HUMAN SYSTEM ANATOMY &

PHYSIOLOGY I

THE CARDIOVASCULAR SYSTEM 2

CIRCULATION & REGULATION

DR WAN SAFWANI WAN KAMARUL ZAMAN

 BLOOD VESSELS

• The three major types of vessels are arteries,

capillaries, and veins

1. Arteries carry blood away from the heart

2. Veins carry blood toward the heart
3. Capillaries contact tissue cells and directly
serve cellular needs
 STRUCTURE OF BLOOD VESSELS WALLS

• The blood vessel walls of the

arteries and veins consists of
three distinct layers:
1. Tunica intima or
tunica interna
(innermost layer)
2. Tunica media
3. Tunica adventitia or
tunica externa
(outermost layer)

• The three layers are more

obvious in arteries than in
veins.
 STRUCTURE OF BLOOD VESSELS
Tunica Interna (Intima)
Simple squamous endothelium
Subendothelial in > 1 mm diam

Tunica Media
Smooth muscle & elastic fiber
layer regulation by
sympathetic nervous system
results in vasoconstriction
and vasodilation

Tunica externa (adventitia):

Collagen fibers that protect and
reinforce vessels
Larger vessels contain vasa
vasorum – nourish the more
external tissues of blood
vessel wall.
VASCULAR COMPONENTS & BLOOD
DISTRIBUTION
 ARTERIAL SYSTEM

• There are three types of arteries:

1.Elastic Arteries
2.Muscular Arteries
3.Arterioles
 ELASTIC OR CONDUCTING ARTERIES
• Elastic or Conducting
Arteries are thick-walled
arteries near the heart; the
aorta and its major
branches
- Low resistance
– Serve as pressure
reservoirs during systole
– Recoil during diastole to
keep blood moving

• Contain elastin – present in all 3

but tunica media has the most
 MUSCULAR OR DISTRIBUTING ARTERIES

• Muscular arteries –
deliver blood to body
organs
– Less stretchy
– Active in
vasoconstriction
• Thickest media
• Tunica media – more
smooth muscle & less
elastic tissue
 ARTERIOLES
• Arterioles are the smallest of the arteries
– transport blood from small arteries to the capillary beds.
– Capable of vasodilation and vasoconstriction.
• Larger arterioles have all 3 tunics
• Tunica media – smooth muscle with scattered elastic fibers
• Smaller arterioles – lead in capillary beds
- consist of a single layer of smooth muscle cells surround
endothelial lining.
 CAPILLARIES

• Most tissues have a rich capillary supply.

• Exceptions:
– Tendons and ligaments
– Cartilage
– Cornea
– Lens
– Epithelial tissues
 STRUCTURE OF CAPILLARIES
• Capillaries are the smallest blood
vessels
– Walls consisting of a thin tunica
interna, one cell thick
– Allow only a single RBC to pass
at a time
– Pericytes on the outer surface
stabilize their walls

• Function:
– Gas exchange
– Nutrients
– Hormones
– Ions
– Others
 TYPES OF CAPILLARIES

• There are three structural types of

capillaries:

1.Continuous
2.Fenestrated
3.Sinusoids
 CONTINUOUS CAPILLARIES
• Continuous capillaries most
abundant in the skin & muscles
– Least permeable, lack pores
– Endothelial cells provide an
uninterrupted lining
– Adjacent cells are connected
with tight junctions
– Intercellular clefts allow the
passage of fluids
– Endothelium contains
pinocytotic vesicles

• Continuous capillaries of the brain

– Have tight junctions completely
around the endothelium
– Constitute the blood-brain
barrier
 FENESTRATED CAPILLARIES
• Fenestrated Capillaries
– They have pores
(fenestrations)
– Found wherever active
capillary absorption or
filtrate occurs
• Example: intestinal
villi, ciliary process of
eye, endocrine glands,
glomeruli of kidney
Characterized by:
– Greater permeability than
continuous capillaries
 SINUSOIDS
• Sinusoidal capillaries are
modified, very permeable
(leaky) capillaries.

• Endothelial lining has fewer

tight junctions & larger
intercellular clefts than
ordinary capilaries

• They have a large lumens with

large fenestrae.
– Found only in the liver,
bone marrow, lymphoid
tissue and in some
endocrine organs.
 CAPILLARY BEDS

• Capillaries do not function independently – capillary beds

• Blood flow from arteriole to venule thru capillary beds

- microcirculation.

• Consists of 2 types of vessels:

1) vascular shunt (metarteriole-thoroughfare channel)
2) true capillaries (exchange vessels)
 CAPILLARY BEDS: MICROCIRCULATION
Vascular shunt
 a short vessel directly connects arteriole &
venule at opposite ends of bed.
 Terminal arteriole metarteriole
(structure intermediate between arteriole &
capillary) thoroughfare channel
(intermediate between capillary & venule)
postcapillary venule

True capillaries
 Branch off metarteriole & return to
thoroughfare channnel.

Precapillary spinchter
 Cuff of smooth muscle fiber
 Acts as valve to regulate blood flow in the
capillary

Blood flow entering capillary bed regulated by

local chemical conditions & arteriolar
vasomotor nerve fibers.
 VENOUS SYSTEM

• Blood is carried from capillary beds to heart by veins

• Along the way – diameter of venous vessels increases & walls

gradually thicken as they progress from venules to larger &
larger veins.

• Consists of: 1) Venules

2) Veins
 VENOUS SYSTEM
Venules form where capillary beds unite
– Postcapillary venules – smallest venules, composed of extremely
porous endothelium and a few pericytes
– Allow fluids and WBCs to pass to tissues
– Large venules have 1 or 2 layers of tunica media

Veins are:
– Formed when venules converge
– Composed of three tunics, tunica intima w/ a thin tunica media and a
thick tunica externa consisting of collagen fibers & elastic networks
– Capacitance vessels (blood reservoirs), contain 60% of the blood
– Much lower blood pressure and thinner walls than arteries
– Have special adaptations to return blood to the heart:
– Large-diameter lumens, which offer little resistance to flow
– Valves (resembling semilunar heart valves), which prevent
backflow of blood, form from folds of tunica intima.
 VENOUS SYSTEM

• Venous sinuses are

specialized,
flattened veins with
extremely thin
walls.
– Example: coronary
sinus of the heart
and dural sinuses
of the brain
 VASCULAR ANASTOMOSES
• Merging blood vessels,
more common in veins than
arteries
• Arterial anastomoses
provide alternate pathways
(collateral channels) for
blood to reach a given body
region
• Example:
– Metarteriole -
thoroughfare channels
shunts of capillary beds
– The heart, brain, liver,
and intestines
PHYSIOLOGICAL TERM: BLOOD FLOW

• Volume of blood flowing through a vessel, an

organ, or the entire circulation in a given
period:
– measured in ml per min.
– equivalent to cardiac output (CO),
considering the entire vascular system
– relatively constant when at rest
– widely variable through individual organs
 PHYSIOLOGICAL TERM: BLOOD PRESSURE

• Force per unit area exerted on the wall of a blood

vessel by its contained blood
– Expressed in millimeters of mercury (mm Hg)
– Measured in reference to systemic arterial BP in
large arteries near the heart
• The differences in BP within the vascular system
provide the driving force that keeps blood moving
from higher to lower pressure areas
 PHYSIOLOGICAL TERM: RESISTANCE

• Resistance – opposition to flow

– Measure of the amount of friction blood encounters
– Generally encountered in the systemic circulation
– Referred to as peripheral resistance (PR)

• The three important sources of resistance are blood:

1. Viscosity – relatively constant
2. Total blood vessel length – relatively constant
3. Blood vessel diameter – smaller diameter increase
resistance
 SYSTEMIC BLOOD PRESSURE
• The pumping action of the heart generates blood
flow through the vessels always moving from
higher- to lower-pressure areas
• Pressure results when flow is opposed by resistance
• Pressure is highest in the aorta but declines
throughout the length of the pathway until it is 0
mm Hg in the right atrium
• The steepest change in blood pressure occurs in the
arterioles
 ARTERIAL BLOOD PRESSURE

• Arterial BP reflects 2
factors of the arteries
close to the heart
– Their elasticity
(compliance or
distensibility)
– The amount of blood
forced into them at any
given time
• Blood pressure in elastic
arteries near the heart is
pulsatile (BP rises and falls
 ARTERIAL BLOOD PRESSURE

• Systolic pressure – pressure exerted on

arterial walls during ventricular
contraction – 120 mm Hg.

• Diastolic pressure – lowest level of

arterial pressure during a ventricular
cycle – 70 – 80 mm Hg.

• Pulse pressure – the difference between

systolic and diastolic pressure

• Mean arterial pressure (MAP) – pressure

that propels the blood to the tissues

• MAP = diastolic pressure + 1/3 pulse

pressure
 CAPILLARY BLOOD PRESSURE

• Capillary BP ranges from 15 to 35 mm Hg

• Low capillary pressure is desirable because high

BP would rupture fragile, thin-walled capillaries

• Low BP is sufficient to force filtrate out into

interstitial space and distribute nutrients, gases,
and hormones between blood and tissues
 VENOUS BLOOD PRESSURE

• Venous BP is steady and changes little during

the cardiac cycle.

• The pressure gradient in the venous system is

only about 15 mm Hg .

• A cut vein has even blood flow; a lacerated

artery flows in spurts.
 FACTORS AIDING VENOUS RETURN
• Venous BP alone is too low
to promote adequate blood
return and is aided by the:
– Respiratory “pump” –
pressure changes created
during breathing suck
blood toward the heart
by squeezing local veins
– Muscular “pump” –
contraction of skeletal
muscles “milk” blood
toward the heart
• Valves prevent backflow
during venous return
MAINTAINING BLOOD PRESSURE

Requires…..

• Cooperation of the Heart

• Blood vessels
• Kidneys
• Supervision of the Brain
 CONTROLS OF BLOOD PRESSURE
• Short-term controls regulate the diameter of the
blood vessels
– Are mediated by 1) the nervous system and 2)
bloodborne chemicals
– Counteract moment-to-moment fluctuations in
blood pressure by altering peripheral resistance

• Long-term controls regulate blood volume using

kidneys
Short-Term Mechanisms: Neural Controls
Impulse traveling along
afferent nerves from
baroreceptors:
Stimulate cardio-
Sympathetic
inhibitory center
impulses to
(and inhibit cardio-
heart
acceleratory center)
( HR and contractility)

Baroreceptors
in carotid
sinuses and
aortic arch Inhibit CO
stimulated vasomotor center
R

Rate of vasomotor
Arterial impulses allows
blood pressure vasodilation CO and R
rises above ( vessel diameter) return blood
normal range pressure to
Homeostatic
Stimulus: range
Rising blood
pressure

Homeostasis: Blood pressure in normal range

Stimulus:
Declining
blood pressure
CO and R
return blood Impulses from
pressure to baroreceptors: Arterial blood pressure
homeostatic Stimulate cardio- falls below normal range
range acceleratory center
Cardiac (and inhibit cardio-
output inhibitory center) Baroreceptors in
(CO) carotid sinuses
Sympathetic and aortic arch
impulses to heart inhibited
Peripheral ( HR and contractility)
resistance (R)

Vasomotor Stimulate
fibers vasomotor
stimulate center
vasoconstriction
Short-Term Mechanisms: Chemical Control

• Blood pressure is regulated by

chemoreceptor reflexes sensitive to
oxygen and carbon dioxide
– Prominent chemoreceptors are the
carotid and aortic bodies
 Long-term Mechanisms: Renal Regulation
• Long-term mechanisms control BP by altering
blood volume
• Baroreceptors adapt to chronic high or low BP
– Direct renal mechanism:
• Increased BP causes kidneys to
eliminate water to lower BP
• Decreased BP causes kidneys to
increase blood volume and BP
– Indirect renal mechanism:
• renin-angiotensin mechanism
– Declining BP causes the release of
renin, which triggers the release of
angiotensin II.
– Angiotensin II is a potent
vasoconstrictor that stimulates
aldosterone secretion.
– Aldosterone enhances renal
reabsorption and stimulates ADH
(Antidiuretic hormone) release.
AUTOREGULATION: LOCAL REGULATION OF BLOOD
FLOW
• Independent of systemic factors
• Changes in blood flow in individual organs – controlled intrinsically by modifying
diameter of local arterioles.
• These factors keep tissue perfusion fairly constant:

1) Metabolic controls – declining in oxygen or nutrients & metabolic substances

e.g. K+, H+, adenosine, lactic acid, prostaglandins.
- most act directly on vascular smooth muscle & cause the
release of nitric oxide (NO) – vasodilator or release of
endothelins – vasoconstrictor

2) Myogenic controls – increased & decrease of stretching of vascular smooth

muscle.
 BLOOD FLOW THROUGH
CAPILLARIES

• Blood flow is slow – through diffusion

• Capillary exchange of respiratory gases

& nutrients – 4 routes:
1) Lipid bilayer of endothelial cell
plasma membranes
2) Fluid-filled intercellular capillary
clefts – small water soluble
molecules e.g. AA
3) Fenestration
4) Active transport - in pinocytotic
vesicles
 BLOOD FLOW THROUGH CAPILLARIES
• Bulk flow – happen parallel as diffusion
• Important in determining relative fluid volumes in bloodstream & extracellular
space.
• 2 forces: hydrostatic & colloid osmotic pressures

Hydrostatic Pressures (HPc)

• Exerted by fluid pressing against the wall of capillary
• In theory, oppose by interstitial fluid hydrostatic pressure (Hpif) – acting
outside capillaries pushing fluid in but Hpif is very little or negative or zero.
• So…..In theory, net HP = difference between HPc and HPif
• Net effective HP at arterial & venous ends = HPc = BP

Colloid Osmotic Pressures (OPc)

• Force opposing hydrostatic pressure due to large molecules – cannot cross the
wall
• Large molecule cause osmosis – pull water in when concentration is lower
• OPIF is lower & does not change much
 BLOOD FLOW THROUGH CAPILLARIES
Hydrostatic-Osmotic Pressure Interactions
• To determine net gain or net loss o fluid from blood – net filtration pressure
(NFP)
• Fluids leave capillary if net HP > net OP & enter if net HP < net OP
• Arterial end HP dominates & venous end OP dominates
 CIRCULATORY
SHOCK

• Condition where blood

vessels are inadequately
filled & blood cannot
circulate normally –
intense drop in BP from
large-scale blood loss.

• Consequences if persist –
cells die & organ damage

• To replace fluid volume

as soon as possible
 MONITORING BLOOD PRESSURE
 Device used clinically for measurement of
blood pressure is the sphygmomanometer
 Consists of an inflatable cuff attached to a
pressure measuring device (gauge).
 The artery most typically selected for use in
measuring blood pressure is the brachial
artery.
 On occasion, the femoral artery may be
preferred.

 Another instrument is a stethoscope.

 Listen to breathing sounds for evaluation of
airway obstruction
 Listen to heart sounds for evaluation of
valvular function
 Listen for resumption of blood flow in
response to external pressure changes
induced by the sphygmomanometer.
 HOMEWORK

CHECK THE NAME & DISTRIBUTION OF MAJOR

BLOOD VESSELS IN THE BODY

(REF: Marieb EN, Hoehn K. Human Anatomy & Physiology 7th Edition. Chap
19: Cardiovascular System: Blood Vessels from pg 747 & 759)