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201 Cards in this Set

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blood clot/gas bubble floating in blood
embolus
factors interfere with normal clotting
1. prothrombin III - deactivates thrombin
2. protein C - inhibits clotting Factors
3. heparin - inhibits thrombin; prevents adherence of platelets to injured site
undesirable clotting
Thromboembolytic Disorders
blood clot in normal blood vessel
thrombus
can dissolve a clot
TPA, streptokinase
inhibits Thromboxane formation
aspirin
inhibits thrombin & platelet deposit
heparin
anticoagulant, blocks Vitamin K
dicumarol
reduced platelet count; generally below 50,000 per cubic millimeter; can cause excessive bleeding from vascular injury
thrombocytopenia
impaired liver function - lack of (Clotting Factors) that are made in liver
procoagulants
essential for liver to make Clotting Factors for coagulation
vitamin K
hereditary bleeding disorders that occur almost exclusively in males
hemophilias
hemophilias

defective Factor VIII (83%)
hemophilia A
hemophilias

defective Factor IX (10%)
hemophilia B
hemophilias

now produces genetically engineered TPA and Factor VIII; patients do not need transfusions as often
Genentech. Inc.
all cells and plasma; anticoagulants (citrate and oxalate salts) used
whole blood transfusion
most of the plasma has been removed prior to transfusion
packed red blood cells
glycoproteins on the surface of blood cells; causes "agglutination" (clumping)
agglutinogens
determined by presence or absence of Type A and Type B agglutinogen proteins on cell membrane
ABO Blood Groups
NO Rh factor
Rh negative (Rh-)
an Rh factor is present
Rh positive (Rh+)
type A blood
GENES: A/A, A/O, O/A
PEOPLE: (30-40%)
Antibodies: Anti-B
Receive Blood from: A, O
type B blood
GENES: B/B, B/O, O/B PEOPLE: (l0-30%)
Antibodies: Anti-A
Receive Blood from: B,O
type AB blood
GENES: A/B or B/A PEOPLE: (3-5%)
Antibodies: none
Receive Blood from: A, B, AB, O
type O blood
GENES: no A or B PEOPLE: (40-50%)
Antibodies: Anti-A, Anti-B
Receive Blood from: O only
Diagnostic Blood Tests

blood glucose level
diabetes
antibodies against either A or B agglutinogen (whichever is not present)

a. transfusion reaction - patient's antibodies attack the donor blood
agglutinins
transfusion reaction - patient's antibodies attack the donor blood
A (anti-B) receives A,O (not B)
B (anti-A) receives B,O (not A)
AB (none) receives A, B,AB,O (universal recipient)
O (anti-A,anti-B) receives O
(universal donor)
antibodies against either A or B agglutinogen (whichever is not present)
agglutinins
when incorrect blood transfused, antibodies will "clump" new blood
agglutination
after clumping, RBCs may rupture, releasing hemoglobin, harming kidney
hemolysis
hemolysis, treatment for:
dilute hemoglobin, administer diuretics
a different group of agglutinogens
Rh factor
delayed and less severe than in ABO confrontation
transfusion reaction
directly from the mother (Rh-) to the newborn (Rh+)
exchange transfusion
Rh- mother antibodies attack Rh+ of older newborn; results in anemia and low oxygen levels (hypoxia)
erythroblastosis fetalis
Diagnostic Blood Tests

lipidemia
high in fat; yellowish plasma
serum with anti-Rh agglutinins which will clump the Rh factor, blocking the reaction of mother’s antibodies
RhoGAM
mixing Donors Blood with Recipient Antibodies (Anti-A, Anti-B, anti-Rh) in order to identify agglutination
Blood Typing
Diagnostic Blood Tests

generally higher WBC count
infection
Diagnostic Blood Tests

significantly higher WBC count
leukemia
Ways of Expanding Blood Volume to Avoid Shock
1. pure plasma without antibodies
2. plasma expanders - purified human serum albumin, plasminate, dextran
3. isotonic saline - normal electrolyte solution isotonic to blood plasma (Ringer's Solution)
Diagnostic Blood Tests

anemia
low hematocrit (below 35%)
Diagnostic Blood Tests

counts % of each of the different leukocytes (helps diagnose)
differential WBC count
Diagnostic Blood Tests

time for clotting to occur
prothrombin time
Diagnostic Blood Tests

diagnose thrombocytopenia
platelet count
Diagnostic Blood Tests

overall blood review
complete blood count
Factors Limiting Growth and Formation of Clots

Limiting Normal Clot Growth
a. blood moves too fast to allow procoagulants
b. factors interfere with normal clotting
Clot Eradication (Fibrinolysis)

healing occurs over ? days
healing occurs over 2 - 10 days
Clot Eradication (Fibrinolysis)

causes the activation of plasminogen
tissue plasminogen activator (TPA)
Clot Eradication (Fibrinolysis)

plasminogen--> ?
plasmin
Clot Eradication (Fibrinolysis)

? degrades proteins within the clot
plasmin
the actual cellular components of blood (special connective tissue)
formed elements

erythrocytes
leukocytes
platelets
complex non-cellular fluid surrounding formed elements; protein & electrolytes
blood plasma
Separation of Components in a Centrifuge

VOLUME LAYER
55% top
clear/yellowish PLASMA
Separation of Components in a Centrifuge

VOLUME LAYER
<1% middle
thin/whitish buffy coat
with LEUKOCYTES & PLATELETS
Separation of Components in a Centrifuge

VOLUME LAYER
45% bottom
reddish mass - ERYTHROCYTES
red blood cells
erythrocytes
white blood cells
leukocytes
cell fragments for clotting
platelets
percentage by VOLUME of erythrocytes when blood is centrifuged (normal = 45%)
hematocrit
Characteristics of Blood

bright red
oxygenated
Characteristics of Blood

dark red/purplish
unoxygenated
Characteristics of Blood
1. much more dense than pure water
2. pH range from 7.35 to 7.45 (slightly alkaline)
3. slightly warmer than body temperature 100.4 F
4. typical volume in adult male 5-6 liters
5. typical volume in adult female 4-5 liters
6. typically 8% of body weight
Distribution & Transport
a. oxygen from lungs to body cells
b. carbon dioxide from body cells to lungs
c. nutrients from GI tract to body cells
d. nitrogenous wastes from body cells to kidneys
Regulation (maintenance of homeostasis)

maintenance of normal body pH
blood proteins (albumin) & bicarbonate
Regulation (maintenance of homeostasis)

maintenance of circulatory/interstitial fluid
electrolytes aid blood proteins (albumin)
Regulation (maintenance of homeostasis)
maintenance of temperature (blushed skin)
Protection

"seal" vessel damage
platelets and proteins
Protection

leukocytes, antibodies, complement proteins
protection from foreign material & infections
Erythrocytes (red blood ells; RBCs)

Structure

diameter / thickness
7.5 micron diameter; 2.0 micron thick
Erythrocytes (red blood ells; RBCs)

Structure

ideal for gas exchange
biconcave disk shape
Erythrocytes (red blood ells; RBCs)

Structure

elastic protein; allows shape change
spectrin
Erythrocytes (red blood ells; RBCs)

Structure

anucleate (no nucleus)
mature cells
Erythrocytes (red blood ells; RBCs)

Structure

very few organelles; mainly a hemoglobin carrier
hemoglobin – 33% of cell mass; carries oxygen
Erythrocytes (red blood ells; RBCs)

Structure

only anaerobic respiration
no mitochondria
Erythrocytes (red blood ells; RBCs)

Structure

ratio erythrocytes:leukocytes
800:1
Erythrocytes (red blood ells; RBCs)

Structure

red blood cell count: # cells per cubic millimeter
i. normal male count
5.1 to 5.8 million
Erythrocytes (red blood ells; RBCs)

Structure

red blood cell count: # cells per cubic millimeter
i. normal female count
4.3 to 5.2 million
large molecules with globin and hemes
hemoglobin
complex protein with 4 polypeptides (2 alpha and 2 beta polypeptides)
globin
IRON containing pigment part of hemoglobin to which oxygen binds
heme group
each polypeptide has
one heme group
each heme carries
one O2
normal hemoglobin levels (grams/l00 ml blood)

infants
14-20 grams/l00 ml
normal hemoglobin levels (grams/l00 ml blood)

adult female
12-16 grams/100 ml
normal hemoglobin levels (grams/l00 ml blood)

adult male
13-18 grams/l00 ml
when oxygen is bound to IRON
oxyhemoglobin
no oxygen bound to IRON
deoxyhemoglobin
when carbon dioxide bound (to polypeptide chain)
carbaminohemoglobin
the maturation, development and formation of blood cells
hematopoiesis (hemopoiesis)
location of hematopoiesis; in blood sinusoids which connect with capillaries; mainly in axial skeleton and heads of femur & humerous
red bone marrow (myeloid tissue)
the mitotic precursor to blood cells before differentiation
hemocytoblast (stem cell)
maturing cell becomes "committed" to being certain type blood cell
differentiation
the maturation, development, and formation of Red Blood Cells (erythrocytes)
erythropoiesis
erythropoiesis
hemocytoblast ->
proerythroblast ->
early (basophilic) erythroblast ->
late (polychromatophilic) erythroblast->
(hemoglobin) normoblast ->
(nucleus ejected when enough hemoglobin)
reticulocyte ->
(retaining some endoplasmic reticulum)
ERYTHROCYTE
3-5 DAYS
hemocytoblast -> reticulocyte
2 DAYS (in blood)
reticulocyte -> ERYTHROCYTE
100-120 DAYS
ERYTHROCYTE lifespan
ERYTHROCYTE death
(primarily destroyed by macrophages in the spleen)
Regulation of Erythropoiesis

hormonal controls

hormone that stimulates RBC production
erythropoietin
Regulation of Erythropoiesis

hormonal controls

DECREASED oxygen level in blood causes
KIDNEYS to increase release of erythropoietin
DECREASED oxygen level in blood

causes
1. Less RBCs from bleeding
2. Less RBCs from excess RBC destruction
3. Low oxygen levels (high altitude, illness)
4. Increased oxygen demand (exercise)
Eythropoietin now genetically engineered and synthesized by
AMGEN of Thousand Oaks
Testosterone can also mildly stimulate production of
RBCs in humans
essential for hemoglobin to carry oxygen
Iron
65% of Fe in body is in
hemoglobin
liver and spleen store most excess Fe bound to
ferritin and hemosiderin
Fe in blood bound to
transferrin
daily Fe loss:
0.9 mg men/l.7 mg women
women also lose Fe during
menstrual flow
essential for DNA synthesis in early mitotic divisions leading to erythrocytes
B-complex Vitamins - Vitamin B12 and Folic Acid
a symptom that results when blood has lower than normal ability to carry oxygen
Anemias
loss of blood from bleeding (wound, ulcer, etc.)
hemorrhagic anemia
erythrocytes rupture (hemoglobin/transfusion problems, infection)
hemolytic anemia
red marrow problems (cancer treatment, marrow disease, etc.)
aplastic anemia
Decrease in Hemoglobin

low Iron levels (diet; absorption, bleeding, etc.)
iron-deficiency anemia
Decrease in Hemoglobin

low Vitamin B12 (diet, intrinsic factor for Vit B absorption)
pernicious anemia
Abnormal Hemoglobin (usually genetic)

easily ruptured RBCs (Greek & Italian genetic link)
thalassemia
Abnormal Hemoglobin (usually genetic)

sickle-shaped RBCs (genetic Africa, Asia, southem Europe link)
sickle-cell anemia
excess RBC count, causes thick blood
Polycythemia
bone marrow problem; hematocrit may jump to 80%
polycythemia vera
high altitude (normal); or too much erythropoietin release
secondary polycythemia
RBCs previously withdrawn are transfused before an event; more RBCs, more oxygen delivery to the body
blood doping in athletes
Leukocytes (white blood cells; WBCs)

General Structure and Function

protection from
microbes, parasites, toxins, cancer
Leukocytes (white blood cells; WBCs)

General Structure and Function

?% of blood volume; ? per cubic mm blood
1% of blood volume; 4-11,000 per cubic mm blood
Leukocytes (white blood cells; WBCs)

General Structure and Function

can "slip between" capillary wall
diapedesis
Leukocytes (white blood cells; WBCs)

General Structure and Function

movement through the body
amoeboid motion
Leukocytes (white blood cells; WBCs)

General Structure and Function

moving in direction of a chemical
chemotaxis
Leukocytes (white blood cells; WBCs)

General Structure and Function

increased "white blood cell count" in response to bacterial/viral infection
leukocytosis
Leukocytes (white blood cells; WBCs)

General Structure and Function

contain membrane-bound granules (neutrophils, eosinophils, basophils)
granulocytes
Leukocytes (white blood cells; WBCs)

General Structure and Function

NO membrane-bound granules (lymphocytes, monocytes)
agranulocytes
granules in cytoplasm can be stained with Wright's Stain; bilobar nuclei; 10-14 micron diameter; all are phagocytic cells (engulf material)
Granulocytes
destroy and ingest bacteria & fungi (polymorphonuclear leuks.; "polys")
neutrophils
a. most numerous WBC
b. basophilic (blue) & acidophilic (red)
c. defensins - antibiotic-like proteins (granules)
d. polymorphonuclear - many-lobed nuclei
e. causes lysis of infecting bacteria/fungi
f. HIGH poly count --> likely infection
neutrophils
lead attack against parasitic worms
eosinophils
a. only 1-4% of all leukocytes
b. two-lobed, purplish nucleus
c. acidophilic (red) granules with digest enzymes
d. phagocytose antigens & antigen / antibody complex
e. inactivate chemicals released during allergies
eosinophils
releases Histamine which causes inflammation, vasodilation, attraction of WBCs
basophils
a. RAREST of all leukocytes (0.5%)
b. deep purple U or S shaped nucleus
c. basophilic (blue) granules with HISTAMINE
d. related to "mast cells" of connective tissue
e. BOTH release Histamine with "IgE" signal
f. antihistamine - blocks the action of Histamine in response to infection or allergic antigen
basophils
WBCs without granules in cytoplasm
C. Agranulocytes
(thymus) respond against virus infected cells and tumor cells
T lymphocytes
(bone) differentiate into different "plasma cells" which each produce antibodies against different antigens
B lymphocytes
lymphocytes primarily in
lymphoid tissues
lymphocytes nucleus
very large basophilic (purple) nucleus
small lymphocytes in blood ? microns
5-8 microns
larger lymphocytes in lymph organs
? microns
10-17 microns
differentiate to become macrophages; serious appetites for infectious microbes
monocytes
largest of all lymphocytes (18 microns)
dark purple, kidney shaped nucleus
monocytes
the production, differentiation, and development of white blood cells
leukopoiesis
hematopoietic hormones that promote leukopoiesis
colony stimulating factors (CSF)
M-CSF
macrophage-monocyte CSF
(colony stimulating factors)
G-CSF
granulocyte CSF
GM-CSF
granulocyte-macrophage CSF
multi CSF
multiple lymphocyte action
IL-3
interleukin 3 (general lymphocytes)
all cells derived from hemocytoblast
leukopoiesis
EOSINOPHIL
NEUTROPHIL
BASOPHIL

lifespan?
0.5 to 9 day lifespan
abnormally low WBC count
leukopenia
leukopenia

causes
HIV infection, glucocorticoids, chemotherapy
cancerous condition of "line" of WBCs
leukemia
myelocytic leukemia
myelocytes
lymphocytic leukemia
lymphocytes
acute leukemia
cancer spreads rapidly
chronic leukemia
cancer progresses slowly
caused by Epstein-Barr virus, excessive monocytes and lymphocytes; fatigue, sore throat, fever; 3 week course
infectious mononucleosis
thrombocytes - "clotting"
Platelets
Platelets (thrombocytes - "clotting")

size?
very small, 2-4 microns in diameter
Platelets (thrombocytes - "clotting")

approximately ? per cubic millimeter
approximately 250-500,000 per cubic millimeter
Platelets (thrombocytes - "clotting")

essential for ? of damaged vasculature
essential for clotting of damaged vasculature
regulates platelet production
thrombopoietin
hemocytoblast->
myeloid stem cell->
megakaryoblast->
promegakaryocyte->
megakaryocyte-> (large multilobed nucleus)
platelets (anucleated parts of megakaryocyte cytoplasm)
Formation of Platelets
plasma makes up ?% of normal blood by volume
plasma makes up 55% of normal blood by volume
water is ?% of the plasma by volume
water is 90% of the plasma by volume
different SOLUTES in the plasma
albumin
globulins
clotting proteins
other proteins
nutrients
electrolytes
pH buffer & osmotic pressure
albumin
binding proteins & antibodies
globulins
clotting proteins
prothrombin & fibrinogen
other proteins
enzymes, hormones, others
glucose, fatty acids, amino acids, cholesterol, vitamins
nutrients
Na+, K+, Ca++, Mg++, Cl-, phosphate, sulfate, bicarbonate, others
electrolytes
stoppage of blood flow after damage
Hemostasis
Hemostasis

General Characteristics
1. vascular spasms (vasoconstriction at injured site)
2. platelet plug formation (plugging the hole)
3. coagulation (blood clotting - complex mechanism)
first response to vascular injury
Vascular Spasms / VASOCONSTRICTION
VASOCONSTRICTION is stimulated by:
a. compression of vessel by escaping blood
b. injury "chemicals" released by injured cells
c. reflexes from adjacent pain receptors
Formation of a Platelet Plug
1. damage to endothelium of vessel
2. platelets become spiky and sticky in response
3. platelets attach to damaged vessel wall to plug it
4. platelets produce thromboxane A2 - granule release
5. serotonin release enhances vascular spasm
6. ADP - attracts and stimulates platelets at site
7. prostacylin - inhibits aggregation at other sites
Coagulation
blood clotting
General Events in Clotting
platelet cells activated by damage->
PF3 and/or Tissue Factor produced by platelet cells->
Factor X activated->
prothrombin activator (enzyme)produced->
prothrombin conversion -> thrombin (another enzyme)
thrombin stimulates: fibrinogen----> fibrin mesh
chemical that inhibits clotting
anticoagulant
chemical that promotes clotting
procoagulant
pathway - within the damaged vessel
intrinsic pathway
a. more procoagulants needed (I-XIII) toward PF3 and Factor X
b. allows more "scrutiny" before clotting occurs
intrinsic pathway
pathway in outer tissues around vessel
extrinsic pathway
skips intrinsic steps straight to PF3 and Factor X
tissue thromboplastin (Tissue Factor)
a. tissue thromboplastin (Tissue Factor) - skips intrinsic steps straight to PF3 and Fac X
b. allows rapid response to bleeding out of vessel (clot can form in 10 to 15 seconds)
extrinsic pathway - in outer tissues around vessel
After activation of Factor X, common pathway:
Factor X, PF3 (thromboplastin), Factor V, Ca++ -->
prothrombin activator ->
prothrombin converted ->
thrombin (active enzyme)
thrombin stimulates: fibrinogen -> fibrin (meshwork)
Ca++ & thrombin -> Factor XIII (fibrin stabilizer)
shrinking of clot
Clot Retraction
Clot Retraction (shrinking of clot)

causes contraction of platelets
actomyosin
Clot Retraction (shrinking of clot)

plasma WITHOUT clotting Factors
blood serum - plasma WITHOUT clotting Factors
Clot Retraction (shrinking of clot)

stimulates fibroblast migration and endothelial growth
platelet-derived growth factor (PDGF)
Clot Eradication
Fibrinolysis
1. anemia, fever, weight loss, bone pain
2. death from internal hemorrhage or infection
3. chemotherapy & radiation therapy used to treat
leukemia