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Physiology

Proteinuria—Protein content in urine, often due to leaky or damaged glomeruli.

Oliguria—An abnormally small amount of urine, often due to shock or kidney damage.

Polyuria—An abnormally large amount of urine, often caused by diabetes.

Dysuria—Painful or uncomfortable urination, often from urinary tract infections.

Hematuria—Red blood cells in urine, from infection or injury.

Glycosuria—Glucose in urine, due to excess plasma glucose in diabetes, beyond the amount able to be reabsorbed in the proximal convoluted tubule.

  • Partial Pressures of O2 and CO2 in the body (normal, resting conditions):

  • Alveoli
    • PO2 = 100 mm Hg
    • PCO2 = 40 mm Hg
  • Alveolar capillaries
    • Entering the alveolar capillaries
      • PO2 = 40 mm Hg (relatively low because this blood has just returned from the systemic circulation & has lost much of its oxygen)
      • PCO2 = 45 mm Hg (relatively high because the blood returning from the systemic circulation has picked up carbon dioxide) 
  • While in the alveolar capillaries, the diffusion of gasses occurs: oxygen diffuses from the alveoli into the blood & carbon dioxide from the blood into the alveoli.

  • Leaving the alveolar capillaries
    • PO2 = 100 mm Hg
    • PCO2 = 40 mm Hg
  • Blood leaving the alveolar capillaries returns to the left atrium & is pumped by the left ventricle into the systemic circulation. This blood travels through arteries & arterioles and into the systemic, or body, capillaries. As blood travels through arteries & arterioles, no gas exchange occurs.
    • Entering the systemic capillaries
      • PO2 = 100 mm Hg
      • PCO2 = 40 mm Hg
    • Body cells (resting conditions)
      • PO2 = 40 mm Hg
      • PCO2 = 45 mm Hg
  • Because of the differences in partial pressures of oxygen & carbon dioxide in the systemic capillaries & the body cells, oxygen diffuses from the blood & into the cells, while carbon dioxide diffuses from the cells into the blood.
    • Leaving the systemic capillaries
      • PO2 = 40 mm Hg
      • PCO2 = 45 mm Hg
  • Blood leaving the systemic capillaries returns to the heart (right atrium) via venules & veins (and no gas exchange occurs while blood is in venules & veins). This blood is then pumped to the lungs (and the alveolar capillaries) by the right ventricle.

Hyperventilation

  1. Treatments :Rebreath air, hold breath (Increase CO2)
    Give oxygen for Hypoxemia

Red Blood Cells (erythrocytes)

  • Women average about 4.8 million of these cells per cubic millimeter (mm3; which is the same as a microliter [µl]) of blood.
  • Men average about 5.4 x 106 per µl.
  • These values can vary over quite a range depending on such factors as health and altitude.
  • RBC precursors mature in the bone marrow closely attached to a macrophage.
  • They manufacture hemoglobin until it accounts for some 90% of the dry weight of the cell.
  • The nucleus is squeezed out of the cell and is ingested by the macrophage.

RBC have characteristic biconcave shape

Thus RBCs are terminally differentiated; that is, they can never divide. They live about 120 days and then are ingested by phagocytic cells in the liver and spleen. Most of the iron in their hemoglobin is reclaimed for reuse. The remainder of the heme portion of the molecule is degraded into bile pigments and excreted by the liver. Some 3 million RBCs die and are scavenged by the liver each second.

Red blood cells are responsible for the transport of oxygen and carbon dioxide.

  • The Autonomic Nervous System (ANS) Controls the Body's Internal Environment in a Coordinated Manner

  • The ANS helps control the heart rate, blood pressure, digestion, respiration, blood pH and other bodily functions through a series of complex reflex actions
  • These controls are done automatically, below the conscious level
  • To exert this control the activities of many different organs must be coordinated so they work to accomplish the same goal
  • In the ANS there are 2 nerves between the central nervous system (CNS) and the organ. The nerve cell bodies for the second nerve are organized into ganglia:
    • CNS -> Preganglionic nerve -> Ganglion -> Postganglionic nerve -> Organ
  • At each junction neurotransmitters are released and carry the signal to the next nerve or organ.
  • The ANS has 2 Divisions, Sympathetic and Parasympathetic

     

  • Comparison of the 2 systems:
  •  

    Anatomical
    Location

     Preganglionic
    Fibers

     Postganglionic
    Fibers

     Transmitter
    (Ganglia)

     Transmitter
    (Organs)

     Sympathetic

     Thoracic/
    Lumbar

     Short

    Long

    ACh

    NE

     Parasympathetic

     Cranial/
    Sacral

     Long

    Short

    ACh

    ACh

     

    The Sympathetic is the "Fight or Flight" Branch of the ANS

  • Emergency situations, where the body needs a sudden burst of energy, are handled by the sympathetic system
  • The sympathetic system increases cardiac output and pulmonary ventilation, routes blood to the muscles, raises blood glucose and slows down digestion, kidney filtration and other functions not needed during emergencies
  • Whole sympathetic system tends to "go off" together
  • In a controlled environment the sympathetic system is not required for life, but it is essential for any stressful situation
  • The Parasympathetic is the Rest and Digest Branch of the ANS

  • The parasympathetic system promotes normal maintenance of the body- acquiring building blocks and energy from food and getting rid of the wastes
  • It promotes secretions and mobility of different parts of the digestive tract.
  • Also involved in urination, defecation.
  • Does not "go off" together; activities initiated when appropriate
  • The vagus nerve (cranial number 10) is the chief parasympathetic nerve
  • Other cranial parasympathetic nerves are: III (oculomotor), VII (facial) and IX (glossopharyngeal)
  • The Hypothalamus Has Central Control of the ANS

  • The hypothalamus is involved in the coordination of ANS responses,
  • One section of the hypothalamus seems to control many of the "fight or flight" responses; another section favors "rest and digest" activities
  • The Adrenal Medulla is an Extension of the Sympathetic Nervous System

  • The adrenal medulla behaves like a combined autonomic ganglion and postsynaptic sympathetic nerve (see diagram above)
  • Releases both norepinephrine and epinephrine in emergency situations
    • Releases a mixture of epinephrine (E = 80%) and norepinephrine (NE = 20%)
    • Epinephrine = adrenaline
  • This action is under control of the hypothalamus
  • Sympathetic & Parasympathetic Systems

  • Usually (but not always) both sympathetic and parasympathetic nerves go to an organ and have opposite effects
  • You can predict about 90% of the sympathetic and parasympathetic responses using the 2 phrases: "Fight or Flight" and "Rest and Digest".
  • Special cases:
    • Occasionally the 2 systems work together: in sexual intercourse the parasympathetic promotes erection and the sympathetic produces ejaculation
    • Eye: the sympathetic response is dilation and relaxation of the ciliary muscle for far vision (parasympathetic does the opposite)
    • Urination: the parasympathetic system relaxes the sphincter muscle and promotes contraction of muscles of the bladder wall -> urination (sympathetic blocks urination)
    • Defecation: the parasympathetic system causes relaxation of the anal sphincter and stimulates colon and rectum to contract -> defecation (sympathetic blocks defecation)
  •  Organ

     Parasympathetic Response
    "Rest and Digest"

     Sympathetic Response
    "Fight or Flight"

     Heart
    (baroreceptor reflex)

    Decreased heart rate
    Cardiac output decreases

    Increased rate and strength of contraction
    Cardiac output increases

     Lung Bronchioles

     Constriction

    Dilation

     Liver Glycogen

    No effect

     Glycogen breakdown
    Blood glucose increases

     Fat Tissue

     No effect

    Breakdown of fat
    Blood fatty acids increase

     Basal Metabolism

     No effect

     Increases ~ 2X

     Stomach

     Increased secretion of HCl & digestive enzymes
    Increased motility

    Decreased secretion
    Decreased motility

     Intestine

     Increased secretion of HCl & digestive enzymes
    Increased motility

     Decreased secretion
    Decreased motility

     Urinary bladder

     Relaxes sphincter
    Detrusor muscle contracts
    Urination promoted

    Constricts sphincter
    Relaxes detrusor
    Urination inhibited

     Rectum

     Relaxes sphincter
    Contracts wall muscles
    Defecation promoted

     Constricts sphincter
    Relaxes wall muscles
    Defecation inhibited

     Eye

     Iris constricts
    Adjusts for near vision

    Iris dilates
    Adjusts for far vision

     Male Sex Organs

     Promotes erection

     Promotes ejaculation

     

Each hormone in the body is unique.  Each one is different in it's chemical composition, structure, and action.  With respect to their chemical structure, hormones may be classified into three groups: amines, proteins, and steroids.

 

 Amines- these simple hormones are  structural variation of the amino acid tyrosine.  This group includes thyroxine from the thyroid gland and epinephrine and norepinephrine from the adrenal medulla.

Proteins- these hormones are chains of amino acids.  Insulin from the pancreas, growth hormone from the anterior pituitary gland, and calcitonin from the thyroid gland are all proteins.  Short chains of amino acids are called peptides.  Antidiuretic hormone and oxytocin, synthesized by the hypothalamus, are peptide hormones.

Steroids- cholesterol is the precursor for the steroid hormones, which include cortisol and aldosterone from the adrenal cortex, estrogen and progesterone from the ovaries, and testosterone from the testes.

The Cardiac Cycle: the sequence of events in one heartbeat.

systole - the contraction phase; unless otherwise specified refers to left ventricle, but each chamber has its own systole.

diastole - the relaxation phase; unless otherwise specified refers to left ventricle, but each chamber has its own diastole.

1) quiescent period - period when all chambers are at rest and filling. 70% of ventricular filling occurs during this period. The AV valves are open, the semilunar valves are closed.

2) atrial systole - pushes the last 30% of blood into the ventricle.

3) atrial diastole - atria begin filling.

4) ventricular systole - First the AV valves close causing the first heart sound, then after the isovolumetric contraction phase the semilunar valves open permitting ventricular ejection of blood into the arteries.

5) ventricular diastole - As the ventricles relax the semilunar valves close first producing the second heart sound, then after the isovolumetric relaxation phase the AV valves open allowing ventricular filling.

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