Nervous System

Functions of Nervous System

Nervous system is master controlling and communicating system of body
Cells communicate via electrical and chemical signals
◦ Rapid and specific
◦ Usually cause almost immediate responses
Functions of Nervous System
Sensory input
◦ Information gathered by sensory
receptors about internal and external
changes

Integration
◦ Processing and interpretation of
sensory input

Motor output
◦ Activation of effector organs (muscles
and glands) produces a response
Functions of Nervous System
Nervous system is divided into two principal parts:

◦ Central nervous system (CNS)

◦ Brain and spinal cord of dorsal body cavity
◦ Integration and control center
◦ Interprets sensory input and dictates motor output

◦ Peripheral nervous system (PNS)

◦ The portion of nervous system outside CNS
◦ Consists mainly of nerves that extend from brain and spinal cord
◦ Spinal nerves to and from spinal cord
◦ Cranial nerves to and from brain
Nervous System’s
Levels Of
Organization
• Central NS
• Peripheral NS
• Sensory Division
• Motor Division
• Somatic NS
• Autonomic NS
• Sympathetic NS
• Parasympathetic NS
Nervous Tissue Histology
Neuroglia & Neurons
Nervous tissue consists of two principal cell types
◦ Neuroglia (glial cells): small cells that surround and wrap delicate neurons
◦ Neurons (nerve cells): excitable cells that transmit electrical signals
Neuroglia of the CNS
Four main neuroglia support CNS neurons
◦ Astrocytes
◦ Microglial cells
◦ Ependymal cells
◦ Oligodendrocytes
Neuroglia of the CNS
ASTROCYTES
• Most abundant,
versatile, and highly
branched of glial cells
• Cling to neurons,
synaptic endings, and
capillaries
• Play role in exchanges
between capillaries and
neurons
Neuroglia of the CNS
MICROGLIAL
CELLS
• Monitor neurons
• Migrate toward injured
neurons
• Can transform to
phagocytize
microorganisms and
neuronal debris
Neuroglia of the CNS
EPENDYMAL
CELLS
• May be ciliated
• Cilia beat to circulate
CSF
• Line the central cavities
of the brain and spinal
column
• Form permeable barrier
between cerebrospinal
fluid (CSF) in cavities and
tissue fluid bathing CNS
cells
Neuroglia of the CNS
OLIGODENDROCYTES

• Branched cells
• Processes wrap CNS
nerve fibers, forming
insulating myelin
sheaths in thicker nerve
fibers
Neuroglia of the PNS
SATELLITE &
SCHWANNCELLS

Satellite cells
• Function similar to
astrocytes of CNS
Schwann cells
• Surround all peripheral
nerve fibers and form
myelin sheaths in thicker
nerve fibers
• Similar function as
oligodendrocytes
Neurons
Neurons (nerve cells) are structural units of nervous system
Large, highly specialized cells that conduct impulses
Special characteristics
◦ Extreme longevity (lasts a person’s lifetime)
◦ Amitotic, with few exceptions
◦ High metabolic rate: requires continuous supply of oxygen and glucose

All have cell body and one or more processes

Neuron Cell Body
Also called the perikaryon or soma
Biosynthetic center of neuron
◦ Synthesizes proteins, membranes, chemicals
◦ Rough ER (chromatophilic substance, or Nissl bodies)

Contains spherical nucleus with nucleolus

Some contain pigments
In most, plasma membrane is part of receptive region that receives input info from other
neurons
Neuron Cell Body
Most neuron cell bodies are located in CNS
◦ Nuclei: clusters of neuron cell bodies in CNS
◦ Ganglia: clusters of neuron cell bodies in PNS
Neuron Processes
Armlike processes that extend from cell body
◦ CNS contains both neuron cell bodies and their processes
◦ PNS contains chiefly neuron processes
Tracts
◦ Bundles of neuron processes in CNS
Nerves
◦ Bundles of neuron processes in PNS
Two types of processes
◦ Dendrites
◦ Axon
Neuron Processes
DENDRITES
Receptive (input) region of neuron
Convey incoming messages toward cell body as graded
potentials (short distance signals)
In many brain areas, finer dendrites are highly specialized to
collect information
Neuron Processes
THE AXON: STRUCTURE
◦ In some neurons, axons are short or absent; in others, axon comprises
almost entire length of cell
◦ Some axons can be over 1 meter long
◦ Long axons are called nerve fibers
◦ Distal endings are called axon terminals
Neuron Processes
AXON
Axon is the conducting region of neuron

Generates nerve impulses and transmits them along

axolemma to axon terminal
◦ Terminal: region that secretes neurotransmitters, which are
released into extracellular space
◦ Can excite or inhibit neurons it contacts

Carries on many conversations with different neurons at same

time
Neuron Processes
The axon: functional characteristics
◦ Axons have efficient internal transport mechanisms
◦ Movement occurs in both directions
◦ Anterograde: away from cell body
◦ Examples: mitochondria, cytoskeletal elements, membrane
components, enzymes
◦ Retrograde: toward cell body
◦ Examples: organelles to be degraded, signal molecules, viruses, and
bacterial toxins
Homeostatic Imbalance
Certain viruses and bacterial toxins damage neural tissues by using
retrograde axonal transport
◦ Example: polio, rabies, and herpes simplex viruses, and tetanus toxin

Research is under way to investigate using retrograde transport to treat

genetic diseases
◦ Viruses containing “corrected” genes or microRNA to suppress defective genes can
enter cell through retrograde transport
Classification of Neurons
STRUCUTURAL
3 types grouped by number of processes

◦ Multipolar: three or more processes (1 axon, others dendrites)

◦ Most common and major neuron type in CNS

◦ Bipolar: two processes (one axon, 1one dendrite)

◦ Rare (ex: retina and olfactory mucosa)

◦ Unipolar: one T-like process (two axons)

◦ Also called pseudounipolar
◦ Peripheral (distal) process: associated with sensory receptor
◦ Proximal (central) process: enters CNS
Classification of Neurons
FUNCTIONAL
3 types of neurons grouped by direction in which nerve
impulse travels relative to CNS
Sensory
◦ Transmit impulses from sensory receptors toward CNS
◦ Almost all are unipolar
◦ Cell bodies are located in ganglia in PNS
Classification of Neurons
FUNCTIONAL
3 types of neurons grouped by direction in which nerve
impulse travels relative to CNS
Motor
◦ Carry impulses from CNS to effectors
◦ Multipolar
◦ Most cell bodies are located in CNS (except some autonomic
neurons)
Classification of Neurons
FUNCTIONAL
3 types of neurons grouped by direction in which nerve
impulse travels relative to CNS
Interneurons
◦ Also called association neurons
◦ Lie between motor and sensory neurons
◦ Shuttle signals through CNS pathways
◦ Most are entirely within CNS
◦ 99% of body’s neurons are interneurons
Membrane Potentials
Like all cells, neurons have a resting membrane potential
Unlike most other cells, neurons can rapidly change resting membrane potential
Neurons are highly excitable
Basic Principles of Electricity
Opposite charges are attracted to each other
Energy is required to keep opposite charges separated across a membrane
Energy is liberated when the charges move toward one another
When opposite charges are separated, the system has potential energy
Basic Principles of Electricity
Definitions
Voltage: a measure of potential energy generated by separated charge
◦ Measured between two points in volts (V) or millivolts (mV)

Current: flow of electrical charge (ions) between two points

◦ Can be used to do work
◦ Flow is dependent on voltage and resistance

Resistance: hindrance to charge flow

◦ Insulator: substance with high electrical resistance
◦ Conductor: substance with low electrical resistance
Generating the
Resting Membrane Potential
• A voltmeter can measure potential (charge) difference
across membrane of resting cell
• Resting membrane potential of a resting neuron is
approximately –70 mV
– The cytoplasmic side of membrane is negatively charged
relative to the outside
– The actual voltage difference varies from
–40 mV to –90 mV
– The membrane is said to be polarized
Generating the
Resting Membrane Potential
Generating the
Resting Membrane Potential
Generating a resting membrane potential depends on:
1. Differences in K+ and Na+ concentrations inside and outside
cells, and
2. Differences in permeability of the plasma membrane to these
ions.
Generating the
Resting
Membrane
Potential
Generating a resting membrane
potential depends on:
1. Differences in K+ and Na+
concentrations inside and
outside cells, and
2. Differences in permeability
of the plasma membrane to
these ions.
Changing the Resting Membrane Potential
• Membrane potential changes when:
– Concentrations of ions across membrane change
– Membrane permeability to ions changes
Changing the Resting Membrane Potential
• Terms describing
membrane potential
changes relative to resting
membrane potential

– Depolarization: decrease
in membrane potential
(moves toward zero and
above)

– Hyperpolarization:
increase in membrane
potential (away from zero)
Graded Potentials
• Short-lived, localized changes in membrane potential
– The stronger the stimulus, the more voltage changes and the
farther current flows
• Triggered by stimulus that opens gated ion channels
– Results in depolarization or sometimes hyperpolarization
• Named according to location and function
– Receptor potential (generator potential): graded potentials in
receptors of sensory neurons
– Postsynaptic potential: neuron graded potential
Graded Potentials
Action Potentials
• Principal way neurons send signals
– Means of long-distance neural communication
• Occur only in muscle cells and axons of neurons
• Action potentials (APs) do not decay over distance as
graded potentials do
• In neurons, also referred to as a nerve impulse
• Involves opening of specific voltage-gated channels
Generating an Action Potential
Generating an
Action Potential
Principal way neurons send signals

Means of long-distance neural

communication

Occur only in muscle cells and

axons of neurons

Action potentials (APs) do not

decay over distance as graded
potentials do

Involves opening of specific

voltage-gated channels
Generating an Action Potential
Repolarization resets electrical conditions, not ionic conditions
After repolarization, Na+/K+ pumps (thousands of them in an axon) restore ionic
conditions
Propagation of an Action Potential
Propagation allows AP to be
transmitted from origin down
entire axon length toward
terminals
Na+ influx through voltage
gates in one membrane area
cause local currents that cause
opening of Na+ voltage gates in
adjacent membrane areas
Since Na+ channels closer to
the AP origin are still
inactivated, no new AP is
generated there
◦ AP occurs only in a forward
direction
Clinical – Homeostatic Imbalance
• Impaired AP impulse propagation can be caused by a
number of chemical and physical factors.
• Local anesthetics act by blocking voltage-gated Na+
channels.
• Cold temperatures or continuous pressure interrupt blood
circulation and delivery of oxygen to neurons
– Cold fingers get numb, or foot “goes to sleep”
The Synapse
Nervous system works because information flows from neuron to neuron
Neurons are functionally connected by synapses, junctions that mediate information
transfer
◦ From one neuron to another neuron
◦ Or from one neuron to an effector cell
The Synapse
Presynaptic neuron: neuron conducting impulses toward synapse (sends information)
Postsynaptic neuron: neuron transmitting electrical signal away from synapse (receives
information)
◦ In PNS may be a neuron, muscle cell, or gland cell

Most function as both

Axon of
presynaptic
neuron

Synapses

Cell body
(soma) of
postsynaptic
neuron
The Synapse
Synaptic connections
◦ Axodendritic: between axon terminals of one neuron and dendrites of others
◦ Axosomatic: between axon terminals of one neuron and soma (cell body) of others
◦ Less common connections:
◦ Axoaxonal (axon to axon)
◦ Dendrodendritic (dendrite to dendrite)
◦ Somatodendritic (dendrite to soma)
◦ Two main types of synapses:
◦ Chemical synapse
◦ Electrical synapse
 Axodendritic
synapses

Dendrites
Axosomatic
synapses
Cell body
Axoaxonal
synapses
Chemical Synapses
Most common type of synapse

Specialized for release and reception of chemical neurotransmitters

Typically composed of two parts

◦ Axon terminal of presynaptic neuron: contains synaptic vesicles filled with

neurotransmitter
◦ Receptor region on postsynaptic neuron’s membrane: receives neurotransmitter
◦ Two parts separated by fluid-filled synaptic cleft

Electrical impulse changed to chemical across synapse, then back into electrical
Chemical Synapses
Transmission across synaptic cleft
◦ Synaptic cleft prevents nerve impulses from directly passing from one neuron to next
◦ Chemical event (as opposed to an electrical one)
◦ Depends on release, diffusion, and receptor binding of neurotransmitters
◦ Ensures unidirectional communication between neurons
Focus Figure 11.3 Chemical synapses transmit signals from one neuron to another using neurotransmitters. Slide 2

Presynaptic
neuron

Presynaptic
neuron
Postsynaptic
neuron

1 Action potential
arrives at axon terminal.

Mitochondrion
Ca2+
Ca2+
Ca2+

Ca2+

Synaptic
cleft
Axon
terminal
Synaptic
vesicles

Postsynaptic
neuron

© 2016 Pearson Education, Inc.

Focus Figure 11.3 Chemical synapses transmit signals from one neuron to another using neurotransmitters. Slide 3

Presynaptic
neuron

Presynaptic
neuron
Postsynaptic
neuron

1 Action potential
arrives at axon terminal.

2 Voltage-gated Ca2+ channels Mitochondrion

open and Ca2+ enters the axon
terminal. Ca2+
Ca2+
Ca2+

Ca2+

Synaptic
cleft
Axon
terminal
Synaptic
vesicles

Postsynaptic
neuron

© 2016 Pearson Education, Inc.

Focus Figure 11.3 Chemical synapses transmit signals from one neuron to another using neurotransmitters. Slide 4

Presynaptic
neuron

Presynaptic
neuron
Postsynaptic
neuron

1 Action potential
arrives at axon terminal.

2 Voltage-gated Ca2+ channels Mitochondrion

open and Ca2+ enters the axon
terminal. Ca2+
Ca2+
Ca2+

Ca2+

Synaptic
3 Ca2+ entry causes cleft
synaptic vesicles to Axon
release neurotransmitter terminal
by exocytosis. Synaptic
vesicles

Postsynaptic
neuron

© 2016 Pearson Education, Inc.

Focus Figure 11.3 Chemical synapses transmit signals from one neuron to another using neurotransmitters. Slide 5

Presynaptic
neuron

Presynaptic
neuron
Postsynaptic
neuron

1 Action potential
arrives at axon terminal.

2 Voltage-gated Ca2+ channels Mitochondrion

open and Ca2+ enters the axon
terminal. Ca2+
Ca2+
Ca2+

Ca2+

Synaptic
3 Ca2+ entry causes cleft
synaptic vesicles to Axon
release neurotransmitter terminal
by exocytosis. Synaptic
vesicles

4 Neurotransmitter
diffuses across the synaptic
cleft and binds to specific Postsynaptic
receptors on the neuron
postsynaptic membrane.

© 2016 Pearson Education, Inc.

Focus Figure 11.3 Chemical synapses transmit signals from one neuron to another using neurotransmitters. Slide 6

Presynaptic
neuron

Presynaptic
neuron
Postsynaptic
neuron

1 Action potential
arrives at axon terminal.

2 Voltage-gated Ca2+ channels Mitochondrion

open and Ca2+ enters the axon
terminal. Ca2+
Ca2+
Ca2+

Ca2+

Synaptic
3 Ca2+ entry causes cleft
synaptic vesicles to Axon
release neurotransmitter terminal
by exocytosis. Synaptic
vesicles

4 Neurotransmitter
diffuses across the synaptic
cleft and binds to specific Postsynaptic
receptors on the neuron
postsynaptic membrane.

Ion movement

Graded potential

5 Binding of neurotransmitter opens ion channels,

resulting in graded potentials.

© 2016 Pearson Education, Inc.

Focus Figure 11.3 Chemical synapses transmit signals from one neuron to another using neurotransmitters. Slide 7

Presynaptic
neuron

Presynaptic
neuron
Postsynaptic
neuron

1 Action potential
arrives at axon terminal.

2 Voltage-gated Ca2+ channels Mitochondrion

open and Ca2+ enters the axon
terminal. Ca2+
Ca2+
Ca2+

Ca2+

Synaptic
3 Ca2+ entry causes cleft
synaptic vesicles to Axon
release neurotransmitter terminal
by exocytosis. Synaptic
vesicles

4 Neurotransmitter
diffuses across the synaptic
cleft and binds to specific Postsynaptic
receptors on the neuron
postsynaptic membrane.

Ion movement
Enzymatic
Graded potential degradation
Reuptake

Diffusion away
from synapse

5 Binding of neurotransmitter opens ion channels,

resulting in graded potentials.

6 Neurotransmitter effects are terminated

by reuptake through transport proteins,
enzymatic degradation, or diffusion away
from the synapse.

© 2016 Pearson Education, Inc.

Chemical
Synapses
Information transfer across chemical
synapses
◦ Six steps are involved:
Electrical Synapses
Less common than chemical synapses
Neurons are electrically coupled
◦ Joined by gap junctions that connect cytoplasm of adjacent neurons
◦ Communication is very rapid and may be unidirectional or bidirectional
◦ Found in some brain regions responsible for eye movements or hippocampus in areas involved
in emotions and memory
◦ Most abundant in embryonic nervous tissue
CARDIOVASCULAR
SYSTEM:
BLOOD
Physical Characteristics and Volume

• Sticky, opaque fluid

• Color scarlet to dark red
• pH 7.35–7.45
• 38C
• ~8% of body weight
• Average volume: 5–6 L for
males, and 4–5 L for females
Functions of Blood

1. Distribution of 3. Protection against

• O2 and nutrients to body cells • Blood loss
• Metabolic wastes to the lungs and • Plasma proteins and platelets
kidneys for elimination initiate clot formation
• Hormones from endocrine organs to • Infection
target organs
• Antibodies
2. Regulation of • Complement proteins
• Body temperature by absorbing and • WBCs defend against foreign
distributing heat invaders
• Normal pH using buffers
• Adequate fluid volume in the
circulatory system
Blood Composition
• Hematocrit
• Percent of blood volume that is RBCs
• 47% ± 5% for males
• 42% ± 5% for females
Blood Plasma

• 90% water
• Proteins are mostly produced by the liver
• Nitrogenous by-products of metabolism—lactic acid, urea,
creatinine
• Nutrients—glucose, carbohydrates, amino acids
• Electrolytes—Na+, K+, Ca2+, Cl–, HCO3–
• Respiratory gases—O2 and CO2
• Hormones
Formed Elements

• WBCs are complete cells

• RBCs have no nuclei or
organelles
• Platelets are cell fragments
• Most blood cells originate in
bone marrow and do not
divide
Erythrocytes

• Biconcave discs, anucleate,

essentially no organelles
• Filled with hemoglobin (Hb) for
gas transport
• Huge surface area relative to
volume
• >97% hemoglobin
• No mitochondria
Erythrocyte Function

• Hemoglobin structure
• Protein globin: two
alpha and two beta
chains
• Heme pigment bonded
to each globin chain
• Iron atom in each
heme can bind to one
O2 molecule
Hematopoiesis & Erythropoiesis

Hematopoiesis Erythropoiesis
• Blood cell formation • Red blood cell production
• Hemocytoblasts (hematopoietic • A hemocytoblast is transformed into a
stem cells) proerythroblast
• Proerythroblasts develop into early
• Give rise to all formed elements
erythroblasts
• Hormones and growth factors push the
cell toward a specific pathway of blood
cell development
Erythropoiesis

• Phases in development
1. Ribosome synthesis
2. Hemoglobin accumulation
3. Ejection of the nucleus and formation of reticulocytes
• Reticulocytes then become mature erythrocytes
Regulation and Hormonal Control of Erythropoiesis

• Too few RBCs leads to

tissue hypoxia
• Too many RBCs
increases blood
viscosity
• Balance between RBC
production and
destruction depends on
• Hormonal controls
• Adequate supplies of
iron, amino acids, and
B vitamins
Fate and Destruction of Erythrocytes

• Life span: 100–120 days

• Old RBCs become fragile, and Hb begins
to degenerate
• Macrophages engulf dying RBCs in the
spleen
Erythrocyte Disorders

• Anemia: blood has abnormally low O2-carrying capacity

• A sign rather than a disease itself
• Blood O2 levels cannot support normal metabolism
• Accompanied by fatigue, paleness, shortness of breath, and
chills
Causes of Anemia

• Sickle-cell anemia
• Defective gene codes for
abnormal hemoglobin (HbS)
• Causes RBCs to become
sickle shaped in low-oxygen
situations
Leukocytes

• Make up <1% of total blood

volume
• Can leave capillaries via
diapedesis
• Move through tissue spaces
by ameboid motion and
positive chemotaxis
• Leukocytosis: WBC count
over 11,000/mm3
• Normal response to bacterial
or viral invasion
Granulocytes

• Neutrophils
• Most numerous WBCs
• Very phagocytic—“bacteria slayers”
• Eosinophils
• Digest parasitic worms that are too large to be
phagocytized
• Basophils
• Are functionally similar to mast cells
Agranulocytes

• Lymphocytes
• Mostly in lymphoid tissue; few circulate in the
blood
• Two types, T and B Cells
• Monocytes
• Largest leukocytes
• Differentiate into macrophages
• Phagocytic cells; against viruses,
intracellular bacterial parasites, and chronic
infections
• Activate lymphocytes to mount an immune
response
Leukopoiesis

• Production of WBCs
• Stimulated by chemical
messengers from bone marrow
and mature WBCs
• All leukocytes originate from
hemocytoblasts
Leukocyte Disorders

• Leukopenia
• Abnormally low WBC count—drug induced
• Leukemias
• Cancerous conditions involving WBCs
• Named according to the abnormal WBC clone involved
• Myelocytic leukemia involves myeloblasts
• Lymphocytic leukemia involves lymphocytes
• Acute leukemia involves blast-type cells and primarily affects children
• Chronic leukemia is more prevalent in older people
Platelets

• Small fragments of megakaryocytes

• Form a temporary platelet plug that helps seal breaks in blood vessels
• Circulating platelets are kept inactive and mobile by NO and prostacyclin from endothelial
cells of blood vessels
Hemostasis

• Fast series of reactions for

stoppage of bleeding
1. Vascular spasm
2. Platelet plug formation
3. Coagulation (blood clotting)
Disorders of Hemostasis

• Thromboembolytic disorders: undesirable clot formation

• Hemophilias include several similar hereditary bleeding
disorders
• Hemophilia A: most common type (77% of all cases); due to a
deficiency of factor VIII
• Symptoms include prolonged bleeding, especially into joint
cavities
• Treated with plasma transfusions and injection of missing
factors
Transfusions

• Whole-blood transfusions are used when blood loss is

substantial
• Packed red cells (plasma removed) are used to restore
oxygen-carrying capacity
• Transfusion of incompatible blood can be fatal
Human Blood Groups

• RBC membranes bear 30 types glycoprotein antigens that are

• Perceived as foreign if transfused blood is mismatched
• Unique to each individual
• Promoters of agglutination and are called agglutinogens
• Presence or absence of each antigen is used to classify blood
cells into different groups
ABO Blood Groups
Rh Blood Groups

• There are 45 different Rh agglutinogens (Rh factors)

• C, D, and E are most common
• Rh+ indicates presence of D
• Anti-Rh antibodies are not spontaneously formed in Rh–
individuals
• Anti-Rh antibodies form if an Rh– individual receives Rh+ blood
• A second exposure to Rh+ blood will result in a typical
transfusion reaction
Transfusion Reactions

• Occur if mismatched blood is infused

• Donor’s cells
• Are attacked by the recipient’s plasma agglutinins
• Agglutinate and clog small vessels
• Rupture and release free hemoglobin into the bloodstream
• Result in
• Diminished oxygen-carrying capacity
• Hemoglobin in kidney tubules and renal failure
Homeostatic Imbalance: Hemolytic Disease of the Newborn

• Also called erythroblastosis fetalis

• Rh– mother becomes sensitized when exposure to Rh+ blood
causes her body to synthesize anti-Rh antibodies
• Anti-Rh antibodies cross the placenta and destroy the RBCs of
an Rh+ baby
• The baby can be treated with prebirth transfusions and
exchange transfusions after birth
• RhoGAM serum containing anti-Rh can prevent the Rh–
mother from becoming sensitized
Blood Typing

• When serum containing anti-A or

anti-B agglutinins is added to
blood, agglutination will occur
between the agglutinin and the
corresponding agglutinogens
• Positive reactions indicate
agglutination
Restoring Blood Volume

• Death from shock may result from low blood volume

• Volume must be replaced immediately with
• Normal saline or multiple-electrolyte solution that mimics plasma
electrolyte composition
• Plasma expanders (e.g., purified human serum albumin,
hetastarch, and dextran)
• Mimic osmotic properties of albumin
• More expensive and may cause significant complications
Diagnostic Blood Tests

• Hematocrit
• Blood glucose tests
• Microscopic examination reveals variations in size and shape
of RBCs, indications of anemias
CARDIOVASCULAR
SYSTEM:
THE HEART &
BLOOD VESSELS
Heart Anatomy

• Approximately the size of a fist

• Location
• In the mediastinum between second rib and fifth intercostal space
• On the superior surface of diaphragm
• Two-thirds to the left of the midsternal line
• Anterior to the vertebral column, posterior to the sternum
• Enclosed in pericardium, a double-walled sac
LOCATION OF THE HEART IN THE MEDIASTINUM
• Relationship of the heart to the sternum, ribs, and diaphragm in a person who is lying
down (the heart is slightly inferior to this position in a standing person).
• Inferior view of a cross section showing the heart’s relative position in the thorax.
LOCATION OF THE HEART IN THE MEDIASTINUM
• Relationship of the heart and great vessels to the lungs.
PERICARDIUM & LAYERS OF THE
HEART WALL
• Superficial fibrous pericardium 1. Epicardium
• Protects, anchors, and prevents 2. Myocardium
overfilling
3. Endocardium
 Left common carotid
Brachiocephalic trunk
artery
Left subclavian artery
Superior vena cava Aortic arch
Right pulmonary Ligamentum arteriosum
artery Left pulmonary artery
Ascending aorta Left pulmonary veins
Pulmonary trunk

Right pulmonary Auricle of

veins left atrium
Circumflex artery
Right atrium
Right coronary artery Left coronary artery
(in coronary sulcus) (in coronary sulcus)
Anterior cardiac vein Left ventricle
Right ventricle
Right marginal artery Great cardiac vein
Anterior interventricular
Small cardiac vein
artery (in anterior
Inferior vena cava interventricular sulcus)
Apex
(b) Anterior view
 Aorta

Superior vena cava Left pulmonary

artery
Right pulmonary Left atrium
artery Left pulmonary
Pulmonary trunk veins
Right atrium
Mitral (bicuspid)
Right pulmonary valve
veins
Fossa ovalis Aortic valve
Pectinate muscles
Pulmonary valve
Tricuspid valve Left ventricle
Right ventricle Papillary muscle
Chordae tendineae Interventricular
septum
Trabeculae carneae
Epicardium
Inferior vena cava Myocardium
Endocardium

(e) Frontal section

Aorta Superior vena cava
Left pulmonary
Right pulmonary artery
artery
Left pulmonary Right pulmonary veins
veins
Auricle of left Right atrium
atrium
Left atrium Inferior vena cava
Great cardiac
vein Coronary sinus
Right coronary artery
Posterior vein (in coronary sulcus)
of left ventricle
Posterior
Left ventricle interventricular
artery (in posterior
Apex interventricular sulcus)
Middle cardiac vein
Right ventricle
(d) Posterior surface view
Pathway of Blood Through the Heart

• The heart is two side-by-side

pumps
• Right side is the pump for the
pulmonary circuit
• Vessels that carry blood to
and from the lungs
• Left side is the pump for the
systemic circuit
• Vessels that carry the blood
to and from all body tissues
Pathway of Blood Through the Heart

• Equal volumes of blood are pumped to the

pulmonary and systemic circuits
• Pulmonary circuit is a short, low-pressure
circulation
• Systemic circuit blood encounters much
resistance in the long pathways
• Anatomy of the ventricles reflects these
differences
Coronary Circulation
Homeostatic Imbalances

• Angina pectoris
• Thoracic pain caused by a fleeting deficiency in blood delivery
to the myocardium
• Cells are weakened
• Myocardial infarction (heart attack)
• Prolonged coronary blockage
• Areas of cell death are repaired with noncontractile scar tissue
Heart Valves

• Ensure unidirectional blood flow

through the heart
• Atrioventricular (AV) valves
• Prevent backflow into the atria when
ventricles contract
• Tricuspid valve (right)
• Mitral valve (left)
• Chordae tendineae anchor AV valve
cusps to papillary muscles
Heart Valves

• Semilunar (SL) valves

• Prevent backflow into the ventricles
when ventricles relax
• Aortic semilunar valve
• Pulmonary semilunar valve
Photograph of the tricuspid valve. Coronal section of the heart.
This bottom-to-top view shows the valve as seen
from the right ventricle.
Heart Valves
Heart Physiology: Sequence of Excitation

1. Sinoatrial (SA) node (pacemaker)

2. Atrioventricular (AV) node
3. Atrioventricular (AV) bundle
(bundle of His)
4. Right and left bundle branches
5. Purkinje fibers
Homeostatic Imbalances

• Defects in the intrinsic conduction system may result in

1. Arrhythmias: irregular heart rhythms
2. Uncoordinated atrial and ventricular contractions
3. Fibrillation: rapid, irregular contractions; useless for pumping
blood
Extrinsic Innervation of the Heart

• Heartbeat is modified by the

ANS
• Cardiac centers are located
in the medulla oblongata
Electrocardiography
• Electrocardiogram (ECG): a composite of all the action potentials generated
by nodal and contractile cells at a given time
• Three waves
1. P wave: depolarization of SA
node
2. QRS complex: ventricular
depolarization
3. T wave: ventricular
repolarization
SA node R Depolarization Repolarization

R
P T

Q P T
S
1 Atrial depolarization, initiated
by the SA node, causes the Q
S
P wave. 4 Ventricular depolarization
AV node R is complete.
R

P T
P T
Q
S
2 With atrial depolarization Q
S
complete, the impulse is 5 Ventricular repolarization
delayed at the AV node. begins at apex, causing the
R T wave.
R

P T
P T
Q
S
Q
3 Ventricular depolarization S
begins at apex, causing the 6 Ventricular repolarization
QRS complex. Atrial is complete.
repolarization occurs.

Figure 18.17
Heart Sounds

• Two sounds (lub-dup)

associated with closing
of heart valves
• First sound occurs as AV
valves close and signifies
beginning of systole
• Second sound occurs
when SL valves close at
the beginning of
ventricular diastole
Mechanical Events:
The Cardiac Cycle
Cardiac cycle: all events
associated with blood flow
through the heart during one
complete heartbeat
• Systole—contraction
• Diastole—relaxation
Autonomic Nervous System Regulation

• Sympathetic nervous system is activated by emotional or

physical stressors
• Norepinephrine causes the pacemaker to fire more rapidly (and
at the same time increases contractility)
Autonomic Nervous System Regulation

• Parasympathetic nervous
system opposes
sympathetic effects
• Acetylcholine hyperpolarizes
pacemaker cells by opening
K+ channels
• The heart at rest exhibits
vagal tone
(parasympathetic)
Homeostatic Imbalances:
Congestive Heart Failure (CHF)
• Progressive condition where the CO is so low that blood
circulation is inadequate to meet tissue needs
• Caused by
• Coronary atherosclerosis
• Persistent high blood pressure
• Multiple myocardial infarcts
• Dilated cardiomyopathy (DCM)
Developmental Aspects of the Heart

• Congenital heart
defects
• Lead to mixing of
systemic and
pulmonary blood
• Involve narrowed
valves or vessels that
increase the workload
on the heart
Blood Vessels

• Delivery system of dynamic structures that begins and ends at

the heart
• Arteries: carry blood away from the heart; oxygenated except for
pulmonary circulation and umbilical vessels of a fetus
• Capillaries: contact tissue cells and directly serve cellular needs
• Veins: carry blood toward the heart
Monitoring Circulatory Efficiency

• Vital signs: pulse and blood pressure,

along with respiratory rate and body
temperature
• Pulse: pressure wave caused by the
expansion and recoil of arteries
• Radial pulse (taken at the wrist) routinely
used
Physiology of Circulation: Definition of Terms

• Blood flow
• Volume of blood flowing through a vessel, an organ, or the entire
circulation in a given period
• Blood pressure (BP) (mm Hg)
• Force per unit area exerted on the wall of a blood vessel by the blood
Measured as systemic arterial BP in large arteries near the heart
• The pressure gradient provides the driving force that keeps blood moving
from higher to lower pressure areas
Physiology of Circulation

• Resistance
• Opposition to flow
• Measure of the amount of friction blood encounters
• Generally encountered in the peripheral systemic circulation
• Three important sources of resistance
• Blood viscosity
• Total blood vessel length
• Blood vessel diameter
Resistance

• 3 Factors that remain relatively constant:

1. Blood viscosity
• The “stickiness” of the blood due to formed elements and
plasma proteins
2. Blood vessel length
• The longer the vessel, the greater the resistance encountered
3. Blood vessel diameter
Systemic Blood Pressure

• The pumping action of the heart generates blood flow

• Pressure results when flow is opposed by resistance
• Systemic pressure
• Is highest in the aorta
• Declines throughout the pathway
• Is 0 mm Hg in the right atrium
• The steepest drop occurs in arterioles
Measuring Blood Pressure

• Systemic arterial BP
• Measured indirectly by the
auscultatory method using a
sphygmomanometer
• Pressure is increased in the cuff
until it exceeds systolic pressure
in the brachial artery
Measuring Blood Pressure

Pressure is released slowly and

the examiner listens for sounds of
Korotkoff with a stethoscope

• Sounds first occur as blood

starts to spurt through the artery
• systolic pressure, normally
110–140 mm Hg

• Sounds disappear when the

artery is no longer constricted
and blood is flowing freely
• diastolic pressure, normally
70–80 mm Hg
Homeostatic Imbalance: Hypotension

• Orthostatic hypotension: temporary low BP and dizziness

when suddenly rising from a sitting or reclining position
• Chronic hypotension: hint of poor nutrition and warning sign
for Addison’s disease or hypothyroidism
• Acute hypotension: important sign of circulatory shock
Homeostatic Imbalance: Hypertension

• Hypertension: high blood pressure

• Sustained elevated arterial pressure of 140/90 or higher
• May be transient adaptations during fever, physical exertion,
and emotional upset
• Often persistent in obese people
Homeostatic Imbalance: Hypertension

• Secondary hypertension is less common

• Due to identifiable disorders, including kidney disease,
arteriosclerosis, and endocrine disorders such as
hyperthyroidism and Cushing’s syndrome

• In arteriosclerosis, the walls of our arteries become thicker and

stiffer, and hypertension results.
Atherosclerosis

• In atherosclerosis, the most common

form of arteriosclerosis, small patchy
thickenings called atheromas form that
can intrude into the vessel lumen,
making it easy for arterial spasms or a
roaming blood clot to close the vessel
completely.
IMMUNE
SYSTEM
General Biology II
Immunity

• Resistance to disease
• Immune system has two intrinsic systems
• Innate (nonspecific) defense system
• Adaptive (specific) defense system
 THE IMMUNE SYSTEM
Surface barriers
• Skin
INNATE • Mucous membranes
DEFENSES Internal defenses
• First line of defense • Phagocytes
• Second line of defense • Natural killer cells
• Inhibit spread of invaders
• Inflammation is its most • Inflammation
important mechanism • Antimicrobial proteins
• Fever
 THE IMMUNE SYSTEM

ADAPTIVE Humoral immunity

• B cells
DEFENSES

• Third line of defense attacks Cellular immunity

particular foreign substances
• Takes longer to react than the • T cells
innate system
 THE IMMUNE SYSTEM
Surface barriers
• Skin
• Mucous membranes

INNATE Internal defenses

DEFENSES • Phagocytes
• Natural killer cells
• Inflammation
• Antimicrobial proteins
• Fever
Innate Defenses: Surface Barriers

• Protective chemicals inhibit or destroy

microorganisms
• Skin acidity
• Lipids in sebum and dermcidin in sweat
• HCl and protein-digesting enzymes of stomach mucosae
• Lysozyme of saliva and lacrimal fluid
• Mucus
• Respiratory System Modifications
• Mucus-coated hairs in the nose
• Cilia of upper respiratory tract sweep dust- and bacteria-laden
mucus from lower respiratory passages
Internal Defenses: Cells and Chemicals

• Necessary if microorganisms invade deeper tissues

1. Phagocytes
2. Natural killer (NK) cells
3. Inflammatory response (macrophages, mast cells, WBCs, and
inflammatory chemicals)
4. Antimicrobial proteins (interferons and complement proteins)
5. Fever
Phagocytes:
Macrophages
• Macrophages develop from
monocytes to become the chief
phagocytic cells
• Free macrophages wander
through tissue spaces
• E.g., alveolar macrophages
• Fixed macrophages are
permanent residents of some
organs
• E.g., Kupffer cells (liver) and
microglia (brain)
Neutrophils and Mechanism of Phagocytosis

• Neutrophils
• Become
phagocytic on
encountering
infectious
material in
tissues
Natural Killer (NK) Cells

• Large granular lymphocytes

• Target cells that lack “self” cell-surface receptors
• Induce apoptosis in cancer cells and virus-infected cells
• Secrete potent chemicals that enhance the inflammatory
response
Inflammatory Response

• Triggered whenever body • Cardinal signs of acute

tissues are injured or inflammation:
infected
1. Redness
• Prevents the spread of 2. Heat
damaging agents
3. Swelling
• Disposes of cell debris and
pathogens 4. Pain
(And sometimes 5. Impairment
• Sets the stage for repair
of function)
Inflammatory Response
Phagocyte Mobilization

• Neutrophils, then
phagocytes flood to
inflamed sites
Antimicrobial Proteins

• Interferons (IFNs) and complement

proteins
• Attack microorganisms directly
• Hinder microorganisms’ ability to reproduce
• Functions
• Anti-viral
• Reduce inflammation
• Activate macrophages and mobilize NK
cells
Fever

• Systemic response to invading microorganisms

• Leukocytes and macrophages exposed to foreign substances secrete
pyrogens
• Pyrogens reset the body’s thermostat upward
• High fevers are dangerous because heat denatures enzymes
• Benefits of moderate fever
• Causes the liver and spleen to sequester iron and zinc (needed by
microorganisms)
• Increases metabolic rate, which speeds up repair
 THE IMMUNE SYSTEM

Humoral immunity
• B cells

ADAPTIVE
DEFENSES
Cellular immunity
• T cells
Adaptive Immunity

• Uses lymphocytes, APCs, and specific molecules to identify

and destroy nonself substances
• Depends upon the ability of its cells to
• Recognize antigens by binding to them
• Communicate with one another so that the whole system
mounts a specific response
Adaptive Defenses

• Adaptive immune response

• Is specific
• Is systemic
• Has memory
• Two separate overlapping arms
1. Humoral (antibody-mediated) immunity
2. Cellular (cell-mediated) immunity
Antigens

• Substances that can mobilize the adaptive defenses and

provoke an immune response
• Most are large, complex molecules not normally found in the
body (nonself)
Cells of the Adaptive Immune System

• Two types of lymphocytes

• B lymphocytes (B cells)—humoral immunity
• T lymphocytes (T cells)—cell-mediated immunity
• Antigen-presenting cells (APCs)
• Do not respond to specific antigens
• Play essential auxiliary roles in immunity
Lymphocytes

• Originate in red bone marrow

• When mature, they have
• Immunocompetence; they are
able to recognize and bind to a
specific antigen
• Self-tolerance – unresponsive to
self antigens
• Naive (unexposed) B and T
cells are exported to lymph
nodes, spleen, and other
lymphoid organs
Antigen-Presenting Cells
(APCs)
• Engulf antigens
• Present fragments of antigens to
be recognized by T cells
• Major types
• Dendritic cells in connective
tissues and epidermis
• Macrophages in connective tissues
and lymphoid organs
• B cells
Macrophages and Dendritic Cells

• Present antigens and activate T cells

• Macrophages mostly remain fixed in the lymphoid organs
• Dendritic cells internalize pathogens and enter lymphatics to present the
antigens to T cells in lymphoid organs
• Activated T cells release chemicals that
• Prod macrophages to become insatiable phagocytes and to secrete
bactericidal chemicals
 Falsely colored scanning
electron micrograph of a B
cell (6,000x).

Humoral
Immune
Response
Adaptive Immune Response
Humoral Immunity Response

• Antigen challenge
• First encounter between an antigen and a naive
immunocompetent lymphocyte
• Usually occurs in the spleen or a lymph node
• If the lymphocyte is a B cell
• The antigen provokes a humoral immune response
• Antibodies are produced
Clonal Selection

• Primary Immune Response

• Occurs on the first exposure to
a specific antigen
• Lag period: three to six days
• Peak levels of plasma antibody
are reached in 10 days
• Antibody levels then decline
Immunological Memory

• Secondary Immune Response

• Occurs on re-exposure to the same
antigen
• Sensitized memory cells respond
within hours
• Antibody levels peak in two to three
days at much higher levels
• Antibodies bind with greater affinity
• Antibody level can remain high for
weeks to months
Active Humoral Immunity
• Occurs when B cells encounter
antigens and produce specific
antibodies against them
• Two types
• Naturally acquired—response
to a bacterial or viral infection
• Artificially acquired—response
to a vaccine of dead or
attenuated pathogens
Example
Vaccines
• Spare us the symptoms of the
primary response
• Provide antigenic determinants
that are immunogenic and
reactive
• Target only one type of helper T
cell, so fail to fully establish
cellular immunological memory
Passive Humoral Immunity

• B cells are not challenged by antigens

• Immunological memory does not occur
• Two types
1. Naturally acquired—antibodies delivered to a fetus via the placenta or to
infant through milk
2. Artificially acquired—injection of serum, such as gamma globulin
• Protection is immediate but ends when antibodies naturally degrade
in the body
Antibodies

• Immunoglobulins—
gamma globulin portion
of blood
• Proteins secreted by
plasma cells
• Capable of binding
specifically with
antigen detected by B
cells
Classes of Antibodies
Classes of Antibodies
Antibody Targets

• Antibodies inactivate and

tag antigens
• Form antigen-antibody
(immune) complexes
• Defensive mechanisms
used by antibodies
• Neutralization and
agglutination (the two most
important)
• Precipitation and
complement fixation
Cell-Mediated
Immune
Response
Adaptive Immune Response
Cell-Mediated Immune Response

• T cells provide defense against intracellular antigens

• Two types of surface receptors of T cells
• T cell antigen receptors
• Cell differentiation glycoproteins
• CD4 or CD8
• Play a role in T cell interactions with other cells
Cell-Mediated Immune Response

• Major types of T cells

• CD4 cells become helper T
cells (TH) when activated
• CD8 cells become cytotoxic T
cells (TC) that destroy cells
harboring foreign antigens
• Other types of T cells
• Regulatory T cells (TREG)
• Memory T cells
Comparison of Humoral and Cell-Mediated Response
• Antibodies of the humoral response
• The simplest ammunition of the immune
response
• Targets
• Bacteria and molecules in extracellular
environments (body secretions, tissue
fluid, blood, and lymph)
• T cells of the cell-mediated
response
• Recognize and respond only to
processed fragments of antigen
displayed on the surface of body cells
• Targets
• Body cells infected by viruses or
bacteria
• Abnormal or cancerous cells
• Cells of infused or transplanted foreign
tissue
Antigen Recognition

• Immunocompetent T cells are activated when their surface

receptors bind to a recognized antigen (nonself)
• T cells must simultaneously recognize
• Nonself (the antigen)
• Self (an MHC protein of a body cell)
MHC Proteins

• Two types of MHC proteins are important to T cell activation

• Class I MHC proteins - displayed by all cells except RBCs
• Class II MHC proteins – displayed by APCs (dendritic cells,
macrophages and B cells)
• Both types are synthesized at the ER and bind to peptide
fragments
Class I & Class II MHC Proteins

Class I Class II
• Bind with fragment of a protein • Bind with fragments of exogenous
synthesized in the cell antigens that have been engulfed
(endogenous antigen) and broken down in a
phagolysosome
• Endogenous antigen is a self-
antigen in a normal cell; a nonself • Recognized by helper T cells
antigen in an infected or abnormal
cell
• Informs cytotoxic T cells of the
presence of microorganisms hiding
in cells (cytotoxic T cells ignore
displayed self-antigens)
T Cell Activation

• APCs (most often a dendritic cell) migrate to lymph nodes

and other lymphoid tissues to present their antigens to T
cells
• T cell activation is a two-step process
1. Antigen binding
2. Co-stimulation
T Cell Activation:
Antigen Binding
• CD4 and CD8 cells bind to
different classes of MHC proteins
(MHC restriction)
• CD4 cells bind to antigen linked to
class II MHC proteins of APCs
• CD8 cells are activated by antigen
fragments linked to class I MHC of
APCs
T Cell Activation:
Antigen Binding
• Dendritic cells are able to obtain
other cells’ endogenous antigens
by
• Engulfing dying virus-infected or
tumor cells
• Importing antigens through temporary
gap junctions with infected cells
• Dendritic cells then display the
endogenous antigens on both
class I and class II MHCs
Cytokines

• Mediate cell development, differentiation, and responses in the immune

system
• Interleukin 1 (IL-1) released by macrophages co-stimulates bound T cells to
• Release interleukin 2 (IL-2)
• Synthesize more IL-2 receptors
• IL-2 is a key growth factor, acting on cells that release it and other T cells
• Encourages activated T cells to divide rapidly
Roles of Helper T(TH) Cells

• Play a central role in the adaptive immune response

• Once primed by APC presentation of antigen, they
• Help activate T and B cells
• Induce T and B cell proliferation
• Activate macrophages and recruit other immune cells
• Without TH, there is no immune response
Helper T Cells

• Interact directly with B cells

displaying antigen fragments
bound to MHC II receptors
• Stimulate B cells to divide
more rapidly and begin
antibody formation
Helper T Cells

• Cause dendritic cells

to express co-
stimulatory molecules
required for CD8 cell
activation
Roles of Cytotoxic T(TC) Cells

• Directly attack and kill other cells

• Activated TC cells circulate in
blood and lymph and lymphoid
organs in search of…
• Targets
• Virus-infected cells
• Cells with intracellular bacteria or
parasites
• Cancer cells
• Foreign cells (transfusions or
transplants)
Natural Killer Cells

• Recognize other signs of abnormality

• Lack of class I MHC
• Antibody coating a target cell
• Different surface marker on stressed cells
• Use the same key mechanisms as Tc cells for killing their
target cells
Regulatory T (TReg) Cells

• Dampen the immune response by direct contact or by

inhibitory cytokines
• Important in preventing autoimmune reactions
Immunodeficiencies

• Congenital and acquired conditions that cause immune cells,

phagocytes, or complement to behave abnormally
Acquired Immune Deficiency Syndrome (AIDS)

• Cripples the immune system by interfering with the activity of

helper T cells
• Characterized by severe weight loss, night sweats, and
swollen lymph nodes
• Opportunistic infections occur, including pneumocystis
pneumonia and Kaposi’s sarcoma
Acquired Immune Deficiency Syndrome (AIDS)

• Caused by human immunodeficiency virus (HIV) transmitted via body

fluids—blood, semen, and vaginal secretions
• HIV enters the body via
• Blood transfusions
• Blood-contaminated needles
• Sexual intercourse and oral sex
• HIV
• Destroys TH cells
• Depresses cell-mediated immunity
Acquired Immune Deficiency Syndrome (AIDS)

• HIV multiplies in lymph nodes throughout the asymptomatic period

• Symptoms appear in a few months to 10 years
• HIV-coated glycoprotein complex attaches to the CD4 receptor
• HIV enters the cell and uses reverse transcriptase to produce DNA from
viral RNA
• The DNA copy (a provirus) directs the host cell to make viral RNA and
proteins, enabling the virus to reproduce
Acquired Immune Deficiency Syndrome (AIDS)

• HIV reverse transcriptase produces frequent transcription

errors; high mutation rate and resistance to drugs
• Treatment with antiviral drugs
• Reverse transcriptase inhibitors (AZT)
• Protease inhibitors (saquinavir and ritonavir)
• New Fusion inhibitors that block HIV’s entry to helper T cells
|HIV & AIDS
Immune System

a print screen from **https://www.youtube.com/watch?v=bjdqw9rXXd8

AIDS | Acquired Immune Deficiency Syndrome
• Cripples the immune system by
interfering with the activity of
helper T cells
• Characterized by severe weight
loss, night sweats, and swollen
lymph nodes
• Opportunistic infections occur,
including pneumocystis
pneumonia and Kaposi’s
sarcoma
HIV causes AIDS | Human Immunodeficiency Virus
• Caused by Human
Immunodeficiency Virus (HIV)
transmitted via body fluids—
blood, semen, and vaginal
secretions
• HIV enters the body via
• Blood transfusions
• Blood-contaminated needles
• Sexual intercourse and oral sex
• HIV
• Destroys TH cells
• Depresses cell-mediated
immunity
HIV
Replication Cycle
• HIV multiplies in lymph nodes
throughout the asymptomatic
period
• Symptoms appear in a few
months to 10 years
• HIV-coated glycoprotein complex
attaches to the CD4 receptor
• HIV enters the cell and uses
reverse transcriptase to produce
DNA from viral RNA
• The DNA copy (a provirus) directs
the host cell to make viral RNA
and proteins, enabling the virus to
reproduce
How is HIV
TRANSMITTED?
• HIV lives in the following bodily
fluids of an infected person:

• Blood
• semen and pre-seminal fluid
(“pre-cum”)
• rectal fluids/anal mucous
• vaginal fluids
• breast milk.
How is HIV
NOT TRANSMITTED?
How can I LIMIT MY RISK of HIV
transmission through sex?
• Use male or female condoms correctly each time you
have sex.
• Take antiretroviral drugs for pre-exposure prophylaxis
of HIV (PrEP).
• Practice only non-penetrative sex.
• Remain faithful in a relationship with an uninfected
equally faithful partner with no other risk behaviour.
How do I know if I’m infected?

• Testing for HIV is the only way to know for

sure if you have HIV.
• Many people do not have any symptoms
and can live for many years without
knowing they have the virus.
ANTIRETROVIRAL Drugs
Treat HIV Infection
• HIV reverse transcriptase
produces frequent transcription
errors; high mutation rate and
resistance to drugs
• Treatment with antiviral drugs
• Reverse transcriptase inhibitors
(AZT)
• Protease inhibitors
• saquinavir and ritonavir
• New Fusion inhibitors that block
HIV’s entry to helper T cells
HIV & AIDS **https://www.youtube.com/watch?v=0TipTogQT3E