Blood and Lymph Flashcards by Brenda Perez

5 major roles of blood

Transportation of essential nutrients and oxygen
2.) Regulation of pH
3.) Fluid loss restriction (injury site)
4.) Defense (against toxins and pathogens)
5.) Regulating Body temperature (blood is 90% water - high heat capacity).

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Blood Characteristics

-Temperature = 100.4 degrees

-5x as viscous as water

-Men have more blood than women (7% of body weight in Kg)

-When centrifuged blood can be separated out into its various constituents. The main component are WBC, Plasma and RBC’s. The plasma has the water components in it (RBC fraction does too).

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Plasma

What is separated out from the RBC/WBC (constitutes 55% of blood). It also has coagulation factors and all of its proteins (Liver synthesizes)

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Albumin

Most abundant, involved with - Osmolarity, pH, transport fat soluble compounds (like hormones and lipids)

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Globulin

2nd abundant, involved with - Steroid binding proteins, apolipoproteins, metal ions, antibodies

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Fibrinogen

(not in serum) - Clotting proteins

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Formed elements

Synthesized within liver: the constituents of blood: WBC, RBC, and platelets. This fraction of the blood is called hematocrit.

a. Hematocrit (formed elements)
b. RBC account for 99% of formed elements

c.) RBCs make 1/3rd of all cells in body

d. Hematocrit is when blood goes into centrifuge

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RBCs are also known as

erythrocytes

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Characteristics of RBCs

RBCs are bi-concave shape;
-Increases surface area (2000x of body)

-Allows for it to more easily fold, they do not have nuclei or mitochondria

-Can form stacks for smooth blood flow through narrow vessels  Rouleaux

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RBCs have

Hemoglobin;

A protein consisting of 4 globular (quaternary) protein subunits, 2 alpha, and 2 Beta - (Contain 270 million hemoglobin units per RBC).

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Oxyhemoglobin

Bound to O2

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De-oxyhemoglobin

without O2

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Carbon Monoxide poisoning

Odorless, tasteless compound: linear sigma, bond to iron VS. 120 degree angle for O2 pi bond. Tighter bond.

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Sickle cell -

Beta chain subunits are mangled up and can attach to each other distorting the RBC bi-concave shape (not all RBCs express it and fetal cells are resistant to it).

-Recessive trait - heterozygous may be protective in malaria

-Hydroxyurea, butyrate and hyperbaric oxygen can help by increasing fetal RBCs

-Fetal Hb lacks beta chain: Does not display sickle cell

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Erythropoiesis

The formation of new RBCs in adults

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What does Erythropoiesis needs?

-Needs nutrients - B12, B6, Folate (B9), Iron Occurs only in Red-bone marrow and myeloid tissues

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Hemocytoblasts (hematopoietic stem cells)

first stem cells of formed elements in red marrow

Turns into active cells - myeloid cells and lymphoid cells (differentiation into RBCs or WBCs) and lymphocytes.

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Stage 1——-Day 1 of the RBC maturation

Pro-erythroblast

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Stage2 ——Day 2 of RBC maturation

“Erythroblasts” (d2 basophilic)

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Stage 3 ——Day 3 of RBC maturation

polychromatophilic

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Stage 4 ——Day 4 of RBC maturation

Normoblastic: ejection of nuclei

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Stage 5 & 6 ———Day 5-7 of RBC maturation

Reticulocyte and

Final. RBCs

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What is an effect of Erythropoietin EPO (hormone)?

directly stimulates erythropoiesis in bone marrow to stimulate cell division/ maturation

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EPO is a …?

glycoprotein from kidneys with extracellular receptor

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Erythropoiesis requires ... ?

amino acids, Fe2+, B12, B6, and B9

Stimulus for release: anemia, low blood flow to kidneys, low lung O2, respiratory surface damage to lungs

Erythropoiesis

RBC tests can

measure size, number and shape to determine what is missing

RBC Recycling

When RBC’s die, age, or undergoes hemolysis or ruptured RBCs  recycled via the spleen/liver (phagocytic type monocytes in liver Kupffer cells)

Alpha/beta chains of Hb eliminated via kidney

RCB Recycling

hemoglobinuria

RBC breakdown found in urine

hematuria

Whole RBC (kidney damage) in urine

Heme stripped of its iron turns into

biliverdin (green)

Biliverdin turns into_____(yellow/orange)- goes to liver to be processes and comes out the Gall bladder into the gut out the stool (give it its color)

Bilirubin

Jaundice

inability to process heme/bilirubin (yellowish pigment) Sun lyses the bonds helps “digest” bilirubin for processing - likely a glucuronidation issue in the liver due to the RBC die off from the switch to using lungs VS chord O2

Our body can store and recycle the iron and it does so with the two metallo-proteins known as

ferritin/hemosiderin.

Ferritin

Intracellular iron storage protein (universal)

Hemosiderin

Iron storage in the spleen from the breakdown of RBCs/Heme.

Transferrin

Blood protein transporter

Every RBC has a surface________

antigen

Four major antigens

- A, B ,O , AB

Rh-factor

Another major portion is the + or - called “rhesus factor”

agglutinogens

Immune system ignores own antigens

agglutinins or Antibodies

antibodies made against antigens

Type O

Has both antibodies to A/B

Type A

Has antibodies to B

Type B

Has antibodies to A

Type AB

Has no antibodies

agglutination (clumping)

When antigens react with antibodies

Cross-reaction (transfusion reaction) occurs when ...?

antigen-antibody complexes form and hemolyze RBCs

Universal donors

(O-)

Universal receivers

Hemolytic Disease of the Newborn

-immune reaction during second pregnancy in the newborn -Occurs only in Rh- women with Rh+ babies -Occurs only if mother is exposed to baby’s blood (only occurs during abortions, amniocentesis, hemorrhage due to trauma (ie. car accident) If both parents are Rh- there is NO risk

Platelets

Called Thrombocytes - aid in blood clotting

What is one function of platelets ?

Release enzymes and chemicals for activating clotting

What is another function of platelets ?

Temporary patch job in damaged blood vessels

What is a function of platelets ?

Reduce size of break (shrink after clot)

Thrombocytopoiesis

platelet synthesis (Red bone marrow)

Megakaryocytes

large cells in the marrow

Process of blood clotting

(hemostasis)

Feedback Control

Plasma contains anticoagulants

Heparin

(from mast/basophils) activates antithrombin-III prevents clotting

Thrombomodulin

Combines with thrombin to activate Protein C  inactivates clotting factors

Prostacyclin

All pathways need what ???

Vitamin K and Ca2+

fibrinolysis

In the repair processes clot dissolves

Leukopoiesis

WBC production

Myeloid (three types) make all formed elements;

i.) Turn into RBC ii.) Turn into Platelets iii.) Turn into WBCs  Basophiles, neutrophils, eosinophils, monocytes - Basophils, neutrophils, eosinophils  mature in Red bone marrow - Monocytes  mature in blood/tissue

Lymphoid- lymphocytopoiesis--- mature in thymus (T-cells), spleen and lymph nodes

Role of WBCs is to remove pathogens, wastes, toxins, damaged cells. -Circulating WBCs are in minute amounts (mostly in tissues)

neutrophil

Most common type of WBC

Lymphoid

Respond to signals of damage or infection: a.) Migrate out of blood into tissues  margination (adherence) diapedesis (migration out/into tissue) b.) Amoeboid movement c.) Chemotaxis - Attracted to specific chemical stimuli guiding immune cells into correct area

Granulocytes (granular leukocyte)

are specialized leukocytes (WBCs) that release granules which release chemicals that destroy pathogens or activate a systemic response.  secretory vesicles and lysozymes

Three granulocytes

Neutrophil, basophil, and eosinophil

Agranulocyte (agranular leukocyte)

Contains lysozymes but too tiny to see in microscope

Two agranulocyte -

monocyte, lymphocyte

Multi-CSF

Increase granulocytes, monocytes, platelets and RBCs

GM-CSF

Increase granulocytes/monocytes

G-CSF

Increase Granulocytes

M-CSF

Increase monocytes

50-70% circulating WBC neutrophil

Neutrophil

Lymphocytes can be broken down into T and B cells.

Neutrophil

2-5 Nuclei lobes (beans strung together)

Neutrophil

Polymorphonuclear Leukocyte

Neutrophil

Highly mobile - first to arrive

Neutrophil

Phagocytic type - attack via recognition from antibodies or complement proteins

Neutrophil

Includes “respiratory burst”  ROS bombs (peroxide and superoxide)

Neutrophil

Degranulation releases content to further kill and digest cell or organism

Neutrophil

Releases prostaglandins and leukotrienes that signal the rest of immunity

Neutrophil

Only survive 10 hours in circulation

Neutrophil

Stain darkly with “eosin”

Eosinophils

2-4% of circulating WBCs

Eosinophils

Engulf antibody-marked bacteria, protozoan, cellular debris

Eosinophils

Primary mode of attack is exocytosis of cytotoxic NO/ enzymes

Eosinophils

Works well against parasites

Eosinophils

Involved with allergies

Eosinophils

Smaller than neutrophils and eosinophils and stain darker than both

Basophils

Less than 1% of circulating WBCs

Basophils

Migrate to site of injury

Basophils

Release granules into interstitial fluid  heparin and histamine

Basophils

Eosinophil attractants

Basophils

Usually the largest (especially in a stain)

Monocytes

One large kidney bean shaped nucleus

Monocytes

2-8% of circulating WBCs

Monocytes

Lasts only 24 hours before migrating into tissue  macrophage

Monocytes

Release attractant contents  Neutrophils, monocytes, fibroblasts

Monocytes

Stain/smear, large circular single nuclei

Lymphocytes

20-40% circulating WBCs

Lymphocytes

Three types T-cells - cell mediated immunity B-cells - humoral immunity (produces antibodies) Natural killer cells - immune surveillance  detection and eradication

Lymphocytes

Differential Count - Blood test for WBCs

Lymphocytes

Leukocytosis

high WBCs (leukemia)

Leukopenia

low WBCs

Produce, maintain, and distribute lymphocytes and other lymphoid cell that defend against infection, toxins and is important for cellular repair.

Primary function of the lymph

Lymphatic vessels

Are the “green” (are they?) vessels that carry lymph fluid around (which enters from interstitial fluid)

Lymphatic Organs

1. Red bone marrow, 2. Thymus

Lymphatic tissue

1. Tonsils, 2. MALT, 3. Lymph nodes, 4. Spleen

Collecting Lymph

Superficial (under skin, mucous membranes) and b. Deep lymphatics (large, deep arteries/veins for muscles head/neck limbs, and trunk)

Lymphatic Capillaries

Branches of lymphatic vessels through tissues which end (non-continuous)

Collecting Lymphs

Collect lymph from lymphatic capillaries

Superficial Lymphatics

Areolar tissues of serous membranes in heart, abdomen, mucous membranes, and skin.

Deep Lymphatics

accompany deep arteries and veins of muscle, limbs, neck, visceral organs

Thoracic Duct

Collects from tissues inferior to the diaphragm and from the left side of the body above diaphragm  empties into L-subclavian vein

Cisterna Chyli

sac-like chamber connected to the thoracic duct that receives the flow from the inferior portion of the lymph first

Right Lymph Duct

Collects from the right side of body above the diaphragm  empties into R-subclavian vein

MALT

mucosa associated lymph tissue

Blood Filtration (old dying RBCs)

Spleen function

Iron metabolism (recycling Iron from dead, damaged RBCs)

Spleen function

Prevention of infection (Rich macrophage white pulp and antigen production, opsonization for phagocytosis)

Spleen function

Red blood cell and platelet storage (hematopoiesis, 25-30% RBCs stored (aids in hemorrhage), 25% of Platelets stored)

Spleen function

Large amounts of macrophages throughout - white pulp has both lymphocytes/dendritic cells

Spleen function

Attacks all without specificity; has general antimicrobial actions - it can react upon first exposure

Innate (non-specific)

Physical barriers

Mainly skin, mucosa

Chemical barriers

Stomach acid and defensins (anti-microbial peptides; Alpha-defensin) and secretory IgA (sIgA).

Cellular

Neutrophils, macrophages, NK cells, interferon, and Complement

a type of “cytokine” various WBC’s release and are well known for anti-viral actions but can be used to generate a bolstered immune response

Interferon

remove damaged cells/destroy invading microorganism

Phagocytes

Neutrophils/eosinophils circulate blood but can enter tissue.

Microphages

from monocytes) engulfing or releasing toxins

Macrophages