CHAPTER #20: THE CARDIOVASCULAR SYSTEM: BLOOD MCC102A

VESSELS AND CIRCULATION

1ST SEMESTER | SY: 2024- 2025

ANATOMY OF BLOOD VESSELS ● Arteries and arterioles smaller lumen and thicker walls
○ To withstand higher pressures Vein

Review of Topics Related to Blood Flow ● Veins and venules have thinner walls and larger lumen
○ Exposed to lower pressures
○ Veins contain valves to ensure one-way flow
● Blood moves through the body by bulk flow through blood
vessels
❖ Lumen—a hollow passageway through which blood
● Flow is proportional to a pressure gradient that must
flows—and a wall that surrounds the lumen.
overcome resistance
❖ Arteries carry blood away from the heart, and therefore
○ High pressure flows to low pressure
are exposed to blood traveling at a higher velocity and
● Arteries carry blood away from the heart and branch to
pressure than veins.
form other vessels
❖ Veins do not have wall structure that tolerates high
● Capillary exchange with tissues occurs primarily via
pressure, and their walls are thinner, their structure
diffusion
baggier and less rigid. Because blood moves more slowly
through veins, they have larger lumens
Circulation Pathways
❖ Both arteries and veins have the same three distinct
layers, called tunics (from the Latin term tunica).
● Arteries and veins transport blood in two distinct circuits:
the systemic circuit and the pulmonary circuit
Anatomy of Blood Vessel Walls
● Systemic circuit carries blood throughout the body, with
the function of providing oxygen and nutrients to the
● Blood travels throughout body in blood vessels
skeletal muscles and organ systems.
○ Travels from areas of higher to lower
● Pulmonary circuit carries blood to the lung for gas
pressure
exchange
● Blood vessel walls are made of layers called tunics
○ taking on more oxygen and getting rid of
1. Tunica intima
carbon dioxide.
2. Tunica media
● Arteries carry blood away from heart
3. Tunica externa
○ Branch to form arterioles
● Capillaries are the sites of exchange
Tunica Intima (Interna)
● Venules and veins carry blood back toward heart

❖ Systemic arteries carry high pressure blood that has just ● Tunica intima (interna)-innermost layer
been expelled from the heart. ○ composed of endothelium and basement
❖ Pulmonary arteries carry blood away from the heart and membrane
toward the lungs for gas exchange. ○ Damage to endothelium exposes collagen
❖ Pulmonary veins then return freshly oxygenated blood fibers, leading to clot formation
from the lungs to the heart to be pumped back out into ○ Endothelial cells release endothelins to
systemic circulation regulate vasoconstriction
● Larger arteries contain internal elastic membrane
STRUCTURE-FUNCTION RELATIONSHIPS (lamina)
○ Additional layer of elastic fibers

Histology of Arteries and Veins ○ Provides additional elasticity to larger

arteries
○ Not found in veins
● Blood vessels share same general characteristics 
○ Vary slightly in structure
❖ Endothelins - Layer can release local chemicals that can
● Lumen = hollow space blood flows through
constrict the smooth muscle within the walls of the vessel.

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VESSELS AND CIRCULATION
1ST SEMESTER | SY: 2024- 2025

❖ Internal elastic membrane - In larger arteries,a thick, ❖ Tunica externa - A substantial sheath of connective
distinct layer of elastic fibers (also called the internal tissue composed primarily of collagen fibers.
elastic lamina) at the boundary with the tunica media. ❖ Vasa vasorum - Larger arteries and veins contain small
➢ Not apparent in veins. blood vessels within their walls known as the vasa
vasorum—which in Latin means “vessels of the vessel”—to
Tunica Media provide them with exchange of nutrients and wastes.
○ function in the outer layers of the vessel or the
pressure exerted by the blood passing through
● Tunica media-middle layer of blood vessel walls
the vessel would collapse it, preventing any
○ composed largely of smooth muscle
exchange from occurring
■ Nervi vasorum regulates
contraction and relaxation of
muscle ARTERIES
● Leads to vasoconstriction
and vasodilation Arteries

● Primarily sympathetic
innervation except for ● Blood vessels that carry blood away from heart
external genitalia ● Elastic arteries-higher percentage of elastic fibers
○ Thicker tunica media in arteries than veins ○ Help propel blood during ventricular diastole
○ Larger arteries contain external elastic ● Muscular arteries-higher percentage of smooth muscle
membrane (lamina) ○ Aid in controlling distribution of blood
■ Provides additional elasticity in
arteries ❖ The arteries closest to the heart have the highest
■ Not seen in smaller arteries or veins proportion of elastic fibers to help them stretch. They are
the largest arteries and are called elastic arteries. Elastic
❖ Vasoconstriction - a narrowing of the vessel that restricts arteries branch into smaller arteries and eventually the
flow within. proportion of muscle in the wall of the vessel becomes
❖ Vasodilation - When the smooth muscle of the tunica substantial. These arteries, muscular arteries, contribute to
media relaxes, the vessel widens blood flow, pressure, and thermoregulation through
❖ Nervi vasorum - Both vasoconstriction and vasodilation vasoconstriction and vasodilation. Muscular arteries
are regulated in part by small vascular nerves, known as branch into smaller arteries, which branch into arterioles.
nervi vasorum or “nerves of the vessel,” that run within the
walls of blood vessels ARTERIOLES
❖ External elastic membrane - In larger arteries there is a
thick external elastic membrane, a wavy elastic fiber layer Arterioles
that provides stretchiness to the vessel.

● Microscopic arteries that lead to capillaries

Tunica Externa ● All three tunics are very thin
● Smooth muscle slightly contracted to maintain vascular
● Tunica externa-outermost tunic tone
○ Composed mainly of collagen and elastic ● Site of greatest resistance to blood flow
fibers ● Able to regulate blood pressure and distribution of blood
● Maintains shape and structure of vessel flow
● Thicker in arteries than in veins 
● Larger arteries and veins are supplied by vasa vasorum ❖ Arteriole - A very small artery that leads to a capillary.
○ Vessels that exchange nutrients and wastes Arterioles - Have the same three tunics as the larger
for the wall vessels, but the thickness of each is greatly diminished.

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❖ Vascular tone - The muscle fibers in arterioles are METARTERIOLES AND CAPILLARY BEDS
normally slightly contracted, causing arterioles to
maintain a consistent muscle tone— in this case referred Metarterioles and Capillary Beds
to as vascular tone—in a manner similar to the muscular
tone of skeletal muscle
● Metarterioles regulate flow of blood into capillary beds
using precapillary sphincters
CAPILLARIES ○ Located at openings of capillary beds from
metarteriole
Capillaries ● Sphincters contract to limit blood flow through capillary
○ Blood moves through thoroughfare channel
● Thin-walled vessels bypassing capillary bed
○ Used for exchange of substances between ● When sphincters relax it allows perfusion of capillary beds
blood and tissues
● Three types differ according to their degree of ❖ Metarteriole - A type of vessel that has structural
“leakiness.”: characteristics of both an arteriole and a capillary.
○ Continuous capillaries ➢ slightly larger than the typical capillary and
○ Fenestrated capillaries contains rings of smooth muscle.
○ Sinusoid(al) capillaries ❖ Capillary bed - A metarteriole brings blood toward a
capillary bed that may consist of 10–100 capillaries
❖ A capillary is a thin-walled microscopic channel that ❖ Precapillary sphincters - circular smooth muscle cells
supplies blood to the tissues themselves (a process called that surround the capillary at its origin with the
perfusion). metarteriole, tightly regulate the flow of blood from a
metarteriole to the capillaries it supplies.
● Continuous capillaries - most common type ❖ Thoroughfare channel - Blood will flow from the
○ Complete endothelial lining metarteriole directly into a thoroughfare channel and then
○ Endothelial cells all touch each other and do into the venous circulation, bypassing the capillary bed
not contain large holes. entirely.
○ Allows exchange of water, gases, and small
molecules VENULES
● Fenestrated capillaries - contain pores through the
endothelial cells to allow larger molecules to cross the Venules
capillary wall easily.
○ Found in small intestine and kidneys
● Extremely small veins
○ Allow greater exchange of fluid and larger
● Merge to form veins 
molecules
● Walls of venules of
● Sinusoid(al) capillaries—least common
○ Endothelium
○ with extensive intercellular gaps and
○ A few bands of smooth muscle
incomplete basement membranes
○ Outer layer of connective tissue
○ Found in liver, spleen, and red bone marrow
○ Allow exchange of plasma proteins and cells

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VESSELS AND CIRCULATION
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VEINS ❖ Arteriovenous anastomosis - provides a detour for the

blood around the route that leads to a capillary bed.
Veins ❖ Portal system - A blood flow pattern in which two
capillary beds are linked between the artery and vein:
➢ Artery → Arteriole → Capillary bed →
● Blood vessels that carry blood toward the heart
Connecting vessel → Venule → Vein

● Thinner walls than arteries Anatomy of Blood Flow Pathways

○ Larger lumens
● Low pressure vessels ● Standard pathway of blood flow is arteries, arterioles,
● Contain valves to prevent backflow capillaries, venules, and veins
● Function as blood reservoirs due to larger lumen ● Alternative pathways of blood flow include:
○ Venoconstriction speeds up venous return to ○ Arterial anastomoses
heart ○ Arteriovenous anastomoses
○ Portal systems
VEINS AS BLOOD RESERVOIRS
ANATOMY OF BLOOD FLOW PATHWAYS
Veins as Blood Reservoirs ➔ In the standard pathway, blood ˜ows away from the heart
in an artery that branches into arterioles, and then gas

● Veins are often referred to as blood reservoirs, or venous and material exchange takes place in the capillaries.

reservoirs. Deoxygenated blood is drained from the capillaries into a

● Veins are able to expand as needed to contain the venule and then ˜ows through veins to return to the heart.

slow-moving blood. ➔ In an anastomosis, multiple arteries, all of which are

● Less dramatic than the vasoconstriction seen in arteries carrying oxygenated blood, merge together and combine

and arterioles, venoconstriction may be likened to a their blood to feed an area. Anastomoses have evolved to

“stiffening” of the vessel wall. guarantee blood ˜ow to critical areas like the brain
➔ An arteriovenous anastomosis provides a stent or bypass

ALTERNATIVE BLOOD FLOW PATHWAYS that avoids the capillary bed. These anatomical blood ˜ow
patterns are present in the hands and feet. During cold
temperatures, blood ˜ows through the shunt and avoids
Alternative Blood Flow Pathways
the capillary bed to prevent heat loss
➔ In a portal system, two capillary beds are linked between
● Typical pattern of blood flow is:
the artery and vein. Typically material such as nutrients or
○ Artery → Arteriole → Capillary bed → Venule
hormones are added to the blood at the ÿrst capillary bed
→ Vein
and then removed at the second capillary bed. Portal
● A few variations:
systems enable exchange between two tissues of the
○ Arterial anastomosis -Multiple arteries
body
supply a common capillary bed
■ Provides alternate routes for arterial
BLOOD FLOW, BLOOD PRESSURE AND RESISTANCE
blood to reach tissue
○ Venous anastomosis-venules split and
Blood Flow
contribute to multiple veins
○ Portal system-links two capillary beds
between the artery and vein ● Blood flow— the movement of blood through a vessel,

■ Artery, arteriole, capillary bed, tissue, or organ, and is usually expressed in terms of

connecting vessel, capillary bed, volume of blood per unit of time.

venule, vein ○ Flow rate is influenced by pressure gradient

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VESSELS AND CIRCULATION
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○ The greater the resistance, the higher the ■ Can occur due to age or chronic
blood pressure must be to maintain flow high blood pressure
○ The greater the pressure gradient, the
greater the flow rate ❖ Blood pressure fluctuates wildly in the vessels close to the
● Flow rate is opposed by resistance heart where ejected blood comes in waves during every
● Blood pressure drives blood flow in the human body heartbeat. During systole the pressure increases
❖ Equation can be used to compare the factors that significantly, and during diastole the pressure drops
influence blood flow: dramatically. As the blood travels farther from the heart it
➢ Flow α pressure gradient/resistance encounters more friction and its pressure decreases
❖ Blood pressure - One form of hydrostatic pressure is between the arterioles and the capillaries. The blood in the
blood pressure, the force exerted by blood upon the walls venules and veins is under very low pressure.
of the blood vessels or the chambers of the heart
❖ Sphygmomanometer - measures blood pressure in Mean Arterial Pressure
millimeters of mercury (mm Hg).

● Mean arterial pressure (MAP) — "average" pressure

ARTERIAL BLOOD PRESSURE
arteries experience
○ Calculated by adding diastolic pressure to
Arterial Blood Pressure one-third of pulse pressure
○ MAP = diastolic BP + 1/3 (PP)
● Measured using a sphygmomanometer at the brachial
artery
●
○ Recorded as a ratio of two numbers
○ Homeostatic range for MAP is 70 - 110 mm Hg
■ Systolic pressure reflects arterial
○ If measured blood pressure is 120/80 mm Hg,
pressure during left ventricular
the MAP would be 93.33 mm Hg
systole
■ 80 + (120-80)/3 = 93.33
■ Diastolic pressure reflects arterial
■ Recall pulse pressure is the
pressure during left ventricular
difference between systolic and
diastole
diastolic pressures
■ For example: 120/80 mm Hg
● Low MAP can lead to ischemia due to poor blood flow
■ Top number represents systolic
○ Ischemia may lead to hypoxia and tissue
pressure, bottom number
death
represents diastolic pressure

❖ Ischemia - Insufficient blood flow.

❖ Systolic pressure reflects the arterial pressure in the
❖ Hypoxia—Inadequate oxygenation of tissues—commonly
brachial artery during ejection of blood when the heart’s
accompanies ischemia.
ventricles contract.
❖ Hypoxemia - refers to low levels of oxygen in systemic
❖ Diastolic pressure is the arterial pressure of blood during
arterial blood
ventricular relaxation, or diastole

PULSE
Pulse Pressure

Pulse
● Pulse pressure (PP) -difference between systolic and
diastolic pressures
● The expansion and recoil of arteries as blood flows
○ Highest in arteries closest to heart
through them
○ Disease: decreases with decreased elasticity
of arteries

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○ Reflection of heart rate measured in beats ○ Decreased CO decreases pressure gradient

per minute (bpm) and flow rate decreases
● Can be felt through the skin at superficial arteries ○ CO = HR × SV
● Weaker at points further away from heart ● Blood volume-amount of blood within vascular system
● Common pulse points are the radial artery (wrist), ○ Lower blood volume (hypovolemia)
common carotid artery (neck), and dorsalis pedis artery decreases pressure gradient and flow rate
(foot) decreases
○ Higher blood volume (hypervolemia)
increases pressure gradient and flow rate
increases

❖ Hypovolemia - In certain disease states such as bleeding,

dehydration, or severe burns, low blood volume
❖ Hypervolemia - or excessive fluid volume, may be caused
by retention of water and sodium, as seen in patients with
heart failure, liver cirrhosis, and some forms of kidney or
endocrine diseases.

FACTORS THAT CONTRIBUE TO RESISTANCE

Factors That Contribute to Resistance

VARIABLES AFFECTING BLOOD FLOW AND BLOOD PRESSURE ● Poiseuille's equation relates resistance to blood flow
● Variables in that equation are:
Variables Affecting Blood Flow and Blood Pressure ○ Blood vessel length
○ Blood viscosity

● Pressure must be higher than resistance for blood to flow ○ Blood vessel radius

● Factors that influence pressure or resistance will affect

flow ❖ Jean-Louis-Marie Poiseuille was a French physician and

○ Cardiac output physiologist who devised a mathematical equation

○ Blood volume describing the resistance to blood flow called Poiseuille’s

○ Vessel compliance equation.

○ Viscosity of blood ➢ examines the factors that contribute to

○ Blood vessel length and diameter resistance

❖ Three factors of resistance (vessel length, blood viscosity,

FACTORS THAT CONTRIBUTE TO THE PRESSURE GRADIENT and vessel radius)

Factors That Contribute to the Pressure Gradient

● Cardiac output (CO)-amount of blood ejected from each

ventricle per minute
○ Increased CO increases pressure gradient
established by left ventricle and flow rate
increases

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Resistance to Flow Blood Vessel Radius

Resistance to flow can be summarized in a mathematical
equation. In this equation, the length of the vessel and the ● Inversely proportional to resistance
viscosity of the blood are both proportional to resistance.
● Vessels of smaller diameter (or radius) have higher
This means that as these numbers increase, the vessel is
resistance and decreased flow
longer, or the blood is thicker, there is more resistance
to flow. The radius of the vessel is inversely proportional to ○ Less vessel space can increase blood flow
resistance, and the radius is raised to the fourth power. This along the wall of vessel
means that as the radius increases, there is less resistance ○ Contact with wall creates more friction and
to flow. The radius of the vessel has a much greater impact higher resistance
on resistance than the other two factors. ● Vessel radius is the most important influence on
resistance
Vessel Length ● Arterioles are greatest site of resistance due to small
radius and ability to further constrict

● The length of a vessel is directly proportional to its

❖ The radius of blood vessels changes anatomically
resistance: the longer the vessel, the greater the
throughout the body according to the type of vessel,
resistance and the lower the flow
❖ An increased radius means there is less blood contacting
○ the reason for this has to do with friction.
the vessel wall, thus lower friction and lower resistance,
● As blood flows within a vessel, or any fluid flows within any
subsequently increasing flow
tube, the blood encounters friction as it contacts the walls
❖ A decreased diameter means more of the blood contacts
of the tube.
the vessel wall, and resistance increases, subsequently
decreasing flow
Blood Viscosity
❖ Compliance is the ability of any compartment to expand
to accommodate increased content.
● The thickness of blood which affects their ability to flow.
❖ Arterioles are the site of greatest resistance in the entire
● Directly proportional to resistance
vascular network.
○ More viscous blood leads to higher
resistance and decreased flow rate
■ Because more viscous blood
moves slower
■ Slower-moving blood creates more
friction because it interacts with
blood vessel wall longer

Changes in Blood Vessel Diameter, Total

Cross-Sectional Area, Blood Pressure, and Blood Flow
Velocity that Occur as Blood Flows through the
Systemic Circuit
(A) Blood vessel diameter decreases as arteries split into
smaller and smaller arteries and then arterioles and

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○ Respiratory pump-alternating pressures

capillary beds. The vessels increase in diameter once
milk blood toward heart
again as venules merge together to form veins and veins
merge to form larger veins. (B) The total cross-sectional ● Valves prevent backflow
area of vessels helps us to understand how much space
these vessels take up in the body. By far, capillaries and ❖ Skeletal muscle pump - describes veins that are
venules take up the most space. (C) Blood pressure sandwiched among muscles in the limbs.
decreases steadily as we move away from the heart; the
➢ As muscles contract (for example, during
right side of the heart has the lowest pressure in the
walking or running) they exert pressure on
entire system. (D) Blood flow is fastest close to the heart;
the velocity or speed of flow decreases as blood moves the veins, squeezing blood up toward the
farther away from the heart, and only picks back up in heart.
the venae cavae. ❖ Respiratory pump aids blood flow through the veins of
the thorax and abdomen.

APPLICATION: HYPERTENSION ➢ During inhalation, the volume of the thorax

increases; this volume increase causes
pressure within the thorax to decrease.
Application: Hypertension
➢ During exhalation, air pressure increases
within the thoracic cavity and the thoracic
● High blood pressure defined as greater than 140/90 mm
veins, driving blood flow toward the heart.
Hg persistently
○ More common in biological males than
CAPILLARY EXCHANGE
biological females
○ Contributing factors include genetics,
obesity, smoking, age, stress, lack of exercise, Methods of Capillary Exchange

and alcohol consumption

● Untreated hypertension may lead to heart, blood vessel, ● Diffusion-primary method of capillary exchange
and organ damage ○ Molecules move from areas of higher to
● Primary hypertension has no identifiable cause (90% of lower concentration
cases) ○ Can be simple diffusion or facilitated
● Secondary hypertension has an identifiable cause (10% of ● Transcytosis —movement through an endothelial cell
cases) ○ Endocytosis coupled with exocytosis
● Can be managed with lifestyle modifications and ● Bulk flow-exchange of fluid between blood and tissues
medications ○ Driven by hydrostatic and osmotic
pressures
❖ Hypertension, or high blood pressure, is defined as having
persistent arterial blood pressure readings of greater than Hydrostatic and Osmotic Pressures
140/90 mm Hg

● Hydrostatic pressure Is generated by any fluid within a

VENOUS SYSTEM closed space
○ Blood hydrostatic pressure = force exerted
Venous Return on walls of vessels by blood
■ Drives movement of fluid out of
● Veins are low-pressure vessels capillaries and into tissues
● Need assistance to move blood toward heart ● Osmotic pressure is determined by solute concentration
○ Skeletal muscle pump-muscle compress ○ Fluid moves toward aro of higher solute
veins concentration

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○ Most solute concentration equalize across a THE ROLE OF LYMPHATIC CAPILLARIES

capillary wall
○ Plasma proteins do not cross wall of Lymphatic Capillaries
capillary
■ Ensures that solute concentration
● Hydrostatic pressure exceeds osmotic pressure during
of blood remains higher than in
bulk flow
tissues
● Imbalance leads to more fluid filtered than reabsorbed
■ Drives movement of fluid into
○ The remaining fluid in the tissues would
capillaries from tissues
accumulate and cause edema (swelling) if
unaccounted for
➔ Hydrostatic Pressure
● Lymphatic capillaries absorb excess interstitial fluid to
❖ The primary force driving bulk flow is hydrostatic pressure
prevent edema
❖ Blood hydrostatic pressure is the force exerted by the
○ Excess interstitial fluid is eventually returned
blood onto the walls of the blood vessels or heart
to bloodstream
chambers.

HOMEOSTATIC REGULATION OF THE VASCULAR SYSTEM

➔ Osmotic Pressure
❖ Osmotic pressure, the force that draws water toward an
❖ Three homeostatic mechanisms—neural, endocrine, and
area with higher solute concentration, works in opposition
autoregulatory—ensure adequate blood flow, blood
to hydrostatic pressure.
pressure, and blood distribution.
➢ Plasma proteins represent the main osmotic
regulators of the blood,
NEURAL REGULATION
❖ Net filtration pressure (NFP) represents the balance of the
hydrostatic and osmotic pressures.
Neural Regulation
➢ equal to the difference between the
hydrostatic and the osmotic pressure.
● Cardiovascular centers in brain regulate blood pressure,

NET FILTRATION PRESSURE distribution, and flow

○ Cardicaccelerator centers-regulate heart
rate (HR) and stroke volume
Net Filtration Pressure
■ Sympathetic cardiac accelerator
nerves increase HR and contractility
● Difference between hydrostatic and osmotic pressures
● Cardioinhibitory centers--decrease HR and stroke
○ Filtration -fluid leaves blood and enters
volume
interstitial fluid (IF)
○ Via parasympathetic vagus nerves
■ Promoted by blood hydrostatic
● Vasomotor centers-control vascular tone
pressure
○ Cause vasoconstriction to influence
○ Reabsorption-fluid leaves IF and enters
resistance, pressure and flow
blood
○ Promoted by colloid osmotic pressure
Baroreceptor Reflexes
■ Determined by plasma proteins

● Baroreceptors are in aorta and carotid bodies

● If blood pressure is too high:
○ Parasympathetic stimulation results in
decreased CO and vasodilation

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● If blood pressure is too low: ➢ EPO stimulates the production of

○ Sympathetic stimulation results in increased erythrocytes within the bone marrow.
CO and vasoconstriction
AUTOREGULATION OF BLOOD FLOW
❖ Aortic baroreceptors are found in the walls of the
ascending aorta just superior to the aortic valve Autoregulation
❖ Carotid baroreceptors are found at the carotid bodies,
the point of divergence of the internal and external carotid
● Local mechanisms that allow tissues to adjust local blood
arteries.
flow
➢ When blood pressure rises too high, the
● Chemical signals open precapillary sphincters of
baroreceptors trigger parasympathetic
metarterioles to increase Mow
stimulation of the heart.
○ Low oxygen, increased carbon dioxide, low
➢ When blood pressure drops too low, the rate
pH, increasing potassium levels
of baroreceptor firing decreases.
○ Nitric oxide release results in vasodilation

Chemoreceptor Reflexes ● Chemical signals can also close precapillary sphincters

○ Increased oxygen, decreased carbon
● Located alongside the baroreceptors are chemoreceptors dioxide, normal pH
that monitor levels of oxygen, carbon dioxide, and
hydrogen ions (pH), and thereby contribute to vascular ❖ Relaxation and opening of the precapillary sphincter:
homeostasis Symptoms of increased metabolism all cause the opening
● The chemoreceptors respond to increasing changing of precapillary sphincters. These include decreased
levels of carbon dioxide, pH, or oxygen and signal the oxygen concentrations, increased carbon dioxide
cardioaccelerator, cardioinhibitor, and vasomotor centers concentrations, increasing levels of lactic acid
to facilitate the cardiovascular system to transport these concentration, and increasing potassium ion
gasses to the lungs for exchange. concentrations.
❖ Contraction and closing of the precapillary sphincter:
ENDOCRINE REGULATION This is triggered by the opposite levels of these same
regulators.
Endocrine Regulation
Myogenic Mechanism

● Epinephrine and norepinephrine—increase BP via

increased CO and Vasoconstriction ● Localized response of smooth muscle in arteriole walls
● Antidiuratic hormone-increases BP by increasing blood ● Low blood flow through arteriole leads to less wall stretch
volume ○ Smooth muscle relaxes to allow dilation of
● Renin-part of renin-angiotensin-aldosterone pathway that vessel to increase blood flow
increases BP ● Higher blood flow through arteriole increases wall stretch
● Angiotensin II-increases BP via vasoconstriction ○ Smooth muscle constricts causing
● Aldosterone-increases blood volume to increase BP vasoconstriction
● Erythropoietin-increases BP via vasoconstriction ○ Reduces amount of blood flow through
● Atrial natriuretic hormone-decreases blood volume to capillary to protect small vessels from
decrease BP damage

❖ Erythropoietin (EPO) is released by the kidneys when ❖ Myogenic response is a reaction to the stretching of the
blood flow and/ or oxygen levels of the blood decrease. smooth muscle in the walls of arterioles as changes in
blood flow occur through the vessel.

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➢ The myogenic response is a protective

function. Excessive blood flow could damage
The Intertwining Circuits of Blood Flow
smaller and more fragile vessels, so the
The cells of the body require oxygen and nutrients and take
myogenic response is a localized reaction
these items out of the blood when it flows through the
that stabilizes blood flow in the capillary systemic circuit. The blood, then poorer in oxygen content,
network that follows that arteriole. returns to the right side of the heart, where it is kept
separate from oxygenated blood as it is pumped to the
CIRCULATORY PATHWAYS lungs for gas exchange.

Blood Flow Circuits The Pulmonary Circuit

● Systemic circuit delivers nutrients and oxygenated blood ● Pulmonary trunk divides to form pulmonary arteries that
to tissues carry dear donated blood to lungs
● Pulmonary circuit sends deoxygenated blood to lungs for ● Gas exchange occurs in lungs and oxygenated blood is
gas exchange returned to heart via pulmonary veins

❖ Systemic circuit brings the blood that has been ejected ❖ Pulmonary trunk - The single vessel exiting the right
from the left ventricle to all of the tissues of the body, ventricle
returning the oxygen-depleted blood back to the right side ❖ Pulmonary trunk splits into two branches, the left and right
of the heart. pulmonary arteries
❖ Pulmonary circuit brings blood from the right side of the ➢ Each pulmonary artery branches many
heart to the lungs for gas exchange. times within the lung, forming a series of
smaller arteries and arterioles that
❖ Anastomoses are especially common in veins, where they eventually lead to the pulmonary capillaries.
help maintain blood flow even when one vessel is blocked ➢ The pulmonary capillaries surround lung
or narrowed, although there are some important ones in structures known as alveoli that are the sites
the arteries supplying the brain of oxygen and carbon dioxide exchange.
❖ A very large artery that is short and branches quickly into ➢ Once gas exchange is completed,
two arteries is typically referred to as a trunk, a term oxygenated blood flows from the pulmonary
indicating that the vessel gives rise to several smaller capillaries into a series of pulmonary venules
arteries. that eventually lead to a series of larger
❖ Sinus - A short, wide vein that collects blood from many pulmonary veins.
smaller veins such as the dural venous sinus in the brain
SYSTEMIC ARTERIES

Systemic Arteries

● Blood from left atrium enters left ventricle

● Left ventricle ejects oxygenated blood into systemic
arteries
○ Largest artery is the aorta

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THE AORTA ○ External carotid artery

■ Branches to form lingual, facial,
The Aorta occipital, maxillary, and superficial
temporal arteries

● Emerges from left ventricle of heart

❖ There are three major branches of the aortic arch—the
● Left and right coronary arteries branch from ascending
brachiocephalic trunk, the left common carotid artery, and
aorta
the left subclavian artery.
● Three branches from aortic arch
➢ Brachiocephalic trunk is the first branch off
1. Brachiocephalic trunk
the aortic arch.
2. Left common carotid artery
➢ The left subclavian and left common
3. Left subclavian artery
carotid arteries arise independently from
the aortic arch but otherwise follow a similar
❖ Aorta is the largest artery in the body
pattern and distribution to the
➢ Carries blood ejected from the left ventricle;
corresponding arteries on the right side
it arches around the top of the heart and
❖ Each subclavian artery ascends to the shoulder, passing
descends through the thorax and to the
beneath the clavicle.
abdominal region, where it splits into the two
➢ supply blood to the arms, chest, shoulders,
common iliac arteries
back, and central nervous system.
❖ The aorta begins at the aortic semilunar valve, which
➢ Each subclavian artery then gives rise to
prevents backflow of blood into the left ventricle while the
three major branches: the internal thoracic
heart is relaxing.
artery, the vertebral artery, and the
❖ Ascending aorta carries blood superiorly for a short
thyrocervical artery
distance before forming a graceful arch, called the aortic
➢ Internal thoracic artery, or mammary
arch, which crests over the heart and then dips
artery, supplies blood to the thymus, the
posteriorly, forming the descending aorta and then the
pericardium of the heart, and the anterior
thoracic aorta as the vessel continues down through the
chest wall
thorax
➢ Vertebral artery passes through the
❖ The aorta passes through an opening in the diaphragm
vertebral foramen of the cervical vertebrae
known as the aortic hiatus; inferior to the diaphragm it is
and then through the foramen magnum into
called the abdominal aorta.
the cranial cavity to supply blood to the
brain and spinal cord.
The Coronary Vessels
➢ The subclavian artery also gives rise to the
thyrocervical artery, which provides blood
● Paired coronary arteries branch from ascending aorta
to the thyroid, the cervical region of the neck,
○ Right coronary artery
and the upper back and shoulder.
○ Left coronary artery
❖ Left common carotid artery arises from the aortic arch
● Form the vessels that supply myocardium of the heart
and ascends toward the neck, where it divides into internal
and external carotid arteries
Arteries Supplying the Head and Neck
❖ External carotid artery supplies blood to the face, lower
jaw, neck, esophagus, and larynx
● Subclavian arteries divide to form: ❖ Internal carotid artery initially forms an expansion known
○ Internal thoracic artery, vertebral artery, as the carotid body, containing the carotid baroreceptors
thyrocervical artery and chemoreceptors.
● Common carotid arteries divide to form: ❖ Both the carotid and vertebral arteries branch once they
○ Internal carotid artery enter the cranial cavity, and some of these branches form

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a structure known as the cerebral arterial circle, an

anastomosis that is remarkably like a traffic circle that
sends off branches (in this case, arterial branches to the
brain)
❖ Anterior cerebral artery - supplies blood to the frontal
lobe of the cerebrum
❖ Middle cerebral artery - another branch, supplies blood
to the temporal and parietal lobes, which are the most
common sites of CVAs
❖ Ophthalmic artery - the third major branch, provides
blood to the eyes
❖ Anterior communicating artery - The right and left
anterior cerebral arteries join together to form an
anastomosis
❖ The posterior portion of the arterial circle is formed by a
left and a right posterior communicating artery that
branches from the posterior cerebral artery, which arises Arteries of the Brain
The internal carotid arteries and the vertebral arteries carry
from the basilar artery.
blood upward toward the brain. The vertebral arteries join at
❖ Basilar artery is an anastomosis that begins at the
the brainstem to form the basilar artery. The two internal
junction of the two vertebral arteries and sends branches
carotid (and one basilar) arteries contribute to an arterial
to the cerebellum and brainstem circle—the cerebral arterial circle—at the base of the brain.

Cerebral Arterial Circle

Thoracic Aorta and Major Branches

● Internal carotid arteries branch from common carotid

● Each bronchial artery (typically two on the left and one on
arteries
the right) supplies systemic blood to the lungs and
● Internal carotid arteries branch to middle and anterior
visceral pleura
cerebral arteries
● Each pericardial artery supplies blood to the pericardium,
● Vertebral arteries merge to form basilar artery
the esophageal artery provides blood to the esophagus,
● Basilar artery branches to form posterior cerebral arteries
and the mediastinal artery provides blood to the
● Communicating arteries connect major branches
mediastinum.
● Each intercostal artery provides blood to the muscles of
the thoracic cavity and vertebral column
● Superior phrenic artery provides blood to the superior
surface of the diaphragm

Arterial Supply of the Thorax and Abdomen

● Arteries of thorax and abdominal branch from aorta

● Celiac trunk branches from abdominal aorta to form.
○ Common hepatic artery
○ Left gastric artery
○ Splenic artery

Arteries Supplying the Head and Neck

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❖ A single celiac trunk emerges from the aorta and divides ● Ulnar artery
into three arteries: the left gastric artery, which supplies ● Radial artery
blood to the stomach and esophagus; the splenic artery, ● Palmar arches
which supplies blood to the spleen; and the common ● Digital arteries
hepatic artery, which supplies blood to the liver.
❖ Branches off the common hepatic artery include the ❖ Axillary artery - Renamed as As the subclavian artery
hepatic artery proper to supply blood to the liver, the exits the thorax into the axillary region
right gastric artery to supply blood to the stomach, the ❖ Brachial artery supplies blood to much of the brachial
cystic artery to supply blood to the gallbladder, and region and divides at the elbow into several smaller
several other branches that supply blood to the branches, including the deep brachial arteries, which
duodenum and the pancreas. provide blood to the posterior surface of the arm, and the
❖ Superior mesenteric artery branches into several major ulnar collateral arteries, which supply blood to the region
vessels that supply blood to the small intestine of the elbow.
(duodenum, jejunum, and ileum), the pancreas, and a ❖ Radial artery and ulnar artery parallel their namesake
majority of the large intestine. bones, giving off smaller branches until they reach the
❖ Inferior mesenteric artery supplies blood to the distal wrist, or carpal region.
segment of the large intestine, including the rectum ❖ Palmar arches that supply blood to the hand,
❖ Inferior phrenic artery is a counterpart of a superior ❖ Digital arteries that supply blood to the digits.
phrenic artery and supplies blood to the inferior surface of
the diaphragm. ARTERIES SERVING THE LOWERING LIMB
❖ Adrenal artery supplies blood to the adrenal glands.
❖ Each renal artery supplies a kidney. Arteries of the Lower Limbs
❖ Gonadal artery supplies blood to the gonads, or
reproductive organs
● Femoral artery
❖ The four paired lumbar arteries are the counterparts of
● Deep femoral artery
the intercostal arteries and supply blood to the lumbar
● Popliteal artery
region, the abdominal wall, and the spinal cord.
● Anterior and posterior tibial arteries
➢ a fifth pair of lumbar arteries emerges from
● Dorsalis pedis artery
the median sacral artery.
● Dorsal and plantar arches
❖ The aorta divides at approximately the level of vertebra L4
into a left and a right common iliac artery but continues
❖ Femoral artery - Renamed as it passes through the
as a small vessel—the median sacral artery— into the
abdominal wall and into the leg
sacrum.
❖ It gives off several smaller branches as well as the lateral
❖ Internal iliac artery sends branches to the urinary
deep femoral artery, which in turn gives rise to a lateral
bladder, the walls of the pelvis, the external genitalia, and
circumflex artery
the medial portion of the femoral region.
❖ The femoral artery also gives rise to the genicular artery,
❖ External iliac artery supplies blood to each of the lower
which provides blood to the region of the knee.
limbs.
❖ Popliteal artery - As the femoral artery passes posterior to
the knee. Branches into the anterior and posterior tibial
ARTERIES SUPPLYING THE UPPER LIMB arteries.
❖ Anterior tibial artery is located between the tibia and
Arteries of the Upper Limbs fibula, and supplies blood to the muscles and integument
of the anterior tibial region.
● Subclavian artery ❖ Dorsalis pedis artery - Upon reaching the tarsal region,
● Axillary artery which branches repeatedly and provides blood to the
● Brachial artery tarsal and dorsal regions of the foot

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❖ Posterior tibial artery provides blood to the muscles and ❖ Bronchial vein drains the systemic circulation from the
integument on the posterior surface of the tibial region. lungs, and several smaller veins drain the mediastinal
❖ The fibular or peroneal artery branches from the posterior region.
tibial artery. It bifurcates and becomes the medial plantar ❖ These veins flow into the azygos vein, and with the smaller
artery and lateral plantar artery, providing blood to the hemiazygos vein (hemi- = “half ”) on the left of the
plantar surfaces vertebral column, drain blood from the thoracic region
❖ There is an anastomosis with the dorsalis pedis artery, and
the medial and lateral plantar arteries form two arches Veins of the Head and Neck
called the dorsal arch (also called the arcuate arch) and
the plantar arch, which provide blood to the remainder of
● Internal jugular veins drain brain and some areas of the
the foot and toes.
face
● Most superficial areas of the head drained by external
OVERVIEW OF SYSTEMIC VEINS jugular veins

Systemic Veins ❖ Blood from the brain and the superficial facial vein flow
into each internal jugular vein
● Return deoxygenated blood to right atrium ❖ Blood from the more superficial portions of the head,
● Many named for the artery they accompany scalp, and cranial regions, including each temporal vein
● Superior vena cava -drains venous blood above and maxillary vein, flows into each external jugular vein
diaphragm
● Inferior vena cava-drains venous blood below Venous Drainage of the Brain
diaphragm

● Dural venous sinuses - Many smaller veins of the

Superior Vena Cava brainstem, and the superficial veins of the cerebrum, lead
to pockets within the dura mater
● Subclavian veins merge with internal jugular veins to ● Superior sagittal sinus - Most of the veins on the superior
form brachiocephalic veins surface of the cerebrum flow into the largest of the
● Brachiocephalic veins merge to form superior vena cava sinuses
● Azygos veins drain blood from thorax ● Straight sinus - Blood from most of the smaller vessels in
the inferior cerebrum flows into the straight sinus.
❖ Superior vena cava drains most of the body superior to
the diaphragm Veins Draining the Upper Limbs
❖ Subclavian vein is the extension of the axillary vein; it runs
in parallel to the subclavian artery. ● Digital veins
➢ It fuses with the external and internal jugular ● Median antebrachial vein
veins from the head and neck to form the ● Palmar venous arches
brachiocephalic vein. ● Median cubital vein
❖ Vertebral vein also flows into the brachiocephalic vein ● Radial vein
close to this fusion. ● Cephalic vein
❖ Internal thoracic vein also known as an internal ● Ulnar vein
mammary vein drains the anterior surface of the chest ● Subscapular vein
wall and flows into the brachiocephalic vein ● Brachial vein
❖ Intercostal vein drains muscles of the thoracic wall ● Axillary
❖ Esophageal vein delivers blood from the inferior portions
of the esophagus

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❖ Digital veins in the fingers come together in the hand to ❖ Hepatic vein - Where blood supply from the liver is
form the palmar venous arches drained and directly into the inferior vena cava.
❖ The radial vein and the ulnar vein parallel the bones of
the forearm and join together at the antebrachium to THE HEPATIC PORTAL SYSTEM
form the brachial vein, a deep vein that flows into the
axillary vein in the brachium. Hepatic Portal System
❖ Median antebrachial vein parallels the ulnar vein, is more
medial in location, and joins the basilic vein in the forearm
● Venous blood from the spleen, stomach, and intestines
❖ Median cubital vein - As the basilic vein reaches the
drains into the hepatic portal vein
antecubital region
○ Brings blood to the liver for detoxification
➢ most common site for drawing blood in
● Renal veins drain the kidneys
clinical settings.
❖ Cephalic vein begins in the antebrachium and drains
❖ The liver also plays a critical function in filtering materials
blood from the superficial surface of the arm into the
absorbed from the intestines Instead of entering the
axillary vein
circulation directly absorbed nutrients (or toxins) travel to
❖ Subscapular vein drains blood from the subscapular
the liver via the hepatic portal system for filtering
region and joins the cephalic vein to form the axillary
vein.
Veins Draining the Lower Limbs

Inferior Vena Cava

● Plantar arches
● Anterior and posterior tibial veins
● Drains blood from below diaphragm
● Fibular vein
● Receives blood from
● Popliteal vein
○ Renal veins
● Femoral vein
○ Adrenal veins
● Deep femoral vein
○ Gonadal veins
● Great saphenous vein
○ Phrenic vein
● Internal, external, and common iliac veins
○ Hepatic veins

❖ The superior surface of the foot drains into the digital

❖ Inferior vena cava parallels the abdominal aorta, where it
veins, and the inferior surface drains into the plantar
can receive blood from abdominal veins
veins, which flow into a complex series of anastomoses in
❖ Lumbar veins - A series that the lumbar portions of the
the feet and ankles, including the dorsal venous arch and
abdominal wall and spinal cord are drained
the plantar venous arch
❖ Blood supply from the kidneys flows into each renal vein,
❖ Anterior tibial vein - drains the area near the tibialis
normally the largest veins entering the inferior vena cava
anterior muscle
❖ Adrenal vein drains the adrenal or suprarenal glands
❖ Posterior tibial vein - drains the posterior surface of the
located immediately superior to the kidneys
tibia and joins the popliteal vein
❖ Gonadal veins - Where gonads are drained
❖ Fibular vein drains the muscles and integument in
➢ Right gonadal vein empties directly into the
proximity to the fibula and also joins the popliteal vein
inferior vena cava, and the left gonadal vein
❖ Small saphenous vein - located on the lateral surface of
empties into the left renal vein.
the leg, drains blood from the superficial regions of the
❖ Phrenic vein - Where each side of the diaphragm are
lower leg and foot, and flows into to the popliteal vein
drained
❖ Popliteal vein - passes behind the knee in the popliteal
➢ Right phrenic vein empties directly into the
region
inferior vena cava, the left phrenic vein
empties into the left renal vein

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❖ Great saphenous vein - A prominent surface vessel Fetal Circulation

located on the medial surface of the leg and thigh that
collects blood from the superficial portions of these areas
● Pulmonary circuit mainly bypassed
❖ Deep femoral vein - drains blood from the deeper
○ Lungs do not oxygenate fetal blood
portions of the thigh
● Foramen ovale = opening in interatrial septum
❖ Femoral circumflex vein - forms a loop around the femur
○ Blood moves from right to left atrium
just inferior to the trochanters and drains blood from the
○ Becomes fossa ovalis
areas in proximity to the head and neck of the femur.
● Ductus arteriosus = connection between pulmonary trunk
❖ Femoral vein penetrates the body wall from the femoral
and aorta
portion of the upper limb, it becomes the external iliac
○ Blood from pulmonary trunk enters aorta
vein, a large vein that drains blood from the leg to the
bypassing lungs
common iliac vein
○ Becomes ligamentum arteriosum
❖ Internal iliac vein - Where the pelvic organs and
integument drained
● Ductus venosus
❖ In addition to blood supply from the external and internal
○ Carries blood from umbilical vein to heart
iliac veins, the middle sacral vein drains the sacral region
■ Bypasses liver
into the common iliac vein.
● Becomes ligamentum venosum

DEVELOPMENT OF BLOOD VESSELS AND FETAL CIRCULATION

❖ Foramen ovale - A opening in the interatrial septum that
allows blood to flow from the right atrium to the left atrium.
The Placenta ➢ .As the newborn begins to breathe (after
birth), this shunt closes.
● Site of nutrient, gas, and waste exchange during ❖ Ductus arteriosus - A short, muscular vessel that
pregnancy connects the pulmonary trunk to the aorta.
○ Maternal and fetal blood do not mix ❖ Ductus venosus - A third shunt, which acts as a
● Umbilical vein carries oxygenated blood temporary blood vessel that branches from the umbilical
● Umbilical arteries carry deoxygenated blood with wastes vein, allowing much of the freshly oxygenated blood from
the placenta—the organ of gas exchange between the
❖ Throughout embryonic and fetal development, mother and fetus—to bypass the fetal liver and go directly
angiogenesis—the creation of new blood vessels—is to the fetal heart.
ongoing as growth proceeds.
➢ Angiogenesis continues throughout
childhood and even in adulthood as needed
during healing or weight gain.
❖ Emerging from the placenta is the umbilical vein, which
carries oxygen-rich blood from the placenta to the fetal
inferior vena cava via the ductus venosus.
❖ Two umbilical arteries carry oxygen-depleted fetal blood,
including wastes and carbon dioxide, to the placenta from
the fetal systemic circulation.

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