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The cardiovascular system is sometimes called the blood- vascular or simply the
circulatory system. It consists of the heart, which is a muscular pumping device, and a closed
system of vessels called arteries, veins, and capillaries. As the name implies, blood contained in
the circulatory system is pumped by the heart around a closed circle or circuit of vessels as it
passes again and again through the various "circulations" of the body.

The vital role of the cardiovascular system in maintaining homeostasis depends on the
continuous movement of blood through the thousands of miles of capillaries that permeate every
tissue and reach every cell in the body. It is in the microscopic capillaries that blood performs its
ultimate transport function. Nutrients and other essential materials pass from capillary blood into
fluids surrounding the cells as waste products are removed.



The heart is a muscular pump that provides the force necessary to circulate the blood to
all the tissues in the body. Its function is vital because, to survive, the tissues need a continuous
supply of oxygen and nutrients, and metabolic waste products have to be removed. Deprived of
these necessities, cells soon undergoirreversible changes that lead to death. While blood is the
transport medium, the heart is the organ that keeps the blood moving through the vessels. It is
located between the lungs in the middle of the chest, behind and slightly to the left of the
breastbone (sternum). A double-layered membrane called the pericardium surrounds the heart
like a sac. The outer layer of the pericardium surrounds the roots of the heart's major blood
vessels and is attached by ligaments to your spinal column, diaphragm, and other parts of your
body. The inner layer of the pericardium is attached to the heart muscle. A coating of fluid
separates the two layers of membrane, letting the heart move as it beats, yet still be attached to
your body.


Blood is actually a tissue. It is thick because it is made up of a variety of cells, each
having a different job. In fact, blood is actually about 80% water and 20% solid.
—Y mlatelets, which help the blood to clot. Clotting stops the blood from flowing out of the
body when a vein or artery is broken. mlatelets are also called thrombocytes.
—Y èed blood cells, which carry oxygen. Of the 3 types of blood cells, red blood cells are the
most plentiful. In fact, a healthy adult has about 35 trillion of them. The body creates
these cells at a rate of about 2.4 million a second, and they each have a life span of about
120 days. èed blood cells are also called erythrocytes.

—Y White blood cells, which ward off infection. These cells, which come in many shapes and
sizes, are vital to the immune system. When the body is fighting off infection; it makes
them in ever-increasing numbers. Still, compared to the number of red blood cells in the
body, the number of white blood cells is low. Most healthy adults have about 700 times
as many red blood cells as white ones. White blood cells are also called leukocytes.
Blood also contains hormones, fats, carbohydrates, proteins, and gases.
Blood carries oxygen from the lungs and nutrients from the digestive tract to the body¶s cells. It
also carries away carbon dioxide and all of the waste products that the body does not need. (The
kidneys filter and clean the blood.) Blood also helps keep your body at the right temperature.
Carries hormones to the body¶s cells sends antibodies to fight infection. Contains clotting factors
to help the blood to clot and the body¶s tissues to heal


Blood vessels are the channels or conduits through which blood is distributed to body
tissues. The vessels make up two closed systems of tubes that begin and end at the heart. One
system, the pulmonary vessels, transports blood from the right ventricle to the lungs and back to
the left atrium. The other system, the systemic vessels, carries blood from the left ventricle to the
tissues in all parts of the body and then returns the blood to the right atrium. Based on their
structure and function, blood vessels are classified as arteries, capillaries, or veins.

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Arteries carry blood away from the heart. mulmonary arteries transport blood that has low
oxygen content from the right ventricle to the lungs. Systemic arteries transport oxygenated
blood from the left ventricle to the body tissues. Blood is pumped from the ventricles into large
elastic arteries that branch repeatedly into smaller and smaller arteries until the branching results
in microscopic arteries called arterioles. The arterioles play a key role in regulating blood flow
into the tissue capillaries. About 10 percent of the total blood volume is in the systemic arterial
system at any given time. The wall of an artery consists of three layers. The innermost layer, the
tunica intima (also called tunica interna), is simple squamous epithelium surrounded by a
connective tissue basement membrane with elastic fibers. The middle layer, the tunica media, is
primarily smooth muscle and is usually the thickest layer. It not only provides support for the
vessel but also changes vessel diameter to regulate blood flow and blood pressure. The outermost
layer, which attaches the vessel to the surrounding tissue, is the tunica externa or tunica
adventitia. This layer is connective tissue with varying amounts of elastic and collagenous fibers.
The connective tissue in this layer is quite dense where it is adjacent to the tunic media, but it
changes to loose connective tissue near the periphery of the vessel.


Capillaries, the smallest and most numerous of the blood vessels, form the connection
between the vessels that carry blood away from the heart (arteries) and the vessels that return
blood to the heart (veins). The primary function of capillaries is the exchange of materials
between the blood and tissue cells. Smooth muscle cells in the arterioles where they branch to
form capillaries regulate blood flow from the arterioles into the capillaries.


Veins carry blood toward the heart. After blood passes through the capillaries, it enters
the smallest veins, called venules. From the venules, it flows into progressively larger and larger
veins until it reaches the heart. In the pulmonary circuit, the pulmonary veins transport blood
from the lungs to the left atrium of the heart. This blood has high oxygen content because it has
just been oxygenated in the lungs. Systemic veins transport blood from the body tissue to the
right atrium of the heart. This blood has reduced oxygen content because the oxygen has been
used for metabolic activities in the tissue cells. The walls of veins have the same three layers as
the arteries. Although all the layers are present, there is less smooth muscle and connective
tissue. This makes the walls of veins thinner than those of arteries, which is related to the fact
that blood in the veins has less pressure than in the arteries. Because the walls of the veins are
thinner and less rigid than arteries, veins can hold more blood.


Blood flow refers to the movement of blood through the vessels from arteries to the
capillaries and then into the veins. mressure is a measure of the force that the blood exerts against
the vessel walls as it moves the blood through the vessels. Like all fluids, blood flows from a
high pressure area to a region with lower pressure. Blood flows in the same direction as the
decreasing pressure gradient: arteries to capillaries to veins.

The rate, or velocity, of blood flow varies inversely with the total cross-sectional area of
the blood vessels. As the total cross-sectional area of the vessels increases, the velocity of flow
decreases. Blood flow is slowest in the capillaries, which allows time for exchange of gases and
nutrients. èesistance is a force that opposes the flow of a fluid. In blood vessels, most of the
resistance is due to vessel diameter. As vessel diameter decreases, the resistance increases and
blood flow decreases. Very little pressure remains by the time blood leaves the capillaries and
enters the venules. Blood flow through the veins is not the direct result of ventricular contraction.
Instead, venous return depends on skeletal muscle action, respiratory movements, and
constriction of smooth muscle in venous walls.

 
mulse refers to the rhythmic expansion of an artery that is caused by ejection of blood
from the ventricle. It can be felt where an artery is close to the surface and rests on something
firm. In common usage, the term blood pressure refers to arterial blood pressure, the pressure in
the aorta and its branches. Systolic pressure is due to ventricular contraction. Diastolic pressure
occurs during cardiac relaxation. mulse pressure is the difference between systolic pressure and
diastolic pressure. Blood pressure is measured with a sphygmomanometer and is recorded as the
systolic pressure over the diastolic pressure. Four major factors interact to affect blood pressure:
cardiac output, blood volume, peripheral resistance, and viscosity. When these factors increase,
blood pressure also increases. The blood vessels of the body are functionally divided into two
distinctive circuits: pulmonary circuit, which circulates blood through the lungs, is the right
ventricle. The left ventricle is the pump for the systemic circuit, which provides the blood supply
for the tissue cells of the body.

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mulmonary circulation transports oxygen-poor blood from the right ventricle to the lungs
where blood picks up a new blood supply. Then it returns the oxygen- rich blood to the left
atrium.

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 The systemic circulation provides the functional blood supply to all body tissue. It carries
oxygen and nutrients to the cells and picks up carbon dioxide and waste products. Systemic
circulation carries oxygenated blood from the left ventricle, through the arteries, to the capillaries
in the tissues of the body. From the tissue capillaries, the deoxygenated blood returns through a
system of veins to the right atrium of the heart.

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The liver is an organ present in vertebrates and some other animals. It plays a major role
in metabolism and has a number of functions in the body, including glycogen storage,
decomposition of red blood cells, plasma protein synthesis, and detoxification. This organ also is
the largest gland in the human body. It lies below the diaphragm in the thoracic region of the
abdomen. It produces bile, an alkaline compound which aids in digestion, via the emulsification
of lipids. It also performs and regulates a wide variety of high-volume biochemical reactions
requiring very specialized tissues.

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The kidneys are organs that filter wastes (such as urea) from the blood and excrete them,
along with water, as urine. In humans, the kidneys are located in the posterior part of the
abdomen. There is one on each side of the spine; the right kidney sits just below the liver, the left
below the diaphragm and adjacent to the spleen. Above each kidney is an adrenal gland (also
called the suprarenal gland). The asymmetry within the abdominal cavity caused by the liver
results in the right kidney being slightly lower than the left one while the left kidney is located
slightly more medial.


 
The kidney is one of the major organs involved in whole-body homeostasis. Among its
homeostatic functions are acid-base balance, regulation of electrolyte concentrations, control of
blood volume, and regulation of blood pressure. The kidneys accomplish these homeostatic
functions independently and through coordination with other organs, particularly those of the
endocrine system. The kidney communicates with these organs through hormones secreted into
the bloodstream.

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The kidneys regulate the pH, by eliminating H ions concentration called augmentation
mineral ion concentration, and water composition of the blood.


Sodium ions are controlled in a homeostatic process involving aldosterone which
increases sodium ion reabsorption in the distal convoluted tubules. When blood pressure
becomes low, a proteolytic enzyme called èenin is secreted by cells of the juxtaglomerular
apparatus (part of the distal convoluted tubule) which are sensitive to pressure. èenin acts on a
blood protein, angiotensinogen, converting it to angiotensin I (10 amino acids). Angiotensin I is
then converted by the Angiotensin-converting enzyme (ACE) in the lung capillaries to
Angiotensin II (8 amino acids), which stimulates the secretion of Aldosterone by the adrenal
cortex, which then affects the renal tubules. Aldosterone stimulates an increase in the
reabsorption of sodium ions from the kidney tubules which causes an increase in the volume of
water that is reabsorbed from the tubule. This increase in water reabsorption increases the
volume of blood which ultimately raises the blood pressure.

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Any significant rise or drop in plasma osmolality is detected by the hypothalamus, which
communicates directly with the posterior pituitary gland. A rise in osmolality causes the kidney
and an increase in urine concentration. The two factors work together to return the plasma
osmolality to its normal levels.

 
The kidneys secrete a variety of hormones, including erythropoietin, urodilatin, renin and
vitamin D.

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"  
Angiotensin is an oligopeptide in the blood that causes vasoconstriction, increased blood
pressure, and release of aldosterone from the adrenal cortex. It is a powerful dipsogen. It is
derived from the precursor molecule angiotensinogen, a serum globulin produced in the liver. It
plays an important role in the renin- angiotensin system. èenin's primary function is therefore to
eventually cause an increase in blood pressure, leading to restoration of perfusion pressure in the
kidneys.


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Angiotensin I is formed by the action of renin on angiotensinogen. èenin is produced in
the kidneys in response to both decreased intra-renal blood pressure at the juxtaglomerular cells,
or decreased delivery of Na+ and Cl- to the macula densa. If more Na+ is sensed, renin release is
decreased. èenin cleaves the peptide bond between the leucine (Leu) and valine (Val) residues
on angiotensinogen, creating the ten amino acid peptide (des-Asp) angiotensin I.

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Angiotensin I is converted to angiotensin II through removal of two terminal residues by
the enzyme Angiotensin-converting enzyme (ACE, or kinase), which is found predominantly in
the capillaries of the lung. ACE is actually found all over the body, but has its highest density in
the lung due to the high density of capillary beds there. Angiotensin II acts as an endocrine,
autocrine/ paracrine, and intracrine hormone. ACE is a target for inactivation by ACE inhibitor
drugs, which decrease the rate of angiotensin II production. Angiotensin II increases blood
pressure by stimulating the Gq protein in vascular smooth muscle cells (which in turn activates
contraction by an Im3-dependent mechanism). ACE inhibitor drugs are major drugs against
hypertension.

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 Angiotensin III has 40% of thepr essor activity of Angiotensin II, but 100% of the
aldosterone producing activity.

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Angiotensin IV is a hexapeptide which, like angiotensin III, has some lesser activity