Chapter 15 – The CV System: Blood Vessels and Hemodynamics

15.1 Overview of Vasculature

-arteries carry blood away from the heart, split into arterioles which then branch into capillaries
which are the smallest blood vessels in the body
-groups of small capillaries unite to form venules, which merge to form veins which bring blood
back to the heart

-all blood vessels contain an inner layer of endothelium surrounded by a basement membrane
-blood vessels (except capillaries) also contain layers of smooth muscle and connective tissue
that surround the basement membrane

-inner layer of epithelial cells in all blood vessels called endothelium, which is continuous with
endocardial lining of the heart
-endothelial cells are active participants in a variety of vessel-related activities including
physically influencing blood flow, secreting locally acting chemical mediators that influence the
contractile state of the vessel’s overlying smooth muscle and assisting with capillary
permeability
-the basement membrane provides support to the endothelial cells

-primary role of smooth muscle of a blood vessel is to regulate the diameter of the lumen
-increase in sympathetic stimulation causes smooth muscle to contract, narrowing the lumen –
vasoconstriction
-decrease in sympathetic stimulation, or the presence of certain chemicals such as nitric oxide
and H+ ions causes smooth muscle to relax, widening the lumen – vasodilation

-the smooth muscle of most blood vessels is partially contracted at all times, the ability to
maintain this state of partial contraction is referred to as vascular tone

-two types of connective tissue present in blood vessel walls, elastic connective tissue and
fibrous connective tissue
-elastic: allow blood vessels to stretch for incoming blood and return back to their original
shape
-fibrous: provide tensile strength to sustain the pressure that the blood exerts against the
vessel walls

-elastic arteries contain a high proportion of elastic connective tissue, the aorta and the
pulmonary trunk are the largest elastic arteries with diameters of about 2.5 cm each, other
elastic arteries have diameters of about 1 cm
-elastic arteries serve as pressure reservoirs that maintain the driving force for blood flow while
the ventricle are relaxing via elastic recoil
-they stretch during ventricular contraction and store some of the pressure generated by the
contraction, then recoil and release the stored pressure during ventricular relaxation
-elastic arteries conduct blood from the heart to the medium sized arteries

-medium sized arteries contain more smooth muscle and less elastic, and are called muscular
arteries, they don’t have the same recoil abilities as elastic tissue but are capable of greater
vasoconstriction and vasodilation
-most arteries in the arterial circuit are muscular arteries and their diameters range from 0.5 cm
to 1 cm
-muscular arteries distribute blood to the organs of the body, and as a muscular artery enters
an organ, it branches off into many arterioles

-arterioles are microscopic vessels that deliver blood to capillaries

-there are approximately 400 million and their diameters range from 15-100 micrometers
-arterioles consist of endothelium, basement membrane, smooth muscle and a small amount of
fibrous connective tissue
-arterioles are known as resistance vessels of the circulation because their small diameters
provide the greatest resistance to blood flow
-even though capillaries are smaller in diameter, there are so many of them un the body that
they collectively offer less resistance to blood flow than arterioles
-vasoconstriction of arterioles increases blood pressure while vasodilation of arterioles reduces
blood pressure

-capillaries are the site of nutrient and waste exchange and they connect arterioles to venules
-arterioles, venules and capillaries make up the microcirculation
-capillaries are the smallest blood vessels in the body have a diameter of only 5-10 micrometers
and length of only 1 mm
-erythrocytes have a diameter of 8 micrometers and must fold themselves to pass through
these vessels in a single file
-the boy contains an estimated 10-40 billions capillaries and they are known as exchange
vessels

-capillaries are only made of a single endothelial layer surrounded by basement membrane, so
substances in the blood only have to pass through one layer to reach interstitial fluid and tissue
cells
-capillary walls contain pores (spaces) that allow passage to certain substances
-exchange of materials only occurs in capillaries and postcapillary venules

-capillaries are absent in a few tissues, such as all covering and lining epithelia, the cornea and
lens of the eye and cartilage

-capillary bed: a network of 10-100 capillaries

-a metarteriole connects the arteriole directly to the venule and serves as a shunt to allows
blood to bypass the capillaries
vasomotion: intermittent contraction and relaxation that causes intermittent blood flow in the
capillaries due to contractions of the smooth muscle and precapillary sphincters
3 different types of capillaries:
1) continuous – most capillaries in the body are continuous, plasma membranes of
endothelial cells form a continuous tube that is interrupted only by intercellular clefts,
found in muscle, connective tissue and the lungs, also found in the brain, permeable to
water and small solutes like Na+ and glucose
2) fenestrated – have fenestrations (pores) ranging from 20-100 nm in diameter that
extend through the endothelial cells, higher permeability to water and solutes than
continuous capillaries and found in kidneys, small intestines and endocrine glands
3) sinusoid – wider and more winding, have bigger fenestrations and intercellular clefts
and an incomplete or absent basement membrane, permeable to water and small
solutes but also larger substances in the blood like proteins and blood cells, found in
bone marrow, spleen and liver

venules that initially receive blood from capillaries are called postcapillary venules and are the
smallest venules, only 10-50 micrometers in diameter and also only consist of an endothelium
surrounded by a basement membrane, they connect to larger venules (50-100 micrometer
diameter) which acquire a layer or two of smooth muscle and a thin layer of fibrous connective
tissue

veins carry blood back to the heart and range from 0.5 mm to 3 cm for the large veins that
enter the right atrium of the heart (the superior and inferior vena cava)
-veins have thinner walls and less smooth muscle and elastic tissue compared to arteries
-many veins, especially those in the limbs contain valves which aid movement of venous blood
to the heart by preventing backflow of blood
-leaky venous valves can cause veins to become dilated or twisted in appearance, this is known
as varicose veins or varices

-contraction of muscles in the lower limbs also helps boost of movement of venous blood back
to the heart, this is known as the skeletal muscle pump

-pressure changes in the thoracic and abdominal cavities during inspiration also promote
movement of venous blood back to the heart, known as the respiratory pump

systemic veins and venules function as blood reservoirs, as the largest portion of your blood
volume at rest – about 64% - is in systemic veins and venules, 13% in systemic arteries and
arterioles, systemic capillaries hold about 7%, pulmonary blood vessels about 9% and the heart
about 7%
-during increased muscular activity, sympathetic innervation causes venoconstriction, which
reduces the volume of blood in reservoirs and allows a greater volume of blood to flow to the
skeletal muscles where it is needed the most
15.2 Capillary Exchange and Lymphatics

-substances enter and leave capillaries via diffusion, transcytosis and s

-diffusion is the most important method of capillary exchange, most substances such as O2,
CO2, glucose, amino acids and hormones enter and leave capillaries via simple diffusion
-O2 and nutrients are normally present in higher concentrations in blood, so they diffuse down
their concentration gradients into interstitial fluid and then into body cells
-CO2 and other wastes released by the body are present in higher concentrations in interstitial
fluid so they diffuse into the blood

-substances in blood diffuse through pores (intercellular clefts and fenestrations)

-lipid soluble (non-polar) substances such as O2, CO2 and steroid hormones can diffuse directly
through the lipid bilayer of endothelial cell plasma membranes
-small water soluble substances like which include ions and polar molecules such as glucose and
amino acids, pass capillary walls through intercellular clefts and fenestrations
-water itself can either diffuse across via pores or through the plasma membrane

-erythrocytes and plasma proteins are too large to pass through the walls of continuous or
fenestrated capillaries, but plasma proteins can pass through fenestrations in the kidneys
-sinusoid capillaries are large enough to let proteins and erythrocytes in

-most capillaries in the brain only let a few substances in as they are tightly sealed by tight
junctions that create the blood-brain-barrier
-the hypothalamus, pineal gland and pituitary gland lack the bbb and undergo capillary
exchange more freely

transcytosis: substances become enclosed within tiny vesicles that first enter the cell by
endocytosis then move across the cell and exit on the other side by exocytosis, mainly used by
large, lipid-insoluble molecules that cannot cross capillary walls in any other way

bulk flow: passive process in which large numbers of ions or molecules move together in the
same direction
-bulk flow occurs from an area of higher pressure to lower pressure
-diffusion is more important for solute exchange between blood and interstitial fluid, bulk flow
is more important for the regulation of relative volumes of blood and interstitial fluid

filtration: pressure driven movement of fluid and solutes from blood capillaries into interstitial
fluid
reabsorption: pressure driven movement of fluid and solutes from interstitial fluid into blood
capillaries
Bulk flow is determined by four pressures collectively known as the Starling forces, two
promote filtration and two promote reabsorption

capillary hydrostatic pressure (Pc) (filtration)

interstitial fluid hydrostatic pressure (Pif) (reabsorption)
plasma colloid osmotic pressure (Pi p) (reabsorption)
interstitial fluid osmotic pressure (Pi if) (filtration)

Net filtration pressure (NFP) = (Pc + Pi if) – (Pi p + Pif)

net outward pressure of about 11mmHg at arterial end of capillary (net filtration)
net inward pressure of about -9 mmHg at venous side of capillary (net reabsorption)

-on average 20 mL of fluid is filtered out of capillary tissues, about 85% (17 L) is reabsorbed and
the remaining 3L enters the lymphatic system and is eventually returned to the blood stream

Lymphatic system consists of lymph, lymphatic vessels, and lymph nodes, bone marrow,
thymus, spleen, bone marrow, tonsils, Peyer’s patches of the small intestine and the appendix

It has 4 primary functions

1) drains excess interstitial fluid and return it to the blood
2) returns filtered plasma proteins back to the blood
3) carries out immune responses
4) transports dietary lipids via special lymphatic vessels called lacteals

lymphatic vessels begin at lymphatic capillaries which are larger and more permeable than
blood capillaries, and allow interstitial fluid to flow into them but not out
-they unite to form larger lymphatic vessels which resemble veins in structure but have thinner
walls
-lymph is filtered of foreign substances at lymph nodes which are located at intervals along the
lymphatic vessel
-lymphatic vessels ultimately empty into the venous system, and like veins, they contain valves

some mechanisms that maintain the flow of lymph include:

-smooth muscle contractions
-skeletal muscle pump
-respiratory pump
15.3 Hemodynamics

blood flow: the volume of blood that flows through any tissue in a given time period, it depends
on the pressure gradient and the resistance

F = delta P/R

blood flows from regions of higher pressure to lower pressure

resistance depends on blood viscosity (thicker), blood vessel length (longer) and blood vessel
radius (smaller)

R = nL/r^4

R = resistance
n = blood viscosity
L = blood vessel length
r = blood vessel radius

total peripheral resistance, aka systemic vascular resistance refers to all the vascular resistances
offered by systemic blood vessels
-arterioles contribute the most resistance, capillaries and venules contribute a little resistance,
arteries and veins are so large that they don’t really contribute any resistance

major function of arterioles is to control TPR – and therefore blood flow and blood pressure to
particular tissues – by changing their radii

when blood flow through a vessel is streamlined and smooth it is known as laminar flow,
laminar flow is quiet
when blood flows through an abnormally constricted area, moves over a rough surface, makes
a sharp turn or exceeds a critical velocity it becomes turbulent

blood pressure: the hydrostatic pressure exerted by blood on the walls of blood vessels, around
110mmHg during systole and 70 mmHg during diastole

blood pressure is determined by cardiac output, blood volume and vascular resistance and is
highest in the aorta and other large systemic arteries

decreases to about 37 mmHg when it reaches the arterial end of the capillaries and 17 mmHg
when it reaches the venous end of the capillaries

pulse is strongest in the arteries closest to the heart, becomes weaker in the arterioles and
disappears altogether in the capillaries
pulse pressure: the difference between systolic pressure and diastolic pressure
PP = SP – DP
-normally about 40 mmHg (110 – 70 = 40)

mean arterial pressure (MAP) is the average blood pressure in the arteries
MAP = DP + 1/3 PP
so about 83 mmHg in a normal person

CO = MAP/TPR

MAP = CO X TPR

compliance is the ability for a hollow object to stretch, veins have a high compliance due to
their thin walls, while arteries have a low compliance

C = delta v / delta p
change in volume / change in transmural pressure
transmural pressure, aka distending pressure, is the pressure difference between n the inside
and outside walls of a hollow object

The velocity of blood flow is inversely proportional to the cross sectional area of the vessel or
group of vessels through which the blood is flowing. velocity is slowest where the total cross
sectional area is greatest

Circulation time is the time required for a drop of blood to pass from the right atrium, through
the pulmonary circulation, to the left atrium, through the systemic circulation, down to the foot
and back again to the right atrium. In a resting person circulation time normally is about one
minute.

venous return is the volume of blood flowing back to the heart through systemic veins
15.4 Control of Blood Flow

-the lungs receive 100% of the cardiac output from the right ventricle, the rest of the organs
receive a fraction of the cardiac output from the left ventricle
-with the exception of the brain, blood flow to these organs increases or decreases in response
to changes in metabolic demand

-changes in blood flow to different organs due to independent adjustments of arteriolar radii

intrinsic control of blood flow are mechanisms within an organ that regulate blood flow y
altering the radii of the arterioles that supply that organ

the ability for a tissue to maintain relatively constant blood flow in the presence of changing
arterial pressure is known as autoregulation

physical changes and local mediators are the two types of intrinsic control

warming promotes vasodilation, cooling causes vasoconstriction

-smooth muscle in arteriole walls are myogenic and contract more forcefully when stretched,
the myogenic response is a form of autoregulation

-stretching of muscles due to increased arterial pressure causes mechanically gated Ca2+
channels to open, calcium enters the cell and binds to calmodulin to form the Ca2+ - calmodulin
complex, which activates the enzyme myosin-light chain kinase (MLCK), MLCK phosphorylates
and activates myosin, which binds to actin to cause contraction, which causes vasoconstriction
of the arteriole

vasodilators: CO2, K+, H+ or adenosine in metabolically active tissues, nitric oxide, bradykinin,
histamine or prostacyclin due to issue trauma or inflammation, reduced oxygen in systemic
circulation

vasoconstrictors: thromboxane A2, superoxide radicals, serotonin, endothelin, reduced O2 in

pulmonary circulation

hyperemia: increased blood flow

active: increases in response to an increase in metabolic activity
reactive: increases in response to a temporary blockage of the blood supply to that area

extrinsic control of blood involves nerves and hormones

-most arterioles are innervated by sympathetic nerves and contain alpha1-adrenergic receptors
in the smooth muscle within their walls
-activation of the alpha 1 receptors causes the arterioles to vasoconstrict
-arterioles in the heart and skeletal muscles have an abundance of beta 2 adrenergic receptors,
and activation of these receptors