This presentation provides a clear understanding of the physiology of the circulatory system. It focus lies on the division and component of the circulatory system, the three major function of the circulatory system, blood composition, structure of the heart, blood circulation; pulmonary and systemic circuit, valves of the heart, the pathway of blood flow through the heart, the cardiac cycle, pressure changes during the cardiac cycle; systole and diastole, cardiac output, heart sounds among others.
This presentation was designed by Fasama H. Kollie and presented by Benetta N. Kekulah, Cordelia Capehart and Abraham Peters.
Circulation is the movement of blood through the vessels of the body induced by the pumping action of the heart. The types of circulation in the human body is described as a part of the physiological study.
This presentation is an overview of the description of the 4 stages of the cardiac cycle (atrial diastole, atrial systole, ventricular systole, ventricular diastole) as well as explaining the mechanism of the cardiac cycle.
Cardiac cycle refers to a complete heartbeat from its generation to the beginning of the next beat.
Cardiac events that occur from –
beginning of one heart beat to the beginning of the next are called the cardiac cycle.
Circulation is the movement of blood through the vessels of the body induced by the pumping action of the heart. The types of circulation in the human body is described as a part of the physiological study.
This presentation is an overview of the description of the 4 stages of the cardiac cycle (atrial diastole, atrial systole, ventricular systole, ventricular diastole) as well as explaining the mechanism of the cardiac cycle.
Cardiac cycle refers to a complete heartbeat from its generation to the beginning of the next beat.
Cardiac events that occur from –
beginning of one heart beat to the beginning of the next are called the cardiac cycle.
The cardiovascular system can be thought of as the transport system of the body.
This system has three main components: the heart, the blood vessel and the blood itself.
The heart is the system’s pump and the blood vessels are like the delivery routes.
The cardiovascular system can be thought of as the transport system of the body.
This system has three main components: the heart, the blood vessel and the blood itself.
The heart is the system’s pump and the blood vessels are like the delivery routes.
This presentation is a combination of different slides which I re-purposed. I included a reference of all the slides I used at the end of my presentation.
A powerpoint designed for the South African Life Sciences syllabus for grade 11. Includes information about blood and it's transportation, the human heart, the lymph system etc. Hope it helps :)
1 GNM - Anatomy unit - 4 - CVS by thirumurugan.pptxthiru murugan
By:M. Thiru murugan
Unit – IV:
Heart : Structure, functions including conduction system & cardiac cycle
Blood vessels : Types, Structure and position
Circulation of blood
Blood pressure and pulse
Heart
The circulatory system:
It consisting of blood, blood vessels, and heart.
This supplies oxygen and other nutrients,
Transports hormones
Removes unnecessary waste products.
Heart and its Structure
The heart is a muscular organ about the size of a fist,
located in mediastinum just behind and slightly left of the breastbone (sternum).
The heart pumps blood through the blood vessels (arteries and veins called the cardiovascular system).
Structure of heart:
Layers of the heart (3)
Chambers of the heart (4)
Valves of the heart (4)
Blood vessels of the heart (5)
3 layers of the heart:
Epicardium/pericardium: outer protective layer of the heart. Visceral and parietal (pericardial fluid). Protection for the heart and big vessels and prevent collapse of heart,
Myocardium: muscular middle layer wall of the heart. Responsible for keeping the heart pumping blood around the body.
Endocardium: the inner layer of the heart. Regulate blood flow through the chambers of the heart and pass the electrical impulses
Chambers of the heart:
The atria: These are the 2 upper chambers, which receive blood. RA / LA
The ventricles: These are the 2 lower chambers, which discharge blood. RV/ LV
A wall of tissue called the septum separates the left and right atria called atrial septum and the left and right ventricle called ventricular septum.
Valves in the heart:
There are four valves
Two-atrio ventricular valves: The 2 types: bicuspid (mitral) - LA & LV, and tricuspid valves - RA & RV.
Two-semilunar valves: The aortic valves and the pulmonary valve.
Major blood vessels of the heart
There are 5 major blood vessels
Pulmonary artery
Pulmonary veins
Aorta[artery]
Inferior vena cava [IVC] veins
Superior vena cava [SVC] veins
Functions of heart:
Pumping oxygenated blood to the body parts.
Pumping nutrients and other vital substances
Receiving deoxygenated blood and carrying metabolic waste products from the body
Pumping deoxygenated blood to the lungs for oxygenation.
Maintaining blood pressure.
Conduction system
The electrical conduction system that controls the heart rate.
This system generates electrical impulses and conducts them throughout the muscle of the heart, stimulating the heart to contract and pump blood.
The electrical pulses determine the order in which the chambers contract & the heart rate
Conductive system consist of:
SA Node
AV Node
Bundle of his or His Bundles – bundle of branches
( right and left)
4. Purkinje fibres
Sinoatrial node (SA) : also known as the pace maker of the heart and Located in the upper wall of the right atrium
Made up of both muscle and nervous tissue
Here the electrical impulse begins
Atrioventricular (AV) node:
located between the atria and ventricles of the heart
The electrical impulse is carried fr
Are your wondering why you urinate above the normal 7-8 times in a 24 hours cycle. Urinary frequency can be defined as needing to urinate more than 7-8 times in a period of 24 hours while drinking about 2 liters of fluid. This can disrupt your normal routine, interrupt your sleep cycle, and it can be a sign of an underlying medical condition
Biology is the branch of science which deals with the study of living organism and their life processes. It covers all aspect of the study of living creatures like growth, structure, occurrence, classification, ecology, economics importance, external form, organization, internal structure, nutrition among others
Medicine as a career has a variety of specializations; but focusing on the branches with more demand that can help you as a future doctor to define your specialty is cardinal
Angina is a type of chest pain caused by reduced blood flow to the heart. It is a symptom of coronary artery disease. Angina, which may also be called angina pectoris, is often described as squeezing, pressure, heaviness, tightness or pain in your chest. Some people with angina symptoms describe angina as feeling like a vise is squeezing their chest or feeling like a heavy weight has been placed on their chest. Angina may be a new pain that needs evaluation by a doctor, or recurring pain that goes away with treatment
this presentation provides a genuine knowledge on cholesterol positive and negative impact on the proper functioning of your health. Take a look at it. Please Don't forget to leave your comment at the comment session for improvement.
Bryophytes comes from the Greek word “Bryo” meaning “Moss” and “Phyte” meaning “Plant” They are eukaryotic plant-like organism without vascular system. They consist of about 20,000 plant species.
Gymnosperm is from the Greek “gymnos” naked, and “sperma” seeds. They are groups of vascular plants that reproduce by means of an exposed seeds or ovules. They are phanerogams according to A. W. Eichler.
Phylum lycophyta (Club mosses, Spike mosses & Quillworts)Fasama H. Kollie
Lycophytes are believed to be the oldest living lineage of vascular plants. Lycophytes , also known as ‘ferns allies’, are a clade of vascular plants similar to ferns, but have unique leaves called microphylls. Lycophytes contain three orders; lycopodium (club mosses), selaginella (spike mosses) and isoetales (Quillworts)
Fungus comes from the Greek word mykes “Mushrooms”
They are Eukaryotic organism that digests food externally and absorbs nutrients directly through its cell walls. Consist of about 100,000 spp.
Phylum Phaeophyta, Rhodophyta & Chlorophyta - Multicellular aglaeFasama H. Kollie
These are the multicellular algae of the kingdom Protista. Phaeophyta are group of multicellular, eukaryotic organisms that belong to the class phaeophyceae in the division chromophyta.
Phylum Cryptophyta describes tiny, motile, unicellular organisms with two slightly unequal flagella bearing lateral hairs. Prymnesiophyta are group of autotrophic, planktonic, binucleated flagellates characterized by the presence of a haptonema
Phylum Bacillariophyta, Xanthophyta & Chrysophyta Fasama H. Kollie
Bacillariophyta is a phylum of the kingdom Protista, consisting of mostly unicellular aquatic algae commonly referred to as Diatoms.
Xanthophytes are the yellow-green algae whereas Chrysophytes are the golden-brown algae.
Small phylum of the Kingdom protista, consisting of mostly unicellular aquatic algae. Many of these organisms exhibit characteristics similar to both plants and animals. organisms of this phylum are also called Euglenozoa, euglenoids, euglenophytes among others.
This is a comprehensive presentation. It will guide you in identifying Euglena.
Organisms with hidden form of reproduction or reproductive structure. This presentation provide a comprehensive knowledge on such organisms thereby aiding to clearly distinguish them from the Phanerogams, which are organisms with and identifiable form of reproduction or their reproductive structures are identifiable.
Unicellular aquatic Eukaryota organism that do photosynthesize. Plant-like protist. This presentation provides a generalize idea of protist focusing specifically on some characteristics of protist as well as their division.
Acute scrotum is a general term referring to an emergency condition affecting the contents or the wall of the scrotum.
There are a number of conditions that present acutely, predominantly with pain and/or swelling
A careful and detailed history and examination, and in some cases, investigations allow differentiation between these diagnoses. A prompt diagnosis is essential as the patient may require urgent surgical intervention
Testicular torsion refers to twisting of the spermatic cord, causing ischaemia of the testicle.
Testicular torsion results from inadequate fixation of the testis to the tunica vaginalis producing ischemia from reduced arterial inflow and venous outflow obstruction.
The prevalence of testicular torsion in adult patients hospitalized with acute scrotal pain is approximately 25 to 50 percent
Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
NVBDCP.pptx Nation vector borne disease control programSapna Thakur
NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
These lecture slides, by Dr Sidra Arshad, offer a quick overview of physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
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2. Presentation Outline
• Overview of the circulatory system
• Function of the Circulatory system
• Transportation
• Regulation
• Protection
• Major components of the
circulatory system
• Cardiovascular system
• Lymphatic system
• Blood Composition
• Structure of the Heart
• Blood Circulation
• Pulmonary and Systemic circuit
• Valves of the Heart
• Pathway of Blood flow through the
heart
• The cardiac cycle
• Pressure changes during the
cardiac cycle: Systole & Diastole
• Cardiac Output
• Heart sounds
• Cardiac Conduction System
3. Presentation Outline
• Blood vessels
• Arteries and Arterioles
• Capillaries and Types
• Veins and Venules
• Lymphatic System
• Conclusion
4. Circulatory System Overview
• The circulatory system consists of
• Blood
• Blood vessels
• The Heart
• Lymphatic vessels
• It works together with other systems in maintaining Homeostasis
• Respiratory
• Urinary
• Digestive
• Endocrine, and
• Integumentary systems
5. Function of The Circulatory System
• Transportation – transport substances essential for cellular metabolism
These substances can be categorized as follows:
• Respiratory – Oxygen (RBC), Carbon dioxide (blood)
• Nutritive - absorbed products of digestion (blood, lymphatics)
• Excretory - Metabolic wastes (such as urea), excess water and ions, etc. (blood into
kidneys = urine)
• Regulation - contributes to both hormonal and temperature regulation
• Hormonal – hormones (blood)
• Temperature - diversion of blood from deeper to more superficial cutaneous
vessels or vice versa
6. Function Cont’d…
• Protection – protects against blood loss from injury and against
pathogens, including foreign microbes and toxins introduced into the
body.
These substances can be categorized as follows:
• Clotting– prevents blood loss when blood vessels are damaged
• Immune function - protect against many disease-causing agents
(pathogens). Performed by leukocytes (white blood cells).
7. Major Components of the Circulatory System
Cardiovascular system consist
of:
• Heart
• Blood vessels: form a tubular
network that permits the
flow of blood
• Arteries, arterioles, veins,
capillaries
Lymphatic system consists of:
• Lymphatic vessels
• Lymphoid tissues
• Found in the spleen, thymus,
tonsil and lymph nodes
• The circulatory system is divided into two major subdivisions:
• The Cardiovascular system and the Lymphatic system
8. Composition of the Blood
• It consist of formed elements that are suspended and carried in fluid
know as plasma
• The formed element of the blood consist of:
• Erythrocyte (RBC)
• Leukocyte (WBC)
• Platelets
• Hematopoiesis is the formation of blood cells
• Hematopoietic stem cells
9. The Constituents of
Blood
• Figure 1.1 The constituents of blood. Blood cells become packed at the
bottom of the test tube when whole blood is centrifuged, leaving the fluid
plasma at the top of the tube.
10. Blood Composition Cont’d…
• Erythropoiesis refers to the formation of erythrocytes
• Leukopoesis refers to the formation of leukocytes
• These processes occur in two classes of tissues after birth
• Myeloid and lymphoid
11. The Heart Structure
• Located in the thoracic cavity in
the mediastinum, between the
lungs and deep to the sternum
• Contains four chamber
• Its about the size of a fist, the
hollow, cone-shaped
• There is a layer of dense
connective tissues b/t the atria
and ventricle
Figure 1.5. The Structure of the Heart
12. Blood Circulation
• Movement of blood through the vessels of the body that is induced
by the pumping action of the heart and serves to distribute oxygen to
and remove wasted products from all parts of the body
• Two (2) types:
• Pulmonary circulation
• Systemic circulation
13. Blood Circulation Cont’d…
• Pulmonary circuit carries deoxygenated
blood away from the heart to the lungs
and returns oxygenated blood to the heart
• Systemic circuit carries oxygenated blood
away from the heart to body system and
returns deoxygenated blood to the heart
• Pulmonary circuit begins in the right
ventricle and ends in the left atrium
• Systemic circuit beings in the left ventricle
and ends in the right atrium
Figure 1.6 A Diagram of the circulatory system.
14. Valves of the Heart
• Two (2) main types:
• Atrioventricular Valves
• Semilunar Valves
Figure 1.7 The heart valves
15. Valves of the Heart: Atrioventricular Valves
• Found between the atria and ventricles
• Constitutes;
• Tricuspid valve
• Bicuspid valve
• Tricuspid valve: right AV valve that
prevents blood from flowing back into the
right atrium when the right ventricle
contract. It has three flaps of tissues
• Bicuspid valves: left AV valve that prevents
blood from flowing back into the left
atrium when the left ventricle contract.
Tricuspid
valve
Bicuspid
valve
AV Valves
16. Valves of the Heart: Semilunar Valves
• Shaped like half moons
• Constitutes;
• Pulmonary valve
• Aortic valve
• Pulmonary valve: beginning of the
pulmonary truck. Prevents blood from
flowing back into the right ventricle
• Aortic valve: beginning of the aorta.
Prevents blood from flowing back into
the left ventricle
Aortic
valve
Pulmonary
valve
18. The Cardiac Cycle
• Cardiac cycle refers to the repeating patterns of contraction and relaxation of the heart.
The phase of contraction is called systole, and the phase of relaxation is called diastole
• One heartbeat = one cardiac cycle
Atria contract and relax
Ventricles contract and relax
• Right atrium contracts (1st Diastole)
• Tricuspid valve opens
• Blood fills right ventricle
• Right ventricle contracts (1st Systole)
• Tricuspid valve closes
• Pulmonary semilunar valve opens
• Blood flows into pulmonary artery
• Left atrium contracts (2nd Diastole)
• Bicuspid valve opens
• Blood fills left ventricle
• Left ventricle contracts (2nd Systole)
• Bicuspid valve closes
• Aortic semilunar valve opens
• Blood pushed into aorta
19. Cardiac cycle
Figure 1.9 The cardiac cycle of ventricular systole and diastole. Contraction of the atria occurs in the last 0.1
second of ventricular diastole. Relaxation of the atria occurs during ventricular systole. The durations given for
systole and diastole relate to a cardiac rate of 75 beats per minute.
20. Pressure Changes During The
Cardiac Cycle: Systole
• Has 2 phases:
1. Isovolumetric contraction – the both ventricles contract to
increase the pressure in the ventricles. As the ventricles begin
their contraction, the intraventricular pressure rises, causing the
AV valves to snap shut and produce the first heart sound (LUB). At
this time, the ventricles are neither being filled with blood
(because the AV valves are closed) nor ejecting blood (because the
intraventricular pressure has not risen sufficiently to open the
semilunar valves).
21. Systole Cont’d…
• 2. Ejection – blood is pumped out
of the ventricles. When the
pressure in the left ventricle
becomes greater than the
pressure in the aorta, the
phase of ejection begins as
the semilunar valves open.
22. • Has 3 phases:
1. Isovolumetric relaxation – both atria and ventricles are
relaxed. As the pressure in the ventricles falls below the pressure
in the arteries, the back pressure causes the semilunar valves to
snap shut and produce the second heart sound (DUB). During
this phase, the AV and semilunar valves are closed. This phase
lasts until the pressure in the ventricles falls below the pressure
in the atria.
Pressure Changes During The
Cardiac Cycle: Diastole
23. Diastole Cont’d…
2. Rapid filling – rapid inflow of blood into
the ventricles. When the pressure in the
ventricles falls below the pressure in the
atria, the AV valves open and a phase of
rapid filling of the ventricles occurs.
3. Atrial contraction (atrial systole) – the
atria contract to deliver the final amount of
blood into the ventricles immediately prior
to the next phase of isovolumetric
contraction of the ventricles.
24. Cardiac Output
• Defined as the amount of blood each ventricle pumps out per minute.
• Determined by:
• Stroke volume – amount of blood that each ventricle pumps out
per beat
• Heart rate – number of times the heart beats in one minute
• Cardiac Output = Heart rate X Stroke volume
25. Cardiac Output Cont’d…
• Normal resting stroke volume = 70 mL of blood
• Normal resting heart rate = 70-72 beats per minute
• When one factor changes, the body regulates the other factor to enhance the cardiac output.
• Normal cardiac output = 4.9-5.4 L/min (based on the body size of an
individual)
• Normal physiological Resting Cardiac Output – 5 L/min
• When the body begins to move, the cardiac output increases so as to
enhance blood flow to the muscles.
26. Heart Sounds
• There are 4 heart sounds, 3 normal, 2 of which are easily
heard
• The 4th heart sound may normally be heard in a young
child, but is abnormal in adults
• The 1st and 2nd heart sounds are associated with the
closure of valves
27. Heart Sound Cont’d…
1st Heart Sound (Lubb)
• When the ventricle contract, the tricuspid and bicuspid valves
snap shut
2nd Heart Sound (Dubb)
• When the atria contract and the pulmonary and aortic valves
snap shut
28. Heart Sound Cont’d…
3rd Heart Sound
• Produced during diastole
• Heard when the two inlet valves opens
• Not usually audible, may be heard in young child
4th Heart Sound
• Caused by contraction of both atria
• It’s heard when there is atrial hypertrophy
• Thickening of the wall of the atria
29. The Heart: Cardiac Conduction System
• Group of structures that send electrical impulses through the heart
• Sinoatrial node (SA node)
• Wall of right atrium
• Generates impulse
• Natural pacemaker
• Sends impulse to AV node
• Atrioventricular node (AV node)
• Between atria just above ventricles
• Atria contract
• Sends impulse to the bundle of His
• Bundle of His
• Between ventricles
• Two branches
• Sends impulse to
Purkinje fibers
• Purkinje fibers
• Lateral walls of ventricles
• Ventricles contract
30. Cardiac Conduction
System
Figure 1.10 The conduction system of the
heart. The conduction system consists of
specialized myocardial cells that rapidly
conduct the impulses from the atria into the
ventricles.
31. Blood Vessels
• Blood vessels form a tubular network throughout the body that
permits blood to flow from the heart to all the living cells of the body
and then back to the heart
• Blood leaving the heart passes through vessels of progressively
smaller diameters, referred to as arteries, arterioles, and capillaries
• Blood returning to the heart from the capillaries passes through
vessels of progressively larger diameters, called venules and veins.
32. Blood Vessels: Arteries and Arterioles
• Strongest of the blood vessels
• Carry blood away from the
heart
• Under high pressure
• Vasoconstriction
• Vasodilation
• Arterioles
• Small branches of arteries
• Aorta
• Takes blood from the heart
to the body
• Coronary arteries
• Supply blood to heart
muscle
33. The
Microcirculation
Figure 1.12 The microcirculation. Metarterioles
(arteriovenous anastomoses) provide a path of least
resistance between arterioles and venules. Precapillary
sphincter muscles regulate the flow of blood through
the capillaries.
34. Blood Vessels: Capillaries
• The arterial system branches extensively to deliver blood to over 40 billion
capillaries in the body.
• The tiny capillaries provide a total surface area of 1,000 square miles for
exchanges between blood and tissue fluid.
• The amount of blood flowing through a particular capillary bed depends
primarily on the resistance to blood flow in the small arteries and arterioles
that supply blood to that capillary bed.
• Vasoconstriction in these vessels thus decreases blood flow to the capillary
bed, whereas vasodilation increases blood flow
35. Types of Capillaries
• In terms of their endothelial lining, these capillary types include those that
are continuous, those that are fenestrated, and those that are
discontinuous.
• Continuous capillaries are those in which adjacent endothelial cells are
closely joined together. These are found in muscles, lungs, adipose tissue,
and the central nervous system.
• Fenestrated capillaries occur in the kidneys, endocrine glands, and
intestines. They are characterized by wide intercellular pores that are
covered by a layer of mucoprotein, which serves as a basement membrane
over the capillary endothelium
• Discontinuous capillaries are found in the bone marrow, liver, and spleen
36. Blood Vessels: Veins and Venules
• Most of the total blood volume is contained in the venous system.
• Unlike arteries, which provide resistance to the flow of blood from the
heart, veins are able to expand as they accumulate additional amounts of
blood.
• Average pressure in the veins is only 2mmHg compared to a much higher
arterial pressure of about 100mmHg
• The low venous pressure is insufficient to return blood to the heart,
particularly from the lower limbs. Veins, however, pass between skeletal
muscle groups that provide a massaging action as they contract.
37. The Action of The
One-way Venous
Valves
Figure 1.13 The action of the one-way venous valves. Contraction of skeletal muscles helps to pump blood toward the
heart, but the flow of blood away from the heart is prevented by closure of the venous valves.
38. Lymphatic System
• Lymphatic vessels absorb excess interstitial fluid and transport this
fluid—now called lymph—to ducts that drain into veins.
• The lymphatic system has three basic functions:
• It transports interstitial (tissue) fluid, initially formed as a blood
filtrate, back to the blood
• It transports absorbed fat from the small intestine to the blood
• It cells—called lymphocytes —help provide immunological
defenses against disease-causing agents
39. Lymphatic System Cont’d…
• The smallest vessels of the
lymphatic system are the
lymphatic capillaries.
• Microscopic closed-ended tubes
that form vast networks in the
intercellular spaces within most
organs
• Once fluid enters the lymphatic
capillaries, it is referred to as
lymph.
Figure 1.14 The relationship between blood capillaries and lymphatic capillaries
40. Lymphatic System Cont’d…
• Before the lymph is returned
to the cardiovascular system,
it is filtered through lymph
nodes
• Lymph nodes contain
phagocytic cells, which help
remove pathogens, and
germinal centers, which are
sites of lymphocyte
production.
Figure 1.15 The relationship between the circulatory and lymphatic systems
41. Location of Lymph
Node Along the
Lymphatic Pathways
Figure 1.16 The location of lymph nodes
along the lymphatic pathways. Lymph nodes
are small bean shaped bodies, enclosed
within dense connective tissue capsules.
42. In Summary
• The circulatory system consists of the cardiovascular system and the lymphatic system.
• Blood transports oxygen and nutrients to all the cells of the body and removes waste
products from the tissues.
• Plasma is the fluid part of the blood, containing dissolved ions and various organic molecules.
• The right and left sides of the heart pump blood through the pulmonary and systemic
circulations, respectively.
• Lymphatic capillaries are blind-ended but highly permeable. They drain excess tissue fluid
into lymph ducts. Lymph passes through lymph nodes and is returned by way of the lymph
ducts to the venous blood.
44. What counts in life is not the mere fact that we have lived. It is
what difference we have made to the lives of others that will
determine the significance of the life we lead.”
THE END
Nelson Mandela