Blood Flashcards
Functions of blood
- Transport of dissolved gases, nutrients, hormones, salutes, ions and metabolic wastes
- Preserving acid base homeostasis
- Maintain body temperature. Distribute heat
- Clotting
- Immune functions
- Stabilize blood pressure - BV plays a role in determining this
Arterial stick
Artery collection of blood
Radial is common
-measure O2 level
Venipuncture
Collection of blood from vein
Median cubical
Why venipuncture vs arterial stick?
- Vein is thinner = easier to puncture
- Easy to locate, closer to surface
- Lower pressure - seals quicker than artery
WBC %
N, L, M, E, B
N (60-70) L (25-30) M (3-8) E (2-4) B (0.5-1)
Buffy coat
Platelets and leukocytes
Formed elements (RBC)
45%
4.8- 5.4 million
Platelets
150-400K
WBC count
5-10K
Physical characteristic
-8% body weight
-Volume: males: 5-6 L
females: 4-5 L
Ph: 7.35-7.45
Hypervolemic vs hypovolemic
Hyper is higher than normal
Hypo is lower than normal
Color: deoxygenated vs oxygenated
OXY - bright red (arterial)
DEOXY - dark red (venous)
Whole blood
When composition is unaltered
Serum
Plasma with clotting factors removed
Packed cell volume
% of blood comprised of formed elements 45% of blood volume (BV)
Hematocrit
% of blood compromised of RBC
Males: 40-54%
Females: 37-47%
Polycythemia
Abnormally high hematocrit
Makes blood viscous
Plasma %
55
Plasma composition
Water: 90-92% Plasma proteins: 7% - albumins, fibrinogens, globulins Solutes: 1% - electrolytes (Na, K, Mg, Cl, HCO, Ca) - glucose and amino acids - gases: O2 and CO2 - metabolic waste: urea, ammonia, bilirubin, uric acid, creatine - regulatory substances: hormones, enzymes and vitamins
Plasma proteins
90% made in liver
Too big to dissolve, remain in solution as colloid
(Albumins, globulins, fibrinogens)
Albumins
58%
Determines BCOP and regulates capillary exchange
Transports fatty acids and thyroid hormones
Globulins
38% Alpha: -protect against inflammation -transport thyroid and steroid hormones -coverts Fe2 -> Fe3 (take away ionic e-)
Beta:
- transferrin, transports iron
- beta lipoproteins, transports lipids
- complement proteins
Gamma:
-involved in immunity (antibodies)
Fibrinogen
4%
Clotting protein
Hematopoiesis
Formation of blood cells
- occurs in red bone marrow
- begins with hemocytoblasts
Hemacytoblast
Multi potent stem cell
Erythropoiesis vs leukopoiesis
Formation of both ‘cytes’
1st step of erythropoiesis
HEMOCYTOBLAST: can be any formed element
2nd step of hematopoiesis
ERYTHROCYTE - CFU: cell is committed to becoming an erythrocytes
3rd step of hematopoiesis
PROERYTHROBLAST: requires hormone erythropoietin
4th step of erythropoiesis
EARLY ERYTHROBLAST:
rapid synthesis of hemoglobin
5th step of erythropoiesis
LATE ERYTHROBLAST:
nucleus shrinks and is ejected with other organelles
6th step of erythropoiesis
RETICULOCYTE:
remaining organelles ejected, cell enters blood stream
7th step of erythropoeisis
ERYTHROCYTE:
mature cell now
Erythropoietin
Hormone that regulates RBC synthesis
-increases production in 2 ways
Increased RBC production:
- increased formation of proerythroblasts (more produced)
- increased rate of proerythroblast maturation
Erythrocyte characteristics:
- Biconcave disc
- large surface area to volume ratio
- able to form stacks (rouleaux)
- cells are flexible (allowing passage trough small capillaries)
- mature human erythrocytes don’t have a nucleus, mitochondria or ribosomes. (No DNA to make protein, no mitosis)
- can make O2 with glycolysis ATP?
Mitochondria
None to stop from consuming O2 to make ATP
Hemoglobin
Protein with 4 subunits
- each subunit has a polypeptide and a heme group (pigment)
- 4 globin units (protein) 2 alpha + 2 beta
- 4 heme units (red pigment)
- each contains an iron ion binds O2
3 forms of hemoglobin:
Embryonic: develops first
Fetal: replaces by 3rd mon. Gestation
Adult: embryonic and fetal have higher affinity for O2
Oxyhemoglobin vs Deoxyhemoglobin
OXY - WITH O2 bound (bright)
DEOXY - WITHOUT O2 bound (dark)
Carbaminohemoglobin
Hemoglobin without CO2 bound
Carboxyhemoglobin
Hemoglobin with CO bound
- CO binds to iron and prevents O2 from binding
Erythrocyte breakdown
- RBC death and phagocytosis
- Globulin breaks down to amino acids they’re recycled for protein
- Fe binds to transferrin - transportation
- Fe transported to liver and spleen and stored as FERRITIN
- To transport Fe binds again to transferrin
- Fe transported to red bone marrow
- Erythropoiesis requires Fe, globin, erythropoietin
- Heme pigment converts to bilverdin (green) then bilirubin (yellow)
- Bilirubin goes to liver
- Bile carries bilirubin to small intestine
- Bacteria converts bilirubin into urobilinogen
- Urobilin sent to kidney, yellow urine
Eosinophil
Stain with acidic dye, should stain pink
- bilobed? Nucleus
- attack large parasites
- sensitive to allergies
- produce histamines to release information –> breaks it down
Basophils
Stain with basic dye
-produce histamine and heparin
His: increased inflammation vasodilator
Hep: anticoagulant enhances effects of most cells
Neutrophils
Take up both stains equally -polymorphonuclear cell PNN?? Nucleus has 3-5 lobes -destroy bacteria -produce lysosomal enzyme/digest bacteria -produce respiratory burst/creates H2O2 -phagocytic cell -pus forming (dead bacteria, cell debris, dead WBC)
Monocytes
Leave blood to become macrophage Elevated in chronic infections Stimulate other cells 1. Release chemical messengers 2. Phagocyrize and present to lymphocytes
Atract fibroblasts - creates scar tissue, isolates infection
Lymphocytes
3 types:
T cells - cellular immunity
B cells - antibody immunity
Natural killer cells - immunological surveillance (NK)
Platelets
Not “true” cells, fragments of larger cell = MEGAKARYOCYTE
life span - 5-9 days
Removed by spleen and liver
About 30% stored for emergencies
Thrombolytopenia
Low platelets
Thrombocytosis
High platelets
Hemostasis
Stops bleeding, prevents hemorrhage (massive blood loss)
Hemostasis events:
Vascular spasm Platelets plug formation Coagulation Clot retraction Thrombolysis
Vascular spasm
- Vessel is injured
- Blood leaks into ECF
- Vessel spasms and leaked blood INCREASES tissue pressure in IF, which DECREASES blood flow and blood loss
Platelet plug formation
- Endothelial cells release Willebrand factor (vWF)
- vWF allows platelets to stick to the collagen fibers in the vessel wall
- Fibrinogen binds to platelets
Platelet Release Reaction
Release ADP and thromboxane. These chemicals bind to the platelets and activate them. This creates a positive feedback loop to activate more and more platelets
Platelet aggregation
Fibrinogen connects platelets to one another to form the platelet plug (temporary)
Coagulation
Process that forms a blood clot
Clotting factors get activated and convert to enzymes
-requires numerous clotting factors (I-XIII)
-clotting factors must be activated to function(as enzymes)
Blood clot
Network of fibrin that traps blood cells, fluid and platelets
Two pathways of coagulation
Extrinsic and intrinsic –> both lead to common pathway
Extrinsic vs intrinsic pathways
E beings with tissue factor
I begins with factor XII
-both end by activating factors X to factor a a
Common pathway
- Factor Xa causes release of prothrombinase
- Prothrombinase converts prothrombin to thrombin (inactive to active)
- Thrombin converts fibrinogen to fibrin
Fibrinogen vs Fibrin
Ogen - H2O soluble
Brin- NOT H2O soluble
*fibrin keeps clot from washing away
Clot retraction
Actin and myosin in platelets contract and squeez serum out of the clot.
-pulls edges of wound together and helps dry clot out
Thrombolysis
- Endothelial cells release tissue
Plasminogen activator? (TPA)? - TPA activates plasminogen into plasmin
- Plasmin degrades c…..!!
Anticoagulants
Decreases clotting by various factors
Heparin
Blocks thrombin
Asplirin
Blocks thromboxane
Warfarin
Vitamin K antagonist (blocks formation of 4 clotting factors
Thrombosis
Clotting in an unbroken vessel (no wound)
Thrombus
Attached clot
Deep Vein Thrombus
Typically in legs
Embolus
Clot, airbubble, fat debris – traveling in blood
Agglutinogens
Antigen on erythrocyte surface
Agglutinins
Antibodies in plasma
-bind to antigen
ABO groups
Determine blood type
2 types of antigen A and B
(A, B, AB, O)
Rh blood group
Determining Rh+ or Rh-
-D antigen
Rh+ has D antigen
Rh- doesn’t have D antigen
Type A
A antigen
Anti B antibody
Type B
B antigen
Anti A antibody
Type AB
Both antigens either antibody
Universal donor
O-
Erythroblastosis Fetalis
Problems rarely develop during 1st pregnancy because enter maternal circulation thus mothers immune system is not stimulated, exposure to fetal HBI
Rhogam
Shot given to Rh- mom 26 weeks/birth
Stops mom from making anti D antibodies
Anemia
Decreased O2 carrying ability
Iron deficiency anemia
RBC can’t produce functional hemoglobin and are unusually small.
Affects ability to bind and transport oxygen
Pernicious anemia
Vitamin B12 (lacking) prevents normal stem cell division in red bone marrow Fewer # of RBC, often large and misshapen
Hemorrhagic anemia
Excessive loss of RBC from bleeding
Hemolytic
Plasma membranes of RBC rupture
Aplastic
Bone marrow stops making RBC