EXAM #1 Flashcards
Structures of the body, pure memorization
anatomy
How the body works, processes
physiology
- Heart, blood vessels, and blood
- contains nervous tissue, muscle tissue, connective tissue and epithelial tissue
The cardiovascular system
3 main functions of the cardiovascular system
- Transport
- Maintenance of homeostasis
- Protection
The Cardiovascular System:
Transport function
- carries nutrients from _ _ to cells throughout body
digestive system
The Cardiovascular System:
Transport function
- carries _ _ from cells of body to kidneys
waste products
The Cardiovascular System:
Transport function
- carries _ from endocrine glands to target cells
hormones
The Cardiovascular System:
Transport function
- carries _ _: oxygen from lungs to cells and carbon dioxide from cells to lungs
respiratory gases
The Cardiovascular System:
Maintenance of Homeostasis
- Helps maintain normal, balanced function of the body by participating in maintenance of:
1. _ _ by absorbing and redistributing heat
2. _ _ levels
3. _ _ and _ concentrations
- body temperature
- body fluid
- pH levels and electrolyte
The Cardiovascular System:
Protection function
- Protects body from _ and other pathogens through the _ _ _
- Prevents excess _ _ at injury sites through _ _ _
- bacteria, immune system elements
- fluid loss, blood clotting mechanisms
What is blood?
- _ _ _
- _ & _ _ (RBC, EBC, platelets) known collectively as the _ _
- Surrounded in _ _ _
- Fluid connective tissue
- cells & cell fragments, formed elements
- liquid extracellular matrix (plasma)
Characteristics of blood:
Approximately _ of body weight
7%
Characteristics of blood:
Average of _ liters
5
Characteristics of blood:
_ liters in smaller adults
4-5
Characteristics of blood:
_ liters in larger adult
5-6
Characteristics of blood:
1 liter ~ 1 quart = _
2 pints
Characteristics of blood:
pH between _ and _
7.35 & 7.45
Characteristics of blood:
pH is <7.35
Acidosis
Characteristics of blood:
pH is >7.45
Alkalosis
pH scale:
Basic = _
Neutral = _
Acidic = _
- 14
- 7
- 1
Characteristics of blood:
Viscosity - _ _ _ than water
- Blood thicker than water because of soluble proteins
5 times greater
Components of Blood:
Makes up about 55% of blood volume
Plasma
Components of Blood:
Makes up about 45% of blood volume
Formed elements (RBC, WBC, Platelets)
Components of Blood:
The pale yellow fluid that makes up the extracellular matrix
Plasma
Components of Blood:
Plasma
- _ ~ 92%
- _ _ ~7%
- Ions, nutrients, gases, hormones, wastes ~ _
- water
- plasma proteins
- 1%
Components of Blood:
More than 90% of plasma is _
- also contains dissolved plasma proteins & other solutes
water
Components of Blood:
Blood cells suspended in the plasma
formed elements
Components of Blood:
Formed elements
- _ ~ 99.9%
- _ ~ > .1%
- ~ > .1%
- Red blood cells
- White blood cells
- Platelets
Components of Blood:
Plasma is very similar to _ _ because water, ions, and small solutes are exchanged across capillary walls
interstitial fluid
Components of Blood:
Difference between plasma and interstitial fluid
interstitial fluid has plasma proteins
Components of Blood:
Plasma proteins (90% synthesized in liver)
- Albumins
- Globulins
- Fibrinogens
Components of Blood:
Plasma proteins
- 60% of plasma proteins
- Responsible for _ _ of blood
Albumins
- osmotic pressure
Components of Blood:
Plasma proteins
- ~35% of plasma proteins
- immunoglobulins attack foreign proteins and _
Globulins
- pathogens
Components of Blood:
Plasma proteins
- Transport _ bind ions, hormones, cholesterol, and other compounds
globulins
Components of Blood:
Plasma proteins
- clotting proteins
Fibrinogens
Components of Blood:
Plasma proteins
- Fibrinogens
- serum = _ after removal of clotting proteins
plasma
Erythrocytes
Red Blood Cells (RBCs)
Function of Red Blood Cells:
- Transport some _ from tissues to lungs
carbon dioxide
Function of Red Blood Cells:
- Transport most _ from lungs to tissues
oxygen
Abundance of Red Blood Cells:
- slightly less than _ the blood volume
half (~45% average)
Abundance of Red Blood Cells:
- _ of the formed elements
99.9%
Abundance of Red Blood Cells:
- _ _ per microliter of blood
4-6 million
Abundance of Red Blood Cells:
_ new RBCs enter blood stream every second & _ RBCs breakdown every second
- 3 million
- 3 million
Abundance of Red Blood Cells:
- % of RBCs
- _ obtained by centrifuging blood sample to separate formed elements from plasma
- buffy coat is layer of WBC & platelets
Hematocrit
Abundance of Red Blood Cells: Example
Hematocrit of _ means whole blood is 58% plasma & 42% formed elements
42
Abundance of Red Blood Cells:
Males have slightly higher _ than females due to more testosterone
hematocrit
Structure of Red Blood Cells
- very small, highly specialized cells
- biconcave disc shape
Structure of Red Blood Cells:
Very small, highly specialized cells
- when mature have _ and _ other organelles (allows to be small)
no and few
Structure of Red Blood Cells:
Very small, highly specialized cells
- densely packed with _
hemoglobin
Structure of Red Blood Cells:
Biconcave disc shape
- Provides large surface to volume ratio necessary for _ _ _
- allows RBCs to stack, bend, flex
rapid gas exchange
Globular protein, formed from 4 polypeptide subunits (2 alpha & 2 beta)
Hemoglobin (Hb)
Hemoglobin (Hb):
- each subunit contains a molecule of _
heme
Hemoglobin (Hb):
Heme - Pigment molecule containing ionized iron (Fe2+) which can _ bind an oxygen molecule
- weak bond, easily broken by pressure gradient
reversibly
Hemoglobin (Hb):
- Each RBC contains about _ Hb
280 million
Hemoglobin (Hb):
- Each RBC can carry over _ molecules of oxygen
a billion
Hemoglobin function:
At lungs, where oxygen concentration is high
- hemoglobin _ oxygen
binds
Hemoglobin function:
At lungs, where oxygen concentration is high
- _ = bright red in color
oxyhemoglobin
Hemoglobin function:
At peripheral tissues, where oxygen concentration is low
- carbon monoxide _ binds to heme iron preventing oxygen from binding
- strong bond, stays for a very long time, blocks out oxygen (O2 cannot compete with CO)
irreversibly
Oxygen concentration high in _ and low in _
- lungs
- tissues
Hemoglobin disorder:
- most common in people from African descent
sickle-cell anemia
Hemoglobin disorder:
- beta chain of Hb is abnormal
- In _ oxygen, Hb molecules interact causing cell to become stiff and curved
low
Hemoglobin disorder:
Sickle-cell
- _ _ _ = 1 single gene, normally fine, extreme oxygen deficit can activate
- _ _ _ = active all the time
- sickle-cell trait
- sickle-cell anemia disorder
Hemoglobin disorder:
- similar but less common genetic hemoglobin disorder
- most common in people of Mediterranean descent
Thalassemia
Blood:
- cells & cell fragments
- approximately 45% of total blood volume
Formed Elements
Blood:
Formed Elements
- Red blood cells (RBC) = _
erythrocytes
Blood:
Formed Elements
- White blood cells (WBC) = _
leukocytes
Blood:
Formed Elements
- Platelets ~ _
thrombocytes
Blood: Formed Elements
White blood cells (WBC) = leukocytes are mostly found in _
tissues
Blood: Formed Elements
The production of blood cells in red bone marrow (known as myeloid tissue)
Hemopoiesis (hematopoiesis)
Pre-fix -cyte means
ex: erythrocyte, leukocyte
cell
Blood: Formed Elements
platelets are _ _
cell fragments
Blood: Hemopoeisis
All begins with _
hemocytoblasts ( -blasts=build, - cyto=cells/stem cells)
Blood: Hemopoeisis
_ in myeloid tissue (red bone marrow) that divide to produce
Stem cells
Blood: Hemopoeisis
2 main kinds of stem cells in myeloid tissue (red bone marrow) that divide to produce
- myeloid stem cells
- lymphoid stem cells
Blood: Hemopoeisis
A kind of stem cell in myeloid tissue (red bone marrow) that divide to produce
- Give rise to RBCs, platelets, and 4 of the 5 types of WBCs
myeloid stem cells
Blood: Hemopoeisis
A kind of stem cell in myeloid tissue (red bone marrow) that divide to produce
- Become lymphocytes (specialized WBCs)
lymphoid stem cells
Blood: Hemopoeisis
_ white blood cells
_ from myeloid stem cells
_ from lymphoid stem cells
- 5
- 4
- 1
Blood: Hemopoeisis
Hemocytoblasts divide by mitosis into _ & _
myeloid stem cells & lymphoid stem cells
Blood: Hemopoeisis
Lymphoid stem cells result in what kind of white blood cell
lymphocyte
Blood: Hemopoeisis
Myeloid stem cells result in what kinds of white blood cells
- basophils
- eosinophils
- neutrophils
- monocytes
Blood: Hemopoeisis
Myeloid stem cells result in
- erythrocytes
- platelets
- 4/5 white blood cells
Blood: Hemopoeisis
Myeloid stem cells
- _ become platelets
megakarocyte
Blood: Hemopoeisis
Myeloid stem cells
- EPO
- ejection of nucleus = _
- then become _
- reticulocyte
- erythrocyte
Blood: RBC formation and turnovers
1% of circulating RBCs are replaced per day
- about _ _ new RBCs enter bloodstream each second
3 million
Blood: RBC formation and turnovers
life span = approximately _ days
- travel ~ 700 miles
120 days
Blood: RBC formation and turnovers
RBCs travel ~ _ per 120 days
700 miles
Blood: RBC formation and turnovers
RBCs are _ and _ constantly at approximately the same rate
destroyed and replaced
Blood: RBC formation and turnovers
RBC made by erythropoiesis in _ _ _
red bone marrow
Blood: RBC formation and turnovers
RBC destroyed by phagocytosis in _ & _
liver and spleen
RBC production called _
- occurs in red bone marrow
erthropoiesis
Stages in RBC production
- Hemocytoblast
- Myeloid stem cell
- Proerythroblast
2-4. erythroblast stages
5-7. reticulocyte
= mature erythrocyte
Stages in RBC production
- immature red blood cell,
- ejected nucleus
- enters bloodstream days 5-7
reticulocyte
Stages in RBC production
- EPO (erythropoietin)
day 1: proerythroblast
Regulation of RBC production (erythropoiesis):
- adequate supply of _ _ and _ and _ _
- _
- amino acids, vitamins B6 & B12, and folic acid
- hormones
Regulation of RBC production (erythropoiesis):
- Hormones
- Thyroxine
- Androgens (testosterone)
- Growth hormone
Regulation of RBC production (erythropoiesis):
Hormones
- released by kidney in response to hypoxia
erythropoietin (EPO)
Regulation of RBC production (erythropoiesis):
Hormones
- stimulates erythroblast cell division
erythropoietin (EPO)
Regulation of RBC production (erythropoiesis):
Hormones
- accelerates Hb synthesis and RBC maturation
erythropoietin (EPO)
erythropoietin (EPO) involved in what 3 main things of RBC production
- released by kidney in response to hypoxia
- stimulates erythroblast cell division
- accelerates Hb synthesis and RBC maturation
Regulation of RBC production (erythropoiesis):
- EPO or packed RBCs –> not a good idea
blood doping
RBC turnover:
After ~120 day lifespan OR damage _ of spleen, liver, and red bone marrow engulf RBCs, remove Hb and break Hb into components
macrophages
RBC turnover:
Macrophages (of spleen, liver & red bone marrow) _ aged or damaged RBCs
engulf
RBC turnover:
Macrophages (of spleen, liver & red bone marrow) remove Hb molecules from _ RBCs
hemolyzed (ruptured)
RBC turnover:
Macrophages (of spleen, liver & red bone marrow) break _ into components
hemoglobin (Hb)
small macrophage (active) = _
Monocyte (inactive)
3 ways for hemoglobin (Hb) turnover
- Globulin proteins
- Heme pigments
- Heme iron is recycled
Hemoglobin (Hb) turnover:
Globulin proteins - disassembled into _ _ to be re-used
amino acids
Hemoglobin (Hb) turnover:
Heme pigments
- converted to biliverdin (greenish), then _ (yellow-orange)
bilirubin
Hemoglobin (Hb) turnover:
Heme pigments
- _ is excreted by liver in bile
Bilirubin
Hemoglobin (Hb) turnover:
Heme pigments
- _ is caused by buildup of bilirubin
jaundice
Hemoglobin (Hb) turnover:
Heme pigments
- converted by intestinal bacteria and oxygen to _ and _
urobilins and stercobilins
Hemoglobin (Hb) turnover:
Heme iron is recycled
- stored in _
- or transported throughout the bloodstream bound to transferrin
phagocytes
Hemoglobin (Hb) turnover:
Bilirubin at high levels can be _
toxic
Hemoglobin (Hb) turnover:
_ stores bile
gallbladder
Hemoglobin (Hb) turnover:
Heme pigments
- makes pee yellow
urobilins
Hemoglobin (Hb) turnover:
Heme pigments
- makes poo brown
stercobilins
Blood disorders:
Low RBC or low hemoglobin
anemia
Blood disorders:
Anemia
- lysing (exploding) of RBCs too fast
Hemolytic
Blood disorders:
Anemia
- low B12
pernicious
Blood disorders:
Anemia
- not enough iron in diet
- pregnancy
iron deficiency
Blood disorders:
Anemia
- actively hemorrhaging (may be internal)
- menstruation
hemorrhagic
Blood disorders:
- high RBC count
polycythemia
Blood disorders:
- _ is blood in urine
- _ is blood proteins in urine
- hematuria
- hemoglobinuria
Leukocytes
White Blood cell
White Blood cells function
- defend the body against pathogens
- remove toxins, wastes & abnormal cells
Abundance of WBCs:
Less than _ of the formed elements
0.1%
Abundance of WBCs:
1 microliter of blood has ~5 million RBCs and _ WBCs
~7 thousand
Abundance of WBCs:
WBCs in blood are small fraction of total WBCs
- majority of WBCs are in _
tissues
White Blood Cells structure:
WBCs have _ _ and typical _ _
- high concentration of secretory vesicles, phagocytic vesicles, and lysosomes
- large nucleus
- cellular organelles
White Blood Cells activity:
WBCs exhibit _ movement
amoeboid
White Blood Cells activity:
WBCs exhibit amoeboid movement in which 2 ways
- emigration (move to areas in need)
- positive chemotaxis (move toward chemicals)
Most White Blood Cells are _
phagocytic
White Blood Cells: Defense against pathogens
nonspecific defenses
- neutrophils
- eosinophils
- basophils
- monocytes
White Blood Cells: Defense against pathogens
specific defenses
lymphocytes
Types of WBCs:
- 50-70% of circulating WBCs
neutrophils
Types of WBCs:
- short life span of ~ 10 hours, or even shorter if
actively engulfing bacteria, debris, etc. (Pus-many dead)
neutrophils
Types of WBCs:
- Phagocytic: engulf pathogens or debris in tissues
neutrophils
Types of WBCs:
- 2-4% of circulating WBCs
eosinophils
Types of WBCs:
- increase in number during parasitic infections (release toxins)
eosinophils
Types of WBCs:
- increase number during allergic reactions
eosinophils
Types of WBCs:
- Phagocytic: engulf antibody-labeled materials, reduce inflammation
eosinophils
Types of WBCs:
- 2-8% of circulating WBCs
Monocytes/Macrophages
Types of WBCs:
- Largest WBC
Monocytes/Macrophages
Types of WBCs:
- Migrate out of blood vessels and become macrophages
Monocytes
Types of WBCs:
- Macrophages = aggressive phagocytes, engulf pathogens or debris
Macrophages
Types of WBCs:
- less than 1% of circulating WBCs
basophils
Types of WBCs:
- cross capillary endothelium and accumulate in damaged tissue
basophils
Types of WBCs:
- release histamine and heparin
basophils
Types of WBCs: Basophils
dilates blood vessels
histamine
Types of WBCs: Basophils
prevents blood clotting
heparin
Types of WBCs:
- 20-40% of circulating WBCs
lymphocytes
Types of WBCs:
- continuously migrate in and out of bloodstream
lymphocytes
Types of WBCs:
- provide defense against specific pathogens or toxins
lymphocytes
Types of WBCs: Lymphocytes
- 3 types of cells
- T cells
- B cells
- NK cells
Types of WBCs: Lymphocytes
mediated immunity
- secrete chemicals
T cells
Types of WBCs: Lymphocytes
humoral immunity, produce antibodies
- when activated pump out antibodies
B cells
Types of WBCs: Lymphocytes
natural killer cells, destroy abnormal tissue cells
- cancer
NK cells
White Blood Cells:
_ _ used to distinguish among disorders
- parasitic infection, inflammation, allergic reaction
differential count
WBC differential count can indicate a disorder of WBCs:
- decreased # of WBCs
Leukopenia
WBC differential count can indicate a disorder of WBCs:
- increased # of WBCs
- leukemia
leukocytosis
cancer of WBCs
leukemia
White Blood Cells:
Leukopenia
decreased # of WBCs
White Blood Cells:
Leukocytosis
increased # of WBCs
WBC produced from _
hemocytoblasts (stem cells)
WBC production:
Eosinophils, basophils, neutrophils and
monocytes are produced in bone marrow by
_ _ _
myeloid stem cells
WBC production:
Lymphocytes produced from stem cells that
migrate to _ _ (thymus, spleen,
lymph nodes)
lymphoid tissue
Platelets:
cell fragments involved in _
clotting
Platelets:
_ per microliter of blood
150,000 to 500,000
low # of platelets
- increased risk for hemorrhage
thrombocytopenia
high # of platelets
- increased risk of blood clots
thrombocytosis
thrombocytopenia
low # of platelets
Thrombocytosis
high # of platelets
Platelets produced in bone marrow from _
megakaryocytes
megakaryocytes produce _ by shedding membrane-enclosed packets of cytoplasm and proteins (cell fragments )
platelets
Major components of the cardiovascular system
- blood
- heart
- blood vessels (arteries, capillaries, veins)
Cardiovascular system:
Blood to and from lungs
pulmonary circuit
Cardiovascular system:
Blood to and from rest of the body
systemic circuit
The heart:
- hollow muscular organ that acts as a _
- receives and pumps blood from two different circuits
- each circuit begins and ends at the heart
pump
The heart circuits:
Carries blood to and from gas exchange surfaces of lungs
- blood travels through circuits in sequence
pulmonary circuit
The heart circuits:
Carries blood to and from the rest of the body
- blood travels through circuits in sequence
systemic circuit
Blood vessels:
carry blood away from the heart
arteries
Blood vessels:
carry blood to the heart
veins
Blood vessels:
small vessels connecting between arteries and veins
capillaries
Blood vessels:
site of exchange of gasses, nutrients, fluids between blood and interstitial fluid
capillaries
The Heart:
Right atrium receives _ _ blood from body
low oxygen
The Heart:
Right ventricle receives low oxygen from the right atrium, pumps it to the _
lungs (pulmonary circuit)
The Heart:
Left atrium receives _ blood from lungs
oxygenated
The Heart:
Left ventricle receives oxygenated blood from left atrium and pumps it to the _
body (systemic circuit)
Chambers of the Heart:
Right and left chambers separated by partitions of connective tissue and muscle
- interatrial sepetum
- interventricular sepetum
Chambers of the Heart:
_ _ separates atria and ventricles
- two distinct muscle masses that contract separately
fibrous skeleton (connective tissue)
Chambers of the Heart:
right & left atria contract as _ _
one unit
Chambers of the Heart:
Right & left ventricles contact as _, after the atrial contraction
one
Chambers of the Heart:
_ control openings across the atrial-ventricular septum
valves
Chambers of the Heart: Internal anatomy & organization
Thin walled chambers
atria
Chambers of the Heart: Internal anatomy & organization
- receive blood from the veins and pump through valves to the ventricles
atria
Chambers of the Heart: Internal anatomy & organization
- thick walled chambers
ventricles
Chambers of the Heart: Internal anatomy & organization
- receive blood from atria and pump through valves into arteries
ventricles
Chambers of the Heart: Internal anatomy & organization
- _ _ is more muscular than the right ventricle
left ventricle
Chambers of the Heart: Internal anatomy & organization
- Left ventricle needs to generate more _ to pump blood through systemic circuit
force
Sequence of events in one cardiac cycle:
1. cardiac contraction
- _ contract, push remaining blood into ventricle, then atria relax
- _ contract, push blood into arteries, then ventricles relax
2. cardiac relaxation
- both atria and ventricles are in relaxed state until next heart beat starts
- atria
- ventricle
Blood flow through heart depends on:
- opening and closing of 4 valves (2 atrioventricular valves, 2 semilunar valves)
- contraction and relaxation of myocardium (cardiac muscle) of atria and ventricles
Blood types are determined by the presence or absence of specific _ & _ in cell membranes of RBCs
glycolipids and glycoproteins
Blood types:
cell surface glycolipids and glycoproteins are cell identity factors called _
antigens
Blood types:
Immune system recognizes _ as “self” (ignores) or “foreign” (attacks)
antigens
Blood types are _ determined
genetically
Blood types:
Glycoprotein = _
Rh factor (+)
Blood types:
Glycolipid = _
A, B, AB
Blood types:
Antibodies to _ surface antigens circulate in the plasma
“foreign”
Blood types:
Antibodies to “foreign” surface antigens circulate in the plasma
- antibodies to A or B
- antibodies to Rh factor –> requires _
sensitization (exposure)
Blood types & cross-reactions:
Antibodies cross-react (bind to) antigens of “foreign” blood cells
- causes _
- causes _
- clumping (agglutination)
- hemolysis
Blood types & cross-reactions:
Hemolytic disease of the newborn can occur in _ fetus carried by _ mother
- Rh +
- Rh -
Blood types:
You are not born with _ but have to be exposed to it to have a (-) negative
Rh factor
Blood type A has
- _ antigens
- _ antibodies
- A antigens
- B antibodies (anti-B)
Blood type B has
- _ antigens
- _ antibodies
- B antigens
- A antibodies (anti-A)
Blood type AB has
- _ antigens
- _ antibodies
- A & B antigens
- No antibodies
Blood type O has
- _ antigens
- _ antibodies
- No antigens
- A & B antibodies (anti-A & anti-B)
Hemostasis
Blood clotting (cessation of bleeding)
3 phases of hemostasis (Blood clotting)
- vascular phase
- platelet phase
- coagulation phase
Hemostasis phases:
- local blood vessel constriction
vascular phase
Hemostasis phases:
Vascular phase
- local blood vessel constriction
- contraction of smooth muscle in blood vessel walls
- _ _
muscular spasm
Hemostasis phases:
Vascular phase
- after spasm, blood vessel releases chemical factors triggering clotting and becomes _
sticky
Epithelium lining the blood vessels is called _
endothelium
Hemostasis phases:
Vascular phase
- blood vessel constricts and spasms
- releases chemical factors and becomes sticky to get ready for platelets
Hemostasis phases:
Platelet phase
- platelet adhesion
- platelets aggregation creates platelet plus (build up)
Hemostasis phases:
Activation
- change shape
- release factors stimulating aggregation and vascular spasm
- release clotting factors and calcium ions
Platelet phase
Hemostasis phases:
clot actually forms
Coagulation phase
Hemostasis phases:
- begins 30 seconds or more after injury
coagulation phase
Hemostasis phases:
Coagulation phase depends on
- clotting factors (11 different proteins)
- calcium
- proenzymes
Hemostasis phases:
Coagulation phase
- Proenzymes are inactive enzymes activated by chemicals from _ _ _ _
damaged cells and platelets
Hemostasis phases:
Coagulation phase
- Triggering initiates a _ _ chain reaction
positive-feedback loop
Blood thinners are _
anti-coagulations
Hemostasis phases:
Coagulation phase - common pathway
- _ and _ pathways are completed first
intrinsic & extrinsic
Hemostasis phases:
Coagulation phase - common pathway
- After intrinsic & extrinsic pathways
Factor X (10)
Hemostasis phases:
Coagulation phase - common pathway
- Factor X (10) chain reaction leads to
prothrombin activator
Hemostasis phases:
Coagulation phase - common pathway
- Prothrombin activator converts _ to _
prothrombin (inactive) to _thrombin (active)
Hemostasis phases:
Coagulation phase - common pathway
- Thrombin contributes to the conversion of _ to _
fibrinogen (inactive) to fibrin (active)
Hemostasis phases:
Coagulation phase - common pathway
- Inactive enzyme made in liver, always present in plasma
prothrombin
Hemostasis phases:
Coagulation phase - common pathway
soluble protein made in liver, always present in plasma
fibrinogen
Hemostasis phases:
Coagulation phase - common pathway
- insoluble strands of protein, form clot, trapping platelets and RBcs
fibrin
Hemostasis phases:
- platelets contract
- pull damaged areas together
retraction
Hemostasis:
- gradual process of dissolving clots
Fibrinolysis
Blood clot process:
Fibrinolysis
- Thrombin and tissue plasminogen activator (t-PA) activate plasminogen, producing _
plasmin
Blood clot process:
Fibrinolysis
- _ & _ activator (t-PA)
Thrombin (inactive) and tissue plasminogen (active with contact)
Blood clot process:
Fibrinolysis (retraction)
- plasmin _ fibrin strands
digests
Clot prevention:
clotting should not occur except in area of _
blood vessel damage
Clot prevention:
Normal plasma contains several anti-coagulants
- enzymes that inhibit clotting by inhibiting one or more
- Antithrombin III
- Thrombomodulin
- Heparin
Clot prevention:
Accelerates activation of antithrombin III)
heparin
Drugs in preventing clotting
- heparin
- coumadin (warfarin)
- aspirin
Drugs that dissolve existing clots
- Tissue plasminogen activator (t-PA)
- Streptokinase and urokinase
Inadequate blood clotting:
Nutrients deficiencies
- low plasma concentrations of _ impairs blood clotting
calcium
Inadequate blood clotting:
Nutrients deficiencies
- _ _ deficiency leads to bleeding disorder - needed in liver for synthesis of four of the clotting factors
- produced by intestinal bacteria
vitamin K
Inadequate blood clotting:
genetic disorder
- inherited, sex-linked
hemophilia
Excessive blood clotting:
- blood clot attached to blood vessel wall
thrombous
Excessive blood clotting:
enlarging _ can block blood vessel or pieces can break off becoming embolus
thrombus
Excessive blood clotting:
A blood clot circulating in blood system
embolus
Excessive blood clotting:
embolus becomes stuck and blocks a blood vessel
embolism
Excessive blood clotting types
- thrombus
- embolus (can become embolism)
The heart:
2 types of cardiac muscle cells
- contractile myocardial cells
- myocardial cells of conducting system
The heart:
contractile myocardial cells & myocardial cells of conducting system work together to produce a _
heartbeat
The heart:
The conducting system
- consists of specialized, _, cardiac muscle cells
non-contractile
The heart:
The conducting system
- _ produce spontaneous action potentials
nodal myocardial cells (pacemakers)
The heart:
The conducting system
- _ _ _ propagate the electrical signal (action potential) rapidly through out the mass of heart muscle cells
conducting myocardial cells
The heart:
The conducting system
- 2 types of nodes
- sinoartial (SA) node
- atrioventricular (AV) node
The heart:
The conducting system - node
- located in wall of right atrium
sinoatrial (SA) node
The heart:
The conducting system - SA node
- initiates action potential that _ the cardiac contraction cycle
starts
The heart:
The conducting system - node
- located at junction between atria and ventricle
atrioventricular (AV) node
The heart:
The conducting system - AV node
- conducts electrical signal _ atrial ventricular septum
across
The heart:
The conducting system
- internodal pathways
- rapidly conduct action potential from SA node to atria muscle cells and to AV node
atrial conducting cells
The heart:
The conducting system
- rapidly conduct action potentials from AV node to ventricle muscle cells
- AV bundle (bundle of His), Bundle branches, Purkinje fibers
ventricular conducting cells
The heart:
The conducting system - atrial conducting cells
- rapidly conduct action potential from _ _ to _ _ _ and to _ _
- SA node
- atrial muscle cells
- AV node
The heart:
The conducting system - ventricular conducting cells
- rapidly conduct action potential from _ _ to _ _ _
- AV node
- ventricle muscle cells
Step 1 of the conducting system of the Heart
SA node activity and atrial activation begin
Step 2 of the conducting system of the Heart
stimulus spreads across the atrial surfaces and reaches the AV node
Step 3 of the conducting system of the Heart
- there is a 100-msec delay at the AV node
- atrial contraction begins
Step 4 of the conducting system of the Heart
impulse travels along the interventricular septum within the AV bundle and the bundle branches to the Purkinje fibers and, via the moderator band, to the papillary muscles of the right ventricle
Step 5 of the conducting system of the Heart
- impulse is distributed by Purkinje fibers and relayed throughout the ventricular myocardium
- atrial contraction is completed, and ventricular contraction begins
Electrocardiogram:
Electrical depolarization spreads from SA node through atrial muscle cells
P wave
Electrocardiogram:
Depolarization spreading from AV bundles and Purkinje fibers through ventricle muscle cells
QRS complex
Electrocardiogram:
Repolarization of ventricle muscle cells
T wave
Abnormalities of conducting system:
Slower than normal heart rate
Bradycardia
Abnormalities of conducting system:
Faster than normal
tachycardia
Abnormalities of conducting system:
Conducting deficits
- _ node can take over if SA node is lost
AV
Abnormalities of conducting system:
Conducting deficits
- an area other than SA or AV node is generating action potentials that initiate contractions
ectopic pacemaker
Abnormalities of conducting system:
abnormal patterns of cardiac electrical activity
- clinically important if pumping efficiency of heart is reduced
arrhythmias
The heart:
Movements and forces generated during cardiac contractions
Cardiodynamics
Cardiodynamics:
Amount of blood in each ventricle at the end of ventricular diastole
End-diastolic volume (EDV)
Cardiodynamics:
Amount of blood remaining in each ventricle at the end of ventricular systole
End-systolic volume (ESV)
Pressure and volume changes:
Atrial systole
- at start of cardiac cycle, atria, and ventricles have blood received during diastole
- ventricles are _
~70% filled
Pressure and volume changes:
Atrial systole pushes blood into the ventricle, filling to _
100%
Pressure and volume changes:
Arterial systole
- 100% filled = _ _ of blood in the ventricles
end-diastolic volume (EDV)
Pressure and volume changes:
Arterial systole
- end-diastolic volume = _ in resting adult
~130 milliliters
Pressure and volume changes:
ventricular systole occurs building up pressure on blood until _ _ open
semilunar valves
Pressure and volume changes:
ventricular systole
- _ _ occurs pushing blood into arteries
ventricular ejection
Pressure and volume changes:
ventricular systole
- ~70-80 milliliters ejected = _
stroke volume
Pressure and volume changes:
ventricular systole
- ~60% ejected = _
ejection fraction
Pressure and volume changes:
ventricular systole
- ~40% remains in ventricle = _
end-systolic volume (ESV)
Pressure and volume changes:
ventricular systole
- stroke volume
~70-80 milliliters
Pressure and volume changes:
ventricular systole
- ejection fraction
~60%
Pressure and volume changes:
ventricular systole
- end-systolic volume (ESV)
~40% remains in ventricle
Cardiodynamics:
Amount of blood pumped out of each ventricle during a single beat
stroke volume (SV)
Cardiodynamics:
EDV - ESV = _
SV
Cardiodynamics:
Percentage of the EDV pumped out of each ventricle during a single beat
ejection fraction
Cardiodynamics:
SV/EDV = _%
EF
Cardiodynamics:
Volume pumped by left ventricle in one minute
cardiac output (CO)
Cardiodynamics:
cardiac output (CO) is measured in _
mL/min
Cardiodynamics:
Heart rate (HR) is measured in _
beats/min
Cardiodynamics:
Stroke volume (SV) is measured in _
mL/beat
Cardiodynamics:
Resting adult has _ liters/min
~6 (6000ml/min)
Cardiodynamics:
75 beats/min x 80 ml/beat = _
6000 ml/min
Control of cardiac output:
cardiac output is adjusted to meet circulatory demands
- change in _ (ANS, hormones, stretch receptors)
heart rate
Control of cardiac output:
cardiac output is adjusted to meet circulatory demands
- change in _ (venous return, blood pressure)
stroke volume
2 controls of cardiac output
- change in heart rate
- change in stroke volume
Valves of the heart:
Between atria and ventricles
atrio-ventricular valves
Valves of the heart:
atrio-ventricular valves
- right AV valve = _
- Left AV valve = _
- tricuspid
- bicuspid (mitral)
Valves of the heart:
- pulmonary valve
- aortic valve
semilunar (ventricular-arterial) valves
Valves of the heart:
Semilunar valve
- from right ventricle into pulmonary arterial trunk (to lungs)
pulmonary valve
Valves of the heart:
Semilunar valve
- from left ventricle into aortic artery (to body tissues)
aortic valve
Functions of heart valve:
controlled by _ _
ventricular contraction
Functions of heart valve:
Atrioventricular (AV) valves
- are in _ _ when atria and ventricles are relaxed
open position
Functions of heart valve:
Atrioventricular (AV) valves
- are in _ when atria are contracting
open
Functions of heart valve:
Atrioventricular (AV) valves
- are _ _ when ventricles contract to prevent backflow of blood from ventricles to atria
forced closed
Functions of heart valve:
Semilunar valves
- are in _ _ when atria and ventricles are relaxed, and when atria contract
closed position
Functions of heart valve:
Semilunar valves
- are _ _ when ventricles contract enough to raise pressure higher than blood pressure in the arteries
forced open
Functions of heart valve:
Semilunar valves
- are _ again when ventricles stop contracting
closed
Valvular disorders:
_ side of heart has most disorders
left
Valvular disorders:
- stenosis
- bicuspid
aortic valve
Valvular disorders:
- prolapse
bicuspid valve
- small
- single nucleus
- abundant mitochondria
- very extensive blood supply
- interconnected by intercalated discs (gap junctions provide electrical interconnection)
myocardial cells (cardiac muscle cells)
Contractile myocardial cells:
Action potential
- rapid _ caused by opening of voltage-gated _ ion channels
- depolarization
- sodium
Contractile myocardial cells:
Action potential
- A _ depolarized phase caused by opening of slow voltage-gated _ ion channels
- plateau
- calcium
Contractile myocardial cells:
Action potential
- repolarization caused by opening of _ ion channels
potassium
Calcium ion & myocardial cell contraction:
- calcium ions bind to _ complex causing it to shift position
troponin-tropomyosin
Calcium ion & myocardial cell contraction:
- Calcium enters the cell membranes during the _ phase
- affected by interstitial calcium levels
plateau
Calcium ion & myocardial cell contraction:
- additional calcium is released from reserves in the _
sarcoplasmic reticulum
Calcium ion & myocardial cell contraction:
- calcium comes from _ _ & _ _
- extracellular fluid
- sarcoplasmic reticulum
Heart sounds are detected with a _
stethoscope
Heart sounds:
“lubb” = _
closing of the AV valves (tricuspid)
Heart sounds:
“dupp” = _
closing of the semilunar valves (bicuspid)
Heart sounds detected by a _
stethoscope
Heart sounds:
sound from blood regurgitating through a valve
heart murmur
Cardiac cycle:
contraction = _
systole (120)
Cardiac cycle:
relaxation = _
diastole (80)
Phases of the cardiac cycle:
Normal heart rate = _
~ 75 beats per minute
Phases of the cardiac cycle:
Each cardiac cycle is _ seconds
0.8 seconds (60 sec/75) or 800 milliseconds
Phases of the cardiac cycle:
As heart rate increases, all the phases of the cardiac cycle _
shorten
Phases of the cardiac cycle:
As heart rate increases _ bpm = 0.5 seconds (500 milliseconds)
~ 120
Phases of the cardiac cycle:
As heart rate increases, all the phases of the cardiac cycle shorten
- greatest reduction is length of time spent in _
diastole
Factors affecting Heart Rate:
_ - both sympathetic and parasympathetic innervate the SA and AV nodes
dual innervation
Factors affecting Heart Rate:
Parasympathetic - _
Acetyl Choline (ACh)
Factors affecting Heart Rate:
Parasympathetic - Acetyl Coline (ACh)
- _ heart rate
decreases
Factors affecting Heart Rate:
Parasympathetic - Acetyl Coline (ACh)
- reduces rate of depolarization in SA nodal cells by increasing _ _ _
potassium ion efflux
Factors affecting Heart Rate:
Sympathetic - _ & _
Norepinephrine (NE) & Epinephrine (E)
Factors affecting Heart Rate:
Sympathetic - Norepinephrine (NE) & Epinephrine (E)
- _ heart rate
increases
Factors affecting Heart Rate:
Sympathetic - Norepinephrine (NE) & Epinephrine (E)
- increases rate of depolarization in SA node by increasing _ _ _
calcium ion influx
Blood vessels:
Carry blood away from heart
arteries
Blood vessels:
3 types of arteries
- elastic arteries
- muscular arteries
- arterioles
Blood vessels:
Conducting arteries
elastic arteries
Blood vessels:
distributing arteries
muscular arteries
Blood vessels:
resistance arteries
arterioles
Blood vessels:
connect arterioles to venules
- 1 cell layer thick
capillaries
Blood vessels:
carry blood toward heart
veins
Blood vessels:
smaller veins = _
venules
Difference between arteries & veins:
- Arteries have _ walls and higher blood pressure than veins
thicker
Difference between arteries & veins:
- A constricted artery has a small, round _
lumen
Difference between arteries & veins:
- a _ has a large, irregular lumen
vein
Difference between arteries & veins:
- The endothelium of a constricted artery is _
folded
Difference between arteries & veins:
- Arteries are more _ than veins
elastic
Difference between arteries & veins:
- veins have _
valves
Arteries:
Undergo changes in _
diameter
Arteries:
Undergo changes in diameter
- passive changes due to _
elasticity
Arteries:
Undergo changes in diameter
- passive changes due to elasticity
- _ _ = high density of elastic fibers
elastic arteries
Arteries:
Undergo changes in diameter
- active changes due to _
contractility
Arteries:
Undergo changes in diameter
- active changes due to contractility
- smooth muscles in walls of muscular arteries and _
arterioles
Arteries:
Undergo changes in diameter
- active changes due to contractility
- _ = decreases the size of the lumen
vasocontriction
Arteries:
Undergo changes in diameter
- active changes due to contractility
- _ = increases the size of the lumen
vasodilation
Arteries:
Undergo changes in diameter
- active changes due to contractility
- vasoconstriction and vasodilation is controlled by _ _ and sympathetic ANS control
local factors (histamine)
- smallest vessels connecting arteries and veins
- thins walls: one layer of endothelium with membrane
Capillaries
Capillaries:
- provide for _ between blood and interstitial fluid of body tissues
exchange
Capillaries are classified according to _
permeability
Capillaries classification:
- no pores, only permit diffusion of water, small solutes, and lipids
continuous capillary
Capillaries classification:
- large gaps allow proteins to move in and out
- mostly in liver
sinusoid capillary
Capillaries classification:
- pores allow for diffusion of larger solubility
fenestrated capillary
_ exchange occurs across walls of arteries or veins
NO
Veins:
Venules & medium-sized veins have _
valves
Veins:
venules & medium-sized veins have valves
- prevent _
- varicose veins due to valve failure
backflow
Veins:
Movement of blood through veins of heart dependent on body movement to compress veins
venous return
Veins:
Venous return
- muscular _
- respiratory pump
compression
Veins:
sympathetic stimulation of smooth muscles in walls of veins can cause decrease in size of lumen
- emergency only
venoconstriction
Distribution of blood:
- total blood volume is _ distributed (~5 liters)
unevenly
Distribution of blood:
- total blood volume is unevenly distributed (~5 liters)
- _ in heart, arteries and capillaries
30-35%
Distribution of blood:
- total blood volume is unevenly distributed (~5 liters)
- _ in venous system
65-70%
Distribution of blood:
- total blood volume is unevenly distributed (~5 liters)
- This creates a _ _
venous reserve
Distribution of blood:
- total blood volume is unevenly distributed (~5 liters)
- venous reserve created in response to blood loss, _ occurs, forcing blood from venous system to arterial system and capillaries
- veins in liver, skin, and lungs
venoconstriction
Cardiac centers in _
brainstem
Cardio-acceleratory center controls _ _ of heart
sympathetic innervation
Cardio-inhibitory center controls _ _ of heart
parasympathetic innervation
Cardiac centers (in brainstem):
monitor blood pressure
baroreceptors
Cardiac centers (in brainstem):
monitor oxygen and carbon dioxide levels in blood
- changes causes reflux response
chemoreceptors
Areas of partial or complete blockage of coronary circulation
- due to plaque or thrombus (clot)
coronary artery disease
Cardiovascular physiology:
Rate of blood flow through arteries, capillaries and veins determined by
- _ on blood
- _ to flow that the blood encounters
- pressure
- resistance
Cardiovascular physiology:
Greater pressure needed to push blood through systemic circuit than pulmonary circuit because _
resistance is greater
Cardiovascular physiology:
Opposes the movement of blood
resistance
Cardiovascular physiology:
Resistance
- _ between blood and walls of blood vessels
friction
Cardiovascular physiology:
Resistance
- _ of blood-more resistance if viscosity of high
viscosity
Cardiovascular physiology:
Resistance
- _ (abnormal - due to vessel damage)
turbulence
Cardiovascular physiology:
Resistance
- for blood to flow, the _ _ must overcome the peripheral resistance
pressure gradient
Cardiovascular physiology:
Resistance - vessel length
- less resistance in _ circuit than _ circuit = less total length of vessels
- pulmonary
- systemic
Cardiovascular physiology:
Resistance - vessel diameter
- less resistance in _ _ vessels
larger diameter
Cardiovascular physiology:
Resistance - vessel diameter
- vasodilation and vasoconstriction change _ _
- so do plaques
peripheral resistance
Pressures within the systemic cardiovascular system:
Highest in arteries near the heart, where it is _ constant
not
Pressures within the systemic cardiovascular system:
~ _ mm Hg during systole
120
Pressures within the systemic cardiovascular system:
~ _ mm Hg during diastole
80 (does not drop to 0)
Pressures within the systemic cardiovascular system:
Pressure drops as blood moves forward
- blood moves from _ _ _ pressure
high to low
Average pressures in systemic system:
- aorta = _ mm Hg
100
Average pressures in systemic system:
- arterioles entering capillaries = _ mm Hg
35
Average pressures in systemic system:
- venules exiting capillaries = _ mm Hg
18
Average pressures in systemic system:
- vena cavae = _ mm Hg
2
Cardiovascular physiology:
- abnormally low blood pressure
hypotension
Cardiovascular physiology:
due to hemorrhage or dehydration
hypovolemia
Cardiovascular physiology:
Hypotension
- overly aggressive drug treatment for high blood pressure
- orthostatic hypotension
- _ (vasomotor) syncope = “fainting at the sight of blood”
vasovagal
Cardiovascular physiology:
Abnormally high blood pressure
- systolic greater than 150 & diastolic greater than 90 at rest
hypertension
Cardiovascular physiology:
causes - smoking, obesity, too much salt, genetic, kidney disease, excessive alcohol
hypertension
Cardiovascular physiology:
Hypertension adverse effects
- _ of left ventricle due to increased workload
- arteriosclerosis - damaged blood vessels
- aneurysm
hypertrophy
