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PHGY 209 > 3. Blood > Flashcards

3. Blood Flashcards

1
Q

functions of blood (3)

A
  • transport
  • acid-base balance
  • protection
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2
Q

normal pH range of blood

A

7.35 - 7.45

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3
Q

normovolemia

A

normal blood volume

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4
Q

hypovolemia

A

lower blood volume

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5
Q

hypervolemia

A

higher blood volume

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6
Q

composition of plasma

A
  • water = 90%
  • proteins =7%
  • ions
  • nutrients, respiratory gases, wastes
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7
Q

method to separate plasma proteins

A

electrophoretic mobility

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8
Q

electrophoresis factors

A
  • number and distribution of charges
  • molecular weight of each protein
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9
Q

plasma proteins (3)

A
  • albumin
  • fibrinogen
  • globulins
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10
Q

plasma proteins (except Y globulin) are synthesised in…

A

liver

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11
Q

Y globulin is synthesised by…

A

lymphoid tissue to produce antibodies

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12
Q

plasma protein in highest concentration

A

albumin: 4%

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13
Q

plasma proteins play a role in…

A

determining the distribution of fluid between plasma and ISF by controlling transcapillary dynamics

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14
Q

Colloidal Osmotic Pressure (COP)

A

only non-diffusible solutes contribute to the effective osmotic pressure

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15
Q

COP normal value

A

25mm Hg

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16
Q

if COP increases…

A

more water will flow into plasma

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17
Q

if COP decreases…

A

more water will flow into ISF

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18
Q

bulk flow/filtration

A

fluid in blood vessel under pressure so tends to push out fluid from capillaries into ISF

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19
Q

osmotic flow/COP

A

plasma proteins tend to pull in fluid inside capillaries

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20
Q

2 majors forms of fluid transport across capillary wall

A
  1. filtration/bulk flow
  2. COP/osmotic flow
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21
Q

starling forces

A

maintain the relative distribution of ECF volume between ISF and plasma at a 3:1 ratio through bulk flow and COP

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22
Q

site where exchanges between plasma and ISF take place

A

capillary bed

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23
Q

blood pressure

A

hydrostatic pressure = bulk flow

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24
Q

percentage of fluid reabsorbed back into capillaries

A

90%

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25
Q

where does 10% fluid not reabsorbed into capillaries go?

A

lymphatic system

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26
Q

each protein exerts an osmotic pressure which is (2):

A
  • directly proportional to its concentration in the plasma
  • inversely proportional to the protein’s molecular weight
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27
Q

which plasma protein contributes the most to COP?

A

Albumin (20mm Hg)

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28
Q

edema (def)

A

accumulation of excess fluid in interstitial space, leading to swelling

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29
Q

factors leading to edema (4)

A
  • increased hydrostatic pressure: more fluid moving out to ISF
  • decreased COP: more fluid moving out to ISF (from liver disease, Kwashiorkor)
  • increased capillary permeability: plasma proteins escape into ISF
  • reduced lymphatic drainage: less fluid drained from ISF (elephantiasis)
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30
Q

role of plasma proteins (3)

A
  • determining distribution of fluid between plasma and ISF by Starling Forces controlling transcapillary dynamics
  • viscosity of plasma –> contributes to blood pressure
  • buffering power of plasma: pH = 7.4
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31
Q

plasma proteins essential for clotting

A

fibrinogen + some globulins

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32
Q

Y globulin function

A

provide specific resistance to infection by producing immunoglobulins/antibodies

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33
Q

which plasma proteins act as carriers for lipids, minerals, hormones and iron?

A

albumin + some globulins

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34
Q

RBC lifespan

A

120 days

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35
Q

Platelet lifespan

A

7 days

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36
Q

WBC lifespan

A

Hours - years

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37
Q

RBC aka…

A

erythrocytes

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38
Q

platelets aka…

A

thrombocytes

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39
Q

WBC aka…

A

leukocytes

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40
Q

number of RBCs in blood

A

5 million / microliter of blood

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41
Q

biggest blood cell

A

leukocytes

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42
Q

smallest blood cell

A

platelets

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43
Q

hematopoeisis

A

all blood cells are dervied from a common multipotent/pluripotent hematopoietic stem cell

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44
Q

processes involved in hematopoiesis (2)

A
  • divison
  • differentiation
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45
Q

cytokines

A

substances released by a cell, affecting growth, development and activity of another cell

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46
Q

Hematopoietic Growth Factors (HGFs)

A

cytokines that influence the proliferation and differentiation of blood cell precursors

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47
Q

sites of hematopoeisis (prenatal)

A
  • 3-4 weeks: yolk sac
  • 4 months: liver and spleen
  • bone marrow
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48
Q

sites of hematopoeisis (postnatal)

A
  • bone marrow for entire life
  • distal long bones (until 30yo)
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49
Q

RBC function

A

facilitate transport of respiratory gases

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50
Q

RBC shape and advantages

A

biconcave disk:
- maximal surface area + minimal diffusion distance for increased diffusion efficiency
- high degree of flexibility to squeeze through narrow capillaries

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51
Q

sickle RBC

A

too thin, squeezed

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52
Q

spherocyte RBC

A

too round

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53
Q

normocytic RBC

A

7 micrometer diameter

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54
Q

microcytic RBC

A

too small

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55
Q

macrocytic RBC

A

too big

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56
Q

Complete Blood Count (CBC) includes

A
  • RBC count
  • WBC count
  • platelet count
  • hematocrit
  • hemoglobin conc.
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57
Q

RBC count is higher in…

A

males

58
Q

RBC rate of production =

A

RBC rate of destruction

59
Q

RBC composition

A
  • water
  • hemoglobin
  • no nucleus
60
Q

How do RBCs function without a nucleus?

A

contain enzyme systems:
- generate energy anaerobically
- convert CO2 to bicarbonate to facilitate transport

61
Q

amount of haemoglobin contained in a RBC (%)

A

33%

62
Q

Hemoglobin (Hb) structure

A
  • 4 Heme group attached to 2 alpha and 2 beta chains
  • Fe2+ attached to Heme
  • Oxygen can attach to Fe2+
63
Q

how many O2 molecules can 1 Hb carry?

A

4

64
Q

HbO2

A

Hb combined with Oxygen

65
Q

DeoxyHb

A

when Oxygen is released from Hb

66
Q

Hemoglobin functions (3)

A
  • transport O2
  • transport CO2
  • act as a buffer
67
Q

O2 carrying capacity of blood

A

20mol O2 / 100ml blood

68
Q

Factors affecting ability of Hb to bind/release O2: (5)

A
  • temperature
  • ionic composition
  • pH
  • CO2
  • intracellular enzyme concentration
69
Q

erythropoiesis

A

production of RBCs

70
Q

reticulocyte

A

newly produced RBC, becomes a regular RBC after 24h

71
Q

normal reticulocyte %:

A

< 1% of RBCs

72
Q

RBC precursor proliferation (3)

A
  • decrease in size
  • loss of nucleus and organelles
  • accumulation of Hb
73
Q

factors determining number RBCs (2)

A
  • O2 requirements (exercise)
  • O2 availability (high altitude)
    -> RBC increase in numbers as oxygen decreases
74
Q

Erythropoietin (EPO)

A

glycoprotein hormone/cytokine which increases RBC production

75
Q

Erythropoietin stimulated by…

A

hypoxia: low oxygen
i.e. decreased RBC count, decreased O2 availability, increased tissue demand for O2

76
Q

EPO function

A
  • stimulate proliferation
  • accelerate maturation
77
Q

Regulation of erythropoiesis process:

A
  1. hypoxia detected in kidney
  2. kidney releases more EPO
  3. Increased EPO in plasma stimulates RBC production in bone marrow
  4. no more hypoxia detected as kidney senses increased O2
  5. kidney decreases release of EPO: NEGATIVE feedback loop
78
Q

testosterone effect on EPO

A

increases EPO release and sensitivity of RBC precursors to EPO

79
Q

oestrogen effect on EPO

A

decreases EPO release and sensitivity of RBC precursors to EPO

80
Q

Destruction of RBCs through phagocytosis

A
  • 120 days max lifespan
  • old RBCs recognised and engulfed by macrophage (liver and spleen)
  • RBC components digested and recycled
81
Q

RBC Globin recycling

A

amino acid pool

82
Q

(RBC) Iron (Fe) recycling

A

stored as Transferrin in the liver, spleen and gut

83
Q

(RBC) Hemoglobin recycling

A

broken down to Heme and stored as bilirubin in liver to then be excreted

84
Q

normal bilirubin concentration

A

1mg/dl

85
Q

bilirubin > 1mg/dl

A

jaundice (common in newborns)

86
Q

causes of non-neonatal jaundice (3)

A
  • excessive hemolysis: too much bilirubin produced
  • liver damage: bilirubin can’t move down liver so backed up into blood cells
  • bile duct obstruction: bilirubin can’t be excreted so backed up into blood cells
87
Q

polycythemia

A

RBC production > destruction

88
Q

anemia

A

RBC production < destruction

89
Q

high hematocrit reasons

A
  • dehydration
  • polycythemia
90
Q

low hematocrit reasons

A
  • fluid retention
  • anemia
91
Q

Hb value in polycythemia

A

> 18g% Hb

92
Q

issue with polycythemia

A

increases blood viscosity which can lead to blood clots

93
Q

2 types of polycythemia

A
  • physiological
  • pathological
94
Q

physiological polycythemia

A

normal body response, secondary effect that occurs due to higher O2 needs or lower O2 availability

95
Q

physiological polycythemia caused by: (4)

A
  • high altitudes
  • increased exercise
  • heavy smoking
  • chronic lung disease
96
Q

pathological polycythemia

A

primary effect that occurs due to a problem in the body

97
Q

pathological polycythemia causes: (2)

A
  • tumors of cells producing EPO
  • unregulated RBC production by bone marrow
98
Q

anemia (def)

A

decrease in oxygen-carrying capacity of blood

99
Q

Hb (%) and RBC count in anemia (male)

A
  • < 4 million RBC / microliter blood
  • < 11g% Hb
100
Q

morphological anemia

A

can be due to reticulocyte production issue during development process

101
Q

morphological anemia size

A
  • microcytic: smaller
  • macrocytic: bigger
102
Q

morphological anemia colour

A

hypochromic = more pale, less Hb

103
Q

etiological anemia causes

A
  • diminished production of RBCs (3)
  • ineffective maturation (1)
  • increased RBC destruction (1)
104
Q

types of etiological anemia (5)

A
  • aplastic/hypoplastic anemia
  • stimulation failure anemia
  • iron deficiency anemia
  • maturation failure anemia
  • haemolytic anemias: RBC Survival Disorders
105
Q

aplastic/hypoplastic anemia

A
  • normocytic, normochromic RBCs
  • abnormality at bone marrow: diminished production
  • etiology: exposure to radiation, drugs
106
Q

stimulation failure anemia

A
  • normocytic, normochromic RBCs
  • etiology: renal disease –> less EPO production = diminished RBC production
107
Q

iron deficiency anemia

A
  • microcytic, hypochromic RBCs
  • etiology: increased requirement for Fe (infancy/adolescence/pregnancy) or inadequate supply of Fe (dietary, failure to absorb)
108
Q

maturation failure anemia

A
  • macrocytic, normochromic RBCs
  • due to ineffective maturation
  • etiology: vitamin B12 or folic acid deficiencies, which are required for DNA synthesis
109
Q

vitamin B12 deficiency cause by

A

Intrinsic Factor deficiency (required for B12 absorption) –> pernicious anemia

110
Q

folic acid deficiency caused by

A

dietary absence (found in leafy greens) or overcooking vegetables

111
Q

haemolytic anemias: RBC survival disorders

A
  • etiology: congenital or acquired
    1. abnormal RBC membrane structure
    2. abnormal enzyme systems
    3. abnormal Hb structure = Sickle cell anemia
112
Q

hemostasis

A

arrest of bleeding following vascular injury

113
Q

primary hemostasis involves

A
  • vascular response
  • platelet response
114
Q

secondary hemostasis involves

A

clot formation

115
Q

hemostasis process (4)

A
  1. vascular injury
  2. vasonstriction: smooth muscles contract to decrease blood loss (vascular response)
  3. platelet plug formation (platelet response)
  4. blood clot formation
116
Q

platelets contain many

A

granules

117
Q

platelets have a nucleus. True/False?

A

False

118
Q

thrombopoiesis

A

production of platelets

119
Q

thrombopoiesis (process)

A
  1. thrombopoietin stimulates platelet production
  2. cell gets larger
  3. nucleus multiplies, creating megakaryocytic containing granules
  4. cell fragments filled with granules released into bloodstream
120
Q

where is thrombopoietin produced

A

liver

121
Q

platelet plug formation process

A
  1. damaged endothelial cells: collagen exposure
  2. platelets adhere to collagen which activates and attracts more platelets
  3. cytokines released
  4. platelets aggregate, forming platelet plug (=white thrombus)
122
Q

platelet functions (5)

A
  • release vasoconstriction agents/cytokines
  • form platelet plug
  • release clotting factor
  • participate in clot retraction
  • promote maintenance of endothelial integrity
123
Q

lack of platelet condition

A

petechia

124
Q

prolonged bleeding caused by

A
  • failure of blood vessels to constrict
  • platelet deficiencies (numerical or functional)
125
Q

RBC are not necessary for blood clot formation. True/False

A

True

126
Q

2 pathways for blood clot formation

A
  • intrinsic
  • extrinsic
127
Q

intrinsic pathway

A
  • slower
  • everything needed found inside blood vessels
  • damage is to blood vessel
128
Q

extrinsic pathway

A
  • faster
  • requires proteins from outside blood vessels
  • damage is to tissue outside blood vessel
  • small amount of thrombin rapidly generated sufficient to trigger positive feedback on intrinsic pathway to generate larger thrombin quantities
129
Q

blood clot formation (process)

A
  1. damage to blood vessel (intrinsic) or damage to tissue outside vessel (extrinsic
  2. interacting plasma factors + Ca2+ + PF3 (intrinsic) or tissue phospholipids (extrinsic) recruit prothrombinase
  3. prothrombinase converts prothrombin to thrombin with Ca2+ help
  4. thrombin converts fibrinogen to fibrin
  5. fibrin cross-linked to factor 8, forming blood clot (=red thrombus)
130
Q

coagulation factors

A
  • Ca2+
  • phospholipids
  • protein Plasma Factors (PF)
131
Q

which coagulation factors can be present in limiting amounts

A

protein Plasma Factors (PF)

132
Q

Single factor Hereditary PF deficiencies

A

haemophilia: factor 8 deficiency

133
Q

Multi factor PF deficiencies

A

liver disease or vitamin K deficiency (co-factor)

134
Q

Clot retraction purpose

A

consolidate clot making it more stable since smaller size

135
Q

clot retraction requires…

A

thrombosthenin, a contractile protein released by platelets

136
Q

clot lysis: fibrinolysis =

A

thrombolysis

137
Q

clot lysis process

A
  1. plasminogen activator released by intrinsic and extrinsic proactivators
  2. plasminogen broken down into plasmin by plasminogen activator
  3. plasmin breaks fibrin down into fibrin fragments
138
Q

factors that affect clotting (3)

A
  • inhibitors of platelet adhesion, i.e. aspirin
  • anticoagulants
  • thrombolytic drugs
139
Q

anticoagulants (def + examples)

A

chemicals that block reactions of the coagulation scheme
-> coumarin blocks synthesis of Prothrombin, PF 7, 9 and 10
-> heparin promotes inhibition of thrombin activation and action

140
Q

thrombolytic drugs (function +examples)

A

promote clot lysis
-> Tissue Plasminogen Activator (t-PA)
-> Streptokinase

PHGY 209 (6 decks)

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