Chapter 18

Blood Vessels
and Circulation

Inner Surface of an Artery

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 Functions of the Peripheral Circulation

• The heart provides the major force that

causes blood to circulate
• The peripheral circulation
1. Carries blood
2. Exchanges nutrients, waste products, and
gases with tissues
3. Helps regulate blood pressure
4. Directs blood flow to tissues
 General Features of Blood Vessels

• Arteries carry blood away from the heart

toward capillaries, where exchange between
the blood and interstitial fluid occurs
– Blood flows from the heart through elastic arteries,
muscular arteries, and arterioles to the capillaries
• Veins carry blood from the capillaries toward
the heart
– Blood returns to the heart from the capillaries
through venules, small veins, and large veins
Fig. 18.2
 General Features of Blood Vessels

• Blood vessels, except for capillaries, have

three layers
– Inner: tunica intima
• Consists of endothelium (simple squamous epithelium),
basement membrane, and internal elastic lamina
– Middle: tunica media
• Contains circular smooth muscle and elastic and
collagen fibers
– Outer: tunica adventitia
• connective tissue
– The thickness and the composition of the layers
vary with blood vessel type and diameter
Fig. 18.1
 Arteries
• Large elastic arteries
– Thick-walled with large diameters
– Tunica media has many elastic fibers and little smooth
muscle
• Muscular (distributing) arteries
– Thick-walled with small diameters
– Tunica media has abundant smooth muscle and some elastic
fibers
• Arterioles
– Smallest arteries
– Tunica media consists of one or two layers of smooth muscle
cells and a few elastic fibers
Arteries

Fig. 18.2
 Capillaries
• Capillaries consist only of endothelium
• A capillary bed is a network of capillaries
• Thoroughfare channels carry blood from
arterioles to venules
– Blood can pass rapidly through
thoroughfare channels
• Precapillary sphincters regulate the flow
of blood into capillaries
Fig. 18.3
Fig. 18.4
 Veins
• Venules connect to capillaries and are
like capillaries, except they are larger in
diameter
• Large venules and all veins have all
three layers
• Valves prevent the backflow of blood in
the veins
Veins

Fig. 18.2
Fig. 18.2
 Aging of the Arteries
• Arteriosclerosis results from a loss of
elasticity in the aorta, large arteries, and
coronary arteries
• Atherosclerosis is the deposition of
materials in arterial walls to form plaques
Fig. 18.5
 Pulmonary Circulation
• Moves blood to and from the lungs
• Pulmonary trunk arises from the right
ventricle and divides to form the
pulmonary arteries, which project to the
lungs
• From the lungs, four pulmonary veins
return blood to the left atrium
Systemic Circulation: Arteries

Arteries carry blood

from the left ventricle
of the heart to all
parts of the body

Fig. 18.6
 Aorta
• Leaves the left ventricle to form the
– Ascending aorta
– Aortic arch
– Descending aorta
• Consists of the thoracic aorta and the
abdominal aorta
• Coronary arteries branch from the aorta
and supply the heart
Aorta

Fig. 18.7
 Arteries to the Head and the Neck

• The following arteries branch from the

aortic arch to supply the head and the
upper limbs
– Brachiocephalic
• Divides to form the right common carotid and
the right subclavian arteries
– Left common carotid
– Left subclavian
• Vertebral arteries branch from the subclavian
arteries
 Arteries to the Head and the Neck

• The common carotid arteries and the

vertebral arteries supply the head
– The common carotid arteries divide to form the
• external carotids: supply the face and mouth
• internal carotids: supply the brain
– Vertebral arteries join within the cranial cavity
to form the basilar artery, which supplies the
brain
– The internal carotids and basilar arteries
contribute to the cerebral arterial circle
Arteries to the Head and the Neck

Fig. 18.9
 Major
Arteries of
the Head
and Thorax

Fig. 18.8
 Fig.
18.10
 Arteries of the Upper Limb
• The subclavian artery continues (without
branching) as the axillary artery and then
as the brachial artery. The brachial artery
divides into the radial and ulnar arteries
– The radial artery supplies the deep palmar
arch
– The ulnar artery supplies the superficial
palmar arch
• Both arches give rise to the digital arteries
 Fig.
18.11
 Fig.
18.12
Branches of the Aorta

Fig.
18.13
 Thoracic Aorta/Branches
• The thoracic aorta has
– Visceral branches that supply the thoracic organs
– Parietal branches that supply the thoracic wall

Fig.
18.13
 Abdominal Aorta/Branches
• The abdominal aorta has
– Visceral branches that supply the abdominal organs
– Parietal branches that supply the abdominal wall

Fig.
18.13
 Abdominal Aorta/Branches
• The visceral branches are paired and
unpaired
– The unpaired arteries supply the stomach,
spleen, and liver (celiac trunk); the small
intestine and upper part of the large intestine
(superior mesenteric); and the lower part of
the large intestine (inferior mesenteric)
– The paired arteries supply the kidneys,
adrenal glands, and gonads
Branches
of the
Aorta
Fig. 18.13
 Major
Arteries
of the
Abdomen
and Pelvis
Fig. 18.14

Fig.
18.14
 Arteries of the Pelvis
• The common iliac arteries arise from the
abdominal aorta, and the internal iliac
arteries branch from the common iliac
arteries
– The visceral branches of the internal iliac
arteries supply the pelvic organs
– The parietal branches supply the pelvic wall
and floor and the external genitalia
 Arteries of the Lower Limb
• The external iliac arteries branch from the
common iliac arteries
• The external iliac artery continues (without
branching) as the femoral artery and then as
the popliteal artery
– The popliteal artery divides to form the anterior and
posterior tibial arteries
• The posterior tibial artery gives rise to the fibular
(peroneal) and plantar arteries
• The plantar arteries form the plantar arch, from which
the digital arteries arise
Arteries of
the Pelvis
and Lower
Limb

Fig.
18.15
Major Arteries of
the Lower Limb

Fig.
18.16
 Systemic Circulation: Veins
• The three major veins returning blood to
the heart are the
– Superior vena cava (head, neck, thorax,
and upper limbs)
– Inferior vena cava ( abdomen, pelvis, and
lower limbs)
– Coronary sinus (heart)
• Veins are of three types:
– Superficial veins
– Deep veins
– Sinuses
Major Veins

Fig.
18.17
 Veins of the Head and Neck
• The internal jugular veins drain the dural
venous sinuses and the veins of the
anterior head, face, and neck
• The external jugular veins and the
vertebral veins drain the posterior head
and neck
 Fig.
18.18
 Fig.
18.19
 Fig.
18.20
 Veins of the Upper Limb
• The deep veins are the small ulnar and radial
veins of the forearm, which join the brachial
veins of the arm. The brachial veins drain into
the axillary vein
• The superficial veins are the basilic, cephalic,
and median cubital
– The basilic vein becomes the axillary vein, which
then becomes the subclavian vein. The cephalic
vein drains into the axillary vein
– The median cubital connects the basilic and
cephalic veins at the elbow
 Fig.
18.21
 Fig.
18.22
 Veins of the Thorax
The left and right
brachiocephalic
veins and the
azygos veins
return blood to
the superior vena
cava

Fig. 18.23
 Veins of the Abdomen and Pelvis

• Ascending lumbar veins from the abdomen join

the azygos and hemiazygos veins
• Veins from the kidneys, adrenal glands, and
gonads directly enter the inferior vena cava
• Veins from the stomach, intestines, spleen,
and pancreas connect with the hepatic portal
vein
– The hepatic portal vein transports blood to the liver
for processing. Hepatic veins from the liver join the
inferior vena cava
 Fig.
18.25
 Fig.
18.26
 Fig.
18.24
 Veins of the Lower Limb
• The deep veins are the fibular
(peroneal), anterior tibial, posterior tibial,
popliteal, femoral, and external iliac veins
• The superficial veins are the small and
great saphenous veins
 Fig.
18.27
 Fig.
18.28
 Physiology of Circulation
• Blood Pressure
– A measure of the force exerted by blood
against the blood vessel wall. Blood moves
through vessels because of blood pressure
– Can be measured by listening for Korotkoff
sounds produced by turbulent flow in
arteries as pressure is released from a
blood pressure cuff
 Fig.
18.29
 Fig.
18.30
 Physiology of Circulation
• Blood Flow Through a Blood Vessel
– The amount of blood that moves through a vessel in
a given period.
– Directly proportional to pressure differences and is
inversely proportional to resistance
– Resistance is the sum of all the factors that inhibit
blood flow. Resistance increases when blood vessels
become smaller and viscosity increases
– Viscosity is the resistance of a liquid to flow. Most of
the viscosity of blood results from red blood cells.
The viscosity of blood increases when the hematocrit
increases or plasma volume decreases
 Physiology of Circulation
• Blood Flow Through the Body
– Mean arterial pressure equals cardiac output
times peripheral resistance
– Vasomotor tone is a state of partial
contraction of blood vessels. Vasoconstriction
increases vasomotor tone and peripheral
resistance, whereas vasodilation decreases
vasomotor tone and peripheral resistance
– Blood pressure averages 100 mm Hg in the
aorta and drops to 0 mm Hg in the right
atrium. The greatest drop occurs in the
arterioles and capillaries
 Physiology of Circulation
• Pulse Pressure and Vascular Compliance
– Pulse pressure is the difference between systolic
and diastolic pressures. Pulse pressure increases
when stroke volume increases or vascular
compliance decreases
– Vascular compliance is a measure of the change in
volume of blood vessels produced by a change in
pressure
– Pulse pressure waves travel through the vascular
system faster than the blood flows. Pulse pressure
can be used to take the pulse
 Fig.
18.31
 Physiology of Circulation
• Blood Pressure and the Effect of
Gravity
– In a standing person, hydrostatic pressure
caused by gravity
• Increases blood pressure below the heart
• Decreases pressure above the heart
 Physiology of Circulation
• Capillary Exchange and Regulation of
Interstitial Fluid Volume
– Capillary exchange occurs through or between
endothelial cells
– Diffusion, which includes osmosis, and filtration are
the primary means of capillary exchange
– Filtration moves materials out of capillaries and
osmosis moves them into capillaries
– A net movement of fluid occurs from the blood into
the tissues. The fluid gained by the tissues is
removed by the lymphatic system
Fluid Exchange Across the Walls of Capillaries

Fig. 18.32
 Control of Blood Flow
• Blood flow through tissues is highly
controlled and matched closely to the
metabolic needs of tissues
• Local Control
– The response of vascular smooth muscle to
changes in tissue gases, nutrients, and
waste products
– If the metabolic activity of a tissue
increases, the diameter and number of
capillaries in the tissue increase over time.
 Control of Blood Flow
• Nervous and Hormonal Control
– The sympathetic nervous system (vasomotor center in the
medulla) controls blood vessel diameter. Other brain areas
can excite or inhibit the vasomotor center
– Epinephrine and norepinephrine cause vasoconstriction in
most tissues. Epinephrine causes vasodilation in skeletal and
cardiac muscle
– The muscular arteries and arterioles control the delivery of
blood to tissues
– The veins are a reservoir for blood
– Venous return to the heart increases because of the
vasoconstriction of veins, an increased blood volume, and the
skeletal muscle pump (with valves)
 Fig.
18.33
 Regulation of Mean Arterial Pressure

• Mean arterial pressure (MAP) is proportional

to cardiac output times peripheral resistance
– Short-Term Regulation of Blood Pressure
• Baroreceptors are sensory receptors sensitive
to stretch
– Located in the carotid sinuses and the aortic
arch
– The baroreceptor reflex changes peripheral
resistance, heart rate, and stroke volume in
response to changes in blood pressure
Baroreceptor Reflex Control of Blood Pressure

Fig. 18.34
 Regulation of Mean Arterial Pressure

• Short-Term Regulation of Blood Pressure

(cont.)
– Epinephrine and norepinephrine are released from the
adrenal medulla as a result of sympathetic stimulation.
They increase heart rate, stroke volume, and
vasoconstriction
– Peripheral chemoreceptor reflexes respond to
decreased oxygen, leading to increased
vasoconstriction
– Central chemoreceptors respond to high carbon dioxide
or low pH levels in the medulla, leading to increased
vasoconstriction, heart rate, and force of contraction
(CNS ischemic response)
Adrenal Medullary Mechanism

Fig. 18.35
Chemoreceptor Reflex Control of Blood Pressure

Fig. 18.36
Regulation of Mean Arterial Pressure

• Long-Term Regulation of Blood Pressure

– Through the renin-angiotensin-aldosterone
mechanism
• Renin is released by the kidneys in response to low
blood pressure
• Promotes the production of angiotensin II, which
causes vasoconstriction and an increase in aldosterone
secretion
– Aldosterone helps maintain blood volume by decreasing
urine production
– The vasopressin (ADH) mechanism causes ADH
release from the posterior pituitary in response to a
substantial decrease in blood pressure
• ADH causes vasoconstriction and helps maintain blood
volume by decreasing urine production
 Renin-
Angiotensin-
Aldosterone
Mechanism

Fig. 18.37
Vasopressin
(ADH)
Mechanism

Fig.
18.38
Regulation of Mean Arterial Pressure

• Long-Term Regulation of Blood Pressure

(cont.)
– The atrial natriuretic mechanism causes atrial
natriuretic hormone release from the cardiac
muscle cells when atrial blood pressure increases.
It stimulates an increase in urinary production,
causing a decrease in blood volume and blood
pressure
– The fluid shift mechanism causes fluid shift, which
is a movement of fluid from the interstitial spaces
into capillaries in response to a decrease in blood
pressure to maintain blood volume
 Fig.
18.39
 Examples of Cardiovascular Regulation

• Exercise
– Local control mechanisms increase blood flow through
exercising muscles, which lowers peripheral resistance
– Cardiac output increases because of increased venous
return, stroke volume, and heart rate
– Vasoconstriction in the skin, the kidneys, the
gastrointestinal tract, and skeletal muscle (non-
exercising and exercising) increases peripheral
resistance, which helps prevent a drop in blood
pressure
– Blood pressure increased despite an overall decrease
in peripheral resistance because of increased cardiac
output
 Examples of Cardiovascular Regulation

• Circulatory Shock
– Baroreceptor reflexes and the adrenal medullary
response increase blood pressure
– The renin-angiotensin-aldosterone mechanism and
the vasopressin mechanism increase
vasoconstriction and blood volume. The fluid shift
mechanism increases blood volume
– In severe shock, the chemoreceptor reflexes
increase vasoconstriction, heart rate, and force of
contraction
– In severe shock, despite negative-feedback
mechanisms, a positive- feedback cycle of
decreasing blood pressure can cause death
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559