(MC 1 ANAPHY):

TOPIC OUTLINE (incomplete cell), shaped like a

[1] OVERVIEW biconcave disc
[2] BLOOD  lifespan: 120 days (4 months)
[3] ANATOMY OF THE HEART  normal count; 5 million per mm3
[4] PHYSIOLOGY OF THE HEART  contains hemoglobin, a protein
that can bind 4 O2 molecules,
OVERVIEW gives its red color
Cardiovascular System  each erythrocute has 250 M
- def: a closed system of heart and blood vessels hemoglobin molecules
a. heart pumps blood  denatured hemoglobin due to pH
b. blood vessels circulate blood changes can destroy its tertiary
c. blood as “fuel of life” structure and therefore, unable
- function: transport oxygen, nutrients, cell wastes, to bind oxygen
hormones, TO AND FROM the cells 2. LEUKOCYTES
 main function: Crucial in body’s
BLOOD defense against disease;
- a fluid type of connective tissue that transports Respond to chemicals released
and distributes nutrients, wastes, hormones, body by damaged tissues (known as
heat, electrolytes, oxygen and carbon dioxide from positive chemotaxis)
one place to another  characteristics: Complete cells,
with nucleus and organelles; Able
2 MAIN COMPONENTS OF BLOOD to move into and out of blood
FORMED - living cells vessels (diapedesis)
ELEMENTS - RBC, WBC, platelets  movement: by amoeboid motion
PLASMA - nonliving fluid matrix, noncellular  normal count: 4,800 to 10,800
WBCs per mm3 of blood
When blood is  WBCs from most to least
separated: abundant: N-L-M-E-B
1. RBCs sink (45% 3. THROMBOCYTES
hematocrit)  also known as “platelets”
2. Buffy Coat settles on  fragments of megakaryocytes or
the middle; a thin large bone marrow cells with a
whitish layer of WBC lobated nucleus
and platelets (<1%)  main function: needed for blood
3. Plasma rises to the clotting by clinging to a torn area
top (55%)  characteristics: essentially
ireggular small fragments, with
PHYSICAL CHARACTERISTICS OF BLOOD deep purple stains
[1] Apperance: Sticky, opaque fluid  normal count: 300, 000
[2] Density: Heavier and thicker than water platelets per mm3
[3] Color range PLASMA - nonliving fluid matrix
Oxygen-rich blood: scarlet red 55% BLOOD PLASMA consists of:
Oxygen-poor blood : dull red or purple  90% water: for carrying
[4] Taste: Metallic, salty substances and
[5] Blood pH: slightly alkaline, between 7.35 absorbing/distributing body heat
and 7.45  6-8% plasma proteins: albumin
[6] Blood temperature: slightly higher than for osmotic pressure of plasma
body temperature, at 38ºC or 100.4ºF and pH buffering, globulin for
[7] Blood Volume: about 5-6 L per average immune defense and lipid
human body (males); 4-5 L for females transport, fibrinogen to inititate
: accounts for 8% of body weight blood clotting)
 1% electrolytes (Na, Cl): for
osmotic balance, pH buffering,
BLOOD COMPOSITION and regulation of membrane
FORMED - living cells permeability
ELEMENTS - RBC, WBC, platelets  other components: nutrients
45% RBC 1. ERYTHROCYTES (glucose, fatty acids, amino
<1% WBC, P  also known as Red Blood Cells acids, vitamins), respiratory
gases (CO2 and O2), hormones,
 main function: to carry oxygen
wastes (urea, uric acid)
 characteristics: anucleate (no
nucleus), lacks mitochondria
Note: Blood composition varies as cells exchange
and contains few organelles
substances with the blood.

MLGA 1
(MC 1 ANAPHY):

 Liver makes more proteins when levels  main function: play a role in
drop immune response
 Respiratory and urinary systems restore  characteristics: large dark purple
blood pH to normal when blood becomes nucleus
too acidic or alkaline  normal count: 1,500-3,00 per
mm3, secondmost abundant
 Leukocytosis WBC (20-45% of WBCs)
 WBC count above 11,000 cells per 5. MONOCYTE
mm3 of blood  largest of the WBCs
 Generally indicates an infection  main function: a macrophage or
 Leukopenia large phagocyte when they
 Abnormally low WBC count migrate into tissues; fights
 Commonly caused by certain chronic infection
drugs, such as corticosteroids and  characteristics: distinctive U- or
anticancer agents kideny-shaped nucleus
 Leukemia  normal count: 100-700 per mm3
 Bone marrow becomes cancerous (4-8% of WBCs)
 Numerous immature WBC are
produced HEMATOPOIESIS (Blood Cell Formation)
 Occurs in red bone marrow (myeloid tissue)
TYPES OF LEUKOCYTES  All blood cells are derived from a common stem
GRANULO - with visible cytoplasmic granules cell (HEMOCYTOBLAST)
CYTES 1. NEUTROPHILS  Hemocytoblasts form two types of descendants
 most numerous WBC  LYMPHOID STEM CELL, which produces
 main function: phagocyte that lymphocytes
eats pathogens at infection sites  MYELOID STEM CELL, which can produce all
via phagocytosis other formed elements
 characteristics: deep purple
multi-lobed nucleus, and pink
fine cytoplasmic granules
 normal count: 3,000-7,000 per
mm3
 numbers increase during
infections (40-70% of WBCs)
2. EOSINOPHILS
 main function: to KILL PARASITIC
WORMS and play a role in
ALLERGY ATTACKS
 characteristics: blue-red nucleus,
brick-red coarse cytoplasmic
granules
 normal count: 100-400 per mm3
(1-4% of WBCs)
3. BASOPHILS
 rarest of the WBCs
 main function: release histamine,
a vasodilator, at site of
infections, contain an RBC FORMATION
anticoagulant heparin - RBCs are anucleate, therefore they are unable to
 characteristics: large U- or S- divide, grow, or synthesize proteins
shaped blue-purple nucleus with - worns out after 100 to 120 days
constrictions of dark-blue - eliminated by phagocytes in the spleen or livin
cytoplasmic granules - replaced by hemocytoblasts in the red bone
 normal count: 20-50 per mm3 marrow
(0-1% of WBCs) - RBC formation is controlled by a hormone called
AGRANUL - without visible cytoplasmic erythropoietin
OCYTES granules - this hormone is relased by the kidneys in
4. LYMPHOCYTE response to low 02 levels in the blood caused by:
 slightly larger than RBCs, smaller a. decreased RBC count
than monocytes; a phagocyte b. decreased amount of hemoglobin
 resides in lympathic tissues c. decreased availability of 02

MLGA 2
(MC 1 ANAPHY):

WBC and PLATELETS FORMATION - a hereditary bleeding disorder

- WBC production is controlled by hormones known where normal clotting factors are
as colony stimulating factors (CSFs) and missing
interleukins that prompt bone marrow to generate - minor tissue damage can cause
leukocytes life-threatening bleeding
- PLATELET production is controlled by a hormone
called thrombopoietin that stimulates formation of BLOOD LOSS AND TRANSFUSION
plateltes from megakaryocytes - Large blood loss have serious consequences
a. loss of 15 to 30%: weakness
HEMOSTASIS b. loss of over 30%: shock (can be fatal)
- The process of stopping the bleeding that results - Blood transfusions are given for substantial blood
from a break in a blood vessel loss, to treat severe anemia, or for
- Hemostasis involves three phases thrombocytopenia
1. Vascular spasms
 produced as immediate response to a HUMAN BLOOD GROUPS
blood vessel injury; smooth muscle - Blood contains antigens (in RBC) or genetically
contracts causing vasoconstriction or determined proteins that the body recognizes as a
spasms that narrow the blood vessel and foreign material that should be attacked by the
decrease blood loss immune system
2. Platelet plug formation a. most antigens are foreign proteins
 Collagen fibers are exposed when there is b. We tolerate our own antigens and fights
a blood vessel injury. Platelets stick to the antigens of other blood types that are
collagen fibers and release chemicals to incompatible
attract more platelets, creating a platelet
plug or white thrombus - Antibodies (in plasma) released by
3. Coagulation (blood clotting) immunoglobulins or immune cells are the
 Fibrinogen from blood plasma interacts “recognizers” that bind to foreign antigens
with Ca2- to form thrombin, an enzyme  - Blood is “typed” by using antibodies that
that catalyzes joining of fibrinogen will cause blood with certain proteins to
molecules to fibrin, an insoluble mesh that clump (agglutination) and lyse
traps red blood cells and platelets,  There are over 30 common red blood cell
forming the clot antigens
 The most vigorous transfusion reactions are
 Blood usually clots within 3 to 6 minutes caused by ABO and Rh blood group
and remains as endothelium or the skin antigens
tissue layer regenerates.
 The clot is broken down after tissue ABO Blood Group
repair. - blood types based on the presence or absence of
antigens A and B
 Presence of both antigens A and B is called
DISORDERS OF HEMOSTASIS type AB
[1] 1. Thrombus  Presence of antigen A is called type A
Undesirable - a clot in an UNBROKEN blood  Presence of antigen B is called type B
Clotting vessel  Lack of both antigens A and B is called
- can be deadly in areas such as type O
the longs
2. Embolus
- a thrombus that breaks away
and floats freely in the
bloodstream
- can clog vessels in critical areas
such as the brain
[2] Bleeding 1. Thrombocytopenia
Disorders - insufficient number of circulating
platelets
- arises from any conditions that
suppresses the bone marrow
- small movements may cause
bleeding that require platelts for
clotting
- evidenced by petechiae (small
purplish blotches on the skin)
2. Hemophilia

MLGA 3
(MC 1 ANAPHY):

Note: The presence or absence of an antigen type  Agglutination or the lack of agglutination
determines your blood type in ABO Blood Group. Its leads to identification of blood type
antibody is the opposite, which defines what blood  Typing for ABO and Rh factors is done in
group you should or not have for transfusion. the same manner
Type O is the universal donor (no antigens A  Cross matching—testing for agglutination of
and B, but has both A and B antibodies) donor RBCs by the recipient’s serum, and
Type AB is the universal recepient (both vice versa
antigens A and B)

Example: I have a B blood type. So I have antigen B

and anti-A antibody. Therefore, I cannot receive
blood from type A or AB (no antibodies). I can only
have transfusion of blood from groups O (universal
donor) and B (similar blood type).

Specifically, I have a B+ blood type. So, I can receive

blood still from groups O and B. But if I have B- blood Observations:
type, I can only receive O- and B- bloods. 1. RBCs of Type AB agglutinate to both Anti-A and -B
serums because it has both antigens A and B.
Rh Blood Group 2. RBCs of Type A agglutinate only to Anti-A serum
- named for the eight Rh antigens (agglutinogen D) because it contains antigen A.
- Most Americans are Rh+ (Rh-positive), meaning 3. RBCs of Type B agglutinate only to Anti-B serum
they carry the Rh antigen (presence of because it contains antigen B.
agglutination) 4. RBCs of Type O does not agglutinate to neither of
- If an Rh–negative person receives Rh+ blood: the serums because it does not have antigens A and
a. The immune system becomes sensitized B.
and begins producing antibodies; hemolysis does not
occur, because as it takes time to produce ANATOMY OF THE HEART-
antibodies Heart - a hollow, visceral organ that pumps blood
b. Second, and subsequent, transfusions throughout the body
involve antibodies attacking donor’s Rh+ RBCs, and - made up of cardiac muscles
hemolysis occurs (rupture of RBCs) - Its size is similar to a human fist, and weighs less
than a found
- LOCATION: in the thoracic cavity, between the
lungs in the inferior mediastinum
- ORIENTATION: apex is directed toward left hip and
rests on the diaphragm; base points toward the right
shoulder

BLOOD TYPING

 Blood samples are mixed with anti-A and

anti-B serum

MLGA 4
(MC 1 ANAPHY):

Walls of the Heart is composed of 3 layers (outer to

Figure A. Location of the heart within the thorax inner):
(anterior view) 1. Epicardium - outer layer; visceral
pericardium
2. Myocardium - middle layer; mostly
cardiac muscle
3. Endocardium - innermost layer next to
heart chamber (lining of heart chambers); also
known as endothelium

Figure B. Location of the heart in respect to the rib

cage within the thorax

The point of maximum intensity is the position on

the chest where the impulse of the left ventricle of
the heart is felt most strongly. This is normally in the
fifth intercostal space on, or just medial to, the left
midclavicular line. It is abbreviated as PMI. CHAMBERS AND ASSOCIATED GREAT VESSELS OF
THE HEART
4 Chambers of the Heart
 Atria (right and left) SUPERIOR
 Receiving chambers “A-kin…Atria!”
 Assist with filling the ventricles
 Blood enters under low pressure
 Ventricles (right and left) INFERIOR
 Discharging chambers “V-sayo…Ventricle!”
 Thick-walled pumps of the heart
 During contraction, blood is propelled into
circulation

Figure C. Location of the heart inferior to the Right Atrium Left Atrium
mediastinum within the thorax (posterior view) Right Ventricle Left Ventricle

COVERINGS OF THE HEART GROSS ANATOMY OF THE HEART

Pericardium - a “double-walled sac” that covers the
heart

2 MAIN LAYERS
 Fibrous pericardium is loose and superficial
(outer)
 Serous pericardium is deep (inner) to the
fibrous pericardium and composed of two
layers:
1. Parietal pericardium: outside layer that
lines the inner surface of the fibrous
pericardium
2. Visceral pericardium: next to heart; also
known as the epicardium (outer layer of
the heart walls)
 Serous fluid fills the space between the layers of
pericardium, called the pericardial cavity
 SEQUENCE OF LAYERS (OUTER TO INNER)
Fibrous peri > Parietal Serous peri > Percardial
Cavity (fluid) > Visceral Serous peri > Heart  Interatrial septum
Walls (Epi-, Myo-, Endocardium) > Heart  Separates the two atria longitudinally
Chamber  Interventricular septum
 Separates the two ventricles
longitudinally

MLGA 5
(MC 1 ANAPHY):

MAJOR FUNCTIONS OF THE HEART [2] SYSTEMATIC CIRCULATION

 Oxygen-rich blood returned to the left
 HEART FUNCTIONS AS A DOUBLE PUMP side of the heart is pumped out into
 Arteries carry O2 blood away the aorta
from the heart (A-A)  Blood circulates to systemic
 Veins carry deO2 (with CO2) arteries and to all body tissues
blood toward the heart (V-T)  Left ventricle has thicker walls
 Cappilarries where gas exchange because it pumps blood to the
occures body through the systemic circuit
 DOUBLE PUMP  Oxygen-poor blood returns to the right
 Right side works as the pulmonary atrium via systemic veins, which
circuit pump empty blood into the superior or
 Left side works as the systemic inferior vena cava
circuit pump

Right Side Left Side HEART VALVES

(PULMONARY (CIRCULATORY - allow blood to flow in only one direction, to prevent
CIRCUIT PUMP) CIRCUIT PUMP) backflow
- valves open and close in response to pressure
- Right Atrium, - Left Atrium, changes in the heart
Right Ventricle, Left Ventricle,  Atrioventricular (AV) valves—between atria
VEINS ARTERIES and ventricles
- Anchored the cusps in place by chordae
tendineae to the walls of the ventricles
- Open during heart relaxation, when blood
passively fills the chambers
- Closed during ventricular contraction
 Left AV valve: bicuspid (mitral) valve
 Right AV valve: tricuspid valve
 Semilunar valves between ventricle and
artery
- Closed during heart relaxation
- Open during ventricular contraction
 Pulmonary semilunar valve
 Aortic semilunar valve

DOUBLE PUMPS
[1] PULMONARY CIRCULATION Right Atrium Left Atrium
 Blood flows from the right side of the TRICUSPID VALVE BICUSPID VALVE
heart to the lungs and back to the left Right Ventricle Left Ventricle
side of the heart
 Blood is pumped out of right side
Pulmonary Artery Aorta
through the pulmonary trunk,
PULMONARY AORTIC
which splits into pulmonary
SEMILUNAR VALVE SEMILUNAR VALVE
arteries and takes oxygen-poor
Right Ventricle Left Ventricle
blood to lungs
 Oxygen-rich blood returns to the
heart from the lungs via
pulmonary veins

MLGA 6
(MC 1 ANAPHY):

 CARDIAC VEINS—drain the myocardium of

blood
 CORONARY SINUS—a large vein on the
posterior of the heart; receives blood from
cardiac veins; drains blood into the right
atrium
 Blood empties into the right atrium via the
coronary sinus

PHYSIOLOGY OF THE HEART

Intrinsic Conduction System
- a unifying control system; also known as —nodal
system—
 Cardiac muscle contracts spontaneously
(regular and continuous way) and
independently of nerve impulses
 Atrial cells beat 60 times per minute
 Ventricular cells beat 20-40 times per
minute
- along with the autonomic nervous system, the
nodal system or the intrinsic conduction system
regulate the heart activity of a healthy human heart

The NODAL SYSTEM:

1. sets the heart rhythm
2. is composed of special nervous tissues
3. ensures heart muscle depolarization in one
direction only (atria to ventricles)
4. enforces a heart rate of 75 bpm

4 COMPONENTS OF NODAL SYSTEM

SINOATRIAL (SA) - located in the right atrium
CARDIAC CIRCULATION NODE - serves as “the heart’s
- Blood in the heart chambers does not nourish the pacemaker”
myocardium ATRIOVENTRICULAR - located at the junction of atria
- The heart has its own nourishing circulatory system (AV) NODE and ventricles
consisting of: - receives impulse from SA node
ATRIOVENTRICULAR - bundle brances located in the
(AV) BUNDLE interventricular septum
PURKINJE FIBERS - spread within the ventricle wall
muscles
- near the chordae tendinae that
pulls valve open and close

 CORONARY ARTERIES—branch from the

aorta to supply the heart muscle with
oxygenated blood

MLGA 7
(MC 1 ANAPHY):

NODAL SYSTEM PROCESS

1. SA node starts each heartbeat.
2. Impulse spreads through the atria to the AV node
3. Atria contract
4. At the AV node, the impulse is delayed briefly
5. Impulse travels through the AV bundle, bundle
branches, and Purkinje fibers
6. Ventricles contract; blood is ejected from the
heart

CARDIDAC CYCLE AND HEART SOUNDS

 The cardiac cycle refers to one complete
heartbeat, in which both atria and ventricles
contract and then relax
 Systole = contraction
 Diastole = relaxation
 Cardiac cycle length is normally 0.8 second

COMPONENTS OF CARDIAC CYCLE

[1] ATRIAL DIASTOLE (ventricular filling)
- relaxation of the atria
 Heart is relaxed  HEART SOUNDS:
 Pressure in heart is low  LUB—longer, louder heart sound caused by
 Atrioventricular valves are open the closing of the AV valves
 Blood flows passively into the atria and  DUP—short, sharp heart sound caused by
into ventricles the closing of the semilunar valves at
 Semilunar valves are closed the end of ventricular systole

[2] ATRIAL SYSTOLE

 Ventricles remain in diastole CARDIAC OUTPUT - amount of blood pumped by
 Atria contract each side (ventricle) of the
 Blood is forced into the ventricles to heart in 1 minute
complete ventricular filling STROKE VOLUME - volume of blood pumped by
each ventricle in one
[3] ISOVOLUMETRIC CONTRACTION contraction (heartbeat)
 Atrial systole ends; ventricular systole - about 70 ml of oxygenated
begins blood is pumped out of the left
 Intraventricular pressure rises ventricle with each heartbeat
 AV valves close HEART RATE - normally 75 beats per minute
 For a moment, the ventricles are TACHYCARDIA - tachy means fast; cardia
completely closed chambers (Rapid HR) means heart
- heart rate (HR) of over 100
[4] VENTRICULAR SYSTOLE (ejection phase) bpm
 Ventricles continue to contract BRADYCARDIA - brady means slow; cardia
 Intraventricular pressure now (Slow HR) means heart
surpasses the pressure in the major - less than 60 beats per minute
arteries leaving the heart
 Semilunar valves open CARDIAC OUTPUT FORMULA
 Blood is ejected from the ventricles - the product of the HR and the stroke volume
 Atria are relaxed and filling with blood
CO = HR x SV
[5] ISOVOLUMETRIC RELAXATION CO = HR (75 bpm) x SV (70 ml/beat)
 Ventricular diastole begins CO = 5250 ml/min = 5.25 L/min
 Pressure falls below that in the major
arteries The amount of blood normally pumped by the right
 Semilunar valves close and left ventricles in one minute is 5.25 L/min, a
 For another moment, the ventricles close value to the liters of blood an average human
are completely closed chambers body has.
 When atrial pressure increases above
intraventricular pressure, the AV REGULATION OF THE STROKE VOLUME
valves open  60 percent of blood in ventricles (about 70 ml)
is pumped with each heartbeat
 Starling’s law of the Heart

MLGA 8
(MC 1 ANAPHY):

 The critical factor controlling SV is how

much cardiac muscle is stretched
 The more the cardiac muscle is stretched,
the stronger the contraction
 Venous return is the important factor influencing
the stretch of heart muscle

FACTORS AFFECTING BASIC HR

[1] NEURAL (ANS) CONTROLS
 Sympathetic nervous system speeds
heart rate
 Parasympathetic nervous system,
primarily vagus nerve fibers, slow and
steady the heart rate

[2] HORMONES AND IONS

 Epinephrine and thyroxine speed up
heart rate
 Excess or lack of calcium, sodium, and
potassium ions also modify heart
activity

[3] PHYSICAL FACTORS

 Age, gender, exercise, body
temperature influence heart rate

MLGA 9