Anatomy & Physiology 2 Exam Three Study Guide What are the functions of blood? -delivers nutrients (glucose, oxygen), removes waste -delivers hormones -protection (delivers antibodies, WBC's, clotting) -helps redistribute heat -helps maintain acid-base balance What is blood made of? -plasma (water in blood) - 55% of blood -formed elements (white & red blood cells) *red bloodWe also discuss several other topics like sphg
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cells - 45% of blood (aka Hematocrit) What are erythrocytes? -red blood cells, are biconcave (increases surface area) -no nucleus, a third of it is hemoglobin -one cell holds one billion molecules of oxygen Where are erythrocytes made? -made in red bone marrow (myeloid tissue/hematopoietic tissue) -myeloid tissue/hematopoietic tissue contains stem cells called hemocytoblasts (blood cell builders, literally) -as a stem cell, it can become a myeloid or lymphoid stem cell, which can become many types of blood cells What is erythropoiesis? -the creation of an RBC -begin w/ myeloid stem cell, ejects nucleus, becomes reticulocyte (immature RBC in tissue that enters the blood stream) -reticulocyte matures into an erythrocyte once in the blood *a reticulocyte count in a blood test give you a good measure of RBC production How does hypoxia influence RBC production? -hypoxia = low blood oxygen, can be caused by anemia, high altitudes -causes kidney & liver to produce erythropoietin (EPO) which goes to red bone marrow & causes cells to mature rapidly, increasing RBC count (and increasing blood's ability to carry oxygen) -2 million blood cells die & are reborn every second -EPO used by athletes to give them greater capacity to hold oxygen, also used in chemotherapy & in people w/ failing livers What is the structure of hemoglobin (within a RBC)? -made of 4 globular proteins (globin) & 4 heme groups (with iron molecule inside) -one hemoglobin can carry 4 molecules of oxygenWhat is the life cycle of an RBC? -lasts 120 days -aged/damaged RBC's pile up in spleen, liver, bone marrow -macrophages (WhiteBC's) engulf RBC's, recycling heme & globin -globin broken down into amino acids, put in blood stream -heme's iron is attached to a protein, stored in liver/spleen -biliverdin (the rest of heme's components) are converted to bilirubin, put in liver, which dumps it into bile *bilirubin gives bile the yellow color, & poop it's brown color What are the functions of RBC's? -deliver oxygen -remove carbon dioxide & hydrogen, carry as waste -maintain acid/base balance -container for hemoglobin What is anemia, hypoxia, hypoplastic anemia, pernicious anemia, iron deficiency, hemolytic anemia, and polycythemia? 1) anemia: too few RBC's/hemoglobin -can lead to very thin blood fluid = overworked heart b/c blood flows so fast (can have hypoxia: low oxygenated blood) 2) hypoplastic anemia: too few RBC's/hemoglobin due to red bone marrow damage (from radiation, drugs, viruses) -treatment: bone marrow transplant 3) pernicious anemia: too few RBC's/hemoglobin due to deficiency in B12 (which is needed to make DNA) -treatment: B12 supplement or shot 4) iron deficiency: too few RBC's/hemoglobin due to low iron intake or blood loss -treatment: iron supplement 5) hemolytic anemia: too few RBC's/hemoglobin due to RBC being lysed open, has shorter lifespan (from malaria, kidney dialysis, sickle cell disease) -treatment: erythropoietin 6) polycythemia: too many RBC's = thick, slow-flowing blood = overworked heart (can have hypoxia because there are too many RBC's flowing thru lungs to catch oxygen) -can be caused by smoking, bone marrow cancer -treatment: donate blood What are leukocytes? -white blood cells -can do diapedesis: flatten themselves/squeeze thru blood vessel to enter tissues -are ameboid, meaning they can "walk" w/ feet in tissue -use positive chemotaxis to move towards a chemical trail to find a microbe -are associated w/ innate immunity (always present to protect you) -are nonspecific (kill any microbe) -derived from myeloid stem cellWhat are granulocytes? -type of WBC, when stained they look grainy -can be neutrophils, eosinophils, basophils What are neutrophils? -most common leukocyte -3-6 lobed nucleus -is the 1st line of defense against bacteria -produce lysozyme & defensins to destroy phagocytized bacteria -we make 100 billion a day, last 2 days What are eosinophils? -bilobed nucleus (looks like headphones) -active against parasitic worms/malaria -digestive enzymes attack worms from outside -make antihistamines (lessens allergic reaction) What are basophils? -U or S shaped nucleus, very rare -produce histamine/heparin (cause inflammation/allergic reaction) -mast cells are similar in connective tissue What are nongranulocytes? -can be monocytes, or natural killer cells What are monocytes? -have this name only when in blood -very large leukocyte, has kidney shaped nucleus -after diapedesis, turn into APC's/macrophages (have this name when in tissue) What are macrophages? -phagocytes that look for cellular debris or foreign invaders (aka antigens: anything that can stimulate immune response) -have toll-like receptors on surface to identify antigen versus own cells -when antigen is phagocytized, the broken pieces (epitopes) are put on its outer membrane as APC's, to signal a warning to other WBC's -secrete Interleukin 1: goes to hypothalamus & causes you to get a fever, sleepy, achy (fever reduces antigen replication b/c they can't function @ high temperatures) -secrete inflammatory agents: makes capillary leaky so more leukocytes escape -secrete tumor necrosis factor to kill blood vessels that are supplying the antigen -dendritic cells are found in digestive/respiratory tract, are the best APC'sWhat is a natural killer cell? -come from a lymphoid stem cell -look for different "self" receptors on cells, like from transplants (if a cell doesn't have a "self" receptor, it's a tumor) and kills them How do leukocytes participate in adaptive immune response? -create specific attack against a microbe -referred to as lymphocytes: come from lymphoid stem cells, are T cells if they travel to thymus & grow fully there, are called B cells if they remain in bone marrow to grow -when done growing, exit thymus & marrow & called Naive T & B cells What is normal WBC count? -5-11,000 cells per microliter What is leukocytosis? -11-500,000 cells per microliter (when fighting infection) What is leukemia? -over 500,000 cells per microliter -cancer of the bone marrow: immature WBC's spill into blood & cannot protect anymore, damaged bone marrow causes aplastic anemia, reduces ability to clot blood, & blood is so viscous that vessels can become plugged What is leukopenia? -below 5,000 cells per microliter -radiation has caused damage to bone marrow -or a virus kills WBC's, aka HIV What is innate immunity? -non-specific, always-present immunity What is competitive exclusion? -first-level defense -your own good microbes that compete with invading microbes What are surface barriers? -first-level defense -skin -mucous membranes of the respiratory, digestive, urinary, & reproductive tract -flushing mechanisms: tears, saliva, urine What are chemical barriers? -first-level defense -acids in stomach & female reproductive tract -lysozyme in saliva & tearsWhat is complement? -second-level defense -a group of 20 plasma proteins that kill bacteria using a chain reaction What is interferon? -second-level defense -made by virally-infected cells, interferon binds to other nearby cells which makes them release antiviral proteins to protect them from a virus What biological barriers make up innate immunity? -phagocytosis via leukocytes (like neutrophil, eosinophil, macrophage, monocyte, dendritic cell, etc) How does inflammation help innate immunity? -when histamine or prostaglandin is released... 1) arterioles dilate = heat and redness 2) capillaries get leaky/albumins & WBC's leak out = swelling & pain What is the adaptive immune response? -specific towards one microbe -takes longer time to respond -memory is created of what you were infected with What is MHC 1? -a surveillance receptor that is produced by every nucleated cell in body -helps identify "self" cells & signals internal cell problems -on a healthy cell, MHC 1 will display a broken piece (epitope) of it's "self" protein -on a cell infected w/ a virus, MHC 1 will display a broken piece (epitope) of the virus to tell other cells that it is infected internally -monitored by T cytotoxic cells, will know to destroy this infected cell thanks to the MHC 1 receptor What is MHC 2? -a surveillance receptor on antigen-presenting cells (APC's, such as macrophages, dendritic cells, B lymphocytes) when they have phagocytized (eaten) an antigen -a broken piece of the antigen is displaced on the MHC 2 as an epitope -monitored by T cytotoxic cells Why are dendritic cells the best APC's? -when they phagocytize an antigen, they present the epitope on both MHC1 and MHC2 receptors, so that both T cells can read itWhat are T Cells? -a T lymphocyte cell that has a T cell receptor that helps them recognize the antigen in the epitope held by MHC receptors -before they mature, they are tested for "self" tolerance in the thymus so that they can correctly distinguish "self" cells from antigens -acquire a CD4 or CD8 attachment receptor, which helps them stabilize when they look at an epitope on an MHC2 or MHC1 -CD4's only attach onto MHC2's (4x2=8) -CD8's only attach onto MHC1's (8x1=8) -when immunocompetent (have everything they need) they leave the thymus but are still naive (haven't seen an antigen yet) and sit in lymphoid tissues What are TCD4 (Helper) Cells? -mature in thymus, leave as naive TCD4 cell that sits in lymphatic tissue 1) will recognize the epitope on an MHC2 2) the dendritic cell will put out a B7 to show that it recognizes its digested antigen as foreign 3) the TCD4 cell puts out a CD28 to touchB7 (step 2-3 is called Co-stimulation) 4) now the TCD4 is activated 5) grows & multiplies (makes lymph nodes swollen) 6) can differentiate into T Helper Cell, an effector cell (the "Chief in Command" of the immune response) that releases chemicals that coordinate other cells in the immune response -secretes Interleukin 2 to activate TCD8 cells & B lymphocytes -secretes B Cell Growth Factor to make B cells grow & multiply -secretes B Cell Differentiation Factor to tell B cells to turn into plasma cells & make antibodies -secretes Gamma Interferon to activate T Cytotoxic Cells 7) can differentiate into T Suppressor Cell too, which calls off the whole immune response once the antigen has been eliminated 8) Memory T Cells stay behind which can remember the antigen if you're exposed a second time What are TCD8 Cells? -sit in lymphoid tissue as naive cell -are a T cell with a CD8 attachment receptor 1) will recognize the epitope on an MHC1 2) the dendritic cell will put out a B7 to show that it recognizes its digested antigen as foreign 3) the TCD8 cell puts out a CD28 & touches B7 (step 2-3 called Co-stimulation) 4) now the TCD8 is activated 5) grows & multiplies (makes lymph nodes swollen) 6) differentiate into Effector T Cytotoxic Cells & leave lymphoid tissue looking for cells infected with the recognized antigen 7) kill infected cell by releasing perforin (makes holes in cell membrane) and proteases enter the cell to cause apoptosis8) Memory T Cytotoxic Cells are T cytotoxic cells that stay behind which can remember the antigen if you're exposed a second time What is the anamnestetic response? -secondary immune response for exposure to an antigen for the second time -faster & larger so you don't feel the symptoms of the infection What is a B lymphocyte? -comes from lymphoid stem cell, finishes developing in bone marrow, tested for self tolerance, gets receptors, etc -sits in lymphatic organs as naive B cells 1) have a B cell receptor (aka an IG receptor, they're just an antibody on the surface of a B cell) which allows them to identify WHOLE antigens on a microbe 2) will phagocytize the whole microbe, break it apart, present epitope on MHC2 3) finds a Helper T Cell, which puts out a CD40L (think L for heLper) and the B cell puts out a CD40 for Co-stimulation 4) the B cell becomes activated, grows & multiplies 5) differentiates into plasma cells, which make antibodies that will stick to the recognized antigen What is an IgM antibody? -biggest antibody, has many areas for antigen to attach onto -one of the first antibodies released by plasma cells in primary immune response -looks similar to A & B antibodies in blood -cannot cross placenta to protect fetus What is an IgA antibody? -antibody found in body secretions (saliva, sweat, mucous, breast milk) -can be passed to baby thru breast milk What is an IgD antibody? -attached to B cell, acts as B cell receptor What is an IgG antibody? -antibody produced in large quantities by plasma cells after they produce IgM's -small enough to cross placenta & protect fetus -main antibody of the 1st & 2nd immune response -what Rh antibodies look like What is an IgE antibody? -stuck in basophils/mast cells, make allergic reactions -made for parasitic worm infectionsWhat are the functions of an antibody? -bind to antigens & mark them for destruction -neutralize microbes -agglutinate microbes or RBC's -opsonization: make microbe easier to phagocytize -precipitation: make antigens insoluble so they cannot leave the body -can activate complement reaction so that the antigen lyses What is active immunity? -body actively creates an immune response w/ antibodies after exposure to an antigen What is passive immunity? -given antibodies to fight off an antigen What is naturally acquired immunity? -body does everything on its own What is artificially acquired immunity? -need medical help to do this What is naturally acquired active immunity? -infection from pathogen, make antibodies naturally, left w/ memory cells What is artificially acquired active immunity? -getting a vaccine injected (containing dead microbe), so your body can make the antibodies & develop immunity What is naturally acquired passive immunity? -naturally acquiring antibodies (so, not making them on your own) from your mother via placenta or breast milk -only offers temporary protection, proteins can degrade What is artificially acquired passive immunity? -getting an injection of antibodies (the gamma globulin portion of plasma) What is a Graft vs. Host reaction? -a bone marrow transplant can attack the cells of the host -immune cells from transplant see every cell in host as foreign, so an immune response happens which tries to kill your cells What are autoimmune diseases? -immune system destroys/attacks its own tissuesWhat is primary/secondary immunodeficiency? -primary: born w/ under-developed immune system (such as no thymus) -secondary: something external damages your good immune system (like HIV) What is hemostasis? -the slowing or stopping of blood flow -begins w/ platelet plug formation after vessel damage What happens during the extrinsic clotting mechanism? -shorter/faster route -triggered by release of Tissue Factor from tissue damage (outside of blood=extrinsic) -Tissue Factor activates a clotting protein, which activates another protein -that protein activates Factor X (aka Prothrombin Activator) in the presence of Platelet Factor 3 & calcium -Prothrombin Activator interacts w/ Prothrombin to form Thrombin -Thrombin interacts w/ Fibrinogen to convert it to Fibrin (forms the fibrin threads that make the clot) What happens during the intrinsic clotting mechanism? -longer, slower route -exposed collagen in damaged vessel activates a series of proteins that eventually activate Prothrombin Activator in presence of Platelet Factor 3 & calcium -Prothrombin Activator interacts w/ Prothrombin to form Thrombin -Thrombin interacts w/ Fibrinogen to convert it to Fibrin (forms the fibrin threads that make the clot) How does clot retraction work? -platelets have actin & myosin that can shorten the fibrin threads, which pulls the damaged tissue closer together How is a clot dissolved? -plasminogen, which was initially bound into the clot, will be converted into plasmin (enzyme that digests fibrin) by Tissue Plasminogen Activator (TPA) What is heparin, antithrombin, and coumadin? -heparin: prevents prothrombin from being converted to thrombin (which prevents the clot from being made, used in hospitals) -antithrombin: inactivates thrombin -coumadin: interfere's w/ liver’s ability to work w/ Vitamin K so that it can't produce prothrombin & other clotting proteins What is thrombocytopenia? -too few platelets, prevents clot formationWhat is a thrombus? -clot formed in a vessel where there's no vessel damage (forms in pooled blood) What is an embolus? -broken off piece of clot that travels & becomes lodged somewhere else What is streptokinase? -enzyme made by bacteria that dissolves clots by making plasminogen convert to plasmin What is hemophilia? -genetic disorder thru x chromosomes that makes person have trouble clotting blood What is the ABO blood type system? -blood types A, B, AB, & O are determined by the presence or lack of an antigen on the cell membrane of an RBC -blood type O: most common, has no A or B antigens on surface -blood type A: has antigen A on surface -blood type B: has antigen B on surface -blood type AB: has antigen A & B on surface What antibodies does each blood type have? -blood type O: has antibodies A & B -blood type A: has antibody B -blood type B: has antibody A -blood type AB: has no antibodies What happens if an antigen & an antibody match up? -for example: antigen A and antibody A -the blood cells will agglutinate (clump up) -a complement reaction will occur that lyses the blood cells -w/ broken blood cells floating around, can be toxic & cause kidney failure Who can donate blood to who? -the blood donor's antigen type cannot match the blood recipient's antibody type -for example, blood type A cannot receive from blood type B (because the donor, B, matches the recipient's antibody) Which blood types are the universal donors & recipients? -type O is universal donor -type AB is universal recipientWhat is the Rh factor? -if you have the Rh antigen, you have a positive blood type (and no Rh antibody) -if you don't have the Rh antigen, you have a negative blood type (and will only make the Rh antibody if you're exposed to Rh positive blood) How can you be exposed to Rh positive blood? -85% of the population is Rh+, likely that you'll come in contact -during an incorrect blood transfusion -during birth, if baby is Rh+, mom can be exposed when placenta tears -during a second birth, if the baby is Rh+, and the mom is Rh+, mom's antibodies can cross thru placenta & cause baby's RBC's to agglutinate & be a stillbirth What is the hemolytic disease of the newborn (aka erythroblastosis fetalis)? -if an Rh+ baby shares it's RBC's across the placenta, exposing mom & causing her to develop the antibodies, the mom's blood can recognize the baby's as foreign and try to attack it -Rhogam can be given to the mother to supply her with the antibodies, that way she doesn't need to produce them (this prevents the immune response) What are platelets? -aka thrombocytes -play role in hemostasis (slowing blood flow) -developed from myeloid stem cell, turns into megakaryocyte in bone marrow (huge nucleus, packaged w/ chemicals) -comes near vessel & releases platelets (which have no nucleus, only chemicals) -last around 10 days How is the platelet plug formed? 1) damaged vessel from cut exposes collagen fibers where endothelium is torn 2) platelets stick to collagen fibers w/ help of Von Willibrand's Factor (protein that helps platelet stick to collagen) 3) once stuck to collagen, platelets become activated & release their chemicals, one of which is fibrinogen 4) fibrinogen causes aggregation (platelets sticking to platelets) What are some chemicals released by platelets? -platelet factor 3: needed for clotting process -serotonin: causes muscle to spasm & constricts the vessel -thromboxane/ADP: causes more constriction to reduce blood loss; can also trigger more platelets to aggregate -prostacyclin: made by intact endothelial cells around cut to inhibit thromboxane -aspirin also inhibits thromboxane, prevents clot from forming by preventing plug from forming -PDGF (platelet-derived growth factor): stimulates repair of damaged vessel wallWhat is thrombocytopenia? -too few platelets, difficulty forming plug & therefore clot What is plasma composed of? -90% water, 10% protein...such as: -albumins: smallest & most common protein, is the main solute in plasma to generate BOP, can transport metals & fats -globulins: transport molecules, can be antithrombin (prevent clotting), or gamma globulins (antibodies) -clotting proteins: fibrinogen, prothrombin What is pH? What is an acidic, neutral or basic pH? -pH: the amount of free H ions in a solution -acidic: below 7 -neutral: 7 -basic: above 7 What are buffers? -regulate the pH of the blood What is an acid (strong & weak) in a buffer system? -when put in water, dissociates & releases H ions (lowers pH) -strong acid: dissociates completely, releasing lots of H -weak acid: incomplete dissociation, releasing little H What is a base (strong & weak) in a buffer system? -when put in water, combines w/ H ions (raises pH) -strong base: dissociates well & grabs all H's -weak base: dissociates but cannot grab many H's What are buffer systems? -pair of chemicals (weak acid & weak base) that help to convert a strong acid or base into a weak one -strong acid + weak base = weak acid -strong base + weak acid = weak base What is the bicarbonate/carbonic acid buffer system? -when pH falls due to increase in H's, bicarbonate will accept H ions as a weak base, & turn into carbonic acid -when pH rises due to decrease in H's, carbonic acid will release H ions as a weak acid, & turn into bicarbonate -carbonic acid is made during cell respiration -bicarbonate is made when carbonic acid dissociates -to maintain neutral blood pH, we need ratio of 20:1 bicarbonate to carbonic acid-we have an increase in carbonic acid constantly, so kidneys constantly add more bicarbonate, & the respiratory system can decrease carbonic acid What is the carbaminohemoglobin/oxyhemoglobin buffer system? -oxyhemoglobin is hemoglobin with oxygen attached, forms in the lungs: functions as a weak base & accepts hydrogens to raise blood pH -carbaminohemoglobin is hemoglobin with CO2 attached, forms in tissues: functions as a weak acid & donates hydrogens to lower blood pH How do other blood proteins function as buffers? -albumin, fibrinogen, etc. can be amphoteric (function as both acid & base) -the amine functional group of an amino acid can accept hydrogen as a weak base & raise the pH -the carboxyl group can release hydrogen as a weak acid & lower the pH What are the four main functions of the lymphatic system? 1) collect excess interstitial fluid/leaked blood protein, & deliver it to the circulatory system 2) filtering lymph to reduce cellular debris/antigens 3) transporting fats from small intestine 4) providing place for APC's to activate T & B lymphocytes What is interstitial fluid called once it enters a lymphatic vessel? -lymph What area of the body does the right lymphatic duct drain from? -drains lymph from right arm & torso into the circulatory system What area of the body does the thoracic duct drain from? -drains lymph from the left arm, legs & torso into the circulatory system What do lymphatic vessels rely upon to move lymph? -valves & skeletal muscle movement Where are nodules found & what structures do they make? -as the simplest lymph organ, it's found in mucous membranes -cluster together to make tonsils & appendix What are nodules made of? -cortex area: contains T lymphocytes -medulla area: contains naive B lymphocytes What are lymph nodes & where are they found? -bean shaped, filter lymph -found along lymph vessels -location for dendritic cells to activate naive T cellsWhere do T lymphocytes finish their development? -thymus When does the thymus growth/function peak? -at puberty, then slowly declines What 3 blood components does the spleen contain? -red blood cells, iron, platelets What is the red pulp of the spleen? -contains lymphocytes arranged into a nodule What is the white pulp of the spleen? -contains red blood cells & macrophages in large sinuses