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Cardiopulmonary Renal > Blood > Flashcards

Blood Flashcards

1
Q

What is blood made up of?

A

55% plasma

45% cells=99% RBC less than 1% WBCs and platelets.

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2
Q

What is blood?

A

Specialized connective tissue
Cells: erythrocytes, leukocytes, thrombocytes

Ground substance: plasma (protein rich)

Forms approx. 7-8% of total body weight

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3
Q

What are the functions of blood?

A

Functions to
-deliver nutrients and oxygen to the tissues

  • transport waste and carbon dioxide away from tissues
  • Serves as medium to transport hormones and other regulatory substances to and from tissues
  • Maintains homeostasis by acting as a buffer, thermoregulation, participates in coagulation
  • Transports humoral agents and cells of the immune system
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4
Q

How is for,action 9f blood different at different stages of life?

A

Embryonic: umbilical vesicle (yolk sac)

Fetal: liver and bone marrow

Adult: bone marrow

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5
Q

What is a hematocrit?

A

Volume of packed erythrocytes

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6
Q

What is Serum?

A

Plasma without clotting factor

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7
Q

What are the components of blood plasma?

A
  • Provides optimal pH and osmolarity for cellular mechanism
  • Contains and transports the cells and elements to the various tissues
  • 91-92% water
  • 7-8% protein
    • Albumin, globulins, fibrinogen
  • 1-2% other
    • electrolytes~ sodium, potassium, calcium etc
    • Non protein nitrogen substances~ urea, uric acid, creatine etc.
    • nutrients~ glucose, lipids and amino acids
    • blood gases~ oxygen, carbon dioxide, and nitrogen
    • Regulatory substances~ hormones and enzymes

Except for the cells and plasma proteins most of these components can easily travel through the blood vessel wall

Assist in formation of interstitial fluid
-connective tissue most similar to plasma

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8
Q

Where are plasma proteins made?

A

In the liver

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9
Q

What are the plasma proteins?

A

Albumin (most abundant)

Globulins

Fibrinogen

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10
Q

What is the function of albumin?

A

Most abundant plasma protein

  • responsible for exerting the concentration gradient between blood and the extracellular tissue fluid
    • colloid osmotic pressure (osmotic pressure on vessel wall) maintains the correct proportion 9f blood to tissue fluid volume

If a significant amount of albumin leaks out into the tissues (or is lost through the kidneys) fluid accumulates in the tissues (swollen ankles by end of the day)

-Act as a carrier protein for horm9nes, metabolites and drugs

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11
Q

What is the function of globulins?

A

Immunoglobins -antibodies

No immune globulins-helps. Maintain osmotic pressure in the blood vessels and serve as carrier proteins fir various substances including hemoglobin

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12
Q

What is the function of fibrinogen?

A

Largest of the plasma proteins and converted to fibrin as needed

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13
Q

What are the formed elements of blood?

A

Erythrocytes -99%

Leukocytes-1%

granulocytes= neutrophils, eosinophils, basophils

Agranulocytes=
-lymphocytes= T cells, B cells and natural killer cells

-monocytes

Thrombocytes(platelets)= special cell fragments

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14
Q

What is the lifespan of an erythrocytes?

A

120 days

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15
Q

Describe the shape of erythrocytes

A

Cells with no nucleus or organelles

7-8 um in diameter(histological ruler)

Biconcave dusk

  • maximizes cell surface area for gas exchange
  • flexible shape for narrow spaces
  • shape is maintained by membrane proteins

Contain hemoglobin (gives blood it’s red color) approx. 1/3 of cell’s weight it’s hemoglobin

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16
Q

How are erythrocytes stained?

A

Eosin

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17
Q

What is the function of Band 3?

A

Binds hemoglobin in erythrocyte cytoskeleton

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18
Q

What is the function of glycoprotein C?

A

Attached the underlying cytoskeleton network to the membrane in erythrocyte cytoskeleton

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19
Q

What is the function of glycosylated proteins in erythrocytes ?

A

Displays specific antigens(A,B,O)

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20
Q

How is the erythrocyte cytoskeleton organized?

A

Undergoes continual rearrangement as required

Organized into a 2-d hexagonal lattice network that gives it its unique shape and flexibility

band 4.1 or band 4.1 protein complex

Tropomyosin

Actin

Adducin

Dematin

Tropomodulin

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21
Q

Describe hemoglobin

A

4 polype0tide chains of globin a, B, d, y- structure varies

Each have iron containing heme group

The combination of chains that form the hemoglobin determines its type

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22
Q

Describe hemoglobin A(a2B2)

A
  • further divided into subtypes

- HbA1c binds irreversibly to glucose

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23
Q

Describe HbA2(a2d2) Population

A

1.5-3%

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24
Q

Describe HbF(a2y2)

A

Less than 1%

Most abundant in the fetus

Binds oxygen more strongly

Found in higher number in individuals with sickle cell and thalassemia

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25
Q

What are the main blood sampling techniques?

A

Venipuncture

Finger or heel prick

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26
Q

How is venipuncture done?

A
  • sample taken from vein with hypodermic needle & syringe
  • median cubical vein

Why not stick an artery?
-veins less pressure.

-veins are closer to surface

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27
Q

How is a finger or heel prick?

A
  • common technique for diabetics to monitor daily blood sugar
  • method used for infants
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28
Q

How is preparation of a blood smear for visualization done?

A

-Drop of blood on a slide, smeared with another slide, dried and stained

  • Wright’s stain
  • use of eosin/methylene blue (Romanovsky)
  • red (acidic), blue (basic) for staining
  • specific granules (azurophilic )(lysosomes)
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29
Q

What is anemia?

A

A lack of sufficient numbers of healthy RBC to accommodate bodily needs

May be temporary e.g., in females once a month or chronic due to an underlying condition

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30
Q

What are the symptoms of anemia?

A
  • fatigue
  • weakness
  • pale skin
  • shortness of breath
  • dizziness or lightheadedness
  • cold hands and feet
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31
Q

What is polycythemia?

A

High numbers of red blood cells in the blood

Two main causes

Primary: polycythemia Vera, a type of blood cancer

Secondary: due to an altitude or diseases that cause reduced oxygen levels

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32
Q

What are the symptoms of polycythemia?

A
  • dizziness or vertigo
  • headaches
  • excessive sweating
  • itchy skin
  • ringing of the ears
  • blurred vision
  • fatigue
  • reddish or purplish skin on the palms, earlobes, and nose
  • bleeding or bruising
33
Q

what is poikilocytosis?

A

Refers to the presence of poikilocytosis in blood

Poikilocytosis are RBCs of distorted shape (can be entirely of a different shape)

When these abnormal cells make up 10% or more of the total population, it is refferred to as poikilocytosis

34
Q

What causes poikilocytosis?

A

The various shapes can due to membrane abnormalities or due to traumatic conditions

35
Q

What is anisocytosis?

A

A blood abnormality where the red blood cells are of unequal sizes

Can be detected in peripheral smears

Can signify conditions such as anem8a and thalassemia

36
Q

What is hereditary spherocytosis?

A

Caused by a variety of molecular defects in the genes that code for spectrin, ankyrin, band 3 and band 4 proteins

These proteins which are essential for the normal shape of an erythrocyte, when deformed, results in a spherical shape of RBC than the biconcave nature of it

37
Q

What is thalassemia ?

A

Hereitary hypochromic anemia resulting from decreased a or B chains

B thalassemia-indicates decreased or absent B chains. Excessive a chains produced in compensation are unable to form tetramers

Instead, they bind to the red blood cell membranes, producing membrane damage, and at high concentrations form toxic aggregates

38
Q

What is sickle cell anemia ?

A

Genetic defect in hemoglobin molevule(Hb-S): hydrophilic glutamic acid is replaced by hydrophobic valine at point 6 in B chain

Any condition resulting in reduced oxygen levels will cause the cells with HbS to sickle

39
Q

What are leukocytes?

A

Unlike RBCs they contain a nucleus and a few organelles

Generally, have a protective function

Great motility, can move from the blood to other tissues with ease

All have azurophilic (primary) granules
-Large lysosomes containing lysosomal acid hydrolases and other enzymes depending on the type of leukocyte

  • Not visible on light microscopy
  • Generally function to destroy and foreign body engulfed by the cell
40
Q

What are the two major types of leukocytes?

A

Granulocytes: those with both azurophilic and specific (secondary granules) that can be observed that can be observed on light microscopy.
-neutrophils, eosinophils, and basophils

Agranulocytes: those with only azurophilic granules
-lymphocytes and monocytes

41
Q

How much of circulating leukocytes consist of nutrophils?

A

60-70%

42
Q

Describe the physical features of the neutrophils

A

Diameter is about 10-12 um

Polymorphonuclear (PMN)

- Nucleus - 2 to 4 lobes connected by thin nuclear strands
  - older cells have more lobes
  - young cells called band cells. (horseshoe shape)
  - inactive X chromosome in females forms a Barr body

Contains 3 types of granules

43
Q

What leukocytes are the first to react en masse to tissue damage?

A

Nutrophils

44
Q

What leukocytes are active phagocytes especially for bacteria?

A

Nutrophils

45
Q

What are the 3 types of granules contained in neutrophils?

A

-specific: enzymes, compliment activators and antimicrobial peptides

Azurophilic: myeloperoxidase , acid hydrolases, defensive, and Cathelicidin

Tertiary: phosohatases, metalloproteinases

46
Q

How does nutrophils treat bacteria ?

A

Bacterial phagocytosis
-lysosymes destroy/ digest bacteria

  • defensin proteins act like antibiotics & poke holes in bacterial cell walls
  • strong oxidants (bleach like) that destroy bacteria
47
Q

What percentage of circulating leukocytes are eosinophils?

A

2-4%

48
Q

Describe eosinophils physical structures

A

Diameter is 10-12 um

Nucleus - bilobed connected by a thin strand

Contains large, uniform-sized specific granules that stain eosinophilic (granule red)

Contains major proteins and enzymes

49
Q

What are the 4 major proteins in eosinophils?

A
  • Major basic proteins- confined in the crystalloid body, gives the color
  • ECP- eosinophil cationic protein
  • EPO- eosinophil peroxidase
  • EDN-eosinophil derived neurotoxin
50
Q

What enzymes are contained in eosinophils?

A

Histaminase

Sulfatase

Collagenase

Cathepsin

51
Q

What 8s the function of eosinophil?

A

Leave capillaries to enter tissue fluid

  • MBP, ECP & EPO- impart cytotoxic effect on protozoans & helminthic parasites
  • EDN causes nervous system dysfunction in parasites

Release histaminase, which neutralizes histamine

-Arylsulphatase neutralizes leukotrienes produced by basophils & mast cells

Antibody-antigen (immune) complexes internalized by eosinophils

52
Q

How much of circulating leukocytes are basophils?

A

Less than 1%

53
Q

What are the physical features 9f the basophils?

A

Diameter is 10 to 12 um

Nucleus- irregular, s-shaped,bilobed

Cytoplasm- large, variable-sized, granules stain blue/purple with basic dyes- obscure the nucleus

Specific granules contain - heparin (sulphate ), hisstamine & leukotrienes, IL-4 & IL 13
-High levels of sulphate so give rise to basophilia of granules

54
Q

When are basophils released ?

A

Heighten inflammatory response and account for hypertensivity (allergic) reaction

55
Q

What are the functions of the basophils?

A

Leave capillaries & enter the CT

Release:
Heparin-anticoagulant
Histamine-vasoactive substance causing vasodilation
Leukotrienes- prolonged constriction of smooth muscles in pulmonary airways
Interleukin 4 & 13- promote synthesis of IgE antibodies

56
Q

What is the percentage of circulating leukocytes are lymphocytes?

A

20-25%

57
Q

Describe the physical features of lymphocytes

A

Diameter can very between 6-30 um

Classified as small, medium and large sized lymphocytes

Nucleus- dark, oval to round

Cytoplasm thin, pale blue rim (of varying size)around nucleus

- contain azurophilic granules
- ribosomes
58
Q

Where are lymlh9cytes found?

A

Blood as well as lymph

59
Q

Lymphocytes are capable of…

A

Recirculation

60
Q

Lymphocytes are…

A

Immunicompetent cells (can recognize and respond to antigens)

61
Q

What are the types of lymphocytes?

A

T cells

B cells

Natural killers

62
Q

What Are the characteristics of T cells?

A

Differentiate in thymus

Cell mediated immunity

Long life span

Attack viruses, fungi, transplanted organs, cancer cells & some bacteria

63
Q

What are the characteristics of B cells?

A

First recognized in bone marrow

  • production of antibodies
  • destroy bacteria and their toxins
  • turn into plasma cells that produces antibodies
  • Variables life span
64
Q

What are the characteristics of natural killer cells?

A

Programmed during development

  • attack many different microbes & some tumor cells
  • destroy foreign invaders by direct attack
65
Q

How much of circulating leukocytes are monocytes?

A

3-8%

66
Q

Describe the physical structures of monocytes

A

Diameter- average 18 um

Nucleus appears indented (kidney shaped)

Cytoplasm- foamy blue gray -contains azurophilic granules

Largest WBC in circulating blood

Doesn’t remain blood fir long, (only 3 days) before migrating ti tissues

67
Q

What do macrophages differentiate into?

A
  • histiocytes in connective tissue
  • alveolar macrophages (Dust cells) in lungs
  • kupfer cells in liver
68
Q

What are the functions of monocytes?

A

Take longer to get to site of inflammation, but arrive in larger numbers

-During inflammation, monocyte leave capillaries to enter that site and transform into tissue macrophage, which function as antigen presenting cells in the immune system

They phagocytose bacteria, dead cells and tissue debris following an infection

Cluster of macrophages—> giant cells at sites of chronic infection

69
Q

How much thrombocytes(platelets) are in the blood?

A

Normal blood contains 250,000 to 400,000 platelets /uL

70
Q

What is the life span of thrombocytes/platelets?

A

5-9 days

71
Q

Describe the physical features if thrombocytes/platelets

A

Measure 2-4 um in diameter

Cytoplasmic fragments from this cell result in platelet formation

Each fragment, enclosed by a pierce of cell membrane, is a platelet (thrombocytes)

Aged and dead platelets are removed by fixed macrophages in the spleen and liver

72
Q

Where are thrombocytes/platelets formed

A

In bone marrow from megakaryocytes

73
Q

What are the functions of granules in thrombocytes /platelets?

A
  • Alpha contains clotting factors and platelet derived growth factor
    • cause proliferation of vascular endothelial cells, smooth muscle & fibroblasts to repair damaged vessels

Dense has ADP, ATP Ca2+, serotonin, fibrin stabilizing factor, & enzymes that produce thromboxane A2

74
Q

What are the functions of thrombocytes/platelets ?

A

Continuous surveillance of blood vessels

Blood clot formation (hemostasis)

Clot plugs ruptured area of blood vessel

Platelets pull on the fibrin threads causing clot retraction
-trapped platelets release factor XIII stabilizing the fibrin threads

Edges of damaged vessel are pulled together

Fibroblasts & endothelial cells repair the blood vessel

Repair of injured tissues

75
Q

What causes elevation of neutrophils 60-70% ?

A

Acute bacterial infection

76
Q

What causes an increase in lymphocyte in blood?

A

20-25%, chronic infection/ cancers

77
Q

What causes an increase in monocytes ?

A

3-8% increase in fungal /viral infection

78
Q

What increases eosinophils?

A

2-4% increases in parasitic infection

79
Q

What causes an increases in basophils?

A

Below 1% increases in allergic reactions

Cardiopulmonary Renal (35 decks)

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