Test 2 Flashcards
Normal pH range of blood.
7.35-7.45
Is the blood slightly acidic or slightly basic?
Slightly basic
Total liters of blood: ____L
5
Approximately how many gallons of blood are there in an adult?
1.2 - 1.5 gallons
Is plasma extracellular or intercellular fluid?
Extracellular
Which of the four basic types of tissue is blood?
Connective tissue
What are the two components of whole blood?
Formed elements/cell and cell fragments + plasma
 what makes up plasma?
 water,  solutes: gases, hormones, enzymes, waste products, ions
List all the plasma proteins.
Albumin, fibrinogen, globulins, other clotting factors
What does albumin do?
Plays a role in maintaining osmotic pressure.
What is osmotic pressure?
Force which water moves across a membrane, due to a concentration gradient
When there is a lot of albumin in the blood, is osmotic pressure high or low?
High
What does fibrinogen do?
Clot blood
What are globulins?
Antibodies and transport proteins
What are erythrocytes?
Red blood cells
What do red blood cells do generally?
Carry oxygen in the bloodstream
What is a leukocyte?
A white blood cell
What do white blood cells generally do?
Immune function
What are thrombocytes?
 platelets
What do platelets do?
Clotting function
Which type of blood cell is the most numerous formed element?
Red blood cells
What is the ratio of red blood cells to white blood cells?
1000:1
What is the ratio of red blood cells to platelets?
10:1
What is a Hematocrit?
The percent of red blood cells in whole blood (38-55% - varies with age and sex)
When whole blood is centrifuged it separates into cells at the bottom of the tube and _____________ at the top. The white blood cells and platelets create a Buffy coat in between the plasma and red blood cells.
Plasma
The percentage volume of red blood cells relative to the volume of the total liquid is called the ___________.
Hematocrit
Define hematopoiesis.
Whole blood formation (Red blood cells, white blood cells, platelets)
Define erythropoiesis.
Red blood cell formation
All blood cells are made in the adult in the ___________.
red bone marrow
Where is red bone marrow located?
In flat bones and in Epiphyseal ends of long bones
In the fetus, blood cells are made in the _________, __________, and _________.
Liver, spleen, thymus
Define Leukopoiesis.
Formation of white blood cells
All blood cells (erythrocytes, leukocytes, and thrombocytes) are derived from the same ______________________.
Hematopoietic stem cell
Depending on which external factors act on it, the hematopoietic stem cell can become one of the following cells:
Red blood cells, white blood cells, platelets
Can hematopoietic Stem cells undergo mitosis?
Yes
Can hematopoietic stem cells become different types of blood cells?
Yes
How does the stem cell know which type of cells become?
Colony stimulating factors and hormones
What are the two growth factors acting on bone marrow cells that affect growth of certain cells?
 erythropoietin and colony stimulating factors
What is erythropoietin?
Hormone made by the kidney when oxygen is low
Erythropoietin _____(increases/decreases)____ erythropoiesis in the bone marrow.
 increases
What do colony stimulating factors do?
Primarily increase growth of blood cells
What is the size of a red blood cell?
7-8 um
How long do red blood cells live?
120 days
In which organs are Red blood cells destroyed?
Spleen and liver
Which cells in the liver sinusoid destroys old red blood cells?
Kupffer cells
What is a reticulocyte?
A cell that is made in the next to last step of erythropoiesis that loses its nucleus to become a red blood cell
When the rate of Erythropoiesis is high a __________ Number of reticulocytes are found in the blood.
High
Which vitamins are important for erythropoiesis?
Folate, vitamin B12, iron
What happens to iron in hemoglobin when it’s broken down?
Iron is salvaged and recycled
What happens to heme in hemoglobin when it is broken down?
Heem forms Bilirubin
What happens to globin in hemoglobin when it is broken down?
Globin is made of amino acids which are broken down
Do red blood cells have nuclei?
 no
Do red blood cells have mitochondria?
No
How do red blood cells produce ATP?
Glycolysis
How many blood cells are there per mm^3
5 million/mm^3
What is polycythemia?
Too many red blood cells which causes thick blood which causes blood clots
What is anemia?
Reduced oxygen carrying capacity of the blood caused by iron deficiency or blood loss
What is a hematocrit?
Percentage of erythrocytes in whole blood sample
What is the normal value of a hematocrit?
Between 38 and 55
Does the value of the hematocrit have units?
No, not really, but usually reported as a percent
How prevalent is hemoglobin in the red blood cell?
95% hemoglobin in red blood cell
What Is oxyhemoglobin? What color is oxyhemoglobin?
Bright red hemoglobin that is carrying oxygen
What element binds to oxygen and hemoglobin?
 Iron
How many oxygen molecules combine to one hemoglobin molecule?
4
What is normal hemoglobin for women and for men?
Women: 12 - 15 g/dL
Men: 13 - 17 g/dL
What is carbaminohemoglobin?
Hemoglobin and carbon dioxide attached
What symptoms or signs are present in anemia?
Fatigue, fast heart rate, shortness of breath
What is hemorrhagic anemia?
Red blood cells are destroyed faster than they are made
What is hemolytic anemia?
Red blood cells are breaking apart caused by sickle cell or infection. Hemolytic anemia causes jaundice.
What is Aplastic anemia?
The inability to make bloods cells in the bone marrow
What is pernicious anemia?
Lack of vitamin B 12/intrinsic factor
What is iron deficiency anemia?
Caused by blood loss
What is sickle cell anemia?
Abnormal hemoglobin that causes red blood cells to sickle when exposed to low oxygen, stopping up circulation
If the anemia is due to a loss of red blood cells, with the hematocrit be low or high?
Low
What do antigens do?
Causes an immune response
What are found on the surface of red blood cells and determine blood type?
 glycoproteins and glycolipids (proteins with sugars or fats attached)
Also called agglutinogens
What does agglutinate mean?
Clump together
The body recognizes its own surface antigens as “_____________” and does not attack its own surface antigens.
 self
If blood is received from someone else with different antigens, the immune system will attack those cells, it does so through plasma proteins called _______.
Antibodies
The Rh factor (D antigen) makes the blood type __________ or __________.
Negative or positive
Only glycolipid (antigen) A is present on the red blood cell = blood group ______
A
Only glycolipid (antigen) B is present on the red blood cell = blood group ______
B
Both glycolipids (antigens) A and B are present on the red blood cell = blood group ______
AB
Neither A nor B glycolipids (antigens) are present = blood group _______
O
Each blood type has ____________ in the plasma against the A or B antigens it does not possess.
Antibodies
Blood group a house which antibodies?
Anti-B
Blood group B has which antibodies?
Anti-A
Blood group oh has which antibodies?
Both a and B antibodies
Blood group AB has which antibodies?
No antibodies
Can a persons blood type change?
No
If the D antigen is present, the person is _______.
Positive
If the D antigen is not present, the person is __________.
 negative
The __________ present on the red blood cell determine the blood type..
Antigens
If the A and D antigens are present, the person would have ________ blood.
A+
If the A and B antigens are present but the D is not, the person would have __________ blood
AB-
There are no antigens on the red blood cell but a and B antibodies, what is the blood type?
O-
There are only D antigens on the red blood cell. What is the blood type?
O+
Could an Rh- Person receive Rh+ blood one time?
Yes, But only one time because it is not until the Rh negative person makes antibodies after one exposure that the person is in danger of a transfusion reaction.
Rh+ blood is never given to a Rh- patient in a clinical setting. True or false?
True
When looking at blood compatibility, the donor’s _________ and the recipients __________ Are significant.
Red blood cells; antibodies
Can a person with A+ blood receive blood from AB+?
No, because the B antibodies will react with the B antigen on the donors red blood cells.
Can a person with B- blood receive blood from O-?
Yes, because there are no antigens on the donor red blood cells, so there will be no reaction with the recipients A antibodies.
What blood type is the universal donor?
A person with O- blood can donate to any blood type, because O- has no antigens.
Which blood type Is the universal recipient?
A person with AB+ blood can receive from any blood type, because AB+ has no antibodies.
Can B + blood donate to AB +?
Yes, AB+ is the universal recipient
Can AB+ blood donate to O+?
No
Can O+ blood donate to AB+?
 yes
Can B+ blood donate to B-?
No
Most people are Rh__
+
RH negative mothers can become pregnant with Rh positive children. The problem will be with the next pregnancy, assuming she is carrying an RH positive child. The mother now has ________. they would cross the placenta and clump The babies blood. That can lead to devastating effects in a condition called ______________ _________.
D antibodies; erythroblastosis fetalis
Mothers who are Rh negative are given _________ before and after delivery.
Rhogam
What is Rhogam?
It contains D antibodies. It prevents the mother from building her own antibodies. Because the mother did not build up any D antibodies of her own, she can carry a second Rh positive child.
Do leukocytes have nuclei?
 yes
Do leukocytes have hemoglobin?
No
How does the size of a white blood cell compared to a red plet cell?
White blood cells are double the size as red blood cells. They are BIGGER!
What is the significance of histocompatibility proteins on the surface of white blood cells?
For immune system response
What is the major histocompatibility complex?
Coding region for surface proteins
How many white blood cells per mm^3?
5,000-10,000/mm^3
What is the clinical term for too many white blood cells?
Leukocytosis
What is the clinical term for two few white blood cells?
Leukopenia
How do you a granular and granular leukocytes differ?
Granular leukocytes have granules in the cytoplasm
Where are granular Leukocytes made?
Red bone marrow
Where are a granular lymphocytes made?
Red bone marrow
What is the general function of white blood cells in the body?
To fight infection and/or disease
Define diapedesis (emigration)
Ability of white blood cells to move through an intact capillary
Which white blood cells are capable of diapedesis?
All Leukocytes
Can red blood cells undergo diapedesis
No
What is chemotaxis?
Movement of cell toward or away from a chemical
What is phagocytosis?
Phagocytes engulf then ingest cells, destroying them
Which white blood cell is the fastest?
 neutrophils
Name all the granular white blood cells.
Neutrophils, eosinophils, basophils
Name all the agranular white blood cells.
Lymphocytes, monocytes
What percent of neutrophils are found in a white blood cell differential?
50 to 70%
What is the major function of a neutrophil?
Phagocytize bacteria
What are the purposes of defensins, lysozymes, and oxidants in the granules of neutrophils?
They are Digestive enzymes That phagocytize bacteria
What is the difference between a band and a PMN (polymorphonuclear leukocyte or “seg”)?
A PMN is old and a band is young.
If a patient has too many neutrophils, what made that indicate?
A bacterial infection
What is a defining characteristic of neutrophils?
2 to 6 lobes of nuclei
What percent Eosinophils are in white blood cell differential?
2 to 5%
What is a defining characteristic of an eosinophil?
Orange granules; bi-lobed nucleus
The granules in eosinophils have chemicals that attack _________________.
Parasitic worms
In addition, eosinophils play a roll in ____________ such as asthma. Eosinophils are important cells in regulating the immune response.
Allergic responses
What percent of white blood cell differential are made up of basophils?
0 to 1%
What defining characteristics does basophils have?
S shaped nuclei; many large granules that look like they bulge past the cellular membrane.
What did the granules of basophils contain?
Histamine, heparin, serotonin
What does histamine do?
Increases inflammation
What does heparin do?
Keeps blood from clotting
What does serotonin do?
Mood stabilization
Explain the significance of basophils in anaphylactic shock.
 too many basophils releasing histamine causes anaphylaxis.
Are mast cells and basophils from the same cell lines?
NO
What percent of a white blood cell differential is made up of lymphocytes?
20 to 30%
What is the defining characteristic of lymphocytes?
Very large nuclei 
What are the three major types of lymphocytes?
B lymphocytes, T lymphocytes, NK cells
What is the function of a B-lymphocyte?
It’s a plasma cell and it has antibody immunity which creates a different specific antibody.
What is the function of a T lymphocyte?
Cellular immunity. Specific T cells are made for specific bacteria.
What is the function of an NK cell?
Combats any abnormal cell
What might an elevated number of lymphocytes indicate?
A viral infection
What percent of a white blood cell differential make up monocytes?
3 to 8%.
What is the defining characteristic of a monocyte?
Its HUGE!!
What is the function of a monocyte?
Specific immunity, phagocytosis
Monocytes leave the blood and become ___________.
 macrophages
Name the places tissue macrophages are located:
Blood, bone marrow, brain, skin
How many White blood cells are counted in a white blood cell differential?
100
What are thrombocytes?
 platelets
Are thrombocytes cells? Why or why not?
No, they’re cell fragments from megakaryocytes
How many platelets are there in a mm^3?
200,000 to 400,000 mm^3
What is the term for an elevated platelet count?
 Thrombocytosis
What is the term for a low platelet count?
Thrombocytopenia
What is the general function of platelets?
Hemostasis (stopping of bleeding)
Are platelets derived from the same hematopoietic stem cell as red blood cells and white blood cells?
Yes, red bone marrow
What is a megakaryocyte?
Huge nucleated cell that gives off platelets
What are the important substances found in platelets:
Contractile proteins actin and myosin, clotting factors, ADP, serotonin, thromboxane A2
What does thromboxane A2 do?
It helps platelets stick together and aggregate.
Why might a baby aspirin be helpful during a heart attack?
They stop clotting
What are the three major steps involved in hemostasis?
Vascular spasm, platelet plug, coagulation
What is a vascular spasm
Damage to the wall of a vessel that causes contraction of the smooth muscle, vasoconstriction helps to limit blood loss.
What does vasoconstriction do?
Helps to limit blood loss
What is a platelet plug
When platelets come in contact with the damaged lining of a blood vessel ( endothelium) The platelets stick to the exposed collagen.
What is the significance of prostacyclin?
Comes from prostaglandin which keeps platelets from sticking
What do platelets do?
They stick,
they break apart releasing their chemicals (ADP, thromboxing, calcium, serotonin;
 this makes more platelets stick and break apart
The end result is a platelet plug
Explain why the formation of a platelet plug is a positive feedback mechanism.
As more platelet stick, more ADP is released, then more platelets stick
What is coagulation
A permanent plug or clot that is actually insoluble fibrin
What does coagulation require?
What factors made in the liver, calcium, platelet factors, tissue factor from damaged cells
Damaged cells release chemicals to activate ___________.
Clotting factors
In a cascade of reactions, one clotting factor activates the next until the _______ is formed.
Prothrombin activator complex/prothrombinase
What are the two ways that lead to the formation of prothrombin activator complex?
Intrinsic pathway and extrinsic pathway
Is intrinsic pathway or extrinsic pathway faster?
Extrinsic pathway
What causes intrinsic pathway
Do you to damage to blood vessels
What causes extrinsic pathway?
Due to additional tissue damage
Prothrombin is catalyzes the following reaction:
 prothrombin (plasma protein) ->  thrombin (another enzyme)
Thrombin catalyzes the following reaction:
Fibrinogen (plasma protein) -> fibrin (insoluble protein)
What is the blood clot?
Insoluble fibrin
What happens during retraction in the clotting process?
Platelets Paul fibrin thought. Serum escapes.
What is serum?
Liquid remaining after blood has clouded. Contains no clotting factors.
How does serum differ from plasma?
Plasma is the liquid remaining after clotting is prevented by an anticoagulant which contains clotting factor. Serum is the liquid remaining after blood has clotted with no clotting factors.
What is fibrinolysis?
When the tissues have repaired, the clot dissolves
What is the following process called?
Plasminogen -> plasmin -> fibrin -> degraded fibrin

Fibrinolysis
Define the following process:
Fibrinogen -> fibrin (catalyzed by the enzyme thrombin)
 coagulation
The heart is found in the ________ of the thoracic cavity.
 mediastinum
What is the approximate size of the heart?
The size of a fist or 8 to 12 ounces
Where is the Apex of the heart located?
On the diaphragm
Where is the base of the heart?
Superiorly where great vessels enter and leave the heart
What part of the heart creates the left order of the heart?
The left ventricle
What part of the heart creates the right border of the heart?
The right atrium
What part of the heart comprises most of the anterior surface of the heart?
Right ventricle
What is pericardium composed of?
Fibrous and serous layers around the heart
What are the 3 layers of pericardium?
Fibrous pericardium, parietal pericardium, visceral pericardium
What is fibrous pericardium made of?
Dense connective tissue
What does fibrous pericardium anchor?
The heart to the diaphragm and large blood vessels
What is the parietal pericardium attached to?
Fibrous pericardium
What tissue is made up of parietal pericardium
Serous membrane (simple squamous epithelium and connective tissue that secretes fluid)
What is the pericardial cavity?
Located between visceral and parietal pericardium that contains fluid to reduce friction
What is another name for visceral pericardium?
 epicardium
The visceral pericardium is attached to the _________.
Myocardium
Explain how pericarditis with affect heart function.
Pericardium information keeps heart muscle from expanding
How would cardiac tamponade affect heart function?
The heart can’t freely beat. Blood or fluid surrounds the heart causing excess pressure keeping the ventricles from expanding.
What is the  myocardium
Cardiac muscle layer of the heart
How do you cardiac muscle cells differ from skeletal muscle cells?
Cardiac muscle cells are branched
Are cardiac muscle cells striated?
 yes
What are two functions of inter-collated discs?
It functions as a desmosome to weld cells together. It also functions as a gap junction for quick communication
What are two main phases of an action potential of the heart and what happens in each phase?
Depolarization when sodium rushes into the cell and the inside of the cell becomes positive.
Repolarization when potassium rushes out of the cell and the inside of the cell becomes negative again.
Is the cardiac muscle action potential the same or different as skeletal muscle action potentials?
 different
What is the difference between a cardiac action potential in a skeletal muscle action potential?
The cardiac lasts longer
Which action potential is longer?
 cardiac
What creates the plateau phase in the cardiac muscle?
Calcium rushing into the cell
What is the significance of the longer refractory period of cardiac muscle?
It prevents tetanus from occurring and ensures each contraction is followed by enough time to allow the heart chamber to refill with blood before the next contraction.
Skeletal muscle contraction completed before the next action potential can begin?
 no
Is cardiac muscle contraction completed before the next action potential can begin?
 yes
Why is it significant that the cardiac muscle contraction is completed before the next action potential can begin?
So that the heart relaxes to let blood fill up by completing the action potential
Explain how myocarditis would affect the heart function.
Heart muscle information; can’t pump necessary amount of blood
What type of epithelium is found in the endocardium?
Simple squamous cells
Why is it important that the endocardium of the heart and endothelium in blood vessels provide a continuous surface of simple squamous cells?
Blood must have smooth surface to travel so no clotting occurs
Does endocardium also cover heart valves?
 yes
Explain how endocarditis would affect heart function
reduced heart valve function - clots forming in valves
The right ventricle of the heart pumps blood through the _________.
Pulmonary circulation
The left ventricle of the heart pumps blood through the _________.
Systemic circulation
The _____ and ______ Pump blood at the same time
Right and left ventricles
And healthy hearts, the _______ and _______ pump The same amount of blood.
What is an artery?
Carries blood away from the heart
What is a vein
Brings blood to the heart
What are the three veins bring blood to the right atrium?
The superior vena cava, inferior vena cava, and the coronary vein (sinus)
Blood flows from the right atrium to the right ventricle through the ___________.
Tricuspid valve
What type of tissue are valves made of?
Dense irregular connective tissue covered by endocardium
How do valves open and close?
Open and close in response to pressure changes
What do valves ensure?
That blood only flows one way through the heart, not backwards
Do atrioventricular valves contain muscle?
 yes
The tricuspid valve closes when the pressure in the ____________ is greater than in the _________.
Right ventricle; right atrium
Blood flows from the right ventricle through a ____________ into the ___________.
Semi lunar valve; pulmonary artery
Define pulmonary circulation
The pulmonary artery carries the blood to the lungs to be oxygenated. 
Right ventricle to the pulmonary semilunar valve to the pulmonary artery to the lungs.
True or false?
 True
The pulmonary artery carries __________ blood.
 deoxygenated
In the lungs oxygen will move into the blood, attach to hemoglobin, and carbon dioxide will leave the blood. True or false?
 True
The pulmonary semilunar valves close when the pressure in the ________ is greater than the _________.
Atrium; ventricles
Blood, now oxygenated, flows from the lungs through the _________ to the ________.
Four pulmonary veins; left atrium
Pulmonary veins filled with oxygenated blood goes to the left atrium. True or false?
 True
Blood flows from the _______ through another atrioventricular valve (_________ or __________) to the ____________.
Left atrium; mitral or bicuspid valve; left ventricle
Blood flows from the _________ through another __________ to the __________ and then through the systemic circulation.
Left ventricle; semi lunar valve; aorta
Name the three Venous openings in the right atrium.
Superior vena cava, inferior vena cava, coronary sinus
Name the four venous openings in the left atrium.
4 Pulmonary veins, left atrialventricular  valve
What is a fossa ovalis
The indentation in the atrial septum between the right and left atria
What is the remnant of what once was the foramen ovale
Fossa ovalis
Blood goes from the right atrium to the foramen ovale to the left atrium to the left ventricle. True or false?
True
Does the atria have myocardium? If so is it thin or thick?
The atria has a thin layer of myocardium
_______% Of the blood flows passively from the atria to the ventricles without being pumped by the atria.
70
Name the types of tissue found in the atrioventricular valves
Endocardium and  dense connective tissue
Atrioventricular valves are like sails attached to “ cords”. What are these chords called?
Chordae tendonae
Chordae tendon a is attached to heart muscles called _______.
Papillary muscles
The chordae tendon a ensure that the valves cannot _________ into the atria during ventricular contraction.
Invert or turn inside out
What is the major purpose of the valves?
To stop flow of blood from going backwards
What would happen if the valves with invert?
Backflow of blood would occur
An atrial ventricular valve opens when the pressure in the _______ is greater than in the ________.
Atrium; ventricle
When the ventricles contract, would the atrioventricular valves be open or closed?
 closed
When the ventricles relax, would the atrio ventricular valves be open or closed?
 Open
Why do ventricles have a thicker myocardium than the atria?
Greater pressure in the ventricles
If the right ventricle and left ventricles pump the same amount of blood, why is the myocardium in the right ventricle thinner than the myocardium in the left ventricle?
The right ventricle does not have as high pressure as the left ventricle
What is the approximate pressure in the pulmonary artery?
 15 mm Hg
What is the approximate pressure in the aorta?
100 mm Hg
How does the pressure in the pulmonary artery and aorta play a role in the thickness of the myocardium?
High pressure = high myocardium thickness
What separates the right Ventricle from the left ventricle?
Interventricular septum
The left ventricle pumps through the _________ Circuit, and the right ventricle pumps through the _________ Circuit.
Systemic; pulmonary
Does the left ventricle pump more blood than the right ventricle? Why or why not
No, they pump the same amount of blood
Name the types of tissues that are found in the semi lunar valves
Endocardium, connective tissue, fibrous tissue
What are shapes like pockets?
Semi lunar valves
The aortic semi lunar valve opens when the pressure in the _________ greater than the ______.
Left ventricle; aorta
When ventricles contract, the semi lunar valves will _________.
Open
What is auscultation
Listening with a stethoscope to heart or lungs
What causes the lub?
Closure of mitral and tricuspid atrioventricular valves at the beginning of ventricular systole
The lubb is the first heart sound
What is the dub?
The second heart sound. Aortic and pulmonary valves close after blood leaves the heart.
Where can the pulmonary semilunar valve be heard?
Second intercoastal space on the left
Where can the mitral valve be heard
Fifth intercoastal Space on the left
Where can the aortic semi lunar valve be heard
Second intercostal space on the right
Where can the tricuspid valve be heard?
Fifth intercoastal Space on the right
 What is a murmur?
Abnormal heart sound produced when blood flow becomes turbulent
What are the coronary arteries?
Two main arteries, the left and the right, that supply the myocardium of the heart. They are branches of ascending aorta near the opening of the aortic semi lunar valve.
What is the right coronary artery do?
Carries blood primarily to the right ventricle and the right atrium
What is the marginal artery do you?
Supplies blood to the right ventricle
What does the left coronary artery do?
Carries blood to the left and right ventricles and left atrium
What does the circumflex artery do?
Supplies blood to the left atrium
What does the anterior interventricular artery do? (left anterior descending artery or LAD)
Supplies blood to both ventricles
Does the coronary sinus have smooth muscle?
No
What is ischemia
Decreased oxygen supply
What is angina pectoris?
Pain in the chest due to low oxygen supply to the heart muscle
What is myocardial infarction
Death of myocardium. This is irreversible because cardiac muscle does not regenerate. Myocardial cells are replaced by collagen.
What is anastomosis
A connection between two structures.
How do pacemaker cells of the heart to reach the threshold potential without nervous system input?
The essay node drifts by itself to the threshold by leaky ion channels
Where is the SA node located?
Located in the right atrial wall and called the pacemaker
