Chapter 18 The Cardiovascular System II: The Blood Vessels

Chapter Outline

Overview of Arteries and Veins

A. Blood vessels transport blood to the tissues, where gases, nutrients, and wastes are
exchanged, and then transport it back to the heart. They also regulate blood flow
to tissues, control blood pressure, and secrete a variety of chemicals.
1. Describe the two circuits that carry blood through the body: The
pulmonary circuit, which transports blood between the heart and lungs, and
the systemic circuit, which transports blood between the heart and body.
2. The pulmonary and systemic circuits are composed of three kinds of blood
vessels—arteries, capillaries, and veins. Describe each type of vessel.
a. Arteries are the distribution system of the vasculature. As they travel
away from the heart, they branch into vessels of progressively smaller
diameter that supply most tissues in the body with blood.
b. Capillaries are the exchange system of the vasculature. They are very
small-diameter vessels that form branching networks called capillary
beds. Gases, nutrients, wastes, and other molecules are exchanged
between tissue cells and the blood through capillary walls.
c. Veins function as the collection system of the vasculature. Veins drain
blood from capillary beds and return it to the heart; small veins merge
with other veins to become progressively larger vessels as they travel
toward the heart.
B. Structure and Function of Arteries and Veins: All blood vessels are tubular
organs that contain a central space—the lumen surrounded by several tissue
layers, or tunics. Three tunics of blood vessel wall are as follows:
1. The innermost tunica intima is composed of endothelium, which is
continuous with the inner lining of the heart, the endocardium.
2. The middle layer of the blood vessel wall is the tunica media, which is
composed of two layers: (1) smooth muscle cells, and (2) elastic fibers. The
smooth muscle cells control the diameter of the blood vessel and so the
amount of blood that flows to organs. Smooth muscle cells are innervated by

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 the sympathetic nervous system called vasomotor nerves. Discuss
vasoconstriction and vasodilation as they relate to vessel diameter. These
nerves stimulate the smooth muscle cells of the tunica media to contract, an
action known as vasoconstriction that narrows the diameter of the vessel.
When sympathetic stimulation of the smooth muscle cells decreases, these
cells relax and the vessel diameter increases, a change called vasodilation.
3. The outermost tunica externa (adventitia) is composed of dense irregular
collagenous connective tissue that supports the blood vessel and prevents it
from overstretching.
4. What are two notable differences between a typical artery wall and the
wall of a typical vein?
a. Most arteries have thicker tunicae mediae than do veins, which reflects
the role of the arteries in controlling blood pressure and blood flow to
organs
b. The internal and external elastic laminae are much more extensive in
arteries than in veins, which reflects the fact that arteries are under
much higher pressure than are veins
5. Arteries: The thickness of each component of the arterial wall depends on the
artery’s size and function: Elastic (conducting) arteries have the largest
diameter, muscular (distributing) arteries have an intermediate diameter,
the smallest arteries are arterioles, while the smallest arterioles are called
metarterioles that directly feed capillary beds in most tissues. Pressure
receptors, or baroreceptors, and chemoreceptors that detect blood oxygen,
carbon dioxide, and hydrogen ion concentrations are found in the aorta and
the common carotid artery.
6. Veins typically outnumber arteries and their lumens have a larger average
diameter. Veins have the following characteristics: (1) veins function as blood
reservoirs, (2) blood can be diverted from the veins to other parts of the body
because veins typically have much thinner walls, fewer elastic fibers, less
smooth muscle, and larger lumens than arteries.

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 7. Veins are classified by their size. The smallest veins are the venules, which
drain blood from capillary beds. Most veins have a thin tunica media with few
smooth muscle cells, and their diameter changes only slightly with
vasodilation and vasoconstriction. Many veins contain venous valves that
prevent blood from flowing backward in the venous circuit.
C. Vascular anastomoses are locations where vessels connect via pathways called
collateral vessels.
Physiology of Blood Flow
A. Introduction to Hemodynamics: Hemodynamics is the physiology of blood
flow in the cardiovascular system. The following is a review of the basic concepts
related to blood flow.
1. Gradients drive most of the processes in the body whether concentration
gradients, pressure gradients, or electrical gradients.
2. Blood pressure is the outward force exerted by blood on the walls of blood
vessels. Blood pressure is highest in the large systemic arteries and lowest in
the large systemic veins.
3. The magnitude of the blood pressure gradient is one main factor that
determines the blood flow, or the volume of blood that flows per minute.
a. Blood flow generally matches cardiac output and averages 5–6
liters/min. Blood flow is directly proportional to the pressure gradient,
meaning that blood flow increases when the pressure gradient
increases and vice versa.
b. The other factor that determines blood flow is resistance. Define
resistance: any impedance to blood flow. Blood flow is inversely
proportional to resistance: as resistance increases, blood flow
decreases.
c. The velocity with which blood flows is largely determined by the
cross-sectional area of the blood vessel. As the arterial system
branches into more, progressively smaller vessels, the total cross-
sectional area increases. This increase in area causes the velocity of

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 blood flow to decrease. For this reason, the velocity of blood flow is
fastest in the aorta and slowest in the capillaries.
B. Factors that Determine Blood Pressure: The three main factors that influence
blood pressure are (1) resistance, (2) cardiac output, and (3) blood volume.
1. Peripheral resistance: Any factor that hinders blood flow through the
vasculature contributes to the overall resistance of that circuit. As peripheral
resistance increases, blood pressure increases. List and describe the three
variables that mainly contribute to resistance:
a. Blood vessel radius dramatically affects resistance. Resistance varies
inversely with the vessel’s radius. As the vessel radius increases
(dilates) the resistance to blood flow decreases, and vice versa.
b. Blood viscosity is the inherent resistance that all liquids have to flow.
Blood has a high viscosity due to the proteins and cells that it contains.
c. Blood vessel length: The longer the blood vessel, the greater the
resistance. More pressure is needed to propel blood through a long
vessel than a short one.
2. Cardiac output (CO) is the product of stroke volume (the amount of blood
pumped with each beat) times heart rate (the number of beats per minute)
a. What are the two factors that determine the pressure gradient
driving circulation? Cardiac output and peripheral resistance. The
relationship is expressed by this mathematical equation:
ΔP = CO × PR
b. A pressure change (ΔP) is caused by altering cardiac output (CO)
and/or peripheral resistance (PR). When cardiac output increases,
blood pressure increases and vice versa.
3. Blood volume and vessel compliance: The final factor that determines
overall blood pressure is the volume of blood in the circulation.
a. The total volume of blood is directly linked to the amount of water in
the blood. When blood contains more water, blood volume increases:
as blood volume increases, blood pressure increases and vice versa.

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 b. Small increases in blood volume are offset by the ability of vessels to
stretch, a property known as compliance. What are the most
compliant vessels? Veins.
C. Blood Pressure in Different Portions of the Circulation: Blood pressure
remains fairly low throughout the pulmonary circuit, but changes significantly as
blood travels through the systemic circuit. Blood pressures averages about 15 mm
Hg in the pulmonary circuit and about 95 mm Hg in the systemic circuit.
1. Systemic arterial pressure: Blood pressure is highest in the aorta and elastic
arteries and declines slightly as it spreads throughout the muscular arteries.
a. Mean arterial pressure (MAP), is the average pressure in the
systemic arteries during an entire cardiac cycle. The MAP generally
measures about 95 mm Hg.
b. The heart has both contraction and relaxation periods. Pressure rises
during ventricular systole and declines during ventricular diastole.
This leads to two separate pressures in the arteries: (1) Systolic
pressure averages about 120 mm Hg, and (2) Diastolic pressure
averages about 80 mm Hg when the person is at rest. The difference
between the systolic and diastolic pressures—about 40 mm Hg—is
known as the pulse pressure.
c. Measuring the arterial blood pressure: Arterial blood pressure is
usually measured in the arm with an instrument called a
sphygmomanometer and a stethoscope.
d. Calculating the mean arterial pressure (MAP): MAP is
approximately equal to the diastolic pressure plus one-third of the
pulse pressure.
MAP = diastolic pressure + 1/3 (systolic pressure – diastolic
pressure)
2. Systemic capillary pressure: As pressure continues to decline throughout the
remainder of the systemic circuit, pressure at the arteriolar end of a capillary
bed is about 35 mm Hg. However, at the venular end of the capillary bed, the
pressure has decreased to about 15 mm Hg. What accounts for the decrease

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 in pressure? This pressure decrease is largely due to the reduction in blood
volume that takes place in capillaries.
3. Systemic venous pressure and mechanisms of venous return: Pressure
declines even further in venules and veins, dropping to about 4 mm Hg in the
inferior vena cava and to 0 mm Hg in the right atrium. What accounts for the
low pressure? The low pressure is largely due to the high compliance of
veins and the declining resistance as vessels merge and become larger.
List and describe three ways in which the rate of venous return is
increased.
a. Venous valves prevent backward flow in some veins while smooth
muscle in vein walls can contract under sympathetic nervous system
stimulation to increase the rate of venous return.
b. Skeletal muscle pumps: Skeletal muscles surrounding the deeper veins
of the upper and lower limbs squeeze the blood in the veins and propel
it upward (toward the heart) as they contract and relax.
c. The respiratory pump helps propel blood through thoracic and
abdominal cavity veins, driven by the rhythmic changes in pressure in
the thoracic and abdominopelvic cavities that occur with ventilation.
Maintenance of Blood Pressure
A. MAP must be constantly maintained around 95 mm Hg. Any deviation from this
set point triggers mechanisms from the nervous, endocrine, and urinary systems
that act to restore blood pressure to this level.
B. Short-Term Maintenance of Blood Pressure: Short-term control of blood
pressure is primarily accomplished by the nervous system and certain hormones
of the endocrine system and achieved by the adjustment of resistance and cardiac
output.
1. Nervous system maintenance of blood pressure: The main branch of the
nervous system in control of homeostasis is the autonomic nervous system
(ANS) via its two divisions: the sympathetic and parasympathetic nervous
systems. Both divisions have immediate effects on blood pressure.

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 a. Sympathetic effects on blood pressure: Sympathetic axons release
norepinephrine and epinephrine onto cardiac muscle cells and the
smooth muscle cells of blood vessels, to produce two immediate
changes: (1) an increase in heart rate and contractility, which increases
cardiac output, and (2) vasoconstriction of all types of vessels, but
especially arterioles, which increases peripheral resistance. Both
changes increase blood pressure.
b. Parasympathetic effects on blood pressure: Axons of the
parasympathetic system, via the vagus nerve, release acetylcholine
primarily onto certain cardiac pacemaker cells and atrial cardiac
muscle cells. This slows the heart rate, which decreases cardiac output
and blood pressure.
c. The baroreceptor reflex: The baroreceptor reflex arc is a negative
feedback loop that responds to increases or decreases in blood
pressure.
2. Endocrine system maintenance of blood pressure: The endocrine system
works with the nervous system to maintain nearly all aspects of homeostasis,
including blood pressure although the hormonal responses are much slower.
a. Hormones that control cardiac output include epinephrine,
norepinephrine, and thyroid hormone.
b. Hormones that control resistance: Epinephrine and norepinephrine
cause vasoconstriction and increase peripheral resistance, elevating
blood pressure. Angiotensin-II is a vasoconstrictor and atrial
natriuretic peptide (ANP) causes a mild decrease in peripheral
resistance.
C. Long-term maintenance of blood pressure by the endocrine and urinary
systems: The long-term maintenance of blood pressure falls to the urinary system
and certain hormones of the endocrine system that affect the kidneys. These
systems control blood pressure by increasing or decreasing the amount of body
water lost as urine, which affects blood volume.
1. The endocrine system regulates blood volume through hormones:

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 a. When blood pressure increases: Atrial cells secrete ANP, which
causes the kidneys to excrete more water and sodium ions to decrease
blood volume, and so blood pressure.
b. When blood pressure decreases: (1) ADH secretion triggers thirst
and increases the amount of water retained by the kidneys, raising
blood volume and blood pressure. (2) Renin secretion from the
kidneys, triggered when the blood pressure drops, activates
angiotensin-II, which induces thirst, causes sodium ion retention, and
as a result increases blood volume. (3) Angiotensin-II also triggers the
secretion of another hormone, aldosterone, which causes retention of
sodium ions and water from the kidneys, increasing blood volume.
2. The urinary system controls blood volume with these responses:
a. If blood pressure increases: More water flows through the filtering
tubules of the kidneys than these cells can return to the blood. This
water is lost from the body as urine. Blood volume and blood pressure
decrease.
b. If blood pressure decreases: Less water flows through the kidneys’
tubules and these cells have more time to reclaim the water and return
it to the blood. This results in decreased urine production and a slight
increase in blood volume and blood pressure.
D. Summary of Blood Pressure Maintenance: The maintenance of blood pressure
by the nervous, endocrine, and urinary systems is summarized in Figure 18.9.
E. Disorders of Blood Pressure, Hypertension and Hypotension: Blood pressure
must be maintained within a certain normal range. If the blood pressure rises too
high (a condition known as hypertension) or falls too low (a condition known as
hypotension), severe disturbances in homeostasis may result.
Capillaries and Tissue Perfusion
A. Introduction to capillaries and tissue perfusion: Capillaries generally are found in
clusters called capillary beds that wind their way through the cells of most tissues.
The blood flow to a tissue through a capillary bed is known as tissue perfusion.

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B. Capillary Structure and Function: Capillaries are extremely thin vessels, with
walls that are only about 0.2 μm in thickness. Each capillary consists of only an
endothelium rolled into a tube and a small amount of basal lamina secreted by the
endothelial cells:
1. Capillary exchange: Nutrients, gases, ions, and wastes must be able to cross
the wall and travel between the blood in the capillary and the tissue cells. This
movement of materials is known as capillary exchange.
2. Types of capillaries: Capillaries in different parts of the body have slightly
different functions and slightly different structures. The three types of
capillaries and their characteristics are as follows: continuous capillaries,
fenestrated capillaries, and sinusoidal capillaries.
C. Blood Flow through Capillary Beds: The flow of blood that takes place within
the body’s capillary beds is collectively called the microcirculation (Figure
18.12).
D. Local Regulation of Tissue Perfusion: Tissue perfusion is regulated by local
factors within each individual tissue, known as autoregulation, or self-regulation.
Autoregulation ensures that the correct amount of blood is delivered to match a
tissue’s level of activity. List and describe the two main types of local
autoregulatory controls:
1. The myogenic mechanism counters a change in blood flow by altering
arteriolar resistance. The velocity of blood flow is related inversely to
resistance, so if resistance increases, velocity decreases, and vice versa.
2. Metabolic controls are mediated by chemicals present in the interstitial fluid
surrounding capillaries. These chemicals are the result of cellular metabolic
(ATP-generating) activities.
E. Tissue Perfusion in Special Circuits: Each organ has its own unique
requirements in terms of blood flow and necessary nutrients.

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