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Pathophysiology > Unit 2 - Chapter 10 - Blood and Circulatory System Disorders > Flashcards

Unit 2 - Chapter 10 - Blood and Circulatory System Disorders Flashcards

1
Q

what is the function of blood

A
  • transport oxygen and nutrients to all tissues
  • remove waste products of cellular metabolism
  • play a critical role in the bodys defenses/immune system and serve in maintaining abody homeostasis
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2
Q

how are blood and lumph transported throughout the body

A

through vessels and the pumping action of the heart

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3
Q

what type of system do the arteries, capillaries and veins constitute

A

a closed circulatroy system

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4
Q

how many types of circulations are there and what are they called

A

-2
- pulmonary circulation
- systemic circulation

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5
Q

expand on pulmonary circulation

A
  • allows for the exchange of oxygen and carbon dioxide in the lungs
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6
Q

expand on systemic circulation

A

provides for the exchange of nutrients and wastes between the blood and the cells throughout the body

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7
Q

where do arteries transport blood to

A
  • transport blood away from the heart into the lungs or to body tissues
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8
Q

what are arterioles and what do they control

A
  • they are the smaller branches of arteries
  • they control the amount of blood flowing into the capillaries in specific areas through the degree of contraction of smooth muscles in the vessel walls
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9
Q

what do precapillary sphincters determine

A

determine the amount of blood flowing from the arterioles into the individual capillaries, depending on the metabolic needs of the tissues

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10
Q

what do venules do

A

they conduct blood from the capillary beds toward the heart

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11
Q

what do larger veins do

A

they collect blood draining from the venules

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12
Q

what do valves in the veins do

A

they keep the blood flowing towards the heart

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13
Q

what are the 3 layers that make up the walls of arteries and veins

A
  • tunica intimia
  • tunica media
  • tunica externa
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14
Q

expand on the tunica intimia

A

composed of endothelial cells

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15
Q

expand on the tunica media

A

layer of smooth muscle

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16
Q

expand on the tunica externa

A

layer of connective tissue and contains elastic and collagen fibers

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17
Q

what does the vasa vasorum consist of and what does it do

A
  • tiny blood vessels that supply blood to the tissues of the blood vessel wall itself
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18
Q

what is autoregulation and provide an example

A
  • a reflex adjustment in a small area of tissue or an organ, whcih varies depending on the needs of the cells in the area
  • ex) localized vasodilation or vasoconstriction in arterioles
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19
Q

what can cause vasodilation

A
  • a decrease in ph, an increase in co2, decrease in oxygen, release of histamine or increase in body temperature
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20
Q

what can cause vasoconstriction

A
  • norepinephrine
  • epinephrine
  • angiotensin
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21
Q

what do capillary walls consist of and why

A
  • consist of a single endothelial layer
  • because it helps to facilitate the exchange of fluid, oxygen, co2, electrolytes, glucose, other nutrients and wastes between the blood and the interstitial fluid
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22
Q

what is the function of blood

A
  • transport system
    -defense mechanism (carrying wbc and antibodies)
  • promotes homeostasis
  • controlling body temp
  • contains clotting factors
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23
Q

how much blood does the human body contain and what is the % composition made of

A
  • 5L
  • 55% is water and its disolved solutes
  • 45% is cells
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24
Q

what does hematocrit refer to

A

refers to the proportion of cells (rbc’s) in blood and indicates the viscosity of the blood
- males have higher hematocrit than females

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25
Q

what could an elevated hematocrit indicate

A
  • dehydration
  • excess rbc’s
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26
Q

what could low hematocrit indicate

A
  • blood loss
  • anemia
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27
Q

what is plasma

A

the clear yellowish fluid remaining after the cells have been removed from the blood

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28
Q

what is serum

A

the fluid and solutes remaining after the cells and fibrinogen have been removed from the plasma

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29
Q

where do all blood cells originate from

A

red bone marrow

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30
Q

what is the process called of when blood cells develop from a single stem cell

A

hemopoiesis or
hematopoiesis

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31
Q

what is dyscrasia

A

a pathologic condition of the blood that usually refers to disorders involving the cellular components of blood

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32
Q

where does erythropoietin originate from and what does it do

A
  • originates from the kidney
  • stimulated rbc production in the red bone marrow
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33
Q

what does hemoglobin (blood protein) consist of

A

two pairs of amino acid chains and four heme groups, each containing a ferrous iron atom, to which the iron molecule can attach,
- heme provides the red color associated with hemoglobin

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34
Q

what color is oxyhemogloubin and deoxyhemogloubin

A
  • oxyhemogloubin is bright red
  • deoxyhemobloubin is dark or blueish red
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35
Q

what does carbaminohemoglobin refer to

A

the small proportion of the co2 in the blood that is carried by hemoglobin

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36
Q

how can carbon monixode poising be noticed

A

bright cherry red color on the lips and face

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37
Q

what is the life space of an rbc

A

120 days

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38
Q

what is excess iron in the body stored as

A

ferritin or hemosiderin in the liver, blood or other tissues

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39
Q

what is hemochromatosis

A

a genetic disorder known as iron overload which results in large amount of hemosiderin accumulating in the liver, heart and other organs causing serious organ damage

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40
Q

when rbcs are destroyed, what happens with the remaining heme balance

A

its converted into bilirubin and is transported to the liver where it is combined with glucuronide

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41
Q

what is hemolysis

A

destruction of rbcs

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42
Q

what does excessive hemolysis cause

A

elevated serum bilirubin levels, which result in jaundice

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43
Q

what is leukopoiesis

A

the production of wbcs

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44
Q

what are examples of colony stimulating actors that are produced by cells

A
  • macrophages
  • t lymphocytes
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45
Q

what is the action called of when wbcs leave the capillaries and enter tissues

A
  • diapedesis or ameboid action
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46
Q

what are the 5 types of leukocytes/ebcs

A
  • lympocytes
  • neutrophils
  • basophils
  • eosinophils
  • monocytes
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47
Q

expand on lymphocytes

A
  • make up 30 - 40% of wbcs
  • important in immune response
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48
Q

expand on neutrophils

A
  • make up 50 - 60% of wbcs
  • aid in tissue damage and commence phagocytosis
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49
Q

expand on basophils

A
  • release histamine and heparin (clotting agent)
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50
Q

expand on eosinophils

A
  • combat the effect soh histamine
  • increased by allergic reactions and parasitic infections
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51
Q

expand on monocytes

A
  • enter tissue to become macrophages which act as phagocytes when tissue damage occurs
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52
Q

what is differential count

A

indicates the proportions of specific ebcs in the blood

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53
Q

expand on platelets/thrombocytes

A
  • not cells, rather fragments from megakaryocytes
  • act as a plug to areas that are bleeding and thicken blood
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54
Q

what is hemostatis

A

the process of stopping bleeding

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55
Q

what are the 3 steps of hemostasis

A
  • immediate response of a blood vessel to injury is vasoconstriction or vascular spasm. In small blood vessels this decreased blood flow and may allow a platelet plug to form
  • thrombocyes tend to adhere to the underlying tissue at the site of injury and if the blood vessel is small, can form a platelet plug in the vessel
  • the blood clotting mechanism is required in larger vessels, by which the clooting factors that are present in inactive forms in the circulating blood are activated through a sequence of reactions
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56
Q

what are the 5 steps of coagulation

A

1) damaged tissue and platelets release factors that stimulare a series of reactions involving numerous clotting factors, producing prothrombin activator
2) prothrombin is coverted into thrombin
3) firbinogen is converted into fibrin threads through the action of the thrombin
4) a fibrin mesh form to trap cells, making up a solid clot, or thrombus, and stopping the flow of blood
5) the clot gradually shrinks or retracts, pulling the edges of damaged tissue closer together and sealing the site

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57
Q

where are the circulating clotting factors produced

A

primarily in the liver

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58
Q

what is required for the synthesis of most clotting factors

A
  • vitamin k
  • calcium ions
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59
Q

what is released in thrombin and what does it fo

A
  • oristaglandin is released
  • this prevents platelets from sticking to nearby undamaged tissues
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60
Q

what is heparin and where is it released from

A
  • an anticoagulant
  • released from basophils or mast cells in the tissues
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61
Q

what is fibrinolysis

A

Fibrinolysis is the breakdown of fibrin within blood clots, which is essential for wound healing

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62
Q

what does agglutination mean

A

clumping of rbcs

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63
Q

expand on type a blood

A
  • a antigen
  • b antibody
  • can receive type o or a blood
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64
Q

expand on type b blood

A
  • b antigen
  • a antibody
  • can receive type o or b blood
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65
Q

expand on type ab blood

A
  • ab antigen
  • no antibodies
  • can receive a, b, o or ab blood (universal recipent)
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66
Q

expand on type o blood

A
  • no antigens
  • anti ab antibodies
  • can receive type o blood (universal donor)
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67
Q

what are signs of a transfusion reaction

A
  • feeling of warmth in the involved vein
  • flushed face
  • headache
  • fever and chills
  • pain in chest and abdomen
  • decreased blood pressure
  • rapid pulse
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68
Q

What is erthroblastosis fetalis

A

rh blood incompatibility between mother and child

69
Q

what is the basic diagnostic test for blood

A

complete blood count

70
Q

what does morphology mean

A

study of the size/shape

71
Q

what is leukocytosis

A

an increase in wbcs in the circulation

72
Q

what is leukopenia

A

a decrease in leukocytes

73
Q

how are different types of anemia distinigushed

A
  • the characteristic size and shape of the cell
  • the prescense of a nucleus in the rbc
74
Q

how can bone marrow function be assessed

A

by the reticulocyte (immature nonucleated RBC) count, plus a bone marrow aspiration and biopsy

75
Q

what does a chemical analysis of the blood determine

A
  • serum levels of components such as iron, vitamin b12, folic acid, urea, glucose and bilirubin
  • can indicate metabolic disorders and disorders within various other body systems
76
Q

how are blood clotting disorders differntiated

A
  • by tests such as bleeding time, prothrombin time or international normalized ratio, partial thromboplastin time
77
Q

when can whole blood, packed rbcs or packed platelets be administered

A
  • when severe anemia or thrombocytopenia develops
78
Q

why is plasma or colloidal colume-expanding solutions a risk free blood therapy

A

because they are free of antigens and antibodies

79
Q

what are some examples of artifical blood products used for blood therapies and what are they made of

A
  • hemolink which is made from human hemoglobin
  • hemopure which is made from cow hemoglobin
  • oxygent which is a synthetic, genetically engineered blood substitute
80
Q

what is epoetin alfa and what does it do

A
  • it’s a form of erythropoietin produced through the use of recombinant DNA technology
  • used to stimulat production of rbcs before certain surgical procedures and for patients with anemia related to cancer or chronic renal failure
81
Q

what are bone marrow or stem cell transplants used for

A
  • treat some cancers, severe immune deficiency or severe blood cell diseases
82
Q

what do anemias do

A

reduce oxygen transport in the blood because of a decrease in hemoglobin content

83
Q

what causes anemia

A
  • declined production of hemoglobin
  • decreased in the number of rbcs
84
Q

the oxygen deficit that occurs in anemias leads to what

A
  • less energy is produced in cells
  • ## cell metabolism and reproduction are diminished
85
Q

what are the signs and symptoms of anemia

A
  • fatigue
  • pale face
  • rapid heart rate
  • difficulty breathing
  • inflamed digestive tract
  • inflamed and cracked lips
  • difficulty swallowing
  • angina (chest pain)
86
Q

expand on iron deficiency anemia

A

too little iron slows down the synthesis of hemoglobin which reduces the amount of oxygen transported in the blood which results in microcytic (small cell) and hypochromic (less color)

87
Q

what are the causes of iron deficiency anemia

A
  • too little consumption of dietary iron
  • chronic blood loss
  • malabsorption syndrome
  • severe liver disease
88
Q

what are the signs and symptoms of iron deficiency anemia

A
  • pale face/skin
  • fatigue, lethargy
  • cold intolerance
  • irritability
  • brittle hair
  • spoon shaped nails
  • menstral irregularities
  • delayed healing
  • heart problems
89
Q

what shows up on diagnostic tests if someone has iron deficiency anemia

A
  • low values from hemoglobin, hematocrit, serum ferritin and serum iron
  • under a mircroscope the rbcs appear hypochromic and microcytic
90
Q

what is the treatment for iron deficiency anemia

A
  • underlying cause must be resolved
  • ## iron rich foods or supplements
91
Q

what is pernicious anemia

A
  • folic acid deficiency (vitamin b12 deficiency or b3)
92
Q

what is pernicious anemia characterized by

A
  • very large, immature, nucleated rbcs
93
Q

what is achlorhydria

A

a problem that occurs in pernicious anemia with the atrophy of the mucosa, because the parietal cells can no longer produce hydrochloric acid, resulting in a low level or absence of acid in the gastric secretions

94
Q

what does pernicious anmeia lead to

A

imapired maturation of rbcs owing to interference with dna synthesis
- and demyelination

95
Q

what is demyelination

A

condition that affects the protective cover of nerve cells

96
Q

what is rarely a cause of pernicious anemia

A
  • dietary insufficiency, because such a small is required to have a healthy amount of b12/b3
97
Q

what type os surgery can cause pernicious anemia

A

gastrectomy

98
Q

what are signs and symptoms of pernicious anemia

A
  • enlarged, red, sore and shiny tongue
  • decrease in gastric acids
  • tingling or burning sensations in the body
99
Q

what shows up in diagnostic tests for someone that has pernicious anemia

A
  • rbcs appear macrocytic or megaloblastic and nucleated
  • bone marrow is hyperactive
100
Q

what is the treatment for pernicious anemia

A
  • supplements
  • b12 injections
101
Q

what is aplastic anemia

A

a disease in which the bone marrow does not produce enough blood cells

102
Q

what does aplastic anemia result from

A

results from impairment or failure of bone marrow, leading to loss of stem cells and pancytopenia

103
Q

what is pancytopenia

A

decreased numbers of erythrocytes, leukocytes and platelets in the blood

104
Q

what is a trend noticed aplastic anemia

A
  • in half the cases the patients are middle aged and the cause is unknown/idiopathic
105
Q

what are factors that may cause/effect aplastic anemia

A
  • myelotoxins (radiation, industrial chemicals, drugs)
  • viruses
  • autoimmune diseases
  • genetic abnormalities
106
Q

what are the signs and symptoms of aplastic anemia

A
  • anemia
  • leukopenia (such as recurrent or multiple infections)
  • thrombocytopenia petechiae (flat, red, pinpoint hemorrhages on the skin)
107
Q

what appears in diagnostic tests if someone has aplastic anemia

A
  • pancytopenia
108
Q

what is the treatment for aplastic anemia

A
  • treatment of the underlying cause
    -removal on bone marrow suppressants
  • blood transfusion
  • bone marrow transplantation
109
Q

what is hemolytic anemia

A
  • excessive destruction of rbc, leading to lor rbc and hemoglobin levels
110
Q

what are the causes of hemolytic anemia

A
  • genetic defects
  • presence of toxins in blood
  • infections such as malaria, transfusion reactions and blood incompatibility in the neonate
111
Q

what is sickle cell anemia

A
  • inherited disease that leads to the formation of abnormally shaped hemoglobin
112
Q

what is changed in someone that has sickle cell anemia

A

in the hemoglobin, one amino acid in the pair of beta-globin chains have been changed from the normal glutamic acid to valine

113
Q

what are some bad things that can happen if you have sickle cell anemia

A
  • obstruction of the small blood vessel
  • thrombus formation
  • multiple infractions
  • tissue necrosis
114
Q

who is more likely to have sickle cell anemia

A
  • people from africa or the middle east
115
Q

when do signs and symptoms of sickle cell anemia appear

A

12 months of age

116
Q

what are the signs and symptoms of sickle cell anemia

A
  • pale skin/face
  • weakness
  • heart problems
    -hyperbilirubinemia
  • splenomegaly
  • vascular occlusions and infractions
  • infection of lungs
  • delayed growth and development
  • congestive heart failure
  • frequent infections
117
Q

what shows up on a diagnostic test for someone that has sickle cell anemia

A
  • if they are a carrier of the gene
118
Q

what is the treatment for sickle cell anemia

A
  • hydroxyurea
  • folic acid
  • avoiding strenous activity and high altitudes
  • prevent dehydration, acidosis, infection and exposure to cold
  • bone marrow transplant
119
Q

what is thalassemia

A

a genetic defect that results in one or more genes for hemoglobin being missing or being varried
- interferes with the production of the globin chains, therefore the amount of hemoglobin synthesized
- accumulation of other chains

120
Q

what are the 2 different types of thalassemia’s and in what groups of people do they occur most often

A
  • thalassemia beta (meditteranean countries like italy and greece)
  • thalassemia alpha (indian, chinese, southeast asian)
121
Q

what are the signs and symptoms of thalassemia

A
  • impaired growth and development in children
  • hyperactivity in the bone marrow
  • heart failure
122
Q

what shows up in diagnostic tests in a person with thalassemia

A
  • rbcs are microcytic and hypochromic
  • increased erythropoietin levels
  • iron overload
123
Q

what is the treatment for thalassemia

A
  • blood transfusions
124
Q

what are the warning signs of blood clotting disorders

A

spontaneous bleeding, excessive bleeding following minor tissue trauma, infections and damaged/fragile blood vessels

125
Q

what are the causes od blood clotting disorders

A
  • thrombocytopenia
  • chemotherapy, radiation treatments and cancers
  • defective platelet therapy
  • vitamin k deficiency
  • liver disease
  • inherited defects
  • hemorrhagic fever viruses
  • anticoagulant drugs
126
Q

what is hemophilia a (classic hemophilia)

A

a deficit or abnormality of clotting factor VIII caused by the X chromosome

127
Q

what are the signs and symptoms of hemophilia

A
  • prolonged or severe hemorrhage
  • persistant oozing of blood after minor injuries
  • spontaneous hemorrhage into joints
  • urine in blood
128
Q

what shows up in diagnostic tests of a person with hemophilia

A
  • normal bleeding time and PT
  • prolonged PTT, APTT and coagulation time
  • serum levels are low
129
Q

what is the treatment for hemophilia

A
  • desmopressin drug
  • dna product
  • other drugs
130
Q

what is von willebrand disease caused by

A
  • most common blood clotting disorder that is caused by a deficit of the von willebrand factor (clotting factor)
131
Q

what are the signs and symptoms of von willebrand disease

A
  • skin rashes
  • frequent nosebleeds
  • easy bruising
  • bleeding of the gums
  • abnormal menstral bleeding
132
Q

what is the treatment for von willebrand disease

A
  • hormones (tablets, injection or nasal spray)
  • antifibrinolytic drugs
133
Q

what is disseminated intravascular coagulation

A

life threatening condition that involved excessive bleeding and excessive clotting

134
Q

what does disseminated intravascular coagulation result from

A
  • obstetric complications
  • infections
  • carcinomas
  • major trauma
135
Q

what are the signs and symptoms of disseminated intravascular coagulation

A
  • low plasma fibrinogen level
  • prolonged bleeding time
  • low blood pressure or shock
  • multiple bleeding sites
  • petechiae
  • mucosal bleeding
  • vascular occlusions
  • respiratory impairment
  • seizures
  • renal failure
136
Q

what is the treatment for dissminated intravascular coagulation

A
  • underlying cause must be treated
137
Q

what is thrombophilia

A

a group of inherities or acquired disorders that increase the risk of developing abnormal clots in the veins or arteries

138
Q

what causes thrombophilia

A
  • deep vein thrombosis
  • pulmonary embolism
  • peripheral vascular disease
  • mutation in the gene
  • surgeries
139
Q

what are the signs and symptoms of thrombophilia

A

non specific

140
Q

what is the treatment for thrombophilia

A
  • underlying cause must be treated
  • anticoagulants
141
Q

what is myelodysplastic syndrome

A

a disease that involves inadequate production of cells by the bone marrow

142
Q

what is the treatment for myelodysplastic syndrome

A
  • transfusion replacements
  • chelation therapy
  • low level chemotherapy
  • bone marrow transplants
143
Q

what is polycythemia

A

a condition in which there is an increased production of rbcs and other cells in the bone marrow

144
Q

what age is it the most common to develop polycythemia

A

40 to 60

145
Q

what are the signs and symptoms of polycythemia

A
  • plethoric and cyanotic patients
  • hepatomegaly
  • itching
  • increased blood pressure
  • headaches
  • visual disturbance
  • thromboses and infractions
  • congestive heart failure
  • high levels of uric acis
146
Q

what shows up in diagnostic tests in a person with polycythemia

A
  • increased cell counts, hemoglobin and hematocrit
  • bone marrow is hypercellular
  • hyperuricemia is present
147
Q

what is the treatment for polycythemia

A
  • drugs
  • radiation
  • phlebotomy
148
Q

what is leukemia

A

group of neoplastic disorders involved the wbc’s
- wbc’s are undifferentiated, immature and nonfunctional and rapidly multiply in the bone marrow and are released into the general circulation

149
Q

what are acute leukemias and chronic leukemias characterized by

A
  • acute leukemias are characterized by high numbers of very immature and nonfunctional cells
  • chronic leukemias are characterized by high numbers of mature cells
150
Q

what is leukemia often associated with

A
  • chromosomal abnormalities (translocations)
  • down syndrome
151
Q

what are the signs and symptoms of leukemia

A
  • untreatable infections
  • severe hemorrhage
  • signs of anemia
  • bone pain
  • weight loss
  • fatigue
  • fever
  • enlarged lymph nodes, spleen and liver
152
Q

what is the treatment for leukemia

A
  • chemotherapy
  • biologic therapy
  • platelet transfusions
  • bone marrow transplants
153
Q

what is arteriosclerosis

A
  • degenerative changes in arteries and arterioles
154
Q

what is peripheral vascular disease

A
  • an abnormailty in the arteries and veins outside the heart
155
Q

what are the 8 steps in the transport of lipids

A

1) dietary intake
2) chylomicrons absorbed into blood and lymph
3) lipid uptake by adipose and skeletal muscle cells
4) remnants to liver
5) liver synthesizes lipoproteins
6) LDL transports cholesterol to cells
7) LDL attached to LDL receptor in smooth muscle and endothelial tissue
8) HDL transports cholesterol from cells to liver

156
Q

what are the signs and symptoms of peripheral vascular disease

A
  • increasing fatigue and weakness
  • leg pain
  • sensory impairment
  • peripheral pulses
  • change in appearance os feet and legs
157
Q

what is the treatment for peripheral vascular disease

A
  • reduction of serum cholesterol intake
  • take platlet inhibitors or anticoagulants
  • stop smoking
  • start exercising
  • take calicum blockers
  • surgical procedures
158
Q

what is an aortic aneurysm

A

a localized dilation and weaking of an arterial wall

159
Q

what are causes of an aortic aneurysm

A
  • trauma
  • syphilis or other infections
  • congential defects
160
Q

what are the signs and symptoms of aortic aneurysm

A
  • masses in abdomen
  • rupture leading to bleeding
  • severe pain and shock
  • loss of pulse
  • organ dysfunction
161
Q

what is the treatment for aortic aneurysms

A
  • surgery
162
Q

what are varicose veins (varicosities)

A
  • irregular dilated and tortuous areas of the superficial or deep veins
163
Q

what can cause varicose veins to develop

A
  • defect or weakness in the vein walls or valves
  • long periods of standing
  • leg crossing
  • pregnancy
  • wearing tight clothes
164
Q

what is the treatment for varicose veins

A
  • keeping legs elevated
  • compression socks
165
Q

what is thrombophlebitis

A

inflammation in a vein that leads to the development of a thrombus or clot

166
Q

what is phlebothrombosis

A

when a thrombus forms spontaneously in a vein without prior inflammation

167
Q

what are factors that predispose you to thrombophlebitis and phlebothrombosis

A
  • sluggish blood flow
  • endothelial injury
    -increased blood coagulation
168
Q

what are signs and symptoms of thrombophlebitis and phlebothrombosis

A
  • aching and burning
  • warm, swollen, red vein
  • fever
169
Q

what is the treatment for thrombophlebitis and phlebothrombosis

A
  • compression socks
  • excercise
  • anticoagulant drugs
  • fibrinolytic therapy
  • surgical interventions

Pathophysiology (10 decks)

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