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58 Cards in this Set
- Front
- Back
Site of blood production in 1st trimester
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Yolk Sac
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type of hgb in first trimester
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ε and ζ
Epsilon and Zeta |
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Mesoblastic Period
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1st trimester
yolk sac detectable at 20 days gestation primarily erythroid epsilon and zeta hemeglobin |
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Site of blood production in 2nd trimester
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Fetal Liver
(spleen, thymus, lymph also active) |
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Hepatic Period
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2nd trimester
fetal liver begins @week 5 or6 Cells morphologically identifable primarily erythroid Spleen, thymus, lymph nodes active |
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Site of blood production in 3rd trimester
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Bone marrow
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Myeloid Period
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3rd trimester
5th month gestation bone cavities of central or peripheral skeleton Hgb A1 appears (α and β chains) Active Myelopoeisis |
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Period of active myelopoeisis
(formation of blood cells other than erythroid) |
Myeloid Period
3rd trimester |
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Sites of Adult Hematopoeisis
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Vertebral bodies
Sternum Ribs Pelvis Skull, proximal epiphyseal of humerous and femur |
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Sites of Adult hematopoesis in times of stress
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Extramedullary hematopoesis
Liver, spleen, etc |
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Bone Marrow Histology
(stuff in BM) |
Fat
Blood Vessels Trabecular bone Hematopoietic islands |
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Cells in bone marrow
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Hematopoietic cells
endothelial cells adipocytes osteocytes stromal cells |
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Purpose of stromal cells in bone marrow
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Specialized fibroblasts
Physical support for hematopoetic cells Express adhesion molecules Secrete growth factors |
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Totipotent stem cells
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Cells capable of unlimited self-renewal and differentiation
Highly resistant to chemotherapy |
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CD34
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Surface antigen of totipotent stem cells
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Dysfunction leads to aplastic anemia or leukemia
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Totipotent Stem cells
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Multipotent stem cells
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Derived from totipotent stem cells
Capable of extended self-renewal and differentiation |
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Progenitor Cells
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aka colony stimulating units
Derived from multipotential stem cells capable of limited self-renewal and differentiation Responsive to hematopoeitic growth factors Express differentiation antigens |
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Normoblasts
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RBC precursors
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Myeloblasts
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Granulocyte precursors
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Monoblasts
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Monocyte precursors
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Lymphoblasts
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Lymphocyte precursors
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Megakaryoblasts
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Platelet precursors
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Precursor Cells
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First morphologically identifiable cells
Little if any self-renewal |
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Erythropoeitin
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Synthesized in kidney
RBC growth factors Synthesis increases in response to decreased rbc levels |
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GM-CSF
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From endothelial cells, stromal cells, lymphocytes in marrow
Synthsis increased with decreased RBC's |
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G-CSF
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From stromal cells in marrow
Synthesis increases in response to infections |
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SCF
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Stimulates totipotent and multipotent stem cells to differentiate
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Interleukins
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Mediate communication betwn WBC's
increased synthesis in response to infections |
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Cytoskeletal proteins of RBC's
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Spectrin
Ankyrin Actin Band 4.1 |
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Neutrophils
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60-70% of WBC's
12-15 μm diameter Usually 3 lobes |
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Types of granules in neutrophils
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Specific and Azurophilic
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Circulating lifespan of neutrophils
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6-7 hours
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Lifespan of neutrophils in tissues
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1-4 days
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Left shift
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Early mobilization of neutrophils from the bone marrow into peripheral blood
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Eiosinophils
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2-4% circulating WBC's
12-15 μm diameter increased in allergic reactions and parasitic infections |
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Eiosinophil granule contents
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Acid phosphatase
Cathepsin β glucouronidase |
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Basophils
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1% circulation WBC's
Bilobed nucleus 12-15 μm diameter Basophilic (dark) staining granules |
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Basophil granule contents
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Histamine and Heparin
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Monocytes
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3-8% circulating WBC's
12-20 μm diameter Live up to 4 days in circulation, then enter tissue and differentiate into macrophages Phagocytize opsonized bacteria Secrete cytokines Have Fc recepters |
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Lymphocytes
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20-25% circulation bacteria
b cells-15% Null Cells-5% t cells-80% |
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Platelets
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No nucleus
pinch off from megakaryocytes in BM 7-10 days in circulation contain granules involved in clot formation |
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clinical indications for bone marrow biopsy
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-unexplained cytopenia
-atypical circulating cells -hematologic neplasias |
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Normal Myeloid:erythroid ratio
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About 1.5-3:1
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Normal RBC value for men
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4.3-5.9 x 10^13/L
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Normal RBC value for women (direct)
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3.5-5.0 x 10^13/L
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Normal WBC for men and women (direct)
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5.0-11.0x 10^9/L
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Normal HGB for men (direct)
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13.6-17.2 g/dL
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Normal HGB for women (direct)
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12.0-15.0 g/dL
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Normal HCT for males(indirect)
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39-49%
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Normal HCT for women (indirect)
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33-43%
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Normal MCV (direct)
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80-100 fL
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Normal MCH (indirect)
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26-34 pg
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Normal MCHC (indirect)
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30-36 pg
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Normal RDW (red cell distribution width) ((direct))
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11.5-14.5
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Normal Platelet value
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105-450 x 10^9/L
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Normal WBC Values
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Neutrophils 60-70%
Eosinophils 2-4% Basophils-<1% Lymphocytes 20-25% Monocytes 3-8% |
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Rule of 3's
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RBC's X 3= Hgb ± 3
Hgb x 3=Hct ± 3 |