Community College of Baltimore County

Revised Summer 2002

Catonsville Campus

Notes and Objectives

Ms. J. Ellen Lathrop-Davis, M. Sc.

Dr. Ewa Gorski, Ph. D.

Mr. Stephen Kabrhel, M. Sc.

Revised Summer 2002

Introduction

BIOL 221 Anatomy & Physiology II is a continuation of BIOL 220 Anatomy & Physiology I. As such, it builds on the concepts first learned in A&P I. You are expected to have successfully completed A&P I (C or better from CCBC or equivalent course from an accredited college or university). In most cases, information covered in A&P I will be utilized without being reviewed in A&P II. It is YOUR responsibility to make sure that you understand the material from A&P I. Selected review topics from A&P I are listed in the Appendix at the end of this lecture supplement. This list merely suggests the most important review topics and is not all-inclusive.

PowerPoint presentations given in class are available through the A&P II web page. Objectives for each topic available through the A&P II web page include live links to other relevant web pages. Web pages for your instructor can be accessed from the main A&P web page. Check your instructor’s page for additional resources.

Good luck and have a great semester!

J. Ellen Lathrop-Davis

Assistant Professor, Biology

BIOL221 Coordinator

Contents

Topic 1 Circulatory System: Blood p. 1

Topic 2 Circulatory System: Heart p. 17

Topic 3 Circulatory System: Blood Vessels p. 35

Topic 4 Circulatory System: Blood Flow, Blood Pressure, and Capillary Dynamics p. 43

Topic 5 Lymphatic System p. 59

Topic 6 Immune System – Resistance to Disease p. 65

Topic 7 Respiratory System p. 81

Topic 8 Digestive System p. 101

Topic 9 Nutrition, Metabolism and Thermoregulation p. 129

Topic 10 Urinary System p. 141

Topic 11 Fluid, Electrolyte and Acid-base Balance p. 157

Topic 12 Reproductive System p. 171

Topic 13 Survey of Development p. 181

Appendix Review Topics from A&P I p. 189

A&P Main Page: http://student.ccbc.cc.md.us/c_anatomy/index.html

A&P II Page: http://student.ccbc.cc.md.us/c_anatomy/ap2web/AP2index.htm

E. Lathrop-Davis / E. Gorski / S. Kabrhel i BIOL221: Anatomy & Physiology II

Revised Summer 2002

TOPIC 1

Circulatory System – Blood

Ch. 18, pp. 651-677

Objectives

Introduction

1. List the major components of the circulatory system.

2. List and describe the major functions of the circulatory system.

Characteristics and Functions of Blood

1. Describe the main physical characteristics of blood.

2. Categorize blood as one of the 4 main types of tissue; defend your answer.

3. List and describe the functions of blood in the body.

4. Define and describe plasma and serum.

5. List the major types of proteins found in plasma and describe their functions.

Erythrocytes

1. Describe the structure and function of erythrocytes.

2. Relate the structure of erythrocytes to their function in transportation of respiratory gases.

3. Describe the structure and function of hemoglobin.

4. Describe the formation and degradation of erythrocytes.

5. Describe the methods of measuring/estimating erythrocyte abundance and estimating production using reticulocyte counts and explain their clinical importance.

6. Describe the methods for assessing the blood’s ability to carry oxygen and explain their clinical importance.

7. Discuss the pros and cons of blood doping.

8. Explain the basis and importance of blood typing.

9. Describe ABO and Rh blood typing and the basis and significance of cross-reactions.

Leukocytes

1. List the type of leukocytes in order of their normal relative abundance and describe the structural features of each.

2. Differentiate between granulocytes and agranulocytes.

3. Describe the process and regulation of white blood cell formation.

4. Discuss the role of leukocytes in phagocytosis and antibody production.

5. Explain the process and significance of white blood cell and differential white blood cell counts.

Hemostasis

1. List and describe the three mechanisms (“phases”) by which the body limits bleeding.

2. Discuss the structure and formation of platelets.

3. Describe the role of platelets in platelet plug formation and coagulation.

4. Describe the stages of platelet plug formation.

5. Describe the regulation of platelet plug formation including stimulation and limitation.

6. Define and differentiate between the intrinsic and extrinsic pathways of blood coagulation.

7. Describe the major stages of the intrinsic and extrinsic pathways of blood coagulation.

8. List the factors that promote or inhibit coagulation.

9. Explain the roles of vitamin K and calcium ions in coagulation.

10. Discuss how the body controls clotting.

11. Discuss the clinical use of heparin, aspirin and coumadin.

12. Define clotting time and bleeding time.

13. Discuss clot retraction and fibrinolysis.

Disorders

1. Describe the following disorders of blood.

a. Anemias (Sickle cell anemia; Hemorrhagic anemia; Iron-deficiency anemia; Pernicious anemia)

b. Thalassemia

c. Jaundice

d. Erythroblastosis fetalis

e. Mononucleosis

f. Polycythemia

g. Neutrophilia

h. Eosinophilia

i. Thrombocytopenia

j. Thrombocytosis

k. Acute leukemia

l. Chronic leukemia

m. Thrombosis

n. Embolism

o. Infarct (stroke, myocardial infarct)

p. Hemophilia

q. Von Willebrand disease

2. Relate the effects of sickle cell anemia and thalassemia to the structure of erythrocytes.

3. Compare and contrast the causes of iron-deficiency anemia, pernicious anemia and

E. Lathrop-Davis / E. Gorski / S. Kabrhel 1 Circulatory System: Blood

Revised Summer 2002

Topic 1: Circulatory System – Blood

E. Lathrop-Davis / E. Gorski / S. Kabrhel 3 Circulatory System: Blood

Revised Summer 2002

I. Major Components of the Circulatory System Fig. 20.2, p. 720

A. Blood

B. Heart

C. Blood vessels

II. Major Functions of the Circulatory System

A. Transportation

B. Protection

1. Against disease and toxins

2. Against blood loss

C. Regulation

1. Blood pressure

2. Blood volume

3. Body temperature

*Most functions are most directly accomplished by blood

III. Blood

A. Physical Characteristics

1. Specific gravity = 1.045-1.065

2. Viscosity = 4.5-5.5

3. pH = 7.35 – 7.45

4. Volume = 7-9% of body weight

a. 5-6 L in males

b. 4-5 L in females

5. Temperature = 100.4 oF (38 oC)

B. Connective tissue: Fig. 18.1, p. 651

1. Cells & cell fragments = “formed elements”

a. erythrocytes = RBCs (99.9%) – carry O2 and CO2

b. leukocytes = WBCs – fight disease

c. thrombocytes = platelets (cell fragments) - hemostasis

2. Matrix (plasma)

a. ground substance (serum)

b. plasma proteins

C. Plasma: definition and composition

1. Definitions

a. Plasma = whole blood minus cells

b. Serum = plasma without protein clotting factors

2. Constituents

a. 92% water

b. 7% plasma proteins

c. 1% other solutes (including inorganic ions [electrolytes], organic nutrients and wastes, respiratory gases)

D. Plasma proteins

1. Most made by liver

2. Albumins (~ 60%)

a. exert osmotic force

b. buffer pH

3. Globulins (~ 35%)

a. immunoglobulins (antibodies) – protect against disease

b. transport proteins (e.g., transferring) - bind ions and small molecules

4. Fibrinogen (~ 4% of all plasma proteins) – soluble protein essential to clotting

5. Other plasma proteins:

a. hormones (e.g., insulin, glucagon)

b. clotting factors (prothrombin)

c. enzymes (e.g., renin)

d. proenzymes (e.g., several proteins involved in clotting)

E. Erythrocytes (RBCs)

1. Functions

a. transport of respiratory gases

Transports about 98.5% of O2 (oxyhemoglobin); about 23% of CO2 (carbaminohemoglobin)

b. Aids conversion of CO2 to bicarbonate (HCO3-)

2. Characteristics Fig. 18.3, p. 654

a. Small, biconcave disk

b. Anucleate, no ribosomes effect on prot. synth?

c. No mitochondria effect on ATP synthesis?

d. Average diameter = 7-8 micrometers (μm)

e. Mean corpuscular volume (MCV)

1) microcytic

2) macrocytic

f. Life span ~ 120 days (or less)

3. Measuring abundance

a. Normally, RBCs account for 99.9% of all formed elements

b. Red blood cell count

1) males: 4.5-6.3 x 106 / mm3 (microliter)

2) females: 4.2-5.5 x 106 / mm3

3) polycythemia

c. Hematocrit – packed cell volume (PCV)

1) males: average 45 (range: 40-54%)

2) females: average 42% (range 37-47%)

3) minimum hematocrit to donate blood = 38%

4) “buffy coat”

5) blood doping

4. Hemoglobin (Hb) Fig. 18.4, p. 655

a. Accounts for > 95% of protein in RBC

b. Main functions:

1) O2 transport

2) CO2 transport

3) aids blood pressure regulation

c. Globular protein with quaternary structure: 2 alpha chains & 2 beta chains

d. Heme

1) non-protein, lipid-like structure

2) porphyrin ring with iron center (binds oxygen)

3) 4 heme per hemoglobin (one per chain)

e. Hemoglobin content of blood

1) measured as g of hemoglobin /dl of blood (grams per deciliter, or 100 ml)

i. male: 14-18 g/dl (g/100 ml)

ii. female: 12-16 g/dl

iii. infants: 14-20 g/dl

2) mean corpuscular Hb (hemoglobin concentration/number of RBCs)

i. normochromic

ii. hypochromic

iii. hyperchromic

5. Location of erythrocyte formation (erythropoiesis)

a. 1st 8 weeks of fetal development, RBCs formed in yolk sac

b. 2nd to 5th months fetal development, RBCs formed in liver (main supplier), spleen, thymus (WBCs), bone marrow (begins in bone marrow during 5th month)

c. Post-natal development and in adults, formed in red bone marrow (myeloid tissue)

1) portions of vertebrae, ribs, scapula, skull, pelvis, proximal heads of femur and humerus

2) yellow marrow can be converted into red marrow, if needed

6. Stages of erythropoiesis Fig. 18.5, p. 656

a. Hemocytoblasts

b. Proerythroblasts

c. Erythroblasts

d. Normoblasts

e. Reticulocyte

1) contains ribosomes and mitochondria àHb synthesis continues

2) leaves bone marrow after 2 days

3) reticulocyte count: normally ~ 0.8% of RBC population (0.8-2.0%)

f. Mature RBC

7. Control of erythropoiesis – under influence of erythropoietin

a. Erythropoietin secreted by kidney under hypoxic conditions:

1) anemia

2) decreased blood flow to kidney

3) decreased oxygen availability

b. Erythropoietin stimulates:

1) increased cell division of stem cells and erythroblasts

2) increased maturation by increasing rate of Hb synthesis

3) negative feedback control Fig. 18.6, p. 657

c. Other factors influencing rate of erythropoiesis

1) indirectly stimulated by thyroxine, androgens, growth hormone

2) adequate diet

i. amino acids

ii. vitamins (B12, B6, folic acid)

(a) pernicious anemia

iii. iron (Fe)

(a) iron-deficiency anemia

8. Erythrocyte recycling

a. 10% hemolyzed

b. 90% phagocytized by macrophages in spleen, liver, bone marrow

1) amino acids released into blood

2) heme broken into Fe and heme

i. Fe transported as transferrin to red bone marrow for reincorporation into Hb or to liver or spleen for storage as ferritin or hemosiderin

ii. porphyrin ring converted to biliverdin à bilirubin (or other forms)

(a) excreted in bile and released in feces

(b) excreted in urine

(i) liver dysfunction

(ii) excessive rupture of RBCs

(iii) obstruction of bile passageways

9. Blood typing

a. Based on surface antigens (integral glycoproteins)

b. At least 50 kinds of proteins used

c. Most common

1) ABO blood group Fig. 18.15, p. 675

2) Rh factor (D)

d. Cross reactions

1) agglutination

2) erythroblastosis fetalis

i. Rhogam

E. Lathrop-Davis / E. Gorski / S. Kabrhel 3 Circulatory System: Blood

Revised Summer 2002

ABO blood types

(see also Table 18.4 p. 673)

Blood Type / A / B / AB[1] / O[2]
Agglutinogens (antigen proteins) Present / A / B / A & B / (neither)
Makes Agglutinins (antibodies) Against / B / A / (neither) / A & B
May Receive Blood From: / A, O / B, O / A, B, AB, O / O
May Give Blood To: / A, AB / B, AB / AB / A, B, AB, O
Genotype / IAIA or IAi / IBIB or IBi / IAIB / ii
Rh Factor / Present or Absent
(A+ or A-) / Present or Absent
(B+ or B-) / Present or Absent
(AB+ or AB-) / Present or Absent
(O+ or O-)

Rhesus (Rh) Factor

Blood Type / Rh+ / Rh-
Agglutinogen D (antigen proteins)
Present or Absent / Present / Absent
Makes Agglutinins (antibodies) Against Agglutinogen / No / Yes[3]
May Receive Blood From: / Rh+ or Rh- / Rh-[4]
May Give Blood To Without Reaction4: / Rh+ / Rh+ or Rh
Genotype / DD or Dd / dd

E. Lathrop-Davis / E. Gorski / S. Kabrhel 3 Circulatory System: Blood

Revised Summer 2002

10. RBC and associated disorders

a. Thalassemia – genetic inability to produce adequate amounts of alpha or beta chains; results in limited production of fragile, short-lived RBCs

b. Sickle-cell anemia – genetic mutation in which 7th amino acid in beta chain is changed; causes Hb molecules to stick when oxygen is not bound leading to characteristic sickle shape of RBCs

c. Other anemias

1) iron-deficiency anemia

2) pernicious anemia

3) hemorrhagic anemia

d. Hemoglobinuria

F. Leukocytes

1. Functions:

a. fight pathogens (provide innate and adaptive resistance)

b. clear debris

c. fight cancer

2. Normal abundance – 5,000-10,000 cells / mm3

a. Leukopenia (< 5,000 cells/mm3)

b. Leukocytosis (>10,000 cells/mm3)

1) normal with disease

2) 100,000 WBCs / mm3 not uncommon with certain types of leukemia

3. Differential WBC count

a. Relative abundance of different kinds of WBCs

b. Accomplished by counting number of each different type in a total of 100 WBCs

4. Types

a. Granulocytes

1) neutrophils: 40-70%

i. phagocytic, especially against bacteria; large number of lysosomes in cytoplasm; highly mobile

ii. 10-14 um in diameter

iii. short life spans (~ 10 hrs; less if highly active)

iv. neutrophilia

2) eosinophils: 2-4%

i. 10-14 μm in diameter

ii. phagocytize antibody-covered objects (bacteria, cellular debris, parasitic worms and protozoa); also respond during allergic reactions; release nitric oxide and cytotoxic enzymes onto target particles

iii. eosinophilia

3) basophils: < 1%

i. 10-12 μm in diameter

ii. accumulate in damaged tissues where they release histamine and heparin

iii. basophilia

b. Agranulocytes

1) lymphocytes: 20-30%

i. 5-17 μm in diameter

ii. most remain in lymphatic tissue

iii. 3 classes of circulating lymphocytes

(a) T cells

(b) B cells

iv. increase associated with a number of infections, especially viral

2) monocytes: 2-8%