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Blood Vessels

 Blood is carried in a closed system of vessels that begins and


ends at the heart
 In adult, blood vessels stretch 60,000 miles!
 The three major types of vessels are arteries, capillaries, and
veins
 Arteries carry blood away from the heart (O2 rich, except
pulmonary)
 They branch, diverge, fork
 Veins carry blood toward the heart (O2 poor, except
pulmonary)
 They join, merge, converge
 Capillaries contact tissue cells and directly serve cellular needs
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Generalized Structure of Blood Vessels
 Arteries and veins are composed of three tunics
tunica interna, tunica media, and tunica externa
 Lumen central blood-containing space
surrounded by tunics
 Capillaries are composed of endothelium with
sparse basal lamina

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Generalized Structure of Blood Vessels

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Tunics
 Tunica interna (tunica intima)
 Endothelial layer that lines the lumen of all vessels
 Continuation w/ the endocardial lining of the heart
 Flat cells, slick surface
 In vessels larger than 1 mm, a subendothelial connective
tissue basement membrane is present
 Tunica media
 Circularly arranged smooth muscle and elastic fiber layer,
regulated by sympathetic nervous system
 Controls vasoconstriction/vasodilation of vessels

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Tunics
 Tunica externa (tunica adventitia)
 Collagen fibers that protect and reinforce vessels
 Contains nerve fibers, lymphatic vessels, & elastin
fibers
 Larger vessels contain vasa vasorum (capillary
network) that nourish more external tissues of the
blood vessel wall

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Blood Vessel Anatomy

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Elastic (Conducting) Arteries
 Thick-walled arteries near the heart; the aorta and
its major branches
 Large lumen allow low-resistance conduction of
blood
 Contain elastin in all three tunics
 Inactive in vasoconstriction
 Serve as pressure reservoirs expanding and
recoiling as blood is ejected from the heart

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Muscular (Distributing) Arteries and Arterioles
 Muscular arteries distal to elastic arteries; deliver
blood to body organs
 Account for most of the named structures in lab
 Have thickest tunica media (proportionally) of all
the vessels
 Active in vasoconstriction
 Arterioles smallest arteries; lead to capillary beds
 Control flow into capillary beds via vasodilation
and constriction

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Capillaries
 Capillaries are the smallest blood vessels (microscopic)
 Walls consisting of a thin tunica interna, one cell thick
 Allow only a single RBC to pass at a time
 Pericytes on the outer surface stabilize their walls

 Tissues have a rich capillary supply


 Tendons, ligaments are poorly vascularized
 Cartilage, cornea, lens, and epithelia lack capillaries

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Vascular Components

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Types of Capillaries
 There are three structural types of capillaries:
 Continuous
 Fenestrated
 Sinusoids

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Continuous Capillaries
 Continuous capillaries are abundant in the skin and muscles
 Endothelial cells provide an uninterrupted lining
 Adjacent cells are connected with tight junctions
 Intercellular clefts allow the passage of fluids & small
solutes
 Brain capillaries do not have clefts (blood-brain barrier)

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Fenestrated Capillaries
 Found wherever active capillary absorption or filtrate formation
occurs (e.g., small intestines, endocrine glands, and kidneys)
 Characterized by:
 An endothelium riddled with pores (fenestrations)
 Greater permeability than other capillaries

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Sinusoids
 Highly modified, leaky, fenestrated capillaries with large
lumens
 Found in the liver, bone marrow, lymphoid tissue, and in some
endocrine organs
 Allow large molecules (proteins and blood cells) to pass
between the blood and surrounding tissues
 Blood flows sluggishly (e.g. in spleen) allowing for removal of
unwanted debris and immunogens

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Capillary Beds
 A microcirculation moving from arterioles to
venules
 Consist of two types of vessels:
 Vascular shunts metarteriolethoroughfare
channel connecting an arteriole directly with a
postcapillary venule
 True capillaries the actual exchange vessels

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Blood Flow Through Capillary Beds
 True capillaries: 10-100/bed
 Branch from, then return to, the capillary bed
 Precapillary sphincter
 Cuff of smooth muscle that surrounds each true capillary at
the metarteriole and acts as a valve to regulate flow
 Blood flow is regulated by vasomotor nerves and local
chemical conditions
 True bed is open after meals, closed between meals
 True bed is rerouted to skeletal muscles during physical
exercise

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Capillary Beds

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Capillary Beds

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Venous System: Venules
 Venules are formed when capillary beds unite
 Postcapillary venules smallest venules,
composed of endothelium and a few pericytes
 Allow fluids and WBCs to pass from the
bloodstream to tissues

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Venous System: Veins
 Veins:
 Formed when venules converge
 Composed of three tunics, with a thin tunica media
and a thick tunica externa consisting of collagen
fibers and elastic networks
 Accommodate a large blood volume
 Capacitance vessels (blood reservoirs) that contain
65% of the blood supply

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Venous System: Veins
 Veins have much lower blood pressure and thinner
walls than arteries
 To return blood to the heart, veins have special
adaptations
 Large-diameter lumens, which offer little
resistance to flow
 Valves (resembling semilunar heart valves), which
prevent backflow of blood
 Venous sinuses specialized, flattened veins with
extremely thin walls (e.g., coronary sinus of the
heart and dural sinuses of the brain)
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Vascular Anastomoses
 Merging blood vessels, more common in veins than
arteries
 Arterial anastomoses provide alternate pathways (collateral
channels) for blood to reach a given body region
 If one branch is blocked, the collateral channel can supply
the area with adequate blood supply
 E.g. occur around joints, abdominal organs, brain, &
heart
 E.g. poorly anastomized organs are retina, kidney,
spleen
 Thoroughfare channels are examples of arteriovenous
anastomoses

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Physiology of Circulation: Blood Flow
 Actual volume of blood flowing in a given period:
 Is measured in ml per min.
 Is equivalent to cardiac output (CO), considering
the entire vascular system
 Is relatively constant when at rest
 Varies widely through individual organs

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Blood Pressure (BP)
 Force / unit area exerted on the wall of a blood
vessel by its contained blood
 Expressed in millimeters of mercury (mm Hg)
 Measured in reference to systemic arterial BP in
large arteries near the heart
 The differences in BP within the vascular system
provide the driving force that keeps blood moving
from higher to lower pressure areas

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Resistance
 Resistance opposition to flow (friction)
 Measure of the amount of friction blood encounters
 Generally encountered in the systemic circulation away
from the heart
 Referred to as peripheral resistance (PR)
 The three sources of resistance are:
 Blood viscosity
 Total blood vessel length
 Blood vessel diameter

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Resistance Factors: Viscosity and Vessel
Length
 Resistance factors that remain relatively constant are:
 Blood viscosity:
 Internal resistance to flow that exist in all fluids
 Increased viscosity increases resistance (molecules
ability to slide past one another)
 Blood vessel length:
 The longer the vessel, the greater the resistance
 E.g. one extra pound of fat = 1 mile of small vessels
required to service it = more resistance

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Resistance Factors: Blood Vessel Diameter
 Changes in vessel diameter are frequent and significantly
alter peripheral resistance

Fluid flows slowly


Fluid flows freely

 The smaller the tube the greater the resistance


 Resistance varies inversely with the fourth power of vessel
radius
 For example, if the radius is doubled, the resistance is 1/16
as much

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Resistance Factors: Blood Vessel Diameter
 Small-diameter arterioles are the major
determinants of peripheral resistance
 Fatty plaques from atherosclerosis:
 Cause turbulent blood flow
 Dramatically increase resistance due to turbulence

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Blood Flow, Blood Pressure, and Resistance
 Blood flow (F) is directly proportional to the difference in
blood pressure (P) between two points in the circulation
 If P increases, blood flow speeds up; if P decreases,
blood flow declines
 Blood flow is inversely proportional to resistance (R)
 If R increases, blood flow decreases
 R is more important than P in influencing local blood
pressure

F = P/R

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Systemic Blood Pressure
 Any fluid driven by a pump thru a circuit of closed
channels operates under pressure
 The fluid closest to the pump is under the greatest
pressure
 The heart generates blood flow.
 Pressure results when flow is opposed by
resistanceeg. Systemic Blood Pressure

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Systemic Blood Pressure
 Systemic pressure:
 Is highest in the aorta
 Declines throughout the length of the pathway
 Is 0 mm Hg in the right atrium
 The steepest change in blood pressure occurs in the
arterioles which offer the greatest resistance to
blood flow

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Systemic Blood Pressure

Copyright 2006 Pearson Education, Inc., publishing as Benjamin Cummings Figure 19.5
Arterial Blood Pressure
 Arterial BP reflects two factors of the arteries close
to the heart
 Their elasticity (how much they can be stretched)
 The volume of blood forced into them at any given
time
 Blood pressure in elastic arteries near the heart is
pulsatile (BP rises and falls)

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Arterial Blood Pressure
 Systolic pressure pressure exerted on arterial
walls during left ventricular contraction pushing
blood into the aorta (120 mm Hg)
 Diastolic pressure aortic SL valve closes
preventing backflow and the walls of the aorta
recoil resulting in pressure drop
 lowest level of arterial pressure during a
ventricular cycle

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Arterial Blood Pressure
 Pulse pressure the difference between systolic and diastolic
pressure
 Felt as a pulse during systole as arteries are expanded
 Mean arterial pressure (MAP) pressure that propels the blood
to the tissues
 Because diastole is longer than systole
 MAP = diastolic pressure + 1/3 pulse pressure
 E.g. systolic BP = 120 mm Hg
 E.g. diastolic BP = 80 mm Hg
 MAP = 93
 MAP & pulse pressure decline w/ distance from the heart
 At the arterioles blood flow is steady
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Capillary Blood Pressure
 Capillary BP ranges from 40 (beginning) to 20
(end) mm Hg
 Low capillary pressure is desirable because high
BP would rupture fragile, thin-walled capillaries
 Low BP is sufficient to force filtrate out into
interstitial space and distribute nutrients, gases,
and hormones between blood and tissues

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Venous Blood Pressure
 Venous BP is steady and changes little during the
cardiac cycle
 The pressure gradient in the venous system is only
about 20 mm Hg (from venules to venae cavae) vs.
60 mm Hg from the aorta to the arterioles
 A cut vein has even blood flow; a lacerated artery
flows in spurts

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Factors Aiding Venous Return
 Venous BP alone is too low to promote adequate
blood return and is aided by the:
 Respiratory pump pressure changes created
during breathing suck blood toward the heart by
squeezing local veins
 Muscular pump contraction of skeletal muscles
surrounding deep veins pump blood toward the
heart with valves prevent backflow during venous
return
 Smooth muscle contraction of the tunica media by
the SNS

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Factors Aiding Venous Return

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Maintaining Blood Pressure
 Maintaining blood pressure requires:
 Cooperation of the heart, blood vessels, and
kidneys
 Supervision of the brain

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Maintaining Blood Pressure
 The main factors influencing blood pressure are:
 Cardiac output (CO)
 Peripheral resistance (PR)
 Blood volume
 Blood pressure = CO x PR
 Blood pressure varies directly with CO, PR, and
blood volume
 Changes in one (CO, PR, BV) are compensated by
the others to maintain BP

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Cardiac Output (CO)
 CO = stroke volume (ml/beat) x heart rate (beats/min)
 Units are L/min
 Cardiac output is determined by venous return and neural
and hormonal controls
 Resting heart rate is controlled by the cardioinhibitory
center via the vagus nerves
 Stroke volume is controlled by venous return (end diastolic
volume, or EDV)
 Under stress, the cardioacceleratory center increases heart
rate and stroke volume
 The end systolic volume (ESV) decreases and MAP
increases
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Cardiac Output (CO)

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Controls of Blood Pressure
 Short-term controls:
 Are mediated by the nervous system and
bloodborne chemicals
 Counteract moment-to-moment fluctuations in
blood pressure by altering peripheral resistance
 Long-term controls regulate blood volume

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Short-Term Mechanisms: Neural Controls
 Neural controls of peripheral resistance:
 Alter blood distribution in response to demands
 Maintain MAP by altering blood vessel diameter
 Neural controls operate via reflex arcs involving:
 Baroreceptors & afferent fibers
 Vasomotor centers of the medulla
 Vasomotor fibers
 Vascular smooth muscle

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Short-Term Mechanisms: Vasomotor Center
 Vasomotor center a cluster of sympathetic neurons in the
medulla that oversees changes in blood vessel diameter
 Maintains blood vessel tone by innervating smooth muscles
of blood vessels, especially arterioles
 Cardiovascular center vasomotor center plus the cardiac
centers that integrate blood pressure control by altering
cardiac output and blood vessel diameter
 Vasomotor fibers (T1-L2) innervate smooth muscle of the
arterioles
 Vasomotor state is always in a state of moderate
constriction

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Short-Term Mechanisms: Vasomotor Activity
 Sympathetic activity causes:
 Vasoconstriction and a rise in BP if increased
 BP to decline to basal levels if decreased
 Vasomotor activity is modified by:
 Baroreceptors (pressure-sensitive), chemoreceptors
(O2, CO2, and H+ sensitive), higher brain centers,
bloodborne chemicals, and hormones

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Short-Term Mechanisms: Baroreceptor-
Initiated Reflexes
 When arterial blood pressure rises, it stretches
baroreceptos located in the carotid sinuses, aortic arch,
walls of most large arteries of the neck & thorax
 Baroreceptors send impulses to the vasomotor center
inhibiting it resulting in vasodilation of arterioles and veins
and decreasing blood pressure
 Venous dilation shifts blood to venous reservoirs causing a
decline in venous return and cardiac output
 Baroreceptors stimulate parasympathetic activity and
inhibit the cardioacceletory center to decrease heart rate
and contractile force
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Short-Term Mechanisms: Baroreceptor-
Initiated Reflexes
 Declining blood pressure stimulates the

cardioacceleratory center to:


 Increase cardiac output and vasoconstriction
causing BP to rise

 Peripheral resistance & cardiac output are


regulated together to minimize changes in BP

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Short-Term Mechanisms: Baroreceptor-Initiated
Reflexes
 Baroreceptors respond to rapidly changing
conditions like when you change posture
 They are ineffective against sustained pressure
changes, e.g. chronic hypertension, where they will
adapt and raise their set-point

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Impulse traveling along
afferent nerves from
baroreceptors:
Stimulate cardio-
Sympathetic
inhibitory center
impulses to
(and inhibit cardio-
heart
acceleratory center)
( HR and contractility)

Baroreceptors
in carotid
sinuses and
aortic arch Inhibit CO
stimulated vasomotor center
R

Rate of vasomotor
Arterial impulses allows
blood pressure vasodilation CO and R
rises above ( vessel diameter)
return blood
normal range pressure to
Homeostatic
Stimulus: Im range
ba
Rising blood la nc
pressure e

Homeostasis: Blood pressure in normal range


Im Stimulus:
ba
la nc Declining
e
blood pressure

CO and R
return blood Impulses from
pressure to baroreceptors: Arterial blood pressure
homeostatic Stimulate cardio- falls below normal range
range acceleratory center
Cardiac (and inhibit cardio-
output inhibitory center) Baroreceptors in
(CO) carotid sinuses
Sympathetic and aortic arch
impulses to heart inhibited
Peripheral ( HR and contractility)
resistance (R)

Vasomotor Stimulate
fibers vasomotor
stimulate center
vasoconstriction

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Short-Term Mechanisms: Chemical Controls
 Blood pressure is regulated by chemoreceptor
reflexes sensitive to low oxygen and high carbon
dioxide levels
 Prominent chemoreceptors are found in the carotid
and aortic bodies
 Response is to increase cardiac output and
vasoconstriction
 Increased BP speeds the return of blood to the
heart and lungs

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Influence of Higher Brain Centers

 Reflexes that regulate BP are integrated in the


medulla
 Higher brain centers (cortex and hypothalamus)
can modify BP via relays to medullary centers

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Chemicals that Increase Blood Pressure
 Adrenal medulla hormones norepinephrine and
epinephrine increase blood pressure
 NE has a vasoconstrictive action
 E increases cardiac output and causes
vasodilation in skeletal muscles
 Nicotine causes vasoconstriction: stimulates
sympathetic neurons and the release of large
amounts of NE & E

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Chemicals that Increase Blood Pressure
 Antidiuretic hormone (ADH, aka vasopressin)
 produced by the hypothalamus
 causes intense vasoconstriction in cases of extremely low
BP
 stimulates the kidneys to conserve H2O
 Angiotensin II
 released when renal perfusion is inadequate
 The kidneys release of renin generates angiotensin II,
which causes vasoconstriction

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Chemicals that Decrease Blood Pressure
 Atrial natriuretic peptide (ANP) produced by the
atrium and causes blood volume and pressure to
decline along with general vasodilation
 Nitric oxide (NO) is a brief but potent
vasodilator
 Inflammatory chemicals histamine, prostacyclin,
and kinins are potent vasodilators
 Alcohol causes BP to drop by inhibiting
antidiuretic hormone (ADH)

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Long-Term Mechanisms: Renal Regulation
 Long-term mechanisms control BP by altering
blood volume
 Increased BP stimulates the kidneys to eliminate
water, thus reducing BP
 Decreased BP stimulates the kidneys to increase
blood volume and BP

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Kidney Action and Blood Pressure
 Kidneys act directly and indirectly to maintain
long-term blood pressure
 Direct renal mechanism alters blood volume
 Indirect renal mechanism involves the renin-
angiotensin mechanism

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Kidney Action and Blood Pressure: Direct Renal
Mechanism
 Increase in BV causes an increase in BP
 This stimulates the kidneys to release H2O which
lowers BV which in turn lowers BP

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Kidney Action and Blood Pressure: Indirect Renal
Mechanism

 Declining BP causes the release of renin, which


triggers the release of angiotensin II
 Angiotensin II is a potent vasoconstrictor that
stimulates aldosterone secretion
 Aldosterone enhances renal reabsorption
resulting in increased BP and BP

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Kidney Action and Blood Pressure

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Monitoring Circulatory Efficiency
 Efficiency of the circulation can be assessed by
taking pulse and blood pressure measurements
 Vital signs pulse and blood pressure, along with
respiratory rate and body temperature
 Pulse pressure wave caused by the expansion and
recoil of elastic arteries
 Radial pulse (taken on the radial artery at the wrist)
is routinely used

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Palpated Pulse

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Measuring Blood Pressure
 Systemic arterial BP is measured indirectly with
the auscultatory method
 A sphygmomanometer is placed on the arm
superior to the elbow
 Pressure is increased in the cuff until it is greater
than systolic pressure in the brachial artery
 Pressure is released slowly and the examiner
listens with a stethoscope

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Measuring Blood Pressure
 The first sound heard is recorded as the systolic
pressure
 The pressure when sound disappears is recorded as
the diastolic pressure

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Alterations in Blood Pressure
 Normal BP at rest: 110-140 mm Hg (systolic) &
70-80 mm Hg (diastolic)
 Hypotension low BP in which systolic pressure is
below 100 mm Hg
 Hypertension condition of sustained elevated
arterial pressure of 140/90 or higher

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Blood Flow Through Tissues
 Blood flow, or tissue perfusion, is involved in:
 Delivery of oxygen and nutrients to, and removal
of wastes from, tissue cells
 Gas exchange in the lungs
 Absorption of nutrients from the digestive tract
 Urine formation by the kidneys

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Velocity of Blood Flow
 Blood velocity:
 Changes as it travels through the systemic
circulation
 Is inversely proportional to the cross-sectional area
 E.g. Fast in the aorta
Slow in capillaries
Fast again in the veins

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Velocity of Blood Flow

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Autoregulation: Local Regulation of Blood
Flow
 Autoregulation automatic adjustment of blood

flow to each tissue in proportion to its


requirements at any given point in time
 Blood flow through an individual organ is
intrinsically controlled by modifying the diameter
of local arterioles feeding its capillaries
 MAP remains constant, while local demands
regulate the amount of blood delivered to various
areas according to need

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Blood Flow: Skeletal Muscles
 Capillary density & blood flow is greater in red
(slow oxidative) fibers than in white (fast
glycolytic) fibers
 When muscles become active, blood flow to them
increases (hyperemia)
 This autoregulation occurs in response to low O2
levels
 SNS activity increases causing an increase in NE
which causes vasoconstriction of the vessels of
blood reservoirs to the skin and viscera diverting
blood away to the skeletal muscles
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Blood Flow: Brain
 Blood flow to the brain is constant, as neurons are
intolerant of ischemia
 Brain cannot store essential nutrients
 Very precise autoregulatory system,
 E.g. when you make a fist, blood supply
shifts to those neurons in the cerobral motor
cortex
 Metabolic controls brain tissue is extremely
sensitive to declines in pH, and increased carbon
dioxide causes marked vasodilation
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Blood Flow: Brain
 Myogenic controls protect the brain from damaging
changes in blood pressure
 Decreases in MAP cause cerebral vessels to dilate
to ensure adequate perfusion
 Increases in MAP cause cerebral vessels to
constrict so smaller vessels do not rupture
 MAP below 60mm Hg can cause syncope
(fainting)

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Blood Flow: Skin
 Blood flow through the skin:
 Supplies nutrients to cells in response to oxygen
need
 Helps maintain body temperature
 Provides a blood reservoir

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Blood Flow: Skin
 Blood flow to venous plexuses below the skin
surface:
 Varies from 50 ml/min (cold) to 2500 ml/min
(hot), depending on body temperature
 Is controlled by sympathetic nervous system
reflexes initiated by temperature receptors and the
central nervous system
 Does this via arteriole-venule shunts located at
fingertips, palms, toes, soles of feet, ears, nose, lips

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Temperature Regulation
 As temperature rises (e.g., heat exposure, fever, vigorous
exercise):
 Hypothalamic signals reduce vasomotor stimulation of the
skin vessels
 Blood flushes into capillary beds
 Heat radiates from the skin
 Sweat also causes vasodilation via bradykinin in perspiration
 Bradykinin stimulates the release of NO which increases
vasodilation
 As temperature decreases, skin vessels constrict and blood is
shunted to deeper, more vital organs
 Rosy cheeks: blood entrapment in superficial
capillary loops
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Blood Flow: Lungs (Think Reversal)
 Blood flow in the pulmonary circulation is unusual
in that:
 The pathway is short
 Arteries/arterioles are more like veins/venules
(thin-walled, with large lumens)
 Because of this they have a much lower arterial
pressure (24/8 mm Hg versus 120/80 mm Hg)

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Blood Flow: Lungs
 The autoregulatory mechanism is exactly opposite
of that in most tissues
 Low pulmonary oxygen levels cause
vasoconstriction; high levels promote
vasodilation
 As lung air sacs fill w/ air, capillary beds dilate
to take it up

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Blood Flow: Heart
 Small vessel coronary circulation is influenced by:
 Aortic pressure
 The pumping activity of the ventricles
 During ventricular systole:
 Coronary vessels compress
 Myocardial blood flow ceases
 Stored myoglobin supplies sufficient oxygen
 During ventricular diastole, aortic pressure forces blood thru the
coronary circulation
 During exercise, coronary blood vessels dilate in response to
elevated CO2 levels

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Capillary Exchange of Respiratory Gases and
Nutrients
 Oxygen, carbon dioxide, nutrients, and metabolic
wastes diffuse between the blood and interstitial
fluid along concentration gradients
 Oxygen and nutrients pass from the blood to
tissues
 Carbon dioxide and metabolic wastes pass from
tissues to the blood
 Water-soluble solutes pass through clefts and
fenestrations
 Lipid-soluble molecules diffuse directly through
endothelial membranes
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Capillary Exchange of Respiratory Gases and
Nutrients

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Four Routes Across Capillaries

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Fluid Movement: Bulk Flow
 Fluid is forced out of capillary beds thru clefts at
the arterial end, with most of it returning at the
venous end of the bed
 This process determines relative fluid volume in
blood stream and extracellular space

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Capillary Exchange: Fluid Movements
 Hydrostatic pressure is the force of a fluid pressed
against a wall
 Direction and amount of fluid flow depends upon
the difference between:
 Capillary hydrostatic pressure (HPc)
 Capillary colloid osmotic pressure (OPc)

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Capillary Exchange: Fluid Movements
 HPc pressure of blood against the capillary walls:
 Tends to force fluids through the capillary walls
(filtration) leaving behind cells and proteins
 Is greater at the arterial end of a bed than at the
venule end
 HPc is opposed by interstitial fluid hydrostatic
pressure (HPif)
 Net pressure is the difference between HPc and
HPif

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Colloid Osmotic Pressure
 The force opposing hydrostatic pressure (HPc)
 OPc created by nondiffusible plasma proteins,
which draw water toward themselves (osmosis)
 E.g. serum albumin
 OPc does not vary from one end of the capillary
bed to the other

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Net Filtration Pressure (NFP)
 Hydrostatic-Osmotic Pressure interactions
determine if there is a net gain or loss of fluid from
the blood, calculated as the Net Filtration Pressure
(NFP)
 NFP all the forces acting on a capillary bed
 Thus, fluid will leave the capillary bed if the NFP
is greater than the net OP and vice versa

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Net Filtration Pressure (NFP)
 At the arterial end of a bed, hydrostatic forces
dominate (fluids flow out)
 At the venous end of a bed, osmotic forces
dominate (fluids flow in)
 More fluids enter the tissue beds than return to the
blood, and the excess fluid is returned to the blood
via the lymphatic system

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Net Filtration Pressure (NFP)

Copyright 2006 Pearson Education, Inc., publishing as Benjamin Cummings Figure 19.16
Circulatory Shock
 Circulatory shock any condition in which blood
vessels are inadequately filled and blood cannot
circulate normally
 E.g. hypovolemic shock: large scale blood loss
 Blood volume decreases causing an increase in
heart rate resulting in a weak pulse
 Vasoconstriction occurs enhancing venous
return

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Circulatory Shock
 Vascular Shock:
 Blood volume is normal, but circulation is poor as a result
of an abnormal expansion of the vascular bed caused by
extreme vasodilation
 Results in rapid fall in blood pressure
 Most common cause is anaphylactic shock
 Body-wide vasodilation due to massive histamine
release
 Neurogenic shock: failure of ANS regulation
 Septic shock (septicemia): severe systemic bacterial
infection

Copyright 2006 Pearson Education, Inc., publishing as Benjamin Cummings


Copyright 2006 Pearson Education, Inc., publishing as Benjamin Cummings Figure 19.17