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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
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
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%
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)
Exam 1, (continued)
The
Heart 18
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
Lecture outline
1. Introduction: Self-introduction, Course syllabus
7%
Plasma
Plasma Proteins
1%
4663% Other Solutes Water
92%
Formed Elements
< .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
After centrifuging, of the listed blood components, which contains the components of immune function?
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
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.
Fetal Hemoglobin
Strong form of hemoglobin found in embryos Takes oxygen from mothers hemoglobin
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
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)
RBC formation
Hemoglobin that is not phagocytized breaks down, and the alpha and beta chains are eliminated in urine. Kidney
Liver Bilirubin Hb
Urobilins
Bilirubin
Urobilins, stercobilins
Eliminated in urine
Eliminated in feces
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
Lecture outline
1. Introduction: Self-introduction, Course syllabus 2. Introduction to blood: composition and multiple roles of blood 3. Red blood cells and functions
RBC
Neutrophil
LM 1500
Eosinophil LM 1500
Basophil
LM 1500
Monocyte
LM 1500
Lymphocyte LM 1500
WBC functions:
Defend against pathogens Remove toxins and wastes Attack abnormal cells
chemotaxis)
4. Some are phagocytic
Neutrophils, eosinophils, and monocytes
Neutrophil Action
5070% of circulating WBCs
pathogen membranes
Eosinophils (Acidophils)
24% of circulating WBCs Attack large parasites
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
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)
Hemocytoblasts
Progenitor Cells
Blast Cells
Proerythroblast
Myeloblast
Monoblast
Lymphoblast
Myelocytes
Erythroblast stages
Band Cells
Promonocyte Prolymphocyte
Erythrocyte
Platelets
Basophil
Eosinophil Granulocytes
Neutrophil
Monocyte
Lymphocyte Agranulocytes
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
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
Platelets
Platelet Production
Also called thrombocytopoiesis
Occurs in bone marrow
Megakaryocytes
Giant cells in bone marrow Manufacture platelets from cytoplasm
Platelets
Cell fragments involved in human clotting system
Nonmammalian vertebrates have thrombocytes (nucleated cells)
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
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.
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
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.
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)