Blood Flashcards
What is blood made up of?
Cells and Plasma
What is plasma made up of?
Blood without any cells ; proteins 7% (albumins globulins, fibrinogen, prothrombin), water 91%, other solutes 2% (ions, nutrients, waste products, Gases, Regulatory substances)
What percentage is plasma is whole blood?
55%
What percentage is Formed elements (cells) in whole blood?
45%
What percentage of whole blood is platelets and leukocytes?
platelets- less than 1%
leukocytes- less than 1%
What are the different kinds of leukocytes?
Neutrophils, Lymphocytes, Monocytes, Eosinophils, Basophils
What are formed elements in the blood?
Erythrocytes (RBC’s) more than 99%
What three kinds of blood cells are there?
- Red
- White
- Platelets
How are all blood cells generated?
from a common stem cell in the bone marrow
What are the three types of WBC’S?
1) Granulocytes
2) Monocytes
3) Lymphocytes
What are the different kinds of Granulocytes?
1) Neutrophils
2) Basophils
3) Eosinophils
What are the two types of lymphocytes?
B Lymphocytes (Humoral) T Lymphocytes (cell- mediated)
What is the main function of RBC’s?
transport O2 and CO2
What is the main function of neutrophils?
phagocytose and destroy invading bacteria
What is the main function of Eosinophils?
Destroy larger parasites and modulate allergic inflammatory responses
What is the main function of Basophils?
release histamine in certain immune responses
What is the main function of Monocytes?
become tissue macrophages, which phagocytose and digest invading microorganisms and foreign bodies as well as damaged semescient cells
What is the main function of B cells?
make antibodies
What is the function of T cells?
kill virus- infected cells and regulate activities of other leukocytes
What is the function of platelets?
Initiate blood clotting
What do WBC’s do during inflammation or infection?
They can actually squeeze themselves outside of the capillaries into the interstitial spaces and attempt to attach foreign particles or microbes
What cell stays within the vascular system?
RBC’s
What cell lacks a nucleus, ER, mitochondria, and ribosome? Therefore it cannot grow or divide?
RBC’s
What is the lifespan of RBC’s?
120 days
How are worn out RBC’s taken care of?
Worn out RBC’s are phagocytosed and digested by macrophages in the liver and the spleen
What is the main form of ATP formation?
Anerobic glycolysis
RBC’ and brain cells depend on what, and have trouble oxidizing anything else?
Glucose
What cell is most responsible for the acid- base buffering power of whole blood?
RBC’s
What is hemoglobin?
The protein molecule that is found in RBC’s that carry oxygen from the lungs to the bodies tissues and returns carbon dioxide from the tissues back to the lungs.
What is Carbonic anhydrase?
Enzyme that catalyzes the reversible reaction between CO2 and water to form carbonic acid H2CO3. The rapidity of this reaction makes it possible for the water of the blood to transport enormous amounts of CO2 in the form of bicarbonate ion HCO3-, from the tissues to the lungs where it is reconverted to CO2 and expelled into the atmosphere as a body waste product
T/F The quantity of RBC’s in the blood differs between sedentary and highly trained persons
True
If not kept inside the RBC, what can leak through the capillary membranes into the interstitial spaces or glomeluar filtrate?
Hemoglobin
RBC’s contain large quantities of what?
Carbonic anhydrase
What cell is biconcave disc shaped, mean diameter of 7.8 um and a thickness of 2.5 um, average volume of 90-85 um3?
RBC’s
Why can the shape of a RBC change?
In order to squeeze through capillaries
What happens to old RBC’s?
They become too fragile and are frequently ruptured as they squeeze through the red pulp of the spleen.
What happens why your spleen is removed?
the number of old abnormal circulating RBC’s is increased
What is the quantity of RBC’s in the blood in healthy men?
5,200,000+/- 300,000
What is the quantity of RBC’s in the blood of healthy women?
4,700,000 +/- 300,000
What is the quantity of hemoglobin in the cells?
RBC’s can hold up to 34g of Hgb in each 100 ml of cells
T/F at 100% saturation, men can hold roughly 20ml of O2/ 100mL
True
T/F at 100% saturation, women can hold roughly 19ml of O2/ 100 ml
True
What is hemocrit?
The ration of the volume of RBC’s to the total volume of blood
Where are RBC’s mainly produced?
Bone Marrow
Does our bodies ability to produce RBC’s decrease with age?
YEs
What bones have the greater ability to produce RBC’s?
Membranous bones like the vertebra, strernum, and ribs
All cells develop in the bone marrow except for what cells?
T lymphocytes ( thymus) Macrophages & Osteoclasts (Monocytes)
T/F Stem cells according to different factors and depending on what they are exposed to they can choose one of the multiple paths- of a common lymphoid progenitor and a common myeloid progenitor.
True; The path they choose is according to a bunch of things to include CSFs.
T/F A single stem cell division can lead to the production of thousands of differentiated progeny, which explains why the # of stem cells is such a small fraction of the total population of hemopoietic cells
True
What is the role of CSF’s?
Colony stimulating factors are glycoproteins that may circulate in the blood and act as hormones or act directly in the blood marrow as local mediators.
What is an example of a CSF?
Erythropeoetin (EPO)
Any condition that leads to a decrease in oxygen level or some sort of hypoxia will stimulate what?
EPO
How does EPO regulate RBC production?
Any condition such as (Decreased RBC’s, decreased hemoglobin, Synthesis, decreased blood flow, hemorrhage, and increased O2 consumption by tissues) is going to induce relative hypoxia- which will stimulate the kidneys to increase EPO secretion.
What happens once EPO is secreted?
Once EPO is secreted- it acts on the bone marrow to increase RBC production and if we have increased RBC production then that is going to eventually lead to an increase in oxygen levels; which through negative feedback is going to stimulate the kidneys to decrease EPO productions and the cycle continues.
What happens if you have both kidneys removed?
If you have both kidneys removed or destroyed-you become anemic because they are no longer about to produce EPO and then their body is producing it through extrameduallry hemopoeises
What happens when there is a decrease in O2?
EPO production increase
What is extramedullary hemopoeisis (liver and kidney) a sign of?
Usually a sign of disease; Extramedullary hematopoesis refers to hematpoiesis in locations other than the bone marrow.
What is angiogenesis?
Formation of new blood vessels from pre-existing vessels?
What is HIF?
Hypoxia inducing factor- it is a transcription factor
What does lack of O2 trigger?
Lack of O2 triggers the secretion of VEGF, which stimulates angiogenesis. Angiogenesis causes formation of more and more capillaries and growth of more vessels- spreads blood more better.
As soon as you start training what happens to blood volume?
Total blood volume increases
Why does Blood volume increase during exercise?
If we study the changes in blood volume w/ exercise over time we will see that total blood volume as soon as you start training increases- but mainly that is due to an increase in plasma volume
Why does plasma volume increase during exercise?
Plasma volume increases when you start to exercise because your body is getting rid of waste products
When does RBC volume start to increase after you start training?
RBC volume starts to increase roughly 14 days (2 weeks) after you start training and then hits a plateau- in which plasma volume decreases a little bit- and that decrease in plasma volume is compensated by an increase in RBC volume and the lasting effect is an increase in total blood volume
When you have an increase in BV- whats happens to stroke volume?
Increase in BV=Increase in SV which means better perfusion of our tissues
What happens during blood doping?
Athletes use to gain cardiovascular effects of an increase in blood volume and increase in RBC volume. Athletes take some of their blood and store it (Freeze it) and before competitions they would then start injecting their own blood back into their systems.
Why is blood doping dangerous?
Because you have an increase in blood viscosity. If you have an increase in blood viscosity. Could cause the blood to stop flowing in certain capillaries- could end up with a stroke or a myocardial infarction
What two nutrients are essential for maturation of RBC and DNA synthesis?
Vitamin B12 and Folic Acid
What happens if there is a deficiency of either Vitamin B12 or folic acid?
Causes maturation failure in the process of erythropoiesis. Lack of either vitamin B12 or folic acid causes abnormal and diminished DNA and failure of nuclear maturation and cell division. The erythroblast cells of the bone marrow will produce larger than normal RBC’s called Macrocytes. RBC’s will cause them to have a short half life that is 1/2 to 1/3 normal.
What is IF?
Intrinsic Factor- A protein carrier that is supposed to bind with B12
What is required for vitamin B12 uptake?
IF is required for vitamin B12 uptake by binding to B12 and protecting it from digestion and binding to specific receptor sites on the borders of the mucosal cells.
What happens if there is a lack of IF?
Lack of IF decreases availability of Vitamin B12.
What is Pernicious Anemia?
A type of macrocytic normochromic anemia.
What causes pernicious anemia?
Lack of B12
What is Anemia?
deficiency of hemoglobin in the blood, which can be caused by either too few RBC’s or too little hemoglobin in the cells.
What is Macrocytic?
The RBC’s become too large
What is Normocytic?
The RBC’s are normal size
What is Microcytic?
The RBC’s become abnormally small
What is Macrochromic?
Increased amounts of hemoglobin
What is Normochromic?
the hemoglobin content is normal
What is Hypochromic?
Reduced amounts of hemoglobin
What is Megablastic?
Unusually large and structurally abnormal RBC’s.
What is Microcytic- Hypochromic Anemia?
- Characterized by red cells that are abnormally small and contain reduced amounts of hemoglobin.
- Related to disorders of iron metabolism or globin synthesis
What is Iron- Deficiency Anemia?
Nutritional iron deficiency or blood loss (most common type of anemia worldwide)
- Metabolic or functional deficiency
- Manifestations when serum HgB decreases to 7-8 gm/dl
What is Normocytic- Normochromic Anemia?
Characterized by red cells that are relatively normal in size and hemoglobin content but insufficient in number.
What are some types of normocytic- normochromic anemias?
- Aplastic: loss of functioning bone marrow
- Post-hemorrhagic: acute blood loss
- Acquired hemolytic- immune destruction of RBC’s
- Hereditary hemolytic- such as in sickle cell anemia
- anemia of chronic inflammation
What is polycythemia?
Overproduction of red blood cells
What is relative polycythemia?
- Result of dehydration
- Fluid loss results in relative increases of red cell counts and Hgb and Hct values
What is hemocrit?
The ratio of volume of RBC’s to the total value of the blood- instrument for measuring this is typically centrifugation
What are the two types of absolute polycythemia?
- Primary absolute
- Secondary absolute
What is primary absolute polycythemia?
- abnormality of stem cells in the bone marrow
- Polycythemia vera (PV) - JAK2 mutation
What is secondary Absolute polycythemia?
Increase in EPO as a normal response to chronic hypoxia or an inappropriate response to EPO- secreting tumors.
What are the two things that can cause secondary absolute polycythemia?
1) Someone who lives at a high altitude
2) Someone who is taking EPO who doesn’t need it
What are the major effects of anemia on the cardiovascular system?
The major effects of anemia is greatly increased cardiac output, as well as increased pumping workload on the heart.
What is polycythemia vera?
- Abnormal, uncontrolled proliferation of RBC’s, WBC’s, and platelets
- insidious (a disease that progresses gradually with inapparent symptoms)
- Manifestations due to increased red cell mass and hematocrit: increased blood viscosity and Hypercoagulopathy
What causes Polycythemia vera?
genetic abberation in the hemocytoblastic cells that produce the blood cells.
What are the main effects of Anemia on the Circulatory System?
- Anemia decreases the blood viscosity (because you don’t have the RBC’s)
- decreased viscosity–>decreased resistance–>increased hypoxia—> increased vasodilation–>Increased blood flow–> increased CO (2-3x normal)–> increased pumping workload of the heart
What are the effects of polycythemia on the circulatory system?
increased viscosity–>decreased flow–>decreased VR
& Polycythemia–> increased blood cells–> increased blood volume–> VR
* Both with balance each other out- so will have normal cardiac output; beyond certain limits, HTN may develop
What two cells protect the body against invading organisms by ingesting them by the process of phagocytosis- or by releasing antimicrobial or inflammatory substances that have multiple effects that aid in destroying the offending organism?
Granulocytes and monocytes
Where are granulocytes and monocytes formed?
Developed in the bone marrow and most remain there until needed peripherally
Where are lymphocytes formed?
Develop mostly in the peripheral lymphoid organs (thymus, spleen, tonsils, lymph nodes, Peyer’s patch)
Where are Megakaryocytes formed?
Developed and reside in the marrow, fragment to release platelets
What is the function of the Neutrophils?
Phagocytes in early inflammation
What is the function of the Eosinophils?
Ingest antigen- antibody complexes
- Induced by IgE hypersensitivity
- Increase in parasitic infections
What is the function of Basophils?
Structurally and functionally similar to mast cells
What is the life span of Granulocytes?
Circulating: 4-8 hours
Tissue: 4-5 days
(shorter timeline with infection and inflammation)
What is the life span of Monocytes/ Macrophages?
Circulating: 10-20 hours
Tissue: Months or longer
What is the lifespan of Lymphocytes?
- Continually re-circulate: lymph…nodes..blood
- Long lived: weeks, months, longer
What is the lifespan of Platelets?
replaced every ten days
What cells respond immediately to infection?
Neutrophils are mature cells that can respond immediately to infections
Monocytes mature in the tissues to become what?
Macrophages
Both Neutrophils and Macrophages exhibit motility by what?
- Diapedesis
- Ameboid motion (crawling like movement)
- Chemotaxis
What two motions of the neutrophils happens very quickly?
Movements of neutrophils by diapedesis through capillary pores and by chemotaxis towards an area of tissue damage- happens very quickly
T/F Neutrophils and monocytes can squeeze through the pores of the blood capillaries by diapedesis. Even though a pore is much smaller than a cell, a small portion of the cells slides through at a time.
True
What is chemotaxis?
Cell movements in a direction controlled by a gradient of a diffusible chemical.
What is phagocytosis?
Ingestion of particles
Phagocytosis is an important function of what two WBC’s?
neutrophils and macrophages
It is important for the phagocytes to be able to accurately distinguish the abnormal cells, how are they able to do so?
The immune system will mark the bacteria or particle- called opsonization
How many bacteria can neutrophils digest?
3-20 bacteria before they die
How many bacteria can macrophages digest?
after being activated in the tissues, are extremely effective phagocytes (up to roughly 100 bacteria before they die)
What can ingest larger particles… damaged RBC’s and malarial paracites?
Macrophages
What happens if a pathogen is too large to be ingested?
Neutrophils can eject large parts of their chromatin along side other molecules
- The injected DNA and histones forms a sticky web that entraps nearby bacteria.
- When they eject the chromatin web they die because they are basically giving away some of their DNA
In both neutrophils and macrophages what fuses with lysosomes and other granules to form phagolysosomes (digestive vesicles)
Phagosomes
How else can bacteria be killed?
Bacteria may be killed even if they are not digested by bactericidal agents
What are some examples of bactericidal agents?
- superoxide
- hydrogen peroxide
- hydroxyl ions
- Hypochlorite
After entering the tissues, this cells becomes fixed and may be a resident for years.
Macrophages
What is the first line of defense?
Innate (natural)(native) immunity; physical, mechanical, biochemical barriers
What is the second line of defense?
Inflammation
What is the third line of defense?
Adaptive (acquired) (specific) immunity
What consists of the first line of defense?
- Physical barriers like the skin, lining of the gastrointestinal, genitourinary, and respiratory tracts.
- Sloughing off of cells
- Coughing and sneezing
- Flushing (urine)
- Vomiting
- Mucus and cilia
What are some epithelial cell-derived chemical barriers?
- secrete saliva, tears, earwax, sweat, and mucus
- Antimicrobial peptides (cathelicidins, defensins, collectins, and mannose-binding lectin)
What are some normal microbiome features of the first line of defense?
Each surface colonized by bacteria and fungi that is unique to the particular location and individual
What is the second line of defense caused by?
Infection, tissue necrosis, trauma, physical or chemical injury, foreign bodies, immune reaction, ischemia)
What are the 5 cardinal signs of inflammation?
Redness, heat, swelling, pain, loss of function
What are the goals for inlammation?
- Prevent and limit infection and further damage
- Initiate adaptive immune response
- Initiate healing
What are the vascular responses of the inflammatory response?
- blood vessel dilation
- increased vascular permeability and leakage
- white blood cell adherence to the inner walls of the vessels and migration through the vessels.
What are the plasma protein systems?
Complement system
clotting system
kinin system
What causes an intense inflammation (production of lethal cellular toxins) and are effectively “walled off”
Staphylococci (staph infection)
What induces less intense inflammation and may be more likely to spread than staphylococci (therefore can spread through the body and cause death.)?
Streptococci (strep)
What does walling off do?
1) Helps control infection response
2) Helps trap bacteria and confine it so it doesn’t spread to the rest of the body.
What do Neutrophils and Macrophages do during inflammation?
- Tissue macrophages that encounter foreign particles enlarge and become mobile to provide a first line of defense
- Within an hour neutrophils migrate to the area in response to inflammatory cytokines (TNF, IL-1)
- Upregulated selctins and ICAM-1 on endothelial cells are bound by integrins on neutrophils, leading to margination, followed by diapedesis, and chemotaxis directing neutrophils into the inflamed tissues, to kill bacteria and scavenge
What is the secondary macrophage invasion?
In response to chemoattractants, monocytes gradually accumulate and become macrophages (after 8 hours)
-In part due to increased bone marrow production, macrophages become the dominant inflammatory cell over several weeks, cleaning up remaining bacteria, necrotic tissues, and directing tissue remodeling.
What happens when neutrophils and macrophages engulf large amount of bacteria?
When they engulf large amounts of bacteria and necrotic tissue, essentially they eventually die- after several days a cavity is often excavated in the inflamed tissues- and that creates the formation of pus
What is pus composed of?
dead bacteria and neutrophils, many dead macrophages, necrotic tissue that has been degraded by proteases, and tissue fluid, often in a cavity formed at the inflammatory site.
How does pus go away?
Over days and weeks it is absorbed into the surrounding tissue and lymph and disappears.
What is heparin?
A substance that can prevent blood coagulation
What cells release histamine, bradykinin, and serotonin?
Basophils and mast cells
When ___ is bound to receptors on their surfaces is cross-linked by its specific antigen, mast cells and basophils degranulate, releasing: histamine, bradykinin, serotonin, heparin, leukotriens, and several lysosomal enzymes.
IgE
What is the role of IgE?
IgE has a special propensity to become attached to mast cells and basophils
-when IgE reacts with the antibody- causes the mast cell or basophil to rupture and release large amounts of histamine, bradykinin, serotonin, heparin.
What does histamine, bradykinin, serotonin, heparin and leukotriens cause?
These substances cause local vascular and tissue reactions that cause allergy manifestations
The final mediators of the allergic response are released when the antibody docks on and activates?
mast cells
The activation stimulates the release of?
Histamine, leukotrienes (etc)
Collectively, these mediators will produce what?
pulmonary edema, peripheral edema, decreased peripheral resistance
When does acquired immunity occur?
Acquired immunity does not develop until after the body is first attacked by a bacterium, virus, or toxin
What is Leukopenia?
low white blood cell count; usually the result of reduced production of cells by the bone marrow
What are the causes of Leukopenia?
radiation, chemical toxins, some medicines
What is Leukemia?
Uncontrolled production of abnormal white blood cells due to a genetic mutation
What are the two types of acquired immunity?
- humoral (B cell)
- Cell-mediated (T Cell)
What are antigens?
A substance that can elicit an immune response
What are lymphocytes?
- They mediate acquire immunity
- Develop in the thymus and bone marrow or central lymphoid organs
What is acquired immunity?
The product of the body’s lymphocytes
What happens to people who have a genetic lack of lymphocytes?
People who have a genetic lack of lymphocytes or whose lymphocytes have been destroyed by radiation or chemicals- means they won’t have an acquired immunity
What are T- Cells responsible for?
Forming the activated lymphocytes that provide “cell mediated” immunity
What are B cells responsible for?
Responsible for forming antibodies that provide “humoral” immunity
By what does the acquired immune system work?
The acquired immune system works by clonal selection
How can the acquired immune system specifically respond to millions of different foreign cells?
Clonal Selection theory
How are lymphocytes activated?
By the innate immune system
where do newly formed lymphocytes migrate from?
Newly formed lymphocytes migrate from the central organ to peripheral organs (tonsils and spleen) and lymphatic vessels.
