anatomy 403: cardio 1

cardiovascular system

• what does the heart do?

pump to drive circulation

cardiovascular system

• what does the vasculature do?

vessels to transport blood

cardiovascular system

• what does the blood do?

liquid connective tissue

cardiovascular system

• what does the lymphatics?

vessels and organs to return excess intersitial fluid to venous return, and modulate immune responses

cardiovascular system

• what are the functions of blood?

transportation, regulation, protection

functions of blood

• transportation

  • ____ (respiratory)

  • ____ (digestive)

  • ____ (digestive, respiratory, urinary)

  • _____ (endocrine) and cytokines

gases, nutrients, wastes, hormones

functions of blood

• regulation

  • _____

  • _____

  • _____

pH, temperature, water balance

functions of blood

• protection

  • _____

  • _____

immune, clotting

physical profile of blood

• “thicker” than water

• 100.4 F

• color: red-purple

• typically 8% 

• ____ liters

4-6

carbonic acid - bicarbonate buffer

• pH: 7.35-7.45

• transportation of CO2

• resist changes in pH

• lungs clear: _____

  • tachypnea (>20 bpm)

  • bradypnea (<12 bpm)

• kidneys clear: ______

CO2, H+ and HCO3-

carbonic acid - bicarbonate buffer

• what molecules do the lungs clear?

CO2

carbonic acid - bicarbonate buffer

• what molecules do the kidneys? 

H+ and HCO3-

carbonic acid - bicarbonate buffer

• what is it called when you have > 20 breaths per minute?

tachypnea

carbonic acid - bicarbonate buffer

• what is it called when you have < 12 breaths per minute?

bradypnea

blood components

• blood plasma (55%) is the _____

• proteins, albumins, globulins, immunoglobulins, and fibrinogens are the _____ 

solvent, solution

blood components 

• ______

  • erythrocytes (RBCs)

  • thrombocytes (platelets)

  • leukocuytes (WBCs)

formed elements

blood components

• what are the three formed elements?

erythrocytes, thrombocytes, and leukocytes

formed elements

• what are the leukocytes?

neutrophils, lymphocytes, monocytes, eosinophils, basophils

formed elements: blood smear

• what are the 3 cell morphologies?

microcytic, normocytic, macrocytic

blood cell formation (hemopoiesis)

• red bone marrow (hematopoietic connective tissue)

  • pluripotent stem cells

    • ______: erythrocytes, thrombocytes, granular leukocytes, mast cells, and monocytes

    • ______: agranular leukocytes (minus monocytes)

myeloid stem cells, lymphoid stem cells 

cytokines

• ________

  • peptides or glycoproteins

  • act on surface membranes

  • different than hormones

  • auto—, para—, or endocrine actions

• secreted by most ______ cells

• _______ (different effect of different tissues)

  • ex) interleukin 4 (ILK-4)

    • B-cell activation, proliferation, and differentiation

    • T-cell proliferation

    • mast cell proliferation

• may be pathologically dysregulated

  • hypercytokemia (cytokine storm)

    • inflammation, system shut down

small signaling molecules, nucleated, pleiotrophic

cytokines

• cytokines are _________ of crossing plasma membrane

incapable

hemopoietic growth factors

• hemopoietic cytokines

  • stimulate growth and/or development of blood ________

formed elements

hemopoietic growth factors

• colony stimulating factors (CSFs) → myeloids

  • named for products on growth media

  • enhance myeloid stem cell _____ and differentiation 

mitosis

hemopoietic growth factors

• interleukins (ILs)

  • vast, diverse

  • mitosis and development of ______ cells

hemopoietic

hemopoietic growth factors

• erythropoietin (EPO)

  • secreted in response to _____ (low oxygen)

  • erythrocytes

hypoxia

hemopoietic growth factors

• thrombopoietin (TPO)

  • secreted in response to ______ damage

  • thrombocytes (platelets)

cellular

what are the hemopoietic growth factors?

hemopoietic cytokines, colony stimulating factors, interleukins, erythropoietin, and thrombopoietin

hemoatological malignancies

• _______ (~30%)

  • bone marrow and leukocytes

  • immature WBCS or poorly developed

• _______ (~56%)

  • lymphatic tissues

• _______ (~14%)

  • bone marrow and plasma cells

leukemia, lymphoma, myelomas

blood group systems

• RBC surface “_____” (agglutinogens)

• 100 genetically identified, 36 recognized systems

• ABO → A, B, AB, O

• Rh

antigen

ABO

• _______ agglutinogens (antigens)

  • ~80% secretors (saliva, semen, etc.)

• _______ (antibodies, IgM) present in plasma

glycosphinogolipid, agglutinins

rh factor

• Rh antigens = _________

  • maternal antibodies (mostly IgG, some IgM)

  • Rh- lacks D antibody

  • Rh+ has D antibody

integral membrane proteins

rh factor

• hemolytic disease of the newborn (HDN)

• ____ fetus in an ____ mother

  • agglutinination and/or hemolysis

  • RhoGam is a 20th week intramuscular injection

Rh+, Rh-

rh factor - hemolytic disease of the newborn

• 1st pregnancy

  • fetus blood leaks across placenta into mother’s bloodstream

• between pregnancy

  • mother’s blood produces ________

• 2nd pregnancy

  • mother’s blood attacks fetal erythrocyte cells 

anti-D antibodies

red blood cells (erythrocytes)

• 4.8-5.4 million RBCs/uL

• biconcave discs (d = 7-8 um)

• hemoglobin (33% vs. 96% weight)

  • 280 million molecules per RBC

  • 13.5-17.0 g/dL

• ______ and lack _____

• 120 day life cycle

anucleate, mitochondria

oxygen

• terminal proton acceptor in chemiosmosis (ATP)

• necessary for active tissues

• ______: low oxygen in the blood

• ______: low oxygen in the tissues

hypoxemia, hypoxia

oxygen

• what is hypoxemia?

low oxygen in the blood

oxygen

• what is hypoxia?

low oxygen in the tissue

hemoglobin

• ____ protein

  • 4 polypeptides (HbA = 2 alpha, 2 beta)

• ____

  • iron containing pigment

globin, heme

hemoglobin

• what are the 3 types of binding for hemoglobin?

cooperative, competitive, and allosteric

hemoglobin

• cooperative binding

  • 1 O2 binds, the affinity increases for more O2 binding

  • O2

• competitive binding

  • CO

• allosteric binding

  • CO2 and H+

  • nitric oxide (NO)

  • binds ______ to hemoglobin

elsewhere

hemoglobin

• what molecule is involved in cooperative binding?

O2

hemoglobin

• what molecule is involved in competitive binding?

CO2

hemoglobin

• what molecule is involved in allosteric binding?

CO2, H+, NO

hemoglobin: hemoglobin-oxygen affinity

• increased affinity is associated with what changes in the sigmoidal curve?

decreased temperature, decreased PCO2, and increased pH

hemoglobin: hemoglobin-oxygen affinity

• decreased affinity is associated with that changes in the sigmoidal curve?

increase temperature, increased PCO2, and decreased pH

hemoglobin: hemoglobin-oxygen affinity

• increased affinity is associated with what shift for the sigmoidal curve?

left shift

hemoglobin: hemoglobin-oxygen affinity

• decreased affinity is associated with what shift for the sigmoidal curve?

right shift

carbon monoxide poisoning

• hemoglobin affinity for ____ much greater than for O2

  • 250x more affinity

CO

erythropoiesis

• erythropoietin (EPO)

  • development in adults:

    • ______ (peritubular interstitial cells - fibroblasts)

    • takes ~10 days to adjust to altitude change

  • development in fetus:

    • ______ (perisinusoidal cells)

• driven by hypoxia-inducible factors (HIF) and (EP)

kidneys, liver 

blood doping

• _______ EPO

• transfusions

  • homologous

  • autologous

• natural blood doping

• ______ risk

  • spontaneous clotting

exogenous, polycythemia

hematocrit

• percentage of RBCs of total blood volume

• ______ < [40-50%] < ______

  • RBCs or plasma volume

  • hemorrhage, dehydration, menstruations, etc.

• critical

  • <15% → cardiac failure

  • >60% → spontaneous clotting

anemia, polycythemia

anemia

• _____ oxygen carrying capacity of the blood, decreased hematocrit 

• various types:

  • iron-deficiency anemia

  • megaloblastic anemia (inadequate B12 intake)

  • hemolytic anemia

  • aplastic anemia

  • microcytic anemia

reduced

anemia

• what two types of anemia have direct issues with hemoglobin?

iron-deficiency and megaloblastic anemia

anemia

• megaloblastic anemia 

  • inadequate ___ intake

  • pernicious anemia (stomach cannot produce intrinsic factor)

B12

anemia

• hemolytic anemia

  • _____ rupture

plasmalemma

anemia

• aplastic anemia

  • _______ destruction

red bone marrow

anemia

• microcytic anemia

  • ____ RBCs

small

white blood cells (leukocytes)

• granular vs. agranular

• phagocytosis

• chemotaxis and emigration

  • attracted to/moving toward _____ signal

chemical

white blood cells (leukocytes)

• what are granular leukocytes?

basophils, eosinophils, neutrophils

white blood cells (leukocytes)

• what are agranular leukocytes?

monocytes and lymphocytes

development

• hematoxylin and eosine (H and E staining)

• H (basic; blue)

  • ____ and ____

• E (acidic; red)

  • ______

nuclei, granules, cytoplasm

granular leukocytes: neutrophils

• no strong dye attraction

  • 2-5+ lobed nuclei

  • polymorphonuclear leukocytes (polys)

• found in blood and tissues

• life span: < 1 week

• phagocytic and chemotaxic

• degranulation

  • ____ and ____

• pus

• ~60% of WBCs (abundant)

lysozyme (bactericidal), non-specific granules

granular leukocytes: basophils

• absorb basic stain → blue-purple

  • 2 lobed nuclei

  • granules obscure nuclei

• life span: 1-2 years

• chemotaxic

• degranulation

  • _____, _____, and _____

• stimulate the formation of IgE on mast cells

  • anaphylaxis

• allergies and ectoparasites

  • ticks

• >1% of WBCs (least abundant)

histamine, heparin, and serotonin

granular leukocytes: eosinophils

• absorb eosin stain (acidic) → red/orange

  • 2-3 lobed nuclei

  • granules do not obscure nuclei

• life span < 2 weeks

• phagocytic (limited)

• chemotaxic

• degranulation (enzymes)

  • _______ and _______

  • major basic protein

    • kills endoparasites

• ~3% of WBCs

histaminidase and leukotrienes

agranular leukocytes: lymphocytes

• nuclei round or indented and stain dark

  • cytoplasm stains blue

• acquired immunity

  • T cells → helper, cytotoxic, suppressor

  • B cells → plasma cells

• innate immunity

  • natural killer cells

• never _______

• small (90%) vs. large (10% lymphocytes)

• ~25% of WBCs

phagocytic

agranular leukocytes: lymphocytes

• what cells are part of acquired immunity?

T and B cells

agranular leukocytes: lymphocytes

• what cells are part of innate immunity?

natural killer cells

agranular leukocytes: monocytes

• U-shaped nuclei

• life span: < 3 days in blood, months in tissues

• _____ in tissues

  • fixed or wandering

• _____ (skin, mucosa)

  • antigen presenting cells

    • innate → adaptive

• ~10% of WBCs

macrophages, dendritic cells

differential white blood cell count

• what is leukocytosis?

high white blood cell count

differential white blood cell count

• what is leukopenia?

low white blood count

platelets (thrombocytes)

• pieces of cytoplasm

  • anucleate

• derived from _______

  • 50 um in diameter

  • polypoid 

  • proplatelets into marrow sinusoids → platelets 

  • thrombopoietin (TPO)

• 150-400 k/uL

• life span: 8-10 days

• macrophages in spleen

megakaryocytes

platelets (thrombocytes)

• coagulation

  • ______

  • soluble (in presence of vascular injury) → insoluble (mesh-like network)

• platelet activation

  • contact with ______ and von Willebrand

  • fibrin

• immune responses

  • inflammation

    • secrete cytokines

  • _______

fibrin, collagen, antibacterial