Blood Vessels

and Circulation
FLORENCE IVAN C. TUBBAN, RN
Blood vessels outside the heart are divided into two classes:

(1) the pulmonary vessels, which transport

blood from the right ventricle of the heart
through the lungs and back to the left
atrium
(2) the systemic vessels, which transport
blood from the left ventricle of the heart
through all parts of the body and back to
the right atrium
Functions of the Peripheral Circulation
● Carries blood
● Exchanges nutrients, waste products, and gases
with tissues
● Transports substances
● Helps regulate blood pressure
● Directs blood flow to the tissues
GENERAL FEATURES
OF BLOOD VESSEL
STRUCTURE
Except in capillaries and venules, blood vessel walls consist of three layers.
BLOOD VESSEL LAYERS (“TUNICS”)
Tunica intima • Innermost layer
(interna) • Receives nutrients from blood in lumen
• Only one cell thick

Tunica media • Middle layer

• Mostly made of smooth muscle cells, elastin
• protein sheets
• Receives nutrients from blood in lumen

Tunica • Outermost layer

adventitia • Made of loosely woven fibers of collagen, elastic
/externa • Protects, reinforces blood vessel; anchors it in
place
• Vaso vasorum (“vessels of the vessels”)
• ▫ Tunica externa blood vessels are very large,
need own blood supply MNEMONIC: LIMA
•Lumen
•Intima/interna
•Media
•Adventitia/externa
 ● High pressure, thicker than veins, no valves
●
ARTERIES ●
Thick-walled with large diameters
Tunica media has many elastic fibers and little smooth muscle

“Elastic” arteries (conducting arteries)
Muscular arteries (distributing arteries)
Arterioles (smallest arteries)
TYPES
▫ Lots of elastin in tunica externa, media
▫ Stretchy; allows arteries to expand, recoil during systole,
diastole
▫ Absorbs pressure
▫ Largest arteries closest to heart (aorta, main branches of aorta,
pulmonary arteries) have most elastic in walls
▫ Carry blood to organs, distant body parts
▫ Thick muscular layer
▫ Artery branches when they reach organs, tissues
▫ Major systemic vascular resistance regulators
▫ Bulky tunica media (thick smooth muscle layer)
▫ Regulate blood flow to organs, tissues
▫ Contract (vasoconstriction) in response to hormones
/autonomic nervous system, ↓ blood/↑ systemic resistance
▫ Vasodilate (relax) ↑ blood flow to organs/tissues, ↓ systemic
resistance
▫ Ability to contract/dilate provides thermoregulation
 ● Low pressure
● Cannot tolerate high pressure but are distensible → adapts to different

Veins ●
volumes, pressures
Veins that have diameters greater than 2 mm contain valves, which ensure
that blood flows toward the heart but not in the opposite direction

TYPE

Venules • small veins that connect to capillaries

• composed of endothelium resting on a delicate connective tissue layer
• structure of venules, except for their diameter, is very similar to that of
capillaries
• function as significant sites of exchange of nutrients and wastes and white
blood cell emigration
Small veins • slightly larger in diameter than venules
• 0.1-1mm
• All three tunics are present in small veins
• Tunica media contains a continuous layer of smooth muscle cells, and the
connective tissue of the tunica adventitia surrounds the tunica media
Medium-sized veins • collect blood from small veins and deliver it to large veins
• 1-10mm
Large-sized veins • >10mm
• > 5 layers of smooth muscle cells with much collagen
• Return blood to the heart
Capillaries
● Capillaries consist only of endothelium
● A capillary bed is a network of capillaries
● Thoroughfare channels carry blood from arterioles to venules
● Exchange metabolites by diffusion to and from cells
● Fluid moves out of vessel, into interstitial space (space between
blood vessels, cells)

Water-soluble substances (ions) cross capillary wall

through clefts, between endothelial cells, through large
pores in fenestrated capillary walls

Lipid-soluble molecules (oxygen, carbon dioxide)

dissolve, diffuse across endothelial cell membranes
Blood Vessels of the
Pulmonary Circulation
● Moves blood to and from the lungs
● Pulmonary trunk arises from the right
ventricle and divides to form the pulmonary
arteries (left and right), which project to the
lungs
● From the lungs, four pulmonary veins return
blood to the left atrium
Blood Vessels of the Systemic
Circulation: Arteries
● Arteries carry blood from the left ventricle of the heart to all parts
of the body
● AORTA : Leaves the left ventricle to form the: LARGEST ARTERY
■ Ascending aorta
■ Aortic arch
■ Descending aorta
○ Consists of the thoracic aorta and the abdominal aorta
○ Coronary arteries branch from the ascending aorta and
supply the heart
● The following arteries branch from the aortic arch to supply the
head and the upper limbs
■ Brachiocephalic
■ Left common carotid
■ Left subclavian
○ The descending aorta extends through the thorax to the
diaphragm known as thoracic aorta
● Abdominal aorta from 2 common iliac arteries
 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 (
right side of the neck) and the right
subclavian arteries (right upper limb)
■ Left common carotid(left side of neck)
■ Left subclavian( left upper limb)
■ Vertebral arteries branch from the subclavian
arteries
■ 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 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
Thoracic Aorta/Branches
● The thoracic aorta has :
○ Visceral branches that supply the thoracic organs
(esophagus, trachea, parietal pericardium and part of lung)
○ Parietal branches that supply the thoracic wall
● Posterior intercostal arteries (intercostal muscles,vertebrae, SC and
deep muscles of back)
● Superior phrenic artery (diaphragm)
● Internal Thoracic arteries: from subclavian artery; descend along
internal surface of anterior thoracic wall give rise to:
● Anterior intercostal arteries( anterior chest wall)
Abdominal Aorta/Branches
● The abdominal aorta has
■ Visceral branches that supply the abdominal organs
■ Parietal branches that supply the abdominal wall
● 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 artery); and the lower part of the large
intestine (inferior mesenteric artery)
■ The paired arteries supply the kidneys(renal
arteries), adrenal glands (suprarenal arteries), and
gonads ( testicular arteries or ovarian arteries)
● The parietal branches of abdominal aorta supply diaphragm and
abdominall wall
○ Inferior phrenic arteries(diaphragm)
○ Lumbar arteries ( lumbar vertebrae)
○ Median sacral artery (inferior vertebra)
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( UB,
rectum, uterus and vagina)
■ 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 for lateral leg
foot
■ The plantar arteries form the
plantar arch, from which the
digital arteries arise
● The anterior tibial artery becomes the dorsalis
pedis artery
BLOOD VESSELS OF THE
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
Veins of the Head and Neck
● External and Jugular Veins
● External Jugular Veins- more superficial
○ Carry blood from posterior head and neck
● The internal jugular veins drain the dural venous
sinuses(brain) and the veins of the anterior head,
face, and neck
● IJV join subclavian vein on each side to form
brachiocephalic vein that forms SVC
Veins of the Upper Limb
● Can be divided into deep and superficial groups
● 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( cubital fossa)
Veins of the Thorax
● The left and right brachiocephalic veins and the
azygos veins return blood to the superior vena
cava
● Anterior Thoracic Wall- anterior intercostal
veins then empty into internal thoracic veins
which empties into brachiocephalic veins
● Posterior Thoracic Wall- posterior intercostal
Veins of the Abdomen and Pelvis
● Ascending lumbar veins from the abdomen join the
azygos and hemiazygos veins
● Veins from the kidneys (renal vein), adrenal
glands(suprarenal veins), and gonads(testicular and
ovarian veins) directly drains blood into the inferior vena
cava
● Internal Iliac veins returns blood from pelvis joining
external iliac veins from lower limbs to form common iliac
veins- combine to form IVC
● Hepatic Portal System- splenic vein (carries blood from
spleen and pancreas), superior mesenteric vein
● Inferior mesenteric vein empties into splenic vein
● S and I mesenteric veins carry blood from intestines
● Splenic Vein S Mesenteric vein joins to form hepatic portal
vein then enters the liver
○ The hepatic portal vein transports blood to the
liver for processing. Hepatic veins from the liver
join the inferior vena cava
Veins of the Lower Limb
○ Deep and superficial
○ Same as arteries in terms of names
● 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
● Great saphenous veins- originates from medial side
of foot and ascends to medial side of leg and drains
into femoral vein
● Small saphenous veins begins lateral side of foot
then joins popliteal vein which becomes femoral vein
● Femoral vein empties into external iliac vein
The Physiology
of Circulation
 Blood Pressure
● BP is the measure of force
exerted by blood against the
blood vessel walls
● BP moves blood through vessels
● BP can be measured by listening
for Korotkoff sounds produced as
blood flows increases and blood
flow decreases
 Pressure and Resistance
● In a normal adult, blood fluctuates between 120 mm Hg (systolic)
and 80 mm Hg( diastolic) in the aorta. If blood vessels constrict,
resistance to blood flow increases, and blood flow decreases.
● Resistance to blood flow is related to the diameter of blood vessel.
● Smaller the diameter the greater the resistance to blood flow, thus
there is a more rapid decline in blood pressure- usually occurs in
arterioles and capillaries
● Blood pressure declines slowly as blood flows from large to
medium sized arteries
● Resistance to blood flow in veins are low
● Muscular arteries, arterioles and precapillary sphincters are
capable of constricting and dilating.
● Resistance to blood flow increase as vessels constricts and the
blood volume flowing through the vessels decline
Capillary Exchange
● Most exchange across the wall of
capillary occurs by diffusion.
○ Blood pressure, capillary
permeability and osmosis
affect movement of fluid
across the wall of capillaries.
There is a net movement of
fluid from the blood into the
tissues. The fluid gained by
the tissues is removed by the
lymphatic system
Pulse Pressure
● PP is the difference between systolic and
diastolic pressures. Pulse pressure increases
when stroke volume increases.
● Ejection of blood from the left ventricle into the
aorta produces a pressure wave, or pulse,
which travels rapidly along the arteries
● A pulse can be detected when large arteries are
near the body surface
 ● Blood flow through a tissue is usually proportional to the
metabolic needs of the tissue and is controlled by the
precapillary sphincters.
●
Local Control of Blood Flow When sphincter relax, blood flow through the capillaries
increase
● When sphincter contract, blood flow through the capillaries
decreases
Nervous and Hormonal Control of
Blood Flow
● The vasomotor center (sympathetic division)
controls blood vessel diameter. Other brain
areas can excite or inhibit the vasomotor
center.
● Vasomotor tone is the state of partial
constriction of blood vessels.
● Epinephrine and norepinephrine cause
vasoconstriction in most tissues. Epinephrine
causes vasodilation in skeletal and cardiac
muscle (hormonal control)
Regulation of Arterial Pressure
● Mean arterial pressure (MAP) is proportional to cardiac output
times peripheral resistance
● MAP= CO x PR; MAP= HR x SV x PR
● Directly proportional to all
Baroreceptors Reflex
● 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
Chemoreceptor Reflex
● Respond to changes in blood concentrations of O2 and CO2 as well
as pH.
● Carotid Bodies (carotid sinuses) and Aortic bodies (aortic arch) -
chemoreceptors
factors
that
increase
blood
pressure
Hormonal Mechanism
Adrenal Medullary Mechanism
Renin- Angiotensin- Aldosterone Mechanism
Anti Diuretic Hormone
Atrial Natriuretic Hormone
• Epinephrine released from adrenal medulla as a result of
sympathetic stimulation increases heart rate, stroke volume
and vasoconstriction
• Renin is released by the kidneys in response to low blood
pressure
• Renin acts on blood protein angiotensinogen to produce
angiotensin I
• Promotes the production of angiotensin II, via conversion of
angiotensin I through ACE 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
• 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 blood pressure
Blood Pressure
Regulation by
Hormones
Clinical correlates
 ● Blood pressure (BP) elevation to a level that
places patients at increased risk for target
Hypertension organ damage in micro- and macrovascular
beds.
● A.K.A. elevated blood pressure : a serious
medical condition that significantly increases
the risks of heart, brain, kidney and other
diseases. (WHO, 2019)

• The total number of hypertensive Filipinos is more than 12

million, with more than half of them are unaware of their
condition. (DOH, 2017)

• It remains to be the leading cause of illness and said to be

one of the identified precipitating factors of premature death
in the Philippines. (DOH, 2017)

• Heart attack and stroke are the top killer diseases in the
country while 60 percent to 70 percent of Filipinos have not
been treated or have seen a cardiologist. (PHA, 2016)
END OF LECTURE