First Week Completed

I have just completed my first week of the Master of Acupuncture program. It’s a great feeling to be back in a learning setting and I couldn’t be more excited. I have already had one meeting of every class.

Classes:
Traditional Chinese Medicine Theory I
Methods and Materials of TCM
Point Location I
History and Cultural Foundations
Structural Anatomy

I have already begun palpating the body and even had a chance to needle a lime. I think he’ll forgive me for whatever pain I have caused him. The semester looks to be full of reading and memorization. Can’t wait to piece together everything from these classes.

Defenses Against Diseases

We all know that we can get sick, but many of us don’t really understand all the efforts our body goes through to keep us healthy. This post will fill you in on the way that our body defends itself from disease.

We have two kinds of defenses. We have non-specific defenses, which is a defense that just keeps everything out that doesn’t belong. These are general barriers and are regarded to innate defenses. We also have specific defense, which target very specific microorganisms or chemicals. This is regarded to as an active defense.
There are two kinds of non-specific defenses. There are first line defenses and second line defenses. First line defenses include the skin. The skin is a continuous surface with a non living top layer with living cells under the top later. The living layer is continuously working to replace lost cells from the top layer. Sweat glands underneath the living layer of skin evaporate fluids, including antimicrobial fluids, to the surface oil glands. These secrete oils that change the pH environments that are inhibitory to the diseases and bacteria. Electrical energy, in either positive or negative direction, also works to repel any chemicals which may be repelled by either charge. Mucous membranes also work as a first line defense. These membranes are thick and sticky and coat the linings of openings into the body. The mucous is made of goblet cells and is very effective as a defense due to its stickiness so that it can trap things. The mucous is acidic and contains antimicrobial chemicals.

The respiratory system is a good example of first line defenses getting utilized. In the nose, there is a wavy shape called a conch. Unfiltered air comes in through the nose and travels through the conchs, while getting filtered by turbinate. In the back of the throat there is a lymphatic tissue which picks up anything that gets through the nose and the throat. Mucous flows down the back of the throat. When swallowing a flap on the trachea closes and mucous goes through the esophagus to the stomach, where anything foreign remaining gets broken down with the mucous. In the trachea, there are ciliated mucous epitheliums. These are cells with little extensions that face where the air is going through. They have proteins that wave around which catch particles and move them up and out of the trachea. Because mucous is dropping downwards simultaneously, while the cilia are moving particles up, the mucous and particles mix, so that that they can travel down the esophagus together once the reach the top of the trachea and that flap closes.



Second line defenses include sneezing, coughing, vomiting, fever, and inflammation. Sneezing is a violent contraction of the diaphragm to get things out of the system through the nasal passage. Coughing clears the throat, trachea and brachial tubes. Vomiting is a violent contraction of the stomach as a reaction to toxins entering. A fever is an increase in body temperature which stimulates the immune system and inhibits bacteria that doesn’t survive in heat. Fevers also increase chemical reactions in the blood. Inflammation is a first response to any trauma. Signs of inflammation are redness, heat, swelling and pain. This occurs when blood vessels dilate. It is a relaxation of the vessel walls and increases blood flow to bring in healing properties.

There is also a compliment system which acts when something makes it past all these defenses and gets into the blood. There are 20 different proteins which are made by the liver that become very reactive in the presence of certain bacteria. These proteins form on the surface of the bacteria and punch whole in the bacterial wall.
Specific Defense is also known as immunity. Substances are recognized as foreign and provoke immune responses are known as antigens. Immunity has specificity for certain antigens and memory of previously encountered antigens so that the second encounter gives an even faster and harsh response. The body has to decide if something is part of itself or if it is foreign and antibodies are only released by specific cells for specific antigens. The cell identifies these antigens by antigen specific receptors on the cell membrane. In the membrane of cells are MHC antigens. This stands for major histocompatability complex. This is unique to every person. These MHC molecules help T cells and B cells recognize that an antigen is foreign. This is very important to the beginning of an immune response.

T cells and B cells are type of white blood cells that attack bacteria or viruses. T cells begin in the bone marrow. Once the T Cell differentiates, it produces antigen specific receptors and becomes antigen dependant. When it is activated by a certain antigen, it differentiates and becomes a killer T Cell. As a killer T cell, the cell leaves the lymph nodes and goes to the blood stream where it clones itself and attacks. The killer t cells have receptors for specific antigens and MHC proteins. If it identifies in passing that the MHC protein fits its receptor, then it keeps moving. If not, then it attacks. Cells which are infected manufacture viral proteins, but still maintain their MHC markers. The killer t cell notices that that there is a viral protein as well as an MHC-1 and if it is infected with a matching antigen that the killer t cell has a receptor for it, then it will know that even though this is part of self, it is being attacked by a foreign object and will attack it. The killer t cells lock onto the MHC and viral protein and produce perferin which punches holes and sends granules which explode inside the cell and instructs self destruction to the nucleus.

B cells do not exit into the blood stream, but rather remain in the lymph nodes. The virgin b cells are undifferentiated cells. B cells are activated or sensitized once in contact with specific antigens and become plasma b cells. Once they are plasma b cells, they are then antigen dependant. Once they become plasma b cells, and come into contact with a specific antigen, they sprout antibodies on their surface as well as clones. All these clones also produce the same antibodies. The antibodies are then released into the bloodstream, while the plasma b cells continue to clone and produce more antibodies. B and t cells that remain become memory cells that are programmed to be ready to respond the next time there is an attack by the same antigen.


APCs are Antigen Presenting Cells. These cells have the eaten the antigen and display and present them by synthesizing a modified form of an MHC marker. This is a type II marker. It’s a combo on the surface of the MHC and the antigen. Microphages carry this combo out to t and b cells to the lymphatic system. B cells can be activated by direct contact by unprocessed antigens, meaning the not eaten by macrophage ones, and processed antigens, meaning ones attached to APCs. T cells only recognize antigens with APCs attached.

Helper t cells are required for co stimulation for the t and b cells. They reside in the lymph nodes and do not kill anything. They become activated by APCs. These are the cells that HIV targets. Eventually the helper t cells stop doing their job with HIV present and there is no more immune system, since the t cells and b cells are helpless without the helper t cells.

pictures taken from:
yaflamingalah.wordpress.com/category/health/
http://hr-is-back.blogspot.com/2008_07_01_archive.html
www.biooncology.com

Getting in the Heart

We are now going to go over the heart. This is an extremely vital part of the body.

The heart is split into two halves by the cardiac septum. Within these two parts, right and left, they are split again into the right and left atrium (top) and the right and left ventricles (bottom). The right atrium and ventricle are connected by a valve called the tricuspid valve. It is made up of three flaps that open from pressure from blood filling up in the right atrium and also from an electrical charge. The left atrium and left ventricle are connected by a mitral valve which opens the same way as the tricuspid valve. On the right side of the heart, blood flows from the vena cava to the right atrium, through the tricuspid valve, to the right ventricle, and out to the lungs. On the left side, blood flows from the lungs, to the left atrium, to the mitral valve, to the left ventricle, and out to the body. The left side of the heart is bigger and has to work much harder because it has to distribute blood all over the entire body.

To detail the cardiac cycle, I’m going to follow the route of blood. Because this is a cycle, it would work to start at any point, but I will start with the right atrium. Blood enters the right atrium from two areas, inferior vena cava and superior vena cava. While the blood is in the atrium, there is an electrical charge that squeezes the atrium and forces blood through the tricuspid valve and into the right ventricle. The ventricle then contracts and applies pressure to the blood. This pressure closes the tricuspid valve. The blood is then pushed out of the ventricle, through the pulmonary artery trunk, which splits into right and left pulmonary and goes into the right and left lungs. Blood passes through capillaries and air sacs and dumps carbon dioxide and picks up oxygen in the lungs. Blood is now oxygenated and goes out through the pulmonary vein. Blood then comes through the pulmonary vein to the left atrium and enters the left ventricle in the same way as into the right ventricle, but this time, the blood is passing through the mitral valve. From the ventricle, the blood goes through an aortic valve to the ascending aorta to the aortic arch and then is distributed all over the body. In the body, the blood delivers oxygen and picks up Co2. The blood is now deoxygenated and reenters the right atrium from the vena cava. Then the cycle repeats. One heartbeat is comprised of the atria contraction and ventricle contraction.

Because the heat pumps based on an electrical impulse, it would be helpful to understand where this impulse comes from. At the top of right atrium, there is an SA Node which sets off a sequence of events by generating electrical current. This current is what contracts the atrium. In the heart muscle wall surrounding the atria, there is a barrier that keeps the signal only within the atria. On the cardiac septum, there is an AV Node. There are bundles of his (AV bundles), which are bundles of fibers coming out of the AV Node. Out of these, there are fibers, called purkinje fibers, which spread out along the ventricles. The AV Node stimulates the fibers to contract the ventricles. The AV Node gets the energy from the contraction of the atria which hits the AV Node. The fibers are conductive and slow the current to delay the signal so that the atria have enough time to complete their contraction before the ventricles begin their contractions.

To monitor the heat, there is a test called an Electrocardiogram. It consists of a P wave, a QRS complex, and a T wave. The P wave is a signal from the atrium, and the QRS complex and the T waves are signals from the ventricle. At first, we see polarization, which is a static (resting) while the heart is electrically charged. Then we see depolarization, a discharge of electrical energy. This is followed by a repolarization, a recharge to polarization. The P wave is the depolarization of the atrium. The QRS complex is ventricular depolarization corresponding to the ventricular contraction. The T wave is the repolarization of the ventricular system, diastole (relaxation).

When we think about what a heart sounds like, we know that there is a silence, followed by two bumps, then silence again. What we just went over corresponds with these sounds. The silence is when the atria cycle is occurring, the first sounds is from the tricuspid and mitral valves and the second bump is the semi-lunar valves from the blood exiting the heart. An example of an abnormal heart sound would be a murmur, which sounds like a gurgle or a hissing. This represents a leaky valve in the heart.

Blood pressure management is very important in regards to the heart and healthy blood flow. Blood pressure tests measure the systolic pressure and the diastolic pressure. The systolic pressure is the pressure in the artery. The number that is measured shows the maximum pressure in that artery during left ventricular systole. The diastolic pressure is the elastic recoil drop of pressure. The number that is measured here shows the minimum to which pressure drops in the same artery during left ventricular diastole.



(image from wikipedia.com)

The Autonomic Nervous System

The autonomic nervous system (ANS) operates below levels of consciousness. It monitors and controls all basic life processes. The ANS is a motor system with 3 target tissues; smooth muscles, glands (exocrine and endocrine), and cardiac muscles.

The autonomic nervous system is organized into pre-ganglionic and post-ganglionic neurons. Synapses between the pre and post-ganglionic neurons are made in the autonomic ganglia. Pre-ganglionic neurons of both divisions, sympathetic and parasympathetic, have their cell bodies in the central nervous system, while post-ganglionic neurons have their cell bodies in the autonomic ganglia and synapse on various organs. The sympathetic ganglia are located in the sympathetic trunk along the vertebral column, while the parasympathetic ganglia are located in or near the target organs.

The ANS contains higher autonomic centers, including the hypothalamus, which monitors blood and hormones, as well as coordinates signals to other centers. The hypothalamus contains the temperature regulation center, as well as the thirst and food intake regulation centers. The ANS is divided into the sympathetic and parasympathetic nervous systems. The sympathetic division is for immediate survival, instant reactions, and instant change. The parasympathetic works to keep a homeostatic flow within the body and focuses on long term survival. When the sympathetic system is activated, it increases heart rate, force of heart beat, blood pressure, adrenaline, respiration, and decreases renal and digestive functions. The parasympathetic system decreases heart rate, respiratory rate, blood pressure, and increases digestive and renal functions.

The sympathetic system is made up of two types of ganglia. There are sympathetic trunk (chain) ganglia and collateral ganglia (in the abdominal cavity). The signal comes from a pre-ganglionic neuron to the ganglion. From this ganglion, the signal can synapse with 20 or more post-ganglionic neurons. This is known as amplification. The post-ganglionic neurotransmitter output is nor-epinephrine. There is also adrenaline releases by a gland on the kidney known as the adrenal medulla.

The parasympathetic nervous system focuses on rest and regeneration. The main functions are salivation, lacrination, urination, defecation, and digestion. It tends to be slow acting; organ by organ. This system has much less amplification than the sympathetic system.

The main neurotransmitters of the autonomic nervous system are acetylcholine and norepinephrine. Acetylcholine is released by the pre-ganglionic neurons in both the sympathetic and parasympathetic divisions. Norepinephrine is released by the post-ganglionic neurons of the sympathetic division, while acetylcholine is released by the post ganglionic neurons of the parasympathetic division.