MLS 038

Name of Professor | CHAP 7 (Circulatory System)

The thicker walls aid in the pumping of blood,

maintain normal blood pressure (BP), and give arteries the
Topic Outline:
● Blood vessels strength to resist the high pressure caused by the contraction
● Heart of the heart ventricles.
● Blood
● Coagulation/Hemostasis
● Disorders of the Circulatory System
● Diagnostic Tests

INTRODUCTION
The circulatory (cardiovascular) system consists of
the heart, blood vessels, and the blood. Blood is circulated
through the blood vessels by the heart to deliver oxygen and
nutrients to the cells and transport waste products to the
organs that remove them from the body.
BLOOD VESSELS
BLOOD VESSEL STRUCTURE

● Tunica externa: the outer layer composed of

connective tissue.
● Tunica media: the middle layer composed of smooth
muscle and elastic tissue.
● Tunica intima: the inner layer composed of a lining of
epithelial cells.
The space within a blood vessel through which the
blood flows is called a lumen.
ARTERIES
Are large thick-walled blood vessels that propel
oxygen-rich blood away from the heart to the capillaries.
● Arterioles - smaller thinner vessels
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 VEINS
Have thinner walls than arteries and carry
oxygen-poor blood, carbon dioxide, and other waste products
back to the heart. No gaseous exchange takes place in the
veins. The BP in the veins is very low. Have one-way valves to
keep blood flowing in one direction as the blood flows through
the veins by skeletal muscle contraction.
Leg veins have numerous valves to return the blood
to the heart against the force of gravity. Most blood tests are
performed on venous blood. Venipuncture is the procedure for
removing blood from a vein for analysis.

VENULES
Small veins that connect capillaries to
larger veins.
CAPILLARIES
● Smallest blood vessels.
● consist of a single layer of epithelial cells to allow
exchanges of oxygen, carbon dioxide, nutrients, and
waste products between the blood and tissue cells.
● The blood in capillaries is a mixture of arterial and
venous blood.
HEART
Hollow muscular organ located in the thoracic cavity
between the lungs and slightly to the left of the body midline
consists of two pumps to circulate blood throughout the
circulatory system. It is enclosed in a membranous sac called
the pericardium.

● Atrium - upper chamber

● Ventricle - collect blood and a lower chamber
The right side is the “pump” for the pulmonary
circulation, and the left side is the “pump” for systemic
circulation.

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 Valves located at the entrance and exit of each
ventricle prevent a backflow of blood and keep it flowing in one
direction.

*When the coronary arteries become obstructed, heart muscle

dies because of lack of oxygen, and a heart attack can occur.
CARDIAC CYCLE
*Both veins and ventricles have valves ● Contraction phase (systole)
*A heart murmur is an abnormal heart sound that occurs when ● Relaxation phase (diastole)
the valves close incorrectly. The electrical impulses of the cardiac cycle are
PATHWAY OF BLOOD THROUGH THE HEART essential to produce rhythmic contraction and relaxation of the
heart muscle.

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 ● The sinoatrial (SA) node, located in the upper right
atrium, is the pacemaker of the heart and initiates the
heartbeat.
● The atrioventricular (AV) node located in the lower
interatrial septum receives the electrical impulse and
both the right and left atria contract forcing blood to
the ventricles.
● The impulse passes to the AV bundle that separates
into right and left bundle branches.
● In the right and left bundle branches the impulse
travels to the Purkinje fibers covering the ventricles,
causing them to contract, forcing blood into the aorta In adults and children older than 3 years, the radial
and pulmonary artery. artery is usually the easiest to locate. If the patient’s pulse is
● The cycle starts again. irregular, it should always be counted for a full 60 seconds.
ELECTROCARDIOGRAM (ECG) BLOOD PRESSURE
The cardiac cycle is measured with an ECG by Pressure exerted by the blood on the walls of blood
placing electrodes connected to a recorder on the patient’s vessels during contraction and relaxation of the ventricles.
arms, legs, and chest. The systolic pressure is the higher of the two
numbers and indicates the BP during contraction of the
ventricles. The diastolic pressure is the lower number and is
the BP when the ventricles are relaxed.
● Sphygmomanometer - BP cuff
The BP cuff is inflated to restrict the blood flow in the
brachial artery and then slowly deflated until loud heart sounds
are heard with the stethoscope. The first heart sounds heard
represent the systolic pressure during contraction of the
ventricles and is the top number of a BP reading. The cuff
continues to be deflated until the sound is no longer heard.
Diastolic pressure during the relaxation of the
ventricles and is the bottom number of a BP reading. An
average BP for an adult is 120/80, representing a systolic
pressure of 120 mm Hg and a diastolic pressure of
80 mm Hg.
BLOOD
Blood, the body's main fluid for transporting nutrients,
waste products, gasses, and hormones through the circulatory
system. An average adult has a blood volume of 5 to 6 liters.
ECG measures the total time of one cardiac cycle and
● Plasma - liquid portion
the timing of the atrial and ventricular contractions and
● Formed elements - cellular portion
relaxation.
HEART RATE/PULSE RATE
The heart contracts approximately 60 to 80 times
per minute. The arterial pulse is a rhythmic recurring wave
that occurs through the arteries during normal pumping action
of the heart. The pulse is most easily detected by palpation
where an artery crosses over a bone or firm tissue.
Common pulse sites are;
● temporal
● carotid
● brachial
● radial arteries

Plasma comprises approximately 55% of the total

blood volume. It is a clear, straw-colored fluid that is about 91%
water and 9% dissolved substances. The formed elements
constitute approximately 45% of the total blood volume and

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include the erythrocytes (red blood cells [RBCs]), leukocytes
(white blood cells [WBCs]), and thrombocytes (platelets).
Blood cells are produced in the bone marrow, which is the
spongy material that fills the inside of the major bones of the
body.

A transfusion reaction may occur when a person

receives a different group of blood because a person’s natural
antibodies will destroy the donor RBCs that contain the antigen
specific for the antibodies.

ERYTHROCYTES
Anuclear biconcave disks that are approximately 7.2
microns in diameter. Erythrocytes contain the protein
hemoglobin to transport oxygen and carbon dioxide.
Hemoglobin consists of two parts, heme and globin. The
heme portion requires iron for its synthesis.
There are approximately 4.5 to 6.0 million
erythrocytes per microliter (µL) of blood. The normal lifespan
for an erythrocyte is 120 days. Macrophages in the liver and RH TYPE
spleen remove the old erythrocytes from the bloodstream and The presence or absence of the RBC antigen called
destroy them. The iron is reused in new cells. the Rh factor or D antigen determines whether a person
BLOOD GROUP AND TYPE is type Rh-positive or Rh-negative. Rh-negative people do not
● Group A blood - A antigen, anti-B antibodies in have natural antibodies to the Rh factor but will form antibodies
plasma if they receive Rh-positive blood. A second transfusion of
● Group B blood - B antigen, anti-A antibodies Rh-positive blood will cause a transfusion reaction.
● Group AB blood - A&B antigen, neither anti-A nor LEUKOCYTES (WBC)
anti-B antibodies Provide immunity to certain diseases by producing
● Group O blood - neither A&B antigen, anti-A & anti-B antibodies and destroying harmful pathogens by
antibodies phagocytosis. Leukocytes are produced in the bone marrow
Groups O and A are the most common, and group from a stem cell and develop in the thymus and bone marrow.
AB is the least common. Circulate in the peripheral blood for several hours and
then migrate to the tissues through the capillary walls. The
normal number of leukocytes for an adult is 4,500 to 11,000
per µL of blood.

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 When stained with Wright’s stain, the cells are BASOPHILS (0% TO 1%)
examined microscopically for granules in the cytoplasm, the
shape of the nucleus, and the size of the cell.
NEUTROPHILS (40% TO 60%)

Least common. The cytoplasm contains large

granules that stain purple-black and release histamine in the
inflammation process and heparin to prevent abnormal blood
clotting.
THROMBOCYTES
The most numerous leukocytes provide protection Are small, irregularly shaped disks formed from the
against infection through phagocytosis. Neutrophils are called cytoplasm of very large cells in the bone marrow called the
segmented or polymorphonuclear cells because the megakaryocytes. Life span of 9 to 12 days. The average
nucleus has several lobes. The number of neutrophils number of platelets is between 140,000 and 440,000 per µL of
increases in bacterial infections. blood. Platelets play a vital role in blood clotting in all stages of
LYMPHOCYTES (20% TO 40%) the coagulation mechanism.

Second most numerous leukocytes. Provide the body

with immune capability by means of B and T lymphocytes. COAGULATION/HEMOSTASIS
Has a large round purple nucleus with a rim of sky blue Hemostasis is the process of forming a blood clot to
cytoplasm. The number of lymphocytes increases in viral stop the leakage of blood when injury to a blood vessel occurs
infections. and lysing the clot when the injury has been repaired.
MONOCYTES (3% TO 8%) STAGE 1 (PRIMARY HEMOSTASIS)

Largest circulating leukocytes and act as powerful Blood vessels and platelets respond to an injury to a
phagocytes to digest foreign material. Has a fine blue-gray blood vessel. Platelets become sticky, clump together (platelet
appearance with vacuoles and a large, irregular nucleus. A aggregation), and adhere to the injured blood vessel wall
tissue monocyte is known as a macrophage. The number of (platelet adhesion) to form a temporary platelet plug to stop the
monocytes increase in intracellular infections and tuberculosis. bleeding.
EOSINOPHILS (1% TO 3%) STAGE 2 (SECONDARY HEMOSTASIS)

The granules in cytoplasm of eosinophils stain

red-orange, and the nucleus has only two lobes. Eosinophils
detoxify foreign proteins and increase in allergies, skin
infections, and parasitic infections.

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 Initiates the formation of fibrin strands to strengthen efficiently, causing fluid accumulation in the lungs and
the platelet plug by forming a fibrin clot. In the coagulation other tissues.
cascade, one factor becomes activated, which activates the ● Myocardial infarction (mi o KAR de al): Death
next factor in a specific sequence. (necrosis) of the heart muscle caused by a lack of
● Common pathway - two pathways, extrinsic and oxygen to the myocardium because of an occluded
intrinsic come together. coronary artery, commonly known as a heart attack.
STAGE 3 ● Pericarditis (per I kar DI tis): Inflammation of the
membrane surrounding the heart, the pericardium,
induced by bacteria, viruses, trauma, or malignancy.
● Rheumatic heart disease (roo MAT ik): An
autoimmune disorder affecting heart tissue following a
streptococcal infection.
DISORDERS OF THE BLOOD
● Anemia (a NE me a): A decrease in the number of
The last factor in the coagulation cascade (Factor erythrocytes or the amount of hemoglobin in the
XIII) stabilizes the fibrin clot. This produces retraction circulating blood.
(tightening) of the clot. ● Leukemia (loo KE me a): A marked increase in the
STAGE 4 number of WBCs in the bone marrow and circulating
blood; leukemias are named for the particular type of
leukocyte that is increased.
● Leukocytosis (LOO ko si TO sis): An abnormal
increase in the number of normal leukocytes in the
circulating blood, as seen in infections.
● Leukopenia (LOO ko PE ne a): A decrease below
normal values in the number of leukocytes, often
After the injury to the blood vessel has healed the caused by exposure to radiation or chemotherapy.
process of fibrinolysis degrades (breaks down) the fibrin clot ● Polycythemia (POL e si THE me a): A consistent
into fibrin degradation products (FDPs). increase in the number of erythrocytes and other
DISORDERS OF THE CIRCULATORY SYSTEM formed elements causing blood to have a viscous
DISORDERS OF THE BLOOD VESSELS consistency.
● Aneurysm (AN u rizm) - A bulge formed by a ● Thrombocytopenia (THROM bo SI to PE ne a): A
weakness in the wall of a blood vessel, usually an decrease in the number of circulating platelets,
artery, that can burst and cause severe hemorrhaging. frequently seen in patients receiving chemotherapy;
● Arteriosclerosis (ar TE re o skle RO sis) - Hardening spontaneous bleeding can result.
of the artery walls contributing to aneurysm or stroke. ● Thrombocytosis (THROM bo si TO sis): An increase
● Atherosclerosis (ATH er O skle RO sis): A form of in the number of circulating platelets.
arteriosclerosis characterized by the accumulation of DISORDERS OF THE COAGULATION SYSTEM
lipids and other materials in the walls of arteries ● Disseminated intravascular coagulation:
causing the lumen of the vessel to narrow and Spontaneous activation of the coagulation system by
stimulate clot formation. certain foreign substances entering the circulatory
● Embolism (EM bo lizm): A moving clot that can system.
obstruct a blood vessel. ● Hemophilia (HEM o FIL e a): A hereditary disorder
● Phlebitis (fle BI tis): Inflammation of the vein wall characterized by excessive bleeding because of the
causing pain and tenderness. lack of a coagulation cascade factor.
● Thrombosis (throm BO sis): Obstruction of a blood
vessel by a stationary blood clot.
● Varicose veins: Swollen peripheral veins caused by
damaged valves, allowing backflow of blood that
causes swelling (edema) in the tissues.
DISORDERS OF THE HEART
● Angina pectoris (an JI na): Sharp chest pain caused
by decreased blood flow to the heart, usually because
of an obstruction in the coronary arteries.
● Bacterial endocarditis (EN do kar DI tis):
Inflammation of the inner lining of the heart caused by
a bacterial infection.
● Congestive heart failure: Congestive heart failure
impairs the ability of the heart to pump blood
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