Exam 3 Flashcards
what does a single drop of blood consist of?
red blood cells
white blood cells
platelets (thrombocytes)
hemocytoblasts
stem cell
how the formed elements of blood start out
occurs in the bone marrow
describe erythrocytes
stem cell/aka RBC’s
no nuclei or organelles/lives approximately 120 days
contributes to blood viscosity - increased # of RBC’s makes blood thicker
filled with hemoglobin (Hb) for transportation of respiratory gases
produce erythropoiesis — produces erythropoietin hormone (EPO)
location: (1) kidneys (2) liver
describe leukocytes
stem cell/aka WBC’s (NLMEB)
complete cells with nucleus and organelles
produces leukopoiesis — produces cytokines chemical
location: macrophages and T-lymphocytes
describe thrombocytes
stem cell/aka platelets (form a temporary plug to seal vessels)
megakarayocyte - cytoplasmic cell fragments
produces thrombopoeisis – produces thrombopoietin hormone
location: (1) liver (2) kidneys
hematocrit:hemoglobin
3:1
describe oxyhemoglobin, deoxyhemoglobin, and carbaminohemoglobin
oxy: ruby red; oxygen bound to iron
(external respiration) oxygen loading takes place in the lungs
deoxy: dark red; low oxygen
(internal respiration) oxygen unloading in the tissues
carba: maroon red; carbon dioxide bound to protein NOT iron
(internal respiration) carbon dioxide unloading in the tissues
hypoxia
aka anemia too few RBC's or Hb decreased oxygen availability increased tissue demand for oxygen erythropoietinn (EPO) released by kidneys as a response
polycythemia
too many RBC’s
creates increase viscosity of the blood
describe the rate of erythropoeisis and EPO
dependent on the ability of RBC’s to transport oxygen, NOT on the # of RBC’s in circulation!!!!!!!!
- renal failure: can result in low EPO and RBC counts (low hematocrit)
- athletic training: increased demand for oxygen/increased blood viscosity
- testosterone: increases release of EPO/high hematocirt
what is required in your diet for erythropoiesis?
nutrients: amino acids, carbohydrates, lipids
iron
vitamin B12
vitamin B9
spleen
graveyard for RBC’s
name the 5 types of WBC’s/leukocytes
1 neutrophil (never) 2 lymphocytes (let) 3 monocytes (monkeys) 4 eosinophils (eat) 5 basophil (bananas)
which WBC’s are granular and which are agrnular?
granulocytes: basophil, neutrophil, eosinophil
agranulocytes: lymphocyte, monocyte
describe neutrophils
most numerous WBC
multi-lobed nuclei
BACTERIA SLAYERS - initiate respiratory bursts to kill (O2 – bleach)
produce antibiotic-like proteins called defensins
describe lymphocytes
large, single, dark purple nuclei
T-cells: aTTack virus-infected & tumor cells (Thymus?)
B-cells: produce antiBodies (Bone marrow?)
describe monocytes
U-shaped or dark purple nuclei
largest WBC
leave circulation, enter tissue, turn into MACROPHAGES
describe eosinophils
red, bi-lobed nuclei
digest parasitic worms
lessen the severity of allergies by inactivating certain inflammatory chemicals released during allergic reactions
describe basophils
lowest amount of RBCs
bilobed nucleus U or S shaped
histamine (vasodilator) and heparin (anticoagulant)
leukopenia
abnormally low WBC count
drug induced, poisons, radiation
leukemia
cancerous conditions from abnormally increased production of WBCs
bone marrow becomes consumed with cancerous WBC’s
hemostasis
stoppage of bleeding
name and describe the 3 steps of blood clotting
1 vascular spasm: constricts the flow of blood
2 platelet plug: forms to temporarily seal small openings in the vessel
3 coagulation: enables the repair of the vessel wall once the leakage of blood has stopped
describe clotting factors 1-12
most are produced in the liver
4 require vitamin K: prothrombin, thrombin, fibrinogen, fibrin (net forms clot)
thrombus
clot that develops and persists in “unbroken” vessel
can block circulation causing tissue death
embolus
a freely floating clot in the blood stream (can block vessels in the body)
- pulmonary emboli can impair lungs
- cerebral emboli can cause strokes
how to prevent the preceding thrombolytic conditions
aspirin
heparin (anticoagulant) - inhibits thrombin needed to form fibrin net
warfarin (coumadin) - interferes with action of vitamin K
Blood type: A
Antibodies:
Antigens:
anti-B
A antigen
Blood type: B
Antibodies:
Antigens:
anti-A
B antigen
Blood type: AB
Antibodies:
Antigens:
no antibodies
A and B antigens
Blood Type: O
Antibodies:
Antigens:
anti-A & anti-B
no antigens
universal donor
O-
universal recipient
AB+
normal blood ph
7.35-7.45
hemolytic disease/erythroblastisfetalis
the Rh- negative mother’s Rh+ antibodies cross the placenta to destroy the RBC’s of the Rh+ baby
pericardium
double-walled sac surrounding the heart
fibrous pericardium
superficial
protects, anchors, and prevents overfilling of the heart with blood
name the layers of the heart wall/pericardium
epicardium
myocardium
endocardium
describe the epicardium
aka visceral pericardium
visceral layer of the serous pericardium
describe the myocardium
spiral bundles of cardiac muscles held together be elastic and collagen fibers that form a dense network called the fibrous skeleton of the heart
describe the endocardium
innermost layer
endothelial layer of the inner myocardial surface that is continuous with blood vessel linings
creates a smooth service for easy blood flow
what are the 4 chambers of the heart?
R & L upper atria
R& L lower ventricles
describe the 2 atria
separated internally by interatrial septum
walls are ridged by pectinate muscles
to R atrium: superior and inferior vena cava, coronary sinus
to L atrium: R & L pulmonary veins
describe the 2 ventricles
separated by interventricular septum
walls are ridged by trabeculae carnae and papillary muscles
Leaving R ventricle: pulmonary trunk
Leaving L ventricle: aorta
describe the pulmonary circuit and its flow
blood that is low in oxygen/high in carbon dioxide goes through a gas exchange that returns blood high in oxygen/low in carbon dioxide to be returned to the left atrium
flow: (1) right atrium (2) tricuspid valve (3) right ventricle (4) pulmonary semilunar valve (5) pulmonary arteries (6) lungs (7) pulmonary veins (8) left atrium
* short, low pressure
describe the systemic circuit and its flow
blood that is high in oxygen/low in CO2 goes through a gas exchange in the capillaries that then puts blood with low oxygen/high CO2 to be put into the right atrium for the cycle to repeat
flow: (1) left atrium (2) bicuspid (mitral) valve (3) left ventricle (4) aortic semilunar valve (5) aorta (6) to the body (7) vena cavas (8) right atrium
* long, higher pressure (higher resistance)
foramen ovale
hole that connects the 2 atria
closes after birth and becomes the fossa ovalis
ductus arteriosis
hole that connects the pulmonary trunk and aorta
closes after birth and becomes the ligamentum arteriosum
name the 4 heart valves
tricuspid valve/ RIGHT atroventricular valve
pulmonary semilunar valve
mitral/bicuspid valve/ LEFT atroventricular valve
aortic semilunar valve
the first heart sound (lub) is the closing of what?
tricuspid valve/ RIGHT atroventricular valve
mitral/bicuspid valve/ LEFT atroventricular valve
the second heart sound (dub) is the closing of what?
pulmonary semilunar valve
aortic semilunar valve
describe where the stethoscope needs to be placed to ausculate (listen) for all 4 heart valves
aortic semilunar valve: R 2nd intercostal
pulmonary semilunar valve: L 2nd intercostal
tricuspid valve: L 5th intercostal
mitral valve: L lower 5th intercostal
coronary circulation
R and L coronary arteries work to supply oxygenated blood to the myocardium
anastomosis
aka angiogenesis
blood vessels merge together
ischemia
inadequate blood supply
angina pectoris
pain due to lack of blood supply to the myocardium
caused by stress-induced spasms of coronary arteries, increased physical demands on the heart, or arteriosclerosis
cells are weakened
myocardial infarction (MI)
heart attack
cause by prolonged coronary blockage/prolonged lack of oxygen to the heart muscles = cardiac muscle cell death
similarities between cardiac and skeletal muscle
striated
describe cardiac muscle
striated, branched, interconnected
intercalated discs: anchoring junctions between cardiac cells
desmosomes
gap junctions
describe cardiac muscle contraction
nodal tissue: intrinsic, automaticity
conduction system:
SA node (pacemaker) - 60-100 bpm **cause atria to contract AV node - 40-60bpm **cause ventricles to contract Bundle of HIS R & L bundle branches Purkinje fibers
name and describe the centers involved in the extrinsic innervation of the heart
*they are located in the medulla oblongata
cardioaccelatory center: supplies SA & AV node, heart muscle, and coronary arteries via the sympathetic nervous system releasing norepinephrin
cardioinhibitory center: inhibits SA & AV node through parasympathetic fibers in vagus nerves releasing acetycholine
vagal tone
if vagus nerves are cut = increase in HR by approximately 25 bpm
heart murmur
abnormal heart sounds
describe systole and diastole
systole: ventricular contraction of heart muscle
diastole: lowest level of arterial pressure during ventricular relaxation of heart muscle
name the 3 phases of the cardiac cycle
(1) ventricular filling - mid to late diastole
(2) ventricular systole - isovolumetric contraction (all 4 valves closed)
(3) isovolumetric relaxation - early diastole (all 4 valves closed)
describe ventricular filling
takes place mid to late diastole
atrial contraction (0.1 seconds) *during P wave AV valves open
end diastolic volume (EDV): volume of blood in each ventricle at the end (120 ml)
describe ventricular systole (isovolumetric contraction)
atria relax, ventricles contract (0.3 seconds) *QRS wave
raising ventricular pressure results in closing of AV valves
end systolic volume (ESV): volume of blood remaining in each ventricle goes from 120 ml to 50 ml
describe isovolumetric relaxation
occurs in early diastole
ventricles relax; all valves closed
quiescent period (0.4 seconds) *T wave -a relaxed state through half of the cardiac cycle
how to calculate stroke volume
SV = EDV - ESV
stroke volume = end diastolic volume - end systolic volume
SV = 120 - 50 SV = 70 ml
how to calculate cardiac output
*volume of blood pumped by each ventricle in 1 minute
CO = HR x SV
cardiac output = heart rate x stroke volume
CO = 75 x 70 CO = 5,250 ml/min or 5.25 L/min
cardiac reserve
difference between resting and maximal cardiac output
describe hyper/hypo -calcemia & -kalemia
hypercalcemia - higher than normal levels of Ca
hypocalcemia - lower than normal levels of Ca
hyperkalemia - higher than normal levels of K
hypokalemia - lower than normal levels of K
describe tachycardia and bradycardia
tachycardia - rapid heart rate; 100 bpm or greater
bradycardia - slow heart rate; 60 bpm or less
commotio cordis
an often lethal disruption of heart rhythm
occurs as a result of a blow to the chest during the T wave causing cardiac arrest
fatality rate 65% with prompt action and 80% without action
congestive heart failure (chf)
left side - pulmonary congestion: blood backing up into the lungs/can lead to suffocation
right side - peripheral congestion: blood backs up at the tissue level (can lead to tissue hypoxia (not enough oxygen))
pulmonary trunk BP
24/8
aorta BP
119/79
what are blood vessels?
a closed system that begins and ends with the heart
name the 3 types of major vessels
arteries/arterioles
veins/venules
capillaries
describe arteries
ALWAYS carry blood AWAY from the heart
blood is oxygenated *except for pulmonary circulation or umbilical
describe arterioles
smallest arteries; lead to capillary beds
control blood flow into capillary beds via sympathetic nervous system vasoconstriction - increased release of norepinephrin and vasodilation - decreased release of norepinephrin
describe veins
ALWAYS carry blood TOWARDS the heart
blood is deoxygenated *except in pulmonary circulation or umbilical
formed when venules converge
*BP lower than arteries (10mmHg or less)
3 tunics; externa is thickest
large-diameter lumen offer little resistance to blood flow
valves prevent backflow of blood
*respiratory pump
*muscular pump
describe venules
very porous; allows fluids and WBCs into tissues
smallest originate as postcapillary venules with a single endothelial layer
larger venules have 1 or 2 layers of smooth muscle
describe capillaries
contact tissue cells and directly serve cellular needs
smallest blood vessels (microscopic)
walls consist of thin (one cell thick) tunica intima
diameter only allows 1 RBC to pass at a time
function: exchange of gases, nutrients, and metabolic wastes between tissue and blood
name the 3 types of capillaries
continuous capillaries
fenestrated capillaries
sinusoidal capillaries
describe continuous capillaries
abundant in the skin and muscles
endothelial cells with tight junctions provide a continuous lining
intercellular clefts (gaps) allows passage of fluids
**everywhere but in the brain
describe fenestrated capillaries
oval shaped pores (fenestrations) that permit greater absorption and filtration
*more permeable
found in small intestines and kidneys
describe sinusoidal capillaries
fewer tight junctions, large intracellular clefts, large lumens
usually fenestrated/allows passage of large molecules and blood
found in:
liver (lined with phagocytes)
*bone marrow
spleen
describe blood flow through the capillaries and the aorta
capillaries: slowest here; allows adequate time for exchange between blood and tissues
aorta: fastest here; blood is being pushed to exit the left ventricle into the body
name and describe the tunica/coverings of the blood vessels
(1) tunica intima (deepest) - endothelium lines the lumen
(2) tunica media (middle) -
smooth muscle & sheets of elastin
sympathetic nerve fibers control vasoconstriction and vasodilation of vessels
(3) tunica externa/adventitia (superficial) - collagen fibers protect & reinforce
what is blood pressure?
amount of pressure exerted on the wall of a blood vessel by blood
expressed in millimeters of mercury (mmHg)
typically describes the arterial BP in large arteries near the heart
blood moves from pressures of high to low
describe regular, high, and low blood pressure
regular: 119/79
high/prehypertension: 130/79
hypertension stage 1: 140/89
hypertension stage 2: 140/92
hypertensive crisis: 180/120
low/hypotension: 80/60
describe a pulse
the number of cardiac cycles per minute
palpitating the systolic pressure surges
pulse pressure
difference between systole and diastole
Mean Arterial Pressure (MAP)
pressure that propels blood through tissues
must be 60mmHg or greater
MAP = diastolic + (pulse pressure/3)
*example: 90/60
MAP = 60 + ((90-60)/3) MAP = 60 + (30/3) MAP = 60 + 10 MAP = 70
what is resistance
aka peripheral resistance (PR)
opposition to flow (amount of friction blood encounters)
encountered in the peripheral systemic circulation
name and describe the 3 sources of resistance
blood viscosity: thickening of blood; remains constant
total blood vessel length: longer length = longer resistance encountered; remains constant
blood vessel diameter: changes with dilation/constriction
how to calculate blood pressure
BP = CO x PR
blood pressure = cardiac output x peripheral resistance
describe the relationship among blood pressure, cardiac output, and peripheral resistance
increase in CO or PR means increase in BP
decrease in CO or PR means decrease in BP
what are the main factors that influence blood pressure?
cardiac output
peripheral resistance
blood volume
capillary blood pressure
blood pressure entering the capillaries
ranges from 15-35 mmHg
low is desirable (high would rupture capillaries)
describe adrenal medulla hormones
released in times of stress
*Ne and Epi increase vasoconstriction & heart rate»_space; high bp
antidiuretic hormone (ADH)
released when bp falls very low
causes intense vasoconstriction»_space; increases bp
also stimulates kidneys to conserve water
angiotensin ll
released in low renal perfusion (kidney delivering of fluid)»_space; decreased bp
kidneys stimulated to release renin which generates angiotensin ll
short term - vasoconstriction»_space; increases bp
long term - stimulates aldosterone & ADH release»_space; increases blood volume»_space; increases bp
circulatory shock
any condition in which blood vessels are inadequately filled and blood cannot circulate normally
name and describe the 3 types of circulatory shock
(1) hypovolemic shock - (low blood volume) results from large scale blood loss
(2) vascular shock - poor circulation resulting from extreme vasodilation
(3) cardiogenic shock - (pump failure) the heart cannot sustain adequate circulation
