48.1
Invertebrate Circulatory Systems
pp. 1064–1065- The kind of circulatory system an invertebrate has tracks its size, complexity, and lifestyle. Small and thin animals need less machinery.
- Sponges and most cnidarians use environmental water as their circulatory fluid. Sponges draw water through many incurrent pores and expel it through one osculum. Hydra moves water through a gastrovascular cavity that serves digestion and circulation at once.
- This works in Hydra because the body wall is only two cell layers thick, so every cell touches either the outside water or the gastrovascular cavity.
- Pseudocoelomate invertebrates (roundworms, rotifers) circulate using body cavity fluid, stirred by body movements. Again, they are small or long and thin.
- Larger animals have tissues several cell layers thick. Interior cells are too far from any surface to exchange directly, so an internal fluid moved by a circulatory system is required.
- In an open circulatory system (most mollusks and arthropods) there is no distinction between circulating fluid and extracellular fluid. That fluid is called hemolymph. Watch Open and closed circulatory systems | Body fluids and circulation | Biology | Khan Academy on YouTube, from Khan Academy India - English
- In an insect, a muscular tube — the heart — pumps hemolymph through channels and cavities in the body; the fluid then drains back into the central body cavity and is recirculated. Flow is a one-way path, not a loop.
- In a closed circulatory system, the fluid — blood — is always inside vessels that carry it away from and back to the heart. Found in cephalopod mollusks, annelids, and all vertebrates. Watch Open and closed circulatory systems | Body fluids and circulation | Biology | Khan Academy on YouTube, from Khan Academy India - English
- Earthworm example: a dorsal vessel contracts rhythmically as the pump, pushing blood through five small connecting arteries (which also pump) into a ventral vessel that carries blood posteriorly before it reenters the dorsal vessel. Smaller branches serve the tissues.
48.2
The Components of Vertebrate Blood
pp. 1065–1068- Blood is a connective tissue: a fluid matrix called plasma in which formed elements — red blood cells, white blood cells, and platelets — circulate. Watch Blood, Part 1 - True Blood: Crash Course Anatomy & Physiology #29 on YouTube, from CrashCourse
- Three functions of circulating blood. 1. Transportation — everything cells need, moving in: red cells carry O₂ on hemoglobin, plasma carries nutrients; wastes move out through liver and kidneys. 2. Regulation — hormones from endocrine glands are delivered, and skin vessels constrict or dilate to conserve or dump heat. 3. Protection — clotting stops blood loss, and leukocytes disable microbes and toxins.
- Composition by volume in mammals: plasma 55%, red blood cells 45%, platelets + leukocytes (buffy coat) <1%. In fish: plasma 69%, red blood cells 30%, buffy coat 1%. Mammals have a much higher hematocrit. Watch Blood, Part 1 - True Blood: Crash Course Anatomy & Physiology #29 on YouTube, from CrashCourse
- Plasma is 92% water and carries three cargo classes. Nutrients, wastes, and hormones — glucose, amino acids, vitamins, nitrogenous wastes, CO₂, endocrine signals. Ions — mostly Na⁺, Cl⁻, and HCO₃⁻, with traces of Ca²⁺, Mg²⁺, Cu²⁺, K⁺, and Zn²⁺. Proteins — made mostly by the liver. Watch Blood, Part 1 - True Blood: Crash Course Anatomy & Physiology #29 on YouTube, from CrashCourse
- Plasma protein breakdown: albumin is the most abundant (54%); α and β globulins (38%) carry lipids and steroid hormones; fibrinogen (7%) is required for clotting. Plasma with the fibrinogen removed is serum. Watch Blood, Part 1 - True Blood: Crash Course Anatomy & Physiology #29 on YouTube, from CrashCourse
- Erythrocytes: about 5 million per microliter (4–6 million/mm³). The fraction of blood volume they occupy is the hematocrit, roughly 45% in humans. Shaped like a doughnut with a central depression that does not pierce through. Watch Blood, Part 1 - True Blood: Crash Course Anatomy & Physiology #29 on YouTube, from CrashCourse
- Mature mammalian erythrocytes lack nuclei; all other vertebrates keep nucleated red cells. Vertebrate hemoglobin is found only inside erythrocytes; in invertebrates the oxygen-binding pigment also floats free in plasma. Watch Blood, Part 1 - True Blood: Crash Course Anatomy & Physiology #29 on YouTube, from CrashCourse
- Leukocytes: fewer than 1% of blood cells — only 1 or 2 per 1000 erythrocytes. They are larger than erythrocytes and have nuclei, and unlike red cells they can squeeze out of capillaries into the interstitial fluid. Watch Blood, Part 2 - There Will Be Blood: Crash Course Anatomy & Physiology #30 on YouTube, from CrashCourse
- Granular leukocytes (named for staining of cytoplasmic granules): neutrophils, eosinophils, basophils. Agranular: monocytes, lymphocytes.
- Abundance order in humans: neutrophils > lymphocytes > monocytes > eosinophils > basophils. Watch Blood, Part 2 - There Will Be Blood: Crash Course Anatomy & Physiology #30 on YouTube, from CrashCourse
- Platelets are cell fragments about 3 µm across, pinched off larger bone marrow cells. They contain actin and myosin, are released on injury, and with fibrin form a plug that contracts to pull wound edges together. Watch Blood, Part 2 - There Will Be Blood: Crash Course Anatomy & Physiology #30 on YouTube, from CrashCourse
- Clotting is an enzyme cascade. Step one is mechanical: smooth muscle in the vessel wall contracts and the vessel constricts. Platelets then stick to each other and to surrounding tissue, forming a plug. Watch Coagulation Cascade and Fibrinolysis - clotting factors, regulation and control mechanism on YouTube, from Armando Hasudungan
- The cascade is triggered by platelets, plasma factors, and molecules from damaged tissue. The liver releases prothrombin; prothrombin activator + prothrombin + Ca²⁺ → thrombin, and thrombin + fibrinogen + Ca²⁺ → fibrin. Activating thrombin is the last step in the cascade. Watch Coagulation Cascade and Fibrinolysis - clotting factors, regulation and control mechanism on YouTube, from Armando Hasudungan
- Insoluble fibrin threads reinforce the platelet plug and contract into a tighter mass. The clot = platelets + fibrin + trapped erythrocytes. After healing, the clot is dissolved — important, because a loose clot can block a brain vessel (stroke) or a coronary vessel (heart attack). Watch Coagulation Cascade and Fibrinolysis - clotting factors, regulation and control mechanism on YouTube, from Armando Hasudungan
- Formed elements have finite life spans. Old cells and fragments are digested by phagocytes in the spleen, and salvaged iron and amino acids are reused.
- Hematopoiesis is blood cell production in bone marrow. Pluripotent stem cells give rise to a lymphoid stem cell (→ B and T lymphocytes) and a myeloid stem cell (→ erythrocytes, megakaryocytes, neutrophils, eosinophils, basophils, monocytes). Watch Blood, Part 2 - There Will Be Blood: Crash Course Anatomy & Physiology #30 on YouTube, from CrashCourse
- When blood oxygen falls, the kidney converts a plasma protein into the hormone erythropoietin, which drives erythropoiesis from myeloid stem cells. This is why erythropoietin is a banned doping agent. Watch Blood, Part 2 - There Will Be Blood: Crash Course Anatomy & Physiology #30 on YouTube, from CrashCourse
- Megakaryocytes are committed marrow cells whose cytoplasm pinches off into platelets.
48.3
Vertebrate Circulatory Systems
pp. 1068–1071- Closed systems and larger hearts put a premium on efficiency. Linking circulation tightly to respiration is what allowed vertebrates to diversify on land and in water and to get large.
- Ancestral chordates likely had a simple tubular heart, like a lancelet — barely more than a heavily muscled zone of the ventral artery, contracting in peristaltic waves.
- Gills demanded a better pump, so fish evolved a true chamber-pump heart: four structures in series forming two pumping chambers. Sinus venosus + atrium = first chamber; ventricle + conus arteriosus = second.
- The fish contraction order — sinus venosus, atrium, ventricle, conus arteriosus — is conserved in all vertebrates even though chamber names and positions changed.
- Fish circulation is a single circuit: heart → gills → body → heart. Its weakness is that blood loses substantial pressure crossing the gill capillaries, so it reaches the tissues slowly and at low pressure. Watch How many chambers do animals' hearts have? | Body fluids and circulation | Biology | Khan Academy on YouTube, from Khan Academy India - English
- Lungs required a second pump. Blood from the lungs returns to the heart first via pulmonary veins, then gets pumped out again to the body. That two-loop design is double circulation: the pulmonary circuit (heart ↔ lungs) plus the systemic circuit (heart ↔ body).
- Amphibians have three chambers — two atria, one ventricle — so some mixing of oxygenated and deoxygenated blood is unavoidable. Two features limit it: the divided atrium (right gets body blood, left gets lung blood) and internal ridges and recesses in the single ventricle that keep the streams somewhat separate. A partial wall in the conus arteriosus steers deoxygenated blood toward the pulmocutaneous artery and oxygenated blood toward the aorta. Watch How many chambers do animals' hearts have? | Body fluids and circulation | Biology | Khan Academy on YouTube, from Khan Academy India - English
- Amphibians also use cutaneous respiration, so the pulmocutaneous circuit sends blood to both lungs and skin. Turtles do cutaneous respiration too.
- Reptiles reduce mixing further with a septum that partially divides the ventricle; in crocodilians the septum is complete, giving two separate ventricles. The conus arteriosus has become absorbed into the trunks of the great arteries. Watch How many chambers do animals' hearts have? | Body fluids and circulation | Biology | Khan Academy on YouTube, from Khan Academy India - English
- Mammals, birds, and crocodilians have four-chambered hearts — two atria and two ventricles — keeping pulmonary and systemic blood completely separate. Bird and mammal hearts are so alike that one diagram serves both, which is a striking case of convergent evolution. Watch How many chambers do animals' hearts have? | Body fluids and circulation | Biology | Khan Academy on YouTube, from Khan Academy India - English
- The four-chambered heart is a double pump with valves preventing backflow, producing one-way continuous flow.
- Full path, starting at the right atrium: superior and inferior venae cavae deliver oxygen-poor blood → right atrium → tricuspid (right AV) valve → right ventricle → pulmonary valve → pulmonary trunk → right and left pulmonary arteries → lungs, where CO₂ is unloaded and O₂ binds hemoglobin. Watch Circulatory System and Pathway of Blood Through the Heart on YouTube, from Amoeba Sisters
- Continuing: pulmonary veins → left atrium → bicuspid (left AV) valve, known medically as the mitral valve → left ventricle → aortic valve → aorta → systemic arteries → tissues, where O₂ is unloaded and CO₂ picked up → systemic veins → venae cavae → back to the right atrium. Watch Circulatory System and Pathway of Blood Through the Heart on YouTube, from Amoeba Sisters
- The efficiency of double circulation is thought to have been important in the evolution of endothermy, which requires a high metabolic rate to hold body temperature at a set point.
- Throughout vertebrate history the sinus venosus has been the pacemaker. It is a major chamber in fish, reduced in amphibians, smaller still in reptiles, and gone as a separate chamber in birds and mammals — surviving as the SA node in the right atrial wall.
48.4
Cardiac Cycle, Electrical Conduction, ECG, and Cardiac Output
pp. 1071–1075- A cardiac cycle is one full heartbeat: atrial systole, then ventricular systole, then a shared relaxation period, diastole. Human average is about 70 beats/min. Watch Cardiovascular | Cardiac Cycle: Digital Version on YouTube, from Ninja Nerd
- Systole means contraction; diastole means relaxation. Both terms apply per chamber set, so always specify atrial or ventricular.
- The five steps of one cycle: 1) atria contract, pushing blood into the ventricles; 2) "lub" — ventricles contract, AV valves shut, and pressure builds until it exceeds aortic and pulmonary pressure, forcing the semilunar valves open; 3) blood is ejected into the aorta and pulmonary artery; 4) "dub" — ventricles relax, ventricular pressure drops below arterial pressure, and the semilunar valves snap shut; 5) ventricles refill while the atria also fill. Watch Cardiovascular | Cardiac Cycle: Digital Version on YouTube, from Ninja Nerd
- Heart sounds come from turbulence as valves slam shut, not from muscle contraction. Lub is softer and longer — the AV valves (tricuspid + mitral) closing, marking the start of ventricular emptying. Dub is louder and shorter — the semilunar valves (pulmonary + aortic) closing, marking the start of ventricular filling. Watch Cardiovascular | Cardiac Cycle: Digital Version on YouTube, from Ninja Nerd
- Auscultation is listening with a stethoscope near the sternum. Each lub-dub pair is one heartbeat. A murmur is an abnormal sound, usually a valve that will not seal and lets blood leak backward.
- Mitral valve prolapse: a cusp balloons backward during ventricular systole, letting a little blood leak into the left atrium. Symptoms can include palpitations, chest pain, anxiety, and fatigue.
- Ventricular volume over the cycle: rises during diastole from about 80 mL to about 160 mL (end-diastolic volume), then drops sharply during ejection back to about 80 mL (end-systolic volume). The difference is stroke volume, about 70 mL. Watch Cardiovascular | Cardiac Output on YouTube, from Ninja Nerd
- Cardiac muscle is autorhythmic — self-exciting. Unlike skeletal muscle it needs no nerve impulse to start contracting. Gap junctions inside intercalated disks let depolarization spread cell to cell very fast. Watch Cardiovascular | Electrophysiology | Intrinsic Cardiac Conduction System on YouTube, from Ninja Nerd
- The cardiac action potential has an extra feature: after the fast Na⁺ influx comes a plateau phase as Ca²⁺ enters through voltage-gated channels. The cell stays depolarized longer, more Ca²⁺ is released from the sarcoplasmic reticulum, and the contraction is stronger and sustained. Ca²⁺ is then pumped back into the SR and out of the cell. The troponin/tropomyosin machinery is the same as in skeletal muscle.
- Conduction pathway: the SA node fires spontaneously and fastest, so it sets the pace for the whole heart (with the autonomic nervous system modulating rate) → depolarization spreads across both atria at once → a connective tissue ring blocks the signal everywhere except the AV node → the AV node delays the signal about 0.1 second, letting the atria finish emptying → the AV bundle (bundle of His) carries it rapidly across the septum → left and right bundle branches → Purkinje fibers deliver it to ventricular muscle → both ventricles contract almost together. Watch Cardiovascular | Electrophysiology | Intrinsic Cardiac Conduction System on YouTube, from Ninja Nerd
- An ECG (electrocardiogram) records the heart’s electrical activity from skin electrodes, with three main waves per beat, roughly one second per cycle. Watch ECG | Body fluids and circulation | Biology | Khan Academy on YouTube, from Khan Academy India - English
- P wave = atrial depolarization, occurring just before atrial systole. Watch ECG | Body fluids and circulation | Biology | Khan Academy on YouTube, from Khan Academy India - English
- QRS complex = ventricular depolarization, just before ventricular systole. It is larger than the P wave because the ventricles — especially the left — are much thicker. Atrial repolarization is buried inside the QRS and is never seen separately. Watch ECG | Body fluids and circulation | Biology | Khan Academy on YouTube, from Khan Academy India - English
- T wave = ventricular repolarization. At this point all four chambers are in diastole, and most of the blood movement into and out of the ventricles happens during this wave. Watch ECG | Body fluids and circulation | Biology | Khan Academy on YouTube, from Khan Academy India - English
- Abnormal wave size, shape, or timing on an ECG flags possible problems in the SA node, AV node, Purkinje fibers, or the muscle itself.
- Cardiac output (CO) is the volume one ventricle pumps per minute: CO = stroke volume × heart rate. Watch Cardiovascular | Cardiac Output on YouTube, from Ninja Nerd
- Worked example: resting HR = 70 beats/min and SV = 70 mL/beat gives CO = 4900 mL/min = 4.9 L/min. That is close to a whole adult’s blood volume, so essentially all of your blood cycles through the heart every minute. Watch Cardiovascular | Cardiac Output on YouTube, from Ninja Nerd
- CO rises with exertion because both stroke volume and heart rate increase — and it also redistributes. Brain flow stays nearly constant in absolute terms while muscle flow soars, so the brain’s share of CO drops even though its supply does not. Watch Cardiovascular | Cardiac Output on YouTube, from Ninja Nerd
48.5
Blood Pressure and Blood Vessels
pp. 1075–1080- Blood pressure is the force blood exerts against vessel walls. Clinically it means pressure in the aorta and large arteries near the heart, which rises and falls as the left ventricle contracts and relaxes. You feel that swing as a pulse because elastic artery walls expand and recoil with each beat. Watch Blood Vessels, Part 2: Crash Course Anatomy & Physiology #28 on YouTube, from CrashCourse
- Vessel path from the heart outward: arteries → arterioles → capillaries → venules → veins → back to the heart. Watch Blood Vessels, Part 1 - Form and Function: Crash Course Anatomy & Physiology #27 on YouTube, from CrashCourse
- Auscultatory method: a sphygmomanometer cuff on the upper arm compresses the brachial artery, which is used because it sits at about heart level. Cuff pressure is raised above systolic (e.g., 150 mm Hg), squeezing the artery shut so there is no flow and no sound. Watch Blood Vessels, Part 2: Crash Course Anatomy & Physiology #28 on YouTube, from CrashCourse
- As the cuff deflates to systolic pressure (e.g., 120), the artery pops open only at each pressure peak, producing turbulent spurts and a tapping sound. The pressure at the first sound is the systolic reading. Watch Blood Vessels, Part 2: Crash Course Anatomy & Physiology #28 on YouTube, from CrashCourse
- Deflating further to diastolic pressure (e.g., 75) leaves the artery open through the whole cycle, so smooth laminar flow returns and the sound vanishes. The pressure where sound disappears is the diastolic reading. Watch Blood Vessels, Part 2: Crash Course Anatomy & Physiology #28 on YouTube, from CrashCourse
- BP is reported systolic/diastolic. Healthy young adult ≈ 120/80 mm Hg; normal ranges are roughly 110–140 systolic and 70–80 diastolic. Hypertension = systolic above 140 or diastolic above 90. Watch Blood Vessels, Part 2: Crash Course Anatomy & Physiology #28 on YouTube, from CrashCourse
- Pressure falls along the circuit: large oscillating pulses in the aorta and large arteries, smoothing and dropping through small arteries, with the steepest drop at the arterioles, then capillaries, venules, veins, ending near 0 mm Hg at the vena cava.
- BP = CO × R (cardiac output times total resistance). Pressure rises when heart rate or stroke volume rises, or when vessels constrict. It falls when the heart slows or blood volume drops from dehydration or hemorrhage. Watch Blood Vessels, Part 2: Crash Course Anatomy & Physiology #28 on YouTube, from CrashCourse
- Baroreceptors — stretch receptors in the aortic arch and carotid arteries — detect pressure changes. Falling BP means fewer signals to the brain’s cardiac center, which responds with more sympathetic and less parasympathetic output to the heart and vessels.
- Kidney pathway: reduced renal blood flow → kidney cells release renin → renin activates angiotensin → angiotensin causes body-wide vasoconstriction and triggers the adrenal cortex to release aldosterone → aldosterone makes the kidneys retain Na⁺ and water → blood volume and pressure rise. Excess Na⁺ has the opposite effect: less aldosterone, more Na⁺ lost in urine.
- Atrial natriuretic peptide (ANP) is released by the right atrial wall when stretched by high blood volume. It promotes Na⁺ excretion by the kidneys, lowering blood volume and pressure — a negative feedback loop opposing renin-angiotensin-aldosterone.
- Nitric oxide (NO) is a gas made by endothelial cells; it diffuses into the smooth muscle layer and relaxes it, dilating the vessel. Nitroglycerin, long used for angina, works by releasing NO.
- Vessel walls have up to four layers: endothelium (innermost, a single epithelial cell layer, present in every vessel), an elastic fiber layer (lets large arteries recoil after each beat), a smooth muscle layer (thick in arteries and arterioles, drives vasoconstriction and dilation), and an outer connective tissue layer. Watch Blood Vessels, Part 1 - Form and Function: Crash Course Anatomy & Physiology #27 on YouTube, from CrashCourse
- Arteries and veins have the same four layers, but arteries have a much thicker smooth muscle layer and two elastic layers. Veins are thin-walled because venous pressure is only about one-tenth of arterial pressure. Watch Blood Vessels, Part 1 - Form and Function: Crash Course Anatomy & Physiology #27 on YouTube, from CrashCourse
- Capillaries are endothelium only — no muscle, elastic, or connective layers. That single-cell wall is why exchange happens there, by diffusion, filtration through pores, and transport across cells. Subtypes: plain, fenestrated (pored), and sinusoid (large gaps, in liver, spleen, bone marrow). Watch Blood Vessels, Part 1 - Form and Function: Crash Course Anatomy & Physiology #27 on YouTube, from CrashCourse
- Resistance rises steeply as radius shrinks: resistance scales with 1/radius⁴, so halving the radius multiplies resistance 16×. Small arteries and arterioles therefore create most of the resistance in the arterial tree.
- Vasoconstriction (arteriole smooth muscle contracts) raises resistance and cuts flow to an organ; vasodilation lowers resistance and increases flow. Chronic arteriole vasoconstriction can produce hypertension.
- Skin vessels use the same mechanism for heat regulation in both ectotherms and endotherms: more skin blood flow means more heat exchange with the environment, less flow conserves heat in the cold. Precapillary sphincters gate individual capillary beds.
- Capillary network stats: every body cell sits within about 100 µm of a capillary; an average capillary is about 1 mm long and 8 µm wide — barely wider than a 5–7 µm red blood cell, which flexes to squeeze through.
- Capillaries collectively have the largest total cross-sectional area of any vessel type, so blood slows down most there — maximizing exchange time. On the venous side, vessels merge, cross-sectional area shrinks, and blood speeds up again. Watch Blood Vessels, Part 1 - Form and Function: Crash Course Anatomy & Physiology #27 on YouTube, from CrashCourse
- Venous return needs help. The venous pump — skeletal muscle contractions squeezing veins — plus one-way venous valves keep blood moving toward the heart. Veins hold most of the body’s blood volume and can stretch to store extra, which is why foot veins bulge after long standing. Watch Blood Vessels, Part 1 - Form and Function: Crash Course Anatomy & Physiology #27 on YouTube, from CrashCourse
- Varicose veins: veins stretched too far by pooled blood leave the one-way valves unable to seal, so blood pools further instead of returning.
48.6
The Lymphatic System
p. 1080- The cardiovascular system is a fully closed loop, but capillary walls still let water and small solutes filter out into the tissues, forming interstitial (tissue) fluid. Watch Lymphatic System: Crash Course Anatomy & Physiology #44 on YouTube, from CrashCourse
- Most fluid leaves near the arteriole end, where blood pressure is higher, and re-enters near the venule end, pulled back by osmosis: large plasma proteins mostly cannot cross the capillary wall, so plasma stays more protein-concentrated than interstitial fluid.
- Edema is tissue swelling from fluid that stays interstitial. Two common causes: high capillary blood pressure (late pregnancy, when the enlarged uterus compresses abdominal veins and raises pressure in leg and foot capillaries) and low plasma protein (liver disease reducing protein production, or too little dietary protein). Watch Lymphatic System: Crash Course Anatomy & Physiology #44 on YouTube, from CrashCourse
- Even normally, capillaries filter out slightly more fluid than osmosis reclaims. The leftover is collected by the lymphatic system — an open-ended, one-way drainage network running parallel to the cardiovascular system. Watch Lymphatic System: Crash Course Anatomy & Physiology #44 on YouTube, from CrashCourse
- Path: lymphatic capillaries (blind-ended and very permeable) → larger lymphatic vessels built like veins with one-way valves → two main lymphatic trunks draining into the left and right subclavian veins near the collarbones. The fluid is called lymph once inside. Watch Lymphatic System: Crash Course Anatomy & Physiology #44 on YouTube, from CrashCourse
- The system also includes lymph nodes and lymphatic organs such as the spleen and thymus.
- Lymph is moved mainly by surrounding skeletal muscle contractions — the same principle as the venous pump — and some lymphatic vessels contract rhythmically on their own. Many fish, all amphibians and reptiles, bird embryos, and some adult birds have dedicated lymph hearts. Watch Lymphatic System: Crash Course Anatomy & Physiology #44 on YouTube, from CrashCourse
- As lymph passes through nodes and organs, phagocytic cells lining the channels filter it, and germinal centers inside nodes are where lymphocytes are activated and multiply.
48.7
Cardiovascular Disease
p. 1081- Cardiovascular disease is the leading cause of death in the US: more than 80 million people affected and over 600,000 deaths per year. Most conditions trace back to arteries that are blocked or that rupture. Watch Atherosclerosis - Pathogenesis, risk factors and complications on YouTube, from Dr Matt & Dr Mike
- Atherosclerosis ("hardening of the arteries") is buildup inside artery walls of fat, excess smooth muscle, cholesterol and fibrin deposits, and cell debris. It raises vascular resistance and narrows the lumen, and a clot forming on top of the plaque can complete the blockage. Watch Atherosclerosis - Pathogenesis, risk factors and complications on YouTube, from Dr Matt & Dr Mike
- Cholesterol does not dissolve well in water, so it travels packaged in lipoproteins. LDL ("bad") delivers cholesterol to body cells; when cells already have enough they downregulate their LDL receptors, so LDL accumulates in blood and deposits in vessel walls. HDL ("good") collects cholesterol and carries it to the liver for disposal. Watch Atherosclerosis - Pathogenesis, risk factors and complications on YouTube, from Dr Matt & Dr Mike
- Risk factors: genetics, smoking, hypertension, and high cholesterol/LDL. Quitting smoking is the single biggest risk-reducing step available to a smoker.
- Arteriosclerosis is calcium deposits hardening artery walls, usually alongside severe atherosclerosis. Hardened arteries cannot expand normally, so flow is restricted, the heart must pump harder, and blood pressure rises. Watch Atherosclerosis - Pathogenesis, risk factors and complications on YouTube, from Dr Matt & Dr Mike
- Heart attack (myocardial infarction) is death of heart muscle cells from inadequate blood supply — about 1 in 5 US deaths. It is triggered by a clot in a coronary artery or by an atherosclerotic blockage. Recovery is possible if the damaged area is small enough that the rest of the heart still pumps effectively. Watch Atherosclerosis - Pathogenesis, risk factors and complications on YouTube, from Dr Matt & Dr Mike
- Angina pectoris is chest pain, often radiating to the left arm and shoulder, from a blood supply that is inadequate but not fully cut off. It is a warning sign, not cell death.
- Stroke is interrupted blood supply to the brain. A hemorrhagic stroke is a burst brain vessel; an ischemic stroke is a cerebral artery blocked by a clot or atherosclerosis. Severity depends on how much brain tissue is affected and where.