Cardiovascular (circulatory) System Blood Structure and Functions A Cells 1 Kinds a Red blood cells (erythrocytes/red corpuscles) b White

blood cells (leukocytes/white corpuscles) (1) Granular leukocytes-neutrophils, eosinophils, basophils (2) Nongranular leukocytes-lymphocytes, monocytes, macrophages c Platelets or thrombocytes 2 Numbers a Red blood cells-4 to 5 million per cubic millimeter of blood b White blood cells-5,000 to 9,000 per cubic millimeter of blood c Platelets-300,000 per cubic millimeter of blood 3 Formation-red bone marrow forms all blood cells except some lymphocytes and monocytes, which are formed by lymphatic tissue in lymph nodes, thymus, and spleen 4 Anemia-inability of blood to carry adequate oxygen to tissues caused by: a Inadequate red blood cell numbers b Deficiency of hemoglobin c Pernicious anemia-deficiency of Vitamin B12 5 Red blood cell functions - transport oxygen and carbon dioxide 6 White blood cell functions - neutrophils, eosinophils, monocytes, macrophages carry on phagocytosis; lymphocytes function to produce antibodies that provides immunity; some are effective against viruses, fungi, transplanted tissue, cancer cells, some bacteria; eosinophils protect against irritants that cause allergies and basophils produce heparin (anti-coagulant) 7 Platelet function-Blood clotting B Blood plasma 1 Definition-blood minus its cells 2 Composition-water containing many dissolved substances, for example, foods, salts, hormones 3 Amount of blood-varies with size and sex; 4 to 6 liters about average; about 7% to 9% of body weight 4 Reaction-slightly alkaline C Blood types or blood groups 1 Type A blood -A antigens on red cells surfaces; anti-B antibodies in plasma 2 Type B blood -B antigens on red cells; anti-A antibodies in plasma 3 Type AB blood-type A and B antigens on red cells; no anti-A or anti-B antibodies in plasma; therefore type AB blood is called universal recipient blood 4 Type 0 blood -no A or B antigens on red cells; therefore type O blood is called universal donor blood; both anti-A and anti-B antibodies in plasma 5 Rh-positive blood-Rh factor antigen present on red blood cells 6 Rh-negative blood-no Rh factor present on red blood cells; no anti-Rh antibodies present naturally in plasma;

Heart A Location, size, and position 1 Triangular organ located in mediastinum with two thirds of mass to left of body midline and one third to right; apex on diaphragm; shape and size of a closed fist 2 Cardiopulmonary resuscitation (CPR)-heart lies between sternum in front and bodies of thoracic vertebrae behind, rhythmic compresson of heart between sternum and vertebrae can maintain blood flow in cardiac arrest; if combined with artificial respiration procedure, can be life-saving B Anatomy 1 Heart chambers a Two upper chambers called atria (receiving chambers)-right and left atria b Two lower chambers called ventricles (discharging chambers)-right and left ventricles C Wall of each heart chamber composed of cardiac muscle tissue called myocardium d Endocardium-smooth lining of heart chambers 2 Covering sac or pericardium a Pericardium is a two-layered with a lubricated space between the two layers b Inner layer called visceral pericardium or epicardium c Outer layer called parietal pericardium 3 Heart valves Four valves keep blood flowing in right direction through heart; prevent backflow (two AV or atrioventricular and two semilunar valves). a Tricuspid-at opening of right atrium into ventricle b Mitral (bicuspid)-at opening of left atrium into ventricle C Pulmonary semilunars-at beginning of pulmonary artery d Aortic semilunars-at beginning of aorta C Heart Sounds I Two distinct heart sounds in every heartbeat or cycle-"lup-dup"

2 First (lup) sound is caused by vibration and closure of AV valves during contraction of heart 3 Second (dup) sound is caused by closure of the semilunar valves during relaxation of heart D Blood Flow through the Heart 1 Heart acts as two separate pumps - the right atria and ventricle performing differ ent functions from the left atria and ventricle 2 Sequence of blood flow: venous blood enters right atrium through superior and inferior vena cavaepasses from right atrium through tricuspid valve to right ventricle; from right ventricle blood passes through pulmonary semilunar valve to pulmonary artery to lungs-blood from lungs returns to left atrium and passes through bicuspid (mitral) valve to left ventricle. Blood in left ventricle is pumped through aortic semilunar valve into aorta and is distributed to body as a whole E Coronary Circulation I Blood, which supplies oxygen and nutrients to myocardium of heart, flows through right and left coronary arteries. The cardiac veins drain the cardiac muscle. 2 Blockage of blood flow through coronary arteries called myocardial infarction (heart attack) 3 Angina pectoris-chest pain caused by inadequate oxygen to heart F Conduction System The contractions of the cardiac muscle cells are generally independent of impulses received from the nervous sys.. The heart initiates and distributes impulses to contract its muscles cells through a system of specialized tissues. 1 SA (sinoatrial) node (pacemaker) is a mass of nerve-like cells located in the wall of the right atrium near the opening of the superior vena cava. Impulses generated here reach all parts of the heart. Pacemaker sets the pace for heart contractions. It depolarizes without nerve intervention. 2 AV (atrioventricular) node - located in the right atrium along the lower part of the interatrial septum. Slows conduction of the impulse. 3 AV (bundle of His) bundle - located in the interventricular septum of the heart 4 Bundle branches -left & right subdivisions of AV bundle (interventricular septum) 5 Purkinje fibers (nerve fibres)- located in the walls of the ventricles. Impulses travel from the SA node across the atrial surfaces to AV node. Atrial contraction begins. Impulses travel along the interventricular septum to the AV bundle and left & right bundle branches to the purkinje fibres. The impulse is distributed by the purkinje fibres and relayed through the ventricular myocardium. At this time, ventricular contraction begins at the apex and spreads toward the base of the heart. Impulses within the heart follow the typical depolarization & repolarization found in all neurons. The stimulus from the SA node depolarizes the membrane of the cardiac muscle cell (sodium channels open and sodium rushes in). As the sodium channels close, calcium channels open slowly and remain open for a long time (Ca enters cytoplasm from 2 places: SER & ECF. Ca binds to troponin which allow actin & myosin filaments to begin sliding past each other, & then tension starts to develop). This is the plateau phase. As Ca channels close, K channels begin to open, and K exits and muscle relaxes. The result is rapid repolarization. Each time the heart beats, a wave of depolarization radiates through the atria, reaching the AV node, travels down the interventricular septum to the apex, turns, and spreads through the ventricular myocardium toward the base. Electrocardiogram (determines if conduction is normal, if heart is enlarged & if certain region are damaged). I. The record of electrical changes during each cardiac cycle is referred to as an electrocardiogram (ECG/EKG). The electrocardiograph = a machine used to record heart electrical activity. Electrodes record current on the sarcolemma of the muscle fibre. The electrodes are attached to a voltmetre. One electrode is positive; other is negative. As an action potential moves across the sarcolemma, it reaches one electrode first. The result is a difference voltage at each electrode. This causes the voltmetre needle to move; a pen at the end of the needle marks the paper, and an electrocardiogram is produced. 2. A normal ECG consists of a P wave (atrial depolarization). QRS complex (ventricular depolarization). and T wave (ventricular repolarization). Note: atrial repolarization is lost in the QRS complex. 3. The P-Q (PR) interval represents the conduction time from the beginning of atrial excitation to the beginning of ventricular excitation; i.e., from the beginning of the P wave to the beginning of the Q wave. The S-T segment represents the time when ventricular contractile fibers are fully depolarized; between the end of the S wave and the start of the T wave. The Q-T segment is from the beginning of the Q wave to the end of the T wave. The segments are used to diagnose myocardial damage. The SA node causes the atria to contract and are reflected in the P wave. After a pause, the impulses from the AV node causes the ventricles to contract. These contractions are shown in the QRS wave. The T wave rep. the time the muscles are recovering from the contraction (ventricular repolarization). H. Factors that affect heart rate Even though outside stimulation is not required for heart activity, the rate of heartbeat & ventricular contraction is

increased by impulses from the sympathetic nervous system and decreased by the parasympathetic nervous system.. Parasympathetic stimulation slows the heart as a result of ACh release. Sympathetic stimulation speeds the heart as a result of NE release. Hormones: E, NE & thyroid hormones increase heart rate. Ions: high Na, K & Ca decrease heart rate.

Emotions (anger, fear, anxiety) may speed heart rate. Emotions (grief) may slow heart rate. Exercise accelerates heart rate. Temperature causes SA node to discharge impulses faster; hence, heart rate increase. Temperature decrease slows heart. Stimulation of pain receptors slow heart; may cause fainting G. Cardiac Cycle (one heart beat) -0.8 secs. The alternating contractions & relaxations of the heart chambers is referred to the cardiac cycle. Systole refers to heart contractions. Diastole refers to relaxations. Cycle= systole + diastole. Blood flows from high pressure to low pressure. Phase 1: ventricular diastole, atrial systole Both ventricles relax simultaneously. Both atria contract simultaneously. Atrial pressure > ventricular pressure; therefore, AV valves open. Atria contract & force blood through AV valves. Valves in the VC & pulmonary vein close. Phase 2: ventricular systole, atrial diastole Both atria relax simultaneously. Both ventricles contract simultaneously. Atrial pressure < ventricular pressure; therefore, AV valves close. Ventricular pressure > pressure in aorta & pulmonary artery; therefore, the aortic and pulmonary valves open. Blood flows to lungs & rest of body. Phase 3: ventricular diastole, atrial diastole Ventricles & atria relax for a short time Ventricular pressure< pressure in aorta & pulmonary artery; therefore, aortic and pulmonary valves close. Pressure in vena cava & pulmonary vein > atrial pressures; therefore atria refills. CYCLE IS NOW COMPLETE - RETURN TO PHASE 1! When systole is occurring in the ventricles (blood is being pumped out), the atria are in diastole & are filling with blood. When atrial > ventricular pressure , blood forces against the AV valves and flows into the ventricles. Blood pressure in the ventricles rises and during contraction, blood flows out of ventricles into the aorta & pulmonary artery. The amt. of blood pumped out of a ventricle during each systole (stroke vol.). The amt. of blood pumped out of a ventricle per min. is the cardiac output.

Atria Ventricles

Diastole = 0.4 Diastole = 0.5

Systole = 0.1

Diastole = 0.3 Systole = 0.3

Cardiac cycle starts with SA node discharge. Atrial systole - 0.1 sec.. AV node discharge impulses. Ventricular systole - 0.3 sec.. Ventricular diastole - 0.5 sec..; ventricular diastole overlaps atrial systole by 0.1 sec..

A 1 2 3 4

G Blood Vessels Kinds Arteries -carry blood away from heart. Arterioles - smaller arteries. Veins -carry blood toward heart. Venules - smaller veins.

5 Sinuses -veins with thin walls 6 Capillaries or sinusoids - carry blood from arterioles to venules BStructure - Outer layer (tunica externa or tunica adventitia). Made of collagen. Thickest in veins. Middle layer (tunica media). Smooth muscle & elastic tissue. Thicker in arteries. Vasoconstriction & vasodilation. Inner layer (tunica intima). Endothelium. Forms valves in veins. Only layer in capillaries. CFunctions - capillaries are sites of material exchange. Arteries distribute blood to all body parts. Veins return blood to the heart. D Names of main arteries Systemic arteries Aorta, branches of aortic arch, head and neck, trunk, upper extremities, lower extremities. E Names of main veins Systemic veins Head and neck, upper extremities, thorax, abdomen, hepatic portal circulation, lower extremities. Blood Pressure A Blood pressure is push, or force of blood in blood vessels BHighest in arteries, lowest in veins CBlood pressure gradient causes blood to circulate; liquids can flow only from area where pressure is higher to where it is lower D Blood volume, heartbeat, and blood viscosity are main factors that produce blood pressure E Blood pressure varies within normal range from time to time

Measurement of Blood Pressure (BP) I. Blood pressure is the pressure exerted by blood on the wall of an artery when the left ventricle undergoes systole and then diastole. It is measured by the use of a sphygmomanometer. 2. Systolic blood pressure (SBP) is the force of blood recorded during ventricular contraction. Diastolic blood pressure (DBP) is the force of blood recorded during ventricular relaxation. Normal blood pressure is 120/80 mm Hg. 3. Pulse pressure is the difference between systolic and diastolic pressure. It normally is about 40 mm Hg and provides information about the condition of arteries. Pulse A Definition-alternate expansion and recoil of blood vessel wall B Places where you can count the pulse easily-temporal, carotid, brachial (front of elbow), femoral (groin), facial (mandible), radial (wrist), popliteal (side of knee), posterior tibial (above inner ankle), Dorsalis pedis ( distal end of instep) Circulatory Routes 1. The largest circulatory route is the systemic circulation. 2. Two of the several subdivisions of the systemic circulation are coronary (cardiac) circulation and hepatic portal circulation. 3. Other routes include the cerebral. pulmonary. and fetal circulations. Systemic Circulation I. The systemic circulation takes oxygenated blood from the left ventricle through the aorta to all parts of the body. including some lung tissue (but does not supply the air sacs of the lungs) and returns the deoxygenated blood to the right atrium. 2. The aorta is divided into the ascending aorta, the arch of the aorta, and the descending aorta. Each section gives off arteries that branch to supply the whole body. 3. Blood returns to the heart through the systemic veins. All the veins of the systemic circulation flow into the superior or inferior venae cavae or the coronary sinus, which in turn empty into the right atrium.

Hepatic Portal Circulation I. The hepatic portal circulation collects blood from the veins of the pancreas, spleen, stomach, intestines, and gallbladder and directs it into the hepatic portal vein of the liver. 2. This circulation enables the liver to utilize nutrients and detoxify harmful substances in the blood. Pulmonary Circulation

The pulmonary circulation takes deoxygenated blood from the right ventricle to the air sacs of the lungs and returns oxygenated blood from the lungs to the left atrium. 2. It allows blood to be oxygenated for systemic circulation. Fetal Circulation I. The fetal circulation involves the exchange of materials between fetus and mother. 2. The fetus derives its oxygen and nutrients and eliminates its carbon dioxide and wastes through the maternal blood supply by means of a structure called the placenta. 3. At birth, when pulmonary (lung), digestive, and liver functions are established, the special structures are no longer needed. Ductus venosus allows blood to bypass foetal liver Foramen ovale permits blood to flow from RA to LA. Ductus arteriosus shunts blood from pulmonary trunk to aortic arch.

Lymphatic System A Consists of lymphatic vessels, lymph nodes, lymph, and spleen BLymph-the fluid in the lymphatic vessels; lymph comes from blood by plasma-filtering fluid, some of which then enters the lymph capillaries to become lymph and be returned to blood by way of lymphatics; largest lym phatic is thoracic duct-drains lymph from all but upper right quarter of body into left subdavian vein C Lymph nodes I Located along certain lymphatics, usually in clusters; for example, at elbow, under arm, in groin, at knee 2Functions-filter out injurious particles such as microorganisms and cancer cells from lymph before it returns to blood; form some white blood cells (lymphocytes and monocytes) D Spleen 1 Forms some white blood cells (lymphocytes and monocytes) 2 Serves as blood bank for body-stores blood until needed and then releases it back into circulation

NERVOUS SYSTEM Organs and Divisions of Nervous System A Central nervous system (CNS)-brain and spinal cord. B Peripheral nervous system (PNS)-all cranial & spinal nerves Coverings and Fluid Spaces of Brain and Spinal Cord A Coverings 1 Cranial bones and vertebrae 2 Cerebral and spinal meninges B Fluid spaces -subarachnoid spaces of meninges, central canal inside cord, and ventricles in brain Cells of Nervous System A Neurons 1 Consist of three main parts: dendrites-conduct impulses to cell body of neuron; cell body of neuron; and axonconduct impulses away from cell body of neuron 2 Neurons classified according to the direction of the impulse: sensory neurons -conduct impulses to spinal cord and brain; motor neurons -conduct impulses away from brain and cord out to muscles and glands; interneurons - conduct impulses from sensory neurons to motor neurons B Neuroglias 1 Astrocytes-star-shaped cells that anchor small blood vessels to neurons 2 Microglias-small cells that move about in inflamed brain tissue carrying on phagocytosis: that is, they engulf and destroy microorganisms and other injurious particles 3 Oligodendroglia Reflex Arcs A Nerve impulses are conducted from receptors to effectors over neuron pathways or reflex arcs; conduction by reflex arc results in a reflex, that is, contraction by a muscle or secretion by a gland. B Simplest reflex arcs called two-neuron arcs-consist of sensory neurons synapsing in spinal cord with motor neurons; three-neuron arcs consist of sensory neurons synapsing in spinal cord with interneurons that synapse with motor neurons Nerve Impulses A Definition-self-propagating wave of electrical negativity that travels along surface of neuron membrane B Mechanism I Stimulus increases permeability of neuron membrane to positive sodium ions 2 Inward movement of positive sodium ions leaves slight excess of negative ions outside at stimulated point; marks beginning of nerve impulses Neurotransmitters A Definition- chemicals released from axon terminals of presynaptic neuron into synaptic cleft (gap)

B Neurotransmitters bind to specific receptor molecules in membrane of postsynaptic neuron, thereby stimulating impulse conduction by it C Names of neurotransmitters-acetylcholine, catecholamines (norepinephrine, dopamine, serotonin), and other compounds Spinal Cord A Outer part composed of white matter made up of many bundles of axons called tracts; interior composed of gray matter made up mainly of neuron dendrites and cell bodies B Functions as center for all spinal cord reflexes; sensory tracts conduct impulses to brain and motor tracts conduct impulses from brain Spinal Nerves A Structure-contain dendrites of sensory neurons and axons of motor neurons B Functions-conduct impulses necessary for sensations and voluntary movements Divisions of the Brain A Brain stem I Consists of three parts of brain; named in ascending order, they are the medulla, pons, and midbrain 2 Structure-medulla, pons, and midbrain; consist of white matter with bits of gray matter scattered through them 3 Function-gray matter in brain stem functions as reflex centers, for example, for heartbeat, respirations, and blood vessel diameter; sensory tracts in brain stem conduct impulses to higher parts of brain; motor tracts conduct from higher parts of brain to cord B Diencephalon 1 Structure and function of hypothalamus a Consists mainly of posterior pituitary gland, pituitary stalk, and the paraventricular and supta~ptic nuclei b ~ as t:he maj~r c~i~ tor controlling autonoin~ ne~ous ~stein, dierefote helps control th~ functioning of most internal organs c Controls hormone secretion by both anterior and posterior pituitary glands, therefore indirectly helps control hormone secretion by most other endocrine glands d Acts as center for controlling appetite; therefore helps regulate amount of food eaten and body weight e Functions in some way to maintain waking state f Probably contains reward and punishment centers 2 Structure and function of thalamus a Rounded mass of gray matter in each cerebral hemisphere; located lateral to each side of third ventricle b Relays sensory impulses to cerebral cortex sensory areas c Functions in some way to produce emotions of pleasantness or unpleasantness associated with sensations C Cerebrum I Largest part of human brain 2 Outer layer of gray matter called cerebral cortex; made up of lobes, which are made up of convolutions; cortex composed mainly of neuron dendrite and cell bodies 3 Interior of cerebrum composed mainly of nerve fibers arranged in bundles called tracts 4 Functions of cerebrum-mental processes of all types, including sensations, consciousness, and voluntary control of movements D Cerebellum I Second largest part of human brain 2 Helps control muscle contractions so that they produce coordinated movements so we can maintain balance, move smoothly1 and sustain normal postures Cranial Nerves See Table 7-1.