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The American Sleep Disorders Association, in 1990, initiated a 5 year process to develop the widely used International Classification of Sleep Disorders (ICSD). The original ICSD listed 84 sleep disorders, each with descriptive details and specific diagnostic, severity, and duration criteria. The ICSD had 4 major categories: (1) dyssomnias, (2) parasomnias, (3) disorders associated with medical or psychiatric disorders, (4) "proposed" sleep disorders. The ICSD has since been revised twice. The second edition, ICSD-2 was released in 2005 which contains a list of 77 sleep disorders. That new list was broken down into 8 sub-categories: (1) Insomnia; (2) Sleep-related breathing disorder; (3) Hypersomnia not due to a sleep related breathing disorder; (4) Circadian rhythm sleep disorder; (5) Parasomnia; (6) Sleep-related movement disorder; (7) Isolated Symptoms, apparently normal variants, and unresolved issues; and (8) Other sleep disorders. A third edition of the ICSD was released in 2014. The major clinical divisions were unchanged in the third edition from the 2nd version, but there was an addition of variations in the diagnostic criteria for pediatric patients with obstructive sleep apnea, and there was a heading of Developmental Issues added to each section of disorders that have developmentally-specific clinical features in order to aid physicians in diagnosing those patients (specifically 9-CM and 10 CM). Sleep Disorders Categories The ICSD-3 lists about 77 sleep disorders which are divided into the following categories: Insomnia Sleep-related breathing disorder Central Disorders of Hypersomnolence Circadian rhythm sleep disorder Parasomnias Sleep-related movement disorder Some of the above categories have a section for isolated Symptoms, apparently normal variants, and unresolved issues Other sleep disorders There are some other sleep disorders that are divided into two appendices of the ICSD-2 manual. They are as follows: Sleep Related Medical and Neurological Disorders; and ICD-10-CM Coding for Substance-induced Sleep Disorders Study the disorders listed under each of the above categories until you have a good idea of what is included in each. There is a complete list of all the current classified sleep disorders in chapter 27, beginning on page 476 of your Sleep Disorders Medicine, 4th edition textbook. Insomnias Insomnias are disorders that usually produce complaints of not enough sleep, poor quality of sleep. Patient perception can play a role in the complaints. Occasionally, a patient may perceive that they are getting poor quality or not enough sleep even though they may be getting what we think is a normal night’s rest. Insomnias are defined by a repeated difficulty initiating sleep, not sleeping long enough, or poor quality sleep regardless of the amount of sleep time. Primary insomnia would not be due to another sleep disorder. If another sleep disorder such as OSA is causing the insomnia, then we call that secondary insomnia. These disorders may require medical treatment if they are long-lasting. Temporary insomnia due to a stressful situation or life event may correct itself with time. The types of insomnia are covered on pages 476 and 480 of your textbook. Sleep-Related Breathing Disorders These are disorders that involve disordered respiration, or breathing during sleep. These may be obstructive or not. There can be various causes of both. Central apnea syndromes include Cheyenne-Stokes breathing pattern and high-altitude periodic breathing. Cheyenne-Stokes is usually associated with either congestive heart failure or a traumatic brain injury which would actually be called secondary Central Sleep Apnea because it is secondary to another problem. It can also occur due to extreme old age, or a “worn-out” heart (a pacemaker may be needed for this type of patient). You will see patients like this occasionally. Primary Central Sleep Apnea has no apparent cause but still results in an irregular breathing pattern. These patients are not necessarily good candidates for CPAP because their breathing problem may not involve an obstruction. If not, you will likely see an increase in the number or length of central apneas after placing them on CPAP. There are newer PAP technologies that have been developed in recent years that do have some effect on the regulation of these types of patients’ breathing pattern but may show limited success in extending life expectancy. The obstructive type of breathing disorders, on the other hand, do respond well to treatment. These will likely make up the vast majority of patients that you will encounter in the sleep laboratory. Refer to pages 476 and 481 for more detailed examples of these disorders. Central Disorders of Hypersomnolence If you break down the word “hypersomnia” into its root terms as you did in medical terminology, it should be apparent that these disorders involve excessive sleepiness. However, the excessive sleepiness cannot be the result of another class of disorder. If a patient has another such disorder, that disorder must be effectively treated before a diagnosis of hypersomnia not due to a sleep-related breathing disorder can be made. These patients may have nights of uninterrupted sleep, but they still have unintended or unwanted lapses into sleep during the day. There can be many different causes of this; some of which are very interesting. Narcolepsy and Kleine-Levin Syndrome fall into this category along with some neurologic or psychiatric disorders. Circadian Rhythm Sleep Disorder Circadian rhythm sleep disorders are sleep disorders related to the internal clock of the human body resulting in an irregular sleep-wake cycle. Patients with these sleep disorders have circadian rhythms that make it difficult for them to function in society. The three extrinsic circadian rhythm sleep disorders are the time zone change syndrome, shift work sleep disorder, and irregular sleep-wake pattern (secondary circadian rhythm disorders). Three intrinsic circadian rhythm sleep disorders are delayed sleep phase syndrome, advanced sleep phase syndrome, and non-24-hour sleep-wake disorder (primary circadian rhythm disorders). For Circadian Rhythm disorders, refer to page 482 of your textbook. Time Zone Change Syndrome (Jet Lag Syndrome): Jet lag is experienced as a result of eastward or westward jet travel, after crossing several time zones, disrupting synchronization between the body's inner clock and its external cues. Symptoms do not occur after north-south travel. jet lag symptoms consist of difficulty in maintaining sleep, frequent arousals, and excessive daytime somnolence. Delayed Sleep Phase Syndrome: The ICSD-2 defines delayed sleep phase syndrome (DSPS) as a condition in which a patient's major sleep episode is delayed in relation to a desired clock time. This delay causes symptoms of sleep-onset insomnia or difficulty awakening at the desired time. Typically, patients go to sleep late (between 2:00 am and 6:00 am) and awaken during late morning or afternoon hours (between 10:00 am and 2:00 pm). Patients cannot function normally in society due to disturbed sleep schedules. Patients may try hypnotic medications or alcohol in attempts to initiate sleep sooner. DSPS patients may be treated by the use of chronotherapy (intentionally delays sleep onset by 2-3 hours on successive days until the desired bedtime has been achieved) or phototherapy (exposure to bright light on awakening). Advanced Sleep Phase Syndrome: Advanced sleep phase syndrome is characterized by patients going to sleep in the early evening and wake up earlier than desired in the morning (2:00 am-4:00 am). Because the patients have early morning awakenings, they experience sleep disruption and daytime sleepiness if they don't go to sleep at early hours. ASPS is most commonly seen in elderly individuals. Diagnosis is based upon sleep logs and characteristic actigraphic recordings made over several days. Chronotherapy may be used to treat ASPS; however, this therapy is not as successful in ASPS as in DSPS. Bright light exposure in the evening has been successful in delaying sleep onset. Non-24-Hour Sleep-Wake Disorder: Also known as Non-entrained, free running, or hypernychthemeral syndrome, is a disorder characterized by a patient's inability to maintain a regular bedtime and a sleep onset that occurs at irregular hours. Patients display increases in the delay of sleep onset by approximately one hour per sleep-wake cycle, causing an eventual progression of sleep onset through the daytime hours and into the evening. These individuals fail to be entrained or synchronized by usual time cues such as sunlight or social activities. This disorder is extremely rare and is most often associated with blindness. Parasomnia The parasomnias are a class of sleep disorders associated with arousals, partial arousals, and sleep stage transitions. They are dysfunctions (including movements and behaviors) that are associated with sleep, or that occur during sleep. Most parasomnias occur during delta sleep or slow wave sleep, although some can occur during any stage. REM Behavior Disorder, Nightmare Disorder, and Recurrent Isolated Sleep Paralysis are also included in this group although they are all associated with REM sleep. Rem Behavior Disorder (RBD) may involve a very drastic or sometimes violent dream enactment. Approximately 88% of known cases are in males. Elderly patients (over the age of 60) make up a high percentage of known cases (60%). RBD is now considered to be a possible indication of a future neurodegenerative disease such as Parkinson’s. Around 50% of patients with REM parasomnias also have some type of central nervous system disorder, and almost 10% have a psychiatric disorder. The treatment for these disorders is usually limited to securing the environment, but can also include the prescription of clonazepam. Think of parasomnias as things that patients may also do while sleeping, excluding movement disorders (other than RBD) which used to be included in this category as well. Examples would be Night Terrors, Nightmares, Hallucinations, Sleepwalking, or Enuresis (bed-wetting), etc. Parasomnias are covered in your text book on pages 482 - 484. Sleep-Related Movement Disorders Bruxism: Bruxism (teeth grinding) occurs most commonly in individuals between ages 10 and 20 years and is commonly noted in children with mental retardation or cerebral palsy. Bruxism is noted most prominently during NREM stages I and II and REM sleep. Episodes are characterized by stereotypical tooth grinding and are often precipitated by anxiety, stress, and dental disease. Occasionally, familial cases have been described. Usually, no treatment is required, but in extreme cases, dental reconstruction and appliances such as mouth guards may be needed. Periodic Limb Movement Disorder: Periodic limb movement disorder (PLMD, or PLMS for Periodic Limb Movements in Sleep) is a common sleep disorder affecting approximately 34% of people over the age of 60 years. PLMD can be defined as repetitive, involuntary limb movements during sleep. These movements are seen mostly in stage II sleep, and not in REM sleep due to muscle atonia in REM. The criteria for the leg movements to qualify as PLMS, the leg movements must last from 0.5 seconds to 5 seconds in duration each, there must be a gap of 5 to 90 seconds between each one, and there must be a cluster of at least 4 of these movements. Symptoms of PLMS often include frequent EEG arousals, fragmented sleep architecture, daytime sleepiness, and a disturbed bed partner. Treatment of PLMS usually includes medications. However, if the leg movements are related to respiratory events, they usually disappear when the respiratory events are corrected via CPAP, BiPAP, dental appliances, etc. The most common medications used to treat PLMS include Clonazepam, Dopamine Agonists, Anticonvulsants, and Opiates. Restless Legs Syndrome: Restless Legs Syndrome (RLS) is a disorder that causes discomfort in the legs and an irresistible urge to move them. This scenario can occur while the patient is asleep or awake. Patients often describe this discomfort as an itching, crawling, or creeping sensation in their legs. RLS is a common disorder, and affects more than 5% of the total population. Most RLS patients begin having symptoms before the age of 20, and continue to have these symptoms throughout their lives. Most patients with RLS also have PLMS. The most common treatments for these disorders are medications, including benzodiazepines, dopamine, opiates, and alpha-adrenergic blockers. Nocturnal Leg Cramps: Nocturnal leg cramps are intensely painful sensations that are accompanied by muscle tightness occurring during sleep. These spasms usually last for a few seconds but sometimes persist for several minutes. Cramps during sleep are generally associated with awakening. Many normal individuals experience nocturnal leg cramps. Causes remain unknown. Local massage or movement of the limbs usually relieves the cramps. Rhythmic Movement Disorder: Rhythmic movement disorder occurs mostly in infants younger than 18 months of age, is occasionally associated with retardation, and is rarely familial. It is comprised of three characteristic movements: head rolling, headbanging, and body rocking. These episodes are usually not remembered once the person awakens. It affects approximately three times as many males as females. Treatment for rhythmic movement disorder usually includes behavior modification, benzodiazepines, and antidepressants. Rhythmic movement disorder is a benign condition, and usually, the patient outgrows the episodes. Other rhythmic movement disorders can be related to the use of a drug or substance, or to another medical condition. Isolated Symptoms, Apparently Normal Variants, and Unresolved Issues This category includes disorders that are borderline normal or are normal variants. These include such examples as long sleeper, short sleeper, hypnic jerks, and other types of twitching or jerking movements that may only occur at sleep onset or in newborns. You have probably seen someone display a hypnic jerk as they fell asleep, or you may have woken yourself jerking because you felt like you were falling. Things like snoring or sleep-talking could be included in this case if they are not causing symptoms of insomnia or excessive daytime sleepiness but are disturbing to the patient or other people. Other Sleep Disorders A diagnosis in this category gives the physician an option for when the diagnosis may not be clear or too unusual to clearly fit into one of the other categories. This diagnosis may often be used as a temporary diagnosis until the actual cause of the disorder is determined. Environmental Sleep Disorder could be something in the surrounding environment, such as a barking dog, that is disturbing the patient's sleep enough to cause symptoms. Appendix A: Sleep-Related Medical and Neurological Disorders This category includes disorders that sometimes occur unrelated to sleep, but are related to sleep in these cases. Examples are sleep-related epilepsy, headaches, Sleep-related Myocardial Ischemia, or gastroesophageal reflux. Fibromyalgia used to be included in this section. While fibromyalgia is not necessarily a disorder that is only related to sleep, it can cause arousals, or disruptions of the patient's sleep and is a common diagnosis of patients that you will see. Appendix B: Other Psychiatric/Behavioral Disorders Frequently Encountered in the Differential Diagnosis of Sleep Disorders This section includes mood disorders, anxiety disorders, schizophrenia, or any other psychiatric diagnosis that may affect the patient's quality of sleep. Therefore, you will also likely see patients who have been referred by a psychiatrist on occasions. Intrinsic and Extrinsic Sleep Disorders These are terms that were previously used to differentiate between disorders that originated from within the body and those that were caused by something in the outside environment. However, I think that you could still see these terms again, so I think it is a good idea for you to be familiar with this terminology. INTRINSIC DISORDERS Intrinsic disorders include various types of insomnia and restless legs syndrome. Narcolepsy and recurrent hypersomnia are disorders of excessive sleepiness. Hypersomnolence can also be caused by narcolepsy, apnea, sleep disordered breathing, or periodic limb movements in sleep. EXTRINSIC DISORDERS Extrinsic sleep disorders include those that originate or develop from causes outside the body. Some of these dyssomnias found within this category include: conditions of inadequate sleep hygiene, altitude insomnia, food allergy insomnia, nocturnal eating, limit-setting sleep disorder, and sleep-onset association disorder. Sleep apnea is a disorder that commonly afflicts more than 12 million people in the United States. The word apnea is of Greek origin and means "without breath." Patients diagnosed with sleep apnea will literally stop breathing numerous times while they are asleep. The apneas on average can last from ten seconds to longer than a minute. These events can occur hundreds of times during a single night of sleep. Obstructive sleep apnea (OSA) is the most common type of apnea found within the category of sleep disordered breathing. OSA is caused by a complete obstruction of the airway, while partial closure is referred to as a hypopnea. The hypopnea is characterized by slow, shallow breathing. There are three types of apneas: obstructive, central, and mixed. So, sleep disordered breathing may be due to an airway obstruction (OSA), an abnormality in the part of the brain that controls respiration (central sleep apnea), or a combination of both ( mixed sleep apnea). This lesson will concentrate on obstructive sleep apnea. OSA occurs in approximately two percent of women and four percent of men over the age of 35. Check out this video for a good example of an OSA patient: Sleep Apnea - Hard to Watch... (Links open in a new window. Right click on link and choose "open in a new window") Obstructive Sleep Apnea sufferers are not always the ones that you would expect. Check out this video of an Asian woman, especially near the end: Sleep Apnea Causes of Obstructive Sleep Apnea The exact cause of OSA is difficult to pinpoint. The site of obstruction in most patients is the soft palate, extending to the region at the base of the tongue. There are no rigid structures, such as cartilage or bone, in this area to hold the airway open. When a patient is awake, muscles in the region keep the passage open. However, a patient who tests positive for OSA will experience a collapsing of the airway when they are asleep. Thus, the obstruction occurs, and the patient awakens to open the airway. The arousal from sleep lasts only a few seconds, but brief arousals disrupt continuous sleep. When the sleep architecture is fragmented, the patient will be prevented from obtaining SWS and REM sleep ( these stages of sleep are needed by the body to replenish its strength ). Once normal breathing is restored, the person falls asleep only to repeat the cycle throughout the night. Typically, the frequency of waking episodes is somewhere between 10 and 60. A patient with severe OSA may have more than 100 waking episodes in a night of sleep. Often, the OSA patient will complain of nonrestorative sleep and excessive daytime sleepiness. Risk Factors The primary risk factor for OSA is excessive weight gain. The accumulation of fat on the sides of the upper airway causes it to become narrow and predisposed to closure when the muscles relax. Age is another prominent risk factor. Loss of muscle mass is a common occurrence associated with the aging process. If muscle mass decreases in the airway, it may be replaced with fat, leaving the airway narrow and soft. Men have a greater risk for OSA. Male hormones can cause structural changes in the upper airway. Below are other common predisposing factors associated with OSA: Anatomic abnormalities, such as a receding chin Enlarged tonsils and adenoids ( the main causes of OSA in children) Family history of OSA ( However, there has been no medically documented facts stating a generic inheritance pattern ) Use of alcohol and sedative drugs, which relax the musculature in the surrounding upper airway Smoking, which can cause inflammation, swelling, and narrowing of the upper airway Hypothyroidism, acromegaly, amyloidosis, vocal cord paralysis, post-polio syndrome, neuromuscular disorders, Marfan's syndrome, and Down syndrome Nasal and sinus congestion or problems Symptoms of OSA The nightly disruption and fragmentation of normal sleep architecture will cause the patient to experience the feeling of nonrestorative sleep. The most common complaint from someone who suffers from OSA is excessive daytime sleepiness (EDS) . The numerous disruptions and arousals will prevent the patient from obtaining a continuous deep sleep. Thus, the individual could also be prone to automobile accidents, personality changes, decreased memory, impotence, and depression. Patients are rarely aware or recall the frequent awakenings that occur following the obstructive episodes. EDS may be mild, moderate, or severe. Some patients will complain of falling asleep in a non stimulating environment, such as reading a book or a newspaper in a quiet room. Severe OSA patients may complain of falling asleep in a stimulating environment, such as during business meetings, eating, or casual conversation. One of the most dangerous scenarios is patients who suffer from OSA can fall asleep behind the wheel. Patients will often complain of feeling like they have not slept at all no matter of the length of time in bed. The same holds true for napping. Other indicators or symptoms of possible OSA include morning headaches and frequent urination during the night. Physical signs that coincides with characteristics of OSA patients include snoring, witnessed apneic episodes, and obesity. Not every individual who snores will test positive for OSA, but most patients who have OSA will snore with moderate to loud levels. Hypertension is prevalent in patients with OSA, although the exact relationship is unclear. It has been medically proven that treating OSA can significantly lower blood pressure. Complications The most prevalent complication for patients who suffer from OSA is a diminished quality of life due to chronic sleep deprivation and previous described symptoms. Coronary artery disease, cerebral vascular accidents (strokes), and congestive heart failure are being evaluated to define the exact nature of their connection to OSA. Still, it has documented that there is a relation between these complications and OSA. Obstructive sleep apnea aggravates congestive heart failure (CHF) by placing stress on the heart during sleep. Statistics show there is a high prevalence of OSA in patients with CHF. Central sleep apnea may be prominent in patients with CHF. Diagnosis The most universal method for diagnosing OSA is to have the patient undergo a sleep study. The technical name for the procedure is nocturnal polysomnograph. The first priority with any procedure is patient safety. A thorough analysis of the information gathered prior to beginning the test will give the technician an opportunity to determine the reason for testing, to verify all necessary monitoring parameters, and to determine the possible need for ancillary equipment. The technician must be aware of any precautions or special patient needs during testing. An understanding and knowledge of the signs, symptoms, and findings of a variety of sleep disorders and sleep related breathing disorders is necessary to ensure patient safety and recording requirements during polysomnography testing. Various medical problems will be encountered with the patients undergoing a sleep study. Examples of these complications include: asthma, COPD, cardiac arrhythmias, carbon dioxide narcosis, and abnormal breathing. Numerous cardiac arrhythmias may occur and they include: asystole, ventricular tachycardia or fibrillation, bigeminy, trigeminy, multi-focal PVC's, heart blocks, atrial fibrillation, bradycardia, or tachycardia associated with sleep apnea. Some of these cardiac arrhythmias are life threatening and require technician intervention. Others are relatively benign and require only that the technician watch the patient closely. Thus, all polysomnography technicians will be required to be certified in Basic Life Support. The polysomnography testing will include recording of multiple physiological parameters in sleep. These parameters usually include EEG, EKG, eye movements, respiration, muscle tone, body position, body movements, and oxygen saturation. The electroencephalogram (EEG) measures brain electrical activity. The brain activity during different stages of sleep as compared to wake is distinctly different. The electrooculogram (EOG) monitors eye movements and allows the examiner to determine REM sleep and wake. The electromyogram (EMG) monitors muscle tone, and the EMG helps to differentiate REM sleep from wake because the muscles relax to a state of paralysis in REM sleep. The electrocardiogram (EKG or ECG) monitors heart rate and graphs the electrical signal as it is conducted through the heart. Respiratory effort belts are placed around the patient's chest and abdomen to detect and record the rising and falling movements associated with respiration. A pulse oximeter is attached to the finger to record oxygen saturation levels in the blood. Leg leads or electrodes are attached to record leg movements which may determine the patient has periodic limb movement disorder. A thermistor is used to monitor breathing. Obstructive sleep apnea is diagnosed if the patient has an apnea/hypopnea index (AHI) of 5 or greater an hour. The respiratory disturbance index (RDI) is sometimes used in place of the AHI and essentially refers to the same data. However, in the recent past, RDI was an index that also included the number of respiratory effort related arousals(RERAS) per hour in addition to the hypopneas and apneas. Some sleep centers may still do this, but most are currently not scoring the RERAS due to non-coverage of insurance. An RDI from five to ten per hour would be a positive finding for OSA as well. Clinically speaking, an obstructive apnea is defined as a complete cessation of airflow for 10 seconds or more with persistent respiratory effort. An obstructive hypopnea is defined as a partial reduction in airflow of at least 30 percent followed by a drop in SaO2 of at least 3% or an arousal from sleep, or an alternate definition of 50 percent reduction in nasal pressure airflow signal followed by at least a 4% drop in SaO2(desaturation). Medicare still requires the 4% drop in SaO2 for their patients, but the first definition is recommended by the American Academy of Sleep currently. SaO2 refers to the amount of Oxygen in the blood being carried by the red blood cells. This will always drop when a patient stops breathing. The many physiological measurements taken usually enable the physician to diagnose or reasonably exclude OSA. Certain scenarios may prove a more difficult diagnosis. Such as, a patient who may have mild OSA at home, or only after using certain medications or alcohol but does not experience any episodes during the sleep study. Thus, the sleep study results must be interpreted with the entire clinical picture in mind. Another condition, called upper airway resistance syndrome, cannot be seen on polysomnography. This syndrome is characterized by repetitive arousals from sleep that probably result from increasing respiratory effort during narrowing of the upper airway. These patients suffer the same sleep disruption and deprivation as other sleep apnea patients. In such cases, the only alarming indicator that is recorded is the recurrent arousals. Ultimately, patients suffering from upper airway resistance syndrome may not test positive for OSA with standard polysomnography testing. Treatment A patient suffering from OSA has several treatment options that include: weight reduction, positional therapy, positive pressure therapy, surgical options, and oral appliances. Significant weight loss has shown tremendous improvement and possible elimination of OSA. The amount of weight a patient needs to lose to achieve noticeable benefits varies. However, one will not need to achieve "ideal body weight" to see improvement. Positional therapy is a method of treatment used to treat patients whose OSA is related to body positioning during sleep. A OSA patient who sleeps flat on their back, or in supine position, will experience worse symptoms in general. This type of therapy has its limits, but some patients have experienced benefits. Some of the strategic methods include: a sock filled with tennis balls is sewn into their shirt to make it uncomfortable for the sleeper to lie on their back, and positional pillows to assist in sleeping on their side. Positive pressure therapy is one of the most if not the best methods of treatment for obstructive sleep apnea. There are three different types of devices: continuous positive airway pressure (CPAP), autotitration, and bi-level positive airway pressure. CPAP, the more common of the three therapy modes, is the most prescribed method of treatment for OSA. A facial or nasal mask is worn by the patient while they sleep. The mask is connected to the CPAP machine with tubing. Positive air pressure is delivered from the machine to the mask and continues to the upper airways establishing a "pneumatic splint" that prevents collapsing of the airways. Autotitration devices are designed to provide the minimum necessary pressure at any given time and change that pressure as the needs of the patient change. Bi-level positive airway pressure differs from the CPAP by reducing the level of positive pressure upon exhalation. Oral appliances are another avenue a patient can try as a therapeutic device. Generally, there are two categories, mandibular advance devices and tongue-retaining devices. Mandibular advance devices are similar to athletic mouth guards. They differ in the mold for the lower teeth is advanced further forward than the mold for the upper teeth. This will cause the jawbone to remain forward and prevent the collapse of the airway. It is effective in mild cases of OSA, particularly if the patient's OSA is positional. Tongue-retaining devices also resemble an athletic mouth guard. It acts as a suction cup and is placed between the upper and lower teeth. The tongue is positioned forward and obstructions caused by the tongue should be minimized. First described in 1981, CPAP therapy has become the most preferred treatment for patients with OSA. CPAP flow generators or machines maintain a constant, controllable pressure to prevent blockage of the upper airway. The positive air pressure travels through the nostrils by a nasal or facial mask. This airflow holds the soft tissue of the uvula, palate, and pharyngeal tissue in the upper airway in position so the airway remains open while the patient progresses into deeper stages of sleep and REM sleep. The CPAP device can be described as a "pneumatic splint." Variations to the CPAP machine are available to help with compliance. BPAP, Bi-PAP or bi-level positive airway pressure is another option for treatment. Those three are one and the same. They are just different ways that you might see this term. The AASM guidelines uses "BPAP" in their protocol publications. BiPAP is a trademarked term by a company named Respironics. Anyway, most of the problems patients experience with CPAP are caused by having to exhale against a high airway pressure. Because the air pressure required to prevent respiratory obstruction is typically less on expiration than on inspiration, Bi-PAP machines are designed to detect when the patient is inhaling and exhaling and to reduce the pressure to a preset level on exhalation. Patients with severe OSA may require maximum levels of pressure to eliminate the obstructive apnea. Bi-PAP may be the chosen method of treatment with this scenario, and Bi-PAP may be used when the patient has more than one respiratory disorder. Regardless of the mechanism used, the goal of the technician should always be to titrate the machine to the lowest possible pressure to eradicate the sleep apnea. Each individual patient with OSA will present a different scenario for the attending polysomnography technician. The sleep study with positive airway pressure titration will need to achieve the optimal pressure for the specific patient. The sleep study with CPAP/Bi-PAP will show not only when the respiratory events have ceased, but also when the arousals from the respiratory events occur. The ultimate goal for the technician during a titration process is to achieve the minimal optimum pressure to eliminate all obstructive events and snoring during all stages of sleep and all body positions while sleeping. Compliance Mask fitting is an essential element of a patient's success with positive airway pressure therapy since it affects compliance and effectiveness of treatment. The higher pressures used during CPAP/Bi-PAP therapy can cause a significant air leak with the mask. The leak can also emerge from the patient's mouth if they are using a mask that doesn't cover the mouth. This can startle a new CPAP user. The leak can wake the patient from sleep. Thus, the mask stability is tested with higher pressures. Higher pressures may also require tighter head gear to maintain an adequate seal. Adversely, this will contribute to the discomfort from wearing the mask. When selecting a CPAP mask the following factors should be considered: comfort quality of air seal convenience quietness air venting CPAP/Bi-PAP machines are also available with humidity. Nasal congestion and dryness are very common complaints with positive airway pressure therapy. Humidification can also be heated. These features have proven to help with patient compliance. Ultimately, the biggest obstacle with compliance is getting patients to comply with their own treatment. Without the patient's willingness to use it, CPAP will not provide effective therapy. Studies have shown that CPAP compliance varies from approximately 65% to 85%. The bottom line for the patient to experience the benefits and relief of complaints is they must use the machine on a nightly basis. Information regarding the degree to which a patient is compliant with CPAP is essential for assessment of therapeutic impact. If problems persist after implementation of CPAP, the causes could include: delivery of insufficient pressure to maintain upper airway patency during sleep misdiagnosis of the etiology of the individual's symptoms failure to use the device for a sufficient duration on a regular basis Possible Side Effects The principal side effects with CPAP/Bi-PAP use include: contact dermatitis nasal congestion rhinorrhea dry eyes mouth leaks nose bleeds (rare) tympanic membrane rupture (very rare) chest pain aerophagia (the excessive swallowing of air, often resulting in belching) pneumoencephalitis (air in the brain, which is extremely rare, reported in a patient with a chronic cerebral spinal fluid leak) claustrophobia smothering sensation Actions can be taken to counteract some of the side effects. Nasal congestion or dryness often can be reduced or eliminated with nasal sprays or humidification. Rhinorrhea can be eliminated with nasal steroid sprays or ipratropium bromide nasal sprays. Epistaxis (nose bleeds) is usually due to dry mucosa and can be treated with humidification. Skin irritation can be combated with different mask materials. Dry eyes are usually caused by mask leaks and can be eliminated by changing to a better fitting mask. Attempts to reduce claustrophobic complaints have resulted in the patient using nasal pillows or prongs as opposed to the nasal or facial mask. Mouth leaks can be reduced or eliminated by using a chin strap. A small number of patients complain of chest pain or discomfort with CPAP use. This can probably be attributed to increased end-expiratory pressure and the consequent elevation of resting lung volume, which stretches wall muscles and cartilaginous structures. The resulting sensation that is created is due to chest wall pressure that persists through the hours of wakefulness. Any complaints of chest pain should always be taken seriously. However, if the complaint by the patient on CPAP proves to be nondiagnostic, Bi-PAP therapy may prove to be an option since expiratory pressure can be reduced. Sometimes it pays for the technologist to develop some psychological skills in order to convince the patient to use the device. I have found that a patient who doesn't seem to believe they need CPAP tends to change her/his mind when they see the data that shows him not breathing. Keep in mind that your patients can't see themselves sleep. They may also not be aware of all the possible complications of OSA down the road. Another area of concern for OSA patients using CPAP/BPAP devices is the negative effects on arterial blood gases and oxyhemoglobin saturation. Studies have reported severe oxyhemoglobin desaturation during nasal CPAP therapy in a hypercapnic (elevated levels of carbon dioxide in the blood) sleep apnea patients. Studies have also shown significant oxygen desaturations with CPAP administration with supplemental oxygen. The exact cause has yet to be determined. This occurrence may be due to the following factors: worsening hypoventilation related to the added mechanical impedance to ventilation associated with exhalation against increased pressure increased dead-space ventilation a decrease in venous return and cardiac output due to increased intrathoracic pressure during CPAP administration in patients with impaired right or left ventricular function and inadequate filling pressure One more possibility is when the optimal pressure setting has not been reached yet. Therefore, a ten second apnea may have turned into a 90 second hypopnea. The patient may not arouse from sleep as quickly to get a breath since the airway is not completely closing off as it was without therapy. This should improve once enough pressure is added, however. Despite the above scenarios and problematic experiences, CPAP/Bi-PAP administration has been reported to improve awake arterial blood gases in OSA patients with hypercapnia and cor pulmonale. Traditional and Evolving Methods of Initiating CPAP/BPAP Different methods have been established for implementation of positive airway pressure therapy. Traditionally, patients have undergone a technician attended PSG-monitored trial of CPAP. Split-night studies are now conducted more frequently. Home CPAP trials is another avenue that is being investigated. Use of predictive formulas to estimate or establish optimal level for CPAP therapy has been investigated. Each scenario has advantages and disadvantages. CPAP Therapy of Nonapneic SDB There are numerous documentations of patients with congestive heart failure (CHF) suffering from sleep-disordered breathing (SDB). Most often the respiratory events will be central in nature (no effort, brain not sending signal to breathe) resembling Cheyne-Stokes respiration (CSR). CSR is defined as a breathing pattern characterized by regular "crescendo-decrescendo" fluctuations in respiratory rate and tidal volume. The presence of SDB was associated with sleep-fragmentation and increased nocturnal hypoxemia. The conclusions from the findings are stated below: There is a high prevalence of daytime sleepiness in patients with CSR in conjunction with CHF. Patients with CHF who also have CSR have a higher mortality than patients who have CHF without CSR. CSR, AHI (apnea/hypopnea index), and the frequency of arousals were correlated with mortality. Furthermore, research has found CPAP has been noteworthy and effective on breathing in patients with CHF and CSR. The results of several studies showed an increase in cardiac output and stroke volume and a reduction in left ventricular wall tension during application of CPAP. The improvements seen in CHF patients with CSR regarding cardiac function during sleep is believed to carry over to wakefulness. Possible factors contributing to the improvements seen include: sleep-related reduction of left ventricular transmural pressure improved oxygenation during sleep reduced sympathetic nervous system activation during sleep CPAP machines have become a lot more sophisticated during the past decade. One of these updates is the ability of some machines to generate an algorithm that can predict the next breath of these central sleep apnea patients. These machines will adjust how much air is delivered during each breath based on this prediction. This has the effect of making the breathing pattern more consistent. You may see this denoted as Auto-SV, or servo-ventilation. We will talk about this more later, but I just wanted you to be aware that there are more sophisticated machines for patients with CHF and irregular breathing patterns that are not due to obstructions. Effects of Altitude Changes and Alcohol Consumption Older CPAP machines will not adjust to changes in altitude. As altitude increases, the older CPAP devices will deliver progressively lower than prescribed pressure. The more modern devices will detect altitude changes and make the appropriate adjustments. The polysomnography technician would benefit from information regarding a patient relocating from a high altitude location to lower altitude or vice versa if there are complaints of the CPAP therapy being nontherapeutic. Alcohol consumption can present further complications for a patient suffering from OSA. Alcohol suppresses the arousal response. The patient may experience a greater frequency and duration of apneas and hypopneas and increased snoring. Excessive alcohol use also increases sleep fragmentation. Taking a sedative can cause these effects to be imitated or exacerbated. Still, there are reports stating moderate alcohol consumption did not significantly alter the level of pressure required to eliminate the obstructive events. Nonetheless, OSA patients should avoid alcohol
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XX. Physical and Cognitive Changes 1. early adulthood: (18-30) a. reach physical peak: strongest, healthiest, and quickest reflexes b. physical decline is slow and gradual (usually unnoticed until late 20s) 1. possible explanations a. cells lose ability to repair themselves b. cells have preset biological clocks (limit ability to divide and multiply) 2. middle age (30-65) a. changes in appearance: grey and thinning hair, wrinkles b. sight difficulties (seeing in the distance) 3. old age (66+) a. muscles and fat begin to break down; lose weight and become shorter b. gradual or sudden loss of hearing c. reaction time slows Health Problems 1. some changes are natural others develop from disease, or lifestyle a. sensible eating, exercising, avoiding tobacco, drugs and alcohol will look and feel younger b. cancer, heart disease, and cirrhosis of the liver (encouraged by lifestyle) Marriage and Divorce 1. 90% of population will marry; 40-60% of new marriages end in divorce a. marriage success: how couples resolve conflicts & how often they share intimate and happy moments 1. arguments are constructive 2. arranged marriages are surprisingly successful Menopause and Sexual Behavior 1. menopause: the biological event in which a woman’s production of hormones is sharply reduced (usually between age of 45 & 50) a. woman stops ovulating and menstruating: conceiving children is no longer possible b. irritability and depression can develop (psychological origin) c. many women enjoy this stage (more confident, calmer, and freer) 2. sexual activity doesn’t decline with age Cognitive Changes 1. mid 20s: learning new skills and information, solving problems, and shifting problem solving strategies improves dramatically 2. 40s: peak of creativity and productivity 3. 50s-60s: peak in humanities (history, foreign languages, and literature) a person’s character and personality remain stable through the years A. Daniel Levinson’s Theory of Male Development (structures and transitions) 1. Early Adult Transition: 17-22 2. Entering the Adult World: 22-28 a. desire to explore the options of the adult world conflict with need to establish a stable life Age 30 transition: 28-33 a. reexamining life structure: occupation, marriage partner, life goals 4. Settling down: 33-40 a. “making it” & “becoming one’s own man” 5. Midlife transition: 40-45 a. “midlife crisis” Entering middle adulthood: 45-50 a. stability if transition was satisfactory 7. Midlife transition: 50-55 a. generativity: the desire, in middle age, to use one’s accumulated wisdom to guide future generations b. stagnation: a discontinuation of development and a desire to recapture the past Culmination of middle adulthood: 55-60 9. Late adult transition: 60-65 10. Late adulthood: 65-70 Female Development 1. women often face the same challenges as males a. 58% of adult women work outside the home 2. women generally don’t have a midlife crisis a. some women see period as a challenge after starting a family first 3. last child leaving home a. usually only traumatic if paired with an unstable marriage 4. depression is common among middle-aged women a. loss of role as mother, daughter, and wife Changes that Come with Aging 1. decremental model of aging: idea that progressive physical and mental decline are inevitable with age a. view is unrealistic b. ageism: prejudice or discrimination against the elderly Misconceptions a. the elderly rarely suffer from poor health, rarely live in poverty, and are rarely victims of crime b. the elderly rarely withdraw from life c. the elderly are rarely inflexible or senile Changes in Health 1. good health in adulthood carries over into old age 2. 80% of elderly have at least one chronic disease a. heart disease, stroke, cancer, diabetes, and arthritis 3. 65-74 year olds: 80% believe health is good 4. 75+: 72% believe health is good 5. quality of care is inferior to that of the general population a. 4% of elderly population live in nursing homes Changes in Life Situation 1. transitions in late adulthood a. 41% of women and 13% of men 65+ are widowed b. 60% of women and 22% of men 75+ are without a spouse 2. more elderly are spending time learning and developing new skills C. Changes in Sexual Activity 1. the best predictor of future behavior is past behavior Adjusting to Old Age 1. a negative self-concept results from: a. changes in health, recognition in the community, rare visits from family and friends, respect of privacy, leisure and work activities b. loss of physical control 2. assertive personalities cope better 3. AARP: speak out about social issues that affect the elderly there is much less decline in intelligence and memory than assumed 2. crystalized intelligence: the ability to use accumulated knowledge and learning in appropriate situations (increases with age) 3. fluid intelligence: the ability to solve abstract relational problems and to generate new hypotheses (decreases as nervous system declines) Dementia: decreases in mental abilities, which can be experienced by some people in old age 1. memory loss, forgetfulness, disorientation of time and place, decline in ability to think, impaired attention, altered personality 2. is not a normal part of normal development Alzheimer’s Disease: a condition that destroys a person’s ability to think, remember, relate to others, and care for herself or himself 1. 4.5 million have disease in U.S. 2. 6th leading cause of death among U.S. adults 3. most often leads to a weakened state that leads to fatal problems 4. causes are not completely understood and there is currently no cure Approaching Death 1. death is a culturally and emotionally confusing and complex process A. Stages of Dying 1. thanatology: the study of dying and death Elisabeth Kubler-Ross: studied how the terminally ill react to their impending death a. denial: “no it can’t be happening to me” 1. often leads to individuals avoiding treatment b. anger: “Why me?” 1. often alienate themselves from others c. bargaining: changing of attitudes combined with bargaining d. depression: begin contemplating the losses that are coming e. acceptance: often experience a sense of calm Making Adjustments 1. Camille Wortman theorized that Kubler-Ross’s stages were just the five most common styles of dealing with death 2. how should we deal with the impending death of others a. provide opportunities for the dying to have respect, dignity and self-confidence b. open communication about dying process and legal and financial issues c. avoid judgments concerning grieving of others the contemporary population is mostly insulated from death 2. life expectancy is much longer today and most people no longer die at home A. Hospice Care 1. hospice: a facility designed to care for the special needs of the dying a. goal is to create the most home-like environment where pain management can be provided b. home-based hospice care is now more frequently used than inpatient Dealing with Grief 1. John Bowlby: grief-based attachment research a. shock and numbness 1. can last several hours or weeks b. yearning and searching 1. grievers often isolate themselves 2. guilt and anger can manifest in this stage 3. may last for several months John Bowbly: disorientation and disorganization 1. depression can manifest 2. new reality becomes very confusing d. reorganization and resolution 1. griever overcomes feeling of isolation Pavlov’s Dogs 1. classical conditioning: a learning procedure in which associations are made between a neutral stimulus and an unconditioned stimulus a. attaching an old prompt or stimulus to a new prompt or stimulus 2. neutral stimulus (N): a stimulus that does not initially elicit any part of an unconditioned response a. sound of tuning fork (Pavlov’s experiment) 3. unconditioned stimulus (US): an event that elicits a certain predictable response typically without previous training a. food (Pavlov’s experiment) 4. unconditioned response (UR): an organism’s automatic (or natural) reaction to a stimulus a. salivation (Pavlov’s experiment) 5. conditioned stimulus (CS): a once-neutral event that elicits a given response after a period of training in which it has been paired with an unconditioned stimulus 6. conditioned response (CR): the learned reaction to a conditioned stimulus A. Acquisition 1. gradually occurs every time a N/US is paired with a UR/CR 2. best timing is when the N is presented just before an US (.5 seconds) B. Generalization and Discrimination 1. generalization: responding similarly to a range of similar stimuli a. Pavlov taught dog to respond to a circle; dog would respond to other figures 2. discrimination: the ability to respond differently to similar but distinct stimuli a. Pavlov proved by never pairing the food with the oval Extinction and Spontaneous Recovery 1. extinction: the gradual disappearance of a conditioned response when the conditioned stimulus is repeatedly presented without the unconditioned stimulus a. Pavlov stopped giving food after sound of tuning fork 2. spontaneous recovery: when a CR reappears when a CS occurs without a US John Watson & Rosalie Rayner: the case of Little Albert a. explored the relationship between classical conditioning and emotional responses b. trained 11-month old Albert to fear lab rat c. Rat (NS) + loud sound (US) => fear (UR) Hobart & Mollie Mowrer 1938 study a. developed a bed-wetting alarm to awaken children as they begin to wet bed b. Full bladder (NS) + Alarm (UCS) => Awaken (UCR) Taste Aversions 1. develop after illness follows dining experience a. usually connected to new food even when other food was eaten John Garcia & R.A. Koelling 1. Rats (A) shocked after drinking flavored water paired with flashing lights and clicking sounds a. rats developed an aversion to the lights/sounds 2. Rats (B) injected with drug activated by drinking water (led to upset stomach) a. rats developed an aversion to the taste of the water c. used to condition coyotes to hate the taste of sheep Behaviorism 1. classical conditioning is a great example of behaviorist theory a. behaviorist study behaviors that can be observed and measured; not unobservable mental activity Reinforcement 1. operant conditioning: learning in which a certain action is reinforced or punished, resulting in corresponding increases or decreases in occurrence a. participant must be actively involved 1. classically conditioned organisms are passive participants Positive and Negative Reinforcement 1. B.F. Skinner: trained rats to respond to lights and sounds (Skinner Box) 2. reinforcement: stimulus or event that follows a response and increases the likelihood that the response will be repeated positive reinforcement: adding something desirable after a behavior occurs 1. food (Skinner Box), social approval, money, extra privileges b. negative reinforcement: removal of something undesirable after a behavior occurs 1. changing a smoke alarm battery, buckling seatbelt, use of an umbrella Primary and Secondary Reinforcers 1. primary reinforcer: stimulus that is naturally rewarding, such as food or water 2. secondary reinforcer: stimulus such as money that becomes rewarding through its link with a primary reinforcer a. Wolfe experiment 1936 (Chimpanzees) b. money is best example Schedules of Reinforcement 1. continuous schedule: reinforcing behavior every time it occurs 2. partial schedule: positive reinforcement occurs sporadically a. acquired behaviors are more slowly established but are more persistent 1. discovered when the Skinner Box kept breaking down ratio schedules: reinforcement based on the number of responses 1. fixed-ratio: reinforcement depends on specified quantity of responses a. most consumer loyalty punch cards 2. variable-ratio: reinforcement after varying number of responses a. slot machines, door to door sales, telemarketing 1. very resistant to extinction interval schedules: reinforcement occurs after an amount of time elapses 1. fixed-interval: reinforcement of first response after a fixed amount of time has passed a. salaries, cramming for tests 2. variable-interval: reinforcement of the first response after varying amounts of time a. fishing, pop quizzes 1. very resistant to extinction shaping: technique in which the desired behavior is “molded” by first rewarding any act similar to that behavior and then requiring ever-closer approximations to the desired behavior before giving the reward 1. flag-raising rat a. reinforce rat for approaching flagpole b. reinforce after rat raises paw while near flagpole c. reinforce after rat gets on hind legs while near flagpole d. reinforce after rat nibbles at cord while on hind legs Combining Responses: Chaining 1. response chains: learned reactions that follow one another in sequence, each reaction producing the signal for the next a. complex skill of swimming involves organizing large response chains 1. arm stroke chain, breathing chain, leg kick chain Aversive Control: process of influencing behavior by means of unpleasant stimuli completed through use of negative reinforcers or punishers A. Negative Reinforcement: increasing the strength of a given response by removing or preventing a painful stimulus when the response occurs 1. escape conditioning: training of an organism to remove or terminate an unpleasant stimulus a. parents removing an unpleasant meal when child whines and gags while eating avoidance conditioning: training of an organism to respond so as to prevent the occurrence of an unpleasant stimulus a. parents deciding against presenting an unpleasant circumstance because child whines at the possibility Punishment 1. leads to the removal or reduction of behavior 2. must be unpleasant to work a. some reprimands may actually serve as reinforcers 3. positive punishment: adding unpleasant circumstances 4. negative punishment: removal of pleasant circumstances Disadvantages of Punishment 1. can produce rage, aggression, and fear in children 2. spanking can lead to increased aggression toward other children 3. can lead to children avoiding person who punishes 4. fails to teach appropriate and acceptable behavior Cognitive Learning 1. social learning: process of altering behavior by observing and imitating the behavior of others a. learning goes beyond mechanical responses to stimuli or reinforcement 2. cognitive learning: form of altering behavior that involves mental processes and may result from observation or imitation Latent Learning and Cognitive Maps 1. Wolfgang Kohler: chimpanzee study on insight 2. Edward Tolman: rat study on cognitive maps and latent learning a. cognitive map: a mental picture of spatial relationships or relationships between events b. latent learning: alteration of a behavioral tendency that is not demonstrated by an immediate, observable change in behavior Learned Helplessness: condition in which repeated attempts to control a situation fail, resulting in the belief that the situation is uncontrollable 1. college students/noise study 2. Martin Seligman Theory a. stop trying b. lower self-esteem c. depression ensues Modeling: learning by imitating others; copying behavior mimicry: performing old, established responses that we might not be using at the time. 2. observational learning: learning to perform a behavior after watching others perform it a. Albert Bandura: Bobo doll experiment 3. disinhibition: the increased likelihood a behavior will be repeated when observed behavior is not punished a. often used to alleviate phobias the systematic application of learning principles to change people’s actions or feelings A. Computer-Assisted Instruction 1. S.L. Pressey (1933) & B.F. Skinner (1950s) a. program that uses reinforcement (new information, choices, or point rewards) each time a student shows they learned something new b. program builds on information student has already mastered Token Economics 1. token economy: conditioning in which desirable behavior is reinforced with valueless objects, which can be accumulated and exchanged for valued rewards a. used in schools, prisons, mental hospitals, and halfway houses Self-Control 1. having people set up personal systems of rewards and punishments to shape their own thoughts and actions a. define the problem b. track the behavior c. set up a behavioral contract Improving Your Study Habits 1. progressively increase study quotas (successive approximations) a. remove conditioned aversive stimuli adjust to change or alter in order to fit or conform adapt A changing to fit new conditions menopause the biological event in which a woman's production of sex hormones is sharply reduced generativity the desire, in middle age, to use one's accumulated wisdom to guide future generations stagnation a discontinuation of development and a desire to recapture the past function the ability to achieve his or her goals within him or her self and the external environment. It includes an individual's behavior, emotion, social skills, and overall mental health assumed accepted as real or true without proof decremental model of aging idea that progressive physical and mental decline are inevitable with age ageism prejudice or discrimination against the elderly dementia decreases in mental abilities, which can be experienced by some people in old age Alzheimer's disease a condition that destroys a person's ability to think, remember, relate to others, and care for herself or himself component A part or element of a larger whole. isolating causing one to feel alone thanatology the study of death and dying hospice a facility designed to care for the special needs of the dying classical conditioning a learning procedure in which associations are made between a neutral stimulus and an unconditioned stimulus neural stimulus a stimulus that does not initially elicit any part of an unconditioned response unconditioned stimulus an event that elicits a certain predictable response typically without previous training unconditioned response an organism's automatic (or natural) reaction to a stimulus conditioned stimulus a once-neutral event that elicits a given response after a period of training in which it has been paired with an unconditioned stimulus conditioned response the learned reaction to a conditioned stimulus generalization responding similarly to a range of similar stimuli discrimination the ability to respond differently to similar but distinct stimuli extinction the gradual disappearance of a conditioned response when the conditioned stimulus is repeatedly presented without the unconditioned stimulus operant conditioning learning in which a certain action is reinforced or punished, resulting in corresponding increases or decreases in occurrence reinforcement stimulus or event that follows a response and increases the likelihood that the response will be repeated secondary reinforcer stimulus such as money that becomes rewarding through its link with a primary reinforce primary reinforcer stimulus that is naturally rewarding, such as food or water shaping technique in which the desired behavior is "molded" by first rewarding any act similar to that behavior and then requiring ever-closer approximations to the desired behavior before giving the reward response chain learned reactions that follow one another in sequence, each reaction producing the signal for the next aversive control process of influencing behavior by means of unpleasant stimuli negative reinforcement increasing the strength of a given response by removing or preventing a painful stimulus when the response occurs escape conditioning training of an organism to remove or terminate an unpleasant stimulus avoidance conditioning training of an organism to respond so as to prevent the occurrence of an unpleasant stimulus social learning process of altering behavior by observing and imitating the behavior of others cognitive learning form of altering behavior that involves mental processes and may result from observation or imitation cognitive map a mental picture of spatial relationships or relationships between events latent learning alteration of a behavioral tendency that is not demonstrated by an immediate, observable change in behavior learned helplessness condition in which repeated attempts to control a situation fail, resulting in the belief that the situation is uncontrollable modeling learning by imitating others; copying behavior token economy conditioning in which desirable behavior is reinforced with valueless objects, which can be accumulated and exchanged for valued rewards
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than that I'nique. I think I would write a name and we cross the rental for past at do period, so like, it is us out of taking off or dealing with all of the logistics, so far, um you are still kind of getting devil or have anything else to figure out on terms of uh, just a piece adistration, conferences, anything else, uh, as usual, um, just, act and lecture or send me an email there's a few little things that I still working out, but hopefully to get settled for all of you. Um, last thing you just wanna say, thank you for your first discussion of us. They were just like specialasure read and, like, showed me how many different ways you're all being with us novel uh, and I now I like, oh, I wish you had another hour. I'm talking with this one. keep talking about it? um but we'll definitely touch on one of the things that you read in your post. today and when, um next week we're moving on to another reading, but we'll have your first conferences and that'll be a chance to talk about that kid's reading by all that really everything that we've discussed so far, so pull on to you all of these ideas that you're having. Okay, um, so today, we're gonna be a no happening, we're gonna talk about some of theorical contacts that can have us understand passing, like what's happening in the novel. Uh, and then we're gonna die further into the text of acting of what Laren is doing with this concept ofaba. Um, first, I just wanted to briefly touch on something that Irene referended in the novel, but that in this outside, it'sersen, using a novel so it references Comicorn, a little piece of history. We have I read thinking at one point, when she's worrying about Claire and correct and she's becoming, uh, and the problem of playing becomes three of her husband Rob, said, what is Luc there? He, was under eight the eight, uh, at the time that Larson was writing, passing, the rhyler case was sort of like a recent new sensation or almost like a celebrity spectacle in New York City. um, and the reason that Irene refers to it in the novel is because of the he centered around a white man who is married to a black woman who could pass her wife. uh, and the question in the rhyment her face was was she has, or did her husband, in fact, already know that she would lack? Uh, I was had like a little brief synopsis of this thing, and they' li. uh up on my versus if you wanted to read more about this soon. a fascinating story. So, in 1921, a wealthy young white man named Kit Reinellander, met Alice Jones, who was working class an racial black women. Rein Linder, the ris guy only, did not like this relationship. the two elopes in 1924, and soon after, because Bryander was part of this aristocratic family, uh, the news paint it up and published a story titled Bradland's son, and Mary is the daughter of a color name. and this led to his father finding out about the marriage and forcing his son to file for an annullment, uh, and then there were all these purpose meetings that began. And in this suit, Kitinlanders side attempted to prove that Alice had to defauded Kit using sex to gain access to hisalth. And social position. um, and then this became, as I said, kind of a big news story and cultural identity that because the right of her family was sort of celebrated being of family and because there were so many intimate details here in the court in the news about their marriage and also about Alex, um and this currently pretty preceding into all. Alice, for her side, I had been single case. She admitted to be black and she insisted that Kip had been aware of it. um and in the end, some surprisingly for the moment of by the court decided in Alice's favor and three, that KI had actually known of her blackness all along, so he was not the victim of any thought. In this case, he was not at the woman who wasying about being white. It was her husband lying about his knowledge about it. And so this is like just another variation of all these birds, like convoluted situations that arose in the midst of the American conception with the color line with racial purity and with racial power. and this is like, you just like another piece of helpful background as we head back into the novel of our characters, um, in our case, player is passing the way, and her husband, John, as far as we know, up to a point, does not have any clue that clear is black. Um, and even though this is the setup, Larsen does something to sort of what, electrify us early on, when she sets the scene with strong balloon and drink the roof and the dressingla this web. Hello, was John's reading player. Um, and I' using that that meansalonate, he's using probably obviously a variation of a regial slarity and word, right? And so this immediately creates like, great confusion for Ine and perjury who are sitting there. uh, and Claire and quickly has to explain why husband is calling you that. Her black eyes let her down. Tell them here, why you call me eyes. The man chuckled, make up his eyes, not I madeless compelled acknowledgepleasantly. He explained, well, you see, it like this, when the first married she was white as well as white as a lily. But I did lay she's getting darker and darker. I tell her if she don't look out, she'll wake up one of these days and find she her and with Edward. Heared with laughter. Claire' ringing bell light laughing his then a little later on. My goodness Jack, what difference would it make it after all these years, you were to find out that I was more than she present color. The put out his hand and refudiating flame definite and final. Oh, no, he declared, nothing like that with me. I know you known, so far right, you can get that slack as you please as far as I concerned, since I know you no. I draw the line back, the open pen words in my family ever happen and never will. Okay, how does our protagonist Irene experience this scene and how does she feel watching it? Yes.. There's. I couldn't. She's sitting at the TV party, you just kind of watching me not even even a while, put the most. But I it upset me, she doesn't know if she can speak up without real very nature. Yes, so she's like having to her appearance, like like looking around and deep confusion and disments. down because like the translated almost like half rest and comments that Cla Gertrude pick up on because the three of them are passing, and you can kind of tell that Claire has a lost experience with it has a conversation because she had she handles it a lot better than Irene does, um, and yeah, if you see all this in totalal turmoil and it keeps out a little bit in intercom conversations. Yes, right, so you trying to be her cool, but they're always like it is irrepressibleomas the sense of way, what the hell is happening here in player like aA... Claire husband to explain why would she bring up that conversation in the I? If she, oh, my husband has absolutely no idea. just for me.ger to know that idea. Why folks think? Why? Why will 30 this? There so many different ideas? few folks in the French? What are you things are? why in the read I Pandora. And all the soation and friends or what we actually. there' exposition to us a reader and to having. Yes, okay, so right, so she's like doing this like to them, like, there is there is a context here for this. Okay, there's a lot of kids and I go, here, here, maybe just go there.. as well. I is trying up all theoth or like making joke from the. because people aren has that beatified for her because she spent all this time for this performance and. And now she does advantage of this route. she work in. Yes. making a joke of her husband, right? why would she create this situation to begin with? so there's a way in which, like, there are different audiences and she created an audience to watch it un full.. sounds like, I g said, oh, you should spot, you know, uh, fire, you layer in my one pass the approaches it is like, you know, those, you don't know, but whatever really you can dola is, so it's like almost like red flag or alarms or something like battery knock and probably at me like, oh my God, like they kind of like on the closed and like my love. They're like email and they like not, everything that happens to Claire because they share this identity, that it's all black men who are can't ask for life, like anything that happening, it is like, immediately there's an implication of what this means for the other in characters. Yes. all this field are sheets like player? because um, like the she wants sitting for a her, our players trying for. and the other player wants to like more hard I his life. um, and it it feels like he's like giving a little taste like this is time, whatever med. So, like, why don't you let me your like a little more psychling real life? Yes, right, so there in which, like, maybe she showing up and like, making a joke at these I' heard a thing that there's another way she's like look at my situation, like this I live in I, uh, but it's both, right, at the same time... This is my back that. I contin what as I Yes, right. She's doing this like dance and shifting the position, uh, by by creating this and this is really dangerous essentially situation, um and and letting her friends in on it. Um, and there is this sense, right that there is, you know, danger in the scene, there is ultimately something that disturbing, but one of the involved is that I may not progress is like this this knowing lap, right? that kind of comes over earth room too, um, because there's something absurd about watching the scene, um, at one point, like Irene's lips trembled almost arm full of, but she made a desperate effort to fight after disastrider laugh and succeeded, um, and then jumped down a little bit, she's looking at her from grocery clear littleressed down a for a. I mean wish there was brief size through she feared by her self comprolled thatiled toridge for her notating anger and in that indignation. So there's like laughter and there's anger and indignation. She had a weepingiety to shout at the manip her and you're sitting here surrounded by three black devils during the teeth. So it does seem, right? that there's a joke and on notolute. He is awake and he is so sure that he would never have a black person in his family or in his house, but in reality, he is sitting there and has a black life, he has the black daughter, and there are two other black men sitting in the are and yet, they all of these women that are just referred to, player, Irene, recru, and and Claara Marjorie, all look white. How are they black? you can turn off, right. Okay, so there's sense in which a appearance is not the only way in which raises being decided, right? That becomes very clear. You can look at way as player and somehow collect Yes. you know, like like slide when you have a conversation down with the blue and it said, like, oh, and players said, what I was large, you color. And he says, well, you know, like, that's not simply means I never not that. So it's not even having, like, that like, DNA more like, you know, that like, it's the not even like it's I I don't even know like what definition is anymore because documentaries is not about, you know, having the access here, you not having that, what countries like, oh, I don't care about how you look, I don't care about you know, what's what's your ancest, you like be somebody else and something like. Yeah, it's really confusing.ired it just that John Lulu by being away, he's so sure he would go, right? There was no way she was getting away with the one or two percent colors in this case, uh, right? Um, but something weird is going on with this definition. two are men and then weonse yet. I think we need lots of different maybe people compared to the John tell the version of of push of the media of excuses. So I think with the women is that someoundaries, here, um the and also I mean for help uh, like, that their response to the outage show and how Yeah, right there are like, so many different ways that race is playing has an identity, but also have like a legal construction and also as a maybe like cartoon characteristic of what blackness is.. I don't know for what like one rule decide, um, who who wasn't? One, but under the law, there was the more, where ne the color lion have already in identities that forces you into one or the other. Yes, so this is exactly where we're headed. This is the streaming I understand, yet how he got to this place in the 1920s, where there are three white open women and all of them are apparently black. In the 1920s, this idea that right even just a tiny percentage of black ancestry made a person black um was part of a law, right? So that is happening in all of these acts were regional integrity acts laws that are prostating American deceased, uh, including in 1984 in Virginia, uh laws like the Virginia racial Integrity act outlawedational marriage and defined a white person as someone who has no pri whatsoever of any one whether than not. Right? And what is that that talk about? Um, and then there are other laws that defined lackers that owned with any trace, right? It could be, 116, uh, a black ancestry remain on. At least kind of law were as they said, white friend across the US and they also extended our back into American history street, one of the first laws that to do this work of criminalizing racial effect on the marriage, uh and defining ways by this strange formula heredity was in 1652 in a specular event. Um we often think about race as something visible, and in any case, it was a uh, but here, right we're seeing that the in terms of the law, uh, we'reology with very technical, legal, and then often invisible ideas of race and of blackness. My question is, and this has already come out a little bit irresponses, but why would Americans come up with such a thing convoluted and frame and specific and some type invisible concepts of race? I? Okay, this is funny back to Elizabeth comment, right? This has to do with the history of Americans labvery. So to answer the session, we're going on a little detour as we as do, as that how my minders. Um, we're going to go back a little bit and think about American slavery and how it works as a racial and social system. Slavery created generations and generations of makes people because, despite all of this talk about the rigid color line, slaveholders systematically crossed. I said on Wednesday that Frosted season on Monday, that Crossing the color line, especially in terms of sexual relationships, what is dangerous and needed as that is true for lacking and sometimes for, and afterately we waited, put and did allwise really violently and systematically. What did this look like? In active events that slaveholders were continuallyaping and they sexual violence was an endemic feature of the system of American slavery. It was not a random event that I approved in some cases of kind. it was a structural part of the system of American slavery. And this kind of knew that sexual violence often led to the murder of a rac children. So when these children were born, they were not considered by their fathers to be their children, they were considered to be their properties, right? Because their mothers then laid those children were and his laid. So imagine as it is a you know, 300 plus year mystery of slavery at there time generations and generations of people who were enslaved and considered to be black, but who look more and more white. This can be really hard to visualize the fact because I need the race, like they shift in different comments, they' shipped at time, we have pretty visual idea of race in the present. Uh, but this these photos for me of us a little bit to understand this. um all of the children in these two photographs were bored into slavery and all of them are considered property and all of that were consideringat. But probably to our eyes, only one of these children as looks black. So when these image of showing us is, again, like a strangeness of racing America. It's really like the fiction of race, of problems of race. We have this idea of rigid color line and then we have this social world that totally always by it. It is like a central problemating America, and it is at part of our 20th as. But it is also at the heart of the first ever African American novelot. Closelle for private's daughter, and they are mostly life was published by a for Lady author William Wells Brown in the 1856, of Phil during safety. um, and it again, at the the first factor all, this very clearly had aitional novel. It's a novel, it's written, it's a perfect of showingagos sla reading the need to project. Uh, the fact that this is the first act there in novel is a good reminder for us that novels, whether they are written by our Americans or by other groups, have not really miss it. Novels are enired or so story different from the literature, how all existed, but novels did not become kind of a cohereric form of that are literature, uh of writing until about the 18th century in Western European culture and then they started to become a major feature of Western European culture, cultureuring art aircraft the 19th century. and writing novels have is like longer durraysans in which histori can take place, and there' group or multiple different kind of stories. This is not super important about us today we're gonna come back see the conduct a lot of this then. but uh this is an important for sit situation in the 20th century where novels aren't one important for getting this little detour we taking the 19th century. Okay. back tootap. Uh, what I said is for novel and it takes up this problem of race and the problem of passing as central issue. Um Some of you here a red hotels and you know that it's like, a very convoluted and melodramatic story. um so we're not gonna do aopsis of this if you're curious, go recoel. um, but it's not that if we' for our course. I just wanna briefly introduce you to a central character in enslaved woman name hotel. This isotel as sheears about your soul. The appearance of Plotel on oct in deep sensation amongst the crow. There she stood in the complexion as light as most of those who are waiting with the wish shouldn' not referisers. The auctionireized by saying that Miss Futel had been observed for the last because she was the most valuable. how much, generally? Well, we're m meant to understand here is that, first of all, the towels of white, that is that the hotel is specially valuable because she looks like, and third, that this value attached to looking weight is sexualized, right? We get this very congestive how less g with it. Um, and this idea that played women were lighter reflection, including white acting, had special sexual values, um, was, again, a feature of this is of American slavery. Because of her lacis and also the other values white and, uh, she is persecuted across this o, which leads to a fact and laborer. She attempts to esclavery, that she gets caught and rather than go back to her factors, she chooses to to wep off the bridge for herck. So this is an illustration of that. This is like hotels weep ack. What did you with this? You might be at the Dr. D NOR. This week in the context of hot is morally righteous, right? She sort of a thing here. The cause of her death is slavery and her choice to die is, as I said, morally righteous, because it's protesting againstly and that means that within the context of the 19th century acad abolitionist dog. Uh, we can get a little bit of this, um, just from the way that lay brown wrote this right. There's no hope for aake for her down the passage. Her resolution was taken. She clasped her hands convulsively and raised them as she, at the same time raised her eyes for its heaven and begged for that mercy and compassion there, which had been denied her on earth, and then, with a single bound, she vaulted over the railings of the bridge and subbed forever beneath the ways of the river, thus died lowau. Okay. So this is a little bit of backstory and literary history that's going to help us understand where we are in our novel and how it ends. And we'll just say briefly that this is not the only novel that our literature that keeps up these issues of acid um, where a lot of really important and central novels of early actingary literature that do this, asking is one of them and then we're gonna read another one about to meet laugh more. This is all behind Ella Larson as she writing happy, and she is engaging with this literary history, but she's also complicating the story, right? I read Redfield and Cla Henry are not martyr characters by any right, the problems that they have are not only caused by outside forces. They have also caused by an own desires and wait. So, rather than writing a novel where black womenomes sort of like the vehicles for explloring an issue like slavery or race or racism. Larsen makes race and racism and passing into a being able or even like a backdrop or exploring black women, and their interiority. and they are desired potentially needed their fear, their anger, and and then ultimately their violence. We see both of these characters, sorry out, but what they are to each other and stay the missions, right? I read in the black world, players in the white, but over time their divisions were like he in by one another. um, andir, at least from our perspective, is getting too close, right? Irene, um, on getting rid of player. So, how does this like, break down in start from thisantingopter in and we talked about on Monday, there's thisensive great attraction in the beginning atoration and the sense that Irene was kind of like, not resist the thrall of player, but at some point in the novel, I mean starts to feel differently, and she becomes ultimately to consumed by Claire as a problem. Where are some of the scen that we start to see this happen for uh yeah, where are some of the turning points in the novel where he gets this ri.t. and I think this happened like somebody to going out, like not a highly lot, but you laugh and youulated things how much else if they really doing without me without. I mean, she like, you know, she's so over on cat I, and then was. Yes, right. So, at some point around an invitation that she wasn't part of, Irene begins to believe that there's a fair. But she have evidence of this fair as what I agree, and then also, we have beers like, do we have of an affair, what what did you think about? like, the truth or reality of theear? I kind of interpreted Irena's a bit of an unreliable narrator. It felt like she was telling them story that had already happened. So maybe her act of the end of the novel influences how she's remembering things and trying to justify why she would have pushed a clear in the end. So she's looking at her while they laughed at each other, so that was a sign and when she's at the party and few kind of corroborates how she feels, you see a little bit more about unreliable narrator or what that means to feel? Um when they're presenting things with objective, but their emotions and personality are actually shaping, what what evidence that preventing you and what descriptors they're using?, that's a really good way of it, so we have she is she's basically our in the sense that like she's the as we've talked about, but the character of his perspective, we're really close to. um and we start to have a approx novel see that there is like a discrepancy between her internal thought process and what is available to us as what evidence of what's happening outside of her, um and so the more and more we start to see that, like we have a little bit alienated from Irene, uh, and so, right, the reality of any of her statements, um, have comes into some question. um, so we don't necessarily know what this affair was um, other than what Irene either think it was or justified the FDA. Yeah. kind of operating? he was maybe for a bit, but I think last class mentioned how she really called Claire beautiful. and how now is that Ryan is somewhat clear and not much evidence of a ware, but maybe if she was in his position, she would find clear in my so there is a question of like whose desire is actually at the center of this, right and Brian was kind of like taking the ball for things that are going on early player, and she's rejecting herself and she comes another very good as one way that we could be. northern hand.. I think like, in terms of like there being any evidence, the only thing that I kind of pull out was the fact that like, they kept going to like parties and stuff without Irene. So, like, if we are gonna give her some of the benefit of the doubt, there is that weird kind of tension that appears when, like, even when Irene is not interested in going, Brian and Claire are still going to these things and Claire spent a lot of time at their home, even when Irene isn't there. So I I do think that, like, yes, the evidence is very sparse, but I can understand how she comes to this conclusions given her perception of what's happening between them., right? There's a little bit Iree, but there is a general sense of what happened and how becomes greater and greater. Oh, I was gonna say uh the one we're being like a ton wild narrator, it's I think it's interesting that she's like totally certain and positive, that like it is happening and even one you trying to like, identify the evidence and she's like, oh, there is it really that much other than maybe I guess it Brian earlier in the all says he doesn't think Claire, is that all with that what I spot later, he's kind of let it sit. And then at the end he's obviously like very distressed. But I think the fact that she just totally dismisses the fact that like, there is't actually that much evidence and she still have certain positive speaks that kind of unreviability little bit.... We are less to one very like what is really at the part of this because what she's going on is maybe not sufficient to to clarify um the problem as she sees it. Um Okay, I have a little off track here in. more. tired until that like he's in very cold family. And so that for old vanity yet what and also afterwards, we can there for months and the right you're getting to look down here. like they there is reasonable doubt about this, and that is just like, I don't really powerful look back about as readers, because we are now we are psychological problems.. I'm not analyst. I remember what was talking about that we really do better and I with that best of families, but from reality having theirairs way of justifying that oh, I I have ruin in my husband life, but if lived in on I thought I commit to Asia, whoa, that's.. Right, okay, so Claire is the problem when they're marriedriage, they might have just had problems in the marriage.. I was a little bit crazy and controlling, especially in her husband, like infe. I' of admitting that the wrong husbandrop. And so I really felt that my. Yes, so great and all of these things are are created by Larson's writing, right? Larsen, who gives us this perspective of Irene, which at the beginning, we are sympathetic to, we we have no reason not to trust, and then she warped our character more and more, and they are all these like critical moments in which the the consciousness, the interiority by being starts to become a place that we has readers are not as comfortable being in, one of those things happens that some of you commented on at the party at Hughes, um, with the breaking of a tea. One is to look at this scene. So, you get a green right into itself, uh, and then let the break that happens in reality, a literal break. Her mental andvisible langu receive it right. What did it mean? How would it affect her in the voice? The voice? She had a surgery. It had been. feeling ofolute uninverted quality. Actually, she didn't have counted. She was to him only the mother of her s of his son. That was all. alone, she was not worse than obstacle. Rage boiled up in her. It was a slight crash on the floor at her feet laid as shadow cup. dark seeing guide the bright grubs, red, shad shock, went on. The fore hers doeta gathered up the white dragons. As from the distance, youword flip voice hanger, though he was she was aware somehow miraculously at the side. Sorry to apologize, that I pushed you. plenty of me. don't tell me it's priceless and you are placeable. It hurts, dear God, how they hurt, but she couldn't think of that nap. Okay, so I want you to tell me how the theme is playing out internally and externally, like, what's happening inside I readhe and then what's happening? between characters and the room and how is it that we're switching back and forth between the two? Like, what what characterizes the writing here were how many who comes sentence that woman over? Yeah. I like, we're getting a lot our head the sentences are we cur and so like we' physically very small uh, and then it was very well on the tiger and there committed. And then all of a sudden there playing actual different of external things that are hurring in the world like, you person it says it clear what it is says, uh, and I guess, but basically it's just written't.. This is like a breakdown of her internal world and we're getting into like short drag sentences. And the other thing like soued with the problem in your life that, like, you're not aware of what's happening with a person sitting next to you or of theity or like, maybe all like what you're teacher ising in front of the room, like, you have a really big problem going on. and so you're at your internal world and then something might happen and you are snackpped out of it and you're suddenly disoriented of like, oh, what's happening in front of me? You live next to me? The voice of Hugh sounds like it's far away, but miraculously he's right there. And so these are some of these moments where we start to say,Ine, is maybe not so reliable, Irene is high that. And then he makes his life kind of icy and cold and a little bit frightening turn in which describes the cuff. Didn't you notice that cup? Well, you're lucky it would be other saying thatcestors were charming conf own. Iotten how many thousands of years ago was that's brand on the ele has I had a little war history, it was brought marked by other. Oh, all right, the English be you call it the underback. I' coming to the fact that I' never figured out a way to get rid of it until about five minutes ago, I had an inspiration. I only had to break it and I was of it forever. So it simple and I never thought of it before. So, what do you hear in this explanation? that she's giving to you? Yeah. She's using the for more, so basicallyolve the way change. That.... getair is she gonna do something else, right? this year. like how comes up, right start everything is having over the course of a series of the conversation. There two other. I think representation of player and how I. I want to get rid of there, she talk about all. And kind of reverse, I think earlier to help when the teacup is, which could also refer to Claire's passing. um, and I' almost like that spoil the end. Yeah, this is foreshadowing for the end for when I bring them up, like cushing clear sort of out of the windowows, like killingberg. I thought this was kind of foreshadowing for that as well.. something for not made it the end, I apologize to you, but there's no real way to talk about this novel without talking about the ending. um, it will still be shocking when you read it if you haven't gotten there yet. And but we're gonna talk about the ending with the end of our time. Now, it all fells crashing gap. Remember in the beginning, we have Irene ascending to the top of the green end, we have all of this movement up there. and then at the very end, we have all of the charactersembled at the top of the building, and the revelation that clear and then passing, uh, because her husband, John Doulouse storms into the room. He says, so you're in Ed order to Dan Edward and his voice was a snarl, and a mode, an expression, of ray and the everything was in confusion. The man had sprread forward, police had lected between them and the blue. She said quickly, hereful, you're the only white man here. And the silver silver voice, as well as of her words was a warning. Players stood at the window as composed as an everyone were not staring at her and curiosity and li, as if the whole structure of their life were not high in practice and for her. She seemed u aware of any danger or uncaring. There was even a same smile on her full red lips and the under shining eyes. was that smile that maddened by reading, she ran across the room her coting with foccity and laid a hand on players of their arms, One thought was exper. She couldn't have Claire and repacified by the Lou. she couldn't have the free Before there stood John Lewis speechless now in his f neighbor, on them, the little hudd of other people and Ryan stepping out from among them. What happened next Irene never afterwards allowed her to remember, never clearly one moment there and then if, a vital flowing thing, like a flame of red and bold. the next, she was gone. There was a cast before and above it the sound not by human, like aast in abey, nig by God, big. Okay, women happened here? Do we have we have love closely and the list between the we know that our have not slow it all in high foot high is slowly evolving in matter, but also, ever since being do throughout the heat and how the sub is. So we don't know who she is. is in the D or is so overwhelmed over the ir culturer. We don't want it being claim to not of itself. I mean it is not on herself and she won't herself whatever, right? And then yet she has the softway face of right here that the service are about really high correct by, the whole forgery loving, loveliness, clear, Henry. How do we maybe think about this ending this ambiguity of the ending in relation to that story, that I go about? Like, what kind of ending did I show you there and what kind of ending is this for a character who kind of constituively is of the same type? That's almost for where I do all of really. It a position already had this plan place that ever found out she wanted to beency and she had to loseation. So this she she just. Okay, so there's medally in which this, like hotel is a lead to freo, we could say maybe this is like, right doing something in here, or it might be something up, other thoughts and thought and that. I when I was reading it awfully, okay, so what happens to her? Um, so we have final like multiple different athletes are basically the have on standard as like CN time. you have I just that at the end fire. I see the fire Yeah, I after this is a broad looking of uh this, she seems just so calm about whole situation so it be, you. It's and ambiguous. One person back. towards freedom because she get the bird can clear she a my knowledge, then she will be home free, but even when like, he did find out she still didn't really succeeded maybe she killed. Yeah, it's all right. So there's like, as opposed to a heroic ending, a morally righteous ending, we are left to wonder it where that her death by being pusbur over death, um the place that the lay right on the ground at the bottom of the sky creaper is like burt and a dark and wathering. um so again, we are not looking at stories that tell us a problem and a solution, we are staying inside of a problem. we are going to end. I want to just prepping for next week, we're shifting years and reading totally a very different kind of stories. But the thing that might help us make this week is to think about laughter in this novel, who is laughing because laughter is gonna be at the center of the that piece. Okay, that a all. Thank you. so much (copy) (copy)
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than that I'nique. I think I would write a name and we cross the rental for past at do period, so like, it is us out of taking off or dealing with all of the logistics, so far, um you are still kind of getting devil or have anything else to figure out on terms of uh, just a piece adistration, conferences, anything else, uh, as usual, um, just, act and lecture or send me an email there's a few little things that I still working out, but hopefully to get settled for all of you. Um, last thing you just wanna say, thank you for your first discussion of us. They were just like specialasure read and, like, showed me how many different ways you're all being with us novel uh, and I now I like, oh, I wish you had another hour. I'm talking with this one. keep talking about it? um but we'll definitely touch on one of the things that you read in your post. today and when, um next week we're moving on to another reading, but we'll have your first conferences and that'll be a chance to talk about that kid's reading by all that really everything that we've discussed so far, so pull on to you all of these ideas that you're having. Okay, um, so today, we're gonna be a no happening, we're gonna talk about some of theorical contacts that can have us understand passing, like what's happening in the novel. Uh, and then we're gonna die further into the text of acting of what Laren is doing with this concept ofaba. Um, first, I just wanted to briefly touch on something that Irene referended in the novel, but that in this outside, it'sersen, using a novel so it references Comicorn, a little piece of history. We have I read thinking at one point, when she's worrying about Claire and correct and she's becoming, uh, and the problem of playing becomes three of her husband Rob, said, what is Luc there? He, was under eight the eight, uh, at the time that Larson was writing, passing, the rhyler case was sort of like a recent new sensation or almost like a celebrity spectacle in New York City. um, and the reason that Irene refers to it in the novel is because of the he centered around a white man who is married to a black woman who could pass her wife. uh, and the question in the rhyment her face was was she has, or did her husband, in fact, already know that she would lack? Uh, I was had like a little brief synopsis of this thing, and they' li. uh up on my versus if you wanted to read more about this soon. a fascinating story. So, in 1921, a wealthy young white man named Kit Reinellander, met Alice Jones, who was working class an racial black women. Rein Linder, the ris guy only, did not like this relationship. the two elopes in 1924, and soon after, because Bryander was part of this aristocratic family, uh, the news paint it up and published a story titled Bradland's son, and Mary is the daughter of a color name. and this led to his father finding out about the marriage and forcing his son to file for an annullment, uh, and then there were all these purpose meetings that began. And in this suit, Kitinlanders side attempted to prove that Alice had to defauded Kit using sex to gain access to hisalth. And social position. um, and then this became, as I said, kind of a big news story and cultural identity that because the right of her family was sort of celebrated being of family and because there were so many intimate details here in the court in the news about their marriage and also about Alex, um and this currently pretty preceding into all. Alice, for her side, I had been single case. She admitted to be black and she insisted that Kip had been aware of it. um and in the end, some surprisingly for the moment of by the court decided in Alice's favor and three, that KI had actually known of her blackness all along, so he was not the victim of any thought. In this case, he was not at the woman who wasying about being white. It was her husband lying about his knowledge about it. And so this is like just another variation of all these birds, like convoluted situations that arose in the midst of the American conception with the color line with racial purity and with racial power. and this is like, you just like another piece of helpful background as we head back into the novel of our characters, um, in our case, player is passing the way, and her husband, John, as far as we know, up to a point, does not have any clue that clear is black. Um, and even though this is the setup, Larsen does something to sort of what, electrify us early on, when she sets the scene with strong balloon and drink the roof and the dressingla this web. Hello, was John's reading player. Um, and I' using that that meansalonate, he's using probably obviously a variation of a regial slarity and word, right? And so this immediately creates like, great confusion for Ine and perjury who are sitting there. uh, and Claire and quickly has to explain why husband is calling you that. Her black eyes let her down. Tell them here, why you call me eyes. The man chuckled, make up his eyes, not I madeless compelled acknowledgepleasantly. He explained, well, you see, it like this, when the first married she was white as well as white as a lily. But I did lay she's getting darker and darker. I tell her if she don't look out, she'll wake up one of these days and find she her and with Edward. Heared with laughter. Claire' ringing bell light laughing his then a little later on. My goodness Jack, what difference would it make it after all these years, you were to find out that I was more than she present color. The put out his hand and refudiating flame definite and final. Oh, no, he declared, nothing like that with me. I know you known, so far right, you can get that slack as you please as far as I concerned, since I know you no. I draw the line back, the open pen words in my family ever happen and never will. Okay, how does our protagonist Irene experience this scene and how does she feel watching it? Yes.. There's. I couldn't. She's sitting at the TV party, you just kind of watching me not even even a while, put the most. But I it upset me, she doesn't know if she can speak up without real very nature. Yes, so she's like having to her appearance, like like looking around and deep confusion and disments. down because like the translated almost like half rest and comments that Cla Gertrude pick up on because the three of them are passing, and you can kind of tell that Claire has a lost experience with it has a conversation because she had she handles it a lot better than Irene does, um, and yeah, if you see all this in totalal turmoil and it keeps out a little bit in intercom conversations. Yes, right, so you trying to be her cool, but they're always like it is irrepressibleomas the sense of way, what the hell is happening here in player like aA... Claire husband to explain why would she bring up that conversation in the I? If she, oh, my husband has absolutely no idea. just for me.ger to know that idea. Why folks think? Why? Why will 30 this? There so many different ideas? few folks in the French? What are you things are? why in the read I Pandora. And all the soation and friends or what we actually. there' exposition to us a reader and to having. Yes, okay, so right, so she's like doing this like to them, like, there is there is a context here for this. Okay, there's a lot of kids and I go, here, here, maybe just go there.. as well. I is trying up all theoth or like making joke from the. because people aren has that beatified for her because she spent all this time for this performance and. And now she does advantage of this route. she work in. Yes. making a joke of her husband, right? why would she create this situation to begin with? so there's a way in which, like, there are different audiences and she created an audience to watch it un full.. sounds like, I g said, oh, you should spot, you know, uh, fire, you layer in my one pass the approaches it is like, you know, those, you don't know, but whatever really you can dola is, so it's like almost like red flag or alarms or something like battery knock and probably at me like, oh my God, like they kind of like on the closed and like my love. They're like email and they like not, everything that happens to Claire because they share this identity, that it's all black men who are can't ask for life, like anything that happening, it is like, immediately there's an implication of what this means for the other in characters. Yes. all this field are sheets like player? because um, like the she wants sitting for a her, our players trying for. and the other player wants to like more hard I his life. um, and it it feels like he's like giving a little taste like this is time, whatever med. So, like, why don't you let me your like a little more psychling real life? Yes, right, so there in which, like, maybe she showing up and like, making a joke at these I' heard a thing that there's another way she's like look at my situation, like this I live in I, uh, but it's both, right, at the same time... This is my back that. I contin what as I Yes, right. She's doing this like dance and shifting the position, uh, by by creating this and this is really dangerous essentially situation, um and and letting her friends in on it. Um, and there is this sense, right that there is, you know, danger in the scene, there is ultimately something that disturbing, but one of the involved is that I may not progress is like this this knowing lap, right? that kind of comes over earth room too, um, because there's something absurd about watching the scene, um, at one point, like Irene's lips trembled almost arm full of, but she made a desperate effort to fight after disastrider laugh and succeeded, um, and then jumped down a little bit, she's looking at her from grocery clear littleressed down a for a. I mean wish there was brief size through she feared by her self comprolled thatiled toridge for her notating anger and in that indignation. So there's like laughter and there's anger and indignation. She had a weepingiety to shout at the manip her and you're sitting here surrounded by three black devils during the teeth. So it does seem, right? that there's a joke and on notolute. He is awake and he is so sure that he would never have a black person in his family or in his house, but in reality, he is sitting there and has a black life, he has the black daughter, and there are two other black men sitting in the are and yet, they all of these women that are just referred to, player, Irene, recru, and and Claara Marjorie, all look white. How are they black? you can turn off, right. Okay, so there's sense in which a appearance is not the only way in which raises being decided, right? That becomes very clear. You can look at way as player and somehow collect Yes. you know, like like slide when you have a conversation down with the blue and it said, like, oh, and players said, what I was large, you color. And he says, well, you know, like, that's not simply means I never not that. So it's not even having, like, that like, DNA more like, you know, that like, it's the not even like it's I I don't even know like what definition is anymore because documentaries is not about, you know, having the access here, you not having that, what countries like, oh, I don't care about how you look, I don't care about you know, what's what's your ancest, you like be somebody else and something like. Yeah, it's really confusing.ired it just that John Lulu by being away, he's so sure he would go, right? There was no way she was getting away with the one or two percent colors in this case, uh, right? Um, but something weird is going on with this definition. two are men and then weonse yet. I think we need lots of different maybe people compared to the John tell the version of of push of the media of excuses. So I think with the women is that someoundaries, here, um the and also I mean for help uh, like, that their response to the outage show and how Yeah, right there are like, so many different ways that race is playing has an identity, but also have like a legal construction and also as a maybe like cartoon characteristic of what blackness is.. I don't know for what like one rule decide, um, who who wasn't? One, but under the law, there was the more, where ne the color lion have already in identities that forces you into one or the other. Yes, so this is exactly where we're headed. This is the streaming I understand, yet how he got to this place in the 1920s, where there are three white open women and all of them are apparently black. In the 1920s, this idea that right even just a tiny percentage of black ancestry made a person black um was part of a law, right? So that is happening in all of these acts were regional integrity acts laws that are prostating American deceased, uh, including in 1984 in Virginia, uh laws like the Virginia racial Integrity act outlawedational marriage and defined a white person as someone who has no pri whatsoever of any one whether than not. Right? And what is that that talk about? Um, and then there are other laws that defined lackers that owned with any trace, right? It could be, 116, uh, a black ancestry remain on. At least kind of law were as they said, white friend across the US and they also extended our back into American history street, one of the first laws that to do this work of criminalizing racial effect on the marriage, uh and defining ways by this strange formula heredity was in 1652 in a specular event. Um we often think about race as something visible, and in any case, it was a uh, but here, right we're seeing that the in terms of the law, uh, we'reology with very technical, legal, and then often invisible ideas of race and of blackness. My question is, and this has already come out a little bit irresponses, but why would Americans come up with such a thing convoluted and frame and specific and some type invisible concepts of race? I? Okay, this is funny back to Elizabeth comment, right? This has to do with the history of Americans labvery. So to answer the session, we're going on a little detour as we as do, as that how my minders. Um, we're going to go back a little bit and think about American slavery and how it works as a racial and social system. Slavery created generations and generations of makes people because, despite all of this talk about the rigid color line, slaveholders systematically crossed. I said on Wednesday that Frosted season on Monday, that Crossing the color line, especially in terms of sexual relationships, what is dangerous and needed as that is true for lacking and sometimes for, and afterately we waited, put and did allwise really violently and systematically. What did this look like? In active events that slaveholders were continuallyaping and they sexual violence was an endemic feature of the system of American slavery. It was not a random event that I approved in some cases of kind. it was a structural part of the system of American slavery. And this kind of knew that sexual violence often led to the murder of a rac children. So when these children were born, they were not considered by their fathers to be their children, they were considered to be their properties, right? Because their mothers then laid those children were and his laid. So imagine as it is a you know, 300 plus year mystery of slavery at there time generations and generations of people who were enslaved and considered to be black, but who look more and more white. This can be really hard to visualize the fact because I need the race, like they shift in different comments, they' shipped at time, we have pretty visual idea of race in the present. Uh, but this these photos for me of us a little bit to understand this. um all of the children in these two photographs were bored into slavery and all of them are considered property and all of that were consideringat. But probably to our eyes, only one of these children as looks black. So when these image of showing us is, again, like a strangeness of racing America. It's really like the fiction of race, of problems of race. We have this idea of rigid color line and then we have this social world that totally always by it. It is like a central problemating America, and it is at part of our 20th as. But it is also at the heart of the first ever African American novelot. Closelle for private's daughter, and they are mostly life was published by a for Lady author William Wells Brown in the 1856, of Phil during safety. um, and it again, at the the first factor all, this very clearly had aitional novel. It's a novel, it's written, it's a perfect of showingagos sla reading the need to project. Uh, the fact that this is the first act there in novel is a good reminder for us that novels, whether they are written by our Americans or by other groups, have not really miss it. Novels are enired or so story different from the literature, how all existed, but novels did not become kind of a cohereric form of that are literature, uh of writing until about the 18th century in Western European culture and then they started to become a major feature of Western European culture, cultureuring art aircraft the 19th century. and writing novels have is like longer durraysans in which histori can take place, and there' group or multiple different kind of stories. This is not super important about us today we're gonna come back see the conduct a lot of this then. but uh this is an important for sit situation in the 20th century where novels aren't one important for getting this little detour we taking the 19th century. Okay. back tootap. Uh, what I said is for novel and it takes up this problem of race and the problem of passing as central issue. Um Some of you here a red hotels and you know that it's like, a very convoluted and melodramatic story. um so we're not gonna do aopsis of this if you're curious, go recoel. um, but it's not that if we' for our course. I just wanna briefly introduce you to a central character in enslaved woman name hotel. This isotel as sheears about your soul. The appearance of Plotel on oct in deep sensation amongst the crow. There she stood in the complexion as light as most of those who are waiting with the wish shouldn' not referisers. The auctionireized by saying that Miss Futel had been observed for the last because she was the most valuable. how much, generally? Well, we're m meant to understand here is that, first of all, the towels of white, that is that the hotel is specially valuable because she looks like, and third, that this value attached to looking weight is sexualized, right? We get this very congestive how less g with it. Um, and this idea that played women were lighter reflection, including white acting, had special sexual values, um, was, again, a feature of this is of American slavery. Because of her lacis and also the other values white and, uh, she is persecuted across this o, which leads to a fact and laborer. She attempts to esclavery, that she gets caught and rather than go back to her factors, she chooses to to wep off the bridge for herck. So this is an illustration of that. This is like hotels weep ack. What did you with this? You might be at the Dr. D NOR. This week in the context of hot is morally righteous, right? She sort of a thing here. The cause of her death is slavery and her choice to die is, as I said, morally righteous, because it's protesting againstly and that means that within the context of the 19th century acad abolitionist dog. Uh, we can get a little bit of this, um, just from the way that lay brown wrote this right. There's no hope for aake for her down the passage. Her resolution was taken. She clasped her hands convulsively and raised them as she, at the same time raised her eyes for its heaven and begged for that mercy and compassion there, which had been denied her on earth, and then, with a single bound, she vaulted over the railings of the bridge and subbed forever beneath the ways of the river, thus died lowau. Okay. So this is a little bit of backstory and literary history that's going to help us understand where we are in our novel and how it ends. And we'll just say briefly that this is not the only novel that our literature that keeps up these issues of acid um, where a lot of really important and central novels of early actingary literature that do this, asking is one of them and then we're gonna read another one about to meet laugh more. This is all behind Ella Larson as she writing happy, and she is engaging with this literary history, but she's also complicating the story, right? I read Redfield and Cla Henry are not martyr characters by any right, the problems that they have are not only caused by outside forces. They have also caused by an own desires and wait. So, rather than writing a novel where black womenomes sort of like the vehicles for explloring an issue like slavery or race or racism. Larsen makes race and racism and passing into a being able or even like a backdrop or exploring black women, and their interiority. and they are desired potentially needed their fear, their anger, and and then ultimately their violence. We see both of these characters, sorry out, but what they are to each other and stay the missions, right? I read in the black world, players in the white, but over time their divisions were like he in by one another. um, andir, at least from our perspective, is getting too close, right? Irene, um, on getting rid of player. So, how does this like, break down in start from thisantingopter in and we talked about on Monday, there's thisensive great attraction in the beginning atoration and the sense that Irene was kind of like, not resist the thrall of player, but at some point in the novel, I mean starts to feel differently, and she becomes ultimately to consumed by Claire as a problem. Where are some of the scen that we start to see this happen for uh yeah, where are some of the turning points in the novel where he gets this ri.t. and I think this happened like somebody to going out, like not a highly lot, but you laugh and youulated things how much else if they really doing without me without. I mean, she like, you know, she's so over on cat I, and then was. Yes, right. So, at some point around an invitation that she wasn't part of, Irene begins to believe that there's a fair. But she have evidence of this fair as what I agree, and then also, we have beers like, do we have of an affair, what what did you think about? like, the truth or reality of theear? I kind of interpreted Irena's a bit of an unreliable narrator. It felt like she was telling them story that had already happened. So maybe her act of the end of the novel influences how she's remembering things and trying to justify why she would have pushed a clear in the end. So she's looking at her while they laughed at each other, so that was a sign and when she's at the party and few kind of corroborates how she feels, you see a little bit more about unreliable narrator or what that means to feel? Um when they're presenting things with objective, but their emotions and personality are actually shaping, what what evidence that preventing you and what descriptors they're using?, that's a really good way of it, so we have she is she's basically our in the sense that like she's the as we've talked about, but the character of his perspective, we're really close to. um and we start to have a approx novel see that there is like a discrepancy between her internal thought process and what is available to us as what evidence of what's happening outside of her, um and so the more and more we start to see that, like we have a little bit alienated from Irene, uh, and so, right, the reality of any of her statements, um, have comes into some question. um, so we don't necessarily know what this affair was um, other than what Irene either think it was or justified the FDA. Yeah. kind of operating? he was maybe for a bit, but I think last class mentioned how she really called Claire beautiful. and how now is that Ryan is somewhat clear and not much evidence of a ware, but maybe if she was in his position, she would find clear in my so there is a question of like whose desire is actually at the center of this, right and Brian was kind of like taking the ball for things that are going on early player, and she's rejecting herself and she comes another very good as one way that we could be. northern hand.. I think like, in terms of like there being any evidence, the only thing that I kind of pull out was the fact that like, they kept going to like parties and stuff without Irene. So, like, if we are gonna give her some of the benefit of the doubt, there is that weird kind of tension that appears when, like, even when Irene is not interested in going, Brian and Claire are still going to these things and Claire spent a lot of time at their home, even when Irene isn't there. So I I do think that, like, yes, the evidence is very sparse, but I can understand how she comes to this conclusions given her perception of what's happening between them., right? There's a little bit Iree, but there is a general sense of what happened and how becomes greater and greater. Oh, I was gonna say uh the one we're being like a ton wild narrator, it's I think it's interesting that she's like totally certain and positive, that like it is happening and even one you trying to like, identify the evidence and she's like, oh, there is it really that much other than maybe I guess it Brian earlier in the all says he doesn't think Claire, is that all with that what I spot later, he's kind of let it sit. And then at the end he's obviously like very distressed. But I think the fact that she just totally dismisses the fact that like, there is't actually that much evidence and she still have certain positive speaks that kind of unreviability little bit.... We are less to one very like what is really at the part of this because what she's going on is maybe not sufficient to to clarify um the problem as she sees it. Um Okay, I have a little off track here in. more. tired until that like he's in very cold family. And so that for old vanity yet what and also afterwards, we can there for months and the right you're getting to look down here. like they there is reasonable doubt about this, and that is just like, I don't really powerful look back about as readers, because we are now we are psychological problems.. I'm not analyst. I remember what was talking about that we really do better and I with that best of families, but from reality having theirairs way of justifying that oh, I I have ruin in my husband life, but if lived in on I thought I commit to Asia, whoa, that's.. Right, okay, so Claire is the problem when they're marriedriage, they might have just had problems in the marriage.. I was a little bit crazy and controlling, especially in her husband, like infe. I' of admitting that the wrong husbandrop. And so I really felt that my. Yes, so great and all of these things are are created by Larson's writing, right? Larsen, who gives us this perspective of Irene, which at the beginning, we are sympathetic to, we we have no reason not to trust, and then she warped our character more and more, and they are all these like critical moments in which the the consciousness, the interiority by being starts to become a place that we has readers are not as comfortable being in, one of those things happens that some of you commented on at the party at Hughes, um, with the breaking of a tea. One is to look at this scene. So, you get a green right into itself, uh, and then let the break that happens in reality, a literal break. Her mental andvisible langu receive it right. What did it mean? How would it affect her in the voice? The voice? She had a surgery. It had been. feeling ofolute uninverted quality. Actually, she didn't have counted. She was to him only the mother of her s of his son. That was all. alone, she was not worse than obstacle. Rage boiled up in her. It was a slight crash on the floor at her feet laid as shadow cup. dark seeing guide the bright grubs, red, shad shock, went on. The fore hers doeta gathered up the white dragons. As from the distance, youword flip voice hanger, though he was she was aware somehow miraculously at the side. Sorry to apologize, that I pushed you. plenty of me. don't tell me it's priceless and you are placeable. It hurts, dear God, how they hurt, but she couldn't think of that nap. Okay, so I want you to tell me how the theme is playing out internally and externally, like, what's happening inside I readhe and then what's happening? between characters and the room and how is it that we're switching back and forth between the two? Like, what what characterizes the writing here were how many who comes sentence that woman over? Yeah. I like, we're getting a lot our head the sentences are we cur and so like we' physically very small uh, and then it was very well on the tiger and there committed. And then all of a sudden there playing actual different of external things that are hurring in the world like, you person it says it clear what it is says, uh, and I guess, but basically it's just written't.. This is like a breakdown of her internal world and we're getting into like short drag sentences. And the other thing like soued with the problem in your life that, like, you're not aware of what's happening with a person sitting next to you or of theity or like, maybe all like what you're teacher ising in front of the room, like, you have a really big problem going on. and so you're at your internal world and then something might happen and you are snackpped out of it and you're suddenly disoriented of like, oh, what's happening in front of me? You live next to me? The voice of Hugh sounds like it's far away, but miraculously he's right there. And so these are some of these moments where we start to say,Ine, is maybe not so reliable, Irene is high that. And then he makes his life kind of icy and cold and a little bit frightening turn in which describes the cuff. Didn't you notice that cup? Well, you're lucky it would be other saying thatcestors were charming conf own. Iotten how many thousands of years ago was that's brand on the ele has I had a little war history, it was brought marked by other. Oh, all right, the English be you call it the underback. I' coming to the fact that I' never figured out a way to get rid of it until about five minutes ago, I had an inspiration. I only had to break it and I was of it forever. So it simple and I never thought of it before. So, what do you hear in this explanation? that she's giving to you? Yeah. She's using the for more, so basicallyolve the way change. That.... getair is she gonna do something else, right? this year. like how comes up, right start everything is having over the course of a series of the conversation. There two other. I think representation of player and how I. I want to get rid of there, she talk about all. And kind of reverse, I think earlier to help when the teacup is, which could also refer to Claire's passing. um, and I' almost like that spoil the end. Yeah, this is foreshadowing for the end for when I bring them up, like cushing clear sort of out of the windowows, like killingberg. I thought this was kind of foreshadowing for that as well.. something for not made it the end, I apologize to you, but there's no real way to talk about this novel without talking about the ending. um, it will still be shocking when you read it if you haven't gotten there yet. And but we're gonna talk about the ending with the end of our time. Now, it all fells crashing gap. Remember in the beginning, we have Irene ascending to the top of the green end, we have all of this movement up there. and then at the very end, we have all of the charactersembled at the top of the building, and the revelation that clear and then passing, uh, because her husband, John Doulouse storms into the room. He says, so you're in Ed order to Dan Edward and his voice was a snarl, and a mode, an expression, of ray and the everything was in confusion. The man had sprread forward, police had lected between them and the blue. She said quickly, hereful, you're the only white man here. And the silver silver voice, as well as of her words was a warning. Players stood at the window as composed as an everyone were not staring at her and curiosity and li, as if the whole structure of their life were not high in practice and for her. She seemed u aware of any danger or uncaring. There was even a same smile on her full red lips and the under shining eyes. was that smile that maddened by reading, she ran across the room her coting with foccity and laid a hand on players of their arms, One thought was exper. She couldn't have Claire and repacified by the Lou. she couldn't have the free Before there stood John Lewis speechless now in his f neighbor, on them, the little hudd of other people and Ryan stepping out from among them. What happened next Irene never afterwards allowed her to remember, never clearly one moment there and then if, a vital flowing thing, like a flame of red and bold. the next, she was gone. There was a cast before and above it the sound not by human, like aast in abey, nig by God, big. Okay, women happened here? Do we have we have love closely and the list between the we know that our have not slow it all in high foot high is slowly evolving in matter, but also, ever since being do throughout the heat and how the sub is. So we don't know who she is. is in the D or is so overwhelmed over the ir culturer. We don't want it being claim to not of itself. I mean it is not on herself and she won't herself whatever, right? And then yet she has the softway face of right here that the service are about really high correct by, the whole forgery loving, loveliness, clear, Henry. How do we maybe think about this ending this ambiguity of the ending in relation to that story, that I go about? Like, what kind of ending did I show you there and what kind of ending is this for a character who kind of constituively is of the same type? That's almost for where I do all of really. It a position already had this plan place that ever found out she wanted to beency and she had to loseation. So this she she just. Okay, so there's medally in which this, like hotel is a lead to freo, we could say maybe this is like, right doing something in here, or it might be something up, other thoughts and thought and that. I when I was reading it awfully, okay, so what happens to her? Um, so we have final like multiple different athletes are basically the have on standard as like CN time. you have I just that at the end fire. I see the fire Yeah, I after this is a broad looking of uh this, she seems just so calm about whole situation so it be, you. It's and ambiguous. One person back. towards freedom because she get the bird can clear she a my knowledge, then she will be home free, but even when like, he did find out she still didn't really succeeded maybe she killed. Yeah, it's all right. So there's like, as opposed to a heroic ending, a morally righteous ending, we are left to wonder it where that her death by being pusbur over death, um the place that the lay right on the ground at the bottom of the sky creaper is like burt and a dark and wathering. um so again, we are not looking at stories that tell us a problem and a solution, we are staying inside of a problem. we are going to end. I want to just prepping for next week, we're shifting years and reading totally a very different kind of stories. But the thing that might help us make this week is to think about laughter in this novel, who is laughing because laughter is gonna be at the center of the that piece. Okay, that a all. Thank you. so much (copy)
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Only pressure forces and heitional force are significant and dominating. This differential fluid element can be cheated as a particle moving along a streamline as shown here. The pressure force acting on the left force of the fluid element alarmmed the streamline is mentioned here FPL is equal two PDA, where B is the pressure of the fluid at the left face of the element and BA is the area of the face of the element. 
The pressure force acting on the right face of the fluid element along the streamline is written here, where P+DP is the pressure of the fluid at the right phase of the helment. The weight of the fluid element w has shown in the figure here, acts vertically in a downward direction and is equal to row GK multipl by BS where row is the density of the fluid. G is the excellentation due to gravity and the is the length of the differential fluid element. 
This w can be resolved or decomposed into two components, the weight component, along the streamline is given here. Now let us take the sign convention for the force acting along the streamline towards the right side is positive and towards the left side is negative. Whereas normal force acting in an upper direction is positive and in a downward direction is negative. 
However, the normal forces will be balanced by bounded wall reaction. Now, let us apply nutants second law in the space coordinate direction along the streamline on a differential fluidary met. This is presented here from the figure shown here, scientific can be written as you see here. substituting scient thera in the equition shown here and simplify Isa equation shown here. 
By eliminating TK, which is common in left and right in terms of the equation, the moment term equation can be written as shown here. here, replacing you do you by half day multiplied by you square and dividing the left hand, right hand side terms by row gives the following equusion as depicted here. When this equation is integrated along the streamline for the whole domain, the right hand side down becomes constantly. That is the last two terms of the next side are differential for an incompressible fluid, roof is concert. 
Then the first term becomes the thick set differential. Therefore, thus equation becomes has shown here, is, and it is popularly known as coronly equation. It is valid for steady, incompressible flow, along a streamline in invisite regions of the flow, applying the bonly equation at location one as shown here, one can have the equation you can see.ain, applying the boundary equation at location two, one can have other equation. 
Therefore, the two equations depicted here can be equated since the left hand sideumps are equal to concent the corresponding equation is shown here. In this equation, you square by two can be recognized as kinetic energy, whereas zZ can be recognized as B by row is the flow energy that is to push the fluidement through the conduit. Now, let us summarize the barley equation. 
Barley equation can be stated since the sum of flu energy, kinetic energy, and potational energy is constant for a state flow and incompressible fluid when the net friction effects are negligible. equation is always viewed as the principle of conservation of tennessy. all the three terms in the Bonon equation shown here are mechanical forms of energy terms and no mechanical form of energy term converts into thermal energy, but they convert ham, themselves, keeping the sum of these three terms always constant. Let us write a borrowed equation in towns of, head in meters. dividing by G throughout the bannery equation can be written in terms of head in meters as represented here. Now let us summarize what we have learned in this topic. 
We derive the panel equation to an ideal flu its tradition, explain specific practical cases where boundary can be applied without any penalty of incurrency, explain the terms involved in the bor equation, applied bonly equation for a profile, flowing through a pipe and final we have written the b equation in
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Organismal close-up: Introduction to the Honeybee. Origins. Honeybees are eusocial. This means that they have the highest level of sociality in animals. When it comes to the structure of the bee: there is the queen who lays eggs and then the worker bees ( lifetime fitness:0, they dont reproduce) Sociality issue: why are they doing what theyre doing? If they dont reproduce Same mother not the same father Eusocial definition: defined by cooperative brood care (including care of offspring from other individuals), overlapping generations within a colony of adults, and a division of labor into reproductive and non-reproductive groups. They evolved from wasp-like ancestors ( predetory/carvineous hymenopteras) ( sting to paralize) in the Cretaceous period, about 145-65 million years ago. Also, during this period, flowering plants became dominant in the world’s flora. Therefore, bees and flowers have been coevolving for over 100 million years. Most wasps are solitary Some are social wasps/bees Wasps parallel bees Ants: hypersocial From their wasp-like ancestors, bees inherited their narrow waist, a stinger, and the ability to build nests. The narrow waist permits the abdomen to be pointed in many directions for stinging and laying eggs. Not their abdomen Thorax= first segment of the abdomen Use the narrow poriton of the “abdomen” to be more mobile To sting To lay eggs The stinger, used in wasps to kill or paralyze prey, is used by bees to defend the colony from robbers. However, wasps are predators, whereas bees feed almost exclusively on nectar and pollen gathered from flowers. Flowers provide the complete diet for the bee colony. Evolution of social structure. Most bees and wasps are solitary species in that individual females lay eggs in either burrows or wood crevices. They provision each egg with pollen and nectar (bees) or prey (wasps). Usually each egg with its food is placed in its own “cell”, which is walled off from the adjoining cell. In these solitary species, the bee/wasp mother never meets her children (she leaves them after provisioning the nest). No colony, all individual bees doing their own thing ( solitary species) Early social species. A few burrowing species are social, where the mother waits for the daughters to be born, and then these daughters help the mother forage and dig or form extra cells for her to lay eggs in. These working daughters are the beginning of the “worker caste”. Social→ female will hang out with the mother after being hatched and then work together to do thing like build nests and find food More advanced species, like bumblebees and yellow-jacket wasps: Here the workers are far more numerous (hundreds in bumblebees and thousands in yellow-jackets). The workers are smaller than the mother “queen” (queen caste), and often have different color patterns. Behavior has been partitioned too. Workers forage, build the nest, and defend it. The queen never leaves the nest and only lays eggs. Annual vs. perennial. In the previous examples, the colony is annual, that is, the foundress queen creates workers (and males), and the colony grows until the end of the growing season, when all bees die except new queens that have been inseminated. ( everyone dies except the new queen burried in the soil→ foundress quen) These new foundress queens will overwinter in a burrow or crevice, and in the spring, start feeding and building a new colony. The colony lasts only ONE YEAR If you see a bee fling around in december= that is a queen bee Only in honeybees (Genus Apis) is the colony perennial, potentially living forever. ( 1 colony= 50/80, 000 bees) Two adaptations have permitted this: Honey storage away from the brood combs (developing offspring). Allows honeybees to survive periods of harsh environmental conditions, like winter and droughts. Supplies the energy to heat the colony during winter. Honeybees use the honey to shiver, which creates heat. During drought, nectar flow (flower availability) may stop (called a “dearth”), but the stored honey can be used until nectar flow resumes. What if it gets warm and then cold all of the sudden→ die HONEY→ colony species fully rely on this to get through harsh environmental conditions Colony formation by swarming. In the late spring, large honeybee colonies reproduce by swarming, which splits the colony. Split into 2 in april The other half leaves and gets their own queen The new colony has a mated queen and a lot of workers and is “ready to go”. This is a big advantage over solitary or more primitive social species that must start each spring with a single foundress queen. Bees use honey to get through winter Bee species. Honeybees are members of the genus Apis. This genus is native to Europe, Asia, and Africa (not the Americas). The number of Apis species is debatable, the number varying from 4 to 15 depending on the taxonomic treatment. There are basically 4 distinct honeybee groups: Dwarf Honeybee: Apis florea & other. Only ¼ inch long. Native from Iran through SE Asia. The comb of the nest is small and only contains a few ounces of honey. Open nest The comb is a single small plate. The nest is usually concealed under leaves or in a cave. People do cut these nests down to harvest the honey, but little honey harvest is achieved. Couple ounces of honey Giant Honeybee: A. dorsata. Large bees about 0.7 inches long. Geographical distribution similar to Dwarf Honeybee. In Nepal, Tibet, and India. The comb of the nest is a large exposed plate which is strong and can contain up to 50 lbs of honey. The nest is not in the dark and must be fully illuminated; they usually hang down from tree branches, placed about 80 ft in the air. Ununsual because nests are in the open and not hidden These bees are aggressive if the nest is raided, and will pursue the raider for up to 300 feet. The copious honey is greatly prized by local peoples. Eastern Honeybee: A. cerana & others. Slightly smaller than the Western Honeybee. Wide distribution covering most of Asia. Over this wide range, several races have evolved, for instance an Indian and Burmese race, a Japanese race, etc. Sometimes these are considered species, other times as subspecies. The nest consists of several combs hanging in parallel plates, each plate being separated by a consistent distance (the “bee space”). Found in dark hollow trees and caves. Bee space= very specific value Comb separated by bee space= they will be int hat space only If too far or too close= bees will purpusefully put it back Everyone tries to understand this concept to grow honey easer ( reasons or beekeepers) In less tropical regions, they store a decent amount of honey. Western Honeybee: A. mellifera. The most widely distributed bee on Earth. It has been under human domestication for so long that its origins are unclear. It appears to be native to Africa, and from there it spread into Europe (perhaps 10,000 years ago), and later with colonial expansion into North America and Australia. The nest is like the Eastern Honeybee, with parallel plates and a dark interior. This nesting behavior adapts well to the artificial nests made by humans. With such a wide range, many races have evolved, often recognized as subspecies. Italian Honeybee, Apis mellifera ligustica: Yellow- and orange-banded abdomen. Originally from Italy and Sicily, now the most widely distributed race in the world. There are better choices for cold regions. They are gentle, disease-resistant, and good foragers. Carniolan Honeybee, A. m. carnica: Dusky brown with more muted orange bands. Originally from Austria and the Balkan region. Has been transported worldwide, like the Italian. Second most popular race after the Italian. Often used in cooler northern areas since they fly in cooler weather than Italians. Gentle, disease-resistant, good nest defenders, and make lots of honey. German Black or Dark European Honeybee, A. m. mellifera: A cold-weather resistant race, from western Europe including Britain, and north and west of the Alps. African Honeybee, A. m. scutellata: Native to southern and central Africa. Looks a lot like the Italian. High honey yields, great disease-resistance, and highly defensive. Accidentally released in Brazil in 1957. After release, hybridized with more gentle European races, giving rise to “Africanized bees”. Cape Honeybee, A. m. capensis: From the Cape Peninsula in South Africa. Unlike other honeybees, female workers are able to lay fertile eggs. In areas where the African and Cape races co-occur, the Cape queens can enter the African colonies, undetected, and lay eggs which lead to laying workers, which eventually destroy the colony. The only bees that can have worker bees lay eggs Egyptian Honeybee, A. m. lamarcki: Small and dark with yellow abdominal bands. Native to the Nile valley region. Defensive behavior and low honey production. This was probably the race used by ancient Egyptians. Today it doesnt make as much honey The Buckfast bee: A hybrid bee developed by Brother Adam at Buckfast Abbey in Devon, England, in 1919. The stimulus to create this new bee came from the massive bee losses caused by the Isle of Wight disease, which occurred between 1906 and 1919 on the Isle of Wight in southern England. Brother Adam at Buckfast Abbey noticed that hybrids between Italian and German Black honeybee survived the disease, and so he began an extensive breeding program to create the Buckfast bee, which is a hybrid involving honeybee strains from Italy, England, France, Turkey, Greece, and two African strains. SUMMARY: hybirds of bees (=buckfast bee) did not die due to the disease → highly disease resistant Buckfast bees have many desirable characteristics and are widely available. Castes. Long abdomen on queen= for big ovaries for the kids Bigger shiefd for protection MASSIVE eyes for drone / furry tail A Western honeybee colony or hive is composed of thousands of individual bees. At the height of summer, a hive may contain up to 50,000 bees. Most of these individuals are workers, which are sterile females. A few hundred individuals are drones, which are fertile males. The hive normally has only one queen, who is female and fertile. These bee castes are easy to distinguish with the naked eye. Each caste has its own roles within the colony. Sex & genetics. Of the three castes, only the queen normally lays eggs. The queen becomes fertilized by mating with several drones on her nuptial flight. The queen stores sperm in a special organ (the spermatheca). What determines sex in the offspring? Unlike humans, bees have no sex chromosomes. Haplodiploidy. (diploid= female, haploid=male) It was previously thought that sex was determined by the number of chromosomes in the organism. In haplodiploidy, queens and workers are diploid with 32 chromosomes, and drones are haploid with 16. When laying eggs, the queen makes the decision to either fertilize or not fertilize the egg. A fertilized egg is diploid and makes either a worker or another queen, whereas an unfertilized egg is haploid and will form a male drone. During inbreeding studies carried out by investigators, diploid drones were created, which brought into question the idea that chromosome number alone determines sex. Sex determination locus (SDL). This genetic locus (a physical position on a chromosome) was hypothesized to exist over 70 years ago. At this locus, a diploid bee can have two genes (alleles) present, whereas a haploid bee can only have one gene present. In a diploid bee, if both genes are the same (called a homozygous genotype), the bee is male (diploid drone). If the genes are different (called a heterozygous genotype), the bee is female. In a haploid bee, only one gene is present (called a hemizygous genotype), which results in a male (drone). Complementary Sex Determiner (csd) gene. In 2003, the actual gene for sex determination was discovered. It is called the Complementary Sex Determiner (csd) gene, which has at least 15 variants (alleles). The product of the csd gene (protein) is required for the bee to become female. This protein binds to the mRNA made from a feminizer gene called fem, causing it to function a certain way, leading to a female. If it does not bind, the function of fem will differ, leading to a male. The product of the csd gene will only be able to bind to fem if both alleles at the SDL are different (heterozygous). Workers, basic structure. The worker is the “routine” bee, which is between ½ - ¾ inch in length, with an almost cylindrical body. Workers, like other castes, can see well, have the ability to detect sound, and have antennae that sense the physical and chemical environment. Chemicals called pheromones are picked up by the antennae, and these chemicals are used to control many activities within the hive. Mouthparts. Worker mouth parts consist of mandibles and a proboscis. The two mandibles oppose each other like scissors, and they are used to bite, chew, and hold objects. The proboscis is a tubular apparatus used for sucking up nectar, and to regurgitate the nectar back in the hive. Pollen collection. One major activity of workers is collection of pollen, which is accomplished by the many feathery hairs on the body. When visiting a flower to drink nectar, pollen adheres to the hairs, and the bee brushes the pollen onto the hind legs using legs bearing special stiff hairs resembling a comb (the pollen brush). When the hind legs are rubbed together, pollen is forced into a specially modified joint on the legs, which then presses the pollen mass into a hard cake. This pollen cake is held in place by a fringe of hairs called the corbicula or pollen basket. These pollen masses are easily seen on workers entering the hive after visiting flowers and are the color of the pollen they have collected. Stinger. As is widely known, workers bear a stinger at the tip of the abdomen. It is used to defend the hive. It is modified from the egg-laying ovipositor; therefore, males don’t have a stinger. The stinger is barbed, and when she attempts to withdraw it after stinging a human, it gets stuck and pulls out some of her abdominal organs, the venom sac and a muscular pumping mechanism. The worker will soon die. The stinger will remain in the skin and will continue pumping venom. It will also release alarm pheromones into the air which alarms other bees to pursue the victim. Wax glands. On the undersurface of the bee’s abdomen are located 8 wax glands. In these glands, special cells secrete beeswax, which forms a blob at first, and then forms into a flat scale or chip shape. These chips are about 1/8-inch-long and can often be seen protruding out from below the abdomen. The beeswax is used to build the comb. The bee scratches off the wax from the glands with its legs, and passes it to its mandibles. Beeswax is mixed with saliva and chewed to make it malleable and the perfect consistency for use. Beeswax is an energetically demanding material to produce. How much honey is needed to make a pound of wax is not agreed on, with estimates varying widely. A reasonable value is about 20 lbs of honey to make 1 lb of beeswax. Workers, early development. An egg laid by the queen hatches in 3 or 4 days. The young larva is visited by adult worker bees, called nurse bees. The larva receives over 140 small meals over a span of five days, at which time the larva is fully grown. This is about nine days after the egg was laid. Larval diet. During the first 3 days of the larva’s life, nurse bees feed the larva a protein-rich secretion from their mandibular and hypopharyngeal glands. This substance is called either “brood food” or “royal jelly”. Its protein content comes from the pollen consumed by the nurse bees. After the 3rd day, nurse bees dilute the brood food with honey and pollen, and the total amount of food fed to the larva is reduced. (For comparison, if the larva is destined to become a queen, nurse bees continue feeding the larva brood food in unlimited quantities. The brood food is never diluted with honey and pollen nor is it reduced in amount.) Larva grown, sealed in. Once the larva is fully grown (about nine days after the egg was laid), the nurse bees seal the cell with wax, which is tan in color and somewhat porous. It takes the nurse bees over 100 visits and 6 hours of effort to seal the cell. Inside the sealed cell, the larva transforms into a pupa, and then undergoes metamorphosis into an adult. Emergence. Generally, a worker bee emerges from her pupal cell 21 days after the egg was laid. For comparison, a drone takes 24 days and a queen 16 days. These development times are similar in the Eastern honeybee, possibly because both species regulate the hive temperature to about 95 deg F. A newly emerged worker bee spends a few hours grooming herself until she is dry. Early life as an adult in the hive. Getting fed. For the next few days, she will stay in the nest and “ask” other workers for food. She sticks her tongue out at the passing workers, and they will respond by opening their mandibles, dropping their tongue a bit, and then regurgitating a droplet of sugary liquid from which the new bee drinks (a process called trophallaxis). After about 3 days, the new bees begin to feed on honey reserves in the honey-storage cells, and on protein-rich pollen located in certain pollen-storage cells. Work duties. During days 4 and 5, the bee may start feeding the developing brood. At first, she can only feed older larvae, which don’t require pure brood food, as she can only regurgitate honey and pollen. By day 6, her hypopharyngeal glands start making brood food, so she can then feed the younger larvae. She uses the protein-rich pollen that she has eaten to make the brood food. From days 10 to 12, her brood food glands are exhausted, so she stops feeding the larvae. Her wax glands start making wax, so she begins making and repairing comb. Workers, adult development. Figure. Consecutive flights of five individual bees. (a, b, c) Consecutive orientation flights of three bees. (d, e) Complete orientation phase before the first foraging flights (FO) of two bees. Venture out, orientation. Also, from days 10 to 12, she will leave the hive for the first time. On her first trip outside, she will defecate for the first time. Orientation. At first, she hovers near the hive to learn the environment around the hive. These are called orientation flights. Circling pattern, with ever-wider circles. Later, she will fly further away. Meeting foragers, making honey. For the next week or two she will stay mostly in the hive, meeting the incoming forager bees. These foragers come into the hive with a full honey stomach and pollen load, and when she meets them, they will regurgitate the liquid and pass it to her (she drinks it). She will take it deep within the hive and regurgitate it, then swallow it, and repeat. As she does this, she partially digests the sucrose in the nectar into fructose and glucose (using the enzyme invertase). This manipulation of the liquid also dries it down to 17-18% moisture, which is extremely concentrated. The final product is honey, which is then deposited into honey-storage cells. Drying of the honey is also aided by the other workers that continually fan their wings to create a draft. She also places the pollen load from the foragers into the pollen-storage cells. Workers, housekeeping, graduation to foraging. Also, during the first weeks in the hive, she will do general housecleaning, like removing debris and dead bees. Observing older foragers. By week 3 or 4, she becomes a forager, and starts off by closely observing the returning older foragers. She especially observes the scout foragers that found new sources of pollen and nectar. These scouts perform communication “dances” that tell the other foragers where the food is located. It takes the new forager time to learn the language of the dancing. Once she figures it out, she will join the foraging force. Foraging duties. When foraging, she is focused primarily on collecting nectar and pollen. But she also will drink water and collect propolis, which is a sticky sap exuded by trees. Propolis is used in the hive to seal gaps and holes and to improve the strength of combs. Guard bees. A small number of bees will become guards, which stand near the hive entrance with their front legs held off the surface, making them look like they are going to pounce. They guard the entrance against non-hive bees and honey robbers. Retirement (death). During summer, she works so hard that she dies within 5 or 6 weeks from emergence. If she emerged in the fall, her activities are far more restricted, and she could live for 5 or 6 months. Workers, communication. Foragers can communicate the presence, direction, nutritional value, and distance to food sources by “dancing” on the comb surface and regurgitating the food. Food is close by. If the food source is within a few hundred feet of the hive, the forager will do the “round dance”, where she moves in circles, alternating between clockwise and counterclockwise directions. The other workers pay close attention to the dance. The forager is covered with scents from the food source, and the other bees will leave the hive in search of matching odors. Food is far away. If the food is further away, the “waggle dance” or “figure-eight” dance is performed. Here there are two circles, one clockwise and the other counterclockwise, with a straight line connecting them. The straight line portion contains several clues: The angle of the line relative to the vertical axis of the comb represents the angle of the sun relative to the food source. The length of the line represents the distance. The intensity of waggling back and forth suggests the quality of the source, with greater waggling corresponding to greater quality. Since the hive is totally dark inside, the observing workers cannot see the dance but instead sense it by vibrations and probably by other means. Workers will press their abdomen to the comb and vibrate signals back to the dancer, and she will regurgitate some of the food for the workers to sample. When traveling to the food source, the foragers can detect the sun’s position in the sky even on overcast days. Queen, basic structure. The queen is longer and narrower than the worker. She is up to ¾ inch in length. Her head and eyes are smaller in comparison to the workers, because she does not forage outside the hive. She has a very short tongue because she never sips nectar from flowers, but is fed directly by her “attendants” (a group of worker bees, also called a “retinue”). Her mandibles are also different, and associated with them are large mandibular glands, which secrete the “queen mandibular pheromone” (QMP) or “queen substance”. (Workers also have these glands, but they don’t secrete QMP.) Her abdomen is long because it contains many eggs. Her legs are not adapted for pollen combing and holding. She has no wax glands. She has a stinger, however it is not barbed like the worker stinger. It is only used for one purpose: killing rival queens. Queen, pheromone. QMP is a complex mixture of chemicals, with only about 24 of them being well known. The queen is constantly attended by her “attendant” workers, which monitor, lick, groom, feed, and exchange body fluids with her. As a result, the attendants pick up the pheromone. The attendants then spread the pheromone to other workers. Within the hive in general, each bee is frequently exchanging fluids and food with other bees, so the pheromone gets spread among all bees in the hive. The presence of QMP is how workers in the hive know that the queen is present. If the queen secretes normal levels of QMP and the hive is not overly crowded, each worker in the hive feels “queenright”, that is, a normally functioning queen is present. If levels of QMP in the hive drop because the queen is not producing enough, the workers will begin preparations to make a new queen. This is termed supersedure. Also, if the number of workers in the hive gets too large, the QMP will get diluted so much that each worker no longer feels “queenright”. This may lead to swarming behavior. To prevent swarming, each worker needs a daily QMP dose of about 0.001 mg. QMP is how the queen exerts her control over the hive. It: Suppresses ovary development in the workers. Therefore, normally workers cannot lay eggs. More about laying workers: If QMP levels drop too much or the queen dies or is removed, ovaries in the workers will develop and they will begin laying eggs. This leads to only drone offspring (because workers are not inseminated and cannot fertilize the eggs), which quickly leads to the death of the hive (unless corrective action is taken by the beekeeper). It is believed that in every colony a few workers are regularly laying eggs, but the prevalence of this is very, very low. See information on the Cape Honeybee (later lecture), where laying workers and clonal offspring can be common. Prevents workers from making new queens. Stimulates foraging and brood rearing. Attracts attendant workers. Helps keep the swarm together when the queen leaves the hive during swarming. Serves as a mating attractant for drones during her nuptial flight. Maintains the general “morale” of the hive. Lack of QMP makes the bees nervous and agitated. Queen, reproduction. Normally, the queen is the only bee in a hive that lays eggs. Eggs are laid singly at the bottom of a cell in the comb. During summer, a healthy queen can lay 1,500 eggs per day, which is more than her body weight. In one year, a queen can produce 200,000 workers. Queen, development. Queen development is very similar to worker development, with a few exceptions. As stated previously, during the first three days of the larva’s life, it is fed brood food. After that, nurse bees continue feeding queen larvae the brood food in unlimited amounts until the larva is fully grown (nine days after the egg was laid). The cell in which the queen develops is very large and peanut-shaped. It is called a “queen cell”. Workers construct this large cell in preparation for making a queen. So much brood food is fed to the larva that the cell fills with it, appearing as a milky white fluid. The queen emerges from the cell 16 days after the egg was laid. Queen life span. On average, queens live from one to three years. But queens can: “Wear out” and produce insufficient QMP. Have their QMP diluted by the hive getting too crowded. Can die or be removed from the hive. All of these fates will stimulate the workers to create new queens (if they have eggs or young larvae to work with). If a queen makes insufficient QMP or the hive is too crowded, workers will gradually make queen cells. If a queen dies or is removed, workers detect her absence within hours and start making queen cells. Queen death in new hive. A new colony with an unmated or poorly mated queen (and therefore no eggs, larvae, or brood) is vulnerable to failing. Such a colony might result from a swarm or from installing a new package of bees into a hive box. The queen embarks on mating flights and hopefully gets successfully mated and returns to the hive. But what if she is killed on her flight (by a bird, dragonfly, etc.)? The colony is doomed because the workers lack the eggs or young larvae from which to make new queens. Workers will eventually start laying eggs, leading to all drone offspring and death of the colony. (A beekeeper who notices this within about two weeks could simply install a new queen that has already been mated.) Queen cells. Queen cells are large, peanut-shaped cells found on the comb face, comb edges, and comb bottoms. There are three types: Emergency. When a queen is killed (or removed by a beekeeper), the workers create these cells from pre-existing cells containing eggs or young larvae. They remodel the cell to fit a developing queen. Such cells may be smaller than the other two kinds of queen cells. Swarm. Under crowding (or other) conditions, workers will gradually create swarm cells, usually many in number, and generally hanging off the bottom of the comb. Swarm cells in the hive tend to be of varying ages. Supersedure. The workers detect that something is wrong with the queen, and they work to replace her by making supersedure cells. A hive usually has two of these cells placed on the face of the comb, but the number and position can vary. The supersedure cells tend to be of the same age. Queen replacement. For the workers to create a new queen, the hive MUST have eggs, or larvae that are no older than three days. If they are older, they will have been fed diluted brood food and be on their way to forming workers. If the original queen is failing or gone, and there are no eggs or three-day or younger larvae, the hive is doomed. All current larvae are on the path to becoming workers, and no queens can be made. Without a queen, no eggs are laid, therefore no brood are made, and within about six weeks all workers (and the hive) will be dead. Queen, birth/regicide/insemination. Virgin queen emerges. When the adult queen chews her way out of the queen cell, she is now a “virgin” queen. Usually, before a virgin queen emerges, the old queen in the hive will leave with some of the workers, forming a swarm. Therefore, the new virgin queen should not encounter a mated queen in the hive. Regicide. Generally there are several other queen cells in the hive. Once the first queen emerges, she is groomed and dried by her attendants. She then seeks out all other queen cells in the hive, tears open the cells with her mandibles, and stings the other queens, queen larvae, and queen pupae to death. Workers can block it. Sometimes, workers will prevent the first-hatched queen from killing the other queens. Workers line up and block her. In this case, the workers want several queens to emerge, and for each to leave with their own swarm. See section on swarming. Nuptial flight. The virgin queen then exits the hive on her “nuptial flight”. She seeks out groups of drones that have gathered at tree tops or other elevated locations (“drone congregation areas”, covered later). The queen and drones locate each other visually and chemically; drones release attractant pheromones, and the queen releases QMP. Once the drones detect the queen, they follow her and attempt to mate for about 30 minutes, and they may fly several miles during this time. Insemination. Drones approach the queen from below, and grasp her abdomen with their legs. The drone inserts his endophallus (a penetrating organ of his genitalia) into the queen’s sting cavity. He then releases his grip and allows his body to flip backward. This body flexing compresses his abdominal organs, which causes an ejaculation of sperm into the queen. The endophallus then snaps off of his body (with an audible “snap”), and he falls to the ground and dies. After mating, the endophallus protrudes from the queen’s abdomen and is termed the “mating sign”, a clear indication that she is no longer a virgin. This mating sign is thought to serve as a sort of plug preventing the sperm from leaking out of the queen. Additional drones can then mate; the mating sign is structured so that a subsequent drone’s endophallus can easily dig out the mating sign and some of the previous drone’s sperm. Once the queen returns to the hive, workers will remove the mating sign. After mating, the queen will begin laying eggs in three or four days. Drones, basic structure. Drones are male. They are larger than workers, about ¾ inch long. They are also much heavier and robust, and hairier. The eyes of a drone are huge and cover most of the head, meeting at the top of the head. Like the queen, the drone does not forage, build the nest, rear brood, or defend the hive. As such he lacks a long tongue, pollen basket, wax glands, and stinger. The purpose of a drone is to locate and mate with a virgin queen. Drones, development. In general, there are no drones in the hive during early spring. Worker bees decide when it is time to make drones, and will construct special drone cells that are larger than normal worker cells. These drone cells are often built at the edge of the comb, and are easy to see because the wax cap protrudes out from the comb surface like the tip of a bullet. When the queen detects these larger cells, she lays a single unfertilized egg in them, resulting in a drone. By mid-summer, there can be hundreds of drones in the hive. Similarities and differences to worker development. Timing of the larval development is similar to the worker, and it is fed the same diet as a worker. The main difference is that it takes 24 days from the egg for an adult drone to emerge from the cell. (For comparison, the worker takes 21 days.) Drones, activity. Drones live within the hive for their first couple of weeks of life, and then start making afternoon flights from the hive. They fly very fast, and join up with drones from other hives to form a “drone comet”, which flies through the neighborhood, visiting certain sites frequently. Drones release “drone pheromone” which attracts other flying drones, which promotes drone congregation. These sites are called “drone congregation areas”, and are often the tops of certain trees or a certain edge of a certain forest. Year after year, drones congregate at these same areas. It is thought that these areas are conducive to mating success. Drones only live a short time, and no intergenerational learning is possible, so how they know to visit these places every year is not understood. As previously stated, the drones give off attractant pheromones to attract the queen. Likewise, the queen’s QMP attracts the drones. Drones, life span. Drones cannot feed themselves, so are totally at the mercy of the workers. If he never gets the chance to mate, the workers commit fratricide. By late fall, when the hive is preparing for winter, workers push the drones out of the hive to starve. Drones are not useless in the hive; they assist in hive temperature regulation. Drones are one way that a colony can send its genes out into the world. Colony reproduction. Swarming is the natural means by which new honeybee colonies are created. It usually occurs in early spring, just before or during the main “nectar flow” (availability of pollen and nectar in the environment). This timing allows the new colony to have ample time and resources to build a new comb and rear brood. When the density of bees in the colony reaches about 36 bees per cubic inch, preparations for swarming begin. As previously stated, dilution of QMP is likely the reason. There are probably other reasons too. Process of swarming. Preparations. Queen cups and cells, egg laid. Preparations begin several days before the actual swarm occurs. The workers start with the construction of queen cups, which are large, wide cell bases usually constructed at the edge of the comb. These cups are then lengthened to form the queen cells (swarm cells), which are spacious. The cells are vertically oriented, and usually near the bottom of the comb. They appear as inch-long, dimpled, peanut-shaped swellings to the beekeeper. The queen lays fertilized eggs in these queen cells. When they hatch, the workers feed the larvae copious brood food in unlimited amounts for about 8 days, at which time the cells are capped with wax. Once the queen cells are capped, the hive is on the pathway to swarming and preventing it is very difficult. Scout bees. A few days prior to swarming, scout bees examine the environment for suitable new nesting sites. These scouts are experienced foragers that know the local area well. Conditioning the old queen for flight. During the swarming, the old queen must fly. Remember that the last time the queen flew was during her nuptial flights. The old queen is bloated with eggs and too heavy to fly, so the workers put her on a “diet” to thin her down so that she can fly again. Workers feed her little and chase her around for exercise. The old queen will greatly slow down her egg laying during this conditioning phase. Changes to worker behavior. Workers engorge themselves with honey. (Why? They will need that energy to build honeycomb at the new colony location.) Foraging activity stops temporarily. Swarming begins and ends. When the swarm begins, the old queen and 10,000 to 20,000 workers leave and fly as a mass, led by the scout bees. The speed of the swarm varies from about ½ - 6 mph, and its shape usually starts off spherical and eventually becomes egg-shaped as it moves. Back in the original colony, the new queens have not yet emerged. Commonly, the swarm will find a resting place on its way to the new nest site. Such a resting swarm is a large and noticeable object (it is during this resting phase that a beekeeper can capture the swarm). A swarm hanging temporarily on a tree branch (for example), is a large mass of workers (with full bellies) surrounding the old queen. Swarms are known to be gentle, since a full honey stomach prevents bees from stinging. If the swarm sits long enough to use up its food it can become aggressive. (The “bee beard” worn by beekeepers is a swarm.) Scouts will urge the swarm onward to the nesting site, and to guide them there, they release Nasonov pheromone from their Nasonov gland at the tip of their abdomen. The swarm is attracted to this pheromone. (Nasonov pheromone is also used at the entrance of the hive to help foragers find the entrance, and it is placed on flowers to guide other foragers to the flowers. A bee releasing the pheromone will raise its abdomen in the air and expose the gland, and then fan its wings vigorously.) Upon arrival at the new site, workers begin construction of the new comb. Recall that workers can make a lot of wax because they engorged themselves on honey before leaving the old hive (equal to about 40% of their body weight). (Like a 170 lb. man eating 68 lbs. of honey.) In a few days, the comb is usable and the queen begins laying eggs to establish the new colony. Occasionally, a swarm will not find a new site and will build an open-air colony. Back in the original colony. The original colony is termed the parent colony. Swarm cells begin to hatch, regicide or not. The first queen to emerge is a virgin queen, and is therefore skinny and is not too different in size from the workers. She seeks out and destroys the other virgin queens that are developing. The virgin queen will then take her orientation flights, then her nuptial flights, get mated to usually about a dozen or so drones (in a drone congregation area), and then return to the colony and begin to lay eggs. Prevention of regicide. Sometimes, workers prevent the virgin queen from killing the other virgin queens. In this case it is believed that the workers sense poor conditions for swarm success (that is, likely low success in setting up a new colony), so they allow multiple swarms to issue from the parent hive to increase the chances that a new colony will establish. These are usually called afterswarms. The first hatched virgin queen will leave with a small afterswarm, and then the next hatched virgin queen may leave with yet another afterswarm, etc. At some point a final virgin queen resides in the parent hive. Each afterswarm issued by the parent hive is small and they get smaller and smaller as the workers in the parent hive are used up.
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Negative and Positive Feedback Loops Control hormone levelsNegative feedback loopHormone release stops in response to decrease in stimulus- Stimulus (eating) raises blood glucose levels- Pancreas releases insulin in response to elevated blood   glucose- Blood glucose decreases as it is used by the body or  stored in the liver - Insulin release stops as blood glucose levels normalize Positive feedback loop As long as stimulus is present, action of hormone continues- Infant nursing at mother’s breast→stimulates  hypothalamus→stimulates posterior pituitary- Oxytocin released→stimulates milk production  and ejection from mammary glands- Milk release continues as long as infant  continues to nurse The Major Endocrine OrgansThe major endocrine organs of the body include: the pituitary, pineal, thyroid, parathyroid, thymus, and adrenal glands, pancreas, and gonads (ovaries and testes)Endocrine glands - Ductless - Release hormones - Directly into target tissues - Into bloodstream to be carried to target tissuesHormones(Greek word hormone – to set into motion)     Pituitary Gland and Hypothalamus o The pituitary gland is approximately the size of a pea. o It hangs by a stalk from the inferior surface of the hypothalamus of the brain, where it is snugly surrounded by the sella turcica of the sphenoid bone. o It has two functional lobes – the anterior pituitary (glandular tissue) and the posterior pituitary (nervous tissue). o The anterior pituitary gland controls the activity of so many other endocrine glands (“master endocrine gland”) o The release of each of its hormones is controlled by releasing hormones and inhibiting hormones produced by the hypothalamus. o The hypothalamus also makes two additional hormones, oxytocinand antidiuretic hormone, which are transported along the axons of the hypothalamic nuerosecretory cells to the posterior pituitary for storage. They are later released into the blood in response to nerve impulses from the hypothalamus. Oxytocin o Is released in significant amounts only during childbirth and nursing. o It stimulates powerful contractions of the uterine muscle during sexual relations, during labor, and during breastfeeding. o It also causes milk ejection (let-down reflex) in a nursing woman. Antidiuretic Hormone (ADH) o ADH is a chemical that inhibits or prevents urine production. o ADH causes the kidneys to reabsorb more water from the forming urine; as a result, urine volume decreases, and blood volume increases. o In larger amounts, ADH also increases blood pressure by causing constriction of the arterioles (small arteries). For this reason, it is sometimes referred to as vasopressin. Anterior Pituitary HormonesThe anterior pituitary produces several hormones that affect many body organs. Growth Hormone (GH) o Its major effects are directed to the growth of skeletal muscles and long bones of the body o At the same time, it causes fats to be broken down and used for energy while it spares glucose, helping to maintain blood sugar homeostasis. ProlactinIts only known target in humans is the breast.After childbirth, it stimulates and maintains milk production by the mother’s breasts.Gonadotropic Hormones (FSH and LH) o Regulate the hormonal activity of the gonads (ovaries and testes) o In women, the FSH stimulates follicle development in the ovaries. o In men, FSH stimulates sperm production by the testes. o LH triggers ovulation of an egg from the ovary and causes the ruptured follicle to produce progesterone and some estrogen. o LH stimulates testosterone production by the interstitial cells of the testes. Pineal Gland The pineal gland is a small, cone-shaped gland that hangs from the roof of the third ventricle of the brain. Melatonin o The only hormone secreted from pineal gland in substantial amounts o Believed to be a “sleep trigger” that plays an important role in establishing the body’s sleep-wake cycle. o The level of melatonin rises and falls during the course of the day and night. o The peak level occurs at night and makes us drowsy o The lowest level occurs during daylight around noon. Thyroid Gland • The thyroid gland is located at the base of the throat, just inferior to the Adam’s apple. • It is a fairly large gland consisting of two lobes joined by a central mass, or isthmus. • The thyroid gland makes two hormones, one called thyroid hormone, the other called calcitonin. Thyroid Hormone o Referred to as body’s major metabolic hormone o Contains two active iodine-containing hormones, thyroxine (T4)and thriiodothyronine (T3) o Most triiodothyronine is formed at the target tissues by conversion of thyronine to triiodothyronine o Thyroid hormone controls the rate at which glucose is “burned”, or oxidized, and converted to body heat and chemical energy (ATP). o Thyroid hormone is also important for normal tissue growth and development, especially in the reproductive and nervous systems. Homeostatic Imbalance ➢ Without iodine, functional thyroid hormones cannot be made. ➢ The source of iodine is our diet (seafoods) ➢ Goiter is an enlargement of the thyroid gland that results when the diet is deficient in iodine. Hyposecretion of thyroxine may indicate problems other than iodine deficiency. If it occurs in early childhood, the result is cretinism. ▪ Results in dwarfism and mental retardation (if discovered early, hormone replacement will prevent mental impairment) Hypothyroidism occurring in adults results in myxedema ▪ Characterized by both physical and mental sluggishness (no mental impairment) ▪ Other signs are puffiness of the face, fatigue, poor muscle tone, low body temperature, obesity, and dry skin (Oral thyroxine is prescribed to treat this condition)   ➢ Hyperthyroidism generally results from a tumor of the thyroid gland. ➢ Extreme overproduction of thyroxine results in a high basal metabolic rate, intolerance of heat, rapid heartbeat, weight loss, nervous and agitated behavior, and a general inability to relax. Graves’ disease o A form of hyperthyroidism o The thyroid gland enlarges, the eyes bulge (exophthalmos) Calcitonin ➢ Second important hormone product of the thyroid gland ➢ Decreases the blood calcium ion level by causing calcium to be deposited in the bones Parathyroid Glands ➢ The parathyroid glands are tiny masses of glandular tissue most often on the posterior surface of the thyroid gland. ➢ Parathyroid hormone (PTH) is the most important regulator of calcium ion homeostasis of the blood. ➢ Although the skeleton is the major PTH target, PTH also stimulates the kidneys and intestine to absorb more calcium ions. Homeostatic Imbalance o If blood calcium ion level falls too low, neurons become extremely irritable and overactive. They deliver impulses to the muscles so rapidly that the muscles go into uncontrollable spasms (tetany), which may be fatal. o Severe hyperparathyroidism causes massive bone destruction. The bones become very fragile, and spontaneous fractures begin to occur. Thymus o Is located in the upper thorax, posterior to the sternum. o Large in infants and children, it decreases in size throughout adulthood. o By old age, it is composed mostly of fibrous connective tissue and fat. o The thymus produces a hormone called thymosin and others that appear to be essential for normal development of a special group of white blood cells (T lymphocytes) and the immune response. Adrenal Glands o The two adrenal glands curve over the top of the kidneys like triangular hats. o It is structurally and functionally two endocrine organs in one.   • it has parts made of glandular (cortex) and neural tissue (medulla) • The central medulla region is enclosed by the adrenal cortex, which contains three separate layers of cells. Hormones of the Adrenal CortexThe adrenal cortex produces three major groups of steroid hormones, collectively called corticosteroids: 1. Mineralocorticoids (aldosterone) ➢ Are produced by the outermost adrenal cortex cell layer. ➢ Are important in regulating the mineral (salt) content of the blood, particularly the concentrations of sodium and potassium ions. ➢ These hormones target the kidney tubules(Distal Convulating Kidney Tubles) that selectively reabsorb the minerals or allow them to be flushed out of the body in urine. ➢ When the blood level of aldosterone rises, the kidney tubule cell reabsorb increasing amounts of sodium ions and secrete more potassium ions into the urine. ➢ When sodium is reabsorbed, water follows. Thus, the mineralocorticoids help regulate both water and electrolyte balance in body fluids. 2. Glucocorticoids (Cortisone and Cortisol)  ➢ Glucocorticoids promote normal cell metabolism and help the body to resist long-term stressors, primarily by increasing the blood glucose level. ➢ When blood levels of glucocorticoids are high, fats and even proteins are broken down by body cells and converted to glucose, which is released to the blood. ➢ For this reason, glucocorticoids are said to be hyperglycemic hormones. ➢ Glucocorticoids also seem to control the more unpleasant effects of inflammation by decreasing edema, and they reduce pain by inhibiting the pain-causing prostaglandins. ➢ Because of their anti-inflammatory properties, glucocorticoids are often prescribed as drugs to suppress inflammation for patients with rheumatoid arthritis. ➢ Glucocorticoids are released from the adrenal cortex in response to a rising blood level of ACTH (Adrenocorticotropic hormone). 3. Sex Hormones ➢ In both men and women, the adrenal cortex produces both male and female sex hormones throughout life in relatively small amounts. ➢ The bulk of the sex hormones produced by the innermost cortex layer are androgens (male sex hormones), but some estrogens (female sex hormones) are also formed. Homeostatic Imbalance1. Addisson’s disease (hyposecretion of all the adrenal cortex hormones) ✓ Bronze tone of the skin (suntan) ✓ Na (sodium) and water are lost from the body ✓ Muscles become weak and shock is a possibility ✓ Hypoglycemia (↓ glucocorticoids) ✓ Suppression of the immune system 2. Hyperaldosteronism (hyperactivity of the outermost cortical area) ✓ Excessive water and sodium ions retention ✓ High blood pressure ✓ Edema ✓ Low potassium ions level (hypokalemia) 3. Cushing’s Syndrome (Excessive glucocorticoids) ✓ Swollen “moon face” and “Buffalo hump” ✓ High blood pressure and hyperglycemia (steroid diabetes) ✓ Weakening of the bones (as protein is withdrawn to be converted to glucose) ✓ Severe depression of the immune system 4. Hypersecretion of the sex hormones leads to masculinization, regardless of sex. Hormones of the Adrenal Medulla ➢ When the medulla is stimulated by sympathetic nervous system neurons, its cells release two similar hormones, epinephrine(adrenaline) and norepinephrine (noradrenaline), into the bloodstream. ➢ Collectively, these hormones are called catecholamines. ➢ The catecholamines of the adrenal medulla prepare the body to cope with short-term stressful situations and cause the so-called alarm stage of the stress response. ➢ Glucocorticoids, by contrast, are produced by the adrenal cortex and are important when coping with prolonged or continuing stressors, such as dealing with the death of a family member or having a major operation (resistance stage). Pancreatic Islets ➢ The pancreas, located close to the stomach in the abdominal cavity, is a mixed gland. ➢ The pancreatic islets, also called the islets of Langerhans, are little masses of endocrine (hormone-producing) tissue of the pancreas. ➢ The exocrine, or acinar, part of the pancreas acts as part of the digestive system. ➢ Two important hormones produced by the islet cells are insulin and glucagon. Insulin ➢ Hormone released by the beta cells of the islets in response to a high level of blood glucose. ➢ Acts on all body cells, increasing their ability to import glucose across their plasma membranes. ➢ Insulin also speeds up these “use it” or “store it” activities. ➢ Because insulin sweeps the glucose out of the blood, its effect is said to be hypoglycemic. ➢ Without it, essentially no glucose can get into the cells to be used. Glucagon ➢ Acts as an antagonist of insulin ➢ Released by the alpha cells of the islets in response to a low blood glucose levels. ➢ Its action is basically hyperglycemic. ➢ Its primary target is the liver, which it stimulates to break down stored glycogen to glucose and to release the glucose into the blood. Gonads ➢ The female and male gonads produce sex cells. ➢ They also produce sex hormones that are identical to those produced by adrenal cortex cells. ➢ The major differences from the adrenal sex hormone production are the source and relative amounts of hormones produced. Hormones of the OvariesBesides producing female sex cells (ova, or eggs), ovaries produce two groups of steroid hormones, estrogens and progesterone. 1. Estrogen (Steroid Hormone) ➢ Responsible for the development of sex characteristics in women (primarily growth and maturation of the reproductive organs) and the appearance of secondary sex characteristics at puberty. ➢ Acting with progesterone, estrogens promote breast development and cyclic changes in the uterine lining (the menstrual cycle) 2. Progesterone (Steroid Hormone) ➢ Acts with estrogen to bring about the menstrual cycle. ➢ During pregnancy, it quiets the muscles of the uterus so that an implanted embryo will not be aborted and helps prepare breast tissue for lactation. Hormones of the TestesIn addition to male sex cells, or sperm, the testes also produce male sex hormones, or androgens, of which testosterone is the most important. 3. Testosterone ➢ Promotes the growth and maturation of the reproductive system organs to prepare the young man for reproduction. ➢ It also causes the male’s secondary sex characteristics to appear and stimulates the male sex drive. ➢ It is necessary for continuous production of sperm. ➢ Testosterone production is specifically stimulated by LH. Other Hormone-Producing Tissues and OrgansPlacenta ➢ During very early pregnancy, a hormone called human chorionic gonadotropin (hCG) is produced by the developing embryo and then by the fetal parts of the placenta. ➢ hCG stimulates the ovaries to continue producing estrogen and progesterone so that the lining of the uterus is not sloughed off in menses. ➢ In the third month, the placenta assumes the job of the ovaries of producing estrogen and progesterone, and the ovaries become inactive for the rest of the pregnancy. ➢ The high estrogen and progesterone blood levels maintain the lining of the uterus and prepare the breasts for producing milk. ➢ Human placental lactogen (hPL) works cooperatively with estrogen and progesterone in preparing the breasts for lactation. ➢ Relaxin, another placental hormone, causes the mother’s pelvic ligaments and the pubic symphysis to relax and become more flexible, which eases birth passage. Developmental Aspects of the Endocrine System ➢ In late middle age, the efficiency of the ovaries begins to decline, causing menopause. o Reproductive organs begin to atrophy o Ability to bear children ends o Problems associated with estrogen deficiency begin to occur (arteriosclerosis, osteoporosis, decreased skin elasticity, “hot flashes”) ➢ No such dramatic changes seem to happen in men. ➢ Elderly persons are less able to resist stress and infection. ➢ Exposure to pesticides, industrial chemicals, dioxin, and pother soil and water pollutants diminishes endocrine function, which may explain the higher cancer rates among older adults in certain areas of the country. ➢ All older people have some decline in insulin production, and type 2 diabetes mellitus is most common in this age group. BLOOD ➢ It is the only fluid tissue in the body. ➢ A homogenous liquid that has both solid and liquid components. ➢ Taste, Odor, 5x thicker than water ➢ Classified as a connective tissue ❖Living cells = formed elements ❖Non-living matrix = plasma (90% water) Components •Formed elements (blood cells)are suspended in plasma •The collagen and elastin fibers typical of other connective tissues are absent from blood; instead, dissolved proteins become visible as fibrin strands during blood clotting •If a sample of blood is separated, the plasma rises to the top, and the formed elements, being heavier, fall to the bottom. •Most of the erythrocytes (RBCs) settle at the bottom of the tube •There is a thin, whitish layer called the buffy coat at the junction between the erythrocytes and the plasma containing leukocytes (WBCs) and platelets   Physical Characteristics and Volume • Color range ➢ Oxygen-rich blood is scarlet red ➢ Oxygen-poor blood is dull red • pH must remain between 7.35–7.45 • Slightly alkaline • Blood temperature is slightly higher than body temperature • 5-6 Liters or about 6 quarts /body   Functions and Composition of Blood 1. Transport of gases, nutrients and waste products 2. Transport of processed molecules 3. Transport of regulatory molecules 4. Regulation of pH and osmosis 5. Maintenance of body temp 6. Protection against foreign substances 7. Clot formation   Plasma • The liquid part of the blood; 90 percent water • Over 100 different substances are dissolved in this straw-colored fluid: ➢ nutrients ➢ electrolytes ➢ respiratory gases ➢ hormones ➢ plasma proteins; and ➢ various wastes and products of cell metabolism   • Plasma proteins are the most abundant solutes in plasma (albumin and clotting proteins) • Plasma helps to distribute body heat, a by-product of cellular metabolism, evenly throughout the body. Formed Elements Erythrocytes (RBCs) • Function primarily to ferry oxygen to all cells of the body. • RBCs differ from other blood cells because they are anucleate (no nucleus) • Contain very few organelles (RBCs circulating in the blood are literally “bags” of hemoglobin molecules ) •Very efficient oxygen transporters (they lack mitochondria and make ATP by anaerobic mechanisms) • Their small size and peculiar shape provide a large surface area relative to their volume, making them suited for gas exchange • RBCs outnumber WBCs by about 1,000 to 1 and are the major factor contributing to blood viscosity. • There are normally about 5 million cells per cubic millimeter of blood. • The more hemoglobin molecules the RBCs contain, the more oxygen they will be able to carry. • A single RBC contains about 250 million hemoglobin molecules, each capable of binding 4 molecules of oxygen. • Normal hemoglobin count is 12-18 grams of hemoglobin per 100 ml of blood • Men: 13-18g/ml Women: 12-16 g/ml   Homeostatic Imbalance Anemia • a decrease in the oxygen-carrying ability of the blood, whatever the reason is. • May be the result of (1) a lower-than-normal number of RBCs or (2) abnormal or deficient hemoglobin content in the RBCs.   Polycythemia Vera • An excessive or abnormal increase in the number of erythrocytes; may result from bone marrow cancer or a normal physiologic response to living at high altitudes, where the air is thinner and less oxygen is available (secondary polycythemia)     Formed Elements Leukocytes (WBCs) • Are far less numerous than RBCs • They are crucial to body defense • On average, there are 4,800 to 10,800 WBCs/mm3 of blood • WBCs contain nuclei and the usual organelles, which makes them the only complete cells in the blood. • WBCs are able to slip into and out of the blood vessels – a process called diapedesis • WBCs can locate areas of tissue damage and infection in the body by responding to certain chemicals that diffuse from the damaged cells (positive chemostaxis) • Whenever WBCs mobilize for action, the body speeds up their production, and as many as twice the normal number of WBCs may appear in the blood within a few hours. • A total WBC count above 11,000 cells/mm3 is referred to as leukocytosis. • The opposite condition, leukopenia, is an abnormally low WBC count (commonly caused by certain drugs, such as corticosteroids and anti-cancer agents) • WBCs are classified into two major groups – granulocytes and agranulocytes – depending on whether or not they contain visible granules in their cytoplasm.   Granulocytes Neutrophils ➢ Are the most numerous WBCs. ➢ Neutrophils are avid phagocytes at sites of acute infection. Eosinophils ➢ Their number increases rapidly during infections by parasitic worms ingected in food such as raw fish or entering through the skin. Basophils ➢ The rarest of the WBCs, have large histamine-containing granules. Histamine ➢ is an inflammatory chemical that makes blood vessels leaky and attracts other WBCs to the inflamed site   Agranulocytes Lymphocytes ➢ Have a large, dark purple nucleus that occupies most of the cell volume. ➢ Lymphocytes tend to take up residence in lymphatic tissues, such as the tonsils, where they play an important role in the immune response. ➢ They are the second most numerous leukocytes in the blood Monocytes ➢ Are the largest of the WBCs. ➢ When they migrate into the tissues, they change into macrophages. ➢ Macrophages are important in fighting chronic infections, such as tuberculosis, and in activating lymphocytes Platelets   ➢ They are fragments of bizarre multinucleate cells called megakaryocytes, which pinch off thousands of anucleate platelet “pieces” that quickly seal themselves off from the surrounding fluids. ➢ Normal adult has 150,000 to 450,000 per cubic millimeter of blood ➢ Platelets are needed for the clotting process that stops blood loss from broken blood vessels. ➢ Average lifespan is 9 to 12 days   Hematopoiesis • Occurs in red bone marrow, or myeloid tissue. • In adults, this tissue is found chiefly in the axial skeleton, pectoral andpelvic girdles, and proximal epiphyses of the humerus and femur. • On average, the red marrow turns out an ounce of new bloodcontaining 100 billion new cells every day. • All the formed elements arise from a common stem cell, thehemocytoblast, which resides in red bone marrow. • Once a cell is committed to a specific blood pathway, it cannotchange. • The hemocytoblast forms two types of descendants – the lymphoidstem cell, which produces lymphocytes, and the myeloid stem cell,which can produce other classes of formed elements.   Formation of RBCs • Because they are anucleate, RBCs are unable to synthesizeproteins, grow, or divide. • As they age, RBCs become rigid and begin to fall apart in 100 to 120 days. • Their remains are eliminated by phagocytes in the spleen, liver, and other body tissues. • RBC components are salvaged. Iron is bound to protein as ferritin, and the balance of the heme group is degraded to bilirubin, which is then secreted into the intestine by liver cells where it becomes a brown pigment called stercobilin that leaves the body in feces. • Globin is broken down to amino acids which are released into the circulation.The rate of erythrocyte production is controlled by a hormone called erythropoietin (from the kidneys) • Erythropoietin targets the bone marrow prodding it into “high gear” to turn out more RBCs. • An overabundance of erythrocytes, or an excessive amount of oxygen in the bloodstream, depresses erythropoietin release and RBC production. • However, RBC production is controlled not by the relative number of RBCs in the blood, but by the ability of the available RBCs to transport enough oxygen to meet the body’s demands   Formation of WBCs and Platelets   • The formation of leukocytes and platelets is stimulated by hormones • These colony stimulating factors (CSFs) and interleukins not only prompt red bone marrow to turn out leukocytes, but also enhance the ability of mature leukocytes to protect the body. • The hormone thrombopoietin accelerates the production of platelets from megakaryocytes, but little is know about how process is regulated. • When bone marrow problems or disease condition is suspected, bone marrow biopsy is done.   Hemostasis If a blood vessel wall breaks, a series of reactions starts the process of hemostasis (stopping the bleeding). Phases of Hemostasis 1. Vascular spasms occur. 2. Platelet plug forms. 3. Coagulation events occur.       Human Blood Groups • An antigen is a substance that the body recognizes as foreign; it stimulates the immune system to mount a defense against it. • The “recognizers” are antibodies present in plasma that attach to RBCs bearing surface antigens different from those on the patient’s RBCs.   ABO and Rh Blood Types The blood group system recognizes four blood types: • Type A, B, AB, and O • They are distinguished from each other in part by their antigens and antibodies. • Specific antibodies are found in the serum based on the type of antigen on the surface of the RBC   ABO and Rh Blood Types BLOOD TYPE Can Accept From Can Donate To A A, O A, AB B B, O B, AB AB A, B, AB, O AB O O O, A, B, AB   The Rh Factor Rh-Positive Rh-Negative Contains the Rh antigen -No Rh antigen   -Will make antibodies if given Rh-positive blood   -Agglutination can occur if given Rh-positive blood     Summary • Blood is responsible for transporting oxygen, fluids, hormones, and antibodies and for eliminating waste materials. • The major components of blood include the formed elements and plasma. • RBCs transport oxygen and carbon dioxide; WBCs destroy foreign invaders. • WBCs include granulocytes and agranulocytes. • Plasma is the liquid portion of unclotted blood. Serum is the liquid portion of clotted blood • Hemostasis includes four stages: blood vessel spasm, platelet plug formation, blood clotting, and fibrinolysis. • ABO and Rh types are determined by the antigen found on the RBCs
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