AP2

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AP2
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2010-07-26 01:56:48
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Exam 2
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  1. Blood Pressure
    Force the blood exerts against the inner walls of all blood vesse
  2. Arterial Blood Pressure
    • Rises when the ventricles contract
    • Falls when the ventricles relax
  3. Systolic pressure
    Maximum pressure during ventricular contraction
  4. Diastolic pressure
    Minimum pressure when the ventricles relax
  5. Creation of a pulse
    • Blood enters the arterial system during ventricular systole, the elastic walls of the arteries stretch
    • Pressure begins to dec. almost immediately at end of the ventricular contraction & the artery walls recoil
    • Strong radial pulse indicates high b.p. & weak radial pulse indicates low b.p.
  6. Factors that Influence Arterial B.P.
    Heart Action
    • Heart rate = Pulse rate
    • Stroke vol =Vol of blood discharged frm the ventricle w/ each contraction, abt 70 ml for an avg. male @ rest
    • Cardiac output = Vol of blood discharged frm the ventricle in 1 min = Stroke vol X H.R.
  7. Factors that Influence Arterial B.P.
    Blood Volume
    • Blood vol = Vol of formed elements + Vol of plasma
    • ~5 liters for avg adult
    • Directly proportional to vol of blood w/in cardiovascular sys
    • Changes in vol initially change b.p., then body attempts to return body to normal b.p.
  8. Factors that Influence Arterial B.P.
    Peripheral resistance
    • Cause=friction btw blood & walls of blood vessels
    • Slows blood flow
    • Must overcome by b.p. so blood continues to flow
    • Contraction of walls of arteries & arterioles raises b.p., but helps to move blood against peripheral resistance
    • Elastic recoil of artery walls maintains some b.p. during diastole & converts intermittent flow of blood in arteries to smoother flow in capillaries
  9. Factors that Influence Arterial B.P.
    Viscosity of blood
    • Ease of flow of blood components past each other
    • Blood cells and some blood proteins increase viscosity
  10. Control of Blood Pressure
    • B.P. is determined by cardiac output (CO) & peripheral resistance (PR)
    • BP = CO x PR
    • Maintenance of b.p. requires regulation of CO & PR
    • C.O. limited by venous return to ventricles
  11. Control of Blood Pressure
    Cardiac Output (CO)
    • Can be influenced by contractility, the force produced during a contraction when a given vol of blood is in the ventricle immediately prior to contraction
    • Influenced by autonomic nervous sys & hormones
    • EX: epinephrine, norepnephrine, & thyroid hormones
    • Influenced by arterial blood pressure detected by baroreceptors in the aortic arch & the carotid sinuses
  12. Venous Blood Flow
    • B.P. decreases as the blood moves through the arterial sys & into the capillary network, so little pressure remains at the venular ends of the capillaries
    • Only partly a directresult of heart action
    • Dependent on:
    • Skeletal Muscle Contraction
    • Breathing
    • Venoconstriction











    • Only partly a direct
    • result

    of heart action
  13. Central Venous Pressure
    • Pressure in the right atrium
    • All veins, except those returning to the heart from the lungs, drain into the right atrium
    • Affects pressure within the peripheral veins
    • Weak heart beat increases central venous pressure
    • Increase in central venous pressure causes blood to back up into the peripheral veins
  14. Paths of Circulation
    2 Major pathways
    • The pulmonary circuit
    • The systemic circuit
  15. Paths of Circulation
    Pulmonary Circuit
    • Between heart & lungs only
    • Pulmonary trunk divides into lt & rt pulmonary arteries, which divide into lobar branches, which enter the lungs
    • After further divisions, arterioles continue into
    • capillary networks associated w/ the walls of the alveoli, aka, air sacs
    • Gas exchange occurs btw air in alveoli & blood in the capillary networks
    • Slightly different hydrostatic osmotic forces push fluid
    • out of the capillary and into alveolar tissues
    • Epithelial lining of alveoli prevents transfer of ions & H20 frm the interstitial fluids into the alveoli
    • Excess interstitial fluids drawn back into capillary by
    • osmosis or into lymphatic vessels
  16. Systemic Circuit
    • Composed of vessels that lead frm the heart to all body parts (except the lungs) & back to the heart
    • Includes the aorta & its branches
    • Includes the sys of veins that return blood to the rt atrium
  17. Characteristics of Venous Pathways
    • Return blood to the heart after gas, nutrient, & waste exchange in the tissues of the body
    • Vessels of the venous sys originate w/ the merging of capillaries into venules, venules into small veins, & small veins into larger ones
    • Unlike arterial pathways, those of the venous sys are difficult to follow due to irregular networks & unnamed tributaries
    • Larger vessels usually parallel arteries
  18. Lifespan Changes
    • Cholesterol deposit in the blood vessels
    • Heart enlargement caused by cardiovascular disease
    • Death of cardiac muscle cells
    • Increase in fibrous connective tissue of the heart
    • Increase in adipose tissue of the heart
    • Valves may thicken or calcify
    • S-A & A-V nodes and A- V bundle become more elastic & may alter the ECG
    • Inc. in b.p. due to dec. diameter of blood vessels & dec. elasticity of arteries
    • Decrease in resting heart rate
    • Number of capillaries decreases
    • Veins change less with age than do arteries
  19. Lymphatic System
    • Is a vast collection of cells & biochemicals that travel in lymphatic vessels & the organs & glands that produce them
    • Is a network of vessels that assist in circulating fluids
    • Is closely associated with the cardiovascular system
    • Transports excess fluid away from the interstitial spaces
    • Transports fluid to the bloodstream
    • Transports fats to the bloodstream
    • Helps defend the body against diseases
  20. Lymphatic Pathways
    • Begin as lymphatic capillaries
    • Merge to form larger lymphatic vessels
    • Largest lymphatic vessels unit with veins in the thorax
  21. Lymphatic Capillaries
    • Microscopic, closed-ended tubes
    • Located in interstitial spaces
    • Networks parallel networks of blood capillaries
    • Walls similar to those of blood capillaries
    • The fluid in the vessels is called lymph
    • Special lymphatic capillaries in the lining of the sm. intestine absorb digest fats & transport them to venous circulation
  22. Lymphatic Vessels
    • Walls are similar to but thinner than those of veins
    • Lymphatic vessels are composed of three layers
    • Have semilunar valves to help prevent backflow
    • Larger vessels lead to lymph nodes and then to larger lymphatic trunks
  23. What are the three layers of the lymphatic vessels?
    • An endothelial lining (inner)
    • Smooth muscle & elastic fibers (middle)
    • Connective tissue (outer)
  24. Lymphatic Trunks and Collecting Ducts
    • Trunks drain lymph from the lymphatic vessels
    • Named for the regions they serve.such as lumbar, intestinal, intercostal, bronchomediastinal, subclavian, & jugular
    • Rt lymphatic duct starts at the union of the right jugular, right subclavian, & right bronchomediastinal trunks & dumps into the subclavian vein near the junction of the rt jugular vein
    • Lt lymphatic duct begins in the abdomen, passes upward through the diaphragm beside the aorta, ascends anterior to the vertebral column through the mediastinum, & empties into the lt subclavian vein near the junction of the lt jugular vein
  25. Tissue and Fluid Lymph
    • Lymph is essentially tissue fluid that has entered a lymphatic capillary
    • Lymph formation depends on tissue fluid formation
  26. Tissue Fluid Formation
    • Capillary b.p. filters H20 & sm molecules frm plasma
    • Fluid contains:
    • Much the same composition as plasma
    • Includes nutrients, gases, and hormones
    • Contains water and dissolved substances
    • Smaller proteins which create plasma colloid osmotic pressure
    • Lacks plasma proteins due to their large size
  27. Lymph Formation
    • Filtration from the plasma normally exceeds reabsorption, leading to the net formation of tissue fluid
    • This increases the tissue fluid hydrostatic pressure within interstitial spaces forcing fluid into lymphatic capillaries forming lymph
    • This process prevents accumulation of excess tissue fluid (edema)
  28. Lymph Function
    • Absorption of dietary fatsDelivery of fats to the bloodstream
    • Collection of small proteins filtered out of the blood capillaries
    • Delivery of these small proteins to the blood stream
    • Collection of excess interstitial fluids
    • Delivery of excess fluids to the bloodstream
    • Delivery of foreign particles, such as bacteria & viruses, to the lymph nodes
  29. How much blood does the heart pump through the body each day?
    7,000 liters
  30. What is the amount of contractions the heart does in an average lifetime?
    2.5 billion times
  31. What does the pulmonary circuit do?
    O2 depleated blood goes to lungs to release CO2 and gain O2
  32. What does the systemic circuit do?
    • O2 rich blood goes to all body cells
    • Wastes collected from body cells
  33. What is the size of the heart?
    • 14 cm long
    • 9 cm wide
  34. Coverings of the Heart
    • Fibrous pericardium
    • Visceral pericardium
    • Parietal pericardium
  35. Fibrous pericardium
    • Outer sac
    • Fibrous and tough
  36. Visceral pericardium
    Inner of two layers of serous membrane
  37. Parietal pericardium
    • Inner lining of the fibrous pericardium
    • Contiguous with visceral pericardium
  38. Pericardial cavity
    location and funtion
    • between visceral and parietal pericardia
    • Contains serous fluid, reduces friction b/t membrane layers during movement
  39. Layers of the Wall of the Heart
    • Epicardium (outer layer)
    • Myocardium
    • Endocardium
  40. Epicardium (outer layer of heart)
    • Aka, visceral pericardium
    • Protects the heart by reducing friction
    • Serous membrane of connective tissue covered by epithelium
    • Has nerve fibers & blood and lymph capillaries
    • Has fat in deeper layers, especially near coronary
    • arteries & cardiac veins
  41. Myocardium (middle layer of heart)
    • Thick
    • Responsible for pumping action of heart
    • Mostly cardiac muscle tissue
    • Muscle fibers are arranged in planes separated by connective tissue &richly supplied with nerve fibers & blood & lymph capillaries
  42. Endocardium (inner layer of heart)
    • •Epithelium & underlying connective tissue
    • Lines all heart chambers, covers valves, & is continuous w/ inner linings of blood vessels
    • Contains blood vessels
    • Contains specialized cardiac muscle fibers called Purkinje fibers
  43. Septa
    • Separate parts of the heart
    • Interatrial septum separates right and left atrium
    • Interventricular septum separates right and left ventricle
  44. Sulci
    • Grooves on surface of heart marking divisions b/t chambers of heart
    • Contains major arteries & veins that supply heart tissue
    • Atrioventricular sulcus encircles heart between atria & ventricles
    • Interventricular sulci separate right and left ventricle
    • Anterior & posterior
  45. Chordae tendineae
    • Strong, fibrous strings attached to cusps on ventricular side
    • Originate frm papillary muscles, which contract when ventricle contracts to prevent cusps frm swinging backward into atrium during contraction
  46. Anastomoses
    Provide alternate routes of blood flow in case a capillary becomes blocked
  47. Heart Action
    • Heart actions are regulated so that atria contract (atrial
    • systole) while ventricles relax (ventricular diastole); followed by ventricles contract (ventricular systole) while atria relax (atrial diastole)
  48. What % of blood in the atrium flows into the ventricle based on creation of a vacuum?
    30%
  49. What causes heart sounds and a murmur?
    • Heat sound:
    • The “lubb”
    • The first heart sound
    • Occurs during ventricular systole
    • The A-V valves are closing
    • The “dupp”
    • The second heart sound
    • Occurs during ventricular diastole
    • The pulmonary and aortic semilunar valves are closing
    • Murmur: abnormal heart sound frm the cusps not completely closing
  50. What are syncytia and what is their importance?
    Cardiac muscle fibers form a functional syncytium, a mass of merging cells that act as a unit
  51. Cardiac Conduction System
    • SA Node -
    • Atrial Synctium -
    • Junctional Fibers -
    • AV Node -
    • AV bundle -
    • Bundle Branches
    • Purkinje fibers
    • Ventricular synctium
  52. Which is known as the "pacemaker"?
    Sinoatrial node (SA Node)
  53. What is an electrocardiogram?
    Recording of electrical changes that occur in the myocardium during the cardiac cycle
  54. P wave
    Slow atrial depolarization triggered by a cardiac impulse frm the S-A node
  55. QRS complex
    • Rapid depolarization
    • Walls are thick so greater change in electrical potential so stronger deflection/signal
  56. T wave
    Slow ventricular repolarization
  57. What regulates the heart rate?
    • SA node controls heart rate
    • Sympathetic and parasympathetic fibers that control the heart rate
    • Regulatory reflex centers that influence heart rate
    • Additional factors that may influence heart rate include:
    • Physical exercise
    • Body temperature
    • Concentration of various ions including:
    • Potassium
    • Calcium
  58. Blood Vessels
    • Arteries - carry blood away from the ventricles of the
    • heart
    • Arterioles - receive blood from the arteries and carry blood to the capillaries
    • Capillaries - sites of exchange of substances between the blood and the body cells
    • Venules -receive blood from the capillaries
    • Veins - carry blood toward the atria of the heart
  59. Arteries
    • Thick strong wall (three layers or tunics)
    • Endothelial- tunica interna
    • Middle layer- tunica media
    • Thickest layer of arterial wall
    • Outer layer- tunica externa or adventitia
    • Thin
  60. Artery
    Type of Wall
    • Thick, strong wall with three layers
    • -Endothelial lining
    • -Middle layer of smooth muscle & elastic tissue
    • -Outer layer of connective tissue
  61. Artery
    Function
    Carries blood under relatively high pressure from heart to arterioles
  62. Arteriole
    Type of Wall
    • Thinner wall than an artery but w/ 3 layers
    • Smaller arterioles have:
    • -endothelial linning
    • -some smooth muscle tissue
    • -small amt of connective tissue
  63. Arteriole
    Function
    • Connects an artery to a capillary
    • helps control the blood flow into a capillary by vasoconstricting or vasodilating
  64. Capillary
    Type of Wall
    Single layer of squamous epithelium
  65. Capillary
    Function
    • Provides a membrane through which nutrients, gases, & wastes are exchanged b/t the blood & tissue
    • Connects an arteriole to a venule
  66. Venule
    Type of Wall
    • Thinner wall than an arteriole
    • less smooth muscle & elastic tissue
  67. Venule
    Function
    Connects a capillary to a vein
  68. Vein
    Type of Wall
    • Thinner wall than an artey but with smaller layers
    • middle layer is poorly developed
    • some have flaplike valves
  69. Vein
    Function
    • Carries blood underrelatively low pressure from a venule to the heart
    • Valves prevent a backflow of blood
    • Serves as blood reservoir
  70. Capillaries
    • Smallest diameter blood vessels
    • Semi-permeable to allow exchange of substances b/t blood & interstitial fluid
  71. Capillary Exchanges
    • Methods of exchange:
    • Diffusion
    • Most important
    • O2, nutrients, CO2, wastes
    • Lipid solubility determines if diffusion is directly through the cell wall or through pores
    • Plasma proteins trapped in capillary b/c they are not lipid soluble & too large to pass through pores
    • Filtration
    • Hydrostatic pressure frm ventricular contractions forces molecules through membranes
    • Force reduced w/ greater distance frm heart due to friction
    • Osmosis
    • Due to impermeable solute on one side of membrane
    • Plasma proteins
  72. Vessels associated with the heart
    • Superior vena cava
    • Inferior vena cava
    • Pulmonary trunk
    • Left and right pulmonary arteries
    • Left and right pulmonary veins
    • Aorta/Aortic arch
    • Left and right coronary arteries
  73. Branches of the aorta
    • Brachiocephalic
    • Common carotid arteries
    • Subclavian arteries
    • Celiac arteries
    • Phrenic arteries
    • Mesenteric arteries
  74. Arteries of the limbs
    • Radial arteries
    • Femoral arteries
  75. Veins
    • Brachiocephalic veins
    • Internal jugular veins
    • External jugular veins
    • Subclavian veins
    • Hepatic portal vein
    • Mesenteric veins
  76. Veins of the limbs
    • Radial arteries
    • Femoral arteries
  77. The lymphatic system
    • Vast collection of cells and biochemicals that travel in lymphatic vessels and the organs and glands that produce them
    • Network of vessels that assist in circulating fluids
    • Closely associated with the cardiovascular system
    • Transports excess fluid away from the interstitial spaces
    • Transports fluid to the bloodstream
    • Transports fats to the bloodstream
    • Helps defend the body against diseases
  78. Basic Lymphatic pathway
    • Begin Lymphatic capillaries
    • Merge to form larger lymphatic vessels
    • Largest lymphatic vessels unite w/ veins in the thorax
  79. What is lymph?
    Fluid in the lymph vessels
  80. Lymph Movement
    • Hydrostatic pressure of tissue fluid drives the lymph into the lymphatic capillaries
    • Epithelial cells of walls of lymphatic capillaries overlap but are not attached to each other creating flap-like valves
    • Valves are pushed open when fluid pressure is greater in the interstitial spaces than in the lymph vessel & close when the pressure is greater inside the vessel
    • Epithelial cells of capillary wall are attached to surrounding connective tissue cell by thin protein filaments
  81. Lymph Nodes
    • Blood vessels and nerves enter through the concave region called the hilum
    • Afferent lymph vessels enter nodes separately and at various locations on the node’s convex surface
    • Efferent vessels leave the node from the hilum
    • A capsule of connective tissue with numerous fibers encloses the node and subdivides it into compartments called lymph nodules
    • Germinal centers within nodules contain actively
    • dividing lymphocytes and monocytes
    • Lymph nodules occur singly and in groups associated w/ mucous membranes of the respiratory & digestive tracts
    • Lymph sinuses are spaces w/in the nodes that provide a complex network of chambers & channels through
    • which the lymph circulates
  82. Locations of Lymph Nodes
    • Lymph nodes are found in groups or chains along the paths of the larger lymphatic vessels throughout the body, including the:
    • Cervical region
    • Axillary region
    • Supratrochlear region
    • Inguinal region
    • Pelvic cavity
    • Abdominal cavity
    • Thoracic cavity
  83. Functions of Lymph Nodes
    • Lymph nodes have two primary functions:
    • Filter potentially harmful particles from the lymph before returning it to the blood stream
    • Provide immune surveillance using macrophages & lymphocytes
    • Attack viruses, bacteria, & other parasites that reach the lymph nodes
    • Macrophages phagocytize foreign substances, damaged cells, & cellular debris
    • Along with the red bone marrow, the lymph nodes are centers for lymphocyte production
  84. Two other lymphatic organs w/ functions similar to those of the lymph nodes
    Thymus and Spleen
  85. Thymus
    • Larger in infancy and during puberty
    • Small in an adult
    • Replaced by fat and connective tissue in the elderly
    • Subdivided into lobules by connective tissue extending inward frm the surface
    • Site of T lymphocyte (or T cell) production
    • Secretes protein hormones called thymosins that induce maturation of T cells after they migrate to other lymphatic tissues
  86. Spleen
    • largest lymphatic organ
    • Located in the upper left abdominal quadrant
    • Has sinuses filled with blood (the major difference from large lymph nodes)
    • Contains two tissue types:
    • White pulp
    • -In tiny islands throughout spleen
    • -Contains lymphocytes
    • Red pulp
    • -Rest of lobules
    • -Contains red blood cells, lymphocytes & macrophages
  87. Mechanical Barriers
    • The skin & mucous membranes create mechanical barriers
    • Considered the first line of defense (all other non-specific defenses are part of the second line of defense)
  88. Second Line of Defense
    • Chemical barriers
    • Natural killer cells
    • Inflammation
    • Phagocytosis
    • Fever
  89. Chemical Barriers
    • Enzymes in body fluids provide a chemical barrier to pathogens, and they may include:
    • Interferons are horomone-like peptides and stimulate phagocytosis
    • Defensins are peptides produced by neutrophils & other granulocytes. They cripple microbes.
    • Collectins are proteins w/ broad protection against bacteria, yeast & some viruses
    • Complement is a group of proteins in plasma & other body fluids that stimulate inflammation, attract phagocytes & enhance phagocytosis
  90. Natural Killer (NK) Cells
    • NK cells are a small population of lymphocytes defending against viruses & cancer by secreting cytolytic substances called perforins that destroy the infected cell
    • NK may also enhance inflammation
  91. Inflammation
    Inflammation produces local redness, swelling, heat and pain
  92. Phagocytosis
    • Removes foreign particles from the lymph
    • In the blood vessels and in the tissues of the spleen, liver or bone marrow
    • The most active phagocytic cells are neutrophils and monocytes
    • Chemicals attract these phagocytic cells to the injury and this is called chemotaxis
  93. Fever
    Begins when a viral or bacterial infection stimulates lymphocytes to proliferate, producing cells that secrete a substance called interleukin-1 (IL-1)
  94. Adaptive (Specific) Defenses or Immunity
    • Third line of defense and known as immunity
    • It is resistance to particular pathogens or to their toxins or metabolic by-products
    • It is based on the ability to distinguish molecules that are part of the body (“self” from “non-self”)
    • Antigens are molecules that can elicit an immune response
  95. Antigens
    • Antigens may be:
    • Proteins
    • Polysaccharides
    • Glycoproteins
    • Glycolipids
    • The most effective antigens are large and complex
    • Haptens are small molecules that are not antigenic by themselves, but when they combine with a large molecule can stimulate an immune response
  96. T Cells and the Cellular Immune Response
    • A lymphocyte must be activated before it can respond to an antigen
    • T cell activation requires antigen-presenting cell (accessory cell) and may include macrophages, B cells and several other types of cells
    • Requires major histocompatibility complex (MHC) or human leukocyte antigens (HLA) to recognize “non-self”
    • T cells can synthesize and secrete polypeptides called
    • cytokines
    • Types of specialized T cells include:
    • -Helper T cells
    • -Cytotoxic T cells
    • -Memory T cells
  97. B Cells and the Humoral Immune Response
    • B cells can be activated when an antigen fits the shape of its receptor
    • Most of the time B cell activation requires T cells
    • T cells release cytokines that stimulate B cells
    • Some B cells may become memory B cells while others differentiate into plasma cells and produce and secrete large globular proteins called antibodies or immunoglobulins
  98. Allergic Reactions
    • Type I
    • -Immediate-reaction allergy
    • -Occurs minutes after contact with allergen
    • -Symptoms include hives, hay fever, asthma, eczema, gastric disturbances, and anaphylactic shock
    • Type II
    • -Antibody-dependent cytotoxic reaction
    • -Takes 1-3 hours to develop
    • -Transfusion reaction
    • Type III
    • -Immune-complex reaction
    • -Takes 1-3 hours to develop
    • -Antibody complexes cannot be cleared from the body
    • -Damage of body tissues
    • Type IV
    • -Delayed-reaction allergy
    • -Results from repeated exposure to allergen
    • -Eruptions and inflammation of the skin
    • -Takes about 48 hours to occur
  99. Transplantation and Tissue Rejection
    • Successfully transplanted tissues and organs:
    • -Cornea
    • -Kidney
    • -Liver
    • -Pancreas
    • -Heart
    • -Bone marrow
    • -Skin
    • When the donor’s tissues are recognized as foreign there is a tissue rejection reaction
    • -Resembles the cellular immune response against antigens
    • -Important to match MHC antigens
    • -Immunosuppressive drugs used to prevent rejection
  100. Transplant Types
    • Isograft
    • Donor: Identical twin
    • EX: Bone marrow transplant from a healthy twin to a twin who has leukemia
    • Autograft
    • Donor: Self
    • Ex: Skin graft from one part of the body to replace burned skin
    • Allograft
    • Donor: Same species
    • Ex: Kidney transplant from a relative or close matched donor
    • Xenograft
    • Donor: Different species
    • Ex: Heart valves from a pig

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