Blood Vessels, Blood flow, Pressure,Vein,Arteries, immune Flashcards
(292 cards)
1
Q
Blood vessels
A
closed system
2
Q
Systemic circulation
A
arteries carry oxygenated blood & veins carry deoxygenated blood
3
Q
Three layers of blood vessels
A
Tunica Intima: closest to the lumen
Tunica Media: Middle layer where muscle tissue is found, where contraction and dilation occur.
Tunica Externa: Outer layer, where loose collagen and elastic fibers are found.
4
Q
What are the three major blood vessels?
A
Arteries, veins, & capillaries
5
Q
Arteries can be divided into 3 groups
A
Elastic, muscular, & arterioles
6
Q
Elastic Arteries
A
Thick walls; largest diameter most elastic, large lumens; low resistance vessels, conducting arteries
7
Q
Muscular Arteries
A
distributing arteries
* thickest tunica media = controls blood flow
* smaller lumen
* more muscle than elastic muscle
* vasomotor fibers keep blood vessels in a state of slight contraction
8
Q
Arterioles
A
t. media is mostly smooth muscle with few elastic fibers
* lead right in capillaries
* smaller arterioles that feed into capillary beds are just a single layer of smooth muscle cells around an endothelial lining
* function = exchange
9
Q
Veins
A
Venueles are formed by the unification of capillaries (So thin that WBCs leave through them to get to the rest of the body
* = endothelium
* larger venules have a thin t. Media & T. externa
* Do not have smooth muscle cells & elastic fibers
10
Q
How are veins formed?
A
Venules join one another. 3 tunics but they are thinner than in arteries, with a wide lumen. Can hold a lot more blood compared to arteries
* blood reservoir
11
Q
Tunica Externa in veins
A
thickest layer with thick longitudinal bundles of collagen & elastic fibers
* large veins in lower extremities must have valves(infoldings of t. Interna
12
Q
Why are veins so important?
A
capacitance vessels & blood reservoirs because can hold large volumes of blood
* but blood pressure in veins is low & can’t overcome gravity. One solution = valves = folds of t. Intima that allow blood to flow only in 1 direction
* values only open when movement occurs
13
Q
v. Vascular Anastomoses
A
Unification of vascular channels (merging of vascular channels)
14
Q
Arterial Anastomoses
A
More than one artery supplying an organ or you have one that goes into the organ, but multiple branches stemming from that one
15
Q
What is the purpose of having multiple arterial anastomoses?
A
In case something happens to one vessel (such as a blockage, or damage) the blood can flow through the others without causing problems for the entire system.
16
Q
Where are arterial anastomoses more common around?
A
Joints, abdominal organs, the brain, and the heart
17
Q
Where are arterial anastomoses poor?
A
Retina, kidney, & spleen
18
Q
Arteriovenous Anastomoses
A
Artery connects directly to the venule without capillaries in between
19
Q
Venous Anastomoses
A
Venules connect with venules without anything in between
20
Q
Capillaries
A
Microscopic with thin walls
* only T. Intima
* a few smooth muscle cells on the exterior to stabilize the vessels called pericytes
* function = exchange of materials
21
Q
What is the function of Capillaries?
A
to exchange material
22
Q
3 types of Capillaries
A
Continuous, fenestrated, & Sinusodia
23
Q
Continuous Capillaries
A
endothelial cells from a continuous lining with cells joined by tight junctions
* gaps called intercellular clefts (fluids and small solutes can pass through)
* simple squamous
* exception: brain capillaries (no intercellular clefts )
* the least permeable capillaries
24
Q
Fenestrated Capillaries
A
endothelial cells have pores or fenestrations. More permeable than continuous. Found in areas of active capillary absorption:
* have tight junctions
* found in areas of absorption and endocrine organs and filtrate formation (kidneys): fluid that has solid in it.
25
Sinusoid Capillaries
found in bone marrow, when blood cells are made
* large lumen & irregularly shaped fenestration’s fewer tight junctions
* larger intercellular clefts
* In the liver: endothelium discontinuous, with large macrophages called kupffer (macrophages found In the liver)
* The liver is the workhorse organ of the body
* synthesize plasma proteins and blood clotting factors
26
What organ is the workhorse of the body?
The liver
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Kupffer Cells
macrophages found in the liver
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In what organs are phagocyte cells on the exterior, and what is their purpose?
In other organs such as the spleen: phagocyte cells are on exterior and send cytoplasmic extensions through the clefts
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Capillaries interconnect and form
capillary beds or capillary plexuses
* microcirculation = blood → capillary bed → venule (blood leaving an arterial to capillary to venule)
* most capillary beds have 2 types of vessels:- a vascular shunt or metarteriole thoroughfare channel &, true capillaries
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most capillary beds have 2 types of vessels
a Vascular shunt or metarteriole thoroughfare channel &, True capillaries
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True Capillaries
exchange vessels (exchange only happens here ) (branches off metarteriole)
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What happens during a contraction?
Blood flow is stopped, blocks off true capillaries (blood circulation is cut off)
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What happens during relaxation?
Blood flow continues
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PreCapillary sphincters
cuffs of smooth muscle, that act as valves
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Open Capillary Spincters
capillaries are in a slight state of constriction due to vasomotor fibers controlled by the nervous system
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Closed Capillary Spincters
if there is nothing to absorb (local chemical conditions) true capillaries stay closed ( local chemical conditions and arteriolar vasomotor nerve fibers control this)
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IV venous system
Join together
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Arteries
Pressure Reservoir & conducting vesssels
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Arterioles
Resistance Vessels
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Capillaries
Exchange Vessels
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Veins
Blood reservoir & conducting vessels
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Blood flow
Volume of blood flowing through a vessel organ or entire circulation in a given period (mL/ min)
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Blood Pressure (BP)
Force per unit area on the wall of a vessel bt the blood contained therein, in mmHg
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systemic Arteriole Blood Pressure
the pressure measured within large arteries in the systemic circulation
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Resistance
a measure of the friction of blood encounters in the systemic or peripheral circulation
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Peripheral Resistance
meeting resistance in the peripheral circulation (away from the heart )
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Causes of resistance
blood viscosity, blood vessel length & diameter
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Blood Viscosity
thickness of blood
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Vessel Length
the longer the vessel the greater the resistance.
The more fat added to the body the more the vessels have to lengthen to accommodate, creating more resistance
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Vessel Diameter
not constant in the body
-The smaller the diameter, the higher the resistance = arterioles
-The larger the diameter, the lower the resistance = large arteries
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Blood from larger vessels
goes into smaller vessels, with higher resistance & blood flow becomes turbulent
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Atherosclerosis
hardening of the atheroma (plaque build-up in vessels)
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Calculation of blood flow
Fa(blood flow) = delta P (change in pressure)/ R (resistance)
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Proportionality of blood flow to pressure and resistance
Blood flow is Directly proportional to changes in Pressure. As delta P increases = Blood flow increases
Blood flow is Indirectly proportional to Resistance. As R increases = Blood flow decreases
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Blood flows along a pressure gradient, in a closed circuit
In a closed circuit, the closer the fluid is to the pump, the higher the pressure.
Therefore systemic b.p. Is highest in the aorta (120 mmHg) and reduces to 2 mmHg at the vena cava.
* resistance is high in the aorta due to only one aorta and only one path
* but having multiple arteries and capillaries, blood vessels, and veins decreases resistance and pressure within the system
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Arterial b.p. is an indicator of
how much the elastic arteries close to the heart can be stretched, & the volume of blood moving through them.
* near the heart bp rises & falls = pulsatile pressure.
Arteriosclerosis increases blood pressure
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Pulsatile Pressure
Near the heart bp rises and falls
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Systolic pressure
Left ventricle contracts, blood flows into the aorta and stretches it & aortic pressure teachers its peak ~120 mmHg
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Diastolic pressure
Aortic valves close & walls of the aorta recoil BUT maintains enough pressure to keep blood flowing to smaller vessels ~ 70-80 mmHg
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Heart distance to MAP
MAP & pulse pressure decreases with an increase in distance from the heart
The further you move from the pump (the heart) MAP and pulse pressure decrease
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Pulse Pressure
The difference between systolic & diastolic
Pulse pressure = Systolic - Diastolic
Pulse pressure INCREASES with stroke volume
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MAP = mean arterial pressure
pressure moving blood through the tissues
MAP = (diastolic pressure + pulse pressure )/ 3
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Capillary B.P.
at the start of capillaries ~ 30mmHg
At the end of capillaries ~ 15mmHg
Low pressure due to thinness
Filtrate = fluid with solutes
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Venous b.p.
Is steady. Pressure gradient from venules to vena cavae is ~15mmHg
Is too low for venous return, so veins get help by:
* the respiratory pump = pressure increases in the abdominal region due to the diaphragm moving down creating a decreased volume & increase in pressure.
* The muscular pump = muscles need to contract to push blood (milking the veins ) up and deliver blood.
* layer of smooth muscle around veins = contraction helps move blood through
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The muscular pump
muscles need to contract to push blood (milking the veins ) up and deliver blood.
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Neutral Mechanisms
Vasomotor control of the medulla, baroreceptors, chemo receptors, & higher brain control
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Maintaining B.P. = Homeostasis
An equal balance throughout body; illness occurs when homeostasis is thrown off
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Vasomotor control
a cluster of neurons in the medulla that send impulses to sympathetic fibers called vasomotor fibers
-smooth muscle of blood vessels especially arterioles
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Vasomotor tone
arterioles always in a state of mild constriction
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Accommodations of the nervous system
The nervous system can make accommodations for parts of the body that are being used
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Vasomotor activity can be modified by
Baroreceptors, chemoreceptors, and higher brain controls
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Baroreceptor reflexes
* Arterial b.p. Increases when the stretch of baroreceptors in carotid sinuses aortic arch & large neck & thoracic arteries → impulses to vasomotor control for inhibition (inhibits vasomotor construction) → vasodilation leads to decrease in b.p.
* arterial b.p. increases when baroreceptors stretch → inhibition of cardiac. control which leads to a decrease in heart rate and a decrease in b.p.
* arterial b.p. Decrease which leads to vasoconstriction an increase in cardiac output and an increase in b.p..
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Chemoreceptor reflexes
respond to chemicals in the blood
-Oxygen decreases, pH of the blood decreases or carbon dioxide levels increase which leads to impulses being sent by chemoreceptors in the aortic arch & large arteries of the neck. → cardiac, control → increase in cardiac output
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Higher Brain controls
* Hypothalamus
* Nervous system
* Endocrine system
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Short term mechanisms
hormonal (nervous system & endocrine system
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Adrenal medulla hormones (epinephrine)
increase vasoconstriction increase blood pressure
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Atrial natriuretic peptide (ANP)(Synthesized by atria)
causes blood volume to decrease, decrease b.p.
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ADH
stimulates kidneys to retain water → increase in blood volume → increase in b.p.
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What happens when the kidneys release renin?
Kidneys release renin → activates angiotensin II (most potent vasoconstrictor in the body) → vasoconstriction
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What does renin do?
Renin → stimulates aldosterone (retain sodium → leads to water retention & blood volume & blood pressure increase) & ADH
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Long Term mechanism
Renal (kidney /urinary system)
* renal regulation works by altering blood volume.
* directly, renal regulation is independent of hormones
* indirectly, renal regulation utilizes the hormone renin.
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Vital Signs
heart rate, respiration, & oxygen saturation
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A pulse
alternating expansion & recoil of arteries in each cardiac cycle → a pressure wave of blood
* The most common pulse that is measured is radial pulse - also known as pressure points (apply pressure & decrease blood flow)
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How do we measure systemic arterial B.P.
indirectly in the brachial artery by the auscultatory method.
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Sounds of korotkoff
1st sound = systolic pressure (artery begins to open and contract)
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Sphygmomanometer
B.P. Cuff (placed superiorly to the elbow, constricts brachial artery)
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sound ends
diastolic pressure (where the sound stops)
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Factors affecting B.P.
sodium levels, stress, race, obesity, age, blood clotting
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Normal adults systolic & diastolic
Systolic = 110- 120 mmHg
Diastolic = 70 - 80 mmHg
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Hypotension
Low blood pressure ( diastolic is less than 70 mmHg)
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Orthostatic Hypotension
temporary low B.P. Usually accompanied by dizziness (mainly happens in the elderly, due to continuous sitting or lying down)
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Chronic Hypotension
due to poor nutrition (long term) (lack of protein to make hemoglobin (plasma protein). (Due to hypothyroidism. & Addison’s disease ).
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Acute Hypotension
Rapid/ instantaneous B.P. drop (circulatory shock, not enough blood flowing through the system)
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Hypertension
rise in blood pressure
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Transient (temporary) hypertension
normal increase in systolic pressure (illness or stress-related)
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Persistent Hypertension
continuous high blood pressure
-increased peripheral resistance. Strains the heart and damage arteries (sustained high blood pressure)
*Primary or essential hypertension = 90% hypertension cases (no definitive cause
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Certain factors are believed to cause hypertension such as
smoking, stress, high salt intake
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Secondary hypertension due to identifiable disorders
10% of all cases:
-blocked renal arteries
-kidney failure
-hyperthyroidism
-thyroid disorders
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Tissue Perfusion
Blood flows through body tissue. It allows:
-Fuel lungs + gas exchange
-Urine making
-Absorb nutrients from the digestive system
-20% of blood flow →skeletal muscles
* In exercise it shunts blood from other systems to get to skeletal muscles
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Blood Velocity
The velocity of blood flow is inversely proportional to the cross-sectional area.
* aorta & large arteries - fast flow (blood)
* capillaries - slow flow through (blood) (exchange happens )
* veins-slow flow
Cross section of aorta = 2.5cm → 40 - 50 cm/sec (flow of blood)
Cross section of combined capillaries = 4500 cm →0.03 cm/sec (flow of blood)
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Capillary blood flow
slow due to the exchange of materials and diameter of capillaries
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Autoregulation
automatic regulation of blood flow to each tissue in proportion to requirements (each organ system can regulate blood flow) (does no damage to the system)
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MAP and CO are constant why? and what is its purpose?
MAP & CO are constant in order to have constant pressure. Therefore, changes in blood flow to individual organs are local or intrinsic, by changing the diameter of the arterioles; in essence, changing the resistance of the arterioles.
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Myogenic
smooth muscle controls (t. Media)
* increase in, intravascular pressure → increase in stretch → vasoconstriction (protect organ)
* decrease in intravascular pressure
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Metabolic
decrease in oxygen & decrease in nutrients = stimuli → relaxation of vascular smooth muscles
* inflammation chems (histamine, kinins & prostaglandins → vasodilation
* vasodilation on arterioles → temporary increase of blood flow
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What is the purpose of long-term autoregulation?
Long-term autoregulation can occur over time to increase blood flow; that is angiogenesis = making the lengthening of blood vessels
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angiogenesis
making lengthening of blood vessels
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How is Blood flow maintained in various areas of the body even when fluctuating MAP?
-Skeletal muscles: blood flow varies with fiber type & muscle activity.
* active or exercise hyperemia = shunting blood from other systems to the skeletal muscles
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Brain and blood flow
Brain: blood flow to the brain is ~ 750 ml/min
* decrease in pH & increase in carbon dioxide = vasodilation
* decrease in MAP = vasodilation to bring more blood flow to the brain to maintain pressure
* increase in MAP = vasoconstriction
* b.p. falls (60 mmHg) = fainting (syncope)
* Brain is less able to compensate for extreme press changes: cerebra edema = brain swelling
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Skin and blood flow
-Skin: blood flow is to supply nutrients & help maintain body temperature.
* lots of arteriovenous anastomoses below the skin which are supplied by sympathetic nerve endings
* blood vessels vasoconstrictor when cold to regulate temperature (to shunt blood to the core of the body)
* Heat = vasodilation of vessels so the core doesn't overheat.
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Lungs and Blood Flow
Lungs: pressure is low ~ 10 mmHg
* low oxygen in lungs →> constriction of blood vessels (vasoconstriction) (opposite in lungs due to oxygen being picked up )
* increased oxygen in lungs →> opening of blood vessels (vasodilation )( In other organs loss of oxygen would cause vasodilation )
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Heart and Blood flow
Heart: hemoglobin in cardiac cells store enough oxygen for the heart muscle in systole.
* blood flow is intermittent.
* myoglobin stores oxygen when constriction occurs
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Blood flow through capillaries is slow & intermittent, why?
because of capillary sphincters = vasomotion
* The 3 processes moving materials across capillary walls = diffusion filtration & reabsorption
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What are the 3 processes moving materials across capillary walls?
Diffusion, filtration, & reabsorption
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What happens during bulk fluid flow?
What does this determine?
But, bulk fluid flow ( fluid leaves capillaries to maintain) is also happening. Fluid is forced out of the capillaries at the arteriole end, and most will return to the capillaries at the venous end.
-This determines the relative fluid in the bloodstream & the EC space.
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oxygen, carbon dioxide, most nutrients & metabolic wastes diffuse, where?
What is diffusion?
oxygen, carbon dioxide, most nutrients & metabolic wastes diffuse between blood & interstitial fluid
* diffusion = flow down a concentration gradient. (Oxygen & nutrients flow down capillaries (down concentration gradient)
* lipid-soluble molecules = insoluble
* small water-soluble molecules = goes in between
* large water-soluble molecules = fenestrated capillaries used
* large molecules like proteins = active transport
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Hydrostatic pressure = HP
the pressure of the fluid against the container (capillary wall) capillary hydrostatic pressure = blood pressure.
* In capillaries = CHP = capillary b.p. = 35mmHg (capillary hydrostatic pressure forces fluid out)
* CHP forces fluid through capillary walls
* as b.p. Drops along a capillary bed: CHP is higher at the arteriole end than the venous end (18 mmHg due to movement of fluid out
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In capillaries = CHP = capillary hydrostatic pressure
35mmHg (capillary hydrostatic pressure forces fluid out)
* CHP forces fluid through capillary walls
* as b.p. Drops along a capillary bed: CHP is higher at the arteriole end than the venous end (18 mmHg due to movement of fluid out
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interstitial fluid hydrostatic pressure =IHP
IHP = 0
* lymphatic vessels take away extra fluid to not exert any pressure on interstitial fluid
* Net hydrostatic pressure = capillary hydrostatic pressure - IHP
Therefore net HP at the arterial & venous end of the capillary bed=CHP at these areas
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Colloid osmotic pressures
Interstitial fluid colloid osmotic pressure =ICOP = 0
pressures by the large molecules in the capillaries that can't diffuse out
* albumin pulls fluid back into capillaries
* These large molecules create the blood colloid osmotic pressure Or BCOP or osmotic pressure ~ 25 mmHg
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Circulatory shock
any condition where blood vessels are not filled & / or blood cannot circulate normally
* not enough blood getting through the system
* most common (hypovolemic)
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Net osmotic pressure
pressure pulling back fluid into the capillaries = BCOP - ICOP = 25 mmHg
* Net gain or net loss of fluid from blood = net filtration pressure (NFP )
* HP>BCOP (blood flows out)
* BCOP>HP (blood flows in)
* NFP =(CHP - IHP) - (BCOP -ICOP) = arteriole
* fluid is forced out at the arterial end of the capillaries & return at the venous end.
* more fluid leaves than that is reabsorbed
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Hypovolemic shock
most common = compensation occurs when cardiac output is low, so HR increases
Fluids are added to maintain b.p.
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Cardiogenic shock
= failure pump = when heart fails, heart can't pump blood through out system = heart attacks
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Vascular shock
blood volume is normal, but circulation is poor due to extreme vasodilation
* causes = vasodilation triggered by anaphylactic shock (system-wide vasodilation) (allergic reaction)
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Neurogenic shock
= failure of ANS regulation of blood vessels (when sympathetic N.S. Doesn't work)
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2 main circulations of the body
Pulmonary, and Systemic
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Septic shock
septicemia due to severe systemic bacterial infection.
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Pulmonary circulation function
to get blood vessels close enough to the air sacs of the lungs to get oxygenated
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Systemic circulation function
to get blood through the entire system / body
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Pulmonary circulation flow
Blood in the right ventricle → pulmonary trunk → right and left pulmonary arteries, which divide in lungs → lobar arteries → arterioles (3 right lobes & 2 left lobes ) → capillaries → venules which join → 2 pulmonary veins from each lung (4 pulmonary veins)
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System Arteries and Veins
Systemic arteries & veins take different pathways:
* heart pumps blood into 1 systemic artery: the aorta and 2 veins the superior and inferior vena cavae
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How do arteries of the systemic circulation run?
How do veins run in systemic circulation?
All arteries run deep & well protected by body tissues
Veins have more interconnections
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2 of the venous systems are unique
dural sinuses that drain blood from the brain, and the hepatic portal circulation
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All systemic circulation branches from where?
The aorta
* arteries of the head, neck, lower & upper extremities are bilaterally symmetrical
* The abdominal region is asymmetrical
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The Aorta and its branches
* as it leaves the left ventricle it is the ascending aorta. Only branches = right and left coronary arteries
* ascending curves to the left as the aortic arch. 3 main branches:
- brachiocephalic trunk = runs under clavicle branches Off into two: the right common carotid & right subclavian
- left common carotid
- left subclavian = supplies head, neck, upper limbs & part of thoracic wall
* Descending or Thoracic Aorta = sends branches to thoracic wall,& visceral organs
- becomes the abdominal aorta inferior to the diaphragm
- supplies abdominal wall & abdominal organs
- abdominal aorta splits into the right & left common iliac arteries for the pelvis & lower limbs
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The aortic arch contains what 3 branches?
- brachiocephalic trunk = runs under clavicle branches Off into two: the right common carotid & right subclavian
- left common carotid
- left subclavian = supplies head, neck, upper limbs & part of thoracic wall
132
Where does the descending aorta or the thoracic aorta send branches?
sends branches to the thoracic wall,& visceral organs
- becomes the abdominal aorta inferior to the diaphragm
- supplies abdominal wall & abdominal organs
- abdominal aorta splits into the right & left common iliac arteries for the pelvis & lower limbs
133
Arteries of the head and neck
4 pairs of arteries serve the head & neck = common carotid arteries & 3 branches from each subclavian artery:
* vertebral artery
* thyrocervical trunk
* costocervical trunk
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Each carotid artery divides into
Each carotid artery divides into internal & external carotid arteries.
* carotid sinus = contains baroreceptors
* both carotid arteries run superiorly up the lateral neck, at the superior larynx, each branches into external & internal carotid arteries
135
The external carotid artery
supplies most of the head except for the brain & organs
* send branches to the thyroid & larynx, tongue, skin, & muscles of the anterior face( facial artery) & posterior scalp(occipital artery).
* each splits to end as temporal ( superficial, supplies carotid gland / salivary gland)arteries & maxillary ( lingual artery( supplies upper & lower jaws & teeth))arteries
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Internal Carotid Arteries
runs through the carotid a canal entering the skull, supplying 80% of the brain & organs (eyes)
* divides into 3 branches:
- ophthalmic artery (eyes & forehead)
- anterior cerebral artery (frontal lobe & parietal lobes of brain)
- middle cerebral artery (lateral hemispheres of the brain )
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Anterior communicating artery
short artery shunt where anterior cerebral anastomose
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Vertebral arteries from the subclavian
runs through the transverse vertebral to the skull through the foramen magnum
139
Basilar Artery
Created by the joining of the right and left vertebral arteries; runs off the brainstem, sends off branches to the cerebellum, pons, and inner ear.
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At the pons midbrain border, the basilar divides into
a pair of posterior cerebral arteries (Comes from a vertebral artery). These connect to the middle cerebral arteries by arterial shunts called posterior communicating arteries
141
posterior communicating arteries
Arterial shunts that connect the middle cerebral arteries
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Cerebral arterial circle or circle of Willis
posterior & anterior communicating arteries, & the anterior cerebral & posterior cerebral
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Upper limbs supplied by branches of the
Subclavian
143
Why do many arteries surround the pituitary gland and chiasma?
* multiple arteries due to collateral circulation: many arteries for one in case a clot occurs another route is available
144
Pathway of Subclavian
Each subclavian (runs laterally over the first rib and under the clavicle ) → axilla where it is called the axillary artery (branches off the subclavian )
* thorax wall supplied from branches of the thoracic aorta & subclavian
* most visceral organs supplied from branches of the thoracic aorta
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Axillary artery
supplies chest wall and other branches:
-thoracoacromial artery
-lateral thoracic artery
-Subscapular artery
-Anterior and posterior humeral circumflex arteries
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Thoracoacromial artery
Supplies deltoid pectoralis muscles
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Lateral thoracic artery
supplies lateral thoracic walls & breasts
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Subscapular artery
supplies scapula posterior thoracic wall & part of the latissamus dorsi
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Anterior and posterior humeral circumflex arteries
raps around the humorous, supplies shoulder joint and part of the deltoid
150
As the axial artery leaves the axillary what artery does it become?
Brachial artery
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Brachial Artery
runs down anterior medial aspect and supplies flexors of arm (muscle)
* one major branch= deep brachial (supplies extensors (muscles))
* below the elbow brachial splits into the radial & ulnar arteries
152
Thorax Wall
* subclavian gives rise to internal thoracic arteries or mammary arteries
* internal thoracic arteries run lateral to the sternum & give Off the anterior intercostal arteries
* thoracic aorta also branches into superior phrenic arteries = diaphragm splits Off intercostal
* Superior diaphragm
153
Thoracic viscera
From the thoracic aorta
* pericardial arteries (supplies pericardium of heart)
* bronchial arteries = two left and one right supplies bronchi, lungs,& pleura
* esophageal arteries = supplies esophagus
* mediastinal arteries= supplies mediastinal area
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Arteries of the Abdomen
All arise from the abdominal aorta
All are paired except, celiac trunk, & superior & inferior mesenteric arteries
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Inferior phrenic (diaphragm) arteries =
supplies diaphragm (branches off abdominal aorta )
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(2nd branch) Celiac trunk (unpaired) =splits into 3:
* common hepatic
* left gastric
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Common Hepatic
sends branches to parts of the stomach, pancreas, and duodenum, the major branch = the hepatic artery proper takes blood to the liver. Branches as the hepatic artery proper which splits into right & left.
158
left gastric
supplies parts of the stomach & esophagus
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Superior mesenteric artery
supplies all of the small intestine and most of the large intestine
160
suprarenal arteries
supplies adrenal glands
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Renal arteries
right and left kdney
162
Gonadal arteries
testicular arteries in men and ovarian arteries in women
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Inferior mesenteric arteries
supplies distal large intestine
164
Lumbar Arteries
supplies posterior/lumbar region (4 pairs of arteries)
165
Right and Left common Iliac arteries
split from abdominal Aorta, supplies pelvis & lower extremities.
166
Internal iliac arteries
supplies pelvic wall, rectum & bladder, uterus & vagina, prostate gland & vas deferens
* branches includes, superior & inferior gluteal arteries ( supplies gluteal muscles), obturator arteries( supplies external genetalia , & internal pudendal arteries ( medial thigh abductor muscle)
166
At sacroiliac joints, common iliac arteries divide into
internal & external iliac arteries
167
External iliac arteries
as enters the thigh, and branches into the femoral arteries
168
Femoral arteries
supplies anterior medial thigh wraps around supple fascia )
* branches include deep femoral which branches into the lateral and medial femoral circumflex arteries (supplies most of the thigh muscle (quadriceps, hamstring)
169
Anterior tibial artery
runs down the anterior tibial
* becomes dorsalis pedis artery in the foot (serves ankle & foot).
170
Popliteal Artery
Supplies knee region
171
Posterior tibial artery
runs down posterior
- branches include fibular or peroneal artery ( supplies lateral muscle)
- at ankle, it divides into lateral & medial plantar arteries (supplies plantar)
172
Superior vena cava
formed by right & left brachiocephalic veins. Each brachiocephalic vein is formed by the union of the internal jugular & subclavian veins
172
Arteries _______, veins _____ into something else going ___
Branch, drain, up
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Inferior vena cava
largest blood vessel & widest in body. Formed by the union of the pair of common iliac veins
174
Vein don't ______, they ________
branch, merge
175
External jugular vein
empties into subclavian, over the external of the skull, drains the scalp, and part of the face & empties into the subclavian
176
Internal Jugular vein
empties into the brachiocephalic trunk receives all blood from the brain & facial vein
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Vertebral vein
empties into the brachiocephalic trunk, drains vertebrae, spinal cord, and neck muscle, & empties into the brachiocephalic.
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Most veins of the brain drain into the ______ → other sinuses →(empties into) ______ veins
dural sinuses, Internal jugular veins
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Brachiocephalic make up
Internal jugular vein + subclavian vein
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2 Brachiocephalics join to form
superior vena cava
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Medial Cubital vein
take blood to do tests (close to skin surface / superficial)
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Brachiocephalic Veins
drains most of the mammary region (breasts). Intercoastal veins 1,2,3 empties in brachiocephalic veins
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Azygos System
drains all viscera of the thorax & thoracic wall
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Veins of the upper limbs pathway
Deep palmar veins merge to form radial & ulnar veins which merge to form the brachial vein → axillary vein → subclavian vein.
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The superficial venous arch drains into 3 major superficial veins
3 major superficial veins:
* cephalic
* basilic
* median antebrachial
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Basilic vein
merges with brachial vein to form axillary vein
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Cephalic vein
drains into axillary
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Azygos vein
originates from the right ascending lumbar vein (abdominal) and drains most of the thoracic region. Empties into superior vena cava
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Homozygous vein
empties into azygos
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Azygous system
Homozygous vein
Azygous vein
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Lumbar veins
drains posterior abdominal wall
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Veins of the abdomen
All empty into the hepatic portal vein → liver →The veins then branch into capillaries, they then combine again to go back to veins = a portal system
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Hepatic portal system
carries blood filled with nutrients from the digestive organs to the liver
* (liver) hepatocytes - take up nutrients
* Kuffer cells = phagocytes
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Gonadal Veins
right empties into the vena cava (testicular veins in males and ovarian veins in females)
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Renal veins
right and left drains the kidneys
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Suprarenal veins
right empties into the inferior vena cava from the adrenal glands (drains adrenal glands, left adrenal veins empties into left renal vein due to proximity)
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Hepatic Portal system
All capillaries empty into the hepatic portal vein (hepatic portal vein -> capillaries -> combined to form hepatic vein
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Cystic Veins
drains gallbladder, empties into hepatic veins (gallbladder)
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Superior Mesenteric Vein
Drains all small intestine, 2/3 of the large intestine, the stomach, & parts of the pancreas
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Splenic Vein
drains the spleen, parts of the stomach, and pancreas (joins the superior mesenteric vein to form hepatic portal vein)
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Inferior mesenteric vein
drains distal 1/3 of the large intestine & rectum (joins splenic vein & superior mesenteric vein to form the hepatic portal vein)
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Medial & lateral plantar veins unite to form?
Dorsalis pedis vein continues as the
The popliteal continues as the? and drains the?
-posterior tibial joined by fibular vein and goes to back of the knee to form popliteal
- as the anterior tibial vein. This joins the posterior tibial at the Renee to form the popliteal vein
-popliteal continues as the femoral vein = drains all muscles in the thigh
* femoral vein → pelvis & becomes the exterior iliac to form common iliac vein (two common iliac veins combine to form inferior vena cava.
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Superficial veins pathway
* dorsal venous arch → great & small saphenous veins
* great saphenous = longest vein in body (runs medially up leg & thigh ) (when a parent needs a coronary bypass, a piece is taken from great saphenous ). Empties into femoral veins
* small (lesser) saphenous = runs laterally → posteriorly → empties into the popliteal vein (starts at the dorsal venous vein).
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The lymphatic system can be divided into two:
Lymphatic vessels and Lymphatic tissues
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Lymphatic tissues
have phagocytic cells and lymphocytes so they can trigger an immune response.
- primarily reticular connective tissue in all lymphoid organs
* macrophages sit on top of fibers
* lymphocytes sit in between fibers
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Lymphatic vessels
picks up lymph
-picks up interstitial fluid becomes lymph and are sent to the circulatory system to go to the heart
* have valves just like veins
* none in bone marrow, bones, teeth, & in the central nervous nervous system.
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Lymphatic vessels and lymphatics
Fluid from capillaries & any escaped plasma proteins must be returned to the CV system. This is done by lymphatic vessels or lymphatics
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When Interstitial fluid that enters the lymphatics
pressure builds up when the area begins to fill up with fluid which forces open valves and fluid moves into lymphatic capillaries
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A. Lymphatic vessels form a one-way system to the heart.
* The system begins as blind-ended lymphatic capillaries between tissue cells, & blood capillaries. All over the body except bone marrow, bone, teeth,& in the central nervous system.
* very permeable
* pressure increases in interstitial fluid til it is greater than in lymphatic capillaries
* pressure increases in lymph capillaries
- takes up escaped nutrients
-takes up excess lymph
-absorbed gas from digestive fats from the digestive system
* lymphatic capillaries will pass through lymph nodes = takes care of bacteria that enter.
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Lacteals
specialized lymphatic capillaries in the mucosa of the intestines
* lymphatic capillaries → collecting vessels → trunks → ducts
* lymph - collecting vessels = have intima, media & externa
* have a lot more valves, and anastomoses, compared to veins
* but like veins they are superficial & deep
* large collecting vessels join to form lymphatic trunks = a pair of lumbar trunks,2 bronchomediastinal trunks, 2 subclavian trunks, 2 jugular trunks( empties head & neck),& 1 intestinal trunk
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Right lymphatic duct
drains the right side of the head, right side of the neck, right of the thorax, and right upper extremities
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Chyle
Lymph that is a milky color, and carries digestive fats taken by everybody in the body due to being picked up by lymphatic capillaries
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Large thoracic duct
Brain everything else including the left side of the head, the left side of the neck, the left side of the thorax
- first seen as an enlarged area called cisterna chyli
* each duct empties into venous circulation = and needs valves, veins, musculatory respiratory pump.
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Lymphoid organs are composed of
lymphoid cells and lymphoid tissues
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Lymphoid cells
originates in bone marrow
- microbes entering our bodies are dealt with by the inflammatory response, phagocytes & lymphocytes
- the main cell of the immune system = protects you against antigens - anything that can evoke an immune response (anything the body sees as foreign ).
- T & B cells protect against Ags (antigens)
- T cells = manage immune response
-B cells = produces antibodies = mobilizes antigens
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T cells
manage immune response
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B cells
Produce antibodies, mobilizes antigens
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Macrophages
phagocytic cells activates T cells
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Dendritic cells
holds onto antigens
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Reticular cells
provide structural support
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Lymphoid tissue can occur as
* diffuse lymphatic tissue = have patchy areas within lymphocytes & macrophages
* lymphoid nodules or follicles = circular structure
* have light staining centers called germinal centers
- have B cells that develop into plasma cel is and release antibodies
- found in intestinal walls as Peyer'S patches & in appendix.
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Where do lymphatic vessels run?
All throughout the body
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Lymph nodes
are bean-shaped with a dense fibrous capsule that sends strands inward as trabecular to divide the node into compartments
* internally - outer cortex & inner medulla
* superficial cortex = have lots of B cells
* deep cortex= have lots of T cells
* lymphoid cortical tissue extends into medulla as medullary cords
* medulla has medulla or lymph sinuses = sinusoidal capillaries
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Lymph enters the node at
convex side through afferent lymphatic vessels → sub-capsular sinuses → deep cortex → medulla & exits at the hills via efferent vessels found in Hilum =Indented area of organ
* one efferent vessel so lymph can leave slowly & everything can activate
* lymphoid = only lymphatic organ that filters lymph
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What filters lymph?
Only lymph nodes filter lymph,
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Spleen (size of a fist)
largest lymphoid organ - just underneath the diaphragm in the left abdominal cavity - curls around the anterior stomach
* served by splenic artery & vein = enters and leaves from Hilum of the spleen.
* Stores platelets where red blood cells come to die
* store breakdown products of red blood cells
* In the fetus, the spleen produces red blood cells
* Function = site of lymphocyte proliferation & response
-macrophages remove foreign material from the blood
- produces erythrocytes in the fetus
* surrounded by fibrous capsule extending inward as trabeculae.
Contains = Red blood cells, macrophages, lymphocytes
Areas with primarily lymphocytes = white pulp
Red pulp= primarily red blood cells (RBCs)
*Capsule of spleen is thin
When the spleen capsule ruptures, massive bleeding occurs and blood flows into the peritoneum
-If the spleen is damaged and taken out the liver takes over its job (function)
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Thymus
bilobed organ extending from the inferior neck to the superior thorax. Secretes hormones thymosin & thymopoietin
* causes T lymphocytes to become immunocompetent(mature) and ready to recognize antigen.
* older adults have fewer T cells due to thymus decreasing in size as we mature.
* thymus has lobules, each with a cortex & medulla
* most cells in cortex = lymphocytes with few macrophages
* medulla = fewer lymphocytes with Hassall’s or thymic corpuscles
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Tonsils
(2)Pair of palatine tonsils = posterior end of the palatine cavity
* (2) Lingual tonsils = found in base of tongue
* pharyngeal tonsil = posterior wall of the nasopharynx (when inflamed it is called adenoids)
* tubal tonsils= found near the tympanic membrane
* follicles with germinal centers. Not fully encapsulated, & epithelium dips down into the interior to form tonsils crypts (where bacteria is collected.
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Peyer's patches
found in the distal small intestine & appendix projection of the first part of the large intestine
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MALT = mucosa-associated lymphatic tissue =
in the mucosa of all organs
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D. Groups of lymphoid follicles
* Peyer's patches
* MALT
* Tonsils
* Peyer’s Patches
* Appendix
* Genital & urinary organs
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Immunity
The ability to fight off diseases infections and resistance to bacteria
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Defense systems
A. Nonspecific =
* 1st line of defense = physical barriers such as the skin and mucous membranes
* 2nd line of defense = phagocytes cells, inflammation, antimicrobial proteins.
Specific defense =
* 3rd line of defense adaptive specific acts against specific pathogens
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Skin and Mucosae
1st line of defense (innate system) intact skin, respiratory system open so lined with mucous membrane
* skin PH = 3-5 = inhibits bacterial growth due to acidity
* good effective barrier due to keratin (protein)
* hard for pathogens to reach
* stomach mucosa = hydrochloric acid , protein digestive enzymes = kills bacteria
* saliva & lacrimal fluid = contain lysozyme that kills pathogens (lines the eyes )
* mucus in digestive & respiratory passages
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When are nonspecific defenses present?
At birth
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2nd line of defense
microbes are recognized by their surface carbohydrates
A. Phagocytes especially macrophages
- free macrophages = alveolar macrophages → dust cells (moves around freely)
- fixed macrophages = sits and waits for something to pass by
- neutrophils- macrophages
- eosinophils
* phagocyte engulfs foreign body & encloses it in a vacuole-phagosome (brings to cells )
* phagosome + lysosome = phagolysosome
* cell must recognize the pathogen's carbohydrate in order for adherence ( to stick ) to happen.
* adherence is more probable if pathogen is coated with complement proteins Or antibodies by a process called opsonization (all macrophages must be attracted to pathogen to eat it )
* if pathogens are too large to phagocytize, the cell releases toxic chemicals to get of pathogens
B. NK cells can lyse & kill bacteria, virally infected cells & cancer cells,
* troll through system constantly to find something to destroy = immune surveillance
* not specific like other lymphocytes & are not phagocytes
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A tissue’s response to injury
*inflammation
* Benefits of inflammation = limits to where pathogens can spread, to get rid of pathogens & help the body heal
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4 cardinal signs of acute inflammation
erythema (redness), localized heat, edema (swelling),& pain
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Inflammation begins with a release of inflammatory chemicals
* macrophages release cytokines (inflammatory chemicals)
* mast cells release histamine
* other chemicals released = kinds, prostaglandins, leukotrienes & complement (causes
* increased capillary permeability, which cause edema (swelling) which pushing on nerve cells that causes pain)
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After inflammation begins
more cells invade, especially neutrophils
* If inflammation was because of pathogens a group of plasma proteins called complement will be activated
* Bone marrow begins to release WBCs at a rapid rate
* leukocytosis occurs
* WBCs will stick to the capillary walls near the sites of inflammation = margination
* diapedesis (leaving area) & positive chemotaxis occur
* neutrophils release cytokines
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Pus
dead or dying neutrophils, damaged tissue cells & possible living & dead pathogens
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Abscess
Walls off pus so it doesn't spread anywhere else
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interferons (IFNS)
interfere with viral replication
* made by virally infected cells, which travels to healthy cells which causes it to make antiviral proteins
* make sure virus never replicates
* can activate macrophages & NK cells
* IFNs = family of proteins that are released from a variety of cells.
* lymphocytes secrete GAMA interferons
* most other lymphocytes secrete Alpha interferons
* fibroblasts secrete Beta interferons
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Antimicrobial proteins
attack microbes directly or inhibit their ability to reproduce including interferons & complement proteins
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Complement proteins
a group of plasma proteins that circulate in the blood in an inactive state. Includes proteins C1 - C9, & factors D, B, & P (proparitin)
* Functions = destroy foreign substances, release chemicals that destroy cells, can lyse bacteria and other cells
* complements/ enhances all other areas of specific & nonspecific
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Classical pathway
Involves antibodies produced by the specific system (C1) complement fixation
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Alternative or properdin pathway
factor B, D, and P recognize polysaccharides in bacteria and C3 activated
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Lectin Pathway
the protein MLB (mannose-binding ) lectin binds to carbohydrates on bacteria thereby activating C3
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Complement can be activated by 3 pathways
* classical pathway
* complement fixation
* alternative or properdin pathway
* cascade system where one protein activates another until a common pathway is reached
* All pathways end when C3 is converted to the active C3b, and a common pathway begins
* All common pathways cause cell lysis, enhance phagocytosis & enhance inflammation
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Lysis
destroy cells, and C3b attaches to the target. This triggers C5 - C9 to form a MAC (membrane attack complex). This puts holes in the target membrane ( attacks membrane)
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Phagocytosis
C3b coats the microbes. This allows for greater recognition by macrophages & neutrophils for phagocytosis = opsonization
C3b enhances phagocytosis
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Inflammation
(localized) complement proteins stimulate mast cells & basophils to release histamine
* C proteins attract more neutrophils & macrophages
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2 branches of specific system
T cell-mediated, B cell-mediated (humoral)
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Fever
abnormally high body temperature that is a systemic response to microbes
* thermostat of the body = hypothalamus keeps body at 37.2° C
* pyrogens = chemicals secreted by Leukocytes & macrophages when exposed to foreign substances (set the hypothalamus up and cause fever)
* high fevers = denature proteins in the body due to too high temperature (dangerous)
* mild or moderate fevers = normal
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Specific Defense (adaptive)
* specific = acts against specific pathogens /antigens
* systemic = throughout the entire body not localized
* has memory = once it reacts to one antigen next time it remembers and knows how to fight it.
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Humoral or Ab (antibody) mediated immunity (B cell)
antibodies bring to bacteria viruses; and bacterial toxins and hold until destroyed
* cannot get into the side cell it can only stick to the outside of the cell.
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Cellular or cell-mediated immunity (T cell)
virally infected, parasitic infections, cancer cells, and foreign
* acts against what is inside of cell
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Antigens
substances that can invoke an immune response
254
Complete Antigens
must have immunogenicity or reactivity
255
Immunogenicity
be able to provoke an immune response
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Reactivity
reacts to T cells and B cells
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Incomplete antigens or haptens
small molecules are not usually antigenic. But in combination with the body's proteins, specific immune systems may see them as foreign & attack. These rxns = hypersensitivities. The small molecules
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Only certain parts of antigen are immunogenic = Antigenic Determinants
Where antibodies will bind (only a specific type of pathogen that is recognized by the body)
259
Self-antigens
(Red blood cell) antigens that the body recognizes
260
MHC
A group of self-antigens are glycoproteins called MHC proteins or HLAs (human leukocyte antigens).
They are coded by genes of the MHC (major histocompatibility complex)
* 2 major groups of MHC proteins:
- class I MHC = found in all nucleated cells (not found in RBCs or platelets)
- class II MHC = found in lymphocytes & APCs (antigen-presenting cells)
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Class I MHC
found in all nucleated cells (not found in RBCs or platelets)
262
Class II MHC
found in lymphocytes & APCs (antigen-presenting cells)
263
Lymphocytes
Must be immunocompetent (must be able to recognize antigens), and must the self tolerant (recognizes self antigens & doesn't attack them
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Where do T cells mature?
the thymus
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Where do B cells mature?
The bone marrow
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When do B cells and T cells mature?
Until T & B cells come into contact with an antigen, they are not mature
* after maturation, T & B cells develop unique receptors on their membranes
267
Antigen challenge
1st encounter between lymphocyte & an antigen
Recognized by B cell
268
APCs engulf
APCs engulf (phagocytosis) antigens & present fragments of them on their cell surfaces to attract T cells
* Cells that at as APCs = dendritic cells like Langerhans' cells of the epidermis,& macrophages
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B cell + antigen = activated B cell
* activated B cell + interactions with T cells becomes sensitized and clonal selection = B cell grows & multiplies fast to form clones of itself
* most cells of the clone = plasma cells = make antibodies
* secretes 100 million antibodies nonstop every hour for 4-5 days
* marks them for destruction
* other cells of the clone = memory cells
* inactivated cells that sits in body for the rest of your life and when the same antigens is reintroduced it fights it off faster.
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primary immune response
Approximately 3-6 days for the B cells to bind, multiply & differentiate into plasma cells. Antibodies levels rise & peak in about 10 days & then decrease
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Secondary immune response (Much more effective)
happens on any subsequent exposure to the same antigen = faster, more prolonged & more effective (due to memory cells)
272
Immunological memory
reaction to antigen starts immediately & antibodies are released
273
Active immunity is naturally acquired
spread from person to person (occurs naturally)
Such as chickenpox or measles
273
B cells + antigen = antibodies
active humoral immunity (the pathogen presents antibodies made by memory cells)
274
Active immunity is induced or artificially acquired
vaccine = make memory cells
275
Passive humoral immunity
antibodies are given to individual
276
Passive immunity is naturally acquired
when you get it as a fetus (passed down from mother to baby) (first immunity until body makes its own)
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Passive immunity is artificially acquired or induced
given antibodies such as antivenom for snake bites or tetanus shot
