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CardioRespiratory Year 1 > Structure and Function of the Blood > Flashcards

Structure and Function of the Blood Flashcards

1
Q

what is the function of blood

A

Carriage of oxygen
Part of immune system
Transport of substances
Maintenance of pH and temperature

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2
Q

what is blood

A

Specialist connective tissue

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3
Q

what percentage of extracellular fluid does plasma make up

A

20%

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4
Q

what is plasma made up of

A

90% water

10% solutes

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5
Q

what percentage of blood is plasma

A

55%

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6
Q

what is the function of plasma

A
  • solvent
  • lubricant
  • cushion
  • heat dissipator
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7
Q

what is is in the water in plasma

A
  • glucose
  • salts
  • dissolved chemicals -
  • makes up 2% of the 90%
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8
Q

what are the proteins in plasma

A

Albumin (60%) (transport and oncotic pressure)
Globulin (36%) (immune)
Fibrinogen (4%) (blood haemostasis - acts as a coagulant )
- makes up 8% of plasma

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9
Q

what are the plasma ions

A
  • inorganic ions such as potassium, sodium, calcium, chloride, bicarbonate and phosphate
  • dissolve carbon dioxide as carbonic acid , hydrogen and bicarbonate ions or bound to amino groups of proteins such as haemoglobin - this is important in maintaining pH
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10
Q

what are the functions of plasma ions

A
  • involved in electrolyte balance to maintain blood pressure and support heart and muscle contraction
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11
Q

How does blood act as a buffer

A

H+ + HCO3-  H2CO3  CO2 + H2O

  • pH depends on the ratio of carbon dioxide and bicarbonate
  • metabolic processes produce excess hydrogen ions which are buffered by excess bicarbonate and carbon dioxide
  • prevent acisodiss
  • histidine residues in haemoglobin bind to free hydrogen ions
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12
Q

what are the function of plasma proteins and name examples

A

Inflammatory response

  • Complement proteins (permeability, opsonisation, chemotaxis, lysis)
  • Cytokines e.g. interferons (released from lymphocytes to interfere with viral replication)

Protection from infection
- antibodies (γ-globulins)

Clot formation – enzymes stimulated in a cascade
- Fibrinogen leading to fibrin clot

Intravascular osmotic effect- albumin

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13
Q

what is the process of making blood cells called

A

Haematopoiesis

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14
Q

how many haematopoietic stem cells are there

A

11,000-22,000 per person

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15
Q

how many bone marrow cells are there to 1 stem cell

A

1 stem cell : 2x108 bone marrow cells

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16
Q

what are the two cells that a bone marrow stem cell can divide into

A
  • Myeloid stem cell

- lymphoid stem cell

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17
Q

What do myeloid stem cells divide into

A
  • erythrocytes
  • megakartocytes these form platelets
  • Myeloblast which leads to eosinophils, neutrophils and basophils
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18
Q

what do lymphoid stem cells divide to form

A

lymphoblast which forms a B and T lymphocyte and natural killer cells

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19
Q

what is the main control of red blood cell production

A

erythropoietin

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20
Q

how many red blood cells are produced a second

A

2 million

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21
Q

what is the lifespan of the red blood cells

A

120 day lifespan

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22
Q

What is haemoglobin structure

A
  • tetramer
  • 4 globin chains
  • 2 alpha and 2 beta chains
  • each has an iron containing heme group
  • the oxygen binds to the heme group chaining the alpha and beta conformation
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23
Q

What are the molecules that promote oxygen release in tissues

A
  • hydrogen ions
  • carbon dioxide
  • 2,3- DPG
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24
Q

What is oxygen release in tissues called

A

Bohr effect

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25
Q

what is anaemia

A
  • this is when you have a lower haemoglobin concentration therefore you have a lower amount of oxygen that is transported around the body
26
Q

How does the body respond to haemoglobin

A
  • anaemia causes a reduction to the oxygen supply of the kidney this increases erythropoietin (hormone) this increases red blood cell production by bone marrow
27
Q

anaemia is not a ..

A

diagnosis because there is always an underlying cause

28
Q

what is the commonest blood disorder

A
  • anaemia 25% wordwide
29
Q

what are the levels that you need to be diagnosed with haemoglobin

A

Hb < 13 g/l (males) , <11.5 g/l (females)

30
Q

what are the symptoms of anaemia

A
  • Tiredness
  • Faint
  • Shortness of breath
  • Worsening of heart related pain (angina)
  • Rapid heart beat (experienced as palpitations)
31
Q

what are the signs of anaemia

A
  • Pale
  • Rapid heart beat (tachycardia)
  • Bounding pulse
  • Systolic flow murmur
  • Cardiac failure
  • Retinal haemorrhages
32
Q

what are the types of anaemia divided by

A

the mean cell volume (size of the red blood cell)

33
Q

what are the types of anaemia

A
  • microcytic - MCV <80 fL
  • Normocytic MCV 80-100 fL
  • macrocytic MCV >100 fL
34
Q

what causes microcytic anaemia

A

Iron deficiency

Thalassaemia

35
Q

what causes normocytic anaemia

A 
Acute blood loss
Anaemia of chronic disease 
(e.g. infections, malignancy)
Renal failure
Leukaemia
Sickle cell anaemia
36
Q

what can cause microcytic anaemia

A

B12/folate deficiency
(megaloblastic anaemia)
Alcohol
Liver disease

37
Q

what are causes of anaemia

A
  • small hypo chromic cells
  • Diet is rare cause
  • Menstrual loss (young females)
  • Infection (hookworm)
  • Growth spurt, pregnancy
  • Gastrointestinal loss:
    Bleeding ulcers, inflammatory bowel disease, CANCER
38
Q

what are platelets
- how many are made a second
- what is there lifespan
what is there role

A 
- Small circulating cells (2 - 3 l)
	without a nucleus
- Fragments of megakaryocytes 
	from bone marrow
- 1 million/second
 - 10 day lifespan

Involved in coagulation

  • Platelet plug
  • Coagulation cascade
39
Q

whats the difference between platelets and clotting proteins

A
  • platelets form an initial plug

- clotting proteins produce a firm thrombus

40
Q

What does low platelet lead to

A
  • called thrombocytopenia which can cause bleeding and bruising
41
Q

What does low clotting factors lead to

A

haemophilia

42
Q

what are the granulocytes

A

Neutrophils
Eosinophils
Basophils

43
Q

what are the lymphocytes

A

T cells
B cells
Natural Killer Cells

44
Q

what are the types of white blood cells

A
  • Granulocytes
  • monocytes
  • lymphocytes
45
Q

describe neutrophils

  • what is there structure
  • what is there half life
  • how many are produced per second
A 
About twice as big as red cell
2 -4 lobes, fine granules
Normally the most common white cell - levels very dynamic
Half-life 6-8 hours
1011/day=1 million/second
46
Q

what diseases`can neutrophils cause

A
  • Neutrophilia - this is an increase in the amount of neurtorphils
  • Neutropenia - decrease in the amount of neutrophils
47
Q

what does neutrophils cause

A

Infection
Inflammation
Tissue damage
Haemorrhage

48
Q

what does neutropenia cause

A

Overwhelming sepsis (blood poisoning)
HIV
Bone marrow failure (no blood cells produced) – aplastic anaemia, leukaemia
B12/folate deficiency

49
Q

describe the structure of eosinophils

-when do eosinophils increase in number

A
  • Bilobed nucleus
  • Bright orange granules

Increase in

  • Parasitic (worm) diseases
  • Skin disorders
  • Asthma
50
Q

describe the structure of basophils

-

A
  • 2 - 3 lobed nucleus
  • Large blue granules containing histamine
  • Variety of causes of increased levels
51
Q

describe the structure of monocytes

describe the function of monocytes

A
  • Large with kidney shaped nucleus
  • turn into macrophages
  • important in immune system – presents foreign substance (antigen) to lymphocytes
  • Increased in chronic infections and viral infections
52
Q

describe the structure of lymphocytes

  • describe the function of lymphocytes (T, B, NK cells)
  • what is the life span
A

Small and dense with little cytoplasm. Few granules

T cells: Coordinate immune responses

B cells: produce antibody

NK cells: viral and tumour
immunity

Increased in viral infections
Lifespan: 1 week-100 years

53
Q

What happens when the bone marrow fails

A 
- anaemia, thombocytopenia, leucopenia 
Fatigue, bleeding, infections, DEATH
- Leukaemia and other haematological cancers
- Aplastic anaemia
- Chemotherapy, toxins, radiation
- B12/folate deficiency
54
Q

How do we detect haematological problems

A
  • full blood count
  • bone marrow biopsy
  • haematologists
55
Q

How are red blood cells measured

A

full blood count

  • Absolute numbers x 1012 /l
  • Mean cell volume (MCV) – average size in fl
56
Q

how do you measure haemoglobin

A

full blood count

  • Amount in whole blood – in g/dl
  • Mean cell haemoglobin (MCH) – average amount of Hb in a red cell – in pg

Reduced if cells are small

  • Mean cell haemoglobin concentration (MCHC) – concentration of haemoglobin in a red cell – in %
  • Reduced if haemoglobin in cell is low
57
Q

How are plasma measured

A
  • full blood count

- Haematocrit (Hct) or packed cell volume (PCV) – ratio or % packed cells

58
Q

How are platelets measured

A
  • full blood count

- Platelet count - absolute number x109/l

59
Q

How are white cells measured

A
  • full blood count
  • White cell count (WCC or WBC) - absolute number x 109/l
  • White cell differential (different types of cells seen)
  • absolute number/l
  • % of total white cells (neutrophils, lymphocytes, etc.)
60
Q

How do you do a blood film

A
  • Spread on glass
  • Fixed with alcohol, stained with May-Grunwald Giemsa
  • Used to examine morphology of cells
  • Bone marrow biopsy may be considered

CardioRespiratory Year 1 (28 decks)

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