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There are several measures that we can adopt in our daily lives to ensure the proper functioning of the
lymphatic system and thus maintain the balance of the organism, such as:

abundant water intake - as the lymph is essentially composed of water, the reduced water intake
hinders its movement;

⚫ performing gentle massages - these activate lymphatic circulation and reduce the accumulation of
lymph in tissues and lymphatic vessels;

⚫aavoid wearing tight clothes - these increase the pressure on the vessels and lymph nodes, making it
difficult for the lymph to move:

• regular practice of physical exercise-stimulates the movement of interstitial and circulating lymph,
facilitating exchanges with cells and a better performance of the immune system

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Cardiovascular system and body balance

The cardiovascular system is made up of the blood, the heart and blood vessels .As we have seen, when
studying blood, the circulatory system is important in the transport of gases, nutrients, waste products
and hormones (fig. 1). It is also involved in the immune response and helps keep the body's pH constant.
Many animals, such as mammals and birds, depend on blood to distribute the heat generated in the
muscles to other organs and thus maintain a constant internal temperature.

Larger animals need a circulatory system to ensure that gases and nutrients are transported to the cells
and that the cells can eliminate waste products.

The heart is the organ responsible for pumping blood for the whole organism.

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heart anatomy

The study of the anatomy (morphology) of the heart is important to know how it works. For this, we can
dissect, that is, open a heart. However, as it is not possible to use human hearts, we propose the
dissection of a pig, lamb or rabbit heart. These mammals have a heart similar to ours, as they have a
similar evolutionary history.

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• In humans, the heart is located in the center of the chest. It is similar in size to a closed fist and in an
adult it weighs about 400 g. Its lower end is oriented to the left.
⚫ The heart is located inside the cardiac cavity, having enough space to change shape and make
heartbeats.

⚫ The heart is a muscular organ, whose contractions are responsible for pumping blood to the lungs
(pulmonary circulation) and the rest of the body (systemic circulation).

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It is possible to identify in the heart:

two ventricles, which pump blood. The left ventricle pumps to the systemic circulation and the right
ventricle to the pulmonary circulation.

The communication between the atria and the ventricles, and between these and the arteries, is made
by the valves, which guarantee the circulation of the blood inside the heart in only one direction,
preventing its reflux.

the pericardia works like a flexivet bag that maintains the position of the heart, prevents it from filling
up too much and protects it from infections.

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Heart Functioning

The blood, when circulating in the blood capillaries that cross the tissues, loses oxygen and receives
carbon dioxide, converting itself into venous blood. This blood is routed to the heart through the vena
cava, which open into the right atrium. The superior vena cava carries blood from the head, neck and
arms. Blood from the abdominal area and lower limbs is routed to the heart through the inferior vena
cava.

The right atrium is separated from the right ventricle by the tricuspid valve. After blood enters the right
ventricle, it contracts and pushes the blood to the pulmonary arteries, which send it to the lungs -
pulmonary circulation (fig. 5). Pulmonary valves separate the right ventricle from the pulmonary
arteries.

In the lungs, the blood loses carbon dioxide and gains oxygen. This arterial blood returns to the heart
through the pulmonary candles, connected to the left atrium (fig. 5). This auricle is separated from the
left ventricle by the bicuspid or mitral valve (fig. 6).

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The left ventricle pumps blood into the aorta, which distributes blood throughout the systemic
circulation. The left ventricle and the aorta artery are separated by the aortic valve (fig. 6).

The ventricles have thicker walls than the atria, as they need to pump blood with greater pressure. The
left ventricle is thicker than the right ventricle. since it has to have a muscular layer that allows it to
pump blood throughout the body, unlike the right ventricle, which only has to pump blood to the lungs.
 In summary, blood circulation in humans can be represented as follows:

pulmonary circulation: heart → lungs → heart;

systemic circulation: heart → organ systems → heart.

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The "lub" sound that is heard on auscultation results from the closing of the atrioventricular valves and
the "dup" sound results from the closing of the adctic and pulmonary valves

cardiac cycle

The heart works permanently to ensure the continuous pumping of blood throughout the body. The
cardiac cycle consists of a sequence of contractions (systole) and relaxation (diastole) of the heart.

The cardiac cycle is considered to start when all cavities are relaxed - atrial and ventricular diastole. In
this phase, blood enters the atria and ventricles. The atria contract - atrial systole to send blood to the
ventricles, which remain relaxed (fig. 8). After the passage of blood to the ventricles, atrial diastole
occurs again.

The ventricles begin to contract when they are filled with blood - ventricular systole (fig. 8). The
increased pressure closes the tricuspid and bicuspid valves, preventing blood from flowing back into the
atria. Contraction of the ventricles pumps blood into the pulmonary arteries and into the aorta.

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In an individual at rest, the heart beats 60 to 75 times per minute, so each cardiac cycle takes less than a
second to complete.

The left ventricle is the cavity that contracts more intensely, generating greater pressure. When this
increases and exceeds the blood pressure in the aorta, the aortic valve opens. During ventricular
diastole, arterial pressure in the aorta reaches its lowest value: around 80 mmHq. The highest blood
pressures, in the order of 120 mmHg, are reached in ventricular systole, when the ventricles pump
blood.

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heart rate

It is possible to count the number of heartbeats by placing the fingertips on the main arteries inside the
wrist, arm or neck (fig. 10A). The pressure variations that we feel are generated by the pumping of blood
during ventricular systole.
 Heart rate is obtained by determining the number of heartbeats per minute (bpm).

When we are at rest, each ventricle pumps about 5 L of blood per minute, that is, all our blood passes
through the heart every minute. The heart of an adult at rest has a heart rate of 72 bpm (beats per
minute).

However, with increased physical activity, the needs for glucose and oxygen transport to cells increase.
These produce more carbon dioxide, which has to be quickly expelled from the body. To do this, the
heart increases the heart rate to pump a greater volume of blood (fig. 10B).

Heart rate during intense physical exercise increases significantly, but should not approach 200 bpm.
Practitioners of regular physical exercise are able to control, through training, the increase in heart rate,
keeping it at safe levels.

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Blood vessels and blood pressure

The blood pumped by the heart is carried by arteries that branch throughout the body. Arteries have a
thick and elastic wall, capable of withstanding the high blood pressure generated during ventricular
systole. The arteries are divided into arterioles which, in turn, are distributed by dense networks of
capillaries (fig. 11).

Capillaries have very thin walls and are the narrowest: sometimes they are so thin that the cells that
make up the blood are transported in a row. The capillary network of a single human being is so
extensive that it could wrap around the Earth twice. → Ass

The fusion of capillaries originates venules, which converge and form veins, responsible for transporting
blood to the heart. Veins have a larger diameter than arteries and their walls are much less thick .

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Blood pressure decreases during transport. At the level of the extensive network of capillaries, the
reduced pressure, associated with a lower speed and a larger contact area, allows for the optimization
of exchanges with the cells. Capillaries are very effective in distributing nutrients, gases and other
substances.

When the blood reaches the veins, it has a reduced pressure, insufficient to return to the heart. To
prevent the accumulation of blood, many veins have associated muscles that, when contracting, push
the blood. The venous valves prevent the blood from reversing its direction, helping to transport it to
the heart (fig. 12).

Blood pressure can be measured with the sphygmomanometer. To do this, an inflatable cuff is placed on
the arm, which, when inflated with air, prevents blood circulation (fig. 13). By reducing the pressure, the
blood starts to circulate intermittently, producing sounds. By listening to the first sounds with the
stethoscope and knowing the pressure from the sphygmomanometer, we can determine the maximum
(systolic) pressure. By further reducing the pressure, the blood will flow normally in the arteries, silently.
This value corresponds to the minimum pressure (diastolic).

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Equit Blood pressures are measured in millimeters of mercury, for example 120-70 mmHg, but for
simplification values 12-7 are used.

Blood pressures vary from person to person, and for the same individual they are not constant
throughout the day or throughout life. For example, blood pressure is lowest during sleep and highest
during the day. In childhood, the pressure is lower, being higher in the elderly. In an adult at rest, the
maximum pressure should be between 100 and 140 mmHg, and the minimum between 60 and 80
mmHg.

The practice of physical exercise, the ingestion of coffee and alcohol, the consumption of tobacco, and
even the act of talking alter blood pressure. The blood requirements of different organs vary according
to their activity. For example, about 30% of blood flows to the brain while reading this text, but only
10% when performing a physical activity. Muscles, on the other hand, only receive 10% of the blood
when they are at rest, but this value increases to 50% during physical exercise.

The organism controls the blood flow through sphincters that block the passage of blood to the
capillaries, directing it to where it is most needed (fig. 14).

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Diseases of the cardiovascular system

Cardiovascular diseases are the leading cause of death in developed countries. More than 17 million
human beings die every year from diseases associated with the cardiovascular system.

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Cardiovascular diseases correspond to an abnormal functioning of the heart or blood vessels, the main
ones being:

⚫a atherosclerosis is an important cause of vascular accidents and corresponds to the hardening of the
inner walls of the arteries, as a result of the accumulation of plaques containing cholesterol and other
fats (fig. 15). These plaques narrow the arteries and impede blood flow, forcing the heart to increase
blood pressure. Plaques can detach from the wall of the blood vessel and obstruct another one of
smaller diameter.

⚫ heart attack - if the coronary artery, which carries blood from the aorta to the tissues of the heart,
becomes blocked, it stops supplying them with blood. These tissues die and the heart does not pump
blood efficiently. A heart attack or myocardial infarction can leave patients with very negative
consequences (paralysis, tension problems, etc.), significantly reducing their quality of life, or even
causing death.
 cerebrovascular accident (CVA) - occurs whenever there is a blockage in the transport of blood to the
brain or rupture of a blood vessel, causing the death of the affected brain tissue.

aneurysm - abnormal dilation of blood vessels, which are at risk of rupture due to a weakness in their
walls or hypertension, releasing blood into the tissues. Aneurysms are very dangerous, especially the
brain ones.

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HEART DISEASES

Include all diseases that affect the cardiovascular. The prevention of some of these diseases depends on
lifestyle changes. Heart diseases are the main causes of death in Portugal, among men and women.

MOST COMMON RISKS

Smoke

high cholesterol

Diabetes

Obesity

Sedentary lifestyle

superior vena cava

TO DETERMINE THE RISK OF HEART DISEASE

 Measure blood pressure

 Test the levels of cholesterol
 Analyze the risk of obesity and diabetes

HOW TO REDUCE THE RISKS

. Do not smoke

Practicing regular physical exercise • Eating fruits and vegetables

Reduce salt and fat intake

Limit alcohol consumption

Perform regular medical tests and examinations .

 They are responsible for huge expenses in the health system and for the loss of
productivity in the economy.

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Treatment of diseases of the cardiovascular system

Today, doctors are able to detect blockages in the coronary arteries and perform angioplasty. In this
procedure, a small catheter with a balloon is inserted into the blocked vessel. The balloon is inflated,
compressing the fatty plaques and placing a "mesh" that prevents the vessel from closing and
normalizes blood flow (fig. 18A).

Cardiac bypass (Fig. 188) also treats the effects of blocked coronary vessels. In this situation, the surgeon
obtains a vessel from another part of the body and creates a new connection between blood vessels, in
order to guarantee blood flow in the heart. Bypass is used when the vessel blockage is extensive or
difficult to access for angioplasty.

Scientific and technological advances have also allowed more efficient diagnosis, the development of
drugs that reduce the accumulation of cholesterol and anticoagulants, which prevent the formation of
blood clots, among others.

18 Technologies used to minimize the impacts of cardiovascular disease: (A) angioplasty and (B) cardiac
bypass with a blood vessel obtained from the arm.