Short Answer (5pt each) Answer 2/3 or all 3 for extra credit –

1. Relate the anatomical differences between arteries, capillaries and veins to

their different functions. How does the nervous system control the flow of
blood through the capillary network?

Arteries transport blood away from the heart, while veins transport blood
back to the heart; capillaries are very thin blood vessels that actually transfer
the oxygen and chemicals in the blood to body tissues, as well as cellular
waste products and carbon dioxide out into the circulatory system. Both
arteries and veins have a three layer structure (tunica externa made of LC
tissue, tunica media made of smooth muscle and collagen DC tissue, and
squamous epithelium tunica interna) along with a basement membrane,
endothelium and in the large vessels a lumen and vasa vasorum; however,
there are key differences in the proportions of these structures that reflect
the different functions of arteries and veins. Arteries have much thicker
tunica mediae since they require smooth muscle to constrict and dilate in
order to maintain blood flow in consistent diasto-systolic pressures for
expedient cellular nutrition and oxygenation. Since veins do not constrict and
dilate as arteries do, they also do not have as much elastic CT as arteries do,
and have a separate system to keep blood flowing via skeletal movement and
one-way valves, which are outcroppings of only venous endothelia. Veins
have thinner walls than arteries because they do not require as much
strength, since venous blood pressure is much lower than arterial blood
pressure due to the force generated by the heart dissipateing into the many
capillaries. And, capillaries themselves are unlike arteries or veins by their
comparatively simple structure of only a basement membrane surrounding
an epithelium – necessary to produce substance exchange between tissues
and the circulatory system.

Neurons innervate only large blood vessels (that is enough to control blood
flow), and they work involuntarily by the vasomotor center in the medulla
oblongata. There are two types of neurons working in blood vessels –
baroreceptors (blood pressure sensors) or chemoreceptors (chemical
sensors). Baroreceptors inhibit or excite the vasomotor center, in degrees
proportional to amount of blood pressure: vasoconstriction/dilation occurs as
a response to overly low/high blood pressure, respectively (control of blood
pressure is important because too high blood pressure leads to edema as it
diffuses out of the capillaries, and the opposite effect of not enough blood
exchanging nutrients and gases with cells if blood pressure is too low).
Chemoreceptors respond to serum pH – if too low, then that means too much
carbon dioxide and a signal is sent to the brain to make the lungs work
harder; the chemoreceptors also excite the vasomotor center to constrict the
blood vessels to increase blood pressure and thus gas exchange in the lungs.
The circulatory system also can be adjusted through direct stimulation of the
brain – if it is not receiving enough blood and nutrients, the cardiac and
vasomotor centers will cause an increase in blood pressure and heartbeat
(this is called the medullary ischemic reflex). Even psychological states like
anger, depression, arousal, stress, etc. can change blood pressure and heart
beat.
2. Explain how normal blood pressure is maintained through the regulation of
cardiac output, peripheral resistance and blood volume. How does blood
viscosity affect blood pressure?

Cardiac output of blood is defined as heart stroke volume multiplied by beats

per time unit, so the regulation of either stroke volume or heart rate will
regulate cardiac output. High blood pressure is often caused by high cardiac
output, so regulation of cardiac output (through neural signals or hormones
like adrenaline, ADH, and ANF) maintains normal blood pressure.

Peripheral resistance in blood vessels is defined as mean arterial pressure

divided by cardiac output – that is, peripheral resistance is the amount of
deceleration effected on blood flow by mostly arterioles (since they lie
between arteries and capillaries, and thus at the boundary between
constriction/dilation and lack of it, they determine ultimate speed of blood
flow). High peripheral resistance will increase blood pressure as blood moves
more slowly and jostle against the endothelia. Looking at the formula,
peripheral resistance is directly correlated with MAP and inversely correlated
with cardiac output, so control of cardiac output (by aforementioned means)
or vasodilation/constriction will control BP.

Blood volume is associated with blood pressure because the circulatory

system is obviously finite in area and high blood density comes with high
blood pressure. High blood pressure associated with high blood volume can
be alleviated with the creation of new blood vessels (angiogenesis) and
vasodilation.

Blood viscosity affects blood pressure much in the same way as blood volume
affects BP, and viscosity is also related to peripheral resistance as there is
decelerative internal friction between the closely packed erythrocytes and/or
serum albumin.

3. George is in congestive heart failure. Because of his condition, his ankles

and feet appear to be swollen and he has trouble breathing. What is
congestive heart failure and what are some of its causes? What is the
relationship between congestive heart failure and the accumulation of fluid in
the feet and ankles? Why does he have trouble breathing? How should he be
treated?

Congestive heart failure is the failure of the heart to pump blood adequately
as a result of some vascular condition such as narrowed coronary artery
disease, disruptive scar tissue from past MIs, high blood pressure, some kind
of heart valve disease, congenital heart defects, and endocarditis (valve
infection) or myocarditis (myocardium infection). Because in congestive heart
failure the heart cannot pump enough blood, edema occurs in the feet and
ankles (or, rather, wherever gravity takes the blood). George probably has
some fluid buildup in his lungs as well, as that is also a major capillary bed,
and so he should have some trouble breathing. While recovering, George
cannot exert himself too much because his heart will not be able to keep up,
but he should not spend all his time lying down either because that puts him
at a greater risk for pulmonary edema. He needs to give his body time to
recover and needs to start maintaining a healthy diet if he had been doing so
before his heart failure. He will take drugs like Angiotensin-Converting
Enzyme inhibitors and vasodilators to lower blood pressure and decrease
resistance; beta blockers improve left ventricle function (the pump driving
blood to rest of body); something like digitalis will increase cardiac output. He
should also take diuretics to help kidney function, which is hurt by the low
blood flow caused by congestive heart failure.