Blood Flashcards

1
Q

What type of tissue is blood?

A

connective

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2
Q

Plasma

A

the nonliving liquid part

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3
Q

Formed elements

A
  • the living cells
  • erythrocytes (RBCs), leukocytes (WBCs), thrombocytes (platelets)
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4
Q

What is the average blood volume in men and women?

A
  • men: 5.5 liters
  • women: 5 liters
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5
Q

Erythrocytes

A
  • most common formed element
  • 5 million RBCs in a cubic mm of blood
  • trillions in the body
  • packed with hemoglobin for O2 transport
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6
Q

Hemoglobin (Hb)

A
  • O2 loading in lungs (produces oxyhemoglobin)
  • O2 unloading in tissues (produces deoxyhemoglobin or reduced hemoglobin)
  • CO2 loading in tissues (20% of CO2 in blood binds to Hb- carbaminohemoglobin)
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7
Q

Where are RBCs formed?

A
  • in red bone marrow from hemocytoblasts or hematopoeitic stem cells
  • control of production is based on O2 levels in blood
  • in adults, kidney senses levels of O2
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8
Q

Too few RBCs leads to…?

A

tissue hypoxia

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9
Q

Too many RBCs…?

A

increases blood viscosity

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10
Q

How many RBCs are made per second?

A

> 2 million RBCs made per second

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11
Q

Balance between RBC production and
destruction depends on…?

A
  • hormonal controls
  • adequate supplies of iron, amino acids, and B vitamins
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12
Q

Erythropoietin (EPO)

A
  • if O2 levels are low (hypoxia), kidney releases erythropoietin (a hormone)
  • stimulates the hematopoietic stem cells to become erythrocytes
  • RBC count increase (due to prolonged exercise, high altitudes, and COPD)
  • direct stimulus for erythropoiesis
  • always small amount in blood to maintain basal rate (high RBCs or O2 levels depress production)
  • dialysis patients have low RBC counts due to damaged kidneys
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13
Q

Causes of hypoxia

A
  • decreased RBC numbers due to hemorrhage or increased destruction
  • insufficient hemoglobin per RBC (e.g., iron deficiency)
  • reduced availability of O2 (e.g., high altitudes, consistent vigorous activity, COPD)
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14
Q

How long do RBCs live?

A
  • about 120 days
  • old or damaged red blood cells
    are removed by the spleen and the
    liver
  • these are the most actively replaced
    cells in the body
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15
Q

What happens when RBCs are removed from blood?

A
  • hemoglobin is broken down
    into heme and globin
  • globin is a protein that is
    digested and recycled
  • heme is broken down into iron
    and bile pigments
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16
Q

What happens to iron after heme is broken down?

A
  • iron is stored in the liver and
    transported back to the red bone
    marrow as transferrin
  • bile pigments, biliverdin and bilirubin, are released into bile as waste and
    ultimately end up in feces giving fecal
    material its characteristic color
    (brownish / greenish)
  • also gives urine its usual color
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17
Q

Jaundice

A
  • occurs when excess bile pigments
    accumulate in body fluid and/or bile ducts are blocked, liver disease
  • sclera looks yellow and skin looks yellow in someone light-complected
  • about 1/3rd of newborns have jaundice (liver needs time to mature; bili lights break down bile pigments)
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18
Q

What are nutrient requirements for erythropoiesis?

A

nutrients, iron, vitamin B12, and folic acid

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19
Q

Nutrients

A

amino acids, lipids, and
carbohydrates

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20
Q

Iron

A
  • available from diet
  • 65% in Hb; rest in liver, spleen, and bone marrow
  • free iron ions are toxic (stored in cells as ferritin and hemosiderin; transported in blood bound to protein transferrin)
21
Q

What is necessary for DNA synthesis for rapidly dividing cells?

A

Vitamin B12 and folic acid

22
Q

Anemia

A
  • blood has abnormally low O2 carrying capacity
  • sign rather than disease itself
  • blood O2 levels cannot support normal metabolism
  • accompanied by fatigue, pallor, shortness of breath, and chills
23
Q

Hemorrhagic anemia

A
  • blood loss rapid (ex, stab wound)
  • treated by blood replacement
24
Q

Chronic hemorrhagic anemia

A
  • slight but persistent blood loss (hemorrhoids, bleeding ulcer)
  • Primary problem treated
25
Q

Iron-deficiency anemia

A
  • caused by hemorrhagic anemia, low iron intake, or impaired absorption
  • iron supplements to treat
26
Q

Pernicious anemia

A
  • autoimmune disease - destroys stomach mucosa
  • lack of intrinsic factor needed to absorb B12 (deficiency in B12)
  • RBCs cannot divide
  • treated with B12 injections
  • also caused by low dietary B12 (vegans)
27
Q

Renal anemia

A
  • lack of EPO
  • often accompanies renal disease
  • treated with synthetic EPO
28
Q

Megaloblastic anemia

A
  • larger, fragile RBCs
  • usually caused by low folic acid
29
Q

Aplastic anemia

A
  • destruction or inhibition of red marrow by drugs, chemicals, radiation, viruses
  • sometimes all cell lines affected
  • clotting and immunity defects
  • treated short-term with transfusions
  • long-term with transplanted stem cells, or synthetic erythropoietin (Procrit) if red marrow is okay, as in chemotherapy of metastatic cancer
30
Q

Sickle-cell anemia

A
  • hemoglobin S (one amino acid wrong in a globin beta chain)
  • RBCs crescent shaped when unload O2 or blood O2 low
  • RBCs rupture easily and block small vessels (poor O2 delivery; pain)
31
Q

How does malaria affect sickle-cell anemia?

A
  • two copies = sickle-cell anemia
  • one copy = sickle-cell trait; milder disease; better chance to survive malaria (lower O2 levels inhibit the pathogen in the blood)
  • Thalassemias (typically Mediterranean ancestry; helps with surviving malaria also)
32
Q

Polycythemia

A
  • genetic predisposition or Bone marrow cancer - excess RBCs
  • severely increased blood viscosity
  • risk of blood clotting when not supposed to
33
Q

Secondary polycythemia

A
  • less O2 available (high altitude) or EPO
    production increases - higher RBC count
  • blood doping by athletes
34
Q

Leukocytes

A
  • make up <1% of total blood volume
  • function in defense against disease
  • can leave capillaries via diapedesis (move through tissue spaces by ameboid motion and positive chemotaxis)
  • 4,800 – 10,800 WBCs/μl blood
35
Q

Leukocytosis

A
  • WBC count over 11,000/mm3
  • normal response to infection
36
Q

What are the two categories of leukocytes?

A

granulocytes and agranulocytes

37
Q

Granulocytes

A
  • visible cytoplasmic granules
  • neutrophils, eosinophils, basophils
38
Q

Agranulocytes

A
  • no visible cytoplasmic granules
  • lymphocytes, monocytes
39
Q

Neutrophils

A
  • most numerous WBCs
  • also called Polymorphonuclear leukocytes (PMNs or polys)
  • granules stain lilac; contain hydrolytic
    enzymes
  • 3-6 lobes in nucleus; twice size of RBCs
  • very phagocytic—”bacteria slayers”
  • 55-70%
40
Q

Eosinophils

A
  • red-staining granules
  • bilobed nucleus
  • granules lysosome-like
  • release enzymes to digest parasitic worms
  • role in allergies and asthma
  • role in modulating immune response
  • 1-4%
41
Q

Basophils

A
  • rarest WBCs
  • nucleus deep purple with 1-2 constrictions
  • large, purplish-black (basophilic) granules contain histamine
  • histamine: inflammatory chemical that acts as vasodilator to attract WBCs to inflamed sites
  • are functionally similar to mast cells
  • 0.5-1%
42
Q

Lymphocytes

A
  • second most numerous WBC
  • large, dark-purple, circular nuclei with thin rim of blue cytoplasm
  • mostly in lymphoid tissue (e.g., lymph
    nodes, spleen); few circulate in blood
  • crucial to immunity
  • T lymphocytes and B lymphocytes
  • 20-40%
43
Q

T Lymphocytes (T cells)

A

act against virus-infected cells and tumor cells

44
Q

B lymphocytes (B cells)

A

give rise to plasma cells, which produce antibodies

45
Q

Monocytes

A
  • largest leukocytes
  • abundant pale-blue cytoplasm
  • dark purple-staining, U- or kidney-shaped nuclei
  • leave circulation, enter tissues, and
    differentiate into macrophages
  • 2-8%
46
Q

Macrophages

A

-actively phagocytic cells
- crucial against viruses, intracellular bacterial parasites, and chronic infections

47
Q

Leukopenia

A

abnormally low WBC count—drug induced

48
Q

Leukemias

A
  • all fatal if untreated
  • cancer - overproduction of abnormal WBCs
  • named according to abnormal WBC clone involved
  • acute leukemia derives from stem cells; primarily affects children
  • chronic leukemia more prevalent in older people
49
Q
A