Blood vessels and circulation

„ Blood is carried in a closed system of vessels that

begins and ends at the heart
Blood Vessels „ 5 types of blood vessels
… Arteries – carries blood away from the heart
… Arterioles – smallest arteries
PART A … Capillaries - place for diffusion
… Venules - smallest veins
… Veins – carries blood to the heart
… Lumen – central blood-containing space

Blood Vessel Anatomy Structure of vessel walls

„ Walls of arteries and veins contain three distinct
layers
… Tunica intima
„ endothelium and connective tissue

„ Internal elastic membrane

… Tunica media
„ Smooth muscle, collagen fibers

„ External elastic membrane

„ Controlled by sympathetic nervous system

…Vasoconstriction/vasodilation

Generalized Structure of Blood

Structure of vessel walls
Vessels
„ Tunica externa or adventitia
… Collagen fibers that protect and reinforce the
vessels
Differences between arteries and
Arteries
veins „ Undergo changes in diameter
… Vasoconstriction – decreases the size of the
„ Vasavasorum lumen
„ Compared to veins, arteries … Vasodilation – increases the size of the lumen
… Have thicker walls „ Classified as either elastic (conducting) or
… Have more smooth muscle and elastic fibers muscular (distribution)
… Are more resilient „ Small arteries (internal diameter of 30 µm or less)
are called arterioles
… Resistance vessels (force opposing blood flow)

Histological Structure of Blood Vessels Capillaries

„ An endothelial tube inside a basal lamina
„ These vessels
… Form networks
… Surround muscle fibers
… Radiate through connective tissue
… Weave throughout active tissues
„ Capillaries have two basic structures
… Continuous
… Fenestrated
„ Sinusoids

Capillaries Continuous Capillaries

„ Continuous capillaries
„ Continuous capillaries are abundant in the skin
… Retain blood cells and plasma proteins and muscles
„ Fenestrated capillaries … Endothelial cells provide an uninterrupted
… Contain pores lining
… Sinusoids … Adjacent cells are connected with
„ Contain gaps between endothelial cells incomplete tight junctions
„ Allow larger solutes to pass … Intercellular clefts allow the passage of fluids
Continuous Capillaries Continuous Capillaries

„ Continuous capillaries of the brain:

… Have tight junctions completely around the
endothelium
… Constitute the blood-brain barrier

Continuous
Capillaries

Fenestrated Capillaries Fenestrated Capillaries

„ Found wherever active capillary absorption or

filtrate formation occurs (e.g., small intestines,
endocrine glands, and kidneys)
„ Characterized by:
… An endothelium riddled with pores
(fenestrations)
… Greater permeability than other capillaries

Fenestrated Capillaries

Sinusoids Sinusoids

„ Highly modified, leaky, fenestrated capillaries

with large lumens
„ Found in the liver, bone marrow, lymphoid
tissue, and in some endocrine organs
„ Allow large molecules (proteins and blood
cells) to pass between the blood and
surrounding tissues
„ Blood flows sluggishly, allowing for
modification in various ways
Sinusoids
Capillary Beds Capillary Beds
„ Collateral arteries
… Many collateral arteries will fuse giving rise to „ Thoroughfare channels
one arteriole … Arteriovenous anastomoses
„ Arteriole „ Connects arterioles to venules
„ Metarterioles „ Capillaries
… Contain smooth muscle
„ Venules
… Precapillary sphincter
… Link arterioles to capillaries

Capillary Beds Capillary Beds

Vascular Components Venous System: Venules

„ Venules are formed when capillary beds unite

… Allow fluids and WBCs to pass from the
bloodstream to tissues
… Postcapillary venules – smallest venules,
composed of endothelium and a few
pericytes (smooth-muscle cell like)
… Large venules have one or two layers of
smooth muscle (tunica media)

Venous System: Veins
„ Veins are:
… Formed when venules converge
… Composed of three tunics, with a thin tunica
media and a thick tunica externa consisting
of collagen fibers and elastic networks
… Capacitance vessels (blood reservoirs) that
contain 65% of the blood supply
The Function of Valves in the Venous
System
Blood Flow
„ Actual volume of blood flowing through a
vessel, an organ, or the entire circulation in a
given period:
… Is measured in ml per min.
… Is equivalent to cardiac output (CO),
considering the entire vascular system
… Is relatively constant when at rest
… Varies widely through individual organs
Venous System: Veins
„ Veins have much lower blood pressure and
thinner walls than arteries
„ To return blood to the heart, veins have special
adaptations
… Large-diameter lumens, which offer little
resistance to flow
… Valves (resembling semilunar heart valves),
which prevent backflow of blood
„ Venous sinuses – specialized, flattened veins
with extremely thin walls (e.g., coronary sinus
of the heart and dural sinuses of the brain)
Vascular Anastomoses
„ Merging blood vessels, more common in veins
than arteries
„ Arterial anastomoses provide alternate
pathways (collateral channels) for blood to
reach a given body region
… If one branch is blocked, the collateral
channel can supply the area with adequate
blood supply
„ Thoroughfare channels are examples of
arteriovenous anastomoses
Blood Pressure (BP)
„ Force per unit area exerted on the wall of a
blood vessel by its contained blood
… Expressed in millimeters of mercury (mm
Hg)
… Measured in reference to systemic arterial
BP in large arteries near the heart
„ The differences in BP within the vascular
system provide the driving force that keeps
blood moving from higher to lower pressure
areas
Resistance
„ Resistance – opposition to flow
… Measure of the amount of friction blood
encounters
… Generally encountered in the systemic
circulation
… Referred to as peripheral resistance (PR)
„ The important sources of resistance are blood
viscosity, total blood vessel length, blood
vessel diameter and turbulence
Resistance Factors: Blood Vessel
Diameter
„ Small-diameter arterioles are the major
determinants of peripheral resistance
„ Fatty plaques from atherosclerosis:
… Cause turbulent blood flow
… Dramatically increase resistance
Resistance
„ Blood viscosity
… The higher the viscosity the higher will be the
resistance. Thus the flow will decrease
„ Turbulence
… Is the resistance due to the irregular, swirling
movement of blood at high flow rates or to
exposure to irregular surfaces. High turbulence
decreases the flow
Resistance
„ Vessel diameter
… Small diameter will have greater friction of
blood against the vessel wall. This will
decrease the flow (greater resistance)
… Most of the peripheral resistance occur in
arterioles. Changes in vessel diameter are
frequent and significantly alter peripheral
resistance
… Resistance varies inversely with the fourth
power of vessel radius
„ if the radius is doubled, the resistance is
1/16 as much
Resistance
„ Vessel length
… Increasing the length of the vessel will
increase the cumulative friction and thus will
decrease blood flow and pressure (greater
resistance).
Resistance Factors: Viscosity and
Vessel Length
„ Resistance factors that remain relatively
constant are:
… Blood viscosity – “stickiness” of the blood
… Blood vessel length – the longer the vessel,
the greater the resistance encountered
Blood Flow, Blood Pressure, and
Systemic Blood Pressure
Resistance
„ Blood flow (F) is directly proportional to the „ The pumping action of the heart generates
difference in blood pressure (ΔP) between two blood flow through the vessels along a
points in the circulation
pressure gradient, always moving from higher-
… If ΔP increases, blood flow speeds up; if ΔP
to lower-pressure areas
decreases, blood flow declines
„ Blood flow is inversely proportional to
resistance (R)
… If R increases, blood flow decreases
„ R is more important than ΔP in influencing local
blood pressure

Systemic Blood Pressure Systemic Blood Pressure

„ Systemic pressure:
… Is highest in the aorta
… Declines throughout the length of the
pathway
… Is 0 mm Hg in the right atrium
„ The steepest change in blood pressure occurs
in the arterioles

Arterial Blood Pressure Arterial Blood Pressure

„ Arterial BP reflects two factors of the arteries
close to the heart
… Their elasticity (compliance or distensibility)
… The amount of blood forced into them at any
given time
„ Blood pressure in elastic arteries near the
heart is pulsatile (BP rises and falls)
„ Systolic pressure – pressure exerted on
arterial walls during ventricular contraction
„ Diastolic pressure – lowest level of arterial
pressure during a ventricular cycle
„ Pulse pressure – the difference between
systolic and diastolic pressure
… EX: 120-80= 40 (Pulse Pressure)
Arterial Blood Pressure
„ Mean arterial pressure (MAP) – pressure that
propels the blood to the tissues
„ MAP = diastolic pressure + 1/3 pulse pressure
… EX: for a 120 x 80 BP:
„ MAP= 80 + 40/3 = 80 + 13 = 90 mm Hg
Venous Blood Pressure
„ Venous BP is steady and changes little during
the cardiac cycle
„ The pressure gradient in the venous system is
only about 20 mm Hg
„ A cut vein has even blood flow; a lacerated
artery flows in spurts
Factors Aiding Venous Return
Capillary Blood Pressure
„ Capillary BP ranges from 20 to 40 mm Hg
„ Low capillary pressure is desirable because
high BP would rupture fragile, thin-walled
capillaries
„ Low BP is sufficient to force filtrate out into
interstitial space and distribute nutrients,
gases, and hormones between blood and
tissues
Factors Aiding Venous Return
„ Venous BP alone is too low to promote
adequate blood return and is aided by the:
… Respiratory “pump” – pressure changes
created during breathing suck blood toward
the heart by squeezing local veins
… Muscular “pump” – contraction of skeletal
muscles “milk” blood toward the heart
… Valves prevent backflow during venous
return
Maintaining Blood Pressure
„ Maintaining blood pressure requires:
… Cooperation of the heart, blood vessels, and
kidneys
… Supervision of the brain
Maintaining Blood Pressure Cardiac Output (CO)

„ The main factors influencing blood pressure „ Cardiac output is determined by venous return
are: and neural and hormonal controls
… Cardiac output (CO) „ Resting heart rate is controlled by the
… Peripheral resistance (PR) cardioinhibitory center via the vagus nerves
… Blood volume … Stroke volume is controlled by venous return
„ Blood pressure = CO x PR (end diastolic volume, or EDV)
„ Blood pressure varies directly with CO, PR,
and blood volume

Cardiac Output (CO) Cardiac Output (CO)

„ Under stress, the cardioacceleratory center

increases heart rate and stroke volume
… The end systolic volume (ESV) decreases
and MAP increases

Maintaining blood pressure through Short-Term Mechanisms: Neural

Cardiovascular Regulation Controls
„ Neural controls of peripheral resistance:
„ Neural mechanisms – short-term control
… Alter blood distribution in response to
„ Endocrine mechanisms – mainly long-term
demands
control. Sometimes short-term also
… Maintain MAP by altering blood vessel
diameter
Short-Term Mechanisms: Neural Short-Term Mechanisms: Neural
Controls Controls
„ Vasomotor Center
… A cluster of sympathetic neurons in the
„ It is a integrating center for three reflex arcs:
medulla that oversees changes in blood … Baroreflexes
vessel diameter … Chemoreflexes
… Maintains blood vessel tone by innervating
… Medullary ischemic reflexes
smooth muscles of blood vessels, especially
arterioles
… Cardiovascular center – vasomotor center
plus the cardiac centers that integrate blood
pressure control by altering cardiac output
and blood vessel diameter

Short-Term Mechanisms: Neural Short-Term Mechanisms: Neural

Controls Controls
„ Baroreflexes
„ Baroreceptors in: carotid sinuses, aortic arch, „ Dilate veins
right atrium, walls of large arteries of neck and
…Decreasevenous return
thorax
„ Increased blood pressure stretches the ƒ Decrease cardiac output
baroreceptors … Stimulate cardioinhibitory center and inhibit
… Inhibits the vasomotor center cardioacceleratory center
„ Dilate arteries „ Decrease heart rate

…Decrease peripheral resistance, „ Decrease contractile force

ƒ Decrease blood pressure

Impulse traveling along

afferent nerves from

Short-Term Mechanisms: Neural baroreceptors:

Stimulate cardio-
inhibitory center
(and inhibit cardio-
acceleratory center)
Sympathetic
impulses to
heart
( HR and contractility)

Controls Baroreceptors
in carotid
sinuses and
aortic arch Inhibit CO
stimulated vasomotor center
R

Rate of vasomotor

„ Declining blood pressure stimulates the Arterial

blood pressure
rises above
normal range
impulses allows
vasodilation
( vessel diameter)
CO and R
return blood
pressure to

cardioacceleratory and vasomotor centers to: Stimulus:

Rising blood
Im
ba
lan
ce
Homeostatic
range

pressure

… Increase cardiac output Homeostasis: Blood pressure in normal range

Im Stimulus:
ba
lan Declining
ce

… Constrict blood vessels

blood pressure

CO and R
return blood Impulses from
pressure to baroreceptors: Arterial blood pressure
homeostatic Stimulate cardio- falls below normal range

„ Increase peripheral resistance range acceleratory center

Cardiac (and inhibit cardio-
output inhibitory center) Baroreceptors in
(CO) carotid sinuses
Sympathetic and aortic arch
impulses to heart inhibited
Peripheral ( HR and contractility)
resistance (R)

„ Baroreceptors adapt to chronic high or low BP Vasomotor Stimulate

fibers vasomotor
stimulate center
vasoconstriction
Short-Term Mechanisms: Neural
Controls
„ Chemoreflexes
„ Sensitive to low oxygen, low pH, and high
carbon dioxide in the blood
„ Prominent chemoreceptors are the carotid and
aortic bodies
„ Their primary role is to adjust respiration to
change blood chemistry
Short-Term Mechanisms: Neural
Controls
„ Medullary ischemic reflex
„ It is an autonomic response to a drop in
perfusion of the brain
„ Cardiovascular center of the medulla
oblongata sends sympathetic signals to the
heart and blood vessels
„ Cardiovascular center also receives input from
higher brain centers
… Hypothalamus, cortex
Hormonal Controls
„ The kidneys control BP by altering blood
volume
… Increased BP stimulates the kidneys to
eliminate water, thus reducing BP
… Decreased BP stimulates the kidneys to
increase blood volume and BP
Short-Term Mechanisms: Neural
Controls
„ Stimulates vasomotor and cardioacceleratory
centers
… Increase HR
„ Increase CO
… Reflex vasoconstriction
„ Increases BP
… Tissue perfusion increases
Hormonal Control
„ Hormones that Increase Blood Pressure
„ Increase peripheral resistance
… Adrenal medulla hormones – NE, E
… Antidiuretic hormone (ADH) – causes intense
vasoconstriction in cases of extremely low BP
… Endothelium-derived factors – endothelin and
prostaglandin-derived growth factor (PDGF)
are both vasoconstrictors
… Angiotensin II
Hormonal Controls
„ Kidneys act directly and indirectly to maintain
long-term blood pressure
… Direct renal mechanism alters blood volume
„ Increased kidney perfusion increases
filtration
… Indirect renal mechanism involves the renin-
angiotensin mechanism
Hormonal Controls Kidney Action and Blood Pressure

… Declining BP causes the release of renin,

which triggers the release of angiotensin II
… Angiotensin II is a potent vasoconstrictor
that stimulates aldosterone secretion
… Aldosterone enhances renal reabsorption
and stimulates ADH release

Hormonal Controls MAP Increases

„ Hormones that Decrease Blood Pressure

„ Atrial natriuretic peptide (ANP) – causes blood
volume and pressure to decline
„ Nitric oxide (NO) – is a brief but potent
vasodilator
„ Inflammatory chemicals – histamine,
prostacyclin, and kinins are potent vasodilators
„ Alcohol – causes BP to drop by inhibiting ADH

Monitoring Circulatory Efficiency Palpated Pulse

„ Efficiency of the circulation can be assessed

by taking pulse and blood pressure
measurements
„ Vital signs – pulse and blood pressure, along
with respiratory rate and body temperature
„ Pulse – pressure wave caused by the
expansion and recoil of elastic arteries
… Radial pulse (taken on the radial artery at
the wrist) is routinely used
… Varies with health, body position, and
activity
Measuring Blood Pressure
„ Systemic arterial BP is measured indirectly
with the auscultatory method
… A sphygmomanometer is placed on the arm
superior to the elbow
… Pressure is increased in the cuff until it is
greater than systolic pressure in the brachial
artery
… Pressure is released slowly and the
examiner listens with a stethoscope
Variations in Blood Pressure
„ Blood pressure cycles over a 24-hour period
„ BP peaks in the morning due to waxing and
waning levels of hormones
„ Extrinsic factors such as age, sex, weight,
race, mood, posture, socioeconomic status,
and physical activity may also cause BP to
vary
Hypotension
„ Orthostatic hypotension – temporary low BP
and dizziness when suddenly rising from a
sitting or reclining position
„ Chronic hypotension – hint of poor nutrition
and warning sign for Addison’s disease
„ Acute hypotension – important sign of
circulatory shock
… Threat to patients undergoing surgery and
those in intensive care units
Measuring Blood Pressure
… The first sound heard is recorded as the
systolic pressure
„ Korotkoff sounds
… The pressure when sound disappears is
recorded as the diastolic pressure
Alterations in Blood Pressure
„ Hypotension – low BP in which systolic
pressure is below 100 mm Hg
„ Hypertension – condition of sustained
elevated arterial pressure of 140/90 or higher
… Transient elevations are normal and can be
caused by fever, physical exertion, and
emotional upset
… Chronic elevation is a major cause of heart
failure, vascular disease, renal failure, and
stroke
Hypertension
„ Hypertension maybe transient or persistent
„ Primary or essential hypertension – risk factors
in primary hypertension include diet, obesity,
age, race, heredity, stress, and smoking
„ Secondary hypertension – due to identifiable
disorders, including renal disease,
arteriosclerosis, hyperthyroidism, obstruction of
renal artery, etc
Blood Flow Through Tissues
„ Blood flow, or tissue perfusion, is involved in:
… Delivery of oxygen and nutrients to, and
removal of wastes from, tissue cells
… Gas exchange in the lungs
… Absorption of nutrients from the digestive
tract
… Urine formation by the kidneys
„ The rate of blood flow to the tissues is
precisely the right amount to provide proper
tissue function
Velocity of Blood Flow
Types of autoregulation
„ Metabolic Controls
„ Declining tissue nutrient and oxygen levels are
stimuli for autoregulation
„ Endothelial cells release nitric oxide (NO)
„ Nitric oxide induces vasodilation at the
capillaries to help get oxygen to tissue cells
„ Other autoregulatory substances include:
potassium and hydrogen ions, adenosine,
lactic acid, histamines, kinins, and
prostaglandins
Velocity of Blood Flow
„ Blood velocity:
… Changes as it travels through the systemic
circulation
… Is inversely proportional to the cross-sectional
area
„ Total cross-sectional area
„ It is the combined cross-sectional area of all
vessel
„ Increased total cross-sectional area will
decrease blood pressure and flow
Autoregulation: Local Regulation of
Blood Flow
„ Autoregulation – automatic adjustment of blood
flow to each tissue in proportion to its
requirements at any given point in time
„ Blood flow through an individual organ is
intrinsically controlled by modifying the
diameter of local arterioles feeding its
capillaries
„ MAP remains constant, while local demands
regulate the amount of blood delivered to
various areas according to need
Types of autoregulation
„ Myogenic Controls
„ Inadequate tissue perfusion or excessively high
arterial pressure:
… Are autoregulatory
… Provoke myogenic responses – stimulation
of vascular smooth muscle
„ Vascular muscle responds directly to:
… Increased vascular pressure with increased
tone, which causes vasoconstriction
… Reduced stretch with vasodilation, which
promotes increased blood flow to the tissue
Control of Arteriolar Smooth
Muscle
Long-Term Autoregulation
„ Is evoked when short-term autoregulation
cannot meet tissue nutrient requirements
„ May evolve over weeks or months to enrich
local blood flow
Blood Flow: Skeletal Muscles
„ Local regulation
„ Resting muscle blood flow is regulated by
myogenic and general neural mechanisms in
response to oxygen and carbon dioxide levels
„ When muscles become active, hyperemia is
directly proportional to greater metabolic
activity of the muscle (active or exercise
hyperemia)
Blood Vessels
PART B
Long-Term Autoregulation
„ Angiogenesis
… Increased of the number of vessels to a
region
… enlargement of existing vessels
„ When a heart vessel becomes partly
occluded
„ Routinely in people in high altitudes,
where oxygen content of the air is low
Blood Flow: Skeletal Muscle
„ Systemic regulation
„ Sympathetic activity increase
„ Arterioles in muscles have cholinergic
receptors
… Muscle blood flow can increase tenfold or
more during physical activity as vasodilation
occurs
„ Arterioles in organs have alpha and beta
receptors
… Vasoconstriction occur to divert blood to the
muscles
Blood Flow: Brain
„ Blood flow to the brain is constant, as neurons
are intolerant of ischemia
„ Metabolic controls – brain tissue is extremely
sensitive to declines in pH, and increased
carbon dioxide causes marked vasodilation
„ Myogenic controls protect the brain from
damaging changes in blood pressure
… Decreases in MAP cause cerebral vessels to
dilate to ensure adequate perfusion
… Increases in MAP cause cerebral vessels to
constrict
Blood Flow: Skin
„ Blood flow through the skin:
… Supplies nutrients to cells in response to
oxygen need
… Helps maintain body temperature
… Provides a blood reservoir
Temperature Regulation
„ As temperature rises (e.g., heat exposure,
fever, vigorous exercise):
… Hypothalamic signals reduce vasomotor
stimulation of the skin vessels
… Heat radiates from the skin
„ Sweat also causes vasodilation via bradykinin
in perspiration
… Bradykinin stimulates the release of NO
„ As temperature decreases, blood is shunted to
deeper, more vital organs
Blood Flow: Brain
„ The brain can regulate its own blood flow in
certain circumstances, such as ischemia
caused by a tumor increasing systemic blood
pressure
„ The brain is vulnerable under extreme
systemic pressure changes
… MAP below 60mm Hg can cause syncope
(fainting)
… MAP above 160 can result in cerebral
edema
Blood Flow: Skin
„ Blood flow to venous plexuses below the skin
surface:
… Varies from 50 ml/min to 2500 ml/min,
depending on body temperature
… Is controlled by sympathetic nervous system
reflexes initiated by temperature receptors
and the central nervous system
Blood Flow: Lungs
„ Blood flow in the pulmonary circulation is
unusual in that:
… The pathway is short
… Arteries/arterioles are more like
veins/venules (thin-walled, with large
lumens)
… They have a much lower arterial pressure
(24/8 mm Hg versus 120/80 mm Hg)

Blood Flow: Lungs
… The autoregulatory mechanism is exactly
opposite of that in most tissues
„ Low oxygen levels in the alveolus cause
vasoconstriction; high levels promote
vasodilation
„ This allows for proper oxygen loading in
the lungs
Blood Flow: Heart
„ Under resting conditions, blood flow through
the heart may be controlled by a myogenic
mechanism
„ Blood flow remains constant despite wide
variation in coronary perfusion pressure
„ During strenuous exercise:
… Coronary vessels dilate in response to local
accumulation of carbon dioxide
… Decreased oxygen in the blood will cause
local release of vasodilators
Capillary Exchange of Respiratory
Gases and Nutrients
… Water-soluble solutes pass through clefts
and fenestrations
… Lipid-soluble molecules diffuse directly
through endothelial membranes
Blood Flow: Heart
„ Small vessel coronary circulation is influenced
by:
… Aortic pressure
… The pumping activity of the ventricles
„ During ventricular systole:
… Coronary vessels compress
… Myocardial blood flow ceases
… Stored myoglobin supplies sufficient oxygen
„ During ventricular diastole, oxygen and
nutrients are carried to the heart
Capillary Exchange of Respiratory
Gases and Nutrients
„ Oxygen, carbon dioxide, nutrients, and
metabolic wastes diffuse between the blood
and interstitial fluid along concentration
gradients
… Oxygen and nutrients pass from the blood to
tissues
… Carbon dioxide and metabolic wastes pass
from tissues to the blood
Capillary Exchange of Respiratory
Gases and Nutrients
Capillary Exchange of Respiratory Gases
and Nutrients
Processes that move fluids across
capillary walls
„ Diffusion of molecules happens
… through adjacent endothelial cell or
… through the pores or
… through channels on the membrane or
… through the membrane of the endothelial cells
„ Filtration
… Capillary hydrostatic pressure (CHP)
… Only small molecules will pass through the
pores of the membrane or between adjacent
endothelial cells
Capillary Filtration
Capillary Exchange
„ Flow of water and solutes from capillaries to
interstitial space
… Plasma and interstitial fluid are in constant
communication
… Assists in the transport of lipids and tissue
proteins
… Accelerates the distribution of nutrients
… Carries toxins and other chemical stimuli to
lymphoid tissues
Processes that move fluids across
capillary walls
„ Reabsorption
… Through osmosis
… The higher the solute concentration the greater
the solution’s osmotic pressure
… Blood colloid osmotic pressure (BCOP) or
oncotic pressure
„ Is the osmotic pressure of the blood
… It works against hydrostatic pressure
Forces acting across capillary walls
„ Capillary hydrostatic pressure (CHP = 35)
„ Blood colloid osmotic pressure (BCOP=25)
„ Interstitial fluid colloid osmotic pressure (ICOP=0)
„ Interstitial fluid hydrostatic pressure (IHP= 0)
Capillary filtration and reabsorption Capillary filtration and reabsorption
„ Processes involved in filtration at the arterial end „ Processes involved in reabsorption at the venous
… Net hydrostatic pressure end
„ CHP – IHP= 35-0=35 … Net hydrostatic pressure
… Net colloid osmotic pressure „ CHP-IHP=18-0=18
„ BCOP – ICOP=25-0=25 … Net osmotic pressure
… Net filtration pressure „ BCOP-ICOP=25-0=25
„ 35-25=10 … Net filtration pressure
„ 18-25=-7

Net Filtration Pressure (NFP)

Filtration and reabsorption

„ NFP=(CHP-IHP) – (BCOP-ICOP)
… IHP=0
… ICOP=0
„ +NFP=fluid moves out of the capillary (arterial
side)
„ -NFP=fluid moves into the capillary (venous side)

Circulatory Shock Circulatory Shock

„ Circulatory shock – any condition in which „ Three types include:

blood vessels are inadequately filled and blood …
cannot circulate normally
„ Results in inadequate blood flow to meet tissue …
needs
…
Hypovolemic shock – results from large-
scale blood loss
Vascular shock – poor circulation resulting
from extreme vasodilation
Cardiogenic shock – the heart cannot
sustain adequate circulation
 Circulatory Pathways

„ The vascular system has two distinct

circulations
… Pulmonary circulation – short loop that runs
from the heart to the lungs and back to the
heart
… Systemic circulation – routes blood through
a long loop to all parts of the body and
returns to the heart

Differences Between Arteries and Developmental Aspects

Veins „ The endothelial lining of blood vessels arises
Arteries Veins from mesodermal cells, which collect in blood
Blood pumped into single
Blood returns via superior and islands
Delivery interior venae cavae and the
systemic artery – the aorta
coronary sinus … Blood islands form rudimentary vascular
Location
Deep, and protected by
Both deep and superficial
tubes through which the heart pumps blood
tissue
by the fourth week of development
Pathways Fair, clear, and defined Convergent interconnections
„ Fetal shunts (foramen ovale and ductus
Dural sinuses and hepatic
Supply/drainage Predictable supply
portal circulation arteriosus) bypass nonfunctional lungs
„ The ductus venosus bypasses the liver
„ The umbilical vein and arteries circulate blood
to and from the placenta

Fetal circulation Developmental Aspects

„ Blood vessels are trouble-free during youth

„ Vessel formation occurs:
… As needed to support body growth
… For wound healing
… To rebuild vessels lost during menstrual
cycles
„ With aging, varicose veins, atherosclerosis,
and increased blood pressure may arise
Pulmonary circuit consists of Pulmonary Circulation
pulmonary vessels
„ Arteries which deliver deoxygenated blood to the
lungs
„ Capillaries in the lungs where gas exchange
occurs
„ Veins which deliver oxygenated blood to the left
atrium

Systemic Circulation
Systemic arteries
„ Ascending aorta
… Right and left coronary arteries originate from
base of aortic sinus
„ Aortic arch
… Brachiocephalic trunk
„ Right common carotid
„ Right subclavian
… Left common carotid
… Left subclavian
„ Descending aorta
… Thoracic and abdominal aortas

Systemic arteries Systemic arteries

„ Axillary
„ Subclavian
… shoulder
… Supplies arms, chest, CNS, shoulder and back
„ Brachial
… Internal thoracic
… Upper arm
„ Pericardium and anterior chest
„ Radial
… Vertebral
„ Ulnar
„ Brain
„ Superficial and deep palmar archs
„ Spinal cord
Arteries of the chest and upper limb Arteries of the neck and head

„ Common carotid artery

… Internal carotid
… External carotid

Arteries of the neck and head

Ophthalmic artery

Basilar artery Maxillary artery

„ External Carotid
Occipital artery
Vertebral artery
Facial artery … Neck
Internal
carotid artery … Esophagus
External
carotid artery
Common
… Pharynx
carotid artery
… Lower jaw

Clavicle (cut)
… face
Subclavian
artery
Brachiocephalic
Axillary trunk
artery Internal thoracic
artery
(b)

Arteries of the Brain and Circle of

Willis
Ophthalmic artery
„ Internal carotid
Basilar artery Maxillary artery
Occipital artery
Facial artery
… Ophthalmic
Vertebral artery
Internal „ eyes
carotid artery
External
carotid artery … Anterior cerebral
Common
carotid artery
„ Frontal and parietal lobes

„ Anterior communicating artery

Clavicle (cut)
Subclavian
artery
Brachiocephalic
… Middle cerebral
Axillary trunk
artery Internal thoracic „ Mesencephalon and lateral cerebral
artery
(b) hemisphere
 Arteries of the Brain and Circle of
Circle of Willis
Willis
„ Vertebral arteries
„ Basilar artery
… Supply medulla oblongata
… Pons
… Cerebellum
„ Basilar artery gives rise to posterior cerebral
and posterior communicanting arteries

Arteries of the Abdomen

Liver (cut) Diaphragm
Inferior vena cava Esophagus
Celiac trunk Left gastric
Hepatic artery artery
proper Left gastroepiploic

Blood Vessels Common hepatic

artery
artery
Splenic artery
Spleen
Right gastric artery
Gallbladder Stomach
Gastroduodenal Pancreas
artery (major portion
Right gastroepiploic lies posterior
artery to stomach)
Superior
PART C Duodenum
Abdominal aorta mesenteric
artery
(b)

Arteries of the Abdomen

Opening
for inferior
Diaphragm Major Arteries of the Trunk
vena cava Inferior phrenic
artery
Hiatus (opening)
for esophagus
„ Descending aorta
Middle suprarenal
Celiac trunk
artery … Thoracic
Renal artery
Kidney
Superior „ For the thorax
mesenteric artery
Lumbar arteries … Abdominal
Gonadal (testicular
or ovarian) artery „ Celiac trunk
Abdominal aorta Inferior
mesenteric artery …Left gastric
Median sacral Common iliac artery
artery …Splenic
Ureter
(c) …Common hepatic
 Major Arteries of the Trunk

„ Superior mesenteric
… Pancreas, small intestine and proximal 2/3 of
the large intestine
„ Suprarenal
„ Renal
„ Gonadals
„ Inferior mesenteric
… Distal 1/3 of the large intestine

Arteries of Common iliac artery

Abdominal aorta the Lower
Internal iliac artery
Superior gluteal artery
External iliac artery

„ Right and left Common iliacs Limbs Deep artery of thigh

Lateral circumflex
femoral artery
Popliteal
artery

… Internal iliac Medial circumflex Anterior

femoral artery tibial
„ Organ of pelvic cavity Obturator artery artery
Femoral artery Posterior Fibular
… External iliac Adductor hiatus tibial artery
Popliteal artery artery
Dorsalis
… Femoral Lateral pedis artery
plantar (from top
… Popliteal artery of foot)
Anterior tibial artery Medial Plantar
„ Anterior tibial Posterior tibial artery
plantar arch
artery
Fibular artery
„ Posterior tibial (c)

…Fibular
Dorsalis pedis artery
„ Dorsal and plantar archs Arcuate artery
Metatarsal arteries
(b)

Dural sinuses
Subclavian vein
External jugular vein
Right and left
Vertebral vein
Systemic Veins Internal jugular vein
Superior vena cava
brachiocephalic veins
Cephalic vein
Brachial vein
Axillary vein
„ Superior vena cava Great cardiac vein
Basilic vein
Splenic vein
Hepatic veins
Median cubital vein
… Drains blood from the head and neck Hepatic portal vein
Superior mesenteric Renal vein
vein Inferior mesenteric vein
„ Inferior vena cava Inferior vena cava

… Drains blood from the remainder of the body Ulnar vein

Radial vein
Digital veins
Internal iliac vein
Common iliac vein
External iliac vein
Femoral vein
Great saphenous vein
Popliteal vein
Posterior tibial vein
Anterior tibial vein
Fibular vein
Dorsal venous arch Dorsal digital
(b) veins
 Veins of the Brain
Venous return from the cranium Superior sagittal
sinus
Falx cerebri
Inferior sagittal
„ Cerebral veins drain the blood into sinuses sinus
Straight sinus
„ Superior sagittal sinus
Cavernous sinus
„ Inferior sagittal sinus
Junction of sinuses
„ Occipital sinus Transverse sinuses

„ Straight sinus Sigmoid sinus

Jugular foramen
„ Left and right transverse sinuses
Right internal
(c) jugular vein

Veins of the Head and Neck

Venous return from the cranium Ophthalmic vein
Superficial
temporal vein
Facial vein
Occipital vein

Posterior
„ Left and right transverse sinuses converge to auricular vein
External
form the sigmoid sinus jugular vein
Vertebral vein
„ Sigmoid sinus becomes internal jugular vein Internal
jugular vein
Superior and middle
thyroid veins
Brachiocephalic
vein
Subclavian
vein
Superior
(b) vena cava

Superficial veins of the head and

Veins of neck and thorax
neck
„ Temporal
„ Facial „ Internal and external jugular
„ Maxillary „ Brachiocephalic trunks
„ They drain into external and internal jugular „ Superior vena cava
veins
Veins in the thorax Veins of the arms
„ Brachiocephalic
„ From lumbar vein „ Subclavian
… Azygos vein (on the right side) … Cephalic
… Hemiazygos (on the left side) … Axillary
„ They drain into the brachiocephalic „ Brachial

„ Basilic

… Median cubital
„ Connects basilic and cephalic

… Brachial divides in radial and ulnar

Internal jugular vein

External jugular vein
Veins of the Abdomen
Brachiocephalic veins
Left subclavian vein
Right subclavian vein
Superior vena cava
Axillary vein Inferior
Azygos vein Hepatic veins
Accessory hemiazygos vein
phrenic vein
Brachial vein
Cephalic vein Hemiazygos vein Inferior vena cava
Basilic vein Posterior Left
Right suprarenal vein
intercostals
suprarenal vein
Inferior Renal veins
Median vena cava
cubital vein Ascending Left ascending
lumbar vein lumbar vein
Median Right
antebrachial Basilic vein gonadal vein Lumbar veins
vein Ulnar vein Left
Cephalic gonadal vein
vein Common iliac vein
Deep palmar
Radial
venous arch
vein External iliac vein
Superficial palmar Internal iliac vein
venous arch (b)
Digital veins
(b)

Veins of the Abdomen

Hepatic Portal System Hepatic veins

„ Contains substance absorbed by the stomach Liver

Gastric veins
Spleen
and intestines
Inferior vena cava
Hepatic portal vein
„ Delivers these compounds to the liver for Splenic vein

Right
… Storage gastroepiploic vein
Inferior
… Metabolic conversion mesenteric vein
Superior
… Excretion mesenteric vein
Small intestine
Large intestine

Rectum

(c)
 Venous Drainage from the Lower
Hepatic portal system
„ Capillaries in the digestive system
Limb
„ Hepatic portal vein
… Inferior mesenteric vein
… Superior mesenteric vein
… Splenic vein
… Gastric veins
… Cystic vein
„ Liver capillaries
„ Hepatic vein

Common iliac vein

Internal iliac vein
External iliac vein
Inguinal ligament

Femoral vein
Great saphenous
vein (superficial)

Great saphenous vein

Popliteal vein
Popliteal vein Anterior tibial vein
Fibular (peroneal) vein

Fibular (peroneal) Small saphenous vein

vein (superficial)
Anterior tibial vein Posterior tibial vein
Dorsalis pedis vein Plantar veins
Dorsal venous arch
Plantar arch
Metatarsal veins
Digital veins
(b) (c)