🫀 Cardiovascular and Immune System Study Guide (Module 6)
1. Layers of the Heart Wall
Epicardium: Outer protective layer; contains blood vessels and nerves.
Myocardium: Thick, muscular middle layer; responsible for heart contraction.
Endocardium: Inner lining of the heart chambers and valves; smooth surface for blood flow.
2. Poiseuille’s Law and Blood Flow
Poiseuille’s Law:
Q = \frac{\pi \Delta P r^4}{8 \eta L}
Where:
Q = flow rate
\Delta P = pressure gradient
r = radius of vessel
\eta = viscosity
L = length of vessel
Clinical Relevance:
Small changes in radius = big changes in flow (radius to the 4th power).
Vasodilation increases blood flow, vasoconstriction decreases it.
Important in blood pressure regulation, shock, and exercise physiology.
3. Vein Valves and Retrograde Flow
Vein valves are semilunar in shape.
They prevent backflow of blood—especially in the legs—when muscles contract and relax.
Work with skeletal muscle pump to return blood to the heart against gravity.
4. Endothelial Cells: Dual Roles
Anticoagulant Role
:
Produce nitric oxide (vasodilation, anti-platelet)
Secrete prostacyclin (inhibits platelet aggregation)
Express thrombomodulin (activates protein C to degrade clotting factors)
Prothrombotic Role
:
When injured, endothelial cells release:
von Willebrand Factor (vWF) from Weibel-Palade bodies → activates platelets
Tissue Factor (TF) → initiates coagulation cascade
5. DVT (Deep Vein Thrombosis)
Blood clot in a deep vein (usually leg).
Biggest risk: Pulmonary Embolism (PE) → clot travels to lungs, blocking arteries.
Can be life-threatening; often occurs with immobility, surgery, cancer.
6. Lymphoid Tissue Types
Type | Location/Function |
Primary | Bone marrow (B-cell development), Thymus (T-cell education) |
Secondary | Lymph nodes, spleen, MALT → where mature lymphocytes activate |
Tertiary | Formed at inflammation/tumor sites (not always present) |
7. T-cell Selection (Positive & Negative)
Occurs in thymus to ensure self-tolerance and functionality.
Positive Selection
(in cortex):
T-cells must bind weakly to self-MHC on cortical thymic epithelial cells (cTECs).
Weak binding = survive.
No binding = apoptosis.
Negative Selection
(in medulla):
T-cells that bind too strongly to self-antigens are eliminated.
Mediated by medullary thymic epithelial cells (mTECs) expressing AIRE.
Prevents autoimmune T-cells.
8. T-cell Education Pathway
Enter corticomedullary junction as double negative (CD4-/CD8-).
In subcapsular zone, T-cells proliferate.
Become double positive (CD4+/CD8+) in cortex.
Undergo positive selection via cTECs.
Migrate to medulla, encounter AIRE-expressing mTECs for negative selection.
Exit as single positive CD4+ (helper) or CD8+ (cytotoxic) T-cells.
9. Germinal Center Reactions
Located in secondary lymphoid organs (e.g., lymph nodes, spleen).
Functions:
Affinity Maturation: B-cells mutate antibody genes → select for higher affinity.
Class Switching: IgM switches to IgG, IgA, or IgE based on cytokine signals → functional specialization.
Result: Stronger, more effective immune responses.
10. Splenic Venous Sinusoids
Sinusoids: Open, leaky capillaries in the red pulp of the spleen.
Healthy RBCs squeeze through endothelial slits.
Old/damaged RBCs get trapped and are phagocytosed by macrophages.
Helps maintain healthy blood cell population.
⭐️ Summary of Major Pathways
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Cardiovascular Flow Regulation
Governed by Poiseuille’s Law: radius has biggest effect.
Endothelial cells control vasodilation (NO) and clotting (vWF, TF).
Vein valves and muscle pump prevent blood backflow.
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T-Cell Development Pathway
Origin in bone marrow → migrate to thymus
Double negative → double positive → single positive
Positive selection: binds self-MHC = survives.
Negative selection: binds self-antigen strongly = deleted.
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B-Cell Activation in Germinal Centers
B-cells bind antigen and present it to helper T-cells.
Enter germinal center:
Dark zone: Proliferation and mutation.
Light zone: Selection for high-affinity clones.
Class switch recombination and exit as memory or plasma cells.