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created 7 years ago by ines
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pages 634 -660

updated 6 years ago by ines

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1

what kind of tissue is blood?

connective tissue

2

what are the two components of blood

plasma and formed elements

3

what are the formed elements in blood

erythrocytes, leukocytes and thrombocytes

4

what are erythorocytes

red blood cells or RBC's

5

what are leukocytes

white blood cells or WBC's

6

what are thrombocytes

platelets

7

hematocrit

the percentage of blood volume that is red blood cells 47%(+ or -) for males and 42%(+ or -) for females

8

what are the physical characteristics of blood

sticky, opaque fluid
color is scarlet to dark red
pH is 7.35 to 7.45
38 degrees C
8 % of body weight
average vol 5-6 liters for males and 4-5 liters for females

9

one of the functions of blood is distribution explain

distributes oxygen and nutrients to body cels
distributes metabolic wastes to the lungs and kidneys for elimination
distributes hormones from the endocrine organs to target organs

10

one of the functions of blood is regulation explain

regulates body temperature by absorbing and distributing heat
regulates normal pH using buffers
regulates adequate fluid volume in the circulatory system

11

what is the most important regulatory function of the blood

regulating body temperature

12

one of the functions of blood is protection explain

protects against blood loss - plasma proteins and platelets initiate clot formation
protects against infection - antibodies, complement proteins and WBC's defend against forgien invaders

13

what is one area where blood doesnt go

cartilage

14

what is blood plasma composed of

90% water, proteins, nutrients, electrolytes, respiratory gases, hormones, and nitrogenous by products of metabolism

15

blood plasma - where are most of the proteins produced, what are the proteins,and what role do they play

mostly produced by the liver
60% albumin - main contributor of osmotic pressure (most important)
36% globulins - antibodies, transport proteins
4% fibrinogen - blood clotting proteins

16

what are the nitrogenous by products of metabolism in blood plasma

lactic acid, urea, creatine

17

what nutrients are found in blood plasma

glucose, carbohydrates, amino acids

18

what are the electrolytes found in blood plasma

Na K Ca Cl and HCO

19

respiratory gases found in blood

oxygen and carbon dioxide

20

which blood cells are the only complete blood cells and why

White blood cells - because they contain a nucleus

21

which blood cells contain no nuclei or organelles

red blood cells

22

platelets are considered what

cell fragments

23

how long do most formed elements survive in the blood stream

only a few days

24

where do most blood cells originate

bone marrow - and dont divide

25

describe an erythrocyte

red blood cell, biconcave discs, anucleate (no nucleus) essentially no organelles, filled with hemoglobin, are the major contributing factor to blood viscosity

26

why does a RBC have a biconcave shape

to give it a huge surface area relative to volume

27

an RBC has no mitochondia so how does it produce ATP

ATP production is anaerobic - which means no oxygen is used to generate ATP, and they are not consuming any of the oxygen that they are carrying

28

what fills a RBC

97% hemoglobin - for gas transport

29

where can you find spectrin and what is its function

on the cytoplasmic face of the plasma membrane - it gives the RCS the flexibility to change shape as necessary as it passes through capilaries and then to resume its biconcave shape.

30

what is the job of RBC's

to transport respiratory gases - oxygen and carbon dioxide

31

what is the job of hemoglobin and what is it made up of

to bind oxygen to the RBC (also what makes RBC's red)
made up of the protein globin, (which is made up of four polypeptide chains, two alpha chains and two beta chains) and the red pigment heme

32

oxygemoglobin

oxygen loading in the lungs - (ruby red)

33

deoxyhemoglobin

unloading of oxygen in the tissues - reduced hemoglobin (dark red)

34

carbminohemoglobin

carbon dioxide unloading in the tissues (carries 20% of carbon dioxide in the blood) occurs from tissues to lungs where carbondioxide is eliminated from the body

35

what is hematopoiesis

hema - blood poiesis - to produce
process in which blood cells are produced -occurs in the red bone marrow of the axial skeleton, girdles and proximal epiphyses of humerus and femur

36

where can 75% of bicarbonate be found

in the plasma

37

explain what hemocytoblasts are

stem cells, give rise to all formed elements

38

97% of oxgen is carried by the RBC's what happens to the rest of it

the rest is disolved as a gas in the blood

39

CO2 is converted to what? the rest is converted to what?

HCO3
carried as carbaminohemoglobin, and the rest is disolved as gas

40

what happens when carbondioxide binds to hemoglobin

it gets rid of the oxygen

41

what does the heme portion of the blood carry

iron

42

erythropoieses

the process of red blood cell production happens in the red bone marrow

43

explain the process of erythropoiesis

begins with the stem cell(hemocytoblast), hormones (erythropoitein EPO)circulating in the blood stream stimulate the cell to become a committed cell, the cell then beomes a proerythroblast at that time huge amounts of ribosomes are produced, next comes phase 1 (early erythroblast) ribosome sythesis occurs then phase 2 (late erythroblast) hemoglobin is sythesized and iron accumulates within the cell, it then becomes a normoblast, when most of the hemoglobin has accumulated the organelles are ejected. phase 3 the nuclear functions end and the nucleus degenerates and is ejectedwhich causes the cell to colapse giving it the biconcave shape resulting in a reticulocyte.

44

how long does the process of erythropoiesis take

about 15 days

45

what happens if you dont have enough RBC's

leads to tissue hypoxia - inadequate oxygen supply to the tissues

46

what happens if you have too many RBC's

an increase in blood viscosity

47

the balance between RBC production and destruction depends on what

hormonal controls and adequate supplies of iron, amino acids and B vitamins

48

describe the erythropoietin EPO process

1. stimulus - hypoxia(low blood O2 carrying ability) decreased RBC count, decreased hemoglobin, decreased availibility of oxygen
2.kidney (liver) releases EPO
3. EPO stimulates the red bone marrow
4. enhanced erythropoiesis increases RBC count
5.O2 carrying ability of blood increases

49

what is erythropoietin EPO

a glocoprotein hormone which directly stimulates erythropoiesis, which is released by the kidneys in response to hypoxia

50

what are causes of hypoxia

hemorrage or increased RBC destruction, insuficient hemoglobin (iron deficiency) and reduced availability of oxygen (high altitudes)

51

what are the effects of EPO

more rapid maturation of committe bone marrow cells
increased circulating reticulocyte count

52

what also enhances EPO production leading to higher RBC counts in males

testosterone

53

what is the hematocrit? what is its normal value

the percentage of blood that is occupied by erythrocytes - it is normally about 45%

54

list two protective funcions of blood

formation of clots - to prevent blood loss
prevent infection - because of antimicrobial proteins

55

are plasma proteins used as fuel for body cells - explain

no their presence in the blood is required to perform many key functions

56

Differentiate into macrophages

Monocyte

57

Form a temporary plug at the site of bleeding

Platelets

58

what are some of the, dietary requirements required for erythropoiesis

amino acids, lipids, and carbohydrates
iron and vitamin B12 and folic acid

59

Where / how is iron stored and transported

65% is stored in the hemoglobin,also in the liver, spleen, and bone marrow
it is stored in cells as ferritin and hemosiderin and transported by transferrin

60

what is Vitamin B12 and folic acid necessary for

DNA synthesis and cell division

61

what is the lifespan of a RBC

100 to 120 days

62

what is the life cycle of a red blood cell

1. low O2 levels in blood stimulate kidneys to produce EPO
2.EPO levels rise in blood
3. EPO and necessary raw materials in blood promote erythropoiesis in red bone marrow
4 new RBC's ente rthe blood stream and function for about 120 days
5. aged and damaged RBC's are engulfed by macropahges of liver, spleen, and bone marrow- the hemoglobin is broken down
6 raw amterials are made available in blood for erythrocyte synthesis

63

what happens to hemoglobin once it is broken down

the heme and the globin are seperated
iron is salvaged for reuse
heme is degraded to the yellow pigment billirubin
- liver secretes bilirubin (in bile) into the intestines
- degraded pigment leaves the body in feces as stercobilin
- globin is metabolized into amino acids

64

what are some erythrocyte disorders

anemia and polycythemia

65

what is anemia

when blood has abnormally low oxygen carrying capacity - its a sign rather than a disease, blood oxygen levels cant support normal metaboolism, accompanied by fatigue, paleness, shortness of breath and chills

66

what are some causes of anemia

1. insufficient erythrocytes
2. low hemoglobin content
3. abnormal hemoglobin

67

describe insufficient erythrocytes

1. hemorrhagic anemias
2. hemolytic anemias
3. aplastic anemias

68

describe hemorrhagic anemias

acute or chronic blood loss

69

describe hemolytic anemias

RBC's rupture prematurely

70

describe aplastic anemias

destruction or inhibition of red bone marrow

71

describe low hemoglobin content

1. iron deficiency anemia
2. prenicious anemia

72

describe iron deficiency anemia

secondary result of hemmorrhagic anemia or inadequate intake of iron-containing foods or impaired iron absorption

73

describe prenicious anemia

deficiency of vitamin B12
lack of intrinsic factor needed for absorption of B12
treated by intramuscular injection of B12 or application of nascobal

74

describe abnormal hemoglobin

1. thalassemias
2. sickle-cell anemia

75

describe thalassemias

absent or faulty globin chain
RBC's are thin, delicate, and deficient in hemoglobin

76

describe sickle-cell anemia

defective gene codes for abnormal hemoglobin (HbS)
causes RBC's to become sickle shaped in low-oxygen situations

77

aplastic

from the start

78

hemmorrhagic

older

79

how many molecules of oxygen can each hemoglobin molecule transport? what part of hemoglobin binds the oxygen?

each hemoglobin molecule can transport four O2
the heme portion of the hemoglobin binds the O2

80

patients with advanced kidney disease often have anemia - explain the connection

the kidneys synthesis of erythropoietin is compromised in advancded kidney disease
RBC production decreases causing anemia

81

what is polycythemia and what does it result from

an excess of RBC's that increases blood viscosity
polycythemia vera- bone marrow cancer
secondary polycythemia - when less oxygen is available (high altitudes) or when less EPO is produced
blood doping

82

what is blood doping

the practice of boosting the number of red blood cells (RBCs) in the bloodstream in order to enhance athletic performance.

83
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red blood cell
description: biconcave, anucleate disc, salmon colored, diameter of 7-8 μm
cells/μL(mm3) of blood: 4-6 million
duration of development: about 15 days
life span: 100- 120 days
function: transport oxygen and carbon dioxide

84

leukocytes

white blood cells
make up over 1% of total blood volume
spherical, nucleated cells
can leave capiliaries via diapedesis

85

diapedesis

The migration of blood cells (especially leucocytes) through the intact walls of blood vessels into the surrounding tissue
(powerpoint def- move through tissue spaces by ameboid motion and positive chemotaxis{positively moving out to tissue to get something it needs})

86

what is leukocytosis

when the WBC count is over 11,000/mm3 - normal response to a viral invasion

87

granulocytes

neutrophil
eosinophil
basophil
these cells are larger than RBS's and have shorter lives
contain a lobed nuclei
are phagocytic - bacteria slayers

88

formation of neutrophils

leukocytes arise from ancestral stem celss called hemocytoblats
committed cell stage: granular leukocytes develop via a sequence involving myeloblasts
developmental pathway: promyelocyte to neutrophilic myelocyte to neutrophilic band cells and finally as neutrophils

89
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neutrophil
description: nucleus multilobed; contain fine granules that take up both acidic and basic dyes, give the cytopasm a lilac color, granules contain hydrolytic enzymes and defensins, diameter of 10-12 μm
cells/μL(mm3) of blood: 3000- 7000
duration of development: about 14 days
life span: 6 hours to a few days
function: phagocytize bacteria

90

formation of eosinophil

leukocytes arise from ancestral stem celss called hemocytoblats
committed cell stage: granular leukocytes develop via a sequence involving myeloblasts
developmental pathway: promyelocyte to eosinophilic myelocyte to eosinophilic band cells and finally as eosinophils

91
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eosinophil
description:red staining bilobed nuclei, red to crimson(acidophillic) coarse, lysosome-like granules 10-12 μm
cells/μL(mm3) of blood: 100-400
duration of development: about 14 days
life span: 5 days
function: kill parasitic worms - complex role in alergy and asthma, modulators of the immune response

92

formation of basophil

leukocytes arise from ancestral stem celss called hemocytoblats
committed cell stage: granular leukocytes develop via a sequence involving myeloblasts
developmental pathway: promyelocyte to basophilic myelocyte to basophilic band cells and finally as basophils

93
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basophil - rarest WBC
description: large puplish-black (basophilic) granules containing histamine 10-14 μm
cells/μL(mm3) of blood: 20-50
duration of development: about 1-7 days
life span: a few hours to a few days
function: release histamineand other mediatorsof inflammation, contain heperin (an anticoagulant) are functionally similar to mast cells

94

histamine

an inflammitory chemical that acts as a vasodilator and attracts other WBC's to inflammed sites

95

agranulocytes

lymphocytes and monocytes
lack visible cytoplasmic granule
have spherical or kidney shaped nuclei

96

lymphocyte formation

leukocytes arise from ancestral stem cells called hemocytoblats
committed cell stage:only lymphocytes arise via the lymphoid stem cell line lymphoid stem cell becomes lymphoblast
developmental pathway: the lymphoblast becomes a prolymphocyte then a lymphocyte some them become plasma cells

97
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lymphocyte
description: large dark purple, circular nuclei with a thin rim of blue cytoplasmmostly in lymphoid tissue, few circulate in the blood 5-17 μm
cells/μL(mm3) of blood: 1500-3000
duration of development: days to weeks
life span:hours to years
function: mount immune response by direct cell attack or via antibodies

98

how many types of lymphocytes are there and what do they do

there are 2 types
T cells - act against virus infected cells and tumor cells
B cells - give rise to plasma cells, which produce antibodies

99

monocyte formation

leukocytes arise from ancestral stem celss called hemocytoblats
committed cell stage: monocytes like granular leukocytes, are progeny of the myeloid stem cell and share a common precursor with neutrophils
developmental pathway: promonocyte to monocytes - some become macrophages (tissue

100
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monocyte - the largest leukocyte
description: abundant pale blue cytoplasm, dark purple staining U or kidney shaped nuclei 14-24 μm
cells/μL(mm3) of blood: 100-700
duration of development: 2 to 3 days
life span: months
function: phagocytosis- crucial against viruses,intracellular bacterial parasites and chronic infections- activate lymphocytes to mount an immune response; leave circulation and develop into microphages in the tissues

101

leukopoiesis

production of white blood cells
stimulated by chemical messengers from bone marrow and mature white blood cells
interleukins - dictators
all leukocytes originate from hemocytoblasts

102

leukocyte disorders include what

leukopenia - abnormally low WBC count - drug induced
leukemia - cancerous condition involving WBC's (named so because of the abnormal WBC clone involved)

103

what sort of cells are involved in acute leukemia? who is primarily affected by this disease

blast type cells
children

104

leukemia

bone marrow totally occupied with cancerous leukocytes, immature nonfunctional WBC's in the bloodstream, death is caused by internal hemorrhage ans overwhelming infections, treatments include irradiation, antileukemic drugs, and stem cell transplants

105

cases of chronic leukemia more prevelant in what age group

older people

106
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thrombocytes - platelets
description: small fragments of megakaryocytes formation of thrombopoietin, blue staining outer region, purple granules 2-4μm
cells/μL(mm3) of blood: 150,000- 400,000
duration of development: 4 to 5 days
life span: 5 to 10 days
function: seal small tears in blood vessels instrumental in blood clotting
circulating platelets are kept inactive and mobile by NO and prostacyclin from endothelial cells of blood vessels

107

which WBC's turn into macrophages in tissues? which other WBC is a voracious phagocyte?

noocytes become macrophages in tissues
neutrophils are also voracious phagocytes

108

platelets are called thrombocytes in other animals. which term that we have learned relates to its name? what does this term mean?

thrombopoietin is derived from the same word as thrombocyte
it is the hormone that promotes platelet formation

109

Amos has leukemia. even though his WBC count is abnormally high. Amos is prone to severe infections, bleeding, and anemia - explain.

his red bone marrow is spewing out many abnormal WBC's which are crowding out the production of normal bone marrow elements
the lack of normal WBC's allows the infections, the lack of platelets fails to stop bleeding and the lack of erythrocytes is anemia

110

thrombopoietin -

thrombocytes

111

formation of platelets

stem cell hemocytobalst
developmental pathway - megakaryoblast becomes promegakaryocyte which becomes magakaryocyte and developes into platelets

112

homestasis - stop bleeding

step 1 vascular spasm - smooth muscle contracts causing vasoconstriction
step 2 platelet plug formation - injury to lining of vessel exposes collagen fibers; platelets adhere (platelets release chemicals that make nearby platelets sticky - platelet plug forms
step 3 coagulation - fibrin forms a mesh that traps red blood cells and platelets forming a clot

113

what are the three phases of coagulation

1. prothrombin activator is formed when tissue is damaged A)intrinsic pathway- factors present within blood stimulate coagulation B) extrinsic coagulation- factors outside blood stimulate coagulation
2. prothrombin is converted into thrombin
3. thrombin catalyzes the joining of fibrinogen to form a fibrin mesh

114

thromboembolytic disorders

undesirable clot formation

115

bleeding disorders

abnormalities that prevent normal clot formation

116

thrombus

clot that developes and persists in an unbroken blood vessel - may block circulation, leading to tissue death

117

embolis

thrombus freely floating in the blood stream
pulmonary emboli impair the ability of the body to obtain oxygen
cerebral emboli can cause strokes

118

how can thromboembolytic conditions be prevented

aspirin- antiprostaglandin that inhibits thromboxane A2
heperin - anticoagulant used clinically for pre and postoperative cardiac care
warfarin - used for those prone to atrial fibrillation

119

disseminated intravascular coagulation

widespread clotting blocks intact blood vessels
severe bleeding occurs because residual blood unable to clot
most common in pregnancy, septicemia (blood infection) or incompatible blood transfusions

120

petechia

A petechia ( /pɨˈtiːkiə/; plural petechiae /pɨˈtiːkɪ.iː/) is a small (1-2mm) red or purple spot on the body, caused by a minor hemorrhage (broken capillary blood vessels).[1

121

thrombocytopenia

dificient number of circulating platelets
a. petechaae appear due to spontaneous widespread hemorrhage
b. due to suppression or destruction of bone marrow (malignancy- radiation)
c. platelet count under 50,000 mm3 is diagnostic
d. treated with transfusion of concentrated platelets

122

impaired liver function may also cause bleeding dsorders - explain

a. inability to synthesize procoagulants
b. causes include vitamin K deficiency (which is required for making clotting factors) hepatitis and cirrhosis
c. liver disease can also prevent the liver from producing bile, impairing fat and vitamin K (fat soluable molecule) absorption

123

hepatitis

Hepatitis is swelling and inflammation of the liver. It is not a condition, but is often used to refer to a viral infection of the liver

124

cirrhosis

Cirrhosis is scarring of the liver and poor liver function. It is the final phase of chronic liver disease.

125

hemophilias include several similar hereditary bleeding disorders describe A B and C

hemophilia A - most common type (77% of all cases) due to a deficiency of factor VIII
hemophilia B - defieciency of factor IX
hemophilia C - mild type defieciency of factor XI

126

one of the symptoms of hemophilia is prolonged bleeding, where does this occur

in the joint cavities

127

how are bleeding disorders treated

with plasma transfusions and injection of missing factor

128

what is a whole blood tranfusion

when blood loss is substantial

129

when are infusions of packed red cells

when whole blood from which most of the plasma has been removed is used to restore oxygen carrying capacity

130

what can occur if a transfusion of incompatible blood is given

it can be fatal

131

how many different varieties of naturally occuring Rbc antigens do humans have

30

132

what do antigens of the ABO and Rh blood groups cause

vigorous transfusion reactions

133

what are the blood types

A
B
AB
and O

134

antigen - agglutinogens

An antigen that stimulates the production of a particular agglutinin, such as an antibody. Also called agglutogen

135

antibodies - agglutinins

An antibody that causes particulate antigens such as bacteria or other cells to clump together.

136
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antigens photo

137

blood group AB

antigen (agglutinogens): A B
antibodies (agglutinins): none
blood that can be received: A, B, AB, and O - universal recipient

138

blood group B

antigen (agglutinogens): B
antibodies (agglutinins): A
blood that can be received: B and O

139

blood group B

antigen (agglutinogens) : A
antibodies (agglutinins): B
blood that can be received : A and O

140

blood group O

antigen (agglutinogens) : none
antibodies (agglutinins) A and B
blood that can be received: O universal donor

141

how many different Rh agglutinogens are there

45 different Rh agglutinogens (Rh factors)
C,D,and E being the most common
second exposure to Rh+ blood will result in a typical transfusion reaction

142

when do transfusion reactions occur

if mismatched blood is infused

143

when transfusion reactions occur what happens to the donors cells

they are attacked by the recipients plasma agglutinins, agglutinate and clog small vessels, rupture and release free hemoglobin into the bloodstream

144

when transfusion reactions occur what does it result in

diminished oxygen carrying capacity
hemoglobin in kidney tubules and rnal failure

145

what is erythroblast fetalis

hemolytic disease of the newborn the Rh- mother becomes sensitized when exposure to Rh+ blood occurs and causes her body to synthesize Rh antibodies which cross the placenta and destroy the RBC's of the Rh+ baby the baby can be treated with prebirth abd after birth transfusions - RhoGAM serum containing anto Rh can prevent the Rh- mother from becoming sensitized

146

what can result from low blood volume

death from shock

147

how can low blood volume be replaced immediately

a. with normal saline or multiple electrolyte solution that mimics plasma electrolyte composition
b. with plasma expanders (purified human serum albumin, hetastarch and dextran) - these would mimic the osmotic properties of albumin, its more expensive and may cause significant complications

148

diagnostic blod tests include what

1. hematocrit
2. blood glucose test
3. microscopic examination - reveals variations in size and shape of RBC's indications of anemias
4. differential WBC count
5. prothrombin time and platelet counts assess hemostasis
6 SMAC - a blood checmistry profile
7. complete blood count (CBC )


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