Chapter 6 & 7
lymph
A clear fluid collected from tissues and transported by lymph vessels to the venous circulation
neutropenia
A deficiency of neutrophils
leukopenia
A deficient number of white blood cells
implantable
A device that can be inserted into tissues
polycythemia
A disease of bone marrow, excess production of RBCs
prosthesis
A manufactured substitute for a missing or diseased part of the body
cardiologist
A medical specialist in the diagnosis and treatment of the heart (cardiology)
lymphiatic system has 3 systems
A network of thin lymphatic capillaries and vessels, similar to blood vessels, that penetrates the interstitial spaces (the spaces between tissues) of nearly every tissue in the body except cartilage, bone, red bone marrow, and the CNS; A group of tissues and organs that produce immune cells; and Lymph, a clear colorless fluid similar to blood plasma but with a composition that varies throughout the body. It flows through the network of lymphatic capillaries and vessels. The lymphatic network begins with lymphatic capillaries that are closed-ended tubes nestled among blood capillary networks (Figure 7.14). The lymphatic capillaries are designed to let interstitial fluid enter so it can become lymph. In addition, bacteria, viruses, cellular debris, and traveling cancer cells can enter the lymphatic capillaries with the interstitial fluid. The lymphatic capillaries converge to form the larger lymphatic collecting vessels, which resemble small veins and have one-way valves. They travel alongside veins and arteries.
Disorders of White Blood Cells (LO 7.3 and 7.6)
A normal cubic millimeter (mm3) of blood contains 5,000 to 10,000 white blood cells. In leukocytosis, the total WBC count exceeds 10,000 per cubic millimeter. Other conditions that increase the WBC count beyond the normal range include: Allergic reactions, which increase the number of eosinophils; Typhoid fever, malaria, and tuberculosis, which increase the number of monocytes; and Whooping cough and infectious mononucleosis, which increase the number of lymphocytes.
nutritionist
A person who specializes in the study of food and liquid requirements for normal function of the human body
thromboembolism
A piece of detached blood clot (embolus) blocking a distant blood vessel
vital signs
A procedure during a physical examination in which temperature (T), pulse (P), respirations (R), and blood pressure (BP) are measured to assess general health and cardiorespiratory function
granulocyte
A white blood cell that contains multiple small granules in its cytoplasm
disorders of the heart
Abnormal Heart Rhythms (LO 6.5) Arrhythmias are abnormal or irregular heartbeats, and six types are commonly seen: Premature beats occur most often in elderly people and are usually associated with caffeine and stress. Atrial fibrillation (A-fib) occurs when the two atria quiver rather than contract correctly to pump blood. This causes blood to pool in the atria and sometimes clot. Ventricular tachycardia (V-tach) is a rapid heartbeat occurring in the ventricles. Ventricular arrhythmias include: Premature ventricular contractions (PVCs), which result when extra impulses arise from a ventricle; and Ventricular fibrillation (V-fib), which occurs when the ventricles lose control, quivering instead of pumping. Heart block occurs when interference in cardiac electrical conduction prevents the atria's contractions from coordinating with the ventricles' contractions. Palpitations are brief but unpleasant sensations of a rapid or irregular heartbeat. They can be brought on by exercise, anxiety, and stimulants like caffeine. Arrhythmias can be treated with medications, but some patients require mechanical pacemakers. Pacemakers consist of a battery, electronic circuits, and computer memory to generate electronic signals. These signals are carried along thin, insulated wires to the heart muscle. Pacemakers are ideal for patients with a very slow heart rate (bradycardia). In emergency situations, external defibrillation is performed through automatic external defibrillators, or AEDs (Figure 6.11). AEDs send an electric shock to the heart in order to stop the heart temporarily so that a normal contraction rhythm can resume. This procedure was used for Danny Gitlin. People with life-threatening arrhythmias may need an implantable defibrillator (ICD), which senses abnormal rhythms. An ICD gives the heart a small electric shock to return its rhythm to normal. Defibrillation is the nonsynchronized delivery of energy to the heart during any phase of the cardiac cycle used in emergency situations. Cardioversion is the delivery of lower levels of energy synchronized to the large R waves of the QRS complex and is mostly used for A-fib or flutter and V-tach.
murmur
Abnormal heart sound heard with a stethoscope when a valve closes or opens abnormally
parenteral
Administering medication by any other means than the GI tract
inotropic
Affecting the contractility of cardiac muscle
neutrophilia
An increase in neutrophils
hemophilia
An inherited disease from a deficiency of clotting factor VIII
patent ducts arterioses (PDA)
An open, direct channel between the aorta and the pulmonary artery in the newborn
rhesus factor
Antigen on surface of red blood cells of Rh+ individuals; it was first identified in Rhesus monkeys
Blood Groups and Transfusions (LO 7.3 and 7.8)
Antigens antigen (AN-tee-jen) Substance capable of triggering an immune response. are molecules that exist on the surfaces of red blood cells. Antibodies are present in the plasma. Each antibody can combine with only a specific antigen. If the plasma antibodies combine with another red cell antigen, bridges form to connect these red cells together. This is called agglutination, or clumping, of the cells. Hemolysis (destruction) of the cells also occurs. The antigens on the surfaces of the cells have been categorized into groups. Two of these groups—the ABO and Rh blood groups—are the most important.
mediastinum
Area between the lungs containing the heart, aorta, venae cavae, esophagus, and trachea
perfusion
Area between the lungs containing the heart, aorta, venae cavae, esophagus, and trachea
Arterioles, Capillaries, and Venules
As the arteries branch farther away from the heart and distribute blood to specific organs, they become smaller, muscular vessels called arterioles. By contracting and relaxing, these arterioles are the primary controllers that help the body direct the amount of blood that the organs and structures receive. From the arterioles, the blood flows into capillaries and capillary beds (Figure 6.19). Red blood cells flow in single file through the small capillaries.
electrical properties of the heart
As your heart muscles contract, they generate a small electrical current that sustains your heartbeat rhythm through a conduction system (Figure 6.7). Here is how this conduction system works: A small region of specialized muscle cells in the right atrium's sinoatrial (SA) node initiates your heartbeat. The SA node is the pacemaker of your heart's rhythm. Electrical signals from the SA node spread out through the atria and rejoin at the atrioventricular (AV) node. The AV is the electrical gateway to the ventricles. Electrical signals leave the AV node and travel to the ventricular myocardium where they stimulate the ventricular myocardium to contract, creating your heartbeat. Sinus rhythm is the term used to describe a normal heartbeat, where normal electrical conduction leads to a ventricular rate of about 60 to 80 beats per minute. An abnormal cardiac rhythm is called an arrhythmia or a dysrhythmia. An electrocardiograph is a device that picks up the heart muscle's electrical changes and amplifies them to record an electrocardiogram in the form of waves (Figure 6.8).
lymph nodes
At irregular intervals, the collecting vessels mentioned above enter into the lymph nodes (Figure 7.15). There are hundreds of lymph nodes stationed all over the body (Figure 7.13). They are concentrated in the neck, axilla, and groin. Their functions are to filter impurities from the lymph and alert the immune system to the presence of pathogens. The lymph moves slowly through the nodes, which filter the lymph and remove any foreign matter. Macrophages in the lymph nodes ingest and break down foreign matter and display its fragments to T cells. This alerts the immune system to the presence of an invader. Lymph leaves the nodes when it enters into the efferent collecting vessels. All these lymph vessels move lymph toward the thoracic cavity. Collecting vessels merge into lymphatic trunks that drain lymph from a major body region. These lymphatic trunks then merge into two large lymphatic ducts—the thoracic duct on the left and the right lymphatic duct, which empty into the veins beneath the collarbone, the subclavian veins (Figure 7.13).
blood supply to heart muscle
Because your heart beats continually and forcefully, it requires an abundant supply of oxygen and nutrients. To meet this need, your cardiac muscle has its own blood circulation called the coronary circulation (Figure 6.3). This system of arteries arises directly from the aorta. If any of your coronary arteries become blocked, the blood supply to a part of your cardiac muscle is cut off (ischemia) and the cells supplied by that artery die (necrosis) within minutes. This is a myocardial infarction (MI) or a "heart attack."
nutrient
Constituent of food necessary for the body to function normally
coarctation
Constriction, stenosis, particularly of the aorta
disorders of heart valves
Cor pulmonale is failure of the right ventricle to pump properly. Almost any chronic lung disease causing low blood oxygen (hypoxia) can cause this disorder. Malfunctions of the valves on the right side of the heart are much less common than those on the left side. The heart valves can malfunction in two basic ways. Malfunctions most often occur in the heart's left side. Stenosis: The valve cannot open fully, and its opening is narrowed (constricted). Because blood cannot flow freely through the valve, it accumulates in the chamber behind the valve. Incompetence or insufficiency is a condition where the heart valve cannot close fully, allowing blood to leak or regurgitate (flow back) through the valve to the heart chamber from which it came. Mitral valve stenosis can occur following rheumatic fever. Because the blood cannot flow freely through the valve, the left atrium becomes dilated (enlarged). Eventually, chronic heart failure results. Mitral valve prolapse (MVP) occurs when the cusps of the valve bulge back into the left atrium when the left ventricle contracts. This allows blood to flow back into the atrium. Aortic valve stenosis is common in the elderly when the valves become calcified due to atherosclerosis. Blood flow into the systemic circulation is diminished, leading to dizziness and fainting. The left ventricle dilates, hypertrophies, ceases to beat strongly, and ultimately fails. Aortic valve incompetence initially produces few symptoms other than a murmur. Eventually the left ventricle is unable to cope with the excess volume of blood and fails. (Figure 6.12 enables you to review the locations of the valves and chambers.) When a valve replacement is necessary, there are two types of artificial valves available: Mechanical or prosthetic valves, which are made from metal alloys and plastics; or Tissue valves, which can come from a pig or cow, a human cadaver (dead person), or a patient's own pericardium.
Coronary Artery Disease (CAD)
Coronary artery disease occurs when the coronary arteries supplying blood to the myocardium are constricted by atherosclerotic plaques called atheroma (compare Figure 6.13(a) to 6.13(b)). This reduces the blood supply to the cardiac muscle. Platelet clumping can occur on the plaque and form a blood clot (coronary thrombosis). Atherosclerosis is the most common form of arteriosclerosis (hardening of the arteries), and it can lead to arteriosclerotic heart disease (ASHD). Angina pectoris (pain in the chest on exertion) is often the first symptom of a reduced oxygen supply to the myocardium. Myocardial infarction (MI) is the death of myocardial cells, caused by the lack of blood supply (ischemia) when an artery eventually becomes blocked (occluded). If the ischemia is not reversed within 4 to 6 hours, the myocardial cells die (necrosis). Shock is a life-threatening condition that occurs when the body is not getting sufficient blood flow; this can damage multiple organs. A classification of shock includes: Cardiogenic shock occurs when the heart fails to pump blood effectively through the body's organs and tissues. Hypovolemic shock occurs from a loss of blood volume, often due to excessive bleeding (hemorrhage) or dehydration. Anaphylactic shock is caused by a severe allergic reaction. Septic shock is caused by a severe infection. Neurogenic shock is associated with damage to the nervous system. Cardiac arrest is the sudden cessation of cardiac activity that results from anoxia (lack of oxygen in the body tissues). Most patients show asystole (no heartbeat) on the cardiac monitor (Figure 6.14). A person in cardiac arrest has no pulse, is not breathing, and can be referred to as a pulseless nonbreather (PNB).
hemolysis
Destruction of red blood cells so that hemoglobin is liberated
embolus
Detached piece of thrombus, a mass of bacteria, quantity of air, or foreign body that blocks a blood vessel
leukemia
Disease when the blood is taken over by white blood cells and their precursors
idk
Disseminated intravascular coagulation (DIC) occurs when a severe bacterial infection activates the clotting mechanism simultaneously throughout the cardiovascular system. Small clots form and obstruct blood flow into tissues and organs, particularly the kidney, leading to renal failure. Thrombus formation (thrombosis) is a clot that forms attached to a diseased or damaged area on the walls of blood vessels or the heart. If part of the thrombus breaks loose and moves through the circulation, it is called an embolus. Thrombocytopenia is a deficiency of platelets. Purpura is bleeding into the skin from small arterioles that produces a larger individual lesion than the tiny red spots or petechiae from capillary bleeds (Figure 7.10a and b). Bruises (or hematomas) are leaks of blood from all types of blood vessels. Idiopathic thrombocytic purpura (ITP) occurs when the immune system destroys the body's platelets. An acute, self-limiting form of the disease occurs in children; a chronic form affects adults.
antihistamine
Drug used to treat allergic symptoms because of its action antagonistic to histamine
disorders of heart wall
Endocarditis is an inflammation of the heart's lining, which is usually secondary to an infection elsewhere. Intravenous drug users and people with damaged heart valves are at high risk for endocarditis. Myocarditis is an inflammation of the heart muscle. It can be bacterial, viral, or fungal in origin, or can arise as a complication of other diseases like influenza. Pericarditis is inflammation of the covering of the heart. The inflammation causes an exudate (pericardial effusion) to be released into the pericardial space between the two layers of the pericardium. This interferes with the heart's ability to contract and expand normally, which reduces cardiac output (CO) and leads to a life-threatening condition called cardiac tamponade. Cardiomyopathy is a weakening of the heart muscle that makes it pump inadequately. This causes the heart to enlarge (cardiomegaly) and leads to heart failure.
erythroblastosis fetalis
Erythroblastosis fetalis is a hemolytic disease of the newborn (HDN)
vitamin
Essential organic substance necessary in small amounts for normal cell function
exudate
Fluid that has passed out of a tissue or capillaries as a result of inflammation or injury
palpitation
Forcible, rapid beat of the heart felt by the patient
clostridium difficle
Gram-positive spore-forming bacteria that causes antibiotic-associated diarrhea.
complement
Group of proteins in serum that finish off the work of antibodies to destroy bacteria and other cells
HIV and AIDS
HIV is one of a group of viruses known as retroviruses. Like other viruses, it can replicate only inside a living host cell and it invades helper T cells and cells in the upper respiratory tract and CNS. Inside the cell, the virus can stay dormant for months or years. When it is activated (AIDS), the new viruses emerge from the dying host cell and attack more cells. This dormant phase (incubation) can range from a few months to 12 years. As the virus destroys more and more cells, the body cannot produce antibodies. Symptoms appear, including chills, fever, night sweats, fatigue, weight loss, and lymphadenitis. Opportunistic infections by bacteria, viruses, and fungi can occur. These infections include toxoplasmosis, pneumocystitis, tuberculosis, herpes simplex, cytomegalovirus, and candidiasis. Cancers can also invade, and a form of skin cancer called Kaposi sarcoma (Figure 7.20) is common.HIV survives poorly outside the human body. It is destroyed by laundering, dishwashing, chlorination, and the use of disinfectants, alcohol, and germicidal skin cleansers.
tricuspid
Having three points; a tricuspid heart valve has three flaps
hodgkin
Hodgkin lymphoma is marked by chronic enlargement of lymph nodes spreading to other nodes in an orderly way
catheter
Hollow tube to allow passage of fluid into or out of a body cavity, organ, or vessel
fetus
Human organism from the end of the eighth week after conception to birth
allergy
Hypersensitivity to a particular allergen
Hypertensive Heart Disease
Hypertension (HTN), the most common cardiovascular disorder in this country, affects more than 20% of the adult population. It results from a prolonged elevated blood pressure in the vascular system, which forces the ventricles to work harder to pump blood. High blood pressure is indicated by a blood pressure reading of 140/90 mmHg (millimeters of mercury) or higher. A normal blood pressure is below 120/80 mmHg. The first number, or systolic reading, reflects the blood pressure when the heart is contracting. The second number, or diastolic reading, reflects the blood pressure when the heart is relaxed between contractions. Primary or essential hypertension is the most common type of hypertension. Its etiology is idiopathic (unknown). Secondary hypertension results from other diseases like kidney disease, atherosclerosis, and hyperthyroidism. Malignant hypertension is a rare, severe, life-threatening form of hypertension that involves a blood pressure reading of greater than 200/120 mmHg. Aggressive intervention is mandatory to reduce the blood pressure.
Immunity (LO 7.11)
Immunity is the state of being able to resist a specific infectious disease. It is classified biologically into two types, although these often respond to the same antigen: Cellular (cell-mediated) immunity: This is a direct form of defense based on the actions of lymphocytes to attack foreign and diseased cells and destroy them. The many different types of T cells, B cells, and macrophages described in the previous lesson of this chapter are involved in this style of attack (Figure 7.18). Humoral (antibody-mediated) immunity: This is an indirect form of attack that employs antibodies produced by plasma cells, which have been developed from B cells. The antibodies bind to an antigen and tag it for destruction. These antibodies are called immunoglobulins, present in blood plasma and body secretions.
Immunization (LO 7.2 and 7.11)
Immunization is the preventive method of stimulating the immune system without exposing the body to an infection. An agent (vaccine) composed of the antigenic components of a killed or attenuated microorganism or its inactivated toxins is injected into the body. Vaccination is a crucial step in keeping our population healthy. For example, vaccination has eradicated smallpox worldwide. However, if we stop vaccinating against smallpox, our population will again be susceptible to smallpox outbreaks. The same concept applies to the diseases in childhood immunizations (Table 7.1).
functions of the heart
In order to keep your body alive, your heart must work all the time, without stopping. Its three most important functions are to: Pump blood. As your heart contracts, it generates pressure that moves your blood through your blood vessels. Route blood. Your heart essentially has two pumps: one on the right side that sends blood through the pulmonary circulation of your lungs and back to the second pump on your left side, which sends blood through the systemic circulation of your body. Your heart valves make this one-way flow of blood possible. Regulate blood supply. The changing metabolic needs of your tissues and organs—for example, when you exercise—are met by changes in the rate and force of your heart's contractions.
Lymphatic Tissues and Cells (LO 7.2 and 7.10)
In some organs, lymphocytes and other cells form dense clusters called lymphatic follicles. These are constant features in the lymph nodes, the tonsils, and the ileum (a part of the small intestine). Lymphatic tissues are composed of a variety of cells that include: T lymphocytes (T cells): The "T" stands for thymus, which is where these cells develop and mature. T lymphocytes make up 75% to 85% of body lymphocytes. B lymphocytes (B cells): These cells mature in the bone marrow. B lymphocytes make up 15% to 25% of lymphocytes. They respond to a specific antigen and become plasma cells to produce antibodies (immunoglobulins, Ig) that immobilize, neutralize, and prepare the specific antigen for destruction. Macrophages that have developed from monocytes ingest and destroy antigens, tissue debris, bacteria, and other foreign matter (phagocytosis).
hypertrophy
Increase in size, but not in number, of an individual tissue element
contagious
Infection can be transmitted from person to person or from a person to a surface to a person
sternum
Long, flat bone forming the center of the anterior wall of the chest
homeostasis
Maintaining the stability, or equilibrium, of a system or the body's internal environment
tonsil
Mass of lymphoid tissue on either side of the throat at the back of the tongue
cardiology
Medical specialty of diseases of the heart
infection
Microbes (microorganisms) are everywhere—in the air, water, and soil and all over our bodies, where they are called normal flora. These normal microorganisms are found on your skin, in your nose and respiratory tract, and in your mouth and digestive tract. Your brain and cardiovascular system, however, are microbe-free (sterile). If microorganisms other than the normal flora invade the body, they become pathogens, which cause an infection. Pathogens include bacteria, viruses, fungi, and parasites. If the infection harms the body, it creates an infectious disease. Bacterial, viral, fungal, and parasitic infections are all caused by pathogens.
flora
Microorganisms covering the exterior and interior surfaces of a healthy animal
Agranulocytes (LO 7.3 and 7.6)
Monocytes (Figure 7.7) are the largest blood cells and are normally 3% to 8% of the total WBC count. Monocytes leave the bloodstream and become macrophages that ingest bacteria, dead neutrophils, and dead cells in the tissues. Lymphocytes (Figure 7.8) are the smallest white blood cells and comprise 25% to 35% of the total WBC count. Lymphocytes are produced in red bone marrow and migrate through the bloodstream to lymphatic tissues—lymph nodes, tonsils, spleen, and thymus—where they multiply. B cells differentiate into plasma cells, which are stimulated by bacteria or toxins to produce antibodies or immunoglobulins (Ig) (Chapter 7). T cells attach directly to foreign antigen-bearing cells like bacteria, which they kill with toxins they secrete. In a laboratory report, a differential white blood cell count (DIFF) lists the percentages of the different leukocytes in a blood sample.
stenosis
Narrowing of a canal or passage, e.g., of a heart valve
Granulocytes (LO 7.3 and 7.6)
Neutrophils (Figure 7.4), also called polymorphonuclear leukocytes (PMNLs), are normally 55% to 65% of the total WBC count. These cells ingest bacteria, fungi, and some viruses. In neutropenia, the number of neutrophils is decreased. In neutrophilia, the number is increased. Eosinophils (Figure 7.5) are normally 2% to 4% of the total WBC count. They leave the bloodstream to enter tissue that is undergoing an allergic response. In allergic reactions, the number and percentage of eosinophils increase. Basophils (Figure 7.6) are normally less than 1% of the total WBC count. Basophils migrate to damaged tissues to release histamine (which increases blood flow) and heparin (which prevents blood clotting).
neutrophil
Neutrophils' granules take up purple stain equally, whether the stain is acid or alkaline
placenta
Organ that allows metabolic exchange between the mother and the fetus
epidemic
Pertaining to an outbreak in a community of a disease or a health-related behavior
edematous
Pertaining to or affected by edema
leukemic (adj)
Pertaining to or affected by leukemia
allergic (adj)
Pertaining to or suffering from an allergy
hemolytic (adj)
Pertaining to the destruction of red blood cells
Disorders of the Lymphatic System (LO 7.10)
Physicians routinely feel the accessible lymph nodes in the neck (cervical nodes), axilla (armpit) (axillary nodes), and groin (inguinal nodes) for enlargement and tenderness, which indicate disease in the tissues drained by the lymph nodes. Cancerous lymph nodes are enlarged, firm, and usually painless. Infections in the lymph nodes cause them to be swollen and tender to the touch, a condition called lymphadenitis. All lymph node enlargements are collectively called lymphadenopathy. When lymph nodes are removed, the process is called lymphadenectomy. Lymphoma is a malignant growth (neoplasm) of the lymphatic organs, usually the lymph nodes. Associated symptoms can be fever, night sweats, fatigue, and weight loss. Lymphomas are grouped into two categories by microscopic examination of affected lymphatic tissues: Hodgkin lymphoma, or Hodgkin disease: The cancer spreads in an orderly manner to adjoining lymph nodes. This enables the disease to be staged depending on how far it has spread; and Non-Hodgkin lymphomas: These occur much more frequently than Hodgkin lymphoma. They include some 30 different disease entities in 10 different subtypes. Diagnostic procedures used to determine lymphoma include a biopsy of an enlarged node, x-rays, CT and MRI scans, a lymphangiogram, and a bone marrow biopsy. Tonsillitis, inflammation of the tonsils and adenoids, occurs mostly in infancy and childhood. The infection can be viral or bacterial, usually streptococcal. It produces enlarged, tender lymph nodes under the jaw. The infection can be recurrent, and a tonsillectomy is sometimes performed (see Chapter 8). If the adenoids also show recurrent infection, an adenoidectomy can be performed, often at the same time as the tonsillectomy. Splenomegaly, an enlarged spleen, is not a disease in itself but the result of an underlying disorder. But when the spleen enlarges, it traps and stores an excessive number of blood cells and platelets (hypersplenism), reducing the number of blood cells and platelets in the bloodstream. Occasionally, a splenectomy is necessary. Ruptured spleen is a common complication from car accidents or other trauma when the abdomen and rib cage are damaged. Intra-abdominal bleeding from the ruptured spleen can be extensive, with a dramatic fall in blood pressure. It is considered a surgical emergency requiring a splenectomy. Lymphedema is localized, brawny (does not easily pit on finger pressure), minimally pitting fluid retention caused by a compromised lymphatic system, often after surgery or radiation therapy. It can also be primary, where the cause is unknown.
toxin
Poisonous substance formed by a cell or organism
mononucleosis
Presence of large numbers of specific, diagnostic mononuclear leukocytes
congenital
Present at birth, either inherited or due to an event during gestation up to the moment of birth
agglutination
Process by which cells or other particles adhere to each other to form clumps
prothrombin
Protein formed by the liver and converted to thrombin in the blood-clotting mechanism
angiogram
Radiograph obtained after injection of radiopaque contrast material into blood vessels
lymphangiogram
Radiographic images of lymph vessels and nodes following injection of contrast material
angiography
Radiography of blood vessels after injection of contrast material
angioplasty
Recanalization of a blood vessel by surgery
defibrillation
Restoration of normal cardiac activity in life-threatening cardiac arrhythmias
tetralogy of fallot (TOF)
Set of four congenital heart defects occurring together
collateral
Situated at the side, often to bypass an obstruction
thoracic cavity
Space within the chest containing the lungs, heart, esophagus, trachea, aorta, venae cavae, and pulmonary vessels
allergist
Specialist in hypersensitivity reactions
immunoglobulin
Specific protein evoked by an antigen. All antibodies are immunoglobulins
follicle
Spherical mass of cells containing a cavity; or a small cul-de-sac, such as a hair follicle
miscarriage
Spontaneous expulsion of the products of pregnancy before fetal viability
Structure, Functions, and Disorders of Red Blood Cells (Erythrocytes) (LO 7.5)
Structure of RBCs (Erythrocytes) (LO 7.5) Each RBC is a disk with edges that are thicker than and raised above the flattened center (Figure 7.2). This biconcave surface area enables a more rapid flow of gases into and out of the disk. The main component of RBCs is hemoglobin (Hb), which gives the cells and blood their red color. Hb is composed of the iron-containing pigment heme bound to a protein called globin. The rest of the red blood cell consists of the cell membrane, water, electrolytes, and enzymes. Mature RBCs do not have a nucleus. Functions of RBCs (Erythrocytes) (LO 7.3 and 7.5) The functions of the RBCs are to: Transport oxygen (O2), in combination with hemoglobin, throughout the body, from the lungs to the cells; Transport carbon dioxide (CO2) from the tissue cells to the lungs for excretion; and Transport nitric oxide (NO), a gas produced by the lining cells of blood vessels that signals smooth muscle to relax, throughout the body. Disorders of Red Blood Cells (LO 7.3 and 7.5) Anemia is a red blood cell condition where the number of RBCs or amount of hemoglobin contained in each RBC is reduced. Both of these conditions reduce the blood's oxygen-carrying capacity, producing shortness of breath (SOB) and fatigue. The different types of anemia include: Iron-deficiency anemia is the diagnosis for Ms. Sosin (Case Report 7.1 on page 137). The cause was chronic bleeding from her gastrointestinal tract due to the aspirin and other painkillers she was taking. Her stools were positive for occult blood. Other causes of iron-deficiency anemia can be heavy menstrual bleeds or a diet deficient in iron. Pernicious anemia (PA) is due to vitamin B12 deficiency. It is caused by a shortage of intrinsic factor, which is normally secreted by cells in the stomach lining (see Chapter 9) and binds with B12. This complex is absorbed into the bloodstream. Without B12, hemoglobin cannot form. The number of red cells decreases, hemoglobin concentration decreases, and the size of the red cells increases. Sickle cell anemia is a genetic disorder found most commonly in African Americans. Here, the production of abnormal hemoglobin causes the RBCs to form a rigid sickle shape (Figure 7.3). The abnormal cells agglutinate (clump together) and block small capillaries. This creates intense pain in the hypoxic tissues (a sickle cell crisis) and can lead to stroke, kidney failure, and heart failure. Sickle cell trait is a minor form of this disease and rarely has any symptoms.
allergen
Substance creating a hypersensitivity (allergic) reaction
matrix
Substance that surrounds and protects cells, is manufactured by the cells, and holds cells together
incompatible
Substances that interfere with each other physiologically
endarterectomy
Surgical removal of plaque from an artery
arterial pulsese
The pulse is always part of a clinical examination because it can provide information about heart rate, heart rhythm, and the state of the arterial wall by palpation (Figure 6.17). The most easily accessible artery is the radial artery at the wrist, where the pulse is usually taken.
hemodynamics
The science of the blood flow through the circulation
Lymphatic Organs (LO 7.2 and 7.10) Spleen (LO 7.2 and 7.10)
The spleen, a highly vascular and spongy organ, is the largest lymphatic organ. It is located in the left upper quadrant of the abdomen, below the diaphragm and lateral to the kidney (Figure 7.16). The functions of the spleen are to: Phagocytose (consume) bacteria and other foreign materials. Initiate an immune response when antigens are found in the blood. Phagocytose old, defective erythrocytes and platelets. Serve as a reservoir for erythrocytes and platelets.
nutrition
The study of food and liquid requirements for normal function of the human body
Components of Blood
The study of the blood and its disorders—the red and white blood cells within the blood, their proportions, and overall cell health—is called hematology. A hematologist is a medical specialist who is trained in this area Blood is a type of connective tissue that consists of cells contained in a liquid matrix. If a blood specimen is collected in a tube and centrifuged, the cells of the blood separate out and fill the bottom 45% of the tube (see Figure 7.1). Ninety-nine percent of these cells are red blood cells (RBCs); white blood cells (WBCs) and platelets make up the remainder of this sample. The hematocrit (Hct) is the percentage of total blood volume composed of red blood cells. Plasma—a clear, yellowish liquid that is 91% water—makes up the remaining 55% of the blood sample in the tube. Plasma is a colloid, a liquid that contains floating particles, most of which are plasma proteins. Nutrients, waste products, hormones, and enzymes are dissolved in plasma for transportation. When blood clots, and the solid clot is removed, serum remains. Serum is a clear, yellowish fluid that contains all the blood proteins not used in clotting and all the electrolytes, antibodies, antigens, and hormones that are carried in blood.
circulatory system
The term circulatory system refers to your heart and blood vessels. It has two major divisions (see Figure 6.18): The pulmonary circulation, which carries deoxygenated blood from the heart to the lungs, and returns oxygenated blood to the heart; and The systemic circulation, which supplies oxygenated blood to every organ except the lungs, and then returns deoxygenated blood to the heart, which pumps it into the pulmonary circulation.
media-
middle
capillary/ capillaries
minute blood vessel between the arterial and venous systems
matern-
mother
effer-
move away from the center
affer-
move toward the center
efferent
moving away from a center
afferent
moving toward a center
-my/o-
muscle
my/o-
muscle
myocardium
muscular layer of the heart
neutr/o-
neutral
neo-
new
-amin(e)
nitrogen- containing substance
-amine
nitrogen- containing substance
in-
not
mis-
not, incorrect
nutri-
nourishment
-nucle-
nucleus
cardiogenic
of cardiac origin
ex-
out of
-ox-
oxygen
oxy-
oxygen
pallor
paleness of the skin
-stin-
partition
percutaneous
passage through the skin, in this case, by needle puncture
tamponade
pathologic compression of an organ, such as the heart
necrosis
pathologic death of cells or tissue
Disorders of Coagulation (Coagulopathies) (LO 7.3 and 7.7)
There are several disorders that can prevent the blood from clotting properly, and these can lead to further health problems. Hemophilia, in its classical form (hemophilia A), is a disease males inherit from their mothers. It results from a deficiency of the coagulation factor named factor VIII. Von Willebrand disease (vWD)—the most common hereditary bleeding disorder—is a protein deficiency of the factor VIII complex (vWF) that is different from the factor deficiency involved in hemophilia.
Systemic Venous Circulation
There are three major types of veins: Superficial, such as those you can see under the skin of your arms and hands; Deep, which run parallel to arteries and drain the same tissues that the arteries supply; and Venous sinuses, which are in the head and heart and have specific functions.
phlebotomist
person skilled in taking blood from veins
artery
Thick-walled blood vessel carrying oxygenated blood away from the heart
bacterial infections
Thousands of different bacteria can cause infections. Bacteria are single-celled microorganisms that reproduce by dividing. Frequently seen bacteria include: Staphylococcus ("staph"), which can be harmless when present on the skin's surface but causes infections in wounds or other normally sterile places, like in a joint or the peritoneum; Streptococcus ("strep"), which is a cause of sore throats; Pneumococcus, which is a cause of pneumonia; and Coliform bacteria that normally live in the GI tract but cause infections elsewhere, such as the urinary tract. In addition, methicillin-resistant Staphylococcus aureus (MRSA) is a type of bacteria that is resistant to the antibiotics normally used to treat staph infections. MRSA infections occur most frequently in hospitals (nosocomial infection), but are now being seen in community health care facilities as community-associated MRSA (CA-MRSA). Clostridium difficile (C.diff) infection is a growing problem in health care facilities, and the infection kills 14,000 people in America alone each year. When broad-spectrum antibiotics, such as clindamycin, have destroyed normal gut flora, C.diff can take over the gut and release toxins, causing severe diarrhea and abdominal pain that can be difficult to treat and can be life threatening or fatal. Carbapenem-resistant Enterobacteriaceae (CRE) is a lethal "superbug" occuring in American hospitals and responsible for about 9,300 infections and 610 deaths every year. The antibiotic carbapenem is considered a last-resort antibiotic for bacteria that have not responded to other antibiotics. In several cases the CRE has been found in duodenoscopes (see Chapter 9), the complex design of which which makes them difficult to clean and sterilize.
-ac
pertaining to
-al
pertaining to
-ale
pertaining to
-ant
pertaining to
-ar
pertaining to
-ary
pertaining to
-ate
pertaining to
-atic
pertaining to
-etic
pertaining to
-ial
pertaining to
-ic
pertaining to
-ious
pertaining to
-istic
pertaining to
-ous
pertaining to
-tic
pertaining to
-tous
pertaining to
al-
pertaining to
ic-
pertaining to
-ated
pertaining to a
-emic
pertaining to a blood condition
-emic
pertaining to a condition of the blood
fetal (adj)
pertaining to a fetus
macrocytic (adj)
pertaining to a large red blood cell
neoplastic (adj)
pertaining to a neoplasm
prosthetic
pertaining to a prosthesis
corpuscular
pertaining to a red blood cell
antiarrhythmic
pertaining to a restoring a normal cardiac rhythm
microcytic
pertaining to a small red blood cell
venous (adj)
pertaining to a vein
anaphylactic (adj)
pertaining to anaphylaxis
atrioventricular
pertaining to both the atrium and the ventricle
hypovolemic
pertaining to decreased blood volume in the body
-lytic
pertaining to destruction
diastolic
pertaining to diastole
myocardial
pertaining to heart muscle
lymphatic (adj)
pertaining to lymph or the lymphatic system
arteriosclerotic
pertaining to or affected by arteriosclerosis
necrotic
pertaining to or affected by necrosis (death)
ischemic
pertaining to or affected by the lack of blood supply to a tissue
maternal
pertaining to or derived from the mother
anemic
pertaining to or suffering from anemia
anoxic
pertaining to or suffering from lack of oxygen
interstitial
pertaining to spaces between cells in an organ or tissue
diaphoretic
pertaining to sweat or perspiration
systolic
pertaining to systole
aortic
pertaining to the aorta
brachial
pertaining to the arm
atria
pertaining to the atrium
atrial
pertaining to the atrium
endocardial
pertaining to the endocardium
epicardial
pertaining to the epicardium
inguinal
pertaining to the groin
cardiac
pertaining to the heart
cardiovascular
pertaining to the heart and blood vessels
pulmonary
pertaining to the lungs and their blood supply
pericardial
pertaining to the pericardium
-ate
pertaining to, composed of
regurgitate
To flow backward; e.g., blood through a heart valve
infect (verb)
To invade an organism by a microorganism
transplant
To transfer from one tissue or organ to another
transufion
Transfer of blood or a blood component from donor to recipient
fibrillation
Uncontrolled quivering or twitching of the heart muscle
petechia/ petechiae (pl)
pinpoint capillary hemorrhagic spot in the skin
-embol-
plug
tampon-
plug
-cusp-
point
-virus
poison
toxic-
poison
ather-
porridge, gruel
ather/o-
porridge, gruel
-dynam-
power
vaccine
preparation to generate active immunity
spherocytosis
presence of spherocytes in blood
coarct-
press together, narrow
-suppress-
press under
-man/o-
pressure
-tens-
pressure
-ation
process
-ion
process
-ism
process
caogulation
process of blood clotting
-ization
process of inserting
-ization
process of inserting or creating
-graphy
process of recording
-ergy
process of working
neoplasia
process to a neoplasm
incubation
process to develop an infection
-gen-
produce
-gen
produce, create
-gen
produce, create, form
pressor
producing increased blood pressure
-phylac-
protect
-immune
protected
immune-
protected from
immune
protected from an infectious disease
-phylaxis
protection
-globin
protein
-globin/o-
protein
-protein
protein
antibody/ antibodies (pl)
protein produced in response to an antigen
sphygm/o-
pulse
-ence
quality of
-ency
quality of
-ency
quality, state of
venogram
radiograph of veins after injection of radiopaque contrast material
urticaria
rash of itchy wheals (hives)
electrocardiogram
record of the electrical signals of the heart
-gram
recording
erythr/o-
red
erythrocyte
red blood cell
hemoglobin
red-pigmented protein that is the main component of red blood cells
specific
relating to a particular entity
-logous
relation
aspiration
removal by suction of fluid or gas from a body cavity
ablation
removal of a tissue to destroy its function
-oid
resemble
-oid
resembling
lymphoid
resembling lymphatic tissue
cardioversion
restoration of a normal heart rhythm by electric shock or medications
-rrhythm
rhythm
-rrhythm-
rhythm
-rhythm-
rhytm
cor pulmonale
right-sided heart failure arising from chronic lung disease
-drome
running
auto-
self, same
-morph/o-
shape
mitral
shaped like the headdress of a catholic bishop
microbe
short for microorganism
ino-
sinew
mono-
single
adenoid
single mass of lymphoid tissue in the midline at the back of the throat
sin/o-
sinus
-cutane-
skin
purpura
skin hemorrhages that are red initially and then turn purple
dorm-
sleep
-cle
small
-ole
small
-ule
small
micro-
small
-fibrill-
small fiber
fibrill-
small fiber
granul/o-
small grain
platelet (thrombocyte)
small particle involved in the clotting process
microcyte
small red blood cell
arteriole
small terminal artery leading into the capillary network
venule
small vein leading from the capillary network
lymphocyte
small white blood cell with a large nucleus
ech/o-
sound wave
interstiti-
space between cells
-ist
specialist
-ist
specialist in
hematologist
specialist in hematology
specif-
species
spher/o-
sphere
clostrid-
spindle
-splen-
spleen
splen-
spleen
splen/o-
spleen
-stasis
stand still
immunity
state of being protected
specificity
state of having a specific, fixed relation to a particular entity
-ity
state, condition
pace-
step
-glutin-
stick
agglutinate
stick together to form clamps
dilation
stretching or enlarging an opening
fibrin
stringy protein fiber that is a component of a blood clot
-compet-
strive together
-ium
structure
-um
structure
-logy
study of
-in
substance
antigen
substance capable of triggering an immune response
coagulant
substance that causes clotting
pollutant
substance that makes an environment unclean or impure
anticoagulant
substance that prevents clotting
-body
substance, body
infarction
sudden blockage of an artery
asthmatic (adj)
suffering from or pertaining to asthma
-ectomy
surgical excision
lymphadenectomy
surgical excision of lymph node(s)
-tomy
surgical incision
adenoidectomy
surgical removal of the adenoid tissue
atherectomy
surgical removal of the atheroma
splenectomy
surgical removal of the spleen
-plasty
surgical repair
-sud-
sweat
diaphor-
sweat
diaphoresis
sweat, perspiration, or sweaty
-glycer-
sweet, glycerol
edema-
swelling
systol-
systole, contraction
opportun-
take advantage of
ablat-
take away
-com-
take care of
-or
that which does something
cardiopulmonary resuscitation (CPR)
the attempt to restore cardiac and pulmonary function
endocardium
the inside lining of the heart
heme
the iron-based component of hemoglobin that carries oxygen
electrocardiography
the method of recording and the interpretation of electrocardiograms
sinus rhytm
the normal (optimal) heart rhythm arising from the senatorial node
epicardium
the outer layer of the heart wall
-dem-
the people
incompatibility
the quality of being incompatible
home/o-
the same
immunology
the science and practice of immunity and allergy
toxicity
the state of being poisonous
sclerosis (noun)
thickening or hardening of a tissue
tri-
three
Viral Infections (LO 7.12)
Viruses are the smallest of the microorganisms. They cannot be seen under an ordinary light microscope but are visible through electron microscope. Viruses spread from person to person through coughs, sneezes, and unwashed hands. Viruses cause specific childhood diseases like measles (rubeola), German measles (rubella), chickenpox (varicella), and mumps. They cause upper respiratory infections (see Chapter 8), including modern respiratory infections like severe acute respiratory syndrome (SARS), avian influenza (bird flu), and West Nile virus (WNV). WNV is a seasonal epidemic in North America that flares up in the summer and fall. Fungal Infections (LO 7.12) Many fungi are "good fungi," for example, the mushrooms that you eat and the yeasts that ferment beer and bread. Penicillin is derived from a fungus. The most common pathogenic fungi are those that cause skin infections (see Chapter 3). Opportunistic fungi are normally harmless, but like their name, they pounce on any opportunity to cause disease. People who are on prolonged doses of antibiotics, are receiving chemotherapy or immunosuppressive therapy, or have diabetes mellitus or AIDS are especially susceptible. Parasitic Infections (LO 7.12) Parasites are organisms that live on or in another organism and steal nourishment from their host. In many rural areas of the world, parasites are endemic. Malaria is caused by a parasite that is transmitted from person to person by a single mosquito bite. Pinworms are the most common parasite in America. Pinworm eggs are introduced into the body through the mouth and hatch in the intestine. The young worms migrate to the anus, where the female deposits her eggs. These eggs can be transferred unknowingly by the fingers from the anus or from infected bedding, to the mouth of the same child or to another child.
Lymphatic System (LO 7.10)
You live in a world that surrounds you with chemicals and disease-causing organisms waiting for a chance to enter your body and harm you. Your body has three lines of defense mechanisms against foreign organisms (pathogens), cells (cancer), or molecules (pollutants and allergens). Physical defense mechanisms include your skin and mucous membranes; chemicals in your perspiration, saliva, and tears; hairs in your nostrils; and cilia and mucus to protect your lungs. The physical defense mechanisms are further discussed in the individual body system chapters. Humoral defense mechanisms (see Lesson 7.3), based on antibodies (Abs). These are found in body fluids and bind to bacteria, toxins, and extracellular viruses, tagging them for destruction. Cellular defense mechanisms, based on defensive cells (lymphocytes). These directly attack suspicious cells like cancer cells, transplanted tissue cells, or cells infected with viruses or parasites. The lymphatic system has three functions: Absorb excess interstitial fluid and return it to the bloodstream; Remove foreign chemicals, cells, and debris from the tissues; and Absorb dietary lipids from the small intestines (see Chapter 9).
Functions of Blood (LO 7.4)
Your blood travels throughout your body while performing a number of important functions. Your blood: Maintains your body's homeostasis (see Chapter 2). Transports nutrients, vitamins, and minerals from your digestive system and storage areas to your organs and cells. Examples of nutrients are glucose and amino acids (see Chapter 9). Transports waste products from your cells and tissues to your liver and kidney for excretion. These waste products include creatinine, urea, bilirubin, and lactic acid. Transports hormones, like insulin and thyroxine (see Chapter 12), from your endocrine glands to target cells. Transports gases, like oxygen and carbon dioxide (see Chapter 8), to and from your lungs and cells. Protects against foreign substances, including microorganisms and toxins. Cells and chemicals in your blood are an important part of your immune system's protective properties. Forms clots. Clots provide protection against blood loss. Clotting is the first step in tissue repair and restoration of normal function.
blood flow through the heart
Your heart (Figure 6.6) has four chambers through which your blood flows. These chambers are the: Right atrium Right ventricle Left atrium Left ventricle Your right and left atria are separated by a thin muscle wall called the interatrial septum. Your right and left ventricles are divided by a thicker muscle wall called the interventricular septum. Your left ventricle pumps blood to all the parts of your body (except the lungs) through the systemic circulation. Oxygen (O2) and nutrients are delivered to your body's cells, and carbon dioxide (CO2) and metabolic waste products are removed from the cells. This deoxygenated blood, via the veins, returns to the heart where the right ventricle pumps blood into the pulmonary circulation to the lungs. In the lungs, the carbon dioxide waste material is exchanged for oxygen from inhaled air (Figure 6.5). This oxygenated blood then travels through the pulmonary veins back to the left side of the heart. You have four valves that work together to ensure the correct flow of blood through your heart; on the right side are the tricuspid and pulmonary valves, and on the left side are the mitral (bicuspid) and aortic valves
-emia
a blood condition
-suffix
a blood condition
node
a circumscribed mass of tissue
thrombus
a clot attatched to a diseased blood vessel or heart lining
occlusion
a complete obstruction
-emic
a condition in the blood
-emic
a condition of the blood
electrode
a device for conducting electricity
trait
a discrete characteristic that has a known quality
pathogen
a disease- causing microorganism
pericardium
a double layer of membranes surrounding the heart
neoplasm (noun)
a new growth, either a benign or malignant tumor
-ade
a process
-ation
a process
-gram
a record
corpuscle
a red blood cell
kaposi sarcome
a skin cancer often seen in AIDS patients
spherocyte
a spherical cell
index/ indices (pl)
a standard indicator of measurement
gurney
a stretcher on wheels used to transport hospital patients
septum/ septa
a thin wall dividing two cavities
bacterium/ bacteria (pl)
a unicellular, simple, microscopic organsim
agranulocyte
a white blood cell without any granules in its cytoplasm
discrimination
ability to distinguish between different things
thrombi (pl)/ thrombolytic (adj)
able to dissolve or break up a blood clot
-ibility
able to do
-sis
abnormal condition
hyper-
above, excessive
epi-
above, upon
asystole
absence of contractions of the heart
nosocomial
acquired while in the hospital
trans-
across
-ion
action
-ize
action
-ion
action, condition
-ion
actions, condition
vaccination
administration of a vaccine
immunization (noun)
administration of an agent to provide immunity
-ize
affect in a specific way
chronotropic
affecting the rate of rhythmic movements- in this case, the heart rate
anti-
against
diuretic
agent that increases urine output
vasoconstrictor
agent that reduces the diameter of a blood vessel
vasodilator
agents that increases the diameter of a blood vessel
pan-
all
dysrhythmia
an abnormal heart rhythm
streptokinase
an enzyme that dissolves clots
leukocytosis
an excessive number of white blood cells
prolapse
an organ slips out of its normal position
opportunistic
an organism or a disease in a host with lowered resistance
thrombocyte
another name for a platelet
leukocyte/ leucocyte (syn)
another term for a while blood cell
lymphadenopathy
any disease process affecting a lymph node(s)
lymphoma
any neoplasm of lymphatic tissue
microorganism
any organism too small to be seen by the naked eye
aort-
aorta
infarct
area of cell death resulting from an infarction
-farct-
area of dead tissue
brahci-
arm
peri-
around
-thet-
arrange
-arter-
artery
arteri-
artery
arteri/o-
artery
arteriosus
artery
prosthet-
artificial part
asthm-
asthma
-lateral
at the side
-atri-
atrium
-phil
attraction
-philia
attraction
dis-
away from
re-
back
retro-
backward
dys-
bad, difficult
bas/o-
base
basophil
basophil's granules attract a basic blue stain in the laboratory
pro-
before
-is
belonging to
hypo-
below
hypo-
below, deficient
hypoxia
below-normal levels of oxygen in tissues, gases, or blood
sub-
beneath
par-
beside, abnormal
inter-
between
interatrial
between the atria of the heart
interventricular
between the ventricles of the heart
hem/o-
blood
hemat-
blood
hemat/o-
blood
-thromb-
blood clot
thromb/o-
blood clot
-emia
blood condition
blood pressure
blood pressure is the force the blood exerts on arterial walls as it is pumped around the circulatory system by the left ventricle. The pressure is measured using a sphygmomanometer and a stethoscope, usually at the brachial artery
-vascul-
blood vessel
angi/o-
blood vessel
vas/o-
blood vessel
vein
blood vessel carrying blood toward heart
coronary circulation
blood vessels supplying the heart muscle
cyanosis
blue discoloration of the skin, lips, and nail beds due to low blood oxygen
corpus-
body
lipoprotein
bonding of molecules of fat and protein
rupture
break or tear of any organ or body part
-genit-
bring forth
synthetic
built up or put together from simpler compounds
-ible
can do
-able
capable
catheter-
catheter
cava
cave
-cyt/o-
cell
-cyte
cell
-cyth-
cell
fibroblast
cell that forms collagen fibers
atrium
chamber where blood enters the hearten both the right and left sides
-tropic
change
-version
change
mutation
change in the chemistry of a gene
varices (pl)/ varicose (adj)
characterized by or affected with varices
-in
chemical compound, substance
-stern-
chest
steth/o-
chest
thorac-
chest, cavity, hollow
circulat-
circular route
lymph-
clear, spring water
thrmb/o-
clot
thromb/o-
clot
caogul-
clot, clump
caogul/o-
clotting
-coagul-
clump
hematoma (bruise)
collection of blood that has escaped from vessels into surrounding tissues
oxyhemoglobin
combination of hemoglobin and oxygen
-ate
composed of, pertaining to
-esis
condition
-ia
condition
-ism
condition
-ity
condition
-osis
condition
arrhythmia
condition when the heart rhythm is abnormal
-ion
condition, action
-ity
condition, state
-systol/e-
contraction
systole
contraction of the heart muscle
hemostasis
control of stopping bleeding
-stasis
control, stop
-gen
create
coron-
crown, coronary
strepto-
curved
cyan-
dark blue
eosin/o-
dawn
necr-
death
necr/o-
death
hypovolemia
decreased blood volume in the body
anemia
decreased number of blood cells
humoral immunity
defense mechanism arising from antibodies in the blood
-penia
deficiency
pancytopenia
deficiency of all types of blood cells
thrombocytopenia
deficiency of platelets in circulating blood
hypoxic
deficient in oxygen
hist-
derived from histidine
-lyt-
destroy
-lysis
destruction
-trophy
development
pacemaker
device that regulates cardiac electrical activity
doppler
diagnostic instrumetn that sends an ultrasonic beam into the body
diastol-
diastole
varix
dilated, tortuous vein
diastole
dilation of heart cavities, during which they fill with blood
-path-
disease
-pathy
disease
nos/o-
disease
path/o-
disease
hemoglobinopathy
disease caused by the presence of an abnormal hemoglobin in red blood cells
cardiomyopathy
disease of the heart muscle, the myocardium
coagulopathy (coagulopathies) (pl)
disorder of blood clotting
-lysis
dissolve
thrombolysis
dissolving of a thrombus (clot)
-crimin-
distinguish
-edema
edema
-cubit-
elbow
electr-
electricity
electr/o-
electricity
-ent
end result, pertaining to
thymus
endocrine gland located in the mediastinum
splenomegaly
enlarged spleen
-megaly
enlargement
cardiomegaly
enlargement of the heart
-suffic/i-
enough
atri-
entrance, atrium
atri/o-
entrance, atrium
-kinase
enzyme
asthma
episodes of breathing difficulty due to narrowed or obstructed airways
palpation
examination with the fingers and hands
ana-
excessive
hyper-
excessive
incompetence
failure of a valve to close completely
immunodeficiency
failure of the immune system
-defici-
failure, lacking
lip/o-
fat
atheroma (plaque)
fatty deposit in the lining of an artery
-sensitiv-
feeling
fet-
fetus
fetal-
fetus
fibr/o-
fiber
-gurgit-
flood
humor-
fluid
serum
fluid remaining after removal of blood cells and the formation of a clot
plasma
fluid, noncellular component of blood
-plas-
formation
-ant
forming
-ant
forming, pertaining to
tetra-
four
de-
from, out of
-ose
full of
lipid
general term for fatty compounds
aden-
gland
-globul-
globular, protein
-glutin-
glue
coll-
glue
-granul/o-
granule
inguin-
groin
capill-
hairlike structure
arteriosclerosis
hardening of the arteries
atherosclerosis
hardening of the arteries due to atheroma (plaque)
-scler/o-
hardness
scler-
hardness
scler/o-
hardness
-id
having a particular quality
-ide
having a particular quality
bicuspid
having two points; a bicuspid heart valve has two flaps
-cardi-
heart
-cardi/o-
heart
cardi-
heart
cardi/o
heart
cardi/o-
heart
-blast
immature cell
-blast-
immature cell
anaphylaxis
immediate severe allergic response
immun-
immune
immun/o-
immune
autoimmune
immune reaction directed against a person's own tissue
alloimmune
immune reaction directed against foreign tissue
immun/o-
immune response
-immune
immunity
en-
in
im-
in
in-
in
antecubital
in front of the elbow
ante-
in front of, before
dormat
inactive
-tom-
incise, cut
-itis
inflammation
lymphadenitis
inflammation of a lymph node(s)
phlebitis
inflammation of a vein
thrombophlebitis
inflammation of a vein with clot formation
myocarditis
inflammation of the heart muscle
endocarditis
inflammation of the lining of the heart
pericarditis
inflammation of the pericardium, the covering of the heart
sclerotherapy
injection of a solution into a vein to thrombus it
-plant-
insert
-plant
insert, plant
endo-
inside
-ator
instrument
defibrillator
instrument for defibrillation
stethoscope
instrument for listening to respiratory and cardiac sounds
sphygmomanometer
instrument for measuring arterial blood pressure
-scope
instrument for viewing
-scope
instrument to examine
-meter
instrument to measure
claudication
intermittent leg pain and limping
-enter-
intestine
infusion
introduction intravenously of a substance other than blood
catheterization
introduction of a catheter
microscopy
investigation of minute objects through a microscope
-ics
knowledge
ischemia
lack of blood supply to a tissue
macro-
large
macrocyte
large red blood cell
monocyte
large white blood cell with a single nucleus
ductus
leading
-nici-
lethal
incub-
lie on, hatch
patent
lie open
-be
life
vita-
life
claudic-
limping
triglyceride
lipid containing three fatty acids
colloid
liquid containing suspended particles
hypo-
low
-pulmon-
lung
pulmon-
lung
lymph-
lymph
lymph/o-
lymph
lymphaden-
lymph node
lymphaden/o-
lymph node
lymph-
lymphatic system, lymph
lymphangi/o-
lymphatic vessels
electrocardiograph
machine that produces the electrocardiogram
aorta
main trunk of the systemic arterial system
poly-
many
poly-
many, much
-oma
mass, tumor
immunologist
medical specialist in immunology
hematology
medical speciality of the blood and its disorders
palpit-
throb
di-
through
per-
through
chron/o-
time
lymphedema
tissue swelling due to lymphatic obstruction
ag- (ad)-
to
ag-
to (same as ad-)
vaccinate
to administer a vaccine
aspirat-
to breathe on
-carriage-
to carry
immunize (verb)
to cause to be resistant to an infectious disease
occlude
to close, plug, or completely obstruct
diffuse
to disseminate or spread out
palpate
to examine with the fingers and hands
-scopy
to examine, to view
-plasm
to form
sclerose (verb)
to harden or thicken
catheterize
to introduce a catheter
isch-
to keep back
-fusion
to pour
perfus-
to pour
-graph
to record
-crit
to seperate
absorb
to take in
syn-
together
con-
together, with
-compat-
tolerate
-lingu-
tongue
-tag-
touch
palpat-
touch, stroke
-therapy
treatment
-oma
tumor, mass
bi-
two
leuk-
white
leuk/o-
white
polymorphonuclear
white blood cell with a multi lobed nucleus
dilat-
widen, dilate, open up
-dilat-
widen, open up
stent
wire-mesh tube use to keep arteries opne
col-
with, together
con-
with, together
phlebotomy
withdrawing blood from a vein through a needle or catheter
end-
within
endo-
within
a-
without
an-
without
anoxia
without oxygen
a-
without, not
-erg-
work
disorders of arteries
An aneurysm is a localized dilation of an artery, and this commonly occurs in the abdominal aorta (Figure 6.21). Aneurysms can rupture, leading to severe bleeding and hypovolemic shock. Surgical repair consists of excision of the aneurysm and replacement with a synthetic graft. Intracranial aneurysms are an important cause of bleeds into the cranial cavity and brain tissue. Thromboangiitis obliterans (Buerger disease) is an inflammatory disease of the arteries with clot formation, usually in the legs. The occlusion of arteries and impaired circulation lead to intermittent pain when walking, and a person will often limp to compensate. Raynaud disease is episodes of spasm (following exposure to cold) of the small arteries supplying the fingers, hands, and feet. It can be associated with connective tissue disorders like scleroderma and lupus. Carotid artery disease affects the carotid arteries—the two major arteries supplying the brain. They can be involved in arteriosclerosis and the deposition of plaque. This puts the patient at risk for a stroke. A carotid endarterectomy can be performed to surgically remove the plaque.
broad-spectrum
An antibiotic with a wide range of activity against a variety of organisms
eosinophil
An eosinophil's granules attract a rosy-red color on staining
Cardiologic Investigations and Procedures
Blood Tests (LO 6.2, 6.3, and 6.5) A lipid profile helps determine the risk of CAD and comprises: Total cholesterol; High-density lipoprotein (HDL) ("good cholesterol"); Low-density lipoprotein (LDL) ("bad cholesterol"); and Triglycerides. Troponin I and T are part of a protein complex in muscle that is released into the blood during a muscle injury. Troponin I is found in heart muscle but not in skeletal muscle, which makes it a highly-sensitive indicator of a recent MI. Diagnostic Tests (LO 6.3, and 6.5) Several diagnostic tests are used to measure heart health. An electrocardiogram (ECG or EKG) is a paper record of the electrical signals of your heart. Cardiac stress testing is an exercise tolerance test that raises your heart rate through exercise (like jogging on a treadmill) and monitors its effect on cardiac function. Nuclear imaging of the heart, which involves the injection of a radioactive substance, can be used with the stress test. Echocardiography uses ultrasound waves to study cardiac function. Magnetic resonance imaging (MRI) can produce detailed images of the heart and identify sections of cardiac muscle that are not receiving an adequate blood supply. Cardiac catheterization detects pressure and blood flow patterns in the heart. A thin tube is inserted into a vein or artery and is then threaded into the heart under X-ray guidance. A coronary angiogram uses a contrast dye injected during cardiac catheterization to identify coronary artery blockages. Treatment Procedures (LO 6.3, and 6.5) The most immediate need in the treatment of MI is to get blood and oxygen to the affected myocardium. This can be attempted in several ways: Injection of clot-busting (thrombolytic) drugs: These drugs are injected within 3½ hours of the MI to dissolve the thrombus. Artery-cleaning angioplasty (percutaneous transluminal coronary angioplasty, or PTCA): A balloon-tipped catheter is guided to the blockage site and inflated. The inflated balloon expands the artery from the inside by compressing the plaque against the artery's walls. Stent placement: To reduce the likelihood that the artery will close up again (occlude), a wire-mesh tube, or stent, is placed inside the vessel. Drug-eluting stents are covered with a special medication to help keep the artery open. Cardioversion and defibrillation have been discussed earlier. Radiofrequency ablation uses a catheter with an electrode in its tip that is guided into the heart to destroy cells from which abnormal cardiac rhythms are originating. Coronary artery bypass surgery (CABG): Healthy blood vessels harvested from the leg, chest, or arm are used to bypass (detour) the blood around blocked coronary arteries. Heart transplant: The heart of a recently deceased person (donor) is transplanted into the recipient after the recipient's diseased heart has been removed.
occult blood
Blood that cannot be seen in the stool but is positive on a fecal occult blood test
autologous
Blood transfusion with the same person as donor and recipient—self-transfusion
Congenital Heart Disease (CHD)
CHD is the result of an abnormal development of the heart in the fetus. Common congenital defects or abnormalities can usually be surgically repaired, and can include the following: Atrial septal defect (ASD) is a hole in the interatrial septum (Figure 6.15). Ventricular septal defect (VSD) is a gap in the interventricular septum (Figure 6.15). Patent ductus arteriosus (PDA) arises from a failure of the ductus arteriosus (a normal blood vessel in the fetus) to close within 24 hours of birth. Coarctation of the aorta is a narrowing of the aorta anywhere along its length. This causes hypertension in the arms behind the narrowing and hypotension in the lower limbs and organs (like the kidney) below the narrowing. Tetralogy of Fallot (TOF) is a syndrome in which four congenital heart defects prevent enough blood from reaching the lungs. TOF occurs in about 5 out of every 10,000 newborns. Babies and children with TOF have episodes of cyanosis and are often called "blue babies." Treatment is with open heart surgery soon after birth or in infancy.
congestive heart failure (CHF)
CHF occurs when the heart is unable to supply enough cardiac output to meet the body's metabolic needs, and the blood backs up to congest the lungs. The most common conditions leading to CHF are: Cardiac ischemia Severe hypertension Valvular regurgitation Aortic stenosis Cardiomyopathy
infectious (adj)
Capable of being transmitted to a person; or a disease caused by the action of a microorganism
ventricle
Chamber of the heart (pumps blood) or a cavity in the brain (produces cerebrospinal fluid)
pernicious anemia
Chronic anemia due to lack of vitamin B12
aneurysm
Circumscribed dilation of an artery or cardiac chamber
syndrome
Combination of signs and symptoms associated with a particular disease process
histamine
Compound liberated in tissues as a result of injury or an immune response
aplastic anemia
Condition in which the bone marrow is unable to produce sufficient red cells, white cells, and platelets
hypersplenism
Condition in which the spleen removes blood components at an excessive rate
von willebrand
E.A. von Willebrand, Finnish physician, 1870-1949
hypersensitivity
Exaggerated abnormal reaction to an allergen
edema
Excessive accumulation of fluid in cells and tissues
immunosuppression
Failure of the immune system caused by an outside agent
case report
Infectious mononucleosis occurs in the 15- to 25-year-old population. Its cause—the Epstein-Barr virus (EBV)—is a very common virus and a member of the herpes family. The EBV is transmitted by an exchange of saliva, such as a kiss. Leukemia is cancer of the blood-forming tissues and produces a high number of leukocytes and their precursors. The leukemic cells multiply, taking over the bone marrow and causing a deficiency of normal red blood cells, white blood cells, and platelets. This makes the patient anemic and vulnerable to infection and bleeding. In leukopenia, the WBC count drops below 5,000 cells per cubic millimeter of blood. Leukopenia is seen in viral infections like measles, mumps, chickenpox, poliomyelitis, and AIDS. In pancytopenia, the erythrocytes (red blood cells), leukocytes (white blood cells), and thrombocytes (platelets) in the circulating blood are all noticeably reduced. This can occur with cancer chemotherapy. Hemostasis (LO 7.3 and 7.7) Hemostasis, the control of bleeding, is a vital issue in maintaining homeostasis, the state of the body's equilibrium. Uncontrolled bleeding can offset the body's balance by decreasing blood volume and lowering blood pressure. Platelets (also called thrombocytes) play a key role in hemostasis. They are minute fragments of large bone marrow cells and consist of a small amount of granular cytoplasm surrounded by a plasma membrane. They have no nucleus. Hemostasis is achieved through a three-step process: Vascular spasm, an immediate but temporary constriction of the injured blood vessels. Platelet plug formation, an accumulation of platelets that bind themselves together and adhere to surrounding tissues. The binding and adhesion of platelets are mediated through von Willebrand factor (vWF), a protein produced by the cells lining the blood vessels. Blood coagulation is the process of going through prothrombin and thrombin to the formation of a blood clot that traps blood cells, platelets, and tissue fluid in a network of fibrin (Figure 7.9). After a blood clot forms, platelets adhere to strands of fibrin and contract to pull the fibers and the edges of the broken blood vessel together. Fibroblasts invade the clot to produce a fibrous connective tissue that seals the blood vessel.
microscope
Instrument for viewing something small that cannot be seen in detail by the naked eye
infection (noun)
Invasion of the body by disease-producing microorganisms
Location of the Heart
It is important to know precisely where the heart is located so that you can perform effective cardiopulmonary resuscitation (CPR). The heart is located in the thoracic cavity between the lungs, in an area called the mediastinum (Figure 6.1a). The heart is shaped like a blunt cone, pointing down and to the left. It rests at an angle with the majority of its mass to the left of the sternum
insufficiency
Lack of completeness of function; e.g., a heart valve that fails to close properly
endemic
Pertaining to a disease always present in a community
idiopathic
Pertaining to a disease of unknown etiology
disorders of the vein
Our veins and arteries can be prone to certain disorders, like the DVT experienced by Mrs. Jones in the preceding case report. Thrombophlebitis is an inflammation of the lining of a vein, allowing clots (thrombi) to form. Deep vein thrombosis (DVT) is a thrombus formation in a deep vein. The increased pressure in the capillaries due to back pressure from the blocked blood flow in the veins creates a collection of fluid in the tissues called edema. A major complication of thrombus (clot) formation is that a piece of the clot can break off (embolus) and be carried in the bloodstream to another organ where it can block blood flow. It often lodges in the lungs, causing a pulmonary embolus or mass (see Chapter 8). Varicose veins are superficial veins that have lost their elasticity and appear swollen and tortuous (Figure 6.20). Their valves become incompetent, and blood flows backward and pools. Smaller, more superficial varicose veins are called spider veins. Treatments offered include laser technology and sclerotherapy, in which solutions that scar the veins are injected into them. Collateral circulations develop to take the blood through alternative routes. A phlebotomist is a technician who draws blood (phlebotomy).
hematocrit
Percentage of red blood cells in the blood
hypertension
Persistent high arterial blood pressure
hypotension
Persistent low arterial blood pressure
pandemic
Pertaining to a disease attacking the population of a very large area
the heartbeat
The actions of the four heart chambers are coordinated. When the atria contract (atrial systole), the ventricles relax (ventricular diastole). When the atria relax (atrial diastole), the ventricles contract (ventricular systole). Then the atria and ventricles all relax briefly. This series of events is a complete cardiac cycle, or heartbeat. The "lub-dub, lub-dub" sounds heard through the stethoscope are made by the heart valves snapping as they close. If there is an abnormality in valve closure, it will produce an extra, abnormal sound called a murmur.
sinoatrial node
The center of modified cardiac muscle fibers in the wall of the right atrium that acts as the pacemaker for the heart rhythm
functions of the circulatory system
The circulatory system has the following three functions: Transportation. It carries oxygen, nutrients, hormones, and enzymes that diffuse from the blood into the cells. Waste products and carbon dioxide diffuse back from the cells into the system and are carried to the lungs, liver, and kidney for excretion. Homeostasis maintenance. The systemic circulation directs blood flow to the tissues to enable them to meet their metabolic needs. Blood pressure regulation. In the systemic circulation, the arteries' ability to expand and contract in coordination with the systole and diastole of the heartbeat maintains a steady flow of blood and blood pressure to the tissues.
Complement Fixation (LO 7.2 and 7.11)
The complement system is a group of 20 or more proteins continually present in blood plasma. Immunoglobulins bind to foreign cells, initiating the binding of complement to the cell and leading to its destruction.
structure of the heart
The heart wall consists of three layers (Figure 6.2): Endocardium: Connective tissue lining the inside of your heart. Myocardium: Cardiac muscle cells that contract to enable your heart to pump blood. Epicardium: An outer single layer of cells overlying a thin layer of connective tissue. The pericardium is a double-layered connective tissue sac that surrounds and protects your heart.
the immune system
The immune system is a group of specialized cells in different parts of the body that recognize and neutralize foreign substances. It is the third line of defense listed earlier in this chapter. When the immune system is weak, it allows pathogens, including the viruses that cause common colds and flu, and cancer cells, to successfully invade the body. Three characteristics distinguish immunity from the first two lines of defense of physical and cellular mechanisms: Specificity: The immune response is directed against a specific pathogen. Immunity to one pathogen does not grant immunity to others. Specificity has one disadvantage; if a virus or a bacterium changes a component of its genetic code, it then becomes a new organism to the immune system. This mutation occurs, for example, with bacteria in response to antibiotics and in HIV's response to anti-HIV drugs (development of resistance). Memory: When exposure to the same pathogen occurs again, the immune system recognizes the pathogen and has its responses ready to act quickly. Discrimination: The immune system learns to recognize agents (antigens) that represent "self" and agents (antigens) that are "nonself" (foreign). Most of this recognition is developed prior to birth. A variety of disorders occur when this discrimination breaks down. They are known as autoimmune disorders. An antigen is any molecule that triggers an immune response. Most antigens are unique in their structure. It is this uniqueness that enables your body to distinguish its own (self) molecules from foreign (nonself) molecules.
Disorders of the Immune System (LO 7.11)
The immune system is prone to very serious disorders, from allergic reactions to life-threatening infections. Hypersensitivity is an excessive immune response to an antigen that would normally be tolerated. In most allergic (hypersensitivity) reactions, allergens (antigens) stimulate the cells to produce histamine. The symptoms produced by these changes include edema, mucus hypersecretion and congestion, watery eyes, and hives (urticaria). Hypersensitivity includes: Allergies—reactions to environmental antigens like pollens, molds, dusts, foods, and drugs. Autoimmune disorders—abnormal reactions to your own tissues. Alloimmune disorders—reactions to tissues transplanted from another person. Anaphylaxis is an acute, immediate, and severe allergic reaction, which can be relieved by antihistamines. Anaphylactic shock is more severe and is characterized by difficulty in breathing (dyspnea) due to bronchiole constriction, circulatory shock, and even death. It is a life-threatening medical emergency. Asthma is triggered by allergens, listed above, and by air pollutants, drugs, and emotions. Bronchioles constrict spasmodically (bronchospasm), leading to the wheezing and coughing of asthma. Autoimmune disorders are an over-vigorous response of the immune system. Here, the immune system fails to distinguish self-antigens from foreign antigens. These self-antigens produce autoantibodies that attack the body's own tissues. This type of response occurs, for example, in lupus erythematosus, type 1 diabetes, multiple sclerosis, rheumatoid arthritis, and psoriasis. Immunodeficiency disorders are a deficient response of the immune system where it fails to respond vigorously enough. These disorders are classified into three categories: Congenital (inborn) disorders are caused by a genetic abnormality that is often sex-linked, with boys affected more often than girls. An example is inherited combined immunodeficiency disease, characterized by an absence of both T cells and B cells (Figure 7.19). These children are very susceptible to opportunistic infections and must live in protective sterile enclosures. Immunosuppression is a common side effect of corticosteroids used in treatment to prevent transplant rejection and in chemotherapy treatment for cancer. Acquired immunodeficiency results from diseases like acquired immunodeficiency syndrome (AIDS), which involves a severely depressed immune system from infection with the human immunodeficiency virus (HIV).
Diagnostic Procedures for Blood Disorders (LO 7.3, 7.4, 7.5, 7.6, 7.7, and 7.9)
The patient's medical and family histories and physical examination are most important tools in diagnosing blood disorders. A complete blood count (CBC) gives important information about the types and numbers of cells in the blood, enabling diagnosis of the cause of such symptoms as weakness, fatigue, and bruising. Included in the CBC is the number of red blood cells; if the count is low, anemia could be present, and if the count is high, polycythemia can be the diagnosis. If the total amount of hemoglobin in the blood and the hematocrit are both low in the CBC, anemia is present. A red blood cell index, the mean corpuscular volume (MCV), shows the average size of the red blood cells. If the cells are small (microcytic), the most common cause is an iron-deficiency anemia. If the cells are large (macrocytic), a possible cause is pernicious anemia. A white blood cell (WBC) count is usually included in a CBC along with the numbers and types of the different WBCs, a WBC differential. These tests give the pathologists and clinicians who read the tests critical information about the body's response to infection, toxic medicines, chemicals, and allergens and show many other conditions, such as leukemia. Also included in a CBC is the number of platelets. A low platelet count can indicate idiopathic thrombocytopenic purpura (ITP). There are more than a dozen coagulopathies (bleeding disorders), and the diagnostic procedures to determine the cause of a patient's abnormal bleeding include the CBC, a bleeding time, prothrombin time (PT), and partial thromboplastin time (PTT), which help define where deficiencies might lie in the clotting process. The combination of all these tests is called a coagulation panel. Other diagnostic procedures for blood disorders include a blood smear, in which a drop of blood is smeared on a slide, stained, and examined under a microscope to determine the size and shape of RBCs, WBCs, and platelets. A bone marrow aspiration (biopsy) is a procedure used to define the production of the different blood cells. In disorders of the lymphatic system, the essential diagnostic procedure is biopsy of an enlarged lymph node. This can be followed by x-rays, CT scans, and MRI scans to determine the spread of a disease such as lymphoma.
Thymus (LO 7.2 and 7.10)
The thymus, a small organ of the immune system located in the center of the upper chest, has both endocrine (see Chapter 12) and lymphatic functions. T lymphocytes develop and mature in the thymus and are released into the bloodstream. The thymus is largest in infancy (Figure 7.17a) and reaches its maximum size at puberty. It then shrinks (Figure 7.17b) and is eventually replaced by fibrous and fatty (adipose) tissue.
Tonsils and Adenoids (LO 7.2 and 7.10)
The tonsils (see Chapter 8) are two masses of lymphatic tissue located at the entrance to the upper part of the throat (the oropharynx) that entrap inhaled and ingested pathogens. Adenoids are similar tissues on the posterior wall of the upper pharynx or nasopharynx (see Chapter 8). The tonsils and adenoids form lymphocytes and antibodies, trap bacteria and viruses, and drain them into the tonsillar lymph nodes for elimination. Both the tonsils and the adenoids can also become infected.
venae cavae
The two largest veins in the body (superior and inferior venae cavae)
ABO Blood Group (LO 7.3 and 7.8)
The two major antigens on the cell surface are antigen A and antigen B. A person with only antigen A has type A blood. A person with only antigen B has type B blood. A person with both antigen A and antigen B has type AB blood. A person with neither antigen has type O blood and is a universal donor, able to give blood to any other person. Specific antibodies are synthesized in the plasma during the first 8 months after birth: Whenever antigen A is absent, anti-A antibody is produced. Whenever antigen B is absent, anti-B antibody is produced. Figure 7.11 shows the different combinations of antigens and antibodies in the different blood types. Rh Blood Group (LO 7.3 and 7.8) If an Rh antigen is present on the red cell surface, the blood is said to be Rh-positive (Rh+). This is common, as about 85% of people are Rh-positive. If there is no Rh antigen on the surface, the blood is Rh-negative (Rh−), which is the case for the other 15% of the population. If an Rh-negative person receives a transfusion of Rh-positive blood, anti-Rh antibodies will be produced. This can cause RBC clumping (agglutination) and destruction (hemolysis). If an Rh-negative woman and an Rh-positive man conceive an Rh-positive child (Figure 7.12a), the placenta normally prevents maternal and fetal blood from mixing. However, at birth or during a miscarriage, fetal cells can enter the mother's bloodstream. These Rh-positive cells stimulate the mother's tissues to produce Rh antibodies (Figure 7.12b). If the mother becomes pregnant with a second Rh-positive fetus, her Rh antibodies can cross the placenta and agglutinate and hemolyze the fetal red cells (Figure 7.12c). This causes hemolytic disease of the newborn (HDN, or erythroblastosis fetalis). Hemolytic disease of the newborn due to Rh incompatibility can be prevented. The Rh-negative mother giving birth to an Rh-positive child should be given Rh-immune globulin (RhoGAM). Other causes of hemolytic disease in newborns include ABO incompatibility, incompatibility in other blood group systems, hereditary spherocytosis, and infections acquired before birth.
Types and Functions of White Blood Cells (Leukocytes) (LO 7.3 and 7.6)
The types of white blood cells (WBCs) can be categorized as granulocytes or agranulocytes. Granulocytes contain a granular cytoplasm, made up of granules, which are sites for enzyme and chemical production. Agranulocytes do not contain cytoplasmic granules.
Therapeutic Procedures for Blood Disorders (LO 7.4, 7.5, 7.6, 7.7, and 7.9)
n anemia, treatment consists of replacing any deficiency in the production of hemoglobin, such as iron or vitamin B12. For hemolytic and aplastic anemias, the treatment is to define and remove the toxin, drug, or radiation source that is causing the destruction of, or inability of the bone marrow to produce, red cells. A bone marrow transplant is the transfer of bone marrow from a healthy, compatible donor to a patient with aplastic anemia, leukemia, lymphoma, or other disease. Several drugs affect blood clotting. Aspirin is given in small 81-mg doses to reduce platelet adherence and agglutination. Heparin, given parenterally, acts quickly to prevent prothrombin and fibrin formation. Warfarin (Coumadin), given orally, also acts to prevent prothrombin and fibrin formation, and its effect is monitored by PT blood tests. Dabigatran etexilate (Pradaxa) and other similar compounds are given orally as anticoagulants in cases of non-valvular auricular fibrillation (see Chapter 6) to prevent blood clots from forming and embolizing. Streptokinase dissolves the fibrin in blood clots, and, if given intravenously within 3 to 4 hours of a heart attack, is often effective in dissolving the clot that has caused the heart attack. Tissue plasminogen activator (TPA) binds to fibrin and also dissolves clots that have caused heart attacks.
-constrict-
narrow
sten/o-
narrow
vena cava
one of the two largest veins in the body
-maker
one who makes
-logist
one who studies, specialist
-organ-
organ, instrument
all-
other, strange
all/o-
other, strange
echocardiography
ultrasound of heart function
pollut-
unclean
sub-
under
substernal
under (behind) the sternum or breastbone
sublingual
underneath the tongue
idi/o-
unknown
epi-
upon, above
-uret-
urination
vaccin-
vaccine, giving a vaccine
varic-
varicosity; dilated, tortuous vein
spleen
vascular, lymphatic organ in left upper quadrant or abdomen
-phleb-
vein
phleb-
vein
phleb/o-
vein
ven-
vein
ven/a
vein
ven/o-
vein
-ventricul-
ventricle
retrovirus
virus with RNA core
microscopic
visible only with the aid of a microscope
-vol-
volume
-ode
way, rode
attenu-
weaken
attenuate
weaken the ability an organism to produce disease
attenuated
weakened