BIO 235 ANATOMY AND PHYSIOLOGY II

Instructor: Dr. Liming Liu lliu@york.cuny.edu Office Hours: Saturday 8:00 -8:50 AM in room AC4M06
Copy righted material (Pearson) for students taking A&P II at York College only

Please sign in on the attendance sheet Please pick up a copy of syllabus

Lecture outline
1. Introduction: Self-introduction, Course syllabus 2. Introduction to blood: composition and multiple roles of blood 3. Red blood cells and functions 4. White blood cells and functions 5. Platelets and functions 6. ABO blood groups

About the course syllabus

Required Text and Materials Textbook: 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.

Academic Integrity

Grading Policy
Lecture: 65% Quizzes/assignments: Exams: (3 X %) Final Exam (Cumulative) Lab: 35% Quizzes/assignments: Exams: (3 X %) Final exam (Cumulative) 10% 60% 30%

20% 60% 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.

Lecture Schedule
Class date Week 1(8/31) Topic Circulatory System: Blood Chapter(s) 17

Week 2 (9/7)

Quiz 1. Circulatory System: 18 The Heart

Week 3 (9/21) Week 4 (9/28) Week 5 (10/5)

Exam 1, (continued)

The

Heart 18

Circulatory System: Blood 19 Vessels Quiz 2. Lymphatic System 20

Academic Integrity
Departmental 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.

Blackboard
All 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 Description
This 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 Objectives
Describe 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 systems Describe 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 scenarios Perform functional testing such as spirometery, and urinalysis Use a microscope to perform complete blood count with differential WBC count

Lets introduce ourselves

Form 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.

Lecture outline
1. Introduction: Self-introduction, Course syllabus

2. Introduction to blood: composition and multiple roles of blood

3. 4. 5. 6. Red blood cells and functions White blood cells and functions Platelets and functions ABO blood groups

7%

Plasma

Plasma Proteins

1%
4663% Other Solutes Water

92%

Formed Elements

Platelets White Blood Cells Red Blood Cells

< .1%

3754%

< .1%

99.9%

 Albumins (60%)
Transport substances such as fatty acids, thyroid hormones, and steroid hormones

Globulins (35%)
Antibodies, also called immunoglobulins
Transport globulins (small molecules): hormone-binding proteins, metalloproteins, apolipoproteins (lipoproteins), and steroid-binding proteins

Fibrinogen (4%)
Molecules that form clots and produce long, insoluble strands of fibrin

 Origins of Plasma Proteins

More than 90% made in liver Antibodies made by plasma cells Peptide hormones made by endocrine organs

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

A. Plasma B. Buffy coat C. Erythrocytes D. Hematocrit

The major function of the most common plasma protein, albumin, is __________.

A. maintenance of plasma osmotic pressure B. buffering changes in plasma pH C. fighting foreign invaders D. both a and b

Lecture outline
1. Introduction: Self-introduction, Course syllabus 2. Introduction to blood: composition and multiple roles of blood

3. Red blood cells and functions

4. White blood cells and functions 5. Platelets and functions 6. ABO blood groups

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?

A. Red blood cells lack mitochondria. B. Red blood cells dont divide. C. Red blood cells are biconcave discs. D. Red blood cells contain myoglobin.

Where does this process occur?

 Fetal Hemoglobin
Strong form of hemoglobin found in embryos Takes oxygen from mothers hemoglobin

Oxygen binds to the _______ portion of hemoglobin.

A. globin B. oxyhemoglobin C. iron atom D. amino acid

A patient with low iron levels would experience which of the following symptoms?

A. An increased white blood cell count B. An increase in energy level C. An increase in fatigue D. A decreased white blood cell count

Vitamin deficiency anemia

Vitamin 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 Turnover

1% of circulating RBCs wear out per day
About 3 million RBCs per second

Hemoglobin Conversion and Recycling

Macrophages of liver, spleen, and bone
marrow
Monitor RBCs Engulf RBCs before membranes rupture (hemolyze)

 Hemoglobin Conversion and Recycling

Phagocytes break hemoglobin into components
Globular proteins to amino acids
Heme to biliverdin Iron

 Hemoglobin Conversion and Recycling

Hemoglobinuria
Hemoglobin breakdown products in urine due to

excess hemolysis in bloodstream

Hematuria
Whole red blood cells in urine due to kidney or tissue damage

 Iron Recycling
Iron removed from heme leaving biliverdin To transport proteins (transferrin) To storage proteins (ferritin and hemosiderin)

Recycling of Red Blood Cell Components

Events Occurring in Macrophages Events Occurring in the Red Bone Marrow

Macrophages in liver, spleen, and bone marrow

Fe2+ Heme Amino acids Average life span of RBC is 120 days Old and damaged RBCs New RBCs released into In the bloodstream, circulation the rupture of RBCs is called hemolysis. Fe2+ transported in circulation by transferrin

RBC formation

90% Biliverdin Bilirubin Bilirubin bound to albumin in bloodstream 10%

Hemoglobin that is not phagocytized breaks down, and the alpha and beta chains are eliminated in urine. Kidney

Liver Bilirubin Hb

Absorbed into the circulation Excreted in bile

Urobilins

Bilirubin

Urobilins, stercobilins

Eliminated in urine

Events Occurring in the Liver

Events Occurring in the Large Intestine

Eliminated in feces

Events Occurring in the Kidney

Predict the outcome of an overdose of the hormone erythropoietin.

A. The blood viscosity increases to levels that may induce heart attacks or strokes. B. The oxygen-carrying capacity remains unchanged despite elevated red blood cell counts. C. Red blood cell counts remain unchanged, but the number of reticulocytes increases. D. Blood viscosity levels decrease while oxygencarrying capacity increases.

What response would you expect after traveling to high altitude for two weeks?
A. Blood levels of oxygen would remain depressed for the duration. B. A surge in iron release from the liver would occur. C. The kidneys would secrete elevated amounts of erythropoietin. D. 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

__________.
A. would have reduced blood iron levels B. would have a decreased number of red blood cells C. would have increased levels of hemoglobin D. would not experience any effects on red blood cells

sickle cell anemia

Lecture outline
1. Introduction: Self-introduction, Course syllabus 2. Introduction to blood: composition and multiple roles of blood 3. Red blood cells and functions

4. White blood cells and functions

5. Platelets and functions 6. ABO blood groups

White blood cells

RBC RBC RBC RBC

RBC

Neutrophil

LM 1500

Eosinophil LM 1500

Basophil

LM 1500

Monocyte

LM 1500

Lymphocyte LM 1500

White Blood Cells

White Blood Cells (WBCs)
Also called leukocytes

Do not have hemoglobin

Have nuclei and other organelles

WBC functions:
Defend against pathogens Remove toxins and wastes Attack abnormal cells

White Blood Cells

WBC Circulation and Movement
Four Characteristics of Circulating WBCs
1. Can migrate out of bloodstream 2. Have amoeboid movement 3. Attracted to chemical stimuli (positive

chemotaxis)
4. Some are phagocytic
Neutrophils, eosinophils, and monocytes

 Neutrophil Action
5070% of circulating WBCs

Very active, first to attack bacteria

Engulf and digest pathogens Degranulation
Removing granules from cytoplasm Defensins (peptides from lysosomes) attack

pathogen membranes

Release prostaglandins and leukotrienes Form pus

 Eosinophils (Acidophils)
24% of circulating WBCs Attack large parasites

Excrete toxic compounds

Nitric oxide Cytotoxic enzymes

Are sensitive to allergens

Control inflammation with enzymes that counteract inflammatory effects of neutrophils and mast cells

 Basophils
Are less than 1% of circulating WBCs Accumulate in damaged tissue Release histamine
Dilates blood vessels

Release heparin
Prevents blood clotting

 Monocytes
28% of circulating WBCs Are large and spherical Enter peripheral tissues and become macrophages Engulf large particles and pathogens Secrete substances that attract immune system cells and fibrocytes to injured area

 Lymphocytes
2030% of circulating WBCs Are larger than RBCs Migrate in and out of blood Mostly in connective tissues and lymphoid organs Are part of the bodys specific defense system

 Three Classes of Lymphocytes

1. T cells
Provide Cell-mediated immunity Attack foreign cells directly 2. B cells Provide Humoral immunity Differentiate into plasma cells Synthesize antibodies 3. Natural killer (NK) cells Detect and destroy abnormal tissue cells (cancers)

The Origins and Differentiation of Formed Elements

Red bone marrow

Hemocytoblasts

Myeloid Stem Cells

Lymphoid Stem Cells

Progenitor Cells

Blast Cells

Proerythroblast

Myeloblast

Monoblast

Lymphoblast

Myelocytes
Erythroblast stages

Ejection of nucleus Megakaryocyte Reticulocyte

Band Cells
Promonocyte Prolymphocyte

Erythrocyte

Platelets

Basophil

Eosinophil Granulocytes

Neutrophil

Monocyte

Lymphocyte Agranulocytes

Red Blood Cells (RBCs)

White Blood Cells (WBCs)

Myeloid stem cell

Lymphoid stem cell

A hematopoietic stem cell will give rise to __________.

A. erythrocytes B. leukocytes C. platelets D. all of the above

An elevated neutrophil count would be indicative of ________.

A. an allergic reaction B. a cancer C. an acute bacterial infection D. a parasitic infection

Antihistamines counter the actions of which white blood cells? A. Neutrophils B. Lymphocytes C. Basophils D. Eosinophils

Leukemia is a general descriptor for which of the following disorders? A. An abnormally low white blood cell count B. Overproduction of abnormal leukocytes C. Elevated counts of normal neutrophils D. Overproduction of abnormal erythrocytes

 The Differential Count and Changes in WBC Profiles

Detects changes in WBC populations Infections, inflammation, and allergic reactions

Lecture outline
1. Introduction: Self-introduction, Course syllabus 2. Introduction to blood: composition and multiple roles of blood 3. Red blood cells and functions 4. White blood cells and functions

5. Platelets and functions

6. ABO blood groups

Platelets
Platelet Production
Also called thrombocytopoiesis
Occurs in bone marrow

Megakaryocytes
Giant cells in bone marrow Manufacture platelets from cytoplasm

A __________ is the progenitor of platelets.

A. thrombopoietin B. thrombocyte C. megakaryocyte D. thrombocytoblast

 Platelets
Cell fragments involved in human clotting system
Nonmammalian vertebrates have thrombocytes (nucleated cells)

Circulate for 912 days

Are removed by spleen

2/3 are reserved for emergencies

Platelets
Platelet Counts
150,000 to 500,000 per microliter Thrombocytopenia
Abnormally low platelet count

Thrombocytosis
Abnormally high platelet count

Platelets
Three Functions of Platelets
1. Release important clotting chemicals 2. Temporarily patch damaged vessel walls 3. Reduce 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

1. Vascular spasms are the immediate vasoconstriction response to blood vessel injury. 2. Platelet Plug Formation 3. Coagulation, or blood clotting, is a multistep process in which blood is transformed from a liquid to a gel 4. Clot Retraction and Repair 5. Fibrinolysis 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?

A. Platelets arent formed until vessel damage occurs. B. Only contact of platelets with exposed collagen fibers and von Willebrand factor causes them to be sticky and form plugs. C. Plugs do form, but are removed by macrophages. D. 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 _________. A. collagen B. tissue factor III C. prothrombin activator D. serotonin

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

Disorders of Hemostasis 1. 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:

A. is at risk for embolism (clots that spontaneously form and wedge in blood vessels). B. has thrombocytopenia. C. is a hemophiliac. D. has a deficiency in a clotting factor.

What Do Your PT, PTT and INR results mean? What do my blood tests mean?
Prothrombin Time Blood Test-PT This 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.

Partial Thromboplastin Time Blood Test-PTT This 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.

Lecture outline
1. Introduction: Self-introduction, Course syllabus 2. Introduction to blood: composition and multiple roles of blood 3. Red blood cells and functions 4. White blood cells and functions 5. Platelets and functions

6. ABO blood groups

Blood Types and Cross-Reactions

RBC

Surface antigens

Opposing antibodies

Agglutination (clumping)

Hemolysis

In a cross-reaction, antibodies react with their target antigens causing agglutination and hemolysis of the affected RBCs.

Rh factor
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.

Differences in Blood Group Distribution

Hemolytic disease of the newborn

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.

Blood Typing
Surface Antigens
Are cell surface proteins that identify cells to

immune system
Normal cells are ignored and foreign cells

attacked

Blood Types
Are genetically determined By presence or absence of RBC surface antigens A, B, Rh (or D)

Blood Typing
Four Basic Blood Types
1. A (surface antigen A) 2. B (surface antigen B) 3. AB (antigens A and B) 4. O (neither A nor B)

Blood Typing
Blood Plasma Antibodies
Type A
Type B antibodies

Type B
Type A antibodies

Type O
Both A and B antibodies

Type AB
Neither A nor B antibodies

ABO and Rh blood type donation showing matches between donor and recipient types
Donors O+ O+ A+ B+ AB+ O ABAB-

A+
B+ Recipi AB+ * ents OABAB-

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?
A. Some type O cells possess B agglutinogens on their surface. B. The Rh factor would cross-react. C. Blood transfusions can only occur within the same blood group. D. The type O blood may have high enough levels of anti-A antibodies that could cross-react with the recipients cells.

Next week
Quiz 1 (blood) Heart (Chapter 18)