Exam 3

HRF’s and HIF’s - regulate secretions of anterior pituitary

ADH and OT – produced by nerve cells in hypothalamus and delivered via axonal transport to the posterior pituitary.

Protein anabolism

Fat catabolism

Muscle and skeletal growth

(Growth Hormone Anterior pituitary)

Hyposecretion - dwarfism

Hypersecretion -giantism

Increases secretions of cortisol from the adrenal cortex (kidney)

(Anterior pituitary - Adrenocorticotropic Hormone )

Increases production of melanin by melanocytes of skin

(Anterior pituitary - Melanocyte Stimulating Hormone)

Stimulates ovulation and progesterone secretion

Stimulates testosterone secretion in the male

(Anterior pituitary - Luteinizing Hormone)

Stimulates egg development and estrogen production

Stimulates sperm production in the male

(Anterior pituitary - Follicle Stimulating Hormone)

Stimulates milk production and prolongs progesterone secretion

Increases sensitivity to LH in males

(Anterior pituitary - Prolactin)

Increases water absorption in the kidney – reduces urine volume

inhibited by alcohol

Diabetes insipidus

- "over flow" and "tasteless"

- unquenchable thirst

(Posterior Pituitary Antidiuretic Hormone)

Stimulates uterine contractions (used to induce labor)

Stimulates milk “let down”

Posterior Pituitary - Oxytocin

T3 and T4

Calcitonin

Increases BMR (metabolic rate) - energy required to keep you alive

Goiter and iodine

thyroid gland – thyroxine and triodothyronine

lowers blood calcium levels

Thyroid Gland

Parathyroid PTH

increase Calcium when levels are low

stimulated when calcium levels are low

Stimulates absorption of calcium by digestive tract and osteoclast activity to release calcium from bone matrix

Parathyroid Glands - Parathyroid Hormone

1. Mineralocorticoids

1. Glucocorticoids

1. Gonadocorticoids

2. Epinephrine

1. Increases sodium and water reabsorption by kidneys

Adrenal Cortex - Aldosterone

2. Androgens - Female sex drive and hair growth

anti-inflammatory

Increase blood glucose levels

Inhibits inflammation and immune response

gives energy to combat body's stressors

Adrenal Cortex – Cortisol

Adrenal Medulla

fight or flight response (adrenalin)

Insulin

Glucagon

decreases blood glucose by glycogenesis, increasing glucose storage in liver and muscle cells, and also by increasing glucose uptake by body cells

Diabetes mellitus

increases blood glucose levels by glycogenolysis, releasing glucose from storage, and stimulating gluconeogenesis.

Estrogens

Progesterone

Stimulates development of the immune system

Thymus gland

ranges from 4.5 to 5.5

therefore blood is thicker than water

resists blood pressure

100.4 degree F or 38 degrees C.

slightly basic

7.35 to a pH of 7.45

Minor shifts in pH to the acidic (acidosis-lower) to the basic

(alkalosis higher) have major effects on the functioning of the body as a whole

from 0.85% to 0.9%

about concentration of the primitive seas in which life first began!

blood comprises approximately 8% of the total weight of the body.

As body weight increases, the amount of blood needed to supply nutrients to the tissues also increases.

males 5 to 6 liters

females 4 to 5 liters of blood.

accumulation of water in the tissue

can be caused by imbalance in the osmotic pressure of the blood (regulation)

plasma (55%) - liquid portion

formed elements(45%) cellular component

(Pleuripotential hemopoietic stem cells) Hemopoiesis

derived from mesenchyme and can differentiate into all types of blood cells

• fetus - yolk sac, thymus gland, liver, spleen, lymph nodes, bone marrow
  
• adult - red marrow and lymph tissue
  

transports oxygen (oxyhemoglobin) and a little carbon dioxide

produced in bone marrow

live for about 120 days

Rate of production about 2-3 million/second

Embryo - 1st weeks - yolk sac

2nd trimester - liver, spleen, and lymph nodes

3rd trimester - bone marrow exclusively

Birth to 5 years - all bones

20 years and older - vertebrae, sternum, ribs, and ilia

Gradual decline in RBC production with age

spleen - narrow sinusoids

Hb phagocytized by spleen and liver cells

globin broken down into amino acids

heme broken down into iron components (recycled) and

non-iron component - biliverdin - bilirubin - small intestine

blood carries WBC's, but they function outside the blood

• diapedesis (squeezing out capillaries)
  
• emigration (moving out of vessel)
  
• chemotaxis (move with concentration gradient)
  

Life spans vary from hours (during infections) to years

ex. lymphocytes returned to the blood via lymphatic circulation

-PHILS AND -CYTES

phagocytic white blood cells that comprise

60-70% of the total white blood cell count

acute infections - first line of defense

(granular leucocytes)

the least numerous

0.5-1% of the total white blood cell count

function in the production of histamine and heparin

associated with the inflammation response

(granular leucocytes)

large phagocytic white blood cells

3-8% of the total white blood cell count

chronic infections

20-25% of the total white blood cell count

production of antibodies that combat viral infections

platelets

adhere to the exposed collagen fibers of damaged blood vessels and fragments thus initiating the clotting reaction.

Water - 91.5%

Plasma proteins: Albumins, Globulins, Fibrinogen

NPN (Non-protein nitrogen) - nitrogenous waste products such as urea

Nutrients - Glucose, fats, vitamins, minerals, etc.

Regulatory substances - Enzymes and hormones

Electrolytes

Plasma proteins manufactured in the liver

maintain the viscosity and osmotic pressure of the blood

water regulation

Plasma antibody proteins released by plasma cells

agents of immunity (e.g. gamma globulin)

soluble precursor to the protein fibrin that functions in the clotting reaction. Plasma proteins manufactured in the liver.

Vascular spasms

Platelet plug

Coagulation

After a blood vessel has been damaged,

the smooth muscle associated with the wall of the vessel contracts

and narrows the vessel's diameter

Damage to the wall of the blood vessel

exposes collagen fibers, which in turn cause platelets to enlarge and adhere to the wall of the vessel

1. Tissue trauma
   
2. Release of Tissue Thromboplastin
   
3. Tissue Thromboplastin + Ca++ + Clotting factors
   
4. Prothrombin Activator + Ca++
   
5. Converts Prothrombin to Thrombin
   
6. Thrombin + Ca++
   
7. converts Fibrinogen to Fibrin
   

1. Platelets contact collagen fibers of vessel wall
   
2. Platelets fragment
   
3. Phospholipids released
   
4. Phospholipids + Ca++
   
5. Activate Clotting Factors
   
6. Prothrombin Activator
   
7. ... Pathway joins Extrinsic Pathway...
   
8. Prothrombin Activator + Ca++
   
9. Converts Prothrombin to Thrombin
   
10. Thrombin + Ca++
    
11. converts Fibrinogen to Fibrin
    

fibrin digestion

enzyme plasminogen is converted to plasmin, and plasmin begins the process of dissolving the clot

(t-PA) breaks down fibrin so WBC eat it up

the clotting of blood in an unbroken vessel

1. exposure of collagen fibers on the inner surface of the vessel,
   
2. the accumulation of plaque deposits in the vessel
   
3. stagnation of blood in a vessel
   
4. turbulence in the blood flow
   

– the clot itself

– a clot, fat globule, air bubble, or some other potential obstruction

in the blood stream.

an embolus that has lodged in a vessel and has cut off the blood supply

either...

blocks some essential step in the clotting pathway

or

inhibits the production of an essential component of the reaction.

inhibits the conversion of prothrombin to thrombin

acts directly on the clotting sequence - it is fast acting.

an antagonist to vitamin K

slowing the production of prothrombin in the liver.

dissolve clots that have formed in unbroken vessels (e.g. coronary vessels). used to reduce damage to the myocardium in the early stages of coronary thrombosis.

chemicals that bind to calcium in blood

clotting is inhibited

but the blood retains its ability to clot once it has been introduced into a patient with active calcium ions in his or her blood

due to lack of iron; protein; and vitamin B12A in diet

dietary supplements or changes in eating habits

due to loss of blood (could be internal)

isolation of the cause of the bleeding.

Hemolysis- the destruction of RBC

can be produced by any number of factors (e.g. parasitic infections, bacteria, venoms)

identify and remove the agent responsible for the destruction of R.B.C.’s.

the bone marrow’s inability to produce RBC even though all nutritional factors are there

Poisons, radiation, and genetic factors

serious and life threatening

bone marrow transplant

genetic error

only one amino acid in the protein chain of hemoglobin is incorrect,

blood cells produced with abnormal shapes and reduced oxygen carrying capacity

abnormally high RBC

athletes blood doping

produced by the virus called EBV (Epstein-Barr virus)

As with any viral infection, the lymphocytes activated and produce antibodies to combat the invading organism

elevated WBC count

short time (transient) high WBC count (infections, mono)

based on the presence or absence of A/B antigens present on the cell membranes of red blood cells

while you have the antibodies for the RBC antigens that you do not possess

  O - universal donor

A   B

  AB - universal recipient

the condition in the second Rh positive child that is conceived due to mother’s blood building antibodies to the Rh factor during the first pregnancy

a bi-layered covering separate from the surface of the heart

Fibrous layer

Serous pericardium

outer layer of the parietal pericardium

attaches the heart to the diaphragm and body wall (keeps it in place)

prevents over distention of the heart (doesn't get too big)

serous membrane

lines the parietal pericardium

secretes lubricating fluids

serous membrane

covers the surface of the heart itself

secretes lubricating fluids

the potential space between the serous layer of the parietal pericardium and the visceral pericardium

the upper chambers

receives blood returning to the heart

The thin muscular wall that separates the right and left atria

the depression in the interatrial septum that marks the position of the opening between the right and left atria hat was present in the fetal heart (foramen ovale)

the grooves on the anterior and posterior surfaces of the heart that externally mark the position of the interventricular septum

the site of major coronary vessels that travel over the surface of the heart.

2 major veins that return blood to the right atrium from the body.

drains blood from all structures

Superior - above the diaphragm (except the myocardium itself)

Inferior - below the diaphragm.

prevents the back flow of blood into the atrium during ventricular contraction.

Tricuspid - between the right atrium and right ventricle

Bicuspid - between the left atrium and left ventricle

These are connective tissue cords

extend from the flaps of the AV valves to the papillary muscles located in the walls of the ventricle.

contract during ventricular contraction

exert tension on the chordae tendineae to prevent AV valves from being forced open by the pressure of the blood in the ventricles. 

if week blood can be forced through the valve back into the atria during ventricular contraction (valvular prolapse and heart murmur.)

Branches from right ventricle to the right and left lungs.

deoxygenated blood

The major artery that carries blood from the left ventricle to the body

subdivisions:

• ascending aorta
  
• aortic arch
  
• descending thoracic aorta
  
• and descending abdominal aorta
  

connective tissue

between the aorta and the pulmonary trunk

ductus arteriosus

“meaty plates” of myocardium that can be observed in the walls of the ventricles.

strengthen the walls of the ventricles

facilitate the ejection of blood during ventricular contraction

1. Superior vena cava- Inferior vena cava – Coronary sinus
   
2. Right Atrium
   
3. Tricuspid valve
   
4. Right Ventricle
   
5. Pulmonary semilunar valve
   
6. Pulmonary trunk
   
7. Pulmonary arteries
   
8. Lungs (gas exchange)
   
9. Pulmonary veins
   
10. Left atrium
    
11. Bicuspid Valve
    
12. Left Ventricle
    
13. Aortic semilunar valve
    
14. Ascending aorta
    

ventricular contraction

when blood is delivered to all the bodies tissues except the myocardium

top # for blood pressure

ventricular relaxation

when myocardium receives blood via the coronary arteries

bottom# for blood pressure

branch from the ascending aorta just superior to the aortic semilunar valve

When the left ventricle contracts, a surge of blood flows up the aorta and the aortic semilunar valve prevents blood from entering these arteries

but when the ventricle is relaxed the blood tries to go backwards but cant due to the closed valve and then goes down these artereis to perfuse the myocardium

regulates the beating of the heart

made of cardiac muscle cells

capable of self-stimulation and contraction

efficient pumping action

influenced by the sympathetic and parasympathetic divisions of the Autonomic Nervous System (ANS).

right atrium just inferior to the superior vena cava opening

pacemaker of the heart

• initiates the signal for contraction of the heart
  
• regulates the cardiac cycle

in the base of the right atrium near the interatrial septum

the signal is slowed as it passes through the AV node allowing the atria to complete their contraction phase before the ventricles are stimulated.

portion of the conduction system that relays the signal from the AV node

into the interventricular septum.

After entering the interventricular septum

travel down the interventricular septum to the apex of the heart and then pass superiorly sending off branches into the ventricular myocardium

allows the down and up again pathway pushing upward toward the pulmonary and aortic openings

• conduction time of the pathway of an impulse through the myocardium is extended due to
  
• damage (ie death of  a myocardial infarction)
• lengthening (enlargements of the heart)
• shorter refractory period ( stimulants such as nicotine or caffeine)
  

represent the depolarization and repolarization of the myocardium

The actual contraction of the atria and ventricles follow the peaks recorded

changes visualize can indicate damage

• increase time between P and QRS- damage to the conduction system that has slowed the conduction time
• S-T segment
• evaluated during- stress tests
• indicator of the efficiency of blood flow to the myocardium

1st

depolarization of the atria

the pressure generated in the atria during atrial systole

the pressure within the arteries leaving the heart that results from the volume of blood in the vessels and the contraction of the arteries themselves.

1. entire heart is in diastole
   
2. right and left atria
   
3. (open AV valve)
   
4. ventricles
   
5. (AV valve closed, semi lunar valve open)
   
6. arteries
   
7. (semi lunar valve closed)
   
8. entire heart is in diastole
   

lubb-dupp

first closing of the AV valves louder

second closing of the semi lunar valves softer

represent abnormal sounds produced by blood as it flows backward through damaged valves

systolic murmurs -  damaged AV valves

Diastolic murmurs - damaged semilunar valves

a measure of the effective pumping action of the left ventricle

CO = stroke volume (ejection fraction) x beats per minute

70 ml x 70 beats per minute = 4900ml or 5L per minute (on average)

rate of the heart increases, cardiac output also increases (but limited)

= EDV -- ESV

70 = 120 - 50mL (on average)

pre-load

the amount of blood that is found in the ventricles at the end of the filling phase (ventricular diastole) just prior to the contraction phase.

deceased if heart rate increases, ventricle relaxation decreased

increased if

• increase in venous pressure that return blood to the heart
  
• increase in the strength of atrial contraction forcing more blood into the ventricles
  

amount of blood that the heart can pump over and above the normal CO observed in the resting state

normal heart can increase CO by 400%

well exercised heart - over 600%

heart rate and force increases, CO will increase, but only to a point because the length of time that the ventricles are in diastole decreases and EDV diseases.

critical relationship between heart rate and stroke volume

1.       Nervous stimulation (ANS)

2.       Chemicals (e.g. epinephrine (NE), acetylcholine (Ach))

3.       Temperature (increase temperature = increased rate)

4.       Emotions (indirect stimulation of ANS)

5.       Gender (females typically have higher heart rates)

6.       Age (rate is highest in the fetus and decreases with age)

sympathetic nervous system

to the SA node and myocardium

increases in both rate and force

Action of norepinephrine (NE)

parasympathetic nervous system

Vagus nerve

to the SA node

decreasing the rate of contraction.

action of acetylcholine (Ach)

Baroreceptors in the internal carotid arteries

monitor blood pressure and convey signals to the medulla. 

An increase in blood pressure stimulates the CIC and inhibits the CAC

A decrease in blood pressure results in the stimulation of the CAC.

A decrease in arterial blood pressure will result

in an increase in heart rate and vice versa.

drop in blood pressure when standing up from a reclining position

due to abnormally long lag period in the response to the carotid sinus reflex.

Baroreceptors located in the aortic arch

similar to the Carotid Sinus Reflex (in carotid arteries)

baroreceptors monitor venous blood pressure in the right atrium and the vena cavae

venous blood pressure rise - CAC - speed up the flow of blood from the venous system through the heart

congestive heart failure- system fails and heart’s inability to “keep up” with venous return causes blood backs up in the venous system

increased force of contraction  an increase in venous return

The heart within physiological limits will efficiently pump all the blood it receives with no venous pooling.

a category of shock

bleeding

increased B.P.....

Cardiac Output- increased CO

Blood Volume- increased blood volume

Peripheral Resistance- increased resistance

• Increased viscosity of blood – resistance to flow
  
• Decreased vessel diameter
  

involves altering one or more of the factor that influence blood pressure.

Diuretics -

Beta blockers –

Calcium channel blockers

Low sodium diets-

Weight loss-

Exercise-

stress

controls the B.P. with diameter of arterioles by vasomotor tone (i.e. the partial sustained contraction)

entirely through sympathetic nervous system controlling both vasoconstriction and vasodilation.

Increased Sympathetic Stimulation

increased B.P.

Decreased Sympathetic Stimulation

decreased B.P

receptors in the aorta and carotids

stimulates vasoconstriction and an increase in B.P. if

• Decreased oxygen,
  
• decreased pH
  
• increased carbon dioxide
  

Chemical that stimulates

vasoconstriction

Chemical that stimulates

vasoconstriction

increase in water content of the blood (blood volume)

increase in B.P

released by Juxtagmerular (JG) apparatus of nephron

angiotensin pathway:

Decreased BP in Kidney → Secretion of Renin → converts Angiotensinogen to Angiotensin l → Carried to lungs → Angiotensin l converted to Angiotensin ll → stimulates secretion of Aldosterone (increased blood volume, increase in sodium in kidneys) and Vasoconstriction --> increase in BP

inflammatory agents act as vasodilators

a vein carries blood to a second capillary bed rather than back to the heart

allows the blood to transport materials directly from one organ to another without passing through the heart.

2 in humans

hypophyseal portal system

hepatic portal system

conducts factors from the hypothalamus to the pituitary

conducts nutrients from the capillaries of the gut tube to the liver (blood can processed by the liver before it passes on to supply the cells of the body)

maintains constant glucose and nutrient  levels in the blood to prevent if from rising dramatically after eating and falling during times of fasting.

Internal iliac arteries of the fetus

Umbilical arteries

Umbilical cord

Placenta (through capillary beds exchanges gases and waste products with the mommy’s endometrium)

Umbilical vein

Umbilical cord

Umbilicus

Umbilical vein divides upon entering fetus

Hepatic portal vein -- Liver -- heptic vein

Ductus venosus

Inferior Vena Cava

Right Atrium

Foramen ovale -- Left Atrium -- Left Ventricle

Right ventricle -- Pulmonary artery -- Ductus arteriosus

Aorta

former umbilical arteries that have close down after birth

from the groin areas along the internal body wall to the level of the umbilical scar.

of the liver

former umbilical vein after it becomes fibrous

These structures are delivered as the “afterbirth”

opening between the right and left atria

gradually closes

fossa ovalis

Foramen ovale represented in the adult heart as a shallow depression in the right atrial

patent foramen ovale

If Foramen ovale does not close after birth

usually requires surgery at some point in life to correct the defect

The urgency of the surgical intervention depends upon the size of the opening that remains allowing blood to flow between the two atria.

The connection between the pulmonary artery and the aorta

ligamentum arteriosm

1. WBC production (lymphocytes --> antibodies)
   
2. Drainage (of contaminated fluids from tissues)
   
3. Filtration (of those fluids)
   
4. Fluid Return (tissue fluid to lymph to plasma to tissue fluid...)
   
5. Fat Transport (gut to blood)
   

Spleen - "the bloods lymph node" -- "plan B"

Thymus - stimulates WBC production

Tonsils

Pharyngeal (top)

Palatine (sides)

Lingual (back)

1. Gas Exchange
   
2. pH Regulation
   
3. Venous pump
   
4. sense of smell
   
5. vocalization

CO2 + H2O → H2CO3 → H+ + HCO3 reaction is driven to the right

increase in hydrogen ions

drop in pH

Holding one’s breath

CO2 + H2O → H2CO3 → H+ + HCO3 the reaction is driven to the left

hydrogen ion concentration drops

pH rises

hyperventilation

draw air into the lungs due to the decrease in intrathoracic pressure

draw blood from the veins into the right atrium.

the mechanical action of drawing air into the lungs and forcing air back out of the lungs.

allows air to enter the nasal cavity

the air filled spaces within the:

a.       Frontal bone  (eye brows)

b.       Sphenoid bone (behind eyes)

c.       Ethmoid bone (between eyes)

d.       Maxilla  (below eye)

Warming the air

Filtering the air- mucus and hairs

Humidifying the air

Reducing the weight of the skull

Provides resonance for the voice

Sense of smell

Nasopharynx

the region from the uvula of the soft palate (the drop shaped extension of the soft palate) to the nasal cavity above the hard palate

contains the opening of the Eustachian tubes and the pharyngeal tonsils

(adenoids)

- the region from the soft palate to the hyoid bone (the hyoid bone lies just superior to the thyroid cartilage of the larynx)

the region from the hyoid bone extending to the opening of the esophagus

the cartilage flap that covers the glottis during swallowing

the opening into the larynx

(voice box)-

the most superior portion of the trachea

the vocal cords- it is composed of cartilage,

cricoid cartilage

thyroid cartilage (Adam’s apple)

(wind pipes)

C-shaped cartilages

the open end directed dorsally

allows the esophagus to expand into the trachea during swallowing.

- the cartilage supported air passageways that branch from the trachea

2 branches

the right branch is more vertical, shorter, and wider than the left most object

aspirated will enter the right bronchus.

not supported by cartilage (different from rest of lung)

smooth muscle

constriction and dilation regulate the flow of air into the alveoli of the

asthma attacks- lungs spasm of the smooth muscle of bronchioles

the microscopic air sacs

only place where gas exchange occurs

dead air space- air in all other areas of the respiratory tract constitutes

simple squamous epithelium

septal cells that secrete surfactant

connect alveolar and capillary walls

simple squamous epithelium of the blood vessel

thinnest possible tissue structures

if disease thickens of the membrane, the efficiency of gas exchange reduces

exchange is via simple diffusion.