Brief Review for Final Exam Aug 09-1

Brief Review for Final Exam Aug 09-1 - Brief Review for...

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Unformatted text preview: Brief Review for Final Brief Review for Final Exam BLOOD FLOW BLOOD FLOW Cranial/caudal vena cava Right atriumTricuspid valveRight ventricle Pulmonic valvePulm arteries (2: one to each lung) Pulm veinLeft atriumMitral valve (bicuspid) Left ventricleAortic valveAorta http://upload.wikimedia.org/wikipedia/commons/thumb/e/e 5/Diagram_of_the_human_heart_(cropped).svg/300px­ Diagram_of_the_human_heart_(cropped).svg.png PLASMA PLASMA Watery portion contains: Electrolytes Plasma proteins Albumin, fibrinogen, globulins (include Ab), coagulation factors Liver produces albumin, most coag factors, most globulins B lymphocytes produce remaining globulins (e.g. IgG) Carbohydrates Lipids BLOOD PRESSURE BLOOD PRESSURE Measured either: Direct method Indirect method Direct: Arterial catheter Catheterize right heart Catheterize left heart Place catheter tip into pulmonary artery (pulmonary wedge pressure) Place catheter into brachial artery or femoral artery into left atrium Venous catheter in jugular vein REGULATION OF CARDIAC REGULATION OF CARDIAC OUTPUT Preload (blood coming to heart) affects End­ systolic volume Afterload (force against which ventricle must eject its contents) affects ESV Right ventricle afterload = mean pulmonary artery pressure Left ventricle afterload = mean systemic arterial pressure Increased Mean pressure more difficult to empty ventricles (vasodilation) BLOOD PRESSURE CONTROL: BLOOD PRESSURE CONTROL: SENSORS AND NEURAL REFLEXES Sensors Primary: Baroreceptors Stretch receptors that detect distension of vascular wallsincreased AP in sensory nervevasodilation and bradycardia Located in carotid sinus and aortic arch (Boron, pg 537) Secondary: Chemoreceptors Detect changes in blood pO , pCO 2 2 and pH Located in CNS (brainstem: medulla; hypothalamus, cerebral cortex) http://student.bmj.com/back_issues/0599/graphics/0599 BLOOD VESSEL INNERVATION BLOOD VESSEL INNERVATION Many blood vessels are innervated with a mix of α1 and β2 receptors It depends on the blood vessel’s job on which type is more prominent or only type present Examples: Blood vessels to skin have only α1 receptors and only vasoconstrict Blood vessels to heart have primarily β receptors 2 so vasodilate PULMONARY VENTILATION PULMONARY VENTILATION Lungs are expanded in 2 ways: 1. Movement of diaphragm 2. Movement of ribs http://cache.eb.com/eb/image?id=62651&rendTypeId=4 CONDUCTING AIRWAYS CONDUCTING AIRWAYS Trachea Right and left mainstem bronchi Bronchioles (lack cartilage, stay open by ­ pressure around them) 1. Terminal bronchioles Total lung capacity – 5 to 6 L in adults Anatomic dead space (lips/nose to terminal bronchioles 150 ml in healthy young males 100 ml in healthy young females 2. Respiratory bronchioles (alveoli bud off these bronchioles) Alveolar ducts Alveolar sacs http://www.mnstrokeregistry.com/asthma/images/lungs4.gif DEFINITIONS DEFINITIONS Inspiratory reserve volume Expiratory reserve volume At end of quiet respiration, additional air a person could inhale with maximal effort After quiet expiration, additional volume of air a person could expire with maximal effort Residual volume Air remaining in lungs after Maximal expiratory effort Minimizes airway collapse Maintains constant blood flow to lung PRINCIPLE OF PRINCIPLE OF INTERDEPENDENCE Each alveolus is joined to the adjacentalveolus, helping to hold it open If an alveolus collapses, it collapses into larger alveoli ↓ total alveolar surface area for O2 and CO2 exchange Clinically, collapsed alveoli recruit more to join – so avoid collapsed alveoli (shunt) http://www.as.wvu.edu/~rbrundage/chapter13a/img028.jpg SURFACTANT SURFACTANT Surface­active agent reduces surface tension Decreases elastic recoil to make lungs easier to inflate Hydrophobic and hydrophilic regions Composed of lipids (90%) and proteins (10%) Plasma proteins (albumin), IgA and 4 apoproteins Contribute to innate immunity by acting as opsonins to coat bacteria and viruses for phagocytosis by macrophages in alveoli Produced by Type II alveolar cells http://www.cesil.com/leaderforchemist/articoli/2005/numero 6_05/rossi_ing/foto/01.jpg MOVEMENT OF GI TRACT MOVEMENT OF GI TRACT 2 types of movement: Peristalsis – propels food through GI tract Mixing http://content.answers.com/main/content/img/elsevier/vet/gr294.jpg GASTRIC EMPTYING GASTRIC EMPTYING Stomach and duodenum control gastric emptying 1. Increased food volume in stomach increases emptying of stomach 2. Food entering duodenum slower stomach emptying 1. 2. If chyme entering duodenum has pH lower than 3.5 to 4, blocks more chyme from entering duodenum until chyme can be neutralized by pancreatic http://www.medhelp.org/Medical­ secretions Dictionary/graphics/images/en/19223.jpg Fatty substances lead to cholecystokinin release from jejunum to block stomach motility from gastrin HORMONES HORMONES Gastrin, CCK, insulin, serotonin enhance intestinal motility Secretin, glucagon inhibit SI motility CLINICALLY… CLINICALLY… Bilirubin is end product of Hb degradation Rbc lysed (~120 days), Hb is phagocytized into globulin and heme biliverdin free bilirubin (gradually released from macrophages into plasma), combines with plasma albumin, transported though blood and interstitial fluids Free bilirubin is absorbed through hepatic cell membrane, converted then excreted into bile calaliculiintestines Bilirubin glucuronide Bilirubin sulfate http://www.mfi.ku.dk/ppaulev/chapter23/images/23­1.jpg ENDOCRINE ENDOCRINE Pituitary gland (brain) Pineal gland Thyroid and parathyroid glands (neck) Thymus (thorax) Adrenal glands (next to kidney) Pancreas Reproductive glands www.drstandley.com/images/endocrine.bmp ADH (VASOPRESSIN) ADH (VASOPRESSIN) Higher concentrations of ADH arteriolar constriction throughout the body increased arterial BP (Vasopressin**)­ what it does in kidney and it’s importance to blood volume Stimulation of ADH secretion: Decreased blood volume Right atrium has stretch receptors (excited by overfilling) send signals to decrease ADH release When unexcited, send signals to increase ADH release INSULIN INSULIN After high­carb meal, Glucose is absorbed into blood Insulin is released Causes rapid uptake, storage and use of glucose by tissues in body, esp. mm, adipose tissue and liver http://www.humanillnesses.com/original/images/hdc_0001_000 1_0_img0082.jpg THE KIDNEYS THE KIDNEYS Regulate arterial pressure Kidneys have dominant role in long­term regulation of arterial pressure by excreting sodium and water Also short­term regulation by secretion of vasoactive substances (renin) leads to angiotensin II http://www.actelion.com/uninet/www/www_main_p.nsf/Content/Cardiovascular %20&%20Renal%20Disease/$File/renin2.jpg THE NEPHRON Each nephron contains: Glomerulus (glomerular capillaries) which filters large amounts of fluid Encased in Bowman’s capsule Tubule, which converts filtered fluid into urine, out renal pelvis www.engin.umich.edu/~CRE/web_mod/viper/pics/nephron.gif ...
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