Chapter 17 (Lecture) Flashcards
blood makes up what percent of our body weight?
8%
consists of four protein chains attached to a heme (iron-containing) group
iron is necessary for function
hemoglobin
without iron and if hemoglobin doesn’t function properly, what can occur
anemia
what is much more effective at binding oxygen than is adult hemoglobin
fetal hemoglobin
binds irreversibly to hemoglobin, thus rendering it ineffective to carry oxygen
carbon monoxide
functions to carry oxygen throughout the circulatory system to the tissues
hemoglobin
essential for allowing CO2 and H2O to react
carbonic anhydrase
how many oxygen atoms can bind to each heme group
1
what is the typical blood volume in females
4-5L
what is the typical blood volume in males
5-6 L
what is the average temperature of blood
100.4 degrees Fahrenheit
what is the typical pH of blood?
7.35-7.45
what is the whole blood viscosity?
4.5-5.5
what is the viscosity of plasma
2.0
what is the mean salinity of blood
0.9%
how much hemoglobin is typically in the female body?
12-16 g/dL
how much hemoglobin is typically in the male body?
13-18 g/dL
bright red blood is indicative of
oxygen rich blood
dark red blood is indicative of
oxygen poor blood
functions of blood
- distribution
- regulation
- protection
formed elements
RBCs, WBCs, and platelets
unformed elements
plasma
what is meant by distribution when referring to blood?
blood is responsible for oxygen delivery, waste transport, and transport of hormones
what is meant by regulation when referring to blood?
regulates body temperature, pH, fluid volume
what is meant by protection relating to blood?
prevens blood loss, protects immune functions
- 55% of blood by volume
- composed mainly of proteins dissolved in serum
- important proteins are albumins, globulins, fibrinogens
- also contains glucose, ions, and gases
plasma
- makes up 60% of plasma
- responsible for maintaining osmotic pressure in capillaries
albumins
- makes up approx 36% of plasma
- consists of transport binding proteins and some antibodies
globulins
- approx 4% of plasma
- responsible for forming blood clots (inactivated form of thrombin)
fibrinogen
- 45% of blood volume
- not technically cells
- 4-6 mill/ul (microliter)
- small biconcave, anucleated disks
erythrocytes (RBCs)
what is the benefit of erythrocytes being small biconcave anucleated disks?
allows for increased surface area for gas exchange
- takes place in red bone marrow
- red blood cell production
hematopoiesis
bone marrow makes approx how much blood each day?
approx 1 oz
stem cells for blood cell production
hemocytoblast
RBCs are produced at what rate
2 million/sec
hormone released by kidney cells in response to:
* decreased RBC in circulation
* decreased O2 availability
* increased tissue demands for O2
stimulates red bone marrow to produce more RBCs
erythropoietin (EPO)
consists of leukocytes and makes up less than 1% fo whole blood
buffy coat
begins accumulating in phase 2 of RBC formation
hemoglobin
what is synthesized in phase 1 of RBC formation
ribosomes
the nucleoblast is ejected from what cell during RBC formation
normoblast
steps to erythropoeisis (RBC formation)
- hemocytoblast
- myeloid stem cell
- proerythroblast
- early erythroblast
- late erythroblast
- normoblast
- reticulocyte
- erythrocyte (RBC)
RBC stem cell, has receptors for erythropoetin
proerythroblast
cell that begins making hemoglobin during erythropoesis
erythroblast
often found in hypoxic solutions
reticulocyte
prefix meaning embolus or wedge
embal-
prefix meaning white or white blood cell
leuko-
prefix meaning clot or associated w/ blood clotting
thrombo-
prefix meaning blood
hemo-
prefix meaning bone marrow or spinal cord
myelo-
prefix meaning red or red blood cell
erythro-
a freely-moving clot that becomes lodged in a small lung vessel
pulmonary embolism
the process of synthesizing new red blood cells in red bone marrow
erythropoiesis
low white blood cell count
leukopenia
the process of stopping bleeding after injury
hemostasis
the hormone signal for increased production of platelets
thrombopoietin
an intermediate of the myeloid stem cell, gives rise to granulocytes
myeloblast
which plasma constituent is the main contributor to clotting
fibrinogen
which part of the hemoglobin molecule binds carbon dioxide for transport?
amino acids of the globin
the heme groups and iron ions are binding points for oxygen, while carbon dioxide binds to and is carried by the globin polypeptides. the combined form is called carbaminohemoglobin
true or false:
erythrocytes can bend and twist to fit through vessels
true
in a centrifuged sample of blood, what should NOT be in the plasma portion of the sample?
platelets
platelets are dense enough that they should be in the buffy coat layer of centrifuged blood
what is a young anucleate erythrocyte called?
reticulocyte
Reticulocytes are a stage in erythrocyte development when the nucleus has just been lost. These are found in circulating blood, but they are typically only a small percent of total red cells.
how many oxygen molecules can be transported by one hemoglobin molecule
four
which of the formed elements is present in the greatest concentration
erythrocytes
what does NOT stimulate erythrocyte production
hyperventilating
Hyperventilating leads to an above-normal level of oxygen in the blood, which would not stimulate RBC production
results from vitamin B12 deficiency
pernicious anemia
Pernicious anemia does result from a vitamin B12 deficiency. The deficiency may be the result of inadequate dietary intake of vitamin B12, or the lack of intrinsic factor (produced in the stomach), which is required for absorption of vitamin B12 in the intestines.
Athletes can use industry-produced EPO as a performance-enhancing drug to increase the effects of their naturally-produced EPO. These athletes will experience
decreased production of EPO by their kidneys
Higher viscosity of blood will increase the amount of stress placed on the heart while it is pumping. Viscosity of blood is highest when
plasma levels are highest
true or false:
the primary of RBCs in the adult human being is the bone marrow in the shafts of the long bones
false
in a cancer patient undergoing chemotherapy, the decision to utilize a CSF capable of specifically stimulating the production of only the granular leukocytes would require that the CSF acts exclusively on
myeloblasts
a person with an extremely high count of neutrophils is likely suffering from
a bacterial infection
which type of leukocyte provides protection against parasitic worms
eosinophils
what enzyme removes unneeded clots after healing has occurred?
plasmin
parent cell for all formed elements of blood
hematopoietic stem cell
You are awaiting the white blood cell differential results for a patient who presented with a ruptured appendix and peritonitis. Which type of leukocyte do you expect to be most elevated over its normal value?
neutrophils
Neutrophils are the body’s bacteria slayers, so you would expect more of them to be present during a serious acute bacterial infection like the one your unfortunate patient has
Your patient has a hematocrit of 56%. You recall from your anatomy and physiology class that high hematocrits are often a sign of blood doping by athletes. However, your patient is an elderly man suffering from the flu. What is most likely accounting for his elevated hematocrit?
he is dehydrated from the flu
abnormally low number of leukocytes
leukopenia
blood is a type of connective tissue. what primary germ layer is responsible for both blood cells and phagocytic brain glial cells
mesoderm
how do platelets enter the blood
they are passed through the wall of a bone marrow capillary
Megakaryocytes place platelets in the blood by passing them through the wall of sinusoidal capillaries (with large openings in their walls) in the bone marrow.
hemostasis is important for
the stopage of bleeding
Hemostasis leads to stoppage of bleeding. The hemostasis response is fast, localized, and controlled. It involves clotting factors and substances released by damaged tissue and platelets.
what is one of the differences between extrinsic and intrinsic blood clotting pathways
one is faster than the other
loss of fibrinogen within the plasma would most likely cause
loss of blood clotting
true or false
the immediate response to blood vessel injury is clotting
false
which ABO blood type is considered to be the universal recipient
AB
Type AB blood is considered to be the universal recipient because neither anti-A or anti-B antibodies (agglutinins) are present.
A mismatch of blood types during a transfusion is dangerous because
preformed antibodies in the recipient’s blood will bind and clump (agglutinate) the donated cells
what is a benefit of utilizing packed red blood cells (PRBCs)
PRBCs contain hemoglobin, so they are able to carry oxygen to the tissues
if a patient’s blood type was determined to be A positive, which blood types could they receive
A+, A-, O+, O-
true or false:
a person with type B could receive blood from a person with either type B or type O blood
true
a person’s hematocrit shows an unusually large buffy coat, what is a likely cause for this?
severe infection
a transfusion in which a patient predonates their own blood and is stored and is immediately available if needed during surgery
autologous transfusions
platelet deficiency
thrombocytopenia
typically genetic in origin and result in a lack of one or omore of the factors involved in the clotting cascade
hemophilias
typically only given in extreme cases, when blood loss is rapid and substantial
whole blood transfusions
red cells with the plasma and leukocytes removed; preferred for oxygen-restoring capacity
packed red blood cell transfusion
have A surface antigens, antibodies for B blood in plasma
A blood
has B surface antigens, antibodies for A blood in plasma
B blood
has AB surface antigens, no antibodies in plasma
AB blood
contains no surface antigens, antibodies for A and B in plasma
O blood
results from clotting in undamaged vessels
thromboembolytic conditions
clot in a vessel
thrombus
a floating clot
embolus
- truly cells, about 1% of blood by volume
- hormones and other stressors can stimulate production in bone marrow (leukopoiesis)
- 5,000-11,000/uL
leukocytes (WBCs)
heme is broken down into … in the small intestine and iron is recycled; globins also recycled
bilirubin
the movement of leukocytes out of the blood vessels and into the site of an immune response
diapedesis
WBC count above 11,000/uL
leukocytosis
WBC count below 4800/uL
leukopenia
during fibrinolysis, after healing, the clot will begin to dissolve, partially through the help of which enzyme
plasmin
- once a clot has formed over a tear, actomyosin moleucles in the platelets begin to contract and draw the edges of the wound together
- fibroblasts and smooth muscle cells are stimulated by PDGF and begin laying down new matrix
- epithelial cells create endolthelial lining
- begins abut 30-60 min after a clot has formed
clot retraction
steps of hemostasis via clotting
- vascular spasm
- platelet plug formation
- coagulation
- contraction of smooth muscle in the walls of blood vessels surrounding an injury forms a temporary tourniquet
- allows the platelet plug to begin forming in the damaged area
- response can last up to 30 min
vascular spasm
- platelets adhere to underlying connective tissue (collagen) in damaged blood vessels
- as they accumulate they release prostaglandins, ADP, and other chemicals
- work well to fix the many small tears that occur in smaller vessels and capillaries each day
- once this is formed, then coagulation can begin
platelet plug formation
- extrinsic and intrinsic pathways work together to form a clot through the formation of activated thrombin and fibrin proteins
- factor X must be present to activate prothrombin factor to make thrombin
- thrombin converts inactive fibrinogen to fibrin, which acts as a glue to cover platelet plug
coagulation
what two enzymes are needed to make thrombin
factor X and prothrombin activator
an enzyme that converts inactive fibrinogen into activated fibrin
thrombin
clots would spread throughout the body from the site fo injury if not for
anticoagulants such as antithrombin and heparin
blood. normally flows smoothly along the … of blood vessels
endothelium
if the endothelium is torn or damaged then what must occur?
a clot must form
what happens if a clot does not form?
a positive feedback pathway can result which leads to decreasing blood volume and eventually death
formation of new WBCs from hemocytoblasts
leukopoiesis
progenitor cell of eosinophils, basophils, and neutrophils
myeloblasts
white blood cell production is typically stimulated by
hormonal factors
progenitor cell of lymphocytes
lymphoblasts
progenitor cell of monocytes
monoblast
- 150,000-400,000/uL
- fragments of megakaryocytes
- essential for proper clotting at the site of a wound and most often counted in with RBCs
- utilizes clotting chemicals such as serotonin, calcium, enzymes, PDGF
- last for about 9-10 days
platelets
- 3-8% of WBCs
- largest WBC
- nucleus generally kidney shaped
- voracious phagocyte that acts in long-term cleanup of chronic infections
- macrophages in lymph tissue
- important for activating lymphocytes during immune response
monocytes
- smallest WBC
- nucleus generally spherical and takes up most of cells
- about 20-30% of WBCs
- T-cells and B-cells
lymphocytes
directly attack antigens during the immune response, mainly viruses and tumor cells
T cells
produce antibodies that are released into the blood
B cells
- large round nuclei with no granules in cytoplasm
- more abundant in lymphoid tissue than blood
agranulocytes
what is the abundancy of wbcs in order from most to least
neutrophils
lymphocytes
monocytes
eosinophils
basophils
multi-lobed nuclei with granules in cytoplasm
granulocytes
- most abundant WBC (50-70%), nucleus has 3-5 lobes
- numbers increase during acute infections (usually bacterial in origin)
- phagocytose bacteria and some fungi
- destroy them by respiratory burst, creates bleaches and peroxides
neutrophils
- 1-4% of WBCs, nucleus often bi-lobed or figure 8 shaped
- cytoplasm dyes red in presence of eosin (acidic)
- usually higher during allergic responses or parasite attacks
- moderate inflammatory process in allergic responses by digesting immune complexes
- surround and destroy parasitic worms w/ enzymes
eosinophils
- <1% of WBC
- large U or S shaped nucleus, stains blue in presence of basic dyes
- releases histamine, which increases inflammation by causing vasodilation, as well as heparin
- release chemotaxic factors
- similar to mast cells found in connective tissue
basophils
caused by blood loss, treated by replacing blood (could result after stab wound)
hemorrhagic anemia
- erythrocytes rupture, or lyse, prematurely
- hemoglobin abnormalities, transfusion of mismatched blood, and certain bacterial and parasitic infections are possible causes
hemolytic anemia
may result from destruction or inhibition of the red marrow by certain drugs and chemicals, ionizing radiation, or viruses
aplastic anemia
insufficient hemoglobin per RBC
iron deficient anemia
lack of intrinisic factor + vitamin B12
pernicious anemia
caused by faulty globin chains
thalassemias
- genetic disease caused by a substitution of a single amino acid during transcription
- causes cell to become stiff and elongated due to malformed hemoglobin
sickle cell anemia
causes of excessive RBCs
- polycythemia vera
- blood doping
- dehydration
excessive RBCs caused by marrow cancer
polycythemia vera
