AnP I Study Guide for Exam 2

Chapter 6: Integunentary system.

Introduction.

1. The skin and its accessory structures constitute the integunentary system.

Skin and its tissues.

1. Skin is a protective covering, helps regulate body temperature, houses sensory receptors, synthesizes chemicals, and excretion wastes.
2. Skin is composed of an epidermis, a dermis, and the subcutaneous layer.
3. The subcutaneous layer is technically not a part of the skin but for the purposes of our discussion here in class we are going to include the subcutaneous layer as part of the skin.
4. The skin is composed of an epidermis and the dermis separated by a basement membrane.
5. The subcutaneous layer is composed of loose connective tissue and adipose tissue that helps conserve body heat.
6. The subcutaneous layer contains blood vessels that supply the skin.
8. The epidermis.
9. The epidermis is a layer stratified squamous epithelium that lacks blood vessels.
10. The stratum basale is the deepest layer of the epidermis.
11. The stratum basale contains cells that divide and grow.
12. Epidermal cells undergo keratinization as they are pushed toward the surface.
13. The outermost layer of the epidermis is called the stratum corneum.
14. The stratum corneum is composed of dead epidermal cells.
15. The epidermis protects the underlying tissues against water loss, mechanical injury, and the effect of harmful chemicals.
16. Melanin protects underlying cells from the effects of ultraviolet light.
17. Melanocytes transfer melanin to nearby epidermal cells.
18. Melanin is the pigment responsible for racial variations in skin color.
20. The dermis.
21. The dermis is a layer composed of irregular dense connective tissue that binds the epidermis to the underlying tissues.
22. Normal blood vessels supplying nutrients to all skin cells.
23. Dermal blood vessels helped to regulate body temperature.
24. Nervous tissue is scattered throughout the dermis.

Accessory structures of the skin.

1. Each hair develops from epidermal cells at the base of the tubelike hair follicle.
2. As the hair shaft develops and grows older cells are pushed towards the surface and undergo keratinization.
3. A hair usually grows for a while, rests, and then is replaced by a new hair.
4. Hair color is determined by genes that direct the type and amount of pigment in each hair cell.
5. Nails consists of keratinized epidermal cells.
6. Sebaceous glands secrete sebum, which softens and waterproofs both the skin and hair.
7. Sebaceous glands are usually associated with hair follicles.
8. Eccrine sweat glands are widely distributed throughout the body and respond to elevated body temperature or emotional stress.
9. Sweat is pearly water but also contains salts and waste products.
10. Apocrine sweat glands moisten the skin when a person is emotionally upset, scared, in pain, or sexually aroused.
11. Heat is a byproduct of cellular respiration.
12. Sweat gland activity increases heat loss by evaporation.
13. When the air is saturated with water, sweat fails to evaporate.
14. Hypothermia is lowered body temperature.
15. Hypothermia causes shivering, mental confusion and lethargy.

Skin color.

1. All humans have about the same concentration of melanocytes.
2. Skin color is largely due to the amount of melanin in the epidermis.
3. Each person inherits genes for melanin production.
4. Ultraviolet light stimulates additional melanin production in the skin.
5. Carotene in the subcutaneous layer may cause the skin to appear yellowish.

Diagram labeling.

1. Please be prepared to label the following diagram: figure 6.2 a which is found on page 172 of your textbook.
2. Please be prepared to label the following diagram: figure 6.4 b which is found on page 174 of your textbook.
3. Please be prepared to label the following diagram: figure 6.5 a which is found on page 177 of your textbook.
4. Please be prepared to label the following diagram: figure 6.9 which is found on page 180 of your textbook.
5. Please be prepared to label the following diagram: figure 6.11 which is found on page 182 of your textbook.

Chapter 7: skeletal system.

Introduction.

1. Individual bones are the organs of the skeletal system.
2. A bone contains very active tissues.
3. Bone support and protect soft tissues, provide attachments for muscles, house blood producing cells, and store inorganic salts.

Bone structure.

1. Bones are grouped according to their shapes-long, short, flat, irregular, or round (sesamoid).
2. The epiphysis is the bone and which is covered by articular cartilage.
3. The shaft of the bone is also called the diaphysis.
4. Except for the articular cartilage, bone is covered by a periosteum.
5. Compact bone as a continuous extracellular matrix with no gaps.
6. Spongy bone has irregular interconnecting spaces between bony plates.
7. Both compact and spongy bone are strong and resist bending.
8. The diaphysis contains a medullary cavity filled with marrow.
9. Compact bone contains osteons cemented together.
10. The osteons contains a central canal which contain blood vessels that nourish the cells of the osteons.
11. Perforating canals connect central canals transversely and communicate with the bones surface and the medullary cavity.
12. Diffusion from the surface of thin tiny plates nourishes cells of spongy bones.
13. Intramembranous bones develop from layers of connective tissue.
14. Osteoblasts within the membranous layers form bone tissue.
15. Mature bone cells are called osteocytes.
16. Most of the bones of the skeleton are endochondral.
17. Endochondral bones develop from cartilaginous skeletons.
18. Endochondral bone forms from primary ossification centers that appear in the diaphysis.
19. Secondary ossification centers appear in the epiphyses.
20. Epiphyseal plates are responsible for lengthening the bone.
21. Long bones continue to lengthen until the epiphyseal plates are ossified.
22. Growth in thickness of the bone is due to ossification beneath the periosteum.
23. The action of osteoclasts forms the medullary cavity.
24. Osteoclasts and osteoblasts continually remodeled bone.
25. The total mass of bone remains nearly constant.

Bone function.

1. Bones shape and form body structures.
2. Bones support and protect his softer, underlying tissues.
3. Bones and muscles interact, producing movement.
4. Red bone marrow houses developing red blood cells, white blood cells and blood platelets.
5. The extracellular matrix of bone tissue contains abundant calcium phosphate in the form of hydroxyapatite.
6. When blood calcium ion concentration is high, osteoblasts are stimulated to form bone tissue and store calcium salts.

Skeletal organization.

1. Usually a human skeleton has 206 bones, but the number may vary.
2. The extra bones in sutures are called central bones.
3. The skeleton can be divided into axial and appendicular portions.
4. The axial skeleton consists of the skull, hyoid bone, vertebral column, and thoracic cage.
5. The appendicular skeleton consists of the pectoral girdle, upper limbs, pelvic girdle, and lower limbs.

The skull.

• The skull consists of 22 bones, which include eight cranial bones and 14 facial bones.
• The cranium encloses and protects the brain and provide attachments for muscles.
• Some cranial bones contain error filled paranasal sinuses that help to reduce the weight of the skull.

Lifespan changes.

1. Gradually bone loss exceeds bone replacement.
2. Aging increases risk of bone fractures.

Diagram labeling.

1. Please be prepared to label the following: figure 7.1 which is found on page 194 of your textbook.
2. Please be prepared to label the following: figure 7.2 which is found on page 194 of your textbook.
3. Please be prepared to label the following: figure 7.4 which is found on page 196 of your textbook.
4. Please be prepared to label the following: figure 7.13 which is found on page 204 of your textbook.
5. Please be prepared to label the following: figure 7.15 which is found on page 207 of your textbook.
6. Please be prepared to label the following: figure 7.19 which is found on page 210 of your textbook.
7. Please be prepared to label the following: figure 7.34 and figure 7.36 which is found on pages 222 and 223 of your textbook.
8. Please be prepared to label the following: figure 7.41 which is found in page 228 of your textbook.
9. Please be prepared to label the following: figure 7.42 which is found on page 229 of your textbook.
10. Please be prepared to label the following: figure 7.47 a which is found on page 234 to textbook.
11. Please be prepared to label the following: figure 7.50 which is found on page 237 of your textbook.

AnP II Study Guide for Exam 2

Chapter 17: the digestive system.

Introduction.

1. Digestion is the process of mechanically and chemically breaking down food so that they can become absorbed.
2. The digestive system consists of an elementary canal and several accessory organs that carry out the processes of digestion, propulsion, digestion, absorption, and defecation.

Gen. Characteristics of the elementary canal.

1. The wall the elementary tract consists of four layers.
2. The four layers of the elementary tract include mucosa, submucosa, muscular layer and the serosa.
3. Peristalsis is responsible for propelling movements.
4. The wall of the tube undergoes receptive relaxation just ahead of the peristaltic wave.
5. The tube is innervated by branches of the sympathetic and parasympathetic divisions of the autonomic nervous system.
6. Parasympathetic impulses generally increase digestive activities.
7. Sympathetic impulses generally inhibit digestive activities.
8. Sympathetic impulses contract certain sphincter muscles, controlling movements through the elementary canal.

The mouth.

1. The mouth is adapted to receive food and begin preparing it for digestion.
2. The mouth serves as an organ of speech and sensory perception.
3. Tonsils consists of lymphatic tissues.
4. Keith mechanically break food into smaller pieces, increasing the surface area exposed to digestive actions.

Salivary glands.

1. Salivary glands secrete saliva, which moistens food, helps bind food particles, begins chemical digestion of carbohydrates, makes taste possible, helps clean the mouth, and regulates pH in the mouth.
2. Salivary glands include cells that secrete digestive enzymes and mucus cells that secrete mucus.
3. Parasympathetic impulses stimulate the secretion of saliva.

The pharynx and the esophagus.

1. Swallowing occurs in three stages.
2. In phase 1 of swallowing food is mixed with saliva and forced into the pharynx.
3. In phase 2 of swallowing involuntary reflex actions move the food into the esophagus.
4. In stage III of swallowing peristalsis transports food to the stomach.
5. Swallowing reflexes momentarily inhibit breathing.
6. Circular muscle fibers in the distal end of the esophagus help prevent regurgitation of food from the stomach.

The stomach.

1. The lower esophageal sphincter serves as a valve between the esophagus and the stomach.
2. The pyloric sphincter serves as a valve between the stomach and small intestine.
3. Parasympathetic impulses and the hormone gastrin enhanced gastric secretion.
4. The three stages of gastric secretion are the cephalic, gastric and intestinal phases.
5. The presence of food in the small intestine reflexively inhibits gastrin secretions.
6. The stomach is not well adapted for absorption.
7. Mixing movements of the stomach aid in the production of chyme.
8. Peristaltic waves move chyme into the pyloric region.
9. The muscular wall of the pyloric region regulates chyme movements into the small intestine.
10. The rate of emptying depends on the fluidity of the chyme and the type of food present.
11. The upper part of the small intestine fills and then an enterogastric reflex inhibits peristalsis in the stomach.
12. Gastric goblet cells secrete mucus into the gastric lumen.
13. Parietal cells secrete intrinsic factor to aid in the absorption of vitamin B12.
14. Parietal cells secrete hydrochloric acid to aid in the digestion of proteins.
15. Chief cells secrete pepsinogen which is a precursor to pepsin.
16. Hydrochloric acid converts pepsinogen to pepsin.
17. Pepsin is a proteins splitting enzymes that digest nearly all types of dietary protein.
18. Gastrin increases secretory activity of gastric glands.
19. Somatostatin inhibit secretion of acid by parietal cells.
20. Cholecystokinin decreases secretory activity of gastric glands and inhibits gastric motility.

Pancreas.

1. Pancreatic juice contains enzymes that can split carbohydrates, proteins, fats, and nucleic acids.
2. Pancreatic juice has a high bicarbonate ion concentration that helps neutralize chyme and causes the intestinal contents to be alkaline.
3. Secretin from the duodenum stimulates the release of pancreatic juice that contains a few digestive enzymes but has a high bicarbonate ion concentration.
4. Cholecystokinin from the intestinal wall stimulates the release of pancreatic juice that contains a high concentration of digestive enzymes.

Liver.

1. The liver is a highly vascular organ enclosed a fibers capsule and divided into lobes.
2. Each lobe consists of hepatic lobules, the functional units of the liver.
3. Bile is the only liver secretion that directly affects digestion.
4. Bile pigments are products of red blood cell breakdown.
5. The gallbladder stores bile between meals.
6. Cholecystokinin from the small intestine stimulates bile release.
7. Bile salts emulsify fats and aid in the absorption of fatty acids, cholesterol, and certain vitamins.
8. Bile salts are reabsorbed in the small intestine.

Small intestine.

1. The small intestine extends from the pyloric sphincter to the large intestine.
2. The small intestine consists of the duodenum, jejunum and ileum.
3. The intestinal wall is lined with villi that greatly increase the surface area and aid in mixing and absorption.
4. Microvilli on the free ends of epithelial cells increase the surface area even more.
5. Intestinal glands are located between the villi.
6. Digestive enzymes embedded in the surfaces of the microvilli, split molecules of sugars, proteins, and fats.
7. Secretion is stimulated by gastric juice, chyme, and reflexes stimulated by distention of the small intestinal wall.
8. Blood capillaries in villi absorbed monosaccharides, amino acids, small chain fatty acids and glycerol.
9. Blood capillaries in villi also absorb water and electrolytes.
10. Fat molecules with larger chains of carbon atoms enter the lacteals of the villi.
11. Fatty acids with short carbon chains into the blood capillaries of the villi.
12. Over distention or irritation of the intestinal lining may stimulate a peristaltic rush and result in diarrhea.
13. The ileocecal sphincter controls movements of the intestinal contents from the small intestine into the large intestine.

Large intestine.

1. The large intestinal wall resembles the wall in other parts of the elementary canal.
2. The large intestine has little or no digestive function although it secretes mucus.
3. Mechanical stimulation and parasympathetic impulses control the rate of mucus secretion in the large intestine.
4. The large intestine absorbs water and electrolytes.
5. Many bacteria inhabit the large intestine, where the breakdown some on digestible substances, such as cellulose, and synthesize vitamins K., B12, thiamine, and riboflavin.
6. The large intestine forms and stores feces.
7. Feces consists of water, undigested material, mucus, and bacteria.
8. The color of feces is due to bile pigments that have been altered by bacterial action.

Diagram labeling.

1. Please be prepared to label the following: figure 17.3 which is found on page 667 of your textbook.
2. Please be prepared to label the following: figure 17.7 which can be found on page 671 of your textbook.
3. Please be prepared to label the following: figure 17.10 which is found on page 672 of your textbook.
4. Please be prepared to label the following: figure 17.20 which is found on page 682 of your textbook.
5. Please be prepared to label the following: figure 17.22 which is found on page 684 of your textbook.
6. Please be prepared to label the following: figure 17.24 which is found on page 686 of your textbook.
7. Please be prepared to label the following: figure 17.30 which is found on page 693 of your textbook.
8. Please be prepared to label the following: figure 17.35 which is found on page 696 of your textbook.

Chapter 18: nutrition and metabolism.

Why we eat.

1. Nutrients include carbohydrates, lipids, proteins, vitamins, and minerals.
2. Essential nutrients are required for health, and body cells cannot synthesize them.
3. Macronutrients include carbohydrates, lipids, and proteins.
4. Micronutrients are vitamins and minerals.
5. Water is also essential.
6. Hormones communicate from the gastrointestinal tract the hypothalamus to control appetite, and monitor fat stores.

Carbohydrates.

1. Polysaccharides, disaccharides, and monosaccharides are carbohydrates.
2. Cellulose is a polysaccharide human enzymes cannot digest.
3. Cellulose provides bulk that facilitates movement of intestinal contents.
4. Carbohydrates are absorbed as monosaccharides.
5. Enzymes in the liver catalyze reactions that convert fructose and galactose into glucose.
6. Oxidation releases energy from glucose.
7. Excess glucose is stored as glycogen or combined to produce fat.
8. Most carbohydrates supply energy.
9. Some carbohydrates are used to produce sugars.
10. Some cells require a continuous supply of glucose to survive.
11. If glucose is scarce, amino acids may react to produce glucose.
12. Glucose is blood sugar.
13. Glucose + Glucose = Maltose
14. Glucose + Fructose = Sucrose
15. Glucose + Galactose = Lactose
16. Lactase enzymatically separates lactose into glucose and galactose.
17. Maltase enzymatically separates maltose into 2 glucose molecules.
18. Sucrase enzymatically separates sucrose into glucose and fructose.

Lipids.

1. Lipids are organic compounds that supply energy and are used to build cell structures.
2. Cholesterol is mostly obtained and foods of animal origin.
3. Before fats can be used as energy sources, they must be broken down into glycerol and fatty acids.
4. Beta oxidation activates fatty acids and breaks them down into segments of two carbon atoms each.
5. Fatty acid segments are converted into acetyl CoA, which can then be oxidized in the citric acid cycle.
6. The liver regulates cholesterol level by synthesizing or excreting it.
7. Fat intake must be sufficient to carry fat soluble vitamins.

Protiens.

1. Proteins proteins are organic compounds that serve as structural materials, active enzymes, and provide energy.
2. Amino acids are incorporated into various structural and functional proteins, including enzymes.
3. During starvation, tissue proteins may be used as energy sources.
4. In an during digestion, proteins are broken down into amino acids.
5. Before amino acids can be used as energy sources, they must be deaminated.
6. The deaminated portions of amino acids can be broken down into carbon dioxide and water or used to produce glucose or fat.
7. All essential amino acids must be present at the same time in order for growth and repair of tissues to take place.
8. In healthy adults, the gain of protein equals the loss of protein, and a nitrogen balance exists.

Energy expenditures.

1. Energy is of prime importance to survival.
2. Energy may be obtained from carbohydrates, fats, or proteins.
3. The potential energy values of food are expressed in calories.
4. The amount of energy required vary from person to person.
5. Factors that influence energy requirements include basal metabolic rate, muscular activity, body temperature, and nitrogen balance.
6. Energy balance exist when caloric intake equals caloric output.
7. If energy balance is positive, body weight increases.
8. If energy balance is negative, body weight decreases.

Vitamins.

1. Vitamins are organic compounds that are essential for normal metabolic processes and cannot be synthesized by body cells in adequate amounts.
2. Fat soluble vitamins are carried in lipids and are influenced by the same factors that affect lipid absorption.
3. Fat soluble vitamins are fairly resistant to the effects of heat.
4. Fat soluble vitamins are not destroyed by cooking or food processing.
5. Vitamin A is an antioxidant required for production of visual pigments.
6. Vitamin D is a group of steroids.
7. Vitamin D can be produced from cholesterol in the skin.
8. Vitamin E is a fat soluble antioxidant area
9. vitamin K is used to produce prothrombin, which is required for blood clotting.
10. Vitamins ADE and K are fat soluble vitamins.
11. Water soluble vitamins include the B vitamins and vitamins C.
12. Vitamin B1 is thiamine.
13. Thiamine functions as a part of coenzymes that oxidize carbohydrates and synthesize essential sugars.
14. Vitamin B2 is riboflavin.
15. Riboflavin functions as part of several enzymes & Co. enzymes are essential to the oxidation of glucose and fatty acids.
16. Vitamin B3 is niacin.
17. Niacin functions as part of co-enzymes required for the oxidation of glucose and for the synthesis of proteins and fats.
18. Niacin can be synthesized from tryptophan.
19. Vitamin B5 is pantothenic acid.
20. Pantothenic acid functions as part of CoA.
21. Thus pantothenic acid is essential for energy releasing mechanisms.
22. Vitamin B6 is pyridoxine.
23. Vitamin B6 a group of compounds that function as co-enzymes and metabolic pathways that synthesize proteins, certain amino acids, antibodies, and nucleic acids.
24. Vitamin B12 is cyanocobalamin.
25. The cyanocobalamin molecule contains cobalt.
26. Vitamin B12 absorption is regulated by the secretion of intrinsic factor from the parietal cells.
27. Folic acid is a set of co-enzymes needed for the metabolism of certain amino acids, DNA synthesis, and the normal production of red blood cells.
28. Biotin is a coenzyme required for metabolism amino acids and fatty acids, and for nucleic acid synthesis.
29. Vitamin C is ascorbic acid.
30. Vitamin C is required for collagen production, the metabolism of certain amino acids, and iron absorption, backspace.
31. Vitamin C is not stored in large amounts.
32. Excess vitamin C is excreted in the urine.

Minerals.

1. Minerals are responsible for about 4% of body weight.
2. About 75% by weight of the minerals are found in bones and teeth as calcium and phosphorus.
3. Minerals are usually incorporated into organic molecules.
4. Some minerals are found in inorganic compounds or is free ions.
5. Minerals composed structure or materials, function in enzymes, and play vital roles in various metabolic processes.
6. Homeostatic mechanisms regulate mineral concentrations.
7. The physiologically active form of minerals is the ionized form.
8. Calcium is essential for forming bones and teeth, conducting nerve impulses, contracting muscle fibers, flooding blood, and activating various enzymes.
9. Phosphorus is incorporated into the salts of bones and teeth.
10. Phosphorus is also in the phospholipids of cell membranes, ATP, and phosphates of body fluids.
11. Potassium is concentrated inside cells potassium maintain the osmotic pressure, regulates pH, metabolizes carbohydrates and proteins, conducts nerve impulses, and contracts muscle fibers.
12. Most sodium is in extracellular fluids or is bound to the inorganic salts of bone.
13. The kidneys, under the influence of aldosterone, regulate the blood concentration of sodium.
14. Sodium helps maintain water balance.
15. Sodium is essential for conducting nerve impulses, contracting muscle fibers, and moving substances through cell membranes.
16. Chlorine acts with sodium to help maintain osmotic pressure, regulate pH, and maintain electronic balance.
17. Magnesium is abundant in the bones as phosphates and carbonates.
18. Magnesium functions in ATP production.
19. Magnesium functions in the breakdown of ATP to ADP.
20. A reserve supply of magnesium is stored in the bones.
21. Excess magnesium is excreted in the urine.
22. Iron is part of hemoglobin in red blood cells in myoglobin muscles.
23. A reserve supply of iron is stored in the liver, spleen, and bone marrow.
24. Copper is required for hemoglobin synthesis, bone development, melanin production, and myelin formation.
25. Copper is important for the proper development of collagen fibers.
26. Iodine is most highly concentrated in the thyroid gland.
27. Iodine is an essential component of thyroid hormones.
28. Iodine is often added to foods as I organized table salt.
29. Fluorine is incorporated into enamel and prevents dental caries.
30. Chromium regulates glucose utilization.

Questions about the AnP II Exam

First, there was an error on the key. The answer for #19 should have been "False". As a result, I "boosted" everyone's score by 2 (two) points from what you saw yesterday.

Second, if you wrote "v." which indicates a "vein" when an "a." which indicates an "artery"; then you were marked down ... it was incorrect.

Third, when studying for my exams, pay close attention to the following: physiologically relevant anatomy. I promise that I WILL focus myself both in class and on exams on the physiologic processes that are MOST relevant in an introductory class that is to prepare you for further study in anatomy and physiology, pathophysiology and a nursing program.

When preparing for an exam, please review the text and lecture notes as covered in class. In your final preparation for any exam, narrow your focus to cover my dictations which are posted on the AnP blog www.drbonci.com.

Consider that the exam is trying to identify if you can understand and recognize basic anatomical and physioloical "truths". You should be able to tell if I am "being truthful" about a stated anatomical or physiological "fact" or if I am lying to you about it.

I hope this helps. I want the best for you.

Andrew

Ready, set, test!

Hi all,

We have covered a tremendous amount of information in class over the past two weeks and now we are ready for our first exam. You must be wondering how in the world are you going to be able to remember it all?!

Here is a little hint ...

Get involved in the NARRATIVE ... as you are studying and thinking this material through ... TALK to yourself about it ... get FLUENT in it. Read it out loud. Discuss it with a classmate. Explain it to a family member. Tell it to your dog or cat. Get COLLOQUIAL about what you're learning and then you'll KNOW it well.

What I would like to see is each of you gain a COMMAND of these ideas and concepts. This will EMPOWER you to be of service to all who have need of you. Remember, sick people come to health care professionals LOST, DISENFRANCHISED and DISEMPOWERED. Your confidence in who you are and what you know will bring great comfort to those you serve. This will be your role in their lives. And, THIS is what I anticipate seeing in each of you.

See you next week ...

Andrew

Pssssssssst .....

A little encouragement for my classes ...

Right Now by Van Halen

Don't wanna wait 'til tomorrow
Why put it off another day?
One by one, little problems
Build up, and stand in our way.

One step ahead, one step behind it
Now ya gotta run to get even
Make future plans I'll dream about yesterday, hey!
Come on turn, turn this thing around

(Right now) Hey! It's your tomorrow
(Right now) Come on, it's everything
(Right now) Catch your magic moment
Do it right here and now
It means everything

Anatomy & Physiology II

Wow! We covered a gigantic amount of information and applied to a variety of situations today. I know ... you're wondering how you're gonna remember it all. As you are studying, engage yourself in "the narrative" of what you're studying. Talk to yourself about what you're learning and thinking. Talk to others about what you're learning ... your spouse, child or pet. Just talk it through.

I had a great time showing you how blood pressure works in lab. It was really cool that we had the opportunity to play with the handheld doppler..

Remember that you're first exam review is available at www.drbonci.com.

Cheers!

SC 1332 Chapter Review

Here is the Chapter Review for Chapters14, 15 and 16. This is intended to help focus you for the first exam which covers these three chapter.


Chapter 14: blood

Introduction.
1.Blood is often considered a type of connective tissue who cells were suspended in a liquid extracellular matrix.
2.It transports substances between the body cells in the external environment and helps maintain a stable internal environment.

Blood in blood cells.
1.Blood can be separated into formed elements and liquid portions.
2.The formed elements portion is mostly red blood cells.
3.the liquid plasma includes water, amino acids, proteins, carbohydrates, lipids, vitamins, hormones, electrolytes, and cellular wastes.
4.Blood cells develop from hemocytoblasts, hemopoietic stem cells in red bone marrow.
5.Cells descended from stem cells respond to hemopoietic growth factors to specialize.
6.Thrombopoietin stimulates megakaryocytes to give rise to platelets.
7.Erythropoietin stimulates formation of red blood cells.
8.Red blood cells or by concave disks with shapes that provide increased surface area and place their cell membranes close to internal structures.
9.Red blood cells contain hemoglobin, which combines loosely with oxygen.
10.Mature red blood cells lack nuclei and other organelles, but contain enzymes needed for energy releasing processes.
11.Red blood cell count is related to the oxygen carrying capacity of the blood and is used in diagnosing and evaluating the courses of diseases.
12.During fetal development, red blood cells form in the yolk sac, liver, and spleen.
13.In adulthood red blood cells are produced in the red bone marrow.
14.Erythropoietin is released in response to low oxygen levels.
15.High altitude, loss of blood, or chronic lung disease can lower oxygen concentration in the blood.
16.The availability of vitamin B12, iron, and folic acid affects red blood cell production.
17.Red blood cells are fragile and are damaged while moving through capillaries.
18.Macrophages in the spleen and liver phagocytize damaged red blood cells.
19.Hemoglobin molecules are decomposed, and the iron from the heme portion is recycled.
20.Biliverdin and bilirubin are pigments, released from heme portion, excreted in bile.
21.The globin portion is broken down into amino acids metabolized by macrophages or released into the blood.
22.Granulocytes include neutrophils, eosinophils, and basophils.
23.Agranulocytes include monocytes and lymphocytes.
24.White blood cells fight infection.
25.Neutrophils and monocytes phagocytize foreign particles.
26.Chemicals released by damaged cells attract and stimulate leukocytes.
27.Eosinophils kill parasites and help control inflammation and allergic reactions.
28.Basophils release heparin, which inhibits blood clotting, and histamine to increase blood flow to tissues that are injured.
29.Lymphocytes are involved in immunity and produce antibodies that attack specific foreign antigens.
30.The number of white blood cells may change in abnormal conditions such as infections, emotional disturbances, or excessive loss of body fluids.
31.A differential white blood cell count indicate the percentage is of various types of leukocytes present.
32.Blood platelets are fragments of megakaryocytes that enter circulation.
33.Platelets help close breaks in blood vessels.

Blood plasma.
1.Plasma is the liquid portion of the blood that is composed of water and a mixture of organic and inorganic substances.
2.Plasma transports nutrients and gases, helps regulate fluid and electronic balance, and helps maintain stable pH.
3.Plasma proteins remain in blood and interstitial fluids and are not normally used as energy sources.
4.Albumins help maintain the osmotic pressure of plasma.
5.Globulin's provide immunity (antibodies) and transport lipids and fat soluble vitamins.
6.Fibrinogen functions in clotting blood.
7.Gases in plasma include oxygen, carbon dioxide, and nitrogen.
8.Plasma nutrients include simple sugars, amino acids, and lipids.
9.Glucose is stored in the liver as glycogen and is released whenever the blood glucose concentration falls.
10.Amino acids are used to synthesize proteins and are deaminated for use as an energy source.
11.Lipoproteins function in the transport of lipids.
12.Nonprotein nitrogenous substances are composed of molecules that contain nitrogen atoms but are not proteins.
13.Nonprotein nitrogenous substances include amino acids, urea, uric acid, creatine, and creatinine.
14.Urea and uric acid are products of catabolism.
15.Creatinine results from the metabolism of creatine.
16.Plasma electrolytes are absorbed from the intestines and are released as byproducts of cellular metabolism.
17.Plasma electrolytes are important in the maintenance of osmotic pressure and pH.

Hemostasis.
1.Hemostasis refers to the stoppage of bleeding.
2.Hemostatic mechanisms are most effective in controlling blood loss from small vessels.
3.Hemostasis consists of blood vessel spasm (vasospasm), platelet plug formation, blood coagulation, and prevention of coagulation.
4.During vasospasm smooth muscles and walls of small blood vessels reflexively contract following injury.
5.During the vasospasm platelets release serotonin that stimulates vasoconstriction and helps maintain vessel spasm.
6.During platelet plug formation platelets adhere to rough surfaces and exposed collagen area
7.during platelet plug formation platelets adhere together at the sight of injuries and form platelet plugs in broken vessels.
8.Blood clotting, the most effective means of hemostasis, involves a series of reactions wherein each reaction stimulates the next reaction.
9.The extrinsic clotting mechanism is triggered when blood contacts damaged tissue.
10.The intrinsic clotting mechanism is triggered when blood contacts a foreign surface.
11.Clot formation depends on the balance between clotting factors that promote clotting and those that inhibit clotting.
12.The major event of coagulation is the conversion of soluble fibrinogen into in soluble fibrin.
13.After forming, the clock retracts and pulls the edges of a broken vessel closer together.
14.Prothrombin activator converts prothrombin to thrombin.
15.Thrombin converts fibrinogen to fibrin.
16.Plasmin is a proteins splitting enzymes a can digest fibrin threads and other proteins associated with blood clots.
17.A thrombus is an abnormal blood clot in a vessel.
18.And embolus is a clot or fragment of a clot that moves in a vessel.
19.Fibroblasts invade a clot, forming connective tissue throughout.
20.The smooth lining of blood vessels discourages the accumulation of platelets.
21.As a clot forms, fibrin absorbs thrombin and prevents the reaction from spreading.
22.Some cells secrete heparin, an anticoagulant.

Blood groups and transfusions.
1.Blood can be typed on the basis of the surface structures of its cells.
2.Red blood cell membranes may contain specific antigens, and blood plasma may contain antibodies against certain of these antigens.
3.Blood typing uses known antibodies to identify antigens on red blood cell membranes.
4.Blood can be grouped according to the presence or absence of antigens A and B.
5.Whenever antigen A is absent, anti-A antibodies are present.
6.Whenever antigen B is absent, anti-B antibodies are present.
7.Adverse transfusion reactions are avoided by preventing the mixing of red blood cells that contain an antigen with plasma that contains the corresponding antibody.
8.Adverse reactions are due to agglutination of the red blood cells.
9.Rh antigens are present on the red blood cell membranes of Rh positive blood.
10.Rh antigens are absent in Rh negative blood.
11.If in Rh negative person is exposed to Rh positive blood, anti-Rh antibodies are produced in response.
12.If an Rh negative female is pregnant with an Rh positive fetus, some of the positive cells may enter the maternal blood at the time of birth and stimulate the maternal tissues to produce anti-Rh antibodies.
13.Anti-Rh antibodies in maternal blood may pass through the placental tissues and react with the red blood cells of an Rh positive fetus.


Chapter 15: cardiovascular system.

Introduction
1.The cardiovascular system is composed of the heart and blood vessels, which circulate blood to supply oxygen to, and remove wastes from, body cells.

Structure of the heart.
1.The heart is located within the mediastinum and rests on the diaphragm.
2.A layered pericardium encloses the heart.
3.The pericardial cavity is a space between the visceral and parietal layers of the pericardium.
4.The wall the hardest three layers.
5.The layers of the heart include and epicardial, a myocardium, and and endocardial.
6.The heart is divided into four chambers.
7.The right atrium receives blood from the vena cava and the coronary sinus.
8.The tricuspid valve guards the right atrioventricular orifice.
9.The right ventricle pumps blood into the pulmonary trunk.
10.The left atrium receives blood from the pulmonary veins.
11.The mitral valve guards the left atrioventricular orifice.
12.The left ventricle pumps blood into the aorta.
13.The aortic valve guards the base of aorta.
14.The skeleton of the heart consists of fibers rings that enclosed the basis of the pulmonary artery, aorta, and atrioventricular orifices.
15.The fibers rings of the skeleton of the heart provide attachments for valves in muscle fibers.
16.Blood that is relatively low in oxygen and high in carbon dioxide enter the right side of the heart from the vena cava and coronary sinus and then is pumped into the pulmonary circulation.
17.After the blood is oxygenated in the lungs and some of the carbon dioxide is removed, it returns to the left side of the heart through the pulmonary veins.
18.The blood moves from the left ventricle into the aorta.

Heart actions.
1.The atria contract while the ventricles relax.
2.The ventricles contract while the atria relax.
3.Contraction of the heart muscle is called systole.
4.Relaxation of the heart muscle is called diastole.
5.Heart sounds are due to the vibrations that the valve movements produce.
6.The first heart sound occurs with A-V valve closure.
7. The second heart sound occurs with the closing of the pulmonary and aortic valves.
8.Cardiac muscle fibers connect to form a functional syncytium.
9.Cardiac muscle fibers are connected by intercalated discs.
10.If any part of the syncytium stimulated, the whole structure contracts as a unit.
11.The cardiac conduction system is composed of specialized cardiac muscle tissue which initiates and conducts a depolarization wave throughout the myocardium.
12.Impulses from the SA node pass slowly to the AV node.
13.Impulses travel rapidly along the AV bundle and Purkinje fibers.
14.Muscles fibers in the ventricular wall form whorls that squeeze blood out of the contracting ventricles.
15.An EKG records electrical changes in the myocardium during a cardiac cycle.
16.The P-wave represents atrial depolarization.
17.The QRS complex represents ventricular depolarization.
18.The T wave represents ventricular repolarization.
19.Parasympathetic impulses decrease heart action.
20.Sympathetic impulses increase heart action.
21.The cardiac center in the middle oblongs regulates autonomic impulses to the heart.

Blood vessels.
1.The blood vessels form a closed circuit of tubes that transport blood between the heart and body cells.
2.The arteries are adapted to carry relatively high pressure blood away from the heart.
3.The arterioles are branches of arteries.
4. The walls of arteries and arterioles consists of layers of endothelium, smooth muscle, and connective tissue.
5.Autonomic fibers that can stimulate vasoconstriction or vasodilation innervate smooth muscles in vessel walls.
6.Capillaries connect arterioles and venules.
7.The capillary wall is a single layer of cells that forms a semipermeable membrane.
8.Openings in the capillary walls are thin slits between endothelial cells.
9.Endothelial cells or brain capillaries are tightly fused, forming a blood brain barrier through which substances moved by facilitated diffusion.
10.Capillary density varies directly with tissue metabolic rates.
11.Pre-capillary sphincters regulate capillary blood flow.
12.Pre-capillary sphincters open when cells are low in oxygen and nutrients and close when cellular needs are met.
13.Gases, nutrients, and metabolic byproducts are exchange between the capillary blood and the tissue fluid.
14.Diffusion provides the most important means of transport between the capillary blood in the tissue fluid.
15.Plasma proteins generally remain in the blood.
16.Filtration, which is due to the hydrostatic pressure of blood, causing outward movement of fluid at the arteriolar end of the capillary.
17.Venules continue from capillaries and merge to form veins.
18.Veins carry blood to the heart.
19.Venus walls are similar to arterial walls but are thinner and contain less muscle and elastic tissue.

Blood pressure.
1.Blood pressure is the force of blood exerts against the insides of the blood vessels.
2.The arterial blood pressure is produced primarily by heart action.
3.Arterial blood pressure rises and falls with phases of the cardiac cycle.
4.Systolic pressure occurs when the ventricles contract.
5.Diastolic pressure occurs when the ventricles relax.
6.Heart action, blood volume, resistance to flow, and blood viscosity influence arterial blood pressure.
7.Arterial blood pressure increases as cardiac output, blood volume, peripheral resistance, or blood viscosity increases.
8.Blood pressure is controlled in part by the mechanisms that regulate cardiac output and peripheral resistance.
9.Cardiac output depends on the volume of blood discharged from the ventricle with each beat (stroke volume) and on the heart rate.
10.The more blood enters the heart, the stronger the ventricular contraction, the greater the stroke volume, and the greater the cardiac output.
11.The cardiac center of the medulla oblongata regulates heart rate.
12.Changes in the diameter of the arterioles, controlled by the vasomotor center of the medulla oblongata, regulate peripheral resistance.
13.Venus blood flow is not a direct result of heart action.
14.Venus blood flow depends on skeletal muscle contraction, breathing movements, and venoconstriction.
15.Many veins contain flat like valves that prevent blood from backing up.
16.Central venous pressure is the pressure in the right atrium.

Paths of circulation.
1.The pulmonary circuit consists of vessels that carry blood from the right ventricle to the lungs, alveolar capillaries, and vessels that lead back to the left atrium.
2.Osmotic pressure rapidly draws water out of the alveoli into the interstitial fluid, so alveoli do not fill with fluid.
3.The systemic circuit is composed of vessels that lead from the heart to all body parts (including vessels supplying the heart itself) and back to the heart.
4.The systemic circuit includes the aorta and its branches as well is the system of veins that return blood to the right nutrients.

Arterial system.
See drawing.

Venous system.
See drawing.

Chapter 16: lymphatic system and immunity.

Introduction.
1.The lymphatic system is closely associated with the cardiovascular system.
2.The lymphatic system transports excess fluid to the blood stream, absorbs fats, and helps defend the body against disease causing agents.

Lyphathic pathways
1.Lymphatic capillaries are microscopic, closed ended tubes that extend into interstitial spaces.
2.They receive fluid through their thin walls.
3.Lacteals are lymphatic capillaries in villi of the small intestine.
4.Lymphatic vessels are formed by the merging of lymphatic capillaries.
5.Lymphatic vessels have walls similar to veins, only thinner, and possess fat old is that prevent back flow of lymph.
6.Larger lymphatic vessels lead to lymph nodes and then merge into lymphatic trunks.
7.Lymphatic trunks drain lymph from large body regions.
8.Trunks lead to to collecting ducts: the thoracic duct and the right lymphatic duct.
9.Collecting ducts join the subclavian veins.
10.Tissue fluid originates from plasma and includes water and dissolve substances that have passed through the capillary wall.
11.As the protein concentration of tissue fluids increases, colloid osmotic pressure increases.
12.Lymph returns to smaller protein molecules and fluid to the blood stream.
13.It transports foreign particles to lymph nodes.
14.Lymph is under low pressure and may not flow readily without external aid.
15.Lymph is moved by the contraction of skeletal muscles and low pressure in the thorax created by breathing movements.
16.Any condition that interferes with the flow of lymph results in edema.
17.Obstruction of lymphatic vessels due to surgical removal of lymph nodes causes edema in the affected area.

Lymph nodes.
1.Lymph nodes are enclosed in connective tissue that extends into the nodes and subdivides them into nodules.
2.Nodules contain masses of lymphocytes and macrophages, as well as spaces through which lymph flows.
3.Lymph nodes aggregate in groups or chains along the paths of larger lymphatic vessels.
4.Lymph nodes primarily occur in cervical, axillary, supratrochlear, and inguinal regions as well as in the pelvic, abdominal, and thoracic cavities.
5.Lymph nodes filter potentially harmful foreign particles from the lymph before it is returned to the blood stream.
6.Lymph nodes are centers for the production of lymphocytes that act against foreign particles.
7.Lymph nodes contain macrophages that remove foreign particles from lymph.

Thymus and spleen.
1.The thymus is a soft, bilobed organ located with in the mediastinum.
2.They thymus is composed of lymphatic tissue subdivided into lobes.
3.Thymic lobes contain lymphocytes that develop from precursor cells in the red bone marrow.
4.Some lymphocytes leave the thymus and provide immunity.
5.The thymus secretes thymosin, which stimulates lymphocytes that have migrated to other lymphatic tissues.
6.The spleen is located in the upper left portion of the abdominal cavity.
7.The spleen resembles a large lymph node that is encapsulated and subdivided into lobes by connective tissue.
8.Spaces within the splenic lobes are filled with blood.
9.The spleen, which filters foreign particles and damaged red blood cells from the blood, contains many macrophages and lymphocytes.

Body defenses against infection.
1.The presence and reproduction of pathogens cause infection.
2.Pathogens include bacteria, complex single celled organisms, fungi, and viruses.
3.An infection may be present without immediately causing symptoms.
4.The body has innate (nonspecific) and adaptive (specific those parenthesis defenses against infection.

Innate (nonspecific) defenses.
1.Each species is resistant to certain diseases that may affect other species but is susceptible to diseases other species may resist.
2.Mechanical barriers include skin and mucous membranes.
3.Intact mechanical barriers prevent entrance of some pathogens.
4.Hair traps infectious agents; and fluids such as tears, sweat, saliva, mucus, and urine wash away organisms before they can firmly attach.
5.Enzymes and gastric juice and tears kill some pathogens.
6.Low pH in the stomach prevents growth of some bacteria.
7.High salt concentration in perspiration kill some bacteria.
8.Interferons stimulate uninfected cells to synthesize antiviral proteins that block proliferation of viruses.
9.Defensins make holes in bacterial cell walls and membranes.
10.Collectins provide broad protection against a wide variety of microbes by grabbing onto them.
11.Activation of complement proteins in plasma stimulates inflammation, attracts phagocytes, and enhances phagocytosis.
12.Natural killer cells secrete perforins, which destroy cancer cells and cells infected with viruses.
13.Inflammation is a tissue response to damage, injury, or infection.
14.The response includes localized redness, swelling, heat, and pain.
15.Chemicals released by damaged tissues attract white blood cells to the site.
16.Clotting may occur in body fluids that accumulate in affected tissues.
17.Connective tissue containing many fibers may form a sac around the injured tissue and thus aid in preventing the spread of pathogens.
18.The most active phagocytes in blood are neutrophils and monocytes.
19.Monocytes give rise to macrophages when they exit the blood stream.
20.Phagocytes remove foreign particles from tissues and body fluids.
21.Viral or bacterial infections stimulates certain lymphocytes to secrete interleukin-1 (IL-1), which temporarily raises body temperature.
22.Physical factors, such as heat or ultraviolet light, or chemical factors, such as acids or bases, can cause fever.
23.Elevated body temperature and the resulting decrease in body iron level and increased phagocytic activity hamper infection.

Adaptive (specific) defenses or immunity.
1.Before birth, body cells inventory “self” proteins and other large molecules.
2.After inventory, lymphocytes develop receptors that allow them to differentiate between nonself (foreign) and self antigens.
3.Nonself antigens combined with T-cell and B-cell surface receptors and stimulate the cells to cause an immune reaction.
4.Hapetens are small molecules that can combine with larger ones, becoming antigenic.
5.Lymphocytes originate in red bone marrow and are released into the blood before they differentiate.
6.Some lymphocytes reach the thymus which mature into T cells.
7.B cells, mature in the red bone marrow.
8.T cells respond to antigens by cell to cell contact (cellular immune response).
9.T cells secrete cytokines, such as interleukins, that enhance cellular responses to antigens.
10.T cells may also secrete substances that are toxic to their target cells.
11.B cells interact with antigen bearing agents indirectly, providing the humoral immune response.
12.The members of each B-lyphocyte variety respond only to a specific antigen.
13.As a group, the members of each variety form a clone.
14.T cells are activated when an immune presenting cell displays a foreign antigen.
15.When a macrophage acts as an accessory cell, it will phagocytize the antigen bearing agent, digest the agent, and displays the antigens on its cell membrane in association with certain MHC proteins.
16.A helper T cell becomes activated when it encounters displayed antigens for which it is specialized to react.
17.Once activated, helper T cells stimulate B cells to produce antibodies.
18.Cytotoxic T cells recognize foreign antigens on tumor cells and cells who surfaces indicate that they are infected by viruses.
19.Stimulated cytotoxic T cells secrete perforins to destroy the cells.
20.Memory T cells allow for immediate response to second and subsequent exposure to the same antigen.

B cells and humoral immunity.
1.A B cell is activated when it encounters an antigen that fits its antigen receptors.
2.An activated B cell proliferates (especially when stimulated by a T-cell), enlarging its clone.
3.Some activated B cells specialize into antibody producing plasma cells.
4.Antibodies react against the antigen bearing agent that stimulated their production.
5.An individual's diverse B cells defend against a very large number of pathogens.
6.Antibodies are soluble proteins called immunoglobulins.
7.Antibodies constitute the gamma globulin fraction of plasma.
8.The five major types of immunoglobulins are IgG, IgA, IgM, IgD, and IgE.
9.IgG, IgA and IgM make up most of the circulating antibodies.
10.Antibodies directly attached to antigens, activate complement, or stimulate local tissue changes that are unfavorable to antigen bearing agents.
11.Direct attachment results in agglutination, precipitation, or neutralization.
12.Activate complement proteins alter infected cells so they become more susceptible to phagocytosis, attract phagocytes, and lyse foreign cell membranes.
13.B Cells or T cells first encountering an antigen for which they are specialized to react constitutes a primary immune response.
14.During this response, antibodies are produced for several weeks.
15.Some B cells remain dormant as memory cells.
16.A secondary immune response occurs rapidly as a result of memory cell response if the same antigen is encountered later.
17.A person who encounters a pathogen and has a primary immune response develops naturally acquired active immunity.
18.A person who receives a vaccine containing a dead or weakened pathogen, or part of it, develops artificially acquired active immunity.
19.A person who receives an injection of antibodies or antitoxin has artificially acquired passive immunity.
20.When antibodies pass through a placental membrane from a pregnant woman to her fetus, the fetus develops naturally acquired passive immunity.
21.As a general rule, active immunity lasts much longer than passive immunity.

Allergic reactions.
1.Allergic or hypersensitivity reactions are excessive misdirected immune responses that may damage tissues.
2.Immediate reaction allergy is an inborn ability to overproduce IgE.
3.Allergic reactions result from mast cells bursting and releasing allergy mediators such as histamine and serotonin.
4.The released chemicals cause allergy symptoms such as hives, hay fever, asthma, eczema, or gastric disturbances.
5.In anaphylactic shock, allergy mediators flood the body, causing severe symptoms, including decreased blood pressure and difficulty breathing.
6.Antibody dependent cytotoxic allergic reactions occur when blood transfusions are mismatched.
7.Immune complex allergic reactions involve autoimmunity, which is an immune reaction against self antigens.
8.Delayed reaction allergy, which can occur in anyone and inflame the skin, results from repeated exposure to allergens.

Transplantation and tissue rejection.
1.A transplant recipient's immune system may react against the donated tissue in a tissue rejection reaction.
2.Matching cell surface molecules (MHC antigens) of donor and recipient tissues and using immunosuppressive drugs can minimize tissue rejection.
3.Immunosuppressive drugs may increase susceptibility to infection.
4.Transplants may take place between genetically identical twins, from one body part to another, between unrelated individuals of the same species, or between individuals of different species.

Lifespan changes.
1.The immune system begins to decline early in life, in part due to the decreasing size of the thymus.
2.Numbers of T cells and B cells do not change significantly, but activity levels do.
3.Proportions of the different antibody classes shift.