Chapter 18: Blood Flashcards

1
Q

What are the major components of the cardiovascular system?

A

The heart and the blood vessels.

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2
Q

What is cardiology?

A

The study of the heart.

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3
Q

What is angiology?

A

The study of the blood vessels.

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4
Q

What kind of tissue is blood?

A

A specialized connective tissue.

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5
Q

Why is blood a connective tissue?

A

It is made up of cells and ECM.

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6
Q

What is hematology?

A

The study of blood.

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7
Q

What are the major functions of blood?

A

Transportation, protection, and regulation.

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8
Q

What is the transport function of blood?

A

Blood carries/transports O2, CO2, nutrients, wastes, hormones, and stem cells.

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9
Q

Oxygen is transported from the ____ to all the ____ of our body.

A

Lungs, cells

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10
Q

Organic nutrients are transported from the ____ to all the ____ for use or for storage.

A

Digestive tract, cells

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11
Q

Carbon dioxide is transported from the ____ to the ____.

A

Cells, lungs

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12
Q

Waste products are transported from the ____ to the ____ for ____.

A

Cells, kidneys, excretion

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13
Q

What are examples of the waste products transported from the cells to the kidneys?

A

Bilirubin, creatinine, nucleic acids, and ammonia.

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14
Q

Hormones are ____ produced by ____.

A

Chemical messengers, endocrine glands

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15
Q

What is the protection function of blood?

A

Blood protects us from inflammation, limits the spread of infection, destroys microorganisms and cancer cells, neutralizes toxins, and initiates clotting.

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16
Q

What blood cells protect us from infections?

A

White blood cells

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17
Q

What cell fragments brings about a mechanism called clotting?

A

Platelets

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18
Q

What is the regulation function of blood?

A

Blood regulates fluid balance, stabilizes pH of ECF, and controls body temperature.

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19
Q

Blood regulates the ____ and ____ of ECF.

A

Volume, composition

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20
Q

What maintains the pH of ECF?

A

The proteins in blood.

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21
Q

When the body is overheating, how do the blood vessels regulate body temperature?

A

Through vasodilation.

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22
Q

When the body is shivering, how do blood vessels regulate body temperature?

A

Through constriction.

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23
Q

What are the physical characteristics of blood?

A

Color, volume, pH, osmolarity, viscosity, and temperature.

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24
Q

What color is oxygenated blood? Where is it seen?

A

It’s bright red and is seen in the arteries.

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25
Q

What is blood in the arteries called?

A

Arterial blood

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26
Q

What color is deoxygenated blood? Where is it seen?

A

It’s dark red and is seen in the veins.

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27
Q

What is blood in the veins called?

A

Veinous blood

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28
Q

What is the volume of blood in an adult human?

A

4 to 6L of blood.

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29
Q

What is the range pH of blood?

A

7.35 to 7.45

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30
Q

What is the pH of arterial blood?

A

7.45

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31
Q

What is the pH of veinous blood?

A

7.35

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32
Q

Why is the pH of arterial blood higher than veinous blood?

A

Arterial blood has less carbon dioxide, so it has more oxygen. Veinous blood has more carbon dioxide, so it has less oxygen.

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33
Q

What is osmolarity?

A

Total concentration of solute particles.

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34
Q

What is the osmolarity of blood?

A

300 milli osm/liter

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35
Q

What is viscosity?

A

Thickness of blood

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36
Q

What is the temperature of blood?

A

Slightly warmer than body temp, 38 C or 100.4F

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37
Q

What is blood plasma?

A

Matrix of blood (ECM).

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38
Q

What is blood plasma made up of?

A

Water, plasma proteins, and whatever the blood transports.

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39
Q

How much of the plasma is made up of water?

A

92%

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40
Q

How much of the plasma is made up of plasma proteins?

A

6% to 8%

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41
Q

How much of the plasma is made up of whatever the blood transports?

A

1% to 2%

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42
Q

What are formed elements? How many kinds are there?

A

Cell and cell fragments. 7

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43
Q

____ and the ____ make up blood.

A

Plasma, 7 formed elements

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44
Q

What is a hematocrit test?

A

A blood tests that measures the percentage of red blood cells in your blood.

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45
Q

What is venipuncture?

A

Puncture of a vein to withdraw a blood sample.

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46
Q

The ratio of ____ to the ____ is called hematocrit or packed cell volume (PCV).

A

RBCs, whole entire blood

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47
Q

What is the RBC count in men?

A

4.6 to 6.2 million/μL.

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48
Q

What is the RBC count in women?

A

4.2 to 5.4 million/μL

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49
Q

μL means _____

A

Micrometer

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50
Q

What is the percentage of whole blood?

A

100%

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51
Q

What is the hemoglobin concentration of whole blood in men?

A

13 to 18 g/dL

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52
Q

What is the hemoglobin concentration of whole blood in women?

A

12 to 16 g/dL

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53
Q

dL means _____

A

Deciliter

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54
Q

In a hematocrit test, what element are the heaviest and settle first?

A

Erythrocytes aka RBCs.

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55
Q

What is the percentage of RBCs in men?

A

42% to 52% cells

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56
Q

What is the percentage of RBCs in women?

A

37% to 48% cells.

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57
Q

What is the buffy coat made up of?

A

White blood cells and platelets.

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58
Q

What is the percentage of buffy coat?

A

Less than 1%

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59
Q

What is the percentage of plasma?

A

55%

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60
Q

What is O2?

A

Oxygen

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61
Q

What is CO2?

A

Carbon dioxide

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62
Q

What is HHb?

A

Deoxyhemoglobin

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63
Q

What is HbO2?

A

Oxyhemoglobin

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64
Q

What is H+?

A

Hydrogen

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65
Q

What is HCO3-?

A

Bicarbonate

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66
Q

What is Cl-?

A

Chloride

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67
Q

What is CAH?

A

Carbon anhydrase

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68
Q

What is serum?

A

The remaining fluid when blood clots and solids are removed.

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69
Q

Serum is identical to plasma except for what?

A

It doesn’t have any fibrinogen.

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70
Q

What is fibrinogen?

A

It forms the framework of a blood clot.

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71
Q

Serum = plasma minus the ____.

A

Clotting factors

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72
Q

What is hemopoiesis?

A

The production of blood.

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73
Q

Where does hemopoiesis occur?

A

In the bone marrow.

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74
Q

What is the technical name for RBCs?

A

Erythrocytes

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75
Q

What is erythropoiesis?

A

RBC production.

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76
Q

What is a reticulocyte?

A

An immature RBC.

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77
Q

What do RBCs look like?

A

Very small, flexible, biconcave discs.

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78
Q

What is the size of RBCs?

A

7.5 μm diameter and 2.0 μm thick at rim.

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79
Q

Do RBCs have a nucleus?

A

No, they are anucleate.

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80
Q

Besides a nucleus, what else do RBCs not have?

A

No cellular organelles and no mitochondria.

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81
Q

What is the total number of RBCs in circulation?

A

4.5 to 6.5 million cells per cubic millimeter of blood.

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82
Q

What are the functions of RBCs?

A

Carry oxygen from the lungs to the cells/tissues and pick up CO2 from the cells/tissues and brings it to the lungs.

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83
Q

What do RBCs have to squeeze into?

A

Blood vessels called capillaries.

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84
Q

What is the size of capillaries?

A

8 μm in diameter.

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85
Q

How long are RBCs able to live in circulation?

A

120 days.

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86
Q

Where do RBCs go at the end of their 120 days?

A

To the spleen, which is called the graveyard for all the old and damaged RBCs.

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87
Q

What is the structure of an RBC?

A

Hemoglobin and carbon anhydrase in the cytoplasm of RBCs, glycolipids on the outer membrane, and inner membrane surface has proteins spectrin and actin.

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88
Q

____ of RBC cytoplasm is filled with a protein called ____.

A

33%, hemoglobin (Hb)

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89
Q

How many oxygen molecules can 1 hemoglobin carry?

A

4 oxygen molecules.

90
Q

What is carbonic anhydrase (CAH)?

A

It is an enzyme in the RBCs cytoplasm.

91
Q

What is carbonic anhydrase (CAH) needed for?

A

Needed for CO2 transport.

92
Q

Hemoglobin simultaneously carries ____ and ____.

A

Oxygen, carbon dioxide

93
Q

What is the structure of a hemoglobin?

A

Hemoglobin is made up of heme and globin. Heme is made up of iron (Fe) placed within a ringlike structure. Globin is the protein, made up of alpha and beta chains.

94
Q

Each Hb molecule consists of how many protein chains? What are they called?

A

4, globins.

95
Q

How many alpha chains and beta chains does an adult Hb have?

A

2 alpha chains (alpha 1, alpha 2) and 2 beta chains (beta 1, beta 2).

96
Q

What are the oxygen molecules attached to on a hemoglobin?

A

Attached to the iron molecule.

97
Q

What is the carbon dioxide attached to on a hemoglobin? What is this called?

A

Attached to the globin chains. This is called carbamino hemoglobin.

98
Q

The bond between hemoglobin and oxygen is ____ and ____.

A

Loose and reversible

99
Q

What are thrombocytes?

A

Platelets

100
Q

What are leukocytes?

A

White blood cells

101
Q

What are the 7 kinds of formed elements?

A

Erythrocytes, platelets, and 5 types of leukocytes.

102
Q

What are the 5 types of leukocytes?

A

Neutrophils, eosinophils, basophils, lymphocytes, and monocytes.

103
Q

What are platelets?

A

Cell fragments from special cell in bone marrow.

104
Q

The components of blood are continually ____.

A

Replaced

105
Q

What are the three major categories of blood plasma proteins?

A

Albumins, globulins, and fibrinogen.

106
Q

Which plasma proteins are the smallest and most abundant?

A

Albumins

107
Q

Albumins make up how much of the plasma proteins?

A

60%

108
Q

What are the functions of albumins?

A

Transport solutes, buffer plasma pH, contribute to viscosity and osmotic pressure, influence blood pressure, flow, and fluid balance.

109
Q

What makes blood stay within the blood vessels? Why?

A

Albumins because they can hold onto water.

110
Q

What would happen if there were insufficient albumins?

A

Blood would leak out into the tissue spaces.

111
Q

Globulins make up how much of the plasma proteins?

A

26%

112
Q

What are the functions of globulins?

A

Solute transport, clotting, and immunity.

113
Q

What are the 3 subclasses of globulins?

A

Alpha, beta, and gamma globulins.

114
Q

Which globulins are the antibodies?

A

Gamma globulins

115
Q

What are the functions of alpha and beta globulins?

A

Transport heavy metals, some ions, and hormones.

116
Q

Fibrinogens make up how much of the plasma proteins?

A

4%

117
Q

Fibrinogen is the soluble precursor of ____.

A

Fibrin

118
Q

What is fibrin?

A

A sticky protein that forms the framework of a blood clot.

119
Q

What organ produces all the major proteins except gamma globulins?

A

The liver.

120
Q

What are gamma globulins produced by?

A

Plasma cells called lymphocytes.

121
Q

What produces all 7 formed elements?

A

Red bone marrow

122
Q

All cells belonging to connective tissue have a common embryonic origin called ____.

A

Mesenchyme

123
Q

What is the process of the formation of blood cells?

A

o The mesenchyme receives a signal to form blood cells.
o It forms a pluripotent stem cell.
o Once the pluripotent stem cell receives the cell signal, it forms colony-forming unit (CFU).
o The pluripotent either turns into a lymphoid hematopoiesis or a myeloid hematopoiesis.
o The myeloid stem cell becomes an erythrocyte CFU.
o The erythrocyte CFU undergoes a series of divisions to become smaller and smaller in size. It loses its organelles and starts to accumulate Hb. It finally releases/ejects its nucleus and becomes a reticulocyte (immature RBC).

124
Q

What is a colony-forming unit?

A

Specialized stem cells only producing one class of formed element of blood.

125
Q

What is lymphoid hematopoiesis?

A

Blood formation in the lymphoid organs.

126
Q

What is a myeloid hematopoiesis?

A

Blood formation in the red bone marrow.

127
Q

What do lymphoid stem cells make?

A

Only lymphocytes

128
Q

What do myeloid stem cells make?

A

All blood cells except for lymphocytes.

129
Q

What percentage of the total RBCs do reticulocytes make up?

A

1%

130
Q

What is the time frame for a hematopoietic stem cell to become a reticulocyte?

A

15 days

131
Q

What is the time frame it takes for a reticulocyte to become an erythrocyte?

A

1-3 days

132
Q

What is a reticulocyte?

A

An immature RBC.

133
Q

What is an erythrocyte?

A

A mature RBC.

134
Q

What 2 organs regulate RBC production?

A

The kidneys and the liver.

135
Q

What is the percentage of RBC production by the kidneys?

A

90%

136
Q

What is the percentage of RBC production by the liver?

A

10%

137
Q

How do the kidneys regulate RBC production?

A

o The kidneys release a glycoprotein called erythropoietic (EPO).
o When O2 content of arterial blood falls:
 It stimulates the kidneys to release EPO.
 EPO stimulates the bone marrow to release more RBCs in circulation.
 This increases oxygen carrying capacity of blood.
 This is a negative feedback mechanism.

138
Q

Where do the RBCs go for destruction when they are old and damaged?

A

The spleen

139
Q

What breaks down the hemoglobin in RBCs? What does it break it down into?

A

Macrophages break down the hemoglobin into heme and globin.

140
Q

What happens to globin after it is broken down from hemoglobin? What happens to it?

A

The globin is broken down even more into amino acids. The amino acids are either used by the cells or stored.

141
Q

What happens to the heme after it is broken down from hemoglobin?

A

The heme is broken down into iron and the ringlike structure.

142
Q

What happens to the iron after it is broken down from heme?

A

Iron combines with transferrin and is transported to all cells of the body to be used or stored.

143
Q

What is transferrin?

A

A transport protein.

144
Q

What are the iron molecules stored as after being broken down from heme?

A

Iron is stored as ferritin. When the ferritin storage is at capacity, iron is then stored to hemosiderin.

145
Q

What is the difference between ferritin and hemosiderin?

A

Ferritin is a smaller molecule; hemosiderin is a bigger molecule.

146
Q

What is the ringlike structure broken down into after being broken down from heme?

A

It is broken down into biliverdin.

147
Q

What color is biliverdin?

A

Green

148
Q

What is biliverdin broken down into?

A

Bilirubin

149
Q

What color is bilirubin?

A

Yellow-green

150
Q

What does bilirubin combine with and where is it transported?

A

It combines with albumin and is transported to the liver.

151
Q

What is bilirubin released as from the liver?

A

Bile

152
Q

What converts bilirubin in the large intestine? What is it converted into?

A

Bacteria in the large intestine converts bilirubin to stercobilin and urobilin.

153
Q

What gives feces the brown color and urine the yellow color?

A

Stercobilin and urobilin

154
Q

How is RBC count maintained?

A

Through negative feedback.

155
Q

What is hypoxemia?

A

Oxygen deficiency in the blood.

156
Q

What causes hypoxemia?

A

A drop in RBC count.

157
Q

What is the process of negative feedback control in erythrocyte homeostasis?

A

o There is a drop in RBC count.
o Hypoxemia occurs.
o Kidneys produce erythropoietin which stimulates bone marrow to release more RBCs.
o RBC count increase in 3 to 4 days.

158
Q

What is anemia?

A

A deficiency of either RBCs or hemoglobin.

159
Q

What are examples of 5 different types of anemia and what are their medical causes?

A

o Iron-deficiency anemia caused by dietary iron deficiency.
o Anemia due to renal insufficiency caused by deficiency of EPO secretion.
o Pernicious anemia caused by deficiency of intrinsic factor leading to inadequate vitamin B12.
o Hypoplastic and aplastic anemia caused by destruction of myeloid tissue by radiation, viruses, some drugs or poisons, or autoimmune disease.

160
Q

What is the difference between the lymphoid stem cells and myeloid stem cells?

A

The lymphoid stem cells make lymphocytes. The myeloid stem cells make all the other blood cells.

161
Q

What is the distinction between agranulocytes and granulocytes?

A

Granulocytes are present within the cytoplasm in the form of granules while agranulocytes exist without granules.

162
Q

What leukocytes are granulocytes?

A

Neutrophils, eosinophils, and basophils.

163
Q

What leukocytes are agranulocytes?

A

Lymphocytes and monocytes.

164
Q

What is phagocytosis?

A

Destruction of microorganisms and any dead tissue by phagocytes.

165
Q

What are phagocytes?

A

Cells that engulf foreign matter.

166
Q

What is chemotaxis?

A

Attraction of the WBCs to the site of infection.

167
Q

What is diapedesis/emigration?

A

Squeezing between endothelial cells.

168
Q

What are the functions of neutrophils?

A

o Phagocytize (kill) bacteria.
o Release antimicrobial chemicals.

169
Q

What are the functions of eosinophils?

A

Phagocytize antigen-antibody complexes, allergens, and inflammatory chemicals.

170
Q

What are the functions of basophils?

A

o Secretes histamine (a vasodilator), which increases blood flow to a tissue.
o Secrete heparin (an anticoagulant), which prevents clotting.

171
Q

What are the functions of lymphocytes?

A

o Destroy cancer cells, cells infected with viruses, and foreign cells.
o Present antigens to activate other cells of immune system.
o Secrete antibodies.

172
Q

What are the functions of monocytes?

A

o Transform into macrophages.
o Phagocytize pathogens, dead neutrophils, and debris of dead cells.
o Present antigens to activate other cells of immune system.

173
Q

How does a differential WBC count work?

A

It identifies what percentage of the total WBC count consists of each type of leukocyte.

174
Q

What is the percentage of neutrophils in a differential WBC count?

A

60% to 70%

175
Q

What is the percentage of eosinophils in a differential WBC count?

A

2% to 4%

176
Q

What is the percentage of basophils in a differential WBC count?

A

Less than 0.5%

177
Q

What is the percentage of lymphocytes in a differential WBC count?

A

25% to 33%

178
Q

What is the percentage of monocytes in a differential WBC count?

A

3% to 8%

179
Q

What does a complete blood count include the values of?

A

o Hematocrit
o Hemoglobin concentration
o Total count for RBCs, reticulocytes, WBCs, and platelets.
o Differential WBC count
o RBC size and hemoglobin concentration per RBC.

180
Q

What is leukopoiesis?

A

Production of white blood cells.

181
Q

What is thrombopoiesis?

A

Production of platelets.

182
Q

How are platelets formed?

A

o Thrombopoiesis is stimulated by a hormone from the liver and kidney called thrombopoietin.
o Some hematopoietic stem cells develop receptors for thrombopoietin and become megakaryoblasts which are cells committed to the platelet-producing line.
o The megakaryoblast duplicates its DNA repeatedly and transforms into a megakaryocyte.
o A megakaryocyte sprouts long tendrils called proplatelets that protrude through the endothelium.
o The blood flow shears off proplatelets which break up into platelets as they travel in the bloodstream.

183
Q

How to platelets differ structurally and functionally from other formed elements?

A

Platelets are not complete cells; they are small fragments of cells. They aid in blood clotting.

184
Q

What are the 4 primary mechanisms involved in hemostasis?

A

Vascular spasm, platelet plug formation, clotting, and repair.

185
Q

What are the 3 stages involved in the platelet plug formation?

A

When a blood vessel is cut:
 Platelets are released.
 The platelets bind with the collagen fibers in the outer most layer (tunica external).
 Platelets release serotonin, ADP, and thromboxane A2. The release of these chemicals helps in the formation of a loose plug of platelets.

186
Q

What is the definition of a clot?

A

Coagulation of blood. A mass of blood that forms when platelets, proteins, and cells stick together.

187
Q

What is clotting (coagulation)?

A

An important process that prevents excessive bleeding when a blood vessel is injured.

188
Q

What are clotting factors?

A

Also called procoagulants, which promote the formation of blood clots more durable than platelets plugs.

189
Q

What are the 4 major stages in the blood-clotting process?

A
  • vascular spasm
  • platelet plug formation
  • blood vessel is repaired
  • blood clot is broken

When a blood vessel is cut, first a vascular spasm occurs. A vascular spasm is the contraction of a blood vessel. Then, a platelet plug forms. Formations of clots happens. Lastly, the blood vessel is repaired, and the blood clot is broken.

190
Q

How do the extrinsic and intrinsic pathways differ?

A

The extrinsic pathway has few steps, takes less time to form a clot, and is activated by tissue factors outside of the blood vessel. The intrinsic pathways has more steps, takes longer to form a clot, and is activated inside the blood vessel without tissue factors.

191
Q

What is the common pathway?

A

Once factor 10 is activated, the remaining steps in the intrinsic and extrinsic mechanisms are identical.

192
Q

What are the steps of the common pathways?

A

o Factor 10 combines with factor 5 and calcium to produce prothrombin activator.
o This enzyme acts on a globulin called prothrombin and converts it to the enzyme thrombin.
o Thrombin then converts fibrinogen into shorter strands of fibrin.
o Factor 8 cross-links these strands to create a dense aggregation that forms the structural framework of a blood clot.

193
Q

What is clot retraction?

A

After a clot has formed, spinous pseudopods of the platelets adhere to strands of fibrin and contract. This pulls on the fibrin threads and draws the edges of the broken vessel together, like a drawstring closing a purse.

194
Q

What is the role of vitamin K in the clotting process?

A

The synthesis of factors 2, 7, 9, and 10 require vitamin K.

195
Q

What is the difference between blood groups and blood types?

A

Blood groups are determined by the presence or absence of antigens on the surface of your RBCs. Blood types are determined based on if you have anti D antigens or not.

196
Q

What are the different blood types?

A

A, B, AB, and O.

197
Q

What is your blood type if you have the presence of D antigen in your blood?

A

Positive

198
Q

What is your blood type if you don’t have the presence of D antigen in your blood?

A

Negative

199
Q

What is the role of surface antigens on RBCs in determining blood groups?

A

Whichever antigen/s you have on the surface of your RBCs is the blood group type that you have.

200
Q

What are blood types based on?

A

Blood types are based on the interactions between antigens and antibodies.

201
Q

A person with blood type A has which antigen/s on the surface of their RBCs?

A

Antigen A

202
Q

A person with blood type B has which antigen/s on the surface of their RBCs?

A

Antigen B

203
Q

A person with blood type AB has which antigen/s on the surface of their RBCs?

A

Both antigen A and B

204
Q

A person with blood type O has which antigen/s on the surface of their RBCs?

A

Neither A nor B

205
Q

Anti-A antibodies bind to which antigen?

A

Antigen A

206
Q

Anti-B binds to which antigen?

A

Antigen B

207
Q

How does the presence or absence of Rh antigen on RBCs determine whether a person is Rh positive or Rh negative?

A

A person who is Rh positive won’t make anti-Rh antibodies. A person who is Rh negative will make anti-Rh antibodies.

208
Q

Blood type A can donate to which blood types?

A

A or AB

209
Q

Blood type B can donate to which blood types?

A

B or AB

210
Q

Blood type AB can donate to which blood types?

A

AB

211
Q

Blood type O can donate to which blood types?

A

O, A, B, and AB

212
Q

Blood type A can receive blood from which blood types?

A

O or A

213
Q

Blood type B can receive blood from which blood types?

A

O or B

214
Q

Blood type AB can receive blood from which blood types?

A

O, A, B, and AB

215
Q

Blood type O can receive blood from which blood types?

A

O

216
Q

What blood type is called the universal donor?

A

Type O

217
Q

What blood type is called the universal recipient?

A

Type AB

218
Q

What happens when an incorrect ABO or Rh blood type is transfused?

A

If incompatible blood is given in a transfusion, the patient’s immune system attacks the donor cells. This reaction can cause shock, kidney failure, circulatory collapse, and death.

219
Q

What is hemolytic disease of the newborn (HDN)?

A

It can occur if an Rh- mother has formed antibodies and is pregnant with a second Rh+ child. Anti-D antibodies can cross the placenta agglutinate fetal erythrocytes. Agglutinated RBCs hemolyze, and the baby is born with hemolytic anemia

220
Q

What is given as a preventative for hemolytic disease of the newborn?

A

The mother is given rhoGAM during pregnancy. It binds fetal agglutinogens in her blood so she will not form anti-D antigens.

221
Q

What is hemolytic disease of the newborn also called?

A

Erythroblastosis fetalis