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Paramedic Programme A&P 2 > Chapter 15 - Blood > Flashcards

Chapter 15 - Blood Flashcards

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1
Q

Describe the important components of blood

A

The blood is made up of cells, fragments of cells and dissolved biochemicals containing nutrients, hormones, oxygen and wastes.

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2
Q

Cardiovascular system consists of?

A

Heart
Blood
Blood vessels

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3
Q

Functions of blood

A

Transportation

Protection by fighting foreign invaders

Clotting to prevent bleeding

Also involved in :
acid base balance
fluid and electrolyte balance
regulation of body temperature

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4
Q

What kind of tissue is blood?

A

Connective tissue with its cells suspended in a liquid, the extracellular matrix.

Is the only fluid tissue in the body

Is a homogeneous liquid. This means it has a similar composition throughout.

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5
Q

Blood contains formed elements

A

Red blood cells

White blood cells or leukocytes

Platelets

Of these only the WBC are complete cells containing nuclei and organelles.

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6
Q

How long do formed elements last in the blood?

A

Most of the formed elements exist for only a few hours or days before they are replaced by new cells.

Most of them do not divide but are replaced by stem cells that continually divide in the red bone marrow

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7
Q

The liquid portion of blood is called?

A

Plasma

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8
Q

Composition of plasma

A

Electrolytes

92% Water

7% proteins - albumins, globulins, fibrinogin

Wastes

Nutrients - vitamins, hormones

Gases - N2 O2 CO2

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9
Q

Blood functions: distribution

A

Delivery O2 from the lungs.
Delivery nutrients from gastrointestinal tract.
Transport of hormones from endocrine organs to target organs.
Transport metabolic waste products from cells to elimination sites: Kidneys for disposal of nitrogenous wastes in the urine
&
Lungs for the elimination of CO2

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10
Q

Blood functions: regulation

A

Maintenance of proper fluid volume in the circulatory system:
Proteins in the blood prevent excessive fluid loss from the bloodstream into tissue spaces. Therefore fluid volume remains in the blood vessels, supporting efficient blood circulation throughout the body.

Maintenance of body temperature by absorption and distribution of body heat, as well as to skin surfaces for heat loss.

Maintenance of normal ph in body tissues, with proteins and other bloodborne solutes becoming buffers, preventing serious changes in blood pH.

The blood also is a reservoir for bicarbonate ions, which are the body’s alkaline reserve.

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11
Q

Blood functions: protection

A

Prevention of infection via the actions of antibodies, complement proteins and WBC’s. this protects the body against bacteria, viruses, and other foreign agents.

Prevention of blood loss via the actions of platelets and plasma proteins, which begin clot formation and slow or stop blood loss.

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12
Q

Three types of plasma proteins

A

Albumins

Globulins - alpha, beta, gamma

Fibrinogen

plasma proteins are heavier then electrolytes and are not typically used as energy sources, remaining in the blood and interstitial fluids.

The liver synthesises and releases more than 90% of the plasma proteins.

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13
Q

Plasma

A

Plasma suspends the cells and platelets of blood. It is a clear, straw coloured liquid made up of 92% water, with organic and inorganic biochemicals.

In many respects the composition of plasma resembles interstitial fluid. Concentrations of major plasma ions are similar to those of the interstitial fluid, differing greatly from the concentrations inside cells.

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14
Q

Most prevalent electrolytes in the plasma

A

Sodium

Chloride

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15
Q

Colloid osmotic pressure

A

Albumins are the smallest plasma proteins but make up 60% of these proteins weight. They are made in the liver and play an important role in the plasma’s osmotic pressure, transporting smaller molecules such as hormones and ions.

Plasma proteins are too large to move through capillary walls, so they create an osmotic pressure to hold water in the capillaries, which is known as ‘colloid osmotic pressure’.

This helps regulate water movement between blood and tissues, to aid in controlling blood volume and blood pressure. Therefore, albumins act as important blood buffers.

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16
Q

Globulins

A

Include alpha, beta and gamma globulins make up 36% of plasma proteins.

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17
Q

Fibrinogen

A

Makes up 4% of plasma proteins

Is important for blood coagulation. Under certain conditions fibrinogen molecules interact to form large, insoluble strands of fibrin. This substance provides the basic framework for a blood clot.

Made in the liver and is the largest in size of the plasma proteins.

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18
Q

The most important blood gases are?

A

Oxygen and carbon dockside.

Nitrogen is also contained in the plasma.

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19
Q

plasma nutrients include?

A

amino acid‘s, nucleotides, lipids and simple sugars absorbed from the digestive tract.

Glucose is transported in the plasma from the small intestines to the liver. in the liver glucose is stored as glycogen or converted to fat. Plasma carries amino acid‘s to the liver to manufacture proteins or to be used for energy. Plasma lipids include triglycerides, cholesterol and phospholipids

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20
Q

plasma lipids

A

lipids are not water soluble, but the plasma is mostly made of water. Hence lipids join with proteins to form lipoproteins which the plasma can carry

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21
Q

non-protein nitrogenous substances

A

they have nitrogen atoms but are not proteins. in the plasma these include amino acid’s, urea and uric acid.

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22
Q

Blood plasma also contains many electrolytes

A

Potassium, calcium, sodium, magnesium, chloride, phosphate, bicarbonate and sulphate ions. The most abundant types are sodium and chloride ions. All plasma constituents are regulated so the blood concentration remains mostly stable.

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23
Q

hematocrit

A

The percentage of blood volume made up of red blood cells

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24
Q

blood volume: red blood cells

A

45%

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25
Q

blood volume: white blood cells and platelets

A

<1%

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26
Q

blood volume: plasma

A

55%

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27
Q

Blood contains formed elements and plasma: plasma contains

A 
Water 
amino acid’s 
carbohydrates 
lipids 
proteins 
hormones 
electrolytes 
vitamins 
cellular wastes
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28
Q

How much blood does an average adult have

A

Approximately 5 litres

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29
Q

Blood contains formed elements and plasma: formed elements

A

Platelets
red blood cells
white blood cells

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30
Q

Blood contains formed elements and plasma: formed elements - WBC

A 
Neutrophils 54-62%
Eosinophyls 1-3%
basophils <1%
monocytes 3-9%
lymphocytes 25-33%
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31
Q

hematocytoblasts

A

the cell all formed elements start as.

All formed elements to rise from hematocytoblasts, which are also called hematopoietic stem cells, Which are undifferentiated precursor cells in the red bone marrow.

Once a cell becomes committed to a certain blood cell pathway, it is unable to change.

32
Q

normal hematocrit values (RBC volume)

A

in a healthy male adult the normal hematocrit value is 47% +/- 5%. In a healthy female adult it is 42% +/- 5%.

33
Q

shape of red blood cells (erythrocytes)

A

They have a biconcave shape meaning they are basically round, with a centre that is depressed in comparison with their edges. The shape helps them to transport gases by increasing the surface area of the cell, allowing more diffusion.

this shape also insures the cell membrane is nearer to the haemoglobin, which carries oxygen, inside the cell.

Red blood cells are about one third haemoglobin, a protein that gives them the right colour. Therefore, haemoglobin is the major protein in red blood cells.

34
Q

erythropoises

A

The formation erythrocytes sites is called a read erythropoiesis.

it only occurs in the red bone marrow or the myeloid tissue which is the tissue that performs hematopoiesis.

erythrocytes have nuclei that are shed as they mature, allowing more room for haemoglobin.

35
Q

erythrocytes structure

A

lacking nuclei, mature red blood cells cannot synthesise proteins or divide to form more cells.

They produce adenosine triphosphate through glycolysis because they do not have mitochondria and use none of the oxygen is carried in the haemoglobin.

Erythrocytosis also have nearly no organelles and contain mostly antioxidant enzymes and structural proteins. The structural proteins allow them to change shape and return to their original shape afterwards. Spectrim in the membrane helps maintain biconcave shape.

36
Q

Red blood cells function

A

To pick up oxygen from the alveoli which binds with haemoglobin, then carry the oxygen to tissues cells

They also remove approximately 20% of the carbon dioxide from tissue cells back to the lungs.

37
Q

Hemoglobin

A

haemoglobin is responsible for the ability of the cells to transport oxygen and carbon dioxide.

when haemoglobin easily and reversibly binds with oxygen oxyhaemoglobin is formed.

when oxygen is released the Oxy haemoglobin is formed. Deoxyhemoglobin is darker red, and blood rich in the deoxyhaemoglobin may appear blueish when seen through blood vessels. Deoxyhemoglobin is also known as reduced haemoglobin.

38
Q

carbaminohemoglobin

A

carbon dioxide binds to the amino acid’s of the globin portion of haemoglobin instead of the heme portion. this forms carbaminohemoglobin.

The loading of carbon dioxide occurs in the tissues, with transport occurring from the tissues to the lungs, where it is eliminated from the body.

39
Q

granulocytes and agranulocytes

A

leukocytes with granular cytoplasm are called granulocytes, those without are called agranulocyte’s.

40
Q

describe the important components of blood

A

the blood is made up of cells, fragments of cells and dissolved biochemicals containing nutrients, oxygen, hormones and wastes.

RBC’s transport gasses
WBC’s fight disease
Platelets aid in clotting

RBC, WBC & platelets are formed elements.

The liquid portion of blood is called plasma

41
Q

Specify the composition of plasma

A

plasma is a clear, straw coloured liquid containing water, amino acids, carbohydrates, lipids, proteins, hormones, electrolytes, vitamins and cellular wastes.

42
Q

List three types of plasma proteins

A

Albumins - the smallest type, making up 60% of plasma proteins by weight.

Globulins - making up 36%

Fibrinogen - the largest type making up 4%

43
Q

List the characteristics of the functions of red blood cells

A

RBC’s have a biconcave shape that helps them transport gasses by increasing the surface area of the cell, allowing more diffusion.

The haemoglobin portion of a RBC carries oxygen.

They produce ATP through glycolysis.

RBC formation is controlled by negative feedback via the hormone erythropoietin.

RBS are vital in supplying body tissues with oxygen.

44
Q

Describe the functions of haemoglobin

A

haemoglobin carries oxygen inside RBC and makes up about one third of each RBC.

haemoglobin gives RBC their colour and binds with oxygen to form oxyhaemoglobin, which is bright red.

when oxygen is released, deoxyhaemoglobin is formed, which is a darker red colour.

RBC have a nuclei which is shed during maturation to allow more room for haemoglobin.

None of the oxygen carried in haemoglobin is used by the RBC.

Iron is required for normal RBC production and for haemoglobin synthesis. Anaemia is caused by too little haemoglobin or by to few RBC.

Haemoglobin is broken down into heme and globin, with the heme decomposing into iron and biliverdin.

45
Q

list the five types of white blood cell

A

neutrophils - phagocytise small particles

eosinophils - help control allergic reactions and inflammation, and kill parasites

basophils - release histamine and heparin

monocytes - phagocytise large particles

lymphocytes - provide immunity

46
Q

describe the function and production of platelets

A

platelets or thrombocytes are incomplete cells arising from ‘megakaryocytes’ that have become fragmented.

they lack nuclei and less then half the size of RBC.

their function is primarily to block injuries to damaged blood vessels and to start forming clots.

47
Q

discuss mechanisms that control blood loss after an injury

A

the stoppage of bleeding is known as haemostasis.

when a small blood vessel is cut or broken, smooth muscles in its wall contract, which is called vasospasm, and loss of blood slows nearly immediately.

After about 30 mins a platelet plug forms and blood begins coagulating.

platelets release serotonin to contract smooth muscles in blood vessels, reducing blood loss.

larger breaks may require a blood clot to stop bleeding.

the formation of a blood clot is known as coagulation, requiring biochemicals known as clotting factors.

the most important event in coagulation is the conversion of the plasma protein fibrinogen into the insoluble threads of the protein called fibrin.

48
Q

Erythropoietin (EPO)

A

is a hormone produced by the kidney that promotes the formation of red blood cells by the bone marrow. The kidney cells that make erythropoietin are sensitive to low oxygen levels in the blood that travels through the kidney.

49
Q

lymphocyte

A

a form of small leucocyte (white blood cell) with a single round nucleus, occurring especially in the lymphatic system.

50
Q

Megakaryocyte

A

A megakaryocyte (mega- + karyo- + -cyte, “large-nucleus cell”) is a large bone marrow cell with a lobated nucleus responsible for the production of blood thrombocytes (platelets), which are necessary for normal blood clotting.

51
Q

non-protein nitrogenous substances (NPNs)

A

The molecules that contain nitrogen in their structure but are not proteins; they are known as “non-protein nitrogenous substances (NPNs).” The NPNs in the plasma include, amino acids, urea, uric acid, creatinine and creatine.

52
Q

Thrombopoietin

A

Thrombopoietin is a glycoprotein hormone produced by the liver and kidney which regulates the production of platelets. It stimulates the production and differentiation of megakaryocytes, the bone marrow cells that bud off large numbers of platelets.

53
Q

Prothrombin

A

Prothrombin is transformed into thrombin by a clotting factor known as factor X or prothrombinase; thrombin then acts to transform fibrinogen, also present in plasma, into fibrin, which, in combination with platelets from the blood, forms a clot (a process called coagulation).

54
Q

Erythropoiesis

A

Erythropoiesis (from Greek ‘erythro’ meaning “red” and ‘poiesis’ meaning “to make”) is the process which produces red blood cells (erythrocytes). It is stimulated by decreased O2 in circulation, which is detected by the kidneys, which then secrete the hormone erythropoietin.

55
Q

Heparin

A

Heparin, also known as unfractionated heparin (UFH), is a medication which is used as an anticoagulant (blood thinner). Specifically it is used to treat and prevent deep vein thrombosis, pulmonary embolism, and arterial thromboembolism. It is also used in the treatment of heart attacks and unstable angina.

56
Q

interleukin

A

any of a class of glycoproteins produced by leucocytes for regulating immune responses.

57
Q

Erythropoietin

A

a hormone secreted by the kidneys that increases the rate of production of red blood cells in response to falling levels of oxygen in the tissues.

58
Q

Thrombopoietin

A

Thrombopoietin is a glycoprotein hormone produced by the liver and kidney which regulates the production of platelets. It stimulates the production and differentiation of megakaryocytes, the bone marrow cells that bud off large numbers of platelets.

59
Q

Hemoglobin

A

Hemoglobin (Hb or Hgb) is a protein in red blood cells that carries oxygen throughout the body. In many cases, a low hemoglobin count is only slightly lower than normal and doesn’t affect how you feel. If it gets more severe and causes symptoms, your low hemoglobin count may indicate you have anemia.

60
Q

Polycythemia

A

Polycythemia (also known as polycythaemia or polyglobulia) is a disease state in which the hematocrit (the volume percentage of red blood cells in the blood) is elevated.

61
Q

Leukemia

A

Leukemia is a type of cancer that affects the blood and bone marrow. Leukemia begins in a cell in the bone marrow. The cell undergoes a change and becomes a type of leukemia cell. Once the marrow cell undergoes a leukemic change, the leukemia cells may grow and survive better than normal cells.

62
Q

embolism

A

An embolism is the lodging of an embolus, a blockage-causing piece of material, inside a blood vessel. The embolus may be a blood clot (thrombus), a fat globule (fat embolism), a bubble of air or other gas (gas embolism), or foreign material.

63
Q

The life span of platelets is about?

A

The average life span of circulating platelets is 8 to 9 days. Life span of individual platelets is controlled by the internal apoptotic regulating pathway, which has a Bcl-xL timer.

Old platelets are destroyed by phagocytosis in the spleen and liver.

Function: Formation of blood clots

Precursor: Megakaryocytes

64
Q

The rate of red blood cell formation is controlled by the hormone called?

A

erythropoietin, a hormone produced primarily by the kidneys. But also in the liver.

The rate of RBC formation is controlled by negative feedback via the hormone erythropoietin.

It is release by the kidneys and liver in response to prolonged oxygen deficiency.

65
Q

breakdown of RBC

A

they circulate for 120 days.

they are broken down in the liver by macrophages.

broken in Heme and Globin.

heme - iron - returned to red bone marrow

heme - biliverdin - biliruben - excreted

globin - amino acids - returned to blood circulation

66
Q

Neutrophils

A

are the most abundant type of granulocytes and the most abundant (54%-62%) type of white blood cells in most mammals. They form an essential part of the innate immune system.

During the beginning (acute) phase of inflammation, particularly as a result of bacterial infection, environmental exposure, and some cancers, neutrophils are one of the first-responders of inflammatory cells to migrate towards the site of inflammation.

They migrate through the blood vessels, then through interstitial tissue, following chemical signals in a process called chemotaxis.

They are the predominant cells in pus, accounting for its whitish/yellowish appearance.

Neutrophils are recruited to the site of injury within minutes following trauma and are the hallmark of acute inflammation.

however, due to some pathogens being indigestible, they can be unable to resolve certain infections without the assistance of other types of immune cells.

67
Q

Eosinophils

A

Eosinophils are a type of disease-fighting white blood cell. This condition most often indicates a parasitic infection, an allergic reaction or cancer. You can have high levels of eosinophils in your blood (blood eosinophilia) or in tissues at the site of an infection or inflammation (tissue eosinophilia).

asthma. parasitic infection. allergy. cancer

68
Q

Basophils

A

They produce histamine and serotonin that induce inflammation, and heparin that prevents blood clotting

69
Q

Monocytes

A

largest blood cell

24 hrs circulating then enters tissue and becomes a tissue macrophage.

when activated they phagocytise foreign invaders.

phagocytosis releases chemicals that attract neutrophils and more monocytes.

70
Q

Diapedesis

A

is the process of leukocytes squeezing between cells of the blood vessel walls to leave the circulation.

they can then move through interstitial spaces, self propelled, via amoeboid motion.

71
Q

functions of haemoglobin

A

Haemoglobin in the blood carries oxygen from the lungs or gills to the rest of the body (i.e. the tissues). There it releases the oxygen to permit aerobic respiration to provide energy to power the functions of the organism in the process called metabolism.

72
Q

Platelet Production.

thrombocyte production

A

Platelets are produced in the bone marrow, the same as the red cells and most of the white blood cells. Platelets are produced from very large bone marrow cells called megakaryocytes.

hemocytoblast - myeloid stem cell - megakaryoblast

73
Q 
Platelet function
thrombocyte function
(primary haemostasis)
A

The principal function of platelets is to prevent bleeding.

Thrombus formation on an intact endothelium is prevented by the balance of endothelin, nitric oxide and prostacyclin. which is release by the endothelium.

when a break in endothelium occurs these substances reduce and platelets are attracted to the site of the break in the tissue.

platelets then change shape at the site of injury and release fibrinogen, serotonin (vasoconstriction) and ADP to activate more platelets.

platelet plug forms.

74
Q

haemostasis

A

the stoppage of bleeding is known as haemostasis. has several steps:

Vasospasm

Platelet plug formation

Coagulation

retraction of the clot

fibrinolysis

75
Q

vasospasm

A

when small vessels are broken vasospasm occurs because smooth muscle contracts.

endothelin (constrictor) release from endothelium outweighs prostacyclin (dilator) and nitric oxide (dilator) causing the constriction.

Paramedic Programme A&P 2 (10 decks)

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