Blood

Front 1

What are the functions of blood?

Back 1

- Transportation: O2, nutrients, hormones, waste products
- Regulation of pH and solute composition (like H2O ballance)
- Protection - clotting and immune functions
- Body temperature - spreading heat from metabolic functions

Front 2

What are typical values for blood pH and temperature, blood volume and hematocrit?

Back 2

pH - 7.38; range: 7.35-7.45
Temp - 38C/100.4 F
Volume - 5-6 L in man; 4-5 L in woman
Hematocrit - 45% of RBCs in total blood volume

Front 3

Blood is classified as what type of tissue?

Back 3

- Connective tissue
- Plasma = fluid extracellular matrix
- RBCs etc = cells

Front 4

What part of the blood is the non-living matrix?

Back 4

- the plasma: a fluid matrix
- only fluid matrix out of all connective tissues

Front 5

Describe the composition of whole blood.

Back 5

Plasma: 55% of volume
Formed elements: 45%; leucocytes, platelets, erythrocytes/rbcs

Front 6

Describe the composition of plasma.

Back 6

- 92% H2O
- 8% solutes (mostly plasma proteins too big to get out of capillaries)
Plasma proteins = albumins, globulins, clotting proteins

Front 7

What is the primary component of plasma?

Back 7

- H2O - 92% of plasma volume

Front 8

Identify the main types of plasma proteins and describe the general functions of each.

Back 8

Albumins - 60%; angiotensin; major contributer to osmotic press., important buffer; transport (TH, steroid hormone, fatty acids)
Globulins - 35%; transport globulins (carry vitamins, metal ions, lipoproteins); immunoglobulin (antibodies)
Clotting proteins - 5%; fibrinogen, prothrombin

Front 9

What is the most numerous type of blood cell?

Back 9

- Erythrocytes/rbcs

Front 10

In adults,where are the formed elements of the blood produced?

Back 10

- red bone marrow in certain bones (mostly flat bones... like hip, sternum etc?)
- also liver and spllen and lymph nodes

Front 11

Describe the structure and function of mature erythrocytes (rbcs).

Back 11

Structure: flexible (so they can fit through tight capillaries); biconcave disk shape from lack of nucleus (lots of surface area, diffusion distances in cell very short), anuclearte
Function: transport O2 and CO2

Front 12

Describe the molecular structure of hemoglobin (Hb).

Back 12

- binds reversibly to O2 and CO2
- made up of polypeptide subunits:two alapha and two beta chains
Each chain: globular part and heme part
Iron at center of heme groups
Hb can carry 4 O2 molecules (saturated)

Front 13

How does adult Hb differ from fetal Hb?

Back 13

- fetal Hb has gamma instead of beta globins
- gamma has a higher affinity for oxygen
- this helps the baby get it's oxygen from the mother's blood
- gradually gamma is replaced with beta

Front 14

What is the typical lifespan of RBCs?

Back 14

80-120 days
- short b/c of all of the physical stress

Front 15

Where are worn out/damaged RBCs removed from the blood and broken down?

Back 15

- removed from circulation by macrophages in liver and spleen

Front 16

What type of cell removes worn out/damages RBCs from the blood?

Back 16

Macrophages - their phagolysosome breaks it down

Front 17

Describe the Hb breakdown products and tell how they are handled.

Back 17

Globin:
- Amino acids - rejoin amino acid bool
Heme:
- ferritin - can cause oxidative damage; stored in liver and spleen; attatched to transferrin for transport; recycled back to bone marrow through blood
- Biliverdin - reuced to bilirubin, released in circulation; bound to albumin in liver and secreted into bilie; changed to urobilinogen by bacteria in intestines; some released back into blood and secreted by kidney in urine, most owidized to stercobilin and excreted in feces

Front 18

Name the hormone that stimulates RBC production. What organ releases this hormone?

Back 18

- erythropoietin (EPO)
- produced by kidneys

Front 19

Describe the negative feedback regulation of erythropoiesis.

Back 19

- Increase in hypoxia (not enough O2 to tissues)
- Increase in EPO by kidneys
- Increase in rbc production in bone marrow
- Increase in O2 circulation
- Decrease in hypoxia
- Decrease in EPO production

Front 20

At which stage of development does the rbc eject its nucleus?

Back 20

Normoblast ejects its nucleus
- becomes a reticulocyte

Front 21

At which stage of development do rbcs leave the bone marrow and enter the circulation?

Back 21

- reticulocyte stage
- after 1-2 days become mature rbcs
- used as index of rate of erythropoiesis

Front 22

What are the three common causes of anemia?

Back 22

Insufficient rbc numbers: from hemmoraging, premature lyising, inhibition of erythropoeisis
- Decreased Hb content of rbcs - from vit B12 or iron deficiency
- Abnormal Hb - from halacemia or sicle cell anemia

Front 23

Describe the stages of RBC development from pluripotent stem cell to mature rbc.

Back 23

- pleuripotent stem cell/hemocytoblast (multiCSF acts on it)
- becomes myeloid stem cell (instead of a lymphoid stem cell, the other type)
- progenetor cells - acted upon by erythropoietin (EPO) to become
- Proerythroblast - the 1st stage of being an immature rbc, where path can't change
- erythroblast
- normoblast - ejects nucleus
- reticulocyte - enters circulation
- mature rbc

Front 24

Describe how leukocytes (wbcs) use diapedesis, amoeboid motion, and chemotaxis to move around in the body.

Back 24

- cells moving in blood
- positive chemotaxis towards conc.
- antigens on wbc and mollecules on endothelial walls interact, slowing cell down (rolls along wall and stops)
- diapedesis - the cell squeezes b/w the endothelial cells inot the tissues
- amoeboid motion - continues positive chemotaxis by swimming towards infection site

Front 25

Identify the two general categories of wbcs and name the specific cells assigned to each category.

Back 25

Granulocytes (neutrophils, eodinophils and basophils):
- lobed nuclei, granules in cytoplasm, live appx 12 hrs, release enzymes when activated
Agranulocytes (monocytes develop into macrophages, lymphocytes):
- sphyrical/oval/kidney shaped nucleus, longer life span

Front 26

Which category of leukocyte has the longest life span?

Back 26

Agranulocytes
- granulocytes have short life span b/c they release enzymes, which hurt them as well as the invaders

Front 27

Describe the histological characteristics of each type of wbc.

Back 27

Neutrophils - 50-70%; small lilac granules, nucleus w/3-5 lobes
Eosinophils - 1-4%; similar in size to neutrophils; red-orange granules; nucleus w/2 lobes
Basophils - <1%; slightly smaller than neutrophils; large purple/black granules; nucleus w/2 lobes
Monocytes - 4-8%; largest one; pale blue cytoplasm; kidney-shaped nucleus; becomes macrophage
Lymphocytes - 25-35%; round nucleus fills almost whole cell; blue cytoplasm a narrow rim around it

Front 28

Describe the general function of each type of wbc.

Back 28

Neutrophils - active phagocyte; chem. attracted to inflamation sites
Eosinophils - defense against parasitic worms; role in allergic rxns
Basophils - release histamine at inflammations; release heparin
Monocytes - develop into wandering or fixed macrophage; in this form for only 1 day in blood; phagocytic cells; role in lymphocyte activation
Lymphocytes - types: T and B lymphocytes; part of immune response

Front 29

List the various types of wbcs in order from most to least numerous.

Back 29

Never Let Monkeys Eat Bananas

Neutrophils
Lymphocytes
Monocytes
Eosinophils
Basophils

Front 30

Which type of wbc accounts for more than half of all circulating leukocytes?

Back 30

Neutrophils

Front 31

Which types of wbcs are important phagocytes?

Back 31

Neutrophils
Monocytes

Front 32

Which type of wbc releases heparin and histamine?

Back 32

Basophils

Front 33

Which type of wbc is the largest of all blood cells?

Back 33

Monocytes

Front 34

Which type of wbc matures in the body tissues to become a macrophage?

Back 34

Monocytes
- develops into wandering or fixed macrophage

Front 35

Describe the process of leukopoiesis from pluripotent stem cell to monocyte and mature granulocyte.

Back 35

- be able to draw table out (see p34/35 in notes)
- hemocytoblast/pleuripotent stem cell
- myloid stem cells
- progenator cells splits into 2 difft types:
-- Myoblast: to melanocyte: to band cells: to mature granulocytes
-- Monoblast: to promonocyte: to mature monocyte

Front 36

Identify the 2 specific families of cytokines that regulate leukopoiesis.

Back 36

- Interleukins (ILs)
- Colony stimulating factors (CSFs)

Front 37

Buffy coat

Back 37

- wbcs and platelets
- presents at the plasma-erthyrocyte junction in a tube of fractionated blood

Front 38

oxyhemoglobin

Back 38

HbO2 - oxygenated hemoglobin
- has bright red color

Front 39

deoxyhemoglobin

Back 39

- no O2 attatched
- dark red, giving blood blue appearance

Front 40

transferrin

Back 40

- transport protein that carries the iron part of heme from storage in liver/spleen to the bone marrow
- keeps it from causing oxidative damage

Front 41

ferritin

Back 41

- the iron part of heme
- can cause oxidative damage
- stored in liver/spleen and recycled back to bone marrow; transported by transferrin

Front 42

biliverdin

Back 42

- green pigment
- when added to iron, makes heme
- reduced to bilirubin... follows pathway and eventually secreted in urine or feces

Front 43

bilirubin

Back 43

- orange pigment made from reduction of biliverdin (part of heme)
- released into circulation
- circulates to liver where secreted into bile and changed into urobilinogen in intestine

Front 44

urobilinogen

Back 44

- part of biliverdin from heme
- made from bilirubin by bacteria in large intestines
- back into circulation; excreted by kidneys into urine (yellow)
- most oxidized into stercobilin and leaves in feces

Front 45

urobilin

Back 45

- urobilinogen excreted by kidneys becomes oxidized into urobilin
- gives urine yellow color

Front 46

stercobilin

Back 46

- Urobilinogen oxidizes to stercobilin in large intestines
- gives feces brown color

Front 47

Jaundice

Back 47

- yellowish tint
- excessive bilirubin in ect
- B/c of: excess rbc destruction or liver damage

Front 48

reticulocyte count

Back 48

- used as index of rate of erythropoiesis
- reticulocytes become mature rbcs in 1/2 days whereas rbcs last 3-4 months
- normally 1-2% of rbcs

Front 49

hypoxia

Back 49

when the tissues don't have enough O2
- causes increased rate of EPO secretion, and then more rbcs to be produced

Front 50

anemia

Back 50

reduced O2 carrying capacity of blood
- indicates an underlying problem
- symptoms: fatigue, pale, SOB

Front 51

leukopenia

Back 51

- too few wbcs - below 5,000/mm cubed
- Normally 5-10 thousand/mm cubed
- result of cancer treatment, glucocorticoid treatment, etc

Front 52

leukocytosis

Back 52

- too many wbcs - more than 10,000/mm cubed
- Normally 5-10 thousand/mm cubed
- indicates: bacterial infection, or transiently in exercise

Front 53

Describe the developments of platelets.

Back 53

- pleuripotent cell stimulated by multiCSF
- myeloid stem, then
- megakaryoblast - repeats rounds of mitosis w/o cytokinesis, becoming multinucleated
- promegakaryocyte - forms gramules
- megakaryocyte - cell makes projections, squeezes them through sinusoidal wall, rupture off, producing platelets
- platelets

Front 54

What hormone regulates the process of platelet formation?

Back 54

thrombopoietin (TPO)

Front 55

Identify and describe the three phases of hemostasis.

Back 55

- Vascular spasm - damage to vessel triggers local vasoconstriction; more damage = more constriction; caused by factors realeased by platelets and endothelial cells
- Platelet plug formation - platelets adhere to exposed collagen fibers, adhere, activate(changing shape) and aggregate; positive feedback cycle initiated
- Coagulation - clotting factors/prostaglandins form prothrombinase, starts a pathway that ends up making interwoven strands of fibrin (the webbing of blood clot)

Front 56

Identify the main chemicals released by activated platelets.

Back 56

- ADP
- TXA2 and serotonin
- Clotting factors (Ca2+ etc)
- PDGF - platelet-derived growth factor

Front 57

What role does each of the main chemicals released by activated platelets play in promoting hemostasis?

Back 57

- ADP - stimulates platelet aggregation
- TXA (an ecosinoid) and Serotonin (the NT in the CNS) - enhance vascular spasms
- Clotting factors (Ca2+)
- PDGF (platelet-derived growth factor) - promotes repair of blood vessel

Front 58

Differentiate between the extrinsic and intrinsic pathways of blood clotting.

Back 58

- Both are part of coagulation/clotting
- Both form prothrombinase, an enzyme
Extrinsic - involves release of tissue factor from endothelial cells, activates factor 10
Intrinsic - no release from damaged endothelial cells; begins w/activation of procoagulents @ injury site by exposure to collagen fibers; platelets release Platelet Factor 3, activates factor nine, activates factor 10
- Both - Factor 10 activated, complexes w/5 and Ca ions to form prothrombinase

Front 59

What enzyme is formed by both the intrinsic and extrinsic pathways to initiate the common pathway of blood clotting?

Back 59

- Prothrombinase - an enzyme
Starts the common pathway that ends with the formation of fibrin, the webbing of the blood clot

Front 60

Describe the steps of the common pathway of the coagulation process.

Back 60

- Starts with prothrombinase converting prothrombin to thrombin
- Thrombin (an enz.) converts fibrinogin (a plasma protein) to fibrin
- fibrin forms threadlike mollecules; an elastic fillament forms meshwork of the blood clot

Front 61

What is clot retraction?

Back 61

- after clot forms
- actin and myosin fibers pull the clot together
- squeeze serum out (the plasma minus the clotting proteins)
- stabalizes clot

Front 62

What is fibrinolysis?

Back 62

- breakdown/dissolving the clot
- activation of plasminogen in the clot to plasmin
- Plasmin breaks it down

Front 63

What proteolytic enzyme is involved in fibrinolysis?

Back 63

Plasminogen = plasma protein caught in clot
- prokinase (u-PA) and tissue plasminogen activator (t-PA) convert it to plasmin
- plasmin is the active enzyme that breaks down clot

Front 64

What factors work to localize and control blood clotting?

Back 64

- Prostacyclin (PGI2) - released by endothelial cells - limits platelet aggregation
- wbcs release factors to slow it down
- plasma enzymes break ADP down
- Anticoagulants:
- anti-thrombin, heparin, warfarin/coumadin, asprin

Front 65

The ABO blood groups are distinguished by the presence or absence of what 2 agglutinogens?

Back 65

- agglutinogens A and B
- codominant

Front 66

What agglutinogents are present on the RBCs of each of the 4 ABO blood types?

Back 66

A - A
B - B
AB - both A and B
O - neither A nor B

Front 67

What genotypes could account for each of the phenotypes of the 4 ABO blood types?

Back 67

A - IAIA or IAi
B - IBIB or IBi
AB - IAIB
O - ii

Front 68

What agglutinins are present in the blood plasma of each of the 4 ABO blood types?

Back 68

= the antibodies against one of the agglutinogents

A - antiB
B - antiA
AB - neither antiA nor antiB
O - antiA and antiB

Front 69

On the basis of ABO blood groups only, identify which donor bloot types are compatible with recipients of each of the 4 ABO blood groups.

Back 69

Receptor - possible donors:

A - A or O
B - B or O
AB - A, B, O
O - O

Front 70

When do anti-Rh antibodies form?

Back 70

- agglutination/transfusoin reaction doesn't occur w/1st exposure to Rh positive blood
- formed during 1st exposure, next time, the agglutination would occur in the Rh -ve person if exposed to +ve blood a second time

Front 71

blood group

Back 71

depends on types Rh agglutinogens
- if you have any of the 8 types = Rh positive; none = Rh negative

Front 72

Blood type

Back 72

determined based on presence or absence of agglutinogents A and B
ABO blood typing

Front 73

agglutinogen

Back 73

antigents on surface or RBCs
determine blood group

Front 74

agglutinin

Back 74

antibodies that circulate in blood and act against RBCs carrying ABO antigents not present on individuel's own rbcs
- production begun slightly after birth

Front 75

agglutination

Back 75

- clumping/aggregation of blood cells
- happens when agglutinins of one kind react with agglutinogens of the same kind

Front 76

transfusion reaction

Back 76

- when an individual receives a transfusion of mismatched blood
- can block blood flow to parts of body

Front 77

erythroblastosis fetalis

Back 77

- mother Rh -ve and foetus Rh+ve
- happens only on second pregnancy/subsequent exposures
- when feotus rbcs are attacked by mother's antibodies

Front 78

anticoagulant

Back 78

inhibits clotting:
- anti-thrombin
- heparin
- warfarin/coumadin
- asprin

Front 79

fibrinogen

Back 79

plasma protein
soluble form, in blood
converted to fibrin by thrombin as part of the common pathway
fibrin = the webbing of clots

Front 80

prothrombin

Back 80

prothrombinase converts it to thrombin
then thrombin converts fibrinogen to fibrin (the webbing of blood clots)

Front 81

serum

Back 81

the plasma minus the clotting proteins
squeezed out of the clot during clot retraction

Front 82

urokinase (u-PA)

Back 82

- part of fibrinolysis
- produced by kidney
- circulates in blood
- released by ET cells when thrombin levels rise
activates plasminogen and changes it to plasmin which breaks down the clot eventually

Front 83

tissue plasminogen activator

Back 83

- role in fibrinolysis
- released by damaged ET cells
- activates plasminogen and turns it into plamin (active form that breaks down fibrin)

Front 84

megakaryocyte

Back 84

- platelets are anucleate fragments of large megakaryocytes
- lifespan is less than 10 days, even when inactive
- makes projections and squeezes them through sinusoidal wall; rupture off = platelets

Front 85

differential cell count

Back 85

the proportional representation of each kind of blood cell in a sample of blood

Front 86

platelet adhesion

Back 86

- platelets adhere to exposed collagen fibers
- the platelets are active, so they change shape and become more sticky (to eachother and to the ET wall)

Front 87

polycythemia

Back 87

abnormal increase in circulating RBCs
causes: blood doping or producint too many
- leads to increase blood viscosity, increased BP and all of the problems that come with that

Front 88

embolus

Back 88

a mass, most commonly a blood clot, that becomes lodged in a blood vessel and obstructs it

Front 89

embolism

Back 89

blockage of artery: a condition in which an artery is blocked by an embolus, usually a blood clot formed at one place in the circulation and then lodging in another

Front 90

thrombus

Back 90

blood clot: a blood clot that forms in a blood vessel and remains at the site of formation

Front 91

thalassemias

Back 91

type of anemia: a hereditary form of anemia, particularly prevalent around the Mediterranean, that is caused by a dysfunction in the synthesis of the red blood pigment hemoglobin

Front 92

immunoglobulin

Back 92

a protein of animal origin with known antibody activity, synthesized by lymphocytes and plasma cells and found in serum

Front 93

polymorphonuclear cell

Back 93

A polymorphonuclear leukocyte (PMN), or granulocyte, is a type of white blood cell whose nucleus has several rounded parts referred to as lobes