Circulatory System

Blood

Dr Ahsan
 The cardiovascular system

• Provides a mechanism for rapid transport of

nutrients, waste products, respiratory gases and cells
 Primary Functions of the Circulatory System

1) Transportation
• Deliver life-supporting materials, i.e., O2, glucose,
amino acid, fatty acids, vitamins, minerals, etc.
• Deliver regulating signals, i.e., hormones to tissue
cells
• Collect waste products from tissue cells and deliver to
special organs (kidney, lung) for disposal
• Distribute heat throughout the body
2) Protection
• Special components of the blood patrol the whole
body and fight against invaded microorganisms and
cancerous cells.
Blood
Functions and Composition of Blood

• Transporting dissolved gases, nutrients,

hormones, and metabolic wastes
• Regulating pH and ion composition of
interstitial fluids
• Restricting fluid loss at injury sites
• Defending the body against toxins and
pathogens
• Regulating body temperature by absorbing
and redistributing heat
 Blood Composition

- Fraction of body weight 8%

- Volume Female: 4-5 L

Male: 5-6 L
- Temperature 38 C (100.4 F)

- pH 7.35 - 7.45

- Viscosity (relative to water) Whole blood: 4.5-5.5

plasma: 2.0
- Osmolarity 280-300 mOsm/L

- Mean salinity (mainly NaCl) 0.85%

 Blood Composition

Hematocrit
RBCs as percent of total blood volume

100%

- Female: 37%-48%
- male: 45%-52%
 Blood Composition

Hemoglobin
Female: 12-16 g/100 ml
male: 13-18 g/100 ml

Mean RBC count

Female: 4.8 million/l
male: 5.4 million/l

Platelet counts 130,000-360,000/l

Total WBC counts 4,000-11,000/l

The composition of blood

• Plasma and formed elements comprise whole

blood.
• Plasma elements include blood cells:
• Red blood cells (RBC)
• White blood cells (WBC)
• Platelets
• Can fractionate whole blood for analytical or
clinical purposes
 Blood Composition

Blood

Plasma 46-63% Formed Elements 37-54%

Plasma Protein 7% Water 92% Other Solutes 1% Platelets WBC RBC 99.9%

Albumin
Monocytes
Neatrophils
Globulin Eg. Electrolytes
Basophils

Fibrinogen
Lymphocytes Eosinophils

Regulatory Proteins
Blood Composition
The Composition of Whole Blood

Fresh whole blood for testing in a lab is usually collected from

a superficial vein.

When checking the

efficiency of gas
exchange, it may be
necessary to draw a
blood sample from
an artery
The Composition of Whole Blood
The chief difference between plasma and interstitial fluid involves
the concentration of dissolved oxygen and proteins.
The Composition of Whole Blood
Plasma

• Plasma is a straw-colored clear liquid part of

blood.
• It contains 91-92% of water and 8-9% of solids
• Accounts for 46-63% of blood volume
Serum
• Serum is the clear straw-colored fluid that
oozes from blood clot.
• Serum = Plasma – Fibrinogen
Composition of Plasma

Water 92% by weight

Proteins Total 6-9 g/100 ml

Albumin 60% of total plasma protein
Globulin 36% of total plasma protein
Fibrinogen 4% of total plasma protein
Enzymes of diagnostic value trace

Glucose (dextrose) 70-110 mg/100 ml

Amino acid 33-51 mg/100 ml
Lactic acid 6-16 mg/100 ml
Composition of Plasma

Total lipid 450-850 mg/100 ml

Cholesterol 120-220 mg/100 ml
Fatty acids 190-420 mg/100 ml
High-density lipoprotein (HDL) 30-80 mg/100 ml
Low-density lipoprotein (LDL) 62-185 mg/100 ml
Neutral Fats (triglycerides) 40-150 mg/100 ml
Phospholipids 6-12 mg/100 ml
Composition of Plasma

Iron 50-150 g/100 ml

Vitamins (A, B, C, D, E, K) Trace amount

Electrolytes
Sodium 135-145 mEq/L
Potassium 3.5-5.0 mEq/L
Magnesium 1.3-2.1 mEq/L
Calcium 9.2-10.4 mEq/L
Chloride 90-106 mEq/L
Bicarbonate 23.1-26.7 mEq/L
Phosphate 1.4-2.7 mEq/L
Sulfate 0.6-1.2 mEq/L
Composition of Plasma

Nitrogenous Wastes
Ammonia 0.02-0.09 mg/100 ml
Urea 8-25 mg/100 ml
Creatine 0.2-0.8 mg/100 ml
Creatinine 0.6-1.5 mg/100 ml
Uric acid 1.5-8.0 mg/100 ml
Bilirubin 0-1.0 mg/100 ml

Respiratory gases (O2, CO2, and N2)

Plasma proteins

More than 90% are synthesized in the liver

Albumins
• Albumins are the most abundant plasma
proteins
• 60% of plasma proteins
• Responsible for viscosity and osmotic
pressure of blood
Additional Plasma Proteins

Globulins
• ~35% of plasma proteins
• Include immunoglobins which attack foreign
proteins and pathogens
• Include transport globulins which bind ions,
hormones and other compounds
Fibrinogen
• Converted to fibrin during clotting
• Are necessary for blood clotting
• Removal of fibrinogen leaves serum
The Formed Elements (Blood Cells)

Formed elements include:

Erythrocytes (red blood cells, RBCs)

Platelets (cellular fragments)

Leukocytes (white blood cells, WBCs)

• Granulocytes
Neutrophils
Eosinophils
Basophils
• Agranulocytes
Lymphocytes
Monocytes
Red Blood Cells

Abundance of RBCs
• Erythrocytes (RBC) account for slightly less than
half the blood volume, and 99.9% of the formed
elements.
• Hematocrit measures the percentage of whole
blood occupied by formed elements
• Commonly referred to as the volume of packed
red cells
Structure of RBCs

• Biconcave disc, providing a large surface to

volume ration
• Shape allows RBCs to stack, bend and flex
• RBCs lack organelles
• Typically degenerate in about 120 days.
The Anatomy of Red Blood Cells
Hemoglobin

• Molecules of hemoglobin account for 95% of the

proteins in RBCs
• Hemoglobin is a globular protein, formed from
two pairs of polypeptide subunits
• Each subunit contains a molecule of heme
which reversibly binds an oxygen molecule
• Damaged or dead RBCs are recycled by
phagocytes
The Structure of Hemoglobin
“Sickling” in Red Blood Cells
Hemopoiesis

• Process of blood cell formation

• Hemocytoblasts are circulating stem cells that
divide to form all types of blood cells
• Whole blood from anywhere in the body has
roughly the same temperature (38ºC), pH (7.4)
and viscosity.
• Bright red color if taken from artery
• Dull red color if taken from vein
RBC life span and circulation

• Replaced at a rate of approximately 3 million new

blood cells entering the circulation per second.
• The destruction occurs mainly in the capillaries
of red pulp of spleen ‘graveyard of RBCs’.
• Because the diameter of splenic capillaries is very
small.
• Destroyed RBCs are fragmented and hemoglobin
is released from the fragmented parts.
• Hemoglobin is immediately phagocytized by
macrophages of the body, particularly the
macrophages present in liver (Kupffer cells),
spleen and bone marrow.
Red Blood Cell Turnover
RBC Production

Erythropoeisis
The formation of new red blood cells
• Occurs in red bone marrow
• Process speeds up with in the presence of EPO
(Erythropoeisis stimulating hormone)
• RBCs pass through reticulocyte and erythroblast
stages
Hematopoiesis
Refers to whole blood cell production.
Stages of RBC Maturation
Stages of erythropoiesis. CFU-E = Colony forming unit-erythrocyte,
CFU-M = Colony forming unit-megakaryocyte, CFU-GM = Colony forming unit-granulocyte/monocyte.
Hematopoiesis

-The red bone marrow is a

network of reticular connective
tissue that borders on wide blood
capillaries called blood sinusoids.
As hemocytoblasts mature, they
migrate through the thin walls of
the sinusoids to enter the blood.
All of blood cells including red and white arise from the same
type of stem cell, the hematopoietic stem cell or hemocytoblast
Feedback Regulation of Erythropoiesis

- regulated by renal
oxygen content.

- Erythropoietin, a
glycoprotein hormone, is
produced by renal cells in
response to a decreased
renal blood O2 content.

- Erythropoietin stimulates
erythrocyte production in
the red bone marrow.
A drop in renal blood oxygen level can result from:

1.Reduced numbers of red blood cells due to

hemorrhage or excess RBC destruction.

2.Reduced availability of oxygen to the blood, as

might occur at high altitudes or during pneumonia.

3.Increased demands for oxygen (common in those

who are engaged in aerobic exercise).
Ways to increase Red Blood Cell Count in Sports

• Legal
Raise RBC count by training athletes at
high altitude

• Illegal
Use erythropoietin, androgen, or their
analogs
Dietary Requirements for Erythropoiesis

Iron

vitamin B12

folic acid

More important to women due to the loss of blood

during menstruation
Erythrocyte Disorders

Anemia
is a condition in which the blood has an
abnormally low oxygen-carrying capacity.
Common causes of anemia include:
1) an insufficient number of red blood cells
2) decreased hemoglobin content
3) abnormal hemoglobin
Two such examples are Thalassemias and
Sickle-cell anemia, which are caused by genetic
defects.
Erythrocyte Disorders

Polycythemia
is an abnormal excess of erythrocytes that
increases the viscosity of the blood, causing it to
sludge or flow sluggishly.
Common causes of polycythemia include:
1)Bone marrow cancer
2)A response to reduced availability of oxygen as
at high altitudes
Blood types

• Determined by the presence or absence of surface

antigens (agglutinogens)
• Antigens A, B and Rh (D)
• Antibodies in the plasma (agglutinins)
• Cross-reactions occur when antigens meet
antibodies
Blood Typing and Cross-Reactions
 Rh Blood Groups
Classify blood groups based on Rh agglutinogens
other than A/B agglutinogens

Rh positive
- RBCs contain Rh agglutinogens.
Rh A
A Rh

A
Rh

Rh

A
- The majority of human beings is Rh positive.
Rh negative
- The RBCs contain no Rh agglutinogens.
- Agglutinins against Rh-positive RBCs are
produced after Rh-negative blood sees Rh-
positive RBCs.

A
A A Rh
Rh
A Rh
A Rh Rh
Rh
B A
A
A
Blood Type Testing
Erythroblastosis Fetalis
The problem with a Rh-negative
mother and her Rh-positive fetus.
 First Preganancy
no anti-Rh

Protected by the
placenta-blood no Rh
barrier, the
mother is not
exposed to Rh
agglutinogens
until the time of
childbirth due to
placental tearing.
Generation of anti-
Rh agglutinins

anti-Rh agglutinins

no Rh
 Born with severe anemia

Treatment:
use anti-Rh  globulin to mask Rh agglutinogens
Rh Factors and Pregnancy
The White Blood Cells

Leukocytes

• Have nuclei and other organelles

• Defend the body against pathogens
• Remove toxins, wastes, and abnormal or
damaged cells
• Are capable of amoeboid movement
(margination) and positive chemotaxis
• Some are capable of phagocytosis
WBCs Vs RBCs

WBCs differ from RBCs in many aspects.

1. Larger in size.
2. Irregular in shape.
3. Nucleated.
4. Many types.
5. Granules are present in some type of WBCs.
6. Lifespan is shorter.
Types of WBC

Granular and agranular

• Granular leukocytes
• Neutrophils – 50 to 70 % total WBC
population
• Eosinophils – phagocytes attracted to foreign
compounds that have reacted with antibodies
• Basophils – migrate to damaged tissue and
release histamine and heparin
Types of WBC

• Agranular leukocytes
• Agranular leukocytes are formed in red bone
marrow.
• Agranular leukocytes include:
• Monocytes - become macrophage
• Lymphocytes – includes T cells, B cells, and
NK cells
White Blood Cells
 Neutrophils

- 40%-70% WBCs

- Nucleus multilobed

- Duration of development: 6-9 days

- Life Span: 6 hours to a few days

- Function: phagocytize bacteria

 Eosinophils
- 1%-4% WBCs
- Nucleus bilobed
- Development:6-9 days
- Life Span: 8-12 days
Function:
1) Kill parasitic worms
2) destroy antigen-antibody complexes
3) inactivate some inflammatory chemical of allergy
 Basophils

- 0.5% WBCs
- Nucleus lobed
- Development: 3-7 days
- Life Span: a few hours to a few days
- Function:
1) Release histamine and other mediators of
inflammation
2) contain heparin, an anticoagulant
 Lymphocytes
- T cells and B cells
- 20%-45% WBCs
- Nucleus spherical or indented
- Development: days to weeks
- Life Span: hours to years
- Function
Mount immune response by direct cell attack
(T cells) or via antibodies (B cells)
Three Classes of Lymphocytes

T cells
• Helper T cells or inducer T cells (CD4 cells)
• Cytotoxic T cells or killer T cells (CD8 cells)
• Suppressor T cells.
• Memory T cells.
B cells
• Plasma cells.
• Memory cells.
Natural killer (NK) cells
• Detect and destroy abnormal tissue cells (cancers)
 Monocytes

- 4%-8% WBCs
- Nucleus U-shaped
- Development: 2-3 days
- Life Span: months
- Function:
Phagocytosis
develop into macrophages in tissues
WBC Production

• Granulocytes and monocytes are produced by

bone marrow stem cells
• Divide to create progenitor cells
• Stem cells may originate in bone marrow and
migrate to peripheral tissues
• Several colony stimulating factors are involved in
regulation and control of production
Leukocytes are deployed
in the infected areas
outside blood vessels via
3 steps.

1) Margination
2) Diapedesis
3) chemotaxis

Blood Capillary
Leukocytes are deployed
in the infected areas
outside blood vessels via
3 steps.

1) Margination

slow down by cell

adhesion molecules
secreted by endothelial
cells, Ameboid
Movement

Blood Capillary
2) Diapedesis:

Leukocytes slip
out of the capillary
blood vessels.

Blood Capillary
3) Chemotaxis:
Chemotaxis is the
attraction of WBCs
towards the injured
tissues by the chemical
substances released
at the site
of injury

Blood Capillary
Phagocytosis

Destroy foreign
substances or
dead cells

Blood Capillary
Leukocyte Disorders

• Normal Leukocyte Count: 4,000 – 11,000/l

• Leukopenia: < 4,000/l normal leukocytes

• Leukocytosis: > 11,000/l normal leukocytes

Leukopenia is one major side effect of chemotherapy.

Leukemia

- Leukemia refers to a group of cancerous conditions

of white blood cells.
- Descendants of a single stem cell in red bone
marrow tend to remain unspecialized and mitotic,
and suppress or impair normal bone marrow
function.
- extraordinarily high number of abnormal
(cancerous) leukocytes
Immunity
Immunity

Immunity is defined as the capacity of the body to

resist pathogenic agents.
Immunity is of two types:
I. Innate immunity.
II. Acquired immunity.
 Types of Immunity

I. Innate immunity.
• It is the inborn capacity of the body to resist pathogens. It is
otherwise called the natural or non-specific immunity.
II. Acquired immunity.
• It is the resistance developed in the body against any
specific foreign body like bacteria, viruses, toxins, vaccines
or transplanted tissues.
• Lymphocytes are responsible for acquired immunity.
Two types of acquired immunity develop in the body:
1. Cellular immunity
2. Humoral immunity
Development And Processing Of Lymphocytes
The two categories are:
1. T lymphocytes or T cells, which are responsible for
the development of cellular immunity.
• Develop in thymus and.
• e.g. CD4, CD8.
2. B lymphocytes or B cells, which are responsible for
humoral immunity.
• Develop in liver (during fetal life) and bone marrow
(after birth)
• e.g. Plasma cells, Memory cells.
Storage: stored in lymph nodes, spleen, bone marrow
and GI tract
ANTIGENS

• Antigens are the substances which induce specific

immune reactions in the body.
Antigens are of two types:
1. Autoantigens or self antigens present on the body’s
own cells such as ‘A’ antigen and ‘B’ antigen in
RBCs.
2. Foreign antigen s or non-self antigens that enter the
body from outside.
Development Of Cell-mediated Immunity

• The invading microbial or non-microbial organisms

carry the antigenic materials.
• These antigenic materials are presented to the
helper T cells by antigen-presenting cells.
Antigen-presenting Cells
Antigen-presenting cells are of three types:
1. Macrophages
2. Dendritic cells
e.g Dendritic, Follicular, Langerhans.
3. B-lymphocytes
Sequence of Events during Activation of Helper T cells
Role of other Cells

Role of Cytotoxic T Cells

• Release lysosomal enzymes, also destroy cancer
cells, destroy even body’s own tissues which are
affected by the foreign bodies
Role of Suppressor T Cells
• Supress cytotoxic T-Cells
Role of Memory T Cells
• Produce cellular memory for future.
 Antibodies Or Immunoglobulins

• An antibody is defined as a protein that is produced by B

lymphocytes in response to the presence of an antigen.
• Five types of antibodies are identified:
1. IgA (Ig alpha)
2. IgD (Ig delta)
3. IgE (Ig epsilon)
4. IgG (Ig gamma)
5. IgM (Ig mu).
• Among these antibodies, IgG forms 75% of the antibodies
in the body.
 Functions of Different Antibodies

1. IgA plays a role in localized defense mechanism in

external secretions like tear
2. IgD is involved in recognition of the antigen by B
lymphocytes
3. IgE is involved in allergic reactions
4. IgG is responsible for complement fixation
5. IgM is also responsible for complement fixation.
Mechanism of Actions of Antibodies

• Antibodies protect the body from invading

organisms in two ways.
1. By direct actions
2. Through complement system.
 Natural Killer Cell

• Natural killer (NK) cell is a large granular cell that

plays an important role in defense mechanism of
the body
• It is not a phagocytic cell but its granules contain
hydrolytic enzymes such as perforins and
granzymes.
• These hydrolytic enzymes play an important role
in the lysis of cells of invading organisms.
Functions of Natural Killer (NK) Cell

Natural killer cell:

1. Destroys the viruses
2. Destroys the viral infected or damaged cells, which
might form tumors
3. Destroys the malignant cells and prevents
development of cancerous tumors
4. Secretes cytokines such as interleukin-2,
interferons, colony stimulating factor (GM-CSF) and
tumor necrosis factor-α.
Cytokines

• Cytokines are the hormone-like small proteins acting as

intercellular messengers (cell signaling molecules) by
binding to specific receptors of target cells.

• These are secreted by WBCs and some other types of cells.

• Their major function is the activation and regulation of

general immune system of the body.
Types Of Cytokines
Depending upon the source of secretion and effects,
cytokines are classified into several types:
1. Interleukins
2. Interferons
3. Tumor necrosis factors
4. Chemokines
5. Defensins
6. Cathelicidins
7. Platelet-activating factor
Immunization

Immunization is defined as the procedure by which

the body is prepared to fight against a specific
disease.
It is used to induce the immune resistance of the body
to a specific disease.
Immunization is of two types:
1. Passive immunization
2. Active immunization.
Passive Immunization

It is done by administration of serum or gamma

globulins from a person who is already immunized
(affected by the disease) to a non-immune person.

Passive Natural Immunization

• from mother to the fetus

Passive Artificial Immunization

• The serum containing the antibody (antiserum)

Active Immunization

Active immunization or immunity is acquired by activating

immune system of the body. Body develops resistance
against disease by producing antibodies following the
exposure to antigens.
Active Natural Immunization
• Due to the activity of memory cells
Active Artificial Immunization
• Vaccines Edward Jenner produced first live vaccine for
smallpox from cowpox virus.
• Toxoid consists of weakened components or toxins
secreted by the pathogens. tetanus, cholera, etc
Immune Deficiency Diseases

1. Congenital immune deficiency diseases

• DiGeorge syndrome (due to absence of thymus)

2. Acquired immune deficiency diseases

• Acquired Immune Deficiency Syndrome (AIDS)

Autoimmune Diseases

• Autoimmune disease is defined as a condition in which the

immune system mistakenly attacks body’s own cells and
tissues
• Common autoimmune diseases are:
1. Insulin-dependent diabetes mellitus
2. Myasthenia gravis
3. Hashimoto thyroiditis
4. Graves disease
5. Rheumatoid arthritis.
Allergy And Immunological Hypersensitivity Reactions

It is defined as abnormal immune response to a chemical or

physical agent (allergen).

• Hypersensitive reactions are classified into five types:

Type I or anaphylactic reactions.

Type II or cytotoxic reactions.

Type III or antibody-mediated reactions.

Type IV or cell-mediated reactions.

Type V or stimulatory/blocking reactions.

Platelets

• Cell fragments involved in human clotting system

• Flattened discs
• Circulate for 9-12 days before being removed by
phagocytes
• Are removed by spleen
• 2/3 are reserved for emergencies
• Transporting chemicals important to clotting
• Forming temporary patch in walls of damaged
blood vessels
• Contracting after a clot has formed
Platelet production (thrombocytopoiesis)

• Megakaryocytes release platelets into circulating

blood
• Rate of platelet formation is stimulated by
thrombopoietin, thrombocyte-stimulating factor,
interleukin-6, and Multi-CSF
Hemostasis

• Prevents the loss of blood through vessel walls

• Three phases –
• Vascular phase
• Platelet phase
• Coagulation phase
Hemostasis

• Vascular phase
• Local blood vessel constriction (vascular
spasm)
• Platelet phase
• Platelets are activated, aggregate at the site,
adhere to the damaged surfaces
The Vascular and Platelet Phases of Hemostasis
Coagulation phase

• Factors released by platelets and endothelial cells

interact with clotting factors to form a clot
• Extrinsic pathway
• Intrinsic pathway
• Common pathway
• Suspended fibrinogen is converted to large
insoluble fibrin fibers
The Coagulation Phase of Hemostasis
The Coagulation Phase of Hemostasis
Clotting factors
Clot retraction

• Final phase of healing

• Platelets contract and pull the edges of the vessel
together
Fibrinolysis

• Clot gradually dissolves through action of plasmin

• Activated form of plasminogen
• Clotting can be prevented through the use of
drugs that depress the clotting response or
dissolve existing clots
• Anticoagulants include heparin, coumadin,
aspirin, dicumarol, t- PA, streptokinase, and
urokinase
Coagulation Disorders

Thrombosis is the abnormal clotting of blood in an unbroken

vessel.

Thrombus is a clot that attaches to the wall of blood vessel.

Embolus is a clot that comes off the wall of blood vessel and
travel in the blood stream.

Embolism is the blockage of blood flow by an embolus that

lodges in a small blood vessel.
Infarction refers to cell death that results from embolism.
Infarction is responsible for most strokes and heart attacks.
Bleeding Disorders

1) Thrombocytopenia
• the number of circulating platelets is deficient
(<50,000/l ).
• causes spontaneous bleeding from small blood vessels
all over the body

2) Deficiency of clotting factors

due to impaired liver function

3) Hemophilia's
Hereditary bleeding disorders due to deficiency of clotting
factors
Bleeding Disorders

1) Thrombocytopenia
• the number of circulating platelets is deficient
(<50,000/l ).
• causes spontaneous bleeding from small blood vessels
all over the body

2) Deficiency of clotting factors

due to impaired liver function

3) Hemophilia's
Hereditary bleeding disorders due to deficiency of clotting
factors
Blood Volume
 Normal Blood Volume
Total amount of blood present in the circulatory
system, blood reservoirs, organs and tissues together
constitute blood volume.

• In a normal young healthy adult male weighing about

70 kg, the blood volume is about 5 L.

• It is about 7% of total body weight.

• It ranges between 6% and 8% of body weight.

• In relation to body surface area, blood volume is 2.8

to 3.1 L/sq M.
Variations In Blood Volume

Physiological Variations
1. Age
2. Sex
3. Surface Area of the Body
4. Body Weight
5. Atmospheric Temperature
6. Pregnancy
7. Exercise
8. High Altitude
9. Emotion

PATHOLOGICAL VARIATIONS
1. Hypervolemia hypovolemia
 Measurement Of Blood Volume
Direct Method
• Direct method is employed only in animals because it
involves sacrificing the life.
• The animal is killed by decapitation and the blood is
collected.
Indirect Method
1. Determination of plasma volume
i. Indicator or dye dilution technique
ii. Radioisotope method.
2. Determination of blood cell volume
i. By hematocrit value
ii. By radioisotope method.
Regulation Of Blood Volume

1. Hypothalamus
2. Hormones
• Antidiuretic hormone
• Aldosterone
• Cortisol
• Atrial natriuretic peptide
Applied Physiology

Hypervolemia Hypovolemia
1. Hyperthyroidism 1. Hemorrhage or Blood
Loss
2. Hyperaldosteronism
2. Fluid Loss
3. Cirrhosis of the Liver
3. Hemolysis
4. Congestive Cardiac
Failure 4. Anemia
5. Hypothyroidism
Reticuloendothelial System
and Tissue Macrophage
 Reticuloendothelial System Or Macrophage System

• Reticuloendothelial system or tissue macrophage

system is the system of primitive phagocytic cells,
which play an important role in defense
mechanism of the body.
• The reticuloendothelial cells are found in the
following structures:
1. Endothelial lining of vascular and lymph channels.
2. Connective tissue and some organs like spleen,
liver, lungs, lymph nodes, bone marrow, etc.
Classification of Reticuloendothelial Cells

Reticuloendothelial cells are classified into two

types:
1. Fixed reticuloendothelial cells or tissue
macrophages.
2. Wandering reticuloendothelial cells

Fixed reticuloendothelial cells are also called

because, these cells are usually located in the tissues
Fixed Reticuloendothelial Cells – Tissue Macrophages

Also called as the tissue macrophages or fixed

histiocytes
Tissue macrophages are present in the following areas:
1. Connective Tissue
2. Endothelium of Blood Sinusoid
3. Reticulum
4. Central Nervous System
5. Lungs
6. Subcutaneous Tissue
Wandering Reticuloendothelial Cells And Tissue Macrophages

• Wandering reticuloendothelial cells are also called

free histiocytes.
There are two types of wandering reticuloendothelial
cells:
1. Free Histiocytes of Blood
i. Neutrophils
ii. Monocytes, which become macrophages and migrate to the
site of injury or infection.
2. Free Histiocytes of Solid Tissue
• During emergency, the fixed histiocytes from connective tissue
and other organs become wandering cells and enter the
circulation.
Functions of Reticuloendothelial System

1. Phagocytic Function
2. Secretion of Bactericidal Agents
3. Secretion of Interleukins
4. Secretion of Tumor Necrosis Factors
5. Secretion of Transforming Growth Factor
6. Secretion of Colony-stimulation Factor
7. Secretion of Platelet-derived Growth Factor
8. Removal of Carbon Particles and Silicon
9. Destruction of Senile RBC
10. Destruction of Hemoglobin
Spleen
Spleen

• Spleen is the largest lymphoid organ in the

body and it is highly vascular.

• It is situated in left hypochondrial region, i.e.

upper left part of the abdomen, behind the
stomach and just below the diaphragm.

• About 10% of people have one or more

accessory spleens which are situated near the
main spleen.
Accessory Spleens
Spleen

• Spleen is covered by an outer serous coat and an

inner fibromuscular capsule.
• From the capsule, the trabeculae and trabecular
network arise.
• All the three structures, viz. capsule, trabeculae
and trabecular network contain collagen fibers,
elastic fibers, smooth muscle fibers and reticular
cells.
• The parenchyma of spleen is divided into red and
white pulp.
 Pulp
Red Pulp
• Red pulp consists of venous sinus and cords of
structures like blood cells, macrophages and
mesenchymal cells.
White Pulp
• The structure of white pulp is similar to that of
lymphoid tissue.
• It has a central artery, which is surrounded by
splenic corpuscles or Malpighian corpuscles.
• These corpuscles are formed by lymphatic sheath
containing
• lymphocytes and macrophages
FUNCTIONS OF SPLEEN

1. Formation of Blood Cells

2. Destruction of Blood Cells
3. Blood Reservoir Function
4. Role In Defense Of Body
Lymphatic System and
Lymph
LYMPHATIC SYSTEM

• Lymphatic system is a closed system of lymph

channels or lymph vessels, through which lymph
flows.

• It is a one-way system and allows the lymph

flow from tissue spaces toward the blood.
Lymph
Lymphatic Vessels
 Organization of Lymphatic System

• Lymphatic system arises from tissue spaces as a

meshwork of delicate vessels.
• These vessels are called lymph capillaries.
• Lymph capillaries start from tissue spaces as enlarged
blind-ended terminals called capillary bulbs.
• These bulbs contain valves, which allow flow of lymph
in only one direction.
• There are some muscle fibers around these bulbs.
• These muscle fibers cause contraction of bulbs so
that, lymph is pushed through the vessels.
• Lymph capillaries are lined by endothelial cells.
• Capillaries unite to form large lymphatic vessels.
• Lymphatic vessels become larger and larger
because of the joining of many tributaries along
their course.
• The structure of lymph capillaries is slightly
different from that of the blood capillaries.
• Lymph capillaries are more porous and the cells
lie overlapping on one another.
• This allows the fluid to move into the lymph
capillaries and not in the opposite direction.
Drainage of Lymphatic System

• Larger lymph vessels ultimately

form the right lymphatic duct and
thoracic duct.
• Right lymphatic duct opens into
right subclavian vein and the
thoracic duct opens into left
subclavian vein.
• Thoracic duct drains the lymph
from more than two third of the
tissue spaces in the body Lymph drainage. Blue area =
Drained by right
lymphatic duct; Pink area =
Drained by thoracic duct
Situation of Lymph Vessels
Lymph vessels are situated in the following regions:
1. Deeper layers of skin
2. Subcutaneous tissues
3. Diaphragm
4. Wall of abdominal cavity
5. Omentum
6. Linings of respiratory tract except alveoli
7. Linings of digestive tract
8. Linings of urinary tract
9. Linings of genital tract
10. Liver
11. Heart.
Lymph vessels are not present in the following
structures:
1. Superficial layers of skin
2. Central nervous system
3. Cornea
4. Bones
5. Alveoli of lungs.
Lymph Nodes

• Lymph nodes are small glandular structures

located in the course of lymph vessels.
• The lymph nodes are also called lymph glands or
lymphatic nodes.
STRUCTUTRE OF LYMPH NODES

• Each lymph node constitutes masses of lymphatic

tissue, covered by a dense connective tissue
capsule.
• The structures are arranged in three layers
namely cortex, paracortex and medulla.
 Functions Of Lymph Nodes

• Lymph nodes serve as filters which filter bacteria

and toxic substances from the lymph.
• Functions of the lymph nodes are:
• 1. When lymph passes through the lymph nodes,
it is filtered, i.e. the water and electrolytes are
removed. But, the proteins and lipids are retained
in the lymph.
• 2. Bacteria and other toxic substances are
destroyed by macrophages of lymph nodes.
Because of this, lymph nodes are called defense
barriers.
Tissue Fluid and Edema
Tissue fluid

• Tissue fluid is the medium in which cells are

bathed.
• It is otherwise known as interstitial fluid.
• It forms about 20% of extracellular fluid (ECF).
Functions Of Tissue Fluid

• contact between blood and cells. And, tissue fluid

acts as a medium for exchange of various
substances between the cells and blood in the
capillary loop.
• Oxygen and nutritive substances diffuse from the
arterial end of capillary through the tissue fluid
and reach the cells.
• Carbon dioxide and waste materials diffuse from
the cells into the venous end of capillary through
this fluid.
FORMATION OF TISSUE FLUID

• Formation of tissue fluid involves two processes:

1. Filtration.
2. Reabsorption.
Applied Physiology – Edema

• Edema is defined as the swelling caused by

excessive accumulation of fluid in the tissues.
• It may be generalized or local.
• Edema that involves the entire body is called
generalized edema.
• Local edema is the one that occurs is specific
areas of the body such as abdomen, lungs and
extremities like feet, ankles and legs.
• Accumulation of fluid may be inside or outside
the cell
TYPES OF EDEMA

• Edema is classified into two types, depending

upon the body fluid compartment where
accumulation of excess fluid occurs:
• 1. Intracellular edema
• 2. Extracellular edema.
Intracellular Edema

• Intracellular edema is the accumulation of fluid

inside the cell.
• It occurs because of three reasons:
1. Malnutrition
2. Poor metabolism
3. Inflammation of the tissues.
Extracellular Edema

• Extracellular edema is defined as the

accumulation of fluid outside the cell.
• Causes for extracellular edema
1. Abnormal leakage of fluid from capillaries into
interstitial space.
2. Obstruction of lymphatic vessels that prevents
fluid return from interstitium to blood.
Conditions which lead to extracellular edema

1. Heart failure.
2. Renal disease.
3. Decreased amount of plasma proteins.
4. Lymphatic obstruction.
5. Increased endothelial permeability.