ANATOMY AND PHYSIOLOGY

BACHELOR OF SCIENCE IN NURSING

YEAR 1

CIRCULATORY SYSTEM: BLOOD

OVERVIEW OF THE CIRCULATORY SYSTEM PRIMARY FUNCTIONS OF THE CIRCULATORY

● The circulatory system is composed of:
o The blood (the circulating material)
o The heart (pump)
o Blood vessels (conduit)
SYSTEM
● TRANSPORTATION
o Deliver life-supporting materials, I.e., 02,
glucose, amino acid, fatty acids, vitamins,
minerals, etc.
o Deliver regulating signals, I.e., hormones
to tissue cells
o Collect waste products from tissue cells
and deliver to special organs (kidney,, lung)
for disposal
o Distribute heat through the body
● PROTECTION
o Special components of the blood patrol the
whole body and fight against invaded
microorganisms and cancerous cells

THE BLOOD

● Internal environment = the interstitium

o H2O
o Glucose
o Lipids
o Amino acids
o Vitamins
o Minerals
o O2
o pH 7.35-7.45
o 38°C
o 280-300mOsm
● Goa = constant (homeostasis)
COMPOSITION OF BLOOD

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Prepared by: ino
 GENERAL PROPERTIES OF BLOOD ● Nitrogenous wastes:
Fraction of body weight 8%
Volume FEMALE: 4-5 L
MALE: 5-6 L
Temperature 38C (100.4 F)
pH 7.35-7.45
Viscosity (related to WHOLE BLOOD: 4.5-5.5
water)
WHOLE PLASMA: 2.0
● Respiratory gases: 02, C02, and N2
OSMOLARITY: 280-300
mOsm/l

MEAN SALINITY (mainly

NaCL): 0.85%
Hematocrit (% of RBCs FEMALE: 37-48%
of total blood volume) MALE: 45-52%
Hemoglobin FEMALE: 12-16g/100mL
MALE: 13-18g/100mL
Mean RBC count FEMALE: 4.8 million/ul
MALE 5.4 million/ul
Platelet count 130,000-360,000/ul FORMED ELEMENTS (BLOOD CELLS)
WBC count 4,000-11,000/ul ● ERYTHROCYTES → Red blood cells (RBC)
● PLATELETS → Cellular fragments
PLASMA ● LEUKOCYTES → White blood cells (WBC)
● Plasma proteins are the most abundant solutes in o Granulocytes
plasma ▪ Neutrophils
● Most plasma proteins are made by the liver except ▪ Eosinophils
for antibodies and protein-based hormones.
▪ Basophils
● Albumin - acts as carrier to certain molecules o Agranulocytes
through the circulation, blood buffer, helps in the
▪ Lymphocytes
osmotic pressure of blood
▪ Monocytes
COMPOSITION OF PLASMA
● Water: 92% by weight
● Proteins: Total 6-9 G/100 ml
 Albumin - 60% of total plasma protein
 Globulin - 36% of total plasma protein
 Fibrinogen - 4% of total plasma protein
 Enzymes of diagnostic value - trace
● Glucose (dextrose): 70-110 mg/100 ml
● Amino acid: 35-51 mg/100 ml
● Lactic acid: 6-16 mg/100 ml
● Total lipid:
● Cholesterol:
● Fatty acids:
● High density lipoprotein:
● Low density lipoprotein:
● Neutral fats (triglycerides):
● Phospholipids: ERYTHROCYTES
● Iron: ● Biconcave disc shape, which is suited for gas
● Vitamins: exchange. The shape is flexible so that RBCs can
● Electrolytes: pass through the smallest blood vessels, i.e.,
capillaries
● Are smaller than leukocytes
● Primary cell content → hemoglobin; the protein that
binds oxygen an carbon dioxide.
● No nucleus for mitochondria

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● GLOBIN
o Consist of two a and two b subunits
o Each subunit binds to a heme group
● HEME GROUPS
o Each heme group bears an atom of iron,
which binds reversibly with one molecule
of oxygen (carry four molecules oxygen)
 OXYHEMOGLOBIN
→ bound with oxygen
→ red
 DEOXYHEMOGLOBIN
→ free of oxygen
→ dark red
 CARBAMINOHEMOGLOBIN
→ 20% of carbon dioxide in the blood
binds to the globin part of hemoglobin, which is
called carbamino-hemoglobin
FUNCTIONS OF ERYTHROCYTES
● Primary Function
o Transport oxygen from the lung to tissue
cell and carbon dioxide from tissue cells to
the lung.
● Buffer blood pH
PRODUCTION OF ERYTHROCYTES
● All blood cells, including red and white, are
produced in red bone marrow.
● On average, one ounce, or 100 billion blood cells, is
made each day.
● Hematopoiesis
o Refers to the whole blood cell production
o The red bone marrow is a network of
reticular connective tissue that borders on
wide blood capillaries called blood
sinusoids. As hemocytoblasts mature, they
migrate through the thin walls of the
sinusoids to enter the blood
● Red bone marrow
o Network of reticular connective tissue that
borders on wide blood capillaries called
blood sinusoids. As hemocytoblasts
mature, they migrate through the thin walls
of the sinusoids to enter the blood.
● Hematopoietic stem cell or hemytoblast
o Stem cell where all blood cells including
red and white arise from.
● Erythropoiesis
o Red blood cell production
o Erythrocytes are produced throughout
whole life to replace dead cells
FEEDBACK REGULATION OF ERYTHROPOIESIS
● Regulated by renal oxygen content
● Erythropoietin
o Glycoprotein hormone
o Produced by renal cells in response to
decreased renal blood O2 content.
o Stimulate erythrocyte production in the red
bone marrow
Renal blood oxygen level drop can result from:
1. Reduced number of red blood cells due to
hemorrhage or excess RBC destruction.
2. Reduced availability of oxygen to the blood, as
might occur at high altitudes or during pneumonia.
3. Increased demands for oxygen (common in those
who are engaged in aerobic exercise)
Ways to increase RBC count in sports
● Legal: Training athletes at high altitude
● Illegal: Use erythropoietin, androgen, or their
analogs
Dietary Requirements for Erythropoietin
● Iron, Vitamin B12, Folic acid (important to women
due to blood loss during menstruation)
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 ERYTHROCYTES LIFE CYCLE ABO BLOOD GROUPS
● Average lifespan: 120 days ● TYPE A: RBCs carry agglutinogen A
● TYPE B: RBCs carry agglutinogen B
● TYPE O: RBCs carry no A nor B agglutinogens
● TYPE AB: RBCs carry both A and B agglutinogens

TYPE A
● Plasma contain preformed antibodies, agglutinin B,
against B agglutinogens

TYPE B
● Plasma contain agglutinin against A agglutinogens

ERYTHROCYTES DISORDERS

ANEMIA
 Condition in which the blood has an abnormally low
oxygen-carrying capacity
 Thalassemias and sickle-cell anemia: genetic
defects
 Common causes:
1. Insufficient number of RBC
2. Decreased hemoglobin content
3. Abnormal hemoglobin TYPE O
● Plasma contain agglutinin against both A and B
POLYCYTHEMIA
agglutinogens
 Abnormal excess of erythrocytes that increases
viscosity of the blood causing it to sludge of flow ● The person who can accept only type O blood
sluggishly transfusion
 Common causes:
1. Bone marrow cancer
2. A response to reduced availability of
oxygen at high altitudes

HUMAN BLOOD GROUPS

● ABO blood types were identified in 1900 by Karl
Landstein (1930 Novel Laureate)
● Blood type is determined by agglutinogens.

AGGLUTINOGENS TYPE AB
 Specific glycoproteins on red blood cell membranes
 All RBCs carry the same specific type of
agglutinogens

AGGLUTININS
 Preformed antibodies in plasma
 Binds to agglutinogens that are not carried by host
RBCs
 Causes agglutination (aggregation and lysis of
incompatible RBCs)

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RH BLOOD GROUPS
● Classify blood groups based on Rh agglutinogens
other than A.B agglutinogens
Rh positive
 RBCs contain Rh agglutinogens
 Majority of human beings are Rh positive
Rh negative
 RBCs have no agglutinogens
 Agglutinins against Rh-positive RBCs are produced
after Rh-negative blood sees Rh-positive RBCs.
● LEUKOCYTES COUNT: 4,000-11,000/µL
FUNCTIONS OF LEUKOCYTES
● Defense against diseases
o Leukocytes form a mobile army that helps
protect the body from damage by bacteria.
Viruses, parasites, toxins and tumor cells
● Protection
LIFE SPAN
● Several hours to several days for the majority
● Many years for a few memory cells
● Leukocytes circulate in the blood for various length
of time
GRANULOCYTES
● Contain specialized membrane-bound cytoplasmic
granules
● Include neutrophils, eosinophils, and basophils
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 AGRANULOCYTES ● MARGINATION
● Lack obvious granules o Slow down by cell adhesion molecules
secreted by endothelial cells
● Include lymphocytes and monocytes
● DIAPEDESIS
o Leukocyte slip out of the capillary blood
vessels
● CHEMOTAXIS
o Gather in large numbers at areas of tissue
damage and infection by following the
chemical trail of molecules released by
damaged cells or other leukocytes
● PHAGOCYTOSIS
o Destroy foreign substances or dead cells

LEUKOCYTES DISORDERS
● Leukopenia: <400/ml normal leukocytes
● Leukocytosis: > 10,000/ml normal leukocytes
● Leukopenia
o Major side effect of chemotherapy

LEUKOPENIA
● Why leukopenia during chemotherapy?
o Cancerous cells grow fast, which
distinguish themselves from most normal
cells
o Chemotherapy is designed to kill fast-
growing cells by interrupting mitotic cell
division including:
▪ Leukocytes
▪ Hair
▪ Intestinal epithelial cells

LEUKEMIA
● Refers to a group of cancerous conditions of WBC;
extraordinarily high number of normal (cancerous)
leukocytes
● Descendants of a single stem cell in red bone
● Leukocytes are deployed in the infected areas
marrow tend to remain unspecialized and mitotic
outside blood vessels by these three (3) steps:
and suppress or impair normal bone marrow
o Margination
function.
o Diapedesis
o Chemotaxis
HEMOSTASIS
● Refers to the stoppage of bleeding
● Both hemostasis and homeostasis are responsible
for maintaining balance
● Has three phases:

1. Vascular spasms

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2. Platelet plug formation ● Coagulation is activated when:
o Blood vessel is broken
o Blood flow slows down

3. Blood clotting/coagulation

● The sequential activation (reaction cascade) of the

clotting factors finally leads to the formation of fibrin
meshwork.
● Blood cells are then trapped in fibrin meshwork to
form a hard clot

PLATELETS
● Not cells; cytoplasmic fragments of extraordinarily
large (up to 60µm in diameter) cells called
megakaryocytes.
● Normal platelet count >> 130,000-400,000µm

PLATELET FUNCTIONS
1. Secretes vasoconstrictors that cause vascular
spasms in blood vessels
2. Form temporary platelet plugs to stop bleeding
3. Secrete chemicals that attract neutrophils and
monocytes to sites of inflammation
4. Secrete growth factors that stimulate mitosis in
fibroblasts and smooth muscle and help maintain
the linings of blood vessels COAGULATION DISORDERS
5. Dissolve blood clots that have outlast their
● THROMBOSIS - abnormal clotting of blood in an
usefulness
unbroken vessel
COAGULATION (CLOTTING) ● THROMBUS - clot that attaches to the wall of blood
vessel
● Many clotting factors in plasma are involved in
clotting and are inactive in blood

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● EMBOLUS - clot that comes off the wall of blood
vessel and travel in the blood stream
● EMBOLISM - blockage of blood flow by an embolus
that lodges in a small blood vessel
● INFARCTION - refers to cell death that results from
embolism. Responsible for strokes and heart attacks.

BLEEDING DISORDERS
● THROMBOCYTOPENIA
o Number of circulating platelets is deficient
(<50,000/mL)
o Causes spontaneous bleeding from small
blood vessels all over the body
● HEMOPHILIAS
o Hereditary bleeding disorders due to
deficiency of clotting factors.