The cardiovascular (CV) system consist of

● A pump (heart)
● A conducting system (blood vessel)
● A fluid medium (blood)
○ Type of connective tissue has cells suspended in a fluid matrix.

Blood:
● transports materials to and from cells
○ O2 and CO2
○ nutrients
○ hormones
○ immune system components i.e antibodies
○ waste products

Important Functions of Blood:

● transportation of dissolved substances
● regulation of pH and ions
● restriction of fluid losses at injury sites
● defense against toxins and pathogens
● stabilization of body temp.

Whole Blood pg. 640-641

1. plasma: water, dissolved proteins, and other solutes
2. formed elements: RBC’s, WBC’s, platelets
a. Red blood cells: a.k.a erythrocytes
i. transports oxygen
b. White blood cells: a.k.a leukocytes
i. part of immune system
c. Platelets:
i. cell fragments involved in blood clotting

Hemopoiesis (hematopoiesis)
● process of producing formed elements
● carried out by myeloid & lymphoid stem cells
○ ^myeloid: make granulocytes, monocytes, erythrocytes & platelets
○ ^lymphoid: give rise to B cells & T cells
Fractionation
● process of separating (into plasma & formed elements) whole blood for clinical analysis

General characteristics of blood

● Normal temperature = 38 Celsius OR 100.4 Fahrenheit
 ● viscosity is 3-4 times that of water
● pH is slightly alkaline (7.35-7.45)
● blood volume is liters = 7% of your body weight in kg
○ adult MALE: 5.6 liters
○ adult FEMALE: 4.5 liters
Plasma
● 50-60% of blood volume
● over 90% water
● plasma & interstitial fluid exchange materials across capillary walls
○ ex: water, ions, small solutes
Plasma proteins (60%)
● albumins make up 60% of plasma proteins
○ important for osmotic pressure of blood
○ fxn as transport molecules for fatty acid, thyroid hormones & steroid hormone
● Globulins (35%)
○ include antibodies → immunoglobulins: function as transport molecules
○ fxn as transport molecules
● Fibrinogen (4%)
○ for clotting
○ combine to form fibrin (process called coagulation)
● Other plasma proteins (1%)
○ variable depending on person
○ mostly peptide hormones (insulin, PRL, TSH , FSH, LH)

Serum
● liquid part of a blood sample which fibrinogen converts to solid fibrin → discard
● can be used to replace a person’s liquid

Origin of plasma protein

● >90% are made in liver
● antibodies made by B cells plasma
● peptide hormones are made by endocrine organs

Red Blood Cells

● make up 99.9% of bloods’ formed elements

Hemoglobin
 ● red pigment that gives whole blood its color
● binds & transports O2 & CO2
(iron makes blood red)

Abundance of RBCs
● Hemocrit (packed cell volume)
○ the percentage of centrifuged whole blood that is RBCs
● MALE: 40-54% (male hormones [androgens] stimulate RBC production)
● FEMALE: 37-47%

Structure of RBCs
● small & highly specialized discs
● thin in middle & thicker at edge
● high surface to volume ratio
○ for quick absorbing & releasing of oxygen
● discs form stacks (rouleaux; roo-Lo)
○ for smooth flow through small blood vessels
○ 7.8 μm RBC passes through a 4 μmcapillary

Lifespan of RBC
● lack nuclei, mitochondria and ribosomes
● can’t repair themselves, only utilize anaerobic metabolism
● live about 120 days

Hemoglobin (Hb)
● protein molecule that transports respiratory gases
● complex quaternary structure
● 4 globular protein subunits
○ each with a heme molecule
○ heme: each contains 1 iron ion
● iron ions associate easily with oxygen (HbO2 ; oxyhemoglobin)
● dissociate easily from oxygen (deoxyhemoglobin)
● Fetal hemoglobin binds oxygen more strongly to take oxygen from mother Hb

Hemoglobin fxns
● carries oxygen
● in low oxygen condition (such as peripheral capillaries) Hb releases oxygen
● binds with CO2 & carries it to lungs
 ○ this bond causes carbainohemoglobin

RBC Formation & Turnover - p. 647

● 1% of circulating RBCs wear out per day
○ 3 million RBC per second
● macrophages in liver, spleen & bone marrow engulf old RBCs so that hemoglobin can
be recycled.

Heme broken down into

● Amino Acids
○ Biliverdin (green)
■ Bilirubin (yellow)
● made into bile by liver & excreted
● Iron
○ gets transported by transferrin to protein-iron storage molecules in bone marrow
■ transferrin: a plasma transport protein
Jaundice: caused by bilirubin buildup in tissues

RBC Production
● erythropoiesis in myeloid tissue (red bone marrow)
○ myeloid tissue: has stem cells that mature to become RBCs

Hemocytoblasts
-Stem cells in myeloid tissue, divide to become:
1. myeloid stem cells → become RBCs and WBCs
2. lymphoid stem cells → become lymphocytes (B cells and T cells)

Stages of RBC maturation pg. 648

● Day 1: proerythroblast
● Day 4: normoblast → ejection of nucleus
● Day 5-7: reticulocyte (enters bloodstream)
Building RBCs:
● Requires:
○ Amino Acids
○ Iron
○ Vitamins B12, B6, and Folic Acid
Pernicious Anemia: decreased RBC production due to lack of B12

Erythropoietin (EPO) A.K.A → erythropoiesis stimulating hormone

● secreted when O2 in peripheral tissues is low
○ hypoxia, could be due to high altitude
blood pg. 651
ABO Blood Type: blood O is universal blood donor
● just remember, plasma antibodies attack and agglutinate foreign antibodies
○ cross rxns in transfusions. aka. transfusion rxn: blood will agglutinate and
hemolyze (burst)
● Rh Factor: (discovered in rhesus monkeys)
○ also called the D antigen
○ you're either Rh positive or Rh negative
■ most people are Rh positive
○ only sensitized Rh negative blood has anti Rh antibodies.
understand the pregnancy situation p. 654 - 655

White Blood Cells (WBCs) AKA Leukocytes

● no hemoglobin; have nuclei and other organelles
Function:
1. Defend against pathogens
2. Remove toxins and wastes
3. Attack abnormal cells
WBC circulation and movement:
● most WBCs in connective tissue proper
● and in lymphatic system organs
● small numbers in blood

Four characteristics of circulating WBCs

1. can migrate out of blood stream
2. have amoeboid movement
3. attracted to chemical stimuli (chemotaxis)
4. some are phagocytic → neutrophils, eosinophils, and monocytes

Type of WBCs:
1. neutrophils: lobed nucleus that may resemble a string of beads
a. 50% -70% of circulating WBC’s
 b. very active; first to attack bacteria
c. engulf and digest pathogens (form pus)
d. degranulation (releasing the chemicals from themselves)
i. releasing the granules from cytoplasm
e. neutrophils release several substances including defensins: lysosomal enzymes
for attacking pathogen
i. also release prostaglandins → has many fxns including
regulating inflammation
2. eosinophils: nucleus in 2 lobes
a. 2-4% circulating WBC’s
b. attack large parasites
c. excrete toxic compounds (to fight the pathogens)
d. control inflammation w/ enzymes that counteract the effects of neutrophils and
most cells.
3. basophils: nucleus cannot be seen through dense granules
a. less than 1% of circulating WBCs
b. accumulate in damaged tissue
c. release histamine - dilates blood vessels
d. release heparin - prevents blood clotting
4. monocytes:
a. 2-8% of circulating WBC’s
b. large and spherical
c. enter peripheral tissues and become macrophages
d. engulf large particles and pathogens
i. secrete substances that attack immune cells to the injured area
5. lymphocytes: only slightly larger than RBCs
a. large nucleus w/ very little cytoplasm
b. 20-30% of circulating WBC’s
c. migrate in and out of blood
d. found mostly in connective tissues and lymph organs
e. part of the specific defense system → remember specific passages to avoid
pathogen
3 Classes of Lymphocytes:
1. T-Cells: cell mediated immunity attack foreign cells directly
2. B-Cells: humoral immunity differentiate into plasma cells → synthesize antibodies
3. Natural Killer (NK cells): Detect and destroy abnormal tissue cells (cancers)
WBC Production p. 659
● All blood cells originate from hemocytoblasts
● Hemocytoblasts differentiate into myeloid and lymphoid stem cells
○ myeloid stem cells: produce all WBCs except lymphocytes
○ lymphoid stem cells: responsible for lymphopoiesis → production of
lymphocytes
WBC Development:
● WBCs develop fully in bone marrow (except monocytes) which develop into
macrophages in peripheral tissue

Platelets:
● cell fragments involved in clotting (non mammalian vertebrates have nucleated
thrombocytes)
● circulate for 9-12 days
● removed by the spleen
● at any moment, ⅓ are in spleen and other organs (not in blood) to be mobilized in case
of bleeding emergency

Diseases pg. 660

● thrombocytopenia: abnormally low platelet count
● thrombocytosis: abnormally high platelet count
Functions of Platelets:
1. Release important clotting chemicals
2. Temporarily patch damaged vessel walls
3. Reduce the size of a break in vessel walls

Platelet Production: aka Thrombocytopoiesis

● occurs in the bone marrow
● megakaryocytes pg. 659: giant cells in bone marrow
○ manufacture platelets from cytoplasm
○ 1 megakaryocyte makes 4,000 platelets before it's broken down
Hormonal Control:
● thrombopoietin (TPO) → made in kidneys
○ stimulates production of megakaryocytes and accelerates platelet production
● multi CST (colony stimulating factor)
○ promotes production of megakaryocytes
Hemostasis = the cessation of bleeding
3 Phases:
1. vascular phase
2. platelet phase
3. coagulating phase

1. Vascular phase: a cut triggers a vascular spasm that lasts 30 minutes

3 Steps
a. endothelial cells contract and expose the basement membrane to the
bloodstream
b. endothelial cells release local hormones called endothelins → stimulate
smooth muscle contraction and stimulate cell division (for repair)
c. endothelial cells become “sticky”
i. stick to each other to help repair small capillaries
ii. also stick to platelets
2. Platelet Phase: Begins within 15 seconds after injury
a. Platelet adhesion
i. to sticky endothelial surfaces
ii. to basement membranes
iii. to exposed collagen fibers
b. Platelet Aggregation
i. They stick together to form a platelet plug: which closes small breaks
c. Platelets release a variety of clotting compounds that speed up aggregation and
other repair processes.
d. Limiting the platelet plug is accomplished by
i. several compounds; prostaglandins: A prostaglandin released by
endothelial cells that inhibits platelet aggregation
ii. the development of the blood clot eventually reinforces the platelet plug
but also isolates it from general circulation, so the clotting factors can’t
continue feeding the positive feedback loop.
3. Coagulation Phase: Begins 30 seconds or more after the injury
a. coagulation = blood clotting
b. CASCADE RXN → chain rxn of enzymes & proenzymes

3 Pathways → convert circulating fibrinogen into insoluble fibrin.

1. Extrinsic Pathway:
a. begins in vessel wall outside bloodstream
b. damaged cells release tissue factor (TF)
 c. TF helps activate Factor X (Factory 10) → aka Sturart Prower factor
i. Factor X:
1. made by liver (requires vitamin K)
2. helps create enzyme that makes thrombin from prothrombin
a. thrombin: enzyme that converts fibrinogen to fibrin
2. Intrinsic Pathway:
a. begins with circulating proenzymes in bloodstream
b. exposed collagen activates enzymes that combine with platelet chemicals which
activates Factor X
3. Common Pathway
a. where intrinsic & extrinsic pathways converge
b. either one of them makes Factor X
c. Factor X activates prothrombinase which converts prothrombin to thrombin
d. Thrombin converts fibrinogen to fibrin

Anticoagulants
● Anticoagulant 3: enzyme present in plasma
● Heparin:
○ released by basophils & mast cells
○ accelerates activation of antithrombin 3
○ used clinically to inhibit clotting
● Aspirin
○ inhibits platelet aggregation

Calcium & Vitamin K

● all 3 coagulation pathways require Calcium ions, so low blood calcium levels = impaired
clotting
● liver needs Vitamin K to make several clotting factors including prothrombin & Factor X
○ Vitamin K:
■ found in green vegetables, grains & organ meat
■ is absorbed with dietary lipids
■ about half of our Vitamin K is manufactured by bacteria in large intestine
■ prolonged use of antibiotics → Vitamin K deficiency

Clot Retraction (aka Syneresis)

● at end of coagulation phase, RBCs & additional platelets get stuck & entangled in tangle
of fibrin
 ● platelets then contract over next 30-60 minutes
● this pulls torn edges of vessel closer together
○ reduces bleeding
○ easier to repair the smooth muscle, endothelium etc

Fibrinolysis
● dissolving of the clot
● carried out by an enzyme called plasmin, which digests fibrin strands