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Anatomy and Physiology > Chapter 17 Blood > Flashcards

Chapter 17 Blood Flashcards

1
Q

What are the three functions of blood?

A

Distribution, Regulation and Protection

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2
Q

What does blood regulate?

A
  1. Body temperature by regulating blood flow to skin and deep organs.
  2. pH in body tissue. Blood cells act as buffers due to proteins in the blood.
  3. Adequate Fluid Volume
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3
Q

What does blood protect against?

A
  1. Blood loss

2. Defense against infection using white blood cells, antibodies and specialized proteins.

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4
Q

Temperature of blood

A

104 F

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5
Q

Why is venous and arterial blood different colors?

A

Differences in hemoglobin content

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6
Q

What is the normal blood pH?

A

7.4

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7
Q

Normal volume of blood in males/females?

A

5-6 liters in males / 4-5 liters in females

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8
Q

What is blood composed of?

A

Plasma and Formed Elements

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9
Q

What is blood plasma composed of?

A
  1. 55% whole blood
  2. 8% plasma proteins
  3. Other solutes 2 % (gases, hormones, nutrients, wastes)
  4. 92% water
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10
Q

What makes up formed elements?

A
  1. 45% whole blood
  2. White blood cells and platlets
  3. Red Blood cells 99%
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11
Q

What two components make up extra cellular fluid (fluid external to cells)?

A

Plasma and interstitial fluid (fluid that bathes the exterior of cells)

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12
Q

What does plasma resemble? Why?

A

Interstitial Fluid due to the continual exchange of water, ions and small solutes across capillary walls.

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13
Q

Name the two primary differences between interstitial fluid and plasma

A
  1. Concentrations of dissolved proteins in blood are much higher because most plasma proteins cannot cross capillary walls due to shape and size.
  2. Levels of respiratory gases; blood transports O2 from lungs to body tissue and CO2 away from tissue to lungs.
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14
Q

What are the function of plasma cells? who makes them?

A

To make antibodies which are proteins.

Lymphocytes

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15
Q

What are antibodies also known as? what part of the blood do they consistute?

A

immunoglobulin

gamma globulin

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16
Q

Name three plasma proteins.

A
  1. Globulin
  2. Albumins
  3. Fibrinogen
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17
Q

What is the most abundant plasma protein? Percentage?

A

Albumin. 60%

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18
Q

Which plasma protein is a major contributor to the osmotic pressure of plasma and what is that pressure known as?

A

Albumin.

BCOP-Blood colloid osmotic pressure

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19
Q

Name functions of albumin plasma protein

A

Transport

Act as buffer in plasma

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20
Q

What percentage of plasma protein is Globulin?

A

36%

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21
Q

What are the functions of globulin

A
  1. Immunoglobulin (the most significant gamma globulins)

2. Transport globulins-they bind ions, hormones and lipids for transport.

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22
Q

What percentage of plasma protein is Fibrinogen?

A

4%

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23
Q

Function of fibrinogen

A

Blood clotting where fibrin is the result.

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24
Q

What is the difference between plasma and serum?

A

Plasma contains the clotting factors still present in solution; serum does not. Serum is plasma without the clotting factors which are in the blood clot.

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25
Q

Where are the primary site of hematopoiesis during second to fifth months?

A

Liver and spleen

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26
Q

Define hematopoiesis

A

Production of formed elements

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27
Q

How much blood and new cells does the bone marrow turn out each day?

A

1 ounce of new blood and 100 billion new cells.

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28
Q

What week of embryonic development do blood cells appear in blood stream?

A

3rd

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29
Q

In early embryonic life, what is the primary site of red blood cell formation?

A

yolk sac

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30
Q

Where are blood cells at the 8th week of embryonic development?

A

Embryonic blood cells move out of bloodstream to liver, spleen, thymus and bone marrow where they differentiate into stem cells.

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31
Q

Where is the primary site of blood cell production after the fifth month?

A

Bone marrow

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32
Q

From what common cell do all formed elements arise?

A

Hemocytoblast which is a common stem cell.

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33
Q

What two kinds of stem cells arise from hemocytoblast?

A
  1. Lymphoid (produces lymphocytes)

2. Myeloid (produce all other formed elements)

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34
Q

What is the technical name of red blood cells?

A

erythrocyte

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35
Q

How many blood cells does the average adult have?

A

25 trillion (1/3 of all the cells in the body)

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36
Q

What is the primary role of red blood cells?

A

Transport of O2, CO2 and respiratory gases

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37
Q

How many red blood cells are in a drop of blood

A

260 million

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38
Q

What is the normal red blood cell count in males?

A

4.7-6.1 million cells/mm3

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39
Q

What is the normal red blood cell count in females?

A

4.2-5.4 million cells/mm3

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40
Q

How do you determine approximate red blood cell count from known hematocrit?

A

% Hematocrit x 11 = total RBC count x 10e4

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41
Q

Define hematocrit

A

Percentage of whole blood occupied by red blood cells

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42
Q

What is the normal hematocrit in the adult male

A

47 +/- 5%

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43
Q

What is the normal hematocrit in adult female

A

42 +/-5%

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44
Q

What is the hematocrit also known as?

A

Packed cell volume

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45
Q

What is the very thin layer that lays between the plasma and red blood cells?

A

White blood and platlets aka the buffy coat.

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46
Q

How do you determine the hematocrit from known hemoglobin value?

A

Hematocrit = 3 x Hemoglobin value

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47
Q

What is the shape, average diameter and maximum thickness?

A

Biconcave disc, average diameter 7.5um and maximum thickness 2.5um

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48
Q

Characteristics of red blood cells

A

stackable (rouleaux) and bend and flex

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49
Q

During which stage of red blood cell formation is hemoglobin actively synthesized.

A

Formative stages

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50
Q

What are red blood cells missing in the mature state?

A

nuclei, ribosomes or organelles associated with transport of respiratory gases

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51
Q

Life span of red blood cells?

A

120 days

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52
Q

Where do red blood cells obtain there energy from?

A

not mitochondria but anaerobic metabolism of glucose absorbed from plasma.

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53
Q

What is the principal function of hemoglobin?

A

It is a protein molecule contained in red blood cells that transports oxygen and CO2

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54
Q

What is the shape and contents of a hemoglobin molecule?

A

Quaternary structure consisting of two alpha chains, two beta chains, iron and heme.

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55
Q

How is oxygen transported via hemoglobin?

A

O2 binds to iron

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56
Q

How many hemoglobin molecules are there per red blood cell

A

250 million

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57
Q

What happens to the blood that is not transported via hemoglobin?

A

it dissolves in plasma

58
Q

How is CO2 transported via hemoglobin?

A

CO2 binds to amino acids in the globlin portions of hemoglobin

59
Q

How much of CO2 transportation is accomplished by hemoglobin?

A

20%

60
Q

How much of intracellular proteins is accounted for by hemoglobin? What does the remaining proteins function as?

A

95%

The remaining function to maintain plasma membrane or promote changes in red blood cell shape.

61
Q

What are the units hemoglobin reported in?

A

grams per 100mL of whole blood.
Gms/dl
Gms %
Hgb or Hb

62
Q

What is the normal range of hemoglobin in adult males?

A

13-18 Gms %

63
Q

What is the normal range of hemoglobin in adult females?

A

12-16 Gms %

64
Q

How do you determine hemoglobin value from hematocrit value?

A

Hct/3=Hgb

65
Q

Define erythropoiesis

A

red blood cell production

66
Q

What is the only site of red blood cell production and the primary site of white blood cell production?

A

red bone marrow

67
Q

How long is the whole red blood cell production process?

A

15 days.

68
Q

What happens during red blood cell production?

A

erythroblasts synthesize hemoglobin

69
Q

What supplies do red blood cell production require?

A

The usual protein, lipids and carbs as well as folic acid, Vitamin B12 and iron.

70
Q

What stimulates Red Blood Cell Production?

A

Erythropoietin

71
Q

Where is Erythropoietin produced?

A

Kidneys

72
Q

When does erythropoietin increase?

A

When peripheral tissues are hypoxic

73
Q

What is the rate of RBC production

A

3 million red blood cells per second

74
Q

How many RBCs are replaced daily?

A

1% or 250 billion

75
Q

How does erythropoietin work?

A

Erythropoietin stimulates stem cells and red blood cells when during a. during anemia b. when blood flow to kidney is decreased c. when O2 to lungs decreases d. when lungs are damaged

76
Q

What hormone increases EPO production?

A

testosterone

77
Q

How does erythropoietin work?

A
  1. Increase in cell division rates of erythroblast

2. speeds up maturation of RBCs via hemoglobin synthesis

78
Q

How much can Red Blood Cells increase by stimulation with erythropoietin?

A

10X

79
Q

Define Anemia

A

Blood has low O2 capacity due to reduction in hemoglobin or hematocrit.

80
Q

Causes of Anemia

A
  1. Insufficient RBC (hemmoragic, hemolytic, aplastic)
  2. Low hemoglobin conent (iron, vit B12 deficient)
  3. Abnormal hemoglobin (thalassemias, sickle cell)
81
Q

Define Polycythemia

A

abnormal excess of RBCs

82
Q

Causes of polycythemia

A

Primary-polycythemia vera
Secondary-Physical Location
Third-Blood Doping

83
Q

Describe 6 steps of red blood cell life cycle

A
  1. Low O2 stimlates kidneys to produce Erythropoietin
  2. EPO levels rise
  3. Erythropoiesis in bone marrow
  4. New Blood cells enter blood stream for 120 days
  5. RBC engulfed by macrophage of spleen, liver and bone marrow.
  6. Raw material available in blood for erythrocyte synthesis.
84
Q

Define Surface antigen

A

Aka agglutinogens are glycoproteins that are genetically determined

85
Q

Define Antibodies

A

Aka agglutins which attack foreign surface antigens in plasma

86
Q

What percents of population are TYPE O, A,B,AB?

A

46%, 40%, 10%, 4%

87
Q

What percent of Americans are Rh positive?

A

85

88
Q

Erythroblastosis fetalis/hemolytic disease of newborn

A

When Rh negative mom gives birth to second Rh positive baby.

89
Q

Define blood typing

A

When anti A and anti B serums are added to blood to observe clumping.

90
Q

Define cross-matching

A

When you mix doner/recipient RBCs with donor/recipient serum.

91
Q

What reactions can cross reactions occur

A

agglutination or hemolysis

92
Q

What is the main worry in blood transfusion?

A

Large amounts of free hemoglobin in blood and hemolysis of blood cell

93
Q

What is the main function of leukocytes

A

To defend against pathogens

94
Q

Leukocyte structure

A

Contain nucei and organelles but no hemoglobin

95
Q

What is the number of circulating WBCs per RBC

A

600-700

96
Q

How many WBCs does a typical microliter of blood have

A

5000-11000 WBCs

97
Q

Define Leukocytosis

A

Greater number of WBCs than normal in peripheral blood due to infection, injury or allergies

98
Q

Define Leukemia

A

Clones of unspecialized WBCs.

99
Q

What are the results of leukemia

A

Malignant cells crowd out blood resulting in

  1. anemia
  2. bleeding problems
  3. compromised immune problems
100
Q

Define Leukopenia

A

Underproduction of WBCs due to drugs, glucocorticoids and bone marrow malignancies

101
Q

Describe WBC characteristics

A

Amoebid mvmt, Diapedisis, Chemotaxis, Phagocytosis

102
Q

Which white blood cell types have non specific defenses

A

Neutrophil, Eosinophil, Basophil, Monocyte

103
Q

Which WBC types have specific defenses?

A

Lymphocytes

104
Q

List WBC types from highest % of circulating WBC to least %.

A

Neutrophil (50-70). Lymphocytes (20-40), Monocytes (3-8), Eosinophil (2-4) Basophil (0.5-1)

105
Q

Which WBC types are granulocytes?

A

Basophil, Eosinophil, Neutrophil

106
Q

Function of Basophil

A

Rush to injury site and release heparin and histamine

107
Q

Which WBC types have longest and shortest life span?

A

Shortest Neutrophils

Longest Lymphocytes

108
Q

Which WBCs are produced and differentiate in bone marrow? Which do not?

A

Bone Marrow-Neutrophil, Eosinophil, Basophil
Monocyte-differentiate in tissue
Lymphocyte-moves between bone marrow and tissue

109
Q

Name the types of Lymphocytes and their function

A

T Cell-direct attack on foreign cells
B Cells-Antibodies in body fluids
Natural Killer-general surveillance

110
Q

Which WBC type can digest large pathogens

A

Eosinophils

111
Q

Which WBC type contains granules that contain lysosomes for digestions and defensins to kill bacteria

A

Neutrophils

112
Q

What is the location and name of cells that produce platlets

A

Megakaryocyte and they are produced in the bone marrow

113
Q

How long do platlets survive

A

10 days

114
Q

How many platlets circulate and how many are stored? Where are they stored?

A

2/3 circulate, 1/3 stored in spleen

115
Q

How are platlets regulated?

A

Hormonally by Thrombopoetin

116
Q

What is the normal concentration of platlets in blood?

A

150-400,000/mm3

117
Q

Thrombocytopenia

A

platlet deficit

118
Q

Thrombocytosis

A

platlet excess

119
Q

Three phases of homeostasis

A

Vascular, Platlet and Coagulation Phase

120
Q

What happens during Vascular Phase

A

Spasm of smooth muscle wall in response to pain or injury

121
Q

What happens during platlet phase

A

Initiates clotting

122
Q

In normal conditions why wont platelts stick to one another?

A

Because endothelial cells release Nitric Oxide and Prostocyclin

123
Q

Name chemicals that platlets release during platlet phase

A

Thromboxane, ADP, Clotting Factors, Serotonin, Calcium Ions

124
Q

In coagulation phase, where are all clotting factors manufactured? What are the exceptions?

A

The liver

Calcium and Thromboxane

125
Q

Name the 4 pathways of coagulation phase?

A
  1. Intrinsic
  2. Tissue Factor
  3. Extrinsic
  4. Common Pathway
126
Q

Which pathway of coagulation phase is fastest?

A

Extrinsic

127
Q

In coagulation phase, Tissue Factor Pathway…which elements when combined lead to factor X?

A

Tissue Factor + Ca + Tissue Factor Complex

128
Q

In coagulation phase, Intrinsic Pathway…which elements when combined lead to factor X?

A

Factor X11 + PF3 + Other Factors

129
Q

Describe the common pathway after Factor X.

A

Begin Prothrombinase (turns prothrombin to thrombin), Thrombin converts fibrinogen to fibrin which forms clot.

130
Q

In addition to fibrinogen, what else does thrombin stimulate?

A

Tissue Factor and PF3 which stimulate extrinsic and intrinsic pathways.

131
Q

What two substances in platelets compact clot and vessel?

A

Actin and Myosin

132
Q

What two substances in platelets repair defects?

A

Platelet growth factor and endothelial factor

133
Q

Define Fibrolysis

A

When the clot gradually dissolves as the vessel repairs.

134
Q

How is the clot eroded?

A

By plasmin which is derived from plasminogen and created by the combination of tPA, Thrombin and Factor XII.

135
Q

Why doesnt a clot once formed, keep expanding and become unnecessarily large?

A
  1. Dilution of clotting factors
  2. Restriction of Thrombin (which converts)
  3. Herparin inhibits thrombin and intrinsic pathway
  4. Action of prostacyclin (inhibits aggregation)
136
Q

Define Thrombus

A 
A clot that develop and persists in an unbroken vessel predisposed by
1.  irregular blood vessel lining
2,  slow blood flow
3.  heart rhythm disturbances
4.  Heart valve damage
137
Q

Embolus

A

A clot that breaks away from the site of its formation in a blood vessle or in the heart

138
Q

Desseminated Intravascular Clotting (DIC)

A

Widespread clotting occurs in intact blood vessels. Fibrin creates clots and once fibrinogen is used up uncontrolled bleeding results. Seen in septicemia, pregnancy or bad transfusions.

139
Q

Causes for abnormal bleeding

A
  1. platlet deficientcy
  2. impaired liver function
  3. Hemophilias (ABC)
  4. Too much anticoagulant
140
Q

Drugs that prevent Fibrin from forming

A
  1. Heparin
  2. Low Molecular Weight Heparin
  3. Coumadin/Warfarin
141
Q

Drugs that act on fibrin by dissolving strands already formed.

A
  1. tPA-Tissue Plasminogen Activator
  2. Urokinase
  3. Streptokinase
  4. Nattokinase
142
Q

Drugs that act on platlets to reduce stickiness

A
  1. Aspirin
  2. Dipyramidole (Persantine)
  3. Plavix (clopidogrel)
  4. IIb/IIa inhibitors

Anatomy and Physiology (1 decks)

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