3/7/2012

Objectives
• Describe the structure and function of arteries,
The veins, and capillaries
• List the major arteries and veins of the body and tell
Cardiovascular the areas of the body they serve
• Define pulse and list the common pulse points

System • Describe how blood pressure is measured

• Describe the factors that regulate blood pressure
• Discuss the mechanisms for capillary exchange
Blood Vessels • Describe homeostatic imbalances involving blood
vessels and blood circulation

Types of Blood Vessels Layers of Vessel Walls

Arteries Tunics
Take blood away from heart Lumen—central opening
Arterioles
Capillaries (capillary beds) Tunica intima
Site of exchange between blood Endothelium
and tissues Simple squamous epithelium
Veins
Venules Reduces friction
Return blood to heart

Tunica media Tunica externa

Smooth muscle
Connective tissue
Circularly arranged
Sheets of elastin Loosely woven collagen
Muscle activity regulated by Protection
vasomotor nerve fibers of
sympathetic nervous system Anchoring
Vasoconstriction—narrowing
Vasodilation—opening

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Arteries Veins
Tunica intima Tunica intima (valves)
Thin tunica media
Thick tunica media
Tunica externa
Tunica externa Low pressure
Need to be Valves prevent
stretchy backflow
Withstand pressure Respiratory pump
from pumping helps return blood to
action of heart heart
Skeletal muscle
activity also helps
with venous return

Muscular
Capillaries
Pump Tunica intima
Form interweaving
capillary beds
works with
Blood flow—microcirculation
Two types of vessels
assistance • vascular shunt (thoroughfare shunt)
• true capillaries (exchange vessels)
of valves

Capillary Beds
Site of nutrient and gas exchange
Most tissues have rich supply
Thoroughfare channel connects
arteriole to venule
10-100 true capillaries branch from
thoroughfare channel
Sphincter muscles control blood
flow through capillary bed

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Homeostatic Imbalance Venous System

• Varicose veins
– Blood pools in feet and legs, inefficient venous
return, overworked valves give way, veins
become twisted and dilated
• Thrombophlebitis
– Complication of varicose veins, clot forms
• Pulmonary embolism
– Clot breaks free and moves to pulmonary
circulation

The vessel layer that controls the diameter of an artery is the Heart acts as double pump
A. tunica externa
B. tunica intima Both pumps act in unison
C. tunica media Unoxygenated blood returns to
D. all of the above heart through venous system
Which of the following structures have valves? Right side pumps blood to lungs
A. arteries
Oxygenated blood returns to
B. veins
C. capillaries
heart through pulmonary veins
D. none of the above
Left side pumps blood to body

Major Arteries of Systemic System

• Aorta- largest, originates left ventricle
– Ascending aorta
• Right and Left coronary arteries
– Aortic arch
• Carotid arteries- head and neck
• Subclavian arteries- serve arms
– Abdominal aorta
• Celiac trunk- stomach, spleen, liver
• Mesenteric arteries- small and large intestine
• Renal arteries- kidneys
• Gonadal arteries- gonads
• Iliac arteries- pelvis and legs

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Venous system contains 65% of

blood volume
Deep veins parallel arteries and
usually have the same name
Some veins superficial—visible
Veins converge to form vena cavae

Major Veins of Systemic System

• Vena cavae- enters right atrium
– Superior Vena cava- blood from head, neck,
and arms
• Jugular vein- brain
• Subclavian vein- arm
• Brachiocephalic- subclavian, Jugular
• Superficial—cephalic, basilic, median cubital
– Inferior Vena cava- blood from lower body
• Common iliac vein- leg and pelvis
• Gonadal veins- gonads
• Renal veins- kidneys
• Hepatic veins- liver
• Superficial—Great saphenous veins- longest, leg

Circle of Willis
Arterial anastomosis
Base of brain—surrounding pituitary
gland and optic chiasma
Formed by internal carotids,
anterior communicating artery,
and posterior communicating
artery
Insures blood supply to brain

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Fetal Circulation
In fetus lungs and digestive organs
not functional
Nutrient and gas exchange through
placenta
Umbilical vein carries nutrient and
oxygen rich blood to fetus
Umbilical arteries carry waste from
fetus to placenta
Hepatic Portal Circulation
Blood from digestive organs delivered
to liver for processing
Arteries feed digestive organs
Blood collected in veins of hepatic
portal system and sent to liver
Hepatic vein returns blood to general
circulation
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Most blood from umbilical vein travels
directly to right atrium in
ductus venosus
Much of blood entering right atrium
shunted to left atrium through
foramen ovale
Blood entering pulmonary trunk
shunted to aorta through
ductus arteriosus
At birth fetal circulation changes
Foramen ovale closes—fossa ovalis
Ductus arteriosus closes and
converts to fibrous ligamentum
arteriosum
Ductus venosus becomes fibrous
band on liver--ligamentum
venosum
Remnants of umbilical arteries and
veins become ligaments of liver
umbilical ligaments
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Monitoring Circulatory Efficiency Common

Pulse Pressure
Blood pressure
Pulse—expansion and recoil of artery Points
Palpate at areas where artery is
close to surface and overlies
a firm structure
Represents a heart beat

Blood pressure measurement

Systemic Blood Pressure
Blood flows along pressure gradient
Heart generates blood flow
Pressure results from resistance
to flow
Closer to pump, higher the pressure
Auscultatory method—indirect
Sphygmomanometer and
stethoscope
Completely compress brachial a.
Listen for blood flow in artery
Korotkoff sounds

Maintaining Blood Pressure

Major factors controlling blood pressure
• Cardiac output
Venous return
Neural, hormonal controls on
heart rate
• Peripheral resistance
First sound—systolic pressure • Blood Volume
Last sound—diastolic pressure All interact to maintain homeostasis

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Peripheral Resistance
Neural control
• sympathetic nervous system
• vasoconstriction
Renal factors
• low BP = renin secretion
• renin  angiotensin I 
angiotensin II (aldosterone)
•  blood volume,  blood pressure
Peripheral Resistance
Diet
• some controversy
• low sodium
• low fat, cholesterol
• helps prevent hypertension
Hypotension—low blood pressure
Indicator of long life
Orthostatic hypotension
Temporary low blood pressure
on standing
Dizziness—blood pools in lower
extremities
Sympathetic vasoconstriction
too slow
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Peripheral Resistance
Temperature
• cold vasoconstricts
• heat vasodilates
Chemicals
• epinephrine-- heart rate and BP
• nicotine—vasoconstricts
• alcohol—vasodilates
Systolic pressure
Between 100 and 140 mm Hg
Diastolic pressure
Between 60 and 90 mm Hg
Varies with gender, weight, race
socioeconomic status,
mood, physical activity,
posture
Chronic hypotension
Reduced blood viscosity
Poor nutrition, anemia, reduced
protein in blood
Acute hypotension
Circulatory shock (blood loss)
Threat to patients undergoing
surgery and those in
intensive care units
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Hypertension—high blood pressure Primary hypertension—90%

Brief elevations normal response No underlying cause identified
to fever, exercise, emotions Contributing factors
Diet—  Ca, K, Mg, Na, fat
Chronic hypertension—”silent killer”
Obesity
Heart works harder—afterload Age—usually after 40
Heart failure, vascular disease, Race—more common in blacks
renal failure, stroke Heredity
Tears in endothelium accelerates Stress
athersclerosis Smoking

Secondary hypertension—10% Capillary Exchange

Linked to an identifiable disorder Tissues bathed in interstitial fluid

Kidney disease, Cushing’s,
Hyperthyroidism
Treat primary disorder and
hypertension resolves
Materials flow between plasma and
interstitial fluid
• lipid soluble—direct diffusion
• vesicular transport—endothelium
• intercellular clefts
• fenestrated capillaries

Direct Diffusion
diffusion fenestration

Vesicular
transport

Diffusion
intracellular
clefts

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Fluid Movements at
Capillary Beds
Hydrostatic pressure on arterial end
pushes material out of capillary
As water in blood declines, proteins
exert osmotic pressure
Higher osmotic pressure of blood on
venous end pulls water back in
Some fluid remains in tissues and Hydrostatic pressure Osmotic pressure
becomes lymph pushes sucks

Development and Aging Disease of Vascular System

Associated with Aging
Congenital heart defects
• half of congenital defect deaths Increased varicose veins
• structural abnormalities of heart
• heart forms in first trimester Atherosclerosis
Hypertension
Heart functions well for a long
lifetime

Atherosclerosis Technology--Isn’t it wonderful?

• degenerative process
• happens with aging
• loss of arterial elasticity
• contributes to hypertension
Coronary Artery Disease
• deposits on arterial walls
• contributes to thrombus formation
Negative impact on vascular health
High protein, high fat diet
Labor-saving devices
High stress jobs
Glamorous bad habits

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A patient’s chart reading 110/75 mm Hg and 79 bpm

the diastolic pressure would be
a. 110
b. 79
c. 75
c. can not be determined

Standing quickly after sitting for a while may produce

dizziness. This is due to
a. chronic hypertension
b. atherosclerosis
c. congestive heart failure
d. orthostatic hypotension

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