Of the vessels, the arteries carry blood away from the heart; the main arterial vessel, the aorta, branches into smaller arteries, which in turn branch repeatedly into still smaller vessels and reach all parts of the body. Within the body tissues, the vessels are microscopic capillaries through which gas and nutrient exchange occurs (see respiration). Blood leaving the tissue capillaries enters converging vessels, the veins, to return to the heart and lungs. The human heart is a four-chambered organ with a dividing wall, or septum, that separates it into a right heart for pumping blood from the returning veins into the lungs and a left heart for pumping blood from the lungs to the body via the aorta.
An auxiliary system, the lymphatic system, is composed of vessels that collect lymph from body tissues. Carried to converging vessels of increasing size, the lymph enters the thoracic duct and is emptied into a large vein near the heart.
In the systemic circulation, which serves the body except for the lungs, oxygenated blood from the lungs returns to the heart from two pairs of pulmonary veins, a pair from each lung. It enters the left atrium, which contracts when filled, sending blood into the left ventricle (a large percentage of blood also enters the ventricle passively, without atrial contraction). The bicuspid, or mitral, valve controls blood flow into the ventricle. Contraction of the powerful ventricle forces the blood under great pressure into the aortic arch and on into the aorta. The coronary arteries stem from the aortic root and nourish the heart muscle itself. Three major arteries originate from the aortic arch, supplying blood to the head, neck, and arms. The other major arteries originating from the aorta are the renal arteries, which supply the kidneys; the celiac axis and superior and inferior mesenteric arteries, which supply the intestines, spleen, and liver; and the iliac arteries, which branch out to the lower trunk and become the femoral and popliteal arteries of the thighs and legs, respectively. The arterial walls are partially composed of fibromuscular tissue, which help to regulate blood pressure and flow. In addition, a system of shunts allows blood to bypass the capillary beds and helps to regulate body temperature.
At the far end of the network, the capillaries converge to form venules, which in turn form veins. The inferior vena cava returns blood to the heart from the legs and trunk; it is supplied by the iliac veins from the legs, the hepatic veins from the liver, and the renal veins from the kidneys. The subclavian veins, draining the arms, and the jugular veins, draining the head and neck, join to form the superior vena cava. The two vena cavae, together with the coronary veins, return blood low in oxygen and high in carbon dioxide to the right atrium of the heart.
The pulmonary circulation carries the blood to and from the lungs. In the heart, the blood flows from the right atrium into the right ventricle; the tricuspid valve prevents backflow from ventricles to atria. The right ventricle contracts to force blood into the lungs through the pulmonary arteries. In the lungs oxygen is picked up and carbon dioxide eliminated, and the oxygenated blood returns to the heart via the pulmonary veins, thus completing the circuit. In pulmonary circulation, the arteries carry oxygen-poor blood, and the veins bear oxygen-rich blood.
The organs most intimately related to the substances carried by the blood are the kidneys, which filter out nitrogenous wastes and regulate concentration of salts; the spleen, which removes worn red blood cells, or lymphocytes; and the liver, which contributes clotting factors to the blood, helps to control blood sugar levels, also removes old red blood cells and, receiving all the veins from the intestines and stomach, detoxifies the blood before it returns to the vena cava (see urinary system).
Disorders of the circulatory system generally result in diminished flow of blood and diminished oxygen exchange to the tissues. Blood supply is also impeded in such conditions as arteriosclerosis and high blood pressure (see hypertension); low blood pressure resulting from injury (shock) is manifested by inadequate blood flow. Acute impairment of blood flow to the heart muscle itself with resulting damage to the heart, known as a heart attack or myocardial infarction, or to the brain (stroke) are most dangerous. Structural defects of the heart affecting blood distribution may be congenital or caused by many diseases, e.g., rheumatic fever, coronary artery disease.
The circulatory system is an organ system that moves nutrients, gases, and wastes to and from cells, helps fight diseases and helps stabilize body temperature and pH to maintain homeostasis. This system may be seen strictly as a blood distribution network, but some consider the circulatory system as composed of the cardiovascular system, which distributes blood, and the lymphatic system, which distributes lymph. While humans, as well as other vertebrates, have a closed cardiovascular system (meaning that the blood never leaves the network of arteries, veins and capillaries), some invertebrate groups have an open cardiovascular system. The most primitive animal phyla lack circulatory systems. The lymphatic system, on the other hand, is an open system.
The main components of the human circulatory system are the heart, the blood, and the blood vessels. The circulatory system includes: the pulmonary circulation, a "loop" through the lungs where blood is oxygenated; and the systemic circulation, a "loop" through the rest of the body to provide oxygenated blood. An average adult contains five to six quarts (roughly 4.7 to 5.7 liters) of blood, which consists of plasma, red blood cells, white blood cells, and platelets.
Two types of fluids move through the circulatory system: blood and lymph. The blood, heart, and blood vessels form the cardiovascular system. The lymph, lymph nodes, and lymph vessels form the lymphatic system. The cardiovascular system and the lymphatic system collectively make up the circulatory system.
Arteries always take blood away from the heart, regardless of their oxygenation, and veins always bring blood back. In general, arteries bring oxygenated blood to the tissues; veins bring deoxygenated blood back to the heart. In the case of the pulmonary vessels, however, the oxygenation is reversed: the pulmonary artery takes deoxygenated blood from the heart to the lungs, and oxygenated blood is pumped back through the pulmonary vein to the heart. As blood circulates through the body, oxygen and nutrients diffuse from the blood into cells surrounding the capillaries, and carbon dioxide diffuses into the blood from the capillary cells.
The release of oxygen from red blood cells or erythrocytes is regulated in mammals. It increases with an increase of carbon dioxide in tissues, an increase in temperature, or a decrease in pH. Such characteristics are exhibited by tissues undergoing high metabolism, as they require increased levels of oxygen.
De-oxygenated blood enters the right atrium of the heart and flows into the right ventricle where it is pumped through the pulmonary arteries to the lungs. Pulmonary veins return the now oxygen-rich blood to the heart, where it enters the left atrium before flowing into the left ventricle. From the left ventricle the oxygen-rich blood is pumped out via the aorta, and on to the rest of the body.
The circulatory systems of all vertebrates, as well as of annelids (for example, earthworms) and cephalopods (squid and octopus) are closed, just as in humans. Still, the systems of fish, amphibians, reptiles, and birds show various stages of the evolution of the circulatory system.
In fish, the system has only one circuit, with the blood being pumped through the capillaries of the gills and on to the capillaries of the body tissues. This is known as single cycle circulation. The heart of fish is therefore only a single pump (consisting of two chambers). In amphibians and most reptiles, a double circulatory system is used, but the heart is not always completely separated into two pumps. Amphibians have a three-chambered heart.
In reptiles, the ventricular septum of the heart is incomplete and the pulmonary artery is equipped with a sphincter muscle. This allows a second possible route of blood flow. Instead of blood flowing through the pulmonary artery to the lungs, the sphincter may be contracted to divert this blood flow through the incomplete ventricular septum into the left ventricle and out through the aorta. This means the blood flows from the capillaries to the heart and back to the capillaries instead of to the lungs. This process is useful to ectothermic (cold-blooded) animals in the regulation of their body temperature.
Birds and mammals show complete separation of the heart into two pumps, for a total of four heart chambers; it is thought that the four-chambered heart of birds evolved independently from that of mammals.
Hemolymph fills all of the interior hemocoel of the body and surrounds all cells. Hemolymph is composed of water, inorganic salts (mostly Na+, Cl-, K+, Mg2+, and Ca2+), and organic compounds (mostly carbohydrates, proteins, and lipids). The primary oxygen transporter molecule is hemocyanin.
Circulatory systems are absent in some animals, including flatworms (phylum Platyhelminthes). Their body cavity has no lining or enclosed fluid. Instead a muscular pharynx leads to an extensively branched digestive system that facilitates direct diffusion of nutrients to all cells. The flatworm's dorso-ventrally flattened body shape also restricts the distance of any cell from the digestive system or the exterior of the organism. Oxygen can diffuse from the surrounding water into the cells, and carbon dioxide can diffuse out. Consequently every cell is able to obtain nutrients, water and oxygen without the need of a transport system.
The knowledge of circulation of vital fluids through the body was known to Sushruta (6th century BCE). He also seems to posses knowledge of the arteries, described as 'channels' by Dwivedi & Dwivedi (2007). The valves of the heart were discovered by a physician of the Hippocratean school around the 4th century BC. However their function was not properly understood then. Because blood pools in the veins after death, arteries look empty. Ancient anatomists assumed they were filled with air and that they were for transport of air.
Herophilus distinguished veins from arteries but thought that the pulse was a property of arteries themselves. Erasistratus observed that arteries that were cut during life bleed. He ascribed the fact to the phenomenon that air escaping from an artery is replaced with blood that entered by very small vessels between veins and arteries. Thus he apparently postulated capillaries but with reversed flow of blood.
The 2nd century AD, Greek physician, Galen, knew that blood vessels carried blood and identified venous (dark red) and arterial (brighter and thinner) blood, each with distinct and separate functions. Growth and energy were derived from venous blood created in the liver from chyle, while arterial blood gave vitality by containing pneuma (air) and originated in the heart. Blood flowed from both creating organs to all parts of the body where it was consumed and there was no return of blood to the heart or liver. The heart did not pump blood around, the heart's motion sucked blood in during diastole and the blood moved by the pulsation of the arteries themselves.
Galen believed that the arterial blood was created by venous blood passing from the left ventricle to the right by passing through 'pores' in the interventricular septum, air passed from the lungs via the pulmonary artery to the left side of the heart. As the arterial blood was created 'sooty' vapors were created and passed to the lungs also via the pulmonary artery to be exhaled.
In 1242, the Arabian physician, Ibn al-Nafis, became the first person to accurately describe the process of blood circulation in the human body, particularly pulmonary circulation, for which he is considered the father of circulatory physiology. Ibn al-Nafis stated in his Commentary on Anatomy in Avicenna's Canon:
"...the blood from the right chamber of the heart must arrive at the left chamber but there is no direct pathway between them. The thick septum of the heart is not perforated and does not have visible pores as some people thought or invisible pores as Galen thought. The blood from the right chamber must flow through the vena arteriosa (pulmonary artery) to the lungs, spread through its substances, be mingled there with air, pass through the arteria venosa (pulmonary vein) to reach the left chamber of the heart and there form the vital spirit..."
Finally William Harvey, a pupil of Hieronymus Fabricius (who had earlier described the valves of the veins without recognizing their function), performed a sequence of experiments and announced in 1628 the discovery of the human circulatory system as his own and published an influential book about it. This work with its essentially correct exposition slowly convinced the medical world. Harvey was not able to identify the capillary system connecting arteries and veins; these were later described by Marcello Malpighi.