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Physiology > Blood > Flashcards

Blood Flashcards

1
Q

composition of blood

A
  • 55% plasma
    • water, proteins, other solutes
  • <1% platelets and WBC
  • 45% RBC
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2
Q

ratio of blood cells

A
  • 4 million RBCs
  • 350,000 platelets
  • 5,000 WBCs
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3
Q

cellular componenets of RBCs

A
  • NO NUCLEUS
  • biconcavity
    • for gas diffusion and squeeding through capillaries
  • thin membrane for easy gas transport
  • 120 day life cycle
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4
Q

cellular components of WBCs

A
  • nucleated
  • classified as either granulocyte or agranulocyte
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5
Q

granulocyte

A

WBC with secretory granules in the cytoplasm

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6
Q

agranulocytes

A

no secretory granules

monocytes and lymphocytes

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7
Q

Process of hematopoiesis to RBC

A
  1. myeloid stem cell is made from pluripotent stem cell
  2. If stimulated by GM-CSF, it can become a granulocyte or a monocyte.
  3. BFUE (Erythroid burst forming units) gives rise to CFUE (Colony forming units- erythromycin)
  4. CFUE requires EPO to become RBC
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8
Q

Process of hematopoesis to platelets

A
  1. Pluripotent cells become myeloid cells
  2. myeloid cells are affected by TPO (thrombopoetin) to become plateltes
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9
Q

G-CSF

A

stimulates the bone marrow to produce granulocyts and stem cells and release them into the bloodstream

  • stimulates the proliferation, differentiation, and maturation until it becomes a mature neutrophil
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10
Q

How is hematopoiesis regulated?

multilineage

A
  • SCF (Stem cell factor)- Supports colony growth, cells can become myeloid or leukocyte
  • GM-CSF- Cells can become granulocyte or monocyte
  • IL-6 - lymphoid arm ??
    • stimulates immune respone
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11
Q

How is hematopoiesis regulated?

lineage-specific cytokines

A
  • G-CSF - will make cell a granulocyte
  • M-CSF - will make cell a monocyte
  • Erythropoetin- makes cell into RBC
  • Thrombopoietin- makes cell into platelet
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12
Q

Erythropoiesis sequence

nucleus?

A
  1. uncommitted pluripotential stem cell with nucleus
  2. EPO makes it committed proerythroblast
  3. becomes normoblast- nucleus shrinks and is reabsorbed
  4. becomes reticulocyte and leaves the marrow ti enter blood stream NO NUCLEUS
  5. becomes erythrocyte, cell achieves final shape and hemoglobin synthesis. Has no nucleus.
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13
Q

___ Hb : ___ nucleus

A

more hb : less nucleus

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14
Q

What is hemoglobin?

A
  • made up of 2 alpha and 2 beta polypeptide chains (globulins) and Heme.
  • heme is derived from iron
  • Oxy hemoglobin- has O2 bound
  • deoxyhemoglobin- does not have O2 bound
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15
Q

What is required for hemoglobin synthesis?

A
  • requirements:
    • proteins- amino acids for structure
    • vitamins- B12, B6, B2, E, C, and folic acid
    • Minerals- iron and copper
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16
Q

What happens if you take B12 and/or folic acid out of the system?

A

Will do a bad job making DNA for hemoglobin and hemoglobin will be crappy and wierd shaped.

wont work as well

break down faster

17
Q

What happens to Iron?

A
  • Fe is transported to liver by transferrin.
  • it is stored in ferritin in the liver
  • When you need it, the transferrin brings it back from storage site to the bone marrow to be used.
  • Fe is inserted into the erythroblast and the mitochondria inserts it into the hemoglobin
  • After the erythrocyte has been around about 120 days, macrophages in the spleen break it down.
  • most of the Fe is recycled and stored in the ferritin again.
18
Q

What happens to the erythrocyte at the end of it’s 120 day life?

A
  1. aged RBCs are destroyed by macrophages in the liver and spleen.
  2. the globin (alpha and beta chains) break down into heme and porphyrin
  3. Porhyrin becomes bilirubin and is transpoted to the liver where it is conjugated and secreted in the bile and goes to the intestines
  4. **increased hgb breakdown or decreased liver/kidney function would cause jaundice
19
Q

Which protein makes somebody RH+?

A

the big D

20
Q

how long do thrombocytes circulate for?

A

about 1 week

21
Q

How are platelets made?

A
  • megakaryocyte grows really big and little pieces break off
  • little pieces break off, this process is called endomitosis and the pieces are the platelets.
  • platelets have and ER, mitochondria, but no nucleus
22
Q

What makes up a platelet?

A
  • alpha granules
    • contain clotting factors
    • When the alpha granule is activated to release, it releases:
      • pro von willebronds factor
      • factor V…etc.
  • dense granules
    • have ADP, Ca, serotonin
23
Q

How does biopsy compare to aspiration when evaluating bone marrow?

A
  • biopsy is more specific/reliable than aspiration
  • biopsy is more expensive and painful
  • biopsy gives more accurate measurement of iron.
  • biopsy shows gross structure and abnormal cells better
  • **must have at low numbers of at least two different types of cells to warrant a biopsy
24
Q

mean corpuscular volume

A

size/weight of RBCs in circulating volume.

weight of RBCs is made up of hgb so this gives you a way to estimate hgb

25
Q

How to peds RBC counts compare to adults and elderly

A
  • higher blood cell counts as infants because hypoxic intrauterine environment stimulates epo
  • elderly blood cells have same lifespan but are replaced more slowly
  • lymphocye function decreases with age.
26
Q

How do platelets adhere

A
  • VWF will adhere to collagen and start piling up
  • GP1b on the platelet will attach to the VWF
  • or GP1a will attach straight to the collagen
  • These attaching will activate GP2b and GP3a to begin aggregating
27
Q

primary hemostasis

A
  1. exposure to collagen
  2. platelets adhere
  3. plateltes activated
  4. aggregation
  5. formation of platelet plug
28
Q

What does thromboxane do?

A
  • with ADP it activates other plateltes and causes aggregation.
  • Thromboxane is released after GP2b and GP3a are activated.
29
Q

Secondary hemostasis

i

A
  1. intrinsic system activated by factor 12
  2. Factor 12 activates factor 10
  3. factor 10 activated prothrombin into thrombin
  4. thrombin activates fibrinogen into fibrin
  5. fibrin builds into clot, working best with normal Ca++ levels.

**Extrinsic system is activated by tissue factors and activates factor 10

30
Q

extrinsic system

A

The extrinsic pathway is activated by external trauma that causes blood to escape from the vascular system. This pathway is quicker than the intrinsic pathway.

31
Q

Intrinsic system

A

The intrinsic pathway is activated by trauma inside the vascular system, and is activated by platelets, exposed endothelium, chemicals, or collagen. This pathway is slower than the extrinsic pathway, but more important

32
Q

Factor X

A

Prothrombin activator. Cleaves prothrombin into thrombin (active)

*thrombin is an enzyme that breaks fibrinogen into fibrin

33
Q

how does the endothelium regulate clot formation?

A
  • Endothelial cell makes prostacyclin
  • prostacyclin activates cAMP, decreasing Ca
    • prostacyclin inhibits Thromboxane
  • Need Ca to form clots
34
Q

What significance do the endothelial cells have?

A
  • Endothelial cells activate protein C which inhibits clotting
  • When subendothelial tissues are exposed, clotting cascade starts
    • collagen
    • basement membrane
    • von willebrand factors
35
Q

Tertiary hemostasis

A
  • the breaking down of the clots
  • T-PA is released from endothelial cells and converts plasminogen into plasmin
  • plasmin breaks down and degrades fibrinogen and fibrin
  • D-dimer results from breakdown of the clots
  • PAI-1 and antiplasmin are inhibitors
36
Q

factor 1

A

fibrinogen

37
Q

factor 2

A

prothrombin

38
Q

factor 3

A

tissue factor

39
Q
A

Physiology (31 decks)

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