Chapter 19

Blood Vessels
Blood Vessel Structure and Function
~60,000 miles of blood vessels in your body

• Blood vessels: delivery system of

dynamic structures that begins and
ends at heart
– Work with lymphatic system to
circulate fluids

• Arteries: carry blood away from

heart; oxygenated except for
pulmonary circulation and umbilical
vessels of fetus

• Capillaries: direct contact with tissue

cells; directly serve cellular needs

• Veins: carry blood toward heart;

deoxygenated except for pulmonary
circulation and umbilical vessels of
fetus

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Structure of Blood Vessel Wall (1 of 4)
• All vessels consist of a lumen, central blood-containing space, surrounded by a wall

• Walls of all vessels, except capillaries, have three layers, or tunics:

1. Tunica intima
2. Tunica media
3. Tunica externa

• Capillaries
– Endothelium with sparse basal lamina

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Structure of Blood Vessel Wall (2 of 4)
1. Tunica intima
▪ Innermost layer that is in “intimate” contact with blood
▪ Endothelium: simple squamous epithelium that lines lumen of all vessels
– Continuous with endocardium
– Slick surface reduces friction
▪ Subendothelial layer: connective tissue basement membrane
– Found only in vessels larger than 1 mm

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Structure of Blood Vessel Wall (3 of 4)
2. Tunica media
▪ Composed mostly of smooth muscle and sheets of elastin
▪ Sympathetic vasomotor nerve fibers innervate this layer, controlling:
– Vasoconstriction: decreased lumen diameter
– Vasodilation: increased lumen diameter
▪ Bulkiest layer responsible for maintaining blood flow and blood pressure

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Structure of Blood Vessel Wall (4 of 4)
3. Tunica externa
▪ Outermost layer of wall
▪ Also called tunica adventitia
▪ Composed mostly of loose
collagen fibers that protect
and reinforce wall and anchor
it to surrounding structures
▪ Infiltrated with nerve fibers,
lymphatic vessels
– Large veins also contain
elastic fibers in this layer
▪ Vasa vasorum: system of tiny
blood vessels found in larger
vessels
– Function to nourish
outermost external layer

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Summary of Blood Vessel Anatomy

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Arteries
• Arteries divided into three groups, based on size and function
– Elastic arteries
– Muscular arteries
– Arterioles

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Elastic Arteries
• Elastic arteries: thick-walled with large,
low-resistance lumen
– Aorta and its major branches

• Elastin found in all three tunics, mostly

tunica media

• Act as pressure reservoirs that expand

and recoil as blood is ejected from
heart
– Allows for continuous blood flow
downstream even between
heartbeats

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Muscular Arteries
• Elastic arteries give rise to muscular
arteries

• They deliver blood to body organs

– Diameters range from pinky-finger size
to pencil-lead size

• Account for most of named arteries

• Have thickest tunica media with more

smooth muscle, but less elastic tissue
– Tunica media sandwiched between
elastic membranes

• Active in vasoconstriction

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Arterioles
• Arterioles: smallest of all arteries
– Larger arterioles contain all three
tunics
– Smaller arterioles are mostly
single layer of smooth muscle
surrounding endothelial cells

• Control flow into capillary beds via

vasodilation and vasoconstriction of
smooth muscle

• Also called resistance arteries because

changing diameters change resistance
to blood flow

• Lead to capillary beds

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 Capillaries
• Microscopic; diameters so small only single
RBC can pass through at a time

• Walls just thin tunica intima

• Pericytes: spider-shaped stem cells help

stabilize capillary walls, control permeability,
and play a role in vessel repair

• Supply almost every cell, except for cartilage,

epithelia, cornea, and lens of eye

• Functions: exchange of gases, nutrients,

wastes, hormones, etc., between blood and
interstitial fluid

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Types of Capillaries
• Have gaps called intercellular clefts
– Allow passage of fluids and small solutes

• Three types of capillaries

1. Continuous capillaries
▪ Abundant in skin, muscles, lungs, and CNS
– Continuous capillaries of brain are unique
• Form blood brain barrier, totally enclosed with tight junctions and no
intercellular clefts

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Types of Capillaries
2. Fenestrated capillary
▪ Involved in active filtration (kidneys), absorption (intestines), or endocrine
hormone secretion
▪ Endothelial cells contain Swiss cheese–like pores called fenestrations
– Allow for increased permeability
– Fenestrations usually covered with thin glycoprotein diaphragm

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Types of Capillaries
3. Sinusoidal capillaries
▪ Fenestrated with larger intercellular clefts; incomplete basement membranes
– Usually have larger lumens
▪ Found only in the liver, bone marrow, spleen, and adrenal medulla
▪ Blood flow is sluggish—allows time for modification of large molecules and
blood cells that pass between blood and tissue
▪ Contain macrophages in lining to capture and destroy foreign invaders

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Capillary Beds
• Capillary bed: interwoven network of capillaries between arterioles and venules

• Microcirculation: flow of blood through bed from arteriole to venule

• Terminal arteriole: branch off arteriole that further branches into 10 to 20 capillaries
(exchange vessels) that form capillary bed
– Exchange of gases, nutrients and wastes from surrounding tissue takes place in
capillaries

• Capillaries then drain into postcapillary venule

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Control of Blood Flow Through Capillaries

• Flow through bed controlled by diameter

of terminal arteriole and upstream
arterioles

• Local chemical conditions and arteriolar

vasomotor nerve fibers regulate amount
of blood entering capillary bed
– Arteriole and terminal arteriole
dilated when blood needed;
– Constricted to shunt blood away
from bed when not needed

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 Vascular Shunts & Precapillary Sphincters
Found in capillaries of serous membranes of intestinal mesenteries
1. Vascular shunt: channel that directly connects arteriole with venule (bypasses
true capillaries)
2. Precapillary sphincter: cuff of smooth muscle surrounding capillary
- Acts as valve regulating blood flow into capillary bed
- Controlled by local chemical conditions (not innervated)

metarteriole–thoroughfare channel shunts

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Veins
• Veins: carry blood toward the heart

• Formed when venules converge

• Have all tunics, but thinner walls with large lumens

• Tunica media is thin, but tunica externa is thick

– Contain collagen fibers and elastic networks
– Called capacitance vessels (blood reservoirs) because they contain up to
65% of blood supply

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Relative Proportion of Blood Volume
Throughout the Cardiovascular System

Figure 19.6 Relative proportion of blood volume throughout the cardiovascular system.
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 • Blood pressure lower than in arteries
Venous Valves
• Adaptations ensure return of blood to heart
– Large-diameter lumens offer little
resistance
– Other adaptations
– Venous valves
▪ Prevent backflow of blood
▪ Most abundant in veins of limbs
– Venous sinuses
▪ Flattened veins with extremely thin
walls
▪ Composed only of endothelium
▪ Examples: coronary sinus of the
heart and dural sinuses of the brain

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Anastomoses
• Vascular anastomoses: interconnections of blood vessels

• Arterial anastomoses: provide alternate pathways (collateral channels) to ensure

continuous flow, even if one artery is blocked
– Common in joints, abdominal organs, brain, and heart; none in retina, kidneys,
spleen

• Arteriovenous anastomoses: shunts in capillaries; example: metarteriole–thoroughfare

channel

• Venous anastomoses: so abundant that occluded veins rarely block blood flow

• (You may be able to see venous anastomoses through the skin on the dorsum of your
hand.)
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Part 2 Physiology of Circulation

Flow, Pressure, and

Resistance

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Definition of Terms (1 of 6)
• Blood flow: volume of blood flowing through vessel in given period of time
– Measured in ml/min
– Overall is relatively constant when at rest, but at any given moment, varies at
individual organ level, based on needs

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Definition of Terms (2 of 6)
• Blood pressure (BP): force per unit area exerted on wall of blood vessel by blood
– Expressed in mm Hg
– Measured as systemic arterial BP in large arteries near heart
– Pressure gradient provides driving force that keeps blood moving from higher- to
lower-pressure areas

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Definition of Terms (3 of 6)
• Resistance (peripheral resistance): opposition to flow
– Friction blood encounters with vessel walls, generally in peripheral (systemic)
circulation
– Three important sources of resistance
▪ Blood viscosity
▪ Total blood vessel length
▪ Blood vessel diameter

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Definition of Terms (4 of 6)
– Blood viscosity
▪ The thickness or “stickiness” of blood due to formed elements and plasma
proteins
– The greater the viscosity, the less easily molecules are able to slide past
each other
▪ Increased viscosity equals increased resistance
– Total blood vessel length
▪ The longer the vessel, the greater the resistance encountered

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Definition of Terms (5 of 6)
– Blood vessel diameter
▪ Has greatest influence on resistance
▪ Frequent changes alter peripheral resistance
– Viscosity and blood vessel length are relatively constant
▪ Fluid close to walls moves more slowly than in middle of tube (called laminar
flow)
▪ Resistance varies inversely with fourth power of vessel radius
– If radius increases, resistance decreases, and vice-versa
– Example: if radius is doubled, resistance drops to 1/16 as much

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Definition of Terms (6 of 6)
– Blood vessel diameter (cont.)
▪ Small-diameter arterioles are major determinants of peripheral resistance
– Radius changes frequently, in contrast to larger arteries that do not
change often
▪ Abrupt changes in vessel diameter or obstacles such as fatty plaques from
atherosclerosis dramatically increase resistance

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Relationship Between Flow, Pressure, and
Resistance
• Blood flow (F) is directly proportional to blood pressure gradient (ΔP)
– If ΔP increases, blood flow speeds up

• Blood flow is inversely proportional to peripheral resistance (R)

– If R increases, blood flow decreases, so

F = P / R

• R is more important in influencing local blood flow because it is easily changed by

altering blood vessel diameter

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Systemic Blood Pressure
• Pumping action of heart generates blood flow

• Pressure results when flow is opposed by resistance

• Systemic pressure is highest in aorta and declines throughout pathway

– Steepest drop occurs in arterioles

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Arterial Blood Pressure
• Systolic pressure: pressure exerted in aorta during ventricular contraction
– Left ventricle pumps blood into aorta
– Averages 120 mm Hg in normal adult

• Diastolic pressure: lowest level of aortic pressure when heart is at rest

• Pulse pressure: difference between systolic and diastolic pressure

• Pulse: throbbing of arteries due to difference in pulse pressures, which can be felt under
skin

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Capillary Blood Pressure
• Ranges from 35 mm Hg at beginning of capillary bed to ∼17 mm Hg at the end of the
bed

• Low capillary pressure is desirable because:

1. High BP would rupture fragile, thin-walled capillaries
2. Most capillaries are very permeable, so low pressure forces filtrate into
interstitial spaces

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Venous Blood Pressure
• Factors aiding venous return
1. Muscular pump: contraction of
skeletal muscles “milks” blood back
toward heart; valves prevent backflow
2. Respiratory pump: pressure
changes during breathing move blood
toward heart by squeezing abdominal
veins as thoracic cage expand
3. Sympathetic venoconstriction:
under sympathetic control, smooth
muscles constrict, pushing blood back
toward heart

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Regulation of Blood Pressure (1 of 2)
• Maintaining blood pressure requires cooperation of heart, blood vessels, and kidneys
– All supervised by brain

• Three main factors regulating blood pressure

– Cardiac output (CO)
– Peripheral resistance (PR)
– Blood volume

• Blood pressure varies directly with CO, PR, and blood volume

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Regulation of Blood Pressure (2 of 2)
• Factors can be affected by:
– Short-term regulation: neural controls alter blood pressure by changing total
peripheral resistance and CO
– Short-term regulation: hormonal controls
– Long-term regulation: renal controls alters blood volume via the kidneys.

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Short-Term Regulation: Neural Controls

• Neural controls operate via reflex arcs that involve:

– Cardiovascular center of medulla
– Baroreceptors
– Chemoreceptors
– Higher brain centers

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Short-Term Regulation: Neural Controls
(Cardiovascular Center)
• Role of the cardiovascular center
– Cardiovascular center: composed of clusters of sympathetic neurons in medulla
– Consists of:
▪ Cardiac centers: cardioinhibitory and cardioacceleratory centers
▪ Vasomotor center: sends steady impulses via sympathetic efferents called
vasomotor fibers to blood vessels
– Cause continuous moderate constriction called vasomotor tone
– Receives inputs from baroreceptors, chemoreceptors, and higher brain centers

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Short-Term Regulation: Neural Controls
(Baroreceptors)
• Baroreceptor reflexes
– Located in carotid sinuses, aortic arch, and walls of large arteries of neck and
thorax
– If MAP is high:
▪ Increased blood pressure stimulates baroreceptors to increase input to
vasomotor center
▪ Inhibits vasomotor and cardioacceleratory centers
▪ Stimulates cardioinhibitory center
▪ Results in decreased blood pressure

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Short-Term Regulation: Neural Controls
(Baroreceptors)
• Baroreceptor reflexes (cont.)
– Resulting decrease in blood pressure due to two mechanisms:
1. Vasodilation: decreased output from vasomotor center causes dilation
– Arteriolar vasodilation: reduces peripheral resistance, MAP falls
– Venodilation: shifts blood to venous reservoirs, decreasing venous
return and CO

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Short-Term Regulation: Neural Controls
(baroreceptors)

2. Decreased cardiac output:

impulses to cardiac centers inhibit
sympathetic activity and stimulate
parasympathetic
– Reduces heart rate and
contractility; CO decrease
causes decrease in MAP

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Short-Term Regulation: Neural Controls
(Baroreceptors)
• Baroreceptor reflexes (cont.)
– If MAP is low:
▪ Reflex vasoconstriction is initiated that increases CO and blood pressure
▪ Example: upon standing, BP falls and triggers:
– Carotid sinus reflex: baroreceptors that monitor BP to ensure enough
blood to brain
– Aortic reflex maintains BP in systemic circuit
▪ Baroreceptors are ineffective if altered blood pressure is sustained
– Become adapted to hypertension, so not triggered by elevated BP levels

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Baroreceptor
Reflexes that
Help Maintain
Blood Pressure
Homeostasis

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Short-Term Regulation: Neural Controls
(Chemoreceptors)
• Chemoreceptor reflexes
– Aortic arch and large arteries of neck detect increase in CO2, or drop in pH or O2
– Cause increased blood pressure by:
▪ Signaling cardioacceleratory center to increase CO
▪ Signaling vasomotor center to increase vasoconstriction -> rise in blood
pressure that follows speeds the return of blood to the heart and lungs.

• Chemoreceptors play a larger role in regulating respiratory rate than blood pressure.

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Short-Term Regulation: Neural Controls

• Influence of higher brain centers

– Reflexes that regulate BP are found in medulla
– Hypothalamus and cerebral cortex can modify arterial pressure via relays to
medulla
– Hypothalamus increases blood pressure during stress
– Hypothalamus mediates redistribution of blood flow during exercise and changes in
body temperature

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Short-Term Mechanisms: Hormonal Controls
• Hormones regulate BP in short term via changes in peripheral resistance or long term
via changes in blood volume

• Adrenal medulla hormones

– Epinephrine and norepinephrine from adrenal gland increase CO and
vasoconstriction

• Angiotensin II stimulates vasoconstriction

• ADH: high levels can cause vasoconstriction

• Atrial natriuretic peptide decreases BP by antagonizing aldosterone, causing

decreased blood volume

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Long-Term Mechanisms: Renal Regulation
• Baroreceptors quickly adapt to chronic high or low BP so are ineffective for long-term
regulation

• Long-term mechanisms control BP by altering blood volume via kidneys

• Kidneys regulate arterial blood pressure by:

1. Direct renal mechanism
2. Indirect renal mechanism (renin-angiotensin-aldosterone)

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Direct and Indirect (Hormonal) Mechanisms for Renal Control of Blood
Pressure

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Long-Term Mechanisms: Renal Regulation
• Direct renal mechanism
– Alters blood volume independently of hormones
▪ Increased BP or blood volume causes elimination of more urine, thus reducing
BP
▪ Decreased BP or blood volume causes kidneys to conserve water, and BP
rises

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Long-Term Mechanisms: Renal Regulation
• Indirect mechanism
– The renin-angiotensin-aldosterone mechanism
▪ Decreased arterial blood pressure causes release of renin from kidneys
▪ Renin enters blood and catalyzes conversion of angiotensinogen from liver to
angiotensin I
▪ Angiotensin-converting enzyme, especially from lungs, converts angiotensin I
to angiotensin II

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Long-Term Mechanisms: Renal Regulation
• Indirect mechanism (cont.)
– Angiotensin II acts in four ways to stabilize arterial BP and ECF:
▪ Stimulates aldosterone secretion
▪ Causes ADH release from posterior pituitary
▪ Triggers hypothalamic thirst center to drink more water
▪ Acts as a potent vasoconstrictor, directly increasing blood pressure

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Factors that Increase MAP

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 Distribution of Blood Flow at Rest and During
Strenuous Exercise

– Redistribution of blood during exercise

▪ At rest, skeletal muscles receive
about 20% of total blood in body,
but during exercise, skeletal
muscle can receive over 70% of
blood
▪ Intrinsic controls: skeletal muscle
arterioles dilate, increasing blood
flow to muscle
▪ Extrinsic controls decrease blood
flow to other organs such as
kidneys and digestive organs
– MAP is maintained despite
dilation of skeletal muscle
arterioles

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Blood Flow in Special Areas (1of 6)
• Brain
– Blood flow to brain must be constant because neurons are intolerant of ischemia
▪ Flow averages ~750 ml/min
– MAP below 60 mm Hg can cause syncope (fainting)
– MAP above 160 mm Hg can result in cerebral edema

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Blood Flow in Special Areas (2 of 6)
• Skin
– Functions of blood flow through skin
1. Supplies nutrients to cells
2. Helps regulate body temperature
3. Provides a blood reservoir

– Blood flow through venous plexuses below skin surface regulates body temperature
▪ Flow varies from 50 ml/min to 2500 ml/min, depending on body temperature
▪ Flow is controlled by sympathetic nervous system reflexes

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Blood Flow in Special Areas (3 of 6)
• Skin (cont.)
– As temperature rises (e.g., from heat exposure, fever, vigorous exercise)
▪ Hypothalamic signals reduce vasomotor stimulation of skin vessels, causing
dilation
▪ Warm blood flushes into capillary beds
▪ Heat radiates from skin
– As temperature decreases, blood is shunted to deeper, more vital organs
▪ Superficial skin vessels constrict strongly
▪ Blood in vessels may become trapped
– Causes rosy cheeks in cold

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Blood Flow in Special Areas (4 of 6)
• Lungs
– Pulmonary circuit is unusual; pathway is short
▪ Arteries/arterioles are more like veins/venules (thin walled, large lumens)
▪ Arterial resistance and pressure are much lower than in systemic circuit
– Averages ~24/10 mm Hg versus 120/80 mm Hg
– Autoregulatory mechanisms are opposite
▪ Low O2 levels cause vasoconstriction, and high levels promote vasodilation
– Allows blood flow to O2-rich areas of lung

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Blood Flow in Special Areas (5 of 6)
• Heart
– Blood flow through heart is influenced by aortic pressures and ventricular pumping
– During ventricular systole, coronary vessels are compressed
▪ Myocardial blood flow ceases
▪ Stored myoglobin supplies sufficient oxygen
– During diastole, high aortic pressure forces blood through coronary circulation

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Blood Flow in Special Areas (6 of 6)
• Heart (cont.)
– At rest, coronary blood flow is ~250 ml/min
▪ Control is probably via myogenic mechanisms
– During strenuous exercise, coronary vessels dilate in response to local accumulation
of vasodilators
▪ Blood flow may increase three to four times
▪ Important because cardiac cells use 65% of O2 delivered
– Other cells use only 25% of delivered O2
– Increasing coronary blood flow is only way to provide more O2

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Capillary Exchange

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Velocity of Blood Flow
• Velocity of flow changes as blood travels through systemic circulation

• Fastest in aorta, slowest in capillaries, then increases again in veins

• Speed is inversely related to total cross-sectional area

– Capillaries have largest area so slowest flow
– Slow capillary flow allows adequate time for exchange between blood and tissues

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Capillary Exchange of Respiratory Gases
and Nutrients
• Vasomotion: intermittent flow of blood through capillaries
– Due to on/off opening and closing of precapillary sphincters
• Many molecules pass by diffusion between blood and interstitial fluid
– Move down their concentration gradients

• Molecules use four different routes to cross capillary:

1. Diffuse directly through endothelial membranes
▪ Example: lipid-soluble molecules such as respiratory gases
2. Pass through clefts
▪ Example: water-soluble solutes
3. Pass through fenestrations
▪ Example: water-soluble solutes
4. Active transport via pinocytotic vesicles or caveolae
▪ Example: larger molecules, such as proteins

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Capillary Transport Mechanisms

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 Fluid Movements: Bulk Flow (1 of 4)
• Fluid is forced out clefts of capillaries at
arterial end, and most returns to blood at
venous end
– Extremely important in determining
relative fluid volumes in blood and
interstitial space

• Bulk fluid flow across capillary walls causes

continuous mixing of fluid between plasma
and interstitial fluid; maintains interstitial
environment.

• Direction and amount of fluid flow depend

on two opposing forces
– Hydrostatic pressures
– Colloid osmotic pressures

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Fluid Movements: Bulk Flow (2 of 4)
• Hydrostatic pressures
– Hydrostatic pressure (HP): force exerted by fluid pressing against wall; two types
▪ Capillary hydrostatic pressure (HPc): capillary blood pressure that tends to
force fluids through capillary walls
– Greater at arterial end (35 mm Hg) of bed than at venule end (17 mm Hg)
▪ Interstitial fluid hydrostatic pressure (HPif): pressure pushing fluid back into
vessel; usually assumed to be zero because lymphatic vessels drain interstitial
fluid

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Fluid Movements: Bulk Flow (3 of 4)
• Colloid osmotic pressures
– Capillary colloid osmotic pressure (oncotic pressure, OPc)
▪ “Sucking” pressure created by nondiffusible plasma proteins pulling water back
into capillary
▪ Opc ∼26 mm Hg
– Interstitial fluid colloid osmotic pressure (OPif)
▪ Pressure is inconsequential because interstitial fluid has very low protein
content
▪ OPif around only 1 mm Hg

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Fluid Movements: Bulk Flow (4 of 4)
• Hydrostatic-osmotic pressure interactions
– Net filtration pressure (NFP): comprises all forces acting on capillary bed
▪ NFP = (HPc + OPif) − (HPif + OPc)
– Net fluid flow out at arterial end (filtration)
– Net fluid flow in at venous end (reabsorption)
– More fluid leaves at arterial end than is returned at venous end
▪ Excess interstitial fluid is returned to blood via lymphatic system

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