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Transcript L6-circulation
Circulation: The Cardiovascular
and Lymphatic Systems
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Cardiovascular System
Cardiovascular system
Consists of heart and blood vessels
Encompasses blood circulation
Delivers oxygen and nutrients to cells
Carries away waste products
Lymphatic system
Drains fluid and proteins from tissues, returns
them to bloodstream
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Cardiovascular
System
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The Heart
Located between
lungs
Myocardium = thick
muscle layer
Endocardium =
inside lining
Epicardium =
Outside lining
Pericardium =
surrounding fibrous
sac
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Location of Heart
The heart is encased in and separated from the walls
of the pericardial cavity by three linings: the
epicardium, which forms the outer part of the heart;
the pericardial sac and the pericardium
The heart fits tightly inside the pericardial cavity, a
subcavity of the thoracic cavityu. The pericardial
cavity is lined with a serous ( thin) membrane called
the pericardium, and the heart is within yet a second
lining called the pericardial sac. This sac contains
about half an ounce of fluid, which lies between it
and the heart’s outer lining
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The structure of the heart
The membrane forming the outer lining of the heart
is called the epicardium
Immediately beneath the epicardium is the
myocardium, comprising the muscles, blood vessels
and nerve tissue that make up the bulk of the heart
The heart’s inner surface is called the endocardium
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Heart (cont’d)
Atrium
Upper receiving chambers
Atria are separated by interatrial septum (plural
septa)
Ventricle
Lower pumping chambers
Pulmonary circuit (right side to lungs)
Systemic circuit (left side to rest of body)
Ventricles are separated by interventricular septum
Also, each atrium is divided from each ventricle by
an atrioventricular septum, which contains various
valves
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Illustrated
Heart
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Heart valves
The right atrioventricular valve, also sometimes
called the tricuspid valve, leads from the right atrium
into the right ventricle
The pulmonary semilunar valve connects the right
ventricle to the lungs, which also connect to the left
ventricle through the left atrium by way of the left
atrioventricular valve, also sometimes called the
bicuspid ot mitral valve
The aortic semilunar valve leads out of the left
ventricle
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Blood Flow Through the Heart
When blood comes back to the heart after having
delivered oxygen and other nutrients to the body’s cells, it
needs to be replenished before going out again. It re-enters
the heart at the atrium
Right atrium receives blood from body
Enters right ventricle and is pumped to lungs
Oxygenated blood returns to left atrium
Enters left ventricle and is pumped to rest of body
One-way valves force blood flow forward
Heart sounds produced when valves close
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The Heartbeat
Systole = contraction (emptying the heart)
Diastole = relaxation ( refilling chambers)
Heart beats start with both atria contracting
Immediately thereafter both Ventricles contract
Wave of increased pressure in the vessels following
ventricular contraction is pulse
Contractions are stimulated by electrical impulse
Blood Pressure
Force of blood exerted against wall of blood vessel
Measured by sphygmomanometer
Measured as both systolic and diastolic, such as 120/80
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Pacemaker and conduction system of
the heart
Contractions are stimulated by a built-in system that
regularly transmits electrical impulses through the
heart
They include the sinoatrial (SA) node, called the
pacemaker because it sets the rate of the heart beat
The atriopventricular (AV) node, the AV bundle
(bundle of His) the left and right bundle branches
and Purkinje fibers
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Conduction System of the Heart
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Clinical Aspects of the
Circulatory System
Atherosclerosis
Accumulation of fatty deposits within artery
Risk factors:
High levels of lipoproteins (especially LDL’s)
Smoking
High blood pressure
Poor diet
Inactivity
Stress
Family history
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Thrombosis and Embolism
Definitions:
Thrombosis = formation of blood clot
Thrombus = blood clot
Embolism = blockage of blood vessel
Embolus = blockage mass
Blockage is usually blood clot
Blockage can also be air, fat, bacteria, or other solid
materials
Stroke = blockage in a cerebral vessel
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Aneurysm
Weakened arterial wall ballooning out
Caused by:
Atherosclerosis
Malformation
Injury
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Heart Diseases
Coronary artery disease
Results from atherosclerosis
Early sign is angina pectoris (chest pain)
Diagnosed by:
ECG
Stress tests
Coronary angiography
Echocardiography
Treatments:
Control of exercise, administration of nitroglycerin
Angioplasty (PTCA)
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Bypass (CABG)
Heart Diseases (con’t)
Myocardial infarction = heart attack
Symptoms:
Epigastric pain
Pain extending to jaw, arms
Pallor (turns pale)
Diaphoresis
Nausea
Dyspnea (difficulty breathing)
May also be burning sensation similar to
heartburn
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Heart Diseases (cont’d)
Arrhythmia
Irregularity of heart rhythm
Bradycardia = slower than average
Tachycardia = faster than average
Fibrillation = extremely rapid, ineffective
Controlled on Long term with pacemaker
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Heart Diseases (cont’d)
Heart failure
Heart fails to empty effectively, leading to
edema
Congenital heart disease
Birth defects
Most can be corrected surgically
Rheumatic heart disease
Streptococcus infection damaging heart valves
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The Vascular System
Arteries and arterioles
Carry blood away from heart
Vasoconstriction and vasodilatation
Become smaller as they go away from the heart?
Capillaries
Smallest vessels
Where exchange between blood and tissues
happens
Veins and venules
Carry blood back to heart
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Conducting arteries
Sometimes called elastic arteries and can have an
inside diameter as great as an inch
The aorta is an example of a conducting artery
The pulmonary artery and aortic trunk are examples
of conducting arteries which move blood away from
the heart
Three major conducting arteries branch from aortic
arch. They are the brachiocephalic trunk, the left
common carotid artery and the left subclavian artery
Both the right subclavian artery and the right
common carotid artery attach to the brachiocephalic
trunk
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Medium size arteries, ( also called muscular arteries
because they contain a lot of muscle tissue) typically have
an inside diameter of about a sixth of an inch (eg external
carotid artery)
Arterioles are the smallest arteries, with an average inside
diameter of 0.0018 of an inch or about 1/100 the size of a
medium size artery
Arteries and arterioles connect to the capillaries which can
be as tiny as one blood cell ( or about ¼ the size of an
arteriole in diameter)
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Principal
Arteries
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Veins
Veins carry blood back to the heart. They follow the same path
as the arteries ( with blood flowing in the reverse direction)
Also, like arteries, they vary in diameter, becoming larger as
they approach the heart because of the increasing volumes of
blood they must carry
The vein counterparts of the conducting arteries are the superior
vena cava and the inferior vena cava. Together they are known as
the venae cavae
Medium veins and venules are the counterparts of the muscular
arteries and arterioles
Superior vena cava drains blood from upper body, including
head neck shoulders and arms
Inferior vena cava receives blood from the lower body, the
dividing line being the diaphragm
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Principal
Veins
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Disorders of the Veins
Varicose veins
Breakdown
in valves with chronic dilatation
Contributing factors:
Heredity
Obesity
Prolonged standing
Pregnancy
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Disorders of the Veins (con’t)
Phlebitis = inflammation of veins
Causes:
Infection
Injury
Poor circulation
Valve damage
Can result in thrombophlebitis (blood clot)
Most damaging if occurring deep
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Hypertension
Commonly known as high blood pressure
Contributing factor in many conditions
Defined as systolic > 140, diastolic > 90
Causes left ventricle to enlarge
First defense: diet and life habits
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Blood and Immunity
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Blood Plasma
90% water
Rest contains:
Nutrients
Electrolytes (dissolved salts)
Gases
Albumin (protein)
Clotting factors
Antibodies
Wastes
Enzymes
Hormones
Relative acidity (pH) steady at 7.4
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Blood Cells
Produced in red bone
marrow
Three kinds:
Red =
erythrocytes
White =
leukocytes
Platelets =
thrombocytes
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Erythrocytes
Main function: carry oxygen to cells
Most numerous of blood cells
Short lifespan (120 days) requires constant replacement
Production regulated by erythropoietin (hormone made in
kidneys)
Leukocytes Protect against foreign substances
Five different types:
Neutrophils
Eosinophils
Basophils
Lymphocytes
Monocytes
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Leukocytes
Phagocytes are often the first immune system cells on the scene
when injury occurs. They prevent infection by cleaning away
pathogens and debris
Phagocytes are two types: microphages and macrophages
The average human body contains one trillion lymphocytes
which include NK cells, T cells and B cells
T cells make up about 80% of the total number of lymphocytes
T lymphocytes depend on the thymus for their activation
T lymphocytes are prompted by a specific antigen; a substance
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that induces sensitivity
Leukocytes
Antigens also stimulate the immune system to generate
antibodies, which can produce immunity from future attacks
by the same type of antigen
Unlike NK cells which roam the body looking for intruders, T
cells attack only when they recognize a specific antigen, and
then only after receiving instructions from special T cells that
distinguish between good and bad antigens
B lymphocytes are derived from bone marrow. Like NK cells,
they roam the body looking for intruders
But unlike NK cells, they stop in lymph tissue to seek out
foreign antigens
However they do not attack until the special T cells instruct
them to do so
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Platelets
Important for hemostasis
Most active during coagulation
Stick together to plug injury site
Interact with clotting factors in plasma to make
wound-sealing clot
Convert fibrinogen to threads of fibrin
Threads of fibrin trap blood cells and plasma to make
clot
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Blood Types
Determined by genetically inherited proteins
Most familiar groups are ABO and Rh
Important to match for blood transfusions
Compatible types determined by cross-matching
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TEST
ABBREVIATION
DESCRIPTION
Differential count
Diff
Relative % of the different
types of leukocytes
hematocrit
Ht, Hct, crit
Relative % of packed red
cells in a given volume of
blood
Packed cell volume
PCV
hematocrit
Mean corpuscular volume
MCV
Volume of an average red
cell
Mean corpuscular
hemoglobin
MCH
Average weight of
hemoglobin in red cell
Mean corpuscular
hemoglobin concentration
MCHC
Average concentration of
hemoglobin in red cell
Erythrocyte sedimentation
rate
ESR
Rate of setting of
erythrocytes per unit of
time, used to detect
infection or inflammation
complete blood count
CBC
Series of tests including cell
counts, hematocrit,
hemoglobin, and cell 47
volume measurements
The Immune System
Launches specific attacks on disease organisms
Involves components of lymphatic system and blood
Immune system response from T cells or B cells
T cells mature in thymus gland
B cells mature in lymphoid gland
Passive immunity: Transfer of antibodies
Naturally (mother’s milk)
Artificially (immune serum)
Active immunity: Individual’s own response to disease
organism
Natural contact
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Vaccine
Clinical Aspects: Blood
Anemia
Decrease in hemoglobin in blood
Can result from:
Too few red blood cells
Cells are too small
Too little hemoglobin
Key tests involve blood counts
Symptoms include fatigue, shortness of breath
Aplastic anemia = destruction of bone marrow
Nutritional anemia (includes pernicious anemia) =
deficiency of vitamin B12
Sideroblastic anemia = body doesn’t use iron properly
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Hemorrhagic anemia = results from blood loss
Types of Anemia (con’t)
Thalassemia (includes Cooley anemia)
Hereditary disease causing rupture of red cells
Affects production of hemoglobin
Sickle cell anemia
Mutation alters hemoglobin molecule
Deformed cells block blood vessels and prevent
tissues from receiving oxygen
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Coagulation Disorders
Thrombocytopenia
Deficiency in number of platelets
Disseminated intravascular coagulation
Widespread clotting, obstructing circulation to
tissues
Hemophilia
Hereditary deficiency of specific clotting factor
Sex-linked disease: Passed from mother to son
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Neoplasms
Leukemia
Rapidly dividing, but incompetent white blood cells
Causes unknown, but may include radiation,
heredity
Treatment includes:
Chemotherapy
Radiation therapy
Bone marrow transplantation
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Neoplasms (con’t)
Hodgkin disease
Disease of lymphatic system that may spread
Contains Reed-Sternberg cells (giant cells in lymph
nodes)
Non-hodgkin lymphoma
Also malignant enlargement of lymph nodes
More common, deadly than Hodgkin disease
Multiple myeloma
Cancer of blood-forming cells in bone marrow
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Clinical Aspects: Immunity
Hypersensitivity
Commonly known as allergy
More sensitive to allergens (pollen, dust)
Anaphylactic reaction
Severe generalized allergic response
Must be treated with epinephrine (adrenaline)
Delayed hypersensitivity reaction
Involves T cells and takes 12 hours for onset
(poison ivy)
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Clinical Aspects: Immunity (con’t)
Immunodeficiency
Any failure in immune system (AIDS)
Starts with HIV infection
Leaves individual susceptible to other infections
Autoimmune disorder
Immune response to own tissues
Cause may be:
Failure of immune system
Body cells altered by mutation or disease
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The Lymphatic System
Role in circulation: return excess fluid and proteins
from tissues back to bloodstream
Fluid known as lymph
Lower part and upper left side of body drains into
thoracic duct
Upper right side of body drains into right lymphatic
duct
Other roles:
Absorb digested fats
Protect body from impurities, microorganisms
Assist with immunity
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Lymphatic Disorders
Lymphadenitis = enlargement of lymph nodes
Lymphedema = tissue swelling
Lymphoma = neoplastic disease affecting white
blood cells
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Thymus
Located behind the sternum
Secretes thymosin, which help T cells develop
Spleen
It contains phagocytes, removes damaged red blood cells, and
recycles and stores reclaimed iron from others
Tonsils
Any collection of lymph tissue can be called a tonsil
include palatine, pharyngeal and lingual tonsils
Lymph nodes
They are structures of variable size that contain macrophages,
filtering out disease-causing antigens and other debris as the
lymph flows through them. These antigens are exposed to
lymphocytes to start immune response
Swollen glands reveal the presence of an infection or injury in
the area of swollen gland
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