LECTURE NOTES EXAM 3 PHYSIO

Lecture 1
Albumin

Attracts water which prevents edema

Gamma Globulin

Used to treat viral hepatitis. Abs secreted from lymphocytes.

Cellular Respiration

ATP Production from mitochondria 

RBC Life Span

120 days

Eryhtropoietin

Stimulates bone marrow to secrete red blood cells. Stimulated by kidney (90%) & Liver (10%). After 120 days, it results in dead RBCs that would be reaccumulated by the spleen & liver. 

B lymphocytes

Release Abs which detect Ags, creating the antibody-antigen complex. 

Antigen-Antibody Complex

Signal other WBCs to arrive to targeted cell for degredation.

Antigen Effect on T Cells

Their Cell membranes change as endocytosis to consume antigens.

During embryonic life at four weeks

The embryo is connected to yolk

Yolk Wall’s two functions

Produces Stem Cells of blood & Germ Cells

Germ Cells

XX for female; XY for male

Yolk Sac Nutrition

Caused by no complete connection of placenta/embryo in first few weeks of pregnancy. Yolk sac only form of nutrition for embryo.

Embryo

First 8 Weeks of Development

Fetus

Week 9 to Birth

Once fetus develops liver

The liver controls RBC production

After fetus is birthed

Bone marrow controls RBC production 

Mother Cells

Become blood stem cells (Myeloid & Lymphoid)

Myeloid produce

Eryhrocytes, Platelets, Nonlymphatic Leukocytes (Eosinophils, Basophils, Neutrophils, Monocytes)

Lymphoids produce

B & T Lymphocytes

Myeloid Pathway for Erythrocytes:

Myeloid Stem Cell → Proerythroblast → Early Erythroblast → Late Erythroblast → Normoblast → Reticulocyte

Required for Reticulocyte to Erythrocyte Conversion

Vitamin B12, Folic Acid, Iron

Anemia

Deficiency of Vitamin B12, Iron, Folic Acid

Anemia’s secondary cause:

Cancer patient receiving chemotherapy. Damages bone marrow → less RBCs produced.

Polycythemia (Polyvera)

Excess Erythrocytes

Primary Polyvera/Polycythemia

Irritation of bone marrow → Excess RBC production
(WBC/Platelets also increase)

Secondary Polyvera/Polycythemia:

Overproduction of Erythropoietin

Effect of RBC Overproduction

Blood is Concentrated → Hypertension, Headaches, Nose bleeding, Vertigo

Effect of Immature WBCs Overproduction

Weak Immune System

Overproduction of Platelets

Blood Clots → Myocardial Infarctions, Atherosclerosis, Stroke

Sickle Cell Anemia

Abnormal Hemoglobin; RBCs can’t carry oxygen

Effects of Sickle Cell Anemia

Increased infection, Femur/Bone Pain, Bilirubin increase → Jaundice, Fever

Sickle Cell Anemia Treatment

Folic Acid Supplements, antibiotics for bacterial infections, Vaccines for Viral

Normocytic Anemia

Abrupt blood loss (Stab, Car Accident, Heavy Hemorrhage)

Macrocytic Anemia

Vitamin B12 or Folate Deficiency

Microcytic Anemia

Iron Deficiency

Leukemia (Blood Cancer)

Overproduction of Immature / Mature WBCs

Lymphocytic Leukemia

Large Number of Mature WBCs

Myelocytic Leukemia 

Large Number of Mature/Immature WBCs (ML)

Leukemia Treatment Steps

1. Chemotherapy 

2. Interferon Alpha

3. Radiation Therapy

4. Stem Cell Transplant

Effect of INFa Therapy

Controls Immature WBC Production

Effect of Radiation Therapy

kills Tumor Cells

Effect of Stem Cell Transplant

Take Mother’s Cells from Healthy Bone Marrow & Transplant it

Aorta BP

Highest Blood Pressure
100 MmHg

Vena Cava BP

4 mmHg

Structures in Vein from low BP

Valves (Surrounded by Skeletal Muscle)
Capillaries 

Effect of Valves

Skeletal Muscle Contraction → Blood flow increases in vein system

Effect of Capillaries

Main place of Gas Exchange, Fluid/Nutrients Absorption, Waste Excretion

Lecture 2
Endocardium

Papillary Muscles Tricuspid and Bicuspid 

Deoxygenated Blood Flow

Vena Cava → Right Atrium → Tricuspid → Right Ventricle → Pulmonary Semilunar → Pulmonary A. → Lungs (Gas Exchange)

Oxygenated Blood Flow

4 Pulmonary v.s → Left Atrium → Bicuspid (Mitral) Valve → Left Ventricle → Aortic Semilunar → Aorta

Walls of Arteries and Veins

Smooth Muscle - Autonomic Nervous system

Capillary Walls

Pores, no smooth muscle, for gas exchange, absorption, secretion

Aorta BP

100 mmHg

Arteries BP

50 mmHg

Arterioles & Capillaries BP

20 mmHg

Blood Pressure Calculation

BP = CO x TPR

Pressure in aorta

higher than venous pressure

Reason for Arterioles & Capillaries BP

Smaller Diameter, More interstitial space

Total Peripheral Resistance

Increases pressure in arteries, aorta

Reason for thick aorta & artery walls 

More elastic fibers 

Arterial System Pressure

Stressed Volume

Velocity (cm/sec)

Speed of blood flow

Velocity-Determining factors

Interstitial Area, Diameter

Blood Flow Determining Factors

TPR, Cardiac Output

Blood Velocity Highest

Aorta, Arteries

Blood Resistance Highest

Capillary, Arterioles (Smaller Diameter, More Interstitial Area)

Resistance Dependent Factors

Vessel Radius, Vessel Length, Blood Viscosity/Concentration

Capacitance/Compliance Highest

Vein (Thinner Wall, Carries More Blood)

Systolic Pressure 

The Pressure in Ventricles During Contractions 

Diastolic Pressure

The Pressure in Ventricles During Relaxation

Pulse Pressure 

Difference between Systolic & Diastolic Pressure 

Hierarchy of Pressure

Arteries > Veins > Atrium

Reason for Hierarchy of Pressure

Atrium shows no resistance to venous system & receives large amounts of venous blood from 2 Vena Cava & 4 Pulmonary v.

Blood Pressure Definition

Pressure from blood vessel walls

Hypertension

Factors leading to vasoconstriction, vaso-obstruction, vaso-destruction 

Clinical Case: 35 year old female has severe headache, hypertension, sometimes nose bleeding, vertigo. Had a cardiac infarction but the doctor checked the blood pressure and told her that she may have a stroke because the blood test shows high levels of platelets, RBCs, neutrophils, and ultrasound shows enlargement of spleen.

Polycythemia (?)

Clinical Case 2: Pregnant female has delivery of the baby but has heavy bleeding during delivery that dropped blood volume and pressure resulting in a coma.

preeclampsia (?)

Lecture 3!
Blood Pressure 

The pressure which comes to the wall of blood vessels by blood flow via ventricular contraction/relaxation

Total Peripheral Resistance (TPR) Site

Arterioles

Reason for Total Peripheral Resistance (TPR)

Arterioles have small diameters & more interstitial area, leading to more blood flow resistance

Primary Hypertension

Environmental Factors (diet, lifestyle, stress) leading to hypertension

Cortisol’s Role on Primary Hypertension

Cortisol increases during stress → Increase in TPR → Increase in Systolic/Diastolic BP

Cause of Primary Hypertension

Unknown; There are only known external factors

Sodium’s Effect on Primary Hypertension

NaCl important for depolarization.
Residual Sodium Enters → Depolarization → Calcium Channels Open → Calcium Enters → Muscle Contraction (Vasoconstriction)

Obesity’s Impact on Primary Hypertension

Obesity associated with endocrine hormone disorder, Type 2 Diabetes

Sympathetic Overstimulation (Primary Hypertension)

Alpha 1 involved in BP. Overstimulation of A-1 → Vasoconstriction

Aldosterone Hormone

Increases BP & Sodium Blood Concentration

Hypernaturinia

High Blood Sodium

RAAS System (Primary Hypertension)

Secretes aldosterone that causes vasoconstriction via hypernatremia. 

Prostaglandin & Bradykinin Vessel Effect

Vasodilators / Vasorelaxers

Prostaglandin & Bradykinin Deficiency (Primary Hypertension)

No relaxation → Hypertension

Cause of 90% of Secondary Hypertension

Hormones (Hormonal Disorder, Endocrine Disorder)

Hormones that cause Secondary Hypertension

Aldosterone, Cortisol, Norepinephrine, Epinephrine, PTH, T3/T4, Calcitonin Deficiency, Prostaglandins 

Adrenal Cortex Hormone Secretion 

Aldosterone, Cortisol, Androgen 

Adrenal Medulla Hormone Secretion (Secondary Hypertension)

Adrenaline, Noradrenaline

Hormones involved in blood pressure

↑ Aldosterone, ↑ Cortisol

RAAS System

Low BP / Hyponatremia → Enzyme Conversion (Angiotensinogen → Angiotensin 1) → ACE Conversion (Angiotensin 1 → Angiotensin 2) → Angiotensin 2 causes Aldosterone secretion → Blood carries Aldosterone to kidney → Aldosterone Binds on Tubule Receptor → Sodium Reabsorption 

Angiotensin 2 Effects

Vasoconstriction, Increase of Aldosterone of Cortex

Aldosterone Allows ___ Reabsorption and ___ Excretion

Sodium, H₂O, and Bicarbonate from urine → Blood
H+ , K+ → urea