LECUTRE

Physo 2B
Lecture Terms & Concepts
Burres-Jones - 2011
LECUTRE STUDY GUIDE Check-List 2 – Circulatory System Anatomy
CH18 pp. 683-718, CH19 pp. 719-734, CH20 pp. 755-764 & 778-814, CH21 pp. 815-837 & 847-848
Identify, Define or Give the Significance of:
Blood Ch 18 (& 21):
Apoferritin (liver protein)
Pale lilac granules
Connective tissue (cells + matrix)
Ferritin (liver storage complex)
Kill bacteria-“first responders”
Formed elements (vs. cells)
Hypoxemia, EPO & Kidneys
Respiratory burst (degranulation)
Plasma ≈ 55% (= matrix)
Emphysema
O2 ⇒ superoxide anions + H+ = H2O2
Serum (= ground substance)
Polycythemia
Hypochlorite (in bleach)
Hemolysis
Killing zone
Erythrocytes (≈7.5 µm) (120 days)
Macrophages “eat” in spleen
Leukocytes
Very active phagocytes
Heme ≠ globin
Granulocytes (4-8 hrs in blood)
Neutrophils
Eosinophils <4%
Globin ⇒ free AAs
Eosinophils
Redish-orange granules
Iron ⇒ blood w/transferring
Basophils
2-lobed nucleus
Heme ⇒ Biliverdin ⇒ Bilirubin
Agranulocytes
⇑Allergies & parasitic infections
Bilirubin+albumin to liver
Monocytes (live 10-20 hrs)
Stimulate basophils & mast cells to
Bilirubin = bile pigment
Lymphocytes (live weeks-decades)
degranulate; +enzymes degrade histamine
⇒Urobilinogen & Urochrome
Platelets
Phagoyctize antigen-antibody complexes
Jaundice
Hematocrit (packed cell volume) ≈ 45%
Primary polycythemia (RBC CFU cancer)
Buffy coat <1%
Basophils <1%
2ndary polycythemias
Albumin (viscosity & osmolarity!)
Dark, bluish-black large granules
(dehydration & hypoxemia)
Globulins (alpha, beta, gamma)
obscure nucleus
Anemias (3 categories)
Histamine=vasodilator
Fibrinogen ⇒ Fibrin
⇓Erythropoiesis or hemoglobin
Heparin=anticoagulant
-kidney failure
Electrolytes
-Iron-deficiency
Similar to Mast cells in CTs
Viscosity
-Pernicious (⇓B12)
Osmolarity
Hemoragic
Agranulocytes:
Colloid osmotic pressure
Hemolytic
Monocytes <6%
Hemopoiesis=Hematopoiesis
Intrinsic factor
Largest WBC
-blast ⇒ -cyte
Hypoxia
Pale sky blue cytoplasm w/kidney
Yolk sac⇒marrow, liver, spleen, thymus
Sickle Cell Disease (homogyous)
shaped nucleus
Myeloid
Sickle Cell Trait (heterozygous)
Become
Macrophages in CT
Lymphoid
HbS (Valine for Glutamic acid)
Most active phagocytes
Pluripotent stem cell
Agglutinate
Tissue-specific cell names:
Colony-forming units (CFUs)
Antigens
Kupffer cells (liver)
Antibodies
Alveolar macrophages (lungs)
Erythrocytes (RBCs) ≈5mil/mm3
ABO Blood Group
Microglia (CNS)
Biconcave
Agglutinogen=on RBC
Dendritic cells (mobile, in epidermis)
Anucleate
Agglutinin=plasma antibody
Reticular cells (fixed, RE cells)
≈2.5 mil cells/sec produced/die
(anti-A or anti-B) p. 698 & 847-848
(RE=reticuloendothelial cells)
Spectrin & Actin
Type O, Type A, Type B, Type AB
ALL
Function as antigen-presenting cells (APCs)
Carbonic anhydrase
Universal recipient
Globin (alpha, beta, delta, gamma)
Universal donor
Lymphocytes ≈30%
Heme
Smallest WBC
HbA (2α 2β)
97.5%
http://nobelprize.org/educational_games/me
Pale sky-blue cytoplasm, LG nucleus
HbA2 (2α 2δ [delta]) 2.5%
dicine/landsteiner/
may nearly fill cell (look for
HbF (2α 2γ [gamma])
crescent of sky blue cytoplasm)
Hemoglobin concentration ≈15 g/dL
Transfusion reaction
Involved in immunity
+
Hemoglobin
Rh blood group: Rh & Rh
3 Categories: Natural (NK) cells
Oxyhemoglobin
anti-D
T cells
Deoxyhemoglobin
Hemolytic disease of the newborn (HDN)
B cells
Carbaminohemoglobin
(=erythroblastosis fetalis)
Erythropoiesis
RhoGAM/Gamulin
Leukopoiesis
Erythropoietin (EPO)
Myeloblasts, Monoblasts, Lymphoblasts
Erythrocyte CFU
Leukocytes (WBCs) ≈ 5,000-10,000/µL
Leukocytosis (⇑10,000 WBCs/µL)
Reticulocyte
p. 701-706, 820-822 & 830[-837]
Leukopenia (⇓5,000 WBCs/µL)
Polyribosomes
Granulocytes:
Leukemia = cancer w/⇑immature WBC #s
3+
2+
Iron: Ferric Fe & Ferrous Fe
Neutrophils ≈60%
Myeloid leukemia (granulocytes)
2+
Stab or Band cells
Fe3+ ⇒ Fe (by stomach acid)
Lymphoid leukemia (agranulocytes)
2+
Gastroferritin (binds Fe )
Polymorphonuclear leukocytes
Transferrin (in blood)
3-5 lobed nucleus
Physo 2B
Platelets (≠thrombocytes)
-stored in spleen, live ≈ 10 days
-2nd most abundant FE after RBCs
-cell fragments, but MANY functions
-form pseudopods when activated
-have α2 receptors; ∴stress⇑clotting
-granules =initiate clot & help dissolve
=vasoconstrict
=attract more platelets
-attract neutrophils to inflammation sites
-phagocytize bacteria
-secrete growth factors, to repair CT &
smooth muscle walls around vessels
Thrombopoiesis & Thrombopoietin
Megakaryocytes (some colonize lungs &
make more platelets there!)
Hemostasis (stopping bleeding), 3 parts:
•Vascular spasm⇒serotonin release
•Platelet plug formation⇒stick&contract
•Bloodclotting⇒degranulation & cascade
to form Fibrin
Procoagulants = liver proteins in plasma
Anticoagulants (heparin, antithrombin)
(Enzymatic) Reaction cascade
Enzyme amplification
Extrinsic mechanism ≈15 sec
Intrinsic mechanism 3-6 min
Ca++ important in both
Factor X = in common
Prothrombin activator activates:
Prothrombin⇒Thrombin
Thrombin activates:
Fibrinogen⇒Fibrin
Clot retraction
PDGF
Fibrinolysis
XII⇒Kallikrein⇒Plasminogen⇒Plasmin
Prostacyclin
Hemophilia
Liver disease & blood clotting
Vitamin K
Hematoma
Thrombosis
Thrombus⇒Embolus
Infarction
Pulmonary embolism
Transient ischemic attack (TIA)
Stroke
Heart Ch 19: p. 719-734 (top)
Circulatory system
Cardiovascular system
Cardiology
Pulmonary circuit
Systemic circuit
Apex & Base
Atrioventricular sulcus & septum
Interventricular sulcus & septum
Endocardium
Lecture Terms & Concepts
Myocardium (w/cardiocytes)
Epicardium=Visceral pericardium
Pericardial cavity w/serous fluid
Parietal pericardium
Pericarditis & friction rub
Superior vena cava (w/Azygous vein)
Inferior vena cava
Right atrium
Opening of coronary sinus
Right auricle (w/Pectinate muscles)
Interatrial septum
Fossa ovalis
Tricuspid valve
Chordae tendinae
Right ventricle
Papillary muscles
Trabeculae carnae
Pulmonary Trunk
Pulmonary semilunar valve
R&L Pulmonary AA.
Ligamentum arteriosum
R&L Pulmonary VV.
Left atrium
Left auricle (w/Pectinate muscles)
Bicuspid (mitral) valve
(has chordae tendinae attached to
papillary muscles too)
Left ventricle
Aorta
Aortic semilunar valve
R&L Coronary AA (base of, on aorta)
Ascending aorta
Aortic Arch
Brachiocephalic Trunk
Left Common Carotid A
Left Subclavian A
Descending aorta
Coronary Arteries:
L/R coronary AA
Circumflex A
Anterior interventricular A
Marginal A
Posterior interventricular A
(collateral circulation & anastomoses)
Cardiac Veins:
Great cardiac vein & Coronary sinus
Middle cardiac vein
Diastole
Systole
Sympathetic innervation (cardiac nerves)
Parasympathetic innervation (Vagus)
Vagal tone (sinus rhythym=70-80 bpm)
Pacemaker cells (100 bpm intrinsic rate)
Nodal rhythym = 40-50 bpm
Arrythmia
Heart block
Burres-Jones - 2011
Cardiac Conduction System:
Sinoatrial node
Atrioventricular node
Atrioventricular bundle (of His)
R&L bundle branches
Purkinje Fibers
Myocardial cells (cardiocytes)
-Branching
-Striated
-Intercalated discs w/
•Desmosomes
•Gap junctions
Atrial Syncytium & Ventricular Syncytium
Fibrous skeleton of heart
Atherosclerosis
Foam cells
Atheroma
Arteriosclerosis
Fatty embolus
NO (nitric oxide) (role of)
Vessels Ch 20: p. 755-764 & 778-808
ARTERY heads AWAY from heart
VEIN heads TOWARD heart
“Lg Artery w/Name⇒Md AA⇒Sm
AA⇒arterioles ⇒capillaries⇒venules⇒Sm
VV⇒Md VV⇒ Lg Vein w/name”
Tunica interna (intima)
Endothelium + basement membrane
Internal elastic lamina (in arteries)
Tunica media (smooth muscle)
(External elastic lamina, if present)
Tunica externa
(Vaso vasorum, if present)
Endothelium produces:
-vasodilators/vasoconstrictors
-liproprotein lipase
-prostaclyclin
-CAMs for leukocyte adherence
Arteries=Resistance Vessels
Arteries BRANCH to smaller arteries
Conducting, Muscular, & Resistance AAs
Arterioles = THE major control sites for
vasodilation/vasoconstriction!!
Metarterioles
Precapillary sphincters
Carotid sinuses (baroreceptors)(int.carotid a)
Carotid bodies (chemoreceptors)(ext. carotid a)
Aortic arch (has both)
Capillaries=Exchange Vessels (+some venules)
Endothelium + basement membrane
NOT found: epithelia, cornea, lens, cartilage,
few in tendons/ligaments
Pericytes
Physo 2B
•Continuous capillaries
-Intercellular clefts
•Fenestrated capillaries
-Filtration pores
•Sinusoids
Capillary beds w/
Metarteriole⇒Thoroughfare channel
¾ shut down at any given time
Lecture Terms & Concepts
(know diaphragm landmark)
Abdominal aorta
Inferior Phrenic AA
•Celiac Trunk
Left Gastric A
Splenic A
Common Hepatic A
Right Gastric A
Veins=Capacitance Vessels
Hepatic Artery Proper
≈54% blood in systemic veins
•Superior mesenteric A
(vs 11% in systemic arteries)
Renal AA
Veins form from smaller TRIBUTARIES
Venous Valves (not in sm, LG veins, ventral Adrenal AA (=Suprarenal AA)
Gonadal AA
body cavity or brain)
Lumbar AA (5 pair)
Skeletal muscle pump
•Inferior mesenteric A
Post-capillary venules=diapedesis site!
Median sacral A
Venous sinuses
Portal system
•Common iliac A
Anastomosis
Internal iliac A
Arteriovenous shunt
External iliac A
(know inguinal ligament landmark)
BLOOD VESSEL LIST:
èFemoral A
Ascending Aorta
Femoral circumflex AA
R&L Coronary AA
Deep femoral A
Aortic Arch
(know adductor hiatus landmark)
Brachiocephalic Trunk
èPopliteal A
Left Common Carotid A
Posterior tibial A
Left Subclavian A
Medial and Lateral Plantar AA
Plantar Arch & Digital AA
Descending aorta (thoracic&abdominal)
Anterior tibial A
Paired visceral branches:
èDorsalis pedis A
Intercostal aa.
èArcuate A
Superior phrenic aa.
Metatarsal AA
Unpaired median visceral branches:
Digital AA
Esophageal, pericardial & bronchial
aa (variable in #)
Additional Circulatory Structures to
Brachiocephalic Trunk
Know:
•R. Common Carotid A
Circle of Willis:
Internal carotid A. (w/carotid sinus=
Vertebral AA
baroreceptor)
Basilar A
External carotid A. (w/carotid body=
Posterior Cerebral AA
chemosensor)
Posterior Communicating AA
Facial A
Internal Carotid AA
Superficial Temporal A
Opthalmic AA
•R. Subclavian A
Middle Cerebral AA
Vertebral A
Anterior Cerebral AA
Internal thoracic (mammary) A
Anterior Communicating A
Thyrocervical Trunk
(know clavicle landmark)
Fetal Circulation:
èR. Axillary A
•Be able to trace TWO paths through heart
Posterior Circumflex Humeral A.
that bypass the lungs!
Anterior Circumflex Humeral A.
Umbilical V ⇒ Ligamentum teres
èR. Brachial A.
Ductus venosus ⇒ Ligamentum venosum
Ulnar A.
Foramen ovale ⇒ Fossa ovalis
Radial A.
Ductus arteriosus ⇒ Ligamentum
Superficial Palmar Arch
arteriosum
Deep Palmar Arch
Umbilical arteries ⇒ Medial umbilical
Metacarpal AA. (common digital aa.)
ligaments
Digital AA.
Burres-Jones - 2011
Hepatic Portal Circulation:
Superior mesenteric v & Splenic v (plus
gastric vv)
= 2 main tributaries of Hepatic Portal V!
Hepatic vv. (drain liver into IVC)
Inferior mesenteric v. drains into Splenic v
Superficial Veins:
Leg:
Great saphenous vein
Lesser saphenous vein
Arm:
Cephalic vein
(Median Antecubital vein)
Basilic vein
Median Cubital Vein
Points to Remember:
Veins that are different than arteries:
Venous sinus circulation:
Superior sagittal sinus
Inferior sagittal sinus to Straight sinus
to Confluence of the sinuses
Transverse sinus to Sigmoid sinus
to Internal Jugular vv
(also Opthalmic vv to Cavernous Sinus to
Confluence)
Brachiocephailic vv = union of
subclavian & int. jugular vv
Superior Vena Cava = union of R & L
Brachiocephalic vv!
R Ascending Lumbar v to Azygyous v
L Ascending Lumbar v to Hemiazygous v
Other points to remember:
•Int. Carotid A runs w/Int. Jugular V
(there are NO carotid veins NOR any
jugular arteries!!!!!)
•Aortic Arch branches ‘parallel’ Superior
Vena Cava tributaries and
•Descending Aortic branches ‘parallel’
Inferior Vena Cava tributaries EXCEPT for
Hepatic Portal System!
(Azygous drainage different from aa. too)
•Only 1 Brachiocephalic Trunk (an artery),
but 2 Brachiocephalic VV!
***Inferior Rectal VV drain into Internal
Iliac VV & NOT the portal system, so
suppository drugs bypass liver!
Physo 2B
Lymphatic System Ch 21:
Fluid, Vessels, Tissue, Organs
3 Major Functions”
•Fluid recovery (excess IF)
•Immunity
•Lipid absorption
Fluid compartments
ICF
ECF=IF + IV (+etc.)
Lacteals
Lymph (no RBCs & ⇓protein)
Chyle
Lymphatic capillaries (bud from veins)
One-way minivalves
Collecting vessels
Lymphatic trunks (6)
Collecting ducts (2) (book misprint)
Right lymphatic duct
Thoracic duct
Skeletal muscle pump
Vessel contractions
Thoracic (respiratory pump)
Immunocompetent
Lymphatic Cells:
Natural Killer (NK) Cells
-attack bacteria
-immune surveillance
T lymphocytes (T cells)
-mature in thymus
B lymphocytes (B cells)
-mature in bone marrow
Macrophages
-develop from monocytes in CTs
-phagocytic!
-display antigen to T cells
Dendritic cells
-Langerhans cells in epidermis
-mobile APCs
-engulf foreign matter
Reticular cells
-form stroma of lymphatic organs
-act as APCs in thymus
(Antigen Presenting Cells [APCs])
(all APCs make MHC-II proteins upon
which to display antigens! = Macrophages,
B cells, Reticular & Dendritic cells)
Lymphatic Tissues:
Diffuse ⇒
Mucosa-associated lymphoid tissue
MALT (GALT+BALT+NALT)
Lymphatic nodules
-in ileum = Peyer’s patches
Lymphatic Organs:
Primary=
Red Bone Marrow (reticular cells &
reticular fibers=very different)
Thymus (lymphatic & endocrine)
Lecture Terms & Concepts
Secondary=
Lymph Nodes
Tonsils
Spleen
Thymus
Capsule w/trabeculae
Cortex & Medulla
Reticular epithelial cells &
Blood-Thymus barrier
Thymic hormones & T cell maturation
Immunocompitance
Reticular cell testing
Negative selection
Clonal deletion
Anergy
Positive selection & clones
Naïve lymphocyte pool
Lymph nodes=most numerous
Cleanse (filter) lymph
T&B cell activation
Cortex & medulla
Capsule & trabeculae
Multiple afferent vessels
Fewer efferent vessels
Stroma of reticular fibers & cells
Cervical nodes
Axillary nodes
Inguinal nodes
Popliteal nodes
Abdominal & Thoracic nodes
Lymphadenitis
Lymphadenopathy
Metastatic cancer
Tonsils
Crypts
Pharyngeal, Palatine & Lingual tonsils
Tonsillitis
Tonsillectomy
Spleen
Produces WBCs in fetus
Monitors blood for antigens=‘giant node’
“Test” RBCs (‘graveyard’)
Red pulp=sinusoids w/RBCs
White pulp=lymphocytes & macrophages
Antimicrobial Proteins
Interferons
Complement = liver plasma proteins
Membrane Attack Complex
Immune Surveillance ⇒NK cells
-not selective, any abnormal cell killed
-bacteria, virus-infected, cancer cells
-Perforins & Granzymes (induce apoptosis)
Burres-Jones - 2011
Fever = pyrexia
=beneficial ⇑metabolic rate & tissue repair
& inhibits bacteria & virus repro.
•Why? Neutrophils & Macrophages release
Interleukin-1, a pyrogen, that acts on ant.
hypothalamus to release prostaglandin E ⇒
raises hypothalamus T° setpoint
•NSAIDS block PGE synthesis!!
I. Onset⇒ chills, shiver, cold&clammy
II. Stadium⇒hot when pathogen present
III. Defervescence
⇒crisis (flush)=sudden
⇒ lysis = slowly falls
Inflammation: p. 834-837
3 purposes
4 signs
3 stages
I. Mobilization
•Damaged cells & Mast cells & Basophils
release vasoactive chemicals: Histamine,
Kinins, Leukotrienes ⇒ Hyperemia ⇒
Margination ⇒ Diapedesis
II. Containment & Destruction
•Fluid pocket of gelatinous fibrin w/heparin
induced ‘clear area’ inside, filled
w/chemotaxically drawn Neutrophils ⇒
phagocytosis & respiratory burst
III. Cleanup & Repair
•Monocytes ⇒ Macrophges ≈ 8-12 hours
•Edema ⇒ lymphatic drainage, Pus, PDGF
& Hyperemia
Diseases/Conditions/Tests:
Hypoproteinemia
Kwashiorkor
CBC test
Differential (WBC) count
BUN test
Polycythemia
Primary polycythemia
2ndary polycythemias
Anemias
Iron-deficiency
Pernicious (⇓B12)
Hemoragic
Hemolytic
Hypoxia
Sickle Cell Disease
Transfusion reaction
Jaundice
Obstructive
Hemolytic
Neonatal
HDN/Erythroblastosis fetalis
Physo 2B
Leukopenia
Leukocytosis
Leukemias
Thrombopenia
Prothrombin time
Hemophilia
Hemotoma
Thrombus
Embolus
Infarction
TIA & Stroke
Valvular stenosis
Mitral valve prolapse
Myocardial infarction
Cardiac tamponade
Atheroma
Arrythymia
Tachycardia
Bradycardia
Heart block
Fibrillation
Blood pressure
Hypersensitivity
Allergies & Allergens
Asthma
Anaphylactic shock
Autoimmune diseases
Lecture Terms & Concepts
Burres-Jones - 2011