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I. Blood vessels A. Arteries carry blood ___________from the heart. 1. Large arteries are the Aorta and Pulmonary arteries 2. Medium arteries such as the radial artery 3. Arterioles are the smallest arteries 4. Act as the pressure system driving blood through the tissues. _________________ 1. Have only one layer of cells making up its wall, a single layer of squamous epithelium (endothelium); 2. are the site where all the exchange between the tissues and the blood takes place. _________ carry the blood back to the heart from the tissues. 1. Large veins are the Inferior and Superior vena cavas 2. Medium veins such as the radial vein 3. Venules are the smallest of the veins 4. Act as the reservoir for blood because the veins are able to distend.



II. Blood Flow is proportional to the ___________ difference divided by resistance. F P R F A. = = = = Blood Flow Pressure Difference Resistance P R

Determinants of _________________ 1. Length of Vessel - does not vary significantly in normal physiology. 2. Viscosity of blood does not vary significantly in normal physiology although blood viscosity is increased in severe dehydration and in the polycythemia (high red blood cell count) that occurs in high altitude adaptation. 3. _______ of vessel is one major determinant of resistance in normal physiology. a. A smaller radius of the vessel results from vasoconstriction. b. A larger radius of the vessel results from vasodilation. 1

c. The ___________ provide the greatest resistance to blood flow. d. Blood flow to an organ is thus largely determined by the degree of vasoconstriction or vasodilation of its arterioles. 4. Thus, resistance is primarily dependent on the radius of the blood vessel. F = Blood Flow; r = radius R = P = Pressure difference; 1 r4 R = Resistance

B. Thus, blood flow is primarily determined by the pressure difference and the radius of the blood vessel. F = P x r4 1. 2. 3. 4. if if if if the P increases, F will increase; the P decreases, F will decrease the r increases, R decreases and thus F increases; the r decreases, R increases and thus F decreases.

III. Blood Flow from Tissues to Tissues A. B. C. D. E. F. G. H. I. Tissue - capillaries Venules Medium veins Inferior or Superior vena cava Right Atrium _________________________ Right Ventricle Pulmonary semilunar valve Pulmonary Artery


J. Lungs K. L. M. N. O. P. Q. R. S. Pulmonary Vein Left Atrium ___________________________________ Left Ventricle Aortic semilunar valve Aorta Medium arteries Arterioles Tissue - capillaries


IV. Blood Pressure 2

A. Systolic Pressure 1. is the _________ blood pressure reached during the cardiac cycle; 2. during systole, the amount of blood leaving the arterioles is only 1/3 stroke volume. 3. The excess volume distends the arteries and raises the arterial pressure. B. Diastolic Pressure 1. is the __________ blood pressure reached during the cardiac cycle. 2. During diastole, the arteries recoil and drive the blood through the arterioles into the capillaries. 3. However, before the blood pressure drops to 0, systole occurs. C. Normal blood pressure is: Systolic = 120 Diastolic 80

D. ___________ Pressure = Systolic - Diastolic pressures If the blood pressure is 120/80, then the Pulse pressure = 120-80 = 40 E. Mean pressure = diastolic pressure + 1/3 pulse pressure 1. If the blood pressure is 120/80, then the Mean pressure = 80 + 1/3 x (40) = 80 + 13 = 93 2. The mean pressure represents the average arterial pressure during the cardiac cycle. 3. This pressure is important because the difference between the mean pressure and the venous pressure is the force which drives blood through the ____________ beds of organs.

F. Measurement of Arterial Blood Pressure 1. ___________________ method of blood pressure measurement 3

a. is based on the correlation of blood pressure and arterial sounds. b. Instruments are necessary to measure blood pressure are: 1. Sphygmomanometer (learn to spell it) 2. Stethoscope (learn to spell it) c. Steps: 1. Place cuff around upper arm 2. Apply stethoscope over the brachial artery 3. Inflation of the cuff greater than the systolic pressure collapses the artery and prevents the blood flow. 4. Decreasing the pressure of the cuff below systolic pressure causes the artery to expand and the blood flows through the constriction which creates turbulence, producing sounds, called the ___________________ sounds. 5. When you first hear the Korotkoff sounds, take the pressure reading and this is the systolic pressure. 6. When the Korotkoff sounds disappear, take the pressure reading and this is the diastolic pressure. d. Therefore, by using the auscultatory method of blood pressure measurement, you can obtain both the ________ and diastolic blood pressures. 2. Second method of blood pressure measurement is the __________________ Method. a. This method requires only the sphygmomanometer. b. Steps: 1. Inflate cuff and occlude blood flow through the brachial artery. 2. Feel for pulse at the radial artery at the wrist; there should be no pulse. 3. Release pressure on cuff. 4. When you feel the pulse at the radial artery, take the pressure and this will be the systolic blood pressure. c. Only the _________ blood pressure can be determined by palpatory method. G. _____________ control the blood flow distribution and can affect the blood pressure. 1. There is a _______________ sphincter of smooth muscle which Can contract and relax affecting the blood pressure. a. Contraction of the precapillary sphincter or vasoconstriction, results in an increase in blood pressure. b. Relaxation of the precapillary sphincter or 4

vasodilation results in a decrease in blood pressure. 2. Factors which control arteriolar diameter: a. Sympathetic Nervous System - some sympathetic nerves (postganglionic neurotransmitter = norepinephrine) cause arterioles to constrict. b. The hormone _______________ causes some arterioles to constrict and others to dilate. c. Angiotensin II, a protein, causes the arterioles to constrict. d. _______________ causes the arterioles to constrict. e. Histamine causes the arterioles to dilate. H. Factors affecting blood pressure (b.p.) 1. An increase in cardiac output (C.O.) increases b.p. 2. A decrease in cardiac output decreases b.p. 3. An increase in stroke volume increases C.O. which increases b.p. 4. A decrease in stroke volume decreases C.O. which decreases b.p. 5. An increase in pulse rate or heart rate increases C.O. which increases b.p. 6. A decrease in pulse rate or heart rate decreases C.O. which decreases b.p. 7. __________ blocking drugs decrease H.R. which decrease b.p. 8. Calcium channel blockers decrease HR, which decreases b.p. V. Veins A. Veins act as a ___ resistant passageway to get blood back to the heart. B. Veins have a lower pressure than arteries and therefore this is where blood is withdrawn from the body. C. The venous pressure is the pressure gradient between the atria of the heart and the veins. D. The venous pressure is a crucial determinant of ________ volume the end diastolic volume (the volume of blood in the ventricle via before ventricular contraction). E. Determinants of venous pressure: 1. The smooth muscle in the walls of the ______ is innervated by the sympathetic nerves causing constriction of the veins increasing venous pressure. 2. When the skeletal muscles contract, the veins going through the muscle are compressed, pushing the blood toward the heart acting as a ___________________________ pump. 3. During inspiration, the abdominal pressure increases and the thoracic pressure decreases which moves the blood from the abdominal to the thoracic cavity, enhancing the flow of blood to the heart acting as a ______________ pump. 4. Venous _________ are found especially in the veins in the lower limbs which prevents the backflow of blood to the tissues, enhancing the flow of blood to the heart.




The primary cardiovascular control center is in the __________ _______________. This center is essential for blood pressure regulation and heart rate.

2. There are arterial baroreceptors which are sensitive to stretch and distension and are responsive to the mean pressure and pulse pressure. a. The _________________is the baroreceptor located in the arch of the aorta. b. The __________ Sinus is the baroreceptor located at the bifurcation of the carotid artery into the internal and external carotid arteries. 3. An increase in the blood pressure

increases the activation of the baroreceptors which stimulates the control center in the medulla oblongata

(+) Stimulates Parasympathetic Nerves


Inhibits Sympathetic Nerves

Heart Rate

Strength of heart contraction


Stroke Volume Blood pressure Cardiac Output

Blood Pressure
A decrease in blood pressure 6

decreases stimulation of the baroreceptors medulla oblongata

Stimulates Sympathetic Nerves Heart rate Strength of heart's contraction Vasoconstriction

Stroke Volume Cardiac Output Blood Pressure Blood Pressure

PATHOLOGIES OF THE CARDIOVASCULAR SYSTEM 1. ____________ is blood pressure in excess of the normal range for the person's age and sex. It is dangerous because: a. the high pressure may damage cerebral blood vessels leading to cerebrovascular accident (stroke). b. it contributes to the development of atherosclerosis. 2. ________ pectoris is chest pain associated with lack of blood flow to the heart. 3. Myocardial Infarction a. The __________ arteries supply the heart with its nutrients and oxygen. 7

b. Decreased coronary blood flow will result in the death of the cardiac muscle cells of the heart or myocardial infarction. 4. ________________ is a disease characterized by a thickening of the arterial wall with large numbers of abnormal smooth muscle cells and deposits of cholesterol. This can lead to an increase in blood pressure and/or blockage of blood vessels. a. Atherosclerosis is the most common form of arteriosclerosis or hardening of the arteries. b. Localized plaques or __________ may protrude into the lumen of the artery and reduce the blood flow to an organ. c. Atheromas can become a site for thrombus or blood clot formation which can occlude the blood flow to an organ. d. Atherosclerosis begins as a result of damage to the endothelium. e. Damage to the endothelium can be caused by smoking, hypertension, high blood cholesterol, and diabetes. f. High blood ______________ is associated with an increase risk of atherosclerosis. g. High cholesterol can be produced by a diet rich in cholesterol and saturated fat. h. Cholesterol is carried in the blood attached to protein carriers called lipoproteins. i. ____________ lipoproteins carry cholesterol to the arterial wall. j. High-density lipoproteins carry cholesterol away from the arterial wall and thus offer protection against atherosclerosis 5. Congestive heart failure results from damage to the cardiac muscle and the cardiac output is not able to maintain the blood flow required by the body. a. Failure of the left ventricle results in _____________________. b. Failure of the right ventricle results in systemic edema and is seen in the legs.