Cardiovascular IV: Blood Vessels Overview: Blood Vessel Structure & Function Arteries carry blood away from

m heart Veins return blood to heart Capillaries = sites of exchange General Structure of Blood Vessel Walls (3 Layers) Tunica Interna (Intima) Endothelium (lining) Subendothelial layer (basement membraneconnective tissue) Tunica Media Circular smooth muscle, elastin Tunica Externa Collagen (connective tissue)
Arteries have thicker wall, veins have valves (prevent backflow) and larger diameter Capillaries have one layer (for exchange by diffusion): simple squamous epithelial cells and basement membrane

Blood Flow Heart contracts to generate pressure; pushes blood around closed system of vessels Pressure gradient (P) is driving force Physics of Fluid Flow (See supplementary notes) Figure 12.5V Pressure gradient (P) governs flow Vascular resistance (R) opposes flow (diameter determining factor)
- Proportional to 1/r^4; little change to radius results in big change to resistance

Vessel radius (r) is major determinant of resistance

Physics of Blood Flow: Apply to our cardiovascular system Pressure Gradient (P) produced by contraction of heart Blood Pressure Resistance opposition to flow Most important factor: FRICTION between blood and walls of blood vessels Sources of resistance:
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Viscosity of blood Blood vessel length Blood vessel radius R = 1/r4 NOTE: Very small change in r big change in R!

Vascular resistance vs. TPR (Total Peripheral Resistance)

Poiseuilles Law (See supplementary notes) Which variables are physiologically regulated?

Laplaces Law (See supplementary notes)

Vascular Compliance (See supplementary notes)

Systemic Circulation Regional Differences Pressure variations throughout systemic circulation Note steep drop in arterioles Arteries Types of Arteries Elastic Arteries Muscular Arteries

Function of Arteries Low resistance pipes Pressure reservoir (especially elastic arteries)
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Pulse pressure = Systolic BP Diastolic BP Average: 40 mm Hg

Two factors affect pulse pressure: Volume of blood within arteries Primarily determined by stroke volume Arterial compliance High in elastic arteries

Pressure Reservoir Function of Elastic Arteries During systole, stroke volume of blood is ejected, stretching compliant walls of elastic arteries When systole ends, stretched arterial walls recoil, continuing to drive blood into arterioles during diastole

NOTE ARTERIAL PRESSURE does NOT go to zero during diastole! Note VENTRICULAR pressure DOES go to almost zero during diastole!

Blood Pressure Blood Pressure = Force / Unit Area exerted by blood on wall of blood vessel Normal: 120/80 Reflects pressure in major systemic arteries Recall pressure drops as blood flows throughout system Mean Arterial Pressure = more useful concept physiologically

Mean Arterial Pressure (MAP) = Diastolic Pressure + 1/3 Pulse Pressure

Arterioles Small arterioles: Considerable resistance to flow Two major roles: Determine relative blood flows to tissues (blood flow distribution) Major factor in determining MAP (due to effect on Total Peripheral Resistance)
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Relationship between arterial pressure, arteriolar radius in different organs, and blood-flow distribution.

Regulation of Blood Flow by Arterioles: Regulation of Arteriolar Radius Myogenic tone: spontaneous contraction of smooth muscle in tunica media Contract smooth muscle more vasoconstriction; relax smooth muscle vasodilation

Recall, F = P/R; and recall R = 1/r4 SMALL increase in radius BIG increase in flow THREE MECHANISMS regulate arteriolar radius: Local Control Neural (reflex) Control Hormonal Control

Local (intrinsic) Control of Arteriolar Radius 1) Active Hyperemia: Blood flow adjusted to meet tissues needs (if tissue needs blood will get it)
Control by themselves (why intrinsic)

Following stimuli increase blood flow (by increasing radii of arterioles, metarterioles and precapillary sphincters): Decreased O2 Increased CO2 Increased [H+] / decreased pH Metabolites, including K+, osmolarity Bradykinin (e.g., in some gland cells) This mechanism is not important in MAP regulation.

2) Flow Autoregulation (if local area BP drops, will open up) Decreased blood pressure in organ arteriolar dilation in organ to restore blood flow Several factors mediate including decreased O2 and increased metabolites This mechanism is not important in MAP regulation.

Other Intrinsic Control Mechanisms - Also aimed at tissue needs, not MAP regulation. 3) Reactive Hyperemia Complete occlusion of blood flow extreme dilation of arterioles.

4) Long Term Autoregulation (if keeps demanding blood, grow more blood vessels) Increase in metabolic demand or prolonged change in arterial pressure increased vascularization Reflex (Neural) Control of Arteriolar Radius -Extrinsic control
sacrifice some tissues, in order to keep you alive

Important in MAP regulation Sympathetic nervous regulation of -adrenergic receptors (alpha 1) Increased sympathetic stimulation vasoconstriction (increase sympathetic tone) Decreased sympathetic stimulation vasodilation
alpha 1 causes smooth muscle contraction decrease blood vessels to gut/digestive, kidneys, skin (e.g.) control by adjusting sympathetic tone

Parasympathetic much less important

Hormonal Control of Arteriolar Radius -Extrinsic control Important in MAP regulation Epinephrine (reinforces sympathetic effects)
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Vasoconstrictor for vessels with 1-adrenergic receptors; vasodilator for vessels with 2- adrenergic receptors Angiotensin II will cover later!!!! Strong vasoconstrictor Part of RAAS (Renin-Angitotensin-Aldosterone System)

Summary: Controls of Arteriolar Radius (Fig. 12.36V) Local controls not important in mean pressure Capillaries Capillary Wall Thin tunica intima RBCs squeeze through single file diffusion, maximizes exchange

Lack muscle layer (squamous epithelium, then basement membrane)

Types of Capillaries Continuous typical capillary Fenestrated Sinusoids

Capillary Beds (Fig. 12.38 V) Metarteriole Vascular shunt if precapillary sphincter closed, blood shunts (diverts) thru shunt no exchange

True capillaries Precapillary sphincters Controlled by intrinsic mechanisms

Capillary Blood Pressure 35 40 mm HG at beginning of capillary bed 15 20 mm Hg at end Velocity of Capillary Blood SLOW Related to great INCREASE in cross-sectional area of vessels at capillary level Importance? Time for exchange Capillary Exchange Exchange occurs between blood and interstitial fluid
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Diffusion Lipid-soluble (O2, CO2) Ions, polar molecules Other (glucose) Vesicular transport Bulk Flow (solutes pull water across membrane) In brain, mediated transport plays role

Bulk Flow and ECF Distribution - Filtration: Fluid moves OUT of capillary (OUT of blood) - Reabsorption: BACK into BLOOD (into capillary) - Four forces govern fluid movement in and out of capillaries: Fig. 12.42 V - Two types of osmotic pressures, two types of pressures
1) 2) 3) 4) Pc = BP (hydrostatic P) in capillaries; favors filtration c = (colloid osmotic pressure-COP) due to protein in blood (albumin); favors reabsorption ip = very small (in interstitial fluid); favors filtration Pif = pressure of interstitial fluid = 0 under normal conditions; favors reabsorption

IGNORE Changes in arteriolar resistance (diameter) lead to changes in capillary hydrostatic pressure (PC) Dilation of arterioles raises PC leading to: More filtration Constriction of arterioles decreases P c leading to: More reabsorption
Beginning of cap bed: F>R End of cap bed: R>F o Any excess filtered fluid lymphatic system

IGNORE Role of Lymphatic System Excess fluid is absorbed by lymphatic capillaries and delivered to lymphatic system One-way vessels return fluid to circulatory system Lymphatic vessels drain into systemic circulation (via subclavian veins to superior vena cava)
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Failure of lymphatic system Edema

Venous System Functional challenge for systemic veins: Only 10 mm Hg pressure push back to right heart Veins structural adaptations help overcome functional challenge Large diameters = low resistance pipes Valves prevent backflow

Varicose Veins IGNORE Weakness / loss elasticity in venous walls Veins widen and stretch Valves dont close backflow of blood Functions of Veins Low resistance conduit (pathway) of blood back to right heart Blood reservoir- can be compliant (easy to stretch) Low resistance because large diameter Venous pressure determines venous return (what gives us end diastolic volume) a major determinant of cardiac output Determinants of Venous Pressure: Volume of Blood Within & Compliance of Wall Veins can accommodate large volumes of blood, with relatively little increase in pressure Due to high COMPLIANCE of venous walls Determinants of Venous Return Total Blood Volume is one determinant of pressure (and thus venous return)

Compliance, normally high, can be decreased to stiffen venous

walls

Sympathetic stimulation increased stiffness of venous walls (decreased compliance) increased venous pressure increased venous return (increase EDV, stroke volume, mean arteriol pressure)

Valves and large lumens also crucial to venous return Two other functional adaptations ensure venous return: Skeletal Muscle Pump Respiratory Pump: no questions on exam

Veins stretchiness high (compliance high, can change it) Increase stroke volume, increase venous pressure

Skeletal Muscle Pump Compression of veins by skeletal muscle contraction raises local venous pressure; then valves prevent backflow Blood forced towards heart (less)

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Respiratory Pump NOT ON EXAM Heart (and lungs) are in thoracic cavity Pressure in thoracic cavity is subatmospheric (negative) Inspiration (inhaling) drops pressure more, expanding lungs and cardiac chambers Decreased pressure in heart facilitates return of blood Note: Exercise effect Why is venous pressure important? Ensure delivery of blood to all organs/tissues

Major determinant of EDV Increase stroke volume, thus increase cardiac output and thus MAP

Pulmonary Circulation Which vessels contain oxygenated / deoxygenated blood?

Pulmonary artery and trunk (deoxy) Pulmonary veins4 (oxy)

Pulmonary Circulation = LOW PRESSURE, LOW RESISTANCE system Compare Blood Pressures Systemic Left heart: 120/1 Aorta: 120/80 MAP: 93 mm Hg Pulmonary Right heart: 25/1 Pulmonary artery: 25/8 (Mean Pulmonary Arterial Pressure) MPAP: 14 mm Hg Walls different, output the same (from right and left) Cardio Cardio Cardio Cardio Cardio I = 5 questions II = 4 III = 21 IV = 13 V = 3 questions

overlapping questions

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O2/Hemoglobin Curve - plots percent saturation of Hb - iron atom can reversibly bind O2 up to 4 O2 (one for each subunit) - PO2 = partial pressure of oxygen - Higher PO2 the greater the % saturation of Hb by O2 - At a certain range, a small increase leads to great increase in % - Plateau around 60 mmHg Shifting Curve - BPG o Shift curve to left, favors loading of O2 onto Hb (Hb more likely to be binding O2, and higher affinity) o Shift to right, decrease affinity (favors release of O2 from Hb) - Temperature - Acidity o Increase (more CO2 = more acidity)

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