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Microanatomy > Blood > Flashcards

Blood Flashcards

1
Q

Plasma

A
  • Liquid extracellular matrix
  • Liquid phase of unclotted blood (original fluid)
  • Mostly water
  • Liquid, cell-free portion of blood
  • Many proteins (albumin)
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2
Q

Relative Abundance

A

Erythrocytes(10^6) > Platelets(10^5) > Leukocytes (10^3)

Neutrophils(50%) > Lymphocytes(30%) > Monocytes(5%) > Eosinophils (5%)> Basophils (less than 1%)

Note: Until age 8, lymphocytes are the most common type of leukocyte

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3
Q

Deviations from normal values

A
  • Cytosis/philia = above normal

- Penia = below normal

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4
Q

Hematocrit

A

-% blood volume occupied by packed erythrocytes after centrifugation

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5
Q

Serum

A

-Plasma minus clotting factors (fibrinogen)

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6
Q

Buffy coat

A

-Thin layer of leukocytes/platelets above red cells after centrifugation

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7
Q

Blood Smears

A

-Romanovsky stains (Wright’s/Giesma)

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8
Q

Methylene blue

A

-Nuclei, ribosomes, basophilic granules stain purple

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9
Q

Azure dyes

A

-Azurophilic granules (lysosomes) stain reddish/purple

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10
Q

Eosin

A

-Stains RBCs pink and specific granules of eosinophils red

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11
Q

Reticulocytes

A
  • Anucleate but contain few residual polysomes

- Small portion (1%) of circulating RBCs

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12
Q

Brilliant cresyl blue

A

-Causes polysomes to clump in reticulocytes and stain darkly (reticulum network)

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13
Q

Poikilocytosis

A
  • Abnormalities in RBC shapes
  • Caused by defects in cytoskeleton (spectrin)
  • Defects in hemoglobin (sickle cell anemia)
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14
Q

Anisocytosis

A
  • Abnormalities in RBC size
  • Macrocytes (abnormally large)
  • Microcytes (abnormally small)
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15
Q

Abnormalities in hemoglobin content

A
  • Hyperchromic - more hemoglobin

- Hypochromic - less hemoglobin

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16
Q

Anemia

A
  • Decreased O2 carrying capacity

- Result of fewer blood cells or less hemoglobin

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17
Q

Platelets

A
  • Limits bleeding and promotes vessel repair
  • Maintains intact endothelium
  • Derived by fragmenting from megakaryocytes
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18
Q

Thrombocytopenia

A
  • Abnormally low platelet count
  • Easy bruising, nosebleeds
  • Petechial rash (small spots) or ecchymoses (large bruises)
  • Idiopathic thrombocytopenic purpura (ITP) - antibodies destroy platelets
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19
Q

Platelet morphology

A
  • Hyalomere - clear outer region made of microtubules, actin filaments, microtubules that maintain shape
  • Granulomere - basophilic stippling; contains 3 types of granules
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20
Q

Platelet Alpha granules

A
  • Platelet-derived growth factor (vessel repair)

- Von Willebrand factor (platelet adhesion to endothelium)

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21
Q

Platelet Delta granules

A
  • Ca2+, ATP, ADP (enhance aggregation)

- Serotonin (vasoconstriction; comes from plasma, not produced by platelets)

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22
Q

Platelet Lambda granules

A

Lysosomal enzymes (clot removal)

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23
Q

Membrane-bound channels

A

1) Open canalicular - invaginations of plasma membrane

2) Dense tubular - stores Ca2+ for exocytosis of granules, not continuous with membrane (similar to SER)

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24
Q

Platelet-mediated events

A

1) Adhesion at site of damage
2) Aggregation to form primary hemostatic plug of platelets
3) Activation to stabilize plug and form secondary hemostatic plug; further aggregation and platelet shape change
4) Clot retraction to decrease size and restore blood flow
5) Clot resorption to remove clot
6) Vessel repair

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25
Q

Platelet adhesion

A
  • Mediated by VWF binding to exposed collagen/laminin of damaged vessels
  • Platelet activation normally absent in healthy vessels because underlying fibers (collagen/laminin) are not exposed to adhesion
26
Q

Platelet aggregation

A
  • Formation of primary hemostatic plug
  • Fills in wall defect
  • Fibrinogen links platelets together
27
Q

Platelet activation

A
  • Secretion of mediators stored in granules
  • Synthesis/released of new mediators (thromboxane TXA2 from arachidonic acid)
  • Changes in platelet shape
  • Further platelet aggregation, vasoconstriction, and coagulation
  • Formation of secondary hemostatic plug with fibrin stabilization
28
Q

Platelet clot retraction

A

-Platelets contract and decreases clot size to reestablish blood flow

29
Q

Platelet clot resorption

A

-Lysosomal enzymes from lambda granules remove clot

30
Q

Platelet vessel repair

A
  • Alpha granules release platelet-derived growth factor

- PDGF induces mitosis for repair/mitosis

31
Q

Prostacyclin (PGI2)

A
  • Derived from arachidonic acid

- Inhibits platelet aggregation

32
Q

Thromboxane (TXA2)

A

-Vasoconstriction and platelet aggregation

33
Q

Cyclooxygenase pathway

A
  • Platelet pathway - produced thromboxane (TXA2) for vasoconstriction and platelet aggregation
  • Endothelial cell pathway - produces prostacyclin (PGI2) and inhibits platelet aggregation
34
Q

Clotting pathologies

A
  • Von Willebrand’s Disease - Deficiency in VWF leading to lack of adhesion
  • Bernard Soulier Syndrome -No VWF receptor leading to lack of adhesion
  • Glanzmann’s Thrombasthenia - deficiency in fibrinogen receptor leading to lack of platelet linkage
35
Q

Granulocytes

A
  • Contain abundant cytoplasmic granules (vacuoles)
  • Contain azurophilic and specific granules
  • Lobulated heterochromatic nucleus
36
Q

Agranulocytes

A
  • Contain few azurophilic granules but no specific granules

- Non-lobulated nucleus

37
Q

Leukocyte Adhesion Molecules

A
  • L selectins on leukocytes
  • Integrins on leukocytes
  • P/E Selectins on inflamed endothelial cells
38
Q

Leukocyte Adhesion Deficiencies

A
  • LAD 1- lack of integrins on leukocytes
  • LAD 2- lack of leukocyte receptors for P/E selectins
  • Both result in decreased diapedesis, leukocytosis, infection
39
Q

Chemotaxis

A

-IL-8, C5a, N-Formyl-methionine

40
Q

Basophil function

A
  • Degranulation increases permeability of vessels

- Can cause allergies (hypersensitivity)

41
Q

Basophil Morphology

A
  • Least lobulated nucleus
  • Heterochromatic nucleus
  • Intensely basophilic with Romanovsky stains
  • Azurophilic granules and very large specific granules
42
Q

Basophil Activation

A
  • IgE binds receptors on basophils and can bind antigens from basophil
  • Degranulation of specific granules (histamine, eosinophil/neutrophil chemotactic factor, proteases)
  • IL 4/13 secretion
  • Platelet-activating factor (PAF), Leukotriene C4 (LTC4)
43
Q

Basophil Mediator Effects

A
  • Vasodilation/permeability by histamine/PAF/LTC4
  • Contraction of airway smooth muscle by histamine/LTC4
  • Increased mucus secretion by goblet cells/mucous glands by histamine
  • Activation of B Lymphocytes/Class switching by IL-4/13
  • Chemotaxis of eosinophils/neutrophils by ECF/NCF
  • Itching by histamine
44
Q

Eosinophil Function

A
  • Kill larvae of certain parasitic worms (helminths)
  • Phagocytosis of antigen-antibody complexes
  • Modulation of basophils/mast cells
  • Specific granules (MBP, ECP, EPO, EDN) and Respiratory burst (ROI/RNI)
45
Q

Eosinophil Morphology

A
  • Bi-lobed (sometimes 3) and heterochromatic
  • Azurophilic granules and many large specific granules
  • Eosinophilic granules (LM)
  • Contain crystalloid in EM (Major basic protein)
46
Q

Eosinophil Activation

A
  • Cross-linking of IgA bound to their plasmalemma
  • Cleave lipids to synthesize LTC4 and PAF
  • Respiratory Burst (ROI/RNI)
  • Degranulation
  • Cytokine secretion
47
Q

Neutrophil Functions

A
  • Highly phagocytic cells; good at killing bacteria
  • Promote inflammation
  • Can produce pus
48
Q

Neutrophil Morphology

A
  • Heterochromatic nucleus with most lobes (2-5) connected by thin strands
  • More than 5 lobes = hypersegmented neutrophils
  • Inactivated X chromosome (Barr body) sometimes visible (drumstick poking out shape)
  • Azurophilic granules/specific granules both small
  • Histochemically stained for myeloperoxidase
  • Very little Golgi when mature (only produce granules during bone marrow differentiation)
49
Q

Neutrophil Azurophilic Granules

A
  • Myeloperoxidase produces HOCL (bleach) from H2O2
  • Bactericidal Permeability-increasing protein (BPI) damages membranes of gram-negative bacteria
  • Lysozyme attacks gram-positive walls
  • Defensins form pores
  • Elastase attacks basement membrane
50
Q

Neutrophil Specific Granules

A
  • Lysozyme
  • Lactoferrin binds free iron to starve bacteria
  • Type IV Collagenase attacks basement membrane
51
Q

Chediak-Higashi Syndrome

A
  • Targeting defect to azurophilic granules
  • Cannot kill bacteria
  • Abnormally large vacuoles resulting from fusion of azurophilic granules with one another that are nonfunctional
52
Q

Monocyte (macrophage) Function

A

-Removal of apoptotic cells

53
Q

Monocyte Morphology

A
  • Largest leukocytes
  • Irregularly (U shaped) nucleus folded on itself
  • Lacy chromatin (“moth-eaten”)
  • Pale nucleus and cytoplasm
  • No specific granules
  • Large pale vacuoles (phagosomes)
  • Well developed Golgi produces azurophilic granules throughout lifespan
54
Q

Macrophage Morphology

A
  • Larger and more phagocytic than monocytes
  • Contain phagocytized material in phagosomes
  • More irregular nucleus than monocyte
55
Q

Macrophage Activation

A
  • Classical activation by IFN gamma from Th cells leads to increased phagocytosis
  • Alternative activation by IL-4/IL-13 produces anti-inflammatory mediators and phagocytosis of apoptotic cells
56
Q

Lymphocytes

A
  • Represent 25-30% of blood leukocytes but 99% of cells in lymph
  • Diapedesis through HEVs
  • Able to recirculate for immune surveillance
57
Q

Lymphocyte Morphology

A
  • Small, medium, or large, depending on state of activation in immune response
  • 90% in blood are small and inactive in immune response
  • Small lymphocyte nucleus is round/kidney shaped and highly heterochromatic
  • No specific granules
  • Blast transformation results in enlargement of cytoplasm and a “smudged” euchromatic nucleus
58
Q

Russell Body Cells

A
  • Old plasma cells

- Large, distended, RER cisternae (Russell bodies) full of antibodies and stain very eosinophilic

59
Q

Natural Killer Cells

A
  • Larger than inactive T or B cells

- Contain more azurophilic granules visible by LM

60
Q

LAD-1

A
  • Deficiency of integrin expression for leukocytes

- Decreased diapedesis, increased leukocyte counts

61
Q

LAD-2

A
  • Deficiency in P/E selectin receptor expression for leukocytes
  • Decreased diapedesis, increased leukocyte counts

Microanatomy (4 decks)

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