CARDIOVASCULAR

SYSTEM:BLOOD
WITH JENNETH ESTAMPA RN, MN
 01 Transport of gases, nutrients, and
waste products
02 Transport of processed molecules

FUNCTIONS 03 Transport of processed molecules

OF BLOOD 04 Regulation of pH and osmosis

05 Maintenance of body temperature

06 Protection against foreign substances

07 Clot formation
 PLASMA FORMED ELEMENTS

55% of total
45% of total
blood
Composition Pale, yellow
blood

of Blood liquid that

Cells and cell
fragments
surrounds cells
Erythrocytes,
91% water, 7%
leukocytes,
proteins, and 2%
thrombocytes
other
 ALBUMIN

Plasma 58% of plasma proteins

Proteins Helps maintain water balance

GLOBULINS FIBRINOGEN

38% of plasma proteins 4% of plasma proteins

Helps immune system Aids in clot formation

COMPOSITION OF BLOOD
 HEMATOPOIESIS
The production of all types of blood
cells
Occurs during embryonic development and
throughout adulthood.
In the fetus: occurs in several tissues,
including the liver, thymus, spleen,
lymph nodes, and red bone marrow.
After birth: hematopoiesis is confined
primarily to red bone marrow
 HEMATOPOIESIS
HEMOCYTOBLASTS

A single stem cell

where all the formed
elements of blood are
derived.
 ERYTHROCYTES

Red blood cells (RBC)

Disk-shaped with thick edges
Nucleus is lost during
development
Live for 120 days
Function: transport O2 to
tissues
 HEMOGLOBIN

Main component of erythrocytes

Transports O2
Each globin protein is attached to a heme
molecule
Each heme contains one iron atom
O2 binds to iron
Oxyhemoglobin: hemoglobin with an O2
attached
HEMOGLOBIN
Production Decreased blood O2 levels cause
of kidneys to increase production of
Erythrocytes the hormone erythropoietin.

Erythropoietin stimulates red Increased erythrocytes cause

bone marrow to produce more an increase in blood O2

erythrocytes. levels.
RED BLOOD CELL
PRODUCTION
 Old red blood cells are removed from
blood by macrophages in spleen and liver
Hemoglobin is broken down
Fate of Old Globin is broken down into amino acids

Erythrocytes Hemoglobin’s iron is recycled

Heme is converted to bilirubin

and Bilirubin is taken up by liver and

released into small intestine as part of
Hemoglobin bile

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HEMOGLOBIN
BREAKDOWN
 LEUKOCYTES
White blood cells (WBC)
Lack hemoglobin
larger than erythrocytes
Nucleated

Functions:
1.fight infections
2.remove dead cells and debris by
phagocytosis
 Types of NEUTROPHILS
Leukocytes: Most common
GRANULOCYTES Remain in blood for 10 to 12
contain specific granules and hours then move to tissues
include neutrophils, Phagocytes
eosinophils, and basophils

EOSINOPHILS BASOPHILS

Reduce inflammation Least common

Destroy parasites Release histamine and heparin

 Types of
Leukocytes:
AGRANULOCYTES
no specific granules

MONOCYTES LYMPHOCYTES

Immune response
Largest sized white blood cells
Several different types (T cells and B

Produce macrophages cells)

Lead to production of antibodies

Types of
White Blood
Cells
 PLATELETS
Are minute fragments of cells, each
consisting of a small amount of cytoplasm
surrounded by a cell membrane.
They are produced in the red bone marrow
megakaryocytes.
Small fragments break off from the
megakaryocytes and enter the blood as
platelets.
Platelets play an important role in
preventing blood loss.
 VASCULAR SPASMS

PREVENTING
Temporary constriction of
BLOOD LOSS blood vessel

PLATELET PLUGS BLOOD CLOTTING

(COAGULATION)

Can seal up small breaks in

blood vessels
PLATELET PLUG
FORMATION
 BLOOD
CLOTTING
Blood can be transformed from a liquid to a gel
Clot:
Network of thread-like proteins called fibrin
that trap blood cells and fluid
Depends on clotting factors
Clotting factors:
Proteins in plasma that are activated following
injury
Made in liver
Require vitamin K
CLOT FORMATION
 CLOT FORMATION
CONTROL

Clots need to be controlled so they

don’t spread throughout the body

Anticoagulants:

Prevent clots from forming

Example - heparin and antithrombin

 CLOT RETRACTION FIBRINOLYSIS

condensing process of
of clot dissolving
serum in clot
plasma is plasminogen
squeezed out (plasma
of clot protein)
Clot helps breaks down
Retraction enhance clot
and healing (fibrin)
Fibrinolysis
 TRANSFUSION
REACTIONS/
AGGLUTINATION ANTIGENS

Clumping of Molecules on
blood cells surface of
(bad) erythrocytes

BLOOD
GROUPING ANTIBODIES BLOOD GROUPS

Proteins in
Injury or surgery Named
plasma that bind
can lead to a according to
to specific
blood transfusion antigen (ABO)
antigens
 ABO Blood
TYPE A BLOOD TYPE B BLOOD
Groups:
Type A antigens Type B antigens
Antigens
Two types of
TYPE AB antigens:
TYPE O BLOOD
BLOOD 1.Type A antigen

has both types of has neither A nor B 2.Type B antigen

antigens. antigens.
 TYPE A BLOOD TYPE B BLOOD
contains anti-B contains anti-A
antibodies, which act antibodies, which act
against type B
antigens
against type A
antigens
ABO Blood
Groups:
TYPE AB
TYPE O BLOOD
Antibodies
BLOOD
has neither type of has both anti-A and
antibody anti-B antibodies
ABO BLOOD GROUPS
AGGLUTINATION
REACTION
TYPE O BLOOD TYPE A BLOOD
are universal donors
because they have no
can receive A and
antigens
can only receive O O blood Blood Donor
blood
and Recipient
According to
ABO Blood
TYPE B BLOOD TYPE AB Types
BLOOD
can receive B and are universal
O blood recipients, can
receive A, B, AB or
O blood
 RH BLOOD GROUP

Rh positive means you have Rh antigens

95 to 85% of the population is Rh+

Antibodies only develop if an Rh-

person is exposed to Rh+ blood by

transfusion or from mother to fetus

 RH INCOMPATIBILITY
IN PREGNANCY

If mother is Rh- and fetus is Rh+ the mother

can be exposed to Rh+ blood if fetal blood

leaks through placenta and mixes with mother’s

blood.

First time this occurs mother’s blood produces

antibodies against antigens.

Any repeated mixing of blood causes a

reaction.
Hemolytic Disease
of Newborn

Occurs when mother produces anti-Rh

antibodies that cross placenta and
agglutination and hemolysis of fetal
erythrocytes occurs
Can be fatal to fetus
Prevented if mother is treated with
RhoGAM which contains antibodies
against Rh antigens

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 COMPLETE
Diagnostic BLOOD COUNT

Blood Provides information such as

RBC count, hemoglobin,
Tests hematocrit, and WBC count

HEMATOCRIT HEMOGLOBIN

% of total blood volume Determines amount of hemoglobin

composed of RBC Indicates anemia
BLOOD TYPING
 WHITE BLOOD CELL
PROTHROMBIN TIME COUNT

time it
takes for
total number
blood to
of white
begin
blood cells
clotting (9
to 12 sec.)
Diagnostic
blood tests
 DIAGNOSTIC
NEUTROPHILS LYMPHOCYTES
BLOOD
60 - 70% 20 - 25% TESTS
WHITE BLOOD CELL
DIFFERENTIAL COUNT
•Determines the % of each 5

MONOCYTES EOSINOPHILS kinds of leukocytes

3 - 8% 2 - 4%
BASOPHILS

0.5 - 1%
 LEUKOPENIA LEUKOCYTOSIS

low white blood

high white
cell count
blood cell
caused by
count
radiation,
caused by
chemotherapy
infections
drugs, tumors,
and leukemia
WHITE BLOOD viral infections
DISORDERS
CARDIOVASCULAR
SYSTEM:HEART
WITH JENNETH ESTAMPA RN, MN
HEART
THE CARDIOVASCULAR SYSTEM

HEART

A muscular organ that is essential for life

because it pumps blood through the body.

A member organ of the cardiovascular

system, which consists of the heart, blood

vessels, and blood.

Pumps approximately 5 liters (L) of blood

per minute.
 THE CARDIOVASCULAR SYSTEM

RIGHT SIDE LEFT SIDE

Pumping blood Pumps blood to

to the lungs all other
tissues of the
and back to
body and back
the left side
to the right
of the heart
side of the
through
heart through
vessels of vessels of the
the pulmonary systemic
circulation.
HEART circulation.
 THE
CIRCULATORY
SYSTEM
GENERATES
BLOOD ROUTES BLOOD
PRESSURE

FUNCTIONS
OF THE
HEART
ENSURES ONE- REGULATES
WAY BLOOD BLOOD SUPPLY
FLOW
 Heart Characteristics

SIZE

Size of a fist and weighs less

than 1 lb.

LOCATION ORIENTATION

Between lungs in thoracic

Apex (bottom) towards left side.
cavity.
 PERICARDIUM PARIETAL
PERICARDIUM
PERICARDIA
Double-layered sac
Membrane around
that anchors and
heart’s cavity
protects heart

VISCERAL PERICARDIAL
PERICARDIUM CAVITY
Membrane on heart’s Space around the
surface heart
 ANTERIOR
INTERVENTRICULAR
CORONARY SULCUS SULCUS

Extends Extends
inferiorly
around the
from the
heart,
coronary
separating
sulcus on the
the atria
anterior
from the surface of the
ventricles.
HEART: heart.

EXTERNAL
ANATOMY
 POSTERIOR
Heart INTERVENTRICULAR
SULCUS

External Extends inferiorly from the

coronary sulcus on the

Anatomy posterior surface of the

heart.

SUPERIOR VENA CAVA

AND INFERIOR VENA
CAVA
Carry blood from the body to
the right atrium.
PULMONARY VEINS
Carry blood from the lungs to the left
atrium.
Two arteries, often called the great
vessels or great arteries, carry blood
away from the ventricles of the heart.
 PULMONARY TRUNK AORTA

Arising from
the right
ventricle, Arising from
splits into the left
the right and ventricle,
left pulmonary carries blood
arteries, to the rest of
which carry the body.
HEART: blood to the
lungs.
EXTERNAL
ANATOMY
Surface Anatomy of the Heart
Coronary HEART CHAMBERS
sulcus
Separates
atria from
ventricles Four Chambers
Left atrium (LA)
Right atrium (RA)
Left ventricle (LV)
Right ventricle (RV)
 THE ATRIA

Superior chambers
Receive blood from veins
Small, thin walled
Contract minimally to push blood into
ventricles

Interatrial septum
- Separates right and left atria
 VENTRICLES

Inferior chambers
Pump blood out of heart to arteries
Thick, strong walled
Contract forcefully to propel blood
out of heart

Interventricular septum
- Separates right and left ventricles
TRICUSPID VALVE Atrioventricular
Heart Valves
AV valve between RA and RV
3 cusps Valves between
the atria and
ventricles
BICUSPID VALVE
(MITRAL)

AV valve between LA and LV

2 cusps
 PAPILLARY MUSCLES
Cone-shaped, muscular pillars
contained in each ventricles.
Attached by chordae tendineae
to the free margins of the
cusps of the atrioventricular
CONTROL OF
valves.
Contract during ventricular
contractions and prevent the
valves from opening into the
HEART
atria by pulling on the chordae
tendineae attached to the valve
cusps.
VALVES

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Semilunar
Heart Valves
Pulmonary Aortic
Have three half-moon shaped
cusps, and are valves between
valve valve
the ventricles and the
between RV and between LV and
arteries.
pulmonary aorta
trunk
Internal Anatomy of the Heart
HEART VALVES
HEART VALVES
BLOOD FLOW THROUGH THE HEART
 Coronary Left coronary
arteries artery
Blood Supply Supply blood to Has 3 branches
to the Heart heart wall
Originate from
Supplies blood
to anterior
base of aorta
(above aortic heart wall and
semilunar left ventricle
valve)
 Right coronary
artery Cardiac veins
Blood Supply Drain blood from
the cardiac muscle

to the Heart Originates on

right side of
Parallel to the
coronary arteries
aorta Most drain blood
into the coronary
Supplies blood
sinus
to right From the coronary
ventricle sinus into the
right atrium
BLOOD FLOW TO THE HEART
 HEART WALL
EPICARDIUM

Surface of heart (outside)

MYOCARDIUM
Thick, middle layer composed of
cardiac muscle

ENDOCARDIUM
Smooth, inner surface
 Cardiac Muscle

One centrally located nucleus

Branching cells
Rich in mitochondria
Striated (actin and myosin)
Ca2+ and ATP used for contractions
Intercalated disks connect cells
1. The heart is at rest and all chambers are
relaxed. Stimulation
2. Cardiac muscle cells in the atrial wall are
stimulated as action potentials spread across
of the
the atrial wall and towards the ventricles. Heart
3. Cardiac muscle cells in the atrial wall
contract, pushing blood into the ventricles.
4. Cardiac muscle cells in the ventricular wall
are stimulated as action potentials spread
across the ventricular wall from the apex of
the heart towards its base.
5. Cardiac muscle cells in the ventricular wall
contract, pushing blood into the great
arteries.
Stimulation of the Heart
Stimulation of the Heart
 Cardiac DEPOLARIZATION PHASE

Muscle Na+ channels open

Action Ca2+ channels open

Potentials
PLATEAU PHASE REPOLARIZATION PHASE

Na+ channels close

K+ channels are open
Some K+ channels open
Ca2+ channels close
Ca2+ channels remain open
 CONDUCTION SYSTEM OF HEART

SINOATRIAL ATRIOVENTRICULAR
NODE NODE

ATRIOVENTRICULAR PURKINJE
BUNDLE FIBERS
CONDUCTION SYSTEM OF HEART

SINOATRIAL
NODE (SA NODE)

In RA
Where action potential
originates
Functions as pacemaker
Large number of Ca2+ channels
CONDUCTION SYSTEM OF HEART

ATRIOVENTRICULAR
NODE (AV NODE)

Located in the lower portion of the right

atrium
Action potentials from SA node sent to this
node
Action potentials spread slowly through it
Slow rate of action potential conduction
allows the atria to complete their
contraction before action potentials are
delivered to the ventricles
CONDUCTION SYSTEM OF HEART

ATRIOVENTRICULAR
BUNDLE

Action potentials from AV node

travel by the AV bundle to the
ventricles
AV bundle divides into a left and
right bundle branches to left and
right ventricles
CONDUCTION SYSTEM OF HEART

PURKINJE FIBERS

At the tips of the left and right

bundle branches, are Purkinje fibers
Purkinje fibers pass to the apex of
the heart and then extend to the
cardiac muscle of the ventricle walls
Action potentials are rapidly
delivered to all the cardiac muscle of
the ventricles
 Action 1. SA node

Potential 2. AV node (atrioventricular)

Path 3. AV bundle

through 4. Right and Left Bundle

Heart branches

5. Purkinje fibers
Conduction System of the Heart
 Electrocardiogram
(EKG)
ECG (EKG)

Record of electrical events in

heart
Diagnoses cardiac abnormalities
Uses electrodes
Contains P wave, QRS complex, T
wave
 P WAVE

Components Depolarization of atria

of ECG/EKG

QRS COMPLEX T WAVE

Depolarization of Repolarization of
ventricles ventricles
Contains Q, R, S waves
Electrocardiogram
 CARDIAC CYCLE

A summative description of all the

events that occur during one
single heartbeat.
The heart is a two sided pump,
with the atria being primers for
pumps and the ventricles being the
actual pumps.
 HEART CHAMBER
CONTRACTIONS

Cardiac muscle contractions

produce pressure changes within
heart chambers.
Pressure changes are responsible
for blood movement.
Blood moves from areas of high to
low pressure.
 Cardiac
Cycle
1.Atrial systole
contraction of atria
2.Ventricular systole
contraction of ventricles
3.Atrial diastole
relaxation of atria
4.Ventricular diastole
relaxation of ventricles
 HEART SOUNDS

Heart sounds are produced due to the closure

of heart valves.
A stethoscope is used to hear heart sounds
The first heart sound makes a ‘lubb’ sound.
The second heart sound makes a ‘dupp’ sound.
The first heart sound is due to the closure of
the atrioventricular valves.
The second heart sound is due to the closure
of the semilunar valves.
Heart Valve Locations
Regulation Stroke Volume Heart Rate
of Heart Volume of blood
Function pumped per Number of heart
ventricle per beats in 1 min.
contraction 72 beats/min.
70
milliliters/beat
 Cardiac Output
Regulation
of Heart Volume of blood pumped by
a ventricle in 1 min.
Function 5 Liters/min.

Cardiac output equals stroke

volume times heart rate

CO = SV × HR
 Intrinsic
Regulation Venous return Preload
of the Heart The degree
ventricular walls
The amount of
refers to the mechanisms are stretched at
blood that end of diastole
contained within the heart
returns to heart Venous return,
itself that control cardiac
preload, and
output. stroke volume are
related to each
other
 Starlings Law
of the Heart Afterload
Intrinsic Relationship
between preload
Regulation and stroke
Volume
Influences cardiac
Pressure
against which
of the Heart output
Example - exercise
ventricles
must pump
increases venous
return, preload, blood
stroke volume, and
cardiac output
 EXTRINSIC
REGULATION OF
HEART
Refers to mechanisms external to the
heart, such as either nervous or
chemical regulation.
Nervous system control of the heart
occurs through the sympathetic and
parasympathetic divisions of the
autonomic nervous system.
Both sympathetic and parasympathetic
nerve fibers innervate the SA node.
 Baroreceptors
Baroreceptor
Reflex Monitor blood

Baroreceptor A mechanism of
pressure in the
aorta and carotid

Reflex the nervous

system that
arteries
Changes in blood
pressure cause
plays an
changes in
important role
frequency of
in regulating action potentials
heart function. Involves the
medulla oblongata
Baroreceptor Reflex
 CHEMORECEPTOR
REFLEX

The chemoreceptor reflex involves

chemical regulation of the heart

function.

Chemicals can affect heart rate

and stroke volume.

 Chemical actions
Epinephrine and
norepinephrine from the
adrenal medulla can increase
Chemoreceptor heart rate and stroke volume
excitement, anxiety, and
Reflex anger can increase cardiac
output
Depression can decrease
cardiac output
Medulla oblongata has
chemoreceptors for changes in
pH and CO2
K+, Ca2+, and Na+ affect
cardiac function
Chemoreceptor Reflex—pH
Summary of Extrinsic Regulation
 Heart
Disease Coronary Artery Myocardial
Infarction
Disease
(heart attack)
Decreases blood Due to closure of
supply to the one or more
heart coronary arteries
Area(s) of
Coronary
cardiac muscle
arteries are lacking adequate
narrowed for blood supply die,
some reason and scars
(infarct)
 ANGIOPLASTY

Procedure opens blocked

Heart blood vessels

Procedures

STENT BYPASS

Procedure reroutes blood

Structures inserted to
away from blocked
keep vessels open
arteries