The force of contraction of the left ventricle which pump bloo i intb the aorta is not sufficient to

return the blood through the veins back towards the heart. The factors involved are:

‫بة الفرعلی‬
‫حاله اكلر‬

‫رد افراکالر‬
‫م استر‬

1. The position of the body

During standing or sitting position gravity assists the venous : etuni from the head and neck.

‫مرے‬
‫لكم‬
‫ايام العمال (لعلكاس‬
‫والده له‬
‫هار به‬
‫میں اعاركان‬
‫ر‬
‫فرزنراتور‬

2. Skeletal muscle pump

2008 The skeletal muscle pump promotes venous return in the folle win way. As each skeletal
muscle contract, it squeezes the soft veins sca tere I through its interior, thereby push (pump)
the blood in them up wanie

towards the heart. The closing of the sem unar valves present in veins bo prevents blood from
falling back as the muscle relaxes. The net effct of

skeletal muscle contraction plus venous valyalar action, therefore, is to move venous blood
toward the heart, to increase the venous return.

3. Respiratory pump

The process of inspiration increases the pressure gradient bei ween peripheral and central veins
by decreasing central venous pressur: and also by increasing peripheral venous pressure ) 3
When the diaphragm contracts, the thoracic cavity becomes arger and the abdominal cavity
smaller. Therefore the pressures in the thoracle cavity, in the thoracic portion of the vena cava,
and in the atria dec 'eas and those in the abdominal cavity and the abdominal veins increase,
this aids in assisting flow of blood towards the heart thus increasing vinouls return.

‫باعريبر‬
Hemodynamics. Factors affecting blood flow

Blood flow is the volume of blood that flows through any tis ue p a given time period in ml/min).
Total blood flow corresponds crdic output, which is the volume of blood that circulates (flow)
though systemic or pulmonary blood vessels per minute. Flow of blood though blood vessels
that supply various body tissues depends on two factor : 1. The pressure differences that drives
the blood flow through a t ssu.

blood flows from a regions of higher to lower pressure. 2. The resistance to blood flow in blood
vessels, the highe: the

resistance, the slower the blood flow.

The Cardiovascular System

Impulses from hypothalamus influence the cardiovascular center, for example, during fear or
anxiety, in turn, impulses from cadiac center increase heart rate.

Other factors which influence heart rate include temperature changes and certain ions. Rise of
body temperature increases heart rate, this is the reason that why heart rate increases during
fever. At the same time, abnormally low body temperature reduces heart rate.

The most important ions that influence heart rate are potassium and calcium ions. In
hyperkalemia (excess extracellular potassium ions), the rate and force of heart beat decreased.
On the other hand, in hypokalemia, the rate and force of heart beat increased.

In hypercalcemia (excess extracellular calcium ions) the rate and force of heart beat increases.
At the same time, in hypocalcemia the rate and force of heart beat decreases.

Factors affecting heart rate

1. Autonomic nervous system:

The sympathetic nerves increase the heart rate and parasympathetic nerves decrease the heart
rate.

2. Circulating hormones:

Adrenaline and noradrenaline hormones increases heart rate (have the same effect as
sympathetic stiimulation), thyroxine hormone increase heart rate.

3. Circulating drugs, electrolytes and dissolved gases

May either increase or decrease heart rate, for example:

o increase CO2 level in blood leads to increase heart rate.

Hypercalcemia increase heart rate. Yo Hyperkalemia decrease heart rate. Je

4. Emotional states:
During fear, anger heart rate increased. 5. Muscular activity (exercise):

During exercise muscles need more blood supply which carry oxygen and nutrients (glucose), so
heart rate is increased.

Ine bioda

3.

‫ا لرم‬
‫وقعے نر‬

Protection

The clotting factors, one of the constitute of plasma coagulatdi

clot) blood, minimizing its loss from ruptured blood vessels. d White blood cells protect the body
against disease though

White blogis process and

‫احیات جاری‬

tect the body a { ains

Antibodies produced from lymphocytes protect the body a șains

,disease ‫حابة من االسر‬

‫لك‬
‫الفاويه هیات هنزانة لرم‬

| ‫کار‬

‫د‬

‫* رگلر گانے‬

: ‫ آمارے لبر االم و الما‬-

Physical characteristics of blood

> Blood if compared with water, blood is denser and more viscidl and slightly sticky Viscosity of
blood is due to, plasma protein espe ially albumin and fibrinogen and erythrocytes.

The temperature of blood is about 38°C (core temperature)||

‫درجة حرارة االرغ‬

‫ الرم مارا‬about 1°C higher than oral or rectal temperature ‫ای من روعة‬
The pH of blood vary between 35.745.7 Blood makes up about 7-8% of body weight.

‫من وزن‬
‫ارے ارم‬

Composition of blood

The blood has two main components: plasma 55% and cells 45% 0 blood volume (Figure 6.1).

55

Plasma 55%

Serum

‫الع‬
‫انشای‬

| Cells 45.

Clot

Figure 6.1 A. The proportions of blood cells and plasma in whole blood separated by

rawit B A hmod clat in rerum

The Cardiovascular System

.. ... Luna

‫راير‬

Pulmonary circulation

‫مليار الع طلع می شمال‬

‫ان‬

‫دوما ارصدته‬

Right side of the heart

‫هلل رح (عل‬

Systemic circulation -

‫نقل الرم من نروح للقلب کون دم کر‬

.
‫مؤكسر‬

U body tissue

‫در‬
‫القريب‬
‫من قلب الحبم‬

Figure 7.1. The relationship between the pulmonary and the systemic circulations.

‫أوكيه رموزه‬
‫بال رول الدمشران | العرب برفع الدم من اسم االلعاب‬

Blood vessels

The blood vessels form a closed circuit of tubes that carries bood from the heart to the cells and
back from cells to the heart. These ve sels include arteries, arterioles, capillaries, venules and
veins (Figure 7.2).

aplaries, Venus to the hear

Heart

Veins

Arteries

| ‫مع الدم عنه ولها‬

‫ انا مانا‬Heart

‫| لعل نگین کاال‬

‫ومرام‬

‫| الشبان‬

‫صل الط‬
‫و‬

‫گو کیر ا‬
‫كلما كان اقرب لها‬
‫پر‬

‫ع بكراكم زب اول‬
‫مع‬emul

‫اطلب االورده و استرالي‬

Capillaria ‫اون‬

Arterioles

‫مواصغر‬
‫و او رات‬

Tha Cardiovascular System

Temporal artery

Facial artery

Common carotid artery

Brachial artery

Radial artery

Femoral artery

Popliteal artery (behind knee)

Posterior tibial artery Dorsalis pedis artery

/ ‫العات‬

1 ‫لتر‬

Figure 7.12 The main pulse points.

doveo

۱۱ ‫لمران‬
۱۰

I'

Information that may be obtained from counting pulse includes: 1. The rate at which the heart is
beating the number of pulse rep: eelit

the heart rate). s) times ] 2. The regularity of the heart beating, i.e. the time interval be well

beats should be same. 3. The volume or strength of beat. 4. The tension-wall of artery should
feel soft under the fingers.

‫)یا دورهمفری‬
‫هل‬
‫زر دار الزمن‬
‫كرار المربیان‬
‫را‬
‫کانال‬
‫دی کہ کل‬

130

‫و‬

ho appe

The Cardiovascular System pressure. In capillary walls, the blood pressure generated when wals
of ventricle contract providing the force for filtration.

Blood pressure assists in movement of blood through arterie: and arterioles. Blood pressure on
the wall of arteries decreases as the dis ande from the heart increases, because of friction
between the blood an 1 the vessels wall (this is called peripheral resistance). For this reason I
looli pressure in the wall of arteries (about 120mHg) is higher than in the arterioles (about 80
mmHg), similarly blood pressure in arterioles h ghet than in capillaries. Blood pressure at the
arterial end of capillari ass (about 35 mm Hg), which is greater than pressure at its venous en!
(15 . mmHg). So, the filtration effect occurs primarily at the arteriole en Is df capillaries.

The presence of a solute on one side of a cell membrane that ca nnd z. cross it creates an
osmotic pressure. Because the plasma protein an traped within the capillaries. (especially
albumin), they create an Os notit pressure that draws water into the capillaries.

The effect of capillary blood pressure, which favours filtre tion opposes the action of the plasma
colloid osmotic pressure, which favours reabsorption. At the arterial end of capillaries, the blood
pressu e is higher than the colloid osmotic pressure, so filtration predominate. At the venous
ends, the colloid osmotic pressure is essentially unchar ged, but the blood pressure has
decreased due to resistance through this capillary, so reabsorption predominates.

Normally, more fluid leaves the capillaries than return to them. Not all the water and cell waste
products return to the blood capillaries.

The excess is drained a way from the tissue spaces in minute lymph capillaries which originate as
blind end tubes with walls similar to, but more permeable than, those of the blood capillaries.
Extra tissue fluic an! some cell waste materials enter lymph capillaries and are event allj
returned to the blood stream.

THE BLOOD

Introduction
Most of the cells of the body cannot move around to obtain their requirements of oxygen and
nutrients and to eliminate carbon dioxide and other waste material. These needs are inet by two
fluids, interstitial fluid and blood. Interstitial fluid bathes body cells. Blood is a connective tissue,
transport fluid, provides communication between the cells of the body and the external
environment.

Blood makes about 7-8% of body weight (about 5.5 liter in men and 5 liter in women).

‫الرندر‬

Functions of blood

The blood has three main functions: 1. Transportation:

Blood carries oxygen from the lungs to the tissues and carbon dioxide from the tissues to the
lungs for excretion. 35

creoljo Blood carries putrients from the alimentary tract to the tissues and the cells waste
product to the excretory organs (kidneys,

lungs and skin). Obe c Hormones secreted by endocrine glands transported by blood to

their target glands and tissues. '&=' Blood carry heat produced in active organs and tissues to
other

less active speech

to aleas of infections.

Blood carry antibodies to areas of infections.

2. Regulation;

The blood which circulate throughout the body help to maintain

.homeostasis in all body fluids

‫المرکی‬
‫ي‬
‫ف‬

Blood helps to regulate pH through buffers. Blood helps to maintain body temperature

‫اما عی طرح ای‬

81 =

‫وين الرسم‬
Right pulmonary artery

Left pulmonary artery

‫ل عز وكر لصن‬
‫ا‬
‫السهل ال‬

E‫قي من‬

Superior vena cava

‫هاوالور رهل الوم من كم إلى الهاب‬

- Left pulmonary veins

‫می برم غراوكر‬

‫ای ج ان الر منها دم اكم غررالوک‬

Inferior vena cava

Figure 7.6 Direction of blood flow through the heart

The pulmonary artery leaves the heart from the base (upper part) of the right ventricle, and the
aorta leaves the heart from the base (upper part) of the left ventricle.

The valves of the heart and of the great blood vessels open and close according to the pressure
within the chambers of the heart. The atrioventricular valves (tricuspied and mitral valve) open
during atrial systole, so the blood moves from atria into the ventricles when atrial pressure is
higher than ventricular pressure, and close during ventricular systole, when ventricular pressure
is higher than atrial pressure.

When the ventricular pressure rises above that in the pulmonary artery and aorta, the
pulmonary and aortic valve open and blood flows into these vessels. When the ventricles relax
and the pressure within these ventricles falls, first the pulmonary and aortic valves close, then
the atrioventricular valves open. The opening and closing of valves ensures that the blood flows
in one direction only. Aortic and pulmonary valve formed by three semilunar cusps.

disse ventricles.ce. When thary and a

‫مراد اليوم اللي سن‬

‫مرد دايموت للعلب‬

Blood supply to the heart

Coronary arteries (right and left) supply blood to the tissues of the heart. They are the first two
branches of aorta immediately distal to the

|
|

Pulmonary circuauon

Pulmonary circulation (Figure 7.15) consists of circulation of lilood! from the right ventricle
through pulmonary atery to the lungs and bac!! from the lungs through pulmonary yeins (two
pulmonary veins from eacl lung) to the left atrium of the heart. Then the blood flow to thlef
ventricle to be pumped again through the systemic circulation. In the lungs exchange of gases
takes place between blood in pulminar capillaries and air in alveoli; through which carbon
dioxide is excreted and oxygen is absorbed.

Left and right pulmonary

arteries Trachea

Plumonary veins

Superior lobe Superior lobe

Middle lobe

Inferior lobe

Inferior lobe

Figure 7.15 The flow of blood between heart and lungs.

‫الباليرررة رموبه خيرا‬

"

lüs

‫اياز‬

sheng

Portal (hepatic) circulation Wg Quo apy dzi

w The portal circulation (Figure 7.16) carries venous blood from the capillary beds of the
abdominal part of the digestive system, the sleer and paricreas to the liver. A vein that carries
blood from one capillar network to another is called a portal vein. In the liver the blood pisse
through a second capillary bed, the hepatic simusoids.

The detour of venous blood through a second capillary bed in the liver before its return to the
heart serves some valuable purposes Fo| example, when a meal is being absorbed, the blood in
the portal veis contains a higher concentration of glucose-more than normal. ivell

mo!

. Hormones
Hormones are chemical compounds synthesized by endocrine glands. Hormones pass directly
from endocrine glands into the blood to their target glands and tissues, where they influence
cellular activity.

. Gases

The most important blood gases are oxygen and carbon dioxide. Plasma also contains a
considerable amount of dissolved nitrogen, which ordinarily has no physiological functions.

Oxygen, carbon dioxide and nitrogen are transported round the body dissolved in water of
blood plasma. Oxygen and carbon dioxide are also transported in chemical combination with
hemoglobin in red blood cells. Most of oxygen (98.5%) is carried in combination with
hemoglobin as oxyhemoglobin and most of carbon dioxide (78%) is carried as bicarbonate ions
dissolved in plasma.

‫مر العرر‬
‫مر من (خر سال‬

3 DRC

‫شرح اال للدرج‬

Blood cells

There are three types of blood cells: Erythrocytes or red blood cells.R BO Thrombocytes or
platelets. show Leukocytes or white blood cells.

The life span (life time) of the blood cells varies (some lymphocytes years, erythrocytes 120 days
and thrombocytes 7-10 days). Blood cells are cotinously dying and being replaced within hours,
days or weeks. The total numbers of erythrocytes (RBC) and thrombocytes

(platelets) regulated by (negative feedback mechanism and their numbers 'normally remains
constant. Leukocytes (WBCs) are different types, they

varies in response to challenges by invading microorganism and other

antigenonse to challenges ocytes (WBC) areal and

‫لون لهم (خمايحطم هل الوار‬

‫مع الث‬

if the

The process of blood cells formation is called hemopotesis or hematopoiesis. Before_birth,

heinopoiesis occurs in the volk sаo of an e embryo, and later in Spleen, thymus, lymph nodes
and liver of a fetus. In
the last three months of fetal life, red borte matrow becomes the primary site of hemopoiesis
and continues after birth and throughout life as the main source of hemopoiesis (blood cells
formation),

The Cardiovascular System

‫شان‬
‫بر‬
‫غرش‬

Yugio

rterioles

Arteries and arterioles T elle u

Arteries are strong, elastic vessels, transport blood a way from the heart under high pressure. C l
icach

Arteries subdivided into progressively thùner tubes and eventually L

,give rise to finer branched called arterioles

‫ر ال‬
‫ا‬
‫الموارتر‬

Lik

Three layers of tissue found in the wall of an artery, they are;

b.

.Outer layer of fibrous tissue

‫اخويا حنای (یے مرج‬

‫او عضالمالر‬

Middle layer of elastic tissue and smooth muscle! 120 Inner lining of squamous epithelium
called endothelium.

The amount of elastic tissue and smooth muscle varies in different

eum called endothelium

‫ انا مرن يعرف‬size of arteries

‫اكر‬
‫ان والحه‬

isluk,

licy The large arteries (elastic arteries), the middle layer consist of more

elastic tissue and less smooth muscle. As the arteries subdivides the amount of elastic tissue
reduced and the smooth muscle increased until in the arterioles the middle layer consist only of
smooth muscle. The wall of - arteries thicker than the wall of veins because the amount of
elastic tissue and smooth muscle in the wall of arteries more than the walls of the veins, this
enables them to withstand the high force (pressure) of arterial blood.

eller NLPigenen The sympathetic branches of the autonomic nervous system stimulate
(innervate) the smooth muscle in the wall of artery and arteriole. Impulses through vasomotor
fibers stimulate the smooth muscles to contract, reducing the diameter of the vessels. This is
vasoconstriction. If vasomotor impulses are inhibited, the smooth muscles relax, and the
diameter of the vessel increases. This is called vasodilatation. Changes in the diameters of
arteries and arterioles greatly influence blood flow and blood pressure.

‫ل‬
‫بعله‬

Veins and venules

The veins are the blood vessels that carry (return) the deoxygenated blood from all parts of the
body at low pressure to the heart. The walls of ! veins have the same structure of arteries in that
they are composed of three distinct layer. The veins have thinner wall, because the middle layer
in the wall of veins contain less elastic tissue and smooth muscle as

.compared with those of arteries ‫وكار‬

‫مایان‬

Many veins have flap like ya yes, which prevent backflow of Blood, ensuring that it flows
towards the heart. Valves are abundant in

The Cardiovascular System

blood pumped (ejected) steadily from the heart into the aorta, the pressure in the wall of blood
vessels, remain constant, so there would be no pulse.
The elasticity of the arterial walls, which allows them to expand with each ejection of blood
(each contraction of the left ventricle) and then recoil.

The number of pulse beats per minute normally it represents the heart rate, average of about
60-100 is cominon during rest condition. The number of pulse varies in different people and in
the same persons at different times.

‫زاک الشعور باله‬

Where pulse can be felt?

The pulse can be felt in the following speciñc locations (Figure 7.12).. 1. Radial artery-at wrist. 2.
Temporal artery-in front of ear. 3. Common carotid artery-along anterior edge of
sternocleidomastoid

muscle at lower level of thyroid cartilage. 4. Facial artery-at lower margin of lower jaw bone (in
groove in

mandible about one way forward from angle jaw). 5. Brachial artery-at bend of elbow along
inner margin of biceps

muscle. 6. Popliteal artery-behind the knee. 7. Posterior tibial artery-behined the medial
malleolus. 8. Dorsalis pedis artery-on the dorsum (upper surface of the foot.

The Blood

‫كانال‬
‫اعالم الفجيرة‬
‫دال‬

Red bone marrow present located in cancellous (spongy) pond tissue, it is present mainly in
sternum, Mbs, vertebrae, skull bones_a id is|

‫ کرد‬N‫ سامانه‬.the epiphysis of long bones e

humerus ,

fem
Pluripotent stem cells (hemocytoblast) are cells that have the a sility to develop into several
different types of cells.

Stem cells in red bone marrow reproduce themselves, prolife rate and differentiate into cells
that give rise to different blood cells (Figure 6.2).

‫)عالا هزعلنية والمكان المس‬

‫ و‬Balochistan ‫بلور‬

| ‫و له‬1 ‫محليه اخمة‬

- Mahold stem ce ‫تے‬

CFV-E Colony-forming unit-erythroc te CFUitleg Colony forming unti-megata rocyte CFV-GM

Colony-farming unit-auto

macrophage

Lymphold them cel

CHUGM

‫يا احالها‬

Eosinophile myeloblast

Berooh myeloblas

Myeloblast

Proerythroblast-Wegalisyoblast

Monoblast: Tlymphoblast Bymphol last !

Nucleus ecled

‫مز‬

/‫تها‬

Resources ‫حداد كه‬

Reticulocyte

Megalaryocyla

Eosinophe

Basophi!

Neutrophe |

Monocyte
rodho Aed blood cell

Platelola

Tlymphocylia

Blymphoc

‫ هللا‬T)

(orythrocyte)

ber

- Granular leukocytos

- Agranular laukocytos

‫رموه‬. ‫تاال ( مجموعة صائ‬

‫المه‬.

‫حارو دلم رشد کرد‬

Metasplus :‫علي بن‬

Aan

casin

Granulocytes

Have large granules in their cytoplasm, they are named according to their cytoplasmic staining
properties:

a. Neutrophils >650 b. Eosinophils. c. Basophils.

‫های دانماى‬

has to 3 day

‫النواه فضا اکتی‬

‫من‬
‫الء س لة‬
‫همائی رات وظائف‬

‫مرا فرا‬

shes

‫ا‬
‫اإلنساي‬
‫ر زهرا (حازما اگر لجزي الريم االيرا تكذب لطه‬

Agranulocytes Without cytoplasmic granules. a. Lymphocytes..

b. Monocytes. Neutron

Neutrophils take their name from the fact that the granules in the so al cytoplasm stain l e with
neulicamiyes. They are called polymorpho

nuclear leukocytes because their nuclei have two or three lobes. They are il 12-15 micron in
diameter, their life span hours to 3 days. Their number Nayerage about 65% of total WBC.count
in a normal blood sample.

Neutrophils are motile, Very active phagocytic cells, they al migrate out of blood vessels to the
tissue spaces by amoeboid movement, the process called diapedesis.

They are attracted to any area of infection by chemical substances released from damaged cells,
called chemotaxin. They engulf and laill they microbes by phagocytosis.

The number of neutrophils increased in some physiological conditions following strenuous

exercise and in the later stages of normal 1 pregnancy. Numbers are also increased in the
following conditions:

bacterial infection, leukaemia, use of oral contraceptives, tissue damge, 0 9 e.g. inflamation,
myocardial infraction, burns, and metabolic disorders, ANEL

I e.g. acute gout, diabetic ketoacidosis.

Eosinophis

Eosinophils cytoplasmic granules are large site, numerous and stain red or orange with acid ives,
such as eosin Their nucleus have two >hes. Normally they account about 2-5% of circulating
white blood cells

WRCS)) They are 10-12 micron in diameter, their life span from (10-12

‫اكرر اكا‬
‫مراد‬
‫الحارثه‬

(WBC) they

‫له يحى دورة‬

Chemoreceptors

Cheinoreceptors, sensory receptors that monitor the chemical composition of blood, they are
located close to the baroreceptors of the carotid sinus and arch of aorta in small structures
called carotid bodies and aortic bodies, respectively. The chemoreceptors detect changes in
blood level of carbon dioxide, oxygen and the acidity of blood (Figure 7.11)
** [H")

+PCO

Chemoreceptors

Chemoreceptors —

CVG

cvc —

Stroke volume Heart rate Vasoconstriction

HitBP

+PO,

EPI

[H) BPCO 1.PO

Chemoreceplors

CVC

Stroke volume Heart rate Vasoconstriction

Figure 7.11 The relationship between stimulation of chemoreceptors and arterial blood
pressure.

Higher centers in the brain

Input to the cardiovascular center from the higher centers in the brain, e.g. hypothalamus is
influenced by emotional states such as fear, anxiety that may stimulate changes in blood
pressure.

The hypothalamus in the brain controls any changes of body temperature, influences
cardiovascular center which responds by adjusting the diameter of blood vessels in the skin (see
unite 3).

‫ م ارات من القيام الرمر‬Pulse

‫ا‬
‫المتر‬
‫و‬

Pulse is defined as a wave of an alternate expansion and recoil of an artery wall, due to
contraction of the left ventricle pumping about 60-> 80 milliliters of blood to the already full
aorta and then into the arterial system.
Two main factors are responsible for the existence of a pulse that can be felt at any point where
a superficial artery can be pressed gently against a bone: 1. Intermittent ejections of blood from
the heart into the aorta, which

alternately increase and decrease the pressure in that vessels. If the

128

Tie Blood

‫الماضي بمعامن‬
‫قاتل اکرم‬

Blood groups and transfusions

Transfusion of blood directly from one person to another prduce various results. Sometimes, the
recipient improved. Other times, the Lot recipient suffered a blood transfusion reaction in which
the red blood cells clumped, and cause obstruction of the blood vessels, hemolysis, ose

leid shock and kidney failure.

Safe transfusions of blood depend on proper matching ,between blood donars and recipients.

‫مغل بتاع الحل‬

‫امه و دعمي‬

Antigens and Antibodies

There are different types of antigen on the surface of red blood. cells, these antigens called
agglutinogens. The antigens are inherited, decides the individuals blood group. The individuals
also make antibodies to these antigens, but not to their own type of antigen, If they do so, the
antigens and antibodies would react causing a transfusion reaction. These antibodies
(agglutinin) found in plasma and they are genetically determined, they differ from antibodies of
acquired immunity.

There are many antigens on the erythrocytes membranes but only few of these can produce
serious transfusion reactions. These include the antigens of ABO group and those of Rh group.

que

‫مودی اور اسم البرا‬

Red

ABO blood group

The ABO blood group is based on the presence or absence of two major protein antigens on
erythrocytes membranes, they are antigen A and antigen B.

• A person with only antigen A has blood group A.

• A person with only antigen B has blood group B.

• A person with both antigen (A and B) has blood group AB.

• A person with neither antigen A nor B has blood group o. w

Thus, all peoples have one of four possible ABO blood types: A, B, AB, or 0.

who win antigen we

v es to wh sljedete Yaw Wlotivodone

‫مویب مع نواب‬

+ ‫کی امالح‬

Vide D.

‫ لرمو‬12 ‫الرد‬

The Cardiovascular System

‫رررة الرا‬

3 | ‫(مهیب‬

Circulation of the blood Systemic (general) circulation

The term circulation of blood means that the blood flows through vessels arranged with each
other to form a circular pattern.

Systemic (general) circulation consists of circulation of blood from the left ventricle of the heart
through blood vessels (aorta and its branches) to all parts of the body and back to the right a
trium of the heart. (Figure 7.13, 14)

The left ventricle pumps blood into the aorta, from aorta, the blood flows into arteries that carry
it into the tissues and organs of the body, where exchange of substances occurs between blood
in blood capillary and the cells of the body. The blood flows out of each tissue and organ by way
of its venules and then its veins.

All of veins of the body join together to form superior and inferior vena cava. These two large
veins return venous blood to the right atrium, then the blood flow to right ventricle of the heart
to complete the systemic circulation. But still the blood has not yet complete full circle back to
its starting point in the left ventricle. To do this and begin again from the starting point, it must
first flow through another circuit, called pulmonary circulation.

‫ما راح ال مدرنتر نتور کربر را سا‬

‫و‬
‫اال بناه سرا‬
‫مع المعتبر حوادرم ای رقیب ای مجر م‬
|

‫نرجع ح طریگورہ (دكم مع هاي الدورة منا الرحة حديث‬

‫األمر السا دو‬
‫سروج حمامات بحورك‬
‫رده سلطان‬
‫بيا حمزة العال سه‬
‫مرا تيره السركا بسررع الدم إل اكمیرا‬
‫ة‬
‫المرار من العار حار كبيره‬
‫ا‬

||

‫ذكر ربات اعالمية ما) وعر بهار مع لحم ويمارع نبردع‬

‫|| یاد را بین (صاالروة كسرك‬

‫اک حرا علوں‬

‫کا‬
‫لونها‬
‫المال ديفان‬

2 Plasma plasma.

522 protein Plasma is a straw coloured transparent fluid, consist of water 1%,

(proteins (albumin, globulins, fibrinogen and clotting factors) and other solutes) (nutrients,
inorganic salts, gases, organic waste products and hormones) 2%.

‫البرزبات الره‬

bunin and

‫الكيه دهند‬

su

• Plasma proteins

Most of the plasma proteins synthesized in the liver, which include album (54% of plasma
proteins), globulin (38%), fibrinogen (7%) and clotting factors (1%).
Plasma proteins, which constitute about. 7% of plasma, are normally retained within the blood,
because they are too large to escape through the capillary pores into the tissues. Plasma
proteins responsible for creating the osmotic pressure of blood (normal osmotic pressure of
blood is about 25 mmHg). This pressure keeps plasma fluid within the circulation.

Suppose plasma proteins levels reduced, due to reduce production or loss from blood vessels,
results in reducing osmotic pressure, so fluid moves into the tissues and body cavities causing
oedema.

‫ كثركر‬.

Album

‫را‬
‫اكتركردنی نروانے ادرم‬

‫اور لوگ‬
‫حامل را در الضغط األسموزی‬

They are synthesized in the liver, they are the most abundant plasma proteins.

Albumin are an important determinant of the osmotic pressure of plasma (maintain normal
plasma osmotic pressure of about 25 im Hg).

By maintaining this pressure, albumin and other plasma proteins .. help in regulation water
movement between the blood and the tissues. In doing so, they help control blood volume.
Blood volume directly related to blood pressure

Lipids. steroid horr Albumin act as carrier molecules for lipids and steroid hormones.

‫يم اال‬

Globulins: ne There are three types of globulins, alpha, beta and gamma

globulins. The liver synthesize alpha and beta globulins, which have a variety of functions,
including transport iron, lipids, (fat souble vitamins and some hormones, e.g. thyroglobulin
carries thyroxine. Gamma globulin produced by plasma cells) which develop from lymphocytes.

labo

The Blood

Pluripotent stem cells produce two further types of stem cells, called myeloid stem cells and
lymphoid stem cells.. .

Myeloid stem cells begin their development in red bone marrow and give rise to red blood cells,
platelets, monocytes, neutrophils, eosinophils and basophiles, Lymphoid stem cells begins, their
development in red bone marrow but complete it in lymphatic tissue, they give rise to
lymphocytes.

‫مرا االم اغرا‬

..

‫کد خاليا الدم (ری‬

Erythrocytes (red blood cells)

Erythrocytes are circular biconcave, non-nucleated disc, their diameter about 7 microns.
Because they fack nuclei, mature erythrocytes cannot synthesize proteins or divide. A lebo
Erythrocytes count 4.5-5

This is the number of erythrocytes per litre or per cubic millimeter (mm) of blood. The typical
range of adult males is 4.5 to 6.5 to million/mm' of blood, and that for adult females is 4.5 to 5
million/mun

• of blood will wys les

4,5,6,5

‫ص ر العثه‬
‫ایده امرة بليط تحك رعرع‬
‫مرة والمعجے‬

Development, control and life span of erythrocytes

The average life span of erythrocytes is about 120 days. Daily a large number of erythrocytes are
removed (hemolysed) from the circulation, and yet the number of erythrocytes remains
constant. This is due to homeostatic negative feedback mechanism

The process of development of erythrocytes from pluripotent stem cells takes about 7 days, this
process called erythropoiesis

I l mi

Two main features characterised erythropoiesis 27-Maturation of the cell

5:- Formation of hemoglobin inside the cell.

‫لية طرها الرم (کا‬

|
‫الكلية الدعو‬

cell

det

‫له اله‬

WSW

‫حماه حماة‬

erythropoiest

‫ا‬
‫أن‬
‫لیر‬

Stepi

Whely

puppy, sbor kedi

The Cardiovascular System Tex Blood pressure

The force or pressure which the blood exerts on the wall of blood vessels called blood pressure.

The systemic arterial blood pressure, simply called arterial blood

pressure and it is the result of discharge of blood from the left ventricle 1 ) into the already full
aorta.

SEX Systolic blood pressure is the pressure produced in the arterial

system due to contraction of the left ventricle it is a bout 120 mmHg.

Diastolic blood pressure is the pressure produced within the arteries during complete cardiac
diastole (during resting of heart) it is about 80 mmHg.

These figures vary according to the time during the day, gender, posture and age of the
individual. Blood pressure tend to reduce during bedrest, and increased with aging and is usually
higher in women than in men.

As the blood leaves the aorta and flows through the systemic circulation, its pressure falls
progressively as the distance from the left ventricle increases. Blood pressure decreases to
about 80 mmHg on the wall of arteriole and to about 35 mmHg at the arteriole end of capillary,
where as at the venous end of capillary the blood pressure reduce to about 15 mmHg.
Blood pressure continues to drop as blood enters verules and then veins because these vessels
are farthest from the left ventricle. Finally, blood pressure reaches 0 mmHg as blood flows into
the right ventricle.

The instrument used to measure arterial blood pressure is sphygmomanometer uche pour le co

Blood pressure

Systolic blood pressure ului,bep Diastolic blood pressure Relax

120 44 mmHg |

80 Mean arterial blood pressure (MABP), the average pressure in arteries, it can be estimated as
follows:

MABP Diastolic Bp + (Systolic BP-Diastolic BP) * Thus, if BP in a person is mmHg, MABP is about
93 mmHg.

123

‫امل ہوتے‬

The Blood

Low blood oxygen

Release into bloodstream Stimulation

Liver

Kidney

Inhibition

‫البته رت الراحة‬
‫السلسه‬

Erythropole in

‫مادة تسح‬

02

Increased oxygen carrying capacity

‫امتناع‬
‫یا‬

Bloodstream

Increased nu.mber of red cells

1
‫حرار دعس‬

Red bone marrow

Figure 6.3 Low blood oxygen causes the kidneys and liver to release erythropoietin, which
stimulates the production of red blood cells that carry oxygen to tissues.

‫عامر عة ہے ضر و اال والرحم (حد‬

‫ (نوع الم‬Maturation of the cell

‫حي النواه‬

During developing erythrocytes the cell decrease in size and lose its el nucleus (Figure 6,4).
Vitamin B12 and folic acid are important for this OP process. They are found in meat and green
vegetables, If the diet contains

more than needed, excess store in the liverb for future use. Absorption of sull vitamin B12
depends on a glycoprotein called intrinsic factop secreted

from stomachi Together the two compounds form intrinsic factor-vitamin B12 complex, this
complex form is protected from the action of enzyme. Absorption of vitamin B12 occur through
the terminal part of small intestine (ileum). The absorption of folic acid occur through
duodenum and jejunum.

Signs of deficient intake of vitamin B12 appear after several years due to large amounts stores in
the liver. Signs of deficient intake of folic acid appear within a few months.

ortaccur thelected from intrinsic fed

‫قلون‬
‫النهاية (برز‬

The Cardiovascular System

A normal ECG pattern includes several deflections, or waves, during each cardiac cycle. The
waves named P, Q, R, S and T (Figure 7.8). When the impulses from the SA node spread over the
atria the p wave arise, corresponding to depolarization of the atrial fibers that will lead to
contraction of the atria.

Depuis puses

Redakitiph

Redan

ilea

tertea

Cuiship! I
CD

- ‫زرد (سمطان‬

0.8 sec

1 sec

Figure 7.8 Electrocardiogram of one cardiac cycle

When the cardiac impulses reaches ventricular fibers from the AV node through the AV bundle
and purkinje fibers, they rapidly depolarize. Because ventricular walls are thicker than those of
the atria, the pen deflects more because the electrical change is greater. When the electrical
change ends, the pen returns to the base line. This mark consists of Q: wave, an Rwave and an S
wave, these waves corresponds to depolarization of the ventricular fibers that will lead to
contraction of the ventricles.

The T wave represents the slowly repolarization of the ventricles lead to the relaxation of the
ventricles.

‫رجحان اهل‬

Cardiac output

All body cells must receive a certain amount of oxygenated blood each minute to maintain
health and life. Metabolically active cells, as during exercise, they take up even more oxygen
from the blood. During rest periods, cellular metabolic need in reduced, so the workload of the
heart reduced.

‫العالما ملغراما عاد‬

Eventually, the accumulation) and attachment of large numbers of abo platelets form a mass
called platelet_plug. This is a positive feedback the system by which many platelets rapidly
arrive at the site of damaged police vessel and quickly form a temporary seal called platelet
plug. aula 6

‫ياعماتح كرعلية حي‬

3 dole

Blood clotting Clotting of blood involved several substances known as clotting factors (Table 6.2).

Table 6.2 Blood clotting factors II Fibrinogen 21 Prothrombin

Tissue factor (thromboplastin) u TV Calcium (Ca) 5V

Labile factor, proaccelerin, Ac-globulin VI Stable factor, proconvertin

Antihemophilic globulin (AHG), antihemophilic factor A Christmas factor, plasma thromboplastin

component (PTA), antihemophilic factor B Stuart prower factor Plasma thromboplastin
antecedent (PTA).
Antihemophilic factor C 12 XII Hageman factor

XII Fibrin stabilizing factor - There is no factor VI - Vitamin K is essential for synthesis of factors II,
VII, IX and X

IX

These factors include calcium ions, several inactive enzymes that are synthesized inside liver and
released in blood stream and various molecules associated with platelets or released by
Gamaged tissues. Most clotting factors are Roman numbers that indicate the order of there
discovery, and not necessarily the order of their participation in the clotting process.

Blood clotting results in formation of an insoluble thread-like mesh of fibrin which traps blood
cells and is much stronger than the rapidly formed platelet plug.

Clotting process summarized as follows:

First stage:

Formation of prothrombin activator called prothrombinase (active thromboplastin).

THE CARDIOVASCULAR SYSTEM

‫ره ما ل مفا و ویانا‬

Introduction

The cardiovascular system is divided into two main parts: 3 The circulatory system.

Consists of heart (acting as a pump) and blood vessels through which the blood flows.

The lymphatic system anails medi c al adinaj

Consists of lymph nodes which filter the lymph and lymph vessels through which the lymph
flows.

The heart act as a pump to maintain a constant circulation of blood throughout the body. The
heart pumps 7.000 liters of blood through the body each day. This muscular pump forces blood
through arteries, connected to smaller-diameter vessels called arterioles, arterioles leads to
thinnest tube, the capillaries, are the sites of nutrients, gases, electrolytes and wastes exchange.
Capillaries converge into venules, which in turn converge into veins that return blood to the
heart completing the closed system of blood circulation.

The right side of the heart deals with deoxygenated blood, which pumps blood to the lungs (the
pulmonary circulation) through which exchange of gases takes place. CO2 leaves the blood in
Pulmonary capillaries of the lungs and enter the alveoli and O, leaves the alveoli and enter the
pulmonary capillaries.
The left side of the heart deals with oxygenated blood, which pumps blood to all parts of the
body (general circulation) in which tissue pick up (extract) O2 and nutrient, and the tissues
waste are passed into the blood for excretion.

Ascus glane

TS

‫وأركمانيه‬
‫بتی عالی صفتت االلتهاب نجد‬
‫العابر‬

TAE DIUM

AJMCOS activated in the Thymus gland and B lymphocytes, activated in lymu hoii
tissue.elsewhere in the body, possibly in the walls of intestine.

Thereafter some cells of both types circulate in the blood and some settle in lymphoid tissue,
mainly in lymph nodes and spleen. The activated lymphocytes encounter antigens they develop
sp cife protective capabilities and each type divides into two groups; efter cells that promote
destruction of their specific antigen, and memory cells that remain in lymphoid tissue and
multiply, passing on their sp.cific protective characteristics to subsequent generation of
cells.abcllveel 'c

T-Lymphocytes are sensitized when they encounter an antige fer the first time. Effectory cells
act directly against antigens in conjunctio n with phagocytes. T-lymphocytes produce a number
of che nic 1 2 substances:

Lymphokinase that attract macrophages to the site. M C

Lymphotoxin that kills foreign cells, e.g., microbes. oL o Interferons that prevent virus
reproduction inside cells.

The memory cells confer cell mediated immunity and subsequent encounters with the same
antigen lead to the proliferation of sens tized lymphocytes. Examples of such antigens include:

. Cells regarded by lymphocytes as abhormal (viruses, cancer cells,

tissue transplant cells). Bacteria. Fungi

Penicillin and aspirin.

• Flowers and plants pollen, epis bei

B-Lymphocytes are activated by microbes and their toxins. They develop into plasma cells which
secrete antibodies. Antibodies pro mo le phagocytosis of foreign materials and neutralize toxins.

The memory cells .confer humoral immunity, i.e. they rea :t to subsequent encounters with the
same antigen by stimulating the production of effector cells and antibodies. Monocytes
‫را فرا‬
‫اراها‬

Monocytes are the largest of all leukocytes, they are about 12-17 micron in diameter, they have
kidney-bean shaped nucleus, bhe gallyu staining cytoplasm. They account for about 5% of all
leukocytes. There life span few months.) some monocytes circulate in the blood an ale actively
motile and phagocytic while others migrate from the blooc in lo

‫ل‬
‫ح وليراکنر‬
‫در‬
‫معاما المانع‬

PIÓ

The Blood

Petal 2ARG major fetal hemoglobin (hemoglobin F-arr.) consists of two alph and two gamma
chains. The delta and gamma chains have the same mu mblir of amino acids as beta chains.

Each molecule of hemoglobin contains four atoms of iron. Eadba atom of iron can carry (bind)
with one molecule of oxygen, therefolle each hemoglobin molecule can carry four molecules of
oxygen.

Hemoglobin level. This is the weight of hemoglobin in whole blood, measured in grams per 100
ml. 13-18

13- 18 Male) 13-18 gm/ 100ml of blood. Female 115-16.5gm/ 100ml of blood 11,5-16.5 15.15

codawi Control of erythropoiesis - The number, of erythrocytes remains relatively constant,

which

means red bone marrow produces erythrocytes at the same ra e of Pl destruction. This is due to
homeostatic negative feedback mechanism w ie

Negative feedback utilizing the horrone erythropoietin, which controls the rate of erythrocytes
formation (Figure 6.3). This hor nos e -produced from kidney and to a Vesser extent from liver in
response to prolonged oxygen deficiency (hypoxia), for example, at high alti uds where the
percentage of oxygen in air is reduced, or after hemorrha ger excessive erythrocytes breakdown
(hemolysis) due to disease, the an out of oxygen delivered to the body cells initally decreases.
This dryp 'n oxygen triggers the release of erythropoietin hormone, which pass va thie blood to
the red bone marrow and stimulate erythrocytes production.

After few days, many newly formed erythrocytes appear in the circulating blood.

The increased rate of production continues until the number of erythr cytes in the circulation is
sufficient to supply body cells with oxygen

PD
‫اگر اسکا سا‬

Destruction of erythrocytes

Erythrocytes are quiet elastic and flexible and during their paisaje through small blood vessels
they bend. As erythrocytes age, these cells become more fragile, and susceptible to hemolysis.

The breakdown or hemolysis of these cells occur in spleen, bolle marrow and liver, macrophages
cells in these organs phagoeytist: ad destroy damaged erythrocytes.

Hemoglobin molecules released from destroyed erythrocytes are broken down into subunits of
heme (an iron containing substances) alld

- 90

The Cardiovascular System

Blood pressure must overcome this force if the blood is to continue flowing. Therefore, factors
that alter the peripheral resistance change blood pressure.

The middle layer (tunica media) in the wall of arterioles consists almost entirely of smooth
muscle which responds to nerve and chemical stimulation. Constriction and dilatation of these
vessels are the main determinants of peripheral resistance. Vasoconstriction increase peripheral
resistance, thus cause rise of blood pressure, conversely, vasodilatation decrease peripheral
resistance, this cause fall of blood pressure.

Control of blood pressure

There are two ways to control blood pressure: 1. Short-term control, from moment to moment,
this way mainly

involves the baroreceptors, chemoreceptors and hormones. 2. Long-term control, this way
mainly involves regulation of blood

volume by the kidneys and the renin angiotensin aldosterone system.

The cardiovascular center in the medulla oblongata of brain regulate heart rate and stroke
volume. The cardiovascular center controls neural, hormonal and local negative feedback
system that regulates blood pressure and blood flow to specific tissues. Groups of neurons
scattered within the cardiovascular center regulate heart rate, contractility (force of contraction)
of the ventricles, and blood vessels diameter. The cardiovascular center receives, integrates and
coordinates inputs from (Figure 7.9):

• Baroreceptors (pressure receptors).

Chemoreceptors. Higher centers in the brain, e.g. hypothalamus.

The Blood
blood, but if the Rh-negative person-who is now sensitized to Rh-positive blood receives another
transfusion of Rh-Positive blood some ma nth later, the donated red cells agglutinate.

A related condition may occur when Rh-negative woman i pregnant with an Rh-positive fetus for
the first time. Such a pregnancy! may be uneventful; however, at bifth (or if a miscarriage
occurs) the placental membranes that separated the mother blood from the feta blood during
the pregnancy tear, and some of the infant's Rh-positive blood cells may enter the mother
circulation. These Rh-positive cells mas then stimulate the mother tissues to begin production
anti-Rh antibodi s.

If a woman who has already developed anti-Rh antibodies becomes pregnant with a second Rh-
positive fetus, these anti-Rh antibodies, culled hemolysins, cross the placental membrane and
destroy the fetal red blood cells. The fetus then develops a condition called erythroblastosis fe
talis (hemolytic disease of the newborn).

‫د ام سب علم‬
‫ بكون اليه الوالده الول على سلم‬+ ‫االم االبن‬

‫ الحنين‬+

‫بنر امام مضاده الن‬

‫ يكون محلة ال الم انبي احمام مفاده‬+ ‫العه جذر‬

‫كون‬

‫| لكل الول مره مع الحمل در من الحل دور رطلحالة تكركال االحرار و (مرا ہ‬

‫بحر منه‬

Ihe Blood

200 Prothrombin

Second stage:

Prothrombin activator (prothrombinase) acts on the plasma protein prothrombin in presence of

Ca*- converting them to thrombin.

Buchu do Brothrombin activator

→ Thrombin

Ca+2 Third stage:

Thrombin acts on another plasına protein fibrinogen converts it to fibrin.

‫عامل‬

Whecow

Thrombin
I nose fibrin threads..

Thrombin

‫و با نرمله‬

child we

Loose fibrin threads_Factor Xlll active

Soluble fibrinogen Fourth stage:

Thrombin activate factor Xill which in turn in presence of Cat2

• convert loose fibrin threads to strengthened fibrin threads. O Factor xull hromom Factor XIII
active

Strengthened fibrin

threads The extrinsic pathway

The extrinsic pathway occurs rapidly within seconds when there is tissue damage outside the
blood stream (circulation). It is so called because the damaged tissue releases protein
substances called tissue factor (TF) also known as thromboplastin which pass into the blood
stream from cells, outside (extrinsic to) blood vessels, which initiate the formation of
prothrombinase (prothrombin activator). The intrinsic pathway

The intrinsic pathway of blood clotting has many steps, more complex as compared with
extrinsic pathway. Intrinsic pathway occurs slowly within 3-6 minutes and is confined to
circulation, its activators within (intrinsic to the blood. If the endothelial cells line blood vessels
become roughened or damaged, blood become in contact with collagen fibers around the
endothelium of the blood vessel

Also trauma to endothelial cells cause damage to platelets, so phospholipids released from the
platelets. Contact with collagen fiber activates clotting factor XII, which begins the reactions that
leads to activate clotting factor X. platelet phospholipids and Cat can also involved in the
activation of factor X.

When factor X is activated, it combines with factor V to form the active enzyme prothrombinase
(prothrombin activator).

The Cardiovascular System

‫ن‬
‫ت‬
‫رمورة للعلن‬
‫زفة‬

nes

‫عر‬
‫اروع‬
‫کس‬
‫کرن‬
‫دان‬

Nerve supply to the heart and regulation of the cardiac cycle

In normal conditions the intrinsic impulses generated within the conducting system is enough to
control heart rate in normal situation, and the blood which pumped from the heart contains the
sufficient amount of the requirement of cells from oxygen and nutrients.

In some conditions the volume of blood pumped changes to accomodate the cellular
requirements. For example, during strenuous exercise, skeletal muscles require more blood, and
the heart increases in response. Since the S.A node normally controles the heart rate, changes in
this rate are often a response to factors that affect the S.A node. The heart is influenced by
autonomic nerves originating in the cardiovascular center in the medulla oblongata which reach
it through the autonomic nervous system, which consist of sympathetic and parasympathetic
nerves and their actions are antagonistic to one another.

The'parasynpathetic fibers reach the S.A and A.V nodes and atrial muscle, when nerve impulses
reach nerve fiber endings, they secrete chemical transmitters acetylcholine, which decrease the
activity of the S.A and A.V node (reduce the rate at which impulses are produced) decreasing the
rate and force of heart beat.

W e Sympathetic fibers reach the heart and join the S.A and A. V node as well as atrial and
ventricular myocardium. The endings of these fibers secrete norepinephrine. (noradrenaline) in
response to nerve impulses, which increase the activity of the S.A and A. V node (increase the
rate at which impulses are produced) increasing the rate and force of heart beat.

The cardiovascular center input of sensory impulses from the cardiovascular system and the
output of motor impulses to cardiovascular system in response.

le

Relah

The receptors sensitive to stretch are located in arch of aorta and carotid arteries.

These receptors, called baroreceptors, can detect any changes in blood pressure. Increasing
pressure stretches these receptors, the signal from these receptors pass to the cardio inhibitory
center in the medulla oblongata.

The response of the medulla oblongata through parasympathetic impulses to the heart via vagus
nerve, decreasing the rate and force of heart beat, leading to lowering blood pressure toward
normal.

116

réci
o

VEB

Anti-A and

All groups

‫تقفيل‬

Table 6.3 The ABO system of blood grouping E co L o ve

Red cell Antibodies Can Can Blood

antigen in serum donate to receive group

(agglutinogen) (agglutinin)

from group A and B

Non

AB All groups A

A . Anti-B A and AB A and O в

Anti-A Band AB B.and O

Non

Anti-B The corresponding antibodies in plasma are called anti-A and anti-B.

Individuals with A blood group can't make Anti-A (they do not have these antibodies in their
plasma). Since otherwise a reaction to their own cells would occur, they make anti-B.

Individuals with B blood group for the same reason, make only Anti-A.

AB blood group have neither antibody. This type of blood groups known as universal recipients.

O blood group have both antibodics (anti-A and anti-B). This type of blood groups known as
universal donors.

‫اور اسی لیے‬

‫عامل برابر‬

Rb bloed group

The Rh blood group was named after the rhesus monkey was the first studied. In humans, this
group includes several Rh antigens (factors).

The most important of these is antigen D. 3714 If any of the antigen D and other Rh antigen are
present on the red
blood cells (erythrocytes) membranes, the blood is said to be Rh-positive, conversely, if the red
blood cells lack Rh antigens, the blood is called Rh negative.

As in the case of antigen A and B, the presence or absence of Rh antigen is an inherited trait. But
unlike anti-A and Anti-B, antibodies for Rh (anti-Rh) do not appear spontaneously. Instead, they
form in Rh negative person in response to special stimulation.

If an Rh-negative person receives a transfusion of Rh-positive, Rh antigens sutimulate the

recipient's antibody-producing cells to begin producing anti-Rh antibodies. In general this first
transfusion has no serious consequences, but the person become sensitized to Rh-positive

tuo

YONI Sey

in platelet count and a thrombopoietin hormone is involved to stimulate red bone marrow to
increase platelets production.

The life span of platelets between 1-10 days, those not used in hemostasis mechanism
destroyed by macrophages cells mainly in spleen. Functions of platelets w

e i c he con su go

‫قانع آالیند‬
‫محو كرر كبير من الصور عن االن‬
‫الية تعلمر األولية‬
‫و‬
‫سن الترف‬

.Formation of platelet plug in hemostasis ,1 ‫ع‬

SON

aliaste

‫الی‬
‫رفع‬

2. Promote vascular spasm which cause vasoconstriction. All go 43. Promote blood clotting
(coagulation). ( es) 234

4. Secretion of thromboplastin (prothrombin activator). 21. 5. Store and release many

substances during hemostasis, they are.

clotting factors, ATP, ADP and serotonin. Hemostasis i Hemostasis is a series of responses that
leads to stop bleeding. When a blood vessel is damaged or ruptured, these series of hemostatic
responses must occur quickly and controlled carefully. Three mechanisms reduce blood loss, in
which platelets play a vital part.

1.21, Vascular spasin. 1 2. Platelet phug formation.

si 3. Blood clotting (coagulation). Vascular spasm

o sas slulo tesos 's When blood vessels are damaged the smooth muscle in their walls contracts
immediately cause, vasoconstriction. Such a vascular spasm reduced the loss of blood for
severeal minutes to several hours, during that time the other hemostatic mechanisms go into
operation. The spasm is probably caused by damage to the smooth muscle, by chemical
substances called serotonin released from damaged platelets and by reflexes initiated by pain
receptors.

‫انفرا اصطن‬

‫شراگودر هالک‬/han ‫ من‬.

‫رقية كرالدم‬
‫ان المري‬

Platelet plug formation

de s us Luis The cytoplasm of platelets contain many vesicles through/which a

lot of substances are stored and released during hemostasis, they are clotting factors, ADP, ATP.
Cak serotonin, thromboxane, prostaglandine and fibrin stabilizing factor.

. L e s When a blood vessel damaged, platelets adhere to the damaged wall and their surface
become sticky, the adherent platelets clump to each other and they release adenosine
diphosphate LADR), which attract more platelets to the site. Circulating platelets stick to those
already at the damaged vessels and they also release their stored chemical to attract more
platelets. This gathering of platelets is called platelets aggregation.

The Cardiovascular System

Heart

‫اا‬

) ‫رکوع سے ان‬

‫ لعل من اماء‬۱ ‫همه‬

‫ بقيم القلیمی (امام در همین وقال‬Interior of the heart

| | Internally the heart is divided into a right and left sides by means of -

‫كراما‬
‫بوتفاع‬

set

‫ها‬
‫ان ت وده‬
‫وصرمعلوی وارفی خا طر‬

‫ در برای‬After birth blood cannot cross this septum from one side to another ‫بیت‬

(‫ع‬

Each side divided by means of valve into upper and lower chambers, the upper chambers, called
atria singular) atrium and the lower chambers called ventricles (Figure 7.5).

‫ا ا را‬

oltoso

//

‫سے ہرر‬
‫چرا داوطاروره علوهادی‬
‫الترسان (الر‬

1. Arch of aort

‫انرا‬
‫ورمر (جن علوي مگر‬
‫العمراني نار‬
‫اسوي ابها‬

1 manan

Bob

Superior vena cava Right pulmonary

‫دار‬
‫ اثر‬pulmonary artery ‫ماريا رلى‬

Left pulmonary veins

Aortic valve

ventricular

Right atrioventriculares

valve

Lall

‫البرما‬
‫اثری‬
‫از‬

‫اکبر درهم اما‬

(۹

‫ورته احرف موطهمتوعك (هران علوا‬

1.

Inferior vena cava

HA - Highl alnum LA Lali, atrium RV - Right venlide L - Lult ventriche

‫المربع‬

Aorta

Papillary muscle with chordae tendinene

Figure 7:5 Interior of the heart.

‫سواتر وماكرلرمال‬
‫ريهام الزاني الطبي االمر‬
‫ار‬
‫تمان‬
‫له كل اإلمام ماده‬
‫اما ما در‬

The right atrioventricular valve (tricuspied valve) has three cusps and control the flow of blood
from fight almum to right ventricle and
prevents the backflow of blood, tile-left atrioventricular valve (mitral oy-valve) bas two cuisps
control the flow of blood from left atrim to left

| ventricle and prevents the backflow of blood ۱ ‫| اضن‬

‫اواني المول‬
‫الوع‬
‫ازي‬
‫اگر‬

These valves open and close according to changes in the pressure in these chambers.

When the pressure in the atrims more than that in the ventrioles (durig atrial systole), the valves
opch. During ventricular systole when the pressure in the ventricles more than that in atriums,
these valves close

1‫را سر االس‬

The Blood

globin (a protein). Iron released by hemolysis store in liver for future use by red bone marrow to
form hemoglobin. ...

Globin is broken down into amino acid, which can be used to synthesise other proteins.

When iron is removed from heme, the non-iron portion of heme is converted to biliverdin,
agreen pigment, and then into bilirubin, a yellow orange pigment, bilirubin enters the blood and
then transported to the liver. Bilirubin secreted from liver as a constitute of bile to small
intestine and then into the large intestine. In the large intestine, bacteria convert bilirubin into
urobilinogen, some urobilinogen is absorbed back into the blood, converted back to a yellow
pigment called urobilin and excreted in urine. Most urobilinogen is eliminated in feces in the
form of a brown pigment called stercobilin, which give feces its characteristic colour.

sliedird) Lys granals

Ragwell

Leukocytes (white blood cells, restats

Leukocytes are the largest blood cells, they contain nuclei and they account for about 1% of
blood volume, classified according to the presence or absence of granules and the dyes they
take up when stained in laboratory. According to presence or absence of granules there are two
main types (Figure 6.5)

‫هة‬

granul

.
(1) Eosinophil

(b) Basophi

Neutrophil

ungranu

(d) Small lymphocyte

(e) Monocyta

3- 4-

Strength of myocardial contraction. Blood volume.

Factors affecting heart rate 1- Autonomic nerve stimulation.

Circulating hormones. Circulating drugs, electrolytes and dissolved gases. Emotional states.
Muscular activity and exercise. Temperature. Sex (gender).

Age.. 9- Position of the body.

Baroreceptor reflex.

‫كل مارد (الدر فتقی ناونان‬

‫العمل كشر‬
‫الهلر‬
‫اوج االم المتر‬
‫ک الر‬
‫وا‬
‫ا‬

Ventricular end diastolic volume (VEDV). VL The volume of blood in the ventricles_immediately
before they contract called ventricular end diastolic volume which determine the stroke volume.
This volume depends on the amount of blood returning to the heart through the superior and
inferior vena cava. If ventricular end diastolic volume (VEDV) increased, this leads to stronger
myocardial contraction, and more blood is pumped. In turn the stroke volume and

cardiac output increase.. lestrength of myocardial contraction. Jabbe cele 8 og

Two main factors leads to increase myocardial contraction. 1. Inereased activity (stimulation) of
the sympathetic nerves

innervating the heart. 2. The action of hormones adrenaline, noradrenaline and

Toel vry thyroxine &

bus Blood volume

The volume of blood circulating in blood vessels, is an important factor to determine stroke
volume, normally this volume kept constant by the sidneys, and if deficient leads to decreasing
venous return ,stroke volume and cardiac output. Venous return

Venous return refers to the amount of blood that is returned to the heart by means of veins.
Venous Peturn considered as the main determinant of the cardiac output.

121

‫حصرا كررتهايل الكل‬

‫ رهبر ابها‬The Blood ‫ج‬

the tissues, where they enlarge and differentiate into macrophages. Some become fixed
macrophages, which ineans they reside in a particular tissue; such as alveolar macrophages in
the lungs, macrophages in the spleen and kupffer cells in the liver.

Other macrophages become wandering macrophages that gather at sites of infection or

inflammation. The number of monocytes are

infective bowel conditions.

‫كور حال البر الريما‬

1 Leukocytes count

Each cubic millimeter of normal blood contains about 5.000 to 10.000 leukocytes, with different
percentage of each type. The numbers ut of leukocytes change in certain abnormal conditions.
In acute

appendicitis, the percentage of neutrophils increases and also the total WBCs count increased,
this increase may be the deciding points for surgery. The procedure in which the different types
of leukocytes are counted and there percentage of total leukocytes count known as differential
white blood cell count (Table 6.1). An increase in the number of leukocytes is leukocytosis and a
decrease in their number is

‫کو‬
‫العمر‬

.leneaenia

‫کرد أزرار القمر‬

‫مار مارلرمم الفم‬

Table 6.1 Differential count of leukocytes (wbite blood cells)

Differential count Type

Normal range % Typical Value% Neutrophils

65-75

165

Eosinophils

2-5 Basophils

1/2-1 Lymphocytes

20-25 Monocytes

3-8

Total

100 1

100

25

‫میرا کے رعي فيه‬

Thrombocytes

platelets

‫نه رسورا‬

‫| الكل‬

‫بها‬

Platelets are very small, colourless bodies which appear as irregular spindle or oval disck, 2-4
micron in diameter, non-nucleated, the nomal blood platelets count between 200.000 to
350.000/mm. of blood. The control of platelets production is not yet clear but it is believed that
a fall

The Cardiovascular System

The other modifications of fetal circulation concern the fetal heart and large arteries.

Because the fetal lungs are deflated and do not provide for gas exchange, blood is shunted away
from the lungs and to the body. The Foramen ovale is an opening in the interatrial septum that
permits some blood to flow from the right atrium to the left atrium, not, as usual, to the right
ventricle. The blood that does enter the right ventricle is pumped into the pulmonary artery.
The Ductus arteriosus is a short vessel that diverts most of the blood in the pulmonary artery to
the aorta, to the body. Both the foramen ovale and the ductus arteriosus permit blood to bypass
the fetal lungs.

Just after birth, the baby breathes, and expands its lungs, which pulls more blood into the
pulmonary circulation. More blood then returns to the left atrium, and a flap on the left side of
the foramen ovale is closed. The ductus arteriosus constricts, probably in response to the higher
oxygen content of the blood, and pulmonary circulation becomes fully functional within a few
days.

6. Temperature: . Increased body temperature leads to increase heart rate, convi rsely

fall in body temperature results in decreasing heart rate.

7. Position of the body:

When the person in upright position the heart rate is usually astore than when lying down.

8. Sex:

In women the heart rate is faster than men.

9. Age:

In babies and small children the heart rate is faster than in older children and adults.

10.Baroreceptor reflex

May either increase or decrease heart rate.

‫)جهاد الفير‬

‫علی الصدر‬

bus

Heart sounds celulele (Weile

4 Heart beat can be heard if a stethoscope, is placed on the shelt wall, to the left of sternum.
Heart sounds are due to vibrations in leat tissues associated with the closing of the valyes. We
can hear two scunds lice lub-dup, separated by a short pause

The first part of a heart sound (lub), is fairly loud occurs & trin ventricular contraction and is due
to closure of atrioventricular valves

The second part (dup), softer and occurs during ventricular relaxation and is due to closure of
aortic and pulmonary valves.

‫المدير العامر امرا‬

pliebolle
ube

" ‫المار‬

i upru

Electrocardiogram

An electrocardiogram or ECG, is a recording of the elec rical changes that occur in the
myocardium during a cardiac cycle. A thu body fluids and tissues can conduct electrical currents,
the elec ricdi changes in the myocardium can be detected by attaching electrodes tth surface of
the body. The pattern of the electrical changes can be displayed on an oscilloscope screen or
traced on paper.

The instrument used to record the changes is electrocardiograph and the tracing is an
electrocardiogram.

118

‫كرر سیانار‬

mne cardiovascular System

‫و‬
‫العلب‬

es per minute is often calicode)

> PU

scle cells Jocale cuspied,

‫میلی متر‬

‫| محقر لت‬

J S A node activity is rhythmic, initiates one impulse after another

70-80 times per minute in an adult. Because it generates the heart we rhythmic contractions, it
is often called the pacemaker.. alones Se pres Atrioventricular node (AY node)

u Saz1 This small mass of specialized cardiac muscle cells located in the 7

inferior portion of the septum that separates the atria above the tricuspied valve. Normally the
AY node is stimulated by impulses that sweep over the atrial myocardium. However, it have the
ability to initiate nerve impulses but at slower rate than the SA node

Atrioventricular bundle (AV bundle or bundle of his)

This is a mass of specialized cardiac muscle fibers that originate from the AV node enters the
upper part of the interventricular septum and divides into right and left bundle branches that lie
just beneath the ), endocardium. About half way down the septum, the branches give rise to

enlarged fine fibers called purkinje fibers. The AV bundle, bundle JAV en branches and the
purkinje fibers convey electrical impulses from the AV pies

node to the apex of myocardium where the wave of ventricular contraction begins, then sweeps
upwards and outwards, pumping blood into, aorta and pulmonary artery. Cardiac cycle

The heart acts as a pump, to push blood to all parts of the body to maintain constant circulation
of blood.

The action of heart consists of a series of events collectively called the cardiac cycle. During each
cardiac cycle, the heart contract followed by relaxation.

Systol is the period of contraction and diastole is the period of relaxation

Normally the cardiac cycle occurs about 60-100 times in each minute, average about 75 times in
each minute, each cycle takes about

0.8 of a second.. do). Each cardiac cyele consists of three phases, they aret :

Atrial systol (contraction of atria) takes about 0.1 sec. Ventricular systole (contraction of
ventricles) takes about 0.3 sec. Complete cardiac diastole (relaxation of the atria and ventricles)
takes about 0.4 sec.

010

The Blood

‫زيوت ال اخام ارجی‬

Gamma globulin a type of antibodies (immunoglobulins) which help to attack viruses nd

bacteria. Fibrinogen:

Fibrinogen synthesized in liver and play an essential role in blood coagulation (clotting). D a b

‫در الرمال‬
‫بروشات‬

Clotting factors is sui prests

They are essential for clotting of blood, most of them synthesized in liver.

• Nutrients:

Plasma nutrients include glucose, amino acid, fatty acid, glycerol and vitamins.

Nutrients and mineral salts (inorganic salts) required by all cells of the body to provide energy,
heat, material for repair and replacement, and for the synthesis of some blood components and
body secretions.
Inorganic salts (mineral salts) (electrolytes).

These include: 0 Positively charged ions (cations) Na, K, Mgt?, Ca*2 O Negatively charged ions
(anions) CI', HPO4*, SO42, HCO 3

Inogranic salts involved in a wide variety of activities, including:

Cell formation. O Contraction of muscles.

Transmision of nerve impulses. O Formation of secretions.

Maintenance of balance between acids and alkalies. Bu

‫)بال‬

Organic waste products

The 'cells waste products carried by the blood to the excretory organs, e.g. urea, creatinine and
uric acid are the waste products of protein metabolism, they are formed in liver and carried by
the blood to the kidneys for excretion. Carbon dioxide released from all cells carried by blood to
the lungs for excretion.

o8L

பாபபடியயாDysreni

‫توابل مالرد‬

Cells

Tissue fluid

‫االنی نفت‬

Co2

dl

Diffusion of -

Og from

-Diffusion of

CO, from tissues

who will blood it

Arterial end of caplllary

Blood flow

Venous end of capillary

Figure 7.3 The exchange of gases in internal respiration

.

‫دعهن کوار قرا‬

‫سائل‬

SECTO Cells

PRODQOmodatglede in Tissue fluid

Lymphatic.

capillary

‫الصوارماهیر‬
‫اطلع عليه هللا‬

Arterial end

Venous end of capillary

Blood flow

of capillary Figure 7.4 Diffusion of nutrients and waste products between capillaries and cells.

The blood flow through the arterial system then to capillaries contains high concentration of
oxygen and nutrient material, these substances diffuse through the capillary walls at their
arterial end and enters the tissue fluid (they diffuse from higher concentration in the blood to
lower concentration in the tissue fluid). Conversely, the concentration of carbon dioxide and
many other wastes present in high concentration in the tissue fluid, these wastes diffuse from
higher concentration in the tissue fluid to lower concentration in blood (at venous end of
capillary).

Plasma proteins in general do not pass through capillary walls and remain in blood because they
are too large to diffuse through the membrane pores, in addition these proteins are not soluble
in the lipid portions of capillary cell membranes.

Diffusion process depends mainly on concentration gradients, filtration forces molecules

through' a membrane with hydrostatic

‫النصراع‬

Cardiac output is the volume of blood pumped from the left v entricle) or the right ventricle
each minute. The volume of blood ejected

from the ventricle during each contraction called stroke volume.

Cardiac output is expressed in liters per minute, cardiac output equals the stroke volume
multiplied by the heart rate (the number of heart beats per minute).
Cardiac output (CO)= Stroke volum (SV) x Heart rate (HR)

(ml/min)

(ml/beat)

(beats/min)

but bug

In a typical resting adult male, stroke volume average 70ml/beat and heart rate is about 75
beats/min. Thus, the average cardiac output is:

= 70ml/ beat x 75 beats/min pour m e = 5250 ml/min

= 5.25 min When the cells of the body use more or less oxygen, cardiac output changes to meet
the need. Factors which increase heart rate or stroke volume normally increase cardiac output.
During mild exercise, stroke volume may increase to 100 ml/beat, and heart rate to 100
beats/min. cardiac output then would be 10l/min. During intense (but still not maximal) exercise
the stroke volume may rise to 140 ml/min and the heart rate may increase to 150 beats/ min
providing cardiac output of 211/min.

Cardiac reserve: is the difference between maximum cardiac cutput and cardiac output during
rest condition. In athletes cardiac output may reach 351/min, so they may have cardiac reserve
seven times their resting state.

Gf - ‫عامر الملی‬

‫در‬
‫کرمان‬
۱ ‫کامل‬
‫علی‬
‫ان ان‬
‫يللر‬

Factors affecting cardiac output

Cardiac output=Stroke volume x Heart rate

When the body cells need more blood supply to meet their requirements of oxygen and
nutrients, heart rate and/ or stroke volume increased.

Factors affecting stroke volume: 1- Ventricular end diastolic volume (VEDV). 2- Venous return.

Position of the body.

Skeletal muscle pump. a Respiratory pump.

- 120

‫و الرم كل مازار‬

autlet sous

ess, opel

The Cardiovascular System

cells remove the excess glucose and store it as glycogen, thus blood leaving the liver usually has
a normal glucose concentration. Liver cells also remove and detoxify various poisonous
substances that may be present in the blood. The venous blood leave liver through hepatic vein
to the inferior vena cava.

To the liver sinusoids

ido

>

Portal veitt Right Left branch/(branch WY

Gastric

‫من كهر‬

‫و آمار حسن (خورما‬

Cystic

vein

veing

‫الحمراد مي‬

Partal vein

‫این رطیل‬

Splenic vein

Superior

>>

mesenteric

Inferior mesenteric
ber

vein

2 N‫بار الرمست‬

Figure 7.16 The portal veinformation and termination

‫نفر‬

‫ موارالر اور لوراكي اكون‬Fetal circulation

12 The fetus depends upon the mother for oxygen and nutrients and

for the removal of carbon dioxide and other waste products. The site of exchange between fetus
and mother is the placenta, which contains fetal and maternal blood vessels that are very close
to one another (Figure 7.17). The blood of the fetus does not mix with the blood of the mother;
substances are exchanged by diffusion and active transport mechanisms.

ORUS By The fetus is connected to the placenta by the umbilical cord, which

contains two utnbilical arteries and one umbilical vein (Figure 7.17). The

umbilical arteries are branches of the fetal internal liac arteries, they Is carry blood from the
fetus to the placenta. In the placenta, carbon dioxide

and waste products in the fetal blodd enter maternal circulation, and oxygen and nutrients from
the mother's blood enter fetal circulation.

1351

do

The Cardiovascular System

PZP and preventing the backflow of blood. Strong, fibrous cord called chordae tendineae extend
from the inferior surface of the cusps of the valves to the papillary muscles (little projection of
myocardium of the ventricles covered with endothelium) prevents tricuspied and inittal valve
from opening upwards towards atrium.

‫مادم‬
‫الرتوي‬
‫الره لدنوے (کرم‬
‫هرمونية مشرک سے ار‬

GGIORE

Flow of blood through the heart

The deoxygenated blood from all parts of the body return by superior and inferior vena cava to
the right atrium of heart (Figure 7.6). This deoxygenated blood pass via tricuspied valve into the
right ventricle (the right side of heart deals with deoxygenated blood), from right ventricle this
blood pumped into pulnionary artery to the lungs, pulmonary artery the only artery in the body
carry deoxygenated blood. Pulmonary valve consist of three cusps control the flow of blood
from right ventricle to pulmonary artery and prevents backflow of blood to right ventricle. The
pulmonary artery divided into right and left pulmonary artery which carry the deoxygenated
blood to the lungs, in the lungs exchange of gas (external respiration) takes place, oxygen is
absorbed and carbon dioxide is excreted, the oxygenated blood from each lung return to the left
atrium of heart by two pulmonary veins (pulmonary vein the only vein in the body carry
oxygenated blood). The blood then passes through mitral valve to left ventricle, from left
ventricle the oxygenated blood pumped into aorta to all parts of the body. The aorta is the first
artery of the general circulation, aortic valves consists of three cusps control the flow of blood
from left ventricle into aorta and prevents the backflow of blood. So we can conclude that the
blood passes from right to left side of heart via the lungs, both atria contract at the same time
which is followed by contraction of both

.ventricles

‫دان قصر عاتمام اعر ے دورة دموه گری‬

in platelet count and a thrombopoietin hormone is involved to stimulate red bone marrow to
increase platelets production.

The life span of platelets between 1-10 days, those not used in hemostasis mechanism
destroyed by macrophages cells mainly in spleen.

‫ادرا‬
‫دے کر سالم االعنه له کانون وال‬
‫لم تعلم االوالد‬

bowy3 D

‫نزم‬

cho

‫را النار‬

will ta

‫الزب‬
‫وضع‬

G.
Functions of platelets w ce euro cabo de sus H 1. Eormation of platelet plug in hemostasis. Buka
n

2. Promote vascular spasm which cause vasoconstriction. Logo 043. Promote blood clotting
(coagulation). ( a ) u 230

4. Secretion of thromboplastin (prothrombin activator). 5. Store and release many substances

during hemostasis, they are

clotting factors, ATP, ADP and serotonin. Hemostasis i Hernostasis is a series of responses that
leads to stop bleeding. When a blood vessel is damaged or ruptured, these series of hemostatic
responses must occur quickly and controlled carefully. Three mechanisms reduce blood loss, in
which platelets play a vital part.

1.8. Vascular spasın. 2. Platelet plug formation.

3. Blood clotting (coagulation). Vascular spasm

When blood vessels are damaged, the smooth muscle in their walls Ni contracts immediately
cause, vasoconstriction. Such a vascular spasm

reduced the loss of blood for severeal minutes to several hours, during that time the other
hemostatic mechanisms go into operation. The spasm is probably caused by damage to the
smooth muscle, by chemical substances called serotonin released from damaged platelets and
by reflexes initiated by pain receptors.

‫لمده با وسا؛‬
‫اوكه رسويد‬
‫تحریک کار کارت ملیاء‬
‫الدلم‬
‫الية‬
‫العرب‬
‫من‬
‫العام‬

Platelet plug formation

de US 's s The cytoplasm of platelets contain many vesicles through/which a lot of substances
are stored and released during hemostasis, they are clotting factors, ADP, ATP, Cat?, serotonin,
thromboxane, prostaglandine and fibrin stabilizing factor. . . DE

When a blood vessel damaged, platelets adhere to the damaged wall and their surface become
sticky, the adherent platelets clump to each other and they release adenosihe Hiphosphate
WDR), which attract more platelets to the site. Circulating platelets stick to those already at the
damaged vessels and they also release their stored chemical to attract more platelets. This
gathering of platelets is called platelets aggregation.

The Cardiovascular System

‫ركنرعنرطراللهی‬
‫با مامورا‬

the veins of the limbs, especially the veins of lower limb. These valves of aid in returnmg blood
to the heart because they open if blood flow is toward the heart, and close if the blood flow in
the opposite direction. Swed

Veins also function, as blood reservoirs, for example, in St hemorrhage a companied by a drop in
arterial blood pressure, reflexly sympathetic nerve impulses stimulate the smooth muscle in the
walls of the veins, this cause vasoconstriction (venous constriction) which help to maintain
blood pressure by returning more blood to the heart. This mechanism ensures a nearly normal
blood flow even when as much as 25% of blood volume is lost.

If the wall of veins cut, the wall collapse while the thicker walled arteries remain open

The smallest vessels that continue from the capillaries and merge to form veins called venules.

No

‫ما‬
‫ اور بحران صو‬N‫زنشے کماء‬

.‫امر سرخ دالیل‬

Capillaries

e layer alle membrillary at its autounding to as

w.

The smallest-diameter blood vessels, connect the smallest arterioles al and the smallest venules
called capillaries. The wall of capillary consist ils of a single layer of squamous (flattened)
epithelial cells, these thin walls l forn semipermeable membrane through which substances
present in

blood leave the blood in capillary at its arterial end to the tissue fluid and many substance pass
from tissue fluid surrounding the cells of the body to blood in capillary (at its venous end).

Cl e o The diameter of blood capillaries about 7 micron, approximately equal to that of an

erythrocytes, through which water and other small molecules substances can pass. Blood cells
and large molecule substances such as plasma proteins do not normally pass through the
capillary walls. Les aulo

,p
lo

‫ولمعال‬
‫مردف‬
‫ر ادك‬

‫المرة حال زارچها كبير‬

‫مبادل‬
‫من مارل الغران‬
‫پیشرانه‬

boril Exchanges in capillaries L 'edises, nutrients, and Metabolie by-products are exchanged
between

the blood in capillaries and the tissue fluid sturounding body cells.

These substances pass (move) through the capillary walls by diffusion, filtration and osmosis
(Figure 7.3,4).

PINS

Proerythroblast

Folic acid

Dietary iron

Diet

Iron

Vitamin B1

‫اگریہ‬

Decrease in size, loss of

nucleus

Synthesis of hemoglobin

Mature erythrocyte

Iron

Hemolysis

Billirubin

‫هيموخلودہ‬
Bo

‫والدین‬
‫كونان‬

Figure 6.4 Maturation of the erythrocyte. Cisuru olíglobin & iron (S)

Formation of hemoglobin:

Hemoglobin is a complex protein, consisting of a protein called G globin and Semne (iron
containing substance), hemoglobin synthesized

insidé developing erythrocytes in red bone marrow and iron is essential for its synthesis. The
small intestine absorbs iron slowly from food.

The body reuses much of iron released during decomposition of hemoglobin from damaged red
blood cells.

Hemoglobin in mature erythrocytes combin with oxygen to form oxyhemoglobin (Hb-02),

therefore the arterial blood is red in colour. In this case the oxygen diffuse from alveoli of lungs
to blood in pulmonary

capillaries transported round the body to maintain a continous supply of oh oxygen to all body
cells. Hemoglobin is also concerned, but to a lesser

extent in transportation of carbon dioxide from all cells of the body to the lungs for excretion.

w Gophon) The hemoglobin molecule consists of four_protein chains, each of which enfolds an-
oxuoen carrying nonprotein group called heme. The major hemoglobin of the human adult,
called hemoglobin A) is composed of two alpha chain each containing 141 amino acids, and two
heta chains, each containing (146 amino acids) and is symbolically represented as a B2. A small
fraction of the heřípglobin normally found in human blood (hemoglobin A.-0282) has two alpha
and two delta chainsThe

Ао

body cells. He the body to m lungs to ble

The Cardiovascu

PNY VODU Factors that influence arterial blood pressure

1. The elasticity of the artery walls alles ww w

The middle layer in the wall of arteries especially in large arteries contains large amount of
elastic tissue. So, when the left ventricle. pump blood into the already full aorta, it distends,
then it recoil pushes the blood onwards. This ability of distension and recoiling occurs
throughout the arterial system. During cardiac diastole the elastic recoil of the arteries
maintains the diastolic blood pressure.

the blahout the care maintains the pul bir

‫عالقے گ‬

vious with cardiac output, and ase or heart rally

2. Cardiac output a

Cardiac output = Heart rate x Stroke volume

Blood pressure various with cardiac output, if either stroke volume or heart rate increases, so
does cardiac output, and as a result, blood pressure initially rises. Conversely, if stroke volume
or heart rate decreases, cardiac output decrease, and the blood pressure also initially

decreases.clays

puidepois

3. Bloed volume

Blood pressure is normally, and directly proportional to blood volume within the cardiovascular
system. Thus any change in blood volume can initially alter blood pressure. For example, if a
hemorrhage reduces blood volume, blood pressure initially drops.

‫عره‬
‫إذاعي لمرور برای مقاومة ونردار بنوعية الدم‬
‫مروج‬

4. Blood viscosity w earing walo

The greater the viscosity of fluid, the greater the resistance to flowing. Red blood cells and
plasma proteins increase the blood viscosity. The higher the blood's viscosity, the higher the
resistance. For example, dehydration and polycythemia (an unusual high number of red blood
cells) increases the viscosity of blood, thus resistance increases, thus increases blood pressure. A
depletion of plasma proteins or red blood cells, due to anemia or hemorrhage decreases
viscosity and thus decreases blood pressure.

‫ احطة المرسان‬N‫اقامت‬

5. Peripheral or arteriglar resistance Lola

Eriction between the blood and the walls of blood vessels produces a force called peripheral
resistance, which delay blood flow.

‫االدزره‬
‫ستره‬
‫ح‬

3. Al

The Cardiovascular System PUN.

aortic valve. Venous blood is collected into numerous small vein: joil together to form the
coronary sinus which empty into the right atriut. 291

‫ عن رول ولرة العمر العلي‬N‫شدت دراسات‬

‫ ل ( الرام و رای‬Conducting system of heart ||

‫مرا به‬
‫هر‬
‫من‬
‫اندام ورا‬

‫( المال‬

‫کما‬
‫البار العلم‬

LA An inherent and rhythmical electrical activity is the reason for heai 1x continuous beating.
The spurce of this electrical activity is a netwo kar

specialized cardiac muscle cells (fibers). These cells are callel autorhythmic fibers, because they
are self excitable. Autorhythmic 1iber repeatedly generate action potentials that trigger heart
contraction without the need for a nerve supply from the brain, (they initiate an distribute
impulses throughout the myocardium) causing coordinater an synchronized contraction of the
cardiac muscle.

Conducting system consists of:

‫به‬

.‫عمار أرنية‬

‫ فية الوردير‬-

: ‫ كان اور تمنا احنا‬Sinoatial node

( SAnode

CoxThis small, elongated mass of specialized cardiac muscle cells. It is in L located in the right
atrium near the opening of superior vena cava (Figur
7.7), and its fibers are continuous with those of atrial syncytium. The cells of the SA node can
reach threshold on their own, wit ou stimulation from nerve fibers or any other outside agents,
the node relli initiate impulses that spread into the surrounding myocardium and stimulate
cardiac muscle fibers to contract.

Superior vena cava

Sinoatrial.

node

Atrioventricular bundle

Atrio ventricular

node

.Left

atrioventricular bundle branch

Inferior vena cava

Network of Purkinja fibres

Figure 7.7 The conducting system of the heart

‫االدزره‬
‫ستره‬
‫ح‬

3. Al

The Cardiovascular System PUN.

aortic valve. Venous blood is collected into numerous small vein: joil together to form the
coronary sinus which empty into the right atriut. 291

‫ عن رول ولرة العمر العلي‬N‫شدت دراسات‬

‫ ل ( الرام و رای‬Conducting system of heart ||

‫مرا به‬
‫هر‬
‫من‬
‫اندام ورا‬

‫( المال‬
‫کما‬
‫البار العلم‬

LA An inherent and rhythmical electrical activity is the reason for heai 1x continuous beating.
The spurce of this electrical activity is a netwo kar

specialized cardiac muscle cells (fibers). These cells are callel autorhythmic fibers, because they
are self excitable. Autorhythmic 1iber repeatedly generate action potentials that trigger heart
contraction without the need for a nerve supply from the brain, (they initiate an distribute
impulses throughout the myocardium) causing coordinater an synchronized contraction of the
cardiac muscle.

Conducting system consists of:

‫به‬

.‫عمار أرنية‬

‫ فية الوردير‬-

: ‫ كان اور تمنا احنا‬Sinoatial node

( SAnode

CoxThis small, elongated mass of specialized cardiac muscle cells. It is in L located in the right
atrium near the opening of superior vena cava (Figur

7.7), and its fibers are continuous with those of atrial syncytium. The cells of the SA node can
reach threshold on their own, wit ou stimulation from nerve fibers or any other outside agents,
the node relli initiate impulses that spread into the surrounding myocardium and stimulate
cardiac muscle fibers to contract.

Superior vena cava

Sinoatrial.

node

Atrioventricular bundle

Atrio ventricular

node

.Left

atrioventricular bundle branch

Inferior vena cava

Network of Purkinja fibres

Figure 7.7 The conducting system of the heart