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Anp final review

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Prepared by Dr. Jhason John J. Cabigon
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Anatomy and Physiology:
Endocrine System
A. Hormones chemical substances that act on body tissues and
organs and affect cellular activity
1. Steroids from the adrenals and the gonads (sex organs)
2. Proteins or small peptides from the other endocrine
glands
B. Regulation
1. Negative feedback to turn down or shut off
2. Positive feedback to speed up
C. Endocrine Glands
1. Pituitary gland (hypophysis) master endocrine gland
a. Anterior Pituitary gland
Thyroid stimulating hormone (TSH) or
thyrotropin
Adrenocorticotropic hormone (ACTH) or
Corticotropin
Gonadotropins
o Follicle Stimulating Hormone promotes
growth of ovarian follicles
o Luteinizing Hormone promotes ovulation;
converts the mature ovarian follicle into the
corpus luteum
Growth hormone (GH) or Somatropin
Prolactin (PRL)
Melanocyte-stimulating hormone (MSH)
b. Posterior pituitary gland
Antidiuretic hormone (ADH or vasopressin)
acts on kidney tubules
Oxytocin uterine contraction and milk ejection
reflex
* Hypothalamic control the production of Pituitary
Gland hormones are under the influence of the
Hypothalamus; the hypothalamus produces Releasing and
Inhibiting hormones that stimulate or inhibits the pituitary
gland; examples of Releasing homones:
Gonadotropin Releasing Hormone (GnRH)
stimulates the anterior pituitary to produce
gonadotropins
Thyroid Releasing Hormone (TRH) stimulates the
anterior pituitary to produce TSH
2. Thyroid gland found in the anterior neck
Thyroxine (T4) & Triiodothyronine (T3) control
metabolic rate and activity of tissues and organs
*Metabolism chemical reactions that transform
substances into energy or materials that the body can
use or store
Calcitonin calcium deposition into bones (thus
decreasing blood calcium)
3. Parathyroid glands secretes parathormone (PTH) which
increases calcium levels in the blood
a. Promotes bone resorption by stimulating osteoclasts
to resorb bone and release calcium ions from bone
matrix into the bloodstream
b. Stimulates calcitriol hormone synthesis in the kidney
c. Promotes calcium absorption in the small intestine
d. Prevents the loss of calcium ions during the
formation of urine
* Calcitonin counteracts PTH
4. Adrenal glands
Adrenal cortex secretes corticosteroids:
o Glucocorticoids increase blood glucose by
gluconeogenesis (formation of glucose from
non-carbohydrate sources like fats and proteins)
o Mineralocorticoids aldosterone promotes
sodium and water retention
o Sex hormones small amounts of androgen,
estrogen and progestin
Adrenal medulla secretes catecholamines
(epinephrine and norepinephrine) that stimulate the
sympathetic nervous system (fight-or-flight response)
5. Pancreas the endocrine section has cell clusters called
islets of Langerhans
Alpha cells produces glucagon (increases blood
glucose)
Beta cells produces insulin (decreases blood
glucose)
Delta cells produces somatostatin (suppresses
insulin and glucagon release; also inhibits growth
hormone)
6. Pineal Gland secretes melatonin which helps establish
the body’s wake-and-sleep cycles
7. Thymus in children, it produces thymosin which
matures T lymphocytes
8. Gonads
a. Female Ovaries growing ovarian follicles produce
estrogen (responsible for female secondary sex
characteristics), while corpus luteum produce
progesterone (influences menstrual cycle)
b. Male Testes interstitial cells of Leydig produce
testosterone (responsible for male secondary sex
characteristics and libido)
9. Other endocrine organs and the hormones produced:
a. Placenta human chorionic gonadotropin (hCG)
which stimulates the ovary to produce sex hormones;
during 3
rd
trimester, the placenta will produce
progesterone and estrogen
b. Stomach Gastrin (stimulates stomach glands to
release HCl acid)
c. Small intestines Secretin (stimulates pancreatic
juice and bile secretion, but inhibits stomach
secretion); Cholecystokinin (stimulates pancreatic
juice and bile secretion, and causes papillary
sphincter to relax); Intestinal Gastrin (inhibits
stomach HCl secretion)
d. Kidneys Erythropoietin (stimulates bone marrow to
produce RBC’s)
e. Heart Atrial natriuretic peptide (ANP inhibits
aldosterone and renin secretion)
* Plasma membranes produce Prostaglandins
* Adipose tissues produce Leptin (suppresses appetite)
D. Common Endocrine Disorders
1. Hyperthyroidism Hyperfunctioning thyroid (FT3 and
FT4 increased)
2. Hypothyroidism usually associated w/ goiter (iodine-
deficiency)
3. Hypoparathyroidism signs of hypocalcemia (muscle
cramps, Chvostek’s sign)
4. Diabetes insipidus ADH deficiency (polyuria)
5. Diabetes mellitus chronic disorder of impaired glucose
tolerance, resulting to hyperglycemia (normal blood
glucose = 80-120mg/100ml of blood)
a. Signs of Diabetes mellitus
Polyuria
Polydipsia
Polyphagia
b. Types of Diabetes mellitus
Type 1 DM Juvenile diabetes; Autoimmune;
Insulin-deficiency; Formerly known as Insulin-
dependent diabetes mellitus (IDDM)
Type 2 DM Adult-onset diabetes; Acquired;
Insulin-resistance; Formerly known as Non-
insulin-dependent diabetes mellitus (NIDDM)
The Blood
A. Description
1. Only fluid tissue
2. Color range
a. Oxygen-rich blood is scarlet red
b. Oxygen-poor blood is dull red

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Prepared by Dr. Jhason John J. Cabigon
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3. pH must remain between 7.357.45
4. Blood temperature is slightly higher than body
temperature
B. Composition
1. Nonliving fluid matrix (plasma) 55%
a. Approximately 90 percent water
b. Includes many dissolved substances
Nutrients
Salts (metal ions)
Respiratory gases
Hormones
Waste products
Proteins
a. Albumin regulates osmotic pressure
b. Clotting factors help to stem blood loss
when a blood vessel is injured
c. Antibodies Y-shaped proteins that help
protect the body from antigens
2. Formed elements 45%
a. Erythrocytes transport oxygen bound to their
hemoglobin; lifespan of 100-120 days (4-6
million/mm
3
); most numerous formed elements,
accounting for almost the 45% of the formed
elements (hematocrit is the measurement of their
percentage in blood)
b. Leukocytes amoeboid cells for protection (4,000-
11,000/ mm
3
)
1. Granulocytes
i. Neutrophils active phagocytes; acute
infections (40-70% of WBCs)
ii. Eosinophils allergic attacks; kills parasitic
worms
iii. Basophils contains histamine
2. Agranulocytes
i. Monocytes macrophages; long-term
“clean-up” team
ii. Lymphocytes immunity
c. Thrombocytes/Platelets for clotting (250,000-
500,000/ mm
3
)
C. Hematopoiesis
1. In the red bone marrow of adults, the Hematocytoblast
differentiates into Lymphoid stem cells and Myeloid stem
cells
2. Lymphoid stem cell will produce Lymphocytes
3. Myeloid stem will give rise to the rest
* Erythropoiesis controlled by erythropoietin from kidney as
a response to reduced blood O
2
level
D. Hemostasis stoppage of blood flow
1. Platelet plug formation platelets become sticky and
attract more platelets
2. Vascular spasms platelets release serotonin causing
vasoconstriction (decreasing blood loss)
3. Coagulation
a. PF3 (coats platelets) interacts w/ TF (from injured
tissue), Vitamin K and calcium to trigger the clotting
cascade
b. Protein activator converts prothrombin to thrombin
c. Thrombin joins fibrinogen to produce fibrin
d. Fibrin forms a meshwork that traps RBC’s (basis of
clot)
E. Undesirable clots
1. Thrombus clot that develops and persists in an unbroken
skin
2. Embolus moving clot
F. Blood Groups
1. ABO
a. Type A contains A-antigen and anti-B
b. Type B contains B-antigen and anti-A
c. Type AB contains both A and B antigen but no
antibodies
d. Type O does not contain antigens but have both
anti-A and anti-B
2. Rh
a. Rh positive presence of antigen D (agglutinogen D)
b. Rh negative absence of antigen D
* Danger is ONLY when the mother is Rh and the father
is Rh+, and the child inherits the Rh+ factor
G. Common Hematologic diseases
1. Thrombocytopenia low platelet
2. Hemophilia hereditary lack of clotting factors
3. Anemia decrease in oxygen carrying capacity of blood
4. Polycythemia excessive RBC’s
5. Leukemia excessive leukocytosis (immature WBCs)
The Cardiovascular System
A. Heart
1. Found in the mediastinum (area between the lungs);
covered by the pericardium (outer parietal and inner
visceral)
2. Functions as double pump: right side (pulmonary pump)
& left side (systemic pump)
3. 3 tissue layers of the heart wall:
a. Epicardium outermost layer; actually the visceral
pericardium
b. Myocardium middle, muscular layer
c. Endocardium innermost layer
4. 4 chambers:
a. 2 atria receiving chambers separated by interatrial
septum; smaller w/ thin walls
b. 2 ventricles discharging chambers/actual pumps
separated by interventricular septum; larger and
stronger than atria w/ thick walls (left ventricle even
thicker than the right ventricle)
5. 4 valves:
a. 2 atrioventricular valves entry valves to the
ventricles; prevents blood to flow back to the atria
Tricuspid valve (right) found between the right
atrium and ventricle
Bicuspid or Mitral valve (left) found between
the left atrium and ventricle
b. 2 semilunar valves exit valves from the ventricles
Pulmonic valve (right) found between the right
ventricle and the Pulmonary trunk
Aortic valve (left) found between the left
ventricle and the Aorta
B. Heart Physiology
1. Intrinsic Conduction /Nodal System
a. Sinoatrial (SA) node pacemaker (intrinsic rate: 60-
80 beats/min); posterior wall of RA
b. Atrioventricular (AV) node functional pacemaker
(rate: 40-60); interatrial septum
c. Atrioventricular bundle (Bundle of His)
d. Right and Left Bundle Branches
e. Purkinje fibers
2. Cardiac Cycle
a. Ventricular filling (diastole)
b. Atrial contraction
c. Isovolumetric contraction
d. Ventricular ejection (systole)
e. Isovolumetric relaxation
3. Concepts in Cardiac Cycle
a. Systole ventricular contraction
b. Diastole ventricular relaxation/filling
c. Stroke volume volume of blood pump out by a
ventricle with each heartbeat
d. Cardiac output amount of blood pump out by a
ventricle in 1 min (SV x HR)
e. Preload end diastolic ventricular volume
f. Afterload ventricular pressure at the end of systole
g. Ejection fraction percentage of blood emptied from
the ventricle during contraction (approximately 60%)
4. Heart Sounds
a. S1 : closure of AV valves (mitral and tricuspid);

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Anatomy and Physiology: Endocrine System A. Hormones – chemical substances that act on body tissues and organs and affect cellular activity 1. Steroids – from the adrenals and the gonads (sex organs) 2. Proteins or small peptides – from the other endocrine glands B. Regulation 1. Negative feedback – to turn down or shut off 2. Positive feedback – to speed up C. Endocrine Glands 1. Pituitary gland (hypophysis) – master endocrine gland a. Anterior Pituitary gland • Thyroid stimulating hormone (TSH) or thyrotropin • Adrenocorticotropic hormone (ACTH) or Corticotropin • Gonadotropins o Follicle Stimulating Hormone – promotes growth of ovarian follicles o Luteinizing Hormone – promotes ovulation; converts the mature ovarian follicle into the corpus luteum • Growth hormone (GH) or Somatropin • Prolactin (PRL) • Melanocyte-stimulating hormone (MSH) b. Posterior pituitary gland • Antidiuretic hormone (ADH or vasopressin) – acts on kidney tubules • Oxytocin – uterine contraction and milk ejection reflex * Hypothalamic control – the production of Pituitary Gland hormones are under the influence of the Hypothalamus; the hypothalamus produces Releasing and Inhibiting hormones that stimulate or inhibits the pituitary gland; examples of Releasing homones: • Gonadotropin Releasing Hormone (GnRH) – stimulates the anterior pituitary to produce gonadotropins • Thyroid Releasing Hormone (TRH) – stimulates the anterior pituitary to produce TSH 2. Thy ...
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