1-30-12 Monday

PHYS/PATH

Blood types: A,B,AB,O
AB is universal recipient, O is universal donor
Rh factor, if you have it you're positive, if you don't, you're negative

Mom with Rh- and baby with Rh+ can lead to Hemolytic disease of newborn (HDN)

uses of blood-last 35 days in blood bank
transfusion
hemopheresis
plasmapheresis
use plasma: replace blood volume, replace clotting factor
hematocrit: normal, anemia, poly c_____
hemaglobin: carries o2
blood cell count, smear, CBC complete blood count
also a blood chemistry test
coagulation studies- bleed time, clot time
bone marrow biopsy, ouch

CHAPT 13- THE HEART

heart, pumps and valves, circulation
location b/w lungs, left side, tilted left, T5-T6 apex, media stinum?
structure 3 layers
endocardium: lines heart interior
myocardium: thickest layer, heart mm
epicardium: thin outmost layer
Pericardium: protective bag around heart, symbol is dog (protector)
Fibrous pericardium holds heart in place
Serous membrane: parietal layer: body cavity side?
pericardial cavity: in between
visceral layer (epicardium): heart side
Myocardium
lightly striated
single nucleous
involuntary
*p.247
4 chambers of heart: R,L atrium; R,L ventricle
4 valves: atrioventriculart valve; tricuspid, mitral/bicuspid.
semilaunar valves
Blood supply to myocardium
coronary circulation
R coronary, Left, coronary sinus
cardiac output; CO=HR 3 SV

Heart conduction system
electrical energy stimulates heart mm
nodes:
-sinoatrial (SA) node (pacemaker): right atrium, generates action potentials
-atrioventricular (AV) nodes
Specialised fibers
-atrioventricular bundle (bundle of His)
-Parkinje fibers (conduction myofibers)
Intercalated disk

Conduction pathway
control heart rate
-autonomic nerve system (ANS)
sympathetic nerv..
parasympathetic
-cranial nerve X vagus
Bradycardia: slow bpm
tachycardia: fast bpm
sinus arrhythmia: an occasional extra beat, normal on occasion
premature beat (extrasystole)
systolic/systole: pressure with the beat
diastolic/diastole: pressure with rest

sounds: lub, dup, murmurs (extra noises)-organic, functional
in elderly: shrink, decrease strength, damage, blockage
factors: smoking, diet, weight, diabetes, gout
stethoscope, ECG, EKG, cath, echo

p.247: chordae tendinease, papillary mm
foramen oval?: closes with first breath

CHAPTER 14
Vascular system: closed system
blood vessels, 4 heart chambers
arteries, arterioles, capillaries, venules, veins
Circuits- 2 groups
Pulmonary
-pulmonary artery and its branches
-capilleries in lungs
-pulmonary vein
Systemic circuit
-aorta
-systemic capillary
-systemic vein

Vessel struct.
3 tunic (coats) of artery and vein
Inner (endothelium) tunic
Middle (smooth involuntary mm) tunic
-controlled by ANS
-thinner in veins
Outer (supporting connective tissue)tunic

capillaries are simple squamous

Systemic Arteries
*aorta: largest artery, receives blood form L ventricle, branches to all organs
ascending aorta-coming up out of heart
aortic arch-bend to go down
thoracic aorta-chest
abdominal aorta- below diaphragm
-cleiac trunk
-superior/inferior mesenteric
-paired lateral branches
Iliac arteries

*anastomoses- communication b/w 2 vessels
**circle of Willis
superficial palmar arch
mesenteric
arterial
*middle cerebral artery most common in stroke

Systemic veins
-superficial veins
cephalic, etc.
saphenous vein
-Deep veins
femoral and iliac, brachial, axillary subclavian .....
superior/inferior vena cava
azygos vein-chest wall
*hepatic portal system: carries blood from ab organs to liver


capillary exchange
diffusion (main process)
bp-moves material into tissue fluid
osmotic- move material into cap.

hydrostatic pressure: push fluid out of capillary
oncotic(osmotic) pressure: water (fluid) back in capillary bed

Nervous system in brain
medulla regulates vasomotor activity
vasodialation/constriction
precapillary sphincter

return blood: contraction of skel. mm, valves, breathing
Pulse: ventricules contract, recoil. Body size, age, activity, emotional state
BP: force on vessel wall: increase bp can cause damage. thickness also determines pressure

Resistance blood flow
peripheral resistance is affected by:
-vasomotor changes
-baroreceptors in large arteries (pressure recept)
-elasticity of blood vessel
-viscosity , total blood volume
BPM-sphygmomanometer: bp cuff
systolic pressure: contraction 120mmHg normal
diastolic: relax 80mmHg normal