exam 2 Flashcards
1
Q
____ carry blood away from heart, ___ carry blood towards the heart
- arteries branch and vessel diameters get smaller as go away from heart
- veins merge and vessel diameters get larger as go back to heart
A
arteries; veins
2
Q
_____ experience higher BP, greater fluctuations in pressure than veins
Arteries closest to the heart experience the greatest blood pressure and fluctuations
* Affects composition and thickness of vessel walls → concentric layers or “tunics” around vessel lumen (note: the names for types of arteries give you clues to this!)
A
arteries
3
Q
_______ must carry blood back towards the heart
under low pressure
Blood below the level of the heart must also be moved
against gravity → need assistance to keep blood flowing towards the heart, prevent the backwards flow of blood
A
veins
4
Q
Differences in vessel composition correspond largely to differences in _____
A
pressure
5
Q
Thicker vessel wall (especially tunica media), elastic membranes, and elastic facilitate the functions of _____
A
arteries
6
Q
As vessel diameter decreases, resistance to flow ______
A
increases
7
Q
As we move toward the heart (i.e., through veins) the diameter ______.
A
increases
8
Q
_______ reduces resistance, increases flow
A
Vasodilation
9
Q
_____ increases resistances, reduces flow
A
vasoconstriction
10
Q
As blood moves away from the heart through arteries, arteries branch, lumen diameter ______ and composition of the vessel wall changes
A
decreases
11
Q
_______ (elastic, large) arteries are the first to receive blood from the heart → experience highest pressure
- Contain alternating thin layers of smooth muscle, collagen, and elastic fibers
- Relatively inactive in vasoconstriction (i.e., routing blood flow to/away from areas of the body)
Serve as pressure reservoirs for smooth blood flow
A
Conducting
12
Q
Adjusting blood flow to meet tissue/organ demands: changing ____ _____ (amount of blood pumped by a ventricle in 1 minute, mL/min)
A
cardiac output
13
Q
center of medulla (sympathetic)
A
Cardioacceleratory center
14
Q
center of medulla
(parasympathetic)
* Vagal tone
* Affect potassium outflow to get less
frequent depolarization
A
Cardioinhibitory center
15
Q
accelerate contraction, ventricular filling, and relaxation -> increase heart rate
A
Epinephrine and norepinephrine accelerate depolarization
16
Q
These are in the carotid arteries and aorta, there are different baroreceptors in the walls of the atria that when overstretched activate a reflex arc that increases heart rate (atrial reflex)
A
baroreceptors
17
Q
affect heart rate
A
Chronotropic agents (time)
18
Q
affect the contractility (contractile strength at a given length)
A
inotropic agents (affect stroke volume)
19
Q
caffeine is both chornotropic and inotropic that increases both heart rate and cardiac output
A
study slide 11
20
Q
degree of stretch of the heart muscle
* Cardiac muscle at rest is at a suboptimal length (stretching moves it towards the optimal length)
* Makes stroke volume proportional to end diastolic volume (Frank-Starling Law)
A
Preload
21
Q
pressure that must be overcome to eject blood (back pressure arterial blood)
- Should be relatively constant
- Issue in patients with
hypertension
A
Afterload
22
Q
Vasodilationreducesresistance, _____ flow
A
increases
23
Q
Vasoconstriction increases resistance, _____ flow
A
reduces
24
Q
- Length of blood vessels explains blood pressure changes as children grow, relatively constant in adults
- Blood viscosity affected by hydration, RBC production
- Turbulence caused by damage to vessels, atherosclerosis
A
Other factors that affect resistance are not adjustable in the moment
25
* Localized, near-instantaneous adjustments
* From within the organ or tissue itself
* Signals typically have short-term effects on precapillary sphincters, can also affect arterioles
* Local regulation (autoregulation or intrinsic regulation):
26
* Want to ensure pressure and volume within the system maintained when:
* Tissue demands shift (for e.g., rest vs exercise)
* Something affects fluid balance in the body (for e.g., hydration levels) * There is blood loss (hemorrhage)
* Nervous and/or endocrine system involved
* Systemic (central or extrinsic) regulation:
27
Too high – affects workload on heart, stress on ____ _____ in maintaining BP
blood vessels
28
Too low – affects ____ ____ in maintaining BP
tissue perfusion
29
* _____ signaling affects water loss in urine, blood pressure (via effects on cardiac output and blood vessels), and red blood cell formation
endocrine
30
* Need pressure to decrease to prevent damage to fragile capillaries
* Increase in resistance due to decreasing luminal diameter of blood vessels helps accomplish this
* Need to allow sufficient time for resources to be exchanged
* Blood velocity decreases at capillaries due to increase in total cross-sectional area -> gives time for exchange!
* Need to ensure resources go into tissues once they reach the associated capillaries
As we near the capillaries, we encounter different challenges
31
1. diffusion through plasma membrane (lipid-soluble substances)
2. movement through intercellular clefts (water-soluble substances)
3. movements through fenestrations (water-soluble substances)
4. transport via vesicles or caveolae (large substances)
mechanisms by which substances are exchanged btw capillaries and interstitial fluid
32
Blood proteins remain in _____ (blood colloid osmotic pressure)
capillaries
33
Along the length of the capillary:
* Capillary hydrostatic pressure (CHP) pushes fluid out of the capillary lumen
*Blood colloid osmotic pressure (BCP) pulls fluid back in
Net movement of fluid (and direction of that movement) determined by the difference between hydrostatic and osmotic pressure
Direction of fluid movement relative to capillaries is determined by net filtration pressure
34
*Anything that affects ____ and ___ can alter delivery of resources, waste removal at capillaries
CHP, BCOP
35
T/F Fluid leaves capillaries at the arteriole end and returns at the venule end
Fluid that is not reabsorbed is returned to the cardiovascular system by lymphatic vessels
T
36
Can you explain how each of the following would affect the net movement of fluids at the capillaries AND why?
1. Plasma albumin deficiency.
2. Obstructed lymphatic drainage.
Plasma albumin deficiency decreases osmotic pressure in capillaries, reducing fluid reabsorption and leading to edema as more fluid remains in the interstitial space.
Obstructed lymphatic drainage prevents excess interstitial fluid and proteins from being cleared, causing fluid accumulation and swelling (lymphedema).
37
flow is directly or indirectly proportional to the pressure gradient and is inversely proportional to resistance
directly
38
resistance is directly or inversely proportional to the 4th power of the vessel radius
inversely ---- vessels further from the heart contribute more to resistance (and flow) than those near the heart
39
1. diffusion through plasma membrane (lipid-soluble substances)
2. movement through intercellular clefts (water soluble substances)
3. movement through fenestrations (water soluble substances)
4. transport via vesicles or vaeolae (large substances)
Mechanisms by which substances are exchanged between capillaries
40
Direction of fluid movement relative to capillaries is determined by ____ ____ ____
net filtration pressure
41
proteins more concentrated in the ___ than tissues
blood
42
Fluid balance: return excess fluid to blood stream (also important for maintaining blood volume, transport of substance)
Lipid absorption: more on this in digestive system (lacteals)
Defense/Immune Surveillance:
Produce, maintain, and distribute lymphocytes and other lymphoid cells (immune-related function!)
Filter microorganisms, foreign substances, and debris from body fluids
major functions lymphoid system
43
collection of lymphoid nodules associated with pharynx
tonsils
44
filter lymph
lymph nodes
45
return fluid to the blood circulation
lymph vessels
46
involved in lymphocyte production
thymus
47
filters blood
spleen
48
1. lymph
2. lymphatic vessels
3. Lymphoid tissues and organs
4. Lymphoid cells – lymphocytes, macrophages, and other cells
Components of the lymphatic system
49
Fluid that is not reabsorbed is returned to the cardiovascular system by ____ vessels
lymphatic
50
originate as dead end tubes called lymphatic capillaries
Lymphatic vessels
51
Larger luminal diameter
Endothelial cells not joined tightly; edges overlap to form valves
Incomplete or absent basement membrane
Blind ends
Collagen anchoring filaments
How are lymphatic capillaries structurally different from blood capillaries? Why is this important?
52
The movement of fluid out of blood capillaries increases pressure in the interstitial space.
Select the statement that BEST explains why interstitial fluid moves into lymphatic capillaries.
53
Return promoted by:
Contraction lymphatic vessels
Contraction skeletal muscles
Thoracic pressure changes
Arterial pulsation
Larger lymphatic vessels have same tunics, but more valves and thinner walls compared to veins
54
Trunks either drain into thoracic veins or converge into ducts
- thoracic duct
- right thoracic duct
Lymphatic vessels are named based on the region of the body (as are clusters of lymph nodes)
55
Why would the cancer cell first travel to a lymph node instead of into the bloodstream?
If a lot of lymph nodes are removed, how might this affect the patient?
If lymph flow is affected, the different treatments may be recommended. Can you explain how each of these treatments would help improve lymphatic drainage?
Compression garments
Physical therapy
Elevating a limb
1. vessels have large enough gaps to detect it
2. harder and makes it less routes and reduce flow and have accumulation, immune cells have poorer ability to detect infections
3. Compression garments apply gentle pressure to the affected area, preventing fluid buildup and promoting lymph flow.
Physical therapy uses manual lymphatic drainage and exercises to stimulate lymph movement and reduce swelling.
Elevating a limb above heart level helps gravity assist in draining excess lymph fluid, reducing swelling.
56
where lymphocytes develop and mature
primary
57
where lymphocytes are activated
secondary
58
______ tissues can be diffuse or concentrated (lymphoid nodules or follicles)
lymphoid
59
______ are designed to “trap” things in crypts
tonsils
pharyngeal, palatine, lingual
60
(aggregated lymphoid nodules)
Peyer’s patches
61
____ nodes function to clean lymph and in immune activation
lymph
62
T cells mature at the ____
thymus
63
_____ promote maturation and development of T cells
thymosin
64
large reserves of immune cells
white pulp
65
Which of these is NOT associated with the lymphatic system?
a. Helps improve the efficiency of pathogen detection
b. Vessels have thicker walls than veins
c. Lymphoid tissues and cells are found at key locations such as just underneath (i.e. deep to) mucosal barriers
d. Ability to build specific defenses
e. Involved in early detection of pathogens in food and air
Vessels have thicker walls than veins
66
Preventing infections
Controlling and/or clearing infections while limiting damage (i.e., to yourself)
Recognizing and responding to threats while not mistaking things that are not threats as threats (i.e., get allergic reactions, failure distinguish self from non-self leads to autoimmune disorders)
The immune system challenges
67
* Ability to respond quickly (minutes
to hours)
* Broad defenses (non-specific)
innate
68
* Takes time (days), especially when
it’s the first (primary) exposure to
a pathogen
* Specific responses
* Added benefit of immune
memory
adaptive
69
- B cells
- t cells
adaptive defenses
70
surface barriers
- skin
- mucuous membrane
- phagocytes
internal defenses
-NKC
-inflammation
-antimicrobial proteins
- fever
innate defenses
71
* Epidermis provides a physical
barrier
* Hairsaidindetectinginsects
* Immunecellsinepidermisand dermis
* Secretions can help “wash” things
away, inhibit with bacterial growth
* Acid mantle formed by sweat and
sebum
* Antimicrobial peptides (for e.g.,
defensins)
Skin represents a barrier to infection
72
Associated with secretion of many
protective chemicals: * Acids
* Enzymes such as lysozyme
* Mucin (dissolves in water to form mucus)
* Defensins
* Antibodies (considered part of adaptive
immunity)
Some mucosal surfaces have additional, structural modifications
Hyaluronic acid in underlying connective tissue adds viscosity to slow pathogen movement
Mucosal surfaces are also considered a barrier -- Pathogens also more commonly infect via this route
73
____ _____ in underlying connective tissue adds viscosity to slow pathogen movement
hyaluronic acid
74
____ pathogens entry into cells and replication --> spread of infection to neighboring cells and or systemic infection
intracellular
75
1. pathogen replication
2. local spread of infection and or systemic infection
extracellular pathogen
76
are usually the first to arrive at an infection site – can kill by phagocytosis, trapping pathogens in a web of DNA and histones, and discharging enzymes that lead to respiratory burst
neutrophils
77
differentiate into macrophages after they leave the bloodstream, arrive later, and aid in fighting pathogen, cleaning up debris, and recruiting cells that can repair the tissue
monocytes
78
1. phagocyte adheres to pathogens or debris
2. phagocyte forms pseudopods that eventually engulf the particles forming a phagosome
3. lysosome fuses with the phagocytic besivles forming a phagocytic vesicle, forming a phagolysosome
4. toxic compounds and lysosomal enzymes destroy pathogens
5. sometimes exocytosis of the vescile removes indigestible and residual material
events of phagocytosis
79
____ and ____ cells secrete chemicals that attract other cells, promote inflammation
basophils and mast
80
Some parasites are too large to be engulfed – ____ function in protection against parasitic worms
eosinophils
81
can produce oxidizing substances and toxic proteins as well as engulf and destroy some antigens
eosinophils
82
are lymphocytes, detect abnormalities in composition of cell membranes
NKC
83
Aid in killing:
* Cancercells * Infectedcells
Considered part of innate because detect general abnormalities such as changes in proteins on cell surface
NKCs
84
1. NK cell releases perforins, which polymerize and form a hole in the enemy cell membrane
2. granzymes form NK cell enter perforin hole and degrade enemy cell enzymes
3. enemy cell dies by apoptosis
4. macrophage engulfs and digests dying cells
NKC
85
Rheumatoid arthritis is an autoimmune disorder associated with joint inflammation. Knowing only this information, what type of innate immune cells would you expect to be involved in this disease?
a. Complement
b.Mast cells
c. Plasma cells
d.Natural killer cells e.Cytotoxic T cells
mast cells
86
Lysozymes (in tears, saliva, nasal secretions, and sweat) lyse cells; acid secretions (sebum in the skin and hydro- chloric acid in the stomach) prevent microbial growth or kill microorganisms; mucus on the mucous membranes traps microorganisms until they can be destroyed.
surface chemicals
87
____ is an amine released from mast cells, baso- phils, and platelets; histamine causes vasodilation, increases vascular permeability, stimulates gland secre- tions (especially mucus and tear production), causes smooth muscle contraction of airway passages (bron- chioles) in the lungs, and attracts eosinophils.
histamine
88
____ are proteins, produced by most cells, that interfere with virus production and infection.
interferons
89
group of plasma proteins that increase vascular permeability, stimulate the release of histamine, activate kinins, lyse cells, promote phagocytosis, and attract neutrophils, monocytes, macrophages, and eosinophils.
complement
90
chemicals, released by neutrophils, mono- cytes, and other cells, that stimulate fever production.
pyrogens
91
Lyses tumor and virus-infected cells
NKC
92
Enters tissues from the blood and defends against parasitic infections; participates in inflammation associated with asthma and allergies
Eosinophil
93
Nonmotile cell in connective tissues that promotes inflammation through the release of chemicals
mast cells
94
Motile cell that leaves the blood, enters tissues, and releases chemicals that promote inflammation
basophil
95
Most effective phagocyte; important in later stages of infection and in tissue repair; located throughout the body
to “intercept” foreign substances; processes antigens; involved in the activation of B cells and T cells
macrophage
96
Leaves the blood and enters tissues to become a macrophage
monocyte
97
Phagocytosis and inflammation; usu- ally the first cell to leave the blood and enter infected tissues
neutrophils
98
- induce antiviral defenses are in uninfected cells
* recruit immune cells (NKC, macrophages
Interferons coordinate defenses against viral infections
99
1. What innate immune cell(s) would you expect to be used to combat the COVID-19 virus and why?
2. What type of signaling molecule would be released by infected cells to help limit its spread?
1. NK cells -- detect abnormalities and destroy virus-infected cells by inducing apoptosis.
2. interferons -- inhibit viral replication and activate immune defenses, helping to limit the spread of the virus.
100
induced by endogenous or exogenous pyrogens that act on the hypothalamus
fever (pyrexia)
101
After activation, differentiates to become plasma cell or memory B cell
b cells
102
Produces antibodies that are directly or indirectly responsible for destroying the antigen
plasma cell
103
Quick and effective response to an antigen against which the immune system has previously reacted; responsible for adaptive immunity
memory b cells
104
Responsible for destroying cells by lysis or by producing cytokines
cytotoxic t cell
105
Activates B cells and cytotoxic T cells
helper t cell
106
Inhibits B cells, helper T cells, and cytotoxic T cells
regulatory t cell
107
Quick and effective response to an antigen against which the immune system has pre- viously reacted; responsible for adaptive immunity
memory t cell
108
Processes antigen and is involved in the activation of B cells and T cells
dendritic cell
109
Antigenic determinants are also called
epitopes
110
Key properties:
1. Specificity
2. Versatility
3. Memory
4. Tolerance
Pattern development and maturation
Must be activated → produce effector and memory cells
What do the cell-mediated (cellular) and humoral branches have in common?
111
1. Genetic processes create a lot of T and B cell diversity
2. Eliminate cells that don’t display functional receptor or have receptors that recognize self instead of non-self
(if not → autoimmune disorders)
3. Send cells to the locations where they are most likely to encounter a matching antigen (for e.g., lymph nodes, spleen)
4. Make more of only those cells that encounter the antigen that matches their receptor
Become an effector cell: deal with the current infection or Become a memory cell
The basic principles of how things work are the same for B and T cells
112
When an individual is given a COVID-19 mRNA vaccine, the cells of their own body start producing the viral spike protein, which is involved in binding and fusing with host cell membranes. What is the MAIN benefit of targeting the spike protein over another one?
a. It is small enough to enter blood capillaries for transport around the body.
b. Antibodies produced against this protein can neutralize the virus.
c. The pieces of the protein antigen can be displayed by both Class I and Class II
MHC molecules.
d. Memory B and T cells will be produced.
e. The variable region of ALL antibodies produced against this antigen will be
identical, making it easier for the innate immune system to do its job.
B
113
1. Mature in thymus
2. Recognize chopped up bits of antigen presented/displayed to T cells by other cells
* Involves major histocompatibility complex (MHC) proteins
1. Receptor = T cell receptor (TCR), bottom figure
* Naïve T cells (have not encountered their antigen) = CD4 and CD8 T cells
* CD4 become helper T cells
* CD8 become cytotoxic T cells
* Activation based on antigen
presentation (by dendritic
cells)
* Class II matches to CD4
* Class I matches to CD8
* Activated T cells differentiate into memory and effector cells
T cell activation requires antigen presentation
114
kill infected and cancer cells, helper T cells coordinate immune defenses and help activate B and T cells
cytotoxic T cells
115
1. Activation and cell division of a cytotoxic T cell by antigen on the surface of a cell
2. Memory T cells responsible for secondary response
3. Release cytokines --> Produce inflammation, initiate phagocytosis, and activate T cells
4. Kill cells on contact
cytotoxic T cell
116
Class I MHC are used to activate
cytotoxic T cells
117
Class II are found only on antigen presenting cells that activate
helper t cell
118
All nucleated cells have class ___ MHC
* Important for detecting infected cells and cancer cells
1
119
Antigen presentation by ____ cells is important for activation of CD4 T cells
dendritic
120
Antigen presentation by _______ more so helps maintain T cell activation or is for purposes of enhancing their ability to kill pathogens
macrophages
121
Antigen presentation by ____ cells is for their own activation
B
122
"Traditional" vaccines contain either an inactivated version of the pathogen (not capable of infecting your cells) or a protein subunit of the pathogen. A major plus of these vaccines is they can be stored at refrigerator temperatures and for significantly longer than mRNA vaccines. They also often are associated with a lower cost.
One of the challenges with using this style of vaccine for something like a virus is that they do not do a good job of stimulating the production of cytotoxic T responses. Can you explain why that would be?
these vaccines mainly activate Class II MHC pathways (focused on helper T cells and antibodies) rather than Class I MHC pathways (focused on cytotoxic T cells).
123
One of the early treatments for COVID patients with severe infections was convalescent plasma (plasma from someone who has recovered from the disease). The main idea
behind this treatment is that the plasma of someone who has recovered from the disease would contain antibodies against the COVID-19 virus.
Are the antibodies associated with the humoral or cell-mediated branch of the adaptive immune system?
humoral
124
This treatment would provide the recipient with ________________ (passive OR active) immunity that is ________________ (short OR long) -lasting.
passive, short
125
The person who donated the plasma would have ________________ (passive OR active) immunity that is ________________ (short OR long) -lasting.
active, long
126
How do you explain your different answers in b and c for the duration of immunity?
- In passive immunity (from plasma transfusion), the recipient only receives the antibodies temporarily, which is why the immunity is short-lasting.
- In active immunity (from the donor's own immune response), the body generates its own immune system memory, leading to long-lasting immunity.
