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00:03 Alright, y'all? I'm gonna see this microphone works. If you guys

00:09 hear me in the back, just I can't hear in the back.

00:11 I pull out the other microphone. ? People in front can hear me

00:14 fine. They're always going to refine right. Um So, what we're

00:19 do today? Uh Well, this this slide right here. What we're

00:22 at is just for those who weren't on Tuesday, basically, go to

00:27 . Uh pull down the slides for uh the orientation basically. That's what

00:32 was an orientation day. Uh There's orientation assessment that's due in what,

00:38 weeks. Something like that. But . The third uh you have reading

00:43 you need to be doing before There's homework assignments that opened after

00:47 If you really want the big go back. I record every one

00:51 my lectures. So you can go the go on the blackboard and there's

00:55 link directly to them and make sure get the quiz started. And if

01:00 have questions, just email me if if you don't understand what's going

01:05 Alright, so, with that in , let's actually do some real stuff

01:09 . Let's deal with Anatomy and All right. And so, what

01:12 would tell you is that this entire unit, what we're dealing with over

01:16 next six lectures is going to be with the cardiovascular system now. Uh

01:25 system is kind of interesting. The starting point. What we're gonna start

01:29 is we're gonna start with this tissue blood and blood is a tissue.

01:33 a weird tissue. It's a tissue is the fluid in nature and actually

01:39 origin is with all these other tissues you wouldn't think that they're related

01:44 All right. So, it's considered connective tissue because of that developmental

01:49 Alright. But it's fluid in You're probably familiar with what blood

01:52 But what is actually blood in It's basically two different things. It's

01:56 matrix, if you recall, if took A and P. One where

02:00 talk about if you haven't taken A P. One, there's gonna be

02:02 lot of referral back to it. there's gonna be times where you may

02:05 to go back and look up stuff the textbook. Alright, So here

02:09 tissues have both the matrix and they cells that live with that matrix.

02:14 in connective tissues, The cells make matrix. In fact, that's almost

02:18 in every case. The only case not true is here in blood,

02:22 doesn't make its own matrix. It's is called plasma. The cells that

02:26 in that plasma are called the formed . And the reason they're formed elements

02:31 because they're not all living cells which kind of weird right now. They're

02:37 sell like at some point they were cell but many of them have been

02:42 over the course of their maturation pro to no longer be functional cells.

02:48 just have a job in the And we're gonna look at red blood

02:52 . That's one of the formed elements . And we're going to see that

02:56 with the red blood cell. Even it has the name blood cell in

03:00 . It's it's not living cell. past that. All right. So

03:04 are three different types of formed We're gonna ultimately go over. We

03:08 the original sites, that's the formal for the red blood cell, abbreviated

03:12 . We have Lucas sites which we're even gonna engage really. We're gonna

03:16 at them like like kind of go as a list on Tuesday. But

03:21 , we're gonna talk about the Lucas in the next unit. When we

03:25 with immunology, these are your white cells. And then the last

03:29 these are the platelets and the platelets an important job in creating blood clots

03:34 we'll talk about them on Tuesday. now, your blood is in constant

03:39 . And this is important that it's constant motion because we have a matrix

03:43 is very, very light and we formed elements that are heavy and if

03:47 was not constant movement, the heavy would fall out of the light,

03:52 stuff, the fluid and they would of sink down out of the

03:55 So you basically they would they would is the term that we would

03:59 So the constant movement of the blood the formed elements and the other the

04:05 parts of the plasma in circulation so it's more or less homogeneous homo same

04:12 , meaning similar all over. So I took a sample of your blood

04:15 your finger and a sample of your from your toe at the same

04:19 it should look exactly the same. right now, why do we care

04:25 blood? Why should we even bother about it? Well, it has

04:27 important functions and we typically think of as being a transporting fluid.

04:33 So its job is to deliver Alright. So there's oxygen that's dissolved

04:37 the blood but it's also carried in formed elements of the blood. There's

04:42 be the red blood cells. All . It carries nutrients to the

04:45 And it also helps you to remove waste. So when those cells in

04:49 body are are using up the oxygen the nutrients that were delivered to

04:52 they produce waste as a byproduct and waste needs to be removed. And

04:56 it's carried in the blood back to places where you have different structures that

05:00 responsible for removing them. So that's of the things that it also plays

05:05 important role of transporting molecules around the for the purposes of signaling and having

05:12 do what they're designed to do. right. So we're gonna talk a

05:17 bit later in this uh this semester the endocrine system. The endocrine system

05:22 basically the hormones that govern how your work. And these are molecules that

05:25 being secreted in one place of your and they're communicating to another part of

05:30 body. And so how do they to those two places? You have

05:33 have some sort of medium through which travels? And that's gonna be the

05:38 . And there's gonna be some sort network through which that medium flows

05:42 And that's your vasculature. Those are arteries and your veins. And we'll

05:45 with that in the next two I think next to it might be

05:49 little bit further back. Right? when we think of blood, that's

05:53 we primarily think about it. It helps me move things around my

05:56 . But it actually has a lot other roles or more are not more

05:59 , but other roles as well. , one thing that it does is

06:02 helps to absorb and distribute heat you ever exercised? Well, let's make

06:07 easy. So for those of us are couch potatoes, right, Have

06:11 ever gone outside in Houston in the ? Right? And immediately your body

06:16 sweating, doesn't it? Right. ? Well, you're basically, you

06:21 , hitting tons and tons of Your body trying to keep your body

06:27 , is absorbing that heat and then to remove the heat from your body

06:31 out to the surface. And so the fluid the water in your blood

06:35 plays that role of absorbing and removing , moving it around the body,

06:41 it to the right places so that can then be removed. It also

06:45 an important role of maintaining ph in body. Alright. So it creates

06:51 allows you to maintain this normalized Now we're gonna talk about this a

06:56 later when we talk about digestion, when you eat primarily proteins, you

07:03 what will happen is and this is through animal products, is your body's

07:08 will actually drop and when you eat lot of vegetable products, your ph

07:11 the opposite direction and your body is to maintain a constant ph And the

07:16 is trying to maintain constant ph for we talked about in A and P

07:20 in the first unit that no one to know about because we all hate

07:23 is chemistry is that there are chemical in your body that have to have

07:27 right environment in order for the chemical to work. Alright, why do

07:33 take chemistry because of stuff like All right. The blood helps you

07:40 out and move acidic products and alkaline around and normalize them to that range

07:48 allows your body to work in, know that ph range that it normally

07:52 in the other thing that it It helps to maintain an adequate fluid

07:57 in your body. All right. we talk about blood pressures.

08:02 what we're gonna be talking about is the proper water salt balance so that

08:06 have the proper volume of water in body so that those chemical reactions can

08:12 as well as to ensure that the that the body is transporting around is

08:17 , Right? So it plays multiple in maintaining the proper volume of fluid

08:23 that your body works the way it's to. So the blood is not

08:27 a passive okay, we're here and just gonna move things around. It

08:31 an important role in regulating aspects of body that you probably haven't given thought

08:37 . All right, The other thing it does is it serves as a

08:42 barrier to the external environment. All , we're gonna talk about blood clots

08:47 clogging. It's called homeostasis. That's be in Tuesday's lecture next week.

08:52 basically it's your body's way of creating band aids. Alright, When you

08:58 your arm, your body says, don't want things coming in and I

09:01 want things going out. So, gonna clot and basically create a structure

09:06 prevents those materials from moving inside and of your body, and then the

09:11 also serves as the medium for the system, and so it serves as

09:16 of that barrier that says, when my internal part of my body

09:20 exposed, I have a way to the cells of the immune system and

09:25 have a way to attack those things could harm me. And so the

09:31 serves as that medium for that. , so the blood has multiple

09:37 Now, you're gonna see this and is where our brains kind of turn

09:41 say, here's a bunch of things can memorize. Please don't memorize

09:45 Ok, these are characteristics that you kind of carry in the back of

09:49 head. But I'm not gonna ask what's the exact volume of blood maintaining

09:53 average male? That's a trivial pursuit . If you ever get on jeopardy

09:58 memorize that maybe you can win yourself couple $1000 right before test. This

10:02 particularly important now in terms of I just want to point out that

10:06 is a deep red. And you've seen pictures in the textbooks and we

10:11 them out that you'll see blood you'll see like arteries are always gonna

10:14 , red, veins are always If you kind of look at your

10:18 and you can kind of see the flowing through it kind of looks a

10:21 bluish and stuff. That's just a . The tint of the skin and

10:26 the blood in it. And that's it kind of gives that particular hue

10:30 is red, but it depending on there's oxygen or not, it actually

10:35 the deepness of that red. So it has lots of oxygen, it's

10:38 of a scarlet color. Guys, bright red. The girls are like

10:43 , I know Scarlett is guys are it's red, right? And then

10:47 it's oxygen poor, it's more of deeper red, kind of like a

10:52 . All right. And so you kind of tell the state of blood

10:56 terms of its oxygen richness based on two colors. Alright. And that

11:02 blue or that deeper red appears in light skinned person like me as kind

11:06 a blue. And so what you're at like in the wrist right

11:09 those are veins. And that's why color veins blue in terms of

11:14 Just kind of think generally speaking, have about five liters of blood in

11:18 body. All right. And that is gonna be not important to

11:21 but just kind of as a general , it's like, okay, I

11:24 of understand because we're gonna use that over and over again. But generally

11:28 women have less because generally speaking, average, the average size of a

11:33 is a lot smaller than the average of a male. So, men

11:37 bigger. Here we go. We more blood. Alright, and

11:41 there's a curve you saw the So that value shifts the larger person

11:46 are, the more blood you Alright, blood is has a certain

11:51 to it. It's more dense than . Um We're not gonna go through

11:55 origins of the phrase blood is thicker water. There is an actual reason

11:58 we say that but it's not because the viscosity, but if you were

12:01 take blood and drop into water as cells begin popping, what you'll see

12:06 it will actually fall down to the of the fluid. Just like it

12:09 blood. If you look at it would separate out. It's because

12:14 has happens to be a little bit so it has it has a higher

12:18 of viscosity. Um plasma concentration. what we're dealing with here is it's

12:26 a specific amount of material that's already the blood. Um you'll hear me

12:31 about this a little bit later on we have a certain osmolarity or certain

12:36 of the blood that's around roughly 300 cosmos. And if those words sound

12:41 I'm speaking Greek, don't worry about . We're not gonna doing any sort

12:45 calculations here. But basically what it is that if we count up the

12:48 of particles, the body tries to the right number of particles in the

12:53 . Alright. And so it's kind sustained at this particular uh level and

13:00 it's sustaining it at this level, allowed to be able to monitor the

13:04 volume. So if you end up less water in your blood, it

13:09 that I need to bring more water the body. And if there's not

13:12 salute, then it means, I need to get rid of excess

13:17 . And so it's this maintenance of concentration becomes important. Your blood is

13:22 warmer. That's because it's water water heat really? Really well. You

13:26 remember learning about specific heats. Heat . You know, if you didn't

13:32 chemistry in college, you probably did sort of life science thing way back

13:35 high school and you probably heard those specific heat. That's what it's referring

13:40 . It just water absorbs heat Really well. All right, so

13:44 slightly higher and slightly alkaline, meaning not the same ph as water.

13:51 , So those are just some general . And what I wanna do is

13:56 want to take blood. And so is you anyone here had your blood

14:00 from you? Like, I you go in and they forcibly tie

14:04 down to a chair and tie that band around your arm. And then

14:08 say look away and you can I can't Yeah, they take your

14:14 . Well, what they do is put them in these little tiny tubes

14:17 they share them with each other. , they don't do that. Know

14:21 they'll do. These tubes actually have anticoagulant in them and then what they

14:25 is they're spinning it down because they're lazy to wait for the two components

14:28 separate from each other and this picture kind of showing you that processes.

14:32 , we're gonna take your blood, gonna put it in a centrifuge and

14:35 gonna separate and we can see the major parts. These are this is

14:39 plasma and the formed elements. And each of these parts have some

14:43 And I want to dive into what characteristics are. So, I want

14:47 start with the plasma because plasma is straightforward. It's water plus stuff.

14:52 . It makes up about 55% of volume. So if you take out

14:55 mils, you should expect 55 mils that to be water. But it's

15:01 just water. There's stuff that's actually the water. Alright. There are

15:06 organic and inorganic components. When we organic. These are things that are

15:11 proteins. Right? And so the of these organic products are happen to

15:17 called plasma proteins. Now, why you think they're called plasma proteins?

15:26 are proteins in the plasma. That's . This is all right. For

15:29 who haven't taken me before, I'm teach you something and you're gonna hear

15:33 every day in the classroom, biologists simple people. Even though it feels

15:38 sometimes it's not that biology is not . We're simple people. We name

15:43 for what they are for what they , that's that's about it.

15:46 if you look at something you're I have no idea what this

15:48 Take a step back and say what's name? It's like, oh,

15:52 plasma proteins are called plasma proteins because proteins that are found in the

15:58 Yeah, I know it's stupid, it makes sense. Okay,

16:05 the inorganic. So there's about 68% the material in that makes up plasma

16:12 these plasma proteins and then the remainder things like ions. So, we're

16:18 like sodium salt. So sodium potassium ion, those type of things

16:23 talking about, like dissolved gasses, gasses simply auction carbon dioxide, hydrogen

16:30 , carbon monoxide if it's a gas it's in the environment, nitrogen if

16:35 carbon. You know, if it's it's also in your blood. All

16:39 . And it's dissolved as a gas that blood. All right. That's

16:44 the primary way of transport of Carbon dioxide will deal with that

16:47 But it's they're dissolved in the Your waist. And any sorts of

16:52 , these make up very, very components. He's also fall under the

16:55 of organic But when we're talking about , were primarily focusing on those plasma

17:01 . So, what are they? right, well, these are

17:04 primarily made in the liver. Their job as a group.

17:11 when you say plasma proteins and you're to the group is their job is

17:15 create an osmotic gradient. Again, just used to words there that are

17:20 chemistry oriented an osmotic gradient is simply presence of something that draws water towards

17:28 . Okay, so, notice we care what the thing is, what

17:31 saying is that it's just something and there is more of that something water

17:38 to dilute it out to balance out body. And so this is one

17:42 the ways that water is drawn into blood and kept in the blood because

17:46 plasma proteins there. Alright, now is important because it has to do

17:54 this last little bit right here, I mentioned when we're talking about blood

17:59 , blood pressure is going to be upon the blood volume. And when

18:02 are modifications or changes in the blood , what you're doing is you're modifying

18:07 ratio of the plasm proteins to that that water. Now, we'll get

18:13 that back when we start talking about kidney and probably at the end of

18:17 unit, we'll talk a little bit blood pressure and how it's maintained.

18:21 , But that's one of the major of all the plasma proteins as a

18:27 group. All right now, because proteins they also carry with them charges

18:34 as a result of that, they as a buffering system. Alright,

18:38 buffer neutralizes acids and bases. So, it allows you to put

18:44 of one or the other into the and that's just a function of the

18:49 groups that are on the sides of these plasma proteins. All right.

18:52 it's a buffer as well. The common plasma proteins are what we're going

18:58 see up here first are the alba . All right. And this is

19:02 group of proteins. And generally these are kind of a sticky

19:06 lack of a better term. They're specific in terms of what they can

19:10 . And that's what they do is kind of sticky and they're like,

19:12 and they stick to things and they those things around. Now you're familiar

19:17 albumin, You probably just don't know . Anyone here eat eggs.

19:23 just just the first three rows. . Okay. One couple people in

19:27 back. Alright, thank you for attention and playing my game.

19:30 The clear stuff that makes up an , not the yolk, but the

19:35 stuff is almost 100% albumin. The portion of it is primarily water.

19:41 it's water and albumin and that's what is. And if you've ever touched

19:46 stuff, it's kind of sticky and . And that's the characteristic of

19:50 It's a very very small protein is sticky and it combined two things in

19:53 non specific way. All right. that's the first group and that makes

19:57 almost 60% of it. The second makes up almost 40% right. These

20:03 called the globulin. Why do you they're called Globulin. The glob

20:08 That's right. They're proteins that kind that clump up. And the reason

20:11 clump up is again, they are molecules. They bind the things.

20:16 so some of the key ones I've broken them down into the three

20:19 classes. We have the alpha betas gammas. The alphas are responsible for

20:24 things like lipids and some metals. , They're kind of a regulator

20:29 Alright, so they determine what things on and turn off. All

20:33 It's just kind of a general The base you are responsible for transporting

20:37 types of molecules. And they're specifically here as iron transporters. And we're

20:43 to see why at the end of lecture we're going to see two of

20:46 types of beta globulin. The third should be something you're very familiar with

20:52 we've been dealing with this term for the last four years. These are

20:57 gamma globulin czar, also known as , which is a fancy word for

21:03 antibody. Alright, so the gamma is the third type and these are

21:07 that are in circulation and their job to basically look for in service part

21:13 the immune system. We have some things in there and where we deal

21:19 the blood clotting and homeostasis. We're be dealing with the clotting factors.

21:24 make up about 4%. The biggest of those plasma proteins are called the

21:29 . It's called fibrinogen. Right. basically a fibrous ma molecule that sits

21:36 in the blood until damage to the comes along. Then you turn it

21:42 and then it creates all these fibers that bind up to each other and

21:47 these networks or meshes that help to in the space where the damage has

21:52 . Alright, now we'll get to energy and when we talk about homeostasis

21:56 you kind of get a sense. , we are clotting factors and then

22:00 we have other molecules that we're just to kind of ignore. These are

22:03 molecules that are just in circulation. These are enzymes and hormones and stuff

22:08 just happen to be in the All right. And they just kind

22:11 fill out the last little bit. , So for the most part,

22:15 we're looking at, as far as proteins are concerned are primarily carriers.

22:21 ? That following these two major classes alba mons and globulin and then we

22:28 the clotting factors as well. That's in a nutshell. Alright, so

22:37 other part It's gonna be what is the packed cell volume. This is

22:41 the formed elements are formed. So you take your blood, it's all

22:46 , you spin it down, you out, you've got the plasma makes

22:50 55%. Then you have the packed volume. That makes up the other

22:55 of about 45%. Now, the is is that that packed cell volume

23:01 of two different groups of of we have heavier cells, these are

23:05 red blood cells. And so they of float down to the bottom and

23:09 you have the lighter cells. These the white blood cells are the Lucas

23:13 , and the platelets. And what do is they form this little layer

23:17 top of the original sites, on of the red blood cells, just

23:21 the plasma. So, basically, you spun it down, you see

23:24 layers, you'd see the plasma. see those little tiny layer, it's

23:27 the Buffy coat, where the white cells are and where the platelets are

23:33 . And then you finally have this packed cell volume that is called the

23:40 . And that's where the red blood are found. And the matter that

23:42 up anywhere between 42 45% of the of whatever sample is that you've just

23:50 . Now, this percentile is gonna . It's gonna be slightly higher in

23:55 . And the reason for that is is responsible for or helps to promote

23:59 production of the hormone that helps to red blood cells called erythropoietin.

24:04 epo is the abbreviation for erythropoietin. when we say slightly higher, slightly

24:09 , we're talking, that's the entire . So, we're talking like 42

24:13 44. So, it's it's almost . All right. So, if

24:19 were to take a blood smear, is kind of what it would look

24:22 . All right, you can see all the not all of them,

24:25 this is what it's the general uh smear would kind of look like showing

24:30 the formed elements you can see within , you can see the platelets all

24:34 little pink things here stained with the uh stand, those are retro sites

24:39 the things with big giant nuclei, are different types of white blood

24:43 And this smear also really does a job of representing what the percentile of

24:50 different formed elements are. So, majority of the formed elements are gonna

24:53 red blood cells alright. Of all these formed elements. And I mentioned

24:59 already. We have a rich leukocyte and don't use throwing.

25:02 that's a bad term now that I taken off the slide, I

25:07 Should be platelets only the Lucas Sorry, 123 there, the Lucas

25:14 are actually living cells alright. Or complete cells is probably the better term

25:20 use Alright. What that means is that they have all the machinery that

25:27 expect to find in a cell. the red blood cells are missing things

25:33 the platelets are missing things. All , so they're not capable of division

25:39 doing other tasks. Now, generally the formed elements once they're released out

25:44 the blood, they only exist for few days. And that's not a

25:47 good word to use a few So, like a platelet for

25:51 will stay in circulation and survive for 10 days. A red blood

25:55 on the other hand, might be days. Is it's rough lifespan,

26:00 ? And then white blood cells have lifespans and they sit in between those

26:04 times and we're not gonna concern ourselves this time. But the idea is

26:08 that they are not a permanent structure circulation. You're constantly turning over these

26:15 populations of cells. All right. other thing that's true about these is

26:20 once you've entered into circulation, the are considered to be mature and they

26:25 actually multiply and divide. Alright. considered in their mature state. The

26:32 state is when they are still found the in there where they're made,

26:37 would be in the bone marrow, example. And that's where they're going

26:41 this constant division. So, if need more white blood cells, you're

26:44 to find them in the bone marrow you're gonna see cells that are dividing

26:48 dividing and dividing and producing the populations cells that you need when you're looking

26:53 the blood, you got what you All right. This process of making

26:58 cells has this long, scary hard spell world a word called hematopoietic versus

27:06 other term that you might see. I think your book uses it more

27:09 . Is he mope oasis? They the exact same thing. All

27:14 And generally speaking, what this term is to take a cell that is

27:21 to form one of those many formed . So you can see up

27:26 we're gonna start with a what is a plastic, sorry, a flurry

27:33 cell. Alright. Pluripotent means can all sorts of different pathways.

27:41 right now, let me who who are the freshmen real quick.

27:43 right. You guys are pluripotent if wanted to you could go over to

27:49 advising office and say I no longer to be a blank major. I

27:53 to be this major. And making change is not a hard thing to

27:58 . Let me see the seniors. right, you are no longer

28:04 It is very difficult for you to a change at this point in your

28:07 , right? You are stuck with you have, right? And you

28:11 going to be what you are when graduate with whatever degree that is.

28:15 , so all of a sudden you as a senior that you don't want

28:21 go into healthcare, you want to an artist, right? You're not

28:26 go and start taking art classes you're gonna get your degree move on

28:30 maybe you'll take art classes later. . So this is like this.

28:37 you've selected your path. Once you've started as your pluripotent cell. Once

28:43 selected your path or your path is for you. You're stuck down your

28:47 . And now you're no longer Now you are committed to that

28:53 You cannot convert a red blood cell a monos ICT by just saying,

28:59 , never mind, I need more these. You have to start from

29:04 . All right. Does that kind makes sense? Sort of?

29:08 it's not the best example because if you want to be a senior

29:12 change your major you can It's hard advise against it. Lots of

29:20 Alright, so, this type of is called ahi most side a

29:26 All right. We're gonna test and how well you guys are. What

29:30 him aside blast mean in english he sido blast. I couldn't hear

29:40 It's immature. Alright, Whenever you blast at the end of a cell

29:44 , it means it's an immature So, basically, it's an immature

29:47 cells. What that says in a a in a big nutshell.

29:51 And then what you're gonna do is going to introduce these cells. These

29:57 cells inside a blast to a specific . Alright, So, the blood

30:03 the body is deciding what do I to make today? What is my

30:07 ? And we're not gonna talk about or how it determines that. All

30:11 . But what it does is it specific signals and says today, I

30:16 this. And so the specific signals gonna cause this pluripotent cells as it's

30:22 and making daughter cells and daughter cells it's gonna give the chemicals and the

30:27 cells are going to go, I'm committing myself down a specific

30:31 And so the two specific pathways gotta very careful not to trip over my

30:36 down here. The two specific pathways either going to be the myeloid

30:40 So, you can see right here are the myeloid cells. They fall

30:45 this beige category over here. Or can move down the lymphoid line.

30:49 right. So, I can either down the myeloid line or I can

30:54 down the lymphoid line. Once I've down that line, I am now

30:57 . If I'm going down myeloid, committed to become a red blood

31:00 I'm committed to become a platelet or committed to become one of the granular

31:04 . I'm committed to become a macrophage here, it says Montecito Montecito is

31:09 immature macrophage. Right? So that one path. And to go down

31:14 specific pathway. Once I've committed down myeloid line, I'm gonna need another

31:19 factor to come along and say, , you're in the myeloid line.

31:23 going to give this factor to So now you're committed down this

31:28 All right. Start with regard to lymphoid line. The lymphoid line only

31:36 lymphocytes, can I time out for second. You don't need to know

31:41 , but I'm gonna tell you because if I don't I'm gonna burst

31:44 the inside and cry a little This picture shows you three lymphoid

31:52 There are more than three lymphoid All right. There are at this

31:58 I think we're up to almost 20 types of lymphoid cells. All

32:03 And they vary and differ from each in what they do. And it's

32:08 of what markers they have on their to help us identify them.

32:13 But for a general population we basically B cells T cells and natural killer

32:21 , which is the coolest name for cell ever. Doesn't that sound cool

32:25 you were so, wouldn't you want be called the natural killer?

32:31 I mean, you can just picture . They have tattoos on their cell

32:34 and stuff. I love it. right. Anyway, producing any of

32:40 cells down the myeloid lymphoid line. all occurs in the red bone marrow

32:43 their specific bones. And here we to see all of you guys who

32:47 A and P. One. Do guys remember where what kind of bones

32:50 gonna have red bone marrow? The proper bunks? Yeah, it's

32:58 It's gonna be flat bones, And the ends of the long

33:03 I think that's what I heard was of long bones. Alright,

33:07 it's the red bone marrow is in places that is hardest to get

33:12 Alright, so I mentioned this and , this is a big giant

33:16 I don't want you to memorize a giant list. I want to just

33:19 of show you that there are some to things you probably should know on

33:24 . But as we introduce them, you'll become more aware of them.

33:28 , so space specific molecule specific the first that you're going to need

33:32 know is it's a rich palette and see it down here, erythropoietin is

33:37 for commitment and then production or the production of the red blood cell at

33:43 bottom of the line. All this is a hormone, It's the

33:46 one in this class that falls into category of hormone. The rest of

33:52 are what are called growth factors or stimulating factors. And generally speaking their

33:58 , kind of match what they But that's part of the reason I

34:00 want you to memorize them is because got these weird names like G CSF

34:06 , GM CSF and what they are they're basically they're committing molecules. So

34:11 up here you can see for example the granular site, modest site or

34:15 uh CSF and what it's doing is you down this line to produce the

34:21 sites on the modest side. But need a specific factor here. The

34:25 site, colony stimulating factor to get down to produce the specific granular sites

34:30 then there's gonna be factors down here this is not even showing you that

34:33 you down this pathway or that Alright. The key point of this

34:39 here is to tell you in order me to get for example, a

34:43 Phil is I have specific factors that pushing me down that pathway. All

34:50 . So, the one that I you to know is erythropoietin. What

34:54 erythropoietin do red blood cells? We're see on Tuesday and when I introduce

35:00 that's when it's time to commit it . Your brain is going to be

35:03 which is responsible for committing you down the mega carrier site pathway. All

35:09 . The reason we're not dealing with now is because I want to kind

35:11 introduce things as a group. All . So, what I want to

35:20 first is pause because I know I've talking and I talk fast and for

35:24 you've never had me, you're not to me going like this for those

35:27 you had me you're starting to okay. I gotta figure out ways

35:29 keep awake. It's been a couple months or almost a month since we've

35:33 this. All right. Are there questions about what we've talked about so

35:39 ? Yes. No, maybe kind Yeah. Okay. We'll go

35:42 All right. Now when you ask question, you have to speak up

35:44 I'm not gonna be able to Yeah. So it's not gonna be

35:54 him aside, oblast, what's happening is as this cell is undergoing

35:59 it's being influenced. And so there's be small modifications that are taking place

36:04 distinguish 11 cell from the myeloid from one cell from the lymphoid

36:09 So you can see up here we a lymphoid stem cell is what they're

36:13 it. And over there you see stem cell. So there's already changes

36:17 have taken place as a result of factors that push them one way or

36:22 other that distinguish it as being But again, for our purposes,

36:27 unimportant. If you're immunology, you'd able to know what those factors

36:32 And there's so many of them. just crazy. Did I answer the

36:35 or did I thank you? it's still considered immature. It's not

36:40 of doing its function well, its function. So yeah, everything everything

36:48 from here down to about right there considered immature. And as we explore

36:56 uh the original polices. So that's red blood cells, I'm gonna show

37:01 a couple of these different stages. , not to memorize, but to

37:05 , oh, there are things that going on and that makes it it's

37:09 non functional at this point for its or what its design is.

37:16 anything else? All right, so deal with the police is alright

37:26 there's that horrible suffix polices, which makes basically says um it's the maturation

37:33 or the production process to produce this cell. Original polices refers to the

37:39 throw site. So what we're doing the pathway to make our retro

37:43 And what I want to show point is first, remember everything here is

37:47 to begin in the bone marrow. right now in utero, you don't

37:51 red bone marrow, so you're gonna different structures that exist while that fetus

37:55 developing. So for example, if are no organs, you'd be using

37:59 yolk sac after uh some organs that would be like the liver and

38:03 spleen these structures take over the job making red blood cells. So this

38:08 even incurring very early on in development we're producing these things um by the

38:13 your child you have bones and so those bones, that's where you're gonna

38:17 the predominant uh marrow in all the . So that's gonna be red bone

38:22 everywhere. But then you kind of up and your red bone marrow in

38:26 places gets replaced by yellow marrow and red marrow stays in the ends of

38:31 long bones. So that's what it's to show you here as well as

38:35 the flat bones. So like your , your shoulder blades, your

38:39 Um This is primarily where you're gonna red marrow. Now, there are

38:47 steps from going from the hematopoietic stem . So, remember that's the

38:53 There we go. That's right up to get to that original site.

39:00 , So, that's what this whole is trying to show you. All

39:04 . So, what are the steps start with commitment? Alright. Our

39:10 start with commitment. Right, Please to say. Of course,

39:14 All right, so, first you're get that stimulating factor that's going to

39:19 you down the myeloid line. that's what you did there.

39:22 I'm gonna go down that myeloid line from there I'm going to then under

39:28 the influence of erythropoietin is I'm gonna a pro original blast. Right?

39:35 you see the term pro at the of a word, it means uh

39:40 . Alright, so, you'll see proteins in some cases are pro hormones

39:46 I would say, okay, it's the active form, it's an inactive

39:49 . It hasn't gone through the process . So, a pro rich pro

39:53 is our is our first step. we go there, we can't become

39:58 of the other type of myeloid So, that's our commitment step.

40:03 , I have no choice. I'm going to become an original site.

40:07 , the development portion is going to under this constant pressure from erythropoietin.

40:14 hormone. All right. And you're go through multiple stages. You're gonna

40:18 with this pro Withrow blast. And gonna work your way through these different

40:22 of stages. Again, I'm not concerned that, you know, the

40:25 the only one I have here is normal blast, which is also called

40:28 Ortho chroma chromatic blast. And the I bring this one up is because

40:34 we're doing here is we're gonna start a whole bunch of this protein called

40:40 . Alright. And hemoglobin under the the influence of the original point is

40:45 be is gonna be ramped up. so the cell just starts turning out

40:49 and tons and tons of hemoglobin and is going to be maintained inside the

40:54 . And eventually you're producing so much you don't need or you don't want

40:59 nucleus. And so when you become normal blast, that's the stage where

41:03 says, like, look, I the space that you're taking up nucleus

41:07 , you go. And so you out the nucleus. And then there

41:10 other organelles that your that the red cell says, I don't need these

41:14 . Because my job ultimately, at end of the day when I'm a

41:18 blood cell is to carry oxygen to parts of the body. And the

41:24 I'm going to do that is I'm to fill myself up with hemoglobin.

41:28 it's gonna start getting rid of I don't expect to live a very

41:32 time. I only want to be for 120 days. I don't need

41:35 reproduce myself. I don't need to any proteins. I don't need to

41:39 myself. I don't need to do . So anything that isn't me making

41:44 initially and then ultimately holding hemoglobin I'm get rid of it. And that's

41:49 going on at this stage. When get here now, quite shortly after

41:56 normal blast, this is where you're all you're left with a bunch of

42:01 and some of the machinery to make that last little bit of hemoglobin and

42:04 actually released out into the bloodstream. this is called a ridiculous sight.

42:09 , you start off as a pro blast. You go through a couple

42:11 stages, you become a normal That normal blast then converts into a

42:16 sight. And it's the ridiculous sight released out into the blood and it

42:20 act just like a red blood But it's not quite ready yet.

42:24 right, using school as again, a as an example, you're an

42:30 , but you haven't graduated yet. out in the real world and you're

42:33 stuff and you're doing things, but don't have a diploma in your hand

42:37 that's what the ridiculous side is it's out in circulation. And in

42:41 , when you do a blood One of the things they do is

42:44 look for the ridiculous sites and it's indicator of how good you're a rich

42:49 machinery is, in other words. you going through a rich oasis?

42:53 are you making new red blood So the ridiculous sight to red blood

42:58 ratio is one of those things that looking for now, you're still producing

43:03 hemoglobin. And then what's gonna happen you go through that last little bit

43:06 maturation. Alright, So we start with commitment, Oh, there it

43:12 , really start off with commitment. go through stages of development and then

43:21 you end up with maturation and here is that last little bit this,

43:24 get rid of the last little bit the organelles. And what you're left

43:28 is basically a couple of ribosomes um are going to break down. And

43:32 now all you have is a plasma with some very basic machinery and a

43:40 bunch of hemoglobin. Alright, you're a bag of hemoglobin. And that

43:46 your job. Now, your job to carry oxygen throughout the body bound

43:51 to hemoglobin. Alright, so that's mature form, it takes about,

43:57 know, 10 days to make So if you lose red blood

44:04 you know, just give a little of time and your body is gonna

44:06 up. But if you're desperate for carrying cells, your body can actually

44:11 more ridiculous sites. And so you these immature cells that can do the

44:16 . Okay, so this is a blood cell You have about nine or

44:24 times 10 to the ninth. So roughly five billion cells per mill of

44:29 . How many liters of blood in body? About five. So that's

44:35 mills. And if you want to the math, that makes it roughly

44:38 five times 10 to the 12 red cells in your body in circulation at

44:42 given moment. Still not the most in your body, but that's pretty

44:47 . Right. Alright. Their job oxygen. All right. Now remember

44:53 said auction is dissolved in the but that is not the primary form

44:57 oxygen movement. This is the primary . So, we're going to bind

45:02 the hemoglobin. So, if you at this sucker, it's flat.

45:05 terms of this nature. It's it's concave meaning it kind of looks like

45:09 beret that's sitting on the shelf. ? And its job this reason its

45:15 is like this is that it allows oxygen to move in and out of

45:19 cell a lot easier. Alright, first off, I think if you

45:24 a cell that was round like a . All right, if you had

45:27 in the middle of the very center that, of that basketball, it

45:31 take a long time for it to to the edge, no matter which

45:34 you went right, It's equidistant. if I have a flat cell,

45:39 ? If I put a molecule of anywhere in that, the distance to

45:43 edge is not very far. So allows for the movement of oxygen in

45:48 out of the cell to from the to and from that hemoglobin very,

45:52 quickly. The second thing that it , it allows for the cell to

45:55 very pliant pliant means it's bendy. , so again, if you try

46:01 palm a basketball, that's that's not hard. But if you try to

46:05 an inflated basketball, that would be . Right? You can't do

46:11 But if I have a flat, I take all the air out of

46:13 basketball and I bend it, that's very hard to do right now.

46:18 reason I want to have a bendy because these cells are moving through the

46:23 vascular structures in the body, which your capillaries and these capillaries can be

46:29 tortuous. They're they're very windy and that they can squeeze around these edges

46:35 move blood or move oxygen. They're efficiently is to their benefit.

46:42 Typically what you'll see is you'll see line up and these structures called rule

46:48 . So just think it was like stack of poker chips and they basically

46:52 in a group just like that. that's another way. So it becomes

46:56 efficient to move things. So they're nucleus to a nucleus means it doesn't

47:03 a nucleus because we got rid of , they have no organelles. So

47:07 mostly him a golden, that's about of the content. So that comes

47:11 to about 280 million molecules per And again, if that's per cell

47:17 there's five billion cells per mill and have 5,000 5000 mills in the

47:22 That's a lot of hemoglobin in your . All right. Still not the

47:27 abundant protein. So there's just lots it and it's there to do some

47:34 simple things move the auction around now cells do generate a T.

47:42 And they use a T. All right. Because they have still

47:47 that they're doing. They're not just bags of hemoglobin. They are functional

47:52 a very generic sense. Being able move things in and out. Um

47:57 they do have some other functionalities that not gonna get into. Right

48:03 We learned an MP one. Or you took biology at any point in

48:08 life, you learned about glycol Right. And you learned about 80

48:13 . Production. So after glycol assist have oxidative phosphor elation. The words

48:18 familiar Nigerian, if it sounds like a word you've heard before.

48:22 You remember Krebs cycle or the citric cycle. Do you guys remember that

48:27 ? And then at the other end that you have the electron transport

48:30 Right. And so if I use of those steps, I can get

48:33 lot of a T. P. ? Right. But in order for

48:37 to do that, what's the factor I need to make? Let me

48:40 a lot of A. T. . What's one thing I need

48:46 Thank you very much. It's What do I have here? A

48:51 bag of hemoglobin that's carrying lots and of oxygen. My job is to

48:57 oxygen from one part of the body the other part of the body.

49:00 I burn my oxygen and my doing job, No, if you work

49:04 bluebell, you can eat the ice . But if you work in the

49:08 and carry oxygen, don't consume the . So it doesn't use all those

49:15 . It only uses that first the anaerobic steps, which is glycol

49:19 . So it never burns its own while it's transporting things. Alright,

49:25 kind of interesting. Okay, so is hemoglobin? Yes, sir.

49:33 again. Uh No, it's extruded of that stuff. So again,

49:38 was just taking up space. And I'm going to do things and

49:41 the question was does it have And it's like, nope, I

49:46 need it because I'm just gonna do stuff. So I'm just keeping it

49:50 . That's a good question. so this is the molecule you get

49:55 see every class of biology that's basic bio this is hemoglobin. Alright.

50:01 its job is to carry the And you can see here it is

50:06 parts right? So there's four globe Alright, there's actually two pairs of

50:12 . There's an alpha and a beta . This is an adult. Children

50:16 have different chains. So they have an alpha delta chain which allows them

50:22 hold on oxygen better for some Alright. Um and it changes as

50:26 get older so we can end up what this is. So here's your

50:31 actually should be like alpha, beta, beta. And then in

50:33 middle of these we have a hem a hem is a pigment to pigment

50:40 . That's what it looks like. what is referred to as a

50:43 All right now when you hear somebody a prosthetic, what do you think

50:48 if I have a prosthetic arm? do I have driving? Do have

50:51 real arm? No, I have that has been added to to allow

50:56 to be functional. Right? You prosthetic teeth, you have prosthetic

51:02 This is a prosthetic right glasses. those of us who can't see.

51:07 , so Hin is a prosthetic. is attached to the globe in so

51:13 this molecule can do its job of oxygen. It has in the center

51:18 it. It has an iron and that iron that is attractive to binding

51:24 because it's a charged ion. So bind to it a couple of other

51:29 combined to it. So it's this that we're interested in. This is

51:35 molecule and it's actually this is um you guys remember primary secondary tertiary quaternary

51:41 of proteins. So this is a structure. It's actually four proteins jumbled

51:48 with these four prosthetic groups. So of these irons combined to one

51:54 When oxygen binds to it, the molecule is referred to as oxy

52:00 That's easy. All right. When don't have oxygen bound to it,

52:06 referred to as the oxy hemoglobin. also easy. And then we get

52:11 weird ones. All right now alle eric is a word that means binding

52:19 . That's that's that's what it So when you see a list erIC

52:23 this particular instance it's saying oh I'm binding at the same point. So

52:27 oxygen binds, that's the natural binding . So an A list ERIC molecule

52:33 going to bind or another molecule to al hysterically, it means he's going

52:37 buy it elsewhere. So these molecules dioxide protons and nitric oxide all bind

52:43 hemoglobin but don't bind to the he bind some some place on the globe

52:48 chain and they affect actually oxygen Alright, so carbon dioxide combined to

52:55 hemoglobin and when it binds to this is the weird one, it's

52:59 carb carb amino hemoglobin. Alright, amino hemoglobin and the reason I'm pointing

53:05 out is because carbon monoxide, that's one that's deadly combined to the heem

53:13 does so irreversibly, you have to get rid of and destroy the hemoglobin

53:18 carbon carbon carbon monoxide binds that one called car boxy hemoglobin, that's where

53:25 gets confusing. Alright, so carbon is when carbon dioxide binds and that's

53:31 . Car boxy hemoglobin is what you into the team irreversibly with carbon

53:35 That's bad. Alright, Protons bind what it does. Um it helps

53:42 form the buffer and the blood, oxide. That's a dilator. It

53:48 plays an important role in moving oxygen . So basically creates Visa dilation and

53:55 there's a whole bunch of other you know, I don't know what

53:57 one is, cyanide. Good. So Fox side, this is this

54:02 a fun one, hydrogen sulfide. stinky. That's what makes rotten egg

54:08 yucky. It's actually a signaling molecule your body but they all bind up

54:13 and this is how you can carry things around in the blood.

54:20 so erythropoietin is the enzyme or is the hormone that governs the process

54:26 making red blood cells. All right , the way this is done is

54:34 done in the kidney. Erythropoietin is in the kidney. Now, why

54:39 I make it in the kidney? all the blood in your body has

54:42 circulate through the kidney at some kidney is sitting there monitoring the state

54:47 the blood. It's removing waste and asking itself, am I getting the

54:51 that I need? And if it get the oxygen needs, that means

54:56 other tissues in your body are not the oxygen it needs. And so

55:00 it's gonna do is it then produces and the with a poisoned from the

55:05 goes to the red bone marrow and make me more red blood cells because

55:09 not getting enough oxygen. But if make more red blood cells, that

55:12 there's gonna be more hemoglobin. If more hemoglobin, then I'm gonna be

55:16 to bind up more oxygen. I'm get more of my oxygen. And

55:20 how we make erythropoietin. So with poison is made in the kidneys in

55:26 to the oxygen carrying capacity of the . Okay, that's the key

55:33 auction carrying capacity of the blood. right, there are factors that affect

55:38 one. Testosterone I mentioned that um testosterone is a hormone that's produced primarily

55:44 the testes. There are other but it's apparently it's testosterone. Um

55:50 what it does, it helps to regulate the production of its report.

55:54 are other factors. Again, the of oxygen. So here, down

55:58 the gulf coast, we have more than if we were hanging out in

56:02 . And so as a result, in Denver are producing more original because

56:08 oxygen in the atmosphere is less. they produce more red blood cells to

56:13 up more available oxygen hold more oxygen their bodies than they would down

56:18 And for those of you who are who have competed against people who live

56:22 higher elevations, they tend to have little bit more stamina. It's not

56:25 lot of fun anyway. Alright. things. Um So yeah, this

56:33 my point here. It's not the of red blood cells that you

56:35 That becomes important. It's it's oxygen carrying capacity. So the less auction

56:41 available to you is going to result more red blood cells. Another way

56:45 can think about this is red blood are like oxygen banks for your

56:50 If you didn't have red blood the amount of oxygen in your body

56:54 enough is not enough to keep you . So you need to put red

56:57 cells in so that you can hold to more oxygen so that your body

57:00 work. So, if there's less out here, that means you're gonna

57:05 to make more red blood cells to in more oxygen into your body so

57:09 your body can work. That's a way to kind of think about

57:13 That kind of makes sense or Hmm. Kind of let's see if

57:19 helps. Well, we'll get there . Alright, so lifespan. Um

57:26 , we don't have anything in the basically kicked everything out. So that

57:30 this uh red blood cells gonna last 100 and 20 days. Put another

57:35 that's roughly four months, so you're your red blood cells about every four

57:40 . Uh As they get older they of start falling apart, they go

57:45 the spleen and they go into the and because of the structure of these

57:49 the structure of these organs um they allow the red blood cells to kind

57:54 blow up, you know, they slamming the walls and they ultimately fall

57:58 . And so now you have all pieces parts that you have to deal

58:01 . And so there are parts of that are gonna be destroyed by the

58:05 . And then anything that's recyclable is be recyclable. Alright, so you're

58:09 gonna keep recycling this material. The on the other hand has to be

58:14 down, It's gonna be broken down globe in which is the protein

58:18 So you get your free amino acids of that and that's where used.

58:21 then the team is gonna be converted another pigment which is used by the

58:27 in different ways. We're gonna see process here in just a second and

58:30 the iron, you're gonna recycle your . Alright, so let's see how

58:37 do this, we're cycling the Alright, so in this picture,

58:42 they're trying to say here is look I've got my dying red blood

58:46 they fall apart. And so what gonna do is I'm gonna take those

58:49 and I'm gonna break them down into different parts. Right? So anything

58:52 an amino acid, I can break down or anything that's a protein and

58:55 down amino acid. But when I the heem I gotta break it down

58:59 the global portion and the iron So what's gonna happen is iron gets

59:04 up by a molecule called ferret in a carrier molecule. Alright. The

59:12 and fair tin arco transported into the . Alright, So that's what it's

59:18 here and then the iron is transferred a molecule that carries it in the

59:24 . This is the plasma protein called ferrin in the name. It even

59:29 you what does it do transports ferris . So it transports iron. All

59:36 . And then that's going to be back through the process of even though

59:41 will lose a little bit in different of excretion through your feces,

59:46 sweat. Um And through menstruation. some iron is lost. But for

59:51 most part you're you're maintaining it and recycling it over and over again.

59:59 , with regard to the heem. , this is that pigment portion.

60:03 , So, the Heem what happens it gets first converted into a different

60:08 . So, this actually does a good job of showing you colors.

60:13 right. So, if you can't the color color blind. Let me

60:16 walk you through Heem helps give Its red color. So that's why

60:21 drawing it up here is red. ? So it's a pigment. So

60:25 the red, it's converted into this pigment by macrophages called Billy Virdon.

60:31 verden verden deals with greens. So a different pigments that kind of a

60:36 pigment. And then what's gonna happen billy burden is then converted into billy

60:44 . All right, Billy Rubin is of a yellowish pigment. Now what's

60:49 happen is this gets transported into the and some of that billy Rubin gets

60:54 into the liver when it gets transported . It helps in the process of

61:00 . Um What we have the liver this material called bile. It's gross

61:06 icky and nasty. All right. bile helps you break down fats.

61:10 very very important. Emulsifier learn about when we talk about digestion. So

61:17 Rubin is one of the components of to help you break down fats.

61:26 when it comes out into the small and helps you break down those fats

61:30 have gut bacteria that can turn that Rubin into a new material called stir

61:37 bill. In other words it breaks it down further and this is now

61:40 brown pigment and that kind of makes . What color is your feces for

61:46 most part. Thank you. Can't afraid to talk about all the parts

61:54 our body. We're going to talk everything excreting and so creating and

61:59 so just get comfortable with it. , so stucco building of the brown

62:05 which is found in feces or what happen. It will be reabsorbed picked

62:10 in the blood. Um And then the kidneys it's converted into a different

62:15 called Euro Billing. And your ability the pigment that makes urine yellowish.

62:23 right. So he m is used the liver to make bile. The

62:31 is broken down in the gut. Turco billon Serco Billon can be excreted

62:39 billy Rubin is reabsorbed and then secreted the kidneys as part of your in

62:45 . It's Euro villain. So that's we deal with him so far.

62:53 , so it's just a process of down the red blood cells.

63:02 Now again for those who are new me, I am not a

63:06 Many of you are going to come to me at the end of class

63:09 say, hey can you tell me this or I worked in a I

63:12 in a hospital. I work in er and I saw this and I'm

63:15 look at you like this. That really cool. I don't have any

63:19 what you're talking about. Okay, I mean it's just a fact of

63:23 what I know versus what you So when it comes to disease.

63:27 don't know stuff but I'm going to a couple of things over the course

63:33 the semester that are major pathologies that should be aware of. All

63:40 And so, what I want to with here are two basic types of

63:44 site volume disorders. Alright. The you've heard of its anemia. You've

63:49 of anemia. Even if you don't what it is. Have you heard

63:52 word anemia? Okay. Alright. we're gonna look at anemia and then

63:55 second thing we're gonna see are called bia's. Now, some of you

63:59 have heard of those and if you don't worry about it, by the

64:02 of the day, you're like, yeah, I've heard of that.

64:04 just didn't know its name. so anemia says um are those diseases

64:12 you find where the original sites are than normal? In other words,

64:17 you were to take out 100 mils fluid, you'd expect to see what

64:22 of being red blood cells do you ? About 45%. 42 to

64:27 Right. But what you're gonna see is that out of those 100

64:30 you would have far less? the packed cell volume would be much

64:35 the maddox. It would be a lower than expected. All right.

64:40 , as a result of missing red cells, that means you now have

64:44 lower oxygen carrying capacity for the All right. So this is why

64:50 is not a good uh condition. you're not providing the tissues with the

64:56 it needs or with the oxygen needs order for it to be functional.

64:59 , there are three basic causes. gonna look at them in the names

65:02 go with them. All right. can have an excessive loss of red

65:06 cells. You can have a decreased of meaning you're not making enough red

65:11 cells, or there could be some of problem with the hemoglobin process.

65:17 . And so the cells are are functioning in that way. All

65:21 But no matter how you slice it you're dealing with anemia, you have

65:27 oxygen delivery, and when you have oxygen delivery, that means the heart

65:31 to make up the difference by moving blood faster To get that blood to

65:36 tissues so it can receive its All right. And if you can't

65:40 that, think about it this Right now, you're breathing a normal

65:44 volume about 500 mils. But after , do you breathe harder or less

65:50 ? Why? After running or Why? Your body wants that

65:55 It's worked. It's burned through the . It needs to replenish its oxygen

66:00 order to be functional. And that's same thing. But now, imagine

66:02 state where your body is in a state of I'm trying to deliver enough

66:07 to keep everybody happy. That's what's on with an anemia. Alright.

66:13 , the policy ischemia is the opposite , you're gonna have an excess of

66:18 , right? So here's normal. anemia. That's policy ischemia.

66:23 So what that means is now you too much red blood cells. So

66:27 dramatic rate is much larger. And that means your blood is more

66:31 It's like ketchup relative to Oh, don't know, just say hot

66:37 I don't know, there's more thickness there is fluid. So that means

66:43 heart has to work harder to push stuff forward, right? If it's

66:47 toothpaste and I know it's not but it would take more to pump

66:52 than it would if it was just liquidy. Alright. So you have

66:56 overcome the pressure in order for you work. And that's what policy steamy

66:59 due. Now, first we said number of red blood cells.

67:08 We said their basic ways that that happen. So, first off is

67:12 we refer to as hemorrhagic. hemorrhagic is just a fancy word for

67:16 . You've got some sort of right, and blood is leaking from

67:20 body. So if I cut off arm, would blood be leaving your

67:26 ? Yeah, that would be a . Alright. And so you're losing

67:30 blood cells. You're starting off at and you're now going down to 4.94.84.7

67:38 Yada Yada. So what would you ? You would have fewer red blood

67:42 . You're bleeding out? You have anemia. All right. You don't

67:47 enough blood to carry oxygen to your for them to be functional.

67:51 why bleeding out is bad? All . We have hemolytic hemolytic here.

67:58 is when the red blood cells are up right there rupturing. Now,

68:04 don't have a really good example of hemolytic, but there are chemicals that

68:07 can put in your body that cause cells to burst open. Um Some

68:13 the venomous snakes have hemolytic venoms and how they kill their prey. Is

68:19 inject them with the venom which causes the red blood cells to lies.

68:23 means they can't carry any oxygen. , while that poor little mouse or

68:27 it is, is trying to run , they have no way to make

68:30 muscles work because all the oxygen is longer being delivered. That's a

68:36 Alright, so here the red blood are licensing So, you have your

68:40 blood cells to carry oxygen. Third is a plastic here, This is

68:46 the urethra political machinery isn't working. , you may have committed to become

68:50 pro rich pro blast. But let's some step to become a normal blast

68:53 disrupted, right? Or some step become a ridiculous sight gets disrupted.

68:59 , you're not making the rbc at end, something along the pathway is

69:04 it. So, you're not making product. And as a function,

69:07 are less red blood cells in So that would be a plastic.

69:13 , so three different ways. I lose them. I can break

69:18 Right? I can't make them that be less red blood cells. All

69:23 . In terms of the hemoglobin we have a nutritional anemia.

69:28 This is probably something we're probably remotely with. Here is I'm deficient of

69:35 sort of factor that allows me to my hemoglobin. Alright, so typically

69:39 would be like iron deficiency. So you're not getting enough iron in your

69:42 , then you don't have a way make the team to make the

69:46 And so now the machinery is stopped you're not making red blood cells with

69:52 hemoglobin, right? So you can't oxygen. That would be a

69:56 One. Another one is pernicious You've probably heard of that one.

70:00 is a little bit more complicated without the pathway of how we go through

70:03 hemoglobin, but there is a chemical the gut called intrinsic factor, it

70:08 you to absorb vitamin B 12, is essential for Winthrop oasis. And

70:13 if you have something that disrupts that um you the intrinsic factor is not

70:19 or you can incorporate or use the 12. That would be pernicious

70:24 You can't make your hemoglobin. so anything that interferes with making hemoglobin

70:30 into that category nutritional pernicious. and the last ones are the abnormal or

70:37 hemoglobin. These are typically those that genetically uh dysfunctional. So um I

70:46 thalassemia, I should have said policy system mia earlier. So thalassemia is

70:51 you don't have the right global And so what they do is they

70:56 themselves in weird ways, they don't or bind up hemoglobin correctly. And

71:01 sickle cell anemia is probably the one everyone's most familiar with. Uh people

71:06 african descent have these um And what have is a shape of the globe

71:11 molecule that is S shaped which because the globe and chain to shift in

71:15 in a way. So it creates long chains of globe and instead of

71:19 four molecules. And so that means not capable of binding oxygen as well

71:27 uh not to go into all the why. But basically having one gene

71:31 makes this s chain global is beneficial fight against malaria's but having two is

71:38 to survival. So there's an advantage having one sickle cell gene. All

71:47 . Policy ischemia. This is the where you have excess. Mhm.

71:53 really kind of demonstrates what's going on , you can see in the peripheral

71:58 in the periphery the swelling that's taking because you're trying to overcome resistance.

72:03 basically the resistance is causing the blood kind of jam up here.

72:08 So what we have here is increased viscosity, increase total uh total peripheral

72:16 . So your heart is working a harder to move the blood around and

72:21 is a function of making too much red blood cells and this is a

72:25 of rich rich is is out of . Whatever the regulation regulating mechanisms whether

72:32 too much erythropoietin or whether there's something that pathway that is being uh produced

72:39 not being regulated correctly results in the of too much red blood cells.

72:46 when it's when it's a when it's pathology we refer to as policy.

72:52 vera this is a bad one. this is the one that you don't

72:56 . Uh this is one that's Secondary policy mia. Which is also

73:01 by the term of acidosis. This what our bodies take advantage of or

73:08 when our altitude changes. So if ever been from Houston and gone to

73:14 out in colorado for a couple of for probably the first week or

73:18 you start experiencing something called altitude Not everyone has it, but it's

73:24 not an uncommon thing for it to . You get dizzy, you might

73:27 get nauseous, you just don't feel but after a couple of days you

73:31 that you acclimate yourself to the And really what's going on here is

73:36 you don't have enough red blood cells deal with that lower oxygen content in

73:41 atmosphere. And so that lack of , your body has to work harder

73:45 kind of bring it in. But don't have the red blood cells to

73:47 it. So you're basically oxygen And that's where the headaches come in

73:51 nosh and all that stuff. But That lack of oxygen, your kidneys

73:57 , Hey, um not enough red cells because I'm not, I don't

74:01 enough oxygen. So, we need make more red blood cells so we

74:03 have more oxygen. So you produce gareth recites. It takes about what

74:09 days is what I said, so you make more red blood cells

74:13 now what you have is you have red blood cells to bind up oxygen

74:16 now carry enough oxygen your body to functional. So, this would be

74:21 polycystic mia. Right? That's that compensatory. The idea basically your body

74:27 or adapting to those oxygen levels and able to adjust so that your now

74:35 . All right. So, that's of what the secondary is. It's

74:40 adapting in such a way that can . All right, we're done for

74:46 , Tuesday we come back. We're to deal with homeostasis. We're gonna

74:50 a couple of Lucas sites. We're learn all these fun little processes.

74:54 to A and P.

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