1. Anatomy and Physiology, Seventh Edition
Rod R. Seeley Idaho State University
Trent D. Stephens Idaho State University
Philip Tate Phoenix College
Chapter 19
Lecture Outline*
*See PowerPoint Image Slides for all figures and tables pre-inserted into PowerPoint without notes.
Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.

2. Cardiovascular System
Chapter 19
Cardiovascular System
Blood

3. Functions of Blood
Transport of gases, nutrients and waste products; e.g. oxygen
Transport of processed molecules; e.g., precursor of vitamin D from skin to liver then kidneys
Transport of regulatory molecules; e.g., hormones
Regulation of pH and osmosis (normal pH of most body tissues between 7.35 and 7.45)
Maintenance of body temperature; e.g., warm blood shunted to the interior of the body
Protection against foreign substances; e.g., antibodies
Clot formation

4. Plasma Liquid part of blood.
Colloid: liquid containing suspended substances that don’t settle out of solution
91% water. Remainder proteins, ions, nutrients, waste products, gases, regulatory substances
Proteins:
Albumins: viscosity, osmotic pressure, buffer, transports fatty acids, free bilirubin, thyroid hormones
Globulins: Transports lipids, carbohydrates, hormones, ions, antibodies, and complement
Fibrinogen: blood clotting

5. Plasma, cont.
Ions: involved in osmosis, membrane potentials, and acid-base balance
Nutrients: glucose, amino acids, triacylglycerol, cholesterol, vitamins
Waste Products:
Urea, uric acid, creatinine, ammonia salts. Breakdown products of protein metabolism
Bilirubin. Breakdown product of RBCs
Lactic acid. End product of anaerobic respiration
Gases: oxygen, carbon dioxide, and inert nitrogen
Regulatory substances: hormones, enzymes

6. Composition of Blood

8. Formed Elements
Red blood cells (erythrocytes). Biconcave discs, anucleate, contain hemoglobin; transports oxygen and carbon dioxide.
White blood cells (leukocytes)
Granulocytes: cytoplasm contains large granules; have multi-lobed nuclei. Three distinctive types: neutrophils, eosinophils, basophils
Agranulocytes: cytoplasm contains small granules and nuclei that are not lobed. Two distinctive types: lymphocytes and monocytes
Platelets (thrombocytes). Cell fragment. Form platelet plugs, release chemicals necessary for blood clotting.

9. Production of Formed Elements
Hematopoiesis or hemopoiesis: Process of blood cell production
Stem cells: All formed elements derived from single population
Proerythroblasts: Develop into red blood cells
Myeloblasts: Develop into basophils, neutrophils, eosinophils
Lymphoblasts: Develop into lymphocytes
Monoblasts: Develop into monocytes
Megakaryoblasts: Develop into platelets

11. Hematopoiesis

12. Red Blood Cells
Found in higher concentration in male than in female plasma
Components
1/3 Hemoglobin
2/3 Lipids, ATP, carbonic anhydrase

13. RBC Function: Transport
Oxygen from lungs to tissues: 98.5% attached to hemoglobin; 1.5% dissolved in plasma
Carbon dioxide from tissues to lungs.
7% dissolved in plasma
23% in combination with hemoglobin
70% transported as bicarbonate ions produced as a result of combination of H2O and CO2 because of enzyme carbonic anhydrase found within RBCs

14. Hemoglobin Types of hemoglobin
Embryonic and fetal: have greater attraction for oxygen than adult. Fetal production stops after birth.
Adult
Oxyhemoglobin: transporting oxygen
Dexoyhemoglobin
Carbaminohemoglobin: transporting carbon dioxide

15. Hemoglobin Composition
Four globin molecules (polypeptide chains): Transport carbon dioxide (carbonic anhydrase involved), nitric oxide. NO brought from lungs to tissues, induces smooth muscles to relax, lowering BP.
Four heme molecules, each containing one iron atom: transport oxygen
Iron required for oxygen transport. Iron absorbed in upper small intestine; absorption increased by stomach acid and vitamin C. Iron lost in urine, feces, menstrual fluid.

16. Erythropoiesis RBCs last 120 days in circulation (enucleated)
Production of red blood cells
Stem cells → proerythroblasts → early erythroblasts → intermediate erythroblasts → late erythroblasts → reticulocytes
Erythropoietin: hormone stimulates RBC production; produced by kidneys in response to low blood O2 levels.

17. Hemoglobin Breakdown
Insert Process Fig with verbiage; Animation Hemoglobin Breakdown.exe and

18. White Blood Cells
Protect body against microorganisms and remove dead cells and debris
Movements
Ameboid: pseudopods
Diapedesis: cells become thin, elongate and move either between or through endothelial cells of capillaries
Chemotaxis: attraction to and movement toward foreign materials or damaged cells. Accumulation of dead white cells and bacteria is pus.

19. Neutrophils: after leaving bone marrow, stay in circulation hours then move into other tissues. Become motile, phagocytize bacteria, antigen-antibody complexes and other foreign matter. Secrete lysozyme. Last 1-2 days.
Eosinophils. Leave circulation and enter tissues during inflammatory response. Prevalent in allergic reactions. Destroy inflammatory chemicals like histamine. Release chemicals that help destroy tapeworms, flukes, pinworms, and hookworms.

20. Basophils: least common
Basophils: least common. Leave circulation and migrate through tissues, play a role in both inflammatory response and allergic reactions. Produce histamine and heparin.
Lymphocytes: produced in red bone marrow but then migrate to lymphatic tissues and proliferate. Responsible for antibody production. Studied extensively with the immune system.
Monocytes: remain in circulation for 3 days, leave circulation and become macrophages. Phagocytic cells. Can break down antigens and present them to lymphocytes for recognition.

21. Platelets
Cell fragments pinched off from megakaryocytes in red bone marrow
Surface glycoproteins and proteins allow adhesion to other molecules; i.e., collagen
Important in preventing blood loss
Platelet plugs
Promoting formation and contraction of clots

22. Hemostasis Arrest of bleeding Events preventing excessive blood loss
Vascular spasm: Vasoconstriction of damaged blood vessels. Can occlude small vessels. Caused by thromboxanes from platelets and endothelin from damaged endothelial cells.
Platelet plug formation
Coagulation or blood clotting

23. Platelet Plug Formation
Platelet adhesion. Occurs when von Willebrand factor connects collagen and platelets.
Platelet release reaction. The release of ADP, thromboxanes, and other chemicals that activate other platelets. They in turn undergo the release reaction: cascade effect.
Platelet aggregation. Activated platelets express surface receptors that bind fibrinogen (protein found in plasma). Fibrinogen forms a bridge between platelets: platelet plug.
Expression of coagulation factor V and phospholipids. Important for coagulation

24. Coagulation Stages Activation of prothrombinase
Conversion of prothrombin to thrombin
Conversion of fibrinogen to fibrin
Coagulation factors.
Proteins found in plasma.
Circulate in inactive state until tissues are injured.
Damaged tissues and platelets produce chemicals that begin activation of the factors.
Pathways
Extrinsic
Intrinsic
Result: blood clot. A network of threadlike fibrin fibers, trapped blood cells, platelets and fluid
Coagulation

26. Clot Formation

27. Extrinsic Clotting Pathway
Begins with chemicals outside of blood
Stage 1
Damaged tissues release tissue factor (TF; factor III)
When Ca2+ is present, forms complex with factor VII, activating factor X
Prothrombinase is formed
Stage 2: prothrombinase converts prothrombin into thrombin
Stage 3
Thrombin converts fibrinogen to fibrin
Thrombin activates factor XIII, which stabilizes clot

28. Intrinsic Clotting Pathway
Begins with chemicals that are part of the blood
Stage 1
In damaged blood vessels, factor XII comes in contact with exposed collagen, activating factor XII
Stimulates factor XI, activates factor IX
Activated factor IX joins with factor VIII, platelet phospholipids and Ca2+ to activate factor X
Prothrombinase is formed
Stages 2 and 3 progress to clot formation

29. Control of Clot Formation
Anticoagulants: prevent coagulation factors from initiating clot formation.
Coagulation occurs when coagulation factor concentration exceeds a given threshold. At site of injury, threshold is exceeded.
Anticoagulants
Antithrombin: produced by liver, slowly inactivates thrombin
Heparin: produced by basophils and endothelial cells. Increases effectiveness of antithrombin
Prostacyclin: prostaglandin derivate from endothelial cells. Causes vasodilation and inhibits release of coagulating factors from platelets

30. Fibrinolysis
Clot retraction. Fibrin threads of clot attached to blood vessel walls. Platelets produce processes that attach to fibrin threads. Actin and myosin molecules within platelets contract, pulling edges of wound together and squeezing out serum.
Clot dissolved by activity of plasmin, an enzyme which hydrolyzes fibrin

31. Blood Grouping
Transfusion: transfer of blood or blood components from one individual to another
Infusion: introduction of fluid other than blood
Determined by antigens (agglutinogens) on surface of RBCs
Antibodies (agglutinins) can bind to RBC antigens, resulting in agglutination (clumping) or hemolysis (rupture) of RBCs
Groups: ABO and Rh

32. ABO Blood Groups

33. Agglutination Reaction

34. Transfusion
Type A blood has anti-B antibodies; Type B blood has anti-A antibodies
Suggested that these antibodies are present because of exposure to A and B antigens on bacteria and food
Donor: gives blood. Recipient: receives blood
Type O as “universal donor”. Can actually cause transfusion reactions because of antibodies in O blood plasma

35. Rh Blood Group First studied in rhesus monkeys Types
Rh positive: Have these antigens present on surface of RBCs
Rh negative: Do not have these antigens present
Hemolytic disease of the newborn (HDN)
Rh positive fetus, Rh negative mother.
Late in pregnancy, Rh antigens of fetus cross placenta (through a tear in placenta or during delivery); mother creates antiRh antibodies (primary response)
Second Rh positive pregnancy might initiate secondary response and HDN (potentially fatal to fetus since antibodies to its RBCs would cross the placenta from the mother to the fetus, destroying fetal RBCs).
Injection of RhoGAM. Contains antibodies against Rh antigens. Antibodies attach to any fetal RBCs and they are destroyed.

36. Erythroblastosis Fetalis

37. Diagnostic Blood Tests
Type and Crossmatch: determination of ABO and Rh blood types. Red cells tested against antibodies
Complete Blood Count
Red Blood Count: number of RBCs/ microliter of blood
Hemoglobin Measurement: grams of hemoglobin/100 mL of blood. For a male, 14-18, female g/100 mL
Hematocrit Measurement: percent of blood that is RBCs
White Blood Cell Count: 5,000-10,000 /microliter of blood

38. Hematocrit

39. Differential White Blood Count: determines percentage of each of the five types of WBC
Neutrophils: 60-70%
Lymphocytes: 20-30%
Monocytes: 2-8%
Eosinophils: 1-4%
Basophils: 0.5-1%
Clotting
Platelet Count: 250, ,000/microliter
Prothrombin Time Measurement: measures how long it takes for blood to start clotting seconds. To test, thromboplastin is added to whole plasma
Blood Chemistry: composition of materials dissolved or suspended in the plasma. Used to assess functioning of many body systems