions are established, the special
structures of the fetal circulation are no longer needed.
a. "he d$&t$s arteros$s becomes the ligamentum arteriosum shortly after birth.
b. "he foramen o(ale becomes the fossa ovalis shortly after birth.
c. "he d$&t$s (enos$s becomes the ligamentum venosum shortly after birth.
d. "he two $m%l&al arteres become the medial umbilical ligaments.
e. "he one $m%l&al (en becomes the ligamentum teres %round ligament of the liverG