ANA113 Exam 2 Study Guide PDF

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ANA113 Exam 2 Study Guide, ANA113 Exam 2 Study Guide...

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*= Personal note for further discussion

Lecture 21 Outline: Heart I General Description of heart:  It is the size of a clinched fist 

It has four chambers: 2 atria and 2 ventricles*

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Base- on superior surface

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Apex: inferior-lateral portion

Embryology of the heart:  Heart begins as a straight tube consisting of only TWO chambers  The interventricular septum divides the ventricle into right and left ventricles  The interatrial septum helps form the two atria but is not actually a complete septum.  Septum:  Blood can pass from the right atrium to the left in a FETUS due to the foramen (-meaning hole) ovale.  The foramen ovale after birth forms what is known as the FOSSA OVALE: the word fossa in Latin means “ditch” or bump.  Why is it important for the foramen ovale to seal at birth?  Do not want the mixing of oxygenated (left atria) and deoxygenated blood (right atria) in a newly born child due to improper development of one of the septa because this can lead to Cynanosis (“blue baby”) o TAKE AWAY MESSAGE FOR EXAM: o If I am a deoxygenated blood cell entering the heart at the right atrium, where is the fossa ovale located? o I would see this important structure on the LEFT SIDE OF THE RIGHT ATRIUM because the foramen ovale used to exist between the right and left atriums. Coverings of heart:  The heart is enclosed in a double-walled sac called the pericardium  This double walled sac is composed of TWO serous membranes o 1) Visceral pericardium: INNER layer attached to the heart. CLOSEST TO THE HEART but can rephrased as “outer covering layer TOUCHING heart (BE CAREFUL!) o 2) Parietal pericardium: OUTER layer. o 3) Pericardial Cavity: space between the visceral and parietal pericardium layers.

o 4) Serous fluid is secreted by the visceral pericardium into the pericardial cavity, which exists between the visceral and parietal layers.  Serous fluid: thin watery fluid to prevent friction* Heart Wall: 3 layers  1) Epicardium: (visceral pericardium) outer most layer composed of fibrous connective tissue. (again visceral is the inner most pericardial layer but also the outer most layer of the heart wall itself, keep this difference in mind)  2) Myocardium: middle layer composed of cardiac muscle (special conduction capabilities)  3) Endocardium: innermost layer compose of simple squamous epithelium.

Blood Flow through the heart: 1) Deoxygenated blood comes into the right atrium via a) Superior vena cava b) Inferior vena cava c) Coronary sinus 2) Blood passes through the tricuspid valve or right atrio-ventricular valve (right AV) 3) Right ventricle 4) Pulmonary trunk 5) Pulmonary semilunar valve 6) Pulmonary ARTERIES (2 arteries) –**deoxygenated blood** (arteries carry blood away!) 7) Lungs 8) Pulmonary vein (4 veins) –oxygenated blood 9) Left atrium 10) Blood passes through the bicuspid valve (mitral/left AV) 11) Left ventricle (strongest chamber, most myocardium, high pressure) 12) Base of Aorta 13) Aortic semilunar valve 14) Arch of aorta (remember 3 branches)

-Important details for exam! -blood moves due to a pressure gradient! -first branch off of the AORTA is the coronary arteries ( think heart is a bit selfish, supplies itself first*** Ventricles of the heart: AV valve stabilization a) papillary muscles b) chordae tendineae Lecture 22 Outline: Heart II The heart’s conduction system is under INTRINSIC (function that is part of organ itself) and EXTRINSIC (function that is initiated outside of the organ of interest) regulation. Components of INTRINSIC conduction system: 1) Sinoatrial node (SA node)* – “pacemaker”, generates impulse on its own 2) Atrio-ventricular node (AV node)- located between the atrium and ventricle it receives an action potential from SA node to send conducting message to the bundle of His. 3) Bundle of His: collection of fibers located in the interventricular septum, transmits conduction signal to purkinje fibers. 4) Purkinje fibers: located in the walls of the ventricles, results in ventricular contraction. EXTRINSIC system:  

Sympathetic stimulation: release of norepinephrine, increases HR Parasympathetic: release of acetylcholine, decreases HR

Systole: the ventricles contract/atria relax. 1st heart sound= “lubb” -When Right ventricle contracts-> blood goes to pulmonary arteries -When Left ventricle contracts -> blood goes to aorta - Both right and left AV valves close

Diastole: ventricles relax. 2nd heart sound= “dubb” - Semilunar valves close and AV valves open

Ausculatory areas: 1) Aortic area- listening for aortic semilunar valve. 2 nd intercostal space on right side. 2) Pulmonic area- listening for pulmonic semilunar valve. 2 nd intercostal space on left side

3) Tricuspid area: listening for right AV valve. 5 th intercostal space, right of sternum 4) Bicuspid area: listening for left AV valve. 5 th intercostal space, left of sternum. Coronary Circulation: heart supplying and carrying away waste for itself. REMEMBER FIRST BRANCH OF THE AORTA IS THE RIGHT AND LEFT CORONARIES. Right Coronary artery: supplies the right atrium and the posterior side of both ventricles. Right coronary has two branches: 1. Right Marginal 2. Posterior inter-ventricular Left Coronary artery: supplies the left atrium, anterior walls of both ventricles and the inter-ventricular septum. Left coronary artery has two branches: 1. Left anterior descending (LAD) 2. Circumflex -Coronary sinus located on the posterior side of the heart, drains into which one of the four heart chambers?

Lecture 28 Outline: Blood What are the three main functions of the blood? Describe each. 1) Transportation  O2/CO2 transport from cells to lungs and vice versa  Nutrients absorbed from the gut  Waste product transport for excretion  Enzymes and hormones for regulation of homeostasis 2) Protection  Prevent unwanted loss of bodily fluids via clotting factors  White blood cells to fight off infections 3) Regulation  Body temperature  pH  body fluid volume **Composition: a) Plasma (55% of blood) - plasma itself is 90% water -10% plasma proteins  what are the three plasma proteins

o Albumin o Fibrinogen o Globulins -plasma contains ions and other compounds like glucose and urea. b) Cellular Elements (45%) -Erythrocytes (RBC) -leukocytes (WBC) -Thrombocytes (platelets): aid in clotting Components of White blood cells: - Neutrophils: phagocytosis of bacteria, debris, usually increased during a bacterial infection - Eosinophils: fight parasites, infections and allergies - Basophils: contain histamines (think inflammatory response), increases in number in some leukemia , affects vascular permeability. - Monocytes: aids in phagocytosis, moves into tissue and becomes a macrophage. Shares function with neutrophils. - Lymphocytes: fights viral infections, immune defense

Picture from lecture notes diagrams on Blood composition.

Bone Marrow: located in spaces or cavities within long and flat bones. -(50%)Red Marrow: hemopoietic (blood forming) -(50%)Yellow Marrow: containing large number of fat cells What type of bone marrow do we have most at birth? - Red marrow - With age our red marrow is replaced with yellow marrow ** What is erythropoietin? -It is a hormone that is produced in the kidneys and influences the rate of red blood cell production Lecture 29 Outline: Routine Blood Tests What does your hematocrit indicate? - how much of one’s blood if composed of red blood cells. On average males tend to have a higher hematocrit level than females Hemoglobin determines “oxygen carrying capacity”. Anemic patients have low hemoglobin levels. ABO SYSTEM: -

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What is the function of an antigen (agglutinogen) ? o It is a type of protein found on the surface of erythrocytes of an individual. o Types include A,B and AB What is an antibody ? o An antibody is present in the plasma serum, produced in response to a surface antigen detection in blood. “clump or stick together”

What is the Rh antigen? Is also a protein found on the surface of red blood cells RH+ means you have antigen and Rh- means you do not. Universal Donors= BLOOD type O because they have NO ANTIGENS on the surface of their blood cells (erythrocytes) so they can get blood from everyone and not have a clumping reaction! You can however be O positive or O negative based on your Rh factor.

Universal recipient+ AB

http://upload.wikimedia.org/wikipedia/commons/thumb/3/32/ABO_blood_type.svg /824px-ABO_blood_type.svg.png

So if your blood cells contain GROUP A antigens on their surfaces, they will produce ANTIBODIES B, to fight off any blood cells that may enter your happy A group blood body. IF your blood cells contain GROUP B antigens on their surface then they will produce ANTIBODIES A to fight off any blood cells that may enter your happy B group blood filled body. Type AB has both antigens so no antibodies are produced. Type O produces all types of antibodies because it has no antigens. Think about it this way, ANTIBODIES are produced to protect your BODIES against some other foreign type of antigen that you weren’t born with. These BIG BAD BODIES are kind of like BODY-guards for to protect against intruding blood types. -Any harry potter fans would understand that ANTIBODIES function like Slytherin house, they WANT TO maintain TRUE birth blood type throughout their lives. ANTIBODIES prevent mixing of blood types. If mixing occurs its going to clump up with these antibodies to prevent the wrong blood type from spreading within our bodies. And Anti-GENS are GENerated by your own body living peacefully on the surface of your blood cells.

Hemopoiesis: (blood cell formation) -

In adults our hemopoietic cells are located in our RED MARROW not our yellow. Think yellow is for ugly mushy fat cells. BLOOD-RED- RED marrow. As we get old, our body is technically less efficient and has a small ratio of red marrow compared to yellow marrow. Appreciate your generous supply of red marrow while you still have it!

KNOW WHAT ERYTHROPOIETIN does??? Influence rate of red blood cell production. - know that mature blood cells have NO NUCLEUS Three mechanisms of Hemostasis (process of preventing blood loss) -Constriction of blood vessels - Coagulation via fibrin and platelets forming a plug to the leaky blood vessel. Tissue damage or Blood contacts a foreign surface -  Prothrombin (need calcium and vitamin K for this) ----Thrombin (converts fibrinogen to fibrin)-fibrin helps form a stable blood clot  Thrombus- blood clot Fibrinolysis: breaks down clots Blood thinners act as an antagonist to Vitamin K....