BLOOD | CHAPTER 11 (threadlike proteins that forms blood

clot)
FUNCTION OF BLOOD ● Serum – plasma without the clotting
● The heart pumps blood through blood factors
vessel that extend throughout the body. Water Acts as solvent and suspending medium I
Blood helps maintain homeostasis in blood components
several ways:
Proteins Maintains osmotic pressure, destroy
1. Transport of gases, nutrients, and foreign substances, transport molecules
waste product and form clots
2. Transport of processed molecules
3. Transport of regulatory molecules Ions Involved in osmotic pressure,
4. Regulation of pH and homeostasis membrane potentials, and
acid-base balance
5. Maintenance of body temperature
6. Protection against foreign Nutrients Source of energy and building block
substances
7. Clot formation Gases Aerobic respiration (oxygen and
CO2
COMPOSITION OF BLOOD
Waste Breakdown of protein metabolism
● Blood is a type of connective tissue that products and RBC
consist of a liquid matrix containing cells
Regulatory Catalyze chemical reaction and
and cell fragments substances stimulate or inhibit many body
● Plasma – liquid matrix; – 55% of the
function
total blood volume
● Formed elements – cell fragments;
45%
● Total blood volume is about 4 to 5 ● Plasma volume and composition remain
liters in an average adult female relatively constant
● Total blood volume is about 5 to 6 ● Water intake through the digestive
liters in an average adult male matches water loss through kidney, lungs,
● Blood makes up to 8% of the total body digestive tract, and skin
weight ● Oxygen and CO2 are important gases;
oxygen enters blood in lungs and CO2
PLASMA enetr the blood in tissue
● Concentration of these substance in the
● Pale yellow fluid that consist of 91% of
blood is also regulated and maintained
water, 7% proteins, and 2% other
within narrow limit
components such as ions, nutrients, gases
and wastes. FORMED ELEMENTS 45% of total composition of
● Contains dissolve plasma; plasma proteins
blood
includes albumin, globulins, and
fibrinogen.
PRODUCTION OF FORMED ELEMENTS
▪ Albumin – 58% of the plasma protein;
plays a major role in stabilizing
extracellular fluid volume by HEMATOPOIESIS – process that produces formed
contributing to oncotic pressure elements; continuous process
(known also as colloid osmotic
pressure) of plasma. ▪ In fetus, it occurs in several tissues like
▪ Globulins – 38% of plasma protein; liver, thymus, spleen, lymph nodes and
such as antibodies and complement red bone marrow
are part of immune system. Transport ▪ After birth, it occurs primarily in red
molecules; protein plasma binds to bone marrow
molecules such as hormones and carry ● All formed elements of blood are derived
them in the blood throughout the from a single population of cells called
body. Clotting factors; formation of hematopoietic stem cells or
blood clot. hemocytoblast
▪ Stem cells differentiate to give 2 types:
▪ Fibrinogen – clotting factor that
● Myeloid stem cells – most formed
constitute 4%of plasma proteins.
elements are derived
● Lymphoid stem cells – rise of
● Activation of clotting factors result to lymphocytes
conversion of fibrinogen to fibrin
 ● CO2 is produced in tissues and
transported through blood to lungs,
it involves transport of bicarbonate
ions, hemoglobin and plasma.
● 70 % of Co2 in blood transported in
a form of bicarbonate ions; the
- Red blood cell/erythrocytes – the most enzyme carbonic anhydrase found
abundant which is the 95% of all inside the RBC, catalyzes a
formed elements reaction of CO2 and H2O into
▪ Disk shaped and biconcave; hydrogen ion and bicarbonate
biconcave shape of RBC increase cell ions
surface allowing gases to move into ● The remaining 30 % of CO2
and out of RBC transported in 2 ways: (1) bound to
▪ Move through capillaries, they change proteins and (2) dissolve in the
shape; they fold and bend around thin plasma. 23% of the CO2 in blood is
centers thereby decreasing in size and transported bound to hemoglobin
passing more easily through small or proteins. 7% of Co2 ids
vessel. Biconcave shape RBC improve transported dissolve in plasma
blood flow in larger capillaries
Life history of RBC
▪ During development, RBC lose nuclei
ad most organelles resulting to unable ● 2.5 million of RBC
to divide; anucleate destroyed every second
▪ RBC live for about 120 days in male and new RBC cells are
and 110 for females produce rapidly
▪ 1/3 of RBC volume is pimgmented ● Stem cell produce
protein hemoglobin, responsible for proerythroblasts, which
the cell’s red color give rise to the RBC line. It
involves a series of cell
Function division
● The process of cell
● Transport O2 from lungs to various tissues division that produces
and help transport of CO2 from tissues to new RBC requires B
the lungs vitamin folate and b12,
● Oxygen transport is accomplish necessary for the synthesis
when O2 enters RBC and binds to of DNA. Iron for
hemoglobin. Each hemoglobin production of
consist of 4 protein chains and 4 hemoglobin
heme groups. There are 2 alpha ● RBC regulated to
globin and 2 beta globin; each ensure homeostatic
globin associated with 1 heme levels; low blood O2
each. levels stimulate RBC
production by releasing
♦ Heme is a red pigmented
glycoprotein
molecules; contains 1 iron atom
erythropoietin by kidneys
which reversibly bind to an
▪ Erythropoietin
oxygen molecule. stimulates red bone
● Hemoglobin picks O2 in lungs and marrow to produce more
release to other tissues RBC
♦ Hemoglobin that is bound to ▪ When blood
O2 is bright red O2 decreases, the
♦ Hemoglobin without bound to production of
O2 is dark red erythropoietin increase
● 98.5% of the O2 transported in which result to production
blood is bound to hemoglobin, of RBC production to red
1.5% of O2 is dissolved in plasma bone marrow.
● O2 is the primary molecule that ● Iron recycling
binds to hemoglobin but other ● When RBCs become old, abnormal and
molecules can be bind like carbon damaged, they are removed from the
blood by macrophages.
monoxide. Prolonged exposure to
● Within the macrophage, the globin is
carbon monoxide can cause
broken down into amino acids that are
nausea, headache,
reused to produce other proteins.
unconsciousness and death
● Iron released from the heme is transported (10-12 hrs) then move to other
to the red bone marrow and used to tissue and phagocytize
produce new hemoglobin. microorganism and foreign
● The heme molecules are converted into substance. Dead neutrophils, cell
bilubrin. debris, and fluid can accumulate
● Bilubrin – yellow pigment molecule;brown as pus at site of infection.
color ● Basophils - least common, contains
● If the liver is not functioning normally, or
large cytoplasmic granules. This
flow of bile is hindered = bilubrin builds up
release histamine and other
and produces jaundice
chemicals that promote
● Jaundice – yellowish color to the skin
● Converted bilubrin into other pigments = inflammation and release of
brown color in feces + yellow color in urine heparin prevents the formation of
- White blood cell/ leukocytes – 5% of the clots.
volume of formed elements ● Eosinophils - contains cytoplasmic
▪ Spherical cells that lack hemoglobin; granules and have 2 lobes of
WBC as well as platelets make up buffy nucleus. This involve in
coat, a thin white layer of cells inflammatory response in allergies
between plasma and RBC and asthma. Destroy worm
▪ WBC are larger than RBC and ithas parasites
nucleus ▪ There are two kinds of agranulocytes
▪ WBC are components of blood, blood ● Lymphocytes – smallest of WBC;
serves as primarily as a means of consist of only thin and
transporting these cells of other body imperceptible ring around the
tissues nucleus. There are a lot of varies
▪ WBC can leave the blood and travel types of lymphocytes which plays
by ameboid movement thru tissues, this an important role in body immune
process the cell projects a cytoplasmic system response. Antibodies and
extension that attaches in an object. other chemicals destroy
▪ 2 function of WBC microorganisms, contribute to
● to protect the body against allergic reaction, reject grafts,
invading microorganism and other control tumors, and regulate
pathogens immune system
● to remove dead cells and debris ● Monocytes - largest WBC; after
from the tissue by phagocytosis leaving the blood, they enter
▪ there are multiple types of WBC, tissues as they enlarge and
named according to its appearance became macrophages.
● granulocytes – large cytoplasmic phagocytize bacteria, dead cells,
granules cell fragments; can breakdown
● agranulocytes – very small granules phagocytized foreign substance
that cannot be seen easily ● Platelets/thrombocytes – cell fragments;
consist of small amount of cytoplasm
surrounded by a cell membrane. Produce
in red bone marrow from large cells called
megakaryocytes
▪ Small fragments break off from the
megakaryocytes and enter the blood
as platelets
▪ Platelets plays an important role in
preventing blood loss

Red blood cell are 700 times more numerous that

white blood cell and 17 times more numerous
than the platelets

PREVENTING BLOOD LOSS

▪ There are three kinds of granulocytes
● Neutrophils – common type; have When blood vessel is damage, loss of blood is
small cytoplasmic granules. Their minimized by three processes:
nuclei are lobed with number of
lobes varying from 2 to 4. This - Vascular spasm
remains in blood for short time
 ▪ An immediate but temporary
constriction of blood vessels
▪ Constriction can close small vessels
completely and stop the flow of blood
through them
▪ Vascular spasm can stimulated by
chemicals released by cells of the
damage blood vessel by platelets
● Platelets release Thromboxanes –
derived from certain
prostaglandins and Endothelin-
endothelial cells lining blood
vessels. Both substance stimulate
vascular spasm
- Platelet plug formation
● An accumulation of platelets that
can seal up a small break in blood
vessels
● Maintains the integrity of the
circulatory system
I. Platelet adhesion – platelets stick to
the collagen exposed by blood vessel
damage
● Von Willebrand factor – protein
produced and secreted by blood
vessel endothelial cells; forms a bridge
bet. Collagen and platelets by binding
to platelet surface receptors and
collagen
II. Platelet release reaction – platelets
release chemicals (ADP and
thromboxane) that activate other
platelets
● Fibrinogen receptors – surface
receptors that bind to fibrinogen
III. Platelet aggregation – fibrinogen forms
bridges be. The fibrinogen receptors of
numerous platelets
- Blood clotting / Coagulation
▪ Blood vessel severely damage, blood
clotting results to formation of blood
clot (Clot – traps blood cells, platelets,
and fluid)( Fibrin – a network of
threadlike protein fibers)
▪ Clotting factors - Formation of blood
clot depends on number of proteins
found in plasma
▪ Stages of clot formation
● Prothrombinase production; it has 2
ways: (A) Inactive clotting factors
due to exposed connective tissue
result to activate or (B)
Thromboplastin, release from
injured tissues causes activation.
● Series of activation of clotting
factors occurs.
● Thombin production:
Prothrombinase / Prothrombin
activator is formed.
● Prothrombinase converts
prothrombin (inactive CF) to
thrombin (active CF).
● Fibrin production; Thrombin
converts fibrinogen (inactive CF) to
fibrin (active CF).
● Each CF activates many additional
CF resulting in formation of a clot.
♦ Vitamin K & Ca – required for
clot formation
♦ Sources of vit. K – diet +
bacteria within the large
intestine
CONTROL OF CLOT FORMATION
- Without control, clotting would spread
from the point of its initiation throughout
the blood vessel. Blood contains:
▪ Anticoagulants – prevent CF from
forming clots under normal condition
● Example, Antithrombin & Heparin
inactivate thrombin. w/o thrombin,
fibrinogen not be converted to
fibrin and no clots will form.
● Unwanted clots form, platelets
encounter damage or diseased
areas of blood vessel or heart wall,
an attached clot called thrombus
and embolus moves through the
blood vessels until it reaches a
vessel that is too small, the blood
flow is stopped may cause death.
● Abnormal blood clotting may be
prevented by anticoagulant such
as heparin, warfarin and
Coumadin
CLOT RETRACTION AND FIBRINOLYSIS
- Clot retraction – a clot begins to condense
into a more compact structure
- Fibrinolysis – process wherein clots are
dissolved
♦ Plasminogen – inactive plasma
protein converted form Plasmin
♦ Tissue plasminogen activator
(t-PA) – stimulate the
conversion of plasminogen to
 plasmin and plasmin slowly
breaks to fibrin
- Heart attack – results when a clot blocks
blood vessels that supply the heart
- Aspirin & Anticoagulant therapies –
prevent heart attacks
- Plasmin activators – quickly dissolve the
clot and restore blood flow to cardiac
muscle
- Streptokinase – a bacterial enzyme used
to dissolve clots
BLOOD GROUPING
- Transfusion (out) – transfer of blood/blood
components form one individual to
another
- Infusion (in) – introduction of fluids other
than blood (saline, glucose) into the blood
- Transfusion reactions – clumping/rupture of
blood cells and clotting within blood
vessels; unsuccessful transfuse of blood
- Antigen – molecules on the surfaces of
RBCs and Antibodies – proteins in plasma
- Antibodies binds to antigen; in a specific
or certain antigen only forms molecular
bridges that connects RBC together
- As a result of Agglutination – clumping of
cells
- Combination of antibodies with antigen
may initiate a reaction of Hemolysis –
rupture of blood cells; cause severe tissue
damage
- Hemogloblin release from lysed RBC that
may cause damage to kidney
Antigens on the surface of RBC have been
categorized into blood groups; ABO and Rh blood
groups – most important in transfusion reactions
- ABO Blood GROUP
▪ ABO blood group system used to
categorized human blood
▪ Antibodies are present in the plasma
of blood and part of the body defense
system and interact with specific
antigen.
▪ Mismatching other blood groups can
cause transfusion reactions
▪ Antibodies in the donor’s blood can
react with antigens on the recipient’s
RBCs
▪ Donor – person who gives blood
▪ Recipient – person who receives blood
▪ Universal Donor = type O blood –
misleading
RH BLOOD GROUP
- First studied in the rhesus monkey
- Can occur through
▪ Transfusion
▪ Transfer of blood across the placenta
to a mother from her fetus
- Rh-positive – have Rh antigens on the
surface of RBCs
- Rh-negative – don’t have Rh antigens\
- Antibodies against Rh Antigens may occur
depending to if Rh positive exposed to Rh
Negative, vice-versa.
- Hemolytic Disease of the Newborn (HDN)
Erythroblastosis fetalis
▪ Pregnant person is Rh positive and her
baby is an Rh negative fetus
▪ Mother produces anti-Rh antibodies
that cross the placenta and cause
agglutination and hemolysis of fetal
RBCs
▪ Doesn’t occur in first pregnancy
▪ Arises in later pregnancies
- Rho (D) immune globulin (RhoGAM)
–prevention of HDN that contains
antibodies against Rh antigens; inactivates
the fetal Rh antigens and prevents
sensitization of the mother
DIAGNOSTIC BLOOD TEST
TYPE AND CROSSMATCH
- Blood typing – determines the ABO and Rh
blood groups of a blood sample
▪ Cells are separated from the plasma
and tested with known antibodies to
determine the type of antigen on the
cell surface.
- Crossmatch – donor’s blood cells are
mixed with the recipient’s serum + donor’s
serum is mixed with the recipient’s cells;
safe = no agglutination occurs in both
COMPLETE BLOOD COUNTS
- Analysis of blood that provides useful info
- Consists of RBC count, hemoglobin +
hematocrit measurements, WBC count
1. Red Blood Count
 - Can be performed electronically with
machine or manually by microscope
- Male – 4.6-6.2 M RBCs/microliter of blood
- Female – 4.2-5.4 M/microliter
- Erythrocytosis – overabundance of RBCs
- Erythrocytopenia – deficiency of RBCs
2. Hemoglobin Measurement
- Male – 14-18 g/100 mL of blood
- Female – 12-16 g/100 Ml
- Anemia – abnormally low hemoglobin
measurement
▪ Aplastic Anemia – inability of red bone
marrow to produce RBCs BLOOD CHEMISTRY
▪ Iron-deficiency Anemia – deficiency
intake or excessive loss
▪ Folate deficiency – fewer cell division;
neural tube defects
▪ Pernicious Anemia – inadequate
vit.B12 or intrinsic function
3. Hematocrit Measurement
- Through centrifuge
- Hematocrit – total blood volume that is
composed of RBCs
- Buffy coat – thin, whitish layer bet. the
plasma and RBCs
- Hematocrit measurement – affected by
no. and size of RBCs
2. Prothrombin Time Measurement
- How long it takes for the blood to start
clotting
▪ Normally is 9-12 s
- Prothrombin time – determined by adding
thromboplastin to whole plasma
- Thromboplastin – chemical released from
injured tissues that starts the process of
clotting
- International Normalized Ratio (INR)
–standardizes time it takes to clot
- High blood glucose levels – pancreas is not
producing enough insulin
- High blood urea nitrogen (BUN) – reduced
kidney function
- Increased bilirubin – indicate liver
dysfunction
- High cholesterol levels – risk of
cardiovascular disease

4. White Blood Count

- 5000-9000 white cells per/microliter of
blood
- Leukopenia – lower than normal WBC
- Leukocytosis – abnormally high WBC
- Leukemia – cancer of the red marrow;
abnormal production of one/more WBC
types; immature and can’t function
normally

DIFFERENTIAL BLOOD COUNT

- Determines % of each of the 5 kinds of

WBCs
- 60-70% Neutrophils
- 20-25% Lymphocytes
- 3-8% Monocytes
- 2-4% Eosinophils
- 0.5-1% Basophils

CLOTTING

1. Platelet count
- 250K – 400K platelets/microliter of blood
- Thrombocytopenia – platelet count is
greatly reduced; caused by decreased
platelet prod. Causing chronic bleeding
It can be caused by decreased platelet
production as a result of hereditary
disorder, lack of vitamins b12, drug
therapy and radiation therapy.
Heart | CHAPTER 12
- A muscular organ that pumps blood
through the body
- Pumps approx. 5L/min of blood
- Approx. the size of a closed fist
- The heart, blood vessel and the blood
make up the cardiovascular system
- Pulmonary circulation – right side of the
heart pumps blood to the lungs and back
to the left and back to the left side of the
heart
- Systematic circulation – left side of the
heart pumps blood to all other tissue of the
body back to the right side of the heart.
FUNCTION OF THE HEART
1. Generating Blood Pressure
2. Routing blood; separates circulation to
ensure the blood flowing in the tissues has
adequate levels of O2
3. Ensuring one-way blood flow
4. Regulating blood supply
SIZE, FORM, AND LOCATION OF THE HEART
- Adult heart is shaped like a blunt cone and
approximately the size of a closed fist
- At the age of 65, heart decreases in size
- Apex – blunt, rounded point of the heart;
directed to the left
- Base – larger, flat part at the opposite end
of the heart
- Heart is located in the thoracic cavity
between two plural cavities that surround
the lungs
- Mediastinum – midline partition
- Pericardial cavity – surrounding cavity of
the heart (own cavity)
- Importance of location and shape of the
Heart
▪ To accurately place a stethoscope
▪ To place chest leads for ECG
▪ To administer CPR (cardiopulmonary
resuscitation)
ANATOMY OF THE HEART
Pericardium
- Heart lies on pericardial cavity; formed by
pericardium or pericardial sac that
surround the heart and anchors to
mediastinum
- Pericardium has 2 layers:
▪ Fibrous pericardium – the outer layer
composed tough, fibrous connective
tissues
▪ Serous pericardium – inner layer,
consist of epithelial cell
● Parietal pericardium – blue/ lines
the fibrous pericardium
● Visceral pericardium – red/ covers
surface of heart
- Pericardial cavity located betw. Visceral
and parietal pericardia
▪ Thin layer of pericardial fluid produce
by serous pericardium
❖ Disorder of pericardium
- Pericarditis – inflammation of serous
pericardium; cause infection, diseases of
connective tissues or damage due to
radiation. has painful sensation can cause
heart attack
- Cardiac tamponade – fatal condition to
blood accumulates in the pericardial
cavity; making heart hard to expand or
pump
External anatomy
- Atria – entrance chamber; located at
base of heart
- Left and right Ventricles – cavities; extend
from the base of the heart towards apex
- Coronary sulcus – Groove; separates the
atria from the ventricles
▪ Anterior interventricular sulcus –
anterior surface
▪ Posterior interventricular sulcus –
posterior surface
- Superior & Inferior vena cava – carry blood
to the Right Atrium
- 4 Pulmonary veins – carry blood form the
lungs to the Left Atrium
- Pulmonary trunk & aorta – exit the heart
- Pulmonary arteries – carry blood to the
lungs
- Aorta – carries blood to the rest of the
body
Heart Chamber and Internal Anatomy
Heart is a muscular pump consisting of four
chambers:
- Right and left atrium
▪ Receives blood from the veins
▪ Function as reservoirs; where blood
returning from veins collects before it
enter the ventricles
▪ Receives blood in from 3 opening: (A)
Superior vena cava (2) inferior vena
cava (3) coronary sinus
● Superior and inferior vena cava
drain blood most of the body
● Coronary sinus drain blood from
most of heart muscles
▪ Interatrial septum – separator of the
two atria
- Right and left ventricles
▪ Major pumping chambers
▪ Ejects blood into the arteries and
forces it to flow through the CS
▪ Right ventricle pumps blood into
pulmonary trunk
▪ Left ventricle pumps blood into aorta
▪ Interventricular septum – separator of
the two ventricles
▪ LV ha sthicker wall than RV; LV
contracts more forcefully and
generates greater blood pressure (120
mm Hg);RV pressure increase up to 24
mm Hg.
▪ Left and right ventricle pumps blood
nearly same volume of blood
Heart valves
- 2 types of valve
▪ Atrioventicular valves
● Located between each atrium
and ventricle
● Betw, right atrium and ventricle is
tricuspid valve, composed of 3
cusps or flaps tissue
● Betw. Left atrium and ventricle is
bicuspid valve or mitral valve
● Allows blood to flow from the atria
into the ventricles;
● Prevents it from flowing back into
the atria
● Papillary muscles – cone-shaped,
muscular pillars; prevents the
valves from opening into the atria
● Chordae tendineae – thin, strong,
connective tissue strings
▪ Semilunar valves
● Located betw. Each ventricle and
its associated great artery
● Pulmonary semilunar valves –
between right ventricle and
pulmonary trunk; blocks blood from
flowing back into the ventricles
● Aortic semilunar valves – betw. Left
ventricle and aorta
● Cardiac skeleton – a plate of
connective tissue; electrical
insulation bet. the atria and the
ventricles; provides rigid
attachment site for cardiac muscle
Route of Blood Flow through the Heart
1. Deoxygenated blood enters the right
atrium from systematic circulation through
the superior and inferior vena cava, and
from coronary sinus
2. Most of the blood that flow at right atrium
flows through tricuspid valve and flows to
relaxed right ventricle. Before the end of
ventricular relaxation, right atrium
contracts enough to pushed blood to right
ventricle to complete right ventricular
filling
3. Right atrial contraction, right ventricle
begins to contract pushing blood against
tricuspid valve, forcing it to close. After
pressure within the right ventricle
increases, the pulmonary semilunar valve
is forced open and blood flows into the
pulmonary trunk. As right ventricle relaxes,
the pressure in pulmonary trunk becomes
greater resulting for pulmonary semilunar
valve to close.
 4. Pulmonary trunk branches to form right
and left pulmonary arteries which carries
blood to the lungs, where CO2 is release
and O2 is picked.
5. After the pulmonary circulation,
oxygenated blood flow to pulmonary
veins
6. Most of the blood that flow at left atrium
flows through bicuspid valve and flows to
relaxed left ventricle. Before the end of
ventricular relaxation, left atrium contracts
enough to pushed blood to left ventricle
to complete left ventricular filling
7. left atrial contraction, left ventricle begins
to contract pushing blood against
bicuspid valve, forcing it to close. After
pressure within the left ventricle increases,
the aortic semilunar valve is forced open
and blood flows into the aorta.
8. Blood flowing through aorta is distributed
to all parts of the body except to those
part of lungs supplied by pulmonary blood
vessel
Blood Supply to the Heart
- Coronary arteries – supply blood to the
wall of the heart; originated in the base of
aorta above aortic semilunar valves
⮚ Left coronary artery – left side of aorta;
supply much of anterior wall of heart and
most of left ventricle
▪ Anterior interventricular artery – lies in
the arterior intreventicular sulcus; blood
supply to the interventricular septum
▪ Circumflex artery – extends around the
coronary sulcus on the left to posterior
surface of heart; blood supply to the
outer side back of the heart.
▪ Left marginal artery – extends inferiorly
a long lateral wall of the left ventricle
from the circumflex artery; blood
supply to the left side of the heart.
⮚ Right coronary artery – right side of aorta;
supply most of the wall of right ventricle;
extend around the coronary sulcus on the
right to posterior surface of heart and
gives rise to the Posterior interventricular
artery
⮚ Right marginal artery – extends inferiorly
along the lateral wall of right ventricle
Cardiac veins
- Drains blood from the cardiac muscle
- Parallel pathways are nearly to coronary
arteries and most of them drain blood into
coronary sinus
Histology of the heart
- Epicardium/Visceral pericardium
▪ Thin, serous membrane forming the
smooth outer surface
▪ Consists of simple squamous epithelium
overlaying a layer of loose connective
tissue + adipose tissue
- Myocardium
▪ Composed of cardiac muscles
▪ Responsible for contraction of the
heart chambers
- Endocardium
▪ Simple squamous epithelium over a
layer of connective tissue
▪ Allows blood to move easily
▪ Forms the heart valves
- Trabeculae carneae – ridges and columns
of cardiac muscle
Cardiac Muscle
- Elongated, branching cells
- Two, centrally located nuclei
- Contains actin and myosin myofilaments
that form sarcomeres
- Rich in mitochondria (produce ATP at
rapid rate)
- Relies on Ca2+ and ATP for contraction
▪ Actin & Myosin myofilaments –
responsible for muscle contraction
▪ Organization of A&M myofilaments –
gives the cardiac muscle a striated
(banded) appearance
▪ Intercalated disks – specialized
cell-to-cell contacts; greatly increase
contact in between; prevents cells
form pulling apart
▪ Gap junctions – specialized cell
membrane structures; allow cytoplasm
to flow freely bet. Cells
Stimulation of The Heart
Muscle contraction do not occur unless the
muscle has been stimulated. Cardiac muscle
must be stimulated before they contract.
Illustration of heart contraction.
1. Heart is at rest and all chambers are
relaxed
2. Cardiac muscles cell in the atrial wall are
stimulated as action potential spread
across atrial wall and toward ventricles
3. Cardiac muscle cell in atrial wall contract,
pushing blood to ventricles
4. Cardiac muscle cell in the ventricular wall
are stimulated as action potential spread
across the ventricular wall from apex of
heart towards the base
 5. Cardiac muscle in the ventricular wall the SA node; contract rapidly and
contract, pushing blood into great arteries independently

(filbrilation – reduces output of the heart to only

few ml of blood per min, occurs to ventricles;
defibrillation – applying strong electrical shock to
Action Potentials in Cardiac Muscles SA to recover and produce action potential. )

- Depolarization phase Electrocardiogram

- Plateau phase – period of slow
repolarization
- Repolarization phase – achieves its
maximum degree of polarization; returns
to the resting membrane potential
- Refractory period
▪ Allows cardiac muscle to contract and
relax almost completely before
another action potential can be
produced
▪ Prevents tetanic contractions from
occurring
▪ Different action potential to other
muscles Electrodes placed on the body surface and
▪ Last longer attached to a recording device can detect the
small electrical changes resulting from action
Conduction System of Heart potential of cardiac muscles
- Contraction of the atria and ventricles is - Normal ECG consist of P wave, QRS
coordinated by specialized cardiac complex and a T wave
muscles in the heart wall that form the - P wave – depolarization of the atrial
conduction system of heart myocardium
- Produce spontaneous action potential - QRS complex – depolarization of the
- It includes: ventricles
▪ Sinoatrial node (SA) – heart’s - T wave – repolarization of ventricles
pacemaker; initiates the contraction of - PQ interval – time bet. the beginning of
the heart; produce faster rate of the P wave and he beginning of the QRS
action potential in heart and with complex; atria contracts and begins to
larger Ca2+; myocardium relax
▪ Atrioventricular node (AV) – spreads ▪ PR interval – common name bcos the
action potential slowly; lower portion Q wave is very small
of right atrium - QT interval – represents the time req. for
● Slow rate of Action potential in AV ventricular depolarization and
node allows the atria to comple repolarization
contraction before action
potential delivered to ventricles Cardiac Cycle
▪ Atrioventricular bundle – a bundle of
- Repetitive pumping process of cardiac
specialized cardiac muscle located in
muscle contractions
intervertricular septum; divide into 2
- Pressure changes produce within the heart
branches
chambers as a result of cardiac muscle
▪ Left & Right bundle branches – two
contraction move blood from areas higher
branches of conducting tissue
pressure to areas of lower pressure
● Action potential pass down the
▪ Atrial systole – refers to contraction of
bundle branches towards apex
atrium;
▪ Purkinje fibers – conduct action
▪ Ventricular systole – refers to
potentials more rapidly than do other
contraction of ventricles
cardiac muscle fibers; from tips of left
▪ Atrial diastole – refers to relaxation of
and right bundles branches; pass to
atria
the apex then extend to cardiac
▪ Ventricular diastole – refers to
muscle of ventricle.
relaxation of ventricles
▪ Ectopic beat – action potentials
originate in an area of the heart than
Heart sounds Effects of aging on the heart

- Stethoscope – used to listen to the sounds
of the lungs and the heart, and even
sounds of the body
- Lubb – closure of the AV valves
- Dupp – closure of the semilunar valves
- Incompetent valve – heart valve does not
not completely close
- Murmurs – abnormal heart sounds; result of
a faulty valve
- Stenosed – when opening of a valve is
narrowed; swishing sound precedes
- Age of 70, cardiac output decreased by
one-third resulting to limited ability to respond
to emergencies, infection, blood loss and
stress
- Hypertrophy – enlargement of left ventricle
- Resting and maximum cardiac output slowly
lower to 30-60%
- Increase cardiac arrhymias occurs as
consequence of decreased number of
cardiac cell
- Coronary artery diseases and heart failure

Regulation of Heart Function

- Cardiac output (CO) – vol. of blood

pumped; 5 L/min
▪ CO = SV x HR
- Stroke volume (SV) – vol. of blood pumped
per ventricle per contraction; 70 mL/beat
- Heart rate (HR) – no. of times the heart
contracts per minute; 72 beats/min

Intrinsic Regulation of the Heart

- Mechanisms contained within the heart

itself
- Venous return – amt. of blood that returns
to the heart
- Preload – degree to which the ventricular
walls are stretched at the end of diastole
- Starling’s Law of the Heart – relationship
bet. Preload and stroke volume
- Afterload – pressure against which the
ventricles must pump blood

Extrinsic Regulation of the Heart

- Mechanisms external to the heart

a. Nervous Regulation: Baroreceptor Reflex
▪ A mechanism of the nervous system in
regulating heart function
▪ Baroreceptors – stretch receptors that
monitor blood pressure
▪ Cardioregulatory center – receives
and integrates action potentials form
the baroreceptors
b. Chemical Regulation: Chemoreceptor
Reflex
▪ Epinephrine & Norepinephrine – causes
increased Heart Rate and Stroke
Volume

Blood Vessel and Circulation | CHAPTER 13
- Blood vessel carry blood to within 2 or 3 cell
diameters of nearly all the trillions of cells that
make up the body
- Blood vessel remain functional
- When blood vessel is damage, they can repair
themselves
Blood flow outside the heart are divided into two:
- Pulmonary vessel – transport blood from right
ventricle of heart to lungs and back to left
atrium
- Systematic vessel - transport blood from left
ventricle of heart to all the parts of the body
and back to right atrium
- Pulmonary and systematic vessel constitute
the circulatory system
FUNCTIONS OF CIRCULATORY SYSTEM:
1. Carries blood
2. Exchanges nutrients, wastes and gases
3. Transports substances
4. Helps regulate blood pressure
5. Directs blood flow to tissues
GENERAL FEATURES OF BLOOD VESSEL STRUCTURE
(PERIPHERAL CIRCULATION)
- Three main types of blood vessel
▪ ARTERIES
● carry blood AWAY from the heart;
oxygenated blood
● blood is pumped from ventricle into
large, elastics arteries, which
branched repeatedly to form
progressively smaller arteries
● As they become smaller, artery walls
undergo gradual transition from
elastic tissue than smooth muscle to
more smooth muscle than elastic.
● CLASSIFICATION:
♦ ELASTIC – largest diameter and
have the thickest walls
⮚ Greater proportion of their wall is
composed of elastic tissue and a
smaller portion of smooth tissue
⮚ Example: aorta and pulmonary
trunk
⮚ Elastic recoil of these arteries
prevents blood pressure from
falling rapidly and maintains
blood flow when ventricle is
relaxed
♦ MUSCULAR – medium-sized and
small diameter
⮚ Wall thickness is from smooth
muscle
⮚ Medium sized arteries called
DISTRIBUTING ARTERY because it
can control blood flow to diff.
regions of the body
⮚ Vasoconstriction – contraction of
smooth muscle in blood vessel;
decrease blood flow and blood
vessel diameter
⮚ Vasodilation – relaxation of
smooth muscle in blood vessel;
increase of blood flow and
blood vessel diameter
⮚ Supplies blood to small arteries;
same structure except the
diameter with small arteries
⮚ Smallest arteries has only 3-4
layer of smooth muscle wall
♦ ARTERIOLES – smallest artery;
transport blood from small artery to
capillary
⮚ Site where exchange occurs
between blood and tissue fluids;
has thinner walls
▪ CAPILLARIES
● Blood flows from arterioles into
capillaries
● Exchange of substance such as O2,
nutrients, CO2, and other waste
products; occurs betw. Blood and
tissue fluid
● Thinner walls than arteries; consist of
endothelium. O.5-1 millimeter long
● Blood flow are more slowly
● PRECAPILLARY SPHINCTERS – regulates
blood flow; located at the origin of
branches of capillaries
●
▪ VEINS
● Blood flow from capillaries into veins
(venules)
● Carry blood TOWARDS the heart;
deoxygenated blood
● thinner walls than arteries and contains
less elastic tissue and fewer smooth
muscle tissue
● from capillaries proceeding toward
heart, small diameter veins come
together to form larger diameter veins
● veins increase in diameter and
decrease in number; as it progress
 towards the heart, the walls increase in
thickness
● CLASSIFICATION:
⮚ VENULES – tubes with a diameter
slightly larger than that of capillary
⮚ SMALL VEINS – slightly larger than
venules; has 3 tunics
⮚ MEDIUM-SIZED VEINS – collect
blood from small veins and deliver
it to large veins
⮚ LARGE VEINS
● Have diameter than 2 mm contains
valves to ensure that blood flows
toward heart but not in opposite
direction.
● Prevents blood flow towards feet in
response to pull of gravity
3 TUNICS OF BLOOD VESSELS
- EXCEPT IN CAPILLARIES AND VENULES, blood
vessel consist of three layers or tunics
1. TUNICA INTIMA – innermost; basement
membrane; composed of Endothelium
o Composed of simple squamous
epithelial cell and amount of
connective tissue
o Muscular arteries, it contains layer
of thin elastic connective tissue
2. TUNICA MEDIA – middle layer; smooth
muscles arranged circularly
o Contains variable amount of
elastic and collagen fiber
o Muscular arteries, layer of elastic
connective tissue in outer margin
3. TUNICA ADVENTITIA/EXTERNA – outer
portion; dense connective tissue adjacent
to tunica media and become loose
connective tissue toward the outer portion
of the blood vessel wall
BLOOD VESSEL OF THE PULMONARY CIRCULATION
- Pulmonary circulation – system of blood vessel
carries blood from right ventricle to lungs and
back to left atrium
- Pulmonary Trunk – blood from right ventricle is
pumped into short vessel
- Right and Left pulmonary arteries – branches
of pulmonary trunk; carries deoxygenated
blood (pulmonary capillaries in lungs, where
blood takes O2 and release CO2) and
deoxygenated blood (from lungs to the left
atrium)
- Pulmonary veins – exits lungs and carries
oxygenated blood to the left atrium
BLOOD VESSEL OF THE SYSTEMIC CIRCULATION:
ARTERIES
- SYTEMATIC CIRCULATION – system of blood
vessel that carries blood from left ventricle to
tissues of the body.
⮚ Oxygenated blood from pulmonary veins
passes to left atrium into left ventricle into
aorta
AORTA
- where all arteries of the systemic circulation
branch directly or indirectly
- 3 PARTS:
1. ASCENDING AORTA – passes superiorly from
LV; where R and L coronary arteries arise
from its base and supply blood to heart
2. AORTIC ARCH – aorta arches posteriorly
and to the left
▪ 3 major arteries that carry blood to the
head and upper limbs:
● BRACHIOCEPHALIC ARTERY
● Left COMMON CAROTID ARTERY
● Left SUBCLAVIAN ARTERY
3. DESCENDING AORTA – longest part; from
thorax and abdomen to upper pelvis
▪ THORACIC AORTA – extends through
the thorax and diaphragm
▪ ABDOMINAL AORTA – extends through
the diaphragm; divide 2 common iliac
arteries
▪ ARTERIAL ANEURYSM – localized
dilation of an artery that usually
develops in response to trauma or a
congenital weakness of the artery wall.
Rupture of a large aneurysm is fatal
can cause death
ARTERIES OF THE HEAD AND NECK
- BRACHIOCEPHALIC ARTERY – first vessel to
branch from the aortic arch (arm and head)
⮚ Right Common carotid artery and Right
Subclavian artery; Left Common carotid
artery and Left
⮚ No artery on the left side of the body; left
common carotid and subclavian branch
directly aortic arch
- SUBCLAVIAN ARTERY – 2nd and 3rd branches;
transport blood to head and neck
- COMMON CAROTID ARTERY – internal and
external; transport blood to upper limb
 ⮚ Extend superiorly along each side of neck
to mandible.
⮚ Base of internal carotid is slightly dilated to
carotid sinus; important in monitoring
blood pressure; pass through carotid
canals and contribute to cerebral arterial
circle (base of the brain)
⮚ External carotid arteries have several
branches supplies the structure of neck,
nose, face, and mouth
- VERTEBRAL ARTERY – supply blood to the brain
and spinal cord
- BASILAR ARTERY – supply blood to the pons,
cerebellum and midbrain
ARTERIES OF UPPER LIMB
- AXILLARY ARTERY – axilla (armpit)
- BRACHIAL ARTERY – arm; measurement of
blood pressure
- ULNAR AND RADIAL ARTERY – forearm and
hand
⮚ RADIAL A – commonly used for taking a
pulse
THORACIC AORTA AND ITS BRANCHES
Thoracic aorta is divided into 2:
- VESCERAL ARTERY – supply the THORACIC
ORGANS
- PARIETAL ARTERY – supply the THORACIC
WALL; major parietal arteries:
⮚ POSTERIOR INTERCOSTAL ARTERY – from
thoracic aorta and extend bet the ribs;
supplies intercostal muscle, vertebrae,
spinal cord and deep muscle at back
⮚ SUPERIOR PHRENIC ARTERY – supply the
diaphragm
⮚ INTERNAL THORACIC ARTERY – descend
along the internal surface of the anterior
thoracic wall; branches of subclavian
arteries
⮚ ANTERIOR INTERCOSTAL ARTERY – Extend
bet ribs to supply the anterior chest wall
ABDOMINAL AORTA AND ITS BRANCHES
Abdominal aorta is divided into 2:
- VISCERAL ARTERIES
⮚ PAIRED BRANCHES
▪ RENAL ARTERIES – kidneys
▪ SUPRARENAL A. – adrenal glands
▪ TESTICULAR and OVARIAN A. – testes
and ovaries
⮚ UNPAIRED BRANCHES
▪ CELIAC TRUNK – supply blood to
stomach, pancreas, spleen, upper
duodenum and liver
▪ SUPERIOR MESENTRIC A. – small
intestines and upper portion of the
large intestines
▪ INFERIOR MESENTRIC A. – remainder of
the large intestines
- PARIETAL ARTERIES
⮚ INFERIOR PHRENIC ARTERIES – diaphragm
⮚ LUMBAR A – lumbar vertebrae and back
muscles
⮚ MEDIAN SACRAL – inferior vertebrae
ARTERIES OF THE PELVIS
Divides at the level of the fifth lumbar vertebra
into two common iliac arteries:
- EXTERNAL ILIAC A – enters lower limbs
- INTERNAL ILIAC A – supplies the pelvic area
⮚ VISCERAL BRANCHES – supply urinary
bladder, rectum, uterus, vagina
⮚ PARIETAL BRANCHES – walls and floor of
the pelvis; lumbar, gluteal and proximal
thigh muscles; external genitalia
ARTERIES OF THE LIMB
- FEMORAL ARTERY – thigh
- POLITEAL ARTERY – popliteal space, posterior
region of the knee
⮚ ANTERIOR TIBIAL A. – dorsalis pedis A.
(ankle)
⮚ POSTERIOR TIBIAL A. – fibular/peroneal A.
(supply blood to the leg and foot)
BLOOD VESSEL OF THE SYSTEMIC CIRCULATION:
VEINS
- Deoxygenated blood from tissues of the body
returns to heart through veins
- SUPERIOR VENA CAVA – head, neck, thorax,
upper Limbs
- INFERIOR VENA CAVA – abdomen, pelvis,
lower limbs
VEINS OF HEAD AND NECK
External and internal jugular veins – 2 major veins
that drain blood from head and neck
- EXTERNAL – more superficial; carries blood
from posterior head and neck, empties the
subclavian veins.
- INTERNAL – larger and deeper; carries blood
from brain, anterior head, face, and neck
⮚ Joins subclavian veins on each side to
form brachiocephalic veins (under
superior vena cava)
VEINS OF THE UPPER LIMBS
- DEEP VEINS – drain deep structure of upper
limbs
⮚ BRACHIAL VEIN – only noteworthy deep
vein which accompany the brachial
artery and empties the axillary vein
- SUPERFICIAL VEIN – drain the superficial
structure of the upper limbs
 ⮚ MAJOR SUPERFICIAL VEINS:
▪ CEPHALIC VEIN – empties in the axillary
vein
▪ BASILIC VEIN – becomes the axillary
vein
▪ MEDIAN CUBITAL VEIN – connects the
Cephalic w/ Basilic vein
CUBITAL FOSSA – site for draining blood
VEINS OF THE THORAX
Three major veins return blood to superior vena
cava:
⮚ RIGHT BRACHIOCEPHALIC VEINS
⮚ LEFT BRACHIOCEPHALIC VEINS
⮚ AZYGOS VEINS
- These veins empties into internal thoracic
veins, which empty into the brachiocephalic
veins
- Blood from posterior thoracic wall collected
by posterior intercostal veins that empty into
the azygos vein on right and hemiazygos vein
or accessory hemiazygos veins on left
VEINS OF THE ABDOMEN AND PELVIS
- Blood from posterior abdominal wall returns
toward heart through ascending lumbar veins
into the azygos vein.
- Blood in abdomen, pelvis and lower limb
return to the heart through inferior vena cava
▪ INTERNAL ILIAC VEINS – drain the pelvis
▪ EXTERNAL ILIAC VEINS – from lower limbs
▪ COMMON ILIAC VEINS – combine to form
the IVC
- Liver is major processing center for substances
absorbed by intestinal tract.
▪ PORTAL SYSTEM – Vascular system; has no
pumping mechanism
▪ HEPATIC PORTAL SYSTEM – begins w/
capillaries in the viscera and ends w/
capillaries in the liver
▪ MAJOR TRIBUTARIES:
▪ SPLENIC VEIN – Carries blood from
the spleen and pancreas
▪ SUPERIOR MESENTRIC VEIN -
♦ SUPERIOR AND INFERIOR MV –
carry blood from intestines
♦ SPLENIC VEIN AND SUPERIOR
MV – enters the liver
▪ Blood from liver flows to hepatic veins, joins
inferior vena cava.
▪ Blood entering the liver thru hepatic portal
is rich in nutrients collected by intestines,
may also contain toxins; within liver,
nutrients are taken up or stored to use by
other cells
▪ OTHER VEINS:
▪ RENAL VEINS – drain the kidneys
▪ SUPRARENAL VEINS – adrenal gland
▪ TESTICULAR AND OVARIAN VEINS -
testes and ovaries
VEINS OF THE LOWER LIMBS
- SUPERFICIAL VEINS:
⮚ GREAT SAPHENOUS VEIN – dorsal and
medial side of foot
⮚ SMALL SAPHENOUS VEIN – lateral side of
foot
PHYSIOLOGY OF CIRCULATION
FUNCTION OF CIRCULATORY SYSTEM:
- To maintain adequate blood flow
- Blood flows through arterial system
primarily as a result of the pressure
produced by the contraction of the heart.
BLOOD PRESSURE
– measure of the force of blood exerted
against the blood vessel walls
▪ SYSTOLIC PRESSURE – ventricle
contract; pressure reaches a maximum
value
▪ DIASTOLIC PRESSURE – ventricle relax;
pressure fall a minimum value
- millimeters of mercury or mmHg – standard
unit for BP
- auscultator method – used by health
professionals to determine blood pressure:
1. Blood pressure cuff connected to
sphygmomanometer wrapped to
patient’s arm and stethoscope placed
over brachial artery. The cuff is inflated
until the brachial artery is blocked
2. No blood flow to constricted area, no
sound can be heard
3. Pressure in the cuff is gradually
lowered. Soon as the cuff declines
below systolic pressure, blood flow
through the constricted area each
time the left ventricle contracts. Blood
flow turbulence produce vibration in
blood and surrounding tissue that can
be heard in stethoscope. Sound called
korotkoff sound, pressure which the first
korotkoff sound is heard is the systolic
pressure
4. As it the pressure is lowered, korotkoff
sound change tone and loudness
5. When pressure is dropped until
brachial artery is no longer constricted
and blood flow is no longer turbulent,
sound disappears and the pressure at
whicj korotkoff sound disappear is the
diastolic pressure
 Blood flow in body tissues are highly controlled
and matched closely to the metabolic needs of
tissue. Mechanism that control blood flow through
tissue is classified as;

- LOCAL CONTROL – periodic contraction

and relaxation of pre-capillary sphincters

PRESSURE AND RESISTANCE – if blood vessels

constrict, resistance to blood flow increases and
blood flow decreases

PULSE PRESSURE

– can be detected on large arteries near

body surface
– difference betw. Systolic and diastolic - NERVOUS CONTROL
pressure; 2 factors affect pilse pressure
▪ stroke volume ▪ SYMPATHETIC NERVE FIBERS – innervate
● systolic pressure increase more most blood vessels of the body
than diastolic pressure; leads high ▪ VASOMOTOR CENTER – controls blood
pulse pressure vessel diameter
▪ vascular compliance ▪ VASOMOTOR TONE – state of partial
● ability of a blood vessel wall to constriction of blood vessels
expand and contract passively
with changes in pressure is an
important function of large arteries
and veins.
● Arteriosclerosis – hardening of
arteries
● Blood ejected to into less elastic
artery higher result of systolic
pressure

CAPILLARY EXCHANGE

– most exchange across the wall of the

REGULATION OF ARTERIAL PRESSURE
capillary occurs by DIFFUSION
– major forces for moving fluid through the
capillary wall are
▪ blood pressure - fluid out the
capillaries
▪ osmosis – moves fluid into capillaries
- Edema/swelling – result of disruption in
normal inwardly and outwardly directed
pressure across the capillary walls
- swelling that is caused by fluid trapped
in your body's tissues
CONTROL OF BLOOD FLOW IN TISSUES
- Adequate blood pressure is required to
maintain blood flow through the blood
vessel
- MEAN ARTERIAL PRESSURE – controlled by
min. to min. basis by changes in heart rate,
stoke vol and pulse rate
▪ Less than the average systolic and
diastolic pressures in aorta bcs diastole
last longer than systole
▪ 70 mm Hg at birth; 95 mm Hg from
adolescence to middle age; 110 mm
Hg to health older person
▪ MAP is equal to cardiac output times
peripheral resistance (resistance to
blood flow)
 ▪ Also. Map is equal to heart rate times
stroke volume times peripheral
resistance
▪ Increase in response to greater HR,SV,
or PR
▪ Decrease in response to lower HR,SV,
or PR
- BARORECEPTOR REFLEXES – respond to
stretch in arteries caused by an increased
in pressure; to keep the blood pressure
within normal range
- CHEMORECEPTOR REFLEXES – respond to
changes in blood oxygen and CO2
concentration and pH; changes blood
concentratiom of O2 and CO2 as well as
pH

HORMONAL MECHANISM – help to control blod

pressure

- ADRENAL MEDULLARY MECHANISM -

Adrenal medullary cells integrate neural,
hormonal, and immune signals. Changes
in adrenal cytokines during the progression
of hypertension may promote blood
pressure elevation by influencing
catecholamine biosynthesis
- RENIN-ANGIOTENSIN-ALDOSTERONE
MECHANISM - a complex multi-organ
endocrine (hormone) system involved in
the regulation of blood pressure by
balancing fluid and electrolyte levels, as
well as regulating vascular resistance &
tone; regulates sodium and water
absorption in the kidney thus directly
having an impact on systemic blood
pressure
- ANTIDIURETIC HORMONW MECHANISM -
stimulates water reabsorbtion by
stimulating insertion of "water channels" or
aquaporins into the membranes of kidney
tubules. These channels transport
solute-free water through tubular cells and LYMPHATIC SYSTEM | CHAPTER 14
back into blood, leading to a decrease in
Pathogens – microorganism that cause diseases
plasma osmolarity and an increase
or damage to the tissues of the body
osmolarity of urine.; DECREASE URINE
VOLUME Lymphatic System – important protection of the
- ARTRIAL NATRIURETIC MECHANISM - a body. It function as:
cardiac hormone which gene and
receptors are widely present in the body. I. Maintenance of fluid balance
Its main function is to lower blood (1) Lymph - the fluid that flows through
pressure and to control electrolyte the lymphatic system, a system
homeostasis. composed of lymph vessels
(channels) and intervening lymph
EFFECTS OF AGING ON THE BLOOD VESSELS nodes whose function, like the
venous system, is to return fluid
ARTERIOSCLEROSIS – arteries become narrowed
from the tissues to the central
and blood flow decreases
circulation.
ATHEROSCLEROSIS – type of arteriosclerosis (2) Lymph contains (a) substances in
plasma pass from blood capillaries
into interstitial spaces then to
 lymphatic capillaries as to become
part of lymph and (b) substances
such as hormones, enzymes, and
waste product
II. Lipid absorption –
(1) The system absorb lipids and other
substances from digestive tract
through lymphatic vessels called
lacteals (lymphatic capillary that
absorbs dietary fats in the villi of
the small intestine.)
III. Defense – pathogens are filtered by
lymph by lymph nodes and from blood
by spleen; involves fighting infections
ANATOMY OF LYMPHATIC SYSTEM
LYMPHATIC CAPILLARIES AND VESSSEL
- The lymphatic capillaries and vessel includes
▪ Lymph
▪ Lymphatic vessels
▪ Lymph nodes
▪ Tonsils
▪ Spleen
▪ Thymus
- Does not circulate fluid in other tissue; carries
fluid in one direction from tissue to circulatory
system
- Fluid moves from blood capillaries into tissues
spaces. Most of the fluid returns to blood but
some of the fluids moves from the tissue
spaces into lymphatic capillaries and become
lymph
- Lymphatic capillaries – tiny, closed-ended
vesssels consisting of simple squamous
epithelium
▪ More permeable than blood
capillaries bcs of lack of basement
membrane as fluids passes easily
▪ Overlapping squamous cells act as
valves that prevent back flows; after
fluid pass through Lymphatic
Capillaries, flows towards thoracic
cavity
▪ Present in most tissue of the body
except:
● Central nervous system
● Bone marrow and tissue lacking
blood vessel
● Epidermis and cartilage
▪ Superficial group of lymphatic
capillaries collects excess interstitial
fluids from dermis and subcutaneous
tissues
▪ Deep group collects excess fluid from
muscle, viscera and other deep
structure
- Lymphatic vessel – resemble small veins;
formed when lymphatic capillaries join
together
▪ Beaded appearance bcs they have one
way valves
▪ When compressed, valves prevent
backward movement of lymph. 3 factors
cause compression:
● Contraction of surrounding skeletal
muscle during activity
● Periodic contraction of smooth muscle
in the lymphatic vessel wall
● Pressure changes in the thorax during
breathing
● Lymphatic vessel converge and
eventually empty into blood at two
location in the body:
▪ RIGHT LYMPHATIC DUCT – lymphatic
vessels from the right upper limb and
the right half of the head, neck and
chest; empties into the right subclavian
vein
▪ THORACIC DUCT – lymphatic vessels
from the rest of the body; empties into
the left subclavian vein
LYMPHATIC ORGANS
Consist of tonsils, lymph nodes, spleen and thymus
- Lymphatic tissue - consists of many
lymphocytes (originate from red marrow) and
other cells, such as macrophages; found
within lymphatic organs. It has fine reticular
tissue form an interlaced network that holds
lymphocytes and other cell in place, It also
traps pathogens. Number of lymphocytes is
part of immune response
▪ Tonsils
▪ Three groups:
● PALATINE TONSILS – located on
each side of the posterior opening
of the oral cavity; Usually referred
to as “the tonsils”
● PHARYNGEAL TONSILS – located
near the internal opening of the
nasal cavity
♦ Adenoid – enlarged
pharyngeal tonsil
 ● LINGUAL TONSIL – on the posterior
surface of the tongue; hard to
remove
● Tonsils form protective ring of
lymphatic tissue around openings
between nasal and oral cavities and
the pharynx
● Protects from pathogens and harmful
material entering the nose and mouth
● Pharyngeal or palatine tonsils are
chronically infected and being
remove
● Tonsillectomy – removal of palatine
tonsils
● Adenoidectomy – removal of
pharyngeal tonsil
● In adults, tonsils decrease in size or
▪ Roughly the size of a clenched fist and
disappear
is located in the left, superior corner of
the abdominal cavity
▪ Has an outer capsule of dense CT and
a small amount of smooth muscle
▪ TRABECULAE – divide the spleen into
small, interconnected compartments
containing 2 specialized types of
lymphatic tissue:
▪
● WHITE PULP – surrounds the arteries
within the spleen; lymphocytes can
stimulated same manner as lymph
nodes
● RED PULP – associated with the
veins; consist of fibrous network
filled with macrophages and RBC
and enlarge capillaries that
▪ LYMPH NODES – rounded structures, vary in connect to the veins;
size of small seed; distributed a long macrophages remove foreign
various lymphatic vessel substances and worn our RBC
▪ Most lymph passes through at least through phagocytosis.
one lymph nodes before entering ▪ Spleen filters blood instead of lymph,
blood cells within spleen detect and respond
▪ Found throughout the body and to foreign substances in the blood and
classified superficial and deep destroy old and damage RBC
● 3 superficial aggregations of lymph ▪ Spleen function as blood reservoir
nodes: (a)inguinal nodes in the ▪ Although it is protected by the ribs, it
groin, (b) axillary nodes in axilla, often get ruptured in abdominal
and (3) cervical nodes in neck injuries, causing severe bleeding, shock
● CAPSULE – dense CT that surrounds and death
each lymph node ▪ Splenectomy – removal of spleen
● TRABECULAE – extensions of the ▪ Thymus
capsule
▪ LYMPHATIC NODULES – dense
aggregations of tissue form from
lymphocytes and other cells
▪ LYMPHATIC SINUSES – spaces between
the lymphatic tissues that contain
macrophages on a network of fibers
▪ GERMINAL CENTERS – lymphatic
nodules containing the rapidly dividing
lymphocytes
▪ Spleen

▪ Bilobed gland roughly triangular in
shape; located in superior
mediastinum, divising thoracic cavity
into left and right parts
▪ Site for maturation of lymphocytes (T
Cells
▪ CAPSULE – thin CT that surrounds each
lobe
▪ TRABECULAE – divide each lobe into
lobules
▪ CORTEX – dark-staining areas where
lymphocytes are numerous
▪ MEDULLA – lighter-staining, central
portion of the lobules; has fewer
lymphocytes
OVERVIEW OF THE LYPHATIC SYSTEM
- Plays an important role in maintaining body
homeostasis by regulating fluid balance and
protecting body against diseases.
- Process:
1. Lymphatic capillaries and vessels remove
fluid from tissues
2. Specialized lymphatic vessel called
lacteals absorb lipids at small intestines.
Lymph in these vessels is referred as chyle
due to high lipid content.
3. Lymph nodes filters lymph by removing
pathogens and debris as the lymph flow
toward thoracic cavity
4. Lymph passes into larger vessels or ducts
and enters the blood
5. Spleen filters blood, the site of
lymphocytes as respond to infection
6. Pre-T cells are produce in red marrow and
migrate to thymus where mature T-cells
come
7. B-cells produce and mature in red bone
marrow; T-cells from thymus circulate to
and populate in other lyphatic tissues
IMMUNITY
- The ability to resist damage from foreign
substances – such as microorganisms, harmful
chemicals, and internal threats. Categorized
in two system:
▪ INNATE IMMUNITY – nonspecific resistance;
the body recognizes and destroys certain
foreign substances, but the response to
them is the same each time the body is
exposed.
▪ ADAPTIVE IMMUNITY – specific immunity;
the body recognizes and destroys certain
foreign substances, but the response to
them improves each time the foreign
substance is encountered. It has 2
subdivision:
▪ Antibody-mediated immunity, involves
B-cells
▪ Cell-mediated immunity, involves
T-cells
Characteristics of adaptive immunity:
▪ SPECIFICITY – ability of adaptive
immunity to recognize a particular
substance
▪ MEMORY – ability of the adaptive
immunity to “remember” previous
encounters with a particular substance
- When bacteria are destroyed before any
symptoms develop, the person is said to be
immune
INNATE IMMUNITY
- PHYSICAL BARRIERS
● Prevent microorganisms and chemicals
from entering the body in two ways:
▪ Skin and mucous membranes form
barriers that prevent their entry
▪ Tears, saliva, and urine wash these
substances from body surfaces
- CHEMICAL MEDIATORS
● molecules responsible for many aspects of
innate immunity; Destroy pathogens and
prevent their entry like lysosomes in tears
that kills certain bacteria
● histamine, complement, prostaglandins,
and leukotrienes, promote inflammation as
well as enhance phagocytosis by certain
WBC. Inferrons protect cells against viral
infections
▪ COMPLEMENT – group of
approximately 20 proteins found in
plasma; complement proteins
circulate in blood as an inactive form,
can be activated by combining with
foreign substances. Once activation
begins it promote inflammation and
phagocytosis of bacterial cells
▪ INTERFERONS – are proteins that
protect the body against viral
infections; they tell your immune
system that germs or cancer cells are
in your body. And they trigger killer
immune cells to fight those invaders.
Interferons got their name because
they "interfere" with viruses and keep
them from multiplying.
- WHITE BLOOD CELL
● Most important cellular components of
immunity; produce in red marrow and
lymphatic tissue as it release to blod
● Important chemicals known to attract
WBC: Complement, Leukotrienes, Kinins,
Histamine
● CHEMOTAXIS – movement of WBC toward
these chemicals
PHAGOCYTIC CELLS NATURAL KILLER CELLS

● PHAGOCYTOSIS – the ingestion and ● Type of lymphocyte produced in Red

destruction of particles by cells called Marrow, account up to 15% of
phagocytes. Most important phagocytes: lymphocytes
▪ NEUTROPHILS – small phagocytic cells ● Recognize classes of cells, such as tumor
that are usually the first cells to enter cells or virus-infected cells in general;
infected tissues, release chemical causes these cells to lyse
signal that increase inflammatory - INFLAMMATORY RESPONSE
response by recruiting and activating
immune cells; often die after
phagocytizing
♦ PUS – accumulation of fluid,
dead neutrophils, and other
cells at a site of infection
▪ MACROPHAGES – monocytes that
leave the blood, enter tissues, and
enlarge about fivefold
♦ MONONUCLEAR PHAGOCYTIC
SYSTEM – phagocytes with a
single (mono), unlobed
nucleus; combination of
monocytes and macrophages
- Dust cells – macrophages in
the lungs
- Kupffer cells – liver
- Microglia – central nervous
system
♦ Ingest more and larger irtems
than neutrophils; macrophages
appears in infected tissues after
neutrophils. Responsible for
phagocytic activity in late
stages of an infection including
cleaning
♦ Also seen in non-infected tissue,
● Involves many chemicals and cells
incase pathogens entered
discussed; similar or vary depending on
non-infected tissues,
the intensity of the response and type of
macrophages easily
injury
phagocytize it
● Chemicals release has several effects:
CELLS OF INFLAMMATION ▪ Vasodilation increase blood flow and
brings phagocytes and other WBC in
● BASOPHILS – derived from red bone the area
marrow; motile WBCs that can leave the ▪ Phagocytes leaves blood abd enter
blood and enter infected tissues tissue
▪ MAST CELLS – nonmotile cells in CT, ▪ Increased vascular permeability allow
esp. near capillaries; located at fibrinogen and complement enter
points where pathogen may enter tissue
like skin, lungs, gastrointestinal tract ▪ Inflammation can be:
and urogenital tract ● LOCAL INFLAMMATION – confined
▪ Can be activated through innate to a specific area of the body
immunity and adaptive immunity ♦ SYMPTOMS: redness, heat,
▪ Release chemicals such as histamine swelling, pain, and loss of
and leukotrienes that produce function
inflammation ● SYSTEMIC INFLAMMATION –
● EOSINOPHILS – produced in red bone generally distributed throughout
marrow; enter the blood, and within a few the body
minutes enter tissues. Associated with ♦ SYMPTOMS: increase in
allergies and asthma neutrophil numbers, fever, and
shock.
 ♦ PYROGENS – stimulate fever
production; affects body
temperature
♦ Red marrow produces and
release large numbers of
neutrophils which produce
phagocytosis
ADAPTIVE IMMUNITY
ANTIGENS – substances that stimulate adaptive
immune responses
i. FOREIGN ANTIGENS – introduced from outside
the body (Ex: bacteria, viruses, chemicals
released by microorganisms)
▪ ALLERGIC REACTION – caused by foreign
antigens that produce an overreaction of
the immune system
ii. SELF-ANTIGENS – molecules of the body
produces to stimulate and immune system
response causing destruction of diseases
▪ AUTOIMMUNE DISEASE – results when
self-antigens stimulate unwanted
destruction of normal tissue
- Adaptive immunity divided into:
▪ Antibody-mediated immunity – involves
proteins called antibodies, which are
found and produce in the plasma
▪ B CELLS – lymphocyte that produces
antibodies
▪ Cell-mediated immunity – involves the
actions of a second type of lymphocyte,
called T cells
▪ Cytotoxic T cells – produce effect of
cell-mediated immunity
▪ Helper T cells – promote or inhibit the
activities of both antibody and
cell-mediated immunity
ORIGIN AND DEVELOPMENT OF LYMPHOCYTES
Clonal Selection of B Cells
- HEMOPOIETIC STEM CELL – in red marrow
capable of giving rise to all blood cells
▪ Both T cells and B cells originate in stem
cells in red marrow. Both circulate to other
lymphatic tissue such as lymph nodes.
More t cells than B cells
▪ B cells enter blood from red marrow
▪ T cells enter blood from thymus
- CLONES – small groups of identical B cells or T
cells that are form during embryonic
development
ACTIVATION AND MULTIPLICATION OF
LYMPHOCYTES
- Specialized B cells or T cells respond to
antigens and produce an adaptive immune
response. For AIR to be effective, two events
must occur:
● Antigen recognition by lymphocytes
▪ ANTIGEN RECEPTORS – proteins of the
lymphocytes
● B-CELL RECEPTORS – antigen
receptors on B cells
● T-CELL RECEPTORS – antigen
receptors on T cells
● Once lymphocytes are activated,
adaptive immune response begins
● In many cases, antigens that are
activated lymphocytes are portion
of larger molecules.
♦ T cells and b cells are recognize
antigens after these large
molecules have been
processes or broken down into
smaller fragments
♦ These large molecules can
originate from either (1) internal
antigen – substance produce
in a cell or (2) external antigen
– foreign antigens that are
phagocytized by
macrophages
● Major histocompatibility complex
(MHC) molecules – are
glycoproteins that have binding
sites for antigens. MHC molecules
are a different group of receptors
found in membrane. Function as
serving tray that holds and present
a processed antigen on outer
surface of cell membrane.
Combine MHC molecule and
processed antigen can bind to a
lymphocytes antigen receptor and
stimulate. It has 2 types:
♦ MHC class I – molecules found
on membranes of nucleated
cells and display internal
antigens
♦ MHC class II – molecules found
on the membrane of
antigen-presenting cell
(includes macrophages, B
lymphocytes and other
defense cells) and display
external antigens
ACTIVATION AND PROLIFERATION OF HELPER T
CELLS
1. ANTIGEN PRESENTING CELL such as
macrophages, phagocytes, processes
and display an antigen on its membrane
on MHC class II
2. Helper T cell interacts with macrophages
though its T-cell receptor
 3. Constimulation occurs through other
chemical signalling such as interleukins
secreted by macrophages and CD4
glycoproteins of the helper T cell
4. Helper T cel is activated and stimulated to
divide through the action of interleukin-2,
producing daughter cells
5. Newly formed daughter helper T cells can
be stimulated to divide as well. These
helper T cells can also stimulate B cells
and cytotoxic T cells
6. Some daughter cell will become memory
T cells and may become active in the
future.
- MHC molecule/antigen combination is usually
only the first signal necessary to produce
response from B or T cell
- Constimulation - second signal; can be
achieve by cytokinesis, which protein or
peptides secreted by one cell as regulator of
neighbouring cells. (ex. Interlukin-1 is a
cytokine released by macrophages that can
stimulate helper t cells
- Lymphocytes has other surface molecules
aside MHC
▪ Helper t cells have glycoprotein called
CD4 which helps connect helper T cells to
the macrophage by binding to MHC class
11
▪ CD4 protein bound by the viruses that
causes AIDS
▪ Cytotoxic T cells have a glycoprotein
called CD8 which helps cytotoxic T cells to
cell diplaying MHC class I
LYMPHOCYTES PROLIFERATION
- Important process that generates the needed
defense cell to protect the body
- Helper T Cells by macrophages, respond by
producing interleukin-2 and interleukin-2
receptors
- interleukin-2 binds to the receptor and
stimulate the helper T cell to divide
- daughter T cells produced by this division can
be presented by macrophages and
stimulated and divide again
- number of helper T cells is greatly increase
and it is important bcs it is necessary for
activation of B cells or cytotoxic T cells
A HELPER T CELLS STIMULATES B CELL TO DIVIDE
AND DIFFERENTIATE INTO PLASMA CELLS WHICH
PRODUCE ANTIBODIES
1. B-cell proliferation begins when a b cell
takes in the same kind of antigen that
stimulated the helper T cells
2. The antigen is processed by the B cells
and presented on the b-cell surface by
an MHC class II molecule
3. A helper T cell is stimulated when it binds
to the MHC class II/antigen complex there
is also constimulation involving CD4 and
interleukins
4. As a result, B cell divides into two
daughter cells
5. One daughter cell differentiates to
plasma cell, which produce antibodies
6. Division process continue, increasing
number of cells capable of producing
antibodies and resulting to sufficient
antibodies to destroy antigen
7. Daughter cell do not become plasma
cells, it become memory B cells and
 become active in the future encounters
of same antigen

ANTIBODY-MEDIATED IMMUNITY

- Exposure to antigen can lead to activation of

B cells and production of antibodies
- Antibodies bind to antigens which destroyed
through different mechanism
- Antibodies are body fluid, antibody-mediated
immunity is effective against extracellular
antigens; it is also involve in allergic reactions
STRUCTURE OF ANTIBODIES

- Antibodies are proteins produced in response

to an antigen
- Y-shaped molecules consisting of four
polypeptide chains;
▪ Two identical heavy chains
▪ Two identical light chains
- End of each “arm” of the antibody is the
variable region, where the part of the
antibody that combines with the antigen. It is
also particular antibody can join only with a
particular antigen similar to lock-and-key of
enzymes
- Rest of the antibody is constant region, it
function as it can activate complement or it
can attached the antibody to cells such as
macrophages, basophils and mast cells
- Antibodies make up a large portion of the
proteins in plasma ; most plasma proteins can
be separated into albumin and alpha, beta
and gamma globulin portions’
- Antibodies are called gamma globulins, bcs it
is found in gamma globulin part of plasma
- Antibodies are also called immunoglobulin,
bcs they are globulins proteins involve.

EFFECTS OF ANTIBODIES

- Directly inactivate antigens or cause them to

clump together
- Indirectly destroy antigens by promoting
phagocytosis and inflammation

ANTIBODY PRODUCTION