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Structure of Blood Vessels Walls
A. Three layers 1. Tunica intera a. Inner most layer b. Endothelium i. Simple squamous c. Some larger vessels have subendothelium i. Loose connective tissue ii. Basement membrane 2. Tunica media
a. Middle layer b. Circularly arranged smooth muscle c. Chemical and nervous control of degree of contraction i. Sympathetic NS d. Change in diameter i. Vasoconstriction ii. Vasodilation 3. Tunica externa a. Made of collagen fibers b. Function i. Protection ii. Reinforcement iii. Anchor to surrounding tissue c. Accessory tissues i. Nerve fibers ii. Lymphatic vessels iii. Elastic network iv. Tiny blood vessels within layer-vasa vasorum
II. Arterial System A. Classification based on size and function 1. Elastic (conducting) arteries a. Characteristics i. Thick-walled ii. Near heart iii. Largest diameter
iv. More elastic v. Large lumen b. Properties i. Dampen BP changes associated with heart contraction ii. Passive accommodation results in smooth flow of blood c. 1.0 - 2.5 cm 2. Muscular arteries-distributing arteries a. Distal to elastic arteries b. Deliver blood to specific organs c. Thick media layer i. More smooth muscle d. 0.3 - 1.0 cm 3. Arterioles a. Determine flow into capillary beds b. Mostly smooth muscle c. 10 µm - 0.3 cm 4. Capillaries a. Smallest blood vessels i. 8 - 10 µm b. Tunica interna only c. Exchange of materials
B. Types of capillary 1. Continuous a. Uninterrupted endothelial cells b. Incomplete tight junctions
i. Intercellular clefts 2. Fenestrated a. Endothelial cells have oval pores i. Fenestrations b. Pores permit greater permeability 3. Sinusoidal a. Modified, leaky capillaries b. Large molecules can pass through
C. Capillary beds
1. Capillaries act as networks-capillary beds
Characteristics vary with size i.100 µm b. Thinner walls and less muscle than arteries . Microcirculation a. Post-capillary venule III. Parts of a capillary bed a. Venous System A. Types of vessels 1. Thin externa 2. Pre-capillary sphincter controls blood flow into capillary 3. True capillaries branch off i. 8 .2. Vascular shunt i. Arteriole to venule 3. Venules a. Metateriole a. Formed from venules b. Terminal arteriole 2. Capillaries rejoin 4. Thoroughfare channel a. Veins a. Connects arteriole with venule b. Little muscle ii. Sequence of blood movement through capillary bed 1. True capillaries D.
Sources of resistance i. generally encountered in the systemic circuitperipheral resistance (PR) a. Little muscle in media i. Physiology of Circulation A. Relationship between flow. Low blood pressure allows walls to thin 2. Prevent backflow b. Blood pressure-force per unit area (mm Hg) 3. Large lumens b. Folds of interna IV. Total blood vessels length-longer the vessels. Resistance-opposition to flow. the greater the resistance iii. Terms 1. Capacitance vessels 1. the larger the diameter. diameter is the greatest source of resistance B. Veins act as reservoirs a. Venous valves a. pressure and resistance . Blood viscosity-thickness related to formed elements ii. Externa is thickest wall layer B. the less resistance (1/r4) b. Blood flow-volume flowing through a given structure per unit time (ml/min) 2. Mostly elastin d.c. In healthy humans. Blood vessel diameter-flow is inversely related to diameter.
Highest in aorta ii. Background 1. Systemic Blood Pressure A.Blood Flow (F) = ∆P/PR (Difference in blood pressure between two points/peripheral resistance V. From higher to lower pressure i. Pressure results when flow opposed by resistance 3. Lowest in right atrium B. Heart pumping generates blood flow 2. Blood flows along a pressure gradient a. Arterial blood pressure .
Volume of blood forced into the arteries near heart 2. Aorta is stretched by blood leaving left ventricle i. Distensibility b. Systolic pressure: 120 mm Hg 3. Blood moves toward periphery because peripheral pressure is lower than aortic pressure i. Compliance ii. Changes associated with diastole . Kinetic energy b. Factors affecting arterial pressure a. Changes associated with systole a. Stretching of arteries near heart i.1.
Venous pressure is too low to promote adequate return b. Capillary blood pressure 1. Respiratory pump i. Characteristics a. 40 mm Hg entering 2.80 mm Hg 4. Blood is forced toward the heart iv. Thoracic veins expand . Semilunar valve closes b. Backflow is prevented by valves iii. Aorta recoils c. Venous return a.a. Difference between systolic and diastolic pressure 5. Pulse pressure a. Relatively steady throughout cardiac cycle b. Functional modification a. Pressure is maintained by reducing volume i. Mean arterial pressure (MAP) a. Abdominal (ventral body cavity) pressure increases squeeze local veins ii. Diastolic pressure + 1/3 pulse pressure C. Chest cavity pressure decreases v. Venous blood pressure 1. Need additional functional modifications 3. 20 mm HG (60 from aorta to arterioles) 2. Gradient from venules to vena cava i. 20 mm Hg exiting D. Diastolic pressure: 70 .
Blood volume B. Blood pressure is directly related to CO. CO = Stroke volume X HR D. Increases stroke volume . Regulation of Blood Pressure A. Reduce effect of vagus nerve i. Increase sympathetic activity a. Factors influences blood pressure 1. Blood moves in direction of heart VI. Peripheral resistance 3. Contraction of skeletal muscle surrounding veins compress vein ii. Blood pressure = Cardiac output X Peripheral resistance 1. Blood enters right atrium b. BV and PR C. Reduce parasympathetic control a. Backflow is prevented by valves iii. Increases contractility of heart i.vi. HR increases 2. Reduces ESV ii. Factors that enhance CO 1. Cardiac output 2. Muscular pump (more important) i. Cardiac output is directly related to blood volume 2.
Increases EDV ii. Alter blood distribution b. Nervous control of peripheral resistance a. Vasomotor center . Increase activity of respiratory and muscular pumps a. Short-term mechanisms 2. Increases heart rate 3.b. Neural control of blood pressure 1. Increases venous return i. Alter blood vessel diameter 3. Releases Epi into blood stream from adrenal medulla i. Increases stroke volume E.
Sympathetic efferents ii. Release NE v. Tonic vasoconstriction 4. Innervate smooth muscle of blood vessels iii. Vasomotor fibers i. Primarily arterioles iv. Baroreceptors . Vasomotor tone i. Vasoconstrictor c.a. Regulation of blood vessel diameter b.
Arteriole dilation reduces peripheral resistance e. When BP rises. Venodilation shifts blood to venous reservoirs i. Pressure sensitive mechanoreceptors ii. Cardiac output declines f. Baroreceptors also send efferent signals to cardiac centers in the medulla . aortic arch and walls of all large vessels c. Inhibits vasomotor center ii. Causes dilation of arteries and veins d. Stretching increases signaling to vasomotor center i.a. Located in carotid sinuses. Detect changes in arterial blood pressure i. receptors are stretched b. Venous return decreases ii.
Primarily involved in control of respiratory rate and depth (see Respiration Lecture) . HR and contractile force decrease g. Chemoreceptors a. Stimulate parasympathetic NS iii. Respond to acute changes in blood pressure i. Inhibit sympathetic NS ii. Located in carotid and aortic arch and carotid sinus c. Aortic reflex maintains supply to systemic circuit 5. Respond to changes in O2 and CO2 concentrations and pH b. Carotid sinus reflex protects blood supply to brain ii.i.
NE and EPI (nicotine is a monoamine agonist) ii. Chemical control of blood pressure 1. Adrenal medulla hormones i. Atrial peptide hormone .F. EPI increase cardiac output by increasing cardiac muscle contractility b. Short-term 2. Blood-borne chemicals a. Levels of O2 and CO2 (see Respiration Lecture) 3. NE is a vasoconstrictor iii. Atrial natriuretic peptide (ANP) i.
causes vasoconstriction d. Angiotensin II also causes release of aldosterone from adrenal cortex vii. When amount of blood entering kidney tubule is too low. Increase capillary permeability g. Reduces blood pressure ii. Posterior pituitary hormone ii. Mediated by release of renin by JGA of kidney tubule ii. Renin catalyzes the conversion of angiotensinogen into angiotensin II iv. Increases blood pressure by increasing water absorption by distal tubule iii. Histamine. Increases water excretion from kidney c. Inflammatory chemicals-vasodilators i. Increases BP vi. renin is released iii. Reduces blood pressure by antagonizing aldosterone iii. Endothelin-vasoconstrictor ii.ii. Nitrous oxide (NO)-fast acting. Angiotensin II i. Inhibits ADH release-increases loss of water in urine . Prostaglandin-derived growth factor (PDGF)-vasoconstrictor iii. Angiotensin II causes vasoconstriction of systemic arterioles v. Endothelium-derived factors i. At high concentrations. local vasodilator f. (see Immune Lecture) ii. Alcohol i. etc. Antidiuretic hormone (ADH) i. Aldosterone increases absorption of water by kidney tubules e.
Increased BP increases amount of filtrate entering tubules ii. Increase in volume increases BP i. Blood pressure change parallels change in blood volume a. Direct action of the kidney a. Kidney responds by absorbing water to increase volume 5. Venous return c. Increases vasodilation (skin) by depressing vasomotor center G. Blood volume affects cardiac output via: a. Decrease in volume decreases BP i.iii. Blood volume decreases and therefore BP b. Stroke volume 4. Indirect renal mechanisms . Alteration to rate of fluid filtration from blood stream to kidney tubules i. Filtrate entering is greater than the amount that can be processed iii. Venous pressure b. Kidney responds by eliminating water to reduce volume b. Renal regulation of blood pressure 1. Kidney controls blood volume by regulating water loss in urine 3. Fluid leaves body in the form of urine iv. EDV d. Long-term mechanisms for blood pressure regulation 2.
Renin-angiotensin mechanism (see above) ii. Pituitary to release ADH iii. Blood flow is distributed to body tissue in an exacting fashion 1. Abdominal organs: 24% . Heart 4% c.i. ADH promotes water reabsorption from by kidney VII. At rest a. Tissue Perfusion A. Aldosterone also causes Post. Kidney: 20% d. Brain: 13% b.
Blood flow through individual organs is intrinsically controlled (i. Capillaries have a total cross-sectional area of 4500 cm2 and a very slow flow (0. During exercise: a. Skin. Flow is fastest through vessels with smallest cross-sectional area i. Aorta has a cross-sectional area (2.e.2. Blood flow velocity 1. Remaining tissues either remain same or decrease B.03 cm/s) C.. autoregulation) . muscles and heart increase b. Inversely proportionate to cross-sectional area of blood vessels to be filled a.5 cm2) and an average velocity of 40-50 cm/s ii.
Capillary Dynamics A. Intrinsic control mechanisms 1. Such blood pressure changes stimulate myogenic responses VIII. Excessive or inadequate blood pressure can damage or cause the death of an organ b. particularly oxygen. Diameter of arterioles feeding a given organ is controlled by that organ D. Myogenic controls a. Metabolic controls-Levels of nutrients.1. act as autoregulation stimuli 2. Gases and nutrients diffuse from capillary to interstitial fluid .
Lower at venous end (17 mm Hg) 3. Forces responsible for the direction and amount of fluid crossing capillary walls 1. Hydrostatic and osmotic pressure a. Force exerted by a fluid against a vessel wall a. Interstitial fluid is withdrawn by lymphatic tissue 4.1. Hpif is assumed to be zero i.Hpif) D. Net osmotic pressure . Net effective hydrostatic pressure is equal to HPc (HPc . Net movement of water from an area of low to high solute concentration a. HPc is opposed by interstitial fluid hydrostatic pressure (Hpif) a. Lipid-soluble diffuse through the plasma membranes of capillary epithelial cells B. Interstitial osmotic pressure (OPif) is much lower i. Greater at arterial end (35 mm Hg) b. Water-soluble solutes pass through clefts and fenestrations 2. Capillary hydrostatic pressure (HPc) forces fluid through capillary wall a.1 to 5 mm Hg c. Capillary colloid osmotic pressure (OPc) iii. Forces oppose C. High concentration of plasma proteins ii. Hydrostatic pressure 1. Hydrostatic pressure is the same as capillary blood pressure 2. 26 mm Hg b. 0. In the capillary bed i. Solute concentration in relatively high in capillary blood i. Osmotic pressure 1.
Function 1. Three in right ii. pulmonary arteries 2. Net filtration pressure (NFP) 1. Bifurcates into rt. Venous end a. NFP = (HPc .OPif) i.i. Two in left 3.OPif) i. arteries subdivide into lobar arteries i.Hpif) . Gas exchange only B.(OPc . In the lungs. Pulmonary trunk a. Arterial end a. Further branching to form pulmonary capillaries .25 = 10 mm Hg 3.25 = -8 mm Hg Circulatory System I. Reflects interaction between hydrostatic and osmotic pressure 2.Hpif) .(OPc . Approximately 25 mm Hg E. and lt. 35 . Lobar arteries branch to form arterioles 4. Pulmonary Circulation A. NFP = (HPc . Sequence 1. 17 . Pulmonary arteries a.
Venules join to form two pulmonary veins per lung 7. Coronary arteries 2. Aorta and Major Arteries of the Systemic Circulation B. Four pulmonary veins drain into left atrium II. common carotid . Overview of Systemic Circulation A. Capillaries drain into venules 6. Brachiocephalic a. R. ventricle) 1.5. Aortic arch (branches in sequence relative to lt.
common iliac III. internal carotid b. common iliac 4. vertebral ii. R. external carotid b. common carotid a. axillary C. Arteries of Head and Neck . axillary 3. subclavian i. R. L. L. Thoracic aorta (above the diaphragm) 1. L. R. external carotid 4. R. R. R. vertebral b. Abdominal aorta (below diaphragm) 1. Visceral branches D. L. Parietal branches 2. internal carotid ii. Parietal branches 2. Visceral branches 3. L. L. subclavian a. R.i.
subclavian artery branches. common carotid artery C. vertebral artery branches off R. Supply occipital and inferior temporal lobes of brain B. posterior cerebral arteries a. vertebral joins with L. Superior thyroid . After R. R. vertebral to form Basilar artery a. Brachiocephalic artery branches off aortic arch 1. Basilar artery is part of Circle of Willis (see below) 4. R. Basilar artery divides to form R. common carotid bifurcates to form R.A. subclavian artery 3. R. and L. external carotid branches as it runs superiorly 1. R. external and internal carotid arteries D. R. Brachiocephalic artery is the R. subclavian artery branches off brachiocephalic artery 2.
Supplies upper and lower jaw b. external carotid splits a. Supplies medial surface of brain b. R. Supplies eyes. Maxillary i. Supplies posterior scalp 5. Supplies thyroid and larynx 2. Occipital a. Supplies skin and muscles of anterior face 4. Circle of Willis .a. Supplies lateral parts of temporal and parietal lobes F. Superficial temporal a. Lingual a. middle cerebral artery i. internal carotid divides to form a. Facial a. forehead and nose 3. R. orbits. Internal carotid 1. anterior cerebral artery i. Supplies tongue 3. R. R. Supplies most of scalp E. Enters the skull and services the brain 2. Opthalmic branches off a. R.
posterior communicating arteries connect posterior cerebral arteries with R. Arteries of Upper Limb and Thorax . and L. anterior cerebral arteries 2. Anterior communicating artery connects R. and L. and L. anterior cerebral arteriors IV.1. R.
Subscapular a. Lateral thoracic a. After giving rise to the R. vertebral artery. R. R. Axillary artery gives off a number of branches 1. Supplies scapula. Anterior and posterior circumflex arteries . Name changes to axillary artery C.A. Thoracoacromial a. subclavian courses laterally and gives off branches to neck (do not need to know these vessels) B. Supplies lateral chest wall and breast 3. subclavian artery passes under clavicle 1. Supplies superior shoulder and pectoral region 2. latissimus dorsi and thorax wall 4.
name changes to brachial artery E. Brachial artery supplies anterior flexor muscles of arm F. Supplies lateral muscles of forearm 2. Deep brachial artery a. Brachial artery splits to form two arteries 1. Supplies triceps brachii (posterior arm) 2. The thoracic aorta gives rise to the next nine pairs a. Radial artery a. As axillary artery enters arm. Brachial artery gives off a branch 1. Arteries of the thorax wall 1. Supplies posterior intercostals spaces and deep muscles of back. Supply deltoid and shoulder joint D. As the internal thoracic artery descends it gives off anterior intercostals arterires i. Supplies anterior intercostals spaces 2. Arteries of the Abdomen . Supplies medial muscles of forearm (Do not need to know arteries of wrist and hand) G. vertebral columns and spinal cord V.a. Ulnar artery a. Costocervical trunk gives rise to the first two posterior intercostals arteries 3. Internal thoracic artery branches off the subclavian artery a.
Abdominal artery lies below the level of the diaphragm B. After giving off gastroduodenal artery. Abdominal aorta descends and gives off the celiac trunk D. As abdominal aorta descends it gives the inferior phrenic arteries 1. Supply the diaphragm C. Gives off branches to stomach. common hepatic becomes hepatic artery i. small intestine and pancreas b. Common hepatic a.A. Supplies stomach c. Hepatic splits into right and left branches . Celiac trunk divides into three branches 1. Right gastroepiploic branches off gastroduodenal artery ii.
Superior mesenteric gives off branches that supply mesenteric organs a. gastric artery a. Abdominal aorta descends and gives off the gonadal arteries (Testicular or ovarian) I. Ileocolic i. Left gastroepiploic branches of splenic artery i. Supply adrenal glands F. Abdominal aorta descends and gives off the inferior mesenteric artery 1. Splenic a. Abdominal aorta descends and gives off the paired renal arteries 1. Supply kidneys on each side of the body H. and middle colic i. Abdominal aorta descends and gives off the suprarenal arteries 1. Supply large intestine b. Supplies stomach 3. L. Intestinal i. Supply appendix. colic . L. Splenic terminates in the spleen c. Supplies stomach and inferior esophagus E. Abdominal aorta descends and gives off the superior mesenteric artery 1. R. Inferior mesenteric gives off branches that supply distal part of the colon a. Sends branches to stomach and pancreas b. colon c.i. Supply transverse colon G. Supplies liver 2.
Aorta terminates giving rise to three arteries 1. common iliacs VI. Abdominal aorta descends and gives off the lumbar arteries 1. Sigmoidal arteries c. and L. R. Common iliac divides into two branches 1. Superior rectal arteries J.b. Arteries of Pelvis and Leg A. Median sacral 2. Internal iliac . Supply posterior abdominal wall K.
rectum. Femoral artery becomes the popliteal artery 1. Divides to serve muscles of gluteal muscles and external genitalia 2. Major Veins of the Systemic Circulation . Supplies knee region F. Bladder. Serves posterior thigh b. Deep femoral artery a. uterus and vagina (prostate and ductus deferns) b. Supplies extensor muscles (Do not need to know arteries of ankle or foot) VII. As external iliac enters thigh it becomes the femoral artery C. Deep femoral artery gives off branches that supply head and neck of femur i. Supplies lateral muscles of the leg 2. Femoral artery descends and passes through adductor hiatus and enters popliteal fossa E. External iliac B. Supply pelvis and visceral organs i. Posterior tibial artery a. Lateral and medial circumflex arteries D.a. Femoral artery gives off branches as it descends down the thigh 1. Popliteal artery divides 1. Gives off peroneal artery i. Anterior tibial artery a.
Inferior vena cava runs from junction of common iliac veins to R. Hepatic veins (R. and R. R. Veins that drain into inferior vena cava 1. Veins that drain into R. R. brachiocephalic vein 1. and L. Superior vena cava runs from union of brachiocephalic veins (L. atrium B.) to R. external jugular vein empties into R.A.) 2. R. R. vertebral vein 3. subclavian vein a. suprarenal vein . subclavian vein *Left side corresponds to right side C. internal jugular vein 2. R. atrium D.
R. Lumbar veins VIII. and L.) 4. gonadal vein 5.3. Transverse . Cavernous d. Superior sagittal b. Most veins drain into dural (meningial) sinuses a. Veins of Head and Neck A. Renal veins (R. Straight c. Drainage of blood from brain 1.
Veins of Upper Limbs and Thorax . Most blood from the brain drains into internal jugular veins B. Superficial temporal IX. Deep veins of the face drain into inferior jugular veins 1.2. Facial 2.
Posterior intercostal veins drain into azygous 2. axillary vein becomes subclavian vein C. Azygous veins that drain into azygous vein a. Distal veins of the arm drain into ulnar and radial veins 2. Ulnar and radial veins unite to form brachial vein 3. Azygous system drains thoracic tissues 1. Superficial drainage of upper limb .A. As brachial vein enters shoulder. At level of first rib. Accessory hemiazygous vein B. Azygous vein drains into superior vena cava a. Hemiazygous b. it becomes axillary vein 4. Deep drainage of upper limb 1.
Hepatic portal system 1. Median cubital vein connects basilic and cephalic veins a. Cystic veins drain gall bladder and join the hepatic veins . Veins of Abdomen A. Connects either to basilic or cephalic veins 2.1. Basilic vein joins with brachial vein 4. Commonly used to obtain blood samples X. Multiple hepatic veins carry blood from liver to inferior vena cava 2. Cephalic vein joins with axillary vein 3. Median vein of the forearm lies between ulna and radius a.
: ovariaries or testes on right side of body i. Renal veins a. renal vein 3.B. Drains spleen. L: left adrenal gland i. Drains large intestine and rectum i. Drains into L. Lumbar veins a. Other veins draining into inferior vena cava 1. ascending lumbar veins 2. Hepatic portal vein carries blood to liver i. Visceral veins draining into hepatic portal vein 1. Hepatic portal vein receives drainage from digestive viscera a. R. parts of the stomach. Joins splenic 3. Drains directly into vena cava b. and L. Joins superior mesenteric D. Drains directly into vena cava b. R. Splenic a. R: right adrenal gland i. Inferior mesenteric a. Gonadal veins a. L. Drain kidneys . Drains into left renal vein 4. and pancreas i. Nutrients are removed C.: ovariaries or testes on left side of body i. Superior mesenteric 2. Suprarenal a.
Above the knee the popliteal becomes the femoral vein C. Veins of Pelvis and Lower Limbs A.E. As the femoral vein enters the pelvis it becomes the external iliac D. Common iliacs join to form inferior vena cava XI. External iliac joins with internal iliac to form common iliac E. Drains medial aspects of the leg . Saphenous veins a. Great i. Anterior and posterior tibial veins joins to form popliteal B.
Longest vein in the body iii. Empties into popliteal vein .ii. Drains deep fascia of calf ii. Small i. Empties into femoral vein b.