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555- Physiology & Pathophysilogy > Topic 1 - Blood > Flashcards

Topic 1 - Blood Flashcards

1
Q

What is blood?

A
  • Organ
  • Made of RBC, WBC, plasma, & platelets
  • Want to avoid giving blood in perfusion (goal directed perfusion)
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2
Q

What does blood do?

A
  • Transport services
  • Protection services
  • Temperature regulation (heating from the inside-out is more uniform)
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3
Q

Plasma

A
  • 54% of TBV
  • 4% of body weight (1L water = 1kg water)
  • 90% water / 10% solute (proteins/electrolytes/organic material)
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4
Q

Electrolytes

A
  • makes up most of solute in NUMBER inside the plasma
  • Ca, K, Na, Cl, Mg, HCO3
  • Impulse conduction, coagulation, cardiac rhythm, fluid balance, muscle function, and acid base balance
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5
Q

Plasma proteins function

A
  • Maintain osmotic pressure
  • Maintain fluid balance
  • Transport and carry
  • Immune functions
  • Enzymes
  • Blood buffers
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6
Q

Plasma protein types

A
  • Albumin : 62%
  • Globulins (all protein except albumin and fibrinogen) : 34%
  • Fibrinogen : 4%
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7
Q

Albumin

A
  • Responsible for colloid osmotic pressure
  • Transport free fatty acids and bilirubin
  • Binds competitively with variety of drugs
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8
Q

Globulins

A
  • Gamma/Immunoglobulins are of interest

- Involved with Immune system

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9
Q

Plasma Proteolytic Protein Systems

A

-Globulin functional group
-Complement system (inflammation)
-Kinin system (vasoactive effects)
-Blood Coag system
(extrinsic/intrinsic factors -> thrombin -> fibrinogen -> clotting)
-Fibrinolytic system (makes plasmin which breaks down fibrin)

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10
Q

Plasma Protease Inhibitors

A
  • Globulin functional group
  • Macroglobulin (inhibits plasmin/thrombin/kallikrien)
  • Antithrombin III (thrombin)
  • C1 inhibitor (Activiated C1/kallikrien)
  • Plasmin inhibitor (plasmin)
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11
Q

Carrier proteins

A
  • Globulin functional group
  • Albumin
  • Haptoglobin
  • Hemopexin
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12
Q

Acute Phase Proteins

A
  • Globulin functional group
  • Involved with inflammatory response
  • Interleukins recruit WBCs
  • Initiates fever
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13
Q

Hypoproteinemia

A
  • Protein deficiency
  • Caused by : malnutrition / protein production (liver problems) / poor absorption / protein excretion / hemodilution
  • Hemodilution caused by CCP….can prime ECC with albumin to help
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14
Q

Hypoproteinemia affects

A
  • Acid-base balance
  • Clotting mechanisms
  • Enzyme dependent reactions
  • Fluid Balance
  • Transport problems
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15
Q

Hyperprotienemia

A
  • Increased plasma proteins
  • More rare than hypo
  • Can cause clots in blood in microvascular
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16
Q

RBC Function

A

Carry O2 and CO2

17
Q

RBC dimensions

A
  • Biconcave discoid
  • 8.1 microns in diameter
  • 1.0 - 2.7 microns (thin part and thick part)
  • 138 microns^2 in area
  • 95 microns^3 in volume
18
Q

RBC Lifecycle

A
  • 120 days

- Stimulated by pO2

19
Q

Normal pO2 that gives us 50% hemoglobin bound to O2

A

25 mmHg

20
Q

Factors that shift Oxy-Hemo curve to right (less affinity)

A
  • Increased PCO2
  • Decreased pH
  • Increase in Temp
  • Increase in 2,3 DPG
21
Q

Bohr affect

A
  • How change in [CO2] affects affinity of O2/Hb
22
Q

Haldene affect

A
  • How [O2] affects CO2/Hb curve

- Opposite affect of Bohr

23
Q

O2 transport

A
  • 2% of total O2 is dissolved in plasma (forms partial pressure)
  • 98% of total O2 bound to Hb inside RBC (reversible bound)
24
Q

CO2 transport

A

Insert picture

25
Q

Methemoglobin

A
  • Formed when normal Fe2+ is oxidized to Fe3+
  • Bad for body…can no longer bind to O2
  • Methemoglobin reductase prevents this in RBC
26
Q

Fetal Hb

A
  • Hb F

- Higher affinity for O2 than Hb A

27
Q

RBC Hemolysis

A
  • Lysis of RBC (can activate clotting cascade)

- Caused by: immune response after transfusion / sepsis / medications / toxins / enzyme deficiency / CPB

28
Q

Types of WBC

A
  • Granulocytes (neutrophils/eosinophils/basophils)
    ~neutrophils big prob for perfusionist
  • Monocytes (become macrophages)
  • Lymphocytes (B and T cells)
29
Q

Neutrophils

A
  • Little version of macrophage
  • very sensitive to stimulation
  • respond to bacteria
  • forms pus
  • removed by macrophages
  • short lived
30
Q

Eosinophils

A
  • Toxic to all antigens
  • function in allergic reactions
  • release chemical called MBP (bad if on CPB)
31
Q

Basophil

A
  • exhibit chemotaxis….not phagocytosis
  • may release histamine and heparin
  • histamine = very potent vasodilator
  • Basophils (in blood) –> Mast cells (in tissues)
32
Q

Monocytes

A
  • mature into macrophages

- very big relatively (12-20 microns)

33
Q

Lymphocytes

A
  • Most complex WBC
  • Directs the immune system
  • T cells are 75% and B cells 25%

555- Physiology & Pathophysilogy (12 decks)

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