Week 3 - Blood Flashcards
1
Q
Blood Function
A
transport of O2 + CO2
protection - restricts fluid loss from damaged BV (platelets + clotting proteins)
regulation - of pH, electrolyte composition (interstitial fluid), body temp
-provides mechanism for rapid transport (nutrients, waste products, respiratory gases)
2
Q
Blood is powered by…
A
the pumping action of the heart
3
Q
Hemoglobin
A
oxygen carrying protein found in RBCs
-approx 280 million hemoglobin molecules in blood
-pigment containing iron (changes color based on oxygenation)
-globulin portion: transports CO2, carbonic anyhrase, nitric oxide
-heme groups (4): transport O2 (iron requred for O2 transport); each bound to a polypeptide; 4 binding sites for O2
within RBCs
4
Q
COPD in Relation to Hemoglobin
A
hypoxemia stimulates erythropoeitin
-hemoglobin will appear both blue and red
5
Q
Hemoglobin + O2
A
hemoglobin + O2 = weak bond
6
Q
Hemoglobin + CO
A
hemoglobin + CO = strong bond
-binds 200x more avidly than O2
knocks O2 off of hemoglobin
7
Q
Nitric Oxide
A
inactivated by Hemoglobin
8
Q
Circulatory System
A
composed of cardiovascular system + lymphatic system
9
Q
Cardiovascular System
Characteristics + Function
A
BV, heart + blood
function : transport nutrients, gases, hormones to cells and pick up wastes for transport for excretion
10
Q
Lymphatic System
Characteristics + Function
A
network of vessels that return fluid escaped from blood vessels to bloodstream
-lymphocytes + lymphoid tissue
-fight against infections and provide immunity to disease
-detrimental -> metastases of cancer easily circulate
11
Q
Blood Cells
Blood Composition
A
formed cells (34-54%)
-platelets/WBCs (“buffy coat”) = 0.1%
-RBCs = 99.9%
12
Q
Plasma
Blood Composition
A
fluid portion and fibrinogen (46-63%)
13
Q
pH of Blood
A
7.35-7.45
14
Q
Blood Volume
Male v. Female
A
female: 4-5 L
male: 5-6 L
15
Q
CBC
(“spun down”)
A
-plasma: 55% of whole blood
-“buffy coat” : <1% (platelets + WBCs)
-RBCs = 45%
16
Q
Packed Cell Volume
A
RBC count / approximation of hematocrit %
17
Q
Hematocrit
A
approximation of RBCs
-normal = 45%
18
Q
Why are there less RBCs in females than males?
A
menstruation
19
Q
Albumin
(Plasma Protein)
A
plasma proteins contributing to osmotic pressure of plasma
-transports lipids and steroid hormones
-aids w/ electrical components, pumps, and pressure gradients to keep everything in the body moving
most abundant
20
Q
Plasma
A
-regulates body temp
-contains electrolytes
-transports blood cells, digestion and hormones
(90% water, nonliving part of blood)
21
Q
RBC Function
A
-transport O2 from lungs to tissues
-transport CO2 from tissues to lungs
22
Q
Components of RBCs
A
hemoglobin, lipids, ATP, carbonic anhydrase
23
Q
Erythrocytes
A
transport O2 from lungs to tissues and CO2 from tissues to lungs
-production of HCO3 due to RBC carbonic anyhydrase
-made in red bone marrow (long bones, cranial bones, ribs, sternum and vertebrae)
-biconcave shape to squeeze through small spaces (30% more surface area for diffusion of O2 across membrane)
-lifespan = 100-120 days
-no organelles, ribosomes or nuclei
components: Hemoglobin, lipids, ATP, carbonic anhydrase
24
Q
Leukocytes
A
WBCs for immune system defense
25
Platelets
| (Function)
**stops bleeding from damaged vessel (hemostasis)**
-vascular spasm
-formation of platelet plug
-blood coagulation
26
Platelets
| (Characteristics)
**cell fragments necessary for hemostasis (clotting) shed from megakaryocytes**
-remain functional for 10 days (removed by macrophages)
-do not leave blood (1/3 stored in spleen + released due to splenic contraction)
| thrombocytes
27
Components of Plasma
**90% H2O, 6-8% plasma proteins, 1% electrolytes (Na+/Cl-)**
-**nutrients** (ex. glucose and amino acids)
-**hormones** (ex. cortisol and thyroxine)
-**wastes** (ex. urea)
-**blood gases** (ex. CO2 and O2)
28
Plasma Proteins
**most produced in the liver (6-8% the plasma's weight)**
-albumins
-globulins (alpha, beta, gamma)
-fibrinogen
-**functions**: buffer pH, maintain osmotic pressure, antibodies, clotting factors
29
H2O
| Plasma
90%; transport medium carrying heat
30
Electrolytes
| Plasma
-membrane excitability
-osmotic distribution of fluid between ECF + ICF
-buffer pH changes
31
Nutrients, wastes, gases, hormones
| Plasma
transported within the blood
| blood gas CO2 plays role in acid-base balance
32
Plasma Proteins
| Plasma
-exert osmotic effect (albumins) important in distribution of ECF between vascular and interstitial compartments
-buffer pH changes
-transport of hormones
-antibodies (gamma/immunoglobulins)
-clotting factors (fibrinogen)
| albumins, globulins, fibrinogen
33
Albumins
| Plasma Proteins
transport many substances, contribute most to colloid pressure
| most abundant plasma protein
34
Alpha and Beta Globulins
| Plasma Proteins
transport may water insoluble substances; clotting factors are alpha and beta; inactive precursor molecules (ex. angiotensin)
35
Alpha Globulins
| Plasma Proteins
carries thyroid hormones
ex. angiotensin
36
Beta Globulins
| Plasma Proteins
lipoprotein carrying Cholesterol + iron (Fe)
37
Gamma Globulins
| Plasma Proteins
antibodies
38
Fibrinogen
| Plasma Proteins
inactive precursor for fibrin meshwork of a clot
| produced in liver
39
Hematopoiesis
| (aka Hemopoiesis)
process of blood cell production
40
Stem Cell
cell in which all formed elements (other cells) are derived from
| ability to develop into many different cell types
41
Reticulocyte
**reticulocyte -> erythrocyte**
-remain reticulocyte for 1-2 days in circulation
-make up 1-2% of erythrocytes
| immature RBCs
42
Reticulocytes in Sickle Cell Patients
immature RBCs kicked out prematurely to keep up with production of RBCs
43
Lymphoblast
develops into lymphocytes
44
Proerythroblast
**proerthyroblast -> early erythroblast -> late erythroblast -> normoblast -> reticulocyte -> erythrocyte**
-committed cells (progenitor cells)
-activated by erythropoietin
-eject nucleus to turn into reticulocyte
| in red marrow; develops into RBC
45
Myeloblast
**myeloblast -> promyelocyte -> myelocyte -> metamyelocyte -> band cell -> [baso/neutro/eosino-phil]**
develops into basophils, neutrophils, and eosinophils
| eventually form leukocytes
46
Monoblast
**monoblast -> promonocyte -> monocyte**
develops into monocytes
| enlarge and form macrophages
47
Megakaryoblast
**megakaryoblast -> promegakaryocyte -> megakaryocyte -> platelets**
-develops into platelets
| (clotting)
48
Genesis of Erythrocytes
**proerthyroblast -> early erythroblast -> late erythroblast -> normoblast -> reticulocyte -> erythrocyte**
49
Genesis of Leukocytes
**myeloblast -> promyelocyte -> myelocyte -> metamyelocyte -> band cell -> [baso/neutro/eosino-phil]**
50
Regulation of total number of RBCs + platelets in circulation by...
**negative feedback system**
-increase WBC types based on response to pathogen
51
Besides the heart, the majority of blood goes...
to the brain, liver and kidneys
52
Kidney Function in Blood
**stimulates marrow to increase RBC production if blood / O2 flow is low**
-hypoxia in kidneys stimulates release of erythropoietin
-get 20% of blood volume w/ every heart beat
-production stops once kidney has received full 20% (negative feedback loop)
53
Control of Erythropoiesis by Kidneys: Process
1. Kidneys detect reduced O2 carrying capacity of blood
2. Less O2 delivered to kidneys -> secretion of hormone erythropoietin into the blood
3. Erythropoietin stimulates erythropoiesis by bone marrow
4. Additional circulating erythrocytes increase O2 carrying capacity
5. Increased O2 carrying capacity relieves initial stimulus that triggered erythropoietin secretion
6. Production of erythropoietin stops once kidney has received their 20% of oxygenated blood supply
54
Erythropoietin
hormone stimulating RBC production
55
Anemia
**refers to below normal O2 carrying capacity of blood**
(about 30% hematocrit)
| characterized by low hematocrit/low Hb
56
Microcytic Anemia
| (Nutritional Anemia)
iron deficiency
57
Macrocytic Anemia
| (Nutritional Anemia)
low B12 or folate
58
Megaloblastic Anemia
| (Nutritional Anemia)
B9 (folic acid) deficiency
| impaired DNA/RNA synthesis -> cells grow without dividing
59
Pernicious Anemia
**lack of intrinsic factor**
-genetic
-atrophic gastritis, loss of parietal cells, gastric bypass, gastrectomy
60
Aplastic Anemia
**chemotherapy agents, radiation, etc.**
-bone marrow shuts off
61
Renal Anemia
**renal (kidney) failure**
-lack of erythropoietin
62
Hemorrhagic Anemia
-GI: bleeding, ulcer, GERD
-menstruation
-bleeding disorders
63
Hemolytic Anemia
ex. sickle cell
64
Polycythemia
**characterized by too many circulating RBCs and elevated hematocrit**
-**two types**: primary & secondary
| about 70% hematocrit
65
Primary Polycythemia
| (Polycythemia Vera)
**caused by tumor like condition of bone marrow**
-erythropoiesis proceeds at uncontrolled rate
66
Secondary Polycythemia
**erythropoietin induced adaptive mechanism to improve blood's oxygen carrying capacity in response to prolonged oxygen delivery to tissues**
-occurs normally in people living at high altitudes + COPD
67
Myeloid Stem Cells form:
-RBCs
-platelets
-monocytes
-neutrophils (bacterial infection)
-eosinophils (allergic reaction)
-basophils
68
Lymphoid Stem Cells form:
lymphocytes
69
Leukocytes
**WBCs for immune defense**
-function outside of bloodstream in loose connective tissue
-have a nucleus
-larger than RBCs
-produced in bone marrow
-**lifespan**: 12 hour-several years
-**two types**: granulocytes + agranulocytes
70
Granulocytes
## Footnote
Leukocytes
-Neutrophils (40-70%)
-Eosinophils (1-4%)
-Basophils (0-1%)
71
Agranulocytes
## Footnote
Leukocytes
-Lymphocytes (20-45%)
-Monocytes (4-8%)
72
Leukocyte Function
1. defend against invading pathogens
2. identify and destroy cancer cells
3. removes worn out cells and tissue debris
73
Differential WBC Count
-**contains formed elements** (platelets, leukocytes, erythrocytes)
-**Granulocytes** (neutrophils, eosinophils, basophils)
-**Agranulocytes** (lymphocytes + monocytes)
74
Neutrophils
| (polymorphonuclear granulocyte)
## Footnote
Leukocytes
**-function: phagocytic cells destroy bacteria**
-60-70% volume
-blue granules/nucleus w/ interconnected lobes
-most numerous + important WBC
-1st wave of cells in inflammation
75
Eosinophils
| (polymorphonuclear granulocyte)
## Footnote
Leukocytes
**-function: role in allergic reactions, detoxify chemicals, reduce inflammation, attack parasitic worms**
-2-4%
-bilobed nuclei; pink or yellow granules containing digestive enzymes
76
Eosinophilia
**increase in circulating eosinophils due to:**
-allergic rxns
-asthma
-hay fever
-parasitic worm infection
77
Basophils
| (polymorphonuclear granulocyte)
## Footnote
Leukocytes
**-function: inflammation**
-<1%
-release heparin (clears fat from blood) + histamine to increase inflammatory response
-bilobed nuceli w/ large purple granules full of chemical mediators for inflammation
| least numerous
78
Heparin
| (Basophils)
## Footnote
Leukocytes
-blood thinner
-clears fat from the blood
-activates anti-thrombin 3
-prevent clotting of blood samples
-used as anticoagulant drug
79
Histamine
| (Basophils)
## Footnote
Leukocytes
**increases capillary permeability**
-released due to allergic rxn
80
Lymphocytes (B + T)
| (mononuclear agranulocyte)
## Footnote
Leukocytes
**-function: effective in fighting serious infections; act against specific molecule (antigen)**
-20-25%
-dense purple staining round nucleus with little cytoplasm
| main fucntional cells of adaptive immune system
81
B Lymphocytes
## Footnote
Leukocytes
plasma cells -> antibodies
-antibody mediate (humoral) immunity
82
T Lymphocytes
## Footnote
Leukocytes
**directly destroy virus invaded cells and cancer cells**
-do not produce antibodies
-punch holes in victim cell
-cell mediated immunity
83
Monocytes
| (mononuclear agranulocyte)
## Footnote
Leukocytes
**-function: transform into macrophages; phagocytic cells**
-4-8%
-largest leukocyte; kidney shaped nucleus
-emerge from bone marrow while immature
-circulate for 1-2 days
-mature/enlarge in resident tissues to become macrophages (65% in liver)
-**lifespan** = several months. -years
84
What cell type would increase with a bacterial infection?
neutrophils
85
What cell type would increase with a viral infection?
lymphocytes
86
What cell type would increase with a parasitic infection?
eosinophils
87
Thrombocytes
| (Platelets)
**cell fragments pinched off from megakaryocytes in red bone marrow**
-important in preventing blood loss (platelet plugs, promotion of clots)
-lack nuclei
-organelles w/ enzymes for generating energy
-high conc. of actin and myosin
-**lifespan** = 10 days
-do not leave blood (1/3 stored in spleen; released upon splenic contraction)
88
Thrombopoietin
**hormone produced by liver increases number of megakaryocytes**
-increase platelet production
89
Growth Factors
**needed to regulate differentiation and proliferation of different stem cells**
-**erythropoietin** (RBCs)
-**thrombopoietin** (platelets)
-**colony stimulating factors/CSFs + interleukins** (WBCs)
90
Heme
**prosthetic group (Fe2+)**
-acts as cofactor delivering O2 to tissues
-reversibly binds
-**coenzyme** = attached temporarily
-**prosthetic group** = attached permanently
91
Carbon Monoxide (CO) + Hemoglobin
**pushes O2 off hemoglobin**
-brain is deprived of O2
-no O2 circulating
92
Sulf-Hb
| Abnormal Hemoglobin
forms due to increased sulfur in blood (irreversible reaction)
93
Carboxy-Hb
| Abnormal Hemoglobin
CO2 replaces O2 and binds 220x tighter than O2
| ex. smokers -> acidic state
94
Met-Hb
| Abnormal Hemoglobin
contains oxidized Fe3+ that cannot carry O2
95
Fetal Hemoglobin (HbF)
**higher affinity for O2 than HbA (adult)**
-maternal Hb (HbA) delivers HbF across placenta (fetal circulation)
96
Erythropoiesis
**production of RBCs; occurs in red bone marrow**
-controlled by CNS neurotransmitters (found in hypothalamus)
| stimulated by kidneys
97
**Erythropoiesis**: Process
1. starts in red bone marrow with proerythroblast
2. cells near the end of development eject nucleus -> reticulocyte
3. develop into mature RBC in 1-2 days
4. negative feedback balances production with destruction
5. controlled condition is amount of oxygen delivery to tissues
6. hypoxia stimulates release of erythropoietin
98
Spleen Function in Blood
removes old erythrocytes from circulation
99
Negative Feedback System in Blood
| (Kidneys)
stops the secretion of erythropoietin once O2 delivery to kidneys returns to normal (20%)
100
Hemostasis
**platelets role in stopping bleeding**
-damaged BV sends signals for platelets -> vasoconstrict -> platelet plug -> clot reinforces plug
-**3 steps**:
1. vascular spasm
2. formation of plateelt plus
3. blood coagulation (clotting)
101
# Step 1:
Damage to BV -> **Vascular Spasm**
## Footnote
Hemostasis
**immediate constriction of BV to minimize blood loss**
-vessel walls press together (sticky/adherent)
102
# Step 2:
Platelet Plug Formation
## Footnote
Hemostasis
**platelets attach to exposed collagen**
-aggregation of platelets causes release of chemical mediators (ADP and Thromboxane A2)
-**ADP** = attracts more platelets
-**Thromboxane A2** = powerful vasoconstrictor promoting aggregation and increased ADP
| positive feedback loop
103
Thromboxane A2
| (Platelet Plug)
## Footnote
Hemostasis
powerful vasoconstrictor promoting aggregation and increasing ADP
104
ADP
| (Platelet Plug)
## Footnote
Hemostasis
attracts more platelets
105
Prostacyclin
| (Platelet Plug)
## Footnote
Hemostasis
inhibits platelet aggregation on normal, undamaged endothelium
106
# Step 3:
Blood Coagulation
| (clot formation/cascade)
**transformation of liquid blood to solid -> clot reinforces the plug (ex. scab)**
1. activation of prothrombinase
2. conversion of prothrombin -> thrombin
3. conversion of fibrinogen -> fibrin (instrinsic clotting path)
| extrinsic and intrinsic pathways
107
Fibrin
**meshwork of the clot**
-contraction of platelets pulls damaged vessel close together
| forms from fibrinogen by intrinsic clotting pathway
108
Clotting Factors
always present in blood plasma (inactive form)
109
Clotting Cascade
**12 clotting factors leading to final conversion of fibrinogen -> stabilized fibrin mesh**
-induced by vessel damage that exposes collagen
-converts fibrinogen to fibrin by instrinsic clotting pathway
110
Intrinsic Pathway
| (Clotting Casacde)
**activated by contact w/ exposed collagen/stops internal bleeding**
-7 steps
-sets off with Factor 12 (Hageman factor)
111
Extrinsic Pathway
| (Clotting Casacde)
**-requires contact w/ tissue factors external to blood**
-4 steps
-full break in the vessel (more dangerous/important)
-tissue thromboplastin released from traumatized tissue activates Factor X
112
**Intrinsic Pathway:** Steps
| (Clotting Cascade)
1. Inactive factor 12 **activated** by damaged vessel -> **Active Factor 12** (Hageman Factor)
2. Inactive Factor 11 is **activated** by Factor 12 -> **Active Factor 11**
3. Ca2+ (Factor 4) **activates** **Factor 9**
4. Ca2+, Factor 8 & PF3 **activate Factor 10**
5. Ca2+, Factor 5 & PF3 **activate** prothrombin (Factor 2) to **Thrombin**
6. Fibrinogen (factor 1) **activated** by Thrombin -> **Fibrin (loose mesh)**
7. Thrombin **activates** Factor 13 -> **Fibrin** (stabilized mesh)
8. Entrapment of blood cells -> **clot**
113
**Extrinsic Pathway**: Steps
| (Clotting Cascade)
1. Tissue damage -> tissue **Thromboplastin** (**Factor 3**)
2. Ca2+ & Factor 7 activate **Factor 10**
3. Ca2+, Factor 5 & PF3 **activate** **prothrombin (Factor 2**) to **Thrombin**
4. Fibrinogen (factor 1) **activated** by Thrombin -> **Fibrin (loose mesh)**
5. Thrombin **activates** Factor 13 -> **Fibrin** (stabilized mesh)
6. Entrapment of blood cells -> **clot**
114
Thrombus
abnormal intravascular clot attached to vessel wall
115
Plasmin
## Footnote
Clot Dissolution
"fibrin splitting" enzyme that dissolves clot
| breaks down Fibrin meshwork
116
Plasminogen
## Footnote
Clot DIssolution
inactive pre-cursor activated by Factor 12 (Hageman Factor)
117
Fibrinolysis
clot dissolved by activity of plasmin
118
Emboli
freely floating clots
119
Factors Causing Thromboembolism
| (3)
1. **roughened vessel surface w/ atherosclerosis** (build up on inside = not smooth, causes embolism -> turbulent blood flow knocks off plaque/plugs something -> triggers clotting path)
2. **stagnant blood forms clot**; slow moving blood **(broken leg -> DVT)**
3. occassionally triggered by **release of tissue thromboplastin** into blood from large amounts of traumatized tissue
4. **imbalances in clotting-anti-clotting system**
120
Hemophilia
**excessive bleeding caused by deficiency of clotting factor**
-cannot form clotting pathway -> bleed non-stop, not clot forms
| commonly Factor 8 deficiency
121
Thrombocyte Deficiency
**low platelets**
-can also lead to diffused hemorrhages
122
Von Wildebrand's Disease
**condition causing extended or excessive bleeding**
-often genetic (inherited)
-deficiency or impairment of Von Wildebrand Factor (vWF)
-**vWF** = allows platelets to stick to collagen (bridge for glycoprotein and collagen)
-cannot complete cascade = bleed
123
vWF
| (von Wildebrand Factor)
allows platelets to stick to collagen (bridge for glycoprotein and collagen)
124
Blood Grouping
determined by antigens (agglutinogens) on RBC surface
125
Agglutination
| (clumping)
antibodies (agglutinins) bind to RBC antigens
| can also lead to hemolysis (rupture) of RBCs
126
Type A Blood
A antigens, anti-B antibodies
127
Type B Blood
B antigens, anti-A antibodies
128
Type AB Blood
A + B antigens, no antibodies
129
Type O Blood
no antigens, anti-A + anti-B antibodies
130
Rh +
have Rh factor
-most of population
131
Rh -
do not have Rh factor
132
Hemolytic Disease of Newborn (HDN)
mother produces anti-Rh antibodies (during first childbirth) that cross placenta (during second childbirth) and cause agglutination and hemolysis of RBCs
