Cardiovascular system Flashcards
how much blood does average adult have
8-12 pints
how much is given during blood transfusion
1 pint
how many pint in a gallon
8 pints
how many miles of blood vessels
70K miles (NYC and SFO 24x)
layers of heart
inside in endocardium (endothelial cells)
myocardium (muscular middle layer - left ventricle has thickest myocardium)
- outmost is epicardium (2 membranes - inner, serous visceral memrane attached to heart and outer, fibrous parietal membrane)
what side of the heart has more coronary arteries
left side because left sidee of heart is more muscular
what is coronary sinus
group of coronary veins joined together
structure of blood vessels
Tunica intima—the innermost, smooth layer in direct contact with the blood
● Tunica media—the middle, thickest layer, capable of contracting and relaxing
● Tunica adventitia—the outer covering, which protects and supports the vessel
what are artiereis
- efferent vessles (away from heart
- much thicker walls than veins and capillars as they have to withsdtand the pressure with which blood is pumped from the heart
- artieral blood is bright red
- most arteries are paired
what are veins?
- afferent vessles
- large veins shart names with artieres tehy run beside
- force is not as great in veins
- since they flow against gravity they have valves
- dark red blood
not a question but memorize main veins and arteries (page 148)
how much blood do veins store?
- 65% to 70%
how to know if it’s an artery or vein during venipuncture/ what to do if you puncutre an artery?
- vein in bouncy and artery is firmer and will puulsate
- artery blood in bright red with flow that is more forceful and may pulsate
- if arteiral puncture remove tourniquet, withdraw need, apply pressure for at least 5 minutes
- avoid veins near arteries
0 notify a nurse or supervisor
What is hematoma
- occurs when blood collects under skin, forming a blue and black mass
- can form as a result of inserting a needle through a vein or anb artery
- or fragile veins
vein commonly used for venipuncture area
- antecubital fossa - elbow pit
site selection
- if dermatitis or other condition place tourniquet over gown or cothing/ wrap arm in gauze
- do not drwa from arm with IV, mastectomy, stroke,
- check for sign with no bp or venipuncture for affected arm
most common vein patterns
H and M
veins used for venipuncture for H pattern
median cubital cephalic and basilic veins
order for h pattern veins
1) median cubital vein - middle, larger, closer to surface, well anchored
2) cephalic vein - well anchored bu harder to palpate (lateral to median cubital vein)
- basilic vein - easier to palpate, not well anchored (roll), medial to median cubiral vein, is close to median nerve and brachial artery
vein used for m pattern veins
median vein, median
cephalic vein, and the median basilic veins
order for m pattern venipuncture
1) median vein - center of forearm, well anchored, less painful
2) median cephalic vein - located away from major arteries and nerves
3) median basilic vein - more painful, located near anterior and posterior branch of the median cutaneous nerve
hand venipuncture
- dorsal venous arch and metacarpal plexus
blood function
- transport oxgven nutruent hormones to body cells and tussyes
- eliminate waste
- maintain water balance
- transoirt antibodies and protective substances to attack pathjogens
-regulate temp
acid-base balance
components of blood
= RBC
= platelets
- wbc (neutrophils, monocyte, eosinophil, lymphocyte, basophil)
what happens IN A TUBE OF ANTICOAGULATED BLOOD
- split into 2 parts : cellular and plama
- cellular is RBC, WBC, and platelets
what percent of blood total volumes are made of formed elements?
- 45% of bloods total volume
- almost 99% of circulating cells are RBC
how much of bloods total volume does plasma make up and what is plasma made of
- 55% of total volume
- 90-92% water and 8-10% solute (electrolytes, enzymes, glucose, hormones, lipids, proteins, metabolic substances)
where can stem cells found?
- myeloid - bone marrow
- lymphoid - lymphatic system
- rbc, platelets, granulocytes (neutrophils, eosinophils, and basophils), monocytes
what blood cells are formed in lymphoid stem cells
- b cells and t cells
wha tis the primary site of blood cell formation at birth?
bone marrow
how much rbc should an healthhy adult have?
y 4.2 to 6.1 million red blood cells per cubic millimeter (mm3
)
of blood
normal amount of rbc for men
M. 4.5–6.2 million/mm3
normal amount of rbc for women
F. 4.2–5.4 million/mm3
leukocytes
5,000–10,000/mm3
thrombocytes
150,000–450,000/mm3
shape of rbc
average 7 to 8 micrometers (μm) across their diameter, and their average volume is 90 femtoliters (fL) (a femtoliter is 10^-15)
- about 18 millions could sit on head of a pin
- viconcave (voth sides cave inward)
what is the lfiespan of erythrocytes
120 days (lose biconave shape and abiltiy to carry oxygen)
- The liver, spleen, and
bone marrow sequester (remove), phagocytize (ingest), and destroy old, wornout red blood cells
how can rbc carry o2 and co2
with hemoglobin - protein with iron compound heme
= rbc contains several million molecules of hemoglobin
high level of bilirubin in blood why?
-= hemolysis in blood can cause jaundice and increase in blood bilirubin
- can occur as a result of liver problems such as pet cirrhosis and onbstruction iof ducts
why place infants with elevated bilirubin levels under ultraviolet lamps
bilirubn is light sensitive
diaspedesis
pass through capillaries’ thin walls to better access pathogens or other foreign invaders
myeloid cells
granulocytes, monocytes
lymphoid cells
(T lymphocytes, B lymphocytes,
and natural killer [NK] cells
polumorphonuclear vs mononuclear meaning
polymorphonuclear, cells
that have a nucleus that is segmented into two or more lobes, and mononuclear,
cells that have a single-lobed nucleus
what is the most numerous rbc?
- neutrophils, 10-16 micrometers across their diameter and have 3 to 4 nuclear lobes
- granules in cytoplasm of neutrophiuls appear tan, pink or lavender
- neutrophils defend body against infections and avg life span is from 6 hrs t oa few days
60-70% of total wbc count
eosinophils
- average 10 to 16 micrometers and have 2 nuclear lobes
- low numbers
- bright red orage with eosin
- control inflammaotry reaction to prevent spread of inflammation
- phagocytize and destroy parasites, respond to allergic reactions, help kill tumor cells
- 8 to 12 days
1-4% of total wbc count
basophils
- bilobed nucleus and cytoplasmic granules that stain deep blue (may appear black)
- 0-1% of total wbc count
- assist with inflammatory response by releasing histamine, releasing heparin, vasodilator, increase during chronic inflammation
- 10-16 micrometers across
- large amt of blood (lung and livers) have largest amt of basophils
monocytes
- large kindey shaped nucleui
-fine cytoplasmic granules - 2-6% of total adult wbc
- largest wbc
- become macropgages
- phagocytize dying cells, microorganisms and forieng substances, levels increasing during chronic infections
- 12-18 micrometers across
lymphocytes
- round nuclei and minimum amt of cytoplasm
- b cells, t cells, NK cells
- 20-30% total wbc count
- b cells assist the immune system by producing antibodies
- t cells assist immune systems, nk cells respond to stressed cells, lymphocyte levels increase during viral infection
- 7-15 micrometers
dense, round nucleus surrounded by v little cytoplasm
t cell vs b cell
- T cells are formed in the thymus
- B cells are formed in the lymphoid tissue of the bone marrow and in the lymph
nodes. - T cells direct cell-mediated immune responses (cells helping other cells perform their function)
- t cells can be subdivided into helper T cells and suppressor T cells.
- Helper T cells, or CD4 cells, help other cells, such as monocytes, perform their functions
more efficiently. - Suppressor T cells, or CD8 cells, control or stop another cell’s activities.
- B-cells are responsible for humoral immunity (the production of antibodies)
percent of neutorphils in infants at birth and children
up to 80%
children have 40-60% lymphocytes and 20-30% neutrophils
what is b cell function (in more detail)
- humor immunity
- help defend the body by transforming into plasma cells,
which then synthesize, or combine, and release antibody molecules. The antibodies are made to match the specific antigens that triggered their production.
This B-cell response is called the humoral response because immunity is in the
humors, or fluids, of the body
what are nk cells ?
- target body cells infected by viruses as well as other types of abnormal cells, including cancer cells.
- rapidresponse to stressed or infected cells without the need for antibodies.
After attaching to a targeted cell, the NK cell breaks through the cell’s membrane and injects chemicals that cause the cell to lyse (break up). NK cells
are also thought to work with other types of lymphocytes to help control
immune responses
what are platelets?
- smallest (1-4 micrometers)
- no nucleus and r not complete cells
- fragments of megakaryocytes (largest cell in bone marrow)
- remain in circulation for 9-12 days
- adult have 150K to 450K per cubic millimeter
- secrete serotonin which causes bv to spasm
- formed in bone marrow and removed by spleen
what is plasma
- pale yellow fluid
- water -s 90-92@ of plasma (amt is monitored by kidney and pituatry gland)
- nutrients through digestive sustem
- hormones (ex: thymosin and insulin)
- electrolytes
- proteins : fibrinogen (clotting and made in liver), globulin (fight foreign invaders), albumin (regulating bp)
- waste
- protective substances (antitoxins, opsonin, agglutinin, bacteriolysins)
serum vs plasma
- plasma is liquid of unclotted blood (blood samples for plasma require anticoagulant - purple or lavender top)
- serum is liquid portion of clotted blood - when fibrinogen converts into fibrin (liquid component without clotting factors) (clot in 10-30 min)
what four events occur following injuries?
- Blood vessel spasm (vasoconstriction)
- Platelet plug formation
- Blood clotting (coagulation)
- Fibrinolysis, or dissolving of the clot and return of the vessel to normal
function
What is centrifugation?
- spinning of test tubes at high temp to seperate anticoagulant blood into cells and plasm
centrifuge for plasma vs serum
- plasma is processed by centriguge then tested
- serum is upright to coagulate then centrifuged before testing
clotting factors
Factor I, II, V, VII, VIII, IX, X
priamry hemostasis vs secondary hemostasis
priamry - platelet plug - platelet clump together
secondary - clotting factors form thrombin which converts fibrinogen into fibrin, takes several minutes
how to identify blood groups
- testing for agglutination - clumping of RVC
- agglutination occurs bc antigens on surface of RBC bind to antibodies in plasma
all the types
type a - antigen A, antibody B
type b - antigen b, antibody A
type AB - antigen A and B, no A or B antibody, universal blood receipient and unviersal plasma donors
- type O - neither A or B antigen, both antibody A and B antibodies, universal donors
What is Rh factor?
- RH positive have Rh antigen, Rh negative dont have Rh antigen
- Rh antigen is assigned letter D
- tested by adding antibodies to D antigen to a drop of pt blood, if agglutiantion Rh positive, no agglutination include Rh=negative blood
What happens if Rh neg person is given Rh-positive blood
- makes antibodies that bind to Rh antigens so second time Rh positive blood antibodies will bind to donor cells
What is truly the universal donor
O negative blood because it has no A, B, or D antigens
What is erythroblastosis fetalis?
if mom is Rh-negative and baby is Rh- positive mother develops antibodies against the fetus’s red blood cells and so the second Rh-positive fetus will have their blood will be attacked by the antibodies right away
how to prevent erythroblastosis fetalis?
give Rh-neg woman drugs that suppress production of anti-D such as RhIg or RhoGAM
What are transfusion reactions?
- when a pt is transfused blood that hey have an antibody to
- aggulation, hemolysis, fever or hives to dead
risk panel for CV
- ApoB (primary component of LDL)
- 9p21 (genoimc marker for CAD)
- N-terminal prohormone of brain natriuretic peptide (NT-proBNP)
- high sensitivty CRP
- homocysteine (elevate = increased risk of heart and bv disease
- fibrinogen (biomarker associated with CV disease)
what is the average volume of blood pumped by heart in 1 min
called cardiac output
is avg of 5L/min
