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340 Cards in this Set
- Front
- Back
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What is the science called that is concerned with the study of blood?
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Hematology
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Describe 3 functions of the blood
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Transportation of oxygen
Regulation - homeostasis Protection - immune system, clotting |
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Blood temperature?
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38 degrees
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How much of blood does the extra-cellular fluid make up?
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20%
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What volume of blood do males and females have?
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Males - 5-6 litres
Females 4-5 litres |
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How many components is the blood made of and what are they?
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Two components: blood plasma and formed elements.
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Percentage of plasma and formed elements in blood?
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45% formed elements
55% blood plasma |
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Example of a formed element?
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Erythrocytes
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What the formed elements (for instance red blood cells) are removed from the blood, what is left?
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A straw yellow liquid known as blood plasma.
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What three things is blood plasma made of?
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Solutes
Proteins Water |
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Name the four proteins found in blood plasma.
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Albumin
Fibroninogen Globulin Others |
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What five different kinds of solutes can be found in the blood plasma?
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Electrolytes
Nutrients Gasses Regulatory substances Waste |
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What three things does the formed elements consist of?
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Thrombocytes/platelets
Erythrocytes/red blood cells White blood cells |
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Name five of the white blood cells found in the formed elements
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Basophils
Neutrophils Lymphocytes Monocytes Eosinophils |
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What synthesises most of the plasma proteins?
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Hepatocytes (liver cells).
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What can B lymphocytes turn into?
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Immunoglobulins
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What are immunoglobulins?
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A type of globulin (plasma protein) that attacks bacteria and viruses.
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What are immunoglobulins also known as?
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Antibodies
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How do antibodies work, simply?
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An antibody binds specifically to the antigen that stimulated its production, disabling the invading antigen.
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What two groups can white blood cells be split into?
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A-granular leukocytes
Granular leukocytes |
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Name three granular leukocytes.
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Basophils
Neutrophils Eosinophils |
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Name three A-granular leukocytes.
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T and B lymphocytes
Natural Killer cells Monocytes |
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What does hematocrit mean?
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The percentage of total blood volume occupied by red blood cells.
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What hormone stimulates the production of erythrocytes?
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Erythropoietin / EPO
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What hormone stimulates the production of EPO?
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Testosterone
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What do all plasma proteins do?
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Exert osmotic pressure
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What two things does the osmotic pressure exerted by plasma proteins help to do?
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Maintain water balance between blood and tissues.
Regulate blood volume |
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Albumins size and function?
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Smallest of the plasma proteins.
Transports steroid hormones and fatty acids. |
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Fibroninogen function?
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Plays an essential role in blood clotting
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What are electrolytes?
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An inorganic salt consisting of ions.
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What do electrolytes help to do?
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Helps maintain osmotic pressure.
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Give three examples of nutrients.
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Glucose
Fatty acids Amino acids |
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Give three exmaples of waste products.
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Urea, uric acid, creatine
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What is hemopoiesis?
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The formation of blood cells.
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Where is the primary site for hemopoiesis?
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Red bone marrow.
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Where is some of the red bone marrow cells derived from?
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Pluripotent stem cells
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What is an important characteristic of pluripotent stem cells?
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They can develop into many different types of cells.
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What two classes of cells do pluripotent stem cells develop into?
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Myeloid stem cells
Lymphoid stem cells |
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Name the five stages of erythropoeisis
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Pluripotent stem cell
Myeloid stem cell Proerythroblast Reticulocyte Erythrocyte |
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Name the five stages of throbocyte cell development
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Pluripotent stem cell
Myeloid stem cell Megakaryoblast Megakaryocyte Thrombocyte |
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Platelets are also known as?
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Thrombocytes
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What are hemopoietic growth factors?
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Hormones that regulate the differentiation and proliferation of certain progenitor cells.
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What hormone increases the number of red blood cells?
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Erythropoietin (EPO).
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What hormone increases the number of platelets?
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Thrombopoietin
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What are cytokines and what do they do?
An example, what produces it and 4 things it does? Secnd example? (5) |
Glycoproteins that stimulate the production of progenitor cells and regulate immune responses.
Interleukin 1 produced by monocytes and macrophages. Stimulates production of progenitor cells, causes fever, globulin production and T cell activation. Interleukin 2 by T helper cells. Growth, proliferation and activation of NK cells, T and B cells |
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What do red blood cells contain?
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Hemoglobin
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What is hemoglobin?
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An oxygen carrying protein
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What three things is hemoglobin made of?
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Iron attached to heme
Globin protein |
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Name three ways erythrocytes are adapted to carry oxygen.
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Biconcave shape
No nucleus No mitochondia (anaerobic energy production) |
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How long do erythrocytes live?
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120 days
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Name the three stage process of the breakdown of globulin in the red blood cell life cycle.
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Macrophages phagocytize worn out red blood cells.
Globulin and heme is split apart The Globulin protein is broken down into amino acids which can then be reused and anabolised back into proteins. |
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Name the four stage process of the breakdown of iron in the red blood cell life cycle
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Iron is removed from the heme
Iron binds to transferrin Iron detached from transferrin and binds to ferretin in the liver Iron then binds back to transferrin and is taken to be reused in the red bone marrow. |
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Name the six stage process of the breakdown of heme in the red blood cell life cycle.
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Heme is converted to biliverdin
Biliverdin is converted to bilirubin in the liver The bilirubin is passed into the small intestine in bile Bilirubin travels to large intestine where bacteria conver it to urobilinogen Some urobilinogen is absorbed into the blood and converted to urobilin and excreted in urine Most passes out as stercobilin |
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Clinical name for cellular oxygen deficiency?
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Hypoxia
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Four things vitamin B12 does
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Synthesizes haemoglobin in RBC's
Synthesizes neutrophils Role in methylation Protects against dementia |
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What do monocytes do?
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They are transported to tissues where they differentiate into macrophages.
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What are fixed and wandering macrophages?
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Fixed macrophages reside in a particular tissue, wandering don't.
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What are major histocompatibility antigens (MHC)?
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Cell identity markers protruding from the plasma membrane.
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Where are MHC's found?
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White blood cells
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Red blood cells have what kind of antigens?
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Blood group antigens, not MHC antigens.
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What is leukocytosis?
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Increase in white blood cells
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What is leukopenia?
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Abnormally low level of white blood cells.
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What do granular leukocytes and monocytes do in the presence of a pathogen?
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They leave the blood stream to fight the pathogen and never return to the blood.
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What do lymphocytes do in the presence of a pathogen?
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Lymphocytes continularly recirculate from the blood to the interstitial spaces, to the lymph and back to the blood.
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What are adhesion molecules?
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Molecules that help white blood cells to stick to the endothelium in vessels, allowing them to slow down and pass through the spaces into interstitial fluid.
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What are phagocytes?
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Any white blood cells that kill pathogens with phagocytosis.
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Two examples of phagocytes?
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Neutrophils and macrophages.
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What is phagocytosis?
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The ingestion of bacteria and excretion of dead matter.
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What are chemotaxis?
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Chemotaxis are chemicals released by microbes which stimulates phagocytes to take action.
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What is the process of withdrawing blood from a vein called?
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Venipuncture
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Where is the most common site of venipuncture?
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Median cubital vein anterior to the elbow.
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A high count of neutrophils may indicate what three things?
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Bacterial infection
Inflamation Burns |
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What is the action that neutrophils can do?
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Phagocytosis with lysozyme
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A high count of lymphocytes may indicate what?
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A viral infection
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What are the specific actions of the two lymphocytes?
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B lymphocytes secrete antibodies
T lymphocytes can do phagocytosis |
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A high count of monocytes may indicate what three things?
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Viral infection
Fungal infection Tuberculosis |
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What is the action associated with monocytes?
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Phagocytosis
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A high count of basophils may indicate what?
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An allergic reaction
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What action is associated with basophils?
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Histamine based immune response.
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What is hemostasis?
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The events that take place in the body which stop bleeding.
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Name three mechanisms that stop bleeding in order.
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Vascular spasm
Platelet plug formation Blood clot / coagulation |
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What is a vascular spasm?
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When arteries or arterioles are damaged, the rings of smooth muscle contract to reduce blood loss.
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Name two things found in platelets?
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Clotting factors
Platelet derived growth factors (PDGF) |
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What are platelet derived growth factors (PDGF) and what do they do?
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PDGF are hormones proliferation of vascular endothelial cells, smooth muscle fibres and fibroblasts to help repair damaged blood vessel walls.
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Three stages of platelet plug formation?
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Platelet adhesion
Platelet release reaction Platelet aggregation/platelet plug formation |
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Explain platelet adhesion
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Platelets stick to the damaged tissues of the blood vessels such as collage fibres underlying the damaged endothelium.
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Explain platelet release reaction
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Platelets become activated and release ADP, PDGF.
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Platelet plug formation
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ADP causes the platelets to become sticking and more platelets stick, causing a 'plug'.
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What is blood serum?
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A straw coloured liquid made of blood minus the clotting proteins. Fibrin is found in the serum.
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Name four components of blood clotting (the final stage of hemostasis).
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Platelets
Fibrin Clotting factors Other cells |
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Explain the blood clot including the four components?
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After the platelet plug formation, clotting factors reinforce the plug, and then serum/fibrin strengthens and glues it together. Other cells can get caught up in the clot reinforcing it.
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Where are most clotting factors made?
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The liver
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Name one clotting factor
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Fibrin
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Vitamin K and blood clots?
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Vitamin K is a fat soluble vitamin and is usualy produced by bacteria in the large intestine. Vitamin K helps synthesise four blood clotting factors.
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People suffering from vitamin K deficiency may have what?
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People suffering from vitamin K deficiency due to malabsorption, maybe due to lack of production of bile, may have uncontrolled bleeding problems.
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What is the process of dissolving a clot called?
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Fibrinolysis
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What are anticoagulants and who might take them?
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Anti coagulants reduce the bodies ability to form clots. People at risk of forming blood clots may take them.
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An example of an anticoagulant and how it works?
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Warfarin.
Reduces blood clot formation by antagonising vitamin K which is important for the formation of four clotting factors. |
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How does aspirin work as an anticoagulant and what does this reduce the risk of?
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It blocks the formation of thromboxane A2 reducing the risk of TIA and mycoardial infaractions.
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What is a myocardial infarction?
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A heart attack
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TIA short for?
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Transient ischemic attack
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What is an antigen?
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A protein or glycolipid marker found on cells.
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What are agglutinogens?
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Antigens found on the surface of red blood cells/erythrocytes.
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Explain the ABO blood group.
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People with type A blood have only type A antigens/agglutinogens
People with type B blood have only type B antigens/agglutinogens People with type AB blood have both A and B antigens/agglutinogens People with neither A or B antigens have type O blood. |
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In relation to blood groups, what does blood plasma usually contain and what are these called?
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Antibodies known as agglutinins
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What are agglutinins?
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Antibodies found in the blood plasma.
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Explain agglutinins and blood group compatibility
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People with type A blood will have anti B agglutinins/antibodies.
People with type B blood will have anti A agglutinins/antibodies. People with AB blood will have neither anti A or anti B agglutinins/antibodies. People with type O blood will have both anti A and anti B agglutinins/antibodies. |
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Explain why blood type compantibility issues do not exist between mother and baby.
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Antibodies in the mother are large and do not cross the placenta.
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What are universal recipents?
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Type AB blood because they have no antibodies and therefore any erythrocyte types (A, B or O) can be given and there will be no reaction due to no antibodies.
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What are universal donors?
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Type O blood is known as universal donors because they have no antigens for antibodies to join onto, so therefore; type O blood can be given to anyone.
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Explain RH+ and RH-, how it works and when it becomes a problem?
What is this called? |
If a mother that has RH- antigens concieves a baby with RH+ antigens, in birth the blood will mix and the mother will produce anti RH+ antibodies.
This is a problem when/if she concieves a second RH+ baby, because she now has anti RH+ antibodies, which will flow through the placenta and into the baby attacking its RH+ blood cells. Hemolytic disease of the newborn (HDN). |
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What does hemolytic/hemolysis mean?
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Breaking down of blood cells.
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Name an anticoagulant chemical and where it is produced? (2)
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Heparin in basophils
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What are prostacyclins an inhibitor of?
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Platelet adhesion
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What is thrombosis and what is a thrombus?(2)
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Thrombosis is clotting in a vblood vessel that impedes the flow of blood. A thrombus is the clot.
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What is an embolus?
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A mass of anything transported in the blood stream?
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What is a pulmonary emobolism?
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An embolus that becomes lodged in the lungs.
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What is anemia?
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A condition where the oxygen carrying capacity of the blood is reduced.
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3 symptoms of anemia?
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Fatigued, inability to tolerate the cold due to lack of ATP being produced (oxygen is needed for ATP), pale colour due to lack of hemoglobin circulating.
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6 types of anemia?
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Hemorhagic anemia
Iron deficiency anemia Megaloblastic anemia Pernicious anemia Hemolytic anemia A plastic anemia |
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Explain iron deficiency anemia
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Iron holds the globin protein complex together giving it its folded structural shape. With no iron, the globin loses it's function.
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Explain megaloblastic anemia.
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A lack of B12 or folic acid causes the red bone marrow to produce abnormally large red blood cells. These are too large to fit into blood vessels.
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What is intrinsic factor?
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A glycoprotein
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What cells produce intrinsic factor?
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Parietal cells in the stomach
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What does instrinsic factor do?
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Binds to vitamin B12.
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What happens then?
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Vitamin B12/intrinsic factor complex travel to the small intestine and pancreatic proteases denature it releasing B12.
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Explain pernicious anemia? Similar to what and how is it different?
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Insufficient production of red blood cells due to lack of intrinsic factor.
Similar to megaloblastic anemia but doesn't produce oversized RBC's. |
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Explain hemolytic anemia simply?
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The premature rupturing of red blood cells.
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What might cause hemolytic anemia? (3)
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Parasites, toxins, abnormal RBC enzymes
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What is a-plastic anemia and what causes it? (3)
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Anemia caused by destruction of red bone marrow cells.
Caused by gama radation, toxins |
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What is sickle cell disease a type of?
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Sickle cell disease is a type of anemia.
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Explain sickle cell disease and two of the things it does.
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Sickle cell disease is casued by a type of hemoglobin. When it gives up it's oxygen, it changes shape stretching the red blood cell into a rod like shape. This causes hemolysis easily and hemopoesis can not keep up with the rate of hemolysis.
It can also cause blockages. |
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What is granulocytopenia and what causes it?
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A reduced number of granulocytes
Insufficient or damaged bone marrow stem cells. Vitamin B12 or folate deficiency |
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What type of disorder is granulocytopenia?
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A leukemia
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Treatment for granulocytopenia?
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Broad spectrum antibiotics
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Age group affected by granulocytopenia?
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Adults
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What is thrombocytopenia?
What type of problem is this? |
Low level of platelets
Blood clotting problem |
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What might cause thrombocytopenia in children?
What might cause thrombocytopenia in adults? |
In children thrombocytopenia might be caused by an acute viral infection.
In adults, thrombocytopenia might be casued by auto immune reactions. |
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What other things might lead to thrombocytopenia?
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HIV
Certain drugs Chemotherapy |
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What is hemophilia a type of?
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Blood clotting disorder
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Two types of clotting disorders?
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Hemophilia and thrombocytopenia
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What causes hemophilia?
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A lack of or abnormality in blood clotting factor VIII (8)
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Most common type of hemophilia?
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Type A
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Inheritance of hemophilia?
What does this mean?? |
X linked recessive trait.
This means it shows up in the male, but the female carrier is a symptomatic. |
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What is an allele?
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A specific type of a gene. For instance, a gene for blue eyes.
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What is the name for a geneotype with two different alleles?
And same alleles? |
Heterozygous
Homozygous |
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Explain dominance and recessive?
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When you have a geneotype, one of the alleles will be dominant and one recessive.
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Difference between geneotype and phenotype?
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Geneotype is the actual alleles and the pheonotype is how its expressed.
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What are the five main types of blood vessels?
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Arteries, Arterioles, capillaries, venuels, veins
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What do arteries do with blood?
Feature of arteries? |
Carry blood away from the heart
Elastic |
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What are arterioles?
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Smallest form of arteries
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What are the blood vessles that branch into tissues called?
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Cappiliaries
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Feature of capiliaries?
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Thin walls that allow substances to exchange between the blood and body tissues.
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When capilliaries rebranch, what is it called?
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Venules
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What do venuels branch into?
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Veins
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What do veins do?
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Carry deoxygenated blood back to the heart
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What is angiogenesis?
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The production of blood vessels
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Angiogenesis and tumors?
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Cancer cells secrete proteins called tumor angiogensis factors that stimulate blood vessel growth to provide nutrients to the tumour.
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How many layers are there to a blood vessel and what are they made of?
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3 layers.
Inner layer made of epithelial tissues. Middle layer made of smooth muscle and elastic connective tissue Outer layer made of connective tissue |
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What are the three layers of a blood vessel called?
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Tunica interna
Tunica media Tunica externa |
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How many types of cappilaries are there?
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Three
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What are the three types of cappilaries called?
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Continuous capillaries
Fenestrated capillaries Sinusoid cappilaries |
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What do continous cappilaries do?
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Thickest endothelium allowing water and ions through.
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What do fenestrated cappilaries do?
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Have windows that allow larger molecules out of the lumen.
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What do sinusoidal cappilaries do?
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Have the greatest permeability allowing RBC's and proteins through the wall.
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What do veins contain and why?
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Veins contain valves to stop backflow of blood.
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What kind of blood vessels contain the most blood volume?
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Systemic veins and venules.
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What are the three ways substances leave and enter blood vessels?
Which is most important? |
Diffusion
transcytosis Bulk flow Most important is difficusion |
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What is diffusion?
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The movement of substances across their concentration gradient.
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Name two water soluble substances and how they pass through the capillaries?
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Amino acids
Glucose Pass through the fenestrations or diffusing through the endothelial cells |
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Name three lipid soluble substances and how they diffuse through cappilaries?
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O2, CO2, steroid hormones
They can pass directly through the lipid membrane of the endothelial cells. |
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Examle of what produces proteins and how they diffuse?
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Hepatocytes in the liver produce plasma proteins such as albumin and fibroninogen which then pass through sinusoid cappilaries.
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What is the blood brain barrier?
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The blood supply to the brain is by continuous cappilaries with tight junctions allowing little substances through.
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What is transcytosis?
An example of what uses this? |
Material enters pinocytic vesicles and enter the bilipid membrane of the cells by endocytosis and exit by exocytosis.
Insulin |
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What is bulk flow, filtration and reabsorption?
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Flow of solutes from high pressure to low pressure areas.
Filtration is solutes from the blood to interstitial fluid. Reabsorption is from interstitial fluid to blood. |
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What two pressures promote filtration and what are they?
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Blood hydrostatic pressure: The pressure exerted by water in the blood plasma
Interstitial fluid osmotic pressure or hydrostatic pressure. |
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What are the balance of these pressures called?
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Net osmotic pressure.
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What is blood colloid osmotic pressure, what other pressure is found in blood and what opposes it?
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The pressure exerted by large proteins in blood plasma is the blood colloid osmotic pressure.
Blood hydrostatic pressure is also found. Hpc opposes it. |
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What regulates heart beat and stroke volume?
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The cardiovascular centre of the medula oblangata
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What also does the CV centre do?
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Control the neural, hormonal and local negative feedback systems that regulate blood pressure.
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Explain what neural regulation of blood pressure is.
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The nervous system controls blood pressure with baroreceptors and chemoreceptors.
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What are baroreceptors and name two places they are found.
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Pressure sensitive receptors found int he carotid sinus of the carotic arteries and the ascending aorta.
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What happens when blood pressure drop with baroreceptors?
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They caue the CV centre to increase sympathetic activity of the heart via cardiac accelerator nerves.
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What also happens when there is an increased amount of sympathetic nervous activity?
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The adrenal medula releases noradrenalin and adrenalin.
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What do chemoreceptors measure?
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H, CO2, O2
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What organ secretes renin?
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The kidneys
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When is renin released?
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When there is a drop in blood volume or blood flow to the kidneys.
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What does sodium depletion cause?
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Drop in blood pressure and blood volume
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What does a drop of sodium cause the body to do?
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Andiotensinogen is converted to angiotensin 1 by renin that is released from the kidneys.
Angiotensin converting enzyme then converts Angiotensin 1 to angiotensin 2. Angiotensin 2 causes vascoconstriction raising blood pressure and also causes aldosterone to be released. |
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What does aldosterone do?
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Causes sodium retention.
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Where is ADH produced and released?
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Produced in the hypothalamus
Released from the posterior pituitary. |
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When is ADH released?
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In response to dehydration of decreased blood volume
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What is ADH also called?
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vasopressin
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Two things ADH does?
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Decrease water loss
Vascoconstriction |
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Where is atrial natriuretic peptide produced and what does it do?
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Released by cells in teh atria of the heart.
Lowers blood pressure by causing vasodialitation and causing loss of salt and water in urine. |
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Artery in the foot?
Artery near teh radius? Artery near the bicep? |
Dorsalis pedia
Radial artery Brachial artery |
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Arteries in the neck?
Arteries in the face? Artieries in the temples? |
Carotid arteries
Facial arteries Superficial temporal arteries |
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Artery in the femur?
Artery behind the knee? Artery form heart? |
Femoral artery
Popliteal artery Aorta |
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Arteries before branching to spleen and stomach?
Three types of arteries after celiac trunk? |
Celiac trunk
Splenic artery, Left gastric artery, Common hepatic artery |
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Two arteries of gastric area?
Four subdivisions of the aorta? |
Superior and inferior mesenteric arteries.
Arch of the aorta, thoracic aorta, abdominal aorta, ascending aorta |
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What are the two main veins in the neck?
What veins do these drain into? And then itno? |
Internal and external jugular veins.
Right and left subclavical veins Superior vena cava |
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Vein from the heart to the lungs?
Main vein from the body to the heart? |
Pulmonary trunk
Inferior vena cava |
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What is the hepatic portal circulation?
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The hepatic portal circulation carried venus blood from the GI organs and spleen to the liver.
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What is a portal vein?
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A vein that carries blood from one capillary network to another.
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Explain glucose and portal veins and how blood levels drop after a meal.
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The liver converts the glucose into glycogen for storage reducing blood glucose level shortly after a meal.
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Two others things the liver does?
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Destroys bacteria by phagocytosis
Detoxifies harmful substances such as alcohol. |
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What two veins form to make the hepatic portal vein?
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Superior mesenteric and splenic veins.
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Where does the superior mesenteric vein drain blood from?
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Intestines, pancreas and stomach.
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Where does the splenic vein drain blood from?
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Intestines, pancreas and stomach.
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Five pulse points in the upper body?
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Superficial temporal artery
Facial artery Carotid artery Brachial artery Radial artery |
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Three pulse points in the lower body?
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Femoral artery
Popliteal artery Dorsalis pedis artery |
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Name seven types of shock
What are the main four that some of the other ones come under? |
Hypovolemic shock
Cardiogenic shock Vascular shock Obstructive shock Neurogenic shock Anaphylactic shock Septic shock |
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Explain hypovolemic shock
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Body fluids fall
Venous return decreases Filling of the heart decreases Stroke volume decreases Cardiac output decreases |
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Explain two causes of cardiogenic shock
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Myocardial infarction
Arrhythmias |
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What happens in anaphylactic shock?
What type? |
Histamine and other mediators cause vasodilitation which cause a type of shock.
Type of vascular shock |
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What is neurogenic shock? What type of shock?
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Damage to the head damages the CV centre in the medula oblongata.
Type of vascular shock |
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Explain obstructive shock
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Shock due to an obstruction in blood vessels. Most commonly pulmonary embolism.
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Two ways the cardiovascular system contributes to homeostasis?
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Carries nutrients, oxygen, hormones to cells of the body and carries wastes such as uric acid, urea and creatine away.
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Three layers of the heart?
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Epicardium - outer layer
Myocardium - middle layer Endocardium - internal layer |
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What are the layers made of?
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Epicardium - Mesothelium and connective tissue
Myocardium - Striated involuntary muscle Endocardium - endothelium and connective tissue |
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What does atria mean?
What does ventricles mean? What is found on the outside of each atrium? |
Recieving chambers
Little b ellies An auricle that increases capacity of the chambers |
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What recieves deoxygenated blood and from where?
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Right atrium from the inferior vena cava, superior vena cava and the coronary sinus
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What recieves oxygenated blood and from where?
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Left atrium from the lungs via four pulmonary veins
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Thickest chamber of the heart?
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Left ventricle
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Four valves?
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Tricuspid - bottom of right atrium
Pulmonary - End of right ventricle Mitral - Bottom of Left atrium Aortic - End of Left ventricle |
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Explain blood flow through the heart.
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Deoxygenated blood from inferior vena cava, superior vena cava and teh coronary sinus goes to the right atrium.
Through tricuspid valve into right ventricle. Through pulmonary valve into pulmonary trunk. From four pulmonary veins into left atrium. Through mitral valve into left ventricle. Through aortic valve into aortic arch. |
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Overall term for all the valves
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Atrioventricular valves
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What are the two main coronary arteries and where do they come from?
What do they do? |
Left and right coronary arteries branch from the ascending aorta.
Supply oxygen to the myocardium |
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What does the left coronary artery divide into?
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Anterior interventricular branch
Circumflex branch |
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Simply, what is hyperthyroidism?
One symptom? |
Excess thyroid hormone
Tachycardia |
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What connects neighbouring muscle fibres in the heart and is found only in cardiac muscle?
What holds the fibres together? |
Intercalated discs
Desmosomes hold the fibres together |
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What are autoarythmic fibres?
What do these do? (2) |
Fibres in the heart that create their own action potentials.
Autoarythmic fibres act as a pacemaker and also create the conduction system of the heart. |
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First step of action potential propogation in the heart?
What does this create? |
The Sinoatrial node repeatedly depolarize creating a pacemaker potential.
The spontaneous depolarization of the sinoatrial node creates a pacemaker potential. |
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What happens when the pacemaker potential reaches its limit?
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An action potential propogates throughout both atria via gap junctions in the intercolated discs.
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What happens next?
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The action potential reaches the atrioventricular node by travelling down through the atrial muscle fibres.
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Where are the SA and AV nodes located?
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SA = top of right atrium
AV = bottom of right atrium. |
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What happens next?
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From the AV node, the action potential enters the atrioventricular bundle where it goes to the ventricles via the left and right bundle branches.
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Final stage of an action potential in the heart?
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The action potential travels from the left and right bundle branches to the purkinje fibres which spread the action potential to the remainder of the ventricles.
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Explain atrial systole
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The SA node depolarizes causing atrial depolarization.
This depolarization causes atrial systole/contraction. This is marked at the start of the first little curve on an ECG. The next spike marks the start of ventricular depolarization which causes ventricular systole. |
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What does the big curve at the end of an ECG mean?
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Ventricular repolarization
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A heart rate greater than what is termed what?
And lower terms what? |
Greater than 100bpm = tachycardia
Less than 60bpm = bradycardia |
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What is ventricular relxation, filling and stretching known as?
What is the contractino called? |
Diastole
Systole |
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S1 heart sound?
S2 heart sound? |
Mitral valve closure
Aortic valve closure |
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What causes systole?
What causes diastole? |
Depolarization
Repolarization |
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What do they look at and for what reason in a FBC?
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The formed elements to tell if you have a viral, fungal, bacterial, parasitic or allergic reaction.
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T lymphocytes start out where and mature where?
B cells? |
Start out from pluripotent stem cells in the bone marrow but mature in the thymus.
Matures in the bone marrow |
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What are helper cells and what do they do? Made from?
What are T surpressor cells and what do they do? |
T helper cells release cytokines which potentise T, B, and NK cells. They also help B cells enlarge and divide after binding to an antigen
T surpressor cells surpress some of the actinos of cells of the immune system. |
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What are cytotoxic cells and what do they do? What immunity do they mediate?
What do B cells eventually become? |
They help destroy tumours, intracellular pathogens, transplants. They mediate cell mediated immunity.
B lymphocytes eventually become plasma cells and actively secrete antibodies. |
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Abreviation of antibodies/immunoglobulins?
T and B cells part of what and what is this? |
lg
Part of the adaptive immune system which remembers pathogens and launch an attack should they ever arrive in the body again. |
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NK cells attack what?
Part of what? |
Virally infected cells
Tumour cells Inate immune system which doesnt need priming, it just notices something is wrong and destroys it. |
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T and B lymphocytes nucleus?
Monocytes nucleus? Monocytes part of the what immune system? |
Large and round.
Large but wobbly Monocyes = . |
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Other name for adaptive immune system?
Macrophage looks like? |
Aquired immune system.
Macrophage bigger than monocyte and looks like it has arms/star. |
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Macrophages also do what aprat from phagocytosis?
Macrophages in the liver, lungs and spleen? |
Stimulates lymphocytes to produce antibodies against the pathogen its encountered.
Liver = kuppfer cells Lungs = dust cells Spleen = helps to phagocytize dead RBC's. |
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Apart from phagocytosis, what do eosinophils do?
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Clear up the mess from degranulation of basophils.
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Parasite infection = which type of cells?
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Eosinophils attack the parasites via phagocytosis.
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Eosinophils look like?
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They have what looks like two lungs connected (one weird shaped nucleus).
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Mast cells and basophils?
Look like? |
Mast cells are found in tissues and are very similar to basophils.
basophils have so many granules they often obscure the nucleus. |
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Antibodies example with pollen?
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IgE's.
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Explain allergic reaction in detail including two substances at the end and what clears it up.
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B lymphocytes make immunoglobulins/antibodies/IgE's against it.
These stick to the basophils antigens and then the basophil degranulates and releases histamine and SRS-A. Eosinophils clear up the mess of the degranulated basophils. |
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Neutrophils look like?
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A bit like eosinophils but 3 lungs instead of 2.
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What comes before macrophages with a pathogen?
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Neutrophils do phagocytosis before.
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Normal blood pressure?
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Less than 120mm Hg Systolic
Less than 80 mm HG diastolic |
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What do you need to measure blood pressure?
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Sphygmomanometer
Stethescope |
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How do you measure blood pressure?
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Place sphygmomanometer on arm of patient with arrow on brachial artery (on the side of the pinky). Two fingers should fit underneat, and it should be 2cm above elbow.
Find the radial pulse and inflate to 80mm Hg. Inflate at 10mm Hg a second taking the pulse until the pulse stops. Inflate 20-30mm Hg above pulse obliteration level. Start deflating. First sound is systolic blood pressure. Dissapears is the diastolic pressure. |
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Arteriosclerosis means?
Found mainly in? |
Generally refers to changes in the blood vessels, arterioles
Older individuals |
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What might happen in arterioclerosis? (3)
This can lead to? (3) |
Elasticity is lost, the BV wall hardens and the lumen becomes narrower.
Ishemia and necrosis of thekidneys, brain or heart. |
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Imbalance of what can also lead to arteriosclerosis?
What causes it? Ratio of calcium to phosphorus ideal? |
Calcium/phosphorus imbalance (excessive calcium)
Poor diet and glandual inheritance Ratio should be 10:4 |
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Arteriosclerosis is commonly found?
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People with an overactive anterior pituitary
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What are anastamosis?
What might cause a heart murmur? |
Connections between the left and right coronary arteries
Defective valves or whole in the septum. |
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What is an atheroma and what is it made of what 5 things?
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Accumulation of debris and swelling of artery walls made of macrophages, , cholesterol, fatty acids, calcium and connective tissue.
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When might atheroscleroris have began to develop?
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May have began to develop during childhood.
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How are the fats transported?
Explain two? |
In VLDL, LDL, and HDL proteins.
LDL has a low density and high amount of fat and is the worst. HDL has a high density and low amount of fat. |
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Explain what LDL's do?
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Transports cholesterol from the liver to cells and binds to receptors, for instance of vascular smooth muscle cells, and enters them.
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Explain what HDL's do?
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Transports cholesterol away from cells to the liver where it is catabolised.
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6 factors for atheroscleroris?
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Diabetes
High cholesterol Inactivity Obesity Tobacco smoke High blood pressure |
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Explain atherosclerosis?
What can happen? |
Damage to arteriole wall
Build up of debris Chemical reactions cause oxidation of cholesterol Inflamatory response releases chemicals which signal to monocytes Macrophages mop up cholesterol Macrophages turn into foam cells which accumulate to form plaque Arteriole wall thickens and hardens Smooth muscle multiplies and moves to the surface of the plaque The atheroma can break off and cause an embolus which can cause a heart attack or TIA. |
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Atherosclerosis in the legs?
Aorta? Brain? Heart? |
Peripheral vascular disease
Anneurism TIA or CVA Angina or MI |
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What is intermittent claudication?
Dissapears? |
Pain generally felt in the calf muscle after exercising.
Dissapears after a short rest |
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Intermittent claudication is a type of?
What happens in the legs? |
Peripheral arterial disease
Atherosclerosis |
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What is a pheochromocytoma and what does it do?
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A tumour on the adrenal glands that causes excess adrenalin and noradrenalin to be produced.
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Explain the three stages of hypertension?
systolic or diastolic taken into account more? |
Prehypertension = 120-139/80-89
Stage 1 = 140-159/90-99 Stage 2 = Greater than 160 or 100 diastolic Either systolic or diastolic is taken into account |
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Hypertension with an unknown cause known as?
Hypertensionw ith a known cause known as? |
Hypertension with unknown cause = Primary hypertension
Hypertension with known cause = Secondary hypertension |
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Three things that might cause hypertension and how
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Decreased blood flow to kidneys (athersclorosis for instance) increases AT2 and aldosterone.
Pheochromocytomas also. |
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What does hypertension do in blood vessels?
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Thickens the tunica media and increases systemic vascular resistance
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What does hypertension do in the heart and brain?
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In the heart it increases afterload which causes the myocardium of the left ventricle to thicken causing muscle damage.
IN the brain the capiliaries can rupture. |
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4 treatments for hypertension?
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Lose weight
Exercise Reduce smoking Reduce salt |
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3 drugs for hypertension
|
ACE inhibitors
Diuretics Calcium channel blockers |
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How do calcium channel blockers work?
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They block calcium from entering the muscle cells of the heart. Calcium is needed for the contraction of the heart.
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What is the major cause of premature mortality in the western world?
|
Ichemic heart disease
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Simple definition of ischemic heart disease?
What is needed by the heart and what is produced? |
An imbalance between myocardial perfusion and myocardial demand
C6H12O6 + 602 = e + 6CO2 + 6H2O |
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In IHD, what starts to block arteries and what 5 things is it made of?
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Atheroma
Fatty acids, cholesterol, macrophages, calcium, connective tissue |
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What is the disease process in ischemic heart disease?
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Atherosclerosis
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What is the first effect of ischemic heart disease or any disease of atherosclerosis?
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Ischemia (reduced blood supply)
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In diseases with atherosclerosis; ischemic heart disease, peripheral arterial disease etc, what three things can happen?
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Ischemia leading to infarction
Turbulant blood supply leading to thrombosis Anneurism (weakening of bv wall) |
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In ischemic heart disease...
Ischemia = ? Thrombosis = ? |
Ischemia = angina
Thrombosis = MI |
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What is a cerebral infarction?
Also known as? |
An ichemic kind of stroke due to infarction of brain tissue.
Cerebral vascular accident |
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Symptoms of an anneurism?
Symptoms of an aortic anneurism? |
Most anneurisms are sporadic but some of them seem to be inherited.
Aortic anneurism = ab pain or abnormal pulsating |
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What does the abdomnical aorta split into?
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The two iliac arteries that carry blood to the legs.
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What are varicose veins and are the viens involved?
What connects them? |
Blue veins showing on legs.
Superficial and deep veins connected by perforator veins. |
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Where are the deep veins found between and what does this do?
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Deep veins are found between muscles so when you contract them it helps to squeeze the blood back towards your heart.
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Where are varicose veins found and what cuases them?
|
They are found in superficial veins due to a problem in the valves causing a back flow of blood.
It is thought that the walls in your veins are weak causing your valves to expand and not work properly. |
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How does DVT form and what is a common process?
In what disease is it sometimes found? |
When there is damage to the endothelial wall by turbulant blood such as found in atherosclerosis.
Found in peripheral vascular disease patients |
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Patients with what symptom might be at risk of what?
|
Patients with intermitent claudication might be at risk of DVT.
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Two different types of raynauds syndrome?
|
Primary = unknown
Secondary = known cause |
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What happens in raynauds?
What can trigger an attack? |
Vasopasm of the arteries causes ischemia to the toes and fingers.
Cold temperature of stress can trigger an attack |
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3 types of edema?
|
Isotonic edema
Hypertonic edema Hypotonic edema |
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What does HPc stand for?
|
Hydrostatic pressure of the capillary
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Water likes to move?
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Towards greatest concentration
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Albumin makes what happen with edema?
Therefore liver problems might cause? |
Albumin causes water to diffuse back into the blood.
Blood pressure or edema problems |
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What does OPc mean?
The more albumin...? |
Osmotic pressure of the capillary created by albumin.
The greater the albumin, the more water is drawn into the cappilary. |
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At the arteriole end, what is the average HPc and what happens?
At the venule end, what is the average HPc and what happens? |
35 mm Hg pushing water out.
18mm Hg pushing water out. |
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With OPc, what happens at the arteriole end and how much?
Venule end? |
OPc = 25 mmHg and drawing water in
Stays the same at venule end |
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In the above case, whats the net osmotic pressure out?
In the above case what is the net osmoticp ressure IN? |
10mm Hg out
7mm Hg in |
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Where does the left over excess fluid go?
|
It goes to lymphatic vessel
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Name four ways edema can happen?
|
1 - Increase HPc
2 - Decreased plasma proteins 3 - Increased capillary permeability 4 - Blockage of lymphatic return |
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What is hyperaldoesteronism?
What does it do? |
Too much aldoesterone produced.
Causes potassium excretion, too much sodium. |
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With edema, name 4 ways increased HPc can happen?
|
Kidney failiure
Hyperaldoesteronism High venous pressure - heart failiure Decreased arteriole resistance |
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With edema, name 4 ways decreased plasma proteins can happen?
|
Kidney problems
Liver problems Burns B12 deficiency = methionine = proteins |
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With edema, name 4 ways increased capillary permeability can happen?
|
Vitamin deficiency (C to make collagen)
Histamine immune reactions (histamine increased permeability for inflamation) Toxins Bacterial infection |
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With edema, name 2 ways blockage of lymphatic return can happen?
|
Cancer
Infection |
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Explain heart failiure?
Symptoms 3? |
Inability of the heart to supply requirements for bodies metabolism
Tachycardia Edema due to venous congestion Breathlessness |
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Two types of heart failiure?
|
Acute - happens suddenly
Chronic happens over time |
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3 types of heart valve problems?
Explain them. At risk of what? But not? |
Valvular stenosis
Valvular insuficiency Mitral valve prolapse Risk of endocarditits except in MVP |
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3 symptoms of valve problems?
|
Shortness of breath
Palpitations Edema |
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Star of normal cardiac rhythm?
Fifth point? |
60-100bpm
Originates from SA node Normal conduction pathway Normal velocity Tail |
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Arrythmia ?
Less than 60bpm? 100-150bpm? 150-250? 250-350? 350+? |
Anything different from normal Cardiac rhythm
Bradycardia Simple Tachycardia/Tachyarythmias Paroxysmal tachycardia/tachyarythmias Flutter Fibrillation |
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Flutters and fibrillations can happen where?
3 classifications of bradyarrythmias? |
Atrial or ventricular
60-40 Mild BA 40-20 Moderate BA 20 - = Extreme BA |
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Any arryhtmias originating from above the ventricles called?
|
Supraventricular Tachyarrythmias
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Automaticity means?
|
Can generate their own action potentials
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Three ways the four points of arrythmias can be caused?
|
Increased automaticity
Triggered automaticity Re-entry |
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Explain how adrenalin or noradrenalin can increase automaticity
|
Adrenalin or noradrenalin stimulates beta one adrenergic receptors which stimulates the phosphorylation of aditional calcium channels and additional calcium comes in.
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What might cause triggered automaticity?
|
Ischemia
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Explain re-entry cause of arrythmia?
|
Electrical activity around scar or electrical resistant tissue increases time taken.
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Explain vegas nerve, inhalation, exhalation and stimulation of SA node.
|
Increased vegas activity = lowering of heart rate
Decreased vegas activity = raising of heart rate During inspiration vegas nerve is inhibited During expiration vegas nerve is excited |
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Four drugs to decrease SA node activity?
|
ABCD
Adenosine Beta blockers calcium channel blockers Digoxin |
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Simple definition of endocarditis?
|
Inflamation of the endocardium, aortic valve, mitral valve and tricuspid valve
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People at risk of endocarditis?
Symptoms? |
Abnormal heart valves
Heart disease Fever type symptoms |
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Diagnosed how?
Treated? |
Blood culture
If bacteria found, an echocardiogram is done. 6 weeks of IV antibiotics |
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Simple definition of pericarditis?
Symptoms? |
Inflamation of the pericardium
Chest pain |
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Treated?
Caused by sometimes?? |
NSAID's and prednisolone
A viral infection. |
