M2F: Cardiovascular System

Components of Cardiovascular and 2% other components, such cells change and become more
System as ions, nutrients, gases, waste like mature red blood cells
1. Blood products, and regulatory - In the later divisions, the newly
2. Heart substances formed cells manufacture large
3. Blood vessels 2. Formed elements amounts of hemoglobin
- living blood cells - After the final cell division, the
Blood
- include red blood cells, white cells lose their nuclei and become
- a fluid that transports oxygen and
blood cells, and platelets completely mature red blood cells.
nutrients to the cell
1. Stem cell
Hematopoiesis
Function of blood 2. Myeloid stem cell
- process that produces formed
1. Transport of gases, nutrients, 3. Proerythroblast
elements
and waste products, processed 4. Early erythroblast
- occurs in the red bone marrow
materials & regulatory molecules 5. Intermediate erythroblast
but some WBC are produced in
2. Regulation of pH and osmosis 6. Late erythroblast
lymohatic tissue for adults
3. Maintenance of body 7. Reticulocyte or nucleus
- occurs in several tissues,
temperature extruded
including the liver, thymus, spleen,
4. Protection against foreign 8. Erythrocyte
lymph nodes, and red bone
substances
marrow for fetus White Blood cells
5. Clot formation
- all formal elements are derived - spherical cells that lack
Physical characteristic of the from hemocytoblast hemoglobin
blood - make up the buffy coat, a thin,
Erythrocytes
1. Color range white layer of cells between
- or red blood cells
- varies from scarlet (oxygen-rich) plasma and red blood cells when
- disk-shaped, with edges that are
to a dull red or purple (oxygen- separated
thicker than the center of the cell
poor) - can leave the blood and travel by
- biconcave shape increases the
2. pH ameboid (like an ameba)
cell’s surface area compared to a
- slightly alkaline, with a pH movement through the tissues
flat disk of the same size
between 7.35 and 7.45. - functions are (1) to protect the
- Biconcave disk; no nucleus;
3. Blood volume body against invading
contains hemoglobin, which colors
- Blood accounts for approximately microorganisms and other
the cell red; 6.5–8.5 μm in
8 percent of body weight, and its pathogens and (2) to remove dead
diameter
volume in healthy adults is 5 to 6 cells and debris from the tissues
- main function: transport oxygen
liters, or about 6 quarts by phagocytosis
from the lungs to the various
4. Temperature
tissues of the body and to help Types of Leukocytes
- (38°C, or 100.4°F) is always
transport carbon dioxide from the 1. Granulocytes
slightly higher than body
tissues to the lungs - containing large cytoplasmic
temperature because of the friction
granules
produced as blood flows through Hemoglobin
- have lobed nuclei, which typically
the vessels - Each protein chain, called a
consist of several rounded nuclear
5. Viscosity globin (glō′bin), is bound to one
areas connected by thin strands of
- Blood is a sticky, opaque fluid heme (hēm), a red-pigmented
nuclear material
that is heavier than water and molecule containing iron
2. Neutrophils
about five times thicker, or more molecules.
- Nucleus with two to four lobes
viscous, largely because of its - Oxygen transport is
connected by thin filaments;
formed elements accomplished when oxygen enters
cytoplasmic granules stain a light
red blood cells and binds to
Components of blood pink or reddish purple; 10–12 μm
hemoglobin specifically at the
1. Plasma in diameter
heme proteim part
- a nonliving fluid matrix - Phagocytizes microorganisms
- a pale yellow fluid that consists of Life history of erythrocytes and other substances
about 91% water, 7% proteins, - After each cell division, the new 3. Eosinophil
 M2F: Cardiovascular System
- Nucleus often bilobed; megakaryocytes in an unbroken blood vessel
cytoplasmic granules stain orange- - Small fragments break off from 2. Embolus formation
red or bright red; 11–14 μm in the megakaryocytes and enter the - If a thrombus breaks away from
diameter blood as platelets the vessel wall and floats freely in
- Participates in inflammatory - play an important role in the bloodstream, it becomes an
response of allergic reactions and preventing blood loss embolus
asthma; attacks certain worm
Hemostasis Blood grouping
parasites
- starts when a blood vessel 1. ABO blood group
4. Basophil
breaks - 2 types of antigen appear in the
- Nucleus with two indistinct lobes;
- hem=blood, stasis= standing still; surface of the RBC namely type A
cytoplasmic granules stain blue-
stopping the bleeding and type B antigen which are
purple; 10–12 μm in diameter
- involves many substances genetically determined
- Releases histamine, which
normally present in plasma, as - type A blood has type A antigen
promotes inflammation, and
well as some that are released by - type B blood has type B antigen
heparin, which prevents clot
platelets and injured tissue cells - type AB blood has type A and B
formation
- phases: antigen
5. Agranulocytes
1. Vascular spasm occurs - type O has no antigen
- very small granules that cannot
- The spasms narrow the blood - transfusion reaction occurs when
be seen easily with the light
vessel, decreasing blood loss until blood is incompatible this is due to
microscope
clotting can occur type a have type B antibodies and
- nuclei are closer to the norm—
2. Platelet plug forms vice versa
that is, they are spherical, oval, or
- Platelets are repelled by an intact 2. RH blood group
kidney-shaped
endothelium, but when the - Rh-positive if they have certain
6. Lymphocytes
underlying collagen fibers of a Rh antigens on the surface of their
- Round nucleus; cytoplasm forms
broken vessel are exposed, the red blood cells
a thin ring around the nucleus; 6–
platelets become “sticky” and cling - Rh-negative if they do not have
14 μm in diameter
to the damaged site these Rh antigens
- Produces antibodies and other
3. Coagulation events occur. - ABO blood type and the Rh blood
chemicals responsible for
- injured tissues are release tissue type are usually expressed
destroying microorganisms;
factor (TF), which interacts with together
contributes to allergic reactions,
PF3 (platelet factor 3), a - Antibodies against the Rh
graft rejection, tumor control, and
phospholipid that coats the antigens do not develop unless an
regulation of immune system
surfaces of the platelets Rh-negative person is exposed to
7. Monocytes
- Clotting factors present in plasma Rh-positive red blood cells
- Nucleus round, kidney-shaped,
and released by injured tissue - If the Rh-negative person is
or horseshoe-shaped; contains
cells interact with Ca2+ to form unfortunate enough to receive a
more cytoplasm than does
thrombin, the enzyme that second transfusion of Rh-positive
lymphocyte; 12–20 μm in diameter
catalyzes joining of fibrinogen blood after becoming sensitized, a
- Phagocytic cell in the blood;
molecules in plasma to fibrin. transfusion reaction results.
leaves the blood and becomes a
- Fibrin forms a mesh that traps
macrophage, which phagocytizes Heart
red blood cells and platelets,
bacteria, dead cells, cell - contracts forcefully to pump
forming the clot
fragments, and other debris within blood through the blood vessels of
tissues Undesirable clotting the body
- A number of anticoagulants, the - pumps approximately 5 liters (L)
Platelets
most important of which are of blood per minute
- minute fragments of cells, each
aspirin, heparin, and warfarin, are
consisting of a small amount of Functions of the heart
used clinically for thrombus-prone
cytoplasm surrounded by a cell 1. Generating blood pressure
patients.
membrane 2. Routing blood
1. Thrombus formation
- produced in the red bone marrow 3. Ensuring one-way blood flow
- A clot that develops and persists
from large cells called 4. Regulating blood supply
 M2F: Cardiovascular System
Characteristics of the heart
1. Size
- generally decreases in size after
approximately age 65, especially
in people who are not physically
active
2. Form
- shaped like a blunt cone and is
approximately the size of a closed
fist
3. Location
- located in the thoracic cavity
between the two pleural cavities
that surround the lungs
Walls of the heart
1. Epicardium
- outermost
2. Myocardium
- consists of thick bundles of Chambers of the heart Great vessels of the heart
cardiac muscle twisted and 1. Left and right atria 1. Superior vena cava and inferior
whorled into ringlike arrangement - located at the base of the heart vena cava
3. Endocardium - where blood enters through the - receives oxygen-poor blood from
- innermost veins the veins of the body
- function primarily as reservoirs, 2. Pulmonary arteries
Pericardium where blood returning from veins - carry blood to the lungs, where
- a double serous membrane collects before it enters the oxygen is picked up and carbon
1. Fibrous pericardium ventricles dioxide is unloaded
- outer layer is tough, fibrous 2. Left and right ventricle 3. Pulmonary veins
connective tissue - extend from the base of the heart - Oxygen-rich blood drains from
2. Serous pericardium toward the apex the lungs and is returned to the left
- inner layer consists of flat side of the heart
epithelial cells with a thin layer of Heart Valves
4. Aorta
connective tissue 1. Atrioventricular (AV) valve
- Oxygen-rich blood returned to the
- composed of 2 parts: - located between each atrium and
left atrium flows into the left
(1) parietal pericardium ventricle
ventricle and is pumped out into
- part lining the fibrous pericardium - tricuspid valves: AV valve
the aorta
(2) visceral pericardium between the right atrium and the
- part covering the heart surface right ventricle has three cusps Route of blood flow through the
3. Pericardial cavity - bicuspid valve: AV valve between heart
- located between the visceral and the left atrium and the left ventricle
parietal pericardia, is filled with a has two cusps
thin layer of pericardial fluid 2. Semilunar valves
produced by the serous - located between each ventricle
pericardium and its associated great artery
- pulmonary semilunar valve:
Trace of blood supply of the located between the right ventricle
heart and the pulmonary trunk
- aortic semilunar valve: located
between the left ventricle and
aorta
1. Left ventricle
 M2F: Cardiovascular System
2. Arteries atria the heart, such as either nervous
3. Capillaries 2. Ventricular systole or chemical regulation
4. Tissues of the body - contraction of the two ventricles - Sympathetic simulation: more
3. Ventricular diastole strongly stimulate the SA and AV
Cardiac muscle cells
- refers to relaxation of the two nodes and the cardiac muscle
- electrically, cardiac muscle cells
ventricles itself
behave as a single unit
- Parasympathetic nerves:
- have intercalated disks that have Heart sounds
primarily vagus nerve fibers, slow
gap junction, single nucleated, 1. “lubb”
and steady the heart, giving it
elongated in structure - first sound
more time to rest during noncrisis
- has lower pitch than second
Conducting system of the heart times.
- occurs at the beginning of
1. Sinoatrial node - Hormones and ions: Various
ventricular systole and results from
- crescent-shaped node of tissue, hormones and ions can have a
closure of the AV valves
located at the right atrium dramatic effect on heart activity.
2. “dupp”
2. Atrioventricular node
- second sound Heart and Homeostasis
- junction of the atria and ventricles
- occurs at the beginning of 1. Baroreceptor Reflex
3. Right and left bundle branches
ventricular diastole and results - for nervous regulation
- located in the interventricular
from closure of the semilunar - mechanism of the nervous
septum
valves system that plays an important role
4. Purkinje fibers
3. Murmurs in regulating heart function
- spread within the myocardium of
- result of faulty valves - baroreceptors: stretch receptors
the ventricle walls
that monitor blood pressure in the
Mean Arterial blood pressure
Electrolcardiogram waves (ECG) aorta and in the wall of the internal
1. Cardiac output
1. P wave carotid arteries, which carry blood
- amount of blood pumped out by
- small and signals the to the brain
each side of the heart (actually
depolarization of the atria 2. Chemoreceptor reflex
each ventricle) in 1 minute.
immediately before they contract - for chemical receptor
2. Heart rate
2. QRS complex - respond to changes in blood
- number of times the heart
- results from the depolarization of concentrations of O2 and CO2, as
contracts each minute
the ventricles, has a complicated well as pH
3. Stroke volume
shape. It precedes the contraction - send action potentials along
- volume of blood pumped per
of the ventricles sensory nerve fibers to the
ventricle each time the heart
3. T waves medulla oblongata
contracts
- results from currents flowing
4. Peripheral resistance Extracellular Ion Concentration
during the repolarization of the
- Changes in the extracellular
ventricles Regulation of the heart
concentration of K+, Ca2+, and
4. Intervals 1. Intrinsic
Na+, which influence other
- PQ interval: because the Q wave - refers to mechanisms contained
electrically excitable tissues, also
is very small, atria contract and within the heart itself
affect cardiac muscle function
begin to relax at the end the - force of contraction produced by
- excess of extracellular K+ causes
ventricles begin to depolarize cardiac muscle is related to the
the heart rate and stroke volume to
- QT interval: extends from the degree of stretch of cardiac
decrease
beginning of the QRS complex to muscle fibers
- K+ concentration increases
the end of the T wave and - if venous return decreases,
further, normal conduction of
represents the length of time resulting in a decreased preload,
action potentials through cardiac
required for ventricular the cardiac output decreases.
muscle is blocked, and death can
depolarization and repolarization - Starling’s law of the heart:
result
relationship between preload and
Cardiac cycle - excess of extracellular Ca2+
stroke volume
1. Atrial systole causes the heart to contract
2. Extrinsic
- refers to contraction of the two arrhythmically
- refers to mechanisms external to
 M2F: Cardiovascular System
- Reduced extracellular Ca2+ 2. Exchanges nutrients - walls of medium-sized arteries
causes both the heart rate and 3. Transport substances are relatively thick compared to
stroke volume to decrease 4. Helps regulate blood pressure their diameter
5. Direct blood flow to the tissues - medium sized arteries supply
Effect of body temperature
blood to small arteries
- affects the metabolism in the Function of blood vessels
- small-sized arteries have smaller
heart just as it affects other tissues 1. Arteries
diameter and thinner walls (3/4
- Elevated body temperature - carry blood away from the heart;
layers) than medium-sized arteries
increases the heart rate, and usually, the blood is oxygenated
which are adapted for vasodilation
reduced body temperature slows (oxygen-rich).
and vasoconstriction
the heart rate - large, elastic, branched
- vasoconstriction: decreases
repeatedly
Effects of Aging on the heart blood vessel diameter and blood
- As the large arteries branch,
- Hypertrophy of the left ventricle flow
blood moves into successively
- Gradual reduction in arterial - vasodilation: increases blood
smaller and smaller arteries and
elasticity vessel diameter and blood flow
then into the arterioles
- Accumulation of lipids 3. Arterioles
2. Capillaries
- Increase in collagen fibers - transport blood from small
- where exchange of substances
- Increased pulmonary edema arteries to capillaries
such as O2, CO2, nutrients, and
- Decline of maximum heart rate - smallest arteries in which the
other waste products occurs
- Decrease in aerobic respiration three tunics can be identified
between the blood and the tissue
- tunica media of arterioles
Blood vessels fluid
consists of only one or two layers
1. Pulmonary vessel - have thinner walls than do
of circular smooth muscle cells
- which transport blood from the arteries
- adapted for vasodilation and
right ventricle of the heart through 3. Veins
vasoconstriction
the lungs and back to the left - carry blood toward the heart;
atrium usually, the blood is deoxygenated Types of Capillaries
2. Systemic vessel (oxygen-poor) 1. Continuous
- transport blood from the left - walls of veins are thinner and - have no perforations and allow
ventricle of the heart through all contain less elastic tissue and only small molecules to pass
parts of the body and back to the fewer smooth muscle cells through
right atrium compared to arteries - present in muscle, skin, fat, and
nerve tissue
Walls of Blood vessel Types of Arteries
2. Fenestrated
1. Tunica intima 1. Elastic arteries
- have small pores that allow small
- lines the lumen, or interior, of the - largest-diameter arteries and
molecules through and are located
vessels, is a thin layer of have the thickest walls
in the intestines, kidneys, and
endothelium (squamous epithelial - greater proportion of their walls is
endocrine glands.
cells) resting on a basement composed of elastic tissue, and a
3. Sinusoidal or discontinuous
membrane smaller proportion is smooth
- have large open pores—large
2. Tunica media muscle
enough to allow a blood cell
- the bulky middle layer, made up - stretch when the ventricles of the
through
mostly of smooth muscle and heart pump blood into them
- present in the bone marrow,
elastic fibers - recoil from this prevents blood
lymph nodes, and the spleen, and
3. Tunica externa pressure from falling rapidly and
are, in essence, the "leakiest" of
- the outermost tunic composed maintains blood flow while the
the capillaries.
largely of fibrous connective ventricles are relaxed
tissue, and its function is to - ex. aorta and pulmonary trunk Types of Veins
support and protect the vessels 2. Muscular arteries 1. Venules and small veins
- include medium-sized (or - Venules have a diameter slightly
Functions of blood vessels distributing arteries) and small larger than that of capillaries and
1. Carries blood arteries are composed of endothelium
 M2F: Cardiovascular System
resting on a delicate connective - occurs when the blood vessels 3. descending aorta
tissue layer that carry oxygen and nutrients - longest part of the aorta that
- Small veins are slightly larger in from your heart to the rest of your extends through the thorax and
diameter than venules, with all 3 body (arteries) become thick and abdomen to the upper margin of
tunics present stiff — sometimes restricting blood the pelvis
2. Medium-sized and large veins flow to your organs and tissues - thoracic aorta: descending aorta
- Medium-sized veins collect blood that extends through the thorax to
Systemic circulation of Arteries
from small veins and deliver it to the diaphragm
- system of blood vessels that
large veins with all 3 tunic are - abdominal aorta: descending
carries blood from the left ventricle
distinctively present which make aorta that extends from the
of the heart to the tissues of the
up the wall of both medium and diaphragm to the point at which it
body and back to the right atrium
large veins divides into the two common iliac
3. Portal veins arteries
- a blood vessel that Arteries of the head and
carries blood from the neck
gastrointestinal tract, 1. Brachiocephalic artery
gallbladder, pancreas and - vessel to the arm and
spleen to the liver head
- This blood contains - first branch off the aortic
nutrients and toxins arch
extracted from digested - splits into the R. common
contents. carotid artery to R.
4. Valves subclavian artery
- veins that have 2. Right common carotid
diameters greater than 2 artery
mm - branches at the level of
- ensure that blood flows the clavicle
toward the heart but not - transports blood to the
in the opposite direction right side of the head and
5. Vasa vasorum neck
- network of small blood 3. Right subclavian artery
vessels that supply the - subclavian: beneath the
walls of large blood clavicle
vessels, such as elastic Arteries of the Upper
arteries (e.g., the aorta) limbs
and large veins (e.g., the 1. Left common carotid
venae cavae) artery
- “vessel of vessel” - second branch off the
aortic arch
Neural innervation of blood
- divides, forming the L. internal
vessel Aorta
carotid and L. external carotid
1. ascending aorta
Aging of the Arteries 2. Left subclavian artery
- part of the aorta that passes
1. Atherosclerosis - branches to vertebral artery part
superiorly from the left ventricle
- refers to the buildup of fats, of the brain, to axillary artery in
2. aortic arch
cholesterol and other substances axilla, to brachial artery in arms, to
- aorta arches posteriorly and to
in and on your artery walls radial artery in radius, and to ulnar
the left which carry blood to the
(plaque), which can restrict blood artery in ulna
head and upper limbs, originate
flow Thoracic aorta and its branches
from the aortic arch: the
- plaque can burst, triggering a 1. Visceral arteries
brachiocephalic artery, left
blood clot - supply the thoracic organs
common carotid artery, and left
2. Arteriosclerosis - branches of the thoracic aorta
subclavian artery
 M2F: Cardiovascular System
supply the esophagus, the - visceral branches of int. iliac Systemic Circulation of veins
trachea, the parietal pericardium, artery supply
and part of the lung organs such as
2. Parietal arteries the urinary
- supply the thoracic wall bladder, rectum,
- major parietal arteries: uterus, and
(1) Posterior arteries- from the vagina
thoracic aorta and extend between - parietal
the ribs branches supply
(2) Superior phrenic arteries- blood to the
supplies the diaphragm walls and floor of
(3) Internal thoracic arteries- the pelvis; the
branches of the subclavian arteries lumbar, gluteal,
(4) Anterior intercostal arteries- and proximal
extend between the ribs to supply thigh muscles;
the anterior chest wall and the external
Abdominal aorta and its genitalia
branches Arteries of the
- 3 unpaired branches lower limbs
1. Celiac trunk- supplies blood to 1. Femoral
the stomach, pancreas, spleen, artery
upper duodenum, and liver - previously
2. Superior mesenteric artery- external iliac
supplies blood to the small artery
intestine and the upper portion of 2. Popliteal
the large intestine artery
3. Inferior mesenteric artery- - extended
supplies blood to the remainder of femoral artery
the large intestine down the thigh which is the
- 3 paired visceral branches: posterior region of the knee Major veins
1. Renal artery- supplies the 3. Anterior and posterior tibial 1. Superior vena cava- returns
kidney artery blood from the head, neck, thorax,
2. Suprarenal artery- supplies the - popliteal artery which branched and upper limbs to the right atrium
adrenal gland slightly inferior to the knee of the heart
3. Testicular arteries- supply the - both of which give rise to arteries 2. Inferior vena cava- returns blood
testes in males | Ovarian arteries- that supply blood to the leg and from the abdomen, pelvis, and
supply the ovaries in females foot lower limbs to the right atrium
- parietal branches: 4. Dorsalis pedis artery Veins of the head and neck
1. Inferior phrenic arteries- - extended anterior tibial artery at 1. External jugular vein- are the
supplies the diaphragm the ankle more superficial of the two sets.
5. Fibular/ Peroneal artery which carry blood from the
2. Lumbar arteries- supply the posterior head and neck, emptying
- extended posterior tibial artery
lumbar vertebrae and back primarily into the subclavian veins
which the lateral leg and foot.
muscles 2. Internal jugular artery- much
3. Median sacral artery- supplies larger and deeper which carry
the inferior vertebrae blood from the brain and the
Arteries of the pelvis anterior head, face, and neck
- 2 common iliac arteries: 3. Subclavian vein- extended
1. External iliac artery- enters a internal jugular vein
lower limb 4. Brachiocephalic vein- extended
2. Internal iliac artery- supplies the subclavian vein
pelvic area 5. Superior vena cava- joined
 M2F: Cardiovascular System
brachiocephalic vein (korotkoff sound heard as pressure
Veins of the upper limbs is increase) and diastolic (pressure
1. Brachial veins at which no sound is heard)
2. Cephalic vein - can be felt at locations where
3. Basilic vein which becomes the large arteries are close to the
axillary vein surface of the body
4. Medium cubital vein- connects
General nursing care of the
the cephalic vein or its tributaries
Cardiovascular system
with the basilic vein, varies in size
- Monitor blood pressure level
5. Cubital fossa- anterior surface
- Encourage regular exercise
of the upper limb at the level of the
- Avoid smoking
elbow often used as a site for
- Promote a low cholesterol and
drawing blood
low fat diet
Veins of the thorax
1. R and L brachocephalic veins
2. Azygos vein
3. Anterior intercostal vein- where
blood returns from the anterior
thoracic wall
4. Internal thoracic veins- empty
into the brachiocephalic veins
5. Posterior intercostal veins-
empty into the azygos vein on the
right
6. Accessory Hemizygous/
Hemiazygous vein- empty into the
azygos vein, which empties into
the superior vena cava
Veins of the abdomen and
pelvis
1. Ascending lumbar veins- where
blood from the posterior abdominal
wall returns toward the heart
2. Internal iliac veins- return blood
from the pelvis
3. External iliac veins- found in the
lower limbs
4. Common iliac veins- forms the
inferior vena cava
Blood pressure
- measure of the force blood exerts
against the blood vessel walls
Blood viscosity
- the measurement of the
stickiness of blood
- directly measure of the ability of
blood to flow through blood
vessels
Pulse pressure
- difference between systolic