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The Gravity of Giraffe Physiology

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12

Giraffe Cardiovascular Adaptations to Gravity

Alan R. Hargens∗ , Knut Petterson† , and Ronald W. Millard‡



Professor of Orthopaedic Surgery, University of California, San Diego;

Kungsladugårdsgatan 110, SE 414 76 Göteborg, Sweden; ‡ Professor of Pharmacology & Cell
Biophysics, University of Cincinnati College of Medicine

GRAVITY AND THE CARDIOVASCULAR SYSTEM latory structures according to the Law of Laplace: Px = S/r
(4). Normally, five components determine transmural pres-
The physiological systems of animals have adapted to Earth’s sure in the circulation: (a) the dynamic pressure resulting
gravity over the past hundreds of millions of years. In gen- from cardiac pumping against peripheral resistance to blood
eral, gravitational adaptations of the cardiovascular system are flow; (b) dynamic pressures due to inertial forces of blood
more pronounced in terrestrial species with greater height and during activity (e.g., the footward acceleration of blood in
thus greater gravity-dependent gradients of blood pressure leg vessels at heel strike during locomotion); (c) pressure due
from head to feet. For example, dinosaurs (1), tree-climbing to the finite compliance (volume/pressure characteristics) of
snakes (2), giraffes (3), and other tall animals have evolved the systemic vasculature, especially the veins (this pressure
mechanisms to provide adequate blood flow and nutrition to is commonly called the mean circulatory filling pressure); (d)
their brains while restricting blood flow and tissue swelling extravascular pressure of tissues and interstitial fluid (e.g., total
in their legs. Terrestrial animals of short stature and marine tissue pressure); and (e) an intravascular hydrostatic pressure
animals probably require much less sophisticated cardiovas- due to gravity (gravitational pressure). Although extravascu-
cular adaptive mechanisms. At the other extreme, aquatic lar tissues and fluid have mass, gravity affects extravascular
snakes have little ability to withstand gravity out of water hydrostatic pressures to a minor extent because tissue fluids
and rapidly “faint” when placed head above tail (2). More- are bound within cells or are discontinuous in most extravas-
over, when gravity is absent even over short periods of time, cular spaces (except for cerebrospinal fluid). Structural and
astronauts experience orthostatic intolerance upon readapta- contractile tissues respond dynamically, within physiological
tion to gravity (see Chapter 58). Because humans are rela- limits and over a long period of time, as adaptive structural
tively tall compared to other species of animals, they too have and functional remodeling, to increased (or decreased) levels
developed extensive and sophisticated regulatory mechanisms of physical stress by increasing (or decreasing) their functional
to maintain cerebral perfusion and prevent lower extremity capability and/or mass (5). Although physiological responses
edema while in an upright posture. In fact, most understand- to stress occur within seconds to minutes, longer-term func-
ing of gravitational mechanisms to date relates to observations tional and structural compensatory adjustments to the initia-
in humans. However, taller terrestrial animals, such as the tion of stress are detectable within hours (6).
giraffe, may allow better understanding of the physiological
adaptations to gravity. For example, blood pressure in giraffes
is high to pump blood to their brain, but high blood pres- TRANSCAPILLARY FLUID BALANCE
sures in their feet would theoretically cause severe dependent
edema. Transcapillary fluid shifts between the microcirculation and
Cardiovascular systems generate and regulate blood pres- the surrounding tissues (Figure 12.1) are dictated by capillary Fig. 12.1
sure to provide flow to tissues. This blood flow nourishes tis- surface area and the ability of capillary basement membrane
sues by supplying oxygen (O2 ) and other nutrients, and by and endothelium to retain plasma proteins. These fluid shifts
removing carbon dioxide (CO2 ) and other waste products. are determined by hydrostatic and colloid osmotic pressures
Transmural pressures (Px : pressure gradients from inside to according to the Starling-Landis equation (7):
outside the circulation) dictate the wall stress (S) and degree
of openness or closure (vessel radius r) experienced by circu- J c = L p A[(Pc − Pt ) − σp (πc − πt )] (Equation 1)

94
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G I R A F F E C A R D I O VA S C U L A R A D A P T A T I O N S T O G R AV I T Y 95

Figure 12.1. Starling pressures, which regulate transcapillary fluid balance. Pressure parameters that deter-
mine directions and magnitude of transcapillary exchange include capillary blood pressure Pc , tissue fluid
pressure Pt (directed into capillary when positive or directed into tissue when negative), plasma and cap-
illary colloidal osmotic pressure πc , and tissue fluid colloidal osmotic pressure πt . Precapillary sphincters
(P.S.) regulate Pc and capillary flow. It is generally agreed that a hydrostatic pressure gradient (P t > lymph
pressure Pl ) drains off excess tissue fluid under conditions of net filtration. Relative magnitudes of pressure
in resting tissues are depicted by the size of the arrows. (Reproduced with permission from Hargens AR.
Interstitial Fluid Pressure and Lymph Flow. In: Skalak R, Chien S, eds. Handbook of Bioengineering. New
York: McGraw-Hill; 1986:1–35.)

where Jc = net transcapillary fluid shift, Lp = hydraulic con- rectional transport towards the lymphatic nodes and thoracic
ductivity of capillary wall, A = capillary membrane filtration duct (8).
area, Pc = capillary blood pressure, Pt = tissue fluid pres-
sure, σp = reflection coefficient for plasma proteins, πc =
capillary blood colloid osmotic pressure, and πt = tissue fluid MICROCIRCULATORY ADAPTATION
colloid osmotic pressure. TO GRAVITY
Again, because blood has continuous columns within the
body, local Pc is greatly affected by gravity. On the other hand, Transcapillary ultrafiltration, Jc , in the human calf is signifi-
because tissue fluids are discontinuous in the body, Pt is rela- cantly lower than that in the forearm in supine subjects (9).
tively unaffected by gravity. Although postural changes are associated with increases in
In most tissues, a net flux of fluid and plasma proteins precapillary resistance, altering pressure and flow characteris-
occurs across the capillary membrane (endothelial cells [ECs] tics within exchange vessels of the dependent limb, no changes
and basement membrane), through the interstitial spaces, and occur in the capillary surface area available for exchange
into the lymphatic system (see Figure 12.1). The hydraulic (10). The autonomic regulation of capillary hemodynamics
conductivity of capillary wall Lp is determined by endothelial in dependent limbs appears to involve a veno-arteriolar reflex
function as well as capillary basement membrane thickness. (11). Exploration of dependent limb capillary filtration has
Generally, the reflection coefficient for plasma proteins, σ p , revealed that the α-adrenergic receptor-mediated vasocon-
is determined by the permeability properties of the capillary strictor response in the circulatory system of the human leg is
wall. Some tissues, such as muscle and skin, have relatively high enhanced upon standing and may represent an adaptive mech-
σp (≈0.9) such that protein transport rates are low. In other anism that limits blood pooling and transcapillary ultrafiltra-
tissues that have lower σ p , such as lung and liver, πt is almost tion in the leg during upright position (12). However, should
equivalent to πc . In these tissues, Lp and filtration rates are rel- autonomic nervous system dysfunction (i.e., dysautonomia)
atively high and lymphatic drainage is critical for tissue fluid exist, profound hypotension will occur without the typical
balance. Recent evidence also indicates that lymphatic vessels reflex tachycardia when standing abruptly. In such individ-
have a two-valve system, with primary valves at the level of the uals, dependent limb vasoconstriction control is decreased
initial lymphatic endothelium and a secondary valve system in significantly (13). In this regard, orthostatic hypotension is a
the lumen of the transporting lymphatics that facilitates unidi- common consequence of such dysfunction in elderly patients.
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96 ENDOTHELIAL BIOMEDICINE

Because the human feet and head experience the great- an early, unpublished theory by August Krogh. Thus, πc in
est change in blood pressure with altered vectors of gravity, the giraffe foot offers no unusual resorptive pressure for pre-
it is worthwhile to understand their structure and functional venting dependent edema. Because of rapid circulation and
responses to gravitational stimuli. Previously, we found that mixing of blood within the cardiovascular system, it is diffi-
elevation of blood pressure to the head produced by a transi- cult to imagine how πc could be significantly higher in the
tion from 60 degrees head-up tilt (HUT) to 6 degrees head- dependent tissues of the giraffe. Although some Pt values in
down tilt (HDT) increases microcirculatory blood flow in the neck were negative, the average bodily Pt ranged between
skin of the head (14). This pressure and flow increase may 1 and 6 mm Hg, except under the tight skin and fascia of
be expected in a tissue not commonly exposed to increased the extremities, where mean Pt was 44 mm Hg. Interestingly,
blood pressure and therefore, not able to regulate blood flow πt in legs was very low (1 mm Hg), except in foot samples
closely to prevent edema. On the other hand, moving the that were contaminated by blood. This finding provided evi-
body from 6-degree HDT to 60-degree HUT actually reduces dence that giraffe capillaries are highly impermeable to plasma
microcirculatory flow in the foot. This response suggests that proteins and that σ p approximates unity in lower limbs. This
the microcirculation of the lower body, normally adapted to conclusion was supported by studies of peripheral lymph that
upright posture on Earth, is able to regulate capillary pres- indicated only trace amounts of protein were present and πl
sure and flow adequately to prevent dependent edema. Com- equaled zero.
bined with vasoconstriction and a thicker capillary basement Of importance, we found that the blood and tissue
membrane in dependent tissues to reduce hydraulic conduc- fluid pressures that determine transcapillary ultrafiltration
tivity (15), other mechanisms for preventing dependent edema are highly variable with exercise (Figure 12.3). These pres- Fig. 12.3
include lymphatic drainage (7) and venous pumps in the leg sures, combined with a tight skin and fascial “antigravity suit,”
(16). move venous blood and tissue fluid upward against grav-
ity, thus preventing pooling of blood and edema in depen-
dent tissues. More proximally, an active skeletal-muscle pump
GRAVITATIONAL PHYSIOLOGY aids venous return. The nonhydrostatic pressure gradient
IN THE GIRAFFE down the giraffe’s jugular vein indicates that blood cascades
down from the head, and that circulation above heart level
The giraffe, Giraffa camelopardalis, represents a unique mam- does not depend on a siphon-like principle, as earlier pro-
malian model for developmental studies of tissue adaptation posed (21). Other edema-preventing mechanisms include
to increasing load bearing. Whereas fetal giraffes develop in dependent precapillary vasoconstriction, abundant lympha-
a quasi-weightless milieu, postpartum giraffes must contend tic drainage, and very low capillary permeability to plasma
with increasing load bearing in their dependent tissues as they proteins.
grow to heights of over 5 meters. Previous studies of the adult Developmental alterations are present in the load-bearing
giraffe cardiovascular system (17–19) indicate that this system tissues of newborn compared with adult giraffes (22). For
is certainly a unique model for investigating the physiology of example, vascular wall thickness closely relates to local blood
being tall and adaptations to large and variable gradients of pressure in the developing giraffe. Tissue samples were col-
blood pressure. These early studies of blood pressures doc- lected from four 5- to 6-year-old, 3.5- to 4-meter, male and
ument that arterial pressure near the giraffe heart is about female giraffes during the 1985 Giraffe Physiology Expedition;
twice that in humans to provide more normal blood pressure and from three newborns and two 25- and 35-year-old, 5-
and perfusion to the brain. In the context of higher systemic meter adult giraffes from the Cincinnati and Cheyenne Moun-
blood pressure and longer hydrostatic columns of blood from tain Zoos. Arterioles and other microcirculatory vessels were
heart to feet, the giraffe circulatory system exhibits significant sampled from skin and muscle of the head, neck, thorax, legs,
increases in vascular wall muscle thickness, capillary basement and feet. Although we never had the opportunity to mea-
membrane thickness, and other vascular control systems in sure blood pressures in newborn giraffes, based on compa-
dependent blood vessels that, in concert, participate in capil- rable studies of other species, the arterial pressures of baby
lary fluid dynamics and edema prevention. giraffes are probably significantly lower at heart level and in
During the 1985 Giraffe Physiology Expedition to Africa, dependent tissues than are those in adult giraffes. It is appar-
our studies focused on hemodynamic adaptations and edema ent that dependent arteries in adults had much thicker walls
prevention in the legs of adult giraffes (3,20). Mean values for than did those in newborn giraffes (Figure 12.4). In adult Fig. 12.4
arterial and venous pressures for giraffes and humans qual- animals, arterial wall hypertrophy correlates directly with the
itatively match the expected gravitation pressure gradients, degree of tissue dependency (Table 12-1). Thus, the wall Table 12.1
using the heart as a reference for fluid discontinuity between thickness-to-lumen ratios of large arteries increase from head
Fig. 12.2 the head and foot (Figure 12.2). Although Pc was not mea- to foot (except for one “ankle” artery that didn’t follow this
sured directly in the giraffe, it is probably near local venous pattern).
pressure (Pv ) in the feet (150 mm Hg) and nearly 10 to 20 We believe the developing giraffe provides an excellent
mm Hg at the top of the giraffe’s neck (3). Importantly, πc was model for investigations of adaptive mechanisms to natural
identical in the giraffe and human and, therefore, contrary to hypertension found in the adult giraffe. Arteries of the feet
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G I R A F F E C A R D I O VA S C U L A R A D A P T A T I O N S T O G R AV I T Y 97

Figure 12.2. Mean arterial Pa , venous Pv , and Starling pressures (Pc , πc , Pt , and πt ) in giraffe (right) as
compared to human (left) at hydrostatic levels between the head and feet. In the giraffe, lymph samples
obtained from the leg had only trace amounts of protein and π1 = 0. Foot samples for π t often were
contaminated by blood and therefore were less reliable. Pt beneath the tight skin and fascia of the legs ranged
between 40 and 50 mm Hg and indicated the presence of a “natural anti-G suit” in the giraffe. Data for
pressures in humans are obtained from several sources in addition to our previous studies. (Reproduced
with permission from Hargens AR, Millard RW, Pettersson K, van Hoven W, Gershuni DH, Johansen K.
Transcapillary Fluid Balance in the Giraffe. In: Staub ND, Hogg JC, Hargens AR eds. Interstitial-Lymphatic
Liquid and Solute Movement, Advances in Microcirculation. Basel, Switzerland: S. Karger; 1987:195–202.)

are exposed to blood pressures greater than 400 mm Hg in capillary basement membrane thickness. The measurements
adult giraffes (3). These vessels have developed pronounced in human samples illustrate a significant age-dependent effect,
smooth-muscle hypertrophy and narrow lumens to accom- with the thickest basement membrane measured in the adult
modate these extraordinarily high blood pressures. Our pre- capillaries. The results also illustrate increased CBMW in the
vious report of a less-than-normal arterial pressure gradient lower legs of adults. CBMW in human infants ranges from
from heart to foot in the upright, stationary giraffe (3) sug- 538 to 563 Å and does not vary significantly with anatomic
gests that the reduction in lumen cross-sectional area plays location. In children, CBMW is significantly thicker (806 to
some role in blood pressure reduction to dependent tissues. 1,076 Å) in all anatomical sites sampled (pectoral, abdomi-
It is interesting that the arterial wall hypertrophy apparently nal, thigh, calf) than that in the same sample sites of infants.
is confined to dependent vessels with diameters over 400 μm As in infants, no difference in the CBMW is noted among
microns in adults and is not observed in newborn giraffes or anatomical locations in children. In contrast, the CBMW of
in vessels near the head of adult giraffes. adults is significantly greater than that in children and infants,
and shows progressive thickening in dependent tissues mov-
ing down toward the feet (pectoral = 964 Å, calf = 1,894 Å).
CAPILLARY BASEMENT MEMBRANE OF THE In giraffe, the CBMW increases from 780 Å at the neck to
GIRAFFE VASCULAR SYSTEM 1,437 Å in the front and hind legs. These data are con-
sistent with the hypothesis that CBMW is strongly influ-
In 1971, Williamson and co-workers (15) measured the capil- enced by intravascular hydrostatic pressure, which is most
lary basement membrane width (CBMW) in muscle obtained extreme in the long hydrostatic column of the giraffe circu-
from human infants (n = 19, 9F/1M, 1-day to 6-month-olds), latory system. This increase in CBMW in the leg of giraffes
children (n = 4, 1F/3M, 3- to 5-year-olds), and adults (n = may be an important contributing factor to microcirculatory
17, 6F/11M, 36- to 75-year-olds) obtained within 6 hours post- fluid homeostasis in dependent tissues with high intravascular
mortem. They also evaluated muscle from one adult giraffe for pressure.
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98 ENDOTHELIAL BIOMEDICINE

Figure 12.3. Range of averaged mean blood and tissue fluid pressures in neck and foot of walking giraffes.
Negative venous and subcutaneous pressures during exercise help prevent dependent edema. With head
upright, mean arterial pressure below the jaw ranged between 36 and 155 mm Hg (e.g., 145/55 mm Hg for
systolic/diastolic pressures). Drinking water in head-down posture raised carotid pressures to 330/240 mm
Hg. (Reproduced with permission from Hargens AR, Millard RW, Pettersson K, van Hoven W, Gershuni DH,
Johansen K. Transcapillary Fluid Balance in the Giraffe. In: Staub ND, Hogg JC, Hargens AR eds. Interstitial-
Lymphatic Liquid and Solute Movement, Advances in Microcirculation. Basel, Switzerland: S. Karger; 1987:195–
202.)

Figure 12.4. Four-hundred-micron diameter artery from foot skin of adult giraffe has thick wall (left)
compared with a similar artery from foot skin of newborn giraffe (right).
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G I R A F F E C A R D I O VA S C U L A R A D A P T A T I O N S T O G R AV I T Y 99

Table 12-1: Ratios of Smooth-Muscle Wall Thickness/ Table 12-2: Innervation of Giraffe Vasculature
Lumen Radius (w/r) for Arteries from the Neck to the Feet
of Adult Giraffes Adventitial Media
Innervation Innervation
Artery w/r Outer Diameter (mm)
Load bearing Tibial artery + −
Carotid 0.15–0.20 9.5–1.0 vessels Popliteal artery ++ −
Brachial 0.33–0.43 5.5–7.5 Metatarsal artery + −
Femoral 0.65–0.68 4.0–4.2 Tarsal artery ++ +
Ulnar 0.70 7.2 Saphenous vein − −
Radial 0.70 5.4 Metatarsal vein − −
“Ankle” 0.33 4.6 Central vessels Ascending aorta ++ ++
Metatarsal 0.51–0.81 3.1–4.8 Pulmonary artery + −
Digital 0.56 4.0 Superior caval vein − −
Inferior caval vein − −
(Reproduced with permission from Hargens AR, Gershuni DH, Danzig LA,
Millard RW, Pettersson K. Tissue adaptations to gravitational stress: newborn Head and neck Carotid artery +++ +++
versus adult giraffes. Physiologist. 1988;31:S110–S113.) Jugular vein + −

The density of nerve terminal (axons) near smooth muscle cells ranges from −
(no nerves observed) to +++ (a dense network present).
INNERVATION OF THE GIRAFFE (Reproduced with permission from Nilsson O, Booj S, Dahlstrom A, Hargens
VASCULAR SYSTEM AR, Millard RW, Pettersson KS. Sympathetic innervation of the cardiovascular
system in the giraffe. Blood Vessels. 1988;25:299–307.)
Giraffes are tall animals, and changing posture will there-
fore cause major circulatory changes, including an increase
of hydrostatic pressure in the head and neck during head- of the outermost layer of the media is found. The ascending
down drinking. However, the structure of the cardiovascular aorta has a denser innervation, with sympathetic fibers fre-
system in the giraffe is adapted gravitationally to the normal quently penetrating into the outer medial layers. The carotid
upright posture of the animal. Because short-term regulation arteries have the densest innervation of all arteries. The nerves
of blood pressure and flow is determined by activity in the penetrate deep into the media, with fibers reaching almost to
sympathetic nervous system, we examined and compared the the intima layer.
innervation of different segments of the cardiovascular system In veins, the sympathetic innervation is sparse. In fact,
(23). In general, efferent, sympathetic nerves control cardiac veins from the lower part of the body and caval veins appear
function, arterial resistance, and venous capacitance. devoid of adrenergic innervation. However, NF-positive, par-
Tissue specimens were obtained from two young male avascular axon bundles are found, and the expected adrenergic
giraffes killed as a part of a conservation-culling program fibers at the medioadventitial border are absent. In the jugular
in Africa. We used antisera against dopamine-β-hydroxylase veins, however, we observed such adrenergic fibers, although
(DβH, marker of adrenergic nerves), neuropeptide Y (NPY, a their density still appears sparse.
peptide transmitter in sympathetic nerves), as well as gen- These observations show that a sympathetic innervation of
eral markers for nerve terminals (synapsin 1) and nerve the vascular system exists in giraffes, but the innervation pat-
fibers/axon bundles (neurofilament, NF). With these anti- tern is nonuniformly distributed. It is surprising that the caval
bodies, a network of nerve terminals and fibers were demon- and load-bearing veins apparently lack sympathetic innerva-
strated. The distribution of nerve elements were similar using tion. This is in sharp contrast to man, wherein veins in the
different antisera. However, although all antibodies visual- extremities, and especially capacitance veins, have a rich sup-
ized varicose nerve terminals indicative of adrenergic fibers, ply of adrenergic fibers, the activity of which is important for
Table 12.2 the NF antibody also marked nonautonomic axon bundles venous return from the legs (24). We can only speculate on
(Table 12-2). why giraffes lack this type of innervation, or alternatively, use
In all arterial blood vessels, a network of nerve terminals other transmitters than those for which we stained. However,
with DβH-, NPY-, and Syn1-positive fibers is found. NF- the larger veins in the legs of giraffe run beneath both the tight
positive fibers are sparsely located at the medioadventitial bor- skin and a stiff fascia. Thus, the capacitance of these veins may
der, and thick paravascular bundles are found frequently. In be limited despite their high venous pressures reported (see
the medial layer of the popliteal artery, NF-positive nerve fibers above), so little capacitance is present to regulate.
also are observed; but the other antibodies used give no label- Sympathetic nerves were, however, found in the jugular
ing, indicating that the nerves are not adrenergic. In general, vein. During upright posture, these veins do not need active
arteries from the extremities have a relatively sparse innerva- regulation, but this could be important during head-down
tion and are usually restricted to the medioadventitial border, drinking, when the pressure gradient is reversed and jugu-
although some evidence for a sparse sympathetic innervation lar pressure increases. Valves also are present in the jugular
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100 ENDOTHELIAL BIOMEDICINE

veins (25), and these could—together with sympathetic


nerves—contribute to prevent blood flow in the retrograde
direction and pooling of blood in the head during those short r To investigate cerebral circulations, in order to un-
periods when giraffes lower their head below heart level to derstand adaptive mechanisms during head-down
drink. drinking behavior in giraffes.
The innervation of limb arteries is similar to that found in
most mammalian species, and innervation is restricted largely
to the medioadventitial border. However, as the thickness of
the medial layer can be extreme in these vessels, the efficiency
in the spreading of excitation from the nerves must be very ACKNOWLEDGMENTS
efficient if these nerves are to control the contractions of the
entire medial sheet. The density of the innervation of large These studies were supported by grants from NSF (DCB-8409253),
arteries increases from foot to head. In the aorta, we found NIH (HL-32703), National Geographic Society (3072–85), Depart-
fibers in the outer medial layer. In the carotid arteries, sympa- ment of Veterans Affairs, and NASA. We thank Professor Wouter
van Hoven and the Department of Zoology, University of Pretoria,
thetic fibres are found penetrating deep into the media, almost
South Africa, for providing giraffes and facilities for our 1985 Giraffe
reaching the intima layer. The physiological significance of Physiology Expedition. We thank Dr. D.G.A. Meltzer and Roodeplaat
this dense innervation is not known. However, the pattern we Research Labs, Dr. Richard Burroughs and the National Zoological
observed is consistent with an adaptive pattern, with dense Gardens in Pretoria, and Dr. Frik J. Stegmann and the University of
innervation in vessels subjected to the largest transient fluctu- Pretoria Veterinary School at Onderstepoort. We thank Dr. Paul Calle,
ations during head-down drinking, and a less dense sympa- the Cheyenne Mountain Zoo, and the Cincinnati Zoo for providing
thetic innervation occurring in the vasculature of load-bearing specimens of baby and aged giraffes.
tissues.
In summary, our results concerning tissue adaptations to
increased load bearing in the developing giraffe, along with REFERENCES
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