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153 Cards in this Set
- Front
- Back
Cardiodynamics
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refers to the movements and forces generated during cardiac contractions
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End-Diastolic Volume
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-the amount of blood in each ventricle at the end of ventricular diastole
-potential blood to be ejected |
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End-Systolic Volume
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-the amount of blood remaining in each ventricle at the end of ventricular systole
-blood remaining after ejection |
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Stoke Volume
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-the amount of blood pumped out of each ventricle during a single beat
SV = EDV - ESV |
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Ejection Fraction
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the percentage of the EDV represented by the SV
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Cardiac Output
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-the amount of blood pumped by the left ventricle in one minute
-actual work done by heart -measured in mL/min CO = HR x SV |
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Cardiac Muscle
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controlled neurally and hormonally
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Dual Innervation of Heart
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-receives efferent signals from sympathetic & parasympathetic nerves
-Parasympathetic --> Vagus Nerve --> restricted towards base of heart innervating SA & AV nodes -Sympathetic --> Thoracic Splanchnic Nerves --> innervates most of heart |
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Chronotropic
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-increase or decrease in heart rate
-Parasympathetic = negative effect (decrease) -Sympathetic (and epinephrine) = positive effect (increase) |
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Inotropic
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-increase or decrease in strength of contraction (Review Slide)
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Dromotropic
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-increase or decrease in rate of action potential
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Increasing heart rate takes time away from what?
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-increased heart rate takes time away from diastolic ventricular filling
-around 210 bpm is the maximum rate without compromising CO |
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Parasympathetic Stimulation
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-Controls rate during resting periods
-increase in parasympathetic activity = decrease in heart rate -Parasympathetic neurons release ACh which opens K+ channels & slows depolarization -hyperpolarization --> takes longer to reach threshold |
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Sympathetic Stimulation
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-Controls heart rate during times of activity
-increase in sympathetic activity = increase in heart rate -Sympathetic neurons release NE which bind to beta receptors & open Sodium-Calcium ion channels increasing the rate of depolarization |
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Atrial Reflex
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-involves adjustments in heart rate in response to and increase in venous return
-walls of atria are stretched = increase in heart reate |
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Preload
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-degree of stretching experienced by ventricular muscle cells during ventricular diastole
-directly proportional to the EDV |
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Three Factors That Influence ESV
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1)preload
2)contractility (force produced during contration) 3)afterload |
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Afterload
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-the amount of tension the contracting ventricle must produce to force open the semilunar valve and eject blood
-what heart has to work against in vasculature |
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Arteries
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-thick walled conducting vessels
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Capillaries
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-exchanging vessels
-adequate perfusion depends on how much blood is in capillaries -only have simple squamous epithelium -there is a concentration gradient & small distance for exchange |
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Veins
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-thin walled capacitance vessels
-contain a lot of the bodies blood because they tend to let blood pool rather than push in along like arteries |
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Artery to Capillary
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-divergence
-smaller vessels, but many more = greater area |
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Capillaries to Veins
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-convergence
-larger vessels, but fewer = lower area |
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In what vessels is the flow rate lowest?
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-capillaries --> have highest rate of diffusion
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Tunica Intima
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-simple squamous epithelium
-continuous with lining of heart |
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Tunica Media
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-circular smooth muscle
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Tunica Externa
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-connective tissue sheath
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Elastic Artery
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-Aorta and its initial branches have elastin layers around smooth muscle
-ventricle contracts --> aorta expands --> aorta passively recoils, --> elastic recoil keeps blood flowing during ventricular diastole |
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Muscular Artery
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-typical artery
-pure conducting vessel -flow determined by pressure & resistance |
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Blood Flow
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-same thing as CO
Flow = change in pressure / resistance -increase in pressure = increase in flow |
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Arterioles
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-last branch that has smooth muscle before capillaries
-smooth muscle in arterioles = strongly contractile -Arterioles have smooth muscle tone --> sympathetic input controls diameter of lumen |
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Vasoconstriciton
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-when arterial smooth muscle contracts, thereby constricting artery
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Vasodilation
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-relaxation of arterial smooth muscle, which increases diameter of lumen
-drop in frequency of sympathetic stimulation below that of normal muscle tone |
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Resistance
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-high resistance = low flow
-low resistance = high flow |
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Viscosity
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-thickness of a fluid
-high viscosity = low flow -low viscosity = high flow |
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Review Relationships
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Pg. 732 Table 21-1
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Radius of vessels on blood flow
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Resistance = 1/r^4
Flow = r^4 |
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Cardiac Plexus
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-the sympathetic & parasympathetic divisions of the autonomic nervous system innervate the heart by means of the Cardiac Plexus
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Cardiac Centers
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-Cardiac Center of the medulla oblongata contain the autonomic headquarters for cardiac control
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Circulating hormones such as Epinephrine, Norepinephrine, and Thryoid Hormone (T3) have what effect on heart rate?
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increase heart rate
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Cardiac Reserve
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difference between resting and maximal cardiac outputs
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Continuous Capillaries
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-complete endothelial lining
-complete basement membrane -least permeable |
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Fenestrated Capillaries
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-have pores that penetrate the endothelial lining
-have a complete basement membrane -permit rapid exchange of water and solutes -most numerous |
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Sinusoidal Capillaries
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-also has fenestrated endothelial lining
-incomplete basement membrane -found in spleen, liver, & red bone marrow -most permeable -allows for exchange of solutes as large as plasma proteins |
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Capillary Bed
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-aka Capillary Plexus
-functioning network of interconnected capillaries |
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Transport Across Capillary Wall
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-oxygen/carbon dioxide
-small, water soluble substances pass through pores -lipid soluble substances pass through endothelial cells -plasma proteins & blood substances (ex. platelets) can not pass through |
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Precapillary Sphincters
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control diameter of entrance to each capillary
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Capillary Filtration
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-movement of water across capillary do to pressure
-blood pressure is the driving force -water outside has Interstitial Fluid Hydrostatic Pressure |
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Blood Pressure
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-aka Blood Hydrostatic Pressure
-refers to arterial pressure |
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Starling Forces
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-Blood Hydrostatic Pressure
-Interstitial Fluid Hydrostatic Pressure -Blood Osmotic Pressure -Interstitial Fluid Osmotic Pressure |
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NDF =
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NDF = (Pc - Pt) - o(Pic -Pit)
Pc-->capillary hydrostatic pressure Pt-->tissue hydrostatic pressure o--> Pic-->capillary plasma oncotic pressure Pit-->tissue fluid oncotic pressure |
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Review Capillary Filtration
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2-12-09 Notes
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Capillary Filtration (net movement)
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-net movement is always outward
-3L of water lost from capillary filtration --> absorbed by Lymphatic Capillaries |
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Lymphatic Capillaries
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-thin walled
-no basement membrane -1 way transport from tissue to venous circulation ending at heart -fluid in lymphatic system is called lymph |
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High endothelial venule / Postcapillary venule
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-cuboidal
-specialized for diapedesis of leukocytes -sensitive to histamine |
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Vein Sizes
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-venules --> medium veins --> large veins (vena cava) --> heart
C = change in V/ change in P C--> compliance |
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Central Venous Pressure
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-increases to increase venous return
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Factors influencing Venous Return & Central Venous Pressure
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-valves in veins
-skeletal muscle pump -respiratory pump -venomotor tone -blood volume |
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Skeletal Muscle Pump
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-squeezes on veins increasing pressure when muscles contract
-this moves blood towards the heart -muscles relax --> blood flows into veins between muscle |
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Respiratory Pump
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-inspiration --> decreases pressure in thoracic cavity & increases pressure in abdominal cavity
-Greater pressure on veins in abdominal cavity --> move blood towards heart |
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Review Slide of Starling's Law of the Heart & Intrinsic vs. extrinsic control of contractility
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-Heart III Slides
-Extrinsic effects Intrinsic |
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Blood Volume
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-Increase in Blood Volume --> Increase in Venous Pressure
-Decrease in BV --> Decrease in VP -long term regulation of blood pressure occurs through regulation of blood volume |
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Flow Equation
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F = ΔP/R
F = volume/time = CO --> CO = ΔP/R --> CO = MAP/R where R α (η . L)/r^4 |
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MAP
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Mean Arterial Pressure
ΔP = MAP MAP = DP + (SP – DP)/3 |
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Total Peripheral Resistance
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-when the viscosity of the blood and the length of the vascular tree are constants, R is most related to the degree of vasoconstriction or vasodilation of all the arterioles in the body, or the total peripheral resistance = TPR
-left ventricle can pump same volume of blood as right ventricle with lower pressure because TPR in lungs is lower |
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Cardiac Output =
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CO = MAP/TPR -->
MAP = CO x TPR |
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Mean Arteriole Pressure (regulation)
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-regulated by cardiac reflexes, which have both neural & hormonal components
-MAP allows for adequate perfusion |
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Cardiac Reflexes
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global --> effects total body blood pressure
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Autoregulation
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-local regulation of BP
-there is always perfusion to brain, heart, & kidneys |
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Hyperemia
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refers to blood flow to skin
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Increased MAP countered by...
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mechanisms that decrease pressure (and vice versa)
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Sensory Input to Cardiovascular Control Center (CCC)
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-Baroreceptors
-Chemoreceptors -Mechanoreceptors/Proprioceptors |
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Baroreceptors
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-most important
-detects BP (stretch) -in walls of aorta & vena cava |
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Chemoreceptors
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-detect levels of Carbon Dioxide/ decrease in pH
-in aorta & carotid artery |
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Mechanoreceptors/ Propioceptors
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-detect activity/movement
-in tendons & joints -associated with exercise |
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Baroreceptor Reflex
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-Aortic Bodies sense stretch --> Vagus Nerve (CN X) carries signal
-Carotid Bodies sense stretch --> Glossopharyngeal Nerve (CN IX) carries signal -Visceral afferent fibers lie in dorsal root ganglia or in the sensory ganglia associated with cranial nerves (VII, IX, X). Their somae lie in the nodose ganglion and project via the vagus to the nucleus tractus solitarius (NTS). -The solitary nucleus and tract are structures in the brainstem (medulla and pons) that carry and receive visceral sensation from the facial (VII), glossopharyngeal (IX) and vagus (X) as well as from ascending spinal tracts -Receives primary afferent neurons related to cardiovascular, respiratory and gastrointestinal functions - These first central neurons within the solitary nucleus can participate in autonomic reflexes that may be as simple as two central neurons with the second neuron being an efferent or motor neuron that projects back directly to the organ such as the heart forming some of the simplest reflex pathways in the brain. |
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Cardiac Control Center
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–cardioacceleratory center (CA) --> sympathetic
–cardioinhibitory center (CI) --> parasympathetic –vasomotor center (VMC) --> sympathetic |
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Adrenergic
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-NE from sympathetic neurons or Epinephrine from renal medulla
-sympathetic |
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Cholinergic
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-Ach
-sympathetic |
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Nitrooxynergic
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-directly promotes NO as vasodilator
-sympathetic |
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Sympathetic stimulation of heart & arterioles -->
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-also causes sympathetic stimulation of veins -->
-increases returning volume to heart --> -increase heart rate & stroke volume |
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Renin-Angiotensin-Aldosterone System
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-effects are 5x stronger than sympathetic
-hormonal effect |
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Review Reflex Arcs of Various Disturbances in circulation
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Heart III slides
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Juxtaglomerular Apparatus
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-source of renin
-macula densa --> sensory component of system |
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CCC & R-A-A systems
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short term responses
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Long term response to increase/decrease in blood pressure
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-effects composition of blood
-activation/deactivation of erythropoetin |
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Natriuretic Peptide
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-released by cells in the right atrium in response to increase in blood pressure & volume
-act to reduce BP -Diuretic -Fluid Shift mechanism --> can be as large as 2-3 L |
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Lymph Flow
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The lymph flow is slow because there is no pump (like the heart) to pump it.
The factors which support the circulation of the lymph are the same factors which support the venous return to the heart: Contraction of the skeletal muscles. The pulsation of the nearby arteries can compress lymph vessels and move the lymph within them. The presence of the valves permitting the lymph to move only in the direction of the blood stream. Pressure changes due to the contraction of respiratory muscles. NB: the immobility blocks the drainage and causes edema. |
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Major Lymph Trunks
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-Lumbar trunks: left and right, drain the lower limbs, the pelvis and the abdomen except the digestive system.
-Intestinal trunk: drains the part of the digestive system located below the diaphragm. It receives the chyle from the digestive tract. -Broncho-mediastinal trunks: left and right, drain the thorax. -Jugular trunks: left and right, drain head and neck. -Subclavian trunks: left and right, drain the upper limbs. These trunks then join one of the two collecting ducts; the thoracic duct or the right lymphatic duct. |
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Right Lymphatic Duct
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-It is about 1.25 cm. in length, if present.
-It ends in the angle of confluence of the right subclavian and the right internal jugular veins (forming the beginning of the right brachiocephalic vein). Tributaries: -The right lymphatic duct receives the lymph from the right side of the head and neck through the right jugular trunk; -from the right upper extremity through the right subclavian trunk; -From the right side of the thorax, through the right bronchomediastinal trunk. -There are variations in the emptying point of the right lymphatic duct. |
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Thoracic Duct
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-It begins in the abdomen by a triangular dilatation, the cisterna chyli, which is situated on the front of the body of the second lumbar vertebra, to the right side of and behind the aorta. The cisterna chyli receives the two lumbar lymphatic trunks, right and left, and the intestinal lymphatic trunk. On ascent, it receives the left bronchomediastinal, left subclavian and left jugular trunks.
-It therefore drains: 2 lower limbs, the pelvis and the abdomen, the left half of the head and neck the left half of the thorax, and the left upper limb. -The thoracic duct conveys the greater part of the lymph and chyle into the blood. -It ends by opening into the left subclavian vein, the left internal jugular vein, or at the angle of junction of these two (left brachiocephalic). -At its termination, thoracic duct possesses a bicuspid valve which faces into the vein, to prevent reflux of blood into the duct. |
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Macrophages
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-phagocytic
-androgen presenting (APC's) |
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Lymphatic Nodules
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have germinal centers
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Lymph Nodes
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-facilitate antibody/antigen interaction --> aka immunity
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Spleen
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-largest lymphoid organ
-deep to ribs, left of stomach -encapsulated organ surrounded by connective tissue -has lymphatic nodules called splenic nodules in spleen -red pulp & white pulp -platelets "stored" in spleen when not in blood -not essential for life, but more prone to infection without it -2 Main Functions 1) Facilitate interaction of foreign antigens w/ cells of immune system (T cells, B cells, macrophages) (occurs in white pulp) -splenic nodules (B Cells) & PALS (T cells) 2) To remove old red blood cells (macrophages) (occurs in red pulp) |
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Central Artery
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-has uniform coating of lymphocytes around it
-acentric coat --> additional coat made up of B cells (if nodules are present) or T cells (if no nodules are present) -2 coats --> white pulp --> always associated with central artery --> after they penetrate white pulp, arteries end |
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Splenic Macrophages
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-PAMS
-Sheathed Capillaries |
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Splenic Sinuses
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-sinusoidal capillaries that let blood back into vessels
-sinuses lined by macrophages --> remove anything left over that needs to be removed before re-entering blood circulation |
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Thymus
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-only involved with immunity; no monitoring
-encapsulated organ -epithelial reticular cells -Thymic Globules --> divisions inside capsule of Thymus 1) outside --> Thymic Cortex 2) inside --> Thymic Medulla |
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Hassall's Corpuscles
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-made up of endothelial reticular cells
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Thymus Cell Selection
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-Thymus selects perfect T cells for circulation
-Recognize body just enough to not attack own cells |
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Blood-Thymus Barrier
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selective barrier that isolates the thymus from the rest of the body
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T Cells also made in diffuse lymphoid tissue (uncapsulated)
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-reason bone marrow transplant workd
-Diffuse Lypmhatic Tissue/MALT -tissue is immediately deep to mucosa (first place an invader would enter) -Cells that form nodules & have germinal center = B cells |
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GALT
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Gastrointestinal Associated Lymphoid Tissue
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Tonsils
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-Associated with upper sections of gastrointestinal & respiratory systems
-Adenoids --> near opening of eustachian tube -Palatine --> back of throat -Lingual --> base of tongue -together form Waldyer's ring |
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Waldyer's Ring
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ring of tonsils at back of oral cavity
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Tonsilectomy
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-not done much any more
-any left over tissue regenerates |
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Ileum
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-contains large lymphatic nodules called Pryor's Patches
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Vermiform Appendix
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-pouch off of colon (cecum)
-thought of as useful lymphatic tissue |
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Body Defenses
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-provide resistance to fight infection, illness, and disease
-2 categories of defense 1) Innate --> non-specific defense 2) Adaptive --> specific defense -the 2 work together to provide resistance to infection & disease |
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Innate Immunity
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-provides initial defense against infection & injury
-comprised of cells & mechanisms that defend host from infection by other organisms in a non-specific way |
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Primary Components of Innate Immunity
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1)Physical & Chemical Barriers
2)Phagocytic cells (neutrophils & macrophages), Natural Killer (NK) cells, & possibly dendritic cells 3)Blood Proteins, including members of complement system & other mediators of inflammation 4)Cytokines regulate & coordinated many of the activities of the cells of innate immunity |
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Times of Innate & Adaptive Immunity
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-Innate Immunity: immediate response --> about 12 days
-Adaptive Immunity: after 1 day |
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Defensins
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-on the skin
-enter cytoplasm of invader -create osmotically active hole --> cell death |
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Immunological Surveillance
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-carried out by NK cells
-Identify and attach to abnormal cell (nonselective) -Golgi apparatus in NK cell: forms perforin vesicles -Vesicles release proteins called perforins (exocytosis) -Perforins lyse abnormal plasma membrane -Also attack cancer cells and cells infected with viruses |
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Immunological Surveillance with Cancer Cells
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With tumor-specific antigens:
-are identified as abnormal by NK cells -some cancer cells avoid NK cells (immunological escape) |
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Immunological Surveillance with Viral Infections
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Cells infected with viruses:
-present abnormal proteins on plasma membranes -allow NK cells to identify and destroy them |
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Complement Proteins
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-about 26 of them; in blood at all times
-activation -- > through a cascade or alternate pathway -alternate pathway requires direct contact with a foreign body |
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Functions of Complement Proteins
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-opsonization --> coat outside to make bacteria more susceptible to phagocytosis
-Membrane Attack Complex (MAC) --> directly lyse bacteria & foreign cells -Causes inflammation --> histimine release, increased blood vessel permeability, chemotactic attracion of phagocytes |
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Inflammation
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1) Produces chemotactic substances to attract phagocytes
2) Increase vascular permeability 3) Cause smooth muscle contraction promoting mast cell degranulation |
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Interferons
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-almost any cell in the body can produce them when stimulated
-Assist immune system by: 1) inhibiting viral replication within host cell 2) inducing host cell resistance to viral infection 3) Activating NK cells and macrophages 4) Increasing antigen presentation to lymphocytes |
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Inflammation (local response)
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-acute inflammation --> occures within seconds, minutes, hours, and days
-chronic inflammation --> occurs over long periods of time |
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Events in acute inflammation
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1)Increased blood flow due to dilation of blood vessels (arterioles) supplying the region
2)Increased permeability of the capillaries, allowing fluid and blood proteins to move into the interstitial spaces 3)Migration of neutrophils (and perhaps a few macrophages) out of the venules and into interstitial spaces |
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Signs of Inflammation
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-Redness
-Swelling -Heat -Pain -Sometimes loss of function |
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Inflammation begins with...
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chemical alarms
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Non-steroidal Anti-inflammatory Drugs (NSAID's)
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-used to reduce inflammation by blocking release of histamine
-glucocorticoids can also be used to stop inflammation |
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Cryogenic Membrane
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isolates injured area/infection
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Vascular Effects during Inflammation
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-Release of histamine
1)Vasodilation --> Heat & Redness 2)Capillary Permeability --> Swelling & Pain |
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Fever
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-a systematic response creating a high body temperature
-triggered by endogenous pyrogens -resets internal thermostat in hypothalamus 1)increases body metabolism 2)accelerates defense 3)inhibits some viruses & bacteria |
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Properties of Adaptive Immunity
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-adaptive immunity mechanisms are slow
1) Tolerance --> self antigens do not normally elicit an immune response 2) Specificity --> a specific defense is initiated by a specific antigen. Each lymphocyte has receptors that bind to one particular antigen i.e “lock and key” 3)Versatility – the numbers of lymphocyte receptors is variable enough to accommodate millions of possible antigens 4)Memory – the basis of acquired immunity |
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Self & Non-self
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At the heart of the immune system is the ability to distinguish between self and nonself. Virtually every body cell carries distinctive molecules that identify it as self.
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MHC Class I
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found on all cells in the body
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MHC Class II
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Found on APCs e.g. macrophages, dendritic cells, and B cells
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Antigens
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-macromolecules that causes an immune response by lymphocytes.
-This response is mediated by an antigen receptor, a surface protein located on B cells and T cells, that specifically binds to antigens and initiates adaptive immune responses. -The antigen receptors on B cells are called B cell receptors and the antigen receptors on T cells are called T cell receptors. |
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Third line of defense in Adaptive Immunity
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Lymphocytes
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Humoral Immunity
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-antibodies in body fluids
-directed against extracellular bacteria 1)B Cells bind antigens --> becomes sensitized 2)B Cell encounters a helper T Cell --> activation 3)Begins secreting cytokines --> B Cell division 4)Inactive Memory B Cells produced 5)Stimulated Memory B Cells --> differentiate into plasma cell --> produce antibodies |
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Cell-Mediated Immune Response
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-occurs when a foreign body enters the cell
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Antigen Presenting Cells (APC's)
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-Macrophages, Dendritic Cells, T Cells
-Amplifies B cell response |
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Epitope
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-smallest part that can be recognized
-just one epitope needed for antigen recognition --> immunity |
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Clonal Selection
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-There are many B cells with different receptors on surface
-B cells only respond to antigens that can fit with/bind with their particular receptor |
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Functions of Antigen-Antibody Complexes
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-Neutralization of antigen-binding sites
-Precipitation and agglutination: formation of immune complex -Activation of complement -Attraction of phagocytes -Opsonization: increasing phagocyte efficiency -Stimulation of inflammation -Prevention of bacterial and viral adhesion |
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Induced Active Immunity
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Develops after administration of an antigen to prevent a disease
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Naturally Acquired Active Immunity
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Develops after exposure to antigens in environment
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Natural Acquired Passive Immunity
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Conferred by transfer of maternal antibodies across placenta or in breast milk
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Induced Passive Immunity
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Conferred by administration of antibodies to combat infection
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Pivotal Role of T(h) cell
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-Release cytokines
-stimulate B Cells --> humoral response (secretion of antibodies by plasma cells) -stimulate Cytotoxic T Cells --> cell-mediated response (attack infected cells) |
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Model of Immune Responses (Speed & Specificity)
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1)Neutrophils
2)NK cells 3)Macrophages 4)Cytotoxic T Cells 5)Plasma Cells 6)Antibody Titer |
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Antibodies
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-belong to a class of protein molecules known as immunoglobulins.
-Immunoglobulins G, D, and E are similar in appearance. |
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IgG
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the major immunoglobulin in the blood, is also able to enter tissue spaces; it works efficiently to coat microorganisms, speeding their destruction by other cells in the immune system.
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IgD
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is almost exclusively found inserted into the membrane of B cells, where it somehow regulates the cell's activation.
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IgE
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is normally present in only trace amounts, but it is responsible for the symptoms of allergy.
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IgA
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a doublet--guards the entrance to the body. It concentrates in body fluids such as tears, saliva, and secretions of the respiratory and gastrointestinal tracts.
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IgM
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usually combines in star-shaped clusters. It tends to remain in the bloodstream, where it is very effective in killing bacteria.
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