THE CARDIOVASCULAR SYSTEM: CIRCULATION

 The Arterial System

Carrying blood to the tissues

    1. Arterial blood pressure

o        Arterial pressure = CO · R

o        Distensibility/elastic properties

o        Systolic pressure

o        Diastolic pressure

o        Pulse pressure

            pulse pressure =systolic pressure - diastolic pressure

o        Measurement of arterial pressure

o        Mean arterial pressure (MAP)

            MAP=1/3 pulse pressure + diastolic pressure

    1. The arteriole provides the major site of resistance to blood flow

o        Arteriole size: 30 µm or less internal diameter

o        Resistance vessels: primary regulatory site in determining local blood flow

o        Relationship between resistance and the diameter of vessels

§         R µ 1/radius4

§         The diameter of a blood vessel is the most important contributing factor for the resistance of flow

 

    1. Regulation of local blood flow to some vascular beds

o        concept of a resting vascular tone

        contributed by spontaneous depolarization of SM cell membrane

o        Autoregulation

§         myogenic activity

§         locally released metabolites

o        CO2 , adenosine, H+ , K+ , heat, depletion of O2, etc.

o        example: occlusion of blood flow to a tissueà reactive hyperemia (reactive vasodilation)

o        Regulation of local blood flow by nerves and circulating hormones

§         role of sympathetic nerves

o        most arterioles are richly innervated by sympathetic nerves (exceptions: coronary vessels and cerebral vessels)

o        continuous neural activity contributes to the resting vascular tone

o        binding of NE a receptors mediates vasoconstriction

§         role of parasympathetic nerves

o        role of some circulating hormones

§         epinephrine

§         binding of EP to b receptors produces vasodilation

§         minimum effect of EP on a receptors

§         angiotensin II - very potent vasoconstrictor

§         atrial natriuretic factor (ANF)

§         potent vsodilator

§         secreted from the atria of the heart and a variety of other tissues

§         increase excretion of salt and water by the kidneys

The Capillary System

Providing the site for exchange of molecules

    1. Structure of the microcirculation and capillary system

o        Microcirculation

§         metarteriole - terminal arteriole

§         thoroughfare channel

§         true capillaries

§         small venule

§         precapillary sphincter

o        Structure of the capillary wall

§         a unicellular layer of endothelium surrounded by a basement membrane

§         0.5 µm thick

§         "pores" in the capillary membrane (6 -7 nm in size)

    1. Molecules exchange across the capillary wall

o        By transcytosis and endocytosis

                large molecules

o        Diffusion

§         through endothelial membrane - lipid soluble molecules: O2, CO2

§         through the water-filled pores - lipid insoluble molecules: glucose, Na+, K+, Cl-

§         factors that facilitate diffusional exchange

o        the distance that the molecules must move is short - >20µm between the capillary and most cells

o        extensive surface area of the capillary wall - 7000 sq. ft

o        slow rate of blood flow in the capillr elationship between velocity of blood flow and the cross-sectional area

 

o        Bulk flow

§         water and dissolved molecules are driven through the pores by bulk flow

§         driving pressure: net pressure gradient of hydrostatic pressure and oncotic pressure

§         filtration and absorption: Starling’s Hypothesis

The Venous System

o        Returning blood to the heart

o        large diameter of veins, thinner wall than corresponding arteries

o        Capacitance vessels: function as low pressure reservoir for blood

o        One-way venous valves, skeletal muscle contraction, and respiration facilitate the return of blood to the heart

o        Varicose veins

The Lymphatic System

o        A second system of vessels

o        The function of lymphatic vessels is to return extra plasma proteins and fluid in the interstitial space back to the circulation

o        Three kinds of lymphatic vessels: lymphatic capillaries, collecting vessels, and lymphatic ducts

Regulation of Systemic Arterial Pressure

Major factors that influence BP are cardiac output, blood volume and peripheral resistance

    1. Short term control of blood pressure

o        Neural controls: ANS (SNS/PNS)

§         vasomotor center (cardiovascular control center) in medulla

o        transmitting parasympathetic impulses through the vagus nerve to the heart

o        transmitting sympathetic impulses through the spinal cord to blood vessels of the body

§         sympathetic nervous system (SNS) innervates: the blood vessels and the heart

§         parasympathetic nervous system (PNS) influences the heart (HR)/little influence in blood vessels

§         Baroreceptor-initiated reflexes (a negative feedback system)

o        pressure sensors: activated by stretching

o        located in carotid artery (carotid sinus), aortic arch

o        afferents to cardiovascular control center

o        efferents to heart, arteries, and veins

§         Chemoreceptor-initiated reflexes

o        chemoreceptors are sensitive to lack of O2, increases in pH and CO of blood

o        located in carotid arteries (two carotid bodies) and aortic arch (several aortic bodies)

o        afferents to vasomotor center

o        effernts (SNS) to vessels - vasoactivity (usually constriction)

§         humoral controls

o        adrenal medulla

o        atrial natriuretic factor

o        angiotensin II

o        antidiuretic hormone

o        endothelins/nitric oxide (NO)

o        prostaglandins

    1. Long-term regulation of blood pressure: renal mechanisms primarily by conserving or releasing salts and water from circulation via the kidneys to maintain blood volume.
    1. Alterations in blood pressure

o        Hemorrhage: loss of blood

o        Exercise and cardiovascular homeostasis