Anatomy & Physiology - Lecture

STUDENT ACTIVITY SHEET BS NURSING / FIRST YEAR

Session # 16

LESSON TITLE: BLOOD VESSELS AND CIRCULATION Materials:

LEARNING OUTCOMES: Book, pen and notebook
Upon completion of this lesson, you can:
1. Define the circulatory system and the classes of blood
vessels constituted;
2. List the functions of the circulatory system;
3. Describe structurally and functionally the general features of
each blood vessel structure;
4. List the major arteries that supply each of the body areas and
their descriptions; Reference:
5. List major veins that carry blood from each of the body VanPutte, C., Regan, J., & Russo, A. (2019). Seeley’s
areas and their descriptions; essentials of anatomy & physiology (10th ed.).
6. Describe the blood pressure and how it is measured; New York, NY: McGraw-Hill Education.
7. Identify the pulse pressure, the factors affecting it, and the
major pulse points in the body;
8. List the events associated with the capillary exchange;
9. State the prominent features in mechanisms that control the
blood flow;
10. Enumerate the short-term and long-term mechanisms in
regulation of arterial pressure;
11. Describe the mean arterial pressure and its computation;
12. Identify the different diseases & disorders associated with the
blood vessels & circulation with its description; and,
13. Enumerate the effects of aging on blood vessels.

LESSON REVIEW/PREVIEW
In order to review from the previous session, you must conceptually answer the posted question without looking at
your notes. This will let you do the recall of a process by mind mapping. Here is the question.

What would happen if a person takes large doses of calcium channel blockers?
If a person takes a large doses of calcium channel blockers, a person may undergo or can experience slow heart rate
and low blood pressure. Symptoms may arise such as dizziness, fatigue, and severe toxicities. This may also lead to death.

MAIN LESSON
You must read & study the concepts and refer to figures/tables in Chapter 13 of the book.

Circulatory System – constituted by the two classes of blood vessels:

▪ Pulmonary Vessels: transport blood from right ventricle of heart through lungs & back to the left
atrium
▪ Systemic Vessels: transport blood from left ventricle through all parts of body and back to right
atrium

Major Functions of Circulatory System:

1. Carries blood 3. Transports substances
2. Exchanges nutrients, waste products, and gases with 4. Helps regulate blood pressure
tissues 5. Directs blood flow to the tissues

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General Features of Blood Vessel Structure (See figure 13.1)

Three Layers of Blood Vessel Walls / Tunics:

▪ Tunica Intima – innermost layer; composed of endothelium consisting of simple squamous
epithelium, basement membrane & small amount of connective tissue
▪ Tunica Media – middle layer; consists of smooth muscles cells arranged circularly around the blood
vessel
▪ Tunica Adventitia – outermost layer; composed of dense connective tissue adjacent to the tunica media;
tissue becomes loose connective tissue toward the outer portion of blood vessel wall

Three Main Types of Blood Vessels:

1. Arteries – carry blood away from the heart; usually oxygenated; normally classified as:
▪ Elastic Arteries: largest diameter & have thickest walls; composed of greater portion of elastic
tissue & smaller portion of smooth muscle (ex: aorta & pulmonary trunk); stretch when the
ventricles pump blood
o Function: elastic recoil prevents blood pressure from falling rapidly & maintains blood
flow while ventricles are relaxed
▪ Muscular Arteries: medium-sized (distributing arteries), relatively thick & tunica intima has
thin elastic connective tissue; contain smooth muscle tissue to control blood flow to different body
regions
o Vasoconstriction – contraction of smooth muscle, decreases blood vessel diameter &
blood flow
o Vasodilation – relaxation of smooth muscles, increases blood vessel diameter & blood
flow
▪ Arterioles: transport blood from small arteries to capillaries; smallest arteries adapted for
vasodilation & vasoconstriction
2. Capillaries – blood flow here from arterioles; where the diffusion or exchange of gases, substances, and
other waste products of occurs between the blood & tissue fluid (See figure 13.3)
▪ Precapillary Sphincters: smooth muscles cells located at the origin of capillary branches that
regulate the amount of blood flow through various sections of the network
3. Veins – carry blood toward the heart; usually deoxygenated; increase in diameter & decrease in number as
progressing toward the heart; may be classified as:
▪ Venules: diameter slightly larger than capillaries; composed of endothelium resting on a
delicate connective tissue layer; all tunics are present
▪ Medium-sized Veins: predominant layer is the tunica adventitia that consists of dense
collagen fibers which determines the degree to which they can distend
▪ Large-sized Veins: diameter greater than 2mm; contain valves which ensure the flow of blood
towards the heart and not to the opposite direction
o Valves – similar in shape to semilunar valves consisting of folds in tunica intima,
forming two flaps; many valves also in medium-sized veins & lower limbs

Blood Flow in Blood Vessels: Arteries  Arterioles  Capillaries  Venules  Medium-sized Veins  Veins 
Heart

Blood Vessels of System Circulation: ARTERIES (See figure 13.6)

Aorta – where arteries of systemic circulation branch directly or indirectly; considered in three parts: (See figure
13.7)
▪ Ascending Aorta – passes superiorly from the left ventricle; where the right & left coronary arteries
arise from its base & supply blood to the heart
▪ Aortic Arch – carry blood to head & upper limbs; where the brachiocephalic artery, left common
carotid artery, left subclavian artery originate
▪ Descending Aorta – longest part; extends through thorax & abdomen to upper margin of the pelvis;
divided into:
o Thoracic Aorta – extends through the thorax to diaphragm
✔ Visceral Arteries – supply the thoracic organs
✔ Parietal Arteries – supply the thoracic walls
● Posterior Intercostal Arteries – extend between ribs, supply the
intercostal muscles, vertebrae, spinal cord, & deep muscles of back

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● Superior Phrenic Arteries – supply the diaphragm
o Abdominal Aorta – extends from diaphragm to point at which it divides to common iliac
arteries
✔ Visceral arteries are divided into paired & unpaired branches (See figure 13.12)
Unpaired Branches Description
Celiac Artery supplies to stomach, pancreas, spleen, upper duodenum, & liver
Superior Mesenteric Artery supplies to small intestine & upper portion of large intestine
Inferior Mesenteric Artery supplies blood to remainder of large intestines

Paired Branches Description

Renal Arteries supply the kidneys
Suprarenal Arteries supply the adrenal glands
Testicular Arteries / supply the testes in males /
Ovarian Arteries supply the ovaries in females

✔ Parietal arteries are divided into:

● Inferior Phrenic Arteries – supply the diaphragm
● Lumbar Arteries – supply the lumbar vertebrae & back muscles
● Median Sacral Artery – supplies the inferior vertebrae

Arteries of Head and Neck (See figure 13.7-13.9)

▪ Brachiocephalic Artery – extends a short distance & then branches at the level of clavicle to form:
o Right Common Carotid Artery – transports blood to right side of head & neck
o Right Subclavian Artery – transports blood to right upper limb
▪ Left Common Carotid Artery – transports blood to left side of head & neck
▪ Left Subclavian Artery – transports blood to left upper limb
o Internal Thoracic Arteries – branches of subclavian arteries; give rise to branches called
anterior intercostal arteries which extend between the ribs to supply anterior chest wall
▪ Internal & External Carotid Arteries – branch off superiorly from each common carotid arteries
o Internal Carotid Arteries – pass through carotid canals & contribute to the cerebral arterial
circle (circle of Willis), supply blood to most of the brain (See figure 13. 8)
✔ Carotid Sinus – located at its base which contains baroreceptors
o External Carotid Arteries – have branches that supply the structures of neck, face, nose, &
mouth
▪ Vertebral Arteries – branch from subclavian arteries; supply blood to spinal cord, vertebra, muscles &
ligaments of neck & some blood to the brain (See figure 13. 10)
o Basilar Artery – forms in union of vertebral arteries; located along anterior, inferior surface of
brainstem; gives off branches that supply blood to pons, cerebellum, & midbrain; contributes to
circle of Willis

Arteries of the Upper Limbs: (See figure 13.11)

▪ Axillary Artery – in the armpit; branch off from subclavian artery located deep to clavicle
▪ Brachial Artery – branch off from axillary arteries; where the blood pressure measurements are taken
▪ Ulnar Artery – branch off from brachial artery, at the elbow; supply the forearm & hand
▪ Radial Artery – branch off from brachial artery; supply the forearm & hand; commonly used for taking
a pulse

Arteries of the Pelvis: (See figure 13.7c & 13.12)

▪ Common Iliac Arteries – comes in two, branch off from abdominal aorta at 5th lumbar vertebrae;
divides into:
o External Iliac Artery – enters the lower limbs to supply blood
o Internal Iliac Artery – supplies the pelvic area
✔ visceral branches supply urinary bladder, rectum, uterus, & vagina
✔ parietal branches supply walls & floor of pelvis; lumbar, gluteal, & proximal thigh
muscles; & external genitalia

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Arteries of the Lower Limbs: (See figure 13.13)
▪ Femoral Artery – branch off from external iliac artery; supplies the thigh
▪ Popliteal Artery – supplies the knee; located in popliteal space
▪ Anterior & Posterior Tibial Artery – supply blood to the leg and foot
▪ Dorsalis Pedis Artery – rise from anterior tibial artery that supplies the ankle
▪ Fibular Artery / Peroneal Artery – rise from posterior tibial artery that supplies the lateral leg & foot
Femoral Triangle – important access point for medical procedures & where pulse in femoral artery can be
palpated; located in superior & medial area of thigh

Blood Vessels of System Circulation: VEINS (See figure 13.14)

Superior Vena Cava – returns deoxygenated blood from head, neck, thorax, & upper limbs to right atrium
Inferior Vena Cava – returns deoxygenated blood from the abdomen, pelvis, & lower limbs to right atrium

Veins of the Head & Neck: (See figure 13.15)

▪ External Jugular Veins – carry blood from posterior head & neck, emptying to subclavian veins
▪ Internal Jugular Veins – carry blood from brain & anterior head, face, & neck; join the subclavian veins
▪ Brachiocephalic Veins – branch off from subclavian veins, joining to form the superior vena cava

Veins of the Upper Limbs: (See figure 13.16)

▪ Deep veins carry blood from deep structures of upper limbs
o Brachial Veins – empty into the axillary vein
▪ Superficial veins carry blood from superficial structures and empty into the deep veins
o Cephalic Vein – empties into axillary vein & basilic vein
o Median Cubital vein – connects the cephalic vein with basilic vein; prominent on cubital
fossa & often used as a site for drawing blood

Veins of the Thorax: (See figure 13.17)

▪ Right & Left Brachiocephalic Veins – major veins that return blood from thorax to superior vena cava
▪ Azygos Vein – major vein that return blood from thorax to superior vena cava
▪ Anterior Intercostal Veins – drain blood from anterior thoracic wall
▪ Internal Thoracic Veins – drain blood into anterior intercostal veins & empty into brachiocephalic veins
▪ Posterior Intercostal Veins – drain blood from posterior thoracic wall & empty into azygos vein on
right side
▪ Hemiazygos Vein / Accessory Hemiazygos Vein – drain blood from left side of posterior
intercostal veins & empty into azygos vein

Veins of the Abdomen and Pelvis: (See figure 13.18)

▪ Ascending Lumbar Veins – blood from posterior abdominal wall returns to heart & drains into the
azygos vein
▪ Common Iliac Veins – combine to form the inferior vena cava; divided into:
o Internal Iliac Veins – return blood from the pelvis
o External Iliac Veins – drain blood from lower limbs
▪ Renal Veins – carry blood from kidneys
▪ Suprarenal Veins – drain the adrenal glands
▪ Testicular Veins – drain the testes in males
▪ Ovarian Veins – drain the ovaries in females

Hepatic Portal System – vascular system that begins & ends with capillary in the viscera & ends with
capillaries in liver; the major vessels in this system are: (See figure 13.19)
▪ Splenic Vein – carries blood from spleen & pancreas
▪ Superior Mesenteric Vein – together with inferior mesenteric vein that empties into splenic vein,
carry blood from the intestines
▪ Hepatic Portal Vein – forms by joining of splenic vein & superior mesenteric vein; blood enters the liver
containing rich nutrients collected from intestines & also toxic substances

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▪ Hepatic Vein – drains blood from the liver & empty into inferior vena cava

Veins of the Lower Limbs: (See figure 13.20)

▪ Great Saphenous Vein – superficial vein that originates over dorsal & medial side of foot & ascends
along medial side of leg & thigh to empty into femoral vein; often surgically removed & used for coronary
bypass surgery
▪ Small Saphenous Vein – begins over the lateral side of foot & joins the popliteal vein
▪ Popliteal Vein – drain blood from knee & empty into femoral vein
▪ Femoral Vein – drain blood from thigh & empty into external iliac vein

You must read & study the concepts and refer to figures/tables in Chapter 13 of the book.

Blood Pressure (BP) – measure of the force blood exerts against the blood vessel walls; normal BP is 120/80
mmHg
▪ Systolic Pressure – maximum force in which the blood is forced into the arteries when ventricles
contract
▪ Diastolic Pressure – minimum value in which blood pressure falls when ventricles relax

Auscultatory Method – used to determine BP with the use of sphygmomanometer (BP cuff), wrapped
around the arm and stethoscope, placed over brachial artery (See figure 13.21)

Korotkoff Sounds – heard through stethoscope caused by turbulence from vibrations in the blood &
surrounding tissues
▪ 1st sound heard is the systolic pressure
▪ the pressure at which the sound disappear is the diastolic pressure

Pulse Pressure – the difference between the systolic & diastolic pressures; affected by two factors:
▪ Stroke Volume – if increased, the systolic pressure increases more than diastolic pressure
▪ Vascular Compliance – related to elasticity of blood vessel wall

Pulse – pressure wave produced from ejection of blood from left ventricle into aorta; can be felt at locations where
large arteries are close to surface of body; vital for monitoring heart rate & rhythm (See figure 13.23) Capillary
Exchange (See figure 13.24)
▪ Most exchange across capillary wall occurs by diffusion
▪ Blood pressure, capillary permeability and osmosis affect movement of fluids across capillary
walls.
▪ Net movement of fluid from blood into tissues
▪ Fluid gained in tissues is removed by lymphatic system

Mechanisms that control the blood flow through the tissues are classified as local, nervous & hormonal control.
Local Control of Blood Flow (See process figure 13.25 & table 13.1)
▪ Achieved by relaxation and contraction of precapillary sphincters:
o Relaxed sphincters  increased blood flow through capillaries
o Contracted sphincters  decreased blood flow through capillaries
▪ Blood flow through a tissue is usually proportional to the metabolic needs of the tissue
▪ Other factors are tissue concentrations of oxygen and nutrients

Nervous and Hormonal Control of Blood Flow (See process figure 13.26 & table 13.1)
▪ Vasomotor Center – area of lower pons & upper medulla oblongata that continually transmits a low
frequency of action potentials to sympathetic nerve fibers; controls blood vessel diameter
▪ Vasomotor Tone – state of partial constriction of blood vessels
▪ The nervous system is responsible for routing the flow of blood, except in capillaries, & for
maintaining BP
▪ Release of epinephrine and norepinephrine by the adrenal medulla alter blood vessel diameter

Regulation of Arterial Pressure: this includes the short-term and long-term mechanisms (Discussed
already in last session. Take a brief memory refresh!)

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Short-term Mechanisms:
1. Baroreceptor Reflexes – most important in controlling BP on short-term basis (See figures 13.27 &
13.28)
2. Chemoreceptor Reflexes (See process figure 13.29)
3. Adrenal Medullary Mechanism (See process figure 13.30)

Long-term Mechanisms: (See process figure 13.33)

1. Renin-Angiotensin-Aldosterone Mechanism (See process figure 13.31)
2. Antidiuretic Hormone Mechanism (See process figure 13.32)
3. Atrial Natriuretic Mechanism

Mean Arterial Pressure (MAP) – proportional to cardiac output times the peripheral resistance
(resistance to blood flow in all blood vessels); slightly less than the average of systolic & diastolic pressures in
aorta (diastole lasts longer)
▪ changes over lifetime: MAP of 70 mmHg at birth, 95 mmHg in adolescence to middle age, & 110 mmHg
in health older person; formula: MAP = CO x PR or MAP = HR x SV x PR

Diseases and Disorders of Blood Vessels and Circulation:

Condition Description
result when the veins of lower limbs become so dilated that the cusps of valves no longer overlap to
Varicose Veins
prevent the backflow of blood
Hemorrhoid varicose veins of the rectum or anus
Phlebitis inflammation of the veins
high blood pressure; categorize as:
▪ Normal: < 120 mmHg systolic & <80 mmHg diastolic
Hypertension ▪ Prehypertension: 120-139 mmHg systolic & 80-89 mmHg diastolic
▪ Stage 1 Hypertension: 140-159 mmHg systolic & 90-99 mmHg diastolic
▪ Stage 2 Hypertension: >160 mmHg systolic & >100 mmHg diastolic
Arteriosclerosis hardening of the arteries, making them less elastic than normal
results from the deposition of fatlike substance contains cholesterol in the walls of arteries that
Atherosclerosis
forms plaques; an age-related condition
results from a disruption in the normal inwardly & outwardly directed pressures across the
Edema
capillary walls
a treatable condition in which blood vessels in fingers & toes undergo exaggerated
Raynaud Syndrome
vasoconstriction in response to emotions or cold exposure
inadequate blood flow throughout the body that causes tissue damage due to lack of oxygen;
classified into five types based on their cause:

▪ Hypovolemic Shock – result of reduced blood volume

✔ Hemorrhagic Shock: caused by internal/external bleeding
✔ Plasma Loss Shock: may occur in severely burned areas of body
✔ Interstitial Fluid Loss Shock: may occur as a result of diarrhea, vomiting, or
dehydration
Circulatory Shock ▪ Neurogenic Shock – caused by vasodilation in response to emotional upset or
anesthesia
▪ Anaphylactic Shock – caused by an allergic response that results in release of
inflammatory substances
▪ Septic Shock – caused by infections that release toxic substances (blood
poisoning), depressing heart’s activity & leading to vasodilation & increased
capillary permeability
▪ Cardiogenic Shock – results from decrease in cardiac output caused by events that
decrease the heart’s ability to function (ex: heart attack, cardiac arrhythmias, &
exposure to electrical shocks)

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Effects of Aging on the Blood Vessels:
▪ Reduced elasticity & thickening of arterial walls result in hypertension & decreased ability to
respond to changes in blood pressure.
▪ The efficiency of capillary exchange decreases with age.
▪ Walls of veins thicken & dilate. Thromboses, emboli, varicose veins, & hemorrhoids are age-related
conditions.

CHECK FOR UNDERSTANDING

You will answer and rationalize this by yourself. This will be recorded as your quiz. One (1) point will be given
to the correct answer and another one (1) point for the correct ratio. Superimpositions or erasures in your
answer/ratio is not allowed. You are given 20 minutes for this activity.

Multiple Choice

1. Functions of the peripheral circulation include all of the following EXCEPT:

a. carries blood to the tissues d. pumps blood into the arteries
b. exchanges waste products, and nutrients e. directs blood flow to areas of increased
c. transports hormones and components of the need
immune system
ANSWER: D
RATIO: All of the following options are correct except option D because Peripheral Circulation have no direct relation
In pumping of bloods into the arteries.

2. The systemic vessels:

a. transport blood through all parts of the body from the left ventricle to the right atrium.
b. supply oxygen and nutrients to all cells of the body.
c. carry away carbon dioxide and waste from all cells of the body.
d. are part of the peripheral circulation.
e. have all of these properties.
ANSWER: E
RATIO: All the statements related to systemic vessels are true with its properties.

3. Which of the following is most likely to be an elastic artery?

a. the ascending aorta d. the parietal arteries
b. the coronary arteries e. None of the items are classified as an
c. the right internal thoracic artery elastic artery
ANSWER: A
RATIO: In the transthoracic plane, the ascending aorta originates at the sinotubular junction (the intersection of the aortic root and
ascending aorta) and ends when it exits the fibrous pericardium, where it becomes the aortic arch.

4. Which of these arteries are able to actively dilate and constrict? (Select all that apply)
a. elastic arteries c. arterioles
b. distributing arteries d. small arteries
ANSWER: B, C, D
RATIO: All of the options are parts of the arteries that are able to actively dilate and constrict except Option A or the elastic arteries
because are likely used for stretching when the ventricles pumps blood.

5. Valves:
a. are found in veins less than 2 mm in diameter.
b. consist of folds in the tunica adventitia.
c. are found more often in the leg veins than in the arm veins.

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d.allow blood to flow only toward the heart.
e.are found both more often in the leg veins than in the arm veins and allow blood to flow only toward
the heart.
ANSWER: E
RATIO: Valves are more commonly seen in leg veins than arm veins, and they only enable blood to flow toward the heart.

6. Capillaries:
a. have a lot of smooth muscle in their walls. d. experience very high internal pressures.
b. are a location of gas and nutrient exchange. e. have all of these properties.
c. are more numerous in such tissues as bone and
dense connective tissue.
ANSWER: B
RATIO: Gases, nutrients, and waste are exchanged between blood and tissue through capillaries. Capillaries are small blood arteries
that branch out from arterioles to build networks that surround body cells.

7. The right common carotid artery and the right subclavian artery branch from the:
a. aorta. d. basilar artery.
b. left common carotid artery. e. vertebral artery.
c. brachiocephalic artery.
ANSWER: C
RATIO: The aortic arch gives rise to the brachiocephalic artery, which is a blood vessel that runs through the head. It supplies blood to
the right carotid and right subclavian arteries. It's also known as the brachiocephalic trunk or the innominate artery.

8. Parietal arteries that branch from the thoracic (descending) aorta:

a. supply the thoracic organs. d. include the superior phrenic arteries.
b. include the posterior intercostal arteries. e. include both the posterior intercostal arteries and
c. include the anterior intercostal arteries. include the superior phrenic arteries.
ANSWER: E
RATIO: The Parietal branches includes the posterior intercostal arteries that supply the intercostal spaces and the superior
Phrenic arteries which supplies the diaphragm and the suprarenal glands.

9. The begins with capillaries in the viscera and ends with capillaries in the liver.
a. superior mesenteric vein d. hepatic vein
b. inferior mesenteric vein e. gastric vein
c. hepatic portal system
ANSWER: C
RATIO: The hepatic portal system is a network of veins that transport blood from the stomach, colon, spleen, and pancreas to the liver's
capillaries. Its primary purpose is to transport deoxygenated blood to the liver, where it is further detoxified before returning to the
heart.

10. Pepper is assigned to take the vital signs of the patients in the geriatric ward. In which of these blood vessels
are blood pressure measurements most commonly taken?
a. brachial vein c. cephalic vein
b. brachial artery d. median cubital vein
ANSWER: A
RATIO: The systolic and diastolic readings of arterial blood pressure recorded with a blood pressure cuff indicate the pressure within
the brachial artery on the arm. This pressure is not the same as the pressure in the aorta.

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RATIONALIZATION ACTIVITY (THIS WILL BE DONE DURING THE FACE TO FACE INTERACTION)
The instructor will now rationalize the answers. You can now ask questions and debate among
yourselves. Write the correct answer and correct/additional ratio in the space provided.
1. ANSWER:
RATIO:

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10. ANSWER:
RATIO:

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LESSON WRAP-UP

You will now mark (encircle) the session you have finished today in the tracker below. This is simply a visual to help
you
track how much work you have accomplished and how much work there is left to do. You

are done with the session! Let’s track your progress.

AL Activity: REVIEW TEST

This activity is an effective way for you to practice and clarify the learnings. With every review test, you can see
how much content you have already learned. You have to answer the set of review questions posted below. Use the
space provided in writing your answer. After completing the answers, immediately check their work against the
provided correct answer from your Main Lesson. Correct your own answers using a different color of pen to see the
differences. To make this activity worthy, make sure to follow the instructions accordingly. Enjoy!

1. What are the parts of aorta?

The 3 parts of the aorta are the ascending aorta, aortic arch, and the descending aorta.

2. What is the primary function of iliac arteries?

The primary function of Iliac arteries is that it is the blood supplier to the different parts of our body which includes the
Bones, organs, muscles, and other structures in the abdomen and pelvis.

3. What are the major vessels in the hepatic portal system?

The major vessels in the hepatic portal system are the Splenic Vein, Superior Mesenteric Vein, Hepatic Portal Vein
And the Hepatic Vein.

4. Describe what would happen if a blockage occurs in internal carotid arteries.

A portion of the brain may be entirely deprived of oxygen, resulting to the destruction of brain tissue, if an artery gets
fully clogged (called carotid occlusion) or if a fragment of the blockage breaks off and goes to a smaller channel where
it completely restricts blood flow.

5. How do the capillaries function in the circulatory system?

The capillaries, despite their small size, are one of the most important components of the circulatory system because
they transport nutrition and oxygen to the cells. Furthermore, the capillaries eliminate waste products like as carbon
dioxide.

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