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NPTE Other Systems > Hematological System > Flashcards

Hematological System Flashcards

1
Q

Plasma makes up what percent of total blood volume

A

55%

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2
Q

Plasma does what

A

carries the cellular elements of blood through circulation

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3
Q

Plasma is composed of

A

91% water
7% proteins
2-3% other small molecules

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4
Q

Plasma - electrolytes in plasma do what

A

determine osmotic pressure and pH balance

these are important for exchange of fluids between capillaries and tissues

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5
Q

Plasma proteins include what

A

albumin, globulins, and fibrinogen

Serum is plasma without clotting factors

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6
Q

Erythrocytes

A

RBCs make up 45% of total blood volume and contain oxygen carrying protein hemoglobin responsible for transporting oxygen

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7
Q

RBCs are produced where

A

in the marrow of the long bones and controlled by hormones (erythropoietin)

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8
Q

RBCs are time limited - survival is what

A

120 days

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9
Q

Leukocytes

A

WBCs make up about 1% of total blood volume and circulate through the lymphoid tissue

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10
Q

Leukocytes function in what

A

immune processes as phagocytes of bacteria, fungi, an viruses
Also aid in capturing toxinc proteins resulting from allergic reactions and cellular injury

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11
Q

Leukocytes are produced where

A

in the bone marrow

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12
Q

Types of leukocytes

A

lymphocytes and monocytes (agranulocytes)

neutrophils, basophils, and eosinophils (granulocytes)

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13
Q

Hematopoiesis is what

A

the normal function and generation of blood cells in the bone marrow

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14
Q

Hematopoiesis - production, differentiation, and function of blood cells is regulated by

A

cytokines and growth factors (chemical messengers) acting on blood forming cells (pluripotent stem cells)

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15
Q

Disorders of Hematopoiesis include

A

aplastic anemia and leukemias

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16
Q

Blood screening tests - complete blood count determines

A

the number of RBCs, WBCs, and platelets per unit of blood

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17
Q

Blood screening tests - white cell differential count determines

A

the relative percentages of individual white blood cell types

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18
Q

Blood screening tests - erythrocyte sedimentation rate (ESR) is what

A

the rate of red blood cells that settle out in a tube of unclotted blood - given in mm per hour

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19
Q

Blood screening tests - elevated ESR would indicate

A

inflammation

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20
Q

Hemostasis is what

A

the termination or arrest of blood flow by mechanical or chemical processes
Can be vasospasm, platelet aggregation, thrombin, and fibrin synthesis

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21
Q

Hemostasis - blood clotting requires what

A

platelets produced in bone marrow, von Willebrand’s factor produced by the endothelium of blood vessels and clotting factors produced by the liver using vitamin K

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22
Q

Hemostasis - fibrinolysis is what

A

clot dissolution that prevents excess clot formation

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23
Q

Hypercoagubility disorders are caused by

A

Inc platelet function - atherosclerosis, DM, elevated blood lipids and cholesterol
Accelerated activity of the clotting system - CHF, malignant diseases, preganancy, use of oral contraceptives, immobility

24
Q

Hypocoagulopathy disorders are caused by

A

Platelet defects as seen in bone marrow dysfunction, thrombocytopenia, thrombocytopathia
Coagulation defects - hemophilia, von Willebrands disease
Vascular disorders - hemorrhagic telangiectasia, vit C def, Cushings, senile purpura

25
Q

Shock - is what

A

an abnormal condition of inadequate blood flwo to the body tissues
Associated with hypotension, inadequate CO, changes in peripheral blood flow resistance

26
Q

Shock - Hypovolemic shock is caused by

A

hemorrhage, vomiting or diarrhea

Loss of body fluids also occurs with dehydration, Addisons disease, burns, pacreatitis, or peritonitis

27
Q

Progressive Shock is associated with what

A

restlessness, and anxiety, weakness, lethargy, pallor with cool moist skin, fall in body temp

28
Q

S/S of hematological disorders

A

Easy bruising with spontaneous petechiae and purpura of the skin
External hematomas might be present

29
Q

RED FLAGS - with PT interventions

A

Extreme caution with manual therapy and use of some modalities (compression)
Strenuous exercise is contraindicated due to inc risk of hemorrhage

30
Q

Anemia - characteristics

A

Dec in hemoglobin levels in the blood

31
Q

Anemia - etiology

A

Decrease in RBC production
Destruction of RBC
Loss of blood (hemorrhage)

32
Q

Anemia - etiology - Dec in RBC production

A

Nutritional deficiency (iron, vit B, folic acid)
Cellular maturation defects
Dec bone marrow stimulation (hypothyroid)
Bone marrow failure (leukemia, aplasia, neoplasm)
Genetic defect

33
Q

Anemia - etiology - RBC destruction

A 
Autoimmune hemolysis
Sickle cell disease
Enzyme defects
Parasites (malaria)
Hyersplenism 
Chronic diseases (RA, TB, CA)
34
Q

Anemia - etiology - loss of blood

A 
Tauma
Wound
Bleeding
Peptic ulcer
Excessive menstruation
35
Q

Anemia - Clinical s/s

A

Fatigue and weak with min exertion
Dyspnea on exertion
Pallor or yellow skin of face, hands, nail beds, lips
Tachycardia
Bleeding of gums, mucous mem, or skin w/o trauma
Severe anemia can see hypoxic damage to liver, kidney, and maybe heart failure

36
Q

Anemia - PT RED FLAGS

A

Pt with anemia exhibit dec exercisee tolerance
Exercise should be instituted gradually with physician approval
RPE should be used

37
Q

Sickle cell disease - what is it

A

Groupd of inherited, autosomal recessive RBC disorders
Erythrocytes, specifically hemoglobin, are abnormal
RBCs are crescent or sickle shaped instead of biconcave

38
Q

Sickle cell disease - types

A 
HbSS (most severe)
HbSC
HbS beta thalassemia 
HbSD
HbSE
HbSO
39
Q

Sickle cell disease - sickle cell trait

A

Heterozygous form of sickle cell anemia characterizes by abnormal RBCs
Individuals are carriers and do not develop the disease

40
Q

Sickle cell disease - Chronic hemolytic anemia (sickle cell anemia)

A

Hemoglobin is released into plasma with resultant reduced oxygen delivery to tissues
Results from bone marrow aplasia, hemolysis, folate deficiency, or splenic involvement

41
Q

Sickle cell disease - Vasooclusion from misshapen erythrocytes

A

Results in ischemia, occlusion, and infarction of adjacent tissue

42
Q

Sickle cell disease - Sickle cell crisis

A

Acute episodic condition occurring in children with sickle cell anemia

43
Q

Sickle cell disease - Sickle cell crisis s/s

A

Pain - acute abdominal pain, painful swelling in hands and feet, persistent HA
Bone and joint crises - extremity and back pain
Naurologic - dizzy, convulsions, coma, nystagmus
Pulmonary - chest pain, cough, dyspnea, tachypnea

44
Q

Sickle cell disease - complications

A

Vascular - stroke, ulcers, infarcts
Pulmonary hypertension
Neuro - paresthesias, CN palsies, hemiplegia, blind
Renal - enuresis, nocturia, hamturia, renal failure
Anemic crisis - rapid drop in hemoglobin
Aplastic crisis - severe anemia
Splenic - liver and spleen enlargement

45
Q

Sickle cell disease - PT interventions

A

Application of warmth is soothing (hydrotherapy)
Relaxation techniques
Exercise intolerance is common - exaggerated HR response
Low to mod exercise is okay

46
Q

Sickle cell disease - PT RED FLAGS

A

Cold is contraindicated as it increased VC and sickling

47
Q

Hemophilia is what

A

A group of hereditary bleeding disorders

Inherited as a sex linked recessive disorder of blood coagulation - affects males, females are carriers

48
Q

Hemophilia - Clotting factor VIII deficiency

A

Hemophilia A

most common - classic hemophilia

49
Q

Hemophilia - Clotting factor IX deficiency

A

Hemophilia B

Christmas disease

50
Q

Hemophilia - Hemarthrosis

A

bleeding into joint spaces

most common in synovial like knees, ankle, elbow, hips

51
Q

Hemophilia - hemorrhage into mm often impacts

A

forearm flexors
gastroc/soleus
iliopsoas

52
Q

Hemophilia - complications

A 
Joint contractures 
Mm weakness
Leg length changes
Postural scoliosis
Dec aerobic fitness 
Gait deviations - equinus, lack knee extensor torque 
ADL deficiency
53
Q

Hemophilia - common s/s seen in PT exam

A 
acute bleeding episodes
dec ROM
stiffening
pain
swelling
tenderness
heat
prickling or tingling sensations
54
Q

Hemophilia - PT interventions

A

Acute - RICE, prevent deformity
Subacute - Isometrics and aquatics, pain management, AAROM, open chain (closed may put pressure into joint), contracture management
Chronic - HEP for inc joint function, aerobic fitness, and strength

55
Q

Hemophilia - PT interventions - RED FLAG

A

passive stretching is rarely used due to risk of myositis ossificans

NPTE Other Systems (10 decks)

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