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Essentials Of Anatomy and Physiology > Chapter 11 - Blood > Flashcards

Chapter 11 - Blood Flashcards

1
Q

What are the general functions of blood?

A

1) Transportation - Nutrients, Waste products, gases and hormones
2) Regulation - fluid-electrolyte balance, acid-0base balance, body temperature
3) Protection - Against pathogens (WBCs) and blood clotting mechanism

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2
Q

How much blood does a person have?

A

4-6 L. Of the total blood volume, 38-48% is composed of various blood cells (formed elements), 52-62% is plasma (liquid portion of blood

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3
Q

Describe Color in blood

A
  • Arterial blood is bright red (d/t high levels of o2)

- Venous blood is dark, dull red (has given up much of its oxygen)

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4
Q

What is the pH of blood?

A

nml range is 7.35-7.45; slightly alkaline.

-Venous blood nmlly slightly lower pH than arterial blood (More C02)

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5
Q

Describe the Viscosity of blood?

A

Blood is 3-5x thicker than water. Viscosity ^ byt presence of blood cells and plasma proteins.

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6
Q

What us blood blasma?

A

Liquid part of blood - 91% water.

  • Responsible for transport of substances (nutrients like glucose, amino acids, vitamins, minerals)
  • Transports waste products of tissues (urea and creatinine)
  • Transports Hormones from endocrine glands.\
  • Also has plasma proteins (clotting factors, HTN regulation
  • Responsible for carrying body heat
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7
Q

What are Plasma Proteins?

A
  • Clotting factors - prothrombin and fibrogen (synthesized in liver)
  • Albumin - synthesized by liver, contributes to colloid osmotic pressure of blood ()pulls tissue fluiud into capillaries) - Maintains nml blood volume and pressure.
  • Globulins (Alpha and beta) - synthesized by liver, carriers fats
  • Gamma globulins are antibodies produced by lymphocytes.
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8
Q

Name the 3 types of blood cells

A

1) Red blood cells
2) White blood Cells
3) Platelets

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9
Q

What are Red blood cells?

A
  • Also called erythrocytes
  • Only human cell without nuclei.
  • produced from stem cells in in hemopoietic tissue (primarily from red bone marrow (sternum, hip bone, vertebrae)
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10
Q

How many RBC’s per micro liter of blood? How is it measured?

A
  • 4.5-6 million cells per micro liter of blood (counts often higher for man then women)
  • Measured by hematocrit. (nml range 38-48%)
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11
Q

What is the function of RBC’s

A
  • Each cells contains the protein hemoglobin - gives them the ability to carry oxygen.
  • ~300 million hemoglobin molecules per RBC, each which can bond to 4 O2 molecules
  • RBC’s pick up 02 in pulmonary capillaries forming oxyhemoglobin –> circulates from lungs, back to the heart, sent off to the body.
  • Nml Hb range is 12-18 grams per 100ml.
  • Can also bond to C02, and does transport some C02 from tissues to the lungs (10% of total C02)
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12
Q

How are RBC’s Produced?

A
  • In fetal development, RBCs a1stt produced by yolk sac –> then by fetal liver and fetal spleen –>bone marrow becomes active during 5th month of gestation
  • In older children/adults, RBCs formed in red bone marrow (contain stem cells)
  • Stem cells of red bone marrow also called hemocytoblasts; - rate of production very rapid, several million new RBCs per second.
  • Normoblast - last stage with a nucleus, which disintegrates as Hb has been produced and chromosomes with the DNA code for Hb are no longer needed.
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13
Q

What happens when body is in a state of hypoxia?

A

-Lack of oxygen –> kidneys produce a hormone caccll erthyoproietin, which stimulates red bone marrow to ^ rate of RBC production.

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14
Q

What is a reticulocyte (RBC production)?

A
  • Fragments of endoplasmic reticulum (no longer needed)
  • Usually found in red bone marrow, small number end up in peripheral circulation.
  • Large nuber in circulating blood mean the number of mature RBCs is not sufficient to carry oxygen needed byt the body (can indicate hemorrhage)
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15
Q

What nutrients are needed for RBC maturation?

A

PProtein and iron - necessary for the synthesis of Hb

  • Copper is part of some enymes involved in Hb synthesis as well
  • Follic acid and B12 are required for DNA synthesis in stem cells of red bone marrow.
  • B12 contains cobalt (also called extrinsic factor)
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16
Q

What is the extrinsic factor

A

V12 contains cobalt, source is external - food. Combines with intrinsic factor to prevent digestion and promote its absorption in small intestine.
-Deficiency = pernicious anemia

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17
Q

What is intrinsic factor?

A

Parietal cells of the stomach lining produce intrinsic factor (combines with b12 in food to prevent its digestion and promote its absorption in the small intestine.
-Deficiency = pernicious anemia

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18
Q

What is the life span of RBCs

A

Live for ~120 days.

-Become fragile with age

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19
Q

What is the tissue Macrophage system?

A
  • Organs that contain macrophages (live spleen, red bone marrow), removed damaged cells from circulation.
  • Old RBCs are phagocytized and digested by macrophages - iron put into the blood to be returned to red bone marrow for synthesis of new Hb (or stored in liver if not needed)
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20
Q

What is the heme portion of Hb?

A
  • Waste product of the Hb molecule.
  • Heme is converted in to bilrubin by macrophages.
  • Live removed bilirubin from circulation, excretes it into bile.
  • Bile is secreted by liver into the duodenum and passes through the small intestine and colon - ultimately eliminated in feces (gives the brown color)
  • If not excreted properly, it billirubin remains in blood –> may cause jaundice.
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21
Q

Describe the ABO group

A
  • 4 Blood types: A, B, AB, O
  • A & B represent antigens on the RBC membrane (someone with type A blood has A antigen on the RBCs, AB = both A & B antigens are present, O means neither A nor B antigen are present)
  • Circulating in plasma of each person are natural antibodies for the antigens NOT present on the RBCs (Type A person has anti-B antibodies in the plasma etc…
  • ABO of great importance for transfusions (person should only received their own type, if not available, ) neg blood can be given)
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22
Q

What is type O blood universal?

A

Type O RBCs have neither A nor B antigens, and will not react with whatever antibodies the recipient may have

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23
Q

What is the Rh factor?

A
  • An antigen (often called D), that may be present on RBCs
  • Those with Rh antigen are Rh Positive, those without are Rh negative (they dont have natural antibodies to the Rh antigen)
  • If a Rh-neg person receive Rh-Pos blood by mistake, antibodies will be formed.
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24
Q

Describe Iron deficient anemia

A
  • d/t lack of dietary iron (not enough to form sufficient Hb)
  • May have nml RBC and nml Hct, but Hb level will always be below nml
25
Q

What causes pernicious anemia?

A

A deficiency in Vitamin B12 (found only in animal foods), in which RBCs are large, misshapen and fragile.
-Also caused by lack of intrinsic factor d/t autoimmune destruction of parietal cells of stomach lining.

26
Q

What is Sickle-cell anemia?

A

Genetic disorder of Hb, cause RBCs to sickle, clog capillaries and rupture.

27
Q

What is Aplastic anemia?

A

Suppression of red bone marrow, decreased production of RBCs, WBCs and platelets.
-Very serious - caused by expsure to radiation, certain chemicals (benzene), or some medications.

28
Q

What is Hemolytic anemia?

A

Disorder that causes rupture of RBCs before the end of their nml life span (Sickle-cell anemia and Rh disease of new born are examples. As is malaria)

29
Q

Describe the basic make up of White blood Cells

A
  • Also called leukocytes
  • 5 types (all larger than RBCs and have nuclei wnen mature)
    1) Neutrophiles - Nuclei in 2 or more lobes - light blue granules
    2) Eosinpophiles - Nuclei in 2 or more lobes - red granules
    3) Basophils - Nuclei in 2 or more lobes - dark blue granules
    4) Lymphocytes - Larger nuclei in one piece
    5) Monocytes - Larger nuclei in one piece - larger than lymphocytes
  • Nml WNBC count is 5000 - 10000 per uL.
30
Q

What is the general function of WBCs?

A

All contribute to same function - to protect body from infectious disease and to provide immunity to certain disease.
-Each kind of leukocyte makes a contribution to this

31
Q

What are the function of neutrophils and monocytes?

A

Capable of phagocytes of pathegns (neutrophils most abundant, monocytes are most efficient phagocytes as they differentiate into macrophages.
-During infection, neutrophils are produced more rapidly (band cells in immature form)

32
Q

What is the function of eosinophils?

A

Beleived to detoxify foreign proteins and will phagocytize anything labeled with antibodies.
-Abundant during allergic reactions and parasitic infections (trichinosis)

33
Q

What is the function of Basophgiles

A

contain granules of herapin and histamine

  • Herpain - anticoagulant that prevents abnml clotting
  • Histamine - released as part of inflammation process, makes capillaries more permeable
34
Q

Name and describe the function of 2 major kinds of lymphocytes

A
  • T cells - help to recognize foreign antigens and may directly destroy some foreign antigens
  • B cells - become plasma cells that produce antibodies to foreign antigens
  • Both provide memory for pathogens.
35
Q

What is the 3rd type of lympocyte?

A

Natural Killer cells (NK cells) - destroy foreign cells by chemically rupturing their membranes.

36
Q

What is leukocytosis?

A

High WBC count - often indicative of infection

37
Q

What is Leukopenia

A

Low WBC count, may be present in early stages of diseases (such as TBV)

  • Exposure to radiationor chemicals (benzene) may destroy WBC s as well
  • Makes someone very susceptible to infection
38
Q

Describe Jaundice (3 main types)

A

A signed caused by excessive accumulation of bilirubin in the blood
-May be a sign of liver disease = hepatic jaundice
Other types:
-Pre-hepatic jaundice = the problem is before the liver (hemollysis of RBCs is taking aplace at a more rapid rate. This is a characteristic of sickle-cell anemia, malaria and Rh disease of the newborn, d/t excessive numbers of RBCs being destroyed, bilirubin is formed at fast r rate than the liver acan excrete it.
-Post-hepatic jaundice means the problem is after the liver, usually d/t bile duct obstruction (aka obstructive jaundice)

39
Q

What is Rh disease of the newborn?

A

Also called erythroblastosis fetalis - result of Rh incompatibility between mother and fetus.

  • If woman is Rh neg and baby is Rh positive, this exposes the woman to Rh-positive RBCs (her immune system will destroy anti-Rh antibodies in response, following delivery)
  • In next pregnancy, maternal antibodies cross the placenta and enter fetal circulation. If next baby is also Rh positive, the antibodies will cause destruction of the fetal RBCs - may result in death of fetus, lesser sx is born anemic and jaundiced from loss of RBCs - tx by gradual transfusion.
  • Best tx is prevention. if Rh-neg woman deliver Rh- positive baby, she should be given RhoGAM within 72 hrs after delivery
40
Q

What is RhoGAM?

A

Used in prevantive tx of Rh disease of the newborn

-An anti-Rh antibody that will label any fetal RBCs and initiate their destruction before her immune system can respond.

41
Q

Describe the general composition of platelets

A

Also called thrombocytes

  • Fragments or pieces of cells.
  • Large cells called megakaryocyttes, which break up into small pieces that enter circulation
  • Nml platelet count is 150000 to 300000 uL
  • Low platelet count - Thrombocytopenia
42
Q

What is Thrombopoietin

A

Hormone produced by liver that ^ rate of platelet production.

43
Q

What is Leukemia?

A

Malignancy of blood-forming tissues

  • Many types, acute or chronic, classified by types of abnml cells produced and by childhood or adult onset.
  • Characterized by overproduction of immature WBCs that cannot perform their nml function –> person becomes susceptible to infection
  • Causes production of other blood cells to decrease (d/t nutrients used by malignant cells)
  • Severe anemia is result of decreased RBC production (busies easily or hemorrhages)
  • Chemotherapy may bring about cure or remission for some forms. Other forms remain resistant to treatment
44
Q

What are Human leuokcyte antigens (HLAs)?

A

Antigens on WBCs that are representative of the antigens present on all the cells of an indivdual. - our “self” antigens that identify cells that belong to the body.

  • They provide ‘self’ comparison for the immune system to use when pathogens enter the body.
  • Certain HLA types seems to be more likely to develop certain autoimmune diseases.
45
Q

What is tissue typing?

A

-In surgical transplantation of organs, HLA is important –> tissue types involves determining HLA types of a donated organ to see if 1 or several will match HLA types of the recipient. –> lessens chance of rejection.

46
Q

What is the general function of platelets?

A

Necessary for hemostatis (prevention of blood loss)

  • Help maintain junctions between adjacent epithelial cells that form capillaries and line larger vessels.
  • Without platelets, cadherins tend to come apart, epithelial cells separate, RBCs and excess plasma leak out.
47
Q

What is a Vascular spasm

A

function of platelet

  • When large vessel (artery or vein) is severed, the smooth muscvle in its wall contracts in response to the damage (myogenic response)
  • Platelets in the area of rupture release serotonin,m which brings about vasoconstriction.
  • Makes diameter of vessel smaller, mayt then be blocked by a blood clot.
48
Q

What are Platelet plugs?

A

when capillaries rupture, damage is too slight to initiate formation of blood clot. The rough surface causes platelets to change shape and become sticky, forming a mechanical barrier to close off the break in capillary.

49
Q

What is Chemical clotting?

A

Stimulus for clotting a rough surface or break within a vessel - the more damage there is, the faster clotting begins (usually 15-120 second)
-Chemical clotting is the series of reactions involving chemicals that normally circulate in the blood - platelet factors, chemical s released by damaged tissues, calcium ions. Also includes prothrombin, fibrogen, factor 8 (plasma proteins)

50
Q

What does Vitamin K do? What is it role in blood?

A

Necessary for the liver to synthesize prothrombin and clotting factors 7, 9, 10.
-Most is produced by intestinal microbiota (bacteria thaat live in the colon)

51
Q

What are the 3 stages of chemical clotting?

A

Clotting cascade - each stage leads to the next because of gravity.
Stage 1) Begins when vessel is cut or damaged internally
Platelet factors, chemicals from damaged tissues, factors 5, 7, 8, 9, 10, 11, 12 and calcium ions are all needed
-Platelet factors + chemicals from damaged tissue + clotting factors + calcium ions form prothrombin activator

Stage 2) Converts prothrombin to thrombin.

  • Prothrombin activator from stage 1, prothrombin and calcium ion factors are needed.
  • -Prothrobin activator converts prothrombin to thrombin

Stage 3) Converts fibrinogen to fibrin
Thrombin from stage 2 , fibrinogen, calcium ions and factor 13 (fibrin stabilizing factor) are required
-Thrombin converts fibrinogen to fibrin.

52
Q

What is a clot made of

A

Fibrin (threadlike protein) - many strands of fibrin form a mesh that traps RBCs and platelets and creates a wall.

53
Q

What happens once a clot is formed

A

Clot reaction and fibrinolysis occur.
1) Clot reaction - Requires platelets, ATP and factor 13, involves folding the fibrin threads to pull the edges of the rupture in the vessel wall closer together (smaller area to be repaired)
@)As repair begins, clot is dissolved (fibrinolysis)

54
Q

How does the body prevent abnormal clotting?

A

Clots do not usually form in inatact vesseels because of the endothelium (simple squamous epithelial lining) which is very smooth –>repels platelets and clotting factors

  • If lining becomes rougherned (i.e. with lipid deposits/atherosclerosis), a clot will form
  • Harapin (from basophiles) is natural anticoagulantr that inhibits the clotting process (blood thinner).
  • Liver produces a globulin (antithrombin), which combines with and inactivates excess thrombin –?helps prevent positive feedback effect)
55
Q

What is thrombosis?

A

Clotting in an intact vessel.

  • clot itself is a thrombus.
    i. e coronary thrombosis is abnml clotting in the coronary artery (decreasing blood oxygen supply to the heart)
56
Q

What is an embolism?

A

A clot or other tissue transported from elsewhere that lodges in and obstructs a vessel.

57
Q

What is Hemophilia?

A

Several forms, all genetic; characterized by inability of the blood to clot properly.
-Without tx, a hemophiliac experiences prolong bleeding after even minor injuries.
-TX is possible with factor 8 obtained through blood donors (not cure).
-Repeated factor 8 infusions may lead to production of antibodies to it by the recipient.
-3 Types:
A - most common, deficiency of factor 8)
B - impaired gene results in lack of factor 9
C - autosomal disorder, lack of factor 11.

58
Q

What is Hemophilia A?

A

Most common form (deficiency of clotting factor 8)

  • Sex-linked trait (located on X chromosome)
  • Without factor 8, the first stage of chemical clotting cannot be completed, and prothrombin activator is not formed.
59
Q

How to dissolve and prevent clots?

A
  • Streptokinase - one of 1st substances used to dissolve clots on coronary arteries (can cause clot destruction throughout body)
  • Thrombolytic chemicals are used now that may disolve clots and prevent damage.
  • Warfarin - common clot preventor.

Essentials Of Anatomy and Physiology (6 decks)

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