Physo 2B Lecture Terms & Concepts Burres-Jones - 2011 LECUTRE STUDY GUIDE Check-List 2 – Circulatory System Anatomy CH18 pp. 683-718, CH19 pp. 719-734, CH20 pp. 755-764 & 778-814, CH21 pp. 815-837 & 847-848 Identify, Define or Give the Significance of: Blood Ch 18 (& 21): Apoferritin (liver protein) Pale lilac granules Connective tissue (cells + matrix) Ferritin (liver storage complex) Kill bacteria-“first responders” Formed elements (vs. cells) Hypoxemia, EPO & Kidneys Respiratory burst (degranulation) Plasma ≈ 55% (= matrix) Emphysema O2 ⇒ superoxide anions + H+ = H2O2 Serum (= ground substance) Polycythemia Hypochlorite (in bleach) Hemolysis Killing zone Erythrocytes (≈7.5 µm) (120 days) Macrophages “eat” in spleen Leukocytes Very active phagocytes Heme ≠ globin Granulocytes (4-8 hrs in blood) Neutrophils Eosinophils <4% Globin ⇒ free AAs Eosinophils Redish-orange granules Iron ⇒ blood w/transferring Basophils 2-lobed nucleus Heme ⇒ Biliverdin ⇒ Bilirubin Agranulocytes ⇑Allergies & parasitic infections Bilirubin+albumin to liver Monocytes (live 10-20 hrs) Stimulate basophils & mast cells to Bilirubin = bile pigment Lymphocytes (live weeks-decades) degranulate; +enzymes degrade histamine ⇒Urobilinogen & Urochrome Platelets Phagoyctize antigen-antibody complexes Jaundice Hematocrit (packed cell volume) ≈ 45% Primary polycythemia (RBC CFU cancer) Buffy coat <1% Basophils <1% 2ndary polycythemias Albumin (viscosity & osmolarity!) Dark, bluish-black large granules (dehydration & hypoxemia) Globulins (alpha, beta, gamma) obscure nucleus Anemias (3 categories) Histamine=vasodilator Fibrinogen ⇒ Fibrin ⇓Erythropoiesis or hemoglobin Heparin=anticoagulant -kidney failure Electrolytes -Iron-deficiency Similar to Mast cells in CTs Viscosity -Pernicious (⇓B12) Osmolarity Hemoragic Agranulocytes: Colloid osmotic pressure Hemolytic Monocytes <6% Hemopoiesis=Hematopoiesis Intrinsic factor Largest WBC -blast ⇒ -cyte Hypoxia Pale sky blue cytoplasm w/kidney Yolk sac⇒marrow, liver, spleen, thymus Sickle Cell Disease (homogyous) shaped nucleus Myeloid Sickle Cell Trait (heterozygous) Become Macrophages in CT Lymphoid HbS (Valine for Glutamic acid) Most active phagocytes Pluripotent stem cell Agglutinate Tissue-specific cell names: Colony-forming units (CFUs) Antigens Kupffer cells (liver) Antibodies Alveolar macrophages (lungs) Erythrocytes (RBCs) ≈5mil/mm3 ABO Blood Group Microglia (CNS) Biconcave Agglutinogen=on RBC Dendritic cells (mobile, in epidermis) Anucleate Agglutinin=plasma antibody Reticular cells (fixed, RE cells) ≈2.5 mil cells/sec produced/die (anti-A or anti-B) p. 698 & 847-848 (RE=reticuloendothelial cells) Spectrin & Actin Type O, Type A, Type B, Type AB ALL Function as antigen-presenting cells (APCs) Carbonic anhydrase Universal recipient Globin (alpha, beta, delta, gamma) Universal donor Lymphocytes ≈30% Heme Smallest WBC HbA (2α 2β) 97.5% http://nobelprize.org/educational_games/me Pale sky-blue cytoplasm, LG nucleus HbA2 (2α 2δ [delta]) 2.5% dicine/landsteiner/ may nearly fill cell (look for HbF (2α 2γ [gamma]) crescent of sky blue cytoplasm) Hemoglobin concentration ≈15 g/dL Transfusion reaction Involved in immunity + Hemoglobin Rh blood group: Rh & Rh 3 Categories: Natural (NK) cells Oxyhemoglobin anti-D T cells Deoxyhemoglobin Hemolytic disease of the newborn (HDN) B cells Carbaminohemoglobin (=erythroblastosis fetalis) Erythropoiesis RhoGAM/Gamulin Leukopoiesis Erythropoietin (EPO) Myeloblasts, Monoblasts, Lymphoblasts Erythrocyte CFU Leukocytes (WBCs) ≈ 5,000-10,000/µL Leukocytosis (⇑10,000 WBCs/µL) Reticulocyte p. 701-706, 820-822 & 830[-837] Leukopenia (⇓5,000 WBCs/µL) Polyribosomes Granulocytes: Leukemia = cancer w/⇑immature WBC #s 3+ 2+ Iron: Ferric Fe & Ferrous Fe Neutrophils ≈60% Myeloid leukemia (granulocytes) 2+ Stab or Band cells Fe3+ ⇒ Fe (by stomach acid) Lymphoid leukemia (agranulocytes) 2+ Gastroferritin (binds Fe ) Polymorphonuclear leukocytes Transferrin (in blood) 3-5 lobed nucleus Physo 2B Platelets (≠thrombocytes) -stored in spleen, live ≈ 10 days -2nd most abundant FE after RBCs -cell fragments, but MANY functions -form pseudopods when activated -have α2 receptors; ∴stress⇑clotting -granules =initiate clot & help dissolve =vasoconstrict =attract more platelets -attract neutrophils to inflammation sites -phagocytize bacteria -secrete growth factors, to repair CT & smooth muscle walls around vessels Thrombopoiesis & Thrombopoietin Megakaryocytes (some colonize lungs & make more platelets there!) Hemostasis (stopping bleeding), 3 parts: •Vascular spasm⇒serotonin release •Platelet plug formation⇒stick&contract •Bloodclotting⇒degranulation & cascade to form Fibrin Procoagulants = liver proteins in plasma Anticoagulants (heparin, antithrombin) (Enzymatic) Reaction cascade Enzyme amplification Extrinsic mechanism ≈15 sec Intrinsic mechanism 3-6 min Ca++ important in both Factor X = in common Prothrombin activator activates: Prothrombin⇒Thrombin Thrombin activates: Fibrinogen⇒Fibrin Clot retraction PDGF Fibrinolysis XII⇒Kallikrein⇒Plasminogen⇒Plasmin Prostacyclin Hemophilia Liver disease & blood clotting Vitamin K Hematoma Thrombosis Thrombus⇒Embolus Infarction Pulmonary embolism Transient ischemic attack (TIA) Stroke Heart Ch 19: p. 719-734 (top) Circulatory system Cardiovascular system Cardiology Pulmonary circuit Systemic circuit Apex & Base Atrioventricular sulcus & septum Interventricular sulcus & septum Endocardium Lecture Terms & Concepts Myocardium (w/cardiocytes) Epicardium=Visceral pericardium Pericardial cavity w/serous fluid Parietal pericardium Pericarditis & friction rub Superior vena cava (w/Azygous vein) Inferior vena cava Right atrium Opening of coronary sinus Right auricle (w/Pectinate muscles) Interatrial septum Fossa ovalis Tricuspid valve Chordae tendinae Right ventricle Papillary muscles Trabeculae carnae Pulmonary Trunk Pulmonary semilunar valve R&L Pulmonary AA. Ligamentum arteriosum R&L Pulmonary VV. Left atrium Left auricle (w/Pectinate muscles) Bicuspid (mitral) valve (has chordae tendinae attached to papillary muscles too) Left ventricle Aorta Aortic semilunar valve R&L Coronary AA (base of, on aorta) Ascending aorta Aortic Arch Brachiocephalic Trunk Left Common Carotid A Left Subclavian A Descending aorta Coronary Arteries: L/R coronary AA Circumflex A Anterior interventricular A Marginal A Posterior interventricular A (collateral circulation & anastomoses) Cardiac Veins: Great cardiac vein & Coronary sinus Middle cardiac vein Diastole Systole Sympathetic innervation (cardiac nerves) Parasympathetic innervation (Vagus) Vagal tone (sinus rhythym=70-80 bpm) Pacemaker cells (100 bpm intrinsic rate) Nodal rhythym = 40-50 bpm Arrythmia Heart block Burres-Jones - 2011 Cardiac Conduction System: Sinoatrial node Atrioventricular node Atrioventricular bundle (of His) R&L bundle branches Purkinje Fibers Myocardial cells (cardiocytes) -Branching -Striated -Intercalated discs w/ •Desmosomes •Gap junctions Atrial Syncytium & Ventricular Syncytium Fibrous skeleton of heart Atherosclerosis Foam cells Atheroma Arteriosclerosis Fatty embolus NO (nitric oxide) (role of) Vessels Ch 20: p. 755-764 & 778-808 ARTERY heads AWAY from heart VEIN heads TOWARD heart “Lg Artery w/Name⇒Md AA⇒Sm AA⇒arterioles ⇒capillaries⇒venules⇒Sm VV⇒Md VV⇒ Lg Vein w/name” Tunica interna (intima) Endothelium + basement membrane Internal elastic lamina (in arteries) Tunica media (smooth muscle) (External elastic lamina, if present) Tunica externa (Vaso vasorum, if present) Endothelium produces: -vasodilators/vasoconstrictors -liproprotein lipase -prostaclyclin -CAMs for leukocyte adherence Arteries=Resistance Vessels Arteries BRANCH to smaller arteries Conducting, Muscular, & Resistance AAs Arterioles = THE major control sites for vasodilation/vasoconstriction!! Metarterioles Precapillary sphincters Carotid sinuses (baroreceptors)(int.carotid a) Carotid bodies (chemoreceptors)(ext. carotid a) Aortic arch (has both) Capillaries=Exchange Vessels (+some venules) Endothelium + basement membrane NOT found: epithelia, cornea, lens, cartilage, few in tendons/ligaments Pericytes Physo 2B •Continuous capillaries -Intercellular clefts •Fenestrated capillaries -Filtration pores •Sinusoids Capillary beds w/ Metarteriole⇒Thoroughfare channel ¾ shut down at any given time Lecture Terms & Concepts (know diaphragm landmark) Abdominal aorta Inferior Phrenic AA •Celiac Trunk Left Gastric A Splenic A Common Hepatic A Right Gastric A Veins=Capacitance Vessels Hepatic Artery Proper ≈54% blood in systemic veins •Superior mesenteric A (vs 11% in systemic arteries) Renal AA Veins form from smaller TRIBUTARIES Venous Valves (not in sm, LG veins, ventral Adrenal AA (=Suprarenal AA) Gonadal AA body cavity or brain) Lumbar AA (5 pair) Skeletal muscle pump •Inferior mesenteric A Post-capillary venules=diapedesis site! Median sacral A Venous sinuses Portal system •Common iliac A Anastomosis Internal iliac A Arteriovenous shunt External iliac A (know inguinal ligament landmark) BLOOD VESSEL LIST: èFemoral A Ascending Aorta Femoral circumflex AA R&L Coronary AA Deep femoral A Aortic Arch (know adductor hiatus landmark) Brachiocephalic Trunk èPopliteal A Left Common Carotid A Posterior tibial A Left Subclavian A Medial and Lateral Plantar AA Plantar Arch & Digital AA Descending aorta (thoracic&abdominal) Anterior tibial A Paired visceral branches: èDorsalis pedis A Intercostal aa. èArcuate A Superior phrenic aa. Metatarsal AA Unpaired median visceral branches: Digital AA Esophageal, pericardial & bronchial aa (variable in #) Additional Circulatory Structures to Brachiocephalic Trunk Know: •R. Common Carotid A Circle of Willis: Internal carotid A. (w/carotid sinus= Vertebral AA baroreceptor) Basilar A External carotid A. (w/carotid body= Posterior Cerebral AA chemosensor) Posterior Communicating AA Facial A Internal Carotid AA Superficial Temporal A Opthalmic AA •R. Subclavian A Middle Cerebral AA Vertebral A Anterior Cerebral AA Internal thoracic (mammary) A Anterior Communicating A Thyrocervical Trunk (know clavicle landmark) Fetal Circulation: èR. Axillary A •Be able to trace TWO paths through heart Posterior Circumflex Humeral A. that bypass the lungs! Anterior Circumflex Humeral A. Umbilical V ⇒ Ligamentum teres èR. Brachial A. Ductus venosus ⇒ Ligamentum venosum Ulnar A. Foramen ovale ⇒ Fossa ovalis Radial A. Ductus arteriosus ⇒ Ligamentum Superficial Palmar Arch arteriosum Deep Palmar Arch Umbilical arteries ⇒ Medial umbilical Metacarpal AA. (common digital aa.) ligaments Digital AA. Burres-Jones - 2011 Hepatic Portal Circulation: Superior mesenteric v & Splenic v (plus gastric vv) = 2 main tributaries of Hepatic Portal V! Hepatic vv. (drain liver into IVC) Inferior mesenteric v. drains into Splenic v Superficial Veins: Leg: Great saphenous vein Lesser saphenous vein Arm: Cephalic vein (Median Antecubital vein) Basilic vein Median Cubital Vein Points to Remember: Veins that are different than arteries: Venous sinus circulation: Superior sagittal sinus Inferior sagittal sinus to Straight sinus to Confluence of the sinuses Transverse sinus to Sigmoid sinus to Internal Jugular vv (also Opthalmic vv to Cavernous Sinus to Confluence) Brachiocephailic vv = union of subclavian & int. jugular vv Superior Vena Cava = union of R & L Brachiocephalic vv! R Ascending Lumbar v to Azygyous v L Ascending Lumbar v to Hemiazygous v Other points to remember: •Int. Carotid A runs w/Int. Jugular V (there are NO carotid veins NOR any jugular arteries!!!!!) •Aortic Arch branches ‘parallel’ Superior Vena Cava tributaries and •Descending Aortic branches ‘parallel’ Inferior Vena Cava tributaries EXCEPT for Hepatic Portal System! (Azygous drainage different from aa. too) •Only 1 Brachiocephalic Trunk (an artery), but 2 Brachiocephalic VV! ***Inferior Rectal VV drain into Internal Iliac VV & NOT the portal system, so suppository drugs bypass liver! Physo 2B Lymphatic System Ch 21: Fluid, Vessels, Tissue, Organs 3 Major Functions” •Fluid recovery (excess IF) •Immunity •Lipid absorption Fluid compartments ICF ECF=IF + IV (+etc.) Lacteals Lymph (no RBCs & ⇓protein) Chyle Lymphatic capillaries (bud from veins) One-way minivalves Collecting vessels Lymphatic trunks (6) Collecting ducts (2) (book misprint) Right lymphatic duct Thoracic duct Skeletal muscle pump Vessel contractions Thoracic (respiratory pump) Immunocompetent Lymphatic Cells: Natural Killer (NK) Cells -attack bacteria -immune surveillance T lymphocytes (T cells) -mature in thymus B lymphocytes (B cells) -mature in bone marrow Macrophages -develop from monocytes in CTs -phagocytic! -display antigen to T cells Dendritic cells -Langerhans cells in epidermis -mobile APCs -engulf foreign matter Reticular cells -form stroma of lymphatic organs -act as APCs in thymus (Antigen Presenting Cells [APCs]) (all APCs make MHC-II proteins upon which to display antigens! = Macrophages, B cells, Reticular & Dendritic cells) Lymphatic Tissues: Diffuse ⇒ Mucosa-associated lymphoid tissue MALT (GALT+BALT+NALT) Lymphatic nodules -in ileum = Peyer’s patches Lymphatic Organs: Primary= Red Bone Marrow (reticular cells & reticular fibers=very different) Thymus (lymphatic & endocrine) Lecture Terms & Concepts Secondary= Lymph Nodes Tonsils Spleen Thymus Capsule w/trabeculae Cortex & Medulla Reticular epithelial cells & Blood-Thymus barrier Thymic hormones & T cell maturation Immunocompitance Reticular cell testing Negative selection Clonal deletion Anergy Positive selection & clones Naïve lymphocyte pool Lymph nodes=most numerous Cleanse (filter) lymph T&B cell activation Cortex & medulla Capsule & trabeculae Multiple afferent vessels Fewer efferent vessels Stroma of reticular fibers & cells Cervical nodes Axillary nodes Inguinal nodes Popliteal nodes Abdominal & Thoracic nodes Lymphadenitis Lymphadenopathy Metastatic cancer Tonsils Crypts Pharyngeal, Palatine & Lingual tonsils Tonsillitis Tonsillectomy Spleen Produces WBCs in fetus Monitors blood for antigens=‘giant node’ “Test” RBCs (‘graveyard’) Red pulp=sinusoids w/RBCs White pulp=lymphocytes & macrophages Antimicrobial Proteins Interferons Complement = liver plasma proteins Membrane Attack Complex Immune Surveillance ⇒NK cells -not selective, any abnormal cell killed -bacteria, virus-infected, cancer cells -Perforins & Granzymes (induce apoptosis) Burres-Jones - 2011 Fever = pyrexia =beneficial ⇑metabolic rate & tissue repair & inhibits bacteria & virus repro. •Why? Neutrophils & Macrophages release Interleukin-1, a pyrogen, that acts on ant. hypothalamus to release prostaglandin E ⇒ raises hypothalamus T° setpoint •NSAIDS block PGE synthesis!! I. Onset⇒ chills, shiver, cold&clammy II. Stadium⇒hot when pathogen present III. Defervescence ⇒crisis (flush)=sudden ⇒ lysis = slowly falls Inflammation: p. 834-837 3 purposes 4 signs 3 stages I. Mobilization •Damaged cells & Mast cells & Basophils release vasoactive chemicals: Histamine, Kinins, Leukotrienes ⇒ Hyperemia ⇒ Margination ⇒ Diapedesis II. Containment & Destruction •Fluid pocket of gelatinous fibrin w/heparin induced ‘clear area’ inside, filled w/chemotaxically drawn Neutrophils ⇒ phagocytosis & respiratory burst III. Cleanup & Repair •Monocytes ⇒ Macrophges ≈ 8-12 hours •Edema ⇒ lymphatic drainage, Pus, PDGF & Hyperemia Diseases/Conditions/Tests: Hypoproteinemia Kwashiorkor CBC test Differential (WBC) count BUN test Polycythemia Primary polycythemia 2ndary polycythemias Anemias Iron-deficiency Pernicious (⇓B12) Hemoragic Hemolytic Hypoxia Sickle Cell Disease Transfusion reaction Jaundice Obstructive Hemolytic Neonatal HDN/Erythroblastosis fetalis Physo 2B Leukopenia Leukocytosis Leukemias Thrombopenia Prothrombin time Hemophilia Hemotoma Thrombus Embolus Infarction TIA & Stroke Valvular stenosis Mitral valve prolapse Myocardial infarction Cardiac tamponade Atheroma Arrythymia Tachycardia Bradycardia Heart block Fibrillation Blood pressure Hypersensitivity Allergies & Allergens Asthma Anaphylactic shock Autoimmune diseases Lecture Terms & Concepts Burres-Jones - 2011