CARDIOVASCULAR

SYSTEM
 CARDIOVASCULAR SYSTEM

• it consists of the heart, blood vessels, and blood. Its primary function is to transport
nutrients and oxygen-rich blood to all parts of the body and to carry deoxygenated
blood back to the lungs.
• the system responsible for delivering blood to different parts of the body.
BLOOD PRESSURE
PHYSIOLOGY OF CIRCULATION
BLOOD PRESSURE
• Blood pressure is the force blood puts on the arteries as it flows through them. It is
measured in units of millimeters of mercury (mmHg).  
• The size and flexibility of the arteries affect blood pressure. If the arteries are stiff and
narrow, blood will put more pressure on the artery walls, resulting in higher blood pressure.
With more relaxed arteries, there is less resistance to blood flow, leading to 
lower blood pressure. 
• Hypertensive 
• Doctors diagnose hypertension when a patient’s blood pressure is consistently 130/80
mmHg or higher. A hypertensive person experiences greater resistance to blood flow in the
arteries, so their heart has to work harder to transport blood throughout the body. This
increases the risk for other serious health problems such as stroke, heart attack, and heart
failure. 
• Hypotensive 
• A person is hypotensive when their blood pressure is much lower than normal,
typically 90/60 mmHg or lower. In this case, the heart doesn’t push blood
through the arteries with enough force. For some people, being hypotensive is
normal and causes no problems.
• For others, low blood pressure may mean some organs get insufficient
blood. Severe hypotension can be caused by a heart attack, sudden blood loss,
and severe infection.
• Hypotension can also be caused by dehydration or certain medicines,
including diuretics, anti-anxiety medication, and some antidepressants. Talk to
your healthcare provider if you are concerned that you may have hypotension.
MEASURING BLOOD PRESSURE
 Measuring blood pressure
• Two arterial blood pressures are measured
• Systolic—pressure in the arteries at the peak of ventricular contraction
• Diastolic—pressure when ventricles relax
• Expressed as systolic pressure over diastolic pressure in millimeters of mercury (mmHg)
• For example, 120/80 mm Hg
• Auscultatory method is an indirect method of measuring systemic arterial blood pressure, most often in the
brachial
SPHYGMOMANOMETER AND
STETHOSCOPE
 KOROTKOFF SOUNDS
• Korotkoff sounds (or K-Sounds) are the "tapping" sounds heard with a stethoscope as the cuff is gradually
deflated. Traditionally, these sounds have been classified into five different phases (K-1, K-2, K-3, K-4, K-
5) and are shown in the figure below.
• K-1 (Phase 1): The appearance of the clear "tapping" sounds as the cuff is gradually deflated. The first clear
"tapping" sound is defined as the systolic pressure.
• K-2 (Phase 2): The sounds in K-2 become softer and longer and are characterized by a swishing sound since
the blood flow in the artery increases.
• K-3 (Phase 3): The sounds become crisper and louder in K-3 which is similar to the sounds heard in K-1.
• K-4 (Phase 4): As the blood flow starts to become less turbulent in the artery, the sounds in K-4 are muffled
and softer. Some professionals record diastolic during Phase 4 and Phase 5
• K-5 (Phase 5): In K-5, the sounds disappear completely since the blood flow through the artery has returned
to normal. The last audible sound is defined as the diastolic pressure.
COMPONENTS OF BLOOD PRESSURE
Systolic and Diastolic Pressures
• The systolic pressure is the higher value (typically around 120 mm
Hg) and reflects the arterial pressure resulting from the ejection of
blood during ventricular contraction, or systole.
• The diastolic pressure is the lower value (usually about 80 mm Hg)
and represents the arterial pressure of blood during ventricular
relaxation, or diastole.
PULSE PRESSURE
the difference between the systolic pressure and the diastolic pressure is the pulse pressure.
For example, an individual with a systolic pressure of 120 mm Hg and a diastolic pressure of
80 mm Hg would have a pulse pressure of 40 mmHg.
THE 2 FACTORS AFFECT PULSE PRESSURE
Stroke volume and vascular compliance
• When the stroke volume increases, the systolic pressure increases more than the diastolic
pressure. This leads to an increase in the pulse pressure.
• Vascular compliance is related to the elasticity of the blood vessel wall. In people who have
asteriosclerosis (HARDENING OF THE ARTERIES), THE ARTERIES ARE LESS
ELASTIC THAN NORMAL. Arterial pressure increases rapidly and falls rapidly in these
less elastic arteries.
 PRESSURE AND
RESISTANCE
• The values for systolic and diastolic pressure vary among healthy people, making the
range of normal values quite broad.
• Physical activity and emotions, affect blood pressure values in a normal person.
• A standard blood pressure for a resting young man adult male is 120mmhg for the
systolic pressure and 80mmhg for diastolic pressure, commonly expressed as 120/80.
• As blood flows from the arteries through the capillaries and veins, blood pressure
falls progressively to about 0 mmhg or even slightly lower by the time blood is
returned to the right atrium.
• Resistance to blood flow is related to the diameter of the blood vessel. The
smaller the diameter of the blood vessel, the greater the resistance flow. As a
consequence of this greater resistance to flow, there is more rapid decrease in
blood pressure as blood flows through smaller vessels.
• The muscular arteries, arterioles, and precapillary sphincters are capable of
constricting (vasoconstriction) and dilating (vasodilation).
• Resistance to blood flow increases as vessels declines.
VARIATIONS IN BLOOD PRESSURE
• Hypotension (low blood pressure)
• Low systolic (below 100 mmHg)
• Often associated with illness
• Acute hypotension is a warning sign for circulatoryshock
• Hypertension (high blood pressure)
• Sustained elevated arterial pressure of 140/90mmHg
• Warns of increased peripheral resistance
CAPILLARY EXCHANGE
• The major forces responsible for moving fluid through the capillary wall are
blood pressure and osmosis.
• Blood pressure forces fluid out of the capillary, and osmosis moves fluid into the
capillary.
• The exchange of materials across the capillary wall varies as blood passes from
one end of the capillary to the other. At the arterial end of the capillary, the
movement of fluid out of the capillary due to blood pressure is greater than the
movement of fluid into the capillary due to osmosis.
 CAPILLARY EXCHANGE OF GASES AND
NUTRIENTS
• Interstitial fluid (tissue fluid) is found between cells
• Substances move to and from the blood and tissue cells through
capillary walls Exchange is due to concentration gradients§ Oxygen
and nutrients leave the blood and move into tissue cells
• Carbon dioxide and other wastes exit tissue cells and enter the blood
• Capillary exchange of gases and nutrients(continued)
• Substances take various routes entering or leaving the blood
• 1. Direct diffusion through membranes
• 2. Diffusion through intercellular clefts (gaps between cells in
the capillary wall)
• 3. Diffusion through pores of fenestrated capillaries
• 4. Transport via vesicles
CONTROL OF BLOOD FLOW IN TISSUES
• Local control of blood flow is achieved by the periodic relaxation and
contraction of the precapillary sphincters. When the sphincters relax,
blood flow through the capillaries increases. When the sphincters
contract, blood flow through the capillaries decreases.
• The precapillary sphincters are controlled by the metabolic needs of
the tissues.
 NERVOUS AND HORMONAL CONTROL OF BLOOD
FLOW
• An area of the lower pons and medulla oblongata, called the vasomotor center,
continually transmits a low frequency of action potentials to the symphatetic
nerve fibers that innervate blood vessels of the body.
• Vasomotor tone- the end result of a complex set of interactions that control relaxation and
contraction of blood vessels. 

• Changes in vasomotor tone will alter blood flow as well as blood pressure . An
increase in vasomotor tone causes blood vessels to dilate and blood pressure to
decrease.
REGULATION OF ARTERIAL PRESSURE
• Adequate blood pressure is required to maintain blood flow through the blood vessels of the body, and several
regulatory mechanisms ensure that blood pressure remains adequate for this task.
• The mean arterial blood pressure (MAP) is slightly less than the average of the systolic and diastolic pressures in
the aorta because diastole lasts longer than systole. The mean arterial pressure changes over our lifetime.
• The body's MAP is equal to the cardiac output (CO) times the peripheral resistance (PR), which is the resistance
to blood flow in all the blood vessels:
• MAP CO × PR
• Because the cardiac output is equal to the heart rate (HR) times the stroke volume (SV), the mean arterial
pressure is equal to the heart rate times the stroke volume times the peripheral resistance (PR):
• MAP HR x SV × PR
• Thus, the MAP increases in response to increases in HR, SV, or PR, and the MAP decreases in response to
decreases in HR, SV, or PR.
BARRORECEPTORS REFLEXES

• Baroreceptors are sensitive to stretch.

• Baroreceptors are located in the carotid sinuses and the aortic arch.
• The baroreceptor reflex changes peripheral resistance, heart rate, and
stroke volume in response to changes in blood pressure.
CHEMORECEPTORS REFLEXES

• Chemoreceptors are sensitive to changes in blood O2 CO2 and pH.

• Chemoreceptors are located in the carotid bodies and the aortic
bodies.
• The chemoreceptor reflex increases peripheral resistance in response
to low O, levels, high CO, levels, and reduced blood pH.
 HORMONAL MECHANISM
• Epinephrine released from the adrenal medulla as a result of sympathetic stimulation increases heart rate,
stroke volume, and vasoconstriction.
• The kidneys release renin in response to low blood pressure. Renin promotes the production of
angiotensin II, which causes vasoconstriction and increased secretion of aldosterone. Aldosterone
reduces urine output.
• ADH released from the posterior pituitary causes vasoconstriction and reduces urine output.
• The heart releases atrial natriuretic hormone when atrial blood pressure increases. Atrial natriuretic
hormone stimulates an increase in urine production, causing a decrease in blood volume and blood
pressure.
 ADRENAL MEDULLARY MECHANISM

• Stimuli that lead to increased sympathetic stimulation of the heart and blood
vessels also cause increased stimulation of the adrenal medulla.
• The adrenal medulla responds by releasing epinephrine and small amounts of
norepinephrine into the blood.
• Epinephrine increases heart rate and stroke volume and causes vasoconstriction,
especially of blood vessels in the skin and viscera. Epinephrine also causes
vasodilation of blood vessels in skeletal muscle and cardiac muscle, thereby
increasing the sup-ply of blood flowing to those muscles and preparing the body
for physical activity.
RENIN-ANGIOTENSIN-ALDOSTERONE MECHANISM

• In response to reduced blood flow, the kidneys release an enzyme called renin

into the circulatory system. Renin acts on the blood protein angiotensinogen to
produce angiotensin I. Another enzyme, called angiotensin-converting enzyme
(ACE), found in large amounts in organs, such as the lungs, acts on angiotensin I
to convert it to its most active form, angiotensin II. Angiotensin II is a potent
vasoconstrictor. Thus, in response to reduced blood pressure, the kidneys’ release
of renin increases the blood pressure toward its normal value.
ANTIDIURETIC HORMONE MECHANISM
• When the concentration of solutes in the plasma increases or when blood
pressure decreases substantially, nerve cells in the hypo-thalamus respond by
causing the release of antidiuretic (to decrease urine production) hormone
(ADH), also called vasopressin (to cause vasoconstriction), from the posterior
pituitary gland. ADH acts on the kidneys and causes them to absorb more water,
thereby decreasing urine volume. This response helps maintain blood volume
and blood pressure. The release of large amounts of ADH causes
vasoconstriction of blood vessels, which causes blood pressure to increase.
ATRIAL NATRIURETIC MECHANISM

• A peptide hormone called atrial natriuretic hormone is released

primarily from specialized cells of the right atrium in response to
elevated blood pressure. Atrial natriuretic hormone causes the
kidneys to promote the loss of Na+ and water in the urine, increasing
urine volume. Loss of water in the urine causes blood volume to
decrease, thus decreasing the blood pressure.
SUMMARY OF REGULATORY MECHANISMS

• The baroreceptor, chemoreceptor, and adrenal medullary reflex

mechanisms are most important in short-term regulation of blood
pressure.
• Hormonal mechanisms, such as the renin-angiotensin-aldosterone
system, antidiuretic hormone, and atrial natriuretic hormone, are
more important in long-term regulation of blood pressure.
EFFECTS OF AGING ON THE BLOOD VESSELS
• Reduced elasticity and thickening of arterial walls result in
hypertension and decreased ability to respond to changes in blood
pressure.
• Atherosclerosis is an age-related condition..
• The efficiency of capillary exchange decreases with age.
• Walls of veins thicken in some areas and dilate in others. Thromboses,
emboli, varicose veins, and hemorrhoids are age- related conditions.
• Age-related problems associated with the cardiovascular system
include:
• Weakening of venous valves
• Varicose veins
• Progressive arteriosclerosis
• Hypertension resulting from loss of elasticity of vessels
• Coronary artery disease resulting from fatty, calcified deposits in the
vessels