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a & p II exam 1 > chapter 19-blood(cardiovascular system) > Flashcards

chapter 19-blood(cardiovascular system) Flashcards

1
Q

cardiovascular system

A

blood, heart & blood vessels (anatomical division)

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2
Q

circulatory system

A

cardiovascular system & lymphatic system (clinical)

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3
Q

blood

A

-a fluid connective tissue
- 3 functions: distribution, regulation & protection

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4
Q

distribution (function of blood)

A

a. deliver O2 & nutrients to cells
b. remove metabolic waste
c. transport hormones to targets

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5
Q

what is the normal pH of blood?

A

7.4

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6
Q

blood is a type of CT, what’s its matrix?

A

plasma

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7
Q

what is the collective term for the blood cells

A

formed elements

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8
Q

the plasma proteins that are most abundant & most responsible for osmotic pressure of the blood are what?

A

albumins

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9
Q

what is the master stem cell for hematopoiesis?

A

hemocytoblast

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10
Q

what is the condition of an elevates hematocrit due specifically to RBCs?

A

polycythemia

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11
Q

rounded to the nearest whole number, erythrocytes are how many micrometers in diameter?

A

8

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12
Q

what specifically does oxygen bind to on a hemoglobin molecule?

A

iron ion(middle of the heme)

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13
Q

a person with a hematocrit of 34% would be described as having some of what?

A

anemia

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14
Q

during erythropoiesis, what’s the initial cell released into the blood from the bone marrow?

A

reticulocyte

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15
Q

what is the organ responsible for producing erythropoietin?

A

kidney

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16
Q

phagocytic cells release what into the blood from recycling of the heme pigment?

A

bilirubin (filtered by liver and ends up in bile making bile appear green)

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17
Q

someone with type B+ blood has what agglutinogens on the surface of their RBCs & automatically produces antibodies against which agglutinogen?

A

B & D, A

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18
Q

what is the leukocyte that functions to release histamine & heparin that contribute to the process of inflammation?

A

basophil

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19
Q

B cells, T cells & NK cells are types of what?

A

lymphocytes

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20
Q

what would describe the general condition of greater than normal numbers of WBCs in the blood?

A

leukocytosis

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21
Q

what is the largest cell in bone marrow that breaks off pieces of itself to produce platelets?

A

megakaryocyte

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22
Q

what is the hormone produced by the kidney that drives platelet production?

A

thrombopoietin

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23
Q

in the clotting cascade, factor X is activated to form what enzyme to facilitate the production of thrombin?

A

prothrombinase

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24
Q

what is released by endothelial cells to inhibit platelet aggregation to control the platelet plug size?

A

prostacyclin

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25
Q

a clot consists of platelets & other blood cells glues together in a web of what?

A

fibrin

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26
Q

what is critical to begin the activity of intrinsic pathway bc upon exposure to collagen or other charged surfaces it functions to activate factors VIII & IX?

A

factor XII

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27
Q

what is a free-floating blood clot that has the potential to block a vessel & lead to tissue death?

A

embolus

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28
Q

what is a disorder of lack of clotting due to deficiency in one or more of the clotting factors?

A

hemphilia

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29
Q

what mineral/ion that’s necessary for normal blood clotting?

A

calcium

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30
Q

regulation (function of blood)

A

a. maintain body temp. -> distribute heat from muscles
b. maintain pH
C. maintain fluid volume

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31
Q

protection (function of blood)

A

a. restrict loss at injury (clotting)
b. prevent infection (leukocyte)

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32
Q

characteristics of blood

A

-pH = 7.4
-temp. = 38°C / 100 °F
-total volume = 4-6L (9-11 pints)

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33
Q

how to estimate blood volume:

A

7% body weight in kg = blood in L (1kg = 2.2 Ib) -> weight Ib /2.2) x 0.07

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34
Q

blood matrix (composition of blood)

A

plasma ~55%
-water + soluble proteins

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35
Q

blood cells/formed elements (composition of blood)

A

-erythrocytes: ~45%, transport O2
-leukocytes: <1%, defense
-platelets: <1%, cell fragments for clotting

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36
Q

plasma

A

90% water + dissolved solutes (nutrients, gasses, hormones, wastes, ions, proteins)

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37
Q

plasma proteins

A

-8% of total plasma
-7.6g/100ml (5x more proteins than interstitial fluid)
-protein remain in plasma, not absorbed by cells for nutrients

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38
Q

albumins (plasma protein)

A

-60% of plasma proteins
-produced by the liver

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39
Q

function of albumins (plasma protein)

A

-act as pH buffer for blood
-contribute to osmotic pressure of blood (keep water in blood)
-transport fatty acids & hormones

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40
Q

globulins (plasma proteins)

A

-35% of plasma proteins
- 2 types: gamma globulins/ antibodies/ immunoglobulins & alpha and beta globulin/transport globulins

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41
Q

gamma globulins/ antibodies/ immunoglobulins (globulins -> plasma protein)

A

-produced by plasma cells in lymphatic system
-function to attack foreign substances

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42
Q

alpha & beta globulin/tranport globulins (globulins -> plasma protein)

A

-produced by the liver
-function to transport small or insoluble compounds to prevent filtration loss by kidney

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43
Q

clotting factors (plasma protein)

A
  • 4% of plasma proteins
    -produced by the liver
    -11 total, fibrinogen most abundant
    -all function to promote or form a clot (serum = plasma -fibrinogen)
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44
Q

other plasma proteins

A

-1% of plasma proteins
-from liver: metabolic enzymes & antibacterial proteins
-from endocrine organs: hormones

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45
Q

hematopoiesis

A

-blood cell production
-all formed elements arise from the same progenitor cell: hemocytoblast in the red bone marrow

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46
Q

hematopoiesis of basophils, eosinophils, neutrophils & platelets

A

exit the bone marrow to blood as mature cells

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47
Q

hematopoiesis of monocytes

A

must mature into macrophages by migrating from the blood to peripheral tissues

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48
Q

hematopoiesis of lymphoid stem cells

A

migrate from the bone marrow to lymphoid tissues to produce mature lymphocytes there

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49
Q

hematopoiesis of erythrocytes

A

enter the blood as reticulocytes which mature in the blood stream

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50
Q

erythrocytes (RBCs)

A

-99.9% of the formed elements of blood
-1/3 of total body cells
-4.2-6.3 million average

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51
Q

hematocrit

A

% of whole blood occupied by formed elements (mostly erythrocytes)
- male = 46%, female = 42%

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52
Q

polycythemia

A

excess erythrocytes but normal blood volume, usually due to bone marrow cancer
-increase in hematocrit = increase in viscosity = increase in heart strain & stroke

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53
Q

erythrocyte structure

A

-biconcave disc
-8μm
-large surface area for gas exchange
-can fold & stack to pass narrow vessels

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54
Q

mature erythrocyte structure

A

-lack all organelles
-no division, no repair
-low metabolic demands
-life span <120 days
-cell is 97% hemoglobin protein (red color)
-hemoglobin transport O2 & CO2

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55
Q

hemoglobin molecule (Hb)

A
  • 2 alpha chains
    -2 beta chains
    -each chain has one heme group with iron in the center: iron binds to O2
    -most O2 carried in blood bound to Hb (some in plasma)
    -only 20% CO2 carried by Hb
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56
Q

oxyhemoglobin

A

O2 bound, bright red

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57
Q

deoxyhemoglobin

A

no O2, burgundy

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58
Q

carbaminohemglobin

A

CO2 bound to amino acids on alpha/beta chains, not on heme
-when plasma O2 is low, Hb releases O2 and binds CO2
-at lungs CO2 exchanged for O2 by diffusion

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59
Q

anemia

A

O2 starvation due to:
1. insufficient # RBCs
2. low Hb
3. abnormal Hb

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60
Q

thalassemia

A

inability to produce alpha or beta chains, slow RBC
production, cells fragile & short lived

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61
Q

sickle cell anemia

A

single amino acid mutation in beta chain, high O2 , cells normal low O2 , Hb misfolds, RBCs deform into crescent shape: fragile, blocks capillaries

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62
Q

erythropoiesis

A

red blood cell formation
-2 million/sec (1 oz new blood per day)
-occurs in reticular CT in red bone marrow, in spongy bone

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63
Q

erythropoiesis steps

A
  1. hemocytoblast differentiates into myeloid
    stem cell
  2. followed by many stages of differentiation, all involving increased protein synthesis
  3. cell fills with Hb, loses organelles
  4. 3-5 days reticulocytes are formed (Hb + some ribosomes), released into blood, 1-2% of total blood RBCs
  5. 2 days in circulation lose ribosomes (no more protein synthesis) = mature
    erythrocyte
64
Q

vitamin B12

A

-vitamin B12 necessary for erythropoiesis for stem cell division
-lack of B12 = pernicious anemia

65
Q

erythropoietin (EPO)

A

-hormone, released by kidney during hypoxia (low O2)
-stimulated red blood production: increase in cell division rates & Hb synthesis = decrease in maturation
-kidney failure often= low RBCs due to lack of EPO

66
Q

blood doping

A

injecting EPO or RBCs to enhance athletic performance: increase in O2 to tissues & increase in hematocrit/viscosity = clots, stroke, heart strain

67
Q

erythrocyte recycling

A

-old/damaged RBCs removed by phagocytes in the spleen
-replaced by new, ~1% turnover per day
-phagocytosed cells are broken down

68
Q

phagocytosis of proteins through erythrocyte recycling

A

protein -> amino acids, released for use

69
Q

phagocytosis of heme through erythrocyte recycling

A

iron removed, bound to transferrin in blood for recycling back to bone marrow (new RBCs)

70
Q

pigment in heme breakdown through erythrocyte recycling

A

pigment -> biliverdin (green) -> bilirubin(yellow-green), released into blood, filtered by liver, excreted in bile

71
Q

pigment in heme breakdown in the gut through erythrocyte recycling

A

bilirubin -> urobilin (yellow) & stercobilins (brown) via bacteria urobilin absorbed, excreted in urine & stercobilins remain feces

72
Q

hemolysis

A

RBC rupture in blood -> hemoglobinuria

73
Q

hemoglobinuria

A

red/brown urine due to kidney filtering intact alpha & beta chains of hemoglobin

74
Q

blood types

A

-all cell membranes have surface antigens
-RBCs have 50+, 3 important for transfusion agglutinogens: A,B,D

75
Q

antigen

A

substance that triggers immune response

76
Q

type A blood

A

surface antigen A (40%)

77
Q

type B blood

A

surface antigen B (10%)

78
Q

type AB blood

A

both A + B antigens (4%)

79
Q

type O blood

A

neither A nor B antigen (46%)

80
Q

Rh+ type blood

A

surface antigen D (85%)

81
Q

Rh- type blood

A

no D antigen (15%)

82
Q

blood type antibodies

A

-at birth, blood contains antibodies against A or B antigens that aren’t present
-the antibodies will cause agglutination (clumping) of antigen (agglutinogen)
-antibodies against D antigen only form upon exposure & are small enough to cross placenta

83
Q

type A blood antibodies

A

antibodies against B antigen

84
Q

type B blood antibodies

A

antibodies against A antigen

85
Q

type AB blood antibodies

A

neither antibody

86
Q

type O blood antibodies

A

antibodies against both A & B

87
Q

hemolytic disease of the newborn/erythroblastosis fetalis

A

Rh- mom pregnant with Rh+ baby, gets exposed to D antigen during birth, makes anti-D antibodies, pregnant with second Rh+ baby, antibodies cross placenta, causes agglutination & lysis of fetal RBCs=anmeia & death

88
Q

prevention of erythroblastosis fetalis

A

treat mother with RhoGAM during first birth to prevent antibody formation

89
Q

leukocytes (WBCs)

A

-<1% total blood volume
-5 types
-all have nuclei & organelles, no hemoglobin
-6000-9000 leukocytes/μl blood
-use blood to travel to tissues, not permanent residents of blood

90
Q

functions of leukocytes (WBCs)

A

-defend against pathogens
-remove toxins & wastes
-remove abnormal/damaged cells

91
Q

characteristics of leukocytes (WBCs)

A
  1. amoeboid movement(crawl around blood)
  2. diapedesis(move out of blood)
    a. margination
    b. emigration
  3. exhibit positive chemotaxis(move toward damage/infections)
  4. phagocytosis- engulfs pathogens & debris (3 of 5)
92
Q

margination of diapedesis of leukocytes (WBCs)

A

adhere to blood vessels

93
Q

emigration of diapedesis of leukocytes (WBCs)

A

pass between endothelial cells

94
Q

neutrophils - granulocytes (polymorphonuclear-PMNs)

A

-non-specific defense
-phagocytic
-50-70% of WBCs
- 3-5 lobed nucleus
-12μm diameter
-granules contain enzymes & defenses
-mobile: first at injury
-life span <10h

95
Q

neutrophils - granulocytes (polymorphonuclear-PMNs) functions

A

-respiratory burst
-degranulation
-prostaglandins
-leukotrienes

96
Q

respiratory burst (function of neutrophils)

A

H2O2 & O2-, kill phagocytosed things

97
Q

degranulation(function of neutrophils)

A

release defesnins, lyse bacteria

98
Q

prostaglandins(function of neutrophils)

A

induce inflammation to stop spread of injury

99
Q

leukotrienes (function of neutrophils)

A

attract phagocytes

100
Q

eosinophils-granulocytes

A

-non-specific defense
-phagocytic
- 2-4% of WBCs
-bilobed nucleus
-12μm diameter
-granules contain toxins
-life span 9d

101
Q

eosinophils functions-granulocytes

A

-phagocytosis of antibody-covered objects
-defense against parasites: exocytose toxins on large pathogens
-reduce inflammation: anti-inflammatory chemicals/enzymes

102
Q

basophils-granulocytes(mast cells in tissues)

A

-non-specific defense
-not phagocytic
-<1% of WBCs
- U-shaped nucleus
-8-10μm diameter
-granules contain histamine & heparin
-life span 9d

103
Q

histamine (contained in basophils)

A

dilate blood vessels

104
Q

heparin (contained in basophils)

A

prevents clotting

105
Q

basophil functions-granulocytes

A

inflammation allergic response via histamine

106
Q

monocyte-agranulocytes (macrophages in tissues)

A

-non-specific defense
-phagocytic
-2% of WBCs
-15 μm + diameter
-kidney-shaped nucleus
-circulate 24h, exit into tissues
-life span several months

107
Q

monocyte function-agranulocytes

A

-phagocytosis: virus & bacteria
-attract phagocytes
-attract fibroblasts for scar formation
-activate lymphocytes to mount immune response

108
Q

lymphocyte-agranulocytes

A

-immune response (specific)
-20-30% of WBCs
-large round nucleus
- 5-17μm diameter
-migratory between blood & tissues
-most in lymphatic system
-life span days to lifetime

109
Q

lymphocyte functions-agranulocytes

A

function depends on type, 3 types: B, T & NK cells

110
Q

B cells (type of lymphocytes)

A

humoral immunity (secrete antibodies)

111
Q

T cells (types of lymphocytes)

A

cell-mediated immunity (foreign cells)

112
Q

NK cells (types of lymphocytes)

A

immune surveillance (destroy abnormal tissue)

113
Q

granulocytes

A

named for visible secretory vesicles & lysosomes (stained)

114
Q

agranulocytes

A

have lysosomes, but they aren’t visible

115
Q

leukopoiesis

A

WBC production
-myeloid stem cells -> basophils, eosinophils, neutrophils, macrophages as directed by specific CSF produced by macrophages & T cells

116
Q

lymphoid stem cells ->

A

lymphocytes production involves an immune response

117
Q

leukopenia

A

too few WBCs

118
Q

leukocytosis

A

excessive WBCs in normal blood volume >100,000/μl -> leukemia, cancerous stem cells, WBCs produced are immature & abnormal

119
Q

infectious mononucleosis: epstein bar virus

A

infection causes production of excess agranulocytes that are abnormal, self-limiting

120
Q

platelets (thrombocytes)

A
  • flattened discs, 2-4μm, 1μm thick
    -cell fragments, no nucleus
    -constantly replaces, 9-12 d in circulation then phagocytosed by cells in spleen
    -1/3 of total platelets held in reserve in spleen, mobilized for crisis
121
Q

functions of platelets

A

-transport lotting chemical, release when activated
-form patch (platelet plug) over damaged vessels
-contract wound after clotting (contain actin & myosin)

122
Q

thrombocytopoiesis

A

platelet production

123
Q

thrombocytopoiesis process

A

-megakaryocyte in bone marrow break off membrane-enclosed cytoplasm to blood
-each megakaryocyte can produce ~4000 platelets
-induced by thrombopoietin from kidney & CSF from leukocytes

124
Q

thrombocytopenia

A

too few platelets <80,000/μl, results in bleeding & petechia

124
Q

thrombocytosis

A

too many platelets >1 million/μl, due to cancer or infection, clotting risk

125
Q

hemostasis

A

-stop bleeding
- 3 phases: vascular spasms, platelets phase & coagulation

126
Q

vascular spasms (1st phase of hemostasis)

A

-begins immediately after injury
-vasoconstriction of the vessels involved in the injury

127
Q

vascular spasms (1st phase of hemostasis) triggers:

A

-injury to the vessel
-chemicals from damaged endothelial cells
-reflex triggered by pain receptors

128
Q

endothelins (occurs concurrently with vascular spasms)

A

-released by endothelial cells
-a hormone
-stimulate vascular spasms & cell division to begin repair

129
Q

von Willebrand factor(occurs concurrently with vascular spasms)

A

-released by endothelial cells
-promotes platelet sticking to endothelium

130
Q

platelet phase (2nd phase of hemostasis)

A

-begins 15-sec post injury
- platelet adhesion, aggregation & plug size
-activated by thrombin
* sets up a positive feedback loop

131
Q

platelet adhesion (platelet phase - 2nd phase of hemostasis)

A

platelets stick to enodthelium

132
Q

platelet aggregation (platelet phase - 2nd phase of hemostasis)

A

platelets stick to each other forming a “platelet plug)

133
Q

ADP (activated by thrombin in the platelet phase & platelets secrete it)

A

stimulates platelet aggregation & secretion

134
Q

thromboxane (activated by thrombin in the platelet phase & platelets secrete it)

A

stimulates vascular spasm & chemo-attract platelets

135
Q

serotonin (activated by thrombin in the platelet phase & platelets secrete it)

A

stimulates vascular spasm

136
Q

clotting factors (5 of 11 proteins) (activated by thrombin in the platelet phase & platelets secrete it)

A

act in clotting cascade

137
Q

platelet-derived growth factor (PDGF) (activated by thrombin in the platelet phase & platelets secrete it)

A

promote vessel repair

138
Q

calcium ions (activated by thrombin in the platelet phase & platelets secrete it)

A

required for aggregation & clotting

139
Q

coagulation (3rd phase of hemostasis)

A
  • begins 30 sec post-injury
    -multistep process, three important steps
140
Q

coagulation (3rd phase of hemostasis) steps

A
  1. prothrombinase is formed from clotting factors
  2. prothrombinase converts prothrombin to thrombin
  3. thrombin converts fibrinogen into fibrin, which forms a mesh to plug the hole
141
Q

blood clot

A

big mesh of fibrin: cells will later get trapped in it making it appear red

142
Q

CSF (colony stimulating factor)

A

produced by macrophage/T cells

143
Q

clotting cascade (events for coagulation)

A

-consists of calcium ions plus 11 proteins that each function as an enzyme to activate the next protein in a controlled series
-5 of the 11 clotting factors are released by activated platelets or endothelial cells
-the remaining 6 are always present in the blood as plasma proteins produced by liver
-2 methods to initiate clotting

144
Q

extrinsic pathway (method of clotting cascade)

A

-fast, initiated by factors outside bloodstream
-only occurs in body
-factor III/tissue factor released by damaged endothelial cells or other tissue or activated platelets + factor VII + Ca2+

145
Q

intrinsic pathway(method of clotting cascade)

A

-slow, initiated by factors present in blood
-can occur in a test tube
-factor XII activated by exposure to collagen (or other charged surfaces like class)
-factor XII causes factor VIII & factor IX to combine

146
Q

common pathway (clotting cascade end result)

A

-come from either intrinsic & extrinsic pathways
-factor X is activated -> prothrombinase -> prothrombin -> thrombin which leads to fibrinogen -> fibrin

147
Q

fibrin in the clotting cascade

A

forms a web that traps blood cells & platelets to seal off wound
-thrombin from the extrinsic & intrinsic pathways forms a strong clot

148
Q

30-60 minutes post-injury of the clotting cascade

A

-clot retraction occurs to reduce wound size
-PDGF stimulates cell division to promote repair

149
Q

fibrinolysis (after clotting cascade)

A

-clot is dissolved
-thrombin (common pathway) & tissue plasminogen activator (TPA from damaged tissue) activate plasminogen (in blood) to form pasta which digests fibrin

150
Q

blood clotting normally prevented by:

A
  1. anticoagulation in blood that inhibits clotting factors (antithrombin III)
  2. heparin from basophils & endothelial cells activates antithrombin III
  3. protein C from liver stimulates plasmin to digest fibrin
  4. prostacyclin from endothelial cells prevents platelet aggregation
151
Q

thrombosis (blood disorder)

A

clotting in undamaged vessels, slow or prevent flow (intrinsic pathway)

152
Q

embolus (blood disorder)

A

free floating thrombosis, blocks small vessels -> tissue damage, heart attack, stroke

153
Q

disseminated intravascular coagulation (blood disorder)

A

widespread clotting followed by systemic bleeding, rare: complications of pregnancy, septicemia or mismatched transfusion
-body-wide clotting

154
Q

hemophilia (blood disorder)

A

inadequate production of clotting factors
-type A -> factor VIII (X chromosomes linked)
-type B -> factor IX
-type C -> factor XI

155
Q

dietary blood disorders

A

-calcium required for clotting cascade
-VitK required for liver to synthesize clotting factors
-iron required for hemoglobin production
-VitB12 required for RBC stem cell division

156
Q

organ health blood disorders

A

-impaired liver = decreased clotting (decreased clotting factors)
-impaired kidney = decreased RBC (decreased EPO) decreased platelets (decreased thrombopoietin)

a & p II exam 1 (4 decks)

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