________carry blood away from the heart to the tissues.

Arteries

What does the wall of an artery consist of?

*tunica interna
*tunica media(which maintains elasticity and contractility
*tunica externa

Large arteries

elastic(conducting)arteries

Medium-sized arteries

muscular(distributing) arteries

Many arteries anastomose, what does that mean?

The distal ends of two or more vessels unite. Anastomoses between arteries provide alternate routes for blood to reach a tissue or organ. Thus, if a vessel is blocked by disease, injury, or surgery, circulation to a part of the body is not necessarily stopped.

What is an alternate blood route from an anastomose called?

collateral circulation

What are arteries that do not anastomose called?

end arteries

What happens if there is an occlusion of an end artery?

It interrupts the blood supply to a whole segment of an organ, producing necrosis(death) of that segment.

Very small, almost microscopic, arteries that deliver blood to capillaries.

Arterioles

How do arterioles assume a key role in regulating blood flow from arteries into capillaries and in altering arterial blood pressure?

Through vasoconstriction(decrease in the size of the lumen of a blood vessel) and vasodialation(increase in the size of the lumen of a blood vessel)

Microscopic blood vessels through which materials are exchanged between blood and tissue cells.

Capillaries

What do capillaries connect?

They usually connect arterioles and venules.

What are capillary walls composed of?

A single layer of cells(endothelium) and a basement membrane.

Capillaries branch to form an extensive network throughout the tissue. What is the purpose of this?

The network increases the surface area, allowing a rapid exchange of large quantities of materials.

How is the flow of blood through capillaries regulated?

By vessels with smooth muscle in their walls.

What are the rings of smooth muscle fibers(cells) that regulate blood flow through true capillaries called?

Precapillary sphincters

What are two types of capillaries?

continuous and fenestrated

What are microscopic blood vessels in organs such as the liver, spleen, and bone marrow called?

Sinusoids
They are wider than capillaries, more tortuous, and specialized for the functions of the specific organs.

Small vessels that are formed from the union of several capillaries.

Venules

What do venules merge to form?

Veins

What do veins consist of?

The same thress tunics as arteries, but have a thinner tunica interna and media and a thicker tunica externa. They have less elastic tissue and smooth muscle and are therefore thinner-walled than arteries.

What do veins contain?

Valves to prevent backflow of blood.

What can weak valves lead to ?

Vericose veins

Veins with very thin walls with no smooth muscle to alter their diameters. Examples are the brain's superior sagittal sinus and the coronary sinus of the heart.

Vascular(venous) sinuses

At rest, where is the largest portion of the blood volume?

Systemic veins and venules, collectively called blood reservoirs.

What happens in cases of hemorrhage?

When blood pressure and volume decrease, vasoconstriction of veins in venous reservoirs helps to compensate for the blood loss.

What are the principle reservoirs?

The veins of the abdominal organs(liver and spleen) and skin.

The volume of blood that flows through any tissue in a given period of time.

Blood flow

The ___________ of blood flow is inversely related to the cross-sectional area of blood vessels.

Velocity; Blood flows most slowly where cross-sectional area is greatest.

Blood flow ___1____ from the aorta to arteries to capillaries and ___2____ as it returns to the heart.

1.Decreases
2.Increases

Blood flow is determined by ______ _____and _____.

blood pressure and resistance

How does blood flow?

From regions of higher to lower pressure; the higher the resistance the lower the blood flow.

What is cardiac output (CO) equal to?

Mean aortic blood pressure(MABP) divided by total resistance(R):
CO=MABP/R

The pressure exerted on the walls of a blood vessel.

Blood Pressure (BP)

In clinical use, BP refers to pressure in the arteries.

What are factors that affect blood pressure?

*Cardiac output
*Blood volume
*Viscosity
*Resistance
*Elasticity of arteries

As blood leaves teh aorta and flows through systemic circulation, its pressure progressively falls to __ mm Hg by the time it reaches the right atriam.

0

_______ refers to the opposititon to blood flow as a result of friction between blood and the walls of the blood vessels.

Resistance

Resistance depends on what?

*Blood viscosity
*Blood vessel length
*Blood vessel radius

_____ ______ ______ refers to all of the vascular resistances offered by systemic blood vessels; most resistance is in arterioles, capillaries, and venules due to their small diameters.

Systemic Vascular Resistance (SVR) (also known as total peripheral resistance)

How do substances enter and leave capillaries?

*Diffusion
*Vesicular transport(endocytosis and exocytosis)
*Bulk flow(filtration and absorption)

The movement of water and dissolved substances(except proteins) through capillaries is dependent upon _____ and _____ _____.

Hydrostatic and osmotic pressures

Which type of pressure is being used when the heart beats and blood moves?

Osmotic pressure

Which type of pressure is being used when the heart relaxes?

hydrostatic pressure

Which type of pressure is greater hydrostatic or osmotic?

Hydrostatic

The near equilibrium at the arterial and venous ends of a capillary by which fluids exit and enter is called what?

Starling's law of the capillaries

amount+speed going in=amount+speed going out
(except when edema is present)

Occasionally, the balance of filtration and reabsorption between interstitial fluid and plasma is disrupted, allowing an abnormal increase in the interstitial fluid called _____.

Edema

Edema may be caused by several factors. Name 5.

1.Increased blood hydrostatic pressure in capillaries due to an increase in venous pressure.
2.Decreased concentration of plasma proteins that lower blood colloid osmotic pressure.
3.Increased permeability of capillaries, allowing greater amounts of plasma proteins to leave the blood and enter tissue fluid.
4.Increased extracellular fluid volume as a result of fluid retention.
5.Blockage of lymphatic vessels postoperatively or due to filarial worm infection.

Name two factors that aid venous return.

*The volume of blood flowing back to the heart from systemic veins
*By increasing the magnitude of the pressure gradient between the venules and the right atrium

Blood return to the heart is maintained by several factors. Name 3.

*skeletal muscle contractions
*valves in the veins(especially in the extremities)
*pressure changes associated with breathing

A group of neurons in the medulla that regulates heart rate, contractility , and blood diameter.

The cardiovascular(CV) center

Where does the CV center receive input from?

higher brain regions and sensory receptors(baroreceptors and chemoreceptors)

Where does output from the CV center flow along?

Sympathetic and parasympathetic fibers

sympathetic impulses along _____ _____ increase heart rate and conrtactility.

cardioaccelerator nerves

Parasympathetic impulses along _____ _____ decrease heart rate.

Vagus(X) nerves

The sympathetic divison also continually sends impulses to smooth muscle in blood vessel walls via _____ _____. The result is a moderate state of tonic contraction or vasoconstriction, called_____ _____.

1.vasomotor nerves
2.vasomotor tone

Important pressure-sensitive sensory neutons that monitor stretching of the walls of blood vessels and the atria.

Baroreceptors(pressoreceptors)

The _____ _____ _____ is concerned with maintaining normal blood pressure in the brain and is initiatd by baroreceptors in the wall of the carotid sinus.

Cardiac sinus reflex

The _____ _____ is concerned with general systemic blood pressure and is initiated by baroreceptors in the wall of the arch of the aorta or attached to the arch.

aortic reflex

What happens if blood pressure falls?

The baroreceptor reflexes accelerate heart rate, increase force of contraction, and promote vasoconstriction.

The _____ _____ _____ responds to increases in venous blood pressure and is initiated by baroreceptors in the right atrium and venae cavae.

Right heart (atrial) reflex

Receptors sensitive to chemicals are called_____.

Chemoreceptors

What do chemoreceptors monitor?

Blood levels of oxygen, carbon dioxide, and hydrogen ion concentration.

Several hormones affect blood pressure and flow by acting on the heart, altering blood vessel diameter, or adjusting the total blood volume. Among the hormones that help regulat3eblood pressure are__1___,__2___,___3__ _____,__4___,___5__ _____ _____,___6__,and __7___.

1.epinephrine
2.norepinephrine(NE)
3.antidiuretic hormone(ADH)
4.angiotensin II
5.atrial natriuretic peptide(ANP)
6.histamine
7.kinins

In most body tissues, oxygen is the principal, though not direct, stimulus for _____.

Autoregulation

_____,or faint, refers to a sudden temporary loss of consciousness followed by spontaneous recovery. It is most commonly due to cerebral ischemia(lack of sufficient blood flow).

Syncope

_____ is an inadequate cardiac output that results in failure of the cardiovascular system to deliver adequate amounts of oxygen and nutrients to meet the metabolic needs of body cells.

What can result from this condition?

Shock

As a result, cellular membranes dysfunction, cellular metabolism is abnormal, and cellular death may eventually occur without proper treatment.

What are the signs and symptoms of shock?

*clammy, cool, pale skin
*tachycardia
*weak, rapid pulse
*sweating
*hypotension(systemic pressure < 90 mm Hg)
*altered mental status
*decreased urinary output
*thirst
*acidosis

What are the stages of shock characterized by?

inadequate perfusion of tissues

_____ _____ refers to decreased blood volume resulting from loss of blood or plasma due to acute hemorrhage or excessive fluid loss(as in excess vomiting, diarrhea, sweating, dehydration, urine production, and burns).

Hypovolemic shock

The development of shock occurs in _____ principle stages, which merge with one another.

Three

What is Stage I of shock?

Compensated (nonprogressive) shock, in which negative feedback systems restore homeostasis.

1.If the initiating cause does not get any worse, a full recovery follows.

2.Compensatory adjustments include activation of the sympathetic division of the ANS, the renin-angiotensin pathway, release of antidiuretic hormone(ADH), and release of vasodilator factors in response to hypoxia.

What is Stage II of shock?

Decompensated(progressive)shock, in which positive feedback cycles intensify the shock and immeadiate medical intervention is required.

1.It occurs when there has been a reduction in blood volume of 15-25%.

2.Among the positive feedback cycles that contribute to decreased cardiac output and blood pressure are depression of cardiac activity, depression of vasoconstriction, increased permeability of capillaries, intravascular clotting, cellular destruction, and acidosis.

What is Stage III of shock?

Irreversible shock, in which there is rapid deterioration of the cardiovascular system than cannot be helped by compensatory mechanisms or medical intervention.

_____ is the alternate expansion and elastic recoil of an artery wall within each heartbeat.

Pulse

Where can the pulse be felt?

It may be felt in any artery that lies near the surface or over a hard tissue, and is strongest in the arteries closest to the heart.

The _____ ______ is the most commonly used to feel the pulse.

Radial artery

What is a normal resting pulse(heart)rate?

Between 70 and 80 beats per minute.

Tachycardia means a rapid resting heart or pulse rate of what?

> 100 beats per minute

Bradycardia indicates a slow resting heart or pulse rate of what?

< 60 beats per minute

_____ _____ is the pressure exerted by blood on the wall of an artery when the left ventricle undergoes systole and then diastole.

Blood pressure

How is blood pressure measured?

By the use of a sphygmomanometer usually in one of the brachial arteries.

_____ _____ _____ is the force of blood recorded during ventricular contraction.

Systolic blood pressure(SBP)

_____ _____ _____ is the force of blood recorded during ventricular relaxation.

Diastolic blood pressure(DBP)

The various sounds that are heard while taking blood pressure are called _____ _____.

Korotkoff sounds

What is the normal pressure of a young adult male?

120/80 mm Hg

_____ _____ is the difference between systolic and diastolic pressure. It normally is about 40 mm Hg and provides information about the condition of the arteries.

Pulse pressure(PP)

What is the largest circulatory route?

the systemic system

What are five of the several subdivisions of the systemic circulation?

(1)coronary(cardiac)circulation-supplies the myocardium of the heart

(2)cerebral circulation-which supplies the brain

(3)hepatic portal circulation-extends from the gastrointestinal tract to the liver

(4)pulmonary circulation

(5)fetal circulation

The _____ _____ takes oxygenated blood from the left ventricle through the aorta to all parts of the body, including some lung tissue(but does NOT supply the air sacs of the lungs) and returns the deoxygenated blood to the right atrium.

Systemic circulation

What are the divisions of the aorta?

*ascending aorta
*arch of the aorta
*descending aorta

Blood vessels develop from isolated masses of mesenchyme in the mesoderm called _____ _____.

blood islands

Blood plasma and blood cells are produced by the _____ _____ of blood vessels, a function later assumed by the liver,spleen, bone marrow, and lymph nodes.

endothelial cells

What is the most common disease affecting the heart and blood vessels? It is classified as primary(essential) or secondary.

Hypertension, or high blood pressure

_____ _____ is a persistently elevated blood pressure that cannot be attributed to any particular organic cause.

primary(essential) hypertension (approximately 90-95% of all hypertension cases)

Only _____ _____ has causes that are identifiable.
What are two of these causes?

Secondary hypertension

kidney disease and adrenal hypersecretion

An _____ is a think, weakened section of the wall of an artery or a vein that bulges outward, forming a balloon like sac of the blood vessel.

aneurysm

What can happen if an aneurysm is left untreated?

It may burst, causing massive hemorrhage with shock, severe pain, cardiovascular accident(CVA, or stroke), or death.

_____ _____ _____ is a condition in which the heart muscle receives inadequate oxygen due to blockage of its blood flow.

Coronary artery disease (CAD)

_____-_____ _____ is a blood clot (thrombus) in a deep vein, especially in the lower extremities.

Deep-venous thrombosis(DVT)

What are two serious complications of deep-venous thrombosis?

pulmonary embolism and postphlebitic syndrome

What are the three areas of heart problems?

*vascular
*electrical
*congenital