Ch. 18

Lymphocytes

-20 - 30% of WBCs, second most abundant type -many in body, few in bloodstream -usually found in the lymphatic system -play critical role in immunity -differ from other WBCs in that lymphocytes are specific to certain pathogens [respond to specific pathogens] -types of lymphocytes include the T and B cells -little cytoplasm around nucleus -lifespan days to decades

Neutrophils

-50 - 70% of circulating WBCs, most numerous WBC -granules are hard to see, stains are neutrals -specialized in attacking and engulfing bacteria -granules produce and store chemicals such as hydrogen peroxide - break open and kill bacteria [used to destroy foreign cells] -during an acute bacterial infection, number of neutrophils increase explosively -during an active attack, release prostaglandins that will increase the local inflammation -will also produce leukotrienes [chemical] to attract other WBCs -stains for both acidic and basic test -short lived, 10 hrs in bloodstream

Leukocyte production

-Hemocytoblast gives rise to myeloid stem cell or lymphoid stem cell [most WBCs are derived from myleoid stem cells] -Myleoid stem cell gives rise to progenitor cell -one type of progenitor cell will give rise to each of the following: neutrophil, eosinophil, basophil or monocyte -Lymphoid stem cell gives rise to lymphocytes by the process of lymphopoiesis actually occurs in the lymphoid tissue -Monocytes are the only WBC that do not fully mature [fully functional] in the bone marrow

Erythropoiesis is regulated by:

-Hormones: erythropoietin, released by the kidneys in response to hypoxia [hormone released by kidney in response to low level of O2 and causes production of myeloid cell] -Adequate supplies of material to make hemoglobin [iron, vitamins, hemoglobin]

Platelet phase

-Platelet adhesion: platelets stick to cells at the injury site -Platelet aggregation: more and more platelets arrive at injury site and begin sticking together to form the platelet plug -platelets release chemical signals that attract other platelets as well as cause increase vascular contraction, blood coagulation, and endothelial repair

Summary

-Type A blood produces antigen A and produce antibody B Type B blood produces antigen B and produce antibody A -Type O is universal donor -Type AB is universal recipient -Rh either positive or negative and produce antigen for one and antibody for other

Hemocytoblast

-all formed elements arise from the same type of stem cell

Hemopoiesis

-all formed elements of the blood are produced through a process of hemopoiesis -occurs [begins] in the red bone marrow, primarily in the axial skeleton, girdles and proximal epiphyses of humerus and femur

Eosinophils

-associated mostly with allergic reaction -dark staining granules with eosin and other acidic dyes -2 - 4% of circulating WBCs -phagocytize antigen-antibody complex such as during an allergy attach -defend against parasitic infections -release enzymes that reduce the degree of inflammation at injury site -lifespan 8 - 12 days

Formed Elements: Platelets

-cell fragments -function in blood clotting

Coagulation Phase

-complex series of steps that lead to the conversion of circulating fibrinogen to fibrin network -fibrin forms network that covers platelet plug and traps blood cells and platelets: blood clot -clot retraction: platelets contract to reduce the size of the clot

Erythrocytes

-contain red pigment, hemogolbin -intracellular protein that binds oxygen and transports it -composed of four globin chains each containing a heme molecule -when oxygen level is low, heme releases bound oxygen -most abundant cell type: 260 million RBCs per drop of blood

Vascular Phase

-cut of vessels causes local construction of the vessel to reduce blood loss [vascular spasm] -endothelial cells release chemical factors and hormones

Platelets

-cytoplasmic fragments of megakaryocytes -megakaryocytes develop from myeloid stem cells -lifespan of a platelet is 10 - 12 days

Basophils

-dark staining granules with basic dyes -rare in blood stream [least of WBC overall] -granules contain histamines and vasodilators that increase inflammation -release other chemical signals that attract basophils and eosinophils [other WBCs]

Steps of breaking down and recycling of RBC

-dead blood cells get caught in capillaries -macrophages eat RBC -hemoglobin recycled in heme and globin components -globin broken down into amino acid to make more proteins -heme broken down into iron and bilirubin [yellow pigment] -iron salvaged and stored as iron-protein complex for reuse -heme makes its way into production of new RBCs -bilirubin secreted by liver and absorbed by small intestine

Blood Types

-determined by presence of specific surface antigens or RBC membranes -antigens are capable of triggering an immune response -antigen: glycoprotein or glycolipid, genetically determined -body produces antibodies of antigens not present -over 50 different groups of surface antigens exist, most often hear about ABO and Rh

Sickle Cell Anemia

-genetic disorder that affects the RBCs -mutation causes a change in hemoglobin, causing hemoglobin to clump together in RBCs, bc hemoglobin molecules becomes charged and attracted to each other -only happens in low O2 levels and thus changes shape of RBCs

Rh during pregnancy

-hemolytic disease of newborn [HDN] results when maternal anti-Rh antibodies attack the RBC of Rh-positive fetus -for Rh- or Rh+ baby's blood is separate from mother's blood, but if bleeding occurs at any point the blood mixes and triggers antibodies to rise which can attack baby. -for second pregnancy the problem occurs bc of raised levels of antibodies in the mother's blood stream as a result of blood mixing from the first pregnancy -the danger is that these antibodies can cross the placental wall and cause complications for the baby

Monocytes

-largest WBC -2 - 8% of circulating WBCs -once enter in peripheral tissue, become macrophages -phagocytize pathogens in tissue -phagocytic giant cell [occurs when threat is to large for one macrophage that cell will combine with another macrophage to become bigger and engulf the threat] -if a monocyte enters something too large, several will fuse to form a phagocytic giant cell -lifespan is several months

Lifespan of Erythrocyte [RBC]

-limited due to lack of organelles and nucleus -over time, lose flexibility, become fragile, hemoglobin begins to degenerate -hemoglobin is broken down and components are recycled -lifespan = 100 - 120 days -old cells become trapped and fragment in smaller blood vessels, dying cells destroyed, usually in the spleen -dying cells are usually recognized and engulfed by macrophages that will break down the RBC and recycle the components of the hemoglobin

Composition of whole blood: Plasma

-non living, fluid matrix -plasma proteins: 8% of plasma volume, most formed in liver

Albumins

-plasma protein -most abundant, transport proteins -transport to outside of cell, osmotic pressure

Globulins

-plasma protein -transport proteins and immunoglobulins -defense

Fibrinogens

-plasma proteins -give rise to fibrin necessary for clotting -insoluble until used and then becomes soluble in blood

Rh group

-positive has the antigen -negative lacks the antigen

Hemocytoblast: Myeloid

-stem cell -gives rise to RBC, most WBC and platelets

Hemocytoblast: Lymphiod

-stem cell -unique bd it only gives rise to lymphocytes

Functions of platelets include:

-transport of chemicals necessary for clotting -form a temporary patch in the wall of the damaged vessel -contraction of clot via F actin

Functions of the Blood

-transport: carries dissolved gasses, nutrients, hormones and waste to and from all areas of the body -regulation of pH [change of bicarbonate ions from conversion of CO2 and electrolyte composition] and electrolyte composition if the interstitial fluids -restricts blood loss at injury sites by clotting -defense from body temp. by releasing heat at surface of skin

Place a single word into each sentence to make it correct, then place each sentence into a logical paragraph order.

1) Antibodies BIND to antigens and mark them for destruction. 2) One method of destruction is called AGGLUTINATION in which each antibody binds two or more antigens. 3) After binding, the antigens are STUCK together. 4) Repitition of this process produces antigen antibody COMPLEXES. 5) These complexes IMMOBILIZE the antigens until immune cells can break them down.

Place a single word into each sentence to make it correct, then place each sentence into a logical paragraph order.

1) As an RBC ages and its membrane PROTEINS deteriorate, the membrane becomes fragile. 2) Without a NUCLEUS the RBC cannot synthesize the protein spectrin found in the membrane. 3) Many of these deteriorated RBCs die in the SPLEEN. 4) Additionally, the kidneys can break up an RBC and split the HEMOGLOBIN molecules up to release recyclable portions. 5)

Place a single word into each sentence to make it correct, then place each sentence into a logical paragraph order.

1) Blood types A, B, AB, and O form the ABO blood group. 2) Your ABO blood type is determined by the presence or absence of ANTIGENS on your RBCs. 3) Each antigen will have a different CARBOHYDRATE complex on the surface of the RBC. 4) Additionally, PLASMA will contain antibodies. 5) These antibodies react with FOREIGN RBC antigens.

Leukocyte terms/Disorders

1) Chronic leukemia: Develops more slowly and may go undetected for many months 2) Acute leukemia: Appears suddenly, progresses rapidly, and causes death within a few months 3) Leukopenia: A total WBC count below 5K WBCs/ul 4) Leukemia: A cancer of the hemopoietic tissues that usually produces an extraordinarily high number of circulating leukocytes and their precursors 5) Leukocytosis: A total WBC count above 10K WBCs/ul 6) Myeloid leukemia: Marked by uncontrolled granulocyte production 7) Lymphoid leukemia: Involves uncontrolled lymphocyte or monocyte production

Place the stages in development of white blood cells in order from first to last.

1) Hemopoietic stem cell 2) Colony-forming units 3) Precursor cells 4) Mature cells

Place a single word into each sentence to make it correct, then place each sentence into a logical paragraph order.

1) Hypoxia is inadequate oxygen TRANSPORT and can be detected by the kidneys and liver. 2) When detected ERYTHROPOIETIN is produced and secreted. 3) The hormone will stimulate the red bone marrow to PRODUCE RBCs. 4) This will result in an increase of OXYGEN transport throughout the body. 5) Thus the correction of hypoxemia is controlled by a NEGATIVE feedback loop.

Which of the following characteristics of a red blood cell increases its ability to carry oxygen to the tissues?

1) Lacking mitochondria, RBCs rely exclusively on anaerobic fermentation to produce ATP. 2) The cytoplasm of an RBC consists mainly of a 33% solution of hemoglobin. 3) RBCs lose nearly all organelles during their development. 4) The cytoplasm also contains an enzyme, carbonic anhydrase. 5) Lacking a nucleus and DNA, RBCs also are incapable of protein synthesis and mitosis. Lacking mitochondria, RBCs rely exclusively on anaerobic fermentation to produce ATP. The lack of aerobic respiration prevents them from consuming the oxygen that they must transport to other tissues. The cytoplasm of an RBC consists mainly of a 33% solution of hemoglobin. It is known especially for its oxygen-transport function. The lack of organelles provide more room for the hemoglobin and oxygen.

Hemostasis

1) There are THREE hemostatic mechanisms. 2) First, VASULAR spasm constricts the broken blood vessel, reducing hemorrhage. 3) In platelet plug formation, a large mass of platelets AGGREGATE and undergo degranulation. 4) Degranulation PROMOTES hemostasis. 5) COAGULATION finishes the process by clotting the blood and protecting the body from excess blood loss.

Choose the correct statement(s) regarding the composition of plasma.

1) Water represents 92% by weight. 2) Albumin is 60% of the total protein portion. 3) The most abundant nitrogenous waste is urea. Plasma is a complex mixture of water, proteins, nutrients, electrolytes, nitrogenous wastes, hormones, and gases. By weight, water represents 92%. Protein is the most abundant plasma solute by weight, totaling 6 to 9 g/dL. Albumin represents 60% of the total protein.

Formed Elements

A) Erythrocyte (RBC's): 1) Transportation of respiratory gases B) Lymphocyte: 1) Differentiate into cells that produce antibodies 2) Include B & T cell subpopulations 3) Include memory cell lines 4) Destroy cancerous and virally infected cells C) Neutrophil: 1) Increase in number during bacterial infections D) Basophil: 1) Vasodilatory and anticoagulatory function 2) Vitally important initiators of the inflammatory response E) Eosinophil: 1) Increase in number during parasitic infections F) Monocyte: 1) Involved with immune clearance 2) Differentiate into dendritic cells and tissue macrophages

When the water on one side of the semipermeable membrane contains hemoglobin molecules and the water on the other side does not...

A) the PO2 will eventually equalize after the hemoglobin molecules become saturated with oxygen. A) the PO2 will eventually equalize after the hemoglobin molecules become saturated with oxygen. B) the PO2 will be unable to equalize after the hemoglobin molecules become saturated with oxygen because of the attraction between oxygen and hemoglobin. C) the area on the side of the oxygen-permeable membrane with the hemoglobin maintains a higher PO2. D) the area on the side of the oxygen-permeable membrane without the hemoglobin maintains a higher PO2. E) the PO2 will be unable to equalize after the hemoglobin molecules become saturated with oxygen because of the repulsion between oxygen and saturated hemoglobin.

The RBC antigens that determine transfusion compatibility are called

Agglutinogens

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

B) heme, biliverdin, bilirubin, conjugated bilirubin, bilirubin derivatives, feces and urine. A) heme, bilirubin, biliverdin, conjugated biliverdin, biliverdin derivatives, feces and urine. B) heme, biliverdin, bilirubin, conjugated bilirubin, bilirubin derivatives, feces and urine. C) heme, bilirubin, conjugated biliverdin, biliverdin, biliverdin derivatives, feces and urine. D) heme, biliverdin, conjugated bilirubin, bilirubin, bilirubin derivatives, feces and urine. E) heme, conjugated biliverdin, biliverdin, bilirubin, conjugated bilirubin, feces and urine.

Erythrocytes shape

Biconcave disc, shape is important to function: -increase surface area for oxygen exchange -enables cells to form stacks -flexible

In the breakdown of hemoglobin, the globin chains

C) are broken down by macrophages into amino acids. A) are converted into biliverdin by macrophages. B) are converted into bilirubin by macrophages. C) are broken down by macrophages into amino acids. D) are stored in various tissues. E) contribute to the color of feces.

Transfusion Compatibilities

COMPATIBLE: 1) O- given to A+ 2) B- given to AB+ 3) O- given to O+ NOT COMPATIBLE: 1) A+ given to O- 2) AB- given to A+ 3) AB+ given to O- 4) O+ given to AB- 5) AB- given to O+ 6) AB- given to B- 7) B+ given to A+ 8) A+ given to AB-

In the breakdown of hemoglobin, the iron

D) All of the choices are correct. A) is transported by transferrin to the liver. B) is transported by transferrin to the spleen. C) is transported by transferrin to the red bone marrow. D) All of the choices are correct.

Match the following disorders of the blood with their definition.

Disseminated intravascular coagulation: Widespread clotting within unbroken vessels, limited to one organ or occurring throughout the body. Infectious mononucleolsis: Infection of B lymphocytes with Epstein-Barr virus, most commonly in adolescents and young adults. Septicemia: Bacteremia (bacteria in the bloodstream) accompanying infection elsewhere in the body. Thrombocytopenia: A platelet count below 100,000/mL. Causes include bone marrow destruction by radiation, drugs, poisons, or leukemia. Thalassemia: A group of hereditary anemias most common in Greeks, Italians, and others of Mediterranean descent; shows a deficiency or absence of alpha or beta hemoglobin.

In this animation, when the hemoglobin molecules become saturated with oxygen molecules...

E) the oxygen molecules in the area on both sides of the oxygen-permeable membrane reach equilibrium. A) equilibrium is unattainable between the two sides of the oxygen-permeable membrane due to the repulsion of the free oxygen molecules by the saturated hemoglobin molecules. B) equilibrium is unattainable between the two sides of the oxygen-permeable membrane due to the affinity of the free oxygen molecules for the hemoglobin molecules. C) the area on the side of the oxygen-permeable membrane without the hemoglobin maintains more free oxygen molecules than the other side. D) the area on the side of the oxygen-permeable membrane with the hemoglobin maintains more free oxygen molecules than the other side. E) the oxygen molecules in the area on both sides of the oxygen-permeable membrane reach equilibrium.

Components of coagulation

EXTRINSIC: 1) Damage to the perivascular tissue 2) Thromboplastin (Factor III) 3) Factor VII INTRINSIC: 1) Factor XII 2) Factor XI 3) Factor IX 4) Factor VIII COMMON PATHWAY OF COAGULATION: 1) Factor X Accumulation 2) Fibrinogen breakdown 3) Factor III 4) Factor I 5) Prothrombin activator 6) Fibrin increase 7) Factor V 8) Thrombin increase 9) Fibrin cross-linking 10) Factor XIII

The kidney hormone _____ stimulates RBC production

Erythropoietin

Oxygen's diffusion from the lungs to the blood ceases as the hemoglobin molecules become saturated with the oxygen molecules.

False

How many oxygen molecules can each hemoglobin molecule transport?

Four

The percentage of blood volume composed of RBCs is called the

Hematocrit (packed cell volume)

The hereditary lack of factor VIII causes a disease called

Hemophilia

Production of all the formed elements of blood is called

Hemopoiesis

The overall cessation of bleeding, involving several mechanism, is called

Hemostasis (The stopping of a blood flow)

Statements regarding blood groups other than ABO and Rh.

INCORRECT: 1) They frequently cause transfusion reactions. CORRECT: 1) They include the MN, Duffy, Kell, Kidd, and Lewis groups. 2) They are useful for such legal purposes as paternity and criminal cases. 3) They are useful for research in population genetics. 4) They are useful for research in anthropology.

Indicate whether the abundance of the given cell type would increase, decrease, or not be affected by the given situation.

INCREASE: 1) Erythrocytes: high altitude 2) Erythrocytes: long term hypoxia 3) Neutrophils: streptococcus infection 4) B lymphocytes: influenza infection 5) Basophils: chronic asthma 6) Eosinophils: tapeworm infection RELATIVELY NO CHANGE: 1) Erythrocytes: acute viral infection DECREASE: 1) Erythrocytes: dietary iron deficiency 2) Erythrocytes: erythropoietin hyposecretion 3) Erythrocytes: declining intrinsic factor 4) Erythrocytes: acute, profuse hemorrhage 5) Erythrocytes: malarial parasitic infection 6) Erythrocytes: radiation therapy

Indicate which form of hemopoiesis can improve the symptoms of each condition.

Improved through erythropoesis: Sickle cell disease Anemia Hemolysis Hypoxia Hemolytic disease of the newborn Malaria Kwashiorkor Hemorrhage Transfusion reactions Improved through leukopoesis: Leukopenia NOT improved through erythropoesis or leukopoesis: Leukemia Hematology Primary polycythemia Secondary polycythemia

_____ is the enzyme responsible for promoting the formation of more kallikrein, completing the positive feedback loop in dissolving clots.

Plasmin In addition to promoting clotting, factor XII catalyzes the formation of a plasma enzyme called kallikrein. Kallikrein, in turn, converts the inactive protein plasminogen into plasmin, a fibrin-dissolving enzyme that breaks up the clot.Thrombin also activates plasmin, and plasmin indirectly promotes the formation of more kallikrein, thus completing a positive feedback loop.

An excessively high RBC count is called

Polycythemia

In healthy blood vessels, platelets do not adhere because the smooth, endothelium is coated with _____.

Prostacyclin

Formed Elements: RBCs

Red blood cells [RBCs], erythrocytes -most abundant cell type -specialized for transporting oxygen

______ results from a mutation that changes one amino acid in the hemoglobin molecule.

Sickle-Cell Disease

Indicate which blood type is being described

TYPE AB+: 1) Expresses all of the major antigens 2) The least common U.S. blood type 3) Expresses the D antigen 4) The universal acceptor 5) Expresses the Rh factor 6) Expresses the A agglutinogen Type O-: 1) Expresses all of the major antibodies 2) The most common U.S. blood type 3) The universal donor 4) Expresses the B agglutinin

Which of the following is NOT a function of platelets?

They inhibit procoagulants. Despite their small size, platelets have a greater variety of functions than any of the true blood cells: They secrete vasoconstrictors, stimulating spasmodic constriction of broken vessels and thus help reduce blood loss. They stick together to form temporary platelet plugs that seal small breaks in injured blood vessels. They secrete procoagulants, or clotting factors, which promote blood clotting. They initiate the formation of a clot-dissolving enzyme that dissolves blood clots that have outlasted their usefulness. They secrete chemicals that attract neutrophils and monocytes to sites of inflammation. They internalize and destroy bacteria. They secrete growth factors that stimulate mitosis in fibroblasts and smooth muscle and thus help to maintain and repair blood vessels.

Choose the correct statement regarding the function of platelets.

They secrete procoagulants, or clotting factors, which promote blood clotting. Despite their small size, platelets have a greater variety of functions than any of the true blood cells: They secrete vasoconstrictors, stimulating spasmodic constriction of broken vessels and thus help reduce blood loss. They stick together to form temporary platelet plugs that seal small breaks in injured blood vessels. They secrete procoagulants, or clotting factors, which promote blood clotting. They initiate the formation of a clot-dissolving enzyme that dissolves blood clots that have outlasted their usefulness. They secrete chemicals that attract neutrophils and monocytes to sites of inflammation. They internalize and destroy bacteria. They secrete growth factors that stimulate mitosis in fibroblasts and smooth muscle and thus help to maintain and repair blood vessels.

The extrinsic pathway of coagulation is activated by _____ from damaged perivascular tissues

Thromboplastin

Free bilirubin is transported by the blood to the liver.

True

In addition to the ABO and Rh groups, there are at least 100 other known blood groups, and they rarely cause transfusion reactions.

True

Iron is transported in the blood by transferrin.

True

Oxygen's great affinity for hemoglobin molecules causes oxygen molecules to diffuse from the lungs to the capillaries.

True

Viscosity vs. Osmolarity

Viscosity: 1) The resistance of a fluid to flow. 2) It results from the cohesion of a fluid's particles. 3) It is the thickness or stickiness of a fluid. 4) If it is too high, the blood flows too sluggishly. Osmolarity: 1) The rate of reabsorption between the bloodstream and tissue fluid is governed by it. 2) The transfer of fluids depends on a balance between the filtration of fluid from the capillary and its reabsorption. 3) If it is too high, the bloodstream absorbs too much water, raising the blood volume, resulting in elevated blood pressure.

Intrinsic factor enables the small intestine to absorb

Vitamin B12

Diapedesis

WBCs: move outside of the bloodstream

Formed Elements: WBCs

White blood cells [WBCs], leukocytes -defense cells

Leukocytes Characteristics

[WBCs] -have nucleus and organelles -make up about 1% of total blood volume -defense cells: defend the body against infection -amoeboid movement: allows WBCs to move along the walls of the vessels and outside of the bloodstream

Process of Erythropoiesis

[involves several stages - all occurring in red bone marrow -Hemocytoblast divides to form myeloid stem cell -Myeloid stem cell differentiates to proerythroblast -Proerthroblast passes through several stages during which the cell is accumulating hemoglobin -Cell sheds nucleus and is called a reticulocyte -Reticulocyte enters bloodstream where it will become mature RBC [acquires hemoglobin]

Jaundice

associated with to muck break down of RBCs and not excretion of waste products and gets released into the bloodstream

Positive Chemotaxis

attracted to particular chemical signals released by damaged cells or other WBCs

Composition of whole blood: Formed Elements

blood cells and cell fragments

Major categories of WBCs

classified based on the staining of granules located in the cytoplasm -Granulocytes -Agranulocytes

Thrombosis

clotting in an unbroken blood vessel -may be initiated by rough surface of vessel wall or slow flowing blood -may also form when blood flows too slowly

Fluid Connective Tissue

contains cells suspended in a fluid matrix

Erythropoiesis

erythropoiesis and destruction of RBC maintain a balance of RBCs in the blood -Hypoxia: too few RBCs -Blood becomes thick: to many RBCs

Blood

fluid connective tissue

Composition of whole blood: Serum

ground substance

Granulocytes

have specialized, membrane-bound granules that are visible when stained -contain phagocytes: [general term for anything that engulfs something], engulf pathogens, cell debris, other material -visible stained granules -have lobed nuclei -larger than RBCs -include 3 different types: Neutrophils, Eosinophils & Basophils

ABO

in ABO, 2 types of surface antigens A and B, type O lacks complete antigens -plasma contains antibodies against "foreign" surface antigens [anti-A antibody or anti-B antibody or both]

Hemoglobin

intracellular protein -made of 4 poly peptide chains of AA called component -Heme: iron containing component and site of O2binding, CO2 binds at globin component

Agranulocytes

lack visible [obvious] stained granules 2 types of agranuocytes: -Lymphocytes -Monocytes

Hemostasis

prevention of blood loss Three phases: Vascular, Platelet, Coagulation

Hemorrhage

the loss of large amounts of blood from vessels -blood clotting can usually prevent hemorrhaging in smaller vessels -extensive hemorrhaging from large vessels usually requires medical intervention