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Physiology > Physiology Exam 5 - Blood Physiology > Flashcards

Physiology Exam 5 - Blood Physiology Flashcards

1
Q

What is blood composed of?

A

formed elements suspended in a liquid called plasma

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2
Q

How many liters of blood do adults have?

A

5-6 L

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3
Q

What is plasma?

A

the matrix of blood; clear, light yellow fluid

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4
Q

What are formed elements?

A

cells and cell fragments:

  • erythrocytes (no nucleus or organelles)
  • white blood cells (cell + nucleus + organelles)
  • platelets (parts of cells)
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5
Q

What does a centrifuge do to blood?

A

divides it into plasma and formed elements

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6
Q

What is the buffy coat?

A

layer of leukocytes and platelets between plasma and erythrocytes

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7
Q

What is the hematocrit?

A

volume of red blood cells

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8
Q

What is plasma composed of?

A

inorganic and organic substances dissolved in water (majority - 92%)
- electrolytes, nutrients, wastes, gases (1%)
- hormones
- plasma proteins (7%)

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9
Q

What are the plasma proteins?

A
  • albumins - 58%
  • globulins - 37%
  • fibrinogen - 4%
  • regulatory proteins - <1%
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10
Q

What is serum?

A

plasma minus fibrinogen and other clotting-related proteins

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11
Q

What is hematopoiesis?

A

the production of all the formed elements of the blood

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12
Q

What is the daily adult production of the different formed elements?

A
  • 400 billion platelets
  • 100 to 200 billion RBCs
  • 10 billion WBCs
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13
Q

What is the multipotential hematopoietic stem cell?

A

a cell that can differentiate into many types of cells; it exhibits self-renewal

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14
Q

What does the yolk sac do?

A

produces stem cells for the first blood cells

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15
Q

What harbors stem cells during fetal development?

A

liver, spleen, and thymus

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16
Q

What harbors stem cells during fetal development and in adulthood?

A

bone marrow

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17
Q

What organ never has hematopoietic stem cells?

A

the brain - the blood brain barrier doesn’t allow the big cells to pass

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18
Q

What is the main function of RBCs?

A

gas transport - carrying O2 from lungs to tissues and CO2 from tissues to lungs

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19
Q

What is the shape of a RBC?

A

discoid cell with biconcave shape

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20
Q

What do RBCs lack?

A

mitochondria (make energy anaerobically) and nucleus and DNA (cannot replicate)

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21
Q

How long is the RBC lifespan?

A

120 days

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22
Q

Where are RBCs synthesized?

A

red bone marrow

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23
Q

What is the process of RBC synthesis called?

A

erythropoiesis

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24
Q

What initiates erythropoiesis?

A

erythropoietin - produced by kidneys in adult and liver in fetal

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25
Q

What is the hemoglobin composition of an erythrocyte?

A
  • 33% of the cytoplasm is hemoglobin
  • 280 million hemoglobin molecules are in one erythrocyte
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26
Q

What is the structure of hemoglobin?

A

quaternary protein with 2 beta and 2 alpha subunits

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27
Q

What are the four polypeptide subunits of hemoglobin referred to as?

A

globins - they bind small amounts of CO2

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28
Q

What binds oxygen to hemoglobin and where?

A

Ferrous ion (Fe) at the center of hemoglobin

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29
Q

How long does it take to develop erythrocytes?

A

3 to 5 days

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30
Q

What are the steps of erythrocyte formation?

A
  • reduction in cell size
  • increase in cell number
  • synthesis of hemoglobin
  • loss of nucleus
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31
Q

What is hypoxemia?

A

low level of oxygen - it increases erythropoiesis through a negative feedback loop

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32
Q

What is hemolysis and where does is occur?

A

the destruction of red blood cells occurring in the spleen and liver

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33
Q

What do macrophages in the spleen do?

A

separate heme from globin (denature the protein)

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34
Q

What is the heme pigment converted into during RBC death and disposal?

A

biliverdin (green) and bilirubin (yellow)

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35
Q

What does the liver do to bilirubin?

A

removes it and secretes it into bile (gallbladder) and then to small intestine (urobilinogen - brown feces)

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36
Q

What is the color of arterial blood?

A

bright red - a lot of O2

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37
Q

What is the color of venous blood?

A

dark crimson - a lot of CO2

38
Q

What is polycythemia?

A

a high concentration of RBCs

39
Q

What is anemia?

A

a low concentration of RBCs

40
Q

How does polycythemia affect plasma/hematocrit ratio?

A

elevated hematocrit

41
Q

How does anemia affect plasma/hematocrit ratio?

A

depressed hematocrit

42
Q

What are the three causes of anemia?

A
  • hemorrhagic anemia from bleeding
  • hemolytic anemia from RBC destruction
  • inadequate erythropoiesis or hemoglobin synthesis
43
Q

What is pernicious anemia?

A

autoimmune attack of stomach tissue (low intrinsic factor) leads to inadequate vitamin B12 absorption

44
Q

What is hypoplastic anemia?

A

slowing of erythropoiesis

45
Q

What is aplastic anemia?

A

complete cessation of erythropoiesis

46
Q

What is primary polycythemia?

A

cancer of erythropoietic cell line causing RBC counts as high as 11 million RBCs per microliter (80% hematocrit)

47
Q

What is secondary polycythemia?

A

dehydration, emphysema, high altitude, physical conditioning causing RBC count up to 8 million RBCs per microliter

48
Q

What are the dangers of polycythemia?

A
  • increased blood volume, pressure, and viscosity
  • can lead to embolism, stroke, or heart failure
49
Q

In what population is Sickle-Cell disease common?

A

people of African descent

50
Q

What occurs in someone with Sickle-Cell disease?

A

the recessive allele modifies the structure of Hb (makes HbS)
- HbS does not bind O2 well
- RBCs become rigid, sticky, pointed at the ends
- they clump together and block small blood vessels

51
Q

What are heterozygotes for the Sickle-Cell allele resistant to?

A

malaria

52
Q

What is hypoproteinemia?

A

a deficiency of plasma proteins

53
Q

What causes hypoproteinemia?

A
  • extreme starvation
  • liver or kidney disease
  • severe burns
54
Q

What is Kwashiorkor?

A

children with a severe protein deficiency who are fed on cereals once weaned from breastmilk

55
Q

What does Kwashiorkor cause?

A
  • thin arms and legs
  • swollen abdomen
56
Q

Who discovered the blood types and when?

A

Karl Landsteiner in 1900

57
Q

What are blood types based on?

A

interactions between antigens and antibodies

58
Q

What are antigens?

A

molecules on cell membrane surface that activate an immune response

59
Q

What are characteristics of antigens?

A
  • they are genetically unique to the individual
  • they can distinguish themselves from foreign matter
  • foreign antigens generate an immune response
60
Q

What are agglutinogens?

A

antigens on the surface of RBCs that are the basis of blood typing

61
Q

What are antibodies?

A

proteins (gamma globulins) secreted by plasma cells

62
Q

What is the function of antibodies?

A
  • provide an immune response to foreign matter
  • bind to antigens and mark them for destruction
  • forms antigen-antibody complexes
63
Q

What type of antigens does a blood type A person have?

A

A antigens

64
Q

What type of antigens does a blood type B person have?

A

B antigens

65
Q

What type of antigens does a blood type AB person have?

A

A and B antigen

66
Q

What type of antigens does a blood type O person have?

A

neither antigen A or B

67
Q

What are agglutinins?

A

antibodies that make RBCs clump together

68
Q

What is agglutination?

A

the clumping of RBCs caused by agglutinins (antibodies) binding to agglutinogens (antigens)

69
Q

What can agglutinins in plasma do for transfusion?

A

causes transfusion mismatch

70
Q

When were Rh (C, D, E) agglutinogens discovered?

A

1940 in rhesus monkey

71
Q

What is Rh D?

A

Rh factor - the most reactive (immunogenic); most expressed on RBCs

72
Q

What is the blood type if there are D antigens on RBC’s?

A

Rh +

73
Q

What is the blood type if there are no D antigens on RBC’s?

A

Rh -

74
Q

How many total blood types are there?

A

8

75
Q

What are transfusion reactions?

A

medical complications that arise after transfusion of whole blood or some of its components

76
Q

What are the types of transfusion reactions?

A
  • acute (immediate symptoms)
  • delayed (days to weeks later)
77
Q

What causes transfusion reactions?

A
  • donor’s RBCs agglutinate as they enter the recipient
  • agglutinated RBC’s block small blood vessels and capillaries
  • agglutination causes hemolysis (opens up hemoglobin in RBC and breaks up)
  • high amounts of hemoglobin can block kidney tubules (acute renal failure)
78
Q

What are characteristics of platelets?

A
  • 2 to 4 micrometers in diameter
  • contain “granules”
  • complex internal structure
  • open canalicular system (OCS - important for delivery of coagulation factors/molecules)
  • amoeboid movement and phagocytosis
  • normal count - 130,000 - 400,000 platelets per microliter
79
Q

What is the function of platelets?

A
  • secrete vasoconstrictors that help reduce blood loss
  • stick together to form platelet plugs to seal small breaks
  • secrete procoagulants (clotting factors) to promote clotting
  • initiate formation of clot-dissolving enzyme
80
Q

What is hemostasis?

A

the stoppage of bleeding

81
Q

What are the three steps of hemostasis?

A
  1. vascular spasm
  2. platelet plug formation
  3. blood clotting (coagulation)
82
Q

Which step of hemostasis is the fastest?

A

vascular spasm

83
Q

Which step of hemostasis is the longest and most effective in stopping bleeding?

A

blood clotting (coagulation)

84
Q

What happens during vascular spasm?

A

rapid constriction of a broken vessel

mechanisms:
- some nociceptors directly trigger constriction
- smooth muscle injury
- platelets release serotonin (vacoconstrictor)

85
Q

What happens during platelet plug formation I?

A
  • absence of prostacyclin (causes vasodilation) in broken endothelium
  • broken vessel exposes collagen
  • platelet pseudopods stick to collagen (due to von Willebrand factor)
  • pseudopods contract, draw together a platelet plug
86
Q

What happens during platelet plug formation 2?

A

platelets degranulate (release contents)
- serotonin (vasoconstrictor)
- Adenosine diphosphate (attracts more platelets)
- Thromboxane A2 (platelet aggregation, degranulation, and vasoconstriction)

this positive feedback cycle occurs until the break in vessel is sealed

87
Q

What happens during coagulation?

A

fibrinogen converts into fibrin threads

procoagulants:
- present in plasma
- produced by the liver
- reaction cascade

88
Q

What does vitamin K do?

A

it is needed for some coagulation factors to be activated: 2, 7, 9, 10

89
Q

What is platelet-derived growth factor (PDGF)?

A

platelets and endothelial cells that are a mitotic stimulant for fibroblasts and smooth muscle

90
Q

What is fibrinolysis?

A

the dissolution of a clot

91
Q

What is hemophilia?

A

a genetic disorder caused by a deficiency of a gene for a specific coagulation factor

92
Q

What is von Willebrand’s disease?

A
  • reduced levels of vWf
  • decreased platelet plug formation

Physiology (6 decks)

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