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Chapter 10.

The Circulatory System

The circulatory system nourishes every part of the body. It has three main parts: the heart, blood
vessels and the blood itself. The fluid bathing the body tissues is derived from the blood; the pump
circulating the blood is the heart; the tubes through which the blood flows are the blood vessels.
If the blood is allowed to stand, it separates into two distinct fractions. Less than half the blood
consists of the solid part: the RBC, WBC, and the platelets. The remainder is a straw colored fluid, the
Erythrocytes. Red blood cell formation (erythropoiesis) is stimulated by any factor lowering the
oxygen available to the body tissues. Therefore, high altitudes, hemorrhage, nutritional deficiencies,
and endocrine disturbances may stimulate the production of red blood cells. The presence of
hemoglobin within the rbc is responsible for its ability to transport oxygen. Hemoglobin combines with
oxygen from the air of the lungs to form oxyhemoglobin, which in turn, readily gives up its oxygen to
tissue cells within the body. Chemically, hemoglobin is a complex organic compound composed of
four porphyrin pigments (heme), each of which contains an atom of iron, plus globin, which is a
globular protein consisting of four amino acid chains.
The life span of erythrocytes is approximately two to four months. The red blood cells
disintegrate, releasing Hb into the blood, and the broken cell debris is removed from the circulation by
the reticuloendothelial system, which consists of special cells in the liver, spleen, bone marrow, and
lymph nodes. The reticuloendothelial cells phagocytize the debris. The fragments are digested and
released into the blood.
The Hb disintegrates into globin and heme. The globular protein fraction is degraded into amino
acids. Heme is broken down into bilirubin and iron. The iron is picked up by the globulin transferin
and is then either deposited in bone marrow for use again, combined and stored in the liver as ferritin
for future use, contributed to form myoglobin in muscle or stored in tissue cells as hemosiderin.
Bilirubin is carried to the liver and excreted with the bile.
Two to ten million cells are destroyed each second yet because of replacement, the number of
circulating cells remains remarkably constant. Reduction in the total number of rbc in the body results
in anemia. Anemia is characterized by the diminished capacity of the blood to transport oxygen to the
tissues. Anemia results if either the number of functional red blood cells or the quantity of hemoglobin
is decreased much below normal. Anemia may be due to deficient blood formation because of poor
nutrition, including dietary deficiency of iron, copper, vitamins, or amino acids. Anemia may also be
caused by loss of blood due to hemorrhage from wounds or because of parasites. It is also caused by
increased cell destruction, or decreased formation of red blood cells.
Leukocytes. Leukocytes or white blood cells differ considerably from erythrocytes in that they are
nucleated and are capable of independent movement. They are classified as granulocytes and
agranulocytes. Granulocytes contain granules within the cytoplasm that stain with common blood
stains, such as Wright’s stain. These cells include neutrophils, eosinophils, and basophils.
Agranulocytes usually show little or no granules in their cytoplasm. They include lymphocytes and
Neutrophils, the most numerous of the granulocytes, contain granules that stain indifferently and
are not notably red or blue. They constitute the first line of defense against infection by migrating to
any area invaded by bacteria, passing through the vessel walls and engulfing the bacteria to destroy
them. In the process, many neutrophils also degrade dead (necrotic) tissue in the area, and the resulting

semiliquid material is known as pus. Eosinophils, also known as acidophils show red staining granules
in the cytoplasm. These cells, which normally are scarce, increase in number in certain chronic
diseases, such as infection with parasites. Basophils, which are blue staining granules, are also rare in
normal blood. They contain heparin and may be involved in preventing blood from clotting in areas of
inflammation. They also contain some histamine and may possibly be the precursors of mast cells.
Lymphocytes are important in the process of immunity, producing antibodies in response to
antigens. Monocytes possess a relatively large amount of cytoplasm and function as phagocytes,
becoming transformed into macrophages after invading infected sites, where numbers reach a peak in
48 hours.
Many diseases are characterized by a change in the number of circulating leukocytes. An increase
in the wbc count, generally indicating an acute infection, is called leukocytosis. Leukopenia, a
reduction in the number of wbc occurs occasionally in viral diseases. Leukemia is characterized by
uncontrolled proliferation of leukocytes which generally resemble immature cells and are usually non-
Thrombocytes. Platelets or thrombocytes are cytoplasmic fragments of giant, multinucleated red
blood cells called megakaryocytes and play an important role in hemostasis, the process of blood
clotting. Platelets function chiefly to reduce loss of blood from injured vessels. Platelets clump
together to form a plug in the initial phase of controlling bleeding. Clumping is followed by the
retraction of platelet pseudopods with enmeshed fibrin and blood cells to produce hard clot. A
deficiency in platelets causes a tendency to bleed.
Plasma. Blood plasma is a straw colored liquid composed of about 90% water and about 10%
chemical compounds, mainly proteins. Plasma can only be maintained if an anticoagulant is added to
keep coagulation from occurring. After coagulation, the fibrinogen separates from plasma, leaving
serum. The four major plasma proteins are albumin, globulin, fibrinogen, and prothrombin.
Blood Groupings. The safe administration of blood from donor to recipient requires typing and
cross-matching. These procedures are necessary since a patient receiving blood incompatible with his
own blood can experience a serious or fatal reaction. The system of classification is based on the
presence of specific antigens (agglutinogens) in the red blood cells and the presence of antibodies
(agglutinins) that react to the antigens.
ABO Groupings. Blood groups are named for the antigens present in the blood. In each case, the
blood contains antibodies to antigens not present in the recipient’s blood. Thus, individuals with
type A blood cannot receive blood from blood type B and AB individuals; type B individuals
cannot receive blood from type A or AB individuals; type O individuals cannot accept blood from
type A, B, or AB individuals; and type AB individuals can accept from all the other blood types.
Individuals with type AB blood are universal recipients and those with type O blood are universal
Blood Antigen Antibody Can give Can receive
type present present blood to blood from
A A Anti-B A, AB A, O
B B Anti-A B, AB B, O
O - Anti-A, Anti-B A, B, O, AB O
AB AB - AB A, B, O, AB
Table 10.1. Compatibility between the different blood types.
Rh Factor. The Rh factor was first found in the blood of the rhesus monkey. It is a system
consisting of at least 8 antigens. Reaction to one of the antigens determines whether a person is Rh

positive or negative. The antigen is usually designated as “D”. This classification is most
significant in the condition erythroblastosis fetalis wherein a mother is Rh negative while her
child (particularly a second child) is Rh positive.
The Heart
The heart is a four-chambered, hollow, muscular organ lying between the lungs in the middle
mediastinum. The pericardium is the sac enclosing the heart. It is an invaginated sac consisting of an
external fibrous coat and an internal serous membrane.

The outer, or parietal, layer of the serous membrane (parietal pericardium) lines the fibrous coat.
The inner, or visceral, layer of the serous membrane (visceral pericardium) adheres to the heart and
becomes the outermost layer of the heart, the epicardium. The wall of the heart consists of three
distinct layers: The epicardium (external layer), the myocardium (middle muscular layer), and the
endocardium (inner layer of endothelium).
The heart is divided into the right and left halves, each half divided into two chambers, the atria
(upper chamber), and the ventricle (lower chamber). The atria are separated by the intra-atrial septum,
while the ventricles are separated by the intra-ventricular septum. The atria serve as receiving
chambers from the lungs and various parts of the body and pump blood into the ventricles. The
ventricles, in turn, pump blood to the lungs and the remainder of the body. The primary function of the
Fig. 10.1. The heart and its parts.

heart is to serve as a muscular pump propelling blood into and through vessels to and from all parts of
the body. There are two types of valves located in the heart. The atrio-ventricular valves (the tricuspid
valve on the right and the bicuspid (mitral) valve on the left), and the semilunar valves (the pulmonary
and the aortic valves).
The Blood Vessels
The blood vessels consist of a closed system of tubes functioning to transport blood to all parts of
then body and back to the heart. Arteries transport blood to various body tissues under high pressure
exerted by the pumping action of the heart. Arterioles, the last branches of the arterial system, act as
control valves through which blood is released into the capillaries. The focal point of the entire
cardiovascular system is the network of about 10 billion microscopic capillaries functioning to provide
a method whereby fluids, nutrients, oxygen, carbon dioxide, and wastes are exchanged between the
blood and interstitial spaces. Veins function to conduct blood from the body tissues to the heart.
Two Closed Circuits of the Circulatory System
Fig. 10.2. Blood circulation.
The circulatory system has two closed circuits: the pulmonary circulation,
carrying blood from the right ventricle to the respiratory surfaces of the lungs and
back to the left atrium, and the systemic circulation, carrying blood from the left ventricle to the
remaining parts of the body and back to the right atrium.