Physiol Lab Quiz 3: Labs 7,8,9 Flashcards
Name the cell that monocytes differentiate into
Macrophages
Distinguish sickle cell disease vs. acute lymphocytic leukemia vs. acute monocytic leukemia vs. eosinophilia
- Sickle cell disease: Defect in protein part of Hb (Hb A (normal) vs. Hb S)
- Acute lymphocytic leukemia AKA acute lymphoblastic leukemia: type of cancer where the bone marrow makes too many lymphocytes
- Acute monocytic leukemia AKA acute monoblastic leukemia: type of cancer where the bone marrow makes too many monoblasts (monocyte precursor)
- Eosinophilia: elevated eosinophil count
Define: antigen, antibody, agglutinate/agglutination
Antigen: molecules (sugars or proteins) on all cell membranes that can be recognized as foreign by another individual
Antibody: proteins released by plasma cells that can bond specifically to antigens
Agglutinate/agglutination: clumping of RBCs due to antibodies attaching to RBC’s antigen
Identify a person’s blood type based on their blood typing plate results
Type: test for patient’s blood type by looking for the presence of antigens using commercially available antibodies
— If agglutination occurs in that blood sample with that antibody, they have that anitgen
Explain erythroblastosis fetalis
- Rh- mom has Rh+ baby
- @ birth, mom may be exposed to Rh+ blood
- May produce anti-D antibodies (takes time)
- Future pregnancies, anti-D antibody cross placenta → agglutination (then hemolysis)
However, RhoGAM covers antigen D, so mom doesn’t make D antibodies
What are erythrocytes and what is their primary function?
red blood cells that transports mostly oxygen and a little bit of carbon dioxide
What are the different types of granulocytes and what do they each do?
Granulocytes: blood cells that contain visible staining granules; there are 3 types (-phils)
1. Neutrophils: combat against bacterial infections by undergoing phagocytosis
2. Eosinophils: responds to allergies and parasitic infections
3. Basophils: It releases histamine, which causes vasodilation allowing more blood to the injured site. It also can release heparin, which is an anticoagulant that helps prevent blood clotting
What are the different types of agranulocytes and what do they each do? Also what are the different types of lymphocytes and what do they each do?
Agranulocytes: leukocytes that contain granules that do not stain well; there are 2 types (-cytes)
1. Lymphocytes: different types of immune functions depending on the type of lymphocyte (3)
— B lymphocytes (B cells): matures in BONE MARROW and can differentiate into plasma cells to secrete antibodies
— T lymphocytes (T cells): matures in the THYMUS and pokes holes in the plasma membrane of cells to have them undergo apoptosis (programmed cell death)
— Natural Killer (NK) cells: attacks bacteria, transplanted tissues, and host cells that contain viruses or become cancerous by poking holes in the plasma membrane to cause them to undergo apoptosis
2. Monocyte: become macrophages that undergo phagocytosis on cells that are infected or on cellular debris; they display the antigen of the pathogen on their plasma membrane to alert our immune system of the pathogen
What are the relative amounts of leukocytes? List them from most to fewest.
Never Let Monkeys Eat Banana
1. Neutrophils
2. Lymphocyte
3. Monocyte
4. Eosinophils
5. Basophils
What are platelets and what do they do?
Platelets: fragments of a bone marrow cell called megakaryocytes. Platelets help with the process of blood clotting
Distinguish the antigen, antibodies (Ab), what RBC they can receive, and what RBC to donate to for the following blood type: A+
Anitgens: A and D
Antibodies (Ab): Anti-B Ab
Receive RBC from: A± ; O±
Donate RBC to: A+; AB+
Distinguish the antigen, antibodies (Ab), what RBC they can receive, and what RBC to donate to for the following blood type: A-
Anitgens: A only
Antibodies (Ab): Anti B & Anti-D Ab
Receive RBC from: A-; O-
Donate RBC to: A± ; AB±
Distinguish the antigen, antibodies (Ab), what RBC they can receive, and what RBC to donate to for the following blood type: B+
Anitgens: B and D
Antibodies (Ab): Anti-A Ab
Receive RBC from: B± ; O±
Donate RBC to: B+; AB+
Distinguish the antigen, antibodies (Ab), what RBC they can receive, and what RBC to donate to for the following blood type: B-
Anitgens: B
Antibodies (Ab): Anti-A & Anti-D Ab
Receive RBC from: B-; O-
Donate RBC to: B± ; AB±
Distinguish the antigen, antibodies (Ab), what RBC they can receive, and what RBC to donate to for the following blood type: AB+
Anitgens: A, B and D
Antibodies (Ab): NONE
Receive RBC from: A±; B± ; AB±; O±
Donate RBC to: AB+
Distinguish the antigen, antibodies (Ab), what RBC they can receive, and what RBC to donate to for the following blood type: AB-
Anitgens: A and B
Antibodies (Ab): Anti-D Ab
Receive RBC from: A-; B- ; AB-; O-
Donate RBC to: AB±
Distinguish the antigen, antibodies (Ab), what RBC they can receive, and what RBC to donate to for the following blood type: O+
Anitgens: D antigens
Antibodies (Ab): Anti-A & Anti-B Ab
Receive RBC from: O±
Donate RBC to: A+; B+; AB+; O+
Distinguish the antigen, antibodies (Ab), what RBC they can receive, and what RBC to donate to for the following blood type: O-
Anitgens: NONE
Antibodies (Ab): Anti-A, Anti-B & Anti-D
Receive RBC from: O-
Donate RBC to: A±; B±; AB±; O±
Name the structure in the cardiac conduction system that serves as the pacemaker
Sinoatrial node (SA node)
Starting from the SA node, list the structures that electrical impulses travel through in the cardiac conduction system
- SA node
- Internodal pathway
- Atrioventricular (AV) node
- Atrioventricular (AV) bundle/ Bundle of His
- Right and Left Bundle branches
- Purkinje fibers
What is the AV node delay?
The AV node slightly holds the electrical impulse to allow sufficient time for the ventricles to fill with blood before it sends the electrical impulse to the AV bundle
Draw an ECG with 3 heartbeats. Be sure to label all the waves on 1st heartbeat, all the segments on the 2nd and all the intervals on the 3rd.
ECG checkpoint:
(3) Waves: P wave, QRS complex, T wave
(3) Segments: PR/PQ segment, ST segment, TP segment
(2) Intervals: PR/PQ interval, QT interval
NOTES:
- Segments: end of one wave-beginning of next wave (flat line); shorter
- Intervals: at least 1 wave + 1 segment; longer
Explain what each ECG wave and complex represent.
- P wave: all the electrical activity that occurs when the atria depolarizes
- QRS complex: all the electrical activity that occurs when the ventricles depolarize. Since the ventricles are a lot larger and have more electrical activity that occurs than the atria, the QRS complex covers up the electrical activity of the repolarization of the atria
- T wave: all the electrical activity that occurs when the ventricles repolarizes
Explain what is occurring for each ECG interval.
NOTE: “intervals” are longer periods compared to the “segments”; 1 wave + 1 segment
* PR/PQ interval: Contains both the P wave and the PR segment
— P wave: Atrial depol. ( at SA node) → internodal pathway → AV node = Atrial systole
— PR segment: Atrial systole occurs
* QT interval: Contains the QRS complex, ST segment and T wave
— QRS complex: Venticular depol. (at AV node) →AV bundle → R/L bundle branches → Purkinje fibers = Ventricular systole
- QRS complex hides atrial repol. (= atrial diastole)
— ST segment: Ventricles contract/systole and atrial diastole
— T wave: Ventricular repol. (ventricular diastole occurs AFTER T wave)
Explain what is occurring for each ECG segment.
- PR/PQ segment: Atrial systole occurs
- ST segment: Ventricular systole and atrial diastole occurs
- TP segment: relaxation of ventricles
Distinguish systole vs. diastole
Systole: contraction (implies for ventricular if “atrial” is not written)
Diastole: relaxtion
Calculate heart rate using the “R wave to R wave method” & “heavy vertical lines method”
R wave to R wave method; to find exact HR
NOTE: Each SMALL square horizontally is 0.04 s, so each LARGE square is 0.2 s
- Count how many big squares are between one
R peak to the next R peak in a QRS complex, and multiply that by 0.2 s = x secs
- EX) 5 big squares x 0.2 s = 1.0 s for a single heartbeat…
(1 beat/1.0 s)(60 s/1 min) = 60 BPM
Heavy Vertical Lines method
- First find a R wave that is on a heavy vertical line (darker line), then count the number of heavy vertical lines until you reach the next R wave.
- EQUATION: 300/# of lines
What is the difference between cardiac arrest vs myocardial infarction?
Cardiac arrest: when the heart stops working or pumping blood due to arrhythmias like Vfib
Myocardial infarction (MI): heart attack; when blood is not able to get to the heart muscle, causing necrosis or tissue death
Under what heart conditions do you typically use the defibrillator?
Pulseless ventricular fibrillation and pulseless ventricular tachycardia
— “Pulseless” means that the blood pressure is so low that you cannot feel a pulse
Distinguish tachycardia vs. bradycardia
Tachycardia/Sinus Tachycardia: when a person’s resting heart rate is greater than 100 bpm
Bradycardia: when a person’s heart rate drops below 60 bpm
Memorize the normal range for the P-R interval. What happens if the person has their P-R interval greater than the range?
Normal PR intervals are 0.2 s or less (0.12-0.20), which is shorter than the length of a big square.
- If it is longer than 0.2 s, then the person has a first-degree AV node block
What changes are there within an ECG when you are at rest versus exercising
During exercise - distance between the peak of one R wave of one heart beat to the next will be closer, due to: the PR interval, QT interval, and the period between the T wave of the first heartbeat to the QRS complex of the next heartbeat
What is myocardial ischemia? How can you detect this on ECG?
Myocardial ischemia: can be caused by atherosclerosis of coronary a.
• Associated with ↑ blood lactic acid; uses anaerobic fermentation instead of O2 to compensate (ischemia involves not having enough oxygen delivered to the cardiocytes)
- Causes chest pain known as angina pectoris
• Detected by changes (elevation or depression) in S-T segment
How will you detect myocardial ischemia on an ECG?
- Downsloping of ST segment
- Elevated ST segment
- Inversed U wave
Define ischemia
Ischemia: not having enough oxygen delivered to the cardiocytes due to inadequate blood flow
Describe the treatment for myocardial ischemia
Nitroglycerin (becomes NO) for vasodilation
Define supraventricular tachycardia (SVT) & name 1 example discussed in class
Supraventricular tachycardia (“SVT”): broad term for arrhythmias originating above ventricles
* Includes atrial tachycardia
Describe ventricular tachycardia (VT)
Ventricular tachycardia (AKA “V-tach”, VT): fast ectopic pacemakers (NOT SA node) in ventricles beat independently → could lead to ventricular fibrillation
— Refers to the abnormal electrical impulses
Define fibrillation
Fibrillation: contraction of different groups of cardiac muscle cells at different times causing NO COORDINATED JUMPING
* Circus rhythms (recycling of waves)
Describe atrial fibrillation (A-Fib) & describe the treatment for A-Fib
Atrial fibrillation: Most common heart arrhythmia; mild BUT associated with higher risk of blood clots
-Treatment: anti-arrhythmia & anti-thrombotic drugs (EX: Warfarin)
Describe ventricular fibrillation (V-Fib) & describe the treatment for V-Fib
Ventricular fibrillation: when the electrical signals of the ventricles are RANDOM, causing the ventricles to contract randomly; preventing proper filling of the ventricles
- Serious; may cause cardiac arrest or lead to sudden death
- Treatment: Implantable cardioverter-defibrillator/ ICD (for high risk patients) or Automated External Defibrillator (AED)
Define heart block & AV node block
- Heart block: failure of any part of the cardiac conduction system to conduct signals
- AV node block: (type of heart block) causes slowing of impulse conduction; 3 main types of AV node block (the more bigger the type, the more serious)
Define blood pressure, systolic pressure, diastolic pressure
- Blood pressure: pressure of blood pushing against BV walls
- Systolic pressure: peak arterial BP attained during ventricular contraction (systole)
- Diastolic pressure: minimum arterial BP occurring during ventricular relaxation (diastole)
Distinguish laminar flow vs. turbulent flow & determine how do they relate to the 1st & last Korotkoff sounds
- Laminar flow: silent since fluid moves in same direction
— Occurs during last Korotkoff sound = the estimated diastolic pressure - Turbulent flow: some parts of fluid move in diff. direction, mixing the blood, causing vibrations
— Very first Korotkoff sound you hear when you start deflating the cuff = the estimated systolic pressure
Name the BP the 1st Korotkoff vs. last Korotkoff sound estimates
1st Korotkoff - Turbulent flow; ~ 120 (Systolic)
Last Korotkoff - Laminar flow; ~ 80 (Diastolic)
What is a heart murmur?
Heart murmur: when there are abnormal heart sounds due to abnormal blood flow through the heart
Name the 2 valves that close during the 1st heart sound (“lub/lup”) vs. the 2 valves that
close during the 2nd heart sound (“dub/dup”)
1st heart sound (“lub”/”lup”) - AV valves close (tricuspid and bicuspid)
2nd heart sound (“dub”/”dup”) - Semilunar valves close (pulmonary and aortic)
Determine the technique used to detect abnormal heart sounds
Auscultation w/ a stethoscope
When you are taking someone’s pulse, what is the action of feeling for their pulse?
Palpate
List the 3 locations of pulse points and their associated estimated systolic blood pressure.
- If you can feel the pulse at the CAROTID ARTERY it means the patient’s systolic pressure is at least 60 mmHg.
- If you can feel the pulse of the FEMORAL ARTERY, their systolic pressure is at least 70 mmHg.
- If you can feel the pulse of the RADIAL ARTERY, their systolic pressure is at least 80 mm Hg.
What did we use to measure blood pressure?
sphygmomanometer and a stethoscope
Which two conditions do you NOT hear sound when measuring someone’s blood pressure Why?
- BP cuff is inflated HIGHER than P of brachial a., no blood is going through
- As the BP cuff continues to deflate, blood will reach laminar flow; no turbulence of blood hitting against the walls of the blood vessel
What is an aneurysm?
Aneurysm: the ballooning of the arteries, due to the blood vessels’ walls thinning out, which can potentially rupture
Use the following for the next few questions:
Given someone’s blood pressure to be 150/100:
What is their pulse pressure? (Show your work)
PP = Systolic pressure - diastolic pressure
PP = 150-100
PP = 50 mm Hg
Use the following for the next few questions:
Given someone’s blood pressure to be 150/100:
What is their MAP? (Show your work)
MAP = diastolic pressure + (pulse pressure/3)
MAP = 100 + (50/3)
MAP = 116.67 mm Hg
Categorize individuals into the appropriate BP classification based on their BP reading: 150/100
Hypertension (Stage 2)
