Lecture 5: The Circulatory System

(Cardiovascular system + Lymphatic system)

Cardiovascular system

Consists of:
• Heart
• Blood vessels
• Blood

*Anatomical right and left*

 What is the function of the heart?

The heart pumps blood through blood vessels to all parts of the
body.

This functions to:

(1) Deliver _________

Oz and nutrients to cells and tissues

(2) Remove _________and

Oz other waste products from cells and tissues
 Where is the heart located in the body?

Base

Apex

Right Left
Where is the heart located in the body?
 Heart wall is mostly composed of muscle!

Myocardium: layer of cardiac muscle forming the heart wall

Why is the myocardium of

the left ventricle so much
thicker than that of the right
ventricle?
Right ventricle sends blood to lungs, left
ventricle sends blood to the entire
body
 Structures of the heart

Q: Is deoxygenated blood
actually blue?
Oxygen-rich
No

Oxygen-poor
Arrows: structures you
need to know Anterior (front) view
Posterior (back) view
Frontal section (cut)
 Great vessels of the heart

(i) Superior vena cava: upper body →right atrium

(ii) Inferior vena cava: lower body → right atrium Veins
(iii) Pulmonary veins (4): lungs → left atrium • carry blood
towards heart

(iv) Pulmonary trunk: right ventricle → lungs

- Branches into 2 pulmonary arteries Arteries
(v) Aorta: left ventricle → body • carry blood
away from heart
Includevalves
whendescribing TO BODY (systemic circulation)
bloodflow
from body

to lungs
to lungs
from lungs

from lungs
from lungs

from lungs

from body
 Heart valves
Ensure that blood moves through heart in one direction
 Atrioventricular (AV) valves
(Separate atria and ventricles)
Prevent blood ow from ventricles to atria

Function?
Function of chordae tendineae?
(heart strings)
Hold the valves
 Semilunar valves

Function?
Prevent ow of blood from arteries to ventricles
What is the sound of your heartbeat?

“LUB DUP”
AV valves closing Semilunar valves closing

https://www.youtube.com/watch?v=gJpT_wHZeF8
 Summary of heart valves

(i) Atrioventricular (AV) valves

o Bicuspid (Mitral)- LEFT
o Tricuspid - RIGHT

• Close when ventricles contract (open when ventricles relax)

• Stops backflow of blood from ventricles into atria

(ii) Semilunar valves

o Pulmonary (pulmonary trunk)
o Aortic

• Open when ventricles contract (close when ventricles relax)

• Stops backflow of blood from arteries to ventricles
 Pulmonary and systemic circulation
The heart is acting as two
individual pumps:

• Pulmonary circuit pump

• Systemic circuit pump

Both pumps are

pumping at the
same time! Blood flows through the
pulmonary AND systemic
circuit with every heart beat!
 Congestive heart failure

Right heart failure Left heart failure

Peripheral Pulmonary
congestion congestion
• Fluid accumulation in • Fluid accumulation
body tissues (more in lungs
notably in the feet,
ankles, fingers)
The cardiac cycle: 1 complete heartbeat

• Systole – heart contraction

• Diastole – heart relaxation

• ~ 75 beats / min (0.8 sec / cycle)

Contraction and relaxation refers to the contraction and

relaxation of the ventricles (as they are doing most of the
pumping work).
The cardiac cycle
 The cardiac cycle (summary)
(1) Atrial diastole / ventricular diastole (0.4s)
• Heart is relaxed, blood is flowing into
atria into ventricles

(2) Atrial systole / ventricular diastole (0.1s)

• Atria contract to empty remaining blood
into ventricles

(3) Ventricular systole / atrial diastole (0.3s)

• Ventricles contract!
• AV valves close
• Semilunar valves open
• Blood flows from ventricles into aorta
and pulmonary trunk
 What controls each heart beat?
• Specialized cardiac muscle cells are part of the intrinsic conduction system
of the heart

• These cells are self-excitable (can contract without signals from the nervous
system)
 Intrinsic cardiac conduction system
• Cells of the cardiac conduction system have different intrinsic rates of
contraction

• SA node: 60-100bpm.
• Atria: 60-80bpm.
• AV node: 40- 60bpm.
• Ventricles: 20-40bpm.
http://www.medicine.mcgill.ca/melp/tuts/r
hythm/rhythm3.htm

Depolarization causes muscle contraction

• The Sinoatrial (SA) node has the highest rate of depolarization and sets the
pace for the entire heart. It is the pacemaker!
 Electrical impulses spread quickly
through the heart

• Cardiac muscle cells are electrically coupled by intercalated disks (contain

gap junctions) between adjacent cells

• Gap junctions connect cytoplasm of 2 cells

 Cardiac cycle is regulated by electrical
impulses that radiate through the heart

0.12s
delay

Electrical impulses
cause contraction!
 Cardiac cycle is regulated by electrical
impulses that radiate through the heart

(1) SA node sends out an electrical impulse to the atria and the AV node.
• Atria contract in unison!

(2) AV node delays the the signal (~0.1s) before relaying impulse to the AV
bundle, the bundle branches and the Purkinje fibers.
• Allows atria to fully empty before ventricles contract

(3) Bundle branches conduct impulse to the apex of the heart

(4) Purkinje fibers conduct impulse throughout the ventricular walls

• Ventricles contract beginning at heart apex (“wringing action”)
 Artificial pacemakers
• How does an artificial pacemaker work? ArtificialSAnode
cardiac conduction
• Why would someone need an artificial pacemaker? Issuewithintrinsic

Implanted electrodes send

electrical impulses to
cardiac muscle cells to
regulate heart rate
 Factors that affect heart rate

(1) Two sets of nerves act on the SA node to increase or decrease heart rate
• Sympathetic nerves → increase HR Ifightorflight
• Parasympathetic nerves → decrease HR rustanddigest

(2) Hormones
• Epinephrine (released from adrenal glands) increases HR
• Thyroid hormone increases HR

(3) Body temperature

• Increase in body temperature increases HR
• Decrease in body temperature decreases HR

(4) Exercise
• HR increases in response to exercise (increased metabolic needs of body)
 ECG: Electrocardiogram
• Electrical impulses generated during the cardiac cycle produce electrical currents
that are conducted through body fluids to the skin

• Currents can be detected by electrodes and recorded as an ECG (also called EKG)

http://biometrics.mainguet.org/types/cardiac.htm
 ECG: Electrocardiogram
• Depolarization of muscle cells causes contraction
• Cells must repolarize before they can be depolarized again
 ECG: Electrocardiogram

SA node fires

P-wave:
• Depolarization of SA node and atria

QRS complex:
• Ventricular depolarization

T-wave:
• Ventricular repolarization

Where is atrial repolarization? ___________________

QRS
by
Masked

Where does the AV node fire? ___________________

 ECG: Electrocardiogram

http://en.wikipedia.org/wiki/Electrical_conduction_system_of_the_heart
ECG: Electrocardiogram
 What can go wrong?

Fibrillation: “V-Fib”

• Lack of adequate blood supply to the heart caused by a myocardial infarction

may cause fibrillation, an uncontrolled shuddering of the heart, making the
heart useless as a pump. Defibrillators stop fibrillation by delivering an electric
shock that “resets” the heart .
 Blood vessels

Arteries:
• Carry blood away from heart
- (towards capillaries)
• Branch into arterioles

Veins:
• Carry blood towards the heart
- (away from capillaries)
• Venules converge into veins

Capillaries:
• Site of exchange (blood → tissue; tissue → blood)
• Upstream end branches from arterioles
• Downstream end converges into venules
What differences do you notice between
arteries and veins?
Artery has bigger lumen and veins, more smooth muscles
 Blood vessel structure

Exchange with tissues is

happening here!
 Blood vessel structure: 3 layers (tunics)

(1) Inner layer (intima):

- Layer of simple squamous epithelium • Capillaries only have
- Also called endothelium the inner layer!
- Minimizes resistance to blood flow

(2) Middle layer (media):

- Smooth muscle and elastic fibers
- For strength, movement and elasticity

http://www.passmyexams.co.uk/GCSE/biology/capillaries.html

(3) Outer layer (externa):

- Connective tissue made largely of collagen fibers
- For support and protection
 Blood vessel structure: arteries vs veins

Feature Difference Reason

Largerinveins
Lumen Low peripheral resistance

Larger in arteries
Middle layer (media) To withstand high pressure
Longerin veins
Outside layer
Provides support
(externa)
Elastic lamina Onlypresentin arteries
To withstand high pressure
(internal/external)
Onlypresentinveins Facilitates return of blood to
Valves
heart (prevents backflow)

It’s all about pressure!

 Blood pressure decreases as blood
travels away from the heart ventricles
Venous valves and the skeletal muscle pump

• Contraction of skeletal muscles provides a

“milking” action to push blood back to
the heart.

• Valves close to ensure blood only moves

in one direction (towards the heart)
 Blood flows slowest through capillaries!
Slow flow in capillaries enhances exchange!
Relative cross-sectional
of different vessels of the
vascular bed
 Blood pressure
• The hydrostatic force that blood exerts on the vessel walls

• Pressure gradient provides driving force to keep blood moving

- (high pressure → low pressure)
 Measuring your blood pressure

Are we measuring venous or arterial blood pressure?

Arterial

Systolic pressure / Diastolic pressure

(ventricles contracted) (ventricles relaxed)

Normal blood pressure in

young healthy individual:

120 / 70 mm Hg
 Blood pressure must be maintained
within a specific range

Too HIGH:
• Could cause a stroke
(blood vessel damage)

Too LOW:
• Lose consciousness
(inadequate tissue perfusion)

http://www.bloodpressureuk.org/BloodPressureandyou/Thebasics/Bloodpressurechart
 Blood pressure is measured using a sphygmomanometer

• Aortic pressure is
measured indirectly in
the brachial artery
 Blood pressure is measured using a sphygmomanometer

• Aortic pressure is
measured indirectly in
the brachial artery
 Blood pressure is measured using a sphygmomanometer

• Aortic pressure is
measured indirectly in
the brachial artery
 Blood pressure is measured using a sphygmomanometer

• Aortic pressure is
measured indirectly in
the brachial artery
 Heart rate (pulse)

• Heart rate can be measured indirectly by Locations to measure pulse:

measuring pulse

• Pulse is the rhythmic stretching of arteries

caused by contraction of the ventricles

• Peripheral resistance in arterioles

impedes blood from exiting the arteries;
this causes the arteries to stretch (systolic
pressure)
 Factors affecting blood pressure
(1) Peripheral resistance: (determined mostly by arterioles)
• Resistance to flow in systemic circulation (friction within vessel walls)
• Depends on
o Blood viscosity
o Total blood vessel length
o Blood vessel diameter

http://medifitbiologicals.com/vasodilators/

Diameter of arterioles is determined by vasoconstriction/vasodilation of

arterioles which is controlled by action of nerve impulses, hormones and other
chemicals on the smooth muscle surrounding the vessels
Vasodilation: decrease blood pressure
Vasoconstriction: increase blood
pressure
Example:
Effect on blood pressure?
- nitric oxide → vasodilation
- endothelin → vasocontriction How does stress affect arterioles?
 Factors affecting blood pressure (cont’d)

(2) Cardiac output: (stroke volume X HR)

• Increased cardiac output → increases pressure

(3) Blood volume

• Increased blood volume → increases pressure

(4) Vessel elasticity

• Less elasticity → higher pressure (ex: arteriosclerosis)
 Cardiac output (CO)
• Amount of blood pumped by the heart in a single minute!

Cardiac output depends on 2 variables:

i. Stroke volume (SV): volume of blood pumped out by ventricles

during each contraction (~70mL)

ii. Heart rate (HR): beats /min

75 bpm

Example:
CO SU x HR
70mL x1756pm 5,254min
 Summary of factors affecting blood pressure

Nerve impulses, hormones and other chemical signals

Blood volume

How does stress affect blood pressure?

 Regulating blood pressure during exercise

During exercise:

Cardiac output (stroke volume X HR) ________________

Increases

(hint: how does exercise affect HR)

Peripheral resistance __________________

Demeans

(hint: would arterioles in muscles constrict or dilate?)

• Cardiac output and peripheral resistance are adjusted together during exercise so
muscles get enough blood flow and blood pressure is maintained (not too low or high)

• You can exercise without passing out or having a stroke!

Cardiac output must equal venous return

If blood pressure is low in veins compared to arteries how can:

venous return = cardiac output?

Resistance of arterioles and

capillaries dissipates the
pressure generated by the
pumping heart
 Factors that increase venous return

(1) Skeletal muscle pump: skeletal muscles and valves provide a “milking” action to
keep blood moving towards the heart.

(2) Respiratory pump: inhaling decreases pressure in the right atrium, vena cava
and other large veins near the heart allowing them to expand and fill with blood
(caused by a drop in intra-thoracic pressure)

(3) Lumens of veins are wider than arteries: less resistance to flow

Rhythmic contractions of smooth muscle in the walls of veins and venules

account for some movement of blood
 Capillaries

• At any given time only 5-10% of

your body’s capillaries have
blood flowing through them!

• Brain, heart, kidney and liver

capillaries are usually filled to
capacity!

• Constriction of arterioles and

Precapillary sphincters (rings of
smooth muscle) control flow of
blood through capillary beds
Example:
During exercise, blood is
diverted from the digestive
tract to skeletal muscles

What would blood flow look

like right after a meal?
 How do molecules cross capillaries?

(1) Vesicles form by endocytosis on

one side and release their contents
by exocytosis on the other side

(2) Diffusion through membrane

(3) Bulk flow through clefts between

endothelial cells (due to fluid pressure)

http://wiki.ubc.caFile:Endothelial_illustration_of_a_continuous_capillary..png#filelinks

• Blood cells and most proteins are too large to cross the capillary wall
(under normal circumstances!)
 Fluid flow across capillaries
Amount and direction of fluid flow depends on:
i) Hydrostatic pressure: fluid pressing against wall (due to blood pressure); “pushing out”
ii) Osmotic pressure: non-diffusible plasma proteins pull water into capillary; “sucking in”

Arterial end: Venous end:

Fluid is lost 85% of fluid
is reabsorbed

“pushing” > “sucking” “pushing” = “sucking” “pushing” < “sucking”

https://opentextbc.ca/anatomyandphysiology/chapter/20-3-capillary-exchange/
 Fluid flow across capillaries
ISF

“pushing out” force

(Hydrostatic pressure) “sucking in” force
(osmotic pressure)

blood

ISF
• Remaining 15% of fluid is
returned to the blood via
the lymphatic system!
 Lymphatic system

• Fluids (and some proteins) that

leak from the capillaries into the
ISF are returned to the blood via
the lymphatic system

• Lymph flows through a network

of lymphatic vessels and
composition is similar to ISF

• Drains into cardiovascular system

via the subclavian veins
 Lymphatic system
• Fluid enters the lymphatic system by diffusing into lymphatic capillaries that are
intermingled among cardiovascular capillaries

• Vessels have valves that prevent backflow and the movement of skeletal muscles pushes
fluid towards the heart
 Lymph nodes

• Lymph nodes are bean-shaped organs

located at intervals along the lymphatic
system
Blood
 BLOOD

PLASMA FORMED ELEMENTS

-90% water
-Salts
-Plasma proteins
Erythrocytes Leukocytes Platelets
(Red blood cells) (White blood cells) Clotting

Granulocytes Agranulocytes
-Neutrophils -Lymphocytes
-Eosinophils -Monocytes
-Basophils

55% ~45% >1%

 Plasma
Function: carries blood cells, cell fragments, nutrients, metabolic wastes, respiratory
gases, and hormones around the body

Composition: (transparent, straw-coloured, pH 7.35-7.45)

i. ~90% water
ii. Ions (electrolytes)
• Osmotic balance
• Functioning of muscles and nervous system
plasma
• pH buffering
iii. Plasma proteins
• Osmotic balance
• pH buffering
• Viscosity of blood
• Transport of water insoluble lipids
• Immunity (antibodies) WBCs
• Blood clotting (ex: fibrinogen)

RBCs
Plasma without clotting factors = serum http://www.seplessons.org/node/2798
 Erythrocytes (red blood cells)
5-6 million cells / mm3

Function: transports oxygen

Structure:
• Biconcave disc (more surface area!)
• No nuclei (more space for hemoglobin!)
• No mitochondria (make ATP by anaerobic metabolism)
• Contains ~250 million molecules of hemoglobin
 Hemoglobin

• Each hemoglobin protein is made of 4 polypeptides

o can bind 4 molecules of O2

• Iron atoms form part of the heme group that binds

oxygen
- 4 heme groups → 4 O2 molecules

• Hemoglobin also binds nitric oxide (NO)

o NO causes vasodilation which relaxes capillary walls to
help delivery of O2 into cells
 Leukocytes (white blood cells)
5 000-10 000 cells / mm3
Function:
• Effectors of the immune system (fight pathogens!)
• Spend most of the time patrolling the interstitial fluid and lymphatic system
 Leukocytes (white blood cells) Never let monkeys
5 000-10 000 cells / mm3 eat bananas

• Neutrophils and Monocytes: phagocytes that engulf and digest bacteria and cell debris
• Lymphocytes: develop into specialized B cells and T cells
• Basophils and Eosinophils: involved in the allergic response
 Platelets (cell fragments)
250 000 – 400 000 cells / mm3
Function: blood clotting!

• Clotting is initiated when the endothelium of a vessel is damaged and

connective tissue in the wall is exposed to blood:

(1) Platelets adhere to collagen

fibers and release a
substance that make nearby
platelets sticky

(2) Sticky platelets form a plug

(3) Fibrin forms a mesh that

traps RBCs and platelets to
form a clot
 Clotting disorders
Hemophilia:
• An inherited defect in any step of the clotting process
• Causes excessive bleeding from even minor cuts and bruises

Spontaneous clotting (Usually prevented by anticlotting factors in the blood):

• Platelets clump with fibrin within a blood vessel forming a thrombus (blood clot)
• A travelling blood clot is called an embolus
• Thrombus or embolus can block the flow of blood and cause a heart attack or stroke
 Blood cells are produced in bone marrow

• Blood cells wear out and must be constantly

replaced!
Ex: Erythrocytes usually circulate for only 3-4
months before being destroyed by phagocytic
cells in the liver and spleen

• All cells develop from a single population of

pluripotent stem cells in the red marrow of
bones (ribs, vertebrae, breastbone, pelvis)

Pluripotent: have the potential to become any type of blood cell

 Leukemia
• Leukemia is a type of blood cancer involving the elevated production of
abnormal white blood cells

Treatment:
• Destroy a patient’s bone marrow
and replace with bone marrow
from a healthy individual

• This replaces the cancerous

pluripotent cells with non-
cancerous ones

By Mikael Häggström - All used images are in public domain., Public Domain,
https://commons.wikimedia.org/w/index.php?curid=8332855
 tin's
Don'tstudy
slideformidterm X Erythrocyte production is regulated by
the hormone erythropoietin
• Erythropoietin is produced in the kidneys in response to low O2 levels in
tissues (hypoxia) to stimulate the production of RBCs (erythropoiesis)
 Arteriosclerosis
Arteriosclerosis is the thickening and hardening of an artery wall

Ex: Atherosclerosis (a type of arteriosclerosis)

i. Plaques develop in the inner wall of the artery

(contain fat, cholesterol and calcium deposits)

ii. Formation is due to an inflammatory response

that is initiated by the deposition of lipoproteins
(LDL) in the vessel wall

iii. Process takes several years and causes

narrowing of the vessel and hardening of the
vessel walls

iv. Plaques can rupture and promote the formation

of a thrombus (or an embolus)
 Risk factors for atherosclerosis

(1) Hypertension (high blood pressure)

• Causes chronic damage to the endothelium that lines arteries (damage promotes
plaque formation)
• Genetics, smoking, lack of exercise, diet rich in saturated fat and high cholesterol
levels all contribute to hypertension

(2) LDL / HDL ratio

• LDL (low density lipoprotein) Badcholesterol
- Associated with depositing cholesterol
in arterial plaques
• HDL (high density lipoprotein) Goodcholesterol
- Associated with removing cholesterol
from the blood

https://plantbasedscientist.wordpress.com/2013/10/27/macronutrients-101-
cholesterol/
 Heart attack and stroke
• Heart attack (myocardial infarction) is the death of cardiac muscle tissue caused
by the prolonged blockage of one or more coronary arteries

• Stroke is the death of nervous tissue in the brain caused by the blockage of an
artery or a leaking/burst blood vessel in the brain

o In both a heart attack and

stroke tissue dies due to lack
of oxygen!

o Any tissue downstream of the

blockage may die
 Angina pectoris
• If a coronary artery is partially blocked a person may feel occasional chest pains

• This is a sign that part of the heart is not receiving enough blood (ex: narrowing
of arteries due to atherosclerosis)

However...many people do not

experience any symptoms of
cardiovascular disease prior to a
heart attack or stroke!

Blausen.com staff (2014). "Medical gallery of Blausen Medical 2014". WikiJournal of

Medicine 1 (2). DOI:10.15347/wjm/2014.010. ISSN 2002-4436.