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58 Cards in this Set

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Site of blood production in 1st trimester
Yolk Sac
type of hgb in first trimester
ε and ζ

Epsilon and Zeta
Mesoblastic Period
1st trimester
yolk sac
detectable at 20 days gestation
primarily erythroid
epsilon and zeta hemeglobin
Site of blood production in 2nd trimester
Fetal Liver

(spleen, thymus, lymph also active)
Hepatic Period
2nd trimester
fetal liver
begins @week 5 or6
Cells morphologically identifable
primarily erythroid
Spleen, thymus, lymph nodes active
Site of blood production in 3rd trimester
Bone marrow
Myeloid Period
3rd trimester
5th month gestation
bone cavities of central or peripheral skeleton
Hgb A1 appears (α and β chains)
Active Myelopoeisis
Period of active myelopoeisis
(formation of blood cells other than erythroid)
Myeloid Period
3rd trimester
Sites of Adult Hematopoeisis
Vertebral bodies
Sternum
Ribs
Pelvis
Skull, proximal epiphyseal of humerous and femur
Sites of Adult hematopoesis in times of stress
Extramedullary hematopoesis

Liver, spleen, etc
Bone Marrow Histology
(stuff in BM)
Fat
Blood Vessels
Trabecular bone
Hematopoietic islands
Cells in bone marrow
Hematopoietic cells
endothelial cells
adipocytes
osteocytes
stromal cells
Purpose of stromal cells in bone marrow
Specialized fibroblasts
Physical support for hematopoetic cells
Express adhesion molecules
Secrete growth factors
Totipotent stem cells
Cells capable of unlimited self-renewal and differentiation

Highly resistant to chemotherapy
CD34
Surface antigen of totipotent stem cells
Dysfunction leads to aplastic anemia or leukemia
Totipotent Stem cells
Multipotent stem cells
Derived from totipotent stem cells
Capable of extended self-renewal and differentiation
Progenitor Cells
aka colony stimulating units

Derived from multipotential stem cells

capable of limited self-renewal and differentiation

Responsive to hematopoeitic growth factors

Express differentiation antigens
Normoblasts
RBC precursors
Myeloblasts
Granulocyte precursors
Monoblasts
Monocyte precursors
Lymphoblasts
Lymphocyte precursors
Megakaryoblasts
Platelet precursors
Precursor Cells
First morphologically identifiable cells

Little if any self-renewal
Erythropoeitin
Synthesized in kidney
RBC growth factors

Synthesis increases in response to decreased rbc levels
GM-CSF
From endothelial cells, stromal cells, lymphocytes in marrow

Synthsis increased with decreased RBC's
G-CSF
From stromal cells in marrow

Synthesis increases in response to infections
SCF
Stimulates totipotent and multipotent stem cells to differentiate
Interleukins
Mediate communication betwn WBC's

increased synthesis in response to infections
Cytoskeletal proteins of RBC's
Spectrin
Ankyrin
Actin
Band 4.1
Neutrophils
60-70% of WBC's
12-15 μm diameter
Usually 3 lobes
Types of granules in neutrophils
Specific and Azurophilic
Circulating lifespan of neutrophils
6-7 hours
Lifespan of neutrophils in tissues
1-4 days
Left shift
Early mobilization of neutrophils from the bone marrow into peripheral blood
Eiosinophils
2-4% circulating WBC's
12-15 μm diameter
increased in allergic reactions and parasitic infections
Eiosinophil granule contents
Acid phosphatase
Cathepsin
β glucouronidase
Basophils
1% circulation WBC's
Bilobed nucleus
12-15 μm diameter
Basophilic (dark) staining granules
Basophil granule contents
Histamine and Heparin
Monocytes
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
Lymphocytes
20-25% circulation bacteria

b cells-15%
Null Cells-5%
t cells-80%
Platelets
No nucleus
pinch off from megakaryocytes in BM
7-10 days in circulation
contain granules
involved in clot formation
clinical indications for bone marrow biopsy
-unexplained cytopenia
-atypical circulating cells
-hematologic neplasias
Normal Myeloid:erythroid ratio
About 1.5-3:1
Normal RBC value for men
4.3-5.9 x 10^13/L
Normal RBC value for women (direct)
3.5-5.0 x 10^13/L
Normal WBC for men and women (direct)
5.0-11.0x 10^9/L
Normal HGB for men (direct)
13.6-17.2 g/dL
Normal HGB for women (direct)
12.0-15.0 g/dL
Normal HCT for males(indirect)
39-49%
Normal HCT for women (indirect)
33-43%
Normal MCV (direct)
80-100 fL
Normal MCH (indirect)
26-34 pg
Normal MCHC (indirect)
30-36 pg
Normal RDW (red cell distribution width) ((direct))
11.5-14.5
Normal Platelet value
105-450 x 10^9/L
Normal WBC Values
Neutrophils 60-70%
Eosinophils 2-4%
Basophils-<1%
Lymphocytes 20-25%
Monocytes 3-8%
Rule of 3's
RBC's X 3= Hgb ± 3

Hgb x 3=Hct ± 3