BIO 235 ANATOMY AND PHYSIOLOGY IIInstructor: Dr. Liming Liulliu@york.cuny.eduOffice Hours: Saturday 8:00 -8:50 AM in room AC4M06Copy righted material (Pearson) for students taking A&P II at York College onlyPlease sign in on the attendance sheetPlease pick up a copy of syllabus

Introduction: Self-introduction, Course syllabusIntroduction to blood: composition and multiple roles of bloodRed blood cells and functionsWhite blood cells and functionsPlatelets and functionsABO blood groups

Lecture outline

About the course syllabusRequired Text and MaterialsTextbook: Human Anatomy and Physiology (8th or 9th Edition), Marieb, E. Hoehn, K(Publisher: Pearson Benjamin Cummings, 2010)Lab Text: Human Anatomy & Physiology Laboratory Manual (10th Edition, Cat Version, UPDATE), Marieb, E. and Mitchell, S.J. (Publisher: Pearson Benjamin Cummings, 2011)Other Supplies: Each student is required to purchase his /her own goggles, lab coat and gloves.

Grading PolicyLecture: 65%Quizzes/assignments: 10%Exams: (3 X %) 60% Final Exam (Cumulative) 30%Lab: 35%Quizzes/assignments: 20%Exams: (3 X %) 60%Final exam (Cumulative) 20%Class Policies:The lowest lecture quiz will be dropped. Therefore, there will be No Make Up Quizzes. No Exceptions. In addition, there will be NO Make Up Lecture or Lab Exams without legitimate, documented evidence of emergencies and/or unless arrangements have been made with the instructor prior to the exam. An unexcused absence from an exam or quiz will earn a grade of zero.

Academic Integrity

Lecture Schedule

Class dateTopicChapter(s)Week 1(8/31)Circulatory System: Blood17Week 2 (9/7)Quiz 1. Circulatory System: The Heart18Week 3 (9/21)Exam 1, The Heart (continued)18Week 4 (9/28)Circulatory System: Blood Vessels19Week 5 (10/5)Quiz 2. Lymphatic System20

Academic IntegrityDepartmental policy precludes use of cell phones during lectures, labs and especially during exams. Violation of this policy will be reported to the Biology Departments Academic Integrity Officer. This could result in lowering of your grade or failure of the course.

BlackboardAll students must have access to Blackboard as important information including but not limited to class notes, study guides, links, etc; will be posted there. If you need assistance with your email address you may contact the service desk at 718 262 5300 or go to 2E03D.

Course DescriptionThis is a continuation of Bio 234 (Anatomy and Physiology 1).A study of the structure and function of the human body. Topics include basic anatomical terminology, general organization of the body, cells and tissues, circulatory system, digestive system, reproductive and excretory systems. Laboratory exercises will include dissection of a representative vertebrate as well as experiments illustrating physiological principles.

Course ObjectivesDescribe the normal composition and function of blood and explain the role of each of its cellular components. Describe the structure and function of the heart and blood vessels and the regulation of blood pressure, perfusion and related hemodynamic parameters. Describe the structure and function of the lymphatic and immune systemsDescribe the structure of the upper and lower components of the respiratory system along with the physiologic control and mechanics of ventilation and its relationship to perfusion.Describe the structure and function of the urinary system in elimination of waste and maintenance of homeostasis.Describe the structure and function of the male reproductive system.Describe the structure and function of the female reproductive systems in the non-pregnant, pregnant and lactating female.Calculate important physiologic markers such as cardiac output, ventilation/perfusion ratio and glomerular filtration rate.Analyze case studies which simulate real life scenariosPerform functional testing such as spirometery, and urinalysis Use a microscope to perform complete blood count with differential WBC count

Lets introduce ourselvesForm study groups. Get contact info from your group member.You may find your future friends here.Please briefly say your name, and a few words about your background and interests.Please listen attentively when others are speaking.

Introduction: Self-introduction, Course syllabusIntroduction to blood: composition and multiple roles of bloodRed blood cells and functionsWhite blood cells and functionsPlatelets and functionsABO blood groups

Lecture outline

Plasma ProteinsOther SolutesWaterPlateletsWhite Blood CellsRed Blood CellsPlasmaFormed Elements4663%3754%7%1%92%< .1%< .1%99.9%

Albumins (60%)Transport substances such as fatty acids, thyroid hormones, and steroid hormonesGlobulins (35%) Antibodies, also called immunoglobulinsTransport globulins (small molecules): hormone-binding proteins, metalloproteins, apolipoproteins (lipoproteins), and steroid-binding proteinsFibrinogen (4%)Molecules that form clots and produce long, insoluble strands of fibrin

Origins of Plasma ProteinsMore than 90% made in liverAntibodies made by plasma cellsPeptide hormones made by endocrine organs

After centrifuging, of the listed blood components, which contains the components of immune function?PlasmaBuffy coatErythrocytesHematocrit

The major function of the most common plasma protein, albumin, is __________.maintenance of plasma osmotic pressurebuffering changes in plasma pHfighting foreign invadersboth a and b

Introduction: Self-introduction, Course syllabusIntroduction to blood: composition and multiple roles of bloodRed blood cells and functionsWhite blood cells and functionsPlatelets and functionsABO blood groups

Lecture outline

Red blood cells are efficient oxygen transport cells. Of the following characteristics, which is the major contributor to the significant oxygen-carrying capacity of a red blood cell?Red blood cells lack mitochondria.Red blood cells dont divide.Red blood cells are biconcave discs.Red blood cells contain myoglobin.

Where does this process occur?

Fetal HemoglobinStrong form of hemoglobin found in embryosTakes oxygen from mothers hemoglobin

Oxygen binds to the _______ portion of hemoglobin.globinoxyhemoglobiniron atomamino acid

A patient with low iron levels would experience which of the following symptoms?An increased white blood cell countAn increase in energy levelAn increase in fatigueA decreased white blood cell count

Vitamin deficiency anemiaVitamin deficiency anemia is a lack of healthy red blood cells caused by lower-than-normal amounts of certain vitamins. The vitamins linked to vitamin deficiency anemia include folate, vitamin B-12 and vitamin C. Vitamin deficiency anemia can occur if you don't eat enough folate, vitamin B-12 or vitamin C. Or vitamin deficiency anemia can occur if your body has trouble absorbing or processing these vitamins. The lack of red blood cells caused by vitamin deficiency anemia can cause weakness and shortness of breath. Vitamin deficiency anemia can usually be corrected with vitamin supplements and changes to your diet.

RBC Formation and Turnover1% of circulating RBCs wear out per day About 3 million RBCs per secondHemoglobin Conversion and RecyclingMacrophages of liver, spleen, and bone marrowMonitor RBCsEngulf RBCs before membranes rupture (hemolyze)

Hemoglobin Conversion and RecyclingPhagocytes break hemoglobin into components Globular proteins to amino acidsHeme to biliverdin Iron

Hemoglobin Conversion and RecyclingHemoglobinuriaHemoglobin breakdown products in urine due to excess hemolysis in bloodstreamHematuriaWhole red blood cells in urine due to kidney or tissue damage

Iron RecyclingIron removed from heme leaving biliverdinTo transport proteins (transferrin) To storage proteins (ferritin and hemosiderin)

Recycling of Red Blood Cell ComponentsEvents Occurring in MacrophagesMacrophages in liver,spleen, and bone marrowHemeBiliverdinBilirubinBilirubin boundto albumin inbloodstreamAmino acidsLiverBilirubinBilirubinExcretedin bileUrobilins,stercobilinsEvents Occurring in the LiverEvents Occurring in the Large IntestineEliminatedin fecesAbsorbed into the circulationEvents Occurring in the KidneyEliminatedin urineUrobilinsKidneyHbHemoglobin that is notphagocytized breaks down,and the alpha and beta chainsare eliminated in urine.Fe2+Fe2+ transported in circulationby transferrin90%10%Old anddamagedRBCsAverage life span ofRBC is 120 daysIn the bloodstream,the rupture of RBCsis called hemolysis.New RBCsreleased intocirculationRBCformationEvents Occurring in the Red Bone Marrow

Predict the outcome of an overdose of the hormone erythropoietin.The blood viscosity increases to levels that may induce heart attacks or strokes.The oxygen-carrying capacity remains unchanged despite elevated red blood cell counts.Red blood cell counts remain unchanged, but the number of reticulocytes increases.Blood viscosity levels decrease while oxygen-carrying capacity increases.

What response would you expect after traveling to high altitude for two weeks?Blood levels of oxygen would remain depressed for the duration.A surge in iron release from the liver would occur.The kidneys would secrete elevated amounts of erythropoietin.There would be no change in blood composition.

If a patient has pernicious anemia, the inability of the body to absorb vitamin B12, the patient __________. would have reduced blood iron levelswould have a decreased number of red blood cellswould have increased levels of hemoglobinwould not experience any effects on red blood cells

sickle cell anemia

Introduction: Self-introduction, Course syllabusIntroduction to blood: composition and multiple roles of bloodRed blood cells and functionsWhite blood cells and functionsPlatelets and functionsABO blood groups

Lecture outline

White blood cells

LM 1500NeutrophilLM 1500LM 1500LM 1500LM 1500EosinophilBasophilMonocyteLymphocyteRBCRBCRBCRBCRBC

White Blood CellsWhite Blood Cells (WBCs)Also called leukocytes Do not have hemoglobinHave nuclei and other organelles WBC functions: Defend against pathogensRemove toxins and wastesAttack abnormal cells

White Blood CellsWBC Circulation and MovementFour Characteristics of Circulating WBCsCan migrate out of bloodstreamHave amoeboid movementAttracted to chemical stimuli (positive chemotaxis)Some are phagocyticNeutrophils, eosinophils, and monocytes

Neutrophil Action 5070% of circulating WBCsVery active, first to attack bacteriaEngulf and digest pathogensDegranulationRemoving granules from cytoplasmDefensins (peptides from lysosomes) attack pathogen membranesRelease prostaglandins and leukotrienesForm pus

Eosinophils (Acidophils)24% of circulating WBCsAttack large parasitesExcrete toxic compoundsNitric oxideCytotoxic enzymesAre sensitive to allergens Control inflammation with enzymes that counteract inflammatory effects of neutrophils and mast cells

BasophilsAre less than 1% of circulating WBCsAccumulate in damaged tissueRelease histamineDilates blood vesselsRelease heparinPrevents blood clotting

Monocytes 28% of circulating WBCsAre large and sphericalEnter peripheral tissues and become macrophagesEngulf large particles and pathogensSecrete substances that attract immune system cells and fibrocytes to injured area

Lymphocytes2030% of circulating WBCsAre larger than RBCsMigrate in and out of bloodMostly in connective tissues and lymphoid organsAre part of the bodys specific defense system

Three Classes of LymphocytesT cellsProvide Cell-mediated immunityAttack foreign cells directlyB cellsProvide Humoral immunityDifferentiate into plasma cells Synthesize antibodiesNatural killer (NK) cellsDetect and destroy abnormal tissue cells (cancers)

The Origins and Differentiation of Formed ElementsBlast CellsProgenitor CellsLymphoid Stem CellsMyeloid Stem CellsHemocytoblastsRed bone marrowProerythroblastErythroblast stagesEjection ofnucleusReticulocyteErythrocyteRed Blood Cells(RBCs)MegakaryocytePlateletsMyelocytesBand CellsAgranulocytesMonoblastPromonocyteMonocyteLymphoblastProlymphocyteLymphocyteMyeloblastBasophilEosinophilNeutrophilGranulocytesWhite Blood Cells (WBCs)

Myeloid stem cellLymphoid stem cell

A hematopoietic stem cell will give rise to __________.erythrocytesleukocytesplateletsall of the above

An elevated neutrophil count would be indicative of ________.an allergic reactiona canceran acute bacterial infectiona parasitic infection

Antihistamines counter the actions of which white blood cells?NeutrophilsLymphocytesBasophilsEosinophils

Leukemia is a general descriptor for which of the following disorders?An abnormally low white blood cell countOverproduction of abnormal leukocytesElevated counts of normal neutrophilsOverproduction of abnormal erythrocytes

The Differential Count and Changes in WBC ProfilesDetects changes in WBC populationsInfections, inflammation, and allergic reactions

Introduction: Self-introduction, Course syllabusIntroduction to blood: composition and multiple roles of bloodRed blood cells and functionsWhite blood cells and functionsPlatelets and functionsABO blood groups

Lecture outline

PlateletsPlatelet Production Also called thrombocytopoiesisOccurs in bone marrowMegakaryocytesGiant cells in bone marrowManufacture platelets from cytoplasm

A __________ is the progenitor of platelets.thrombopoietinthrombocytemegakaryocytethrombocytoblast

Platelets Cell fragments involved in human clotting systemNonmammalian vertebrates have thrombocytes (nucleated cells) Circulate for 912 daysAre removed by spleen2/3 are reserved for emergencies

PlateletsPlatelet Counts150,000 to 500,000 per microliter ThrombocytopeniaAbnormally low platelet countThrombocytosisAbnormally high platelet count

PlateletsThree Functions of PlateletsRelease important clotting chemicalsTemporarily patch damaged vessel wallsReduce size of a break in vessel wall

A break in a blood vessel stimulates hemostasis, a fast, localized response to reduce blood loss through clotting

Vascular spasms are the immediate vasoconstriction response to blood vessel injury.Platelet Plug FormationCoagulation, or blood clotting, is a multistep process in which blood is transformed from a liquid to a gelClot Retraction and RepairFibrinolysis removes unneeded clots through the action of the fibrin-digesting enzyme plasmin

Coagulation, or blood clotting, is a multistep process in which blood is transformed from a liquid to a gel 1.Factors that promote clotting are called clotting factors, or procoagulants; those that inhibit clot formation are called anticoagulants. 2.The clotting process involves three phases: formation of prothrombin activator, conversion of prothrombin to thrombin, and the formation of fibrin mesh from fibrinogen in the plasma.a.The intrinsic pathway of clotting is so named because all factors necessary are present within the blood. It is a slower clotting pathway, and may be triggered by negatively charged surfaces, such as activated platelets, collagen, or glass.b.The extrinsic pathway is triggered through an endothelium-derived protein factor, called tissue factor (TF) or factor III, and can occur very rapidly.

Fibrinolysis removes unneeded clots through the action of the fibrin-digesting enzyme plasmin

Why dont platelets form plugs in undamaged vessels?Platelets arent formed until vessel damage occurs.Only contact of platelets with exposed collagen fibers and von Willebrand factor causes them to be sticky and form plugs.Plugs do form, but are removed by macrophages.Platelets dont form plugs, it is the megakaryocytes that form the plugs.

Activation of the extrinsic pathway of coagulation requires exposure of the blood to _________.collagentissue factor IIIprothrombin activatorserotonin

Why doesnt a clot fill the entire vasculature system once it has started forming?Rapid blood flow washes away and dilutes activated clotting factors.Thrombin is inactivated by antithrombin III if it enters the general circulation.Both a and b occur.Neither a nor b occurs.

Disorders of Hemostasis1.Thromboembolytic disorders result from conditions that cause undesirable clotting, such as roughening of vessel endothelium, slow-flowing blood, or blood stasis.2.Disseminated intravascular coagulation is a situation leading to widespread clotting throughout intact vessels, and may occur as a complication of pregnancy, septicemia, or incompatible blood transfusions.3.Bleeding disorders arise from abnormalities that prevent normal clot formation, such as a deficiency in circulating platelets, lack of synthesis of procoagulants, or hemophilia.

An oral heparin medication might be prescribed for a patient who:is at risk for embolism (clots that spontaneously form and wedge in blood vessels).has thrombocytopenia.is a hemophiliac.has a deficiency in a clotting factor.

Prothrombin Time Blood Test-PTThis test is done to evaluate the blood for its ability to clot. It is often done before surgery to evaluate how likely the patient is to have a bleeding or clotting problem during or after surgery. Normal PT Values: 10-12 seconds (this can vary slightly from lab to lab) Common causes of a prolonged PT include vitamin K deficiency, hormones drugs including hormone replacements and oral contraceptives, disseminated intravascular coagulation (a serious clotting problem that requires immediate intervention), liver disease, and the use of the anti-coagulant drug warfarin. Additionally, the PT result can be altered by a diet high in vitamin K, liver, green tea, dark green vegetables and soybeans. What Do Your PT, PTT and INR results mean?What do my blood testsmean?

Partial Thromboplastin Time Blood Test-PTTThis test is performed primarily to determine if heparin (blood thinning) therapy is effective. It can also be used to detect the presence of a clotting disorder. It does not show the effects of drugs called low molecular weight heparin or most commonly by the brand name Lovenox.

Normal PTT Values: 30 to 45 seconds (this can value slightly from lab to lab)

Extended PTT times can be a result of anticoagulation therapy, liver problems, lupus and other diseases that result in poor clotting.

International Normalized Ratio Blood Test-INR

Normal INR Values: 1 to 2

The INR is used to make sure the results from a PT test is the same at one lab as it is at another lab. In the 1980s the World Health Organization determined that patients may be at risk because the results of a PT test would vary from one lab to another, based upon the way the test was done. The normal range for one lab would be different than a normal value from another lab, creating problems for patients who were being treated in several locations. In order to standardize the results between labs, the INR was created. The INR result should be the same, regardless of the location where the tests are performed.

Introduction: Self-introduction, Course syllabusIntroduction to blood: composition and multiple roles of bloodRed blood cells and functionsWhite blood cells and functionsPlatelets and functionsABO blood groups

Lecture outline

Blood Types and Cross-ReactionsIn a cross-reaction, antibodies react with their target antigens causing agglutination and hemolysis of the affected RBCs.Surface antigensOpposing antibodiesRBCAgglutination (clumping)Hemolysis

An individual either has, or does not have, the "Rhesus factor" on the surface of their red blood cells. This term strictly refers only to the most immunogenic D antigen of the Rh blood group system, or the Rh- blood group system.Rh factor

Differences in Blood Group Distribution

The hemolytic condition occurs when there is an incompatibility between the blood types of the mother and the fetus. There is also potential incompatibility if the mother is Rh negative and the father is positive. When any incompatibility is detected, the mother receives an injection at 28 weeks gestation and at birth to avoid the development of antibodies toward the fetus. These terms do not indicate which specific antigen-antibody incompatibility is implicated. The disorder in the fetus due to Rh D incompatibility is known as erythroblastosis fetalis.Hemolytic disease of the newborn

Blood TypingSurface AntigensAre cell surface proteins that identify cells to immune system Normal cells are ignored and foreign cells attackedBlood TypesAre genetically determinedBy presence or absence of RBC surface antigens A, B, Rh (or D)

Blood TypingFour Basic Blood TypesA (surface antigen A)B (surface antigen B)AB (antigens A and B)O (neither A nor B)

Blood TypingBlood Plasma AntibodiesType AType B antibodiesType BType A antibodiesType OBoth A and B antibodiesType ABNeither A nor B antibodies

ABO and Rh blood type donation showing matches between donor and recipient types

DonorsO+A+B+AB+O- A-B-AB-RecipientsO+A+B+AB+ *O-A-B-AB-

Why is it possible for a person with type A negative blood to have a reaction when receiving a large transfusion of whole type O negative blood?Some type O cells possess B agglutinogens on their surface.The Rh factor would cross-react.Blood transfusions can only occur within the same blood group.The type O blood may have high enough levels of anti-A antibodies that could cross-react with the recipients cells.

Next weekQuiz 1 (blood)Heart (Chapter 18)

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