Professional Documents
Culture Documents
Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.
Anatomy of the Heart
• Left atrium
Receives O2-rich blood
Blood enters atrium through 4 pulmonary
veins
Blood leaves left atrium through an AV
valve (bicuspid or mitral)
• Left ventricle
Forms the apex of the heart
Blood leaves the left ventricle through the
aortic semilunar valve and enters the
aorta
Fig 12.3
Anatomy of the Heart
o Heart Sounds
• First sound, "lub"
Heard when ventricles begin to contract
AV valves close
Lasts longer and has a lower pitch
• Second sound, "dup"
When ventricles relax
Semilunar valves close
• Heart murmurs
Due to ineffective, leaky valves
Valves do not close properly
Allows blood to backflow into atria or ventricles
after valves have closed
Anatomy of the Heart
o Coronary Circulation
• Heart cells are not nourished by the blood in
the chambers
• The left and right coronary arteries branch
from the aorta
Coronary arteries branch numerous times
Heart is encircled by small blood vessels
• After blood passes through cardiac
capillaries it enters the cardiac veins
• Cardiac veins enter the coronary sinus
• Coronary sinus enters the right atrium
Fig 12.4
Physiology of the Heart
• Nodal Tissue
Has muscular and nervous characteristics
SA (sinoatrial) node – upper posterior
wall of the right atrium
Initiates the heartbeat
Sends out an excitation impulse every 0.85
seconds
Pacemaker of the heart
AV (atrioventricular) node – base of the
right atrium
Impulse is delayed
Signals the ventricles to contract
Atrioventricular bundle (AV bundle)
Purkinje fibers
Fig 12.5
Physiology of the Heart
Artificial pacemaker may be implanted if the SA
node fails to work properly
Heart block – slow beating of the heart due to a
damaged AV node
Ectopic pacemaker
An area other than the SA node that can become the
pacemaker
May cause an extra beat
Caffeine and nicotine can stimulate an ectopic
pacemaker
Electrocardiogram
http://nobelprize.org/educational_games/medicine/ecg/
o Capillaries
• Microscopic blood vessels
• One layer of endothelial cells
• Site of nutrient and gas exchange
• Not all capillary beds are in use at the
same time
Most have a shunt
Precapillary sphincters control the
entrance of blood into capillaries
Fig 12.9
Anatomy of Blood Vessels
o Blood Pressure
• The force of blood against blood vessel walls
• Highest in the aorta
• Decreases with distance from left ventricle and is lowest
in the venae cavae
• Fluctuates between systolic blood pressure and diastolic
blood pressure
• Mean arterial blood pressure
Pressure in the arterial system averaged over time
Equals cardiac output x peripheral resistance
Increasing CO increases MABP
Peripheral resistance is the resistance to flow between blood and the
walls of a blood vessel
- The smaller the blood vessel or the longer the blood vessel the
greater the resistance
- The greater the resistance the higher the blood pressure
Fig 12.11
Physiology of Circulation
• Evaluating circulation
Pulse
Alternating expansion
and recoil of arterial Fig 12.14
walls
Can be felt in
superficial arteries
(pulse points)
- Radial artery
- Common carotid
Pulse rate normally
indicates the rate of
the heartbeat
Physiology of Circulation
Blood pressure
Usually measured in
brachial artery
Sphygmomanometer is an
instrument that records
pressure changes Fig 12.15
The blood pressure cuff is
inflated until no blood flows
through the artery
Korotkoff sounds
- produced when the
pressure in the cuff is
released and blood
begins to hit the arterial
walls
- Systolic pressure
- When sounds end
diastolic pressure is
recorded
Physiology of Circulation
o Pulmonary circuit
• Blood from the body collects in the
right atrium
• Blood moves into the right ventricle
• Right ventricle pumps blood into the
pulmonary trunk
• Blood flows into the pulmonary
capillaries in the lungs
• Blood flows from the lungs through the
pulmonary veins and into the left
atrium
Circulatory Routes
o Systemic circuit
• Includes all other arteries and veins of the body
• Aorta and venae cavae are the major pathways
for blood in the systemic circuit
Aorta is the largest artery
Superior and inferior venae cavae are the largest veins
• Begins in the left ventricle
• The left ventricle pumps blood into the aorta
• Branches from the aorta go to the major body
regions and organs
Circulatory Routes
Table 12.1
Fig 12.16
Circulatory Routes
Table 12.2
Fig 12.17
Circulatory Routes
• Hypothalamus-Hypophyseal Portal
System
• Blood Supply to the Brain
Anterior and posterior cerebral arteries and
the carotid arteries supply the brain with
arterial blood
Cerebral arterial circle (circle of Willis)
The blood vessels form a circle
Provides alternate routes for supplying arterial
blood to the brain
Equalizes blood pressure in the brain's blood
supply
Fig 12.19
Circulatory Routes
• Fetal Circulation
Four circulatory features do not present in
adult circulation
Foramen ovale
Ductus arteriosus
2 Umbilical arteries, 1 umbilical vein
Ductus venosus
Fetal Circulation
Features:
Site of exchange of oxygen, carbon dioxide
and nutrients, waste material occur in
placenta between fetus and the mother is
placenta ( 2 umbilical arteries, 1 umbilical
vein) by diffusion and active transport
Fetal blood does not mix with maternal
blood
the fetus does not use its lungs (deflated)
and no gaseous exchange occurs
Path of blood in the fetus
Blood in the umbilical arteries is oxygen poor
Blood in the umbilical veins is oxygen rich
o Heart http://file.zhangxiu.com/source/7/5/7/9/7579c443l1GE.mp3
o Arteries
• Atherosclerosis and arteriosclerosis are
common
• Chances of coronary thrombosis and
heart attack increase
• Occurrence of varicose veins increases
Thromboembolism
Pulmonary embolism
Homeostasis
Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.
Lymphatic System
o Three main functions
• Fluid balance
• Fat absorption
• Defense
o Lymphatic vessels
• Form a one-way system
• Begins with lymphatic capillaries
Tiny, closed-ended vessels
Take up excess tissue fluid (lymph)
• Vessels merge and then enter one of two ducts:
Thoracic duct
Right lymphatic duct
• Vessels have valves and movement of lymph depends on
skeletal muscle contraction
• Edema is localized swelling caused by the accumulation of
lymph
Fig 13.1
Organs, Tissues, and Cells of the
Immune System
o Primary Lymphatic Organs
• Lymphocytes originate and/or mature in
these organs
• Red Bone Marrow
Site of stem cells that produce blood cells
In an adult, red bone marrow is found in:
Sternum
Vertebrae
Ribs
Skull
Part of the pelvic girdle
Proximal heads of the humerus and femur
Lymphocytes differentiate into B and T
lymphocytes
B lymphocytes mature in the red bone marrow
T lymphocytes mature in the thymus
Organs, Tissues, and Cells of the
Immune System
• Thymus Gland
In the thoracic cavity
Largest in children and shrinks as a
person ages
Lobules are filled with lymphocytes
Produces thymic hormones
Aids in maturation of T lymphocytes
May have other functions in immunity
Critical to immunity
Fig 13.2
Fig 13.3
Organs, Tissues, and Cells of the
Immune System
o Secondary Lymphatic Organs
• Places where lymphocytes encounter and
bind with antigens
• Spleen
Largest lymphatic organ
Consists of two types of tissue:
White pulp – has a concentration of lymphocytes
Red pulp – surrounds venous sinuses and is involved
in filtering blood
Blood entering the spleen is filtered through
venous sinuses
Lymphocytes and macrophages react to pathogens
Macrophages engulf debris and remove old red blood
cells
Organs, Tissues, and Cells of the
Immune System
• Lymph nodes
Small structures occurring along lymphatic vessels
Connective tissue
Forms a capsule
Divides node into compartments
- Contains nodules packed with B lymphocytes
- Sinus that contains T lymphocytes
Lymph passing through the sinus is filtered by
macrophages
T lymphocytes fight infection and attack cancer
cells
• Lymphatic nodules
Concentrations of lymphatic tissue not surrounded
by a capsule
Tonsils
Peyer patches
Appendix
Nonspecific and Specific Defenses
o Nonspecific Defenses
• Barriers to entry
Physical
Intact skin
Mucous membranes
Chemical
Sebaceous gland secretions
Lysozyme in perspiration, saliva, and tears
Urine
pH of the stomach
Normal flora
Nonspecific and Specific Defenses
• Inflammatory reaction
Four signs:
Redness
Heat
Swelling
Pain
Chemical mediators cause capillaries to dilate and
become more permeable
Excess blood causes redness and increased
temperature
Fluids and proteins escape the capillaries and cause
swelling and clot formation
Migration of phagocytes
Chronic inflammation is treated with anti-
inflammatory agents
Fig 13.4
Nonspecific and Specific Defenses
o Specific Defenses
• Respond to antigens
• Lymphocytes have antigen receptors
B lymphocytes
Mature in the bone marrow
Give rise to plasma cells that produce
antibodies
T lymphocytes
Mature in the thymus gland
Directly attack cells that have nonself proteins
or regulate the immune response
Nonspecific and Specific Defenses
o Structure of Antibodies
• Basic unit is a Y-shaped protein molecule with two
arms
"heavy" polypeptide chain
"light" polypeptide chain
• Chains have constant regions at the trunk of the Y
• The class of antibody is determined by the structure
of the constant region
• Monomers – single Y-shaped molecules
• Dimers – paired Y-shaped molecules
• Pentamers – clusters of 5 Y-shaped molecules linked
together
o Function of Antibodies
• Neutralization
• Forming immune complexes
Fig 13.6
Nonspecific and Specific Defenses
Table 13.1
Nonspecific and Specific Defenses
o Types of T Cells
• Cytotoxic T cells
Destruction of virus-infected or cancer
cells
Have storage vacuoles containing Perforin
molecules
Responsible for cell-mediated immunity
• Helper T cells regulate immunity by
secreting cytokines
Fig 13.8
Nonspecific and Specific Defenses
o Active Immunity
• Often develops naturally
• Immunization
Involves the use of vaccines
After the first exposure, a primary
response occurs
A second exposure ("booster") produces a
secondary response
• Depends on the presence of memory
cells
• Usually long-lasting
Induced Immunity
o Passive Immunity
• Occurs when an individual is given
prepared antibodies
(immunoglobulins)
• Is temporary
• Can be used in the event of an
unexpected exposure to an infectious
disease
Induced Immunity
o Monoclonal Antibodies
• Every plasma cell derived from the
same B cell
• Secretes antibodies against one
antigen
• Can be produced in vitro
• Are being used for quick and certain
diagnosis of various conditions
• Used to carry radioactive isotopes or
toxic drugs to tumors
Fig 13.11
Induced Immunity
o Hypersensitivity Reactions
• Allergies
Response to substances that are harmless
to the body (allergens)
Type I, II, III, IV
Allergic Reactions
Immune attacks against nonharmful substances
that can damage tissues
IgE-Mediated Allergic Response (Type I)
Immediate allergic response (within seconds of contact
with an allergen)
Caused by IgE antibodies
IgE antibodies are attached to the plasma membrane of
mast cells in the tissues and basophils in the blood
When an allergen attaches to the IgE antibodies,
histamine is released
E.g. hay fever, asthma
Anaphylactic shock occurs when the allergen has entered
the blood stream. This causes drop in blood pressure due
to increased blood vessel dilation and permeability of
the capillaries. E.g. bee stings, penicillin shots
T-Cell Mediated Allergic Response
(Type IV)
Initiated by memory T-cells at the site of
allergen contact
Delayed allergic responses, developed more
slowly than Ig-E regulated responses
Regulated by cytokines secreted by T cells and
macrophages
E.g. skin test of tuberculosis, contact dermatitis
such as cosmetics, jewelry, poison ivy.
Induced Immunity
• Tissue Rejection
Transplanted tissue is recognized as not
"self"
Cytotoxic T cells cause disintegration of
the transplanted tissue
Can be controlled by:
Selecting organs that have the same type of
HLA antigens as those of the recipient
Administering immunosuppressive drugs
Induced Immunity
• Autoimmune Diseases
Cytotoxic T cells or antibodies attack the
body's own cells
Cause is unknown
Examples:
Myasthenia gravis
Multiple sclerosis
Systemic lupus erythematosus
Rheumatoid arthritis
No cures, but can be managed with
medications
Induced Immunity
• Immune Deficiency
The immune system is unable to protect
the body from disease
Can be acquired or genetic
Without treatment, common infections
can be fatal
Effects of Aging