Cardiovascular System

The Blood Vessels

Video: The Circulatory System <http://www.youtube.com/watch?v=NJzJKvkWWDc>. Video: Heart Anatomy <http://www.youtube.com/watch?v=H04d3rJCLCE>.

The Arteries Arteries and arterioles take blood away from the heart. The largest artery is the aorta. The middle layer of an artery wall consists of smooth muscle that can constrict to regulate blood flow and blood pressure. Arterioles can constrict or dilate, changing blood pressure (smaller circumference = greater pressure). The Capillaries Capillaries have walls only one cell thick to allow exchange of materials with tissue fluid. Not all capillary beds are open at the same time. For example, contraction of a sphincter muscles closes off a capillary bed (network of many capillaries) and blood can flow through an arteriovenous shunt that bypasses the capillary bed.

The Veins Venules drain into veins that take blood to the heart. Veins have much less smooth muscles and connective tissue than an artery. Veins often have valves that prevent the backward flow of blood when closed (helps maintain pressure).

Questions 1. Name the 3 types of major vessels in the circulatory system and their function. Rank them in order from smallest diameter to largest. Capillaries: join arterioles to venules; have thin walls for the exchange of substances (oxygen, nutrients, wastes) between blood and tissue fluid Arteries: carry blood away from the heart to the capillaries Veins: take blood from the capillary beds to the heart 2. What are 2 major structural differences between arteries and veins? There is less smooth muscle and connective tissue in the walls of veins (and venules) than in the walls of arteries and arterioles. Veins often have valves, while arteries do not. 3. What is the function of an arterio-venous shunt? Only certain capillary beds are open at any given time. When the pre-capillary sphincter muscles contract, the blood cannot enter the capillary vessels. An arterio-venous shunt allows blood to bypass the closed capillary beds and go directly from an arteriole to a venule. This allows for the efficient allocation of resources, as the oxygen and the nutrients in the blood is delivered to where it is needed, and it does not have to pass through inactive capillary beds. 4. What is the largest artery? What are the largest veins? largest artery: aorta (25 mm wide) largest veins: superior vena cava (20 mm wide) and inferior vena cava (35 mm wide)

The Heart
Structure The heart muscle forms the myocardium. The pericardium is the outer membranous sac. The septum is a wall dividing the right and left sides. The right and left atria empty into the right and left ventricles, respectively. Atrioventricular valves occur between the atria and the ventricles, and semilunar valves occur between the ventricles and the attached arteries.

Atrioventricular Valves

Passage of Blood Through the Heart Blood follows this sequence through the heart: superior and inferior vena cava right atrium right ventricle pulmonary arteries lungs pulmonary veins left atrium left ventricle aorta The oxygen rich and oxygen poor blood never mix. The Heartbeat Systole is the contraction of heart chambers. Diastole is their relaxation. The heart sounds, lub-dub, are due to the closing of the atrioventricular valves, followed by the closing of the semilunar valves. Intrinsic Control of Heartbeat The SA (sino-atrial) node (pacemaker) initiates the beat and causes the atria to contract, on average, every 0.85 seconds. The AV (atrio-ventricular) node conveys the stimulus and initiates contraction of the ventricles. The signal for the ventricles to contract travels from the AV node through the atrioventricular bundle to the smaller Purkinje fibers. SA and AV Nodes

Extrinsic Control of Heartbeat A cardiac control center in the medulla oblongata speeds up or slows down the heart rate by way of the parasympathetic (decreases heart rate) and the sympathetic (increases heart rate) systems.

Video: Heart Structure | Biology | Anatomy <http://www.youtube.com/watch?v=MduG0mbW09A>.

The PSNS and SNS

The autonomic nervous system (means automatic) helps regulate internal organs and glands subconsciously. The parasympathetic nervous system (PSNS) regulates the resting activities. The sympathetic nervous system (SNS) regulates the stimulating activities. Heart Hormones

Hormones epinephrine and norepinephrine also stimulate faster heart rate. They are derived from the amino acid tyrosine. The Electrocardiogram

An electrocardiogram (ECG) is a recording of the electrical changes that occur in the myocardium during a cardiac cycle. Atrial depolarization creates the P wave. Ventricular depolarization creates the QRS wave. Ventricular repolarization produces the T wave. Note: atrial repolarization is missing because its signal is masked by ventricular depolarization (they occur at the same time)

Video: Anatomy & Physiology Online <http://www.youtube.com/watch?v=v3b-YhZmQu8>

Questions 1. What do P waves, QRS signals, and T waves signal as happening soon? P waves indicate that the atria are about to contract. The QRS complex signals that the ventricles are about to contract. T waves indicate that the ventricular muscle fibers are recovering from contraction. 2. What is ventricular fibrillation? Ventricular fibrillation is the uncoordinated contraction of the ventricles. It can be caused by an injury or a drug overdose. Once the ventricles are fibrillating, they have to be defibrillated by applying a strong electrical current for a short period of time, and then the SA node may be able to re-establish a coordinated beat. 3. Why do the atrial muscles contract first, followed by the ventricular muscles? The SA node initiates a heartbeat by sending out a stimulus which causes the atria to contract. When the impulses reach the AV node, there is a slight delay that allows the atria to finish their contraction before the ventricles begin their contraction. The signal for ventricular contraction then travels from the AV node through the two branches of the AV bundle before reaching the numerous and smaller Purkinje fibers.

The Vascular Pathways

The Pulmonary Circuit The pulmonary trunk from the right ventricle branches into four pulmonary arteries (2 on the left, 2 on the right) which take blood to the lungs. Four pulmonary veins return blood to the left atrium.

The Systemic Circuit The systemic circuit starts with the aorta from the left ventricle. The aorta branches into an artery going to a specific organ. Generally, an artery divides into arterioles and capillaries which then lead to venules. The vein that takes blood to the vena cava often has the same name as the artery that delivered blood to the organ (eg. renal artery and renal vein). In the adult systemic circuit, arteries carry blood that is relatively high in oxygen and relatively low in carbon dioxide; veins carry blood that is relatively low in oxygen and relatively high in carbon dioxide. This is the reverse of the pulmonary circuit: the pulmonary artery carries deoxygenated blood to the lungs, and the pulmonary veins take oxygenated blood to the heart.

Blood Flow in Arteries Blood pressure due to the pumping of the heart accounts for the flow of blood in the arteries. Systolic pressure is high when the heart expels the blood (highest pressure). Diastolic pressure occurs when the heart ventricles are relaxing (lowest pressure). Both decrease with distance from the left ventricle because blood enters more and more arterioles and arteries (as well as capillaries, venules, and veins). Blood Flow in Capillaries Blood moves slowly in capillaries because there are more capillaries than arterioles. This allows time for substances to be exchanged with tissues.

Video: Capillaries | Biology | Anatomy <http://www.youtube.com/watch?v=Q530H1WxtOw>. Blood Flow in Veins Venous return is dependent upon Skeletal muscle contraction Presence of valves in veins Respiratory movements Compression of veins causes blood to move forward past a valve that then prevents it from returning backward. Changes in thoracic and abdominal pressure that occur with breathing also assist the blood in returning. Varicose veins develop when the valves of veins become weak. Hemorrhoids are due to varicose veins in the rectum. Phlebitis is inflammation of a vein and can lead to a blood clot and possible death. Questions 1. Do all arteries carry oxygen-rich blood and all veins carry oxygen-poor blood? No: the pulmonary artery carries oxygen-poor blood to the lungs, and the pulmonary veins carry oxygen-rich blood to the heart. 2. Where does the heart get its own blood from? Coronary arteries carry oxygen and nutrients to the heart. 3. Why might someone faint and why would this be beneficial? Someone might faint because of a lack of oxygen. This would be beneficial because fainting causes the person to fall, lowering them to a horizontal position where blood can easily get to the head (the blood does not have to act against gravity anymore). Video: BBB-Lymphocytes <http://www.youtube.com/watch?v=cD_uAGPBfQQ>.

Blood
Blood Composition Blood separates into two main parts: plasma and cells. Plasma contains mostly water (90-92%) and plasma proteins (78%), but it also contains nutrients and wastes. Ex: Albumin is a large plasma protein that transports bilirubin, a breakdown product of hemoglobin. Red Blood Cells Red blood cells contain hemoglobin for oxygen transport. Red blood cells lack a nucleus and have an approximately 120-day lifespan. When worn out, the red blood cells are dismantled in the liver and spleen. Iron is reused by the red bone marrow where stem cells continually produce more red blood cells. Lack of hemoglobin results in anemia. The kidneys produce erythropoietin to increase blood cell production when oxygen levels are low (this poses a possibility for drug abuse in athletes). White Blood Cells White blood cells have a nucleus, are fewer in number than red blood cells, and defend against disease. Granular leukocytes carry enzymes and proteins and help defend against microbes. Neutrophils phagocytize pathogens Basophils release histamine, which promotes blood flow to injured tissues Eosinophils phagocytize antigen-antibody complexes and allergens Some white blood cells live a long time, while others live for only a few days. Agranular leukocytes consist of monocytes and lymphocytes. Monocytes differentiate into phagocytic dendritic cells and macrophages. Dendritic cells capture microbes with long, spiky arms and signal other white blood cells to defend the body. Lymphocytes (2 types: B-lymphocytes and T-lymphocytes) assist the body in specific immunity. Infectious mononucleosis (mono) is characterized by excessive B-lymphocytes. AIDS is characterized by excessively low T-lymphocytes.

Video: How White Blood Cells Work <http://www.youtube.com/watch?v=0TvTyj5FAaQ>. The Platelets and Blood Clot Formation Red bone marrow produces megakaryocytes that fragment into platelets at a rate of about 200 billion a day; the blood contains 150 000 300 000 per mm3. Twelve other clotting factors help platelets form blood clots. The platelets and two plasma proteins, prothrombin and fibrinogen, function in blood clotting: Platelets clump at the site of a puncture when a blood vessel in the body has been damaged. Damaged blood vessels and tissue cells release prothrombin activator, which then converts prothrombin to thrombin in a reaction requiring Ca2+. Thrombin, in turn, participates in an enzymatic process with fibrinogen that results in fibrin threads. Fibrin threads wind around the platelet plug and provide the framework for the clot. Trapped red blood cells make a clot appear red. When blood vessel repair is initiated, an enzyme called plasmin breaks down the fibrin network. Serum contains all the components of plasma except fibrinogen. Hemophilia is an inherited clotting disorder due to a deficiency in a clotting factor. Video: How Does Blood Clot <http://www.youtube.com/watch?v=--bZUeb83uU>. 1. Platelets 2. Red Blood Cells 3. Plasma 4. Epidermis 5. Skin 6. White Blood Cells 7. Blood Vessels 8. Dermis 9. Fibrin Threads 10. Cornified Layer (Scab) Bone Marrow Stem Cells Bone marrow is multipotent, able to continually give rise to particular types of blood cells. The skin and brain also have stem cells, and mesenchymal stem cells give rise to connective tissues, including heart muscle.

Capillary Exchange In a capillary, water moves out at the arterial end due to blood pressure (BP OP = 9 mm Hg). At the venule end, water moves in due to osmotic pressure (BP OP = 9 mm Hg). In between, nutrients diffuse out and wastes diffuse in to the tissue fluid that bathe cells. Questions 1. What would the body do to adapt to living at a higher altitude, where oxygen is thinner? The number of red blood cells usually increases whenever arterial blood carries a reduced amount of oxygen. Under conditions at a higher altitude, the kidneys would increase the production of a hormone called erythropoietin, speeding up the maturation of red blood cells in the bone marrow. 2. What effect would carbon monoxide inhalation have on a person? headache, dizziness, weakness, nausea, vomiting, chest pain, and confusion High levels of CO inhalation can cause loss of consciousness and death, since the carbon monoxide combines more readily with hemoglobin than oxygen. This makes the hemoglobin unavailable for oxygen transport, preventing the tissues from getting the oxygen they need. 3. What function do the following perform? Which ones are granular and which ones are agranular? Neutrophils: phagocytize and digest bacteria; granular (the granules contain enzymes and proteins) Eosinophils: phagocytize antigen-antibody complexes and allergens; granular Basophils: release histamine, promoting blood flow to injured tissues; granular Lymphocytes: responsible for specific immunity; consists of T and B lymphocytes; agranular Monocytes: differentiate into dendritic cells and macrophages which phagocytize pathogens and cellular debris; agranular 4. What does the enzyme plasmin do? Plasmin destroys the fibrin network formed during a blood clot, restoring the fluidity of the plasma. 5. What are stem cells, and what are a couple of examples of how they might be used in the future for treatment of diseases?

 Stem cells are undifferentiated cells which are ever capable of dividing and producing new cells. These cells go on to differentiate into more specific types of cells with a specific role in the body. A patients own bone marrow stem cells could be used for curing leukemia, diabetes, heart disease, liver disease, and brain disorders such as Alzheimer disease or Parkinson disease. This is extra beneficial because it eliminates the possibility of rejection. 6. What are two pressures involved in capillary walls, and what does each one do? Osmotic pressure: tends to cause water to move into blood from tissue fluid; created by the presence of salts and the plasma proteins Blood pressure: tends to cause water to move from blood into tissue fluid Arterial end: blood pressure is higher than the osmotic pressure of blood; water exits the capillary Midway along the capillary: the two forces essentially cancel each other out, and there is no net movement of water; solutes diffuse according to their concentration gradient Venous end: blood pressure is less than osmotic pressure, and water moves into the capillary

Cardiovascular Disorders
Atherosclerosis Atherosclerosis is due to a buildup of fatty material, mainly cholesterol, under the inner lining of arteries. The deposits, called plaque, can cause a clot (thrombus) to form, and they can dislodge as an embolus and lead to thromboembolism.

Video: How cholesterol clogs your arteries <http://www.youtube.com/watch?v=XZB2GciZnr4>. Video: Artery Explorer <http://www.youtube.com/watch?v=GBf59Z8tgA0>. Video: What happens during a Heart Attack? <http://www.youtube.com/watch?v=H_VsHmoRQKk>.

Stroke, Heart Attack, and Aneurysm If a moving blood clot or embolus lodges in a cerebral blood vessel or a cerebral blood vessel bursts, the blockage causes a stroke to occur, where a portion of the brain dies.

If a blood clot lodges in a coronary blood vessel, a heart attack occurs. Partial blockage of a coronary artery causes angina pectoris. An aneurysm is a ballooning of a blood vessel.

Coronary Bypass Operations Removing a segment of another blood vessel to replace a clogged coronary artery is a common operation. It may be possible to replace this surgery with gene therapy that causes new blood vessels to grow where the heart needs more blood flow.

Video: Coronary Artery Angioplasty (PCI, Heart Stent Surgery) <http://www.youtube.com/watch?v=N7nghr9TpSU>. Clearing Clogged Arteries Angioplasty uses a long tube inserted through a vessel to the point where the artery or vein is blocked; inflating the tube may force the vessel open. Why start from the leg during angioplasty? The arteries of the lower body are more superficial than the arteries around the heart, making them easier to find and easier to get into.

Dissolving Blood Clots Medical treatments for dissolving blood clots include use of t-PA (tissue plasminogen activator), which converts plasminogen into plasmin, an enzyme that dissolves blood clots, but can cause brain bleeding. Aspirin reduces the stickiness of platelets and reduces clot formation as well as the risk of heart attack.

Heart Transplants and Artificial Hearts Heart transplants are routinely performed but immunosuppressive drugs must be taken thereafter. There is a shortage of human organ donors. Work is currently underway to improve an artificial heart, and muscle cell transplants may someday be useful. Hypertension About 20% of Americans suffer from hypertension, or blood pressure higher than 140/90. The best defense against hypertension is regular check-ups and a life-style that lowers the risk of hypertension, such as healthy diet coupled with exercise.

Video: Hypertension <http://www.youtube.com/watch?v=xnyfElxkBlI>. Video: Understanding High Blood Pressure <http://www.youtube.com/watch?v=4jRy-YlZONA>. Question 1. Name 5 different conditions/disease that can affect the circulatory system and explain how each one affects the circulatory system. Explain what the possible consequences are for each one. Atherosclerosis: Plaque builds up beneath the inner linings of arteries, tending to protrude into the lumen of the blood vessel and interfering with blood flow. Clots may form on the irregular arterial wall, putting the person at risk of thromboembolism, a stroke, a heart attack, or aneurysm. Stroke: A small cranial arteriole bursts or is blocked by an embolus. The lack of oxygen causes a portion of the brain to die, and paralysis or death can result. Heart Attack: When a coronary artery becomes completely blocked, perhaps because of thromboembolism, a portion of the heart muscle dies due to the lack of oxygen. Aneurysm: The ballooning of a blood vessel, most often the abdominal artery or the arteries leading to the brain. It may develop when atherosclerosis and hypertension weaken the walls of an artery. If a major blood vessel such as the aorta bursts, death is likely. Hypertension: High blood pressure (ie. greater than 140/90). Left untreated, hypertension can cause considerate damage to the blood vessels, heart, brain and kidneys.