o The blood vessels of the body form a network more complex than an interstate highway system.

The blood
vessels carry blood to within two or three cell diameters of nearly all the trillions of cells that make up the
body. Blood flow through them is regulated, so that cells receive adequate nutrients and so that waste
products are removed. Blood vessels remain functional, in most cases, in excess of 70 years. And like many
other structures of the body, when blood vessels are damaged, they repair themselves.

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, and
(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 CIRCULATORY SYSTEM

1. Carries blood. Blood vessels carry blood from the heart to all the
tissues of the body and back to the heart.
2. Exchanges nutrients, waste products, and gases with tissues.
Nutrients and O2 diffuse from blood vessels to cells in essentially
all areas of the body. Waste products and CO2 diffuse from the
cells, where they are produced, to blood vessels.
3. Transports substances. Blood transports hormones, components
of the immune system, molecules required for coagulation,
enzymes, nutrients, gases, waste products, and other
substances to and from all areas of the body
4. Helps regulate blood pressure. The circulatory system and the
heart work together to regulate blood pressure within a normal
range.
5. Directs blood flow to the tissues . The circulatory system directs
blood to tissues when increased blood flow is required to
maintain homeostasis.

GENERAL FEATURES OF BLOOD VESSEL STRUCTURE

o Arteries - carry blood away from the heart; usually, the blood is oxygenated (oxygen-rich). Blood is
pumped from the ventricles of the heart into large, elastic arteries, which branch repeatedly to form
progressively smaller arteries.
o Capillaries - it is at the capillaries where exchange of substances such as O2, CO2, nutrients, and other
waste products occurs between the blood and the tissue fluid.
o Veins - carry blood toward the heart; usually, the blood is deoxygenated (oxygen-poor).

From the inner to the outer wall, the tunics are (1) the tunica intima, (2) the tunica media, and (3) the tunica
adventitia, or tunica externa

1. Tunica intima or innermost layer - consists of an endothelium composed of simple squamous epithelial
cells, a basement membrane, and a small amount of connective tissue.
2. Tunica media or middle layer - consists of smooth muscle cells arranged circularly around the blood
vessel. It also contains variable amounts of elastic and collagen fibers, depending on the size and type
of the vessel.
 3. Tunica adventitia - is composed of dense connective tissue adjacent to the tunica media; the tissue
becomes loose connective tissue toward the outer portion of the blood vessel wall.

Arteries

Elastic arteries - are the largest-diameter arteries and have the

thickest walls. . Elastic arteries stretch when the ventricles of the heart
pump blood into them. The elastic recoil of these arteries prevents
blood pressure from falling rapidly and maintains blood flow while the
ventricles are relaxed.

Muscular arteries - include medium-sized and small arteries. The walls

of medium-sized arteries are relatively thick compared to their
diameter.

Distributing arteries - because the smooth muscle tissue enables

these vessels to control blood flow to different body regions.

Vasoconstriction ( Contraction) - decreases blood vessel diameter and

blood flow.

Vasodilation (Relaxation) - increases blood vessel diameter and blood

flow.

Arterioles - transport blood from small arteries to capillaries. Arterioles are the smallest arteries in which the
three tunics can be identified.

Capillaries

 Blood flows from arterioles into capillaries. Capillaries branch to form networks
 Precapillary sphincters - these precapillary sphincters are located at the origin of the branches of the
capillaries and, by contracting and relaxing, regulate the amount of blood flow through the various
sections of the network.
 Endothelium - which is a layer of simple squamous epithelium surrounded by delicate loose
connective tissue.

Veins

 Blood flows from capillaries into venules and from venules into small veins.
 Venules - have a diameter slightly larger than that of capillaries and are composed of endothelium
resting on a delicate connective tissue layer
 Valves - which ensure that blood flows toward the heart but not in the opposite direction

BLOOD VESSELS OF THE PULMONARY CIRCULATION

o Pulmonary circulation - is the system of blood vessels that carries blood from the right ventricle of the heart
to the lungs and back to the left atrium of the heart.
o Pulmonary veins - exit the lungs and carry the oxygenated blood to the left atrium.
o Pulmonary trunk –
 The pulmonary trunk then branches into the right and left pulmonary arteries, which extend to the
right and left lungs, respectively.
Varicose - veins result when the veins of the lower limbs become so dilated that the cusps of the valves no
longer overlap to prevent the backflow of blood.
Thromboses – is the formation of a blood clot inside a blood vessel, obstructing the flow of blood through the
circulatory system.
Phlebitis - is inflammation of a vein, usually in the legs. It most commonly occurs in superficial veins. Phlebitis
often occurs in conjunction with thrombosis and is then called thrombophlebitis or superficial thrombophlebitis.
Gangrene - is a type of tissue death caused by a lack of blood supply. Symptoms may include a change in
skin color to red or black, numbness, swelling, pain, skin breakdown, and coolness.
Emboli - is an unattached mass that travels through the bloodstream and is capable of creating blockages.
When an embolus occludes a blood vessel, it is called an embolism or embolic event.

BLOOD VESSELS OF THE SYSTEMIC CIRCULATION: ARTERIES

 The systemic circulation is the system of blood vessels that carries blood from the left ventricle of the heart
to the tissues of the body and back to the right atrium. Oxygenated blood from the pulmonary veins passes
from the left atrium into the left ventricle and from the left ventricle into the aorta. Arteries distribute blood
from the aorta to all portions of the body.

Aorta

All arteries of the systemic circulation branch directly or indirectly from the aorta. The aorta
is usually considered in three parts—(1) the ascending aorta, (2) the aortic arch, and (3)
the descending aorta.

 Ascending aorta - is the part of the aorta that passes superiorly from the left
ventricle.
 Coronary arteries - arise from the base of the ascending aorta and supply blood to
the heart
 Aortic arch – is the top part of the main artery carrying blood away from the heart.
Aortic arch syndrome refers to a group of signs and symptoms associated with
structural problems in the arteries that branch off the aortic arch.

Three major arteries, which carry blood to the head and upper limbs, originate from the
aortic arch: (1) the brachiocephalic artery, (2) the left common carotid artery, and (3) the
left subclavian artery

 Descending aorta - is the longest part of the aorta. It extends through the thorax and abdomen to the
upper margin of the pelvis.
 Thoracic aorta - is a bulge in the part of your aorta that runs through your chest. It forms when your aorta
wall grows weak from plaque, connective tissue disorders or other factors.
 Common iliac arteries - branches off from the bottom part of the abdominal aorta (the largest blood
vessel in the abdomen) into the right common iliac artery and left common iliac artery. Each common
iliac artery further branches into an external iliac
 Abdominal aorta - is the largest artery in the abdominal cavity. As part of the aorta, it is a direct
continuation of the descending aorta (of the thorax). Abdominal aorta. Segments of the aorta, with
both suprarenal and infrarenal abdominal aorta. The abdominal aorta and its branches.
 Arterial aneurysm - is a localized dilation of an artery that usually develops in response to trauma or a
congenital (existing at birth) weakness of the artery wall.
Arteries of the Head and Neck

o Brachiocephalic artery – is one of the three great vessels of the aortic arch that supplies blood to the
head, neck and upper extremities.
o Right common carotid artery - which transports blood to
the right side of the head and neck
o Right subclavian artery - which transports blood to the right
upper limb
o Left common carotid artery - transports blood to the left
side of the head and neck,
o Left subclavian artery - transports blood to the left upper
limb.
o Carotid sinus - which contains structures important in
monitoring blood pressure
o External carotid arteries - have several branches that
supply the structures of the neck, face, nose, and mouth.
o Internal carotid arteries - pass through the carotid canals
o Cerebral arterial circle -
o Vertebral arteries - which branch from the subclavian arteries and pass to the head through the
transverse foramina of the cervical vertebrae.
o Basilar - is the main artery that carries blood to the back portion of your brain. It forms where the blood
vessels that extend through your spinal cord (vertebral arteries) come together. The basilar artery and all
its branches are called the vertebrobasilar system.
o Artery - a critical part of your cardiovascular system, are blood vessels that distribute oxygen-rich blood
to your entire body. These tube-like vessels and the muscles inside them ensure your organs and tissues
have the oxygen and nutrients they need to function.

Arteries of the Upper Limbs

The arteries of the upper limbs are named differently as they pass into different
body regions, even though no major branching occurs.

 Axillary artery - is the main artery of the upper extremity and originates as a
continuation of the subclavian artery at the lateral margin of the first rib.
 Brachial artery - is the major blood vessel supplying blood to your arms. It
starts just below your shoulder and runs down through your elbow, stopping
where your forearm begins.
 Ulnar artery - is a blood vessel in your arm. It supplies oxygen-rich blood to
your forearms, wrists and hands. The ulnar artery is one of the two branches
of the brachial artery. The other branch is the radial artery.
 Radial artery - supplies the posterolateral aspect of the forearm as well as
vascular territories, including the elbow joint, carpal bones, thumb, and
lateral index finger.

Thoracic Aorta and Its Branches

The branches of the thoracic aorta can be divided into two groups: The visceral arteries supply the thoracic
organs, and the parietal arteries supply the thoracic wall.

 Posterior intercostal arteries - which arise from the thoracic aorta and extend between the ribs. They
supply the intercostal muscles, the vertebrae, the spinal cord, and the deep muscles of the back.
  Superior phrenic - are small branches arising either side from the lower part of the thoracic aorta just
before it passes through the aortic hiatus.
 Internal thoracic arteries - supplies the breast and the anterior chest wall. The internal thoracic artery
travels along the inner surface of the anterior chest wall on both sides.
 Anterior intercostal arteries - which extend between the ribs to supply the anterior chest wall

Abdominal Aorta and Its Branches

The branches of the abdominal aorta, like those of the thoracic aorta,
can be divided into visceral and parietal groups. The visceral arteries
are divided into paired and unpaired branches. There are three major
unpaired branches: (1) the celiac trunk, (2) the superior mesenteric
artery, and (3) the inferior mesenteric artery.

 Renal arteries - carry a large volume of blood from the heart to

the kidneys. The kidneys filter waste and excess fluid from the
blood.
 Suprarenal arteries - the aorta on each side between the
inferior phrenic artery and the renal artery. They run laterally
across the diaphragmatic crura.
 Testicular arteries - a branch of the abdominal aorta,
descends through the inguinal ring into the cranial border of
the spermatic cord in a tortuous manner and divides near the
testis into several branches to supply the testis and epididymis
 Ovarian arteries - is an artery that supplies oxygenated blood to
the ovary in females. It arises from the abdominal aorta below
the renal artery.
 Inferior phrenic arteries - are paired branches of the abdominal aorta/celiac trunk supplying the
diaphragm. Their importance lies with the fact that the right inferior phrenic artery is the most common
extrahepatic arterial supply of a hepatocellular carcinoma.
 Lumbar arteries - are the four pairs of branches of the abdominal aorta found on the posterior
abdominal wall. These arteries arise in series with the posterior intercostal arteries and complete the
abdominal portion of the vascular supply of the posterior trunk wall.
 Median sacral artery - arises from the abdominal aorta at the level of the bottom quarter of the third
lumbar vertebra. It descends in the middle line in front of the fourth and fifth lumbar vertebrae, the
sacrum and coccyx, ending in the glomus coccygeum (coccygeal gland).

Arteries of the Pelvis

o Common iliac arteries - is a large artery of the abdomen paired on each side. It originates from the aortic
bifurcation at the level of the 4th lumbar vertebra.
o External iliac artery - provides the main blood supply to the legs. It passes down along the brim of the
pelvis and gives off two large branches - the "inferior epigastric artery" and a "deep circumflex artery."
o Internal iliac artery - is the primary artery supplying the pelvic viscera and an important contributor to
structures of the pelvic wall, perineum, gluteal region, and thigh.

Arteries of the Lower Limbs

o Femoral artery - is a major blood vessel in your body. It carries blood from the bottom of your abdomen
down through your lower limbs. This artery starts in the upper front part of your thigh, near the groin.
 o Popliteal artery - is located behind your knee and runs behind your knee pit. Below your knee joint, the
arteries divide into the anterior tibial artery and the tibioperoneal (or tibiofibular) trunk.
o Anterior tibial artery - arises from the popliteal artery in the popliteal fossa and continues distally as the
dorsalis pedis artery.
o Posterior tibial artery - is the direct continuation of the tibioperoneal trunk. It descends in the posterior
compartment, lying on posterior tibialis for most of its course and covered by gastrocnemius and soleus
muscles.
o Dorsalis pedis artery - is a main artery of the foot. It is a continuation of the anterior tibial artery as it
crosses the ankle joint.
o Fibular artery - is the posterior lateral branch of the tibial-peroneal trunk in the lower extremity just distal
to the popliteal fossa.

BLOOD VESSELS OF THE SYSTEMIC CIRCULATION: VEINS

 The superior vena cava returns blood from the head, neck, thorax, and upper limbs to the right atrium
of the heart, and the
 The inferior vena cava returns blood from the abdomen, pelvis, and lower limbs to the right atrium

Veins of the Head and Neck

o External jugular veins - located in the anterior and lateral neck,

receives blood from the deeper parts of the face as well as the
scalp — the external jugular vein forms from the combination of the
posterior auricular and retromandibular vein.
o Internal jugular veins - is a paired venous structure that collects
blood from the brain, superficial regions of the face, and neck, and
delivers it to the right atrium.
o Subclavian veins - is classified as a deep vein and is the major venous
channel that drains the upper extremities.
o Brachiocephalic veins - helps return oxygen-poor blood from your
head, neck and arms back to your heart. It's a paired vein, meaning
you have one on each side of your body (right and left). Each
brachiocephalic vein begins at the place where your subclavian
vein and internal jugular vein meet.

Veins of the Upper Limbs

Brachial veins - which accompany the brachial artery and empty into the axillary vein.

Cephalic vein - is a superficial vein of the upper limb and it's one of the two main veins of
the arm. Its name derives from 'cephalic' meaning head, as the vein runs up to the
shoulder.

Axillary vein - is a large blood vessel that conveys blood from the lateral aspect of the
thorax, axilla (armpit) and upper limb toward the heart.

Basilica vein - runs down the ulnar side of the arm, and also helps in draining the dorsal
venous network of the hand. It is shorter than the cephalic vein, and terminates once it
joins the brachial vein near the elbow.
 o Median cubital vein - located in the triangular area inside the elbow known as the cubital fossa. It is a
superficial vein, meaning that it lies close to the skin, making it a preferred site for drawing blood and
establishing intravenous access.
o Cubital fossa - is a superficial vein of the arm on the anterior asepct of the elbow. It classically connects
the cephalic vein and the basilic vein.

Veins of the Thorax

o Left brachiocephalic veins - helps return oxygen-poor blood from your head, neck and arms back to your
heart.
o Right brachiocephalic veins - is about 2.5cm long. The right vein is formed by the confluence of the right
subclavian vein and the right internal jugular vein.
o Anterior intercostal veins - are the veins which drain the anterior intercostal space.
o Internal intercostal veins
o Posterior intercostal veins
o Hemiazygos vein - is a vein running superiorly in the lower thoracic region, just to the left side of the
vertebral column
o Accessory hemiazygos vein - drains the superior left hemithorax

Veins of the Abdomen and Pelvis

o Ascending lumbar veins - is a vein that runs up through the lumbar region on the side of the vertebral
column.
o Internal iliac veins - begins near the upper part of the greater sciatic foramen, passes upward behind
and slightly medial to the internal iliac artery and, at the brim of the pelvis, joins with the external iliac
vein to form the common iliac vein.
o External iliac veins - Start behind the inguinal ligament, two narrow bands in the pubic area that
connect your abdominal muscles to your pelvis.
o Common iliac veins - forms in the abdomen, at the level of the fifth lumbar vertebrae. It divides into two
branches.
o Portal system - is a system of blood vessels that begins and ends with capillary beds and has no
pumping mechanism, such as the heart, in between.
o Hepatic portal system - begins with capillaries in the viscera and ends with capillaries in the liver.
o Splenic vein - is a large vessel located retroperitoneally in the upper part of the abdominal cavity.
o Superior mesenteric vein - is a large blood vessel in the abdomen. Its function is to drain blood from the
small intestine as well as the first sections of the large intestine and other digestive organs.
o Inferior mesenteric vein - is a blood vessel that drains blood from the large intestine. It usually terminates
when reaching the splenic vein, which goes on to form the portal vein with the superior mesenteric vein
(SMV).
o Hepatic portal vein - It carries blood from the intestines, gallbladder, pancreas and spleen and delivers
it to the liver.
o Hepatic veins - are blood vessels that return low-oxygen blood from your liver back to the heart.
o Renal veins carry blood from the kidneys
o Suprarenal veins drain the adrenal glands.
o Testicular veins drain the testes in males
o Ovarian veins drain the ovaries in females
Veins of the Lower Limbs

o Saphenous vein - are closer to your skin's surface, compared with deep veins (which are deep inside your
body). Your great saphenous vein extends from your foot to your upper thigh.
o Great saphenous vein - is the largest vein of the human body. It is also known as the long saphenous vein.
The great saphenous vein starts from the medial marginal vein of foot, runs superficially along the length
of the lower limb, to finally empty into the femoral vein.
o Small saphenous vein - primary function is to receive deoxygenated blood from the lower legs and return
it to the heart.
o Popliteal vein - is a deep vein of the leg. It drains blood away from the leg into the femoral vein, which
drains blood to the inferior vena cava to return to the right atrium of the heart.

PHYSIOLOGY OF CIRCULATION

 The function of the circulatory system is to maintain adequate blood flow to all body tissues. Adequate
blood flow is required to provide nutrients and O2 to the tissues and to remove the waste products of
metabolism from the tissues. Blood flows through the arterial system primarily as a result of the pressure
produced by contractions of the heart ventricles.

Blood Pressure

 Blood pressure is a measure of the force blood exerts

against the blood vessel walls. In arteries, blood pressure
values go through a cycle that depends on the rhythmic
contractions of the heart.

 Systolic pressure - measures the pressure in your arteries

when your heart beats.
 Diastolic pressure - measures the pressure in your arteries
when your heart rests between beats.
 Auscultatory - is based on the detection of Korotkoff
sounds issued from the acoustic transudcer signal.
 Sphygmomanometer - To measure blood pressure, your
doctor uses an instrument call a sphygmomanometer, which is more often referred to as a blood pressure
cuff. The cuff is wrapped around your upper arm and inflated to stop the flow of blood in your artery.
 Stethoscope - is a device that helps physicians or healthcare providers primarily to listen to the sounds
generated internally by your heart, lungs and intestinal tract. It is also used to check blood pressure.
 Korotkoff sounds - Sounds heard when the blood begins to pass through an artery as an obstruction is
removed, as when a blood pressure measuring cuff is deflated.

Hypertension, or high blood pressure, affects at least 20% of all people at some
time in their lives.
The following guidelines* categorize blood pressure for adults:
 Normal: less than 120 mm Hg systolic and 80 mm Hg diastolic
 Prehypertension: from 120 mm Hg systolic and 80 mm Hg diastolic to 139
mm Hg systolic and 89 mm Hg diastolic
 Stage 1 hypertension: from 140 mm Hg systolic and 90 mm Hg diastolic
to 159 mm Hg systolic and 99 mm Hg diastolic
 Stage 2 hypertension: greater than 160 mm Hg systolic and 100 mm Hg
diastolic
Pressure and Resistance

 In a normal adult, blood pressure 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.

Pulse Pressure

o Arteriosclerosis - is a type of vascular disease where the blood vessels carrying oxygen away from the
heart (arteries) become damaged from factors such as high cholesterol, high blood pressure, diabetes
and certain genetic influences.
o Pulse - represents the tactile arterial palpation of the cardiac cycle (heartbeat) by trained fingertips.

Capillary Exchange

1. Most exchange across the wall of the capillary occurs by diffusion.

2. Blood pressure, capillary permeability, and osmosis affect movement of fluid across the wall of the
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.
 Edema or swelling - results from a disruption in the normal inwardly and outwardly directed pressures
across the capillary walls.

CONTROL OF BLOOD FLOW IN TISSUES

o Blood flow provided to the tissues by the circulatory system is highly controlled and matched closely to
the metabolic needs of tissues. Mechanisms that control blood flow through tissues are classified as (1)
local control or (2) nervous and hormonal control.

Local Control of Blood Flow

 Local control of blood flow is achieved by the periodic relaxation and contraction of the precapillary
sphincters. When the sphincters relax, blood flow through the capillaries increases. When the sphincters
contract, blood flow through the capillaries decreases.
 Other factors that control blood flow through the capillaries are the tissue concentrations of O2 and
nutrients, such as glucose, amino acids, and fatty acids

Homeostasis: Control of Blood Flow

Stimulus Response
Regulation by Metabolic Needs of Tissues
Increased CO2 and decreased pH or decreased O2 Relaxation of precapillary sphincters and subsequent
and nutrients, such as glucose, amino acids, and fatty increase in blood flow through capillaries
acids, due to increased metabolism
Decreased CO2 and increased pH or increased O2 Contraction of precapillary sphincters and subsequent
and nutrients, such as glucose, amino acids, and fatty decrease in blood flow through capillaries
acids
Regulation by Nervous Mechanisms
Increased physical activity or increased sympathetic Constriction of blood vessels in skin and viscera
activity
Increased body temperature detected by neurons of Dilation of blood vessels in skin (see chapter 5)
hypothalamus
Decreased body temperature detected by neurons of Constriction of blood vessels in skin (see chapter 5)
hypothalamus
Decrease in skin temperature below a critical value Dilation of blood vessels in skin (protects skin from
extreme cold)
Anger or embarrassment Dilation of blood vessels in skin of face and upper
 thorax
Regulation by Hormonal Mechanisms (Reinforces
Increased Activity of Sympathetic Division)
Increased physical activity and increased Constriction of blood vessels in skin and viscera;
sympathetic activity, causing release of epinephrine dilation of blood vessels in skeletal and cardiac
and small amounts of norepinephrine from adrenal muscle
medulla
Long-Term Local Blood Flow
Increased metabolic activity of tissues over a long Increased number of capillaries
period, as occurs in athletes who train regularly
Decreased metabolic activity of tissues over a long Decreased number of capillaries
period, as occurs during periods of reduced physical
activity

Nervous and Hormonal Control of Blood Flow

 Nervous control of blood flow is carried out primarily through the sympathetic division of the autonomic
nervous system. Sympathetic nerve fibers innervate most blood vessels of the body, except the capillaries
and precapillary sphincters, which have no nerve supply.
 Vasomotor center - continually transmits a low frequency of action potentials to the sympathetic
nerve fibers that innervate blood vessels of the body.
 Vasomotor tone - is the end result of a complex set of interactions that control relaxation and
contraction of blood vessels.
 Nervous control of blood vessels also causes blood to be shunted from one large area of the body to
another. It is important to note that the different mechanisms regulating blood flow work together to meet
tissue needs. Nervous control of blood vessels during exercise and local control through the relaxation of
precapillary sphincters together increase blood flow through exercising skeletal muscle several-fold. The
sympathetic division also regulates hormonal control of blood flow through the release of epinephrine and
norepinephrine from the adrenal medulla. These hormones are transported in the blood to all parts of the
body. In most blood vessels, these hormones cause constriction, which reduces blood flow.

REGULATION OF ARTERIAL PRESSURE

o Adequate blood pressure is required to maintain blood flow through the blood vessels of the body, and
several regulatory mechanisms ensure that blood pressure remains adequate for this task.
o The mean arterial blood pressure (MAP) is slightly less than the average of the systolic and diastolic
pressures in the aorta because diastole lasts longer than systole. The mean arterial pressure changes
over our lifetime. MAP is about 70 mm Hg at birth, is maintained at about 95 mm Hg from adolescence
to middle age, and may reach 110 mm Hg in a healthy older person.

The body’s MAP is equal to the cardiac output (CO) times the peripheral resistance (PR), which is the resistance
to blood flow in all the blood vessels:

MAP = CO × PR

Because the cardiac output is equal to the heart rate (HR) times the stroke volume (SV), the mean arterial
pressure is equal to the heart rate times the stroke volume times the peripheral resistance (PR):

MAP = HR × SV × PR
Baroreceptor Reflexes

o Baroreceptor reflexes activate responses that keep the blood pressure within its normal range.
Baroreceptors respond to stretch in arteries caused by increased pressure. They are scattered along the
walls of most of the large arteries of the neck and thorax, and many are located in the carotid sinus at
the base of the internal carotid artery and in the walls of the aortic arch.
o These baroreceptor reflexes regulate blood pressure on a moment-to-moment basis. When a person
rises rapidly from a sitting or lying position, blood pressure in the neck and thoracic regions drops
dramatically due to the pull of gravity on the blood.

Chemoreceptor Reflexes

o Chemoreceptor reflexes respond to changes in blood concentrations of O2 and CO2, as well as pH.
Carotid bodies are small structures that lie near the carotid sinuses, and aortic bodies lie near the aortic
arch.

Hormonal Mechanisms

 In addition to the rapidly acting baroreceptor and chemoreceptor reflexes, four important hormonal
mechanisms help control blood pressure.

Adrenal Medullary Mechanism

o Stimuli that lead to increased sympathetic stimulation of the heart and blood vessels also cause
increased stimulation of the adrenal medulla. The adrenal medulla responds by releasing epinephrine
and small amounts of norepinephrine into the blood.
o This leads to an increase in blood pressure. Epinephrine also causes vasodilation of blood vessels in
skeletal muscle and cardiac muscle, thereby increasing the supply of blood flowing to those muscles
and preparing the body for physical activity.

Renin-Angiotensin-Aldosterone Mechanism

o Angiotensin -converting enzyme (ACE), found in large amounts in organs, such as the lungs, acts on
angiotensin I to convert it to its most active form
o Angiotensin II is a potent vasoconstrictor. Thus, in response to reduced blood pressure, the kidneys’
release of renin increases the blood pressure toward its normal value.
o Aldosterone acts on the kidneys, causing them to conserve Na+ and water. As a result, the volume of
water lost from the blood into the urine is reduced.

Antidiuretic Hormone Mechanism

o Antidiuretic hormone (ADH), also called vasopressin, from the posterior pituitary gland. ADH acts on the
kidneys and causes them to absorb more water, thereby decreasing urine volume. This response helps
maintain blood volume and blood pressure. The release of large amounts of ADH causes
vasoconstriction of blood vessels, which causes blood pressure to increase.

Atrial Natriuretic Mechanism

o Atrial natriuretic hormone is released primarily from specialized cells of the right atrium in response to
elevated blood pressure. Atrial natriuretic hormone causes the kidneys to promote the loss of Na+ and
water in the urine, increasing urine volume. Loss of water in the urine causes blood volume to decrease,
thus decreasing the blood pressure.