CARDIOVASCULAR SYSTEM

Claire
Claire Intia
Intia
Fun facts!
Layers of the heart
Heart Chambers
VALVES
 Heart conduction
 Cardiac electrophysiology (specialized electric cells that
consist of the Purkinje cells and nodal cells)
o Automaticity
o Excitability
o Conductivity
 The SA and AV node
Terms to remember:
 Cardiac cycle (beginning of one heartbeat to the next)
each cardiac cycle has diastole, atrial systole and
ventricular systole
 Cardiac output (total amount ejected of blood by the
ventricles in liters/min, 4-6 L/min)
 Stroke volume (Amount of blood ejected from one of the
ventricles per heartbeat)
Heart rate and cardiac output
 Parasympathetic and sympathetic nervous system
 Cathecolamines and thyroid hormones
 Baroreceptors
STRONG VOLUME AND CARDIAC OUTPUT

 Preload (is the degree of stretch of the ventricular cardiac muscle fibers at
the end of the diastole) Left ventricular end-diastolic-pressure)
o Frank starling law states that as the volume of blood returning to the
heart increases so is the contraction and the stroke volume
o Is blood volume is reduced, preload is also decrease.
 Afterload (is the resistance to ejection of blood from the ventricle)
 Contractility (Force generated by contracting myocardium)
 Ejection fraction (blood that is ejected every heart beat)
ANATOMIC AND PHYSIOLOGIC OVERVIEW OF
HEMATOLOGY
Blood
 Erythrocytes (Red blood Cells)
 Leukocytes (White blood cells)
 Thrombocytes (Platelets)
Function of the blood
◦ The blood makes up approximately 7% to 10% of the normal body
weight.
 It serves as a link between the body organs, oxygen and nutrients
 Blood carries hormones, nutrients and antibodies
 It carries waste product produced by cellular metabolism of the
lungs, skin, liver and kidneys
 Clotting mechanism (fibrinolysis)
◦ BONE MARROW
◦ In adult, this is limited to PELVIS, RIBS, VERTEBRAE and
STERNUM.

◦ As people age, the Red marrow is being replaced by yellow

marrow
◦ (fat). However, it can be replaced again by red marrow if
more red
Blood formation:
Erythrocytes or RBC
 The normal RBC is biconcave disc that resembles a soft ball compressed
between two fingers.
 Mature erythrocytes have hemoglobin which contains iron.
 Primary function of the RBC is to transfer oxygen to lungs and tissues.
 Occasionally, the marrow release immature erythrocytes called reticulocytes
into the circulation. (this happens as there is a response to increased
demand for RBC such as bleeding)
o Oxyhemoglobin
o 100 ml of whole blood contains 15 g of hemoglobin
Erythropoiesis
◦ Mature erythrocytes are released into the circulation.
 Differentiation of the myeloid stem cell into an
erythroblast is stimulated by erythropoietin, a hormone
produced by the kidneys.
◦ IRON STORES AND METABOLISM
 With iron deficiency, bone marrow iron stores are rapidly depleted,
hemoglobin synthesis is depressed and erythrocytes produced by the
marrow is small and low in hemoglobin.

◦ VITAMIN B12 and FOLATE METABOLISM

 For normal erythrocytes production, the bone marrow also requires to have
vitamin B12, Folate and vitamin B6.
 Megaloblastic Anemia
◦ RED BLOOD CELL DESTRUCTION
 The average lifespan of RBC is 120 days. Aged RBC lose their elasticity and
becomes trapped in small blood vessels and the spleen. As they are
destroyed, hemoglobin is reused
 Some hemoglobin breaks down to form bilirubin and is secreted in the bile.
 Most of the iron is recycled to form new hemoglobin in the bone marrow.
 Small amount, however, are lost through urination, fecal matter and
menstruation.
◦ 
Leukocytes (WBC)
 Generally divided into 2 general categories: granulocytes
and lymphocytes.
 It protects the body from infection and tissue injury.
◦ GRANULOCYTES
 Defined by the presence of granulocytes in the cytoplasm
of the cells.
o Eosinophils, Basophils and Neutrophils
 The key difference between basophil and eosinophil is
that Basophils can stimulate inflammation responses by
releasing heparin, histamine, and serotonin
while Eosinophils provide important defense against
parasites by phagocytosis and producing antihistamines.
  Neutrophil blood levels increase naturally in response to
infections, injuries, and other types of stress.
◦ AGRANULOCYTES
 Monocytes
o Largest of the leukocytes.
o It is produced by the bone marrow; they remain in the
circulation for a short time before becoming entering into the
tissue and transforming into MACROPHAGES.
 Lymphocytes
o Produced in the lymphoid cells and sometimes the thymus.
Stay in the lymphoid tissue to mature and when activated, they
serve as a potent killer for virus-infected and cancer cells. They
are the ones who produced cytokines.
Function of leukocytes
◦ Protect the body from invasion of bacteria and virus
◦ T Lymphocytes are responsible for delayed allergic
reactions and foreign rejection and destruction of tumor
cells called the CELLULAR IMMUNITY.
◦ Immunoglobulins which are protein that destroys foreign
materials, this is called HUMORAL IMMUNITY
Platelets:
◦ PLATELETS (THROMBOCYTES) It is a giant cell in
the bone marrow called megakaryocytes.
◦ Plays an important role in controlling bleeding.
◦ They circulate in the blood stream in an inactive form
wherein they maintain the integrity of the blood vessels.
◦ Lifespan of 7 to 10 days.
◦ Substance release from the platelet activate coagulation
factors in the blood plasma and initiate the formation of a
clot composed of fibrin.
 
PLASMA AND PLASMA PROTEIN

◦ 90% made of protein and the rest are consist of plasma

protein, clotting factors small amounts of other substance
like nutrients, enzyme, waste products and gasses.
◦ Plasma protein consists of albumin and globulins.
◦ Albumin is important in the maintenance of fluid within
the vascular space.
Hemostasis
◦ HEMOSTASIS
◦ Is the process of preventing blood loss from intact vessels
and of stopping bleeding from a severed vessels which
requires adequate numbers of functional platelet.
◦ Primary hemostasis
◦ Secondary hemostasis