Chapter 17: Blood Flashcards

1
Q

What are the three main functions of blood?

A

transport, regulation and protection

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2
Q

Transport Function

A

distribute o2, nutrients, and hormones to cells and metabolic wastes (co2 and nitrogenous wastes) to elimination sites

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3
Q

Regulation Function

A

maintains normal body temp, pH of body fluids and fluid volume in blood vessles

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4
Q

Protection Function

A

prevents blood loss and defends body against invading microorganisms

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5
Q

Characteristics of Blood

A

sticky, viscous fluid with a metalic taste (due to iron); color ranges from bright red (o2 rich, arteries) to dark red (o2 poor, veins); pH ranges from 7.35-7.45 (blood is slightly basic); volume varies by sex (5-6L in adult male and 4-5L in adult female)

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6
Q

Composition of Blood

A

consists of plasma (liquid portion) and 3 formed elements: erythrocytes, leukocytes, and platelets; components can be separated by centrifugation (WBC is the buffy coat); hematocrit values- healthy male 42-52%, healthy females 37-47%

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7
Q

Plasma

A

90% water and 10% solutes

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8
Q

What are the solutes found in plasma?

A

electrolytes (ions, na, k, ca, cl, hco3- bicarbonate); plasma proteins (albumin, globulins, fibrinogen, and most produced by liver); nitroginous substances (urea, uric acid, creatinine); nutrients (glucose, amino acids, fatty acids and glycerol, vitamins); respiratory gases (o2 and co2); hormones (steroids and TH transported by plasma protein)

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9
Q

Structure of Erythrocytes

A

biconcave disc (~7.5 micrometer diameter); at maturity lack a nucleus (anucleate) and mitochondria (so they only produce ATP by glycolysis); packed with hemoglobin molecules; each of which contains 4 heme hroups and 4 globin chains; life span about 120 days (filtered and recycled by spleen)

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10
Q

Function of Erythrocytes

A

transports respiratory gases; 98% of o2 transported from lungs to tissues is bound to the iron atom of heme; 20% of co2 transported from tissues to lungs is bound to globin (carbaminohemoglobin)

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11
Q

Erythropoiesis

A

RBC production; occurs in red bone marrow; derived from hematopoietic stem cell (aka heocytoblasts) (all blood cells come from this); mostly in axial skeleton

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12
Q

Phases of Erythropoiesis

A

hematopoietic cells to myoblast to proerythroblast (once at this phase it is committed to forming a RBC); phase 1- ribosome synthesis; phase 2- hemoglobin accumulation then phase 3- ejection of nucleus then a reticulocyte and then it enters the blood; whole process takes 15 days; process requires nutrients, vit. b12, folic acid, adnd iron

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13
Q

What regulates erythropoiesis?

A

erythropoietin (EPO) hormone synthesized by the kidney

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14
Q

Erythropoietin Mechanism

A

1) stimulus- hypoxia (inadequate o2 delivery) due to decreased RBC, decreased hemoglobin, decreased availability of o2; 2) kidney releases erythropoietin; 3) stimulates red marrow; 4) enhanced erythropoiesis increases RBC; 5) o2 carrying ability of blood rises

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15
Q

Fate of RBCs

A

aged and damaged red blood cells are engulfed by macropahges of spleen, liver, and bone marrow; hemoglobin is broken down; iron and amino acids are recycled; bilirubin is a waste product that the liver uses to make bile

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16
Q

Erythrocyte disorders are classified as either….

A

anemia or polyathemia

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17
Q

Anemia

A

reduced o2 carrying capacity of blood caused by blood loss, insuffience RBC production, or excessive destruction of RBC

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18
Q

Hemorrhagic Anemia

A

may be acute (rapid blood loss) or chronic (slow and persistent)

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19
Q

Iron Deficiency Anemia

A

inadequate intake or malaabsorption of iron

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20
Q

Pernicious Anemia

A

autoimmune disease; imune cells attack stomach mucosa cells that produce intrinsic factor (required for intestinal cells to absorb b12); mostly seen in elderly

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21
Q

Renal Anemia

A

lack of EPO (erythropoietin)

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22
Q

Aplastic Anermia

A

destruction or inhibition of red bone marrow; one of the reasons they do cancer treatments in cycles and not continuous

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23
Q

Thalassemias

A

genetic; one of the 2 beta globulin chain is absent or defective resulting in fragile RBC that rupture prematurely

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24
Q

Sickle Cell Anemia

A

genetic; beta globulin gene corder for production of beta globulin chains that have 1 amino acid substitution (val is swapped for glu at position 6); RBC rupture prematurely

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25
Q

Polycythemia

A

abnormal excess of RBCs caused by polycethemia vera; seondary polycythemia

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26
Q

Polycythemia Vera

A

bone marrow cancer

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27
Q

Secondary Polycythemias

A

occur as a result of elevated EPO production or hypoxia (decrease in o2 availability due to living at high altitudes or smoking)

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28
Q

Blood Doping

A

injecting EPO or harvesting and storing RBCs; artificially induced polycythemia

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29
Q

Characteristics of Leukocytes

A

WBC; nuceleate; less numerous than RBCs’ exit capillaries via diapedesis; exhibits amoeboid movement in tissues and postive chemtaxis (move towards certain chemicals); protective functions

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30
Q

What are the two major types of leukocytes?

A

granulocytes and agranulocytes

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31
Q

Saying to remember the order of leukocytes by amount (from highest to lowest)

A

Never Let Monekys Eat Bananas; neutrophils, lymphocytes, monocytes, eosinophiles, and basophiles

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32
Q

Granulocytes

A

spherical; larger and have shorter life span that RBCs; multilobed nucleus; cytoplasmic granules

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33
Q

Neutrophils

A

granulocyte; multilobed; kinda big; not very noticable granules; 3000-7000; takes about 14 days to develop; life span of 6 hrs to a few days; phagocytize bacteria

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34
Q

Eosinophil

A

bilobed; granulocyte; definitive granules; 100-400; about 14 days to make; life span about 5 days; kills parasitic worms and complex role in allergy and asthma

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35
Q

Basophil

A

granulocyte; bilobed; really dark granules; 20-50; takes 1-7 days to make and life span of a few hrs to a few days; release histamine and other mediators of ifalmmation contain heparin, an anticoagulant; also involved in allerfica reactions

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36
Q

Agranulocytes

A

spherical; spherical or kidney shaped nucleus; lack visible cytoplasmic granules

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37
Q

Lymphocyte

A

agranulocyte; large circular nucleus; little cytoplasm seen; 1500 - 3000; takes days to week to make and life span of hours to years; mount immune response by direct cell attack of via antibodies

38
Q

B Cells

A

type of lymphocyte; form antibody producting plasma cells; made in bone marrow

39
Q

T Cells

A

type of lymphocyte; attack viral infected cells and tumor cells; made in thymus

40
Q

Monocyte

A

usually the largest; typically ‘U’ shaped nucleus; light cytoplasm; 100-700; developed in 2-3 days and life span of months; phagocytosis; develop into macrophages in the tissues

41
Q

Leukopoesis

A

WBC production; occurs in red bown marrow; derived from hematopoietic cells (aka hemocytoblasts); regulated by interleukins and colony stimulating factors

42
Q

What do myoblasts lead to?

A

eosinophils, basophils, neutrophils and monocytes

43
Q

Leukocytic Disorder

A

involve over or underprodcution of WBCs

44
Q

Leukopenia

A

underproduction; abnormally low number of WBCs in blood; usually induced by glucocorticoids or anticancer drugs

45
Q

Leukemias

A

overproduction (aka leukocytosis) of abnormal WBCs; crowd out other cell lines; acute forms advance rapidly (more serious primarily affect kids); chronic form advances slowely (primarily affect elderly)

46
Q

Myeloid Leukemia

A

involves myeoblast descendants (neutrophils, eosinophils, basophils)

47
Q

Lymphocytic Leukemia

A

involves lymphoblast descendant (B and T cells)

48
Q

Infectious Mononucleosis

A

aka mono; overproduction of abnormal WBCs; caused by epstein bar virus

49
Q

Characteristics of Platelets

A

anucleate cytoplasmic fragments; have granules containing substances involved in clotting (ADP, serotonin, Ca2, enzymes , fibrinogen, platelet derived growth facotr; seal small tear in blood vessels istrumental in blood clotting

50
Q

Thrombopoiesis

A

platelet production; occurs in red bone marrow; derived from hematopoietic stem cells; regulated by thrombopoietin (hormone produced by liver and kidney)

51
Q

ADD HEMATOPOIESIS SUMMARY

A
52
Q

Hemostasis

A

process that stopes blood loss from a damaged blood vessel; rapid; localized; triggered by injury to blood vessels; inactive platelets circulate in blood

53
Q

Events of Hemostasis

A

vascular spasm then platelet plus formation; then coagulation

54
Q

Vascular Spasm

A

vascular smooth muscle contracts (vasoconstriction)

55
Q

Platelet Plug Formation

A

platelets activated; stick to exposed collagen fibers and each other creaing a temporary plug

56
Q

Coagulation

A

clotting; reinforces platelet plug with fibrin threads; requires cloting factors, CA2 and vit K

57
Q

ADD CLotting FACTORS

A
58
Q

What are the three phases of coagulation?

A

phase 1: intrinsic/extrinsic pathway; phase 2: common pathway; Phase 3: common pathway

59
Q

Phase 1: Intrinsic/Extrinsic Pathways

A

slowest of the three phases; results in the formation of prothrombin activator (required for phase 2); involves two pathways

60
Q

Intrinsic Pathway

A

all factors needed for clotting found WITHIN blood; triggered by negatively charged surfaces (activated platelets, collagen, glass); many steps therefore slower than extrinsic pathway

61
Q

Extrinsic Pathway

A

one factor needed for clotting (tissue factor) which is found outside the blood; tissue factor is a membrane cound glycoprotein found in subendothelial tissues; fewer steps therefore faster than intrinsic

62
Q

Phase 2: Common Pathway

A

prothrombin activator catalyzes conversion of prothrombin II to thrombin (required for pahse 3)

63
Q

Phase 3: Common Pathway

A

thrombin catalyzes conversion of soltuble fibronogen I to insoluble fibrin threads XIII to bind fibrin threads tightly forming a fibrin mesh

64
Q

How long does it take the clotting process to be complete?

A

3-6 mins

65
Q

Clot Retraction

A

stabilizes clot; platelets contract to compact clot; platelets release plateltet derived growth factor which stimualtes blood vessel repair

66
Q

Fibrinolysis

A

degrades clot; endothelial cells in area of clot secrete tissue plasminogen in clot to plasmin (fibrin digesting enzyme that dissolves fibrin mesh)

67
Q

Thromboemolytic Disorders

A

cause undesirable clotting

68
Q

Thrombus

A

clot that develops and persists in an unbroken vessel

69
Q

Embolus

A

clot traveling through bloodstream; may cause embolism

70
Q

What do you use to help prevent undesirable clotting?

A

use anticoagulants; aspirin, heparin, warfarin

71
Q

Bleeding Disorders

A

prevent normal clottig

72
Q

Thrombocytopenia

A

deficiency of platelets; results in formation of petechiae on skin

73
Q

Impaired Liver Function

A

deficiency of clotting factors due to lack of vit. K, hepatitis, or cirrhosis

74
Q

Hemophilias

A

genetically inherited deficiency

75
Q

Hemophilia A

A

lacking factor VIII; most common type; x linked

76
Q

Hemophilia B

A

lacking factor IX; sex linked

77
Q

Hemophilia C

A

lack factor XI; rarest; autosomal

78
Q

Type A Blood

A

exhibits A antigens; has anti B antibodies in plasma

79
Q

Type B Blood

A

exhibits B antigens; has anti A antibodies in plasma

80
Q

Type AB Blood

A

has both A and B antigens; NO antibodies

81
Q

Type O Blood

A

NO antigens; BOTH A and B antibodies

82
Q

Order of blood types from most common to least common

A

O, A , B , AB

83
Q

Rh Blood Groups

A

based on the presence of absence of 1 antigen (D or Rh antigen); Rh+ have D antigen; Rh - (do not have D antigens)

84
Q

Rh-

A

anti-Rh antibodies do NOT form in the plasma of Rh- individuals UNLESS they have been EXPOSED to the D antigen; like a transfusion or birth

85
Q

Hemolytic Disease of the Newborn

A

aka erythroblastosis fetialis; occurs when an Rh- women is pregnant with her SECOND Rh+ child; reason why Rh- women given RhoGAM shot before or shortly after birth, miscarraige or abortion it blocks the production of anti Rh antibodies

86
Q

Transfusion Reactions

A

occur when receipients antibodies attack the transfused fonors RBCs causing them to aggulinate (clump)

87
Q

How to Blood Type

A

use of anti A, B, D sera to determine the blood group of donor and receipinet BEFORE blood is transfused

88
Q

Differential White Blood Count

A

count 100 WBC and identify/categorize

89
Q

Prothrombin Time (test)

A

amount of time it takes for blood to clot

90
Q

Platelet Count

A

you actually count the platelets

91
Q

Comprehensive Metabolic Panel

A

tests basically everything

92
Q

Complete Blood Count

A

counts all formed elements in blood