Chapter 17 Blood

Circulatory System Function: - Transport: * Internal transport system: delivers water, nutrients, salts, ions, enzymes, hormones, oxygen as heat (from ___________); therefore, helps regulate ______________ and removes metabolic wastes, and carbon dioxide as well. - Regulation: * Regulates ____________ contents in the body (homeostasis) and regulates the _____________ (pH balance) preventing abrupt changes in the body with buffers (what are the three main buffers?). - Protection: * Defends the body against infections with _________. Protects from blood loss by ___________ and circulates blood proteins (including ______, _______, and __________)

* (muscles)/ body temperature * fluid, electrolyte/ acid-base balance/ proteins (albumins), phosphate, and sulfate * WBCs/ clot formation/ (antibodies, interferon, and complement proteins)

WBCs: - Functions: * crucial to our defense against disease (________) * remove toxins, wastes and abnormal or damaged cells * can detect chemical signs of damage in surrounding tissue, leaving the blood stream (_________) and entering the damaged area. - Characteristics: * have a _______ and other organelles * lack ________ (do not carry oxygen) * capable of _______ movement by ________ * can migrate in and out of the bloodstream (_________) * attracted to specific chemical stimuli called ________, usually given off by _________. * kinds include: ___________; all are capable of _________. - __________: have lobed nuclei and are packed with ____________, appear grainy and are easily stained. - __________: lack visible cytoplasmic granules. Although similar to each other, structurally, the two types are ________ distinct and unrelated cell types.

* (pathogens) * (diapedesis) * nuclei * hemoglobin * amoeboid/ pseudopods * (diapedesis) * chemotaxis/ inflammation * basophils, eosinophils, neutrophils, lymphocytes, and monocytes/ phagocytosis - granulocytes/ lysosomal enzymes - agranulocytes/ functionally

The WBCs or Leukocytes: - WBCs are larger than RBCs, but fewer in number. * WBCs are about _______ micrometers across and exist about 4000-11,000/cubic mm (microliter) of blood. - WBCs are the only complete _______ blood cell with all the ________. - WBCs are capable of independent _____________; adhere to vessel walls called __________ and squeeze out between epithelial cell ..... called _________ or _________ and move through the body fluid (interstitial fluid), targeting microbes, bacteria, parasites, virus, and worms). - WBCs locate microbes by __________, following chemical signals from the site of infection and detect by looking for changes in their ________.

* 10-20 - nucleated/ organelles - amoeboid movement/ margination/ diapedesis or emigration - chemotaxis/ cell membranes

Other Diseases: - Protists and other worms often cause disease in humans. * ________ causes African sleeping sickness. - The _________ matures in the intestine causing severe malnutrition in its host; can grow up to 2 feet long.

* Trypanosoma - Ascaris worm

Clotting Factors: - Normal blood clotting depends on: * ___________ (pro-coagulates) which are plasma _________ made by the _______. They are numbered according to there _________, not their sequence ...... include calcium and 11 proteins. * many are __________ (inactive) -> active enzyme (first enzyme activates a second enzyme ...... creating a _________) * three pathways: ?

* clotting factors/ proteins/ liver/ discovery dates * pro-enzymes/ cascade * common, intrinsic, and extrinsic

Oxygen Transport: - At the lungs: * What occurs? Blood turns what color? - At the body tissues: * What occurs? Cells use this for respiration and what happens to the color of blood? - Can pick up CO2 forming HbCO2 (___________); only _____% forms this compound which attaches to the _______ rather than heme group.

* hemoglobin picks up O2 (oxygen + Hb -> HbO2 = oxyhemoglobin)/ bright (scarlet) red * hemoglobin dumps O2 (HbO2 -> Hb (deoxyhemoglobin) + O2)/ turns bluish black (cyanotic) - (carboxyhemoglobin)/ 20%/ amino acids

- RBC shape allows: * bending and flexing in capillaries (because of the _____ protein) forming stacks called ________. * _______: giving each RBC a large surface area-to-volume ratio for expedited gas exchange.

- (spectrin)/ rouleau - biconcave

Basophils cont.: - Least numerous WBC; less than _____% of WBC. - Move out of blood to discharge granules in ___________ at sites of _________; contain granules composed of two powerful proteins: __________ and ___________. * Histamine: intensifies inflammatory response in body, causing ___________; ________ is a part of overall defense against infections (also in _____________: hypersensitivity is a problem = need EPI pen) * Heparin: this is an ____________ of blood, preventing blood clotting in an unbroken blood vessel.

- 1 - IF/ inflammation/ histamine and heparin * vasodilation/ inflammation/ (allergic reactions) * anticoagulant

Characteristics of Blood: - Temperature: ___________, slightly above normal body temp. - Viscosity: blood is ___________ than water and more cohesive. - pH: blood is slightly _____ with a pH between ______ and ______. - Body of adult man contains ________ liters of whole blood, women contain about _________ liters. - Approximately _______% of body mass - Color is _______ when saturated with oxygen; _______ when unsaturated with oxygen.

- 100.4 F (38 C) - 5 times thicker - alkaline/ 7.35 and 7.45 (average of 7.4) - 5-6/ 4-5 - 7-8 - bright red/ dark red

Eosinophils cont.: - ________% of circulating WBCs. - Numerous in the lining of ______ and ______ tracts - Attack and destroy larger parasites ..... _______ and ________, by surrounding them and digesting their tissue. - Increase dramatically with __________ and __________. - Can phagocytize _________ complexes that coat pathogens with antibodies (known as __________) and by ________ of toxic compounds of _________ and __________.

- 2-4 - respiratory and digestive - tapeworms and roundworms - parasitic infection and allergic reactions - antigen-Ab/ (opsonization)/ exocytosis/ nitrogen dioxide and cytotoxic enzymes

Lymphocytes cont. - The second most numerous WBCs; account for ________% of WBCs. - Continually circulate between interstitial spaces of tissue, lymphatic fluid and blood. - Are mostly concentrated in _______ and lymphoid organs (include ?); only 2% are circulating. - Make up the "immune system" of the body and they can provide long-term protection against infections (_____ = anything that is foreign). - Different kinds of lymphocytes: * ________: defense against invading foreign cells and tissue and coordinates immune responses. * _________: responsible for humoral immunity (production of __________ which distribute antibodies) and _________ cells. * _________: 5-10% responsible for immune surveillance (detection and subsequent destruction of abnormal tissue cells, prevention of cancer).

- 20-30 - lymph nodes/ (tonsils, spleen, and thymus) - antigen * T cells * B cells/ (plasma cells)/ memory * Natural killer (NK) cells

Types of WBCs; - Differential Count per cubic mm? - What are the granulocytes? - What are the agranulocytes?

- 4,000-11,000 - basophils (least numerous), eosinophils, and neutrophils (most numerous) - lymphocytes (right next to arteries and veins) and monocytes

- Type A: has surface antigen ______ (on RBCs) and anti-_____ antibodies (in plasma). - Type B: has surface antigen _______ (on RBCs) and anti-______ antibodies (in plasma). - Type AB: has surface antigen _____ (on RBCs) and _______ anti - A or B antibodies (in plasma). - Type O: has _______ surface antigens A or B (on RBCs) and anti-_______ antibodies (in plasma). - Since RBC antigens promote agglutination (clumping), they are specifically called ___________. * surface antigens + opposing antibodies --> agglutination (clumping) and hemolysis!

- A/ B - B/ A - A and B/ neither - neither/ A and B - agglutinogens

- WBC and all other nucleated cells have membrane proteins that protrude out into ECF called _______________. These ________ are unique for each person except in identical twins. - Why do certain hormones work on only certain places in the body?

- MHC (major histocompatibility antigens)/ markers - Because of the membrane proteins receptors (they are specific)

Parasites: - ___________: is a parasitic roundworm commonly found in the intestines of humans and generally enter the human host as larvae in contaminated food. - _________: reside in the lymph nodes and vessels of humans and other hosts in tropical areas. Carried by mosquitos! They obstruct the lymph system resulting in edema and this disease is often called elephantiasis. - _________: are parasites of the vertebrate digestive tracts and are released in the feces of humans = can penetrate barefoot people if steps on! Signs and symptoms include: anemia, bloody sputum, intestinal irritation, and general ill health. - _________: cause the well know disease trichinosis. Found in uncooked pork products - _________: is a parasitic nematode infection; infection can be caused by poor personal hygiene. Inhabit the large intestines and attach to its walls and cause pruritis = causes people to scratch their anus = worms get under fingernails - _________: is a parasitic flatworm that inhabits the small bile ducts of the human liver = leads to inflammation, serious illness and death. All of these types of flatworms are very damaging to the hosts. - ____________: is a type of parasitic flatworm acquired from uncooked pork and other meats. Has no digestive tract, so nutrients are absorbed through the body walls.

- Ascaris (ascaris lumbricoides) - Filarial worms - hookworms - Trichina worms - pinworms (enterobius) - Asian liver fluke (FLUKES are all damaging) - pork tapeworm

Lymphocytes: - Nucleus spherical - fills half or more of cell - Visible granules in cytoplasm - Two kinds: ? * B lymphocytes - which make up ____________ are specific to blood and lymph (make ____________). * T lymphocytes - _____________ "cell killers" = seek and destroy. Kills cells invaded by viruses or tumor cells. - Produced in ____________ of bone marrow as immature cells but mature in ___________.

- B and T lymphocytes * humoral (fluid) immunity/ (antibodies, Abs, immunoglobulins) * cellular immunity - lymphoblast tissue/ lymphatic tissues

- Two types of lymphocytes include: ? * T lymphocytes: undergo maturation in the _______ under the control of _________. T lymphocytes are part of ________________. T-cells attack and destroy viruses, virus infected cells and tumor cells. One group of T lymphocytes called _________ initiate and coordinate the entire immune response against infection. * B lymphocytes: these undergo maturation in the _________ itself and are used for _______________. Activated B lymphocytes create and release _________ (other names include ?) which will inactivate the pathogen by ___________ (clumping); the clumped pathogen will then be removed by macrophages. The specific defense against a particular pathogen by lymphocytes is called _________. Some of the T and B cells remain in the body years after an infection as _________, which help prevent a secondary infection by the same pathogen. __________ is based on the body's ability to produce memory cells after infectious agents enter the body.

- B and T lymphocytes * thymus/ thymosin (educated hormone)/ CMI (cell mediated immune response = go after cells)/ T4 cells * germinal centers/ antibody mediated immune response/ antibodies (Abs or immunoglobulins or Igs)/ agglutination/ antigen-antibody response/ memory cells/ vaccination

Erythropoiesis cont.: - Induced by _________, a hormone released by the ________. * Kidneys release EPO when ________ declines or _________ decreases. * EPO stimulates the ________ to differentiate into RBCs. * __________ (young RBCs without the nucleus and most of the organelles) enter the blood stream from the ____________ 15 days after the start of erythropoiesis. * because RBCs are _________, they remain functional in blood for only about _____ days (no ribosomes, or mitochondria); then they are broken down and the components recycled, mainly in the _______, and partly in the ______ (_______ is called the graveyard of RBCs). - In days 4-7 of erythropoiesis, what occurs?

- EPO (erythropoietin)/ kidneys * RBC count/ hemoglobin content * hemocytoblasts * reticulocytes/ red bone marrow * a-nucleated/ 120/ spleen/ liver/ (spleen) - ejection of nucleus

Hemoglobin: - abbreviated? - A red pigment molecule specialized for __________; synthesized before loss of nucleus. - Shape: 2 _____ chains and 2 ______ chains of polypeptides; each with an ______ atom. - Each RBC contains _______ hemoglobin molecules .... meaning each RCB can carry a _______ molecules of O2. - RBCs are over _____% Hb. - Because RBCs lack mitochondria, they generate ATP by _________; therefore, do not consume any O2, making then very efficient O2 ________.

- Hb - transport of O2 and CO2 - alpha/ beta/ iron (Fe) - 250 million/ billion - 97% - anaerobic respiration/ transporters

Basophils: - Nucleus lobe: _______ shaped. - Cytoplasmic granules; large and basic: purplish/black stain known as a ________ stain. - Rarest of the WBCs - _________ containing granules, is an inflammatory chemical that acts as a ___________ and interacts and attracts other WBCs to the inflamed area. * _________ counter the inflammation. - Granulated cells similar to ________ (found in CT of skin and mucous membrane of respiratory tract and GI tract). Both cell types bind to a particular ____________ (____________) that can cause the release of ___________. Can also release ________ and ________ (the latter can cut long proteins apart). * ARISES FROM DIFFERENT CELL LINES!

- U or S - Wright's - histamine/ vasodilator * antihistamines - mast cells/ antibody (immunoglobulin E)/ histamine/ heparin and proteases

Leukemia: - Cancerous condition involving an overproduction of abnormal _______. The renegade leukocytes are members of a _____________ (descendants of a single cell) that remain unspecialized and proliferate out of control, impairing ___________ function. - The leukemias are named according to the __________ and the type of cell primarily involved. - The most common cause of death with leukemia is __________ and overwhelming infections. - Irradiation and antileukemic drugs can destroy the rapidly dividing cells and induce remissions. - Accumulation of WBC in red bone marrow will interfere with RBC, WBC, and platelet production ..... may cause decrease in _______ and increase susceptibility to _________ with abnormal blood clotting. - Acute = ________/ chronic = _________.

- WBC/ single clone/ bone marrow - rate at which they progress - internal hemorrhage - O2/ infections - children/ adults

- At the onset of an infection, there is a sudden increase in _______ count, over _________ WBCs/ 100 ml of blood; this sudden increase in response to an infection is called _________ and is an adaptation to fighting off infections. - WBCs engulf and destroy infectious agents (_________) by ___________ using __________; and by other immune responses (part of the innate system).

- WBCs/ 11000/ leukocytosis - pathogens/ phagocytosis/ pseudopods

- Oxygen deficiency stimulates __________ production by kidneys -> stimulates red blood cell production in __________ -> causes restores _________ level. * what type of feedback is this?

- erythropoietin -> bone marrow -> oxygen * negative feedback

Blood Groups: - Blood groups are determined by the presence or absence of specific surface protein markers [ ______ and _______ ] called ________ on the RBC membrane. * An _______ is anything the body considered to be foreign and that generates an immune response. * Blood does not have the _______ cell marker (other cells of the body do)!!!!! - Two major blood groups: * __________: has surface antigen A. * __________: has surface antigen B * __________: has surface antigen A and B. * _________: has neither surface antigen A or B. * _________: indicates the presence of Rh surface antigen * _________: the absence of the Rh antigen - At least _____ blood groups and more than _______ antigens can be detected on the surface of RBCs.

- [glycoproteins and glycolipid]/ antigens * antigen * MHC - 1 * Type A * Type B * Type AB * Type O * Rh+ * Rh- - 24/ 100

Plasma Proteins: - ________ (60%) - ________ (36%) and includes what two subcategories? - ________ (4%) - ______ and _______

- albumins - globulins (antibodies (Ab or Ig) and transport proteins - clotting proteins - enzymes and hormones

Plasma Proteins cont.: - ________: most abundant plasma protein (_____%); contributing to _____________ of plasma (is the water retention capacity of blood) and also acts as a __________. - ________: (alpha, beta, gamma) = (____%) * __________: bind small ions, hormones, and other factors that might otherwise be lost at _________ or have low solubility in _______. - transport of ________, _______, and ________ in the blood. * ___________ and ________ transports ACT * __________ transports metal ions (what transports iron?) * __________ carry triglycerides and other lipids -> lipoproteins * __________ (TEBG: testosterone - binding globulin) * __________ (________) attach foreign proteins and pathogens - _________ (4%) - soluble protein which is converted into ______ (solid, threadlike protein) during blood clotting ...... if you remove this 4% soluble protein = ______. - other important proteins: _______, prolactin (PRL), thyroid (TSH), follicle (FSH), (LSH), __________ (which is important in blood pressure).

- albumins/ 60%/ osmotic pressure/ chemical buffer - globulins/ 36% * transport globulins/ kidneys/ water - fatty acids, thyroid hormones, and some steroid hormones * thyroid binding hormone and transcortin * metallo-proteins (transferrin) * apolipoproteins * steroid binding proteins * immunoglobulins (Ig) or antibodies (Ab) - fibrinogen/ fibrin/ serum - insulin/ angiotensinogen

Systemic Circulation: Arteries - Main artery = ________; ascending and arch * Branches to form iliac arteries in pelvis * ________ arteries branch from this main artery.

- aorta - systemic

Eosinophils: - Digest little bits at a time - Nucleus appears ________: have figure 8 shaped nucleus - Cytoplasmic granules; ______ and _______ making their stains red/orange - Destroy ____________ as well as immune complexes. * flatworms (_________ and ________) * roundworms (________ and _________) - The worms are ingested in food (usually _______) or invade the body via skin, burrowing into the intestinal/respiratory mucosae, residing in these ____________ tissues. - To kill, many eosinophils will gather around and release ________ from granules onto the parasite's surface ..... digesting it away. - Eosinophils also have complex roles in many other diseases including ________ and ________.

- bi-lobed - coarse and acidic - parasitic worms * tapeworms and flukes * pinworms and hookworms - raw/ loose connective - enzymes - allergies and asthma

- Blood platelets initiative __________ (PF3) which leads to ________ = stoppage of blood flow from a cut or damaged blood vessel. - What kind of feedback system is this?

- blood clotting/ hemostasis - positive

- Because RBCs are not nucleated, they do not have MHC molecules or cell identity markers; they do, however, have a different kind called ___________ and include what 3 kinds?

- blood group antigens/ A, B, and O antigens

Hemostasis: - Vascular spasm: the cut-ends of a blood vessel constricts in order to reduce _________ (the greater damage to vessel cells = increase spasms). - Platelet-plug formation: blood platelets accumulate at the blood vessel damage site (___________) forming a platelet plug; _____________ cause platelets to swell and become sticky (helped by ______, ________, and _________ = will keep bleeding if we don't have these) then the blood platelets break up and release a number of chemicals (___________), which along with vitamin K and calcium form ____________. - Blood clotting or coagulation of blood: (this step reinforces the platelet-plug) in the blood plasma; there is an inactive enzyme called ________ (or ___________). This inactive enzyme is activated by the ___________ to form an active enzyme known as _________. * Thrombin acts on ___________ to form insoluble _________. * Fibrin traps the blood cells and nets large proteins in blood to help form the ___________. Why does fibrin need to be insoluble? - The liquid that separates from the clot is called _______. 1-2 hours after clotting, the clot shrinks in a process called ___________ and helps heal the wound. 2-3 days after the clot formation, the clot is dissolved by another enzyme called _______, present in blood plasma. The process of dissolving the clot is called __________.

- blood loss - (collagen layer)/ von Willebrand factor/ (ADP, serotonin, and prostaglandins)/ (clotting factors)/ prothrombin activator - prothrombin (thrombinogen)/ prothrombin activator/ thrombin * fibrinogen/ fibrin * blood clot/ because interstitial fluid has lots of H20 which would break it down and prevent clotting - serum/ clot retraction/ plasmin/ fibrinolysis

- Clinical laboratory tests called _________ and ________, ensures the proper identification of blood group antigens and antibodies in both donor and recipient to prevent _______________. - A third antigen, _____, was also found on RBC ..... called _________ (rhesus monkey). * ______ - you have the antigen, _____ - means you do not have the antigen. * blood normally does not have anti-Rh _________ for the Rh factor. * there are _____ Rh factors; only ________ are common.

- blood typing and cross-matching/ transfusion reactions - D/ Rh factor * Rh+/ Rh- * antibodies * 52/ C, D, and E

Blood Platelet Production: - Occurs in the ___________. - Platelets are the shedding pieces of __________ (giant cells) - Each giant cell produces about 4000 platelets. - The giant cell production is stimulated by ________ from the ________.

- bone marrow - megakaryocytes - TPO (thrombopoietin)/ kidneys

Transplants: - ________ transplants replaces cancerous or abnormal red bone marrow with healthy red bone marrow for the proliferation of healthy blood counts. * This can only occur when the red bone marrow is sufficiently damaged by _________ or ________ to kill the cancer cells and destroy the patient's immune system; it then can be replaced with new heathy red bone marrow; but the patient is extremely susceptible to _________ during the interim. - Healthy red bone marrow, usually taken from the ________ of the hip bone with a syringe, can be used from a donor or from the patient, if they are in remission. * The tissue is injected and it migrates to the recipient's bone marrow, hopefully to proliferate, * There is risk of T-cells attacking recipient's tissue .... called _________. - Transplants have been used successful for aplastic anemia, certain types of leukemia, SCID (_______________), Hodgkin's disease, non-Hodgkin's lymphoma, multiple myeloma, thalassemia, sickle-celled disease, breast cancer, ovarian cancer, testicular cancer, and hemolytic anemia. - New advances involve _________ for pluripotent stem cells (cells are not fixed).

- bone marrow * chemotherapy or radiation/ disease - iliac crest * graft-versus-host- disease - severe combined immunodeficiency disease - cord-blood transplant

3 Important Steps in Clotting: - Release of _________ from both injured tissue cells and sticky platelets at injury site (forms _________) - Series of complex chemical reactions (cascade) leading to formation of _________. - Formation of ______ (insoluble threads) that trap blood cells to form a clot. **** MOST CLOTTING FACTORS ARE MADE IN THE _________.

- clotting factors/ (platelet plug) - thrombin - fibrin - liver

Steps in Clot Formation: - Damaged cells expose ________, which activate platelets, causing them to form a plug. - Both damaged cells and activated platelets release chemicals (_________) that convert ________ into the enzyme _______. - Thrombin catalyzes conversion of ________ into protein fibers called ________, which forms a meshwork around platelets and traps RBCs.

- collagen - (Factor X)/ prothrombin/ thrombin - fibrinogen/ fibrin

- ____________: tells us about the state that the body is in based on the number of each type of cell in a sample of 100 WBC. * ________ WBCs = normal but will increase with infection * ________ WBCs = infection * _______ WBCs = severe infection * _______ WBCs = hospitalization, list an example! - _________: inadequate number of WBCs - _________: excessive numbers of WBCs; normal; protective response to stressors like ____________. - Sometimes neutrophils can increase number if the body have been given _________ or _________ treatments.

- differential count * 5000 * 10000 * 15000 * 20000 = appendicitis (LRQ) - leucopenia - leukocytosis/ invading microbes, strenuous exercise, and anesthesia and surgery - epinephrine or cortisone

Abnormal Blood Clotting: - _________: drifting clot, an abnormal mass in the blood stream. - _________: embolus that becomes stuck in the blood vessel blocking circulation to downstream tissue, killing tissue. - __________: tissue damage caused by an embolism. * _________: infarct at the brain. * _________: infarct at the heart. - __________: enzymes that inhibit clotting; used on patients who are at increased risk of forming blood clots. * __________: present in plasma; quickly inactivates any thrombin not bound to fibrin. * __________: (most used clinically [hemodialysis and open heart surgeries] to prevent clotting) natural anticoagulant found in _________ and ______ cells. * _________: (aka Warfarin; active ingredient in rate poison) interferes with action of vitamin K; therefore, no clots. * _________: anti-prostaglandin drug that inhibits thromboxane A2; blocks platelet aggregation and platelet plug formation.

- embolus - embolism - infarct * stroke * myocardial infarction - anticoagulants * anti-thrombin III * heparin/ mast and basophil cells * Coumadin * aspirin

Leukopoiesis: - What WBCs come from myeloid stem cells? - What WBCs come from lymphoid stem cells? - Explain the maturation and function of monocytes, B lymphocytes, and T lymphocytes! - Lymphocytes need stimulation by ________ to become active.

- eosinophils, basophils, neutrophils, and monocytes (in red bone marrow) - B and T lymphocytes (in lymphoid tissue) - monocytes -> macrophages (hunts and engulfs bacteria)/ B lymphocytes -> plasma cells (make antibodies)/ T lymphocytes -> effector T cells (killer and are used against cancer and viruses) - pathogens

Erythropoiesis cont.: - Production of RBCs, stimulate by the peptide hormones _________ (EPO, a ___________), ________, __________ (testosterone), and __________. * ________ does not stimulate erythropoiesis hence the difference in hematocrit values in men and vs. women. - Function of Erythropoietin: * stimulates increased cell division rates in ____________. * speeds up maturation of _______, accelerating the rate of _________ synthesis. - Occurs only in the red bone marrow (__________), which is located: ? - Remember, under extreme blood loss. _________ can convert to red marrow. - Stages of RBC maturation: ____________ stages - ejects _________ upon synthesis of ________ (7 days); ________ stage at 15 days; has made all of its hemoglobin _____ days before entering circulation and is considered mature. - Myeloid stem cells (________) - divide to produce __________. - Lymphoid stem cells = divide to produce different _________.

- erythropoietin (glycoprotein), thyroxin, androgens, and growth hormone * estrogen * erythroblasts * RBC/ hemoglobin - myeloid tissue/ vertebrae, sternum, ribs, skull, scapulae, pelvis, and proximal limb bones - yellow marrow - erythroblast/ organelles/ hemoglobin/ reticulocyte/ 2 - (hemoblast)/ RBC and WBC - lymphocytes

Erythroblastosis Fetalis: - No problem with ______ pregnancy. - Maternal and fetal blood don't mix. - During delivery, if blood mixes, mother becomes sensitized to _____ blood, she will begin to produce __________. - This may also occur due to placental abnormalities, prior tubal pregnancies, miscarriages, abortions or amniocentesis in which subsequent pregnancies with an Rh+ fetus, mother's anti-Rh antibodies will cross the placenta causing fetal blood cells to ________ and be destroyed. - Effects on fetus may range from _______, to brain damage (______), to possible death. - ________ shots at 28 weeks and after delivery may prevent sensitization. - RhoGam offers no protection after a woman is sensitized.

- first - Rh+/ anti-Rh antibodies - agglutinate - jaundice/ (anoxia) - RhoGAM

Neutrophils cont.: - Also considered as the ____________ and are the most numerous type. - ________% of circulating blood. - Highly mobile so first to arrive; engulf pathogen by _____________ creating vesicles that fuse with ________ containing ________ (antimicrobial proteins), which makes holes in the bacteria, cell wall of fungi, and envelope of viruses - Specialized in attacking and digesting bacteria that have been marked with _______ (the marking is called _________). - Secrete __________ (help in ___________ for attracting other phagocytes) and _________ (increase capillary permeability) when under attack mode; these secretions both increase _________. - Short life span = 10 hours; when active = only 30 minutes (die after engulfing 1-2 dozen bacteria; then release chemicals .... ________ to attract more neutrophils). - _______: IF with cellular debris, dead neutrophils, and dead bacteria. - Numbers increase explosively during acute bacterial infections (________ or _________) - Bacteria replicate every ___________.

- first responders - 50-70% - phagocytosis/ lysosomes/ defensins - Abs - antibodies (opsonization) - leukotrienes (chemotaxis)/ prostaglandins/ diapedesis - cytokines - pus - appendicitis or meningitis - 20 minutes

Hematocrit: - Is the percent of ___________. - Normal Hematocrit is around ______ of blood volume, depending on gender: * females = _______, males = _______, and this is due to _______.

- formed elements - 45% * 38-46%/ 40-54%/ body size

- Cell Components = _________ - Include? - What are the only true cells of the formed elements and what does their tiny membrane extensions do?

- formed elements - erythrocytes (RBCs), platelets, leukocytes (WBCs) - leukocytes (WBCs)/ increase surface area

Blood Composition: Formed Elements: - ________: blood cells and fragments that are suspended in plasma = _________. * __________: 99.9% of formed elements * __________: bodies defense * __________: bound cell fragments that contain enzymes and other substances important to the process of clotting. - _________ = plasma + formed elements - ________ raises viscosity of blood -> there is an increase in? * provide an example that she mentions multiple times in class! - Most blood cells do not divide. Instead, stem cells, __________ cells, divide continuously in ________ to make _________ and ______ stem cells. * Lymphoid stem cells divide to make _________. * Myeloid stem cells divide to make __________.

- formed elements/ hematocrit * RBCs or erythrocytes * WBCs or leukocytes * platelets or thrombocytes - whole blood - high hematocrit/ RBCs * high altitudes - pleuripotent/ red bone marrow/ myeloid and lymphoid * lymphocytes * all other formed elements

Blood: - __________; study of blood - Blood consists of a liquid portion called ________ (____%) and solid portions called _________ (____%). - In centrifuged blood, ______ appears as a pale liquid, WBCs and platelets separating as the _________, while ________ form a red solid mass; together these fractions are called ________ or ________. - Excess fluid continually diffuses out at ______ and into the lymphatic system.

- hematology - plasma (55%)/ blood cells (45%) - plasma/ buffy coat/ RBCs/ formed elements or hematocrit - capillaries

Erythroblastosis Fetalis: - Also known as HDN: ________ disease for the newborn. - Erythroblastosis Fetalis may occur: * when a ______ mother gives birth to an ______ child; the fetal blood may sensitize the mother. * the mother will produce _______ against Rh+ cells after delivery as blood mixes. * if the mother conceives a second ______ child, her antibodies will cross the placenta and kill the fetus. - To prevent: __________ (_____________)is given to the mother after first birth; it binds to the Rh+ antibodies before the second conception. - Anything that is attached to a cell cannot cross the placenta. - In severe cases, we can do _____________ to avoid damage or death and one + after birth.

- hemolytic * Rh-/ Rh+ * antibodies * Rh+ - RhoGAM (anti-Rh gamma globulin = a type of protein) - inter-utero transfusions

- _________: to prevent loss of blood through the walls of damaged vessels and establish tissue repairs. - Three phases of hemostasis: * __________: vascular spasm (____________ decreases the size of the vessel) slows down or stops loss of blood (if minor) * __________: attachment of platelets to the damaged area forming a ___________ (platelet aggregation, occurs within 15 sec). * __________: blood clotting, sealing off the damaged portion of the vessel. - Co-factors needed for clotting = ____________ * __________ (needed for every system) * _________ (not directly involved in coagulation but is required for synthesis of 4 other clotting factors) * __________ * _________ (in cascade or chain reaction)

- hemostasis * vascular phase/ smooth muscle * platelet phase/ platelet plug * coagulation phase - clotting factors * calcum * vitamin K * prostaglandins * pro-enzymes

- The main stimulus for erythropoiesis is ________, a decrease in oxygen-carrying capacity of blood. - Erythropoietin is released: * during ______ * when blood flow to the _________ declines * when ________ of air declines like in high altitudes * when the __________ of the lungs are damaged - How might hematocrit change if you moved from a town at sea level to a high mountain area? - What type of feedback system is the erythropoietin release? - _______; not enough RBCs.

- hypoxia * anemia * kidneys * O2 content * respiratory surface - increase in hematocrit = called blood doping - negative feedback - anemia

Veins: - Major veins = _________ - __________, so we can see them - Deep veins run next to arteries - Often have same names as arteries - Arteries _______, veins _________.

- inferior and superior vena cava - superficial - branch/ converge

Pathways of Hemostasis: - Intrinsic: everything the blood needs to clot is ______________. * begins with ________ (pro-enzymes) * assisted by _________, that is released by aggregating platelets * series of linked reactions occur that activates _________ and ______. * these factors together (enzyme) then activate _________; * the process is ________ * produces more ________ which reinforces the _________ produced by the extrinsic pathway * _____ and ______ - Extrinsic: needs a factor outside of the bloodstream called ___________. * beings with the release of ________ (tissue factor) * the more tissue damaged, the more _________ released, the faster clotting occurs. * ________ + ________ + ___________ (clotting factor) = enzyme capable of activating __________. * the process is _______ than intrinsic hemostasis * ________ the clotting process * produces less _______ than the intrinsic pathway * USED IF ITS A BIGGER BLEED! - Common Pathway: when a blood vessel is damaged, both intrinsic and extrinsic pathways respond * begins when enzymes from either intrinsic or extrinsic pathways activate __________. * forms the enzyme __________. * prothrombinase converts the proenzyme __________ into the enzyme _________. * thrombin converts _______ (soluble plasma protein) to strands of ______ (insoluble strands), which catch RBCs and WBCs.

- inside the bloodstream * factor XII * platelet factor * Factor VIII and IX * Factor X * slow * thrombin x2 * vitro and vivo - tissue thromboplastin * Factor III * tissue factor * tissue factor + calcium + Factor VII/ Factor X * shorter/ faster * speeds up * thrombin * Factor X * prothrombinase * prothrombin/ thrombin * fibrinogen/ fibrin

Hemoglobin cont.: - Each chain contains a central ______ core = also called ______. - Heme transports _______, gives the red color to RBCs; * the protein chain (______ part, can carry some carbon dioxide = ____%). This is in the form of __________. - Hemoglobin makes up _____ of RBC weight; 15% of the blood's weight and accounts for 95% of intracellular protein; less in females. - _______ can also be picked up by Hb, acting as a vasodilator and improving blood flow.

- iron/ heme (Fe) - oxygen * globin/ 20%/ carbamino-Hb - 33% - nitrous oxide (NO)

Blood Flow cont. - Systemic circuit: starts from the _________ where oxygenated blood is sent to all body parts through arteries - veins return the deoxygenated blood to the __________, which then empties into the __________. - Pulmonary circuit: starts from the __________ where deoxygenated blood is pumped to the lungs (through the _________ and ________) for oxygenation - oxygenated blood is returned to the __________ by ___________- this blood then goes into the left ventricle. - Total blood volume = _________.

- left ventricle/ right atrium/ right ventricle - right ventricle/ pulmonary trunk and pulmonary arteries/ left atrium/ pulmonary veins - 5 L in female and 6 L in males

WBC Disorders: - ____________: low WBC counts, often seen with __________. - ____________: over-abundance of WBC; more common problem, seem in most types of leukemia and almost always accompanies bacterial infection. - ____________: cancer of the B lymphocytes whose plasma cells produce defective antibodies (an antibodies is a type of ___________). Most common and deadly blood related cancers in people over 65. - ___________: include a number of blood cancers; marked leukocytosis. Acute or chronic based on how quickly symptoms appear after the disease appears: * _____________: more common in older adults, mostly in men; can live many years. * ____________: mainly a disease in children (80%), highly curable in children, not so in adults .... symptoms include fever, bone pain and increased rates of infection, ...... anemia, swelling of the lymph nodes, spleen, and liver are common. * ___________: results from cancerous transformation of granulocytic precursor cells in bone marrow; accounts for 20% of all leukemias, ..... mostly in adults between 20-60 years. Onset is slow, diagnosed by marked increase of granulocytes and extreme enlargement of the spleen. Treatment with drug Gleevec, which blocks signal to proliferate unchecked. * ___________: pathological transformation of myeloid stem cells. Onset is sudden and progresses rapidly. Prognosis is poor 30-50% but advances in bone marrow and stem cell treatments; transplantation have increased cure rates.

- leukopenia/ acquired immunodeficiency syndrome (AIDS) - leukocytosis - multiple myeloma/ (protein) - leukemia * CLL: chronic lymphocytic leukemia * ALL: acute lymphocytic leukemia * CML: chronic myeloid leukemia * AML: acute myeloid leukemia

WBC Formation: - Known as ? - ________ are small glycoproteins that stimulate development of WBC types especially those of non-specific defenses. - WBC populations are regulated by: * ___________: we can now artificially stimulate specific blood cell lines (G-CSF). EX: _________ is used to stimulate production of neutrophils I patients undergoing _________ or ____________. * ____________ (Ils)

- leukopoiesis - cytokines * CSF (colony stimulating factors)/ Neupogen/ chemotherapy or clotting disorders * interleukens (Ils)

Plasma: - _______ part of blood. - Contains?

- liquid - water (mostly), proteins, hormones, nutrients, electrolytes, respiratory gases, and wastes

3 Main Components: - Blood: a _______ tissue (modified ____________); acting as the internal _________ medium of molecules and ions. - Heart: a _________, 4-chambered pumping organ that keeps the blood flowing under pressure through blood vessels. - Blood Vessels of 3 kinds: * _________: most take blood away from the heart towards the body tissues. * _________: most take blood towards the heart from tissues. * _________: microscopic vessels in between the arteries and veins, making up the __________ in blood circulation.

- liquid/ (CT)/ transport - muscular * arteries * veins * blood capillaries/ exchange area

Jaundice: - In newborns, caused by the ______ not functioning fully * secretes _______ into the blood causing the yellow color. * exposure to __________ will break down the substance. * ______ is one of the last organs to develop, so early babies often are jaundice. - Jaundice is common in other conditions involved with liver disease; ______ or ______.

- liver * bilirubin * fluorescent lights (bili lights) * liver - hepatitis or cirrhosis

Infectious Mononucleosis: - Many of the __________ are so large and atypical that they were originally mis-identified as ___________ and the disease was mistakenly named mononucleosis. - The atypical cells have much more cytoplasm and a larger nucleus. - Symptoms include fever, sore throat, severe fatigue, achy, and enlargement of lymph nodes and spleen. - Sometimes called _____ or __________; is an infection usually caused by the ____________. - The designation "mononucleosis" refers to an increase in one type of WBC (___________) in the bloodstream.

- lymphocytes/ monocytes - mono or the kissing disease/ Epstein-Barr virus (EBV) - lymphocytes

Monocytes cont.: - largest WBC (2x RBC) - When they leave the blood vessels and enter the tissue fluids, they take in water and become larger, differentiating into aggressive ___________. Some are fixed and reside permanently in the _______ and ________ while others wander and roam. - Circulate 24 hours as large macrophages ...... wander through tissue fluids to pick up and destroy any foreign matter and cellular debris by __________, so they are called the _________ of the body. - Active macrophages can attract _________ that produce scar tissue to wall off injury or pathogens as in ________ (capsule of fibroblasts). - Macrophages not only provide non-specific defense against infections, but also alert _________ to initiate the immune response of long-term defense against infections, making them an _________.

- macrophages/ lungs and spleen - phagocytosis/ scavengers - fibroblasts/ tuberculosis (TB) - lymphocytes/ APC or antigen presenting cell

Removal of RBC; Hemoglobin Recycling: - _________ usually engulf "old" RBCs in ____________; however, _________ can also occur - cell membrane ruptures releasing hemoglobin; if Hb is not phagocytized it cannot be re-cycled. * if RBC ruptures in vessels, Hb is removed in ________ (ie no recycling and break down -> causes urine to turn red or brown ..... called __________). * if the intact RBCs are in urine .... called __________ ...... may indicate damage to the _________. - If RBCs are engulfed before hemolysis, hemoglobin has different fates: 1. amino acids (protein) * ______________ are broken down into AA, metabolized by macrophages or released into the blood. * once broken down by phagocytic cells, the _______ portion is transported in blood bound to __________ as _________ and sent to the _____. 2. Iron * Iron is recycled, combined with proteins and forms iron storage molecules such as ______ and _________. These are stored in the ______ and used in erythropoiesis. * The rest of heme is converted into _________ (green; seen in bad _______) -> converted to _________ (yellow), which is used in making ______ by the liver. Large intestinal bacteria convert bilirubin into __________ that can be absorbed into bloodstream and excreted into ______ - giving it a yellow color. - ________ is yellowing of skin indicating ________ is blocked or ______ cannot absorb. - Bile is produced in the ______ and stored in the _______; this substance _________.

- macrophages/ spleen, liver, and bone marrow/ hemolysis * urine/ hemoglobinuria * hematuria/ kidneys * alpha and beta chains (globin) * heme/ albumin/ transferrin/ liver * ferritin and hemosiderin/ liver * biliverdin/ (bruises)/ bilirubin/ bile/ urobilinogens/ urine - jaundice/ bile duct/ liver - liver/ gallbladder/ emulsifies fats

- Venipuncture is usually done where? - Because _______ are less dense than RBCs but more dense than blood plasma, they form a very thin buffy coat layer when centrifuged.

- median cubital vein - WBCs (includes platelets as well)

Thrombocytopoiesis - Broken pieces of large stem cells called ____________; are _________ cell fragments in the plasma, about ____________ per microliter of blood; remain active in blood for about ______ days.

- megakaryoblasts/ a-nucleated/ 250000-500000. 9-10

RBC Count cont: - ____________: autoimmune disease; destruction of lining of stomach; often seen in elderly and accompanies protein malnutrition (lack ___________) which is needed to absorb _______ (needed to make RBCs). RBCs are larger than normal and are called _________. - __________: similar to pernicious anemia in that it causes low RBC count resulting from a _________ deficiency (_________). Common among alcoholics or malnutritioned individuals. - __________: body destroys RBCs (autoimmunity) - _________: caused by lack of EPO; accompanies renal disease because damaged kidneys cannot make EPO. - _________: genetic disorder (abnormal _________ - becomes spiky and sharp) which causes RBCs to crescent shape when they upload oxygen or when too little oxygen is present (during vigorous exercise or increased metabolic rate of if they have ________). * occurs mostly in African Americans who live in the malaria belt and their descendants, one out of every 500 African American newborns. * sickling only occurs when two copies (___________) exist in an individual, reducing the malaria parasite's ability to survive, while enhancing WBC ability to destroy RBCs. * individuals with only one copy of the gene have a better chance of surviving the tropical disease, malaria. * what AA is present in sickle cell anemia?

- pernicious anemia/ (intrinsic factor)/ vitamin B12/ macrocytes - folate deficiency anemia/ vitamin B9 (folic acid) - histolytic anemia - renal anemia - sickle cell anemia/ hemoglobin/ malaria * homozygous * valine

Genetics of Blood Types: - ________ is determined by the genotype. - Alleles; * (dominant) IA - __________ * (dominant) IB - __________ * (recessive) i - __________ - Blood Type: * A blood type (phenotype) = ________ or _______ (genotype) * B blood type (phenotype) = _______ or _______ (genotype) * AB blood type (phenotype) = ________ (genotype) (known as _________) * O blood type (phenotype) = _________ (genotype) - Having one, good, functional protein is _________ to not having it.

- phenotype * antigen A * antigen B * non coding * IA + IA (homozygous) or IA + iO (heterozygous) * IB + IB or IB + iO * IA + IB/ (co dominance) * i + i - dominant

- _______ makes up about 7% of plasma. - Includes?

- plasma proteins - albumins/ globulins/ clotting proteins/ enzymes and hormones

RBC Count Effect: - _________: "sludge blood" too many RBCs due to altitude or hyper-plastic red bone marrow. * __________: infusing a pint of self blood before competition. * __________: athletes live/train at altitude - _________: is a bone marrow cancer; characterized by dizziness. - ________: inability to produce adequate amount of alpha and beta chains of Hb; occurs in people of Mediterranean ancestry. - ________: low hemoglobin in the RBCs or low hematocrit causing the tissue in the body to be deprived of oxygen; symptoms included: weak, lethargic, confused, feeling cold, pale, feeling tired, and shortness of breath. - ________: low RBC count as a result of bleeding. - ________: hypo-plastic red bone marrow (trouble making RBCs); usually occurs from destruction of bone marrow from drugs, toxic chemicals (chemo) or radiation. - ________: the RBCs produced are smaller than usual and are called __________; not enough iron to bind hemoglobin (missing _______ group). Worldwide medical problems, why?, also very common in __________.

- polycythemia * illegal blood doping * natural blood doping - polycythemia vera - thalassemia - anemia - hemorrhagic anemia - aplastic anemia - iron deficient anemia/ microcytes/ (heme)/ people do not get enough iron in the foods they eat/ pregnancy

Neutrophils: - nucleus with 3 to 8 lobes; also called ________ or _________. - Some granules contain ______________ and are regarded as lysosomes. Smaller granules have a potent brew of antimicrobial proteins called _________ = these form peptide spears that pierce holes in bacteria membrane. - Granules in the cytoplasm are ________ (will kill bacteria); causing a dramatic increase of metabolic rate ...... this is called a _____________, which produces ________ and _________ = kills bacteria. - Phagocytize _________ and some __________. - Attracted to sites of __________. - Produced in bone marrow by ___________.

- polys or polymorphonuclear leukocytes - hydrolytic enzymes/ defensins - bactericidal/ respiratory burst/ hydrogen peroxide (H2O2) and super oxide anion (bleach or O2-) - bacteria/ fungi - inflammation - myeloblasts (myeloid tissue)

- The rate of RBC formation by __________ equals the rate of RBC destruction by __________. - Excess iron can bind to and damage cell molecules so ______ and _______ act as protective protein escorts during transport so that no iron is found in blood. * Iron overload is dangerous to _____, _____, _____, and _______. Can allow microbes to flourish in gut causing lethal problems.

- red bone marrow/ macrophages - ferritin and transferrin * liver, heart, gonads, and pancreas

- What are the primary differences between plasma and interstitial fluid? * levels of _____________ (i.e oxygen and carbon dioxide) = at capillaries there is less ____ and more _____ from cells. * concentrations and types of __________ which are 5x greater in ________ and cannot cross capillary walls because ___________. - What are two other names for interstitial fluid?

- respiratory gases/ O2/ CO2 - dissolved proteins/ blood/ they are so big - IF or lymph

Erythropoiesis: Red Blood Cell Production: - Almost 2 million RBCs are produced every ________ in a healthy body. - For RBC production, we need: * ______ and ______ complex (especially ______ and _______). Antibiotics kill good _______ which makes __________; therefore, this is why people taking antibiotics for long times become anemic. * We need about _____ of iron per day. Good sources of iron are green leafy vegetables, meat, eggs, and liver; good sources of Vit. B are liver, green vegetables, yeast, whole grains and meat .... what is the problem with liver? - Whole blood contains _______ RBCs per 1 WBC. - RBC retain ________ but have no nucleus, no ribosomes, and no mitochondria (so ensures ____ gets transported and not used); therefore, RBCs undergo __________.

- second * iron and vitamin B (folic acid and Vit. B 12)/ E. coli/ Vit. B12 * liver is very fatty - 1000 - cytoskeleton/ (O2)/ anaerobic respiration

- Blood poisoning = ________. * an infection enters the bloodstream * can be deadly * treated with antibiotics * also called _______. * this is bad for people with diabetes because they have ________. - __________: bleeding or excessive RBC destruction.

- septicemia * sepsis * poor circulation - hemorrhage

Abnormal Hb cont.: - _________; results from one AA mistake out of 150 in the ______ chains. When defective Hb gives up its bound oxygen, the adjacent Hb molecules interact causing the cells to become stiff and curved resulting in fragile and easily damaged cells, dying in ______ days. Additionally, they can become stuck in _______ resulting in blockage and cell starvation. * Genetically, the form of anemia (_____________) exists as an evolutionary protection against _________. The disease causes leaking of _________ ions which kills the malaria parasites that live inside the RBCs. Thereby conferring a higher than average survival benefit; people who are sickle cell carriers usually do not die of malaria. Malaria kills 1 million/year; 150 million people infected. * Caused by a __________, and carried by _________. * Complicated life cycle, parasite invades ______ and _______, ..... rupture of RBCs causes symptoms of chills and fever, treated with _________.

- sickle cell anemia/ beta/ 10-20/ capillaries * (autosomal recessive/ homozygous)/ malaria/ potassium * sporozoan, Plasmodium/ Anopheles mosquito * spleen and liver/ Chloroquinine

Agranulocytes: - Involved in ____________ - No visible granules in cytoplasm - Have spherical or kidney shaped nucleus - What are the two kinds?

- specific defenses - monocytes and lymphocytes

Blood Flow: - Heart maintains a double circuit of blood when it contracts and relaxes, what are the two circuits? - The upper two chambers called the ______ are the _______ chambers, and the lower two chambers called the _______ are the ______ chambers of the heart. - In blood pressure, exchange takes place at the capillaries. At this point there is no pressure to get the blood back to the heart. By utilizing __________, veins push the blood forward.

- systemic or body circuit and the pulmonary or lung circuit. - atria/ receiving/ ventricles/ pumping (thicker) - muscles

- ___________ is injected into a heart attack patient. It induces the removal of blood clots in the blood vessels of the heart. - ________ and other chemicals that prevent blood clotting are called _________. - _______ has anti-coagulant properties.

- tPA (tissue plasminogen activator) - heparin/ anti-coagulants - aspirin

Abnormal Hemoglobin: - __________: abnormal genetic disease resulting from inability to produce adequate amounts of alpha or beta chains of hemoglobin, inhibiting production of RBCs which are already fragile and short lived. This condition results in problems with development and growth. Individuals must undergo recurrent blood transfusions. - _______: not enough iron -> decreased RBCs. - _______: caused by toxins, gamma radiation or certain medications that inhibit enzymes needed for hemopoiesis. - ______: insufficient hemopoiesis caused by inability of the stomach to produce intrinsic factors that are needed for ______ absorption. - ______: RBCs rupture, releasing Hb into blood, causing damage (clogging) at kidneys.

- thalassemia - anemia - aplastic anemia - pernicious anemia/ vit. B12 - hemolytic anemia

Blood Formation in Embryos: - RBCs appear in the embryo during the _______ week. - __________ is the primary site of blood formation (first 8 weeks). - Cells differentiate into stem cells that produce cells by division. - ______ and ______ are primary sites for hemopoiesis during second to fifth month. - ________ is the primary site for RBC and WBC production by 28th week and in adults.

- third - embryonic yolk sac - liver and spleen - bone marrow

Platelets: - Also known as? - Characteristics: * cell ___________ * most (1/3) of platelets are held in ________ in case of a circulatory crisis. * __________ is produced by the ___________ stimulating platelet formation. * each platelet circulates for 9-12 days and then is removed by phagocytes in the ____________. - Function: * transport chemicals important to the vascular _________ process. * will form a temporary patch in damaged vessels called _________ which slows blood loss. * active contraction after clot formation reducing break in vessel wall (what type of feedback?) * ___________; clot

- thrombocytes * fragments * spleen * thrombopoietin (TPO)/ liver and kidneys * spleen * clotting * platelet plug * positive feedback * thrombosis

Disorders: - Thromboembolic disorders: ________ is a blood clot in an unbroken blood vessel. A free-floating thrombus is called an ________. A large thrombus in the __________ will block blood flow to heart muscles (coronary thrombosis). As embolus circulates within the blood vessels and clogs small blood capillaries, causing an ________, usually a life-threatening condition (________ embolism is the most common). * LARGELY HAPPENS AFTER SURGERIES! - ___________: abnormally low platelet count; causes bleeding from small blood vessels all over the body (_________), forming purple patches on skin. - _________: a sex-linked bleeding disorder in which blood fails to clot due to missing clotting factors. Occurs mainly in males (1 out of 10000). Most common form is ________ caused by absence of ________ protein. - _________: lacking plasma protein that binds and stabilizes factor VIII. - __________: excessive platelet production due to: infection, inflammation, or cancer.

- thrombus/ embolus/ coronary arteries/ embolism/ (pulmonary) - thrombocytopenia/ (petechiae) - hemophilia/ Hemophilia A/ Factor VIII - von Willebrand disease (vWF) - thrombocytosis

RBCs or Erythrocytes: - Function: ? - Shape: _______ (increases surface area) and is about _____ microns. - ___________ per mm^3. - ________ and no organelles (mature = gives up nucleus), why? * life span is less than _______. - Is the most numerous blood cell, about 5-6 million per cubic mm (or 1 micrometer); ____ of body cells; ____% of hematocrit. - RBCs can change shape slightly because of the flexible protein called _______ in cytoplasm (allowing RBC to fold in capillaries) - Also carries _____% of carbon dioxide.

- transport oxygen (by means of hemoglobin) - biconcave/ 7.5 - 5,000,000 - a-nucleated/ metabolize anaerobically = increase efficiency of oxygen transport. * 120 days - one-third/ 99% - spectrin - 20%

What can nitrous oxide (NO) do once picked up by hemoglobin?

- vasodilator and improve blood flow

Monocytes: - Nucleus U or kidney shaped filling half or more of cell. - NO visible cytoplasmic granules - Provide defense against _____ and ____________ in chronic infections (EX: ___________) - Produced by __________ (from _________ line) in lymphatic tissues - Respond to and are attracted to ___________ (in a process known as ___________). - Born in the __________. but complete development, differentiation and division in the ___________ of the body. Thus they primarily are considered to be produced in the latter.

- viruses and INTRAcellular bacteria/ (STIs hid inside lysosomes.... like chlamydia) - mono-blasts (myeloid) - cytokines/ (chemotaxis) - marrow/ lymphatic tissues

Plasma cont. - Fluid CT - 92% is ______. - 7% ______. Plasma proteins - makes up ___________% of the volume of whole blood, why? They serve a variety of functions, but not normally taken up by cells to be used as fuels or metabolic wastes. * 90% of proteins are made in the _______. - ___________; electrolytes, nutrients, gases, hormones, wasters (_____, _______, and ________). These maintain ______ (total concentration of dissolved materials or osmotic concentration) and _____. Allows __________ and ________ activity: * electrolytes include? - Inflammation of the liver? Explain where version A comes from! - As people get older, their electrolytes can get out of ranges, resulting in?

- water - proteins/ 46-63%/ cannot pass through capillary walls * liver - inorganic salts/ (urine, uric acid, creatinine)/ osmolarity / pH/ muscle contractions and neuronal activity * sodium, potassium, bicarbonate, chloride, calcium, magnesium, HCO3-, HPO3-, SO4-. - hepatitis/ drinking dirty water - hallucinations

- Transfusion reactions occur if an ______ person receives ______ blood, then the immune system becomes sensitized and begins to produce ________ against the foreign antigen soon after transfusion. * The second occurrence often causes ________, or clumping in vessels and Hb accumulation at ______ causing renal shutdown. - Transfusions can be given to alleviate _________, to increase blood volume (like after a hemorrhage) or to improve immunity, but they can also transmit HIV and Hepatitis B and C viruses. - If a person's blood volume is so low that shock is imminent, there may not be time for cross matching, so ___________, or ___________ (__________) is used to prevent shock. - Some tests of importance: * ________: blood chemical profile measuring electrolytes, glucose, and markers of liver and kidney disorders. * ________: complete blood count. * ________: to asses the ability of blood to clot. * _______: when thrombopenia is suspected.

Rh-/ Rh+/ antibodies * hemolysis/ kidneys - anemia - normal saline/ electrolyte solution (Ringer's solution) * SMAC * CBC * Pro-thrombin time * Platelet count

Blood Typing: - Genetically determined ________ (A and B) called _______ cover the surface of RBCs. - However, the ______ usually contains antibodies called ________ that react with these A or B antigens, if the two are mixed .... the anti-A antibodies react with antigen A and the anti-B antibodies react with antigen B. - Normally, you do not have antibodies that react against your own cells; ________ are the exception. - If different blood types are transfused, antibodies in the recipient's plasma bind to the antigens on the donated RBCs, causing ________ or clumping creating an ____________, sometimes referred to as __________ of RBCs. - These antigen-antibody complexes activate other plasma proteins called _________ which make the donated RBCs leak, causing _________ or rupture, releasing _____________, eventually clogging the __________ filtration membranes which may bring on death.

antigen/ agglutinogens - plasma/ agglutinins - autoimmune diseases - agglutination/ antigen-antibody complex/ cross-linking - complement proteins/ hemolysis/ hemoglobin/ kidney's

What are the three main components of the cardiovascular system?

blood, heart, and blood vessels (arteries, capillaries, and veins)

What is the three main functions of the circulatory system?

transport, regulation, and protection