BMS 508 Exam 1 Study Guide PDF

Exam 1 Study Guide Chapter 17- Blood ​ Functions and features of blood (volumes, %, Ph, formed elements, other cells, etc.) ○​ Functions; ​ Transports; oxygen, carbon dioxide, nutrients, waste, and hormones ​ Regulation; pH Balance (7....

Exam 1 Study Guide Chapter 17- Blood ​ Functions and features of blood (volumes, %, Ph, formed elements, other cells, etc.) ○​ Functions; ​ Transports; oxygen, carbon dioxide, nutrients, waste, and hormones ​ Regulation; pH Balance (7.35-7.45), temperature, fluid balance ​ Protection; fights against infections, and form clots to stop bleeding ○​ Features; ​ Volume; males have 5-6 liters, females have 4-5 liters ​ Plasma; 55% of blood, liquid part of blood carries nutrients, waste and proteins ​ Formed elements; 45% of blood, solid parts of blood, RBCs carry oxygen thru body, WBCs helps fight infections, platelets helps blood clots, spectrin gives flexibility ​ Males have 42-47% of hematocrit, females have 37-42% ○​ Plasma Proteins; ​ Albumin; helps maintain right amount of water in blood ​ Globulin; help immune system ​ Fibrinogen; helps blood clot ○​ Electrolytes; sodium, potassium, calcium that helps muscle and nerves function ○​ Nutrients; carries glucose, fats, and vitamins to cells for energy and growth ○​ Waste; carries waste like urea, which kidneys filter out ​ Processes and important anatomical structures involved in life cycles of erythrocytes ○​ Erythropoiesis; production of red blood cells, occurs in red bone marrow, stimulated by erythropoietin ​ Stem cells (hemocytoblasts) -> proerythroblast -> erythroblast stages -> reticulocyte (immature RBC) -> mature erythrocyte; happens in 1-2 days ○​ Circulation & Function; RBCs transport oxygen from lungs -> tissues, CO2 from tissues-> lungs, lifespan~ 120 days ○​ Destruction & Recycling; aged RBCs removed by spleen and liver ​ Hemoglobin Breakdown; heme-> converted to bilirubin, iron-> reused for new RBCs, globin-> broken into amino acids  ○​ Anatomical structures involved; bone marrow produces RBCs, kidneys release erythropoietin, spleen & liver break down old RBCs ​ Which WBC would be elevated based on targets (neutrophils= bacteria) ○​ Neutrophils; bacterial infections ○​ Lymphocytes; viral infections ○​ Monocytes; chronic infections and inflammations ○​ Eosinophils; parasitic infections and allergic reactions ○​ Basophils; allergic reactions and inflammation ​ What are things that can change hematocrit (hyper hydration, blood loss, infections, etc) and HOW they influence it ○​ Dehydration; increases hematocrit, less plasma, RBC seem more concentrated ○​ Overhydration (hyperhydration); lowers hematocrit, more plasma dilutes RBC ○​ Blood loss; hematocrit initially normal, then decreases due to fluid replacement ○​ Anemia; lowers hematocrit due to fewer RBCs ○​ High Altitude; increases hematocrit ○​ Polycythemia; increases hematocrit due to excessive RBC production ​ Steps of blood clotting, what might happen if certain components are missing ○​ Step 1, Vascular Spasm; blood vessel constricts to reduce blood loss ○​ Step 2, Platelet Plug Formation; platelets adhere to damaged vessels and release chemicals to recruit more platelets ○​ Step 3, Coagulation; series of chemical reactions lead to the conversion of fibrinogen (soluble) into fibrin (insoluble), forming clot ○​ If certain components are missing: ​ Platelet Deficiency (Thrombocytopenia)-> impaired clot formation, excessive bleeding ​ Vitamin K Deficiency-> impaired production of clotting factors, prolonged bleeding ​ Hemophilia-> missing clotting factors causing uncontrolled bleeding, genetic disorder ​ Liver disease-> reduced production of clotting factors, leading to bleeding disorders ​ Familiar with all types of blood disorders (thromboembolic and bleeding disorders) ○​ Clotting Disorders; ​ Thrombosis; formation of abnormal blood clot in unbroken vessel ​ Embolism; a clot that breaks loose and travels in bloodstream ○​ Bleeding Disorders;  ​ Hemophilia; genetic disorder causing lack of clotting factors that cause uncontrolled bleeding ​ Thrombocytopenia; low platelet count leading to excessive bleeding ​ Liver Disease; reduced clotting factor production leading to increased bleeding ​ Disseminated Intravascular Coagulation (DIC); condition causing widespread clotting followed by excessive bleeding due to clotting factor depletion ​ VERY familiar with ABO and Rh. components are based on blood type (type A has A-antigens on RBCs and may have type B antibodies in plasma) ○​ Blood Groups; ​ Type A; A antigens on RBCs, anti-B antibodies in plasma ​ Type B; B antigens on RBCs, anti-A antibodies in plasma ​ Type AB; both A and B antigens, no antibodies (universal recipient) ​ Type O; no antigens, both anti-A and B antibodies (universal donor) ○​ Rh Factor ​ Rh+; Rh antigen on RBCs, no anti-Rh antibodies ​ Rh-; no Rh antigen, but can develop anti-Rh antibodies if exposed to Rh+ ​ If Rh- mother carries an Rh+ fetus, she may produce anti-Rh antibodies Chapter 18- The Heart ​ Understand how blood travels through the heart and to both systemic and pulmonary circuits ○​ Deoxygenated blood (right side -> lungs) ​ Superior & Inferior Vena Cava -> Right Atrium ​ Right Atrium -> Tricuspid Valve -> Right Ventricle ​ Right Ventricle -> Pulmonary Semilunar Valve -> Pulmonary Arteries ​ Pulmonary Arteries -> Lungs (CO2 out, O2 in) ○​ Oxygenated blood (lungs -> left side -> body) ​ Lungs -> Pulmonary Veins -> Left Atrium ​ Left Atrium -> Bicuspid Valve -> Left Ventricle ​ Left Ventricle -> Aortic Semilunar Valve -> Aorta -> Body ○​ Pulmonary Circuit; right side pumps deoxygenated blood to lungs  ○​ Systemic Circuit; left side pumps oxygenated blood to body ​ Understand the role of the values in normal heart function and in pressure ○​ Valves ensure one-way flow; ​ Atrioventricular valves; tricuspid & bicuspid valves ​ Semilunar valves; pulmonary & aortic valves ○​ Pressure & Valve Function; ​ AV valves open when atrial pressure is higher than ventricular pressure ​ AV valves close when ventricles contract (prevent backflow) ​ Semilunar valves open when ventricular pressure is higher than artery pressure ​ Semilunar valves close when ventricles relax (preventing backflow) ​ You should be able to read and diagnose an ECG based on described conditions talked about in lectures ○​ Key Components of ECG/EKG; ​ P Wave; atrial depolarization (atria contracting) ​ QRS Complex; ventricular depolarization (ventricles contracting) ​ T Wave; ventricular repolarization (ventricles relaxing) ○​ Common ECG/EKG Conditions; ​ Bradycardia; slow heart rate (long R-R interval) ​ Tachycardia; fast heart rate (short R-R interval) ​ Atrial Fibrillation; no clear P waves, irregular rhythm ​ Ventricular Fibrillation; no organized QRS complex, life threatening ​ Heart Block; delayed or blocked signal between atria & ventricle (long PR interval) ​ Enlarged R waves; bigger heart ​ Elevated or depressed s-t segment; Cardiac ischemia, lack of blood flow ​ Prolonged Q-T interval; Ventricles unable to repolarize ​ You need to know the cardiac cycle formulas and be able to perform their calculations without calculators ○​ EDV; end-diastolic volume (max blood in ventricle before contraction) ○​ ESV; end-systolic volume (blood left after contraction) ○​ HR; heart rate (beats per minute) ○​ SV; stroke volume (mL per beat) ○​ SBP; systolic blood pressure ○​ DBP; diastolic blood pressure  ○​ Key Formulas; ​ Stroke Volume (SV); SV = EDV - ESV ​ Cardiac Output (CO); CO = HR x SV ​ Ejection Fraction (EF); EF = SV/EDV x 100 (as a %) ​ Mean Arterial Pressure (MAP); ⅓ (SBP - DBP) + DBP ​ Understand the autonomic nervous systems roles on the heart (Ch 14) including specific receptor types (table 14.3, 14.4, 14.5) and influences ○​ Neurotransmitter; ​ Norepinephrine (NE) ○​ Receptor Types; ​ B1 (Beta-1); increases HR & contractility ​ a1 (Alpha-1); vasoconstriction ○​ Effects on Heart; ​ Increased HR (chronotropic effect) ​ Increase contractility (inotropic effect) ​ Increased conduction speed (dromotropic effect) ○​ Neurotransmitter; ​ Acetylcholine (ACh) ○​ Receptor Type; ​ Muscarinic (M2) ○​ Effects on Heart; ​ Decreased HR (via vagus nerve) ​ Decreased conduction speed Nervous System Neurotransmitter Receptor Effect Sympathetic Norepinephrine (NE) B1, a1 Increased HR & contractility Parasympathetic Acetylcholine (ACh) M2 Decreased HR & conduction speed Chapter 19- Blood Vessels & Pressure ​ Understand the anatomy of vessel types AND how the anatomy is related to their function and blood pressure regulation ○​ Vessels (not capillaries) have 3 layers of tunics; ​ Tunica Intima; inner most layer, “intimate” with blood ​ Tunica Media; middle, bulkiest layer, made of smooth muscle and elastic fiber ​ Tunica Externa; outermost layer, lots of nerve fiber & lymphatic vessels ○​ Other things in vessels; ​ Endothelium; simple squamous layer that lines lumen of all vessels ​ Vasa Vasorum; system of micro-vessels found in larger blood vessels, nourish outermost layers w/ blood supply ​ Lumen; central blood-containing space surrounded by thin wall of tissue ○​ Arteries; ​ Thick walls & smaller lumen which maintains high blood pressure ​ Away from heart ​ Pulmonary circuit -> deoxygenated blood from heart to lungs ​ Systemic circuit -> oxygenated blood from heart to tissues ​ Elastic arteries (aorta) stretch and recoil to maintain blood pressure ​ Muscular arteries (femoral arteries) adjust diameter through vasoconstriction/dilation to regulate pressure and flow ○​ Arterioles; ​ Smaller branches of arteries ​ Thick tunica media w/ high smooth muscle content ​ Acts as resistance vessels, controlling flow to capillaries ​ Primary site of vasodilation/constriction ○​ Capillaries; ​ Small vessels that help with direct contact with tissue cells ​ Directly serves cellular needs ​ Small epithelial later w/ basal lamina surrounding cells ​ Site of gas & nutrient exchange between blood and tissues ​ BP drops significantly to allow for diffusion and prevent damage to vessels ○​ Venules; ​ Thin walls with some smooth muscle ​ Larger lumen than capillaries, but smaller than veins ​ Collects deoxygenated blood from capillaries & begin return flow to heart ​ Some constriction happens to push blood forward ○​ Veins; ​ Thin walls, less smooth muscle, but larger lumen ​ Contains valves to prevent backflow ​ Relies on skeletal muscle contraction and respiratory movements to aid blood return to heart ​ Towards the heart ​ Systemic circuit -> deoxygenated blood to body  ​ Pulmonary circuit -> oxygenated blood to heart ​ Serves as blood reservoir (60-70% of total blood volume) ​ Vasoconstriction can shift blood to arterial system to maintain pressure ​ Understand the relationship between blood flow, pressure, and resistance ○​ Blood Flow; ​ Volume of blood moving through vessel per unit time (mL/min) ​ Directly proportional to pressure difference ​ Increases with higher cardiac output & vasodilation ​ Decreases with vasoconstriction & increased blood viscosity ○​ Blood Pressure; ​ the force exerted by blood on vessel walls (mmHg) ​ Created by the heart’s pumping action ​ Highest in aorta (120mmHg) lowest in veins (5mmHg) ​ Regulated by cardiac output, blood volume, vessel diameter ○​ Resistance; ​ Opposition to blood flow, caused by friction between blood and vessel walls ​ Smaller diameter of vessels means higher resistance ​ Thicker blood means higher resistance ​ Longer vessels means higher resistance ○​ If BP increases, BF increases, unless resistance increases ○​ If resistance increases, BF decreases, unless BP also increases ○​ Arterioles play a huge role in regulating resistance thru vasoconstriction/dilation ​ Be familiar with all discussed types of blood pressure regulation Mechanism Time Frame Key Players Response to ↓ Response to ↑ BP BP Baroreceptors Seconds Carotid & aortic ↑ HR, ↓ HR, vasodilation baroreceptors vasoconstriction Chemoreceptors Seconds Carotid & aortic ↑ BP to increase Weak effect bodies oxygen RAAS System Seconds to Kidneys, ↑ BP & volume N/A minutes angiotensin II, aldosterone ADH (vasopressin) Minutes to hours Posterior ↑ water retention & N/A pituitary vasoconstriction  ANP Minutes to hours Heart atria N/A ↓ BP & Blood Volume Kidneys (Direct Hours to days Kidneys Water retention, Water excretion, Mechanism) ↑ BP ↓ BP Epinephrine/ Seconds to Adrenal medulla ↑ CO & N/A Norepinephrine minutes vasoconstriction ​ Understand the relationship between blood pressure and blood volume and how changes to one may change the other ○​ Blood Volume directly influences BP; more volume = higher BP, less volume= lower BP ○​ BP affects blood volume by controlling kidney function and fluid balance ○​ Short-term regulation; nervous system & hormones, quickly adjusts BP ○​ Long-term regulation; kidneys, maintains blood volume & BP overtime ​ Understand the short and long-term regulatory controls of blood pressure and how they operate Regulation Type Mechanism Time Frame Effect on BP Short-Term (Neural & Baroreceptor Seconds to minutes Adjusts HR, Hormonal) reflex, vasoconstriction/dilation to chemoreceptor stabilize BP reflex, epinephrine, RAAS, ADH, ANP Long-Term (Kidneys) Renal Hours to days Regulates Blood Volume to mechanisms control BP overtime (pressure diuresis, RAAS) ○​ Short-term mechanism provides immediate responses (standing up quickly) ○​ Long-term mechanisms ensure long-term BP stability (controlling BP in chronic hypertension) ​ Understand how the body detects blood pressure and blood volume Sensor types Location Detects Response to High Response to Low BP/BV BP/BV Baroreceptors Carotid sinus, aortic arch Arterial BP (stretch) Vasodilation, ↓ HR → Vasoconstriction, ↑ HR Lowers BP → raises BP Chemoreceptors Carotid & aortic bodies O2, CO2, pH levels No major effects on BP ↑ BP & HR to increase oxygen delivery Atrial Stretch Receptors Heart (atria) Blood Volume (atrial Releases ANP → Activates SNS → raises stretch) reduces BV BP & HR Juxtaglomerular Cells Kidneys Renal perfusion (low Reduces renin → Releases renin → RAAS BP/BV) excretes more Na+ & activation → Raises water BP & BV