Heart walls - 3 distinct layers: 1 - endocardium - innermost layer; epithelial tissue that lines the entire circulatory system

2 myocardium - thickest layer; consists of cardiac muscle 3 - epicardium - thin, external membrane around the heart Most of the muscle
cells in the heart are contractile cells. The autorhythmic cells are located in these areas: Sinoatrial (SA), or sinus, node- 60 - 100
per minute (usually 70 - 80 per minute) <-- pacemaker; Atrioventricular (AV) node- 40 - 60 per minute; Atrioventricular (AV) bundle (also
sometimes called the bundle of His)- 40 - 60 per minute; Right & left bundle branches- 20 - 40 per minute; Purkinje fibers- 20 - 40 per
minute Electrocardiogram (ECG) = record of spread of electrical activity through the heart:: P wave = caused by atrial depolarization,
QRS complex = caused by ventricular depolarization, T wave = caused by ventricular repolarization; Regulation of Stroke Volume:
intrinsic control ==> related to amount of venous return (amount of blood returning to the heart through the veins) extrinsic control ==>
related to amount of sympathetic stimulation Capillaries: site of exchange of materials between blood & tissues, exchange may occur
by simple diffusion, VEINS serve as a blood reservoir; When we measure blood pressure, we use the blood flowing through the arteries
because it has a higher pressure than the blood in the veins. BLOOD: The hematocrit, also known as packed cell volume (PCV) is the
volume percentage (%) of red blood cells in blood. It is normally 45% for men and 40% for women. Plasma=55% of blood volume. 7.4.
60-100 bpm. BP- Systolic/Diastolic: 120/80 (high=hypertension); Mean arterial pressure, is defined as the average pressure in a
patient's arteries during one cardiac cycle. Tachy- too fast, brady- too slow
Lymph nodes: Adenoids on posterior wall above border of soft palate. Peyer's patches found within intestinal wall. Spleen is like
lymph nodule - blood vessels expand so blood is available in times of need. Red pulp has RBC, lymphocytes, macrophages & removes
bacteria. White Pulp has lymphocytes. Thymus - where T-lymphocytes develop. Medula secretes thymosin for T-ls to grow. Red Bone
Marrow - origin of all blood cells, where stem cells divide. Found in skull, sternum, ribs, clavicle, spine column, femur, humerus. GALT
(gut lymph tissue) - in intestinal wall, has lymphocytes, plama cells, macrophages. Digestive tract has largest mass of lymphatic
tissue. Lymphoid tissue in gut, stomach (w/ age), appendix. MALT (mucosa) - mucosa of XX reproductive + respiratory tract. SALT
(skin) - in dermis. Nonspecific Innate - quick response: First line - skin, stomach acid, harmless bacteria in intestines, tears, saliva,
ear wax + mucous membranes block entry + trap antigens. Second line - WBCs, inflammatory response prevent spreading of
antigens, starts ASA first line fails, uses phagocytosis (phagocytes produces in marrow), scavengers (dead cells + microorganisms),
complement proteins (one activates another and so on, then attract phagocytes, bind to microbes so WBCs can use phagocytosis &
make holes in bacteria cell walls + membranes), releases histamines, cause swelling, redness. Neutrophils - kill bacteria & die after,
60% of WBC, patrol tissues, dead ones = puss. Monocytes - made in marrow, circulate in blood for 1-2 days then called macrophages
- found in organs NOT blood, release interferon + interleukin to protect cells of specific response, long lived, antigen presenting cells activate adaptive IS, display antigens to lymphocytes. Basophils - ingest foreigners, produce heparin + histamines, allergies. Mast
cells - regulate inflammatory resp, in connect tissues, mucous membranes, release histamines, anaphylaxis. Dendritic cells - in
contact w/ environment, nose lungs stomach intestines, links adaptive + innate IS, present antigens 2 t-cells. Natural Killer - tumor &
virus fighters, both specific & non, release proteins made by virus infected cells which binds to receptors of non-infected cells, causing
them to make a substance that will interfere with viral reproduction and activate macrophages.
Specific Adaptive - slower response: Third line - specific attack, lymphocytes + antibodies. pathogens are remembered. Antigen =
proteins w/ plasma membrane, recognized during antigen presentation. B&T cells - WBC lymphocytes. Humoral (antibody-mediated
response) - defends against extracellular stuff by binding to antigens, makes them easier targets for phagocytes & complement
proteins. USES: B cells - made in marrow, have B cell receptor protein to bind to specific antigen. Plasma B cell - produce antibodies.
When B cell attach antigen, form MHC complex which binds to Helper T-Cell which secretes interleukin so B cell multiplies. Plasma
cells make immunoglobins, antibodies which clump & mark microbes, activate complement proteins. Complement Fixation: uses
phagocytosis. Neautralization: active sites on virus blocked so they cant bind to normal cell. Agglutinization: clumping.
Precipitation: soluble stuff cross-links, becomes insoluble, precipitates out. Inflammation.
Cell mediated response defends against intracellular stuff & cancer by binding to infected cells. NO antibodies, instead activates
phagocytes, uses t-cells & cytokines. T-cells: some direct immune responses, others directly attack stuff. Helper t-cells: help b-cells
mature, activates t-cell + macrophage. Killer t-cells: kill infected cell, tumor, have proteins that rupture membranes allow H2O & salt to
enter and rupture, asthma, graft rejection, malignancy. Regulatory t-cell - shut down t-cell response at end, prevent autoimmunity.
Primary immunity: antibody # peaks, declines days after first exposure to antigen. Secondary Immunity: memory cells for repeats,
lasts as long as B & T memory cells exist. NATURAL IMMUNITY: Active - self-develop antibodies & long lived, Passive - breast milk,
short lived. ARTIFICIAL, DELIBERATE IMMUNITY: Active - vaccines, long live. Passive - inject antibodies from another person, short
lived & immediate. Antibiotics prevent bacteria from dividing. Antivirals prevent virus from reproducing, doesnt get rid of them.
Intrinsic Asthma - 10% of cases, develop after 30, no allergy link. Extrinsic Asthma - 90%, allergy, childhood.
Multiple Sclerosis - body attacks nerves, muscle weakness, spasms. Lesions white matter. Inflammation by t-cells.
Systemic Lupus: Healthy tissue attacked, antibodies against good proteins, affects internal organs (heart, lungs, kidneys, liver,
nervous system). Rashes heal from inside out, look like bites. immunosuppressants help.
HIV infects vital cells in the human immune system such as helper T cells, macrophages, and dendrite cells.

Hemolytic Disease of Newborn: Mom is Rh- baby is Rh+. Type A blood has A antigens only. Type B blood has B antigens only. Type
AB blood has both A and B antigens present. Type O blood lacks both A and B antigens.
Functions: regulates temp, protects against injury & infection, sense perception, water loss, chem synthesis. Protecting / barrier:
keratanized cells form waterproof barrier, protects against bacteria & abrasions. substances that can penetrate skin: Lipid-soluble
substances (o2, CO2, steroids, fat-soluble vitamins), Oleoresins of certain plants (poison ivy), Organic solvents (acetone), Salts of
heavy metals. Chemical barrier: Skin secretions such as sebum(low pH slows bacteria growth), human defensins (antimicrobial
peptidesn natural antibiotic), acid mantle of the skin kills bacteria, Cathelicidins are proteins prevent Strep A infection in wounded skin,
melanin. Biological barriers: Langerhans cells (present antigens to lymphocytes), macrophages, and DNA (the electrons in DNA
absorb UV radiation, converts to heat). Temperature regulation: sweat, When it is cold outside dermal blood vessels constrict and pull
the blood away from the skin keep it close to the body core to protect internal organs. Cutaneous sensation: Meissners corpuscles &
Merkel discs - light touch, Pascinian corpuscles - pressure, Pascinian receptors lies in deeper dermis/hypodermis & detect deep
pressure contacts, Hair root plexus - sensations from movement of hairs, Hair follicle receptors movement across the surface of the
skin, Bare nerve endings: painful stimuli (chemicals, heat). Metabolic functions: syntheses of vitamin D (which acts like a hormone to
regulate Ca) from UV light and is converted to its active form in the liver then kidneys, blood resevoir - shunts blood, converts chemicals
into others. Serous Membrane: Lines openingless body cavities, secretes surface lubricating fluid. Mucous membrane: line cavities
with openings to outside. Synovial membrane: inner lining of joints, secretes synovial fluid. Cutaneous membrane: skin (made up of
epidermis and dermis). Thin skin: hairy, covers everything except palms & soles, more sebaceous glands, less receptors and sweat
glands. Thick skin: hairless, epidermis w/ ridges bc of dermal papillae. EPIDERMIS: keratinocytes - 90% of epidermal cells,
waterproof & protects. Melanocytes: 8%, absorbs UV. Langerhans: from marrow, immune responses, UV = very bad. Merkel cells:
lowest # of epi cells, found in lowest layer, function in touch. Stratum Corneum Layer: 25-30 layers of dead k-cells, are barrier,
replaced. Stratum lucidum - thick skin only, 3-5 layers dead k-cells, thick plasma membranes. Stratum granulosum - secrets lipids
repel water, 3-5 k-cells w/ apoptosis, organelles start disintegrating, transition between living & dead cells. Stratum spinosum - below
granulosum above basale, 8-10 layers k-cells, give flexibility. Stratum basale - deepest layer, where new cells are found, 1 column kcells. k-cell cycle takes 4 weeks.DERMIS: 2nd deepest part, nerves glands hair embedded, mainly connecting tissue like collagen
which makes up 70%. Papillary layer: superficial part, elastic fiber, dermal papillae increase area. Reticular layer: deepest part,
dense connective tissue, strength & elasticity, hair nerves sebaceous glands. HYPODERMIS: connective & adipose.
Cyanotic - blue, no O2 in hemoglobin. Jaundice - buildup bilirubin when RBC broken down. Erythmya - engorgement of capillaries bc
of allergies, inflammation, etc. = red. Pallor - pale, anemia, low BP. Bronze - Addisons disease, adrenal cortex. Bruising - hematoma,
blood clot, hemophilia, low vitamin C. Leathery skin - clumpy elastic fiber, immune problems, skin cancer. SKIN COLOR: Melanin - in
epi mostly, same # melanocytes for all races, difference in color bc of amount of pigment melanocytes make, Freckles = spots of
melanin collection, eumelanin more brown / black & phenomelanin more red/ yellow. Environment - UV, (Eumelanin provides
protection from UV, pheomelanin break down with too much UV). Carotene - precursor for Vitamin A, found in stratum corneum and
fatty areas of dermis & hypodermis. Hemoglobin - carries O2. friction ridges: markings on fingertips characteristic of primates.
flexion lines: on flexor surfaces of digits, palms, wrists, elbows etc skin is tightly bound to deep fascia at these point. AGING: Stars @
20, stem cell activity decline so repair is harder, epi dendritic cell decrease function, Vita D3 decrease so Ca decrease and skin is
brittle, Blood supply to dermis declines, hair follicles make thinner hair or die, dermis thins becomes less elastic = wrinkles, fat spreads,
skin dries. HAIR ANATOMY: Shaft - oval = curly, round = straight. Root - medulla (pigment, air spaces), cortex (middle, in dark hair has
pigment, in grey has air bubbles) cuticle (top layer, keratinized cells). Follicle - Bulb (has papillae and blood vessles to nourish follicle),
matrix (hair growth). Root plexus - sense. Arrector pili muscles contract and pull hair = goose bumps. HAIR GROWTH: Anagen Growth,Inside the follicle, new hair cells form at the root of the hair shaft. As the cells form, they push older cells out of the follicle. As
they are pushed out, the cells die and become the hair we see. Catagen - Transitional, follicle shrinks, lower part breaks to rest.
Telogen - resting,hair doesnt grow, papillae rest, shaft breaks so hair falls. COLOR: Dark has true melanin, Blond / red have melanin
w/ iron/sulfur. Gray = less tyrosinase (enzyme which initiates melanin production) White = air bubbles in the medullary shaft. SWEAT
GLANDS: Eccrine - secretes sweat (98% H20 2% salts), removes waste. Appocrine - stimulated during emotions & stress, begins @
puberty, same stuff as in eccrine. Sebaceous - connected to follicles, grease, not in palms or soles, made of cholesterols proteins salts
pheremones, prevents evaporation, keeps skin soft, acne = inflammation of sebaceous glands. Cerumonious - glands of external ear
make wax. NAILS: made of keratanized epi cells. Body - visible. Lunola - crescent area. Hypoychium - secures nail to fingertip, thick
stratum coroneum. Eponychium - band of epi, where cells multiply. FUNCTIONS OVERALL - protects ends of digits, scratching,
grasping.DISEASES: Lesions are variations in skin - elevated (shadow on edges like warts), flat (pussy lesion), depressed (inner
shadow like lacerations, ulcers.) Infections - viral, warts, fungus, bacterial (boils and carbuncles inflammation of hair follicle and
sebaceous glands) Contact dermatitis - skin becomes inflamed after contact. Irritant dermatitis (most common, looks like burn, contact
w/ acid & alkaline stuff), allergies (exposure to stuff you are extra sensitive to). Psoriasis (genetic) - chronic, skin becomes scaly, cycle
of skin production multiplies by 3-4, stratum corneum gets thick from dead skin, triggered by trauma. BURNS: 1st deg - surface layer
skin is gone, skin is red and inflamed. 2nd deg - deeper, blisters from fluid buildup around outer layer of epi, 3rd deg - full thickness of
skin is gone, susceptible to infections, dehydration, electrolyte imbalances, might need grafts. 4th deg - to muscle, bone. CANCER:
Basal cell carcinoma - least malignant most common (78%), stratum basale cant make keratin, tissue erosion, lose boundary
between epi and derm, red blotchy looking dudes. Squamous Cell carcinoma - 20%, cells in stratum spinosum, from squamous cells

in epi, from UV, small hard raised red growth, spreads quickly. Malignant melanoma - melanocytes, 1/% cancer, begins with weird
moles, blackish blobs.