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1. Functions of the cardiovascular system and its major components:

• Transport: Oxygen, nutrients, hormones, and waste products.

• Regulation: Body temperature, pH balance, and fluid volume.

• Protection: Blood clotting mechanisms and immune defenses (WBCs, antibodies).

1. Composition, average volume, and physical characteristics of whole blood:

• Whole blood is composed of plasma (55%) and formed elements (45%).

• Formed elements include erythrocytes, leukocytes, and platelets.

• Average adult blood volume: 5–6 liters in males, 4–5 liters in females.

• Blood is denser and more viscous than water, with a metallic taste and slightly alkaline pH (~7.35–7.45).

1. Composition, pH, and functions of plasma:

• Plasma is ~90% water and contains proteins (albumin, globulins, fibrinogen), electrolytes, gases, nutrients, enzymes, and hormones.

• Maintains osmotic balance, transports substances, and serves as a medium for metabolic exchange.

• Plasma pH is maintained within the normal blood pH range (7.35–7.45).
  II. CARDIOVASCULAR SYSTEM – HEART

1. Functions of the heart:

• The heart functions as a pump to circulate blood throughout the body.

• It ensures continuous delivery of oxygen and nutrients to tissues and removal of waste products.

1. Size, position, and orientation of the heart:

• Approximately the size of a fist.

• Located in the mediastinum between the lungs, slightly left of midline.

• The base is superior and directed toward the right shoulder; the apex points inferiorly toward the left hip.

1. Pericardium structure and function:

• Fibrous pericardium: tough outer layer, protects and anchors the heart.

• Serous pericardium: inner double-layered membrane.

  • Parietal layer lines the internal surface of the fibrous pericardium.

  • Visceral layer (epicardium) covers the external heart surface.

• Pericardial cavity: filled with serous fluid to reduce friction.

1. Heart wall layers:

• Epicardium: outer layer (visceral pericardium).

• Myocardium: thick middle layer composed of cardiac muscle.

• Endocardium: inner layer lining the heart chambers and valves.
  III. CARDIOVASCULAR SYSTEM – VESSELS

1. Types of blood vessels and their functions:

• Arteries: carry blood away from the heart (oxygen-rich in systemic circulation).

• Elastic arteries: large, near the heart (e.g., aorta); stretch and recoil.

• Muscular arteries: distribute blood to organs.

• Arterioles: smallest arteries; regulate blood flow into capillary beds.

• Capillaries: site of gas/nutrient/waste exchange.

• Venules: collect blood from capillaries.

• Veins: return blood to the heart; contain valves to prevent backflow.

• Venous sinuses: flattened veins with thin walls (e.g., coronary sinus).

1. Vascular diseases:

• Atherosclerosis: buildup of plaque in arteries; narrows vessels.

• Arteriosclerosis: thickening/hardening of arterial walls.

• Varicose veins: enlarged veins due to valve failure.

• Aneurysm: localized vessel dilation; risk of rupture.

• Phlebitis: inflammation of a vein.

• Thrombophlebitis: vein inflammation with clot formation.

1. Blood flow, pressure, and resistance:

• Blood flow: volume of blood flowing through a vessel.

• Blood pressure: force exerted by blood on vessel walls.

• Resistance: opposition to flow, affected by:

  • Blood viscosity (\uparrow viscosity = \uparrow resistance)

  • Vessel length (\uparrow length = \uparrow resistance)

  • Vessel diameter (\downarrow diameter = \uparrow resistance)

1. Blood pressure terms and normal values:

• Systolic pressure: pressure during ventricular contraction (~120 mmHg).

• Diastolic pressure: pressure during ventricular relaxation (~80 mmHg).

• Pulse pressure = Systolic – Diastolic (~40 mmHg).

• Mean Arterial Pressure (MAP) \approx Diastolic + 1/3(Pulse Pressure).

1. Regulation of blood pressure:

• Short-term: neural (baroreceptors, vasomotor center), hormones (Epi, NE, ANP, ADH).

• Long-term: kidneys regulate blood volume via renin-angiotensin-aldosterone system.

1. Hypertension and hypotension:

• Hypertension: chronically high BP. Primary (unknown cause) or Secondary (known cause).

• Hypotension: low BP; may cause dizziness, fainting.

1. Cross-sectional area and blood velocity:

• Total cross-sectional area \uparrow in capillaries \rightarrow \downarrow velocity \rightarrow efficient exchange.

1. Autoregulation of blood flow:

• Local control of blood flow.

• Short-term: metabolic (low O2, high CO2) and myogenic (stretch reflex).

• Long-term: angiogenesis (new vessels).

1. Capillary exchange and pressures:

• Hydrostatic pressure (HP): pushes fluid out of capillaries.

• Osmotic pressure (OP): pulls fluid into capillaries.

• NFP = (HPc + OPif) – (HPif + OPc).

• Arterial end: net filtration (fluid leaves capillary).

• Venous end: net reabsorption (fluid reenters capillary).

1. Edema and shock:

• Edema: excess fluid in tissues (\uparrow HP or \downarrow OP).

• Shock types:

  • Hypovolemic: low blood volume.

  • Vascular: widespread vasodilation.

  • Cardiogenic: heart failure.

  • Anaphylactic: allergic vasodilation/increased permeability.
    IV. LYMPHATIC AND IMMUNE SYSTEMS

1. Functions of the lymphatic system:

• Returns excess interstitial fluid to the blood.

• Absorbs dietary fats from the intestine via lacteals.

• Provides immune defense by filtering lymph and housing lymphocytes.

1. Composition of lymph and lymphatic vessels:

• Lymph: fluid similar to plasma but without proteins.

• Vessels include: lymphatic capillaries \rightarrow collecting vessels \rightarrow trunks \rightarrow ducts (right lymphatic and thoracic).

1. Lymph circulation mechanisms:

• Skeletal muscle contraction.

• Respiratory pump.

• Valves in lymph vessels prevent backflow.

1. Structure of lymph nodes:

• Capsule, trabeculae (internal framework), cortex (B cells in follicles), medulla (cords of B cells and macrophages), afferent and efferent lymphatics.

1. Organs of the lymphatic system:

• Spleen: filters blood, recycles RBCs, stores platelets.

• Thymus: site of T cell maturation.

• Tonsils: trap pathogens from food/air.

• Peyer’s patches: monitor bacteria in the intestine.

1. Non-specific vs specific immunity:

• Non-specific: barriers (skin, mucosa), phagocytes, NK cells, complement, interferons, inflammation.

• Specific: B cells (humoral immunity), T cells (cell-mediated).

1. Immune response characteristics:

• Specificity, memory, systemic effect.

1. Cells of immunity:

• B lymphocytes: produce antibodies.

• T lymphocytes: kill infected cells or regulate responses.

• Macrophages: antigen-presenting cells.

• Plasma cells: antibody-producing B cells.

1. Antigen and antibody terms:

• Antigen: substance that triggers immune response.

• Complete antigen: has both immunogenicity and reactivity.

• Hapten: small molecule that becomes antigenic when attached to proteins.

• Epitope: specific part of antigen recognized by immune cells.

1. Humoral and cell-mediated responses:

• Humoral: B cells \rightarrow plasma cells \rightarrow antibodies.

• Cell-mediated: T cells directly attack infected cells.

1. Immunity types:

• Active natural: infection.

• Active artificial: vaccination.

• Passive natural: maternal antibodies.

• Passive artificial: injection of antibodies (e.g., gamma globulin).

1. Antibodies and immunoglobulins:

• IgG: main antibody in secondary response.

• IgA: in secretions (saliva, mucus).

• IgM: first antibody made during infection.

• IgE: allergy and parasite defense.

• IgD: B cell receptor.

1. MHC and graft types:

• MHC I: all body cells; present to CD8+ T cells.

• MHC II: APCs; present to CD4+ T cells.

• Autograft: same person.

• Isograft: identical twin.

• Allograft: same species.

• Xenograft: different species.

1. Hypersensitivity and autoimmune disorders:

• Type I: immediate (anaphylaxis).

• Type II: cytotoxic (blood transfusion reaction).

• Type III: immune complex (SLE).

• Type IV: delayed (contact dermatitis).

• Autoimmunity: immune system attacks self-antigens (e.g., MS, RA).

• SCID: genetic defect in B/T cells.

• AIDS: HIV destroys CD4+ T cells.
  V. RESPIRATORY SYSTEM

1. Functions of the respiratory system:

• Pulmonary ventilation: movement of air in and out of lungs.

• External respiration: gas exchange between lungs and blood.

• Internal respiration: gas exchange between blood and tissues.

• Transport of respiratory gases via blood.

• Regulation of blood pH and voice production.

1. Respiratory zones:

• Conducting zone: nose, pharynx, larynx, trachea, bronchi, bronchioles (air passage only).

• Respiratory zone: respiratory bronchioles, alveolar ducts, alveolar sacs (site of gas exchange).

1. Respiratory organs and their functions:

• Nose: warms, moistens, filters air; olfaction.

• Pharynx: passageway for air and food.

• Larynx: voice production, maintains airway.

• Trachea: windpipe, supported by cartilage rings.

• Bronchi/Bronchioles: branch into lungs.

• Alveoli: site of gas exchange.

• Pleurae: reduce lung friction.

1. Respiratory membrane:

• Composed of alveolar epithelium, fused basement membrane, and capillary endothelium.

• Thin barrier allows rapid gas diffusion.

1. Pressures and ventilation:

• Intrapulmonary pressure: pressure inside alveoli.

• Intrapleural pressure: always negative relative to alveoli.

• Air flows in when intrapulmonary < atmospheric; flows out when > atmospheric.

1. Factors influencing ventilation:

• Airway resistance.

• Alveolar surface tension (surfactant reduces it).

• Lung compliance and elasticity.

1. Lung volumes/capacities:

• Tidal Volume (TV): normal breath ~500 mL.

• IRV/ERV: extra air in/out.

• Residual Volume (RV): air remaining after forced exhale.

• Vital Capacity (VC) = TV + IRV + ERV.

• Total Lung Capacity (TLC) = VC + RV.

1. Gas laws and exchange:

• Dalton’s Law: total pressure = sum of gas partial pressures.

• Henry’s Law: gas dissolves in liquid based on partial pressure and solubility.

• O2 diffuses from alveoli to blood; CO2 from blood to alveoli.

1. Gas transport:

• O_2: mostly bound to hemoglobin (Hb).

• CO_2: as bicarbonate (70%), bound to Hb (20%), or dissolved (10%).

1. Regulation of breathing:

• Medulla: sets basic rhythm.

• Pons: smooths transitions.

• Chemoreceptors: respond to pCO2, pO2, pH.

• Higher centers (cortex, hypothalamus) can override for speech/emotion.

1. Respiratory disorders:

• Emphysema: alveolar wall destruction.

• Asthma: bronchoconstriction, inflammation.

• TB: bacterial lung infection.

• Lung cancer: uncontrolled cell growth.

• Cystic fibrosis: thick mucus obstructs airways.
  VI. URINARY SYSTEM

1. Functions of the urinary system:

• Removal of metabolic wastes (urea, creatinine).

• Regulation of blood volume, pressure, pH, and electrolytes.

• Hormone production: renin (BP regulation), erythropoietin (RBC production).

• Activation of vitamin D and gluconeogenesis during fasting.

1. Organs and their functions:

• Kidneys: filter blood, form urine.

• Ureters: transport urine to bladder.

• Urinary bladder: stores urine.

• Urethra: eliminates urine from body.

1. Location and coverings of the kidneys:

• Located retroperitoneally (behind the peritoneum).

• Covered by renal fascia (anchors), adipose capsule (cushions), and renal capsule (protects).

1. Internal anatomy of kidneys:

• Cortex: outer layer.

• Medulla: inner layer with pyramids.

• Renal pelvis: collects urine and connects to ureter.

1. Nephrons:

• Functional units of kidneys (~1 million/kidney).

• Consist of renal corpuscle (glomerulus + Bowman’s capsule) and renal tubule (PCT, loop of Henle, DCT, collecting duct).

1. Cortical vs. Juxtamedullary nephrons:

• Cortical: short loops, mostly in cortex.

• Juxtamedullary: long loops extending into medulla; key for urine concentration.

1. Kidney blood supply:

• Renal artery \rightarrow segmental \rightarrow interlobar \rightarrow arcuate \rightarrow cortical radiate \rightarrow afferent arteriole \rightarrow glomerulus \rightarrow efferent arteriole \rightarrow peritubular capillaries/vasa recta \rightarrow veins (reverse path).

1. Ureters, bladder, urethra:

• Ureters: use peristalsis to move urine to bladder.

• Bladder: smooth muscle sac; internal (involuntary) and external (voluntary) sphincters.

• Urethra: varies in length between sexes; external sphincter under voluntary control.

1. Urine formation processes:

• Glomerular filtration: plasma pushed from glomerulus to Bowman’s capsule.

• Tubular reabsorption: nutrients and water returned to blood.

• Tubular secretion: wastes (e.g., H$^+, K$^+, drugs) added to filtrate.

1. Filtration membrane and GFR:

• Composed of fenestrated capillaries, basement membrane, and podocytes.

• GFR (glomerular filtration rate): ~120 mL/min; controlled by intrinsic (myogenic, tubuloglomerular) and extrinsic (SNS, hormones) mechanisms.

1. Tubular reabsorption:

• PCT: reabsorbs glucose, amino acids, electrolytes, water.

• Loop of Henle: descending reabsorbs water; ascending reabsorbs NaCl.

• DCT and collecting duct: fine-tune under hormonal control (ADH, aldosterone).

1. Tubular secretion and pH control:

• Secretes H$^+, K$^+, NH$^+_4, drugs.

• Acidifies urine and maintains blood pH.

• Buffered by HCO$^_3^-$, phosphate, and ammonia.

1. Countercurrent multiplier and urine concentration:

• Loop of Henle and vasa recta establish osmotic gradient.

• Allows concentration of urine in presence of ADH.

1. Urine composition and micturition:

• Normal: water, urea, electrolytes, creatinine.

• Abnormal: glucose, protein, blood, ketones.

• Micturition: bladder stretch \rightarrow spinal reflex \rightarrow detrusor contraction and sphincter relaxation.
  VII. FLUID, ELECTROLYTE, AND ACID-BASE BALANCE

1. Fluid compartments of the body:

• Intracellular fluid (ICF): ~2/3 of total body water; inside cells.

• Extracellular fluid (ECF): ~1/3 of total body water.

  • Includes interstitial fluid and plasma.

• Exchange occurs across cell membranes and capillary walls.

1. Fluid volume and solute composition:

• ICF: high in K$^+, Mg$^{2+}$, phosphate, and proteins.

• ECF: high in Na$^+, Cl$^-$, bicarbonate.

• Water moves by osmosis toward higher solute concentration.

1. Water intake and output regulation:

• Intake: drinking, food, metabolism.

• Output: urine, feces, sweat, insensible loss (breathing, skin).

• Regulated by thirst center in hypothalamus and hormones (ADH, aldosterone, ANP).

1. Major electrolytes:

• Sodium (Na$^+$): main ECF cation; regulated by aldosterone, ANP.

• Potassium (K$^+$): main ICF cation; regulated by aldosterone.

• Calcium (Ca$^{2+}$): bones, muscle contraction; regulated by PTH and calcitonin.

• Chloride (Cl$^-$): ECF anion; follows Na$^+$.

• Magnesium (Mg$^{2+}$): enzyme cofactor, mostly in bone.

1. pH regulation mechanisms:

• Buffer systems: bicarbonate, phosphate, proteins (immediate response).

• Respiratory system: changes CO_2 to adjust pH (minutes).

• Renal system: excretes H$^+, reabsorbs HCO$^_3^- (hours to days).

1. Acidosis and alkalosis:

• Respiratory acidosis: \uparrow CO_2 (hypoventilation).

• Respiratory alkalosis: \downarrow CO_2 (hyperventilation).

• Metabolic acidosis: \uparrow H$^+$ or \downarrow HCO$^_3^- (e.g., diarrhea, ketoacidosis).

• Metabolic alkalosis: \downarrow H$^+$ or \uparrow HCO$^_3^-$$ (e.g., vomiting).

• Compensation: lungs/kidneys adjust to restore pH.
  VIII. DIGESTIVE SYSTEM

1. Functions of the digestive system:

• Ingestion, propulsion, digestion (mechanical and chemical), absorption, and defecation.

1. Alimentary canal vs. accessory organs:

• Alimentary canal: mouth, pharynx, esophagus, stomach, small and large intestines.

• Accessory organs: teeth, tongue, salivary glands, liver, gallbladder, pancreas.

1. Digestive process terms:

• Ingestion: food into mouth.

• Propulsion: swallowing, peristalsis.

• Mechanical digestion: chewing, churning, segmentation.

• Chemical digestion: enzymatic breakdown.

• Absorption: nutrients into blood or lymph.

• Defecation: elimination of feces.

1. Regulation of digestion:

• Mechanoreceptors and chemoreceptors detect stimuli.

• Short reflexes: enteric nerve plexuses.

• Long reflexes: CNS involvement.

• Hormones from enteroendocrine cells regulate secretions.

1. Peritoneum and mesenteries:

• Parietal peritoneum: lines abdominal wall.

• Visceral peritoneum: covers organs.

• Falciform ligament: attaches liver to anterior wall.

• Greater omentum: drapes from stomach.

• Lesser omentum: connects stomach and liver.

• Mesentery: suspends small intestine.

• Mesocolon: anchors colon.

1. Histology of the GI tract:

• Mucosa: epithelium, lamina propria, muscularis mucosae.

• Submucosa: connective tissue with blood vessels and nerves.

• Muscularis externa: circular and longitudinal muscle layers.

• Serosa (or adventitia): outer covering.

1. Structures and functions of the mouth:

• Includes lips, cheeks, palate, tongue, and teeth.

• Tongue aids in taste and food manipulation.

• Salivary glands secrete saliva containing amylase and lysozyme.

1. Saliva and teeth:

• Saliva: 99% water, enzymes, electrolytes, mucin, IgA.

• Functions: moisten food, digest starch, antimicrobial.

• Teeth types: incisors, canines, premolars, molars.

1. Esophagus and swallowing:

• Connects pharynx to stomach.

• Swallowing involves voluntary and involuntary phases.

• Upper esophageal sphincter and lower (cardiac) sphincter control food entry.

1. Stomach anatomy and function:

• Regions: cardia, fundus, body, pylorus.

• Rugae: folds allowing expansion.

• Secretes gastric juice: HCl, pepsinogen, mucus, intrinsic factor.

• Cells: chief (pepsinogen), parietal (HCl, IF), mucous, enteroendocrine (gastrin).

1. Small intestine:

• Duodenum, jejunum, ileum.

• Modifications: circular folds, villi, microvilli.

• Functions: digestion and absorption.

• Receives bile and pancreatic juice.

1. Liver, gallbladder, pancreas:

• Liver: produces bile, processes nutrients, detoxifies.

• Gallbladder: stores bile.

• Pancreas: acinar cells produce enzymes; islets secrete insulin/glucagon.

1. Large intestine:

• Cecum, colon, rectum, anal canal.

• Functions: water absorption, feces formation.

• Features: haustra, taenia coli, epiploic appendages.

1. Digestion and absorption of nutrients:

• Carbohydrates: salivary/pancreatic amyl