Dravens Study Notes

Directional Terminology

  1. Anterior (Ventral):
    • Refers to the front of the body or a body part.
    • Example: The sternum (breastbone) is anterior to the spine.
  2. Posterior (Dorsal):
    • Refers to the back of the body or a body part.
    • Example: The heart is posterior to the sternum.
  3. Superior (Cranial or Cephalic):
    • Indicates that a body part is above another or toward the head.
    • Example: The head is superior to the abdomen.
  4. Inferior (Caudal):
    • Means that a body part is below another or toward the lower end of the body.
    • Example: The stomach is inferior to the lungs.
  5. Medial:
    • Describes a position closer to the midline of the body.
    • Example: The nose is medial to the eyes.
  6. Lateral:
    • Refers to a position further from the midline, toward the sides.
    • Example: The ears are lateral to the nose.
  7. Proximal:
    • Indicates that a body part is closer to the point of attachment to the trunk or another reference point.
    • Example: The shoulder is proximal to the elbow.
  8. Distal:
    • Describes a position farther from the point of attachment or another reference point.
    • Example: The wrist is distal to the elbow.
  9. Superficial (External):
    • Means a position closer to the surface of the body or a body part.
    • Example: The skin is superficial to the muscles.
  10. Deep (Internal):
  • Refers to a position further away from the surface, closer to the internal core of the body.
  • Example: The bones are deep to the muscles.
  1. Intermediate:
  • Indicates a structure that is between two other structures.
  • Example: The collarbone is intermediate between the breastbone and the shoulder.

Glomerulus and Bowman’s Capsule

Glomerulus

  • It’s a cluster of capillaries surrounded by the Bowman’s capsule located at the beginning of a nephron in the kidney.
  • The glomerulus is responsible for filtering blood to form a protein-free filtrate, which is the first step in the process of producing urine.
  • Blood pressure forces water and small molecules (like electrolytes, glucose, and amino acids) out of the blood and into the Bowman’s capsule while larger proteins and blood cells remain in the bloodstream.

Bowman’s Capsule

  • A cup-like sac encircling the glomerulus that receives the filtrate produced by the glomerulus.
  • This filtrate, once collected, is passed down the nephron for further processing into urine.
  • The Bowman’s capsule is part of the renal corpuscle and has two layers: the parietal layer (simple squamous epithelium) and the visceral layer (podocytes that closely surround glomerular capillaries).

Kidney and Ureters

Kidney:

  • Each kidney is a bean-shaped organ located on either side of the spine just below the rib cage.
  • They filter approximately 120-150 quarts of blood daily to remove waste, excess salts, and water to form urine.
  • The kidneys are also involved in hormone production (e.g., erythropoietin for red blood cell production) and regulate blood pressure, electrolytes, and acid-base balance.
  • They contain millions of nephrons, the basic structural and functional units responsible for urine formation.

Ureters:

  • Two thin tubes that connect each kidney to the bladder.
  • They are muscular structures that propel urine using peristalsis (a wave-like contraction) from the kidneys to the bladder.
  • The ureters have a valve mechanism that prevents urine backflow once it enters the bladder.

Anti-diuretic Hormone (ADH) and Ureters

Anti-diuretic Hormone (ADH)

  • Also known as vasopressin, it’s produced by the hypothalamus and stored in the posterior pituitary gland.
  • ADH is released into the bloodstream when blood osmolality (solute concentration) rises or blood volume decreases.
  • It acts on the kidney’s collecting ducts, increasing their permeability to water. This results in more water being reabsorbed from the urine back into the bloodstream, reducing urine volume and concentrating the urine.
  • This hormone plays a crucial role in maintaining fluid balance, preventing dehydration.

Ureters:

  • As mentioned, they carry urine from the kidneys to the bladder.
  • Their smooth muscle walls help propel urine via peristalsis, and the valves at the bladder end prevent backflow.

Functions in the Urinary System and Reproductive System: Male Urethra

Urinary System

  • The primary role is to remove waste and excess substances from the bloodstream.
  • Comprises the kidneys, ureters, bladder, and urethra.
  • Helps regulate blood volume, pressure, electrolyte levels, and acid-base balance through filtration, reabsorption, secretion, and excretion processes.
  • Produces hormones like renin and erythropoietin, contributing to blood pressure regulation and red blood cell production.

Male Urethra:

  • A tube that connects the urinary bladder to the external urethral orifice.
  • It has a dual function: transporting urine from the bladder during urination and conveying semen during ejaculation.
  • The male urethra is longer than the female urethra and consists of three regions: prostatic, membranous, and spongy (penile) urethra.

Complement System

  • A series of over 30 small proteins in the blood plasma that work with (complement) the immune system to destroy pathogens.
  • Activated in response to the presence of antibodies bound to pathogens or directly by pathogen surface proteins.
  • Major roles include:
    • Opsonization: Coating pathogens with complement proteins to enhance phagocytosis.
    • Chemotaxis: Recruiting immune cells to infection sites.
    • Cell lysis: Forming membrane attack complexes (MAC) that create pores in pathogen cell membranes, leading to cell death.
    • Immune Clearance: Assisting in clearing immune complexes from the circulation.

Cell Behavior in Hypertonic and Hypotonic Solutions

Hypertonic Solution

  • A solution with a higher solute concentration than the inside of the cell.
  • Water moves out of the cell into the hypertonic solution due to osmosis, causing the cell to shrink (crenate).

Hypotonic Solution

  • A solution with a lower solute concentration than the inside of the cell.
  • Water enters the cell due to osmosis, causing the cell to swell and potentially burst (lyse) if excess water isn’t managed.

Isotonic Solution

  • Has the same solute concentration as inside the cell, resulting in no net movement of water. The cell retains its normal shape.

Type of Epithelium on the Bladder

Transitional Epithelium

  • Also called urothelium, this type of epithelium lines the bladder, ureters, and upper part of the urethra.
  • It consists of several layers of cells that change shape in response to bladder distension, enabling the bladder to expand and contract.
  • The surface cells appear round or dome-shaped when the bladder is empty but become flattened when the bladder is full.
  • Its elasticity and protective properties help the bladder withstand the stress of urine storage and emptying while preventing urine from permeating into surrounding tissues.

Innate vs. Adaptive Immunity

Innate Immunity

  • Overview: The body’s first line of defense, providing immediate but non-specific protection.
  • Components:
    • Physical Barriers: Skin and mucous membranes prevent pathogen entry.
    • Chemical Barriers: Acidic environments (stomach acid) and enzymes (lysozyme in saliva and tears) destroy pathogens.
    • Cellular Defenses: Phagocytic cells (macrophages, neutrophils) ingest pathogens, while natural killer cells destroy infected or cancerous cells.

Adaptive Immunity

  • Overview: A highly specific immune response that develops upon exposure to a specific pathogen or antigen.
  • Components:
    • Humoral Immunity: B cells produce antibodies to neutralize extracellular pathogens.
    • Cell-Mediated Immunity: T cells target and destroy infected host cells, activate other immune cells, and regulate immune responses.

Mucous Membranes

  • Structure: Mucous membranes consist of an epithelial layer that secretes mucus, and a connective tissue layer underneath. Goblet cells within the epithelium are responsible for mucus production.
  • Function:
    • Trap and remove pathogens, dust, and particles.
    • Moisturize and protect underlying tissues from mechanical damage and dehydration.
    • Line respiratory, digestive, and urogenital tracts to act as barriers against harmful microorganisms.

Antibodies (Immunoglobulins)

  • Overview: Y-shaped proteins produced by B cells as part of the adaptive immune system.
  • Structure:
    • Two heavy chains and two light chains form a Y-shaped molecule with constant (Fc) and variable (Fab) regions.
    • The variable region binds specifically to antigens.
  • Classes:
    • IgG: Most abundant; provides long-term immunity and crosses the placenta.
    • IgM: First antibody produced; effective in agglutination and complement activation.
    • IgA: Found in mucous secretions; protects mucosal surfaces.
    • IgE: Involved in allergic responses and defense against parasites.
    • IgD: Found on B cell surfaces; functions as a receptor.

B and T Cells

B Cells

  • Development and Maturation: Originate and mature in the bone marrow.
  • Functions:
    • Plasma Cells: Produce and secrete antibodies in response to pathogens.
    • Memory B Cells: Retain the memory of specific antigens, enabling rapid response upon re-exposure.

T Cells

  • Development and Maturation: Originate in the bone marrow but mature in the thymus.
  • Functions:
    • Helper T Cells (CD4+): Activate other immune cells, including B cells and cytotoxic T cells.
    • Cytotoxic T Cells (CD8+): Directly destroy infected or cancerous cells.
    • Regulatory T Cells: Suppress excessive immune responses and maintain self-tolerance.

Adrenal Glands

  • Location: Sit on top of the kidneys, each weighing about 4-5 grams.
  • Structure:
    • Cortex: Outer layer responsible for steroid hormone production.
    • Medulla: Inner region that produces catecholamines (adrenaline, noradrenaline).
  • Hormones:
    • Cortisol: Glucocorticoid that regulates metabolism and the stress response.
    • Aldosterone: Mineralocorticoid that helps maintain blood pressure by regulating sodium and potassium levels.
    • Adrenaline and Noradrenaline: Fight-or-flight hormones that increase heart rate, blood flow, and energy availability.

Pancreatic Islets

  • Structure: Clusters of endocrine cells within the pancreas.
  • Major Cell Types and Their Hormones:
    • Alpha Cells: Produce glucagon, which raises blood sugar levels.
    • Beta Cells: Produce insulin, which lowers blood sugar levels.
    • Delta Cells: Produce somatostatin, which regulates other pancreatic hormones.

Androgens

  • Definition: A group of steroid hormones, the most well-known being testosterone.
  • Production:
    • Mainly produced in the testes and adrenal glands.
    • Small amounts are also produced in the ovaries.
  • Functions:
    • Promote male sexual development, spermatogenesis, and libido.
    • Influence muscle growth, bone density, and red blood cell production.
    • Androgens also have minor roles in female physiology, such as libido and hormone balance.

Antigens

  • Definition: Substances that provoke an immune response by binding to specific antibodies or T cell receptors.
  • Types:
    • Exogenous: Enter the body from the external environment (bacteria, viruses, toxins).
    • Endogenous: Arise within the body (infected cells, cancer cells).
    • Autoantigens: Self-antigens that can trigger autoimmune disorders if recognized by the immune system.

Microvilli

  • Structure: Tiny, finger-like projections that increase surface area on epithelial cells.
  • Function:
    • Found predominantly in the small intestine to maximize nutrient absorption.
    • Contain enzymes on their surfaces to help digest nutrients before absorption.

Glomerulus and Bowman’s Capsule

  • Glomerulus:
    • Network of capillaries that filters blood to produce a protein-free filtrate.
    • Blood pressure forces water and small solutes through the capillary walls into the Bowman’s capsule.
  • Bowman’s Capsule:
    • Cup-like sac that surrounds the glomerulus and collects the filtrate.
    • This filtrate moves through the nephron’s tubules for further processing into urine.

Thymus

  • Location and Structure: Located in the upper chest, it shrinks with age (largest during childhood).
  • Function:
    • Site of T cell maturation and differentiation.
    • Produces hormones like thymosin that promote T cell development and immune function.

Kidney Failure and Dialysis Machine

  • Kidney Failure: A condition where the kidneys lose their ability to filter and eliminate waste from the blood.
  • Dialysis Machine:
    • A life-saving device used in cases of end-stage renal disease.
    • Filters waste products, excess water, and toxins from the blood, replacing the kidney’s filtering function.
    • Two main types:
      • Hemodialysis: Blood is filtered through a machine using a dialyzer (artificial kidney).
      • Peritoneal Dialysis: The lining of the abdomen (peritoneum) acts as the filter to remove waste.

Loop of Henle

  • Part of the nephron that lies between the proximal and distal convoluted tubules.
  • Has a descending limb that permits water reabsorption and an ascending limb that allows salt reabsorption.
  • Generates a concentration gradient in the kidney, crucial for water reabsorption and urine concentration.

Autoimmune Disorders: Allergy, Rheumatoid Arthritis, AIDS

  • Allergy: An exaggerated immune response to allergens, such as pollen, food, or animal dander. Symptoms include sneezing, itching, and rashes.
  • Rheumatoid Arthritis:
    • An autoimmune disorder where the immune system attacks the joints.
    • Causes pain, swelling, and deformities, primarily in hands and feet.
  • AIDS (Acquired Immunodeficiency Syndrome):
    • Caused by the Human Immunodeficiency Virus (HIV), which attacks the immune system, particularly CD4+ T cells.
    • Leads to severe immunodeficiency, making the body vulnerable to opportunistic infections and certain cancers.

Excessive Growth Hormone

  • Acromegaly: A condition caused by the overproduction of growth hormone (GH) by the pituitary gland, often due to a benign tumor.
  • Symptoms:
    • Enlarged hands, feet, and facial features.
    • Joint pain, thicker skin, and deepened voice.
  • Can lead to complications like type 2 diabetes and high blood pressure.

Arterial Blood Pressure

  • Arteries: Blood vessels that carry oxygenated blood away from the heart.
  • Characteristics:
    • Have the highest blood pressure in the circulatory system due to proximity to the heart’s pumping action.
    • Elastic walls help maintain consistent blood flow.
  • Capillaries: Smallest blood vessels with lower pressure than arteries, allowing for nutrient and gas exchange.

Contraction and Electrical Signals

  • Sinoatrial Node (SA Node):
    • Known as the heart’s natural pacemaker.
    • Generates electrical signals that trigger atrial contraction.
  • Atrioventricular Node (AV Node):
    • Delays the signal slightly before sending it to the ventricles, ensuring the atria contract before the ventricles.
  • Systole and Diastole:
    • Systole: Period of heart contraction, pumping blood out of the heart.
    • Diastole: Period of relaxation, allowing the heart chambers to fill with blood.
  • Heart Chambers:
    • The heart’s four chambers (two atria, two ventricles) work together in a coordinated cycle, with atria contracting slightly before ventricles.

Hypertension (High Blood Pressure)

  • Definition: Consistently elevated blood pressure (above 140/90 mmHg).
  • Causes:
    • Genetics, diet, lack of exercise, and underlying health conditions.
    • Can lead to serious conditions like stroke, heart attack, and kidney disease.
  • Management: Lifestyle modifications (diet, exercise) and medications.

Brachial Artery

  • Location: Runs along the upper arm, near the biceps.
  • Clinical Importance:
    • The most common site for measuring blood pressure with a sphygmomanometer.
    • Blood pressure taken here provides an accurate reading of systemic blood pressure.

Lymphatic System

  • Overview: A network that complements the circulatory system by returning excess fluid to the bloodstream and managing immunity.
  • Functions:
    • Drains interstitial fluid and returns it to the bloodstream.
    • Filters pathogens and debris through lymph nodes.
    • Contains lymphocytes (B and T cells) that identify and fight infections.

Plasma

  • Definition: The liquid component of blood.
  • Composition:
    • About 90% water and 10% dissolved substances, including electrolytes, hormones, nutrients, and waste products.
    • Contains important proteins like albumin (maintains osmotic pressure), fibrinogen (involved in clotting), and globulins (immune function).

Red and White Blood Cells

Red Blood Cells (RBCs)

  • Function: Deliver oxygen to body tissues by binding it to hemoglobin, an iron-containing protein.
  • Structure: Biconcave disc shape, which increases the surface area for gas exchange and allows flexibility through capillaries.
  • Lifespan: Around 120 days before being recycled in the spleen and liver.

White Blood Cells (WBCs)

  • Function: Play a crucial role in immunity by identifying and neutralizing pathogens like bacteria and viruses.
  • Types:
    • Neutrophils: Most common type; phagocytic (engulf and digest bacteria).
    • Lymphocytes: Include B and T cells that provide specific immune responses.
    • Monocytes/Macrophages: Become macrophages in tissues; phagocytic.
    • Eosinophils and Basophils: Involved in allergic responses and parasitic infections.

Phagocytosis

  • The process by which certain white blood cells (e.g., neutrophils and macrophages) engulf and digest foreign particles, bacteria, and cellular debris.
  • Involves the extension of the cell membrane to surround the target, forming a phagosome, which then merges with a lysosome to digest the material.

Systole and Diastole

Systole

  • Refers to the contraction of the heart, particularly the left ventricle, to pump blood into the systemic circulation via the aorta.
  • Results in the highest arterial blood pressure (systolic pressure).

Diastole

  • Refers to the relaxation phase of the cardiac cycle, allowing the heart chambers to fill with blood.
  • Results in the lowest arterial blood pressure (diastolic pressure).

Valves in the Heart and Veins

Heart Valves

  • Tricuspid Valve: Between the right atrium and right ventricle.
  • Bicuspid (Mitral) Valve: Between the left atrium and left ventricle.
  • Pulmonary Valve: Between the right ventricle and the pulmonary artery.
  • Aortic Valve: Between the left ventricle and the aorta.

Valves in Veins

  • Located throughout veins in the body, these prevent backflow of blood, especially in the limbs, to ensure blood returns efficiently to the heart.

Depolarization and Contraction of the Heart

  • Depolarization: Electrical signals trigger the heart muscle cells to change their electrical state, leading to muscle contraction (systole).
  • Atrial Depolarization: Initiates atrial contraction.
  • Ventricular Depolarization: Causes ventricular contraction.

Characteristics Not Seen on an ECG

  • The ECG (electrocardiogram) provides information on the heart’s electrical activity but does not show physical contraction directly.
  • Atrial repolarization is usually not seen on an ECG because it coincides with the larger ventricular depolarization.

ECG Waves: P, QRS Complex, T Waves

  • P Wave: Represents atrial depolarization leading to atrial contraction.
  • QRS Complex: Reflects ventricular depolarization leading to ventricular contraction.
  • T Wave: Represents ventricular repolarization, allowing the ventricles to relax and refill.