1. Copyright © 2012, 2007, 2003, 1997, 1991 by Mosby, Inc., an affiliate of Elsevier Inc.1 CHAPTER 12 CIRCULATORY SYSTEM

2. Copyright © 2012, 2007, 2003, 1997, 1991 by Mosby, Inc., an affiliate of Elsevier Inc.2 Chapter 12 Learning Objectives  Define at least 10 terms relating to the circulatory system.  Describe two functions of the circulatory system.  List five functions of blood.

3. Copyright © 2012, 2007, 2003, 1997, 1991 by Mosby, Inc., an affiliate of Elsevier Inc.3 Chapter 12 Learning Objectives  Describe the function of lymph.  Identify at least three methods of assessment of the circulatory system.  Describe at least five disorders of the circulatory system.

4. Copyright © 2012, 2007, 2003, 1997, 1991 by Mosby, Inc., an affiliate of Elsevier Inc.4 Structure and Function  Structure of the circulatory system  Includes the blood and lymph that move throughout the body  Function of the circulatory system  Blood and lymph are tissues that maintain homeostasis and provide immunity.

5. Copyright © 2012, 2007, 2003, 1997, 1991 by Mosby, Inc., an affiliate of Elsevier Inc.5 Blood  The body contains approximately 4 to 5 liters of blood, making up about 8% of the body’s weight.  Functions  Transporting nutrients, oxygen, and hormones  Removing metabolic wastes and carbon dioxide  Providing immunity with antibodies  Maintaining body temperature and electrolyte balance  Clotting to prevent bleeding from a wound

6. Copyright © 2012, 2007, 2003, 1997, 1991 by Mosby, Inc., an affiliate of Elsevier Inc.6 Hematocrit FIGURE 12-1 Hematocrit.

7. Copyright © 2012, 2007, 2003, 1997, 1991 by Mosby, Inc., an affiliate of Elsevier Inc.7 Red Blood Cells (Erythrocytes)  Erythrocytes contain a protein called hemoglobin that carries oxygen to all cells and removes carbon dioxide.  Each red blood cell lives 90 to 120 days.  New cells are manufactured by the red marrow or myeloid tissue in bones.  Hemopoiesis (hematopoiesis) is the process by which a few million new blood cells are made each second.  The liver and spleen remove dead red blood cells and reuse the material.

8. Copyright © 2012, 2007, 2003, 1997, 1991 by Mosby, Inc., an affiliate of Elsevier Inc.8 Erythrocytes Circulating in the Blood FIGURE 12-2 Erythrocytes circulating in the blood. (Courtesy Ward’s Natural Science Establishment, Rochester, N.Y.)

9. Copyright © 2012, 2007, 2003, 1997, 1991 by Mosby, Inc., an affiliate of Elsevier Inc.9 White Blood Cells (Leukocytes)  White blood cells  Remove foreign particles  Fight infection  Help prevent disease  There are fewer white blood cells than red  White blood cells are larger than red  Leukocytes live about 9 days

10. Copyright © 2012, 2007, 2003, 1997, 1991 by Mosby, Inc., an affiliate of Elsevier Inc.10 Five Types of White Blood Cells  Neutrophils  Basophils  Eosinophils  Lymphocytes  Monocytes

11. Copyright © 2012, 2007, 2003, 1997, 1991 by Mosby, Inc., an affiliate of Elsevier Inc.11 Formed Elements of Blood

12. Copyright © 2012, 2007, 2003, 1997, 1991 by Mosby, Inc., an affiliate of Elsevier Inc.12 Platelets (Thrombocytes)  Smallest blood cells  Promote clotting to prevent blood loss  Can form a plug to seal small vessels by themselves or start the clotting process  Produced in red bone marrow  Live about 5 to 9 days

13. Copyright © 2012, 2007, 2003, 1997, 1991 by Mosby, Inc., an affiliate of Elsevier Inc.13 Plasma  Plasma is a pale yellow liquid that remains when elements are removed from blood.  Whole blood is 55% plasma.  Plasma is 90% water and approximately 10% proteins.  Plasma helps to fight infection and assists in the clotting (coagulation) of blood.  Serum is plasma without the clotting proteins.

14. Copyright © 2012, 2007, 2003, 1997, 1991 by Mosby, Inc., an affiliate of Elsevier Inc.14 Plasma  Plasma contains  Nutrients  Electrolytes  Oxygen  Enzymes  Hormones  Wastes

15. Copyright © 2012, 2007, 2003, 1997, 1991 by Mosby, Inc., an affiliate of Elsevier Inc.15 Blood Typing  A person’s blood type is an inherited characteristic.  A blood type is determined by the antigens located on the surface of the red blood cell.  Clumping of incompatible cells blocks blood vessels and may cause death.

16. Copyright © 2012, 2007, 2003, 1997, 1991 by Mosby, Inc., an affiliate of Elsevier Inc.16 Blood Typing  Four main blood types  A  B  AB (universal recipient) Person with AB can safely receive any type of blood. Person with AB can safely receive any type of blood.  O (universal donor) Blood can safely be given to a person with any blood type. Blood can safely be given to a person with any blood type.

17. Copyright © 2012, 2007, 2003, 1997, 1991 by Mosby, Inc., an affiliate of Elsevier Inc.17 Blood Types

18. Copyright © 2012, 2007, 2003, 1997, 1991 by Mosby, Inc., an affiliate of Elsevier Inc.18 Approximate Distribution of Blood Types in the U.S. Population

19. Copyright © 2012, 2007, 2003, 1997, 1991 by Mosby, Inc., an affiliate of Elsevier Inc.19 Blood Typing  Rh factor  Antigen  Found in red blood cells  Among North Americans, 85% have Rh-positive blood.  Giving Rh-positive blood to a person with Rh- negative blood can be fatal. Considered a foreign particle to the Rh person’s blood and recipient tries to combat it by forming antibodies Considered a foreign particle to the Rh person’s blood and recipient tries to combat it by forming antibodies  Rh factor is important in an Rh-negative mother having a second Rh-positive baby.

20. Copyright © 2012, 2007, 2003, 1997, 1991 by Mosby, Inc., an affiliate of Elsevier Inc.20 Erythroblastosis Fetalis FIGURE 12-3 In erythroblastosis fetalis, an Rh- (Rh negative) mother may form antibodies against the Rh+ blood of a fetus. That infant is not harmed, but when a second Rh+ (Rh positive) fetus is formed, the mother’s antibodies will attack the unborn baby’s blood. (From Patton KT, Thibodeau GA: Anatomy & physiology, ed 7, St. Louis, 2010, Mosby.)

21. Copyright © 2012, 2007, 2003, 1997, 1991 by Mosby, Inc., an affiliate of Elsevier Inc.21 Lymph and Lymphatic Tissue  Two important functions  Providing immunity  Maintaining the body’s fluid balance  Lymph is a watery substance formed from fluid that filters into body tissue or resides interstitially.  Lymphatic tissues consist of the tonsils, thymus, spleen, nodes, and lymph vessels.

22. Copyright © 2012, 2007, 2003, 1997, 1991 by Mosby, Inc., an affiliate of Elsevier Inc.22 Lymph Vessels and Nodes FIGURE 12-4 Lymph vessels and nodes. (From Fritz S: Mosby’s fundamentals of therapeutic massage, ed 4, St. Louis, 2008, Mosby.)

23. Copyright © 2012, 2007, 2003, 1997, 1991 by Mosby, Inc., an affiliate of Elsevier Inc.23 Immunity  Two forms of immune response  Barrier provided by the skin, mucous membranes, tears, and leukocytes  Antibodies formed by leukocytes in response to antigens or foreign materials that enter the body  May be a localized or systemic reaction  Acquired and inherited types of immunity

24. Copyright © 2012, 2007, 2003, 1997, 1991 by Mosby, Inc., an affiliate of Elsevier Inc.24 Assessment Techniques  Hemoglobin (Hgb) test measures the amount of oxygen-carrying ability of the blood.  Hematocrit (Hct) measures the volume of erythrocytes in the blood.  Sedimentation rates measure how long erythrocytes in the blood take to settle to the bottom of a container.  Reticulocyte studies measure the number of immature red blood cells.

25. Copyright © 2012, 2007, 2003, 1997, 1991 by Mosby, Inc., an affiliate of Elsevier Inc.25 Assessment Techniques  Red blood cell (RBC) counts determine the number of circulating red blood cells in 1 mm 3 of blood.  Platelet or thrombocyte counts measure the number of platelets in 1 mm 3 of blood to determine clotting ability.  Aspiration biopsy cytology (ABC) studies examine bone marrow from the iliac crest of the hip.

26. Copyright © 2012, 2007, 2003, 1997, 1991 by Mosby, Inc., an affiliate of Elsevier Inc.26 Disorders of the Circulatory System  Acquired immunodeficiency syndrome (AIDS)  Dysfunction of the immune system caused by a virus  Allergy  Hypersensitive response by the immune system to an outside substance  Anemia  Blood has an inadequate amount of hemoglobin or red blood cells, or both.

27. Copyright © 2012, 2007, 2003, 1997, 1991 by Mosby, Inc., an affiliate of Elsevier Inc.27 Disorders of the Circulatory System  Autoimmune  Conditions in which the immune system of the body turns against itself  Elephantiasis  Massive accumulation of lymphatic fluid in body tissues, causing an abnormally large growth of tissue or hypertrophy  Erythroblastosis fetalis  Condition in which the mother forms antibodies against the antigens in the unborn baby’s blood

28. Copyright © 2012, 2007, 2003, 1997, 1991 by Mosby, Inc., an affiliate of Elsevier Inc.28 Elephantiasis FIGURE 12-5 Swelling from Filaria worms in elephantiasis may require surgery to remove the extra tissue. (From Patton KT, Thibodeau GA: Anatomy & physiology, ed 7, St. Louis, 2010, Mosby.)

29. Copyright © 2012, 2007, 2003, 1997, 1991 by Mosby, Inc., an affiliate of Elsevier Inc.29 Disorders of the Circulatory System  Hemophilia  Rare, sex-linked genetic disease in which the blood is missing a clotting factor  Hepatitis  Viral infection of the blood  Hodgkin’s disease  Malignant cancer of the lymph system

30. Copyright © 2012, 2007, 2003, 1997, 1991 by Mosby, Inc., an affiliate of Elsevier Inc.30 Autoimmune or Autoimmune-Related Disorders

31. Copyright © 2012, 2007, 2003, 1997, 1991 by Mosby, Inc., an affiliate of Elsevier Inc.31 Heptatitis

32. Copyright © 2012, 2007, 2003, 1997, 1991 by Mosby, Inc., an affiliate of Elsevier Inc.32 Disorders of the Circulatory System  Leukemia  Also called blood cancer, it is an abnormal malignant increase in the number and longevity of white blood cells.  Lymphosarcoma  It is a group of malignant cancers of lymph tissues other than Hodgkin's disease.  Polycythemia  An abnormal increase in the number of blood cells makes the blood thicker and slower flowing.

33. Copyright © 2012, 2007, 2003, 1997, 1991 by Mosby, Inc., an affiliate of Elsevier Inc.33 Disorders of the Circulatory System  Septicemia  Also called blood poisoning, it is an infection that occurs when pathogens enter the blood.  Sickle cell anemia  The genetic condition results in malformed red blood cells.  Splenomegaly  An enlargement of the spleen is caused by an acute infection such as mononucleosis or anemia.

34. Copyright © 2012, 2007, 2003, 1997, 1991 by Mosby, Inc., an affiliate of Elsevier Inc.34 Disorders of the Circulatory System  Thalassemia  One of the most common genetic blood disorders  Thrombocytopenia  Decrease in the number of platelets in the blood  Thrombosis  Condition in which a blood clot, called a thrombus, forms in the blood vessels

35. Copyright © 2012, 2007, 2003, 1997, 1991 by Mosby, Inc., an affiliate of Elsevier Inc.35Embolus FIGURE 12-6 Development of an embolus.

36. Copyright © 2012, 2007, 2003, 1997, 1991 by Mosby, Inc., an affiliate of Elsevier Inc.36 Deep Vein Thrombosis (DVT) FIGURE 12-7 A, Deep vein thrombosis (DVT) causes swelling of the leg. B, An embolus from a DVT blocks blood flow in the pulmonary artery. (From Patton KT, Thibodeau GA: Anatomy & physiology, ed 7, St. Louis, 2010, Mosby.)

37. Copyright © 2012, 2007, 2003, 1997, 1991 by Mosby, Inc., an affiliate of Elsevier Inc.37 Issues and Innovations  Transfusion  New methods developed to minimize risks  Autologous transfusions Collection and transfusion of a person’s own blood Collection and transfusion of a person’s own blood Prevents complications of blood transfusion, risk of disease transmission and tissue rejection Prevents complications of blood transfusion, risk of disease transmission and tissue rejection  Platelet donations Donated through a process called apheresis Donated through a process called apheresis Used for patients undergoing Used for patients undergoing  Bone marrow transplantation  Organ transplantation  Chemotherapy  Radiation therapy

38. Copyright © 2012, 2007, 2003, 1997, 1991 by Mosby, Inc., an affiliate of Elsevier Inc.38 Issues and Innovations  Interferon  Protein that prevents a virus from reproducing Made in the body by T lymphocytes (WBCs) Made in the body by T lymphocytes (WBCs)  Three versions Alpha interferon – used to treat hairy cell leukemia, malignant melanoma, and Kaposi sarcoma Alpha interferon – used to treat hairy cell leukemia, malignant melanoma, and Kaposi sarcoma Beta interferon – used to treat relapsing multiple sclerosis and genital warts Beta interferon – used to treat relapsing multiple sclerosis and genital warts Gamma interferon – used to treat infections Gamma interferon – used to treat infections

39. Copyright © 2012, 2007, 2003, 1997, 1991 by Mosby, Inc., an affiliate of Elsevier Inc.39 Issues and Innovations  Monoclonal antibodies  Proteins have unique abilities in the blood. Can be harvested and fused to new cells in laboratory tissue cultures Can be harvested and fused to new cells in laboratory tissue cultures Used in treating some cancers and some viruses Used in treating some cancers and some viruses Used in organ transplantation to prevent rejection Used in organ transplantation to prevent rejection Used to slow the progress of autoimmune diseases Used to slow the progress of autoimmune diseases Help diagnosis of malignant tumors, leukemia, and some sexually transmitted infections Help diagnosis of malignant tumors, leukemia, and some sexually transmitted infections Researching use in treating circulatory system disorders Researching use in treating circulatory system disorders

40. Copyright © 2012, 2007, 2003, 1997, 1991 by Mosby, Inc., an affiliate of Elsevier Inc.40 Summary  Two functions of the circulatory system  Maintain homeostasis  Provide immunity for the body  Functions of the blood  Transport nutrients, gases, hormones, and wastes  Provide immunity  Maintain body temperature and electrolyte balance  Prevent blood loss by clotting

41. Copyright © 2012, 2007, 2003, 1997, 1991 by Mosby, Inc., an affiliate of Elsevier Inc.41 Summary  The function of lymph is to maintain fluid balance and provide immunity.  Assessments of the circulatory system  Blood surveys such as hemoglobin levels, hematocrit levels, and sedimentation rates  Bone marrow may be examined by using an aspiration biopsy.

42. Copyright © 2012, 2007, 2003, 1997, 1991 by Mosby, Inc., an affiliate of Elsevier Inc.42 Summary  Disorders of the circulatory system  Allergies  Anemia  Elephantiasis  Hemophilia  Hepatitis