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Test II: Blood, Blood Vessels, Heart, Lymph System, & Immunology

Blood, The Heart, Blood Vessels, Lymphatic System, Immunology
What is the average amount of blood in the body (in Liters)
5 - 6 L
What is the normal pH of the blood?
What are the two parts of the blood?
1. Plasma
2. Formed Elements
What is the fluid portion of blood?
What is the cell portion of blood?
Formed elements
Name 7 Solutes in plasma:
1. Glucose
2. Bicarbonate
3. Na+
4. K+
5. Urea
6. Amino Acids
7. Lipoproteins
Name the three plasma proteins:
1. Albumin
2. Globulin
3. Fibrinogen
What is the significance of albumin?
It maintains the osmotic pressure of the blood.
What is meat by osmotic pressure?
The amount of pressure needed to stop the flow of water through the blood vessel wall.
How many erythrocytes are there per cubic millimeter?
4-6 million RBC/mm3
How long do RBC live?
120 days
(3-4 months)
What is the size of a RBC?
Why do RBC only live a few months?
When they age they lose flexibility and no longer can squeeze through tight junctions
Where are RBCs destroyed?
In the liver and spleen
Name a few unique Characteristics of a RBC:
1. Lack a nucleus & most organelles (no mitochondria)
2. Biconcave shape
3. Appear like doughnuts (more cytoplasm on the outer edge than in the middle)
4. Can't reproduce
How do RBCs get ATP?
Glycolysis (make 2 ATP)
Name two functions of RBCs:
1. Carry oxygen (Oxyhemoglobin)
2. Carry carbon dioxide (Carbaminoglobin)
What is erythropoiesis?
The formation of RBCs
What is hematopoiesis?
The formation of various blood cells (RBCs, WBCs, Platelets)
What is a hematopoietic stem cell?
A pluripotent stem cell that undergoes mitosis and can differentiate into the different types of blood cells depending upon what factors act on it.
Where does erythropoiesis occur in adults?
The red bone marrow at the epiphyses of long bones and the spongy bone of flat bones.
Where does erythropoiesis occur in the fetus?
The liver, spleen, and thymus.
What vitamins/minerals are needed for erythropoeisis?
Intrinsic factor made by parietal cells is needed to absorb vitamin B12 which is crucial in the formation of RBCs.
How is the kidney involved in erythropoiesis?
The hormone erythropoietin is made by the kidneys to when oxygen levels are low in order to produce RBCs.
When is eryhropoietin produced?
When oxygen levels in the blood are low.
What is hypoxia?
Too little oxygen present in the body/tissues.
What is a hematocrit?
The percentage of RBCs in whole blood.
What is a normal hematocrit?
38-55% (RBCs)
What is the normal amount of hemoglobin?
How many hemoglobin are in one RBC?
280 million
What is the function of hemoglobin?
Carry oxygen
What is oxyhemoglobin?
Hemoglobin with oxygen attached (bright red in color).
What mineral is in heme?
How many oxygen can hemoglobin bind to?
What is the globin part of hemoglobin made of?
Alpha, beta, and gamma globulins, transport proteins, and antibodies
What can globin bind to?
Carbon dioxide
When hemoglobin is broken down, what happens to heme, iron, and globin?
Heme = is used by the liver to form bilirubin that leaves with bile

Iron = is stored in the liver and recycled

Globin = is broken down into amino acids and recycled
What is jaundice? Does it always mean a liver or bile duct problem?
Jaundice is the yellowing of they eyes and the skin. It is caused by excess of bilirubin and can indicate over-stimulation of hemolysis (hemolytic anemia).
What color is deoxyhemoglobin?
What is cyanosis?
The bluish discoloration of the skin and mucous membranes due to lack of oxygen in the blood.
Name five causes of anemia:
1. Hemorrhagic Anemia = bleeding
2. Hemolytic Anemia = Splitting of RBCs due to faultiness
3. Pernicous Anemia = lack of vitamin B12
4. Sickle Cell Anemia = faulty hemoglobin
5. Iron deficiency = iron loss/menstruation
What is polycythemia?
Too many rood blood cells
Why is polycythemia dangerous?
The high amount of red blood cells will cause the viscosity of the blood to be become too thick and to great for the heart to pump.
What is a reticulocyte, and when do they appear in the blood?
An immature RBC (the last stage before becoming a RBC). They appear in the blood during erythropoiesis.
How many leukocytes are there in a cubic millimeter of blood?
5,000 - 10,000/mm3
Where are white blood cells made?
In the red bone marrow
What is leukocytosis?
Too many WBCs
What is leukocytopenia?
Too few WBCs
What is the major histocompatability complex (MHC)?
It is a complex that helps body cells recognize each other as "self"
Why is the major histocompatiability complex significant?
It helps cells with self-recognition which is important for tissue typing. It allows the cells to differentiate from foreign or abnormal cells.
Name all five white blood cells:
1. Neutrophils
2. Lymphocytes
3. Monocytes
4. Eosinophils
5. Basophils
What white blood cells are agranular?
Lymphoytes & Monocytes
Which white blood cells are grnaular?
What is diapedesis? Which cells can perform it?
It is the movement of a white blood cell through an intact blood vessel wall.
What is chemotaxis?
Chemicals that attract white blood cells to a particular area of damage.
What is the percentage of neutrophils in a WBC differential?
What is the typical appearance of a neutrophil?
Segmented nucleus (PMNs = polymorphonucleocytes)
What is the function of a neutrophil?
phagocytize bacteria
When does the increase of neutrophils occur?
During a bacterial infection
What are the three granules in a neutrophil?
What is the percentage of eosinophils in a WBC differential?
What do eosinophils look like?
Have reddish orange granules
Bilobed nucleus
What is the function of eosinophils?
Destroy parasites
Phagocytize antigen-antibody complexes
What granules do eosinophils have?
Enzymes that destroy parasites (worms)
When is the # of eosinophils elevated?
Worms & allergies
What is the percentage of basophils in a WBC differential?
What is the function of basophils?
Mediates inflammation in the tissues
What granules do basophils contain?
Histamine (for vasodilation, inflammation, swelling)
Heparin (anti-clotting agent)
Mast cells and basophils have similarities and differences, list them.
-Basophils are granular WBCs that circulate throughout the blood.
-Mast cells are located in areolar connective tissue cells
-Both contain granules rich in histamine and heparin
What do basophils look like?
They have an s-shaped nucleus with dark blue-purple granules
What is the percentage of lymphocytes in a WBC differential?
Where are lymphocytes made?
In the red bone marrow
What does a lymphocyte look like?
The nucleus takes up almost the entire cell
What are the three types of lymphocytes? List their functions
1. T-cells = cell-mediated immunity
2. B-cells = Make antibodies (humoral)
3. NK cells = survey body cells and destroy abnormal cells
What is the percentage of monocytes in a WBC differential?
What is the size of a monocyte?
3X that of a RBC (18-24um)
What does a monocyte look like?
3X the size of a RBC
Horseshoe shaped nucleus
What is the function of a monocyte?
Phagocytic, become macrophages during diapediesis
What are macrophages?
They are big eaters that engulf debris, foreign materials, bacteria, and viruses.
Name 5 places you can find fixed macrophages:
1. Kupffer cells in the liver
2. Microglia in the brain
3. Langerhan cells in the skin
4. Osteoclasts in bone
5. Alveolar macrophages in the lungs
How many thrombocytes are there per cubic millimeter?
What is another name for thrmobocytes?
Platelets come from which large cell?
Megakaryocytes (in the bone marrow)
What is the life span of a platelet?
8-10 days
What is the function of platelets?
1. Release chemicals (serotonin, ADP, thromboxane)
2. Adhesion
3. Forms a temporary plug
Name 3 important granules in thrombocytes:
1. ADP (aggregation & degranulation)
2. Thromboxane (A2) (prostaglandin for aggregation and sticking)
3. Serotonin (vasoconstriction/vascular spasms)
What are the three steps to stop bleeding?
1. Adherence
2. Release of chemicals (ADP, serotonin, thromboxane)
3. Aggregation (formation of temporary plug)
What is serum?
Plasma without clotting proteins
What is a thrombus?
A stationary blood clot in an unbroken blood vessel
What is an embolus?
Moving blood clot
What is the cause of hemopholia?
Lackig a clotting factor, most commonly FVIII
Why is vitamin K important regarding hemostasis?
Needed for the production of clotting factors
(II , VII , IX , X)
Why is the liver important regarding hemostasis?
The liver is essential for normal blood clotting as it makes clotting factors (thrombin which comes from prothrombin is a clotting factor made in the liver).
Can a blood clot form without calcium?
No, calcium is a required coenzyme in most of the steps in the formation of a permanent clot.
What converts prothrombin to thrombin?
What converts fribrinogen to firbin in hemostasis?
How is fibrin different from plasma proteins?
It is insoluble
Where do fibrinogen and prothrombin come from?
The liver
What is the intrinsic pathway of clotting?
The very slow process of clotting that begins in the bloodstream itself, and is due to damage of a blood vessel.
What is the extrinsic pathway of clotting?
The very fast process of clotting outside of the bloodstream, and is due to additional tissue damage.
What is syneresis (retraction)?
When fibrin threads are pulled taut (drawn tight)
How does syneresis (retraction) occur?
Actin/myosin contractile proteins pull the fibrin threads
What causes firbinolysis?
Once the epithelium has repaired, the clot will dissolve (catalyzed by plasmin).
What makes a blood type?
The glycoproteins on the surface of RBCs (antigens = cause an immune response).
What antibodies does a person with O blood have?
A, B
What antigens does a person with A blood have?
What is the Rh factor?
It is the positive antigen present on some RBC.
Does a person who is Rh- have antibodies against Rh+?
Yes, after exposure.
Can a person with O+ blood donate to a person with B+ blood?
Yes, O+ blood only has the D antigen which the B+ blood group recognizes.
Can a person with AB+ blood donate to a person with O+ blood?
No, because the O+ blood has A & B antibodies.
Why is AB+ the universal recipient?
Because it has no antibodies
What blocks thromboxane?
What is thrombocytosis?
Too many clotting cells
What is thrombocytopenia?
Too few clotting cells
What is the danger with Rh- women and pregnancy?
If a woman is Rh- and has never been exposed to Rh+, her first born child will expose her to it. This will be a problem for the second child because the mother now posses the Rh+ antibody and will clump this baby's blood.
What is erythroblastosis fetalis?
A hemolytic disease of a newborn, which can lead to a stillborn and many debilitating diseases.
What is Rhogam?
The shot of Rh+ anitbodies given to Rh- mothers who give birth to Rh+ children to avoid erythroblastosis fetalis in the next child.
During firbinolysis what catalyzes Fibrin to Firbinogen?
When do unwanted blood clots form?
1. Slow blood flow (post op patient that is not moving)
2. Overweight patients (blood pooiling)
3. A rough endothelium (someone with extra fatty plaque, this causes an uneven surface and platelets start sticking)
What is DIC (disseminated intravascular coagulation)
Abnormal or excessive clotting
Name three anti-coagulants:
1. Heparin
2. Vitamin K antagonoist
3. TPA (tissue plasminogen activator)
Diagram the clotting process:
Prothrombinase catalyzes:
Prothrombin --> thrombin
Thrombin catalyzes:
Fibrinogen --> fibrin
What is coagulation?
What is a band?
A young neutrophil
What is prostacyclin?
The lining in the blood vessels to keep platelets from sticking
What is anemia?
Lowered oxygen carrying capacity of the blood
(fatigue, cold feed, dizziness)
What makes up the left border of the heart?
The left ventricle
What makes the right border of the heart?
Right atrium
What makes up the anterior side of the heart?
Right ventricle
What is the apex?
The inferior point of the heart
What is the base?
The superior portion of the heart where the major vessels emerge.
Name the three layers of the pericardium (superficial to deep)
1. Fibrous pericardium
2. Visceral pericardium
3. Epicardium
Where is pericardial fluid located?
In the pericardial cavity
Name four histological characteristics of cardiac muscle tissue:
Intercalated discs
Central nuclei
Gap Junctions
How does a cardiac action potential differ from a skeletal one?
Cardiac muscle has a calcium plateau, has leaky sodium ion channels so it is never really at rest, has a longer refractory period, and does not undergo tetanus
What is the significance of the plateau phase?
It causes a much longer refractory period, thus preventing the myocardium from undergoing tetanus.
Why does extracellular calcium have a strong influence on heart function?
The more extracellular calcium, the more calcium that will flood into the cell during depolarization. This will cause an increase in the force of contraction.
What is the endocardium made out of?
Simple squamous epithelium
What does endocarditis lead to valve problems?
The valves are lined with endocardium, so if the endocardium is inflamed the valves will be inflamed and will have trouble opening and closing.
Name the three venous openings into the right atrium:
1. Superior vena cava
2. Inferior vena cava
3. Coronary sinus
Name the four venous openings to the left atrium:
4 pulmonary veins
What is the structure called between the ventricles?
The interventricular spetum
What is the purpose of the heart valves?
To prevent backwards flow of blood.
Name the two AV valves:
Tricuspid (Right)
Biscuspid/Mitral (Left)
What is the significance of chordae tendinae?
They prevent the valves from inverting into the atria.
What causes the AV valves to open and close?
The valves open when the pressure is greater than in the ventricles.
When during the cardiac cycle are the AV valves open?
When the ventricles are relaxed.
When during the cardiac cycle are the AV valves closed?
When the ventricles are contracted.
Name the two semilunar valves:
1. Pulmonary Semilunar Valve (right)
2. Aortic Semilunar Valve (left)
When are the semilunar valves open & closed during the cardiac cycle?
They are open during systole and closed during diastole.
What is the lub-dub you hear during auscultation?
Lub = AV valves closing
Dub = Semilunar valves closing
Where is systole in the lub-dub?
Systole is in the "lub" portion. That is when the AV valves are closing (contracting).
Name the two coronary arteries that bring blood to the heart.
The right and left coronary arteries
Which artery do the left and right coronary arteries branch off of?
The aorta
Name two branches of the left coronary artery:
1. LAD (anterior interventricular artery)
2. Circumflex artery
What does the LAD artery supply?
Left and right ventricle
What does the circumflex artery supply?
Left atrium
What is ischemia?
Lack of oxygen to an organ
What is a murmur?
An irregular/abnormal heart sound
What is an anastomosis?
The connections between blood vessels that provide an alternate route.
What is a myocardial infarction?
It is the death of the myocaridal tissue (heart attach)
What is angina pectoris?
Chest pain due to ischemia.
What is ventricular fibrillation?
When the action potential circulates around the ventricle causing cardiac output to = zero.
What is cor pulmonale?
Right side heart failure due to pulmonary disease.
What is cardiac tamponade?
The accumulation of blood/fluids in the pericardial cavity.
What is AV block?
When the action potential is delayed from the SA node to the bundle of his, this indicates that the AV node isn't functioning properly.
What is atrial fibrillation?
The action potential is circulating the atria, but 70% of the blood still fills the ventricle because of passive filling.
What is tachycardia?
An abnormally fast heartbeat, >100bpm
What is bradycardia?
An abnormally slow heart beat, <50-60bpm
Is there a difference between the stroke volume in the right and left ventricles of a normal heart?
No, approximately 70mL of blood is pumped out of each ventricle.
What type of tissue is the conduction system of the heart made of?
Cardiac musucle and internodal fibers
Why is the SA node the pacemaker?
Because it sets the pace of the heart (72x/min)
Where is the SA node located?
The right atrium
Name some factors that can affect the SA node:
-Sympathetic nervous system increases HR
-Vagus nerve of PSNS decreases HR
-Thyroid hormone increases HR
-Age, exercise, temperature
How does the electrical wave of depolarization flow through the conduction system?
SA node --> AV node --> Bundle of HIS --> Bundle Branches --> Purkinje Fibers
What is the significance of the annulus fibrosis (separates the atria from the ventricles)?
It is a piece of electrically inert tissue, meaning the action potential cannot reach the ventricles except through the AV node.
What is the significance of the AV node?
It delays the impulse a little so that the ventricles contract after the atria.
In the EKG, what is the P wave?
Depolarization of the atria (atrial conraction)
In the EKG, what is the QRS wave?
Depolarization of the ventricles (ventricular contraction)
Repolarization of the atria
In the EKG, what is the T wave?
Repolarization of the ventricles
What is cardiac cycle?
One systole and one diastole
What two important components are there to ventricular diastole?
1. Passive ventricular filling (blood from the atria flows into the ventricles)
2. Atrial systole = the atria contract to push the last 30% of blood into the ventricles (actively flowing)
During what phase does the cardiac cycle begin?
Atrial systole / ventricular diastole
What is meant by isovolumetric contraction?
This occurs during systole. All 4 valves are closed (pressure in the ventricles is not great enough to open the semilunar valves)
What is happening to the myocardium during diastole?
It is relaxing and reoxygenating
Approx. how long does ventricular systole last?
0.3 seconds
What is meant by isovolumetric relaxation?
This occurs during diastole. All 4 valves are closed (pressure in the atria is not great enough to open the AV valves)
How log is he cardiac cycle in a patient whose heart beats at a rate of 96/min?
60/96 = .63seconds
Which part of the cardiac cycle is more compromised during tachycardia?
Define cardiac output:
The amount of blood pumped by one ventricle in one minute.
(SV x HR)
What is cardiac reserve?
The amount you can increase your heart rate above normal
Name three ways to increase stroke volume:
Adrenaline, Calcium, Digitalis
Explain the frank starling law:
The more blood that gets into the ventricle (EDV), the larger the stroke volume will be.
Name three ways to increase heart rate:
Adrenaline, Thyroid hormone, Exercise
Name two ways to decrease heart rate:
Vagus nerve
Cold temperature
What are the units for cardiac output?
Liters per minute (L/min)
What is a normal cardiac output?
5 L/min

CO = SV x HR
CO = 70mL x 72bpm = 5 L/min
What is preload?
Venous return = amount of blood returning to the heart
What happens to cardiac output when preload is suddenly increased?
It will increase.
(Frank Starling Law - the more blood that fills into the ventricles the more blood pumped)
What is afterload?
Arterial blood pressure
What happens to the cardiac output when afterload is suddenly increased?
It will decrease.
(the greater the afterload the harder it is for the heart to pump)
What happens to the ESV when afterload is suddenly increased?
(what happens to the ventricles when you increase your blood pressure?)
It will increase (your ventricles have to increase the force of contraction)
What happens to the EDV when preload is suddennly increased?
It will increase
(Frank Starling Law - the more blood that fills into the ventricles the more blood pumped)
How do you increase preload?
By increasing the force of contraction:
What would be the effect of adrenaline on ESV?
ESV = the amount of blood left after systole

Adrenaline would cause ESV to decrease because it increases the force of contraction, thus pumping more blood.
What is the foramen ovale/ovalis? What does it become?
It is a hole between the right and left atria i fetal life. After birth it becomes the fossa ovalis.

(blood that comes into the right atrium can flow into the left atrium bypassing the lungs as they do not function in the womb)
What is the ductus arteriosus? What does it become?
It is a vessel connecting the pulmonary artery and the aorta in fetal life because the lungs do not function. It becomes the ligamentum arteriosum after birth.
Name some risk factors for heart disease:
High cholesterol
Family history
What is LDL and HDL?
LDL = low density lipoprotein, bad fat that is deposited into the adipose tissue in the periphery of the body.

HDL = High density lipoprotein, good fat that carries cholesterol away from the arteries.
What is CHF?
Congestive heart failure (right & left) = cardiac output is low and there is a danger that not enough blood is being pumped to the pulmonary or systemic circuits.
Name the signs of right heart failure:
Peripheral edema
Name the signs of left heart failure:
Pulmonary edema
What is a vein?
A vessel that carries blood to the heart
What is an artery?
A vessel that carries blood away from the heart.
Name two arteries that carry deoxygenated blood:
Pulmonary artery
Umbilical artery
Name two veins that carry oxygenated blood:
Pulmonary veins
Umbilical vein
Which three factors aid venbous return to the heart?
1. Breathing
2. Muscle Milking
3. Valves
What causes varicose veins?
Leaky/faulty valves (blood flows backwards causing the veins to distend)
What is the function of veins during blood loos?
Blood reservoir - allows blood to flow back to the heart
Name the three layers of arteries.
-Tunica Interna = Endothelium and elastic tissue
-Tunica Media = Thick smooth muscle and elastic fibers
-Tunica Externa = Collagen fibers and elastic fibers
Name the three layers of veins.
-Tunica Interna = Endothelium
-Tunica Media = Thin layer of smooth muscle
-Tunica Externa = Thick layer of CT (anchors and allows for protection)
What is a capillary made of?
Endothelium (Simple squamous epithelium and basement membrane)
Are all capillaries filled with blood all of the time:
No, they are only open if the tissue it supplies has a high oxygen demand.
Name the two factors that cause the precapillary shincter to open:
Low oxygen
Low pH (acidic)
High carbon dioxide
What is the difference between a
Continuous Capillary
Fenestrated Capillary
Continuous Capillary - tight junctions (BBB)
Fenestrated Capillary - pores, filter (Kidneys)
Sinusoid - leaky, large proteins can pass (Liver)
Name four places in the body without capilaries:
Lens, cornea, cartilage, epithelium
What is function of the capillary?
Nutrient exchange
How does capillary exchange take place?
Hydrostatic and osmotoic pressure
(The amount of fluid that leaves the capillaries is equal to the amount of fluid entering the capillaries)
How do these pressures work? Are they pulled in or out?
Hydrostatic pressure OUT = (30mmHg arteriole end, 15mmHg venous end)

Osmotic pressure IN = 22mmHg
What is edema?
Swelling, accumulation of interstitial fluid
Name four causes of edema:
1. Blockage of lymphatic vessels
2. Increased venous pressure
3. Loss of albumin
4. Septicemia
What is an arteriole made of and why are they so important?
Endothelium and smooth muscle - they are key in regulating blood pressure
What is blood pressure?
The force of blood on the wall of an artery
Explain how pressure changes in blood vessels:
-Aorta (100mmHg) -->
-Arteries (95-90mmHg) -->
-Arteriole (30mmHg) -->
-Capillary (30-15mmHg) -->
-Venules (15-10mmHg) -->
-Veins (10-0mmHg)
Name 6 things that affect blood pressure:
1. Resistance (the greater the resistance the higher the BP)

2. Blood volume (the greater the blood volume the higher the blood pressure)

3. Sympathetic nervous system (regulated by the hypothalamus - controls arteriole diameter along with the medulla oblongata)

4. Chemoreceptors (chemical receptors - when oxygen is low or CO2 is high, the brain increases blood pressure)

5. Baroreceptors (pressure receptors, when pressure increases the brain increases the heart rate)

6. Cardiac output (the greater the cardiac output the higher the blood pressure)
What is total peripheral ressitance?
The sum of forces that opposes blood flow in a vessel.
Name three things that increase resistance to blood flow:
A. Viscosity
B. Length of blood vessel
C. Radius (arteriole diameter)
Where is the blood pressure the highest? Where is it the lowest?
Arteries = highest pressure
Veins = lowest pressure
What is shock?
Failure of the cardiovascular system to meet the oxygen needs of the tissues.
Name 6 causes of shock:
1. Obstructive shock
2. Septic shock
3. Hypovolemic shock (low blood volume)
4. Cardiogenic shock
5. Neurogenic shock
6. Anaphylactic shock
What is meant by compensated shock? What system is activated?
It's when the pulse, breathing, and sweating increases, and vasoconstriction occurs. The sympathetic nervous system is activated.
What is meant by irreversible shock?
When the cell and tissue damage is irreversible
Where does the pulmonary circulation begin and end?
Right Ventricle, Left Atrium

Right ventricle --> pulmonary artery --> arterioles --> capillaries --> pulmonary veins --> left atrium
Where does the systemic circulation begin and end?
Left Ventricle, Right Atrium

Left ventricle --> Arteries --> arterioles --> capillaries --> venules --> veins --> right atrium
Explain the hepatic portal system. Name all of the structures:
A portal system is a system in which a vein sits between two capillaries.

Superior mesenteric artery --> artery --> arterioles --> capillaries in the villus --> superior mesenteric vein --> intestinal vein --> hepatic portal vein --> liver --> sinusoids --> central vein --> hepatic vein --> inferior vena cava
Explain the circle of willis:
It is a anastomosis at the base of the skull between the carotid and vertebral arteries. The brain is supplied by these four arteries alone).
Name three pulse points on the arm:
Name two pulse points on the face:
Name three pulse points on the leg:
Posterior Tibial
Name a pulse point on the foot:
Dorsalis pedis
Name a pulse point on the neck:
What characteristics do lymph vessels and veins have in common?
-Thin walls with SIMPLE SQUAMOUS lining
-Thin tunica media (smooth muscle & elastic fibers)
Is lymph pumped by the heart? What is lymph?
No (does not contain blood), lymph is a fluid that is similar to plasma (contains interstitial fluid, fat, & lymphocytes).
How does lymph move?
From higher to lower pressure:
lymph nodes --> lymphatic ducts --> subclavian vein --> circulation
What is the purpose of lymph nodes?
They absorb fats, drain interstitial fluid, and provide immunity
What is the cisterna chyli?
It is a large sac that collects lymph from the lower body and intestines.
How is lymph drained from the right leg?
Lymph from the legs and abdomen flows into the cisterna chyli --> thoracic duct --> drains the left side of the body and face --> to the junction between the left jugular and subclavian vein
How is lymph drained from the right arm?
Lymph from the right side of face and right arm --> right lymphatic duct --> junction between right jugular and subclavian vein
Where does lymph ultimately end up?
General circulation
Name the three main functions of the lymphatic system:
1. Absorb fats
2. Drain interstitial fluid
3. Immunity
What are the 3 functions of the spleen? Is it intraperitoneal or retroperitoneal?
1. Eliminates old RBCs
2. Makes B-cells
3. Stores & releases blood
What is the function of the thymus?
1. Place where T-Cells mature
2. Self recognition
What is the function of the tonsils?
Prevent the spread of bacteria in the mouth and throat
What is nonspecific resistance (innate)?
Resistance against many types of microorganisms.
What is specific resistance (acquired)?
Resistance against a specific microorganism. There is a different response for each antigen.
List 4 phagocytic cells:
Explain the process of phagocytosis
Adherence of bacterium --> formation of phagosome (endocytosis of foreign antigen) --> formation of phagolysosome --> digestion of bacteria
Which phagocytes are found in the bloodstream?
What are tissue phagocytes called?
What is complement and what is its function?
A series of plasma proteins that "sticks" to foreign invaders to help with phagocytosis (can punch holes in foreign membranes)
What is an NK cell, and how is it different from a B or T lymphocyte?
NK cells are nonspecific cells that destroy abnormal body cells using perforins.

B & T lymphocytes are specific.
-B cells = make antibodies
- T cells = key in cellular immunity
Give 4 examples of chemical barriers to disease:
1. Oil from sebaceous glands
2. Lysozyme in tears
3. HCl in gastric juice
4. pH of the vagina
Which cells make interferon and why?
Infected cells make interferon inhibit the reproduction of viruses in neighboring cells
Is a plasma cell the same as a B cell?
Yes, when B cells are activated they divide, become plasma cells, and rapidly make antibodies.
What is an antigen?
A chemical (often a protein [glycoprotein]) that causes an immune response.
Explain the location and significance of MHC-I:
It is a self recognition cell that has surface proteins found on all body cells.
Explain the location and significance of MHC-II:
It is a self recognition cell that has surface proteins found on immue cells (APCs & B cells).
Which cells have MHC-I, and why?
Infected body cells. They present the antigen with MHC-I to stimulate a specific immune response.
Which cells have MHC-II, and why?
APCs and macrophages have MHC-II to present the antigen with its MHC-II.
Which cell responds to the MHC-I + antigen?
Tcytotoxic cells
Which cell responds to the MHC-II + antigen?
T helper cells (CD4)
What does a macrophage do in an antibody response?
Phagocytize foreign invaders and present the antigen to the immune cells
What does the B cell do?
B cells divide, become plasma cells, and make antibodies (have MHC-II and can preset the antigen to the T helper cells)
What does a T helper cell do in a humoral response?
Recognizes MHC-II, divides, and releases cytokines to enhance humoral response (activates B cells)
What is a B memory cell?
A B cell that "remembers" the foreign invader so that the next response will be much quicker.
What does a macrophage do in a cell-mediated response?
Presents the antigen to a T helper cell
What does a T helper cell do in a cell-mediated response?
Divides and releases cytokines to activate tcytotoxic cells)
What does a tcytotoxic cell do?
Destroys infected cells (punches holes into foreign membranes)
-Also forms T-memory cells
How many different antigens does a Tcytotoxic cell respond to?
One specific antigen
What are the two types of specific immunity?
Humoral immunity
Cellular immunity
What is humoral immunity?
This is when antibodies attack antigens that are free in the plasma (exogenous antigens).
What is cellular immunity?
This is when cells attack antigens that are inside of other cells (endogenous antigens).
Differentiate between primary and secondary response:
The primary response is the first response. It takes longer as it is the first exposure to the antigen.

The secondary response is quicker because the IgG titer is greater and lasts longer.
Name the 5 classes of antibodies:
1. IgG
2. IgM
3. IgA
4. IgE
5. IgD
What is the function of IgG?
It is the most prevalent antibody, can cross the placenta, the titer can determine whether someone has had an infection or not.
What is the function of IgM?
It is produced during a fresh infection and has 10 binding sites
What is the function of IgA?
It is a secretory antibody found in body secretions
(saliva, respiratory mucus, vaginal secretions)
What is the function of IgE?
It is an antibody found on mast cells and basophils.When bound to a specific agent they cause those cells to degranulate.
What is the function of IgD?
It is an antibody found on memory B cells waiting for the foreign agent to return.
How many antigens can bind to IgG?
How many antigens can bind to IgM?
What good does antibody binding of an antigen do anyway?
So T-cells can perform a specific immune response to the antigen and so memory cells can be made.
What is monoclonal expansion?
Making a lot of the same cell.
What is natural passive immunity?
I got antibodies from someone else by natural means (breastfeeding)
What is natural active immunity?
I got sick and made the antibodies
What is artificial active immunity?
I made my own antibodies but the stimulation was artificial (vaccination)
What is artificial passive immunity?
I received a shot of antibodies
(antivenom - getting bitten by a rabid animal)
Explain the pathogenesis of an allergy:
IgE atibodies form against harmless substances
Explain the pathogenesis of an autoimmune disease:
The body makes antibodies against its own healthy tissues.
Explain the pathogenesis of anaphylactic shock:
Extreme and severe allergies develop due to the failure of the circulatory and respiratory systems.
Which cell is affected in aids?
T helper cells (CD4 - they increase the immune response by replicating and releasing cytokines)
Why would the P wave be inverted?
The SA node is not working and the AV node has taken over
What is important about the ST segment
It can detect ischemia or hypoxia (if elevated or depressed)
Is atrial contraction and atrial depolarization the same thing?
Contraction occurs after depolarization (action potential)
What is the equation for EDV?
Equation for cardiac cycle:
General length of systole
0.3 seconds
Equation for cardiac output:
Cardiac Output = SV x HR

The amount of blood pumped by one ventricle in one minute.
Inotropic refers to ______.
Stroke volume
Chronotropic refers to _____.
Heart Rate
Ejection Fraction equation & definition:
The percentage of blood pumped by one ventricle.

SV/EDV x 100
Equation for mean arterial pressure:
Diastolic + (pulse pressure/3) = MAP
Equation for pulse pressure:
pulse pressure = systole - diastole
The lumen of the blood vessels reduce to ____ and this causes ___________. (Coronary blood flow)
Angina Pectoris
Normal values for:
EDV = 120mL
ESV = 50mL
SV = 70mL
Where does the heart get its oxygen?
The right and left coronary arteries