Dr. Vo Anatomy and Physiology II (BIOL 2224) Test 1 Study Guide

plasma proteins

Dissolved proteins found in the blood. 99% of these proteins are albumins, globulins, and fibrinogen, with the remaining 1% being enzymes and hormones whose levels are highly variable. 90% of these proteins are formed by the liver.

albumins

Transport fatty acids and steroids, help regulate osmotic pressure of the blood. Compose ~60% of plasma proteins.

globulins

Proteins found in blood involved in transport (transport globulins) as well as immune functions as antibodies (immunoglobulins).

fibrinogen

A blood protein essential to blood clotting. The conversion of this protein into its active form (fibrin) is among the final steps in clot formation, and is triggered by thrombin.

colony stimulating factors (CSFs)

Stimulate growth and differentiation of immature leukocytes in bone marrow.

multi-CSF

CSF that accelerates production of granulocytes, monocytes, platelets, and RBCs.

EPO (erythropoietin)

Promotes growth of red blood cells. A glycoprotein formed in the kidneys and liver, particularly the kidneys in response to a low O2.

GM-CSF

Stimulates granulocyte and monocyte production.

G-CSF (granulocyte colony stimulating factor)

Stimulates granulocyte production.

M-CSF

Stimulates monocyte production.

Vitamin K

Vitamin ___ is a group of vitamins that the body needs for blood clotting, helping wounds to heal. There's also some evidence vitamin ___ may help keep bones healthy.

Phases of Hemostasis

Vascular phase, platelet phase, coagulation phase.

Vascular Phase of Hemostasis

A phase involving vasoconstriction and adhesion of platelets to damaged endothelium.

Platelet Phase of Hemostasis

Begins with attachment of platelets to sticky endothelial surfaces, basement membrane, exposed collagen fibers, and other platelets. Platelets release chemicals to promote aggregation, a positive feedback loop.

Coagulation Phase of Hemostasis

Depending on clotting factors or procoagulants in the pathway; includes calcium and 11 different proteins; causes a cascade reaction of enzymes and proenzymes that ends in the conversion of circulating fibrinogen into insoluble fibrin.

Clot Retraction

Once the fibrin meshwork has formed, platelets and RBCs stick to the fibrin strands. The platelets then contract, and the entire clot begins to undergo clot retraction, a process that continues over 30-60 minutes.

Extrinsic Pathway of Coagulation

Factors released by damaged tissues begin cascade.

Tissue damage -> Factor III -> Ca2+ + Factor VII -> Tissue factor complex -> Factor X and the common pathway.

Intrinsic Pathway of Coagulation

Happens in blood vessels when collagen fibers of the basement membrane are exposed to blood.

Collagen fibers of basement membrane -> Factor (XII) -> Platelet factor + Ca2+ + Factors VIII and IX -> Factor X activator -> Factor X and the common pathway.

Common Pathway of Coagulation

Activated X stimulates the final steps in the clotting cascade:

Prothrombin-> Thrombin, thrombin then activates -> Fibrinogen-> Fibrin.

Fibrin threads are the insoluble network that traps platelets. RBCs and cellular debris.

Leukocytes

White blood cells, fight infection.

Neutrophils

Most abundant WBC (50-70%). Phagocyte that consumes pathogens and tissue debris. Round cell with lobed nucleus. A granulocyte.

Lymphocytes

Second most abundant WBC (20-40%). A type of white blood cell that make antibodies to fight off infections. A specific immune defense cell with three functional classes (T cell, B cell, NK cell). Nucleus is massive compared to rest of cell. An agranulocyte.

Monocytes

Third most abundant WBC (2-8%). An agranular leukocyte that is able to migrate into tissues and transform into a macrophage. Nucleus looks like a kidney bean, cell is massive next to an RBC.

Eosinophils

A white blood cell containing granules that are readily stained red by eosin. Reduces inflammation and is phagocytic against antibody tagged pathogens. Rare (2-4%) but more common than basophils. Increase in numbers with parasitic or allergic antagonists.

Basophils

A circulating leukocyte that produces histamine and other chemicals to produce inflammation as well as heparin. Granulocyte with a difficult to distinguish nucleus due to the tremendous amount of blue/black granules. Least numerous leukocyte (< 1%).

Mnemonic to Remember % of Leukocytes

Never-Let-Me-Eat-Bologna.

Neutrophils (50-70%)

Lymphocytes (20-40%)

Monocytes (2-8%)

Eosinophils (2-4%)

Basophils (< 1%)

pH of Blood

pH: Alkaline 7.35-7.45pH

Temperature of Blood

100.4 F (38 C)

Viscosity of Blood

5x thicker than water.

Red Blood Cells (Erythrocytes)

Transport oxygen and carbon dioxide. Contains hemoglobin. No nucleus. Average lifespan is ~120 days.

Heme

Iron-based, pigment part of hemoglobin. Each ring structure contains an iron ion at the center. Carries O2 that can be reversibly bound with ease. Can also carry CO2.

Hemoglobin (HGB, Hb, Hgb)

Iron-containing protein in red blood cells that carries oxygen for delivery to cells. Composed of two alpha chains, two beta chains, and four heme structures.

Oxyhemoglobin (HbO2)

O2 bound to hemoglobin. Blood is bright red.

Carbaminohemoglobin (HbCO2)

CO2 bound to hemoglobin. Blood is deep red hue.

Deoxyhemoglobin (HHb)

Hemoglobin with no O2 or CO2 bound to it.

Blood Type

Determined by the type of surface antigens present on red blood cells.

Surface Antigens (Agglutinogens)

RBC surface proteins that identify cells to immune system. Normal cells are ignored and foreign cells attacked.

Antibodies (immunoglobulins)

Proteins within plasma that react with antigens. Some of these proteins react with surface antigens on foreign RBCs that cause the RBCs to clump together (agglutination).

Universal Donor

O negative

Universal Recipient

AB positive

Erythropoeisis

Process of making new red blood cells. Stimulated by low O2 delivery. RBCs originate in the red bone marrow in adults. EPO stimulated. RBC proliferation and maturation occurs. Reticulocyte release.

Reticulocyte

Immature red blood cell found in blood circulation, has since ejected its nucleus previously when it was a normoblast.

RBC formation

Hematopoietic Stem Cells (HSCs) -> Myeloid Stem Cells +EPO -> Proerythroblasts -> Erythroblasts -> Reticulocyte -> Mature RBC

Plasma

Fluid portion of blood. Makes up 55% of whole blood and is composed of 92% water, 7% plasma proteins, and ~1% other solutes.

Formed Elements

Cellular portion of whole blood. It composes around 45% of whole blood. It is itself composed of 99.9% red blood cells, < 0.1% white blood cells, and < 0.1% platelets.

Anemia

A condition in which the blood is deficient in red blood cells, in hemoglobin, or in total volume. Usually caused by kidney failure or erythropoietin.

Pernicious Anemia

Lack of mature erythrocytes caused by inability to absorb vitamin B12 into the bloodstream.

Iron-deficiency Anemia

A condition in which blood lacks adequate healthy red blood cells due to lack or iron from diet or from issues with iron absorption.

Hypoplastic Anemia

Caused by a decline in erythropoiesis.

Aplastic Anemia

Failure of blood cell production in the bone marrow.

Sickle Cell Anemia

Hereditary disorder of abnormal hemoglobin producing sickle-shaped erythrocytes and hemolysis. Makes one resistant to malaria parasite.

Hormonal Response to Dehydration

Aldosterol, ADH, Angiotensin II

Layers of the Heart

Pericardium, myocardium, endocardium.

Pericardium (Epicardium)

Fibrous, serous sac that contains the heart. Has a parietal and visceral layer that is a dense outer layer and serous membrane covering the heart, respectively. Restricts heart movements, prevents excessive movement and friction, and overfilling with blood.

Myocardium

Thick middle muscle layer of the heart. Pumps blood and is composed of a special cardiac muscle tissue.

Endocardium

Inner lining of the heart. Consists of epithelial tissue that prevents clots and is continuous with the endothelium of the great vessels.

Foramen Ovale

Connects the two atria in the fetal heart, becomes fossa ovalis.

Ductus Arteriosus

A blood vessel in a fetal heart that bypasses pulmonary circulation by connecting the pulmonary artery directly to the ascending aorta. Becomes the ligamentum arteriosum in a mature heart.

Pectinate Muscle

Internal ridges of myocardium in right atrium and both auricles.

Coronary Sinus

enlarged vessel on the posterior aspect of the heart that empties blood into the right atrium.

Moderator Band

This structure stretches from a papillary muscle on the interventricular septum to the wall of the right ventricle. Functionally it is important because it conducts impulses between these two regions on the heart, thereby coordinating the contraction of the cells and it may also help prevent overdistention of the ventricular wall

Papillary Muscles

Responsible for pulling the atrioventricular valves closed by means of the chordae tendineae.

Trabeculae Carneae

Muscular ridges on the internal surface of the ventricles.

Conduction System of the Heart

Generates and delivers (conducts) the electricity to all the muscle fibers of the heart resulting in a smooth, complete contraction of the cardiac muscle fibers, which forcefully ejects the blood outside the heart.

SA node -> AV node -> AV bundle -> Bundle branches -> Purkinje fibers.

Sinoatrial Node (SA)

Group of cells in the right atrium where the electrical signal is generated that establishes the heartbeat.

Internodal Pathways

Interconnect the SA Node with the AV Node, conducts impulses throughout to the atrial working cells.

atrioventricular (AV) Node

A node of specialized heart muscle located in the septal wall of the right atrium; receives impulses from the sinoatrial node and transmits them to the atrioventricular bundle.

AV bundle (Bundle of His)

Fibers in the heart that relay a nerve impulse from the AV node to the ventricles.

Bundle Branches

Branches of the AV bundle that divide to the right and left sides of the interventricular septum.

Purkinje Fibers

Fibers in the ventricles that transmit impulses to the right and left ventricles, causing them to contract.

Path of Blood Through the Heart

Right Atrium → Tricuspid Valve → Right Ventricle → Pulmonary Valve → Pulmonary Artery → Lungs → Pulmonary Vein → Left Atrium → Bicuspid (Mitral) Valve → Left Ventricle → Aortic Valve → Systemic Circuit → Venae Cavae → Right Atrium

Right Atrium

the right upper chamber of the heart that receives deoxygenated blood from the venae cavae and coronary sinus.

Tricuspid Valve

A valve that is situated at the opening of the right atrium of the heart into the right ventricle and that resembles the mitral valve in structure but consists of three triangular membranous flaps.

Right Ventricle

Pumps deoxygenated blood to the lungs through the pulmonary artery. Less muscular than its left counterpart.

Pulmonary Semilunar Valve

Heart valve opening from the right ventricle to the pulmonary artery.

Left Atrium

Chamber that receives oxygenated blood from the pulmonary veins and pumps it into systemic circulation.

Mitral Valve

A valve in the heart that guards the opening between the left atrium and the left ventricle; prevents the blood in the ventricle from returning to the atrium. Alternative name is bicuspid valve.

Left Ventricle

Pumps oxygenated blood to the body through the aorta. Considerably more muscular than its right counterpart as it has to pump harder to get blood to the rest of the body.

Aortic Semilunar Valve (Aortic Valve)

Located between the left ventricle and the aorta and controls blood entering the arterial system (systemic circuit).

Blood Pressure

Pressure exerted by the blood upon the walls of the blood vessels, especially arteries, usually measured by means of a sphygmomanometer and expressed in millimeters of mercury. Represented as a fraction Systole/Diastole

Diastole

The relaxation phase of the heartbeat; the period of least pressure.

Systole

Contraction phase of the heartbeat; the period of most pressure.

S1

The first heart sound, heard when the atrioventricular (mitral and tricuspid) valves close.

S2

The second heart sound, heard when the semilunar (aortic and pulmonic) valves close.

P Wave

Depolarization of atrial myocardium and signals onset of atrial contraction on an EKG.

P-R Interval

Duration of atrial depolarization and AV node delay on an EKG.

QRS Complex

Ventricular depolarization and atrial repolarization on an EKG.

QT Interval

the part of an ECG that reflects the time from ventricular depolarization through repolarization.

T Wave

Ventricular repolarization and relaxation.

Cardiac Cycle

A complete heartbeat consisting of contraction and relaxation of both atria and both ventricles.

Ventricular Diastole

The period between ventricular contractions when the ventricles are repolarizing. Longest phase of the cardiac cycle.

Mitral Valve Prolapse

Improper closure of the valve between the heart's upper and lower left chambers.

Bradycardia

Slow heart rate (less than 60 bpm).

Tachycardia

Fast heart rate (HR greater than 100bpm).

Normal Sinus Rhythm (NSR)

regular rhythm of the heart cycle stimulated by the SA node (average rate of 60-100 beats/minute).

Aortic Arch Branches (right to left)

brachiocephalic trunk (right subclavian, right common carotid artery), left common carotid artery, left subclavian artery

Pulmonary Circuit

Carries blood to and from gas exchange surfaces of lungs.

Venae Cavae -> Right Atrium -> Tricuspid Valve -> Right Ventricle -> Pulmonary Valve -> Lungs -> Left Atrium

Systemic Circuit

Circuit of blood that carries blood between the heart and the rest of the body.

Left Atrium -> Mitral Valve -> Left Ventricle -> Aortic Valve -> Aorta -> Body

Tunica Externa

Outer layer of a blood vessel which connects it to surrounding tissues. Composed of collagen and elastic fibers. Veins have some smooth muscle fiber mixed in.

Tunica Media

The middle and thickest layer of tissue of a blood vessel wall, composed of elastic tissue and smooth muscle cells that allow the vessel to expand or contract in response to changes in blood pressure and tissue demand. Arteries have an external elastic membrane.