BLOOD VESSELS & CIRCULATION o Usually thinner and contain less

INSTRUCTOR: LAWRENCE TIMBREZA elastic tissue and fewer smooth

muscle cells
BLOOD VESSELS o Increase in diameter as they progress
Blood vessels contribute to homeostasis by toward the heart and their walls
providing the structures for the flow of blood to and increase in thickness
from the heart and the exchange of nutrients and o Can be classified:
wastes in tissues. They also play an important role in ▪ Venules
adjusting the velocity and volume of blood flow. ▪ Small veins
Blood vessels outside the heart are divided ▪ Medium sized veins
into two classes: ▪ Large veins
1. the pulmonary vessels, which transport blood • In summary, blood flows from the arteries into
from the right ventricle of the heart through the arterioles, arterioles into capillaries,
the lungs and back to the left atrium capillaries into venules, venules to small veins,
2. the systemic vessels, which transport blood veins return to heart.
from the left ventricle of the heart through all
parts of the body and back to the right BLOOD VESSEL WALLS
atrium. • Blood vessel walls consist of three layers,
Together, the pulmonary vessels and the excluding the capillaries and the venules.
systemic vessels constitute the circulatory system. • From inner to the outer wall, modifications of
this basic design account for the five types of
BLOOD VESSEL FUNCTIONS blood vessels and the structural and
1. Carry blood functional differences among the various
2. Exchange nutrients, waste products, gases vessel types.
within tissues • Always remember that structural variation
3. Transport substances correlate to the differences in function that
4. Regulate blood pressure occur throughout the cardiovascular system.
5. Direct blood flow to tissues o Tunica intima
The cardiovascular system contributes to ▪ Lines the lumen or interior of
homeostasis of other body systems by transporting the vessel is a thin layer of
and distributing blood throughout the body to endothelium (simple
deliver materials (such as oxygen, nutrients, and squamous epithelial cell)
hormones) and carry away wastes. The structures resting on a basement
involved in these important tasks are the blood membrane which provides
vessels, which form a closed system of tubes that resilience to the vessels
carries blood away from the heart, transports it to the ▪ Endothelial cells – little more
tissues of the body, and then returns it to the heart. than a passive barrier
The left side of the heart pumps blood through an between the blood and the
estimated 100,000 km (60,000 mi) of blood vessels. remainder of vessel wall. It is
The right side of the heart pumps blood through the now known that they are
lungs, enabling blood to pick up oxygen and unload active participants in a variety
carbon dioxide. of vessel related activities
including:
VESSEL STRUCTURE • Physically influencing
• Arteries blood flow
o Carry blood away from the heart to • Secreting locally
other organs active chemical
o Large elastic arteries leave the heart mediators that
and divide into medium-sized influence the
muscular arteries that branch out into contractile state of
the various regions of the body the vessel’s overlying
o Normally classified into one of three smooth muscle
categories: • Assisting with capillary
▪ Elastic permeability
▪ Muscular ▪ Its cells fit closely together and
▪ Arterioles form a slick surface that
o Various arteries form a continuum decreases friction as blood
from the largest elastic arteries to the flows through the vessel
smallest arterioles. lumen.
o Blood flows from arterioles into o Tunica media
capillaries ▪ Bulky middle layer
• Capillaries ▪ Composed of smooth muscle
o The thin walls allow the exchange of and variable amounts of
substances between the blood and elastic and collagen fibers,
body tissues depending on the size and
o Blood flows more slowly in this type of vessels
structure and there are far more of ▪ Some of the larger arteries
them than any other blood vessel have elastic laminae, which
type are sheets of elastic tissue.
o Blood flows into the veins ▪ In addition to the scattered to
• Veins the scattered elastic fiber, the
o Blood vessels that convey blood from smooth muscle, which is
the tissues back to the heart, which controlled by the sympathetic
are usually deoxygenated nervous system, is active in
changing the diameter of the

BLOOD VESSELS & CIRCULATION | HONGCHANHAOSRC17

 vessels and composed of
outer layer of elastic
connective tissue.
o Tunica adventitia
▪ Outermost layer
▪ Composed largely of dense
fibrous connective tissue and
its function is to support and
protect the vessels
▪ The tissue becomes loose
connective toward the outer
portion of the blood vessel
wall.
TYPES OF ARTERIES
• Elastic Arteries
Elastic arteries also are called
conducting arteries. They have the largest
diameter among arteries, but their vessel
walls (approximately one-tenth of the
vessel’s total diameter) are relatively thin
compared with the overall size of the vessel.
These vessels are characterized by well-
defined internal and external elastic
laminae, along with a thick tunica media
that is dominated by elastic fibers, called the
elastic lamellae Elastic arteries include the
two major trunks that exit the heart (the aorta
and the pulmonary trunk), along with the
aorta’s major initial branches, such as the
brachiocephalic, subclavian, common
carotid, and common iliac arteries. As blood
is ejected from the heart into elastic arteries,
their walls stretch, easily accommodating the
surge of blood. As they stretch, the elastic
fibers momentarily store mechanical energy,
functioning as a pressure reservoir.
• Muscular Arteries
Medium-sized arteries are called
muscular arteries because their tunica media
contains more smooth muscle and fewer
elastic fibers than elastic arteries. The large
amount of smooth muscle, approximately
threequarters of the total mass, makes the
walls of muscular arteries relatively thick. Thus,
muscular arteries are capable of greater
vasoconstriction and vasodilation to adjust
the rate of blood flow. Medium-sized arteries
supply blood to small arteries. Small arteries
have about the same structure as the
medium-sized arteries, except for a smaller
diameter and thinner walls. The smallest of
the small arteries have only three or four
layers of smooth muscle in their walls
• Arterioles
Arterioles are abundant microscopic
vessels that regulate the flow of blood into
the capillary networks of the body’s tissues.
Arterioles have a thin tunica interna with a
thin, fenestrated (with small pores) internal
elastic lamina that disappears at the terminal
end. The tunica media consists of one to two
layers of smooth muscle cells having a
circular orientation in the vessel wall. They
are also adapted for vasodilation and
vasoconstriction.
CAPILLARIES
Blood flows from arterioles into capillaries.
Capillaries branch to form networks. Blood flow
through capillary networks is regulated by smooth
muscle cells called precapillary sphincters. These
precapillary sphincters are located at the origin of
the branches of the capillaries and, by contracting
and relaxing, regulate the amount of blood flow
through the various sections of the network. They
have diameters of 5– 10 μm and form the U-turns that
connect the arterial outflow to the venous return.
Since red blood cells have a diameter of 8 μm, they
must often fold on themselves in order to pass single
file through the lumens of these vessels. Networks of
capillaries are more numerous and more extensive in
the lungs and in highly metabolic organs such as the
liver, kidneys, skeletal muscles, and cardiac muscles.
TYPES OF VEINS
Blood flows from capillaries into venules and from
venules into small veins.
• Venules
o Venules have a diameter slightly
larger than that of capillaries and are
composed of endothelium resting on
a delicate connective tissue layer.
The structure of venules, except for
their diameter, is very similar to that of
capillaries.
• Medium sized veins
o Medium-sized veins collect blood
from small veins and deliver it to large
veins. The three thin but distinctive
tunics make up the wall of the
medium-sized and large veins. The
tunica media contains some circular
smooth muscle and sparsely
scattered elastic fibers. The
predominant layer in veins is the outer
tunica adventitia, which consists
primarily of dense collagen fibers.
• Veins
o Veins lack the internal or external
elastic laminae found in arteries. They
are distensible enough to adapt to
variations in the volume and pressure
of blood passing through them but
are not designed to withstand high
pressure. The lumen of a vein is larger
than that of a comparable artery,
and veins often appear collapsed
(flattened) when sectioned.
o Many veins, especially those in the
limbs, also contain valves, thin folds of
tunica interna that form flaplike
cusps. The valve cusps project into
the lumen, pointing toward the heart.
The low blood pressure in veins allows
blood returning to the heart to slow
and even back up; the valves aid in
venous return by preventing the
backflow of blood.
Varicose veins. Varicose veins are common in
people who stand for long periods of time (for
example, cashiers and hairdressers) and in obese
(or pregnant) individuals. The common factors are
the pooling of blood in the feet and legs and
inefficient venous return resulting from inactivity or
pressure on the veins. In any case, the overworked
valves give way, and the veins become twisted
and dilated. A serious complication of varicose
veins is thrombophlebitis, inflammation of a vein
that results when a clot forms in a vessel with poor
circulation. Because all venous blood must pass
through the pulmonary circulation before
traveling through the body tissues again, a
common consequence of thrombophlebitis is clot
detachment and pulmonary embolism, which is a
life-threatening condition in which the embolism
lodges in a vessel in the lung. Gangrene may also
result wherein lack of blood flow leads to death
and infection of anaerobic bacteria.
BLOOD VESSELS & CIRCULATION | HONGCHANHAOSRC17
PULMONARY CIRCULATION VESSELS
The pulmonary circulation is the system of
blood vessels that carries blood from the right
ventricle of the heart to the lungs and back to the
left atrium of the heart. It is composed of two major
blood vessels: pulmonary trunk and pulmonary veins.
The pulmonary trunk carries blood from the right
ventricle towards the lungs while the pulmonary
veins exit the lungs and carry oxygen-rich blood to
the left atrium.
SYSTEMIC CIRCULATION VESSELS
The systemic circulation is the system of blood
vessels that carries blood from the left ventricle of the
heart to the tissues of the body and back to the right
atrium. Oxygenated blood from the pulmonary veins
passes from the left atrium into the left ventricle and
from the left ventricle into the aorta. Arteries
distribute blood from the aorta to all portions of the
body.
PARTS OF THE AORTA
1. Ascending Aorta
- Passes superiorly from left ventricle
2. Aortic Arch
- Contains three major arteries which
carry blood from aorta towards the
head and upper limbs
3. Descending Aorta
- Extends through the thorax and
abdomen to pelvis
4. Thoracic Aorta
- Part of the descending aorta that
extends through thorax to diaphragm
5. Abdominal Aorta
- Descending aorta that extends from
the diaphragm where it divides at the
common iliac arteries
ARTERIES OF THE HEAD AND NECK
1. Branches of aortic arch
- The first vessel to branch from the aortic
arch is the brachiocephalic artery. This
artery extends a short distance and
then branches at the level of the
clavicle to form the right common
carotid artery, which transports blood
to the right side of the head and neck,
and the right subclavian artery, which
transports blood to the right upper limb.
- There is no brachiocephalic artery on
the left side of the body. Instead, both
the left common carotid and the left
subclavian arteries branch directly off
the aortic arch. They are the second
and third branches of the aortic arch.
The left common carotid artery
transports blood to the left side of the
head and neck, and the left subclavian
artery transports blood to the left upper
limb.
2. Cerebral Arterial Circle
- The common carotid arteries extend
superiorly along each side of the neck
to the angle of the mandible, where
they branch into internal and external
carotid arteries. The base of each
internal carotid artery is slightly dilated
to form a carotid sinus, which contains
structures important in monitoring
blood pressure (baroreceptors). The
external carotid arteries have several
branches that supply the structures of
the neck, face, nose, and mouth. The
internal carotid arteries pass through
the carotid canals and contribute to
the cerebral arterial circle (circle of
Willis) at the base of the brain. The
vessels that supply blood to most of the
brain branch from the cerebral arterial
circle.
3. Vertebral Artery
- The vertebral arteries supply blood to
the spinal cord as well as the vertebrae,
muscles, and ligaments in the neck.
4. Basilar Artery
- The basilar artery supplies blood to the
pons, cerebellum, and the midbrain. Its
right and left branches contribute to
the cerebral arterial circle.
ARTERIES OF THE UPPER LIMB
1. Axillary Arteries
2. Brachial Arteries
3. Ulnar Arteries
4. Radial Arteries
The subclavian artery, located deep to the
clavicle, becomes the axillary artery in the axilla
(armpit). When the axillary artery extends into the
arm, it is then referred to as the brachial artery. Blood
pressure measurements are normally taken from the
brachial artery. The brachial artery branches at the
elbow to form the ulnar artery and the radial artery,
which supply blood to the forearm and hand. The
radial artery is the one most commonly used for
taking a pulse. The pulse can be detected easily on
the thumb (radial) side of the anterior surface of the
wrist.
THORACIC AORTA AND ITS BRANCHES
1. Visceral arteries
2. Parietal arteries
a. Posterior intercostal artery
b. Superior phrenic artery
3. Internal thoracic artery
4. Anterior intercostal artery
The branches of the thoracic aorta can be
divided into two groups: The visceral arteries supply
the thoracic organs, and the visceral branches of
the thoracic aorta supply the esophagus, the
trachea, the parietal pericardium, and part of the
lung. The parietal arteries supply the thoracic wall.
The major parietal arteries are the posterior
intercostal arteries, which arise from the thoracic
aorta and extend between the ribs. They supply the
intercostal muscles, the vertebrae, the spinal cord,
and the deep muscles of the back. The superior
phrenic arteries supply the diaphragm.
The internal thoracic arteries are branches of
the subclavian arteries. They descend along the
internal surface of the anterior thoracic wall and give
rise to branches called the anterior intercostal
arteries, which extend between the ribs to supply the
anterior chest wall.
ABDOMINAL AORTA BRANCHES
1. Celiac trunk arteries
2. Superior mesenteric arteries
3. Inferior mesenteric arteries
4. Renal arteries
5. Hepatic arteries
6. Testicular arteries
7. Ovarian arteries
8. Inferior phrenic arteries
9. Lumbar arteries
The branches of the abdominal aorta, like
those of the thoracic aorta, can be divided into
visceral and parietal groups. The visceral arteries are
divided into paired and unpaired branches. There
are three major unpaired branches: (1) the celiac
BLOOD VESSELS & CIRCULATION | HONGCHANHAOSRC17
trunk, (2) the superior mesenteric artery, and (3) the
inferior mesenteric artery. The celiac trunk supplies
blood to the stomach, pancreas, spleen, upper
duodenum, and liver. The superior mesenteric artery
supplies blood to the small intestine and the upper
portion of the large intestine, and the inferior
mesenteric artery supplies blood to the remainder of
the large intestine.
There are three paired visceral branches of
the abdominal aorta. The renal arteries supply the
kidneys, and the suprarenal arteries supply the
adrenal glands. The testicular arteries supply the
testes in males; the ovarian arteries supply the
ovaries in females.
The parietal branches of the abdominal
aorta supply the diaphragm and abdominal wall.
The inferior phrenic arteries supply the diaphragm;
the lumbar arteries supply the lumbar vertebrae and
back muscles; and the median sacral artery supplies
the inferior vertebrae.
ARTERIES OF THE PELVIS
1. Common Iliac Artery
2. External Iliac Artery
3. Internal Iliac Artery
The abdominal aorta divides at the level of
the fifth lumbar vertebra into two common iliac
arteries. Each common iliac artery extends a short
distance and then divides to form an external iliac
artery, which enters a lower limb, and an internal
iliac artery, which supplies the pelvic area.
ARTERIES OF THE LOWER LIMB
1. Femoral Arteries
2. Popliteal Arteries
3. Anterior and posterior arteries
4. Fibular Arteries
Like the arteries of the upper limbs, the
arteries of the lower limbs are named differently as
they pass into different body regions, even though
there are no major branches. The external iliac artery
in the pelvis becomes the femoral artery in the thigh.
The femoral artery extends down the thigh and
becomes the popliteal artery in the popliteal space,
which is the posterior region of the knee. The
popliteal artery branches slightly inferior to the knee
to give off the anterior tibial artery and the posterior
tibial artery, both of which give rise to arteries that
supply blood to the leg and foot. The anterior tibial
artery becomes the dorsalis pedis artery at the ankle.
The posterior tibial artery gives rise to the fibular
artery, or peroneal artery, which supplies the lateral
leg and foot.
VEINS
1. Superior Vena Cava
2. Inferior Vena Cava
Veins return blood into the heart. In the
systemic circulation, the blood returning to the heart
is deoxygenated. In the pulmonary circulation, the
blood returning to the heart in the pulmonary veins is
oxygenated. The superior vena cava returns blood
from the head, neck, thorax, and upper limbs and
empties to the right atrium of the heart, and the
inferior vena cava returns blood from the abdomen,
pelvis, and lower limbs and empties to the right
atrium.
VEINS OF THE HEAD AND NECK
1. External jugular vein
2. Internal jugular vein
3. Subclavian veins
4. Brachiocephalic veins
The two pairs of major veins that collect
blood from the head and neck are the external and
internal jugular veins. The external jugular veins are
the more superficial of the two sets. They carry blood
from the posterior head and neck, emptying
primarily into the subclavian veins. The internal
jugular veins are much larger and deeper. They
carry blood from the brain and the anterior head,
face, and neck. The internal jugular veins join the
subclavian veins on each side of the body to form
the brachiocephalic veins. The brachiocephalic
veins join to form the superior vena cava.
VEINS OF THE UPPER LIMBS
1. Brachial veins
2. Cephalic veins
3. Median cubital veins
The veins of the upper limbs can be divided
into deep and superficial groups. The deep veins,
which carry blood from the deep structures of the
upper limbs, follow the same course as the arteries
and are named for their respective arteries. The only
noteworthy deep veins are the brachial veins, which
accompany the brachial artery and empty into the
axillary vein. The superficial veins carry blood from
the superficial structures of the upper limbs and then
empty into the deep veins. The cephalic vein, which
empties into the axillary vein, and the basilic vein,
which becomes the axillary vein, are the major
superficial veins. Many of their tributaries in the
forearm and hand can be seen through the skin. The
median cubital vein usually connects the cephalic
vein or its tributaries with the basilic vein. Although
this vein varies in size among people, it is usually quite
prominent on the anterior surface of the upper limb
at the level of the elbow, an area called the cubital
fossa, and is often used as a site for drawing blood.
VEINS OF THE THORAX
1. Right and left brachiocephalic veins
2. Azygos veins
3. Internal thoracic veins
4. Posterior intercostal veins
5. Hemiazygos vein
Three major veins return blood from the
thorax to the superior vena cava: the right and left
brachiocephalic veins and the azygos vein. Blood
returns from the anterior thoracic wall by way of the
anterior intercostal veins. The right and left
brachiocephalic veins, and azygos vein drain blood
from the thorax into superior vena cava. These veins
empty into the internal thoracic veins, which empty
into the brachiocephalic veins. Blood from the
posterior thoracic wall is collected by posterior
intercostal veins that empty into the azygos vein on
the right and the hemiazygos vein or the accessory
hemiazygos vein on the left. The hemiazygos and
accessory hemiazygos veins empty into the azygos
vein, which empties into the superior vena cava.
VEINS OF THE ABDOMEN AND PELVIS
1. Common iliac vein
2. External iliac vein
3. Internal iliac vein
4. Renal vein
5. Suprarenal vein
6. Testicular vein
7. Ovarian vein
Common iliac vein is formed by the external
and internal iliac veins, and it empties into the inferior
vena cava. External iliac vein drains blood from
lower limbs and empty into the common iliac vein.
Internal iliac vein drains blood from the pelvic region
and it empties into the common iliac vein. The renal
vein drains blood from kidneys, suprarenal vein
drains the adrenal gland, testicular veins drain the
BLOOD VESSELS & CIRCULATION | HONGCHANHAOSRC17
testes in males, and ovarian veins drain the ovaries in
females.
HEPATIC PORTAL VEIN
1. Splenic vein
2. Superior mesenteric vein
3. Inferior mesenteric vein
4. Hepatic vein
The liver is a major processing center for
substances absorbed by the intestinal tract. The
hepatic portal system is a vascular system that
begins with capillaries in the viscera and ends with
capillaries in the liver. The major vessels of the
hepatic portal system are the splenic vein and the
superior mesenteric vein. The inferior mesenteric
vein empties into the splenic vein. The splenic vein
carries blood from spleen and pancreas. The
superior and inferior mesenteric veins carry blood
from the intestines. The splenic vein and the superior
mesenteric vein join to form the hepatic portal vein,
which enters the liver.
VEINS OF THE LOWER LIMBS
1. Femoral veins
2. Great saphenous veins
3. Popliteal veins
The veins of the lower limbs, like those of the
upper limbs, consist of deep and superficial groups.
The femoral vein empties into the external iliac vein.
The great saphenous vein originates over the dorsal
and medial side of the foot and ascends along the
medial side of the leg and thigh to empty into the
femoral vein. It is a superficial vein. The popliteal
veins drain blood from knee and empty into the
femoral vein.
BLOOD PRESSURE
The function of the circulatory system is to
maintain adequate blood flow to all body organs.
Adequate blood flow is required to provide nutrients
and oxygen to the organs and to remove the waste
products of metabolism from the organs. Blood flows
through the arterial system, primarily as a result of the
pressure produced by the contractions of the heart
ventricles.
Blood pressure is the pressure the blood exerts
against the inner walls of the blood vessels, and it is
the force that keeps the blood circulating
continuously even between heart beats. In arteries,
blood pressure values go through a cycle that
depends on the rhythmic contractions of the heart.
When the ventricles contract, blood is forced into
the arteries, and the pressure reaches a maximum
value called the systolic pressure. When the
ventricles relax, blood pressure in the arteries falls to
a minimum value called the diastolic pressure. The
standard unit for measuring blood pressure is
millimeters of mercury (mm Hg).
PULSE PRESSURE
The difference between the systolic and
diastolic pressures is called the pulse pressure. For
example, if a person has a systolic pressure of 120
mm Hg and a diastolic pressure of 80 mm Hg, the
pulse pressure is 40 mm Hg. Two factors affect pulse
pressure: stroke volume and vascular compliance.
When the stroke volume increases, the systolic
pressure increases more than the diastolic pressure.
This leads to an increase in the pulse pressure. During
periods of exercise, the stroke volume and pulse
pressure increase substantially. Vascular compliance
is related to the elasticity of the blood vessel wall. In
people who have arteriosclerosis, the arteries are less
elastic than normal. Arterial pressure increases
rapidly and falls rapidly in these less elastic arteries.
Therefore, the pulse pressure is greater than
normal, even though the same amount of blood is
ejected into the aorta as in a normal person.
Arteriosclerosis increases the amount of work the
heart performs because the left ventricle must
produce a greater pressure to eject the same
amount of blood into a less elastic artery. In severe
cases, the heart’s increased workload leads to heart
failure.
The alternating expansion and recoil of an
artery that occurs with each heartbeat of the left
ventricle creates a pressure wave or pulse that
travels through the entire arterials system. Normally,
the pulse rate equates to heart rate. The pulse
averages from 70-76 beats per minute in a healthy
resting person which are influenced by activity,
postural modifications, and emotions.
Health professionals should know the major
locations of pulse detection because monitoring the
pulse can yield important information about the
heart rate, the heart rhythm, and other
characteristics. For example, a weak pulse usually
indicates a decreased stroke volume or increased
constriction of the arteries.
BLOOD PRESSURE GRADIENT
• Blood is forced along a descending pressure
gradient.
• Pressure in blood vessels decreases as
distance from the heart increases.
• Pressure is high in the arteries, lower in the
capillaries, and lowest in the veins.
When the ventricles contract, they force
blood into large, thick-walled elastic arteries close to
the heart that expand as the blood is pushed into
them.
The high pressure in these elastic arteries
forces the blood to continuously move into areas
where the pressure is lower. The pressure is highest in
the large arteries closest to the heart and continues
to drop throughout the systemic pathway, reaching
zero at the right atrium. Recall that the blood flows
into the smaller arteries, then arterioles, capillaries,
venules, veins, and finally back to the large vena
cava entering the right atrium of the heart. It flows
continuously along a pressure gradient (from high to
low pressure) as it makes its circuit, day in and day
out. The valves in the large veins, the milking activity
of the skeletal muscles, and pressure changes in the
thorax are so important because together they
ensure blood flows back to the heart to be pumped
out to the body again. The pressure differences
between arteries and veins become very clear when
these vessels are cut. If a vein is cut, the blood flows
evenly from the wound; a lacerated artery produces
rapid spurts of blood. A similar pressure drop occurs
as blood flows through the pulmonary pathway.
Resistance to blood flow is related to
diameter of the blood vessel. The smaller the
diameter of the blood vessel, the greater the
resistance to flow. As a consequence, there is also a
more rapid decrease in pressure as blood flows
through smaller vessels. This is evident in the arterioles
and capillaries because their small diameters
increase resistance to blood flow.
The low blood pressure in veins is actually due
to their large diameters which decreases the blood
resistance. Though blood pressure is low, other
structures participate to ensure that the blood within
veins would still flow. It is ensured by the valves that
prevent backflow, as well as the skeletal muscle
movements that periodically compress veins forcing
blood to flow toward the heart.
CAPILLARY EXCHANGE
BLOOD VESSELS & CIRCULATION | HONGCHANHAOSRC17
 The major forces responsible for moving fluid
through the capillary wall are blood pressure and
osmosis. Blood pressure forces fluid out of the
capillary, and osmosis moves fluid into the capillary.
Fluid moves by osmosis from the interstitial space into
the capillary because blood has a greater osmotic
pressure than does interstitial fluid. Recall that water
moves to areas of higher concentration of dissolved
molecules, and the greater the concentration of
dissolved molecules in a fluid, the greater the
osmotic pressure of the fluid. Blood has a greater
osmotic pressure because of the large
concentration of plasma proteins that are unable to
cross the capillary wall. The concentration of proteins
in the interstitial space is much lower than that in the
blood.
Approximately nine-tenths of the fluid that
leaves the capillary at the arterial end reenters the
capillary at its venous end. The remaining one-tenth
of the fluid enters lymphatic capillaries and is
eventually returned to the general circulation. The
capillary wall acts as a selectively permeable
membrane, which prevents proteins from moving
from the capillary into the interstitial space but allows
fluid to move across the capillary wall.
LOCAL CONTROL OF BLOOD FLOW
Blood flow provided to the tissues by the
circulatory system is highly controlled and matched
closely to the metabolic needs of tissues.
Mechanisms that control blood flow through tissues
are classified as (1) local control or (2) nervous and
hormonal control.
Local control of blood flow is achieved by
the periodic relaxation and contraction of the
precapillary sphincters. When the sphincters relax,
blood flow through the capillaries increases. When
the sphincters contract, blood flow through the
capillaries decreases. The precapillary sphincters are
controlled by the metabolic needs of the tissues. The
concentration of the nutrients also controls the blood
flow. Blood flow increases when oxygen level
decrease.
NERVOUS CONTROL OF BLOOD FLOW
Nervous control of blood flow is carried out
primarily through the sympathetic division of the
autonomic nervous system. Sympathetic nerve fibers
innervate most blood vessels of the body, except the
capillaries and precapillary sphincters, which have
no nerve supply.
An area of the lower pons and upper
medulla oblongata, called the vasomotor center,
continually transmits a low frequency of action
potentials to the sympathetic nerve fibers that
innervate blood vessels of the body. As a
consequence, the peripheral blood vessels are
continually in a partially constricted state, a
condition called vasomotor tone. Changes in
vasomotor tone will alter blood flow as well as blood
pressure. An increase in vasomotor tone causes
blood vessels to constrict further and blood pressure
to increase. A decrease in vasomotor tone causes
blood vessels to dilate and blood pressure to
decrease. Nervous control of blood vessel diameter
is an important way that blood pressure is regulated.
Nervous control of blood vessels also causes
blood to be shunted from one large area of the
body to another. For example, nervous control of
blood vessels during exercise increases vasomotor
tone in the viscera and skin and reduces vasomotor
tone in exercising skeletal muscles. As a result, blood
flow to the viscera and skin decreases, and blood
flow to skeletal muscle increases.
HORMONAL CONTROL OF BLOOD FLOW
The sympathetic division also regulates
hormonal control of blood flow through the release
of epinephrine and norepinephrine from the adrenal
medulla. These hormones are transported in the
blood to all parts of the body. In most blood vessels,
these hormones cause constriction, which reduces
blood flow. But in some tissues, such as skeletal
muscle and cardiac muscle, these hormones cause
the blood vessels to dilate, increasing blood flow.
MEAN ARTERIAL PRESSURE
Adequate blood pressure is required to
maintain blood flow through the blood vessels of the
body, and several regulatory mechanisms ensure
that blood pressure remains adequate for this task.
The mean arterial blood pressure (MAP) is slightly less
than the average of the systolic and diastolic
pressures in the aorta because diastole lasts longer
than systole.
The body’s MAP is equal to the cardiac
output (CO) times the peripheral resistance (PR),
which is the resistance to blood flow in all the blood
vessels:
MAP = CO x PR
The mean arterial pressure changes over our
lifetime. MAP is about 70 mm Hg at birth, is
maintained at about 95 mm Hg from adolescence
to middle age and may reach 110 mm Hg in a
healthy older person.
BARORECEPTOR REFLEX
Baroreceptor reflexes activate responses
that keep the blood pressure within its normal range.
These baroreceptor reflexes regulate blood pressure
on a moment-to-moment basis. When a person rises
rapidly from a sitting or lying position, the
baroreceptor reestablishes a normal blood pressure
within a few seconds. Baroreceptors respond to
stretch in arteries caused by increased pressure. They
are scattered along the walls of most of the large
arteries of the neck and thorax, and many are
located in the carotid sinus at the base of the
internal carotid artery and in the walls of the aortic
arch.
CHEMORECEPTOR REFLEX
Chemoreceptor reflexes respond to changes
in blood concentrations of O2 and CO2, as well as
pH. Carotid bodies are small structures that lie near
the carotid sinuses, and aortic bodies lie near the
aortic arch. They send action potentials along
sensory nerve fibers to the medulla oblongata. There
are also chemoreceptors in the medulla oblongata.
This increased blood pressure causes a
greater rate of blood flow into the lungs which helps
raise blood oxygen and reduce blood carbon
dioxide levels. They only function only emergency
situation and usually do not play a major important
role in regulating the cardiovascular system. They
also respond strongly only when oxygen levels in
blood fall to very low levels or when carbon dioxide
levels become substantially elevated.
ADRENAL MEDULLARY MECHANISM
BLOOD VESSELS & CIRCULATION | HONGCHANHAOSRC17
 The adrenal medullary mechanism results
from stimulation of the adrenal medulla by the
sympathetic nerve fibers. The adrenal medulla
releases epinephrine and smaller amounts
of norepinephrine into the bloodstream. These
neurohormones affect the cardiovascular system in
a fashion similar to direct sympathetic stimulation,
causing increased heart rate, increased stroke
volume, and vasoconstriction in blood vessels to the
skin and viscera. Epinephrine also causes
vasodilation of blood vessels of the heart. The
adrenal medullary mechanism is short-term and
rapid-acting. It responds within seconds to minutes
and is usually active for minutes to hours. Other
hormonal mechanisms are long-term and slow
acting. They respond within minutes to hours and
continue to function for many hours to days.
The walls of all arteries undergo changes as
people age. Some arteries change more rapidly
than others, and some individuals are more
susceptible to change than others. The most
significant effects of aging occur in the large, elastic
arteries, such as the aorta; in large arteries carrying
blood to the brain; and in the coronary arteries.
Changes in arteries that make them less
elastic, referred to as arteriosclerosis, occur in nearly
every individual and become more severe with
advancing age. A type of arteriosclerosis called
atherosclerosis results from the deposition of material
in the walls of arteries that forms plaques. The
material is composed of a fatlike substance
containing cholesterol. The fatty material can
eventually be dominated by the deposition of dense
connective tissue and calcium salts

RENIN-ANGIOTENSIN-ALDOSTERONE MECHANISM
In response to reduced blood pressure, the
kidneys’ release of renin increases the blood pressure
toward its normal value. Renin acts on the blood
protein angiotensinogen to produce angiotensin I.
Another enzyme, called angiotensin-converting
enzyme (ACE), found in large amounts in organs,
such as the lungs, acts on angiotensin I to convert it
to its most active form, angiotensin II. Angiotensin II is
a potent vasoconstrictor.
Angiotensin II also acts on the adrenal cortex
to increase the secretion of aldosterone.
Aldosterone acts on the kidneys, causing them to
conserve Na+ and water. As a result, the volume of
water lost from the blood into the urine is reduced
and blood pressure is maintained.

ATRIAL NATRIURETIC HORMONE

A peptide hormone called atrial natriuretic
hormone is released primarily from specialized cells
of the right atrium in response to elevated blood
pressure. Atrial natriuretic hormone causes the
kidneys to promote the loss of Na+ and water in the
urine, increasing urine volume. Loss of water in the
urine causes blood volume to decrease, thus
decreasing the blood pressure.
The workings of the aldosterone and ANP are
antagonistic with each other.

ANTIDIURETIC HORMONE MECHANISM

When the concentration of solutes in the
plasma increases or when blood pressure decreases
substantially, nerve cells in the hypothalamus
respond by causing the release of antidiuretic
hormone (ADH), also called vasopressin, from the
posterior pituitary gland (figure 13.32). ADH acts on
the kidneys and causes them to absorb more water,
thereby decreasing urine volume. This response helps
maintain blood volume and blood pressure. The
release of large amounts of ADH causes
vasoconstriction of blood vessels, which causes
blood pressure to increase.

Overall, the baroreceptor, chemoreceptor, and

adrenal medullary reflex mechanism are most
important in the short-term regulation of blood
pressure. On the other hand, hormonal
mechanism, such as renin-angiotensin-
aldosterone system, antidiuretic hormone, and
atrial natriuretic hormone are more important in
the long-term regulation of blood pressure.

EFFECTS ON AGING OF BLOOD VESSELS

BLOOD VESSELS & CIRCULATION | HONGCHANHAOSRC17