1. Circulation & Blood Vessels
Chapter 14
Pages 274 – 296

2. Blood Circulation Page 275 Major circulatory systems
Cardiopulmonary circulation – blood to the lungs & back
Systemic circulation – blood to the tissues & cells & back
Specialized circulatory systems
Coronary circulation –blood to the heart & back
Portal circulation –blood from the organs of digestion to the liver through the portal vein
Fetal circulation – occurs in the pregnant female. The fetus obtains oxygen & nutrients from the mother’s blood.

3. Cardiopulmonary Circulation
Page 275
Cardiopulmonary Circulation
Deoxygenated blood from the heart flows to the lungs, where carbon dioxide is exchanged for oxygen
Oxygenated blood then returns to the heart

4. Page 276
Figure 14-2
Right atrium  tricuspid valve  right ventricle  pulmonary valve  pulmonary arteries  lungs  pulmonary veins  left atrium  bicuspid (mitral) valve  left ventricle  aortic valve  aorta  body  vena cava

5. Systemic Circulation Pages 275 – 277
Circulates nutrients, oxygen, water, & secretions
Carries away waste products
Helps equalize body temperature
Aids in protecting the body from harmful bacteria
The aorta’s 1st three branches
Common coronary artery
Brachiocephalic artery
Subclavian arteries

6. Page 275
Figure 14-1
Right atrium  tricuspid valve  right ventricle  pulmonary valve  pulmonary arteries  lungs  pulmonary veins  left atrium  bicuspid (mitral) valve  left ventricle  aortic valve  aorta  body  vena cava

7. Coronary Circulation Page 277
Brings oxygenated blood to the heart muscle
Right & left branches of the coronary artery
Exchange of oxygen & waste occurs at capillary level
Deoxygenated blood returns through the coronary veins to the coronary sinus (a trough in the posterior wall of the right atrium)

8. Portal Circulation Pages 277 – 278 A branch of the general circulation
Veins from the pancreas, stomach, small intestine, colon, & spleen empty their blood into the hepatic portal vein, which goes to the liver
Liver ensures that the blood’s glucose concentration is kept within a relatively narrow range

9. Page 277
Figure 14-4

10. Fetal Circulation Pages 278 – 279 Occurs in the unborn baby (fetus)
Fetus obtains oxygen & nutrients from the mother’s blood, not through its own lungs & digestive system
The fetal blood does not mix with the mother’s blood; the exchange of gases, food, & waste occurs through the placenta
The most common symptom of congenital heart defect is cyanosis (a bluish discoloration to the skin & mucous membrane caused by a lack of oxygen in the blood)

12. Page 279
Blood Vessels
Arteries – Carry oxygenated blood away from the heart to capillaries (exception – pulmonary arteries)
Capillaries – Smallest blood vessels & Can only be seen through a microscope
Veins – Carry deoxygenated blood away from the capillaries to the heart

13. Arteries Page 279 Layers of the walls
Tunica adventitia (externa) = consists of fibrous connective tissue with bundles of smooth muscle cells that lend great elasticity to the arteries.
Tunica media = middle arterial layer
Tunica intima = inner layer
Aorta leads away from the heart & branches into smaller arteries
Smaller arteries branch into arterioles
Arterioles give rise to the capillaries

14. Capillaries Pages 279 – 281 Connect the arterioles & venules
Muscle & connective tissue disappear & they become a simple endothelial cell layer
Selective permeability
Control of blood flow by precapillary sphincters – this system allows for regulation of blood flow to so-called active tissues.

15. Pages 281 – 282
Veins
Layers of the walls: Tunica externa, Tunica media, Tunica intima
Walls much thinner than arteries; Do not have to withstand as much pressure
Veins have valves so blood flows in one direction ;Toward the heart
Largest vein is the vena cava
Superior vena cava returns blood from the upper part of the body
Inferior vena cava returns blood from the lower part of the body

16. Venous Return Pages 282 – 283 Valves help keep venous blood moving
Skeletal muscles contract to push venous blood along its path
Pressure changes occur when we breath, which helps bring venous blood back to the heart
Stationary positioning can decrease flow back to the heart for oxygenation, can cause drowsiness

17. Pages 283 – 284
Blood Pressure
Systolic blood pressure = pressure measured at the moment of contraction.
Diastolic blood pressure = pressured measured when the ventricles relax
Pulse pressure = the difference between the systolic & diastolic
Normal values – 120/80
Factors that affect blood pressure
Volume of blood – loss of blood loss of pressure
Blood viscosity – thicker blood higher pressure
Total peripheral resistance – narrow vessels higher pressure
Stressors – muscles around the vessel contract higher blood pressure

18. Page 284
Pulse
Alternating expansion & contraction of an artery as blood flows through it (It should be the same as the heart rate)
Can feel pulsating beat at certain points on the body; where the artery is near the surface of the skin and over a bone (pulse points)

19. Pulse Points
Pages 284 – 285
Brachial artery – at the crook of the elbow, along the inner border of the biceps muscle
Common carotid artery – in the neck, along the front margin of the sternocleidomastoid muscle, near the lower edge of the thyroid cartilage
Femoral artery – in the inguinal or groin area
Dorsalis pedis artery – on the anterior surface of the foot, below the ankle joint
Popliteal artery – behind the knee; (hard to feel)
Radial artery – at the wrist, on the same side as the thumb (most common site for taking the pulse)
Temporal artery – slightly above the outer edge of the eye
Pressure points can be used to stop bleeding distal to the pulse point

20. Effects of Aging Page 283 SB
Arteries become less elastic, dilated & elongated
Systolic BP increases due to reduced elasticity
Baroreceptors become rigid & less sensitive to pressure changes, causing postural hypotension
Can correct many congenital heart defects
Baroreceptors = sensor in the artery monitors the blood pressure

21. Disorders of Circulation & Blood Vessels
Page 285
Disorders of Circulation & Blood Vessels
Aneurysm = ballooning out of an artery, accompanied by a thinning arterial wall, caused by a weakening of the blood vessel.
Arteriosclerosis = occurs when the arterial walls thicken because of a loss of elasticity as aging occurs.
Atherosclerosis = occurs when deposits of fat form along the walls of the arteries.
Gangrene = death of body tissue due to an insufficient blood supply caused by disease or injury.

22. Disorders of Circulation & Blood Vessels
Pages 285 – 287
Disorders of Circulation & Blood Vessels
Phlebitis (thrombophlebitis) = inflammation of the lining of a vein, accompanied by clotting of blood.
Embolism = a traveling blood clot.
Varicose veins = swollen veins that result from a slowing of blood flow back to the heart.
Hemorrhoids = varicose veins in the walls of the lower rectum & the tissues around the anus.
Cerebral hemorrhage = bleeding from blood vessels within the brain.
Peripheral vascular disease = caused by blockage of the arteries, usually in the legs.

23. Disorders of the Blood Vessels
Pages 287 – 290
Disorders of the Blood Vessels
Hypertension = high blood pressure
Normal – Less than 120/80
Pre-hypertension – 120–130/80–89
Stage I hypertension – 140–159/90–99
Stage II hypertension – 160 & above/100 & above
White coat hypertension = only high around Dr.
Hypotension = low blood pressure
Transient ischemic attacks (TIAs) = temporary interruptions of blood flow to the brain.
Cerebral vascular accident (CVA) = sudden interruption of the blood supply to the brain [stroke]
Strokes can cause:
hemiplegia = paralysis on the left or right side of the body
Aphasis = loss of speech & memory
Dysphasia = inability to say what one wishes.
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An acronym to help assess whether someone is having a stroke is F-A-S-T
Face – ask the person to smile & see if one side of the face droops down
Arms – ask the person to raise both arms; watch to see if one arm drifts down
Speech – ask the person to repeat a simple sentence; check for slurred speech or if the sentence is repeated back correctly
Time – if any symptoms are present, call for emergency help immediately

24. Hypoperfusion/Shock Pages 290 – 291
Inadequate flow of blood carrying oxygen to the organs & body systems
Hypoperfused tissue will stop working properly
Main causes of hypoperfusion
Excessive blood or fluid loss
Change in size of the arteries & veins (may be too dilated, & not enough pressure to move blood through the blood vessels.
Inadequate pumping of the heart
Body will attempt to compensate for shock by increasing the respiration rate, increasing heart rate, or sacrificing blood supply to organs to protect blood flow to the brain.