Antigens and Antibodies
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What are the effects of antibodies binding to antigens? When antibodies attach to antigens of foreign cells, they cause the foreign cells to clump together and eventually undergo immune system mediated destruction
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Red Blood Cells
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What happens during development and the name of each stage Developing RBCs lose their nucleus and many other organelles as they mature
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When a maturing RBC loses it’s nucleus, it becomes a reticulocyte
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The mature form is highly specialized for oxygen transport
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The Circulatory System
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Where is the heart located in the thoracic cavity? The heart is located in the mediastinum, which extends from the sternum anteriorly to the vertebral column posteriorly, and lies medially between the two lungs and the pleural membranes that cover them.
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Red Blood Cells
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What is hemoglobin and what does it do? Hemoglobin is a protein molecule adapted to carry O2
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Human Blood Groups
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What is special about antibody production in negative individuals? Anti-Rh antibodies not spontaneously formed in Rh– individuals
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Anti-Rh antibodies form if Rh– individual receives Rh+ blood, or Rh– mom carrying Rh+ fetus
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Human Blood Groups
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What is the Rh antigen? is an inherited protein found on the surface of red blood cells
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Red Blood Cells
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How are old RBCs destroyed Ruptured RBCs are removed from circulation and destroyed by fixed phagocytotic macrophages in the spleen and liver
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Human Blood Groups
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Which naturally produce what antibodies? Type A- Anti B antibody
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Type B- Anti A antibody
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Type AB- Neither antibodies
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Type O- Both A and B antibodies
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Abnormalities of Erythropoiesis
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List some causes low iron intake, hemolysis, autoimmune disease, blood loss, or lack of production in the bone marrow
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The CV System
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What does the CV system consist of? consists of three interrelated components: Blood Heart Blood vessels
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Anemias
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What is sickle-cell disease and how are RBC affected? An autosomal recessive disorder
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A genetic defect in the primary DNA sequence leads to production of a faulty Hgb β chain, and RBCs that take on a rigid, sickle-shape
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Antigens and Antibodies
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What are antibodies? Proteins produced by B-cells (immune cells) that are used by the immune system for identification and destruction of foreign objects
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Formed Elements
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What are WBCs and list characteristics discussed in PPT leukocytes
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Have nuclei and a full complement of other organelles
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do not contain the protein Hgb
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Shorter life-span compared to RBCs
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divided into two groups depending on whether they contain conspicuous chemical-filled cytoplasmic granules (when stained) Granulocytes Agranulocytes
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Antigens & Antibodies
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What are antigens? surface identification markers to the immune system
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Leukocytes
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Why is it important for WBC function This allows them to pinpoint the area of damage/inflammation/infection and gather in large numbers to remove debris and fight infection
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Blood Transfusion
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What is a blood transfusion? The process of transferring blood or blood products from one person to another
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Granulocytes
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List the granulocytes, the role of each, and their relative abundance Neutrophil
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The most numerous WBC in normal blood (50-70% of circulating white blood cells)
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PMNs are granulocytes with a pinkish cytoplasm
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one of the two major phagocytes in the body
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their principal role is to fight bacterial infections
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Use a variety of chemicals destroy pathogens
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Eosinophils
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Characterized by their large red granules
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Involved in mediation of inflammation and phagocytosis of antigen-antibody complexes
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They are much less numerous than neutrophils (2-4% of circulating WBCs)
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they have also been associated with the development of allergies
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Basophils
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Contain large, dark blue, histamine containing granules
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Normally, they are the lowest number of circulating WBCs (only 0-1%),
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Play an important role in the escalation of inflammatory responses
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Hemostasis
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What are the three steps and describe the process of each Vascular spasm
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Vasoconstriction ( vascular smooth muscle squeezing) of damaged blood vessel
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Formation of a platelet plug
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Positive feedback cycle
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Damaged endothelium exposes the blood vessel collagen fibers (important structural proteins) to blood flowing through it
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Platelets stick to exposed collagen fibers via help of the plasma protein Von Willebrand factor
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Platelets swell, become spiked and sticky, and release particular chemical messengers:
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The aforementioned chemical messengers cause more platelets in the area affected to swell, become spiked and sticky, stick to the exposed collagen and release more chemical messengers, which cause the process to continue and amplify
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Usually takes about a minute for the platelets to form a plug large enough to affect blood loss.
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Coagulation
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Reinforces platelet plug with mesh-like arrangement of fibrin threads
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Blood transformed from liquid to gel-like substance (clot) helping to reinforce and seal larger breaks
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Cardiac Muscle Tissue: Electrophysiology
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List basic electrophys differences with skeletal muscle Action potential and contractile phase last much longer in contractile cardiac myocytes
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extends absolute refractory period and allows time for proper contraction necessary for pressure build up needed for ejection of blood from heart chamber
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Return to repolarization results from inactivation of Ca2+ channels during the open period of voltage-gated K+ channels
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Ca2+ pumped back into SR and extracellular fluid
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Long absolute refractory period (250 ms)
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Another Action potential and contraction cannot begin until relaxation is well underway. For this reason, tetanus (sustained contraction) cannot occur in cardiac muscle This allows for sufficient time between contractions for the chambers to fill with blood – cannot properly fill if contracting
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Cardiac Conduction: Sequence of Excitation
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What is the SA node and why is it the pacemaker? Pacemaker of heart in right atrial wall
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Depolarizes faster than rest of non-contractile myocardium
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What is the AV node and why is it important? In inferior interatrial septum (separation line between atria)
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Allows atrial contraction to mostly complete prior to conducting the AP that will be responsible for ventricular contraction
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What is the AV bunde and what is its job? In superior interventricular septum (separation line between ventricles)
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Only electrical connection between atria and ventricles
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Basics of right and left bundle branches Two pathways in interventricular septum
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Carry impulses toward apex of heart
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What is the Subendocardial network and why is it important? Complete pathway through interventricular septum into apex and ventricular walls
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More elaborate on left side of heart - more muscle mass
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AV bundle and subendocardial conducting network depolarize 30X/minute in absence of AV node input
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Blood
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What type of tissue is blood? connective tissue
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Composed of: Plasma (~55%) Formed elements (~45%)
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Components Of Blood
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Components of blood Plasma (~55% of whole blood by volume)
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What is it mostly? (Plasma) 91.5% water and 8.5% solutes
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What are the different constituents? Water and Solutes
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What are plasma proteins and where are most made? Specific proteins confined to blood are called plasma proteins
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Which are found in the greatest amount (by weight, by number)? Albumins, Globulins, Fibrinogen
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Heart Location
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How is it oriented? The heart is located in the middle mediastinum.
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Base The base of the heart is tipped up medially and posteriorly
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Apex the apex projects inferiorly and laterally.
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Autorhythmicity
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How are they connected to each other and to the contractile cardiac myocytes? The conducting system is in contact with the contractile cardiac myocytes via gap junctions
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What are those connections used for? Once a group of autorhythmic cells reaches threshold and start an action potential (AP), all of the cells in that area of the heart also depolarize by spread of ions through gap junctions.
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Formed Elements
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What is hemopoiesis? Process by which the formed elements of blood develop
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Where does it take place in humans? From late fetal development to death
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What 2 main types of stem cells do the pluripotent cells give rise to? Myeliod and lymphoid stem cells
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Why are the lymphoid stem cells named so? their beginning development in the red bone marrow and ending in the lymphoid tissue
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Acute Lymphoblastic Leukimia
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From what line of blood cells does ALL develop? White Blood Cells
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Chambers Of The Heart
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Right heart and pump consists of the right atrium and right ventricle Takes in venous blood from the body and pumps it to the lungs for oxygenation.
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Left heart and pump consists of the left atrium and left ventricle Takes in freshly oxygenated pulmonary blood and pumps it systemically (meaning to the body).
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Top pump A weak pump consisting of the right and left atria. The atria receive venous blood and top-off the ventricles by giving an “atrial kick” (atrial contraction) before the ventricles contract.
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Bottom pump A strong pump consisting of the right and left ventricles – pumps out to arteries It’s the main pump for the pulmonary and systemic circuits.
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Chambers Of The Heart
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List the 4 chambers of the heart Right Atrium Right Ventricle Left Atrium Left Ventricle
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Regulation of Hemopoiesis
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What is the importance of their discovery and artificial synthesis? Laboratory made hemopoietic growth factors have shown great promise in helping reduce some of the side effects of chemotherapy as well as treatment of particular disieases and genetic defficiencies
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Intravascular Clotting
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What is intravascular clotting and the define the terms in each Formation of a clot in an unbroken blood vessel (usually a vein) is called thrombosis.
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The clot itself is called a thrombus
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Embolism: embolus obstructing a vessel
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Intavascular Clotting
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Why is this dangerous and list some risk factors Blocks blood supply to region and can result in tissue death
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Risk factors – atherosclerosis, infection, inflammation, slowly flowing blood, or blood stasis from immobility
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Antigens and Antibodies
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Can a single antibody bind to any antigen? Why? No, Each antibody type is very specific for a particular antigen
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Anticoagulant Drugs
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Identify the anticoagulant drugs in the PPT and their respective mechanisms Aspirin-Antiprostaglandin that inhibits thromboxane A2 synthesis
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Heparin-Helps antithrombin block thrombin formation and activity
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Warfarin-Interferes with action of vitamin K in clot formation/Works slower than heparin
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Dabigatran-Directly inhibits thrombin
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Clot Retraction
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What is clot retraction and how does it occur? is the consolidation of the fibrin reinforced clot. As the clot retracts, it pulls the edges of the damaged vessel closer together, decreasing the risk of further damage
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The Electrocardiogram
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What is an ECG An ECG is a recording of the electrical changes on the surface of the body resulting from the depolarization and repolarization of the myocardium.
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Why is it important clinically? An ECG recording can help us determine normal from abnormal cardiac activity:
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What does each wave and interval represent P wave - atrial depolarization
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P-Q interval - time it takes for the atrial contraction to top-off the ventricles
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QRS wave - ventricular depolarization and atrial repolarization
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S-T segment - time it takes to empty the ventricles before they repolarize (the T wave
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Blood
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What is hematology and how does blood contribute to homeostasis? The study of blood, blood forming tissues, and the disorders associated with them
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Blood contributes to homeostasis by: Transporting respiratory gasses, nutrients, metabolites, and hormones to and from your body’s cells. Helping to regulate body pH and temperature. Providing protection through its clotting mechanisms and immune defenses
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Blood Transfusion
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How is whole donated blood processed (separated)? Almost all donated blood in the U.S. is separated into its various components to make better use of it
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WBC Indies
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What does it mean if a type of WBC is present in excess amounts? In this peripheral blood smear a patient with lymphocytic leukemia has a WBC >150,000 and 90% of the WBCs are cancerous lymphocytes!
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Action Potential Initiation by Pacemaker Cells
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Describe their action potential steps Pacemaker potential End of repolarization closes voltage-gated K+ channels Special (funny current) channels open and let positive ions enter the cell positive ion flow in moves membrane voltage in a positive direction
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Depolarization Once the threshold value is met (AP membrane voltage) Fast voltage-gated Ca2+ channels open Ca2+ influx rising phase of action potential
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Repolarization-Slow voltage-gated K+ channels open outflow of K+ greater than Ca2+ inflow as the voltage-gated Ca2+ channels close
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Antigens and Antibodies
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What are cellular antigens typically made of? Proteins
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Glycolipids
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Glycoproteins
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Proteolipids
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Cardiac Conduction
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Two important roles of autorhythmic fibers Formation of the conduction system of the heart
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Act as pacemakers within that system.
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Human Blood Groups
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Know the different blood groups Types A, B, AB, and O
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Cardiac Muscle Tissue: Electrophysiology
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List electrophys similarities with skeletal muscle Contractile cardiac muscle fibers have a stable resting membrane potential – stay at stable negative charge until signaled
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In contractile cardiac muscle fibers, depolarization opens fast voltage-gated Na+ channels in the cell membrane
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Positive sodium rushes in and causes brief reversal of membrane potential – goes from negative to positive
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What is responsible for depolarization phase? Depolarization is due to Na+ influx through fast voltage-gated Na+ channels
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What change in cell functioning does depolarization produce? Depolarization wave results in opening of slow Ca2+ channels in T-tubule membrane (around peak and early repolarization) - influx of calcium-SR releases Ca2+
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Blood Groups
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Which can donate to and receive from who and why? Blood typing for ABO status is done using single drops of blood mixed with different antisera
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Agglutination with an antisera indicates the presence of that antigen on the RBC
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Cardiac Muscle Tissue
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What are they heavily reliant on? High dependence on aerobic respiration (needs O2) for ATP production
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What can they use to make more fuel? Can even use lactic acid from skeletal muscles to make more ATP
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How are they connected to, and communicate with, each other Cardiac myocytes connect to, and communicate with, adjacent neighboring cells through gap junctions in intercalated discs.
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APs spread to other cardiac myocytes by ion travel through gap junctions
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Transfusion Reaction
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What is the danger in someone receiving mismatched blood? Diminished oxygen-carrying capacity
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Diminished blood flow beyond blocked vessels
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Hemoglobin in kidney tubules-renal failure
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Heart Location
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What is the function of the pericardium? The pericardium is the membrane that surrounds and protects the heart and retains its position in the mediastinum
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List the layers and properties of each? The fibrous pericardium is a very dense and non-flexible connective tissue that helps protect and anchor the heart.
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The inner serous pericardium is subdivided into;
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parietal layer adheres to the outermost fibrous layer
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visceral layer also viewed as the outer surface of the heart wall
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A thin pericardial fluid lubricates the space between the visceral and parietal pericardium (pericardial cavity).
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Agranulocytes
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List the agranulocytes , the role of each, and their relative abundance Monocytes
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Arise from the same immediate precursor cell as the 3 granulocytes (the myeloid stem cell), but no granules
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Along with neutrophils, monocytes are the other major group of phagocytic cells.
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Constitute only 3-8% of the circulating WBCs
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Crucial in the defense against viruses, certain bacterial parasites, fungi, and chronic infections
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Differentiate into Macrophages in tissues
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Some become “fixed” (localized to a particular tissue) and others become “wandering” (roamers that congregate at sites of infection or inflammation)
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Lymphocytes
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Do not have granules or phagocytize
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The major soldiers in immune system battles
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Approximately 20-30% of circulating white cells
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Lymphocytes are the cornerstone of the specific immune response
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Continuously move between blood and lymphatic tissue
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Develop into;T-cells B-cells Natural killer cells
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Anemias
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How may this affect the health of those with the full phenotype of the disease? Sickling decreases the cells' flexibility and results in a variety of complications
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Acute Lymphoblastic Leukimia
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What characterizes it? Characterized by the overproduction and accumulation of cancerous, immature white blood cells, known as lymphoblasts.
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Formed Elements
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How are they classified? Have nuclei and a full complement of other organelles
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do not contain the protein Hgb
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Shorter life-span compared to RBCs
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divided into two groups depending on whether they contain conspicuous chemical-filled cytoplasmic granules (when stained)
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Formed Elements
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What is hematocrit? the % of RBCs per unit blood volume
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Acute Lymphoblastic Leukimia
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What characterizes it? Characterized by the overproduction and accumulation of cancerous, immature white blood cells, known as lymphoblasts.
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Abnormalities of Erythropoiesis
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What is iron deficiency anemia and why is it important for women to know of its cause? Too few healthy red blood cells due to too little iron in the body
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20% of all women of childbearing age have some form of iron deficiency anemia
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Acute Myeloid Leukimia
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From what line of blood cells does AML develop? Cancer of the myeloid line of blood cells
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Red Blood Cells
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What do they specialize in? The mature form is highly specialized for oxygen transport
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Components Of Blood
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List the three formed elements of blood Red Blood Cells (RBCs) White Blood Cells (WBCs) Platelets
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Abnormalities of Erythropoiesis
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What is polycythemia and what can cause it? a condition of excess number of RBCs per unit volume
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Hypoxia
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Characteristics of Blood
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What is ECF? extracellular fluid
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Plasma volume constitutes roughly 25% of extracellular fluid
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Other 75% of ECF is interstitial fluid
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Red Blood Cells
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How is it able to do its job (what element is necessary)? A Hgb molecule consists of 4 large globin proteins (2 alpha and 2 beta chains), each embedding an iron-containing heme center
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The iron binds oxygen
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Each hemoglobin can bind to 4 oxygen molecules.
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Formed Elements
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Why is the bi-concave shape important? Allows for high surface area to cell volume, which is optimal for gas exchange Also allows RBCs to deform without rupturing Very important in capillary circulation
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Cardiac Muscle Tissue
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What are the two types of cardiac muscle cells? Contractile fibers and non-contractile fibers
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Properties Excitable tissue-changes in electrical states that affect cellular activity
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Like skeletal muscle, cardiac muscle is striated
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Contractile units organized much the same as skeletal
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Unlike skeletal muscle, cardiac muscle fibers; Are shorter Can branch Have only one (usually centrally located) nucleus.
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Have many mitochondria
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Readily switches fuel source for aerobic respiration
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The Circulatory System
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What is the job of the heart and how does it contribute to homeostasis? The heart and blood vessels transport water, gases (O2, CO2, N2), proteins, hormones, and waste products throughout the body.
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Involved in the regulation of temperature and blood pH.
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Also helps facilitate the functions of the immune system.
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Red Blood Cells
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What characteristics about the RBC contribute to this specialization? Due to the lack of most organelles, the majority of their internal space is available for oxygen transport
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Layers of The Heart Wall
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What are the three layer of the heart wall?What composes each? The epicardium-the thin, transparent outer layer of the heart wall also called the visceral layer of the serous pericardium.
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The myocardium-the thick middle layer composed of cardiac muscle
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The endocardium-a simple squamous epithelial layer (known in the circulatory system as "endothelium”).
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Regulation of Hemopoiesis
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List and define the hemopoietic growth factors Erythropoietin (EPO) – increases the # of RBC precursers (formed in kidneys)
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Thrombopoetin (TPO) – stimulates formation of platelets from megakaryocytes (formed in liver)
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Cytokines – small glycoproteins that regulate the development of different blood cells( formed by red bone marrow cells, leukocytes,
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Characteristics of Blood
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List the characteristics of blood Blood is more dense and viscous (thicker) than water.
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Has a temperature of ~38 deg C (1 deg C higher than oral or rectal body temp)
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Slightly alkaline
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pH ranging from 7.35 – 7.45
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Changes from dark to bright red depending on oxygen content
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Average blood volume in: Males = 5 to 6 liters (~1.5 gal) Females = 4 to 5 liters (~1.2 gal) Difference mainly due to body size
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Acute Myeloid Leukimia
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What characterizes it? characterized by the rapid growth of abnormal white blood cells that accumulate in the bone marrow and interfere with the production of normal blood cells
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Autorhythmicity
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What is autorhythmicity? The self initiated rhythmical electrical activity displayed by the heart
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What does that mean for the heart? Because heart muscle is autorhythmic, it does not rely on the central nervous system to stimulate a heartbeat
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How abundant are autorhythmic fibers? Approximately 1% of cardiac cells are autorhythmic fibers
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Autorhythmicity
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What do they not do? Do not function in contraction
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What is special about them? have specialized features that are essential for normal heart excitation
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What do they do for the heart? Constitute a network called the conducting system
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The conducting system is in contact with the contractile cardiac myocytes via gap junctions
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These cells are what initiate the heartbeat and help spread the impulse (action potential) rapidly through the heart
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Components of Blood
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Which is most abundant in blood? Red Blood Cells
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Characteristics of Blood
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What is ISF and how does it relate to blood? Interstitial fluid (ISF)
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Fluid that bathes body tissues
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Constantly renewed by blood
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Cardiac Conduction: Sequence of Excitation
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Describe the pathway of action potential conduction through the heart Sinoatrial node Atrioventricular node Atrioventricular bundle Right and left bundle branches Subendocardial conducting network (Purkinje fibers
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WBC Indices
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What is a WBC differential and why is it important? To enhance the diagnostic value of a WBC count, the percentages of each of the 5 types of WBCs is determined by using a machine to do a statistical analysis of the blood sample
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Shifts in the normal percentages of circulating WBCs will often point towards a bacterial infection (elevated percentage of neutrophils) or a viral infection (elevated percentage of lymphocytes
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Blood Transfusion
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What is serum? serum is just plasma without the clotting factors
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Formed Elements
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What are platelets, their role, and life span? Derived from megakaryocytes that splinter into 2000-3000 fragments
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Short life span (5 – 9 days)
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Form a platelet plug in damaged vessels and release chemicals that promote clotting
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Hemostasis
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What is hemostasis? The sequence of responses that halt bleeding
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Describe the importance of this response? When blood vessels are damaged or ruptured, the hemostatic response must be quick, localized to the region of damage, and carefully controlled in order to be effective
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What does it require? Requires various clotting factors, and substances released by platelets and injured tissues Three mechanisms reduce blood loss (Vascular spasm Formation of a platelet plug Blood clotting (coagulation)
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WBC Indies
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What is leukocytosis? Increase in WBC count above 11,000 cells/microliter
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What is Leukopenia? WBC count less than 5,000 cells/microliter
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WBC Indices
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Why are WBC indices clinically important? Shifts in the normal percentages of circulating WBCs will often point towards a bacterial infection (elevated percentage of neutrophils) or a viral infection (elevated percentage of lymphocytes
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Fibrinolysis
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What is fibrinolysis, the fibrinolytic system, and why is it important? a clot has a tendency to enlarge quickly, creating the potential for impairment of blood flow through undamaged vessels
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Fibrinolysis
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What enzymes are important in this system and how do they function (what do they affect)? Both body tissues and blood contain substances that can transform plasminogen (inactive form made by liver) to plasmin, (the enzyme that actively dissolves clots)
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Antithrombin, blocks the activity of thrombin, can be activated to help slow clot formation
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WBC Indices
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Compare number of circulating WBCs to RBCs WBCs are far less numerous than RBCs in the blood
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Normal concentration ~5,000-10,000 cells/microliter
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Leukocyte Movement
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What is emigration? The process by which WBCs leave the blood stream
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Leukocytes
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What is phagocytosis and which WBCs are the main active phagocytes? the process of engulphing a substance or another cell
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Monocytes and neutrophills are the main active phagocytes in the body
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Human Blood Groups
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What does positive and negative designate? Those with the Rh antigen are said to be Rh+ (positive)
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Those without the Rh antigen are Rh- (negative)
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Leukocytes
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What is positive chemotaxis? Chemicals released by microbes, other WBCs, and inflamed tissues can attract particular WBCs, a phenomenon
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Antigens and Antibodies
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Define agglutinogen and how the term relates to antigens Promoters of clumping
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Thus antigens are also called agglutinogens because they can trigger a clumping response from the immune system
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Anemias
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What are they at increased risk for? Increased risk of stroke
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Antigens and Antibodies
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What are antibodies also called? Antibodies are called agglutinins
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Anemias
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What is hemorrhagic anemia? precipitous blood loss, and results in an equal decrease in Hct, Hgb content, and RBC count
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Human Blood Groups
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Which have what antigens? Type A- A antigen
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Type B- B antigen
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Type AB- A and B antigens
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Type O- Neither A or B antigens
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Abnormalities of Erythropoiesis
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What is anemia? lowered oxygen carrying capacity of the blood
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Human Blood Groups
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Which can donate to and receive from who and why? |
Red Blood Cells
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Why do RBC’s have a limited life span? mature RBCs lack a nucleus or any protein making instructions
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This means they cannot synthesize new components to repair damaged ones
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Human Blood Groups
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What is it named after? Named due to its discovery in the blood of the Rhesus monkey
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