Review of Anatomy and Physiology of Blood Vessels and Blood

Blood Vessels

The peripheral circulation system can be divided into the systemic and the pulmonary vessels. This system is regulated to maintain sufficient blood flow to tissues.

Functions
y y y y y Carry blood Exchange nutrients and gases Transport hormones Regulate blood pressure And direct blood flow

General Features of Blood Vessel Structure

1. Blood is pumped from the heart through the elastic arteries, muscular arteries, and arterioles to the capillaries. 2. Blood returns to the heart from the capillaries through venules, small veins, and large veins. 3. Except for capillaries and venules, blood vessels have 3 layers: y The tunica intima consists of endothelium, basement membrane, and connective tissue.

y y

The tunica media, the middle layer, contains circular smooth muscle and elastic fibers. The outer tunica adventitia is a connective tissue.

Arteries
1. Large elastic arteries have many elastic fibers but little smooth muscle in their walls and carry blood from the heart to smaller arteries with little decrease in pressure. 2. Muscular arteries have much smooth muscle and some elastic fibers and undergo vasodilation and vasoconstriction to control blood flow to different regions of the body. 3. Arterioles are the smallest and have smooth muscle cells and a few elastic fibers and undergo vasodilation and vasoconstriction to control blood flow to local areas.

Capillaries
1. Capillaries consist of only endothelium and are surrounded by a basement membrane and loose connective tissue. 2. Nutrient and waste product exchange is the principal function of capillaries. 3. Blood is supplied to capillaries by arterioles. Precapillary sphincters regulate blood flow to capillary networks.

Veins
1. Venules are endothelium surrounded by a basement membrane. 2. Small veins are venules covered with a layer of smooth muscle and a layer of connective tissue. 3. Medium-sized and large veins contain less smooth muscle and elastic fibers than arteries of the same size. 4. Valves prevent backflow of blood in the veins.

Blood Vessels of the Pulmonary Circulation

The pulmonary circulation moves blood to and from the lungs. The pulmonary trunk carries oxygen-poor blood from the heart to the lungs, and pulmonary veins carry oxygen-rich blood from the lungs to the left atrium of the heart.

Blood Vessels of the Systemic Circulation: ARTERIES Aorta

The aorta leaves the left ventricle to form the ascending aorta, aortic arch, and descending aorta, which consists of the thoracic and abdominal aorta.

Arteries of the Head and Neck

1. The brachiocephalic, left common carotid, and left subclavian arteries branch from the aortic arch to supply the head and the upper limbs. 2. The common carotid arteries and the vertebral arteries supply the head. The common arteries divide to form the external carotids( which supply the face and mouth) and the internal carotids(which supply the brain).

Arteries of the Upper Limbs

The subclavian artery continues as the axillary artery and then as the brachial artery, which branches as to form the radial and ulnar arteries.

The Thoracic Aorta and Its Branches

The Thoracic aorta has visceral branches, which supply the thoracic organs, and parietal branches, which supply the thoracic wall.

The Abdominal Aorta and Its Branches

The abdominal aorta has visceral branches, which supply the abdominal organs, and parietal branches, which supply the abdominal wall.

Arteries of the Pelvis

Branches of the internal iliac arteries supply the pelvis.

Arteries of the Lower Limbs

The common iliac arteries give rise to the external iliac arteries, and the external iliac artery continues as the femoral artery and then as the popliteal artery in the leg. The popliteal artery divides to form the anterior and posterior tibial arteries.

Blood Vessels of the Systemic Circulation: VEINS

The superior vena cava drains the head, neck, thorax, and upper limbs. The inferior vena cava drains the abdomen, pelvis, and lower limbs.

Veins of the Head and Neck

1. The internal jugular veins drain the brain, anterior head, and anterior neck.

2. The external jugular veins drain the porterior head and posterior neck.

Veins of the Upper Limbs

The deep veins are the brachial, axillary, and subclavian; the superficial veins are the basilic, cephalic, and median cubital.

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

1. Posterior abdominal wall veins join the azygos veins. 2. Veins from the kidney, adrenal glands, and gonads directly enter the inferior vena cava. 3. Veins from the stomach, intestines, spleen, and pancreas connect with the hepatic portal vein, which transports blood to the liver for processing. The hepatic veins form the liver join the inferior vena cava.

Veins of the Lower Limbs

1. The deep veins course with the deep arteries and have similar names. 2. The superficial veins are the small and great saphenous veins.

The Physiology of Circulation Blood Pressure

1. Blood pressure is a measure of the force exerted by blood against the blood vessel wall. Blood pressure moves blood through vessels. 2. Blood pressure can be measured by listening for Korotkoff sounds produced as blood flows through arteries partially constricted by a blood pressure cuff.

Pressure and Resistance

Blood pressure fluctuates between 120 mmg Hg (systolic) and 80 mm Hg ( diastolic) in the aorta. If constriction of blood vessels occurs, resistance to blood flow increases, and blood flow decreases.

Pulse Pressure
1. Pulse Pressure is the difference between the systolic and diastolic pressure. Pulse pressure increases when stroke volume increases. 2. A pulse can be detected when large arteries are near the surface of the body.

Capillary Exchange
1. Most exchange across the wall of the capillary is by diffusion. 2. Blood pressure, capillary permeability, and osmosis affect movement of fluid across the wall of the capillaries. There is a net movement of fluid from the blood into the tissues. The fluid gained by the tissue is removed by the lymphatic system.

Local Control of Blood Vessels

Blood flow through a tissue is usually proportional to the metabolic needs of the tissue and is controlled by precapillary sphincters.

Nervous Control of Blood Vessels

1. The vasomotror center(sympathetic division) controls blood vessel diameter. Other brain areas can excite or inhibit the vasomotor center. 2. Vasomotor tone is a state of partial contraction of blood vessels. 3. The nervous system is responsible for routing the flow of blood, except in the capillaries and precapillary sphincters, and is responsible for maintaining blood pressure.

Regulation of Arterial Pressure

Mean Arterial Preassure (MAP) is proportional to cardiac output times the peripheral resistance.

Baroreceptor Reflexes
1. Baroreceptors are sensory receptors that are sensitive to stretch. 2. Baroreceptors are located in the carotid sinuses and the aortic arch. 3. The baroreceptor reflex changes the peripheral resistance, heart rate, and stroke volume in response to changes in blood pressure.

Chemoreceptor Reflex
1. Chemoreceptors are sensitive to changes in blood oxygen, carbon dioxide and Ph. 2. Chemoreceptors are located in the carotid bodies and the aortic bodies. 3. The chemoreceptor reflex increases peripheral resistance in response to low oxygen levels, high carbon dioxide levels, and reduced blood ph.

Hormonal Mechanisms
1. Epinephrine released from the adrenal medulla as a result of sympathetic stimulation increases heart rate, stroke volume, and vasoconstriction. 2. Renin is released by the kidneys in response to low blood pressure. Renin promotes the production of angiotensin II, which causes vasoconstriction and an increase in

aldosterone secretion. Aldosterone reduces urine output. Angiotensin II can also cause vasoconstriction. 3. ADH released from the posterior pituitary causes vasoconstriction ad reduces urine output. 4. Atrial Natriuretic Hormone is released from the heart when atrial blood pressure increases. It stimulates an increase in urine production, causing a decrease in blood volume and blood pressure.

Short-Term and Long-Term Regulation

1. The baroreceptor mechanisms are most important in short-term regulation of blood pressure. 2. Hormonal mechanisms, such as the rennin-angiotensin-aldosterone system and atrial natriuretic hormone, are more important in long-term regulation of blood pressure.

Blood

Functions of Blood
1. Blood transport gases, nutrients, waste products, processed molecules, and regulatory molecules. 2. Blood regulates ph, fluid, and ion balance. 3. Blood is involved with temperature regulation and protects against foreign substances such as microorganisms and toxins. 4. Blood clotting prevents fluid and cell loss and is part of tissue repair.

Composition of Blood
1. Blood is a connective tissue consisting of plasma and formed elements. 2. Total blood volume is approximately 5 L.

Plasma
1. Plasma is 91% water and 9% suspended or dissolved substances. 2. Plasma maintains osmotic pressure, is involved in immunity, prevents blood loss, and transports molecules.

Formed Elements
The formed elements are cells( red blood cells and white blood cells) and cell fragments(platelets).

Production of Formed Elements

Formed elements arise (hematopoesis) red bone marrow from stem cells.

Red Blood Cells (erythrocytes)

1. Red blood cells are disk-shaped cells containing hemoglobin, which transports oxygen and carbon dioxide. Red blood cells also contain carbonic anhydrase, which is involved with carbon dioxide transport. 2. In response to low oxygen levels, the kidneys produce erythropoietin, which stimulates red blood cell production in red bone marrow. 3. Worn-out red blood cells are phagocytised by macrophages in the spleen or liver. Hemoglobin is broken down, iron and amino acids are reused, and heme becomes bilirubin that is secreted in bile. 4. Normal levels:
y y y

Women: 4.2 to 5.4 million/uL Men: 4.7 to 6.1 million/uL Children: 4.6 to 4.8 million/uL

White Blood Cells (leukocytes)

1. WBCs protect the body against mmicroorganisms and remove dead cells and debris. 2. Granulocytes contain cytoplasmic granules, and there are 3 types of granulocytes: neutrophils are small phagocytic cells, basophils promote inflammation, and eosinophis reduce inflammation. 3. Agranulocytes have very small granules and are of two types: lymphocytes are involved in antibody production and other immune system responses;monocytes become macrophages that ingest microorganisms and cellular debris.

4. Normal level: 4,500-10,000 white blood cells per microliter (mcL)

Platelets (thrombocytes)
1. Platelets are cell fragments involved with preventing blood flow. 2. Normal level: 150,000 to 450,000 platelets per microliter of blood 3.

Preventing Blood Loss Vascular Spasm

Blood vessels constrict in response to injury, resulting in decreased blood flow.

Platelet Plugs
1. Minor damage to blood vessels is repaired by platelet plugs. 2. Platelet adhere to collagen, release chemicals(ADP and thromboxanes) that activate other platelets, and connect to one another with fibrinogen to form platelet plugs.

Blood Clotting
1. Blood clotting, or coagulation, is formation of a clot( a network of protein fibers called fibrin). 2. There are 3 steps in the clotting process: Activation of clotting factors by connective tissue and chemicals, resulting in the formation of prothrombinase. Conversion of prothrombin to thrombin by prothrombinase. Conversion of fibrinogen to fibrin by thrombin.

Control of Clot Formation

Anticoagulants in the blood, such as antithrombin and heparin, prevent clot formation.

Clot Retraction and fibrinolysis

1. Clot retraction condenses the clot, pulling the edges of damaged tissue closer together. 2. Serum is plasma without clotting factor. 3. Fibrinolysis(clot breakdown) is accomplished by plasmin.