Heart Anatomy
Location
Superior surface of diaphragm
Left of the midline
Anterior to the vertebral column,
posterior to the sternum
Heart Covering
Pericardial physiology
Protects and anchors heart
Prevents overfilling
Heart Covering
Pericardial anatomy
Fibrous pericardium
Serous pericardium (separated by
pericardial cavity)
Epicardium (visceral layer)
Heart Wall
External
Heart:
Vessels
that
Supply/Drain the Heart (Posterior View)
Frontal
section
showing
interior
chambers and valves
Papillary
muscles
and
trabeculae
carneae muscles mark ventricular walls
Left
atrium bicuspid
valve left
ventricle
Left
ventricle aortic
semilunar
valve aorta
Heart muscle:
Is stimulated by nerves and selfexcitable (automaticity)
Contracts as a unit
Has a long (250 ms) absolute
refractory period
Autorhythmic cells:
Initiate action potentials
Have unstable resting potentials
called pacemaker potentials
Use calcium influx (rather than
sodium) for rising phase of the action
potential
Heart Physiology: Intrinsic Conduction
System
Heart
Physiology:
Sequence
of
Excitation
Heart
is
inhibited
by
the
parasympathetic cardioinhibitory center
Electrocardiography
Ventricular systole
Atria relax
Rising ventricular pressure results in
closing of AV valves
Isovolumetric contraction phase
Ventricular ejection phase opens
semilunar valves
Phases of the Cardiac Cycle
Blood
loss
and
extremely
rapid
heartbeat decrease SV
Preload and Afterload
Extrinsic Factors Influencing Stroke
Volume
Contractility
is
the
increase
in
contractile
strength,
independent
of
stretch and EDV
Agents/factors
that
decrease
contractility include:
Acidosis
Increased extracellular potassium
Calcium channel blockers
Contractility and Norepinephrine
Sympathetic
stimulation
releases
norepinephrine and initiates a cyclic AMP
second-messenger system
Regulation of Heart Rate: Autonomic
Nervous System
PNS
dominates
the
autonomic
stimulation, slowing heart rate and
causing vagal tone
Bainbridge Reflex
Bainbridge
(atrial)
reflex
a
sympathetic reflex initiated by increased
blood in the atria
Causes stimulation of the SA node
Stimulates baroreceptors in the atria,
causing increased SNS stimulation
Chemical Regulation of the Heart
The
hormones
epinephrine
and
thyroxine increase heart rate
Intraand
extracellular
ion
concentrations must be maintained for
normal heart function
Factors Involved in Regulation of
Cardiac Output
Homeostatic Imbalances
Hypernatremia
blocks
heart
contraction by inhibiting ionic calcium
transport
Atherosclerosis
Blood
Overview of Blood Circulation
Blood transports:
Oxygen from the lungs and nutrients
from the digestive tract
Metabolic wastes from cells to the
lungs and kidneys for elimination
Hormones from endocrine glands to
target organs
Regulation
Blood maintains:
Appropriate body temperature by
absorbing and distributing heat
Normal pH in body tissues using
buffer systems
Adequate
fluid
volume
in
the
circulatory system
Protection
glucose,
carbohydrates, amino acids
Electrolytes sodium, potassium,
calcium, chloride, bicarbonate
Respiratory gases oxygen and
carbon dioxide
Formed Elements
Contain
the
plasma
membrane
protein spectrin that:
Structural
characteristics
that
contribute to its gas transport function
are:
Biconcave shape that has a huge
surface area to volume ratio
Discounting
water
content,
erythrocytes are 97% hemoglobin
ATP is generated anaerobically, so the
erythrocytes do not consume the
oxygen they transport
Erythrocyte Function
Erythrocytes
are
dedicated
to
respiratory gas transport
Hemoglobin
reversibly
binds
with
oxygen and most oxygen in the blood is
bound to hemoglobin
Each
hemoglobin
molecule
can
transport four molecules of oxygen
Hemoglobin (Hb)
Carbaminohemoglobin hemoglobin
bound to carbon dioxide
Carbon dioxide loading takes place in
the tissues
Production of Blood Cells
Erythropoiesis requires:
Proteins, lipids, and carbohydrates
Iron, vitamin B12, and folic acid
Hemolytic
anemia
prematurely
ruptured erythrocytes
Macrophages:
Are highly mobile and actively
phagocytic
Activate lymphocytes to mount an
immune response
Production of Leukocytes
All
leukocytes
originate
from
hemocytoblasts
Hemocytoblasts
differentiate
into
myeloid stem cells and lymphoid stem
cells
Lymphoid
stem
cells
become
lymphoblasts
involves
myeloblasts
Lymphocytic leukemia involves
lymphocytes
Treatments
include
irradiation,
antileukemic drugs, and bone marrow
transplants
Platelets
Platelets
are
fragments
of
megakaryocytes with a blue-staining outer
region and a purple granular center
immediate
vasoconstriction in response to injury
Platelet plug formation
Coagulation (blood clotting)
Platelet Plug Formation
Coagulation
follows
intrinsic
and
extrinsic pathways
Coagulation
Repair
Platelet-derived growth factor (PDGF)
stimulates rebuilding of blood vessel
wall
Fibroblasts form a connective tissue
patch
Endothelial cells multiply and restore
the endothelial lining
Factors
Limiting
Clot
Growth
or
Formation
There
are
eight
different
Rh
agglutinogens, three of which (C, D, and E)
are common
Anti-Rh
antibodies
are
not
spontaneously formed in Rh individuals
Transfusion
reactions
occur
when
mismatched blood is infused
Plasma expanders:
Have osmotic properties that directly
increase fluid volume
Are used when plasma is not available
Examples: purified human serum
albumin, plasminate and dextran
Microscopic examination:
Variations in size and shape of RBCs
predictions of anemias
Type and number of WBCs
diagnostic of various diseases
Abnormal
thrombus
and
embolus
formation
reflects
the
progress
of
atherosclerosis
The
Cardiovascular
Vessels
System:
Blood
Blood Vessels
Capillaries
are
composed
of
endothelium with sparse basal lamina
Tunica media
Smooth muscle and elastic fiber layer,
regulated by sympathetic nervous
system
Controls vasoconstriction/vasodilation
of vessels
Found
wherever
active
capillary
absorption or filtrate formation occurs
(e.g., small intestines, endocrine glands,
and kidneys)
Characterized by:
An endothelium riddled with pores
(fenestrations)
Greater permeability to solutes and
fluids than other capillaries
Sinusoids
A
microcirculation
of
interwoven
networks of capillaries, consisting of:
Vascular
shunts
metarteriole
thoroughfare channel connecting an
arteriole directly with a postcapillary
venule
True capillaries 10 to 100 per
capillary bed, capillaries branch off the
metarteriole
and
return
to
the
thoroughfare channel at the distal end
of the bed
The Respiratory System
Respiratory System
Respiratory zone
Site of gas exchange
Consists of bronchioles, alveolar
ducts, and alveoli
Conducting zone
Provides rigid conduits for air to reach
the sites of gas exchange
Includes all other respiratory
structures (e.g., nose, nasal cavity,
pharynx, trachea)
Olfactory mucosa
Lines the superior nasal cavity
Contains smell receptors
Respiratory mucosa
Lines the balance of the nasal cavity
Glands secrete mucus containing
lysozyme and defensins to help destroy
bacteria
Valsalvas maneuver
Air is temporarily held in the lower
respiratory tract by closing the glottis
Causes intra-abdominal pressure to
rise when abdominal muscles contract
Empties the bladder or rectum
Acts as a splint to stabilize the trunk
when lifting heavy loads
Trachea
Bronchioles
Consist of cuboidal epithelium
Have a complete layer of circular
smooth muscle
Lack cartilage support and mucusproducing cells
Respiratory Zone
Alveolar walls:
Are a single layer of type I epithelial
cells
Permit gas exchange by simple
diffusion
Secrete angiotensin converting
enzyme (ACE)
Alveoli
Parietal pleura
P = pressure of a gas in mm Hg
V = volume in cubic millimeters
Subscripts 1 and 2 represent the
initial and resulting conditions,
respectively
Inspiration
Examples include:
Deformities of thorax
Ossification of the costal cartilage
Paralysis of intercostal muscles
Respiratory Volumes
Alveolar Ventilation
Respiratory membranes:
Are only 0.5 to 1 mm thick, allowing
for efficient gas exchange
Have a total surface area (in males) of
5070 m2 (40 times that of ones skin)
Thicken if lungs become waterlogged
and edematous, whereby gas exchange
is inadequate and oxygen deprivation
results
Decrease in surface area with
emphysema, when walls of adjacent
alveoli break
Internal Respiration
At the tissues:
Bicarbonate quickly diffuses from
RBCs into the plasma
Chloride shift to counterbalance the
outrush of negative bicarbonate ions
from the RBCs, chloride ions (Cl) move
from the plasma into the erythrocytes
Pons centers:
Influence and modify activity of the
medullary centers
Smooth out inspiration and expiration
transitions and vice versa
As exercise begins:
Ventilation increases abruptly, rises
slowly, and reaches a steady-state
Intrinsic controls
Nerve plexuses near the GI tract
initiate short reflexes
Short reflexes are mediated by local
enteric plexuses (gut brain)
Extrinsic controls
Long reflexes arising within or outside
the GI tract
Involve CNS centers and extrinsic
autonomic nerves
Digestive System Organs and
Peritoneum
Peritoneal cavity
Lubricates digestive organs
Allows them to slide across one
another
Lamina Propria
Loose areolar and reticular connective
tissue
Nourish the epithelium and absorb
nutrients
Contains lymph nodes (part of MALT)
important in defense against bacteria
To withstand abrasions:
The mouth is lined with stratified
squamous epithelium
The gums, hard palate, and dorsum of
the tongue are slightly keratinized
Lips and Cheeks
Functions include:
Gripping and repositioning food
during chewing
Mixing food with saliva and forming
the bolus
Initiation of swallowing, and speech
Periodontal ligament
Anchors the tooth in the alveolus of
the jaw
Forms the fibrous joint called a
gomaphosis
Accumulation of calculus:
Disrupts the seal between the
gingivae and the teeth
Puts the gums at risk for infection
Food is ingested
Pharyngeal-esophageal phase
controlled by the medulla and lower pons
All routes except into the digestive
tract are sealed off
The stomach:
Holds ingested food
Degrades it both physically and
chemically
Delivers chyme to the small intestine
Enzymatically digests proteins with
pepsin
Secretes intrinsic factor required for
absorption of vitamin B12
Regulation of Gastric Secretion
Chyme is either:
Delivered in small amounts to the
duodenum or
Forced backward into the stomach for
further mixing
Regulation of Gastric Emptying
Production of bile
Processing bloodborne nutrients
Storage of fat-soluble vitamins
Detoxification
Cholecystokinin causes:
The gallbladder to contract
The hepatopancreatic sphincter to
relax
Gallstones crystallization of
cholesterol which can obstruct the flow of
bile
Location
Lies deep to the greater curvature of
the stomach
The head is encircled by the
duodenum and the tail abuts the spleen
Exocrine function
Secretes pancreatic juice which
breaks down all categories of foodstuff
Acini (clusters of secretory cells)
contain zymogen granules with
digestive enzymes
Examples include
Trypsinogen is activated to trypsin
Procarboxypeptidase is activated to
carboxypeptidase
These bacteria:
Colonize the colon
Ferment indigestible carbohydrates
Release irritating acids and gases
(flatus)
Synthesize B complex vitamins and
vitamin K
Functions of the Large Intestine
Haustral contractions
Slow segmenting movements that
move the contents of the colon
Haustra sequentially contract as they
are stimulated by distension
Salmonellosis is treated
symptomatically
Chemical Digestion: Carbohydrates
Ca2+ absorption:
Is related to blood levels of ionic
calcium
Is regulated by Vitamin D and
parathyroid hormone (PTH)
Water Absorption
Juxtamedullary nephrons:
Are located at the cortex-medulla
junction
Have loops of Henle that deeply
invade the medulla
Have extensive thin segments
Are involved in the production of
concentrated urine
Capillary Beds of the Nephron
Macula densa
Tall, closely packed distal tubule cells
Lie adjacent to JG cells
Function as chemoreceptors or
osmoreceptors
The filtrate:
Contains all plasma components
except protein
Loses water, nutrients, and essential
ions to become urine
Glomerular filtration
Tubular reabsorption
Secretion
Glomerular Filtration
Under stress:
Norepinephrine is released by the SNS
Epinephrine is released by the adrenal
medulla
Afferent arterioles constrict and
filtration is inhibited
Angiotensin I is converted to
angiotensin II
Angiotensin II:
Causes mean arterial pressure to rise
Stimulates the adrenal cortex to
release aldosterone
Loop of Henle
H2O, Na+, Cl-, K+ (descending)
Ca2+, Mg2+, and Na+ (ascending)
DCT
Ca2+, Na+, H+, K+, and water
HCO3- and Cl
Collecting duct
Water and urea
Na+ Entry into Tubule Cells
Osmolality
The number of solute particles
dissolved in 1L of water
Reflects the solutions ability to cause
osmosis
Odor
Fresh urine is slightly aromatic
Standing urine develops an ammonia
odor
Some drugs and vegetables
(asparagus) alter the usual odor
pH
Slightly acidic (pH 6) with a range of
4.5 to 8.0
Diet can alter pH
Specific gravity
Ranges from 1.001 to 1.035
Is dependent on solute concentration
Chemical Characteristics of Urine
Voiding reflexes:
Stimulate the detrusor muscle to
contract
Inhibit the internal and external
sphincters
Developmental Aspects