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Flashcards in Chapter 19: Blood Deck (122)
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1
Q

Functions of Blood

A
  1. Transportation
  2. Regulation
  3. Protection
2
Q

Blood Function: Transportation

A
  • transports oxygen and nutrients to body cells
  • transports wastes to lungs and kidneys for excretion
  • transports hormones from endocrine organs to target organs
3
Q

Blood Function: Regulation

A
  • maintains pH using buffers
  • maintains body temperature by absorbing and distributing heat
  • maintains adequate fluid volume in circulatory system
4
Q

What are the three types of plasma proteins that are found in plasma?

A
  1. Albumin
  2. Globulins
  3. Fibrinogen
5
Q

Albumin

A
  • (60%) major contributors to the osmotic pressure of plasma

    • important in the transport of fatty acids, thyroid hormones, some steroid hormones and other substances

    • produced by the liver

6
Q

3 Types of Globulins

A
  1. Alpha
  2. Beta
  3. Gamma
7
Q

Function of Alpha/Beta Globulins

A
  • are transport proteins, carrying things like metal ions (iron and copper for example) and lipid hormones.

    • Produced by the liver

8
Q

Gamma Globulins

A
  • Antibodies released by plasma cells during immune response that attack foreign proteins and pathogens

    • Not produced by the liver

9
Q

Fibrinogen

A

• (~4%) functions in clotting:
◦ under certain conditions, fibrinogen molecules will interact with each other forming large, insoluble strands of fibrin
• produced by the liver


10
Q

Plasma

A

fluid component of blood (approx 55% of whole blood)

11
Q

Plasma Compostion

A
  • water (92%)
    • Plasma Proteins (albumins, globulins, fibrinogen) (7%)
    • Other Solutes (electrolytes, nutrients, wastes) (1%)
12
Q

Give a normal range of blood volume in healthy humans

A

Adult male: 5-6 L

Adult female: 4-5 L

13
Q

Hematology

A

Study of blood

14
Q

Hematocrit

A

Percentage of blood volume composed of red blood cells

15
Q

Differential WBC count

A

Percentage of each type of leukocyte

16
Q

Hemolysis

A

Destruction of red blood cells

17
Q

Complete blood count

A

Tests that screens for anemia and other infections, includes counts of RBC’s, WBC’s , platelets per microliter of whole blood , hematocrit, differential WBC count

18
Q

Describe the formation of blood cells (hematopoiesis) and all terms discussed in lecture

A

check notes for chart

19
Q

Hematopoiesis

A

Process of blood cell formation in bone marrow

20
Q

What are the types of blood cells?

A
  1. Leukocyte
  2. Erythrocytes
  3. Platelets
21
Q

Describe the function of each blood cell type

A
  1. Erythrocytes- transports O2 in blood
  2. Leukocytes- defends body against pathogens
  3. Platelets- contains enzymes and other substances important to the process of blood clotting and coagulation
22
Q

Characteristics of RBC’s

A
  • small in diameter
    • cell has biconcave disc shape, anucleate & has no organelles
    • average life span 120 days
    • filled with Hemoglobin for gas transport
    • contain spectrin and other proteins
    • RBC diameters are larger than some capillaries
23
Q

Erythropoiesis

A

Formation of RBC’s

24
Q

What are the stages of Erythropoiesis ?

A
  1. Myeloid stem cell: transforms into proerythroblast
  2. Proerythroblast: divides many times, transforming into basophilic erythroblasts
  3. Reticulocytes: still contains small amounts of ribosomes
  4. Mature erythrocyte: in 2 days, ribosomes degrade , transforming into mature RBC
25
Q

Regulation of Erythropoiesis

A

Maintains balance between RBC production and destruction

26
Q

Too few RBC’s lead to

A

Tissue hypoxia

27
Q

Too many RBC’s leads to

A

Increases blood viscosity

28
Q

In what two ways are Erythropoiesis regulated ?

A
  1. Hormonal Control

2. Dietary Requirements

29
Q

Erythropoietin (EPO)

A

Hormone that stimulates the production of RBC’s

30
Q

How do hormones regulate Erythropoiesis?

A
  • Erythropoietin (EPO) - hormone that stimulates formation RBC’s
    • always small amount of EPO in blood to maintain basal rate
    • Released by kidneys (some in liver) in response to hypoxia
31
Q

hypoxia inducible factor (HIF)

A
  • accumulation triggers the synthesis of EPO

- monitors oxygen levels in the blood

32
Q

At low O2 levels, oxygen sensitive enzymes in the kidneys cannot degrade

A

Hypoxia-inducible factor (HIF)

33
Q

How does dietary requirements regulate Erythropoiesis?

A

• amino acids, lipids and carbs
• Iron: available from diet
◦ 65% of iron is found in hemoglobin, rest is in liver, spleen and bone marrow
• Vitamin B12 and folic acid are necessary for DNA synthesis for rapidly dividing cells such as developing RBC’s

34
Q

Reticulocytes

A

Immature RBC without a nucleus

35
Q

Blood doping

A

Athletes remove, store and reinfuse RBC’s before an event to increase oxygen levels and increase stamina

36
Q

Explain RBC turnover

A
  • life span: 100-120 days
    • RBCs cannot synthesize new proteins or grow or divide
    • Old RBC’s become fragile & Hb starts to degenerate
    • Can get trapped in smaller circulatory channels, especially in spleen
    • Macrophages in spleen, liver, red bone marrow engulf & break down dying RBC’s
37
Q

Hypoxia

A

Abnormal reduction of O2 delivered to tissues

38
Q

Normoxia

A

Normal oxygen conditions

39
Q

Anemia

A

Not enough healthy RBC’s to carry adequate oxygen to the body tissues
Symptoms: fatigue, dyspnea and chills

40
Q

Polycythemia

A

Excessive numbers of RBC’s: increases blood viscosity causing sluggish blood flow

41
Q

Name 7 types of anemias

A
  1. Hemorrhagic anemia
  2. Chronic hemorrhagic anemia
  3. Iron-deficiency anemia
  4. Pernicious anemia
  5. Renal anemia
  6. Aplastic anemia
  7. Hemolytic anemia
42
Q

Hemorrhagic anemia

A
  • rapid blood loss (ex: severe wound, heavy menstruation)

* treated by blood replacement

43
Q

Chronic hemorrhagic anemia

A

• slight but persistent blood loss
◦ ex) hemorrhoids, bleeding ulcer
• primary problem must be treated to stop blood loss

44
Q

Iron-deficiency anemia

A
  • can be caused by hemorrhagic anemia, but also by low iron intake or impaired absorption
    • RBC’s produced are called microcytes
    • Treatment: iron supplements
45
Q

Pernicious anemia

A
  • autoimmune disease that destroys stomach mucosa that produces intrinsic factor (which is needed to absorb B12 which is needed to help RBC’s divide ) 

    • Can also be caused by low dietary intake of B12
46
Q

Renal anemia

A

• caused by lack of EPO
• Often accompanies renal disease
◦ kidneys cannot produce enough EPO
• Treatment: synthetic EPO

47
Q

Aplastic anemia

A
  • Destruction or inhibition of red bone marrow
    • Can be caused by drugs, chemicals, radiation or viruses - usual cause unknown
    • Treatment: short-term with transfusions, long-term with transplanted stem cells
48
Q

Hemolytic anemia

A

• premature lysis of RBC’s
• Can be caused by:
◦ incompatible transfusions or infections
◦ hemoglobin abnormalities usually genetic disorder resulting in abnormal hemoglobin
▪ thalassemias and sickle-cell anemia

49
Q

Thalassemias

A

• one globin chain is absent or faulty
• RBC’s are thin, delicate and deficient in hemoglobin
• Many subtypes that range in severity
◦ very severe cases may require monthly blood transfusions

50
Q

Sickle cell anemia

A

• Hemoglobin S: mutated hemoglobin
◦ Only 1 amino acid is wrong in a globin beta chain of 146 amino acids
• RBC’s become crescent shaped when O2 levels are low
• Treatment: acute crisis treated with transfusions; inhaled nitric oxide

51
Q

What are the three types of polycythemias?

A
  1. Polycythemia Vera
  2. Secondary polycythemia
  3. Blood doping
52
Q

Polycythemia Vera

A
  • bone marrow cancer leading to excess RBC’s
    • Hematocrit may go as high as 80%
    • Treatment: therapeutic phlebotomy
53
Q

Secondary polycythemia

A

caused by low O2 levels (example: high altitude) or increased EPO production

54
Q

Characteristics of Human Blood

A
  • Average Temp: 38 degrees Celsius
  • pH Slightly basic/alkaline (pH: 7.35 - 7.45)
  • sticky and more dense than water (5x more viscous)
  • consist of blood cells + fluid matrix (plasma)
55
Q

Describe the structure and function of the hemoglobin molecule.

A
  • Contains globulin and heme. Globulin is composed of 4 polypeptide chains: 2 alpha and 2 beta chains with 1 iron in each that binds to oxygen.
  • Each heme can carry 1 02, 4 total.
  • 1 heme pigment is bonded to 1 globulin chain: gives blood red color
56
Q

Compare and contrast granulocytes and agranulocytes.

A
  • agranulocytes contain no visible granules in their cytoplasm; lymphocytes and monocytes
  • granulocytes contain visible granules in their cytoplasm; neutrophils, basophils and eosinophils
57
Q

General Function of Neutrophils

A
  • very phagoctyic
  • kill microbes by process called respiratory burst
  • denfinsin granules merge with phagosome: form spears that pierce holes in membrane of ingested microbe
58
Q

3 Types of Lymphocytes

A
  1. T Lymphocytes (T Cells)
  2. B Lymphocytes (B Cells)
  3. Natural Killer Cells
59
Q

B lymphocytes (B cells)

A

give rise to plasma cells, which produce antibodies

60
Q

T lymphocytes (T cells)

A

act against virus- infected cells and tumor cells

61
Q

Natural Killer Cells

A

kill cancer cells

62
Q

Describe WBC circulation and movement

A
  1. Can migrate out of the bloodstream - diapedesis
  2. Have amoeboid movement
  3. Attracted to chemical stimuli (positive chemotaxis)
  4. Some are phagocytic: Neutrophils, Eosinophils and Monocytes
63
Q

Reticulocyte Count

A

percentage of circulating reticulocytes

Normal = 038%

64
Q

General Function of Basophils

A
  • Contain histamine: dilates blood vessels (attracts WBCs to inflamed sites)
  • Contain heparin: prevents blood clotting
  • functionally similar to mast cells
65
Q

General Function of Eosinophils

A
  • attack large parasites (parasitic worms): release enzymes, digesting their surface
  • excrete toxic compounds
  • play a role in allergies & asthma
  • control inflammation w/ enzymes that counteract inflammatory effects of neutrophils & mast cells
66
Q

General Function of Monocytes

A
  • leave circulation entering tissues and differentiate into macrophages
  • actively phagocytic cells
  • crucial against viruses, intracellular bacterial parasites and chronic infections
  • secrete substances that activate lymphocytes to mount an immune response and fibroblast to injured area
67
Q

What are the 3 types of WBC disorders?

A
  1. Leukemias
  2. Infectious mononucleosis
  3. Leukopenia
68
Q

What are the 2 types of leukemias?

A
  1. Acute (quickly advancing) leukemia

2. Chronic (slowly advancing) leukemia

69
Q

Leukemia

A
  • cancerous condition involving overproduction of abnormal WBC’s (usually involve clones of single abnormal cell)
  • Named according to abnormal WBC clone involved (myeloid leukemia involves myeloblast descendants and lymphocytic leukemia involves lymphocytes
70
Q

Acute Leukemia

A
  • quickly advancing
  • derives form stem cells
  • primarily affects children
71
Q

Chronic Leukemia

A
  • slowly advancing
  • involves proliferation of later cell stages
  • more prevalent in older people
72
Q

What is Infectious mononucleosis?

A

-highly contagious viral disease (kissing disease)

caused by epstein-Barr virus

73
Q

What is the result of infectious mononucleosis?

A
  • results in high numbers of agranulocytes
  • involve lymphocytes becoming enlarged
  • Syptoms: tired, achy, chronic sore throat, low fever
  • Run course with rest in 4-6 weeks
74
Q

Leukopenia

A
  • abnormally low WBC count

- can be drug induced

75
Q

Describe the formation of human platelets.

A
  • also known as thrombocytopoiesis, is regulated by thrompoietin
  • formed in the myeloid line from megakaryoblast
  • megakaryocytes sends cytoplasmic projections into lumen of capillary
  • these projections break off into platelet fragments
  • age quickly and degenerate in about 10 days
76
Q

Describe the function of Platelets

A
  • release important clotting chemicals
  • form temporary platelet plug that helps seal breaks in blood vessels
  • reduce size of break in vessel wall
77
Q

hemostasis

A
  • sequence of fast reactions for stoppage of bleeding

- requires clotting factors and substances released by platelets and injured tissues

78
Q

What are the 3 steps in hemostasis?

A
  1. Vascular Spasm
  2. Platelet Plug Formation
  3. Coagulation (blood clotting)
79
Q

What happens during Vascular Spasm?

A
  • Vessel responds to injury with vasoconstriction
  • most effective in smaller blood vessels
  • reduces blood flow until other hemostatic mechanisms can be activated
80
Q

What triggers vascular spasm?

A
  • direct injury to vascular smooth muscle
  • chemicals released by endothelial cells and platelets
  • pain reflexes
81
Q

What happens during Platelet Plug formation?

A

begins with attachment of platelets to sticky endothelial surfaces, to the basement membrane, to exposed collagen fibers and to each other. As they become activated, platelets release a variety of chemicals that promote aggregation, vascular spasm, clotting and vessel repair.

82
Q

Explain what the following do during Platelet Plug formation.

  1. prostacyclins and nitric oxide
  2. ADP
  3. Von Willebrand Factor
  4. Serotonin and thromboxane A2
A
  1. prostacyclins and nitric oxide - prevent platelet sticking
  2. ADP - causes more platlets to stick and release their contents
  3. Von Willebrand Factor - helps to stabilize platelet-collagen adhesion
  4. Serotonin and thromboxane A2 - enhances vascular spasm and platelet aggregation
83
Q

What happens during Coagulation?

A
  • reinforces platelet plug with fibrin threads
  • blood is transformed from liquid to gel - called clotting (coagulation)
  • series of reactions use clotting factors (procoagulants), mostly plasma proteins
84
Q

Describe how blood coagulation occurs and define the coagulation cascade as discussed in lecture: intrinsic, extrinsic and common pathways, the significance of vitamin K

A

..

85
Q

What are the 2 major types of disorders of hemostasis?

A
  1. Thromboembolic disorders

2. Bleeding disorders

86
Q

What are bleeding disorders and name the 3 types?

A
  • abnormalities that prevent normal clot formation
    1. thrombocytopenia
    2. impaired liver function
    3. hemophelia
87
Q

What are thromboembolic disorders and name the 3 types?

A
  • results in undesirable clot formation
    1. thrombus
    2. embolus
    3. embolism
88
Q

thrombus

A

clot that develops and persists in unbroken blood vessel

-may block circulation, leading to tissue death

89
Q

embolus

A

thrombus freely floating in bloodstream

90
Q

embolism

A

embolus obstructing a vessel

91
Q

thrombocytopenia

A
  • deficient number of circulating platelets
  • petechiae appear
  • due to suppression or destruction of red bone marrow
  • Treatment: transfusion of concentrated platelets
92
Q

Impaired liver function

A
  • inability to synthesize procoagulants (clotting factors)
  • causes include vitamin k deficiency, hepatitis or cirrhosis
  • liver disease can also prevent liver from producing bile, which is need to absorb fat and vitamin k
93
Q

What are the 3 types of hemophilia?

A
  1. Hemophelia A - most common type due to factor VIII deficiency
  2. Hemophelia B - factor IX deficiency
  3. Hemophelia C - factor XI deficiency, milder
94
Q

What are the symptoms and treatment of hemophilia?

A
  • symptoms: prolonged bleeding, especially in joint cavities

- treatment - injections of genetically engineered factors

95
Q

Describe clot retraction

A

tightening of the fibrin clot

  • actin and myosin in platelets contract with 30-60 min.
  • contraction pulls on fibrin strands, squeezing serum from clot
  • draws rupture blood vessels edges together
  • vessel is healing even as clot retraction occurs
96
Q

Platelet-derived growth factor (PDGF)

A

released by platelets and stimulates the division of smooth muscle cells and fibroblasts to rebuild blood vessel wall during clot retraction

97
Q

Vascular Endothelial growth factor (VEGF)

A

stimulates endothelial cells to multiply and restore endothelial lining during clot retraction

98
Q

Describe Fibrinolysis

A
  • dissolution of the clot
  • process whereby the clot is gradually dissolved after repair is completed
  • begins within 2 days and continues several days until clot is dissolved
  • plasminogen, plasma protein that is trapped in clot, is converted to plasmin (fibrinolysin, a fibrin digesting enzyme
99
Q

Describe factors that limit normal clot growth

A
  • swift removal of clotting factors

- inhibition of activated clotting factors

100
Q

. List the four general types of human blood

A
  1. A
  2. B
  3. AB
  4. O
101
Q

Someone with type O- or O+ blood can donate and receive blood from

A

O- can receive: O-
O+ can receive: O+, O-
donate: to anyone, universal donor

102
Q

Someone with type A- or A+ blood can receive and donate blood to

A

A- can receive: A-, O-
A+ can receive: A+, A-, O+, O-
A- can donate to: A-, A+, AB+, AB-
A+ can donate to: A+, AB+

103
Q

Someone with type B- or B+ blood can receive and donate to

A

B- can receive: B-, O-
B+ can receive: B+, B-, O+, O-
B- can donate to: B-, B+, AB-, AB+
B+ can donate to: B+, AB+

104
Q

Someone with with type AB- or AB+ blood can receive and donate blood to who

A

AB- can receive: AB-, B-, A-, O-
AB+ can receive: AB+, AB-, B+, B-, A+, A-, O+, O- (all blood types)
AB- can donate: AB-, AB+
AB+ can donate: AB+

105
Q

antigen

A
  • agglutinogen

- foreign protein that stimulates white blood cells to make antibodies

106
Q

antibodies

A
  • agglutinins

- immune systems molecules that attack cells with foreign antigens

107
Q

agglutination

A

the clumping together in suspension of antigen-bearing cells, microorganisms, or particles in the presence of specific antibodies

108
Q

Hemolytic Disease of a Newborn

A
  • newborn baby is Rh + and mother is Rh -

- when the mother and the baby blood type does not match, the mother’s antibodies attack the baby.

109
Q

Rh Factor

A

presence, or lack, of antigens on the surface of red blood cells that may cause a reaction between the blood of the mother and the fetus
if your blood has this protein, it is RH+, if not it is (-)

110
Q

warfarin

A
  • used for people prone to atrial fibrillation

- interferes with action of vitamin K

111
Q

heparin

A

anticoagulant used clinically for pre- and postoperative cardiac care

112
Q

venipuncture

A

Inscision into vein with needle to remove venous blood sample

113
Q

arterial puncture

A

puncture of the radial, femoral, or brachial artery with the purpose of obtaining an arterial sample for testing pH, oxygen, carbon dioxide

114
Q

hemophilia

A

a rare, inherited blood disorder in which the blood does not clot normally.

115
Q

leukocytosis

A

increase in the # of leukocytes in blood

116
Q

septicemia

A

Blood poisoning due to the presence of bacteria and/or their toxins in the blood.

117
Q

jaundice

A

A result of liver disease, and it is yellowing of the skin.

118
Q

positive chemotaxis

A

Movement of the leukocyte in the direction of the chemical trail released by damaged cells or other leukocytes

119
Q

universal donor

A
  • Type O blood

- A donor whose RBCs lack the antigens commonly attacked by recipient antibodies

120
Q

universal recipient

A

Type AB (No antibodies in plasma)

121
Q

procoagulants

A
  • involved in the steps for transforming blood from a liquid to a gel
  • helps blood to clot
122
Q

anticoagulants

A
  • dissolve blood clots

- act to prevent blood clots from forming. blood thinners