Circulatory system

The circulatory system, also called the

cardiovascular system or the vascular
system, is an organ system that permits
blood to circulate and transport nutrients
(such as amino acids and electrolytes),
oxygen, carbon dioxide, hormones, and
blood cells to and from the cells in the
body to provide nourishment and help in
fighting diseases, stabilize temperature
and pH, and maintain homeostasis.
 Circulatory system

The human circulatory system (simplified). Red

indicates oxygenated blood carried in arteries,
blue indicates deoxygenated blood carried in
veins. Capillaries, which join the arteries and
veins, and the lymphatic vessels are not shown.

Identifiers

MeSH D002319

TA A12.0.00.000

FMA 7161
 Anatomical terminology

The circulatory system includes the

lymphatic system, which circulates
lymph.[1] The passage of lymph for
example takes much longer than that of
blood.[2] Blood is a fluid consisting of
plasma, red blood cells, white blood cells,
and platelets that is circulated by the heart
through the vertebrate vascular system,
carrying oxygen and nutrients to and
waste materials away from all body
tissues. Lymph is essentially recycled
excess blood plasma after it has been
filtered from the interstitial fluid (between
cells) and returned to the lymphatic
system. The cardiovascular (from Latin
words meaning "heart" and "vessel")
system comprises the blood, heart, and
blood vessels.[3] The lymph, lymph nodes,
and lymph vessels form the lymphatic
system, which returns filtered blood
plasma from the interstitial fluid (between
cells) as lymph.

The circulatory system of the blood is

seen as having two components, a
systemic circulation and a pulmonary
circulation.[4]

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
lymphatic system, on the other hand, is an
open system providing an accessory route
for excess interstitial fluid to be returned
to the blood.[5] The more primitive,
diploblastic animal phyla lack circulatory
systems.

Many diseases affect the circulatory

system. This includes cardiovascular
disease, affecting the cardiovascular
system, and lymphatic disease affecting
the lymphatic system. Cardiologists are
medical professionals which specialise in
the heart, and cardiothoracic surgeons
specialise in operating on the heart and its
surrounding areas. Vascular surgeons
focus on other parts of the circulatory
system.

Structure
Cardiovascular system
 Depiction of the heart, major veins and arteries
constructed from body scans.

Cross section of a human artery

Relative percentages of cardiac output delivered to

major organ systems
The essential components of the human
cardiovascular system are the heart, blood
and blood vessels.[6] It 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. The systemic circulation can also
be seen to function in two parts – a
macrocirculation and a microcirculation.
An average adult contains five to six
quarts (roughly 4.7 to 5.7 liters) of blood,
accounting for approximately 7% of their
total body weight.[7] Blood consists of
plasma, red blood cells, white blood cells,
and platelets. Also, the digestive system
works with the circulatory system to
provide the nutrients the system needs to
keep the heart pumping.[8]

The cardiovascular systems of humans

are closed, meaning that the blood never
leaves the network of blood vessels. In
contrast, oxygen and nutrients diffuse
across the blood vessel layers and enter
interstitial fluid, which carries oxygen and
nutrients to the target cells, and carbon
dioxide and wastes in the opposite
direction. The other component of the
circulatory system, the lymphatic system,
is open.
Arteries

Oxygenated blood enters the systemic

circulation when leaving the left ventricle,
through the aortic semilunar valve. The
first part of the systemic circulation is the
aorta, a massive and thick-walled artery.
The aorta arches and gives branches
supplying the upper part of the body after
passing through the aortic opening of the
diaphragm at the level of thoracic ten
vertebra, it enters the abdomen. Later it
descends down and supplies branches to
abdomen, pelvis, perineum and the lower
limbs. The walls of aorta are elastic. This
elasticity helps to maintain the blood
pressure throughout the body. When the
aorta receives almost five litres of blood
from the heart, it recoils and is responsible
for pulsating blood pressure. Moreover, as
aorta branches into smaller arteries, their
elasticity goes on decreasing and their
compliance goes on increasing.

Capillaries

Arteries branch into small passages called

arterioles and then into the capillaries.[9]
The capillaries merge to bring blood into
the venous system.[10]

Veins
Capillaries merge into venules, which
merge into veins. The venous system
feeds into the two major veins: the
superior vena cava – which mainly drains
tissues above the heart – and the inferior
vena cava – which mainly drains tissues
below the heart. These two large veins
empty into the right atrium of the heart.

Portal veins

The general rule is that arteries from the

heart branch out into capillaries, which
collect into veins leading back to the heart.
Portal veins are a slight exception to this.
In humans the only significant example is
the hepatic portal vein which combines
from capillaries around the
gastrointestinal tract where the blood
absorbs the various products of digestion;
rather than leading directly back to the
heart, the hepatic portal vein branches into
a second capillary system in the liver.

Heart

View from the front

The heart pumps oxygenated blood to the
body and deoxygenated blood to the
lungs. In the human heart there is one
atrium and one ventricle for each
circulation, and with both a systemic and a
pulmonary circulation there are four
chambers in total: left atrium, left ventricle,
right atrium and right ventricle. The right
atrium is the upper chamber of the right
side of the heart. The blood that is
returned to the right atrium is
deoxygenated (poor in oxygen) and
passed into the right ventricle to be
pumped through the pulmonary artery to
the lungs for re-oxygenation and removal
of carbon dioxide. The left atrium receives
newly oxygenated blood from the lungs as
well as the pulmonary vein which is
passed into the strong left ventricle to be
pumped through the aorta to the different
organs of the body.

Coronary vessels

The heart itself is supplied with oxygen

and nutrients through a small "loop" of the
systemic circulation and derives very little
from the blood contained within the four
chambers. The coronary circulation
system provides a blood supply to the
heart muscle itself. The coronary
circulation begins near the origin of the
aorta by two coronary arteries: the right
coronary artery and the left coronary
artery. After nourishing the heart muscle,
blood returns through the coronary veins
into the coronary sinus and from this one
into the right atrium. Back flow of blood
through its opening during atrial systole is
prevented by the Thebesian valve. The
smallest cardiac veins drain directly into
the heart chambers.[8]

Lungs
The pulmonary circulation as it passes from the heart.
Showing both the pulmonary and bronchial arteries.

The circulatory system of the lungs is the

portion of the cardiovascular system in
which oxygen-depleted blood is pumped
away from the heart, via the pulmonary
artery, to the lungs and returned,
oxygenated, to the heart via the pulmonary
vein.
Oxygen deprived blood from the superior
and inferior vena cava enters the right
atrium of the heart and flows through the
tricuspid valve (right atrioventricular valve)
into the right ventricle, from which it is
then pumped through the pulmonary
semilunar valve into the pulmonary artery
to the lungs. Gas exchange occurs in the
lungs, whereby CO2 is released from the
blood, and oxygen is absorbed. The
pulmonary vein returns the now oxygen-
rich blood to the left atrium.[8]

A separate system known as the bronchial

circulation supplies blood to the tissue of
the larger airways of the lung.
Systemic circulation

The systemic circulation and capillary networks shown

and also as separate from the pulmonary circulation

Systemic circulation is the portion of the

cardiovascular system which transports
oxygenated blood away from the heart
through the aorta from the left ventricle
where the blood has been previously
deposited from pulmonary circulation, to
the rest of the body, and returns oxygen-
depleted blood back to the heart.[8]

Brain

The brain has a dual blood supply that

comes from arteries at its front and back.
These are called the "anterior" and
"posterior" circulation respectively. The
anterior circulation arises from the internal
carotid arteries and supplies the front of
the brain. The posterior circulation arises
from the vertebral arteries, and supplies
the back of the brain and brainstem. The
circulation from the front and the back join
together (anastomise) at the Circle of
Willis.

Kidneys

The renal circulation receives around 20%

of the cardiac output. It branches from the
abdominal aorta and returns blood to the
ascending vena cava. It is the blood supply
to the kidneys, and contains many
specialized blood vessels.

Lymphatic system

The lymphatic system is part of the

circulatory system. It is a network of
lymphatic vessels and lymph capillaries,
lymph nodes and organs, and lymphatic
tissues and circulating lymph. One of its
major functions is to carry the lymph,
draining and returning interstitial fluid back
towards the heart for return to the
cardiovascular system, by emptying into
the lymphatic ducts. Its other main
function is in the adaptive immune
system.[11]

Development
The development of the circulatory system
starts with vasculogenesis in the embryo.
The human arterial and venous systems
develop from different areas in the
embryo. The arterial system develops
mainly from the aortic arches, six pairs of
arches which develop on the upper part of
the embryo. The venous system arises
from three bilateral veins during weeks 4 –
8 of embryogenesis. Fetal circulation
begins within the 8th week of
development. Fetal circulation does not
include the lungs, which are bypassed via
the truncus arteriosus. Before birth the
fetus obtains oxygen (and nutrients) from
the mother through the placenta and the
umbilical cord.[12]

Heart
Arteries

The human arterial system originates from

the aortic arches and from the dorsal
aortae starting from week 4 of embryonic
life. The first and second aortic arches
regress and forms only the maxillary
arteries and stapedial arteries respectively.
The arterial system itself arises from
aortic arches 3, 4 and 6 (aortic arch 5
completely regresses).

The dorsal aortae, present on the dorsal

side of the embryo, are initially present on
both sides of the embryo. They later fuse
to form the basis for the aorta itself.
Approximately thirty smaller arteries
branch from this at the back and sides.
These branches form the intercostal
arteries, arteries of the arms and legs,
lumbar arteries and the lateral sacral
arteries. Branches to the sides of the aorta
will form the definitive renal, suprarenal
and gonadal arteries. Finally, branches at
the front of the aorta consist of the
vitelline arteries and umbilical arteries.
The vitelline arteries form the celiac,
superior and inferior mesenteric arteries of
the gastrointestinal tract. After birth, the
umbilical arteries will form the internal
iliac arteries.

Veins
The human venous system develops
mainly from the vitelline veins, the
umbilical veins and the cardinal veins, all
of which empty into the sinus venosus.

Function
Cardiovascular system

Animation of a typical human red blood cell cycle in the

circulatory system. This animation occurs at a faster
rate (~20 seconds of the average 60-second cycle) and
shows the red blood cell deforming as it enters
capillaries, as well as the bars changing color as the
cell alternates in states of oxygenation along the
cell alternates in states of oxygenation along the
circulatory system.

About 98.5% of the oxygen in a sample of

arterial blood in a healthy human,
breathing air at sea-level pressure, is
chemically combined with hemoglobin
molecules. About 1.5% is physically
dissolved in the other blood liquids and
not connected to hemoglobin. The
hemoglobin molecule is the primary
transporter of oxygen in mammals and
many other species.

Lymphatic system
Clinical significance
Many diseases affect the circulatory
system. These include a number of
cardiovascular diseases, affecting the
cardiovascular system, and lymphatic
diseases affecting the lymphatic system.
Cardiologists are medical professionals
which specialise in the heart, and
cardiothoracic surgeons specialise in
operating on the heart and its surrounding
areas. Vascular surgeons focus on other
parts of the circulatory system.

Cardiovascular disease
Diseases affecting the cardiovascular
system are called cardiovascular disease.

Many of these diseases are called

"lifestyle diseases" because they develop
over time and are related to a person's
exercise habits, diet, whether they smoke,
and other lifestyle choices a person
makes. Atherosclerosis is the precursor to
many of these diseases. It is where small
atheromatous plaques build up in the walls
of medium and large arteries. This may
eventually grow or rupture to occlude the
arteries. It is also a risk factor for acute
coronary syndromes, which are diseases
which are characterised by a sudden
deficit of oxygenated blood to the heart
tissue. Atherosclerosis is also associated
with problems such as aneurysm
formation or splitting ("dissection") of
arteries.

Another major cardiovascular disease

involves the creation of a clot, called a
"thrombus". These can originate in veins or
arteries. Deep venous thrombosis, which
mostly occurs in the legs, is one cause of
clots in the veins of the legs, particularly
when a person has been stationary for a
long time. These clots may embolise,
meaning travel to another location in the
body. The results of this may include
pulmonary embolus, transient ischaemic
attacks, or stroke.

Cardiovascular diseases may also be

congenital in nature, such as heart defects
or persistent fetal circulation, where the
circulatory changes that are supposed to
happen after birth do not. Not all
congenital changes to the circulatory
system are associated with diseases, a
large number are anatomical variations.

Investigations
Magnetic resonance angiography of aberrant
subclavian artery

The function and health of the circulatory

system and its parts are measured in a
variety of manual and automated ways.
These include simple methods such as
those that are part of the cardiovascular
examination, including the taking of a
person's pulse as an indicator of a person's
heart rate, the taking of blood pressure
through a sphygmomanometer or the use
of a stethoscope to listen to the heart for
murmurs which may indicate problems
with the heart's valves. An
electrocardiogram can also be used to
evaluate the way in which electricity is
conducted through the heart.

Other more invasive means can also be

used. A cannula or catheter inserted into
an artery may be used to measure pulse
pressure or pulmonary wedge pressures.
Angiography, which involves injecting a
dye into an artery to visualise an arterial
tree, can be used in the heart (coronary
angiography) or brain. At the same time as
the arteries are visualised, blockages or
narrowings may be fixed through the
insertion of stents, and active bleeds may
be managed by the insertion of coils. An
MRI may be used to image arteries, called
an MRI angiogram. For evaluation of the
blood supply to the lungs a CT pulmonary
angiogram may be used.

Vascular ultrasonography include for

example:

Intravascular ultrasound
Ultrasonography of deep venous
thrombosis
Ultrasonography of chronic venous
insufficiency of the legs
Surgery

This section needs expansion.

There are a number of surgical procedures

performed on the circulatory system:

Coronary artery bypass surgery

Coronary stent used in angioplasty
Vascular surgery
Vein stripping
Cosmetic procedures

Cardiovascular procedures are more likely

to be performed in an inpatient setting
than in an ambulatory care setting; in the
United States, only 28% of cardiovascular
surgeries were performed in the
ambulatory care setting.[13]

Society and culture

This section needs expansion.

In Ancient Greece, the heart was thought

to be the source of innate heat for the
body. The circulatory system as we know it
was discovered by William Harvey

Other animals
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
lymphatic system, on the other hand, is an
open system providing an accessory route
for excess interstitial fluid to be returned
to the blood.[5] The more primitive,
diploblastic animal phyla lack circulatory
systems.

The blood vascular system first appeared

probably in an ancestor of the triploblasts
over 600 million years ago, overcoming the
time-distance constraints of diffusion,
while endothelium evolved in an ancestral
vertebrate some 540–510 million years
ago.[14]

Open circulatory system

The open circulatory system of the grasshopper –

made up of a heart, vessels and hemolymph. The
hemolymph is pumped through the heart, into the
aorta, dispersed into the head and throughout the
hemocoel, then back through the ostia in the heart and
the process repeated.
In arthropods, the open circulatory system
is a system in which a fluid in a cavity
called the hemocoel bathes the organs
directly with oxygen and nutrients and
there is no distinction between blood and
interstitial fluid; this combined fluid is
called hemolymph or haemolymph.[15]
Muscular movements by the animal during
locomotion can facilitate hemolymph
movement, but diverting flow from one
area to another is limited. When the heart
relaxes, blood is drawn back toward the
heart through open-ended pores (ostia).

Hemolymph fills all of the interior

hemocoel of the body and surrounds all
cells. Hemolymph is composed of water,
inorganic salts (mostly sodium, chloride,
potassium, magnesium, and calcium), and
organic compounds (mostly
carbohydrates, proteins, and lipids). The
primary oxygen transporter molecule is
hemocyanin.

There are free-floating cells, the

hemocytes, within the hemolymph. They
play a role in the arthropod immune
system.
Flatworms, such as this Pseudoceros bifurcus, lack
specialized circulatory organs

Closed circulatory system

Two-chambered heart of a fish

The circulatory systems of all vertebrates,

as well as of annelids (for example,
earthworms) and cephalopods (squids,
octopuses and relatives) 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.[16]

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, mammals, and crocodilians 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 and crocodilians evolved
independently from that of mammals.[17]

No circulatory system

Circulatory systems are absent in some

animals, including flatworms. 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.

Some animals, such as jellyfish, have more

extensive branching from their
gastrovascular cavity (which functions as
both a place of digestion and a form of
circulation), this branching allows for
bodily fluids to reach the outer layers,
since the digestion begins in the inner
layers.

History

Human anatomical chart of blood vessels, with heart,

lungs, liver and kidneys included. Other organs are
numbered and arranged around it. Before cutting out
the figures on this page, Vesalius suggests that
readers glue the page onto parchment and gives
instructions on how to assemble the pieces and paste
the multilayered figure onto a base "muscle man"
illustration. "Epitome", fol.14a. HMD Collection, WZ 240
V575dhZ 1543.

The earliest known writings on the

circulatory system are found in the Ebers
Papyrus (16th century BCE), an ancient
Egyptian medical papyrus containing over
700 prescriptions and remedies, both
physical and spiritual. In the papyrus, it
acknowledges the connection of the heart
to the arteries. The Egyptians thought air
came in through the mouth and into the
lungs and heart. From the heart, the air
travelled to every member through the
arteries. Although this concept of the
circulatory system is only partially correct,
it represents one of the earliest accounts
of scientific thought.

In the 6th century BCE, the knowledge of

circulation of vital fluids through the body
was known to the Ayurvedic physician
Sushruta in ancient India.[18] He also
seems to have possessed knowledge of
the arteries, described as 'channels' by
Dwivedi & Dwivedi (2007).[18] The valves of
the heart were discovered by a physician
of the Hippocratean school around the 4th
century BCE. 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.

The Greek physician, Herophilus,

distinguished veins from arteries but
thought that the pulse was a property of
arteries themselves. Greek anatomist
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.[19]
In 2nd century AD Rome, the 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 1025, The Canon of Medicine by the

Persian physician, Avicenna, "erroneously
accepted the Greek notion regarding the
existence of a hole in the ventricular
septum by which the blood traveled
between the ventricles." Despite this,
Avicenna "correctly wrote on the cardiac
cycles and valvular function", and "had a
vision of blood circulation" in his Treatise
on Pulse.[20] While also refining Galen's
erroneous theory of the pulse, Avicenna
provided the first correct explanation of
pulsation: "Every beat of the pulse
comprises two movements and two
pauses. Thus, expansion : pause :
contraction : pause. [...] The pulse is a
movement in the heart and arteries ...
which takes the form of alternate
expansion and contraction."[21]

In 1242, the Arabian physician, Ibn al-Nafis,

became the first person to accurately
describe the process of pulmonary
circulation, for which he is sometimes
considered the father of circulatory
physiology.[22] 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..."

In addition, Ibn al-Nafis had an insight into

what would become a larger theory of the
capillary circulation. He stated that "there
must be small communications or pores
(manafidh in Arabic) between the
pulmonary artery and vein," a prediction
that preceded the discovery of the
capillary system by more than 400
years.[23] Ibn al-Nafis' theory, however, was
confined to blood transit in the lungs and
did not extend to the entire body.
Michael Servetus was the first European to
describe the function of pulmonary
circulation, although his achievement was
not widely recognized at the time, for a
few reasons. He firstly described it in the
"Manuscript of Paris"[24][25] (near 1546),
but this work was never published. And
later he published this description, but in a
theological treatise, Christianismi
Restitutio, not in a book on medicine. Only
three copies of the book survived but
these remained hidden for decades, the
rest were burned shortly after its
publication in 1553 because of
persecution of Servetus by religious
authorities.
Better known discovery of pulmonary
circulation was by Vesalius's successor at
Padua, Realdo Colombo, in 1559.

Image of veins from William Harvey's Exercitatio

Anatomica de Motu Cordis et Sanguinis in Animalibus,
1628

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 published
Exercitatio Anatomica de Motu Cordis et
Sanguinis in Animalibus in 1628, which
"demonstrated that there had to be a direct
connection between the venous and
arterial systems throughout the body, and
not just the lungs. Most importantly, he
argued that the beat of the heart produced
a continuous circulation of blood through
minute connections at the extremities of
the body. This is a conceptual leap that
was quite different from Ibn al-Nafis'
refinement of the anatomy and bloodflow
in the heart and lungs."[26] This work, with
its essentially correct exposition, slowly
convinced the medical world. However,
Harvey was not able to identify the
capillary system connecting arteries and
veins; these were later discovered by
Marcello Malpighi in 1661.

In 1956, André Frédéric Cournand, Werner

Forssmann and Dickinson W. Richards
were awarded the Nobel Prize in Medicine
"for their discoveries concerning heart
catheterization and pathological changes
in the circulatory system."[27] In his Nobel
lecture, Forssmann credits Harvey as
birthing cardiology with the publication of
his book in 1628.[28]

In the 1970s, Diana McSherry developed

computer-based systems to create images
of the circulatory system and heart
without the need for surgery.[29]

See also
Cardiology
Vital heat
Cardiac muscle
Major systems of the human body
Amato Lusitano
Vascular resistance

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2. "Let's beat cancer sooner" . Cancer
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Medical Dictionary
4. "How does the blood circulatory system
work?" . PubMed Health. 1 August 2016.
5. Sherwood, Lauralee (2011). Human
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133-10893-1.
6. Cardiovascular+System at the US
National Library of Medicine Medical
Subject Headings (MeSH)
7. Pratt, Rebecca. "Cardiovascular System:
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9. National Institutes of Health. "What Are
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February 3, 2014.
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The Circulatory System
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