Exam 14: Intro to Blood & Lymphatics
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| Characteristics of blood: Contains | (1) Blood is a viscous red fluid which contains, red blood cells, white blood cells and platelets which are suspended in a light yellow fluid called plasma.
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| Characteristics of blood: Volume | (2) Plasma constitutes 55% of blood volume. Remaining 45% is RBC, WBC, and platelets.
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| Characteristics of blood: Acidity | Blood is slightly alkaline pH of 7.35-7.45.
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| Characteristics of blood: Average Volume (adult) | 5-6 liters
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| Functions of blood: Oxygen & Nutrients | Transports oxygen and nutrients to cells and waste products away from cells, and transports hormones from the endocrine glands to the tissue and cells.
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| Functions of blood: Fluid and Electrolytes | Regulates the acid-base balance with buffers, aids in control of body temperature (due to high water content), and controls water content of cells based on sodium concentrations.
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| Functions of blood: Infection | Protects the body against infection with leukocytes and prevents blood loss with the clotting mechanism.
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| Red Blood Cells- Erythrocytes: Contains | cytoplasm and hemoglobin.
compound in the blood that transports oxygen and carbon dioxide
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| Red Blood Cells- Erythrocytes: Production | Produced in the red bone marrow through erythropoiesis.
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| Normal Hemoglobin levels: | Men: 14-18 g/dl.
Women: 12-16 g/dl.
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| Erythropoiesis | the process of RBC production
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| hematocrit | a measure of the packed cell volume of red blood cells, expressed as percentages of the total blood volume.
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| Leukocytes (WBC): Purpose | Conduct body defense from foreign invaders- can leave blood stream to fight foreign invaders such as bacteria.
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| Leukocytes (WBC): Production | Produced in bone marrow
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| Leukocytes (WBC): 2 Broad Categories | granulocytes and nongranulocytes.
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| differential white blood cell count | examination in which the different kinds of WBC’s are counted and reported as percentages of the total examined.
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| Granulocytes: 3 types | neutrophils, eosinophils and basophils
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| phagocytosis | process by which bacteria, cellular debris, and solid particles are destroyed and removed; "eat" invaders
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| Neutrophils: Volume | make up 70% of WBC
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| Neutrophils: Purpose | Ingest bacteria and dispose of dead tissue – a mature neutrophil is called a segmental neutrophil or “seg” because nucleases is segmented.
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| Eosinophils: Purpose | Key in allergic responses.
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| Basophils: Purpose | a) Key in the non-specific immune response, seen in allergic and inflammatory reactions.
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| Nongranulocytes: 2 Types | Monocytes & Lymphocytes
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| Monocytes | WBCs that circulate in the blood stream and work similarly to neutrophils.
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| Monocytes: Purpose | Second type of WBC that arrives at the scene of an injury.
Move into the tissue, where they engulf foreign antigens and cell debris.
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| Lymphocytes | are white blood cells that form antibody, a special protein that combats foreign invaders or antigens. Lymphocytes are broken down into two groups T cells and B cells that directly kill invaders and produce antibodies.
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| Thrombocytes (Platelets): Production | Produced in the red bone marrow.
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| Thrombocytes (Platelets): Purpose | Assist in clotting formation
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| Thrombocytes (Platelets): Normal value | 150,000-400,000 per mm3 of blood.
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| Hemostasis | Body process that stops flow of blood and prevent hemorrhage.
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| Hemostasis: Three actions | 1) Vessel spasm.
2) Platelet plug formation.
3) Clot formation.
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| Blood types: determined | determined by the presence or absence of specific antigens on the outer surface of the RBC’s.
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| ABO typing system: types | Type A.
Type B.
Type AB-Universal recipient.
Type O- Universal Donor
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| Rh Factor: Rh Positive | If located on the surface of the RBC’s
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| Rh Factor: Rh Negative | People who do not have Rh factor
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| Lymphatic System: Description | Subdivision of the cardiovascular system- Consists of lymphatic vessels, lymph fluid and lymph tissue.
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| Lymphatic System: Functions | (a) Maintain fluid balance.
(b) Produce (mature) lymphocytes (WBC produced in the bone marrow but matured in lymph tissue).
(c) Absorption and transportation of lipids from the intestine to the stream.
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| Lymph fluid: Formed | (b) Fluid is formed in the tissue spaces and transported via the lymphatic system to eventually reenter the circulatory system
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| Lymph Fluid: Without Drainage | volume overload in tissues would occur
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| Lymphatic vessels: Description | Vessels that connect lymph nodes and collect lymph fluid
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| Lymphatic Vessels: Purpose | Connected to the circulatory system for return of lymph fluid to blood.
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| Lymph tissue: Types | Lymph Nodes.
Tonsils.
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| Lymph Nodes (glands): Two Functions | a) Filter impurities from the lymph.
b) Produce lymphocytes (T cell and B cells).
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| Lymph Nodes: Locations | The body contains 500-600 lymph nodes- most numerous in axilla, groin, abdomen, thorax, and cervical regions.
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| Tonsils: Purpose | 1) Protect the body against invasion.
2) Produce lymphocytes and antibodies.
3) Trap bacteria and may become enlarged.
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| Spleen: location | Located in left upper quadrant, just below the diaphragm - highly vascular
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| Spleen: Functions | 1) Serves as a reservoir for blood. Stores approximately 500 ml.
2) Matures lymphocytes, monocytes and plasma cells (B cells).
3) Destroys worn-out RBCs.
4) Removes bacteria by phagocytosis (engulfing and digesting).
5) Produce RBCs before birth.
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| Thymus: Location | Located between the lungs in the mediastinum
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| Thymus: Function | (c) Responsible for the development of T cells for the cell mediated immune response before they migrate to the lymph nodes and the spleen.
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| Thymus: Fun Facts | (b) Functions in utero and for several months after birth to develop the immune system.
The thymus atrophies at puberty.
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| Blood and Lymph Diagnostic Tests | CBC. Erythrocyte Indices. Differential Count. Peripheral Smear. Schilling Test & Anemia Profile. Gastric Analysis. Lymphangiography. Bone Marrow Aspiration or Biopsy.
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| Complete Blood Count (CBC): Function | (a) Detects many disorders of the hematological system and provides data for the diagnosis and evaluation of disorders in other body systems.
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| Complete Blood Count (CBC): Includes | (b) Includes red and white cell counts, hematocrit and hemoglobin level, erythrocyte (RBC) indices, differential white cell count, and examination of the peripheral blood cells.
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| Erythrocyte Indices (Red Cell Indexes): Function | Measurements of the size and hemoglobin content of erythrocytes.
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| Erythrocyte Indices (Red Cell Indexes): Includes | Mean corpuscular volume (MCV).
Mean corpuscular hemoglobin (MCH).
Mean corpuscular hemoglobin concentration (MCHC).
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| Mean corpuscular volume (MCV) | the average volume or size of a single RBC.
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| Mean corpuscular hemoglobin (MCH) | the average amount of (weight) hemoglobin within an RBC.
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| Mean corpuscular hemoglobin concentration (MCHC) | the average concentration or the percentage of hemoglobin within an RBC.
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| Differential Count: Description | Actual cell count of leukocytes.
Identifies the number and percentage of individual types, i.e., neutrophils, basophils, eosinophils, monocytes and macrophages.
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| Peripheral Smear | (a) Often accompanies the differential WBC count and permits examination of the size, shape, and structure of individual RBCs, WBCs and platelets.
(b) Most informative of all hematologic tests.
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| Schilling Test and Megaloblastic Anemia Profile: Description | Laboratory test that identifies the etiology of pernicious anemia (vitamin B12 deficiency).
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| Schilling Test and Megaloblastic Anemia Profile: Purpose | (c) The test measures absorption in the stomach radioactive vitamin B12 which is dependent on intrinsic factor, produced by the gastric mucosa (secreted by parietal cells, which also secrete HCI acid).
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| Gastric Analysis: Purpose | Evaluates presence of intrinsic factor.
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| Gastric Analysis: Fun Fact | In pernicious anemia the gastric secretions are minimal and the pH remains elevated, after injection of histamine (histamine injection should cause an increased HCL acid secretion if parietal cells are functioning properly).
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| Radiologic studies: Involves | Involve primarily computed tomography (CT) or magnetic resonance imaging (MRI) for evaluating the spleen, liver or lymph nodes.
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| Bone marrow aspiration or biopsy: Piurpose | specific for establishing the diagnosis and for treatment response. Used when diagnosis is not clearly established by peripheral blood smears or when further information is needed.
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| Bone marrow aspiration or biopsy: Most Common Spot Used | b) Iliac crest most commonly used, although the sternum can also be used
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| Bone marrow aspiration or biopsy: Most Commonly Performed on | persons with marked anemia, neutropenia, acute leukemia, and thrombocytopenia.
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