Chapter 18- Blood Flashcards
Functions of blood
Transportation (O2/CO2)
Protection (blood clotting elements and WBCs)
Regulation (of temperature)
pH of blood
7.35-7.45
Slightly basic
Blood is composed of a fluid portion called _____ and solid portion called _____ _______. These include ______, ______, and ______.
Plasma
Formed elements
RBCs, WBCs, and platelets
Plasma
Consists of mostly water (91%)
Electrolytes, proteins, wastes (urea), nutrients (glucose), and respiratory gases (O2, CO2)
Plasma
Consists of mostly water (91%)
Electrolytes (Na/K/Cl), proteins, wastes (urea), nutrients (glucose), and respiratory gases (O2, CO2)
Plasma proteins
Albumin
Globulin
Fibrinogen
Plasma composes ___% of whole blood
55
(majority)
Plasma vs Serum
Serum = Plasma minus the fibrinogens, which is what makes blood clot
Which is the majority of formed elements? RBCs, WBCs, or platelets?
RBCs
Official names of formed elements
Red blood cells = erythrocytes
White blood cells = leukocytes
Platelets = thrombocytes
Hematocrit is the
Percentage of RBC’s over volume
RBC% / volume
Hematocrit measures the
percentage of RBC’s in the blood
Average hematocrit for a person at sea level
40
Alternate name for hematocrit
Packed cell volume
Blood cells are formed by a process called ______. Within the red bone marrow, there are undifferentiated stem cells called __________, which will give rise to either RBCs. WBCs and platelets.
Blood cells are formed by a process called HEMOPOIESIS. Within the red bone marrow, there are undifferentiated stem cells called HEMOCYTOBLASTS, which will give rise to either RBCs. WBCs and platelets.
Compare hemopoiesis in a fetus, adult, and child
Adult- red bone marrow in SELECT bones
Child- red bone marrow in ALL bones
Fetus- yolksac
Erythrocytes
-shape
-composed of ____ = an _____
- adult vs early stages?
-Biconcave discs
-Composed of hemoglobin= an oxygen-carrying pigment
-As an adult, they lack a nucleus and mitochondria, but they had them during the early stages of an erythrocyte
Hemoglobin contains
4 polypeptides, heme, and iron
Each hemoglobin molecule can carry ___ molecules
4
Benefits of the biconcave shape of erythrocytes
increased surface area and gives cell more flexibility to squeeze through small vessels
Lack of a nucleus in a mature erythrocyte allows for hemoglobin to fit in, therefore ___ ___ _ __ ___. Since there is no nucleus, ___ ____ can occur. The RBC becomes _____ and either breaks or is ______ by the _____, _____, and ______.
more O2 can be carried
no repair
fragile
phagocytized by the liver, spleen, and red bone marrow
The absence of mitochondria in an erythrocyte causes 3 things:
1) more hemoglobin
2) shorted erythrocyte lifespan
3) unused oxygen (the sole purpose of erythrocytes is to carry oxygen to others)
The process of RBC production is called _______. It occurs in the _____ beginning with as all formed elements do, _______
Erythropoiesis
Red bone marrow
Hemocytoblasts
Cells stages present in erythropoiesis:
Hemocytoblast —> Proerythroblast —> early, intermediate, late erythroblast —-> Reticulocyte —> RBC
Which section has a nucleus, and where is each section found
Hemocytoblast —> Proerythroblast —> early, intermediate, late erythroblast —-> Reticulocyte —> RBC
Hemocytoblast —> Proerythroblast —> early, intermediate, late erythroblast } all have a nucleus and are only found in the red bone marrow. takes 3-4 days.
Reticulocyte —> RBC } no nucleus and is only found in the blood. takes 1-2 days.
How long does it take for a hemocytoblast to become a mature RBC?
1 week
Reticulocyte count: in a blood sample, reticulocytes account for -% of all RBCs in the blood sample. Approximately __% of our RBCs are lost every day and need to be replaced.
.5-1.5%
1%
A low reticulocyte count may indicate ___ or ___. A high reticulocyte count may indicate a ____ ____ ____.
anemia or leukemia
recent blood loss
Regenerative anemia
5% reticulocyte count
over-generating reticulocytes, possible recent blood loss
Nonregenerative anemia
0% reticulocyte count
Under-generating reticulocytes may indicate anemia or leukemia. 0% might make sense if they just lost a lot of blood.
The number of RBCs must be kept constant. The body maintains this level by ______, a hormone that controls ______. It’s released by the _____ which stimulated the red bone marrow to increase RBC production. The direct stimulus is _____, which means __________.
The number of RBCs must be kept constant. The body maintains this level by ERYTHROPOIETIN, a hormone that controls ERYTHROPOIESIS. It’s released by the KIDNEYS which stimulated the red bone marrow to increase RBC production. The direct stimulus is HYPOXIA, which means LACK OF ADEQUATE O2 AT TISSUE LEVEL.
_________ erythropoietin can be given for certain hypoxic state situations like hemorrhages (decrease in RBCs) or respiratory illness
Recombinant
_____ have a higher % of RBC (higher hct) due to the presence of __________
Males
Testosterone
Effect on hematocrit levels:
living vs visiting the mountains.
Living: Permanent increase to 50%
Visiting: Temporary increase to 50%
_____ cells in the liver and _____ in the spleen phagocytize old RBCs
Kupfer
Macrophages
RBCs only live for ___-___ days due to the lack of _____. Breakdown products ( ___ and ___ )are recycled. Macrophages in the ___, ___, and other tissues phagocytize the old red blood cells.
100-120 days
a nucleus
iron and amino acids
liver, spleen
Pathway of an erythrocyte life span
Heme –> biliverdin –> bilirubin –> bile –> urobilogen –> stercoblin
Icterus/jaundice
Yellow tint to skin because of yellow blood.
Jaundice happens when there’s too much bilirubin, a yellow-orange substance, in your blood.
Anemia
-what is it
-symptoms
-3 main causes
Reduced oxygen-carrying ability in the blood due to a decrease in RBCs/hemoglobin level
Fatigue, pale, cold
Not produced, lost, destroyed
Hemorrhagic anemia
Lost
blood loss–> decrease # of RBCs
Hemolytic anemia
Destroyed
RBCs rupture permanetly
Cause? parasites, tranfusion of mismatched blood
Aplastic anemia
Not produced
Pathology of red bone marrow leads to a low count or malformed RBC
Cause? cancer, radiation, drugs
Dietary anemia
Not produced
Not enough iron in blood (to carry O2)
Pernicious anemia
Not produced- deficiency in vitamin B12
Due to lack of INTRINSIC FACTOR in the stomach. I.F is needed to absorb B12 in small intestine, and B12 is needed for RBM to produce erythrocytes
Pernicious anemia (cont.)
Decrease in intrinsic factor –> decrease in ____ –> decrease in amount of _____
of RBCs
O2 to tissues
Sickle Cell Anemia
Destroyed
RBC loses round shapes and sickles
Abnormal increase of RBCs/too many RBCs is called _____
Polycythemia
Polycythemia occurs when hematocrit is ___ and above. Too many red blood cells is bad because it increases ___ of blood, which ___ ___ the flow and ___ the rate of oxygen getting to tissues
65%
viscosity
slows down
decreases
Primary polycythemia (absolute) vs Secondary polycythemia (relative)
In both cases, the blood is too thick. The result is the same but the cause is different.
Primary/Absolute: red bone marrow is overactive so it can’t get oxygen around fast enough
Secondary/Relative: due to dehydration
What factors cause a higher hematocrit level?
Males
Training
Dehydration
Recombinant erythropoietin
Blood Doping
Blood Doping meaning
Individual’s already-high-hematocrit blood is drawn and stored, and the RBCs are later transfused into the person right before a competition
results in an increase of O2 to tissues
Athletes typically do this- seen esp. in biking
Leukocytes
Nucleated cells
Important in body’s defense against invaders
Formed within red bone marrow from hemocytoblasts
2 types of WBCs and a description/ex.
granular WBCs- 1 lobed nucleus, granules in cytoplasm. ex: neutrophils, eosinophils, basophils
agranular WBCs- 1 nucleus (not lobed), no granules in cytoplasm. ex: lymphocytes and monocytes
Pathways for different WBCs (3)
Hemocytoblast –> Myeloblast –> neutrophils, eosinophils, or basophils
Hemocytoblast –> Monoblast –> Monocyte
Hemocytoblast –> Lymphoblast –> Lymphocyte
Stimulus for WBC production
Infection
WBCs only survive for a few ____, with one exception: ______
days
lymphocytes
Leukocytosis
When the number of WBCs increase due to an infection. This is a NORMAL PROCESS.
Diapedesis
The movement of WBCs from the blood into tissues
Chemotaxis
Attraction of phagocytes to microbes by a chemical stimulus
% of neutrophils, eosinophils, and basophils in the blood
60-70% neutrophils (majority)
2-4% eosinophils
.5-1% basophils
Neutrophils
tissue developed in red bone marrow
lobed nucleus, granules
function: phagocytosis
Eosinophils
tissue developed in red bone marrow
lobed nucleus, red granules
function: allergy + parasites
Basophils
tissue developed in red bone marrow
lobed nucleus, blue granules
function: histamine + heparin
Lymphocytes
tissue developed in red bone marrow and lymphoid tissue
compact nucleus, no granules
function: antibodies
20-25% in blood
Monocytes
tissue developed in red bone marrow and lymphoid tissue
large nucleus, no granules
function: phagocytosis
Terminology (suffix meanings)
-cytosis and -philia = increase #
-penia = decreased #
Infectious mononucleosis
Infects lymphocytes
Symptoms include sore throat, tiredness, and fever
Can last weeks-months
Leukemia
Leads to leukocytosis
uncontrolled production of WBCs, which can decrease RBC and thrombocyte (platelet) production
Thrombocytes
-percent of blood
-fragments of _____
-survives for _____
-produced from
-functions to
1% of blood
Fragments of megakaryocytes
Survives for 5 days
Produced from hemocytoblasts
Functions to prevent blood loss (clotting)
Hemostasis
A hemostatic process that will stop the loss of blood (balance of the blood)
3 phases of hemostasis
Vascular Spasms
Platelet Plug
Coagulation (blood clotting)
Vascular spasms
constriction of the smooth muscle of the vessel that’s been injured
lasts a few mins to a few hours
localized
Platelet plug formation forms a plug within ______ which temporarily seals the ________
Forms a plug within 1-2 minutes which temporarily seals the break in the vessel’s wall
3 steps to platelet plug formation
- Platelet adhesion
- Platelet activation
- Platelet aggregation
Describe the three steps to platelet plug formation
First comes platelet adhesion, which is where the thrombocytes stick to exposed collagen with the assistance of von wilebrand factor.
Second is the platelet activation, which releases prostaglandin to attract additional thrombocytes to the area
Lastly is platelet aggregation, where new thrombocytes stick to existing ones with the assistance of fibrinogen, creating a plug
Explain the effects of aspirin
Antiprostaglandin prevents prostaglandin from woking, preventing the plug from forming
Coagulation
During coagulation, a clot is formed in the injured area
-Procoagulants
-Anticoagulants
Procoagulants
Substances that enhances the clot formation: (called clotting factors)
Most are made by the liver and requires vitamin K
Anticoagulants
Substances that inhibit the formation of a clot
Endogenous anticoagulants: Heparin, Antithrombin
Exogenous anticoagulants: Heparin, Coumadin, EDTA
Normally, _____ dominated and clotting is prevented. But, when a vessel is ruptured, the _______ activity in that area will increase and a clot forms,
Anticoagulants
Procoagulants/clotting factors
Most procoagulants/clotting factors are plasma proteins the ___ makes that circulate in ____ form until mobilized
liver
inactive
2 pathways that are involved in forming a blood clot:
What does each release? What do they both need?
Extrinsic Pathway and Intrinsic Pathway
The extrinsic pathway releases factor 3
The intrinsic pathway release factor 12
They both release factor 10 –> prothrombinase –> thrombin
Both needs calcium
The extrinsic pathway releases factor ___, while the intrinsic pathway releases factor ___. They both need _____ for each pathway. They both release factor __ –> prothrombinase –> thrombin. Describe what the last two do (converts_____).
Factor 3
Factor 12
Calcium
Factor 10
Prothrombinase: converts prothrombin into thrombin
Thrombin: converts fibrinogen to fibrin (forms clot, end result)
Clot Retraction
Formed within 30-60 minutes
The clot contracts and brings the ruptured edges of the vessel closer together
Fibrinolysis
Removes the unneeded clot when healing occurs
Begins within 2 days (and continues over several days until the clot is dissolved)
Plasminogen
an inactive blood protein that needs to be activated by t-PA to become plasmin, an active enzyme
In emergency situations, when a person has formed an abnormal clot that is blocking circulation (like a heart attack), ____ or _____ can be _____ into the blood or introduced at the clot site
t-PA or Streptokinase (a bacterial enzyme)
injected
What actually breaks down the clot?
Plasmin.
t-PA just converts plasminogen to plasmin, which is the one to break it down
Hemophilia
hereditary deficiencies in clotting factors
may cause spontaneous bleeding
absence of factors
Vitamin K deficency
Vitamin K is needed to produce 4 of the factors in the clotting process
Imapired liver function
Unable to synthesize the procoagulants, even if Vitamin K is present
ex: hepatitis, cirrhosis
Thrombocytopenia
The number of platelets is reduced leading to spontaneous bleeding
Von Willebrands Disease
Absence on Von Willebrand Factor
What’s the result of something impacting platelet/thrombocyte formation
Bleeding
Thrombosis
If the thrombus (the actual clot) is large enough, ______________
A clot that develops and persists on a wall of an unbroken vessel
If the thrombus (the actual clot) is large enough, it may block circulation leading to the death of a tissue
Embolus
When the thrombus breaks away from the vessel wall and floats freely in the blood
A thrombus is commonly formed in the
legs
Treatments of a myocardial infarction (heart attack)
Aspirin
Vasodilator
TPA
Heparin
anticoagulant, prevents clots
DIC stands for
and means..
Disseminated
Intravascular
Coagulation
Clots are forming everywhere at the same time
_________ are present shortly ___ ___
Antibodies are present shortly after birth
Main reaction to compare in transfusions is ____ ____ and _____ ____
donor antigen
recipient antibody
Antigen
On the surface of RBCs
Those who have antigen A of the surface of their RBC have type __ blood
A
Those without antigen A or B have type ___ blood. Those with both antigen A and B have type ___ blood.
O
AB
O is _____ and A and B are _______
Recessive
Codominant
Antibodies
Located in the plasma and react with the antigens of other blood types
When incompatible bloods are mized together, the most dangerous reaction occurs between the ____ of the donor and the _____ of the recipient
antigens
antibodies
In a ______ ____, the RBCs burst, releasing _______ into the blood
transfusion reaction
hemoglobin
Hemolysis
The bursting of red blood cells
List each blood type and its antigens and antibodies
Type A:
Type B:
Type AB:
Type O:
Type A:
A antigen and anti-B antibodies
Type B:
B antigen and anti-A antibodies
Type AB:
A and B antigens and no antibodies
Type O:
No antigens and anti-A and anti-B antibodies
Universital Recipient and why
AB, no antibodies so the blood won’t attack any blood its given
Universal Donor and why
Type O, no antigens, won’t attack any blood that it gives
Humans are born with the ____ ____ and will develop appropriate antibodies shortly ____ ____ (generally by ______)
ABO antigens
after birth
2 months
Those who have Rh antigens on their RBCs are
Those who don’t are
Rh positive
Rh negative
Normally there are no __________ in the blood of Rh- people. However, they develop ___ exposure to Rh+ blood. This differs from ABO antibodies that are always there in the plasma starting from birth.
anti-Rh antibodies
after
Problems can occur in a pregnancy if the mom is Rh ___ and the child is Rh ___. If this happens, _____ ___ __ __ ____ may occur which may be treatable, but is preventable
negative
positive
Hemolytic Disease of the Newborn
B- has no ___ ______, unless it is mentioned that B- has received a previous blood tranfusion by someone with B+ blood, in which it ________
Rh antibodies
does have Rh antibodies
Hemolytic Disease of the Newborn: 2 points
Normally, there won’t be problems with the first pregnancy, but the formation of Rh antibodies will cause problems in later pregnncies
The mixing of blood occurs during labor. The blood of the newborn and the mother are separate during the pregnancy
What is given to Rh- mothers during pregnancy (and within 72 hrs after delivery)?
An injection of Rhogam (doesn’t allow anti-Rh antibodies to form)
Tranfusion Reactions occur when the blood of the __________________. Symptoms of this are:
donor is not the same as the recipient
fever, vomiting, and hemoglobin deposition in kidney tubules
What’s different about hemoglobin a fetus vs an adult?
Adult: 2 alpha chains and 2 beta chains
Fetus: 2 alpha chains and 2 gamma chains, binds oxygen more tightly that adults do, which allows the fetus to extract oxygen from the mother’s bloodstream
What’s the stimulus for Erythropoietin?
Hypoxia
