FINALS: ANATOMY AND PHYSIOLOGY LECTURE
M4: L1. Hematopoeisis
The lifespan of the formed elements is very
brief. Although one type of leukocyte called
memory cells can survive for years, most
erythrocytes, leukocytes, and platelets normally
live only a few hours to a few weeks. Thus, the
body must form new blood cells and platelets
quickly and continuously. When you donate a
unit of blood during a blood drive
(approximately 475 mL, or about 1 pint), your
body typically replaces the donated plasma
within 24 hours, but it takes about 4 to 6 weeks
to replace the blood cells. This restricts the
frequency with which donors can contribute
their blood. The process by which this
replacement occurs is called hemopoiesis,
or hematopoiesis (from the Greek root haima- =
“blood”; -poiesis = “production”).
Sites of Hemopoiesis
Prior to birth, hemopoietic occurs in a number of
tissues, beginning with the yolk sac of the
developing embryo, and continuing in the fetal
liver, spleen, lymphatic tissue, and eventually
the red bone marrow. Following birth, most
hemopoiesis occurs in the red marrow, a
connective tissue within the spaces of spongy
(cancellous) bone tissue. In children,
hemopoiesis can occur in the medullary cavity
of long bones; in adults, the process is largely
restricted to the cranial and pelvic bones, the
vertebrae, the sternum, and the proximal
epiphyses of the femur and humerus.
Throughout adulthood, the liver and spleen
maintain their ability to generate the formed
elements. This process is referred to as
extramedullary hemopoiesis (meaning
hemopoiesis outside the medullary cavity of
adult bones). When a disease such as bone
cancer destroys the bone marrow, causing
hemopoiesis to fail, extramedullary hemopoiesis
may be initiated.
Hemopoietic Growth Factors
Development from stem cells to precursor cells
to mature cells is again initiated by hemopoietic
growth factors. These include the following:
 Erythropoietin (EPO) is a glycoprotein
hormone secreted by the interstitial
fibroblast cells of the kidneys in
response to low oxygen levels. It
prompts the production of erythrocytes.
Some athletes use synthetic EPO as a
performance-enhancing drug (called
blood doping) to increase RBC counts
and subsequently increase oxygen
delivery to tissues throughout the body.
EPO is a banned substance in most
organized sports, but it is also used
remedically in the treatment of certain
anemia, specifically those triggered by
certain types of cancer, and other
disorders in which increased erythrocyte
counts and oxygen levels are desirable.
 Thrombopoietin, another glycoprotein
hormone, is produced by the liver and
kidneys. It triggers the development of
megakaryocytes into platelets.
 Cytokines are glycoproteins secreted by
a wide variety of cells, including red
bone marrow, leukocytes, macrophages,
fibroblasts, and endothelial cells. They
act locally as autocrine or paracrine
factors, stimulating the proliferation of
progenitor cells and helping to stimulate
both nonspecific and specific resistance
to disease. There are two major subtypes
of cytokines known as colony-
stimulating factors and interleukins.
o Colony-stimulating
factors (CSFs) are glycoproteins
that act locally, as autocrine or
paracrine factors. Some trigger
the differentiation of
myeloblasts into granular
leukocytes, namely, neutrophils,
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eosinophils, and basophils.
These are referred to as
granulocyte CSFs. A different
CSF induces the production of
monocytes, called monocyte
CSFs. Both granulocytes and
monocytes are stimulated by
GM-CSF; granulocytes,
monocytes, platelets, and
erythrocytes are stimulated by
multi-CSF. Synthetic forms of
these hormones are often
administered to patients with
various forms of cancer who are
receiving chemotherapy to
revive their WBC counts.
Interleukins are another class of cytokine
signaling molecules important in hemopoiesis.
They were initially thought to be secreted
uniquely by leukocytes and to communicate
only with other leukocytes, and were named
accordingly, but are now known to be produced
by a variety of cells including bone marrow and
endothelium. Researchers now suspect that
interleukins may play other roles in body
functioning, including differentiation and
maturation of cells, producing immunity and
inflammation. To date, more than a dozen
interleukins have been identified, with others
likely to follow. They are generally numbered
IL-1, IL-2, IL-3, etc.
When a blood vessel is damaged, blood can leak
into other tissues and interfere with normal
tissue function, or blood can be lost from the
body. The body can tolerate a small amount of
blood loss and can produce new blood to replace
it. But a large amount of blood loss can lead to
death. Fortunately, when a blood vessel is
damaged, blood loss is minimized by three
processes:  (1) vascular spasm; (2) platelet plug
formation; and (3) blood clotting.
Hemostasis is the process by which the body
seals a damaged blood vessel and prevents
further loss of blood. 
 An injury to a blood vessel initiates the process
of hemostasis. Blood clotting involves three
steps. First, vascular spasm constricts the flow
of blood. Next, a platelet plug forms to
temporarily seal small openings in the vessel.
Coagulation then enables the repair of the vessel
wall once the leakage of blood has stopped. The
synthesis of fibrin in blood clots involves either
an intrinsic pathway or an extrinsic pathway,
both of which lead to a common pathway.
Functions of the Heart
The heart is a muscular organ that is responsible
for circulating blood in the body. Its contraction
creates the pressure that ejects blood into the
major blood vessels (aorta and pulmonary trunk)
and eventually to the remainder of the body.
Its functions (VanPutte, Rega, Russo, 2019)
includes:
 Generating blood pressure. Blood
pressure is required for blood flow
through the blood vessels
 Routing blood. Heart moves blood
through the pulmonary and systemic
circulations
 Ensuring one-way blood flow. Valves of
the heart ensure a one-way flow of
blood through the heart and  blood
vessels
 Regulating blood supply. Heart adjusts
blood flow by changing the rate and
force of heart contractions as needed.
II. Cardiac cycle - refers to the repetitive
contraction and relaxation of the heart chambers.
These chambers act as pumps. The atrium is
considered as the primer pump because they fill
the ventricles with blood while the ventricles act
as the power pump because their contraction
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forces blood to flow through the pulmonary and
systemic circulation.
 Cardiac cycle consists of systole and
diastole:
 Atrial systole is contraction of the atria
 Systole is contraction of the ventricles
 Atrial diastole is relaxation of the atria
 Diastole is relaxation of the ventricles
Heart sounds
There are two main heart sounds. The first heart
sound is represented by the syllable lubb, while
the second heart sound is represented by dupp
 First sound occurs at the beginning of
ventricular systole as Atrioventricular
(AV) valves close
 Second sound occurs when semilunar
valves close at the beginning of
ventricular diastole.
Among people with incompetent heart valve, a
valve does not close completely. This allows the
blood to leak when the valve is supposed to be
closed. This causes blood to flow in the reverse
direction. For example, if the tricuspid valve (an
AV valve) is incompetent, it will allow blood to
flow from the right ventricle to the right atrium.
The blood leaks through the incompetent valve
making a swishing (represented by shhh) sound
immediately after the first heart sound. These
faulty valves causes an abnormal heart sound
called murmurs.
Heart function may be assessed through
various measurements.
 Cardiac output (CO) is the volume of
blood pumped by each ventricle of the
heart per minute.
 Stroke volume (SV) is the volume of
blood pumped by each ventricle per
contraction.
 Heart rate (HR) is the number of times
the heart contracts each minute.
The mechanisms that modify the stroke volume
and heart rate are classified
as intrinsic and extrinsic.
 Intrinsic regulations involve
mechanisms contained in the heart
itself. 
 Extrinsic regulation refers to
mechanisms outside of the heart. 
Blood is carried through the body via blood
vessels. An artery is a blood vessel that carries
blood away from the heart, where it branches
into ever-smaller vessels. Eventually, the
smallest arteries, vessels called arterioles,
further branch into tiny capillaries, where
nutrients and wastes are exchanged, and then
combine with other vessels that exit capillaries
to form venules, small blood vessels that carry
blood to a vein, a larger blood vessel that returns
blood to the heart.
 Arteries and veins transport blood in two
distinct circuits: the systemic circuit and
the pulmonary circuit
Systemic arteries provide blood rich in oxygen
to the body’s tissues. The blood returned to the
heart through systemic veins has less oxygen,
since much of the oxygen carried by the arteries
has been delivered to the cells.
In the pulmonary circuit, arteries carry blood
low in oxygen exclusively to the lungs for gas
exchange.
Pulmonary veins then return freshly oxygenated
blood from the lungs to the heart to be pumped
back out into systemic circulation. Although
arteries and veins differ structurally and
functionally, they share certain features.
Blood Flow, Blood Pressure, and Resistance
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Blood flow refers to the movement of blood
through a vessel, tissue, or organ, and is usually
expressed in terms of volume of blood per unit
of time. It is initiated by the contraction of the
ventricles of the heart. Ventricular contraction
ejects blood into the major arteries, resulting in
flow from regions of higher pressure to regions
of lower pressure, as blood encounters smaller
arteries and arterioles, then capillaries, then the
venules and veins of the venous system.  Lymph
Homeostatic Regulation of the Vascular
System
In order to maintain homeostasis in the
cardiovascular system and provide adequate
blood to the tissues, blood flow must be
redirected continually to the tissues as they
become more active. In a very real sense, the
cardiovascular system engages in resource
allocation, because there is not enough blood
flow to distribute blood equally to all tissues
simultaneously. For example, when an
individual is exercising, more blood will be
directed to skeletal muscles, the heart, and the
lungs. Following a meal, more blood is directed
to the digestive system. Only the brain receives
a more or less constant supply of blood whether
you are active, resting, thinking, or engaged in
any other activity.
ONE OF THE BASIC TENETS OF LIFE IS
THAT ORGANISMS CONSUME OR USE
OTHER ORGANISMS IN ORDER TO
SURVIVE.  permits fluid to enter the capillary but prevents
Some microorganisms, such as certain bacteria
or viruses, use humans as a source of nutrients
and as an environment where they can survive
and reproduce. As a result, some of these
microorganisms can damage the body, causing
diseases or even death. Any substance or
microorganism that cause diseases or damage to
the tissue of the body is considered
as pathogen. Not surprisingly, the body has
ways to resist or destroy pathogens.
The lymphatic system is important for the
protection of the body, but in addition to that,
this system carries out the following functions:
I. Components of the Lymphatic System
The lymphatic system consists of a fluid
(lymph), vessels that transport the lymph, and
organs that contain lymphoid tissue.
Lymph is a fluid similar in composition to blood
plasma. It is derived from blood plasma as fluids
pass through capillary walls at the arterial end.
As the interstitial fluid begins to accumulate, it
is picked up and removed by tiny lymphatic
vessels and returned to the blood. As soon as the
interstitial fluid enters the lymph capillaries, it is
called lymph. Returning the fluid to the blood
prevents edema and helps to maintain normal
blood volume and pressure.
LymphaticVessels
Lymphatic vessels, unlike blood vessels, only
carry fluid away from the tissues. The smallest
lymphatic vessels are the lymph capillaries,
which begin in the tissue spaces as blind-ended
sacs. Lymph capillaries are found in all regions
of the body except the bone marrow, central
nervous system, and tissues, such as the
epidermis, that lack blood vessels. The wall of
the lymph capillary is composed of endothelium
in which the simple squamous cells overlap to
form a simple one-way valve. This arrangement
lymph from leaving the vessel.
LymphaticOrgans
Lymphatic organs are characterized by clusters
of lymphocytes and other cells, such as
macrophages, enmeshed in a framework of
short, branching connective tissue fibers. The
lymphocytes originate in the red bone marrow
with other types of blood cells and are carried in
the blood from the bone marrow to the
lymphatic organs. When the body is exposed to
 FINALS: ANATOMY AND PHYSIOLOGY LECTURE
microorganisms and other foreign substances,
the lymphocytes proliferate within the lymphatic
organs and are sent in the blood to the site of the
invasion. This is part of the immune response
that attempts to destroy the invading agent.
The lymphatic organs include:
 Lymph Nodes
 Tonsils
 Spleen
 Thymus
THE LYMPHATIC SYSTEM INCLUDES A
NETWORKS OF VESSELS, DUCTS, AND
NODES, AS WELL AS ORGANS AND
DIFFUSE TISSUE THAT SUPPORT THE
CIRCULATORY SYSTEM.
These structures help to filter harmful
substances from the bloodstream. Organs of the
lymphatic system, such as the spleen, thymus,
and tonsils, house specialized cells that destroy
the harmful pathogens.
1. The Lymphatic System Consists of
Two Main Parts: The Vessel Network
and the Nodes and Organs
Lymphatic vessels and ducts provide the
complex transportation network of the lymphatic
system. These vessels carry a fluid
called lymph away from body tissues and
capillary beds to be filtered by nodes and
organs, then returned to the bloodstream. The
lymph nodes and lymphatic organs provide the
key functional sites of the lymphatic
system. The lymphatic organs, including the
thymus and spleen, and diffuse tissues contain
lymphocytes and other defense cells produced
by the bone marrow. The lymph nodes are
interspersed along the vessel network and filter
lymph. Node lymphocytes can enter the lymph
vessels in order to eliminate pathogens.
2. Lymph Organs Filter Unwanted
Substances Out of the Bloodstream
and Body Tissues 
Lymph derives from interstitial fluid that
surrounds the cells of body tissues. This
interstitial fluid comes from the bloodstream, as
capillaries exchange substances with tissue cells
and fluid leaves the capillaries. Much of the
fluid reenters the capillaries directly. The rest
moves into lymphatic capillaries and vessels as
lymph. Lymph is clear and colorless and
contains white blood cells. The white blood cells
can destroy pathogens and remove some
unwanted substances from the interstitial fluid as
it flows toward lymphatic tissues and lymph
nodes. Here, concentrations of white blood cells
called lymphocytes are added. Lymphocytes
fight bacteria and other pathogens before the
lymph flows back into the bloodstream.
3. Pathogens Are Destroyed Inside the
Lymph Nodes
Substances are exchanged between the
bloodstream and body cells through interstitial
fluid. Part of this fluid enters the lymphatic
vessel network as lymph and travels toward the
lymph nodes. Lymph nodes are bean-shaped
structures that help filter unwanted substances
from lymph. They contain a high concentration
of lymphocytes, a type of white blood cell that
proliferates in the lymphatic system to combat
pathogens. Groups of lymph nodes sit where the
head and limbs meet the torso—at the axilla
(armpit), groin, and neck—and in the intestinal
region. During an infection, inflamed lymph
nodes can sometimes be felt in these areas.
4. Lymph Travels Throughout the Body
Before It Returns to the Bloodstream
Lymph originates from interstitial fluid that is
formed where capillaries and body tissues
exchange fluid and other substances. The lymph
drains into lymphatic capillaries. The lymphatic
 FINALS: ANATOMY AND PHYSIOLOGY LECTURE
capillaries conduct the fluid into larger
lymphatic vessels, which carry it toward lymph
nodes and lymphoid organs. The nodes and
organs filter the lymph and eliminate harmful
substances. Filtered lymph then moves toward
major lymphatic ducts—namely, the thoracic
duct and right lymphatic duct, located at the
junction between the subclavian and internal
jugular veins. These ducts empty the filtered
lymph into the veins to rejoin the bloodstream.
Immunity is the ability to resist damage from
pathogens, such as microorganisms; harmful
chemicals, such as toxins released by
microorganisms; and internal threats, such as
cancer cells.  phagocytic ability, at least at some point during
The immune system is a collection of barriers,
cells, and soluble proteins that interact and
communicate with each other in extraordinarily
complex ways. The modern model of immune
function is organized into three phases based on
the timing of their effects. The three temporal
phases consist of the following:
Barrier defenses such as the skin and mucous
membranes, which act instantaneously to
prevent pathogenic invasion into the body
tissues
The rapid but nonspecific innate immune
response, which consists of a variety of
specialized cells and soluble factors
The slower but more specific and
effective adaptive immune response, which
involves many cell types and soluble factors, but
is primarily controlled by white blood cells
(leukocytes) known as lymphocytes, which help
control immune responses
1. Barrier Defenses and the Innate Immune
Response
The different modes of barrier defenses are
associated with the external surfaces of the
body, where pathogens may try to enter. The
primary barrier to the entrance of
microorganisms into the body is the skin. Not
only is the skin covered with a layer of dead,
keratinized epithelium that is too dry for bacteria
in which to grow, but as these cells are
continuously sloughed off from the skin, they
carry bacteria and other pathogens with them.
Additionally, sweat and other skin secretions
may lower pH, contain toxic lipids, and
physically wash microbes away.
Cells of the Innate Immune Response
Many of the cells of the immune system have a
their life cycles. Phagocytosis is an important
and effective mechanism of destroying
pathogens during innate immune responses. The
phagocyte takes the organism inside itself as a
phagosome, which subsequently fuses with a
lysosome and its digestive enzymes, effectively
killing many pathogens. On the other hand,
some bacteria including Mycobacteria
tuberculosis, the cause of tuberculosis, may be
resistant to these enzymes and are therefore
much more difficult to clear from the body.
Macrophages, neutrophils, and dendritic cells
are the major phagocytes of the immune system.
2. The Adaptive Immune Response: T
lymphocytes and Their Functional Types
The ability of the adaptive immune response to
specifically recognize and make a response
against a wide variety of pathogens—is its great
strength. Antigens, the small chemical groups
often associated with pathogens, are recognized
by receptors on the surface of B and T
lymphocytes. The adaptive immune response to
these antigens is so versatile that it can respond
to nearly any pathogen. This increase in
specificity comes because the adaptive immune
response has a unique way to develop as many
as 1011, or 100 trillion, different receptors to
recognize nearly every conceivable pathogen.
 FINALS: ANATOMY AND PHYSIOLOGY LECTURE
Primary Disease and Immunological Memory
The immune system’s first exposure to a
pathogen is called a primary adaptive response.
Symptoms of a first infection, called primary
disease, are always relatively severe because it
takes time for an initial adaptive immune
response to a pathogen to become
effective.Upon re-exposure to the same
pathogen, a secondary adaptive immune
response is generated, which is stronger and
faster that the primary response. The secondary
adaptive response often eliminates a pathogen
before it can cause significant tissue damage or
any symptoms. Without symptoms, there is no
disease, and the individual is not even aware of
the infection. This secondary response is the
basis of immunological memory, which protects
us from getting diseases repeatedly from the
same pathogen. By this mechanism, an
individual’s exposure to pathogens early in life
spares the person from these diseases later in
life.
Self-Recognition
A third important feature of the adaptive
immune response is its ability to distinguish
between self-antigens, those that are normally
present in the body, and foreign antigens, those
that might be on a potential pathogen. As T and
B cells mature, there are mechanisms in place
that prevent them from recognizing self-antigen,
preventing a damaging immune response against
the body. These mechanisms are not 100 percent
effective, however, and their breakdown leads to
autoimmune diseases, which will be discussed
later in this chapter.
T Cell-Mediated Immune Responses
The primary cells that control the adaptive
immune response are the lymphocytes, the T and
B cells. T cells are particularly important, as
they not only control a multitude of immune
responses directly, but also control B cell
immune responses in many cases as well. Thus,
many of the decisions about how to attack a
pathogen are made at the T cell level, and
knowledge of their functional types is crucial to
understanding the functioning and regulation of
adaptive immune responses as a whole.
T Cells
The T cell, on the other hand, does not secrete
antibody but performs a variety of functions in
the adaptive immune response. Different T cell
types have the ability to either secrete soluble
factors that communicate with other cells of the
adaptive immune response or destroy cells
infected with intracellular pathogens. 
Antigens
Antigens on pathogens are usually large and
complex, and consist of many antigenic
determinants. An antigenic
determinant (epitope) is one of the small regions
within an antigen to which a receptor can bind,
and antigenic determinants are limited by the
size of the receptor itself. Our immune system is
essential for our survival. Without an immune
system, our bodies would be open to attack from
bacteria, viruses, parasites, and more. It is our
immune system that keeps us healthy as we drift
through a sea of pathogens. 
B Cells
B cells are immune cells that function primarily
by producing antibodies. An antibody is any of
the group of proteins that binds specifically to
pathogen-associated molecules known as
antigens. An antigen is a chemical structure on
the surface of a pathogen that binds to T or B
lymphocyte antigen receptors. Once activated by
binding to antigen, B cells differentiate into cells
that secrete a soluble form of their surface
 FINALS: ANATOMY AND PHYSIOLOGY LECTURE
antibodies. These activated B cells are known as
plasma cells.
Plasma Cells
Another type of lymphocyte of importance is the
plasma cell. A plasma cell is a B cell that has
differentiated in response to antigen binding,
and has thereby gained the ability to secrete
soluble antibodies. These cells differ in
morphology from standard B and T cells in that
they contain a large amount of cytoplasm packed
with the protein-synthesizing machinery known
as rough endoplasmic reticulum.
Natural Killer Cells
A fourth important lymphocyte is the natural
killer cell, a participant in the innate immune
response. A natural killer cell (NK) is a
circulating blood cell that contains cytotoxic
(cell-killing) granules in its extensive cytoplasm.
It shares this mechanism with the cytotoxic T
cells of the adaptive immune response. NK cells
are among the body’s first lines of defense
against viruses and certain types of cancer.
*M5: L1: Overview of the Respiratory
System
It is undeniable that O2 is a very important
molecule in order for us to live. It is mostly part
of the metabolic processes that the body has, and
as an example of that is Cellular Respiration
which can continue with or without O2 but not
on longer periods of time. It is the responsibility
of the Respiratory System to supply the body
with enough O2, just like the digestive system,
the respiratory system is made up of tracts or
passageways where air rich in O2 passes
through. Aside from taking in oxygen, the
system is also works in excretion of a metabolic
waste which is CO2 and if not, may cause a
serious harm in the body.
The respiratory system as mentioned is similar
to the digestive system, organs are mostly
passageways. It is divided in to two which is the
upper respiratory tract and the lower respiratory
tract.
The upper respiratory tract is composed mainly
of the nose, the nasal cavity and the pharynx.
The tract serves as a security measure or serves
as the first line of defense for the whole system.
The air inhaled will pass through the nose and
nasal cavity, these passages are lined with hair,
cilia and mucous to help trap foreign bodies and
materials, the air then will be moistened and
warmed so that it is cleansed. The filtered
foreign materials will be moved into the
pharynx, some being swallowed, sneezed and
coughed outside the system.
The lower respiratory tract is composed mainly
by the Larynx, Trachea, Bronchi, and Lungs.
The Lungs is the major respiratory organ and
inside it are smaller branching tubes which are
the bronchioles that holds the alveoli as sites of
gas exchange. For details about the different
organs starting for the upper tract. 
*M5: L2. Ventilation and Lung Volumes
LESSON 2.1: VENTILLATION AND LUNG
VOLUMES
Respiration is the process of supplying O2 into
the bloodstream that will then be transported to
the tissues and cells where it is needed. It is also
a process that allows the removal of CO2 as a
waste product of metabolic processes that occurs
in the body. Lesson 2 will discuss topics about
the physiology of respiration or the processes
that includes gas exchange and gas transport.
Basic information such as lung volume and
capacities should be learned first and you will
need to understand first the process of diffusion
which was discussed on previous lessons and is
fundamental in learning respiration.
 FINALS: ANATOMY AND PHYSIOLOGY LECTURE
Lung Ventilation or also known as "Breathing"
is the process of acquiring air (Inspiration) as
well as expelling it from the lungs (Expiration).
Please remember that the lungs has its capacities
for acquiring air as well as expelling it, not all
air in the lungs are expelled as some retains for
an important and functional reason. The capacity
mentioned is measurable and is measured
through volumes (mL). The apparatus used in
measuring lung volume capacity is the
"spirometer". This measurement aids in the
assessment of one's health condition.  Carbon
 LESSON 2.2: GAS EXCHANGE
Gas exchanges obeys the law of diffusion, where
diffusing substances, the gas, moves from a
higher concentration toward the area of a lower
concentration. Gas exchange not solely for the
movement of Oxygen, it also speaks of the
removal of a waste product which is Carbon
dioxide. Respiration is divided into two: Internal
Respiration and External Respiration. External
respiration happens between the alveoli and the
blood wherein exchange of gases happens. It is
obvious that the inspired air contains a higher
concentration of Oxygen molecule compared to
what the blood has after a systemic circulation,
due to all oxygen demands of cells and tissues
(Internal Respiration), and blood carried by
arteries has a higher concentration of carbon
dioxide compared to oxygen as byproduct of
some metabolic processes. 
LESSON 2.3: GAS TRANSPORT IN THE
BLOOD
Oxygen Transport
1. Dissolved in blood. Some of the oxygen
molecule does not need to bind to hemoglobin, it
moves through the blood freely with ease. Some
of the oxygen is dissolved in the blood plasma,
because plasma is the part of the blood that fills
the spaces between the blood and the platelets.
Plasma is the true liquid form of the blood that
forms the matrix.
2.Bound to hemoglobin. Within red blood cells,
there are many molecules of hemoglobin (Hb),
in which oxygen binds to, creating
oxyhemoglobin.  The compared to oxygen
molecules dissolved in the blood plasma,
majority of them are still bounded to the Hb.
Oxygen gas is transported through
oxyhemoglobin, otherwise known as the bond
between oxygen and hemoglobin.
Dioxide Transport
1. Dissolved in blood. Much like oxygen, carbon
dioxide is also capable of being dissolved in the
blood, but too much carbon dioxide that is
dissolved within the blood can cause problems
by making your blood pH drop - making it
acidic. Therefore, only about 7 percent of carbon
dioxide is dissolved into the blood stream.
2. Bound to hemoglobin. again, much like
oxygen, carbon dioxide can also bind to
hemoglobin in order to travel through the
bloodstream. Carbon dioxide binds to
hemoglobin in the lungs, creating
carbaminohemoglobin, in comparison to oxygen
which typically binds to hemoglobin in all other
cells of the body. The partial pressure of oxygen
is higher than the partial pressure of carbon
dioxide within the cells of the lungs, causing the
carbon dioxide to diffuse into the lung cells
attempting to make the two sides even. This is
the exact opposite of what occurs during oxygen
binding to hemoglobin.
3. Bicarbonate. Carbon dioxide mixes with
water present within the cells. What happens is a
chemical reaction occurs, and the enzyme
carbonic anhydrase is responsible for joining the
two, and carbonic acid is formed as a result.
This acid does not stay much longer as it would
be harmful for the body, but instead it releases a
hydrogen ion leaving a product of bicarbonate
(HCO3-) which acts as a buffer maintaining the
 FINALS: ANATOMY AND PHYSIOLOGY LECTURE
optimal pH of the blood. This form of carbon LESSON 4: NUTRITION, METABOLISM,
dioxide is the most common within the body. AND BODY TEMPERATURE
REGULATION
*M5: L5. Digestion
Nutrition is a process where food is taken in and
Digestion is the process of breaking down food used by the body. It includes digestion,
material into absorbable substances as it passes absorption, transport and metabolism. It is also a
the digestive tract. study of food and drink requirements for optimal
growth and body function. It is a way of
Digestion can be Mechanical or Chemical. 
determining which one is good for us and which
Mechanical digestion is purely physical in will be bad especially if taken in too much. 
process altering the physical attributes of the
 Nutrients are chemicals that they body uses as a
food material from large food portion or parts to
source of energy or a building block for making
smaller food particles increasing surface area
new molecules that will be functional in the
and mobility throughout the tract.  Mastication
body - could be a new protein that will replace
also known as chewing including the tongue
worn out or damaged ones. Some of this
movement is a mechanical digestion where in
nutrients can be manufactured by the body, but
food is masticated in the mouth turning larger
there are certain types of nutrients that the body
food particles into smaller one before being
cannot produce and that is a reason for us to take
transported along the tract. It is also a process of
up food. These are called Essential Nutrients.
mixing food with saliva.  It also happens in the
stomach wherein more changes in form occur  Metabolism are complex processes that the
due to the mixing process happening there. body needs to undergo in order to supply its
needs - this means that some are used up, like
Chemical digestion however is the breakdown of
energy, or some needs replacement due to
food molecules, from complex to their simplest
damage and some are stored as back up,
form that can be absorbed by the body,
especially when sources becomes scarce. This
specifically in the intestines. Digestion happens
only proves that this body is very efficient and
with the presence of secretions along the tract -
that nothing is being wasted.
most are enzymatic in nature. 
*M5: L7. Overview of Urinary System
For you to better understand the topic you need
to watch an animated video, explaining the LESSON 1: OVERVIEW OF THE
process of digestion as well as the movement of URINARY SYSTEM
food inside the digestive tract.
The main goal of the urinary system is to filter
LESSON 3: ABSORPTION AND the blood and eventually get rid of the wastes
TRANSPORT filtered. Aside from being a filter the urinary
system also plays an important role in the
After food materials are completely digested
following: regulation of blood pH, regulation of
into their simplest absorbable form which are
blood pressure, regulation of red blood cell
your macromolecules known as Carbohydrates,
production, and vitamin D synthesis. These are
Proteins, and Lipids. They are  absorbed from
numbers of important function that the urinary
the lumen and will be transported into the blood
needs to perform in order to attain homeostasis
vessels, for the saccharides and amino acids, or
and what we mean by important is that these
the lymphatic vessel, for the lipids.
 FINALS: ANATOMY AND PHYSIOLOGY LECTURE
processes are vital. Changes in the system, may
put one's life quality at risk.
 The urinary system is made up of a pair of
Kidney, Ureters, Urinary bladder, and Urethra.
The kidneys containing the nephrons is the
major organ used for filtering wastes from the
blood, and the others are mostly tracts or
bladders that will then act as passageways of
excretion and the main waste product from the
system is the urine. In this module, you will
learn the different organs of the system as well
as their function. You will then understand how
crucial the function of the system in maintaining
homeostasis in the body.
LESSON 2 - MECHANISM OF URINE
PRODUCTION
Urine production includes three steps: Filtration,
Reabsorption, and Secretion. Urine is the final
product which is a collection of waste products
that comes from the different tissues of the
body, that is being collected by the blood and
will then pass through the kidneys for collecting
this wastes material and will then eventually be
excreted from the body. In the medical field,
urine content is being checked and tested for
diagnosing a possible health condition. The
process wherein urine is assessed is called
Urinalysis.
Below are the steps for urine formation:
1. Glomelular Filtration
Each kidney contains over 1 million tiny
structures called nephrons. Each nephron has
a glomerulus, the site of blood filtration. The
glomerulus is a network of capillaries
surrounded by a cuplike structure, the
glomerular capsule (or Bowman’s capsule). As
blood flows through the glomerulus, blood
pressure pushes water and solutes from the
capillaries into the capsule through a filtration
membrane. This glomerular filtration begins the
urine formation process.
2. Tubular Reabsorption
The resulting filtrate contains waste, but also
other substances the body needs: essential ions,
glucose, amino acids, and smaller proteins.
When the filtrate exits the glomerulus, it flows
into a duct in the nephron called the renal tubule.
As it moves, the needed substances and some
water are reabsorbed through the tube wall into
adjacent capillaries. This reabsorption of vital
nutrients from the filtrate is the second step in
urine creation.
3. Tubular Secretion
The filtrate absorbed in the glomerulus flows
through the renal tubule, where nutrients and
water are reabsorbed into capillaries. At the
same time, waste ions and hydrogen ions pass
from the capillaries into the renal tubule. This
process is called secretion. The secreted ions
combine with the remaining filtrate and become
urine. The urine flows out of the nephron tubule
into a collecting duct. It passes out of the kidney
through the renal pelvis, into the ureter, and
down to the bladder.
Urine content
Urine is about 95% water and 5% waste
products. Nitrogenous wastes excreted in urine
include urea, creatinine, ammonia, and uric acid.
Ions such as sodium, potassium, hydrogen, and
calcium are also excreted.
LESSON 3: REGULATION OF
EXTRACELLULAR FLUID PRODUCTION
 FINALS: ANATOMY AND PHYSIOLOGY LECTURE
Homeostasis requires that the intake of
substances equals their elimination. Needed
water and ions enter the body by ingestion;
excess water and ions exit the body by excretion.
The amounts of water and ions entering and
leaving the body can vary over the short term.
For example, greater quantities of water and ions
are lost in the form of perspiration on warm days
than on cool days, and varying amounts of water
and ions may be lost in the form of feces.
However, over a long period, the total amount of
water and ions in the body does not change
unless the individual is growing, gaining weight,
or losing weight. Regulating the amounts of
water and ions in the body involves the
coordinated participation of several organ
systems, but the kidneys are the most important,
with the skin, liver, and digestive tract playing
supporting roles. Two mechanisms help regulate
the levels of ions in the extracellular fluid: thirst
regulation and ion concentration regulation.
LESSON 4: REGULATION OF ACID-BASE
BALANCE
Acid-base balance
a state of equilibrium between acidity and alkali
nity of the body fluids. An acid is a substance ca
pable of giving up a hydrogen ion during a chem
ical exchange, and a base is a substance that can 
accept it. The positively charged hydrogen ion (
H+) is the active constituent of all acids. Blood's
pH normally 7.35 to 7.45, meaning it is slightly
alkaline or basic and going higher or lower may
already cause some problem (acidosis and
alkalosis). Buffers or chemicals that can resist
change in the pH of a solution even though an
acid or a base is added, is the main component
of the blood in maintaining its pH. The urinary
and respiratory system are the one responsible
for regulating these chemicals in the blood.
M6: L1. Overview of Male and Female
Reproductive System
Male Reproductive System
The function of the male reproductive system is
to produce sperm and transfer them to the
female reproductive tract.
The paired testes are a crucial component in this
process, as they produce both sperm and
androgens.
Several accessory organs and ducts aid the
process of sperm maturation and transport the
sperm and other seminal components to the
penis, which delivers sperm to the female
reproductive tract. 
The structures of the male reproductive system
include the testes, the epididymides, the penis,
and the ducts and glands that produce and carry
semen.
 Female reproductive system
The female reproductive system functions to
produce gametes and reproductive hormones.
However, it also has the additional task of
supporting the developing fetus and delivering it
to the outside world.
The female reproductive system is located
primarily inside the pelvic cavity.
The ovaries are the female gonads.
The gamete they produce is called an oocyte. 
M6: L2. Physiology of Male and Female
Reproductive systems Part 1
2.1 Production of gametes and their discharge
into the ducts
Unique for its role in human reproduction,
a gamete is a specialized sex cell carrying 23
chromosomes—one half the number in body
cells. At fertilization, the chromosomes in one
male gamete, called a sperm (or spermatozoon),
 FINALS: ANATOMY AND PHYSIOLOGY LECTURE
combine with the chromosomes in one female
gamete, called an oocyte.
M6: L3. Menstrual and Ovarian Cycles
Female monthly sexual cycle (or menstrual
cycle)
The normal reproductive years of the female are
characterized by monthly rhythmical changes in
the rates of secretion of the female hormones
and corresponding physical changes in the
ovaries and other sexual organs.
 The duration of the cycle averages 28 days. It
may be as short as 20 days or as long as 45 days
in some women, although abnormal cycle length
is frequently associated with decreased fertility.
There are two significant results of the female
sexual cycle.
 Only a single ovum is normally released
from the ovaries each month, so that
normally only a single fetus will begin
to grow at a time.
 The uterine endometrium is prepared in
advance for implantation of the
fertilized ovum at the required time of
the month.
 Menarche – it is the time of the first
menstrual cycle.
 The Follicular Phase
When a female child is born, each ovum is
surrounded by a single layer of granulosa cells;
the ovum, with this granulosa cell sheath, is
called a primordial follicle.
Oocyte maturation-inhibiting factor – keeps the
ovum suspended in its primordial state in the
prophase stage of meiotic division.
After puberty, when FSH and LH from the
anterior pituitary gland begin to be secreted in
significant quantities, the ovaries, together with
some of the follicles within them, begin to grow.
o Primary follicles – follicles wherein
growth of additional layers of granulosa
cells occur. The first stage of follicular
growth is moderate enlargement of the
ovum itself, which increases in diameter
twofold to threefold.
o Theca – a second mass of cells which
came from spindle cells derived from
the ovary interstitium collect in several
layers outside the granulosa cells.
Two layers:
o Theca interna – the cells take on
epithelioid characteristics similar to
those of the granulosa cells and develop
the ability to secrete additional steroid
sex hormones (estrogen and
progesterone).
o Theca externa – which is the outer layer,
develops into a highly vascular
connective tissue capsule that becomes
the capsule of the developing follicle.
The early growth of the primary follicle up to
the antral stage is stimulated mainly by FSH
alone. Then greatly accelerated growth occurs,
leading to larger follicles called vesicular
follicles.
This accelerated growth is caused by the
following:
(1) Estrogen is secreted into the follicle and
causes the granulosa cells to form increasing
numbers of FSH receptors; this causes a positive
feedback effect, because it makes the granulosa
cells even more sensitive to FSH.
(2) The pituitary FSH and the estrogens combine
to promote LH receptors on the original
granulosa cells, thus allowing LH stimulation to
occur in addition to FSH stimulation and
 FINALS: ANATOMY AND PHYSIOLOGY LECTURE
creating an even more rapid increase in follicular
secretion.
(3) The increasing estrogens from the follicle
plus the increasing LH from the anterior
pituitary gland act together to cause proliferation
of the follicular thecal cells and increase their
secretion as well.
Atresia
After a week or more of growth— but before
ovulation occurs—one of the follicles begins to
outgrow all the others; the remaining 5 to 11
developing follicles involute and these follicles
are said to become atretic.
Mature follicle
A single follicle which reaches a diameter of 1
to 1.5 centimeters at the time of ovulation.
 Ovulation
Ovulation in a woman who has a normal 28-day
female sexual cycle occurs 14 days after the
onset of menstruation.
 Stigma – small area in the center of the
follicular capsule wherein shortly before
ovulation, this area protrudes like a
nipple.
 Corona radiata – a mass of several
thousand small granulosa cells which
surrounds the ovum.
*Luteinizing Hormone – is necessary for final
follicular growth and ovulation. Without this
hormone, even when large quantities of FSH are
available, the follicle will not progress to the
stage of ovulation.
The Luteal Phase
Luteinization – The process wherein the
remaining granulosa and theca interna cells
change rapidly into lutein cells in the first few
hours after expulsion of the ovum from the
follicle. They enlarge in diameter two or more
times and become filled with lipid inclusions
that give them a yellowish appearance.
Corpus Luteum – secretes estrogen in particular
and progesterone to a lesser extent, during the
luteal phase of the ovarian cycle, have strong
feedback effects on the anterior pituitary gland
to maintain low secretory rates of both FSH and
LH.
Corpus luteum begins to involute and eventually
loses its secretory function as well as its
yellowish, lipid characteristic about 12 days
after ovulation, becoming the corpus albicans;
during the ensuing few weeks, this is replaced
by connective tissue and over months is
absorbed.
Lutein cells secrete small amounts of the
hormone inhibin, this hormone inhibits secretion
by the anterior pituitary gland, especially FSH
secretion. Low blood concentrations of both
FSH and LH result, and loss of these hormones
finally causes the corpus luteum to degenerate
completely, a process called involution of the
corpus luteum.
Final involution normally occurs at the end of
almost exactly 12 days of corpus luteum life,
which is around the 26th day of the normal
female sexual cycle, 2 days before menstruation
begins. At this time, the sudden cessation of
secretion of estrogen, progesterone, and inhibin
by the corpus luteum removes the feedback
inhibition of the anterior pituitary gland,
allowing it to begin secreting increasing
amounts of FSH and LH again. FSH and LH
initiate the growth of new follicles, beginning a
new ovarian cycle. The paucity of secretion of
progesterone and estrogen at this time also leads
to menstruation by the uterus.
Summary:
 FINALS: ANATOMY AND PHYSIOLOGY LECTURE
About every 28 days, gonadotropic hormones
from the anterior pituitary gland cause about 8 to
12 new follicles to begin to grow in the ovaries.
One of these follicles finally becomes “mature”
and ovulates on the 14th day of the cycle.
During growth of the follicles, mainly estrogen
is secreted.
After ovulation, the secretory cells of the
ovulating follicle develop into a corpus luteum
that secretes large quantities of both the major
female hormones, progesterone and estrogen.
After another 2 weeks, the corpus luteum
degenerates, whereupon the ovarian hormones
estrogen and progesterone decrease greatly,and
menstruation begins. A new ovarian cycle then
follows.
M6: L4. Menstrual Phase and Menopause
Menstrual Phase
Associated with the monthly cyclical production
of estrogens and progesterone by the ovaries is
an endometrial cycle in the lining of the uterus
that operates through the following stages:
(1) proliferation of the uterine endometrium
(2) development of secretory changes in the
endometrium
(3) desquamation of the endometrium (known as
menstruation)
 If the ovum is not fertilized, about 2 days before
the end of the monthly cycle, the corpus luteum
in the ovary suddenly involutes, and the ovarian
hormones (estrogens and progesterone) decrease
to low levels of secretion.
Menstruation is caused by the reduction of
estrogens and progesterone, especially
progesterone, at the end of the monthly ovarian
cycle.
At age 40 to 50 years, the sexual cycle usually
becomes irregular, and ovulation often fails to
occur. The period during which the cycle ceases
and the female sex hormones diminish to almost
none is called menopause.
 The cause of menopause is “burning out” of the
ovaries. Throughout a woman’s reproductive
life, about 400 of the primordial follicles grow
into mature follicles and ovulate, and hundreds
of thousands of ova degenerate. At about age 45
years, only a few primordial follicles remain to
be stimulated by FSH and LH, the production of
estrogens by the ovaries decreases as the number
of primordial follicles approaches zero. When
estrogen production falls below a critical value,
the estrogens can no longer inhibit the
production of the gonadotropins FSH and LH.
Instead, the gonadotropins FSH and LH (mainly
FSH) are produced after menopause in large and
continuous quantities, but as the remaining
primordial follicles become atretic, the
production of estrogens by the ovaries falls
virtually to zero.
Cardiac Cycle
Repetitive contraction and relaxation of the heart
chambers
o Overview of Systole and Diastole
o Atrial systole is contraction of
the atria
o Systole is contraction of the
ventricles
o Atrial diastole is relaxation of
the atria
o Diastole is relaxation of the
ventricles
o Overview of Systole and Diastole
(cont.)
o During systole
 AV valves close
 Pressure increases in the
ventricles
 Semilunar valves are
forced to open
FINALS: ANATOMY AND PHYSIOLOGY LECTURE
 Blood flows into the
aorta and pulmonary
trunk
o At the beginning of diastole
 Pressure in the
ventricles decreases
 Semilunar valves close
to prevent backflow of
blood from the aorta
and pulmonary trunk
into the ventricles
o When the pressure in the
ventricles is lower than in the
atria, the AV valves open and
blood flows from the atria into
the ventricles
o During atrial systole, the atria
contract and complete the filling
of the ventricles
• Events Occurring During Ventricular
Systole
– Ventricular depolarization
• Initiates contraction of
the ventricles, which
increases ventricular
pressure
– The AV valves
close
– Semilunar
valves open
– Blood is ejected
from the heart
– The volume of blood in a
ventricle just before it contracts
is the end- diastolic volume
– The volume of blood after
contraction is the end- systolic
volume
• Events Occurring During Ventricular
Diastole
– Ventricular repolarization
• Ventricles relax
– Blood flowing
back toward the
relaxed
ventricles
closes the
semilunar
valves
– The AV valves
open and blood
flows into the
ventricles
• Approximately 70% of
ventricular filling
occurs when blood
flows from the higher
pressure in the veins
and atria to the lower
pressure in the relaxed
ventricles
• The atria contract and
complete ventricular
filling
• Aortic Pressure Curve
– Contraction of the ventricles
forces blood into the aorta
• The maximum pressure
in the aorta is the
systolic pressure
– Elastic recoil of the aorta
maintains pressure in the aorta
– Blood pressure in the aorta falls
as blood flows out of the aorta
• The minimum pressure
in the aorta is the
diastolic pressure
 FINALS: ANATOMY AND PHYSIOLOGY LECTURE
• Heart sounds (lub-dup) are associated
with closing of heart valves
– First sound occurs as AV valves
close and signifies beginning of
systole
– Second sound occurs when SL
valves close at the beginning of
ventricular diastole
Cardiovascular System:
Blood Vessels and Circulation
Functions of the Peripheral Circulation
• The heart provides the major force that
causes blood to circulate
• The peripheral circulation
1. Carries blood
2. Exchanges nutrients, waste
products, and gases with tissues
3. Helps regulate blood pressure
4. Directs blood flow to tissues
Pulmonary Circulation
• Moves blood to and from the lungs
• Pulmonary trunk arises from the right
ventricle and divides to form the
pulmonary arteries, which project to the
lungs
• From the lungs, four pulmonary veins
return blood to the left atrium
Systemic Circulation: Arteries
Arteries carry blood from the left ventricle of the
heart to all parts of the body
Aorta
• Leaves the left ventricle to form the
– Ascending aorta
– Aortic arch
– Descending aorta
• Consists of the thoracic
aorta and the abdominal
aorta
 FINALS: ANATOMY AND PHYSIOLOGY LECTURE
• Coronary arteries branch from the aorta
and supply the heart

Arteries to the Head and the Neck

• The following arteries branch from the
aortic arch to supply the head and the
upper limbs
– Brachiocephalic
• Divides to form the
right common carotid
and the right subclavian
arteries
– Left common carotid
– Left subclavian
• Vertebral arteries
branch from the
subclavian arteries
• The common carotid arteries and the
vertebral arteries supply the head
– The common carotid arteries
divide to form the
• external carotids:
supply the face and
mouth
• internal carotids:
supply the brain
– Vertebral arteries join within the
cranial cavity to form the basilar
artery, which supplies the brain
– The internal carotids and basilar
arteries contribute to the
cerebral arterial circle

Arteries of the Upper Limb

• The subclavian artery continues
(without branching) as the axillary
artery and then as the brachial artery.
The brachial artery divides into the
radial and ulnar arteries
– The radial artery supplies the
deep palmar arch
 FINALS: ANATOMY AND PHYSIOLOGY LECTURE
– The ulnar artery supplies the Thoracic Aorta/Branches
superficial palmar arch
• Both arches give rise to • The thoracic aorta has
the digital arteries
– Visceral branches that supply
the thoracic organs

– Parietal branches that supply the

thoracic wall

Abdominal Aorta/Branches

• The abdominal aorta has

– Visceral branches that supply

the abdominal organs

– Parietal branches that supply the

abdominal wall

Branches of the Aorta

• The visceral branches are paired and

unpaired
 FINALS: ANATOMY AND PHYSIOLOGY LECTURE
– The unpaired arteries supply the
stomach, spleen, and liver
(celiac trunk); the small
intestine and upper part of the
large intestine (superior
mesenteric); and the lower part
of the large intestine (inferior
mesenteric)
– The paired arteries supply the
kidneys, adrenal glands, and
gonads
Arteries of the Pelvis
• The common iliac arteries arise from the
abdominal aorta, and the internal iliac
arteries branch from the common iliac
arteries
– The visceral branches of the
internal iliac arteries supply the
pelvic organs
– The parietal branches supply the
pelvic wall and floor and the
external genitalia
Arteries of the Lower Limb
• The external iliac arteries branch from
the common iliac arteries
• The external iliac artery continues
(without branching) as the femoral
artery and then as the popliteal artery
– The popliteal artery divides to
form the anterior and posterior
tibial arteries
• The posterior tibial
artery gives rise to the
fibular (peroneal) and
plantar arteries
• The plantar arteries
form the plantar arch,
from which the digital
arteries arise
Systemic Circulation: Veins
• The three major veins returning blood to
the heart are the
– Superior vena cava (head, neck,
thorax, and upper limbs)
 FINALS: ANATOMY AND PHYSIOLOGY LECTURE
– Inferior vena cava ( abdomen,
pelvis, and lower limbs)
– Coronary sinus (heart)
• Veins are of three types:
– Superficial veins
– Deep veins
– Sinuses
Veins of the Head and Neck
• The internal jugular veins drain the
dural venous sinuses and the veins of the
anterior head, face, and neck
• The external jugular veins and the
vertebral veins drain the posterior head
and neck
Veins of the Upper Limb
• The deep veins are the small ulnar and
radial veins of the forearm, which join
the brachial veins of the arm. The
brachial veins drain into the axillary
vein
• The superficial veins are the basilic,
cephalic, and median cubital
– The basilic vein becomes the
axillary vein, which then
becomes the subclavian vein.
The cephalic vein drains into the
axillary vein
– The median cubital connects the
basilic and cephalic veins at the
elbow
Veins of the Thorax
The left and right brachiocephalic veins and the
azygos veins return blood to the superior vena
cava
Veins of the Abdomen and Pelvis
• Ascending lumbar veins from the
abdomen join the azygos and
hemiazygos veins
• Veins from the kidneys, adrenal glands,
and gonads directly enter the inferior
vena cava
• Veins from the stomach, intestines,
spleen, and pancreas connect with the
hepatic portal vein
– The hepatic portal vein
transports blood to the liver for
processing. Hepatic veins from
the liver join the inferior vena
cava
Veins of the Lower Limb
• The deep veins are the fibular
(peroneal), anterior tibial, posterior
tibial, popliteal, femoral, and external
iliac veins
• The superficial veins are the small and
great saphenous veins
 FINALS: ANATOMY AND PHYSIOLOGY LECTURE
Physiology of Circulation
• Blood Pressure
– A measure of the force exerted
by blood against the blood
vessel wall. Blood moves
through vessels because of
blood pressure
– Can be measured by listening
for Korotkoff sounds produced
by turbulent flow in arteries as
pressure is released from a
blood pressure cuff
• Blood Flow Through a Blood Vessel
– The amount of blood that moves
through a vessel in a given
period.
– Directly proportional to pressure
differences and is inversely
proportional to resistance
– Resistance is the sum of all the
factors that inhibit blood flow.
Resistance increases when
blood vessels become smaller
and viscosity increases
– Viscosity is the resistance of a
liquid to flow. Most of the
viscosity of blood results from
red blood cells. The viscosity of
blood increases when the
hematocrit increases or plasma
volume decreases
• Blood Flow Through the Body
– Mean arterial pressure equals
cardiac output times peripheral
resistance
– Vasomotor tone is a state of
partial contraction of blood
vessels. Vasoconstriction
increases vasomotor tone and
peripheral resistance, whereas
vasodilation decreases
vasomotor tone and peripheral
resistance
– Blood pressure averages 100
mm Hg in the aorta and drops to
0 mm Hg in the right atrium.
The greatest drop occurs in the
arterioles and capillaries
• Pulse Pressure and Vascular
Compliance
– Pulse pressure is the difference
between systolic and diastolic
pressures. Pulse pressure
increases when stroke volume
increases or vascular
compliance decreases
– Vascular compliance is a
measure of the change in
volume of blood vessels
produced by a change in
pressure
– Pulse pressure waves travel
through the vascular system
FINALS: ANATOMY AND PHYSIOLOGY LECTURE
faster than the blood flows.
Pulse pressure can be used to
take the pulse
• Blood Pressure and the Effect of
Gravity
– In a standing person, hydrostatic
pressure caused by gravity
• Increases blood
pressure below the heart
• Decreases pressure
above the heart
• Capillary Exchange and Regulation of
Interstitial Fluid Volume
– Capillary exchange occurs
through or between endothelial
cells
– Diffusion, which includes
osmosis, and filtration are the
primary means of capillary
exchange
– Filtration moves materials out
of capillaries and osmosis
moves them into capillaries
– A net movement of fluid occurs
from the blood into the tissues.
The fluid gained by the tissues
is removed by the lymphatic
system
Control of Blood Flow
• Blood flow through tissues is highly
controlled and matched closely to the
metabolic needs of tissues
• Local Control
– The response of vascular
smooth muscle to changes in
tissue gases, nutrients, and
waste products
– If the metabolic activity of a
tissue increases, the diameter
and number of capillaries in the
tissue increase over time.
• Nervous and Hormonal Control
– The sympathetic nervous system
(vasomotor center in the
medulla) controls blood vessel
diameter. Other brain areas can
excite or inhibit the vasomotor
center
– Epinephrine and norepinephrine
cause vasoconstriction in most
tissues. Epinephrine causes
vasodilation in skeletal and
cardiac muscle
– The muscular arteries and
arterioles control the delivery of
blood to tissues
– The veins are a reservoir for
blood
– Venous return to the heart
increases because of the
vasoconstriction of veins, an
increased blood volume, and the
skeletal muscle pump (with
valves)
 FINALS: ANATOMY AND PHYSIOLOGY LECTURE
Regulation of Mean Arterial Pressure
• Mean arterial pressure (MAP) is
proportional to cardiac output times
peripheral resistance
– Short-Term Regulation
Blood Pressure
• Baroreceptors
sensory receptors
sensitive to stretch
– Located in the
carotid sinuses
and the aortic
arch
– The
baroreceptor
reflex changes
peripheral
resistance, heart
rate, and stroke
volume
response
changes
blood pressure
– Epinephrine and norepinephrine
are released from the adrenal
medulla as a result of
sympathetic stimulation. They
increase heart rate, stroke
volume, and vasoconstriction
– Peripheral chemoreceptor
reflexes respond to decreased
oxygen, leading to increased
vasoconstriction
– Central chemoreceptors respond
to high carbon dioxide or low
pH levels in the medulla,
leading to increased
vasoconstriction, heart rate, and
force of contraction (CNS
ischemic response)
• Long-Term Regulation of Blood
Pressure
– Through the renin-angiotensin-
of aldosterone mechanism
• Renin is released by the
are kidneys in response to
low blood pressure
• Promotes the
production of
angiotensin II, which
causes vasoconstriction
and an increase in
aldosterone secretion
– Aldosterone
helps maintain
blood volume
by decreasing
urine
in production
to
in – The vasopressin (ADH)
mechanism causes ADH release
from the posterior pituitary in
response to a substantial
decrease in blood pressure
• ADH causes
vasoconstriction and
helps maintain blood
volume by decreasing
urine production
– The atrial natriuretic mechanism
causes atrial natriuretic hormone
release from the cardiac muscle
cells when atrial blood pressure
increases. It stimulates an
increase in urinary production,
 FINALS: ANATOMY AND PHYSIOLOGY LECTURE
causing a decrease in blood
volume and blood pressure
– The fluid shift mechanism
causes fluid shift, which is a
movement of fluid from the
interstitial spaces into capillaries
in response to a decrease in
blood pressure to maintain
blood volume
Urinary system: Renal function
– Regulation of plasma ionic composition
– Regulation of plasma volume
– Regulation of plasma osmolarity
– Regulation of plasma hydrogen ion
concentration (pH)
– Removal of metabolic wastes and
foreign substances
– Secondary endocrine organ
Urine Formation
Renal exchange processes
– Glomerular filtration – in renal capsule
– Reabsorption – in renal tubules
– Secretion – in renal tubules
Glomerular filtration
• Plasma is filtered through fenestrated
epithelium
• About 180 liters of plasma are filtered
per day  filtrate
• Filtrate = plasma - proteins
• About 2 liters of urine produced per day
Forces acting on filtration
• Glomerular capillary hydrostatic
pressure  due to blood hydrostatic
pressure against capillary wall (BHP)
• Glomerular osmotic pressure due to the
presence of solutes (proteins) in the
blood (BOP)
• Bowman’s capsule hydrostatic pressure
 pressure of filtrate against Bowman’s
capsule wall (CHP)
• Bowman’s capsule osmotic pressure 
due to the pressure of solutes in the
filtrate (COP)
• Net filtration rate  fluid moves from
the glomerulus into the capsule
• The glomerular filtration rate (GFR) =
volume of plasma filtered per unit of
time = 125 ml/min  180 liters per day
• Filtration fraction =
• GFR/renal plasma flow = 20%
Urine Formation: Reabsorption in the
Proximal Convoluted Tubule (PCT)
• Glucose, amino-acid, sodium will be
pumped out of the tubules, by active
transport (ATP needed)
• Chloride will follow sodium into the
peritubular space (accumulation of
positive charges draws chloride out)
• Water will move into the peritubular
space because of osmosis
• Some compounds present in high
concentration in the filtrate but low in
the blood can move through diffusion
Glucose reabsorption
• The transporter for glucose on the
basolateral membrane has a limited
capacity to carry glucose back into the
blood. If blood glucose rises above 180
mg/dl, some of the glucose fails to be
reabsorbed and remains in the urine 
glucosuria
• 70% of sodium and water are
reabsorbed in PCT
• Reabsorption is not regulated
• Amino-acids, glucose should be 100%
reabsorbed at the end of the PCT
• The filtrate, at the end of the PCT
should be iso-osmolar to the filtrate at
the beginning
Urine Formation: Reabsorption in the Loop
of Henle
• Characteristics of Loop of Henle:
 FINALS: ANATOMY AND PHYSIOLOGY LECTURE
-- Descending tubule: permeable to water
has no sodium pumps
-- Ascending loop: thick epithelium is
impermeable to water but has many
sodium pumps
-- Na+, Cl- and K+ are pumped out into the
interstitial fluid  Cl- follows
(electrochemical gradient)  water follows
by osmosis = counter-current multiplier
-- formation of an osmotic gradient in the
renal medulla which is important for water
reabsorption in the CT
• Additional filtrate is reabsorbed
• The filtrate is concentrated as it travels
through the loop but returns to a
concentration similar to the other end.
• Reabsorption in this segment is also
(like PCT) not regulated
• The longer the loop, the more
concentrated the filtrate and the
medullary IF become
• Importance: the collecting tubule runs
through the hyperosmotic medulla 
more ability to reabsorb H2O
Urine Formation: Reabsorption in the
Distal Convoluted Tubule (DCT)
– DCT and CT tubular walls are different
from the PCT and Loop of Henle wall:
 DCT and CT walls have tight
junctions and the membrane is
impermeable to water
 the cell membrane has
receptors able to bind and
respond to various hormones:
ADH, ANP and aldosterone
 The binding of hormones will
modify the membrane
permeability to water and ions
DCT
– ADH is low  no binding to receptors
 H2O is not reabsorbed
back into
– the blood
– H2O remains in the renal tubule
– high urine volume
CT
ADH is released by post. Pituitary
– Binds to receptors in CT
– channels open  H2O moves
– into the IF and blood  low urine
– volume
Regulation of ADH secretion
• The neurosecretory neurons for ADH (in
the hypothalamus) are located near the
center monitoring blood osmotic
pressure
 if BOP ↑ ADH secretion and release ↑ 
water reabsorption ↑  blood is diluted 
BOP↓ (typical homeostatic regulation)
 If BOP ↓  ADH secretion and release
↓  H2O reabsorption ↓  BOP ↑ 
urine volume ↑
 Lack of ADH? Symptoms?
Sodium regulation
• Hypernatremia causes water retention
and high blood pressure
• Hyponatremia  hypotension
• Because sodium is tightly linked to BP,
BP is regulating sodium movement in
the tubules
• Recall that BP directly affects GFR 
GFR is sensed by the macula densa of
the Juxta-glomerular Apparatus (JGA)
• If too low, the juxta-glomerular cells of
the JGA secrete renin into the blood
• As a result, aldosterone will be secreted
by the adrenal cortex  promotes
sodium reabsorption in the DCT and CT.
• Another hormone, Atrial Natriuretic
Peptide or ANP promotes sodium
dumping by the DCT and CT.
Urine Formation: Secretion
• Secretion: Selective transport of
molecules from the peritubular fluid to
the lumen of the renal tubules
• Excretion: Molecules are dumped
outside the tubules
• Example of excreted waste products:
urea, excess K+, H+, Ca++
Clinical applications
• Carbonic anhydrase inhibitors:
• Osmotic diuretics:
• Thiazide diuretics
• Loop diuretics:
• K+ sparring diuretics:
 FINALS: ANATOMY AND PHYSIOLOGY LECTURE
Clinical application: the Glomerular Filtration
Rate
• GFR: important value for estimating the
kidney function.
• Calculated by using molecules which
are filtered but not secreted nor
reabsorbed.
• P X GFR = U X V
• P = plasma
concentration of A, in
mg/mL
• GFR = glomerular
filtration rate
plasma, in mL/min
• U = urine concentration
of A, in mg/mL
• V = rate of urine
production in,
mL/min
• Solving the equation for
GFR will give:
• GFR = (U X V)/P
• GFR = (U X V)/P
• Best molecule to use: inulin but not
occurring naturally in the body
• Second best: creatinine
• Urea: cannot be used since it is both
secreted and reabsorbed (why is it so?)
Regulation of GFR (Glomerular Filtration Rate)
• GFR needs to be constant
• Changes in BHP will affect GFR
strongly BHP is a function of SBP
• GFR regulation:
- to increase GFR:
**vasoconstrict efferent vessel
** vasodilate afferent vessel
• Vasoconstriction of the efferent vessel
is under the control of:
• Epinephrine/Norepinephrine from the
ANS
• Angiotensin II from the renin-
angiotensin system
• Vasodilation of the afferent vessel is
under the control of:
– paracrines secreted by the
macula densa  stimulate
vasodilation of neighboring
vessel
– - myogenic reflex (automatic
constriction of smooth muscles
lining the wall when the artery
is stretched by increased
pressure
Micturition
• Controlled by the sacral
parasympathetic NS
of • Stretch sensors in the bladder wall send
impulses to the sacral spine
•  reflex opening of the urethral
smooth muscle
in
• Impulses also sent to the cortex to
notify the brain of the need to urinate
•  if the moment is OK, the person will
go to the bathroom (hopefully!), and
will open the skeletal (voluntary)
muscle of the urethral sphincter  the
person will be able to urinate
Clinical applications:
– Water intake:
- drink
- food
- catabolism
– Overall, intake should equal output
– Urine output should be less than water
intake (drinks)
– Urine is constantly formed at a
minimum rate of about 20-30 ml/h
Regulation of Fluid Volumes and Electrolyte
Excretion
Thirst and Ion Regulation
Water intake is controlled by neurons in the
hypothalamus, collectively called the thirst
 FINALS: ANATOMY AND PHYSIOLOGY LECTURE
center. When blood becomes more
concentrated, the thirst center responds by
initiating the sensation of thirst (figure 18.20).
When water or another dilute solution is
consumed, the blood becomes less
concentrated and the sensation of thirst
decreases. Similarly, when blood pressure
drops, as occurs during shock, the thirst center
is activated, and the sensation of thirst is
triggered. Consumption of water increases the
blood volume and allows the blood pressure to
return to its normal value. Other stimuli can
also trigger the sensation of thirst. For example,
if the mucosa of the mouth becomes dry, the
thirst center is activated. Thirst is one of the
important means of regulating extracellular
fluid volume and concentration.
Ion Regulation
Regulating the concentrations of positively
charged ions, such as Na+, K+, and Ca2+, in the
body fluids is particularly important. Action
potentials, muscle contraction, and normal cell
membrane permeability depend on the
maintenance of a narrow range of
concentrations for these ions. Important
mechanisms control the concentrations of these
ions in the body. Negatively charged ions, such
as Cl−, are secondarily regulated by the
mechanisms that con-trol the positively charged
ions. The negatively charged ions are attracted
to the positively charged ions; when the
positively charged ions are transported, the
negatively charged ions move with them.
Potassium
• Electrical excitability of cells
• Major osmotically active solute in cells
• Acid-base balance
• The kidneys are the major site in
control of potassium balance
Potassium Balance
• Regulatory mechanisms keep plasma
potassium in narrow range
• Aldosterone plays a critical role
• Hypokalemia
• Muscle weakness and failure of
respiratory muscles and the
heart
• Causes low intake, diarrhea,
Conn’s disease
• Hyperkalemia
• Can lead to cardiac arrhythmias
• Causes include kidney disease,
diuretics, Addison’s disease
Factors that influence K+ redistribution
• Insulin (increase cell uptake)
Diabetic patients have higher K+ after
meal
• Insulin injections helps correct
hyperkalemia
• Aldosterone (increase excretion)
• Conn’s syndrome (hypokalemia)
• Addison’s disease
(hyperkalemia)
• Epinephrine (β2-adrenergic stimulation
increase cell uptake)
• β2-receptors blockers (propranolol) can
cause hyperkalemia (hypertension
patients)
• Metabolic acidosis (increases
extracellular K+)
• Metabolic alkalosis (decreases
extracellular K+)
• Mechanism:
• ↑ [H+] inhibits Na+-K+ ATPase
(↓ K+ uptake)
• Cell lysis (hyperkalemia)
• Severe muscle injury
• RBC destruction
• Strenuous exercise
• K+ release from muscle cells
(hyperkalemia)
• Can be severe in diabetic or β-
adrenergic blocker patients
• Increased extracellular osmolarity
• Cell dehydration concentrates K+ inside
cells leading to diffusion out
 FINALS: ANATOMY AND PHYSIOLOGY LECTURE
• Also present in diabetes
mellitus
Sites of K+ Reabsorption and Secretion
• When K+ intake goes up thus increasing
filtered load, the amt. reabsorbed
increases but not as much as the amt.
secreted.
Mechanism of K+ Secretion
• Na+/K+ pump at basolateral membrane
of principal cells pumps K+ into the cell
creating a diffusion gradient to the
tubular lumen through special K +
channels
K+ secretion responsible for variations in
excretion levels
• Main secretion sites
• Principal cells (late distal
tubules)
• Cortical collecting ducts
• Secretion and reabsorption
depending on body need
• ↑ intake ↑ secretion (can exceed the
filtrate)
• ↓ intake ↓ secretion
K+ secretion by Principal cells
• Since dietary loads of K+ are mainly
secreted by principal cells, the most
important factors causing secretion are:
• Increased [K+]p
• Increased Aldosterone
• Increased tubular flow rate
• Increase H+ (acidosis) decrease
K+ secretion
Most important mechanism controlling K+
levels
• Three mechanisms:
• ↑ Na+-K+ ATPase activity
• ↑ K+ gradient from interstitial
fluid to the interior of the
epithelial cells
• ↑ aldosterone (via Na+-K+
ATPase and ↑ permeability of
lumen membrane)
Effect of Aldosterone on K+ Excretion
• The sharp increase in excretion above
4.1 meq/L due to direct stimulation of
Na+/K+ pump to increase [K+] cell and
diffusion to lumen
• Note: Aldosterone increases
basolateral Na+/K+ pump activity and
luminal border permeability to K+
Feedback mechanism for control of [K+]p by
Aldosterone
• [K+]p increase causes [aldosterone]p
increase which causes an increase in K+
excretion which causes [K+]p to return to
normal
• An increase in [K+]p has a direct effect on
principal cells and an indirect effect
through aldosterone release. Both
cause increased secretion by the
principal cells.
Increase in distal tubular flow rate
• Causes: volume expansion, ↑ Na+
intake, diuretics (all stimulate K+
secretion)
• Mechanism:
• ↑K+ in tubular lumen, ↓ K+ driving
force across membrane → ↑ tubular
flow flushes K+ out
Effect of High Na+ Intake on K+ Excretion
• The increased K+ secretion due to the
increased distal tubular flow rate is
another example of gradient time
transport
Hypokalemia
• Reabsorption via intercalated cells
• Secretion stops
• H+-K+ ATPase in lumen (minor role
during excretion)
Disturbances in calcium levels
• Hypocalcemia: ↑ in excitability of nerve
and muscle cells (spastic skeletal muscle
contraction hypocalcemic tetany )
• Hypercalcemia: depression of
neuromuscular excitability and cardiac
arrhythmias
Dietary calcium
• Intake and loss must be balanced
• High excretion via feces (900 mg/day of
1000 mg/day intake)
 FINALS: ANATOMY AND PHYSIOLOGY LECTURE
• 99% stored in bones (reservoir)
• 1% extracellular fluids and 0.1%
intracellular fluids
Calcium Absorption
• Most ingested calcium is lost in feces
• Absorption controlled to meet daily
need of body
• Amount absorbed is dependent on
Vitamin D and Parathyroid hormone
Control of calcium renal excretion
• Renal calcium excretion=calcium
filtered- calcium reabsorbed
• 50% undergo filtration
• 99% filtered reabsorbed , 1% excreted
Regulation of phosphate and sulphate
• Controlled by an overflow mechanism
• Tmax=0.1mM/min
• Below Tmax, all phosphate reabsorbed
• Above Tmax, excess is excreted
• Normal diet (milk and meat) contains
large amounts of phosphate and is
excreted in urine
• Some ions, such as phosphate
ions (PO43−) and sulfate ions(SO42−), are
reabsorbed by active transport in the
kidneys. Therate of reabsorption is
slow, so that if the concentration of
these ions in the filtrate exceeds the
nephron’s ability to reabsorb them, the
excess is excreted into the urine. As
long as the concentration of these ions
is low, nearly all of them are
reabsorbed by active transport. This
mechanism plays a major role in
regulating the concentration of
PO43− and SO42− in the body fluids.
Role of PTH in phosphate excretion
• Promotes bone resorption (↑ ECF
phosphate)
• Decreases Tmax in renal tubules (loss
via urine)
• ↑ PTH ↓ tubular phosphate
reabsorption ↑ excretion
• Secondary Hyperparathyroidism
Secondary Hyperparathyroidism
• Chronic renal failure is the most
common causes of secondary
hyperparathyroidism. Failing kidneys do
not convert enough Vitamin D to its
active form, and they do not adequately
excrete phosphorus.
• Insoluble calcium phosphate forms in
the body and removes calcium from the
circulation. Both processes leads to
hypocalcemia and hence secondary
hyperparathyroidism.
Control of blood volume and ECF
• Effect of blood pressure on Na+ and
water excretion! (Most basic and
powerful)
• Pressure Natriuresis
• Pressure Diuresis
• Usually parallel to each other
Pressure Natriuresis
• In acute arterial pressure:
• 30-50mm Hg changes results 2-
3 fold ↑ Na+ excretion
• Independent of sympathetic
nervous system, hormones
(ADH, Angiotensin II or
aldosterone)
• In chronic arterial pressure:
• Pressure natriuresis greatly
enhanced
• Renin suppression (↓
Angiotensin II and aldosterone)
Basic renal-body fluid feedback mechanism
Summary:
• Prevents continuous accumulation of
salt and water during increased salt and
water intake
• Dependent on functional kidney and
pressure diuresis
• Minimal changes in BV, ECF, CO and AP
during large salt and water intake
Nervous & Hormonal Factors and the Renal-
Body Fluid System
• Sympathetic Nervous System (blood
loss)
• Arterial baroreceptors
• Low pressure stretch receptors
• Angiotensin II (blood loss)
• Aldosterone (blood loss)
• ADH (restricted dietary intake of H 2O)
• ANP (congestive heart failure)
 FINALS: ANATOMY AND PHYSIOLOGY LECTURE
Sympathetic Nervous System
• Decrease in blood volume
(hemorrhage) activates pressure
sensitive receptors
• Increase sympathetic stimulus to
kidneys
• Constriction of renal artery (↓
GFR)
• ↑ tubular reabsorption of salt
and water
• ↑ renin (↑ angiotensin II and
aldosterone)
Angiotensin II
• Angiotensin II formation directly related
to sodium and water intake
• ↑ sodium intake (↓ renin and
angiotensin II)
• ↓ sodium and water reabsorption
• ↑ excretion of sodium and water
• The renin-angiotensin system amplifies
the pressure natriuresis mechanism
Aldosterone
• Net effect to increase sodium and water
reabsorption and potassium excretion
• ↓ sodium intake ↑ aldosterone
• ↑ sodium intake ↓ aldosterone
• Aid the pressure natriuresis mechanism
“Escape” effect during oversecretion of
Aldosterone
• Conn’s syndrome
• Increase in arterial pressure allows
kidneys to “escape” the initial sodium
and water retention (Via pressure
natriuresis and diuresis)
• Sodium excretion matches intake
Anti-Diuretic Hormone (ADH)
• Water retention with normal salt
excretion
• 24-48 h without water slight decrease
in ECF volume and AP (with ADH)
• Without ADH significant decrease in ECF
volume and AP
• High ADH levels can cause severe
reduction in extracellular sodium
Atrial Natriuretic Peptide (ANP)
• Released by overstretch of the atria
(excess blood volume)
• ↑ GFR and ↓ sodium reabsorption
• ↑ excretion of salt and water
(compensates excess blood)
• Excess ANP or absence does not cause
major changes in BV (because small
changes in BP via pressure natriuresis)
ACID-BASE BALANCE
• Normal function of body cells depends
on regulation of the hydrogen ion (H+)
concentration within very narrow limits.
• Acid-Base imbalances are frequently
diagnosed with Arterial Blood Gas.
Regulation of Acid-Base balance
• The symbol pH refers to the negative
logarithm of the H+ concentration.
• A pH of 7.0 is neutral; an acidic solution
has a pH less than 7.0; and an alkaline
solution has a pH greater than 7.0
• Normal serum pH is 7.35-7.45
• Three physiologic systems act
interdependently to maintain a normal
serum pH
• Chemical buffering of excess acid or
base by buffer systems in the blood
plasma and in cells.
• Excretion of acid by the lungs
• Excretion of acid or regeneration of
base by the kidneys.
Modulation of serum pH by buffer systems
• Chemical buffers are solutions that
resist changes in pH
• A buffer is made up of a weak acid and
its conjugate base.
• The most important extracellular buffer
is the HCO3 −/H2CO3 system, described
by the equation:
• H+ + HCO3 − ↔H2CO3 ↔ CO2 + H2O
• The organic acids formed during cellular
energy metabolism are strong acids.
• Example of buffering reactions
• Strong acid buffered:
• HCL + (H2CO3/NaHCO3) → H2CO3 +
NaCl
• Strong base buffered:
• NaOH + (H2CO3/NaHCO3) →NaHCO3 +
H2O
• Proteins such as hemoglobin in RBCs
and albumin in the plasma are
 FINALS: ANATOMY AND PHYSIOLOGY LECTURE
quantitatively the most important
blood buffers.
• Negatively charged ions, such as
phosphate within body cells and
carbonate within bones, are important
intracellular buffers.
• Buffer systems act instantly to minimize
the impact of adding strong acids or
bases to body fluids.
• The concentrations of bicarbonate ions
and of carbonic acid are controlled by
two independent physiological systems.
• Carbonic acid concentration is
controlled by the lungs while
bicarbonate ions is through the lungs.
Regulation of volatile acids by the lungs
• Volatile acids are acids that can be
converted to gases.
• During normal ventilation (breathing),
the lungs exhale large quantities of
“potential” acid in the form of CO2
• CO2 diffuses from body cells into the
blood, where it may combine with
water to form H2CO3 , which then
dissociates into its component ions: H+
and HCO3-. This hydrolysis reaction,
which is reversible, is shown as follows:
• H2O + CO2 ↔H2CO3 ↔ HCO3- + H+
• The law of mass action states that the
rate of a chemical reaction is directly
proportional to the molecular
concentrations of the reacting
substances.
• The rate and direction of the hydrolysis
reaction are determined by (1) the
addition of substrate or (2) the removal
of end product.
• In the lungs, CO2 diffuses along its
concentration gradient from the plasma
to the alveoli, from which it is exhaled.
Regulation of fixed acids and bicarbonate by
the kidneys
• Fixed acids are acids that cannot be
converted to gases, thus should be
eliminated in the urine.
• These fixed acids include the ff: Sulfuric,
phosphoric, ketones, lactic acid and
occasionally, ingested toxins such as
salicylates, drugs and methanol.
• The kidneys regulate serum pH by
secreting H+ into the urine and by
regenarating HCO3- for reabsorption in
the blood.
URINARY BUFFER SYSTEMS
• The three principal buffer systems in
renal tubules are the bicarbonate,
ammonia and phosphate (titratable
acid) systems.
• Bicarbonate buffer
• Ammonia buffer
• Phosphate buffer
Bicarbonate Buffer
• H+ is secreted into the tubular lumen by
tubular cells in countertransport with
sodium.
• The combination of H+ with filtered
bicarbonate regenerates CO2 in a
reversal of the hydrolysis reaction.
• This CO2 is reabsorbed into tubular
cells, where hydrolysis proceeds.
Ammonia Buffer
• Depends on the generation of ammonia
(NH3) from amino acids in renal tubular
cells.
• NH3 diffuses into the tubular lumen,
where it may combine with secreted H+
to form ammonium (NH4+)
• NH4+ is excreted in the urine in
combination with Cl- from NaCl
Phosphate Buffer
• Results in the formation of weak acids
that are excreted in the urine.
FINALS: ANATOMY AND PHYSIOLOGY LECTURE