Download Exam II Review Material

Anatomy and Physiology
Exam II
Review Materials
Endocrine
1.
Know the different types of glands
a.
Endocrine
b.
Exocrine
2.
Know the characteristics of hormonal secretions
a.
Chemical substances secreted by cells into extracellular fluids
b.
Regulate metabolic function of other cells in the body
3.
Know the characteristics of the two general classes of hormones
a.
Amino acid-based hormones
i.
Most hormones
b.
Steroid hormones
i.
Gonadal and adrenocortical hormones
4.
Know the actions of hormones
a.
Alter plasma membrane permeability
b.
Alter protein or regulatory molecule synthesis
c.
Activate or inactivate enzyme
d.
Induction of secretory activity
e.
Stimulate mitosis
5.
Know the mechanisms by which hormones have their effects
a.
G-protein linked receptor activation of intracellular second messengers
i.
Amino acid-based hormones
ii.
Require intracellular second messengers
b.
Direct gene activation
i.
Steroid hormones
ii.
Lipid soluble
iii.
Employ chaperones
iv.
Association with DNA sequence turns on gene
6.
Know what determines where a hormone has its effects (Target cell specificity)
a.
Presence and location of specific protein receptors
7.
Know the factors that determine response to a hormone
a.
Hormonal levels
b.
Number of receptors on target cell
c.
Receptor affinity
i.
Can be up or down regulated based on microenvironmental conditions
8.
Know the different stimuli that cause hormonal release
a.
Humoral
i.
Endocrine glands release hormones in direct response to changing levels of ions
or nutrients
b.
Neural
i.
Nerve fibers stimulate hormonal release
c.
Hormonal
i.
Glands release hormones in response to other hormones
9.
For each of the endocrine glands discussed in class, know:
a.
Anatomy
b.
Hormones released
c.
Control of hormonal secretion and production
d.
Know the effects of each hormone
10.
Know the 6 anterior and 2 posterior pituitary hormones
a.
Know the function of each
11.
Know how the hypothalamus controls the pituitary (neuroendocrine function)
12.
Endocrine glands and associated hormones
a.
Hypothalamus
i.
Releasing and inhibiting hormones for anterior pituitary
b.
Anterior pituitary
i.
FSH & LH (gonadotropins)
ii.
GH
iii.
TSH
iv.
Prolactin
v.
ACTH
c.
Thyroid
i.
T3 and T4
d.
Parathyroid
i.
PTH
e.
Adrenal medulla
i.
NE and epi
f.
Adrenal cortex
i.
Mineralocorticoids
ii.
Glucocorticoids
iii.
Gonadocorticoids
g.
Pineal gland
i.
Melatonin
h.
Thymus
i.
Thymosins
ii.
Thymopoietin
Immunity
1.
Know the difference between specific and non-specific immunity
2.
Know the different types of non-specific immune responses
a.
Skin and mucous membranes
b.
Phagocytosis
c.
Interferon
d.
Complement system
3.
Know the different types of phagocytic cells
a.
Neutrophils
b.
Monocytes
c.
d.
e.
Macrophages
Eosinophils
Natural killer (NK) cells
4.
Know the events that take place during inflammation—response to tissue damage or entry by
microorganism
a.
Vasodilation
b.
Chemical signals—initiate inflammatory response
c.
Migration of phagocytic cells
d.
Widespread inflammatory response to severe infection
i.
Bone marrow stimulated release of neutrophils
ii.
Pyrogens released by leukocytes cause fever—inhibit bacterial growth, facilitate
phagocytosis
5.
Know the basic characteristics of the specific immune system
a.
Specificity
b.
Diversity
c.
Self/non-self recognition
d.
Memory
6.
Know the two basic types of lymphocytes and the types of immune responses in which they
participate
a.
B cells are responsible for humoral response
i.
Form and mature in bone marrow
b.
T cells are responsible for cell-mediated response
i.
Form in marrow and mature in thymus gland
7.
Know the following terms
a.
Antigen
i.
Foreign substance that elicits a lymphocytic response
ii.
Present on surface, produced by or released from bacteria, viruses, etc.
b.
Antibody
i.
Antigen-binding immunoglobulin produced by B cells
ii.
Function as effectors
c.
Antigen receptor
i.
Recognizes and distinguishes antigens
ii.
Present on plasma membranes of lymphocytes
8.
Know the events that take place during an immune response
a.
Each lymphocyte only recognizes one antigen
b.
Specificity determined during embryological development
c.
When encountered in the body, antigens are bound by specific lymphocytes, which then
divide and differentiate
d.
Clonal population of effector cells specific to that antigen is created (Clonal selection)
e.
Second clonal population of memory cells is created
9.
Know the characteristics of an immune response
a.
Pathogen present in fluids of the body
b.
Primary—first exposure to antigen
i.
Lag period to maximum production of effector cells
ii.
Lymphocytes differentiate into B and T cells
iii.
B cells give rise to effector cells (plasma cells) that secrete antibodies
c.
Secondary—encounter a previously encountered antigen
i.
Faster (2-7 days), prolonged response
ii.
More numerous antibodies
iii.
Based on memory
10.
Know the function of a MHC
a.
Self/Non-self Recognition—immune system distinguishes between the body’s own
molecules and foreign molecules
b.
Class I MHC
i.
All nucleated cells
ii.
Facilitate antigen binding to cytotoxic T cells
c.
Class II MHC
i.
Found only on specialized cells—macrophages, B cells and activated T cells
ii.
Facilitate antigen binding to helper T cells
11.
Know the characteristics of a humoral response
a.
Produce antibodies specific to toxins, free bacteria and viruses present in body fluids
i.
Antibodies are produced and secreted as soluble proteins that circulate in blood
or lymph
12.
Know the characteristics of a cell-mediated response
a.
Response to intracellular infection by viruses, bacteria, etc
b.
Depends on direct action of lymphocytes
c.
Infected cell presents antigen on MHC
d.
Helper T recognizes MHC/antigen complex
e.
Helper T signals for appropriate lymphocyte
i.
Cytotoxic T-cell
ii.
B cells and macrophages
f.
Memory and effector populations are made
g.
Cytotoxic T cells releases perforin which lesions infected cell
h.
Infected cell (target cell) undergoes lysis and dies
i.
Pathogen may be destroyed or released to be attacked by antibodies
j.
Cytotoxic T cell continues to live and may kill other cells with antigen-MHC complex
13.
Know the five types of immunoglobins and to what they respond (**Not Discussed in Lecture)
a.
IgM—circulating, appear during initial response
b.
IgG—cross blood vessels, protect against bacteria, viruses and toxins in blood, trigger
complement system
c.
IgA—in mucous membranes, prevent attachment of bacteria and viruses to epithelial
surfaces, also in tears, saliva, and perspiration
d.
IgD—found on external membranes of B cells, initiates B cell differentiation
e.
IgE—attaches to receptors on mast cells and basophils, stimulates releases of histamine
and other chemicals that
cause allergic reaction
14.
Know the difference between passive and active immunity
a.
Active immunity—conferred by recovery from an infectious disease
i.
Naturally following recovery from infection
ii.
Artificially by immunization
b.
Passive immunity—transfer of antibodies from one individual to another
i.
Placental transfer of IgG antibodies
ii.
Nursing
Cardiovascular Function
1.
Know the anatomical location of the heart
2.
Know the structure of the pericardium
3.
Know the three layers of the heart
a.
Epi, myo, and endocardium
4.
Know the chambers, valves, major vessels, and anatomical features of the heart
5.
Know the two circuits through which blood flows
a.
Pulmonary
b.
Systemic
6.
Know the basic characteristic of cardiac muscle
a.
Branched, short, and interconnected fibers
b.
Striated
c.
Cardiac muscle fibers are functionally connected
i.
Intercalated discs
ii.
Anchoring desmosomes
iii.
Electrical coupling via gap junctions
d.
Functional syncytium
i.
Entire myocardium acts as a single unit
ii.
Result of gap junctions
7.
Know the coronary arteries and veins
8.
Know the components of the intrinsic conductance system
a.
Autorhymic cells
i.
SA and AV nodes
b.
Atrioventricular bundle (bundle of His)
c.
Bundle branches
d.
Purkinje fibers
Cardiovascular Physiology
1.
Know the physiology of the pacemaker potential
a.
Na+ influx (slow) offset by K+ efflux (slow)
b.
K+ permeability gradually decreases
c.
Influx of Na+ depolarizes the cardiac cells
d.
Depolarization opens fast CA+ channels
e.
Ca2+ influx from extracellular space causes rising phase of action potential
f.
Repolarization causes K+ permeability to increase
i.
Cardiac cells repolarize
g.
K+ channels inactivate
h.
Cycle starts again
2.
Know the physiology of the cardiac action potential
a.
Na+ influx--depolaration
b.
Na+ channels close: K+ efflux—early repolarization
c.
d.
e.
f.
Ca2+ influx--plateau
Ca2+ channels close
K+ efflux--repolarization
K+ channels close
3.
Electrocardiograph
a.
Know the physiological events that correspond with each deflection and interval
i.
P
ii.
QRS
iii.
T
iv.
PR
v.
QT
4.
Know the mechanical events that occur during heart contraction
a.
Heart sounds
b.
EKG
c.
Ventricular pressure changes
d.
Ventricular volume changes
e.
Aortic pressure changes
5.
Know how to calculate cardiac output (CO)
6.
Cardiac function regulation
a.
Sympathetic nervous system
i.
Increases heart rate
ii.
Increases strength of contraction
iii.
Reduces ESV
iv.
Mediated by ß1 adrenergic receptors
b.
Parasympathetic nervous system
i.
Decreases heart rate
ii.
Mediated by acetycholine
iii.
Hyperpolarizes (inhibits) SA node
c.
Chemical regulation (Adrenal medulla)
i.
Epinephrine
ii.
Sympathetic nervous system
iii.
Increases HR and contractility (like NE)
d.
Physical factors
i.
Age
ii.
Gender
iii.
Exercise
iv.
Body temperature
Blood Pressure
1.
Know the anatomy of the vessels in the arterial and venial systems
a.
Classification based on size
b.
Differences between arteries and veins
2.
Know the basic structure of a capillary bed
3.
Know the relationship between blood flow, pressure and resistance
4.
Know how arterial pressure changes throughout the systemic circuit
5.
Regulation of blood pressure
a.
Relationship between CO and BP
i.
BP = CO X PR
b.
Factors that affect CO affect BP
i.
Directly related
c.
Factors that change blood volume affect BP
i.
Directly related
d.
Factors that affect vessel diameter affect BP
i.
Inversely related
6.
Know how the nervous system controls BP
a.
Vasomotor center
i.
Vasoconstriction
ii.
Sympathetic NS
b.
Baroreceptors
i.
Detect changes in arterial blood pressure
ii.
Stretching increases signaling to vasomotor center (inhibits)
iii.
Causes dilation of arteries and veins
iv.
Reduces peripheral resistance
v.
Inhibits sympathetic NS (HR and contractile force decrease)
c.
Chemoreceptor
i.
O2 and CO2
ii.
Blood borne chemicals
7.
Know how blood-borne chemicals affect BP
a.
Adrenal medulla hormones
i.
NE and EPI (nicotine is a monoamine agonist)
ii.
NE is a vasoconstrictor
iii.
EPI increase cardiac output by increasing cardiac muscle contractility
b.
Atrial natriuretic peptide (ANP)
i.
Atrial peptide hormone
ii.
Reduces blood pressure by antagonizing aldosterone
iii.
Increases water excretion from kidney
c.
Antidiuretic hormone (ADH)
i.
Posterior pituitary hormone
ii.
Increases blood pressure by increasing water absorption by distal tubule
iii.
At high concentrations, causes vasoconstriction
d.
Angiotensin II
i.
Mediated by release of renin by JGA of kidney tubule
ii.
When amount of blood entering kidney tubule is too low, renin is released
iii.
Renin catalyzes the conversion of angiotensinogen into angiotensin II
iv.
Angiotensin II causes vasoconstriction of systemic arterioles
v.
Increases BP
vi.
Angiotensin II also causes release of aldosterone from adrenal cortex
vii.
Aldosterone increases absorption of water by kidney tubules
8.
Know how blood pressure is controlled by renal function
a.
Kidney controls blood volume by regulating water loss in urine
b.
Blood volume affects cardiac output via:
i.
Venous pressure
c.
d.
ii.
Venous return
iii.
EDV
iv.
Stroke volume
Direct control
i.
Alter amount of water leaving as urine
ii.
BV and BP are directly related
Indirect
i.
Renin-angiotensin mechanism
ii.
Aldosterone also causes Post. Pituitary to release ADH
iii.
ADH promotes water reabsorption from by kidney