Circulation

HUMAN PHYSIOLOGY
(BODY FLUIDS AND CIRCULATION)
Every living cell needs constant supply of materials (i.e., nutrients, oxygen and other essential substances)
and simultaneously the removal of wastes or harmful substances. It is, therefore, essential to have efficient
mechanisms for the movement of these substances to the cells and from the cells. Different groups of
animals have evolved different methods for this transport. Simple organisms like sponges and coelenterates
circulate water from their surroundings through their body cavities to facilitate the cells to exchange these
substances. More complex organisms use special fluids within their bodies (body fluids) to transport such
materials. Blood and lymph are the most commonly used body fluids in most of the higher organisms
including humans.
Different animals have different types of fluid circulation for the transport of materials.
1. Intracellular circulation. In unicellular organisms (like Amoeba, Paramoecium) as well as individual

cells of multicellular organisms, cytoplasm shows regular streaming movement called cyclosis. It helps in
distribution of materials (food and oxygen) in the cells. It also brings CO2 and nitrogenous waste near the cell
membrane so that these may diffuse out.
2. Extracellular Circulation. In multicellular animals an extracellular fluid circulates outside the cells. It is
of following types :
(i) Environmental Fluid Circulation (Water Circulation). Many lower invertebrates such as sponges and
Hydra don't have a circulatory fluid. These animals circulate the surrounding water through the cavities in
their bodies with the help of flagella.
(ii) Body Fluid Circulation : The more active animals need a rapid supply of food and oxygen and quicker
removal of waste materials. To meet this requirement, they have developed special body fluids which circu-
late within the body like :
(a) Body Cavity Circulation. It occurs in roundworms (e.g., Ascaris), which possess a fluid filled body cavity
called pseudocoel. The contraction of the body wall causes circulation of body fluid to transport the materials.
(b) Blood Vascular System. It occurs in higher invertebrates and all chordates. These animals possess a
special circulating fluid called blood. A special contractile organ, called heart causes circulation of the blood
to transport the materials.
(c) Lymphatic System. It occurs in all vertebrates. Lymphatic system consists of lymph and lymph vessels.
Lymph also help in the transport of certain substances to and from the tissue cells.
Body fluids are the medium of transport of the materials in the body. The body fluids can be distinguished into
two types: the intracellular fluid and the extracellular fluid.
1. Intracellular Fluid (ICF). The fluid which is present within the cells is called intra-cellular fluid.
2. Extracellular Fluid (ECF). All the fluids outside the cells are collectively called extracellular fluid. Out of
these fluids, blood and lymph are involved in the transporation of materials.
Blood is a special connective tissue consisting of a fluid matrix, the plasma and cells, the blood corpuscles.
About 5 litres of blood circulates in the body of an adult person. It is slightly alkaline fluid having pH 7.4.
Blood consists of a watery fluid called plasma containing floating bodies termed formed elements of blood.
4.1 Plasma :
Plasma is a straw coloured, viscous fluid constituting nearly 55 per cent of the blood.
NEET_ HUMAN PHYSIOLOGY - 1

Factors for clotting of blood are also present in the plasma in an inactive form. Plasma without the clotting
factors is called serum.
Plasma Proteins :
Proteins are the second largest (i.e., 7 percent) constituents ofplasma. Albumins, globulins and fibronogen
are the important types of proteins present in the plasma.
Albumin and globulins retain water in blood plasma.
Certain globulins called immunoglobulins (glycoproteins) act as antibodies. Prothrombin help in blood
clotting by changing soluble fibrinogen to insoluble fibrin. Plasma also contain small amount of minerals like
Na+ , Ca2+ , Mg2+ , HCO3– , Cl–
Functions of Blood Plasma. The blood plasma functions in
(i) transport
(ii) prevention of blood loss
(iii) retention of fluid in blood due to plasma proteins.
(iv) uniform distribution of heat all, over the body
4.2 Formed Elements (Blood Corpuscles)
The formed elements include blood corpuscles or blood cells and blood platelets or thrombocytes. The blood
corpuscles are of two types : erythrocytes or red blood corpuscles (RBCs) and leucocytes or white blood
corpuscles (WBCs). Nearly 45 percent volume of blood consists of formed elements.
1. Erythrocytes (Red Blood Corpuscles or RBCs) :
They are the most abundant of all types of cells in the blood.
Red blood corpuscles of all adult mammals are enucleated (non-nucleated), and lack cell organelles. They
are biconcave and circular in shape. However, in camel and Llama, RBCs are nucleated and oval in shape.
A healthy adult man has, on an average 5 millions to 5.5 millions of RBCs /mm 3 of blood. The total count
of RBCs is more in man than in a woman. It is due to the fact that women undergo menstruation. An
abnormal rise in RBC count is termed as polycythemia. Decrease in the number ofRBCs is called
erythrocytopenia.
The decrease in RBC count causes oxygen shortage in the blood, which stimulates the release of the
hormone, erythropoietin from the kidney cells into the blood. Erythropoietin stimulates the bone marrow to
increase the production of RBCs.
The RBCs contain a red coloured, iron containing complex protein called haemoglobin, hence the colour
and name of these cells. 100 ml of blood of a normal man contains about 14-16 g of haemoglobin and of
normal woman an average of 12-14 g haemoglobin. Thus, the quantity of haemoglobin is less in women as
they undergo menstruation.
The process of erythrocyte formation is called erythropoiesis. In the early few weeks of embryonic life,
primitive nucleated RBCs are produced in yolk sac (one of the embryonic membranes). In later embryonic
stage, RBCs are mainly produced in the liver and spleen. But from birth ownwards RBCs are produced in
the bone marrow by the hemacytoblasts (erythrocyte forming cells).
Iron and proteins are necessary raw materials for the synthesis of haemoglobin. However, vitamin B12 and
folic acid stimulate the maturation of RBCs. Deficiency of any these nutrients can cause anaemia.
The RBCs have an average life span of 120 days after which they are destroyed in the spleen. Therefore,
spleen is called the graveyard of RBCs. .
The adult haemoglobin molecule is made of 2 alpha chains and 2 beta chains. Each alpha chain consists
of 141 amino acids while, each beta chain has 146 amino acids.

Functions of RBCs.
Haemoglobin of RBCs plays a significant role in transport of respiratory gases (i.e., oxygen and carbon
dioxide).
2. Leucocytes (White Blood Corpuscles or WBCs) :
The leucocytes are the most active and motile constituents of blood as well as lymph. They are colourless
due to the lack of haemoglobin. They are nucleated and rounded or irregular in shape.
They can change their shape like Amoeba and are thus, capable of amoeboid movement. This enables
them to squeeze out of blood capillaries into the tissues. This process is called diapedesis.
The leucocytes are relatively lesser in number. This varies from 4000 to 11000/mm 3 of blood in adult
humans. Rise in WBC count is termed leucocytosis. Increased TLC shows acute bacterial infection or
malignancies like leukemia (blood cancer). Fall in WBC count is called leukopenia.
The leucocyets are of two main types : Granulocytes and Agranulocytes
(i) Granulocytes : They contain granules and irregularly lobed nucleus in the cytoplasm. Based on their
staining property, the granulocytes are divided into three types.
(a) Eosinophils : They are characterised by a bilobed nucleus. They contain numerous coarse granules that
are stained bright red with acidic dye (e.g., eosin). The proportion of eosinophils is 2-3 per cent. They resist
infections and are also associated with allergic reactions.
(b) Basophils : They have two to three lobed nucleus. Basophils contain fewer coarse granules, which can
be stained with basic dyes, (e.g., methylene blue). They are the least (0.5-1.0per cent) among WBCs.
Basophils secrete histamine, serotonin and heparin and are involved in inflammatory reactions.
(c) Neutrophils : They have two to seven lobed nucleus. Neutrophils do not take colour when exposed to
acidic, as well as basic dyes. They are the most abundant cells (60-65 per cent) of the total WBCs. Certain
neutrophils in female mammals possess a small spherical lobe attached to their nucleus by a stalk. This
lobe is called drum stick (= sex chromatin) or Barr body. Neutrophils are phagocytic cells which destroys
foreign organisms entering the body.
(ii) Agranulocytes : They lack granules in their cytoplasm. Agranulocytes are of two types.
(a) Lymphocytes. They are smaller in size with large rounded nucleus. They possess scant pale blue
cytoplasm. They have a proportion of about 20-25 per cent. They produce serum globulins (antibodies) to
destroy microbes and their toxins, reject graft and kill tumour cells. Lymphocytes occurs in two major
types--B lymphocytes (B. cells) and T-lymphocytes (T-cells).Both are responsible for immune responses
of the body.
(b) Monocytes. They are the largest of all types of WBCs and somewhat amoeboid in shape. They have
kidney shaped nucleus. Monocytes constitute 6-8 per cent of total WBC. They are motile and phagocytic in
nature and engulf bacteria and cellular debris. Generally they change into macrophages after entering tissue
spaces.
Diagrammatic representation of formed elements in blood

The process of formation of leucocytes is called leucopoeisis. The granulocytes and monocytes are formed
in bone marrow. Lymphocytes are produced mainly in lymph nodes, spleen, thymus, tonsils, bone marrow
and Peyer's patches of small intestine.
3. Thrombocytes (Blood Platelets) :
They are flat and non-nucleated fragments of the cells rather than true cells. Thrombocytes are fewer than
the RBCs and more than the WBCs in number. There are about 1,500,00-4,500,00 platelets/mm 3 of the
blood.
Platelets are formed from the megakaryocytes (special cells in the bone marrow). Formation of thromb-
ocytes is called thrombopoiesis. The normal life span of blood platelet is about a week.
Platelets can release a variety of substances called platelet factors (e.g., thromboplastin) most of which
are involved in the coagulation of blood. A reduction in the number of platelets (thrombocytopenia) can
lead to clotting disorders which will lead to excessive loss of blood from the body.
4.3 Haemopoiesis : The process of formation of blood is called haemopoiesis and the tissues which form
blood corpuscles are termed haemopoietic tissues. In mammals, yolk sac (one of the embryonic mem-
brane), liver, bone marrow, lymph nodes, spleen and thymus are the haemopoietic organs in the embryo. In
adult most of the blood corpuscles are formed in the red bone marrow of long bones. Lymphocytes are,
however, formed in thymus, some in spleen, lymph nodes, tonsils and Peyer's patches.
SUMMARY OF HUMAN BLOOD CORPUSCLES
Type of Cor pus cle and

Char acte r s Form ation and Life s pan Function
Num be r pe r m m 3 of blood
1. Erythroc ytes (RBCs) Circular, biconcave, By yolk sac in the early few Transport of oxygen and
5-5.5 million in males and 4.5–5 denuc leated, have elastic w eeks of embryonic lif e, in some amount of carbon
million in f emales. Number plasma membrane and later embryonic stage by the dioxide.
increases during exercise and at homogeneous cytoplasm w ith liver and spleen, f rom birth
high altitudes. haemoglobin, cell organelles onw ards by bone marrow , lif e
absent 7–8 µm w ide, 1 – 2 µm span 120 days.
thick
2. Leucocyets (WBCs) Colourless, rounded or irregular, Bone marow , lymph nodes, A ct as soldiers,
4000–11000. Number in nucleated 12-20 µm w ide. spleen, thymus, tonsils and scavengers, some help in
increases during inf ection Peyer's Patches. healing.
(i) Granuloc ytes Cytoplasm has granules,
nucleus lobed.
(a) Eosinophils 2–3% of Bilobed nucleus, c oarse Bone marrow , lif e 4 to 8 hours
Resist inf ections,
leucocytes granules in c ytoplasm, take in the blood, 4 to 5 days in the
assoc iated w ith allergic
acidic stain. tissue reactions.
(b) Basophils 0.5–1.0% of Tw o to three lobed nucleus, Release
Bone marrow , lif e 4 to 8 hours histamine,
leucocytes . f ew er number of c oarse in the blood, 4 to 5 days in the
serotonin and heparin,
granules, take basic stain. tissues involved in inf lammatory
reactions.
(c) Neutrophils 60–65% of Tw o to sev en lobed nucleus, Bone marrow , lif e 4 to 8 hours Phagocytic , engulf germs
leucocytes . f ine granules, do not take acidic in the blood, 4 to 5 days in the and dead cells.
as w ell as basic stains. tissue
(ii) A granulocytes Cytoplasm lacks granules
nucleus not lobed.
(a) Lymphocytes 20%–25% of Large rounded mucleus, scant Lymph nodes, spleen, thymus, Motile, non-phagocytic,
leucocytes . cytoplasm. tonsils, bone marrow , Peyer's secrete antibodies, help in
patches, lif e few days or healing.
months or ev en years.
(b) Monocytes 6–8% of Largest of all types of Bone marrow lif e 10 to 20 Motile, phagocytic, engulf
leucocytes leucocytes , nucleus beam hours. germs and cell debris,
shaped, enough cytoplasm. of ten c hange into
macrophages.
(3) Thrombocytes (Platelets) Irregular, non-nucleated Bone marrow , lif e about a Release platelet f actors,
150000 – 350000 f ragments of cells w eek. involved in blood clotting.
4.4 Blood Groups : Human beings have more than 30 types of antigens on the surface of blood cells. They
give rise to different types ofblood groups. Two such grouping-theABO and Rh are widely used all over the
world.
1. ABO Blood Groups :
Karl Landsteiner (1900) reported first time ABO blood groups in human beings. He discovered A, Band O
blood groups. While AB blood group was found out by de Castello and Steini (1902).ABO grouping is based
on the presence or absence of two surface antigens (chemicals that can induce immune response) on
the RBCs namely A and B. Similarly, the plasma of different individuals contain two natural antibodies
(proteins produced in response to antigens).

The distribution of antigens and antibodies in the four groups of blood ,A, B,AB and O are given in Table.
Blood groups and Donor Compatiblity
Don or 's Gr oup (Can Re cipie nt's Gr oup

Bloo d Gro up Antig e n on RBCs Antibodie s in Plas m a
g e t blo od fr om ) (can g ive blood to)
A A anti-B A, O A, AB
B B anti-A B, O B, A B
AB A, B None A , B, A B, O AB
O None anti A , B O A , B, A B, O
During blood transfusion, any blood can not be used. The blood of a donor has to be carefully matched
with the blood of a recipient before any blood transfusion to avoid severe problems of clumping (production
of clots that clog capillaries).
The group O blood can be donated to persons with any other blood group. Therefore, the individuals with
blood group O are called 'universal donors'. Persons with AB group can accept blood from persons with
any group of blood. Therefore, such persons are called 'universal recipients'.
2. Rh (Rhesus) Blood Groups :
Landsteiner and Weiner (1940)discovered another protein on the surface of red blood corpuscles of rhesus
monkey and many human beings. They called it as Rh factor or Rh-antigen.
Depending on the race, 80 to 99 percent of humans possess this factor and are Rh positive (Rh+), Others
who do not have this factor are knownas Rh negative (Rh–).
The formation of Rh protein is controlled by a dominant gene, whichmay be designated as R. Thus, RR

(homozygous dominant) and Rr (heterozygous) individuals areRh positive, and rr (homozygous recessive)
individuals are Rh negative.
Phenotypically, Rh positive and Rh negative individuals are normal. The problem arises when an Rh - ve
person, is exposed to Rh + ve blood during blood transfusion or pregnancy.
(i) Incompatibility During Blood Transfusion : The first transfusion of Rh+ blood to the person with Rh–
blood causes no harm. However, the recipient starts preparing antibodies (anti Rh factor) against Rh antigen
in his/her blood. If the recipient person receives Rh+ blood second time, the anti Rh factor present in his/her
blood attack and destroy red blood corpuscles of the received blood.
(ii) Incompatibility During Pregnancy :
A special case of Rh incompatibility (mismatching) has been observed between the Rh– blood of a
pregnant mother and Rh+ blood of the foetus. The Rh antigens of the foetus do not get exposed to the
Rh- blood of the mother in the first pregnancy as the two bloods are well separated by the placenta. However,
during the delivery of the first child, there is a possibility of exposure of the maternal blood to the Rh+ blood
from the foetus.
In such cases, the mother starts preparing antibodies (anti-Rh factor) against Rh antigen in her blood. In
case of her subsequent pregnancies, the Rh antibodies from the mother (Rh–) blood can leak into the blood
of foetus (Rh+) and destroy the foetal RBCs.
This could be fatal to the foetus or could cause severe anaemia and jaundice to the baby, i.e., the haemolytic
disease of the new born (HDN). This condition is called erythroblastosis foetalis (destruction of the eryth-
rocytes of foetus). This can be avoided by administering anti-Rh antibodies to the mother immediately after
the delivery of the first child.
4.5 Blood Coagulation (Blood Clotting) :
When an injury is caused, the wound does not continue to bleed for a long time. Usually the blood stops
flowing outside after sometimes due to blood coagulation or blood clotting. This is a mechanism to prevent
excessive loss of blood from the body.
Inside an intact blood vessel, blood does not coagulate due to the presence of active anticoagulants,
heparin and antithrombins. Procoagulants also occur in the blood but are in an inactive state.

As soon as a blood vessel is ruptured, the injured area invites formation of a clot. Procoagulants become
active, overcome anticoagulants and cause blood coagulation.
The process of coagulation can be described in three major steps.
(i) At the site of an injury, the blood platelets disintegrate and release a phospholipid, called platelet factor-
3 (platelet thromboplastin). Injured tissue also release a lipoprotein factor called thromboplastin. These two
factors combine with calcium ions (Ca2+) and certain proteins of blood plasma to form an enzyme called
prothrombinase.
(ii) In presence of calcium, the prothrombinase inactivates heparin (or antipro thrombin-anticoagulant).
Prothrombinase also catalyses the conversion ofprothrombin (an inactive plasma proetin) into an active
protein called thrombin and some small peptide fragments.
(iii) Thrombin acts as enzyme and first causes depolymerization of fibrinogen (a soluble plasma protein)
into its monomers. Later thrombin stimulates repolymerization of these monomers into long insoluble fibre
like polymers called fibrin. The thin long and solid fibres of fibrin form a dense network upon the wound and
trap blood corpuscles and platelets to form a clot. The clot seals the wound and checks the bleeding. A clot
is formed at the wound in about 2-8 minutes after injury. Soon after, the clot starts contracting (clot retrac-
tion) and a pale yellow fluid called serum, starts oozing out from it. This serum is blood minus the cor-
puscles and fibrinogens.
Role of Vitamin K in Blood Clotting. Vitamin K is necessary for the synthesis of prothrombin in the liver.
When vitamin K is not sufficient in the body, blood clotting becomes inefficient.
Cascade Theory of Blood Clotting. This theory of blood coagulation was putforth by Macferlane. Ac-
cording to this theory 13 factors are required for blood clotting. The factors operate in a cascade manner
in which the activated form of a factor catalyses the activation of the next factor.
Clootting Fa ctor Synonym s

I Fibrinogen
II Prothrombin
III Thromboplas tin
IV Calc ium
V P roacc elerin, Labile factor, Acc elerator globin (A c-globin)
VI Hypothetical fac tor (A ctivation produc t of fac tor V)
VII Proconvertin (Serum Prothrombin Conversion Accelerator or SPCA)
VIII Antihaemophilic fac tor (AHF).
Plasma thromboplastin c omponent (PTC), Christmas factor,
IX Antihaemophilic fac tor B
X Stuart Power factor.
XI P las ma thromboplas tin antec edent (PTA), A ntihaemophilic factor C.
XII Hagemen factor, Glass factor
XIII Fibrin stabiliz ing factor (FS F), Loki Lorand factor.
Clotting Factors Present in Human Blood and their Synonym

4.6 Functions of Blood : Blood serves following functions in the body :
(i) Blood transports O2 from the respiratory organs to the tissues and CO2 from the tissues to the respira-
tory organs.
(ii) Blood transports the digested food from the alimentary canal to the different body cells.
(iii) Hormones are carried by blood from the endocrine glands to the target organ.
(iv) Blood transports excretory matter to the kidneys or other excretory organs.
(v) Blood allows the transfer of heat from the deeper tissues to surface of the bodywhere it can be lost.
(vi) Some leucocytes are phagocytic in nature, and certain leucocytes produce antitoxins to neutralize the
toxins released by the foreign germs.
(vii) Bloodmaintains the body temperature to a constant level after distributing heat within the body.
(viii) The clotting factors present in the blood prevent loss of blood from the site of injury by the formation of
clot.
(1) Lymph : is a colourless mobile connective tissue present in the lymphatic system. When the blood
passes through the capillaries in tissues, some water along with many small watersoluble substances and
some leucocytes (WBCs) move out into the spaces between the cells of tissues leaving the larger proteins
and erythrocytes (RBCs) in the blood vessels. This fluid released out is called the interstitial fluid or tissue
fluid. It has the same mineral distribution as that in plasma. An elaborate network of vessels called lymphatic
system collects this fluid and drain it back to the major veins.
The fluid present in the lymphatic system is called the lymph.
Lymph consists of lymph plasma (fluid) and lymph corpuscles (cells).
Differences betw een Blood and Lym ph

It is red in c olour due to the pres ence of
1. 1. It is colourless as red blood cells are absent.
haem oglobin in red c ells .
It moves away from the heart and towards the It moves in one direction i.e. , from tissues to sub-
2. 2.
heart. clavians.
It consists of plasma and W BC (m aximum
3. It consists of plas ma, RBC, W BC, and plastelets. 3.
lymphocytes)
Its plas ma has more proteins, c alcium and Its plasma has less protein, calcium and
4. 4.
phosphorus . phosphorus.
5. Glucose conc entration is low. 5. Glucose concentration is higher in lym ph.
6. Flow of blood is fas t. 6. Lym ph flows very slowly .
(2) Lymph capillaries :

Minute, thin walled, soft tubules which are same as blood capillaries in structure, but they
are closed on their free end.
They are distributed in complete body between blood capillaries but in few body parts they
are completely absent. e.g. – Epidermis, hairs, nails, claws, cornea of eye, brain, spinal
cord, bones, cartilage, bone marrow and spleen
Note : Lymph capillaries of villi of intestine are called Lacteals in which colour of lymph is Milky.
(3) Lymph vessels : Lymph capillaries combine to form Lymph vessels which are same as veins in str.
But unidirectional valves are more in lymph vessel.
Lymph vessels of complete body are combine to form two major lymph vessel.
(1) Right thoracic lymph vessel :

It is formed by fusion of lymph vessel of Right hand, Right thorax, Neck and Head region

This lymph vessel opens in right subclavian vein.
(2) Left thoracic lymph vessel : It is formed by fusion of lymph vessel of Left hand, Left
thorax, Neck and head region, Complete alimentary canal and abdominal cavity and
both hind limbs
It open in left subclavian vein.
End of lymph vessels form nodes like structures called as lymph nodes.
Lymphocytes are present in lymph nodes.
5.1 Functions of Lymph :

1. Lymph acts as 'middle man' which help in exchange of nutrients and gases between the blood and the
cells.
2. Fats are absorbed through lymph in the lacteals present in the intestinal villi.
3. When the volume of blood decreases in the blood vascular system, the lymph rushes from the lymphatic
system to the blood vascular system to maintain the bloodvolume in the body.
4. It destroys the invading microorganisms and foreign particles in the lymph nodes.
5. To produce and secret Antibodies.
Spleen :
Largest lymphoid organ.
Mesodermal in origin.
BLOOD BANK of body.
Graveyard of RBC.
It is present in abdominal cavity at the lateral surface to stomach attach by the help of Mesentry.
Around spleen splenic capsule is present composed of WFCT (White fibrous connective tissue).
Many longitudinal septums arise from splenic capsule and appear in spleen called as Trabeculae.
These septums divides tissue of spleen in incomplete segments.
In spleen special type of C.T. is filled called splenic pulp or Recticulo-endothelial tissue.
This tissue has two parts :
(1) White pulp : It is scattered in the form of yellow or brownish patches.
(2) Red pulp : Maximum part of spleen is composed of this pulp. Due to more no. of RBC’s, it ap
pears red in colour.
Functions of Spleen :
(1) To produce lymphocytes.
(2) Destroy bacteria and viruses.
(3) During embryonic stage act as haemopoietic organ.
(4) It destroys dead RBC’s.
The circulatory patterns are basically of two types : open and closed. In open circulatory system, the
blood is pumped by the heart, which passes through large vessels into open spaces or body cavities called
sinuses. This type of system is present in arthropods and molluses.
In closed circulatory system, the blood pumped by the heart is always circulates through a closed network
of blood vessels. This system of circulation is more advantageous because the flow of fluid is regulated in
better way.
All vertebrates possess a muscular and chambered heart. It acts as a pumping organ of the blood vascular
system. It receives blood from and pump the blood to the various organs and tissues ofthe body.Fishes have
a 2-chambered heart with an atrium and a ventricle, Amphibians and the reptiles (except crocodiles) have a
3-chambered heart with two atria and a single ventricle whereas, crocodiles, birds and mammals possess a
4-chambered heart with two atria and two ventricles.

In fishes, the heart handles only deoxygenated blood. Such a heart is called venous heart. It pumps out
deoxygenated blood which is oxygenated by the gills and supplied to the body parts from where deoxygen-
ated blood is returned to the heart. It is called single circulation.
In amphibians and reptiles, the heart receives both deoxygenated and oxygenated blood and is called
arteriovenous heart. The left atrium of the heart receives oxygenated blood from the gills/lungs/skin and
the right atrium gets the deoxygenated blood from other body parts. However, they get mixed up in the single
ventricle which pumps out mixed blood. It is called incomplete double circulation.
In crocodile, birds and mammals oxygenated and deoxygenated blood received by the left and right atria
respetively passes on to the ventricles of the same sides. The ventricles pump it out without any mixing up,
i.e., two separate circulatory pathways are present in these organisms. It is called double circulation.
Differences between Open and Closed Circulatory Systems

Ope n S yste m Close d Syste m
1. Blood flow through open s pac es c alled 1. Blood flow through blood vessels.
lacunae or sinus es .
2. Body tiss ues are in direc t c ontact with 2. Body tiss ues are not in direc t contact
blood. with blood.
3. Blood flows at low pressure through 3. B lood flow at high pressure through
lacunae and s inuses. c losed blood vess els.
4. Body cavity containing blood is called 4. B ody cavity does not contain blood
haemoc oel. and is called coelom.
5. Exchange of m aterials is direct 5. Ex change of materials tak e plac e
between blood and body c ells. through tissue fluid.
6. It is s low and les s efficient. 6. It is fast and more efficient.
7. Volume of blood flowing through 7. Volume of blood flowing through
tiss ues and organs is not regulated. tiss ues and organs is well regulated by
c ontractile arteries and other blood
vess els.
8. Found in arthropods (prawns, c rabs, 8. Found in annelids (earthworms,
lobsters, insects, spiders), in annelids Neries ), in c ephalopod mollusc s
(leec h), in non-cephalopod molluscs (pila, (octopus, squids), in echinoderms and
snails, oysters and clamps) and vertebrates.
protochordates like tunicates or
Herdmania.
Human circulatory system also called the blood vascular system consists of a muscular heart, a network
of closed branching blood vessels and the blood.
7.1 Human Heart : The human heart is mesodermally derived organ located between the lungs in thoracic
cavity.

The heart is protected by a double walled membranous sac called pericardium. It consists of a fibrous
layer called perietal pericardium and an inner serous layer called visceral pericardium. The latter is attached
to the heart. In between the two layers, there is a very narrow space, called the pericardial cavity which is
filled with a pericardial fluid. It protects the heart from shocks and mechanical injuries and also allow its
free movements.
7.2 External Structure :
Human heart consists of four chambers : two relatively small upper chambers called atria (sing.atrium)
and two larger lower chambers called ventricles. The left and right atria are separated externally by a
shallow vertical interatrial groove. A transverse groove is present between the atria and ventricles, called
coronary sulcus. It is slightly towards atria so ventricles appear bigger than atria.
Two groove are also present on the ventricle. These are called the anterior interventricular sulcus and
posterior interventricular sulcus. These sulci have coronary arteries through which the heart receives blood.
The right atrium is slight larger than the left atrium because interauricular groove is slightly towards left
auricle. The right and left atria receive blood from different body parts. The right atrium receives deoxygenated
blood from all parts of the body,except the lungs, through the superior and inferior vena cava. Pulmonary
veins bring oxygenated blood to the left atrium from the lungs. The right and left atria pour their blood into the
right and left ventricles, respectively.
From the right ventricle arises a pulmonary trunk, which soon bifurcates to form right and left pulmonary
arteries, which supply deoxygenated blood to the lungs of the respective side.
The left ventricle gives rise to an ascending aorta , through which the oxygenated blood is supplied to the
coronary artries and the systemic circulation of the body. Left ventricle is large because interventricular
sulcus is towards right side.
7.3 Internal Structure : Internally, the four chambers of the heart are separated by septa and valves.
The right and left atria are separated by inter-atrial septum. An oval depression is present on this septum,
called as fossa ovalis. It represents the remanant of foramen ovale (an opening in the interatrial septum of
the foetal heart).
The right atrium receives the openings of superior vena cava, inferior vena cava and coronary sinus. The
opening of inferior vena cava is guarded by Eustachian valve. The opening of coronary sinus has coronary
orThebasian valve. The left atrium receives four openings of pulmonary veins.
The two ventricles are separated by interventricular septum.
Each atria cover small part of ventricle of its side by the folds of their wall. These covered part
of ventricles are called as atrial Appendix.
One Perceval [superior vana-cava] and one post caval [inferior vana-cava] are directly open in right
atria.
In rabbit two precavals and one post vana-cava are present.
In left atria four (human) or two (rabbit) pulmonary veins open which bring oxygenated blood.
From right ventricle pulmonary arch and from left ventricle carotido-systemic arch arise directly.
Heart wall consists of three layers

(1) Epicardium :
Outermost
Composed of simple squamous epithelium
Mesodermal in origin.
(2) Myocardium :
Middle layer
Thickest layer of heart wall.
Composed of cardiac muscles. These muscles are branched, striated and involuntary in nature.
They contract whole life and do not get fatigue.
In these muscles fast contractions occur.

(3) Endocardium :
Inner most
Composed by Simple squamous Epithelium.
It is endodermal in origin.
Each atria open in ventricle of its side by Atrio – ventricular foramen [A.V. foramen]. On right
A.V. foramen, a valve of 3 folds is present called as Tricuspid valve. On left A.V. foramen a valve of
two folds is present called Bicuspid / Mitral valve.
These valves prevent reverse flow of blood. Ends of these cusps/flaps are attached with muscular
processes of wall of ventricles [papillary muscles] by thread like structures called as chorda
Tendinae.
These threads prevent valve to shift in opposite direction.
From right ventricle pulmonary arch and from left ventricle carotido – system Arch arise. At the base
of each Arch 3 semilunar valves are present.
Outside of heat where both these arch intersect, they are interconnected by fibrous strip called
ligamentum Arteriosus. During embryonic development at the place of this ligament a narrow
Ductus Arteriosus is present, which close before birth.
7.4 Pumping Action of Human Heart : Heart is a complex pumping organ which receives blood from
different parts of the body in its atria and pump it to the various body parts from ventricles.
Heart muscles continuously generate impulses in a manner that causes rhythmic contraction and relax-
ation of the heart chambers in a specific sequence.
A contraction of the heart is called a systole and its relaxation a diastole. The atria and ventricles contract
alternately. The contraction of heart (systole) and the relaxation of heart (diastole) constitute the heart beat.
Nodal Tissue or Excitatory and Conductive System of the Heart. The heart rhythm is maintained by a
highly specialised excitatory and conductive system, which includes sinoatrial node (SA node), inter nodal
pathways, the atrio-ventricular node (AVnode), the AVbundle and the bundle of purkinje fibres.
The sino-atrial node or SA node (SAN also called pace maker) is a small, flatened and ellipsoid strip of
muscle fibre of 0.3 mm size, which is situated in the upper lateral wall of the right atrium.
The atrio-ventricular node or AV node (AVNalso called pace setter) is another strip of muscle fibre, lies in
the wall between the right atrium and right ventricle. A bundle of nodal fibres called atrio-ventricular bundle
(AVbundle) arises from the AVN and passes through the atrio-ventricular septa. It emerges on the top of the
interventricular septum and immediately divides into a right and left bundle.
These bundles give rise to minute fibres throughout the ventricular musculature ofthe respective sides and
are called Purkinje fibres. These fibres along with right and left bundles are known as bundle of His.
Working of Nodal Tissue :

The nodal musculature has the ability to generate action potentials without any external stimuli, i.e., it is
autoexcitable. However, the number of action potentials that could be generated in a minute, vary at
different parts of the nodal system.
The SAN (SA node) can generate the maximum number of action potentials, i.e., 70-75 min ", and is
responsible for initiating and maintaining the rhythmic contractile activity of the heart. Therefore, it is called
the pacemaker.
The action potential generated in the SAN spontaneously initiates a wave of contraction which spreads
over both the atria more or less simultaneously. This also stimulates the AVN (AVnode) through internodal
pathway, which generates a fresh wave of contraction that passes over both the ventricles simultaneously
along the bundle of His and Purkinje fibres.
The ventricular contraction begins at the apex of the heart and passes quickly towards the origin of the
pulmonary and systemic arches. The entire conduction of the impulse is organised in such a way that, there
is a delay in transmission of impulse from SA node to the ventricle.

The human heart is myogenic (myo = muscle, genic = originating from), as the action potential for
its rhythmicity originates from a muscle, however, it is regulated by the nerves.
Differences between Neurogenic heart and Myogenic heart
S.No. Neurogenic heart Myogenic heart

The heart beat is initiated by a The heart beat is initiated by a
1 ganglion situated near the heart. patch of modified heart muscle
The impulse of contraction orginates The impulse of contraction
from nervous system. orginates itself in the heart
2
The heart normally stops beating The heart removed from the body
immediately after removal from the continues to beat for some time.
body. Therefore, heart transplantation Therefore, heart transplantation is
3 is not possible. possible.
Examples: Hearts of some annelids Examples: Hearts of molluscs and
4 and most arthropods. vertebrates
The sequence of events, which occur from the beginning of one heart beat to the beginning of the next
(completion of one heart beat), is called cardiac cycle.
During a heart beat there is contraction and relaxation of atria and ventricles. The contraction phase is
called the systole while the relaxation phase is called the diastole. When both the atria and ventricles are
in diastolic or relaxed phase, it is referred as joint diastole.
A complete heart beat consists of a systole and diastole of both the atria, plus the systole and diastole of
both the ventricles.

During joint diastole, the blood flows from the superior and inferior vena cavae into the atria. But there is
no flow of blood from the ventricles to the aorta and pulmonary trunk as the semilunar valves remain closed.
The pumping action during single cardiac cycle involves following steps :
1. Atrial Systole : The two atria contract simultaneously due to wave of contraction stimulated by the
SAnode. The blood is pumped into the ventricles as the bicuspid and tricuspid valves are open. Atrial systole
takes about 0.1 second. Soon after systole, the atria enters into diastole phase for the next 0.7 second.
From the atria, nearly 70% of the blood passively flows into the ventricles. The rest of the blood is pumped
into the ventricles by the contraction of atria.
2.Ventricular Systole: When the atrial systole approaches its end, the ventricles begin to contract due to
a wave of contraction, stimulated by the AVnode. The bicuspid and tricuspid valves close immediately pro-
ducing part ofthe first heart sound. When the ventricles complete their contraction, the blood flows into the
pulmonary trunk and aorta as the semilunar valves open. The ventricular systole takes about 0.3 seconds.
3. Ventricular Diastole. Soon after systole, the ventricles undergo relaxation and the semilunar valves are
closed. This causes second heart sound. The bicuspid and tricuspid valves open, when the pressure in the
ventricles falls and blood flows from the atria into the ventricles. The period of ventricular diastole is of about
0.5 seconds.
4. Joint Diastole. During this phase both the atria and ventricles are in diastole. As no contraction is present
anywhere, the phase ofjoint diastole is also called general pause. The total duration of a cardiac cycle is 0.8
seconds. Thus, many cardiac cycles are performed per minute.
Events of cardiac cycle :

(1) Ventricular cycle (0.8 sec)
(a) ventricle systole : 0.3 sec
(b) ventricle diastole : 0.5 sec
(2) Atrial cycle (0.8 sec)

(a) Atrial systole : 0.1 sec.
(b) Atrial diastole : 0.7 sec.
So,
Total duration of systole of heart = 0.4 sec.
Total duration of joint diastole = 0.8 – 0.4 = 0.4 sec.
(1) Ventricular Systole :

It is an important process because by the contraction in ventricles blood flow in Arches.
There are four stages in ventricular systole :
(a) Isometric contraction :
By the contraction in wall of ventricles, pressure increase in ventricles, so cuspid valve of
A.V. foramen become close.

At this moment first heart sound is heard in the form of Lub.
(b) Period of ejection :
Due to increased pressure in ventricles, cuspid valve become close and semilunar valve of
Arch open up. So blood flow in Arch.
(c) Protodiastole :
Due to ejection of blood, pressure decrease in ventricles, so flow of blood from ventricles to
arch also decreases called protodiastole.
(d) Isometric relaxation :
Due to ejection of blood from ventricles to Arch, pressure decrease in ventricles and pres
sure increase in arch. When it become more than ventricles semilunar valve of Arch become
close. At this moment second heart sound heared in form of Dup or Dub. Now ventricles
start relaxation.
Note : During ventricular systole, atria receive blood from veins, so they filled with blood.
(2) Ventricular diastole : Two stages :
(a) Rapid inflow :

Due to ejection of blood pressure decrease in ventricles and atria filled with blood so
pressure become more in atria. So cuspid valve of A.V. foramen open up and blood
rapidly enter into ventricle called rapid inflow.
(b) Diastasis :
After rapid inflow, flow of blood from atria to ventricle decrease. Now atria transfer blood
to ventricle at the same rate at which they receive blood from veins called diastasis.
(3) Atrial systole :
At the end of ventricular diastole, atria contract and transfer more blood in ventricles,
This decreases pressure in atria.
(4) Atrial diastole :

Due to ventricular systole, pressure increase in ventricle and it exceeds atrial pressure.
Therefore cuspid valve of AV foramen closed and then atria start relaxation called
atrial diastole.
8.1 Heart Sounds :

The beating heart produces characteristic sounds which can be heard by placing the ear against the
chest or by using stethoscope (an instrument which magnifies sounds and conduct them to ear).
The first heart sound-Lub is associated with the closure of the bicuspid and tricuspid valves. It is low
pitched (not very loud) and of long duration (lasts for 0.15 seconds). The second heart sound-dup is associ-
ated with the closure of the semilunar valves. It is highly pitched (louder/sharper) and shorter in duration
(lasts for 0.1 seconds).
The heart sounds are of clinical diagnostic significance. Damage to the bicuspid or tricuspid valve effects
the quality of the first heart sound. When the semilunar valves are injured, a soft hissing noise "lub shhh" is
heard in place of the second sound. This is called a heart murmur. It may be caused by the syphilis,
rheumatic fever or any other disease which injures the semilunar valves and affects their working. As a result,
the blood can leak back from the pulmonary trunk and aorta into the ventricles.
The rhythmic contraction and relaxation of the heart constitute the heart beat. Each heart beat includes
one systole and one diastole of the heart to distribute and receive blood to and from the body.Our heart
normally beats 70-75 times in a minute (average 72 beats min-I).
As a result of heart beat, a wave of distention passes along the arteries, immediately after a ventricular
systole. This wave of distention is called arterial pulse. It can be felt by placing a finger tip on the artery (radial
artery) near the wrist. This artery palpitates at a rate corresponding to that of heart beat.
Thus, pulse rate increases during exercise, fever and emotional and psychological excitements. The
pulse rate is more rapid when a person is standing than when he/she is lying down.

9.1 Regulation of Heart Beat : Although the cardiac impulse has a myogenic origin, the rate of its
formation and conduction is regulated by the neural and endocrine systems.
1. Neural Regulation : The cardiac centre lies in the medulla oblongata of the brain. From cardiac centre,
the SA node receives two sets of nerve fibres. Sympathetic that stimulates the SA node and accelerate the
heart beat, and parasympathetic (vagus nerve) that inhibit the SA node and retard the heart beat.
2. Hormonal Regulation : The hormones secreted by the medulla of the adrenal glands uiz adrenaline
(epinephrine) and noradrenaline (norepinephrine) playa significant role in the regulation of heart beat.
Noradrenaline accelerates the heart beat under normal conditions while adrenaline does this function at the
time of emergency.These hormones directly influence the SA node.
Another hormone, thyroxine secreted by thyroid gland increases heart rate.
Body temperature also affects the pace maker. Just 1°C rise in temperature increases the heart rate by
about 10 beats/minute. This is why our pulse rate is much higher in fever.
9.2 Rate of heart beat :
One systole and one Diastole makes one heart beat and heart beats per minute is called heart rate.
Normal heart beat rate Rhythmia
Abnormal heart rate Arrhythmia
Decrease in heart rate Bradycardia
Increase in heart rate Tachycardia
Heart rate in some animals

Smaller animals have higher heart rate because of their higher metabolic rate.
Elephant - 29/min.
Human - 70-80/min.
Foetus (human) - 140-150/ min.
New born baby - 115-130/min.
Horse - 35-40/min.
Rat - 300-500/min.
Frog - 64/min.
Rabbit - 200/min.
Other Factors :
Exercise Rate of heart beat
Emotion
Tension HR
Excitement
Body temperature Rate of heart beat
Just after taking food rate of heart beat increase.

Blood flows in Arteries and it exerts some pressure on their wall called Blood Pressure.
B.P. was first measured by Stephan Halls in Horse
B.P. measured by sphygmomanometer
This instrument invented by Riva Rocci
B.P. measured in Brachial Artery
B.P. is of two types :
(1) Systolic B.P. :
During systole pressure exerted by blood. 120 mm Hg [110 – 140]
(2) Diastolic B.P. :
During diastole of heart pressure exerted by blood.
80 mm Hg [70 – 90]
Pulse Pressure :
It is difference of systolic and diastolic B.P.
Affecting factors :
Exercise B.P.
Emotion
Tension B.P.
Excitement
Age B.P. increases with age
Body posture standing < sleeping
Obesity B.P.
Just after taking food B.P.
ECG is a graphical representation of the electrical activity of the heart during a cardiac cycle.
Each peak in the ECG is identified with a letter from P to T that corresponds to a specific electrical activity
of the heart.
The P-wave represents the electrical excitation (or depolarisation) of the atria, which leads to the
contraction of both the atria.
The QRS complex represents the depolarisation of the ventricles, which initiates the ventricular contraction.
The contraction starts shortly after Q and marks the beginning of the systole.
The T-wave represents the return of the ventricles from excited to normal state (repolarisation). The end of
the T-wave marks the end of systole.
Obviously, by counting the number of QRS complexes that occur in a given time period, one can
determine the heart beat rate of an individual. Since the ECGs obtained from different individuals have
roughly the same shape for a given lead configuration, any deviation from this shape indicates a possible
abnormality or disease. Hence, it is of a great clinical significance
Diagrammatic presentation of a standard ECG

The blood flows strictly through a fixed route through the arteries and veins. Arteries carry blood from the
heart to different body parts. Veins bring blood from different body parts to the heart.
Basically, each artery and vein consists of three layers or coats.
1. Tunica intima. It is the innermost coat which is made up of an elastic membrane made up of elastic tissue
of yellow fibres and squamous endothelium lining the lumen.
2. Tunica media. It is a middle coat which is formed of elastic connective tissue and smooth muscle fibres.
It is thicker in artery .
3. Tunica externa (= tunica adventitia). It is the outermost coat formed of connective tissues.
The veins have valves to prevent backward flow of blood. In the organs both arteries and veins divide to
form arterioles and venules respectively.
The arterioles and venules further divide into the thin walled vessels called capillary. The wall of capillaries
is made up of endothelium only.The nutrients, hormones, gases, etc. can diffuse into the tissue cells through
the wall of capillaries and vice versa.
Differences between Arteries and Veins

Arteries Veins
1. Arteries carry blood from the heart to the 1. Veins bring back blood from different
different parts of the body. parts of the body to the heart.
2. They are usually deep seated. 2. They are superficially situated.

3. The wall of arteries are thick and 3. The wall of the veins are thin and non
muscular. muscular.
4. Arteries have no valves. 4. Veins have valves to prevent backflow of
the blood
5. In arteries the blood flows with jerks. 5. In veins blood flows smoothly.
6. The flow of the blood is fast as the blood 6. The flow of blood in veins is not so fast
in arteries is under great pressure. because the blood in veins is under low
pressure.
7. Except the pulmonary arteries all the 7. Except pulmonary veins all the vein carry
arteries carry oxygenated blood. deoxygenated blood.

(A) Arterial system
It involves aorta, arteries, arterioles and meta-arterioles. It supplies oxygenated blood to all parts of the body
except lungs. The left ventricle of the heart pumps the oxygenated blood into a single, question marked
shaped, long vessel called left carotid-systemic aorta. It is the largest blood vessel of the body. After
ascending from the heart, the systemic aorta turns and descends down to the level of lower border of fourth
lumbar vertebra. At its distal extremity, it bifurcates into right and left common iliac arteries. The sytemic
aorta has following parts -
(1) Ascending aorta : It gives off left and right coronary arteries.
Brachiocephalic (innominate) : Unpaired, largest branch of the aorta divides into right subclavian towards
right side and right common carotid towards left side. Right subclavian gives off vertebral artery (supplies to
head and part of right shoulder) and then enters into right arm, now called axillary artery or brachial artery,
which divides into ulnar and radial arteries in the region of elbow. The right common carotid, enters into head
and divides into external and internal carotids which supply the right parts of head by their branches.
Left common carotid : Unpaired artery, enters into head and divides into left external and internal carotids
which supply the left part of the head by their tributaries. The external carotids of both sides provide blood to
thyroid gland, tongue, throat, face, ear, scalp. The internal carotids of both sides supply to brain, eye, inner
part of nose and forehead. These internal carotids go upward and enter skull through foramen magnum and
unite at the base of brain along with the vertebral arteries of both sides. So, there is formation of a ring shaped
artery called as "Circle of willis", From this circle, many branches or arteries arise which go to different
parts of brain.
In frog, the internal carotid has at its base, carotid labyrinth (spongy mass of non-contractile fibro-elastic
tissue) which acts as a sensory organ to detect blood pressure in artery.
Left subclavian artery: Unpaired artery, it gives off a left vertebral artery (supplies to head and part of left
shoulder) and then enters into left arm, now called left axillary artery or left brachial artery which divides into
ulnar and radial arteries in the region of elbow.
(2) Descending aorta : The aorta turns towards the back of heart and finally converts into dorsal aorta. The
descending dorsal aorta is called thoracic aorta in thoracic region and abdominal aorta in abdominal region.
From thoracic segment of aorta : Several pairs of small arteries arise in this region to supply various parts
such as pericardium (pericardial artery); lungs and bronchi (bronchial artery); oesophagus (oesophageal
artery); mediastinal organs and thymus (mediastinal artery); intercostal muscles and mammary glands
(intercostals and subcostal arteries); upper surface of diaphragm (superior phrenic artery).
From abdominal region of aorta : In the abdominal region, abdominal aorta gives off several pairs of
arteries. Some of the major ones are as follows -
Inferior phrenic artery : Right and left to supply the lower surface of the diaphragm.
Coeliac artery: Unpaired, divides into three branches
(i) Left gastric artery: To stomach.
(ii) Common hepatic artery: To pylorus, pancreas, gall bladder, liver, cystic duct, hepatic ducts etc.
(iii) Splenic artery: To pancreas, stomach and spleen.
Superior mesenteric : Unpaired, supplies various parts of small intestine (except superior part of duode-
num part of colon and caecum). Its sub branches are
(i) Pancreo duodenal artery: To pancreas and duodenum.
(ii) Jejunal artery: To jejunum.
(iii] Iliac artery: To ileum and jejunum.
(iv) IIiocolic artery: To ileum and colon.
Supra renal artery: Supplies the adrenal glands.
Renal arteries: One pair, supply to kidney.

Lumbar arteries : 4 pairs, supply the skin, muscles, joints, vertebrae, meninges, spinal cord etc. in the
lumbar region.
Sacral artery: Supplies the tissues of sacral region. Inferior mesenteric artery: Unpaired, supplies most
part of colon, rectum and anal canal.
Common iliac arteries : Two, right and left, formed by bifurcation of aorta at its lower end. Each common
iliac artery divides into external and internal iliac arteries. The internal iliac (hypogastric) artery supplies
viscera and wall of pelvic region, perineum and gluteal regions. The external iliac artery enters into the leg
now called femoral artery continues down the thigh, now called popliteal artery which bifurcates into anterior
and posterior tibial arteries, at about the level of knee.
Arterial system in human body

(B) Venous system
It originates in tissues by union of capillaries and ends in the atrium of heart. It includes two major veins -
superior and inferior vena cava which drain the deoxygenated blood into the right atrium.
(1) Superior vena cava (pre caval) : Single, formed by the union of right and left brachiocephalic (innomi-
nate) veins. It collects blood from head, neck, arms and chest region. It involves the followingveins -
Brachiocephalic veins: Two, each is formed by the union of an outer subclavian vein and medial internal
jugular vein. Each vein also receives blood from different thoracic parts of its side through three main veins.
(i) Internal thoracic vein : From some muscles a mammary glands.
(ii) Inferior thyroid vein : From thyroid gland.
(iii) Left superior intercostal vein : From upper part thorax.
Internal jugular vein : Two, right and left. Each one formed by the union of numerous sinuses and veins of
the cranil cavity, superior part of the face and some part of neck and colle blood from these regions.

Subclavian veins : Two, right and left, formed in the shoulder region by union of cephalic and axillary
respective sides.
(i) Axillary veins : Two, right and left, present in respective arms and collect blood from these regions.
(ii) Cephalic veins: Two, right and left, collect blood fron respective arms and shoulder region.
External jugular veins : Two, right and left, open into respective subclavian vein. They collect the blood
from parotid gland, facial muscles and superficial parts of cranium.
Azygos and hemiazygos veins : Azygos vein originates in lumbar region towards right side of mediastinum
and ascend upwards small veins from lumbar and thoracic parts of backbone oesophagus, mediastinum,
pericardium etc. empty into it.
Towards the left side of the body originates hemiazygos anc accessory hemiazygos collects blood from
oesophagus mediastinum, intercostal muscles, mammary glands etc. and drains into Azygos which in turn
opens into superior vena cava. Accessor, hemiazygos drains blood into left innominate vein.
(2) Inferior vena cava (Post caval) : It is the largest vein, originated in inferior lumbar region by the union
of right and left common iliac veins and opens into right atrium by separate opening. It collects blood from all
body structures below the diaphragm. It involves following veins -
Common iliac veins: Two, right and left. Each one is formed by union of external and internal iliacveins.
External iliac vein : This is the continuation of femoral vein which collects blood from leg. Femoral vein in
turn is formed by the union of anterior tibial vein, posterior tibial vein, popliteal vein, large saphenous vein,
small saphenous vein, etc. which collect blood from different parts of leg. External iliac vein also collects
blood from pubic region and parts of pelvis through number of small veins. Great saphenous vein is the
longest vein of the body.
Internal iliac (Hypogastric) veins: Two, right and left. Each one is formed by union of number of small
veins, which collect blood from pelvis, pelvic viscera, pelvic girdle, sacrum, rectum, ureter, urinary bladder,
uterus, vagina, prostate glands, seminal vesicle, penis, scrotum etc. (i.e. number of reproductive organs).
Lumbar veins : Four pairs, which collect blood from muscles, skin and vertebrae of lumbar region and
drains it into inferior vena cava.
Genital veins : In man, right testicular vein collects blood from male organs and inguinal regions and drains
it into inferior vena cava. Left testicular vein drains the blood into left renal vein. In woman, the right ovarian
vein drain blood from ovaries, uterus etc. and empties into inferior vena cava. The left ovarian vein opens into
left renal vein.
Renal veins : Two, right and left collects blood from respective kidneys and opens into inferior vena cava.
The left renal veill is about three times longer than the right one.
Suprarenal vein: Two, right and left, collects blood from adrenal glands. Right one opens into inferior vena
cava whereas left one opens into left renal vein.
Inferior phrenic veins : These veins drain the blood from lower surface of diaphragm. The right one ends in
post caval. The left one is often doubled with its one branch ending in left renal or suprarenal vein and the
other in post caval.
Hepatic veins : They drain blood from liver into the post caval. Urea is maximum in hepatic vein while it is
minimum in renal vein.

Venous system in male human being
The movement of blood follows double circulation (systemic and pulmonary circulation) and circulation through
special regions.
13.1 Double Circulation : (i) Systemic Circulation. It involves the flow of oxygenated blood from the left
ventricle to all parts of the body and deoxygenated blood from various body parts to the right atrium. It is
also called systemic circulation.
The systemic circulation starts from the left ventricle of the heart, passes to the aorta, to the arteries
originating from it and to all their branches, thence to the arterioles, capillaries, venules and the veins of
the whole body and finally to the two vena cavae which enter the right atrium.
As the systemic circulation supplied blood to most of the tissues of the body, it is also called the
greater circulation or peripheral circulation. The systemic circulation carries oxygen and nutrients to body
tissues and removes carbon dioxide and other wastes from the tissues.
(ii) Pulmonary Circulation : The flow of deoxygenated blood from the right ventricle to the lungs and the
return of oxygenated blood from the lungs to the left atrium is called the pulmonary circulation.

The pulmonary trunk arises from the right ventricle and then divides into the right pulmonary artery and
left pulmonary artery which supply deoxygenated blood to the right and left lungs respectively.
Two pulmonary veins from each lung transport the oxygenated blood to the left atrium. The systemic
circulation and pulmonary circulation constitute the double circulation.
The left side ofthe heart (left atrium and left ventricle) has oxygenated blood and is called systemic heart,
and the right side of the heart (right atrium and right ventricle) has deoxygenated blood and is called pulmo-
nary heart.
Schematic plan of blood circulation in human

D ifferences betw een Systemic and Pulmonary C irculations
Syste m ic Circula tion P ulm onary Circula tion
1. It is a larger circuit, which supplies 1. It is sm aller circuit whic h carries
blood to the various parts of the body blood to the lungs and back to the
and back to the heart. heart.
2. It supplies oxygenated blood to all 2. It carries deoxygenated blood to
parts of the body. the lungs for oxygenation.
3. The blood is pum ped by left 3. The blood is pumped by right
ventricle and received by the right ventricle and received by left atrium .
atrium.
13.2 Circulation Through Special Regions : (i) Coronary Circulation. Besides, the systemic circulation
and pulmonary circulation, the supply of blood to the heart muscles (myocardium) is also important. The
flow of oxygenated blood from the ascending aorta to the heart muscle and the return of deoxygenated
blood from the heart muscle to the right atrium is called coronary (cardiac) circulation. The right and left
coronary arteries arise from the ascending aorta which supply oxygenated blood to the heart muscle.
The coronary veins bring deoxygenated blood to the coronary sinus. The latter carries deoxygenated
blood to the right atrium.
(ii) Portal Circulation. A vein which collects blood from one organ by one set of capillaries and distributes
the blood to some other organ by another set of capillaries instead of sending it to the heart is called a portal
vein. The portal vein together with the small veins by which it receives blood and the capillaries by which it
supplies blood to a specific organ forms a portal system. A portal system is named after the organ to which
it carries blood. The humans have two types of portal systems; hepatic portal system and hypophysical
portal system.
(a) Hepatic Portal Circulation. The hepatic portal system includes a single large vein, the hepatic portal
vein. This vein receives a number of small veins from the different regions ofthe digestive tract and its
associated structures. At its other end, it bifurcates into right and left branches, which enter the corre-
sponding liver lobes and break up into capillaries to supply the blood. Blood from the liver is carried by a
pair of hepatic veins to the inferior vena cava.
Importance of Hepatic Portal Circulation
(i) It brings absorbed food such as glucose and amino acids from the alimentary canal
(ii) It removes the waste products like urea produced by the deamination of ammonia in the liver
(iii) It carries blood proteins produced in the liver.
(b) Hypophysical Portal Circulation. It is a minor portal system which consists oftwo hypo physical portal
vein which carry blood from the hypothalamus ofthe brain to the anterior lobe ofthe pituitary gland
(hypophysis). This portal system enables the hormones of hypothalamus to reach the anterior lobe of the
pituitary gland.
1. High Blood Pressure (Hypertension) : The pressure exerted by the flow of blood on the elastic walls of
the arteries is called blood pressure. The blood pressure is greater during the systole than during the
diastole. In normal young person, the systolic pressure is 120 mm Hg and diastole pressure is 80 mm Hg.
It is normally expressed as 120/80. The pressure varies with age. It is also influenced by the rate of heart
beat.
The increase in the blood pressure beyond 140mm Hg (systolic) and 90 mm Hg (diastolic), is referred to
as high blood pressure. A continuous or sustained rise in the arterial blood pressure is known as hypertension
High blood pressure is a silent killer. It can damage vital organs like heart, brain, kidneys and eyes.
Fall in blood pressure is termed as low blood pressure or hypotension. H

Measurement of Arterial Blood Pressure. Blood pressure is measured with the help of a apparatus called
sphygmomanometer.
2. Atheroslerosis :
It is caused due to the deposition of lipids (specially cholesterol) on the wall lining the lumen of large and
medium sized arteries. Such a deposition is called atheromatous or atherosclerotic plaque.
Its formation starts with the deposition of minute cholesterol particles/crystals in the tunica intima and
smooth muscles. Gradually, these plaques grow due to the proliferation of the fibres and small muscles
around it. This results into the reduction of the lumen size of the artery, and consequently, the flow of blood
is also reduced.
In extreme circumstances, these plaques may completely block the artery. Such plaques, if formed in the
coronary artery, reduce the blood supply to the heart, or may stop the supply to the heart. This may result
in heart attack or stroke.
High concentration of cholesterol in the form of low density lipoproteins (LDL) in the blood plasma is
responsible for atherosclerosis.
3. Angina : It is also called 'angina pectoris. It appears when no enough oxygen is reaching the heart
muscle. As a result, a symptom of acute chest pain appear in the chest. Angina can occur in men and
women of any age but it is more common among the middle aged and elderly persons. It occurs due to the
conditions that affect the blood flow.
4. Heart Failure : It is the state of heart when it is not pumping blood effectively enough to meet the needs
of the body. It is sometimes called 'congestive heart failure' because congestion of the lungs is one of the
main symptoms of this disease.
5. Heart Attack : It is the condition, when a part of heart muscles is suddenly damaged by an inadequate
blood supply. It is also called myocardial infarction.
6. Cardiac Arrest : It is a condition of complete stoppage of the heart beat i.e., sudden and complete loss
of cardiac function.

1. Arteriosclerosis (Arterio = artery, sclerosis = hardening). The hardening and loss of elasticity of the
walls of arteries is called arteriosclerosis. It is caused, when calcium salts precipitate with the cholesterol
leading to the formation of plaques. This calcification of the plaques, ultimately makes the wall of the
arteries stiff and rigid, and is referred to as the hardening of the arteries.
2. Rheumatic Heart Disease (RHD). It is caused due to repeated attack of rheumatic fever. The fever is
caused by Streptococcus bacteria. The patient may suffer with acute rheumatic fever and infection of
throat. Rheumatic fever may cause permanent damage of one or more valves (mitral or aortic semilunar
valves), pericarditis and myocarditis. Damage to the heart valves is detectable by a modified heart sound
called a murmur. Poor sanitation, bad housing and overcrowding promote rheumatic heart disease.
3. Heart Block. It is a condition in which the component of the impulse conduction system is disrupted,
causing irregularity in the heart rhythm. The two common types of heart blocks are :
(i) AV block : The impulse from SA node do not reach the AV node.
(ii) Bundle branch block : Failure of the atrial impulse to reach the ventricles.
Such types of patients are provided with an artificial electronic device, which regularly sends small amount
of electrical charge for maintaining the rhythmicity of the heart. This device is known as artificial pacemaker.
It is implanted subcutaneously in the upper thoracic region and is connected with the heart.
(1) Cardiac output :

Volume of blood which is pumped by heart per minute is called cardiac output. It is 5 ltr/min.
(2) Cardiac Index :
C.O.
C.I. =
Total body area
5 ltr/min
=
1.7 m2
= 3 Lit/min/m 2
Volume of blood pumped by heart per minute per square meter area of body is called Cardiac index.
(3) Stroke volume :

Volume of blood which is pumped by left ventricle in aorta in each heart beat.
C.O.
S.V. =
Rate of Heart beat
5 lit
=
72
S. V. = 70 ml
(4) End systolic volume :

Volume of blood which remain in ventricle after ventricular systole is called end systolic volume.
It is 50 ml
(5) End diastolic volume :

Volume of blood which is present in ventricle at the end of ventricular diastole or at the beginning of
ventricular systole.
EDV = ESV + SV
= 50 + 70 = 120 ml

1. Blue Baby :- A baby with a blue tinge to the skin due to insufficient oxygenation of the blood.
2. Angioplasty (= Balloon catheterisation). It is a technique for unblocking coronary arteries that have
atherosclerotic plaque.
3. Coronary Artery Bypass Grafting (CABG). In this surgical procedure, a blood vessel from another part of
the body is used to bypass the blocked region of a coronary artery. The saphenous vein (from the leg) and
the internal mammary artery (from the chest) are mostly used for this graft.
4. Defibrillator. It is an electrical device, which is used to treat abnormal and asynchronous contraction of
the heart muscles (called fibrillation),
5. An artificial pacemaker is placed subcutaneously in patients with irregularity of heart rhythm. An artificial
pacemaker is a small mechanical device that is operated by a lithium battery. This device uses electrical
impulses to keep the heart beating at a regular rate. The pacemaker wires are threaded through a large vein
to the heart, Most commonly, the generator is placed below the subcutaneous fat of the chest wall, above the
muscles and bones of the chest. However, the placement may vary on a case by case basis. The outer
casing of pacemakers is so designed that it will rarely be rejected by the body’s immune system . It is
usually made of titanium , which is inert in the body.
6. Most common cause of myocardial infarction is thrombosis in left anterior descending (LAD) artery which
is branch of Left coronary artery.
7. Example of anticoagulant (substances which prevent blood clotting)
Natural -Heparin
Artificial - EDTA (Ethylene Diamine Tetra acetic Acid), Na citrate, oxalate
8. Thrombus : Blood clot sometimes formed in blood vessels blocking the flow of blood
9. SA node is also called as 'heart of heart'.
10. Methaemoglobin : A sort of “blue baby syndrome” can also be caused by Methemoglobinemia. It is
believed to be caused by high nitrate contamination in ground water resulting in decreased oxygen carrying
capacity of hemoglobin in babies leading to death. The groundwater is thought to be contaminated by leach-
ing of nitrate generated from fertilizer used in agricultural lands and waste dumps
11. Echocardiography : It is a technique for detection of functional status of heart and measurment of param
eters like ejection fraction (ES), EDV, ESV, etc.
12. Fresh frozen plasma (FFP) contains all coagulation factors in normal concentrations. Plasma is free of
red blood cells, leukocytes and platelets. One unit is approximately 250mL and must be ABO compatible.
Rh factor need not be considered. Since there are no viable leukocytes, plasma does not carry a risk of CMV
transmission or Graft Vs. Host Disease (GVHD).

Type (I) : Very Short Answer Type Questions : [01 Mark Each]
1. Write the differences between P- wave and T-wave
2. Is human circulatory system open or closed?
3. Urea is transported by ?
Type (II) : Short Answer Type Questions : [02 Marks Each]
4. What is the heart skeleton composed of? Give its role.
5. Why do we consider blood as a connetive tissue
Type (III) : Long Answer Type Questions: [03 Mark Each]
6. Describe the coronary circulation.
Type (IV) : Very Long Answer Type Questions: [05Mark Each]
7. What is cardiac cycle ? describe the events that occur during joint diastole and atrial systole.
8. Draw a labelled diagram of internal structure of Heart.
OBJECTIVE QUESTIONS
STRUCTURE AND FUNCTION OF HEART
1. The blood returning to the heart from lungs via pulmonary vein has more
(1) RBC per ml of blood (2) Haemoglobin per ml of blood
(3) Oxygen per ml of blood (4) Nutrient per ml of blood
2. The nerve like modified muscle in the right auricle is know as
(1) Lymph node (2) Atrio-ventricular node
(3) Pacemaker (4) Bulbus arteriosus
3. The first heart sound is
(1) 'Lubb' sound at the end of systole (2) Dup' sound at the end of systole
(3) 'Lubb' sound at the beginning of systole (4) 'Dup' sound at the beginning of systole
4. In the heart of mammals the bicuspid valve is situated between
(1) Left auricle and left ventricle (2) Post caval and right caval
(3) Right auricle and left auricle (4) Right ventricle and pulmonary aorta
5. The heart of a healthy man beats normally per minute
(1) 60-70 times (2) 70-80 times (3) 80-90 times (4) 85-95 times
6. Since it is the sinu-auricular node which initiates the impulses in the heart of mammal is called
(1) Cholinergic (2) jodrenergic (3) Neurogenic (4) Myogenic
7. Which valve is present between the left atrium and the ventricle
(1) Tricuspid (2) Mitral (3) Aortic (4) Pulmonary
NEET - Body Fluids & Circulation - 27

8. Epinephrine is secreted by
(1) Adrenal medulla and increases the heart rate
(2) Adrenal medulla and decreases the heart rate
(3) Adrenal cortex and increases the heart rate
(4) Adrenal cortex and decreases the heart rate
9. Heart beat can be initiated by
(1) Sinu-auricular node (2) Atrio-ventricular node
(3) Sodium ion (4) Purkinje's fibres
10. Innervation of heart in the intact animals is primarily meant for
(1) Initiation of heart beat (2) Regulation of heart beat
(3) Release of acetylcholine only (4) Release of adrenalin only
11. Purkinje's fibres are special types of
(1) Muscle fibres located in heart
(2) Nerve fibres located in cerebrum
(3) Connective tissue fibres joining one bone to another bone
(4) Sensory fibres extending from retina into optic nerve
12. The pericardium and the pericardial fluid help in
(1) Protecting the heart from friction, shocks and keeps it moist
(2) Pumping the blood
(3) Receiving the blood from various parts of the body
(4) None of these
13. For reaching left side of heart, blood must pass through
(1) Liver (2) Kidneys (3) Lungs (4) Brain
14. Which one of the statement is correct with reference to the circulation of blood in a mammal
(1) Left auricle receives oxygenated blood from the lungs
(2) Pulmonary artery returns oxygenated blood from the lungs to the left auricle
(3) Pulmonary vein carries venous blood from right auricle to lungs
(4) Venous blood is returned to the left auricle
15. The typical Lubb-Dup sounds heard in the heart beat of a healthy person are due to
(1) Closing of the tricuspid and bicuspid valve (2) Blood flow through the aorta
(3) Closing of the tricuspid and semilunar valves (4) Closing of the semilunar valves
16. During ventricular diastole
(1) The auricles relax (2) The heart contracts
(3) The heart pumps blood (4) The ventricles relax
17. Valve that guards the right auriculoventricular aperture is ?
(1) Coronary valve (2) Tricuspid valve (3) Bicuspid valve (4) Semilunar valve
18. Heart beats are accelerated by
(1) Cranial nerves and acetylcholine (2) Sympathetic nerves and acetylcholine
(3) Cranial nerves and adrenaline (4) Sympathetic nerves and epinephrine
19. Left shift of oxyhaemoglobin curve is noticed under
(1) Normal temperature and pH (2) Low temperature and high pH
(3) Low pH and high temperature (4) Low pH and low temperature

20. The duration of cardiac cycle is
(1) 0.8 sec (2) 0.8 sec (3) 0.08 sec (4) 0.008 sec
21. When the heart beat increases the condition is called
(1) Bradycardia (2) Tachy cardia (3) Leucopenia (4) Cardiac arrest
22. Blood vessel which brings deoxygenated blood from the heart muscle is
(1) Coronary artery (2) Coronary vein (3) Pulmonary artery (4) Pulmonary vein
23. Which one is the correct route through which pulse making impulse travels in the heart
(1) SA node Purkinje fibres Bundle of His AV node Heart muscles
(2) AV node SA node Purkinje fibres Bundle of His Heart muscles
(3) AV node Bundle of His SA node Purkinje fibres Heart muscles
(4) SA node AV node Bundle of His Purkinje fibres Heart muscles
24. Purkinje fibre is found in
(1) Conduction system of heart (2) Brain
(3) Nephrons of kidneys (4) Sensation of skin
25. Which of the following statements is false
(1) Blood from the right side of the heart is carried to the lungs by the pulmonary artery
(2) The term pleura refers the double layered covering of the kidney
(3) Pancreas is both an exocrine and endocrine gland
(4) Scurvy is caused by the deficiency of vitamin C
26. The chamber of human heart, which has thickest wal
(1) Right atrium (2) Left atrium (3) Right ventricle (4) Left ventricle
27. The cardiac pacemaker in a patient fails to function normally. The doctors find that an artificial pace maker
is to be grafted in him. It is likely that it will be grafted at the site of
(1) Sinuatrial node (2) Atrioventricular node
(3) Atrioventricular bundle (4) Purkinje system
28. The wall of heart is made up of
(1) Epicardium (2) Myocardium (3) Endocardium (4) All of the above
29. Which of the following is different from others in absence of muscular coat
(1) Veins (2) Arteries (3) Capillaries (4) Arterioles
30. The post-caval vein collects blood from
(1) Hind limbs (2)Hind limbs and organs of the body cavity
(3) Body cavity organs (4) Renal organs
31. Inter-auricular septum in the embryonic stages has a/an
(1) Foramen ovale (2) Fenestra ovalis (3) Fenestra rotunda (4) lnter-auricular aperture
32. Bundle of His is a network of
(1) Nerve fibres found throughout the heart (2) Muscle fibres distributed throughout the heart walls
(3) Muscle fibres found only in the ventricle wall (4) Nerve fibres distributed in ventricles
33. In rabbit oxygenated blood flows from
(1) Left auricle to left ventricle during auricular systole
(2) Right auricle to right ventricle during ventricular systole
(3) Right ventricle to aorta during w;ntricular systole
(4) Pulmonary vein to left auricle during auricular systole

34. Below normal heart beat is called
(1) Bradycardia (2) Tachycardia (3) Hyperpiesis (4) All of these
35. The blood vascular system of mammals is known as double vascular system because
(1) A group of veins carry oxygenated and other group conduct deoxygenated blood
(2) Oxygenated blood runs from heart to different organs by one set of veins while deoxygenated blood
runs from heart to lung by another set
(3) the two different systems never meet
(4) All of the above
36. Which one of the following is a matching pair
(1) Lubb - sharp closure of AV valves at the beginning of ventricular systole
(2) Dup - sudden opening of semilunar valves at the beginning of ventricular diastole
(3) Pulsation of the radial artery-valves in the blood vessels
(4) Initiation of the heart beat Purkinje fibres
37. Mammals are said to have a "double circulatory system". This means
(1) That the blood vessels are paired
(2) That there are two types of blood vessels attached to every organ; an artery and a vein
(3) That there are two system; one from the heart to the lungs and back to the heart and other to and from
rest of the body
(4) That the blood circulates twice as quickly
38. An open circulatory system occurs in
(1) Man (2) Reptiles (3) Animal (4) Insects
39. If blood cells are eliminated from the blood, the liquid left is
(1) Serum (2) Plasma (3) Lymph (4) Synovial fluid
40. Match the blood vessels of human heart listed under column-I with the functions given under Column-II;
Choose the answer which given the correct combination of the alphabets of the two columns
(1) A = t, B = p, C = r, D = q (2) A = t, B = r, C = p, D = s
(3) A = s, B = t, C = r, D = p (4) A = t,
41. Which one of the following is not related to the clotting of blood
(1) Fibrin (2) fibrinogen (3) Ca++ (4) Na+ of the plasma
42. Pace maker of the heart is
(1) S.A node (2) A.V. node (3) A.V. septum (4) I.A septum
43. Blood returns from lungs to heart through
(1) Right auricle (2) Right ventircle (3) Left ventricle (4) Left auricle

44. Covering of heart is called
(1) Pericardium (2) Peritoneum (3) Perineurium (4) Periostium
45. Chordae tendinae are found in
(1) Ventricle of heart (2) Atria of heart (3) Joints (4) Ventricle of brain
46. Neurogenic heart is characteristic of
(1) Lower vertebrates (2) Humans (3) Rat (4) Rabbit
47. Papillary muscles are found in mammalian
(1) Auricles (2) Ventricles (3) Pinna (4) Eyes
48. The heart beat increases at the time of interview due to
(1) Corticotrophic hormone (2) Hyper secretion of renin
(3) Secretion of adrenaline (4) Antidiuretic hormone secretion
49. An artifical pacemaker is implanted subcutaneously and connected to the heart in patients
(1) Having 90% blockage of the three main coronary arteries
(2) Having a very hight blood pressure
(3) With irregularity in the heart rhythm
(4) Suffering from arteriosclerosis
50. Systolic pressure of heart is higher than diastolic pressure because
(1) Blood is forcefully pumped into arteries by the heart during systole and not during diastole
(2) Arteries offer resistance to the flowing of blood during systole only
(3) Arteries contract during systole only
(4) Volume of blood in heart is greater during systole than during diastole.
51. Mitral valve in mammals guards the opening between
(1) Stomach and intestine (2) Pulmonary vein and left auricle
(3) Right atrium and right ventricle (4) Left atrium and left ventricle
52. Which one of the following organs can be called a sort of "bloodbank" ?
(1) Heart (2) Liver (3) Spleen (4) Lungs

53. Which of these has a closed type of circulatory system ?
(1) Cockroach (2) Fish (3) Mollusces (4) Scorpion

54. A coronary sulcus is found
(1) Upon surface of liver between right and left liver lobes
(2) Upon heart surface between right and left auricles
(3) Upon heart surface between ventricle and atrium
(4) Upon heart surface between right and left ventricles.
55. Single heart circuit occurs in
(1) Fishes (2) Frogs (3) Reptiles (4) Man
56. The number of one of the following increases during allergic diseases
(1) Lymphocytes (2) Basophils (3) Eosinophils (4) Neutrophils
57. Vagus nerve on stimulation will cause heart rate to
(1) Decrease (2) Increase (3) No change (4) None of these

58. Rate of heart beat is highest in
(1) Whale (2) Elephant (3) Mouse (4) Man
59. Which of the following is the anticoagulant used in blood cell counting?
(1) Acetic acid (2) Formaldehyde (3) EDTA (4) Benzene
60. If a person is suffering from christmas disease, then he is deficient of
(1) Factor IX (2) Homogentisic acid (3) Thrombin (4) Vitamin C

61. If due to some injury the chordae tendinae of the tricuspid valve of the human heart is partially non-
functional, what will be the immediate effect
(1) The flow of blood into the aorta will be slowed down
(2) The ‘ pacemaker’ will stop working
(3) The blood will tend to lfow back into the left atrium
(4) The flow of blood into the pulmonary artery will be reduced
62. G-6-P dehydrogenase deficiency is associated with haemolysis of
(1) Lymphocytes (2) RBCs (3) Platelets (4) Leucocytes
63. An oval depression called fossa ovalis, is seen on
(1) inter atrial septum (2) inter ventricular septum
(3) right auriculo-ventricular septum (4) left auriculo-ventricular septum
64. Cardiac output is determined by
(1) heart rate (2) stroke volume (3) blood flow (4) Both (1) and (2)
65. Generally, artificaial pacemaker consists of one battery made up of
(1) Nickel (2) dry cadmium
(3) photo sensitive material (4) Lithium
66. Which type of white blood cells are concerned with the release of histamine and the natural anticoagulant
heparin
(1) Neutrophils (2) Basophils (3) Eosinophils (4) Monocytes
67. Which of then following sequences is truely a systemic circulation pathway
(1) Right ventricle Pulmonary aorta Tissues Pulmonary veins Left auricle
(2) Right ventricle Left ventricle Aorta Tissues veins Right auricel
(3) Left auricel Left ventricle Pulmonary aorta Tissues Right auricle
(4) Left auricle Left ventricle aorta Arteries Tissues Veins Right atrium
68. In diastole, heart is filled by
(1) mixed blood (2) venous blood (3) oxygenated blood (4) deoxygenated blood
69. To which of the following bundle of His passes stimulus of contraction
(1) AV- node (2) SA - node (3) Purkinje fibre (4) Atrium
70. Choose the correct pathway on the transmission of impulse in the heart beat.
(1) AV– node SA -node Bundle of His Purkinje fibres
(2) SA– node AV -node Bundle of His Purkinje fibres
(3) AV– node Bundle of His SA -node Purkinje fibres
(4) SA– node Purkinje fibres Bundle of His AV-node

71. The pH of blood is
(1) between 7-8 (2) between 2-4 (3) between 12-14 (4) between 4-7
72. Life span of RBC is
(1) 50 days (2) 70 days (3) 120 days (4) 220 days
73. The number of valves that guard the opening at the origin of carotico systemic aorta is
(1) two (2) three (3) four (4) one
74. The valves, which allow blood to flow from the ventricles into the arteries and not in the opposite direction
are
(1) AV- valve (Atrio ventricular valve) (2) bicuspid and tricuspid valve
(3) semilunar valve (4) aortic and mitral valve
75. The low pressure below the arterial pO2 results in
(1) release of CO2 from the cell (2) formation of haemoglbin
(3) production of bicarbonate (4) formation of carbonic acid
BLOOD VESSEL
76. Serotonin in the blood
(1) Relaxes blood vessels (2) Prevents clotting of blood
(3) Helps in clotting of blood (4)Constricts blood vessels
77. The artery can be distinguished from the vein in having
(1) Thicker walls (2) More blood cells (3) More plasma (4) Larger cavity
78. The pulse beat is measured by the
(1) Artery (2) Capillary (3) Vein (4) None of these
79. Blood vessels carrying blood from lungs to heart
(1) Pulmonary artery (2) Pulmonary vein (3) Azygous vein (4) Coronary artery
80. The artery which supplies blood to the diaphragm is known as
OR
The diaphragm is supplied with blood by
(1) Cardiac artery (2) Phrenic artery (3) Lingual artery (4) Lumbar artery
81. Which of the followinghas no muscular wall
(1) Artery (2) Vein (3) Arteriole (4) Capillary
82. Thrombosis in which coronary artery is met most frequently in
(1) Right coronary artery (2) Left anterior descending artery
(3) Left circumflex coronary artery (4) Right circumflex coronary artery
83. The blood pressure is high in
(1) Arteries (2) Veins (3) Capillaries (4) Veins of portal system
84. Which of the following vein has least amount of urea
(1) Pulmonary vein (2) Hepatic portal vein (3) Hepatic vein (4) Renal vein
85. In closed circulatory system blood is enclosed by
(1) Tubes (2) Ducts (3) Valves (4) Vessels
86. The blood vessel which brings oxygenated blood from lungs towards the heart of frog is
(1) Pre caval (2) Post caval (3) Pulmonary vein (4) Pulmonary artery

87. Blocking of arteries due to deposition of fats and calcium is called
(1) Arterosclerosis (2) Atherosclerosis (3) Emphysema (4) Heart syndrome
88. The exchange of materials between blood and interstitial fluid is by
(1) Arterioles (2) Arteries (3) Capillaries (4) Veins
89. Blood vessels that contain valves are called
(1) Arteries (2) Veins (3) Capillaries (4) All the above
90. Arteries are
(1) Thin-walled and blood flows under diminished pressure
(2) Thick-walled and blood flows under high pressure
(3) Thick-walled and blood flows under high pressure
(4) Thick-walled and blood flows under diminshed pressure
91. The amount of blood supplied to brain per minute is
(1) 450ml (2) 550ml (3) 750ml (4) 1,000ml
92. Blood clot sometimes formed in vessels blocking the flow of blood is called
(1) Bolus (2) Pus (3) Ulcer (4) Thrombus
93. You are required to draw blood from patient and to keep in in a test tube for analysis of blood corpuscles
and plasma. You are also provided with the following four tyes of test tubes.
Which of them will you no use for the purpose
(1) Test tube containing calcium bicarbonate (2) Chilled test tube
(3) Test tube containing heparin (4) Test tube containing sodium oxalate
94. Haematuria means
(1) RBCs in the urine (2) WBCs in the urine
(3) Both (1) and (2) (4) None of these
95. Rh– person donated blood to Rh+ person for the second time, Then
(1) Rh– person will die (2) Nothing happens to Rh+ perosn
(3) Rh+ blood strts reacting reacting to Rh–blood (4) Rh+ person will die
96. Haemoglobin molecule is made up of
(1) One -chains and one -chain (2) Two - chains and two - chains
(3) two - chains and one - chain (4) one - chain and two - chains
97. Pulse beat is generally measured from
(1) Radial artery (2) Femoral artery (3) carotid artery (4) Coronary artery
BLOOD PRESSURE, ECG

98. In a standard ECG which one of the following alphabets is the correct representation of the respective of
the human heart
(1) R - repolarisation of ventricles (2) S - start of systole
(3) T - end of diastole (4) P - depolarization of the atria
99. Sphygmomanometer measure
(1) Nerve conduction rate (2) Heart beat rate
(3) Blood pressure (4) Pulse rate

100. ECG records
(1) Electric current of the body (2) Potential differences
(3) Pulse rate (4) Quantity of blood pumped per minute
101. QRST is related with
(1) Ventricular contraction or depolarization (2) Auricular contraction
(3) Auricular relaxation (4) Cardiac cycle
102. In an ECG, the depolarization of atria is indicated by
(1) P - wave (2) Q - wave (3) R - wave (4) S - wave
103. Normal diastolic pressure in young man is about
(1) 20 mm Hg (2) 80 mm Hg (3) 100 mm Hg (4) 130 mm Hg
104. P - wave of ECG occur before the
(1) Onset of ventricular ejection (2) End of atrial contraction
(3) Beginning of atrial contraction (4) None of these
105. Blood pressure increases and heart rate decreases in response to
(1) Exercise (2) Haemorrage
(3) Exposure to high altitude (4) Increased intracranial pressure
106. In all the leads of ECG, all following are positive except
(1) P (2) Q (3) R (4) T
107. Which causes increase in heart rate
(1) Growth hormone (2) Adrenaline
(3) Parasympathetic system (4) None of these
108. An adult human with average health has systolic and diastolic pressures as
(1) 80 mm Hg and 88 mmHg (2) 70 mm Hg and 120 mm Hg
(3) 120 mm Hg and 80 mm Hg (4) 50 mm Hg and 80 mm Hg
109. Persons suffering from high blood pressure should take the following precaution to avoid excessive rise
in their blood pressure
(1) Sleep as much as possible (2) Avoid standing
(3) Increase their weight (4) Avoid emotional disturbances and excitement.
110. Blood pressure instrument records
(1) Systolic pressure (2) diastolic pressure (3) Both (1) and (2) (4) None of the above
111. The difference between systolic and diastolic pressure in human is
(1) 120 mm Hg (2) 80 mm Hg (3) 40 mm Hg (4) 200 mm Hg
112. In an ECG, the wave related to atria is
(1) P-wave (2) Q- wave (3) R-wave (4) S-wave
113. A heart murmur indicates a defective
(1) Bunddle of his (2) heart valves (3) sino- atrial node (4) atrio- ventricular note
114. Tachycardia is
(1) fast heart rate (2) slow heart rate (3) stop heart rate (4) normal heart rate
115. The normal level of haemoglobin per 100mL of blood in women is
(1) 14 g (2) 18 g (3) 12g (4) 10g

116. During the process of blood coagulation, vitamin -K helps in the
(1) formation of prothrombin (2) formation of thromboplastin
(3) conversion of fibrinogen into fibrin (4) conversion of prothrombin into thrombin
117. CAD stands for
(1) Carotid Arterial Dysfunction (2) Cerebral Artery Dysfunction
(3) Coronary Artery Disease (4) Calcium Activated Disease
LYMPHATIC SYSTEM
118. The lymphocytes protect from
(1) Pathogens (2) Lymph (3) Leucocytes (4) Toxins
119. Antibodies fight against
(1) Infection (2) Thirst (3) Starvation (4) Heart failure
120. Which organ is considered as "Graveyard of RBC" where most of them are destroyed by macrophages
(1) Red bone marrow (2) Spleen (3) Kidney (4) Intestine
121. The old worn out RBCs are filtered out by
(1) Kidney (2) Liver (3) Spleen (4) Heart
122. An antibody is a
(1) Molecule that specifically inactivates an antigen
(2) WBC which invades bacteria
(3) Secretion of mammalian RBC
(4) Component of blood
123. The antibodies are formed in
(1) Bone marrow (2) Spleen (3) Calcium (4) Liver
124. T - Lymphocytes originate from
(1) Thymus (2) Bone marrow (3) Liver (4) None of these
125. If the spleen is removed from the body of an adult man then
(1) Antibody production will be less (2) RBC production will be lowered
(3) WBC production willbe lowered (4) Filtration of dead RBC will stop
126. Spleen is
(1) Haemopoeitic (2) Lymphoid (3) Reproductive (4) Celluloid
127. The principle function of the lymph node in the man is
(1) Destruction of old RBC
(2) Destruction of old WBC
(3) Collection and destruction of pathogens in the blood
(4) Production of WBC
128. Humoral antibodies are produced by
(1) B - cells (2) T - cells (3) Globulins (4) Plasma cells
129. If thymus gland of an infant is removed which of the following will not form
(1) T - lymphocytes (2) B - lymphocytes (3) Erthryocytes (4) Granulocytes
130. Lymph vessels are united to form
(1) Lymph heart (2) Cisterna chyle (3) Thoracic duct (4) Jugular vein

131. Immunoglobulins are produced by
(1) Lymphocytes (2) Spleen (3) Leucocytes (4) Monocytes
132. The lymph serves to
(1) Transport O2 to the brain
(2) Transport CO2 to the lungs
(3) Return the interstitial fluid to the blood
(4) Return the WBCs and the RBCs to the lymph nodes
133. Antigens are present
(1) Inside nucleus (2) On cell surface (3) Inside cytoplasm (4) On nuclear membrane
134. Lymph is colourless because
(1) WBC are absent (2) WBC are present
(3) Haemoglobin is absent (4) RBC are absent
135. The important function of spleen is/are
(1) To produce lymphocytes.
(2) During embryonic stage act as haemopoietic organ.
(3) It destroys dead RBC’s.
(4) All of the above
136. Serum is
(1) blood without corpuscles (2) blood without fibrinogen
(3) blood without fibrinogen and corpuscles (4) otherwise called as plasma
137. Coagulation of blood in blood vessesls in living body is prevented by
(1) prothrombin (2) heparin
(3) Prothrombin and calcium together (4) plasminogen and calcium together
PORTAL SYSTEM
138. A portal system is a system in which
(1) A vein starts from an organ and ends up in heart
(2) An artery breaks up in an organ and restarts by the union of its capillaries
(3) The blood from the gut is brought into the kidney before it is poured into posterior venacava
(4) A vein breaks up in an organ into capillaries and restarts by their union as a new vein in the same
organ
139. Hypophyseal portal system is found in
(1) Kideny (2) Liver (3) Brain (4) Heart
140. Hepatic portal system starts from
(1) Digestive system to liver (2) Kidney to liver
(3) Liver to heart (4) Liver to kidney
141. Blood circulation that starts in capillaries and ends in capillaries is called
(1) Portal circulation (2) Hepatic circulation (3) Cardiac circulation (4) None of these

OBJECTIVE QUESTIONS
1. Which statement is false?
(1) Veins are typically larger in diameter than arteries
(2) Because of their small size capillaries contain blood that is moving more quickly than in other parts of
the circulatory system
(3) The walls of arteries are elastic,enabling them to stretch and shrink with changes in blood pressure .
(4) Veins contain more blood than any other part of the circulatory system
2. Blood cells that increase in number during allergic colditions like asthma are:
(1) Neutrophils (2) Basophils (3) Eosinophils (4) Iymphocytes
3. The main function of the white blood cell in the human immune system is to :
(1) Combat and destroy antigenic particles
(2) Produce antigens to combat antibodies
(3) Carry oxygen around the body
(4) Trsnsport antigens to B memory cells in the lymph nodes
4. In an undamaged blood vessel, conversion of prothrombin to thrombin is prevented by :
(1) Fibrinogen (2) Ca++ (3) Factor VII (4) Heparin

5. Which of the follwing animals is correctly matched with the chemical used for the excretion of metabolic
wastes ?
(1) Human-urea (2) Bird-ammonia (3) Fish -urea (4) Elephant -uric acid
6. In mammals, which of the following contains blood with the highest oxygen content ?
(1) Right atrium (2) Jugular vein (3) Pulmonary artery (4) Left ventricle
7. Red blood cells when immersed in 1.2% saline solution and observed under a microscope show :
(1) Bursting (2) Shrinkage (3) Intact round cells (4) Bulging
8. Nucleus of the neutrophil is :
(1) 2 lobed (2) Spindle shaped (3) 3 lobed (4) spherical
9. In a cardiac output of 5250 ml per minute with 75 heartbeats per minute, the stroke volume is :
(1) 70 ml (2) 80 ml (3) 355 ML (4) 460 ml
10. The volume of blood pumped out by ventricle during each beat is known as stroke volume. If a healthy adult
has a pulse rate of 72 and stroke volume of 70 ml, then the cardiac output is. [KVPY_2007_SB]
(1) 70 ml/min. (2) 72 ml/min (3) 5040 ml/min (4) 140 ml/min
11. Arteries do not have valves but veins do, because : (KVPY 2008 SA)
(1) Arteries have a narrower lumen than veins
(2) Arteries have thicker walls than veins
(3) Arteries carry oxygenated blood whereas veins carry deoxygenated blood
(4) Valves prevent backflow of blood in veins

12. One difference between blood and lymph is that : [KVPY_2009_SB]
(1) blood contains WBC and lymph contains RBC
(2) blood contains RBC and WBC and lymph contains only WBC
(3) blood contains RBC and lymph contains WBC
(4) blood is liquid while lymph is solid
13. Saturated dietary fats increase the risk of heart disease by : (KVPY 2009 SA)
(1) widening arteries by thinning their walls (2) narrowing veins by carbohydrate deposition
(3) narrowing arteries by fat deposition (4) narrowing arteries by carbohydrate deposition
14. In humans, Rhesus conditions can arise when : (KVPY 2009 SA)
+ – – +
(1) father is Rh and mother is Rh (2) father is Rh and mother is Rh
(3) either father or mother is Rh+ (4) either father or mother is Rh–
15. An individual has O blood group if his/her blood sample. (KVPY 2009 SA)
(1) Clumps only when antiserum A is added
(2) Clumps only when antiserum B is added
(3) Clumps when both antiserum A and antiserum B are added
(4) Does not clump when either antiserum A or antiserum B is added
16. Although blood flows through large arteries at high pressure, when the blood reaches small capillaries
the pressure decreases because [KVPY_2011_SB]
(1) the values in the arteries regulate at he rate of blood flow into the capillaries
(2) the volume of blood in the capillaries is much lesser than the that in the arteries
(3) the total cross-sectional area of capillaries arising form an artery is much greater than that of the
artery
(4) elastin fibers in the capillaries help to reduce the arterial pressure
17. The fluid part of blood flows in and out of capillaries in tissues to exchange nutrients and waste materials.
Under which of the following conditions will fluid flow out from the capillaries into the surrounding tissue?
(1) When arterial blood pressure exceeds blood osmotic pressure [KVPY_2010_SB]
(2) When arterial blood pressure is less than blood osmotic pressure
(3) When arterial blood pressure is equal to blood osmotic pressure
(4) Arterial blood pressure and blood osmotic pressure have nothing to do with the outflow of fluid from
capillaries
18. Blood clotting involves the conversion of (KVPY 2011 SA)
(1) prothrombin to thromboplastin (2) thromboplastin to prothrombin
(3) fibrinogen to fibrin (4) fibrin to fibrinogen
19. The heart of an amphibian is usually (KVPY 2012 SA)
(1) two chambered (2) three chambered (3) four chambered (4) three and half chambered
20. A smear of blood from a healthy individual is stained with a nuclear stain called hematoxylin and then
obseved under a light microscope. Which of the following cell type would be highest in number ?
(KVPY 2012 SA)
(1) neutrophils (2) lymphocytes (3) eosinophils (4) monocytes

AIIMS CORNER
1. Granules are not present in (AIIMS 2002)
(1) Monocytes (2) Neutrophils (3) Basophils (4) Eosinophils
2. Which one of the following is a matching pair of a certain body factor and its value in a normal human
adult? (AIIMS 2003)
(1) Urea-5-l0 mg/100 ml of blood
(2) Blood sugar (fasting)-70-l00 mg/100 ml.
(3) Total blood volume-3-4 litres
(4) ESR in Wintrobe method-9-l5 mm in males and 20-35 mm in females.
3. Which one of the following is a matching pair? (AIIMS 2003)
(1) Lub-sharp closure of AV valves at the begining of ventricular systole.
(2) Dup-sudden opening of semilunar valves at the begining of ventricular diastole.
(3) Pulsation of the radial artery-valves in the blood vessels.
(4) Initiation of the heart beat-Purkinje fibres.
4. Formation of non-functional methaemoglobin causes blue-baby syndrome. This is due to
(1) excess of arsenic concentration in drinking water (AIIMS 2005)
(2) excess of nitrates in drinking water
(3) deficiency of iron in food
(4) increased methane content in the atmos-phere
ASSERTION / REASONING
In each of the following questions a statement of Assertion (A) is given followed by a corresponding
statement of Reason (R) just below it. Of the statements, mark the correct answer as
(1) If both assertion and resaon are true and reason is the correct explanation of assertion
(2) If both assertion and reason are true but reason is not the correct explanation of assertion
(3) If assertion is true but reason is false
(4) If both assertion and reason are false
5. Assertion : WBC's accumulate at the site of wounds by diapedesis.
Reason : It is sqeezing of leucocytes from the endothelium. (AIIMS 2002]
(1) (2) (3) (4)
6. Assertion : Saline water is not given to patients of hypertension. [AIIMS 2000]
Reason : Saline water can cause vomiting and may drop blood pressure suddenly causing cardiac arrest.
(1) (2) (3) (4)
7. Assertion : Blood pressure is arterial blood pressure. [AIIMS 2000]
Reason : It is measured by sphygmomanometer.
(1) (2) (3) (4)
8. Assertion : Heart of fish contains only deoxygenated blood.
Reason : Oxygenated blood do not return back to the heart in fishes.
(1) (2) (3) (4)

9. Assertion : An artificial pacemaker can replace the sinoatrial node of heart.
Reason : This is because , an artificial pacemaker is capable of stimulating the heart electrically to
maintain its beats .
(1) (2) (3) (4)
10. Assertion : Electorcardiogram is record of eletrical activity of the heart which shows certain waves called
P,Q,R,S and T waves . [AIIMS 2000]
Reason : It gives important information concerning the spread of excitation to the different parts of heart
and it is of value in the diagnosis of cases of abnormal cardiac rhythm and myocardial damage.
(1) (2) (3) (4)
PART- 1
1. Which type of white blood cells are concerned with the release of histamine and the natural antico
agulant heparin ? (AIPMT 2008)
(1) Monocytes (2) Neutrophils (3) Basophils (4) Eosinophils.
2. The most active phagocytic white blood cells are (AIPMT 2008)
(1) Neutrophils and monocytes (2) Neutrophils and Eosinophils
(3) Lymphocytes and macrophages (4) Eosinophils and Lymphocytes.
3. In human, blood passes from the post caval to the diastolic right atrium of heart due to
(1) Pressure difference between the post caval and atrium (AIPMT 2008)
(2) Pushing open of the venous valves
(3) Suction pull
(4) Stimulation of the sino auricular node.
4. The haemoglobin of a human foetus (AIPMT 2008)
(1) Has a higher affinity for oxygen than that of an adult
(2) Has a lower affinity for oxygen than that of an adult
(3) Its affinity for oxygen is the same as that of an adult
(4) Has only 2 protein sub unit instead of 4
5. If due to some injury the chordae tendinae of the tricuspid valve of the human heart is partially non
functional, what will be the immediate effect (AIPMT 2010)
(1) The pacemaker will stop working
(2) The blood will tend to flow into the left atrium
(3) The flow of blood into the pulmonary artery will be reduced
(4) The flow of blood into the aorta will be slowed down
6. The kind of epithelium which forms the inner walls of blood vessels is (AIPMT 2010)
(1) Columnar epithelium (2) Ciliated columnar epithelium
(3) Squamous epithelium (4) Cuboidal epithelium
7. ABO blood groups in humans are controlled by the gene I. It has three alleles - I A, IB, and i. Since there are
three different alleles, six different genotypes are possible. How many phenotyes can occur
(1) One (2) Four (3) Two (4) Three (AIPMT 2010)

8. The haemoglobin content per 100 ml of blood of a normal healthy adult is (AIPMT 2010)
(1) 12 - 16 g (2) 5 - 11g (3) 25 - 30g (4) 17 - 20
9. Given below are four statements (a-d) regarding human blood circulatory system
(a) Arteries are thick-walled and have narrow lumen as compared to veins
(b) Angina is acute chest pain when the blood circulation of the brain is reduced
(c) Persons with blood group AB can donate blood to any person with any blood group under ABO system
(d) Calcium ions play a very important role in blood clotting (AIPMT 2010)
Which two of the above statements are correct
(1) (c) and (d) (2) (a) and (d) (3) (a) and (b) (4) (b) and (c)
10. 'Bundle of His' is a part of which one of the following organs is humans (AIPMT 2011)
(1) Brain (2) Heart (3) Kidney (4) Pancreas
11. Arteries are best defined as the vessels which (AIPMT 2011)
(1) Supply oxygenated blood to the different organs
(2) Supply blood to visceral organs away from heart
(3) Break up into capillaries which reunite to form a vein
(4) Carry blood from one visceral organs to another visceral organ
12. Which one of the following statements is correct regarding blood pressure (AIPMT 2011)
(1) 130/90 mmHg is considered high and requires treatment
(2) 100/55 mmHg is considered an ideal blood pressure
(3) 105/50 mmHg is makes one very active
(4) 190/110 mmHg may harm vital organs like brain and kidney
13. A person with unknown blood group under ABO system, has suffered much blood loss in an accident and
needs immediate blood transfusion. His one friend who has a valid certificate of his own blood type offers
blood donation without delay. What would have been the type of blood of the donor friend (AIPMT 2011)
(1) Type B (2) Type AB (3) Type O (4) Type A
14. A certain road accident patient with unknown blood group needs immediate blood transfusion. His one
doctor friend at once offers his blood. What was the blood group of the donor ? [AIPMT Pre 2012]
(1) Blood group B (2) Blood group AB (3) Blood group O (4) Blood group A
15. A patient brought to a hospital with myocardial infarction is normally immediately given : [AIPMT Pre 2012]
(1) Penicillin (2) Streptokinase (3) Cyclosporin-A (4) Statins
16. Compared to those of humans, the erythrocytes in frog are [AIPMT Pre 2012]
(1) Without nucleus but with haemoglobin (2) nucleated and with haemoglobin
(3) very much smaller and fewer (4) nucleated and without haemoglobin.
17. People who have migrated from the planes to an area adjoining Rohatang Pass about six months back :
(1) have more RBCs and their haemoglobin has a lower binding affinity to O2. [AIPMT Pre 2012]
(2) are not physically fit to play games like football.
(3) suffer from altitude sickness with symptoms like nausea, fatigue, etc.
(4) have the usual RBC count but their haemoglobin has very high binding affinuty to O 2.
18. If nerves of heart are cut, then heart will (CPMT 1992)
(1) Beat rhythmically (2) Stop (3) Beat arhythmically (4) Shrink
19. Which one of the following is not applicable to coagulation of blood? (AFMC 1996)
(1) Fibrin (2) Fibrinogen (3) Calcium (4) Bilirubin

20. If haemoglobin is replaced by haemocyanin,the blood will carry (MP PMT 1996)
(1) Less oxygen (2) More oxygen (3) No oxygen (4) Same amount of oxygen
21. RBC in mammals have no nucleus because (Hr PMT 1993)
(1) It is degenerated during development (2) They do not have nucleus since early stage
(3) Nucleus is harmful for RBC (4) Nucleus decreases surface area
22. In sun the face becomes reddish due to (UP CPMT 1996)
(1) Effect of light
(2) Expansion of blood capillaries
(3) Breakup of RBC and release of haemoglobin
(4) Irritation of skin
23. 'Dup' sound is produced during closure of (CBSE 1994)
(1) Semilunar valves (2) Bicuspid valve (3) Tricuspid valve (4) Both (2) and (3)
24. Blood pressure increases and heart rate decreases in response to (CPMT 1994)
(1) Haemorrage (2) Exercise
(3) Exposure to high altitude (4) Increased intracranial pressure
25. Hepatic portal system connects (AFMC 1997)
(1) Digestive system to liver (2) Kidney to liver
(3) Liver to digestive system (4) Liver to kidneys
26. A muscular wall is absent in (CPMT 1999)
(1) Venule (2) Vein (3) Capillary (4) Arteriole
27. Heart of crocodile is (Kerala PMT 2002; Manipal PMT 2001)
(1) Single chambered (2) Two chambered (3) Three chambered (4) Four chambered
28. The RBC at higher altitude will (AFMC 2002)
(1) Increase in size (2) Decrease in size (3) Increase in number (4) Decrease in number
29. When heart beat decreases the condition is called (AFMC 2002)
(1) Bradycardia (2) Tachycardia (3) Leucopenia (4) Cardiac arrest
30. Murmur is a disorder of (BUP, Pune 2002)
(1) Heart valves (2) AV node (3) SA node (4) Pulmonary vein
31. Which pair will be most important in initiating blood clotting? (G-GSIPU, N. Dehli, 2002)
(1) Ca and prothrombin (2) Prothrombin and thromboplastin
(3) Thrombin and fibrinogen (4) Prothrombin and fibrinogen
32. The conduction of impulse from SA node moves to (JIPMER 2002)
(1) AV node (2) Bundle of His (3) Purkinje fibres (4) Cardiac muscles
33. Christmas disease is (AMU 2002)
(1) Haemophilia A (2) AIDS (3) Haemophilia B (4) Haemolytic jaundice
34. Papillary muscles are associated with (CMC Vellore 2002)
(1) Ventricles (2) Auricles (3) Dorsal aorta (4) Chordaetendinae
35. Pulmonary artery carries blood from (JIMPER 2002)
(1) Deoxygenated blood from heart to lungs (2) Deoxygenated blood from lungs to heart
(3) Oxygenated blood from heart to lungs (4) Oxygenated blood from lungs to heart
36. The most abundant granulocytes in human body is (KCET, 2002)
(1) Basophils (2) Eosinophils (3) Neutrophils (4) Monocytes

37. Adrenaline directly affects (CBSE 2002)
(1) Islet of Langerhans (2) Sinoatrial node
(3) Oxyntic cells of stomach (4) Dorsal root ganglia of spinal cord
38. Which of the chemical in blood is an anticoagulant? (Wardha 2002)
(1) Sodium citrate (2) Citric acid (3) Chlorine (4) None
39. One of the following vessel is without valves (BVP Pune 2002)
(1) Artery (2) Pulmonary artery (3) Vein (4) Aorta.
40. Fresh frozen plasma (FFP) does not contain (BVP Pune 2002)
(1) Frozen protoplasm (2) Platelets (3) Factor VII (4) Gammaglobulins.
41. Which of the following corpuscle had kidney shaped nucleus? (BVP Pune 2002)
(1) Eosinophils (2) Monocyte (3) Neutrophil (4) Lymphocyte
42. Hardening of the arteries due to deposition of cholesterol is called (KCET 2002)
(1) Thrombosis (2) Atherosclerosis (3) Rhinitis (4) Stenosis
43. Which proteolytic enzyme induces lysin of fibrin during fibrinolysis? (Hr PMT 2002)
(1) Plasmin (2) Fibrin (3) Thrombin (4) Platelets
44. Collection of WBC at a site of infection through capillaries is (Pb. PMT 2002)
(1) Phagocytosis (2) Hemolysis (3) Diapedesis (4) None
45. Systemic heart refers to (CBSE PMT 2003)
(1) The two ventricles together in humans
(2) The heart that contracts under stimu-lation from nervous system
(3) Left auricle and left ventricle in higher vertebrates
(4) Entire heart in lower vertebrates.
46. Bundle of His is a network of (CBSE PMT 2003)
(1) Nerve fibres found throughout the heart
(2) Muscle fibres distributed throughout the heart walls
(3) Muscle fibres found only in the ventricle
(4) Nerve fibres distributed in ventricles.
47. A heart murmur indicates a defective (Orissa JEE, 2003)
(1) Sinuauricular node (2) Atrioventricular node
(3) Bundle of His (4) Heart valve.
48. Identify the correct sequence of events in a cardiac cycle (Orissa, JEE, 2003)
(1) Joint Diastole, atrial systole, ventricular diastole, ventricular systole
(2) Atrial systole, ventricular systole, ventricular diastole, Joint diastole
(3) Ventricular systole, ventricular diastole, Joint diastole, atrial systole
(4) Ventricular diastole, Joint diastole, ventricular systole,atrial systole.
49. Which is correct? (Orissa PMT 2004)
(1) Blood has WBC and lymph has RBC
(2) Blood has WBC, RBC and lymph has nothing
(3) Blood has RBC, WBC and lymph has WBC
(4) Lymph has WBC, RBC and blood has RBC.
50. Serum is (Orissa PMT 2004)
(1) Blood without fibrinogen (2) Lymph without corpuscles
(3) Blood without corpuscles and fibrinogen (4) Lymph.
51. In higher vertebrates,SA node helps in (Orissa PMT 2004)
(1) Conduction of blood (2) Initiation of heart beat
(3) Opening of tricuspid valve (4) Opening of bicuspid valve.

52. During heart beat the correct sequenc of events will be (Kerala PMT 2005)
(1) atrio-ventricular node - bundle of His- sino-atrio node- network of Purkinje
(2) network of Punkinje fibres-atrio - 6 ventricular node - sino-atrio node - bundle of His
(3) atrio-ventricular node - sino-atrio node- bundle of His - Purkinje fibres
(4) sino-atrial node - atrio-ventricular node- bundle of His - purkinje fibres
(5) sino-atrial node - atrio-ventriuclar node- Purkinje fibres - bundle of His.
53. 'Heart of Heart' is (BHU 2005)
(1) SA node (2) AV node (3) Bundle of His (4) Purkinje fibres.
54. Which one of the following is phagocytic? (BHU 2005)
(1) monocyte (2) RBC (3) eosinophil (4) basophil
55. How many times a red blood corpuscle will have to pass through the heart in its journey from hepatic
artery to the aorta?
(1) two times (2) only once (3) several times (4) four times.
56. Which chamber of the human heart has the thickest muscular wall ? (KCET 2005)
(1) left auricle (2) left ventricle (3) right auricle (4) right ventricle.
57. The Barr body is observed in (Kerala PMT 2005)
(1) basophil of male (2) neutrophil of female (3) basophil of female (4) eosinophils.
58. What happens when the pacemaker is non functional ? (Kerala PMT 2005)
(1) onlythe auricles will contract rhythmically
(2) the cardiac muscles do not contract in a coordinated manner rhythmically
(3) only ventricles will contract rhythmically
(4) cardiac muscel will contract in a coordinated manner rhythmically
59. Which of the following statements are wrong? (Kerala PMT 2005)
(i) Leucocytes disintegrate in the spleen and liver.
(ii) RBC, WBC and blood platelets are produced by bone marrow.
(iii) Neutrophils bring about destruction and detoxification of toxins of protein origin.
(iv) The important function of lymphocytes is to produce antibodies.
(1) (i) and (ii) only (2) (z) and (iv) only (3) (i) and (iii) only (4) (ii) and (iii) only
60. Rhythmic heart beat is maintained by a highly specialized excitatory and conductive system. The
correct sequence of events will be (Kerala PMT 2005)
(1) atrio-ventricular node - bundle of His - sino-atrio node - network of Purkinje fibers
(2) network of Punkinje fibre-atrio - ventricular node - sino-atrio node -bundle of His
(3) atrio-ventricular node - sino-atrio node- bundle of His - Purkinje fibres
(4) sino-atrial node - atrio-ventricular node - bundle of His - Purkinje fibres
(5) sino-atrial node - atrio-ventricular node- Purkinje fibres - bundle of His.
61. Universal donor blood group is (J & K CET 2005)
(1) O (2) AB (3) A (4) B
62. In an accident there is great loss of blood and there is no time to analyse the blood group.
Which blood can be safely transferred? (Orissa JEE 2005)
(1) O and Rh negative (2) 0 and Rh positive (3) AB and Rh negative (4) AB and Rh positive.
63. Which of the following substances if intro-duced into the blood stream, would cause coagulation of
blood at the site of its intro-duction? (CBSE PMT 2005)
(1) Fibrinogen (2) Thromboplastin (3) Heparin (4) Prothrombin.
64. Carotid artery supplies (AFMC 2005)
(1) oxygenated blood to lungs (2) oxygenated blood to brain
(3) oxygenated blood to intestine (4) none of these.
65. The process of formation of blood corpuscles is called (AFMC 2005)
(1) haemopoiesis (2) haemolysis (3) haemozoin (4) none of these.

BOARD LEVEL EXERCISE : HINT & SOLUTIONS
1. Difference between
P - wave T-wave
(i) The P-wave represents the (i) The T-wave represents the return of the ventricles from excited
electrical excitation (or depolarisation) to normal state (repolarisation)
of the atria (ii) The end of the T-wave marks the end of systole
2. Closed
3. Blood Plasma
4. Heart has a central fibrous skeleton composed of dense connective tissue. It provides support , and site for
origin and insertion of cardiac myocytes.
5. We caonsider blood as a connective tissue because of their special function of linking and supporting other
tissue / organs of the body blood is a fluid connective tissue containing plasma, RBC, WBC and platelets. It
is main circulating fluid that helps in the transport of varius substances.
6. (i) Coronary Circulation : Besides, the systemic circulation and pulmonary circulation, the supply of
blood to the heart muscles (myocardium) is also important. The flow of oxygenated blood from the ascend-
ing aorta to the heart muscle and the return of deoxygenated blood from the heart muscle to the right atrium
is called coronary (cardiac) circulation. The right and left coronary arteries arise from the ascending aorta
which supply oxygenated blood to the heart muscle. The coronary veins bring deoxygenated blood to the
coronary sinus. The latter carries deoxygenated blood to the right atrium.
7. Pumping Action of Human Heart : Heart is a complex pumping organ which receives blood from different
parts of the body in its atria and pump it to the various body parts from ventricles.
Heart muscles continuously generate impulses in a manner that causes rhythmic contraction and
relaxation of the heart chambers in a specific sequence.
A contraction of the heart is called a systole and its relaxation a diastole. The atria and ventricles
contract alternately. The contraction of heart (systole) and the relaxation of heart (diastole) constitute the
heart beat.
Nodal Tissue or Excitatory and Conductive System of the Heart. The heart rhythm is maintained by
a highly specialised excitatory and conductive system, which includes sinoatrial node (SA node), inter
nodal pathways, the atrio-ventricular node (AVnode), the AVbundle and the bundle of purkinje fibres.
The sino-atrial node or SA node (SAN also called pace maker) is a small, flatened and ellipsoid strip of
muscle fibre of 0.3 mm size, which is situated in the upper lateral wall of the right atrium.
The atrio-ventricular node or AV node (AVNalso called pace setter) is another strip of muscle fibre, lies
in the wall between the right atrium and right ventricle. A bundle of nodal fibres called atrio-ventricular
bundle (AVbundle) arises from the AVN and passes through the atrio-ventricular septa. It emerges on the
top of the interventricular septum and immediately divides into a right and left bundle.
These bundles give rise to minute fibres throughout the ventricular musculature ofthe respective sides
and are called Purkinje fibres. These fibres along with right and left bundles are known as bundle of
His.

8.
EXERCISE - 1
1. (3) 2. (3) 3. (3) 4. (1) 5. (2) 6. (4) 7. (2)

8. (1) 9. (1) 10. (2) 11. (1) 12. (1) 13. (3) 14. (1)
15. (3) 16. (4) 17. (2) 18. (4) 19. (2) 20. (1) 21. (2)
22. (2) 23. (4) 24. (1) 25. (2) 26. (4) 27. (1) 28. (4)
29. (3) 30. (2) 31. (1) 32. (3) 33. (1) 34. (1) 35. (4)
36. (1) 37. (3) 38. (4) 39. (2) 40. (2) 41. (4) 42. (1)
43. (4) 44. (1) 45. (1) 46. (1) 47. (2) 48. (3) 49. (3)
50. (1) 51. (4) 52. (3) 53. (2) 54. (3) 55. (1) 56. (3)
57. (1) 58. (3) 59. (3) 60. (1) 61. (4) 62. (2) 63. (1)
64. (4) 65. (4) 66. (2) 67. (4) 68. (4) 69. (3) 70. (2)
71. (1) 72. (3) 73. (2) 74. (3) 75. (1) 76. (4) 77. (1)
78. (1) 79. (2) 80. (2) 81. (4) 82. (1) 83. (1) 84. (4)
85. (4) 86. (3) 87. (2) 88. (3) 89. (2) 90. (2) 91. (3)
92. (4) 93. (3) 94. (1) 95. (2) 96. (2) 97. (1) 98. (4)
99. (3) 100. (2) 101. (1) 102. (1) 103. (2) 104. (3) 105. (4)
106. (2) 107. (2) 108. (3) 109. (4) 110. (3) 111. (3) 112. (1)
113. (2) 114. (1) 115. (3) 116. (1) 117. (3) 118. (1) 119. (1)
120. (2) 121. (3) 122. (1) 123. (2) 124. (2) 125. (4) 126. (2)

127. (3) 128. (1) 129. (1) 130. (3) 131. (1) 132. (3) 133. (2)
134. (3) 135. (4) 136. (3) 137. (2) 138. (4) 139. (3) 140. (1)
141. (1)
EXERCISE - 2
1. (2) 2. (3) 3. (1) 4. (4) 5. (1) 6. (4) 7. (2)
8. (3) 9. (1) 10. (3) 11. (4) 12. (2) 13. (3) 14. (1)
15. (4) 16. (3) 17. (1) 18. (3) 19. (2) 20. (3)
EXERCISE - 3
1. (1) 2. (2) 3. (1) 4. (2) 5. (2) 6. (3) 7. (2)
8. (1) 9. (1) 10. (1)
EXERCISE - 4
1. (3) 2. (1) 3. (1) 4. (1) 5. (3) 6. (3) 7. (2)
8. (1) 9. (2) 10. (2) 11. (2) 12. (4) 13. (3) 14. (3)
15. (2) 16. (2) 17. (1) 18. (1) 19. (4) 20. (1) 21. (1)
22. (2) 23. (1) 24. (4) 25. (1) 26. (3) 27. (4) 28. (3)
29. (1) 30. (1) 31. (1) 32. (1) 33. (3) 34. (1) 35. (1)
36. (3) 37. (2) 38. (4) 39. (1) 40. (2) 41. (2) 42. (2)
43. (3) 44. (3) 45. (3) 46. (3) 47. (4) 48. (2) 49. (3)
50. (3) 51. (2) 52. (4) 53. (1) 54. (1) 55. (1) 56. (2)
57. (2) 58. (2) 59. (3) 60. (4) 61. (1) 62. (1) 63. (2)
64. (2) 65. (1)

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Circulation

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HUMAN PHYSIOLOGY

(BODY FLUIDS AND CIRCULATION)

1. Intracellular circulation. In unicellular organisms (like Amoeba, Paramoecium) as well as individual

NEET_ HUMAN PHYSIOLOGY - 1

Albumin and globulins retain water in blood plasma.

NEET_ HUMAN PHYSIOLOGY - 2

Diagrammatic representation of formed elements in blood

SUMMARY OF HUMAN BLOOD CORPUSCLES

Type of Cor pus cle and

NEET_ HUMAN PHYSIOLOGY - 4

Don or 's Gr oup (Can Re cipie nt's Gr oup

2. Rh (Rhesus) Blood Groups :

The formation of Rh protein is controlled by a dominant gene, whichmay be designated as R. Thus, RR

NEET_ HUMAN PHYSIOLOGY - 5

Clootting Fa ctor Synonym s

Clotting Factors Present in Human Blood and their Synonym

Differences betw een Blood and Lym ph

5. Glucose conc entration is low. 5. Glucose concentration is higher in lym ph.

6. Flow of blood is fas t. 6. Lym ph flows very slowly .

(2) Lymph capillaries :

(1) Right thoracic lymph vessel :

NEET_ HUMAN PHYSIOLOGY - 7

5.1 Functions of Lymph :

NEET_ HUMAN PHYSIOLOGY - 8

Differences between Open and Closed Circulatory Systems

NEET_ HUMAN PHYSIOLOGY - 9

The two ventricles are separated by interventricular septum.

Heart wall consists of three layers

NEET_ HUMAN PHYSIOLOGY - 10

Working of Nodal Tissue :

NEET_ HUMAN PHYSIOLOGY - 11

S.No. Neurogenic heart Myogenic heart

NEET_ HUMAN PHYSIOLOGY - 12

Events of cardiac cycle :

(2) Atrial cycle (0.8 sec)

(1) Ventricular Systole :

NEET_ HUMAN PHYSIOLOGY - 13

(2) Ventricular diastole : Two stages :

(a) Rapid inflow :

(4) Atrial diastole :

8.1 Heart Sounds :

NEET_ HUMAN PHYSIOLOGY - 14

Abnormal heart rate Arrhythmia

Decrease in heart rate Bradycardia

Increase in heart rate Tachycardia

Heart rate in some animals

Just after taking food rate of heart beat increase.

NEET_ HUMAN PHYSIOLOGY - 15

Diagrammatic presentation of a standard ECG

NEET_ HUMAN PHYSIOLOGY - 16

Differences between Arteries and Veins

2. They are usually deep seated. 2. They are superficially situated.

NEET_ HUMAN PHYSIOLOGY - 17

NEET_ HUMAN PHYSIOLOGY - 18

Arterial system in human body

NEET_ HUMAN PHYSIOLOGY - 19

NEET_ HUMAN PHYSIOLOGY - 20

NEET_ HUMAN PHYSIOLOGY - 21

Schematic plan of blood circulation in human

NEET_ HUMAN PHYSIOLOGY - 22

Fall in blood pressure is termed as low blood pressure or hypotension. H

NEET_ HUMAN PHYSIOLOGY - 23

NEET_ HUMAN PHYSIOLOGY - 24

(1) Cardiac output :