NERVOUS SYSTEM

ANATOMY AND PHYSIOLOGY

Prepared by:
SHERLEEN JANE D. FERNANDEZ
Faculty, College of Arts and Sciences
 Functions of the Nervous System
1. Sensory input – gathering information∙ To
monitor changes occurring inside and outside the body
(changes = stimuli)
2. Integration ∙ to process and interpret sensory input
and decide if action is needed.
3. Motor output
∙ A response to integrated stimuli
∙ The response activates muscles or glands
Copyright © 2003 Pearson Education, Inc. publishing as Benjamin Cummings Slide 7.1a

FUNCTIONS OF THE NERVOUS

SYSTEM
• Receiving sensory input
• Integrating information
• Controlling muscles and glands
• Maintaining homeostasis
• Establishing and maintaining mental activity
Organization of the Nervous
System
 Nervous Tissue: Neurons
∙ Neurons = nerve cells
∙Functional unit of the nervous system
∙Cells specialized to transmit messages
Copyright © 2003 Pearson Education, Inc. publishing as Benjamin Cummings Slide 7.8
 Neuron Anatomy
1. Cell body
• Center of the neuron and contains
the organelles
2. Dendrites
• conduct impulses toward the cell
body
3. Axons
• conduct impulses away from the
cell body
4. Myelin sheath
• Covers the axon and helps speed
neural impulses
5. Node of ranvier
• Makes the transfer of information
faster
6. Axon terminal
• Form junctions with other cells
1. Bipolar
• 1 axon, 1 dendrite
 Types of Neuron
2. Unipolar
 • 2 axons, no dendrite

3. Multipolar
• 1 axon, several dendrites

Nervous Tissue: Support

Cells (Neuroglia or Glia)
1. Astrocytes(CNS) ∙ Star-shaped that encircles blood vessels and nerves thus provides blood-brain barrier
2. Microglia (CNS)
∙ Spider-like phagocytes
3. Ependymal cells (CNS) ∙ NONCILIATED – produces cerebrospinal fluid (CSF)
∙ CILIATED – responsible for transport or
circulation of CSF
4. Oligodendrocytes(CNS) ∙ Produce myelin
sheath in the central nervous system
5. Satellite cells(PNS)
∙ Protect neuron cell bodies
6. Schwann cells(PNS) ∙ Form myelin sheath in
the peripheral nervous system

Copyright © 2003 Pearson Education, Inc. publishing as Benjamin

Cummings Slide 7.5
MYELIN SHEATH
MULTIPLE SCLEROSIS
 MULTIPLE SCLEROSIS
• Potentially disabling disease of the brain and spinal
cord

• The immune system attacks the protective sheath

(myelin) that covers axons

MULTIPLE SCLEROSIS
• Signs and symptoms

• Numbness or weakness in one or more limbs that

typically occurs on one side of your body at a time, or
the legs and trunk
• Partial or complete loss of vision, usually in one eye at
a time, often with pain during eye movement

• Prolonged double vision

MULTIPLE SCLEROSIS
• Tingling or pain in parts of your body

• Electric-shock sensations that occur with certain neck

movements, especially bending the neck forward
(Lhermitte sign)

• Tremor, lack of coordination or unsteady gait

• Slurred speech
 • Fatigue, dizziness

• Problems with bowel and bladder function

BLOOD-BRAIN BARRIER

4 Features of Brain and Spinal Cord

1. Bone
• Brain – cranium
• Spinal cord – vertebrae
* Inner membrane: meninges
2.Cerebrospinal fluid
• protects brain and spinal cord from trauma
• supplies nutrients to nervous system tissue
• removes waste products from cerebral metabolism 2.Astrocytes
• blood-brain barrier
• supplying nutrients to nerve tissue and
aiding in post-traumatic repair and
scarring processes 3.Tissues
• Gray matter - contains the cell bodies,
dendrites and axon terminals of
neurons,
• White matter - made of axons
connecting different parts of grey
matter to each other

Copyright © 2003 Pearson Education, Inc. publishing as Benjamin Cummings Slide

7.36a
GRAY AND
WHITE MATTER
 RESTING MEMBRANE
POTENTIAL
•A resting (non-signaling) neuron has a voltage
across its membrane called the resting
membrane potential, or simply the resting
potential.
•The resting potential is determined by
concentration gradients of ions across the
membrane and by membrane permeability
to each type of ion.
CONTINUOUS
CONDUCTION
SALTATORY
 CONDUCTION

NEUROTRANSMITTERS
∙ Chemicals messengers that transmit signals from a neuron
to a target cell across a synapse. Target cell may be a
neuron or some other kind of cell.
Copyright © 2003 Pearson Education, Inc. publishing as Benjamin Cummings Slide 7.26

ALZHEIMER’S DISEASE
• Most common form of dementia
• Associated with a decrease in Acetylcholine-secreting
neurons
 BOTULISM
• Caused by toxin of Clostridium botulinum
• Blocks the release of acetylcholine from the
presynaptic terminal
DEPRESSION
 DEPRESSION

MAJOR DEPRESSIVE
 DISORDER
⚫Depressed mood or a loss of interest or pleasure in daily activities for
more than two weeks
⚫Mood represents a change from the person's baseline
⚫Impaired function: social, occupational, educational
⚫Specific symptoms, at least 5 of these 9, present nearly every day
⚫Depressed mood or irritable most of the day, nearly every day, as
indicated by either subjective report (e.g., feels sad or empty) or
observation made by others (e.g., appears tearful)
⚫Decreased interest or pleasure in most activities, most of each day
⚫Significant weight change (5%) or change in appetite ⚫
Change in sleep: Insomnia or hypersomnia
⚫Change in activity: Psychomotor agitation or retardation
⚫Fatigue or loss of energy
⚫Guilt/worthlessness: Feelings of worthlessness or excessive or inappropriate
guilt
⚫Concentration: diminished ability to think or concentrate, or more
indecisiveness
⚫Suicidality: Thoughts of death or suicide, or has suicide plan
 COCAINE
• Acts by inhibiting the reuptake of norepinephrine
 MORPHINE
• Mimics endorphins, the “happy hormone”
EXERCISE AND
ENDORPHINS
REFLEX ARC
CRANIAL AND SPINAL
NERVES
 SPINAL CORD
• Extends from the foramen magnum to the level of the
2nd lumbar vertebra
DERMATOMES
 PLEXUSES
⚫Most of the spinal nerves are organized into 3 major
plexuses where neurons of several spinal nerves come
together and intermingle
⚫Reorganizes the neurons so that branches of nerves
extending from each plexus contain neurons from
different spinal segments
⚫The 3 major plexuses are
⚫Cervical plexus (C1 to C4)
⚫Brachial plexus (C5 to T1)
⚫Lumbosacral plexus (L1 to L4-S1 to S4)
CERVICAL PLEXUS
 BRACHIAL PLEXUS

5 MAJOR NERVES OF
THE BRACHIAL PLEXUS
• Axillary nerve – innervates the shoulder
• Radial nerve – innervates the posterior arm and
forearm
• Musculocutaneous nerve – innervates the anterior
muscles of the arm
• Ulnar nerve – innervates 2 anterior forearm muscles
and most of the intrinsic arm muscles
• Median nerve – innervates most of the anterior forearm
muscles and some of the intrinsic hand muscles
LUMBOSACRAL PLEXUS

FOUR MAJOR NERVES OF

THE LUMBOSACRAL PLEXUS
• Obturator nerve – innervates muscles of the medial
thigh
• Femoral nerve – innervates the anterior thigh muscles
• Tibial nerve – innervates posterior thigh muscles
• Common fibular nerve – innervates muscles of the
lateral thigh and leg

• Sciatic nerve – tibial + common fibular nerve (bound

together within a common connective tissue sheath)

THE BRAIN
⚫Brainstem
 ⚫Medulla oblongata
⚫Pons
⚫Midbrain
⚫Cerebellum
⚫Diencephalon
⚫Thalamus
⚫Epithalamus
⚫Hypothalamus
⚫Cerebrum

BRAINSTEM
• Connects the spinal cord to the remainder of the
brain
• Controls several nuclei involved in vital body
functions like heart rate, blood pressure, and
breathing
• Consists of
• Medulla oblongata
• Pons
• Midbrain
BRAINSTEM
BRAINSTEM
 CRANIAL NERVES IN
BRAINSTEM

MEDULLA OBLONGATA
⚫Involved in
⚫Heart rate regulation
⚫Control of blood vessel diameter
⚫Breathing
⚫Swallowing
⚫Vomiting
⚫Coughing
⚫Sneezing
⚫Balance
⚫Coordination
⚫Conscious control of skeletal muscles

PONS
• Involved in
• Information relay between cerebellum and cerebrum
• Breathing
• Swallowing
• Balance
• Chewing
• Salivation

MIDBRAIN
• Involved with
• Relaying auditory signals
• Visual reflexes
• Touch
• Eye movements
• Pupil diameter
• Lens shape
• Regulation of body movement (substancia nigra)
GLASGOW COMA SCALE
CEREBELLUM
 CEREBELLUM
• Attached to the brainstem (Pons) by large
connections called cerebellar peduncles
• Involved in
• Maintaining balance
• Muscle tone
• Coordinating fine motor movement
• Learning motor skills (in partnership with the cerebrum)

DIENCEPHALON
• Part of the brain between the brainstem and the
cerebrum
• Thalamus
• Epithalamus
• Hypothalamus
THALAMUS
 THALAMUS
• Largest part of the diencephalon
• Most sensory inputs that ascend through the spinal cord
and brainstem projects to the thalamus, where
ascending neurons synapse with thalamic neurons
• The thalamus influences mood and registers an
unlocalized, uncomfortable perception of pain
 EPITHALAMUS
• Small area superior and posterior to the thalamus
• Consists of a few small nuclei involved in emotional and
visceral response to odors plus the pineal gland
• The pineal gland influences the onset of puberty
PINEAL GLAND =
PUBERTY
 HYPOTHALAMUS
⚫Most inferior part of the diencephalon
⚫Plays a major role in controlling the secretion of
hormones from the pituitary gland
⚫Involved in
⚫Body temperature
⚫Hunger
⚫thirst
⚫Sexual pleasure
⚫Rage
⚫Fear
⚫Relaxation after meals
HYPOTHALAMUS
CEREBRUM
CEREBRAL FISSURES
 CEREBRUM
⚫Largest part of the brain
⚫Frontal lobe – important in the control of voluntary motor
functions, motivation, aggression, mood, and olfactory
(smell) perception
⚫Parietal lobe – principal center for receiving and consciously
perceiving most sensory information
⚫Occipital lobe – functions in receiving and perceiving visual input
⚫Temporal lobe – involved in olfactory and auditory sensations and
plays an important role in memory, also involved in
abstract thought and judgement
⚫Insula – “hidden” deep within the lateral fissure (involved
with the sense of taste)
 BLOOD SUPPLY OF THE BRAIN
• The brain is very vulnerable to compromises in blood
supply

• The blood supply to the brain is divided into anterior

and posterior segments

• The 2 main arteries that supply blood to the brain are

1. The internal carotid arteries (anterior portion)
2. The vertebral arteries (posterior brain and
brainstem)
ANATOMY OF THE CIRCLE OF WILLIS

STROKE
• Stroke is when blood flow to an organ stops either by
blockage (bara) or rupture (putok) of a blood vessel

• Stroke to the brain is referred to as Cerebrovascular

Accident (CVA), of which there are 2 types

• Hemorrhagic CVA – due to rupture of blood vessels

supplying the brain (pumutok ang ugat sa utak)

• Ischemic CVA – due to blockage of blood vessels

supplying the brain (nagbara ang ugat sa utak)
STROKE
 STROKE
• There are important signs of a stroke that we should be
aware of and watch out for

• The more quickly the patient receives treatment, the

better the prognosis, as a stroke left untreated for too
long can result in permanent brain damage

STROKE
• Some common signs and symptoms
• difficulty walking
• dizziness
• loss of balance and coordination
• difficulty speaking or understanding others who are
speaking
• numbness or paralysis in the face, leg, or arm, most
likely on just one side of the body
• blurred or darkened vision
• a sudden headache, especially when accompanied
by nausea, vomiting, or dizziness

STROKE
• Prevention

• Maintain normal blood pressure

• Limit saturated fat, transfat, and cholesterol intake
• Refrain from smoking, and drink alcohol in moderation
• Control diabetes
 • Maintain a healthy weight
• Get regular exercise
• Eat a diet rich in vegetables and fruits

SENSORY FUNCTIONS
• Sensory input to the brainstem and diencephalon
helps maintain homeostasis
• Sensory input to the cerebrum and cerebellum keeps
us informed about our environment
• The spinal cord and brainstem contain a number of
ascending or sensory tracts that transmit information via
action potentials from the periphery to various parts of
the brain
 ASCENDING TRACTS
(SENSORY)
• Spinothalamic tract – pain and temperature sense
• Dorsal column – touch, position, pressure sense
• Spinocerebellar tract – body position sense

• Ascending tracts typically cross from one other side of

the body to the other in the spinal cord or brainstem
SENSORY TRACTS
 DESCENDING TRACTS
• Direct
• Lateral Corticospinal tract – skilled movements
• Anterior Corticospinal tract – trunk muscle movement
• Indirect
• Rubrospinal – coordination of movement
• Reticulospinal – Posture adjustment
• Vestibulospinal – Posture and balance
• Tectospinal – movement in response to visual reflexes
PLANTAR REFLEX/BABINSKI TEST
PLANTAR REFLEX/BABINSKI TEST
• Three possible responses to the test
1. Flexor: the toes curve down and inwards, and the
foot inverts; this is the response seen in healthy adults.
2. Indifferent: there is no response.
3. Extensor: the hallux dorsiflexes, and the other toes fan
out; this is Babinski's sign, which indicates damage to
the central nervous system if elicited in an adult, but
normal reflex if elicited in infants

DESCENDING TRACTS
• Crossover of axons in the brainstem or spinal cord are
typical of descending pathways
• The left side of the brain controls the skeletal muscles
on the right side of the body and vice versa
BASAL NUCLEI
• Group of functionally-related nuclei important in
planning, organizing, and coordinating motor
movements
• Two primary nuclei
• Corpus striatum – deep within the cerebrum
• Substancia nigra – in the midbrain
 CEREBELLUM
• Attached to the brainstem (Pons) via cerebellar
peduncles
• Involved in maintaining balance and muscle tone and
coordinating fine motor movement
• Function inhibited by alcohol
• Along with the cerebrum, is involved with learning new
skills

TESTS FOR CEREBELLAR

FUNCTION
• Alternating pronation – supination test (APST)
• Finger to nose test (FTNT)
 SPEECH AREAS OF THE
CEREBRAL CORTEX
• Sensory speech area in the parietal lobe (Wernicke
area) - functions in understanding and formulating
coherent speech
• Motor speech area in the frontal lobe (Broca area) –
controls the movement necessary for speech
 HEMISPHERIC
LATERALIZATION
 LIMBIC SYSTEM AND
EMOTIONS
• Involves the olfactory cortex and certain deep cortical
regions and nuclei of the cerebrum and the
diencephalon
• The limbic system influences long-term declarative
memory, emotions, visceral responses to emotions,
motivation, and mood
• Lesions of the limbic system can result in voracious
appetite, increased (often perverse) sexual activity,
and docility (loss of normal fear and anger responses)
 MENINGES
⚫Connective tissues that surround and protect the spinal
cord and the brain
⚫Dura mater
⚫Archnoid mater
⚫Pia mater

⚫Epidural space – between vertebrae and dura mater

⚫Subdural space – between dura mater and arachnoid
mater
⚫Subarachnoid space – between arachnoid mater and
pia mater
MENINGES
SIGNS OF MENINGEAL
IRRITATION
 CEREBROSPINAL FLUID
• Produced by the choriod plexuses, specialized
structures made of ependymal cells, which are located
in the ventricles
• Fills the brain ventricles, central canal of the spinal cord,
and the subarachnoid space
• Arachnoid granulations penetrate the superior sagittal
sinus, a dural venous sinus in the longitudinal fissure,
through which the CSF passes from the subarachnoid
space into the blood
HYDROCEPHALUS – DUE TO
BLOCKAGE OF CSF FLOW
HYDROCEPHALUS
 THE CRANIAL NERVES
• The cranial nerves are 12 pairs of nerves that can be
seen on the inferior surface of the brain
• Some of these cranial nerves carry sensory information
from the organs to the brain
• Other cranial nerves control voluntary muscles of the
face, head, and neck
• Other cranial nerves are connected to smooth muscles,
glands or internal organs such as the heart and lungs
CRANIAL NERVES
CRANIAL NERVES
OPTIC, II
OCULOMOTOR, III
TROCHLEAR, IV
TRIGEMINAL, V
ABDUCENS, VI
FACIAL, VII
VESTIBULOCOCHLEAR, VIII
GLOSSOPHARYNGEAL, IX
VAGUS, X
ACCESSORY, XI
HYPOGLOSSAL, XII
THE CRANIAL NERVES
BELL’S PALSY
BELL’S PALSY VS STROKE
 BELL’S PALSY VS STROKE
• If you have a patient come in complaining of new or
acute onset of unilateral facial paralysis without any other
sensory or motor deficits determine which parts of the face
are affected

• Have the patient attempt to raise both eyebrows as if

surprised. Then have the patient smile

• If they cannot raise their eyebrows and cannot move the

lower portion of their face on one side (full half or face)
they have Bell's palsy and should be given steroids +/-
antivirals
 BELL’S PALSY VS STROKE
• If the lower portion of the face is paralyzed but the
eyebrows rise symmetrically, then you have to be
concerned for a stroke and should get imaging and
further consideration of treatment (depending on time
of presentation and cause)
BELL’S PALSY VS STROKE
 BELL’S PALSY VS STROKE
• The forehead receives motor innervation from both
hemispheres of the cerebral cortex

• A stroke that compromises motor innervation of the face

would therefore only result in paralysis of the lower half of
the face - the forehead still receiving innervation from
the unaffected hemisphere

• In Bell's Palsy, the inflammation of the facial nerve

interrupts the innervation after the motor commands
from both hemispheres have joined, so that the forehead
is paralyzed
BELL’S PALSY VS STROKE
 AUTONOMIC NERVOUS SYSTEM
(ANS)
•the part of the nervous system responsible for control of
the bodily functions not consciously directed, such as
breathing, heart rate, digestive processes, etc

•Has two divisions

1. Sympathetic autonomic nervous system
2. Parasympathetic autonomic nervous system

AUTONOMIC NERVOUS SYSTEM VS

 SOMATIC MOTOR NERVOUS
SYSTEM
• Usually in somatic motor neurons, axons from the CNS
extend uninterrupted to the effectors (neuron na may
super habang axon)

• In the autonomic nervous system, axons from the CNS do

not extend all the way from the CNS to the target tissues
• two extra neurons are involved
• Yung unang neuron, from the brain
• Yung ikalawang neuron, from the autonomic ganglia

• Ang tawag sa unang neuron preganglionic neuron

• Ang tawag sa ikalawang neuron, post-ganglionic neuron
AUTONOMIC NERVOUS SYSTEM
(ANS)
NEUROTRANSMITTERS OF THE
NERVOUS SYSTEM
 SYMPATHETIC AUTONOMIC
NERVOUS SYSTEM
• Regulates “Fight or flight” response

• Preganglionic cell bodies are in the lateral horn of the

spinal cord gray matter between T1 and L2

• Main function is to activate physiologic changes that

prepares the body for combat/escape
 THE SYMPATHETIC AUTONOMIC
NERVOUS SYSTEM PREPARES US FOR

Fighting Fleeing
SYMPATHETIC AUTONOMIC
NERVOUS SYSTEM
PARASYMPATHETIC
 AUTONOMIC NERVOUS SYSTEM
•Regulates “Rest and digest” response

•Preganglionic cell bodies are located either within the

brainstem nuclei (CN III, VII, IX, X) or within the lateral part
of the central gray matter of the spinal cord between S2
to S4

•Kaya pagkakain mo tamad na tamad ka gumalaw kasi

activated ng kain ang parasympathetic ANS mo
 PARASYMPATHETIC
AUTONOMIC NERVOUS SYSTEM

SYMPATHETIC VS
PARASYMPATHETIC AUTONOMIC
NERVOUS SYSTEMS
 COCAINE
• Commonly snorted, inhaled as smoke, or dissolved and
injected into a vein

• Signs of use may include fast heart rate, sweating, and large
pupils. High doses can result in very high blood pressure or
body temperature

• Effects begin within seconds to minutes of use and last

between five and ninety minutes
• Cocaine acts by inhibiting the reuptake of
serotonin, norepinephrine, and dopamine

METAMPHETAMINE
HYDROCHLORIDE
• Low to moderate doses
• methamphetamine can elevate mood, increase
alertness, concentration and energy in fatigued
individuals, reduce appetite, and promote weight loss

• Relatively high doses

• can induce psychosis, breakdown of skeletal muscle,
seizures, and bleeding in the brain
 METAMPHETAMINE
HYDROCHLORIDE
• Chronic high-dose use
• can precipitate unpredictable and rapid mood swings,
psychosis (paranoia, hallucinations, delirium, and
delusions) and violent behavior

• Methamphetamine's ability to increase energy has

been reported to lift mood and increase sexual
desire to such an extent that users are able to
engage in sexual activity continuously for several
days
 METAMPHETAMINE
HYDROCHLORIDE
• Methamphetamine is known to possess a high
addiction liability and high dependence liability (high
likelihood that withdrawal symptoms will occur when
methamphetamine use ceases)

• Heavy recreational use of methamphetamine may

lead to a post-acute-withdrawal syndrome, which
can persist for months beyond the typical withdrawal
period
 METAMPHETAMINE
HYDROCHLORIDE
• Methamphetamine is neurotoxic to
human midbrain dopaminergic neurons

• It has also been shown to damage serotonin neurons in

the CNS.

• Damage includes adverse changes in brain structure

and function, such as reductions in gray matter volume
 HEROIN
• Is an opioid used commonly as a sedative and
painkiller

• Has euphoric effects

• Intravenous injection is the fastest route of drug

administration, causing blood concentrations to
rise the most quickly, followed by smoking,
 suppository (anal or vaginal insertion), insufflation
(snorting), and ingestion (swallowing)

MARIJUANA
• Also known as Cannabis
• The main psychoactive part
of cannabis is
tetrahydrocannabinol (THC)

MARIJUANA
• the immediate desired
effects from consuming
cannabis include relaxation
and euphoria, a general
alteration of conscious
perception, increased
awareness of sensation, increased libido and
distortions in the perception of time and space
• At higher doses, effects can include altered body
image, auditory and/or visual illusions, hallucinations
and ataxia

• In some cases, cannabis can lead to dissociative states

such as depersonalization
 Principles of
Anatomy and
Physiology
14th Edition

CHAPTER 19
The Cardiovascular System: The Blood
Copyright © 2014 John Wiley & Sons, Inc. All rights reserved.
Functions and Properties of Blood
Blood is a liquid connective tissue
consisting of cells surrounded by a liquid
matrix (plasma).

Copyright © 2014 John Wiley & Sons, Inc. All rights reserved.
Functions and Properties of Blood
The cellular components (formed
elements) of blood include red blood
cells, white blood cells and platelets.
The plasma portion of blood consists of
water, proteins and other solutes.

Copyright © 2014 John Wiley & Sons, Inc. All rights reserved.
Functions and Properties of Blood

Copyright © 2014 John Wiley & Sons, Inc. All rights reserved.
Functions and Properties of Blood

Copyright © 2014 John Wiley & Sons, Inc. All rights reserved.
Functions and Properties of Blood
Blood transports oxygen, carbon dioxide,
nutrients, hormones, heat and waste
products.
Blood regulates homeostasis of all body
fluids, pH, body temperature and water
content of cells.
Blood protects against excessive loss by
clotting and against infections through the
use of white blood cells.

Copyright © 2014 John Wiley & Sons, Inc. All rights reserved.
Functions and Properties of Blood

Copyright © 2014 John Wiley & Sons, Inc. All rights reserved.
4. Formation of Blood Cells
Lymphocytes are able to live for years while most
other blood cells live for hours, days, or weeks.
The number of red blood cells and platelets
remains rather steady while that of white blood
cells varies depending on invading pathogens and
other foreign antigens.
The process of producing blood cells is
hemopoiesis (hematopoiesis). Pluripotent
stem cells differentiate into each of the different
types of blood cells.
Copyright © 2014 John Wiley & Sons, Inc. All rights reserved.
Red Blood Cells
5. Formation of Blood Cells

Copyright © 2014 John Wiley & Sons, Inc. All rights reserved.
Copyright © 2014 John Wiley & Sons, Inc. All rights reserved.
Red Blood Cells
Red blood cells (erythrocytes) contain the
protein hemoglobin that is used to carry
oxygen to all cells and to carry 23% of total
carbon dioxide to the lungs.
Each hemoglobin molecule contains an iron
ion which allows each molecule to bind four
oxygen molecules.
Red blood cells have no nucleus or other
organelles and are biconcave discs. The lack
of a nucleus and the shape allow the cells to
efficiently carry oxygen.

Copyright © 2014 John Wiley & Sons, Inc. All rights reserved.
Red Blood Cells

Hemoglobin is also involved in regulating

blood flow and blood pressure via the
release of nitric oxide which causes
vasodilation that improves blood flow and
enhances oxygen delivery.
Copyright © 2014 John Wiley & Sons, Inc. All rights reserved.
Red Blood Cells
Red blood cells also contain carbonic
anhydrase which catalyzes the conversion of
carbon dioxide and water to carbonic acid.
This compound transports about 70% oc
carbon dioxide in the plasma. It is also a
buffer.
Red blood cells live for only about 120
days. Dead cells are removed from the
circulation by the spleen and liver.
Breakdown products from the cells are
recycled and reused.
Copyright © 2014 John Wiley & Sons, Inc. All rights reserved.
Red Blood Cells

Erythropoiesis (production of red blood

cells) begins in the red bone marrow.
Copyright © 2014 John Wiley & Sons, Inc. All rights reserved.
Red Blood Cells
Reticulocytes (immature red blood cells)
enter the circulation and mature in 1 to 2
days.
Erythropoietin, a hormone released by
the kidneys in response to hypoxia
(lowered oxygen concentration) stimulates
differentiation of hematopoietic stem cells
into erythrocytes.
Interactions Animation:

Copyright © 2014 John Wiley & Sons, Inc. All rights reserved.
Red Blood Cells
Erythropoietin

You must be connected to the Internet and in Slideshow Mode to

run this animation.

Copyright © 2014 John Wiley & Sons, Inc. All rights reserved.
Red Blood Cells

Copyright © 2014 John Wiley & Sons, Inc. All rights reserved.
White Blood Cells
White blood cells (leukocytes) contain a
nucleus and organelles, but no hemoglobin.
Leukocytes are classified as either
granular (containing vesicles that appear
when the cells are stained) or agranular
(containing no granules).
Granular leukocytes: neutrophils,
eosinophils, basophils

Copyright © 2014 John Wiley & Sons, Inc. All rights reserved.
White Blood Cells
Agranular leukocytes: lymphocytes,
monocytes

White blood cells may live for several

months or years. Their main function is to
combat invading microbes.

Copyright © 2014 John Wiley & Sons, Inc. All rights reserved.
White Blood Cells
During an invasion, many white blood
cells are able to leave the bloodstream
and collect at sites of invasion. The
process is called emigration
(diapedesis).

Copyright © 2014 John Wiley & Sons, Inc. All rights reserved.
White Blood
Cells

Copyright © 2014 John Wiley & Sons, Inc. All rights reserved.
6. White Blood Cells
In general, an elevation in the white
blood count usually indicates an
infection or inflammation.
A low white blood cell count may
develop due to several causes.
A differential white blood cell count
will help to determine if a problem exists.

Copyright © 2014 John Wiley & Sons, Inc. All rights reserved.
7. White Blood Cells

Copyright © 2014 John Wiley & Sons, Inc. All rights reserved.
Copyright © 2014 John Wiley & Sons, Inc. All rights reserved.
Platelets
Platelets are used to clot the blood.
Under the influence of the hormone
thrombopoietin, hemopoietic stem cells
differentiate into platelets.
Megakaryocytes in red bone marrow
splinter into 2000–3000 fragments to
create the platelets that contain many
vesicles but no nucleus.
Platelets survive for only 5 to 9 days.
Copyright © 2014 John Wiley & Sons, Inc. All rights reserved.
Platelets

Copyright © 2014 John Wiley & Sons, Inc. All rights reserved.
Platelets

Copyright © 2014 John Wiley & Sons, Inc. All rights reserved.
 Stem Cell Transplants from Bone
8.
Marrow and Cord Blood
Bone marrow transplants are performed
to replace cancerous red bone marrow
with normal red bone marrow. The
donor’s marrow is usually collected from
the iliac crest of the hip bone.
Stem cells collected from an umbilical
cord after birth are frozen and may also be

Copyright © 2014 John Wiley & Sons, Inc. All rights reserved.
Hemostasis
used and have advantages over bone
marrow transplants.
Hemostasis means to stop bleeding. The
process involves:
Vascular spasm
Platelet plug formation
Blood clotting (coagulation)

Copyright © 2014 John Wiley & Sons, Inc. All rights reserved.
Hemostasis

Copyright © 2014 John Wiley & Sons, Inc. All rights reserved.
Hemostasis

Copyright © 2014 John Wiley & Sons, Inc. All rights reserved.
Hemostasis
Blood clotting involves several clotting
(coagulation) factors identified by
Roman numerals and divided into three
stages.
The three stages are the extrinsic
pathway, intrinsic pathway and
common pathway.

Copyright © 2014 John Wiley & Sons, Inc. All rights reserved.
Hemostasis

Copyright © 2014 John Wiley & Sons, Inc. All rights reserved.
Hemostasis

Copyright © 2014 John Wiley & Sons, Inc. All rights reserved.
Hemostasis
Once the clot forms, it consolidates
(tightens) to pull the edges of the
damaged vessel together.
Vitamin K is needed for normal clot
formation although it is not directly
involved. It is used in the synthesis of 4
clotting factors.
Small, unwanted clots are usually
dissolved by plasmin (fibrinolysin).

Copyright © 2014 John Wiley & Sons, Inc. All rights reserved.
Blood Groups and Blood Types
Blood is characterized into different blood groups based on the
presence or absence of glycoprotein and glycolipid antigens
(agglutinogens) on the surface of red blood cells.

There are 24 blood groups and more than 100 antigens

Because these antigens are genetically controlled, blood types

vary among different populations.

Classification is based on antigens labeled A, B or AB with O

being the absence of the antigens.

An additional antigen, Rh, is present in 85% of humans.

Copyright © 2014 John Wiley & Sons, Inc. All rights reserved.
Blood Groups and Blood Types

Copyright © 2014 John Wiley & Sons, Inc. All rights reserved.
Blood Groups and Blood Types
Blood plasma usually contains antibodies
(agglutinins) that react with A or B
antigens. An individual will not have
agglutinins against his or her own blood
type.

Copyright © 2014 John Wiley & Sons, Inc. All rights reserved.
Blood Groups and Blood Types

Copyright © 2014 John Wiley & Sons, Inc. All rights reserved.
Blood Groups and Blood Types

Copyright © 2014 John Wiley & Sons, Inc. All rights reserved.
Blood Groups and Blood Types
In order to determine a person’s blood
type, typing and cross-matching are
performed.
A drop of blood is mixed with an
antiserum that will agglutinate blood
cells that possess agglutinogens that react
with it.

Copyright © 2014 John Wiley & Sons, Inc. All rights reserved.
Blood Groups and Blood Types

Copyright © 2014 John Wiley & Sons, Inc. All rights reserved.
 Hemolytic Disease of the
9.
Newborn
At birth, small amounts of fetal blood leak
into the maternal circulation. If the baby is
Rh+ and the mother is Rh–, she will
develop antibodies to the Rh factor.
During her next pregnancy with an Rh+
baby, when she transfers antibodies to the
fetus (a normal occurrence), transferred
Copyright © 2014 John Wiley & Sons, Inc. All rights reserved.
anti Rh antibodies will attack some of the
fetus’ red blood cells causing
agglutination and hemolysis.

Copyright © 2014 John Wiley & Sons, Inc. All rights reserved.
10.Hemolytic Disease of the
Newborn

Copyright © 2014 John Wiley & Sons, Inc. All rights reserved.
Copyright © 2014 John Wiley & Sons, Inc. All rights reserved.
11.Disorders: Homeostatic
Imbalances
Sickle cell disease is a genetic anemia
(oxygen-carrying capacity of the blood
is reduced).
The red blood cells of individuals with this
disease contain hemoglobin-S (Hb-S)
that causes red blood cells to bend into a

Copyright © 2014 John Wiley & Sons, Inc. All rights reserved.
sickle shape when it gives up oxygen to
the interstitial fluid.

Copyright © 2014 John Wiley & Sons, Inc. All rights reserved.
12.Disorders: Homeostatic
Imbalances

Copyright © 2014 John Wiley & Sons, Inc. All rights reserved.
Copyright © 2014 John Wiley & Sons, Inc. All rights reserved.
13. End of Chapter 19
Copyright 2014 John Wiley & Sons, Inc.
All rights reserved. Reproduction or translation of this work beyond that permitted
in section 117 of the 1976 United States Copyright Act without express
permission of the copyright owner is unlawful. Request for further information
should be addressed to the Permission Department, John Wiley & Sons, Inc. The
purchaser may make back-up copies for his/her own use only and not for
distribution or resale. The Publisher assumes no responsibility for errors,
omissions, or damages caused by the use of these programs or from the use of
the information herein.

DIFFERENCE OF SYSTOLIC VERSUS DIASTOLIC AND BLOOD FLOW CHART

Copyright © 2014 John Wiley & Sons, Inc. All rights reserved.
Copyright © 2014 John Wiley & Sons, Inc. All rights reserved.
Copyright © 2014 John Wiley & Sons, Inc. All rights reserved.
ARTERIOSCLEROSIS
 Usually cause by buildup of fat deposits and other substances on the walls of the
arteries.
 Makes them thicker, narrower and less elastic
 Can lead to high blood pressure, chest pain and heart attacks
 Partly genetic but can also be prevented by healthy diet that is low in saturated
fats
 Can be treated surgically with a procedure called angioplasty. This involves
inflating a specially made balloon in the blocked artery to break up the placque

HEART FAILURE
 This is the inability of the heart to pum enough blood to meet the body’s energy
demands

Copyright © 2014 John Wiley & Sons, Inc. All rights reserved.
  It can be caused by several things including high blood pressure from narrowed
arteries or toxicity due to prolonged alcohol use. Whatever the cause, the heart is
too weak to pump enough blood. Symptoms include chest pain and sever
shortness of breath.
 This can eventually lead to death when the heart’s ability to pump blood becomes
severely limited
 Can be treated with proper diet, exercise and drugs that decrease blood pressure
and increase contractility of the heart.

ANEURYSM
 A weak pint in an artery that leads to a bulge or bubble in the wall of the artery.
When this tears, the results can be life threatening
 It is usually caused by genetic defect.
 It can occur anywhere but is most dangerous when it is in an artery that supplies a
vital organ or organs (e.g. the brain or the aorta)
Copyright © 2014 John Wiley & Sons, Inc. All rights reserved.
  Immediate surgery is required to remove the damaged part of the artery and sew
up the remaining ends

STROKE

 Caused by damage to blood vessels supplying the brain. This can be due to a
blockage (ischemic stroke) or a rupture (hemorraghic stroke). Either way, brain
cells die and do not recover.
 This could cause permanent brain damage unless it is treated very quickly.
Victims may be left unable to speak or walk without assistance.
 Drugs that break up clots may help if used quickly and surgert may be required if
an artery is ruptured.

LEUKEMIA – CANCER OF THE BLOOD

 Cancer is a condition in which cells divide in an uncontrolled manner. Cancer of

the white blood cells is called leukemia.
Copyright © 2014 John Wiley & Sons, Inc. All rights reserved.
 Causes of leukemia are not always known but may be the result of a virus or
genetic mutation
 When there are too many white blood cells, there is no room for enough red cells.
This makes the blood unable to supply enough oxygen to the body. Weakness and
shortness of breath are common symptoms.
 It can be treated with a blood transfusion (replacing diseased blood with healthy
blood) or chemotherapy but it is a very deadly disease.

Copyright © 2014 John Wiley & Sons, Inc. All rights reserved.