Chapter 10 Blood Flashcards
1
Q
Cardiovascular system consists of:
A
- Fluid – blood
- Conducting tubes – blood vessels
- Capillaries
- Arteries
- Veins - Pump – heart
2
Q
Functions of Blood
A
- Transports O2, CO2, nutrients, hormones, wastes
- Regulates pH and ion composition by absorbing and neutralizing acids
- Restricts fluid loss at injury sites with clotting process
- Defends against toxins and pathogens with white blood cells and antibodies
- Stabilizes temperature by absorbing heat and distributing blood flow to different areas
3
Q
Blood
A
- The only fluid connective tissue in the human body
- Components of blood
1. Formed elements - living cells (RBC, WBC, platelets)
2. Plasma - non-living matrix
Volume in body (~8% of body weight):
5 – 6 liters in average male
4 – 5 liters in average female
4
Q
Physical Characteristics of Blood
A
- Blood is a sticky opaque fluid with a salty metal taste
- ~5 x thicker than H2O
- Oxygen-rich blood is scarlet red
- Oxygen-poor blood is dull red/blue
- pH 7.35 – 7.45 (alkaline)
- Blood temperature is slightly higher than body temperature (38°C or 100.4°F)
5
Q
If blood is centrifuged
A
- Erythrocytes sink to the bottom Hct ~45%
- Buffy coat in the middle - leukocytes and platelets ~1%
- Plasma rises to the top ~55%
6
Q
Blood Plasma
A
- Straw colored fluid – contains over 100 substances (proteins, ions, nutrients, gases, wastes)
- Transports organic and inorganic molecules, formed elements, heat
- Forms ~55% of whole blood volume
- Composed of:
90% water
7% plasma proteins
3% other solutes
7
Q
blood plasma composed of
A
90% water
7% plasma proteins
3% other solutes
8
Q
water
A
90 % of plasma volume; solvent for carrying other substances, absorbs heat
9
Q
salt electrolytes
A
sodium-osmotic balance and pH buffering potassium- regulation of membrane calcium- permeability magnesium chloride bicarbonate
10
Q
plasma proteins
A
albumin-osmotic balance and pH buffering
fibrinogen-clotting of blood
globulins- defense ( anti bodies and lipid transport
11
Q
substances transported by blood
A
- nutrients
- waste products of metabolism (Urea and uric acid)
- Respiratory gases ( O2 and CO2)
- Hormones (steroids and Thyroid Hormone are carried by plasma proteins)
12
Q
platelets function
A
blood clotting
13
Q
Cell Type: Erythrocytes (red blood cells)
A
Function: transport O2 and help transport CO2
14
Q
Cell Type: Leukocytes ( white blood cells)
A
Function: defense and immunity
15
Q
Plasma Proteins
A
- Albumin
- regulates osmotic pressure
- keeps water in the blood stream
- regulates fluid volume (small assistance with pH)
*Clotting proteins/factors (fibrinogen, prothrombin)
helps to prevent blood loss when a blood vessel is injured
- Globulins:
- Antibodies - help protect the body from pathogens
- Lipid carriers - HDL’s and LDL’s
16
Q
Other Plasma Solutes
A
*Electrolytes
Na+, K+, Ca2+, Mg2+, Cl–, HCO3–, HPO4–, SO42–
*Organic nutrients
Lipids, carbohydrates, amino acid
*Organic wastes
Urea, uric acid, creatinine, bilirubin, ammonium ions
17
Q
Formed Elements - RBC
A
**Erythrocytes (RBCs) - ~45% (37–54%) of whole blood (termed Hematocrit)
-Main function is to carry O2 – also transport some CO2
18
Q
Red Blood Cells
A
- RBC count is number of RBCs per microliter (cubic millimeter)
- Males: 4.5–6.3 million per µL
- Females: 4.2–5.5 million per µL
- RBCs make up about 1/3 of all cells in the human body
19
Q
Functional Aspects of Red Blood Cells
A
1.Large surface area-to-volume ratio
Oxygen bound to hemoglobin in RBCs
Greater surface area allows for faster exchange of oxygen
- RBCs can form stacks
Allows easier flow through narrow blood vessels without jamming - Flexibility
Can bend and flex to squeeze through capillaries as small as 4 µm (nearly half the normal RBC diameter
20
Q
Features of Red Blood Cells
A
*Filled with hemoglobin (Hb):
-Iron-containing protein that binds with oxygen
-Each RBC has ~250 million Hb molecules
14–18 g/dL whole blood in males
12–16 g/dL whole blood in females
21
Q
Oxyhemoglobin – bright red
A
Blood with oxygen bound to hemoglobin
22
Q
Deoxyhemoglobin –dark red / blue
A
Blood with lots of hemoglobin not bound to oxygen
23
Q
Red Blood Cell Production and Recycling
A
-RBCs continually produced and recycled (3 million / sec)
- Short lifespan of 120 days, then:
- Plasma membrane ruptures or cell is engulfed by macrophages
*Broken down in spleen (main site) or liver
24
Q
Formed Elements -
A
WBC -White blood cells
25
Leukocytes (WBCs)
- Crucial in the body’s defense against disease
- Defends the body against bacteria, viruses, parasites, tumors – can move between blood and tissues
- Circulate in bloodstream for short period then migrate into loose and dense connective tissue
26
Formed Elements
* Attracted to specific chemical stimuli released by damaged tissues
- This positive chemotaxis guides WBCs to pathogens and damaged tissue
* Some (neutrophils, eosinophils, monocytes) are phagocytes
- Surround and destroy the foreign substance by phagocytosis
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phagocytes
neutrophils
eosinophils
monocytes
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Formed Elements
* When inflammation or infection in the body --- the body produces more WBC (normally 5000 – 10000 WBC/µL)
* Can measure WBC in the blood
- High levels (over 11,000) means there is infection or inflammation – increased number is called leukocytosis
- Low levels (called leukopenia) means they are being destroyed – often by drugs (chemotherapy or steroids)
– these low levels puts them at risk for infection
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2 Categories of leukocytes
1 . Granulocytes
2. Agranulocytes
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Granulocytes
- Granules in their cytoplasm
| - Include neutrophils, eosinophils, and basophils
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Agranulocytes
- Lack cytoplasmic granules
| - Include lymphocytes and monocytes (macrophages)
32
WBCs from most to least abundant
```
Neutrophils
Lymphocytes
Monocytes
Eosinophils
Basophils
```
33
Easy way to remember this list
```
N ever
L et
M onkeys
E at
B ananas
```
34
Neutrophils (Granulocyte)
* Most common of WBC – 50 to 70%
* Life span ~12 hours
* Role is phagocytosis
- High quantity in exudates
35
Bad situation to have low levels of neutrophils
- Will not be able to fight infections
| - Chemotherapy destroys neutrophils
36
Basophils (Granulocyte)
* <1% of leukocytes
* Main role is release of histamine to activate inflammation
---Inflammatory chemical that makes blood vessels leaky and leads to chemotaxis
---Reason why you get swelling with inflammation/infection
*Also releases heparin (anticoagulant) – so blood does not clot with all these extra cells
37
Eosinophils (Granulocyte)
* 2 – 4% of leukocytes
* Secrete chemicals that destroy certain parasites or allergens
- Those with parasite infection or allergic reaction will have elevated eosinophil count
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agranulocytes
1. Lymphocytes
| 2. Monocytes
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Lymphocytes
- 20–40 % of leukocytes
| - Comprised of B-cells and T-cells (part of immune system
40
Monocytes
- 2–8 % of leukocytes
- Largest of the white blood cells
-Mature into dendritic cells or macrophages
Also eat up old RBCs
41
Dendritic Cells
Dendritic cells are present in those tissues that are in contact with the external environment, such as the skin and the inner lining of the nose, lungs, stomach and intestines
42
Function of Dendritic Cells
- as antigen presenting cells (APC).
| - act as messengers between the innate and the adaptive immune systems.
43
NK (Natural Killer) Cells (3rd type of lymphocyte)
- provide rapid responses to viral-infected cells, acting at around 3 days after infection, and respond to tumor formation.
- Typically, immune cells detect foreign antigens presented on infected cell surfaces, triggering cytokine release, causing lysis or apoptosis.
- unique, as they have the ability to recognize stressed cells in the absence of antibodies and foreign antigens, allowing for a much faster immune reaction
44
Mast Cells (like Basophils
*present in most tissues characteristically surrounding blood vessels and nerves, and are especially prominent near the boundaries between the outside world and the internal milieu, such as the skin and mucosa of the respiratory and digestive tract.
-
*Contains many granules rich in histamine and heparin.
-Best known for their role in allergy and anaphylaxis
Also play an important protective role, being highly involved in wound healing, angiogenesis, immune tolerance, defense against pathogens, and bloodbrain barrier function.
45
Formed Elements
Platelets (thrombocytes)
46
Platelets (thrombocytes)
* Not actually cells – they are fragments of cells
* They cling to broken blood vessel or tissue, thus helping to control blood loss
* Needed for the clotting process
- Low number means more bleeding
- High number means clotting
*Life span of ~9-12 days
47
DEFINITION OF HEMATOPOIESIS
* blood cell (RBC, WBC, platelets) formation
| - Occurs in red bone marrow – common sites include skull, pelvis, ribs, sternum, heads of humerus and femur
48
Bone marrow
produces different cells at different rates – does this based on the body needs
49
Erythropoietin (EPO) is :
released into plasma when oxygen levels are low (hypoxia) such as with:
Anemia
Declining blood flow to kidneys
Decreased O2 content of air (ex: high altitudes)
Damage to respiratory surface of lungs
50
Erythropoietin (EPO)
stimulates stem cells in bone marrow to produce RBCs
51
Formation of White Blood Cells and Platelets
Controlled by hormones
52
Controlled by hormones
* Colony stimulating factors (CSFs) and interleukins prompt bone marrow to generate leukocytes
- Role of thymosin in maturation?
* Thrombopoietin stimulates production of platelets
53
Thrombopoietin
stimulates production of platelets
54
Blood Clotting Measurements
Partial thromboplastin time (PTT)
Prothrombin time (PT)
International normalized ratio
55
Partial thromboplastin time (PTT)
- performance indicator of the efficacy of both the "intrinsic" (now referred to as the “contact activation pathway”) and the common coagulation pathways.
56
Prothrombin time (PT)
* measures the efficacy of the extrinsic pathway (“tissue factor pathway”)
- PTT and PT are used in conjunction
57
International normalized ratio (INR)
-the ratio of a patient's prothrombin time to a normal (control) sample, as the time may vary according to the test used
58
PLASMA
is the liquid cell free part of the blood, that has been treated with anti-coagulants
-has all the clotting factors
59
SERUM
the liquid part of the blood after coagulation, therefore
devoid of clotting factors as fibrinogen
-not included,anything that is used for
blood clotting
60
Clot Dissolution
*Process of clot dissolving is fibrinolysis
* Begins with activation of plasminogen to plasmin
- Plasmin erodes clot
61
fibrinolysis
Process of clot dissolving
62
Plasmin is
- produced in an inactive form, plasminogen, in the liver, and circulates in the blood.
- Although plasminogen cannot cleave fibrin, it still has an affinity for it, and is incorporated into the clot when it is formed.
63
Tissue plasminogen activator (t-PA) :
-converts plasminogen to the active plasmin, thus allowing fibrinolysis to occur.
is released into the blood very slowly by the damaged endothelium of the blood vessels, so that after several days (when the bleeding has stopped), the clot is broken down.
- plasminogen is inactive
64
Blood Groups and Transfusions
*Large losses of blood have serious consequences
- Loss of 15 to 30 percent causes weakness, pallor
- Loss of over 30 percent causes shock - can be fatal
*Transfusions are the only way to replace blood quickly
***Transfused blood must be of the same blood group
65
Transfusions are
the only way to replace blood quickly
66
Transfused blood
must be of the same blood group
67
ANTIGEN
Each RBC contain genetically determine protein called antigen – this makes each individual unique
68
***ANTIGEN IS
a substance that the body recognizes as foreign – it stimulates the immune system to release antibodies to defend the body against the antigen (called antigen-antibody response)
69
antigen-antibody response)
antibodies to defend the body against the antigen
Type A, has Anti-B Antibodies
Type B, has Anti A antibodies
70
Blood Groups
- There are over 30 common red blood cell antigens
| - The most vigorous transfusion reactions are caused by ABO and Rh blood group antigens
71
Rh Blood Groups
* Named because of the presence or absence of Rh antigens
- Rh+:carry the Rh antigen (most prevalent)
- Rh-: do not carry the Rh antigen
* Problems can occur in mixing Rh+ blood with Rh– blood
72
Cross-reactions
occurs when antigens of one blood type are exposed to antibodies from another blood type
- response is agglutination or clumping together (block blood vellel)
- Cells may rupture (hemolysis)
73
Cross-reactions
Main cause is transfusion of incorrect blood type
74
RhoGAM
shot can prevent buildup of anti-Rh+ antibodies in mother’s blood
75
Cross-reactions
Response is agglutination or clumping together (block blood vellel)
Cells may also rupture (hemolysis)
76
BLOOD TYPING
TYPE AB
TYPE B
TYPE A
TYPE O
77
TYPE AB
contains Antigen A and B; agglutinates with both Sera
78
TYPE B
contains Antigen B;
| agglutinates with anti B serum
79
TYPE A
contains Antigen Type A;
| agglutinates with anti B serum
80
TYPE O
No Antigen
| does not agglutinates with either serum
81
Blood Analysis -
CBC- Complete Blood Count
82
CBC- Complete Blood Count
Measurement of cells in the blood:
*White Blood Cells
* Red Blood Cells
- Hemoglobin
- Hematocrit
*Platelet
83
White Blood Cells (Leukocytes)
Normal Count 4.0-10.0 x 109/L
( need to know this number!)
```
Neutrophil
Lymphocyte
Monocyte
Eosinophils
Basophils
```
_no need to memorize D' %
84
Neutrophil
Function:
Phagocytosis of microorganisms
85
Lymphocyte
Participates in cell-mediated and humoral immunity against viruses.
86
Monocyte
Participate in immune and inflammatory response
87
Eosinophils
Role in allergic conditions, parasitic infections, phagocytosis
= 1 - 4 %
88
Basophils
Contain histamine, serotonin, heparin
granules. Precise function not clearly understood.
-0 - 0.75 %
89
Red Blood Cells (Erythrocytes
* The majority of cells in the blood are red cells.
* Normal Count
- 4.4-5.7 x 1012/L Male
- 4.0-5.2 x 1012/L Female
90
Red Cells Indices
Hemoglobin (Hb)
Hematocrit (Hct)
91
Hemoglobin (Hb)
-Amount (grams) of Hb per L of blood
Male: 140-174 g/L (14.0-17.4 g/dL)
Female: 123-157 g/L (12.3-15.7 g/dL)
-not memorize but understand
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Hematocrit (Hct)
Percentage of blood occupied by RBCs
Male: 0.420 – 0.520 (42% - 52%)
Female: 0.370 – 0.460 (37% - 46%)
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Platelets
* Their primary role is to prevent bleeding, participate in blood coagulation, inflammation and wound healing.
* Normal Count 150-400 x 109/L
- (memorize dz #)
94
Developmental Aspects of Blood
1. Sites of blood cell formation
- The fetal liver and spleen are early sites of blood cell formation
- Bone marrow takes over hematopoiesis by the 7th month
2. Fetal hemoglobin differs from hemoglobin produced after birth
- Physiologic jaundice results in infants in which the liver cannot rid the body of hemoglobin breakdown products fast enough
95
Fetal Hemoglobin
- Fetal hemoglobin (also hemoglobin F, HbF) is the main oxygen transport protein in the human fetus during the last seven months of development (makes up 50 – 95% of all hemoglobin at birth).
- Functionally, fetal hemoglobin differs most from adult hemoglobin in that it is able to bind oxygen with greater affinity than the adult form, giving the developing fetus better access to oxygen from the mother's bloodstream.
- In newborns, fetal hemoglobin is nearly completely replaced by adult hemoglobin by approximately 6 months postnatally
96
Aging Blood
- Values remain constant
- Fasting glucose increases
- Take longer to produce RBC
- Recover more slowly from bleeding episodes
- WBC respond to infection more slowly
- Greater risk of anemia and clotting disorders
97
Define hematocrit.
the ratio of the volume of red blood cells to the total volume of blood.
98
Define hemostasis and name its three phases.
Hemostasis
1. vascular
2. platelet
3. coagulation
recheck
99
During an infection, which components of blood would be elevated?
neutrophil
100
Why is it important for RBCs to have a large surface area-to-volume ratio?
The volume/surface ratio is frequently used to explain why cells are microscopic .on a spherical cell volume increases faster than the surface area as the sphere gets bigger. surface materials cannot exchange things the cell needs adequately to service the cytoplasm.
Big things can absorb small things,
a too large surface area I cant think of a problem but to small of one could be a problem.
Surface area is also important for cells like red blood cells and muscle cells and big cells
From Yahoo.
101
Describe hemoglobin
- is the pigment that makes blood red. It also transports oxygen from our lungs to the cells in our body. The hemoglobin molecule contains iron, an essential mineral found in our diet.
- is a protein in red blood cells that carries oxygen. The hemoglobin test measures how much hemoglobin is in your blood.
From Yahoo.
102
Compare oxyhemoglobin with deoxyhemoglobin.
oxyhemoglobin :hemoglobin combined with oxygen
deoxyhemoglobin: The form of hemoglobin without oxygen, the predominant protein in red blood cells.
- purple blue
103
Define hemostasis and name its three phases.
Hemostasis- Stoppage of bleeding resulting from a break in a blood vessel
Phases:
1. vascular
2. platelet
3. coagulation
104
Identify the five types of white blood cells.
1. Neutrophils
2. Lymphocytes
3. Monocytes
4. Eosinophils
5. Basophils
105
Which types of white blood cells would you find in the
| greatest numbers in an infected cut?
Eosinophils do all of the described actions.
Monocytes and neutrophils because they are phagocytes
106
How do basophils respond during inflammation?
during inflammation, basophils release a variety of chemicals including histamine and heparin, that exaggerate the inflammation and attract other types of WBCs
107
Define hematopoiesis
Definition: blood cell (RBC, WBC, platelets) formation
-Occurs in red bone marrow – common sites include skull, pelvis, ribs, sternum, heads of humerus and femur
108
Explain the role of erythropoietin (EPO)
EPO stimulates stem cells in bone marrow to produce RBCs
109
connective, fluid
1.Blood is a complex _______ tissue and is the only _______ tissue in the body.
Your Answer: connective, fluid
110
formed, platelets
2 The living cells and cell fragments in blood are called the _______ elements and include erythrocytes, leukocytes, and _______.
111
people with types AB, A, B, or O
10.If a person has type AB blood, then that person can receive blood from which type donors?
112
antigen, antibodies
9. Any substance the body deems as foreign is an _______ and the response molecules that react are called _______.
113
coagulation
7. Hemostasis, involving three major phases including vascular spasms, platelet plug formation, and blood clotting, is called _______.
114
leukocytes
5. Accounting for about 1 % of total blood volume, _______ form a protective, movable army to defend the body against bacteria, viruses, parasites, and tumor cells.
115
hemocytoblast
6. All formed elements arise from a single type of stem cell named a _______.
116
hemoglobin
4. The molecule most responsible for carrying oxygen in blood is known as
117
Your Answer: plasma
3.Composed of approximately 90 percent water, over 100 different substances are dissolved in this straw-colored fluid called
118
albumin
A protein in the plasma that contributes to the osmotic pressure of blood is _______.
119
could be A, B or O, but could not be AB
A woman with blood type O has a baby with type O. The father _______.
Correct. The father is required to contribute one gene for O.
120
hemoglobin
Although it carries much oxygen, _______ is more attracted to pesticides and carbon monoxide.
Correct. Hemoglobin has greater bonding affinity to carbon monoxide than to oxygen.
121
Your Answer:
7.35-7.45; acidosis
The normal pH of blood is in the range of _______; therefore, a pH of 7.10 would be a condition called _______.
Correct. The normal, slightly alkaline pH range of blood is 7.35 to 7.45. A pH of 7.10 would indicate the blood has become too acidic, a condition called acidosis.
122
live about 30 days
Each of the following is a characteristic of red blood cells EXCEPT that they _______.
Correct. This is false. Red blood cells may live as long as 120 days.
123
Each of the following occurs when blood clots after a cut EXCEPT _______.
thrombin converts fibrin into fibrinogen
124
Fragments of megakaryocytes that rupture into pieces and are responsible for clotting are called _______.
Correct. Platelets are important for controlling blood loss and clotting.
platelets
125
Neutrophils, eosinophils, and basophils are alike in that they _______.
Correct. Other types of white blood cells are agranulocytes.
are granulocytes
126
The largest of all the white blood cells (WBCs) is the _______.
Correct. These are the largest of all the white blood cells
monocyte
127
Which of the following terms is unrelated to the others?
The other terms relate to immune responses.
Blood clotting
128
Which type of WBC increases during allergic reactions and parasitic worm infections?
Eosinophils
129
Unlike red blood cells, white blood cells
have nuclei
130
When oxygen levels are low, the _______ is/are stimulated to release _______.
Correct. This hormone targets the bone marrow to turn out more red blood cells to increase the blood's ability to transport oxygen.
kidneys; erythropoietin
131
Which of the following is a hereditary bleeding disorder, commonly called the "bleeder's disease"?
Correct. This hereditary disorder results from a lack of any of the factors needed for clotting.
Hemophilia
132
The doctor sticks your finger, takes some blood, and does a WBC count. The count (12,500 cells/mm3) indicates leukocytosis. What could you conclude?
Correct. Normal WBC counts are between 3000 and 5000 cells/mm3.
It is a high WBC count, indicating a bacterial or viral infection.
133
What is the most numerous type of white blood cell, and an active phagocyte that increases rapidly during acute infections
Neutrophil
134
The process by which white blood cells move into and out of the blood vessels is called _______.
diapedesis
135
The rapid sequence of vascular spasms, platelet plug formation, and coagulation is known as _______.
hemostasis
136
While blood typing, the sample
| is mixed with anti-A serum and anti-B serum. There is no agglutination. You could conclude that _______.
-the sample is type O
Correct. Any agglutination would indicate the presence of A or B antibodies. Type O blood lacks these antibodies.
