Exam 1 Flashcards
Blood & Heart
What are the 3 functions of the blood?
- Transportation of nutrients and waste
- Regulation of pH & body temperature
- Protection from blood loss & foreign body invasion
What type of tissue is blood?
liquid connective tissue
Blood is what percent of body weight?
8%
What are the average pH ranges for blood?
7.35 - 7.45
What are the 2 components of blood?
- Plasma (55%)
2. Formed elements (45%)
Blood is ____ times more viscous than water.
4-5
What is blood - formed elements?
Plasma
What is plasma - plasma proteins?
Serum
What is plasma composed of?
90-92% water, nutrients & waste, plasma proteins, serum
What are formed elements?
Erythrocytes (RBCs, leukocytes (WBCs), & platelets (thrombocytes).
Biconcave, Anucleate, & contains hemoglobin.
Erythrocytes (RBC)
Anucleate
no nucleus
Biconcave shape of RBC provide:
- greater surface area (carry more oxygen)
2. Flexibility
structural protein composed of 4 polypeptide chains each containing a heme group
Globin
iron-containing fuctional portion of the hemoglobin
Heme group
forms a reversible bond with oxygen
FE++
controls the production rate of new RBCs
Erythropoietin
produced at a rate of ~ 2mil/sec, lives for ~ 120 days
Erythrocytes
reduced oxygen carrying capacity
Anemia
faulty bone marrow
Aplastic anemia
decreased B12 (necessary for RBC production)
Pernicious anemia
destruction of blood cells
Hemolytic anemia
blood loss
Hemorrhagic anemia
results in microcytes
Iron deficiency anemia
genetic defect causes one globin chain to become rigid
Sickle-cell anemia
genetic defect resulting in absent or faulty globin chain (Mediterranean Sickle-Cell)
Thalassemia
excess of RBCs
Polycythemia
Primary polycythemia (Polycythemia vera)
blood too thick
Secondary polycythemia
elevated RBC count
What are the 6 steps of Erythropoiesis?
- Hemocytoblast
- Proerythroblast
- Erythroblast
- Normoblast
- Reticulocyte
- Erythrocyte
Numerous fine granules which stain pale lilac w/ a darker multi-lobed nucleus. Phagocyte.
Neutrophil
Purplish black granules that often obscure a bi-lobed nucleus, intensify inflammation & allergic reactions
Basophils
Distinct red granules; bilobed nucleus, phagocytes, combat parasitic worms & release anti-inflammatory chemicals
Eosinophils
Pale blue cytoplasm w/ U or Kidney shaped nucleus, develop into macrophages once in tissue, phagocytes
Monocytes
Large, dark purple nucleus occupies most of the cell, produce antibodies and provide immunity
Lymphocytes
Granulocytes
WBC “philled” with granules
What are the 3 granulocytes?
Neutrophil, Basophil, Eosinophil
attack bacteria & their toxins, develop into plasma cells which release antibodies
B lymphocytes (B Cells)
attack viruses, fungi, cancer cells, transplanted cells & some bacteria, work w/ B cells to provide immunity
T Lymphocyte ( T Cells)
Kill cells that have been bound by antibodies or cells that exhibit abnormal traits, use perforins & granzymes to destroy the cells
Natural Killer (NK) Cells
decreased WBC count (bone marrow issue)
Leukopenia
increased WBC count
Leukocytosis
infection of B cells caused by Epstein-Barr virus
Infectious mononucleosis
group of cancerous conditions involving WBC
Leukemia
stimulated by interlurkins (IL) & colony-stimulating factors (CSF)
Leukopoiesis
What are the multiple pathways of Leukopoiesis?
- Monoblast> Promonocyte> Monocyte
- Lymphoblast> Prolymphocyte> Lymphocyte
- Myeloblast> Promyelocyte> Myelocyte (eosinophilic, basophilic, or neutrophilic)> Band Cell (eosinophilic, basophilic, or neutrophilic)> Eosinophil, Basophil, or Neutrophil
What are the 3 mechanisms that stop blood loss?
- Vascular spasm
- Platelet plug formation
- Coagulation
Vasoconstriction of the damaged vessel, can last minutes - hours
Vascular spasm
Triggered by Von Willebrand factor (VWF), platelet adhesion, platelet aggregation, platelet plug
Platelet Plug formation
initial sticking of platelets to the wound site, activates more platelets
Platelet adhesion
the sticking of platelets to already present platelets
Platelets aggregation
A cluster of platelets that temporarily seals the break in a vessel wall
Platelet plug
Coagulation involves over 30 different chemicals including:
13 different clotting factors, vitamin K, and Ca++
formed following the coming together of various clotting factors
Prothombin activator (enzyme)
what does prothrombin activator do?
converts prothrombin (plasma protein) to thrombin (enzyme)
what does thrombin do?
converts fibrinogen (plasma protein) to fibrin (fibers of the clot) that trap formed elements
clot shrinks to promote healing
clot retraction
clot is broken down
fibrinolysis
a clot in a healthy vessel
thrombus
a thrombus that has broken free and entered circulation
embolus
when an embolus becomes trapped in another vessel
embolism
an inability of the blood to clot properly, sex-linked disorder
hemophilia
decreased platelet count, caused by any condition that suppresses or destroys bone marrow
thrombocytopenia
what stimulates thrombopoiesis?
thrombopoietin
what are the steps of thrombopoiesis?
Hemocytoblast> Megakaryoblast> Promegakaryocyte> Megakaryocyte (ruptures as it enters circulation)> Platelet
has A antigen, B antibodies
Type A blood
has B antigen, A antibodies
Type B blood
has A & B antigens, no antibodies
Type AB blood
has no antigens, A & B antibodies
Type O blood
has at least 1 Rh antigen
Rh+
has no Rh antigens
Rh-
the universal donor (no antigens)
Type O blood
the universal recipient (no antibodies)
Type AB blood
hemolytic disease of a newborn
Erythroblastosis Fetalis
where is the heart located?
within the mediastinum, within the pericardial cavity
The cone shaped hearts apex faces what?
the left hip
the dual walled structure surrounding the heart
pericardium
thicker, outermost layer, protects heart, anchors to surrounding structures, prevents overfilling.
Fibrous Pericardium
what are the 2 layers of the pericardium?
Fibrous pericardium and Serous pericardium
What are the 2 layer of the serous pericardium?
Parietal layer and Visceral layer
outer layer of the serous pericardium, attached to fibrous pericardium
Parietal layer
epicardium, integral part of the heart wall.
Visceral layer
separates the parietal and visceral layers, filled with pericardial fluid creating friction free work area.
Pericardial cavity
visceral layer of the serous pericardium, composed of a thin layer of connective tissue
Epicardium
what are the 3 layers of the heart wall?
Epicardium, Myocardium, Endocardium
layer of heart wall composed of cardiac muscle tissue
Myocardium
layer of heart wall composed of simple squamous epithelium, is continuous with blood vessels entering and leaving heart.
Endocardium
What are the 4 chamber of the heart?
L and R Atria, L and R Ventricles
upper, thin walled, smaller chambers of the heart that receive blood from veins
Atria (plural)/ Atrium
exterior extruding surface of the atrium
Auricle
separates the R and L atria
Interatrial septum
shallow depression found in right atrium, remnant of foramen ovale.
Fossa Ovalis
receive blood from superior vena cava, inferior vena cava, and coronary sinus
Right Atria
receive blood from 4 pulmonary veins of the lungs
Left Atria
vein carrying blood from structures above the diaphragm to heart
Superior vena cava
vein carrying blood from structures below the diaphragm to the heart
Inferior vena cava
veins carrying blood from heart to heart
Coronary sinus
lower, bigger chambers of the heart
Ventricles
separates the ventricles from the atria
atrioventricular septum
separates L and R ventricles
interventricular septum
What are the 2 muscle formations of the ventricles?
Trabeculae carnae, and Papillary mucles
muscle formation with internal ridges
Trabeculae carnae
muscle formation with finger-like projections attached to small tendons
Papillary muscles
What are the 2 types of heart valves?
Atrioventricular (AV) valves and Semilunar valves
What are the 4 heart valves?
Tricuspid valve, Bicuspid/ Mitral valve, Pulmonary valve, Aortic valve
valves found between the atria and ventricles, attached to papillary muscles
Atrioventricular (AV) valves
What are the 2 AV valves?
Tricuspid valve and Bicuspid valve
valve between R atrium and ventricle
Tricuspid valve
valve between L atrium and ventricle
Bicuspid/ Mitral valve
attaches AV valves to papillary muscles
Chordae tendinae
valves that remain open when ventricles are relaxed
AV valves
the papillary muscles contract and pull on the chordae tendinae to ___?___ during ventricular contraction, therefore __?___.
keep the AV valve closed; preventing the backflow of blood into the atria.
valves found between ventricle and its corresponding artery,
Semilunar valves
what are the 2 semilunar valves?
Pulmonary valve and Aortic valve
valve between the R ventricle and the pulmonary trunk
Pulmonary valve
valve between the L ventricle and the aorta
Aortic valve
valves that remain closed when ventricles are relaxed
Semilunar valves
circulation that occurs on the right side of the heart
Pulmonary circulation
What is the process of pulmonary circulation?
De-oxygenated blood from R atrium> tricuspid valve> R ventricle> pulmonary valve> Pulmonary trunk> lungs for gas exchange (alveoli)> Oxygenated blood> pulmonary veins> back to L atrium
circulation that occurs on the left side of the heart
Systemic circulation
which side of the heart is bigger?
Left
what is the process of systemic circulation?
Oxygenated blood from L atrium> bicuspid/mitral valve> L ventricle> aortic valve> aorta> to body for gas exchange> Capillaries (w/in tissues)> De-oxygenated blood> superior/inferior vena cava> back to R atrium
circulation branch of systemic loop
Coronary circulation
what is the process of coronary circulation?
Blood from L ventricle> Aorta> R and L coronary arteries> Myocardial capillaries for gas exchange> cardiac veins> coronary sinus> R atrium
artery that supplies the right atrium, has 2 main branches
Right coronary artery
supplies anterior and lateral portions of the right ventricle
Marginal artery
supplies posterior side of both ventricles
Posterior interventricular artery
what are the 2 main branches of the right coronary artery?
Marginal artery and Posterior interventricular artery
what are the 2 main branches of the left coronary artery?
Anterior interventricular artery and Circumflex artery
supplies anterior side of both ventricles
anterior interventricular artery
supplies left atrium and all portions of the left ventricle
Circumflex artery
What are the 4 cardiac veins?
Great cardiac vein, Posterior cardiac vein, Middle cardiac vein, Small cardiac vein
the largest cardiac vein, drains the anterior aspect of the heart.
Great cardiac vein
drain the posterior and lateral aspects of the heart
Posterior, Middle, and Small cardiac veins
involves autorhythmic cells and cardiac muscle cells
cardiac muscle contraction
make up the conduction system, responsible for action potential (AP) generation and conduction (pacemaker)
Autoryhthmic Cells
considered the hearts natural normal pacemaker, under control of nervous and endocrine systems
SA (sinoatrial) node
start near the apex and moves up thru ventricles, site of synapse between conduction system and ventricular myocardium
Purkinje Fibers
striated, braching and mononucleated, intercalated disc, AP generation
Cardiac muscle cells
cellular junctions that allow ion movement between cells
Intercalated Disc
longer refractory period than skeletal muscle tissue, cannot undergo tetanus
Cardiac muscle cells
Depolarization is caused by an opening of ?.
voltage gated Na+ channels
Repolarization is caused by an opening of ?.
voltage gated K+ channels
Plateau caused by an opening of ?.
voltage gated Ca++ channels, leakage of K+
What makes the SA node fire?
Ca++ moving in
what is the process of contraction?
AP generated in SA node travels to atrial myocardium and AV node (causes atrial contraction)> AP travels from AV node to bundle of His then along bundle branches to the Purkinje fibers> AP travels down the sarcolemma and causes voltage gated Ca++ channels in sarcolemma to open> Ca++ moves into the cell from the ECF and binds to receptor on the SR> Ca++ release channels open in the SR causing larger amounts of Ca++ to be released from the SR (calcium-induced calcium release)> Ca++ binds to troponin initiating contraction (sliding filament mechanism)
What are the 4 events that happen during 1 heartbeat?
Atrial and Ventricular Systole (contraction), Atrial and Ventricular Diastole (relaxation)
What are the 3 phases of the cardiac cycle?
- Ventricular relaxation 2. Ventricular filling 3. Ventricular ejection
occurs just after blood is ejected from the ventricles, semilunar valves are open and AV valves are closed
Ventricular relaxation
causes decreased ventricular P
Ventricular diastole
begins when AV valves open, rapid ventricular filling, Atrial systole, End Diastolic Volume EDV
Ventricular filling
volume of blood in the ventricle just prior to contraction
End Diastolic Volume EDV
ventricular systole, closing of AV valves, opening of semilunar valves, ventricular ejection, atrial filling
Ventricular ejection
causes increased ventricular P
Ventricular systole
causes first heart sound
Closing of AV valves
causes second heart sound
Closing of semilunar valves
Ventricular diastole, closing of semilunar valves, opening of AV valves
Ventricular relaxation
the amount of blood in one heartbeat
Stroke volume
total amount of blood pumped by each ventricle per minute
cardiac output
What are the 2 mechanisms for the regulation of Cardiac Output?
regulation of stroke volume and regulation of HR
What are the 3 factors of Stroke Volume regulation?
- Preload 2. Contractibility 3. Afterload
stretch on the cardiac muscle just before contraction
Preload
strength of contraction
Contractibility
pressure the ventricles must overcome to eject blood
Afterload
Increased EDV = ?
Increased Preload, SV, CO; Decreased Afterload
Decreased EDV = ?
Decreased Preload, SV, CO; Increased Afterload
promote Ca++ movement into the cells
Positive inotropic agents
inhibit Ca++ movement into cells
Negative inotropic agents
pressure the ventricles must overcome to eject blood (blood pressure)
afterload
where is the cardiovascular center located?
medulla oblongata
fight or flight
sympathetic
rest and digest
parasympathetic
the cardiovascular center is composed of 3 centers:
cardioacceleratory center
cardioinhibitory center
vasomotor center
sympathetic; heart beats faster
cardioacceleratory center
parasympathetic; heart beats slower
cardioinhibitory center
sympathetic only; blood vessel diameter
vasomotor center
in aortic arch and bifurcation of common carotid artery; monitors O2 and CO2 levels
chemoreceptors
in aortic arch and carotid sinus; monitors blood pressure
baroreceptors
in skeletal muscles and joints; movement and body position
proprioceptors
responds to hypoxia, hypercapnia, acidosis, or low BP; stimulates cardiac accelerator nerves
sympathetic NS
responds to alkalosis or high BP, stimulates vagus nerve;
parasympathetic NS
mimic the sympathetic nervous system
epinephrine and norepinephrine
blocks Ca++ movement into SA node, HR decreases
hypernatremia
inhibits AP generation, HR decreases
hyperkalemia
increases conc. gradient, HR increases
hypercalcemia
decreases conc. gradient, HR decreases
hypocalcemia
atrial depolarization on EKG
P-Wave
Ventricular depolarization, atrial repolarization is occurring but is masked on EKG
QRS-Complex
Ventricular repolarization on EKG
T-Wave