FINAL EXAM REVIEW

1. KNOW THE FUNCTIONS OF BLOOD

• Blood has 3 major functions: Transportation, regulation, and protection. 

  • Transportation: blood carries gases (oxygen & carbon dioxide), nutrients, waste products, hormones, enzymes, and catalysts throughout the body

  • Regulation: regulates body temperature, blood water concentration, PH values 

  • Protection: provides immunity and promotes blood clotting, essential for hemostasis

2. KNOW THE CHARACTERISTICS, NUMBER, FUNCTION AND LIFESPAN OF RBCs, WBCs, PLATELETS

• Red blood cells

  • Biconcave dis-shaped structures

  • NO nucleus

  • have proteins on the membrane for identification

  • Number: 4.8 to 5.4 million

  • Life span: about 120 days to 4 months

  • Function: carries oxygen around the body

• White blood cells

  • Larger than the red blood cells

  • YES nucleus

  • Reproduce on their own

  • Broken into two headings: ➀ Granulocyte (basophils, eosinophils, neutrophils) ➁ Agranulocytes - no granules (lymphocytes and monocytes): travel to an infection site at a slower rate, increase their #s. Involved with chronic infections. Neutrophils normally get to the infection first then monocytes. ) Lymphocytes-T/B cells, monocyts, Basophil, Enophophils, Neutrophils.

  • Number: about 5,000 to 10,000

  • Life span: for hours to days ~ decades

  • Function: fights infections and microbes in the body

• Platelets

  • Fragments of cells, NOT a whole cell

  • NO nucleus

  • Number: about 150,000 to 400,000

  • Life span: 5 to 9 days

  • Function: involved with blood clotting and coagulation

3. DIFFERENTIATE BETWEEN: LEUKEMIA, LEUKOCYTOSIS, LEUKOPENIA

• Leukemia: WBC cancer, abnormal WBCs multiply uncontrollably

• Leukocytosis: increase in the # of WBCs >10,000

• Leukopenia: decrease in the # of WBCs <5,000

4. DIFFERENTIATE: AGRANULOCYTES VS. GRANULOCYTES

• Agranulocytes: non-granulated inside

  • Examples: lymphocytes and monocytes

• Granulocytes: graininess in them

  • Think of Uncle BEN’s rice: basophils, eosinophils, neutrophils

5. KNOW THE 3 MAJOR PLASMA PROTEINS

• Albumin: “sponge” hold water. most common, works like a sponge and maintains osmotic pressure of water in blood

• Globulins: backbone of antibodies in blood, called immunoglobulins that make antibodies

• Fibrinogen: involved in coagulation, final step in blood clotting, least common plasma protein

6. WHAT IS PLASMA?

• Plasma is straw-colored liquid function of blood

  • Plasma makes up 55% of blood

  • Plasma is 91.5% water

  • If you took out clotting factor that is called serum

7. UNDERSTAND HEMOSTASIS AND THE 3 STAGES OF COAGULATION

• Hemostasis: process to stop bleeding in small cuts

1. Vascular spasm/vasospasm: decrease blood vesse. contraction of blood vessels, called vasocontraction. We reduce the diameter of the blood vessel which reduces blood flow.

2. Platelet plug formation:  as platelets strike damaged epithelial lining and collagen fiber, they begin to stick together and get larger and seal up the hole and pull it together.150,000 -400,000, 5-9 days, blood clotting. 

3. Coagulation: has three stages of cascading chemicals. Coagulation.a) Formation of prothombinase. b) protrombin→prothrombinase→thrombin. c) fibrogen→thrombin—>fibrin threads. 

   • Formation of prothrombinase

   • Conversion of prothrombin into thrombin using prothrombinase

   • Conversion of fibrinogen (plasma protein) into fibrin threads using thrombin

8. UNDERSTAND BLOOD TYPING: SURFACE PROTEINS, ISOANTIBODIES, COMPATIBILITY 

Blood types: A, B, AB, O

Surface proteins: 

• Type A has A proteins on cell

• Type B has B proteins on cell 

• Type AB has both AB proteins on cell 

• O does not have any proteins on cell

Isoantibodies: in plasma, 

• Type A has anti-B in plasma

• Type B has anti-A in plasma

• Type AB does not have any in plasma

• Type O has both anti-A and anti-B in plasma

Compatibility:

• Type A: can receive Type A and O blood

• Type B: can receive Type B and O blood

• Type AB: can receive Type AB, A, B, O blood (universal receiver) 

• Type O: can receive Type O blood (universal donor)  

RH proteins: another protein on cell 

• can either have RH proteins on cell (RH-positive) or not have RH proteins on cell (RH-negative)

• If RH-positive, you cannot have anti-RH antibodies in plasma or WBCs would attack RBCs

• If RH-negative, you are not born with anti-RH antibodies but will make them if exposed to RH-positive blood

• Only time it causes problems is in hemolytic disease of newborns - if RH-positive man and RH-negative woman have baby that is RH-positive so mother makes anti-RH antibodies which could affect next RH-positive baby. Mother is given Rogam injections that blocks anti-RH. 

9. KNOW THE COVERINGS SURROUNDING THE HEART

• Pericardium: fibrous and inner double serous layers enclose and protect heart. 

10. KNOW THE 3 LAYERS OF THE HEART WALL

• Epicardium/visceral layer of the serous pericardium: epicardium= vessels larger of sereous pericardium. 

• Myocardium: cardiac muscle layer of heart, most substantial layer

• Endocardium: deep thin layer that lines the insides of chambers

11. UNDERSTAND THE 4 CHAMBERS OF THE HEART, 4 VALVES, CHORDAE TENDINEAE,  FOSSA OVALIS AND CIRCULATION THROUGH THE HEART

• Atria: 2 smaller upper chambers (between right and left)

  • smooth inside

  • separated by interatrial septum

  • Pumps blood to ventricles (left to left, right to right)

• Ventricles: 2 larger lower chambers (right and left)

  • Separated by interventricular septum

  • Right ventricle: pumps blood to lungs

  • Left ventricle: pumps blood to rest of body through aorta

• Valves: prevent backflow of blood so only moves in one direction

  • 2 AV (atrioventricular) valves: between atria and ventricles

• Right atrium to right ventricle: tricuspid valve

• Left atrium to left ventricle: bicuspid or mitral valve

• Pulmonary valve: right ventricle to pulmonary trunk 

• Aorta valve: left ventricle to aorta 

• Chordae tendinae: little strings, tendinous cords made of CT that attach from valve flaps of AV valves and anchor to the papillary muscles in ventricle 

  • tricuspid and bicuspid valves ONLY

  • Prevent prolapse of AV valves that are under a lot of pressure

• Fossa ovalis: small depression in wall of right atrium in interatrial septum 

  • Remnant of foramen ovale, hole in heart during fetal development that closes up

• Circulation through heart: right atrium → tricuspid valve → right ventricle → pulmonary valve → pulmonary trunk → lungs → left atrium → bicuspid/mitral valve → left ventricle → aortic valve → aorta → around body → right atrium

12. KNOW THE PARTS OF THE CONDUCTION SYSTEM OF THE HEART

1. SA/sinoatrial node: 

   1. in posterior wall of right atrium.    

   2. Pacemaker of heart

   3. Goes down to two atria

2. AV/atrioventricular node: 

   1. Bottom of right atrium

   2. Staggers for fraction of section

3. AV bundle

4. Right and left bundle branches

5. Purkinje fibers: allowing heart to contract the lower chambers

13. WHAT CREATES THE HEART SOUNDS?  WHAT IS AN ABNORMAL SOUND CALLED? 

The closure of the valves create heart sounds 

• Lubb = closure of AV valves (tricuspid and bicuspid valves) 1st sound closure.

• Dupp = closure of semilunar valves (pulmonary and aortic valves) 2nd sound closure..

Abnormal sound is called heart murmur 

14. UNDERSTAND WHAT THE 3 DEFLECTION WAVES OF AN EKG INDICATE  MATCHING

• P-wave: first wave

  • Can be called atrial contraction, atrial depolarization, and atrial systole (contraction).

• QRS complex: ventricular contraction, ventricular depolarization and ventricular systole

• T-wave: ventricular relaxation, ventricular repolarization, ventricular diastole 

15. UNDERSTAND THE EFFECTS OF THE SYMPATHETIC AND PARASYMPATHETIC NERVOUS SYSTEM ON THE HEART

• Sympathetic nervous system: flight or fight system

  • Speeds up the heart and increase force of contractions 

  • Uses neurotransmitter norepinephrine/noradrenaline 

• Parasympathetic nervous system: rest and restore system

  • Slows down the heart and reduce force of contractions contractions

  • Uses neurotransmitter acetylcholine 

16. KNOW THE FOLLOWING TERMS:  angina pectoris, pernicious anemia, bicuspid valve prolapse, polycythemia, thrombocytopenia

Matching

• Angina pectoris: chest pain associated with heart disease due to insufficiency of RBCs

• Pernicious anemia: insufficient hemopoiesis from inability of stomach to produce intrinsic factor, needed for absorption of vitamin B in the small intestine 

• Bicuspid valve prolapse: backflow of blood from the left ventricle into the left atrium,can cause mitral insufficiency. In MVP one or both cusps of the mitral valve protrude into the left atrium during ventricular contraction, when left av pushes back during ventricular systole 

• Polycythemia: the number of RBCs is abnormally high

• Thrombocytopenia: Very low platelet count that results in a tendency to bleed from capillaries.

17. KNOW THE FOLLOWING TERMS:  vaso vasorum, tunica interna, tunica media, tunica externa, elastic arteries, muscular arteries, arterioles, capillaries, veins

MATCHING

• Vaso vasorum: blood vessels that supply blood vessels

• Tunica interna: deep layer of the blood vessels, 

  • made of endothelium

  • Internal elastic tissue

• Tunica media: middle layer of blood vessels, 

  • made up of smooth muscle

  • External elastic tissue

• Tunica externa: fibrous collagen tissue that supports it

• Elastic arteries: large conducting elastic arteries 

  • Example: aorta 

• Muscular arteries: distributing medium-sized arteries

  • Have more muscle tissue

  • Involved with vaso constrction and vaso dilation

  • Example: radial arteries, ulnar arterieries brachial arteries, femoral arteries,
    Tibial arteries, etc (limb arteries) 

• Arterioles: very very small transitional arteries

  • Carries blood from the medium-sized arteries to the capillary beds

• Capillaries: smallest microscopic blood vessels, major area of diffusion

  • Found everywhere in the body except in epithelial tissue, cartilage, epidermis, and cornea of the eyes

• Veins: drain the blood from the capillary beds coming back to the heart

  • Have a thinner wall than an artery

  • NO elastic tissue

  • NO under pressure

  • YES valves, when arteries don’t have the valves  

18. UNDERSTAND:  vasoconstriction vs. vasodilation

• Vasoconstriction: when blood vessels narrow, reduce blood flow, increase blood pressure

• Vasodilation: when blood vessels widen, increase blood flow, lower blood pressure

19. KNOW:  which vessels are the most important physiologically

• Capillary!!

• They don’t have the most blood in them but they are important bc all of our diffusion and active transport mechanisms take place

• Where we give off nutrients and pick up waste products

20. KNOW:  which artery is used to check the pulse which artery is used to check the blood pressure

• Radial artery - When checking the PULSE 

  • Easy to get to, lateral side of the wrist

• Brachial artery - When checking the BLOOD PRESSURE

  • Next to the biceps

21. KNOW:  the name of the instrument used to take blood pressure

• Sphygmomanometer

22. KNOW:  features of the fetal circulation [Matching]

23. KNOW:  the anatomical order of the respiratory system [multiple choice]

1. Nose/nasal cavity area

2. Nasopharynx

3. Oropharynx (directly posterior to the oral cavity)

4. Laryngopharynx (most inferior part of the pharynx)

5. Larynx (voice box)

6. Trachea

7. Primary (main) bronchi

8. Secondary (lobar) bronchi

9. Tertiary (segmental) bronchi

10. Bronchioles

11. Terminal bronchioles

12. Respiratory bronchioles

13. Alveolar ducts

14. Alveolar sacs

24. KNOW:  the functions of the nose

1. Warms, moistens and filters the air

2. Olfaction = sense of smell

3. Vocal resonance (sound of voice comes from the shape of the nose/nasal cavity, sinuses)

25. KNOW:  the parts of the nasal septum 

• Perpendicular plate of ethmoid

• Vomer

• Septal cartilage

26. KNOW:  where the auditory tube location and function

Auditory tube:

• Also known as Eustachian tube

• Connects the nasopharynx to middle ear

• Allows us to equalize the air pressure on both sides of the eardrum

• If you travel in mountains, there is less atmospheric pressure and the eardrum wants to bulge out slightly. If you swallow, it allows atmospheric pressure to travel up the auditory tube to the inner side of the eardrum and it equalizes. 

27. KNOW:  cartilage structures in larynx / structure & function

• (1) epiglottis: moveable cartilage flap that seels off the larynx when we are swallowing so we don't aspirate liquids or solids into our respiratory system

• (2) thyroid cartilage: Adam’s apple which is largest cartilage structure. It is a landmark structure that lets us know where the larynx is

• (3) Cricoid cartilage: first true cartilage ring that we feel below thyroid cartilage and it indicates junction of larynx and trachea. 

28. KNOW:  the control center of normal respiration

• Medullary rhythmicity center - found in medulla oblongata in brainstem - lowest most primitive part of the brain

• Pons - allows us to take prolonged inhalation or exhalation or hold our breath. 

29. KNOW:  the chemical control mechanism of respiration

Carbon dioxide is the main chemical control because as CO2 l in evels go up, our blood pH will go down. Blood has to have pH of 7.35-7.5 so if you hold your breath, you affect pH of blood which signals brain to breathe faster and get CO2 out and O2 in and shift pH levels.

30. KNOW:  anemic hypoxia, stagnant hypoxia, histotoxic hypoxia, hypoxic hypoxia

Matching

• Hypoxia: medical term for a decrease delivery or availability of oxygen to tissues

• Anemic hypoxia: oxygen is available but RBC issue - decreased number of RBC or decreased number of functional RBC. Oxygen is available, but RBCs can’t bring them

• Stagnant hypoxia: oxygen and RBC is available but there is something going on with the cardiovascular system so can’t pump blood to lungs or out the aorta to the rest of body

  • Ex: heart attack, major blood loss,

• Histotoxic hypoxia: inability of cells to use oxygen 

  • Ex: cyanide poisoning which blocks the cells from using oxygen

• Hypoxic hypoxia: decreased availability of oxygen due to decreased availability of oxygen

  • High altitude which has less oxygen

31. KNOW:  parts of the lymphatic system; function of the lymphatic system; different types of lymphatic tissue MATCHING

Parts: 

• Lymph - fluid interstitial intercellular fluid found in lymph vessels

• Lymph vessels - like veins, thinly muscled walls, have valves, do NOT transport lymph anywhere, pick lymph from capillary beds and carry it back to bloodstream, returning leaked intercellular fluid and plasma proteins out cleansing it and returning it to blood

• Lymph organs and structures: spleen (largest lymphatic tissue), thymus gland, lymph nodes, tonsils, diffuse loose lymphatic tissue in digestive system, bone marrow

Function: 

• Cleanses and returns leaked plasma proteins from capillary beds back to blood, 

• Cleanses and returns interstitial plasma fluid back to bloodstream 

• transportation of dietary fats, 

• Protection and immunity in both specific and non-specific immune resistance - involved in manufacture of WBCs 

32. KNOW:  methods of non-specific disease resistance

• Mechanical barrier: skin, intact mucous membranes, epiglottis, urination, defecation

• Chemical: sebum on skin, acids in vagina, lacrimal apparatus (tears), gastric juice

• Antimicrobial agents: complement, interferons, properdins

• Phagocytosis: eating cells

• Natural Killer (NK) Cells

• Inflammation

• Fever

33. DIFFERENTIATE BETWEEN:  IgG, IgA, IgM, IgD, IgE

Matching

• Ig: immunoglobins or antibodies

• IgG: involved in protecting against in bacteria and viruses by enhancing phagocytosis

• IgA: found in secretions of body -  tears, saliva, mucous, breastmilk, blood

• IgM: involved in causing microbes in agglutination and cytolysis (punching hole in cell membrane)

• IgD: activates more B-cells to be converted into plasma cells to make more antibodies

• IgE: found on outside of mass cells or basophils and involved in allergic reactions

34. KNOW: cells produced upon exposure to an antigen, plus their functions

• T cells: directly attack the foreign invaders, develop from the thymus gland

  • Helper T Cells

  • Cytotoxic T Cells

  • Memory T cells

• B cells: produce antibodies to attack the foreign proteins, develop from the gut and spleen, and differentiate into plasma cells

• Memory cells: BOTH T and B cells produce MEMORY CELLS are programmed to recognize the original antigen, with a SECOND EXPOSURE there is a faster reaction time, conferring immunity

• Helper Cells: When a person is infected with HIV(human immunodeficiency virus), it will affect and infect helper cells, preventing both T cells and B cells from functioning properly

35. KNOW:  the structure of an antibody 

• Y-shaped protein substances that have a pair of heavy chains and a pair of light chains

• Constant portion

  • determines the antibody class (IgA, IgG, IgM, IgD, etc)

• Variable portion

  • antigen-binding site(ABS) is found on the tip of the variable portion, which changes to match each specific antigen (foreign protein) the antibody is exposed to

36. KNOW DEFINITION OF:  dyspnea, bradycardia, tachycardia MATCHING

• Dyspnea

  • Difficulty or labored breathing, shortness of breath

• Bradycardia

  • Abnormally slow heart rate, typically below 60 beats per minute 

• Tachycardia:

  • Abnormally fast heart rate, generally above 100 beats per minute