Cardiovascular System

* blood
* heart
* blood vessels ( arteries, veins, capillaries )

Lymphatic system
* lymph ( interstitial fluid )
* lymphatic vessels
* lymph glands

Blood
*
*
*
*
*

slightly viscous - 4.5 to 5.5 ( due to cells and plasma proteins )

consists of ____________________(~99% RBC's and 1% WBC's) & ______________(extracellular fluid)
pH of 7.35 to 7.45 ( arteries pH ~7.4 and veins pH ~7.35 )
0.85 to 0.90% NaCl
males ~ 5 to 6 liters , females ~ 4 to 5 liters

Hematocrit
* the % of the blood that is formed elements ( cells )
* males ~ 42% , females ~38%
* the greater the hematocrit, the _________________ the friction between the cells.
Water has a viscosity of 1.0, and blood is 4.5 to 5.5. This means that 4.5 to 5.5 times as much pressure
is required to force whole blood through a given tube as is required for water.

Formed elements - RBC's and WBC's

* Erythrocytes or Red Blood Cells contain no _____________________
* their major function is to carry Hemoglobin which in turn carries oxygen
~14-16.5 grams Hb/100ml blood, ~12-15 grams Hb/100ml blood
* Hemoglobin is also an excellent buffer
* ~7.7 in diameter, biconcave
* carry O2 and CO2 attached to hemoglobin-* ~5.0 million/mm3, ~4.5 million/mm3
Formation of blood cells is called __________________________
Formation of red blood cells is called ____________________________
embryo adult -

Life span ~120 days

* The _______________ and the ______________ remove the old RBC's from the system
* the Hb is broken down by the liver into Fe, billiruben (which is oxidized into billiverden)
Production
*
*
*
*
*

1) a low O2 concentration causes the kidneys to produce _______________________ a

hormone, into the blood
2) erythropoietin causes the kidneys to increase production of___________________________
___________________ - cellular O2 defficiency, cells not receiving enough O2
___________________ - the number of functional RBC's and/or their Hb level is low therefore the
blood has a low O2 carrying capacity
also lack of Fe ( for Hb )
lack of certain AA ( for the protein globin )
lack of vitamin B12 (helps RBC formation by Red bone marrow)
1) B12 is obtained from liver (yucky) and meat. An intrensic factor is secreted by the mucosa
of the stomach which picks up the B12 ( extrensic factor )
2) both go to the liver to form Anti-anemic factor.
3) Anti-anemic factor goes to bone marrow to stimulate cell production

Leucocytes - WBC's
*
*
*
*
*
*
*

from bone marrow (N,E,B) and lymphoid tissue (L,M)

amoeboid movement
nucleated and no Hb
carry out ____________________________ (movement out of capillaries)
5,000 to 10,000/mm3 of blood
destroy bacteria (pathogens) by ________________________ (cell eating) and by bacteriolysis (bursting)
_______________________ - chemical substances which cause WBC's to move toward or away
from the source.
*life span - 2 to 300 days (Why such a range?)
*destroyed by microbes, spleen, liver, bone marrow and lymph nodes

Types of WBC's
* ____________________________ ( also called Polymorphonuclear )
- origionate in myeloid tissue ( red bone marrow )
- Hematocytoblast - immature cells formed from undifferentiated mesenchymal cells in red bone marrow
1) _________________________ ~ 65%
- phagocytic
- release lysozyme
2) Eosinophils ~ 3%
- associated with allergies
- found in extremely large numbers when the body is infected with ______________________
3) Basophils ~ 1%
- liberate heparin into the blood to prevent clotting ( Why? )
- in large numbers at the site if inflammation
- also involved in allergic reactions
* Agranular - produced in lymphoid tissue ( _______________, ______________, ______________ )
4) Monocytes ~ 6%
- phagocytic
- become macrophages
- more powerful phagocytes than ___________________________
5 )_________________________ ~ 25%
- play a large role in immunity
- become phagocytic macrophages at the site of inflammation
Thrombocytes - platlets, no nucleus
- formed from _______________________________ which fragment
while still in the bone marrow
- ~ 300,000/mm3
- 2-4 in diameter or oval disks
- 1 week life span
- contain thromboplastin to start the clotting mechanism
Plasma

the liquid part of blood

straw colored
whole blood minus the cells
~________ % of the total blood
91% water
contents include: albumins, globulins, fibrinogen & prothrombin, glucose, lipids, O2, CO2,
Na+, Ca++, Mg+, Fl-, I-, Cl-, K+, HCO3, Fe, AA, urea, lactic acid, vitamin A, vitamin C,
enzymes, hormones

________________ is _______________ minus the clotting factors.

- an example is the fluid expressed from a clot
________________- a foreign protein

Antibody - special proteins produced by the body that inactivate antigens

Antigen-Antibody response
- an antigen enters the body and reacts with B lymphocytes
- the B lymphocytes become _____________________ which are capable of producing
antibodies which will attach to the antigen.
- antibodies are ________________________________

Blood clotting
1) vessel cut or ruptured - vessel contracts to reduce flow ( How? )
2) platlets attempt to plug the opening in the vessel, when they contact the collagen fibers
they become sticky and secrete ADP which perpetuates the cycle ( Why? )
3) blood clot forms
4) growth of fibrous tissue into clot to close hole in the vessel permanently

Coagulation - the process of clotting

* Extrensic pathway - caused from damaged tissue
1) an extract from the damaged tissue, tissue thromboplastin, is released into the blood.
2) tissue thromboplastin reacts with Ca++ ions to form extrensic thromboplastin
3) extrensic thromboplastin and several factors react to form prothrombin
4) prothrombin reacts with Ca++ to become thrombin
5) thrombin reacts with Ca++ to catalyze the conversion of __________________________to fibrin
* Intrensic pathway - the blood itself is traumatized
1) the endothelial lining and platlets are both negatively charged and repel each other, therefore they
don't stick together.
2) platlets will stick to a ruptured lining ( Why? )
3) platlets release coagulation factors & form intrensic thromboplastin
4) intrensic thromboplastin helps to convert prothrombin into thrombin
5) thrombin helps to convert fibrinogen into fibrin
Clot retraction - occurs within 30 min. to close wound, serum is expressed from the clot
Fibrinolysis Plaque Thrombosis Embolus Embolism -

ABO blood grouping

Antigen - a protein on the surface of the RBC, also called agglutinins.

Blood
Type

Antigen

Antibody

A
B
AB
O

Antibody - a protein in the plasma of the blood.

Rh factor - an antigen on the surface of the RBC
- Rh- means the antigen is not present

- Rh+ means the antigen is present

* If an Rh- individual is exposed to an Rh+ individuals blood, then he will produce

_______________________
Hemolytic disease of the newborn or Erythroblastosis fetalis
- effects 1 out of 30 births
- the result of an Rh- mother having an Rh+ fetus
- must receive anti-Rh-gamma2-globin antibody preparation also called _____________________

Conduction system - a self contained pacemaker for the heart

1) SA node
2) AV node
3) AV bundle
4) Lt and Rt. bundle branches
5) Myoconduction fibers
- a mass of conducting cells
or
- electrocardiogram
- a recording of the electrical activity of the heart

wave - atrial depolarization

- SA node impulse traveling over atria causing them to contract
QRS segment - ventricular depolarization
- impulse traveling through the ventricles causing them to contract
wave - repolarization of the ventricles
* What's missing as far as you being able to see from this EKG waveform?
* Can you tell if a person has a heart murmur from an EKG waveform?
Coronary circulation - blood supply to the myocardium
- remember the openings to the coronary arteries, the lt. and rt. coronary arteries, circumflex
artery, opening of the coronary sinus
* Read the clinical application on page 601
* Ventricular pressure during contraction must overcome arterial pressure before the aortic or
pulmonary semilunar valves will open.
- relaxation phase
- contraction phase
Cardiac cycle - both atrial and ventricular systole's and diastole's.

Timing - approx. 75 beats per minute

Lubb - AV valves closing during ventricular systole .
Dupp - Semilunar valves closing during ventricular diastole .
or Cardiac minute output
- the amount of blood ejected from the lt. ventricle into the aorta per minute
1) the volume of blood pumped out of the lt. ventricle per contraction
2) the # of heartbeats per minute
* ave. stroke volume approx. 70 ml
* ave. heart rate approx. 75 beats per minute
cardiac output = stroke volume x heart rate
= 70 ml x 75 bmp
= 5250 ml/min. or 5.25 l/min.
- located in the medulla
- receives input from sensory receptors and higher brain centers
- Chemoreceptors monitor chemical changes in the blood
- Baroreceptors monitor blood pressure in major veins and arteries
1) carotid arteries ---------------> Carotid sinus reflex
2) aortic arch ---------------> Aortic reflex
3) superior and inferior vena cava ---------------> Right heart reflex
- these baroreceptors are stimulated by the blood pressure stretching the walls of the arteries.
Impulses are sent until the blood pressure returns to normal.

Cardiac accelerator nerves - consists of sympathetic nerve fibers which extend from the
cardiovascular center of the medulla to the spinalcord in the thoracic region.
- these nerves innervate the
,
and the
.
- their fibers release norepinephrine
* the effects are:

1) increased heart rate

2) increased strength of contraction

(
) nerves - consists of parasympathetic nerve fibers which extend from the medulla
- these fibers innervate the SA node and the AV node
- their fibers release acetylcholine
* the effects are:

1) decreased heart rate

2) decreased strength of contraction

Examples:

high blood pressure - impulses from the baroreceptors are sent to the cardiovascular
center to
the Vagus (X) nerves and
the cardiac

accelerator
nerves. The result is a slowing of the force and rate of the heart which allows more time
for the excess amount of blood on the arterial side to drain thereby lowering the systolic
blood pressure.
low blood pressure - impulses from the baroreceptors are sent to the cardiovascular
center to stimulate the cardiac accelerator nerves and inhibit the Vagus (X) nerves .
The result is an increase in the force and rate of the heart which sends more
blood
volume to the arterial side thereby increasing the systolic blood pressure.
Chemical regulation of heart , released due to fear, stress, anger
or anxiety , and thyroid hormones increase excitability of SA node which causes
heart
rate and strength of contraction to increase.
Temperature - heat causes AV node to discharge faster; cold has a reverse effect.
Age, gender and fitness - also effect the rate of the heart

Cardiovascular system - a closed circulatory system of vessels containing blood.

- always carry blood away from the heart
- always carry blood to the heart
100 - 120
Aorta

100 - 40
arteries

40 - 25
arterioles

12 - 8
venules

10 - 5
veins

2
vena cava

25 - 12
arterial capillaries

25 - 12
venous capillaries

0
rt. atrium

Arteries are composed of three tunic (coats)

1) tunica interna (intima)
* simple squamous epithelium * a layer of elastic tissue - internal elastic membrane

2) tunica media
*
(circular) and
* external elastic membrane
* these two components make the arteries very contractile

3) tunica externa (adventitia)

* elastic and collagen fibers (loose C.T.)
- the hollow space in the center of the blood vessel where the blood flows

Smooth muscle - inervation by sympathetic nerve fibers (ANS) causes a decreasein the diameter
of the lumen .
* remove the sympathetic stimulation and the diameter of the lumen
increases . (when would these events occur?)
Elastic or conducting arteries
- conduct blood away from the heart to large sized arteries
- aorta, bracheocephalic, common carotid, subclavian, vertebral, common iliac
Muscular or Distributing arteries
- medium sized arteries; distribute blood to the body
- axillary, brachial, radial, intercostal, splenic, mesentaric, femoral, popliteal, tibial arteries
. - the junction of two or more vessels supplying the same body region,
an end to end union or joining
Collateral circulation
- the alternate blood flow of an anastamosis to an area

Arterioles
- small arteries that deliver blood to capillaries
- tunics change to a layer of endothelium and a few smooth muscle fibers
- can vasodialate and vasoconstrict
Capillaries
- a single layer of endothelium (a true capillary )
- their primary function is the exchange of gasses and nutrients
* many - muscles, liver, kidneys, lungs, nervous system
* few - tendons, ligaments
* none - cornea, cartilage
- there is a very large surface area for exchange of nutrients and gasses
- a small arteriole which goes from an arteriole to a venule
- controls the blood flow to capillaries
capillaries
- meander, don't go straight from an arteriole to a venule
capillaries - have no pores
capillaries - have pores for proteins and fluids to pass through
- examples: choroid plexes of the brain and eye
- small blood vessels (larger than capillaries), found in the liver, spleen,
parathyroid and adenohypophysis
- lined with phagocytic cells

- convey blood from arterioles to venules

- from capillaries to form small veins
*
*
*
*
*

- carry blood toward the heart

contain valves to keep the blood flowing toward the heart
collapse when cut
composed mostly of fibrous tissue
blood pressure is low
and
aid venous blood flow

Pulse -

force to the pressure in arteries caused by the ventricles contracting

approx.
to
per minute
all arteries have a pulse
temporal, carotid, facial, brachial, tibial, radial

Blood pressure - the amount of

on the walls of your arteries

- a measurement of the force of the blood being pumped by the lt. ventricle
- the recoil pressure
- the ventricle is in a relaxed state
- a measurement of the resistance pressure in the vessel
- Arteriosclerotic plaque materials in the vessels will increase the diastolic pressure
- is the difference between systolic and diastolic presure
- veins which have lost their elasticity due to weak valves
- blood pools and fluid collects in the surrounding tissues
- deeper veins are aided by
and don't varicose
- varicose veins of the walls of the anal canal
Arterial blood pressure is affected by:
1) Cardiac output - the amount of blood pumped by the left ventricle per minute
* an increase in stroke volume or heart rate will increase the blood pressure
2)

.
* a decrease in blood volume will lower blood pressure
* high salt intake results in high water retention and an increased blood pressure

3)

- the resistance to blood flow

* viscosity - thickness, more friction
* diameter of the blood vessels
* length of the blood vessels

Control of blood pressure

1) Vasomotor center - in medulla
2)

- in aorta and carotid sinus and vena cava

3) Chemoreceptors - in aorta and carotid sinus

4) Higher brain centers - control blood pressure by the emotional state
5) Chemicals - vasoconstriction

- vasodialation

Fetal Circulation
The
removes carbon dioxide and wastes from the fetal circulation. It also
allows oxygen and nutrients to pass from the mothers blood supply to the fetus by means of diffusion
across capillaries. The placenta is highly vascularized and is in close contact with the uterine walls.
Normally, there is not maternal and fetal blood mixing
Blood from the fetus is brought to the placenta by the
which are
branches of the internal iliac arteries. Oxygenation occurs at the placenta. Blood carrying oxygen
and nutrients returns to the fetus by way of the
.
The umbilical vein enters the liver and joins to the IVC as the
.
After birth, this vessel atrophies and becomes a fibrous cord called the round ligament. Oxygenated
and de-oxygenated blood mixes in the
.
This blood enters the right atrium. Since the lungs are not yet functioning to oxygenate the baby's
blood, the heart has a couple of modifications. In the septum between the right and left atria is a
hole, with a one way flap, called the
.
Blood is allowed to pass from the right atrium into the left atrium, but it can't return to the right atrium
due to the one-way flap. About 1/3rd of the blood entering the right atrium passes through this
opening and is sent to the systemic circulation. After birththis opening closes and becomes a shallow
depression called the Fossa Ovalis.
The other 2/3rds of this blood is sent into the pulmonary trunk but most of it passes through
the
a vessel which connects the pulmonary trunk to the aorta.
This shunts most of the blood away from the pulmonary circulation since the lungs are not yet
functional in the oxygenation of the baby's blood. After birth, this vessel atrophies and becomes
a fibrous cord, the
.
Other Key Terms
thrombus
embolism