Circulation
Circulation
Chapter 32
Cardiovascular disease (CVD) is the leading cause of untimely death in Western countries.
The risk of CVD can be reduced by following guidelines for a heart-healthy life-style.
1. Hypertension
a. An estimated 30% of Americans suffer from hypertension (high blood pressure).
b. Under the age of 45, a reading above 130/90 is hypertensive.
c. Beyond the age of 45, a reading above 140/95 is hypertensive.
d. The diastolic pressure is what is emphasized when medical treatment is considered.
2. Atherosclerosis
a. Hypertension is seen in individuals with atherosclerosis.
b. Soft masses of fatty materials, mostly cholesterol, accumulate beneath the inner linings of
arteries.
c. As this plaque accumulates, it protrudes into the vessel and interferes with blood flow.
d. Atherosclerosis develops in early adulthood but the symptoms may not appear until age 50
or older.
e. Plaque can cause a blood clot to form on irregular arterial walls.
f. As long as a clot remains stationary, it is a thrombus.
g. If a clot dislodges, it is an embolus, a blood clot that moves in the blood.
h. In some families, atherosclerosis is inherited as familial hypercholesterolemia.
3. Stroke and Heart Attack
a. Stroke, heart attack, and aneurysm are associated with hypertension and atherosclerosis.
b. A stroke can result in paralysis or death; a small cranial arteriole bursts or is blocked by an
embolus.
1) A stroke is also called a cardiovascular accident (CVA).
2) Whether paralysis or death occurs depends on the extent of the portion of the brain
that lacks O2.
3) Warning symptoms that foretell stroke include: numbness in hands or face, difficulty
speaking, blindness in one eye, etc.
c. A myocardial infarction (MI) is also called heart attack.
1) This occurs when a portion of the heart muscle dies due to a lack of O2; this may be
caused by a thromboembolism blocking a coronary artery.
2) A partially blocked coronary artery causes angina pectoris causing pains or a flash of
burning.
3) Nitroglycerin and related drugs dilate the blood vessels and relieve pain.
E. New Information About Preventing Cardiovascular Disease (Nature of Science reading)
1. Alcohol
a. The American Heart Association says that people who consume one or two alcoholic drinks
per day have a 30% to 50% reduction in cardiovascular diseases compared to non-drinkers.
2. Resvertrol
a. The “red wine effect” refers to the low levels of CVD in France despite a high fat diet.
b. One explanation may be that wine is often consumed during meals.
c. Red wine contains a high level of resvertrol, an antioxidant.
d. The benefits of resvertrol alone are questionable.
3. Omega-3 Fatty Acid
a. Saturated fat and trans fats should be replaced with monounsaturated fats and
polyunsaturated fats.
b. The American Heart Association recommends eating two servings of fish a week, especially
fish that are high in omega-3 fatty acids.
c. The omega-3 fatty acids have many benefits including:
1) Decreasing triglyceride levels
2) Slowing the growth rate of atherosclerotic plaque
3) Lowering blood pressure
32.4 Blood
1. The blood of mammals has two components: plasma and formed elements (cells and platelets).
A. Plasma
1. Plasma contains water and many types of molecules, including nutrients, wastes, salts, and
proteins.
2. Salts and proteins buffer the blood.
a. They effectively keep the blood pH near 7.4.
b. They maintain the blood osmotic pressure so water has a tendency to enter capillaries.
3. Some plasma proteins are involved in blood clotting.
4. Some plasma proteins assist in transporting large organic molecules in the blood.
a. Lipoproteins that transport cholesterol are globulins.
b. Albumin, a common plasma protein, transports bilirubin, a breakdown product of
hemoglobin.
B. Formed Elements
1. Formed elements are of three types: red blood cells (RBCs), white blood cells (WBCs), and
platelets.
2. Red Blood Cells
a. Red blood cells (erythrocytes) are small biconcave disks.
b. When mature, RBCs lack a nucleus and contain hemoglobin.
c. There are 6 million RBCs per mm3 of whole blood.
d. Each RBC contains about 250 million hemoglobin molecules.
1) Hemoglobin contains four globin protein chains, each with an iron-containing heme
group.
2) The iron atom of a heme group loosely binds with an O2 molecule; thus, blood carries
oxygen.
3) Anemia is either a lack of enough RBC or insufficient hemoglobin; an individual suffers
from a tired, run-down feeling.
e. RBCs are manufactured in the red bone marrow of the skull, ribs, vertebrae, and the ends of
long bones.
f. The growth factor erythropoietin is produced when an enzyme from the kidneys acts on a
precursor made by the liver and stimulates production of red blood cells; as a drug it helps
people with anemia.
g. Before being released from bone marrow, the RBCs lose their nucleus and synthesize
hemoglobin.
h. Red blood cells have a life span of about 120 days; then they are destroyed chiefly in the
liver and spleen.
i. When the RBCs are destroyed, the hemoglobin is released; the iron is recovered and
returned to the bone marrow where it is reused.
j. The heme portions undergo chemical degradation and are excreted by the liver as bile
pigments; it colors the feces.
C. Blood Types
1. ABO System
a. The presence or absence of type A and B antigens on red blood cells determine a person’s
blood type.
b. If the person has type A blood, the A antigen is on the red blood cells; if the person is type B,
the B antigen is on the red blood cells.
c. In the ABO system, there are four blood types: A, B, AB, O.
1) Individuals have naturally-occurring antibodies to blood type antigens not present on
their blood cells; these are called anti-A and anti-B
2) RBCs with a particular antigen agglutinate when exposed to corresponding antibodies,
e.g., type A RBCs will agglutinate in the presence of anti-A antibody (as would be found
in the blood of a type B individual).
3) Agglutination is the clumping of red blood cells due to a reaction between antigens on
the red blood cells.
4) To receive blood, the recipient’s plasma must not have an antibody that causes donor
cells to agglutinate.
i. Recipients with type AB blood can receive any type of blood; they are the universal
recipient.
ii. Recipients with type O blood cannot receive A, B, or AB; but they are a universal
donor.
iii. Recipients with type A blood cannot receive B or AB.
iv. Recipients with type B blood cannot receive A or AB.
2. Rh System
a. Rh factor is an important antigen in human blood types.
b. Rh positive (Rh+) has the Rh factor on red blood cells; Rh negative (Rh-) lacks the Rh antigen
on RBCs.
c. Rh-negative individuals do not have antibodies to Rh factor but make them if exposed to Rh+ blood.
d. Rh factor is particularly important during pregnancy.
1) Hemolytic disease of the newborn is possible if the mother is Rh negative and the father
is Rh positive.
2) Rh positive is a genetically dominant trait; an Rh negative mother and an Rh positive
father pose a Rh conflict.
3) The child’s Rh positive RBCs can leak across the placenta into the mother’s circulatory
system when the placenta breaks down.
4) The presence of the “foreign” Rh positive antigens causes the mother to produce anti-
Rh antibodies.
5) Anti-Rh antibodies pass across the placenta and destroy the RBCs of the Rh positive
child.
3. White Blood Cells
a. White blood cells (leukocytes) differ from RBCs in being larger and in having a nucleus.
b. WBCs lack hemoglobin and appear translucent without staining.
c. Granular leukocytes contain conspicuous granules in their cytoplasm and have a lobed
nucleus.
1) Neutrophils have granules that stain slightly pink; they are amoeboid, spherical cells
that readily squeeze through capillary walls and phagocytize foreign material.
2) Eosinophils have granules that take up the red dye eosin.
3) Basophils have granules that take up a basic dye, staining them deep blue.
d. A newly discovered stem cell growth factor (SGF) increases the production of all WBCs,
which helps patients with low immunity.
e. Agranular leukocytes lack granules in their cytoplasm and have a circular or indented
nucleus.
1) Monocytes are amoeboid and able to enter tissues where they transform into
macrophages.
2) Macrophages release white blood cell growth factors that increase the number of
leukocytes.
3) Pus is a thick, yellowish fluid that contains a large proportion of dead WBCs that have
fought infection.
4) Lymphocytes play a key role in fighting infection and include two types.
i. T cells are lymphocytes that directly attack virus-infected cells.
ii. B cells can be stimulated to produce one type of antibody specific for one type of
antigen.
5) An antigen is any substance stimulating production of antibodies; antigen is foreign to
the body.
6) Antibodies combine with antigens to promote their being phagocytized by a
macrophage.
7) A person is actively immune when many B cells produce a specific antibody for an
infection.
4. Platelets
a. Platelets (thrombocytes) result from fragmented giant cells (megakaryocytes) in the bone
marrow.
b. 200 billion platelets are produced a day; blood contains 150,000–300,000 platelets per mm3.
c. Platelets are involved in blood clotting, or coagulation.
5. Blood Clotting
a. When a blood vessel is damaged, platelets clump at the site of the puncture and partially
seal the leak.
b. The platelets and damaged tissue cells release a clotting factor called prothrombin activator.
c. With calcium ions, prothrombin activator catalyzes a reaction converting prothrombin to
thrombin.
d. Thrombin acts as an enzyme to sever two amino acid chains from each fibrinogen molecule.
e. These activated fragments join end-to-end forming long threads of fibrin.
f. Fibrin threads wind around the platelet plug and provide a framework for a clot.
g. RBCs are trapped within the fibrin threads, making the clot appear red.
h. When blood vessel repair is initiated, plasmin destroys the fibrin network and restores
plasma fluidity.
D. Capillary Exchange
1. Two forces control the movement of fluid through the capillary walls.
a. Osmotic pressure tends to cause water to move from tissue fluid to the blood.
b. Blood pressure tends to cause water to move from the blood to tissues.
c. At the arterial end of a capillary, blood pressure is higher than osmotic pressure: water exits
and moves into tissues.
d. Along the capillary, O2 and nutrients diffuse out into the tissue fluid, while CO2 and other
metabolic wastes diffuse into the capillaries from the tissue fluid.
2. Midway along a capillary, there is no net movement of water.
3. The tissue fluid is intercellular fluid that surrounds the cells; the circulatory system exchanges
materials with this fluid.
4. The exchange between the blood and tissue fluid occurs by diffusion through the one-cell-thick
capillary walls.
a. At the venule end, osmotic pressure is higher than blood pressure and water moves back
into the blood.
b. Almost the same amount of fluid that left the capillary returns to it; there is always some
excess tissue fluid collected by the lymphatic capillaries.
5. The tissue fluid within lymphatic vessels is lymph.
6. Lymph returns to the systemic venous blood when lymphatic vessels enter the subclavian veins
in the shoulder.
7. Not all capillary beds are open at the same time; precapillary sphincters shunt blood along
various pathways.
8. Through capillary dilation and constriction, blood also distributes heat to body parts and
conserves heat when cold.
E. How Horseshoe Crabs Save Human Lives (Nature of Science reading)
1. Horseshoe crabs are classified in the phylum Arthropoda.
2. They have a primitive open circulatory system.
a. The elongated heart pumps hemolymph between the gills and the body, without returning
to the heart in between.
b. The blood of horseshoe crabs contains hemocyanin, which binds to oxygen using copper
instead of iron.
c. The blood also contains amebocytes, which protect the horseshoe crab from bacterial
infections.
3. Federick Bang studied the immune system of horseshoe crabs.
a. He found that any Gram-negative bacteria injected in the horseshoe crabs caused the
horseshoe crab to die from coagulation of the circulatory fluid.
4. Bang developed a test, LAL test, to extract the horseshoe crab’s amebocytes, which could be
mixed with any sample to determine if that sample is contaminated by Gram-negative bacteria.
5. In order to conduct the LAL test, hemolymph has to be removed from the horseshoe crabs.
a. Medical companies catch the horseshoe crabs using trawlers.
b. The hemolymph is removed by puncturing the heart with a needle.
c. Thirty percent of the hemolymph is removed from the horseshoe crab.
d. The animals are usually returned to the ocean 72 hours after the procedure.