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Chapter 18 A&P
| Question | Answer |
|---|---|
| Functions of the blood (3) | - Transport - Protection - Regulation |
| Transport function of the blood (6) | - O2 - CO2 - nutrients - wastes - hormones - stem cells |
| Protection function of the blood (6) | - Inflammation - reduce infection - destroy microorganisms - cancer cells - neutralize toxins - initiate clotting |
| Regulation function of the blood (3) | - Fluid balance - stabilizes pH of ECF - temperature control |
| Hematology | the study of blood |
| Components and General Properties of blood (2) | - Adults have 4 to 6 L of blood - A liquid connective tissue consisting of cells and extracellular matrix |
| Plasma | matrix of blood |
| Formed elements of blood and examples (4) | - blood cells and cell fragments - red blood cells - white blood cells - platelets |
| Erythrocytes (3) | - heaviest and settle first - 37% to 52% total volume - Hematocrit or PCV (packed cell volume) |
| White blood cells and plateles (2) | - 1% total volume - Buffy coat |
| Plasma components and genral properties (3) | - The remainder of volume - 47% to 63% - liquid portion of blood |
| Three categories of cells (formed elements) | - Erythrocytes (RBC) - Platelets (Cell fragments from megakaryocyte in bone marrow) - Leukocytes (WBC) |
| Leukocyte types divided into two categories | - Granulocytes (with granules) - Agranulocytes (without granules) |
| Granulocytes (3) | - Neutrophils - Eosinophils - Basophils |
| Agranulocytes (2) | - Lymphocytes - Monocytes |
| Serum (2) | - remaining fluid when blood clots and solids are removed - identical to plasma except for the absence of fibrinogen |
| Three major categories of plasma proteins | - Albumins - Globulins - Fibrinogen |
| Plasma proteins are formed by ... except ... | liver immunoglobulins |
| Albumins (2) | - smallest and most abundant - Contribute to viscosity and osmolarity |
| Globulins (2) | - Provide immune system functions - Alpha, beta, and gamma globulins |
| Fibrinogen | Precursor of fibrin threads (blood clot) |
| Nitrogenous compounds (2) | - Free amino acids from dietary protein or tissue breakdown - Nitrogenous wastes (urea) |
| Nutrients in blood plasma (6) | - glucose - vitamins - fats - cholesterol - phospholipids - minerals |
| Viscosity | fluid resistance to flow (thickness) |
| Whole blood is ... times as viscous as water | 4.5 to 5.5 |
| Plasma is ... times as viscous as water | 2.0 |
| Osmolarity of blood | concentration of dissolved particles that cannot pass through the blood vessel wall |
| If osmolarity of blood is too high | blood absorbs too much water, increasing the blood pressure |
| If osmolarity of blood is too low | too much water stays in tissue, blood pressure drops, and edema occurs |
| Optimum osmolarity is achieved by | the body’s regulation of sodium ions, proteins, and red blood cells |
| Hypoproteinemia (4) | - Deficiency of plasma proteins - Extreme starvation - Liver or kidney disease - Severe burns |
| Kwashiorkor (3) | - Children with severe protein deficiency - thin arms and legs - swollen abdomen |
| Adult production of ... platelets, ... RBCs, and ... WBCs every day | 400 billion 100-200 billion 10 billion |
| Hemopoiesis | production of blood, especially its formed elements |
| Pluripotent stem cells (PPSC) | Formerly called hemocytoblasts or hemopoietic stem cells |
| Colony‐forming unit | specialized stem cells only producing one class of formed element of blood |
| Myeloid hemopoiesis | blood formation in the bone marrow |
| Lymphoid hemopoiesis | blood formation in the lymphatic organs (beyond infancy this only involves lymphocytes) |
| Two principal functions of erythrocytes (2) | - Carry oxygen from lungs to cell tissues - Pick up CO2 from tissues and bring to lungs |
| Erythrocytes lack (2) | - mitochondria - nucleus and DNA |
| Each hemoglobin molecule consist of (2) | - four globins - four heme groups |
| globins and what it consist of for adult vs fetal (3) | - Globins bind CO2 - Adult Hb has two alpha and two beta chains - Fetal Hb contains two alpha and two gamma chains |
| Heme groups | Nonprotein moiety that binds O2 to ferrous ion (Fe) at its center |
| RBC count and hemoglobin concentration indicate | amount of O2 blood can carry |
| Hematocrit (packed cell volume) (men vs women) (3) | - percentage of whole blood volume composed of RBCs - Men 42% to 52% cells - women 37% to 48% cells |
| Hemoglobin concentration of whole blood (men vs women) | - Men 13 to 18 g/dL - Women 12 to 16 g/dL |
| RBC count (men vs women) | - Men 4.6 to 6.2 million/μL - Women 4.2 to 5.4 million/μL |
| Erythropoiesis | RBC production |
| How many RBCs are produced per second? | 1 million |
| Erythropoiesis lifespan | 120 days |
| how long does erythropoiesis take to develop | 3 to 5 days |
| Erythrocyte Production (4 steps) | 1) Hemopoietic stem cell 2) Colony forming unit (Erythrocyte CFU) 3) Precursor cells (Erythroblast and Reticulocyte) 4) Mature cells (erythrocyte) |
| Iron Metabolism ( first 4 steps) | 1) Mix of Fe^2+ and Fe^3+ ingested 2) Stomach acid turns Fe^3+ to Fe^2+ 3)Fe2^+ binds to gastroferritin 4) Gastroferritin transports Fe^2 + to small intestine and releases it for absorption |
| Iron Metabolism (last 4 steps) | 5) In blood plasma, Fe^2+ binds to transferrin 6) In liver, some transferrin releases Fe^2+ for storage 7) Fe2^+ binds to apoferritin to be stored as ferritin 8) Remaining transferrin is distributed to other organs |
| What does RBCs do in erythrocyte death and dispoal? | RBCs rupture (hemolysis) in narrow channels of spleen and liver |
| What does macrophages in spleen do in erythrocyte death and dispoal? (2) | - Digest membrane bits - Separate heme from globin |
| When macrophaes in spleen separate heme from globin what happens? (2) | - Globins hydrolyzed into amino acids - Iron removed from heme |
| When iron is removed from heme what happens (4) | 1) Heme pigment converted to biliverdin (green) 2) Biliverdin converted to bilirubin (yellow) 3) Released into blood plasma (kidneys—yellow urine) 4) Liver removes bilirubin and secretes into bile |
| When bilirubin is concentrated in gallbladder... (2) | - released into small intestine - bacteria create urobilinogen (brown feces) |
| Polycythemia | an excess of RBCs |
| types of polycythemia (2) | - Primary polycythemia - Secondary polycythemia |
| Primary polycythemia | Cancer of erythropoietic cell line in red bone marrow |
| Secondary polycythemia | From dehydration, emphysema, high altitude, or physical conditioning |
| Dangers of polycythemia (2) | - Increased blood volume, pressure, viscosity - Can lead to embolism, stroke, or heart failure |
| Causes of anemia (3) | - Inadequate erythropoiesis or hemoglobin synthesis - Hemorrhagic anemias from bleeding - Hemolytic anemias from RBC destruction |
| Inadequate erythropoiesis or hemoglobin synthesis is caused by (5) | - kidney failure and insufficient erythropoietin - iron-deficiency anemia - Pernicious anemia - Hypoplastic anemia - Aplastic anemia |
| Pernicious anemia | autoimmune attack of stomach tissue leads to inadequate vitamin B12 absorption |
| Hypoplastic anemia | slowing of erythropoiesis |
| Aplastic anemia | complete cessation of erythropoiesis |
| RBC antigens called | agglutinogens |
| Types of RBC antigens and how are they determined | - Called antigen A and B - Determined by glycolipids on RBC surface |
| Antibodies called | agglutinins |
| Agglutinins location and types | - Found in plasma - Anti A and anti B |
| The ABO group and when does it appear | - Antibodies (agglutinins); anti-A and anti-B - Appear 2 to 8 months after birth; max concentration by 10 years of age |
| Antibody-A or antibody-B (or both or neither) are found in | plasma |
| Do you form antibodies against your antigens? | no |
| The ABO group causes | Agglutination |
| Agglutination | Each antibody can attach to several foreign antigens on several different RBCs at the same time |
| The ABO group is responsible for | mismatched transfusion reaction |
| Universal donor (3) | - Type O: most common - Lacks RBC antigens - Donor's plasma may have both antibodies against recipient's RBCs ( Anti-A and Anti-B) |
| Universal recipient (2) | - Type AB: rarest blood type - Lacks plasma antibodies; no Anti-A or Anti-B |
| Rh (C, D, E) agglutinogens discovered in | rhesus monkey in 1940 |
| Rh D is the most | reactive |
| for Rh D, a pateint is considered blood type | Rh+ if having D antigen (agglutinogens) on RBCs |
| Rh frequencies vary among | ethnic groups |
| Which agglutinins are not normally present | Anti-D |
| Anti-D agglutinins are formed in | Rh- individuals exposed to Rh+ blood eg. Rh− woman with an Rh+ fetus or transfusion of Rh+ blood |
| Hemolytic disease of the newborn (HDN) can occur | if Rh- mother has formed antibodies and is pregnant with second Rh+ child |
| Anti- D antibodies can cross | placenta |
| Prevention of Hemolytic disease of the Newborn | RhoGAM given to pregnant Rh− women so she will not form anti-D antibodies |
| WBC are the ... abundant formed element | least ( 5,000 to 10,000 WBCs/uL) |
| WBC protect against | infectious microorganisms and other pathogens |
| WBC have a ..., nucleus | Conspicuous/visible |
| WBCs spend only a few hours in the | bloodstream before migrating to connective tissue |
| WBCs retain their organelles for | protein synthesis |
| All WBCs have lysosomes called | nonspecific (azurophilic) granules |
| Granulocytes (some WBCs) have specific granules that contain | enzymes and other chemicals employed in defense against pathogens |
| Types of leukocytes (2) | - Granulocytes (contain granules - Arganulocytes (Lack prominent granules) |
| Types of Granulocytes (3) | - Neutrophils ( 60% to 70%) - Eosinophils (2% to 4%) - Basophils (less than 1%) |
| Neutrophils (3) | - barley visible; three to five lobed nucleus - aggressively antibacterial - Neutrophilia |
| Neutrophilia | rise in number of neutrophils in response to bacterial infection |
| Eosinophils (4) | - Large rosy-orange granules; bilobed nucleus - increased numbers in parasitic infections, collagen diseases, allergies, diseases of spleen and CNS - phagocytosis of antigen - Release enzymes to destroy large parasites |
| Basophils (4) | - Large, abundant, violet granules - increased numbers in allergies - secrete histamine (vasodilator) - secrete Heparin (anticoagulant) |
| vasodilator | speeds flow of blood to an injured area |
| anticoagulant | promotes the mobility of other WBCs in the area |
| Types of Agranulocytes (2) | - Lymphocytes (25% to 33%) - Monocytes (3% to 8%) |
| Lymphocytes (3) | - Variable amounts of bluish cytoplasm (scanty to abundant) -Ovoid/round, uniform dark violet nucleus - increased numbers in diverse infections and immune responses |
| Monocytes (3) | - Usually largest WBC - Ovoid, kidney-, or horseshoe-shaped nucleus - increased numbers in chronic infections and inflammation |
| Lymphocytes functions (4) | - Destroy cells - "Present" antigens to activate other immune cells - Coordinate actions of other immune cells - Secrete antibodies and provide immune memory |
| Monocytes fucntions (3) | - Leave bloodstream and transform into macrophages - Phagocytize pathogens and debris - "Present" antigens to activate other immune cells - antigen-presenting cells (APCs) |
| Leukopenia | low WBC count: below 5,000 WBCs/μL |
| Cause and Effects of Leukopenia | Causes: Radiation, poisons, infectious disease Effects: elevated risk of infection |
| Leukocytosis | high WBC count: above 10,000 WBCs/μL |
| Cause and Differential WBC count of Leukocytosis | Causes: infection, allergy, disease Differential WBC count: identifies what percentage of the total WBC count consist of each type of leukocyte |
| Leukemia | cancer of hemopoietic tissue usually producing a very high number of circulating leukocytes |
| Myeloid leukemia | uncontrolled granulocyte production |
| Lymphoid leukemia | uncontrolled lymphocyte or monocyte production |
| Acute leukemia | appears suddenly, progresses rapidly, death within months |
| Chronic leukemia | undetected for months, survival time 3 years |
| Effetcs of leukemia (3) | - normal cell percentages disrupted - impaired clotting - opportunistic infections |
| Values of a complete blood count (5) | - Hematocrit - Hemoglobin concentration - Total count for RBCs, reticulocytes, WBCs, and platelets - Differential WBC count - RBC size and hemoglobin concentration per RBC |
| Hemostasis (3) | - The cessation/ending of bleeding - Stopping fatal leaks - Hemorrhage |
| Hemorrhage | excessive bleeding |
| Three hemostatic mechanisms | - Vascular spasm - Platelet plug formation - Blood clotting (coagulation) |
| Platelets | small fragments of megakaryocyte cells |
| Platelet contains a complex | internal structure and an open canalicular system |
| Normal platelet count | 130,000 to 400,000 platelets/μL |
| Platelet functions (6) | - secrete vasocontrictors= reduce blood loss - form platelet plugs - secrete procoagulants/clotting factors - attract neutrophils and monocytes to inflammation - phagocytize/destroy bacteria - growth factors = repair blood vessels |
| Vascular spasm | - prompt constriction of a broken vessel - most immediate protection agaisnt blood loss |
| Cause and Effects of vascular spasm | Cause: pain receptors, smooth muscle injury and platelets release serotonin (vasoconstrictor) Effects: prompt constriction of a broken vessel and provides time for other two clotting pathways |
| Pain receptors of vascular spasm | some directly innervate blood vessels to constrict |
| Prompt constriction of a broken vessel in vascular spasm (2) | - Pain receptors - short duration (minutes) - Smooth muscle injury - longer duration |
| For platelet plug formation, intact vessels have a | smooth endothelium coated with prostacyclin—a platelet repellant |
| For platelet plug formation, broken vessels exposes | collagen |
| For platelet plug formation, platelet pseudopods stick to | damaged vessel and other platelets |
| For platelet plug formation, pseudopods contract | a platelet plug |
| For platelet plug formation, platelets degranulate releasing | a variety of substances |
| For platelet plug formation, serotonin is a | vasoconstrictor |
| For platelet plug formation, ADP | attracts and degranulates more platelets |
| For platelet plug formation, Thromboxane A2, an eicosanoid... | promotes platelet aggregation, degranulation, and vasoconstriction |
| For platelet plug formation, positive feedback cycle is | active until break in small vessel is sealed |
| Coagulation (clotting) | last and most effective defense against bleeding |
| Coagulation converts | plasma protein fibrinogen into insoluble fibrin threads to form framework of clot |
| Procoagulants (clotting factors) (2) | - usually produced by the liver - Are present in plasma |
| Extrinsic pathway | Factors released by damaged tissues begin cascade (outside blood) |
| Intrinsic pathway | Factors found in blood begin cascade (platelet degranulation) |
| Extrinsic pathway steps (4) | 1) Tissue Damage 2) Tissue Factor (TF) 3) VIIa by Ca 4) TF + VIIa by Ca |
| Intrinsic pathway steps (6) | 1) Collagen exposed 2) XIIa 3) XIa 4) IXa by Ca 5) VIIIa by Ca/PF 6) IXa + VIIIa by Ca/PF |
| Common pathway | where intrinsic and extrinic pathways converge |
| Common pathway steps (7) | 1) Xa 2) Va Ca/PF 3) Prothrombin activates Thrombin with Ca/Prothrombinase 4) Fibrinogen 5) Fibrin 6) Cross linked fibrin 7) thrombin also activates XII |
| Clot retraction occurs within | 30 minutes |
| Platelet-derived growth factor secreted by (2) | - platelets and endothelial cells - Mitotic stimulant for fibroblasts and smooth muscle to multiply and repair damaged vessel |
| Fibrinolysis | dissolution of a clot |
| Factor XII speeds up formation of | kallikrein enzyme |
| Kallikrein converts | plasminogen into plasmin, a fibrin-dissolving enzyme that breaks up the clot |
| Prevention of platelet repulsion | Platelets do not adhere to prostacyclin-coated endothelium |
| Prevention of thrombin dilution | By rapidly flowing blood |
| Prevention of natural anticoagulants (2) | - Heparin (from basophils and mast cells) interferes with formation of prothrombin activator – Antithrombin (from liver) deactivates thrombin before it can act on fibrinogen |
| Deficiency of any clotting factor can | shut down the coagulation cascade |
| Hemophilia | family of hereditary diseases characterized by deficiencies of one factor or another |
| Sex-linked recessive (on X chromosome) (2) | - Hemophilia A missing factor VIII (83% of cases) - Hemophilia B missing factor IX (15% of cases) |
| Hemophilia C missing | factor XI (autosomal) |
| Thrombosis | abnormal clotting in unbroken vessel |
| Thrombus | clot |
| Pulmonary embolism | clot may break free, travel from veins to lungs |
| Embolus | anything that can travel in the blood and block blood vessels |
| Infarction (tissue death) may occur | if clot blocks blood supply to an organ (MI or stroke) |
| What is required for formation of clotting factors | Vitamin K |
| What are the types of vitamin K antagonists | - Coumarin - warfarin (Coumadin) - heparin |
| Aspirin suppresses | thromboxane A2 |
| Other anticoagulants discovered in animal research (2) | - Medicinal leeches used since 1884 (hirudin) - Snake venom from vipers (arvin) |
| Dissolving clots that have already formed (3) | - strepokinase - Tissue plasminogen activator - Hementin |
| Streptokinase | enzyme made by streptococci bacteria |
| Tissue plasminogen activator (TPA) | works faster, is more specific, and now made by transgenic bacteria |
| Hementin | produced by giant Amazon leech |
Created by:
JessicaKim1230