Circulatory System Reviewer PDF

CIRCULATORY SYSTEM REVIEWER THE BLOOD oxygen and help transport carbon dioxide Blood 2. Leukocytes (WBC) - 4000 - 11,000 - The only fluid tissue in the huma...

CIRCULATORY SYSTEM REVIEWER THE BLOOD oxygen and help transport carbon dioxide Blood 2. Leukocytes (WBC) - 4000 - 11,000 - The only fluid tissue in the human per sample(mm^3), defense and body immunity and is a mix of - Classified as a connective tissue: lymphocytes and monocytes Living cells = formed 3. Platelets (thrombocytes) - 250,000 elements (RBC, WBC, to 500,000 per sample(mm^3), blood Platelets) clotting Non-living matrix = plasma Physical Characteristics of Blood WHEN GETTING A BLOOD SAMPLE: 1. Color Orange Plasma (55%) Oxygen rich blood is scarlet 1. Water - solvent for carrying other red substances; absorbs heat. Plasma is Oxygen poor blood is dull red made of 90% water. 2. pH must remain between 2. Electrolytes: 7.35 (acidosis) - 7.45 (alkalosis) Sodium - osmotic balance 3. Blood temperature is slightly higher Potassium - pH buffering than body temperature Calcium - regulation of membrane Photomicrograph of a Blood Smear Magnesium - regulation of membrane Chloride - permeability Bicarbonate 3. Plasma Proteins Albumin - osmotic balance and pH buffering Fibrinogen - clotting of blood Globulin - Defense or antibodies and lipid transport RBC - donut shape because they lack 4. Substances transported by blood nucleus in the center, bi-concave, Rouleaux plasma: formation of the RBC. Nutrients - glucose, fatty acids, amino acids, vitamins WBC - hypersegmented or multi globular Waste products of (neutrophils), very huge nucleus metabolism - urea, uric acid (lymphocytes), Respiratory gasses - Oxygen and Carbon Dioxide Platelets - not considered cells because Hormones they lack the common characteristics of Formed Elements (cells) 45% cells, only called as cell fragments 1. Erythrocytes (RBC) - 4 to 6 million per sample(mm^3). Transports  CIRCULATORY SYSTEM REVIEWER Characteristics of Formed Elements of shaped nucleus with constrictions, the Blood stains dark blue - Granules contains histamine 1. Erythrocytes (vasodilator chemical) which is Outnumbers the WBC discharged at sites of inflammation (1000 RBC : 1 WBC) salmon-colored biconcave Agranulocytes of Leukocytes: discs, anucleate; literally sacs of hemoglobin (iron Lymphocytes binding protein); most - 1500 to 3000 (20-45% of WBC) organelles have been - Cytoplasm pale blue and appears as ejected. thin rim around nucleus; spherical Transport oxygen, bound to (or slightly indented) dark hemoglobin molecules; also purple-blue nucleus transport small amount of - Part of immune system; one group carbon dioxide (B lymphocytes) produces 2. Leukocytes antibodies; other group (T lymphocytes) involved in graft Granulocytes of Leukocytes: rejection fighting tumors and viruses, and activating B lymphocytes Neutrophils Monocytes - 3000 to 7000 (40% to 70% of WBC) - 100 to 700 (4-8% of WBC) - Cytoplasm stains pale pink and - Abundant gray-blue cytoplasm; dark contains fine granules, which are blue-purple nucleus often kidney difficult to see; deep purple nucleus shaped consists of 3 to 7 lobes connected - Active phagocytes that become by thin strands of nucleoplasm macrophages in the tissues; long - Active phagocytes; number term “clean up team” increase in increases rapidly during short term number during chronic infections or acute infections such as tuberculosis Eosinophils - 100 to 400 (1-4% of WBC) 3. Platelets - Red coarse cytoplasmic granules, - Essentially irregular shaped figure 8, or bilobed nucleus stains cell fragments; stain deep blue-red purple - Kills parasitic worms: increase - Needed for normal blood during allergy attacks; might clotting; initiate clotting phagocyte antigen-antibody cascade by clinging to complexes and inactivate some broken area; help to control inflammatory chemicals blood loss from broken blood Basophils vessels - 20 to 50 (0-1% of WBC) - Cytoplasm has a few large blue-purple granules; U- or S-  CIRCULATORY SYSTEM REVIEWER Thrombocytosis - inc plt Hemoglobin count, may develop - Iron containing protein thrombus or embolus - Binds strongly, but reversibly, to CREATION OF BLOOD CELLS oxygen - Each hemoglobin has 4 oxygen Hematopoiesis binding sites - Blood cell formation - Each erythrocyte has 250 million - Occurs in red bone marrow hemoglobin molecules - All blood cells are derived from a Leukocytes (WBC) common stem cell called - Crucial in the body’s defense against hemocytoblast disease - Hemocytoblast differentiation: - These are complete cells, with Lymphoid Stem Cell - nucleus and organelles produces lymphocytes - Able to move into and out of blood Myeloid stem cell - produces vessels (diapedesis) other formed elements - Can move by ameboid motion except lymphocyte - Can respond to chemicals released by damaged tissues (positive Fate of Erythrocyte chemotaxis) - Unable to divide, grow, or synthesize proteins LEUKOCYTES LEVELS IN BLOOD - Wear out in 100 to 120 days - Normal levels are between 4000 and - When worn out, are eliminated by 11000 cells per millimeter phagocytes in the spleen or liver - Abnormal leukocyte levels: - Lost cells are replaced by division of Leukocytosis - above hemocytoblasts 11000/ml, generally indicates an infection. Control of Erythrocyte Production Leukopenia - abnormally low - Rate is controlled by a hormone leukocyte level, commonly (erythropoietin) caused by certain drugs. - Kidneys produce most erythropoietin During intake of as a response to reduced oxygen immunosuppressive agents. levels in the blood, especially when Platelets patient have anemia - Derived from ruptured - Homeostasis is maintained by multinucleated cells negative feedback from blood (megakaryocytes) oxygen levels - Needed for clotting process HOMEOSTASIS - Normal platelet count = - Stoppage of blood flow 300,000/mm^3 (150 - 450) - Result of a break in a blood vessel Thrombocytopenia - dec plt - Homeostasis involves 3 phases: count, has tendency to bleed Platelet plug formation Vascular spasms Coagulation  CIRCULATORY SYSTEM REVIEWER Can be deadly in areas like the heart Platelet Plug Formation b. Embolus a. Collagen fibers are exposed by a A thrombus that breaks away break in a blood vessel and floats freely in the b. Platelets become sticky and cling to bloodstream fibers Can later clog vessels in c. Anchored platelets release critical areas such as the chemicals to attract more platelets brain d. Platelets pile up to form a platelet Bleeding Disorders plug a. Thrombocytopenia Vascular Spasms - Platelet deficiency a. Anchored platelets release serotonin - Even normal movements can b. Serotonin causes blood vessel cause bleeding from small muscles to spasm blood vessels that require c. Spasms narrow the blood vessel platelets for clotting decreasing blood loss b. hemophilia Coagulation - Hereditary bleeding disorder a. Injured tissues release - Normal clotting factor are thromboplastin missing b. PF3 (a phospholipid) interacts with Blood Groups and Transfusions thromboplastin, blood protein clotting a. Large losses of blood have serious factors and calcium ions to trigger a consequences clotting cascade - Loss of 15 to 30% causes c. Prothrombin activator converts weakness prothrombin to thrombin (an - Loss of over 30% causes enzyme) shock which can be fatal d. Thrombin join fibrinogen proteins b. Transfusion are the only way to into hair like fibrin replace blood quickly e. Fibrin forms a meshwork (basis for a c. Transfused blood must be of the clot) marks the end of a blood same blood group clotting process Blood Clotting - Blood usually clots within 3 to 6 minutes - The clot remains as endothelium regenerates - The clot is broken down after tissue is repaired Undesirable Clotting a. thrombus A clot in an unbroken blood vessel  CIRCULATORY SYSTEM REVIEWER Human Blood Groups Rh Dangers during Pregnancy a. Blood contains genetically a. Problems can occur in mixing Rh+ determined proteins blood in a body with Rh - blood b. A foreign protein (antigen) may be b. Danger is only when the mother is attacked by the immune system Rh - and the father is Rh + and the c. Blood is “typed” by using antibodies child inherits the Rh+ factor that will cause blood with certain c. The mismatch of an Rh - mother proteins to clump (agglutination) carrying an Rh+ baby can cause - Antigens are found on the problems for the unborn child red cell surface - The first pregnancy usually - Antibodies are in the plasma proceed without problems d. There are over 40 common red - The immune system is blood cell antigens/agglutinogens sensitized after the first e. The most vigorous transfusion pregnancy reactions are caused by ABO and - In a second pregnancy, the Rh blood group mother’s immune system antigens/agglutinogens produces antibodies/agglutinins to ABO Blood Groups attack the Rh+ blood a. Based on the presence or absence (hemolytic disease of the of 2 antigens/agglutinogens newborn or erythroblastosis Type A fetalis) Type B Blood Typing Type AB a. Blood samples are mixed with anti-A b. The lack of these and anti-B serum antigens/agglutinogens is called b. Coagulation or no coagulation leads type O to determining blood type c. The presence of both A and B is c. Typing for ABO and Rh factors is called type AB done in the same manner d. The presence of either A or B is d. Cross Matching - testing for called Types A and B, respectively agglutination of donor RBCs by the recipient’s serum and vice versa RH Blood Groups a. Named because of the presence or absence of one of 8 Rh antigens (agglutinogen D) b. Most americans are Rh+ c. Rh positive has the D antigen on the red cells (Rh+) d. Rh negative lacks the F antigen on the red cells (Rh-)  CIRCULATORY SYSTEM REVIEWER a. Blood Type O = most common ABO type; universal donor; exclusive recipient can only receive blood type O during transfusion b. Blood type AB = least common ABO type; universal recipient; exclusive donor can receive blood type ABO Genotypes a. Blood type A = AA;AO b. Blood type B = BB;BO c. Blood type AB = AB d. Blood type O = OO O allele = recessive A and B alleles = codominant  CIRCULATORY SYSTEM REVIEWER EXTERNAL HEART ANATOMY THE BLOOD HEART AND BLOOD VESSELS Cardiovascular System - A closed system of the heart and blood vessels The heart pumps blood Blood vessels allow blood to circulate to all parts of the body - The function of the cardiovascular The Heart Chambers system is to deliver oxygen and a. Right and Left side act as separate nutrients (glucose, amino acids, and pumps fatty acids) and to remove carbon b. 4 Chambers: dioxide and other waste products 1. 2 Atria Location of the Heart - Receiving Chamber - Thorax in between the lungs of Deoxygenated - Pointed apex directed towards the blood left hip or 5th left ICS MCL - Atria is separated by - Base is along the 2nd rib a septum (interatrial Heart Coverings septum) a. Pericardium - double serous - Right and Left Atrium membrane 2. 2 Ventricles Visceral Pericardium - next to - Discharging the heart chambers of Parietal Pericardium - oxygenated blood outside layer - Ventricles are b. Serous fluid fills the space between separated by a the layers of pericardium septum Heart Wall (interventricular a. Epicardium septum) - Outside layer - Right and Left - Thislayer is the visceral Ventricle pericardium The Heart Valves - Connective tissue layer a. Allow blood to flow in only one b. Myocardium direction across the different - Middle layer chambers of the heart - Mostly cardiac muscle b. 4 Valves: c. endocardium 1. 2 Atrioventricular Valves - Inner layer - Bicuspid valve or - endothelium Mitral valve (left)  CIRCULATORY SYSTEM REVIEWER - Tricuspid valve (right) 1. Pulmonary Circulation 2. 2 Semilunar valves - between ventricle and artery Pulmonary circulation is responsible for - Pulmonary Semilunar transporting deoxygenated blood from the Valve heart to the lungs for oxygenation and then - Aortic Semilunar back to the heart. Here's how it works: Valve Valves open as blood is pumped through, Deoxygenated Blood Flow: The and is held in place by chordae tendineae right ventricle of the heart pumps (heart strings) and it closes in order to deoxygenated blood into the prevent backflow. pulmonary arteries, which carry the blood to the lungs. The Heart: Associated Great Vessels Oxygenation in the Lungs: In the a. Aorta lungs, the blood releases carbon - Leaves left ventricle dioxide (a waste product) and picks b. Pulmonary arteries up oxygen. - Leave right ventricle Return to the Heart: The newly c. Vena cavae oxygenated blood returns to the - Enter right atrium heart via the pulmonary veins, - Deposits the deoxygenated which deliver it to the left atrium. blood d. Pulmonary veins (4) Pulmonary circulation ensures that blood - Enter left atrium gets reoxygenated and ready for systemic - Deposit oxygenated blood circulation. from the lungs 2. Systemic Circulation 2 Major Circulations in the Human Body Systemic circulation moves oxygenated a. Systemic Circulation blood from the heart to the rest of the body b. Pulmonary Circulation and returns deoxygenated blood back to the heart. Here's the process: Oxygenated Blood Flow: The left ventricle pumps oxygen-rich blood into the aorta, the largest artery in the body, which distributes the blood to smaller arteries and capillaries throughout the body. Nutrient and Gas Exchange: In the tissues and organs, the blood delivers oxygen and nutrients to cells and picks up waste products, including carbon dioxide. Return of Deoxygenated Blood: The deoxygenated blood returns to  CIRCULATORY SYSTEM REVIEWER the heart through the venae cavae - Bundle Branches (superior and inferior), which empty - Purkinje fibers into the right atrium. Heart Contraction This system maintains the body’s supply of oxygenated blood and removes metabolic waste, such as carbon dioxide. Filling of Heart Chambers - THe Cardiac Cycle a. Mid to late Diastole (Ventricular Filling or Relaxation) b. Ventricular Systole (atria in diastole) Coronary Circulation - called ventricular contraction a. Blood in the heart chambers does c. Early Diastole not nourish the myocardium b. The heart has its own nourishing circulatory system - Coronary arteries - Cardiac veins - Blood empties into the right atrium via the coronary sinus Heart COnduction System Cardiac Cycle a. Intrinsic Conduction System (Nodal Events of one complete heartbeat: System) Mid-to-late Diastole - blood flows - Heart muscle cells contract, into the ventricles without nerve impulses, in a Ventricular Systole - blood pressure regular continuous way builds before ventricle contracts, Special Tissue sets the pace: pushing out blood - Sinoatrial Node (SA Node) Early Diastole - atria finish re-filling, is the pacemaker ventricular pressure is low - Atrioventricular Node (AV NODE) known as autorhythmic cells - Atrioventricular bundle or bundle of His  CIRCULATORY SYSTEM REVIEWER Cardiac Output (CO) Blood Vessels: vascular system - Amount of blood pumped by each - Taking blood to the tissues and back side of the heart in one minute a. Arteries - CO = (heart rate X stroke volume) b. Arterioles Stroke Volume c. Capillaries - Volume of blood pumped by each d. Venules ventricle in one contraction e. Veins Difference of Artery and Vein a. Artery - Lumen size of artery is relatively smaller than the vein but more regular in shape - Arterial wall is thicker than the vein because of the thicker tunica media - Intraluminal pressure in the artery is higher compared to the vein Regulation of Heart Rate - Artery is deeper in location - Stroke volume usually remains b. Vein relatively constant - Vein is more collapsible than Starling’s law of the Heart - the artery due to the thin the more that the cardiac arterial wall muscle is stretched, the - Lumen size is larger stronger would be the compared to artery contraction - Lower intraluminal pressure - Changing heart rate is the most compared to artery common way to change cardiac - The thickest layer is the output tunica externa or adventitia Increased Heart Rate: Factors Anatomy of Blood Vessels Sympathetic Nervous System 3 layers (Tunics) - Crisis 1. Tunica Intima or Interna - Low blood pressure - Endothelium, simple Hormones squamous - Epinephrine 2. Tunica Media - Thyroxine - Smooth muscle Exercise - Controlled by Decreased Blood Volume sympathetic nervous system Decreased Heart Rate: Factors 3. Tunica Externa or Adventitia Parasympathetic Nervous System - Mostly fibrous High blood pressure or blood volume connective tissue Decrease venous return  CIRCULATORY SYSTEM REVIEWER Capillary - only has 1 layer of endothelium, 5. Movement is under the influence of serves as the site of diffusion of respiratory both the osmotic and blood gasses pressures Differences Between Blood Vessel Types Major Arteries of Systemic Circulation - Walls of arteries are the thickest 1. Arterial branches of the ascending specifically the AORTA aorta - Lumen of veins are larger - R and L coronary arteries - Skeletal muscle “milks” blood in 2. arterial branches of the aortic arch veins toward the heart - Brachiocephalic or - Walls of capillaries are only 1 cell innominate artery layer thick to allow for exchanges - L common carotid artery between blood and tissue - L subclavian artery Capillary Beds 3. Arterial branches of the thoracic Capillary beds consists of 2 types of aorta vessels: - Intercostal arteries (provides 1. Vascular Shunt blood supply to the - Directly connects an intercostal muscles attached arteriole to a venule to the rib cage) 2. True Capillaries - exchange - Bronchial arteries vessels - Esophageal arteries - Oxygen and nutrients - Phrenic arteries cross to cells 4. Arterial Branches of the Abdominal - Carbon dioxide and Aorta metabolic waste - Celiac trunk (L gastric artery, products cross into splenic artery, common blood, sphincters hepatic artery) open - SMA (Superior Mesenteric Capillary Exchange Artery in small intestines and - Substances are exchanged due to portion of large intestine) concentration gradients or - Renal arteries differences - Gonadal Arteries - Oxygen and nutrient leave the blood - Lumbar Arteries - Carbon dioxide and other wastes - IMA (Inferior Mesenteric leave the cells Arteries in the distal end of Capillary Exchange Mechanisms the colon) 1. Direct diffusion occurs across - Common iliac arteries plasma membranes (Exterminal branch, provides 2. Endocytosis or exocytosis blood supply for the muscles 3. By way of the intercellular clefts in the lower extremities, and (gaps) the Internal provides blood - Plasma membrane not joined supply in the organs in the by tight junctions pelvic cavity) 4. By way of the fenestrations (pores)  CIRCULATORY SYSTEM REVIEWER Major Veins of Systemic Circulation - R gonadal vein (L gonadal 1. Superior vena cava vein empties into the L renal - Drains the venous blood in vein) organs lying superior to the - Renal veins (drain kidneys) diaphragm - Hepatic portal vein (Most 2. Inferior Vena cava digestive organs) - Drains blood in the organs - Hepatic veins (liver) lying inferior to the Special Circulations of the Body: diaphragm 1. Intracranial Circulation 2. Hepatic Portal Circulation (DIgestive a. Veins draining into the SVC System) - Radial and ulnar veins into 3. Fetal Circulation the deep brachial vein and 4. Hypothalamus and Pituitary glands into the axillary vein 5. Renal Circulation - Cephalic vein (drains medial lateral aspect of arm) into the Arterial Supply of the Brain (Intracranial axillary vein Circulation) - Basilic vein (drains medial - Middle Cerebral Artery aspect of arms) into the - Circle of Willis (Anterior brachial vein communicating artery, Anterior - Basilic and cephalic veins cerebral artery, posterior and are joined by the Median anterior communicating artery, Cubital Vein posterior cerebral artery) - Subclavian vein - Basilar Artery - External jugular vein - Pons (drains skin and muscles of - Vertebral Artery the head) - Internal Carotid Artery - Vertebral vein (drains posterior part of the head) 1. ICA (Internal Carotid Artery) - Inter Jugular Vein (drains - Gives rise to anterior and dural sinuses of the brain) middle cerebral arteries - Brachiocephalic veins and supplies most of the receives venous drainage cerebrum from Subclavian, vertebral 2. Vertebral Arteries (Paired) and IJV; join to from SVC - Form the basilar artery - Azygos vein drains the supplies the brainstem and thorax cerebellum b. Veins draining into the IVC - Basilar arteries divides to - Anterior and posterior form posterior cerebral tibial veins and fibular vein arteries (posterior part of the (drain calf and foot) cerebrum) - Great saphenous veins 3. Circle of willis - Common iliac veins - Provides more than one route for blood to reach the  CIRCULATORY SYSTEM REVIEWER brain tissue in case of a clot or impaired blood flow Pulse Hepatic Portal Circulation - Pressure wave of the blood - Drain the digestive organs, spleen, - Monitored at “pressure points” where and pancreas, and delivers the pulse is easily palpated blood to the liver via the hepatic 9 Pulse Points portal vein 1. Temporal Artery - lateral aspect of - Liver is drained by the hepatic head veins that enter the IVC 2. Facial Artery - lateral to the - Inferior Mesenteric Vein (draining mandibular area part of the Large Intestine) drains 3. Carotid Artery - lateral aspect of the into the splenic vein (which drains neck, should not be palpated the spleen, pancreas, and left side of simultaneously because it might lead the stomach) to Bradycardia or slowing down of - Splenic Vein and Superior the heart rate Mesenteric Vein (drain the Small 4. Brachial Artery - antecubital area intestine and first part of the Large 5. Radial artery - lateral aspect or distal intestine) join to form the hepatic end of forearm portal vein 6. Femoral Artery - inguinal area - Left gastric vein (draining the right 7. Popliteal artery - back of the knee side of the stomach) drains directly 8. Posterior Tibial artery - medial into the hepatic portal vein aspect of leg 9. Dorsalis Pedis Artery - dorsal of foot Circulation to the Fetus Blood Pressure - Differ from adult circulation due to Measurements are made on the the presence of shants (ductus pressure in large arteries arteriosus and Foramen Ovale) a. Systolic - pressure at the - There is a placenta connected to the peak of ventricular umbilical vessels, 2 veins and 2 contraction arteries b. Diastolic - pressure when - There is also the Ductus Venosus ventricles relax which is not found in the adult Pressure in blood vessels decreases circulation as the distance away from the heart Remnants of the Fetal Circulation: increases 1. Foramen ovale - fossa ovalis 2. Ductus Arteriosus - ligamentum arteriosum 3. Ductus Venosus - ligamentum venosum 4. Umbilical vein - ligamentum teres 5. Umbilical arteries - umbilical ligaments  CIRCULATORY SYSTEM REVIEWER Formulas in getting Blood Pressure - Renin causes hormonal BP = CO x TPR control - Wherein CO is cardiac Temperature output; TPR is total - Heat has a vasodilating peripheral resistance effect BP = CO x SVR - Cold has a vasoconstricting - Where SVT is systemic effect vascular resistance) Chemicals SYSTOLIC PRESSURE Diet - P50 = age in years x 2 + 90 - P5 = age in years x 2 + 70 Diastolic pressure: - ⅔ of systolic pressure Comparison of Blood Pressures in DIfferent Vessels BloodPressure: Effects of Factors Neural Factors - Autonomic nervous system adjustments (sympathetic division) Renal Factors - Regulation by altering blood volume