The Mission of the Cardiovascular System

● The mission of the cardiovascular system is to keep blood flowing through

capillaries.
● Capillary exchange allows the movement of substances between blood
and interstitial fluid.
● Approximately 7% of the blood in systemic capillaries is involved in this
exchange.
● Substances enter and leave capillaries through:
1. Diffusion,
2. Transcytosis,
3. Bulk flow.
1. Diffusion
● Diffusion is the most important method of capillary exchange.
● Oxygen, carbon dioxide, glucose, amino acids, and hormones diffuse in
and out of capillaries.
● Oxygen and nutrients diffuse down their concentration gradients into
interstitial fluid and then into body cells.
● Wastes released by body cells, such as CO2, diffuse into interstitial fluid
and then into blood.
Capillary Wall Permeability
● Capillary walls allow substances to cross through intercellular clefts or
fenestrations.
● Water-soluble substances like glucose and amino acids pass through
intercellular clefts or fenestrations (small pores (holes) ranging from 70 to
100 nm in diameter) .
● Lipid-soluble materials like oxygen, carbon dioxide, and steroid hormones
can pass directly through endothelial cells.
● Most plasma proteins and red blood cells cannot pass through capillary
walls of continuous and fenestrated capillaries.
Sinusoids
● Sinusoids have larger intercellular clefts that allow proteins and blood
cells to pass through.
● Hepatocytes in the liver release plasma proteins like fibrinogen and
albumin into the bloodstream through sinusoids.
● Red bone marrow allows blood cells to enter the bloodstream through
sinusoids.

So: Sinusoids (SĪ-nū-soyds;

sinus = curve) are wider and more
winding than other capillaries. Their endothelial cells may
have unusually large fenestrations. In addition to having an
incomplete or absent basement membrane
Blood-Brain Barrier
● Capillaries in the brain have tight junctions and are highly selective with
permeability.
● Movement of substances into and out of brain capillaries is limited.
● The tight junctions create a blockade known as the blood-brain barrier.

● In certain brain areas, like the hypothalamus, pineal gland, and pituitary
gland, the blood-brain barrier is absent
● Materials in these areas experience easier capillary exchange
● Allows for the movement of substances in and out of capillaries
2. Transcytosis
● Transcytosis involves the transport of substances across capillary walls
● Substances in blood plasma are enclosed within pinocytic vesicles
● Vesicles enter endothelial cells via endocytosis, move across the cell, and
exit via exocytosis
● Used for large, lipid-insoluble molecules that cannot cross capillary walls
through other means
● Examples include insulin (small protein) and certain antibodies (proteins)
3. Bulk Flow: Filtration and Reabsorption
● Bulk flow is the movement of ions, molecules, or particles in a fluid
together
- Occurs from areas of higher pressure to areas of lower pressure
- Important for regulating the volumes of blood and interstitial fluid
● Filtration is the movement of fluid and solutes from blood capillaries into
interstitial fluid
● Reabsorption is the movement of fluid from interstitial fluid into blood
capillaries
Net Filtration Pressure***
● Net filtration pressure (NFP) is the balance of pressures that determines
the volumes of blood and interstitial fluid
● Filtration is promoted by: 1). blood hydrostatic pressure (BHP) and 2).
interstitial fluid osmotic pressure
● Reabsorption is promoted by blood colloid osmotic pressure
● Volume of fluid reabsorbed is almost as large as the volume filtered
● Known as Starling’s law of the capillaries
Hydrostatic Pressure in Capillaries
● Hydrostatic pressure is the pressure exerted by water in blood plasma
against blood vessel walls
● Blood hydrostatic pressure (BHP) is high at the arterial end of a capillary
and low at the venous end
● BHP pushes fluid out of capillaries into interstitial fluid
● Opposing pressure from interstitial fluid (Interstitial Fluid Hydrostatic
Pressure: IFHP) pushes fluid from interstitial spaces back into capillaries
● Uusally, IHFP is very small (very small negative to very small positive).
Thus, IFHP will be assumed to equal 0 mmHg.
Osmotic Pressure and Blood Plasma Proteins
● Osmotic pressure across a capillary wall is primarily due to blood plasma
proteins
● These proteins are too large to pass through fenestrations or gaps
between endothelial cells
● Blood colloid osmotic pressure (BCOP) averages 26 mmHg in most
capillaries
Effect of BCOP on Fluid Movement
● BCOP 'pulls' fluid from interstitial spaces into capillaries
● The balance of pressures determines whether fluids leave or enter
capillaries
● If pressures pushing fluid out of capillaries exceed those pulling fluid in,
filtration occurs
Opposing Forces: IFOP
● Opposing BCOP is interstitial fluid osmotic pressure (IFOP)
● IFOP 'pulls' fluid out of capillaries into interstitial fluid
● IFOP is normally very small (0.15 mmHg) due to low protein content in
interstitial fluid
Protein Leakage and Lymphatic System
● Protein that leaks from blood plasma into interstitial fluid does not
accumulate
● Protein passes into lymph plasma in lymphatic capillaries
● Protein is eventually returned to the blood
Balance of Pressures
● Fluid movement depends on the balance of pressures
● Excess pressures pushing fluid out of capillaries lead to filtration
● Excess pressures pushing fluid out of interstitial spaces lead to
reabsorption
The net filtration pressure (NFP), which indicates the direction

of fluid movement, is calculated as follows:

Capillary Pressure at Venous End
● At the venous end of a capillary, the negative value (−9 mmHg) represents
a net inward pressure.
● Fluid moves into the capillary from tissue spaces through reabsorption.
Fluid Reabsorption
● Approximately 85% of the fluid filtered out of capillaries is reabsorbed.
● The excess filtered fluid and some blood plasma proteins enter lymphatic
capillaries.
Lymphatic System
● Lymph plasma drains into the junction of the jugular and subclavian veins
in the upper thorax.
● Materials that entered the interstitial fluid return to the blood through the
lymphatic system.
Fluid Filtration
● In tissues throughout the body, about 20 liters of fluid filter out of
capillaries every day.
● 17 liters of the filtered fluid are reabsorbed, while 3 liters enter lymphatic
capillaries.
● See table 21.7
21.3 Hemodynamics:
Factors Affecting Blood Flow
What is Hemodynamics?
● Hemodynamics refers to the forces involved in circulating blood
throughout the body.
● Blood flow is the volume of blood that flows through any tissue in a given
time period.
● Total blood flow is cardiac output (CO), the volume of blood that
circulates through systemic (or pulmonary) blood vessels each minute.
Factors Influencing Cardiac Output
● Cardiac output (CO) depends on heart rate (HR) and stroke volume (SV).
● Cardiac output (CO) = heart rate (HR) × stroke volume (SV).
Factors Affecting Blood Flow
● Blood flow is driven by pressure difference and resistance.
● Blood flows from regions of higher pressure to regions of lower pressure.
● The greater the pressure difference, the greater the blood flow.
● The higher the resistance, the smaller the blood flow.
1. Blood Pressure
● Blood pressure (BP) is the hydrostatic pressure exerted by blood on the
walls of a blood vessel.
● BP is determined by cardiac output, blood volume, and vascular
resistance.
● BP is highest in the aorta and large systemic arteries.
● Systolic blood pressure (SBP) is the highest pressure attained in arteries
during systole.
● Diastolic blood pressure (DBP) is the lowest arterial pressure during
diastole.
Cardiac Output
● Cardiac output equals heart rate multiplied by stroke volume
● CO = HR x SV
● MAP = CO x R
Effect of Cardiac Output on Mean Arterial
Pressure
● If cardiac output increases (due to an increase in stroke volume or heart
rate), mean arterial pressure rises
● If cardiac output decreases (without a change in resistance), mean arterial
pressure decreases
Effect of Blood Volume on Blood Pressure
● Blood pressure depends on the total volume of blood in the cardiovascular
system
● Normal blood volume in an adult is about 5 liters
● Decreased blood volume (e.g. from hemorrhage) decreases blood
pressure
● Increased blood volume (e.g. water retention) tends to increase blood
pressure
2. Vascular Resistance
● Vascular resistance is the opposition to blood flow due to friction between
blood and the walls of blood vessels
● Factors affecting vascular resistance:
a. size of the lumen,
b. blood viscosity,
c. total vessel length
a. Size of the Lumen
● The smaller the lumen of a blood vessel, the greater its resistance to
blood flow
● Resistance is inversely proportional to the fourth power of the diameter
● Vasoconstriction narrows the lumen, and vasodilation widens it
b. Blood Viscosity
● Viscosity of blood depends on red blood cell to plasma ratio and protein
concentration
● Higher viscosity increases resistance
● Dehydration or polycythemia increases viscosity and blood pressure
● Anemia or hemorrhage decreases viscosity and blood pressure
c. Total Vessel Length
● Resistance to blood flow is directly proportional to the length of the blood
vessel
● Obese individuals may have hypertension due to increased blood vessel
length in adipose tissue
Systemic Vascular Resistance
● Systemic vascular resistance (SVR) refers to all vascular resistances
offered by systemic blood vessels
● Arterioles, capillaries, and venules contribute the most resistance
● Arterioles control SVR by changing their diameters
● Vasodilation or vasoconstriction of arterioles affects SVR, blood pressure,
and blood flow to tissues
Regulation of Systemic Vascular Resistance
● Vasomotor center in the brain stem regulates SVR
● Changes in arteriolar diameter have significant effects on SVR, blood
pressure, and blood flow to specific tissues
3. Venous return
● Venous return is the volume of blood flowing back to the heart through
the systemic veins
● It is influenced by the pressure generated by contractions of the heart's
left ventricle
Pressure Difference
● The pressure difference from venules (averaging about 16 mmHg) to the
right ventricle (0 mmHg) causes venous return to the heart (from area of
high pressure to area of low pressure: with pressure gradient)
● Increased pressure in the right atrium or ventricle can reduce venous
return
● Incompetent tricuspid valve can lead to blood regurgitation and
decreased venous return
Mechanisms of Venous Return
● Standing up challenges venous return due to gravity
● Two pumps assist in pumping blood from the lower body back to the heart
1. Skeletal muscle pump
2. respiratory pump
● Both pumps rely on the presence of valves in veins
1. Skeletal Muscle Pump
● During rest, both the proximal and distal valves in the leg are open,
allowing blood to flow upward
● Contractions of leg muscles compress the vein, pushing blood through the
proximal valve
● The distal valve closes to prevent blood from flowing back
● People who are immobilized lack leg muscle contractions, resulting in
slower venous return
● Slower venous return may lead to circulation problems in immobilized
individuals
The Process of Blood Flow
● Muscle relaxation causes a drop in
pressure in the compressed vein
section, leading to the closure of the
proximal valve.
● The distal valve opens as blood
pressure is higher in the foot than in the
leg, and the vein fills with blood from
the foot.
● The proximal valve reopens.
2. Respiratory pump
● The respiratory pump also aids in blood flow by compressing and
decompressing veins during inhalation and exhalation.
● During inhalation, the diaphragm moves downward, causing a decrease in
pressure in the thoracic cavity and an increase in pressure in the
abdominal cavity. This leads to the compression of abdominal veins and
the movement of a greater volume of blood into the thoracic veins and
right atrium.
● Valves in the veins prevent backflow of blood from the thoracic veins to
the abdominal veins during exhalation.
4. Velocity of Blood Flow
● The velocity (speed =cm\sec) of blood flow is inversely related to the
cross-sectional area (Diameter).
● Blood flow is slowest in areas with the greatest total cross-sectional area,
such as capillaries.
● As arteries branch, the total cross-sectional area increases, resulting in
slower blood flow further away from the heart.
● Flow becomes faster as venules unite to form veins and the total cross-
sectional area decreases.
● In the aorta, the cross-sectional area is small and the velocity of blood
flow is relatively fast.
● In capillaries, the total cross-sectional area is large and the velocity of
blood flow is slow.
● In the venae cavae, the cross-sectional area is smaller than in capillaries
and the velocity of blood flow is higher.
● The slow rate of flow through capillaries aids the exchange of materials
between blood and interstitial fluid.
Circulation Time
● Circulation time is the time required for a drop of blood to travel from the
right atrium, through the pulmonary circulation, and back to the left atrium,
through the systemic circulation, down to the foot, and back again to the
right atrium.
● In a resting person, circulation time is approximately 1 minute.
21.4 Control of Blood Pressure and Blood Flow
Introduction
● Blood pressure regulation involves interconnected negative feedback
systems
● Adjustments are made to heart rate, stroke volume, systemic vascular
resistance, and blood volume
● Some systems allow rapid adjustments for sudden changes, while others
provide longterm regulation
● Blood flow distribution may also need adjustments in specific situations
● Blood pressure is regulated by:
1. Neural regulation: Baroreceptores and chemoreceptors
2. Hormonal control
Role of the Cardiovascular Center
● The cardiovascular center in the medulla oblongata regulates heart rate,
stroke volume, blood pressure, and blood flow
● Neurons within the cardiovascular center control various functions like
heart stimulation, inhibition, and blood vessel diameter control
● Input to the cardiovascular center comes from higher brain regions and
sensory receptors
1. Neural Regulation of Blood Pressure
● The nervous system regulates blood pressure through;
1. baroreceptor reflexes
2. chemoreceptor reflexes
● Baroreceptor reflexes (Aortic and Bainbridge reflexes) involve pressure
sensitive sensory receptors in the aorta, internal carotid arteries, and
other large arteries
● The carotid sinus reflex and aortic reflex are the two major baroreceptor
reflexes
Chemoreceptor Reflexes
● Chemoreceptors monitor the chemical composition of blood
● Located close to the baroreceptors in carotid bodies and aortic bodies
● Detect changes in blood levels of O2, CO2, and H+
● Stimulated by hypoxia, acidosis, or hypercapnia
● Send impulses to the cardiovascular center
2. Hormonal Regulation of Blood Pressure
I. Renin-angiotensin-aldosterone (RAA) system
II. Epinephrine and norepinephrine
III. Antidiuretic hormone (ADH)
IV. Atrial natriuretic peptide (ANP)
I. Renin-Angiotensin-Aldosterone (RAA) System
● Activated when blood volume falls
● Juxtaglomerular cells in the kidneys secrete Renin
● Renin acts on angiotensinogen to produce angiotensin I
● Angiotensin-converting enzyme (ACE) converts angiotensin I to
angiotensin II
● Angiotensin II raises blood pressure through vasoconstriction and
increased reabsorption of sodium and water
II. Epinephrine and Norepinephrine
● Released by the suprarenal medulla in response to sympathetic
stimulation
● Increase cardiac output by enhancing heart contractions
● Cause vasoconstriction in skin and abdominal organs
● Cause vasodilation in cardiac and skeletal muscle
III. Antidiuretic Hormone (ADH)
● Produced by the hypothalamus and released from the posterior pituitary
● Released in response to dehydration or decreased blood volume
● Causes vasoconstriction and increases blood pressure
● Promotes water reabsorption in kidneys
IV. Atrial Natriuretic Peptide (ANP)
● Released by cells in the atria of the heart
● Lowers blood pressure through vasodilation
● Promotes salt and water loss in urine
● Reduces blood volume
Summary:
Regulation of
Blood Pressure
by Hormones
Autoregulation in the Pulmonary and Systemic
Circulations
● The systemic circulation dilates in response to low O2 levels to ensure
increased O2 delivery to tissues.
● By contrast, the walls of blood vessels in the pulmonary circulation
constrict in response to low O2 levels.
● The pulmonary autoregulatory response redirects blood flow to
betterventilated areas of the lung.
● This ensures that poorly ventilated pulmonary alveoli receive less blood,
optimizing gas exchange.
21.5 Checking Circulation
1. Pulse
● The pulse is the alternating expansion and recoil of elastic arteries after
each systole of the left ventricle.
● It is created by a traveling pressure wave.
● Pulse is strongest in arteries closest to the heart and gets weaker in
arterioles and capillaries.
● It can be felt in arteries near the body surface that can be compressed
against a bone or firm structure.
Pulse Rate
● The pulse rate is usually the same as the heart rate.
● Normal resting pulse rate is about 70 to 80 beats per minute.
● Tachycardia is a resting heart or pulse rate over 100 beats per minute.
● Bradycardia is a resting heart or pulse rate under 50 beats per minute.
● Bradycardia is commonly observed in endurance-trained athletes.
2. Measuring Blood Pressure
● Blood pressure refers to the pressure in arteries generated by the left
ventricle during systole and the pressure remaining in the arteries during
diastole.
● Blood pressure is usually measured in the brachial artery in the left arm
using a sphygmomanometer.
● A sphygmomanometer consists of a cuff, rubber bulb, and a meter to
measure pressure.
● The cuff is inflated to compress the brachial artery and then slowly
deflated to measure blood pressure.
● The first sound heard through the stethoscope corresponds to systolic
blood pressure, while the disappearance of sounds indicates diastolic
blood pressure.
Normal Blood Pressure
● The normal blood pressure of an adult male is less than 120 mmHg
systolic and less than 80 mmHg diastolic.
● In young adult females, the pressures are 8 to 10 mmHg less.
● Regular exercise and good physical condition may result in even lower
blood pressure.
● Slightly lower blood pressure than 120/80 may indicate good health and
fitness.
Pulse Pressure
● Pulse pressure is the difference between systolic and diastolic pressure.
Pulse Pressure (PP)= Systolic BP- Diastolic BP
● Normal pulse pressure is about 40 mmHg.
● Abnormal conditions like atherosclerosis and patent ductus arteriosus can
greatly increase pulse pressure.
● The ratio of systolic pressure to diastolic pressure to pulse pressure is
approximately 3:2:1.