Exam 4 Flashcards
1
Q
colloid
A
liquid that contains suspended substances
2
Q
blood components
A
plasma (55-65%) formed elements (35-45%)
3
Q
plasma
What is it mostly
What is it
What is suspended in it
A
liquid fraction
Is mostly water
Is a colloid
proteins are suspended in plasma
4
Q
formed elements
A
erythrocytes (RBCs)
leukocytes (WBCs)
thrombocyte (platelet)
5
Q
plasma proteins in suspension
A
albumin
globulins
fibrinogen
6
Q
albumin
function
In plasma
A
regulates water balance between tissues, blood, and osmotic pressure
transport of hormones (T3 and T4) and other molecules
7
Q
globulins
function
In plasma
A
transport of hormones (E2 and CORT) and other molecules
8
Q
fibrinogen
function
In plasma
A
clotting
9
Q
serum
what is it
A
liquid fraction of blood that was allowed to clot, then centrifuged
10
Q
does serum contain clotting factors
A
no
11
Q
what is plasma
A
liquid fraction of blood
blood that is collected with anticoagulant and then centrifuged
12
Q
does plasma have clotting factors
A
yes
13
Q
white blood cells
Types
A
granulocytes
agranulocytes
highly motile
14
Q
white blood cells
granulocytes
Types
A
neutrophils
eosinophils
basophils
15
Q
agranulocytes
white blood cells
Types
A
lymphocytes
monocytes
16
Q
WBC chemotaxis
A
movement of WBC between circulation and tissue
17
Q
WBC chemotaxis in response to
A
toxins
chemicals released from damaged/infected tissue
18
Q
WBC chemotaxis
inflammation
What does it do
3
A
vasodilation (histamines)
increased capillary permeability
neutrophils and macrophages accumulation
19
Q
pus
WBCs
A
dead WBCs, bacteria, cell debris
20
Q
neutrophils
how common
function
A
most common (60-70%)
first responders to infections
phagocytize bacteria, antigen-antibody complexes, and other foreign bodies
21
Q
most common WBC
A
neutrophils
22
Q
eosinophils How common What does it defend against Function Regualtes what?
A
less common (2-4%)
defense against parasites
attach to parasites and release chemicals to kill it
regulation of inflammatory response
23
Q
response to inflammatory response
eosinophils
What does it do
What does it destroy
A
aggregate in tissues during allergic reaction
destroy inflammatory chemicals, prevent spread of allergic inflammation
24
Q
basophils
How common
function
A
rare (.5-1%)
proliferate during allergic reaction
25
what happens when basophils proliferate during allergic reactions
Releases what?
release heparin
| release histamines
26
heparin
anticoagulant
27
histamine release
| What does it do
increases blood flow
| leads to itching, redness associated with allergies
28
lymphocytes
How rare
What types
fairly common (20-25%)
B lymphocytes
T lymphocytes
natural killer cells
29
natural killer cells
| lymphocytes
destroy tumor and virus- infected cells
30
B lymphocytes
Originate where
Differentiate into
originate in bone marrow
| differentiate into plasma cells or memory cells
31
b lymphocytes
function
Produce what
production of antibodies specific to pathogens
| immunological memory
32
T lymphocytes
Originate where
What type of cells
originate from in bone marrow, mature in thymus
cytotoxic T cells
helper T cells
33
cytotoxic T cells
| lymphocytes
destroy tumor and virus-infected cells
34
helper T cells
| lymphocytes
secrete cytokines to activate B cells and cytotoxic T cells
35
monocytes
How common
function
```
somewhat common (3-8%)
leave circulation and transform into macrophages
```
36
what happens when monocytes become macrophages
| Stimulates what?
phagocytize bacteria, debris
stimulate chemotaxis of other cells-
release chemical messengers
37
Red blood cells
| Primary function
Oxygen and CO2 transport
38
Red blood cells
| Characteristics
Anucleated and biconcave
39
What does the anucleated and biconcavity of red blood cells allow for
Increased surface area, more space for hemoglobin, can fold and pass through small capillaries
40
What are the 4 subunits of hemoglobin
Globin (polypeptide) bound to heme
41
What is heme
Red pigment molecules, contains one Fe atom
42
What binds to heme
Oxygen
43
Where does oxygen bind on heme
At Fe in center (reversible binding)
44
Where does CO2 bind on hemoglobin
Attaches to globin not Fe
45
How is hemoglobin molecule arranged
```
4 subunits
Beta 2 Beta 1
Alpha 2 Alpha 1
Heme in center
Globin around heme
```
46
Adult hemoglobin
2 alpha globins and 2 beta globins
47
Embryonic hemoglobin
2 zeta globins and 2 epsilon globins
48
Fetal hemoglobin
2 alpha globins and 2 gamma globins
49
When is hemoglobin fetal
After 6 months after birth go to adult
50
Hemoglobin
| Forms and affinities
Adult, embryonic, and fetal hemoglobin
Embryonic and fetal have high affinity for oxygen
Oxygen from mother’s blood at placenta in lower quantities
51
Sickle cell disease
What is it
What does it do
Abnormality if hemoglobin gene, irregular RBC shape
| Cell blocks blood flow or breaks, reduces oxygen delivery to tissues
52
What does sickle cell carry
Carries some protection from Plasmodium parasites (malaria)
53
Production of formed elements
| What is it called
Hematopoiesis
54
Hematopoiesis
Blood cell production
55
Fetal hematopoiesis
| Where 5
In yolk sac, thymus, spleen, lymph nodes and red marrow
56
Post-natal hematopoiesis
| Where
Mostly in red marrow
57
Hemocytoblast
Stem cell origin of all formed elements
58
Hematocytoblast division
1 daughter cell remains as hematocytoblast
Other daughter cell forms either:
1 myeloid stem cell
2 lymphoid stem cell
59
Myeloid stem cell
| Develop into
Develops into RBCs, platelets, or most WBCs
60
Lymphoid stem cells
| Develops into
Develops into lymphocytes
61
Erythropoiesis
Red blood cell production
62
Erythropoiesis
| Steps
Hemocytoblast- makes copy of itself and myeloid stem cell
Myeloid stem cell commits to proerthroblast
proerthroblast goes to early erythroblast
early erythroblast goes to intermediate erythroblast
Intermediate erythroblast goes to late erythroblast
Late erythroblast goes to reticulocytes
Reticulocytes goes to mature blood cells
63
Proerythroblast
Undergoes mitotic divisions
64
Early erythroblast
Nucleolus disappears
65
Intermediate erythroblast
Start producing hemoglobin
Nucleus condenses
Other organelles degernate
66
Late erythroblast
Nucleus ejected
| Hemoglobin at max levels
67
Reticulocytes
Reticulum
| Enter bloodstream
68
Reticulum
Fragments or clumps of residual ribosomes and mitochondria
69
Mature red blood cells
```
Reticulum disappears (2 days)
Cells attain biconcavity
```
70
What regulates erythropoiesis
Erythropoietin
71
What is erythropoietin (EPO)
Peptide hormone produced by kidney
| Stimulates red marrow to produce RBCs
72
What is the stimulus for release for erythropoietin
Low blood oxygen levels
73
Erythropoietin negative feedback loop
Stimulus- low blood oxygen levels
Kidneys- increased EPO secretion through blood stream to
Target tissue- red marrow- increase in RBC production
Increases blood oxygen levels
Where does negative feed back happen?- at kidneys
74
ABO blood group
Blood type based on antigen on surface of RBCs
Antibodies associated with each blood group
Important for matching blood donors
75
How blood type works
| Type a
Antigen A
Produces Anti B antibody
Antigen and antibody reaction- agglutination
76
Agglutination
Clumping
77
Rh blood group
```
First studied in rhesus monkeys
Based on antigen D on RBCs
Positive if present, negative if absent
Genetically determined
Rh antigen can develop through transfusion and blood crossing placenta from mother to fetus
```
78
Tubular reabsorption
water and solutes reabsorbed over entire length
| of tubule system
79
Bulk reabsorption
1 Mostly in PCT- 70% filtrate ( water, glucose, amino acids, bicarbonate) actively transported out of PCT
2 In loop of Henle- reabsorption of Na+
80
Tubular reabsorption- PCT
| Apical side
Has brush border, increases reabsorption
81
Tubular reabsorption- PCT
Reabsorption mechanisms
5
1. Active transport
2. Secondary active transport
3. Electrostatic attraction
4. Osmosis
5. Solvent drag
82
Tubular reabsorption-PCT
Reabsorption mechanism
Active transport
```
Na+ pumped out of PCT into blood against
concentration gradient (requires ATP)
```
83
Tubular reabsorption-PCT
Reabsorption mechanism
Secondary active transport
Glucose and amino acids move with Na+
84
Tubular reabsorption-PCT
Reabsorption mechanism
Electrostatic attraction
Negative ions follow Na+
85
Tubular reabsorption-PCT
Reabsorption mechanism
Osmosis
Water reabsorption
86
Tubular reabsorption-PCT
Reabsorption mechanism
Solvent drag-
Other solutes follow water
87
Tubular reabsorption- PCT
| Transport limit
1. Limit to how much can be reabsorbed
| 2. High concentration of substances will result in some of that substance appearing in urine
88
Tubular reabsorption
Loop of Henle
Thin descending
Permeable to water
Water reabsorbed
Concentrates filtrate
Passive transport
89
Tubular reabsorption
Loop of Henle
Thin ascending limb
Permeable to small solutes,
impermeable to water,
water retained in filtrate, dilutes filtrate
Passive transport
90
When does filtrate reach its highest concentration
At bend of loop of Henle
91
Tubular reabsorption
Loop of Henle
Thick ascending loop
Active reabsorption of Na+, K+, Cl-
| Impermeable to water (water retained in filtrate, dilutes filtrate)
92
What happens in the loop as water and solutes are reabsorbed
Loop first concentrates the filtrate, then dilutes it
93
Tubular reabsorption/Collecting duct
| Regulated reabsorption
Reabsorption at DCT and collecting duct under hormonal control
94
Tubular reabsorption DCT
Hormone
Aldosterone
Secreted by
Does what
Secreted by adrenal cortex
| Increases Na+ reabsorption
95
Tubular reabsorption DCT
Hormone
Parathyroid hormone
Secreted by
Does what
Secreted by parathyroid glands
| Increases Ca++ reabsorption
96
Tubular reabsorption DCT
Hormone
Atrial natriuretic factor
Secreted by
What does it do
Secreted by atrial myocardium
Reduces Na+ and water reabsorption
Reduces blood volume and BP
97
Tubular reabsorption DCT
Hormone
Vasopressin
Secreted by
Does what
Secreted by posterior pituitary
| Increases water reabsorption
98
What does coffee and alcohol do
Block vasopressin secretion
| Has a diuretic effect
99
Tubular secretion
What does it remove
What does it regulate
Removal of substances from blood, secreted into filtrate
| Regulation of pH- secretion of H+ or bicarbonate into filtrate
100
What can be secreted by tubular secretion
| 5
Various ions, ammonium, creatine, urea, drugs/toxins
101
What is the nephron
Functional unit of kidney
102
Components of nephrons
A renal corpuscle
Tubules
Collecting duct
103
Nephron
| Renal corpuscle
Glomerus
| Bowman’s capsule
104
Renal corpuscle
| Glomerus
Network of capillaries, blood supply for filtration, blood flows under high BP (60 mm Hg) compared to other capillary systems
105
Renal corpuscle
| Bowman’s capsule
Receives fluid filtered through glomerus (filtrate)
106
Nephrons
Tubules
Types
Proximal convulted tubule (PCT), loop of Henle, distal convulted tubule (DCT)
107
Nephrons
| Collecting duct
Drains to ureter via the renal pelvis
108
Reabsorption
Pulling substances out of filtrate and returned to blood
109
Secretion
Secreting substances from the blood
110
Nephron type
Cortical
| Juxtamedullary
111
Nephron type
| Cortical
Corpuscle in cortex
| Short loop of Henle (not far into medulla)
112
Nephron type
| Juxtamedullary
Corpuscle next to medulla
| Long loop of Henle (extensive water reabsorption/ produces more concentrated urine.
113
General urine formation
Glomerular filtration
Tubular reabsorption
Tubular secretion
Excretion
114
Where does bulk reabsorption and regulated reabsorption occur
At tubular reabsorption
115
Renal circulation
```
Afferent arterioles
Efferent arterioles
Peritubular capillaries
Coritical nephrons
Juxtamedullary nephrons
```
116
Renal circulation
| Afferent arterioles
Supply glomerulus with blood to be filtered
117
Renal circulation
| Efferent arterioles
Transport “cleaned” blood away from glmerulus
118
Renal circulation
| Peritubular capillaries
From branches of efferent arterioles
Reabsorption into blood from tubules
Secretion from blood into tubules
119
Renal circulation
| Cortical nephrons
Entire tubular system surrounded by peritubular capillaries
120
Renal circulation
| Juxtamedullary nephrons
Dived into vasta recta
| Helps formation of concentrated urine
121
What drives glomerular filtration
```
By pressure in capillaries
GCP (50-60) out
Capsular pressure (10) in
Colloid osmotic pressure (30) in
Filtration pressure= GCP-Capsular-Colloid= 50-10-30= 10
```
122
Glomerular filtration
What is filtered
Where does filtrate go
Plasma filtered through holes of glomerular capillaries
Filtrate captured in Bowman’s capsule
Substances filtered through pores into Bowman’s capsule
Average glomerular filtration rate (GFR)- 180L/day
Urine output 1-2L/day
123
Filtered substances in glomerular filtration
Small molecules filtered out of blood
Water, electrolytes, glucose, amino acids, nitrogenous wastes
Glomerulus capillaries are impermeable to protein (too big) and blood cells, and other large substances
124
Regulation of renal activity
Renin- angiotensin- aldosterone system (RAAS)
| Regulation of BP and kidney activity
125
Where is dysregulated RAAS commonly found
In people with high BP
126
What medication is used in people with dysregulated RAAS
ACE inhibitors
127
RAAS System
| How it works
Stimulus: decreased BP
Kidneys produce enzyme renin
Liver produces protein Angiotensinogen
Renin cleaves angiotensinogen to produce Angiotensin I
Lungs produce enzyme angiotensin converting enzyme (ACE)
ACE converts angiotensin I to angiotensin II- potent vasoconstrictor
128
What is a potent vasoconstrictor
Angiotensin II
129
how does angiotensin II work
Stimulates vasoconstriction (increases BP)
Stimulates aldosterone (increases Na+ reabsorption, increases BP)
Stimulates secretion of vasopressin (increases water reabsorption which increases BP, increases BP on its own)
Stimulates SANS activity (increases BP)
130
Ovaries
Female gonads
| Gamete production, hormone production
131
Follicle
Structure that houses ovum (gamete) made up of 2 different cell types
132
Granulosa cells
Gamete development, aromatase production
133
Thecal cells
Produce androgens, these are converted to estrogens by granulosa cells
134
Two types of follicle cells
Granulosa cells
| Thecal cells
135
How many gametes are ovulated
| Females
Only a couple of hundred
136
Uterus
| What does it do
Supporting and maintaining pregnancy
137
Reproductive cycles and HPG axis
Repeat in predictable manner (28-30 days)
Inter relationship between hypothalamus, pituitary, and ovaries
Leads to monthly preparation of uterus to accommodate fertilized egg
138
Menstruation
Shedding of uterine lining in absence of implantation
139
Menarche
Initial onset of menstruation
| Average age in US is 12 years old
140
Menopause
Permanent cessation of menstruation
After 40 years old, cycles become irregular and finally ceases
Ovaries no longer respond to LH/FSH
Without negative feedback, GnRH, LF/LSH may increase in effort to stimulate ovaries
141
Ovarian cycle
Predictable cyclic changes in oocyte/ovarian follicle (28-30 days)
142
Two components to ovarian cycle
Oogenesis
| Folliculogenesis
143
Oogenesis
| Steps
Oogonium- diploid
Mitosis- one daughter cell replaces oogonium, other primary oocyte
Primary paused in prophase I
This occurs before birth
When puberty starts
Meiosis I resumes
Uneven division of primary oocyte
One is small polar body (degrades), one becomes secondary oocyte (pauses at metaphase II until penetrated by sperm)
After penetrated by sperm, completes meiosis II
Splits again into polar body (degrades), one becomes mature ovum
144
Oogonium
Formed during fetal development
145
primary oocyte
Starts to go through meiosis I
146
secondary oocyte
Starts meiosis II
Gets released during ovulation
Pauses at metaphase II
If sperm penetrates oocyte meiosis II completes
147
Follicogenesis
Development of follicle that houses the egg
Primordial follicle- granulosa cells- proliferate,
Proliferation of thecal cells- outside of follicle,
Within follicle production of follicular fluid
When ovulation occurs secondary oocyte is expelled from follicle
Follicle ruptures, produces hormones
Becomes corpus luteum
148
Follicular fluid
Nourish oocyte
| Collects in antrum
149
Hormones of ovarian cycle
| Phases
Follicular phase
| Luteal phase
150
Follicular phase
GnRH from hypothalamus- stimulates anterior pituitary to secrete LH and FSH
These travel to ovaries
At first negative feedback from estradiol occurs
Follicle secretes estradiol in very high concentrations triggers switch to positive feedback
High estradiol leads to more secretion of GnRH, LH/FSH
LH surge- large peak of LH secretion- causes ovulation- expulsion of ovum from follicle, follicle ruptures
151
Luteal phase
```
Corpus luteum (ruptured follicle)
Produces large amounts of progesterone
Some E2 produced (switch back to negative feedback)
```
152
FSH
| Stimulates what
Stimulates growth of follicle
153
LH stimulates
Stimulates production of estradiol by granulosa/thecal cells
154
what happens if pregnancy does occur
Development of blastocyst which secretes human chorionic gonadotropin
155
What happens if pregnancy does not occur
Corpus luteum stops function and cycle begins again
156
Human chorionic gonadotropin
Preservation of corpus luteum
| Corpus luteum keeps producing hormones to support pregnancy
157
Hormonal birth control
Exogenous ethinyl estradiol (synthetic estradiol)
Constant level of E2 and progesterone
Negative feedback to pituitary and hypothalamus to suppress secretion of FSH and LH- no follicle development, no LH surge/ovulation
Relies on proper pill use
