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PHGY 209 > BLOOD > Flashcards

BLOOD Flashcards

1
Q

What percentage of the body mass is blood?

A

7%

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2
Q

How many litres of blood are in the body?

A

5L

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3
Q

What are the functions of Blood? (3)

A

Transport
Acid-Base Balance
Protective

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4
Q

What are the transport blood functions?

A

Nutritive, Respiratory, Excretory, Hormone Transport

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5
Q

What are the acid-base balance blood functions?

A

Regulation (normal ph range of 7.30-7.45)

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6
Q

What are the protective blood functions?

A

Some blood cells, and some blood proteins

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7
Q

What is blood composed of?

A

Plasma, Buffy Layer, RBCs

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8
Q

Normal Blood Volume

A

Normovolemia

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9
Q

Lower Blood Volume

A

Hypovolemia

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10
Q

Higher Blood Volume

A

Hypervolemia

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11
Q

What is the composition of plasma?

A 
90% water
Ions (0.9% NaCl)
Nutrients 
Respiratory Gases
Proteins
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12
Q

3 Types of plasma proteins

A

Albumins. Globulins, Fibrinogen

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13
Q

Hematocrit

A

Percentage of Blood Volume occupied by Red Blood Cells

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14
Q

4 ways to separate Plasma Proteins

A
  1. Differential Precipitation by salts
  2. Sedimentation in an ultracentrifuge
  3. Electrophoretic Mobility
  4. Immunological Characteristics
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15
Q

What is electrophoresis?

A

Fractionation method based on the movement of charged particles along a voltage gradient

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16
Q

Rate of Migration

A

is influenced by # and distribution of charges and molecular weight of each protein

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17
Q

% of Albumins

A

60

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18
Q

% of Globulins

A

35

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19
Q

% of Fibrinogen

A

5

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20
Q

Origin of plasma proteins in the liver?

A

Albumin, Fibrinogen, a1,a2, B Globulin

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21
Q

Origin of plasma proteins in the lymphoid tissue?

A

Y globulin

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22
Q

The ___ is the origin of each type of plasma protein except Y globulins

A

liver

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23
Q

What happens to plasma proteins if the liver is diseased

A

plasma proteins decreased

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24
Q

What happens to plasma proteins during a renal disease?

A

decrease of Albumin

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25
Q

What happens to plasma proteins during a bacterial infection?

A

increase of Y (gamma) globulin

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26
Q

Net Flow

A

for water to move

the difference in osmotic pressure

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27
Q

Only __________ solutes contribute to the effective osmotic pressure

A

Non-Diffusible

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28
Q

What solutes do not contribute to the effective osmotic pressure? Why?

A

Diffusible

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29
Q

Plasma Proteins are diffusible/non-diffusible

A

non-diffusible

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30
Q

Exerting an osmotic effect

A

colloidal osmotic pressure

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31
Q

What is the colloidal osmotic pressure of plasma?

A

25 mm Hg

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32
Q

What happens when the colloidal osmotic pressure of plasma increases?

A

water flows into plasma

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33
Q

What happens when the colloidal osmotic pressure of plasma decreases?

A

water will flow into ISF

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34
Q

What is the role of plasma proteins? (3)

A
  1. Determines the distribution of fluid between the plasma and ISF by controlling transcapillary dynamics
  2. Contribute to the viscosity of plasma by maintaining blood pressure
  3. Contribute to the buffering power of plasma to maintain normal pH 7.30-7.45
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35
Q

Is there protein diffusion across the capillary wall

A

No protein diffusion

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36
Q

What is the major contribution to the colloidal osmotic pressure?

A

No protein diffusion across the capillary wall

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37
Q

What does the colloidal osmotic pressure of plasma determine?

A

Amount of water into or out of capillaries

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38
Q

Bulk Flow

A
  • hydrostatic pressure difference between the compartments

- flow of molecules subjected to a pressure difference

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39
Q

2 Transcapillary Dynamics

A

Filtration

Osmotic Flow

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40
Q

What does filtration do?

A

tends to push out the fluid from inside the capillaries

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41
Q

What does osmotic flow do?

A

due to plasma proteins and tend to pull in or retain fluid inside capillaries

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42
Q

The magnitude of bulk flow

A

hydrostatic pressure difference

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43
Q

What type of forces are filtration and osmotic flow?

A

starling forces

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44
Q

what do starling forces determine?

A

The distribution of ECF volume between the plasma and ISF

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45
Q

Diffusion

A

The exchange of nutrients, gases, and wastes across the capillary wall

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46
Q

The main organ in the circulatory system

A

Heart

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47
Q

Capillary Bed

A

the site where exchanges take place between plasma and ISF

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48
Q

Arterial

A

Blood enters capillaries

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49
Q

Venous

A

Blood exits capillaries

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50
Q

Net filtration pressure

A

the total pressure that promotes filtration

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51
Q

Net absorption pressure

A

the total pressure that promotes absorption

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52
Q

where do exchanges take place?

A

along the whole length

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53
Q

What percentage of fluid filtered out is reabsorbed directly back into the capillary?

A

90%

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54
Q

What percentage of fluid filtered out is drained by lymphatic vessels?

A

10%

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55
Q

Lymphatic System

A
  • network of blind-ended terminal tubules
  • coalesce to form lymphatic vessels
  • converge to form large lymphatic ducts
  • drain into large veins in the chest
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56
Q

Order of plasma protein concentrations

A

Fibrinogen < Globulins < Albumin

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57
Q

Order of plasma protein molecular weight

A

Albumin < Globulins < Fibrinogen

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58
Q

Order of plasma protein C.O.P

A

Fibrinogen < Globulins < Albumin

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59
Q

Most abundant plasma proteins

A

Albumin

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60
Q

Proteins exert osmotic pressure

  • related to
  • inversely related to
A

related to concentration

inversely related to molecular weight

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61
Q

Factors of Transcapillary Dynamics (4)

A
  1. hydrostatic pressure
  2. C.O.P
  3. capillary permeability
  4. lymphatic drainage
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62
Q

Edema

A

Accumulation of excess fluid in the interstitial spaces

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63
Q

Conditions that lead to edema

A

increased hydrostatic pressure
decreased plasma protein - (C.O.P)
increasing capillary permeability
obstruction of lymphatic drainage

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64
Q

Why does hydrostatic pressure increase?

A

Net filtration increases

Net absorption decreases

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65
Q

Why does C.O.P. decrease?

A

Failure to synthesize plasma proteins (Liver disease)
Loss of protein (Kidney disease)
Severe protein malnutrition (KWASHIORKOR)

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66
Q

Why does capillary permeability increase?

A

The capillary wall becomes more permeable

  • more plasma proteins escape into ISF
  • which exert an oncotic effect
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67
Q

How does lymphatic drainage become obstructed?

A

Elephantiasis resulting from parasite infestation

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68
Q

Fibrinogen and some globulins are essential to _________

A

clotting

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69
Q

Y-globulin provides

A

specific resistance to infection

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70
Q

Albumin and some globulins act as

A

carriers for lipids, minerals, hormones

- cholesterol, iron, steroid hormones

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71
Q

Types of Blood Cells

A

Red Blood Cells - erythrocytes
Platelets - thrombocytes
White Blood Cells - Leukocytes

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72
Q

Size of Red Blood Cells

A

7.2μ

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73
Q

Size of Platelets

A

2-3μ

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74
Q

Size of White Blood Cells

A

10-18μ

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75
Q

Order the size of the 3 Blood Cells

A

Platelets < Red Blood Cells < White Blood Cells

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76
Q

The lifespan of Red Blood Cells

A

120d

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77
Q

The lifespan of Platelets

A

7-8d

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78
Q

The lifespan of White Blood Cells

A

hrs-yrs

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79
Q

Cytokines

A

substances that are released by one cell and affect the growth and development and activity of another cell

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80
Q

What do cytokines influence

A

Proliferation and differentiation of blood cell precursors - hematopoietic growth factors

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81
Q

Prenatal Sites of Hematopoiesis

A

Liver and spleen

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82
Q

Postnatal Sites of Hematopoiesis

A

Axial skeleton, distal long bones, flat bones of skull, shoulder blades, pelvis, vertebrae, sternum, ribs, rounded end of long bones

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83
Q

Complete blood count

A

RBC, WBC, platelet, Hb concentration

84
Q

Function of RBCs

A

facilitate the transport of respiratory gases between lungs and cells

85
Q

What are blood cells derived from?

A

Multipotential stem cell, committed stem cells

86
Q

What is the RBC shape

A

biconcave disk

87
Q

What is the RBC shape due to?

A

presence of (spectrin) a fibrous protein

88
Q

Advantage of the biconcave disk

A

maximal surface area and minimal diffusion distance for its volume
a high degree of flexibility

89
Q

What is the benefit of the high degree of flexibility of biconcave disk shape

A

allows cells to squeeze through narrow capillaries

90
Q

Cell size and shape can change in _______ states

91
Q

RBC have no __________

A

subcellular organelles

92
Q

True/False: In RBC, the rate of production = the rate of destruction

93
Q

Composition of RBC

A

Water, Hb, Lipids, proteins and ions

94
Q

Structure of Hemoglobin Structure

A

Betta chain, alpha chain, Heme, Iron

95
Q

How does RBC generate energy?

A

ATP anaerobically

96
Q

RBC have important _____ systems

97
Q

Glycolytic Enzymes

A

Generate energy

98
Q

Carbonic Anhydrase

A

CO2 Transport

99
Q

Each molecule of Hb can bind to ___ O2 molecules

100
Q

In lungs, Hb becomes _____

A

saturated with O2

101
Q

In tissues, O2 ______

A

dissociates from Hb

102
Q

Hemoglobin Functions

A
  • Transport of O2
  • Transport of small amounts of CO2 –> attached to polypeptide chains
  • Act as a buffer
103
Q

Factors affecting Hemoglobin to bind and release O2 (5)

A
  1. Temperature
  2. Ionic composition
  3. pH
  4. pCO2
  5. Intercellular Enzyme Concentration
104
Q

Red Cell Precursors Differentiation

A

Decrease in size, loss of nucleus, progressive accumulation of Hb

105
Q

What can an injection of bone marrow stem cells reconstitute?

A

All hematopoietic cell types

106
Q

Myeloid and lymphoid stem cells are under the influence of

A

HGFs (cytokines)

107
Q

Reticulocytes have some ______ ___

A

Some residual RNA

108
Q

Normal Reticulocytes Count (meaning and %)

A

amount of effective erythropoiesis in bone marrow, <1 %

109
Q

What is a reticulocyte?

A

immature RBC

110
Q

Factors determining # of RBCs

A

O2 requirements

O2 availability

111
Q

Erythropoietin

A

a glycoprotein hormone/cytokine produced largely by the kidney (renal cortex)

112
Q

Release of Erythropoietin

A

stimulated by hypoxia

  • from decreased RBC count
  • decreased O2 availability
  • increased tissue demand for O2
113
Q

Hypoxia has been produced by

A

recombinant DNA technology

114
Q

Regulation of Erythropoietin

A
  • To maintain homeostasis

- Erythropoietin released in presence of hypoxia stimulates the bone marrow to produce more RBCs

115
Q

Erythropoietin is a ________ feedback loop

116
Q

Hormonal effects on erythropoietin

A
  • Testosterone increases the release of erythropoietin, increases the sensitivity of RBC precursors to erythropoeitin
  • Estrogen has opposite effects
117
Q

Lifespan of RBCs

118
Q

Can anything prolong the RBCs lifespan

119
Q

How is old RBCs recognized and removed from circulation?

A

By highly phagocytic cells (macrophages)

120
Q

What happens to Bilirubin after macrophage?

A

Liver –> intestimal tract

121
Q

What happens to Globin after macrophage?

A

Amino acid pool

122
Q

What happens to Iron after macrophage?

A

Transferrin –> ferritin storage –> bone marrow –> reused in RBC

123
Q

What is jaundice?

A

yellowing of the skin

124
Q

Jaundice is due to _________

A

hyperbilirubinemia

125
Q

Causes of Jaundice (3)

A

exessive hemolysis
hepatic damage
bile duct obstruction

126
Q

Clinical indices

A

Number of RBCs
Amount of Hb
Hematocrit (Ht)

127
Q

Hematocrit

A

Percentage of Blood Volume occupied by Red Blood Cells

128
Q

Anemia

A

decrease in oxygen-carrying capacity blood

129
Q

Polycythemia

A

Less plasma volume

130
Q

Physiological Polycythemia

A

increased physical activity
at high altitudes
chronic lung disease
heavy smoking

131
Q

Pathological Polycythemia

A

Tumours of cells producing Erythropoietin

Unregulated production by Bone Marrow

132
Q

What results from polycythemia

A

increase blood viscosity

blood clots

133
Q

What results from anemia

A

decreased RBC count

Hb Content

134
Q

What do subjects of anemia look like?

A

pale, tired, weak

135
Q

Microcytic

136
Q

Normocytic

137
Q

Macrocytic

138
Q

Normochromic

139
Q

Hypochromic

140
Q

Causes of Amenias

A
  1. Diminished Production
  2. Ineffective Maturation
  3. Increased Destruction
141
Q

Diminished Production results from:

A 
Abnormal site (radiation, drugs)
Abnormal stimulus (renal disease)
Inadequate raw materials (iron deficiency)
142
Q

Ineffective Maturation results from:

A

Deficiencies of Vitamin B12 and Folic Acid

143
Q

Where does Vitamin B12 absorption occur?

A

Intrinsic Factor Deficiency
- pernicious anemia
in ileum

144
Q

Increased Destruction results from:

A

toxins, drugs, and antibodies

145
Q

The total amount of iron in the body

146
Q

Daily intake in Diet

147
Q

Where is Iron in the body? %?

A

Hb 65% Stored 30% Myoglobin 5% Enz 1%

148
Q

Hemorrhage

A

Loss of Blood

149
Q

Hematoma

A

Accumulation of blood in tissues

150
Q

Two types of hemorrhage

A 
external
internal (into tissues)
151
Q

Hemostasis

A

The arrest of Bleeding following vascular injury

152
Q

Primary Hemostasis

A

Vascular response and platelet response

153
Q

Secondary Hemostasis

A

Clot Formation

154
Q

T/F Platelet response is only important in primary hemostasis

A

False, Platelet response is important in both primary and secondary hemostasis

155
Q

Steps of Vascular Injury

A

Vasoconstriction
Platelet Plug Formation
Blood Clot Formation

156
Q

Vasoconstriction

A
  • Opposed endothelial cells stick together

- Smooth muscle cells in vessel wall respond to injury by contracting

157
Q

Platelet Response

A

Platelet Plug of white thrombus

158
Q

How does vasoconstriction occur?

A

After releasing of vasoconstricting agents

159
Q

Platelet Structure

A

2-4 um diameter
No nucleus
Many granules
Many filaments, microtubules, mitochondria, sER

160
Q

Purpose of granules

A

factors for vasoconstriction, platelet aggregation, clotting, growth

161
Q

Platelet Life Span

162
Q

Where does platelet production occur?

A

Committed stem cell in Bone marrow
Thrombopoietin mostly from liver
Platelets from Bloodstream

163
Q

Platelet factors are released and attract ______

A

more platelets

164
Q

4 steps of Platelet Plug formation

A
  1. adhesion
  2. activation and release of cytokines
  3. aggregation
  4. consolidation
165
Q

What is adhesion facilitated by

A

Von Willebrand factor

166
Q

Platelet functions (5)

A 
Release of vasoconstricting agent
form platelet plug
release clotting factors
participate in clot retratction
promote maintenance of endothelial integrity
167
Q

Petechiae

A

small red/purple spot caused by bleeding into the skin

168
Q

Abnormal primary hemostatic response

A

Prolonged Bleeding

169
Q

Prolonged Bleeding can occur from ________ and _______

A

failure of the blood vessels to constrict and platelet deficiencies

170
Q

Platelet deficiencies occur due to (2)

A

numerical <75,00/ul thrombocytopenia

functional —> congenital or acquired by drugs, toxins, antibodies

171
Q

Thrombus

A

Blood clot

172
Q

Are RBC and WBC needed for clotting?

173
Q

Clot formatrion is a function of ________

174
Q

Clotting is innitiated by injury to ________

A

blood vessel wall

175
Q

Clotting results in __________ in presence of ____

A

activation and interaction of group of plasma proteins and clotting factors in presence of calcium ions and some phospholipid agent

176
Q

Tissue Factors (prot & phospholipid) released from damaged cells (Intrinsic or Extrinsic Pathway)

A

Extrinsic Pathway

177
Q

Exposed Collagen (Intrinsic or Extrinsic Pathway)

A

Intrinsic Pathway

178
Q

Damage to the blood vessel (Intrinsic or Extrinsic Pathway)

A

Intrinsic Pathway

179
Q

Damage to tissue outside vessel (Intrinsic or Extrinsic Pathway)

A

Extrinsic Pathway

180
Q

How long does the Intrinsic Pathway take?

181
Q

How long does the Extrinsic Pathway take?

A

15-20 seconds

182
Q

How is clotting kept in check?

A

inhibitors of platelet adhesion and anticoagulants

183
Q

What do clotting pathways produce?

A

prothrombin –> thrombin

fibrinogen –> fibrin

184
Q

Generate large quantities of thrombin (Intrinsic or Extrinsic Pathway)

A

Intrinsic Pathway

185
Q

Generate rapid small amounts of thrombin (Intrinsic or Extrinsic Pathway)

A

Extrinsic Pathway

186
Q

Anticoagulants

A

naturally occurring chemicals which block one or more of the reactions of the coagulation scheme, thereby inhibiting the coagulation scheme

187
Q

Factors in Coagulation

A

Ca++
Phospholipids
Protein Plasma Factors

188
Q

Clotting Factor Deficiencies can be from _____ or ______

A

congenital or acquired

189
Q

Congenital Clotting Deficiencies

A

Hereditary deficiencies of a single factor (haemophilia)

190
Q

Acquired Clotting Deficiencies

A

Usually multifactor deficiencies

  • liver diseases
  • vitamin K deficiency
191
Q

What does clot retraction depend on?

A

presence of a contractile protein (thrombasthenia) released by platelets

192
Q

Serum

A

plasma without fibrinogen and other clotting factors

193
Q

Clot lysis (Fibrinolysis)

A

Dissolve blood clots

194
Q

Anticoagulant Drugs

A

Coumadin

Heparin

195
Q

Thrombolytic Drugs

A

Tissue plasminogen activator

Streptokinase

196
Q

Inhibitors of Platelet Adhesion

197
Q

Intrinsic Proactivitors

A

Endothelial Cell Factors

198
Q

Extrinsic Proactivitors

A

Tissue Factors

199
Q

pernicious anaemia

A

Vitamin B12 deficiency

200
Q

Classification of aplastic anaemia

A

Normocytic, Normochromic

201
Q

Classification of stimulation failure anaemia

A

Normocytic, Normochromic

202
Q

Classification of iron deficiency anaemia

A

Microcytic, Hypochromic

203
Q

Classification of Maturation

Failure Anemia

A

Macrocytic, Normochromic

204
Q

Anemia that might be accompanied by jaundice

A

Hemolytic Anemias

205
Q

Clot Retraction depends on presence of

A

contractile protein (thrombosthenin) released by platelets.

206
Q

Serum is plasma without

A

fibrinogen and

other clotting factors

PHGY 209 (10 decks)

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