Anatomy and Physiology: Course Proficiency Objectives

c. Describe the structure and function of lymph nodes [Figure 20.6]

-As lymph transported back to blood stream, filtered through lymph nodes. -Large clusters of nodes where lymphatic vessels converge- cervical, axillary, inguinal Structure: Most bean-shaped, 1 inch in length -dense fibrous capsule -fewer efferent than afferent lymphatics -swollen lymph nodes where large number of bacteria, viruses present -can become secondary cancer sites -contain follicle centers that are lighter stained Lymph takes detours through lymph nodes, cleaned of debris and "examined" by immune cells.

c. Describe the role of antidiuretic hormone in water balance [Figure 26.6].

-Increases in plasma osmolality trigger thirst and release of antidiuretic hormone (ADH) slide 12

b. Explain the roles of the pulmonary and systemic circuits.

-The right side of the heart pumps blood to the pulmonary circuit (only to the lungs) -The left side of the heart pumps blood to the systemic circuit( the entire body)

g. Explain the redistribution of blood flow that occurs during exercise

-blood flow extremely changeable -exercise hyperemia (increased blood flow to certain part of the body) - during exercise, local controls Override sympathetic vasoconstricition - increase in heart, skeletal muscle and skin in where blood is redistributed Autoregulation in response to decreased oxygen, increased carbon dioxide and lactic acid (vasomotor center also invovled)

g. Describe the structural adaptations of the small intestine for absorption.

1. Circular folds (plicae circulares) 2. Villi- epithelia= absorption columnar enterocytes 3. Microvilli- create brush border and brush border enzymes

g. Describe the different ways in which carbon dioxide can be carried in the blood (i.e. dissolved, bound to hemoglobin, as bicarbonate).

1. Dissolved in plasma: -7-10% of carbon dioxide 2. Chemically bound to hemoglobin: -20% of transported carbon dioxide carried within RBC's as carbaminohemoglobin -CO2 bings to amino acids of Hb -does not interfere with 02 binding (to iron on heme) 3. Bicarbonate ion in plasma -70% of CO2 transported as bicarbonate ion in plasma

f. Compare and contrast the cell-mediated and humoral immune responses. Include: i. A distinction in the roles of B-cells and T cells in each type of response ii. Whether or not the system recognizes free antigens

1. Humoral or antibody-mediated- Use PLAN (precipitation, lysis, agglutination, neutralization) -antibodies produced by lymphocytes circulate in blood and lymph (body's humors" -antibodies bind to bacteria and their toxins, free viruses -inactivate them and mark them for destruction B cells produced the antibodies and the system can recognize free antigens 2. Cell-mediated required the MHC classes to present the antigen -lymphocytes act against targets -directly by lysing -indirectly by releasing chemical mediators that enhance inflammatory response T cells are more involved and the system can't see free antigens

b. Briefly describe the 6 major digestive processes.

1. Ingestion 2. Propulsion- swallowing (oropharynx), peristasis (esophagus, stomach, small intestine and large) 3. Mechanical Digestion- chewing (mouth), churning (stomach), segmentation (small intestine) 4. Chemical Digestion 5. Absorption- through the lymph vessels and blood vessel 6. Defecation

c. Describe the conduction system of the heart. Include in your description the pathway through and role of each of the following structures: i. SA node (pacemaker) ii. AV node iii. Bundle of His, bundle branches iv. Purkinje fibers

1. SA node (pacemaker)- sets heart rate 2. AV node- impulse delayed 0.1 sec, allows atria to finish contraction before ventricles contract 3. AV bundle- the only electrical connection between atria and ventricle. 4. Right and left bundle branches 5. Purkinje fibers Cardiac conduction system: coordinates and synchronizes heart activity, forces heart to contract in units. Defects in intrinsic conduction system: can causes arrhythmias, uncoordinated atrial and ventricular contractions, and fibrillation. Defective SA Node: may lead to ectopic focus, may have AV node set pace (40-60 bpm), Extrasystole or premature ventricular contractions. AV node damage: Heart block

Chapter 22 (Respiratory System) a. Briefly describe the 4 essential processes that must happen for the respiratory system to accomplish respiration.

1. pulmonary ventilation (breathing) 2. external respiration 3. transport of respiratory gases 4. internal cellular respiration -First two specific for respiratory system -Last two accomplished by circulatory system

Chapter 21 (Immune System) a. Compare and contrast innate and adaptive immunity.

1st line- surface barriers- skin and mucous membranes (innate defenses) 2nd line- Internal defenses: phagocytes, Natural killer cells, inflammation, antimicrobial proteins, fever (innate defenses) 3rd line- adaptive defenses- humoral immunity (B cells) cellular immunity (T Cells)- adaptive immunity

h. Describe the role of secondary active transport in absorption.

ATP is needed and ATP hydrolysis and sodium moving out and moving down its concentration gradient and pulls with it an amino acid or monoscarid

d. Compare and contrast the postabsorptive and absorptive states. Include in your contrast section the role of insulin and glucagon in driving these states.

Absorptive state: The fed state (during or right after eating)​ Anabolism > catabolism​ Amino acids anabolize to proteins​ Glucose anabolizes to glycogen​ Glycerol and fatty acids anabolize to triglycerides In Skeletal Muscle: Excessive glucose is stored as glycogen​ Amino acids are used to make proteins​ Triglycerides are the primary energy source here​ Liver: Excess glucose is stored as glycogen or converted to glycerol ​ Glycerol combines to fatty acids to form triglycerides​ Amino acids are made into proteins and sent to other tissues and others are deaminated (remove nitrogen) to keto acids​ Keto acids used in Krebs cycle to yield ATP or keto acids converted to fatty acids for liver fat stores​ ​ Triglycerides are used as primary energy source in liver Adipose Tissue: Excess glucose made into triglycerides for storage​ Triglycerides are used as primary energy source Most Tissues: Glucose is used as energy source Hormonal Control: increase in blood glucose stimulates insulin release Post-absorptive: The fasting state, GI is empty ​ Anabolism < catabolism​ Proteins catabolize into amino acids ​ Glycogen catabolizes into glucose​ Triglycerides catabolizes into glycerol and fatty acids Skeletal Muscle: Glycogenolysis - glycogen splitting - glycogen then converted to pyruvic acid through glycolysis​ Special condition: in prolonged fasting - proteins are converted to amino acids, then go to the liver to convert to keto acids and glucose Liver: Glycogenolysis ​ Gluconeogenesis ​ Triglycerides undergo lipolysis to glycerol and then glycerol is converted to glucose in the liver Adipose Tissue: Lipolysis - converts triglycerides to release glycerol to liver for the conversion to glucose Brain: Glucose is used for energy at the expense of other tissues ​ Most tissues: Fatty acids, glycerol, and ketone bodies used for energy Hormonal Control: Decrease in blood glucose stimulates glucagon release Other impacts: Epinephrine of SNS - lipolysis and gluconeogenesis​ Growth Hormone - lipolysis and gluconeogenesis​ Thyroxine -- lipolysis​ Sex hormones (testosterone) - would not be active in post-absorptive state​ Corticosteroids (cortisol) - stimulates lipolysis, gluconeogenesis, and protein breakdown

Chapter 23 (Digestive System) a. Identify and describe the anatomical organs contributing to digestion [Figure 23.1] and describe layers of the alimentary canal.

Alimentary canal (GI tract): -digest and absorbs -mouth, pharynx, esophagus, stomach, small intestine, large intestine Accessory digestive organs: teeth, tongue, gallbladder Accessory glands: salivary glands, liver, pancreas The layers of the alimentary canal: Mucosa: epithelium, lamina propria, muscularis mucosae Submucosa- blood vessels and lymphatics Muscularis externa: circular layer, longitudinal layer Serosa: connective tissue, epithelium (mesothelium) From esophagus to anal canal, walls have same four tunics

c. Describe the respiratory membrane including a description of each component.

Alveolar and capillary walls and their fused basal laminas form the respiratory membrane alveolar- capillary membrane (air- blood barrier) the three parts- alveolar epithelium, fused basement membrane and the capillary endothelium (where Co2 and O2 passes through) (external respiration) -Type I squamous and some type II surfactant-secreting cuboidal cells in alveolar wall -Gas exchange occurs by simple diffusion across the alveolar-capillary membrane

Describe the elements in blood involved in blood typing including the definitions of antigens and antibodies; describe what makes a person type A, B, AB, or O and Rh

An antigen is a glycoprotein on the surface of RBC An antibody is a protein that will bind specifically to the antigen Rh- does not make RH antibody unless we are exposed. Type A blood: A antigen and Anti-B antibody Type B blood: B antigen and Anti-A antibody Type AB blood: contains A and B antigens but no antibodies Type O blood: has no antigens but both antibodies

Chapter 24 (Metabolism) a. Compare and contrast catabolism and anabolism, and oxidation and reduction.

Anabolism: synthetic Catabolism: degradative Oxidation: occurs via the gain of oxygen or loss of hydrogen. -oxidized substance losses electrons Reduction: the gain of hydrogen or electrons and loss of oxygen

e. Define the phrase "antigenic determinants."

Antigenic Determinants: -part of entire Ag -immunogenic -free Abs/ activated lymphocytes bind -single antigen may be recognized by many antibodies -large proteins have hundreds

i. State the definition of the phrase "autoimmune disease."

Autoimmune Diseases: friendly fire from autoantibodies (destory self) - failure of proper training of T lymphocytes -Most common: Multiple sclerosis (MS), Myasthenia gravis, Type I (juvenile) diabetes mellitus, rheumatoid arthritis

c. State the relationships that exist between flow, pressure, and resistance

Blood flow: volume of blood flowing through a vessel, organ, or entire circulation (Cardiac output) in a given period Blood Pressure: force per unit area exerted on the blood vessel wall by its contained blood, usually means systemic arterial pressure in largest arteries, pressure gradient drives blood movement Resistance: friction or opposition to flow, mostly occurs away from heart, peripheral resistance (PR) Blood flow directly proportional to difference in blood pressure (P) and inversely proportional to peripheral resistance (R) R more important for incluencing local blood flow. Risisntace varies with the 4th power of the vessel radius or 1/r4 F= P/R

h. Explain how hydrostatic pressure and osmotic pressure gradients work at the capillary level to end up with a net filtration pressure

Bulk fluid flow: direction and amount of fluid flow depends upon two opposing forces- hydrostatic pressure (HP) and colloid osmotic pressure (OP) - arterial end net filtration of 10, 8 -venous end net filtration of 2 the entire net filtration outward of 2 and the lymph capillaries are picking up the loss -net fluid loss or gain determined from net filtration pressure: NFP = (HPc-HPif)-OPc-OPif ) the hydrostatic pressure it pushing the fluid in and out of the capillaries, and the osmotic pressure is pulling the fluid in and out of the capillaries. Movement direction different at two ends Hydrostatic pressure- is pushing the fluid Osmotic pressure- is pulling the fluid.

h. Explain the reaction that produces bicarbonate including an explanation of how the chloride shift contributes to the process and when the reaction may move to the right or left (lungs vs. systemic tissues).

CO2 + H20 --> H2CO3 ---> H+ + HCO 3 Carbonic acid- bicarbonate buffer system: resists shifts in blood pH affected by respiratory rate and depth: -slow shallow breathing: increases carbonic acid level, drops pH -rapid, deep breathing: -reduces carbonic acid level, increases pH move from left to right in tissues -C02 is being picked up and then carbonic anhydrous making carbonic acid and then carbonic acid dissociates to bicarbonate (shifted out to proton to the plasma by Chlroide shift) and protons. One Bicarb out on Cl in move from right to left in lungs BIcarbonate is brought in at the lungs is broken down to carbonic acid by the presence of H+ and then carbonic anhydrase breaks down to Co2 and water

d. Define deglutition.

Coordination of tongue, soft palate, pharynx, esophagus, and over 22 separate muscle groups -Voluntary buccal phase -Involuntary pharyngeal- esophageal phase: -controlled by swallowing center in medulla and lower pons 1. Buccal phase: -the upper esophageal sphincter is contracted (closed) -the tongue presses against the hard palate, forcing the food bolus into the oropharynx 2. Pharyngeal- esophageal phase begins: -the tongue blocks the mouth -the soft palate and its uvula rise, closing off the nasopharynx -the larynx rises so that the epiglottis blocks the trachea -the upper esophageal sphincter relaxes: food enters the esophagus 3.Pharyngeal- esophageal phase continues -the constrictor muscles of the pharynx contract, forcing food into the esophagus inferiorly -the upper esophageal sphincter contracts after food enters

g. State the role of the corpus luteum

Corpus luteum causes rise in estrogen and progesterone during luteal phase ​ -estrogen and progesterone trigger changes uterine lining​ -regression of corpus luteum leads to menses​

d. Describe the mechanisms of dehydration and hypotonic hydration [Figure 26.7].

Dehydration: Excessive loss of water from ECF-> ECF osmotic pressure rises-> Cells lose water to ECF by osmosis and cells shrink Hypotonic hydration: Excessive water enters ECF->ECF osmotic pressure falls-> water moves into cells by osmosis and cells swell

e. State the relative contribution of each branch of the autonomic nervous system in each phase of the male sexual response (erection and ejaculation).

Erection: During sexual arousal, PSNS reflex promotes release of nitric oxide (NO)​ -NO causes vasodilation​ Expansion of corpora cavernosa: compresses their drainage veins and retards blood outflow and maintain enlargement​ Corpus spongiosum functions in keeping urethra open during ejaculation​ Stimulated by: touch and mechanical stimulation, induced or inhibited by emotion or higher mental activity​ Impotence: inability to attain or sustain an erection Ejaculation: Propulsion of semen from male duct system​ At ejaculation, SNS stimulation causes:​ -reproductive ducts and accessory organs to contract and empty contents​ -bladder sphincter muscle to constrict, prevention expulsion ofurine​ -bulbospongiosus muscles undergo rapid series of contractionsand propel semen from urethra

b. Describe the relative distribution of sodium and potassium in the different body compartments and the pump that maintains that distribution.

Extracellular fluids are similar (except for the high protein content of plasma): -Na+ is chief cation -Cl- is major anion Intracellular fluids have low Na+ and Cl-: -K+ is chief cation -Phosphate is chief anion Sodium and potassium concentration in extra- and intra-cellular fluids are nearly opposites: -Reflects activity of cellular ATP-dependent sodium-potassium pumps

f. Describe the roles of the following hormones in regulating digestion: Gastrin, CCK, secretin.

Gastrin- increase HCL production and motilty the movement different peristalic waves (in the stomach) CCK- inhibits gastric juice secretion, tell the stomach slow down, increase the output of pancreatic juice Secretin- secretion of the duct cells of the pancreas to release bicarbonate rich pancreatic juice and inhibits gastric secretion and motile

c.Define glomerular filtration rate and micturition.

Glomerular filtration rate (GFR) = total amount of filtrate formed per minute by kidneys -normal in adults= 120- 125 ml/min -directly proportional to new filtration pressure, blood pressure, dehydration -increase in arterial (glomerular) blood pressure increase in GFR -dehydration decreases GFR Micturiton- is peeing slide 30 shows the slide

b. Briefly describe the three stages glucose is taken through to yield large amounts of ATP.

Glycolysis: In the cytosol Inputs: (1) Glucose, (2) ATP, (4) ADP, 2 NAD+, 4 phosphate group Outputs: 2 Pyruvate, 2 NADH, 2 ADP, 4 ATP- 2 ATP net Krebs Cycle: Mitochondrial Matrix Inputs: 2 Acetyl Coa, 2 ADP, 6 NAD+, 2 FAD Outputs: 4 CO2, 6 NADH, 2 FADH2, 2 ATP Electron Transport Chain: 1st part: -electrons from NADH+ H+ flow along energy gradient -some of energy used by each complex to pump protons from mitochondiral matrix to intermembrane space 2nd part: -protons in the intermembrane space create an electrochemical proton gradient -gradient drives them through the ATP synthase complex -ATP synthase used this electrical energy to synthesize ATP from ADP + P

Chapter 27 (Reproductive System) a. Identify the male and female gonads and gametes.

Gonads: primary sex organs that produce sex cells and secrete sex hormones​ Male: testes; female: ovaries​ Gametes: sex cells​ Male: sperm; female: egg/ovum

e. Define cardiac output, heart rate, and stroke volume, EDV, ESV, and contractility and describe the relationship that exists between them. Include a description of how these parameters are controlled at the: i. Sympathetic nervous system level ii. Parasympathetic nervous system level.

Heart Rate (HR)- beats/minute Stroke Volume (SV)= volume/beat -volume of blood pumped by ventricle with each beat -increase force of contraction, increase stroke volume Cardiac Output (CO)= HR x SV -volume of blood pumped by each ventricle/minute -beats/minute x volume/beat= volume/minute a. Increase in Stroke volume and increase in Heart rate= increase in Cardiac output b. increase in EDV (preload)= increase in stroke volume. Decrease in ESV= increase in Stroke volume. SV= EDV-ESV i. Sympathetic nervous system: increases both rate and force of heartbeat ii. Parasympathetic nervous system: slows heart epinephrine and nonpinephrine increase Ca2 in the contractile cells and increase contraction.

f. Explain the oxygen-hemoglobin dissociation curve and describe the changes that can occur to it when there are changes in environmental pH, CO2, and temperature.

Influence of P02 and Hb saturation: -oxygen- hemoglobin dissociation curve -hemoglobin almost 100% saturated at 70 mm Hg -rapid loading and unloading at partial pressures corresponding to steep portion of curve -25% of oxygen unloading to tissues Other influences of Hb saturation: Increase in temperature and H+ in blood (to the right as well) -decrease Hb's affinity for oxygen -oxygen- hemoglobin dissociation curve shifts to right (when there is increased carbon dioxide or decrease in ph) -enhances oxygen unloading from the blood -these factors highest in systemic capillaries

h. State the hormone that triggers ovulation.

LH

d. Describe the process of phagocyte mobilization that occurs during inflammation [Figure 21.3].

Leukocytosis: neutrophils enter blood from bone marrow Margination: neutrophils cling to the capillary wall - this step is mediated by selectins, which are cell adhesion molecules Diapedesis: neutrophils flatten and squeeze out of the capillaries Chemotaxis: neutrophils follow the chemical trai

d. List the lymphoid organs [Figure 20.5] and describe the role of the thymus

List: Thymus, red bone marrow, lymph nodes, tonsils, spleen, peyer's patches (in the small intestine) part of MAlT, and appendix Thymus Structure: bilobed Most active: newborn through childhood, atrophies by adulthood. -Prepares T lymphocytes to do battle -Outer cortex =, inner medulla -Blood-thymus barrier *Secrete thymosin and thymopoietin

Chapter 20 (Lymphatic System): a. Compare and contrast the characteristics of lymphatic capillaries and blood capillaries

Lymphatic capillaries have valves to prevent back flow of lymph and want a net forward pressure and they have minivalves if the endothelium and and sit for lymph to move in

f. Describe the elements that make up the MAP (HR, SV, and TPR); state the relationship that exists between these elements, and describe the short (baroceptors) and long term regulation (renin-angiotensin) of MAP

MAP= SV x HR x TPR (Stroke volume, heart rate, total peripheral resistance) -Baroreceptor Reflexes: receptor for the change in pressure -Located in: carotid sinuses, aortic arch, walls of large elastic arteries of neck and thorax -When blood pressure rises - baroreceptor reflexes cause the heart rate to decrease which then causes the blood pressure to decrease -When blood pressure decreases - causes the heart rate to increase and restore blood pressure levels -Are not effective at protecting against sustained pressure changes - this is a SHORT TERM fix -Kidneys work to regulate our blood volume. An increase in blood volume will increase our blood pressure -Direct mechanism: if the blood pressure increases, kidneys cannot filter all the fluid so more leaves as urine; if we excrete more urine, this will decrease our blood volume and will then decrease blood pressure; if blood pressure decreases, the kidneys will conserve water to increase blood volume and increase blood pressure -Indirect mechanism: Renin-Angiotensin system If blood pressure decreases the kidneys will secrete renin into the blood Renin acts on angiotensinogen to form angiotensin I ACE acts on angiotensin I to form angiotensin II Angiotensin II stimulates the release of aldosterone (aldosterone tells the kidneys to conserve sodium) Angiotensin II increases ADH release (ADH tells kidneys to conserve water) Angiotensin II increases thirst - increases water intake Angiotensin II stimulates vasoconstriction; increases resistance

i. Describe how the medulla controls respiratory rate and include the role of pCO2 in those control mechanisms; describe when hyperventilation is triggered.

Medulla: Ventral respiratory group (VRG) -pacesetting respiratory center -12-15 breaths/minute: eupnea Dorsal respiratory group (DRG) -integrates input from perihpheral stretch and chemoreceptors Pco2: -most powerful respiratory stimulant -increased Pco2 = hypercapnia -pH drops -stimulates central chemoreceptors -triggers hyperventilation -converse triggers hypoventilation and apnea ( happens when increased partial pressure of Co2 and protons)

b. Define lymph

Once interstitial fluid enters lymphatics, it is called lymph

c. Compare and contrast peristalsis and segmentation.

Peristalsis- adjacent segments of alimentary canal organs alternately contract and relax -food is moved distally along the tract -primarily propulsive; some mixing may occur Segmentation: Nonadjacent segments of the alimentary canal organs contract and relax. -food is moved forward, then backward -primarily mixes food and breaks it down mechanically; some propulsion may occur

b.Describe the general steps in phagocytosis.

Phagocyte adheres to pathogens or debris Phagocyte forms pseudopods that eventually engulf the particles, forming a phagosome Lysosome fuses with the phagocytic vesicle, forming a phagolysosome Toxic compounds and lysosomal enzymes destroy pathogens Sometimes exocytosis of the vesicle removes indigestible and residual material

g. Describe primary and secondary response as it relates to humoral immunity that includes a definition of memory.

Primary: sees antigen A - responds to antigen A by producing anti-bodies to A after a delay; there will be a memory B cell created for the next exposure Secondary: sees antigen A again and responds faster and larger than before; the response is more prolonged and more effective and more memory cells

c. Describe the cardinal signs of inflammation (redness, heat, swelling, pain) and generally state what causes each of the signs [Figure 21.4].

Redness=rubor Release of inflammatory chemicals, dilate arterioles, local hyperemia (more blood flow to area) causes redness Swelling=tumor Release of inflammatory chemicals, increased capillary permeability, capillaries leak fluid, leaked protein rich fluid in tissue spaces Heat=calor Release of inflammatory chemicals, dilate arterioles, local hyperemia (more blood flow to area) causes redness Pain=dolar Release of inflammatory chemicals Increased capillary permeability, capillaries leak fluid, leaked protein rich fluid in tissue spaces

e. Distinguish between respiratory acidosis, respiratory alkalosis, metabolic acidosis, and metabolic alkalosis.

Respiratory acidosis: condition that occurs when lungs cannot remove enough CO2 produced by the body - excess CO2 causes the pH to decrease (MORE ACIDIC) ​ Respiratory alkalosis: disturbance in acid and base balance due to hyperventilation​ Metabolic acidosis: a condition in which too much acid accumulates in the body - can result from buildup of metabolic acids - phosphoric, uric, lactic acids, and ketones​ Metabolic alkalosis: metabolic condition in which the pH is elevated, result of increased bicarbonate - rising pH and bicarbonate levels

b. Compare and contrast the conducting and respiratory zones.

Respiratory zone (gas exchange): respiratory bronchioles, alveolar ducts, alveoli- comes off of the terminal bronchiole Conducting zone: (conduit for air, cleanse, humidify, warm) -all other passageways

b. Define spermatogenesis and oogenesis and state where each of these processes take place.

Spermatogenesis: It takes place in seminiferous tubule​ Mitosis involves a single cell division that results in two identical, diploid daughter cells, then meiosis has two rounds of cell division: primary spermatocyte to secondary spermatocyte, and then secondary spermatocyte to spermatid - this produces 4 haploid daughter cells Oogenesis formation of oocytes in ovary - unlike spermatogenesis the number of oocytes is determined at birth​ ​ Follicular phase - period of follicle growth (day 1-14)​ Ovulation occurs midcycle​ Luteal phase - period of corpus luteum activity (day 14-28)

d. Define arterial, systolic, and diastolic blood pressure, mean arterial pressure, and pulse pressure.

Systemic Blood pressure: Highest in the aorta, declines to lowest at right atrium. -Arterial blood pressure pulsatile- peak is systolic pressure (120 mm Hg normal) -diastole, aorta pressure is lowest (70-80 mm Hg normal) Pulse pressure= difference between systolic and diastolic pressure. (pulse) Mean (average) arterial pressure= diastolic pressure + pulse pressure/3 -drives blood to tissues MAP= SV x HR x TPR

h. Describe cell-mediated immunity and state the roles of the following in this type of response: i. Antigen presenting cells → CD4 (helper T cells) Viral infected cells → CD8 (cytotoxic T cells

T cells must recognize self and non-self MHC class 1- display endogenous antigen (virus or cancer), CD8 are the ones who are activated MHC class 2- exogenous antigens (bacteria), antigen presenting cell (MCH2) is recognized by CD4 -CD4 = TH = primary helper cell Important to cellular immunity; when activated, helper T cells multiply and tell macrophages and cytotoxic T cells to go to the infection site -CD8 = TC = cytotoxic cell Primary role is to kill toxic or target cells

e. Describe how oxygen is carried in blood including a description of the role of hemoglobin in this process.

Transport of Respiratory Gases by Blood: -oxygen poorly soluble in water -hemoglobin carries 98.5% of oxygen -rapid, reversible oxygen loading and unloading -HHb+ O2 --> Hb02 + H+ -forward reaction in lungs -reverse reaction in tissues -affinity of hemoglobin changes with state of oxygen saturation

b. Briefly describe 3 major mechanisms that drive urine formation.

Urine formation/ blood composition adjustment: glomerular filtration, tubular reabsorption, secretion 1. produces the filtrate in the glomerular capillaries 2. It flows down the renal tubule and collecting duct and the peritubular capillaries do reabsorption or things that are still needed in the body 3. Finally the vasa recta secrete it into the urine

f. Identify the three general layers of the uterine wall and state which layer is structurally dynamic in that its morphology varies with the menstrual cycle

Uterine wall:​ -Perimetrium: outermost layer; visceral peritoneum​ -Myometrium: middle layer; interlacing layers of smoothmuscle​ -Endometrium: mucosal lining of uterine cavity Endometrium: has numerous uterine glands that change in length as the endometrial thickness changes​ Stratum functionalis: undergoes cyclic changes in response toovarian hormones; is shed during menstruation​ Stratum basalis: forms a new functionalis after menstruation ​ ends; does not respond to ovarian hormones​ Spiral arteries: degeneration and regeneration of these cause functionalis to shed during menstruation

Chapter 26 (Fluid, Acid- Balance Balance): a. Define the fluid compartments of the body [Figure 26.1].

Water occupies two main fluid compartments: Total body water (volume= 40L and 60% of body weight) -Intracellular fluid (ICF)- about two thirds of body water by volume, contained in cells (Volume= 25L and 40% of body weight) -Extracellular fluid (ECF) consists of two major subdivisions (Volume 15L and 20% of weight) 1. Plasma- the fluid portion of the blood (Volume= 3L and 20% of ECF) 2. Interstitial fluid (IF)- fluid in spaces between (Volume= 12L and 80% of ECF)

f. Define congestive heart failure.

When the heart cannot pump adequate blood to the tissues CO so low

I. Chapter 19 (Cardiovascular System: Blood Vessels): a. Describe the tunics of a typical blood vessel and state features of these tunics can be used to differentiate between the elastic arteries, muscular arteries, and arterioles.

a. 1. Tunica Interna (intima)- simple squamous endothelium 2. Tunic media- circularly arranged smooth muscle and elastin (vasoconstriction and vasodilation) bulkiest in arteries 3. Tunica Externa- loosely woven collagen, allows it to keep its form Elastic (conducting) arteries- large diameter lumen (space in the middle), ex: aorta and its major branches Muscular (distributing) arteries- deliver blood to organs, proportionately, the thickest media, smooth muscle, and elastin Arterioles: smallest of arteries, largest have all three tunics, blood flow into capillaries determined by arteriole diameter.

c. State which molecule(s) are our most storable form(s) of energy

glycogen and neurtal fats or triglycerides

e. Describe what happens to blood pressure through the systemic circuit.

greatest at the arota and arteries and decrease through the capillaries and lowest at the venous and veins

Chapter 25 (Urinary System) a. Describe the following features of the urinary system: i. nephron ii. filtration membrane iii. glomerulus

i. PCT -> Loop of henle -> DCT -> collecting duct Cortical nephron: -short nephron loop -Glomerulus further from the cortex- medulla junction -efferent arteriole supplies peritubular capillaries Juxtamedullary nephron: -long nephron loop -glomerulus closer to the cortex- medulla junction -efferent arteriole supplies vasa recta ii. 1. Fenestrated endothelium of glomerular capillaries 2.Visceral membrane of glomerular capsule made by podocytes 3. Intervening basement membrane (fused basal lamina of other two layers )- permits most solutes and only the smallest proteins to pass iii. Glomerulus (capillary bed fed/ drained by arteriole) + renal tubule prodcues the filtrate in the glomerular capillaries

Chapter 17 (blood): a. Describe the formed elements in blood. Include in your description the following: i. Grouping/abundance of formed elements (agranulocytes/granulocytes) ii. Structure/function relationship of erythrocytes iii. Site of production/common stem cell of formed elements iv. Hormonal regulation of erythropoiesis

i. Granulocytes: neutrophils, eosinophils, and basophils agranulocytes: monocytes and lymphocytes Most abundant to least: Neutrophils, Lymphocytes, Monocytes, Eosinophils, Basophils ii. Structure: small, biconcave, "mini donut", anucleate (no organelles, bag of hemoglobin", deformable spectrin net, lives about 28 days Functions: pick up oxygen in lung capillary beds, release to tissues through other capillaries throughout the body, pick up carbon dioxide in tissue capillary beds, return to lungs Erythrocyte structure and function highly complementary: large surface area relative to volume, over 97% hemoglobin, doesn't consume transported oxygen iii. Leukopoiesis= Production of WBCs, stimulated by hormones and glycoproteins called cytokines. Cytokines further classified as either interleukins or colon-stimulated factors. Macrophages and T lymphocytes are important sources. Stimulatory hormones released in response to specific chemical signals The main cell for all formed elements is the hematopoietic stem cell or hemocytoblast. iv. 1. Stimulus: Hypoxia (inadequate O2 delivery) due to: decreased RBC count, decreased amount of hemoglobin, decreased availability of O2 2. Kidney (and liver to a smaller extent) releases erythropoietin. 3. Erythropoietin stimulates red bone marrow 4. Enhanced erythropoiesis increases RBC count 5. O2-carrying ability of blood rises

b. Describe the capillary bed [Figures 19.4 and 19.5]. Include in your description: i. how precapillary sphincters can control blood flow ii. distinctions between continuous, fenestrated, and sinusoidal type capillaries

i. Precapillary sphincters: control blood route, rerouting controlled by vasomotor nerve fibers, local chemical conditions for exercise ii. Capillaries: smallest blood vessels, allows exchange of materials between blood and interstitial fluid, tunica interna only 1. Continuous- are most common, contain intercellular clefts but not present in brain capillaries (blood-brain barrier) 2. Fenestrated (oval pores)- active capillary absorption of filtrate formation, small intestine, kidneys 3. Sinusoidal- highly modified, leaky, large molecules, blood cells pass, ex: liver bone marrow, lymphoid tissues, spleen, and adrenal medulla

d. Summarize and integrate the events that occur during the cardiac cycle. Include in the summary and integration what is occurring at the following levels [Focus Figure 18.2]: i. Define and compare systole and diastole ii. ECG → describe what happens in the cycle to produce the P, QRS, and T waves iii. Heart sound production and timing iv. Chamber blood flow and relative pressure; ventricular blood volume

i. Systole- contraction period of heart Diastole- relaxation period of heart ii. p wave: atrial depolarization qrs complex: ventricular depolarization t wave: ventricular repolarization p-q interval: time from atrial excitation to beginning of ventricular excitation. s-t segment: entire ventricle depolarized Q-T interval: ventricular depolarization through repolarization "electrical systole of the ventricles" iii. Basic rhythm is lup-dub, pause, lub-dup Pause indicates quiescent period. First sound= Close of AV valves, beginning of systole (loud, long) Second sound= close of semilunar valves, beginning of ventricular diastole (short, sharp) iv. Cardiac Cycle: 1. Period of ventricular filling: mid-to-late diastole- - AV open, Sv closed 2. Ventricular systole: Isovolumetric (EDV is within) contraction phase and ventricular ejection phase. -AV closed and SV open 3. Isovolumetric relaxation: early diastole- End systolic volume (ESV) -AV open and SV closed

d. Define or state the following: i. tidal volume ii. vital capacity iii. residual volume vs. dead space (compare/contrast) iv. spirometer v. Boyle's law vi. Dalton's Law vii. Henry's Law viii. Ventilation-perfusion coupling

i. Tidal volume: is the amount of air that moves in or out of the lungs with each respiratory cycle. resting breath ii. Vital Capacity: refers to the maximal volume of air that can be expired following maximum inspiration. (IRV + TV+ ERV) iii. Residual volume: is the volume of air remaining in the lungs after maximum forceful expiration. In other words, it is the volume of air that cannot be expelled, thus causing the alveoli to remain open at all times. The residual volume remains unchanged regardless of the lung volume at which expiration was started. 1200ml Dead space: -air that is present in the conducting zone and isn't involved -called anatomical dead space -about 150 ml iv. Use of spirometer to: -evaluate losses in function -follow course of disease -doesn't provide specific diagnosis -differentiates between obstructive and restrictive lung diseases v. Boyle's law: -relationship between pressure and volume of gases (inversely related) -P1V1= P2V2 -P= pressure of gas in mm Hg -V= volume of gas in cubic mm vi. Dalton's law of Partial Pressures: -Total pressure exerted by a mixture of gases= sum of the pressures exerted independently by each gas in the mixture -pressure exerted by each gas (its partial pressure) is directly proportional to is percentage in the total gas mixture vii. Henry's law: -When mixture of gas is in contact with liquid, gas will dissolve in liquid in proportion to its partial pressure -Ability of gas to dissolve in liquid depends on solubility of gas in liquid and temperature of liquid. Oxygen is only 1/20th as soluble viii. Ventilation-perfusion coupling: Ventilation inadequate: -arterioles constrict -redirects blood to area where P02 higher Passageways where CO2 is high -dilation to eliminate CO2 rapidly

b. State the order and briefly describe the stages of hemostasis, namely: i. Vascular spasm ii. Platelet plug formation iii. Coagulation (Fibrin formation)

i. Vascular spams: First, immediate response, Triggered by: 1. Direct injury to a vascular smooth muscle (vasoconstriction) 2. Chemicals released by endothelial cells and platelets 3. Reflexes initiated by local pain receptors ii. Platelet plug formation: Von Willebrand factor- enhances platelet stickiness to collagen -Platelets release serotonin, ADP, and thromboxane A2 - attract more platelets to site and is a positive feedback iii. The last three steps of coagulation: 1. Prothrombin activator formed 2. Prothrombin activator converts prothrombin is converts to thrombin 3. Thrombin catalyzes joining of fibrinogen molecules into fibrin mesh Both intrinsic and extrinsic pathway both lead to factor X activation Factor X + TF/ PF3 + Ca2 + Factor V= prothrombin activator

Chapter 18 (The Heart): a. Identify and describe the external and internal anatomical structures of the heart [Figure 18.5 (b, d, and e)] including: i. The components of the pericardium and the layers of the heart wall [Figure 18.3]. ii. Types of heart valves and roles of each.

i. pericardium- is what encloses the heart the layers of heart- epicardium, myocardium, endocardium ii. AV: Atrioventricular Values: Mitral (bicuspid) and tricuspid - atria into ventricle- prevent back flow of blood SL: Semilunar valves: Aortic and Pulmonary- blood from the ventricle to the outside of the heart

e. Describe and state the roles of the following features or cells of the GI tract in digestion: i. rugae of the stomach ii. gastric glands 1. Mucous neck cells 2. Parietal cells 3. Chief cells iii. Exocrine pancreas iv. liver v. Gallbladder

i. rugue- allow for the expansion of the stomach after the consumption of foods and liquids, greater surface area ii. gastric glands- produce gastric juice 1. Mucous neck cells- acidic mucus 2. Parietal cells: -HCL (pH 1.5- 3.5, activates pepsin) -intrinsic factor, glycoprotein required for vit B12 absorption 3. Chief cells- pepsinogen iii. accessory exocrine digestive organ -produces many enzymes (as well as releasing bicarbonate) , break down all categories of foods- in the small intestine - trpsinogen, chymotrypsinogen, Kyrocarboxypeptidase, pancreatic lipase, amplise iv. accessory organ associated with small intestine -many metabolic and regulatory functions -digestive functions: produce bile for export to duodenum (bile emulsifies fat) v. the gallbladder- -stores bile that is not immediately needed for digestion -concentrates bile by absorbing water and ions

c. Identify the primary sex hormones for the male and female.

males: androgen females: estrogen and progestrone

e. Identify the most active reabsorption site of the nephron.

proximal convoluted tubule

d. Identify the 3 accessory glands that contribute to semen production

seminal gland, prostate gland, bublo-urethral gland

d. Describe the role of the renin-angiotensin mechanism in blood pressure regulation.

slide 15