Topic 6

Circulation
Human biology june 2023
4HB
11/12/2022
Part 1
Heart structure
Cardiac cycle
Coronary arteries
Cardiac out out
Blood group

Dr. Nihal Gabr

 Pulmonary artery Aorta
Heart structure

RD Left
Pulmonary vein

LO
x8
4 chambers
Right atrium
Vena cava atrium
2 upper atria
2 lower ventricles Left
Semilunar valves ventricle
Right
Bicuspid
Tricuspid ventricle
4 valves

2 atrioventricular valves 2 semilunar valves

Tricuspid ( Right atrioventricular) Aortic valve
Bicuspid ( left atrioventricular ) . Pulmonic valve
Septum

4 blood vessels

Aorta Venacava ( inferior and superior)

Pulmonary vein Pulmonary artery

Vein ……atrium ….into heart

Artery……ventricle …..away from the heart
 Pulmonary artery Lungs

&
Pulmonary Aorta

·
Pulmonary circulation

Pulmonary vein

Left

LO
Vena cava Right atrium

RD atrium

Double circulatory system Left

Right ventricle
where the blood enters the
ventricle
heart twice in one complete Systemic circulation
circulation .

Hepatic
Hepatic vein Hepatic artery
Liver

Hepatic portal vein

Small intestine

Renal vein Renal Renal artery

Kidney
 Why do we need to have a double circulatory system

( blood enter the heart twice in one circulation

1. To ensure separation of oxygenated and deoxygenated blood
To maintain steep concentration gradient

2. To pump blood under 2 different pressures

Higher pressure generated by contraction of muscular walls of left ventricle to pump
blood to all body parts ( longer distance ) and lower pressure from right ventricle to lungs
to prevent damage of delicate pulmonary capillaries / lungs
Read

Diastole
Systole
Relax
Contract

Cardiac
cycle
Diastole : heart muscle is relaxed ( filling of the heart )
Ventricles and atria are relaxed ………………..atrioventricular open …….semilunar valve is closed

Atria systole ( filling of the ventricles ) Draw on

Atria contract , ventricle relax …….atrioventricular vales open ….semilunar valve closed heart valves
( open /
Ventricular systole ( emptying of the heart 0 close)
Ventricle contract , atria relax….atrioventricular valve close …..semilunar vale open

Coronary arteries supplies heart muscle with sufficient amount of oxygen and
Coronary glucose to respire aerobically and release energy to keep contracting and pumping

arteries blood .
As the heart muscle is thick muscle so diffusion would be too slow and insufficient
in supplying the oxygen and nutrients

Why do we need to have a circulatory system

To over come the limitation of diffusion
( oxygen need to be travelled over a long distance , high energy demand )
1. Human small surface area to volume ratio….so longer diffusion distance …so
diffusion alone would be insufficient to supply the required amount of oxygen and
nutrients to body cells to meet high energy demand / high metabolic rate .
Cardiac Heart rate X stroke volume ( volume of blood pumped by the heart)

out put beats per minute (bpm)

Increase in heart rate can be stimulated by :
1. Electrical impulses through nerves
2. Under control of hormone which is adrenaline

We have two situations in which cardiac output change

Exercise
W
-
Sleeping

Cardiac out put increase Heart rate slow down

To increase the supply of blood to muscles All body organs are working slowly
To supply them with more oxygen and glucose for With less energy demand.
more aerobic respiration……………. So less oxygen is needed to release energy
 What stimulate the increase in heart rate during
exercise

1. Increase in CO2 4. The electrical

concentration in blood impulses from brain

due to increase of will be sent to

aerobic pacemaker in the

respiration ..which is a heart across the

weak acid . accelerator nerve

stimulating the

2. Decrease in blood increase in heart rate .

pH is detected by
receptors in carotid 5. Then Co2

artery and aorta . concentration in

blood decrease and

3. Send impulses to return back to normal

cardiac center in
medulla of brain Brain reduce heart
rate
By negative feed back
Through decelerator
nerve .
 MATCHING DONOR
Blood groups
DAN …..donor ….antigen
RAB …..recipient ……antibody
Blood group A. B. O. AB

Why its not important to take

A into consideration
A B
Antigen on A B
B
antibodies of donor ?
A B
surface of B A 1.Because the volume of
A
RBCs A B
A blood donated is small
A B B
compared to the total volume
No of blood in body of recipient .
Antigen A Antigen B Antigen Antigen A and B
2. So any antibodies from
Antibodies Against donor are too diluted to
NO
in blood Against B Against A both A show ant effect .
ANTIBODIES
and B

A person with blood group O is a

universal DONOR ….
A person with blood group AB is a
universal recipient …..
Blood group Antigen on surface of RBC Antibodies in blood Donors to this blood group

A Antibodies to B Blood group A and O

Blood group A

Blood group B B Antibodies to A Blood group B and O

Blood group o No antigens Antibodies to A and B Only O

Blood group AB A and B No antibodies All blood groups

Person with blood group AB can take blood from any person , yet can only donate to person with blood group AB
Recipient
Person with blood group AB as a recipient , has no antibodies to any blood group .
So if the donor is any blood group like A having antigen A , B having antigen B , or O having no antigens
So no agglutination ..so AB is considered UNIVERSAL RECIPIENT .

Person with blood group AB as a donor , has antigens A and B DAN

RAB
So if the recipient is with blood group other than AB , they have antibodies against A or B
Example , blood group A , has antibodies against B , if blood group B has antibodies against A , blood group O
has antibodies against A and B
So agglutination leads to blockage of blood vessels .
O universal donor
AB is universal recipient
Donor ……antigen
Recipient ……antibodies

Organ transplant :
Limitations ; that bodies own lymphocytes can recognise the non self antigen on the surface of the cells
of donated organs …..so lymphocytes will release antibodies against the foreign cells ….so tissue
rejection takes place

7
7
Y

Tissue typing Immuno suppressants.

Find a donor with SIMILAR
antigens to REDUCE risk of
Drugs to slow
tissue rejection Exposed to
down immune
radiation
system
17/12/2022
Part 2
Heart disease
Heart diseases *
Angina, myocardial infarction ( heart attack) , cardiac arrest
^
Factors increasing risk to CHD

1. / diabetes / lack of exercise / hereditary ( genes)

2. Diet with high Saturated fats ……..increase blood cholesterol level …..accumulate on walls of arteries
( coronary arteries ) …form atheroma …….narrowing blood vessels …increase blood pressure ….increase risk of
clotting / thrombosis…..depriving heart muscle from oxygen .

3. Smoking
Nicotine :
1. Constrict of coronary arteries
A) thus increasing blood pressure ….so putting extra strain on heart muscle and increase risk of building
atheroma
B) less blood supply ( less oxygen ) to heart muscle .
2. Speed up heart rate

4. High blood pressure ; damage to the endothelium of artery cause build up atheroma on walls of arteries
leading to atherosclerosis …putting extra strain on heart muscle to work harder to pump blood .

5. High salt intake ….increase blood pressure ………….

How coronary arteries become diseased

Fat accumulates on walls of arteries

Leading to of atheroma
Narrowing lumen of artery
Increasing blood pressure
Reducing blood supply ( oxygen and glucose ) to heart muscle
Heart muscle unable to respire normally so not enough energy needed to
contract
So angina ....also plaque might block artery / blood clot forms ( thrombosis)
depriving heart muscle from oxygen ... so heart attack

Prevent CHD

1. Exercise : lower blood cholesterol level , strengthen heart muscle , lower resting blood pressure , releaae
stress , elevate mood .
2. Diet less saturated fat and less salt
3. Stop smoking , and drinking alcohol .
 Treatment
Drugs Surgery

Statins …….lower blood cholesterol level

Act as competitive inhibitors For the enzymes

to
involved in synthesis of cholesterol in blood
….lowering blood cholesterol . Angioplasty Heart transplant

Enzyme ..in liver ….cholesterol Functioning heart from

a matching donor who
Plant stanol esters is a person who has
Similar structure to cholesterol recently died
Reduce absorption of cholesterol form the small intestine in blood
Disadvantages /limitations
Beta blockers
Probability of organ rejection
Heart Block the receptors of some hormones such as Hard to find a matching donor
muscle adrenaline ……..slow down of heart rate .
Big surgery can’t be done to patient with
Aspirin ( anti-platelets ) chronic advanced diseases such as liver

Reduce risk of clotting Solution cancer , diabetes.

Artificial heart used till they find a matching
Antihypertensives donor but not successful as permanent solution.
ACE inhibitors Ventricular assist help heart to function
Angioplasty

1. Long thin catheter with a special guide wire , surrounded by a

non inflated balloon and a stent …..is inserted by a doctor
into narrowed artery through leg or arm .

2. The doctor uses the guide wire to help direct the catheter
through vessels to reach the blocked region of coronary
artery ….being watch on X ray screen .

3. Once the catheter reached the narrowed or blocked artery ,

the balloon inflated with water , PUSHING THE ATHEROMA
AGAINST THE walls OF ARTERY .
The inflated balloon expand the stent

4. The ballon is deflated and balloon and the catheter with guide
wire are removed leaving the stent to keep the artery open
allowing a normal blood flow to heart muscle .
24/12/2022

Monoclonal antibodies

Part 3

DR. Nihal Gabr

 Drugs
Read

¥É¥¥
Statins '
They are used to lower blood cholesterol level
Reducing risk of building of atheroma on walls of arteries
Reduce risk of atherosclerosis ….help reduce risk of heart attack and stroke

Mechanism : act as a competitive inhibitor

Compete on the active site of the enzyme responsible for the formation of cholesterol in liver
Inhibit the synthesis of cholesterol .

Plant stanol esters Similar structure to the cholesterol

Thus they inhibit / reduce absorption of cholesterol from intestine into blood .
They naturally occurring substances found in plants ( vegetable oil ) .
They have nt been found affecting development of CVDs .
m_€ →
-0

→
Beta blockers
✓ -0
Heart muscle
Block receptors on surface of heart muscle Cardiac muscle
So heart muscle doesn’t respond to hormones like adrenaline :
So reducing heart rate ( slow down ) and also heart beats with less force …..thus decreasing
blood pressure
 "
Why beta blockers are powerful treatment for angina ?
Imp
09%7--02
i
Oz →

Beta blockers block the receptors …..reducing heart rate and Heart muscle
stroke volume ……so heart has to work less hard and need less relaxed ..so need les
oxygen …..
i oxygen
Definition of angina : chest pain due to the reduced blood flow
to heart muscle and thus reduced oxygen supply .

Yooo Yao
"
Hypertension '

Long term condition at which blood pressure in arteries is persistently higher than normal …….which is a risk
factor for stroke …heart failure , . Kidney failure .

Treatment
How to measure blood pressure :
Mercury manometer ( sphygmomanometer ) Antihypertensives
Digital blood pressure meter . ACE inhibitor
-

Angiotensin converting enzyme

Systolic/ diastolic (ACE) inhibitor
120 / 80 …..normal
Over 140 /90+ persistent …….hypertension .
 ✂

Normally

When blood pressure falls …..the kidney produce rennin enzyme in blood

Renin ACE
Angiotensinogen Angiontensin I Angiotensin II

Inactive protein ( 10 amino acids ) Active protein ( 8 amino acids )

Plasma protein

Hormone ( Ang II ) act on blood

vessels ..causing vasoconstriction
ACE inhibitor …increasing blood pressure

1. Block action of ACE ( angiotensin converting enzyme )

2. Prevention Ang I from binding to ACE
3. So Ang I is not converted into Ang II
4. So blood vessels ( arteries) remain dilated
5. Reduction production of ADH ( antidiuretic hormone)
6. So less water and salts reabsorbed into blood
7. So reducing blood pressure

ADH
Urine
 Lymphocytes are of two types
Active primary immune response

Pathogen
Microorganism causing disease such as fungi , bacteria , virus

O
B cells / B lymphocytes T cells / T
Antigen on its lymphocytes
y surface ( non self )
Will be taken
1 Recognised / detected by immune system incase of HIV
Stimulate an active immune response ……..stimulate spleen to infection
release lymphocytes ( B lymphocytes/ B cells )
B cells Divide by mitosis
2 1.pathogen enter / invade the body
Cloning
2. Stimulate an active immune response
Forms a clone of lymphocytes 3. Activated lymphocytes divide by mitosis to
form a clone of lymphocytes
4. Release antibodies
5. Leave memory cells for faster secondary
immune response
Plasma cells Leave memory cells

Remain circulating in the blood

Activated B cells release
for faster secondary immune
antibodies ( cant divide by mitosis
response against same
…instead they are short lived )
pathogen
 💉
Monoclonal antibodies

One type ( high degree of specificity )

Large amount 7. Large scale production ..where once
the hybridoma cells that produce desired
antibody is identified , they will be isolated
and cloned allowing unlimited supply of
1. Inject the antigen into mouse
monoclonal antibody .

2. This will activate specific

6. Screening and testing hybridoma
lymphocytes ( stimulate active immune
that produce the desired antibody by
response )
testing its ability to bind to antigen
Lymphocytes divide by mitosis and
differentiate into plasma cella
( activated b cells ) and memory cells

5. Hybridoma cells are then

isolated and placed in wells in a
3. Activated B cells / plasma
tray to grow into clones
cells isolated from the spleen of
the mouse ….
4. Fuse the plasma cells with myeloma cells
( cancer cells ) in a special media ….produce
hybridoma cells . Add hybridoma cell
Why are monoclonal antibodies produced in this way :

The activated lymphocytes / plasma cells that secrete the antibodies can’t divide by mitosis
So they are fused with myeloma cells so they can divide indefinitely .
Where they form hybridoma cells that can divide many times and release antibodies

Importance of monolclonal antibodies

Diagnosis Treatment
Pregnancy test
'
Site of blood clot
High degree of specificity ..being able to bind to a
Type of Cancer
specific antigen on the infected or cancerous cell
1. They are produced using antigens from cancer
cells A) binding monoclonal antibody with anticancer drug

2. Thus having high degree of specificity C Which has high degree of specificity so
3. So able to detect one antigen they bind to specific antigen on cancer
4. So used to detect cancer antigen in samples C
cells .
taken from patients
B) bind to the antigen on the cancer cell …trigger
Where the antibody is labelled by binding them to :
an immune response .
A) color dye
zoomcar
more
B) radioactive chemical
C) to fluorescent substance
31/12/2022
Part 4
Blood vessels
Blood cells
Lymphatic system
 Blood vessels
Thick outer layer : contain collagen
to withstand high blood pressure
1 . Artery
without bursting .
Function : carry blood under
What creates this high blood pressure in
high pressure away from heart
All arteries carry oxygenated w arteries ?
Because arteries carry blood away from the
blood except for pulmonary heart where the blood is being pumped by the
artery contraction of the thick muscular walls of the
Narrow lumen to ventricles under high pressure
maintain high
blood pressure Middle layer ( thicker than veins ) :

nu
Contain smooth muscles :

Vasodilation contract ( vasoconstriction ) and relax

man ( vasodilation ) to adjust the volume of blood
Muscles
delivered to different body parts
um
Vasocontriction
ever
Digestive
system
Contain elastic fibres:
Arterioles : smaller branches of
Stretch ( expand ) recoil ( gets narrower) to
arteries ..higher proportion of smooth maintain high blood pressure .
muscles …so can contract and relax …to
adjust volume of blood delivered to body Heart Stretch Recoil
tissues Low pressure
High pressure
 2. Vein
Wide lumen : to offer less resistance to blood flow
which is already moving under low pressure

i Valves : semilunar to prevent back flow of blood

Function : transport blood

from body to heart under low
pressure
Al veins carry deoxygenated 1. Surrounded by skeletal muscles , veins hav thin wall to easily affected by
blood except pulmonary vein the contraction of muscles to squeeze on blood and push blood forward .
2. Semilunar valve to prevent back flow of blood
3. Negative intra thoracic pressure …during inhalation
Low pressure
Help ensure the blood return to heart .
W

Inhaling
High pressure
Volume of chest cavity increase
Pressure inside the lungs decrease
3. Capillaries
1. Thin wall / wall is one cell thick
For shorter diffusion distance

o 2. Large number branches :

Increase surface are …to reach all body cells
Blood pressure low / reduced
Decrease in flow rate of blood in capillaries
Allow sufficient time for exchange of substances for
more diffusion

Offer resistance blood flow

3. Pores in walls
Filtration of small molecules allowing diffusion /
exchange of substances between blood and cells .

4. Small tiny lumen

Almost same size as the RBCs
A) to allow RBCS to move slowly for efficient gas
exchange
B) bring RBCS closer to surface for shorter diffusion
distance .
 1.5 kpa
Artery 2 kpa
Vein 10 kpa
-

Thicker wall Thinner wall

Arteries
I Vein
Narrower lumen Wider lumen
Artery carries blood Capillaries Low pressure as it
No semilunar Semilunar valves under high pressure … A) branched ..large surface receives blood from
valves as they carry blood area..so longer distance capillaries where it
away from the heart has already lost its
High blood Low blood ( away from the heart )
where blood is pumped B) filtration by leakage of pressure + wide
pressure / pressure / by thick muscular blood plasma out through lumen
pulsatile pulsatile walls of ventricles + capillary pores ..volume of
blood decrease so pressure
narrow lumen
More muscular Less muscular of blood is reduced

Carry blood Carry blood to

away from heart heart

:
Difference in pressure
Q=
Why no pulse in vein ? Flow rate R Resistance to blood flow

P R
1. Pulse waves through arteries and arterioles
get weaker as we move far away from the heart Arterioles offer more resistance to blood
2. Where it disappears by time it reaches the flow over capillaries …….. decrease in
I

capillries blood pressure is higher in arterioles than in

3. Vein receive blood from capillaries …so no capillaries
pulse in vein
 4. At the other end of the capillary ( to
2. Blood pressure is higher than Lymphatic system
vein ) , the osmotic pressure is higher
osmotic pressure ..thus plasma than blood pressure . So tissue fluid will
filter out under high pressure return back to blood at venous end by
through capillary pores osmosis

"

-
1 Arterioles '
1. Arterioles
i.
,
.ie
÷
Blood coming from arteries
under high pressure Tissue fluid
5

3. Tissue fluid is formed , which is an immediate environment around every cell

Formed due to …filtration of blood plasma ( without RBCs and plasma proteins as they
are large molecules that cant pass through capillary pores )
Which leaks out of capillary pores under high pressure 5.Lymph vessels
A) drain excess tissue
To allow exchange of substances between blood and cells + example . fluid to join lymphatic
system
B) prevent edema
 Blood Tissue fluid Lymph

Blood has all components Plasma with some types of Similar to tissue fluid
Plasma + plasma proteins WBCs ( phagocytes) Except that it has more
+ blood cells No large plasma proteins and no WBCs
RBCs nor platelets

Filtration of plasma under high Drainage of the excess

pressure tissue fluid

Lymphatic system

1. Return tissue fluid back to the

Transport different Immediate environment
circulation after filtration and
substances and blood cells around every cells to allow
removal of dead cells and
exchange of substances
pathogens
between cells and blood
2. Prevent edema
3. Transport fatty acids from the
lacteal in villi into blood after
changing into a soluble form
 Blood components
55% blood plasma
Blood cells
Liquid part
WBCs
RBCs
90% water 10 % dissolved substances Platelets
Amino acids, glucose , vitamins ,
minerals , oxygen , urea and
plasma proteins 1. Platelets
At damages tissue
100% CO2 being transported in blood as ….platelets become in
5% …….dissolved in blood plasma contact with damaged
"
85%……HCO3-
NRB tissue( collagen fibres) …
10% …….carbamino haemoglobin * they become activated
A) they become more sticky
B) release thrombokinase
Thrombokinase
Prothrombin …………………………thrombin
Inactive protein Active protein
-
Soluble fibrinogen …………insoluble fibrin
#x
Fibrin form a mesh …trap blood cells and form clot
…dry out to form a scab ….prevent entrance of
pathogens and blood loss
 WbC Antigens
+
Receptor proteins
2
Lymphocytes
C
-

T
h h
Pathogen
1. Receptor proteins on the surface membrane of lymphocytes recognise and bind to specific
Immune antigen on specific pathogen .
response 2. They divide by mitosis and form a clone of lymphocytes
3. Then release antibodies
4. Then antibodies bind to antigen on surface of the pathogen and mark the pathogen ……for the
phagocyte to engulf and digest the pathogen i.e for faster and easier engulfing and digesting of
pathogen by phagocyte
By phagocytosis ….
5. Leaving memory cells for faster secondary immune resposne

✓ I
 . & &

2 June 2012 Paper 2

6-

r
ab
3 June 2014
lG Paper 2
iha
6-
AB Donor → recement
any blood gp .
.N

recepie.nl#3 →
any Blood qp Donor .

①
Person with blood group as a donor, has antigens A and B
Dr

While person with other blood groups as recipients such as A has

①

antibodies to B, also recipient with blood group B has Antibody to

A
So agglutination and blockage of blood vessel. ①
①
Person with blood group AB as a recipient, is a universal recipient,
has he has no antibodies ....so no agglutination with any other blood ①
group antigen .

1 1 089
✓
=

=
 . & &
5 June 2015 Paper 2

r
ab
lG
iha
.N
Dr

1 1 092
 . & &

Cholesterol build on walls of coronary artery

r
Forming atheroma

ab
Increase blood pressure
Reducing blood flow to heart muscle
lG
Less oxygen to heart muscle
Leading to heart attack / angina
iha
.N
Dr

1 1 093
1
.

1
Dr
.N

094
iha
lG
&

ab
r
&
 . & &

Increase both blood pressure and heart rate

Plasma

r
ab
Increase heart rate
More oxygen and glucose
lG
Transported to muscles
For more aerobic respiration
To release more energy
iha
Stimulate increase of break down of glycogen into glucose
to increase blood glucose level .
.N
Dr

1 1 095
 . & &

6 June 2015 Paper 2

-41000×0-5×365

r
=

ab
7482500
lG
low platelets
iha
•
count
to blood
• help in
clothing .
.N
Dr

1 1 096
 . & &

DAN
RAB

r
ab
0 → Donor
A, AB→ Recipient
Bio

person with blood

lG group 0 as a donor,
AILBLAIE
0 →Receplent
→ Donor
.

has no antigen acting as a universal donor

iha
where if Receprent is with Blood group A
having antibodies

to B or Blood gp B with Anti A , gp AB with no antibodies

cause no agglutination
.N

person with Blood group E- as a recepient has anH to D-and

Dr

B so with Donor of antigen D- orB

agglutination causing blockage of blood vessel .

1 1 097
 . & &

DAN

r
ab
RAB

lG
Person with blood groupO as a donor , has no antigens , acting as a

÷¥ universal donor
Where no agglutination with antibodies of the recipient of any other
iha
blood group
Person with blood group O as a recipient, has antibodies to A and B
.N

So if the donor is with blood group A with antigens A , blood group B

r-E.EE with antiges B , blood group AB with antigen A and B so

Dr

agglutination ..so blockage of blood vessels .

1 1 097