THE CARDIOVASCULAR SYSTEM

BLOOD

Functions and Composition of Blood

Blood helps maintain homeostasis in several ways:

 Transport of gases, nutrients, waste products
 Transport of processed molecules
 Transport of regulatory molecules
 Regulation of pH and osmosis
 Maintenance of body temperature
 Protects against foreign substances such as microorganisms and toxins
 Blood clotting prevents fluid and cell loss and is part of tissue repair

- Blood is a connective tissue consisting of plasma and formed elements

- Blood is the body’s only fluid tissue
- It is composed of liquid plasma and formed elements
Formed elements include:
Erythrocytes, or red blood cells (RBCs)
Leukocytes, or white blood cells (WBCs)
Platelets
Hematocrit: the percentage of RBCs out of the total blood volume

 Total blood volume is approximately 5 liters

- Blood is a sticky, opaque fluid with a metallic taste

- Color varies from scarlet to dark red
- The pH of blood is 7.35–7.45
 - Temperature is 38 degree C
- Blood accounts for approximately 8% of body weight
- Average volume: 5–6 L (1.5 gallons) for males, and 4–5 L for females

Plasma
- Pale yellow fluid containing over 100 solutes
- Mostly water (91%)
- Contains proteins (7%):
Albumin (58% of the plasma proteins)
Helps maintain osmotic pressure
Globulins (38% of the plasma proteins)
Immunity: antibodies and complement
Transport: bind to molecules such as hormones
Clotting Factors
Fibrinogen (4% of the plasma proteins)
Converted to fibrin during clot formation
- Other substances (2%)
Ions (electrolytes): sodium, potassium, calcium, chloride, bicarbonate
Nutrients: glucose, carbohydrates, amino acids
Waste products: lactic acid, urea, creatinine
Respiratory gases: oxygen and carbon dioxide

Formed Elements
Erythrocytes or red blood cells (RBCs)
 About 95% of formed elements
 RBCs have no nuclei or organelles
Leukocytes or white blood cells (WBCs)
 Most of the remaining 5% of formed elements
 Only WBCs are complete cells
 Five types of WBCs
Platelets
 Just cell fragments
 Most formed elements survive in the bloodstream for only a few days

Production of Formed Elements

 Most blood cells do not divide but are renewed by stem cells (hemocytoblasts) in bone marrow
 Hematopoiesis: blood cell production
Occurs in different locations before and after birth
- Fetus
Liver, thymus, spleen, lymph nodes, and red bone marrow
- After birth
In the red bone marrow of the
Axial skeleton and girdles
Epiphyses of the humerus and femur
Some white blood cells are produced in lymphatic tissues
 Hemocytoblasts give rise to all formed elements
Growth factors determine the type of formed element derived from the stem cell
Red Blood Cells
- Biconcave discs, anucleate, essentially no organelles
- RBCs are dedicated to respiratory gas transport
- Filled with hemoglobin (Hb), a protein that functions in gas transport
- RBCs are an example of how structure fits function
- Biconcave shape has a huge surface area relative to volume
- Structural characteristics contribute to its gas transport function
- Biconcave shape also allows RBCs to bend or fold around their thin center
- Gives erythrocytes their flexibility
- Allow them to change shape as necessary

Hemoglobin (Hb)
- Accounts for about a third of the cell’s volume
Consists of:
- The protein globin, made up of two alpha and two beta chains, each bound to a heme group
 - Each heme group bears an atom of iron, which can bind to one oxygen molecule
- Heme molecules transport oxygen (Iron is required)
- Oxygen content determines blood color
Oxygenated: bright red
Deoxygenated: darker red
- Globin molecules transport carbon dioxide
- One RBC contains 250 million Hb groups thus it can carry 1 billion molecules of O2

Erythropoiesis is the production of RBCs

- A hemocytoblast is transformed into a proerythroblast
- Proerythroblasts develop into early erythroblasts
- The developmental pathway consists of three phases
1. Ribosome synthesis in early erythroblasts
2. Hb accumulation in intermediate erythroblasts and late erythroblasts
3. Ejection of the nucleus from late erythroblasts and formation of reticulocytes
- Reticulocytes are released from the red bone marrow into the circulating blood, which contains ~1-3%
reticulocytes
- Reticulocytes then become mature erythrocytes
Red Blood Cell Production
 Circulating erythrocytes: The number remains constant and reflects a balance between RBC
production and destruction
- Too few RBCs leads to tissue hypoxia
- Too many RBCs causes undesirable blood viscosity
 Erythropoiesis is hormonally controlled and depends on adequate supplies of iron, amino acids, and
B vitamins (folate and B12)
Erythropoietin (EPO) release by the kidneys is triggered by:
- Hypoxia due to decreased RBCs
- Decreased oxygen availability
- Increased tissue demand for oxygen
- Enhanced erythropoiesis increases the:
 RBC count in circulating blood
 Oxygen carrying ability of the blood

 The life span of an erythrocyte is 100–120 days

 Old RBCs become rigid and fragile, and their Hb begins to degenerate
 Dying RBCs are engulfed by macrophages located in the spleen or liver
 Heme and globin are separated and the iron is salvaged for reuse
 Globin chains are broken down to individual amino acids and are metabolized or used to build
new proteins
 Iron released from heme is transported to the red bone marrow and is used to produce new
hemoglobin
 Heme becomes bilirubin that is secreted in bile
 In the intestines bilirubin is converted by bacteria into other pigments
 Gives feces its brown color
 Gives urine its yellow color
White Blood Cells
 Only blood components that are complete cells
 Are less numerous than RBCs
 Make up 1% of the total blood volume
 Can leave capillaries via ameboid movement and move through tissue spaces
 Two functions of WBCs:
 Protect the body against invading microorganisms
 Remove dead cells and debris from tissues by phagocytosis
 Named according to their appearance in stained preparations
 Granulocytes: contain large cytoplasmic granules
 Agranulocytes: very small granules that cannot be easily seen with the light microscope

Granulocytes: neutrophils, eosinophils, and basophils

 Contain cytoplasmic granules
 Are larger and usually shorter-lived than RBCs
 Have lobed nuclei
 Are all phagocytic cells

Neutrophils most common type of WBC

 Have two types of granules that:
 Take up both acidic and basic dyes
 Give the cytoplasm a lilac color
 Contain peroxidases, hydrolytic enzymes, and defensins (antibiotic-like proteins)
 Neutrophils are our body’s bacteria slayers
 Pus is an accumulation of dead neutrophils, cell debris and fluid at sites of infections

Basophils account for 0.5% of WBCs

 Have large, purplish-black (basophilic) granules that contain
  Histamine: inflammatory chemical that acts as a vasodilator and attracts other WBCs
(antihistamines counter this effect)
 Heparin: prevents the formation of clots

Eosinophils account for 1–4% of WBCs

 Have red-staining, bilobed nuclei connected via a broad band of nuclear material
 Have red to crimson (acidophilic) large, coarse, lysosome-like granules
 Lessen the severity of allergies by reducing inflammation
 Lead the body’s counterattack against parasitic worms

Agranulocytes: lymphocytes and monocytes

 Lack visible cytoplasmic granules
 Are similar structurally, but are functionally distinct and unrelated cell types
 Have spherical (lymphocytes) or kidney-shaped (monocytes) nuclei

Lymphocytes account for 25% or more of WBCs

 Have large, dark-purple, circular nuclei with a thin rim of blue cytoplasm
 Are found mostly enmeshed in lymphoid tissue (some circulate in the blood)
 There are two types of lymphocytes: T cells and B cells
B cells
 Stimulated by bacteria or toxins
 Give rise to plasma cells, which produce antibodies
T cells
 Protect against viruses and other intracellular microorganisms
 Attack and destroy the cells that are infected

Monocytes account for 4–8% of leukocytes

 They are the largest leukocytes
 They have an abundant pale-blue cytoplasm
 They have purple-staining, U- or kidney-shaped nuclei
 They leave the circulation, enter tissue, and differentiate into macrophages
 Are highly mobile and actively phagocytic
 Activate lymphocytes to mount an immune response
Identification of WBCs

Platelets
 Fragments of megakaryocytes with a blue-staining outer region and a purple granular center
 Function in clotting by two mechanisms
1. Formation of platelet plugs, which seal holes in small vessels
2. Formation of clots, which help seal off larger wounds in the vessels
 Preventing Blood Loss
 A series of reactions for stoppage of bleeding
 Three phases occur in rapid sequence
 Vascular spasms: immediate vasoconstriction in response to injury
 Thromboxanes and endothelin can cause vascular spasms
 Platelet plug formation
 Coagulation (blood clotting)

Platelet Plugs
 Platelets do not stick to each other or to blood vessels
 Upon damage to blood vessel endothelium platelets:
 With the help of von Willebrand factor (VWF) adhere to collagen
 Are stimulated by and then release more thromboxane and ADP, which attract still more
platelets
 Stick to exposed collagen fibers and form a platelet plug
 The platelet plug is limited to the immediate area of injury by prostacyclin
 Can seal up a small breaks in a blood vessels that occur many times each day

Blood Clotting
 Blood clotting, or coagulation, is the formation of a clot (a network of protein fibers called fibrin)
 Blood clotting begins with the extrinsic or intrinsic pathway
 Both pathways end with the production of activated factor X
 Extrinsic pathway begins with the release of thromboplastin from damaged tissue
 Intrinsic pathway begins with the activation of factor XII

 Activated factor X, factor V, phospholipids, and Ca2+ form prothrombinase

 Prothrombin is converted to thrombin by prothrombinase
 Fibrinogen is converted to fibrin by thrombin
  Insoluble fibrin strands form the structural basis of a clot
 Fibrin causes plasma to become a gel-like trap
 Fibrin in the presence of calcium ions activates factor XIII that:
 Cross-links fibrin
 Strengthens and stabilizes the clot
 Away from the site of injury anticoagulants in the blood, such as antithrombin and heparin, prevent
clot formation

Clot Retraction and Fibrinolysis

 Clot retraction: stabilization of the clot by squeezing serum from the fibrin strands
 Results from the contraction of platelets, which pull the edges of damaged tissue closer
together
 Serum, which is plasma minus fibrinogen and some clotting factors, is squeezed out to the clot
 Thrombin and tissue plasminogen activator activate plasmin, which dissolves fibrin (fibrinolysis)
 Blood Grouping
 Transfusion reactions occur when mismatched blood is infused
 Antibodies can bind to the donor’s RBC antigens, resulting in agglutination or hemolysis of RBCs,
leading to
 Diminished oxygen-carrying capacity
 Clumped cells that impede blood flow
 Ruptured RBCs that release free hemoglobin into the bloodstream

ABO Blood Group

The ABO blood groups consists of:
Two antigens (A and B) on the surface of the RBCs
Two antibodies in the plasma (anti-A and anti-B)

Blood type Antigens Present Antibodies Present

A B Anti-A Anti-B

AB + + – –

B – + + –

A + – – +

O – – + +
 Rh Blood Group
 Rh-positive blood has certain Rh antigens (the D antigen), whereas Rh-negative blood does not
 Antibodies against the Rh antigen are produced when a Rh-negative person is exposed to Rh-
positive blood
 The Rh blood group is responsible for hemolytic disease of the newborn, which can occur when the
fetus is Rh-positive and the mother is Rh-negative
 Diagnostic Blood Tests
 Laboratory examination of blood can assess an individual’s state of health
 Microscopic examination:
 Variations in size and shape of RBCs: prediction of anemia
 Type and number of WBCs: diagnostic of various diseases
 Chemical analysis can provide a comprehensive picture of one’s general health status in relation to
normal values

The complete blood count consists of the following

 Red blood cell count (million/mL)
 Male 4.6-6.2 million/mL
 Female 4.2-5.4 million/mL
 Hemoglobin measurement (grams of hemoglobin per/mL of blood
 Male 14-18 g/100mL
 Female 12-16 g/100mL
 Hematocrit measurement (percent volume of RBCs)
 Male 40%-52%
 Female 38%-48%

 White blood cell count (WBCs/mL)

 Male and Female 5000-9000 WBCs/mL
 Differential white blood cell count (the percentage of each type of WBC)
 Neutorphils – 60%-70%
 Lymphocytes – 20%-25%
 Monocytes – 3%-8%
 Eosinophils – 2%-4%
 Basophils – 0.5%-1%
Clotting
Platelet count and prothrombin time measure the ability of the blood to clot
Blood Chemistry
The composition of materials dissolved or suspended in plasma can be used to assess the functioning
and status of the body’s systems
 Glucose
 Urea
 Nitrogen
 Bilirubin
 Cholesterol

THE HEART

Functions of the Heart

 Generating blood pressure
 Required for blood flow through the blood vessels
 Routing blood
 Two pumps, moving blood through the pulmonary and systemic circulations
 Regulating blood supply
 Adjusts blood flow by changing the rate and force of heart contractions as needed

Pulmonary circulation
The flow of blood from the heart through the lungs back to the heart
Picks up oxygen and releases carbon dioxide in the lungs
System circulation
The flow of blood from the heart through the body back to the heart
Delivers oxygen and picks up carbon dioxide in the body’s tissues
Location, Shape, and Size of the Heart
Location
 Anterior to the vertebral column, posterior to the sternum
 Left of the midline
 Deep to the second to fifth intercostal spaces
 Superior surface of diaphragm
 Shaped like a blunt cone, with an apex and a base
 Approximately the size of your fist
Anatomy of the Heart
 The heart consists of two atria and two ventricles
 Pericardium: a double-walled sac around the heart composed of
 A superficial fibrous pericardium
 A deep two-layer serous pericardium
 The parietal layer lines the internal surface of the fibrous pericardium
 The visceral layer lines the surface of the heart
 They are separated by the fluid-filled (pericardial fluid) pericardial cavity

The pericardium
 Fibrous pericardium
 Protects and anchors the heart
 Prevents overfilling of the heart with blood
 Serous pericardium
 Allows for the heart to work in a relatively friction-free environment
The heart wall has three layers:
Epicardium
Visceral layer of the serous pericardium (visceral pericardium)
Provides protection against the friction of rubbing organs
Myocardium
Cardiac muscle layer forming the bulk of the heart
Responsible for contraction
Endocardium
Endothelial layer over crisscrossing, interlacing layer of connective tissue
Inner endocardium reduces the friction resulting from the passage of blood through the heart

Atria
 Receiving chambers of the heart
 Each atrium has a protruding auricle
 Veins entering the right atrium carry blood to the heart from the systemic circulation
 Inferior vena cava
 Superior vena cava
 Coronary sinus
 Veins entering the left atrium carry blood to the heart from the pulmonary circulation
 Four pulmonary veins

Ventricles
 Discharging chambers of the heart
 Papillary muscles and trabeculae carneae muscles mark ventricular walls
 Arteries carrying blood away from the heart
 Pulmonary trunk exits the right ventricle carrying blood to the pulmonary circulation
 Aorta exits the left ventricle carrying blood to the systemic circulation

External Anatomy
 Each atrium has a flap called an auricle
 The coronary sulcus separates the atria from the ventricles
 The interventricular grooves separate the right and left ventricles
Heart Chambers
 The interatrial septum separates the atria from each other
 The fossa ovalis is the former location of the foramen ovalis through which blood bypassed the
lungs in the fetus
 The interventricular septum separates the ventricles
Heart valves
Ensure unidirectional blood flow through the heart
Atrioventricular (AV) valves lie between the atria and the ventricles
AV valves prevent backflow into the atria when ventricles contract
Chordae tendineae anchor AV valves to papillary muscles
Tricuspid valve: separates the right atrium and ventricle
Bicuspid valve: separates the left atrium and ventricle
Semilunar valves prevent backflow of blood into the ventricles
Aortic semilunar valve: lies between the left ventricle and the aorta
Pulmonary semilunar valve: lies between the right ventricle and pulmonary trunk
Route of Blood Flow Through the Heart
Blood from the body flows through the right atrium into the right ventricle and then to the lungs
Blood returns from the lungs to the left atrium, enters the left ventricle, and is pumped back to the body

Blood Flow Through the Heart

Blood Supply to the Heart
Coronary arteries branch off the aorta to supply the heart
Blood returns from the heart tissues to the right atrium through coronary sinus and cardiac veins
Electrical Activity of the Heart
Conducting System of the Heart
 The sinoatrial (SA) node and the atrioventricular (AV) node are in the right atrium
 The AV node is connected to the bundle branches in the interventricular septum by the AV bundle
 The bundle branches give rise to Purkinje fibers, which supply the ventricles
 The SA node initiates action potentials, which spread across the atria and cause them to contract
 SA node generates impulses about 75 times/minute
 Action potentials are slowed in the AV node, allowing the atria to contract and blood to move into
the ventricles
 AV node delays the impulse approximately 0.11 seconds
 Then the action potentials passes from atria to ventricles via the atrioventricular bundle
 AV bundle splits into two pathways in the interventricular septum (bundle branches)
 Bundle branches carry the impulse toward the apex of the heart
 Purkinje fibers carry the impulse to the heart apex and ventricular walls
Electrocardiogram (ECG)
 Records only the electrical activities of the heart
 P wave corresponds to depolarization of the atria (SA node)
 QRS complex corresponds to ventricular depolarization
 T wave corresponds to ventricular repolarization
 Atrial repolarization record is masked by the larger QRS complex
 Based on the magnitude of the ECG waves and the time between waves, ECGs can be used to
diagnose heart abnormalities
Cardiac Cycle
 Repetitive contraction and relaxation of the heart chambers
 Overview of Systole and Diastole
 Atrial systole is contraction of the atria
 Systole is contraction of the ventricles
 Atrial diastole is relaxation of the atria
 Diastole is relaxation of the ventricles
 During systole
 AV valves close
 Pressure increases in the ventricles
 Semilunar valves are forced to open
 Blood flows into the aorta and pulmonary trunk
 At the beginning of diastole
 Pressure in the ventricles decreases
 Semilunar valves close to prevent backflow of blood from the aorta and pulmonary trunk into
the ventricles
 When the pressure in the ventricles is lower than in the atria, the AV valves open and blood flows
from the atria into the ventricles
 During atrial systole, the atria contract and complete the filling of the ventricles

Cardiac Cycle
Events Occurring During Ventricular Systole
 Ventricular depolarization
 Produces the QRS complex
 Initiates contraction of the ventricles, which increases ventricular pressure
 The AV valves close
 Semilunar valves open
 Blood is ejected from the heart
  The volume of blood in a ventricle just before it contracts is the end- diastolic volume
 The volume of blood after contraction is the end- systolic volume

Events Occurring During Ventricular Diastole

 Ventricular repolarization
 Produces the T wave
 Ventricles relax
 Blood flowing back toward the relaxed ventricles closes the semilunar valves
 The AV valves open and blood flows into the ventricles
 Approximately 70% of ventricular filling occurs when blood flows from the higher pressure in
the veins and atria to the lower pressure in the relaxed ventricles
 Atrial depolarization produces the P wave
 The atria contract and complete ventricular filling

Aortic Pressure Curve

 Contraction of the ventricles forces blood into the aorta
 The maximum pressure in the aorta is the systolic pressure
 Elastic recoil of the aorta maintains pressure in the aorta and produces the dicrotic notch
 Blood pressure in the aorta falls as blood flows out of the aorta
 The minimum pressure in the aorta is the diastolic pressure
 Heart sounds (lub-dup) are associated with closing of heart valves
 First sound occurs as AV valves close and signifies beginning of systole
 Second sound occurs when SL valves close at the beginning of ventricular diastole
Events Occurring During the Cardiac Cycle
Mean Arterial Blood Pressure
 Mean arterial pressure is the average blood pressure in the aorta
 Adequate blood pressure is necessary to ensure delivery of blood to the tissues
 Proportional to cardiac output (amount of blood pumped by the heart per minute) times
peripheral resistance (total resistance to blood flow through blood vessels)
 CO X PR
 CO is the product of heart rate (HR) and stroke volume (SV)
  HR is the number of heart beats per minute
 SV is the amount of blood pumped out by a ventricle with each beat
 SV = end-diastolic volume (EDV) minus end-systolic volume (ESV)
 EDV = amount of blood collected in a ventricle during diastole
 ESV = amount of blood remaining in a ventricle after contraction
 CO (ml/min) = HR (72 beats/min) x SV (70 ml/beat)
 CO = 5040 ml/min (~5 L/min)
 Cardiac reserve is the difference between resting and maximal CO
 Venous return is the amount of blood returning to the heart
 Increased venous return increases stroke volume by increasing end-diastolic volume
 Increased force of contraction increases stroke volume by decreasing end-systolic volume

Regulation of the Heart

Intrinsic Regulation
 Modifies stroke volume through the functional characteristics of cardiac muscle cells
 Starling’s law of the heart describes the relationship between preload and the stroke volume of the
heart
 An increased preload causes the cardiac muscle fibers to contract with a greater force and
produce a greater stroke volume
 Afterload is the pressure against which the ventricles must pump blood.

Extrinsic Regulation
 Modifies heart rate and stroke volume through nervous and hormonal mechanisms
 The cardioregulatory center in the medulla oblongata regulates the parasympathetic and
sympathetic nervous control of the heart
 Epinephrine and norepinephrine are released into the blood from the adrenal medulla as a
result of sympathetic stimulation. They increase the rate and force of heart contraction

 Parasympathetic stimulation is supplied by the vagus nerve

 Decreases heart rate.
 Postganglionic neurons secrete acetylcholine, which increases membrane permeability to K.
Hyperpolarization of the plasma membrane increases the duration of the prepotential
 Sympathetic stimulation is supplied by the cardiac nerves
 Increases heart rate and the force of contraction (stroke volume)
 Postganglionic neurons secrete norepinephrine, which increases membrane permeability to
Ca2+. Depolarization of the plasma membrane decreases the duration of the prepotential

The Heart and Homeostasis

Effect of Blood Pressure
 Baroreceptors monitor blood pressure and the cardioregulatory center modifies heart rate and
stroke volume
 In response to a decrease in blood pressure, the baroreceptor reflexes increase heart rate and
stroke volume
 When blood pressure increases, the baroreceptor reflexes decrease heart rate and stroke volume

Effect of pH, Carbon Dioxide, and Oxygen

 Carotid body and aortic chemoreceptor receptors monitor blood oxygen levels
 Medullary chemoreceptors monitor blood pH and carbon dioxide levels
 Chemoreceptors are not important for the normal regulation of the heart, but are important in the
regulation of respiration and blood vessel constriction

Baroreceptor and Chemoreceptor Reflexes

Effect of Ions and Body Temperature
 Increased extracellular K+ decrease heart rate and stroke volume
 Decreased extracellular K+ decrease heart rate
 Increased extracellular Ca2+ increase stroke volume and decrease heap rate
 Decreased extracellular Ca2+ levels produce the opposite effect
 Heart rate increases when body temperature increases, and it decreases when body temperature
decreases

Effects of Aging on the Heart

 Aging results in gradual changes in the function of the heart, which are minor under resting
conditions but are more significant during exercise
 Some age-related changes to the heart are the following
 Decreased cardiac output and heart rate
 Increased cardiac arrhythmias
 Hypertrophy of the left ventricle
 Development of stenoses or incompetent valves
 Development of coronary artery disease and heart failure
 Exercise improves the functional capacity of the heart at all ages.

Blood Vessels and Circulation

Functions of the Peripheral Circulation

 The heart provides the major force that causes blood to circulate
 The peripheral circulation
1. Carries blood
2. Exchanges nutrients, waste products, and gases with tissues
3. Helps regulate blood pressure
4. Directs blood flow to tissues

General Features of Blood Vessels

 Arteries carry blood away from the heart toward capillaries, where exchange between the blood
and interstitial fluid occurs
 Blood flows from the heart through elastic arteries, muscular arteries, and arterioles to the
capillaries
 Veins carry blood from the capillaries toward the heart
 Blood returns to the heart from the capillaries through venules, small veins, and large veins
 Blood vessels, except for capillaries, have three layers
 Inner: tunica intima
 Consists of endothelium (simple squamous epithelium), basement membrane, and
internal elastic lamina
 Middle: tunica media
 Contains circular smooth muscle and elastic and collagen fibers
 Outer: tunica adventitia
  connective tissue
 The thickness and the composition of the layers vary with blood vessel type and diameter

Arteries
 Large elastic arteries
 Thick-walled with large diameters
 Tunica media has many elastic fibers and little smooth muscle
 Muscular (distributing) arteries
 Thick-walled with small diameters
 Tunica media has abundant smooth muscle and some elastic fibers
 Arterioles
 Smallest arteries
 Tunica media consists of one or two layers of smooth muscle cells and a few elastic fibers
Capillaries
 Capillaries consist only of endothelium
 A capillary bed is a network of capillaries
 Thoroughfare channels carry blood from arterioles to venules
 Blood can pass rapidly through thoroughfare channels
 Precapillary sphincters regulate the flow of blood into capillaries
Veins
 Venules connect to capillaries and are like capillaries, except they are larger in diameter
 Large venules and all veins have all three layers
 Valves prevent the backflow of blood in the veins
Aging of the Arteries
 Arteriosclerosis results from a loss of elasticity in the aorta, large arteries, and coronary arteries
 Atherosclerosis is the deposition of materials in arterial walls to form plaques
Pulmonary Circulation
 Moves blood to and from the lungs
 Pulmonary trunk arises from the right ventricle and divides to form the pulmonary arteries, which
project to the lungs
 From the lungs, four pulmonary veins return blood to the left atrium

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
 Ascending aorta
 Aortic arch
 Descending aorta
 Consists of the thoracic aorta and the abdominal aorta
 Coronary arteries branch from the aorta and supply the heart
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 and the right subclavian arteries
 Left common carotid
 Left subclavian
 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
Major Arteries of the Head and Thorax
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
Branches of the Aorta
Thoracic Aorta/Branches
 The thoracic aorta has
 Visceral branches that supply the thoracic organs
 Parietal branches that supply the thoracic wall
Abdominal Aorta/Branches
 The abdominal aorta has
 Visceral branches that supply the abdominal organs
 Parietal branches that supply the abdominal wall
Abdominal Aorta/Branches
 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); and the lower part of the large
intestine (inferior mesenteric)
 The paired arteries supply the kidneys, adrenal glands, and gonads

Branches of the Aorta

Major Arteries of the Abdomen and Pelvis

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
 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
 The plantar arteries form the plantar arch, from which the digital arteries arise

Arteries of the Pelvis and Lower Limb

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

Major Veins
Veins of the Head and Neck
 The internal jugular veins drain the dural venous sinuses and the veins of the anterior head, face,
and neck
 The external jugular veins and the vertebral veins drain the posterior head and neck
Veins of the Upper Limb
 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
Veins of the Thorax
The left and right brachiocephalic veins and the azygos veins return blood to the superior vena cava
Veins of the Abdomen and Pelvis
 Ascending lumbar veins from the abdomen join the azygos and hemiazygos veins
 Veins from the kidneys, adrenal glands, and gonads directly enter the inferior vena cava
 Veins from the stomach, intestines, spleen, and pancreas connect with the hepatic portal vein
 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
 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
Physiology of Circulation
Blood Pressure
 A measure of the force exerted by blood against the blood vessel wall. Blood moves through vessels
because of blood pressure
 Can be measured by listening for Korotkoff sounds produced by turbulent flow in arteries as
pressure is released from a blood pressure cuff
Blood Flow Through a Blood Vessel
 The amount of blood that moves through a vessel in a given period.
 Directly proportional to pressure differences and is inversely proportional to resistance
 Resistance is the sum of all the factors that inhibit blood flow. Resistance increases when blood
vessels become smaller and viscosity increases
 Viscosity is the resistance of a liquid to flow. Most of the viscosity of blood results from red blood
cells. The viscosity of blood increases when the hematocrit increases or plasma volume decreases

Blood Flow Through the Body

 Mean arterial pressure equals cardiac output times peripheral resistance
 Vasomotor tone is a state of partial contraction of blood vessels. Vasoconstriction increases
vasomotor tone and peripheral resistance, whereas vasodilation decreases vasomotor tone and
peripheral resistance
 Blood pressure averages 100 mm Hg in the aorta and drops to 0 mm Hg in the right atrium. The
greatest drop occurs in the arterioles and capillaries

Pulse Pressure and Vascular Compliance

 Pulse pressure is the difference between systolic and diastolic pressures. Pulse pressure increases
when stroke volume increases or vascular compliance decreases
 Vascular compliance is a measure of the change in volume of blood vessels produced by a change in
pressure
 Pulse pressure waves travel through the vascular system faster than the blood flows. Pulse pressure
can be used to take the pulse
Blood Pressure and the Effect of Gravity
 In a standing person, hydrostatic pressure caused by gravity
 Increases blood pressure below the heart
 Decreases pressure above the heart

Capillary Exchange and Regulation of Interstitial Fluid Volume

 Capillary exchange occurs through or between endothelial cells
 Diffusion, which includes osmosis, and filtration are the primary means of capillary exchange
 Filtration moves materials out of capillaries and osmosis moves them into capillaries
 A net movement of fluid occurs from the blood into the tissues. The fluid gained by the tissues is
removed by the lymphatic system

Control of Blood Flow

 Blood flow through tissues is highly controlled and matched closely to the metabolic needs of
tissues
 Local Control
 The response of vascular smooth muscle to changes in tissue gases, nutrients, and waste
products
  If the metabolic activity of a tissue increases, the diameter and number of capillaries in the
tissue increase over time.

Nervous and Hormonal Control

 The sympathetic nervous system (vasomotor center in the medulla) controls blood vessel diameter.
Other brain areas can excite or inhibit the vasomotor center
 Epinephrine and norepinephrine cause vasoconstriction in most tissues. Epinephrine causes
vasodilation in skeletal and cardiac muscle
 The muscular arteries and arterioles control the delivery of blood to tissues
 The veins are a reservoir for blood
 Venous return to the heart increases because of the vasoconstriction of veins, an increased blood
volume, and the skeletal muscle pump (with valves)

Regulation of Mean Arterial Pressure

 Mean arterial pressure (MAP) is proportional to cardiac output times peripheral resistance
 Short-Term Regulation of Blood Pressure
 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
 Epinephrine and norepinephrine are released from the adrenal medulla as a result of sympathetic
stimulation. They increase heart rate, stroke volume, and vasoconstriction
 Peripheral chemoreceptor reflexes respond to decreased oxygen, leading to increased
vasoconstriction
 Central chemoreceptors respond to high carbon dioxide or low pH levels in the medulla, leading to
increased vasoconstriction, heart rate, and force of contraction (CNS ischemic response)
Long-Term Regulation of Blood Pressure
 Through the renin-angiotensin-aldosterone mechanism
 Renin is released by the kidneys in response to low blood pressure
 Promotes the production of angiotensin II, 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

Renin-Angiotensin-Aldosterone Mechanism
Vasopressin (ADH) Mechanism
 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 a
decrease in blood volume and blood pressure
 The fluid shift mechanism causes fluid shift, which is a movement of fluid from the interstitial spaces
into capillaries in response to a decrease in blood pressure to maintain blood volume
Examples of Cardiovascular Regulation
Exercise
 Local control mechanisms increase blood flow through exercising muscles, which lowers peripheral
resistance
 Cardiac output increases because of increased venous return, stroke volume, and heart rate
 Vasoconstriction in the skin, the kidneys, the gastrointestinal tract, and skeletal muscle (non-
exercising and exercising) increases peripheral resistance, which helps prevent a drop in blood
pressure
 Blood pressure increased despite an overall decrease in peripheral resistance because of increased
cardiac output

Circulatory Shock
 Baroreceptor reflexes and the adrenal medullary response increase blood pressure
 The renin-angiotensin-aldosterone mechanism and the vasopressin mechanism increase
vasoconstriction and blood volume. The fluid shift mechanism increases blood volume
 In severe shock, the chemoreceptor reflexes increase vasoconstriction, heart rate, and force of
contraction
 In severe shock, despite negative-feedback mechanisms, a positive- feedback cycle of decreasing
blood pressure can cause death