Arteries carry blood away from the heart, whereas veins return blood to the heart.

Arteries and veins are continuous with each other through smaller blood vessels. Blood cells become packed at the bottom of the test tube when whole blood is centrifuged, leaving the fluid plasma at the top of the tube. White blood cells and platelets form a thin, light-colored buffy coat at the interface between the packed red blood cells and the plasma. Plasma is a straw-colored liquid consisting of water and dissolved solutes. The major solute of the plasma in terms of its concentration is Na+. Fibrinogen is an important clotting factor found in plasma produced by the liver. The fluid from clotted blood is called serum and its fibrinogen has been converted to fibrin. It is otherwise identical to plasma. The heart is divided into four chambers. The right and left atria receive blood from the venous system; the right and left ventricles pump blood into the arterial system. The right and left sides of the heart are separated by a muscular wall, or septum. Cardiac cycle: the phase of contraction is called systole, and the phase of relaxation is called diastole. Atrial contraction occurs toward the end of diastole, when the ventricles are relaxed; when the ventricles contract during systole, the atria are relaxed. The heart has a two-step pumping action. The right and left atria contract almost simultaneously, followed by contraction of the right and left ventricles 0.1 to 0.2 seconds later. During the time when both the atria and ventricles are relaxed, the venous return of blood fills the atria. The buildup of pressure that results causes the AV valves to open and blood to flow from the atria to the ventricles. The ventricles are about 80% filled before the atria contract and when the atria contract it adds the other 20% to the end-diastolic volume (total volume of blood in the ventricles at the end of diastole). Contraction of the ventricles in systole ejects about two thirds of the blood they contain (stroke volume). This leaves one third of the initial amount left in the ventricles as the end-systolic volume. The ventricles then fill with blood during the next cycle. Electrical activity: The spread of atrial depolarization creates the P wave (atrial contraction, systole). The spread of depolarization into the ventricles is represented by the QRS wave (contraction of ventricles, atrial relaxation), Repolarization of the ventricles produces the T wave (ventricle relaxation). At rest, the venous system thus contains about 65 to 70 percent of total blood volume, with the heart, arteries, and capillaries containing 30 to 35 percent of total blood volume. Albumin accounts for 60-80% of plasma proteins. They provide osmotic pressure needed to draw water from interstitial fluid to capillaries and maintain blood pressure. Blood types A, B, AB, O. A can only give to A and AB. B can only give to B and AB. O can give to anybody. AB can receive from anybody. A can only receive from A and B can only receive from B. End-diastolic volume: total volume of blood in the ventricles at the end of diastole (atrial relaxation). Stroke volume: amount of blood ejected from ventricles during systole (ventricle contraction). End-systolic volume: amount of blood left in the ventricles at the end of systole (ventricle relaxation).

Heart murmurs are abnormal heart sounds produced by abnormal patterns of blood flow in the heart. Many murmurs are caused by defective heart valves. ECG: electrocardiogram is a recording of the electrical currents produced by the heart. Einthoven triangle: lead I goes from right arm to left arm, lead II goes from right arm to left leg, lead III goes from left arm to left leg. The right leg is used as a ground lead. Ischemia is inadequate blood flow. A tissue is ischemic when its oxygen supply is deficient because of inadequate blood flow. Myocardial ischemia shows up as a depression of the S-T segment of an ECG. Increased ventricular filling results in increased stroke volume. Mechanisms that affect the cardiac rate are said to have a chronotropic effect. Mechanisms that affect the strength of contractions are said to have an inotropic effect. The release of ADH from the posterior pituitary occurs when neurons in the hypothalamus called osmoreceptors detect an increase in plasma osmolality. ADH stimulates water reabsorption from the filtrate. Renin breaks down angiotensinogen to angiotensin 1. Angiotensin 1 is then broken down to angiotensin 2, which acts to constrict blood vessels. This causes blood pressure to rise. Oversecretion of renin can cause hypertension (high blood pressure). Diapedesis: the migration of white blood cells through the endothelial walls of blood capillaries into the surrounds connective tissue. When macrophages detect pathogenic signals, they secrete cytokines. These attract neutrophils and monocytes through chemotaxis- movement toward chemical attractants. The chemical attractants are a subclass of cytokines known as chemokines. The cerebral flow is held constant at about 750 mL per minute. Cerebral blood flow is not normally influenced by sympathetic nerve activity. Cerebral blood flow is regulated almost exclusively by local intrinsic mechanisms (autoregulation). Brain regions with the highest metabolic activity receive the most blood. Aldosterone stimulates the reabsorption of salt by the kidneys. Renin activates angiotensinogen and converts it to angiotensin 1. Angiotensin 1 is then converted to angiotensin 2. Angiotensin 2 causes vasoconstriction of arterioles and stimulates the adrenal cortex produce aldosterone. Pyrogen is a fever producing substance. These can be either internal (endogenous) or external (exogenous) to the body. T cells provide cell-mediated immunity. They are produced in the bone marrow but mature in the Thymus. B cells can be transformed by antigens into plasma cells that secrete antibodies. They are responsible for humoral immunity. Innate, or nonspecific immunity are defense mechanisms inherited as part of the structure of each organ. This allows an organism to combat pathogens without prior exposure to them. Adaptive, or specific immunity is the acquired ability of lymphocytes to defend against specific pathogens by prior exposure to those pathogens. The function of lymphocyctes is directed a specific molecules known as antigens.

Lymphocytes are a type of mononuclear leukocyte. They are responsible for humoral and cell-mediated immunity. Helper T cells aid the specific immune response of B lymphocytes and killer T lymphocytes through the secretion of chemical regulators called lymphokines. HIV destroys helper T cells, resulting in decreased immunological function and greater susceptibility to opportunistic infections. Phagocytic cells: neutrophils are located in blood and all tissues. Monocytes are located in the blood. Tissue macrophages (histocytes) are located in all tissues. Kupffer cells are located in the liver. Alveolar macrophages are located in the lungs. Microglia are located in the central nervous system. The ability of antibodies to stimulate phagocytosis is termed opsonization. Vaccination is the clinical introduction of active immunity by introducing antigens into the body so that the immune system becomes sensitized to them. The immune system will mount a secondary response to those antigens upon subsequent exposures. Pneumothorax is an abnormal condition in which air enters the intrapleural space, either through an open chest wound or from a tear in the lungs. This can lead to the collapse of the lung. Internal respiration is the diffusion of gas between interstitial fluid and cytoplasm. Involves the uptake of O2 and production of CO2 with individual cells. Also called cellular respiration. External respiration includes all processes involved in exchanging O2 to CO2 between the body and the environment. Involves moving air in and out of the lungs (inhaling and exhaling). The conducting zone consists of airways that conduct the air to the respiratory zone, which is the region where gas exchange occurs (respiratory bronchioles). With increasing altitude, the total atmospheric pressure and the partial pressure of the constituent gases decrease. Checomreceptors are collectively sensitive to changes in the PCO2, pH, and P02 of the blood. Central chemoreceptors are located in the medulla oblongata and the peripheral chemoreceptros are contained within small nodules associated with the aorta and the carotid arteries. The diaphragm separates the abdominal and thoracic cavities. Distension refers to an enlarging or ballooning effect, such as the lungs during respiration. Elasticity is the tendency of a structure to return to its initial size after being distended. Compliance is the ability of the lungs to expand or stretch under pressure. Surfactant is a substance fond in the alveolar fluid that reduces surface tension. Emphysema is a chronic, progressive condition in which alveolar tissue is destroyed. The remaining alveoli become larger, resulting in decreased vital capacity and increased airway resistance. Acute respirator distress syndrome (ARDS) is a condition in which lung compliance and surfactant are decreased. This causes the blood leaving the lungs to have abnormally low oxygen concentration. In alveoli PO2= 105 mm Hg and PCO2= 40 mm Hg

Calculate partial pressure of gas percentage x pressure of air. Oxygen is 21% and Nitrogen is 78%. If a scuba diver rises too quickly, bubbles of nitrogen gas can form in the tissue fluids and enter the blood. The bubbles of nitrogen gas in the blood can block small blood channels, producing muscles and joint pain as well as more serious damage. This is known as decompression sickness, or the bends. The primary treatment for decompression sickness is hyperbaric oxygen treatment.