Chapter 18 Flashcards
Within our bodies is a connective tissue, ________, so valuable that donating a portion of it to someone else can save that person’s life.
blood
____ is regenerated continuously and is responsible for transporting the gases, nutrients, and hormones our bodies need for proper functioning.
blood
Blood is considered a ____ because it contains formed elements (red blood cells, white blood cells, platelets) and dissolved proteins in a liquid ground substance called ____.
fluid connective tissue
plasma
__ to ___ liters of this blood is continuously pumped through our blood vessels.
4 to 6 liters
Blood is the specialized fluid that is transported through the ______, which is composed of the heart and blood vessels.
cardiovascular system
Blood vessels form a circuit away from the heart and back to the heart that includes arteries, ____, and veins.
capillaries
_____ transport blood away from the heart, whereas ____ transport blood toward the heart.
arteries
veins
____ are permeable, microscopic vessels between arteries and veins. They serve as the sites of exchange between the _____ and ___.
capillaries
blood and body tissues
It is from our capillaries that oxygen and nutrients ___ the blood, and carbon dioxide and cellular wastes ___ the blood.
exit
enter
Blood is composed of ____ and plasma.
formed elements
leukocytes, erythrocytes and platelets
___ function to transport respiratory gases in the blood.
Erythrocytes (red blood cells)
____ contribute to defending the body against pathogens.
Leukocytes (white blood cells)
____ help clot the blood and prevent blood loss from damaged vessels.
Platelets
_____ is the fluid portion of blood containing plasma proteins and dissolved solutes.
plasma
The three functions of blood.
transportation
regulation
protection
Blood transports formed elements and dissolved molecules and ____ throughout the body.
ions
The ____ that serves as the “delivery system” for the body.
blood
Blood vessels carry oxygen from and carbon dioxide to the lungs, nutrients absorbed from the GI tract, hormones released by ______, and heat and waste products from the _____.
endocrine glands
systemic cells
Even when you take a medication, the ____ delivers it to the cells in the body.
blood
Blood participates in the regulation of body temperature, body pH, and ____.
fluid balance
Blood helps regulation body temperature. This is possible because blood absorbs ____ from body cells, especially skeletal muscle, as it passes through blood vessels of body tissues. ______ is then released from blood at the body surface as blood is transported through blood vessels of the ____.
heat
heat
skin
Blood, because it absorbs acid and base from ____, helps maintain the pH of cells. Blood contains chemical ____ that bind and release hydrogen ions to maintain blood pH until the excess is eliminated from the body.
body cells
buffers
Water is added to the blood from the ____ and lost in numerous ways (urine, sweat, and respired air). There is a constant exchange of fluid between the blood plasma in the capillaries and the interstitial fluid surround the cells of the body’s tissues.
gastrointestinal tract
Blood contains proteins and ions that exert _____ to pull fluid back into the capillaries to help maintain normal fluid balance.
osmotic pressure
Blood contains leukocytes, plasma proteins and various molecules that help ___ the body against potentially harmful substances.
protect
Components of blood, including platelets and plasma proteins, also protect the body against _____.
blood loss
Physical characteristics of blood (6)
color volume viscosity plasma concentration temperature blood pH
The ____ of blood depends upon whether it is oxygen-rich or oxygen-poor.
color
Oxygen-rich blood is _____ or almost ____.
bright red or almost scarlet
Oxygen-poor blood is not blue, rather, a ____.
dark red.
The bluish appearance of our veins can be attributed to both the fact that we can see the blood traveling through the _____ veins in the skin and how ___ is reflected back to the eye from different colors. Lower-energy light wavelengths, like red, are absorbed by the skin and not reflected back tot eh eye, but higher energy wavelengths like blue are reflected back.
superficial
light
The average volume of blood in an adult is ___ liters (L).
5
Males tend to have, on average blood volume, ___ to ___ liters (L). The greater amount of blood in males is due to their larger average size.
5 to 6
Females tend to have, on average blood volume, ___ to ___ liters (L).
4 to 5
Sustaining a normal blood volume is essential in maintaining ____.
blood pressure
Blood is about __ to ___ times more viscous than water, meaning is is thicker.
4 to 5
Viscosity of blood depends upon the amount of _____ in the blood relative to the amount of fluid.
dissolved substances
Viscosity is increased if the amount of substances - primarily _____ - increases, or the amount of fluid decreases or both.
erythrocytes
_____ is the relative concentration of solutes in plasma.
plasma concentration
The plasma concentration is normally a ___ % concentration, and it determines whether fluids move into or out of the plasma by ____ as blood is transported through capillaries.
0.09%
osmosis
The plasma concentration is used to determine _____ concentrations, which are usually isotonic to plasma.
intravenous plasma concentrations (IV)
If an individual is dehydrated, the plasma becomes ____, and fluid moves into the plasma from the surrounding tissues.
hypertonic
The temperature of blood is about ___C higher than measured body temperature.
1 degree C
Body temperature is 37C (98.6F), your blood temp is about ____C ( F), therefore blood warms areas through which it travels.
38C
100.4F
Blood plasma is slightly ____, with a pH between ____ and ____.
alkaline
7.35 and 7.45
Plasma proteins, like all proteins of the body have a three dimensional shape that is dependent upon ___ concentration.
H+
if the pH is altered from the normal range, plasma proteins become ____ and are unable to carry out their functions.
denatured
_____ is both plasma and formed elements, can be separated into its liquid and cellular components by using a _____.
whole blood
centrifuge
A device that spins the sample of blood in a tube so that heavier components collect at the bottom is called a _____.
centrifuge
When using a centrifuge blood separates into three components. Name them from the superior part of the test tube to the inferior portion.
Plasma
buffy coat
Erythrocytes
____ form the lower layer of the centrifuged blood. They typically make up about ____ of a blood sample.
Erythrocytes
44%
A thin ___ makes up the middle layer of centrifuged whole blood. It is a slightly gray-white layer composed of both ___ and _____. This makes up less than ___ of a blood sample.
buffy coat
leukocytes and platelets
1%
Plasma is a straw-colored liquid that rises to the top in the test tube and makes up about ___ of blood.
55%
The percentage of the volume of all formed elements in the blood is called the ______.
hematocrit
Hematocrit values vary somewhat and are dependent upon the ____ and ____ of the individual.
age and sex
A very young child’s hematocrit may vary from ___ to ___, and that range will narrow to ___ to ___ as the child becomes older.
30% to 60%
35% to 50%
Adult males tend to have a hematocrits ranging between ___% and ___%, whereas adult females hematocrits range from ___% to ___%.
42% to 56%
38% to 46%
Males typically have a higher hematocrit because _______ stimulates the kidney to produce the hormone erythropoietin (EPO) which promotes erythrocyte production.
testosterone
An elevated hematocrit may indicate that the patient is either ____ or participating in _____, whereas a lowered hematocrit often suggest the patient is suffering from anemia.
dehydrated
blood doping
All of the components of the formed elements can be viewed by preparing a ____.
blood smear
Not only does the blood contain buffers to help maintain the body’s pH, but the ____ system and ___ system also help to maintain pH.
urinary system
respiratory system
___ are the most numerous of the formed elements.
Erythrocytes
These are anucleate cells and appear as pink or pale purple, bioconcave discs.
erythrocytes
Leukocytes are larger than _____.
erythrocytes
The nucleus is very noticeable in ____.
leukocytes
Platelets appear as small _____ of cells.
fragments
Plasma is composed primarily of water, about ___% of its volume), plasma proteins, and other solutes including electrolytes, nutrients, respiratory gases, and wastes.
92%
Plasma is an ____ because it is fluid found outside of cells.
extracellular fluid (ECF)
Plasma is similar to interstitial fluid, in that both have similar concentrations of electrolytes, nutrients and waste products. however of the most significant differences is that _____ is higher in plasma than in the interstitial fluid.
protein concentration
Blood is considered a ___ because it contains proteins in the plasma.
colloid
Plasma proteins include albumin, globulins, ____ and other clotting proteins, and regulatory proteins such as enzymes and some _____.
fibrinogen
hormones
____, alpha and beta globulins, and both fibrinogen and other proteins involved in clotting are produced in the ___.
albumin
liver
Plasma proteins such as ____-globulins and regulatory proteins, are produced by _____ and other organs, respectively.
gamma
leukocytes
Collectively, these plasma proteins exert osmotic pressure and present the loss of fluid from the blood as it moves through the _____.
capillaries
Osmotic pressure exerted by plasma proteins is called _____.
colloid osmotic pressure
The ____ is responsible for drawing fluids into the blood and preventing excess fluid loss from blood capillaries into the ICF, thus helping to maintain blood volume and consequently _____.
osmotic pressure
blood pressure
If plasma protein levels _____, such as might occur due to liver disease (resulting in decreased production of ______) or kidney damage (resulting in increased elimination of plasma proteins, colloid osmotic pressure also ____. This decrease results in fluid loss from the blood and fluid retention in the interstitial space.
decrease
plasma proteins
decreases
____ are the smallest and most abundant of the plasma proteins, making up approximately ____ of plasma proteins.
Albumins
58%
Because albumin is the most abundant type of plasma protein, it exerts the greatest _____ to maintain blood volume and blood pressure.
colloid osmotic pressure
Albumins act as transport proteins that carry ions, hormones, and some ____ in the blood.
lipids
_____ are the second largest group of plasma proteins, forming about ___% of all plasma proteins.
Globulins
37%
The smaller ____ and the larger ____ primarily bind and transport certain water-insoluble molecules and hormones, some metal, and ions.
alpha-globulins
beta-globulins
____ are also called immunoglobulins, or ____, which play a part in the body’s defenses.
Gamma-globulins
antibodies
_____ makes up about 4% of all plasma proteins.
Fibrinogen
Fibrinogen as well as other clotting proteins are responsible for ____ formation.
blood clot
Following trauma to the walls of blood vessels, fibrinogen is converted into long, insoluble strands of fibrin, which help form a _____.
blood clot
When the clotting proteins are removed from plasma, the remaining fluid is termed _____.
serum
____ proteins form a very minor class of plasma proteins (less than 1% of total plasma proteins).
regulatory
Regulatory proteins include both ____ to accelerate chemical reactions in the blood and ______ being transported throughout the body to target cells.
enzymes
hormones
Blood is also considered a ____ because it contains dissolved ions as well as organic and inorganic molecules
solution
The organic and inorganic molecules in the blood include ___, nutrients, gases, and waste products.
electroylytes
Common molecules found in blood plasma.
glucose
amino acids
lactate
lipids
Electrolytes in arterial plasma
sodium potassium calcium hydrogen chloride bicarbonate phosphate
normal ranges for sodium in arterial plasma
35-145 milliequivalents per liter
normal ranges of potassium in arterial plasma
3.5-5.0 mEq/L
normal ranges of calcium in arterial plasma
8.4 - 10.2 mg/dL
normal ranges of hydrogen in arterial plasma
pH 7.35-7.45
normal ranges of chloride in arterial plasma
96-106 mEq/L
normal ranges of bicarbonate in arterial plasma
23.1 - 26.7 mEq/L
normal ranges of phosphate in arterial plasma
2.5-4.1 mEq/L
function of sodium in arterial plasma
neuron and muscle function; fluid balance; contransporter
function of potassium in arterial plasma
neuron and muscle function
function of calcium in arterial plasma
hardens bone, release of neurotransmitter, muscle contraction, blood clotting, second messenger
function of hydrogen in arterial plasma
pH Balance
normal range of glucose in blood plasma
fasting 70 -100 mg/dL; 2 hours after a meal :
normal range of lactate
4.5 - 14.4 mg/dL
normal range of cholesterol
100 - 200 mg/dL
normal range of HDL
40-80 mg/dL
normal range of VLDL/LDL
10-100 mg/dL
normal range of Triglycerides
30-149 mg/dL
normal range of phopholipids
6-12 mg/dL
function of chloride in arterial plasma
anion bound to sodium; component of gastric acid (HCl); chloride shift
function of bicarbonate in blood plasma
pH balance
function of phosphate in blood plasma
binds with calcium and deposited in bone
fuel molecule for cellular respiration (primary energy source for nervous tissue); tightly regulated by a number of hormones, including insulin and glucagon
glucose found in blood plasma
monomers for synthesizing protein; also regulated by some of the same hormones as glucose
amino acids in blood plasma
by product of glycolysis
lactate
molecules that generally do not dissolve in water
lipids
plasma membrane component; synthesis of steroid hormones; bile salts
cholesterol
transport lipids to the liver
HDL
transport lipids from the liver
VLDL/LDL
fuel molecules
triglycerides
molecules that form plasma membrane bilayer
phospholipids
Formed elements have a relatively short life span; new ones are continually produced by the process of _____, also called _______.
hemopoiesis, hematopoiesis
The red bone marrow (____ tissue) is responsible for hemopoiesis.
myeloid
Hemopoiesis occurs in most bones in young children, but as an individual reaches adulthood, hemopoiesis is _____to selected bones primarily in the axial skeleton.
restricted
The process of hemopoiesis starts with hemopoietic stem cells called _____.
hemocytoblasts
Hemocytoblasts are considered ___ cells, meaning that they can differentiate and develop into many different kinds of cells.
pluripotent
Hemocytoblasts produce two different lines for blood cell development: 1) the ___ line forms erythrocytes, all leukocytes except lympohcytes, and megakaryoctes. 2) the ____ line forms only lymphocytes.
myeloid
lymphoid
The maturation and division of hemopoietic stem cells is influenced by ________, or colony-forming units (CFUs).
colony-stimulating factors (CSFs)
CSFs or CFUs are molecules that are all growth factors, except for _____, which is a hormone.
erythropoietin
Erythocytes make up more than ____% of formed elements with a concentration between 4.2 and 6.2 million per cubic millimeter.
99%
The process of erythrocyte production is called ______.
erythropoiesis
Normally, erythrocytes are produced at the rate of about _____ per second.
3 million
The hormone erythropoietin (EPO) controls the rate of production by _____ the rate of erythorocytes formation.
increasing
Dietary requirements for normal erythropoiesis include iron, ____, and amino acids.
vitamin b
The process of erythropoiesis begins with a ______, which under the influence of multi-CSF forms a progenitor cell.
myeloid stem cell
The progenitor cell forms a _______, which is a large, nucleated cell.
proerythroblast
The proerythroblast becomes an ____, which is a slightly smaller cell that is producing hemoglobin in its cytosol.
erythroblast
The next stage of erythropoiesis is called a ____, is a still smaller cell with more hemoglobin the cytosol; its nucleus has been ejected.
normoblast
A cell called a ______ eventually is formed which has lost all organelles except some ribosomes, so it can continue to produce hemoglobin (through protein synthesis).
reticulocyte
The transformation from myeloid stem cell to reticulocyte takes about ___ days.
5 days
Some reticulocytes finish maturation while circulating in blood vessels and in normal circumstances, make up 0.5 - 2% of the ______.
circulating blood.
One to two days after entering the circulation, the reticulocyte degenerate, and the reticulocyte becomes a ______.
mature erythrocyte
Without a nucleus and cellular organelles, the mature erythrocyte is essentially a plasma membrane “bag” containing ____.
hemoglobin
Leukocytes make up less than _____ of formed elements with a concentration between 4500 and 11,000 per cubic meter.
0.01%
The production of leukocytes is called ______.
leukopoiesis
Leukopoiesis involves three different types of maturation processes: granulocyte maturation, monocyte maturation, and _____ maturation
lymphocyte
All three types of granulocytes (_____, _____, _____) are derived from a myeloid stem cell.
neutrophils
basophils
eosinophils
A myeloid stem cell is stimulated by multi-CSF and GM-CSF to form a ____ cell.
progenitor
The granulocyte line develops when the progenitor cell forms a _____ under the influence of G-CSF.
myeloblast
The myeloblast ultimately differentiates into one of the three types of ____.
granulocytes
Like granulocytes, monocytes are also derived from a _____.
myeloid stem cell
The myeloid stem cell differentiates into a ____ cell and under the influence of M-CSF this cell forms a _____. This is the monocyte line.
progenitor cell
monoblasts
Eventually, the monoblast forms a promonocyte that differentiates and matures into a _____.
monocyte
Lymphocytes are derived from a lymphoid stem cell through the _______.
lymphoid line
The lymphoid stem cell differentiates into ______ and _______.
B-lymphoblasts
T-lymphoblasts
B-lymphoblasts mature into B-lymphocytes, whereas T-lymphoblasts mature into _______.
T-lymphocytes
Some lymphoid stem cells differentiate directly into a natural killer (_____) cells.
NK
Platelets are also called ___.
thrombocytes
Thrombocytes make up less than ___% of formed elements with a concentration between 150,000 and 400,000 per cubic millimeter.
1%
The production of platelets is called _____.
thrombopoiesis
During thrombopoiesis, the myeloid stem cell, a committed cell called a ______ is produced.
megakaryoblast
Megakaryoblasts matures under the influence of thrombopoietin to form a _______.
megakaryocyte
Megakaryocytes are easily distinguished both by their large size and their ____, _____ nucleus. Each megakaryocyte then produces _____ of thrombocytes.
dense, multilobed
thousands
The process of how megakaryoctes produce thrombocytes was in question until 2007. Researchers reported that megakaryoctes produce _____ from themselves called proplatelets. While still attached to the megakaryoctye, these proplatelets extreough the blood vessel wall in the ____. The force from the blood flow “___” these proplatelets into the fragments we know as platelets (thrombocytes)
long extension
red bone marrow
slices
____ are very small, flexible cells, with a diameter of approximately 7.5 um.
erythrocytes
Although, erythrocytes are commonly referred to as red blood cells or RBCs, the term “red blood cell” is a misnomer because a mature erythrocyte lacks a ____ and ____.
nucleus and cellular organelles
A more appropriate name for red blood cells is a _____.
formed element
An erythrocyte has a unique _____ structure.
bioconcave disc
Erythrocytes are composed of a plasma membrane within which are house about ___ million hemoglobin molecules.
280 million
_____ transport oxygen and carbon dioxide between the tissues and the lungs.
erythrocytes
The fact that erythrocytes lack a nucleus and organelles enables them to carry ____ more efficiently.
respiratory gases
The bioconcave shape and flexibility of erythrocytes allow them to stack and line up in single file, termed a ____, as they pass through capillaries.
rouleau
A latticework of spectrin protein supports the plasma membrane of the erythrocyte on its internal surface and provides _____ to the erythrocyte as it moves through the capillaries.
flexibility
_____ is a red-pigmented protein that transports oxygen and carbon dioxide.
hemoglobin
When blood is maximally loaded with oxygen, it is termed _____ and appears ____.
oxygenated
bright red
When some oxygen is lost and carbon dioxide is gained during systemic cellular gas exchange, blood is called _____ and appears _____.
deoxygenated and appears dark red
Each hemoglobin molecule consists of four protein molecules called ____.
globins
Two of these globins are called _____ and the other two, which are slightly different, are called _____.
alpha chains
beta chains
All globin chains contain a ___ group, which is composed of a porphyrin (organic compound) ring, with an _____ in its center.
heme group
iron ion
Oxygen binds to the _____ in heme groups for transport in the blood.
Iron
Because each molecule of hemoglobin has four heme groups, it has ___ iron and is capable of binding ____ molecules of oxygen.
4
4
The oxygen binding is fairly weak; this allows rapid attachment of oxygen with hemoglobin when erythrocytes pas through the _____ of the lungs, and _____ when erythrocytes pass through the systemic capillaries of body tissues.
blood capillaries
rapid detachment
Carbon dioxide and the globin molecule (not ___) have a similar weak attachment relationship for the transport of _____ molecules.
not Fe+
carbon dioxide
Carbon dioxide binds to the globin protein molecule as blood moves through ___ capillaries and is released as blood moves through the capillaries of the lungs.
systemic
Erythropoiesis is controlled by the hormone _____.
erythropoietin (EPO)
The kidneys are the primary produces of EPO, although the liver also secretes a small amount of _____ as well.
erythropoietin (EPO)
The EPO is released due to the initial stimulus is a decrease in ______ levels. This decrease may be caused by the continuous removal of aged erythrocytes, blood loss, or ________.
blood oxygen
exposure to high altitudes
_____ within the kidney detect low blood oxygen levels as the blood travels through blood vessels within the kidney. As a result, certain cells in the kidney release the hormone EPO into the ____.
chemoreceptors
blood
EPO is transported through the blood and reaches the ______. There, EPO stimulates _____ in the red bone marrow to increase the rate of erythrocyte production. Additional erythrocytes are released into circulation ( a process that takes a ___), so more oxygen can be transported from the lungs and delivered to the cells. Blood oxygen levels ____ as a result. Increased oxygen levels inhibit release of EPO from kidney cells through negative feedback.
red bone marrow
myeloid cells
a few days
increase
The ____ gland secretes small amounts of testosterone in ____, and the testes secrete large amounts of testosterone in males.
adrenal gland
both sexes
Testosterone stimulates the ___ to produce more EPO. Because males have higher levels of testosterone, they also usually have a higher erythrocyte count and a higher ____.
kidneys
hematocrit
Environmental factors such as ____, can affect EPO release and ultimately affect the hematocrit.
altitude
The absence of both a nucleus and cellular organelles comes at a cost to the erythrocyte and affects its _____.
longevity
A mature erythrocyte cannot synthesize proteins either to ____ itself or to _____ damaged membrane regions.
repair
replace
______ and the wear-and-tear of circulation through blood vessels cause erythrocytes to become more fragile and less flexible.
aging
The erythrocyte has a finite maximum life span of about ____ days. Every day, about __% of the oldest ciruculating erythrocytes are removed from circulation. These old erythrocytes are ______ in both the spleen and liver by cells called _____.
120 days
1%
phagocytized
macrophages
Three molecular components must be accounted for in the destruction of hemoglobin: the globin protein, the iron ion, and the _____.
heme group
When hemoglobin is deconstructed two of the components are processed for recycling; the other component is metabolically _____ and then excreted from the body.
altered
______ are broken down into free amino acids, most of which are used by the body for protein synthesis to make new erythrocytes or other body proteins.
globin proteins
The _____ component in hemoglobin is removed and transported by a globulin protein called ______ to the liver or spleen where the Iron then is bound to storage proteins called _____ and _____.
iron
transferrin
ferritin
hemosiderin
_______ is a large water-soluble protein that serves as the primary storage mechanism for iron.
Ferritin
Iron is stored mainly in the ____ and ____, and it is transported by transferrin to the red bone marrow as needed for erythrocyte production.
liver and spleen
Small amounts of iron, approximately 0.9 mg, are lost daily in sweat, urine, and ____. In females, additional iron is ___ in those who have a monthly menstrual flow.
feces
lost
The heme group released from hemoglobin is converted within macrophages first into a green pigment called _____.
biliverdin
____ is any condition in which either the percentage of erythrocytes is lower than normal or the oxygen-carrying capacity of the blood is reduced (such as may occur if the hemoglobin is abnormal).
anemia
Biliverdin is eventually converted into a yellowish pigment called ____ which is transported by albumin to the liver.
bilirubin
Bilibrubin is a component of a digestive secretion called ____, which is produced by the liver and released into the _____.
bile
small intestines
Symptoms of anemia include lethargy, shortness of breath, pallor of the skin, and ______, fatigue, and heart palpitations.
mucous membranes
Those suffering from anemia have a decreased oxygen delivery to body tissues and consequently, the ___ must work harder to supply oxygen to the body.
heart
____ anemia is characterized by significantly decreased formation of both erthrocytes and hemoglobin. This condition results from defective red bone marrow, perhaps as a result of poisons, toxins, or radiation exposure.
aplastic
______ anemia occurs when destruction of erthrocytes is more rapid than normal. It is usually due to a genetic defect, which results in the production of abnormal membrane proteins that make the erythrocyte plasma membrane very fragile.
congenital hemolytic anemia
____ anemia is characterized by the presence of large number of immature, nucleated cells (calle erythroblasts and normoblasts) in the circulating blood. An accelerated pace of cell maturation causes immature cells to be present in the blood. These cells cannot function normally and thus anemia results.
Erythroblastic
____ anemia results from heavy blood loss. The hemorrhage may be caused, for example, by chronic ulcers of by heavy or prolonged menstrual flow.
hemorrhagic
____ anemia is a chronic progressive anemia of adults caused by failure of the body to absorb vitamin B12. This vitamin is found in fish and meat, so most individuals receive enough B12 in their diet, unless they are vegans or strict vegetarians.
pernicious
A defect in the production of _____, a glycoprotein secreted by stomach lining cells to protect B12 in the stomach and enhance B12 absorption in the small intestine, leads to pernicious anemia. Individuals who have pernicious anemia due to defective intrinsic factor production must receive B12 intramuscular or subcutaneous injections, since they are unable to absorb oral B12.
intrinsic factor
___ disease is an autosomal recessive anemia that occurs when a person inherits two copies of the sickle-cell gene. Erythrocytes become sickle-shaped at lower blood oxygen concentrations, making the unable to flow efficiently through the blood vessels to body tissues and more prone to destruction (called hemolysis).
Sickel - cell disease
Most anemias are treated by letting the patient’s own ____ replace the erythrocytes.. This process may be facilitated through the use of pharmaceutical EPO. However, anemia is often a symptom of another disease or problem.
bone marrow
A _____ is the transfer of blood or blood components from a donor to a recipient.
tranfusion
The plasma membrane of an erythrocyte has numerous molecules called ____ or ______ which project from the surface.
surface antigens or agglutinogens
Surface antigens have significant implications for blood transfusion, and some cases, ____.
pregnancy
There are two groups of surface antigens that determine a person’s blood type: ___ blood group and the ___ protein.
ABO blood group and the Rh protein
The best known antigens are those that form the ___ blood group.
ABO
The ABO blood group consists of two surface antigens, which are glycoproteins called ___ and ____.
A and B
The presence of absence of the A antigen, the B antigen, or both is the criterion that determines your ______.
ABO blood type
Type A blood has erythrocytes with surface antigen ____ only.
A
Type B blood has erythrocytes with surface antigen ___ only.
B
Type AB blood has erythrocytes with surface antigen ____.
A and B
Type O blood has erythrocytes with _____ surface antigen A or B.
neither
The ABO surface antigens on erythrocytes are accompanied by specific ____ or ____ within the blood plasma.
antibodies or agglutinins
In general, an antibody is a ___ shaped protein that binds to a specific antigen that is perceived as foreign to the body.
Y shaped
The ABO blood group has both ____ and ____ antibodies that react with the surface antigen A and the surface antigen B, respectively.
anti-A and anti-B
Type A blood has ___ antibodies within its plasma.
anti-B
Type B blood has ____ antibodies within its plasma.
anti-A
Type AB blood has ___ antibodies within its plasma.
neither anti-B and anti-A
Type O blood has ___ antibodies within its plasma.
both anti-B and anti-A
Another common surface antigen on erythrocyte plasma membranes determines the ___ blood type.
Rh
The Rh blood type is determined by the presence or absence of the Rh surface antigen, often called either Rh factor or _______.
surface antigen D
When the Rh factor is present, the individual is said to be ____. When an individual is termed ____ when the surface antigen is lacking.
Rh positive Rh+
Rh negative Rh-
Antibodies to the Rh factor (termed ____) appear in the blood only when an Rh negative individual is exposed to Rh positive blood. This most often occurs as a result of an inappropriate blood transfusion.
anti-D antibodies
Individuals who are Rh positive never exhibit anti-D antibodies, because they possess the Rh antigen on their ____.
erythrocyes
Only individuals who are ____ can exhibit anti-D antibodies, and that can occur only after ____ to Rh antigens.
anti-D antibodies
exposure
The ____ and ___ blood types are independent of each other, and neither of them interacts with or influences the presence or activities of the other group.
Rh and ABO
Blood types become clinically important when a patient needs a blood ___.
transfusion
Compatibility between donor and recipient must be ascertained prior to blood transfusions. If a person is transfused with blood of an incompatible types, ___ in the plasma bind to surface antigens of the transfused erythrocytes and clumps of erythrocytes bind together in a process termed ______.
antibodies
agglutination
Agglutination causes clumped erythrocytes which can block blood vessels and prevent ____.
normal circulation of blood
Eventually, some or all of the clumped erythrocytes may rupture, a process called ____. The release of erythrocyte contents and fragments into the blood often causes further hemolytic reactions and ultimately may damage _____. Therefore, compatibility between donor and recipient mus be determined prior to blood donations and transfusions using an agglutination test.
hemolysis
organs
Universal donor
O-
Universal recipient
AB+
The potential presence of anti-D antibodies is especially important in pregnant women who are _____ and have an ___ fetus.
Rh-
Rh+
An Rh incompatibility may result during pregnancy if the mother has been previously exposed to Rh positive blood. As a result of the prior exposure, the mother has anti-D antibodies that may cross the placenta and ____ the fetal erythrocytes, resulting in severe illness or death.
destroy
The illness that occurs in the newborn due to Rh incompatibility is called ____ or erythroblastosis fetalis.
hemolytic disease of the newborn (HDN)
Leukocytes help defend the body against ___.
pathogens
Leukocytes differ from erythrocytes in that they are about __ to ___ times larger in diameter, contain a nucleus and cellular organelles and do not contain ___.
1.5 to 3
hemoglobin
Leukocytes are ____ and remarkably flexible.
motile (capable of movement within interstitial fluid
Most leukocytes are found within ___, as opposed to in the blood.
body tissues
Leukocytes enter the tissues from blood vessels by a process called ____, whereby they squeeze between the endothelial cells of the blood vessel walls.
diapedesis
____ is a process in which leukocytes are attracted to a site of infection by the presence of molecules released by damaged cells, dead cells, or invading pathogens.
chemotaxis
The five types of leukocytes are divided into two distinguishable classes ___ and ___ based upon the visible presence or absence of secretory vesicles in the cytosol termed specific ____.
granulocytes and agranulocytes
granules
Leukocytes with a nucleus that is multilobed ( as many as 5)
neutrophils
The most abundant leukocyte is ___.
neutrophils
Neutrophils ____ pathogens, especially bacteria.
phagocytize
1% to 4% of total leukocytes is made up of ____.
Eosinophils
Eosinophils have a ___ nucleus.
bilobed
The cytosol of eosinophils have a ___ or ____ specific granules when stained.
reddish or pink-orange
These leukocytes phagocytize antigen-antibody complexes and allergens.
eosinophils
These leukocytes release chemical mediators to destroy parasitic worms.
eosinophils
These leukocytes release enzymes that target pathogens.
neutrophils
Make up 50% - 70% of total leukocytes
neutrophils
Basophils have a ___ nucleus and their cytosol contains ____ specific granules when stained.
bilobed
deep blue-violet
These leukocytes release histamine (vasodilator and increases capillary permeability) and heparin (anticoagulant) during inflammatory reactions.
basophils
These leukocytes make up 0.5% - 1% of total leukocytes.
basophils
The three types of granulocytes.
neutrophils
eosinophils
basophils
The two types of agranulocytes
lymphocytes
monocytes
These leukocytes coordinate immune cell activity.
lymphocytes
These leukocytes produce antibodies.
lymphocytes
A lymphocytes nucleus is ___ or ___.
round or slightly indented
A think rim of cytosol surrounds nucleus and the nucleus is usually stained dark in this leukocyte. Nucleus almost takes up the entire cell.
lymphocytes
Monocytes have a ____ or ___ nucleus which generally stains pale.
kidney shaped or c shaped
Monocytes have an ___ amount of cytosol around the nucleus.
abudnant
These leukocytes attack pathogens and abnormal and infected cells.
lymphocytes
These leukocytes exit blood vessels and become macrophages.
monocytes
These leukocytes make up 20% to 40% of total leukocytes.
lymphocytes
These leukocytes make up 2-8% of total leukocytes.
monocytes
These leukocytes phagocytize pathogens, cellular fragments, dead cells, and debris.
monocytes
____ have specific granules in their cytosol that are clearly visible when viewed with a microscope.
granulocytes
Granulocytes get their names for the granules’ affinities for certain ____.
stains
Neutrophils usually remain in circulation for about ___ to ___ hours before they exit the blood vessels and enter the tissue spaces, where they phagocytize infectious pathogens, especially ____.
10 to 12 hours
bacteria
The number of neutrophils in a person’s blood rises dramatically in the presence of a chronic ____.
bacterial infection
A neutrophil is about __ times larger in diameter than an erythrocyte.
1.5
An eosinophil is about ___ times larger in diameter than an erythrocyte.
1.5
Basophils are about ___ times larger than erythrocytes.
1.5
The least numerous of the granulocytes.
basophils
The primary components of basophil granules is ___ and ___.
histamine and heparin
The release of heparin from basophils inhibits ____.
blood clotting
Leukocytes in order of their relative abundance
Never Let Monkeys Eat Bananas Neutrophils Lymphocytes Monocytes Eosinophils Basophils
____ are leukocytes that have such small specific granules in their cytosol that they are not clearly visible under the light microscope.
agranulocytes
Most lymphocytes reside in __ organs and structures.
lymphatic organs
A lymphocytes is usually about the same size as a ___.
erythrocytes
When activated, lymphoctes grow ___ and have proportionally more cytosol.
larger
Smaller, nonactivated lymphoctes have a diameter less than that of an erthrocytes, whereas activated lymphocytes may be ___ times the diameter of an erythrocytes.
2
There are three categories of lymphocytes; ___ manage and direct an immune response; some directly attack foreign cells and virus-infected cells.
T-lymphocytes (t-cells)
____ are stimulated to become plasma cells and produce antibodies.
B-lympocytes (b-cells)
___ attack abnormal and infected tissue cells.
NK cells or natural killer cells
A reduced number of leukocytes causes a serious disorder called ____.
leukopenia
The decreased number of leukocytes may increase the risk of a person ____ an infection or decrease their ability to fight infection effectively.
developing
____ results from a slightly elevated leukocyte count and may be caused by a variety of factors, such as a recent infection or stress.
leukocytosis
The term, ____, or white blood cell differential count, measures the amount of each type of leukocyte in your blood and determines whether any of the circulating leukocytes are immature.
differential count
Infection, tissue necrosis, bone marrow failure, cancers, or some other stresses to the body can affect the total ranges or percentages of a specific type of ____, so differential counts are useful for diagnosing ailments.
leukocytes
Acute bacterial infections, acute stress, and tissue necrosis typically are associated with an increase in ____, called ____.
neutrophils
neutrophilia
Increased presence of immature neutrophils is referred to as ____.
left-shifted differential
Decreased neutrophil count, called ____, may occur with certain anemias, drug or raditon therapy, and from other causes.
neutropenia
Leukemia is a malignancy (cancer) in the ____ forming cells.
leukocytes
There are several categories of leukemia, but all are marked by abnormal development and proliferation of ____, both in the bone marrow and the circulating blood.
leukocytes
____ leukemia progresses rapidly, and death typically occurs within a few months after the onset of symptoms. They tend to occur in children and young adults.
acute leukemia
___ leukemia progresses more slowly; survival usually exceeds 1 years form the onset of symptoms. This form of leukemia usually occur in middle-aged and older individuals.
chronic
Viral infections such as mumps, rubella, or mononucleosis, typically produce an increased number of ___.
lymphocytes
Lymphoctes values can increase to ___ in extreme cases.
20,000
Conditions that can cause lymphocytosis include chronic bacterial infections, some leukemias, multiple ____ (cancer of the plasma cells), which are derived from B-lymphocytes.
myeloma
Decreased lymphocyte counts can occur with ____, other leukemias, and sepsis, which is the presence of a pathogenic organism or substance in the blood.
HIV infection
Eosinophil numbers can increase in response to allergic reactions, parasitic infections, or some ___ diseases.
autoimmune
Monocyte number may increase with chronic inflammatory disorders or _____, and may decrease due to prolonged prednisone drug therapy.
tuberculosis
Basophil counts can increase due to myeloproliferative disorders which result from an overproduction of some formed elements in the bone marrow and can ____ due to acute allergic and stress reactions.
decrease
______ are irregular-shaped, membrane-enclosed cellular fragments that are about 2 um in diameter (less than 1/4 the size of erythrocytes).
platelets or thrombocytes
Thrombocytes are ___ fragments and unlike erthrocytes, they never had a nucleus.
cell
The concentration of platelets in an adult ranges from ____ to about 400,000 per cubic millimeter of blood, although the count may rise further during times of stress.
150,000
Platelets can circulate in the blood for ___ to ___ days, unless they are needed earlier for hemostasis. Thereafter, they are broken down, and their contents are recycled.
8 to 10 days
____% of thrombocytes are stored in the spleen.
30%
If there is damage to a blood vessel, hemostasis is initiated. Hemostasis is a stoppage of ___.
bleeding
There are __ sequential phases of hemostasis; vascular spasm, platelet plug formation, and ______ phase.
three
coagulation
When a blood vessel is injured, the first phase in hemostasis to occur is a _____, whereby the blood vessel constricts suddenly and in so doing, limits the amount of blood that can leak form this damaged vessel.
vascular spasm
The vascular spasm continues during the next phase, as both platelets and the endothelial cells of the blood vessel wall release an array of ____ to further stimulate the vascular spasm.
chemicals
The ____ usually lasts from a few to many minutes. The more extensive the vessel and tissue damage, the greater the degree of _____.
vascular spasm phase
vasoconstriction
The second phase in hemostasis is the formation of a _____.
platelet plug
Normally, the endothelial wall (inner lining of a blood vessel) is smooth and is coated with an eicosanoid called, _____ which activates a pathway in both platelets and endothelial cells that involves production of cAMP to ultimately inhibit platelet activation.
prostacyclin
The end result is that prostacyclin serves as a platelet ____.
repellent
Once a blood vessel is damaged, however, the collagen fibers within the connective tissue beneath the endothelial cells in the vessel wall become ____.
exposed
Platelets adhere to the collagen fibers with the assistance of plasma protein called ______, which serves as a bridge between platelets and collagen fibers.
von Willlebrand factor
As the platelets start to stick to the vessel wall, their morphology changes dramatically; they develop _________ that further adhere to the blood vessel wall.
long processes
As more and more platelets aggregate to the site, a ____ develops to close off the injury.
platelet plug
The platelet plug phage is less than a ____ minutes for a small to medium sized injury, but this is a temporary measure to block the flow of blood through the vessel where it is ____.
few minutes
damaged
Platelets undergo this morphologic change and become activated: Their cytosol ____, releasing chemicals to assist with hemostasis.
degranulates
Once the platelets release chemicals the following process occurs .
prolonged vascular spasms
attraction of other platelets
stimulation of coagulation
repair of the blood vessel
Prologned vascular spasms with the release of _______ and thomboxane A2 (an eicosanoid) is a rxn to the release of chemicals by the platelets.
serotonin
Attraction of other platelets with the release of adenosine diphosphate (ADP) and thomboxane A2, which facilitates the _____ and release of these chemicals in other platelets.
degranulation
Stimulation of coagulation with the release of procoagulants that _____ blood clotting (the third phase) in rxn to platelets releasing chemicals.
enhance
Repair of the blood vessel as platelets secrete substances to stimulate epithelial tissue, smooth muscle, and ______ to replicate result from the platelets undergoing a morphologic change.
fibroblasts (cells to of connective tissue)
Platelets are not only involved in the second phase of platelet plug formation, but they also increase events of the ___ and ___ phases.
1st and 3rd phases
vascular spasms and stimulation of coagulation
Through the release of specific substances, platelets increase all three processes of _____.
homostasis
Decreased homeostasis becomes a concern in individuals with a low platelet count, known as _____.
thombrocytopenia
The formation of the platelet plug is an example of positive feedback and typically is formed within ___ minuted.
1
The healthy endothelial cells near the site of injury are still releasing their prostacyclin, so the plug ______.
does not grow to large
The most important and complex component of hemostasis is ____ or blood clotting.
coagulation
A blood clot has an insoluble protein network composed of ____, which is derived from soluble fibrinogen. This meshwork of protein traps other elements of the blood, including erythrocytes, leukocytes, platelets, and plasma proteins, to form ___.
fibrin
the clot
Blood coagulation is a process that requires numerous substances, including calcium, clotting factors, platelets, and ______.
vitamin K
The clotting factor number are in order of their ____, and not their position in the clotting pathway.
discovery
Most clotting factors are inactive enzymes, and most of these are produced by the _____.
liver
The initiation of blood clotting can occur by two separate mechanisms: The intrinsic pathway (also known as the contact activation pathway) or the _____ pathway.
extrinsic (or tissue factor pathways)
The ____ pathway is triggered b damage to the inside of the vessel wall and is initiated by _____.
intrinsic pathway
platelets
The intrinsic pathway typically takes approximately ___ to ___ minutes.
3 to 6
Steps of the intrinsic pathway
- platelets adhering to a damaged vessel wall release factor XII (Hageman factor)
- Factor XII converts the inactive factor XI to the active factor XI (Antihemophilic factor C)
- Factor XI converts inactive factor IX to active factor IX (Antihemophilic factor B (christmas factor)
- Factor IX binds with Ca2+ and platelet factor 3 to form a complex that converts inactive factor VIII to active factor VIII (Antimhemophilic factor A)
- Factor VIII converts inactive factor X to active factor X (thrombokinase)
Factor X, activated by either the intrinsic or extrinsic pathway, is the first step of the common pathway.
Steps of the common pathway
- Active factor X (Thombokinase) combines with factors II (Prothrombin) and factor V (Proaccerlerin), Ca2+, and platelet factor 3 (PF3) to form prothrombin activator
- Prothrombin activator activates prothrombin to thrombin
- Thrombin converts soluble fibrinogen into insoluble fibrin
- In the presence of Ca2+, factor XIII (Fibring-stablizing factor) cross-links and stabilizes teh fibrin monomers into a fibrin polymer that serves as the framework of the clot.
The _____ pathway is initiated by damage to the tissue that is outside of the vessel, and this pathway usually takes approximately ___ seconds. This pathways occurs more quickly because there are fewer steps required.
extrinsic
15 seconds
Steps of the extrinsic pathway
- Tissue factor (thomboplastin; Factor III) released from damaged tissues combines with factor VII and Ca2+ to form a complex
- This complex converts inactive factor X to active factor X
Clotting Factor I
Fibrinogen
Activated to fibrin
Both pathways
If Clotting Factor I is deficient
Afibrinogemia - during pregnancy can cause premature separation of placenta.
Clotting Factor II
Prothrombin
Protease; activated to thrombin
Both pathways
If Clotting Factor II is deficient
Hypoprothrombinemia - decreased syntehsis in liver generally due to insufficient vitamin K
Clotting Factor III
Tissue factor ( thromboplastin)
cofactor; activates factor VII
extrinsic
Clotting Factor IV
Calcium
Ion essential to both pathways
both pathways
Clotting Factor V
Proaccelerin
Cofactor; activates factor VII; combines with factor X to form prothrombin activator
Both pathways
Clotting Factor VI
Accelerin
Redundant to activated factor V
Both pathways
If Clotting Factor V is deficient
Parahemophilia
Clotting Factor VII
Proconvertin
Protease; activates factor X
Extrinsic
If Clotting Factor VII is deficient
Hypoconvertinemia
Clotting Factor VIII
Antihemophilic factor A
Cofactor; activates factor X
Intrinsic pathways
If Clotting Factor VIII is deficient
Hemophilia A - classical hemophilia
Clotting Factor IX
Antihemophilic factor B (Christmas factor)
Protease; activates factor VIII
Intrinsic Pathway
If Clotting Factor IX deficient
Hemophilia B - Christmas disease
Clotting Factor X
Thrombokinase
Protease; combines with factor V to form prothrombin activator
Both
If Clotting Factor X deficient
Stuart-Power factor deficiency
Clotting Factor XI
Antihemophilic factor C
Protease; activates factor IX
Intrinsic pathway
If Clotting Factor XI deficient
Hemophilia C
Clotting Factor XII
Hageman factor
protease; activates factor XI and plasmin; converts prekallikrein to kallikrein
Intrinsic pathway
Clotting Factor XIII
Fibrin-stabilizing facotr
cross-links fibrin
both pathways
_____ disorders can be caused by several different conditions including hemophilia, a vitamin k deficiency, thrombocytopenia, or intake of various drugs.
bleeding
a group of bleeding disorders caused by specific genetic mutations.
hemophilia
Females are typically the carriers of the gene for hemophilia but may not experience symptoms because they have two X chromosomes, and one of the two X chromosomes may be ___.
normal
1 in 5000 males in the united states has ____.
hemophilia A
1 in 250000 males in the united states has ___
hemophilia B
_____ deficiency is more common in newborns than adults and in individuals with ____ or bilary diseases or chronic problems with fat abosrption.
Vitamin K
liver
A deficiency in platelet count
thrombocytopenia
increased tendency to clot blood
hyperocagulation
a clot within a blood vessel that travels within the blood
embolus
a clot within the blood vessel
thrombus
occurs in the pulmonary circulation of the lungs and can lead to breathing problems and perhaps death if not treated.
pulmonary embolism
Treatment for a thrombus or ___ typically is with ____ medication.
blood thinning
A mutation of the gene for the synthesis of factor V is the most common genetic cause of hypercoagulation. Present in 3% of the population.
Leiden mutation
Like platelet plug formation, the ________ is regulated by positive feedback.
clotting cascade
When over 10% of the blood volume has been lost, a ____ response is initiated.
survival
As blood volume decrease, blood pressure _____.
decreases
If greater than 10% of the blood volume is lost from the blood vessels, the ____ division of the autonomic nervous system is activated bringing about increases vasoconstriction of blood vessels, increased ______, and increased ____ of heart contraction in an attempt to maintain blood pressure.
sympathetic
heart rate
force
If greater than 10% of the blood volume is lost blood flow is ______ to the heart and the brain to keep these vital structures functioning.
resdistrbuted.
These survival responses are effective in maintaining blood pressure until approximately ___% of the blood is lost.
40%
Blood loss greater than 40% results in insufficient blood volume within the blood vessels and blood pressure ______ to levels unable to support life.
decreases
A blood clot is a temporary measure to stop blood loss through damaged ____.
vessel wall
To return to normal, the blood vessel wall must be repaired and the clot ____. Elimination of the blood clot includes both clot retraction and ____.
fibrinolysis
______ occurs as the clot is forming when actinomyosin, a contractile protein within platelets, contracts and squeezes the serum out of the developing clot. This makes the clot smaller as the sides of the vessel wall are ___.
clot retraction
pulled closer together
To destroy the fibrin framework of the clot, _____ degrades the fibrin strands through fibrinolysis.
plasmin
Fibrinolysis begins within ___ days of the clot formation and occurs slowly over a ___ of days.
2 days
number
A damaged blood vessel, impaired blood flow, atherosclerosis, or _____ of the blood vessels can all potentially initiate blood clotting
inflammation
Certain nutrients and vitamins must be present and available for blood clotting to occur ___.
normally
The first primitive hemopoietic stem cells develop in the sac wall of the ___ by the 3rd week of development.
embryo
The primitive ____ stem cells go on to colonize other organs, such as the liver, spleen, and thymus.
hemopoietic
In these organs, very primitive stem cells develop into the ____ that produce all of the formed elements.
hemocytoblasts
Later in fetal development (perhaps beginning at 10 weeks), the hemocytoblasts begin to colonize ____, although the liver doesn’t completely cease its blood cell production until close to birth.
red bone marrow
Hemopoiesis occurs in most bones in _____, but as an individual reaches adulthood, hemopoiesis is restricted to selected bones in the ____ skeleton.
young children
axial
Older individuals have relatively less red bone marrow and may be more prone to developing ____, which is a decrease in the number of circulating erythrocytes.
anemia
Older red bone marrow may be less able to meet any demands for an increased number of ___.
leukocytes
The leukocytes in the elderly may be less efficient and active than those in younger individuals, and the elderly may have decreased number of ____.
leukocytes
Certain types of leukemias also are more prevalent among the elderly, probably due to the _____ being less efficient.
immune systems
