Blood Vessels

Introductory Note: Knowledge of the structure and function of blood vessels and other aspects of
the heart and vascular system are parts of training in many therapies, such as Massage (incl.
"Indian Head Massage", "Swedish Massage", "Acupressure Massage" etc.), Aromatherapy,
Shiatsu, and others. This page is intended to include the detail required for most Basic / First
Level Courses in these therapies, and some ITEC Diplomas.
The main types of blood vessels are:

Arteries,

Arterioles,

Capillaries,

Venules, and

Veins.

These are described and compared on this page.

1. Diagrams
The following diagram summarises the sequence of blood flow through the heart, arteries,
arterioles, capillaries, venules, veins, then back to the heart:

The following diagram summarises the structural differences between different types of blood
vessels.
More information about this also follows in the next section.

2. Structure and Functions of Blood Vessels

Structure
Arteries The walls (outer structure) of arteries

contain smooth muscle fibre that contract

and relax under the instructions of the
sympathetic nervous system.

Arteriole Arterioles are tiny branches of arteries

s

that lead to capillaries. These are also

under the control of the sympathetic
nervous system, and constrict and dialate,
to regulate blood flow.

Functions
Transport blood away from the heart;

Transport oxygenated blood only

(except in the case of the pulmonary
artery).

Transport blood from arteries to

capillaries;

Arterioles are the main regulators of

blood flow and pressure.

Capillari Capillaries are tiny (extremely narrow)

blood vessels, of approximately 5-20
es

micro-metres
(one micro-metre = 0.000001metre)
diameter.
There are networks of capillaries in most
of the organs and tissues of the body.
These capillaries are supplied with blood
by arterioles and drained by venules.
Capillary walls are only one cell thick
(see diagram), which permits exchanges
of material between the contents of the
capillary and the surrounding tissue.

Venules Venules are minute vessels that drain

blood from capillaries and into veins.

Many venules unite to form a vein.

Veins

The walls (outer structure) of veins

consist of three layers of tissues that are
thinner and less elastic than the
corresponding layers of aerteries.
Veins include valves that aid the return of
blood to the heart by preventing blood
from flowing in the reverse direction.

Function is to supply tissues with

components of, and carried by, the
blood, and also to remove waste from
the surrounding cells ... as opposed to
simply moving the blood around the
body (in the case of other blood
vessels);

Exchange of oxygen, carbon dioxide,

water, salts, etc., between the blood
and the surrounding body tissues.

Drains blood from capillaries into

veins, for return to the heart

Transport blood towards the heart;

Transport deoxygenated blood only

(except in the case of the pulmonary
vein).

3. Comparison between Arteries and Veins

Arteries
Transport blood away from the heart;

Veins
Transport blood towards the heart;

Carry Oxygenated Blood

(except in the case of the Pulmonary
Artery);

Carry De-oxygenated Blood

(except in the case of the Pulmonary
Vein);

Have relatively narrow lumens (see

diagram above);

Have relatively wide lumens (see

diagram above);

Have relatively more muscle/elastic

tissue;

Have relatively less muscle/elastic

tissue;

Transports blood under higher pressure

(than veins);

Transports blood under lower pressure

(than arteries);

Do not have valves (except for the

semi-lunar valves of the pulmonary
artery and the aorta).

Have valves throughout the main

veins of the body. These are to prevent
blood flowing in the wrong direction,
as this could (in theory) return waste
materials to the tissues.

Artery

An artery (pl. arteries) is one of several types of blood vessels that transport blood
around the body.
Other blood vessels include: arterioles, veins, venules, and capillaries.
The structure of an artery is as follows:

The walls (outer structure) of arteries contain smooth muscle fibre that contract and
relax under the instructions of the sympathetic nervous system.

The functions of arteries include:

Transport blood away from the heart;

Carry Oxygenated Blood(except in the case of the Pulmonary Artery);
Have relatively narrow lumens (see diagram above);
Have relatively more muscle/elastic tissue;
Transports blood under higher pressure (than veins);
Do not have valves (except for the semi-lunar valves of the pulmonary artery and
the aorta).

Aorta

The aorta is the main artery that carries blood away from the heart. Blood is pumped from the left ventricle
heart (via the aortic valve) into the aorta.

After ascending (passing upwards) for a short distance, the aorta arches backward and to the left side. It then pa
over the root of the left lung before progressing downwards within the thorax on the left side of the vertebral
column. Then it passes into the abdominal cavity, through the aortic hiatus in the diaphragm, and terminates
opposite the lower border of the fourth lumbar vertebra where it divides into the right and left common iliac arte

Aortic valve

The aortic valve is one of the semilunar valves of the heart.

It consists of three pockets shaped like half-moons.
It's function is to prevent blood that is leaving the heart via the left ventricle (into the aorta),
from flowing backwards and so re-entering the heart.
This is extremely important because backflow of blood through an incompletely closed valve
such as the aortic valve (a condition known as "regurgitation") can lead to congestive heart
failure. That is a situation in which the heart can no-longer pump enough blood out to supply the
body's needs for oxygen.

Ascending aorta

The ascending aorta is a part of the aorta (a main artery) that carries blood away from the heart.
It begins at the upper part of the base of the left ventricle (of the heart), passes upward, forward,
and to the right - in the direction of the hearts axis. The ascending aorta is enclosed within the
pericardium in a tube of the serous pericardium, common to it and the pulmonary artery and is
about 5 cm. in length.
Arteriole

An arteriole is one of several types of blood vessels that transport blood around the body.
Other blood vessels include: arteries, veins, venules, and capillaries.

The structure of an arteriole is:

Arterioles are tiny branches of arteries that lead to capillaries.

These are also under the control of the sympathetic nervous system, and constrict and
dialate, to regulate blood flow.

The functions of arterioles include:

Transport blood from arteries to capillaries;
Arterioles are the main regulators of blood flow and pressure.

Atrioventricular valves

The atrioventricular valves are two of the four valves within the heart - the other two valves
being the semilunar valves.
The atrioventricular valves are located between the the atria and the ventricles of the heart.
The atrioventricular valve between the left atrium and the left ventricle is called the bicuspid
valve (also known as the mitral valve), and the atrioventricular valve between the right atrium
and the right ventricle is called the tricuspid valve.

In each case, as the atrium of the heart contracts it pushes a quantity of blood into the
corresponding ventricle. The atrioventricular valve consists of dense connective tissue covered
by endothelium and acts to prevent blood from flowing backward from the ventricle to the
atrium: This is important as the next action in the sequence is the contaction of the ventricle to
push the blood out of the heart into an artery for transport to the next organ around the body.
The opening and closing of the atrioventricular valves is controlled by the differences in
pressure across them:
When blood passes from an atrium to a ventricle, the atrioventricular valve is pushed open (and
the papillary muscles relax and the chordae tendineae lose their tension, becoming slack). At
the next stage in the sequence the ventricle contracts. This forces blood out from the ventricle
into the artery via which it leaves the heart. This contraction of the ventricle and the
corresponding increase in blood pressure within that ventricle also presses the cusps of the
atrioventricular valve together until their edges meet, closing the valve. At the same time, the
papillary muscles contract and the chordae tendineae tighten - both of which also help to prevent
the cusps from enabling the atrioventricular valves to open.
When in the next stage of the sequence the ventricle relaxes and the atrium contracts, the blood
pressure situation is reversed, the relaxation/tension of the papillary muscles and the chordae
tendineae also reverses, and the atrioventricular valve allows blood to pass from the atrium to
the ventricle again.

The following diagrams are simple summaries of the main parts of the heart, the functions of
which are described below.

Right-Hand Side of the Heart

The right-hand side of the heart
receives de-oxygenated blood from the
body tissues (from the upper- and
lower-body via the Superior Vena
Cava and the Inferior Vena Cava,
respectively) into the right atrium.
This de-oxygenated blood passes
through the tricuspid valve into the
right ventricle. This blood is then
pumped under higher pressure from
the right ventricle to the lungs via the
pulmonary artery

What are the Functions of the Heart ?

The main functions of the heart can be summarised as follows:

Left-Hand Side of the Heart

The left-hand side of the heart rece
oxygenated blood from the lungs (
the pulmonary veins) into the left
atrium. This oxygenated blood then
passes through the bicuspid valve i
the left ventricle. It is then pumped
the aorta under greater pressure (as
explained below). This higher pres
ensures that the oxygenated blood
leaving the heart via the aorta is
effectively delivered to other parts
the body via the vascular system o
bllod vessels (incl. arteries, arterio
and capillaries).

How does the heart perform these functions ?

The pump action performed by the heart is achieved by a sequence of alternating contraction and
relaxation of the heart muscle (illustrated above). In this context the term "systole" refers to the
contraction part of the sequence and the term "diastole" to the relaxation part of the sequence.
Hence, the "systolic" and "diastolic" pressures may be measured and recorded separately when
monitoring blood pressure.
This process is directed by the nervous system, nerve impluses initiating each sequence. The
whole series of actions that cause alternating contractions and relaxations may be summarised in
five stages:
1. The vagus nerve stimulates the sinoatrial node (SAN), the pacemaker of
the heart.
The sinoatrial node (SAN) is a tiny area of specialised cardiac (meaning
"heart") muscle in the upper wall of the right atrium, near the vena cava - as
shown above. The fibres of the SAN contract rhythmically approx. 70 times
each minute. After each of these contractions, the impluse is dispersed
across the atrial cardiac muscle, leading to ...
2. ... simultaneous contraction of both the right and left atria. This movement of
the cardiac muscle pushes blood from the atria into the ventricles (via the
tricuspid and bicuspid valves).
3. The contractions of the atria send impulses down the Purkinje fibers, which in
turn stimulate the atrioventricular node (AVN). The atrioventricular node
is a mass of modified cardiac muscle located in the lower/central part of the
right atrium of the heart. The Purkinje fibres are referred to by various
names in different textbooks, so are also known as "Purkyne Fibres",
"Purkynje Fibres", and as the "Bundle of His". This/these are a bundle of
modified cardiac muscle fibers that transmit impulses from the atra, via the
AVN, to the ventricles.
4. The action potential from the impulse transmitted down the Purkinje fibers
reaches the right and left branches of the Purkinje fibres - as shown in the
diagram on the right. This causes the ...
5. ... ventricles to contract, which pushes blood upwards into the arteries that
take the blood away from the heart (the pulmonary artery taking blood to the
lungs, and the aorta taking blood to the body).

Systemic Circulation is the system of blood vessels and associated tissues that supplies blood,
and hence oxygen, to all parts of the body.

One of the best ways to describe this system is using a diagram:

Diagram summarizing Systemic Circulation

This diagram and systemic circulation itself may be summarised in words as follows:
Oxygenated Blood

Oxygenated blood leaves the lungs and enters the Left Atrium (LA) of the
heart via the pulmonary veins.

This oxygenated blood is then pumped from the Left Atrium (LA) of the heart
to the Left Ventricle (LV) of the heart, and then out of the heart to the body
tissues via the aorta, which is the major artery leaving the heart.

The aorta divides into other arteries that serve different parts of the body (as
mentioned on the page about the
structure of the heart). These can be separated into two categories: blood
supply to the upper-body, and blood supply to the lower-body.

Blood Supply to the Upper-Body:

The aorta leads to the subclavian arteries that take blood to the arms
(some of which eventually reaches the hands),
and also to the carotid artery that carries blood to the head.

Blood Supply to the Lower-Body:

The aorta also leads to the hepatic artery that carries blood to the liver,
the mesenteric artery that carries blood to the small intestines,
the renal arteries that carry blood to the kidneys,
and the iliac arteries that carry blood to the legs (some of which eventually
reaches the feet.).

Deoxygenated Blood

Blood is deoxygenated when it leaves the tissues and organs it has supplied
with oxygen and other nutrients, to return back to the pulmonary circulatory
system.
This can also be summarised for the upper-body and lower-body separately:

Return of Blood from the Upper-Body:

Blood returns from the head via the jugular veins, and from the arms via
the subclavian veins. All of the blood in the major veins of the upper body
flows into the superior vena cava, which returns the blood to the right
ventricle of the heart.

Return of Blood from the Lower-Body:

Blood returns from the small intestines by passing through the hepatic
portal vein to the liver.
Blood returns from the liver via the hepatic vein, from the kidneys via the
renal veins, and from the legs via the iliac veins. All of the blood in the
major veins of the lower body flows into the inferior vena cava, which
returns the blood to the right ventricle of the heart.

After re-entering the (right atrium of the) heart via the superior vena cava
and the inferior vena cava, deoxygenated blood is pumped into the right
ventricle of the heart and then out of the heart to the lungs via the
pulmonary artery.

Deoxygenated blood enters the lungs and is oxygenated before leaving the
lungs (as oxygenated blood), and so the cycle begins again ...

Measurement of Blood
Pressure
Blood pressure can be measured by
an instrument called a
sphygmomanometer.
A column of mercury is linked to an
inflatable cuff which is wound
around the upper arm. A stethoscope
is then used to listen to the sounds
of the blood in the brachial artery, at
the bend of the elbow.
The sounds start at the systolic
pressure:
(heart contraction => higher
pressure)
and finish at the diastolic pressure:
(heart relaxation => lower pressure).
Hence blood pressure is expressed
as :
"height of column of Hg at systolic
pressure "
"height of column of Hg at diastolic
pressure".
Normal Blood
Pressure is about

mm
Hg.

High Blood pressure is also known as "hypertension". Low blood pressure is also known as
"hypotension".
The following table summaries key causes, effects, and symptoms of both "High" and "Low"
Blood Pressure:

Causes of Condition
High Blood Pressure

May be of unknown cause

Effects / Symptoms
Damage to arteries & veins.

(essential hypertension, or
hyperpiesia)
May result from kidney disease,
including narrowing of the renal
artery (renal hypertension)
Or endocrine diseases (such as
Cushing's disease or
phaeochromocytoma)

Holes get blocked up by

colesterol.

Hypertension is symptomless
until the symptoms of its
complications develop.
These include :

Or disease of the arteries (such as

contraction of the aorta) - which is
known as secondary, or
symptomatic hypertension.
More general contributory factors
are :
Stress; Obesity; Age; Social Class;
Smoking; Lack of exercise; Poor
diet.

Atherosclerosis

Heart failure,

Cerebral haemorrage,

Kidney failure.

Low Blood Pressure

Can occur following:

Temporary Hypotension :

Excessive fluid loss (e.g. through

diarrhoea, burns or vomiting),

Simple faint (syncope)

Severe blood loss (haemorrage)

from any cause.

Light-headed

Sweats
Other causes may include:
Impaired conciousness
Myocardinal infarction,
Severe Hypotension :

Pulmonary embolism,

Peripheral circulatory failure

(cardiogenic shock)

Severe infections,

Unrecordable blood pressure

Allergic reactions,

Weak pulses

Arrhythmias,

Suppression of urine
production

Acute abdominal conditions (e.g.

pancreatitits),
Addisons disease, and

Drugs (e.g. an overdose of the

drugs used to treat hypertension).

Brachiocephalic artery

The brachiocephalic artery is also known as the "innominate artery".

It is a short artery that begins as the first large branch of the aortic arch, passes upwards towards
the right, then terminates at the lower neck near to the right sternoclavicular joint.
At the lower neck the brachiocephalic artery divides into the right common carotid artery and
the right subclavian artery.

Brachiocephalic veins

The brachiocephalic veins are also sometimes known as the "innominate veins".
The term brachiocephalic vein can refer to either of two veins, one of which is located on each
side of the neck and is formed by the junction of the external jugular and the subclavian veins
(on the appropriate side of the body).
The two brachiocephalic veins join to form the superior vena cava which drains blood from the
head, neck, thorax, and arms.

Venule

A venule is one of several types of blood vessel that transport blood around the body.
Other blood vessels include: arteries, arterioles, veins and capillaries.

The structure of a venule is:

Venules are minute vessels that drain blood from capillaries and into veins.
Many venules unite to form a vein.

The functions of venules include:

Drains blood from capillaries into veins, for return to the heart.