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Old Wednesday, July 11, 2007
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Default Topic # 11

circulatory system





circulatory system, group of organs that transport blood and the substances it carries to and from all parts of the body. The circulatory system can be considered as composed of two parts: the systemic circulation, which serves the body as a whole except for the lungs, and the pulmonary circulation, which carries the blood to and from the lungs. The organs of circulatory system consist of vessels that carry the blood and a muscular pump, the heart, that drives the blood.

Of the vessels, the arteries carry blood away from the heart; the main arterial vessel, the aorta, branches into smaller arteries, which in turn branch repeatedly into still smaller vessels and reach all parts of the body. Within the body tissues, the vessels are microscopic capillaries through which gas and nutrient exchange occurs . Blood leaving the tissue capillaries enters converging vessels, the veins, to return to the heart and lungs. The human heart is a four-chambered organ with a dividing wall, or septum, that separates it into a right heart for pumping blood from the returning veins into the lungs and a left heart for pumping blood from the lungs to the body via the aorta.

An auxiliary system, the lymphatic system, is composed of vessels that collect lymph from body tissues. Carried to converging vessels of increasing size, the lymph enters the thoracic duct and is emptied into a large vein near the heart.



artery

artery, blood vessel that conveys blood away from the heart. Except for the pulmonary artery, which carries deoxygenated blood from the heart to the lungs, arteries carry oxygenated blood from the heart to the tissues. The largest arterial trunk is the aorta, branches of which divide and subdivide into ever-smaller tubes, or arterioles, until they terminate as minute capillaries, the latter connecting with the veins. Other important arteries are the subclavian and brachial arteries of the shoulder and arm, the carotid arteries that lead to the head, the coronary arteries that nourish the heart itself, and the iliac and femoral arteries of the abdomen and lower extremities. The walls of the large arteries have three layers: a tough elastic outer coat, a layer of muscular tissue, and a smooth, thin inner coat. Arterial walls expand and contract with each heartbeat, pumping blood throughout the body. The pulsating movement of blood, or pulse, may be felt where the large arteries lie near the body surface.


capillary

microscopic blood vessel, smallest unit of the circulatory system. Capillaries form a network of tiny tubes throughout the body, connecting arterioles (smallest arteries) and venules (smallest veins). Through the thin capillary walls, which are composed of a single layer of cells, the nutritive material and oxygen in the blood pass into the body tissues, and waste matter and carbon dioxide in turn are absorbed from the tissues into the bloodstream.



vein

vein, blood vessel that returns blood to the heart. Except for the pulmonary vein, which carries oxygenated blood from the lungs to the heart, veins carry deoxygenated blood. The oxygen-depleted blood passes from the capillaries to the venules (small veins). The venules feed into larger veins, which eventually merge into the superior and inferior vena cavae, large vessels that consolidate the blood flow from the head, neck, and arms and from the trunk and legs, respectively (see also circulatory system). The vena cavae direct the blood back into the heart. The walls of a vein are formed of three layers like the walls of an artery. However, these layers are thinner and less muscular and collapse when empty. With such notable exceptions as the portal system, most veins contain valves, formed by pouches in their inner coats, that keep the blood from flowing backward. Valves are most numerous in the veins of the extremities, and are absent in the smallest veins. Veins are subject to inflammation, dilatation or enlargement (as in a varicose vein), rupture, and blockage by blood clots (thrombosis).




Systemic Circulation


In the systemic circulation, which serves the body except for the lungs, oxygenated blood from the lungs returns to the heart from two pairs of pulmonary veins, a pair from each lung. It enters the left atrium, which contracts when filled, sending blood into the left ventricle (a large percentage of blood also enters the ventricle passively, without atrial contraction). The bicuspid, or mitral, valve controls blood flow into the ventricle. Contraction of the powerful ventricle forces the blood under great pressure into the aortic arch and on into the aorta. The coronary arteries stem from the aortic root and nourish the heart muscle itself. Three major arteries originate from the aortic arch, supplying blood to the head, neck, and arms. The other major arteries originating from the aorta are the renal arteries, which supply the kidneys; the celiac axis and superior and inferior mesenteric arteries, which supply the intestines, spleen, and liver; and the iliac arteries, which branch out to the lower trunk and become the femoral and popliteal arteries of the thighs and legs, respectively. The arterial walls are partially composed of fibromuscular tissue, which help to regulate blood pressure and flow. In addition, a system of shunts allows blood to bypass the capillary beds and helps to regulate body temperature.

At the far end of the network, the capillaries converge to form venules, which in turn form veins. The inferior vena cava returns blood to the heart from the legs and trunk; it is supplied by the iliac veins from the legs, the hepatic veins from the liver, and the renal veins from the kidneys. The subclavian veins, draining the arms, and the jugular veins, draining the head and neck, join to form the superior vena cava. The two vena cavae, together with the coronary veins, return blood low in oxygen and high in carbon dioxide to the right atrium of the heart.



blood pressure

blood pressure, force exerted by the blood upon the walls of the arteries. The pressure in the arteries originates in the pumping action of the heart, and pressure waves can be felt at the wrist and at other points where arteries lie near the surface of the body. Since the heart can pump blood into the large arteries more quickly than it can be absorbed and released by the tiny arterioles and capillaries, considerable inner pressure always exists in the arteries. The contraction of the heart (systole) causes the blood pressure to rise to its highest point, and relaxation of the heart (diastole) brings the pressure down to its lowest point.

Blood pressure is strongest in the aorta, where the blood leaves the heart. It diminishes progressively in the smaller blood vessels and reaches its lowest point in the veins. Blood pressure manifests itself dramatically when an artery is severed or pierced and the blood (under pressure) ejects in spurts.

Since blood pressure varies in different arteries, the pressure in the brachial artery of the forearm serves as a standard. A sphygmomanometer measures blood pressure in millimeters of mercury; blood pressure gauges that do not use mercury also produce readings that are expressed in terms of millimeters of mercury. Normal blood pressure readings for healthy young people should be below 120 mm for systolic pressure and 80 mm for diastolic pressure, commonly written as 120/80 and read as “one-twenty over eighty.” With age, and the constriction of the small arteries and then the larger ones, blood pressure increases, so that at 50 years, a person may typically have a systolic pressure between 140 and 150, and a diastolic pressure of about 90.

Factors other than heart action and the condition of the arteries also influence blood pressure. Temporary high blood pressure usually occurs during or following physical activity, nervous strain, and periods of rage or fear. Therapy for persistent high blood pressure, sometimes called hypertension, consists of sufficient rest, a diet low in salt and alcohol, reduction in weight where there is obesity, and increased exercise. Drug therapy may include diuretics, beta-blockers, calcium-channel blockers, or ACE inhibitors. Low blood pressure (hypotension) has not been studied as extensively as high blood pressure. If not caused by disease or injury, it is generally considered to be a benign or even advantageous condition; however, studies have linked hypotension with feelings of tiredness or faintness and minor psychiatric conditions in some people.




Pulmonary Circulation


The pulmonary circulation carries the blood to and from the lungs. In the heart, the blood flows from the right atrium into the right ventricle; the tricuspid valve prevents backflow from ventricles to atria. The right ventricle contracts to force blood into the lungs through the pulmonary arteries. In the lungs oxygen is picked up and carbon dioxide eliminated, and the oxygenated blood returns to the heart via the pulmonary veins, thus completing the circuit. In pulmonary circulation, the arteries carry oxygen-poor blood, and the veins bear oxygen-rich blood.



The Body's Filtering System




The organs most intimately related to the substances carried by the blood are the kidneys, which filter out nitrogenous wastes and regulate concentration of salts; the spleen, which removes worn red blood cells, or lymphocytes; and the liver, which contributes clotting factors to the blood, helps to control blood sugar levels, also removes old red blood cells and, receiving all the veins from the intestines and stomach, detoxifies the blood before it returns to the vena cava .



Circulatory Disorders



Disorders of the circulatory system generally result in diminished flow of blood and diminished oxygen exchange to the tissues. Blood supply is also impeded in such conditions as arteriosclerosis and high blood pressure ; low blood pressure resulting from injury (shock) is manifested by inadequate blood flow. Acute impairment of blood flow to the heart muscle itself with resulting damage to the heart, known as a heart attack or myocardial infarction, or to the brain (stroke) are most dangerous. Structural defects of the heart affecting blood distribution may be congenital or caused by many diseases, e.g., rheumatic fever, coronary artery disease.


rheumatic fever

systemic inflammatory disease, extremely variable in its manifestation, severity, duration, and aftereffects. It is frequently followed by serious heart disease, especially when there are repeated attacks. Rheumatic fever usually affects children. It is closely related to a preceding streptococcal infection (e.g., streptococcal tonsillitis or pharyngitis). Some of its symptoms are tenderness and inflammation about the joints, fever, jerky movements, nodules under the skin, and skin rash. If inflammation of the heart, or myocarditis, is mild, there is no permanent heart damage, but if the valves of the heart become inflamed, they may become scarred and deformed, permanently impairing their function. Such heart damage can sometimes be corrected by surgery.

Treatment of rheumatic fever is with penicillin, salicylates, and steroids; extended rest is usually necessary. Rheumatic fever may be prevented by prompt treatment of all streptococcal infections. Cardiac damage may possibly be avoided if prophylactic measures are taken after a first attack of rheumatic fever, i.e., long-term maintenance doses of antibiotics, to discourage streptococcal infections and recurrences of rheumatic fever. Rheumatic fever has declined in incidence in the industrialized countries, but has increased in prevalence in the Third World.


coronary artery disease

coronary artery disease, condition that results when the coronary arteries are narrowed or occluded, most commonly by atherosclerotic deposits of fibrous and fatty tissue. Coronary artery disease is the most common underlying cause of cardiovascular disability and death. Men are affected about four times as frequently as women; before the age of 40 the ratio is eight to one. Other predisposing factors are lack of blood supply; spasms in the coronary vessels, which cause and/or are caused by hypertension; diabetes; high cholesterol levels; adverse physical reactions to mental stress; and heavy cigarette smoking. The primary symptom is angina pectoris, a pain that radiates in the upper left quadrant of the body due to the lack of oxygen reaching the heart. A myocardial infarction (heart attack) is precipitated when the interior passage of an artery, usually already narrowed by atherosclerosis (see arteriosclerosis), is completely blocked by thrombosis (blood clot) or arterial plaque.

Nitroglycerin, beta-blockers, and calcium-channel blockers are often used for control of angina. Aspirin, with its ability to inhibit blood clots, cholesterol-lowering drugs (e.g., simvastatin), and estrogen replacement in postmenopausal women all appear to have a protective effect against eventual heart attack. If the buildup of plaque has progressed, an invasive or surgical procedure is often necessary, although a combination of a strict low-fat diet, stress management, and exercise has been found to reverse the disease. The most common procedure is angioplasty with a balloon catheter. The use of the balloon catheter often can be complicated by cracks or weakening of the walls of the vessels and may lead to rapid reclogging of the vessel. Another procedure is coronary artery bypass surgery, which splices veins or internal mammary arteries to the affected coronary artery in order to bypass the atherosclerotic blockage and supply blood to the heart muscle. A cold laser may be used to remove atherosclerotic plaques with bursts of ultraviolet light. It does little damage to the arteries and leaves the walls of the vessels smooth, without the burning and scarring created by hot lasers. Mechanical cutting devices, called atherotomes, are sometimes to ream atherosclerotic plaque material from the vessel in a procedure called atherectomy.
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Last edited by Sureshlasi; Wednesday, September 12, 2007 at 07:13 PM.
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