Ch 10 Circulatory System Flashcards

1
Q

What is blood?

A

Connective tissue because it has a nonliving matrix and living cells
Plasma is the nonliving fluid component of blood.
Formed elements (below) are the cells and cell fragments.
Erythrocytes (red blood cells, RBCs)
Leukocytes (white blood cells, WBCs)
Thrombocytes (platelets)

liver, spleen and bone marrow remove, phagocytize and destroy old RBC

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2
Q

What is Hematopoiesis?

A

Formation of red and white cells from stem cells- Stem cells are always first
Two types myeloid from bone marrow (RBC, platelets, NEB and monocytes) and lymphoid from lymphatic system (b and t cells)
During fetal development-RBCs are made in the yolk sac, the liver, and the spleen.
After birth - Most blood cells are produced in red bone marrow by stem cells called hemocytoblasts.
Life span of an RBC is about 120 days

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3
Q

What is Erythropoietin ?

A

Regulates erythropoiesis = production of RBCs
Produced by the kidneys and released when oxygen concentrations in the blood get low. Stimulates red bone marrow to produce more RBC

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4
Q

What do V 12 and folic acid do?

A

Affect erythropoiesis

it is absorbed from the small intestine and functions in DNA synthesis

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5
Q

What does Iron do?

A

Iron is necessary to make hemoglobin.
it is absorbed from the small intestine
Anemia -Too few RBCs, too little iron, too little hemoglobin, or insufficient vitamin B 12

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6
Q

What are the nutrients in plasma?

A

Amino acids, glucose, nucleotides, and lipids that have all been absorbed from the digestive tract
Lipids must combine with molecules called lipoproteins to be transported by plasma.
Different types of lipoproteins are chylomicrons, very low-density lipoproteins (VLDL), low-density lipoproteins (LDL) (bad for you - clogs arteries), and high-density lipoproteins (HDL) (protects against heart disease)

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7
Q

What are Globulins?

A

Protein in plasma - 36%
Alpha globulin - Produced in liver , Transports lipids and fat soluble vitamins
Beta globulin - Produced in liver , Transports lipids and fat soluble vitamins
Gamma globulin - Produced in lymphatic tissues , are antibodies

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8
Q

What are Albumins?

A

Protein in plasma - 60%, smallest but most abundant
Found in the liver . Help maintain osmotic pressure .
Participate in blood pressure regulation, transport hormones

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9
Q

What are fibrogens?

A

Protein in plasma - 4%

Found in the liver. Key role in clotting

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10
Q

What are the gases in plasma?

A

Dissolved in plasma

Oxygen, carbon dioxide, and nitrogen

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11
Q

What are electrolytes in plasma?

A

Dissolved in the plasma

Sodium, potassium, calcium, magnesium, chloride, bicarbonate, phosphate, and sulfate

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12
Q

What are the Nonprotein nitrogenous substances ?

A

Amino acids, urea, and uric acid

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13
Q

What are erythrocytes?

A

Small cells that have a biconcave shape
Mature RBCs do not have a nucleus and cannot reproduce.
Transports O2 and CO2.

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14
Q

What is hemoglobin?

A

A pigment in RBCs
Hemoglobin that carries oxygen is called oxyhemoglobin and is bright red in color
Hemoglobin that is not carrying oxygen is called deoxyhemoglobin and has a darker red color
Carboxyhemoglobin refers to hemoglobin that is carrying carbon dioxide.

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15
Q

Centrifuged sample of blood

A

packed cell volume
Percentage of RBCs in relationship to the total blood volume is called the hematocrit or packed cell volume
Normal hematocrit is about 37 to 43 percent in females and 43 to 49 percent in males
On top of the RBCs is the plasma.
Between is a thin layer that is whitish in color and is referred to as the “buffy coat”
White blood cells and platelets

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16
Q

How are olds RBC filtered and what do they become?

A

Average life span of an erythrocyte is approximately 120 days.
Old RBCs are filtered out by macrophages in the liver and spleen.
One of the substances released from destroyed RBCs is a pigment called biliverdin that is converted to bilirubin in the liver.
Bilirubin is used to make bile, a substance that emulsifies or breaks apart fat molecule.
Accumulation of bile causes jaundice

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17
Q

What is Anemia?

A

Occurs when the blood has less than its normal oxygen-carrying capacity
RBC count, or hemoglobin concentration, is less than normal
Normal level in men is 13.8 to 17.2 grams/100 mL
Normal level in women is 12.1 to 15.1 grams/100 mL
Signs and symptoms
Tiredness, weakness, pallor, tachycardia, numbness or coldness of the hands and feet, dizziness, headache, and jaundice

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18
Q

What is Iron deficiency anemia?

A

Iron is needed to make hemoglobin, so low iron levels cause low hemoglobin levels.
When there isnt enough iron, it is pulled from the bone marrow
Pregnant women, heavy menstrual cycles, and chronic bleeding conditions such as ulcers and colon cancer

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19
Q

What is Aplastic anemia?

A

Result of bone marrow destruction due to toxic chemicals. All cell lines have been depleted
Damages bone marrow
Chemotherapy and radiation therapy, as well as some cancers and toxins

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20
Q

What is Hemolytic anemia?

A

Sickle cell disease, an autosomal recessive condition
RBCs that are normal in shape will sickle or hemolysied (becomes hard) and this will cause them to get stuck in capillaries (destroys RBCs)
Joint and chest pain, numbness in extremities, jaundice, infections, sores on the skin, delayed growth, stroke, seizures, and breathing difficulties, retina damage, spleen, liver, or kidney and lung damage
Antibiotics, blood transfusions, pain medications, bone marrow transplants, supplemental oxygen

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21
Q

What is Pernicious (megaloblastic) anemia?

A

Pernicious anemia is caused by the loss of stomach cells that produce intrinsic factor which allows for the absorption of B12. - So B12 and folic acid deficiency.
All cell lines become affected
Its a type of megaloblastic anemia - causes enlarged RBC that cannot absorb b12 or folic acid
More often called egaloblastic anemia
Causes excess of immature RBCs

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22
Q

What are WBCs?

A

Destroys pathogenic organisms
Categorized into two groups based on whether or not they have granules in their cytoplasm
Granulocytes have granules in their cytoplasm
Neutrophils, eosinophils, and basophils
Agranulocytes do not have granules in their cytoplasm.
Monocytes and lymphocytes
All leukocytes contain a nucleus.

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23
Q

What are Neutrophils?

A

they are 60% of WBC
have granules
Nucleus with three to five lobes and have phagocytic qualities
Release pyogenes causing fever
Destruction of bacteria with lysosomal enzymes and their numbers increase in the early stage of acute inflammation.
stain tan, pink, or lavendar
Pus

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24
Q

What are Eosinophils?

A

(3%) of WBCs
granules
Fight parasitic infections and are also increased in number in people with acute or active allergies
nucleus is bilobed- stain red/orange in acid stain
phatgocytic

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25
Q

What are basophils

A

<1% of WBCs
Release substances such as histamine, which promotes inflammation
Release heparin, which is an anticoagulant to prevent blood clot formation
nucleus is bilobed but looks like it takes over the whole cell , stains blue in basic stain
liver and lungs have the most basophils
Do not phagocytize - they swell the area by histamine

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26
Q

What are Monocytes?

A

8% of wbcs - very big kidney shaped almost take over the cell with mononucleus - bean shaped
Agranulocytes - cytoplasmic granules are absent
Active and quite large called (macrophages) when they leave the blood vessel and enter tissues
2-3 times larger than RBC. Nucleus can be spherical or lobed.
phagocytizes large particles - primary function
they engulf not only pathogens but also old RBC
increase in chronic infection - TB
LARGEST WBC

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27
Q

What are lymphocytes?

A
25-33% of wbcs
only a little larger than wbcs. the nucleus almost fills the whole cell but you can see a little cytoplasm - less than mono and more than baso
dense round nucleus 
Produce Ab - lives the longest 
provides immunity 
T cell, b-Cell and NK cell 
increase in viral infections
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28
Q

What is a normal WBC count and what happens if low or elevated?

A

A normal WBC count is between 5.0 and 10.0 cells per 10 to the 9 per liter
Significantly elevated = leukocytosis
Infection, by cancer, and by some drugs
Below normal = leukopenia
Viral infections or congenital bone marrow disorders, cancer, immune disorders, and some drugs
A differential WBC count lists the percentages of the different types of leukocytes in a sample of blood

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29
Q

What happens at the beginning of a bacterial infection or acute inflammation?

A

Number of neutrophils increases

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30
Q

What happens 2 weeks after a bacterial infection?

A

Monocytes increase

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31
Q

What happens during a parasitic infection

A

Eosinophil numbers increase

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32
Q

What happens in viral infections and chronic illness?

A

Lymphocytes increase

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33
Q

What happens in a person with AIDS

A

T Lymphocytes decrease

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34
Q

What happens during allergic reactions?

A

Basophils increase

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35
Q

What is Diapedesis?

A

WBCs crossing the blood vessel wall into the interstitium

Means “walking across”

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36
Q

What are Thrombocytes?

A

Also known as platelets. Cytoplasmic fragments
Helps control blood loss from broken vessels
Derived from very large cells located in the bone marrow called megakaryocytes (multilobed nucleas)
Do not have a nucleus
Normal count is between 130,and 360 x 10 to the 9 per liter platelets of blood
Platelets secrete seratonin causing vessel narrowing . Platelets are formed in the bone marrow and old ones are removed by the spleen

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37
Q

What is Thrombocytopenia?

A

Too few platelets, causing abnormal bleeding
Caused by leukemia, medications, or even idiopathic reasons
Bleeding may be mild or life threatening

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38
Q

What is Thrombocythemia?

A

Increase in the platelet count
Cause may be idiopathic or secondary to cancer, hemorrhage, and infection
Most cases are benign
Can cause serious thrombus or embolus formation

39
Q

What is Hemodynamics?

A

Hemodynamics is the study of blood flow.

40
Q

What is Blood pressure?

A

BP is defined as the force that blood exerts on the inner walls of blood vessels.
BP is highest in arteries and lowest in veins.
Systolic pressure or systole- Ventricles contract, BP is greatest in the arteries
Diastolic pressure or diastole- Ventricles relax, BP in arteries is at its lowest point
BP reported as the systolic over the diastolic number

41
Q

What is BP affected by?

A

cardiac output, blood volume, vasoconstriction, and blood viscosity.
Cardiac output is the total amount of blood pumped out of the heart in one minute.
When a person loses a large amount of blood, his or her BP significantly decreases.
If BP falls too low, vasoconstriction, which is the constriction of blood vessel walls, helps raise blood pressure

42
Q

How is BP regulated?

A

Baroreceptors are one way BP is regulated
Baroreceptors located in the aorta and carotid arteries detect BP changes and relay the information to the cardiac center in the medulla oblongata
Cardiac center then either increases or decreases the heart rate as needed

43
Q

How is BP measured?

A

BP is measured using a sphygmomanometer and stethoscope.
Pulsation of blood going through the arteries at certain locations can be felt
Feel a pulse are the carotid artery in the neck and radial artery in the wrist
Pulse rate is counted in beats per minute
Healthy individual is typically between 60 and 90 beats per minute

44
Q

What is hypertension?

A

Commonly known as high BP
Essential, idiopathic, or primary hypertension
Defined as a consistent resting BP at 140/90 mm Hg or higher
Hypertension is commonly known as the “silent killer”.
Increases a person’s risk of heart attack, stroke, heart failure, and kidney failure

45
Q

What is Secondary hypertension?

A

Cause has been identified
Narrowing of the arteries, oral contraceptives and cold medicines, kidney disease, endocrine disorders, pregnancy, drug use, sleep apnea, obesity, smoking, a high-sodium diet, excessive alcohol consumption, stress, and diabetes mellitus

46
Q

What is Hemostasis?

A

Control of bleeding
Three processes:
Blood vessel spasm
Platelet plug formation
Blood coagulation
If a blood vessel ruptures, the smooth muscle in the damaged vessel contracts and the blood vessel spasms.
Platelets begin to stick to the broken area and to each other to form a platelet plug.

47
Q

How does blood coagulate?

A

Formation of a blood clot is called blood coagulation.
Plasma protein fibrinogen is converted to fibrin.
Sticks to the damaged area of the blood vessel, creating a mesh web that entraps blood cells and platelets
Stops bleeding until the vessel has repaired itself

48
Q

What is an abnormal blood clot?

A

Abnormal blood clot is called a thrombus.
Occludes an artery in the heart or brain it can cause myocardial infarction (blocking coronal artery) or cerebral vascular accident (blocking cerebral artery)
Portion of the thrombus can break off and travel through the bloodstream
Traveling portion of the thrombus is called an embolus
Embolus may eventually block a small artery

49
Q

What is Hypoperfusion?

A

Hypoperfusion to tissues resulting in decreased oxygen and nutrient delivery resulting in shock. There are 4 types of shock

50
Q

What is Hypovolemic shock ?

A

Trauma that causes severe bleeding and loss of blood volume

51
Q

What is Cardiogenic shock ?

A

Heart is failing and is not pumping an adequate amount of blood to the body

52
Q

What is Vascular shock ?

A

Vasodilation, or dilation of blood vessels
Septic shock-Bacterial infections
Neurogenic shock-Head trauma

53
Q

What is Obstructive shock ?

A

Blockage of an artery causing a decrease in blood flow or perfusion of tissues

54
Q

How is blood typing done?

A

presence or absence of antigens (agglutinogens) on the surface of red blood cells

55
Q

What can antibody/gen is in type A and what can they receive?

A

gen - A
body - B
R - A and O

56
Q

What can antibody/gen is in type B and what can they receive?

A

gen - B
body - A
R - B and O

57
Q

What can antibody/gen is in type AB and what can they receive?

A

gen - A B
body - none
R - A, B, AB and O - universal recipients

58
Q

What can antibody/gen is in type O and what can they receive?

A

gen - none
body - A B- universal donor
R - O

59
Q

What is Agglutination?

A

Clumping of RBCs that can occur if a patient is given the wrong blood type during a blood transfusion
Occurs because proteins called antigens on the surface of RBCs bind to antibodies in plasma

60
Q

What is the Rh group?

A

First discovered on erythrocytes of the Rhesus monkey
Rh-positive have erythrocytes that contain the Rh antigen
Rh-negative have erythrocytes that do not contain the Rh antigen
If a person who is Rh-negative is given Rh-positive blood, then the Rh-negative person’s blood will make antibodies that bind to the Rh antigens.
If the Rh-negative person is given Rh-positive blood a second time, the antibodies will bind to the donor cells and agglutination will occur.
Types A and B can be Rh positive or negative

61
Q

How is hemolytic disease of the newborn or erythroblastosis fetalis caused?

A

Rh-negative female has a child with an Rh-positive male
Blood of an Rh-positive fetus mixes with the mother’s blood that is Rh-negative, the mother will develop antibodies against the fetus’s RBCs
Second Rh-positive fetus, the mother’s antibodies may cross the placenta and attack and destroy the fetus’s RBCs, condition is called hemolytic disease of the newborn or erythroblastosis fetalis

62
Q

What do blood vessels do?

A

Transport channels through which the blood travels

Arteries carry blood away from the heart and the blood in them is oxygenated.

63
Q

What do arteries and arterioles do?

A

Deliver oxygen and nutrients to the tissues
Large artery to smaller arteriole to capillary
Carry blood away from the heart - Efferent
carry oxygenated blood - except for the pulmonary arteries which carry deoxygenated blood to lungs for oxygenation

Arteries are high-pressure vessels
Three layers, or tunics
Tunica intima (inner most) is made up of a single layer of squamous epithelium called endothelium.
Tunica media is made up of smooth muscle, vasoconstriction (increase BP) or vasodilation (decrease BP).
Tunica externa (outer most) is made up of connective tissue.

64
Q

What are Veins and Venules?

A

Afferent
Veins carry blood toward the heart and carry deoxygenated blood except for pulmonary veins that carry oxygenated blood from lungs to heart
Blood is under much lower pressure.
Also have a tunica intima, tunica media, and tunica externa
Tunica media of veins is thinner, with less smooth muscle
Also serve as reserviors and store about 70% of total blood volume
Because they hold the most amount of blood and have thinner wall they are used for blood collection

65
Q

How do veins return blood to the heart?

A

Veins depend on two mechanisms to return blood to the heart they work against gravity because they take blood back to the heart
Pumping action of skeletal muscle
Pressure changes in the thoracic cavity that “draw” blood toward the heart
Valves work to prevent blood from “falling down” due to gravity

66
Q

What are capillaries

A

Smallest of the blood vessels
Thin walls—only about one cell layer thick
Allow substances to easily pass into and out of capillaries
Referred to as exchange vessels
Precapillary sphincters
Control the amount of blood that flows into them
Connect arterioles to venules

67
Q

How do substances move through the capillaries?

A

Substances that move through the capillary walls do so through diffusion, filtration, and osmosis
Blood is under pressure as it enters the capillary
Water is forced through the capillary wall via filtration
Blood leaves a capillary, it has a high solid concentration and a low water concentration
Water moves back into the capillary via osmosis

68
Q

What is an Aneurysm?

A

Results from a ballooned, weakened arterial wall
Most causes of aneurysms are unknown
Risk to developing an aneurysm is atherosclerosis, congenital conditions, traumatic injury to the chest
Often no signs and symptoms
Primary treatment is surgery to repair the aneurysm

69
Q

What is Thrombophlebitis?

A

Thrombus and inflammation develop in a vein
Prolonged inactivity, oral contraceptives, postmenopausal hormone replacement therapy, some cancers, paralysis in the arms or legs, the presence of a venous catheter, family history of this condition, varicose veins, and trauma
Tenderness and pain in the affected area; redness, swelling, and tenseness of the affected areas; fever; and a positive Homan’s sign
Application of heat to the affected area, elevation of the legs, anti-inflammatory drugs, anticoagulant medications, the wearing of support stockings, removal of varicose veins, and surgery to remove the clot

70
Q

What are Varicose Veins?

A

Tortuous or twisted, dilated veins that are usually seen in the legs
In the rectum, they are called hemorrhoids
Caused by prolonged sitting or standing, damage to valves in the veins, a loss of elasticity in the veins, obesity, pregnancy, use of oral contraceptives, or hormone replacement therapy
Discomfort in the legs, discoloration around the ankles, clusters of veins, and enlarged, dark veins that are seen through the skin
Sclerotherapy, laser surgery, vein stripping, and endoscopic vein surgery to close off affected veins

71
Q

What is the Pulmonary Circuit?

A

Pulmonary circulation is referred to as the low-pressure circuit.
BP is normally only one-eighth of that in the systemic circuit.
Purpose of this circuit is to take deoxygenated blood to the lungs and exchange carbon dioxide for oxygen
Blood returning to the heart is oxygenated

72
Q

What is the path for the pulmonary circuit?

A
Right atrium through the tricuspid valve
Into the right ventricle 
Through the pulmonary semilunar valve 
Into the pulmonary trunk 
Into the pulmonary arteries 
Into the lungs into pulmonary veins 
Into the left atrium
73
Q

What is the Systemic Circuit?

A

Systemic circulation is referred to as the high-pressure circuit.
Function of this circuit is to deliver oxygen and nutrients to body cells.
Also picks up carbon dioxide and waste products from body cells

74
Q

What is the path for the systemic circuit?

A

Left atrium through the bicuspid valve
Into the left ventricle
Through the aortic semilunar valve
Into the aorta
To the systemic arteries to arterioles to capillaries to venules to veins
To the superior and inferior venae cavae
Into the right atrium of the heart

75
Q

How are arteries paired?

A

Left and a right artery of the same name
Major exceptions - aorta comes directly off the left ventricle and is the largest artery. It is unpaired and is arched toward the left
Brachiocephalic trunk - large artery corresponds to aorta, but it comes off it and arches to the right

76
Q

What are the parts of the aorta?

A

Has three parts
Ascending aorta that extends from the left ventricle
Aortic arch
Descending aorta

77
Q

Ascending aorta - branch and organ supplied to

A

branch - right and left coronary

supplied - heart

78
Q

What portion of the aorta and branch supplies the right upper limb, and right side of head

A

Arch of aorta with brachiocephalic artery branch

79
Q

What portion of the aorta and branch supplies the left side of head

A

Arch of aorta with left common carotoid artery branch

80
Q

What portion of the aorta and branch supplies the left upper limb

A

Arch of aorta with left subclavian artery branch -

81
Q

What portion of the aorta and branch supplies the bronchi

A

in the descending aorta- thoracic aorta with brochial artery

82
Q

What portion of the aorta and branch supplies the pericardium

A

in the descending aorta- thoracic aorta with pericardial artery branch

83
Q

What portion of the aorta and branch supplies the esophagus

A

in the descending aorta- thoracic aorta with esophageal artery branch

84
Q

What portion of the aorta and branch supplies the mediastinum

A

in the descending aorta- thoracic aorta with mediastinal artery branch

85
Q

What portion of the aorta and branch supplies the thoracic wall

A

in the descending aorta- thoracic aorta with posterior intercostal artery branch

86
Q

What is the Venous System?

A

Arteries that supply blood to an area have corresponding veins associated with them
Large veins often have the same names as the arteries they run next to
Veins do not “supply” blood, but instead “drain” blood from an area
Largest veins of the body are the superior and inferior vena cavae
Empty into the right atrium of the heart

87
Q

Tests

A
  • Complete blood count (CBC)& Differential
  • Platelet count
  • Prothrombin time (PT/INR) & Partial Thromboplastin time (PTT)
  • Iron and Total iron binding capacity studies
  • Vit B12
  • ABO (blood group) and Rh factor
  • Blood group antibody test
  • Reticulocyte count
  • RBC Electrophoresis
  • Blood test for various cancer
  • Various Chemistries and Microbiology tests
88
Q

normal RBC count

A

Adult male is about 5.5 million erythrocytes per 10 to the 12 per liter
Adult female about 4.5 million erythrocytes per 10 to the 12 per liter

89
Q

What will happen if you poke artery instead of vein

A

Arteries have pulse and veins dont and the blood will be bright red as it is oxygenated blood . It will squirt . Put loads of pressure on it .

90
Q

T cell

A

formed in thymus,
cell mediated immunity
Helper t and suppessor T
Helper t - CD4 help other such as monocytes - these are destroyed by HIV

Suppressor - CD8 - stop another cells activities

91
Q

B cells

A
formed in lymphoid tissue of bone marrow and lymph nodes
humoral immunity (in fluids of body) - production of antibodies 
transform into plasma cells then release Ab to match specific Ag  that triggered their production
92
Q

NK cells

A

respond quickly to stress without the need of Ab

Break through cell membrane and lyse the cell

93
Q

What does plamsa contain

A
Proteins - fibrinogen, globulin, albumin
Electrolytes 
hormones like thymosin
water
nutrients - amino acids,  glucose, fatty acids 

liquid portion of unclotted blood

94
Q

Serum

A

liquid portion of clotted blood containing fibrin clot

NO FIBRINOGEN