ch18 Flashcards
What does the circulatory system consist of?
Heart
Blood Vessels
Blood
What does the cardiovascular system consist of?
Heart
Blood vessels
What is hematology?
Study of blood
What are the main functions of the circulatory system?
Transport
Protection
Regulation
How many litres of blood does an adult have?
4-6L
What type of tissue is blood?
A liquid connective tissue
What is plasma?
matrix of blood
clear light yellow fluid
What are formed elements?
Blood cells and cell fragments
RBC
WBC
platelets
Name the 7 formed elements
Erythrocytes
Platelets
Neutrophils
Eosinophils
Basophils
Lymphocytes
Monocytes
What are erythrocytes?
Red blood cells
(RBC)
What are platelets?
cell fragments of megakaryocytes
Name the five leukocytes
Neutrophils
Eosinophils
Basophils
Lymphocytes
Monocytes
What type of blood cell are leukocytes?
White blood cells
Name the Granulocytes
Neutrophils
Eosinophils
Basophils
Name the agranulocytes
Lymphocytes
Monocytes
Name the cell type

Eosinophil
Name the formed element

Erythrocyte
Name the formed element

Basophil
Name the formed element

Lymphocyyte
Name the formed element

Monocyte
Name the formed element

Neutrophil
Name the formed element the black line leads to

platelets
What is Hematocrit
centrifuging of blood to separate components
What is the buffy coat ?
A small layer of leukocytes and platelets between plasma and blood
What is the normal volume of RBC
37-52%
What volume of plasma is normal ?
47-63%
What is blood plasma made up of?
Water
Proteins
Nutrients
electrolytes
nitrogenous wastes
Hormones
Gases
What is Serum?
remaining fluid when blot clots and solids are removed
Serum is identical to plasma except for….
abscence of fibrinogen
What are the three major categories of plasma proteins?
Albumins
Globulins
Fibrinogen
What is the function of Albumin proteins
Contribute to viscosity and osmolarity
influence blood pressure
influence blood flow
influence fluid balance
what is the function of Globulins?
Antibodies
provide immune system functions
What are the 3 types of globulins
Alpha
Beta
Gamma
What is the function of fibrinogen
precursor of fibrin threads that help form blood clots
Where are plasma proteins formed?
Albumins and fibrinogen: Liver
Globulins: plasma cells
What is blood viscosity ?
How thick or sticky your blood is
Why is viscosity important?
Circulatory function relies upon blood being right thickness to flow.
If blood is too thick?
viscous, can clog arteries and veins
raise blood pressure
What is blood osmolarity ?
total molarity of those dissolved particles that cannot pass through the blood vessel wall
If osmolarity is too high?
blood absorbs too much water raising blood pressure
if osmolarity is too low ?
- too much water stays in the tissue
- blood pressure drops
- edema occurs
How is optimum osmolarity acheived?
body’s regulation of sodium ions, proteins and RBC’s
What is kwashiorkor?
- children with severe protein deficiency
- thin arms and legs
- swollen abdomen
What is Hypoproteinemia?
- Deficiency of plasma proteins
- extreme starvation
- Liver or kidney disease
- severe burns
What is hemopoiesis?
Production of blood and formed elements
What to hemopoietic tissues do?
produce blood cells
What does the yolk sac do?
produces stem cells for first blood cells
Red Bone marrow produces which of the formed elements?
All 7
What are pluripotent stem cells?
hemopoietic stem cells, where all formed elements begin
What is a colony forming unit?
specialized stemm cells that only produce one class of formed element
what is myeloid hemopoiesis?
blood formation in the bone marrow
What is lymphoid hemopoiesis?
blood formation in the bone marrow
After infancy this only means Lymphocytes
What are the two principle functions of Erythrocytes?
- Carry oxygen from lungs to cell tissues
- Pick up CO2 from tissues and bring to lungs
Describe the anatomy of erythrocytes
Biconcave shape with thick rim
Lose nearly all organelles during development
lack mitochondria
Lack nucleus and DNA
Blood type determined by surface glycoproteins and glycolipids
cytoskeletal proteins give membrane durability and resilience
Each HB molecule is comprised of
4 protein chains
Adult HB has..
2 alpha and 2 beta chains
fetal Hb contains….
2 alpha and 2 gamma chains
What do globins bind?
CO2
How many heme groups in hemoglobin?
4
Why are erythrocytes and hemmoglobins lower in women?
- Androgens stimulate RBC production
- periodic menstrual losses
- Women have more body fat
What is erythopoiesis?
RBC production
How many RBC are produced per second?
1 million
What is the average lifespan of an erythrocyte?
120 days
How long does erythropoiesis take?
3-5 days
Erythrocyte colony foming units have receptors for…
erythropoietin (EPO)
Where is EPO produced
Kidneys
What is the common name for dietary iron (Fe3+)
Ferric
What is the common name for dietary iron (FE2+)
Ferrous
What is iron metabolism?
Absorption of iron in to body to be turned in to hemoglobin and myoglobin
Stomach acid converts Fe3+ to…..
Fe2+
……binds to Fe2+ and transports it to the small intestine
Gastroferritin
Iron is absorbed into the blood plasma from the small intestine and binds to…….for transport to bone marrow liver and other tissues
transferrin
In the liver, some transferrin releases…….for storage
Fe2+
Fe2+ binds to apoferritin to be stored as
ferritin
Reamining transferrin is distributed to other organs to make…….
Hemoglobin and myoglobin
Why do we need B12 and folic acid have for iron metabolism?
Rapid cell division and DNA synthesis that occurs in erythropoiesis
Why do we need vitamin C and copper for iron metabolism?
Cofactors for enzymes synthesizing hemoglobin
What are the stimuli for increasing erythropoiesis
- Low levels O2 (hypoxemia)
- High altitude
- increase in exercise
- Loss of lung tissue in emphysema
*
Which type of feedback control is involved in erythrocyte homeostasis?
Negative feedback control
What is hemolysis?
rupturing of RBCs in liver and spleen
what is the role of macrophages in the spleen?
- digest membrane bits
- separate heme from globin
What are the two types of polycythemia?
Primary polycythemia (polycythemia vera)
Secondary polycythemia
What is primary polycythemia?
Cancer of the erythropoietic cell line in red bone marrow
RBC count as high as 11 million RBC
Hematocrit 80%
What is secondary polycythemia?
RBC up to 8 million
caused by dehydration, emphysema high altitude or physical conditioning
Dangers of polycythemia
Increased blood volume
Increased blood pressure
Increased viscosity
Can lead to embolism, stroke or heart failure
Three causes of anemia
Inadequate erythropoiesis or hemoglobin synthesis
Hemorrhagic anemia from bleeding
Hemolytic anemia from RBC destruction
What is pernicious anemia?
autoimmune attack of stomach tissue leading to inadequate B12 absorption
What is Hypoplastic anemia?
Slowing of erythropoiesis
What is Aplastic anemia
complete cessation of erythropoiesis
Three potential consequences of Anemia
Tissue hypoxia and necrosis
blood osmolarity is reduced
blood viscosity is low
what is sickle cell disease?
Hereditary defetct in erythrocytes resulting in them becoming sickle shaped
What are the effects of sickle cell?
Hbs does not bind oxygen well
RBC’s become sticky and rigid
RBCs clump together and blook small blood vessels
Blood types are based on interactions between…..
Antigens expressed on cell membrane and antibodies in plasma
What are antigens?
Complex molecules on the surface of RBCs that activate an immune response
Used to distinguish self from foreign bodies
what are agglutinogens?
antigens on the surface of the RBC tht are the basis for blood typing
what are antibodies?
Proteins (gamma globulins) secreted by plasma cells
What is the function of antibodies?
They bind to foreign antigens and mark them for destruction
What is an antigen antibody complex?
The result of an antibody binding to a foreign antigen
What are agglutinins
Antibodies in the plasma that bring about transfusion mismatch
What is agglutination?
Antibody molecule binding to antigens
Causes clumping of RBCs
What is another name for antibodies?
B cells
Plasma cells
RBC antigens A and B are called?
Agglutinogens
Anti- A and Anti -B are both types of
Agglutinins
Most common blood type is
O
Rarest blood type is
AB
Blood type A has which Agglutinogens (antigens) and which Antibodies (Agglutinins)
A antigens
B antibodies
Blood type B has which Agglutinogens (antigens) and which Antibodies (Agglutinins)
B antigens
Anti-A antibodies
Blood type AB has which Agglutinogens (antigens) and which Antibodies (Agglutinins)
both A and B antigens
no antibodies
Blood type O has which Agglutinogens (antigens) and which Antibodies (Agglutinins)
neither antigen
Both Anti A and Anti B antibodies
Which is the universal donor and why
type O
Because it has no antigens to be detected by antibodies in plasma of recipient
Which is the universal recipient blood type and why?
AB
because it has no antibodies in the plasma to react to antigens
What is a transfusion reaction
forming of agglutinins resulting in agglutination of the blood because antibodies in the recipient blood have reacted to antigens in the donor blood
What are the possible results of a transfusion reaction?
blockage of small blood vessels
renal failure
death
what are the Rhesus groups?
C,D and E
Which is the most reactive Rhesus group?
D
You are either Rhesus Positive or?
Negative
A patient is RH+ if they have
D antigens (agglutinogens) on the RBC
What is hemolytic disease of the newborn (HDN)?
Occurs when a pregnant mother is RH- and fetus is RH+
First pregnancy ok
Second pregnancy problematic because she has developed Anti D antibodies
Why would we give a pregnant woman RhoGAM?
To prevent her body from creating anti d
What are Leukocytes?
White blood cells
Roughly how many WBCs do we expect to see?
5,000 to 10,000
Least abundant formed element
Monocytes give rise to what?
Macrophages
What is a common characteristic of all WBC’s?
Conspicuous nucleus
Which leukocytes are classifies as granulocytes?
Neutrophils
Basophils
Eosinophlis
Which leukocytes are classified as agranulocytes?
Lymphocytes
Monocytes
Where do WBCs migrate to ?
Connective tissue
Main functions of WBC’s (Leukocytes)
Protectagainst infectious microorganisms and other pathogens
What is the normal percentage of Neutrophils?
60-70%
What is the normal percentage of Eosinophils?
2-4%
What is the normal percentage of Basophils?
less than 1%
What is the normal percentage of Lymphocytes?
25-33%
What is the normal percentage of Monocytes?
3-8%
Main function of Neutrophils
aggressively antibacterial
responds to bacterial infections
Main function of Eosinophils
fights parasitic infections
collagen diseases
allergies
disease of spleen and CNS
Main functions of basophils
fight chickenpox, sinusitis,diabetes
main function of Lymphocytes
destroy cancer cells
virally infected cells
All kinds of immune responses
B-cells
main function of Monocytes
Viral infections and inflammation
Also antigen presenting cells (APC)
What is Leukopoiesis?
Production of white blood cells
What are the main categories of leukopoiesis?
Pluripotent stem cell
colony forming units
precursor cells
mature cells
Put the following in order:
Pluripotent stem cell
eosinophil
Eosinphilic myeloblast
Eosinophilic CFU
Eosinophilic promyelocyte
Eosinophilic myelocyte
Pluripotent stem cell
Eosinophilic CFU
Eosinophilic myeloblast
Eosinophilic promyelocyte
Eosinophilic myelocyte
Eosinophil
which cell line do NK cells, T- cells and B- cells come from
Lymphoblasts/lymphocyte
What is Leukopenia?
Low WBC count (below 5000)
Elevated risk of infection
Possible causes of Leukopenia
Radiation
Poisons
infectious disease
What is leukocytosis?
high WBC above 10,000
Possible causes of leukocytosis?
Infection, allergy, disease
What is a deifferential WBC count?
identifies what percentage of the total wbc count consist of each type of cell
What is Leukemia?
Cancer of hemopoietic tissue ususally producing a very high number of circulating lymphocytes
what is Myeloid leukemia?
uncontrolled granulocyte production
What is lymphoid leukemia?
uncontrolley lymphocyte or monocyte production
What is Acute leukemia?
- appears suddenly
- progresses rapidly
- death within months
What is chronic leukemia?
can go undetected for months
survival time 3 years
Possible effects of Leukemia?
normal cell percentages disrupted
impaired clotting
opportunistic infections
What is Hemostasis?
Cessation of bleeding
what are the three mechanisms of hemostasis?
- Vascular spasm
- platelet plug formation
- blood clogging (coagulation)
Which formed element plasy the most important role in hemostasis?
Platelets
How are platelets formed?
Stem cells become megakaryocytes in red bone marrow which break small pieces off to become platelets
What is a normal platelet count?
130,000-400000
What are the functions of platelets?
Secrete vasoctonstrictors
form platelet plugs
secrete procoagulants
initiate formation of clot-dissolving enzyme
chemically attract neutrophils and monocytes to sites of inflammation
phagocytize and dissolve bacteria
secrete growth factors that stimulate mitosis to repair blood vessels
What is thrombopoiesis?
what is vascular spasm?
prompt constriction of a broken vessel
mos immediate protection againts blood loss
the last and most effective defense against bleeding is?
Clotting (Coagulation)
What are the two pathways of coagulation?
Intrinsic
Extrinsic
What is the trigger for the extrinstic coagulation path ?
Damaged perivascular tissue
What is the trigger for the intrinsic coagulation pathway ?
Platelets release Hagemen facctor
What are the two clotting factors for the extrinsic coagulation mechanism?
Thromboplastin (factor III)
Factor VII
Both coagulation pathways merge to activate factor…?
X (10)
What nutrient do both pathways require?
Calcium
What type of feedback loop does coagulation use?
Positive feedback loop
Thrombin speeds up activation of prothrmbin activator
Clot retraction occurs within …..
30 minutes
What is fibrinolysis?
dissolution of a clot
Which enzyme converts plasminogen to plasmin?
Kallikrein
What is plasmin?
a fibrin dissolving enzyme that breaks up the clot
Natural anticoagulants
Heparin - from mast cells and basophils
Antithrombin (from liver)
What is a clotting disorder?
Deficiency of any clotting factor that can shut down the coagulation cascade
What is Hemophilia?
Hereditary clotting disorder
Which is the most dramatic Hemophilia
Hemophilia A
What is a Hematoma?
masses of clotted blood in the tissues
What is a thrombosis?
Abnornal clottin gof an unbroken vessel
What is a thrombus?
A clot
What is a pulmonary embolism?
clot that has broken free and travelled to block blood vessels
What is an embolus?
Anything that can travel in the blood and bloock blood vessels
What is an infarction?
Tissue death due to blocked vessels
what is the structure labelled 5?
Lungs