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Physiology 209 > Blood > Flashcards

Blood Flashcards

1
Q

Blood functions

A
  1. Transport
    - Nutritive
    - Respiratory
    - Excretory
    - Hormone transport
    - Temperature regulation
  2. Acid-Base Balance
    - normal pH range 7.30-7.45
  3. Protective
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2
Q

Accounts for what percent of body mass?

A

Account for 7% of body mass

~5 L

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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

Total Blood Volume occupied by blood and Plasma

A

blood ~2.25 L

plasma ~2.75L

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7
Q

Composition of Plasma

A
  1. > 90% water
  2. Na+, K+ , (Ca++, Mg++)
    Cl-. HCO3-, (PO4–)
  3. Glucose, amino acids, lipids, O2, CO2
  4. Proteins (colloids) = 7%g
    Albumins
    Globulins
    Fibrinogen
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8
Q

Separating Plasma Proteins

A
  1. Differential Precipitation by Salts
  2. Sedimentation in Ultracentrifuge
  3. Electrophoretic Mobility
  4. Immunological Characteristics
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9
Q

Electrophoresis

A
  • fractionation method based on movement of charged particles along a voltage gradient
  • rate of migration is influenced by the number and distribution of charges and by MW of each protein.
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10
Q

Origin of Plasma Proteins

A

Liver: Albumin, Fibrinogen, alpha1 and 2, Beta globulins

Lymphoid Tissue produces Y globulin

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11
Q

Plasma Proteins Properties

A

Albumin, 69 MW, 4g% conc.
Globulin, 90-800 MW, 2.7g%
Fibrinogen 350 MW, 0.3g%

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12
Q

Role of Plasma Proteins

A
  1. Major role in determining the distribution of fluid between the plasma and the ISF compartments by controlling transcapillary dynamics.
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13
Q

What does Plasma have more of than ISF, in regards to make up?

A

Plasma and ICF both have somewhat equal conc. of Na, K, Cl, HCO3.

Plasma has more protein than ISF!

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14
Q

Colloidal Osmotic (Oncotic) pressure (C.O.P.) of plasma

A

Only non-diffusable solutes contribute to the effective Osmotic Pressure of a solution

Diffusible solutes do not contribute

Plasma Proteins are non-diffusible , therefore, they can exert an osmotic effect.

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15
Q

Osmotic flow

A

tends to “pull in” or retain fluid inside the capillaries.

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16
Q

Starling Forces

A
  1. Filtration

2. Osmotic Flow

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17
Q

How much fluid filtered out is reabsorbed directly back into capillaries?

A

90% reabsorbed

10% is drained by lymphatic vessels

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18
Q

Lymphatic System

A

-A network of blind-ended terminal Tubules, which coalesce to form larger lymphatic vessels, which converge to form large lymphatic ducts,
which drain into the large veins in the chest

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19
Q

Lymphatic Vessels

A
  • the walls of lymphatic vessels are made up of a single layer of endothelial cells
  • they are highly permeable to all ISF constituents, including proteins(which might have leaked out into the ISF from the plasma)
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20
Q

Daily Volume of fluid filtered in ISF by the Capillaries

A

20L

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21
Q

Daily Total blood flow

A

6,000 L

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22
Q

Daily Volume of fluid returned to the capillaries by absorption

A

17 L

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23
Q

Daily volume of fluid returned by lymph drainage into the capillaries

A

3 L

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24
Q

Each protein fraction exerts an osmotic pressure which is

A

i. directly related to its conc. in the plasma

ii. inversely related to the molecular Weight of that protein

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25
Q

COP of Plasma Proteins

A

Albumin ~20 mmHg
Globulins ~5 mmHg
Fibrinogen ~

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26
Q

Factors in Transcapillary Dynamics

A
  1. Hydrostatic Pressure
  2. C.O.P.
  3. Capillary Permeability
  4. Lymphatic Drainage
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27
Q

Edema

A

accumulation of excess fluid in the interstitial spaces.

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28
Q

Under which conditions can edema develop?

A
  1. Increased hyrdostatic pressure.
  2. Decreased C.O.P.
  3. Increased capillary Permeability

Increased filtration
Decrease in Net absorption

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29
Q

Causes for Decreased C.O.P.

A

a. Failure to synthesize plasma proteins

b. Severe protein malnutrition

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30
Q

Elephantiasis

A

blockage of lymphatic drainage resulting from parasite infestation

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31
Q

Role of Plasma Proteins

A
  1. Major role in determining the distribution of fluid between the plasma and the ISF compartments by controlling transcapillary dynamics
  2. Contribute to the viscosity of plasma
    (Viscosity is a contributing factor to the maintenance of BP)
  3. Contribute to the buffering power of plasma
    -normal pH range ~7.4
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32
Q

Specific Plasma Protein Functions

A

i. Fibrinogen and some globulins are essential to clotting
ii. Y-globulins (immunoglobulins) provide specific resistance to infection
iii. Albumin and some globulins act as carriers for lipids, minerals, hormones

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33
Q

Blood Cells

A
  • Red Blood Cells - Erythrocytes
  • Platelets - thromocytes
  • WBC - Leukocytes
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34
Q

Hematopoiesis

A
  • all blood cells are derived from a common multipotential (pluripotential) hematopoietic stem cell
  • an inducer will stimulate a Stem cell to progress into a certain type of stem cells

Two phases:

  1. Division
  2. Differentiation
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35
Q

Eythropoiesis

A

production of RBC

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36
Q

Thrombopoiesis

A

production of platelets

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37
Q

Leukopoiesis

A

production of WBC

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38
Q

Cytokines

A

-substances (protein or peptides) which are released by one cell and affect the growth, development, and activity of another cell

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39
Q

Hematopoietic Growth Factors (HGFs)

A

-cytokines influencing the proliferation and differentiation of blood cell precursors

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40
Q

Sites of Hematopoiesis Prenatal

A

Yolk Sac, Liver and Spleen

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41
Q

Sites of Hematopoiesis Postnatal

A
  • Distal long bones, Axial Skeleton

- Flat bones of skull, shoulder blades, pelvis, vertebrae, sternum, ribs, proxymal epiphyses of long bones.

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42
Q

Advantage of Shape of RBC (DISK)

A
  1. Maximal surface area and minimal diffusion distance for its volume (Increases the efficiency of O2 and CO2 diffusion)
  2. High degree of flexibility (Allows cells to squeeze through narrow capillaries)
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43
Q

What is there none of in a red blood cells

A

No subcellular organelles

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44
Q

RBC’s important Enzyme Systems

A

Glycolytic Enzymes –> Generate Energy

Carbonic Anhydrase –> CO2 Transport

45
Q

Carrying Capacity of blood

A

20 ml O2/ 100 mL blood.

Solubility of O2 in plasma is very low: 0.3 mL O2/100 mL plasma

46
Q

Hb Functions

A
  1. Transport of O2
  2. Transport of CO2
  3. Acts as a buffer
47
Q

What are the advantages of having Hb inside the Cell (rather than dissolved in plasma)

A

i. re Plasma Viscosity
ii. re Plasma C.O.P.
iii. re Loss via kidney

48
Q

Hemoglobin Values for Males and Females

A

female - 16g/100 mL blood

male - 14 g/100 mL blood

49
Q

How much of each gram of Hb holds when it is fully saturated

A

1.34 mL O2

50
Q

The O2 carrying capacity of blood

A

15x1.34 = 20 mL O2/100 mL blood

51
Q

Factors affecting the ability of Hb to bind and release O2

A
  1. Temp
  2. Ionic Composition
  3. pH
  4. pCO2
  5. Intracellular enzyme conc.
52
Q

Time period for Division and Differentiation of the RBC

A

3-5 days,

In circulation 24 hours

53
Q

Red Cell precursors Proliferation

A
  1. Decrease in size
  2. Lose of nucleus
  3. Accumulation of Hb
54
Q

Factors Determining # of RBCs

A
  1. O2 requirements

2. O2 availability

55
Q

How does altitude affect pO2

A

pO2 decreases with increase of altitude

56
Q

Erythropoietin

A
  • a glycoprotein hormone/cytokine produced largely by the kidney
  • if it has been purified, sequenced, gene has been cloned, and EPO has been produced by recombinant DNA technology.
57
Q

What is the stimulus for the release of erythropoietin?

A

Hypoxia: which may result from decreased RBC count, or decreased availability of O2 to blood, or increased tissue demand for O2.

58
Q

Regulation of Erythropoiesis

A

Increase in O2 supply –> decreased release of erythropoietin –> erythropoietin in plasma –> bone marrow –> increase in RBCs –> increase in oxygen supply –> back to top

59
Q

Regulation of Erythropoiesis

A

Erythropoietin, released from the kidney in presence of hypoxia, stimulates the bone marrow to produce more RBC’s, thereby maintaining homeostasis

Once there is an increase in O2 supply there is a decreased release of erythropoietin

60
Q

Negative Feedback Loop of Erythropoiesis

A

Severe accidental hemorrhage –> Less Hb available for O2 transport –> reduced supply of O2 to kidneys –> increased production and release of erythropoietin –> increased production of erythrocyte precursors in bone marrow –> increase discharge of young erythrocytes in blood –> more Hb for O2 transport –> negative feedback to stop production and release of erythropoietin.

61
Q

Erythropoietin Action

A

Pluripotent Stem Cell –> Commited Stem Cell (EPO Stimulates Proliferation) –> EPO accelerates Maturation –> Reticulocytes –> Mature RBC

62
Q

How does testosterone affect erythropoietin

A
  • increase of erythropoietin

- increase in sensitivity of RBC precursors to Erythropoietin

63
Q

How does estrogen affect erythropoietin

A

Has opposite effects of testosterone

64
Q

Life span of RBC’s

A

120 days

65
Q

Does anything prolong RBC lifespan

A

NOTHING!!!!

66
Q

How are RBC’s removed

A

Old RBCs are recognized as such and are removed from the circulation by a system of highly phagocytic cells know as macrophages (in liver and spleen)

67
Q

Jaundice

A

a medical condition with yellowing of the skin or whites of the eyes, arising from excess of the pigment bilirubin and typically caused by obstruction of the bile duct, by liver disease, or by excessive breakdown of red blood cells.

  • excessive hemolysis
  • bile duct obstruction causing bilirubin to circulate the body
68
Q

Hemolysis

A

the rupture or destruction of red blood cells

69
Q

Polycythemia

A

RBC production > destruction

70
Q

Anemia

A

RBC production

71
Q

Normal RBC g%

A

16 g%

72
Q

Polycythemia RBC g%

A

> 18g% Hb

73
Q

What causes physiological Polycythemia? (secondary of increase in O2 needs or decrease in O2 availability)

A
  • at high altitudes
  • increased physical activity
  • chronic lung disease
  • heavy smoking
  • tumors of cells producing erythropoietin
  • Unregulated production by bone Marrow
74
Q

What is the problem in polycythemia?

A

-Increase in blood viscosity

= sluggish blood flow –> blood clots

75
Q

Classification of Anemias

A

Morphologic:
1. Microcytic Normocytic Macrocytic

  1. Normochromic Hypochromic
76
Q

Normocytic

A

Normal RBC, normal size, shape HB, etc. Just abnormal amount in the plasma

77
Q

Macrocytic

A

Abnormally large RBC

78
Q

Microcytic

A

Abnormally small RBC

79
Q

Normochromic

A

form of anemia in which the concentration of hemoglobin in the red blood cells is within the standard range. However, there are insufficient numbers of red blood cells

80
Q

Hypochromic

A

red blood cells (erythrocytes) are paler than normal

81
Q

Total Amount of Iron in Body and proportions in the body

A 
4 g in total
65% Hb
30% stored
5% myoglobin 
1% enzyme
82
Q

Daily intake in Diet of Iron

A

~15-20 mg

83
Q

Daily absorption from gut (depending on need by body)

A

~1 mg Males

~2 mg Females

84
Q

How much Iron that normal erythropoiesis requires

A

25 mg Fe/d

85
Q

Iron in normal RBC destruction

A

25 mg Fe/d

1mg/d lost, 24 mg/d recycled

86
Q

What causes Pernicious Anemia?

A

Intrinsic factor deficiency, which affects Vitamin B12 absorption.
Occurs in the ileum.

87
Q

Loss of Blood - Hemorrhage

A

a. External

b. Internal (into tissues)

88
Q

Hematoma

A

accumulation of blood in tisses

89
Q

Hemostasis

A

the arrest of bleeding following vascular injury

Vascular injury –> Vasoconstriction –> Platelet Plug Formation –> Blood clot formation

90
Q

Primary Hemostasis

A

Comprised of:

  • Vascular response
  • Platelet Response

Begins within seconds of injury, lasts only minutes

91
Q

Secondary Hemostasis

A

clot formation

92
Q

Vascular Response to Injury

A
  • Opposed endothelial cells stick together

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

93
Q

Platelet Response (white thrombus)

A

platelet plug forms

94
Q

Platelet Structure

A 
~2-4 um diameter
-No nucleus
-Many granules: factors for vasoconstriction, platelet aggregation, clotting, growth, etc. many filaments, microtubules, mitochondria, sER.
~ 250,000/uL
Life Span: 7-10d
95
Q

Thrombopoietin

A

hormone produced by the liver and kidney which regulates the production of platelets.It stimulates the production and differentiation of megakaryocytes, the bone marrow cells that bud off large numbers of platelets.

96
Q

Platelet Plug Formation

A
  1. Adhesion
  2. Activation and release of cytokines
  3. Aggregation
  4. Consolidation
97
Q

Platelet Functions

A

a. Release vasoconstricting agents/ cytokines
b. Form platelet Plug (Red Thrombus)
c. Release clotting factors
d. Participate in Clot retraction
e. Promote maintenance of Endothelial Integrity

98
Q

Abnormal Primary Hemostatic Response –> Prolonged Bleeding

A
  1. Failure of Blood vessel to constrict
  2. Platelet deficiencies
    a. Numerical
    b. Functional
99
Q

How does aspirin affect TXA2

A

In small doses inhibits synthesis and release

100
Q

Thrombus

A

blood clot

101
Q

Clotting

A
  • initiated by injury to blood vessel wall
  • results in sequential activation and interaction of a group of plasma proteins/clotting factors (some acting as enzymes, others as cofactors) in the presence of Ca++ and some phospholipid agents
102
Q

The effect of small amounts of thrombin?

A

The small amounts of thrombin generated rapidly by the extrinsic scheme are sufficient to trigger its strongly positive feedback effects on the intrinsic scheme to generate larger quantities of thrombin

103
Q

Petechaie

A

a small red or purple spot caused by bleeding into the skin

104
Q

What keeps clotting in check

A

Inhibitors of platelet adhesion and anticoagulants (naturally occurring chemicals which block one or more of the reactions of coagulation scheme.

105
Q

Clotting Factor Deficiencies

A

Congenital: hereditary deficiencies (usually) of a single factor . e.g. VII (hemophilia)

Acquired: Usually multifactor deficiencies e.g.

i. Liver disease
ii. Vitamin K deficiency

*Vitamin K is a cofactor in synthesis of Prothrombin, VII, IX, X

106
Q

Thrombosthenin

A
  • contractile protein released by platelets.

- the presence of this determines the retraction of blood.

107
Q

Clot Lysis (Fibrinolysis)

A 
-break down of clots
helped via
1. Inhibitor of Platelet Adhesion(eg. Aspirin)
2. Anticoagulant Drugs (interfere with clot formation)
i. Coumarin
ii. Heparin
3. Thrombolytic Drugs (promote lysis)
i. Tissue Plasminogen Activator (t-PA)
ii. Streptokinase
108
Q

Coumarin

A

blocks synthesis of functional Prothrombin, VII, IX, X

109
Q

Heparin

A

Promotes inhibition of thrombin activation and action

Physiology 209 (9 decks)

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