Anatomy and Physiology B

UNIT 4: Cardiovascular System

Lecturer: MR E .NDLOVU [WHTC]
2019
LEARNING OUTCOMES
At the end of this module students should be able to:

•Define related concepts Artery, Arterioles, Vein, Capillaries, Cardiac/Heart, Stroke

volume, Cardiac output, anastomosis, pulse, blood, Erythrocyte/ Red blood cells,
Leucocyte/White blood cells, Thrombocytes/Platelets, Plasma, Serum,
Hematopoiesis, Bone marrow, Megakaryocyte etc.
•Identify components of cardiovascular system and their structures (The heart,
Blood vessels (Artery, vein and Capillaries) and Blood (Erythrocytes, Leucocytes,
Platelets and Plasma)
•Describe heart in regards to (location, chambers and valves)
•Describe the structure and layers and functions of the heart
•Describe the two types of circulation in the cardiovascular system (Systemic and
Pulmonary circulation) and the path of blood in the body
• Describe the electrical conduction of the heart
• Explain factors affection the heart rate and stroke volume
• Describe types, structures and functions of blood vessels (Artery,
• vein and capillaries)
• Describe compositions and function of blood and its components
• Explain how and blood is made
• Differences between plasma and serum
• Explain different five type of Leucocytes and their functions
• Explain functions of the Erythrocyte and platelets
• Explain function of antibodies
• Identify conditions affecting cardiovascular system
• Describe blood group and Rhesus system
Components of the cardiovascular System
1. The heart
2. Blood vessels (system of tubes includes: Arteries and
arterioles carry blood from heart to body parts
• Venules and Veins Carry blood Back from tissues to heart.
• Vein serve as blood reservoirs and collect the blood to return it
to the heart.
• Blood capillaries form a fine vessels connecting the arterioles
with venules (gas, nutrients, waste Exchange between blood
and tissues).
3. Blood
Blood vessels include:

Arteries = carry oxygenated rich blood away from heart

to body
Veins = carry oxygen poor blood to heart, away from
body
Capillaries = smallest vessels allow for gases exchange
(oxygen and carbon dioxide) to cells.
 NB!! 2 Types of Circulation
In cardiovascular blood passes through 2 circulation in series.
• 1 full circulation consist of 2 circulation together.
• Both circulation start and end at heart.

1. The systemic (or greater or high pressure) Circulation

It starts in the left ventricles ➤ the aorta ➤systemic arteries ➤systemic capillaries
➤ systemic veins ➤ superior and inferior vena cava ➤ ends in right atrium.
2.The pulmonary (or lesser or low pressure) Circulation
It starts in the right ventricle➤ the pulmonary trunk ➤pulmonary arteries➤
pulmonary capillaries➤ pulmonary veins➤ ends in the left atrium.
 The Heart
=It is a hallow, cone shaped muscular pump organ
that keep circulation going on.
=A pump composed of 4 chambers (2 atria &
Ventricles) separated by a septum (partition
separating 2 cavities).

Supplied blood by coronary arteries and coronary

veins
NB!!!! The heart has 3
layers:

Epicardium - external layer,

Myocardium - middle layer and
Endocardium - inner layer.
Heart provide driving force of cardiovascular.
Its is the size of hand’s fist of the same person.

It has:
Apex
Base
Surfaces (Diaphragmatic and Sternocostal)
Borders (right, Left and Inferior)
Pericardium
• =Double Layer sac membrane that surround and protect the heart.

• Pericardium consists of 2 principle portions.

1.Outer Fibrous -tough, elastic, dense irregular connective tissue.
FUNCTION prevent overstretching of heart, Provide protection, anchor heart in
mediastinum.

2. Inner Serous pericardium -Thinner, more delicate membrane that form a

double layer around heart. (outer parietal layer) (inner Visceral layer also called
epicardium)
• There is a thin film fluid between parietal and visceral called Pericardial fluid.
Function to reduce friction between membrane as the heart moves.
NB!! Functions of the heart
1. To pump blood into 2 circuits - systematic and pulmonary
circulations.
2. Left side of heart pump freshly oxygenated blood into
systemic circulation to all parts of body.
3. Right side of heart to pump deoxygenated blood to
Pulmonary circulation for gas exchange-to pic up oxygenated
blood.
4. To receive freshly oxygenated blood from pulmonary
circulation in left side of heart to pump it to systemic circulation.
NB!!! 4 CHAMBERS OF THE HEART

1. Right Atrium
2. Right Ventricle
3. Left Atrium
4. Left Ventricle
Valves in Veins
Function: To prevent backflow of blood in body.
• Found in heart and veins.

Why are they only found in veins?

• Because blood returns to heart against gravity, so
backflow must be prevented.
NB!! 4 Valves of the Heart
1. Tricuspid valve
Separates right atrium from right ventricle

2. Pulmonary semilunar valve

Separates right ventricle from pulmonary artery

3. Bicuspid (Mitral) valve

Separates left atrium from left ventricle

4. Aortic semilunar valve

Separates left ventricle from aorta
 NB!!!
Blood Vessels
NB!!!!!! Anastomosis
Is a connection or opening between two things
(especially cavities or passages) that are normally
diverging or branching, such as between blood
vessels, leaf veins or steams.
NB!!! Circulation of the Blood
1. Blood enters the heart through the inferior and superior vena cava,
flowing into the right atrium.
2. The blood passes through the tricuspid valve into the right ventricle.
3. It than passes through the pulmonic semilunar valve, entering the
pulmonary artery of the pulmonary circulation.
4. It flows through the pulmonary bed of the right and left lungs to the
pulmonary vein, reentering the heart at the left atrium.
5. It then flows through the bicuspid valve, into the left ventricle.
6. Passing through the aortic semilunar valve, the blood enters the aorta
and systematic vascular system.
Cardiac Conduction
The Electrical Cardiac Conduction System/
Activities
• =is a group of specialized cardiac muscle cells in the walls of
the heart that send signals to the heart muscle causing it to
contract.
• Conductivity= Ability to respond to an electrical impulse.
• Electrical impulse=A sudden flow of electrical current in one
direction. 
• The main components of the cardiac conduction system are
the SA node, AV node, bundle of His, bundle branches, and
Purkinje fibers.
Depolarization Path:
1.SA Node  AV Node
2.Atria Contract
3.(Delay)  AV Bundle
4.Ventricles Contract
(Blood ejected out of arteries, leaving heart)

Diastole - the time during which cardiac muscle relaxes.

Systole - the time in which cardiac muscle is contracting .
• cardiac output: The volume of blood pumped by
the heart each minute, calculated as heart rate
(HR) X (times) stroke volume (SV).

• pulse: Pressure waves generated by

the heart in systole move the arterial walls,
creating a palpable pressure wave felt by touch.

• stroke volume (SV) is the volume of blood

pumped from the left ventricle per beat.
The Heart blood supply
Left Coronal Artery
• Together supply most of the left ventricle, left atrium, 2/3 of
intraventricular septum, half of intra atrial septum and part of
right atrium.

Right Coronary Artery

• Supplies anterior and posterior portions of right ventricular
myocardium, right atrium, sinus node, posterior 1/3 of
intraventricular septum and portion of vase of right ventricle.
Coronary Veins

• Closely parallel the arterial system

• Some coronary venous blood enters the heart
through the Thebesian vein.

• Thebesian veins empty directly into all chambers

thus creating some venous admixture lowering Pa02.
Checking Circulation
Pulse=The rhythmic dilation of an artery that results from beating of
the heart. Pulse is often measured by feeling the arteries of the wrist
or neck.
 NB!!!! Factors affecting the heart rate
• Autonomic nervous system
• Circulating hormones
• Position
• Exercise
• Emotional state
• Age
• Temperature
• Baroreceptor reflex= Baroreflex or baroreceptor reflex is one of the body's homeostatic
mechanisms that helps to maintain blood pressure at nearly constant levels.
• Drugs including medicine

• NB!!! Be able to explain these factors with examples.

 NB!!
Blood
 Blood
Blood = is a combination of plasma and cells that
circulate through the entire body.
=It is a specialized bodily fluid that supplies essential
substances around the body, such as sugars, oxygen, and
hormones.
Serum = is an amber - colored, protein-rich liquid which
separates out when blood coagulates. It contains no
fibrinogens.
NB!!!! Blood Consists of:

1.Erythrocytes or Red blood cells

2.Leucocytes or White blood cells
3.Platelets or Thrombocytes (Lymphocytes,
Monocytes, Eosinophils, Basophils, Neutrophils)
4.Plasma
Plasma vs Serum
Where are blood cells made?
The bone marrow =is the spongy material in the
center of the bones that makes all types of blood
cells.

There are other organs and systems in our bodies that

help regulate blood cells.
The lymph nodes, spleen, and liver help regulate the
production, destruction, and differentiation
(developing a specific function) of cells.
NB!!! Hematopoiesis meaning

=The production and development

of new cells in the bone marrow is
a process called
• Blood cells formed in the bone marrow start out as a
stem cell.
• A stem cell (or hematopoietic stem cell) is the initial
phase of all blood cells.
• As the stem cell matures, several distinct cells evolve,
such as the red blood cells, white blood cells, and
platelets.
• Immature blood cells are also called blasts.
• Some blasts stay in the marrow to mature.
• Others travel to other parts of the body to develop into
mature, functioning blood cells.
 Common blood tests
Test Uses
Cell Blood Count, which includes: To aid in diagnosing anemia and other blood disorders and
White blood cell count (WBC) certain cancers of the blood; to monitor blood loss and
Red blood cell count (RBC) infection; or to monitor a patient's response to cancer
Platelet count therapy, such as chemotherapy and radiation.
Hematocrit red blood cell volume (Hct)
Hemoglobin (Hb) concentration. The oxygen-carrying
pigment in red blood cells
Differential blood count

Platelet count To diagnose and/or monitor bleeding and clotting disorders.

Prothrombin time (PT) and partial thromboplastin time (PTT) To evaluate bleeding and clotting disorders and to monitor
anticoagulation (anticlotting) therapies.
 NB!!
Functions of Blood
1. To supplying oxygen to cells and tissues
2. To providing essential nutrients to cells,
such as amino acids, fatty acids, and glucose
3. For removing waste materials, such as
carbon dioxide, urea, and lactic acid.
4. To protecting the body from infection and
foreign bodies through the white blood cells
5. For transporting hormones from one part of the
body to another, transmitting messages, and completing
important processes
6. For regulating acidity (pH) levels and body
temperature, water content of cells
7. For engorging parts of the body when needed, for
example, a penile erection as a response to sexual
arousal.

NB!! Be able to explain these functions with

examples.
 Plasma
PLASMA= is straw-colored liquid consisting of 90%
Water and dissolved solutes (proteins, lipids, inorganic
ions (salts) and glucose).

The plasma accounts for 55% of the blood volume.

proteins include hormones.

The salts include urea, that are waste products of cells.
 Red blood cell
• RBC= are flattened biconcave discs generated in red bone marrow by process of
erythropoiesis from hemocytoblast a stem cell.
• Shape provides increased surface area for diffusion
• Lacks nuclei and mitochondria
• Has semi-permeable membrane
• Contains Hemoglobin (Heme=iron pigment; Globin=protein )is the protein
inside red blood cells that carries oxygen.
• Red blood cells also remove carbon dioxide from your body, transporting it to
the lungs for you to exhale.
• Approximately 30 trillion in body.
• They typically live for about 120 days, and then they die.
Leukocytes are further classified into two
subcategories:

1. Granulocytes which consist of neutrophils,

eosinophils and basophils; and
 2. Agranulocytes which consist of lymphocytes
and monocytes.
• Agranular=lack cytoplasmic granules under microscope.
• The main role of white blood cells is to protect the body against invasion
by disease-causing microorganisms (pathogens), such as bacteria or viruses.
• They do this in 2 main ways: 1. Phagocytosis and 2. Antibody
production

• Around 75% of white blood cells are phagocytes, these are the cells
which phagocytose ('cell eating').
• The process involves ingesting microorganisms, by changing their shape
and producing extensions in their cytoplasm, called pseudopodia.
• These enclose the microorganism in a vacuole.
• The phagocyte then secretes enzymes into the vacuole which break
down the microorganism.
The other type of white blood cell to be aware of are lymphocytes.

Their function is to make antibodies.

ANTIBODIES=These are soluble proteins, that pass into the plasma,
and can recognize the chemical 'markers' called antigens on the surface
of pathogens.
The antibodies stick to these antigens and destroy the pathogen in several
different ways. For example:
1) they can cause the different pathogens to stick together, so
phagocytes can ingest them more easily 
2) acting as a label (COMOUFLAGE) on the pathogens so phagocytes
recognize them more easily 
3) cause the pathogen cells to burst 
4) neutralize the toxins produced by the pathogens 
• some lymphocytes develop into memory
cells, which help to make us immune to a
disease.

• These cells stay in the blood for many years,

and so if a microorganism re-infects, the
memory cell can quickly reproduce and
produce antibodies, to deal with the infection
much faster. 
 NB!! 5 Types of white blood cells and their functions
• Monocytes. They have a longer lifespan than many white blood cells and help to break down
bacteria.
• Lymphocytes. They create antibodies to defend against bacteria, viruses, and other potentially
harmful invaders.
• some lymphocytes develop into memory cells, which help to make us immune to a disease.
These cells stay in the blood for many years, and so if a microorganism re-infects, the memory
cell can quickly reproduce and produce antibodies, to deal with the infection much faster. 
• Neutrophils. They kill and digest bacteria and fungi. They are the most numerous type of white
blood cell and your first line of defense when infection strikes.
• Basophils. These small cells appear to sound an alarm when infectious agents invade your blood.
They secrete chemicals such as histamine, a marker of allergic disease, that help control the
body's immune response.
• Eosinophils. They attack and kill parasites, destroy cancer cells, and help with allergic responses.
Number of diseases and conditions may influence white
blood cell levels:
• Weakened immune system. This is often caused by illnesses such as HIV/AIDS or by treatments
related to cancer. Cancer treatments such as chemotherapy or radiation therapy can destroy white
blood cells and leave you vulnerable to infection.
• Infection. A higher-than-normal white blood cell count usually indicates some type of infection—
white blood cells are multiplying to destroy an enemy, such as bacteria or a virus.
• Myelodysplastic syndrome. This condition causes abnormal production of blood cells. This includes
white blood cells in the bone marrow. 
• Cancer of the blood. Cancers including leukemia and lymphoma can cause uncontrolled growth of an
abnormal type of blood cell in the bone marrow. This results in a greatly increased risk for infection
and or serious bleeding.
• Myeloproliferative disorder. This disorder refers to various conditions that trigger the excessive
production of immature blood cells. This can result in an unhealthy balance of all types of blood cells
in the bone marrow and too many or too few white blood cells in the blood.
• Medicines. Some medicines can raise or lower the body's white blood cell count. 
NB!! Functions of the Platelets in the human body

• Secrete vasoconstrictors which constrict blood vessels, causing

vascular spasms in broken blood vessels
• Form temporary platelet plugs to stop bleeding
• Secrete procoagulants (clotting factors) to promote blood clotting
• Dissolve blood clots when they are no longer needed
• Digest and destroy bacteria
• Secrete chemicals that attract neutrophils and monocytes to sites
of inflammation
• Secrete growth factors to maintain the linings of blood vessels
 Megakaryocyte
is a large bone marrow cell with a lobulated
• = 

nucleus responsible for the production of

blood thrombocytes (platelets), which are
necessary for normal blood clotting. 

•Megakaryocytes usually account for 1 out of

10,000 bone marrow cells in normal people.
 Disorders of blood
•Anemia: This is a shortage of RBCs or hemoglobin in the blood.
As a result, the cells do not transport oxygen effectively, and
symptoms can include fatigue and pale skin.
•Blood clots: These can be vital for the healing process of
wounds and injuries. However, some clots 
coagulate inside a blood vessel and create a blockage. They can
also become dislodged and move through the heart to the lungs,
leading to a pulmonary embolism. Clots can be fatal.
•Blood cancers: Leukemia, myeloma, and lymphoma are 
types of blood cancer. Mutated blood cells divide uncontrollably
without dying at the normal point in the life cycle of a cell.
Blood Groups
&
Blood Types
 NB!! 4 MAJOR BLOOD TYPES
• ABO Blood Group system and Rh blood group system

• ABO blood group is based on two antigens called A and B.

• People who's RBCs display only Antigen A on RBCs = are said type A BLOOD.
BLOOD TYPE TYPE A TYPE B TYPE AB TYPE O

RBCs A ANTIGEN B ANTIGEN BOTH A AND B NEITHER A NOR B

ANTIGEN ANTIGEN

PLASMA ANTI-B ANTI-A NEITHER BOTH ANTI-A AND B

ANTIBODY ANTIBODY ANTIBODIES ANTIBODIES
NB!!! Next slide

THE ABO SYSTEM OF BLOOD GROUPING

ACCORDING TO BLOOD TYPE, ANTIGENS,
ANTIBODIES, DONORS AND RECIPIENTS.
 Antibodies in Can donate to Can receive from
Blood group Red cell antigen
serum group (s) group (s)

AB AB;A; B;O (All

(universal recipient)
A and B NONE AB
groups)

A A Anti- B A and AB A and O.

B B Anti - A B and AB B and O

AB; A; B; O (All
O (universal donor) NONE Anti- A and Anti- B O
groups)
NB!!!!
•Donor= Person who give blood.
•Recipient = Person who receive
blood.
•Group A positive or A negative: A antigens are found on the surfaces
of blood cells. Anti-B antibodies are found in the plasma.

•Group B positive or B negative: B antigens are found on the surfaces

of blood cells. Anti-A antibodies are found in the plasma.

•Group AB positive or AB negative: A and B antigens are found on the

surfaces of blood cells. There are no antibodies are found in the plasma.

•Group O positive and O negative: There are no antigens are found on

the surfaces of blood cells. Both anti-B and anti-A antibodies are found
in the plasma.
-Group O (universal donor) (common) blood can be given to
people of virtually any blood type, and
-people with Group AB+(universal recipient) (less common)
blood can generally receive blood from any group. 
Talk to your doctor to find out your blood type.
If you donate blood, a doctor can also tell you your blood
type.
-Blood groups are important during pregnancy. If a woman has
Rh D negative blood, for example, but her fetus inherits Rh D
positive blood from the father, treatment will be needed to 
prevent a condition known as hemolytic disease of the
newborn (HDN).
 Rh Blood Group Antigens
• Terms “D positive” and “D negative”= refer only to presence or absence of the Rh antigen D
on the red blood cell. Protein= in chemical nature

The Rh antigens and corresponding antibodies account for majority of unexpected antibodies
encountered.
Rh antibodies stimulated as a result of transfusion or pregnancy, they are immune.

• Individuals who lack D antigen DO NOT have anti-D.

• There are 49 Rh antigens

• D antigen is the most important
• Rh += have Rh antigen on surface cell membranes (more people)
• Rh - =don’t have Rh…(less people)

• Important: Transfusion and pregnancy

Complications
• = Causes destruction of RBC which leads to Renal
failure.
• Anemia
• ABO incompatibility= Hemolytic disease of the
newborn
• Miscarriage
• Pathologic Jaundice=High level of bilirubin in blood
NB!! on the next slide
of ABO Incompatibility
Rh- Iso immunization meaning

•Rhesus disease, Rhesus incompatibility

•RhD Hemolytic Disease of the Newborn
• When Rh negative mother gets pregnant to Rh positive
fetus, she may be sensitized to Rh antigen and develop
antibodies. These antibodies will cross the placenta and
cause hemolysis of fetal RBCs.
NB!! ABO and Rh
End!
References:
1. Waugh, A & Grant, A. (2014). Ross and Wilson
Anatomy and Physiology in Health and Illness, 12th
Edition, Livingstone

2. Tortora, G. J. & Grabowski, S. R. (2003). Principles

of Anatomy and Physiology, 10th edition. London;
Wiley