Lecture Exam 1 Flashcards

Question

What is erythrocyte production called? explain.

Answer 1

erythropoiesis normally takes 3 to 5 days and involves four major developments: 1. A reduction in cell size 2. an increase in cell number 3. the synthesis of hemoglobin 4. and the loss of the nucleus and other organelles

Answer 2

* It beins when a hemopoietic stem cell (HSC) becomes an erythrocyte colony-forming unit (ECFU), which has receptors for erythropoietin (EPO), a hormone secreted by the kidneys * EPO stimulates the ECFU to transform into an erythroblast (normoblast) * Erythroblasts multiply and synthesize hemoglobin * When this task is completed, the nucleus shrivels and is discharged from the cell * The cell is now called a reticulocyte, named for a temporary network (reticulum) composed of ribosome clusters (polyribosomes). * Reticulocytes leave the bone marrow and enter the circulating blood * In a day or two, the last of the polyribosomes disintegrate and disappear, and the cell is a mature erythrocyte

Answer 3

Ferric (Fe³⁺) and Ferrous (Fe²⁺) Stomach acid converts most Fe³⁺to Fe²⁺, the only form that can be absorbed by the small intestine

Answer 4

* A protein that is produced by the stomach, then binds Fe 2+ and transports it to the small intestine. Here it is absorbed by the blood, binds to a plasma protein called transferrin, and travels to the bone marrow, liver and other tissues * Bone marrow uses iron for hemoglobin synthesis; muscle uses it to make the oxygen-storage protein myoglobin; and nearly all cells use iron to make electron-trnsport molecules called cytochromes in their mitochondria. * The liver binds surplus iron to a protein called apoferritin, forming an iron-storage complex called ferritin. * It releases Fe2+ into circulation when needed

Answer 5

For example hemorrhaging and may result in a state of hypoxemia (oxygen deficiency in the blood) Negative feedback * The kidneys detect this and increase their EPO output * Three or four days later, the RBC count begins to rise and reverses the hypoxemia that started the process

Answer 6

1. **Albumins** (60% - Liver) * Water soluble, maintain osmotic pressure (BCOP) 2. **Globulins** (35% - Liver, plasma cells) antibodies * Transport, Immunity 3. **Fibrinogen** (4% - Liver) * Clotting 4. Other (1%): * eg. **Hormones**

Answer 7

1. **Electrolytes (salts)** * Cellular activity, osmotic pressure * Cations: Na+, K+, Ca2+ * Anions: Cl-, HCO3- 2. **Gases** * O2, CO2, N2 3. **Nutrients** * Amino acids, glucose, fats 4. **Wastes** * N-containing, creatine, bilirubin

Answer 8

Percent of blood that is RBC (35 - 55%) * females are lower, espcially unift at sea level * Highly fit men that live well above sea level have a higher count

Answer 9

* Bi-concave disc * Flexible * except if the person has sickle cell anemia * genetic, DNA, disorder (half moon) * Stackable * No nucleus, few organelles

Answer 10

* Oxygen carrying protein * Normal level: 12-18 grams/ dl * Structure: * Four polypeptide subunits * Heme groups * Iron containing: red colored, bind to O2, CO2

Answer 11

1. Erythropoeisis * in myeloid tissue (marrow) 2. Myeloid stem cells * tissue that will become RBC, found in marrow 3. Proeythroblasts * will become RBC 4. Red blood cells 5. Controlled by erythropoeitin (EPO) * Released in response to: * Low O2 levels: * anemia (damaged or no/low iron) * Blood loss (kidneys will signal for RBC release) * Respiratory damage * Exercise

Answer 12

* Lifespan ~120 days * 3 million produced and destroyed per second * Phagocytosis (macrophages in liver) * some parts recycled * Proteins -\> AA * Heme -\> iron + biliverdin (helps breakdown fat) * some are excreted * biliverdin -\> bilirubin

Answer 13

antigens + antibodies

Answer 14

* Primarily remain in CT (blood) * bloodstream is for point to point transportation * Amoeboid movement (squeeze or shake into tinny places = diapedisis) * Migration out of bloodstream * Chemotaxis (chemical signals) * Phagosytosis

Answer 15

1. **_Neutrophils_** * Most common (70%) * Mobile * **Phagocytes** of 'marked' bacteria * **Suicidal** eaters - **Pus** 2. **_Eosinophils_** * 2-4% of WBCs * Attack eukaryotic **parasites: worms and protozoa** * **Exotoxin** release * Phagocytic 3. **_Basophils_** * Rare (\<1%) * Granules contain **histamine and heparin** * ****Heparin - prevents blood from clotting (anticoagulant) * Histamine - increases inflammation (vasodilator) * **Inflammatory response** 4. **_Monocytes_** * 5-10% of WBC * Huge **macrophages** 5. **_Lymphocytes_** * 20-30% of WBC * Immune system function * **B cells** * **T cells** * **NK cells**

Answer 16

* Originates in the bone marrow * Production hormonally regulated - CSF * Hemocytoblasts can differentiate into the Myeloid stem cells and Lymphoid stem cells

Answer 17

* Function in hemostasis * Develop from megakaryocytes * 10 day circulation * Specific functions: * Physical plugging of wounds * Chemical control of clotting

Answer 18

1. **_Vascular Phase_** * Vascular spasm decreases diameter of vessels (muscle contraction) * Decreased blood flow 2. **_Platelet Phase_** * Platelet adhesion to lamina and aggregate (form plug) 3. **_Coagulation Phase_** * Formation of blood clot * Clottting factors -\> fibrin formation * Extrinsic Pathway * Triggered by chemicals released from damaged endothelium * Intrinsic Pathway * Triggered by exposure to collagen (proenzyme activation) * Common Pathway * Bigins with enzymatic Factor X activation (from either pathway)

Answer 19

* Coverings: * Pericardium - heart sits in the sac * Epicardium - outside of the heart * Endocardium - inner lining of the heart * Cardiac Muscle * Myocardium - interconnected via intercalated discs * contractile and conducting tissue

Answer 20

Issues: 1. Coronary artery atherosclerosis 2. Blocked in a blood vessel Fixes: 1. Coronoary artery bypass surgery 2. CABG = "cabbage" or stents

Answer 21

Produces a record of the electrical activity of the heart. It utilizes numerous electrodes to understand the activity at different distances from the heart.

Answer 22

* **P wave:** * Produced when a signal from the SA node spreads through the atria and depolarizes them * Atrial systole begins * Time required for impulses to travel from the SA node to the AV node * **QRS complex:** * small downward deflection (Q), a tall sharp peak (R), and a final downward deflection (S) * Produced when the signal from the AV node spreads through the ventricular myocardium and depolarizes the muscles * **T Wave:** * generated by ventricular repolarization immediately before diastole * The ventricles take longer to repolarize than to depolarize; the t wave is therefore smaller and more spread out than the QRS comples, and it has a rounder peak

Answer 23

arrhythmia

Answer 24

the hallmark of a heart attack (myocardial infarction) * most in patients with a history of coronary artery disease * In striking contrast to the steady sinus rhythm, the ECG shows weak, chaotic ventricular depolarization * Electrical signals travle randomly about the mycardium and return to repeatedly restimulate the same area instead of dying out like a normal ventricular depolarization

Answer 25

**Pressure,** which impels a fluid to move **resistance,** which opposes flow

Answer 26

**sphygmomanometer** a calibrated mercury monometer with its open lower end attached to an inflatable pressure cuff wrapped around the arm

Answer 27

auscultation | (AWS-cul-TAY-shun)

Answer 28

* The first and second heart sounds, symbolized S1 and S2 * often described as a "lubb-dupp" * S1 = louder and longer * S2 = softer and sharper * In children and adolescents it is normal to hear a third heart sound (S3) * in adults this is called triple rhythm or gallop, which may indicate an enlarged and failing heart

Answer 29

1. **_Ventricular filling._** * During Diastole, the ventricles expand and their pressure drops beloow that of the atria * As a result, the AV valve open and blood flows into the ventricles (vent pressure rise) * **Three phases:** * First one-third: rapid ventricular filling * Second one third: diastasis, marked by slower filling. P wave of the EKG, depolarization of atria * Third one third: atrial systole completes the filling process. right atrium contracts slightly before left * At end of stage, each ventricle contains an **end-diastolic volume (EDV)** of 130 mL 2. **_Isovolumetric contraction_** * atria repolarize, relax, and remain in diastole for the rest of the cardiac cycle * Ventricles depolarize, generate the **QRS complex**, and begin to contract * reverse the pressure gradient between atria and ventricles * Heart sound **S1 begins** at this phase * Called isovolumetric because even though the ventricles contract, they **do not eject blood yet** and there is no change in their volume (pressure in aorta and lungs too high) 3. **_Ventricular ejection_** * Begins when ventricular pressure exceeds arterial pressure and forces the **semilunar valves to open** * **T wave** then occurs late in this phase, beginning at the moment of peak ventricular pressure * the amount ejected = **stroke volume (SV)** and precentage is called **ejection fraction**, **end-systolic volume (ESV)** is the amount after ejection 4. **_Isovolumetric relaxation_** * This is **early ventricular diastole**, when the **T wave ends** and the ventricles begin to expand * closing of the semilunar valves

Answer 30

blood accumulates in the lungs, causes pulmonary hypertension, edema and a rist of drawing in one's own body fluid

Answer 31

cardiac output (CO) If HR is heart rate (beats/min) and SV is stroke volume (mL/beat), CO = HR x SV

Answer 32

by taking a persons pulse at same point where an artery runs close to the body surface

Answer 33

is a persistent, resting adult heart rate above 100 bpm can caused by stress, anxiety, stimulants, heart disease or fever

Answer 34

is a persistent, resting adult heart rate below 60 bpm it is common during sleep and in endurance-trained athletes Endurance training enlarges the heart and increases its stroke volume, enabling it to maintain the same ouput with fewer beats

Answer 35

Positive chronotropic agents = raise HR Negative chronotropic agents = lower HR

Answer 36

medulla oblongata that contain the cardiac centers initiate autonomic output to the heart (cardiostimulatory effect and cardioinhibitory effect)

Answer 37

they release norepinephrine, which binds to beta-adrenergic fibers in the heart * Activates the cyclic adenosine monophosphate (cAMP) second- messenger system in the cardiocytes and nodal cells * cAMP activates an enzyme that opens a Ca2+ channel in the plasma membrane * The Ca2+ inflow accelerates depolarization of the SA node and contraction of the cardiocytes, so it speeds up the heart * In addition, cAMP accelerates the uptake of Ca2+ by the sarcoplasmic reticulum and thereby enables cardiocytes to relax more quickly * By accelerating both contraction and relaxations, norepinephrine and cAMP increase the heart rate

Answer 38

have cholinergic, inhibitory effects on the SA and AV nodes * Acetylcholine (ACh) binds to muscarinic receptors and opens K+ gates in the nodal cells * As K+ exits the cells, they become hyperpolarized and fire less frequently, so the heart slows down * The vagus nerves have a faster-acting effect on the heart than the sympathetic nerves becasue ACh acts directly on the ion channels in the plasma membrane; sympathetic effects are slower because of the time taken fort eh cAMP system to act on the ion channels

Answer 39

* **_Proprioceptors:_** * in muscles and joints provide information on changes in physical activity * **_Baroreceptors (pressoreceptors):_** * pressure sensors in the aorta and internal carotid arteries * **_Chemoreceptors:_** * occur in the aortic arch, carotid arteries and the medulla oblongata itself, and are sensitive to blood pH, CO2 and O2 levels * They are more important in respiratory control than in cardiovascular control but they do influence the heart rate

Answer 40

* In hyperkalemia, a potassium excess, K+ diffuses into the cardiocytes and keeps the memebrane voltage elevated, inhibiting cardiocyte repolarization * The myocardium becomes less excitable, the heart rate becomes slow and irrgular and the heart may arrest in diastol

Answer 41

* calcium excess (hypercalcemia) causes a slow heartbeat, whereas a calcium deficiency (hypocalcemia) elevates the heart rate * Such calcium imbalances are relatively rare, however, and when they do occure, they primary effect is on contraction strength

Answer 42

Increased preload or contractility increases stroke volume, whereas increased afterload opposes the emptying of the ventricles and reduces stroke volume 1. **_Preload_** * amount of tension (stretch) in the ventricular myocardium immediately before it begins to contract 2. **_Contractility_** * how hard the myocardium contracts for a given preload * increase caused by factors that make the cardiocytes more responsive to stimulation * Factors that affect contractility are called: * positive inotropic agents - increase * Calcium- increases strength * increases excitation-contraction coupling of muscle * Prolongs the plateau of the myocardial action potentials * Negative inotropic agents - decrease * too much calcium (hyperkalemia) has a negative effect because it reduces the strength of myocardial action potentials and thus reduces the release of Ca2+ in the sarcoplasm 3. **_Afterload_** * is the sum of all forces a ventricle must overcome before it can eject blood * The most significant contribution to afterload is the blood pressure in the aorta and pulmonary trunk immediately distal to the semilunar valve; it opposes the opening of these valves and thus limits stroke volume

Answer 43

1. **_Tunica Interna:_** * lines the inside of the vessel and is exposed to the blood * Simple squamous epithelium called endothelium * Selectively permeable barrier to materials entering or leaving bloodstream, secretes chemicals that stimulate dilation or constriction of vessels, repels blood cells and platelests so blood flow is not obstructed 2. **_Tunica Media:_** * middle layer, usually the thickest * consists of smooth muscle, collagen, and in some cases elastic tissue * strengthens the vessel s and prevents blood pressure from repturing them, and it regulates the diameter of a blood vessel 3. **_Tunica Externa:_** * outermost layer * Consists of loose connective tissue that often merges with that of neighboring blood vessels, nerves, or other organs * It anghors the vessel to adjacent tissues and provides passage for small nerves, lymphatic vessels and smaller blood vessels that supply the tissues of the larger vessels

Answer 44

They are divided into three classes by size 1. **_Conducting (elestic or large) arteries_** * are the largest, examples include aorta, common carotid and subclavian arteries, pulmonary trunk, and common iliac arteries * They have a layer of elastic tissue called the internal elastic lamina at the border between the interna and media, but microscopically, it is incomplete and difficult to distinguish from the tunica media * These areteries expand as they receive blood during ventricular systole and recoil during diastole 2. **_Distributing (muscular or medium) arteries:_** * are smaller branches that distribute blood to specific organs * Examples include brachial, femoral, renal, and splenic arteries * they tipically have up to 40 layers of smooth muscle constituting about three-quarters of the wall thickness 3. **_Resistance (small) arteries_** * usually too variable in number and location to be given individual names * They exhibit up to 25 layers of smooth muscles and relatively little elastic tissue * They have a thicker tunica media in proportion to the lumen * aka **arterioles**

Answer 45

These receptors transmit information to the brainstem that serves to regulate the heartbeat, blood vessel diameters and respiration 1. **_Carotid sinuses_** * **Baroreceptors** (pressure sensors) that monitor blood pressure * adjust blood pressure (baroreflex) * Ascending the neck on each side is a **common carotid artery** * They have a relatively thin tunica media and an abundance of glossopharyngeal nerve fibers 2. **_Carotid bodies_** * Located near the branch of the **common carotid arteries**, these are **oval receptors** about 3x5 mm in size, innervated by sensory fibers of the **glossopharyngeal nerves** * They are **chemoreceptors** that monitor changes in blood composition * primarily transmit signals to the brainstem respiratory centers, which adjust breaking to stabilize the blood pH and its CO2 and O2 level 3. **_Aortic bodies_** * These are one to three **chemoreceptors** located in the **aortic arch** near the arteries to the head and arms * same structure and function as carotid bodies, but transmit their signals to the brainstem via the **vagus nerves**

Answer 46

microvasculature (microcirculation)

Answer 47

exchange of materials from tissues into the blood stream They consist of only an endothelium and basal lamina

Answer 48

distinguished by the ease with which they allow substances to pass through their walls and by structural differeences that account for their greater or lesser permeability 1. **_Continuous capillaries_** * occur in **most tissues**, such as skeletal muscles * Their endothelial cells, held together by tight junctions, form a continuous tube * Contain protein-carbohydrate layer = basal lamina * endothelial cells separated by narrow intercellular clefts * Some continuous capillaries exhibit cells called pericytes that lie external to the endothelium 2. **_Fenestrated capillaries_** * Have endothelial cells riddled with patches of filtration pores (fenestrations) * Allow for the **rapid passage of small molecules**, but still **retain most proteins and larger particles** in the blood stream * Important in **organs that engage in rapid absorption or filtration** 3. **_Sinusois (discontinuous capillaries)_** * Irregular blood-filled spaces in the **liver, bone marrow, spleen, and some other organs** * Twisted, tortuous passageways that conform to the shape of the surrounding tissue * **proteins and blood cells can pass through pores**

Answer 49

1. **_Postcapillary venules_** * the smallest of the veins beginning with diameter of about 10 to 20 um. Receive blood from capillaries directly or by way of the distal ends of the thoroughfare cahnnels * Exchange fluid with surrounding tissues 2. **_Muscular venules_** * receive blood from teh postcapillary venules, up to 1 mm diameter 3. **_Medium veins_** * up to 10 mm in diameter. Most veins with individual names are in this category (radial and ulnar veins for example) * many contain venous valves to direct flow to heart 4. **_Venous sinuses_** * veins with especially thin walls, large lumens and no smooth muscle (coronary sinus and dural sinuses of brain. * not capable of vasoconstriction 5. **_Large veins_** * Greater than 10 mm, they have smooth muscles in all three tunics. * Have relatively thin tunica media * Ex. Vena cavae, pulmonary veins, jugular veins and renal veins

Answer 50

* Blood flows through two consecutive capillary networks before returning to the heart * occurs in the kidneys; connecting the hypothalamus and anterior pituitary and connecting the intestines to the liver

Answer 51

a point of **convergence between two blood vessels other than capillaries** * In an **_arteriovenous anastomosis (shunt),_** blood flows from an artery directly into a vein and bypasses the capillaries * helps to **reduce heat loss** in the extremities during cold weather

Answer 52

1. **_flow_** * amount of blood flowing through the organ, tissue or blood vessel in a given time (mL/min) 2. **_Perfusion_** * flow per given volume or mass of tissue (mL/min/g)

Answer 53

* **_Systolic pressure_** - peak arterial BP attained during ventricular contraction * **_Diastolic pressure_** - is the minimum arterial BP occuring during the ventricular relaxationg between heartbeats * The difference between systolic and iastolic pressure = **_pulse pressure_** * _**Mean arterial pressure (MAP**)_ = mean pressure you would obtain if you took measurements at several intervals throughout the cardiac cycle * **diastolic + 1/3 (pulse pressure)**

Answer 54

1. **_arteriosclerosis =_** * when there is an increase in stiffness of the arteries (hardening of the arteries) 2. **_atherosclerosis =_** * growth of lipid deposits in the arterial walls = plaques 3. **_Hypertension =_** * high BP = commonly considered to be a chronic resting blood pressure higher than 140/90 4. **_Hypotension =_** * Cronic low resting BP

Answer 55

the opposition to flow that the blood encounters in vessels away from the heart 1. **_Blood viscosity_** * most significant is the erythrocyte count and albumin concentration to determine the level of viscosity of blood 2. **_Vessel length_** * The longer th eliquid travels in the tube, the more cumulative friction it encounters, pressure and flow declines wiht distance 3. **_Vessel Radius_** * The only significant way of controlling peripheral resistance from moment to moment are vasoconstrictions, the carrowing of a vessel and vasodilation, the widening of a vessel

Answer 56

1. **_Local Control_** * **Autoregulation** = ability of the tissues to regulate their own blood supply * Platelets, endothelial cells and the perivascular tissues secrete a variety of **vasoactive chemicals** that stimulate vasodialation under such conditions as trauma, inflammation, and exercise * If tissue's blood supply is cut off from a time and then restored, it often exhibits reactive **hyperemia** - an increase above the normal level of flow * Over a long time, a hypoxic tissue can increase its own perfusion by **angiogenesis** = the growth of new blood vessels 2. **_Neural Control_** * In addition to local control, the blood vessels are under remote control by the central and autonomic nervous system * Vasomotor center (**medulla oblongata**\_ exerts sympathetic control over blood vessels throughout the body * The vasomotor center is an integrating center for three autonomic reflexes - **baroreflex** (pressure regulation), **chemoreflexes** (pH, chemistry, O2 and CO2 concentrations), and **medullary ischemic reflex** (response to reduced perfusion of the brain, aka medulla oblongata monitors its own blood supply) 3. **_Hormonal Mechanisms_** * **Angiotensin II** - vasoconstrictor that raises BP * **Aldosterone** - salt-retaining hormone = water retension, increasing blood volume and pressure * **Natriuretic peptides** - increase Na excretion by kidnesy, reducing blood volume and pressure * **Antidiuretic hormone** - promotes water retentions, increases blood volume and pressure, also a vasoconstrictor * **Epinephrine and norepinephrine** - stimulates vasoconstriction and raises BP. however, in coronary blood vessels they bind to beta-adrenergic receptors and cause vasodilation, increasing blood flow the th emyocardium during exercise

Answer 57

* Taken up by the capillaries: * CO2 and other wastes, and many of the sam esubstances as they give off: glucose and fatty acids released from storage in the liver and adipose tissue; calcium and other minerals released from bone; antibodies secreted by immune cells; and hormones secreted by the endocrine glands

Answer 58

1. the endothelial cell cytoplasm 2. intercellular clefts between the endothelial cells 3. filtration pores of the fenestrated capillaries

Answer 59

1. **_Diffusion_** * glucose and oxygen, being more concentrated in the systemic blood than in the tissue fluid, diffuse out of blood * Carbon dioxide and other wastes being more concentrated in the tissue fluid, diffuse into the blood (O2 and CO2 diffuse in opposite directions) 2. **_Transcytosis_** * Process in which endothelial cells pick up material on one side of the plasma membrande by pinocytosis or receptor-mediated endocytosis, transport the vesicles across the cell, and discharge the material on the other side by exocytosis * Fatty acids, albumin and some hormones such as insuline move this way 3. **_Filtration and Reabsorption_** * typically, fluid filters out of the arterial end of a capillary and osmotically reenters it at the venous end * This fluid delivers materials to the cells and removes their metabolic wastes * Hydrostatic pressure is a physical force exerted by a liquid against a surface such as a capillary wall * These forces are opposed by colloid osmotic pressure (COP), the portion of the osmotic pressure due to protein. * The difference between the COP of blood and tissue fluid is called oncotic pressure * dens to draw water into the capillary by osmosis, opposing hydrostatic pressure * These opposing forces produce a net filtration pressure (NFP) of 13 mm Hg out * Net reabsorption pressure - reabsorbing into capillarys

Answer 60

the accumulation of excess fluid in a tissue * often shows as swelling of the face, fingers, abdomen, or ankles but also occurs in internal organs where its effects are hidden from view * Often occurs when fluid filters into a tissue faster than it is reabsorbed

Answer 61

1. **_Increased capillary filtration_** * numerous conditions can increase the rate of capillary filtration and caccumulation of fluid in the tissues. * Kidney failure, leads to water retention and hypertension. Histamine dilates arterioles and raises capillary pressure and makes the capillary wall more permeable 2. **_Reduced capillary reabsorption_** * Capillary reabsorption depends on oncotic pressure, which is proportional to the concentration of blood albumin * Deficiency of albumin (hypoproteinemia) produces edema by reducing the reabsorption of tissue fluid * commonly seen in regions of famine due to dietary protein deficiency 3. **_Obstructed lymphatic drainage_** * Lymphatic system, is a network of one-way vessels that collect fluid form the tissues and return it to the bloodstream. Obstructions of these vessels or the surgical removal of them can interfere with fluid drainage

Answer 62

1. **_The pressure gradient_** * generated by the heart is the most important force in venous flow, even though it is substantially weaker in the veins than in the arteries 2. **_Gravity_** * flow downhill 3. **_The skeletal muscle pump_** * In the limbs, the veins are surrounded and messaged by the muscles. Contracting muscles squeese the blood out of the compressed parts of a vein, and the valves ensure that this blood can go only toward the heart 4. **_The thoracic (respiratory) pump_** * Aids the flow of venous blood from the abdominal to the thoracic cavity. When you inhail your thoracic cavity expands and then the internal pressure drops 5. **_Cardiac suction_** * During ventricular systole, the tendinous cords pull the AV valve cusps downward, slightly expanding the atrial space * This creates a slight suction that draws blood into the atria from the venae cavae and pulmonary veins

Answer 63

venous pooling

Answer 64

is any state in which cardiac output is insufficient to meet the body's metabolic need There are two categories of circulatory shock: 1. **_Cardiogenic shock:_** * caused by inadaquate pumping by the heart, usually as a result of myocardial infarction 2. **_Low venous return (LVR) shock:_** * in which cardiac output is low because too little blood is returning to the heart

Answer 65

1. **_Hypovolemic shock_** * most common form, is produced by a loss of blood volume as a result of hemorrhage, trauma, bleeding ulcurs, burning or dehydration * Dehydration is the major cause of death from heat exposure 2. **_Obstructed venous return shock_** * Occurs when any object, such as a growing tumor or aneurysm, compresses a vein and impedes its blood flow 3. **_Venous pooling (vascular) shock_** * occurs when the body has a normal total blood volume, but too much of it accumulates in the lower body * Neurogenic shock - is a form of venous pooling shock that results from a sudden loss of vasomotor tone, allowing the vessels to dialate

Answer 66

septic shock

Answer 67

anaphylactic shock

Answer 68

1. **_Fluid recovery_** * continually filters from blood capillaries into the tissue spaces. * Reabsorbs excess and returns to the blood 2. **_Immunity_** * picks up foreign cells and chemicals from the tissue. Fluid passes through lymph nodes, where immune cells stand guard against foreign matter 3. **_Lipid absorption_** * In the small intestine, special lymphatic vessels called lacteals absorb dietary lipids that are not absorbed by the blood capillaries

Answer 69

1. **_Lymph_** - the recovered fluid 2. **_Lymphatic vessels_** - which transport the lymph 3. **_Lymphatic tissue_** - composed of aggregates of lymphocytes and macrophages that populate many organs of the body 4. **_Lymphatic organs_** - which these cells are especially concentrated and which are set off from surrounding organs by connective tissue capsules

Answer 70

usually a clear, colorless fluid, similar to blood plasma but low in protein * Originates as tissue fluid that has been taken up by the lymphatic vessels

Answer 71

* Lymph flows through a system of lymphatic vessels (lymphatics) similar to blood vessels. * These begin with macroscopic lymphatic capillaries (terminal lymphatics), which penetrate nearly every tissue of the body but are absent from the central nervous system, cartilage, cornea, bone, and bone marrow * closed at one end (ie. blind end) * valves - based on pressure differences open and close * lacteal

Answer 72

lymphatic capillaries -\> collecting vessels -\> six lymphatic trunks -\> two collecting ducts -\> subclavian veins Thus, there is a continual recycling of fluid from blood to tissue fluid to lymph and back to the blood

Answer 73

1. **_Natural killer (NK) cells_** * large lymphocytes that **attack and destroy bacteria**, transplanted tissues, and host cells that have either become infected with viruses or turned cancerous 2. **_T lymphocytes (T cells)_** * Lymphocytes that mature in the **thymus** and later depend on the thymic hormones; thymus-dependent 3. **_B lymphocytes (B cells)_** * lymphocytes that differentiate into plasma cells - connective tissue cells that secrete antibodies. * mature in the **bone marrow** of humans 4. **_Macrophages_** * very large, avidly phagocytotic cells of the connective tiessues. They develop from monocytes that have emigrated from the bloodstream * Is an antigen-presenting cell (APCs) = phagocytes 5. **_Dendritic cells_** * branched, mobile APCs found in the epidermis, mucous membranes, and lymphatic organs * Play an important role in alerting the immune system to pathogens that have breached the body surfaces 6. **_Reticular cells_** * branched, stationary APCs that contribute to the connective tissue framework (stroma) of the lymphatic organs

Answer 74

empty into venous system 1. Thoracic duct - left side 2. Right lymphatic duct - right side

Answer 75

lymphopoeisis

Answer 76

are aggregates of lymphocytes in the connective tissues of mucous membranes and various organs * The simplest form is diffuse lymphatic tissue, in which the lymphocytes are scattered rather than densely clustered 1. **_Lymph Nodules: (follicles)_** * **__**Small and widespread 2. **_MALT (mucosa-associated)_** * **__**Internal epithelia - digestive track 3. **_Tonsils/adenoids_** * **__**Upper pharynx

Answer 77

1. **_Thymus_** * Location: posterior to sternum * Function: maturation of T cells, hormonal control of immunity (thymosins( 2. **_Lymph nodes_** * Location: widely distributed, localized along spine and in axillary, cervical and inguinal regions * Function: Filtration, stimulation of immune system 3. **_Spleen_** * Location: located in upper left abdomen * Function: damaged blood cell removal, Iron/blood storage, Immune response 4. **_Red bone marrow_** 5. **_Tonsils_**

Answer 78

1. **_Fluid homeostais:_** * Fluids returned from capillaries * Flow provides fro lymphocytes circulation 2. **_Lipid distribution:_** * Lacteal 3. **_Defense:_** * Lymphocyte control * production * maintenance * distribution

Answer 79

1. **_The first line of defense:_** * consists of external barriers, notably the skin and mucous membrane 2. **_The second line of defense:_** * Consists of several nonspecific defense mechanisms against pathogens that break through the skin or mucous membrane * These defenses include leukocytes and macrophages, antimicrobial proteins, natural killer cells, inflammation and fever 3. **_the third line of defense:_** * mediated by the immune system, which not only defeats a pathogen but leaves the body with a "memory" of it, enabling one to defeat it so quickly in future encounters that the pathogen causes no illness

Answer 80

1. **_Physical barriers_** * **__**Skin * Desmosomes = attachment ponts to skin that prevent penetration * Keratin = protein of skin * Hair * Secretions * sweat, lysozyme (enzymes that breakdown bacterial cell walls), mucus (grabs onto bacteria to get rid of them) 2. **_Macrophages_** * Macrophages * Fixed or free (wandering) * Diapedesis * Chemotaxis - move with chemical signals * Target adhesion (stick to areas and distory invading bacteria) 3. **_Immunological Surveillance_** * **__**NK cells * Recognize abnormal membrane proteins * Virus-infected and cancerous cells * Mechanism: perforins (perforate) * NK cell activity 4. **_Interferons_** * **__**Proteins produced by lymphocytes and macrophages * Coordinate anti-viral and anti-tumor activities 5. **_Complement System_** * Complement Activity * Membrane destruction * Inflammation (histamine release) * Macrophage chemotaxis * Opsonization (enhanced phagocytosis) * Assist antibody activity * Classical and alternative pathways * Antibodies 1st or not 6. **_Inflammatory Response_** 7. **_Fever_** * **__**Pyrogen-activated thermostat reset

Answer 81

* **_Specificity_** - attacks against specific antigens * **_Versatility (diversity)_** - can respond to a whole bunch of different things * **_Memory_** - cn create a response * **_Tolerance for self_** - do not attack self cells

Answer 82

**_Innate_** * Genetically determined **_Acquired_** * Active (natural or induced) * Passive (natural or induced)

Answer 83

* **_Cytotoxic T cells_** - (army rangers/ navy seals) * Cell- mediated immunity * Result: death of cells * **_B cells_** - (air force that pushes buttons from afar) * Humoral immunity * Result: production of antibodies

Answer 84

1. **_Antigen presentation_** * **'foreign'** (or not!) molecule 'presented' to lymphocytes 2. MHC Proteins: 1. **_MHC Class I_** * In all nucleated cells * **Self recognition** * Antigen presentation: * Viral/bacterial infected cells * **"hot dog in a bun"** (bun stays the same, but different type of hot dog (proteins) * Binds to **CD8 cells** 2. **_MHC Class II_** * Present only in antigen-presenting cells **(APCs**) * eg. **macrophages and lymphocytes** * Antigen presentation: * Antigenic fragments (outside substance foreign) * **Binds to CD4 cells (helper T cells**) * Molecular interactions * T cell Summary * Incredibly divers (\> 3,000 alleles @ 3 loci)

Answer 85

1. **Cytotoxidc T cells** (do the real work) * The killers 2. **Memory T cells** * The diary 3. **Suppressor T cells** * The reins

Answer 86

* **Cytotoxic and suppressor T cells** * CD8 markers -\> MHC I * **Costimulation** * Chemical signals confirming infection

Answer 87

* **Cytotoxic T cells** = death * via proliferation (perference = molecular swards) * **Memory T cells** * **Suppressor T cells** * time release immune suppression * after a certain amount of time they become active and shut down cell activity

Answer 88

* **Lymphotoxin** * bind to enzymes in the cells and disrupt cellular mechinery * **Cytokins** * alter the structure of DNA, flip on a switch to cause self distruction (apoptosis) * **Proforins** * destruction of cell membrane

Answer 89

* **B cells** * Antibody producers * **Helper T cells** * Stiumlate B cell activity

Answer 90

* Sensitization: clonal selection * Antigen binding to variable membrane antibodies * Activation: Via activated T_H interaction * Antibody production * Memory B cell production - become activated when they see the antigen * Clonal selection - sensitization * CD 4 Cell Activation * MHC Class II -\> T_H cell activation, Memory T_H cells * B cell activation

Answer 91

* Y-Shaped proteins * Constant and variable regions * Antigen binding sites * Antigenic determinant (binding) sites

Answer 92

* **_IgM:_** * good agglutinator, first antibody secreted * **_IgG:_** * Most common, cross placenta * **_IgA:_** * Found in secretions, colostrum (first milk from mom) * **_IgD:_** * Found on surface of B cells * **_IgE:_** * Causes cells to release histamine(basophil and mast cells)

Answer 93

* **Neutralization of viral/bacterial binding** * Agglutination/precipitation - clump up * **Complement activity** * **Opsonization** - some are very attracted to macrophages * **Stimulation of inflammation**

Answer 94

1. **_Primary Response_** * First exposure * Antibody titer - test to see if exposed * Peaks 1-2 weeks after exposure * Plasma cells die quickly * Suppressor T cells take over 2. **_Secondary Response_** * Memory B cells -\> Plasma cells * Large scale production of antibodies * Pathogen stopped * Comparing: * Secondary response = much more rapid response, does not show specificity, variety, tolerance for self * \*\*\* does show memory

Answer 95

1. **_Immunodeficiency_** * Genetic Abnormalities * eg. interleukin receptor malformation * or CD8 protein malformation * Acquired * Hodgkin's disease (lymph node cancer) * AIDS (T_H cell infection) * AIDS progression 2. **_Autoimmune Diseases_** * Failure to recognize self 3. **_Hypersensitivity_** * Allergies * Over-reaction to non-harmful antigens * Localized degranulation (histamine release) * Eg hayfever

Answer 96

widespread degranulation, vasodilation your immuse response to something

Answer 97

Intercalated discs Desmosomes Gap junctions

Answer 98

AEROBIC!!! Tons o' mitochondria Mostly fueled by fatty acids Resistant to fatigue

Answer 99

1. **_Conducting cells ("officers")_** * Autorhythmicity * Cannot maintain stable resting potential * Spontaneous depolarization * Prepotential * "funny current" 2. **_Contractile cells ("grunts")_** * Most cardiac muscle cells * Similar to skeletal muscles cells * Stimulated by conducting system * Contractile cell physiology * Three stages * Rapid depolarization * Plateau * Repolarization * Refractory period (s) * Ca2+ levels critical! * Prolonged depolarization

Answer 100

1. **_SA Node_** * "pacemaker" of the heart * In right atrium * Fastest beating (80-100 bpm) autorhythmic unit 2. **_AV Node_** * Delys ventricular contraction * Maximum rate: 230 bpm 3. **_AV bundle, Bundle branches and Purkinje Fibers_** * Conduction to apex of heart and ventricles

Answer 101

* Electrocardiogram (ECG) * Electrodes (leads) * Placement * ECG readings * P wave (atrial depolarization) * QRS complex (Ventricular depolarization) * T wave (ventricular repolarization) * Diagnostics: * Amplitude * Intervals

Answer 102

* **Systole** * Contraction and expulsion * **Diastole** * Relaxation and filling * Blood moves from high to low pressure areas

Answer 103

1. **_Ventricular filling_** * A/V valves open * Venous return (passive) * Atrial contraction 2. **_Isovolumetric contraction_** * All valves closed (Why??) 3. **_Ventricular Ejection_** * Semilunar valves open * Maximum ventricular pressure 4. **_Isovolumetric Relaxation_** * Early diastole, all valves closed * Very low chamber pressure

Answer 104

* **_S1 = "lub"_** * Closing of the A/V valves * **_S2 = "dup"_** * Closing of the semilunar valves

Answer 105

Cardiac output = heart rate x stroke volume Cardiac output directly proportional to HR and SV

Answer 106

1. ANS Control 2. Hormonal control

Answer 107

* **_Dual innervation_** * Autonomic tone * **_Cardioacceleratory centers (via SNS)_** * Increases heart rate * **_Cardioinhibitory centers (via PSNS)_** * Decreases heart rate * Mechanisms: * ***Sympathetic stimulation*** * Increase in Ca2+ permeability -\>depolarization * ***Parasympathetic stimulation*** * Increase in K+ permeability -\> hyperpolarization

Answer 108

* epinephrine and norepinephrine (increase HR) * Bind to beta receptors * Increases cAMP inside cells * Increases SA node frequency * Increases Myocardial conduction

Answer 109

* EDV: End diastolic volume (maximum) * ESV: End systolic volume (minimum) * Stroke volume (SV) = EDV - ESV * Ejection fraction = SV/EDV x 100 * Cardiac output (CO) = SV x HR

Answer 110

1. **_Preload_** * Caused by venous return and atrial contraction * Increase EDV = Increased preload = increased SV * Starling's law * increased blood = increased stretching = increased optimum length-tension relationship 2. **_Ventricular Contractility_** * Changes in strength of ventricular contraction * ANS: sympathetic stimulation increases contractility * Hormones: epinephrine, norepinephrine, thyroid hormones increase contractility 3. **_Afterload_** * Based on aortic (and vascular) pressure * Needs to be overcome to eject blood * Increased afterload = decreased stroke volum

Answer 111

difference between resting and maximal cardiac output pumping potential

Answer 112

* Tunica intima: endothelium + CT * Tunica media: smooth muscle + CT * Tunica externa: CT only

Answer 113

* Less muscular * Thinner walled * Less eleastic (higher compliance) * Often contain valves

Answer 114

* More elastic * Contractile (regulatory function) * vasoconstriction/ vasodilation

Answer 115

1. **_Elastic arteries_** * The largest vessels * Aortae, pulmonary vessels, initial aortic branches * Function: * Bulk flow of blood * Absorb pressure changes * Pressure reservoirs: Store energy 2. **_Muscular arteries_** * Smaller diameter * ex. brachial, femoral, renal, hepatic, gastric * Function: local distribution of blood (perfusion) 3. **_Arterioles_** * Local control of blood flow into capillary beds * Influence peripheral resistance of sasulature

Answer 116

* **_Carotid and aortic sinuses_** * Baroreceptors (BP) * **_Carotid and aortic bodies_** * Chemoreceptors (pH and CO2/O2)

Answer 117

* Site of material exchange * Endothelial tube, one cell thick * Form networks called capillary beds in tissue * Anastomosis - lots of areas of redundances (multiple ways to get from point A to B) * Flow regulated by precapillary sphincter

Answer 118

* **_Continuous_** * Most common * Allow diffusion of water, solutes, lipid-soluble substances * **_Fenestrated_** * Perforated walls * allow passage of larger materials: hormones, nutrients, wastes * **_Sinusoids_** * Found in liver, spleen, marrow * Allow for material exchange

Answer 119

* Highly distensible (compliant) * volume reserviors * Valves (low venous pressure) * Blood flow aided by skeletal muscle contraction * Venoconstriction * Prevents blood loss

Answer 120

Targeted perfusion of tissues to match demand * Tools: (aka effectors!!) 1. Heart: change in cardiac output 2. Vessels: change in peripheral resistance

Answer 121

change in pressure / resistance

Answer 122

Location: * Carotid sinuses, aortic sinuses, right atrium Control: * Neural message!!!

Answer 123

* Location: adrenal glands, kidneys and hypothalamus * Messages: * NE and E (sympathetic activation) * Activation of RAAS * Erythropoeitin (EPO) * Antidiuretic Hormone (ADH) * Response: * Sympathetic activation * increase CO, peripheral vasoconstriction * ADH, aldosterone, hypothalamus, EPO * increase blood volume

Answer 124

* Receptor location: heart * Message: ANP, BNP * Response: * Increase water and sodiume loss at kidneys * decrease thirst (hypothalamus) * Inhibition of ADH, aldosterone, NE and E * Peripheral vasodilation

Answer 125

* Stimuli: increase CO2, decrease O2, decrease pH * Receptor location: * carotid and aortic bodies (chemoreceptors) * Responses: * Cardioacceleratory centers stimulated * Cardioinhibitory centers inhibited * Vasomotor centers stimulated * Respiratory centers stimulated

Answer 126

* light * vasodilation to skeletal muscle * Increased venous return (respiratory pump) * increased CO * Heavy * greatly increased CO * Shunting blood from 'non-essential' organs * Long term adjustments: * increases SV, BP maximums * Increased cardiac health

Answer 127

fluid move out of capillaries = filtration ie. at the arterial end

Answer 128

fluid move IN to capillaries = REABSORPTION ie. at the venous end

Answer 129

* **_Hydrostatic_** * Capillary hydrostatic pressure (CHP) * Interstitial hydrostatic pressure (IHP) = negligible * **_Osmotic_** * Capillary (blood colloid osmotic pressure -BCOP) * proteins are the key * Interstitial fluid (ICOP) = negligible * **_Net filtration pressure (NFP)_** * net hydrostatic pressure - net osmotic pressure * values changes from arterial end to venous end

Answer 130

dissolved plasma proteins

Answer 131

* fluid leaving, due to low venous pressure * solutes and fluids leaving together * NFP = no net flow out of capillary

Lecture Exam 1 Flashcards

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