The Peripheral Circulation

B.Pimentel, M.D.
University of Makati – College of Nursing
PERIPHERAL CIRCULATION

1. Capillaries

3. Arteries

5. Veins
PERIPHERAL CIRCULATION
Capillaries

Structure - the capillary wall

consists primarily of
endothelial cells on a basement
membrane. A layer of loose
connective tissue merges with
the connective tissue
surrounding the capillary. 7 to
9 micrometers in diameter.
PERIPHERAL CIRCULATION
Capillaries

Function - exchange of gases, nutrients, hormones... between blood and

the interstitial fluid.

Substances cross capillary walls by diffusing through the endothelial

cells, through fenestrae, or between the endothelial cells. Lipid
soluble substances such as oxygen and carbon dioxide readily diffuse
through the plasma membrane of the endothelial cells.
PERIPHERAL CIRCULATION
Capillaries

Types of Capillaries
2. Continuous capillaries - walls exhibit no gaps between endothelial
cells, less permeable. Located in muscle and nervous tissue.

4. Fenestrated capillaries - endothelial cells have numerous

fenestrae. Located in intestinal villi, ciliary process of the eye,
choroid plexus of the CNS, and glomeruli of the kidneys.

6. Sinusoidal capillaries - larger diameter capillary with larger

fenestrae. Located in endocrine glands.
PERIPHERAL CIRCULATION
Continuous Capillaries

Capillaries which lack pores

= fenestrations and in
which adjacent
endothelial cells are held
together by tight
junctions to limit fluid
exchange between the
plasma and the tissue
fluid by controlling fluid
transfer between
endothelial cells.
PERIPHERAL CIRCULATION
Fenestrated Capillaries

Primarily seen in the glomerular

capillaries in the nephrons of
the kidney, which have pores =
fenestrations
Permitting regulated fluid
exchange.
PERIPHERAL CIRCULATION
Sinusoidal Capillaries

Primarily the capillaries in the

liver, bone marrow, some
endocrine glands and in
lymphoid tissue, which lack
pores = fenestrations
PERIPHERAL CIRCULATION
Capillaries

Capillary Network
Arterial capillaries - ends of the capillaries closest to arterioles.
Venous capillaries - ends closest to venules.

Blood flows from an arteriole to a metarteriole, which have smooth

muscle cells along their walls. Blood then flows into a
thoroughfare channel, which extends in a relatively direct fashion
from a metarteriole to a venule
PERIPHERAL CIRCULATION
Capillaries
PERIPHERAL CIRCULATION
Capillaries

Precapillary sphincters - are smooth muscle cells located at the origin of

the branches from the thoroughfare channel, they function in
regulating flow in the capillaries
PERIPHERAL CIRCULATION
Arteries And Veins

Structure - consists of three layers or tunics

2. Tunica Intima - consists of endothelium (continuous with the heart
and all blood vessels), connective tissue basement membrane,
lamina propria (thin layer of connective tissue), and internal elastic
membrane (fenestrated layer of elastic fibers.

4. Tunica Media - smooth muscle cells arranged circularly around

the vessel. arteries have a thicker tunica media than veins.

6. Tunica Adventitia - outer tunica composed of connective tissue.

Contain blood vessels called vaso vasorum which supplies the
artery. The tunica media and adventitia can not obtain nutrients
from the lumen. Also contains nerves.
PERIPHERAL CIRCULATION
Arteries And Veins
PERIPHERAL CIRCULATION
Arteries

Conduct blood away from the heart, to the lungs and body.

Types of arteries
4. Large elastic arteries - largest diameter, a greater amount of elastic
tissue and a smaller amount of smooth muscle in their walls.

6. Muscular arteries - walls are thick compared to their diameter,

tunica media has the most amount of muscle than any other vessel.
Partially regulate blood supply to different regions of the body by
constricting or dilating.

8. Arterioles - transport blood from arteries to capillaries. Capable of

vasodilation and vasoconstriction
PERIPHERAL CIRCULATION
Elastic Arteries
PERIPHERAL CIRCULATION
Elastic Arteries
PERIPHERAL CIRCULATION
Muscular Arteries
PERIPHERAL CIRCULATION
Muscular Arteries
PERIPHERAL CIRCULATION
Arterioles
PERIPHERAL CIRCULATION
Arterioles
PERIPHERAL CIRCULATION
Veins

Conducts blood from the body and lungs to the heart.

Types of veins
4. Venules and small veins - venules conduct blood from the
capillaries to small veins, they are structurally similar to
capillaries. Small veins have a thin layer of smooth muscle in a
continuous layer.

6. Medium veins - collect blood from small veins and deliver to large
veins.

8. Large veins - transport blood from medium veins to the heart.

PERIPHERAL CIRCULATION
Veins

Valves - veins with a diameter greater than 2mm. contain valves.

Prevents blood flow away from the heart

Arteriovenous anastomoses - allow blood to flow from arterioles to

venules without passing through the capillaries
PERIPHERAL CIRCULATION
Factors Affecting Blood Flow

1. Resistance to flow of the walls

3. Blood pressure

5. Viscosity

7. Vascular compliance
PERIPHERAL CIRCULATION
Factors Affecting Blood Flow

1. Resistance to flow of vessel walls

• Laminar flow - streamlined flow of blood through smooth walled

vessels.

• Turbulent flow - when blood passes a constriction, sharp bend, or

a rough vessel wall, will interrupt laminar flow.
PERIPHERAL CIRCULATION
Factors Affecting Blood Flow

2. Blood Pressure
A measure of the force blood exerts against blood vessel walls.

• Measured in millimeters of mercury (mmHg).

• Systolic pressure - the highest pressure of blood that stretches the
aorta to its maximum, as blood is ejected out of the left ventricle.
• Diastolic pressure - lowest level of aortic pressure as the aorta and
elastic arteries recoil maintaining pressure on the reducing blood
volume.
• Pulse pressure - the difference between systolic and diastolic
pressures. Two major factors influence pulse pressure; stroke
volume and vascular compliance.
PERIPHERAL CIRCULATION
Factors Affecting Blood Flow

3. Viscosity
The measure of the resistance of a liquid to flow.

• The viscosity of blood is influenced largely by Hematocrit - the

percentage of the total blood volume composed of RBC's.

• Increased hematocrit will increase blood viscosity, and the converse

is true.
PERIPHERAL CIRCULATION
Factors Affecting Blood Flow

4. Vascular compliance

• The tendency for blood vessel volume to increase as the

blood pressure increases.

• The more easily the vessel wall stretches, the greater its
compliance.
PERIPHERAL CIRCULATION
Capillary Exchange and Regulation of Interstitial Fluid
Volume
• Capillary exchange - the movement of substances into and out of
capillaries. The most important means by which capillary
exchange occurs is diffusion.

• Net filtration pressure - the force responsible for moving fluid

across capillary walls.

• Interstitial fluid pressure - the pressure of interstitial fluid within

tissue spaces. It si -3 mm hg. because of the suction effect
produced by the lymphatic vesels as they pump fluid from the
tissues.
PERIPHERAL CIRCULATION
Local Control of Blood Flow by the Tissues

1. Functional characteristics of the capillary bed. Local factors regulate

these structures primarily. As the rate of metabolism increases in a
tissue, blood flow through its capillaries increases. The precapillary
sphincters relax, allowing blood to flow into the local capillary bed.
Vasodilator substances are produced as the rate of metabolism
increases. The substances then diffuse from the tissue supplied by
the capillary to the area of the precapillary sphincter, the
metarterioles and arterioles, to cause vasodilation.
PERIPHERAL CIRCULATION
Local Control of Blood Flow by the Tissues

• Chemicals that cause vasodilation: 1. Carbon dioxide, 2. Lactic

acid, 3. Adenosine, 4. Adenosine monophosphate, 5. Adenosine
diphosphate, 6. Endothelium derived relaxation factor, 7. Potassium
ions, and 8. Hydrogen ions.

• Lack of nutrients can also regulate local blood flow; oxygen and
other nutrients.

• Blood flow through capillaries is cyclic. The cyclic fluctuations is

the result of periodic contraction and relaxation of the precapillary
sphincters called vasomotion.
 PERIPHERAL CIRCULATION
Local Control of Blood Flow by the Tissues

2. Autoregulation of blood flow. The maintenance of blood flow by

tissues is called autoregulation. The mechanisms responsible for
autoregulation are the same for vasomotion.

3. Long term local blood flow. Through tissues is matched closely to the
metabolic requirements of the tissue if elevated or decreased for a long
period of time
PERIPHERAL CIRCULATION
Local Control of Blood Flow by the Tissues

4. Nervous and hormonal regulation. Nervous control of arterial blood

pressure is important in minute to minute regulation of local
circulation. The blood pressure must be adequate to cause blood
flow through capillaries in response to; rest, during exercise, or in
circulatory collapse (shock). Nervous regulation also provides a
means of shunting blood from one region to another.

Vasomoter center - pons and medulla oblongota is tonically active.

Alow frequency of action potentials is continually transmitted. This
accounts for slight constiction of all blood vessels, a condition called
vasomotor tone.
REGULATION OF MEAN ARTERIAL PRESSURE

The mechanisms that operate to maintain arterial blood pressure within a

normal range.

Mean arterial pressure - is slightly less than the average of systolic and
diastolic pressures.

Short term regulation

6. Baroreceptors
7. Adrenal medullary
8. Chemoreceptor reflexes
9. CNS ischemic response - in response to emergency situations in
which blood flow to the brain is severely restricted or when blood
pressure falls below approximately 50 mmHg.
REGULATION OF MEAN ARTERIAL PRESSURE

Long term regulation

1. Renin-Angiotensin-Aldosterone mechanism - regulates kidney
function, and can also influence peripheral circulation causing
vasoconstriction. The control of urine output continues to operate
until the blood pressure is precisely within normal limits.

2. Vasopressin (ADH) mechanism works in harmony with the renin-

angiotensin-aldosterone mechanism.

3. Atrial natriuretic mechanism - is released from the cells of the atria.

A major stimulus for its release is increased venous return.
REGULATION OF MEAN ARTERIAL PRESSURE

4. Fluid shift mechanism - important role when dehydration occurs.

The interstitial volume acts as a reservoir, shift of this fluid back into
circulation is a powerful mechanism in which blood pressure is
maintained.

5. Stress relaxation response - smooth muscle cells. Action of the

smooth muscle of vessels is directly related to blood volume and
blood pressure. A decline in blood volume causes a decline in blood
pressure, the smooth muscles of vessels will contract causing
vasoconstriction, this in turn reduces the volume of blood vessels
thereby increasing the blood pressure. The converse is true.
Thank You….