BIO 202 Exam 1

List AND describe the four types of intercellular communication pathways that enable the body to maintain homeostasis.

- Direct communication -- Exchange of ions and molecules between adjacent cells across gap junctions -- Occurs between two cells of same type -- Where have we seen these before? -- Cardiac muscle cells - Paracrine communication -- Uses chemical signals to transfer information from cell to cell within single tissue -- Most common form of intercellular communication -- i.e. Certain growth factors -Endocrine communication -- Endocrine cells release chemicals (hormones) into bloodstream -- Alters metabolic activities of many tissues and organs simultaneously -- Analogy once again: Bulk mail - in Russian -Synaptic communication

Compare and contrast the processes of down regulation and up regulation. Use an example that was discussed in class to support your response.

- Down-regulation Presence of a hormone triggers decrease in number of hormone receptors When levels of particular hormone are high, cells become less sensitive Receptors are all filled up Some receptors are broken down by the target cell - Up-regulation Absence of a hormone triggers increase in number of hormone receptors When levels of particular hormone are low, cells become more sensitive Receptors are available

List AND describe the products of the follicular cells and the parafollicular cells of the thyroid gland.

- Follicular Cells Produce: -- Thyroglobulin (Globular Protein) --- Transport proteins --- Attach to most T4 and T3 molecules in the bloodstream -- Thyroxine (T4) - contains 4 Iodine molecule -- Triiodothyronine (T3) - contains 3 Iodine molecules - Parafollicular (C - Cells) Produce: -- Calcitonin (more on this soon)

Compare and contrast the functionality of free vs. protein bound hormones in the plasma (bloodstream).

- Free Hormones Remain functional for less than 1 hour Diffuse out of bloodstream: bind to receptors on target cells Are broken down and absorbed by cells of liver or kidney Are broken down by enzymes in plasma or interstitial fluids - Protein bound Thyroid and Steroid Hormones Remain in circulation much longer Enter bloodstream More than 99% become attached to special transport proteins Bloodstream contains substantial reserve of bound hormones A reserve Why do thyroid and steroid hormones stay in circulation longer?

Compare and contrast the roles of insulin and glucagon. Make sure you know specifically which cells make insulin and glucagon (beta vs. alpha cells)

- Insulin - lowers blood glucose -- Stimulates glucose uptake by cells (primarily liver and skeletal muscle) -- Produced by Beta Cells - Glucagon - raises blood glucose -- Promotes conversion (change of glycogen in the liver to glucose) and release into bloodstream -- Produced by Alpha cells -- These hormones are antagonists that maintain blood sugar homeostasis

Diagram the general mechanism of action of a lipid soluble hormone. Then, compare and contrast a steroid hormone vs. thyroid hormone mechanisms of action. Yes, they are both lipid soluble hormones, but they have slightly different mechanisms of action.

- Lipid soluble hormones: Glucocorticoids Estrogens Androgens Thyroid hormone (T3) Calcitriol (the active form of vitamin _?_) Diffuse across the plasma membrane to reach receptor proteins on inner surface of membrane (intracellular receptors) REMEMBER: Anything that originates from cholesterol is lipid soluble! - Hormones and Intracellular Receptors Alter rate of DNA transcription in nucleus Directly affect metabolic activity and structure of target cell Includes steroids and thyroid hormones Steroid - has a 4 ring structure Lipid soluble, passes right through Receptor is in the cell or nucleus Thyroid hormone - lipid soluble, passes through In nucleus - changes how DNA is read, changes what proteins that cell makes Mitochondria has a receptor - creates energy when binded, usually really skinny and energetic if have over producing thyroid

What are the four effects of PTH?

- PTH raises blood calcium levels -- Osteoclasts do NOT have a receptor for PTH instead, PTH causes osteoblasts to release osteoclast-stimulating factor (RANKL) increasing osteoclast population -- promotes calcium reabsorbtion by the kidneys -- promotes calcitriol synthesis in the kidneys -- inhibits collagen synthesis and bone deposition by osteoblasts

Explain the difference between Type I and Type II Diabetes Mellitus. Make sure you understand the difference between receptor cell insensitivity and Islet cell burnout when talking about Type II Diabetes Mellitus.

- Type 1 Diabetes is caused by an autoimmune disorder - a problem with the body's immune system. -- In a healthy body, specialized cells (called beta cells) in the pancreas make insulin. -- In type 1 diabetes, the immune system mistakes beta cells for invaders and attacks them. When enough beta cells are destroyed, symptoms of diabetes appear. - In Type 2 Diabetes the beta cells still produce insulin. -- However, either the cells do not respond properly to the insulin (insulin receptor insensitivity) AND/OR the insulin produced naturally is not enough to meet the needs of the body (Islet cell burnout). -- Obesity and inheritance are common causes.

Diagram AND label the process of RBC recycling making sure to include: a. How iron is recycled. b. The pathway of hemoglobin to bilirubin.

1% of circulating RBCs wear out per day: about 3 million RBCs per second Macrophages of liver, spleen, and bone marrow: monitor RBCs engulf RBCs before membranes rupture (hemolyze) Iron: To transport proteins (transferrin) Taken back to bone marrow to be used in new hemoglobin To storage proteins (feritin and hemosiderin) Stored in the liver if excess transferrin Hgb to bilirubin pathway: globular proteins to amino acids heme to biliverdin (due to iron being stripped away) Green color Then converted to bilirubin - Has orange-yellow color Liver removes bilirubin Jaundice if liver damage 3. Iron

List AND describe the three types of pressure in the cardiovascular system.

1. Blood pressure (BP) Arterial pressure (mm Hg) 2. Capillary hydrostatic pressure (CHP) Pressure within the capillary beds 3. Venous pressure Pressure in the venous system (Blood pressure lowest in the veins)

Diagram the phases of the cardiac cycle making sure to include what is happening to the chambers of heart, the valves in the heart, and on an EKG during the following: a. Atrial systole b. Isovolumic contraction of the ventricles c. Ventricular ejection d. Isovolumic relaxation of the ventricles e. Late ventricular diastole (passive ventricular filling) f. Yes, you should probably draw out that huge cardiac cycle graph showing the EKG, Ventricular Pressures, and Left Ventricular Volume. You will probably see this on the MCAT and definitely on your medical licensing boards. You may ask, why draw it if it's already right there in front of you? Because by drawing it out and labeling it yourself, you will learn! ☺ Trust me!

1a - diastile - passive filling - filling based on pressure gradient between the atria and ventricles - lower pressure in ventricles and higher in atria 1b - atria are not contracting yet, the AV valves are open to fill the ventricles - ventricular diastole 1c - systole - aggressive the atria contract and get atrial kick (last 10% goes to Atraia and ventricles 2 - ventricles contract, same volume, but blood ain't movin' yet - same volume, ventricles contracting but the volume doesn't change, squeezing a full water bottle with the cap on AV Valves slammed shut (S1 heart sound - the lub of lub dub of heart) - makes pressure and prevents backflow 3 - ejection, blood is moving (steps 2 and 3 are both ventricular systole) - squeezing blood out 4 - ventricular diastole - isovolumetric relaxation - ventricles relax, pressure drops, volume stays the same, aotric and pulmonary valves shut S2 heart sound Valves make sounds when they shut lub dub lub dub lub dub - this is a cycle, it repeats over and over again

Where does ANP and BNP come from? What causes their release? What are their effects on the cardiovascular system when they are released?

2 hormones - made by heart ANP and BNP (above) - na - Na+ sodium - if you eat a lot of salt, water follows, blood pressure is high, blood volume is high, as it goes through the heart, it stretches out too much The wall of the atrium releases ANP and the ventricle releses BNP - these two go to the kidneys - tell them to get rid of the sodium (and therefore water) - should decrease his blood pressure

Name the four types of blood and explain who can receive what type of blood for a transfer.

A B AB O Rh factor or not

What is the difference between a thrombus and an embolus? Discuss why both of these can result in death.

A thrombus is a blood clot that is abnormal An embolus is a piece of blood clot that flows through blood until it gets to a tiny blood vessel and clogs it completely

What is atrial fibrillation? Why might someone have to be on blood thinners if they have this condition?

AF - irregularly irregular - fast without any regularity - super fast - like a bad drummer Blood doesn't get through because of quivvering atria, there will be little blood clots and could cause strokes - people take blood thinners with it

Explain afterload and predict how different factors can affect afterload.

AFTERLOAD IS BAD!! Any restriction for blood to get out of the heart Always there but don't want more of it Blood vessels arent always wide open, they change diameter Take aorta and crush it, left ventricle will have a hard time getting blood out through it, that is afterload If you get plaque buildup and the artery narrows, afterload goes up, SV goes down Calcified aortic valve, can't open properly, afterload up, SV down Hypertention (high Blood pressure) - arterioles are clamped down, afterload up, SV down

What are the major hormones (and their associated functions) of the adrenal medulla? Easy cheesy! Please, please, please, make sure you know what catecholamines are!

Adrenal Medulla Contains two types of secretory cells 1. One produces epinephrine (adrenaline) -- 75 to 80% of medullary secretions 2. The other produces norepinephrine (noradrenaline) -- 20 to 25% of medullary secretions - After it is released it can hit 5 receptors -- Alpha 1 and 2 -- Beta 1, 2, and 3

Compare and contrast albumins, globulins, and fibrinogen.

All are in plasma Albumin: most abundant Globulins: transport, clotting, immunity Fibrinogen: framework of blood clot Albumins help transport substances: Fatty acids Thyroid hormones Steroid hormones *Hormones that are not attached to a carrier protein are called what? Globulins Antibodies, also called immunoglobulins (more on this in a few weeks) Transport globulins (small molecules): Hormone-binding proteins Metalloproteins Carry metal ions Apolipoproteins (lipoproteins) I.E. Triglycerides Steroid-binding proteins I.E. Testosterone

What does the P-R interval allow to happen during the contraction of the heart?

Allows AV node to slow it down so the ventricles have time to fill up and get ready to contract

What are the three ways in which hormones are classified? Yes, you will have to which type of chemical structure each hormone that we study falls under. For example, you will need to know that catecholamines are amino acid derivatives.

Amino acid derivatives -Where have we seen amino acids before? Peptide hormones Lipid derivatives Steroids Corticosteroids/ anabolic steroids All of these either circulate freely in the blood or are bound to transport proteins

Describe Cardiac Output (CO) and predict what factors can increase or decrease CO.

Amount Of Blood Ejected By The Ventricle In 1 MINUTE Cardiac Output = Heart Rate X Stroke Volume About 4 To 6L/Min At Rest Vigorous Exercise CO To 21 L/Min For Fit Person And Up To 35 L/Min For World Class Athlete

Explain preload and predict how different factors can affect preload.

Amount of tension in ventricular myocardium before it contracts Incr. Preload causes incr. force of contraction Exercise incr. venous return, stretches myocardium (incr. preload) , myocytes generate more tension during contraction, incr. CO matches incr. venous return Preload says what goes in must come out, the more blood that fills ventricle during diastole, the more blood the heart has to pump out when it hits systole/conraction Stretch out the wall of the vetricles and it is at the optimal length (actin and myosin) so there is more tension and strength for contraction Amt of blood returning to heart increases, vantricles get more blood, stretch out more, stronger contraction

What is an ECG (EKG)? Explain why there are upward and downward deflections on an EKG, making sure to differentiate these deflections from the depolarization and repolarization events that you would find on an action potential graph!

An EKG ONLY tells you if there is some type of electrical activity in the heart! The ups and down do not represent depolarization and repolarization, just electrical activity

Compare and contrast angina and an infarction. How would the symptoms differ?

Angina pectoris - partial obstruction of coronary blood flow can cause chest pain; pain caused by ischemia (restricted blood flow), often activity dependent Myocardial infarction - complete obstruction causes death of cardiac cells in affected area; pain or pressure in chest that often radiates down left arm

Adenohypophysis = _?_

Anterior pituitary

TSH is made in the _?_

Anterior pituitary

ADH is also known as _?_

Antidiuretic hormone

Antigens vs antibodies

Antigens - unique molecules on cell surface - used to distinguish self from foreign - foreign antigens generate immune response Antibodies - secreted by plasma cells - as part of immune response to foreign matter

What exactly are antigens, antibodies, and what is agglutination?

Antigens: unique molecules on cell surface used to distinguish self from foreign foreign antigens generate immune response Antibodies: secreted by plasma cells as part of immune response to foreign matter Agglutination: antibody molecule binding to antigens, causes clumping

What is TPR? List AND describe, in detail, the three factors which affect TPR. Yes, you should be addressing vascular resistance, viscosity, and turbulence.

Any time blood passes something, it loses pressure - called TPR - total peripheral resistance THIS IS A TEST QUESTION Resistance is anything that cuases flow to slow When it passes valves and blood vessel walls and constriction, BV hitting other things, when blood starts to swirl --1. Vascular resistance - how much resistance blood encounters as it flows through the wall The longer the vessel the greater the resistance The wider, the less resistance to flow it is (least in the center - like freeway) Smooth muscle alpha 1 receptors causes contraction, if you block it, it relaxes --2. Viscosity - Thickness of blood Blood is thicker than water If they get dehydrated the viscosity could go up Polycythemia - many RBC - increases viscosity and slows the flow through BVs Hypoproteinemia - lower viscosity - less solute of blood --3. Turbulence: Same as when plane hits turbulence Slows down the flow Anytime there is plaque deposit, it starts to swirl around and can't get through as quickly

What are the arteries, in relation to the cardiovascular system, which carry deoxygenated blood? How many are there?

Arteries - Pulmonary arteries - carry deoxygenated blood to the lungs (1 trunk, 2 arteries) Aortic artery - carries oxygenated blood to the whole body (1)

Arteries vs. veins - anatomical and physiological differences

Arteries - strong and thick Veins - smushed, valves

What are the functions of an artery, arteriole, vein, venule, and capillary?

Arteries : blood flows Away from heart Arteriole: small artery Veins: blood Visits the heart Venule: small vein Capillary: tiny vessels that connect veins and arteries

Where is most vasodilation and vasoconstriction taking place in terms of blood vessel size?

Arterioles Relative to their size, they have a lot of smooth muscles THEY CONTROL THE BLOOD PRESSURE by adjusting their diameter!!!!!

What chambers of the heart function to receive blood from the veins?

Atria

ANP and BNP

Atrial natriuretic peptide (ANP) Produced by cells in right atrium Brain natriuretic peptide (BNP) Produced by ventricular muscle cells The wall of the atrium releases ANP and the ventricle releses BNP - these two go to the kidneys - tell them to get rid of the sodium (and therefore water) - should decrease his blood pressure

Compare and contrast the apex and the base of the heart.

Base - broad superior portion of heart Apex - inferior end, tilts to the left, tapers to point

Megakaryocytes

Become platelets

List AND describe the characteristics of red blood cells (RBC's).

Biconcave disc shaped Smaller than white blood cells, larger than platelets No nucleus or other organelles when mature NO mitochondria - WHY? How do RBC's get energy then? Produced in the red marrow of long bones Destroyed in the liver and spleen Contain the iron protein compound HEMOGLOBIN whose chief function is to combine with oxygen and carry it to the cells

Compare and contrast blood flow and perfusion.

Blood flow: RATE of blood flowing through a tissue in a given time (ml/min) Perfusion: RATE of blood flow PER GIVEN MASS OF TISSUE (ml/min/g)

Describe the pathophysiology of varicose veins.

Blood pools and back flows because of broken valves

Factors affecting blood flow through a vessel

Blood pressure (BP) Arterial pressure (mm Hg) Capillary hydrostatic pressure (CHP) Pressure within the capillary beds Venous pressure Pressure in the venous system Any time blood passes something, it loses pressure - called TPR - total peripheral resistance THIS IS A TEST QUESTION Resistance is anything that cuases flow to slow When it passes valves and blood vessel walls and constriction, BV hitting other things, when blood starts to swirl

What are the other names for parafollicular cells of the thyroid gland?

C cells

Explain why breathing high levels of carbon monoxide (CO) can lead to death.

Carbon monoxide really really loves hemoglobin Has 40x the affinity of oxygen for hemoglobin -- breathing it may lead to death

Manipulation of the cardiac output equation

Cardiac Output = Heart Rate X Stroke Volume SV = EDV-ESV

Where is the cardiac center for the heart?

Cardiac center of medulla oblongata an autonomic control center with two neuronal pools: Cardioacceleratory center (sympathetic) Cardioinhibitory center (parasympathetic)

What type of tissue comprises the bulk of the myocardium?

Cardiac muscle

Compare the cardiocceleratory and cardioinhibitory centers' effects in terms of: a. Autonomic nerve fibers involved. b. Neurotransmitters involved. c. Effects on the pacemaker cardiac action potential. d. Effects of extreme sympathetic stimulation or damage to the vegas nerve. e. Effect of atropine on the muscarinic Ach receptors of the heart's pacemaker tissue

Cardioacceletory: Cluster of neurons in cardioacceletory center - when fires - motor out of grey matter, sympathetic chain, goes to SA and AV nodes (norepinephrine) Brain has small control over the heart and HR Epinephrine hits Beta 1 acceptor on heart causing it to speed up (on SA and AV node) Reduced repolarization - each beat, you are closer to threshold - don't need as much funny current to hit threshold Slope (m) of area under dotted line is more steep WHEN EPINEPH IS AROUND - allows SA node to depolarize more quickly Cardioinhibitory: Slows things down Vagus wanders everywhere - even to AV node and SA node Parasymp - releases Ach on receptors to slow things down Intrinsic rate - property of SA node without stimulation - goes about 100x a minute, due to parasymp firing, it keeps it close to 70 or 80 at resting, more relaxed = parasymp outflow and even lower If you get excited, sympathetic goes up and causes HR to go up and be stimulated more M2 is a muscarinc receptor Parasympathetic outflow to heart Second messenger system Ionotropy - strength of contraction Chronotropy - HR If someone is in cardiac arrest - you want to stimulate sympathetic or block parasympathetic Atropine blocks parasympathetic, part of resusitation - with paddles Membrane potential goes further from threshold - hyperpolarizes Na+ Slows down funny current

List several ways that a ventricular heart cell and pacemaker heart cell differ in terms of action potential generation.

Cardiocyte: no threshold, fast depolarization, long phase of contraction, fast repolarization Pacemaker cell: threshold of -50 or -40mV, Ca2+ opens (instead of Na+), slow repolarization, hyper-polarization then back to threshold, has funny current

What is the significance of a prolonged Q-T interval?

Caused by delayed repolarization of the heart following a heartbeat, increases the risk of episodes of torsades de pointes (a form of irregular heartbeat that originates from the ventricles) may lead to palpitations, fainting, and sudden death due to ventricular fibrillation An abnormal repolarization of the heart, in which different cardiocytes repolarize at different rates Leads to early after-depolarizations of certain ventricular cardiocytes which may be propagated to neighboring cells, leading to re-entrant ventricular arrhythmias Early after-depolarizations (EADs) seen in LQTS are believed to be due to reopening of calcium channels during the plateau phase of the cardiac action potential. Since adrenergic stimulation can increase the activity of these channels, this is an explanation for why the risk of sudden death in individuals with LQTS is increased during increased adrenergic states (i.e., exercise, excitement)

What are platelets and what is their major function?

Cell fragments that play major role in clotting system Release chemicals important to clotting process Formation of temporary patch in walls of damaged blood vessels Active contraction after clot has formed

Baroreceptros

Changes in BP detected by stretch receptors (baroreceptors), in large arteries above heart Aortic arch Carotid sinus (base of each internal carotid artery)

Where are the chemoreceptors? Predict how the chemoreceptors will respond to hypoxia, hypercapnia, and acidosis in terms of respiratory rate and vasomotion.

Chemoreceptors in aortic bodies and carotid bodies Located in aortic arch Subclavian arteries External carotid arteries Hypoxemia (low O2), hypercapnia (high CO2) and acidosis (low blood pH) stimulate chemoreceptors, instruct vasomotor center to cause vasoconstriction, incr. BP, incr. lung perfusion and gas exchange

What is the scientific term for the "heart strings" that extend from the AV cusps to the papillary muscles? What is their function?

Chordae Tendineae - they hold the valves to make them like parachutes to prevent backflow

Factors affecting chronotrophy of the heart

Chronotropy = increase or decrease in HR Positive chronotropic agents incr. HR Negative chronotropic agents decr. HR Positive agents - caffeine, epinephrine, TH, cold medicine (psudoephedrine) Negative - heroine, vicaden, depressents, zanex, alcohol

What is chronotropy?

Chronotropy = increase or decrease in HR Positive chronotropic agents increase HR Negative chronotropic agents decrease HR Causes: Positive agents - caffeine, epinephrine, TH, cold medicine (psudoephedrine) Negative - heroine, vicaden, depressents, zanex, alcohol

Be familiar with the general values found in a CBC, especially, hematocrit, hemoglobin, and WBC count.

Complete blood count A LOT MORE RBC (millions) than WBC (thousands) Platelets (hundred thousands) Hematocrit - around 35-55% Hemoglobin - around 12-18

Ventricular myocyte potential role of calcium

Contraction - causes the plateau in the graph

Explain contractility and predict the effects of positive and negative inotropic agents on contractility. What does inotropic mean anyways?

Contraction force for a given preload (The force of the heart beat - how much power it beats with) Inotropy is the same thing - force Preload may not change when epinephrine is released, but it beats with more force - EDV stays same, but SV increases If you have positive agent, you jump up onto blue line above

Where would you find the sulci of the heart?

Coronary sulcus - divides atria and ventricles Anterior and posterior interventricular sulci: separate left and right ventricles contain blood vessels of cardiac muscle

Why does an individual who is hypothyroid develop a goiter? NO, YOU DO NOT HAVE TO MEMORIZE THE PATHWAY INVOLVED IN THE PRODUCTION OF THYROID HORMONE! I just want you to understand how it is possible to someone to be hypothyroid and still have an enlarged thyroid gland. ☺

Could have if hyper or hypo - if it is too busy it builds up if it doesn't make functional hormone the bad stuff builds up Goiter is just swelling - you can't tell what type from looking at them

Compare and contrast blood pressure, pulse pressure, and mean arterial blood pressure (MAP).

Diameter - capillaries lowest Cross sectional area - capillaries highest Blood pressure - Vena cava lowest Velocity - capillaries lowest

Pulse pressures

Difference between systolic pressure and diastolic pressure

Up vs. down regulation

Down Regulation: When the cell is overstimulated by the hormone or something that looks like it, there is a decrease in number of receptors on the cells Up Regulation: If there is not enough of the hormone, the cells make more receptors to try and grab whatever the body has in it

Compare the distribution of blood in the human body at rest and during exercise.

During exercise incr. perfusion of lungs, myocardium and skeletal muscles, decr. perfusion of kidneys and digestive tract

Describe in detail the cells of the Islets of Langerhans. Is this the endocrine or exocrine pancreatic tissue?

ENDOCRINE - Cells in the pancreas, clump of different colored cells

What is an ectopic focus of pacemaker tissue? How can this be problematic?

Ectopic foci - region of spontaneous firing (not SA) Latent pacemaker cells can control HR, it means the SA node isn't functioning correctly? It can be less accurate or productive

Thyroid gland functions

Elevates O2 rates, increases heart rate, force of contraction, increase blood pressure (usually), lowers blood Ca levels by storing in bone

What is the inner lining of the heart called?

Endocardium

Compare and contrast the endocrine system and the nervous system. Make sure you understand the differences between a neurotransmitter and a hormone, addressing the importance of receptor specificity.

Endocrine - Uses hormones released by endocrine glands Effects many effector organs (i.e. HGH to all muscles) Is slower and longer lasting Nervous - Uses electricity and chemicals to send a fast message Has a specific effector organ (i.e. certain muscle) Uses neurotransmitters released by neurons

List AND describe the three ways that endocrine reflexes can be triggered. Provide examples!

Endocrine reflexes can be triggered by - Humoral stimuli -- Changes in composition of extracellular fluid - Hormonal stimuli -- Arrival or removal of specific hormone - Neural stimuli -- Arrival of neurotransmitters at neuroglandular junctions

Compare and contrast endocrine and exocrine glands.

Exocrine - used in digestion Endocrine - secretes insulin and glucagon

Show mathematically the relationship between flow, pressure, and resistance.

F = changeP/R F = flow changeP = difference in pressure between what the heart can generate and the peripheral capillary beds R = resistance to flow

Diagram the process of fibrinolysis.

Fibrinolysis = breaking a clot apart Tissue Plasminogen Activator (tPA): Activate Plasminogen Plasminogen Produces Plasmin: Digests Fibrin Strands Anticoagulants = clot busters Antithrombin III (From Liver) Deactivates Thrombin Before It Can Act On Fibrinogen Heparin (From Basophils And Mast Cells) Activates Antithrombin III Warfarin (Coumadin) tPA activates plasmin to degrade clot

Diagram how the Frank Starling Curve demonstrates how EDV stroke volume are related.

Frank - Starling Law of Heart SV = EDV (End Diastolic Volume) Ventricles eject as much blood as they receive More they are stretched (incr. preload) the harder they contract The more blood you put in, the more blood you get out with every beat - SV Optimal overlap, if you put too much, it is stretched too far and can't contract as well. If you keep doing this, the actin and myosin will stay overstretched, the heart gets bigger and gets floppy - could lead to heart faliure Putting the Actin and Myosin in the Goldy Locks zone Occuring during ventricular diastole You can over fill - it will stretch

Diagram the renin, angiotensin, aldosterone system, making sure to include the intermediate organs and messengers involved. Yes, this may seem confusing at first, but take the time to learn it really well now, because you will see it again during the renal (kidney) unit.

Function of this slide and previous is to raise blood pressure (DON'T FORGET END GOAL) Hemorrhage is bad - 1. HUGE loss of blood - 2. volume goes down, 3. pressure goes down Liver releases angiotensinogen that does nothing unless it is activated - when there is 4. decreased flow to the kidneys 5. They secrete renin - that takes 6. angiotensinogen to 7. angiotensin I - it has to go through the 8. lungs ACE converts to 9. angiotensin II (the good stuff!) Causes arterioles to clamp down - increasing blood pressure - very powerful vasoconstrictor DIRECT AFFECT ON BVS Goes to 10. adrenal cortex and increases 11. aldosterone by Glomerulosa, 12. Na+ incr, water follows and increases blood volume INCREASE BLOOD VOLUME Goes to posterior pituitary and raises ADH - saves water which increases blood pressure Vasoconstriction, aldosterone, ADH Affects, direct and indirect To increase blood pressure RAA SYSTEM - renin-angiotensin-aldosterone pathway

What is another name for Growth Hormone? Where is it produced?

GH, or Somatotropin, released by ant. pit. in response to GHRH - somatocrin releases GH - somatotropin, if hits liver, some converted to somatomedins Somatomedins cause most of the growth, take amino acids from diets and increase lean muscle mass, signal bone tissue to become bigger, if they are still growing, the epephysial plates are open and will allow growth, intersticial (longer) growth and appositional (wider) growth Use some of the fat to create energy to increase lean muscle mass Tells liver to break down glycogen into glucose - cause blood glucose to go up - has a diabetogenic effect (not diabetes) Look at role of somatomedins (target hormones) - there is releasing AND inhibiting - be able to tell what will happen with each Raise blood sugar: glucagon, GH, and cortisol (glucocorticoid?)

List AND describe the key differences between a skeletal muscle AP and a heart muscle cell AP.

Gap junctions in cardiac muscle allow current to flow to near by cells, cells are self-excitable, have a long time of absolute refractory period for the heart to contract

Is there just one cause of hemophilia, or multiple causes? Explain!

Genetics It can affect different clotting by either not being fully functional or being completely gone

Discuss the way in which hormones promote body homeostasis.

Get stimulated when homeostasis is thrown off

Hormones made by the adrenal cortex (which layer, what hormone, and its associated function) as well as the adrenal medulla

Glomerulosa: aldosterone - When it is released in blood stream and goes to kidney, tells kidney to conserve sodium (sodium SAVER) and to remove potassium from the blood (potassium KICKER OUTER) Fasciulata: Cortisol - tells body to begin to put you in a state where you have energy when you wake up - signals liver to release sugar into blood, if there isn't enough it tells body to make more sugar and then release it, the body can make sugar by taking pieces of muscles and adipose tissue to help you get energy you need with amino acids It is a catabolic hormone that tells body to break down body material and build sugar Reticularus: Androgens - sex hormones secreted when stimulated by ACTH

Cortisol negative feedback system

Gluconeogenesis, adipose broken down, FFAs, diabetic-state (not diabetes), anti-inflammatory, protein in skeletal muscle

What exactly is stroke volume?

Governed by three factors: Preload Contractility Afterload Example: High Preload or contractility causes high SV High Afterload causes low SV

Compare and contrast the functions of granulocytes and agranulocytes.

Granulocytes: Neutrophils (inrc. in bacterial infections) phagocytosis of bacteria Eosinophils (incr. in parasitic infections or allergies) phagocytosis of antigen-antibody complexes, allergens and inflammatory chemicals release enzymes to destroy parasites Basophils (incr. in chicken pox, sinusitis, diabetes) secrete histamine (vasodilator) secrete heparin (anticoagulant) Agranulocytes: Lymphocytes (T-cells, B-cells, NK cells) Decr. in diverse infections and immune responses destroy cells (cancer, foreign, and virally infected cells) "present" antigens to activate other immune cells coordinate actions of other immune cells secrete antibodies and provide immune memory Monocytes (Decr. in viral infections and inflammation) differentiate into macrophages phagocytize pathogens and debris "present" antigens to activate other immune cells

What is a cause of hyperthyroidism discussed in class? What are some of the symptoms? Why do these symptoms result?

Graves Disease: ONE CAUSE (not the only cause) of too much thyroxin produced and secreted Autoimmune disease (Antibodies stimulate the thyroid gland to make T3/T4) Leads to nervousness, and an increase in the following: body temp., heart rate, metabolic rate, blood pressure, weight loss

What is acromegalic giantism?

Growth Hormone over-secretion continues after epiphyseal plates have closed Occurs in adults Bones of hands face and feet are enlarged Due to the release of growth hormone Growth plates are closed so only parts of body grow

CO (Carbon Monoxide)

Has 40x the affinity of oxygen for hemoglobin (Carbon monoxide really really loves hemoglobin)

Describe the anatomical location of the adrenal glands.

Hat on the kidneys

List AND define some common Latin prefixes and suffixes associated with the circulatory system.

Hemo/a-: blood Anti-: against Erythros-: red Leukos-: white -cyte: cell -penia: poverty, not enough -osis: too many Thrombos-: clot -stasis: halt, stop

Describe the process of hemopoiesis, making sure to include the organs and regions of the body associated with this process.

Hemopoietic tissues produce blood cells: 1. yolk sac produces stem cells - colonize fetal bone marrow, liver, spleen and thymus 2. liver stops producing blood cells at birth 3. spleen remains involved with WBC production 4. lymphoid hemopoiesis occurs in widely distributed lymphoid tissues (thymus, tonsils, lymph nodes, spleen and peyers patches in intestines) 5. red bone marrow pluripotent stem cells 6. myeloid hemopoiesis produces RBCs, WBCs and platelets 7. At birth and until about the age of seven, nearly all marrow is red, as the need for new blood formation is high 8. in adults, red marrow is found only in the vertebrae, hips, breastbone, ribs, and skull and at the ends of the long bones of the arms and legs

Explain the importance of a RBC's biconcave disc shape.

High surface-to-volume ratio: quickly absorbs and releases oxygen Discs form stacks: -Rouleau smooths flow through narrow blood vessels Discs bend and flex entering small capillaries: 7.8 µm RBC passes through 4 µm capillary *folded pizza to get into mouth - MMMMM PIZZA!

Role of chord tendineae in the AV valve function

Hold the AV valves so they don't back flow

Define hormone and target organ.

Hormone - Stimulate synthesis of enzymes or structural proteins Increase or decrease rate of synthesis Turn existing enzyme or membrane channel "on" or "off" Target organ - Are specific cells that possess receptors needed to bind and "read" hormonal messages

Diagram the mechanism of action of a lipid insoluble hormone. Make sure to show the second messenger systems and the role of G-proteins.

Hormones that are NOT lipid soluble Catecholamins Prolactin Adrenocorticotropic Hormone (ACTH) Growth Hormone Antidiuretic Hormone (ADH) Oxytocin. Peptide Hormones Atrial-natriuretic Peptide (ANP) Atrial Natriuretic Factor (ANF) Insulin Leptin Unable to penetrate plasma membrane What is the plasma membrane made of? Bind to receptor proteins at outer surface of plasma membrane (extracellular receptors) - Hormones and Plasma Membrane Receptors Bind to receptors in plasma membrane Cannot have direct effect on activities inside target cell Use intracellular intermediary to exert effects First messenger: leads to second messenger may act as enzyme activator, inhibitor, or cofactor results in change in rates of metabolic reactions - Important Second Messengers Cyclic-AMP (cAMP) Derivative of ATP Cyclic-GMP (cGMP) Derivative of GTP Calcium ions

Detailed effects of hypertension on the heart

Hypertention (high Blood pressure) - arterioles are clamped down, afterload up, SV down

TRH is made in the _?_

Hypothalamus

What would be the result of an iodine deficiency in individual's diet?

Hypothyroidism - Key step: iodination, add iodine to the hormone being made - thyroid hormone, if there isn't enough iodine the unfinished hormone builds up in the gland and you don't have enough functional thyroid hormone but the gland is filling with the unfinished hormone

Describe the relationship between the total cross sectional area of vessels and velocity of blood flow. Why is this important for gas exchange at the capillary level?

If he is going slow, he can drop of his Os and grab some CO(2)s Don't forget cellular respiration ATP is made using O2 Pressure in capillaries is the slowest (NOT THE LOWEST)

Compare and contrast the causes and symptoms of left vs. right sided heart failure.

If left starts to fail, blood coming from lungs, blood backs up Backs up into capillaries in lungs, makes fluid get pushed out into airsacs of lungs, has a raspy sound in their lungs when they breath If right side fails - backs up in hole body

Diagram what will happen during a transfusion reaction.

If you put the wrong blood into someone it creates clumps and can clog vessels and create multisystem organ failure and kill them

What would happen if someone took Human GH from an exogenous (outside) source? Use a negative feedback diagram to support your answer!

If you take anything from outside soure - body ability to make it goes down If athletes take it, they can't make it on own anymore If happens when young, can cause gigantism

Where will you find the bicuspid and tricuspid valves in the heart? These valves are sometimes referred to as AV valves? What does AV stand for?

In between the atria and ventricles Called AV valves (atrialventricular) Bicuspid = Left AV valve Tricuspid = Right AV valve

Where will you find the pulmonary and aortic semilunar valves in the heart?

In the atria going to the aorta and the pulmonary trunk

What is the specific space in the thoracic cavity where the heart is located?

In the mediastinum In pericardial cavity

Factors affecting stroke volume

Incr. Preload or contractility causes incr. SV Incr. Afterload causes decr. SV

What is an infarction? Where are two deadly regions that an infarction can occur?

Infarction (blockage) may occur if clot blocks blood supply to an organ (MI or stroke) Heart and lungs

Exactly where insulin and glucagon are made and their corresponding effects

Insulin: made in Beta cells of Islet of Langerhans - reduces blood glucose levels by stimulating glucose uptake by liver and skeletal muscle cells Glucagon: made in the Alpha cells of the acini space - increases blood glucose levels

Diagram the three ways in which the hypothalamus can interact with the endocrine or nervous system.

Integrates activities of nervous and endocrine systems in 3 ways: 1. Acts as an endocrine organ 2. Secretes regulatory hormones: special hormones that control endocrine cells in pituitary gland 3. Contains autonomic centers: exert direct neural control over endocrine cells of adrenal medullae

Where would you find the interatrial setpum and interventricular septum of the heart?

Interatrial septum - wall between atria Interventricular septum - thicker wall between ventricles

Oxyhemoglobin vs. deoxyhemoglobin

Iron (Fe) ion that interacts with O2 molecule = oxyhemoglobin Bright red Fe not bound to O2 = deoxyhemoglobin Dark red/burgundy

Explain the pathophysiology of Diabetes Insipidus.

Is a chronic disorder of the pituitary gland or hypothalamus that is the result of a deficiency of vasopressin (also called the antidiuretic hormone or ADH). Inadequate ADH secretion reduces the kidney's ability to conserve water. More frequently found in males. Trauma or tumors may also cause the condition NOTHING TO DO WITH BLOOD SUGAR LIKE OTHERS

Hypothesize some other causes of hyperthyroidism. Think about what else could cause thyroxine levels to be chronically elevated! Hint: Don't just fixate on the thyroid gland! ☺

Issues with the hypothalamus - less likely Tumor or damage to adenohypophysis (ant. pituitary)

Can preload be increased indefinitely? Why or why not?

It can be strengthened, but it can also get overstretched if too much blood is going in, but efficiency goes down with stretching

The bulk of the heart rests on this side of the body.

Left

Effects of left sided and right sided heart failure

Left Heart Failure: Inability of left side to pump into systemic circulation  Right Heart Failure: Blood backs up in hole body Increased pressure in all capillaries of the body - feet, legs, arms, neck - look swollen and puffy

Describe some conditions associated with leukocytes that were discussed in class.

Leukopoiesis - life cytle of WBC, erythropoiesis is at the top (RBC) All RBC, WBC and platelets come from hemocytoblasts (blast - in bone marrow has power to differentiate into any cell) Megakaryoblast - become platelets Myeloblast - become BENs - granulocytes Lymphoblasts - become lymphocytes - agranulocytes Hemocytoblasts - become all of them Acute myeloblast leukemia - mutated - cancer dividing like crazy, taking up space in bone marrow, begin to spill out into blood stream Leukopenia - low WBC count (<5000/L) causes: radiation, poisons, infectious disease effects: elevated risk of infection Leukocytosis = high WBC count (>10,000/L) causes: infection, allergy and disease Leukemia = cancer of hemopoietic tissue myeloid and lymphoid - uncontrolled WBC production acute and chronic - death in months or 3 years effects - normal cell % disrupted; impaired clotting

Describe the anatomical location of the pancreas.

Lies between Inferior border of stomach and proximal portion of small intestine

What are the major effects and target tissues of Growth Hormone?

Liver converts somatotropin to somatomedins (compounds which initiate tissue growth) IN MOST TISSUES, general metabolic hormone which has a glucose sparing effect: Major effects are directed to growth of skeletal muscles and long bones Causes amino acids to be built into proteins Causes fats to be broken down for a source of energy IN THE LIVER - diabetogenic effect: Stimulates breakdown of glycogen reserves in liver What will this do to blood glucose levels? Tells liver to break down glycogen into glucose - cause blood glucose to go up - has a diabetogenic effect (not diabetes) Raise blood sugar: glucagon, GH, and cortisol (glucocorticoid?)

Diagram AND label the process of erythrocyte homeostasis, making sure to focus on the importance of erythropoietin.

Low Oxygen levels in the blood Sydney the kidney secretes erythro. Goes to red bone marrow Increases RBC formation If low O2 levels, kidneys try to bring up O2 carrying capacity of blood If person doesn't have enough O2, the body tried to build RBC to get more oxygen to tissues (takes a while) People train in high altitude so they make more RBC then when they come back down they can have more O2 held

What is the name of the space in a blood vessel where blood flows?

Lumen

GH effects

Major effects are directed to growth of skeletal muscles and long bones Causes amino acids to be built into proteins Causes fats to be broken down for a source of energy Stimulates breakdown of glycogen reserves in liver

Briefly, list AND describe the endocrine tissues of other systems. Yes, we will cover these in detail as the semester progresses, but you still need to be familiar with them for this unit!

Many organs of other body systems have secondary endocrine functions Intestines (digestive system) Kidneys (urinary system) Heart (cardiovascular system) Thymus (lymphoid system and immunity) Gonads (reproductive system) Breast Tissue (reproductive system)

List AND describe the factors which affect local blood pressure and flow.

Metabolic theory of autoregulation Autoregulation - something happening without signal from endocrine or nervous systems BVs can do this based on what is going on in the surrounding tissue If it is starved for O2 or making a lot of CO2, the BV can get bigger without a signal from endo. Or neuro. Running - BV dilate to get more O2 to muscles to feel better Vasoactive chemicals Substances that stimulate vasomotion; histamine, bradykinin, Nitric Oxide (NO) Reactive hyperemia Blood supply cut off then restored Angiogenesis - new BV growth (months or years) New good blood flow with more BV growing there, more O2 gets delivered Growth around obstruction - if there is a blockage, the BV will be created to make up for the loss of blood flow Bad with cancer

Rh factor and pregnancy

Mom is Rh-, baby is Rh+ (from dad) If during pregnancy or delivery, the baby's blood gets into the mom's body (unusual because cells get super close for O2 diffusion, but don't touch) mom will make antibodies against the Rh factor

Use Hemolytic Disease Of A Newborn to describe the importance of the Rh factor, making sure to explain how RhoGAM works.

Mom is Rh-, baby is Rh+ (from dad) If during pregnancy or delivery, the baby's blood gets into the mom's body (unusual because cells get super close for O2 diffusion, but don't touch) mom will make antibodies against the Rh factor To test, you don't really want to take sample of baby's blood or amniotic fluid If you can't test the father, assume the baby is positive (always assume if the mom is Rh-) During week 28 you give her RhoGAM (an antibody against an antibody - antibody against potential antibodies that mom is making against Rh factor)

Predict the causes and timing of the cardiac murmurs discussed in class.

Murmur is abnormal blood flow across valve - it is a sound; not a disease Blood going through narrow path, going backwards, stenosis = narrow

What is the muscular (middle) layer of the heart is called?

Myocardium

What does myogenic mean? How about autorhythmic?

Myogenic - heartbeat originates within heart Autorhythmic - regular, spontaneous depolarization

What does natriuresis mean?

Natriuretic - lose Na+ (and water) in the urine

What exactly are neurosecretory cells? Where exactly are they found?

Neurosecretary neurons make releasing hormones which get down through the hypophyseal portal system

Describe the anatomical location of the parathyroid glands.

On the back of the thyroid gland

Summarize the GAS (General Adaptation Syndrome). Use a personal example if it helps you!

Our body's reaction to stress Originally described by Hans Selye 3 stages Stage 1: Alarm reaction (AR) Stage 2: Stage of resistance (SR) Stage 3: Stage of exhaustion (SE) Ex: Stage 1: Alarm: Working out (stress) "Feel the burn", Adding stress to the body to make a muscular change Stage 2: Adaptation: Muscles start to build to deal with the stress (Survival of the fittest) Stage 3: Exhaustion: "Overtraining" Muscles break down, injury

Explain the concept of overdrive suppression, including the intrinsic pacemaker rates of the different regions of the heart.

Overdrive suppression - SA node drives the heart Controls heart rate over all the other tissues even though they are capable in case SA node is damaged Other tissues = latent pacemakers

List the two hormones of the posterior pituitary gland and their target tissues.

Oxytocin - target organ uterus ADH - target organ kidneys

PTH and calcitonin's role in calcium homeostasis

PTH: raises blood calcium levels by stimulating osteoclasts and inhibits osteoblasts Calcitonin: reduces blood calcium levels by reducing osteoclast activity

What is a PVC? Can this be a normal occurrence?

PVC - premature ventricular contractions Get an early beat in ventricle that originates in the ventricle Feels like a big thud - if get 3 or more togetehr, it can be really bad It can be normal if it only happens once really rarely - can be caused by epi or norepi release

Funny current of pacemaker

Pacemaker potential - super low and slow depolarization generated by a slow sodium entry - these sodium channels love negativity - their mouths are always open (sodium going into the cell) but runs into a positive and closes its mouth - the more positive the membrane becomes, the more the sodium channel shuts The closer you get to threshold, the more the sodium channel tends to close, sodium is going in and making the membrane more positive - not depolarization, called graded, slow depolarization or pacemaker potential

Adrenergic vs. muscarinic receptor in cardiac pacemaker tissue

Parasympathetic hits Muscarinic ACh Muscarinic - slows heart down Since adrenergic stimulation can increase the activity of these channels, this is an explanation for why the risk of sudden death in individuals with LQTS is increased during increased adrenergic states (i.e., exercise, excitement)

PTH = _?_

Parathyroid hormone

Explain the relationship between the parietal pericardium and the epicardium.

Parietal pericardium - outside layer of sac surrounding heart Epicardium (Visceral Pericardium) - inside layer of sac that covers the outer surface of the heart

Trace the pathway of blood flow through the heart (don't forget to include circulation to and from the lungs).

Picture

List the major components of blood (both plasma AND cellular elements).

Plasma: 55% of blood volume Water Blood Proteins Nutrients Cellular Elements: 45% of blood volume Buffy coat - WBC RBCs

Formed elements of blood

Platelets White blood cells - leukocytes (WBCs) Red blood cells - erythrocytes (RBCs)

What are the three "formed elements of blood?"

Platelets White blood cells - leukocytes (WBCs) Red blood cells - erythrocytes (RBCs)

Neurohypophysis = _?_

Posterior pituitary

What occurs to the mother and developing fetus during gestational diabetes?

Pregnant women who have never had diabetes before but who have high blood sugar (glucose) levels during pregnancy are said to have gestational diabetes. Gestational diabetes affects about 4% of all pregnant women - about 135,000 cases of gestational diabetes in the United States each year. The placenta supports the baby as it grows. Hormones from the placenta help the baby develop. But these hormones also block the action of the mother's insulin in her body. This problem is called insulin resistance. Insulin resistance makes it hard for the mother's body to use insulin. She may need up to three times as much insulin.

ADH and oxytocin are produced in the _?_ and stored in the _?_

Produced in the hypothalamus and stored in the neurohypophysis

Describe the functions of blood.

Provides to cells/tissues: Nutrients Oxygen (O2) Hormones/enzymes Removal of wastes Special cells to protect against disease & infection (WBCs & antibodies) Regulates: pH & ion composition of cellular fluids Clotting capabilities to restrict blood loss Body temperature

Compare and contrast systemic and pulmonary circulation.

Pulmonary Circuit - blood vessels that carry blood to and from alveoli of lungs for gas exchange (Right Side of the heart) Systemic Circuit - transports blood to and from rest of body (Left side of the heart) FIGURE 8 SHAPE

Pulmonary arteries vs. pulmonary veins vs. coronary arteries

Pulmonary arteries - Deoxygenated blood away from the heart to the lungs Pulmonary veins - Oxygenated blood back to heart to be pumped all over Coronary arteries - arteries that bring blood to the heart muscle so it can function

RBC recycling, including the fate of the heme group

RBC die - they live about 4 months of 120 days 3 mil die per second - their components are reused All the pieces of Hb get reused RBC are eaten by WBC called macrophages (3 things at top are recycled)

What does prolapse and regurgitation refer to in terms of the heart?

Regurgitation: Failure of valves - Prolapse = valve opens backwards Causes backflow of blood into atria i.e. Systolic Heart Murmur

Predict the effects of the following chronotropic chemicals: a. Catecholamines b. Caffeine c. Nicotine d. Thyroid hormone

Remember Chronotropy = Affects Heart Rate a. Catecholamines (NE And Epinephrine) (Neurotransmitters - Camp 2nd Messenger) Potent Cardiac Stimulants b. Caffeine Inhibits Camp Breakdown c. Nicotine Stimulates Catecholamine Secretion d. Hormones TH increases Adrenergic Receptors In Heart by changing how DNA in pacemaker cells is read, makes more B 1 adrenergic receptors, increases Sensitivity To Sympathetic Stimulation, increases HR

RAA

Renin-Angiotensin-Aldosterone Pathway Hemorrhage is bad - 1. HUGE loss of blood - 2. volume goes down, 3. pressure goes down Liver releases angiotensinogen that does nothing unless it is activated - when there is 4. decreased flow to the kidneys 5. They secrete renin - that takes 6. angiotensinogen to 7. angiotensin I - it has to go through the 8. lungs ACE converts to 9. angiotensin II (the good stuff!) Causes arterioles to clamp down - increasing blood pressure - very powerful vasoconstrictor DIRECT AFFECT ON BVS Goes to 10. adrenal cortex and increases 11. aldosterone by Glomerulosa, 12. Na+ incr, water follows and increases blood volume INCREASE BLOOD VOLUME Goes to posterior pituitary and raises ADH - saves water which increases blood pressure

List AND describe the major metabolic effects of thyroid hormone. Make sure to include which tissues are being affected!

Responds to high blood Ca2+ levels in blood and secretes calcitonin to store Ca in bone Elevates rates of oxygen consumption and energy consumption; in children - rise in body temp Incr. heart rate and force of contraction; rise in blood pressure Incr. sensitivity to sypathetic stimulation Maintains normal sensitivity of respiratory centers to changes in O2 and CO2 delivery Stimulates RBC formation - enhances O2 delivery Stimulates activity in other endocrine tissues Accelerates turnover of minerals in bone Thyroid gland affects metabolic rate. If it is hyper functioning, the patient will lose weight because of the insane speed of the metabolism. If it is hypo functioning, the patient will gain weight.

Define negative feedback and describe its role in regulating blood levels of the various hormones. Use an example if you like! ☺

Response to changed body condition if body is high or low from normal level signal tells body to make changes that will bring body back to normal level once body is back to normal level, signal is turned off

Valve operation in the cardiac cycle

S1 - AV valve shutting - ventricles are contracting isovolumetric (contraction phase - pressure building but blood isnt moving yet) S2 - SL (aorting and pulmonary) valves shutting S3 - AV valves open - blood flowing across valve S4 - Atria contract (atrial systole/ atrial kick)

Explain the origin and the timing of the S1 and S2 heart sounds.

S1 - First heart sound - louder and longer "lubb", occurs with closure of AV (tricuspid and bicuspid) valves - ventricles are contracting isovolumetric (contraction phase - pressure building but blood isnt moving yet) S2 - Second heart sound - softer and sharper "dupp" occurs with closure of semilunar valves (aortic and pulmonary valves)

Compare and contrast S-T segment elevation and S-T segment depression on an ECG.

ST segment ELEVATION equals INJURY (Myocardial Infarction) and... ST segment DEPRESSION equals ISCHEMIA (reduced blood flow through a coronary artery)

What region of the heart is referred to as the pacemaker?

Sinoatrial node (SA node)

GAS

Stage 1: Alarm reaction (AR) - fight or flight Stage 2: Stage of resistance (SR) - body responds to stress by working to reduce stress Stage 3: Stage of exhaustion (SE) - can be gradual or really fast

Explain how hemoglobin's affinity for oxygen changes as oxygen is unloaded into peripheral tissues.

Start at the top with 4 O2 molecules bound to hemoglobin Primack driving in car with 3 friends all out of car First is easiest to get off 2nd is a little harder 3rd is really tough 4th is forced off - very very difficult to get off This shows it is very difficult to desaturate the hemoglobin completely Only happens if the metabolically active tissues are cranking out energy and need the O2 to function Start at the bottom - hemoglobin is car, has no oxygen ("people in it") 1st is hardest to get in 4th is super easy to get on It is called cooperativity of binding Every time one binds, you get a confimational change in shape It changes shape so it is easier for the O2 to get on the hemoglobin and to resaturate it

What bone protects the heart anteriorly?

Sternum (and ribs)

Where are the baroreceptors? Predict how the baroreceptors will restore homeostasis to blood pressure with increases or decreases in blood pressure.

Stretch receptors in large arteries above heart Aortic arch Carotid sinus (base of each internal carotid artery)

Where are the SVC and IVC? What do they drain into?

Superior side and Inferior side of Right Atrium Come from all over the body, bring in deoxygenated blood to the right atrium

What exactly is a pulse? What are normal pulse ranges for men and women? What is tachycardia? Bradycardia? Can these either of these two conditions be "normal?" Explain!

Surge of pressure in artery Infants have HR of 120 bpm or more Young adult females avg. 72 - 80 bpm Young adult males avg. 64 to 72 bpm HR rises again in the elderly Tachycardia: resting adult HR above 100 Stress, anxiety, drugs, heart disease or raise in body temp. Bradycardia: resting adult hr < 60 In sleep and endurance trained athletes

What hormone does the pineal gland produce? What are its effects?

Synthesize hormone melatonin that helps you sleep

What is systole? How about diastole?

Systole - atrial/ventricular contraction Diastole - atrial/ventricular relaxation

Describe the events that are occurring in the brachial artery when a blood pressure is taken.

Systolic number is the first sound you hear When you stop hearing it it is your diastolic number

Tachycardia vs bradycardia

Tachycardia: resting adult HR above 100 Stress, anxiety, drugs, heart disease or body temp. Bradycardia: resting adult hr < 60 In sleep and endurance trained athletes Fast heart beat has no problem - but if at rest someone's is above 100 bpm its called tachycardia Slow heartbeat - if resting is below 60 bpm it is called brady cardia

Role of ADH

Tells the kidneys to keep water in the body and not to excrete it

Draw AND label the arrangement of blood vessels arising from the aortic arch. Make sure to include the fact that there is no left brachiocephalic trunk! ☺

The Aortic Arch serves the upper body by passing into the: Brachiocephalic Trunk (notice the right common carotid does not come directly off the aortic arch!) Left Common Carotid Artery Left Subclavian Artery Descending Aorta

What the heck is a CABG? Generally explain the procedure.

The Coronary Artery Bypass Graft (CABG) involves bypassing major blocks in the blood vessels of the heart to improve the blood to the cardiac muscle (myocardium). The conduits used for bypass grafting can be veins taken from the legs or arterial conduits which include the mammary arteries from the chest wall, the radial artery from the forearm and an artery from near the stomach

Sketch AND explain the process of amplification in regards to the effects of hormones.

The Process of Amplification Is the binding of a small number of hormone molecules to membrane receptors Leads to thousands of second messengers in cell Magnifies effect of hormone on target cell

What is the largest artery of the human body?

The aorta

What anatomical structures in the neck would be affected by goiter?

The entire neck looks swollen because of the large thyroid. This mass will compress the trachea (windpipe) and esophagus (swallowing tube) leading to symptoms such as coughing, waking up from sleep feeling like you can't breath, and the sensation that food is getting stuck in the upper throat

Explain why blood pressure drops the further you get from the heart. Make sure to talk about the elastic rebound of arteries.

The further you get from the heart, the average blood pressure decreases You can't feel a pulse in a vein - it is systolic/diastolic etc. Arteries have elastic recoil, that is what you feel Veins hardly have any pressure in them

Discuss the role and the importance of the coronary arteries and coronary veins.

The heart is a muscle and needs oxygen like the rest of our tissues, these bring oxygenated blood to the heart

Anatomical and physiological relationship between the hypothalamus and anterior pituitary.

The hypothalamus is just superior to the anterior pituitary Hypothalamus makes the hormones and they are stored and stimulated in the anterior pituitary.

Describe the anatomical location of the thyroid gland.

The neck, on top of the larynx

Describe the importance of the plateau in a heart cell's action potential. What ion is responsible for this plateau?

The plateau is caused by Ca2+ channels remaining open, causing the heart to contract (actin and myosin) - long contraction

What determines if a hormone will elict a response in a certain tissue?

The target tissue and its receptors

What happens if the P-R interval is too long? In other words, where is the wave of depolarization getting bottle necked?

The ventricles may not receive the signal to depolarize, therefore getting rid of QRS and T waves - ventricles don't contract Getting cut off at P wave

What is thrombocytopoiesis? What giant cell is associated with this process? Where do you find this giant cell?

Thrombocytopoiesis (platelet production) occurs in bone marrow megakaryoblasts Find megakaryoblasts in red bone marrow

T3/T4 are made in the _?_

Thyroid

Role of coronary arteries

To supply the heart with blood

From outermost to innermost, what are the three tunics (layers) of an artery.

Tunica adventita Tunica intima Tunica media

What layer of an artery consists mostly of smooth muscle?

Tunica intima

Compare and contrast the roles of releasing hormones and inhibiting hormones in the hypothalamus.

Two Classes of Hypothalamic Regulatory Hormones Releasing hormones (RH) Stimulate synthesis and secretion of one or more hormones at anterior lobe Inhibiting hormones (IH) Prevent synthesis and secretion of hormones from the anterior lobe Rate of secretion is controlled by negative feedback

Type I vs Type II Diabetes

Type I: Autoimmune disease Immune system mistakes beta cells for invaders and attacks them. Beta cells are wiped out (make insulin) Need to take insulin by injection Type II: Pancreas is going nuts - beta cells are going into overdrive Eat tons of sugar, beta cells cranking out insulin, Cells downregulate and get desensitized - don't respond to insulin anymore Beta cell burn out - they are done producing insulin Cells don't respond or insulin produced is not enough

Compare and contrast the effects of acute and chronic stress on the body.

Types of stress Short term - nervous for an event, epinephrine Long term - too much gluco and mineral corticoids

What causes dwarfism?

Under secretion of growth hormone during childhood.

Stages of blood clotting

Vascular Phase - Local blood vessels constrict to stop loss of blood - "vascular spasm" Lasts ~30 mins. Platelet Phase - Platelets activate, aggragate (clump together) & stick to damaged surface to form "platelet plug" Release ADP, thromboxane A2, serotonin, clotting factors, platelet-derived growth factors, Ca2+ ions Begins within ~15 secs. Coagulation Phase - Begins 30 secs. or more after injury Conversion of fibrinogen to insoluble protein fibrin

Diagram AND describe the three phases of hemostasis.

Vascular Phase -Local blood vessels constrict to stop loss of blood - "vascular spasm" Lasts ~30 mins. Platelet Phase -Platelets activate, aggragate (clump together) & stick to damaged surface to form "platelet plug" Release ADP, thromboxane A2, serotonin, clotting factors, platelet-derived growth factors, Ca2+ ions Begins within ~15 secs. Coagulation Phase -Begins 30 secs. or more after injury Conversion of fibrinogen to insoluble protein fibrin Clot retraction: platelets contract & pull torn edges of vessel closer Fibrinolysis: clot dissolves

What are the veins, in relation to the cardiovascular system, which carry oxygenated blood? How many are there?

Veins - visit the heart Superior and inferior vena cava - carry deoxygenated blood to the heart (2) Pulmonary veins - carry oxygenated blood to the heart (4 - 2R 2L)

Explain the major differences between arteries and veins.

Veins have different tunics/layers, not as much elasticity or smooth muscle - not nearly as much pressure or blood pressure regulation - it is a return due to gravity or muscle contraction around vein to get blood back to heart Veins have one way valves to prevent back flow of blood

What are the bottom two chambers of the heart called?

Ventricles

List AND describe the effects of angiotensin II

Very potent PERIPHERAL VASOCONSTRICTOR Increases aldosterone production (adrenal cortex) Increases ADH (vasopressin) production (posterior pituitary) Water retention in the kidneys In high concentrations, also causes vasoconstriction Increases Thirst (hypothalamus) Increases cardiac output

Relate albumin levels in the blood to the concept of osmolarity. MAKE SURE YOU UNDERSTAND WHAT OSMOLARITY IS - NOT JUST A DEFINITION, BUT HOW IT RELATES TO THE RELATIVE AMOUNTS OF SOLUTE IN A SOLUTION AND WHAT IT MEANS IN TERMS OF BLOOD VOLUME/PRESSURE REGULATION.

Viscosity and PLASMA OSMOLARITY & OSMOTIC PRESSURE (blood volume, pressure, flow) albumins "pulling" water towards it *Water follows solute, the solute, water, and pressure is on the left of the above picture, not a lot on the right because maybe there was liver damage - not enough albumin, not enough water, or volume, pressure goes down

Stroke volume definition

Volume of blood pumped from the left ventricle per beat

Generally, what are leukocytes, what do they do, and where are they found in the body?

WBC Structure - No hemoglobin Functions - Defend body against pathogens Remove toxins, waste & damaged cells Location & Movement - Most WBCs in body in Connective Tissue Proper or lymphathic organs Circulating WBCs only small fraction of total population Use bloodstream as mode of transportation to area of infection/injury

Show on a clotting cascade diagram where some common anticoagulants function.

Warfarin - Intrinsic: X and Prothrombin II Extrinsic: VII Heparin - Extrinsic: Thrombin IIa

Explain how digitalis works to increase cardiac contractility.

You can't put more Ca into their heart cells, if you give them Digoxin Effect of digitalis/digoxin increases amount of Calcium in myocardial cell Digitalis targets Na K pump in heart cell - normally does K in and Na out, it blocks this - Na can't get out, you have more Na in heart cell, calcium can't get out, there is more calcium, troponin, tropomyosin, actin and myosin can work more to contract more powerfully, SV goes up, CO goes up

Draw AND label the four phases of an action potential of a pacemaker cell in the heart. Then, answer the following questions: a. What ions slowly leaks out of the cell, helping the cell to begin to depolarize? b. What is the funny current? c. What ion is primarily responsible for depolarization once threshold is reached? d. How does the pacemaker cell repolarize? e. What is the significance of the slow depolarization of the pacemaker cell?

a. K+ slowly leaks out b. Funny current is K+ leaking out and Na+ leaking in, slowly depolarizing to threshold c. Depolarization caused by Ca+ opening d. Repolarize by Ca+ closing and K+ opening (flowing out) e. The K+ is slowly leaving, causing it to be slow

Outline/Draw the sequence of events which an ECG (EKG) shows, making sure to include the following: a. P wave b. P-R interval c. QRS complex d. Q-T interval e. T wave f. Make sure to relate which regions of the ECK correlate to the regions of the heart that are depolarizing.

a. P wave - atria depolarize b. P-R interval - from start of atrial depolarization to start of QRS complex c. QRS complex - ventricles depolarize d. Q-T interval - from ventricular depolarization to ventricular repolarization e. T wave - ventricles repolarize f. above

What are the major hormones (and their associated functions) of the adrenal cortex? This one should take you some time! You will have to know the hormones AND the effects of the hormones produced by the: a. Zona glomerulosa b. Zona fasciculate c. Zona reticularis

a. Produces mineralcorticoids under stimulation by ACTH Aldosterone (main mineralcorticoid) - blood pressure regulation Stimulates: CONSERVATION OF SODIUM IONS and ELIMINATION OF POTASSIUM IONS Increases sensitivity of salt receptors in taste buds Secretion responds to: drop in blood Na+, blood volume, or blood pressure or rise in blood K+ concentration b. Produces glucocorticoids under stimulation by ACTH "Chronic stress hormone" Glucocorticoids (ie: cortisol and hydrocortisone) Liver converts some cortisol to cortisone Increased hepatic gluconeogenesis/glycogenesis Adipose and protein tissue are broken down and released into the blood FFA's and aa's are taken up by the liver and used for glucose synthesis and glycogen formation This is called gluconeogenesis and glycogenesis Some of this newly built glucose is released into the bloodstream Prolonged exposure to glucocorticoids leads to a diabetic-like state due to the increase in plasma glucose Show anti-inflammatory effects: Inhibits activities of white blood cells and other components of immune system (when released in reasonable amounts) Body fat redistribution? CA therapy? c. Produces androgens under stimulation by ACTH Network of endocrine cells Forms narrow band bordering each adrenal medulla Produces androgens under stimulation by ACTH

Draw AND label the four phases of an action potential of a plain old regular heart cell (cardiocyte). Then, answer the following questions: a. What is the resting potential value? b. What causes the threshold to be reached? c. What is the threshold value? d. When sodium gates close, which gates open? e. The influx of calcium into the heart cell causes what to happen. Hint: Think actin and myosin! ☺ f. What ion is responsible for repolarization? g. How does the length of the action potential compare to an action potential in a skeletal muscle cell? Why is this important? h. Summarize the role of calcium ions in cardiac muscle contractions.

a. Resting potential: -90mV b. Threshold met when stimulated by neighboring cardiocyte c. Threshold: ??? d. Na+ close, Ca2+ open e. SR releases more Ca2+ and causes actin and myosin to make a contraction f. Potassium causes repolarization g. much much slower AP than skeletal muscle, this is contraction and constant beating that needs to stay active, can't get tired out quickly h. Calcium causes the contraction to occur and for blood to flow Step 1 - Depolarization (very brief) Stimulus (from neighboring cardiocyte) opens voltage regulated Na+ gates, (Na+ rushes in) membrane depolarizes rapidly Action potential peaks at +30 mv Na+ gates close quickly Step 2 Plateau - 200 to 250 msec (long), SUSTAINS CONTRACTION Slow Ca2+ channels open, Ca2+ binds to fast Ca2+ channels on SR, releases Ca2+ into cytosol: Contraction Step 3 Repolarization - Ca2+ channels close, K+ channels open, rapid K+ outflux returns cell to resting potential

Explain the following blood disorders: a. Sickle cell disease b. Pernicious anemia c. Thalassemia d. Some underlying causes of jaundice (Note: jaundice is not a disease, but rather a symptom of many different diseases).

a. Sickle cell disease individual has shortened life in low O2 concentrations HbS causes cell elongation and sickle shape cell stickiness causes agglutination and blocked vessels intense pain; kidney and heart failure; paralysis; stroke chronic hypoxemia reactivates hemopoietic tissue enlarging spleen and bones of cranium b. Pernicious anemia Low RBC production due to unavailability of vitamin B12 What type of person has a lack of B12 in their diet? Gastrointestinal disease which causes absorption problems Strict vegetarians (a small percentage of people that get pernicious anemia) Insufficient B12 supplements - found in fortified foods c. Thalassemia - make less hemoglobin and have fewer circulating red blood cells than d. Some underlying causes of jaundice Yellowish-brownish staining of skin & sclerae (whites of eyes) caused by high levels of chemical called bilirubin in blood Bilirubin is a waste product that comes from old, destroyed RBCs & is removed from blood by liver (eliminated in the feces, giving it its brown color)

What are papillary muscles? What are their functions?

attach to the cusps of the atrioventricular valves via the chordae tendineae and contract to prevent inversion or prolapse of these valves on systole

Explain what hematocrit is AND more importantly, predict what changes in the human body could increase or decrease this value.

determines the percentage of the formed elements in the plasma. The term hematocrit means "to separate blood. (Newborn: up to 60% Adults: (males): 40- 54% (Females): 36 - 46% Pregnancy: decreased hematocrit, especially in the last trimester as plasma volume increases Children: varies with age)

What does the "lock and key system refer to? Explain!

hormone fits receptor on "target" cell

Why do larger veins have valves?

in larger veins one-way valves allow blood to flow only toward heart

Describe the importance of the elasticity of an artery? What happens to this elasticity as one ages? How would this affect a person?

maintains blood pressure even when heart relaxes

Describe the structure AND function of hemoglobin. Spend some time on this one! ☺

molecule responsible for transporting O2 & CO2 to & away from tissues Single pigment molecule of heme Iron (Fe) ion that interacts with O2 molecule = oxyhemoglobin Bright red Fe not bound to O2 = deoxyhemoglobin Dark red/burgundy

What is the name given to the thin, tough sac which covers the heart? What happens if blood gets caught in the space between between this sac and the heart itself?

pericardial cavity/pericardium If blood gets in there, it causes Pericardial Tamponade - compression of the heart

Diagram the main players associated with leukopoiesis.

pluripotent stem cells - myeloblasts - form neutrophils, eosinophils, basophils monoblasts form monocytes lymphoblasts form B and T lymphocytes and NK cells T lymphocytes complete development in thymus

EPO

secreted when oxygen in peripheral tissues is low (hypoxia) due to disease or high altitude

Which side of the heart has a thicker ventricular wall? Why?

the left ventricle - it has to pump blood all the way around the body, but the right ventricle only has to pump it to the lungs

What is a venipuncture?

the puncture of a vein as part of a medical procedure, typically to withdraw a blood sample or for an intravenous injection

What is V-Fib? Why is this really, really bad?

ventricular fibrulation they are for sure unconsious - quivvering - not enough O2 in body Vfib is really bad AKA cardiac arrest

What is V-Tac? What can this degenerate into?

ventricular tachycardia - Vtach - QRS is too wide - bipassing specialized electrical cells Probably unconscious It can turn into V-Fib