CIRCULATION

Diffusion alone is insufficient for transporting chemicals over

macroscopic distances in animals, such as transporting glucose from
the digestive tract and oxygen from the lungs to the brain. The
circulatory system solves this by ensuring substances don't have to
diffuse very far to enter or leave a cell. By transporting fluid
throughout the body, it functionally connects the body cells' aqueous
environment to the organs exchanging gases, nutrients, and waste
products. For instance, in mammalian lungs, oxygen diffuses into the
blood from inhaled air, while carbon dioxide moves in the opposite
direction. The circulatory system then distributes the oxygen-rich
blood to all body parts, facilitating chemical exchange between blood
and interstitial fluid in microscopic capillaries.

TYPES OF CIRCULATORY SYSTEMS

The blood circulatory system in animals can be broadly categorized
into two types: open and closed.
A. Open Circulatory System: Found in some invertebrates like
arthropods, this system involves a fluid called hemolymph bathes the
internal organs directly. One or more hearts pump hemolymph into
sinuses surrounding the organs, where chemical exchange occurs
between the hemolymph and body cells.
B. Closed Circulatory System: Confined to vessels, blood is distinct
from interstitial fluid. It is found in annelids, some mollusks (like
octopus and squid), and vertebrates. Blood is pumped by one or more
hearts into large vessels, which then branch into smaller ones coursing
through the organs. Materials are exchanged between the blood and
interstitial fluid bathing the cells.
During vertebrate evolution, the heart has become increasingly
complex, ranging from the two-chambered heart of fish to the four-
chambered heart of birds and mammals.
i. Single Circuit Circulation: Fish have a two-chambered heart
consisting of an atrium and a ventricle. Deoxygenated blood from the
body enters the atrium, then the ventricle pumps it into the ventral
aorta. Valves prevent backward flow of blood.
ii. Double Circuit Circulation: Found from amphibians to mammals, this
system has separate pulmonary and systemic circulation. In
amphibians and reptiles, the heart has three chambers: two atria and
one ventricle. Oxygenated blood from the lungs returns to the left
atrium, while deoxygenated blood from the body enters the right
atrium. These blood streams remain partially mixed in the ventricle. In
crocodiles, birds, and mammals, the heart is four-chambered, with
completely separated chambers for oxygenated and deoxygenated
blood. This allows for complete double circuit circulation.

General Characteristics of a Circulatory

System
All circulatory systems have three major components:
1. A Fluid (Blood): Blood serves as the medium of transport, carrying
nutrients, oxygen, hormones, and waste products throughout the
body.
2. A System of Channels or Vessels: These vessels conduct the blood
throughout the body, ensuring it reaches all cells and tissues. The
vessels include arteries, veins, and capillaries.
3. A Pump (Heart): The heart, or a modified blood vessel, acts as the
pump that keeps the blood circulating. It generates the pressure
needed to move blood through the vessels and ensures adequate
circulation to all parts of the body.

Human Heart
The human heart has a somewhat conical form and is enclosed by the
pericardium. It is located between the lungs, with one-third situated
on the right and two-thirds on the left of the midline, just behind the
sternum.

Layers of Heart Wall:

The heart wall consists of three layers enclosed in the pericardium.
The fibrous pericardium, made of thick fibrous connective tissue, and
the serous pericardium, consisting of an outer fibrous layer and an
inner double serous membrane layer, define the borders of the middle
mediastinum. Between the layers of the serous pericardium is a small
amount of serous pericardial fluid that lubricates the layers and
prevents friction during heart contractions.
1. Epicardium: The outer layer of the heart wall, formed by the visceral
layer of the serous pericardium.
2. Myocardium: The muscular middle layer of the heart wall,
containing excitable tissue and the conducting system.
3. Endocardium: A middle concentric layer, consisting of a
subendocardial layer. The rest of the heart is composed mainly of the
subepicardial and subendocardial layers.
Structure of the Heart:
The human heart consists of four chambers: two upper thin-walled
atria and two lower, thick-walled ventricles. Two large veins, the
superior and inferior vena cava, enter the right atrium, while two pairs
of pulmonary veins open into the left atrium. Similarly, two large
arteries emerge, one from the right ventricle (pulmonary artery) and
the other from the left ventricle (systemic aorta). The chambers are
separated by vertical membranous interatrial and interventricular
septa, with four valves preventing backward flow of blood.
Atrioventricular Valve (Tricuspid or Bicuspid Valve): Prevents
backward flow of blood between the right atrium and right ventricle,
or left atrium and left ventricle.
- Semilunar Valves: Located at the exits of the heart, preventing blood
from flowing back into the ventricles.
The left ventricle has more muscular walls than the right ventricle, as
it pumps blood to the entire body (systemic circulation), while the
right ventricle pumps blood to the lungs (pulmonary circulation).

Phases of Heartbeat:
Heartbeats, rhythmically and regularly, occur at approximately 72
times per minute at rest. The cardiac cycle involves alternating
contraction (systole) and relaxation (diastole) of the heart chambers.
Atria contract synchronously, emptying their contents into the
ventricles. Ventricles then contract simultaneously, forcing blood into
the arteries leaving the heart. Both chambers then relax briefly before
the cycle repeats. Ventricular systole is the period of ventricular
contraction, while the rest of the cycle, including relaxation of all
chambers followed by atrial contraction, is called ventricular diastole.
The familiar "LUB-DUB" sound of the heart occurs as valves close
during the cardiac cycle.

S.A Node and A.V Node

A region of the heart known as the sinoatrial node (SAN), or
pacemaker, maintains the heart's pumping rhythms by setting the rate
at which all cardiac muscle cells contract. Composed of specialized
muscle tissue, the SA node is located in the wall of the right atrium,
near the point where the superior vena cava enters the heart. Similar
to nerve cells, the SA node generates electrical impulses.
These impulses spread rapidly through the walls of the atria, causing
them to contract in unison. They also pass to another specialized
muscle tissue region, the atrioventricular (AV) node, located in the
wall between the right atrium and right ventricle. Here, the impulses
are delayed for about 0.1 second, ensuring that the atria contract first
and empty completely before the ventricles contract.
The excitation then travels to all parts of the ventricles through two
bundles of specialized muscle fibers: the atrioventricular bundle or
bundle of His in the ventricular septum, and then into the ventricular
wall through a network of fibers called Purkinje fibers.

ELECTROCARDIOGRAM (ECG)
The impulses that travel through cardiac muscle during the heart cycle
generate electrical currents, which are conducted through body fluids
to the body surface. Here, these currents can be detected by
electrodes placed on the skin and recorded as an electrocardiogram
(ECG).
By analyzing an electrocardiogram, we can observe the electrical
changes in the form of depolarization and repolarization. Atrial
depolarization, initiated by the SA node, produces the P wave. During
the expression of the P wave on the ECG recording, the ventricles of
the heart are in diastole.
The P-R interval, extending from the start of the P wave to the
beginning of the QRS complex, indicates the time required for the SA
depolarization to reach the ventricles. The QRS complex consists of a
short downward deflection (Q), a sharp upward spike (R), and a
downward deflection (S). It represents the depolarization of the
ventricles, during which they are in systole, ejecting blood from the
heart.
The S-T segment, following the QRS complex, represents the period
between the completion of ventricular depolarization and the
initiation of repolarization. The T wave is produced by ventricular
repolarization. A normal ECG indicates proper heart function, with the
QRS complex occurring just before ventricular contraction and the T
wave preceding ventricular relaxation.

BLOOD VESSELS
As blood leaves the heart, it travels from the aorta to arteries, then to
arterioles, capillaries, venules, veins, and finally returns to the heart
via the vena cava. Let's delve into each type of blood vessel in more
detail.
Arteries
Arteries are the first vessels blood enters after leaving the heart. They
are thick-walled and composed of three layers: the outer tunica
externa, the middle tunica media with smooth muscles and elastic
fibers, and the inner tunica interna (intima) consisting of squamous
endothelium. Arteries expand and recoil between heartbeats, aiding in
pumping blood and maintaining steady flow through smaller vessels.
They branch into smaller vessels called arterioles, which regulate
blood distribution within the body.
Capillaries
Capillaries are the smallest vessels where exchange of substances
between blood and body cells occurs. Their walls consist of a single
layer of endothelium, offering minimal resistance to the diffusion of
substances. Capillaries are extremely narrow and facilitate continuous
leakage of fluid from blood plasma into surrounding tissues, forming
interstitial fluid. Exchange of nutrients, gases, wastes, and hormones
occurs across capillary walls.
Veins
Blood from capillaries drains into venules, which then empty into
larger veins. Veins provide a low-resistance pathway for blood return
to the heart. Their walls are thinner and more expandable than
arteries, and they contain smooth muscle. Skeletal muscle
contractions during exercise and breathing aid in venous return. Veins
have one-way valves to prevent blood backflow and ensure flow only
toward the heart.

ROLE OF ARTERIOLES IN VASODILATION AND VASOCONSTRICTION

Arterioles, with their muscular walls, can contract and relax in
response to nerve signals, hormones, and local chemicals. They
regulate blood flow to tissues and organs. For example, in hot
weather, arterioles in the skin dilate (vasodilation) to dissipate heat,
while in cold weather, arterioles in extremities constrict to conserve
heat, potentially leading to frostbite.
ROLE OF PRE-CAPILLARY SPHINCTER IN THE FLOW OF BLOOD
THROUGH CAPILLARIES
The flow of blood in capillaries is regulated by tiny rings of smooth
muscles called pre-capillary sphincters that surround the junctions
between arterioles and capillaries. These sphincters open and close in
response to local changes signaling the needs of nearby tissues, such
as accumulation of carbon dioxide, lactic acid, or other cellular wastes.
When these signals indicate increased blood flow is needed, the pre-
capillary sphincters and nearby arteriole muscles relax, allowing more
blood to flow through the capillaries.

VASCULAR PATHWAY
The human cardiovascular system comprises two major pathways:
pulmonary circulation and systemic circulation.
Pulmonary Circulation
Deoxygenated blood from the entire body collects in the right atrium,
passes into the right ventricle, and is pumped into the pulmonary
artery. The pulmonary artery divides into right and left pulmonary
arteries, carrying blood to the lungs. In the pulmonary capillaries,
carbon dioxide is released, and oxygen is picked up. Oxygenated blood
returns to the left atrium through pulmonary veins.
Systemic Circulation
Systemic circulation involves the aorta and vena cava as the major
pathways. Arteries carry oxygenated blood (bright red), while veins
carry deoxygenated blood (dull red or blue when viewed through the
skin).
Coronary Circulation
Coronary arteries supply blood to the heart wall (myocardium),
branching from the aorta just above the aortic semilunar valve. They
form capillary beds, which merge into venules, then cardiac veins
empty into the right atrium.
Hepatic Portal System
The hepatic portal system, found between the small intestine and
liver, begins and ends in capillaries. Blood passes from intestinal villi
into venules, forming the hepatic portal vein that connects the
intestine to the liver. The hepatic vein leaves the liver, entering the
inferior vena cava.
Renal Circulation
Renal arteries arise directly from the abdominal aorta, entering the
kidneys. Branches pass through the medulla, forming glomerular
arterioles. Blood then enters the peritubular capillaries and vasa recta.
Veins drain these capillary networks, exiting the kidney as a single
renal vein that joins the inferior vena cava.

RATE OF BLOOD FLOW IN BLOOD VESSELS

Blood flows at varying speeds through vessels, faster in large arteries
and slower in capillaries. Despite individual capillaries being narrow,
the vast capillary bed area slows blood flow, aiding material exchange.
Blood speeds up after leaving capillary beds due to reduced total
cross-sectional area.

BLOOD PRESSURE
Blood pressure is the hydrostatic force of blood on vessel walls,
propelling blood from the heart through arteries to capillary beds.
Measured with a sphygmomanometer, blood pressure consists of
systolic pressure (during ventricular contraction) and diastolic
pressure (during relaxation), typically expressed as systolic/diastolic
mmHg.

Baroreceptors
Baroreceptors, mechanoreceptors sensitive to blood pressure
changes, relay information to the autonomic nervous system. High-
pressure arterial baroreceptors sense blood pressure, while low-
pressure volume baroreceptors are found in large veins and atrial
walls, helping maintain proper blood pressure.

CARDIOVASCULAR DISORDERS
Diseases affecting the heart, blood vessels, and circulation are
collectively termed cardiovascular disorders.

Thrombus
A thrombus is a blood clot formed within an intact blood vessel,
typically initiated by atherosclerotic plaques. These plaques damage
the vessel's endothelium, leading to platelet accumulation and clot
formation. Thrombus and embolus are dangerous conditions
increasing the risk of heart attack or stroke.
Atherosclerosis
Atherosclerosis is a disease where arterial walls lose elasticity,
thickening and narrowing due to the formation of fatty lesions called
atheromatous plaques. Causes include smoking, hypertension, obesity,
high cholesterol, and family history, with risk increasing with age.

Heart Problems
Heart problems encompass angina pectoris, heart attack, and heart
failure. Angina pectoris is chest pain due to inadequate oxygen supply
to the heart, often during exertion. A heart attack (myocardial
infarction) occurs when part of the heart muscle dies due to oxygen
deprivation from blocked coronary arteries. Heart failure is the heart's
inability to pump blood adequately.
Congenital Heart Problems
Congenital heart problems involve structural defects present at birth,
affecting heart walls, valves, or blood vessels.

Principles of Angiography
Angiography is X-ray imaging of blood flow using substances opaque
to X-rays. It helps diagnose vascular blockages.

Treatment of Cardiovascular Disorders

Treatment includes coronary bypass surgery, angioplasty, and open-
heart surgery to improve blood flow. Lifestyle changes such as diet,
weight management, smoking cessation, and exercise also play crucial
roles.
Hypertension and Hypotension
Hypertension, or high blood pressure, increases the risk of
cardiovascular disorders, often termed the "silent killer" due to its lack
of symptoms until complications arise. Hypotension, or low blood
pressure, can cause symptoms such as fatigue, dizziness, and nausea.
Lifestyle Modifications
Lifestyle changes like a healthy diet, weight management, smoking
cessation, cholesterol control, and regular exercise can significantly
reduce the risk of cardiovascular disorders.
LYMPHATIC SYSTEM
The lymphatic system comprises a network of vessels (lymphatics) that
drain lymph from all body tissues back to the circulatory system. It
includes numerous small lymph nodes, the thymus, and spleen, closely
associated with the circulatory system.
Composition and Formation of Intercellular Fluid
Intercellular or tissue fluid is derived from blood passing through
capillaries. Capillary walls are permeable, allowing all blood
components except R.B.Cs and blood proteins to pass into the
intercellular spaces. Lymph, formed from about 15% of tissue fluid
along with W.B.Cs, cell debris, and microorganisms, returns to the
heart through lymphatic vessels.
Comparison of Intercellular Fluid and Lymph
Lymph, a colorless fluid, contains lymphocytes, small proteins, and
fats. It transports substances from tissue cells and intercellular spaces
back to the circulatory system.
Lymphatic Vessels
Lymph capillaries form a network of thin-walled vessels with one-way
valves, allowing large particles and fluid to enter. Lymph flows into
larger vessels, propelled by nearby muscle contractions. One-way
valves regulate flow, with efferent vessels merging into the thoracic
trunk or right lymphatic trunk.
Role of Lymph Vessels in Villi
In the small intestine, lymph capillaries absorb digested fats, which are
too large for blood capillaries but can enter lymph capillaries easily.
These fats may constitute around 1% of lymphatic fluid.

Lymphoid Tissue
Lymph vessels are interrupted by lymph nodes, which filter lymph,
exposing it to macrophages and lymphocytes that destroy foreign
particles. The spleen, located in the left side of the abdominal cavity,
filters blood, removing foreign particles and aged blood cells.