The Cardiovascular System

Blood
Chapter 20

Introduction
The living body is in constant chemical
communication with its external environment
Gas exchange, nutrient absorption, waste
elimination, and exocrine secretions occur at
speicialized sites or organs because all parts of the
body are linked by the cardiovascular system (CVS)
The 3 components of the CVS include:
- The pump or heart
- The circulating fluid or blood
- The network of blood vessels

Functions of the Blood

Blood is a specialized fluid CT that maintains
homeostasis by:
1) Distributing nutrients, oxygen, and hormones
2) Carrying metabolic wastes to the kidneys
3) Transporting specialize cells (WBCs) that
defend peripheral tissues from infection and
diseases
Body cells deprived of circulation may die in
minutes

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Composition of Blood
Whole blood consists of 2 components:
Plasma the liquid matrix that contains dissolved
proteins
Formed elements blood cells and cell fragments
suspended in the plasma
- RBCs transport oxygen and carbon dioxide
- Leukocytes (WBCs) components of the immune system
- Platelets, small membranous sacs of cytoplasm that contain
enzymes and other factors essential for blood clotting

 Whole blood is sticky, cohesive, and resistant to flow

- pure water viscosity = 1.0
- plasma viscosity = 1.5
- whole blood viscosity ~ 5.0 (interactions between water
molecules and the formed elements)

Blood volume low or high are potentially dangerous

- Hypovolemic = low
- Hypervolemic = high

5 -6 liters in an adult man; 4-5 liters in an adult

woman
Alkaline pH (range of 7.35 to 7.45)
Temperature = 38 C or 100.4 F

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Composition of Whole Blood

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Fig 20.1

Plasma
Resembles interstitial fluid but:
Concentrations of dissolved O2 and CO2:
- higher [O2] so diffuses out of the bloodstream into
peripheral tissues
- lower [CO2] so diffuses out of tissues into the bloodstream

Contains significant quantities of dissolved proteins

- large size and globular shapes prevent most from crossing
capillary walls and remain trapped within the CVS

The Plasma Proteins

Account for ~7% of the plasma composition
3 major classes:
1. Albumin most abundant (~60%) and smallest
- major contributor to the osmotic pressure of plasma
- transports fatty acids, steroid hormones, other substances

2. Globulins include transport & immunoglobulins 35%

- immunoglobulins or antibodies attack foreign proteins and
pathogens
- transport globulins bind small ions, hormones, or compounds
that are insoluble or will be filtered out of blood at the kidneys

3. Fibrinogen largest of the proteins, accounts for ~4%

- essential for normal blood clotting (fibrinogen molecules form
insoluble strands of fibrin)
- conversion of plasma to serum removes fibrin

Albumin and globulins can attach to water insoluble

lipids -triglycerides, fatty acids, and cholesterol
- lipoproteins readily dissolve in plasma
- delivered to peripheral tissues

Liver synthesizes & releases >90% of plasma protein

- liver disorders can alter the composition and functional
properties of the blood
- inadequate synthesis of fibrinogen no clotting response

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Formed Elements
Major cellular components - RBCs and leukocytes
RBCs or erythrocytes
- most numerous cell account for almost of the blood
volume
- transports oxygen and carbon dioxide
- during differentiation and maturation RBCs lose most of
their organelles so degenerate after ~120 days
- anaerobic metabolism = no O2 usage

Histology of Red Blood Cells

Biconcave disc thin
central region and a
thicker outer margin
- greater surface area
- strength and flexibility
- can form stacks called
rouleaux (sing., rouleau)
Diameter 7.7um with a
max thickness of 2.85um
(center = 0.8um)

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Figure 20.2

RBCs and Hemoglobin (Hb)

A RBC loses all intracellular components not
associated with it primary function
- transport of O2 and CO2
- consists of a PM surrounding cytoplasm (66% water; 33%
proteins)

Hb a red pigment accounts for >95% of the proteins

- gives RBCs the ability to transport O2 and CO2
- oxygenated Hb has a bright red color
- deoxygenated Hb has a deep red color

 Each polypeptide
chain subunit has a
single heme molecule
with an iron ion - can
interact with O2
- interaction is very
weak
- CO2 binds aas, also
reversible
O2 in plasma = diffuse
into RBCs
CO2 = Hb releases
CO2 diffuses into the
plasma
Figure 20.3

Opposite in tissues
active cells consume O2
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Blood Types
Are determined by the presence or absence of
surface antigens (agglutinogens) on an RBC PM
- glycoproteins or glycolipids are genetically determined
- at least 50 different antigens have been identified
- 3 of particular importance A,B, and D (Rh factor)

Blood type must be checked before you give or

receive blood
- surface antigens on your own RBCs are recognized as self
and ignored by your immune system
- your plasma contains antibodies (immunoglobulins) that
will attack foreign surface antigens (agglutins)
- cross reaction occurs (agglutination and hemolysis)

Blood Typing

RBC

Fig 20.4

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Leukocytes
WBCs are scattered throughout peripheral tissues
- circulating WBCs are only a small fraction

Defend the body against invasion by pathogens

- remove toxins, wastes, and abnormal or damaged cells

2 major classes
1) Granulocytes have large granular cytoplasmic inclusions
2) Agranulocytes do no possess visible cytoplasmic granules

Typical ul of blood contains 6000-8000 WBCs

- leukopenia (penia = poverty) <2,000 is serious
- leukocytosis refers to excessive numbers (>30,000)

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Histology of White Blood Cells

Figure 20.5
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Granulocytes
Neutrophils most numerous WBC (60%)
Phagocytize and destroy bacteria
- also release bacteria-destroying substances into ECM of
the infected tissue
- pus is composed of dead neutrophils and other WBCs
plus tissue debris and dead bacteria

Nucleus 2 to 6 lobes
Granules pick up acidic and basic stains
- membrane-walled sacs of digestive enzymes

Figure 17.4b

Eosinophils: 1 4% of all WBCs that function during allergic

reactions and parasitic infections (gather in digestive tube wall)
Granules contain digestive enzymes
- phagocytose allergens then degrade histamine
- attach to parasites release enzymes that digest and destroy
the invaders

Figure 17.4c

Basophils (base loving) rarest, about 0.5% of all

leukocytes
Nucleus usually two lobes
Granules secrete histamines and molecules
Function in inflammation mediation

Agranulocytes
Lymphocytes (T and B cells) most important
cells of the immune system (20 45% of WBCs)
Nucleus occupies most of the cell volume (stains dark
purple)

Function in lymphoid CTs play a crucial role in

immunity
- effective in fighting infectious organisms
- act against antigens (induce against) a specific foreign
molecule that induces a response
- T cells attack foreign cells directly
- B cells differentiate and produce antibodies
- NK cells responsible for immune surveillance

Platelets
Flattened, membrane-enclosed enzyme packets
- aka thrombocytes are derived from megakaryocytes

Megakaryocytes (mega = big; karyon = nucleus)

- during their growth and development manufacture structural
proteins, enzymes, and membranes
- gradually shed their cytoplasm as platelets ~4000
- then nucleus is engulfed by phagocytes for recycling

Platelets circulate for 10 12 days then are

removed by phagocytes
- a ul of circulating blood contains ~350,000 platelets
- 1/3 are held in the spleen and other vascular organ as
reserves

Histology of
Megakaryocytes and
Platelet Formation

Figure 20.6

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 Thrombocytopenia <80,000/ul indicates excessive

platelet destruction or inadequate production
- bleeding along digestive tract, within the skin, occasionally
in the CNS

Thrombocytosis may exceed 1,000,000/ul

accelerated platelet formation
- infection, inflammation, or cancer

Hemostasis vascular clotting system

- includes plasma proteins, and cells and tissues of the
circulatory system
- prevents loss of blood through walls of damaged vessels
- both restricts blood loss and establishes a framework for
tissue repairs
- requires vit K and calcium ions

Platelet Functions
1. Transport of chemicals important to the clotting
process by releasing enzymes and other factors
they help to initiate and control the clotting process
2. Formation of a temporary patch in the walls of
damage BVs: clump together at an injury site,
forming a platelet plug to slow rate of blood loss
3. Active contraction after clot formation has
occurred: contain filaments of actin and myosin
that can interact to produce contractions that
shorten them
- after a blood clot has formed, platelet contractions
reduces the size of the clot and pulls together the cut edges
of the vessel wall

Platelet Plug Formation

19-31

Mechanism of the Platelet Plug

When platelets come in contact with a
damaged vascular surface, platelets
attach to the exposed collagen fibers in
the vascular wall.
Platelets immediately change their own
characteristics.

 Platelets begin to swell and assume

irregular forms with numerous
irradiating pseudopods protruding
from their surfaces
Contractile proteins in the platelets
contract forcefully and cause the
release of granules that contain
multiple active factors

 Adenosine diphosphate (ADP) is

released which causes surface of
nearby circulating platelets to become
sticky and it adheres to the first layer of
aggregated platelets

 The aggregated platelets adhere to the

von Willebrand factor that leaks into
the traumatized tissue from the plasma
It leads to the release of more ADP ,
which cause more platelets to pile up at
the defected site.

 The aggregating process is reinforced

by the formation of Thromboxane A2.
It directly promotes platelet
aggregation and further enhances it
indirectly by triggering the release of
even more ADP from the platelet
granules.
Formation of platelet plug takes place

The aggregated platelet plug not only

physically seal the break in the vessel
but, also perform three other important
roles:
Actin and myosin which were the
contractile proteins in the platelets
contract

 This compacts and strengthens the the

plug which was initially, a loose plug.
Secondly, various chemicals released
from the platelet plug include several
vasoconstrictors (serotonin,
epinephrine and Thromboxane A2 )
cause vascular vasospasm

 Thirdly, the platelet plug release other

chemical substances that play a role in
blood clotting.
Platelet plugging mechanism alone is
sufficient to seal tears in the
capillaries and small vessels but, large
holes require formation of blood clot
to stop bleeding.

Limitation of Platelet Plug

Normal endothelium of the vessel
release Prostacyclin which prevents
platelet aggregation.
So, platelet plug is limited to the
defected part of the vessel and does
not spread to the normal vascular
tissue.

Formation Of Blood Clot

If there is a large defect in the vessel
then blood clot + platelet plug are
required to stop bleeding.
As clot on the top of platelet plug
supports it and reinforces the seal over
the break in the vessel.

Onset Of Formation Of Blood Clot:

15 20 sec in severe trauma.
1 2 min in minor trauma.

 Ultimate step in clot formation is the

conversion of fibrinogen which is a
soluble protein that is produced by the
liver and is normally always present in
the plasma to fibrin which is insoluble
thread like molecule.
thrombin

Fibrinogen

Fibrin

 Fibrin molecules adhere to the

damaged vessel surface forming a
loose netlike meshwork that traps the
cellular elements of blood.
The clot appears red because of
abundance of RBC that are trapped in
it.

Coagulation
Stages
Activation of
prothrombinase
Conversion of
prothrombin to
thrombin
Conversion of
fibrinogen to fibrin

Pathways
Extrinsic
Intrinsic
19-50

Structure of a Blood Clot

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Figure 20.7

Clot Formation

19-52

 The original fibrin web is weak

because the fibrin threads are loosely
interlaced.
Rapidly, various chemical linkages are
formed between adjacent strands to
strengthen and stabilize the clot mesh
work.

 The cross linkage process which is

catalyzed by a clotting factor known as
factor XIII (Fibrin stabilizing factor).

Fibrinolysis

Clot dissolved by
activity of plasmin,
an enzyme which
hydrolyzes fibrin

19-57

Blood Grouping
Determined by antigens (agglutinogens)
on surface of RBCs
Antibodies (agglutinins) can bind to RBC
antigens, resulting in agglutination
(clumping) or hemolysis (rupture) of RBCs
Groups
ABO and Rh

19-58

Blood Grouping
Determined by antigens (agglutinogens)
on surface of RBCs
Antibodies (agglutinins) can bind to RBC
antigens, resulting in agglutination
(clumping) or hemolysis (rupture) of RBCs
Groups
ABO and Rh

19-59

ABO Blood Groups

19-60

Agglutination Reaction

19-61

Rh Blood Group
First studied in rhesus monkeys
Types
Rh positive: Have these antigens present on
surface of RBCs
Rh negative: Do not have these antigens
present

Hemolytic disease of the newborn (HDN)

Mother produces anti-Rh antibodies that cross
placenta and cause agglutination and hemolysis
of fetal RBCs
19-62

Erythroblastosis Fetalis

19-63

Hemopoiesis
Process of blood cell formation
- appear in circulation during 3rd week of embryonic
development
- as other organ systems develop, some embryonic blood
cells move out of the circulation into the liver, spleen,
thymus, and bone marrow
- these embryonic cells differentiate into stem cells that
produce blood cells
- in the adult bone marrow becomes the primary site of blood
cell formation
Pluripotential stem cells (PPSC) give rise to all blood cells
- process requires a series of separate steps

The Origins and Differentiation of Formed Elements

Figure 20.8
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PPSC

Progenitor cells

Figure 17.8

Erythropoiesis
Formation of erythrocytes
- primary site is the red bone marrow in the adult
- but in extreme conditions the fatty yellow marrow can be
converted to red marrow
- requires adequate supplies of amino acids, iron, vit B12
- regulated by erythropoiesis-stimulating hormone or
erythropoietin (EPO) produced and secreted under hypoxic
conditions primarily in the kidneys

Leukopoiesis
Stem cells that produce WBCs originate in the bone
marrow
- granulocytes complete their development in bone marrow
- monocytes begin their differentiation in the bone marrow,
enter the circulation, and complete their development as free
macrophages in peripheral tissues

Lymphopoiesis stem cells originate in the bone

marrow
- many subsequently migrate to the thymus to produce
immature T cells

The Heart
A muscular double pump
Pulmonary circuit takes blood to and from the
lungs
Systemic circuit vessels transport blood to
and from body tissues
Atria receive blood from the pulmonary and
systemic circuits
Ventricles the pumping chambers of the heart

The Pulmonary and Systemic

Circuits

Figure 18.1

Location and Orientation within

the Thorax

Figure 18.2

Structure of the Heart

Coverings

Figure 18.3

Structure of the Heart Layers

of the Heart Wall
Epicardium visceral layer of the serous
pericardium
Myocardium consists of cardiac muscle
Muscle arranged in circular and spiral
patterns

Endocardium endothelium resting on a

layer of connective tissue
Lines the internal walls of the heart

Heart Chambers
Internal divisions
Atria and ventricles
Interventricular and interatrial septa

External markings
Coronary sulcus
Anterior and posterior interventricular sulcus

Heart Chambers

Figure 18.5b

Heart Chambers

Figure 18.5e

Inferior View of the Heart

Figure 18.5d

Pathway of Blood Through the

Heart
Begin oxygen-poor blood in the superior
and inferior venae cavae
Go through pulmonary and systemic circuits

Blood Flow Through the Heart

Figure 18.6

Pathway of Blood Through the

Heart

Figure 18.6b

Heartbeat

7080 beats/minute at rest

Systole contraction
Diastole expansion
Systole and diastole also refer to:
Stage of heartbeat when ventricles contract
and expand

Structure of Heart Wall

Walls differ in thickness
Atria thin walls
Ventricles thick walls

Structure of Heart Wall

Left ventricle
three times
thicker than right
Exerts more
pumping force
Flattens right
ventricle into a
crescent shape

Figure 18.7

Heart Valves Valve Structure

Figure 18.8a

Function of the Atrioventricular

Valves

Figure 18.9a

Function of the Atrioventricular

Valves

Figure 18.9b

Function of the Semilunar

Valves

Figure 18.10a, b

Heart Sounds
Lub-dup sound of valves closing
First sound lub the AV valves closing
Second sound dup the semilunar
valves closing

Conducting System
Cardiac muscle tissue has intrinsic ability
to:
Generate and conduct impulses
Signal these cells to contract rhythmically

Conducting system
A series of specialized cardiac muscle cells
Sinoatrial (SA) node sets the inherent rate of
contraction

Microscopic Anatomy of Heart

Muscle

Cardiac Muscle Contraction

Heart muscle:
Is stimulated by nerves and is self-excitable
(automaticity)
Contracts as a unit
Has a long (250 ms) absolute refractory
period

Cardiac muscle contraction is similar to

skeletal muscle contraction

Heart Physiology: Intrinsic

Conduction System
Autorhythmic cells:
Initiate action potentials
Have unstable resting potentials called
pacemaker potentials

Heart Physiology: Sequence of

Excitation

Heart Physiology: Sequence of

Excitation
Sinoatrial (SA) node generates impulses
about 75 times/minute
Atrioventricular (AV) node delays the
impulse approximately 0.1 second
Impulse passes from atria to ventricles via
the atrioventricular bundle (bundle of His)

Heart Physiology: Sequence of

Excitation
AV bundle splits into two pathways in the
interventricular septum (bundle branches)
Bundle branches carry the impulse toward the
apex of the heart
Purkinje fibers carry the impulse to the heart
apex and ventricular walls

cont

R atr cont

L vent

A recording of the electrical

changes that occur within
the myocardium as the
heart contracts.

R vent cont

Electrocardiograms (ECG / EKG)

Electrocardiograms (ECG / EKG)

Atria repolarized
Ventricle depolarized
Heart relaxed

AV node and
walls depolarize

Atrial walls
completely
depolarized

Atria repolarizes
Ventricle
depolarizes

Ventricular walls
repolarize

Heart Excitation

Innervation
Heart rate is altered by
external controls
Nerves to the heart
include:
Visceral sensory fibers
Parasympathetic
branches of the vagus
nerve
Sympathetic fibers
from cervical and upper
thoracic chain ganglia
Figure 18.13

Blood Supply to the Heart

Functional blood supply
Coronary arteries

Arise from the aorta

Located in the coronary sulcus
Main branches
Left and right coronary arteries

Blood Supply to the Heart

Figure 18.14