Chapter 19 - The Cardiovascular System: The Blood Flashcards
What is Blood?
Blood:
Liquid Connective Tissue
Consists of cells surrounded by Plasma (liquid matrix)
Composition:
Blood Plasma: 55%
Buffy coat composed of WBC and Platelets
RBC: 45%
What is Cellular Components of Blood?
Cellular Components of Blood: (Formed Elements)
1- RBC
2- WBC
3- Platelets
What is Plasma Portion of Blood?
Plasma Portion of Blood:
1- Water
2- Proteins
3- Other solutes
What is Composition of Blood?
Whole Blood 8% of body weight
A- Blood Plasma 55%:
1- Proteins 7%:
Albumins 54%
Globulins 38%
Fibrinogen 7%
All other proteins 1%
2- Water 91.5%
3- Other solutes 1.5%:
Electrolytes
Nutrients
Gases
Regulatory Substances
Waste Products
B- Formed Elements 45%:
1- Platelets:
150,000-400,000
2- WBC 5,000-10,000:
Neutrophils 60-70%
Lymphocytes 20-25%
Monocytes 3-8%
Eosinophils 2-4%
Basophils 0.5-1%
3- RBC:
4.8-5.4 Million
What is Functions and Properties of Blood?
1- Transport oxygen, CO2, nutrients, hormones, heat, and waste products
2- Regulate homeostasis of all body fluids, pH, body temperature, and water content of cells
3- Protect against excessive loss by clotting, and uses WBC to protect against infections
What is the Description and Function of Blood Plasma’s Water?
91.5%
1- Description:
Liquid portion of blood
2- Function:
Solvent and suspending medium
Absorbs, transports, and releases heat
What is the Description and Function of Blood Plasma’s Plasma Proteins?
7%
1- Description:
Most produced by liver
2- Function:
Responsible for Colloid Osmotic Pressure
Major contributors to blood viscosity
Transport hormones (steroid), fatty acids, and calcium
Help regulate blood pH
What is the Description and Function of Blood Plasma’s Albumins?
1- Description:
Smallest and most numerous plasma proteins
2- Function:
Help maintain Osmotic Pressure, an important facto in the exchange of fluids across blood capillary walls
What is the Description and Function of Blood Plasma’s Globulins?
1- Description:
Large proteins (Plasma Cells produce Immunoglobulins)
2- Function:
Immunoglobulins help attack viruses and bacteria
Alpha and Beta Globulins transport iron, lipids, and fat-soluble vitamins
What is the Description and Function of Blood Plasma’s Fibrinogen?
1- Description:
Large protein
2- Function:
Plays essential role in blood clotting
What is the Description and Function of Blood’s Electrolytes?
1- Description:
Inorganic salts
Cations:
Na+
K+
Ca2+
Mg2+
Anions:
Cl-
HPO42-
SO42-
HCO3-
2- Function:
Help maintain osmotic pressure
Play essential role in cell functions
What is the Description and Function of Blood’s Nutrients?
1- Description:
Products of digestion such as amino acids, glucose, fatty acids, glycerol, vitamins, and minerals
2- Function:
Essential roles in cell functions, growth, and development
What is the Description and Function of Blood’s Gases?
1- Oxygen:
Important in many cellular functions
2- CO2:
Involved in regulation of blood pH
3- N2:
No known function
What is the Description and Function of Blood’s Regulatory Substances?
1- Enzymes:
Catalyze chemical reactions
2- Hormones;
Regulate metabolism, growth, and development
3- Vitamins:
Cofactors for enzymatic reactions
What is the Description and Function of Blood’s Waste Products?
1- Description:
Urea, Uric Acid, Creatine, Creatinine, Bilirubin, Ammonia
2- Function:
Most are breakdown products of protein metabolism that are carried by the blood to organs of excretion
What is Formation of Blood Cells?
Lymphocytes are able to live for years while most other blood cells live for hours, days, or weeks
Number of RBC and Platelets remains rather steady while that of WBC varies depending on invading pathogens and other foreign antigens
Hemopoiesis: (Hematopoiesis)
Process of producing Blood Cells
Pluripotent Stem Cells differentiate into each of the different types of blood cells
What is Origin and Development of Blood Cells?
Pluripotent Stem Cell:
Can turn to any type of blood cell
A- Myeloid Stem Cell:
1- Colony-Forming Unit - Erythrocyte (CFU-E):
Then Proerythroblast
Then Reticulocyte (Nucleus is ejected)
Then Erythrocyte (RBC)
2- Colony-Forming Unit - Megakaryocyte (CFU-Meg):
Then Megakaryoblast
Then Megakaryocyte
Then Platelets
3- Mast Cell (tissue cell)
4- Colony-Forming Unit - Granulocyte Macrophage (CFU-GM):
a- Eosinophilic Myoblast
Then Eosinophil
b- Basophilic Myeloblast
Then Basophil
c- Myeloblast
Then Neutrophil
d- Monoblast
Then Monocyte
Monocyte can later become Macrophage (tissue cell)
B- Lymphoid Stem Cell:
1- T Lymphoblast
Then T Lymphocyte (T Cell)
2- B Lymphoblast
Then B Lymphocyte (B Cell)
B Cell can later become Plasma Cell (tissue cell)
3- Natural Killer (NK) Lymphoblast
Then NK Cell
What is RBC?
RBC (Erythrocytes):
Contain the protein Hemoglobin
What is Hemoglobin?
Hemoglobin:
Used to carry oxygen to all cells, and CO2 to Lungs
Each Hemoglobin molecule contains an Iron Ion which allows each molecule to bind 4 oxygen molecules
What is RBC’s Structure?
RBC:
No nucleus or other organelles
Biconcave Disc - allows it to carry oxygen more efficiently
Made of:
1- Hemoglobin Molecule made of Globins:
2 Alpha Polypeptide Chains
2 Beta Polypeptide Chains
2- Iron-containing Heme
What does Hemoglobin do?
Involved in regulating blood flow and BP via the release of Nitric Oxide (NO)
NO causes Vasodilation, which improves blood flow and enhances oxygen delivery
What is Carbonic Anhydrase?
RBC also contain Carbonic Anhydrase
Carbonic Anhydrase:
Catalyzes the conversion of CO2 and water to Carbonic Acid
Carbonic Acid transports about 70% of CO2 in Plasma
(more makes blood acidic)
How long can RBC live?
RBC live for only about 120 days
Dead RBC are removed from circulation by the Spleen and Liver
Breakdown products of RBC are recycled and reused
What is the RBC Life Cycle?
1- RBC death and phagocytosis by Macrophage in Spleen, Liver, or Red Bone Marrow
2- RBC is broken down to Globin then Amino Acids then ejected from Macrophage to be reused for protein synthesis
3- Heme is taken out from dead RBC, converted to Biliverdin then Bilirubin (inside Macrophage) and Iron that binds to the protein Transferrin (out of Macrophage)
4- Bilirubin and and Iron bound to Transferrin go to Liver
5- The Iron becomes Ferritin in Liver then taken out as Iron bound to Transferrin out of Liver
6- Transferrin takes Iron to Red Bone Marrow
7- In Red Bone Marrow, Erythropoiesis happens:
Iron + Globin + Vitamin B12 + Erythropoietin
A new RBC is formed, and lives for about 120 days in circulation before cycle starts over
8- The Bilirubin goes from Liver to Small Intestine to Large Intestine
Bacteria in Large Intestine turns Bilirubin into Urobilinogen
9- Some Urobilinogen becomes Stercobilin then Feces
10- Some Urobilinogen goes to Kidney where it becomes Urobilin and then Urine
What is Erythropoiesis?
Erythropoiesis:
Production of RBC
Begins in Red Bone Marrow
Erythropoietin (EPO), a hormone released by the Kidneys in response to Hypoxia (low oxygen concentration) stimulates differentiation of Hematopoietic Stem Cells into Erythrocytes
What is Reticulocyte?
Reticulocyte:
Immature RBC
Enter the circulation and mature in 1 to 2 days
What is Negative Feedback Loop for Hypoxia?
1- Oxygen delivery to kidneys (and other tissues) decreased
2- Kidney Cells detect low oxygen levels, increase EPO secretion into blood
3- Proerythroblasts in Red Bone Marrow mature more quickly into Reticulocytes
4- More Reticulocytes enter circulating blood
5- Larger number of RBC in circulation
6- Increased oxygen delivery to tissues
What is WBC?
WBC (Leukocytes):
Contain nucleus and organelles
No Hemoglobin
Can be:
1- Granular
2- Agranular
What is Granular WBC?
Contain vesicles that appear when the cells are stained
Granular Leukocytes:
1-Neutrophils
2- Eosinophils
3- Basophils
What is Agranular WBC?
Contain no granules
Agranular Leukocytes:
1- Lymphocytes (T Cells, B Cells, NK Cells)
2- Monocytes
How do WBC look when Stained?
1- Neutrophils:
Granular
4-5 Lobes Nucleus
2- Eosinophils:
Granular
Reddish
Kidney-shaped Nucleus
3- Basophils:
Granular
Dark purple
Nucleus hidden behind granules
4- Lymphocytes:
Agranular
Nucleus covers most of cell
5- Monocyte:
Agranular
Horseshoe-shaped Nucleus
How long do WBC Live?
WBC may live for several months to years
Their main function is to combat invading microbes
What is WBC Diapedesis (Emigration)?
Diapedesis (Emigration):
During an invasion, many WBC are able to leave bloodstream and collect at sites of invasion
Steps of Diapedesis:
1- Neutrophil in bloodstream
2- Neutrophil has Integrins on its surface
3- Rolling - Neutrophil rolls towards Endothelium of blood vessel
4- Sticking - Neutrophil sticks to Selectins on Endothelial Cells
5- Squeezing - Neutrophil squeezes between Endothelial Cells and go into Interstitial Fluid
What is WBC Count?
In general, an elevation in WBC count usually indicates an infection or inflammation
A low WBC count may develop due to several causes
A differential WBC count will help determine if a problem exists
What does High Count and Low Count mean for Neutrophils?
1- High Count:
Bacterial infection
Burns
Stress
Inflammation
2- Low Count:
Radiation exposure
Drug toxicity
Vitamin B12 Deficiency
Systemic Lupus Erythematosus (SLE)
What does High Count and Low Count mean for Lymphocytes?
1- High Count:
Viral infections
Some Leukemias
Infectious Mononucleosis
2- Low Count:
Prolonged illness
HIV infection
Immunosuppression
Treatment with Cortisol
What does High Count and Low Count mean for Monocytes?
1- High Count:
Viral or Fungal infections
Tuberculosis
Some Leukemias
Other chronic diseases
2- Low Count:
Bone Marrow suppression
Treatment with Cortisol
What does High Count and Low Count mean for Eosinophils?
1- High Count:
Allergic reactions
Parasitic infections
Autoimmune diseases
2- Low Count:
Drug toxicity
Stress
Acute allergic reactions
What does High Count and Low Count mean for Basophils?
1- High Count:
Allergic reactions
Leukemias
Cancers
Hypothyroidism
2- Low Count:
Pregnancy
Ovulation
Stress
Hypothyroidism
What is Platelets?
Megakaryocytes in Red Bone Marrow splinter into 2,000-3,000 fragments to create Platelets that contain many vesicles but no nucleus
Platelets are used to clot blood
Under the influence of the hormone Thrombopoietin, Hemopoietic Stem Cells differentiate into Platelets
Platelets survive for only 5-9 days
They are not cells
What is the Number, Characteristics and Functions of RBC?
1- Number:
Females:
4.8 Million
Males:
5.4 Million
2- Characteristics:
Biconcave Discs
No nuclei
Live for 120 days
3- Functions:
Hemoglobin in RBC transports oxygen and CO2 in blood
What is the Number, Characteristics and Functions of WBC?
1- Number:
5,000-10,000
2- Characteristics:
Most live for a few hours to a few days
3- Functions:
Combat pathogens and other foreign substances that enter body
What is the Number, Characteristics and Functions of Neutrophils?
1- Number:
60-70% of WBC
2- Characteristics:
Nucleus with 2-5 lobes connected by thin strands of Chromatin
Cytoplasm has very fine, pale lilac granules
3- Functions:
Phagocytosis
Destruction of bacteria with Lysozyme, Defensins, and strong oxidants, such as Superoxide Anion, Hydrogen Peroxide, and Hypochlorite Anion
What is the Number, Characteristics and Functions of Eosinophils?
1- Number:
2-4% of WBC
2- Characteristics:
Nucleus has 2 lobes connected by thick strand of Chromatin
Large, red-orange granules fill cytoplasm
3- Functions:
Combat effects of Histamine in allergic reactions
Phagocytize Antigen-Antibody Complexes
Destroy certain parasitic worms
What is the Number, Characteristics and Functions of Basophils?
1- Number:
0.5-1% of WBC
2- Characteristics:
Nucleus has 2 lobes
Large cytoplasmic granules appear deep blue-purple
3- Functions:
Liberate Heparin, Histamine, and Serotonin in allergic reactions that intensify overall inflammatory response
What is the Number, Characteristics and Functions of Lymphocytes?
1- Number:
20-25% of WBC
2- Characteristics:
Small or large
Nucleus is round or slightly indented
Cytoplasm forms rim around nucleus that looks sky blue
The larger the cell the more cytoplasm is visible
3- Functions:
Mediate immune responses including Antigen-Antibody reactions
B Cells develop into Plasma Cells which secrete Antibodies
T Cells attack invading viruses, Cancer Cells, and transplanted tissue cells
NK Cells attack wide variety of infectious microbes and certain spontaneously arising Tumor Cells
What is the Number, Characteristics and Functions of Monocytes?
1- Number:
3-8% of WBC
2- Characteristics:
Nucleus is horseshoe-shaped
Cytoplasm is blue-gray and appears foamy
3- Functions:
Phagocytosis (after transforming into Fixed or Wandering Macrophages)
What is the Number, Characteristics and Functions of Platelets?
1- Number:
150,000-400,000
2- Characteristics:
Fragments that live 5-9 days
Contain many vesicles but no nucleus
3- Functions:
Form Platelet Plug in Hemostasis
Release chemicals that promote Vascular Spasm and blood clotting
What is Stem Cell Transplant from Bone Marrow and Cord Blood?
Bone Marrow transplants are performed to replace Cancerous Red Bone Marrow with normal Red Bone Marrow
The donor’s Marrow is usually collected from the Iliac Crest of the Hip Bone
Stem Cells collected and frozen from an Umbilical Cord after birth may also be used, and have advantages over Bone Marrow Transplants
What is Hemostasis?
Hemostasis is a sequence of responses that stop bleeding
The process involves:
1- Vascular Spasm
2- Platelet Plug Formation
3- Blood Clotting (Coagulation)
What is Platelet Plug Formation?
1- Platelet Adhesion:
Platelets adhere to Collagen Fibers at area where Endothelium is damaged
2- Platelet Release Reaction:
Platelets release ADP, Serotonin, and Thromboxane A2
3- Platelet Aggregation:
Platelets form plug to close up damaged Endothelium
What is Blood Clotting in Hemostasis?
Blood Clotting involves several Clotting (Coagulation) Factors
Blood Clotting can be activated in one of 2 ways:
1- Extrinsic Pathway
2- Intrinsic Pathway
Both of these pathways lead to the formation of Prothrombinase and from there the Common Pathway continues
What is Extrinsic Pathway for Blood Clotting?
Uses Factors 3, 5, 7, and 10
1- Tissue trauma
2- Tissue Factor (TF) is released
3- TF and Ca2+ activate Clotting Factor X
4- Activated Factor X and Factor V and Ca2+ make Prothrombinase (not named Factor VI)
What is Intrinsic Pathway for Blood Clotting?
Uses Factors 4, 5, 8, 9, 10, 11, and 12
1- Blood trauma
2- Damaged Endothelial Cells expose Collagen Fibers, and with damaged Platelets, Factor XII is activated
3- Damaged Platelets make Activated Platelets which then make Platelet Phospholipids
4- Activated Factor XII, Ca2+, and Platelet Phospholipids activate Factor X
5- Activated Factor X, Factor V, and Ca2+ make Prothrombinase
What is Common Pathway for Blood Clotting?
Uses Factors 1, 2, 4, and 13
1- Prothrombinase, Prothrombin (Factor II) and Ca2+ make Thrombin
2- Thrombin activates Platelets and Factor V from Intrinsic Pathway
3- Thrombin with Ca2+ and Fibrinogen (Factor I) make Loose Fibrin Threads
4- Thrombin activates Factor XIII
5- Loose Fibrin Threads and Activated Factor XIII make Strengthened Fibrin Threads
What is the Name, Source, and Pathway Activation of Factor I?
1- Name:
Fibrinogen
2- Source:
Liver
3- Pathway:
Common
What is the Name, Source, and Pathway Activation of Factor II?
1- Name:
Prothrombin
2- Source:
Liver
3- Pathway:
Common
What is the Name, Source, and Pathway Activation of Factor III?
1- Name:
Thromboplastin
Tissue Factor
2- Source:
Damaged tissues and activated platelets
3- Pathway:
Extrinsic
What is the Name, Source, and Pathway Activation of Factor IV?
1- Name:
Ca2+
2- Source:
Diet, bones, and platelets
3- Pathway:
All 3 pathways
What is the Name, Source, and Pathway Activation of Factor V?
1- Name:
Proaccelerin
Labile Factor
Accelerator Globulin (AcG)
2- Source:
Liver
3- Pathway:
Extrinsic and Intrinsic
There is no Factor VI, what replaces it?
There is no Factor VI
Prothrombinase (Prothrombin Activator) is a combination of activated Factors V and X
What is the Name, Source, and Pathway Activation of Factor VII?
1- Name:
Serum Prothrombin Conversion Accelerator (SPCA)
Stable Factor
Proconvertin
2- Source:
Liver
3- Pathway:
Extrinsic
What is the Name, Source, and Pathway Activation of Factor VIII?
1- Name:
Antihemophilic Factor (AHF)
Antihemophilic Factor A
Antihemophilic Globulin (AHG)
2- Source:
Liver
3- Pathway:
Intrinsic
What is the Name, Source, and Pathway Activation of Factor IX?
1- Name:
Christmas Factor
Plasma Thromboplastin Component (PTC)
Antihemophilic Factor B
2- Source:
Liver
3- Pathway:
Intrinsic
What is the Name, Source, and Pathway Activation of Factor X?
1- Name:
Stuart Factor
Power Factor
Thrombokinase
2- Source:
Liver
3- Pathway:
Extrinsic and Intrinsic
What is the Name, Source, and Pathway Activation of Factor XI?
1- Name:
Plasma Thromboplastin Antecedent (PTA)
Antihemophilic Factor C
2- Source:
Liver
3- Pathway:
Intrinsic
What is the Name, Source, and Pathway Activation of Factor XII?
1- Name:
Hageman Factor
Glass Factor
Contact Factor
Antihemophilic Factor D
2- Source:
Liver
3- Pathway:
Intrinsic
What is the Name, Source, and Pathway Activation of Factor XIII?
1- Name:
Fibrin-Stabilizing Factor (FSF)
2- Source:
Liver
Platelets
3- Pathway:
Common
What Happens when Clot is Formed?
Once the Clot forms, it retracts (tightens) to pull the edges of the damaged vessel together
Vitamin K is needed for normal clot formation because it is used in the synthesis of 4 clotting factors
Plasmin:
An enzyme that is part of the Fibrinolytic System
Dissolves small unwanted clots
What is Blood Group and Blood Type?
Blood is characterized into different blood groups based on the presence or absence of Glycoprotein and Glycolipid Antigens (Agglutinogens) on the surface of RBC
There are 24 Blood Groups and more than 100 Antigens
Because these Antigens are genetically controlled, blood types vary among different populations
Classification is based on Antigens labeled A, B, or AB
O is the absence of the Antigens
An additional Antigen, Rh, is present in 85% of humans
What is Antibodies (Agglutinins)?
Antibodies (Agglutinins):
Produced by body, in blood Plasma
No Agglutinins against our own Blood Type
What is Characteristics of Blood Type A?
1- Agglutinogen (Antigen):
A
2- Agglutinin (Antibody):
Anti-B
3- Compatible Donor Blood (No Hemolysis):
A
O
4- Incompatible Donor Blood (Hemolysis):
B
AB
What is Characteristics of Blood Type B?
1- Agglutinogen (Antigen):
B
2- Agglutinin (Antibody):
Anti-A
3- Compatible Donor Blood (No Hemolysis):
B
O
4- Incompatible Donor Blood (Hemolysis):
A
AB
What is Characteristics of Blood Type AB?
1- Agglutinogen (Antigen):
A
B
2- Agglutinin (Antibody):
Neither Anti-A nor Anti-B
3- Compatible Donor Blood (No Hemolysis):
A
B
AB
O
4- Incompatible Donor Blood (Hemolysis):
None
What is Characteristics of Blood Type O?
1- Agglutinogen (Antigen):
Neither A nor B
2- Agglutinin (Antibody):
Anti-A
Anti-B
3- Compatible Donor Blood (No Hemolysis):
O
4- Incompatible Donor Blood (Hemolysis):
A
B
AB
What is Agglutination?
Typing and cross-matching are performed in order to determine a person’s Blood Type
Agglutination: Hemolysis of blood cells that possess Agglutinogens (Antigens) when a drop of blood is mixed with an Antiserum (Antibody) that reacts with it
ex: Agglutination of Type O blood when Antigen A or B or AB is mixed with it
What is Hemolytic Disease of the Newborn?
At birth, small amounts of fetal blood leak into the maternal circulation
If baby is Rh+ and mother is Rh-, she will develop Antibodies to the Rh Factor (Anti-Rh)
During her next pregnancy with a Rh+ baby, when she transfers Antibodies to the fetus (a normal occurrence), transferred Anti-Rh Antibodies will attack some of the fetus’ RBC causing agglutination and hemolysis
What are some Blood Disorders?
Sickle Cell Disease:
Genetic Anemia
Oxygen-carrying capacity of RBC is reduced
RBC of individuals with Sickle Cell Disease contain Hemoglobin-S (Hb-S), which causes RBC to bend into sickle shape when it gives up oxygen to the interstitial fluid