Blood Vessels-Chps.

14-19
Powered by the pumping action of the heart Heart ArteriesElastic muscular Arterioles Capillaries Venules veins

Transporting nutrients and oxygen to the tissues Transporting waste products away from the tissues Transporting hormones

Lecture outline
I. Review anatomy of vessels A. Arteries B. Elastic C. Muscular D. Arterioles- resistance vessels E. Capillaries- exchange vessels F. Veins- capacitance vessels
II. Ohms law is flow = change in pressure/ resistance A. Blood Flow i. Laminar vs. turbulent B. Pressure- blood pressure i. Mean arterial pressure (MAP) ii. Central venous pressure iii. Pulse pressure C. Resistance i. Factors of resistancePoiseuilles law III. Getting to know Flow better A. Velocity B. Control of flow i. Autoregulation ii. Nervous system iii. Endocrine-kidney (unit 4)

IV. Exchange of extracellular fluid- the microcirculation A. Starling Forces i. Capillary hydrostatic pressure ii. Interstitial hydrostatic pressure iii. Capillary colloid osmotic pressure iv. Interstitial colloid osmotic pressure B. Lymphatic drainage C. Causes of edema

 Branch and diverge Blood away from heart Walls have 3 tunics
Tunica intima-simple squamous endothelium
Tunica media-circular sheets of smooth muscle (vasodilation and vasoconstriction- diameter controlled by local factors and sympathetic NS)

Arteries

Tunica adventitiaconnective tissue with collagen and elastin in longitudinal arrangement

 Elastic- largest arteries near heart Low resistance More elastin interspersed with the tunica media Can distend and recoil back to pump blood (maintain blood pressure) Muscular Supply organs Can regulate diameter of artery to control blood supply to organ Thick tunica media with more smooth muscle External and internal elastic lamina.

Arteries

Arterioles
Smallest arteriesresistance arteries THICK tunica media- little compliance Diameter controlled by local factors (intrinsic) and sympathetic division (extrinsic) and long-term factors (hormones) Metarterioles- just upstream of capillary beds. Precapillary sphincterscontrols blood reaching capillary bed.

Capillaries
Smallest blood vessels Single layer of endothelial cells and basal lamina Renew interstitial fluid- pick up wastes, drop off nutrients, etc. Most cells only 20-30 m away Over 10 billion of them.

Types of Capillaries
Continuous
Most common and least permeable Intercellular clefts and transcellular cytosis allows for exchange of molecules Abundant in skin and muscle

Fenestrated Holes in the endothelial

membrane Found in kidney

Sinusoidal/ discontinuous
Most permeable and least common Big holes in endothelial membranes Big clefts between cells Liver, spleen, and bone marrow especially

Veins

Volume reservoir- capacitance vessels (60-70%) of blood Have vasomotor control. Valves in abdominal veins prevent backflow Skeletal muscle pump and respiratory pump

Vascular Distensibility= is the fractional increase in

volume for each mmHg rise in pressure times original volume- veins are 8x more distensible

0 mmHg Artery

100 mmHg
100 ml

Vein

800 ml

In hemodynamics, its more valuable to know the total quantity of blood that can be stored in a given portion of the circulation for each mmHg pressure rise. 10 Capacitance = increase in volume/increase in pressure The capacitance of veins is 24 times that of arteries.

Ohms Law
Q=P/R Flow (Q) through a blood vessel is determined by: 1) The pressure difference (P) between the two ends of the vessel
Directly related to flow

2) Resistance (R) of the vessel

Inversely related to flow

Can you rearrange the equation above and solve for P? Solve for R?

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Blood Flow (L/min)

Blood flow is the quantity of blood that passes a given point in the circulation in a given period of time. Unit of blood flow is usually expressed as milliliters (ml) or Liters (L) per minute. Overall flow in the circulation of an adult is 5 liters/min which is the cardiac output.

CO= HR X SV
70 b/min x 70 ml/beat =4900ml/min
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 Blood usually flows in streamlines with each layer of blood remaining the same distance from the wall, this type of flow is called laminar flow. When laminar flow occurs, the velocity of blood in the center of the vessel is greater than that toward the outer edge creating a parabolic profile.
Laminar flow

Characteristics of Blood Flow

Blood Vessel

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Laminar Vs. Turbulent Blood Flow

Causes of turbulent blood flow: high velocities sharp turns in the circulation rough surfaces in the circulation rapid narrowing of blood vessels

Turbulent flow

Laminar flow is silent, whereas turbulent flow tend to cause murmurs. Murmurs or bruits are important in diagnosing vessels stenosis, vessel shunts, and cardiac valvular lesions.
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Effect of Wall Stress on Blood Vessels

Turbulent flow increases resistance and wall stress Nitric oxide released by endothelial cells to reduce the stress

Aortic Aneurysm

Atherosclerosis

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Blood Pressure The driving force

Blood pressure (hydrostatic pressure) is the force exerted by the blood against any unit area of vessel wall. Measured in millimeters of mercury (mmHg). A pressure of 100 mmHg means the force of blood was sufficient to push a column of mercury 100mm high. All vessels have it but were usually addressing arteries when we refer to it.

Stephen Hales 1733

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Ejected Blood
contracted

When the LV contracts more blood enters the arterial system than gets pushed onward. This causes the arteries to stretch and pressure within them to rise. The highest pressure achieved is known as the systolic pressure.
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Recoil of the elastic artery

relaxed

As the LV relaxes, the stretched arterial walls recoil and push the contained blood onward through the system. As they recoil, the amount of blood contained decreases as does pressure. The lowest pressure achieved just before the next contraction is the diastolic pressure.
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Mean Arterial Pressure (MAP)

FLOW = arterial - venous pressure (P) resistance (R) Is an average, but not a simple arithmetic average Heart spends longer in diastole than systole Value is significant- why? The difference between the mean arterial pressure and the pressure in the venous system drives the blood through the capillary beds. MAP= .4 (systolic) + .6 (diastolic)= 96mmHg Venous pressure is about 2mmHg
100 mmHg

A
0 mmHg R = .1mmHg/ml/min

FLOW = 1000 ml/min

100 mmHg

B
20 mmHg R = .1mmHg/ml/min FLOW = 800 ml/min
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Central Venous Pressure

Pressure in the right atrium is called central venous pressure.

determined by the balance of the heart pumping blood out of the right atrium and flow of blood from the large veins into the right atrium.
normally 0 mmHg, but can be as high as 20-30 mmHg. More vigorous heart contraction (lower CVP). Less heart contraction (higher CVP) Factors that increase CVP: increased blood volume increased venous tone (peripheral pressure) dilation of arterioles decreased right ventricular function Skeletal and respiratory pumps

Figure 15-9; Guyton and Hall

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Arterial Pulsations and Pulse Pressure

The height of the pressure pulse is the systolic pressure (120mmHg), while the lowest point is the diastolic pressure (80mmHg). The difference between systolic and diastolic pressure is called the pulse pressure (40mmHg). Systolic Pressure

Pulse Pressure
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Diastolic Pressure

Factors Affecting Pulse Pressure

Stroke volume increases in stroke volume increase pulse pressure, conversely decreases in stroke volume decrease pulse pressure. Arterial compliance decreases in compliance increases pulse pressure; increases in compliance decrease pulse pressure.

Figure 15-5; Guyton and Hall

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Stroke volume

Cardiac output Mean Pressure

Systolic Pressure

Stroke volume

}
Diastolic Pressure
Time

Pulse Pressure
Arterial compliance

Total Peripheral resistance

HR x SV = CO = MAP/ TPR MAP= (0.4 SP) + (0.6 DP) PP= SP- DP

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 The intensity of pulsations becomes progressively less in the smaller arteries. The degree of damping is proportional to the resistance of small vessels and arterioles and the compliance of the larger vessels.
Elastic arteries: large radii, low resistance, some pressure reservoir Muscular arteries Smaller radii Little more resistance More pressure reservoir Arterioles Thick tunica media vs. radius major pressure reservoir

Damping of Pulse Pressures in the Peripheral Arteries

Whats an anatomical reason for why the pressure fluctuation disappears here?

Figure 15-6; Guyton and Hall

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Blood Pressure Profile in the Circulatory System

120
Pulmonary veins
25

100

Small veins

Capillaries

Large veins

60 40 20 0

Systemic

Pulmonary

Circulatory pressure- averages 100mmHg Arterial blood pressure-100-35mmHg Capillary pressure- 35mmHg at beginning and 10-15mmHg at end Venous pressure-15-0mmHg

Large pressure drop across the arteriolar-capillary junction

Capillaries

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Pulmonary arteries

Pressure (mmHg)

Venules

Resistance
Resistance is the impediment to blood flow in a vessel. Can not be measured directly
How Would a Decrease in Vascular Resistance Affect Blood Flow?

R = P = mmHg Q ml/min

FLOW =

P RESISTANCE

Conversely,

FLOW =

P RESISTANCE
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Therefore, flow and resistance are inversely related!

Resistance makes a difference for the two sides of the heart!

Lets say the CO (flow) is roughly 100ml/sec (easier math). To calculate systemic resistance vs. pulmonary resistance we need to know pressure differences. Pulmonary resistance is 16-2/100 Systemic resistance is 100/100 So, CO is same on each side of heart (has to be!), but right side generates less pressure due to lower resistance (1/7th than systemic).
100 mmHg

16
mmHg

2mmHg

0mmHg

R = P = mmHg Q ml/min
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Factors of Resistance
Q =_Pr4 8 l

Poiseuilles Law =
Blood viscosity Total vessel length Vessel diameter

Resistance (length)(viscosity) (radius)4

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Viscosity
What are the major contributors to blood viscosity? As viscosity increases, resistance will An increase in plasma EPO will cause resistance to

Figure 14-11; Guyton and Hall

Figure 14-12; Guyton and Hall

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Total Vessel Length

Longer the vessel.....more opportunity for resistance.

Radius

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So, lets review: Blood Flow is volume flowing/time

Ohms Law Blood Flow (Q) = P/ R
Blood flow in center is fastestbecause that is the area of least resistance

P1

P2

Increase pressureincrease blood flow Decrease resistanceincrease blood flow Increase resistancedecrease blood flow
Vessel diameter Viscosity length Turbulence (usually result of an occlusion reducing vessel diameter unevenly)
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P= P1-P2

As resistance decreases, flow will As the pressure gradient increases, flow will Which does the heart influence more: pressure gradient or resistance?

Flow (amount of blood/time) MUST be the same through vessels in series!

If a pipes diameter changes over its length, a fluid will flow through narrower segments faster than it flows through wider segments because the volume of flow per second must be constant throughout the entire pipe. Flow (volume/time) vs. velocity (distance/time) are NOT synonyms!

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If capillaries have such a small diameter, why is the velocity of blood flow so slow?
Aorta >Arterioles > Small veins >Capillaries

We need slow blood flow in the capillariesthe exchange vessels

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Control of blood flow through vessels- Why is this important?

Perfusion vs. ischemia vs. hypoxia vs. anoxia vs. infarction Tissue Perfusion Dependent on:
Cardiac output Peripheral resistance Blood pressure

Regulation of perfusion dependent on:

Autoregulation (Acute, local, intrinsic) Neural mechanisms (acute) Endocrine mechanisms (longterm) http://www.flometrics.com/services/artery/

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Autoregulation the automatic adjustment of blood flow to each tissue in proportion to the tissues requirements at any instant even over a wide range of arterial pressures

Working Muscle Tissue

active hyperemia: when tissues become active, blood flow increases.

Tissue temp. rises Tissue CO2 levels rise Tissue O2 levels fall Lactic acid levels rise

Arterioles serving tissue vasodilate and precapillary sphincters relax Increased blood flow to tissue

Aka: intrinsic metabolic vasodilation CO2 removed Now arterioles will vasoconstrict and precapillary sphincters contract Lactic acid removed

Heat removed

O2 delivered

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Autoregulation of Blood Flow to specific tissues

Vasodilator agents
Histamine Nitric oxide Elevated temperatures Potassium/hydrogen ions Lactic acid Carbon dioxide Adenosine/ ADP

Vasoconstrictors
Norepinephrine and epinephrine Angiotensin Vasopressin (ADH) Thromboxane

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Other ways to ultimately change blood flow throughout the body is to change Pressure and Resistance

Arterial Pressure = Cardiac Output x Total Peripheral Resistance

Short term BP control- nervous

37 Long Term BP control- hormonal

Brain Centers involved in Short Term BP Control

Vasomotor
Adjusts peripheral resistance by adjusting sympathetic output to the arterioles

Cardioinhibitory- transmits
signals via vagus nerve to heart to decrease heart rate. (parasympathetic)

Cardioacceleratory/ contractility-sympathetic output

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Vasomotor control: Sympathetic Innervation of Blood Vessels

Sympathetic nerve fibers innervate all vessels except capillaries and precapillary sphincters (precapillary sphincters follow local control) Innervation of small arteries and arterioles allow sympathetic nerves to increase vascular resistance. Large veins and the heart are also sympathetically innervated.
Figure 18-2; Guyton and Hall

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Anatomy of the Baroreceptors

spray type nerve endings located in the walls of the carotid bifurcation called the carotid sinus and in the walls of the aortic archpressoreceptors that respond to stretch. Signals from the carotid sinus are transmitted by the glossopharyngeal nerves . Signals from the arch of the aorta are transmitted through the vagus into the NTS.

Important in short term regulation of arterial pressure.

They are unimportant in long term control of arterial pressure because the baroreceptors adapt.
Figure 18-5; Guyton and Hall

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Response of the Baroreceptors to Arterial Pressure

Constrict Common Carotids Pressure at Carotid Sinuses

Figure 18-7; Guyton and Hall

Arterial Pressure

Constrictors

Baroreceptors respond to changes in arterial pressure. As pressure increases the number of impulses from carotid sinus increases which results in:

1) inhibition of the vasoconstrictor 2) activation of the vagal center

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Figure 18-5; Guyton and Hall

Functions of the Baroreceptors

Maintains relatively constant pressure despite changes in body posture.
Decrease Venous return

Supine

Standing

Sympathetic Nervous Activity Vasomotor Center Sensed By Baroreceptors Decrease Cardiac Output

Decrease Arterial Pressure

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BP rises
Decreased vasomotor activity Decreased NE release on arterioles Vasodilation

Detected by baroreceptors in aortic arch & carotid sinus

Decreased PR

Info sent to cardiac and vasomotor centers

Increased cardioinhibitory activity

Increased vagus activity

Decreased BP

Increased ACh release on heart Decreased cardioacceleratory activity Decreased CO Decreased NE release on heart Decreased SV and HR

Carotid and Aortic Chemoreceptors

Chemoreceptors are chemosensitive cells sensitive to oxygen lack, CO2 excess, or H ion excess. Chemoreceptors are located in carotid bodies near the carotid bifurcation and on the arch of the aorta. Activation of chemosensitive receptors results in excitation of the vasomotor center. O2 CO2 pH
Figure 18-5; Guyton and Hall

Chemoreceptors

VMC

Sympathetic activity

BP
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Nervous control also found in the heartBainbridge Reflex

Prevents damming of blood in veins, atria and pulmonary circulation. Increase in atrial pressure increases heart rate.

Stretch of atria sends signals to VMC via vagal afferents to increase heart rate and contractility.
Atrial Stretch Vagal
afferents Vasomotor Center
Heart rate
Contractility
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The Microcirculation-chapter 16 Important in the transport of nutrients to

tissues. Site of waste product removal. Over 10 billion capillaries with surface area of 500-700 square meters perform function of solute and fluid exchange.

Figure 16-1; Guyton and Hall

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Most substances are exchanged via diffusion

Concentration

differences across capillary enhances diffusion.

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Determinants of Net Fluid Movement across Capillaries-Starling forces

Figure 16-5; Guyton and Hall

Capillary hydrostatic pressure (Pc)-tends to force fluid outward through the capillary membrane.
(30 mmHg arterial; 10mmHg venous- average 17.3mmHg)

Interstitial fluid hydrostatic pressure (Pif)- opposes filtration when value is positive (but its not positive-- due to lymphatic drainage! 3mmHg).
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Determinants of Net Fluid Movement across Capillaries-Starling forces

Figure 16-5; Guyton and Hall

Plasma colloid osmotic pressure ( c)- opposes filtration causing osmosis of water inward through the membrane
Colloid osmotic pressure of the blood plasma. (28mmHg) 75% from albumin; 25% from globulins

Interstitial fluid colloid pressure ( if) promotes filtration by causing osmosis of fluid outward through the membrane
Colloid osmotic pressure of the interstitial fluid. (8mmHg) 3gm%
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Net Forces in Capillaries

Filtration= Kf X (Pc- Pif - c + if)
Mean forces tending to move fluid outward: Mean Capillary pressure Negative interstitial free fluid pressure Interstitial fluid colloid osmotic pressure TOTAL OUTWARD FORCE Mean force tending to move fluid inward: Plasma colloid osmotic pressure TOTAL INWARD FORCE
Summation of mean forces: Outward Inward NET OUTWARD FORCE

mmHg
17.3 3.0 8.0 28.3
28.0 28.0

28.3 28.0 0.3

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Net filtration pressure of .3 mmHg which causes a net filtration rate of 2ml/min for entire body (2-4 liters/day!)

If capillary BP is greater than capillary OP, there will be net movement of fluid out of the capillary.

Capillary BP
Filtration

Pressure

Capillary OP
Reabsorption

If capillary BP is less than capillary OP, there will be net movement of fluid into the capillary.

Arterial end

Venous end

Distance along the capillary

Filtration= Kf X (Pc- Pif - c + if)

 Lymphatic vessels collect lymph from loose connective tissue

Fluid flows only toward the heart Collect excess tissue fluid and blood proteins and carry to great veins in the neck All three tunics NO pump! Valves!

2ml/min Excess tissue fluid is returned to the blood vessels via the lymphatic system!

contains plasma, water, ions, sugars, proteins, gases, amino acids- is colorless, but low in protein compared to blood Lymph can contain hormones, bacteria, viruses, cellular debris, traveling cancer cells, macrophages

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Causes of Edema
Excessive accumulation of tissue fluid. Edema may result from: High arterial blood pressure. Venous obstruction. Leakage of plasma proteins into interstitial fluid. Valve problems Cardiac failure Decreased plasma protein. Obstruction of lymphatic drainage. ElephantiasisWuchereria bancrofli
I would see your homework packet and study page 303 of Guyton and Hall!
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Unbalanced Ventricular Output

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Unbalanced Ventricular Output

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Hypertension
Starvation

capillary BP

ISF formation

Lack of dietary protein Histamine

in plasma albumin

capillary OP

ISF formation

Vasodilation

capillary BP

capillary permeability

ISF formation

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Burn/crush injury

capillary permeability

Cap OP

ISF formation

Backup of blood in pulmonary circuit

pulmonary capillary BP

ISF formation

L. Ventricle failure

Decreased blood flow in systemic circuit

systemic capillary BP

ISF formation
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