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CBIO 2210 Exam 2 Study guide

by: Elise Weidner

CBIO 2210 Exam 2 Study guide CBIO2210

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Elise Weidner

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Study guide for exam 2 including questions from Top Hat, the quiz, and notes.
Anatomy and Physiology II
Rob Nichols
Study Guide
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This 13 page Study Guide was uploaded by Elise Weidner on Sunday February 14, 2016. The Study Guide belongs to CBIO2210 at University of Georgia taught by Rob Nichols in Spring 2016. Since its upload, it has received 207 views. For similar materials see Anatomy and Physiology II in Anatomy at University of Georgia.

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Date Created: 02/14/16
CBIO 2210 Test 2 Study Guide Sections Covered:  Leukocytes, platelets, and coagulation (OS 18.4-18.5)  Heart anatomy (OS 19.1; also covered extensively in lab last week)  Cardiac muscle electrical activity (OS 19.2; also covered in lab this week)  Cardiac Cycle, EKG, heart sounds (OS 19.3; covered in lab this week) Top Hat Questions: 1. Which of the following is true of all leukocytes? a. They are nucleated i. (not all leukocytes have granules…Cells that have granules are secretory cells) 2. A chemical vasoconstrictor that promotes vascular spasm in cut blood vessels a. Serotonin 3. Bone marrow tests on a 76 year old male indicate an excessive number of immature B cells. What is the best diagnosis from this? a. Chronic lymphocytic leukemia i. Chronic=elderly, B cells are lymphocytic 4. Unlike skeletal muscle fibers, cardiomyocytes (pick 2) : a. Are branched b. Have gap junctions that allow ion flow to adjacent cells 5. The pacemaker potential of autorhythmic cells is due to: a. Sodium flowing through “slow” sodium channels (never get a resting period) 6. Parasympathetic(slows heartrate back down) impulses from the vagus nerve releases_____, causing a ______ of the pacemaker cells a. Acetylcholine; hyperpolarization(makes them slightly more negative which makes them slightly less likely to respond to a stimulus) 7. Where can you listen to the tricuspid valve on heart a. In the fifth intercostal space, to the right (or left) of the sternum 8. The P wave of a normal EKG corresponds to a. Atrial depolarization 9. Which of the following is happening between S1 and S2 heart sounds? (2 answers) a. Ventricles emptying b. SL valves are open Quiz Questions 1. What are the most abundant agranulocytes? a. Monocytes b. Neutrophils c. Lymphocytes d. Eosinophils 2. Which cells aid in the body’s defense processes by secreting histamine and heparin? 1 a. Platelets b. Erythrocytes c. Basophils 3. If a certain drug blocks neutrophils from attaching to blood vessel walls and exciting the blood, it can be aid that the drug blocks: a. Diapedesis b. Chemotaxis c. Coagulation d. Erythropoiesis 4. Leukopoiesis involves the development of leukocytes along two lineages. The myolocytic lineage can lead to all of the following except: a. T lymphocytes b. Monocytes c. Erythrocytes 5. Leukopenia: a. Is usually a side effect of a bacterial infection b. Is defined as a WBC count of > 11,000/microliter c. Is classified as lymphocytic or myelocytic d. Can be caused by chronic stress 6. Compared to the intrinsic pathway of coagulation, the extrinsic pathway is ______ and requires _______. a. Slower, calcium b. Slower, platelet activation c. Faster, vessel damage d. Faster, thromboplastin 7. In the coagulation cascade, the common pathway begins when: a. damaged tissue cells release tissue factor (thromboplastin). b. platelets adhere to collagen that is exposed on damaged vessels. c. platelets release calcium. d. prothrombin is converted to thrombin by factor Xa. 8. Hemophilia is characterized by: a. Thrombocytosis (excessive platelet count) b. Excessive fibrinogen production by the liver c. Defective production of one (or more) of the clotting factors d. Inadequate production of heparin 9. The lifespan of circulating platelets is about: a. 10 days b. 120 days c. 1 year d. 1 month 10. Each of the following can reduce or inhibit clot formation EXCEPT: a. ADP b. Aspirin 2 c. Vitamin K deficiency d. Hypocalcemia Leukocytes 1. Leukocyte make up what percent of circulating blood volume? a. <1% 2. You should never have over 10,000 leukocytes in your blood but you actually have billions of leukocytes, where are most of them located? a. Lymph nodes in lymphatic system 3. Leukocytes are a “true cell” (T/F) a. True 4. What 4 properties make a leukocyte a true cell? Describe them. a. Diapedesis-used to describe how white blood cells have ability to “walk through walls” i. They squeeze through cells by using connections to trigger cells of wall of vessel to relax b. Ameboid-motion-can use collagen fibers these to crawl toward where they are going like and amoeba c. Chemotaxis- leave trail of chemicals to call other leukocytes for help, the response creates a swelling d. Margination- white blood cells move over to side of blood vessel near an infection 5. Why do Leukocytes need to live longer than the 120 day RBC lifespan? a. They need to “remember” so they can respond quicker. Ex: if you get chickenpox as a child, you will not get it again because the immune system will be able to respond quicker because it will recognize the problem 6. What is Leukopoiesis? a. a form of hematopoiesis in which white blood cells (WBC, or leukocytes) are formed in bone marrow 7. Name the two major lineages of leukopoiesis. a. Myeloid b. Lymphoid 8. What is a band cell? a. An immature version of leukocyte 9. Name some properties of a band cell. a. Granular with nucleus like monocyte b. Not uncommon outside of marrow, but rare c. Large numbers may be indicative of something going wrong in bone marrow d. Normal range = 3-5% of total leukocyte count e. Have more of a horseshoe shape nucleus 10. What is the leukocyte disorder that involves a WBC count higher then 11,000/microliter? a. Leukocytosis (it is a normal reaction if you have a bacterial infection) 11. What is leukopenia? 3 a. A leukocyte disorder of lowered WBC count 12. What can cause leukopenia? a. Medications i. antipsychotics (clonazepam[-old anti-psychotic drug], risperidone) ii. Chemo (kills cells, creates iii. Immunosuppressive (anti-inflammatory may drive WBC count down) b. Chronic stress i. Chronic if lasts longer than 2 or 3 minutes ii. Stress originally meant to get away from predators 13. What leukocute disorder is characterized by high numbers of immature, ineffective leukocytes of that lineage that do not function properly circulating in blood? a. Leukemia 14. What are the two types of leukemia? a. Myelocytic or lymphocytic 15. What is the difference between acute and chronic leukemia? a. Acute is more common in children (respond better to treatment) b. Chronic more common in elderly 16. What makes leukemia so dangerous? a. Makes people highly susceptible to infections and tumors b. Death commonly due to hemorrhage and infection Platelets 17. Platelets are formed from segments of what? a. Megakaryotes 18. Megakaryote: a cell with a big nucleus that says in bone marrow 19. Why do granules on platelets need the growth factor PDGF? a. platelets come into use when something bad happens(usually tissue damage), mitosis needs to be stimulated by PDGF to fill in damaged tissue 20. What is hemostasis? a. Rapid series of reactions to stop blood losses from vessels b. Results in “clotting” known as coagulation *look at picture/diagram on slideshow, especially #2 (the role of serotonin)* 21. Are platelets always active? Why or why not? a. No, they are only active when there is an addition of ADP or thromboxane A2 and it converts to its “superhero” state. b. Because we only want blood coagulation if there is a place that needs repairing, otherwise our blood would clot and clog vessels. 22. What do activated platelets do? a. Adhere to collagen (exposed by damaged vessels) b. Release serotonin (promotes vasoconstriction) c. Release chemotactic agents that i. Attract macrophages and neutrophils 23. What do activated platelets release to tell nearby platelets to activate? 4 a. Thromboxane A2 24. Why can’t we have NSAIDS before surgery? a. They block the formation of thromboxane which prevents blood clotting and the patient could lose too much blood 25. What are the three major results of platelet plug? a. Actin and myosin contract to compact and strengthen plug b. Serotonin and thromboxane A2 cause vasoconstriction c. Plugged platelets release other chemical factors that initiate the next phase: coagulation i. A clog/coagulation is a stable strong closure with tough fibrin web ii. Plug is loose aggregation (blot, don’t wipe blood of patient) 26. Compare and contrast the two pathways for the coagulation-cascade mechanism a. Intrinsic pathway: (contact activation pathway) relies on platelets and platelet factors, slower (3-6 minutes to start) b. Extrinsic pathway: faster at starting (15-20 seconds) i. massaging irritates tissues which stimulates cells to release tissue factor which makes it go faster c. Both form Factor X which helps turn on prothrombin activator, both use calcium d. Final product is a cross-linked fibrin clot no matter which pathway Cardiovascular System: Heart (chapter 19) Heart Anatomy 27. Name and describe the three layers of the wall of the heart a. Epicardium i. Outside of myocardium ii. Folds back on itself and creates pericardial sac which has fluid that reduces friction of heart as it beats iii. Aka, Visceral layer of the serous pericardium iv. Aka, Visceral pericardium b. Myocardium i. Cardiac muscle (makes up most of heart) ii. Wraps the heart iii. Form a spiral of muscle fibers when observed from the bottom up iv. This layer is thicker in left ventricle and thinner in right ventricle v. This maintains a one-way flow of blood vi. It is thicker on the left ventricle because muscle builds up from consistently pumping blood against a greater resistance c. Endocardium i. Innermost layer ii. Composed of simple squamous epithelium tissue called endothelium iii. Endothelium is unique because it does not trigger an immune response, only lines heart chambers and blood vessels 5 Pulmonary and Systemic Circuits 28. What are the 2 separate circuits driven by each side of the heart and name the direction of blood flow for each. a. Pulmonary: right, lungs, left b. Systemic: left, body, right Heart Anatomy: Valves 29. What are the two different Atrioventricular valves? a. Tricuspid (right AV valve) b. Bicuspid (left AV or mitral valve) 30. What are the two Semilunar valves and where is the blood coming from when it enters these valves? a. Pulmonary ( right SL valve) i. Blood coming from right ventricle b. Aortic valve i. Blood leaving left ventricle 31. What is the function of chordae tendineae? a. Anchor the AV valves and keep edges of valve from flapping backwards (keeps blood from flowing back in wrong way) i. Contraction of the papillary muscles and tightening of the chordae tendineae prevents valvular prolapse and ensures one way flow of blood. 32. When you hear a heartbeat, what are you hearing? a. The closing of valves 33. What causes blood to flow into a valve? a. There is less pressure in the valve than in the vein Clinical Pathologies 34. What is a murmur and what causes it? a. Non-sharp sound of the heart caused by loose valves not closing all the way 35. What are incompetent valves? a. Valves that do not close completely and don’t keep blood from going backwards. Cardiac Conduction System 36. What are the two populations of cells in the heart and what are their characteristics? a. Cardiomyocytes (or cardiocytes) i. Cardio muscle cells ii. 99% of population of cells of wall of heart iii. Contract when activated b. Autorhythmic pacemaker cells i. 1% of population of cells of wall of heart ii. Non-contractile iii. Own internal rhythm 6 iv. Spontaneously depolarize themselves and activate cells they are attached to with gap junctions v. Wilhelm His and Jan Evangelista Purkinje examined hearts and found these authorhythmic cells. 37. Does the sinoatrial or atrioventricular node depolarize faster? a. The SA node depolarizes 75 times per minute when taken out of the heart, the AV node depolarizes slower (around 50 times a minute) on its own, but since the SA depolarizes the AV node it sets the pace. 38. What is the sequence of excitation of the heart? a. The SA node activates the atria and depolarizes the AV node which depolarizes the ventricles 39. Although the heart is autorhythmic, what assists in regulating heart rate? a. Central nervous system 40. How does it do this? a. By altering the responsiveness of the conduction system of the heart. i. hyperpolarizing pacemaker cells (makes them more negative which makes beginning point lower so threshold is harder to reach) = less likely to depolarize ii. slightly depolarizing PM cells (makes less negative) = more likely to depolarize b. every cell more positive outside and more negative inside because of sodium (+1 charge) potassium(+1 charge) pump i. becomes more positive as sodium enters, (more negative if potassium goes out) ii. when it reaches the threshold calcium floods in (+2 charge) 41. What are the two forms of extrinsic innervation of the heart and how do they differ? a. Sympathetic (increases heart rate) i. Comes from Cardio-acceleratory center ii. Using Cardiac nerve iii. 230 bpm iv. Neurotransmitters alter the PM cell’s permeability to Na+ and Ca2+ v. allowing some Na+ and Ca2+ to leak in causes slight depolarization = more irritable cells vi. Uses norepinephrine (NE) neurotransmitter b. Parasympathetic (decreasing heart rate) i. Comes from cardio-inhibitory center ii. Uses CN X and cardiac nerve iii. Vagal tone (vagus nerve sends impulses to maintain the normal heartrate at rest-slow it down) iv. Neurotransmitters alter PM cell’s permeability to K+ 1. Allowing some K+ to leak out causes hyperpolarization=less irritable cells 7 42. Know the different aspects of what this graph represents: a. Resting membrane potential for cell (-70mv polarized) in cytoplasm in cell b. When stimulate the cell (bring positive sodium inside) it becomes depolarized and gets closer to zero c. Sodium keeps coming in until hits threshold at +30 where it stops coming (if this were all that happened would level off) but the cell instead repolarizes and potassium begins to leave the cell making it negative again i. Undershoot sometimes happens where it is hyperpolarized (goes under starting negative point) and then goes back to normal 43. Do pacemaker cells have a resting period? Why or why not? a. Not really, “slow” Na+ channels allow Na+ to leak back into cardiac muscle cells (they never really close) b. these cells never really have a stable “resting” potential (get to around -60 and immediately begins to depolarize again) c. rather, they exhibit what are known as pacemaker potentials (because not resting potential) d. at threshold, Ca2+ channels open e. depolarization is due to both Na+ and Ca2+ influx Cardiac v. Skeletal Muscle 44. What are some similarities between skeletal muscle and cardiac muscle cellular anatomy? a. striated (actin-myosin overlapping) b. T tubules, sarcoplasmic reticulum regulates Ca2+ c. sliding filaments (troponin-tropomyosin activated by Ca2+) 45. How is cardiac muscle different from skeletal muscle? a. cardiac muscle fibers are shorter, thicker, branched, and interconnected b. one (maybe 2) centrally located nuclei 8 c. spaces between cells filled with connective fibers acting as insertions for cardiac muscle fibers d. intercalated discs: desmosomes and gap junctions (means cells are electrically coupled: the contraction of one activates the contraction of adjacent cell) –when one cell depolarizes, it depolarizes next cell e. large mitochondria (25-35% of cell volume)-give muscle cells fatigue resistance, so can more rapidly resupply with ATP and not likely wear out(skeletal muscles wear out when you exercise, heart does not) 46. Compare cardiac and skeletal muscle based on: means of stimulation, organ v. motor unit contraction, and length of absolute refractory period. a. Means of stimulation: i. skeletal muscle fibers are stimulated by nerve endings ii. some cardiac cells are auto-rhythmic (can depolarize themselves and the rest of the heart) b. Organ v. motor unit contraction i. skeletal muscle motor unit contraction does not stimulate neighboring motor units ii. the heart either contracts as a coordinated unit, or it doesn’t iii. “functional syncytium” (organ contracts as a single unit) iv. due to gap junctions between adjacent cells c. Length of absolute refractory period i. skeletal muscle: 1 - 2 ms, resulting in a twitch of 15 - 100 ms. (does not force relax, needs to be able to retain contraction) ii. cardiac muscle: 250 ms,(long refractory period-not as much variation) resulting in a 300 ms contraction –forces heart to rest/relax between beats iii. prevents tetany(the retaining of contraction/not relaxing) 47. How does ARP differ in cardiac and skeletal muscle? a. Skeletal muscle has a short ARP so the muscle can respond to a new stimulus before it has relaxed fully. This may lead to tetany, a sustained contraction of the muscle fiber. (this allows you to pick up something heavy and hold onto it) b. The ARP of cardiac muscle spans almost the entire time that it is contracted, preventing tetany (in the heart tetany is deadly because it would stay contracted). c. Repolarization is delayed- caused by calcium flowing into cytoplasm (both from outside the cell and from the SR inside the cell) which causes the cell to remain positive a little longer than in skeletal muscle 9 Cardiomyocytes 48. Calcium causes a plateau phase in myocardial contraction, what is the effect of this? a. delays repolarization which allows the cardiac muscle to reach full potential i. Ca2+ that is needed for contraction enters cytoplasm from both the ECF and the SR. 1. In fact, it’s the Ca2+ influx from the ECF triggers release of Ca2+ from SR ii. The [Ca2+] in the cytoplasm determines the force of contraction (FOC) of the cardiocytes. 1. Calcium concentration is proportional to FOC 2. Later we’ll see how increased FOC ⇒ increased blood pressure 3. Ca2+ channel blockers El Electrocardiogram (ECG or EKG) 49. What does an electrocardiogram measure? a. Measures electrical activity of the heart 50. Explain each letter on the PQRST wave. a. P = atrial depolarization i. What does that mean is happening/where? 1. Ions are moving, so Na+ ions moving into cells of atria b. QRS complex = ventricular depolarization (and technically atrial repolarization) i. What’s happening/where? 1. Na+ ions moving into AD nodes and ventricles 10 c. T = ventricular repolarization i. What’s happening? 1. K+ is going out of ventricle cells ii. What’s event is missing? 1. Atrial repolarization is missing, it is during the QRS complex Heart Sounds 51. What are the first two heart sounds called and what causes each? a. Lubb = 1st heart sound (S1) = closing of AV valves b. Dupp = 2nd heart sound (S2) = closing of SL valves 52. Know where auscultation of each valve is: a. Cardiac Cycle 53. What is the cardiac cycle? How long does one cycle last? a. all events associated with blood flow through the heart during one complete heartbeat b. about 0.8 seconds during resting heart rate 54. What is the difference between diastole and systole? a. diastole (cardiac muscle relaxing) b. systole (cardiac muscle contracting) 55. Name the 4 major phases and if they are diastole or systole. a. Ventricular filling (to fill the ventricles must relax) i. diastole b. Isovolumetric contraction i. systole c. Ventricular ejection i. systole d. Isovolumetric relaxation i. Diastole 11 56. The phases and what happens in each: a. 1.Ventricular Filling i. AV valves open; SL valves closed ii. rapid filling begins when atrial pressure > ventricular pressure iii. passive filling 1. due to lower ventricular pressure, which is… 2. due to increased ventricular volume as ventricles relax iv. diastasis = filling slows v. ventricles fill to 70-80% of capacity b. 1c. Atrial Systole i. AV valves still open; SL valves still closed ii. signaled by P wave 1. SA node fires iii. Atrial pressure increases, blood pushed into ventricles iv. ” adds 20-30% more to ventricle’s final volume (EDV) (their one big job) v. EDV = 120-140 mL 1. Reaches End Diastolic Volume (around 120 or 140) c. 2. Isovolumetric Contraction (first sound) i. AV valves slam shut causing S1 sound 1. SL valves don’t open yet ii. Signaled by QRS complex iii. Ventricles contract until their pressure exceeds pressure in aorta (or pulmonary artery) d. 3. Ventricular Ejection i. AV valves still closed; SL valves burst open ii. Rapid initial ejection which slows down as pressures equalize iii. T wave signals ventricular diastole iv. ESV = 60 mL (End Systolic Volume) v. Stoke volume (60-80 mL)- amount pumped out for one contraction e. 4. Isovolumetric Relaxation i. AV valves still closed; SL valves slam shut causing S2 ii. SL valves shut because pressure in ventricles < aortic (and pulmonary) pressure because… iii. T wave causes ventricles to relax and rebound, expanding, increasing volume/decreasing pressure iv. (…and back to ventricular filling) v. (between S1 and S2 the ventricles empty) 57. Does the heart ever rest? a. Yes, it is called quiescence and it lasts about 0.4 seconds (about half the cycle) when neither atria or ventricles are contracting, the mitochondria are recharging ATP 12 13


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