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389 Cards in this Set

  • Front
  • Back
Generation of red blood cells
Erythropoeisis
Hormone involved in generation of RBC
EPO
Erythropoeisis
Generation of white blood cells
leukopoeisis
Erythropoeisis
the generation of red blood cells
Leukopoeisis
the generation of white blood cells
Where are blood cells made?
Red bone marrow
Where is the red bone marrow derived from?
mesenchyme
where are blood islands?
yolk sac
At what week of development are blood islands present?
3 weeks post conception
Where do stem cells originate in the fetus?
blood islands in the yolk sac
Where to the stem cells go from the blood islands?
liver, spleen, thymus, red bone marrow
This organ produces blood cells up to birth then stops.
Liver
This organ will make RBC until birth, but then continues to produce WBC (lymphocytes) during the rest of life
spleen
Discuss the liver's role in production of blood cells before and after birth.
The liver produces blood cells up to birth then stops.
Discuss the spleen's role in production of blood cells before and after birth.
The spleen produces red blood cells until birth, but produces lymphocytes after birth for life.
What does EPO stimulate?
bone marrow for generation of blood cells
What stimulates bone marrow to generate blood cells?
erythropoeitin
What kind of bone has red bone marrow?
cancellous bone
What does the suffix -blast mean?
immature cell
what does the prefix mega- mean?
large
What does the prefix pro- mean?
Precursor cell
What are the physical characteristics of Blood?
Color, volume, viscosity, temperature, and pH...
Table 18.1
Color:
- scarlet (oxygen rich) to dark red (oxygen poor)
Volume:
- 4-5L (females)
- 5-6L (males)
Viscosity (relative to water):
- 4.5-5.5 times (whole blood)
Temperature:
- 38 degrees C (100.4 degrees F)
pH:
- 7.35 - 7.45
Define plasma
Fluid part of the blood
Makes up ~55% of the blood
An extracellular fluid
Similar to interstitial fluid in concentrations of nutrients, waste products, and electrolytes
Significant difference between interstitial fluid and plasma is that protein concentrations are much higher in plasma.
Composed primarily of water (~92%), plasma proteins (~7%), and dissolved organic and inorganic molecules and ions (~1%)
What color is plasma?
pale yellow
What kind of solution is plasma?
colloid
liquid-like solution with suspended proteins
like jello
This is the fluid matrix of the blood
plasma
How is blood a connective tissue?
it has a fluid matrix, colloid solution
How much of plasma is water?
~91% Claire says
~92% book
How much of plasma is proteins?
-~9% Claire says
~7%
What is the ~1% of plasma that is not water or proteins?
waste, ions, gases, etc.
Where are most proteins produced?
At the liver
Are proteins large or small molecules?
Large molecules
How do proteins get into the blood from the liver?
Cross blood vessel walls
What are albumens?
Blood proteins
very important in osmotic pressure
can also be transport proteins
What are globulins?
blood proteins
play a role in immunity (IgG, IgM, etc.)
thyroid binding globulin is a specific transport protein
What is fibrinogen?
blood protein involved in blood clotting
fibrin is present
cleaves something off and makes something active
What other important solutes are in the blood?
glucose, salts, etc.
Describe the relationship between serum and plasma
Serum is plasma without the clotting proteins
The first blood-forming tissue of the embryo
blood islands
Why is blood considered to be a connective tissue?
Because it contains formed elements and dissolved proteins in a liquid ground substance called plasma.
What are the formed elements of blood?
Red blood cells, white blood cells, platelets
Is blood alkaline or acidic?
alkaline (7.35 - 7.45pH)
Define arteries:
blood vessels carrying blood away from the heart
Define veins:
blood vessels carrying blood toward the heart
Define capillaries:
The smallest blood vessel.
Its thin walls allow movement of substances between blood and interstitial fluid
What is the term for red blood cells?
erythrocytes
What is the term for white blood cells?
leukocytes
What is the function of erythrocytes?
Transport respiratory gases in the blood
What is the function of leukocytes?
Defend against pathogens
What is the function of platelets?
help clot he blood and prevent loss of blood from damaged vessels
The fluid portion of the blood containing plasma proteins and dissolved solutes
Plasma
What are the three main functions of the blood?
Transportation, protection, and regulation
The amount of heat absorbed and released is regulated by _____
by: 1, 2
the hypothalamus
1 - stimulating muscle contraction to increase the amount of heat generated (shivering, goosebumps)
2 - redistributing blood flow to the dermis through vasoconstriction (to retain heat) and vasodilation (to release heat)
List some things transported by the blood:
nutrients from the GI tract, O2, CO2, hormones, waste products, medicine, heat
The blood participates in the regulation of these three things:
Body temperature, body pH, fluid balance
How does blood regulate body temperature?
Heat is absorbed from body cells, especially skeletal muscle, as it passes through blood vessels of body tissues. Heat is then released from blood vessels near the surface of the skin into the environment.
How does blood regulate body pH?
Blood absorbs acids and bases from body cells, and contains chemical buffers (proteins and bicarbonate) that bind and release Hydrogen ions H+ to maintain blood pH until the excess is eliminated from the body.
How does blood regulate fluid balance?
Water is added to the blood from the GI tract and is lost in numerous ways (ie urine/skin). There is also a constant exchange of fluid between the blood plasma and the interstitial tissues surround the body's cells.
Blood contains proteins and ions that exert osmotic pressure to pull fluid back into the capillaries to maintain a normal fluid balance
How does blood protect the body?
Blood contains leukocytes, plasma proteins, and various molecules that help protect the body from pathogens, as well as platelets and plasma proteins that protect the body against blood loss.
Explain why veins appear to be blue.
The bluish appearance of our veins can be attributed to both (1) the fact that we can see the blood traveling through the superficial veins through the skin and (2) how light is reflected back to the eye from different colors. Lower energy light wavelengths, like red, are absorbed by the skin and not reflected back to the eye. Higher energy wavelengths, like blue, are reflected back to the eye.
Blood viscosity increases if:
the amount of dissolved substances (primarily erythrocytes) increasees, the amount of fluid decreases, or both
What is whole blood?
plasma and its formed elements
what is plasma and formed elements called?
whole blood
The test tube of a centrifuge, in order from heaviest to lightest,...
erythrocytes (44%), buffy coat (leukocytes and platelets) (<1%), Plasma, (55%)
Of the 7% proteins in the blood, what is the makeup?
Albumins 58%
Globulins 37%
Fibrinogen 4%
Regulatory proteins <1%
In whole blood, how many platelets are there?
150-400 thousand per cubic mm
150-400 thousand per cubic mm in whole blood...
platelets
In whole blood, what percentages of leukocytes are present?
Leukocytes: 4.5-11 thousand per cubic mm
Neutrophils 50 - 70%
Lymphocytes 20 - 40%
Monocytes 2 - 8%
Eosinophils 1 - 4%
Basophils 0.5 - 1%
NLMEB
Neutrophils
Lymphocytes
Monocytes
Eosinophils
Basophils
Name the different leukocytes
neutrophils
lymphocytes
monocytes
eosinophils
basophils
How many erythrocytes are present per cubic mm?
4.2 - 6.2 million per cubic mm
a cubic mm of blood is equivalent to ____
1 microliter
The percentage of the volume of all formed elements in the blood is called the ____-
hematocrit
Define hematocrit
the percentage of the volume of all formed elements in the blood.
what is the clinical definition of hematocrit?
the percentage of erythrocytes
What is the average hematocrit of an adult male?
42% to 56%
What is the average hematocrit of an adult female?
38% to 46%
Why do males have a higher hematocrit?
Because testosterone stimulates the kidney to produce the hormone erythropoeitin, which promotes erythrocyte production.
Identify the formed elements in this blood smear:
Identify the formed elements in this blood smear:
Most numerous, red/pink concave disks: erythrocytes
Larger, nucleated: neutrophil
small fragments, platelets
The solvent in which formed elements are suspended and proteins and solutes are dissolved.
Water (~92% of plasma)
Exerts osmotic force to retain fluid within the blood
Contributes to blood's viscosity
Responsible for some fatty acid and hormone transport
Albumin
~58% of plasma proteins
Alpha-globulins transport lipids and some metal ions
Beta-globulins transport ironions and lipids in blood
Gamma-globulins are antibodies that immobilize pathogens
Globulins
Participates in blood coagulation (clotting)
Fibrinogen (~4% of plasma proteins)
Consists of enzymes and hormones
Regulatory proteins (<1% of plasma proteins)
Help establish and maintain membrane potentials, maintain pH balance, and regulate osmosis (control of the percentage of water and salt in the blood)
Electrolytes (eg, sodium, potassium, calcium, chloride, iron, bicarbonate, and hydrogen)
Energy source; precursor for synthesizing other molecules
Nutrients (eg, amino acids, glucose, cholesterol, vitamins, fatty acids)
Oxygen is needed for aerobic cellular respiration; carbon dioxide is a waste product produced by cells during this process
Respiratory gases
oxygen:<2% dissolved in plasma, 98% bound to hemoglobin within erythrocytes
carbon dioxide: 7% dissolved in plasma, 27% bound to hemoglobin within erythrocytes, 66% converted to HCO3-
Waste products serve no function in the blood plasma; rather, they merely are being transported to the liver and kidneys where they can be removed from the blood
Wastes
(breakdown products of metabolism
eg lactic acid, creatine, urea, billirubin, ammonia)
The smallest and most abundant of the plasma proteins
albumin
% of albumen
58%
Second largest group of plasma proteins
globulins
37%
Smallest to largest: alpha-globulin vs beta-globulin
alpha<beta-globulin
What do alpha and beta-globulins primarily bind?
certain water-insoluble molecules and hormones, some metals (eg iron), and ions (eg Ca2+)
What are gamma-globulins?
immunoglobulins, or antibodies
% of fibrinogen?
4%
What does fibrinogen do?
responsible for blood clot formation
How are plasma protein levels related to colloid osmotic pressure?
Higher levels of protein = greater concentration gradient therefore greater osmotic pressure
Blood is considered a connective tissue as well as a solute. Why a solute?
Because it contains dissolved organic and inorganic molecules and ions, including electrolytes, nutrients, gases, and waste products.
These are called the formed elements and they make up about _____% of whole blood
erythrocytes, leukocytes, and platelets; 45%
What do mature red blood cells lack that all other cells have?
nucleus and organelles, such as mitochondria and ribosomes
What is another name for hemopoiesis?
hematopoiesis
What is another name for hematopoiesis?
hemopoiesis
Wher does hemopoiesis occur?
red bone marrow (myeloid tissue) of certain bones
The process of hemopoiesis starts with ______
hemopoietic stem cells called hemocytoblasts
What does pluripotent cell mean
can differentiate and develop into many different kinds of cells
Hemocytoblasts produce two different lines for blood cell development: The _____ line forms (1) (2) (3). The _____ line forms only _____
myeloid line:
1 - erythrocytes
2 - all leukocytes except lymphocytes (including granulocytes and monocytes)
3 - megakaryocytes (cells that produce platelets)
lymphoid line: only lymphocytes
These cells give rise to platelets
Megakaryocytes
The myeloid line gives rise to _____ , _____, and _____
red blood cells and megakaryocytes (which give rise to platelets) and leukocytes (except for lymphocytes)
The maturation and division of hemopoietic stem cells is influenced by ________
colony-stimulating factors (CSFs)
or colony-forming units (CFUs)
CSFs are all growth factors except:
erythropoietin, which is a hormone
colony-stimulating factors are all _____ except erythropoietin, which is a hormone
growth factors
Erythrocytes make up more than _____% of formed elements with a concentration between _____ million and _____ million per cubic millimeter
99%
4.2 and 6.2 million per cubic millimeter
The process of erythrocyte production is called _____
erythropoiesis
What rate are erythrocytes produced at normally?
3 million per second
Dietary requirements for normal erythropoiesis include _____, _____, and _____
iron, B vitamins (eg folic acid riboflavin), and amino acids (to build proteins)
A process where the blood clots and stops blood flow through an injured blood vessel wall.
Hemostasis
Hemostasis:
A process where the blood clots and stops blood flow through an injured blood vessel wall.
Three sequential phases of hemostasis:
vascular spasm, platelet plug formation, and coagulation
What is the diameter of erythrocytes?
7 micrometers
What is the diameter of leukocytes?
11.25 - 22.5 micrometers
Compare erythrocyte, leukocyte, and platelet size:
WBD are 1.5 to 3 times larger than RBC
Platelets are <1/4 the size of a RBC ~2 micrometers
Life span of RBC, WBC, and platelets
RBC ~120 days
WBC varies from 12 hours (neutrophils) to years (lymphocytes)
platelets ~8-10 days
Density of RBC, WBC, and platelets
RBC:
Females - 4.8 million
Males - 5.4 million

WBC: 45,000 - 11,000

Platelets: 150,000 - 400,000
Where does hematopoiesis occur?
Red bone marrow (myeloid tissue) of certain bones
What is myeloid tissue?
Red bone marrow
What is another name for red bone marrow?
myeloid tissue
The blood stem cell:
hemocytoblast
What does pluripotent mean?
can differentiate and develop into many different kinds of cells
The term for the ability of a cell to differentiate and develop into many different kinds of cells
pluripotent
How many different lines do hemocytoblasts produce?
Two:
Myeloid, lymphoid
The myeloid line forms :
erythrocytes, all leukocytes except lymphocytes, and megakaryocytic (cells that produce platelets)
The lymphoid line forms:
lymphocytes and natural killer cells
Which line develops megakaryocytes?
Myeloid
Which line develops leukocytes (except lymphocytes)?
Myeloid
Which line develops red blood cells?
Myeloid
Which line develops platelets?
myeloid
Undifferentiated blood cells are called:
hemocytoblasts
Hemopoiesis occurs where?
red bone marrow of certain bones
The hormones and growth factors that stimulate blood cell differentiation to either the myeloid or lymphoid cell line:
colony stimulating cells CSF
Hemopoiesis along the myeloid cell line follows one of ____ pathways. List them.
Three;
erythropoiesis
thrombopoiesis
leukopoiesis
Erythropoiesis begins with stimulation of myeloid stem cells by _____
CSF
CSF Stimulates myeloid stem cells and forms _____
progenitor cells, which gives rise to proerythroblasts
This is the first committed cell along the erythrobpoiesis pathway
proerythrocytes
This hormone initiates the erythroblast stage:
erythropoietin
The new cell formed after a normoblast ejects its nucleus
reticulocyte
Do reticulocytes have a nucleus? Hemoglobin?
No; yes, some, but they continue to form Hb
Where do the organelles of a reticulocyte degenerate?
In the blood stream;
after the reticulocyte has entered the blood stream
This hormone is involved in the differentiation of megakaryocytes
Thrombopoietin
The first committed cell in thrombopoiesis?
megakaryoblast
The leukocytes formed by the myeloid line:
granulocytes:
neutrophils
basophils
eosinophils

monocytes
list the granulocytes
basophils
neurtrophils
eosinophils
these leukocytes share a common stem cell:
granulocytes and monocytes
The two kinds of lymphocytes produced by leukopoiesis
B-lymphocytes; T-lymphocytes
How many erythrocytes are produced per second?
3 million
Leukocytes make up less than ____% of formed elements in the blood
How many?
0.01%
4,500 to 11,000 mm^3
Platelets make up less than ____% of formed elements
How many?
1%
150,000 - 400,000
The production of platelets
thrombopoiesis
This leukocyte has a multi-lobed nucleus
megakaryocyte
How many platelet can each megakaryocyte produce?
Thousands
The long processes of megakaryocytes that are extended through the blood vessel wall are called _____
proplatelets
How do proplatelets become platelets?
Extended through the blood vessel wall (between endothelial cells) in the red bone marrow and are spliced by the force of the blood flow into platelets
Why is the term red blood cell a misnomer?
It lacks a nucleus and organelles, so it is not a cell
it is more appropriate to call it a formed element
The RBC is a biconcave disk. Give its dimensions:
diameter; narrowest section; widest section
7-8 micrometers in diameter
0.75 micrometers at narrowest section
2.6 micrometers at widest section
RBCs stacked up in a line are called
rouleau
What is a rouleau?
RBCs lined up
What facilitates the fact that RBCs can form a rouleau?
Their biconcave shape
This protein supports the plasma membrane of a RBC and contributes to its flexibility as it moves through the capillaries:
spectrin protein
What is spectrin protein?
the protein that forma a latticework on the plasma membrane of the RBC which supports the membrane and contributes to its flexibility as it passes through the capillaries
What three processes can a RBC no longer engage in due to the lack of a nucleus and mitochondria?
The loss of the nucleus means the RBC can not produce proteins or divide by mitosis; the lack of mitochondria means the cell can not perform aerobic cellular respiration.
The term for oxygen bound hemoglobin
oxyhemoglobin
The term for unoxygenated hemoglobin
deoxyhemoglobin
the term for hemoglobin with carbon dioxide bound to an amino group
carbaminohemoglobin
carbaminohemoglobin
the term for hemoglobin with carbon dioxide bound to an amino group
Each Hb molecule consists of four protein building blocks called _____. Two are called ____ and two are called ____
globin;
alpha chains; beta chains
All globin chains contain a _____ group
heme
heme groups are made up of _____ ring with _____ in its center
porphyrin ring; iron in the center
what is a porphyrin ring?
Four Nitrogen molecules in a ring
Oxygen binds to the _____ in heme groups for transport in the blood
Fe2+
iron
The weak binding of O2 to Fe2+ in Hb allows for:
rapid attachment to Fe2+ when passing through the capillaries in the lungs and rapid detachment from Fe2+ when passing through the capillaries at the body tissues
Where does CO2 attach on Hb?
globin molecule
(not Fe2+)
Where is EPO primarily produced?
Kidneys
(Liver produces small amounts)
What is the initial stimulus of the production of EPO?
decrease in blood oxygen levels
Give four reasons for decrease oxygen in the blood
1 - continuous removal of aged erythrocytes
2 - exercise
3 - blood loss
4 - high elevation where atmospheric oxygen levels are lower
_____ within the kidney detect low blood oxygen as the blood travels through the blood vessels of the kidney
chemoreceptors
After EPO is produced by certain kidney cells and released into the blood, where does it travel to?
bone marrow
The EPO stimulates _____ cells in the red bone marrow to increase the rate of erythrocyte production
myeloid
Through negative feedback, how is the release of EPO inhibited?
increased blood oxygen levels
How does EPO regulate erythrocyte production?
Low blood oxygen levels are detected by kidney chemoreceptors, which triggers the release of erythropoietin (EPO) into the blood. EPO stimulates the red bone marrow to produce more erythrocytes. EPO release is then inhibited when blood oxygen levels rise.
This hormone stimulates the kidney to produce EPO
testosterone
Why do men have a higher hematocrit than women?
Testosterone stimulates the kidneys to produce EPO.
Why does the lack of a nucleus and organelles decrease erythrocyte longevity?
It can not produce proteins to repair itself or to replace damaged membrane regions
Old erythrocytes are phagocytized where?
spleen/liver
What phagocytizes old erythrocytes?
macrophages
How many components of Hb are separated during phagocytosis of old RBC's
Three:
Heme
Iron
globin
Which component of Hb is converted to something else during erythrocyte destruction?
heme:
from heme, remove iron, convert to biliverdin, then to bilirubin
Which Hb component is not broken down, but either stored for reuse or excreted?
Iron
Five ways iron is lost:
urine, sweat, feces, injury, menstruation
How is iron transported in the blood?
Transferrin transport protein
trans for transport
ferrin for iron
What happens to globin during the destruction of erythrocytes?
broken down into amino acids and reused by the body
What happens to heme during the destruction of erythrocytes?
The iron is removed, it is converted to biliverdin then to biliruben. The biliruben is transported to the liver and then released as a component of bile into the small intestine. The small intestine converts biliruben to bilinogen. Most of the bilinogen goes to the large intestine and is converted to stercobilin and expelled in the feces, but some urobilinogen is absorbed back into the blood, converted to urobilin and is excreted in the urine
What happens to the iron molecule during destruction of erythrocytes?
attaches to transferrin to be moved throughout the blood. some is lost daily by injury, menstruation, sweat, urine, feces. Some travels to the liver and is stored attached to ferritin and hemosiderin. Some is transported to the red bone marrow for erythrocyte production
What is iron attached to during its storage in the liver?
ferritin and hemosiderin
What is hemosiderin?
Iron attaches to it during storage in the liver
What is ferritin?
Iron attaches to it during storage in the liver
The term for low RBC count:
high RBC count: (high cells in general)
anemia
polycythemia
a condition in which the oxygen-carrying capacity of rbcs is reduced
anemia
a condition in which RBC percents are lower than normal
anemia
The consequence of anemia:
The heart must work harder to get oxygen delivered to the tissues
Types of anemia: (8)
Aplastic anemia
congenital hemolytic anemia
erythroblastic anemia
Familial mycrocytic anemia
hemorrhagic anemia
macrocytic anemia
pernicious anemia
sickle-cell disease
ACEFHMPS
8 types of anemia
A Car Eventually Flies High Miles Per Sky
How is biliruben transported to the liver?
albumen
what is another name for blood type related antigens?
agglutinogens
What is another name for blood type related antibodies in the plasma?
agglutinins
What are agglutinins?
blood type related antibodies in the plasma
What are agglutinogens?
blood type related antigens
What disease forms in a second pregnancy with an RH+ fetus?
hemolytic disease of the newborn
erythroblastosis fetalis
what is the size difference between leukocytes and rbc
1.5 - 3x larger
How do leukocytes get from the blood to the tissues?
diapedesis
a process in which leukocytes are attracted to a site of infection by the presence of molecules released by damaged cells, dead cells, or invading pathogens.
chemotaxis
What are the two distinguishable classes of leukocytes?
granulocytes and agranulocytes
the class of leukocytes with the visible presence of cytoplasmic secretory vesicles termed specific granules
granulocytes
Identify this leukocyte:
nucleus is multilobed, as many as 5 lobes
cytoplasm contains neutral or pale, specific granules when stained
neutrophil
What does a neutrophil look like?
nucleus is multilobed, as many as 5 lobes
cytoplasm contains neutral or pale, specific granules when stained
What is the function of neutrophils?
Phagocytize pathogens, especially bacteria
Release enzymes that target pathogens
Identify this leukocyte:
Phagocytize pathogens, especially bacteria
Release enzymes that target pathogens
Neutrophils
Identify this leukocyte:
Approximate % 50-70% of total leukocytes
1800 - 7800 cells per microliter
neutrophils
Identify this leukocyte:
Nucleus is bilobed
Cytoplasm contains reddish or pink-orange specific granules when stained
Eosinophil
What is the function of eosinophils?
Phagocytize antigen-antibody complexes and allergens.
release chemical mediators to destroy parasitic worms
Identify this leukocyte:
Phagocytize antigen-antibody complexes and allergens.
release chemical mediators to destroy parasitic worms
Eosinophils
Identify this leukocyte:
Approximate % 1-4% of total leukocytes
100-400 cells per microliter
eosinophils
Identify this leukocyte:
Nucleus is bilobed
Cytoplasm contains deep blue-violed specific granules when stained
basophils
What is the function of basophils?
Release histamine (vasodilator and increases capillary permeability) and heparin (anticoagulant) during inflammatory reactions
Identify this leukocyte:
Release histamine (vasodilator and increases capillary permeability) and heparin (anticoagulant) during inflammatory reactions
Basophils
Identify this leukocyte:
Approximate % 0.5 - 1% of total leukocytes
20-50 cells permicroliter
basophils
identify this leukocyte:
Round or slightly indented nucleus (fills the cell in smaller lymphocytes)
Nucleus is usually darkly stained
Thin rim of cytoplasm surrounds nucleus
Lymphocytes
What is the function of lymphocytes?
Coordinate immune cell activity
Attack pathogens and abnormal and infected cells
Produce antibodies
Identify this leukocyte:
Coordinate immune cell activity
Attack pathogens and abnormal and infected cells
Produce antibodies
Lymphocyte
Identify this leukocyte
Approximate % 20-40% of total leukocytes
1000-4000 cells per microliter
Lymphocytes
Identify this leukocyte:
Kidney-shaped or C-shaped nucleus
Nucleus is generally pale staining
Abundant cytoplasm around nucleus
Monocytes
What is the function of monocytes?
Exit blood vessels to become macrophages
Phagocytize pathogens (eg bacteria, viruses), cellular fragments, dead cells, debris
Identify this leukocyte:
Exit blood vessels to become macrophages
Phagocytize pathogens (eg bacteria, viruses), cellular fragments, dead cells, debris
Monocyte
Identify this leukocyte:
Approximate % 2-8% of total leukocytes
(100-700 cells permicroliter)
Monocytes
What are the three granulocytes?
neutrophils
eosinophils
basophils
The most numerous leukocyte in the blood
neutrophil
How much larger is a neutrophil than a RBC?
1.5x
What is another name for neutrophils?
polymorphonuclear leukocytes (PMN)
polymorphonuclear leukocytes (PMN)
neutrophils
How long do neutrophils generally stay in the blood before exiting to the tissues?
10-12 hours
The number of neutrophils in a person's blood rises dramatically in the presence of _________
chronic bacterial infection
This leukocyte has a bilobed nucleus with a thin strand connecting the two lobes
eosinophils
The primary components of basophil granules are
histamine and heparin
Do agranulocytes have granules?
Yes but they are so small they are not clearly visible under light microscope
Where do lymphocytes reside?
lymphatic organs such as the lymph nodes and the spleen
This leukocyte is about the same size as a RBC
lymphocyte
This leukocyte grows larger when activated
lymphocytes
What are the three categories of lymphocytes?
T-lymphocytes
B-lymphocytes
Natural Killer cells
This leukocyte can bee up to 3x the diameter of a RBC
Monocytes
This leukocyte resides in the blood for 3 days before exiting to the tissues
monocyte
Macrophages come from which leukocyte?
monocyte
What is the term for a decrease in leukocytes?
leukopenia
What is the term for an increase in leukocytes?
leukocytosis
What is a differential count?
measures the amount of each type of leukocyte in your blood, and determines whether any of the circulating leukocytes are immature.
What is differential count?
the measures of the amount of each type of leukocyte in your blood, and determines whether any of the circulating leukocytes are immature.
the measures of the amount of each type of leukocyte in your blood, and determines whether any of the circulating leukocytes are immature.
differential count
Acute bacterial infections, acute stress, and tissue necrosis typically are associated with an increase in _____
neutrophils
Increased presence in immature neutrophils is referred to as ________
left-shifted differential
Why would immature neutrophils be present in the blood?
When there is an infection the body tries to create more and more neutrophils and pushes immature cells into the blood.
What is the term for decreased neutrophil count
neutropenia
Neutropenia
decreased neutrophil count
what are some causes of neutropenia?
certain anemias, drug or radiation therapy
Viral infections such as mumps, rubella or mononucleosis, typically produce _______
also chronic bacterial infections, some leukemias, and multiple myeloma
lymphocytosis; an increase in lymphocytes
Decreased lymphocyte cells is called
lymphocytopenia
what shape are platelets?
irregular
what is the diameter of platelets?
2micrometers
What is another name for platelets?
thrombocytes
are platelets true cells?
no. they do not have a nucleus. they are a cell fragment.
what cell produces platelets?
megakaryocyte
what is hemostasis?
blood l
The name for blood clotting
hemostasis
About 30% of platelets are stored in the _____
spleen
Abnormally small number of platelets in circulating blood is termed _____
thrombocytopenia
_____ is the process where the blood clots and stops blood flow through an injured blood vessel wall
hemostasis
What are the three phases of hemostasis?
vascular spasm, platelet plug formation, and coagulation
What is the first phase of hemostasis when a vessel is injured?
vascular spasm
How long does the vascular spasm last?
from a few to many minutes
Second phase of hemostasis
platelet plug formation
What are eicosanoids?
primary type of local hormone.
they are signaling molecules and are formed from fatty acids that contain a chain of 20 carbon atoms
primary type of local hormone.
they are signaling molecules and are formed from fatty acids that contain a chain of 20 carbon atoms
Eicosanoids
What kind of hormone is prostacyclin?
eicosanoid
What kind of eicasonoid is present in the endothelium of blood vessels?
prostacyclin
What does prostacyclin do?
activates a pathway in both platelets and endothelial cells that involves production of cAMP to ultimately inhibit platelet activation. Prostacyclin serves as a platelet repellent.
What must be exposed for platelets to begin to stick?
collagen fibers
Platelets adhere to the collagen fibers with the assistance of a plasma protein called _____
Von Willebrand factor
This serves as a bridge between platelets and collagen fibers
von Willebrand factor
How does the morphology change in a platelet as they start to stick to a blood vessel wall?
long processes develop that further adhere them to the vessel wall
What is a platelet plug made of?
multiple platelets adhering to the vessel wall
How long does it take for a platelet plug to form?
a few minutes
Is platelet plug formation permanent?
No it is temporary
Describe the morphologic change in platelets to become activated:
cytoplasm degranulates, releasing chemicals to assist with hemostasis.
Do platelets degranulate?
Yes
Four process that occur in response to the degranulation of platelets
Prolonged vascular spasm
Attraction of other platelets
Stimulation of coagulation
Repair of the blood vessel
Desribe how prolonged vascular spasm works
(occurs in response to the degranulation of platelets)
release of serotonin and thromboxane A2 (which is an eicasonoid)
Attraction of other platelets
Simulation of coagulation
Repair of blood vessel
What is seratonin?
Look up
What is thromboxane A2
Look up
The release of ____ and _____ which facilitates the degranulation and release of these chemicals in other platelets
adenosine diphosphate (ADP) and thromboxane A2
the release of ADP and thromboxane A2 does what?
stimulates the release of these chemicals in other platelets
how does stimulation of coagulation work?
with the release of procoagulants that enhance blood clotting (the third phase)
how do blood vessels repair?
as platelets secrete substances to stimulation of epithelial tissue, smooth muscle, and fibroblasts of connective tissue to replicate
What keeps a platelet plug from growing too big?
The neighboring endothelial cells are still secreting prostacyclin, which inhibits platelet activation.
Hemophilia is due to what kind of genetics?
X-linked
Classic hemophilia is also called
Hemophilia A
What protein is declined or missing in hemophilia A?
normal factor VII protein
What protein is declined or missing in hemophilia B?
deficiency of factor IX
What protein is deficient in hemophilia C
factor XI
The deficiency in platelet count
thrombocytopenia
what is thrombocytopenia?
decrease in platelet count
Name some drugs that interfere with blood clotting
aspirin, ibuprofen, NSAIDs, warfarin (coumadin), ginko biloba, garlic supplements
what is hypercogulation?
an increased tendency to clot blood
What is a thrombus
a clot within a blood vessel
If a thrombus dislodges and travels through the blood, it is called
embolus
What are the blood-related dangers of birth control pills and hormone replacement therapy?
increased risk in blood clotting
What is the Leiden mutation?
mutation of the gene for the synthesis of factor V, causes hupercoagulation
the most important and and most complex component of hemostasis
coagulation or blood clotting
a blood clot has an insoluble protein network composed of _____
fibrin
fibrin is derived from _____
soluble fibrinogen
the fibrin network does what?
traps other elements of blood, including erythrocytes, leukocytes, platelets, and plasma proteins
Substances involved in coagulation
calcium, clotting factors, platelets, and vitamin K
What vitamin is required for the synthesis of clotting factors II, VII, IX, and X?
vitamin k
Which clotting factors are proteases?
VII and IX
What are the two separate mechanisms to initiate blood clotting?
extrinsic (also known as tissue factor pathway)
intrinsic (also known as contact activation pathway)
What two pathways converge to get to the common pathway of clotting?
intrinsic and extrinsic
which clotting pathway occurs with the damage of a blood vessel? which with damage to tissues?
intrinsic; extrinsic
The common clotting pathway converts _____ into _____ and _____ into _____
prothrombin (factor II) into thrombin
fibrinogen (factor I) into fibrin
What initiates the intrinsic pathway?
platelets
How long does the intrinsic pathway usually take?
3-6 minutes
The five steps of the intrinsic pathway
1 - platelets adhering to a damaged vessel wall release factor XII.
2 - Factor XII converts the inactive factor XI to the active factor XI
3 - Factor XI changes inactive factor IX to active factor IX
4 - Factor IX binds with Ca2+ and platelet factor 3 to form a complex that converts inactive factor VIII to active factor VII
5 - Factor VIII changes inactive factor X to active factor X
How is the extrinsic pathway initiated?
damage to tissue outside of the vessel
How long does the extrinsic pathway usually take?
15 seconds
What are the two steps of the extrinsic pathway for clotting?
1 - Tissue thromboplastin released from damaged tissues combines with factor VII and Ca2+ to form a complex
2 - This complex converts inactive factor X to active factor X
What is the first step in the common pathway
activated Factor X
What are the 4 steps of the common pathway for clotting?
1 - Factor X combines with factors II and V, Ca2+, and platelet factor 3 to form prothrombin activator
2 - Prothrombin activator activates prothrombin to thrombin
3 - Thrombin converts soluble fibrinogen to soluble fibrin
4 - In the presence of Ca2+, factor XIII is activated Factor XIII cross-links and stabilizes the fibrin monomers into a fibrin polymer that serves as the "framework" of the clot.
The size of a clot is limited because
Thrombin is either trapped within the clot or thrombin quickly degraded by enzymes within the blood.
How much blood loss initiates a survival response?
10%
What is activated with more than 10% blood loss?
sympathetic division of the autonomic nervous system
How does the sympathetic nervous system help maintain blood pressure with severe blood loss?
increases heart rate, increases vasoconstriction of blood vessels, and increased force of contraction
blood flow is also redirected to the heart and the brain
Tip for remembering sequence of factors for intrinsic:
For extrinsic pathway:
intrinsic
count backwards from 12, skipping 10 because that is the goal
extrinsic
coming together of 7 and 3, and by adding them you get 10, which is the goal
Elimination of blood clots include _______ and _____
clot retraction and fibrinolysis
Clot retraction occurs as the clot is forming when ______, a contractile protein within platelets, squeezes the serum out of the developing clot.
actinomyosin
How is the fibrin network of a clot destroyed?
plasmin degrades the fibrin strands through fibrinolysis
This means low oxygen in the blood: This means low oxygen at the tissues:
hypoxemia
hypoxia
What chemicals are in platelet granules?
ADP
Platelet derived growth factors
seratonin
calcium
lots of enzymes
About 30% of ______ are stored at the spleen
platelets
_____ _______ of the megakaryocytic is important in fragmentation
cytoplasmic extensions called proplatelets
What is a pro platelet?
cytoplasmic extensions of megakaryocyte that reach between the endothelium into the blood vessels and break off to form platelets.
The 7 functions of platelets:
1 - blood clotting
2 - secrete growth factors/can repair blood vessel linings (PDGF platelet derived growth factor)
3 - Can secrete vasoconstrictor substances to prevent blood loss
4 - platelet plug formation
5 - phagocytosis
6 -chemotaxic (very important)
7 - can assist with clot dissolution
Why don't platelets stick to the endothelium?
Nitric oxide and prostacyclin are secreted by the endothelial cells to make them slick.
What has to be exposed in the vessel to get platelet aggregation?
collagen
HHow does platelet aggregation occur?
Platelets get sticky and they stick together. vonWillebran's factor is activated from the endothelial cells, platelets stick together. Calls in more platelets, stick together and swell up. Platelets get irradiating processes, like arms that intertwine with each other to make the platelets stick together. At this point they are called activated platelets.
Platelets secrete large amounts of ______ once activated from their granules
Thromboxane A2, seratonin, ADP once activated
What is the process called when platelets secrete their chemicals?
degranulation, which involves exocytosis
Shat role does seratonin play in activated platelets?
very good vasoconstrictor
What role does ADP play in activated platelets?
Very good chemotaxic signal, recruits other platelets to the area and to degranulate
What role does thromboxane A2 play in activated platelets?
Does everything: good vasoconstrictor, aggregator, degranulator.
How long does the platelet plug last?
in place by about 30 seconds after injury until clotting occurs
How do we get to prothrombinase to thrombin?
prothrombinase cleaves prothrombin into thrombin
it was inactive and it was made active (thrombin is active)
Prothrombin is unstable in the presence of enzyme and _____
calcium
What vitamin is needed for prothrombin?
Vitamin K
What does the subscript (a) mean next to thrombin IIa?
It means it has been activated.
Where is fibrinogen produced?
Liver
Why doesn't fibrinogen leave the blood vessels?
High molecular weight protein
what cleaves fibrinogen?
activated thrombin
______ molecules can be cross-linked
fibrin
Why is it important that fibrinogen is soluble?
It's present in the plasma
Once activated thrombin cleaves off a piece of fibrinogen, it becomes
fibrin, an insoluble polymer
When activated thrombin interacts with Ca2+ to react with XIII factor and fibrin, what happens
can get cross linkage
What gets trapped in the cross linkage meshwork of fibrin?
rbc, platelets, plasma, etc.
In the extrinsic pathway, what is released to activate the cascade?
proteolytic enzymes
Tissue Factor (TF)
Extrinsic pathway ends in what?
prothromibinase
This is a protein in platelets
actinomyosin
What does actinomyosin in a platelet do?
Help close off the injured area, pulls the sides of the vessels together
What secretes PDGF?
Platelet derived growth factor:
platelets and endothelium secrete it
it stimulates fibroblasts and smooth muscle
helps repair blood vessel wall after injury
What enzyme cleaves fibrin?
plasmin
What is the fibrinolysin system?
Going to be able to lyse the fibrin network
starts about 2 days post-clot
What is plasminogen?
precursor to plasmin, is in a clot
inactive until it is turned on
What activates plasminogen?
tPA
tissue plasminogen activator
is secreted by endothelial cells
How do we limit clotting?
smooth endothelium
blood is moving, washing away extra clotting stuff
thrombin is localized to site of injury
Thrombin cleaved/inactivated by anti-thrombin at the liver
Heparin released from basophils and mast cells which inhibit pathways down to clotting
What is secreted by the endothelial cells to inhibit platelet aggregation?
nitric oxide
prostoglandin
vitamin E
What is an antagonist to vitamin K?
Warfarin/Coumidin
What vitamin is needed at the liver to make clotting proteins?
Vitamin K