Blood Cells and the Hematopoetic System Flashcards
Blood is a specialized connective tissue that consists of blood cells (red blood cells, white blood cells, and platelets) suspended in an extracellular fluid, known as ________
plasma
The major difference between plasma and serum is the presence of _________ in the plasma from an anticoagulated centrifuged whole blood specimen.
fibrinogen
The most abundant of the blood cells, the ___________ or _____, function in oxygen and carbon dioxide transport.
erythrocytes or RBCs
The leukocytes, or ______, serve various roles in immunity and inflammation.
WBCs
__________are small cell fragments that are involved in blood clotting.
platelets
Plasma ______ serves as a transport vehicle for materials carried in the blood.
water
As a transport medium, plasma carries nutrients from the gastrointestinal tract and oxygen from the lungs to body cells while picking up waste products from the cells for delivery to excretory organs. It also transports _________ and facilitates the exchange of chemical mediators.
hormones
Plasma participates in _______ and acid–base balance, and it contains the plasma proteins that contribute to the osmotic regulation of body fluids. In addition, because water has a high capacity to hold heat, plasma can absorb and distribute much of the heat that is generated in the body.
electrolyte
The plasma proteins are the most abundant solutes in plasma. It is the presence of these proteins that distinguish the composition of plasma from that of interstitial fluid. The major types of plasma proteins are (3)
albumin
globulins
fibrinogen
Except for the blood-borne hormones and gamma globulins, most plasma proteins are produced by the ______, which secretes them into the blood.
liver
_________ is the most abundant and makes up approximately 54% of the plasma proteins. It does not pass through the pores in the capillary wall to enter the interstitial fluid and therefore contributes to the plasma osmotic pressure and maintenance of blood volume. It also serves as a carrier for certain substances and acts as a blood buffer.
albumin
the _____ globulins transport bilirubin and steroids
alpha
the _____ globulins transport iron and copper
beta
the ______ globulins constitute the antibodies of the immune system.
gamma
_______ makes up approximately 7% of the plasma proteins. It is a soluble protein that polymerizes to form the insoluble protein fibrin during blood clotting.
fibrinogen
The blood cells, including the erythrocytes, leukocytes, and platelets, originate in the ______ _________
bone marrow
true or false.
Erythrocytes have no nuclei or organelles and platelets are just cell fragments. Most blood cells do not divide. Therefore, division of cells in the bone marrow must continually renew them.
true
_____ are the most numerous of the formed elements. They are small, biconcave disks
RBCs or erythrocytes
RBCs have a large surface area and can easily deform into just about any shape to move through the small capillaries of the circulatory system. They contain the oxygen-carrying protein, _________, that functions in the transport of oxygen.
hemoglobin
Ninety percent of the erythrocytes, which have their origin in the bone marrow, live approximately _____ days in the circulation and then are phagocytosed in the bone marrow, spleen, and liver
120
Although erythrocytes have no organelles, they have soluble enzymes, including ________ _________, within their cytosol. This enzyme facilitates the formation of carbonic acid from carbon dioxide and water, which in turn dissociates into bicarbonate and hydrogen ions. Thus, erythrocytes also contribute to carbon dioxide transport and regulation of acid–base balance and are considered a superior acid–base buffer.1
carbonic anhydrase
The leukocytes, or white blood cells, are 10 to 12 µm in diameter and thus much larger than RBCs.2 However, they constitute only 1% of the total blood volume. They originate in the bone marrow and circulate throughout the ________ tissues of the body.
lymphoid
____________ are crucial to our defense against disease in the following ways:
- They are responsible for the immune response that protects against disease-causing microorganisms.
- They identify and destroy cancer cells.
- They participate in the inflammatory response and wound healing.
leukocytes
neutrophils, eosinophils, basophils are classified as
granulocytes
lymphocytes and monocytes are classified as
agranulocytes
____________ are spherical and have distinctive multilobar nuclei. They are all phagocytic cells that are identifiable because of their cytoplasmic granules. They have two types of granules—the specific granules that bind neutral, basic, or acidic dye components and azurophilic granules. The azurophilic granules stain purple and are lysosomes.
granulocytes
___________ are primarily responsible for maintaining normal host defenses against invading bacteria and fungi, cell debris, and a variety of foreign substances.
neutrophils
__________ are very mobile and are the first cells to go to an area of tissue damage. Their migration is a result of the release of adhesion molecules on their surface, which connects with ligands on the endothelial cells
neutrophils
The neutrophils have their origin in the ___________ that are found in the bone marrow
myeloblasts
The myeloblasts are the committed precursors of the granulocyte pathway and do not normally appear in the peripheral circulation. When they are present, it suggests a disorder of blood cell ___________ and __________
proliferation and differentiation
The myeloblasts differentiate into promyelocytes and then myelocytes. Usually, a cell is not called a myelocyte until it has at least 12 granules.1 The myelocytes mature to become metamyelocytes, at which point they lose their capacity for ________
mitosis
Mature neutrophils are often referred to as segs because of their segmented nucleus. Development from stem cell to mature neutrophil takes approximately __ _______ before it enters the bloodstream
2 weeks
____________ is an increase in immature neutrophils (“band” forms) seen in the peripheral blood. It is most commonly seen in acute infections and tissue injuries that promote the accelerated release of neutrophils and their precursors into the circulation.
neutrophilia
After release from the marrow, the neutrophils spend only approximately 4 to 8 hours in the circulation before moving into the _______ where they live for 4 or 5 days
tissues
Epinephrine, exercise, stress, and corticosteroid drug therapy can cause rapid ________ in the circulating neutrophil count by shifting cells from the marginating to the circulating pool.
increases
Endotoxins or microbes have the opposite effect, producing a transient ___________ in neutrophils by attracting neutrophils into the tissues.
decrease
These leukocytes constitute 1% to 3% of the total white blood cells and increase in number during allergic reactions and parasitic infections.
eosinophils
These granules contain heparin, an anticoagulant; histamine, a vasodilator; and other mediators of inflammation such as leukotriene that cause bronchoconstriction of smooth muscles in pulmonary airways.
basophils
Both the basophils and mast cells are thought to be involved in allergic and _____________ reactions
hypersensitivity
They originate in the bone marrow from lymphoid stem cells and are the main functional cells of the immune system. They move between blood and lymph tissue, where they may be stored for hours or years. Their function in the lymph nodes or spleen is to defend against microorganisms through the immune response.
lymphocytes
the ____ lymphocytes are so named because they were first recognized as a separate population in the bursa of Fabricius in birds and bursa-equivalent organs (e.g., bone marrow) in mammals. They differentiate to form antibody-producing plasma cells and are involved in humoral-mediated immunity.
B
the _____ lymphocytes differentiate in the thymus. They activate other cells of the immune system (helper T cells) and are involved in cell-mediated immunity (cytotoxic T cells)
T
_________ _________ cells participate in innate or natural immunity and their function is to destroy foreign cells.
natural killer
The monocytes, which are precursors of the mononuclear phagocyte system, are often referred to as __________ when they enter the tissues.
macrophages
the largest of WBCs
monocytes
The _______ engulf larger and greater quantities of foreign material than the neutrophils. These leukocytes play an important role in chronic inflammation and are also involved in the immune response by activating lymphocytes and by presenting antigen to T cells.
monocytes
The macrophages are known as _______ in loose connective tissue, _______ cells in the brain, and _______ cells in the liver. Other macrophages function in the alveoli, lymph nodes, and other tissues.
histiocytes in connective tissue
microglial cells in brain
Kupffer cells in liver
Granulomatous inflammation is a distinctive pattern of chronic inflammation in which the __________ form a capsule around insoluble materials that cannot be digested.
macrophages
circulating cell fragments of the large megakaryocytes that are derived from the myeloid stem cell. They function to form the platelet plug to help control bleeding after injury to a vessel wall
thrombocytes or platelets
Thrombocytes have a membrane but no nucleus, cannot replicate, and, if not used, last approximately ___ days in the circulation before the phagocytic cells of the spleen remove them.
10
the ____________ ________ encompasses all of the blood cells and their precursors, the bone marrow where blood cells have their origin, and the lymphoid tissues where some blood cells circulate as they develop and mature.
hematopoietic system
__________ begins in the endothelial cells of the developing blood vessels during the 5th week of gestation and then continues in the liver and spleen. After birth, this function is gradually taken over by the bone marrow.
hematopoiesis
Marrow that is made up predominantly of ____ ______ is called yellow bone marrow
fat cells
In adults, red marrow is largely restricted to the flat bones of the (3)
pelvis, ribs, and sternum
The blood-forming population of bone marrow is made up of three types of cells—self-renewing stem cells, differentiated progenitor (parent) cells, and functional mature blood cells. All of the blood cell precursors of the erythrocyte (i.e., red cell), myelocyte (i.e., granulocyte or monocyte), lymphocyte (i.e., T lymphocyte and B lymphocyte), and megakaryocyte (i.e., platelet) series are derived from a small population of primitive cells called the
pluripotent stem cells
Several levels of differentiation lead to the development of committed unipotential cells, which are the progenitors for each of the blood cell types. These cells are referred to as
colony forming units
Under normal conditions, the numbers and total mass for each type of circulating blood cell remain relatively constant. The blood cells are produced in different numbers according to needs and regulatory factors. This regulation of blood cells is thought to be at least partially controlled by hormone-like growth factors called
cytokines
__________ anemia develops when the multipotent stem cells fail to grow and provide cells for differentiation. The result is concomitant anemia, thrombocytopenia, and granulocytopenia (pancytopenia).
aplastic
Unregulated overproduction of the red cell mass is termed _____________. Thrombocytosis occurs when the bone marrow produces too many platelets.
polycythemia
__________ represent a spectrum of diseases characterized by an abnormal proliferation of white blood cells.
leukemias
Stem cell transplants may be derived from the patient (__________) or from a histocompatible donor (_________).
from self - autologous
from compatible person - allogenic
Umbilical cord blood from HLA-matched donors is a transplant option for children and carries less risk of
graft vs host disease
Many people with leukemia obtain ______ ______ _________ that greatly impact their ability to have a remission
stem cell transplants
Stem cell transplants focus on correcting bone marrow failure, immunodeficiencies, hematologic defects and malignancies, and inherited errors of metabolism.
The white cell differential count is the determination of the relative proportions (percentages) of
individual white cell types
The erythrocyte sedimentation rate (ESR) is a screening test for monitoring the fluctuations in the clinical course of a disease such as chronic fatigue syndrome, lupus erythematosus, or polymyalgia rheumatica (PMR). Symptoms of these inflammatory disorders include fatigue, fever, and headache, which are all a result of the systemic effects of cytokine release. ____________ sedimentation rate indicates inflammation and is used as a baseline and trend indicator in managing
increased
An individual is diagnosed with PMR and will have an initial ESR drawn. If the ESR is > 60 the person is diagnosed with a more severe PMR than if the person had an elevated ESR of 40. Generally, the person is prescribed ________, and then at follow-up visits, the dose will be gradually decreased depending on the ESR and the person’s symptoms.
prednisone
In anticoagulated blood, RBCs aggregate and sediment to the bottom of a tube. The rate of fall of the aggregates is accelerated in the presence of fibrinogen and other plasma proteins that are often _________ in inflammatory diseases.
increases
Bone marrow aspiration is performed with a special needle inserted into the bone marrow cavity, through which a sample of marrow is withdrawn. Usually, the __________ _______ ______ is used in all people older than 12 to 18 months of age. Other sites include the anterior iliac crest, sternum, and spinous processes T10 through L4.
posterior iliac crest
true or false
The sternum is not commonly used in children because the cavity is too shallow and there is danger of mediastinal and cardiac perforation.
true
The major hazard of these procedures is the slight risk of __________. This risk is increased in people with a reduced platelet count or any type of bleeding dyscrasia.
hemorrhage
