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Herlihy 15
Blood
| Question | Answer |
|---|---|
| BLOOD | |
| 3 Functions of blood | 1.)transports substances around body; 2.) participates in the regulation of fluid and electrolyte balance, acid-base balance; and body temp, and 3.) blood contains clotting factors that can stop blood loss |
| Parts of blood | Plasma and blood cells |
| Serum | Plasma without the clotting proteins |
| Erythrocytes | red blood cells RBC - primarily involved with transporting oxygen to all body tissues |
| Leukocytes | white blood cells WBC - protect body from infection |
| Thrombocytes | platelets that protect from bleeding |
| Hematocrit | separation of packed cell volume into plasma and blood cells. Normal is 45% cells and 55% plasma. Blood cells are mostly RBC; small layer in between is WBC and platelets called buffy coat |
| Htc - decrease in % can indicate... | anemia - lower than normal RBCs. But the percentage can also change in dehydrated person where % of RBCs goes up relative to plasma-number of RBCs is not less, but blood volume is less so plasma is less |
| Hemopoiesis | blood cell formation |
| 2 types of hemopoietic tissue | red bone morrow and lymphatic system |
| Myeloid hempoiesis | blood formation in the red bone marrow; primarily in ends of long and flat irregular bones-femur, sternum, cranial vertebrae and pelvis |
| How does bone marrow produce 3 different types of blood cells? | Stem cells in marrow differentiates into 3 different blood cells |
| Myelosuppression | bone marrow produces inadequate number of blood cells leading to deficiencies in: RBC-aplastic anemia; platelets; or WBC Can be caused by cancer therapies |
| Aplastic anemia | myelosuppression (bone marrow depression) leads to deficiency in RBCs |
| Leukopenia | deficiency of WBCs (leukocytes) due to myelosuppression (bone marrow depression) leads to leukopenia - open to infection |
| Thrombocytopenia | deficiency in thrombocytes (platelets) from bone marrow depression - risk of hemorrhage |
| Polycythemia vera | over-activity and excess production of blood; increases viscosity of blood burdens heart |
| The patient with polycythemia vera is: | red faced with elevated RBC count, elevated hematocrit and elevated hemoglobin |
| BLOOD CELLS | |
| RED BLOOD CELLS | |
| Erythrocytes | RBCs most numerous, red bone marrow produces several million per second; primarily concerned with transport of oxygen and carbon dioxide |
| Erythropoiesis | production of RBC's (erythrocytes) |
| Reticulocyte | also retics; immature RBCs in blood usually very small. increase could indicate bleeding and bone is being signaled to produce more; decrease could indicate patient unable to produce RBC as in myelosuppression or severe iron deficiency |
| RBC shape and content | large, disk, flexible; no mitochondria, produces ATP anaerobically-without using the oxygen it is carrying; lacks nucleus and DNA-cannot reproduce; old RBCs are removed and replaced |
| Hemoglobin | large protein molecule in RBCs; 2 parts: globin-protein and heme-iron. Oxygen attaches to the iron atom in the heme. Globin transports CO2. |
| Hypoxemia | deficiency of oxygen in blood; cyanosis |
| Necessary for hemoglobin... | iron, B12, folic acid, protein |
| Intrinsic factor | secreted by stomach and necessary for absorption of B12 - |
| Pernicious Anemia | lack of intrinsic factors lead to B12 deficiency - used to be "violent death" now easily treated with B12 |
| Erythropoietin | hormone secreted by kidneys to signal bone marrow to produce more RBCs increases oxygen in tissue |
| Polycythemia | too many RBC's - kidneys detect lack of oxygen (lung disease or high altitude are secondary polycythemias) |
| Athletes, bone-marrow depressed patients, and patients with renal failure increase RBCs with... | EPO erythropoietin |
| Life span of RBC | about 120 days |
| When RBC gets worn and ragged the macrophages in spleen and liver remove them and... | phagocytose them. |
| Hemolytic anemia | hemolysis - RBCs are removed faster than produced; and jaundice from bile that is in excess due to rapid destruction of RBCs |
| WHITE BLOOD CELLS | |
| Production of WBCs is | Leukopoiesis |
| Granulocytes | WBCs with granules. produced in red bone marrow 3 types of granulocytes: neutrophils, basophils and eosinophils |
| Neutrophil | most common granulocyte; most important role is phagocytosis. go to infection to phagocytose pathogens. only last 10-12 hours |
| Neutropenia | deficiency of neutrophils |
| Shift to the left | production so rapid in response to pathogen than neutrophils are immature. |
| Differential white blood count | test to look are %s of different types of white blood cells which helps identify pathogen |
| Basophils | granulocyte that release histamine and anti clot |
| Eosinophils | involved in inflammatory response; destroy certain parasites; elevated in persons with allergies |
| Agranulocytes | WBCs without granules |
| 2 types of agranulocytes | lymphocytes-reproduce in red bone marrow and lymphoid tissue; and monocytes-is phagocytotic-differentiating into fixed and wandering macrophages |
| Names and Classifications of WBCs | Naughty-Neutrophils Little-Lymphocytes Monkeys-Monocytes Eat=Eosinophils Bananas-Basophils says Grandpa - Granulocytes BEN Basophils, Eosinphils, Neutrophils |
| Hemostasis | Stop bleeding |
| 3 events to stop bleeding | Vascular spasm- decreases vessel and therefore blood When torn vessel activates platelets which are sticky and form platelet plug Clotting factors form clot (exercise decreases platelet stickiness and stress increases it) |
| Stages in Clotting | 1. Prothrombin activator PTA activates clotting factors in blood from their inactive form 2. In presence of calcium PTA activates thrombin 3. Thrombin activates fibrinogen fibers which forms a net |