Ebook Anatomy and physiology (5E): Part 2

(BQ) Part 2 book “Anatomy and physiology” has contents: The cardiovascular system, the lymphatic system and immunity, the respiratory system, the nervous system, the endocrine system, the reproductive system, the digestive system,… and other contenTs.

The cardiovascular system is the body’s transport

system and comprises blood, blood vessels and

the heart Blood provides the fluid environment

for our body’s cells and is transported in

specialised tubes called blood vessels The

heart acts like a pump which keeps the blood

circulating constantly around the body.

The cardiovascular system

6

OBJECTIVES

By the end of this chapter you will understand:

the different types of blood cells

between the different blood vessels

circulation

system

cardiovascular and other body systems

In practice

It is essential for therapists to have a good working

knowledge of the cardiovascular system in order

to be able to understand the physiological effects

of treatments Treatments such as massage help to

improve circulation by assisting the venous flow

back to the heart By enhancing blood flow, delivery

of oxygen and nutrients to the tissues is improved

and the removal of waste products is hastened

The composition of blood

The percentage composition

AB Any of these groups AB

Red blood cells are called erythrocytes and they

contain the red protein pigment haemoglobin,

which combines with oxygen to form

oxyhaemoglobin The pigment haemoglobin

assists the function of the erythrocyte in

transporting oxygen from the lungs to the

body’s cells and in carrying carbon dioxide away

Some white blood cells are known as

phagocytes as they have the ability to ingest

micro-organisms which invade the body and

cause disease Other specialised white blood

cells, called lymphocytes, produce antibodies to

protect the body against infection

Platelets

Fibrin

Fibrin filaments, red blood cells and white blood cells the blood clot is formed

The coagulation

Formation of the platelet plug Vascular spasm

Vessel injury

HEMOSTASIS

p The stages of haemostasis

Summary of the blood-clotting process

Prothrombin and fibrinogen are always present

in our blood, but they aren’t activated until

a prothrombin activator is made in response

Erythrocyte (err-rith-ro- sytes)

Disc-shaped structuresNon-nucleatedRed in colour due to protein haemoglobin

Transport the gases of respiration

Leucocytes (loo-co-sytes)

Largest of all the blood cellsWhite due to lack of haemoglobin

Protect the body against infection and disease

Thrombocytes or

platelets

Granular disc-shaped, small fragments

of cells

Blood clotting

The middle layer (tunica media) of arteries

contains more smooth muscle than is found in

veins, thus allowing arteries to constrict and

dilate to adjust the volume of blood supplied

● carry blood under high pressure

● give rise to small blood vessels called arterioles, which deliver blood to the capillaries

Inner layer

Inner layer Elastic layer Smooth muscle

Valve Valve

VeinARTERY AND VEIN

p The structure of an artery and a vein

KEY FACTS

Veins:

● have thinner muscular walls than arteries

● are generally superficial, not deep-seated

● have valves at intervals to prevent the backflow of blood

● have a large lumen, allowing more blood to flow with less resistance

● carry blood towards the heart

● carry deoxygenated blood (except the pulmonary veins) from the lungs

● carry blood under low pressure

● form finer blood vessels called venules which continue from capillaries

KEY FACTS

Capillaries:

● are superficial microscopic blood vessels that form part of the

microcirculation

● have thin walls, only a single layer of cells thick, to enable the

diffusion of dissolved substances to and from the tissues

● have no valves

● have a narrow lumen; this means that many capillaries can fit in

a small space, increasing the surface area for diffusion

● carry blood under low pressure, but higher than in veins

● carry both oxygenated and deoxygenated blood as they

exchange oxygen and carbon dioxide with tissues

● are responsible for supplying the cells and tissues with nutrients

● unite arterioles and venules, forming a network in the tissues

Artery to

Arterioles to

Capillaries to

Venules to

p Blood flow from an artery to a vein

Vasodilation and vasoconstriction

an artery must contain the pressure of blood pumped from the heart, its walls are thicker and more elastic

KEY FACT

Oxygenated blood flowing through the arteries appears bright red in colour due to the colour of the oxygen-binding pigment, haemoglobin

As haemoglobin moves through capillaries in red blood cells, it offloads some oxygen and picks up carbon dioxide, changing colour in the process This explains why blood flowing in veins appears darker

p The structure of the heart

Branches of ascending aorta

Superior vena cava

Right pulmonary veins

from right lung

Right pulmonary artery

Branch of pulmonary artery

Left pulmonary veins from left lung

3 Endocardium (the inner layer)–thisthinlayerlinestheheart’s

1 Tricuspid valve Between the right atrium

and the right ventricle

2 Bicuspid or mitral valve Between the left atrium

and the left ventricle

3 Aortic valve Between the left

ventricle and the aorta

4 Pulmonary valve Between the pulmonary

artery and the right ventricle

If either of the coronary arteries is unable to

supply sufficient blood to the heart muscle, a

heart attack occurs The most common site of a

heart attack is the anterior or inferior part of the

left ventricle

Blood flow through the heart

Bloodmovesintoandoutoftheheartinaco-ordinatedandprecisely

timedrhythm

veins

Pulmonary veins

Lungs

Oxygenated blood

Deoxygenated blood

Left atrium

Left ventricle

Left ventricle Septum

Head and arms

Liver Stomach and intestines

Kidneys, reproductive organs, lower limbs

Systemic circulation

Branches of the aorta

Descending aorta

Right

atrium

Right atrium atriumLeft

Right

ventricle

Right ventricle

Inferior

vena cava

p Blood flow through the heart

To study the blood flow through the heart, follow the arrows on the

diagram on the previous page

Blue indicates the flow of deoxygenated blood and red shows the flow

of oxygenated blood

Remember that although arteries carry oxygenated blood and veins

carry deoxygenated blood, there is an exception to the rule: the

pulmonary arteries carry deoxygenated blood and the pulmonary veins

carry oxygenated blood

The function of the heart

Superior vena cava

Inferior vena cava

Atria fill with blood

Pulmonary valve Pulmonaryartery Aorta

Aortic valve

Tricuspid valve

Mitral valve

Atria contract and ventricles fill with blood

Ventricles contract and blood is pumped to lungs and around body

Pulmonary vein

Ventricles relax and cycle starts again

healthypersonthisislikelytobebetween60and70cycles,orbeatsper

minute

KEY FACT

On average the heart beats 100 000 times a day In an average

lifetime, that is around 2.5 billion heartbeats!

An electrical device known as a pacemaker can be implanted to

assist or take over initiation of the signal that starts a heartbeat This

may be necessary if the SA node is diseased or damaged

Blood capillaries

of the right lung Pulmonary artery Superior vena cava

Inferior vena cava Blood capillaries of the liver

Portal vein Hepatic artery

Blood capillaries of the upper part of the body

Ascending aorta

Blood capillaries

of the left lung Aortic arch Pulmonary vein Left atrium Left ventricle

Descending aorta

Blood capillaries of the stomach

Blood capillaries of the spleen

Blood capillaries of the intestines

Renal artery Blood capillaries of the kidneys

Blood capillaries of the lower part of the body

Right atrium Right ventricle

p The pulmonary and systemic circulation

General or systemic circulation

The increase in blood flow

during a massage can help

to bring fresh oxygen and

nutrients to the tissues via the

arterial circulation and can aid

the removal of waste products

via the venous circulation By

boosting blood circulation,

therefore, massage can help to

improve the condition of the

skin and muscle tone

The cardiovascular system

Remind yourself of the following blood vessels and parts of the heart:

1 Write each one on a separate piece of card or paper.

2 Sort the cards into the correct order to represent the blood flow

through the heart

3 Colour code the cards: use red to represent oxygenated blood and

blue to represent deoxygenated blood.

Subclavian artery

External carotid artery Internal carotid artery

Coeliac trunk Splenic artery

Renal artery

Common iliac artery Internal iliac artery External iliac artery

Common carotid arteries

Aortic arch Axillary artery

Posterior tibial artery

Deep plantar arch

Ulnar artery

Superficial/deep palmar arches Digital artery

p Main arteries

Blood circulation to the

head and neck

Internal carotid artery

External carotid artery

Maxillary artery

Facial artery Lingual artery

Thyroid artery Common carotid artery

p Blood flow to the head and neck

Main arteries of the face and head

Table 6.4 Arteries of the face and head

Name of artery Location Area artery supplies

Common carotid artery

(right and left) Located on each side of the neck Divide into the external and internal carotid arteries

External carotid artery Branches off from the common carotid

Supplies blood to the brain

Occipital artery Branch of the external carotid artery

opposite the facial arteryPath is below the posterior belly of digastric to the occipital region

Supplies blood to the back of the scalp and sternomastoid muscles, and deep muscles in the back and neck

Facial artery Branch of the external carotid artery a

little above the level of the lingual artery

Supplies blood to the structures of the face

Maxillary artery Branches from the external carotid artery

just deep to the neck of the mandible

Supplies deep structures of the face

Lingual artery Rises from the external carotid between

the superior thyroid artery and facial arteryLocated easily in the tongue

Supplies the oral floor and tongue

Blood circulation to the arm and hand

Main arteries of the arm and hand

Deep palmar artery

Superficial palmar arch

Digital arteries

p Arteries of the arm and hand

Table 6.5 Arteries of the arm and hand

Name of

artery Location Area artery supplies

Ulnar artery Runs down the forearm next to the ulnar bone,

across the carpals into the palm of the hand

Supplies the anterior aspect of the forearm

Radial

artery

Runs down the forearm and continues over the carpals to pass between the first and second metacarpals into the palm

Supplies the posterior aspect of the forearm

palmar arch Continuation of the radial artery, lies 1 cm proximal to the superficial palmar arch, across centre of palm

Supplies blood to palm and fingers

Table 6.6 Arteries of the abdominal wall

Name of artery Location Area it supplies

Hepatic artery Branch of the celiac trunk that arises from

the abdominal aorta at the level of the upper part of the first lumbar vertebra

Supplies oxygenated blood to the liver, stomach, duodenum and pancreas

Renal artery One of two blood vessels leading off from

the abdominal aorta that go to the kidneys

Supplies oxygenated blood to the kidneys

Splenic artery Branched from the celiac artery (first major

branch of the abdominal aorta) and runs above the pancreas to the spleen

Supplies oxygenated blood to the spleenHas several branches that deliver blood to the stomach and pancreas

Inadditiontothemainvisceralbranchofabdominalarteriesabove,

otherarteriesare:

andlargeintestines

Main arteries of the leg and foot

Table 6.7 Main arteries of the leg and foot

Name of artery Location Area it supplies

Femoral artery Main artery in the thigh (continuation of

external iliac artery)

Supplies oxygenated blood to the tissues of the leg

Popliteal artery Behind the knee and the back of the lower leg Supplies oxygenated blood to the knee joint

Anterior tibial

artery

On anterior of lower leg, crossing the anterior aspect of the ankle joint, at which point it becomes the dorsalis pedis artery

Carries oxygenated blood to the anterior compartment of the leg and dorsal surface of the foot, from the popliteal artery

Posterior tibial

artery Branches off from the popliteal artery and runs down the leg, just below the knee

Carries blood to the posterior compartment

of the leg and plantar surface of the foot, from the popliteal artery

Plantar arch Runs from the fifth metatarsal and extends

medially to the first metatarsal (of the big toe)

Supplies oxygenated blood to the underside,

or sole, of the foot

Posterior tibial artery

Plantar arch

Anterior tibial artery Popliteal artery Femoral artery External iliac artery

p Arteries of the leg and foot

Anterior tibial vein

Long/great saphenous vein

Short/small saphenous vein

Femoral vein

Popliteal vein

Posterior tibial vein

Dorsal venous arch Dorsal digital veins

Venous drainage of the face and head

Superficial temporal vein

p Venous drainage from the head and neck

ofthecervicalvertebraeandenterthesubclavianveins.Thevertebral

veinsdraindeepstructuresoftheneck,suchasthevertebraeand

muscles

Main veins of the face and head

Table 6.8 Main veins of the face and head

Name of vein Location

Area of body it receives venous return from

External jugular vein

Situated on the side of the neck

Drains most of the outer structures of the head, including the scalp and deep portions of the face

Internal jugular vein

Situated on the side of the neck

Drains most of the cerebral veins and outer portions of the face

Common facial vein Crosses the external carotid artery and enters the

internal jugular vein at a variable point below the hyoid bone

Drains most of the blood from the face, draining directly into the internal jugular vein

Anterior facial vein

Lies behind the facial artery Drains blood from the face

before joining the common facial vein

Maxillary vein

Runs alongside the maxillary artery

Drains blood from the face, directs blood flow to the internal and external jugular veins

Superficial temporal vein

Side of the head Drains the forehead and

Ulnar vein

Deep palmar venous arch

Superficial palmar venous arch Palmar digital veins

Right subclavian vein

Main veins of the arm and hand

Table 6.9 Main veins of the arm and hand

Name of vein Location Area of body it receives venous return from

Subclavian vein Under the clavicle and anterior to the

Brachial vein In the arm between the shoulder and the

elbow, runs alongside the brachial artery

Drains the muscles of the upper arm

Basilic vein Inner side of forearm area Drains the medial aspect of the upper limbs via

numerous superficial veins

Cephalic vein Runs up the lateral side of the arm from

the hand to the shoulder

Drains the dorsal venous network of the hand

Ulnar vein Runs parallel to the ulna bone of the

Palmar digital veins Run between the fingers Carry deoxygenated blood away from the fingers

Venous drainage of thoracic and abdominal walls

Table 6.10 Main veins of the thoracic and abdominal walls

Name of vein Location Area of body it receives venous return from

Iliac vein Lower part of the abdomen, in the pelvic region Pelvis and lower limbs

Splenic vein Runs close to the course of the splenic artery

(above the pancreas to the spleen)

The spleen, the stomach fundus and part of the pancreas (part of the hepatic portal system)

Renal vein Posterior of the abdominal wall, connects the

kidneys to the inferior vena cava

Kidneys

Hepatic vein Connects to the liver in the upper right side

of the abdominal cavity

Liver

Hepatic

portal vein The upper right quadrant of the abdomen, originating behind the neck of the pancreas

All of the blood draining from the abdominal digestive tract, as well as from the pancreas, gall bladder, and spleen (part of the hepatic portal system)

External iliac vein

Dorsal digital veins Dorsal venous arch

Posterior tibial vein Anterior tibial vein

Short/small saphenous vein Popliteal vein Long/great saphenous vein Femoral vein

Main veins of the leg and foot

Table 6.11 Main veins of the leg and foot

Main veins of the Leg Location Area of body it receives venous return from

Great (long)

saphneous vein

Longest vein in the human body, extending from the top of the foot

to the upper thigh and groin

Drains blood from the inner part of the foot, the skin and fat of the front and inner aspect of the lower leg, and the skin and fat of the inner part of the thigh

Small (short)

saphenous vein Superficial vein in the posterior of the lower leg

Drains the lateral surface of the leg, and runs up the posterior surface of the leg to drain into the popliteal vein

Femoral vein Large vein in the groin

(continuation of the popliteal vein)

Carries blood back to the heart from the lower extremities

Popliteal vein Behind the knee and the back of

the lower leg

Carries blood from the knee (as well as the thigh and calf muscles) back to the heart

Anterior tibial vein In the anterior of the lower leg Originates and receive blood from the dorsal pedis

veins, on the back of the foot, and empties into the popliteal vein

Posterior tibial vein In the posterior of the lower leg Drains the posterior compartment of the leg and the

plantar surface of the foot to the popliteal vein, which

it forms when it joins with the anterior tibial vein

Dorsal venous arch Superficial vein that connects the

small saphenous vein and the great saphenous vein

Drains oxygen-depleted blood through the foot

as in exercise, therefore results in a temporary increase in blood pressure

Factors affecting blood

In practice

Always take a detailed history of a client’s symptoms and medical or surgical treatment, so you are aware of any cardiac and/or circulatory problems If there is a history of cardiovascular illness, seek advice from the client’s GP before treating, as this may determine the nature and duration of the proposed treatment

In practice

Stress predisposes people to angina attacks

Massage and other relaxation therapies may help

alieviate symptoms by decreasing the activity of

the sympathetic nervous system

Since sudden exposure to extreme heat or cold can

bring on an attack, keep the client warm

Clients with arteriosclerosis are prone to thrombus

formation Deeper manipulation should not be

used as it could encourage a thrombus to dislodge

and travel to the lungs, heart or the brain

Refer clients to their GP before any treatment if

they have a history of stroke, heart attack, angina

or thrombosis If treatment is encouraged, use

gentle methods and avoid overstimulation

High blood pressure

an adaptation of routine, some treatments may

be possible Correct positioning of the couch is essential to maximise comfort of the client with blood pressure problems Make sure the client is not lying down too long and doesn’t get up too fast

Congenital heart disease

In practice

Depending on the type of defect, surgery

undertaken and GP’s advice, it may be more

appropriate and comfortable for the client to

be treated in a seated position

After a heart attack, no treatment should be given

until the client is fully recovered, and only in liaison

Take care if applying pressure with massage to avoid bruising; clients with leukaemia have a tendency to bleed

Be aware that the lymph glands, liver and spleen can be very tender

Electrical treatments would be contraindicated

in a client with a pacemaker Seek the GP’s advice before offering any other form of treatment

The site of the pacemaker is likely to be tender and should be avoided, if any suitable treatment

Clients on warfarin (an

anticoagulant medication) have

an increased risk of bleeding

and you should be aware of

this with reference to any

skin-piercing treatments such as

epilation or ear piercing

In practice

The site of phlebitis can be

tender and careful handling is

essential

Massage should be avoided so

as not to dislodge clots

Interrelationships with other systems

The cardiovascular system

The cardiovascular system links to the following body systems

Key words

Agranulocyte: one of the two main categories of

leucocytes

Antigen: a substance that can trigger an immune

response if foreign to the body

Aorta: the main artery of the body, supplying

oxygenated blood to the circulatory system

Arteriole: a small branch of an artery leading into

capillaries

Artery: a type of blood vessel that carries

oxygenated blood away from the heart

Atrium: one of two upper cavities of the heart from

which blood is passed to the ventricles

Basophil: a type of granulocyte

Blood: the fluid circulating through the heart, arteries,

veins and capillaries of the circulatory system

Blood pressure: the amount of pressure exerted by

blood on an arterial wall due to the contraction of

the left ventricle

B-lymphocyte: a type of white blood cell that

makes antibodies

Capillary: the smallest blood vessel, which unites

arterioles and venules

Cardiac cycle: the sequence of events between one

heartbeat and the next

Clotting: the process in which blood changes from

liquid into a solid state to form a thick lump

Clotting factors: proteins in the blood that control

bleeding

Diastolic: the minimum blood pressure when the

heart muscle relaxes and blood flows into the heart

from the veins

Endocardium: the lining of the heart’s cavities

Eosinophil: a type of granulocyte

Erythrocyte: red blood cell, which transports the

gases of respiration

Fibrin: an insoluble protein that forms a fibrous

mesh during blood clotting

Fibrinogen: a soluble protein present in blood

plasma, from which fibrin is produced

Granulocyte: one of the two main categories of

leucocytes

Haemoglobin: a red iron–protein complex

responsible for transporting oxygen in the blood

Heart: hollow muscular organ which lies in the

thorax above the diaphragm and between the lungs, acts as a pump to provide a constant circulation of blood throughout the body

Hypertension (high blood pressure): when the

force of blood pushing against the walls of blood vessels is consistently too high

Hypotension (low blood pressure): when the force

of blood pushing against the walls of blood vessels

is consistently too low

Inferior vena cava: a large vein carrying

deoxygenated blood into the heart

Leucocyte: white blood cell, which protects the

body against infection and disease

Lumen: a void inside a blood vessel through which

which makes up the bulk of the heart

Neutrophil: a type of granulocyte Pericardium: the membrane enclosing the heart,

consisting of an outer fibrous layer and an inner double layer of serous membrane

Phagocytosis: the process by which a white blood

cell ingests micro-organisms

Plasma: the colourless, liquid part of blood Portal circulation: circulation of blood to the liver

from the small intestine, the right half of the colon and the spleen through the portal vein

Pulmonary artery: an artery carrying blood from

the right ventricle of the heart to the lungs for oxygenation

Pulmonary circulation: the circulatory system

between the heart and the lungs

Pulmonary vein: a vein carrying oxygenated blood

from the lungs to the left atrium of the heart

Pulse: a pressure wave that can be felt in the

arteries and which corresponds to the beating

of the heart

Septum: a partition separating the two chambers of

the heart

Stethoscope: a medical instrument for listening to

the action of the heart or breathing

Sphygmomanometer: an instrument for measuring

blood pressure

Sinoatrial (SA) node: a specialised piece of heart

tissue that generates the electrical impulses to

control the heartbeat

Superior vena cava: a large vein carrying

deoxygenated blood into the heart

Systemic circulation: part of the cardiovascular

system that carries oxygenated blood away from the

heart to the body and returns deoxygenated blood

back to the heart

Systolic: maximum pressure of the heartbeat, which

represents the pressure exerted on the arterial wall

during active ventricular contraction

Thrombin: an enzyme in blood plasma which causes

the clotting of blood by converting fibrinogen to

fibrin

Thrombocyte (platelet): a small fragment of a cell

involved in blood clotting

Thromboplastin: a plasma protein that helps with

blood coagulation

T-lymphocyte: a type of white blood cell that

circulates around the body, scanning for cellular abnormalities and infections

Tunica externa (tunica adventitia): the outermost

layer or tunic of a vessel (except capillaries)

Tunica intima: the innermost lining or tunic of a

vessel

Tunica media: the middle layer or tunic of a vessel

(except capillaries)

Vasoconstriction: constriction of the smooth

muscle of a blood vessel, resulting in a decreased vascular diameter

Vasodilation: relaxation of the smooth muscle in

the wall of a blood vessel, resulting in an increased vascular diameter

Vein: a type of blood vessel that carries

deoxygenated blood towards the heart

Ventricle: one of the two lower chambers of the

heart

Venule: a very small blood vessel in the

microcirculation that allows blood to return from the capillary beds to drain into the veins

Revision summary

The cardiovascular system

● Blood is a type of liquid connective tissue.

cells and the external environment to help

maintain a stable cellular environment

or absence of two antigens – A and B – on the

surface of red blood cells

blood

fluid (plasma) and 45% blood cells

erythrocytes, leucocytes and thrombocytes.

oxygen to the cells and carrying carbon dioxide

away

● Leucocytes are designed to protect the body

against infection

● Thrombocytes are involved in the clotting process.

● Blood clotting or coagulation is a biological

process that stops bleeding

● Haemostasis is the physiological process by

which bleeding ceases It involves three basic steps: vascular spasm, the formation of a platelet plug, and coagulation, in which clotting factors promote the formation of a fibrin clot

and tissues

● Clotting factors are proteins in the blood that

control bleeding

(clotting factor I), prothrombin (clotting factor II) and thromboplastin (clotting factor III).

defence, regulation of heat and clotting

arteries, veins and capillaries.

● Arteries carry oxygenated blood away from

the heart They have thick, muscular walls in order to withstand the high pressure of blood

● Veins carry deoxygenated blood towards the

heart They have thinner walls and blood is carried under lower pressure

● Capillaries are the smallest vessels in the

circulatory system They unite arterioles and

venules Their walls are sufficiently thin to

allow dissolved substances in and out of them

and between the lungs

an outer pericardium, a middle myocardium and

an inner endocardium.

a partition called a septum Each side is divided

into a thin-walled top chamber called an atrium

and a thick-walled bottom layer called a ventricle.

the large veins and pump it to the bottom chambers

to the body’s organs and tissues

● Stage 1 – deoxygenated blood flows into the

right atrium When the right atrium is full, it empties into the right ventricle

● Stage 2 – when the right ventricle is full, it

pushes blood into the pulmonary artery to the lungs, where the blood becomes oxygenated

● Stage 3 (taking place at the same time as

stage 1) – oxygen-rich blood fills the left atrium

When full, the blood passes to the left ventricle

● Stage 4 (taking place at the same time as

stage 2) – when the left ventricle is full it forces blood into the aorta and to all parts of the body

between one heartbeat and the next

second

simultaneosuly and force blood into the relaxed ventricles

push blood out through the aorta and the

pulmonary artery.

fill up with blood

system between the heart and the lungs It consists

of the circulation of deoxygenated blood from

the right ventricle of the heart to the lungs via the pulmonary arteries to become oxygenated

Oxygenated blood is then returned to the left

atrium by the pulmonary veins.

circulatory system and carries oxygenated blood from the left ventricle of the heart to the aorta and around the body

● Blood pressure is defined as the amount of

pressure exterted by blood on an arterial wall

due to the contraction of the left ventricle.

pressure and respresents the pressure exerted

on the arterial walls during ventricular contraction

pressure and is when the heart muscle relaxes (ventricular relaxation) and blood flows into the heart from the veins

100 and 140 mm Hg systolic and between

60 and 90 mm Hg diastolic.

● High blood pressure is when the resting

blood pressure is above normal and when consistenly exceeding 160 mm Hg systolic and 95 mm Hg diastolic

● Low blood pressure is defined as a systolic

pressure of 99 mm Hg or less and diastolic

of 59 mm Hg

arteries, such as the carotid or brachial arteries, and corresponds to the beating of the heart and the contraction of the left ventricle

minute

Test your knowledge

questions

Multiple choice questions

1 Which of the following accounts for 55% of the

composition of blood?

a hormones

b haemoglobin

c fluid or plasma

d erythrocytes, leucocytes and thrombocytes

2 Which blood cell protects the body against

3 Which of the following is not a function of blood?

a transport of oxygen, carbon dioxide, nutrients

and hormones

b protection and defence

c synthesis of vitamins A, D and E

d clotting

4 What is the function of an artery?

a to carry oxygenated blood

b to carry blood under high pressure

c to carry blood away from the heart

d all of the above

5 Which of the following statements is false?

a Veins carry deoxygenated blood.

b Veins are generally superficial.

c Veins do not have valves.

d Veins carry blood towards the heart.

6 What is the function of a capillary?

a to carry only deoxygenated blood

b to carry only oxygenated blood

c to prevent backflow of blood

d to supply cells and tissues with nutrients

7 What is the name of the blood vessel that

carries deoxygenated blood from the heart

to the lungs?

a pulmonary vein

b aorta

c pulmonary artery

d inferior vena cava

8 Which of the following has branches that carry

oxygenated blood around the body?

a left ventricle

b left pulmonary vein

c aorta

d superior vena cava

9 Which of the following best describes the flow of

blood through the heart?

a Blood flows from the capillaries to the veins,

to the arteries and then to the aorta

b Blood flows into the right atrium, then into the

right ventricle, then into the pulmonary artery

The blood returns from the lungs and enters the left atrium, then flows into the left ventricle and into the aorta to all parts of the body

c Blood flows into the sinoatrial nodes, then to

the right ventricle, aorta and coronary arteries

d Blood flows from the brachial artery, to the

left ventricle, the pulmonary arteries and onto the right atrium

10 Where does the blood supply to the arm start?

a at the brachial artery

b at the radial artery

c at the ulnar artery

d at the subclavian artery

13 Describe one characteristic and one function

of each of the following types of blood cells:

a erythrocyte 2 marks

b leucocyte 2 marks

c thrombocyte or platelet 2 marks

14 Name the type of blood cell that is crucial

15 Briefly describe each of the following parts

of the circulation system:

a pulmonary circulation 2 marks

b systemic circulation 2 marks

The lymphatic system is a unidirectional

drainage system for the tissues It helps to

provide a circulatory pathway for tissue fluid

This is transported as lymph from the tissue

spaces of the body into the venous system,

where it becomes part of the blood circulation

Through the filtering action of the lymphatic

nodes, along with the actions of specific organs

such as the spleen, the lymphatic system also

helps to provide immunity against disease.

The human body is equipped with a variety

of defence mechanisms that prevent the entry

of foreign agents known as pathogens This

defence is called immunity When working

effectively, the immune system protects the

body from most infectious micro-organisms It

does this both directly through cells that attack

micro-organisms and indirectly by releasing

chemicals and protective antibodies.

The lymphatic system and

immunity

7

OBJECTIVES

By the end of this chapter you will understand:

main lymphatic nodes of the head, neck and the body

and thymus

lymphatic and other body systems

Functions of the lymphatic system

Drainage of excess fluid from the tissues

It is essential for therapists to

have a working knowledge of

the lymphatic system in order

to understand the effects of

lymphatic drainage on the

tissues Muscle tension can

put pressure on the lymphatic

vessels and interfere with

efficient drainage Any

treatment which relaxes the soft

tissue, such as massage, can

help acclerate lymph drainage