ch. 19 blood

Primary differences between plasma and interstitial fluid:

(1) The levels of respiratory gases (oxygen and carbon dioxide, due to the respiratory activities of tissue cells) (2) The concentrations and types of dissolved proteins (because plasma proteins cannot cross capillary walls).

_______________ and ___________ affect almost every aspect of the clotting process. (a) Calcium, vitamin K (b) Calcium, vitamin B12 (c) Sodium, vitamin K (d) Sodium, vitamin B12

(a) Calcium, vitamin K

Which type of antibodies does plasma contain for each of the following blood types? (a) type A (b) type B (c) type AB (d) type O

(a) anti-B antibodies; (b) anti-A antibodies; (c) neither anti-A nor anti-B antibodies; (d) both anti-A and anti-B antibodies

Dehydration would (a) cause an increase in the hematocrit (b) cause a decrease in the hematocrit (c) have no effect on the hematocrit (d) cause an increase in plasma volume

(a) cause an increase in the hematocrit

The waste product bilirubin is formed from (a) transferrin (b) globin (c) heme (d) hemosiderin (e) ferritin

(c) heme

A difference between the A, B, and O blood types and the Rh factor is (a) Rh agglutinogens are not found on the surface of red blood cells (b) Rh agglutinogens do not produce a cross-reaction (c) individuals who are Rh− do not carry agglutinins to Rh factor unless they have been previously sensitized (d) Rh agglutinogens are found free in the plasma (e) Rh agglutinogens are found bound to plasma proteins

(c) individuals who are Rh− do not carry agglutinins to Rh factor unless they have been previously sensitized

Erythropoietin directly stimulates RBC formation by (a) increasing rates of mitotic divisions in erythroblasts (b) speeding up the maturation of red blood cells (c) accelerating the rate of hemoglobin synthesis (d) all of these

(d) all of these

Stem cells responsible for lymphocytopoiesis are located in (a) the thymus and spleen (b) the lymph nodes (c) the red bone marrow (d) all of these structures

(d) all of these structures

A hemoglobin molecule is composed of: (a) two protein chains (b) three protein chains (c) four protein chains and nothing else (d) four protein chains and four heme groups (e) four heme groups but no protein.

(d) four protein chains and four heme groups

Serum is _____________________________________ (a) the same as blood plasma (b) plasma minus the formed elements (c) plasma minus the proteins (d) plasma minus fibrinogen (e) plasma minus the electrolytes

(d) plasma minus fibrinogen

Monocytes

*A type of white blood cell that transforms into macrophages, extends pseudopods, and engulfs huge numbers of microbes over a long period of time *An agranular leukocyte that is able to migrate into tissues and transform into a macrophage.

Platelets release chemicals, which ones?

- ADP - PDGF: Platelet-derived growth factor - stimulated smooth muscle cells and fibroblasts - Calcium - Clotting Factors

List the events that occur during the Red Bone Marrow:

- Fe2+ transported in bloodstream by transferrin - RBC formation - New RBCs released into bloodstream - In the bloodstream, the rupture of RBCs is called hemolysis - Hemoglobin that is not phagocytized breaks down, and the alpha and beta chains are eliminated in urine

What five major functions are performed by blood?

1. Transports dissolved gases, nutrients, hormones, and metabolic wastes. 2. Regulates pH and electrolyte composition of interstitial fluids throughout the body 3. Restricts fluid losses through damaged vessels or at other injury sites. 4. defends against toxins and pathogens 5. Stabilizes body temperature.

vascular phase

1st hemostasis step: *blood vessel contracts*; membrane becomes sticky & hormones released

platelet phase

2nd hemostasis step: platelets adhere to vessel and platelets aggregate together forming a *platelet plug*

formed elements make up how much of a person's whole blood volume?

37−54%

Coagulation phase

3rd hemostasis step: blood clotting enzyme chain reaction, ending with *fibrinogen converted into fibrin*

There are 280 million Hb molecules in one RBC. A single Hb molecule carries ___ molecule(s) of O2, which means that a single RBC carries about ___ O2 molecules.

4; 1 billion

what is the diameter of RBCs?

7.2-8.4 uM

what percentage of plasma volume is water

90%

Basophils

A circulating leukocyte that produces histamine.

Anemia

A condition in which the blood is deficient in red blood cells, in hemoglobin, or in total volume.

Granulocytes

A group of leukocytes containing granules in their cytoplasm; neutrophils, eosinophils, basophils.

Hemophilia

A hereditary disease where blood does not coagulate to stop bleeding

blood bank

A place where whole blood or blood plasma is drawn, typed, processed, and stored under refrigeration for future use

A test for prothrombin time is used to identify deficiencies in the extrinsic clotting pathway; prothrombin time is prolonged if any of the factors are deficient. A test for activated partial thromboplastin time is used in a similar fashion to detect deficiencies in the intrinsic clotting pathway. Which factor would be deficient if a person had a prolonged prothrombin time but a normal partial thromboplastin time?

A prolonged prothrombin time and a normal partial thromboplastin time indicate a deficiency in the extrinsic system but not in the intrinsic system or common pathway. Factor VII would be deficient.

Lymphocytes

A type of white blood cell that make antibodies to fight off infections

jaundice

A yellowing of the skin and eyes

List the events of hemolytic disease of the newborn

Antibodies develop Maternal anti-Rh antibodies Cross the placenta and enter the Fetal blood stream Antibodies destroy fetal RBCs- Anemia

In the disease mononucleosis ("mono"), the spleen enlarges because of increased numbers of phagocytes and other cells. Common signs and symptoms of this disease include pale complexion, a tired feeling, and a lack of energy sometimes to the point of not being able to get out of bed. What might cause these signs and symptoms?

As the spleen enlarges, so does its capacity to store additional red blood cells, leading to fewer red blood cells in circulation, producing anemia. The decreased number of RBCs in circulation decreases the body's ability to deliver oxygen to the tissues, slowing their metabolism and producing the tired feeling and lack of energy. Because there are fewer RBCs than normal, the blood circulating through the skin is not as red, producing a pale complexion.

Why is aspirin sometimes prescribed for the prevention of vascular problems?

Aspirin helps prevent vascular problems by inhibiting clotting. It inhibits platelet enzymes involved in the production of thromboxane A2 and prostaglandins, thereby inhibiting clotting. It also prolongs bleeding time.

what is the structure of a red blood cell?

Biconcave structure; anucleate; lacks most organelles

white blood cells

Blood cells that perform the function of destroying disease-causing microorganisms

What is the role of blood in the stabilization and maintenance of body temperature?

Blood stabilizes and maintains body temperature by absorbing and redistributing the heat produced by active skeletal muscles.

Recycling of iron

Body recycles 85% of iron found in hemoglobin

carbaminohemoglobin

CO2 combined with hemoglobin

Relate the structure of hemoglobin to its function:

Each molecule of hemoglobin consists of four protein subunits, each of which contains a single molecule of heme, a nonprotein ring surrounding an iron ion. These central iron ions are what actually bind and release oxygen molecules.

What four conditions cause the release of erythropoietin?

Erythropoietin is released (1) during anemia, (2) when blood flow to the kidneys declines, (3) when the oxygen content of air in the lungs declines, and (4) when the respiratory surfaces of the lungs are damaged.

Red Blood Cells, Erythrocytes, are made up of 75% formed elements

False: RBCs are made up of 99.9% formed elements

T/F -- the liver synthesizes 70% of plasma proteins

False: the liver synthesizes 90% of plasma proteins

What contribution from the intrinsic and the extrinsic pathways is necessary for the common pathway to begin?

Initiation of the common pathway requires the activation of Factor X by the extrinsic and/or intrinsic pathways.

Plasma

Liquid part of blood

Neutrophils

Most abundant white blood cell., The most abundant type of white blood cell. Phagocytic and tend to self-destruct as they destroy foreign invaders, limiting their life span to a few days.

Which kinds of WBCs contribute to the body's nonspecific defenses?

Neutrophils, eosinophils, basophils, and monocytes function in nonspecific defenses.

embolism

Obstruction of a blood vessel by a clot of blood or foreign substance

Hemoglobin Recycling

Phagocytes break hemoglobin into components Globular proteins to amino acids Heme to biliverdin Iron

________________________ contains antibodies (agglutinins) that will react with foreign surface antigens.

Plasma on RBC surface

What initiates and controls clotting, as well as patches damaged blood vessels?

Platelets or thrombocytes

What is the difference between prothrombin and thrombin?

Prothrombin is an inactive precursor that is converted to thrombin during coagulation. Thrombin is an enzyme that causes the clotting of blood by converting fibrinogen to fibrin.

The Hematocrit (1 microliter or 1 cubic millimeter) of whole blood contains 4.5-6.3 million ___________________.

RBCs

What blood cells are essential for the transport of oxygen?

RBCs

T/F -- WBCs are the most abundant blood cells in the body

RBCs are the most abundant blood cells in the body

How do red blood cells differ from white blood cells in both form and function?

Red blood cells are biconcave discs that lack mitochondria, ribosomes, and nuclei, and they contain a large amount of hemoglobin. RBCs transport oxygen, while WBCs are involved in immunity. The five types of white blood cells vary in size from slightly larger to twice the diameter of an RBC, contain a prominent nucleus, and may contain granules with distinct staining properties.

After Randy was diagnosed with stomach cancer, nearly all of his stomach had to be removed. Postoperative treatment included regular injections of vitamin B12. Why was this vitamin prescribed, and why were injections specified?

Removal of most of Randy's stomach eliminated the production of intrinsic factor, which is essential for the absorption of vitamin B12 by intestinal cells. Thus Randy was prescribed vitamin B12 to prevent pernicious anemia, and he needed injections of vitamin B12 because if taken orally, his intestines could no longer absorb it.

____________________ protein allows shape changes twist in capillaries

Spectrin protein

Almost half of our vitamin K is synthesized by bacteria that inhabit the large intestine. Based on this information, how could taking a broad-spectrum antibiotic for a long time cause frequent nosebleeds?

Taking a broad-spectrum antibiotic kills a wide range of bacteria, both pathogenic and nonpathogenic, including many of the normal flora, or microbiota, of the intestine. Reducing the intestinal flora substantially decreases the amount of vitamin K they make available to the liver to produce prothrombin, a vital component of the common pathway. With decreased amounts of prothrombin in the blood, normal minor breaks in the vessels of the nasal passageways do not seal off as quickly, producing nosebleeds.

Name the three types of lymphocytes and identify their functions:

The primary lymphocytes are (1) T cells, which are responsible for cell-mediated immunity; (2) B cells, which are responsible for humoral immunity; and (3) NK cells, which are responsible for immune surveillance.

Name the three major types of plasma proteins and identify their functions:

The three major types of plasma proteins are albumins, globulins, and fibrinogen.

hemolytic disease of the newborn

This disease occurs in the fetus if the fetus is Rh+ while the mother is Rh-.

Bilirubin orange-yellow pigment

This yellow color is caused by a high level of bilirubin, a yellow-orange bile pigment. Bile is fluid secreted by the liver. Bilirubin is formed from the breakdown of red blood cells.

T/F -- Hemoglobin (Hb) binds reversibly with oxygen

True

T/F -- In plasma, respiratory gases (CO2) are transported as bicarbonate

True

T/F -- RBCs cannot divide, synthesize proteins or enzymes

True

T/F -- Transferrin, a protein that transports iron, is elevated in iron-deficiency anemia, indicating that the body needs more iron

True

T/F -- When traveling through relatively narrow capillaries, RBCs may stack like dinner plates

True

T/F -- plasma carries steroid hormones

True

T/F -- water, ions, and small solutes are continuously exchanged between plasma and interstitial fluids across the walls of capillaries

True

__________________________ has RBCs with both A and B surface antigens.

Type AB blood

If you have ________________________ , your plasma contains anti-A antibodies, which will attack ___________________________

Type B blood; Type A surface antigens

RhoGAM

Used to prevent an immune response to Rh positive blood in people with an Rh negative blood type

What four characteristics of WBCs are important to their response to tissue invasion or injury?

WBCs exhibit (1) emigration (diapedesis), squeezing between adjacent endothelial cells in the capillary wall; (2) amoeboid movement, a gliding movement that transports the cell; (3) positive chemotaxis, the attraction to specific chemical stimuli, and (4) phagocytosis (engulfing particles for neutrophils, eosinophils, and monocytes).

How do elements of blood defend against toxins and pathogens in the body?

White blood cells defend against toxins and pathogens. Neutrophils, eosinophils, and monocytes engulf and digest bacteria, protozoa, fungi, viruses, and cellular debris. Lymphocytes are specialized to attack and destroy specific foreign cells, proteins, and cancerous cells, directly or through the production of antibodies.

oxyhemolobin

a bright red substance formed by the combination of hemoglobin with oxygen, present in oxygenated blood.

Anemia

a deficiency of red blood cells

Schilling test

a diagnostic analysis for pernicious anemia

erythroblastosis fetalis

a disorder that results from the incompatibility of a fetus with Rh-positive blood and a mother with Rh-negative blood, causing red blood cell destruction in the fetus; a blood transfusion is necessary to save the fetus

Sickle-Cell anemia

a genetic disorder that causes abnormal hemoglobin, resulting in some red blood cells assuming an abnormal sickle shape

hemopoietic growth factor

a group of proteins that cause blood cells to grow and mature

Myeloproliferative disorder

a group of slow-growing blood cancers; characterized by large numbers of abnormal RBCs, WBCs, or platelets growing and spreading in the bone marrow and the peripheral blood.

Erythropoietin

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.

Eosinophils

a white blood cell containing granules that are readily stained by eosin.

Plasma contributes approximately _____ percent of the volume of whole blood, and water accounts for _____ percent of the plasma volume. a) 55, 92 b) 25, 55 c) 92, 55 d) 35, 72

a) 55, 92

what condition leads to a decrease in hemocrit?

a) dehydration

plaque

abnormal accumulation of large quantities of lipids within a blood vessel wall

Disseminated Intravascular Coagulation (DIC)

abnormal activation of the proteins involved in blood coagulation, causing small blood clots to form in vessels and cutting off the supply of oxygen to distal tissues

Hemosiderosis

abnormal increase of iron in blood

what is the normal Hematocrit, or packed cell volume (PCV), in adult males and females? Does it differ?

adult males is 46; adult females is 42

Clot retraction

after coagulation, platelets contract pulling torn blood vessel together

What makes up 60% of plasma proteins?

albumin

If you have Type A blood, your plasma contains _____________________, which will attack Type B surface antigens.

anti-B antibodies;

dyscrasia

any abnormal condition of the blood

bone marrow biopsy

aspiration of bone marrow tissue and examination under a microscope for evidence of malignant cells

The lifespan of a RBC is: a) 90 days b) 120 days c) 30 days d) 1 week

b) 120 days

The following is a list of the phases involved in the process of hemostasis. coagulation fibrinolysis vascular spasm retraction platelet phase The correct sequence of these phases is a) 5, 1, 4, 2, 3, b) 3, 5, 1, 4, 2, c) 2, 3, 5, 1, 4, d) 3, 5, 4, 1, 2, e) 4, 3, 5, 2, 1.

b) 3, 5, 1, 4, 2,

Hemoglobin that is not phagocytized breaks down, and the alpha and beta chains are eliminated in ______________________________ a) bile b) urine c) mucus d) RBCs

b) urine

Erythroblasts

baby's immature red blood cells

what converts bilirubin to urobilins?

bacteria

a fluid connective tissue

blood

Deep vein thrombosis (DVT)

blood clot (thrombus) forms in a large vein, usually in a lower limb

Type O blood has RBCs lacking ___________________ surface antigens.

both A and B

If you have Type O blood, your plasma contains ___________________________

both anti-A and anti-B antibodies

stercobilin

breakdown product of bilirubin that gives feces its brown color

Ecchymosis

bruising

blood temperature is approxiamately ____________, and blood pH averages ______________________. a) 36 degrees celsius, 7.0 b) 39 degrees celsius, 7.8 c) 38 degrees celsius, 7.4 d) 37 degrees celsius, 7.0

c) 38 degrees celsius, 7.4

monocytes transform into _______________________ in tissues, where they __________________. a) basophils; exacerbate inflammation b) plasma cells; synthesize and release antibodies c) macrophages; are phagocytic and release chemicals that attract neutrophils d) natural killer cells; detect and destroy abnormal tissue cells

c) macrophages; are phagocytic and release chemicals that attract neutrophils

why can't a person with Type A blood safely receive blood from a person with Type B blood? a) mixing blood types causes infections in the recipient b) the anti-a antibodies in type a's plasma would react with type b's blood c) type b blood would agglutinate in the recipient's blood vessels and plug small vessels to vital organs

c) type b blood would agglutinate in the recipient's blood vessels and plug small vessels to vital organs

formed elements of the blood include: a) plasma, fibrin, and serum b) albumins, globulins, and fibrinogen c) wbcs, rbcs, and platelets d) all of these

c) wbcs, rbcs, and platelets

surface antigens

cell surface proteins that identify cells to immune system

Buffy coat is a layer formed after _______________

centrifugation

Pulmonary embolism

clot or other material lodges in vessels of the lung

Agglutination

clumping of red blood cells

what nourishes the heart?

coronary vessels

In a ______________________, antibodies react with their target antigens causing agglutination and hemolysis of the affected RBCs.

cross-reaction

thrombolytic

drug that breaks down blood clots

hypervolemic

excessive blood volumes

Hemoglobinuria

excretion of free hemoglobin in the urine

Aplastic anemia

failure of blood cell production in the bone marrow

lymphoid stem cells

give rise to lymphocytes

myeloid stem cells

give rise to red blood cells, monocytes, neutrophils, eosinophils, basophils, and platelets

deoxyhemoglobin

hemoglobin without oxygen

Hemochromatosis

hereditary disorder with an excessive buildup of iron deposits in the body

blood doping

inject extra red blood cells before competition to improve performance

Hemoglobin binds and transports oxygen; heme pigment; and, __________________________________

iron center (combines reversibly with oxygen molecule)

Pernicious anemia

lack of mature erythrocytes caused by inability to absorb vitamin B12 into the bloodstream

hypovolemic

low blood volume

Thrombocytopenia

low platelet count

Agranulocytes

lymphocytes and monocytes

Polycytemia

many blood cells

anaerobic metabolism

metabolism in the absence of oxygen

If you have Type AB blood, your plasma has ___________________________ antibodies.

neither anti-A nor anti-B antibodies.

which type of wbc is found in greatest numbers in an infected cut?

neutrophils

normovolemic

normal blood volume

Solutes in plasma include:

nutrients, electrolytes (Na+, K+, Ca2+, Mg2+, Cl-), and wastes

Hematocrit

percentage of blood volume occupied by red blood cells

thrombocytopoiesis

platelet production, occurs in bone marrow

What contains enzymes, has no nucleus, sticks to vessel walls, and activates intrinsic pathway?

platelets

hematuria

presence of blood in the urine

Three types of formed elements in blood?

red blood cells, white blood cells, platelets

plasmapheresis

removal of plasma from withdrawn blood by centrifuge

Platelets

small, membrane- bound cell fragments that contain enzymes and other substances important for clotting

Phlebotomist

specialist in drawing blood

thrombus

stationary blood clot; attached to the inner surface (luminal) of a blood vessel

hemostatisis

stoppage of bleeding; vascular phase platelet phase, coagulation phase

hematology

study of blood

Type A blood has RBCs with ____________________ only

surface antigen A

Type B blood has RBCs with __________________ only

surface antigen B

septicemia

systemic toxic illness due to bacterial invasion of the bloodstream from local infection. Signs and symptoms include: chills, fever, and exhaustion. Treated with massive doses of antibiotics; also referred to as blood poisoning.

Thrombophilia

tendency to develop blood clots

Blood type depends on _______________________________________________________________

the presence of surface antigens (agglutinogens) on RBC surfaces

arterial stick

the puncture of an artery, usually on the inside of the wrist, to obtain arterial blood

iron overload

the state of having more iron in the body than it needs or can handle, usually arising from a hereditary defect. Also called hemochromatosis; characterized by bronze skin, enlarged liver, diabetes mellitus, and abnormalities of the pancreas.

Transferrin glycoproteins bind iron ___________________, but ___________________ a) loosely; irreversibly b) tightly; irreversibly c) tightly; reversibly d) loosely; reversibly

tightly; reversibly

Hemoglobin structure

two alpha and two beta polypeptide chains; and four heme groups

Buffy coat contains ________________________

white blood cells

urobilin

yellow pigment in urine

The volume of whole blood that is composed of plasma is:

~55%