The circulatory system

The disease takes two different forms depending apparently on whether ergotoxia, the alkaloid ia ergot, attacks predomiaantiy the aervous or the circulatory system. The former coaditioa is characterized by severe coavulsive seizures the latter produces an iatense burning and itching of the skin called St. Anthony s Fire. 

Lead enters the body through inhalation and ingestion, is absorbed into the circulatory system from the lungs and digestive tract, and excreted via the urine and feces. Normally, intake of lead approximately equals output. However, excessive exposure and intake can cause tissue concentrations to increase to the point where illness can result. 

Strong acids and strong alkaUes can severely bum the skin, chromium compounds can produce skin rashes, and repeated exposure to solvents causes removal of natural oils from the skin. Infection is always a concern for damaged skin. Absorption through the skin is possible for materials that are appreciably soluble iu both water and oil, eg, nitrobenzene, aniline, and tetraethyllead. Other materials can be absorbed if first dissolved iu extremely good solvents, eg, dimethyl sulfoxide. Subcutaneous iujection can occur accidentally by direct exposure of the circulatory system to a chemical by means of a cut or scratch or iuadvertent penetration of the skin with a hypodermic needle. 

Ca.rdia.c-AssistDevices. The principal cardiac-assist device, the intra-aortic balloon pump (lABP), is used primarily to support patients before or after open-heart surgery, or patients who go into cardiogenic shock. As of the mid-1990s, the lABP was being used more often to stabilize heart attack victims, especially in community hospitals which do not provide open-heart surgery. The procedure consists of a balloon catheter inserted into the aorta which expands and contracts to assist blood flow into the circulatory system and to reduce the heart s workload by about 20%. The disposable balloon is powered by an external pump console. 

The biodistribution of the ideal radiopharmaceutical would show extremely rapid distribution via the circulatory system to the organs of interest and htfle distribution to others. It would be rapidly extracted by the organ or tissue of interest differentially in a way that reflects the disease process of interest. Ideally, abnormahties should be defined by substantial increases in the concentration of the agent because lesions defined by a decrease from surrounding concentrations, ie, cold-spot imaging, are more difficult to image. 

The filariform larva found in moist soils may be either ingested or penetrate the skin of its host. It is then carried through the circulatory system to the lungs and migrates up the respiratory tree into the digestive tract. The worms feed on intestinal tissue and blood. Some worms may persist in humans as long as nine years. Infestations cause cutaneous reactions, pulmonary lesions, intestinal ulcerations, and anemia. 

The second example of an air pollutant that affects the total body burden is carbon monoxide (CO). In addihon to CO in ambient air, there are other sources for inhalation. People who smoke have an elevated CO body burden compared to nonsmokers. Individuals indoors may be exposed to elevated levels of CO from incomplete combustion in heating or cooking stoves. CO gas enters the human body by inhalation and is absorbed directly into the bloodstream the total body burden resides in the circulatory system. The human body also produces CO by breakdown of hemoglobin. Hemoglobin breakdown gives every individual a baseline level of CO in the circulatory system. As the result of these factors, the body burden can fluctuate over a time scale of hours. 

CO Reduction in the ability of the circulatory system to transport O Impairment of performance on tasks requiring vigilance Aggravation of cardiovascular disease. 

When cells lie adjacent to each other in animal tissues, they are often connected by gap junction structures, which permit the passive flow of small molecules from one cell to the other. Such junctions essentially connect the cells metabolically, providing a means of chemical transfer and communication. In certain tissues, such as heart muscle that is not innervated, gap junctions permit very large numbers of cells to act synchronously. Gap junctions also provide a means for transport of nutrients to cells disconnected from the circulatory system, such as the lens cells of the eye. 

Acetoacetate and /3-hydroxybutyrate are transported through the blood from liver to target organs and tissues, where they are converted to acetyl-CoA (Figure 24.29). Ketone bodies are easily transportable forms of fatty acids that move through the circulatory system without the need for eomplexation with serum albumin and other fatty acid—binding proteins. 

FIGURE 25.38 Lipoprotein components are synthesized predominantly in the ER of liver cells. Following assembly of lipoprotein particles red dots) in the ER and processing in the Golgi, lipoproteins are packaged in secretory vesicles for export from the cell (via exocy-tosis) and released into the circulatory system. 

Thromboxane A-2 has been implicated in a number of disorders of the circulatory system including coronary artery spasms, unstable angina pectoris, traumatic and endotoxic shock, and heart attacks. It is formed normally very near its receptors and is rapidly deactivated by metabolizing enzymes so circulating levels are quite low. Furthermore, it is opposed in its actions by the prostacyclins. When these controls are defective, pathology results and drugs can be the resort in attempts to restore the normal healthy balance. For one example, furegrelate (6) is a throm-... 

The circulatory systems used in association with machine tools are generally conventional in nature, although occasionally their exceptional size creates special problems. The normal installation comprises a storage tank or reservoir, a pump and filter, suitable sprays, jets or other distribution devices, and return piping. The most recent designs tend to eliminate wick feeds and siphon lubrication. 

A thrombus is a mass of cells and protein composed principally of platelets and fibrin, but also containing red and white blood cells. A thrombus which forms in the circulatory system can become occlusive in that the thrombus can physically block flowing blood. 

Metabolic acidosis can also result when a person is severely burned. Blood plasma leaks from the circulatory system into the injured area, producing edema (swelling) and reducing the blood volume. If the burned area is large, this loss of blood volume may be sufficient to reduce blood flow and oxygen supply to all the body s tissues. Lack of oxygen, in turn, causes the tissues to produce an excessive amount of lactic acid and leads to metabolic acidosis. To minimize the decrease in pH, the injured person breathes harder to eliminate the excess C02. However, if blood volume drops below levels for which the body can compensate, a vicious circle ensues in which blood flow decreases still further, blood pressure falls, C02 excretion diminishes, and acidosis becomes more severe. People in this state are said to be in shock and will die if not treated promptly. 

The neutrophils (also called polymorphonuclear leucocytes, PMNs), which are the professional phagocytes of the body. They constitute >70% of the total leucocyte population, remaining in the circulatory system for less than 48 hours before migrating into the tissues, in response to a suitable stimulus, where they phagocytose material. They possess receptors forFc and activated C3 which enhance their phagocytic ability (see later in chapter). 

Distribution. Once inside the body, trichloroethylene is easily absorbed into and distributed through the circulatory system. The amount that is not absorbed initially on inhalation is expired unchanged (see Section 2.3.1.1). Absorption from the gastrointestinal tract often leads to a first pass through the liver, where toxic metabolites can form (see Section 2.3.3). Trichloroethylene and its metabolites may form adducts with blood proteins, and the metabolite glyoxylate may become incorporated into amino acids (Stevens et al. 1992), thus facilitating their distribution. The ability of these compounds to traverse membranes accounts for then-generalized systemic effects. 

The principal function of the circulatory system is to supply oxygen and vital metabolic substrates to cells throughout the body, as well as removal of metabolic waste products. Circulatory shock is a life-threatening condition whereby this principal function is compromised. When circulatory shock is caused by a severe loss of blood volume or body water it is called hypovolemic shock, the focus of this chapter. Regardless of etiology, the most distinctive manifestations of hypovolemic shock are arterial hypotension and metabolic acidosis. Metabolic acidosis is a consequence of an accumulation of lactic acid resulting from tissue hypoxia and anaerobic... 

Circulatory shock A life-threatening condition wherein the circulatory system is unable to deliver enough oxygen and metabolic substrates to meet the demands of tissues and adequately clear metabolic waste products from those tissues. 

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