Circulating Cells & Blood Vessels Part 1 Flashcards
When you spin blood in a centrifuge, the ____ settle at the bottom and the ____ settles on top.
Erythrocytes
Plasma
To measure _____, centrifuge blood sample in a tube with anticoagulants
Hematocrit
Plasma vs serum:
____ clots
____ lacks protein fibrinogen and some other clotting factors
Plasma
Serum
The most abundant cell in the blood are ____
Erythrocytes
Erythrocytes appear as pink, _____ discs on blood smear
Biconcave
_____ appear small and round on a blood smear
Platelets
Glycoporin C and Band 3 express different carbohydrates that are responsible for ____ ____ ____
ABO blood typing
_____ have multiple lobed nuclei
Neutrophils
____ have binuclei and large bright orange granules
Eosinophils
_____ have multi lobe nuclei and large purple granules which often obscure the nucleus
Basophils
____ are round with a round nucleus which takes up majority of the cell
Lymphocyte
____ have kidney shaped nucleus without granules
Monocyte
____ and _____ are involved in allergic conditions
Eosinophils
Basophils
First line of defense:
Second line of defense:
Neutrophils, eosinophils, Basophils
Monocytes
Lymphocytes are ___ or ____. They both appear large and round with large a nucleus
T cells
B cells
____ are found in the bone marrow and circulation. They leave the circulation and give rise to clones. They become plasma cells that produce antibodies. They also have memory.
B cell
____ make up 80 to 90% of circulating lymphocytes. They must pass through the thymus. They develop individual anti-genic specificity while in the thymus. They are activated by antigen presentation.
T cells
___ ____ is the site of hematopoiesis which is the process of blood cell production. It contains stem cells, progenitor cells, and mature blood cells.
Bone marrow
The ____ contains mostly mature cells while the ___ ___ contains cells at all different stages
Blood
Bone marrow
____ is the development of RBC maturation.
_____ is the state where the stem cell has differentiated to define its erythroid lineage
A ____ ___ aka ____ no longer has a nucleus
Erythropoiesis
Pronormoblast
Polychromatic erythrocyte
Reticulocyte
Erythrocytes function to transport ___ and ___
O2
CO2
____ ___ ____ stains reticulocytes due to them containing residual ribosomal RNA
New Methylene blue
_____ refers to the production of white blood cells. It involves different pathways for the production of neutrophils, eosinophils and basophils, monocytes, and lymphocytes.
Leukopoiesis
T cells mature in the ____
B cells mature in the ___ ___
Thymus
Bone marrow
Leukocyte maturation:
1. ____ stage
2. ____ stage where the cell has committed to neutrophil lineage
Myeloblast
Promyelocyte
In situations where more neutrophils are needed, there might be a shift toward immature forms in the peripheral blood. This is often referred to as a ___ ___ based upon old cell counters with immature cells on the left side
Left shift
_____ is the process of platelet production. It starts from a ____ stem cell, which differentiates into a megakaryocyte which then produces platelets by fighting off it’s cytoplasm
Thrombopoiesis
Hematopoietic
Structure of blood vessels:
Three outside layers
1.
2.
3.
Tunica intima
Tunica media
Tunica adventitious (tunica externa)
_____ have a more rigid structure, they are around and have small lumens
_____ are flat and have large lumens
Arteries
Veins
____ ____ are the first branch from the heart. They contain a high amount of ____ to withstand the pressure. Examples include _____, ____, _____, ____ ___ ___, and ___ ___
Elastic arteries
Elastin
Aorta
Carotid
Subclavian
Common iliac arteries
Pulmonary trunk
Elastic (conducting) arteries:
Tunica intima: contain ____ cells connected by tight junctions. They have granules called ____ ____ that store and release von Willebrand factor and P selection. They have internal ____ ____
Endothelial
Weibel-Palade bodies
Elastic lamina
Elastic artery:
Tunica media: many fenestrated lamellae of ____. Circularly, arranged, smooth, muscle bundles, alternate with ___. Very few fibroblasts present.
Elastin
Elastin
Elastic artery:
Tunica adventita:
Relatively thin, contains ___ ___
Contains ____ ___ (nerves of the blood vessels)
Vasa vasorum
Nervi vasorum
Diagram of elastic artery wall:
After the elastic arteries come the ____ ___. They have thick tunica media, composed, primarily of ___ ___ with less elastin. The tunica intima contains a prominent internal ___ ___
Muscular arteries
Smooth muscle
Elastic lamina
Muscular (distributing) arteries:
Tunica intima: thinner than ___ arteries
Tunica media: 30 to 40 layers of ___ ___
Tunica adventita: connective tissue components with some thin ___ ___. Vasa vasorum and Nervi vasorum present
Elastic
Smooth muscle
Elastic laminae
Picture of muscular artery:
Picture with elastic stain, highlighting the elastin in muscular arteries:
After the muscular arteries come the ____. They typically have a diameter of less than 0.1 mm.
Arterioles
Arteriole:
Tunica intima: ____, thin layer of connective tissue, sometimes an ___ ___
Tunica media: 1 to 3 layers of ___ ___
Tunica adventita: scant, produced by ___. Only contain Nervi vasorum, no vaso verum is needed
Endothelium
Smooth muscle
Fibroblasts
Picture of arteriole:
Compare an arteriole to venule:
Venule has a much smaller wall
Review:
After arterioles comes ____. They’re usually short and narrow about 8 to 10 µm in diameter. An RBC is 7 microns. They have _____ layer of elongated, simple squamous endothelial cells. ___ and ___ have been identified in cells. They are joined together by tight junctions.
Capillaries
Single
Vimentin
Desmin
Three Major capillary types:
Continuous
Fenestrated
Sinusoid (discontinuous)
____ ____ is endothelial cells completely cover the luminal surface
Continuous capillary
____ capillary is endothelial cells, have a small holes through the cell surface to allow direct contact between the lumen and connective tissue
Fenestrated
_____ capillary have spaces between endothelial cells that allow direct contact between lumen and connective tissue
Sinusoid (discontinuous)
Continuous capillaries are found in:
Muscles, connective tissue, and CNS
Fenestrated capillaries are found in:
Kidney glomeruli
Endocrine glands
Intestinal villi
Exocrine pancreas
Sinusoid capillary is found in:
Liver, spleen, bone marrow, lymph nodes
_____ are generally associated with continuous capillaries and small venules. They surround the capillaries, and most likely aid in ____
Pericytes
Contractions
Fenestrae in capillary allows for small ____ to pass
Molecules
Sinusoids in a heart:
Sinusoids in the bone marrow:
Regulation of blood flow in a capillary bed:
_____ are short vessels that branch to supply blood to the capillary bed. Tunica media contains rings of smooth muscle cells that behave as a precapillary sphincter
Metarteriole
______ ____ provide direct connection between arterial and venule, common in the hands and feet. Tunica media includes smooth muscle cells who is contraction is regulated by ___ ___ from the hypothalamus for thermal regulation
Artriovenous anastomosis (AVA)
Adrenic axons
Diagram of capillary bed and shunts:
____ take blood back to the heart and greatly out number the arteries. They have a larger lumen. ___% of blood volume is in veins.
Veins
____ ____ receive blood from the capillary bed. They are similar to capillaries
Postcapillary venule
____ ____ are the site for immigration of leukocytes from Buss aluminum into tissue spaces
Post capillary venules
Smooth muscle cell investment increases as ____ get larger.
Venules
___ ____ are less than 1 cm in diameter.
Tunica intima: endothelium, and some reticular fiber
Tunica media: smooth, muscle cells, intermingled with collagen fibers, and fibroblasts
Tunica adventitia: is the thickest layer containing collagen and elastic fibers
Medium veins
Many medium veins have ____
Valves
____ ____ include vena cava, pulmonary, portal, renal, internal jugular, iliac
Tunica intima: endothelium, and a thick sub endothelial layer with elastic fiber
Tunica media: not well developed and often not a parent
Tunica adventitia: collagenfibers, elastic fibers, vasa vasorum, longitudinally, disposed, smooth, muscle bundles
Large veins
_____ and beans keep blood flowing in the right direction they consist of folds of the ___ ____. They prevent backflow of blood.
Valves
Tunica intima
____ ____ occur when there is an abnormally enlarged and tortuous vein. Usually affect superficial veins in legs. Due to loss of muscle tone, ____ _____, and valvular incompetence
Varicose veins
Wall degeneration
____ ____ carry lymph. They have a been like structure with thinner walls and closely spaced valves
Lymph capillaries
A is a vein
B is a lymphatic vessel
C is an artery
_____ is accumulation of fluid and tissues, due to disrupted balance of hydrostatic and colloid osmotic pressure
Edema
_____ is fluid accumulation in body cavities. Common in disorders, that affect cardiovascular, Reno, or hepatic functions. It is due to increased _____ pressure or reduced ____ osmotic pressure
Effusions
Hydrostatic
Colloid
Edema and effusions can be inflammatory (_____) or non-inflammatory (____)
Exudates
Transudates
edema is caused by increased ____ ___, reduced plasma osmotic pressure (_____), sodium retention, or lymphatic obstruction
Hydrostatic pressure
Hypoproteinema
_____ is the process of blood clot formation at sites of vascular injury. It is essential for life and can be disrupted in various disorders. ____ disorders involve excessive bleeding. ____ disorders involve the formation of blood clots.
Hemostasis
Hemorrhagic
Thrombotic
____ ____ is the initial phase of blood clotting that occurs immediately after blood vessel injury, it involves the formation of ___ ____ to seal the damaged vessel, and prevent further bleeding
Primary hemostasis
Platelet plug
___ ____ is blood vessel construction in response to injury to reduce blood flow. It is mediated by vasoconstrictor substances released from damaged, endothelial cells and platelets. Examples: ____, ______, _____ , and ____
Vascular spasm
Endothelin
Thromboxane A2
Serotonin
ADP (adenosine diphosphate)
___ ___ is one platelets adhere to the exposed sub, endothelial matrix at the site of injury. ____ ___ ____, released from the endothelium and platelets acts as a bridge between platelets and damage. Blood vessel walls promoting the initial formation of platelet plugs
Platelet adhesion
von Willebrand factor (vWF)
____ platelets undergo shape change and release granule contents such as ___ and ___ to promote further platelet activation and aggregation
Activates
ADP
thromboxane A2
Platelet said here to each other through binding of ____ to the ____ ___ receptors on platelet surfaces this process leads to the formation of a stable platelet plug
Fibrinogen
Glycoprotein Ilb/Illa
____ ____ involves the formation of a fibrin clot to reinforce the platelet plug. It relies on a cascade up, enzymatic reactions, known as the ____ ____
Secondary hemostasis
Coagulation cascade
Coagulation cascade is initiated by ___ ___ being exposed to blood upon vessel injury. It is amplified, by sequential activation of coagulation factors, leading to the formation of ____, which converts soluble fibrinogen into insoluble fiber in strands.
Tissue factor (TF)
Thrombin
___ ____ form a meshwork trapping red blood cells and platelets resulting in the formation of a stable clot
Fibrin formation
Anticoagulant factors such as ___ and ____ counteract the coagulation cascade to prevent excessive clot formation
Antithrombin
Protein C
_____ is initiated to dissolve the clot once the injured vessel is repaired, mediated by ____ which breaks down, fiber in strands. ____ is tissue, plasminogen activator and is used to break down clots in the case where someone has a clot, obstructing the blood flow to vital organs.
Fibrinolysis
Plasmin
t-PA
_____ is when clotting is excessive and outside of normal physiological state. ____ ____ represents primary abnormalities which lead to thrombus formation, including ___ ___, ______, and abnormal ___ ____
Thrombosis
Virchow’s Triad
Endothelial injury
Hypercoagulability
Blood flow
____ ____ leads to an imbalance of pro thrombotic and antithrombotic factors. Causes of this include:
Endothelial injury
Hypertension
Turbulent blood flow
Bacterial endotoxins
Toxins absorbed from cigarette smoke
Picture of arterial thrombi
A ruptured atherosclerotic plaque within a coronary artery with a cute thrombus formation of creating an acute occlusion resulting in infarction of the LV and IV septum
Normal blood flow is called ____ meaning straight and quick flow. ____ flow AKA STASIS enhances pro coagulant activities. Platelets are now in direct contact with endothelium. It prevents washout of clotting factors.
Laminar
Turbulent
Causes of turbulent flow/stasis
Immobilization
Aneurysms
Sickle cell anemia
Hyperviscosity
Arthro-sclerotic plaques
Heart valve abnormalities
____ ____ predispose, patience to stasis and superficial venous thrombi
Varicose veins
____ ___ ____ occurs in larger veins of the legs/pelvis. Often related to immobilization and hypercoagulable states. Often form behind the ____ ___. they can break off and travel to lungs, causing a _____ ____
Deep vein thrombosis
Valve cusps
Pulmonary embolism
_____ states occur when there are alterations of coagulation pathways that predisposes thrombosis.
Ex: ___ ____, Factor V Leiden resistance, protein C cannot inactivate Factor V
Hypercoagulability
Primary thrombophilia
Primary thrombophilia is genetic. Secondary thrombophilia is ___. Causes include:
Acquired
Immobilization
MIs, atrial fabulation, prosthetic, cardiac valves, tissue, injury, cancer
____ ____ ___ can cause secondary thrombophilia
Disseminated intravascular coagulation (DIC)
4 fates of thrombus:
Dissolve
Organization and recanalization
Propagation
Embolization
_____ is the result of fibrinolysis. This is the therapeutic purposes of t-PA (tissue plasminogen activator). Older thrombi are more resistant to ___
Dissolution
Plasmin
Older thrombi may undergo ____ with endothelial cells, fibroblasts and smooth muscle growing into the thrombus. Small rudimentary vascular channels, eventually reopen the vessel in a process called ____
Organization
Re-canalization
_____ is thrombi growth and accumulation of additional platelets and fibrin. Arterial thrown by attend to propagate in a ____ fashion. Venus thrombi tend to propagate along the flow of blood.
Propagation
Retrograde (toward the heart)
____ is a dislodged or fragment of Throne by which travel to other sites within the circulation
Embolization
We have been talking about _____, other types of emboli include fat and marrow embolism, air embolism, and amniotic fluid embolism
Thromboembolism
___ ____ most of the time arise from intracardiac drawn by mostly associated with left ventricle wall, infarctions or a dilated left atrium and atrial fibrillation
Systemic thromboembolism
_____ is the result of occlusion of either arterial supply or venous drainage.
Red versus white infarction depends on how the organ is perfused, and if it is single or dual blood supply
Infarction
___ ___ are sometimes called anemic infarcts. They occur in solid organs with single material supply.
Example: heart, spleen, and kidney
The road to the anterior ___ ___ is blocked, no blood (anemic) gets to the anterior left ventricular
White infarcts
Left ventricle
____ ____ are also called hemorrhagic infarcts. Blood continues to flow into the ____ area. They are caused by venous occlusion and re-perfusion of a site of arterial occlusion. They are seen in organs with dual circulation, including the lungs, liver hands and intestines.
Red infarct
Necrotic
Red infarcts are associated with blood being ____ . Reperfusion is when blood spills into the area that was previously narcotic, but that part of the vein is no longer intact so blood spills out into the area causing a ____ ____
Trapped
Hemorrhagic infarct
Lungs have both a ____ circulation and ___ circulation. There is first a closure causing ischemia and becoming ___ and then the blood gains excess to that area again via a ___ blood supply
Pulmonary
Bronchial
Necrotic
Second
