The main function of the vascular system is transportation. On the one hand, it transports nutrients absorbed by the digestive system and oxygen absorbed by the respiratory system to tissues and cells, and at the same time, it transports metabolites and carbon dioxide Transport to urinary system, respiratory system In addition, hormones produced by endocrine organs and endocrine tissues are transported to target organs and target cells to regulate their activities. The latest research finds the vascular system endothelial cells The smooth muscle also has endocrine function, participating in metabolism and immunity. 1、 Cardiovascular system
The cardiovascular system consists of the heart, blood vessels (including arteries, capillaries and veins) and blood
（1） Heart
1, heart Location and form of 2. Structure of heart cavity
The heart cavity is divided into two halves with longitudinal atrial septum and ventricular septum. Each half is further divided into the upper atrium and the lower ventricle. The ipsilateral atrium and ventricle are each connected by the atrioventricular orifice
3. Structure of core wall
The heart wall consists of epicardium, myocardium and endocardium
4. Cardiac blood vessel 5. Heart conduction system and nerve control 6. Pericardium
（2） Blood vessel
1. Types and distribution of blood vessels
2. Blood vessels of pulmonary circulation
3. Blood vessels of systemic circulation
(1) Artery system of systemic circulation
(2) Venous system of systemic circulation
2、 Lymphatic system
The lymphatic system consists of lymphatic vessels, lymphatic tissues, lymphatic organs and lymph
（1） Lymphatic vessel
Lymphatic pipeline refers to the pipeline through which lymph passes. It can be divided into lymphatic capillaries, lymphatic vessels, lymphatic trunks and lymphatic vessels according to the collection order, caliber and thickness of the pipe wall
2. Lymphatic vessels
3. Lymphatic trunk
4. Lymphatic duct
5. Lymphogenesis and lymphatic circulation
（2） Lymphatic tissue and organs
1. Lymphoid tissue
2. Lymphatic organs
(1) Thymus
(2) Spleen
(3) Tonsil
(4) Haemolymph node
(5) Lymph nodes
Vascular microanatomy
1、 Cardiovascular system
（1） Blood vessel
1. Capillaries
(1) Structure
(2) Classification
① Continuous capillary
② Porous capillary
③ Blood sinus
2. Artery
3. Veins
（2） Heart
1. Endocardium
2. Myocardial membrane
3. Epicardium
4. Heart valve
（3） Microcirculation
Blood circulation in microvessels between arterioles and venules
1. Structure
2. Way
2、 Lymphatic system
（1） Thymus
1. Cortex
2. Medulla
（2） Lymph nodes
1. Cortex
2. Medulla
（3） Spleen
1. Membrane and trabecula
2. Essence
(1) White pulp
(2) Red pulp
Circulatory physiology
1、 Heart pumping function
（1） Cardiac cycle
Every time the heart contracts and relaxes, it is called a cardiac cycle
Generally, a cardiac cycle process is divided into
1. Atrial systole
2. Ventricular systolic period
3. Ventricular diastole
（2） Heart rate
The number of heart beats per minute is called heart rate
（3） Heart sound
（4） Cardiac output and its influencing factors
1. Stroke output and minute output
Stroke output=ventricular end diastolic volume - ventricular end systolic volume
Output per minute=heart rate × stroke output
2. Main factors affecting cardiac output
(1) Venous reflux
(2) Contractility of ventricular muscle
(3) Heart rate
2、 Myocardial Bioelectric phenomenon And physiological characteristics A, Working cells: form the walls of atrium and ventricle
It has excitability, conductivity, contractility, but not self-discipline
B, Special myocardial cells: special conduction system constituting the heart, with excitability, conductivity, self-discipline, and almost no systolic function
（1） Bioelectric phenomena of cardiac myocytes
1. Working cell transmembrane potential and its formation mechanism
(1) Resting transmembrane potential: the two sides of the membrane are polarized in the resting state, and the intramembrane potential is - 90mv
(2) Action potential: Compared with skeletal muscle, the action potential of ventricular muscle in the repolarization process is much more complex and has a longer duration. It is not symmetrical with the ascending branch. Generally, numbers such as 0,1,2,3,4 are used to represent various periods of myocardial action potential
① Depolarization process (phase 0)
② Repolarization phase 1:
③ Phase 2 repolarization - platform
④ The end of rapid repolarization (phase 3)
⑤ Rest period (4 periods)
（2） Electrophysiological characteristics of myocardium
All myocardial cells are excitable
1. Factors determining and influencing excitability:
___① Resting potential level
___② Threshold potential level
___③ Character of Na+channel: Na+channel has three states: active, inactive and standby
2. Excitatory Periodic change : ___③ Supernormal period
3. The relationship between the periodic changes of excitability and contractile activity in the process of excitation:
(1) No rigidity contraction
(2) Functional fitness
(3) Pre contract and compensatory interval
（3） Automatic rhythm of myocardium
The characteristic that tissues and cells can automatically generate rhythmic excitation without external stimulation is called autorhythmicity (short for autonomy). The autorhythmicity of myocardium originates from the cardiomyocytes themselves. The tissues or cells with autorhythmicity are called autorhythmicity or autorhythmicity cells
（4） Conduction of cardiac conduction and excitation in the heart__
3、 Vascular physiology
（1） Blood flow, blood flow resistance, blood pressure
1. Formation of blood pressure and its influencing factors
Blood pressure refers to the lateral pressure of blood in the blood vessel on the vessel wall per unit area, that is, pressure. The unit of blood pressure is kPa
(1) Formation of blood pressure
① The filling of blood vessels and the circulatory system Average filling pressure Only when the blood fills the blood vessel can we talk about the lateral pressure on the vessel wall ② Cardiac ejection: the energy released by the ventricular contraction is divided into two parts
___A. It is used to promote blood flow. It is kinetic energy,
___B. The formation of lateral pressure on blood vessel wall is potential energy
③ Peripheral resistance
(2) Factors affecting arterial pressure
All factors that can affect cardiac output and peripheral resistance can affect arterial blood pressure
① Cardiac output per beat
② Heart rate
③ Peripheral resistance
④ Elastic reservoir of arteries and great arteries
⑤ Ratio of circulating blood volume to vascular system volume
2. Blood pressure, pulse pressure
When the ventricle contracts, the arterial pressure rises to the highest value, which is called systolic pressure; When the blood pressure drops to the lowest value during ventricular diastole, it is called diastolic pressure; The difference between systolic pressure and diastolic pressure is called pulse pressure
（2） Formation and influencing factors of tissue fluid
Effective filtration pressure =(capillary pressure+tissue colloid osmotic pressure)-（ Plasma colloid osmotic pressure +Organizational static pressure) When the effective filtration pressure is greater than 0, tissue fluid will be generated, otherwise tissue fluid will be reabsorbed
（3） Formation of lymph
Some of the tissue fluid left in the tissue returns to the lymphatic vessels to form lymph
1. Physiological significance of lymph reflux
① It can bring protein molecules in tissue fluid back to the blood
② Remove large molecules in tissue fluid that cannot be reabsorbed by capillaries, as well as red blood cells and bacteria in tissue,
③ It plays an important role in the absorption of nutrients, especially fat
④ It plays a role in the balance of tissue fluid production and reabsorption
2. Factors affecting the formation of lymph:
4、 Regulation of cardiovascular activities
（1） Neuromodulation
1. Nerve branches of the heart
2. Nerve innervation of blood vessels
3. Cardiovascular center
4. Cardiovascular reflex
(1) Carotid sinus Baroreceptor reflex - Decompression reflex (2) Carotid body And main vein chemoreceptor reflex （2） Humoral regulation
1. Renin angiotensin system
2, Vasopressin (Antidiuretic urea) 3, adrenaline , norepinephrine 4. Vasoactive substances generated by vascular endothelium
§ Blood
1、 Internal environment of the body
The fluid contained in animal body is collectively called body fluid
Single celled organisms live in water and can exchange materials directly with the water environment. Most cells of multicellular organisms cannot directly contact the water environment of the external environment, but can only exchange with the water (or external) environment indirectly through extracellular fluid. Therefore, extracellular fluid constitutes the direct environment for cell life, called the internal environment, to distinguish the external environment where the whole organism lives
2、 Composition and physicochemical properties of blood
1. Composition of blood
2. Physical and chemical properties of blood
(1) Blood color and smell
(2) Blood density
(3) Blood viscosity
(4) Osmotic pressure of blood
Osmotic pressure refers to the force that the solute in the solution causes water molecules to diffuse from one side of the solution to the other through the semipermeable membrane
Plasma osmolality includes Plasma crystal osmotic pressure And plasma colloid osmotic pressure. The plasma osmotic pressure formed by crystalline substances (such as electrolytes) in plasma is mainly called crystal osmotic pressure. It is very important to maintain the water balance inside and outside cells from Plasma protein The osmotic pressure formed is called colloid osmotic pressure, which plays an important role in the water balance inside and outside blood vessels (5) PH
The blood of animals is weakly alkaline. Under normal conditions, in addition to the elimination of excessive acid-base substances through the lungs and kidneys, it mainly depends on the buffer pairs in the blood. The most important buffer pair is NaHCO3/H2CO3. The content of NaHCO3 in the blood is called alkaline storage
3、 Blood cell physiology
1. Red blood cells
(1) Plasticity
Red blood cells will deform when passing through vessels with a diameter smaller than that of red blood cells, and then return to their original state after passing
The characteristic that red blood cells can remain suspended in plasma without sinking is called the suspension stability of red blood cells. It is expressed by the distance of sinking in the blood sedimentation tube at the end of the first hour Erythrocyte sedimentation Speed, referred to as ESR (3) Erythrocyte osmotic fragility
The rupture of red blood cells due to physical reasons is called mechanical brittleness. When the concentration of NaCl further decreases, some red blood cells will expand and rupture due to excessive expansion hemoglobin This phenomenon is called erythrolysis, or hemolysis for short Hypotonic solution It is characterized by swelling, cracking and hemolysis, which is called osmotic fragility. The function of hemoglobin can only be exerted in intact red blood cells 0.85% - 0.9% NaCl is isotonic solution and isotonic solution
2. Physiological function of white blood cells
3. Platelets
(1) Physiological characteristics of platelets
A, adhere
When the vascular endothelium is damaged and collagen tissue is exposed, platelet adhesion is immediately caused, which is called platelet adhesion
B, gather
Platelets adhere to each other and aggregate into clusters, which is called platelet aggregation
C, shrink
It refers to the contraction process of contractile protein in platelets. It can lead to blood clot retraction, thrombosclerosis, and is conducive to the hemostasis process
D, adsorbent
Platelets can adsorb various coagulation factors in plasma on the surface
(2) Physiological function of platelet
It mainly participates in physiological hemostasis and blood coagulation
4、 Physiological hemostasis
（1） Physiological hemostasis
The blood flows out of the blood vessel and stops bleeding after several minutes under normal circumstances, which is called physiological hemostasis
The physiological hemostasis process includes three processes:
___(1) Contraction of small blood vessels immediately after injury
___(2) Thrombosis To achieve preliminary hemostasis ___(3) fibrin Block formation （2） Blood coagulation
1. Concept
When blood leaves blood vessels, it changes from a sol state to a gel state that cannot flow, which is called blood coagulation (or hemagglutination)
2. Coagulation process can be divided into three steps
The first stage is the activation and formation of coagulation factor FX into FXa Prothrombin Complex (prothrombin activator); The second stage is the activation of prothrombin (FII) into thrombin (FIIa);
The third stage is Fibrinogen (F Ⅰ) into fibrin (F Ⅰ a) 3. There are two ways to trigger blood coagulation
① Coagulation which is caused by the formation of thromboplastin by coagulation factors in plasma is called endogenous activation pathway
② The coagulation factor is activated by tissue factor released from extravascular tissue, and the coagulation is called exogenous activation pathway
（3） Anticoagulation and coagulation promotion measures
1. Anti coagulation measures
① Remove calcium ions from blood
② Low temperature retards snow condensation
③ Smooth surface: it can reduce the aggregation and disintegration of platelets, weaken the trigger of coagulation process, thus delaying the formation of thrombin
④ Use heparin and dicoumarin
⑤ Mixing
2. Coagulation promotion measures
① Ca2+promotes coagulation
② Vitamin K promotes blood coagulation
③ Heating
