Transcript Ativity 25 - PCC - Portland Community College

Exercise 21
Blood Vessels & Circulation
Portland Community College
BI 232
Blood vessels
• Conduits that carry
oxygen and nutrients to
cells and remove wastes
• Arteries transport blood
away from the heart.
• Deliver blood to capillary
beds where gas and
nutrient exchange occurs.
• Veins transport blood
toward the heart.
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Martini
pg. 711
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General Circulatory Patterns
• Two main circuits:
• Pulmonary circulation: Blood goes from the heart
to the lungs and returns to the heart. The
pulmonary trunk and its branches; leave the right
ventricle of the heart and contain deoxygenated
blood.
• Systemic Circulation: Blood goes from the heart
to rest of the body. The aorta and its branches;
leave the left ventricle of the heart and contain
oxygenated blood.
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Artery and Vein
Histology
• Walls have 3 layers:
• Tunica intima
• Tunica media
• Tunica externa
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Tunica Intima
• Is the innermost layer near the lumen
• Includes:
• The endothelial lining
• Connective tissue layer
• Internal Elastic Membrane: In arteries, is a
thick layer of elastic fibers in the outer
margin of the tunica intima
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Tunica Media
• Is the middle layer
• Contains concentric sheets of smooth
muscle in loose connective tissue
• Binds to inner and outer layers
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Tunica Externa
(aka: Tunica Adventitia)
•
•
•
•
Is outer layer
Contains connective tissue sheath
Anchors vessel to adjacent tissues
In arteries:
• Contain collagen
• Elastic fibers
• In veins:
• Contain elastic fibers
• Smooth muscle cells
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Elastic Arteries
• Also called conducting arteries, these are the
largest arteries
• Tunica media has many elastic fibers and few
muscle cells
• Elasticity evens out pulse force
• Examples:
• Pulmonary trunk
• Aorta
• Common carotid arteries
• Subclavian arteries
• Common iliac arteries
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Aorta
n = smooth muscle cell TI = tunica intima
el = elastic fibers
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end = endothelial cells TA = tunica adventitia TM = tunica media
Vasa Vasorum
• “Vessels of Vessels”
• Small arteries and
veins in the walls of
large arteries and
veins
• Supply cells of
tunica media and
tunica externa
Vasa Vasorum
Aorta
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Muscular Arteries
• Also called distribution arteries, are
medium-sized (most arteries)
• Tunica media has many muscle cells
• Examples:
• External carotid arteries
• Brachial arteries
• Femoral arteries
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Muscular Arteries
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Arterioles
•
•
•
•
The smallest branches of arteries
Feed into capillaries
Have little or no tunica externa
Have thin or incomplete tunica media
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Arteriole
end = endothelial cell nucleus
e
n = nsmooth muscle nucleus
rbc d= red blood cells
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Capillaries
• The smallest vessels
• Structure: Simple squamous epithelium tube
• Lumen side has a thin basal lamina
• No tunica media, No tunica externa
• Location of exchange between blood and
interstitial fluid.
• Gasses and chemicals diffuse across their walls
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Veins
• Carry blood to the heart
• Are larger in diameter than arteries
• Have thinner walls
• Contain valves
• Folds of tunica intima that prevent blood
from flowing backward
• Venules: The smallest veins that carry
blood away from the capillaries
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Veins
• Medium-sized veins:
• Thin tunica media and few smooth muscle cells
• Tunica externa with longitudinal bundles of
elastic fibers
• Large veins:
• Have all 3 tunica layers
• Thick tunica externa
• Thin tunica media
• Example: Inferior and Superior vena cava
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Venous Valve in Medium Vein
ad = adipose tissue
TA = tunica adventitia
TM = tunica media
v = valve
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Large
Vein
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Arteries Vs. Veins
• Arteries and veins run side-by-side
• Arteries have thicker walls and higher blood
pressure
• Collapsed artery has small, round lumen
• Vein has a large, flat lumen
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Vein
Artery
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Aortic Arch
Left Coronary A.
Ascending Aorta
Right Coronary A.
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Aortic
Arch
External carotid
Internal Carotid
Common Carotid
R. Vertebral
R. Axillary a.
R.Subclavian a.
L.Subclavian a.
Brachiocephalic Trunk
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Right Common
Carotid
R.Subclavian
Vertebral
L..Subclavian
Brachiocephalic
Trunk
Left
Common
Carotid
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Descending aorta
• Thoracic aorta:
above the diaphragm
• Includes the intercostal
arteries which run
between the ribs
• Abdominal aorta:
below the diaphragm
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Axillary
Artery
R. Axillary a.
Brachial a.
Radial a.
Ulnar a.
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Circle of Willis
Internal Carotid
Vertebral
External carotid
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Arteries of the head and neck
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Circle of
Willis
Anterior communicating
Anterior cerebral
Internal Carotid (cut)
Middle cerebral
Posterior communicating
Posterior cerebral
R. Vertebral
Basilar
L. Vertebral
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Anterior cerebral
Internal Carotid
Middle cerebral
Posterior cerebral
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Abdominal
Aorta
Celiac Trunk
Superior Mesenteric
Renal A.
Gonadal
Inferior Mesenteric
Common Iliac
External Iliac
Internal Iliac
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Abdominal
Common Hepatic
Aorta
Celiac Trunk
Left Gastric
Splenic
Superior Mesenteric
Inferior Mesenteric
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Spleen
Splenic a.
Renal a.
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Thigh
Anterior
Posterior
External Iliac
Femoral
Deep Femoral
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Lower
Leg
Femoral
Popliteal
Anterior
tibial
Fibular
Fibular
Dorsalis
Pedis
Posterior
tibial
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Axillary vein
Cephalic vein
Brachial vein
Basilic vein
Median
Cubital vein
Cephalic vein
Radial vein
Basilic vein
Ulnar vein
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Brachiocephalic
Right Left
Subclavian vein
Axillary vein
Cephalic vein
Brachial vein
Basilic vein
Azygos
Hemiazygos
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Petrosal sinus
Superior
Sagittal sinus
Cavernous sinus
Straight sinus
Transverse sinus
Sigmoid sinus
Internal Jugular
Brachiocephalic
Vertebral Vein
Right
Left
External Jugular
Subclavian vein
Superior
Vena42Cava
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Femoral
Popliteal
Great
Saphenous
Small
Saphenous
Small
Saphenous
Anterior
Tibial
Anterior
Tibial
Fibular
Posterior
Tibial
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Deep Femoral
Femoral
Great Saphenous
Popliteal
Small
Saphenous
Anterior
Tibial
Posterior
Tibial
Small
Saphenous
Fibular
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Hepatic veins
Inferior Vena Cava
Renal vein
Common iliac vein
Internal iliac vein
External iliac vein
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Inferior Vena Cava
Hepatic veins
Hepatic Portal vein
Splenic vein
Superior
Mesenteric
Inferior
Mesenteric
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Hepatic Portal Circulation
• Veins that flow into the
liver before returning to
the heart
• Blood from digestive
organs and spleen travel to
capillaries of the liver.
• The liver processes the
blood before sending it
through the hepatic vein.
• Blood then travels to the
inferior Vena Cava
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Thoracic Veins
• Intercostal veins
which drain the
intercostal muscles
• Azygos and
hemiazygos veins
which drain blood
from the thoracic
region
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Fetal Circulation
• Lungs of fetus are non
functional.
• Oxygen and nutrients
move from the
maternal side of the
placenta to the fetal
bloodstream and CO2
and wastes moves
from the fetal blood to
the placenta
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Fetal Circulation
• Blood flow
• From the umbilical
cord blood travels
through the ductus
venosus which shunts
the blood to the
inferior vena cava
• From the VC blood
travels to the right
atrium of the heart
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Fetal Circulation
• Blood can then move either to the right ventricle
or through a hole in the right atrium called the
foramen ovale (bypass route)
• Blood in the right ventricle moves into the
pulmonary trunk where another shunt vessel, the
ductus arteriosus carries blood to the aortic arch,
bypassing the lungs.
• Closing to the foramen ovale leaves the fossa
ovalis which we learned about in the heart lab.
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Blood Pressure
• Maintenance of bp is important
for the health of the heart and
proper functioning of various
organs
• The force exerted by blood on
the walls of blood vessels.
• A function of the pumping
action of the heart and the
resistance to flow as blood
moves through the blood
vessels.
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Blood Pressure
• In large elastic
arteries, the BP
fluctuates between a
max. and min. value
• Systolic pressure is
the maximum pressure
exerted on bv walls.
• Diastolic pressure is
the minimum level
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Blood Pressure
• Measured in units
called millimeters of
mercury (mmHg)
• If the pressure in a bv
is 95mm Hg, it means
that the force exerted
by the blood will
cause a column of
mercury to rise 95mm
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Blood Pressure Cuffs
• BP cuffs come in
Large Adult
different sizes.
• Be sure to choose the
one that is appropriate
for the patient
Infant
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Measuring Blood Pressure
• Most cuffs are
marked with an O
or an arrow. This
should be placed
near the artery.
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Measuring Blood Pressure
• Place the BP cuff
snugly on the
patient's arm.
• Check to make sure
you have found the
artery.
• Line the mark on
the cuff up with the
artery
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Measuring Blood
Pressure
• Stethoscope: Note how
the ear pieces slant
slightly in one direction.
• Make sure the ear pieces
on the stethoscope are
point away from you
when you put them on.
• Place stethoscope on the
artery, tucked slightly
under the cuff
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Measuring Blood
Pressure
WRONG TECHNIQUE
• The cuff should be
placed at the level
of the heart.
• The patients arm
(or leg) should be
completely relaxed.
• Resting on the
table or in their lab
is helpful
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CORRECT TECHNIQUE
Inflate the Cuff
• A Grasp the bulb so that
your thumb can easily
access the valve.
• Turn the valve to the right
to tighten it and pump up
the cuff, turn it to the left to
loosen it and deflate the
cuff.
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Measuring Blood
Pressure
• Pump up the cuff until the
sphygmomanometer reads
180 to 200.
• Loosen the valve to let a little of the air out.
• Listen for the first heartbeat, that is the top number
(systolic BP)
• Continue to listen until there are no more
heartbeats. The last beat you hear is the bottom
number (diastolic BP)
• Let the air all the way out and remove the cuff.
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Video Demonstration for
Measuring Blood Pressure
• http://www.uams.edu/csc/programs/orientat
ion/bloodPressure/TakingBP1.mov
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Normal Blood Pressure
•
Reference:
• August 2004, National Heart Lung and Blood Institute – Diseases and Conditions Index
• http://www.nhlbi.nih.gov/health/dci/Diseases/Hbp/HBP_WhatIs.html
• For adults 18 and older who:
• Are not on medicine for high blood pressure
• Are not having a short-term serious illness
• Do not have other conditions such as diabetes and kidney
disease
• Systolic BP: Less than 120
• Diastolic BP: Less than 80
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Pre-Hypertension
• Systolic BP: between 120-139
• Diastolic BP: between 80-89
• Examples: 118/82, 128/89, or 130/86
• If your blood pressure is in the pre-hypertension range,
it is more likely that you will end up with high blood
pressure unless you take action to prevent it.
• Note: When systolic and diastolic blood pressures
fall into different categories, the higher category
should be used to classify blood pressure level.
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Hypertension
• Stage 1
• Systolic BP: between 140-159
• Diastolic BP: between 90-99
• Stage 2
• Systolic BP: 160 or higher
• Diastolic BP: 100 or higher
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Hypotension
• Hypotension is a subnormal arterial pressure.
• There is not enough pressure to adequately perfuse
the tissues.
• There is usually a mean arterial pressure (MAP)
below 60 mmHg.
• MAP= diastolic + 1/3(systolic-diastolic)
Example: BP= 120/70
MAP= 70 + 1/3(120-70)= 86.6
• People who are chronically hypertensive may feel
symptoms of hypotension if their mean arterial pressure
drops by 40 mmHg, even if the absolute value is still
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over 60.
Pulse
• The rhythmic
expansion and recoil
of the arteries is
known as the pulse.
• Can be found in
various locations
• Diminish in smaller
arteries and are absent
in capillaries and veins
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Pulse
Radial Pulse
Carotid Pulse
Brachial Pulse
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Pulse
Posterior Tibial Pulse
Dorsalis Pedis Pulse
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The End
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