Chapter 11 Blood

Explain what causes a transfusion reaction and its outcome

Caused by interactions between antigens and antibodies Outcome: clumping or rupture of blood cells and clotting within blood vessels.

Lymphocytes

Smallest of WBC Cytoplasm consists of only a thin, sometimes imperceptible ring around the nucleus Several types-play important role in the body's immune response (T AND B CELLS) Produce antibodies and other chemicals that destroy microorganisms, contribute to allergic reactions, reject grafts, control tumors, and regulate the immune system

Describe the formation of a platelet plug. What role does collagen, von Willebrand factor, thromboxane A2 and ADP play in the formation of a platelet plug?

1. Platelets stick to the collagen exposed by blood vessel damage (platelet adhesion) 2. Most platelet adhesion is mediated through von Willebrand factor, a protein produced and secreted by blood vessel endothelial cells. 3. Von willebrand forms a bridge between collagen and platelets by binding to platelet surface receptors and collagen 4. After platelets adhere to collagen, they become activated, change shape, and release chemicals. 5. In the platelet release action, platelets release chemicals, such as ADP and thromboxane, which bind to their respective receptors on the surfaces of other platelets, activating the platelets. These activated platelets also release ADP and thromboxane, activating more platelets. 6. As platelets become activated, they express surface receptors called fibrinogen receptors, which can bind to fibrinogen, a plasma protein. 7. In platelet aggression, fibrinogen forms bridges between the fibrinogen receptors of numerous platelets, resulting in a platelet plug.

Type O blood

A and B antibodies

Type AB blood

A and B antigens

Type A blood

A antigen, B antibodies

Compare the effect of antithrombin, heparin, and plasmin on either clot expansion or clot dissolution

Antithrombin and heparin inactivate thrombin causing fibrinogen to not convert to fibrin and NO CLOT forms: clot expansion Plasmin slowly breaks down the fibrin causing a CLOT: clot dissolution

Type B blood

B antiven, A antibodies

Eosinophils

Contain cytoplasmic granules that stain bright red with eosin, acidic stain 2 lobed nucleus Involved in inflammatory responses associated with allergies and asthma Chemicals are involved in destroying certain worm parasites

Transfusion of type B blood into a type A person

Donor: Type B Recipient: Type A A antibodies from Type B fuse into A antigens to Type A-antibodies are usually diluted out and not much of a problem

Why does a deficiency in iron, vitamin B12, folate or erythropoietin cause anemia? Why will RBC count, hemoglobin measurement, and hematocrit be usually reduced with each type of anemia?

Erythropoietin and iron are both needed for normal red blood cell production as well as vitamin B12 and Folate. Both vitamin B12 and folic acid are required for DNA synthesis. Erythrocytes have no nucleus. All would be reduced because there is not enough blood being produced. It reduces the blood's ability to transport oxygen.

Predict the effect of high altitude where the percentage of oxygen in the air is reduced and chronic kidney disease on this pathway

High altitude: oxygen levels in blood decrease causing an increase in erythropoietin production, increasing RBC production Kidney disease: causes anemia-reduced production of erythropoietin

Monocytes

Largest of WBC After they leave the blood and enter tissues, they enlarge and become macrophages, which phagocytize bacteria, dead cells, cell fragments, and other debris within the tissues Macrophages can break down phagocytized foreign substances and present the processed substances to lymphocytes causing activation of lymphocytes

Describe how a decrease in blood oxygen levels causes an increase in the number of red blood cells- what is the role of the kidney and the bone marrow?

Low blood oxygen levels stimulate red blood cell production by increasing the formation and release of the glycoprotein erythropoietin, primarily in the kidneys. Erythropoietin stimulates red bone marrow to produce more red blood cells. -When blood oxygen levels decrease, the production of erythropoietin increases, which increases RBC production

For any given blood type be able to identify compatible blood types (that wouldn't cause a transfusion reaction)

Recipients with blood type O can receive blood from type O only. Blood type A can receive blood from blood types A and O. Blood type B can receive blood from blood types B and O. Blood type AB can receive blood from blood types A, B, AB, and O.

Explain why the first pregnancy of an Rh negative mother with and Rh positive baby is not detrimental to the fetus, but a second Rh positive fetus can develop hemolytic disease of the newborn (HDN)

Rh blood group: those antibodies are only produced with exposure to blood-Rh negative person is exposed to Rh positive person 1st pregnancy: Baby is A positive, Mother is A negative. During delivery some blood from the baby goes to the mother 2nd pregnancy: Mother is A negative with Rh antibodies in her plasma. The mother produces anti-Rh antibodies that cross the placenta and cause agglutination and hemolysis of fetal RBCs.

Functions of Blood

Transport of gases, nutrients, waste Transport of processed molecules Transport of regulatory molecules Regulation of pH and osmosis Maintenance of body temperature Protection against foreign substances Clot formation

Agranulocytes

lymphocytes, monocytes

Granulocytes

neutrophils, basophils, eosinophils

Explain how one type of stem cell in the bone marrow can become either a red blood cell, white blood cell, or platelet

(Hemocytoblasts) The development of each cell line is regulated by specific GROWTH FACTORS. That is, growth factors determine the types of formed elements derived from the stem cells and how many formed elements are produced

Compare how oxygen and carbon dioxide are carried by the blood. Would systemic venous blood (blood returning to the heart from the tissues) have high levels of oxygen, carbon dioxide or both? what about systemic arterial blood?

Oxygen transport: hemoglobin, which consists of 4 protein chains and 4 heme groups O2 binds to Iron Hemoglobin picks up oxygen in the lungs and releases oxygen in other tissues. Carbon dioxide transport: produced in tissues and transported in the blood to the lungs, where it is removed from the blood. It involves bicarbonate ions, hemoglobin, and plasma. Carbonic anhydrase catalyzes a reaction that converts CO2 and H2O into a hydrogen ion and a bicarbonate ion. Systematic venous blood: high levels of CO2 Systematic arterial blood: high levels of O2 *Red blood cells primary function is to transport oxygen from the lungs to the various tissues of the body and to help transport carbon dioxide from the tissues to the lungs. Blood going from the tissues to the lungs has a high CO2 and low O2 concentration. Blood going from the lungs to the tissues has a low CO2 and high O2 concentration.

Explain the advantage of using plasma instead of serum in a patient with an excessive bleeding problem (hemophiliac)

Plasma has better clotting factors and contains water, electrolytes, a lot of sodium and chloride, and a little potassium and calcium Serum is plasma without the clotting factors

Basophils

Least common WBC Contain large cytoplasmic granules that stain blue or purple with basic dyes Release histamine and other chemicals that promote inflammation. Release heparin, which prevents formation of clots

Neutrophils

Most common WBC Have small cytoplasmic granules that stain with both acidic and basic dyes Nuclei are lobed with the number of lobes varying from 2-4 Remain in blood for short time, move into other tissues, and phagocytize microorganisms and other foreign substances

Explain how the shape and flexibility of erythrocytes (RBC) aid with their function

The biconcave shape increases the cell's surface area compared to a flat disk of the same size. The greater surface area makes it easier for gases to move into and out of the red blood cell. The red blood cell can bend or fold around its thin center, decreasing its size and enabling it to pass more easily through smaller blood vessels.

Blood characteristic

Type of CT Heavier than water O2 content determines color Temp slightly higher than rest of body Males (5-6 L) Females (4-5 L)