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A&P2 Exam 1
Ch. 17-21
| Question | Answer |
|---|---|
| what is the normal range of pH for blood | 7.35-7.45 |
| what is a plasma protein | the most abundant solute in blood |
| plasma proteins remain in the ___ and are... | remain in the blood and are not taken up by cells |
| plasma proteins are mostly produced | by the liver |
| distribution of plasma proteins in the blood: 60% ___, 36% ___, 4% ___ | albumins, globulins, fibrinogen |
| albumins functions include: | drawing in water/transporting hydrophobic substances in blood, major contributors to plasma's osmotic pressure, blood buffer |
| globulins functions include: | antibodies released by plasma B cells, transport hydrophobic substances in blood |
| fibrinogens functions include: | producing fibrin during blood clotting |
| hemoglobin is made up of 2 components | heme and globin |
| heme is the | pigment bonded to each globin chain |
| the structure of heme includes: | central iron atom binds to 1 O2, gives blood red color, carbon monoxide competes with O2 for binding |
| each hemoglobin molecule can transport | 4 O2 |
| globin is | composed of 4 polypeptide chains (2 alpha, 2 beta) |
| in globin the polypeptide chains bind to | CO2 (not in competition with O2) |
| O2 loading in the lungs produces | oxyhemoglobin (ruby red) |
| O2 unloading in tissues produces | deoxyhemoglobin or reduced hemoglobin (dark red) |
| CO2 loading in tissues produces | carbaminohemoglobin (20% of CO2 in the blood binds to hemoglobin) |
| blood cells are formed in the ___ bone marrow by ___ | red, hemocytoblasts |
| erythropeoiesis is | the creation of RBCs (2 million RBCs are made per second) |
| life cycle of an RBC: | 1: erythropoiesis 2: circulation (120 days) 3: RBC death and phagocytosis 4: Fe3+ transported via transferrin 5: Billirubin derived products |
| erythropoiesis is controlled by the hormone ___ which is secreted from ___ | erythropoietin, kidneys |
| anemia is the | low O2 carrying capability of RBCs |
| anemia has 3 key causes: | blood loss, low RBC production, high RBC destruction |
| leukocytes are | WBCs (Never Let Monkeys Eat Bananas) |
| there are 2 categories of leukocytes | granulocytes: neutrophils, eosinophils, basophils agranulocytes: lymphocytes, monocytes |
| neutrophils | bacteria slayers |
| eosinophils (ewww) | allergies, asthma, digest worms |
| basophils | contain histamine and heparin |
| lymphocytes | crucial to immunity, T + B cells |
| monocytes | turn into macrophages |
| platelets | are responsible for platelet plug formation and blood clotting |
| blood types | AB is the universal recipient O is the universal donor |
| the heart has two side by side pumps: | right side: receives O2 poor blood from body > pumps to lungs via the pulmonary circuit left side: receives O2 rich blood from the lungs > pumps to body tissues via the systemic circuit |
| receiving chambers of the heart: | right atrium: receives blood returning from systemic circuit left atrium: receives blood returning from pulmonary circuit |
| pumping chambers of the heart: | right ventricle: pumps blood to pulmonary circuit |
| the pericardium is a 2 layered serous membrane | parietal layer: lines internal surface of pericardial cavity visceral layer (epicardium): on external surface of heart |
| 3 layers of the heart wall | epicardium, myocardium, endocardium |
| epicardium | outer, visceral layer of serous pericardium |
| myocardium | middle, contractile cardiac muscle cells and layer of connective tissue (cardiac skeleton) |
| trendocardium | inner, continuous w/ endothelial lining of blood vessels, lines heart chambers and covers cardiac skeleton |
| inter arterial septum | separates atria |
| inter ventricular septum | separates ventricles |
| 3 veins that empty into the right atrium | superior vena cava, inferior vena cava, coronoary sinus |
| 4 pulmonary veins empty into | the left atrium |
| the right ventricle pumps blood into the ___ trunk | pulmonary |
| the left ventricle pumps blood into the | aorta |
| the trabeculae carneae are irregular ridges of ___ on ___ (prevent surface tension) | muscle, walls |
| papillary muscles anchor chordae tendineae that are attached to | heart valves |
| the heart valves open in response to ___ changes. there are 4 total, divided into 2 categories: | pressure atrioventricular (AV) valves semilunar (SL) valves |
| AV valves prevent | back flow into atria when ventricles contract |
| 2 AV valves: | tricuspid valve (right AV valve) bicuspid valve (left AV valve) |
| SL valves prevent | back flow into ventricles when ventricles relax |
| 2 SL valves: | aortic semilunar valve pulmonary semilunar valve |
| pulmonary circuit: | SVC, IVC and coronary sinus > right atrium > tricuspid valve > right ventricle > pulmonary trunk > pulmonary arteries > lungs > pulmonary veins > left atrium |
| systemic circuit | left atrium > bicuspid valve > left ventricle > aortic SL valve > aorta > systemic circulation |
| coronary circulation is | the blood supply to the heart |
| arteries arise from the base of the ___ | aorta |
| left side of coronary circulation: | left coronary artery branches > anterior interventricular artery and circumflex artery |
| right side of coronary circulation: | right coronary artery branches > right marginal artery and posterior inter ventricular artery |
| coronary sinus empties into the | right atrium (formed by merging cardiac veins) |
| the coronary sinus consists of | great cardiac vein, middle cardiac vein, small cardiac vein |
| cardiac muscle cells are: | short, striated, branched, interconnected |
| cardiac muscles have: | central nuclei, numerous mitochondria, t-tubules, SR |
| cardiac muscle also contains intercalated discs which are | the junctions between cells desmosomes: hold cells together gap junctions: allow ions to pass between cells |
| the heart depolarizes and contracts ___ nervous system stimulation | without |
| coordinated heartbeat is a function of: | gap junctions and the intrinsic cardiac conduction system |
| 3 parts of pacemaker action potential: pacemaker potential (resting membrane potential) | depolarization closes K+ channels and opens slow Na+ channels > causes continual slow depolarization |
| 3 parts of pacemaker action potential: depolarization | at threshold Ca2+ channels open and allow a huge influx of Ca2+ > causes rising phase of action potential |
| 3 parts of pacemaker action potential: repolarization | K+ channels open causing efflux of K+ |
| sequence of cardiac excitation | SA node > AV node > atrioventricular bundle > right and left bundle branches > purkinje fibers |
| SA (sinoarterial) node | pacemaker of heart in the right atrial wall, depolarizes faster than the rest of the myocardium, generates impulses about 75x/min (sinus rhythm), impulse spreads across atria to AV node |
| AV (atriovenrtricular) node | in the inferior intertatrial septum, delays impulses, allows atrial contraction prior to ventricular contraction |
| AV bundle (bundle of His) | in the inferior interventricular septum, only electrical connection between atria and ventricles |
| right and left bundle branches | 2 pathways in interventricular septum, carry impulses toward apex of the heart |
| purkinje fibers | complete pathway through iv septum into apex and ventricular walls, AV bundle and P fibers depolarize in the absence of AV node input, ventricular contraction immediately follows from apex toward atria |
| ECG is the | composite of all action potentials generated by nodal and contractile cells at a given time |
| 3 waves of ECG: | P wave: depolarization of SA node and atria QRS complex: ventricular depolarization and atrial repolarization T wave: ventricular repolarization |
| ECG intervals | P-R interval: atrial systole S-T segment: ventricular systole and atrial diastole after T wave: ventricular diastole |
| systole means ___, diastole means ___ | contraction, relaxation |
| normal heart sounds (lub-dup) | lub: AV valves close, ventricular systole begins dup: SL valves close, ventricular diastole begins |
| cardiac sympathetic nervous system response | activated by emotional or physical stressors, Norepinephrine release causes pacemaker to fire rapidly > increased heart rate |
| cardiac parasympathetic nervous system response | Acetylcholine hyperpolarizes pacemaker and opens K+ channels > decreased heart rate |
| fetal heart structures | foreamen ovale: connects 2 atria > remnant is the fossa ovalis in adults ductus arteriosus: connects pulmonary trunk to aorta > remnant is the ligamentum arteriosum in adults |
| types of blood vessels: | arteries, capillaries, veins |
| arteries | carry blood away from the heart, pressure reservoirs, oxygenated except for pulmonary and umbilical arteries |
| capillaries | contact tissue cells, exchange vessels > exchange of gasses, nutrients, wastes, hormones etc. |
| veins | carry blood toward the heart, volume reservoirs |
| arteries and veins have 3 wall layers: | tunica intima, tunica media (contains smooth muscle) , tunica external > sympathetic motor nerve fibers control vasoconstriction and vasodilation |
| capillaries only have 1 wall layer | endothelium with spare basal lamina |
| lumen are | central blood containing spaces of blood vessels |
| elastic arteries | large thick walled arteries with elastin in all 3 tunics, found in the aorta and its major branches > smooth muscle is inactive in vasoconstriction, act as pressure reservoirs |
| muscular arteries | distal to elastic arteries > deliver blood to body organs, thick tunica with more smooth muscle and less elastic tissue > smooth muscle is active in vasoconstriction, most common type of artery |
| arterioles | smallest arteries that lead to capillary beds, provide peripheral resistance > vasodilation and vasoconstriction have greatest effect on blood flow, precapillary sphincters regulate blood flow into capillaries |
| capillaries | walls consist of thin tunica intima > smallest only allow one RBC to pass at a time, surrounded by pericytes which stabilize walls and control permeability |
| continuous capillaries | abundant in skin, muscles, lungs and CNS > often have associated pericytes > pinocytotic vesicle ferry fluid across endothelial cell > most continuous capillaries have intercellular clefts |
| fenestrated capillaries | occur in areas of active filtration (kidney), absorption (s. intestine), and areas of hormone secretion > fenestrations are swiss cheese-like holes > number of fenestrations can increase in some organs |
| sinusoid capillaries | occur in liver, bone marrow, spleen, adrenal medulla > large intercellular clefts, fenestrations, few tight junctions > incomplete basement membranes > irregularly shaped w/ large lumens > blood flows through slowly |
| venules | are formed when capillary beds unite > allow fluids and WBCs into tissues > consist of endothelium and pericytes > larger venules have 1-2 layers of smooth muscle |
| veins are formed when | venules converge |
| veins compared to arteries | thinner walls, larger lumens > lower BP > thin tunica media, thick tunica externa of collagen fibers and elastic networks > blood reservoirs, contain up to 65% of blood supply |
| adaptive features of veins | large lumens offer little resistance > venous valves prevent back flow of blood > venous sinuses are large flattened veins with very thin walls (eg. coronary sinus) |
| blood pressure is the | force exerted on the wall of a blood vessel by blood > pressure gradient provides driving force that keeps blood moving from higher to lower pressure areas |
| systolic BP | pressure exerted in aorta during ventricular contraction > highest healthy is 120 mm Hg |
| diastolic BP | lowest level of aortic pressure during ventricular relaxation > highest healthy is 80 mm Hg |
| pulse pressure | difference between systolic and diastolic pressure > throbbing of arteries = pulse |
| muscular pump | contraction of skeletal muscles "milks" blood toward heart, valves prevent back flow |
| respiratory pump | breathing in moves blood toward heart by both the squeezing of abdominal veins and expansion of thoracic veins |
| venoconstricition | under sympathetic control, pushed blood toward heart |
| cardiac output | CO = SV x HR SV: stroke volume > affected by venous return HR: heart rate > maintained by medullary centers |
| neural controls of blood vessels | higher brain centers, cardiovascular center of medulla, baroreceptors, chemoreceptors |
| hypothalamus control of blood vessels | hypothalamus and cerebral cortex can modify arterial pressure via relays to medulla > hypothalamus increases BP during stress > mediates reidstribution of blood flow during exercise and changes in body temp |
| medulla oblongata control of blood vessels | contains cardiac centers, cardioinhibitory: slows heart, cardioacceloratory: speeds heart > vasomotor center, sends impulses via sympathetic efferents to vessels, moderate constriction = vasomotor tone |
| medulla oblongata receives inputs from | baroreceptors, chemoreceptors, higher brain centers |
| baroreceptors and chemoreceptors are located | in carotid arteries and aortic arch |
| baroreceptors effects | increased BP: inhibition of vasomotor and cardioacceleratory centers, stimulates cardioinhibitory center decreased BP: sitmulates vasomotor and cardioacceleratory centers, inhibits cardioinhibitory center |
| chemoreceptors effects | detect drop in CO2, pH, or O2 > cause increased BP > stimulating cardioacceleratory center: increased HR and contractility > stimulating vasomotor center: increased vasoconstriction |
| chemical controls of blood vessels | hormonal and renal controls |
| hormonal controls that cause increased BP | epinephrine and norepinephrine, adrenal gland, increased HR, contractility, vasoconstriction > angiotensin ii, vasoconstriction > ADH, vasoconstriction and anti-diuretic > aldosterone, anti-diuretic |
| hormonal controls that cause decreased BP | ANP, increases vasodilation and diuretic |
| what organ system can have long term effects on BP, blood volume, and blood filtration | renal (kidneys) > RAS, kidneys may release renin when BP is decreased |
| pulses where a pulse can be palpated on the patient | temporal artery, facial artery, common carotid artery, brachial artery, radial artery, femoral artery, popliteal artery, posterior tibial artery, dorsals pedis artery |
| steps of using a Sphygmomanometer to measure a patient's BP | pressure in cuff is increased until it exceeds systolic in brachial artery > pressure is slowly released, listen for Korotkoff sounds > systolic pressure is first sounds > diastolic is when sounds stop |
| hypertension | 140/90 |
| hypotension | 90/60 |
| circulatory shock is | any condition where blood vessels are not filled so blood cannot circulate normally |
| hypovolemic shock | results from large scale blood loss |
| vascular shock | results from extreme vasodilation and decreased peripheral resistance |
| cardiogenic shock | results when an inefficient heart cannot sustain adequate circulation |
| fetal shunts (foreamen ovale and ductus arteriosus bypass | nonfunctional lungs |
| fetal ductus venosus bypasses | liver |
| umbilical vein and arteries circulate blood | to and from the placenta |
| primary lymphoid organs | thymus, bone marrow thymus: in neck and partially overlying the heart > grows until teen years then slowly dies with aging > cortex is site of maturing T cells and macrophages > medulla contains thymic corpuscles > no B cells present in thymus |
| function of the primary lymphoid organs | to produce lymphocytes and provide a site for them to mature |
| lymphocytes are the cells of the ___ system, and are created in ___ | the immune system, red bone marrow |
| 2 types of lymphocytes | T cells: mature in thymus B cells: mature in red bone marrow |
| functions of T and B cells | both: protect against antigens T cells: manage immune response, attack and destroy infected cells B cells: produce plasma cells that secrete antibodies > antibodies mark antigens for destruction via phagocytosis |
| secondary lymphoid organs | lymph nodes, spleen, tonsils, GALT (gut associated lymphoid tissue), diffuse lymphoid tissues |
| structure and function of the secondary lymphoid organs | site where mature lymphocytes first encounter their antigen > largely made up of reticular connective tissue |
| lymph nodes | found in clusters along lymphatic vessels > cervical, axillary, inguinal > consist of fibrous capsule > trabeculae divide node into compartments > 2 histologically distant regions: cortex, medulla |
| lymph node cortex | contains follicles with germinal centers, heavy with diving B cells > dendritic cells nearly surround follicles, help active both T and B cells > deep cortex houses T cells in transit, T cells circulate continuously throughout lymphatic system |
| lymph node medulla | medullary cords extend inward from cortex and contain B cells, T cells, and plasma cells > medullary lymph sinuses contain macrophages |
| lymph node function | filter substances that travel through lymphatic fluid (lymph) |
| tonsils function | gathering and removing pathogens from food and air, form ring of lymphatic tissue around pharynx > overlying epithelium helps to trap and destroy bacteria + allow immune cells to build memory for pathogens |
| palatine tonsils | at posterior of oral cavity |
| lingual tonsils | grouped at base of the tongue |
| pharyngeal tonsils | in posterior wall of nasopharynx |
| tubal tonsils | surrounding openings of auditory tubes into pharynx |
| lymphatic vessels are | a 1 way system in which lymph flows toward the heart |
| lymphatic capillaries | are very permeable > lacteals: specialized lymph capillaries present in intestinal mucosa that digest fat and deliver it to blood |
| lymphatic collecting vessels | similar to veins but have thinner walls and more internal valves > collecting vessels in skin travel with superficial veins, deep vessels travel with arteries |
| lymphatic trunks are | a formed union of the largest collecting vessels (paired subclavian, paired jugular) > feed into lymphatic ducts |
| lymphatic ducts | right lymphatic duct: drains right arm and right side of head and thorax thoracic duct: arises from cisterns chyli and drains the rest of the body both: empty into venous circulation at junction of internal jugular and subclavian vein |
| innate defnse cells | first line of defense is skin and mucosae > second is antimicrobial proteins, phagocytes and other WBCs phagocytes: mark pathogens for destruction via oposins > neutrophils and macrophages |
| neutrophils | 1st on the scene, die fighting |
| macrophages | phagocytize hundreds of cells, free and fixed macrophages, dying neutrophils are replaced with monocytes to clean up |
| natural killer (NK) cells | induce apoptosis in cancer and virus infected cells, secrete chemicals that will enhance the inflammatory response, not phagocytic |
| adaptive defense cells | humoral immunity: B cells cellular immunity: T cells |
| the adaptive immune system | is highly specific > amplifies inflammatory response > recognizes and targets specific antigens > response is not restricted to initial site |
| humoral immunity (B cells) | defense from extracellular antigens > most clone cells become plasma cells, secrete specific antibodies which circulate in the blood and lymph, clone cells that don't become plasma cells become memory cells that will recognize and respond to same antigens |
| cellular immunity (T cells) | T cells defend against intracellular antigens > activation is a 2 step process: antigen binding, co-stimulation > both occur on surface of same APC and required for clonal selection |
| T cell receptors (TCR) bind to | antigen-MHC complex on APC surface |
| activated T cells | enlarge and proliferate > differentiate > response peaks within about a week > apoptosis occurs from the 7-30day mark > activity dies down as antigen declines > memory T cells remain |
| Class 1 MHC proteins | on all nucleated cells > bind with fragments of endogenous proteins |
| Class 2 MHC proteins | on APCs (dendritic cells, macrophages, and B cells) > bind to fragments of exogenous proteins from antigens that have been phagocytized |
| CD4 cells bind to MHC 2 to become these effectors | T helper cells (TH), regulatory T cells, memory T cells |
| CD8 cells bind to MHC 1 to become these effectors | cytotoxic T cells (TC), memory T cells |
| functions of T helper (TH) cells | overall immune response > activation of CD4 > activation of CD8 > stimulation or co-stimualtion of B cells |
| functions of cytotoxic T (TC) cells | directly attack and kill other cells > activated TC circulate through blood and lymph > target virus infected cells, cells w/ bacteria or parasites, cancer cells, foreign cells |
| TC cells release perforins and granzymes by exocytosis | perforins: create pores through which granzymes can enter target cells granzymes: stimulate apoptosis |
| 5 steps of lymphocyte development, maturation and activation | origin: all originate in red bone marrow > maturation: in prim. lymph. organs > seeding: in seco. lymph. organs and circulation > antigen encounter and activation > proliferation and differentiation |
| antibodies are produced by | immunoglobulins, proteins secreted by plasma cells (B cells) |
| antibody type IgM | first released, fixes and activates complement, potent agglutinating agent |
| antibody type IgA (secretory IgA) | found in mucus and other secretions, helps prevent pathogens entering |
| antibody type IgD | attached to surface of B cells, functions as B cell receptor |
| antibody type IgG | 75-85% of antibodies in plasma, form secondary and late primary responses, crosses placental barrier |
| antibody type IgE | active in some allergies and parasitic infections, cause mast cells and basophils to release histamine |
| B cells can | switch antibody classes but retain antigen specificity |
| antibodies targets and functions | inactivating and tagging antigens for destruction, forming antigen-antibody immune complexes > defensive mechanisms: neutralization, agglutination, precipitation, and complement fixation |
| active humoral immunity | B cells encounter antigens and producer antibodies natural: getting a cold and eventually producing antibodies artificial: response to vaccine of dead/attenuated pathogens or mRNA |
| passive humoral immunity | ready made antibodies introduced into the body, B cells not challenged by antigens natural: antibodies delivered via placenta or breastmilk artificial: injection of serum (such as gamma globulin) |
| what are the 2 chemicals that cause inflammation and how does it occur SAQ1/5 | The two chemicals that are known to cause inflammation are histamines, prostaglandins and complement. SPHR |
| swelling SAQ2/5 | caused by leaky capillaries (vascular permeability), helps to isolate area from other healthy tissue |
| pain SAQ3/5 | caused by leaky capillaries and swelling which applies pressure to pain receptors |
| heat SAQ4/5 | result of vasodilation |
| redness SAQ5/5 | also result of vasodilation |
Created by:
nurse.esme
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