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73 Cards in this Set
- Front
- Back
Oxygen is the nutrient needed by body cells for the production of ATP
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Blood is iquid connective tissue that transports nutrients to body cells
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Plasma is the liquid portion of non-clotted blood
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albumin is the plasma protein that is important in controlling osmosis within the body
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Fibrinogen is the plasma protein that is converted by thrombin into fibrin threads in the blood clotting pathway
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Hepatocyte is the type of liver cell that produces the majority of the plasma proteins
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Gamma Globulins are plasma proteins made by differentiated B cells that are more commonly called antibodies
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a Erythrocyte is a red blood cell
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leukocyte is the general name for any white blood cell
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Hemopoiesis is the process of making the various blood cells within the red bone marrow
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Erythropoietin is the growth factor that differentiates red blood cells
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Thrombopoietin is the growth factor that differentiates a stem cell into a megakaryocyte cell
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Platelets are the small pieces of megakaryocyte cells that assist in blood clotting
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T cells are the type of lymphocyte that targets intracellular antigens
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Hemostasis is the process of stopping bleeding in the body
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Vascular spasm is the vasoconstriction of cut arteries to reduce bleeding
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Intrinsic pathway is the blood clotting pathway used for minor cuts
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Prothrombinase is the product of both the intrinsic and extrinsic pathways
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Vitamin K is the type of vitamin required for the synthesis of several of the blood clotting factors
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AV valves is the term used to describe the tricuspid and bicuspid valves which are located between the atria and ventricles of the heart
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the pulmonary artery is vessel exiting from the right ventricle of the heart
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Blood exiting the right ventricle of the heart travels through this valve...PULMONARY SEMILUNAR VALVE
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Blood exiting the left ventricle of the heart passes through this valve...AORTIC SEMILUNAR VALVE
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Visceral pericardium is the membrane that attaches to the outside of the heart
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Another name for the visceral pericardium...epicardium
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PARIETAL PERICARDIUM is the membrane that lines the cavity wall that the heart is located in
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PERICARDIAL SPACE IS THE Space between the visceral and parietal pericardium
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CARDIAC TAMPONADE IS A Very serious condition that results from blood filling the pericardial space and putting back-pressure on the heart
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Intercalated discs are the thickening of the membrane between cardiac muscle cells that contain gap junctions
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A site other than the SA node that initiates the electrical stimulus in the heart...ECTOPIC SITE
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The p wave Represents atrial contraction on an EKG
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t wave Represents ventricular RELAXATION on an EKG
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Another word for contraction or depolarization...SYSTOLE
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STROKE VOLUME IS THE AMOUNT OF BLOOD PUMPED OUT OF THE HEART PER HEART BEAT
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functions of the blood
transportation regulation of... temp osmosis ph protection-WBC clotting |
Plasma proteins made by hepatocytes…
albumin, fibrinogen, and alpha and beta globulins |
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Always put osmosis with albumin
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Osmosis-movement of water from a high concentration of water to a low concentration of water
Too few albumin proteins in the blood will cause water to shift into the tissues causing edema |
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FIBROGINOGEN-blood clotting
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GLOBULINS-3 kinds=alpha, beta, and gamma
Alpha-form chaperone proteins and complement proteins Beta-form chaperone proteins and complement proteins |
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Gamma globulins are the only plasma proteins that are NOT made by the liver cells…the hepatocytes
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A special group of cells make antibodies when an antigen comes into our body and antibodies kill antigens. The cells that make antibodies are called B-cells.
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When an antigen comes into the body the B-cells are activated and they further specialize (differentiate) into a plasma cell which make the antibodies. So plasma cells make the antibody that kills the antigen
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Another name for an antibody is a Gamma globulin and antibodies are proteins
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Gamma globulins are antibodies and they are proteins made by plasma cells which is a differentiated B cell.
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Granulocytes-basophils, neutrophils, eosinophils
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Agranulocytes-monocytes that turn into macrophages in the tissues, and 3 types of lymphocytes… B cells, T cells, and NK (natural killer)
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Hemopoiesis-the process of making blood cells-all of them. This process takes place in the red bone marrow which is in the ends of our long bones (femur, tibia, fibula, ect) and in our sternum, hip bone as well as our skull bones have red bone marrow
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In the red bone marrow there is adult stem cells also called hemopoietic stem cells
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Hemopoietic stem cells are partially differentiated and is in the red bone marrow
A hemopoietic stem cell can be turned into any type of blood cell |
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Kidneys make a growth factor called erythropoietin which is responsible for making RBC
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Thrombopoietin growth factors influence hemopoietic stem cells to make megakaryocytes which break off into pieces and make thrombocytes
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The growth factors that differentiate the various WBC’s are grouped into two groups
1-Colony stimulating factors 2-Interleukins |
Recall the differentiation pathway of RBC’s are under the influence of the growth factor erythropoietin
The initial cell is an hemopoietic stem cell which is an adult stem cell found in the red bone marrow Erythropoietin converts the hemopoietic stem cell into a… Proerythroblast-an immature red blood cell that differentiates into a… Polychromic erythroblast-manufactures all the hemoglobin (Hgb) Once Hgb is made then the polychromic erythroblast expunges the nucleus and then the cell is called… Reticulocyte-a new red blood cell and at this stage the other organelles are expunged which leaves the mature erythrocyte with only hemoglobin |
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erythrocyte differentiation
under the influence of erythropoietin hemopoietic stem cell proerythroblast polychromic erythroblast manufacturing all Hgb and nucleus gets expunged reticulocyte all other organelles are expunged leaving mature RBC with only Hgb |
RBC's are born and live about 120 days and then they die
The spleen and the liver are responsible for destroying the worn out RBC |
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RBC are filled with hemoglobin-Hgb
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Each Hgb cell is made to look like this…
4 proteins called globins Associated with each globin is a pigment called the heme group giving blood its red color Attached to each heme group is an iron-Fe Attached to each iron is an oxygen…So… Each Hgb is capable of carrying 4 oxygen molecules When a Hgb molecule is bound with its 4 oxygen we call it saturated |
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Hgb is a transport molecule…sometimes it is saturated and other times you may find it devoid of O2 due to it just dropping off its O2 to the tissues
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Anemia-lack of oxygen carrying capacity
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Anemia-lack of oxygen carrying capacity
In other words…the hemoglobin in the blood cannot carry adequate amounts of O2 Reasons why… 1-Low iron-therefore nothing for the O2 to bind to 2-low red red blood cell count a-bleeding b-kidney failure-the kidneys wouldn’t be making erythropoeitin 3-bone problems 4-sickle cell anemia (SCA)…sickle cell anemia causes rbc’s to shrivel up and shriveled up rbc’s cannot hold adequate amounts of oxygen |
Hypoxia-lack of oxygen to the tissues
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So if you are anemic then you will become hypoxic becoming cyanotic.
You can have hypoxia without being anemic because there could be a barrier preventing O2 from getting to the tissues even though there is plenty of O2 in the blood. Possible reasons preventing blood from getting to the tissues… #1 cause-blood clot As you age plague forms inside the walls of the arteries and as this occurs and a clot builds up in the coronary arteries the body will grow a new vessel to go around the obstruction. This is called COLATERAL CIRCULATION. The problem is that this collateral circulation provides less flow than the original artery however this is much better than not having any circulation. This is why having a heart attack at an older age is more beneficial because your body has had time t o grow these collateral circulatory arteries. |
As you age plague forms inside the walls of the arteries and as this occurs and a clot builds up in the coronary arteries the body will grow a new vessel to go around the obstruction. This is called COLATERAL CIRCULATION
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There are two tests to determine O2 carrying capacity of the blood
1-hematocrit (Hct)-measures the number of red blood cells 2-hemogloblin(Hgb)-measures how much hemoglobin is in each red blood cell |
leukocytes in order of activation
basophils neutrophils monocytes-->macrophages eosinophils |
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Basophils is activated first
Release histamines establishing and inflammatory response which vasodilates the vessels close to wound site taking more blood cells to the wound. It also makes the walls more permeable which is essential because we want the blood cells to get out of the vessels and into the tissues where he infection is. |
neutrophils
(they are phagocytic eating up bad stuff and die making pus) There are two types of neutrophils…young and old Bands-young neutrophils because their nucleus in still one big band Segs-old neutrophils because their nucleus is starting to segment into little pieces |
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monocytes
When they leave the tissue and go into the wound they turn into macrophages which go in and clean up all the dead stuff. These are the most important phagocytic cells in the body |
eosinophils
They make an antihistamine called histaminases that turns off the inflammatory response. Eosinophils are highly activated when you are infected with a parasite. |
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Lymphocytes-these are activated more for a generalized infection
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There are 3 different types of lymphocytes
B cells T cells NK cells |
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B cells typically target the extracellar environment (outside between the cells in the matrix) antigens (what is infecting us) any bugs outside the cells. B cells function by differentiating into plasma cells which produce antibodies to destroy that antigen
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There is variety of different T cells and they target intracellular antigens meaning that one of our cells is infected. They perforate the cell and kill it.
One important T cell is called the TH cells (h stands for helper) they are T cells that get attacked when a person is infected with HIV AIDS. These T Helper cells mediate the activity or both the B cells and all the other T cells. So if these cells are lost then we have lost our specific immune system…our immune system that forms a memory and can help recognize stuff. |
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B cells and T cells are very special because they can make a memory of infections but before they can form the memory they must first see the infection and then they can remember it forever.
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NK (natural killer)-roam around our body and look for our cells that just don’t look right (tumor cells) and they kill them. NK cells produce a chemical called perforins. This chemical perforates the membrane of our cell. Remember the outside covering of our cells is called the plasma membrane and that separates the extracellar and intracellar environments from one another. Once the membrane is perforated it ruins the integrity of the cell. Whenever the membrane ruptures the cell will die.
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Leucopenia-means you have a low number of WBC’s
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Leukocytosis-excess WBC count
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Rule of thumb-people suffering from from either of the above due to infection more than likely will have leucopenia with a viral infection and leukocytosis with a bacterial infection
Leukocytosis is also seen with leukemia and other types of cancer. Treatment to get rid of these excess WBC is chemotherapy which kills off all types of blood cells |
This shows you how many of each kind of WBC you have. A very valuable tool because it helps you determine a little better what is going on with the individual. Ex-high level of eosinophils could indicate parasitic infection or that you may be getting over and infecetion. A high level of band neutrophils would mean that they have a very acute current infection. High level of macrophages mean you are in the middle of an infection and they are in there trying hteir best to eat everything up. A high level of NK cells means you may have a tumor.
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Hemostasis means to stop our bodies from bleeding
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3 very distinct processes happen when ever we are cut
1-vascularspasm-this reduces the size of the vessel…vasoconstriction reduces the amount of blood loss It is more difficult for a vessel that is nicked than one that has been severed off to spasm 2-platelet plug-typically platelets do not have tendrils but if the blood vessel wall is damaged then the platelet comes along and sticks to it and grows tendrils that other platelets come along and get caught and stuck to which then grow more tendrils and eventually it makes a nice plug of the wound. Although it closes the wound and stops the bleeding it is very delicate…not a strong closure of the wound . 3-clot-the blood clotting process is a very long and involved pathway. There are special chemicals called clotting factors that are activated in order which ends up with a blood clot. |
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1-Intrinsic pathway-gets its clotting factors from inside the blood. Used for minor bleeds
2-Extrinsic pathway-gets its clotting factors from outside the blood. Used for major cuts or bleeds |
So when you cut yourself initially the intrinsic or extrinsic pathway gets used which will involve a whole bunch of clotting factors. After the initial pathway begins the common pathway.
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Regardless of which pathway used is that the end result will be that an enzyme will be made called
Prothrombinase |
Prothrombinase-enzyme made in the blood which converts into…
This is the start of the common pathway at prothrombinase all the way to the fibrin threads Prothrombin-this is a plasma protein that should be in everyone’s blood all the time. Prothrombin is inactive but will get converted to thrombin once it is activated by the prothrombinase. Thrombin then converts fibrinogen into fibrin threads. The fibrin threads are in fact the blood clot that covers the wound and close it up. They are very strong. |
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Recall that prothrombin and fibrinogen are our regular plasma proteins and should be in our blood at all times
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end of intrinsic or extrinsic pathway is prothrombinase and this is also the start of the common pathway
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common pathway
prothrombinase prothrombin thrombin fibrinogin fibrin threads note prothrombin and fibrinogin are always in everyones blood |
Vitamin K is a fat soluble and is very important as it is required to make several of the clotting factors. Vitamin K is stored in the liver. So liver failure is just awful for blood clotting because you are not able to make your plasma proteins fibrinogen and prothrombin and you cannot store vitamin K.
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end product of common pathway
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fibrin threads
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attached to the outside to the heart is a membrane called the epicardium which makes up the outside layer of the heart. Also called the visceral pericardium.
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Recall that every organ has two membranes. The visceral membrane that lines the organ itself and the parietal membrane that lines the cavity that the heart is in
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In addition to the epicardium/visceral pericardium is another membrane that lines the cavity that the heart is in (the pericardial cavity) This is called the parietal pericardium. This makes a sac for the heart to be in.
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the space between the visceral pericardium and the parietal pericardium is called pericardial space
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cause cardiac tamponade. This is where one of the layers either the visceral or parietal membrane of the heart gets damaged and as a result the pericardial space fills up with blood which constricts the heart by putting pressure on it and inhibits the heart from effectively filling with blood and pumping efficiently.
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The Heart Wall
The visceral pericardium-the outer layer of the heart. Also known as the epicardium Deep to the visceral pericardium or epicardium is a thick muscular layer called the myocardium The myocardium is thickest in the left ventricle because it has the most pumping power Deep to the myocardium is the endocardium…this also makes up the heart valves |
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Cardiac muscle cells tend to be elongated and they have intercalated discs between them.
Intercalated discs- Thickening of the cardiac muscle cell membrane Inside each intercalated disc is a gap junction |
Cardiac muscle cells are involuntary and highly branched. They also have a property that makes them autorhythmic which means they can start their own action potentials.
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Ectopic site-when a little group of muscles in the heart becomes overexcited and take over the SA node
An ectopic site can cause the heart to beat up to 250-260bpm |
Electrical conduction route
Begins in the SA node Travels through the gap junctions to the right and left atria to the AV node…once the stimulus gets here the atria contract In order for the stimulus to get through the wall dividing the atria and ventricles it goes through the Bundle of His-section in the wall where the stimulus crosses over to the Right and Left bundle branches putting it on either side of the ventricular septum into each ventricle Now in the base of the ventricles the stimulus spreads out to the Perkinje fibers carrying the stimulus into the ventricles…after this the ventricles contract |
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A big dipped Q wave is usually indicative of a previous heart attack
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Extra p-waves between QRS complexes are due to a heart block
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A widened QRS is highly indicative of a BBB-bundle branch block
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Cardiac cycle
1-4 chambers in diastole 2-Atria fill 3-pressure opens the AV valves 4-rapid ventricular filling 5-SA node fires R and L atria AV node 6-atria contract=p wave 7-Bundle of HisL and R bundle branchesperkinje fibers…ventricles contract=QRS complex 8-open semilunar valves 9-ventricles relax=t wave |
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Cardiac cycle
1-4 chambers in diastole 2-Atria fill 3-pressure opens the AV valves 4-rapid ventricular filling 5-SA node fires R and L atria AV node 6-atria contract=p wave 7-Bundle of HisL and R bundle branchesperkinje fibers…ventricles contract=QRS complex 8-open semilunar valves 9-ventricles relax=t wave |
the cardiac cycle
1-At the beginning of the cardiac cycle all 4 chambers of the heart are in diastole…they are relaxed 2-The atria are filling with blood and as they get full of blood pressure is getting generated. 3-The pressure from the blood filling the atria pops open the AV valves. (tricuspid and bicuspid valves) 4-rapid ventricular filling 5-SA node fires ->impulse goes through the R and L atria to the AV node 6-atria contract-see a p-wave 7-impulse goes through the Bundle of His-> to the Land R bundle branches to the perkinje fibers and the Ventricles contract. As they start to contract it pulls on the chordae tendenae holding the AV valves down so they won’t convert. QRS complex is shown on EKG 8- The pressure of the ventricles contracting pops open the semiunar valves Blood from the R ventricle goes through the pulmonary semilunar valve going to the lungs and at the same time blood from the L ventricle goes through the aortic semilunar valve going to the body 9-ventricles relax showing a t-wave on the EKG |
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You should always have some residual blood left in the ventricles
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End diastolic volume-how much blood is in the ventricle right before it contracts…at the end of its resting period. An average amount is about 200 mL
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End systolic volume-the amount of blood left in the ventricles after contracting. Appox-130 mL
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Stroke volume-the the amount of blood actually pumped out of the left ventricle per heart beat or per contraction. Approx 70 mL
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Heart murmur-an extra sound with each heart beat
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1-valvular stenosis…if something is stenosed it will not open properly
The valve that is most often stenosed is the aortic semilunar valve and causes a squishing sound. This stenosis affects your stoke volume which leads to poor tissue perfusion |
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valvular stenosis goes with aortic valve
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valvular regurgitation- Regurgitation meaning that blood shoots back up through the valve.
Typically effects bicuspid/mitral valve and causes an additional Dubb sound=Lubb Dubb Dubb |
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valvular regugitation goes with mitral valve
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septal defect-primary means there is a problem in the atria or ventricle septa.
The foramen ovale is the hole in the atrial septa of the fetus & should close before the fetus is born. The more critical septal defect is a hole in the ventricular septa. This is very serious and the classic diagnostic test is a chest x-ray which shows a huge right ventricle. This is because the blood shoots through the hole in the septum from the left ventricle and rams into the lateral wall of the right ventricle. |
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Tunica interna is the innermost wall
The inside lining of the blood in the lumen is often referred to as the endothelium The inside lining of the tunica interna is the endothelium The tunica interna is a single layer of simple squamous epithelial cells with a basement membrane. Simple=one cell layer thick squamous=fried egg shaped The inside lining layer of the cells not including the basement membrane is the endothelium. If you include the basement membrane with the epithelial cells then that is the tunica interna Remember the basement membrane is a nonliving layer that glues the cells to the layer beneath Endothelium is the inside layer of a blood vessel lumen also known as the tunica interna |
Endothelium is the inside layer of a blood vessel lumen also known as the tunica interna
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The middle layer is the tunica media-very important layer
Composed of varying amounts of elastic fibers and smooth muscle This smooth muscle wall is responsible for the vasodilatation and constriction |
External layer of the blood vessel walls is the tunica externa made of connective tissue that keeps the vessel intact
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Arteries
Divided into three groups 1-elastic (conducting)-the largest vessels Include the aorta, brachiocephalic, pulmonary, common carotids There is more elastic fibers than smooth muscle in their middle layer the tunica media When the left ventricle contracts the blood surges into the aorta causing the aorta to stretch to accomadate the blood then the elastic fibers in the middle tunic recoil it back to its original size which in turn surges the blood into the body. So in essence the large vessels act as a back up pump 2-muscular (distributing)-all the other arteries are in this category The middle tunic of these arteries have more muscle so they are better at vasoconstriction and vasodilatation. This also helps distribute the blood out to the body’s tissues. 3-arterioles-smallest arteries. They are microscopic and numerous. Do NOT have names They have different patterns in different people growing into webs. Have a large amount of smooth muscle in their walls and are very important in controlling blood pressure through vasoconstriction and vasodilatation. |
arteries
elastic (conducting)-the largest vessels Include the aorta, brachiocephalic, pulmonary, common carotids There is more elastic fibers than smooth muscle in their middle layer the tunica media When the left ventricle contracts the blood surges into the aorta causing the aorta to stretch to accomadate the blood then the elastic fibers in the middle tunic recoil it back to its original size which in turn surges the blood into the body. So in essence the large vessels act as a back up pump |
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arteries
muscular (distributing)-all the other arteries are in this category The middle tunic of these arteries have more muscle so they are better at vasoconstriction and vasodilatation. This also helps distribute the blood out to the body’s tissues. |
arteries
arterioles-smallest arteries. They are microscopic and numerous. Do NOT have names They have different patterns in different people growing into webs. Have a large amount of smooth muscle in their walls and are very important in controlling blood pressure through vasoconstriction and vasodilatation. |
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The capillary wall is the only vessel wall that we get nutrient/waste exchange across
The walls are specially designed for this exchange One cell layer thick of simple squamous cells with a basement membrane so… They only have the internal tunic Between each cell are spaces called fenestrations |
ways capillary walls are highly adapted for nutrient/waste exchange
1-one cell layer thick 2-they have fenestrations |
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2 reasons why pressure is less in veins than in arteries
1-further away from the pumping source 2-because the size of their lumen goes from small to large |
Capillary exchange-
simple diffusion facilitated diffusion active transport vesicular transport and the most important is BULK FLOW |
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Passive movement when things move all on their own from high to low
Two ways the above can happen 1-pass through the phospholipids-simple diffusion 2-open a protein doorway-facilitated diffusion General rules… If something passes through the phospholipids we call it simple diffusion 4 things can go through simple diffusion Oxygen, water, carbon dioxide, and small lipids |
Facilitated diffusion-when things move using a protein doorway
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Active transport-when we have to use energy and we are moving things from low to high
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Vesicular transport-Sometimes things are too big to pass through doorways, particularly antibodies as they are big proteins. So the golgi apparatus packages up the antibody and ships it out as a vesicle.
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Bulk flow is controlled by two pressures
**1-blood hydrostatic pressure (bhp)-the pressure of the water in the blood against the inside wall of the capillary. This pressure always moves fluid out of the capillary and this is called filtration Filtration-movement of fluid out of the capillary **2-blood colloid osmotic pressure (bcop)-the difference in osmotic pressure across the capillary wall. This pressure will always move water back into the capillary and this is called reabsorbtion |
**1-blood hydrostatic pressure (bhp)-the pressure of the water in the blood against the inside wall of the capillary. This pressure always moves fluid out of the capillary and this is called filtration
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Filtration-movement of fluid out of the capillary
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**2-blood colloid osmotic pressure (bcop)-the difference in osmotic pressure across the capillary wall. This pressure will always move water back into the capillary and this is called reabsorbtion
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**Blood flow from the arteriole into the capillary will produce high BHP because your going from a large tube to a much smaller one.
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**As you move down the capillary less and less fluid moves out because there is less pressure as I have put the water out.
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The concentration of albumins changes because the fluid has moved out so they are becoming more concentrated=same amount of albumins but not so much water causes a higher concentration of albumins. Because there is now more water in the tissues blood colloid osmotic pressure takes over which will now move the fluid back into the capillary. The albumins are the colloid in the vessel. As you go down the capillary to the venule less and less water comes in because the osmotic pressure becomes decrease due to the concentration of the albumins rising.
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About 30L of fluid is moved out a day and 27L of fluid are moved back into the blood a day. The other 3L is picked up by the lymphatic capillaries and it travels through the lymphatic vessels and returned back into the blood via the subclavian vein.
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2 pressures that control bulk flow-blood hydrostatic pressure and blood colloid osmotic pressure
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The cause of BHP is the movement of a large volume of blood into a smaller tube
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The cause of BCOP is fluid has moved out and the albumins have become concentrated and that upset osmosis across the capillary wall
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**1-blood hydrostatic pressure (bhp)-the pressure of the water in the blood against the inside wall of the capillary. This pressure always moves fluid out of the capillary and this is called filtration
**2-blood colloid osmotic pressure (bcop)-the difference in osmotic pressure across the capillary wall. This pressure will always move water back into the capillary and this is called reabsorbtion |