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Physiology > Blood > Flashcards

Blood Flashcards

0
Q

How does blood act as a transportation fluid (general)?

A

Blood BRINGS: nutrients, oxygen, water, etc.; blood REMOVES: CO2, waste/toxins, heat, water, etc.

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0
Q

How is erythropoesis in bone marrow controlled?

A

The hormone erythropoietin from the kidneys

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1
Q

In order to do functional work, blood must do what?

A

Be kept ceaselessly moving

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2
Q

What is the normal appearance of blood?

A

Darker when deoxygenated, lighter when oxygenated

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2
Q

What type of secondary polycythemia conditional to living in high elevation?

A

Physiologic (high altitude) polycythemia

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3
Q

What is the normal pH of blood?

A

~ pH 7.4

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3
Q

What are some of the adverse effects of polycythemia?

A

Increased RBC’s increases the viscosity of blood, putting increased work load on heart

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4
Q

At what temperature is blood normally maintained?

A

37 C or 98.6 F

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4
Q

How might anemia put strain on the heart?

A

Decreased RBC’s decreases

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5
Q

How much more viscous is blood than water?

A

3-5X more viscous

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5
Q

What are some of the non-regulatory factors required for RBC synthesis?

A

Iron and amino acids (hemoglobin synth.), Vit B12 and folic acid (DNA synthesis in erythropoiesis)

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6
Q

How much blood is normally found in the circulatory system?

A

~ 5 liters

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6
Q

What is a malabsorption of Vit B12 that would slow erythropoiesis, producing fragile macrocytes (large RBCs)

A

Pernicious anemia

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7
Q

What percent of blood is plasma, WBC’s/platelets, and RBC’s?

A

Plasma ~ 55%, WBC’s ~ tiny %, RBC’s ~ 45%

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7
Q

What is the normal lifespan of an RBC?

A

120 days

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8
Q

What is another name for the WBC/platelet layer of centrifuged blood?

A

The “Buffy Coat”

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8
Q

What is the erythrocyte sedimentation rate (ESR)?

A

Taking a sample of blood and letting the RBC’s settle out on their own (no centrifuging)

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9
Q

What might an altered WBC count indicate?

A

The presence of infectious agents (usually elevates the WBC count)

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9
Q

What might an elevated erythrocyte sedimentation rate indicate?

A

During infection, arthritis, and other inflammatory diseases, the ESR would be elevated. Reacting blood tends to clump and fall out of solution.

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10
Q

What is the name of the inferior layer of centrifuged blood and what is it called?

A

This layer is composed of erythrocytes (RBC’s) and is known as the HEMATOCRIT

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10
Q

What fraction of blood does plasma represent?

A

~55%

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11
Q

What is a low hematocrit indicate?

A

Anemia

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11
Q

What are some common functions of plasma proteins?

A

Plasma colloidal osmotic pressure (greatest), carriers, defense, clotting/coagulation, blood viscosoty (small).

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12
Q

What are the two general causes of anemia?

A

Loss of blood or inadequate production

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12
Q

What are the three classifications of plasma proteins?

A

Albumin (smallest, greatest %), globulin (larger, less common), fibrinogen (largest, smallest %)

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13
Q

An RBC count < 4 million/mm^3 is known as ______.

A

Anemia

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13
Q

What condition is marked by a lack of plasma proteins (particularly albumin)?

A

Hypoproteinemia

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14
Q

An RBC count > 6 million/mm^3 is known as ________.

A

Polycythemia

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14
Q

What are some of the complications of hypoproteinemia; when might they be seen?

A

Seen during starvation, liver disease, nephrosis, intestinal malabsorption; lack of plasma proteins decreases osmotic pressure, leading to adema.

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15
Q

What are three typical causes for polycythemia?

A

disease, dehydration, or living in high altitudes

15
Q

Which plasma protein is the most common and greatest contributer to plasma colloidal oncotic pressure?

A

Albumin.

16
Q

RBC’s contain hemoglobin, which carry lots of O2; about how much Hb is there in normal blood?

A

~ 15 grams per 100 ml (1 dl)

16
Q

Why is maintaining plasma colloidal oncotic pressure necessary?

A

To prevent excessive fluid filtration (out of blood vessels)

17
Q

How is total RBC# (hematocrit) a FUNCTION of O2 content of blood?

A

O2 availability is critical and is a function of RBC number and Hb content per RBC.The greater the demand for O2, the greater the O2 content in blood.

17
Q

What are the three classifications of globulin proteins?

A

alpha globulin, beta globulin, gamma globulin

18
Q

What type of globulin functions as carrier protein for lipids (LDLs) and iron (transferrin)?

A

beta globulin

19
Q

What type of globulin functions as clotting factors and carrier proteins, such as HDLs, clotting factors, and complement system?

A

alpha globulin

20
Q

What type of globulin functions as antibodies?

A

gamma globulin

21
Q

As the main precursor to a clot, what zymogen is a precursor to fibrin?

A

fibrinogen

22
Q

What protein polymerizes when activated into an insoluble mesh to minimize blood loss (aka coagulation)?

A

Fibrin

23
Q

Define hemostasis.

A

Ability of blood to maintain its volume.

24
Q

How does hemostasis react to a tear in a blood vessel?

A

By vascular constriction and formation of platelet plugs

25
Q

Vascular constriction in blood vessels is initiated by trauma, which then initiates:

A

Nervous stimulation from area, vasoconstrictors such as endothelin-1 (vessels), and thromboxane A2 and serotonin (platelets).

26
Q

Platelet plug formation in blood vessels is initiated by trauma, which then initiates:

A

Thromboxane (tissues) and thrombin (from clot), which promote platelet aggregation.

27
Q

Platelets are small cell fragments from which cell located in bone marrow?

A

Megakaryocytes

28
Q

What is the three phase reaction of platelets that is initiated by contact with a damaged vessel wall?

A

Adherence (mostly to exposed collagen), aggregation (forming platelet plug), and secretion (mostly seretonin for vasoconstriction).

29
Q

What is clot formation?

A

The initiation of the conversion of fibrinogen to fibrin via a clotting cascade.

30
Q

What key initiating enzyme activates prothromin to thrombin?

A

Prothrombin activator

31
Q

What is prothrombin activator?

A

Complex substance of several molecules, mostly Factor X (and Factor Va, Ca, membrane phospholipids)

32
Q

Describe the clotting cascade from Prothrombin Activator to a dense mat of fibrin

A

Prothrombin activator -> prothrombin -> thrombin -> fibrinogen -> fibrin -> fibrin threads -> loose mesh -> dense mat

33
Q

What are the two pathways that can initiate the formation of a clot?

A

Intrinsic pathway and extrinsic pathway

34
Q

Describe the intrinsic pathway of clot formation.

A

Starting with factor IX (with co-factor Factor VIIa) -> Factor X -> Factor Xa -> prothrombin -> thrombin -> fibrinogen -> fibrin

35
Q

Describe the extrinsic pathway of clot formation.

A

Starting with factor VIIa (with co-factor Factor III) -> Factor X -> Factor Xa -> prothrombin -> thrombin -> fibrinogen -> fibrin

36
Q

Which clotting pathway is fastest and which is strongest between extrinsic and intrinsic?

A

The Intrinsic pathway is more powerful, but is slower; extrinsic is faster, but weaker

37
Q

What outside element is required for the extrinsic pathway to function, thus naming it so.

A

Tissue Factor (TF); required along with Factor VIIa to convert Factor X to Factor Xa

38
Q

What role does Ca2+ have in the clotting pathways?

A

A common cofactor that is required in several reactions in both the extrinsic and intrinsic pathways.

39
Q

During normal hemostasis, which pathway is preferred, extrinsic or intrinsic?

A

Neither; both are activated.

40
Q

How does thrombin help to facilitate clot formation?

A

Thrombin positively feeds back onto both extrinsic (on VII, X) and intrinsic (on X, XI, VIII, V) pathways.

41
Q

How long does clotting normally take?

A

~1-6 min

42
Q

What is partial thromboplastin time?

A

A measurement of clotting time that gives an indication of the total amount of prothrombin in blood.

43
Q

The last stage of a clot is retraction, which produces plasma free of clotting factors, also known as:

A

serum

44
Q

How are the endothelial linings of BVs designed to be anti-clotting in nature?

A

Smooth, simple squamous epithelium, and a glycocalyx coating that repels clotting factors

45
Q

How does consumption of clotting factors work as an anticlotting mechanism?

A

Clots minimize blood flow and cover collagen

46
Q

What protein functions to reduce clotting factors by binding and inactivating thrombin?

A

Thrombin activates ? globulin Antitrombin III, which binds and deactivates it.

47
Q

What is heparin and what does it do?

A

Anticoagulant produced by mast cells and basophils; binds to Antithrombin III and enhances its ability to destroy thrombin

48
Q

What is fibrinolysis, or the fibrinolytic system?

A

System that breaks down fibrin.

49
Q

When does the destruction of fibrin take place?

A

Almost immediately

50
Q

What protease, activated simultaneously as fibrin forms, destroys clotting factors?

A

Plasminogen is activated to plasmin, which destroys fibrin

51
Q

What cofactor helps activate plasminogen to plasmin?

A

Tissue plasminogen activator (tPA), released from injured tissues a day or so later

52
Q

Where is Vit. K utilized and where is it made?

A

Required for synthesis of several clotting factors, produced by intestinal bacteria

53
Q

What substance (drug) acts as a competative inhibitor for vitamin K sites in hepatocytes?

A

Coumarin (dicourmarol), used to minimize dangerous clotting

54
Q

What bleeding disease results from a lack of Factor VIII?

A

Hemophilia A

55
Q

What is a thrombus?

A

An abnormal clot that forms in a vessel

56
Q

What is an embolism?

A

A thrombus that breaks away and freely floats, it can plug any vessel it cannot fit through.

Physiology (3 decks)

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