COMPLETE HA&P II Exam 2 Lecture Objectives Study Guide
COMPLETE HA&P II Exam 2 Lecture Objectives Study Guide Biol 2230-001
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Clemson University Spring 2016 Human Anatomy and Physiology II Exam 2 Lecture Objectives Blood General Information about Blood: • Blood is a type of connective tissue and it is the only liquid tissue in the body • Cells are embedded in the background matrix (liquid portion) of the blood • Blood is contained within blood vessels • The body has about 5 L (Gallon and half) of blood + 8% of body weight is made up of blood • Blood temperature: About 100 degrees F, which is above normal body temperature à Allows heat exchange in maintenance of body temperature -‐ Ex: Blood can be shunted from the surface to the core to increase temperature • Blood pH: 7.35-‐7.45 1. List the functions of blood. • Delivers oxygen as well as nutrients -‐ Ex: Glucose and oxygen are the 2 major components for cellular respiration • Transports metabolic wastes -‐ Ex: In cellular respiration, active cells produce waste like carbon dioxide that is sent back into the blood for disposal -‐ Ex: Break down of proteins through deamination releases 3 NH as a waste product that is transported to the kidneys to be eliminated through urine • Transports hormones (Chemical messengers) that can affect cells with the specific cell receptor • Maintains body temperature • The pH of blood is confined to a narrow range that is slightly on the basic side of neutral (7.35-‐7.45) + has buffers to help regulate pH • Because blood is a liquid tissue, it is responsible for maintaining fluid volume -‐ Blood has to go through interstitial cells in order to enter cells and also comes back out of cells through the interstitial space to enter back into the blood stream (Many factors affect this) • Components of the blood prevent blood loss: Clotting proteins/factors à Ex: Damage occurs to a blood vessel and the blood components help seal off the blood vessel in order to not lose blood • Functions in preventing infection as a part of the immune system à Has immune cells, anti-‐bodies, etc. 2. Describe the composition of whole blood. • Components: Formed Elements- Erythrocytes -‐ The liquid portion of the blood contains the formed elements – These include cells, cell residue, etc. -‐ Erythrocytes: Red blood cells that function in carrying respiratory gases (Mainly oxygen) -‐ Red blood cells can carry carbon dioxide too, but this is not the primary method of its transport in the body -‐ 45% of the total blood volume is made up of red blood cells -‐ Red blood cells are not really living cells: All are produced in the bone marrow, and once the living cells reach a point where they leave the bone marrow, they no longer perform mitosis and divide and have lost the nucleus and organelles; therefore, these are considered to be dying cells -‐ Some red blood cells last for decades and others for a few minutes • Components: Formed Elements—Leukocytes -‐ Leukocytes are true living cells with nuclei, organelles, and the ability to reproduce -‐ Assist in immunity along with the immune system -‐ Less than 1% of the total blood volume is made up of white blood cells -‐ Each type of leukocyte cell has as separate function, but together they all function for immunity • Components: Formed Elements—Platelets -‐ Platelets are fragments of other cells (AKA thrombocytes) à Includes pieces of plasma membranes and cytoplasm that have been pinched off of other cells -‐ Within platelets, there are vesicles that contain proteins that are involved in blood clotting -‐ Leukocytes and platelets combined make up less than 1% of the total blood volume • Components: Plasma -‐ Liquid portion of the blood -‐ Plasma makes up 55% of the blood volume -‐ Hematocrit (Diagnostic Test): o Used to observe the different proportions of the components (Erythrocytes, leukocytes, platelets, and plasma) in the blood o Have a capillary tube that draws blood up from a pricked finger that is put into clay, has one end plugged and centrifuged so the blood separates into its different components o Results: Slightly less than half = red blood cells, slightly more than half = plasma, and the green color (In picture) = white blood cells and platelets combined o Used to determine anemia, sufficiency of blood cells, and excess blood cells • Composition of Plasma -‐ The plasma is 90% water -‐ Contains other substances in solution (Many are proteins + non-proteins) o Albumin: Most common in blood (Produced by the liver) o Globulins: Immune proteins (Ex: Gamma globulins) o Enzymes o AA Based Hormones -‐ Non-‐proteins: o Nitrogenous waste o Nutrients such as glucose + others that are transported throughout the body o Electrolytes: Charged ions such as calcium and sodium o Respiratory gases (Some are transported through red blood cells and others through the plasma—liquid portion of blood) 3. Describe the structure, function and production of erythrocytes. • Red blood cells are small, biconcave cell remnants that do not have a nucleus or organelles • The purpose for the loss of the nucleus and organelles is so that a pigment protein called hemoglobin could be fit inside the structure in order to be able to carry oxygen • Red blood cells also contain antioxidant enzymes that eliminate free radicals (Excess hydrogen ions that have escaped and become toxic to the body) • On average there are about 5 million red blood cells/mL of blood between men and women • Men have a higher amount of red blood cells though (5.1-‐5.8 million) and females have (4.3-‐5.2 million) • Erythropoiesis -‐ Hematopoiesis: Means “production of blood cells” o Erythropoiesis (Production of red blood cells) and leucopoiesis (Production of white blood cells) are types type of hematopoiesis o An ounce of blood is produced a day and will contain 100 billion cells o The types of blood cells produced depends on the needs of the body o Ex: When exercising, more oxygen is needed so red blood cells are produced more o Ex: Stress causes body to catch a cold so more white blood cells are needed o All hematopoiesis occurs in the bone marrow o In the bone marrow, there is a hemocytoblast (Hematopoietic stem cell)= Pluri potent cell that can give rise to a number of different cells and not just one type (Red or white blood cells) -‐ Erythropoiesis Steps: Process takes 3-‐5 days to complete o Hemocytoblast produces a myeloid stem cell, which is also a pluri potent cell (Can produce red or white blood cells) o Myeloid stem cell à proerythroblast à early erythroblast à late erythroblast à normoblast o Normoblast loses its nucleus and organelles, and it accumulates hemoglobin molecules and becomes a reticulocyte o The reticulocyte leaves the bone marrow and matures in the blood stream (NOT the bone marrow) to become a fully functional erythrocyte -‐ Regulation of Erythropoiesis o Erythropoietin: Produced in the kidney § Kidneys asses the level of oxygen in the blood § When it is detected that there is a need for more oxygen, erythropoietin is released and signals the bone marrow to make more red blood cells § *Red blood cell formation is based on oxygen concentration and NOT the number of red blood cells o Testosterone: § Stimulates the kidneys to release erythropoietin § Males have higher levels of testosterone than females à Why males have more red blood cells à More iron in the body, which has shown a link to heart disease § There is evidence that males donating blood 4 times per year helps reduce risk of heart disease (Applies for females after menopause as well—before blood is lost through menstruation) o Iron: § If there isn’t iron present, hemoglobin cannot be produced to carry the oxygen § Body compensates by storing iron (From diet) in the forms of ferritin and hemosiderin § When the body transports iron to the bone marrow for red blood cell formation, it is transported in the transferrin form § Red blood cells are essentially dead cells, and when they are broken down, the body attempts to salvage the iron by converting it back to transferrin to transfer to the liver to reconvert in the storage form of hemosiderin to be recycle § Overall: Iron is needed to make hemoglobin, and hemoglobin is needed to make red blood cells o B vitamins: Especially B12 and Folic Acid § When a female becomes pregnant, she consumes a daily prenatal vitamin that has many B vitamins to make sure there is enough oxygen being produced for her and the baby o Dietary nutrients: § Enough dietary nutrients is needed to be able to create the red blood cells in the first place § Includes proteins, lipids, and carbohydrates that are all necessary to make the plasma membrane and organelles (In the bone marrow) § Overall: Dietary and chemical signals are all a part of the erythropoiesis process • Erythrocyte Longevity -‐ Erythrocytes last on average for about 4 months -‐ Old ones are phagocytized by macrophages à Heme is split off the globin as a result and is transported to the liver to be re converted and stored as hemosiderin and ferritin that is bound to proteins -‐ The hemoglobin molecule is converted to bilirubin that is picked up by the liver and converted into bile -‐ Bile aids in digestion of lipids and is constantly being produced by the liver but can be stored in the gallbladder when it’s not needed -‐ Some of the breakdown of bilirubin (Pigment portion) is expelled in feces and turns the color brown -‐ Some of the globin is broken down to amino acid constituents that are put into storage to later be used to rebuild other proteins -‐ Overall: The erythrocyte is recycled as much as possible, but it still loses some components in general 4. Describe the chemical make-up of hemoglobin. • Hemoglobin o Hemoglobin is a combination of globin (Protein) and heme (pigment) o Heme pigment makes our blood red (With or without oxygen attached to the heme) o Globin protein bound to heme pigment = hemoglobin • Globin o Globin is complex protein with 4 subunits (4 polypeptide chains linked together) à Means this has quaternary structure because there is more than one subunit o Of the 4 subunits, there are 2 alpha and 2 beta that are all linked together o Each of the 4 globin subunits attaches to a heme • Heme -‐ Heme pigment contains iron that is attracted to oxygen (oxygen binding iron) • Hemoglobulin -‐ The center core of each subunit is the heme that binds to one molecule of oxygen so that it carries a total of 4 molecules of oxygen -‐ There are 250 million hemoglobulin molecules in an individual red blood cell so that each one carries 1 billion oxygen molecules -‐ Oxygen plays an important role with the oxidation of glucose and obtaining energy (All active cells require a lot of energy so the 5 million red blood cells/mL of blood is really helping out) • Oxi- vs. Deoxyhemoglobulin -‐ Oxygen dissociation curve -‐ Oxihemoglobin (Deep scarlet red): When oxygen is bound to hemoglobin o Deoxyhemoglobin (Purplish-‐red): When there is no oxygen bound to hemoglobulin o Hemoglobin is a carrier molecule that picks up oxygen where levels are high in the lungs and releases it in places where oxygen is low in active cells o Have an S-‐shaped curve (NOT linear) à Tells us that deoxyhemoglobulin starts to pick up oxygen and this changes the affinity for oxygen – Means that once hemoglobulin has the first oxygen bound, it is able to bind to more oxygen more quickly and the molecule does not like to give the oxygen up o Overall, deoxyhemoglobulin progresses to oxyhemoglobulin based on concentration gradients and affinity for oxygen • Carbaminohemoglobulin -‐ Carbaminohemoglobulin means that the globulin part is bound to carbon dioxide -‐ Hemoglobulin is able to transport only about 20% of carbon dioxide as a result; The rest is carried in the plasma -‐ Plasma is made up of 90% water, so when carbon dioxide enters the water it’s transfored into carbonic acid à dissociates to form bicarbonate (HCO ), 3which is the form in which carbon dioxide is transported in throughout the body 5. Define diapedesis. • Greek: dia; pedan-‐ Means “to go through, leap” • Ability for a blood cell to the leave the blood vessels in the passing of circulation • Red blood cells are incapable of diapedesis—They stay in circulation • Some white blood cells are able to diapedese (Monocytes) 6. List the classes, structural characteristics and functions of leukocytes. • Leukocytes -‐ Complete cells with nuclei and organelles -‐ Display positive chemotaxis: Release chemicals in an area so that other white blood cells will migrate towards that area—attraction to an area (Pass through circulation) -‐ White blood cells make up < 1% of total blood volume à 4,800 -10,800 WBC/uL of blood • Leukocytes -‐ 2 Types: a) Granulocytes: Contain granules in vesicles 1. Neutrophils: o Most common of all white blood cells (Account for 50-‐70% of white blood cell population) o Multilobed nucleus (Key characteristic) o Contain granules o Phagocytic cells o Function during inflammatory response—Part of the immune response in tissue repair and inflammation 2. Eosinophils: o Make up 2-‐4% of all white blood cells o 2 lobed nucleus—Often looks U-‐shaped o Contain enzymes in their granules that digest parasitic worms 3. Basophils: o Make up 0.5-‐1% of all white blood cells o Contain histamines in their granules that 1) Dilate blood vessels so that more blood is delivered to specific spot 2) Promotes the attraction of other white blood cells to that area b) Agranulocytes: Don’t have granules 1. Lymphocytes: o Second most numerous white blood cells (Account for 25%) o Most of the cell is made up of the nucleus o Major immune cell: Includes T-‐lymphocytes (Attack viruses and tumors) and B-‐lymphocytes (Attack bacteria and produce antibodies) o Predominantly found in the lymphoid tissue 2. Monocytes: o Make up 3-‐8% of all white blood cells o Have a U-‐shaped nucleus o Largest in size of white blood cells o Phagocytic cells o Able to diapedese: Can leave circulation to differentiate into highly mobile macrophages (Phagocytic + activate lymphocytes to mount the immune response) 7. Describe leucopoiesis. • Leukopoiesis -‐ Hemocytoblasts (Stem cell in the bone marrow) give rise to myeloid stem cells (Produce all other formed elements) and lymphoid stem cells (Produce lymphocytes) • Granulocyte Leukopoiesis -‐ Hemocytoblasts à myeloid stem cells à myeloblasts (Committed cell that can only become a granulocyte at this point) -‐ Myeloblasts accumulate lysosomes (Granules) to become promyelocytes that differentiate into myelocytes -‐ Cell division stops here at the myelocyte stage so that nuclei start to arch to form band cells à Nuclei constrict and segment so that the myelocyte (Do have accumulated granules) becomes a mature granulocyte • Agranulocyte Leukopoiesis: Monocytes -‐ Hemocytoblasts à myeloid stem cells à monoblasts (Committed cell that can only become an agranulocyte at this point)à promonocytes -‐ Promonocytes leave the bone marrow to become monocytes in lymph tissues (Can last for months) • Agranulocyte Leukopoiesis- Lymphocytes -‐ Hemocytoblasts à lymphoid stem cells (Committed cell that produces agranulocyte-lymphocytes) à lymphoblasts à prolymphocytes -‐ Prolymphoctes leave the bone marrow and become mature lymphocytes in the lymph tissue -‐ Specifically: T and B lymphocytes comes from lymphoid stem cells • Regulation of Leukopoiesis -‐ Interleukinsà Accumulation stimulates luekopoiesis in the bone marrow -‐ Colony-Stimulating Factors (CSF’s) à Accumulation stimulate leucopoiesis in the bone marrow 8. Describe the structure, function and formation of platelets. • Platelets -‐ Anucleated cytoplasmic fragments of megakaryocytes à Does not contain organelles either and are essentially chunks of pinched off cytoplasm + granules -‐ Granules contain clotting chemicals -‐ Role of platelets is to cause blood clotting • Thrombopoiesis -‐ Old name for platelets = thrombocytes -‐ Hemocytoblasts à myeloid stem cells à megakaryoblasts (Committed cell) -‐ Megakaryoblasts undergo repeated mitosis but no cytokinesis to form megakaryocytes where its cytoplasmic extensions break off to be platelets • Regulation of Thrombopoiesis -‐ Thrombopoietin: oHormone that stimulates platelet formation in the bone marrow when they’re needed by the body 9. Give examples of disorders caused by abnormalities of each of the formed elements. • Erythrocyte Disorders -‐ Anemias: o In terms of any time the blood has a low oxygen carrying ability o Insufficient numbers of red blood cells—Can’t carry enough oxygen o Have irregularly shaped red blood cells like in sickle cell anemia that have a crescent moon shape—Can’t properly hold oxygen -‐ Polycythemia: o Too many red blood cells packing blood vessels o Leads to inability to push through blood vessels and makes the blood sludge-‐like and incapable of delivering oxygen to any tissues • Leukocyte Disorders -‐ Leukemia: o Cancer of white blood cells o Abnormal cell division -‐ Infectious mononucleosis: o White blood cell disorder that is in response to an infection from the Epstein-‐Barr virus o Epstein-‐Barr virus causes can increase in the production of agranulocytes (Excessive amounts) -‐ Leukopenia: oDeficiency in the number of white blood cells 10. Describe the process of hemostasis, differentiating the intrinsic pathway from the extrinsic pathway. • Hemostasis -‐ Hemostasis = prevent blood loss = function of platelets -‐ Blood is a fluid tissue that is contained within blood vessels all the time -‐ Few cells that are able to move out of circulation and pass across the wall of blood vessels = diapedesis; Most blood cells can’t do this -‐ Damage to blood vessels would result in blood loss so this is where hemostasis comes into play -‐ 3 Major Steps of Hemostasis: a) Vascular spasm: o When the blood vessel is damaged and is cut/open, the blood vessel immediately constricts o Constriction of the blood vessels slows down the passage of blood and therefore the loss of blood b) Platelet plug formation: o Platelets will collect at the site of damage o There is a chemical signal that causes the platelets to stay where there is constriction of the blood vessel as it still bleeds c) Coagulation: o Blood clotting occurs and there is coagulation o Damage to the blood vessel is plugged with a blood clot to prevent the loss of blood, and this stimulates the repair of the blood vessel o The blood vessel will grow back together as a result and become an integral unit again • Platelet Plug Formation -‐ Blood vessel has to be damaged for there to be an accumulation of platelets -‐ When there is damage to a blood vessel, underlying connective tissue, specifically collagen fibers, are exposed to the blood -‐ Also, damage to a blood vessel causes the accumulation of 2 chemicals that cause platelets passing by to stick at the site of damage (Stick to the collagen fibers): a) von Willebrand Factor: Plasma protein that’s already in the blood, but as blood passes by the damaged vessel this protein will accumulate due to the exposure of the collagen fibers b) The damaged blood vessel itself releases thromboxane A = 2 prostaglandin (A paracrine = local signaling molecule) that accumulates at the damaged site -‐ Once the platelets are attached to the site of damage due to von Willebrand factor and thromboxane A , thrombin ac2ivates platelets to break down and release their contents from their granules (Clotting factors) -‐ Important to not plug the whole blood vessel as it’s being repaired or else blood won’t be able to pass through • Intrinsic Pathway to Coagulation (First way involving action of platelets) -‐ After the platelets form, coagulation follows = gelling of blood at the site of damage (A very complex process) -‐ Coagulation involves a series of reactions in which clotting factors are converted to active forms -‐ Ultimately aggregated platelets are stimulated to dump their contents from their granules (clotting factors) to lead to coagulation and release PF 3 -‐ PF ac3 es a bunch of intermediates (10 steps Not discussed here), which results in the activation of factor X -‐ Once factor X is activated, it combines with calcium, PF and f3ctor V to form prothrombin activator -‐ Prothrombin activator activates prothrombin and catalyzes the conversion of prothrombin (Inactive form) to thrombin (Active form) -‐ Thrombin catalyzes the polymerization of fibrinogen into fibrin (Active form) that surrounds the accumulated platelets like a hairnet to hold everything together in place -‐ Thrombin also activates factor XIII, which links fibrin strands together and makes a mesh -‐ *There are 13 clotting factors in total • Extrinsic Pathway to Coagulation -‐ Extrinsic pathway aids the intrinsic pathway in making the blood clot -‐ The extrinsic pathway is a short cut that skips some intermediate steps so that instead of relying on the platelets to release their contents of clotting factors from their granules, the damaged cells of the blood vessel release chemicals -‐ These chemicals = tissue factor (That is in addition to the thrombxoin A being released), which interacts with PF to allow a short cut to 2 3 factor X activation) -‐ Tissue factor helps the coagulation process and speeds it along, but it’s important to note that it won’t do this alone because PF comes3 from 11. List factors that limit clot formation. • Limitations to Platelet Plug -‐ Intact endothelial cells secrete PGI (prostacyclin)=2A prostaglandin that prevents platelets from sticking to where it is secreted on healthy cells -‐ Heparin is also secreted by healthy intact endothelial cells that prevent platelet attachment -‐ Vitamin E quinone: Vitamin E is a blood thinner that prevents platelets from adhering -‐ Essentially, the body regulates where a clot is needed and where it isn’t needed efficiently • Clot Limiting Factors -‐ Clotting factors are released by platelets that cause the clot to accumulate but with blood still flowing through the damaged blood vessel, some of the chemicals are transported away and diluted so that they aren’t having an effect on the clot itself in order to make sure that the clot doesn’t get too big -‐ Antithrombin III inactivates thrombin, which in turn slows down the clotting process -‐ Protein C inhibits the intermediate steps in the activation of factor X in the intrinsic pathway events (Caused by platelets) -‐ Heparin: Produced by intact endothelial cells that enhances antithrombin III and inhibits the intrinsic pathway events in order to keep the clot from getting too big 12. Explain how the processes of retraction and fibrinolysis relate to the natural elimination of a blood clot. • Clot Retraction -‐ As the blood vessel is repairing itself, it is necessary to break down the clot slowly so it is not released all at one -‐ Platelets contained within their granules have proteins involved with retraction (Contractile proteins) -‐ The contractile proteins pull to contract, and as they contract, they cause the platelets to contract and squeeze out serum out of the blood clot so that it becomes harder, denser, and smaller -‐ As the blood vessel starts to contract, it pulls the two edges of the blood vessel together to have tissue repair -‐ PDGF (Platelet Derive Growth Factor) is released by the platelets as they start to break down and stimulates healing of the blood vessel by stimulating cell divisionà Granulation tissue forms and there is regeneration of the tissue so that the epithelium and connective tissue are in tact o Another way of explaining: As platelets start to breakdown and the clot is shrinking, platelets release PDGF chemical that tells neighboring cells to start dividing so that the blood vessel repairs itself -‐ With the blood vessel fixed, the clot is even smaller and still needs to be broken up (Don’t want to release it at one time) • Fibrinolysis -‐ Fibrinolysis: Process of breaking down fibrin—Clot is broken apart as a result of the blood vessel being healed -‐ Fibrin mesh must be broken up slowly so that small pieces are released into circulation and can be phagocytized, otherwise the whole rest of the clot could lodge into blood vessels of the lungs or brain and cause death -‐ New endothelial cells produce plasminogen activator (AKA TPA), which activates plasminogen that is released by the clot -‐ The clot produces plasminogen that is activated to plasmin due to the new endothelial cells that were produced during blood vessel repair -‐ Plasmin digests the fiber 13. Identify the hemostatic disorders. • Thromboembolytic Disorders: Excessive blood clot production -‐ Thrombus: o Forms a blood clot in healthy blood vessels o Stationary à it blocks the flow of blood o This can become an issue with long-‐distance plane flights where people don’t move their legs frequently • Embolism: -‐ Blood clot that moves through the body and it ultimately finds an area that it can’t pass through à clog up -‐ Bleeding Disorders: Insufficient blood clot production • Thrombocytopenia: -‐ Insufficient amount of platelets in the body -‐ Reduction of platelets due to disease/pathology such as an infection • Hemophilia: -‐ Genetic disorder that causes excessive bleeding -‐ Individual isn’t able to produce one of the clotting proteins since he/she doesn’t have a gene for the protein so blood clot can’t be produced -‐ Can apply for any of the 13 clotting factor proteins but can be an extra problem with some of the more important ones that were discussed 14. Describe the ABO and Rh blood groups (Human Blood typing). • Determined by the presence of agglutinogens = ABO and Rh (D) • Agglutinogen: Some people refer to them as antigens, but antigens actually are a marker that stimulate the immune system to attack it • Agglutinogens would human blood typing are found on the surface of red blood cells • A agglutinogen on a red blood cell = Blood type A • B aggultinogen on a red blood cell = Blood type B • A and B agglutinogens on a red blood cell = Blood type AB • Neither A or B agglutinogens on a red blood cell = Blood type O • Rh factor = AKA D agglutinogen • Ex: If have A agglutinogen + Rh (D) agglutinogen = A+ • If the Rh (D) is not present on the surface of the red blood cell, then there is a “—“ after the A, B, AB, or O blood type • All 3 agglutinogens present on the surface of a red blood cell = AB+ • Agglutinogens (Markers) on red blood cells determine agglutinins à -‐ Blood type A produces anti-‐B agglutinins, which attacks cells with the B agglutinogen (Why blood type B cannot be donated and mixed with blood type A) -‐ Blood type B produces anti-‐A agglutinins, which attacks cells with the A agglutinogen (Why blood type A cannot be donated and mixed with blood type B) -‐ Blood type AB produces neither anti-‐A agglutinins or anti-‐B agglutinins (Universal recipient) -‐ Blood type O produces anti-‐A agglutinins and anti-‐B agglutinins (Can only accept O blood type) • Individual with blood type O -‐ = universal donor because it has absolutely no agglutinogens so any blood type has nothing to attack • Re-‐emphasis: Individual with blood type AB+ is the universal recipient because it doesn’t produce any agglutinins (Won’t reject any blood type) • Hemolytic Disease of Newborn or Erythroblastosis Fetalis: -‐ If a female is Rh (D)-‐ and she gets pregnant with a baby that is Rh (D)+ = male is Rh (D)+ then the first baby is ok -‐ Rh (D)+ accumulates as a result in the mother -‐ The second baby is not ok because as soon as it is born, its blood coagulates so that it dies shortly after birth -‐ Important for mother with Rh (D)-‐ to receive a shot of rhogam, which suppresses production of anti RH (D) agglutinins (Often times given to mother regardless of blood type) The Heart 1. Describe the location and orientation of the heart. • Heart is about the size of a fist à Make fist with hand and put at the center of chest à Oriented at an angle and is located in the mediastinum cavity • Base of the heart = Top • Apex of the heart = Bottom • This is because embryologically speaking the heart is right side up so that the apex is at the top but during the developmental process, there is d-‐ looping so that it turns upside down 2. Name the coverings of the heart. • The heart is covered by a sac-‐like structure = pericardium that has 2 parts: a) Fibrous pericardium: -‐ Outer most part (most superficial) that is made of dense connective tissue that protects it b) Serous pericardium: -‐ 2 layered sac that contains the parietal layer (belongs to the cavity) and the visceral layer (belongs to the organ) -‐ The visceral layer is the outer most layer of the heart itself = epicardium -‐ In between the parietal and visceral layers is the pericardial cavity which is filled with pericardial fluid that protects the heart by preventing friction when it beats + help dissipate heat so that the heart muscle doesn’t fatigue 3. Describe the structure and the function of the three layers of the heart. • Epicardium: Outer-‐most layer of the heart = visceral layer of the serous pericardium • Cardiac muscle: Myocardium • Endocardium: Lining of the heart; Squamous epithelial tissue with a little connective tissue underneath it *Squamous epithelial tissue lines all the blood vessels in the body 4. List the chambers and anatomical landmarks of the heart. • The human heart is divided into 4 chambers à 2 atria are located at the base (Top) and 2 ventricles are located at the apex (Bottom) and they are all separated from each other • The left ventricle has a thicker myocardium in its ventricular wall because it has to send blood throughout the entire body • The right ventricle only sends blood to the lungs so not as much force is required • All 4 chambers of the atria and ventricles are separated • The 2 atria are separated by interatrial septum • Before birth, the blood enters the baby’s right atrium and short-‐cuts to the left atrium since the blood doesn’t have to go to the lungs for oxygen because it’s not breathing • After birth, the little hole between the 2 atria is officially and completely closed as the baby takes its first breath and then the interatrial septum is present • The 2 ventricles are separated by the interventricular septum -‐ On top of the interventricular septum, there is a groove where there are the coronary arteries and veins that supply blood to the heart muscle that are protected by a lot of fat • On the outside of the heart, there are special markings that can indicate whether or not the front or back is being looked at: -‐ Coronary sulcus: Runs down at a diagonal on the front of the heart -‐ Interventricular Groove: On the back of the heart, this groove runs straight up and down the heart 5. Describe the structure and composition of the heart chambers. • Atria: Auricles -‐ Atria hold blood -‐ Auricles: Looks like an ear flap that is found inside the atria and it creates an extension to increase the surface area for the atrium to be able to hold more blood • Atria: Pectinate Muscles -‐ Located on the upper surface of the atria, there are bands of muscle fibers = pectinate muscles -‐ Pectinate muscles help the atria to contract and push blood into the ventricles • Atria: Fossa ovais -‐ The fossa ovais is the opening in the embryo where blood shortcuts from the right to left atrium -‐ The fossa ovais closes immediately when the baby takes its first breath after being born à The blood has to go from the right atrium to the right ventricle in order to go to the lungs and come back to be pumped to the rest of the body • Ventricles: Trabeculae carneae -‐ Trabeculae carneae: Muscle bundles that make up the walls of the ventricles; Extend into the ventricles • Ventricles: Papillary muscles -‐ Papillary muscles: Extend off the walls of the ventricles that are connected to the caps of the valves of the heart -‐ Contract to tense the right and left atrioventricular valves via the chordae tendineae just before ventricular systole 6. Trace the pathway of blood flow through the heart, including the major blood vessels. • All blood from the blood enters the right atrium (NOT the lungs) via the vena cava • 2 parts of the vena cava: 1) Superior vena cava: Blood from the head (Above the heart) 2) Inferior vena cava: Blood from below the heart • Coronary Sinus: -‐ Coronary arteries and veins feed the myocardium -‐ The coronary veins come together to feed into the coronary sinus à right atrium -‐ Found on the back of the heart (Can tell it’s the back by the groove that is straight up and down) • Pulmonary veins -‐ There are right and left pulmonary veins (For the right and left lungs) that meet together and empty into the left atrium of the heart -‐ Pulmonary veins = The most oxygen rich blood vessel in the body (Returning oxygenated blood from the lungs) • Pulmonary artery -‐ Pulmonary artery carries oxygen-‐poor blood -‐ Blood leaves the right ventricle to through the pulmonary artery to go to the lungs to be oxygenated • Aorta: The left ventricle connects to the aorta, which pumps blood throughout the body 7. Differentiate the pulmonary and systemic circuits. • Pulmonary Circuit: -‐ Deoxygenated blood is delivered to the right atrium that ultimately sends it to the right ventricle via the pulmonary trunk to be pumped to the lungs for the pick up of oxygen and the release of carbon dioxide (Gaseous exchange) • Systemic Circuit: -‐ Oxygenated blood re-‐enters the left atrium via the pulmonary veins à left ventricle to be send out to the rest of the body for the drop off of oxygen and pick up of carbon dioxide to be disposed of • Tracing the flow of blood through the heart:Start with vena cava Blood from the inferior and superior vena cava enter the right atrium à tricuspid atrioventricular valve à right ventricle à pulmonary semilunar valve à pulmonary artery à lungs, where have capillary bed where gaseous exchange occurs à pulmonary vein (Blood is oxygen rich at this point) à right atrium à bicuspid (mitral) atrioventricular valve à left ventricle à aortic semilunar valve à aorta à tissues of the body where there are capillary beds that off-‐load oxygen and pick up waste à vena cava 8. List the major coronary arteries and veins. • Arteries: Deliver oxygenated blood to the heart -‐ Coronary arteries (Left and right coronary arteries direct blood flow directly to the heart that is supplied by the aorta) -‐ Anterior interventricular artery -‐ Circumflex artery -‐ Marginal artery -‐ Posterior interventricular artery • Veins: Pick up deoxygenated blood from the heart + coronary veins empty into the coronary sinus à vena cava à right atrium -‐ Great cardiac vein -‐ Middle cardiac vein -‐ Small cardiac vein -‐ Anterior cardiac vein • Coronary arteries and veins are located all around the heart that all go to the same place à Location known as an anastosome 9. Identify the name and location of the valves that control the flow of blood through the heart. • Atrioventricular Valves -‐ Blood flows through the heart and it’s the blood that creates the pressure for it to travel throughout the body—It moves from high to low pressure to conduct movement -‐ Ex: Blood going from the right atrium (greater pressure) to the right ventricle (lesser pressure)—The creation in these pressure differences + the contraction of the heart creates the necessary increase in pressure for the blood to be pushed along à Structures are therefore necessary to regulate the flow of blood or else the blood wouldn’t leave the heart -‐ In general, blood flow is regulated by structures = valves and response to pressure (Results from contraction of the heart) • Tricuspid valve: -‐ Atrioventricular valve (AV) -‐ Located on the right side of the heart in between the right atrium and right ventricle -‐ Thickness of the right ventricle’s wall is thinner because it doesn’t need to generate as much pressure since it is delivering
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