Blood and Hematopoiesis Flashcards
What is blood?
Blood is a ___ ___ that is comprised of
___ Elements (Blood ___)
____ (the ___ in which peripheral blood cells are ____)
What is blood?
Blood is a connective tissue that is comprised of
Formed Elements (Blood cells)
Plasma (the liquid in which peripheral blood cells are suspended)
Blood separation
Blood can be separated into layers after _____
____= estimate of the volume of packed ____/unit volume of blood
Normal value 40-50% in men, 35-45% in women
Blood separation
Blood can be separated into layers after centrifugation
Hematocrit = estimate of the volume of packed erythrocytes/unit volume of blood
Normal value 40-50% in men, 35-45% in women
Plasma
____
____(Na+, Cl)
7% plasma ____ (Albumin, fibrinogen, globulins)
___, __, __ ,___, ____, ____, other
Plasma
Water
Electrolytes (Na+, Cl)
7% plasma proteins (Albumin, fibrinogen, globulins)
Hormone, fats, aa, vitamins, carbohydrates, lipoproteins, other
Blood Cell Counts ___>___>____
Red blood cells (RBC, _____s)
approximately 4.3 million / mm3 in females
approximately 4.8 million/ mm3 in males
White blood cells (WBC, _____)
Normal levels = 6,000 – 9,000/ mm3
Platelets
approximately 250,000 platelets / mm3
Blood Cell Counts RBC>Platelets> WBC
Red blood cells (RBC, erythrocytes)
approximately 4.3 million / mm3 in females
approximately 4.8 million/ mm3 in males
White blood cells (WBC, leukocytes)
Normal levels = 6,000 – 9,000/ mm3
Platelets
approximately 250,000 platelets / mm3
Erythrocytes
___ ____ approximately 8 microm diameter in wet smears and 7 microm in dried smears
____
biconcave shape
Life span of approximately _____
Erythrocytes
Biconcave discs approximately 8 microm diameter in wet smears and 7 microm in dried smears
Anucleate, biconcave shape
Life span of approximately 120 days
Reticulocytes
1-2% of RBC and are classified as such for ___ days in circulation
Considered to be ___ ____ erythrocytes – they contain residual ___ ____
____s stained in ___
Reticulocytes
1-2% of RBC and are classified as such for 1-2 days in circulation
Considered to be less mature erythrocytes – they contain residual ribosomal RNA
Polyribosomes stained in clumps
Erythrocyte Variations
Decreased erythrocytes = ____
Increased erythrocytes = ____
Presence of a high percentage of erythrocytes of differing sizes = ____
Macrocytes = > _ micro m
Microcytes = < _ micro m
Erythrocyte Variations
Decreased erythrocytes = anemia
Increased erythrocytes = polycythemia
Presence of a high percentage of erythrocytes of differing sizes = anisocytosis
Macrocytes = > 9 micro m
Microcytes = < 6 micro m
Sickle Cell Anemia
Erythrocytes with an amino acid ____n in hemoglobin rendering them ___
The cells often assume a ___ shape.
Important in individuals of ___ ___ descent.
Severe damage to ___ ___ can occur due to the ____ of small __ ___s.
Sickle Cell Anemia
Erythrocytes with an amino acid substitution in hemoglobin rendering them inflexible.
The cells often assume a sickle shape.
Important in individuals of African American descent.
Severe damage to peripheral circulation can occur due to the blockage of small blood vessels.
Leukocytes
Granulocytes (______ _____)
___
___
____
Agranulocytes (____ ____)
___
___
Leukocytes
Granulocytes (polymorphonuclear leukocytes, PMN)
Neutrophils
Eosinophils
Basophils
Agranulocytes (mononuclear leukocytes)
Lymphocytes
Monocytes
Neutrophils
______% of leukocytes
Neuts are most numerous of WBC in adult
12-15 micro m
Live for ___ days, half life in blood is 6-8 hours
May have ___ ___
___-___ nucleus
____ cells are immature neutrophils
Neutrophils
50-75% of leukocytes
Neuts are most numerous of WBC in adult
12-15 micro m
Live for 1-4 days, half life in blood is 6-8 hours
May have Barr Bodies
Multi-lobed nucleus
Band cells are immature neutrophils
Neutrophils
Contain ____
____
____
Contain granules
Specific
Azurophilic
Eosinophils
___ % of leukocytes
12-15 mm
Defining characteristics:Usually has a ___ nucleus (can have ___ lobes)
Lobes of nucleus are ____
Last about __ hours in circulation
____ granules in cytoplasm
Lots of ___ ___ granules
Granule matrix=___ ___
FCNS:
Increased in ___ infections, in ___ responses, ___. Also increased in ___ ___
____
Eosinophils
1-3% of leukocytes
12-15 mm
Defining characteristics:Usually has a bilobed nucleus (can have 3-4 lobes)
Lobes of nucleus are connected
Last about 8 hours in circulation
Eosinophilic granules in cytoplasm
Lots of small, pink granules
Granule matrix=lysosomal enzymes
FCNS:
Increased in parasitic infections, in allergic responses, asthma. Also increased in aromatic poisoning
Exocytosis
Basophils
9-10 mm in diameter
0.5-1.0% of leukocytes (__ ___)
Nucleus contains ___ lobes
___, __ staining ___ granules
Lots of __, ___ granules
Granules contain heparin, histamine, leukotrienes, serotonin
FCNS:
___ reaction
____
____
PAF = platelet activating factor
Allergic response in the skin, can also drive systemic anaphylaxis
Basophils
9-10 mm in diameter
0.5-1.0% of leukocytes (least numerous)
Nucleus contains 2-3 lobes
Large, dark-staining specific granules
Lots of fat, purple granules
Granules contain heparin, histamine, leukotrienes, serotonin
FCNS:
Allergic reaction
Anaphylaxis
Shock
PAF = platelet activating factor
Allergic response in the skin, can also drive systemic anaphylaxis
Monocytes
12-15 mm in diameter (____ cells in peripheral blood)
3-8% of leukocyte population
Life span 5-8 days
___, ____, ___- or ___ -shaped nucleus
___ cytoplasm
___ cells
Very ___ ____ granules (lysosomes)
FCN
Leave the ___ and enter ___. Once they are in the tissue, they are called ____
Macrophages are also “____ ____ ”.
___ and ____ particulate matter, tissue debris, infectious agents
You will observe them later in this course in the spleen, liver, and lungs
An important part of the ___ immune system
Monocytes
12-15 mm in diameter (largest cells in peripheral blood)
3-8% of leukocyte population
Life span 5-8 days
Big, ovoid-, peanut- or kidney-shaped nucleus
Pale cytoplasm
Big cells
Very small azurophilic granules (lysosomes)
FCN
Leave the blood and enter tissues. Once they are in the tissue, they are called macrophages.
Macrophages are also “professional phagocytes”.
Ingest and remove particulate matter, tissue debris, infectious agents
You will observe them later in this course in the spleen, liver, and lungs
An important part of the innate immune system
Lymphocytes
Can range from ___(6-8 mm), to l____e (>10-12mm)
____ lymphocytes are the most numerous in blood smear
28% of leukocytes
___, __ , ___ nucleus
__ ___ cytoplasm
FCNS
Will be dealt with extensively in your immunology course
B cells (__%)
(___ derived) Originate in __ ___
Can differentiate into ___ cells – these cells secrete ____
T cells (__ %)
Originate in __ ___, mature in ___
___ ___ immunity, ___, help for ___ ___n by B cells, ___of immune response
NK cells (_%)
“Natural killer” – lack cell __ ___ of B or T cells, attack ___ ___ or ___ cells.
You can’t __ the ___ between these cells on a regular blood smear!
Lymphocytes
Can range from small (6-8 mm), to large (>10-12mm)
Small lymphocytes are the most numerous in blood smear
28% of leukocytes
Spherical, big purple nucleus
Not much cytoplasm
FCNS
Will be dealt with extensively in your immunology course
B cells (15%)
(Bursa derived) Originate in bone marrow
Can differentiate into plasma cells – these cells secrete immunoglobulins (antibodies)
T cells (80%)
Originate in bone marrow, mature in thymus
Cell mediated immunity, cytoxocity, help for antibody production by B cells, regulation of immune response
NK cells (5%)
“Natural killer” – lack cell surface antigens of B or T cells, attack virus infected or tumor cells.
You can’t tell the difference between these cells on a regular blood smear!
Platelets
Cell ____ 2-5 mm in diameter
200-400,000/mm3
Defining characteristics:
____ nucleated ___, ___, ___ , ___
___ light-___ stained transparent zone – the hyalomere
____al zone containing __ __s – the granulomere
Open canalicular system
Liberates __ ___
Marginal bundle
Microtubules maintain __ ___
Platelets
Cell fragments 2-5 mm in diameter
200-400,000/mm3
Defining characteristics:
Non-nucleated flat, biconvex, round or ovoid
Peripheral light-blue stained transparent zone – the hyalomere
Central zone containing purple granules – the granulomere
Open canalicular system
Liberates active molecules
Marginal bundle
Microtubules maintain ovoid shape
A Field Guide for Spotting Blood Cells
How numerous is it?
__<_<_<_<_<_
How big is it?
____<_<_<_<_
What shape is the nucleus?
RBC = __
Monocyte = ___
Lymphocyte = __, ___
___, ___ = 2 or 3 lobes
___= multilobed
What size and color are the granules?
Basophil = __, ___
Eosinophil = ___, ___
Neutrophil = __ ___
Platelets = ___ and ___
A Field Guide for Spotting Blood Cells
How numerous is it? BEMLNR
Basophils< Eosinophils< Monocytes< Lymphcytes< Neutrophils< RBC
How big is it? PRLGM
Platelets< RBC< Lymphocytes< Granulocytes< Monocytes
What shape is the nucleus?
RBC = none
Monocyte = horseshoe
Lymphocyte = large, round
Eosinophil and Basophil = 2 or 3 lobes
Neutrophil = multilobed
What size and color are the granules?
Basophil = big and purple
Eosinophil = smaller and pink
Neutrophil = tiny granules
Platelets = light and dark
Summary
Blood is a connective tissue consisting of formed elements (cells) and plasma
Blood cells may be differentiated by frequency in the blood, cell size, shape of nucleus, and the size and color of granules
Blood cells have unique functions, these functions are dependent upon their structure.
Summary
Blood is a connective tissue consisting of formed elements (cells) and plasma
Blood cells may be differentiated by frequency in the blood, cell size, shape of nucleus, and the size and color of granules
Blood cells have unique functions, these functions are dependent upon their structure.
Clinical Correlates
Gingival infiltration in a patient with fever, fatigue, and weight loss is most suggestive of acute ___, especially monocytic variants of acute myelogenous leukemia. This patient’s gingival infiltration resolved after treatment for acute myelomonocytic leukemia.
AML spreads to the ___, they may swell or bleed, and if the T-cell variety of ALL spreads to the throat, it may cause c____g or suffocation (Oncology Channel, 1998).
Clinical Correlates
Gingival infiltration in a patient with fever, fatigue, and weight loss is most suggestive of acute leukemia, especially monocytic variants of acute myelogenous leukemia. This patient’s gingival infiltration resolved after treatment for acute myelomonocytic leukemia.
AML spreads to the gums, they may swell or bleed, and if the T-cell variety of ALL spreads to the throat, it may cause coughing or suffocation (Oncology Channel, 1998).
Anemias Wreak Havoc in the Oral Cavity
Pernicious anemia, iron deficiency anemia, and Plummer–Vinson syndrome usually affect the oral mucosa. The oral manifestations are early and common, and are characterized by an atrophic, ___,___ tongue. A___ sensation, taste __, __ __, and rarely ___ may be present.
The differential diagnosis includes atrophic lichen planus and malnutrition disorders. The diagnosis is based on hematological laboratory tests.
Anemias Wreak Havoc in the Oral Cavity
Pernicious anemia, iron deficiency anemia, and Plummer–Vinson syndrome usually affect the oral mucosa. The oral manifestations are early and common, and are characterized by an atrophic, smooth and red tongue. A burning sensation, taste loss, angular cheilitis, and rarely erosions may be present. The differential diagnosis includes atrophic lichen planus and malnutrition disorders. The diagnosis is based on hematological laboratory tests.
Hematopoiesis
The process of ____
Hematopoeitic tissues
Any tissue which actively or potentially produces ___ ___
Two types
___– __ __ of ___
___ – elements of the larger ___ ___ (we’ll deal with these later)
Hematopoiesis
The process of renewal
Hematopoeitic tissues
Any tissue which actively or potentially produces blood cells
Two types
Myeloid – red marrow of bones
Lymphoid – elements of the larger lymphatic system (we’ll deal with these later)
Stem Cells
(___ cells)Divide into ___ lineages (___cells):
Lymphoid
Myeloid
___
___
___
____
Stem Cells
(Pluripotential cells)Divide into two lineages (multipotential cells):
Lymphoid
Myeloid
Granulocytes
Monocytes
Erythrocytes
Megakaryocytes
Bone Marrow
Red vs. Yellow
Yellow = ___ ___
Red = ____
In newborns, bone marrow is all ___ , gradually replaced by ____ with age
In adult, hematopoeisis mainly occurs in ___ ___ . ___ and __ ___
Bone Marrow
Red vs. Yellow
Yellow = adipose tissue
Red = hematogenous
In newborns, bone marrow is all red, gradually replaced by yellow with age
In adult, hematopoeisis mainly occurs in cancellous bone. Vertebrae and hip joint
Bone Marrow Structure
Stroma
3 dimensional meshwork of __ ___s and ___
____ cells and ____
____ and other ___
Sinusoidal capillaries
Formed by a ____s layer of ____ cells
Release of ___ ___ cells is controlled by ___ ___
Bone Marrow Structure
Stroma
3 dimensional meshwork of reticular cells and fibers
Hematopoetic cells and macrophages
Collagens and other proteins
Sinusoidal capillaries
Formed by a discontinuous layer of epithelial cells
Release of bone marrow cells is controlled by releasing factors
Release of cells from bone marrow
Releasing factors
___
___
___
__ ___
Cells crossing into ___ ___
Note gaps between the ___ cells
Release of cells from bone marrow
Releasing factors
C3
Glucocorticoids
Androgens
Bacterial toxins
Cells crossing into sinusoid capillaries
Note gaps between the endothelial cells
Erythrocytes in various stages of erythropoiesis
E1 is least mature – E4 most mature
Note disappearance of ___
Increase in __ ___ of +___ (ncreasing levels of ___)
Erythrocytes in various stages of erythropoiesis
E1 is least mature – E4 most mature
Note disappearance of mitochondria
Increase in electron density of nucleus (increasing levels of hemoglobin)
Granulopoeisis
The ____ contains ___ (____ granules)
Specific granules appear ___ ___ into neutrophilic, eosinophilic, or basophilic ____
(sometimes these are all referred to as “_____”)
___–>______à à à Neutrophil, Basophil, Eosinophil
Granulopoeisis
The promyelocyte contains lysosomes (azurophilic granules)
Specific granules appear after differentiation into neutrophilic, eosinophilic, or basophilic myelocytes
(sometimes these are all referred to as “metamyelocytes”)
MyeloblastàPromyelocyteà à à Neutrophil, Basophil, Eosinophil
Band Cells (Immature Neutrophils)
AKA “___ ___”
“Shift to the___
Means you have higher amt of band cells compared to neutrophils
Means you are losing the war
Lots of band cells in the blood = ___ ___
Band Cells (Immature Neutrophils)
AKA “Stab cells”
“Shift to the left”
Means you have higher amt of band cells compared to neutrophils
Means you are losing the war
Lots of band cells in the blood = clinical significance
The difference between a band cell and a monocyte?
Band cell = ___ ___e shaped nucleus
Monocyte ___ or ___shaped nucleus
Monocytes are usually ___
The difference between a band cell and a monocyte?
Band cell = thin horseshoe shaped nucleus
Monocyte = peanut or kidney-shaped nucleus
Monocytes are usually bigger
Other cells in bone marrow
Megakaryocytes
Produce ___
Plasma cells
These are mature ___ ___ that are sequestered in ___ ___
Sometimes observed in bone marrow ___
Other cells in bone marrow
Megakaryocytes
Produce platelets
Plasma cells
These are mature B lymphocytes that are sequestered in bone marrow.
Sometimes observed in bone marrow smears
Megakaryocyte
Extensive ___ complex
Granules contain PDGF, VWF, platelet factor ___
Rough er and lots of Golgi present because platelets have ____so they need to originate in the Golgi complex.
Megakaryocyte
Extensive Golgi complex
Granules contain PDGF, VWF, platelet factor IV
Rough er and lots of Golgi present because platelets have granules so they need to originate in the Golgi complex.
Plasma Cells
Can be found in ___ ___ ___s and in ___ organs
Subset of lymphocytes (B cells)
Characteristics:
“__ ___”, ___ (not center) placed nucleus
___ cytoplasm
Plasma Cells
Can be found in all connective tissues and in lymphoid organs
Subset of lymphocytes (B cells)
Characteristics:
“Clock-faced”, eccentrically (not center) placed nucleus
Basophilic cytoplasm
Summary
Hematopoeisis is the production of new blood cells.
Occurs mainly in___ bone marrow in adults
Stem cells, progenitor cells, precursor cells and mature cells have different growth kinetics and growth factor requirements
Erythropoeitic, granulopoeitic, and thrombopoeitic precursor cells can be distinguished in bone marrow smears
Megakaryocytes and plasma cells are also easily distinguishable
Summary
Hematopoeisis is the production of new blood cells.
Occurs mainly in red bone marrow in adults
Stem cells, progenitor cells, precursor cells and mature cells have different growth kinetics and growth factor requirements
Erythropoeitic, granulopoeitic, and thrombopoeitic precursor cells can be distinguished in bone marrow smears
Megakaryocytes and plasma cells are also easily distinguishable
