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BIOL 2302 Human Anatomy & Physiology II - 2302_lecture03_0124
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00:01 All right. Guys can hear me . Okay, good. Um So
00:09 were we last week? First day class. First day of lecture.
00:13 talked about blood. We talked and that there were three different types of
00:18 that are found are really formed elements are found in blood. Alright.
00:22 you remember what those three are? do we talk about on Tuesday?
00:26 what was the one form element? talked about? Red blood cells?
00:30 right. So that means there's two . That means today we get to
00:33 about the other two. Do you know what they're called? White blood
00:37 and platelets? Great. Alright. what we're gonna do is we're gonna
00:42 our introduction to the white blood cells I say we're starting our introduction because
00:48 we're gonna do is we're gonna talk them and then we're going to ignore
00:51 . Other than the little facts that learned today. Until after the first
00:55 . In which case Then we start about immunology. And then we're coming
00:59 to those white blood cells, Which seems kind of a gyp but
01:03 just the way it kind of Alright. And then we're gonna talk
01:07 the platelets today. We're gonna talk thrombosis. Alright. Or sorry,
01:11 thrombosis. Homeostasis. Alright. And just a fancy word for saying making
01:17 . All right. And that's not that are people picketing at a protest
01:22 not a protest, but at a . But scabs as in like the
01:25 you like to pick out when no looking right. Because we all do
01:29 . Alright, alright, so that's today is. And we're gonna start
01:32 with local polices, which we learned weird uh prefix suffix polices refers to
01:39 creation of cells. And we said we're dealing with the whole process of
01:45 , a police. As we we started off with this pluripotent cell
01:48 then we give the specific fat they are going to drive the the
01:54 down one sort of lineage or the sort of lineage. And the way
01:57 can think about this is these cells always in a process of constant
02:00 So the pluripotent cells are dividing and more pluripotent cells and they're doing it
02:05 slowly because you don't need a lot them, they're just kind of hanging
02:08 and I'm gonna make another one. there's two of us now. And
02:11 that factor come comes along and hey you you need to go down
02:16 line and that line could be either myeloid line or it can be the
02:19 line. And we looked at the blood cell, we said this is
02:22 of the pathways that we can go if we have the right factors.
02:26 that was with the poet in and what a rich oasis was. So
02:31 police is looking at all the other and then there's gonna be one other
02:35 we're going to see at the very , which is thrombosis, which deals
02:39 the platelets. So local police is how do we get these white blood
02:45 and you get these white blood cells going down one of these two different
02:48 . So here we have something right? You can go down the
02:53 line and you can produce one group white blood cells or you can go
02:58 the lymphoid line and go down another create another group of white blood
03:05 All right now, depending on which you're gonna go down remember in your
03:10 , you don't know what you're gonna , it's dependent upon which sort of
03:13 you are going to be exposed So for example, if you're going
03:16 the myeloid line, you get this called multi colony colony stimulating factor,
03:23 . And really what it says look, there's a lot of things
03:25 the myeloid line and this little chemical discovered it just kind of initiates you
03:30 down this line and then to avoid rich oasis or thrombosis, then another
03:37 comes in and that's the G. . C. S. F.
03:40 that stands for granular site Monos So that's the Gm portion. And
03:45 so that's basically saying, okay, avoiding these two things. But now
03:49 can go down this pathway and depending whether you get another specific factor,
03:55 G CSF or the M CSF, gonna become a granule a site or
03:59 monastery site. So you see there's lot of like checkpoints and a lot
04:03 chemicals that are showing up and telling cell which way to go.
04:09 And it's kind of what you've been your whole life. You've been making
04:13 based on things that are interesting and to you, right? You're sitting
04:17 this classroom because at some point in life you experience something that triggered you
04:23 go down a particular pathway and then experience something else and it triggered to
04:26 down something more specific. And then gonna be all the way along the
04:30 and eventually you're gonna become the That's that's the interesting you because of
04:34 these little tiny triggers along the that's what these cells are doing.
04:38 difference is that the triggers here chemicals they're being released because the body needs
04:43 things. All right. So if going down the myeloid line, you're
04:47 either become a granular site or a site or if you go down the
04:52 line, you're gonna become a lymphocyte there are a variety of different types
04:56 lymphocytes. We're gonna limit it to In our discussion. I think we're
05:01 to about 20 that are known and probably more than that because I haven't
05:05 up with the field, but the that you guys need to know are
05:08 B cells and T cells and the killer cell, which is the coolest
05:14 in the body. Just because of name. Right. All right.
05:20 , What are Lucas sides? Either white blood cells? These are still
05:24 . They are the true cells of formed elements. All right. They're
05:28 make up such a small portion of blood that is like less than
05:34 This blood smear that you see up is not a good representation of what
05:37 blood smear is, what we saw the previous lecture. That's a better
05:42 because it's like tons and tons of blood cells, maybe a couple of
05:46 Sprinkle around here and there and then couple of these white blood cells
05:50 But this is a great picture because shows you the five basic types of
05:55 blood cells in the picture, and gonna use this as a way to
05:57 of help us learn how to identify . All right now, white blood
06:02 are the mobile units of the immune , which is why we just introduce
06:08 here and why we move on. , so, these are the cells
06:12 defend against all those things that are to kill you right now. Thank
06:19 . Immune insights. Alright, that's other word that we use from his
06:22 insights, right? They do not hemoglobin, that means they do not
06:26 any sort of role in carrying oxygen the body. Their function is immune
06:33 . Now there are five basic They vary in structure function. You
06:38 identify them fairly easily under the slides you know what you're looking for and
06:43 we have here. And I don't I put them in any sort of
06:45 order is neutrophils, lymphocytes, lymphocytes then we have the cinephiles and besa
06:51 all right. And we're gonna walk how to identify them. And I
06:55 part of your homework is to look a picture and go, yeah,
06:57 how it is now in your What's gonna happen is you're gonna get
07:04 who want to be mean to right? They're gonna try to find
07:09 to write test to trick you. you have taken me think that's what
07:13 do. I do not do I don't sit there and go,
07:15 do I abuse my students? If want to abuse you? You'd get
07:19 professor. Like I had an Organic where we were getting twenties on our
07:23 out of 100. Yes, that an average on one exam. I
07:28 a roommate who got a zero on , still ended up with a C
07:32 the exam and that's scary. Is stupid? All right. Now,
07:37 I'm trying to get out here is if we put these on the
07:41 I am not going to try to , let's make this tricky. So
07:44 can't identify it. What I'm trying do is trying to connect what are
07:48 things I need to learn to be identify? So the picture will have
07:51 thing that you need to learn. ? So that's the key thing
07:55 So before we start looking at we need to understand what these things
08:00 doing because the white blood cells being your blood. That's a nice way
08:03 defend your body against pathogens. Except pathogens don't always end up in the
08:09 pathogens get into your body all sorts different ways. And so these white
08:14 cells which play a role in dealing these pathogens need to find a way
08:20 get to those pathogens. And what do is they use to mechanisms in
08:26 to find where they need to go then to how to get there.
08:30 . The first term that you're gonna here is chemo tax is actually the
08:34 term on the slides. But it's bold one is chemo taxes. Chemo
08:40 which? What do you think that chemical? Alright. And then taxes
08:45 to move. Alright, you remember because of taxis move you around.
08:49 know you have Ubers now it's on chemo Uber. It's a chemo taxes
08:53 chemo taxes is simply a chemical message attracts a cell to where that chemical
08:59 coming from. All right. Anyone ever watched shark week on Discovery
09:06 a couple of one person, two . All right. How do sharks
09:10 their prey for the people who do blood in the water, Right?
09:14 always hear there's blood in the And so what you see and it's
09:18 they do. They actually detect the . And what they'll do is sharks
09:22 swimming along, swimming along, swimming . And then they detect either the
09:26 in the water. There's another way they can detect prey. But let's
09:29 use the chemical one. They take blood in the water. And then
09:32 they do is they begin behaving They start creating these large, sweeping
09:38 trying to find the source of the . So every time they detect a
09:41 bit more chemical that causes them to again and then they kind of sweep
09:45 if they detect it again, and just causes them to draw in to
09:49 that chemical is coming from. That be an example of chemo taxes at
09:54 macro level. Right? Because you're with the blood in the water.
09:58 is what the cells are doing. chemicals of a damaged tissue are gonna
10:02 released specifically to attract the immune insights released out into the blood. They're
10:07 into the surrounding interstitial fluid. And that signal ultimately gets into the
10:14 where these cells are located and the detect that chemical that causes them to
10:19 down and even stick to the walls blood vessels. And then they follow
10:24 chemical until they get to the the thick portion of the signal. In
10:28 words where there's the most chemical and what they do is they flatten themselves
10:33 they sneak their way in between the and then they wiggle their way through
10:38 those cells to where that damages. that process of flattening themselves and moving
10:44 of the blood cell is what is to as diet dcis. It goes
10:48 another name called excavation. Now I a boring picture up here that or
10:54 said excavation extra visitation. So extra basil referring to the vasculature. Alright
11:02 what we have up here is something very boring to look at if you
11:07 on youtube and type in diabetes is are at least 40 videos you can
11:11 and there's a really good one that a neutral fill extra vacation. Alright
11:17 extra visitation, write that word up if you just google that or just
11:22 that on youtube you're gonna get like two minute video and you'll get to
11:25 a really good example of what this like. It's all digital but it's
11:29 it does um or what what it like and so you can just kind
11:34 see that and it has an So it's just another thing for you
11:37 kind of use to help you learn . Alright so our white blood
11:42 these Lucas sites are gonna be using method to get to where they need
11:46 go. Now we already said that source of these different types of Lucas
11:54 come from either myeloid line or the line. Alright. But we actually
12:00 them not based on origin. Typically we do is we divide them based
12:04 what they look like. Alright. remember when we first discovered cells were
12:09 through microscopes and were describing the things we see. All right. And
12:14 using stains to see those things. what the first thing that they notice
12:19 that some cells had Granules and some didn't have Granules. And so in
12:24 wisdom, the people who were looking these cells named the cells based on
12:28 presence of Granules. So we had sites and a granular sites.
12:36 if you know your language, you your nomenclature. Anything time you put
12:40 A at the front of a word means without. Alright. So we
12:44 the cells with Granules in the cells Granules. Very very clever. All
12:48 . Now there are some key features help us to identify granule sites from
12:53 granular sites other than the Granules. example, the granular sites have these
12:59 that don't look like nuclei, they like someone took a balloon and popped
13:03 and so they're all well weird And so what we say is that
13:06 nuclei have multiple lobes. So they're lobed and very often what you'll see
13:13 multi nuclear Granules sites, mm Gs often the time what you'll see with
13:19 . Alright, so they have multi . And if I go back,
13:25 just gonna go back a slide So you can two slides right?
13:29 can see like up here looks like took a balloon and popped it.
13:33 ? When you look at a you expect a nucleus to kind of
13:36 like that. That doesn't look like nucleus at all. So, that
13:40 be an example of a multi lobe . That looks multi lobe again.
13:46 is that? That has multiple Now, there's a clear distinction between
13:51 and that. Right. Can you that there's a difference between those
13:54 Yeah. Can you tell the difference those two? Can you tell the
13:58 between that cell and that cell? a little harder. But can you
14:01 it? Yeah. All right. , you can imagine one of the
14:04 you're gonna be doing is you're gonna looking at the nucleus. Alright.
14:07 gonna be looking at the nucleus And two, I'm gonna be looking at
14:10 or not there are Granules. Here's really overt granule look at that.
14:15 see those Granules. Do you see Granules right? There's not Granules really
14:22 ? Those are big and obvious. and obvious. Big and obvious.
14:27 so obvious. All right. And those are the kinds of features we're
14:32 at to distinguish between a granule site a granule site. The nucleus.
14:38 whether or not there's Granules. Now granule sites are all the fills.
14:44 right. So we have a besa and fill and a neutral fill.
14:50 each of those are named because of type of stain they pick up.
14:56 right. So neutral Phil we're gonna here in just a moment. Pick
15:01 both an acidic and basic stain and NFL picks up only an acidic stain
15:07 then the bazaar filled picks up only basic state. So their nomenclature comes
15:11 the type of stain they that they and we'll see the picture and then
15:14 just kind of memorize what that All right. The last thing I
15:19 point out is that the granule sites all functionally Faiga sites. Alright.
15:24 fake sites. Faga sites, sites those cells that eat other things.
15:31 . Figo refers to eating. And what they do is they consume other
15:38 and we'll get to what items they in just a second. All right
15:43 , the a granule sites. We pointed out, they're the ones that
15:46 that nucleus that looks like a nucleus you'd expect the nucleus to look
15:49 Big and obvious. All right. don't have Granules like the like the
15:54 sites do. So really what you to do to distinguish between the two
15:58 types. The monas sites and the is to understand which one is bigger
16:02 the other, right? Which one a nucleus that's larger than the other
16:07 takes up most of this. And the easy part. Alright. So
16:11 harder part is just knowing which one granule site and which one takes up
16:15 type of of stain. Alright. what I wanna do is I want
16:19 walk through these now as I was over in this morning, I looked
16:22 these down here and apparently I didn't the bottoms here for some reason.
16:26 we're just gonna ignore these right And what I wanna do is I
16:31 to just kind of look at the histology here to help you see what
16:37 looking at. All right. So first type of cell we want to
16:40 at as a granule site, it the neutrophils. It is the most
16:43 type of immuno site that exists or that is in your body.
16:48 It is fag aesthetic. It is first line of defense. So when
16:52 go and scrape your knee and you go out and wash it really quickly
16:57 you let's say you get some sort horrible nasty bacteria in your body.
17:02 first thing that is going to come that bacterium is a neutral Phil and
17:07 gonna attack it's going to destroy It releases the chemicals to help kill
17:12 that bacteria and then it goes and swallows it up and breaks it down
17:17 in the process, what it's gonna is it's going to call in reinforcements
17:21 releasing a chemical that brings in other of of of of things to ensure
17:28 that bacteria doesn't escape. And what calling this is the inflammatory response and
17:33 deal with the inflammatory response after the test. That's part of the immune
17:38 that we look at now in terms what what we're looking for is that
17:42 is the big one that has all multi lobe. This is the one
17:46 looks like the popped balloon. And so I've kind of squared it
17:50 . Pop balloon popped balloon. And we're looking at here. And it's
17:55 if you look compare this to that compare this to that. This one
17:58 big giant blue Granules. This one has pink Granules. This right here
18:03 a mixture of purplish type Granules. again, the picture I'm showing here
18:09 not great. This is just pulled of the textbook and they don't always
18:13 the rights to the best pictures I go on the internet and steal
18:16 I mean borrow things for the purposes education. Right? And so I
18:22 find you perfect pictures to demonstrate this an exam if need be alright.
18:27 the idea here is that we have that are both red and blue,
18:32 and red. Plus blue makes Okay, so they're not gonna be
18:38 dark or as bright as those types Granules. All right, so neutral
18:47 fag acidic. The most purple weird looking nucleus. The NFL Is
18:59 here with this nice red nucleus or nucleus red um granule. Now the
19:06 makes up a portion about 1-4%. right. And what it's looking for
19:11 something that has been marked for Alright. We're looking for what are
19:16 antibody antigen complexes. We're going to with the question of antigen a little
19:21 later today and we're going to deal it more in a more complex
19:24 But in essence what an antigen is something that is recognized by the
19:28 system. And really what we're gonna is we're gonna have soluble proteins that
19:34 along and bind that thing that you shouldn't be here. And then
19:39 that antibody sits there is a big flag and says um immune system.
19:44 got something come deal with this. that's what the NFL does and it
19:49 for that antigen antibody complex. The our flag to be destroyed and its
19:54 is to come and destroy it. right now, that's number one.
19:58 other thing that it does, and don't really have to deal with this
20:01 so much here in the first But this is more of a third
20:04 thing, you know? So if get like a parasite. So there's
20:09 sorts of horrible nasty things that are there trying to kill you again,
20:12 learn all about them. But one them is worms. Anyone here want
20:15 worm. Yeah, hookworms, Pin worms, hookworms actually a
20:24 But pin worms, there's a real one out of the Middle East called
20:29 calculus met in Insys even has a name done to draw calculus.
20:34 And whenever you hear I think of , you know, this is a
20:38 bad little worm that migrates down into foot and what it does actually
20:43 And so it actually impregnates itself. as you're walking along the sores on
20:48 foot where it's located, actually expand . It puts its little pregnant body
20:52 out there and every time you step put pressure that causes that that sort
20:56 rupture and release eggs out onto the or wherever you're walking so that the
21:00 person coming along can pick up those in your foot and then it repeats
21:06 its life cycle. We have You've heard of a fluke like,
21:10 that's a fluke, no, that's a horrible organism that goes and lives
21:13 your liver and cause all sorts of things. The world is full of
21:18 that find you tasty and delicious and to kill you and if you ever
21:23 an opportunity to take a parasite class it because it is so cool
21:30 You've heard of elephantiasis, you probably it elephant itis. Elephantiasis not heard
21:35 that one. Oh go look that up. It's a fun one.
21:39 . All sorts of a body of . And anyway this bad boy comes
21:45 alongside the worm and says, hey you doing worm says I'm doing all
21:50 , I'm just gonna keep causing my says you know you are and it
21:55 up and release a whole bunch of like a pirate and a broadside and
21:58 punches holes in the sides of that kills the worm. And then other
22:03 immune insights come along and devour and . He's also play a role in
22:08 that. All right now its key here is not multi lobes. So
22:14 got 1234 lobes here. It's actually lobed and very often you can see
22:19 two lobes. It's like here's here's one you might even see the
22:21 strand in between them. It may like you have two nuclei. All
22:26 now these take up acidic dyes and why you see a red red Granules
22:33 in the NFL again name for The bazaar fill is the one that
22:39 all hate. But it's good for . I mean it's important that we
22:43 it right? But this is the , it makes up a very very
22:46 portion of the whole population. Its is to make histamine and make heparin
22:52 now. Histamine you're familiar with, ? Histamine is what you deal with
22:56 you have allergies, right? When it gets that time of year,
23:00 got popped up, right? Those all chopped up, everything is
23:04 It's What do you take to make feel better? What do you
23:10 And anti histamine? Right? It the pressure and you can breathe for
23:16 minutes before it runs off. What histamine is? It's a vaso
23:23 . Alright. And it causes What inflammation does it opens up as
23:27 result, opens up the blood So fluid flows into that space and
23:32 a pressure to trap whatever is in space. So, think about a
23:36 bite. Right? Mosquito bite. get this localized a demon, this
23:40 tiny inflammation. All right. That's immune system, saying we have found
23:44 that's not supposed to be here. trying to trap it in this particular
23:48 so that the immune system can deal it, and that's what histamine
23:52 Heparin is an anti coagulant. coagulation is what your blood vessels
23:59 right? When the or what It's how your body prevents itself from
24:04 out. So, it creates blood . That's what coagulation is. Is
24:07 clot to prevent something like blood from a blood vessel. But if your
24:13 dilating, you don't want that material the blood to go out of that
24:18 vessel and create a clot. That's . So heparin is the anti coagulant
24:23 allow that fluid to continue to flow against a very localized uh effect.
24:32 , so Heparin and histamine is what bazaar field produces. Alright now,
24:40 their nuclei is by Loeb it's really to see in this picture, but
24:45 actually does look like a backwards S right. And so you can kind
24:51 look at them and you're like, , if I look at this,
24:53 kind of looks like a see if on the side or maybe an
24:57 So they're kind of like a nucleus kind of like been compressed and bent
25:01 kind of the way you can look it. And again, these are
25:06 basic guys. And so you end with these very large blue Granules and
25:11 how you identify it. Yeah, one right here is a neutral
25:18 So where this is real obvious to what I mean, where it's like
25:25 are multi lobes. This is just way that it's situated. Is that
25:30 actually seeing the three lobes? And kind of differently. But again,
25:35 this a histology class? No. am I going to try to find
25:40 to say, can you identify this cell? Or am I going to
25:43 here is an obvious example of this of cells. So, that's what
25:47 shooting for. All right. I you to learn the obvious when you
25:51 pathologist. That's when they'll give you trick cells where you're sitting there
25:55 I have no idea what I'm looking . Are you sure this came out
25:57 a human? All right. that's not what we're shooting for.
26:01 not shooting for confusion. Alright. those are the three granular sites.
26:06 sites and lymphocytes are a little bit . All right. So, the
26:10 sites are the largest leukocyte. if you're looking at a picture and
26:13 have a frame of reference, it's , okay, I can see that
26:17 cell is really, really big relative the other cells. So, you
26:21 imagine if you get a question that , can you identify what the cell
26:25 ? And you see two and one them is box and one of them's
26:27 than the other one. That should your first clue is like,
26:30 this is probably the monos site. right. But you're not always gonna
26:34 that frame of reference. So, other thing is that you should be
26:37 for the type of nucleus. It the nucleus is fairly large, but
26:41 doesn't take up the entire side of . Alright. And typically what you'll
26:46 is that it might be kidney So, there's kind of a little
26:48 of a bend in the nucleus. , so, this one you can
26:51 of see the bend looks kind of a kidney kind of like a letter
26:56 . Alright now, what amon aside it's an immature macrophage. Alright,
27:02 is, it is a cell that be signal to become that macrophage which
27:08 around and starts consuming things that shouldn't in your body. And we have
27:13 all over our body there in our . We have what are called resident
27:16 . We have wandering macrophages. So on a site is an example of
27:20 macrophage that hasn't gotten to its destination hasn't matured yet. All right,
27:29 that's going to be in circulation. the last one is the lymphocyte lymphocyte
27:35 making up probably the second largest population between 20 to 40%. Um but
27:41 any given time you're not going to all your lymphocytes in circulation, you're
27:46 find that the lymphocytes kind of hang in different organs. What are called
27:51 lymphoid organs. Alright, again, deal with that after the exam.
27:56 right now, they're the ones that we think about immunity and the immune
28:00 . These are the cells we primarily about. We think B cells and
28:03 think about T cells, you've probably those two words, Alright, B
28:08 when they mature, B cells are immature form but when they are activated
28:13 of some sort of insult some sort pathogen, they mature in what is
28:19 a plasma cell and they start shedding very specific antibody for the thing that
28:24 been exposed. Now, I'm not try to explain this right now because
28:29 requires its own discussion because it is complex. Alright. And it's incredibly
28:36 that our bodies are designed to fight in the universe that doesn't belong in
28:40 bodies. If you start thinking about , it's kind of a really cool
28:46 . Everything that's not you is not something that your immune system should be
28:51 to recognize, which is kinda Alright. So that's the B
28:54 the T cell does the same thing it does. So in a very
28:59 way, it's actually the cells themselves involved in the immune response. All
29:05 , so, what we have here different types of immunity, we have
29:09 is called human or antibody mediated um . So it's through the release of
29:16 antibodies that the B cells are are you and it's the t cells are
29:21 themselves. So their cell mediated So they're basically using themselves to attack
29:28 things that are attacking you. And , they're very, very specific to
29:31 they will attack. All right the key feature of these, if
29:34 look at them, they're smaller than mona site and if you look at
29:38 nucleus it takes up the majority of cytoplasm. Alright, so it's basically
29:43 side of plasma is this little tiny that kind of sits around the edge
29:47 they don't have Granules. Neither of sites of lymphocytes have Granules.
29:51 so that's how you identify them. are the five basic types. Any
30:00 ? Yeah, yeah, we're gonna to that later. You don't need
30:04 know today. Just B cells are , right. I tend to sometimes
30:10 really excited and give you extra stuff don't need to know right now.
30:13 cells cell mediated or sorry, is mediated T cells are gonna be cell
30:19 immunity. All right, anyone Alright, so, part of the
30:26 is you will see these probably pictures these and you just have to kind
30:30 go, can I identify them? , if you know those characteristics Granules
30:35 of the granule and the type of , you're gonna be good to
30:38 Alright, pathology, like I it's a lot harder. Alright,
30:44 the last thing I want to kind point out here is that when we
30:46 a blood smear, what we're one the things that a physician or the
30:51 is gonna be, or the pathology gonna be looking for is they're gonna
30:53 looking at the population of cells that to be in that blood smear.
30:58 , so, if there is a count, So, like if this
31:01 a normal blood smearing, if you carefully you can see look see how
31:06 and far between those lymphocytes are are , those Lucas sites are. There's
31:10 a lot in that picture. And you look even harder, it's you
31:14 even really see where the platelets There's a platelet here and there and
31:17 , but they're just not really And that's kind of what a normal
31:20 smear looks like. But if you a blood smear and you see something
31:24 this with a whole bunch of that's kind of telling, isn't
31:28 That's telling you something is going on body. And and you can look
31:32 at the notes. What does the field deal with? What? Say
31:38 , I thought I heard it bacterial . So, if you look at
31:42 blood smear and you see a whole of neutrophils, that's a good indication
31:46 you have a bacterial infection, And your body is fighting it.
31:51 so that's when the doctor said, , we need to put in
31:55 figure out what the infection is, even do a smear to figure out
31:59 actually going on. And for those you take a micro you know,
32:03 the fun little things that can affect that are bacterial, Right? And
32:06 down here we have another one where , in this particular case, you
32:10 look at the cells, you can there's a whole bunch of lymphocytes in
32:13 . All right. Now, in particular case, this is a
32:18 Alright. And so leukemias, your producing white blood cells. But if
32:22 wasn't a function of white blood I mean, it wasn't leukemia.
32:27 you had a whole bunch of what would that suggest to you,
32:31 you think Whatever they said, I mean, I can't hear.
32:37 . It basically says that there's an and that your body is fighting
32:41 Right? And so maybe we need be looking for what that is.
32:45 right. So, these profiles help as future health care workers to help
32:52 what the pathogen is that's causing the state. So, this is one
32:58 the reasons why we have to know things. It's not just because
33:02 we have 24 lectures and we've got fill them up with stuff. All
33:06 . Sometimes it feels like that we're good with that. Alright.
33:14 Yeah. Well, so, remember we said is we gave you I
33:23 you kind of a percentage. All . And again, I'm not gonna
33:26 not gonna beat you over the head all this stuff. Right. But
33:29 say, what is the most common of white blood cell? We said
33:32 was the neutrophils. What was the most common? It was the
33:35 And so, you'd expect in a smear, Knowing that only 1% of
33:39 population of all the cells in the smear are gonna be Lucas sites.
33:43 . You'd expect in that that you expect to see maybe one or
33:49 neutrophils, maybe a lymphocyte, maybe is a center fill maybe a base
33:54 Phil. Right? That's what you'd . But if you do that blood
33:58 and you saw a particular population like this one again, the picture is
34:03 small and it's really hard for us see. But if you look at
34:05 like, oh my goodness, those multi nuclear granule sites or neutrophils.
34:11 do I know about neutrophils? I that neutrophils do this right. They
34:16 with bacterial infection. So being the healthcare worker, that's how you make
34:21 decisions for an A. And Class. I'm not gonna ask you
34:25 is the disease state because one we've talked about it. And to that's
34:29 the expectation. The expectation is can identify yourself and again, can it
34:35 simple? That makes sense. anyone else? All right. I
34:44 know why we teach this next thing we're gonna because it's in the book
34:47 everyone always teaches it and maybe it people feel smart and helpful.
34:52 Human blood groups, A B. groups. All that fun stuff.
34:56 we're coming back to that term antigen antibody. Alright, so I was
35:02 come in here with something I decided leave in in in the in the
35:06 to try to help explain what an is because very often when we think
35:11 we think immediately this is pathogenic and is something that's bad. Right.
35:17 that's not what what it is an is simply something that the immune system
35:22 recognize. Right? So you have and proteins and and cells in your
35:30 that are anti genic, right? you don't want your immune system to
35:40 it. And so your body has anything that can recognize your own
35:46 Because that would be bad. Because immune system's job is to kill things
35:50 it recognizes. It doesn't know what versus non self which we'll get to
35:56 . It basically just knows if I them. So to destroy it.
35:59 right. So, you are made of antigens. Alright. And everything
36:03 you is made up of antigens and is simply something that is detectable by
36:08 immune system to elicit an immune response our red blood cells. We have
36:16 group of antigens that help those cells identified not only by the immune system
36:23 by other things. Alright. And what we don't want is we don't
36:27 to have an immune system that recognizes own red blood cells. Okay.
36:34 if something foreign gets in our body has these antigens, we want to
36:38 able to recognize them. All And so the basis of the
36:43 B. O. System is the of two major antigens that almost all
36:50 us carry. All right now, truth is, there are a lot
36:54 antigens on red blood cells. But are the big boys. This is
36:59 like easily discovered. Um And and known this for a long time.
37:04 so the idea here is um if give somebody blood, for example,
37:10 you get a transfusion and you're receiving that has an anti gen that you
37:16 have, then your immune system is to attack it. Right?
37:21 I want to give someone blood that have an auntie jen that I have
37:27 that I don't have. I want give someone blood that either has antigens
37:32 I have because I don't have an system that recognizes or has no antigens
37:35 all. All right, So on surfaces, those antigens are gonna be
37:43 as foreign if you don't have that energy. Alright now we have a
37:50 for these particular types of antigens. call them a glutinous jen's long ugly
37:57 now, where the word comes from that when you take these blood cells
38:03 you put them in the blood, immune system looks at them and
38:06 I don't like them and they start up together and creating these massive,
38:11 clots that then occlude the flow of which are damaging to your body.
38:16 ? If blood can't flow in your that equals bad, would you
38:20 Right, So gluten? You can think it sounds like clumping, doesn't
38:24 just sounds right. It's gluey and what a glutinous again. All right
38:33 , As I said, we have whole bunch of these there are about
38:36 different varieties of naturally occurring antigens on red blood cells. The big group
38:43 the a. b. o. . Alright. And the other big
38:47 is the Rh group. Now the . B. O. Group is
38:50 one that we're most familiar with. ? You're A. Or B.
38:54 you're So what does that mean? right. If you're a what that
38:59 Is that your red blood cells in bodies have that? And again,
39:03 has the A antigen on all the blood cells. So what that also
39:07 is that your immune system lacks the to that antigen? All right.
39:15 that make sense? If I had A antibody I would recognize my own
39:20 antigens in my own immune system would my red blood cells and destroy them
39:25 then I wouldn't be able to carry in my body. Is that
39:30 It's very bad. Okay so a you're A that means you have the
39:36 , you lack the antibody? If B. You have the B.
39:42 , you lack the B. Antibody far you with me if you're a
39:49 . What does that mean? What you have? You have the
39:53 And you have the B. What do you lack the A.
39:59 the B. Antibody? And if oh what that means is you have
40:06 the A. Antigen or the Antigen that means you do have the
40:13 . And the B. Antibody. one thing I didn't say in all
40:17 is if you're A. And just . Whereas you lack the A
40:23 You do have the B. Okay so think of it this way
40:31 I am blank that means I don't blanks antibody. But I do have
40:38 other antibody. Okay so I'll go again since I see the look if
40:45 am A I have the A antigen That's what's on my cells. I
40:51 not have the A antibody because that attack it. But because I don't
40:57 bee I have bee antibodies. So a B. B. Red blood
41:03 comes along I'm going to destroy it that's foreign. Do not like
41:09 Okay if I am be that means have the B. Antigen. That
41:15 I lack the B. Antibody. I have the A antibody. So
41:23 don't attack my own cells that have . But if I'm giving an A
41:27 cell with an A. On it will attack the A. And then
41:31 B. I have the A. . Antigens. So A. And
41:35 . Antigens I don't have a antibodies don't have B antibodies. You can
41:39 me anything you want because you give a cell with just a.
41:44 I can't see them as anything but if you give me a cell with
41:48 on them. I don't have any . Can't see them. I can
41:51 the B. Blood. I'm good go and if you give me an
41:55 . A cell that has neither of . That's great because there's no image
41:58 attack. And if I'm oh that I don't have an A. And
42:06 I don't have a B. And means I do have an A.
42:10 and a B. Antibody. You give me a cell with an
42:14 And again you cannot give me a with a B. And then you
42:17 to give me cells that have no . Otherwise I will just attack
42:21 So The universal recipient one that we're anything is a B. Right?
42:29 universal donor I give it to anybody the O. And then the
42:34 Can only receive a the B. only receive B. Or O.
42:38 . O. S. Can go everybody. All right so that's how
42:43 A. B. O. Group . All right and it takes a
42:45 while to just kind of walk yourself . Don't just sit there and go
42:49 I gotta move on kind of walk through. What is my auntie
42:53 What are my antibodies? What does mean? An antibody attacks? What's
42:58 ? Alright so if I am a don't want to attack A. I
43:02 have that antibody that okay so far Rh is a little bit different.
43:10 the most prevalent form of the our group is called the antigen D.
43:15 if there's A D. That must there's A C. And we already
43:18 about the A's and the B's and . There's a whole bunch of
43:21 All right and you're either positive for or you're not right. So you're
43:28 positive or negative your be positive or your A. B positive negative.
43:33 O. Positive or negative. When say you're positive that means you're positive
43:38 that D. Antigen. Alright so your blood represents the presence of
43:45 B. Or O. Or the of that D. And again Now
43:51 to point this out just to beat dead horse, there are 45 Rh
43:55 groups. We don't talk about any them. We only talk about the
44:00 . Right the sea and the er comin along with the D. But
44:04 the D. That is most So looking at the population here,
44:09 of you guys are positive for the . Antigen. That's about 300 people
44:14 the class. So you're looking at about 240 of U. 250 of
44:20 are are positive for Rh just based those numbers. It's kind of
44:25 All right now the weird thing about is that right now in circulation you
44:31 have antibodies looking for Rh Alright they're looking for that. And again alright
44:37 often the way that the immune system is that you have a cell sitting
44:41 twiddling its thumbs waiting for the pathogen show up. So right now there
44:45 an alien protein out there in this that would cause you a great deal
44:50 harm and you have a cell that's to attack it and produce those antibodies
44:56 until you get exposed to it it's gonna sit there and twiddle its thumbs
45:00 Cool. Right I don't know where alien protein comes from. What do
45:05 think? Ryan maybe vega off someplace now that's what the cell that recognizes
45:19 R. H. D. And is it's sitting there quietly. Nothing's
45:24 on. Haven't been exposed. So not worried about it and then you
45:31 exposed to that antigen and that's when body says that shouldn't be here,
45:37 going to attack it and it starts that antibody for it. Alright so
45:43 you are are H. Um negative the one that's producing that antibody to
45:52 D antigen. Okay. Does that sense to you? So if I
45:59 have it, if I do not it on my own cells it's not
46:03 there as a marker on my I have the antibody to kill it
46:09 it's not in normal circulation but if exposed to that auntie june. My
46:16 system wakes up says find it and it and that's what it goes looking
46:22 now where this becomes most important is pregnancy. Okay so ladies, you
46:29 be Rh negative and your offspring as function of your mate produces an Rh
46:38 offspring and that blood will pass accidentally and forth between the mother and the
46:46 during term. Alright, so think giving birth, right? You give
46:52 placenta rips some of the blood escapes the placenta and enters into the
46:56 What's the mother's immune system gonna do that blood? What's he gonna
47:01 Does it belong there? No, not her blood, it's her offspring's
47:07 . So now she has antibodies. looking for this positive blood. Whenever
47:13 shows up again, I'm not pregnant I'm not producing it. So it's
47:18 looking for it. Second pregnancy comes . Second offspring is Rh positive.
47:26 that immune system want to do? . Kill, kill right now,
47:32 good news is we know this and we have ways to suppress it.
47:35 so it's not a big deal. this would be an example of why
47:39 stuff becomes important. We had all babies dying for unknown reasons over the
47:45 of centuries. Finally, someone finally out, oh the mother is trying
47:49 kill it without even knowing because her doesn't like that blood kind of
47:57 All right now what I wanted to . So that's kind of looking at
48:04 R. H. S. So kind of shows you what we're
48:09 right? Having the energy in versus antibody. So there's your blood sample
48:15 or not you're a B. oh right so you can see the
48:17 type over there and whether or not our age. And what is basically
48:20 look this blood sample is a So if I give it an antibiotic
48:26 a look at what the blood cells . All right they clump up,
48:33 gluten. Nice. Right so that's you get that gluten ation. But
48:40 I'm anti B are there any bees this sample? So notice that doesn't
48:45 any different here. I gotta I give an anti A. So
48:51 antibody that's against A. Nothing But look what happens when you put
48:55 sample where there's a lot of B clumps up and this is how you
49:01 kind of look at it. You see here again I maybe if I
49:04 an antibody against A. If I an antibody against be it clumps up
49:09 antibody recognizes the antigen. And lastly I'm oh oh I have no
49:15 no antigens. So it doesn't matter I have an A. Or
49:18 It just looks all the same. so that's just a visual way of
49:23 able to see all the things that just described antibodies attack the region for
49:30 they are specific. And I'm gonna there for a second before we go
49:39 thrombin polices and I want you to this in mind because I don't want
49:43 go into a lot of detail today I want to spend all our time
49:47 about antibodies in the next unit where appropriate. But I want you to
49:55 about think of all of you who vaccinated and why you got vaccinated,
50:01 . Whether it was for covid or for regular stuff. Lou you
50:06 think about what it's trying to And we're gonna come back to those
50:11 again and see what that vaccine is to to accomplish. All right.
50:16 it deals with antibodies. Okay, asleep. Yeah. Don't get as
50:26 as I do about this stuff is cool stuff. Once you start seeing
50:29 your immune immune system can do, just like just bring it. I'm
50:34 take it all on. But we'll here with the blood. All
50:39 Any questions about A B. R. H. Yes.
50:44 So Yes. So, it's it's same. It can happen the same
50:51 , but it's less. So because when you see all right, we're
50:55 we're gonna we're gonna we're gonna jump some some reproductive stuff which is very
51:01 for me because I can talk for minutes just on this stupid alright.
51:05 pregnancy, there is a barrier between and child called the Placenta. There's
51:11 actual exchange of blood between the right? There's a barrier. But
51:15 there's a tear in that barrier, can be an exchange. But that's
51:20 rare. The real tearing that takes during labor and delivery babies birthed everyone's
51:28 . Everyone's ignoring what happens next. you have to get rid of the
51:32 . The placenta is £9 of not baby joy, but it's basically £9
51:38 material that needs to be removed. so while you're sitting there going,
51:41 look at the cute little baby, what we just produce. You're actually
51:44 birth to a placenta as well. the placenta is torn from the uterine
51:50 . All right now it's a natural . You're not gonna notice. Don't
51:53 freaking out about this. But this is normal. Right? And so
51:57 torn. And so when there's that of that tissue, that's where you
52:02 the intermingling. But by then because modern technology, what do we do
52:09 we give birth? I know you've done this at least 30 times in
52:12 life, right? You've all given , right? Usually have like one
52:16 in the class may be right. first thing you do when they're when
52:19 born is they go and they clamp umbilicus, right? So that's where
52:23 blood is being transferred from the And then they say dad, here's
52:27 pair of forceps and now baby is from the placenta. So there's really
52:34 overt way that that's gonna be see transfer now. Could you?
52:39 but it's very very unlikely tearing in skin. Something along those lines
52:45 But not often. Good question. else? Yeah. I'm gonna step
52:56 from the reproductive part. If you know for those of you haven't taken
52:59 before. I'll say this about 30 over the semester. My background is
53:03 reproductive physiology. When we start talking reproduction, I turn into a little
53:06 schoolboy, I get really, really and I'll talk about just about
53:13 And when we get to reproduction, goal is to embarrass you all and
53:16 you all blush for the entire Sorry, class, not show
53:21 It's a classic. I remember it's . It's class. All right,
53:26 little bit. So we've introduced so red blood cells and their function.
53:35 do red blood cells do carry Okay. We've introduced the idea of
53:40 blood cells. White blood cells do response. And so now we gotta
53:45 with that third formed element. That third formed element is the
53:49 And it's created through a process called polices. The platelet itself is not
53:54 whole cell. It's actually a portion cell that's been ripped off from a
54:00 larger cell called. And it even larger cell mega Cariou site. I
54:06 to put that into mega mega. do it right now. The mega
54:10 side. Alright. So this is comes down the myeloid line. It
54:15 a specific enzyme that is responsible hormone comes along called. That makes it
54:23 . And all the other ones are stimulating factors. Alright. And this
54:28 wheaton is responsible for two things. first thing it is is responsible for
54:34 that pluripotent cell towards making that mega site. So that's easy. That's
54:40 what erythropoietin did. So that's not . But the other thing that it
54:43 is it tells that mega cargo site start behaving in a weird way.
54:49 when I say this weird way, it does is it starts shimmering or
54:53 or something, it starts taking portions its cytoplasm and starts doing this and
54:57 starts extending out that cytoplasm off to side and then as the blood comes
55:03 it helps sharing off that little portion cytoplasm that was blabbed outward. These
55:10 real scientific words, believe it or . A blob is an actual word
55:14 we use in science. Right? , you can imagine it's just sharing
55:17 these little bits and pieces off the carrier site. So when your body
55:20 in need of platelets, it's telling mega carrier sites start doing this so
55:25 we can rip portions off of you then that little portion that got ripped
55:29 is the platelet and it contains within side of skeletal elements from the mega
55:33 a site plus other factors that are away Granules that are stored away for
55:40 usage of coagulation. Alright. They're to play a role in this process
55:47 homeostasis. Homeostasis is basically producing blood . All right, So that's what
55:54 , this sheer force. And then , you have the organ in the
55:59 uh side of exotic elements. Typically don't have them all in circulation.
56:04 spleen holds a whole bunch of them . So your spleen is sitting over
56:08 on the side going, yeah, guys can all hang out here until
56:10 really needed And they don't stick around really long time. You know,
56:15 said that they're not real cells. only portions of cells. So they
56:18 a lifespan of about 10 days. , so just give you that
56:23 Red blood cells. Their lifespan is 120 days. These things are a
56:27 bit over a week. And they're basically broken down and destroyed and
56:32 their elements are going to be But the reason we are interested in
56:36 platelet is because of this process. , Alright. Homeostasis is making a
56:42 . It's this process of taking this blood vessel and repairing it so that
56:46 blood stays in your body and doesn't outside your body where it's useless.
56:52 three basic steps. I feel like Oh, so No one here watched
57:01 oso. I'm getting old. Disney . Thank you. one person.
57:15 mom didn't plop you in front of television. No, you guys are
57:17 the ipad generation aren't, you Okay. You know, you know
57:22 . So so what did the agencies in every episode? There are three
57:27 steps or anything. Whatever you need do. Three basic steps. You
57:30 to make your bed three basic You need to make yourself a glass
57:32 water. Three basic steps. You to clean up after yourself. Three
57:35 steps. He taught you how to and be a young young human.
57:41 right. I don't think they ever about going to the bathroom or anything
57:44 three basic steps. So, the basic steps here, we're gonna see
57:48 vascular spasm. We're gonna see the of the platelet plug, and then
57:52 the platelet plug, we're gonna see coagulation. Alright. The vascular spasm
57:57 the most interesting in my mind because not something we really think about.
58:02 can see in this picture up we got a blood vessel. We've
58:04 a knife to it and we shift shift the blood vessel. Alright,
58:09 you tear a blood vessel, blood to leave via the path of least
58:13 . So, you can imagine I have my blood vessel. I've
58:16 my blood vessel, right? You the blood vessel, everyone can
58:20 right? So from the side I've the blood vessel. So, the
58:25 thing that we're going to do is is called the bachelor spasm. And
58:28 that vascular spasm does is the muscle surrounds that blood vessel is going to
58:35 and it's going to include the flow blood. Can you see down the
58:39 vessel in further anymore? Can you down my blood vessel? No.
58:46 what I've done is I've blocked the of blood in that vessel. So
58:51 can't leave through the through the crack the slice because I'm preventing it from
58:57 in. Now, this works really well on very small blood
59:01 Capillaries which we'll learn about small arteries small veins doesn't work so well on
59:08 vessels. Alright. Things that have lot of pressure behind them because that
59:12 is going to just keep opening up vessel so that things escape out.
59:17 . But this is one of the first things and it happens in every
59:21 blood vessel. It's just most effective the smallest ones. Now, what
59:28 doing here is the first step is slow the flow of blood through that
59:33 . And what we're dealing is um I want to say here, it's
59:38 initiated the process is there's a chemical released from those cells that have been
59:44 or cut. And this chemical is in to fill in. Alright,
59:49 in essence there's a chemical message that damage has occurred. Tell the muscles
59:53 to do and that's when the muscles going to create that vascular spasm.
59:59 , now there's gonna be other Remember we said we have these leukocyte
60:05 are responding to a chemical message to attracted to the area where damage
60:09 because all sorts of horrible things are to try to come in through that
60:13 , right? When you skin your , right? Things are going to
60:18 to get into your body where that is because you are tasty and yummy
60:22 everything wants to kill you. Alright, so, we're gonna release
60:30 that are gonna bring in the neutrophils are going to bring in other things
60:35 help fight. Whatever will be All right, but that's step number
60:39 vascular spasm. Now, the second is gonna be the platelet plug.
60:45 here what we're doing is we're saying platelets that are in circulation, what
60:49 going to do is they're gonna begin congregate in the place where that damage
60:55 . Now, normally in your blood , we have these cells called
61:02 right? It's a type of of cell that lines inside of all your
61:08 vessels, and your heart, and blood cells don't naturally stick to those
61:14 , Right? But that tear, you've done is you've now broken that
61:22 . So, you can imagine here the wall of the inside of that
61:25 helium. And if I've torn it , I'm exposing collagen and other things
61:31 no longer um that no longer look that in death helium and it's that
61:37 surface that attracts the platelets, platelet . I don't recognize this. I
61:45 stick to it and that's when it really, really excited. Then it
61:50 on its social media party at the and it becomes like house party.
62:01 a new movie that every two or years that come out with a new
62:04 party movie and I can't the new . Is that um, Kobe Bryant's
62:07 , I think, or something, can't remember. It's a new movie
62:10 just came out and it's a house . You know what house party
62:13 right? Two idiots decide to throw party and then the whole universe shows
62:18 . That's what's going on here. the starts releasing factors didn't come hang
62:26 , man. My parents are Platelets start showing up and they start
62:31 in and moving in and they aggregate you get more and more and more
62:36 more. And what would happen is nothing else happened, then that whole
62:40 would just fill up with platelets and your blood will stop flowing. And
62:42 would be bad. So while there's message to attract these platelets in,
62:49 right, they're gonna start changing as . So there's some factors that are
62:53 be released. So the factors are are that are found in the
62:57 For example, Von Will brand factor a signal that's already in circulation that
63:03 , when that platelet becomes activated, responds that bond will brand factor and
63:08 its own materials to start attracting the platelets. These would be examples of
63:13 of the things that are going to activating them. The key thing here
63:17 calcium, that's the one I want to keep things about calcium is involved
63:20 . All right now, what they're doing here is they're just jamming up
63:24 whole they're filling up the space and preventing things from moving in and
63:29 They have mass. Now I said of the things that they don't do
63:35 they don't keep multiplying and filling up whole space till blood stops flowing.
63:39 the one true thing about a party of control is that next door to
63:43 party out of control is the grumpy man. And what does the grumpy
63:47 man always say, stay off my . Right? And so while the
63:54 are sitting there attracting more platelets, surrounding cells, the endo thallium is
64:02 a chemical message that says stay away here, stop congregating. So that
64:10 where the platelets are gonna aggregate, ? And that's what this is trying
64:14 show you is here. The platelet releasing message saying, hey you guys
64:18 hang out. But over here we're a message that says stay away.
64:23 the message, we're using this to a D. P. Okay,
64:27 just another nucleotide just like a teepee that and we just remove one of
64:31 phosphates. And then here we got cycling and process cycling is the chemical
64:37 don't go away, go away. is where you're supposed to be.
64:41 , that limits the platelet plug. these chemicals that the platelets are releasing
64:46 also going to help uh you reinforce that vascular spasm. So,
64:52 basically saying blood can't come through but that's coming through. This is
64:56 the platelets need to aggregate and they showing up and that's where they're gonna
64:59 up. And finally, what they're do is they're gonna start releasing factors
65:05 are going to affect the plasma. right now, remember, blood is
65:11 things, blood is water plus stuff call that plasma and blood is formed
65:18 . And we've learned the formed So, we're coming back to the
65:21 a little bit here and we're looking what's inside there. So, there
65:25 stuff circulating in your body right now want to form clots? Alright,
65:30 are chemicals whose sole job it is to help produce a blood clot.
65:36 do you need to clot your blood now? Know anyone here need to
65:40 your blood? No. All No, but it's in circulation.
65:46 so all you need to do is activate it to turn it on in
65:49 need And that's the job of the is to create lease that signal to
65:54 this process. All right. And we're gonna do is we're also gonna
65:58 in things to help start the initiation repair. In other words, we
66:02 to repair the damage. So, platelet when it's activated is is sending
66:08 signals to other cells to come in start doing the repair. So,
66:14 one faster spasm. Step to platelet and activation. Step three. The
66:21 results in the actual coagulation. if I were to get a drop
66:25 blood and drop it on the would it coagulate? Sure, these
66:35 are saying no, you want to with them? Do we want to
66:38 up here and fight about it? answer is it would the only thing
66:44 blood needs in order to initiate this is a foreign surface, Right?
66:51 that foreign surface in that tear is collagen. That's not the end of
66:56 , right? And helium being the cell, you're the vessel, the
67:00 cell. So when I expose the to collagen, that's something foreign,
67:04 gonna initiate the whole process to get this coagulation. If I take a
67:08 of blood and drop it on the , you know, or on the
67:13 eventually what it'll do is it'll coagulate people think, oh, I was
67:16 drying up, No, it is all the elements that are in blood
67:20 need to create that coagulation are already . Their intrinsic to that blood.
67:26 what those are These are inactive plasma . Now, the first thing that
67:31 gonna do is we need to create net or mesh work to help reinforce
67:36 platelet plug remember the platelets have been ? They're jamming up this whole but
67:41 not doing the greatest job in the . What we need to do is
67:43 need to fill in this little tiny in between them and we need to
67:47 that and create an actual blockade. so there is an element in your
67:52 called fibrinogen. Alright. And it's circulation right now. And you need
67:57 enzyme to come along and convert that engine into a molecule called very cleverly
68:06 in. It creates fibers. That's it looks like. Alright, there's
68:11 blood cells caught in the fibers of fibrous. All right now the enzyme
68:17 do this is in circulation. But now it is in active in your
68:21 . It's called pro thrombin. But platelets convert pro thrombin into thrombin.
68:31 when you have that thrombin, you're initiate this coagulation cascade. Coagulation cascade
68:39 a nightmare to memorize. So, news. Do we have to memorize
68:44 ? Hell yeah. No, no, we don't. Okay.
68:47 , it's all right. So here's problems with it. Look, the
68:51 . The coagulation cascade is a bunch proteins that are involved in taking something
68:56 isn't coagulated and making it coagulant. . And there's a whole bunch of
69:00 involved here and the proteins are And this is why it's such a
69:03 based on the order in which the was discovered. Not in the order
69:08 which they activate each other. So can see over here is like,
69:11 , I've got 12. And then this is not a good one.
69:14 better if I look at, this a better way to look at
69:16 You can see here's 12, there's . There's nine. There's 10.
69:20 know, Over here, there's Again, there's seven down there,
69:23 five. So you can see there's like, oh, one turns
69:27 two turns on, three turns on , no, no, it's 12
69:30 on 11, which turns on Which turns on 10 yada yada
69:34 So, we are not here to these, we're here to understand what
69:38 is. The coagulation cascade is a of proteins that are already in our
69:42 that when activated cause coagulation to take . And there's two separate pathways.
69:50 that is referred to as being one that's referred to as being
69:54 alright. And these two pathways converge become what is called the common
69:59 The word intrinsic means. They're always is part of the system. Extrinsic
70:04 . It comes from the outside. . And why we have these two
70:09 . No one knows, but maybe arose separately in the body, like
70:12 both. So, they used it . Right? So, the intrinsic
70:17 is what we're just describing everything in blood that needs to create a coagulation
70:21 already there in the blood. if I do damage to a blood
70:26 , Right? That blood vessel, by virtue of exposing that foreign
70:32 there's enough elements inside the blood to this process to go through all these
70:37 steps to get me down to what called the common pathway. We'll get
70:40 the common pathway. It takes about minutes to create a coagulation event.
70:46 it's fairly quick as far as we're , right? I mean, 3-6
70:49 . That's not that long. It longer to boil an egg.
70:55 But the extrinsic is when the tissue I've been damaged, I'm outside of
71:01 blood vessel, but damage has occurred and we need to repair the damage
71:07 we gotta make sure blood is not out. And so now the tissue
71:12 sending a signal that initiates the common . And this is very quick.
71:17 can create coagulation in under 15 So, depending on where the damage
71:22 coming from, whether it's within the vessel or outside the blood vessel,
71:26 using intrinsic versus extrinsic. That's the way to look at it. And
71:32 , notice, have I said anything what's turning what's on, It's just
71:37 long pathway. But when we get to the bottom, ultimately, what
71:40 gonna do is we're going to activate pro thrombin. We're gonna turn it
71:46 . Remember that's already in the And what we're gonna do is that
71:49 the enzyme that turns the plasma protein into fiber in which creates that
71:59 And when that clot begins to form going to seal the break and blood
72:05 either leave in or go out and can't go out. Ever notice
72:12 Get that scab and basically that's your Band Aid. That's your body protecting
72:17 from the external environment. It'd be lot cooler if it had bugs bunny
72:22 it. But you know, it what it is. So, the
72:29 in the common pathway are plasma proteins they're there to protect the blood from
72:35 . That's that's their job. we don't want this to extend
72:46 And so there are factors that prevent from just going rampant and filling up
72:52 entire blood vessel. All right, are the anticoagulants. So, we
72:56 things like nitric oxide and process That's the indo Thelen that's those cells
73:01 where the tear is saying, it's old man saying get off my
73:05 And so what you're doing is you're controlling where the clot is being formed
73:10 where that Claude is actually taking We mentioned. Heparin. Remember Heparin
73:15 a molecule that prevents coagulation. It that pathway. It interferes with the
73:22 of what thrombin is. Remember thrombin an enzyme that allows you to make
73:27 vibrant. And then there's some other like protein C. That plays a
73:33 in blocking things. Now, when put on a band aid, do
73:38 want to work forever? Maybe if three years old, you do right
73:44 a God daughter I think. And just loved band aids and she just
73:50 band aids all the time. The statement. But while chicks dig scars
73:57 and let's face it, you guys , right, chicks dig scars.
74:02 don't want to see scabs. A scab is a temporary occlusion of
74:07 flow of blood from the body. allowing the material underneath to repair itself
74:16 to renew itself so that you can have a normal about a beautiful
74:22 Right? Beautiful scar there. It allows it to repair itself so
74:26 you can live a normal existence and tissue can function itself. So if
74:34 scab is not a permanent thing, needs to be a pathway that breaks
74:38 down. And that's what this deals . We need to break down the
74:42 in. Now. How do you like to pick at your scabs?
74:49 fun, isn't it? Right, we pick out a little bit too
74:53 , it starts bleeding again. It's , oh we blow on it thinking
74:58 gonna speed up the process. It it's just fun, right? But
75:03 notice that the scab will disappear on own. And the reason for that
75:07 because there are plasma proteins. Plasminogen the key one that when thrombin is
75:15 , right? So we have pro becomes thrombin, thrombin is the enzyme
75:19 makes fiber engine become fiber. In same enzyme thrombin activates plasminogen. And
75:27 is the scissor that begins breaking down fiber in. Right. The thing
75:34 , is that this scissors a lot than the scab formation. So you
75:40 begin breaking down the uh the But you do so so much slower
75:47 you don't it doesn't look like you're it. But eventually as the cell
75:52 repairing itself or the tissues repairing that plasminogen which was inactive, which
75:57 now active. Plasma. What it's is it's removing the scab and allowing
76:02 new formed tissue to replace it. process is called fiber analysis license.
76:11 you guys remember that word means So fiber and break down. So
76:16 right there in the name. So hard part here is we have three
76:19 proteins we need to know right programming thrombin fibrinogen becomes fibrous plasminogen becomes
76:30 Know their roles we're done for today we come back, we're going to
76:35 what is it? We're going to with the heart. We're going to
76:40 heart. I love the heart.
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