BHERU LAL

ANATOMY AND PHYSIOLOGY

Table of Contents

Syllabus 3

Lecture Schedule 8

Correcting tests 9

Disease presentation project 10

People parts and cat anatomy 16

Unit 1 19

Study guide 21

Organ system overview: cat dissection 23

Lecture notes 25

Unit 2 43

Study guide 45

Heart lab 47

Lecture notes 51

Unit 3 71

Study guide 73

Blood review 75

Lecture notes 79

Unit 4 109

Study guide 111

Urinary lab 113

Digestion lab 115

Lecture notes 117

Digestive system flash cards 149

Unit 5 151

Study guide 153

Respiratory lab 155

Reproductive systems lab 159

Lecture notes 161

The End 179

Five steps to better critical thinking

Use when evaluating primary or secondary literature.

1. Identify the study question and hypotheses.

• Are the hypotheses adequate potential answers to the question(s), or did the authors omit better potential answers?

2. Gather information.

• Learn more about the study questions. If you don’t understand a word, concept or phrase, look it up!

• How did the authors approach the problem (look at the experimental design)?

• Is their approach logical?

• Is there a better approach you can suggest?

3. Evaluate the evidence.

• Where did the information (or study sample) come from?

• Does it represent a random sample?

• What biases could be expected in the experimental design?

• How accurate are the data collecting methods?

• Are the researchers receiving funding from a company/agency that would like them to come to a particular conclusion?

4. Consider alternatives and implications.

• Return to the two hypotheses and examine them in light of the results. Identify the advantages and disadvantages of both. What do you conclude is the best hypothesis?

• Does the authors’ conclusion(s), based on the results, make sense?

• Are there other conclusions the authors didn’t consider?

5. Choose and implement the best hypothesis.

• Now that we have an answer (or maybe we don’t if the data were inconclusive) where do we go from here? This is called implication for future research and is part of any comprehensive research paper.

• How will the results of this study affect biology/medicine in general?

A few fundamental errors of experimental design

Certain fundamental fallacies you need to avoid in your work and to watch out for in others’ work.

1. Circular reasoning—assuming the truth of the thing you are trying to support (remember: you can never “prove” something) in the process of trying to support it.

2. Confusing theorems with their converse—e.g. just because a victim of leukemia becomes anemic doesn’t mean that anyone who’s anemic has leukemia.

3. Concluding a causal relationship between two events that actually are both a result of a third factor—frequently happens in medicine and often leads to treating the symptoms rather than the disease. May also occur in biology where researchers study complex systems.

4. Arriving at incorrect conclusions due to failure to fully consider the possibility of chance occurrences—usually result from lack of proper controls or insufficient replications.

5. Bias—outcome of experiment affected by the criteria used to select the study group (sample MUST be random and should have at least 20 individuals), or by the preconceived ideas of the experimenter or the subject.

6. Failure to consider variables other that those under study.

People Parts

Below are all the human parts (please see also the cat anatomy list) you are responsible for knowing for the lab exam. Use your textbook and lab manual pictures to help you study. Page and figure (F) numbers correspond to your textbook.

Endocrine

Know on pictures, torso and muscle models

Pituitary gland thymus

Pineal gland pancreas

Thyroid adrenal glands

Parathyroids ovary

Testis hypothalamus

Heart—Know on beef hearts, heart and torso models

Epicardium tricuspid valve

Myocardium bicuspid (mitral) valve

Endocardium chordae tendineae

Atria (R/L) papillary muscles

Marginal branch pulmonary veins

Great cardiac vein ascending aorta

Middle cardiac vein R/L coronary artery

Small cardiac vein circumflex branch

Coronary sinus posterior interventricular

branch

Pulmonary trunk pulmonary arteries (R/L)

Ventricles (R/L) pulmonary semilunar valve

Interarterial septum aortic semilunar valve

Trabeculae carneae interventricular septum

Superior vena cava Inferior vena cava

anterior interventricular branch (left anterior

descending artery)

Blood vessels-- Know the circulatory and torso models, and textbook figures/tables.

Blood—See your textbook! Know on microscope slide:

Erythrocytes

Leukocytes:

Basophils Eosinophils

Neutrophils Lymphocytes

Monocytes

Platelets

Urinary—Know on urinary and torso models

Kidneys Urinary bladder

Ureters urethra

Kidneys—Know on kidney model

Renal capsule renal sinus

Renal cortex minor calyx

Renal medulla major calyx

Renal columns renal pelvis

Renal pyramids renal papilla

Respiratory—Know on torso and muscle models

Internal nares nasopharynx

External nares oropharynx

Lingual tonsils laryngopharynx

Pharyngeal tonsil trachea

Palantine tonsil lungs—superior, (middle),

inferior lobes

Epiglottis larynx

Bronchioles bronchi—primary, secondary,

tertiary

Teeth

Know types: incisor, cuspid (canine), bicuspid (premolar), molar, in addition to figure listed above.

Reproductive—Know on torso model

Male—

Ejaculatory duct seminal vesicle

Prostatic urethra ampulla

Ductus deferens prostate gland

Corpus cavernosum Prepuce

Corpus sponginosum testis

bulbourethral gland Penile urethra epididymis Glans penis membranous urethra

Female—

Mons pubis cervix

Prepuce suspensory ligament

Clitoris ovary

Vestibule uterine (fallopian) tube

Labia majora fimbriae

Labia minora round ligament

Urethral orifice uterus

Vaginal orifice vagina

Broad ligament

Cat Anatomy

Ventral body cavity organs

Greater omentum heart

Lungs thymus

Diaphragm stomach

Spleen small intestine

Large intestine

Endocrine glands

Thyroid thymus

Pancreas adrenal glands

Ovaries testes

Digestive system

Gall bladder Pancreas

Esophagus

Liver

Stomach + rugae

Small intestine + villi

Duodenum Jejunum

Ileum

Large intestine

Cecum Ascending colon

Transverse colon Descending colon

Rectum Mesentery

Respiratory

Trachea Diaphragm

Lungs

Urinary

Urinary bladder kidneys

Urethra ureters

Reproductive (IF, and only if, we have time for this lab, you will be responsible for this material)

Male—see LAB MANUAL figure 46.11, 46.12

Spermatic cord (vas deferens) testis

Scrotum prostrate gland

Urethra penis

Bulbourethral gland epididymis

Female—see LAB MANUAL figure 47.12

Fimbriae uterine tube

Ovary uterine horn

Body of uterus vagina

Unit One

Study Guide

1. Explain the relationship between thyroid hormone production and the body’s response to cold weather.

2. How do lipophilic and lipophobic hormones differ with regard to their method of entry into the cell? Give two examples of lipophilic and two examples of lipophobic hormones.

3. Describe the fundamental differences between the neurohypohysis and the adenohypohysis. Which one is not considered a true gland? Why?

4. What determines if a cell is a target for a hormone?

5. What is the difference between the parenchyma and the stroma of a gland?

6. Identify the organs of the endocrine system and their location. Can you describe their position using anatomically correct terms in a fill-in-the-blank question? E.g.: The adrenals are ____________ to the kidneys in humans. Also, if you were given a drawing of a human, could you label the organs?

7. What is the hypothalamo-hypophysis portal system and the hypothalamo-hypophyseal tract?

8. What two general types of hormones (you don’t need to identify specific hormones) are secreted by the hypothalamus? Five of these hormones are ____ hormones and two of them are _____ hormones.

9. What are the four general classes of hormones? Be sure you can identify examples of each type.

10. What are the general functions of ADH and Oxytocin? What endocrine gland produces them?

11. What are the general functions of FSH, LH, TSH, TH, ACTH, PRL and GH?

12. What is the difference between hypertrophy and hyperplasia?

13. Secretion of most hormones is controlled by ______ feedback loops. Which hormone operates via the other type of feedback loop during childbirth?

14. Distinguish between synergistic, antagonistic and permissive effects.

15. Distinguish between these pituitary disorders: pituitary dwarfism, gigantism, acromegaly, diabetes insipidus.

16. What gland produces serotonin and where is it located? What is serotonin converted into?

17. What is myxedema and what causes it?

18. Briefly describe the differences between endemic and toxic goiter, including cause and some symptoms.

19. What is the relationship between calcitonin and parathyroid hormone?

20. The adrenal medulla secretes _________ which are important in the fight-or-flight response.

21. The adrenal cortex secretes corticoids, mineral corticoids and glucocorticoids. What are the general functions of each of these groups of hormones? Explain the following terms in relationship to these hormones: glycogenolysis, gluconeogenesis, glycogenesis, lipid catabolism, protein catabolism.

22. In the pancreas what do alpha, beta and delta cells secrete respectively?

23. Briefly and generally identify the differences between Cushing’s and Addison disease. What causes each?

24. Identify the three types of diabetes. Describe the major differences between each. Which is the most common type? How are type I and type II treated? What specifically causes type I and II?

25. Why is exercise so beneficial for diabetics? Be sure you discuss GLUT-4s, resistin and bovine insulin!

26. From the moment insulin enters the bloodstream, it works much more quickly than estrogen. Considering how each hormone acts on its target cells, explain this difference.

27. Explain specifically why cortisol suppresses the immune system.

28. What are primary, secondary and tertiary literature and what are the defining features of each?

29. What is a peer-reviewed journal?

30. What is a double-blind study?

31. Distinguish between a prospective and a retrospective trial.

32. Identify the stages of clinical trials and what happens in each stage.

And, if you have a little extra time, try quizzing yourself with:

• Testing your recall, Ch. 17, all.

• Testing your comprehension, Ch. 17, questions 2 and 3. Note: Answers to these questions are in the comprehension tests for each chapter at the class website.

Good luck and don’t panic!

The Universe is a friendly place! 

Organ System Overview: Cat Dissection

The questions in italics are ones which you have to complete in class.

The other questions you can answer outside of class if you run out of time.

 Prepare to dissect a cat by first donning gloves and obtaining a dissection tray and tools. Follow the instructions given in class, along with the guidelines in your lab text. After opening your specimen, see if you can identify the following organs:

 Heart

 Lungs

 Kidneys

 greater omentum (large sheet of fat covering digestive organs)

 stomach

 small intestines

 large intestines

 liver, bladder

 trachea

2. Now locate on your specimen the endocrine organs listed in the table below. Spaces have been left for you to fill in LATER (i.e. when you’re not wearing gloves) regarding the general function of each organ. Note: some organs you will not be able to locate during your dissection for any of the following reasons: poor dissection technique destroys a gland, inconspicuous nature of the gland, involution (atrophy) of the gland, gland located in an area not dissected such as the cranium.

Organ Location Function(s)

Hypothalamus Immediately superior to the pituitary gland; forms the walls and base of the third ventricle. Connected to the pituitary via the infundibulum.

Anterior pituitary gland Immediately superior to the sella turcica, anterior to the posterior pituitary gland.

Posterior pituitary gland Immediately superior to the sella turcica, posterior to the anterior pituitary gland.

Thyroid gland Inferior to the larynx (voice box), superficial and lateral to the trachea. Consists of two lobes linked together by a thin mass of tissue called the isthmus. Can be difficult to locate depending on how careful a dissection job you did.

Parathyroid glands Set into the posterior side of the thyroid. Two or more small, round glands per side. Very difficult to locate; you probably won’t find them.

Adrenal glands Superior and medial to the kidneys in cats (superior only in humans), these are bean-shaped and hard. Try rubbing your finger along the area where you would expect the adrenal to be. You may be able to feel it before you see it.

Pancreas Deep and somewhat superior to the stomach. Looks a bit like fatty tissue but it’s not.

Thymus Deep to the sternum, but superficial and superior to the heart. Atrophies over time; depending on the age of your specimen, you may not see the thyroid.

Pineal gland This small, pine-shaped (thus the name pineal) gland sits in the roof of the third ventricle of the brain.

Ovaries/Testes Ovaries: bilateral glands shaped like almonds located in the pelvic cavity. Refer to lab illustrations for help in locating. Testes: also bilateral glands. Located in the scrotum. May not be present if your specimen was neutered.

3. Identify three things you notice about the cats internal organs which is similar to what you see in humans.

4. Identify three things you notice about cats which is NOT like what you see in humans.

The Endocrine System

What are hormones?

• Hormon = “to excite”

– “troph” = to nourish, grow, change

• Chemical messengers

• Target most cells in the body

• Note: endocrine system is not continuous

• Endocrine glands produce

– Vs. exocrine glands

– Parenchyma (function) vs. stroma (form)

What do they do?

• Alter activity (metabolism) of target cell

• Alter PM permeability or voltage

• Stimulates production of proteins/enzymes

• Activates/deactivates enzymes

• Stimulates mitosis

• Induces secretory activity

How does the endocrine sys. compare to the nervous sys.?

• Slow messages

• Prolonged, continued response

• Via blood

• Can continue to adapt/respond to conditions for day or even weeks

• Often general, widespread effects on many organs

What are the types of hormones?

• Eicosanoids (paracrines)

• Monoamines

• Steroids

• Peptides

What are the types of hormones?

• Eicosanoids (paracrines)

– More localized, lipids

– Not true hormones

– Leukotrines (inflammation)

– Prostaglandins

• Inc. bp, dec. uterine contractions, enhance clotting, etc.

• Biogenic amines

– AKA monoamines

– From tyrosine (except melanin from tryptophan)

– Includes some neurotransmitters

• NE, epinephrine, dopamine (catecholamines)

• NE from SNS, E from adrenal medulla

– Also thyroid hormones (TH)

What are the types of hormones?

• Steroids

– From cholesterol: lipid sol.

– Sex steroids

– Corticosteroids (cortisol, aldosterone, etc.)

• Passes through PM

– travel to cell via transport protein

• proteins extend half-life

– Bind to DNA receptor in nucleus

• Activates transcription

• 3 binding sites on DNA receptor molecule

– Hormone

– Chromatin acceptor site

– DNA activation site

• Peptides

– 3 to 200 aa’s

• ADH, oxytocin

– All releasing/inhibiting from hypothalamus

• Most from anterior pituitary

– Bind to PM receptor

• Can’t pass through PM

• Act through secondary messengers

How do secondary messengers work again?

• cAMP

– Hormone binds to G protein

– Activates adenylate cyclase

• causes cAMP production

– cAMP activates/deactivates kinases

• By contrast: T3, T4 (direct cell entry, no secondary messenger)

– binds to:

• mitochondria

– Stimulates oxidative metabolism

• Ribosomes

– Stimulates translation

• Nucleus

– Stimulates transcription

– Na+-K+ pump controlled this way

What are the mechanisms of hormonal action?

• Only cells w/ appropriate receptors respond to hormone

– These are target cells

– Receptors on PM, nucleus, mitochondria, other organelles

• Receptors

– Specificity

– Saturation

– Amplification

– Up-regulation

• More receptors

• Greater sensitivity

• Oxytocin receptors in late pregnancy

– Down-regulation

• Fewer receptors

• Response to high concentrations

• Adipocytes & insulin

How do hormones interact with each other?

• Synergistic effects

– Greater than sum

– FSH + testosterone = adequate sperm production

• Permissive effects

– Hormone enhances target’s response to second hormone

• Estrogen stimulates up regulation of progesterone receptors

• Antagonistic effects

– Opposing actions

– Insulin vs. glucagon

– Estrogen vs. prolactin

What is the hypothalamus-hypophysis axis?

• Hypothalamus secretes: releasing/inhibiting hormones

• Hypophysis = __________________

• No nerve connection to adenohypophysis (anterior __________)

• Releasing and inhibiting hormones sent via blood

• hypothalamo-hypophyseal portal system

• Neurohypophysis—not a true gland (posterior _________)

• Mass of axons from hypothalamus

• Hypothalamo-hypophyseal tract

• Hormones stored in neurohypophysis

• Oxytocin

• ADH

• Nerve signal stimulates release

Anterior pituitary hormones

Hormone Target cell(s) Action

Follicle-stimulating hormone (FSH) Ovaries, testes

(A gonadotropin) Stim egg dev.

Stim. Sperm prod.

Luteinizing hormone (LH) Ovaries, testes

(a gonadotropin)

Peak at mid-menstrual cycle Stim. Egg release & corpus luteum to release progesterone

Stim. Interstitial testicular cells to release testosterone

Hormone Target cell(s) Action

Thyroid-stimulating hormone (TSH) Thyroid gland

Stim. thyroid growth and hormone secretion (metabolism)

Adrenocorticotropic hormone (ACTH) Adrenal cortex

Pancreas (insulin release) Reg. Stress response

Stim. Ad. cortex to secrete glucocorticoids (glucose, fat and protein metabolism)

Prolactin (PRL) Mammary glands

Testes Stim. milk synthesis after birth

Sensitizes testes to testosterone (permissive)

Growth Hormone (GH) or Somatotropin

Many

Esp. liver

Secreted mainly at night

Stim. Hyperplasia (growth by mitosis) and hypertrophy (growth by cells getting larger) of tissues

Increases fatty acid metabolism and decreases muscle uptake of glucose

Liver: stim. Somatomedins production (insulin-like growth factors, IGF); this stim. fat, cartilage, bone, tissue

Bone growth at epiphyseal plates

What does the posterior pituitary secrete?

• ADH--antidiuretic hormone

– AKA vasopressin

• Causes vasoconstriction at very high levels

– Inc. water retention (lower urine vol.)

– Prevent dehydration

• Oxytocin

– Stims uterine contractions

– Stims milk secretion after birth

• Nerve system stimulation controls both

– Nursing stimulus

– Osmoreceptors in blood vessels detect inc. osmolarity and stim. ADH

– Stretching of baroreceptors inhibits ADH

How do negative feedback loops control secretion?

• Important: Almost all hormonal regulation operates on negative feedback loops!

• Products from target organs often inhibit further secretion of hormone

• Example:

– Dehydration lowers blood volume and pressure

– Osmoreceptors detect

– Stimulates hypothalamus to secrete ADH via posterior pituitary

– Blood volume/pressure increases

– Osmoreceptors detect

– Inhibit further ADH release

• Another example: thyroid hormone (see p. 645 (new) (646, old) if you’re interested)

What are some pituitary disorders?

• In juveniles

– Hyposecretion (hypopituitarism)

• Pituitary dwarfism

– Hypersecretion: gigantism

• In adults

– Hypersecretion: acromegaly

• Posterior lobe hyposecretion: diabetes insipidus (which is: _______________________)

– WHY?

What is the pineal gland?

• Roof of third ventricle

• Produces serotonin

– Converted to melatonin

– Possible sexual maturation control

• Prevent early maturation?

What is the thymus?

• Location: mediastinum

• Involution after puberty (shrinks like pineal)

• Secretes thymopoietin

– Regulates development of T-lymphocytes

What is the thyroid?

• Largest endocrine gland

– Wraps around trachea

• Contains

– Sacs: thyroid follicles

• Lined with follicular cells which secrete T3 and T4

• Increases BMR, HR and heart contraction

– C cells

• Produce calcitonin

– Stores calcium by stimulating osteoblasts, inhibiting osteoclasts

• Antagonistic to parathyroid hormone (PTH)

• Regulation via the hypothalamo-hypophyseal-thyroid axis

What are some thyroid diseases?

• Hyposecretion

– Congenital hypothyroidism

• facial thickening, low body temp, lethargy, brain damage

– Adults: myxedema

• Low BMR, sluggish, sleepy, weight gain, cold, tissue swelling

What is goiter?

• Another thyroid disorder; two types

• Endemic goiter: dietary deficiency of iodine

– No TH produced so pituitary receives no neg. feedback and more more TSH produced

– Results in hypertrophy

• Toxic goiter (Grave’s disease)

– Autoimmune disease

– Abnormal antibodies mimic TSH, raising TH levels

• Called thyroid-stimulating immunoglobin

– Causes high BMR & HR, sleeplessness, weight loss, exophthalmos (eyes bulge)

What are the parathyroids?

• PTH: stim’s osteoclasts, inhibits osteoblasts

– Calcium released

• Hypoparathyroidism

– If parathyroid removed:

• Decreased calcium levels

• tetany and death without HRT

• Hyperparathyroidism:

– Bone softening, fragility, deformity

– Renal calculi formation

What are the adrenal glands?

• Adrenal medulla

– Sympathetic neurons innervate

– Secrete catecholamines

• Adrenal cortex

– Makes more than 25 corticoids (AKA corticosteroids)

– Small amounts of sex steroids (androgen/estrogen)

• Including DHEA (an androgen) which is converted to testosterone

– Mineralcorticoids

• Mostly aldosterone (retain Na+, secrete K+)

– Glucocorticoids

• Secreted in response to ACTH

• Cortisol (hydrocortisone) is most important

– Stimulate gluconeogenesis (fat and protein catabolism) and glycolysis

– Stress response

– Suppresses immune system

What are some adrenal disorders?

• Regulated by hypothalamo-hypophyseal-adrenocortico axis

. Cushing syndrome

– Via adrenal tumor or ACTH excess

• Hyperglycemia, hypertension, muscular weakness, edema, “moon face”, “buffalo hump”

• Addison disease

– Hyposecretion of glucocorticoids and mineralcorticoids

• Hypoglycemia, Na/K imbalance, loss of stress resistance, hypotension,

• Via excess ACTH secretion (b/c no neg. feedback)

• Bronzing b.c ACTH stimulates melanin production

• Fatal if not treated with corticoids

What does the pancreas secrete?

• Mostly exocrine digestive tissue

• Some endocrine tissue in pancreatic islets

– Islets of Langerhans

These secrete:

– Insulin via beta cells

• A peptide hormone

• Stimulates glycogenesis and inhibits glycogenolysis and gluconeogenesis

• Recruits glucose transporter proteins (GLUTs)

– Glucagon via alpha cells

• Stimulates gylcogenolysis (glycogen hydrolysis)

– Somatostatin (GHIH) via delta cells

• Paracrine secretion

• Modulates beta and alpha cell secretions

What are some pancreatic disorders?

• Hyperinsulinism

– Sometimes pancreatic tumor causes

– Sometimes accidental over-injection

– Causes hypoglycemia, weakness, hunger,

• Hypoglycemia stimulates E, glucagon, GH secretion

– Anxiety, hi HR, sweating

– Insulin shock—brain deprived of glucose

» Disorientation, convulsions, unconsciousness

What are some pancreatic disorders?

• Diabetes mellitus (DM)

– Diabetes = “to syphon or run through)

– Mellitus = “sweet”; insipidus = “tasteless”

• Hyposecretion or inaction of insulin

• Three signs:

• Polyuria (excessive urine output)

• Polydipsia (intense thirst)

• Polyphagia (intense hunger)

– Tests reveal hyperglycemia, glycosuria, ketonuria

What types of DM can patients have?

• Type I—insulin-dependent (IDDM)

– 10% of cases

– Autoimmune destruction of beta cells

– AKA juvenile diabetes (age 12)

• Type II—non-insulin dependent (NIDDM)

– Insulin resistance

• Adipocytes secrete resistin?

• Shortage of insulin receptors?

• Heredity, age, obesity

• AKA adult onset (age 40)

What do the gonads secrete?

• Exocrine products: egg and sperm

• Endocrine products: gonadal hormones

• We’ll cover this more at the end of the semester

What is stress and how do we adapt to it?

• Any stimulus that upset homeostasis

– Body copes via stress response (AKA general adaptation syndrome, GAS)

• Alarm reaction

– NE from sympathetic, E from adrenals = Fight or flight

• Stage of resistance

– If stress continues, glycogen reserves drop

– Cortisol dominates to provide fuels for metabolism

• Long-term cortisol exposure suppresses immune system

• Stage of exhaustion

– Fat reserves exhausted, rely on protein

• Body wasting and weakening

– Rapid decline and death: heart/kidney failure, infection

Unit Two

Exam Study Guide

1. Why does the right atrium contract before the right ventricle? Why do the atria contract together? Do the ventricles contract as a unit?

2. Trace the pathway of blood, beginning at the right atrium until it returns to the right atrium again. Don’t worry about anything aside from the major blood vessels connected to the heart but do include all valves, chambers, etc. What portion of the pathway is defined as the pulmonary circuit? The systemic circuit?

3. What is the role of the foramen ovale (in adults, called the fossa ovalis)?

4. Describe the role of coronary circulation. What four major arteries and two major veins help form this circuit? Explain why anastomoses are important to coronary circulation.

5. Identify and explain these diseases/procedures: MI, mitral valve prolapse, valvular stenosis, rheumatic fever, coronary vascular disease (CHD) AKA atherosclerosis; thrombus, embolus, arrhythmia, fibrillation, laser and balloon angioplasty, coronary bypass surgery, artificial pacemaker, ischemia, angina pectoris, hypertension.

6. Why are the pulmonary arteries called arteries if they carry de-oxygenated blood?

7. What are the risk factors for CHD?

8. Beginning with the SA node, explain how myocytes function to make the heart autorhythmic.

9. Identify the major components of an ECG (P wave, QRS complex, T wave). What does each represent? Why is there no repolarization wave for the atria? Can you identify irregular ECGs such as those on your lecture outline?

10. Which is more serious, atrial or ventricular fibrillation? Why?

11. What is the formula for calculating stroke volume? What three factors regulate stroke volume? What factors can affect contractility?

12. Compare/contrast: systole, diastole; tachycardia, bradycardia; inotropic, chronotropic.

13. Distinguish between the cardioaccelatory and cardioinhibitory centers. Where are they located? Explain this statement: the heart is controlled by the nervous system but doesn’t require the nervous system in order to function.

14. What are propioceptors and baroreceptors?

15. What hormones do the kidneys, hypothalamus and adrenals secrete which affect blood pressure?

16. Identify the phases of the cardiac cycle.

17. Discuss the relationship between blood flow, pressure gradients and vascular blood resistance. How does atherosclerosis affect this relationship?

18. What factors control peripheral (vascular) resistance? How do these factors affect arterial pressure, venous return, and local blood flow?

19. What are the general characteristics of a blood vessel? What are some reasons why blood pressure drops as blood moves from arteries to veins? Check out figure 20.8 to help answer this question.

20. What mechanisms allow gases and nutrients to move across the capillary wall? How do lipid-soluble, non-lipid-soluble and very large particles make the journey?

21. Generally explain how blood pressure and osmotic (oncotic) pressure oppose one another and how this determines which way fluids flow on the arteriole side of the capillary bed. Compare this to the direction of flow on the venous side.

22. What are portal systems and anastomoses? Define varicose veins, conducting arteries, distributing arteries, capillaries (fenestrated, continuous), venules, veins, thoroughfare channel (also called a shunt), perfusion, hypertension, hypotension, aneurysm, vasomotion, vasodilation, vasoconstriction, autoregulation, angiogenesis, reactive hyperemia, hypoxia, baroreflex, chemoreflex, capillary exchange, diffusion, transcytosis, filtration, reabsorption, thoracic pump, pressure gradient, thoracic pump, cardiac suction, skeletal muscle pump, venous pooling, edema, orthostatic hypotension, septal defects, peripheral vascular disease, metabolic theory of autoregulation,

23. In what ways do arteries and veins differ? How does this relate to their functions?

24. What mechanisms and anatomical features do veins use to help return blood to the heart?

25. How does the body re-direct blood during exercise?

26. What is circulatory shock? Distinguish between hypovolemic shock, obstructed venous return shock, vascular shock, septic shock, anaphylactic shock, neurogenic shock.

27. What’s the difference between compensated and non-compensate shock? Which is a negative and which is a positive feedback loop?

28. Why do you get dizzy if you get up after sunbathing?

29. Vascular resistance can change for a variety of reasons. Predict specifically how it would change if the following variables were altered: blood viscosity, vessel radius, vessel length.

30. Which type of artery is most important in controlling blood flow routing? Why?

31. What role does the medulla oblongata play in controlling blood flow? How (in very general terms) does the limbic system affect blood flow?

Also, quiz yourself using your textbook:

• Testing your recall, Ch. 19 (1-2, 4-20); Ch. 20 (1-20).

o Note: You can find the answers to these questions in Appendix B of your textbook.

• Testing your comprehension, Ch. 19 (questions 1, 2, 4, 5); Ch. 20 (questions 3, 4, 5).

o Note: You can find the answers to these questions in the comprehension tests for each chapter at the class website.

Good luck and don’t panic!

The Universe is still a friendly place!



Heart Lab

1. Using the heart models, identify the following structures so you’re well prepared for the lab practical. If another team is already using the models, skip to another question and come back to this one later.

 R/L atria

 R/L ventricles

 Aorta

 Superior vena cava

 Inferior vena cava

 R/L pulmonary arteries

 R/L pulmonary veins

 R/L coronary arteries

 Marginal artery

 Circumflex artery

 Anterior interventricular a.

 Posterior interventricular a.

 Great cardiac vein

 Middle cardiac vein

 R/L AV valves

 R/L semilunar valves

 Chordae tendineae

 Papillary muscles

 Base

 Apex

2. Examine the beef heart. Locate as many of the structures listed below as you can.

 R/L atria

 R/L ventricles

 Aorta

 Superior vena cava

 Inferior vena cava

 R/L AV valves

 R/L semilunar valves

 Chordae tendineae

 Papillary muscles

 Base

 Apex

3. Compare the size of the L and R ventricular walls in the beef heart. Which has a thicker wall? _______________

4. Explain why this would be.

5. Determining heart rate. Locate your pulse either radially (at the wrist, just medial to the radius) or at the carotid (the carotid arteries are lateral to the larynx in the neck). Count the number of pulses for 15 seconds, then multiply by 4 to get your beats per minute (heart rate or HR).

4. Number of beats _____________ X 4 = ____________________ beats per minute (bpm)

5. A cardiac cycle is the amount of time it takes the heart to complete one beat and is measured in seconds (usually is a value of less that one second). If there are 60 seconds in one minute, and your heart rate is ___________bpm, then how long does it take your heart to complete one cardiac cycle? Show your work below.

6. Auscultation means to listen to sounds in the body, such as using a stethoscope to hear the heart beat. Obtain a stethoscope and use it to listen to the lubb, dupp sound your lab partner’s heart makes each time it beats. The lubb sound (S1) results from turbulence of the blood as the AV valves close (during systole). The dupp sound (S2) occurs at diastole as the semilunar valves close and the ventricles relax to receive more blood.

4. Which sound (S1 or S2) is louder in a patient at rest? ______________________

5. Why?

7. Familial hypercholesterolemia is an autosomal recessive genetic disorder with incomplete dominance. In this disease, an individual’s cells are not able to dock LDL proteins on their surface. As a result, the LDL proteins cannot unload their lipids and the lipids remain in the blood, increasing LDL and cholesterol levels drastically. If an individual is born with two copies of the Hf allele 9the recessive, mutated form), they die of heart attack, usually by age 4. Those born with one version of the normal allele (HF) and one of the recessive allele can dock some of their LDL proteins but not many, and their blood cholesterol levels are high, too. These individuals typically die of heart attack by their mid-20s. Individuals who are homozygous dominants live normal lifespans.

8. Imagine a man who is a carrier for this disease marries at 18 to a woman who is also a carrier. For this problem, show all five steps to solving a genetics problem which you learned from last semester. If you didn’t have Kerry last semester, find a classmate who did and get the five steps from them.

a. What are the chances that a child of theirs will die as a toddler?

b. What are the chances a child of theirs will die in their 20s?

Blood Pressure Lab

Health professionals use a sphygmomanometer to measure arterial blood pressure in mmHg (millimeters of mercury). Usually, this measurement is done at the brachial artery in the antecubital area with the help of a stethoscope. As the inflatable cuff of the sphygmomanometer fills with air, the pressure in the cuff eventually exceeds the pressure of blood flowing through the brachial artery. This stops blood flow through the artery. As air is slowly released from the cuff and air pressure drops, it eventually falls below the pressure of the blood and the artery opens, allowing blood flow to resume. As blood flow returns to normal, turbulent sounds of the blood (Korotkoff sounds) can be heard through the stethoscope.

a. Find a partner and take turns determining each other’s blood pressure. If you have never taken someone’s blood pressure before, ask Kerry or a fellow student with experience for help.

b. The systolic pressure value is measured when you hear the first sound as blood begins to flow again through the still partially occluded artery. Normal average systolic pressure for an adult is _____________________ mmHg.

c. The diastolic pressure value is measured when the last, faint beating sound is heard as the pressure cuff deflates. Normal average diastolic pressure for an adult is ______________ mmHg.

d. Record the values you obtained for your partner and for yourself below. Be sure to label your values in mmHg.

i. Partner systolic __________________, diastolic __________________.

ii. Your systolic __________________, diastolic __________________.

e. Repeat blood pressure measurements for both you and your partner and record your second values below. Be sure to label your values in mmHg.

i. Partner systolic __________________, diastolic __________________.

ii. Your systolic __________________, diastolic __________________.

f. Calculate the average systolic and then average diastolic for your partner by A) adding the systolic values together, then dividing by two and B) adding the diastolic values together, then dividing by two. Do the same thing for your values and record the averages below. Be sure to label your values in mmHg.

i. Partner’s average systolic ___________________, average diastolic________________

ii. You average systolic______________________, average diastolic________________

g. The pulse pressure is the difference between the systolic and diastolic values. Calculate the pulse pressures for you and your partner, using your average values. Be sure to label your values in mmHg.

i. Partner’s pulse pressure _______________________

ii. Your pulse pressure __________________________

h. Mean arterial pressure (MAP) is the average blood pressure (BP) over the course of the cardiac cycle. It increases when cardiac output increases, or when vessel resistance increases. Because the heart spends more time in ventricular diastole than in other portions of the cycle, the equation for calculating MAP is weighted accordingly.

MAP = diastolic BP + (pulse pressure/3)

i. Calculate your partner’s MAP and your MAP below.

Partner’s MAP = diastolic BP ___________________ + (pulse pressure _____/ 3) = _______

Your MAP = diastolic BP ___________________ + (pulse pressure _____/ 3) = _______

Cardiovascular System:

THE HEART

What does the heart do?

• 100,000 hb/day

• ~3B hb/lifetime

• 4,000 gallons (15,000 L) blood pumped/day

• ~60% of blood in veins at any given time

What are the heart parts?

• In thoracic cavity: mediastinum

– Apex points slightly to left

– Base at “top” of heart

• Around heart: pericardium

• Heart: three layers

– Epicardium

– Myocardium

– Endocardium

What is the pericardium?

• Parietal pericardium

– Fibrous layer: dense irregular c.t. (outside)

– Serous layer: moist (inside)

• Turns inward at base (top of heart) to form visceral pericardium

• Visceral pericardium

– Covers heart surface (epicardium)

• Pericardial cavity

– Between parietal and visceral pericardium

– Contains pericardial fluid

• Pericarditis

Cardiac tamponade

What are the three layers of the heart?

• Epicardium = visceral pericardium

– Contains fat deposits in sulci

– Other areas: thin and transparent

• Myocardium

– Cardiac muscle fibers

– Held together by fibrous skeleton (collagenous and elastic fibers)

– Recall: intercalated discs which contain gap junctions, desmosomes

• Endocardium

– Endothelium

• Continuous with vascular endothelium

What’s inside the heart?

• Four chambers

– Two atria + auricles

• Interatrial septum

– Fossa ovalis

– Two ventricles

• Interventricular septum

• Four valves

– Atrioventricular valves

• Right: tricuspid

• Left: bicuspid (mitral)

• Chordae tendineae

• Papillary muscles

• Prolapse

What’s inside the heart?

• Four valves

– Semilunar valves

• Right: pulmonary semilunar

• Left: aortic semilunar

• Valve disorders

– Stenosis

• Stiffened cusps; scar tissue occludes opening

• Often rheumatic fever causes

– Autoimmune disease attacks mitral valve: scarring and more heart work

– Incompetent valve causes regurgitation and turbulence = heart murmur

– Mitral valve prolapse (MVP)

What blood vessels lead to/from the heart?

• Superior/inferior vena cava

– Empty into R atrium

• Pulmonary trunk

– At pulmonary semilunar valve: R/L pulmonary arteries

• R/L pulmonary veins empty into L atrium

• Ascending aorta

– Brachiocephalic trunk

• R common carotid artery and R subclavian artery

– L common carotid artery

– L subclavian artery

• Ductus arteriorsus: pulm. a. to aorta in fetus

• Systemic vs. pulmonary circuit

• Cor pulmonale

What are the coronary arteries?

• Heart doesn’t get blood from chambers, it has its own blood vessels instead

• Two stem immediately from ascending aorta

• Left coronary artery (two branches)

– Anterior interventricular branch

– Circumflex branch

• Right coronary artery (two branches)

– Posterior interventricular branch

– Marginal branch

• Anastomoses

– Prevent myocardial infarction

What are the coronary veins?

• Coronary sinus

– 20% of blood directly into right atrium

– 80% dumps into:

• Greater cardiac vein

• Middle cardiac vein

• To coronary sinus to right atrium

What are some coronary diseases?

• Coronary artery disease (atherosclerosis)

– Risk factors (8)

– Atherosclerotic plaque

– Thrombus and embolism

• Heparin

• Coumadin (warfarin) (blocks synth. Of II, VII, IX, X)

• Angioplasty

• Coronary artery bypass grafting

What are some coronary diseases?

• Ischemia

• Angina pectoris

• Myocardial infarction

What path does blood take through the heart?

• Trace the blood flow through the heart, systemic and pulmonary circuits beginning at the right atrium. Be sure to include all valves, chambers and major blood vessels connected to the heart.

How does the heart beat?

• Myogenic cells

• Sinoatrial (SA) node: innate rate: ~100 b/min

– Right atrial myocardium

– Primary pacemaker; slow Na+ inflow

– ANS regulates

• Atrioventricular (AV) node (Bundle of His)

– Single point of electrical connection bet. atria and ventricles

• 40-50 bpm = nodal rhythm

• Damage = total heart block

– 100 msec delay

– ANS regulates

• AV bundle (right and left)

• Purkinje fibers (conduction fibers)

• Ectopic focus

How do myocytes create a potential?

• Myogenic cells

– -60 mV potential

– “leak” to generate pacemaker potential

• Slow Na+ leak w/no K+ outflow

• -40 mV threshold

– Fast Ca2+ gates open (depolarize)

– Then repolarization = K+ gates open

• Myocytes

– Slow Ca2+ channels prolong contraction

What is the cardiac cycle?

• Terminology

– Systole

– Diastole

– Normal sinus rhythm: 60-100 b/min; 70 ave.

– Tachycardia; >100

– Bradycardia; < 60

– Palpitation

What is an electrocardiogram (ECG)?

• Wrists, ankles, six chest locations

• Basic ECG waves

– P wave: atrial depolarization and systole

• When SA fires

– QRS complex: ventricular depolarization

• When AV node fires

• Note: this masks atrial repolarization and diastole

• S-T segment: beginning of ventricular systole

– T wave: ventricular repolarization and diastole

How do we interpret ECGs?

• Size and timing of waves

• Significance of large waves

– P wave: mitral valve stenosis

– Q wave: MI

– R: ventricular hypertrophy

• Arrhythmias

– AV block

– Fibrillation

What are the phases of the cardiac cycle?

• All this happens in less than a second!

• Relaxation phase (quiescent period)

– T wave initiates at end of heart beat

– All chambers: diastole

– Ventricular pressure falls below atrial pressure

• Causes AV valve to open and ventricles to begin filling

• Ventricular filling

– SA node fires (P wave begins)

– Atrial systole follows

– End-diastolic volume (EDV) pushed into ventricles (~25 ml)

What are the phases of the cardiac cycle?

• Ventricular systole

– AV node sends impulse to Purkinje fibers

– Ventricles begin to depolarize and contract = isovolumetric contraction

– Ventricular ejection (~70 ml ejected = stroke volume)

– Blood remaining in ventricles (end systolic volume, ESV ~60 ml)

What are the phases of the cardiac cycle?

• Isovolumetric relaxation

– Early ventricular diastole

• Ventricular filling

– Further relaxation of ventricles lowers pressure to below that of atria

– AV valves open and blood pours in

• Murmur = turbulence

• Incompetent = swish sound from not closing completely

• Stenotic = whistle b/c stiff

What are the phases of the cardiac cycle?

• Stroke volume

– SV = EDV – ESV (amt of blood in one cycle)

– Three factors regulate SV

• Preload

– Stretch on ventricles before contraction

– Starling’s law (think of rubber bands)

– Ventricles eject as much as they receive

– Keep both sides equal

» Congestive heart failure if sides not equal

What are the phases of the cardiac cycle?

– Contractility; determined by other factors than preload

• Force of the contraction

• ANS controls

– Sympathetic and epinephrine

– Parasympathetic: vagal tone

» Abnormal electrolytes can affect

• Inotropic agents (vs. chronotropic agents)

– Hyperkalemia = negative inotropic agent

– NE/E = positive inotropic agents

– Afterload

• Pressure in aorta and pulmonary trunk

What is cardiac output?

• CO (ml/min) = SV (ml/beat) X HR (beat/min)

– Total amount ejected from right OR left ventricle in one minute

• Auscultation

– Lubb: blood turbulence from AV valve closure

– Dubb: blood turbulence from closure of semilunar valves

What regulates the heart?

• Chronotropic effects and agents

• Nervous system doesn’t initiate heart beat

– Instead modifies its rate and force via autonomic innervation

• Medullary Cardiovascular Center (CV)

– Cardioacceleratory center (sympathetic): NE

– Cardioinhibitory center (parasympathetic): acetylcholine

• Vagus nerve to SA and AV node

• Ach opens K+ channels = hyperpolarization

– NE and acetylcholine action

• Beta adrenergic receptors on cardiac fibers

– Use of beta blockers to control hypertension

What regulates the heart?

– Baroreceptors

– Potassium

• Hyperkalemia: slows beat, may arrest in diastole

– Too much potassium raises membrane potential making repolarization difficult

• Hypokalemia: leaves cells hyperpolarized

– Need more stimulus to reach threshold

• Hormonal regulation of bp

– Kidneys: renin production (raises bp)

– Hypothalamus: ADH production

– Adrenals: aldosterone production

Blood Vessels and Circulation

What is circulation?

• Deliver oxygen, nutrients to tissues

– Remove waste products

• Different organs/regions receive varying amounts of blood at different times

• Perfusion: blood flow per volume or mass

What is the general anatomy of blood vessels?

• Generalized route: heart, arteries, arterioles, capillaries, venules, veins

– Recall: definition of artery

• Only through one capillary bed

– Portal systems are exceptions

• Hypothalamo-hypophyseal portal system

• Kidneys

• Small intestines to liver

– Anastamoses also exceptions

• Arterial or venous anastomoses

• Arteriovenous shunts

What walls make up blood vessels?

• Three layers (tunics) in arteries and veins

– Tunica external (tunica adventitia): outermost

• Loose CT; anchors vessel in place

• Elastic and collagen fibers

– Tunica media: middle layer, thickest of three

• Smooth muscle; some elastic fibers

• Vasodilation/vasoconstriction

– Tunica interna (tunica intima)

• Endothelium over basement membrane

• Some fibroconnective tissue

• Secretes vasodilators and vasoconstrictors

• Smooth so blood passes easily

What are arterioles and metarterioles?

• Tolerate surges in blood pressure

• Different sizes

– Conducting (elastic): largest

• Expand and recoil

• Pressure reservoir during diastole

– Distributing (muscular): to specific organs

• More smooth muscle; thicker, most vasodynamic

– Resistance (arterioles—small): primary controllers of blood flow and route

• Major site of pressure regulation/distribution

• Metarterioles: short vessels linking arterioles and capillaries

– With capillary sphincter

What are capillaries?

• Distributions of gases, nutrients

• Only endothelium (one layer) and basement membrane

– Very thin; 0.2 to 0.4 micrometers

– About 1B in body

– No cell in body is more than about 60-80 micrometers away!

• Except: cartilage, tendons, ligaments, epithelia, cornea and lens

What are capillary beds?

• 10-100 capillaries with a shunt (thoroughfare channel) directly connected to venule

– Precapillary sphincters along metarteriole

– ~75% of all capillaries closed at any one time

– Blood travels SLOWLY

• Types of capillaries

– Continuous: most tissues

• Endothelial cells with tight junctions

• Narrow intercellular clefts for small solute passage

– Fenestrated: kidneys, small intestines, endocrine glands

• Endothelial cells with many holes

• Rapid passage of small solutes

What are capillary beds?

• Sinusoids: irregular blood-filled spaces

– Bone marrow, liver, spleen

– Conform to organ shape, some fenestrated

– How liver delivers albumin, other proteins to the blood

What are veins and venules?

• Phlebotomy: incision in vein to draw blood

• Venules collect capillary blood

• Venous sinuses: veins with v. thin walls, large lumens, no smooth muscle (e.g. heart, brain)

• Lower bp than arteries. Why???

• Internal valves prevent backflow

– Help when skeletal muscles relaxed

• So does thoracoabdomino action (thoracic pump)

– Mostly in medium-sized veins of arms/legs

– About 54% of blood in systemic veins at rest

• Varicose veins: veins stretched, valves become incompetent = blood pools

– Hemorrhoids: type of varicose veins

What affects blood flow?

• Without it = necrosis or even death

• Affected by blood pressure, vascular resistance

– Blood flow = force (pressure gradient)/resistance

• Measure bp with sphygmomanometer

What is blood pressure?

• Force of blood on vessel wall

– Pressure gradients occur

• Capillaries to interstitial fluid

• Ventricle to atria for blood to flow through pulmonary or systemic circuits

– Measure diastole and systole

• Pulse pressure = systole – diastole

• Mean arterial pressure (MAP) = average over cardiac cycle

– MAP = dias + 1/3 pulse pressure

– MAP also = CO X R

How is blood pressure regulated?

• Recall MAP = CO X R

• SV and HR affect b/c CO = SV X HR

• Peripheral resistance via arterioles changing diameter

– Vasoconstriction: sympathetic, adrenal medulla

– Vasodilation: parasympathetic

• Blood volume also affects

• Hormonal

– Aldosterone, ADH: long-term effects

– Angiotensin II (ACE inhibitors)

– Atrial natriuretic peptide (antagonizes aldosterone)

What is vascular resistance?

• Friction between blood and vessel wall

– Peripheral resistance: sum of all vessel resistance in systemic circuit

– Albumin and erythrocytes, mainly

• Blood flow inversely related to resistance

– Garden hose vs. straw

• More surface area contact in straw for same amount of water = more resistance

• Causes: blood viscosity, vessel length, vessel diameter, vessel elasticity, lumen occlusion

– Diameter regulated to change resistance

What is atherosclerosis?

• Damage to endothelium initiates process

– Progresses to fatty streak stage: lipids/macrophages in tunica intima

• Become fibrous plaque

– Increases with smooth muscle and protrudes into lumen

– Plaque is unstable

• Break, tear leads to thrombus, possible embolism

What are some blood pressure characteristics?

• Pressure gradient from aorta (~120 mmHg) to right atrium (~0 mmHg)

– Elastic arteries: highest pressure, lowest R

– Muscular arteries: some pressure loss (smaller diameter, less elastic)

– Arterioles: smallest diameter, largest R, largest decrease

– Capillaries: small, numerous, small gradient with ECF but enough

• Why need low pressure? Edema

– Venules, veins: pressure gradient still toward heart

• Valves, skeletal muscle pump and diaphragm help

What are some blood pressure deviations?

• Hypertension: 140/90; receptors reset

– Strains heart (higher afterload)

– Can lead to swelling which can cause vessel rupture (aneurysm), kidney failure

– Risks: obesity (fat = greater vessel length), atherosclerosis, smoking (nicotine = vasoconstrictor)

– Treat with diet, anti-hypertensive drugs

• Hypotension: 100/60

– Causes: blood loss, dehydration, anemia

What monitors blood pressure?

• Neural reflex arcs

– Baroreceptors (baroreflex)

• Aortic arch (systemic)

• Carotid sinus (to brain)

• Right atrium (monitors venous return)

– Propioceptors: in muscles

• Not a true monitor, but does affect bp

– Chemoreceptors (chemoreflex)

• Respond to decrease O2, increased CO2 and pH decrease

• Aortic body, carotid body

What are some nervous system controls?

• Medulla oblongata

– Cardiac center: stimulate or inhibit

– Vasomotor center: blood vessel diameter

• Higher centers can also influence

– Hypothalamus (limbic system)

What are local controls?

• Autoregulation: ability of tissues to regulate own blood supply

– Metabolic theory of autoregulation

• inadequate perfusion leads to accumulation of metabolites

• This stimulates vasodilation

– Short-term hypoxia

• respond with reactive hyperemia (above normal flow increase)

– Long-term hypoxia

• tissue can undergo angiogenesis

What is va