Blood vessel

The arterial system

A blood vessel is any of the tubular channels that convey blood throughout the body, whether arteries (including arterioles) that convey blood toward the heart, veins (including venules) that convey blood away from the heart, or the tiny capillaries that connect arterioles and venules. The capillaries enable the actual exchange of water, gases, and chemicals between the blood and the tissues.

There is enormous variability in the size of blood vessels, ranging in humans from capillaries of only 8 μm to the aorta with a diameter of 25 millimeters (one inch) (Blakemore and Jennett 2001).

Types

There are three principal categories of blood vessels: arteries, veins, and capillaries. The arteries are muscular blood vessels that carry blood away from the heart to the cells, tissues, and organs of the body. The veins are blood vessels that carry blood toward the heart, most with one-way valves that prevent backflow. The arteries subdivide into smaller arteries, which give rise to smaller, threadlike blood vessels called arterioles, which are the smallest of the true arteries. Likewise, venules are small, threadlike veins. Capillaries are the smallest of a body's blood vessels and connect arterioles and venules. The capillaries are where all of the important exchanges happen in the circulatory system, enabling the interchange of water, oxygen, carbon dioxide, and many other nutrient and waste chemical substances between blood and surrounding tissues.

The arteries are perceived as carrying oxygenated blood to the tissues, while veins carry deoxygenated blood back to the heart. This is true of the systemic circulation, by far the larger of the two circuits of blood in the body, which transports oxygen from the heart to the tissues of the body. However, in pulmonary circulation, the arteries carry deoxygenated blood from the heart to the lungs and veins return oxygenated blood from the lungs to the heart. The difference between veins and arteries is their direction of flow (out of the heart by arteries, returning to the heart for veins), not their oxygen content. In addition, deoxygenated blood that is carried from the tissues back to the heart for reoxygenation in systemic circulation still carries some oxygen, though it is considerably less than that carried by the systemic arteries or pulmonary veins.

There are various kinds of blood vessels:

• Arteries
  • Aorta (the largest artery, carries blood out of the heart)
  • Branches of the aorta, such as the carotid artery, the subclavian artery, the celiac trunk, the mesenteric arteries, the renal artery and the iliac artery.
• Arterioles
• Capillaries (the smallest blood vessels)
• Venules
• Veins
  • Large collecting vessels, such as the subclavian vein, the jugular vein, the renal vein and the iliac vein.
  • Venae cavae (the 2 largest veins, carry blood into the heart)

They are roughly grouped as arterial and venous, determined by whether the blood in it is flowing away from (arterial) or toward (venous) the heart. The term "arterial blood" is nevertheless used to indicate blood high in oxygen, although the pulmonary artery carries "venous blood" and blood flowing in the pulmonary vein is rich in oxygen. This is because they are carrying the blood to and from the lungs, respectively, to be oxygenated.

Anatomy

The arteries and viens have the same basic structure. There are three layers, from inside to outside while the capillaries have only one thick cell:

• Tunica intima (the thinnest layer): a single layer of simple squamous endothelial cells glued by a polysaccharide intercellular matix, surrounded by a thin layer of subendothelial connective tissue interlaced with a number of circularly arranged elastic bands called the internal elastic lamina.
• Tunica media (the thickest layer): circularly arranged elastic fiber, connective tissue, polysaccharide substances, the second and third layer are separated by another thick elastic band called external elastic lamina. The tunica media may (especially in arteries) be rich in vascular smooth muscle, which controls the caliber of the vessel.
• Tunica adventitia: entirely made of connective tissue. It also contains nerves that supply the muscular layer, as well as nutrient capillaries (vasa vasorum) in the larger blood vessels.

Capillaries consist of little more than a layer of endothelium and occasional connective tissue.

When blood vessels connect to form a region of diffuse vascular supply it is called an anastomosis (pl. anastomoses). Anastomoses provide critical alternative routes for blood to flow in case of blockages.

Laid end to end, the blood vessels in an average human body will stretch approximately 62,000 miles (100,000 km)—2 times around the earth.^{[citation needed]}

Physiology

Blood vessels do not actively engage in the transport of blood (they have no appreciable peristalsis), but arteries - and veins to a degree - can regulate their inner diameter by contraction of the muscular layer. This changes the blood flow to downstream organs, and is determined by the autonomic nervous system. Vasodilation and vasoconstriction are also used antagonistically as methods of thermoregulation.

Oxygen (bound to hemoglobin in red blood cells) is the most critical nutrient carried by the blood. In all arteries apart from the pulmonary artery, hemoglobin is highly saturated (95-100%) with oxygen. In all veins apart from the pulmonary vein, the hemoglobin is desaturated at about 75%. (The values are reversed in the pulmonary circulation.)

The blood pressure in blood vessels is traditionally expressed in millimetres of mercury (1 mmHg = 133 Pa). In the arterial system, this is usually around 120 mmHg systolic (high pressure wave due to contraction of the heart) and 80 mmHg diastolic (low pressure wave). In contrast, pressures in the venous system are constant and rarely exceed 10 mmHg.

Vasoconstriction is the constriction of blood vessels (narrowing, becoming smaller in cross-sectional area) by contracting the vascular smooth muscle in the vessel walls. It is regulated by vasoconstrictors (agents that cause vasoconstriction). These include paracrine factors (e.g. prostaglandins), a number of hormones (e.g. vasopressin and angiotensin) and neurotransmitters (e.g. epinephrine) from the nervous system.

Vasodilation is a similar process mediated by antagonistically acting mediators. The most prominent vasodilator is nitric oxide (termed endothelium-derived relaxing factor for this reason).

Permeability of the endothelium is pivotal in the release of nutrients to the tissue. It is also increased in inflammation in response to histamine, prostaglandins and interleukins, which leads to most of the symptoms of inflammation (swelling, redness and warmth).

Role in disease

Blood vessels play a role in virtually every medical condition. Cancer, for example, cannot progress unless the tumor causes angiogenesis (formation of new blood vessels) to supply the malignant cells' metabolic demand. Atherosclerosis, the formation of lipid lumps (atheromas) in the blood vessel wall, is the prime cause of cardiovascular disease, the main cause of death in the Western world.

Blood vessel permeability is increased in inflammation. Damage, due to trauma or spontaneously, may lead to haemorrhage. In contrast, occlusion of the blood vessel (e.g. by a ruptured atherosclerotic plaque, by an embolised blood clot or a foreign body) leads to downstream ischemia (insufficient blood supply) and necrosis (tissue breakdown).

Vasculitis is inflammation of the vessel wall, due to autoimmune disease or infection.

References

ISBN links support NWE through referral fees

• Blakemore, C., and S. Jennett. 2001. The Oxford Companion to the Body. New York: Oxford University Press. ISBN 019852403X.

Cardiovascular system
Blood  |  Heart → Aorta → Arteries → Arterioles → Capillaries → Venules → Veins → Vena cava → Heart → Pulmonary arteries → Lungs → Pulmonary veins → Heart

Template:Arteries of thorax and abdomen

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