Over 60,000 Cardiovascular System – Vessels

Cardiovascular System: Vessels miles of vessels

Blood Vessel Anatomy:
per human body
(branch / diverge / fork)

Elastic Muscular Arterioles

Arteries Arteries

Vessel Types:
Heart (nutrient
exchange)
1) Arteries (away from heart)
2) Capillaries Capillaries
3) Veins (toward heart)

Veins Venules

(join / merge / converge)

Cardiovascular System – Vessels Cardiovascular System – Vessels

Blood Vessel Anatomy: Blood Vessel Anatomy: Only tunic present

in capillaries
Vessels composed of distinct tunics :
O2-rich;
CO2-poor 1) Tunica intima
Pulmonary circuit Tunica intima • Endothelium (simple squamous epithelium)
(short, low pressure loop)
• Connective tissue ( elastic fibers)
O2-poor;
CO2-rich
(long, high pressure loop) 2) Tunica media
Systemic circuit • Smooth muscle / elastic fibers
• Regulates pressure / circulation
• Sympathetic innervation
Lumen
O2-poor; O2-rich; Vasa
CO2-rich CO2-poor 3) Tunica externa vasorum
• Loose collagen fibers
• Nerves / lymph & blood vessels
• Protects / anchors vessel
% / volume not fixed:
Function: • Alteration of arteriole size
1) Circulate nutrients / waste • Alteration of cardiac output Vasomotor stimulation = vasoconstriction
2) Regulate blood pressure Tunica media Vasomotor relaxation = vasodilation
• Combination of two above
Tunica externa
Costanzo (Physiology, 4th ed.) – Figure 4.1

Cardiovascular System – Vessels Relative tissue Cardiovascular System – Vessels Relative tissue
makeup makeup
Blood Vessel Anatomy: Blood Vessel Anatomy:
Smooth muscle

Smooth muscle

Arteriosclerosis:
Fibrous tissue

Fibrous tissue
Elastic tissue

Elastic tissue
Endothelium

Endothelium

Arteries: Hardening / stiffening of arteries Capillaries:

Major groups:
D = Diameter
T = Thickness
1) Capillaries:
1) Elastic Arteries (conducting arteries):
• Location of blood / tissue interface D: 9.0 m
D: 1.5 cm
• Large, thick-walled (near heart) T: 1.0 m
T: 1.0 mm • Stabilized by pericytes (smooth muscle cells)
•  [elastic fibers] (pressure reservior)

Types of Capillaries:
2) Muscular Arteries (distributing arteries):
• Deliver blood to organs D: 6.0 mm
T: 1.0 mm
•  [smooth muscle] (vasoconstriction)

3) Arterioles:
• Control blood into capillaries D: 37.0 m
T: 6.0 m A) Continuous 2) Fenestrated 3) Sinusoidal:
• Neural / hormonal / local controls • Uninterrupted lining • Oval pores present • Holes / clefts present
• Found throughout body • Located in high absorption / • Allow passage of large
(most common type) filtration regions (e.g., kidney) molecules (e.g., liver)

Marieb & Hoehn (Human Anatomy and Physiology, 8th ed.) – Table 19.1 Marieb & Hoehn (Human Anatomy and Physiology, 8th ed.) – Table 19.1 / Figure 19.3

1
 Cardiovascular System – Vessels Cardiovascular System – Vessels Relative tissue
makeup
Blood Vessel Anatomy: Blood Vessel Anatomy:

Smooth muscle
Leukocyte

Fibrous tissue
Elastic tissue
margination

Endothelium
Capillaries: Veins:

Capillaries do not function independently – Instead they

Major groups:
form interweaving networks called capillary beds
1) Venules:
Vascular True capillaries Not all capillaries are perfused D: 20.0 m
shunt with blood at all times… • Formed where capillaries unite T: 1.0 m
• Extremely porous

2) Veins (capacitance vessels):

D: 5.0 mm
• Large lumen; “volume” sink T: 0.5 mm
• Low pressure environment

Terminal Postcapillary Precapillary sphincters Venous sinuses:

arteriole venule
Specialized, flattened veins
• 10 - 100 capillaries / bed • Sphincters control blood flow composed only of endothelium;
supported by surrounding tissues
a) Vascular shunt through capillary bed
b) True capillaries
Marieb & Hoehn (Human Anatomy and Physiology, 8th ed.) – Figure 19.4 Marieb & Hoehn (Human Anatomy and Physiology, 8th ed.) – Figures 19.3 / 19.5

Cardiovascular System – Vessels

Vascular anastomoses:
Blood Vessel Anatomy: Regions where vessels unite,
forming interconnections

Heart
Heart

Venous anastomoses
are common; vein blockages
collateral
rarely lead to tissue death Arteriovenous channels
anastomosis
Arterial anastomoses
provide alternative channels
for blood to reach locations
• Joints
• Abdominal organs
• Brain

Retina, spleen, & kidney have

Great saphenous limited collateral circulation
vein harvest
Marieb & Hoehn (Human Anatomy and Physiology, 8th ed.) – Figure 19.2

Cardiovascular System – Vessels Cardiovascular System – Vessels

To stay alive, blood must
Would you want
Pathophysiology: Most common form to find this pipe Hemodynamics: be kept moving…
of arteriosclerosis in your house?

Atherosclerosis:
Blood Flow:
Formation of atheromas (small, patchy thickenings)
Volume of blood flowing past a
on wall of vessel; intrude into lumen
point per given time (ml / min)

1) Endothelium injured 3) Fibrous plaque forms

The velocity of blood flow is not related to proximity of heart, but depends
• Infection / hypertension • Collagen / elastin fibers
deposited around dying or
on the diameter and cross-sectional area of blood vessels
2) Lipids accumulate / oxidize dead foam cells
• LDLs collect on tunica intima
4) Plaque becomes unstable
Foam cells: • Calcium collects in plaque v = Q /A
Macrophages engorged • Vessel constricts; arterial wall
with LDLs; form fatty streak frays / ulcerates (= thrombus)
v = Velocity (cm / sec)
Link Q = Flow (mL / sec)
Outcome: A = Cross-sectional area (cm 2)
Statins: • Myocardial infarctions
Cholesterol-lowering
drugs • Strokes A = r2
• Aneurysms Angioplasty / Stent Bypass surgery
Costanzo (Physiology, 4th ed.) – Figure 4.4

2
 Cardiovascular System – Vessels Cardiovascular System – Vessels
To stay alive, blood must
Hemodynamics: be kept moving… v = Q /A

Blood Flow:
A man has a cardiac output of 5.5 L /
Volume of blood flowing past a
min. The diameter of his aorta is
point per given time (ml / min) estimated to be 20 mm, and the total
cross-sectional area of his systemic
capillaries is estimated to be 2500 cm2.
The velocity of blood flow is not related to proximity of heart, but depends
on the diameter and cross-sectional area of blood vessels What is the velocity of blood flow
in the aorta relative to the velocity
v = Q /A of blood flow in the capillaries?
Blood velocity is
highest in the aorta cm 3 (1 cm)
and lowest in the A = r2 A = (3.14) (10 mm)2 A = 3.14 cm 2
capillaries Capillaries
(5500 mL)
Artery Vein
5.5 L / min 5500 cm 3 / min
vcapillaries = vaorta =
2500 cm 2 3.14 cm 2 800x
difference
vcapillaries = 2.2 cm / min vaorta = 1752 cm / min
Randall et al. (Eckert Animal Physiology, 5th ed.) – Figure 12.23

Cardiovascular System – Vessels Cardiovascular System – Vessels

To stay alive, blood must To stay alive, blood must
Hemodynamics: be kept moving… Hemodynamics: be kept moving…

Blood flow through a blood vessel or a series of blood vessels is Heart

determined by blood pressure and peripheral resistance generates
initial
pressure

Blood Pressure:
Force per unit area on wall of
vessel (mm Hg)

• The magnitude of blood flow is directly proportional to the size of the pressure
difference between two ends of a vessel

Blood Flow (Q) = Difference in blood pressure ( P)

• The direction of blood flow is determined by the direction of the pressure gradient
Vessel resistance
generates
Always moves from high to low pressure pressure gradient

Costanzo (Physiology, 4th ed.) – Figure 4.8

Cardiovascular System – Vessels Cardiovascular System – Vessels

To stay alive, blood must To stay alive, blood must
Hemodynamics: be kept moving… Hemodynamics: be kept moving…

Blood flow through a blood vessel or a series of blood vessels is (difference in voltage)
determined by blood pressure and peripheral resistance
(current) Difference in blood pressure ( P)
Blood Flow (Q) =
Peripheral Resistance: Peripheral resistance (R)
Amount of friction blood encounters (electrical resistance)
passing through vessels
(mm Hg / mL / min)
Analogous to Ohm’s Law (V = I x R OR I = V / R)
• Blood flow is inversely proportional to resistance encountered in the system

Q = P / R
1 A man has a renal blood flow of 500
Blood Flow (Q) = mL / min. The renal atrial pressure R = P / Q
is 100 mm Hg and the renal venous
Peripheral resistance (R) pressure is 10 mm Hg. 100 mm Hg – 10 mm Hg
R =
What is the vascular resistance of 500 mL / min
The major mechanism for changing blood flow in the
the kidney for this man?
cardiovascular system is by changing the resistance of blood
vessels, particularly the arterioles R = 0.18 mm Hg / mL / min

3
 Cardiovascular System – Vessels Cardiovascular System – Vessels
To stay alive, blood must To stay alive, blood must
Hemodynamics: be kept moving… Hemodynamics: be kept moving…

The factors that determine the resistance of a blood vessel to The total resistance associated with a set of blood vessels also depends
blood flow are expressed by Poiseuille’s (pwä-zwēz) Law: on whether the vessels are arranged in series or in parallel

A) Series resistance:
Powerful relationship! R = Resistance
Slight diameter change
8Lη η = Viscosity of blood
R = Sequential arrangement (e.g., pathway within single organ)
equals
large resistance change
r4 L = Length
r = Radius

1) Blood viscosity 2) Vessel Length 3) Vessel Diameter Arteriolar resistance is the greatest which equates to
the area with the greatest decrease in pressure

The total resistance is equal to the sum of the individual resistances

 viscosity =  resistance  length =  resistance  diameter =  resistance

Costanzo (Physiology, 4th ed.) – Figure 4.5

Cardiovascular System – Vessels Cardiovascular System – Vessels

To stay alive, blood must To stay alive, blood must
Hemodynamics: be kept moving… Hemodynamics: be kept moving…

The total resistance associated with a set of blood vessels also depends Ideally, blood flow in the cardiovascular system is streamlined
on whether the vessels are arranged in series or in parallel
1) Laminar Flow: Characterized by parabolic velocity profile
B) Parallel resistance: • Flow is 0 velocity at wall; maximal at center
Simultaneous arrangement (e.g., pathway among various circulations) • Layers of fluid slide past one another
Blood ~ 4x
Viscosity: more viscous
Adding a new resistance to the Measure of the resistance to sliding than water
circuit causes total resistance between adjacent layers
to decrease

No loss of pressure
in major arteries What would you expect to happen to blood viscosity  viscosity in
as vessel diameter decreases? capillaries – Why?
Increasing the resistance in one
circuit causes total resistance
to increase
Fahraeus – Lindqvist Effect:
()
Relative viscosity of blood decreases with
RBCs Hematocrit
decreasing vessel diameter
The total resistance is less than any of the individual resistances (< 0.3 mm ~ 1.8x water)

Reduced energy required to drive blood

through microcirculation Plasma Skimming Exit to smaller
Costanzo (Physiology, 4th ed.) – Figure 4.5 Costanzo (Physiology, 4th ed.) – Figure 4.6
vessels

Cardiovascular System – Vessels Cardiovascular System – Vessels

To stay alive, blood must To stay alive, blood must
Hemodynamics: be kept moving… Hemodynamics: be kept moving…

Ideally, blood flow in the cardiovascular system is streamlined The capacitance of a blood vessel describes the volume of
blood a vessel can hold at a given pressure
1) Laminar Flow: Characterized by parabolic velocity profile
• Flow is 0 velocity at wall; maximal at center Volume (mL)
• Layers of fluid slide past one another Compliance =
Viscosity:
Blood ~ 4x (mL / mm Hg) Pressure (mm Hg)
more viscous
Measure of the resistance to sliding than water Compliance = slope of line
between adjacent layers
Compliance is high in veins Unstressed
(large blood volumes @ low pressure) volume
2) Turbulent Flow: Blood moves in directions not aligned with axis of blood flow
• More pressure required to propel blood Compliance is low in arteries Stressed
• Noisy (stethoscope) (low blood volumes @ high pressure) volume

Reynolds Number: Anemia

Total blood volume = Unstressed volume + Stressed volume
Thrombi
Indicator of whether flow will be
laminar or turbulent Changes in compliance of the veins cause
redistribution of blood between arteries and veins Arterial pressure increases in
 Re = turbulence (> 2000) Factors affecting Reynolds Number: elderly due to lower compliance
• Venoconstriction
1) Viscosity ( viscosity =  Reynolds number)
2) Velocity ( velocity =  Reynolds number)
Costanzo (Physiology, 4th ed.) – Figure 4.6 Costanzo (Physiology, 4th ed.) – Figure 4.7

4
 Cardiovascular System – Vessels Cardiovascular System – Vessels
To stay alive, blood must To stay alive, blood must
Hemodynamics: be kept moving… Hemodynamics: be kept moving…

As noted earlier, blood pressure is not equal throughout system Although mean pressure is high and constant, there are
pulsations of aortic (and arterial) pressure
~ 100
mm Hg
1
High initial pressure: Dicrotic
notch
• Large volume of
blood entering aorta
• Low compliance of
1
aortic wall

Systolic Pressure: Dicrotic notch:

Pressure from ventricular contraction Brief period following
closure of aortic valve
Diastolic Pressure: where pressure drops
due to retrograde flow
Pressure from ventricular relaxation

Costanzo (Physiology, 4th ed.) – Figure 4.8 Costanzo (Physiology, 4th ed.) – Figure 4.9

Cardiovascular System – Vessels Cardiovascular System – Vessels

To stay alive, blood must
Hemodynamics: be kept moving… Pathophysiology:

Although mean pressure is high and constant, there are Several pathologic conditions alter the arterial
pulsations of aortic (and arterial) pressure pressure curve in a predictable way

Arteriosclerosis:

Pulse Pressure:
Systolic pressure – Diastolic pressure  compliance =  systolic pressure C = V/P
• Reflective of stroke volume Aortic stenosis:
Mean Arterial Pressure: Why is it not
Diastolic pressure + 1/3 Pulse pressure + 1/2 pulse pressure?

 Stroke volume =  systolic pressure

Costanzo (Physiology, 4th ed.) – Figure 4.9 Costanzo (Physiology, 4th ed.) – Figure 4.10

Cardiovascular System – Vessels Cardiovascular System – Vessels

To stay alive, blood must To stay alive, blood must
Hemodynamics: be kept moving… Hemodynamics: be kept moving…

As noted earlier, blood pressure is not equal throughout system As noted earlier, blood pressure is not equal throughout system
Pulsations in large arteries greater than aorta
~ 100 ~ 100 • Pressure wave travels faster than blood ~ 100 ~ 100 ~ 50 ~ 20 ~4
mm Hg mm Hg • Pressure waves reflected at branch points mm Hg mm Hg mm Hg mm Hg mm Hg
2 2
Pressure remains high: Pressure remains high:
Largest
Profile similar in
• High elastic recoil of • High elastic recoil of drop pulmonary system
artery walls artery walls but with much lower
• Pressure reservoir • Pressure reservoir pressures (25 / 8)
Energy
1 2 1 2 consumed
3 to overcome
frictional
Dramatic drop in pressure:
forces
• High resistance to flow 4
3
4
Pressure continues to drop:
• Frictional resistance to flow
• Filtration of fluid out of
Blood return assisted by:
capillaries
• Large lumen ( resistance)
• Valves
Costanzo (Physiology, 4th ed.) – Figure 4.8 Costanzo (Physiology, 4th ed.) – Figure 4.8 • Muscular pumps

5
 Note:
Cardiovascular System – Vessels Cardiovascular System – Vessels
Equation deceptively simple;
in reality, cardiac output and
Blood Pressure Regulation: Blood Pressure Regulation:
peripheral resistance are not
independent of each other
Factors Affecting Blood Pressure:
Mean arterial pressure (Pa) is the driving force for blood flow, and
must be maintained at a high, constant level *
Blood Volume
( Blood Volume =  BP)

Difference in blood pressure ( P)

Blood Flow (Q) =
Peripheral resistance (R) Mean Arterial Pressure (Pa) = Cardiac Output (Q) x Peripheral
Resistance (R)
Cardiac Output * Vessel Diameter *
( CO =  BP) ( D =  R =  BP)

Blood Viscosity
( V =  R =  BP)
Pa is regulated by two major systems that work via
negative feedback to maintain ~ 100 mm Hg Vessel Length
Mean Arterial Pressure (Pa) = Cardiac Output (Q) x Peripheral
( L =  R =  BP)
Resistance (R)
Vessel Elasticity
( VE =  R =  BP)
* Variables that can be readily manipulated

Cardiovascular System – Vessels Cardiovascular System – Vessels

Blood Pressure Regulation: System 1 Blood Pressure Regulation:

Baroreceptor mechanisms are fast, neurally mediated reflexes that attempt Baroreceptor mechanisms are fast, neurally mediated reflexes that attempt
to keep Pa constant via changes in cardiac output and vessel diameter to keep Pa constant via changes in cardiac output and vessel diameter

Baroreceptors:  Pa
(+) (+)
Function:
• Mechanoreceptors (respond to stretch)
•  Pa =  stretch =  firing rate
•  Pa =  stretch =  firing rate
(integration center; medulla) (-)
(+)
While sensitive to absolute level of
pressure, they are most sensitive
rates of changes in pressure cardiovascular
centers in
Location: medulla

• Carotid sinus (increase / decrease in Pa) Decrease in

(+) Increase in
• Glossopharyngeal nerve (IX) HR / contractility (-) (-) (-) (-) vessel diameter
( CO)
• Aortic arch (increase in Pa) ( PR)
• Vagus nerve (X)

Marieb & Hoehn (Human Anatomy and Physiology, 8th ed.) – Figures 18.4 / 19.22 Costanzo (Physiology, 4th ed.) – Figure 4.31

Cardiovascular System – Vessels Cardiovascular System – Vessels

Valsalva Maneuver:
Blood Pressure Regulation: Expiring against a closed glottis; used Blood Pressure Regulation: System 2
to test integrity of baroreceptor reflex

Baroreceptor mechanisms are fast, neurally mediated reflexes that attempt Renin-angiotensin II-aldosterone system is a slow, hormonally mediated
to keep Pa constant via changes in cardiac output and vessel diameter response to keep Pa constant via changes in blood volume

 Pa
(-) Detected by mechanoreceptors
in afferent arterioles
Released by
juxtaglomerular cells
(kidney)
(integration center; medulla) (+) Decapeptide;
(-) no biological activity

cardiovascular
centers in
medulla
(Produced by liver) (lungs / kidneys)
Increase in
(-) Decrease in
HR / contractility (+) (+) (+) (+) vessel diameter
( CO)
( PR)

Costanzo (Physiology, 4th ed.) – Figure 4.31 Costanzo (Physiology, 4th ed.) – Figure 4.33

6
 Cardiovascular System – Vessels Cardiovascular System – Vessels

Blood Pressure Regulation: Blood Pressure Regulation:

Renin-angiotensin II-aldosterone system is a slow, hormonally mediated Additional mechanisms aid in regulating mean arterial pressure
response to keep Pa constant via changes in blood volume
A) Peripheral chemoreceptors C) Antidiuretic hormone (ADH)
(carotid bodies / aortic arch) (posterior pituitary)

(adrenal cortex) (kidney) (hypothalamus) (blood vessels) • Respond to  PO2with vasoconstriction

and increased heart rate aka vasopressin

B) Central chemoreceptors
(medulla oblongata) • Respond to an  serum osmolarity and
a  in blood pressure
• Respond to primarily to  PCO2 and  pH
• Triggers vasoconstriction (V1 receptors)
Brain becomes ischemic
D) Atrial natriuretic peptide (ANP)
 PCO2 and  pH (atria)
 Blood Volume
Increased sympathetic outflow

BIG RED BUTTON

Intense arteriolar vasoconstriction in

peripheral capillary beds • Respond to an  in blood pressure
Redirects blood • Triggers vasodilation and  H2O excretion
Costanzo (Physiology, 4th ed.) – Figure 4.33 to brain

Cardiovascular System – Vessels Cardiovascular System – Vessels

Functions of the arterioles, capillaries,

Microcirculation: Microcirculation:
lymphatic vessels, and veins

Fluid movement across a capillary wall is driven by the

Heart Starling pressures across the wall
Exchange across capillary wall:
capillary
(lipid soluble) (water soluble) Starling equation:
Pc c
O2 / CO2 Fluids Solutes
Jv = Kf [(Pc – Pi) – (c – i)] Kf
interstitial fluid
Directly through Aqueous clefts
endothelium between cells Pi i
Jv = Fluid movement (mL / min)
Kf = Hydraulic conductance (mL / min  mm Hg) Water permeability of capillary wall (structural property)

Pc = Capillary hydrostatic pressure (mm Hg) Capillary fluid pressure

• Simple diffusion drives exchange of
gases and solutes Pi = Interstitial hydrostatic pressure (mm Hg) Interstitial fluid pressure

• Fluid transfer across membrane occurs c = Capillary osmotic pressure (mm Hg) Capillary osmotic pressure (due to [protein])
via osmosis
i = Interstitial osmotic pressure (mm Hg) Interstitial osmotic pressure (due to [protein])
• Hydrostatic pressure Starling
• Osmotic pressure forces
Direction of fluid movement (Jv) may be into or out of capillary
Filtration = Net fluid movement is out of capillary and into interstitial fluid ((+) number)
Microcirculation
Absorption = Net fluid movement is into capillary and out of interstitial fluid ((-) number)
Marieb & Hoehn (Human Anatomy and Physiology, 8th ed.) – Figure 19.2

Cardiovascular System – Vessels Cardiovascular System – Vessels

In a skeletal muscle of an individual, the In a skeletal muscle of an individual, the

following Starling pressures were measured: following Starling pressures were measured:

Pc = 30 mm Hg Pc = 30 mm Hg
Pi = 1 mm Hg Pi = 1 mm Hg
Kf = 0.5 mL / min  mm Hg Kf = 0.5 mL / min  mm Hg
c = 26 mm Hg c = 26 mm Hg
i = 3 mm Hg i = 3 mm Hg

What is the direction and magnitude What is the direction and magnitude
of fluid movement across this capillary? of fluid movement across this capillary?

Jv = Kf [(Pc – Pi) – (c – i)]

Jv = 0.5 [(30 – 1) – (26 – 3)] Jv = 0.5 (6)
Pc = +30 c = -26 +6
Jv = 0.5 [29 – 23] Jv = 3 mL / min
(filtration)
Jv = 0.5 (6) Jv = 3 mL / min
(filtration) Pi = -1 c = +3

7
 Cardiovascular System – Vessels Cardiovascular System – Vessels

Microcirculation: Microcirculation:

Fluid movement across a capillary wall is not Lymphoid system returns excess fluid to bloodstream
equal along the length of a capillary
Additional Functions:
 Lymph node biopsy
• Produce / maintain / distribute lymphocytes
• Distributes hormones / nutrients / waste products

Arterial end Lymph nodes filter

fluids (99% purified)

+10 Pc = +35 c = -26 Pc = +17 c = -26 -8 Flow of Lymph:

• Originate as pockets
Venous end
• Large diameters / thin walls
• One-way valves (external)
Pi = 0 c = +1 Pi = 0 c = +1

Lymphatic ducts Lymphatic Trunks

Jv = 0.5 (2) What happens to the fluid
not returned to the capillary?
Jv = 1 mL / min
(net filtration) Lymphatic capillaries Lymphatic vessels Collecting Vessels

One-way valves (internal)

Randall et al. (Eckert Animal Physiology, 5th ed.) – Figure 12.37 Marieb & Hoehn (Human Anatomy and Physiology, 8th ed.) – Figure 20.1

Cardiovascular System – Vessels Cardiovascular System – Vessels

Microcirculation: Pathophysiology:
• Lymph from right side of • Lymph from left side of
Flow of Lymph: body above diaphragm head, neck, and thorax
Edema (swelling) results from an increase
Thoracic Duct: in interstitial fluid volume
• Begins inferior to diaphragm
Forms when the volume of fluids filtered out of the capillaries exceeds the
• Empties into left subclavian vein ability of the lymphatics to return it to circulation

Elephantiasis

Right Lymphatic Duct: Jv = Kf [(Pc – Pi) – (c – i)]

• Empties into right subclavian vein
Causes:
1) Increased capillary hydrostatic pressure
• Arteriole dilation
• Deep vein thrombosis
• Heart failure

2) Decreased capillary osmotic pressure

• Severe liver failure (limited protein synthesis)
• Protein malnutrition 4) Impaired lymphatic drainage
• Prolonged standing
3) Increased hydraulic conductance
• Removal / irradiation of lymph nodes
Cisterna chyli: • Severe burn
• Parasitic infection
Chamber that collects lymph from • Inflammation (leaky vessels)
abdomen, pelvis, and lower limbs
Similar to Marieb & Hoehn (Human Anatomy and Physiology, 8th ed.) – Figure 20.2

Cardiovascular System – Vessels Cardiovascular System – Vessels

Special Circulations: Special Circulations:

Blood flow is variable between one organ and another, depending The mechanisms that regulate blood flow are categorized as
on the overall demands of each organ system local (intrinsic) control and neural / hormonal (extrinsic) control
Local controls are most important mechanism for regulating
1) Local control: coronary, cerebral, skeletal muscle, pulmonary,
Interorgan differences in blood and renal circulation
flow results from differences A) Autoregulation
in vascular resistance • Maintenance of constant blood flow in face of changing arterial pressure
Blood flow to specific organs can
increase or decrease depending on Myogenic Hypothesis:
metabolic demands Q = P / R When vascular smooth muscle is
stretched, it contracts
What about the lungs?
Changes in blood flow to an
individual organ are achieved by  BP  BP =  smooth muscle stretch = vasoconstriction
altering arteriolar resistance =
ALTERNATIVELY

 BP =  BP =  smooth muscle stretch = vasodilation

Marieb & Hoehn (Human Anatomy and Physiology, 8th ed.) – Figure 19.13

8
 Cardiovascular System – Vessels Cardiovascular System – Vessels

Special Circulations: Special Circulations:

The mechanisms that regulate blood flow are categorized as The mechanisms that regulate blood flow are categorized as
local (intrinsic) control and neural / hormonal (extrinsic) control local (intrinsic) control and neural / hormonal (extrinsic) control
Local controls are most important mechanism for regulating
Neuronal / hormonal controls are most important
1) Local control: coronary, cerebral, skeletal muscle, pulmonary, 2) Neuronal / Hormonal controls: mechanism for maintaining skin circulation
and renal circulation
B) Active hyperemia A) Neuronal
• Blood flow to an organ is proportional to its metabolic activity • Sympathetic innervation of vascular smooth muscle

C) Reactive hyperemia (Repayment of oxygen ‘debt’) B) Hormonal

• Blood flow to an organ is increased in response to a period of decreased blood flow
Vasodilator metabolites

Histamine Serotonin Prostaglandins

Metabolic Hypothesis: • arteriodilator; venoconstrictor • local vasoconstriction • local vasodilators / vasoconstrictors
O2 delivery to a tissue is matched H+ K+ •  Pc = local edema
CO2 lactate CO2 H+ K+ lactate Back to resting…
to O2 consumption by altering
O2 Fluid
arteriole resistance
Bradykinin
• arteriodilator; venoconstrictor
•  Pc = local edema
Tissues Tissues Tissues

Cardiovascular System – Vessels

Pathophysiology:

Circulatory shock refers to any condition in which

the blood vessels are inadequately filled

A) Hypovolemic Shock B) Vascular Shock C) Cardiogenic Shock

Large-scale blood loss Abnormal expansion of Heart malfunctions
vascular beds due
Thready pulse
to extreme vasodilation

(  HR;extreme
vasoconstriciton)

• Acute hemorrage • Myocardial infarction

• Severe vomiting / diarrhea
• Anaphylaxis (allergies)
• Extensive burns
• Failure of ANS regulation
• Septicemia (bacteria)