Physio Lecture 12 Questions (Exam 2)

Front 1

What is the average blood volume of females? males?

Back 1

Average total blood volume of females is 4.5-5.5L, for males 5.0-6.0L

Front 2

What is hematocrit? What is the "normal" hematocrit value?

Back 2

Hematocrit is the ratio of packed red blood cells to total blood volume in a centrifuged sample of blood, expressed as a percentage. A normal hematocrit value is ~45%.

Front 3

When blood is centrifuged, which layer contains WBCs? RBCs?
Platelets?
albumin and fibrinogen? glucose?
Ions?

Back 3

WBC's and platelets are both in the "buffy coat".
RBC's are at the bottom and are red in color.
Albumin, fibrinogen, glucose and ions are all in the plasma at the top of the tube (generally
yellowish in color).

Front 4

What are the major proteins of plasma? Where are albumin and plasminogen synthesized? What are their functions?
.

Back 4

The major plasma proteins are albumin, globulins and fibrinogen. . They are synthesized in the liver. They provide the colloid osmotic pressure in the blood vessels (this helps to bring fluid back into the plasma from the interstitial fluid – we will discuss this later in the class)

Front 5

What are the scientific/medical names of red blood cells, white blood cells, and platelets?

Back 5

The scientific/medical names of red blood cells are erythrocytes, white blood cells are leucocytes, and platelets are thrombocytes

Front 6

From what type of cell do RBCs, WBCs, and platelets originate from? Where is this original type cell found?

Back 6

They all originate from pluripotent hematopoietic stem cells found in the bone marrow.

Front 7

What is the relative percentage of RBCs to WBCs in whole blood?

Back 7

Roughly 5,000,000 RBC to 5,000 WBC's, a ratio of 1000:1, because of differences in size, the percentages (of volume) found in the hematocrit are 45 (RBC): 1 (WBC)

Front 8

What is erythropoisis?

Back 8

Erythropoiesis refers to the formation of erythrocytes (RBC).

Front 9

What controls the rate at which it erythropoisis occurs?

Back 9

Erythropoiesis refers to the formation of erythrocytes (RBC). The amount of erythropoietin that
is in the blood stream.

Front 10

What is anemia? How do the following contribute to anemia: B12, kidney disease, iron
deficiency, malaria?

Back 10

(These answers are from the lab).
Anemia is a condition in which insufficient oxygen is
transported to the body's cells, it is usually associated with an abnormal reduction in the red
blood cell count, hemoglobin concentration, or hematocrit, or any combination of these
measurements.
B12 is necessary for cell division, so without enough B12, new RBC's can't be formed.
Kidney disease results in lower and lower concentrations of erythropoietin, until none is
made, and so RBC production stops.
Iron is an essential element in the heme group that allows the hemoglobin molecule to complex with ("carry") oxygen, so without it, the hemoglobin won't transport oxygen.
And malaria is a parasite that infects RBC's , which causes the RBC's to rupture, this and sickle-cell anemia are both forms of hemolytic anemias.
NOTE: Aplastic anemias are due to destruction of bone marrow by toxins or radiation or cancer.
Hemolytic anemias refer to the rupture of RBC's as in sickle cell anemia or malaria.

Front 11

What is the difference between plasma and serum?

Back 11

Plasma is the complete fluid portion of blood. If plasma is allowed to clot, and the clots
centrifuged so that the clot is separated from the remaining fluid, the remaining fluid is called serum. (So serum = plasma - fibrinogen and clotting factors

Front 12

What are the three types of granular leucocytes?

Back 12

The three granular leucocytes are neutrophils, eosinophils, and basophils.

Front 13

What are the two major types of agranular leucocytes?

Back 13

The two types of
agranular leucocytes are monocytes/macrophages and lymphocytes.

Front 14

What are the two types of lymphocytes?

Back 14

Lymphocytes are divided
into B-lymphocytes (B-cells), and T-lymphocytes (T-cells)

Front 15

Which cell type is responsible for
producing antibodies?

Back 15

The only cells that make antibodies
are B-cells.

Front 16

If, when analyzing a patents hematocrit, >1% of a "buffy coat" is observed - what might this indicate?

Back 16

This could indicate that the person has an infection, or leukemia.

Front 17

About how many hemoglobin molecules are in a single RBC?

Back 17

There are about 280 million hemoglobin molecules in a single RBC.

Front 18

What element is essential for transport of oxygen by hemoglobin?

Back 18

The element essential for
transport of oxygen is iron.

Front 19

What hormone stimulates RBC maturation?
Where is it produced?

Back 19

Erythropoietin stimulates RBC maturation. It is produced in the kidneys

Front 20

What is responsible for the ABO blood types?
Why is it important to not transfuse the wrong
blood type into a patient?

Back 20

The ABO blood type is produced by the presence or absence of specific antigens on the RBC's.

If you transfuse the wrong blood type into a patient, the RBC's will agglutinate (clump together). These cells that are agglutinated can act like a clot and block off blood flow to any areas of the body (including the heart and the brain.) Alternatively, the donors antibodies could attack and destroy any of the patients remaining RBC's

Front 21

What is hemostasis?

Back 21

Hemostasis is the process which stops bleeding

Front 22

what are Platelets?

Back 22

Platelets are fragments of megakaryocytes
which when activated will quickly stick to and "plug" the damaged area of the blood vessel endothelium.

Front 23

What causes platelets to stick to an injured vessel wall, to one another?

Back 23

Initially the exposed collagen attracts the platelets and causes them to stick, then the platelets
themselves start releasing ADP, serotonin and thromboxane A2 (TxA2). Serotonin and TxA2 aid in causing vasoconstriction of the local area, and ADP and TxA2 recruit more platelets to
form a more contracted/tight plug.

Front 24

What is Collagen?

Back 24

Collagen is a protein found in the extracellular matrix, under the endothelial cells
of the blood vessel, which binds the platelets to begin to form the "plug".

Front 25

von Willebrand factor?

Back 25

von Willebrand factor
is another protein in the extracellular matrix that helps by binding to both collagen and platelets

Front 26

What causes platelets to stick to an injured vessel wall, to one another

Back 26

Initially the exposed collagen attracts the platelets and causes them to stick, then the platelets themselves start releasing ADP, serotonin and thromboxane A2 (TxA2). Serotonin and TxA2 aid in causing vasoconstriction of the local area, and ADP and TxA2 recruit more platelets to
form a more contracted/tight plug.

Front 27

What is fibrin?
What triggers its formation?

Back 27

Fibrin is created from conversion of fibrinogen to fibrin and will infiltrate into the platelet plug to create a very firm and stable clot.
Fibrinogen is converted to fibrin by a complex series of
"clotting factors" which activate one another until fibrin is formed.

Front 28

What is the advantage of having a multi-step
process (a series of enzymatic reactions) to trigger a response rather than a single-step process?

Back 28

Having a multi-step process
is important as it provides a series of check points to assure that the body doesn't just form fibrin in the blood that could clog up the vessels and cause hypoxia and even death

Front 29

What role does Ca++ play in the clotting process, and how do we use this knowledge?

Back 29

Ca++ is required
as a cofactor for many of the clotting factors to become active. We can use this knowledge to prevent fibrin formation when it is occurring aberrantly.

Front 30

How is a clot dissolved?

Back 30

A clot is dissolved by the formation of plasmin from plasminogen. This is important because when we no longer need the clot, we don't want to release it into the blood stream to clog our vessels

Front 31

What are anticoagulants?

Back 31

Anticoagulants are molecules that can prevent fibrin formation.

Front 32

Which anticoagulants are typically used in blood collection vials?

Back 32

Blood collection vials typically
use "sodium citrate" or "EDTA" which are chemicals that chelate or bind the free Ca++ in the plasma. Binding the Ca++ cofactor makes it impossible for the clotting factors to work.

Front 33

Which anticoagulants can be injected into patients and why are they used?

Back 33

Two common molecules that are used in patients are heparin and coumarin type drugs (ie, coumadin or warfarin). Heparin inhibits thrombin from working and coumarin type drugs indirectly
reduces the interactions of Ca++ of the clotting factors, which slow down the clotting process.
Heparin is often used in IV's to prevent a clot forming in the IV - called a "Hep block".
And if a patient is too prone to forming fibrin naturally, they are often put on coumarin type
drugs to prevent aberrant clots from forming in their blood.

Front 34

Formed Elements

Back 34

Red blood cells, White blood cells, platelets

Front 35

Plasma

Back 35

Liquid portion of the blood, made up of three types of proteins: albumin, globulin, fibrinogen

Front 36

Albumin

Back 36

Plasma protein, smallest and most abundant: accounts for 60-80 % of plasma, creates colloid osmotic pressure that draws H2O from interstitial fluid into capillaries to maintain volume and pressure

Front 37

Globulin

Back 37

Plasma protein, carries lipids throughout the blood stream and to the body (water and lipids don’t mix so very important)

Front 38

Fibrinogen

Back 38

Plasma protein, serves as a clotting factor and is converted into fibrin that forms an insoluble threadlike molecule that forms a meshwork of a clot during blood coagulation, activated by thrombin

Front 39

Fibrin

Back 39

Formed from plasma protein fibrinogen (which is activated by thrombin), forms a threadlike molecule that createss a meshwork of a clot known as the “platelet plug”

Front 40

Serum

Back 40

The fluid left over when blood blots. (Serum=Plasma-fibrinogen)

Front 41

Chylomicron

Back 41

Transport cholesterol and lipids from intestines to liver and tissues via blood

Front 42

LDL

Back 42

Low Density Lipoprotein; transport cholesterol and lipids from liver to tissues (too much is bad, b/c if you build up cholesterol and lipids in tissues this leads to plaque build-up)

Front 43

Thrombocytes

Back 43

Platelets, smallest of formed elements, lack nucleus and mitochondria, fragments of megakaryocytes, constitutes most of mass of blood clots, survive 5-9 days, release serotonin to vasoconstrict and reduce blood flow to clot area

Front 44

HDL

Back 44

High Density Lipoprotein; transport excess cholesterol from tissues and delivers to liver (healthy, excess cholesterol from tissues is properly disposed of or stored in the liver for future use)

Front 45

Granular Leukocytes

Back 45

Help detoxify foreign substances and release heparin, include Eosinophils, basophils, neutrophils, have a graney appearance

Front 46

Hematopoiesis

Back 46

Formation of blood cells from stem cells in bone marrow, makes blood cells, contains two processes for RBC and WBC

Front 47

Erythrocytes

Back 47

RBCs, flattened biconcave discs that provide increased surface area for diffusion, lack nuclei and mitochondria, contains about 280 million hemoglobin molecules, lifespan ~120 days, old RBS are removed from blood by phagocytic cells in liver, spleen, and bone marrow, use glycolysis to make ATP, constantly being made

Front 48

Erythropoiesis

Back 48

Formation of RBCs, stimulated by erythropoietin (EPO) from the kidney

Front 49

Erythropoietin (EPO)

Back 49

Stimulates the production of RBC’s

Front 50

Bone Marrow

Back 50

Contains stem cells that are used in the formation of blood cells

Front 51

Heme Group

Back 51

Iron-containing groups bound to each polypeptide chain within a hemoglobin molecule which binds to the oxygen molecules, thus each hemoglobin can carry four oxygen molecules due to the four iron heme groups

Front 52

Folic Acid

Back 52

Required for adequate DNA replication

Front 53

B12

Back 53

Required for adequate DNA replication

Front 54

TPA (Tissue Plasminogen Activator)

Back 54

Given to patients with abnormal clots, dissolves an abnormal clot

Front 55

Hemoglobin (Hg)

Back 55

Found in red blood cells, consists of 4 globin folded polypeptide change and four iron heme groups used to attach to oxygen, a reddish pigment,

Front 56

Bilirubin

Back 56

Bile pigment, which is a waste product redrived from the degradation of hemoglobin during the breakdown of old RBCs, accumulation of this causes jaundice of the skin giving it an orangish color

Front 57

ABO System

Back 57

Major antigen group

Front 58

Antigen

Back 58

Found in cells, Any substance (as a toxin or enzyme or protein) that stimulates the production of antibodies, present on RBC surface that specifies blood type, triggers a specific immune response against itself when it gains entry into the body

Front 59

Antibody

Back 59

Found in plasma, An immunoglobulin produced by a specific activated B lymphocyte against a particular antigen, binds with the specific antigen against which it is produces and promotes the antigenic invaders destruction by augmenting nonspecific immune responses already initiated against the antigen,

Front 60

Agglutinate

Back 60

Clump together, if different blood types are mixed the antibodies will cause mixture and form clumping

Front 61

Universal Donor

Back 61

Type O, because it lacks A & B antigens, in blood shortage able to give this blood type with only the cells and not the plasma

Front 62

Universal Recipient

Back 62

Type AB because doesn’t make anti-A or anti-B antibodies so their blood won’t agglutinate

Front 63

Rho (D)/ Rh Factor

Back 63

Type of antigen found in RBC, Rh+ has Rho(D) antigens and Rh- does not, 85% of population is Rh+, can cause a problem when a Rh- mother has Rh+ babies b/c the mother may be exposed to Rh+ blood of fetus

Front 64

Erythroblastosis Fetalis

Back 64

Occurs when antibodies of Rh- mother and Rh+ fetus cross antibodies at the placenta causing hemolysis of fetal RBCs

Front 65

Diapedesis/Extravasation

Back 65

Able to squeeze through capillary walls, WBC’s are able to do this

Front 66

Leukopoiesis

Back 66

Formation of WBC’s

Front 67

Megakaryocyte

Back 67

Fragments of these form thrombocytes

Front 68

Intrinsic Pathway

Back 68

The conversion of fribinogen to fibrin, this pathway occurs when clots damaged vessels and blood left in test tube, it is initiated by exposure of blood to negatively charged surface of flass or blood vessel collagen, activated factor XII (Hageman factor) which then initiates a series of collagen factors, (most clotting factor require Ca to be activated), Ca then converts prothrombin to thrombin which then converts fibrinogen to fibrin

Front 69

Factor XII (Hageman Factor)

Back 69

Is activated by coming into contact with either exposed collagen in an injured vessel or a foreign surface such as a glass test tube, exposed collagen also initiates the formation of platelet plug and the chain reaction leading to clot formation

Front 70

Eosinophils

Back 70

WBC’s that are important in allergic responses and in combating internal parasite infestations

Front 71

Basophils

Back 71

WBC’s that synthesize, store, and release histamine, which is important in allergic responses, and heparin which hasten the removal of fat particles from blood

Front 72

Neutrophils

Back 72

WBC’s that are phagocytic specialists and important in inflammatory responses and defense against bacterial invasion, most prevalent (50%-75% of leukocytes), goes thru body and cleans up messes

Front 73

Agranular Leukocytes

Back 73

Are either destructive/phagocytic (lymphocytes) or produce antibodies (monocytes)

Front 74

Monocytes  Macrophages

Back 74

WBC’s that emigrate from the blood, enlarge, and become marchophages, large-tissue phagocytes

Front 75

Phagocytes/Phagocytosis

Back 75

A type of monocytes and WBCs

Front 76

Lymphocytes

Back 76

Become either T- or B- Cells, 20-40% of these cells expand during infection, provides immune defense against targets for which they are specifically programmed

Front 77

Cell-Mediated Immunity

Back 77

A specific immune response accomplished by activated T lymphocytes, which directly attack unwanted cells, T-CELLS, attack infected host cells, cancer cells, and foreign cells

Front 78

T-Cells

Back 78

Develop from lymphocytes that seed thymus, can only be replenished up until late childhood, can be depleted by AIDS or Chemo, do not secrete antibodies, provide cell-mediated immunity which attacks infected cells

Front 79

Thymus

Back 79

Grows during childhood, gradually regresses after puperty, contains T cells that cannot be replenished

Front 80

B-Cells

Back 80

Mature in the bone marrow, fight infections by secreting antibodies into blood and lymph, provide humoral immunity, only job is to make antibodies which mark cells for destruction

Front 81

Humoral Immunity

Back 81

Occurs in B-cells that helps mark cells for destruction and secrete antibodies

Front 82

Hematocrit

Back 82

Percentage of blood volume occupied by erythrocytes as they are packed down in a centrifuged blood sample, 45% is normal

Front 83

Polycythemia

Back 83

Excess circulating erythrocytes, accompanied by an elevated hematocrit, not always a bad thing can occur from high levels of elevation

Front 84

Buffy Coat

Back 84

The middle layer of a centrifuge spin that contain less then 1% of material, a mixture of platelets and WBC’s

Front 85

Hemostasis

Back 85

The stopping of bleeding from an injured vessel, cessation of bleeding, promoted by reactions initiated by vessel injury which vasoconstricts blood flow to area where a platelet plug forms which the plug and surroundings are infiltrated by web of fibrin forming a clot

Front 86

NO (Nitric Oxide)

Back 86

A chemical mediator released from endothelial cells and other tisses, exerts a wide array of effects ranging from caushing local arteriolar vasodilation to acting as a toxic agent against foreign invaders to serving as a unique type, production is activated by ATP, Ach, bradykinin, L-arginine, and histamine

Front 87

Collagen

Back 87

Found underneath endothelial cells and are used when damaged endothelium allows forming of platelet plug by combining with platelets and allow them to stick

Front 88

Von Willaband Factor

Back 88

Found underneath endothelial cells and are used in forming platelet plug, increased bond by binding to both collagen and platelets

Front 89

Platelet Plug

Back 89

When platelets stick to collagen, they release ADP, serotonin, and Thromboxane A2 which stimulated vasoconstriction, reducing blood flow to wound, as platelets continue to be sticky and attach, this continues to form platelet plug which becomes infiltrated by meshwork of fibrin (comes from plasma protein)

Front 90

Plug Contraction

Back 90

Platelet plug undergoes plug contraction to form more compact plug that initiates clotting factors

Front 91

Extrinsic Pathway

Back 91

The conversion of fibrinogen to firbin that allows for clotting shortcut, damage to outside blood vessels releases tissue thromboplastin that triggers a clorring shortcut

Front 92

Tissue Thromboplastin

Back 92

Occurs in extrinsic patheway that triggers a clotting shortcut, found in damage to outside blood vessels

Front 93

Prothrombin

Back 93

Activated by factor x which then activated thrombin, which activates fibrinogen and then activated fibrin and forms the fibrin meshwork to form the clot

Front 94

Thrombin

Back 94

Activated by prothrombin which then activated fibrinogen which then activated fibrin and forms the firbrin meshwork to form the clot, activated plasminogen

Front 95

Kallikrein

Back 95

Activated by factor XII (Hageman Factor) which converts plasminogen into plasmin which digest fibrin dissolving the clot

Front 96

Plasmin/Plasminogen

Back 96

Plasminogen is converted into Plasmin by the activated XII Factor (Hageman factor) plasmin then digest fibrin dissolving the clot, also activated by thrombin

Front 97

Ca Chelator

Back 97

A type of anticoagulant that prevents clotting (e.g. sodium citrate or EDTA

Front 98

Sodium Citrate

Back 98

A type of anticoagulant, is a Ca Chelator that prevents clotting

Front 99

EDTA

Back 99

A type of anticoagulant, is a Ca Chelator that prevents clotting

Front 100

Heparin

Back 100

A type of anticoagulant, activated antithrombin III (block thrombin) stops clots from forming and therefore cannot dissolve clots

Front 101

Coumarin/Warfarin

Back 101

A type of anticoagulant, blocks clotting indirectly reducing the effect of Ca which results in slower clotting times

Front 102

Anemia

Back 102

A reduction below normal in O2 carrying capacity of the blood , insufficient oxygen transported to the body cells, associated with abnormal reduction of RBC’s. can be contributed by B12 (needed for cell division), kidney disease(lowered/no EPO production), iron deficiency(no attachment of oxygen to hemoglobin), and malaria(infections of RBC’s causing them to rupture)