Circulatory and Respiratory Systems - NCLEX-PN

The average adult body contains 4.5-6 liters of blood, depending on size and gender. Blood volume (BV) can be calculated by the following formula, given the hematocrit (HC) and plasma volume (PV):

The three main types of proteins in the blood are albumin, globulin, and fibrinogen. Major histocompatibility complex is not a free plasma protein, but rather a class of proteins found on the surface of all nucleated cells (MHC class I) and on the surface of certain immune cells known as antigen-presenting cells (MHC class II). They play an important part in immune function by displaying foreign antigens for communication between leukocytes.

The only anucleate blood cells are erythrocytes, or red blood cells. These cells are created with nuclei, but each daughter cell will then lose its nucleus in order to create more suface area for hemoglobin to bind oxygen and for easier passage through narrow capillaries.

Sympathetic innervation will decrease the heart rate, which will automatically decrease the cardiac output

The vagus nerve provides the main parasympathetic innervation of the heart. The recurrent laryngeal nerve, a branch of the vagus nerve, innervates the majority of the intrinsic muscles of the larynx. The cardiac nerve is part of the sympathetic innervation of the heart.

The majority of blood supply to the left atrium and left ventricle is provided by the left coronary artery. The septal branches and left circumflex artery are smaller divisions of this main artery. The posterior descending artery supplies the posterior one-third of the interventricular septum.

The nurse is most likely palpating the abdominal aorta. This vessel is large, generally 2.5-4 cm in diameter, and a strong pulse can often be felt on palpation. The femoral artery is also an area where a pulse may be felt, but it is only palpable in the mid-inguinal point of the inner thigh. The exterior iliac artery branches off of the abdominal aorta below the umbilicus, and the inferior mesenteric artery is a minor artery and is not generally palpable on examination.

The lymphatic system has several roles in the body, including drainage of interstitial fluid from tissues, transportation and activation of lymphocytes, and absorption and transportation of dietary fats. Red blood cells, however, are unable to enter lymph vessels, and so the lymphatic system does not participate in any type of gas exchange.

T-cell maturation occurs in the thymus, a small organ located in the upper part of the mediastinum, between the heart and the sternum. Mature T cells then may either circulate in the lymph or blood or reside in lymph nodes. The spleen is not a site of T cell maturation, though it does have other important immune functions, such as the production of antibodies and the removal of antibody-coated pathogens. The cisterna chyli is a part of the lymphatic system that is involved in lipid digestion.

Dietary fat is absorbed via lacteals, small lymph vessels contained within the body of the intestinal villi. Microvilli, tiny projections covering the surface of the villi, help with the absorption of minerals, vitamins, and other micronutrients. The cisterna chyli is a dilated pouch at the lower end of the thoracic duct that serves as a collection point for fatty chyle from the intestinal lacteals.

The proper unit when recording a patient's blood pressure is mmHg, or millimeter of mercury. This is derived from a historical measurement of how many millimeters of mercury in a mercury manometer were able to be elevated by a particular pressure. Due to it's toxicity, are longer used in medical equipment, though the unit remains in use.

The left ventricle is the most commonly enlarged heart structure seen in chronic hypertension. The left ventricle must overcome the afterload of the arterial system by becoming hypertrophied. As a result, the heart gets remodeled to overcome the systemic high blood pressures. The left ventricle directly pumps blood from the heart to the systemic circuit.

Many gases, such as room air, are composed of several gasses (in the case of room air, primarily nitrogen, oxygen, and several trace gasses). Partial pressure is the amount of pressure that each gas contributes. To find the total pressure of a gas mixture, one would find the sum of all partial pressures of each individual gas.

Gas exchange in the lung occurs exclusively in the alveoli, the tiny grape-like clusters of sacks at the terminus of the bronchioles of the lung. The gas contained in the larger structures of the lung - the trachea, bronchi, and bronchioles, is termed "dead space" as it does not participate in gas exchange.

Gas exchange in the alveoli occurs by the process of simple diffusion. The blood that enters the lung capillaries is relatively low in oxygen and high in , in comparison to the room air that is drawn into the alveoli during respiration. The separation between the capillaries and the alveolar epithelium is thin enough that these gasses can exchange across their pressure gradients by the process of simple diffusion.

The main trigger for the impulse to breathe is high carbon dioxide (decreased blood pH). In response to a decrease in blood pH, the medullary respiratory center triggers the diaphragm and the external intercostal muscles to increase breathing rate.

Myoglobin, an oxygen-binding protein in the muscle tissue, can bind with one molecule of oxygen. Hemoglobin, the main oxygen-binding metalloprotein in red blood cells, can bind four molecules of oxygen.

While hyperventilation or tachypnea may be triggered by various forms of acidosis, they will not cause a decrease in blood pH, but rather push the blood into a more alkaline state. This occurs due to loss of carbon dioxide during respiration, followed by a compensatory decrease in bicarbonate ions. The result is in an elevation in the pH of the blood. This condition is known as respiratory alkalosis.

There are five lobes total in the human lungs: the right lung has three lobes (the upper lobe, the middle lobe, and the lower lobe) while the left lung has two lobes (the upper lobe and the lower lobe).

The topmost part of the lungs is the apex. This area extends into the neck above the 1st rib and is the location auscultated for a diagnosis of a pancost tumor. The lingula of the lung is a small flap of the lowest part of the upper lobe of the left lung. The hilum is the entry point of the lung for the bronchi, pulmonary artery and vein, and nerves. The trachea is not a part of the lung at all; it is the cartilaginous tube that connects the pharynx and larynx to the lung.