HBHD 13e Ch15

Copyright © 2015 Wolters Kluwer Health | Lippincott Williams & Wilkins
Chapter 15
Blood Vessels and Blood
Circulation

Copyright © 2015 Wolters Kluwer • All Rights Reserved
Overview

Key Terms
aneurysm endothelium varices
aorta hemorrhage varicose vein
arteriole hypertension vasoconstriction
arteriosclerosis hypotension vasodilation
artery phlebitis vasomotor
baroreceptor pulse vein
compliance shock vena cava
capillary sinusoid venous sinus
elasticity sphygmomanometer venule
embolus thrombosis
endarterectomy

Overview of Blood Vessels
Learning Objectives
1.Differentiate among the five types
of blood vessels with regard to
structure and function.
2.Compare the pulmonary and
systemic circuits relative to location
and function.

Systemic Arteries
Learning Objectives
3.Name the four sections of the aorta,
and list the main branches of each
section.
4.Trace the pathway of blood through
the main arteries of the upper and
lower limbs.
5.Define anastomosis, cite its
function, and give four examples of
anastomoses.

Systemic Veins
Learning Objectives
6.Compare superficial and deep veins,
and give examples of each type.
7.Name the main vessels that drain
into the superior and inferior venae
cavae.
8.Define venous sinus, and give four
examples of venous sinuses.
9.Describe the structure and function
of the hepatic portal system.

Circulation Physiology
Learning Objectives
10.Explain the forces that affect
exchange across the capillary wall.
11.Describe five factors that regulate
blood flow.
12.Define pulse, and list six factors
that affect pulse rate.

Circulation Physiology (cont.)
Learning Objectives
13.List four factors that affect blood
pressure.
14.Explain the role of baroreceptors
in controlling blood pressure.
15.Explain how blood pressure is
commonly measured.

Case Study
Learning Objective
17. Based on the opening case
study, discuss the dangers of
thrombosis, and describe one
approach to its treatment.

Word Anatomy
Learning Objective
18. Show how word parts are used to build words related
to the blood vessels and circulation.

The Vascular System
• A closed system of vessels that transports blood to and
from the lungs and body tissues

Overview of Blood Vessels (cont.)
Blood Vessel Types
•Arteries
•Arterioles
•Capillaries
•Venules
•Veins

Figure 15-1 The cardiovascular system.
Which arteries contain oxygen-poor blood? Which veins
contain oxygen-rich blood?

Figure 15-2 Sections of small blood vessels.
Which vessels have valves that control blood flow?

Blood Circuits
•The pulmonary circuit
– Pulmonary trunk and its branches
– Capillaries in lungs
– Pulmonary veins
•The systemic circuit
– Aorta
– Systemic arteries
– Systemic capillaries
– Systemic veins

Vessel Structure
• Three tunics (coats) of arteries and veins
• Inner (endothelium)
• Middle (smooth [voluntary] muscle)
– Controlled by the autonomic nervous system
– Thinner in veins
• Outer (supporting connective tissue)

Figure 15-3 Cross-section of an artery and vein.
Which type of vessel shown has a thicker wall?

✓
Checkpoints
15-1 What are the five types of blood vessels?
15-2 What are the two blood circuits, and what areas
does each serve?
15-3 What type of tissue makes up the middle tunic of
arteries and veins, and how is this tissue controlled?
15-4 How many cell layers make up the wall of a
capillary?

Systemic Arteries (cont.)
The Aorta
•Largest artery
•Receives blood from the left ventricle
•Branches to all organs
Parts of the Aorta
•Ascending aorta
•Aortic arch
•Thoracic aorta
•Abdominal aorta

Branches of the Ascending Aorta and Aortic Arch
•Ascending aorta
– Left and right coronary arteries
•Aortic arch
– Brachiocephalic artery
• Right subclavian artery
• Right common carotid artery
– Left common carotid artery
– Left subclavian artery

Branches of the Descending Aorta
•Branches to the chest wall, esophagus, and bronchi
•Intercostal arteries

Branches of the Abdominal Aorta
•Celiac trunk
– Left gastric artery
– Splenic artery
– Hepatic artery
•Superior mesenteric artery
•Inferior mesenteric artery

Branches of the Abdominal Aorta (cont.)
•Paired lateral branches
– Superior and inferior phrenic arteries
– Renal arteries
– Gonadal arteries (ovarian and testicular arteries)
– Lumbar arteries

Figure 15-4 The aorta and its branches.
How many brachiocephalic arteries are there?

Iliac Arteries and Their Subdivisions
•Internal iliac arteries
•External iliac arteries
– Femoral artery
• Popliteal artery
 Tibial arteries
 Dorsalis pedis

Arteries That Branch to the Arm and Head
•External carotid artery
•Internal carotid artery
•Subclavian artery
– Vertebral artery
– Axillary artery
• Brachial artery
 Radial artery
 Ulnar artery

Figure 15-5 Principal systemic arteries.
What large vessels branch from the terminal aorta?

Figure 15-6 Arteries of the neck and head.

Anastomoses
•A communication between two vessels
•Examples
– Cerebral arterial circle (circle of Willis)
– Superficial palmar arch
– Mesenteric arches
– Arterial arches

✓
Checkpoints
15-5 What are the subdivisions of the aorta, the largest
artery?
15-6 What are the three branches of the aortic arch?
15-7 What areas are supplied by the brachiocephalic
artery?
15-8 What is an anastomosis?

Systemic Veins (cont.)
• Superficial veins
– Cephalic, basilic, median cubital veins
– Saphenous veins
• Deep veins
– Femoral and iliac vessels
– Brachial, axillary, subclavian vessels
– Jugular veins
– Brachiocephalic vein

The Venae Cavae and Their Tributaries
•Superior vena cava
– Head, neck, upper extremities
•Azygos vein
– Chest wall
•Inferior vena cava
– Right, left veins from paired parts, organs
– Unpaired veins from the spleen, digestive tract

Figure 15-7 Principal systemic veins.
How many brachiocephalic veins are there?

Venous Sinuses
Coronary sinus
•Cranial venous sinuses
– Cavernous sinuses
• Petrosal sinuses
– Superior sagittal sinus
• Confluence of sinuses
– Transverse sinuses (lateral sinuses)

Figure 15-8 Veins of the head and the neck and the cranial
sinuses, lateral view.
Into what vessel do the hepatic veins drain?

The Hepatic Portal System
•Carries blood from abdominal organs to the liver
– Superior mesenteric vein
– Splenic vein
– Gastric, pancreatic, inferior mesenteric veins
– Sinusoids

Figure 15-9 Hepatic portal system.
Into what vessel do the hepatic veins drain?

✓
Checkpoints
15-9 What is the difference between superficial and
deep veins?
15-10 What two large veins drain the systemic blood
vessels and empty into the right atrium?
15-11 What is a venous sinus?
15-12 The hepatic portal system takes blood from the
abdominal organs to which organ?

• Blood exchanges oxygen, carbon dioxide, other
substances generated by cells.
• Tissue fluid (interstitial fluid) is the exchange medium.

Capillary Exchange
•How substances move between cells and capillary blood
– Diffusion
• Main process
– Blood pressure
• Moves material into tissue fluid
– Osmotic pressure
• Moves material into capillaries

Figure 15-10 The role of capillaries.

The Dynamics of Blood Flow
•Vasomotor center in the medulla regulates vasomotor
activities.
– Vasodilation
– Vasoconstriction
•Precapillary sphincter

Return of Blood to the Heart
•Mechanisms that promote blood’s return to the heart
– Contraction of skeletal muscles
– Valves in the veins
– Breathing

Figure 15-11 Blood return.
Which of the two valves shown is closer to the heart?

✓
Checkpoints
15-13 What force helps push materials out of a
capillary? What force helps draw materials into
a capillary?
15-14 Name the two types of vasomotor changes.
15-15 Where are vasomotor activities regulated?

The Pulse
•Ventricular contraction
•Wave of increased pressure
•Begins at heart and travels to arteries

The Pulse (cont.)
•Influenced by various factors
– Body size
– Gender
– Age
– Muscular activity
– Emotion
– Body temperature
– Thyroid secretion

Blood Pressure
•Force exerted by blood against vessel walls
•Determined by
– Total blood volume
– Cardiac output
– Resistance to blood flow
– Blood vessel compliance and elasticity

Total Blood Volume
• Total amount of blood in vascular system at any given
time

Cardiac Output
• Volume of blood pumped out of each ventricle in
one minute
• Heart rate
– Beats per minute
• Stroke volume
– Controlled by force of contractions

Circulation Physiology
Resistance to Blood Flow
•Peripheral resistance is affected by:
– Vasomotor changes
– Baroreceptors in large arteries
– Elasticity of blood vessels
– Viscosity
– Total blood volume

Blood Vessel Compliance and Elasticity
•Ease with which arteries expand
– Atherosclerosis
•Ability of vessels of return to their original size

Control of Blood Pressure
•Negative feedback loop
•Baroreceptors
•Sympathetic and parasympathetic responses

Blood Pressure Measurement
•Pressure is measured in the brachial arm artery using a
sphygmomanometer.
– Systolic pressure
• Occurs during heart contraction
• Normal systolic: 120 mm Hg
– Diastolic pressure
• Occurs during heart relaxation
• Normal diastolic: 80 mm Hg

Figure 15-14 Measurement of blood pressure.

Figure 15-12 Blood pressure.
In which vessels does the pulse pressure drop to zero?

Abnormal Blood Pressure
•Hypotension
– Lower than normal blood pressure
•Hypertension (High blood pressure)
– Kidney disease
– Endocrine disorders
– Arterial disease
– Tumors
•Essential hypertension
– No apparent medical cause

Figure 15-13 The baroreceptor response.

Treatment of Hypertension
•Established guidelines
– Stage 1
• Lifestyle modifications
– Stage 2
• Drug therapy

✓
Checkpoints
15-16 What is the definition of a pulse?
15-17 What is the definition of blood pressure?
15-18 What is the most significant factor in determination
of peripheral resistance?
15-19 What are the sensors for blood pressure called?
15-20 What two components of blood pressure are
measured?
15-21 What is the medical term for high blood pressure?

Vascular Disorders
Learning Objective
16.Discuss six disorders involving the
blood vessels.

Vascular Disorders (cont.)
• Arterial degeneration
– Arteriosclerosis
• Complications
• Aneurysm
• Hemorrhage
• Shock
– Types of shock (cardiogenic, septic, hypovolemic,
anaphylactic)
• Thrombosis
• Varicose veins

Figure 15-15 Stages in atherosclerosis.

Figure 15-16 A cerebral aneurysm in the cerebral arterial
circle.

Figure 15-17 Varicose veins.

✓
Checkpoints
15-22 What is the general term for any hardening of
the arteries?
15-23 What is a bulging sac in a vessel wall called?
15-24 What is the term for profuse bleeding?
15-25 What is circulatory shock?
15-26 What term describes a twisted and swollen vein?

Case Study (cont.)
• Hereditary protein S deficiency may cause blood to clot more
easily.
• Deep vein thrombosis (DVT) can cause a phlebitis.
– Signs: Pain, redness, swelling, pulmonary embolus (blood
clot breaks loose and travels to the lung causing
shortness of breath, chest pain, cough, or fainting)
– Daily injections and/or oral doses of anticoagulant
medication until clot is resolved
– Frequent laboratory tests to adjust dose of anticoagulants
• Supportive treatment: Compression stocking and hourly
activity of sitting for prolonged periods.
• No hormone replacement therapy for women.
• No hormonal contraceptives for girls if they test positive for
the genetic trait.

Word Anatomy (cont.)

HBHD 13e Ch15

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