Anatomy and Physiology Chapter 17: Blood

What are 3 steps to blood clotting? (PLATELETS)

1. Vascular spasm 2. Platelet plug formation 3. Coagulation (blood clotting)

Which blood types can BLOOD TYPE A receive? (BLOOD TYPES)

A+: A+, A-, O+, O- A-: A-, O-

Which blood types can BLOOD TYPE AB receive? (BLOOD TYPES)

AB+: A+, A-, B+, B-, AB+, AB-, O+, O- AB-: A-, B-, AB-, O-

AML (LEUKOCYTE DISORDERS)

Acute Myeloid leukemia, ~60 years old, progresses rapidly, increase in myeloid cells, not a good prognosis

ALL (LEUKOCYTE DISORDERS)

Acute lymphoblastic leukemia, <15 years old, better prognosis in children than adults, bone marrow replaced by great increase of lymphoblasts, most responsive to therapy

What is the function of Agranulocytes? (LEUKOCYTES)

Aganulocytes are cytoplasmic granules that not very visible and have a spherical or kidney shaped nuclei. They recognize antigens (this is crucial to immunity).

Albumin (PLASMA)

Albumin makes up 60% of plasma protein. They serve as substance carriers, blood buffers, and are major contributors of plasma osmotic pressure.

Which antibodies does BLOOD TYPE B have? (BLOOD TYPES)

Antibody A

Which antibodies does BLOOD TYPE O have? (BLOOD TYPES)

Antibody A, Antibody B

Which antibodies does BLOOD TYPE A have? (BLOOD TYPES)

Antibody B

What does aspirin do? (ANTICOAGULANT DRUGS)

Antiprostaglandin inhibits thromboxane A2

What is Aplastic anemia, what is it caused by, and how is it treated? (ERYTHROCYTE DISORDERS)

Aplastic anemia is the destruction or inhibition of red marrow by chemicals, drugs, radiation, or viruses. The cause is unknown. It can be treated short-term with blood transfusions or long-term with transplanted stem cells. ALL CELL LINES ARE AFFECTED.

What are 3 Anticoagulant Drugs?

Aspirin, Heparin (immediate treatment), /warfarin (permanent treatment)

What do B lymphocytes do? (LEUKOCYTES)

B lymphocytes give rise to plasma cells which produce antibodies.

Which blood types can BLOOD TYPE B receive? (BLOOD TYPES)

B+: B+, O+, B-, O- B-: B-, O-

What are Basophils? (LEUKOCYTES)

Basophils are the rarest WBCs. They have a deep purple nucleus with 1-2 constrictions. They are large purplish-blackish granules containing histamine (inflammatory chemical that acts as a vasodilator that attracts WBCs to inflamed sites). Their function is similar to that of mast cells.

Thrombus (PLATLET DISORDERS)

Blood clot that develops and persists in unbroken blood vessel

Distributing (BLOOD FUNCTIONS)

Blood delivers O2 and nutrients to body cells, transports metabolic wastes to lungs and kidneys for elimination, transports hormones from endocrine organs to target organs.

What is anemia? (ERYTHROCYTE DISORDERS)

Blood has a low O2 carrying capacity. It is a sign of disease rather than a disease itself. Blood O2 levels cannot support a normal metabolism.

Regulating (BLOOD FUNCTIONS)

Blood helps maintain body temperature by absorbing and distributing heat, helps maintain normal pH by using buffers (alkaline reserve of bicarbonate ions), helps maintain adequate fluid volume in circulatory system.

What is blood? (BLOOD COMPOSITION)

Blood is fluid connective tissue.

What are the causes of anemia? (ERYTHROCYTE DISORDERS)

Blood loss, low RBC production, high RBC destruction

CML (LEUKOCYTE DISORDERS)

Chronic myeloid leukemia, ~30-60 years old, see mature increase in neutrophils, basophils, and eosinophils in blood, treated with tyrosine kinase inhibiotrs which greatly improve prognosis

DIC (PLATLET DISORDERS)

Clotting causes bleeding. Widespread blood clots blocks intact vessels and severe bleeding occurs due to residual blood being unable to clot. Often occurs as pregnancy complication (septicemia) or after incompatible blood transfusions

How does platelet plug formation work? (PLATELETS)

Damaged endothelium exposes collagen fibers -Platelets will stick to collagen fibers via plasma protein von Willebrand factor -Platelets swell and become spiked and sticky then release chemical messengers

What are the 3 functions of blood?

Distributing substances, Regulating blood levels of substances, Protection

Embolism (PLATLET DISORDERS)

Embolus obstructing a vessel

What are Eosinophils? (LEUKOCYTES)

Eosinophils are red- staining granules with bilobed nucleus. The granules are lysosome-like and release enzymes for digestion. Have roles in allergies and asthma and modulating immune response.

Rh groups →hemolytic disease of the newborn

Erythroblastosis fetalis is when an Rh- mom has an Rh + fetus First baby Rh+ and mother Rh- = healthy baby Second baby Rh+ and mother Rh- = RBCs of Rh+ baby are destroyed and prebirth transfusions are necessary and exchange transfusions after birth

What is the structure of erythrocytes? (ERYTHROCYTES)

Erythrocytes are biconcave discs so their surface area is huge,in comparison to their volume. They are anucleate (lack a nucleus), do not have a mitochondria or any other organelles. Their diameters are larger than some capillaries.

Formed Elements →RBCs (BLOOD COMPOSITION)

Erythrocytes are red blood cells. RBCs have no nuclei or any other organelles. 45% of blood composition.

How are erythrocytes destroyed? (ERYTHROCYTES)

Erythrocytes destruction is characterized by the separation of Heme and globin. When they separate iron is salvaged for reuse, heme degrades to yellow pigment (bilirubin), liver secretes bilirubin into intestines, and globin is metabolized into amino acids.

What is the life span of erythrocytes? (ERYTHROCYTES)

Erythrocytes live 100-120 days when they no longer synthesize proteins, grow, or divide.

What is erythropoietin? (HEMOGLOBIN)

Erythropoietin is a hormone secreted by the kidneys that increases the rate of production of red blood cells in response to falling levels of oxygen in the tissues.

What are the basic symptoms of anemia? (ERYTHROCYTE DISORDERS)

Fatigue, pallor, shortness of breath

What is fibrin? (PLATELETS)

Fibrin is an insoluble protein formed from fibrinogen during the clotting of blood. It forms a fibrous mesh that impedes the flow of blood.

What is fibrinogen? (PLATELETS)

Fibrinogen is a soluble protein present in blood plasma, from which fibrin is produced by the action of the enzyme thrombin

What is the function of blood platelets? (PLATELETS)

Form temporary platelet plug to help seal breaks in blood vessels

What are formed elements? (BLOOD COMPOSITION)

Formed elements are living blood "cells" suspended in plasma. Most only survive in bloodstream for a few days.

What 2 parts is hemoglobin composed of? (HEMOGLOBIN)

Globin- composed of 4 polypeptide chains (2 alpha and 2 beta chains) Heme- pigment bonded to each globin chain that gives blood its red color

What is the function of Granulocytes? (LEUKOCYTES)

Granulocytes are visible granules in the cytoplasm that fight off bacteria and fungi.

Diagnostic blood tests

Hematocrit- test for anemia Blood glucose tests- diabetes Differential WBC count Prothrombin time and platelet counts assess hemostasis SMAC (blood chemistry profile)- liver and kidney disorders Complete blood count- checks formed elements, hematocrit, hemoglobin

Stem cell sequence: (ERYTHROCYTES)

Hematopoietic stem cell→ proerythroblast→reticulocyte→erythroblast

Hemophilia A (PLATLET DISORDERS)

Hemophilia A is a bleeding disorder caused by factor VIII deficiency. Makes up 77% of all cases of Hemophilia. Symptoms: prolonged bleeding (especially into joint cavities) Treatment: Plasma transfusions, injections of missing factors (there is an increased HIV and hepatitis risk

Hemophilia B (PLATLET DISORDERS)

Hemophilia B is a bleeding disorder caused by factor IX deficiency. Symptoms: prolonged bleeding (especially into joint cavities) Treatment: Plasma transfusions, injections of missing factors (there is an increased HIV and hepatitis risk

Hemophilia C (PLATLET DISORDERS)

Hemophilia C is a bleeding disorder caused by factor XI deficiency. Symptoms: prolonged bleeding (especially into joint cavities) Treatment: Plasma transfusions, injections of missing factors (there is an increased HIV and hepatitis risk

What does Heparin do? (PLATELETS)

Heparin is immediate treatment. anticoagulant used clinically for pre- and postoperative cardiac care

Infectious mononucleosis (LEUKOCYTE DISORDERS)

Highly contagious viral disease (Epstein-Barr virus), high numbers of atypical agranulocytes, symptoms: tired, achy, chronic sore throat, low fever, Runs course with rest

Impaired liver function (PLATLET DISORDERS)

Impaired liver function is the inability to synthesize procoagulants.Caused by Vitamin K deficiency, hepatitis, or cirrhosis. Impaired fat absorption and liver disease can also prevent liver from proper fat and vitamin K absorption and producing bile

What is Iron deficiency anemia caused by and how is it treated? (ERYTHROCYTE DISORDERS)

It is caused by hemorrhagic anemia, low iron intake, or impaired iron absorption. It is treated with iron supplements. RBCs are microcytic or hypochromic.

What is Hemorrhagic anemia caused by and how is it treated? (ERYTHROCYTE DISORDERS)

It is caused by rapid blood loss. It is treated by blood replacement.

What is Chronic Hemorrhagic anemia caused by and how is it treated? (ERYTHROCYTE DISORDERS)

It is caused by slight but persistent blood loss (Hemorrhoids, bleeding ulcer). It is treated treatment of primary problem.

Formed Elements →WBCS (BLOOD COMPOSITION)

Leukocytes are white blood cells. WBCs are complete cells. WBC+Platelets= <1% of blood composition.

What are lymphocytes? (LEUKOCYTES)

Lymphocytes are the second most numerous WBC. They have large, dark-purple, circular nuclei with a thin rim of blue cytoplasm. They are made up mostly of lymphoid tissue. Theyy are crucial to immunity as they recognize antibodies.

What are Monocytes /macrophages? (LEUKOCYTES)

Monocytes are the largest leukocyteswith abundant pale-blue cytoplasm and a dark-purple staining U- or kidney- shaped nuclei. Macrophages are monocytes that differentiate after leaving circulation and entering tissues. They fighat against viruses, intracellular bacterial parasites, and chronic infections. They also activate lymphocytes to mount an immune response.

What are Neutrophils? (LEUKOCYTES)

Neutrophils are the most numerous WBCs. They are also called polymorrphonuclear leukocytes. They stain lilac and contain hydrolytic enzymes (defensins). Twice the size of RBCS, there are 3-6 lobes in nucleus. VERY PHAGOCYTIC- bacteria fighters

Which antibodies does BLOOD TYPE AB have? (BLOOD TYPES)

None

Which blood types can BLOOD TYPE O receive? (BLOOD TYPES)

O+: O+, O- O-: O-

Describe the steps in this sequence: O2 loading in lungs ---O2 unloading in tissues---CO2 loading in tissues. (HEMOGLOBIN)

O2 is loaded into lungs producing oxyhemoglobin (ruby red) --- O2 unloads in tissues producing deoxyglobin or reduced hemoglobin (dark red) --- CO2 loads in in tissues and 20% of CO2 in blood binds to Hb producing carbaminohemoglobin

Transfusion reactions

Occur if mismatched blood type infused -> donors cells are attacked by recipient's plasma agglutinates causing agglutinations and clogs small vessels. Vessels rupture and release hemoglobin into bloodstream Symptoms: Fever, chills, low blood pressure, rapid heartbeat, nausea, vomiting Treatment: Fluids and diuretics used to wash out hemoglobin

What is Pernicious anemia, what is it caused by, and how is it treated? (ERYTHROCYTE DISORDERS)

Pernicious anemia is an autoimmune disease in which the stomach mucosa is destroyed. It is caused by a lack of intrinsic factor that is needed to absorb vitamin B12 (causes B12 deficiency), RBCs cannot divide (causes macrocytes), or low dietary intake of B12. It is treated with B12 injections and B12 nasal gels.

Contents of Plasma (PLASMA)

Plasma is composed of 90% water and over 100 dissolved solutes including nutrients, gases, hormones, wastes, proteins, and inorganic ions.

What is plasma? (BLOOD COMPOSITION)

Plasma is non-living fluid matrix. Make up 55% of blood composition.

Protection (BLOOD FUNCTIONS)

Plasma proteins and platelets initiate clot formation to help prevent blood loss and blood helps prevent antibodies, complement proteins, and WBCs

Plasma Proteins (PLASMA)

Plasma proteins are the most abundant solutes because they remain in blood and are not taken up by cells. Plasma proteins are produced by 60% albumin, 36% globulins, and 4% fibrinogen.

What is plasmin? (PLATELETS)

Plasmin is an enzyme, formed in the blood in some circumstances, that destroys blood clots by attacking fibrin

What is Polycythemia Vera and what is it characterized by? (ERYTHROCYTE DISORDERS)

Polycythemia vera is bone marrow cancer causing excessive RBCs and severely increased blood viscosity.

What is prothrombin? (PLATELETS)

Protein in blood plasma that is converted to enzyme thrombin, it promotes blood clotting

What is the function of erythrocytes? (ERYTHROCYTES)

RBCs purpose is transporting respiratory gas transport, hemoglobin binds reversibly with oxygen, they contribute to cell viscosity

What is coagulation? (PLATELETS)

Reinforcement of platelet plug with fibrin threads, blood transformed from liquid to gel, Vitamin K is necessary to synthesize 4 of the clotting factors

What is Renal anemia caused by and how is it treated? (ERYTHROCYTE DISORDERS)

Renal anemia is caused by a lack of EPO and accompanies renal disease. It is treated with synthetic EPO.

Formed Elements →Platelets (BLOOD COMPOSITION)

Responsible for making the blood clot. Platelets are cell fragments. WBC+Platelets= <1% of blood composition.

What is Sickle cell anemia, how is it caused, and how is it treated? (ERYTHROCYTE DISORDERS)

Sickle cell anemia is characterized by Hemoglobin S and caused by a sickle cell gene, Black people and descendants of the African malarial belt, and malaria. RBCs rupture easily, block blood vessels, and are crescent shaped when O2 is unloaded or O2 is low. Can be treated with blood transfusions, inhalation of nitric oxide, Hydroyurea to induce formation of fetal hemoglobin that does not sickle, blocking RBC ion channels, stem cell replacements, or gene therapy.

What does spectrin do? (ERYTHROCYTES)

Spectrin provides flexibility to change shape.

What do T lymphocytes do? (LEUKOCYTES)

T lymphocytes act against virus infected cells and tumor cells.

What is Thalassemia alpha anemia and how is it caused? (ERYTHROCYTE DISORDERS)

Thalassemia alpha is decrease in alpha globin synthesis. It is common in Africans and Asians.

What is Thalassemia beta anemia and how is it caused? (ERYTHROCYTE DISORDERS)

Thalassemia beta anemia is decrease in beta synthesiscaused by a point mutation in beta chains.

What are the dietary requirements to make new erythrocytes? (ERYTHROCYTES)

The nutirents amino acids, lipids, and carbohydrates are essential. IRON is important. Vitamin B12 and folic acid are necessary for DNA synthesis for rapidly dividing cells (This develops RBCs)

What is thrombin? (PLATELETS)

Thrombin causes the clotting of blood by converting fibrinogen to fibrin

Thrombocytopenia (PLATLET DISORDERS)

Thrombocytopenia is a deficiency of platelets in the blood. This causes bleeding into the tissues, bruising, and slow blood clotting after injury. Caused by supression or destruction of red bone marrow. Treated by transfusion of concentrated platelets.

What is a vascular spasm? (PLATELETS)

Vasoconstriction of damaged blood vessel

What does Warfarin do? (PLATELETS)

Warfarin is permanent treatment. It is also know as Coumadin. Used in patients prone to atrial fibrillation. It interferes with action of Vitamin K.

What are Leukocytes? (LEUKOCYTES)

White blood cells that function in defense against disease. Thye make up <1% of total blood volume.

Where are blood cells are made in fetus?

Yolk sac, liver, spleen

CLL (smudge cells) (LEUKOCYTE DISORDERS)

chronic lymphoblast leukemia, >60 years old, affect B cell lymphocytes, most common form in adults, smudge cells

Embolus (PLATLET DISORDERS)

thrombus freely floating in blood stream