Chapter 18 Flashcards
What is hemodynamics?
The forces that circulate blood throughout the body
What is the formula for blood pressure?
Cardiac output x systemic vascular resistance
Components of cardiac output?
Heart rate and stroke volume
What is stroke volume?
The blood volume ejected from the heart with each heartbeat
How does blood vessel radius affect systemic vascular resistance?
Vasoconstriction increases SVR, vasodilation decreases SVR
What happens if you go septic?
Vasodilation occurs and blood pressure decreases
What is hypertension?
High blood pressure
Functions of blood?
Transportation, protection, and regulation (of pH, fluids, and temperature)
What is hematology?
The study of blood
What is the usual blood pH?
7.35-7.45
What is acidosis?
When the blood is too acidic, leading to arrhythmias and cardiac arrest
Causes of acidosis?
Diabetes (metabolic acidosis) and lung disease (respiratory acidosis)
Formed elements of blood?
Erythrocytes, leukocytes, thrombocytes, neutrophils, eosinophils, basophils, lymphocytes, and monocytes
What are the granulocytes?
Neutrophils, eosinophils, basophils
What are the agranulocytes?
Lymphocytes and monocytes
What are thrombocytes also known as?
Platelets
What is blood made of?
Plasma and blood cells
What is hematocrit?
The amount of red blood cell volume per amount of blood volume (ex: 45mL of RBCs in 100mL of blood is .45 hematocrit)
What is the buffy coat?
The layer of white blood cells and platelets that lies between plasma and blood cells in separated blood
What is in plasma?
Nutrients, electrolytes, hormones, and gases
Major categories of plasma proteins that are formed by the liver?
Albumin, globulins, and fibrinogen
What does albumin do?
Contributes to viscosity and osmolarity of blood. Influencing blood pressure, flow, and fluid balance
What do globulins do?
Act as antibodies and provide immune system functions
What does fibrinogen do?
Acts as a precursor of fibrin threads which help with blood clot formation
What is hemopoiesis (or hematopoiesis)?
Blood cell production
Where does hemopoiesis occur in adults?
Red bone marrow of the axial skeleton, girdles, and humerus and femur
Where does hemopoiesus of children occur?
In all red bone marrow
Components of the circulatory system?
Heart, blood vessels, and blood
Components of the cardiovascular system?
Heart and blood vessels
What blood vessel carries blood to the heart?
Veins
What blood vessel carries blood away from the heart?
Arteries
What is blood serum?
All of the components of blood plasma, except fibrinogen
What is myeloid hemopoiesis?
Blood formation in bone marrow
What is lymphoid hemopoiesis?
Blood formation in lymphatic organs
What are pluripotent stem cells?
The stem cells that give rise to the formed elements of blood. Hormones and growth factors push cells toward a specific cell type
Simple steps of RBC production?
Erythropoietin hormone, nucleus is discarded, cell matures
What do erythroblasts do?
Multiple and synthesize hemoglobin
What synthesizes hemoglobin?
Erythroblasts
What happens for cells to become reticulocytes?
The nucleus is discarded
Do mature RBCs have nuclei?
No
What do reticulocytes turn into?
Erythrocytes
Functions of erythrocytes?
Carry oxygen from lungs to cell tissues, pick up carbon dioxide from tissues and bring it to the lungs
How do erythrocytes make ATP?
With anaerobic fermentation, they lack mitochondria
Function of hemoglobin?
Gas transport
What are globins?
Protein chains (2 alpha 2 beta) found in hemoglobin. 4 total
What are heme groups?
Nonprotein moieties that bind oxygen to ferrous ion at its center. 4 total in hemoglobin
What is oxyhemoglobin?
Fully loaded heme with 4 oxygen molecules
What is deoxyhemoglobin?
Unloaded heme
What is necessary for RBC production?
Iron
What is Ferritin?
Excess iron stored in the liver
What is hematocrit?
Percentage of whole blood volume composed of RBCs
Hematocrit of men and women?
42-52% in men, 37-48% in women
Ways to measure quantities of erythrocytes and hemoglobin?
Hematocrit, hemoglobin concentration, and RBC count
Hemoglobin concentration of men and women?
13-18 g/dL in men, 12-16 g/dL in women
RBC count in men and women?
4.6-6.2 million/microliter in men, 4.2-5.4 million/microliter in women
How does negative feedback work for erythrocytes?
Drop in RBC count causes kidney hypoxemia, kidney production of erythropoietin stimulates bone marrow, RBC count increases in 3-4 days
How are erythrocytes disposed of?
Macrophages engulf and lyse dying RBCs in the spleen and liver
What happens to globins when RBCs are dying?
They get hydrolyzed into amino acids
What is polycythemia?
An excess of RBCs
What is primary polycythemia?
Due to cancer of erythropoietic cell line in red bone marrow. RBC count as high as 11 million RBCs/microliter
What is secondary polycythemia?
Due to dehydration, emphysema, high altitude, or physical conditioning. RBC count as high as 8 million RBCs/microliter
What is anemia?
Deficiency of RBCs or hemoglobin
Causes of anemia?
Inadequate erythropoiesis or hemoglobin synthesis, hemorrhagic anemias, and hemolytic anemias
What is hemolytic anemias?
RBC destruction
Consequences of anemia?
Tissue hypoxia and necrosis, reduced blood osmolarity, and lowered blood viscosity
What is sickle-cell disease?
A hereditary hemoglobin defect primarily affecting African-Americans
Genetic info about sickle-cell disease?
It’s caused by a recessive allele. Sickle cell anemia is homozygous recessive, sickle cell trait is heterozygous
What are antigens?
Found on red blood cells, the determinator for what a person’s blood type is
What are antibodies?
Found in the plasma, they are the opposite of a person’s blood type. They bind to like-lettered blood cells and mark them for destruction
What is agglutination?
When antibodies attack antigens and mark them for destruction
What determines your blood type?
Your antigens
What is the universal recipient?
AB+
What is the universal donor?
O-
What is notable about blood plasma?
The blood plasma may have antibodies, so it needs to be separated from the blood so it doesn’t attack the antigens
What is the Rhesus factor?
The Rh group, whether you’re + or -
Most reactive antigen for Rh group?
Anti-D / antigen-D
What is hemolytic disease of the newborn (HDN)?
When an Rh- woman is pregnant with an Rh+ fetus, her second Rh+ baby will be attacked by the mother’s developed antibodies
How can you prevent hemolytic disease of the newborn?
By taking an Rh immune globulin such as RhoGAM
What does RhoGAM do?
It binds to the fetus’s antigens during the first pregnancy, preventing the mother’s immune system from recognizing them and forming antibodies
Least abundant formed element?
Leukocytes
What do leukocytes do?
Protect against infectious microorganisms and other pathogens
Where are WBCs found?
In the bloodstream for a few hours; afterward they migrate to connective tissue
What do myeloblasts make?
Neutrophils, eosinophils, and basophils
What is the production of WBCs called?
Leukopoiesis
What do monoblasts make?
Monocytes
What do lymphoblasts make?
Lymphocytes
What are the granulocytes?
Neutrophils, eosinophils, and basophils
What are the agranulocytes?
Lymphocytes and monocytes
What do neutrophils do?
Phagocytize bacteria and release antimicrobial chemicals
When do neutrophils raise in number?
During bacterial infections
What do eosinophils do?
Treat parasitic infections, collagen diseases, allergies, and spleen or CNS diseases
What do basophils do?
Secrete histamine to speed flow of blood, and heparin to promote mobility of other WBCs in the area
When does number of basophils increase?
During chickenpox, sinusitis, and diabetes
What do lymphocytes do?
Destroy cancer, foreign, and virally infected cells, coordinate actions of other immune cells, and secrete antibodies and provide immune memory
When do lymphocyte numbers increase?
During diverse infections and immune responses
What do monocytes do?
Leave the bloodstream to become macrophages, which phagocytize pathogens and debris
When do monocytes increase in number?
During viral infections and inflammation
What is leukopenia?
Low WBC count
Causes and effects of leukopenia?
Causes: radiation, poisons, infectious disease
Effects: elevated risk of infection
What is leukocytosis?
High WBC count
Causes of leukocytosis?
Infection, allergy, and disease
What is leukemia?
Cancer of hemopoietic tissue that produces an extraordinarily high number of circulating leukocytes and their precursors
What is acute leukemia?
Suddenly appearing, rapidly progressing leukemia that causes death within months
What is chronic leukemia?
Leukemia that stays undetected for months and has a survival time of 3 years
What is plasma mostly made up of?
Water
Average lifespan of a red blood cell?
4 months / 120 days
What plasma protein is necessary for blood clotting?
Fibrinogen
Most numerous white blood cell?
Neutrophils
Least numerous white blood cell?
Basophils
White blood cells in order from most numerous to least numerous?
Neutrophils, lymphocytes, monocytes, eosinophils, and basophils
Universal recipient?
AB+
What is acidosis?
When blood pH is below 7.35-7.45
What is most carbon dioxide transported as?
HCO3-, or bicarbonate
What is oxygen attached to on hemoglobin?
The heme group
What vitamins are needed for blood clotting?
Calcium and Vitamin K
What are thrombocytes?
Platelets
What are the steps of thrombopoiesis?
Stem cells become megakaryoblasts, and then megakaryocytes
What do thrombocytes do?
Secrete vasoconstrictors to reduce blood loss, stick together to form platelet plugs against small breaks, secrete procoagulants or clotting factors to promote clotting, initiate formation of clot-dissolving enzyme, secrete chemicals to attract neutrophils and monocytes to sites of inflammation, and secrete growth factors to stimulate mitosis to repair blood vessels
Steps of hemostasis?
Vascular spasm, platelet plug formation, and coagulation
What happens during vascular spasm?
The blood vessel constricts to stop blood loss
What happens during platelet plug formation?
The broken vessel exposes collagen, which allows platelet pseudopods to stick to the damaged vessel and other platelets, contracting to pull the vessel walls together
What happens during coagulation?
Plasma protein fibrinogen is converted into fibrin threads to form the framework of a clot
What is needed for both the extrinsic and intrinsic pathways?
Calcium
How does positive feedback have a role in blood clotting?
Thrombin speeds up formation of the prothrombin activator
What is hemophilia?
A deficiency of a clotting factor, causing you to bleed for longer
What is hemophilia A?
Missing factor VIII, 83% of cases
What is hemophilia B?
Missing factor IX, 15% of cases
What is hemophilia C?
Missing factor XI, autosomal and not sex-linked
What is thrombosis?
Abnormal clotting in an unbroken blood vessel
What is a thrombus?
A clot
What is an embolus?
Anything that can travel in the blood and block blood vessels
What is pulmonary embolism?
When a clot breaks free and travels from the veins to the lungs
What is an infarction?
Tissue death caused by blockage of blood supply
What breaks down clots?
t-PA, tissue plasminogen activator
