A&P Chapter 18 Circulatory System

The heme (with or without iron) of hemoglobin is converted into biliverdin and then bilirubin by marcraphages.

without iron

steps of iron metabolism in order. Start with iron intake, and finish absorption from the digestive tract.

1. A mixture of Fe2+ and Fe3+ is ingested. 2. The stomach acid converts Fe3+ to Fe2+. 3. Fe 2+ binds to gastroferritin. 4. Gastroferritin carries Fe2+ to intestine for absorption.

List in order the events of platelet plug formation.

1. Contact with collagen of a broken vessel or another rough surface. 2. Platelets grow long spiny pseudopods. 3. Pseudopods contract and draw the vessel walls together. 4. Mass of platelets forms a platelet plug.

What are the steps of Hemostasis?

1. Vascular spasm 2. Platelet plug formation 3. Blood coagulation

Adult hemoglobin consists of which of the following? 2 alpha chains and 2 beta chains 2 alpha and 2 gamma chains 1 alpha chain, 1 beta chain, and 1 gamma chain

2 alpha chains and 2 beta chains

The process of erythropoiesis normally takes how many days? 8-16 120 3-5 27-31

3-5

How long does erythropoiesis take to complete? One week 3-5 days One month One day

3-5 days

The structure of hemoglobin consists of ____________ chains.

4

One molecule of hemoglobin contains which of the following? 4 globin chains and 4 heme groups 1 globin chain and 1 heme group 4 globin chains and 1 heme group 2 globin chains and 2 heme groups

4 globin chains and 4 heme groups

What is the average volume of blood in an adult? 4 to 6 liters 1 to 3 liters 7 to 10 liters

4 to 6 liters

The total blood volume in the avarage adult female is ____.

4-5 L

The total blood volume in the average adult male is _____.

5-6 L

An individual with A antigens on their RBCs, but no B antigens, has which ABO blood type? Type B Type O Type AB Type A

A

Which erythrocyte cell-surface antigens determine a person's ABO blood group? A O B D

A B

Which erythrocyte cell-surface antigens determine a person's ABO blood group? O A B D

A B

Which of the following most accurately describes a platelet plug? A signal that initiates megakaryocyte production in the bone marrow A site where platelets are formed in the bone marrow A mass of platelets and trapped formed elements A region on a platelet that forms the pseudopod

A mass of platelets and trapped formed elements

What is vascular spasm? A short-lived mechanism in which the damaged vessel dilates, increasing the amount of clotting agents A short-lived mechanism in which the damaged vessel narrows to minimize blood loss The response of a capillary network to changing carbon dioxide levels A long-term mechanism that triggers fibrin production

A short-lived mechanism in which the damaged vessel narrows to minimize blood loss

Neutrophil

A type of white blood cell that engulfs invading microbes and contributes to the nonspecific defenses of the body against disease.

Sarah is an abuser of antacids. What is a possible side effect of excessive antacid use? Decreased numbers of granules in leukocytes Decreased secretion of erythropoietin Decreased hemoglobin production Decreased absorption of iron by the intestine

Decreased absorption of iron by the intestine

Describe normal erythrocytes. Have a complex nucleus Have a biconcave shape Contain mitochondria and other organelles Contain hemoglobin to transport gases like oxygen

Have a biconcave shape Contain hemoglobin to transport gases like oxygen

Which term refers to the production of blood, especially the formed elements? Hemolysis Hematopoiesis Erythropoiesis Erythroblastosis

Hematopoiesis

Which term refers to the production of blood, especially the formed elements? Multiple choice question. Erythropoiesis Hemolysis Erythroblastosis Hematopoiesis

Hematopoiesis

Which clinical measurements express the blood's ability to carry oxygen? Hemoglobin concentration WBC count RBC count Platelet count Hematocrit

Hemoglobin concentration RBC count Hematocrit

Which term refers to limiting blood loss from an injured vessel? Erythropoiesis Hemolysis Hematocrit Hemostasis

Hemostasis

At which stage of erythrocyte development are the RBCs released into the blood? Mature erythrocyte Colony forming unit Reticulocyte Erythroblast

Reticulocyte

How do reticulocytes differ from mature red blood cells? Select all that apply. Reticulocytes have polyribosomes; RBCs do not. RBCs are more numerous; only 0.5-1.5% of circulating blood cells are reticulocytes. A reticulocyte doesn't have a nucleus; a RBC does.

Reticulocytes have polyribosomes; RBCs do not. RBCs are more numerous; only 0.5-1.5% of circulating blood cells are reticulocytes.

Old blood cells usually die as they pass through what organ? Kidneys Heart Spleen Lungs

Spleen

Old blood cells usually die as they pass through what organ? Kidneys Spleen Heart Lungs

Spleen

What is the role of erythropoietin? Stimulates RBC production Dissolves clots Stimulates clot formation Acts as a chemoattractant for leukocytes

Stimulates RBC production

Iron needs to be in the Fe2+ form to be absorbed. Which of the following converts Fe3+ to Fe2+? Ferritin Intestinal enzymes Apoferritin Stomach acid

Stomach acid

Select all that apply Which statements are true about neutrophils? Their count only rises in response to parasitic infections. They are the most abundant leukocyte. They are agranulocytes. They have multi lobed nuclei when mature.

They are the most abundant leukocyte. They have multi lobed nuclei when mature.

What role do macrophages play in RBC death and disposal? They seek out and destroy old RBCs throughout the body. Old RBCs differentiate into macrophages. Macrophages tag old RBCs with antibodies. They separate the heme from the globin of hemoglobin, and hydrolyze globin into free amino acids.

They separate the heme from the globin of hemoglobin, and hydrolyze globin into free amino acids.

What role do macrophages play in RBC death and disposal? They separate the heme from the globin of hemoglobin, and hydrolyze globin into free amino acids. Old RBCs differentiate into macrophages. Macrophages tag old RBCs with antibodies. They seek out and destroy old RBCs throughout the body.

They separate the heme from the globin of hemoglobin, and hydrolyze globin into free amino acids.

What is the purpose of a differential WBC count? To determine the number and ratio of each type of leukocytes in a sample To determine the number of RBCs in a sample To determine the number of RBCs, platelets and WBCs in a sample To determine the number of RBCs and WBCs in a sample

To determine the number and ratio of each type of leukocytes in a sample

What is the purpose of a differential WBC count? To determine the number of RBCs in a sample To determine the number of RBCs, platelets and WBCs in a sample To determine the number and ratio of each type of leukocytes in a sample To determine the number of RBCs and WBCs in a sample

To determine the number and ratio of each type of leukocytes in a sample

True or false: Erythrocytes circulate for about 120 days before they die.

True

What is the first response to a blood vessel injury? Platelet plug formation Blood clot formation Vascular spasm Vasodilation

Vascular spasm

One method of destruction is called ______________ in which each antibody binds two or more antigens.

agglutination

The most abundent plasma protein is ________.

albumin

Two of the hemoglobin chains are _____ and two are _____ proteins

alpha: beta

Two of the hemoglobin chains are _____ and two are _____ proteins

alpha; beta

Hemolytic disease of the newborn (HDN) occurs when

an Rh-negative woman is carrying an Rh-postive fetus

Globulins

antibodies

Your blood type is determined by the presence or absence of ___________ on your RBCs.

antigens

Antibodies _____ to antigens and mark them for destruction.

bind

Coagulation means

blood clotting

Fibrinogen

blood clotting

Each antigen will have a different _______________ complex on the surface of the RBC.

carbohydrate

Hemoglobin transporting _________ _________ is called carbaminohemoglobin.

carbon dioxide

Viscosity and osmolarity will both increase if the amount of ____________ in the blood increases.

erythrocytes and protein

2. When low oxygen levels in the blood are detected, ______________ is produced and secreted.

erythropoietin (EPO)

True or false: A total WBC count is more useful than a differential WBC count when trying to pin down the specific cause of a disease.

false

True or false: Coagulation involves only two chemical reactions.

false

The meshlike framework of a blood clot is formed by a sticky protein called ______. fibrin collagen globulin albumin

fibrin

As part of coagulation, the plasma protein called ______ is converted to fibrin. albumin collagen hemoglobin fibrinogen

fibrinogen

These antibodies will react with _________ RBC antigens.

foreign

The structure of hemoglobin consists of _____ chains

four

When they are in the tissues, masses of clotted blood are called ______. emboli hematomas hemophilia

hematomas

Each of the protein chains are conjugated to a nonprotein ______ group.

heme

Each of the protein chains are conjugated to a nonprotein ____________ group.

heme

The sequence in the breakdown of the non-iron portion of the heme is:

heme, biliverdin, bilirubin, conjugted bilirubin, bilirubin derivatives, feces and urine

Additionally, the kidneys can break up an RBC and split the _____________ molecules up to release recyclable portions.

hemoglobin

The rupture of red blood cells is called

hemolysis

The stoppage of blood loss, or ____________ is very important to the maintenance of homeostasis.

hemostasis

The clotting cascade that originates from within the blood itself is called the ______ pathway. intrinsic extrinsic

intrinsic

This group contains an ____________ ion in the center.

iron

This heme group contains an _____ ion in the center.

iron

Hemoglobin bonded to carbon ___________ is called carboxyhemoglobin.

monoxide

RhoGam injections are given to prevent sensitization of the ________.

mother

In hemolytic disease of the newborn antibodies from the _______ cross the placenta and affect the ________.

mother; fetus

5. Thus the correction of hypoxemia is controlled by a __________ feedback loop.

negative

Without a _________ the RBC cannot synthesize the protein spectrin found in the membrane.

nucleus

4. This will result in an increase of ____________ transport throughout the body

oxygen

This center portion of the heme group will reversibly bind __________ and carbon dioxide.

oxygen

This center portion will reversibly bind ____________ .

oxygen

Additionally, ________ will contain antibodies.

plasma

The main components of blood are a fluid portion called _____________ and formed elements that include the blood cells.

plasma

When collagen in the wall of a blood vessel is exposed as a result of injury, ______ adhere and develop long, spiny pseudopods which draw the vessel walls back together. prostacyclin platelets leukocytes fibrin

platelets

3. The hormone will stimulate the red bone marrow to __________ RBCs.

produce

Albumin

protein in blood; maintains the proper amount of water in the blood

As an RBC ages and its membrane _________ proteins deteriorate, the membrane becomes fragile.

proteins

Many of these deteriorted RBCs die in the ________.

spleen

The process of platelet formation is called ______. Multiple choice question. leukopoiesis thrombopoiesis hemostasis hemopoiesis

thrombopoiesis

Hypoxemia is inadequate oxygen ___________ and can be detected by the kidneys and _______.

transport

1. Hypoxemia is inadequate oxygen ___________ and can be detected by the kidneys and _______.

transport; liver

Platelet activation is an example of positive feedback. What does that mean? Activating one platelet leads to the activation of another platelet, and then another. Activating one platelet starts a cascade of fibrin formation. Activating one platelet leads to a positive outcome. Activating one platelet makes it more difficult to activate another.

Activating one platelet leads to the activation of another platelet, and then another.

What are the three primary types of plasma proteins? Albumins, globulins, fibrinogen Antibodies, lipoproteins, transferrin Serum, fibrin, fibrinogen Heme, iron, globin

Albumins, globulins, fibrinogen

What is hemophilia? An environmentally triggered disease An inherited disorder caused by a deficiency of clotting factors A disease caused by the inability to absorb vitamin K A disease that leads to increased plasma retention

An inherited disorder caused by a deficiency of clotting factors

Inadequate erythropoiesis or hemoglobin synthesis, hemorrhage, and increased RBC destruction are all common causes of the erythrocyte disorder called __________ (one word).

Anemia

Inadequate erythropoiesis or hemoglobin synthesis, hemorrhage, and increased RBC destruction are all common causes of the erythrocyte disorder called ____________(one word).

Anemia

A person is considered Rh-positive (Rh+) if he has which antigen? Antigen B Antigen D Antigen A

Antigen D

A person tells you that she has A+ blood. Which antigens are expressed on the surface of her RBCs? Antigen B Antigen D Antigen A

Antigen D Antigen A

A person's specific blood type is based on which of the following? Antigens expressed on the RBC plasma membrane Antibodies located on the RBC plasma membrane Differences in white blood cell production The form of hemoglobin produced by the RBCs

Antigens expressed on the RBC plasma membrane

_________ inhibits the action of the enzyme cyclooxygenase (COX) which aids in the action of platelets.

Aspirin

Antigens on the surface of the erythrocyte membranes determine which of the following? Oxygen-carrying capability Blood type Shape of the RBC Structure of the hemoglobin

Blood type

Antigens on the surface of the erythrocyte membranes determine which of the following? Oxygen-carrying capability Blood type Structure of the hemoglobin Shape of the RBC

Blood type

The cardiovascular (not circulatory) system includes which of the following? Bone marrow Blood vessels Heart Blood

Blood vessels Heart

Hemostasis usually involves which mechanism(s) of coagulation? Both extrinsic and intrinsic Only intrinsic Only extrinsic

Both extrinsic and intrinsic

Which system includes the heart and blood vessels, but does not include the blood? Cardiovascular Lymphatic Circulatory Respiratory

Cardiovascular

Which statement about clotting factors is true? They are identified by roman numerals which indicate the order of the reactions. Most are produced in the spleen. Clotting factors initiate a cascade of reactions. They are also known as anticoagulants.

Clotting factors initiate a cascade of reactions.

Which term refers to the interaction of protein factors to produce a clot? Coagulation Precipitation Agglutination Clumping

Coagulation

What is the main goal of coagulation? Collagen retraction Release of chemotaxic compounds Conversion of fibrinogen into fibrin Release of oxygen by the RBCs

Conversion of fibrinogen into fibrin

Iron is a crucial component of which of the following? Cytochromes Hemoglobin Myoglobin Albumin

Cytochromes Hemoglobin Myoglobin

Decreased blood osmolarity could cause which of the following? Increased reabsorption of tissue fluid Increased blood viscosity Edema Low blood pressure

Edema Low blood pressure

The cell indicated by the arrow is a(n) ___________, also known as a red blood cell, the most abundant formed element in the blood.

Erythrocyte

True or false: In most cases of bleeding, only the intrinsic mechanism of coagulation is activated.

False

True or false: A, B, AB and O are the only blood groups.

False

Which blood cells are biconcave and lack a nucleus and other organelles? Monocytes Erythrocytes Eosinophils Macrophages

Erythrocytes

Which blood cells are critical to survival because of their ability to transport oxygen? Thrombocytes Erythrocytes Leukocytes

Erythrocytes

Hypoxemia, resulting from hemorrhage, high altitude, or emphysema, may stimulate which of the following? Anemia Neutropenia Neutrophilia Erythropoiesis

Erythropoiesis

Which is a hormone that stimulates erythrocyte production? Hemolin Insulin Thrombolin Erythropoietin

Erythropoietin

Which may activate platelets? Ferritin Reticulocyte activating factor Low oxygen concentrations Exposed collagen

Exposed collagen

The extrinsic mechanism of coagulation is initiated by which of the following? Clotting factors in the plasma Prostacyclin coating the endothelium Myeloblasts released prematurely from the bone marrow Factors released by damaged blood vessels (thromboplastin)

Factors released by damaged blood vessels (thromboplastin)

Which can cause anemia? Inadequate hemoglobin synthesis Hemorrhage Increased hemolysis Increased erythropoiesis

Inadequate hemoglobin synthesis Hemorrhage Increased hemolysis

Keeping in mind the structure of hemoglobin, name the nutrient that is critical for hemoglobin synthesis. Magnesium Iodine Lead Iron

Iron

What is the functional role of platelet-derived growth factor (PDGF)? It stimulates mitosis in smooth muscles and fibroblasts. It tightens the fibrin threads to cause clot retraction. It increases the fragmentation of megakaryocytes. It stimulates the division of platelets.

It stimulates mitosis in smooth muscles and fibroblasts.

The alternate term for a white blood cell (WBC) is --.

Leukocyte

What are the least common formed elements of the blood? Leukocytes Erythrocytes

Leukocytes

Which term refers to the development of white blood cells? Leukopoiesis Erythropoiesis Leukocytosis Hemolysis

Leukopoiesis

The most abundant formed elements are the ___s.

RBCs

What causes hemolytic disease of the newborn? Fetal anti-D destroys maternal erythrocytes Fetal anti-A destroys fetal erythrocytes Maternal anti-D destroys fetal erythrocytes Maternal B antigens cause fetal production of anti-B antibodies

Maternal anti-D destroys fetal erythrocytes

What causes hemolytic disease of the newborn? Maternal B antigens cause fetal production of anti-B antibodies Maternal anti-D destroys fetal erythrocytes Fetal anti-D destroys maternal erythrocytes Fetal anti-A destroys fetal erythrocytes

Maternal anti-D destroys fetal erythrocytes

Select all that apply Iron is a crucial component of which of the following? Albumin Myoglobin Hemoglobin Cytochromes

Myoglobin Hemoglobin Cytochromes

Select all that apply How does the body use iron? Nearly all cells use Fe2+ to make electron-transport molecules (cytochromes) in their mitochondria. The muscles use Fe2+ to make the myoglobin. The bone marrow uses Fe2+ for hemoglobin synthesis. Fe2+ is transported in the blood by an alpha globulin called ceruloplasmin.

Nearly all cells use Fe2+ to make electron-transport molecules (cytochromes) in their mitochondria. The muscles use Fe2+ to make the myoglobin. The bone marrow uses Fe2+ for hemoglobin synthesis.

Hypoxemia triggers the production of erythropoietin. Erythropoietin increased the rate of erythropoiesis. This an example of which of the following? Negative feedback control Cascade reaction Positive feedback control Hemostasis

Negative feedback control

Which granulocyte is aggressively antibacterial, and has a band-shaped nucleus when young? Lymphocyte Monocyte Eosinophil Basophil Neutrophil

Neutrophil

Why are only old RBCs destroyed in the spleen? Old cells rupture in the narrow channels of the spleen because they are no longer flexible or resilient. Old RBCs have lower hemoglobin content which marks them for destruction by macrophages in the spleen. Old cells have markers on the membrane that indicate they are no longer functional; the spleen recognizes these markers, targeting them. Old RBCs swell so that they don't fit through the sinus spaces of the spleen.

Old cells rupture in the narrow channels of the spleen because they are no longer flexible or resilient.

Why are only old RBCs destroyed in the spleen? Old cells have markers on the membrane that indicate they are no longer functional; the spleen recognizes these markers, targeting them. Old cells rupture in the narrow channels of the spleen because they are no longer flexible or resilient. Old RBCs have lower hemoglobin content which marks them for destruction by macrophages in the spleen. Old RBCs swell so that they don't fit through the sinus spaces of the spleen.

Old cells rupture in the narrow channels of the spleen because they are no longer flexible or resilient.

Which property of blood is defined as the total molarity of dissolved particles that cannot pass through the blood vessel wall? Viscosity pH Osmolarity Surface tension

Osmolarity

Which property of blood is defined as the total molarity of dissolved particles that cannot pass through the blood vessel wall? pH Viscosity Osmolarity Surface tension

Osmolarity

What is hemostasis? The breakdown of red blood cells Hereditary blood-coagulation disorder Mass of clotted blood in the tissues Physiological process that controls excessive bleeding

Physiological process that controls excessive bleeding

Select all that apply What are the three hemostatic mechanisms? Select three answers from the list below. Agglutination Platelet plug formation Vascular spasm Blood clotting

Platelet plug formation Vascular spasm Blood clotting

Select all that apply Which mechanisms are used by the body to prevent inappropriate clotting? Platelet repulsion caused by prostacyclin Presence of anticoagulants such as heparin and antithrombin Exposure of collagen fibers and thromboplastin Dilution of clotting factors

Platelet repulsion caused by prostacyclin Presence of anticoagulants such as heparin and antithrombin Dilution of clotting factors

What is erythropoiesis? White blood cell production Red blood cell production Platelet production

Red blood cell production

At which stage of erythrocyte development are the RBCs released into the blood? Colony forming unit Mature erythrocyte Erythroblast Reticulocyte

Reticulocyte

The reproduction of fibroblasts and smooth muscles during injury repair is triggered by which of the following? Platelet-derived growth factor Histamine Serotonin-releasing factor Erythropoietin

Platelet-derived growth factor

Which formed elements release vasoconstrictors, promote blood clotting, initiate dissolution of clots, and secrete growth factors? Erythrocytes Basophils Platelets Neutrophils

Platelets

As platelets aggregate during the second step of hemostasis (shown in this picture), which of the following events occur? Prostacyclin and collagen is released from the platelets. Reason: Recall that collagen is in the wall of the blood vessel and prostacyclin coats the endothelium. They are not released by platelets. Platelets degranulate resulting in release of thromboxane A, ADP and serotonin. Pus accumulates within the blood vessels. Reason: Recall that formation of pus is not one of the hemostatic mechanisms.

Platelets degranulate resulting in release of thromboxane A, ADP and serotonin.

Platelet repulsion, dilution, and substances such as heparin or antithrombin help do what? Enhance gas diffusion in capillary networks Prevent inappropriate clotting Increase the spread of infection Prevent HDN

Prevent inappropriate clotting

Platelet repulsion, dilution, and substances such as heparin or antithrombin help do what? Prevent inappropriate clotting Increase the spread of infection Enhance gas diffusion in capillary networks Prevent HDN

Prevent inappropriate clotting

Which is another term for clotting factors? Anticoagulants Platelets Procoagulants Growth factors

Procoagulants

What is thrombopoiesis? Dissolution of a clot Production of platelets Formation of a clot Production of thrombin

Production of platelets

Which is not true regarding the life cycle of erythrocytes? Production of red blood cells takes about one month. An erythrocyte lives for an average of 120 days. About one million red blood cells are formed per second. About 20 mL of packed RBCs are produced per day.

Production of red blood cells takes about one month.

What is leukopoiesis? Production of white blood cells Cancer that affects blood and bone marrow A type of small, round agranulocyte Elevated WBC count (above 10,000 WBCs/μl

Production of white blood cells

Select all that apply Platelets perform which of the following functions? Promote clotting and also initiate dissolution of clots Release factors that attract WBCs Present phagocytized antigens on their membranes Release vasoconstrictors

Promote clotting and also initiate dissolution of clots Release factors that attract WBCs Release vasoconstrictors

Which clinical measurements express the blood's ability to carry oxygen? RBC count Hematocrit Platelet count WBC count Hemoglobin concentration

RBC count Hematocrit Hemoglobin concentration

The hematocrit and hemoglobin concentration are clinical data that describe which of the following? Whether the immune system is competent Whether there is an infection The amount of oxygen the blood can carry A person's risk for diabetes

The amount of oxygen the blood can carry

Following the first pregnancy with an Rh+ fetus, the immune system of an an Rh- woman produces anti-D antibodies. During her next pregnancy the baby is at risk of developing Hemolytic Disease of the Newborn (HDN), but only if which of the following is true? The father's blood is Rh-. The baby's blood is Rh-. The baby's blood is Rh+. The mother's blood type has changed to Rh+.

The baby's blood is Rh+.

Following the first pregnancy with an Rh+ fetus, the immune system of an an Rh- woman produces anti-D antibodies. During her next pregnancy the baby is at risk of developing Hemolytic Disease of the Newborn (HDN), but only if which of the following is true? The mother's blood type has changed to Rh+. The baby's blood is Rh-. The father's blood is Rh-. The baby's blood is Rh+.

The baby's blood is Rh+.

The term hematopoiesis refers to which of the following? The production of hemoglobin The production of blood The formation of new bone marrow The synthesis of the heme moiety

The production of blood

What is hemolysis? The process that controls bleeding in the case of hemorrhage The production of blood, especially of its formed elements The rupture of red blood cells The percentage of erythrocytes in the total blood volume

The rupture of red blood cells

Which statement about blood groups is true? There are 6 blood grouping schemes for blood based on the type of hemoglobin in the cell. There is only one blood grouping scheme which describes 4 blood types. There are two different blood grouping schemes that describe combinations of 2 antigen. There are many blood grouping schemes that describe over 500 antigens.

There are many blood grouping schemes that describe over 500 antigens.

What happens to the fragments of old red blood cells after they rupture? They circulate in the plasma. They are excreted by the kidney. They are recycled by macrophages. They are degraded by plasma enzymes.

They are recycled by macrophages.