1. Welcome to Anatomy & Physiology II
Who am I?
Greg Erianne, Ph.D.
Office Hours; See Syllabus
Office Location: Rm. SH 205
Tel; (voice mail)
PLEASE BE SURE TO INITIAL THE SIGN-IN SHEET IN THE BACK OF THE CLASSROOOM EACH TIME YOU COME TO CLASS!!
41 slides (plus syllabus/Web site review) – 102 min. [sp08 – 120 min; sp10 – 130 min]
1st class slides 1-33 plus syllabus Web site review. (82 min) [sp08 1st class slides 1-22 plus syllabus Web site review (80 min); sp10 1st class syllabus (75 min)]
2nd class slides 34 – 41 (20 min.) [sp08 2nd class slides (40 min); sp10 2nd class 20-end (55 min)]

2. Emergency Evacuation Procedures
Emergency evacuation may be required when there is an actual or potential danger to the occupants of any building as a result of fire or other emergency situation. When a fire alarm is sounded, all occupants must leave the building(s) via the nearest exit and proceed immediately to the designated staging area and remain 50 feet from any building. Fire Marshals will direct the evacuation. All walkways and roads must remain clear for emergency vehicles. Take all belongings with you. You will remain there until the all clear is sounded, or a Fire Marshal directs you to a remote staging area. Evacuation of physically disabled individuals will be assisted or coordinated by the faculty at the site. DO NOT USE ELEVATORS DURING THE EVACUATION PROCESS. The evacuation staging area for this classroom or laboratory is:
CH First Floor (classroom for Tues/Thurs AM classes;
Primary: Rear exit to lot 1 50 ft past walkway
Secondary: Parking lot 1
SH First and Second Floors (classroom/lab);
Primary: Lawn above HH stairs
Secondary: Parking lot 5
Note: slide moved…

3. Overview of Lecture 1 Course and Publisher Web sites
Course Description/Textbook/Lab Book
Course Objectives and Syllabus Review
Blueprint for success/Study strategy
Overview of blood
Blood volume and composition
Formed elements of blood
Blood plasma
Hemostasis
Blood groups and transfusions

4. Course Web Sites
Our Web sites for this class are located at:
(Main)
Announcements (VERY IMPORTANT TO LOOK AT FREQUENTLY!)
Syllabus and all lecture/lab schedules
Lecture and Lab slides used in class (ppt and pdf formats)
Supplementary online materials for Lecture and Lab
Lecture and Lab Exam Study Guides
Links to many other sites including Pearson’sWeb site
Extra credit assignments
(Blackboard Learn; Secondary)
You will need your student ID and password for the Blackboard (BB) site
This BB site will be used ONLY grades and grade-related things
(from Pearson Science)
You will need the course ID and have to register if you haven’t been to this site before
Lots of resources to use for A&P II – take advantage of it!
Printing slides and other materials (see I sent)

5. Outline of Course/Requirements
Course Description
Lecture / discussion format
Lectures may not follow the order of Marieb’s Human Anatomy & Physiology, 9th edition – please check your syllabus!
Figures used for class
Laboratory
Marieb’s Laboratory Manual, 11th edition
Reading assignments for lab should be done BEFORE you come to lab

6. Blueprint for Success Most importantly…
Skim your textbook BEFORE lecture and make notes
Take notes in your own words and become mentally involved during lecture; review/rewrite your notes after lecture
Ask questions if you don’t understand
Continually review previously learned material
Use all the study aids available to you
***Before taking the exam, you should be able to take a BLANK study guide and answer all the questions WITHOUT YOUR NOTES!!!!
**See the Suggested Study Method on Web at the gserianne.com Web site – Please review this!!!
**Be sure to print slides/materials if you want them for class/lab – make a schedule for yourself

7. Major objectives of this course
In general, you will…
Master the objectives listed in the syllabus
Develop a further mastery of scientific/biomedical terminology
Further develop your ability to think logically and critically
Let’s review the syllabus and handouts…

8. Grading for A&P II Lecture
(3 lecture exams + Final Exam) **If Final Exam grade is higher than your lowest lecture exam grade, it will replace that lowest exam grade
Lecture Exam %
Lecture Exam %
Lecture Exam %
Final Exam %
TOTAL %
Lab
Lab Exam %
Lab Exam %
Attend./Participation %
TOTAL %
A = 90.00% or higher average
B = 80.00% – 89.99%
C = 70.00% – 79.99%
D = 60.00% – 69.99%
F = 59.99% or lower average
NOTE: CCM does NOT use '+' or '-' grades

9. Anatomy and Physiology
Marieb’s Human
Anatomy and Physiology
Ninth Edition
Marieb w Hoehn
Chapter 17
Blood
Lecture 1
Slides 1-15; 80 min (with review of syllabus and Web sites) [Lecture 1]
Slides 16 – 38; 50 min [Lecture 2]
118 min (38 slides plus review of course Web sites and syllabus)

10. Overview of Blood – (Hem-)
Blood is what type of tissue?
Connective tissue.
Functions
transports vital substances (O2, waste)
maintains stability of interstitial fluid
distributes heat
hemostasis
prevents infection
Blood Cells (formed elements)
form in red bone marrow
red blood cells
white blood cells
platelets (cell fragments)
Plasma (liquid portion - matrix)
contains dissolved substances
mostly water and proteins
amount of blood varies with
body size
changes in fluid volume
changes in electrolyte concentration
amount of adipose tissue
about 7-8% of body weight
About 5.0 liters of blood in adult
Hematology = study of blood
Some useful conversions: 1L = 1Kg (2.2 lbs); 1 pint = 1.04 lb; 2 pints = 1L

11. Blood Composition
Hematocrit (HCT) – Percentage of red cells in blood by volume. Also called Packed Cell Volume (PCV). Usually about 45%
What would happen to the hematocrit if someone was dehyrated and lost plasma volume?
Figure from: Saladin, Anatomy & Physiology, McGraw Hill, 2007

12. Formed Elements of the Blood
45% of blood
Figure from: Hole’s Human A&P, 12th edition, 2010

13. Origin of Blood Cells
All formed elements of blood arise from a common hematopoietic pluripotent stem cell (a hemocytoblast) in the red bone marrow
Figure from: Hole’s Human A&P, 12th edition, 2010

14. Red Blood Cells erythrocytes biconcave (↑ surface area)
one-third hemoglobin (~ 280 million Hb molecules per RBC)
oxyhemoglobin
deoxyhemoglobin
can readily squeeze through capillaries
lack nuclei and mitochondria
Figure from: Hole’s Human A&P, 12th edition, 2010

15. Hemoglobin
General structure: - Four polypeptides chains - A porphyrin - An iron atom
Heme
Figure From: Martini, Anatomy & Physiology, Prentice Hall, 2001

16. Red Blood Cell Count
number of RBCs in a cubic millimeter (mm3) of blood (1 mm3 = 1 microliter, µl)
4,600,000 – 6,200,000 in males
4,200,000 – 5,400,000 in adult females
4,500,000 – 5,100,000 in children
Average is about 5 x 106 RBCs / µl
Number of RBCs reflects blood’s oxygen carrying capacity

17. Red Blood Cell Production
low blood oxygen causes kidneys and liver to release erythropoietin which stimulates RBC production (up to 30 million per second under maximum EPO stimulation!)
Erythropoiesis
Normally about 3x10^6 new RBCs enter the circulation every second.
Erythropoiesis normally takes about 3-5 days.
vitamin B12, folic acid and iron necessary for RBC production
Figure from: Hole’s Human A&P, 12th edition, 2010

18. Blood Viscosity and Osmolarity
Viscosity (thickness)
Resistance to flow of blood
Whole blood is about 5x as viscous as water
Changes in viscosity can put strain on the heart
Erythrocytosis (polycythemia)  viscosity
Osmolarity
Due to NUMBER of ‘particles’ dissolved, not the type
Na+, proteins, erythrocytes
Osmolarity determines fluid flow between blood and tissues

19. Red Blood Cell Turnover
The average life span of an RBC is about 120 days (4 months)
Iron is carried in the blood by transferrin to red bone marrow, liver
Figure From: Martini, Anatomy & Physiology, Prentice Hall, 2001
Porphyrin from worn out RBCs is converted into biliverdin and bilirubin
Men lose about 0.9 mg of iron/day, women about 1.7 mg/day. We must consume about 5-20 mg/day of iron to replace losses (pregnant women about mg/day)

20. Types of Anemia
Anemia – deficiency of RBCs or Hb in RBCs; reduces O2-carrying capacity of blood
aplastic anemia
bone marrow damaged
toxic chemicals
radiation
iron deficiency anemia
hemoglobin deficient
lack of iron
pernicious anemia
excess of immature RBCs
inability to absorb B12
hemolytic anemia
RBCs destroyed
toxic chemicals
thalassemia
hemoglobin deficient
RBCs short-lived
defective gene ( or -chain)
sickle cell anemia
abnormal shape of RBCs
defective gene (-chain)

21. White Blood Cells leukocytes protect against disease
interleukins and colony-stimulating factors stimulate development in red bone marrow
granulocytes
neutrophils
eosinophils
basophils
agranulocytes
lymphocytes
monocytes
‘phils’ are filled with granules!

22. Neutrophils light blue granules in acid-base stain lobed nucleus
other names
segs
polymorphonuclear leukocyte (PMNs)
bands (young neutrophils)
first to arrive at infections
phagocytic
*55% - 65% of leukocytes (most numerous type of WBC)
elevated in bacterial infections
Figure from: Hole’s Human A&P, 12th edition, 2010

23. Basophils deep blue granules from basic stain
Figure from: Hole’s Human A&P, 12th edition, 2010
deep blue granules from basic stain
release histamine and heparin in allergic reactions (similar to mast cells)
less than 1% of leukocytes

24. Eosinophils deep red granules in acid stain bilobed nucleus
Figure from: Hole’s Human A&P, 12th edition, 2010
deep red granules in acid stain
bilobed nucleus
participate in allergic reactions
defend against parasitic worm infestations
1% - 3% of leukocytes
elevated in worm infestations and allergic reactions, collagen diseases, diseases of spleen

25. Monocytes largest blood cell agranulocyte kidney-shaped or oval nuclei
Figure from: Hole’s Human A&P, 12th edition, 2010
largest blood cell
agranulocyte
kidney-shaped or oval nuclei
leave bloodstream to become macrophages
3% - 9% of leukocytes
elevated in typhoid fever, malaria, tuberculosis, viral infections, inflammation

26. Lymphocytes about the size of RBC agranulocytic large spherical nuclei
thin rims of cytoplasm
T cells
B cells
NK cells
important in immunity
produce antibodies
25% - 33% of leukocytes
decreased T Cells in AIDS
Figure from: Hole’s Human A&P, 12th edition, 2010

27. Diapedesis
Diapedesis - leukocytes squeeze through capillary walls to enter tissue space outside the blood vessel
Figure from: Hole’s Human A&P, 12th edition, 2010

28. White Blood Cell Counts
number of WBCs per mm3 of blood
5,000 – 10,000 per mm3 (or μl) of blood
leukopenia (-penia = deficiency of cell number)
low WBC count
typhoid fever, flu, measles, mumps, chicken pox, AIDS
leukocytosis (-cytosis = increase in cell number)
high WBC count
acute infections, vigorous exercise, great loss of body fluids
differential WBC count
lists percentages of types of leukocytes
may change in particular diseases

29. Blood Platelets called thrombocytes when nucleated (in birds)
cell fragments of megakaryocytes
membrane bound
150,000 – 500,000 per mm3 of blood (average ≈ 350,000 per µl)
help control blood loss from broken vessels
About 25-40% are stored in spleen until needed, rest circulate freely in blood for about 10 days.

30. Blood Plasma straw colored liquid portion of blood 55% of blood
Figure from: Hole’s Human A&P, 12th edition, 2010

31. Plasma Proteins Albumins most numerous plasma proteins (~55%)
‘transport’ proteins
originate in liver
help maintain osmotic pressure of blood
Alpha and Beta Globulins
originate in liver
transport lipids and fat-soluble vitamins
Gamma Globulins
originate in lymphatic tissues (plasma cells)
constitute the antibodies of immunity
Fibrinogen
originates in liver
plays key role in blood coagulation

32. Gases and Nutrients Gases Nutrients oxygen amino acids carbon dioxide
nitrogen
Nutrients
amino acids
simple sugars
nucleotides
lipids
lipoproteins

33. Nonprotein Nitrogenous (NPN) Substances
molecules containing nitrogen that are not proteins
urea – product of protein catabolism; about 50% of NPN substances ( BUN – blood urea nitrogen; one indicator of kidney function)
uric acid – product of nucleic acid catabolism
amino acids – product of protein catabolism
creatine – stores phosphate groups (energy)
creatinine – product of creatine metabolism

34. Plasma Electrolytes sodium potassium calcium magnesium chloride
bicarbonate
phosphate
sulfate

35. Hemostasis cessation of bleeding Platelet Plug Formation
triggered by exposure of platelets to collagen
platelets adhere to rough surface to form a plug
Blood Vessel Spasm
triggered by pain receptors, platelet/endothelial cell release of various substances
smooth muscle in vessel contracts (vascular spasm)
Blood Coagulation
triggered by platelets, cellular damage and blood contact with foreign surfaces
blood clot forms
1. Vascular phase
2. Platelet phase
3. Coagulation phase
Hemostasis

36. Platelet Plug Formation
Substances released by platelets:
- ADP (platelet activator)
- thromboxane A2 and serotonin (vessel constriction)
- clotting factors
- Ca2+ (aids in coagulation)
- PDGF
Example of positive feedback
Figure from: Hole’s Human A&P, 12th edition, 2010

37. Blood Coagulation Three cascades: Instrinsic Extrinsic Common*
Coagulation is an example of positive feedback
~ 15 sec.
Partial Thromboplastin Time (PTT) measures instrinsic pathway and is prolonged by heparin.
Prothrombin time (PT) Measures extrinsic pathway and is prolonged by warfarin (coumadin).
~ 3-6 min.
Figure from: Martini, Anatomy & Physiology, Prentice Hall, 2001

38. Blood Coagulation Extrinsic Clotting Mechanism (shorter, faster)
chemical outside of blood triggers blood coagulation
triggered by tissue factor or thromboplastin (not found in blood, thus it’s extrinsic and produced by damaged tissue)
Intrinsic Clotting Mechanism (longer, slower)
chemical inside blood triggers blood coagulation
activators are in direct contact with blood or contained within the blood triggered by Hageman factor (XII; found inside blood)
triggered when blood contacts a ‘foreign’ surface, e.g., collagen fibers, glass tube
Both pathways are activated after blood vessel damage

39. Blood Clots
After forming, blood clot retracts (~60%) and pulls the edges of a broken vessel together
Platelet-derived growth factor stimulates smooth muscle cells and fibroblasts to repair damaged blood vessels
Thrombus – blood clot
Embolus – blood clot moving through blood
Serum is the fluid expressed from a clot, i.e., the plasma minus clotting factors

40. Factors Preventing Coagulation
The smooth lining (endothelium) of blood vessels discourages the accumulation of platelets
Prostacyclin released by endothelial cells (aspirin)
Some cells secrete heparin (an anticoagulant)
As a clot forms, fibrin absorbs thrombin and prevents the reaction from spreading
Antithrombin (in plasma) interferes with the action of excess thrombin (activated by heparin)
Plasmin digests blood clots (generated from plasminogen via the action of a plasma enzyme, kallikrein) *

41. Review Major Blood Cell Type red blood cell white blood cell platelet
Scientific Name
erythrocyte
leukocyte
thrombocyte
Circulating Concentration/
mm3 blood
4-6 million/
5-10,000/
150, ,000/
General Function
transportation of oxygen
fight infection
blood clotting
Key Characteristic
Biconcave disks, lack nucleus and mitochondria, contain Hb, erythropoietin
Granulocytes and agranulocytes, some are phagocytic
Fragments of giant megakaryocyte

42. Review Specific WBC Function/ Event of Increase? Differential %
Morphological feature
Neutrophil
general phagocytosis;
acute bacterial infections
54%-62%
Light purple granules, multilobed nucleus
Eosinophil
kills parasites; involved in inflammation and allergic reactions
1%-3%
Dark red granules, bilobed nucleus
Basophil
Inflammatory reactions: releases heparin (natural anticoagulant) and histamine (inflammation)
less than 1%
Deep blue granules, bilobed nucleus usually obscured by granules
Monocyte
phagocytosis of large particles;
typhoid, malaria, mononucleosis
3%-9%
Large, kidney-shaped or oval nucleus
Lymphocyte
produce antibodies/immunity;
viral infections, tissue rejection, tumors, TB, whooping cough
25%-33%
Slightly larger than RBCs, large nucleus with thin rim of cytoplasm