Blood and Lymphatic System PDF

**BLOOD** **Functions of Blood** 1. Transport gases, nutrients, waste products, processed molecules & regulatory molecules. 2. Regulates pH as well as fluids & ion balance. 3. Involved with temperature regulation & protects against foreign substances such as MCO & toxins. 4. **Blood...

**BLOOD** **Functions of Blood** 1. Transport gases, nutrients, waste products, processed molecules & regulatory molecules. 2. Regulates pH as well as fluids & ion balance. 3. Involved with temperature regulation & protects against foreign substances such as MCO & toxins. 4. **Blood clotting** prevents fluid & cell loss & is part of tissue repair. **Composition of Blood** 1. **Blood** is a connective tissue consisting of plasma & formed elements. It is **scarlet to dull red**, depending on the amount of O2 carried. 2. Total vol. in an average adult is approx. **5-6 L (M)**, **4-5 L (F)**. 8% of Total body weight.  **Plasma** 1. **91% of water** & **9% suspended** or **dissolved substances**, nutrients, gases, hormones, waste, proteins, and salts. It makes up **55% of whole blood**. 2. maintains osmotic pressure, is involved in immunity, and prevents blood loss & transport molecules. **RBC- (erythrocytes)** 1. **disk-shaped cells** containing **hemoglobin** which transport O2 & CO2. **RBC** also contain **carbonic anhydrase**, which involved with CO2 transport. 2. In response to decrease blood O2 levels, **kidney** produce **erythropoietin**, which stimulates RBC production in **red bone marrow**. 3. **Worn-out RBC** are phagocytized by macrophages in the **spleen or liver**. **Hemoglobin** is broken down, ion & amino acids are reused & heme becomes **bilirubin** that is secreted in bile. 4. Life-span is **100-120 days**. **WBC (Leukocytes)** 1. Protects the body against MCO & remove dead cells & debris. - **Neutrophils**- small phagocytic cells. - **Basophils**- promote inflammation - **Eosinophils**- influence inflammation.  - **Lymphocytes**- involved in antibody production & other immune system response. - **Monocytes**- become macrophages that ingest MCO & cellular debris. - When bacteria, viruses & other foreign substance invade the body, WBC increase (leukocytosis) & fight them. - decrease in WBC- **leukopenia** **Platelets** - cell fragments involved with preventing blood loss (act in **blood clotting**). - Preventing Blood Loss 1. **Vascular spasm**- blood vessels constrict in response to injury, resulting in decreased blood flow 2. **Platelet Plug formation** - Repair minor damage to blood vessels. - Form when platelets adhere to collagen, release chemicals that activate other platelets & connect to one another with fibrinogen. **Blood Clotting** - Or **coagulation** is the formation of a clot (a network of protein fibers called **fibrin**) a. Activation of clotting factors by connective tissue & chemicals resulting in the formation of prothrombinase. b. Conversion of prothrombin to thrombin by prothrombinase. c. Conversion of fibrinogen to fibrin by thrombin. - **Anticoagulants** in the blood such as **antithrombin** & **heparin**, prevent clot formation. - **Clot retraction** condenses the clot, pulling the edges of damaged tissue close together. - **Serum** is plasma without clotting factors - **Fibrinolysis** (clot breakdown) is accomplished by plasmin. **Blood Grouping** - Blood groups are determined by antigens on the surface of RBC. - In transfusion reactions, antibodies can bind to RBC antigens, resulting in agglutination or hemolysis of RBC. - **[ABO Blood Grouping]**: Mismatching the ABO blood group can result in a transfusion reaction.  **Rh Blood Grouping** - **Rh+ blood** has Rh antigen - **Rh --** has no Rh antigen - Antibodies against the Rh antigens are produced when Rh (--) person is exposed to Rh (+) blood. - **Rh blood group** is responsible for hemolytic disease of the newborn, which can occur when the fetus is Rh (+) & the mother is Rh (-). **ABO blood group system** - the classification of human blood based on the inherited properties of red blood cells (erythrocytes) as determined by the presence or absence of the antigens A and B, which are carried on the surface of the red cells. - Persons may thus have type A, type B, type O, or type AB blood  **Diagnostic blood Test** - Type & cross match - Blood typing determines the ABO & Rh blood groupings of a blood sample. - X-match tests for agglutination reactions between donors & recipient blood. - **Complete Blood Count (CBC)**- consists of RBC count, hgb measurement, Hct measurement & WBC. - **Differential WBC**- determines the % of each type of WBC. - **Clotting**- Platelet (PT) count & (PTT) Prothrombin time measurement determine the **bloods ability to clot**. - **Blood chemistry**- composition of materials dissolved or suspended in plasma (glucose, urea, nitrogen, bilirubin & cholesterol) used to assess the functioning state of the body's systems. - **RBC ( erythrocyte )** -- **4.5 -- 5.5 million / m3** - **Anemia** --low RBC - **Polycythemia vera** --high RBC - **WBC ( leukocyte )** -- **5,000 -- 10,000 m3** - **infection** --High WBC - **PLATELETS ( thrombocytes )** -- **150,000 -- 200,000 / m3** - **Hemorrhage/ Bleeding** --low Platelet count ---------------------- **LYMPHATIC SYSTEM** ---------------------- **Lymphatic System** - Also called the **lymphoid system** - an **organ system in vertebrates** that is part of the circulatory system and the immune system. - It is made up of a **large network** of lymphatic **vessels**, lymphatic or lymphoid **organs**, and lymphoid **tissues**. - The vessels carry a clear fluid called **lymph** towards the heart. **Function** - Maintains fluid balance in tissues, absorbs fats from the small intestine & defends against microorganisms (MCO) & foreign substances.  **Anatomy of the Lymphatic System** - Consists of **lymph**, **lymphocytes**, **lymphatic vessels**, **lymph nodes**, **tonsils**, **spleen** & **thymus**. 1. **Lymphatic Vessels**- carry **lymph away from tissues**. **Valves** in the vessels ensure the one-way flow of lymph. 2. **Skeletal muscle contraction**- contraction of lymphatic vessel, **smooth muscle** & **thoracic pressure** changes moves, moves the lymph through the vessels. 3. **Thoracic duct** & the **lymphatic duct** empty lymph into the blood. **Lymphatic organs** 1. **Lymphatic tissue** **produces lymphocytes** when exposed to foreign substance, & it filters lymph & blood. 2. **Tonsils** **protect the opening** between the nasal & oral cavities & the pharynx 3. **Lymph nodes**- located along lymphatic vessels; **filter lymph**. 4. **White pulp of the spleen**- responds to foreign substance in the blood, whereas the red pulp phagocytizes foreign substance & worn-out RBC. The **spleen** also function as a reservoir for blood. 5. **Thymus**- processes lymphocytes that move to other lymphatic tissue to respond to foreign substance. - **Lymphatic system** removes fluid from tissues, absorbs fats from the small intestine & **produces B cells** & **T cells**, which are responsible for immunity.  **Immunity** 1\. Ability to resist the harmful effects of MCO. & other foreign substance. 2\. Classified as innate or adaptive. A. **Innate Immunity** a. [Physical Barriers:] 1. **skin** & **mucous membrane** are barriers that prevent MCO from entering the body. 2. **Tears**, **saliva** & **urine** wash away MCO. **B. Physical Mediators** 1. kills MCO, promotes phagocytosis & increase inflammation. 2. **lysozyme in tears** & **complement in plasma** are example of chemical involved in innate immunity. 3. **interferons**- prevent the replication of viruses. 4.  **C. WBC** 1. **chemotaxis**- **ability** of cells to move toward MCO or sites of Tissue damage. 2. **Neutrophils**- **first phagocytic cells** to respond to MCO. 3. **Macrophages**- **large phagocytic cells** that are active in latter part of an infection; are positioned at sites where MCO may enter tissues. 4. **Basophils & Mast cells**- **promotes** inflammation. **Eosinophils** also **play a role** in inflammation associated with allergic reaction. 5. **Natural Killer Cells**- **lyse tumor cells** virus infected cells. **D. Inflammatory Response** 1. **MCO** invade damaged tissue. 2. **Basophil** release heparin & histamine & kinin production occurs 3. **Vasodilation** occurs along with increased capillary permeability. 4. **Blood flow** increases to the affected tissue & **fluid** collects within it. 5. **Neutrophils** flock to the invasion site to engulf &destroy MCO from dying cells. 6. **Tissue Repair**. 7. **If bacteria remain**- additional chemical mediators activated.  **Immune Function** - The lymphatic system plays a **major role** in the body\'s immune system, as the **primary site** for cells relating to adaptive immune system including **T-cells** and **B-cells**. - Cells in the lymphatic system react to antigens presented or found by the cells directly or by other dendritic cells. - When an antigen is recognized, an **immunological cascade** begins involving the activation and recruitment of more and more cells, the production of antibodies and cytokines and the recruitment of other immunological cells such as **macrophages**.  I. **Activation & multiplication of lymphocytes**  II. Antibody- mediated Immunity   **[How macrophages accomplish phagocytosis:]** - **Chemotaxis** - attract macrophages to the antigen site - **Opsonization** - **coats the MCO**, enhancing macrophage binding to this antigen - **Ingestion** - macrophage extends its membrane around the opsonized MCO, engulfing it within the vacuole (**phagosome**) - **Digestion** - forms **phagolysosome**, where antigen destruction occurs - **Release** - once digestion is complete, **macrophages expels** digestive debris ---------------------- **DIGESTIVE SYSTEM** ---------------------- **Digestive System** - Consists of the **gastrointestinal tract** plus the **accessory organs** of digestion (the **tongue**, **salivary glands**, **pancreas**, **liver**, and **gallbladder**). Digestion involves the breakdown of food into smaller and smaller components, until they can be absorbed and assimilated into the body. **Functions** - To take in food - Breaks down the food - absorbed the digested food molecules - Provides nutrients to the body  **Oral Cavity** [3 pairs of large salivary glands] - **Parotid** - **Submandibular** - **Sublingual gland** - **Lips & cheeks**- mastication & speech - **Tongue**- speech, taste, mastication & swallowing - **Teeth**- 32 permanent teeth - **Root of the oral cavity**- - Divided into **hard** & **soft palate** - **Salivary glands**- produce serous & mucous secretions.  **Mastication** - Accomplish by the teeth, which **cut**, **tear** & **crush the food**. **Pharynx** - Consists of **nasopharynx,** **oropharynx**, & **laryngopharynx** **Esophagus** - **Connects** the pharynx to the stomach. The upper & lower esophageal sphincters regulate movement **Deglutition** - act of **swallowing** **Histology of Gi tract** [4 Tunics] - **Mucosa** - **Submucosa** - **Muscularis** - **Serosa** or **Adventitia**  **Peritoneum** - A **serous membrane** that lines the abdominal cavity & covers the organ. - **Mesenterics** are double layers of peritoneum that extend from body wall to many abdominal organs. - **Retroperitoneal** organs are located behind the parietal peritoneum.  **Stomach** - Has a **cardiac opening** from the esophagus and **pyloric opening** into the duodenum - The **wall of the stomach** consist of 3 muscle layers (**LONGITUDINAL, CIRCULAR AND OBLIQUE**) - **Gastric glands** -- produce mucus, hydrochloric acid, pepsin, gastrin and intrinsic factor  **Secretion of the Stomach** 1. **Mucus** protects the stomach lining 2. **HCL acid** kills MCO & activates pepsin 3. **Pepsin** starts protein digestion 4. **Intrinsic factor** aids in **Vit B12** absorption 5. **Gastrin** helps regulate stomach secretions & movements **Regulation of Stomach Secretion**  1. **Cephalic phase** - **Vagus nerve** stimulates gastric secretion even before food is swallowed. 2. **Gastric phase** - **Food** stretches the stomach and activates **myenteric** and **vagovagal reflexes**. These reflexes stimulate **gastric secretion**. Histamine and gastrin also stimulate acid and enzyme secretion 3. **Intestinal phase** - **Intestinal gastrin** briefly stimulates the stomach, but then secretin and the enterogastric reflex inhibit gastric secretion and motility while the duodenum processes the chyme already in it. **Sympathetic nerve fibers** suppress gastric activity, while **vagal** (**parasympathetic**) stimulation of the stomach is now inhibited **Stomach Movement** - **Mixing waves** mix the stomach contents with the stomach secretions to form **chyme**. - **Peristaltic waves** move the chyme into the duodenum. **Small Intestine**  **Function** - **Duodenum**: **first part** of the small intestine. It extends from the **pyloric sphincter** of the stomach, wraps around the head of the pancreas in a **C-shape** and ends at **duodenojejunal flexure**. This flexure is attached to the **posterior abdominal wall** by a peritoneal fold called the **suspensory muscle** (**ligament**) of duodenum, also called the **ligament of Treitz**. - **Jejunum**: the **second part** of the small intestine. It begins at the **duodenojejunal flexure** and is found in the **upper left quadrant** of the abdomen. The jejunum is **entirely intraperitoneal** as the **mesentery proper** attaches it to the **posterior abdominal wall**. - **Ileum**: the **last** and **longest part** of the small intestine. It is found in the **lower right quadrant** of the abdomen, although the terminal ileum can extend into the pelvic cavity. The **ileum** terminates at the ileal orifice (**ileocecal junction**) where the cecum of the large intestine begins.  **Large Intestine** 1. **Bacteria** make **vitamin K** 2. Site of water and mineral absorption 3. Collect undigested material and form feces 4. **Rectum**: **retroperitoneal**; stores feces, extends from **rectal valve to anal canal**; **columns** and **sinuses** 5. Regulation of defecation - **Internal sphincter** = smooth muscle - **External sphincter** = skeletal muscle  **Liver** - **Largest gland**- **3lb** (1.4 kg) **RUQ** of abdomen.  - **Kupffer's cell** - lining the sinusoids remove bacteria & toxins that have enter the blood through the **intestinal capillaries**.  **Functions** 1. **Removes** **potentially toxic by-products** of certain medications 2. **Prevents shortages of nutrients** by storing vitamins, minerals and sugar. 3. **Metabolizes** or breaks down, nutrients from food to produce energy, when needed. 4. Produces **most proteins** needed by the body. 5. Helps your body fight infection by removing bacteria from the food. 6. Produces **most of the substances** that regulate blood clotting. 7. Produces bile, a compound needed to digest fat and to absorb vitamins **A**, **D**, **E** and **K**. **Pancreas** **Functions** 1. Functions of pancreas 2. the enzymes secreted in the pancreas help break down **carbohydrates**, **fats**, **proteins**, and **acids** in the duodenum. 3. The pancreas also secretes a bicarbonate to **neutralize stomach acid** in the duodenum. 4. The hormones secreted by in the pancreas are **insulin** and **glucagon** (which regulate the level of glucose in the blood).