ANATOMY OF CARDIOVASCULAR SYSTEM

AND BLOOD
 LEARNING OUTCOMES

By the end of this lecture you should be able to:

◾ Describe the cells of the blood & the basis of the ABO
system
◾ Describe the anatomy of the thorax
◾ Outline the subdivisions of the mediastinum
◾ Define & distinguish between the pulmonary & systemic
circuits
◾ Describe the gross anatomy of the heart & its four chambers

◾ Outline the structure & function of the valves of the heart

◾ Describe the arterial blood supply to the heart

 BLOOD
◾ connective tissue – matrix plus cells/formed
elements
◾ plasma - the liquid matrix of blood
◾ cells - formed elements of the blood
 FUNCTIONS OF BLOOD

 transportation: dissolved gases, nutrients, hormones & metabolic

wastes
 regulation of pH & ion composition of interstitial fluids
 restriction of fluid loss at injury sites (clotting)
 defence against toxins & pathogens
 stabilisation of body temperature
 REGULATION OF ERYTHROPOIESIS

◾ requires vitamin B12

◾ without B12 normal stem cell division does not occur & pernicious anaemia
results
◾ erythropoiesis is stimulated directly by erythropoietin (EPO) a peptide hormone
◾ released by kidneys & liver in response to hypoxia (low tissue O 2 levels)

◾ erythropoietin travels to red bone marrow & stimulates stem cells &
developing RBCs
◾ synthetic EPO – increases number of O 2 carrying blood cells, but
increases viscosity of blood & heart work rate
RED BLOOD CELLS & HAEMOGLOBIN
 RECYCLING OF RED BLOOD CELLS
[HAEME]
◾ macrophages of liver, spleen
& bone marrow monitor
quality & engulf old RBCs
◾ each component of
haemoglobin
molecule is recycled
◾ globular proteins
disassembled into amino
acids & released for other
cells to use
◾ heme units are stripped of iron
& turned into biliverdin (green
in bruises)
◾ biliverdin is turned into
bilirubin (orange/yellow of
jaundice) & transported to
the liver - excreted as bile
 ABO BLOOD TYPES

◾ plasma membranes contain surface antigens

◾ antigens enable the immune system to recognise them as ‘self’
◾ antibodies in the plasma recognise antigens as ‘self’ or ‘foreign’
◾ blood ‘type’ - classification determined by presence & absence of
antigens on red blood cell plasma membranes
◾ RBCs have 50+ surface antigens
◾ three are important
◾ A, B and Rh (or D)
 ABO BLOOD TYPES - A N TIGENS

◾ Type A: surface antigen A only

◾ Type B: surface antigen B only
◾ Type AB: both surface antigen A & B
◾ Type O: neither surface antigen A
nor B
 ABO BLOOD TYPES - ANTIGENS
◾ Rh positive (Rh+) indicates presence of Rh antigen on surface of the RBC
◾ Rh negative (Rh-) indicates absence of this surface antigen

Examples:
◾ AB + is A & B & Rh surface antigens
◾ O + is neither A nor B but with Rh surface antigens (most common blood type)
◾ plasma of Rh negative individuals will only contain Anti-Rh antibodies if they
have been sensitised by exposure to Rh-positive RBCs (e.g. haemolytic
disease of the new born)
 ABO BLOOD TYPES - A N TIBODIES

◾ Type A: Anti-B antibodies in the plasma

◾ Type B: Anti-A antibodies in the plasma
◾ Type AB: neither Anti-A nor Anti-B antibodies in the
plasma
◾ Type O – both Anti-A and Anti-B antibodies in the
plasma
 C ROSS-REACTIONS IN TRANSFUSIONS
◾ when a plasma antibody meets its surface antigen the RBCs agglutinate
(stick
together) & haemolyse (rupture)
◾ clumps & fragments of RBCs can then block small blood vessels
◾ compatibility of donor & recipient is essential
◾ surface antigens on donor RBCs are more important than antibodies in
donor
plasma
 TESTING FOR COMPATIBILITY

Two processes:
 determining blood
type
 a cross-match test
 TESTING FOR COMPATIBILITY

Two processes:
 determining blood
type
 a cross-match test
 HAEMOLYTIC DISEASE OF THE NEW BORN

◾ can arises when Rh-negative woman is carrying an Rh-positive fetus

◾ when fetal & maternal blood mix at delivery (or antepartum

haemorrhage,
amniocentesis) the mother recognises fetus’ Rh antigens as being foreign
 HAEMOLYTIC DISEASE OF THE NEW BORN
◾ mixing of blood can stimulate mother’s immune system to produce anti-Rh
antibodies (sensitisation)
◾ if mother has another Rh-positive fetus her anti-Rh antibodies cross the
placenta & attack (haemolyse) fetus’ red blood cells
 HAEMOLYTIC DISEASE OF THE NEW BORN

 anaemia & high levels of bilirubin producing jaundice – can cause death

 administer anti-D antibodies to mother during pregnancy & after

delivery

 will destroy fetal RBCs that enter maternal circulation

 no sensitisation, no antibodies
 LEARNING OUTCOMES

By the end of this lecture you should be able to:

◾ Describe the cells of the blood & the basis of the ABO
system√
◾ Describe the anatomy of the thorax
◾ Outline the subdivisions of the mediastinum

◾ Define & distinguish between the pulmonary & systemic

circuits
◾ Describe the gross anatomy of the heart & its four chambers

◾ Outline the structure & function of the valves of the heart

◾ Describe the arterial blood supply to the heart

 THE THORAX

◾ comprises: 12 thoracic vertebrae, sternum & ribs

◾ inlet & outlet
◾ encloses heart & lungs - some protection for spleen, liver &
kidneys
◾ provides attachment for pectoral girdle & upper limbs
◾ able to contract & expand during respiration
THE THORA X
 THORACIC X -RAY: A-P
Clavicl VIEW
e

Rib
1

Heart
shado
w
Rib
11

T1
vertebra

Photos © McGraw-Hill Education

 THE RIBS
 12 pairs

 articulate posteriorly with bodies & transverse processes of

vertebrae

 articulate anteriorly with their costal cartilages

 costal cartilages (hyaline cartilage) attach rib to sternum

 costochondral joints classified as primary cartilaginous joints

 STERNUM

◾ bony plate anterior to the heart - palpable [subcutaneous] in

parts
◾ three regions
◾ manubrium
◾ body (gladiolus)
◾ xiphoid process

Other features:
 jugular notch
 manubriosternal junction/joint [sternal angle]
THE RIBS
 THE RIBS
 head - portion of rib that articulates with bodies of thoracic
vertebrae
 superior & inferior articular facets
 neck - narrow portion distal to the head
 tubercle - wider, rough area distal to the neck
 articulates with transverse costal facet of vertebra
 angle - lateral curve of rib
 shaft - long, sloping, blade-like portion of rib
 costal groove on inferior margin of shaft
 A N ATOMY OF THE
RIBS

(b) Ribs 2-10 (b) Superior view

 THE RIBS
◾ True ribs (Ribs 1-7)
◾ each articulates with sternum via costal
cartilage

◾ False ribs (Ribs 8-12)

◾ connect to costal cartilage of rib above
◾ forms costal margin

◾ Floating ribs (Ribs 11-12)

◾ no cartilaginous connection to sternum
◾ no connections to costal cartilages above
◾ no tubercles
◾ no attachments to transverse processes of
COSTAL CARTILAGES
INTERCOSTAL MUSCLES

D iaphragm separates thorax from

abdomen
 LEARNING OUTCOMES

By the end of this lecture you should be able to:

◾ Describe the cells of the blood & the basis of the ABO
system √
◾ Describe the anatomy of the thorax √
◾ Outline the subdivisions of the mediastinum
◾ Define & distinguish between the pulmonary & systemic
circuits
◾ Describe the gross anatomy of the heart & its four chambers

◾ Outline the structure & function of the valves of the heart

◾ Describe the arterial blood supply to the heart

 CHEST C AVITY & ITS C O N TENTS

Mediastinum
 heart
 great vessels
 trachea
 oesophagus
 nerves

 right & left pleural cavities:

lungs
 MEDIASTINAL BOUNDARIES

 anteriorly: sternum

 posteriorly: vertebral
column

 inferiorly: diaphragm

 superiorly: thoracic inlet

 MEDIASTINAL SUBDIVISIONS

 descriptive
 superior & inferior mediastinum
 anatomical plane T4 (sternal angle)

T4 plane:
 arching aorta
 tracheal bifurcation
 azygos vein enters SVC
 thoracic duct crosses vertebral
column
 MEDIASTINAL SUBDIVISIONS
Inferior mediastinum

 further subdivided by fibrous pericardium

into:

 anterior mediastinum

 middle mediastinum

 posterior mediastinum

 pericardium

 heart

 rootsof great
vessels
 LEARNING OUTCOMES

By the end of this lecture you should be able to:

◾ Describe the cells of the blood & the basis of the ABO
system √
◾ Describe the anatomy of the thorax √
◾ Outline the subdivisions of the mediastinum √
◾ Define & distinguish between the pulmonary & systemic
circuits
◾ Describe the gross anatomy of the heart & its four chambers

◾ Outline the structure & function of the valves of the heart

◾ Describe the arterial blood supply to the heart