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 (see respiration). 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.

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.

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 (see urinary system).

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 (see hypertension); 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.

See also heart disease; angina pectoris.

The circulatory system (or cardiovascular system) is an organ system that moves nutrients, gases, and wastes to and from cells, and helps stabilize body temperature and pH to maintain homeostasis. While humans, as well as other vertebrates have a closed circulatory system, some invertebrate groups have open circulatory system. The most primitive animal phyla lack circulatory systems.

Human circulatory system

The main components of the human circulatory system are the heart, the blood, and the blood vessels.

Furthermore, these components can either belong to the systemic circulation and the pulmonary circulation. The systemic circulation is the main part of the circulatory system, while the pulmonary system oxygenates the blood.

Systemic circulation

Main article: Systemic circulation

Systemic circulation is the portion of the cardiovascular system which carries oxygenated blood away from the heart, to the body, and returns deoxygenated blood back to the heart.

In the systemic circulation, arteries bring oxygenated blood to the tissues. As blood circulates through the body, oxygen diffuses from the blood into cells surrounding the capillaries, and carbon dioxide diffuses into the blood from the capillary cells. Veins bring deoxygenated blood back to the heart.

The release of oxygen from red blood cells or erythrocytes is regulated in mammals. It increases with an increase of carbon dioxide in tissues, an increase in temperature, or a decrease in pH. Such characteristics are exhibited by tissues undergoing high metabolism, as they require increased levels of oxygen.

Pulmonary circulation

Main article: Pulmonary circulation

Pulmonary circulation is the portion of the cardiovascular system which carries oxygen-depleted blood away from the heart, to the lungs, and returns oxygenated blood back to the heart.

De-oxygenated blood enters the right atrium of the heart and flows into the right ventricle where it is pumped through the pulmonary arteries to the lungs. Pulmonary veins return the now oxygen-rich blood to the heart, where it enters the left atrium before flowing into the left ventricle. From the left ventricle the oxygen-rich blood is pumped out via the aorta, and on to the rest of the body.

Heart

In the heart there is one atrium and one ventricle for each circulation, and with both a systemic and a pulmonary circulation there are four chambers in total: left atrium, left ventricle, right atrium and right ventricle.

Closed circulatory system

The circulatory systems of humans is closed, meaning that the blood never leaves the system of blood vessels. In contrast, oxygen and nutrients diffuse across the blood vessel layers and enters interstitial fluid, which carries oxygen and nutrients to the target cells, and carbon dioxide and wastes in the opposite direction.

Other vertebrates

The circulatory systems of all vertebrates, as well as of annelids (for example, earthworms) and cephalopods (squid and octopus) are closed, just as in humans. Still, the systems of fish, amphibians, reptiles, and birds show various stages of the evolution of the circulatory system.

In fish, the system has only one circuit, with the blood being pumped through the capillaries of the gills and on to the capillaries of the body tissues. This is known as single circulation. The heart of fish is therefore only a single pump (consisting of two chambers). In amphibians and most reptiles, a double circulatory system is used, but the heart is not always completely separated into two pumps. Amphibians have a three-chambered heart.

Birds and mammals show complete separation of the heart into two pumps, for a total of four heart chambers; it is thought that the four-chambered heart of birds evolved independently from that of mammals.

Open circulatory system

The open circulatory system is an arrangement of internal transport present in animals such as molluscs and arthropods, in which fluid (called hemolymph) in a cavity called the hemocoel bathes the organs directly and there is no distinction between blood and interstitial fluid; this combined fluid is called hemolymph or haemolymph. Muscular movements by the animal during locomotion can facilitate hemolymph movement, but diverting flow from one area to another is limited. When the heart relaxes, blood is drawn back toward the heart through open-ended pores.

Hemolymph fills all of the interior hemocoel of the body and surrounds all cells. Hemolymph is composed of water, inorganic salts (mostly Na⁺, Cl^-, K⁺, Mg²⁺, and Ca²⁺), and organic compounds (mostly carbohydrates, proteins, and lipids). The primary oxygen transporter molecule is hemocyanin.

There are free-floating cells, the hemocytes, within the hemolymph. They play a role in the arthropod immune system.

No circulatory system

Circulatory systems are absent in some animals, including flatworms (phylum Platyhelminthes). Their body cavity has no lining or enclosed fluid. Instead a muscular pharynx leads to an extensively branched digestive system that facilitates direct diffusion of nutrients to all cells. The flatworm's dorso-ventrally flattened body shape also restricts the distance of any cell from the digestive system or the exterior of the organism. Oxygen can diffuse from the surrounding water into the cells, and carbon dioxide can diffuse out. Consequently every cell is able to obtain nutrients, water and oxygen without the need of a transport system.

Measurement techniques

• Electrocardiogram
• Sphygmomanometer
• Pulse meter
• Stethoscope
• Pulse

Health and disease

Main article: Cardiovascular disease

Main article: Congenital heart defect

History of discovery

The valves of the heart were discovered by a physician of the Hippocratean school around the 4th century BC. However their function was not properly understood then. Because blood pools in the veins after death, arteries look empty. Ancient anatomists assumed they were filled with air and that they were for transport of air.

Herophilus distinguished veins from arteries but thought that the pulse was a property of arteries themselves. Erasistratus observed that arteries that were cut during life bleed. He ascribed the fact to the phenomenon that air escaping from an artery is replaced with blood that entered by very small vessels between veins and arteries. Thus he apparently postulated capillaries but with reversed flow of blood.

The 2nd century AD Greek physician, Galen knew that blood vessels carried blood and identified venous (dark red) and arterial (brighter and thinner) blood, each with distinct and separate functions. Growth and energy were derived from venous blood created in the liver from chyle, while arterial blood gave vitality by containing pneuma (air) and originated in the heart. Blood flowed from both creating organs to all parts of the body where it was consumed and there was no return of blood to the heart or liver. The heart did not pump blood around, the heart's motion sucked blood in during diastole and the blood moved by the pulsation of the arteries themselves.

Galen believed that the arterial blood was created by venous blood passing from the left ventricle to the right by passing through 'pores' in the interventricular septum, air passed from the lungs via the pulmonary artery to the left side of the heart. As the arterial blood was created 'sooty' vapors were created and passed to the lungs also via the pulmonary artery to be exhaled.

In 1242 the Arab physician Ibn al-Nafis became the first person to accurately describe the process of blood circulation in the human body, including pulmonary circulation. He stated:

"...the blood from the right chamber of the heart must arrive at the left chamber but there is no direct pathway between them. The thick septum of the heart is not perforated and does not have visible pores as some people thought or invisible pores as Galen thought. The blood from the right chamber must flow through the vena arteriosa (pulmonary artery) to the lungs, spread through its substances, be mingled there with air, pass through the arteria venosa (pulmonary vein) to reach the left chamber of the heart and there form the vital spirit..."

Contemporary drawings of this process have survived. In 1552, Michael Servetus described the same, and Realdo Colombo proved the concept, but it remained largely unknown in Europe.

Finally William Harvey, a pupil of Hieronymus Fabricius (who had earlier described the valves of the veins without recognizing their function), performed a sequence of experiments and announced in 1628 the discovery of the human circulatory system as his own and published an influential book about it. This work with its essentially correct exposition slowly convinced the medical world. Harvey was not able to identify the capillary system connecting arteries and veins; these were later described by Marcello Malpighi.

See also

• Cardiology
• Lymphatic system
• Noise health effects
• Blood vessels
• Innate heat
• Cardiac muscle
• Major systems of the human body
• Heart
• Amato Lusitano
• William Harvey

External links

• The Circulatory System, a comprehensive overview
• The InVision Guide to a Healthy Heart An interactive website
• NCP Cardiovascular Medicine A Journal Covering Clinical Cardiovascular Medicine

Human organ systems
Cardiovascular system • Digestive system • Endocrine system • Immune system • Integumentary system • Lymphatic system • Muscular system • Nervous system • Reproductive system • Respiratory system • Skeletal system • Urinary system

Cardiovascular system
Blood  |  Heart  → Aorta → Arteries → Arterioles → Capillaries → Venules → Veins → Vena cava → Heart → Pulmonary arteries → Lungs → Pulmonary vein

Anatomy of torso, cardiovascular system: heart
Structures	atria (interatrial septum, musculi pectinati) • ventricles (interventricular septum, trabeculae carneae, chordae tendinae, papillary muscle) • valves • cusps
Regions	base • apex • grooves (coronary/atrioventricular, interatrial, anterior interventricula, posterior interventricular) • surfaces (sternocostal, diaphragmatic) • borders (right, left)
Right heart	(vena cavae, coronary sinus) → right atrium (auricle, fossa ovalis, limbus of fossa ovalis, crista terminalis, valve of the inferior vena cava, valve of the coronary sinus) → tricuspid valve → right ventricle (conus arteriosus, moderator band/septomarginal trabecula)  → pulmonary valve → (pulmonary artery and pulmonary circulation)
Left heart	(pulmonary veins) → left atrium (auricle) → mitral valve → left ventricle → aortic valve (aortic sinus) → (aorta and systemic circulation)
Layers	pericardium  (sinus) • epicardium • myocardium • endocardium • cardiac skeleton (fibrous trigone, fibrous rings)
Conduction system	Cardiac pacemaker • SA node • AV node• bundle of His • Purkinje fibers

Cardiovascular system, physiology: cardiovascular physiology
Volumes	Preload - Afterload - End-systolic volume - End-diastolic volume - Frank-Starling law of the heart
Interactions	Cardiac output - Wiggers diagram - Pressure volume diagram
Tropism	Chronotropic - Dromotropic - Inotropic
Hemodynamics	Baroreflex - Kinin-kallikrein system - Renin-angiotensin system - Vasoconstrictors - Vasodilators - Compliance - Vascular resistance
Other	Electrical conduction system of the heart (Cardiac action potential)

Prenatal development/Mammalian development of circulatory system
Vascular	Blood island arteries: Dorsal aorta - Aortic arches - Vitelline arteries - Ductus arteriosus - Umbilical artery veins: Cardinal veins - Ducts of Cuvier - Vitelline veins - Ductus venosus - Umbilical vein
Heart development	Primitive heart tube: Truncus arteriosus - Bulbus cordis - Primitive ventricle - Primitive atrium - Sinus venosus Septum primum (Ostium primum, Ostium secundum) - Septum secundum (Foramen ovale) - other septa (Endocardial cushions/Septum intermedium, Aorticopulmonary septum) - Atrial canal

Circulatory system pathology (I, 390-459)
Hypertension	Hypertensive heart disease - Hypertensive nephropathy - Secondary hypertension (Renovascular hypertension)
Ischaemic heart disease	Angina pectoris (Prinzmetal's angina) - Myocardial infarction - Dressler's syndrome
Pulmonary circulation	Pulmonary embolism - Cor pulmonale
Pericardium	Pericarditis - Pericardial effusion - Cardiac tamponade
Endocardium/heart valves	Endocarditis - mitral valves (regurgitation, prolapse, stenosis) - aortic valves (stenosis, insufficiency) - pulmonary valves (stenosis, insufficiency) - tricuspid valves (stenosis, insufficiency)
Myocardium	Myocarditis - Cardiomyopathy (Dilated cardiomyopathy, Hypertrophic cardiomyopathy, Loeffler endocarditis, Restrictive cardiomyopathy) - Arrhythmogenic right ventricular dysplasia
Electrical conduction system of the heart	Heart block: AV block (First degree, Second degree, Third degree) - Bundle branch block (Left, Right) - Bifascicular block - Trifascicular block Pre-excitation syndrome (Wolff-Parkinson-White, Lown-Ganong-Levine) - Long QT syndrome - Adams-Stokes syndrome - Cardiac arrest Arrhythmia: Paroxysmal tachycardia (Supraventricular, AV nodal reentrant, Ventricular) - Atrial flutter - Atrial fibrillation - Ventricular fibrillation - Premature contraction (Atrial, Ventricular) - Sick sinus syndrome
Other heart conditions	Heart failure - Cardiovascular disease - Cardiomegaly - Ventricular hypertrophy (Left, Right)
Cerebrovascular diseases	Intracranial hemorrhage/cerebral hemorrhage: Extra-axial hemorrhage (Epidural hemorrhage, Subdural hemorrhage, Subarachnoid hemorrhage) - Intra-axial hematoma (Intraventricular hemorrhages, Intraparenchymal hemorrhage) - Anterior spinal artery syndrome - Binswanger's disease - Moyamoya disease
Arteries, arterioles and capillaries	Atherosclerosis (Renal artery stenosis) - Aortic dissection/Aortic aneurysm (Abdominal aortic aneurysm) - Aneurysm - Raynaud's phenomenon/Raynaud's disease - Buerger's disease - Arteritis (Aortitis) - Intermittent claudication - Arteriovenous fistula - Hereditary hemorrhagic telangiectasia - Spider angioma
Veins, lymphatic vessels and lymph nodes	Thrombosis/Phlebitis/Thrombophlebitis (Deep vein thrombosis, May-Thurner syndrome, Portal vein thrombosis, Venous thrombosis, Budd-Chiari syndrome, Renal vein thrombosis, Paget-Schroetter disease) - Varicose veins (Hemorrhoid, Esophageal varices, Varicocele, Gastric varices, Caput medusae) - Superior vena cava syndrome - Lymph(Lymphadenitis, Lymphedema, Lymphangitis)
See also congenital (Q20-Q28, 745-747)

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