closed delivery system that begins and ends at the heart Arteries – carry blood away from the heart, they “branch,” “diverge” Arteries, arterioles, and capillaries Veins – carry blood toward the heart, so they “join,” “converge” Capillaries, venules, and veins In the systemic circulation, arteries always carry oxygenated blood and veins always carry oxygen-poor blood In the pulmonary circulation, it is opposite. The arteries carry oxygen-poor blood to the lungs and the veins carry oxygen-rich blood to the heart Exchange between blood and tissue cells occur through the thin capillary walls Structure of Blood Vessel Walls Most vessels have three distinct layers, or tunics, that surround a central blood- containing space, the vessel lumen Tunica interna or tunica intima – the innermost tunic, also called endothelium, the simple squamous epithelium, that lines the lumen of all blood vessels Tunica media – the middle tunic, mostly circularly arranged smooth muscle cells. Vasoconstriction and vasodilation are due to the effect on the smooth muscle cells Tunica externa or tunica adventitia – connective tissue, that protects and reinforce the vessel Arterial System P.695 Conducting (Elastic) Arteries – the aorta and its major branches P.696 Distributing (Muscular) Arteries – which deliver blood to specific body organs Arterioles – have two tunics, tunica media and tunica interna Capillaries – exceedingly thin walls just a thin tunica interna P.698 Capillary beds – Capillaries do not function independently. Instead they form interweaving networks Microcirculation – The flow of blood from an arteriole to a venule, that is, through a capillary bed Venous System P.698 Blood is carried from the capillary beds toward the heart by veins Venules – are formed when capillaries unite Veins – Venules join to form veins. Veins usually have three distinct tunics, but their walls are always thinner and their lumens larger than those arteries P.699 Venous valves – that prevent blood from flowing backward Varicose veins – Vascular anastomoses - where vascular channels unite. Most organs receive blood from more than one arterial branch, and supplying same territory often merge P.701 Blood flow – is the volume of blood flowing through a vessel, or an organ in a given period (ml/min) Blood pressure (BP) – the force per unit area exerted on a vessel wall by the blood, expressed as mmHg P.702 Resistance – is opposition of flow and is a measure of the amount of friction blood encounters as it passes through the vessels As most friction is encountered in the peripheral circulation, well away from the heart called peripheral resistance There are three important sources of resistance: blood viscosity, vessel length, and vessel diameter Blood viscosity – the greater the viscosity, the slower the flow Total blood vessel length – the longer the vessel, the slower the flow Blood vessel diameter – Because blood viscosity and vessel length normally unchanging. Changes in blood vessel diameter are frequent, and significantly alter peripheral resistance Relationship Between Flow, Pressure, and Resistance Resistance (R) =Pressure (P)/Flow (F) Blood flow is inversely proportional to the peripheral resistance in the systemic circulation, if R increases F decreases Systemic Blood Pressure – The pumping action of the heart generates blood flow. Pressure results when flow is opposed by resistance P.703 Arterial Blood Pressure – two factors: (1) compliance or distensibility (2) the volume of blood forced into them at any time Figure 19.6 Systolic Blood Pressure Diastolic Blood Pressure Pulse Pressure Venous Blood Pressure – venous blood pressure is steady and changes very little during the cardiac cycle P.704 Despite the structural modifications of veins (large lumens and valves), venous pressure is normally too low to promote adequate venous return Hence, two functional adaptations are critically important to venous return The respiratory pump – The muscular pump – Maintaining Blood Pressure - R=P/F P. 705 Vasomotor center – that oversees the changes in the diameter of the blood vessels, located in the medulla oblongata Any increase in sympathetic activity produces vasoconstriction and a rise in blood pressure Decreased sympathetic activity allows the vascular muscle to relax and causes blood pressure to decline Vasomotor fibers release norepineph- rine which is a potent vasoconstrictor P.705 Vasomotor activity is modified by inputs from: P.706 (1) Baroreceptors (pressure sensitive) that respond to changes in arterial pressure and stretch P.707 (2) Chemoreceptors that respond to changes in blood levels of O2, CO2 and H+ Baroreceptors are located in the carotid sinus and aortic arch Chemoreceptors located close to the baroreceptors in the carotid sinus and aortic arch Adrenal medulla hormones – Angiotensin II – Atrial natriuretic peptide (ANP) - Atrial natriuretic peptide (ANP) Antidiuretic hormone (ADH) P.710 Pulse – the alternating expansion and recoil of elastic arteries during each cardiac cycle that create a pressure wave and transmitted through the arterial tree You can feel a pulse in any artery close to the body surface by compressing the artery against firm tissue, and this provides an easy way to count heart rate Radial pulse – is routinely used Brachial pulse – Carotid pulse - The pulse of a healthy man may be around 66 beats/min when he is lying down, 70 when he sits up, 80 when he suddenly stands During vigorous exercise or emotional upset, pulse rates between 140 and 180 are not unusual because of sympathetic effects on the heart Measuring Blood Pressure P.710 Auscultatory method – Systemic arterial blood pressure is measured indirectly in the brachial artery of the arm The blood pressure cuff or sphygmomanometer is the instrument The sounds of Korotkoff Hypertension – high blood pressure, may be transient or persistent P.711 Chronic hypertension – is a common and dangerous disease that warns of increased peripheral resistance. An estimated 30% of people over the age of 50 years are hypertensive P.711 Primary or essential hypertension – 90% people suffer, in which no underlying cause has been identified, can be the following factors: Diet, obesity, age, race, heredity, stress, smoking Primary hypertension cannot be cured, but can be controlled by ……. Secondary hypertension – which accounts for 10% of cases, is due to identifiable disorders, such as excessive renin secretion, arteriosclerosis etc. Hypotension or low blood pressure – systolic pressure below 100 mmHg Orthostatic hypotension – low blood pressure and dizziness when rise suddenly from a reclining or sitting position, in elderly people Chronic hypotension – poor nutrition P.712 Velocity of Blood Flow – velocity is inversely related to the cross- sectional area of the blood vessels P.712 Figure 19.14 It is fastest in the aorta and other large arteries, slowest in the capillaries, and then picks up speed again in the veins Slow capillary flow is beneficial because it allows adequate time for exchange between the blood and tissue cells Autoregulation –is the automatic adjustment of blood flow to each tissue Capillary Dynamics P.716 O2, CO2 and most nutrients, and metabolic wastes pass between the blood and interstitial fluid by diffusion Fluid movements – two dynamic and opposing forces – hydrostatic and colloid osmotic pressures P.719 Figure 19.17 Hydrostatic pressure (HP) – is the force exerted by a fluid pressure against a wall Capillary hydrostatic pressure (HPc) P.718 Interstitial fluid hydrostatic pressure (HPif) P.718 Colloid osmotic pressure (OP) – the force opposing hydrostatic pressure, large nondiffusible molecules, such as plasma proteins, that are prevented from moving through the capillary membrane Capillary Colloid osmotic pressure (OPc), also called oncotic pressure Colloid osmotic pressure (OPif) – NFP = (HPc – HPif) – (OPc – OPif) Circulatory shock – extreme form of hypotension The most common form of shock is hypovolemic shock, which results large-scale loss of blood, severe vomitting, diarrhoea, extreme burns Vascular shock – blood volume is normal and constant, but there is poor circulation caused extreme vasodilation
Cardiogenic shock – or pump failure,
occurs when the heart is so inefficient that it cannot sustain adequate circulation, such as myocardial infarction (MI) P.722 Pulmonary circulation – P.723 Systemic circulation – P.742 Hepatic portal system – carries nutrient rich blood from the digestive organs to the liver P.750 Aneurysm – a balloon-like outpocketing of an artery wall that places the artery at risk for rupture; chronic hypertension or arteriosclerosis
Angiogram – diagnostic technique
involving the infusion of a radiopaque substance into the circulation for X-ray examination of specific blood vessels. The major technique for diagnosing coronary artery occlusion and risk of a heart attack Diuretic – a chemical that promotes urine formation Phlebitis – inflammation of a vein accompanied by painful throbbing Phlebotomy – a venous incision made for withdrawing blood