Bio Ch. 18-20

Using a typical electrocardiogram for EKG tracing be able to Label the three major waves including the P wave, QRS complex and T-wave, identify the heart activity that produces each wave.

When the P wave appears atrial contraction/atrial systole is happening. During the QRS wave there's contraction of the ventricles which is also called ventricular systole. Repolarization of the ventricular fibers then the T wave and then the ventricular relaxation/diastole.

Trace the pathway blood follows as it flows through the heart, and distinguish between systemic circulation and pulmonary circulation.

Blood enters the superior vena cava, into the right atrium, through tricuspid valve into the right ventricle up and out the pulmonary artery into the lungs. From the lungs blood come in through the pulmonary vein through the left atrium through the bicuspid valve into the left ventricle through the aortic valve and into the aorta which goes through the body.

Define intravascular clotting and explain the difference between a thrombus and an embolus..

Intravascular clotting is a rare condition that affects the blood ability to clot and stop bleeding. A thrombus is a blood clot that is formed within the vascular system of the body and it impends blood flow. An embolism is an obstruction of an artery, typically by a clot of blood or an air bubble.

Describe progenitor cells and precursor cells.

Progenitor cells are similar to a stem cell but are already more specific and have a target cell that they will differentiate into. Precursor cells are stem cells that have developed to the stage where they are committed to forming a particular new blood cell.

What are the formed elements of blood?

Red blood cells - erythrocytes white blood cells -leukocytes platelets -thrombocytes.

Describe the physiology of a red blood cell

Red blood cells contain an oxygen carrying protein called hemoglobin. Red blood cells main role is to carry oxygen through the body from the lungs.

Describe the basic structure of a blood vessel by describing the three tunics that comprise blood vessel walls: tunica interna, tunica media and tunica externa.

The tunica interna is the inner lining in direct contact with blood. The tunica media is a muscular and connective layer and the tunica externa is elastic and collagen fibers that help anchor the vessel to surrounding tissue.

Briefly discuss blood distribution and blood reservoirs.

Blood distribution: Oxygenated arterial blood (red) and deoxygenated venous blood (blue) are distributed around the body. A blood reservoir is an organ or vessel that holds large proportions of blood, and veins are vessels termed as the blood reservoirs of the body. This is because they hold the largest amount of blood,

Describe the heart sounds and site the cardiac events responsible for those sounds.

'LUB' which is when the AV valves close. 'Dupp' which is when the SL valves close.

Describe the anatomy of a red blood cell.

A red blood cell is called an erythrocyte. Erythrocytes are red, biconcave disc, with no nucleus or organelles and have no mitochondria.

Discuss the following regarding arteries: a. Basal vasoconstriction and Vasodilation b. Elastic arteries and their function as pressure reservoirs c. Muscular arteries and their function as distributing arteries.

A.) Vasodilation, the widening of blood vessels Vasoconstriction is the narrowing (constriction) of blood vessels by small muscles in their walls. B.)Arteries have elastic walls that enable them to act as a pressure reservoir. The elastic arteries distend when the ventricles eject blood from the heart C.)A muscular artery (or distributing artery) is a medium-sized artery that draws blood from an elastic artery and branches into "resistance vessels" including small arteries and arterioles.

Describe the three stages involved in platelet plug formation, include the roles of ADP, thromboxane A2, and serotonin.

Adhesion is the first stage and it is stimulated by damaged tissue, pseudopods stick to damaged vessels. The second stage is called release reaction and it is when activated platelets interact with one another and release vesicle contents, release serotonin and ADP. Aggregation is the third stage and that is when ADP and thromboxane a2 activate adjacent platelets. This forms a mass of platelets helping to plug the hole.

Describe the sequence of events making up the cardiac cycle.

All the events associated with one heartbeat. Systole and diastole of the atria and ventricles in each cycle. The atria and ventricles alternating contracting and relaxing which forces blood from a higher pressure to a lower pressure.

Describe the formation of thrombocytes (platelets) from Megakaryocytes and the role of Thrombopoietin plays in the process

Megakaryocyte splinters into 2000-3000 fragments. Thrombopoietin is a glycoprotein hormone produced by the liver and kidney which regulates the production of platelets.

What is the developmental formation of RBCs? (Erythropoiesis)

Myeloid Stem Cell -> Proerythroblast -> Reticulocyte -> Mature Erythrocyte

Explain the significance of variations in cardiac (myocardial) thickness.

Myocardium is sexist near the ventricles because that is where the heart needs to create a lot of pressure to pump blood into the aorta and throughout systemic circulation.

Describe how the presence or absence of the Rh antigens on red blood cells determines whether a person is classified as RH positive or RH negative.

People who is red blood cells have the Rh antigen Rh positive people who lack the Rh antigen Rh negative.

Describe the following functions of white blood cells: phagocytosis, chemo taxis, immune responses, and emigration or diapedesis.

Phagocytosis is described as cell eating. Diapedesis is when blood cells migrate through the intact walls of blood vessels into surrounding tissue. Chemotaxis is when there is movement of an organism in response to chemical stimuli. The general function of white blood cells is to combat invaders by phagocytosis or immune responses.

What is the difference between blood plasma and formed elements?

Plasma is the liquid portion of blood. Formed elements are cells and cell fragments in blood.

Define pulse and explain how and where it is measured.

Pulse refers to a pressure wave that expands and recoils the artery when the heart contracts/beats. It is palpated at many points throughout the body. The most common locations to accurately assess pulse as part of vital sign measurement include radial, brachial, carotid, and apical pulse

Purpose of bone marrow transplants. Benefits of cord-blood transplants.

Purpose of BONE-MARROW TRANSPLANTS are to replace cancerous cells with non cancerous cells which will establish normal RBC counts. The benefits of a CORD-BLOOD TRANSPLANT is the stem cells.

Define the following terms related to the blood clotting process: serum, clot, clotting, clotting factors.

Serum is blood plasma minus the clotting proteins. Clotting is a series of chemical reactions culminating in formation of fibrin threads. A clot is a thick mass of coagulated liquid especially blood. Clotting factors are several in active enzymes, various molecules associated with platelets or released by damage tissues.

Compare the structure and components of a cardiomyocytes to the skeletal muscle fiber

Skeletal muscle is voluntary and response to conscious stimuli. Cardiac muscle is involuntary and found only in the heart.

Explain the concept of cardiac output, be able to use stroke volume and heart rate to calculate cardiac output and define cardiac reserve.

Stroke volume (SV) - amount ejected from one ventricle with one beat Heart rate (HR) - the number of beats per minute CO = stroke volume (SV) x heart rate (HR)

Describe hemoglobin breakdown products which include transferrin ferritin Bilirubin urobilinogen and stercobilin

TRANSFERRIN is a blood plasma glycoprotein that plays a role in iron metabolism. FERRITIN is a protein produced that helps iron in tissues. BILIRUBIN is an orangey yellow pigment formed in the liver by the breakdown of hemoglobin and is excreted in bile. Non-iron him ends as yellow pigment called UROBILIN in your in or brown pigment in STERCOBILIN which is in feces.

Distinguish between the atrioventricular valves and the semi lunar valve's in terms of location, structure, and function. Include a description of how the chordae tendineae and papillary muscles help control AV valve function.

The atrioventricular valves are a tricuspid valve and mitral(bicuspid) valve. They are located between the atria and the corresponding ventricle. Semi lunar valve's: the pulmonary valve and aortic valve. They are located between the ventricles and their corresponding artery, and regulate the flow of blood leaving the heart. The mitral and tricuspid valve's are supported by the attachment of fibrous chords called chordae tendineae. The Chordae tendineae are attached to papillary muscles, located on the interior surface of the ventricles, these muscles contract during ventricular systole to prevent prolapse of the valve leaflets into the atria.

Describe how each of the following helps regulate blood pressure a. Cardiovascular center, B. Neural regulation, C. Hormonal regulation

The cardiovascular center can alter heart rate and stroke volume to increase blood pressure and flow. Neurological regulation of blood pressure and flow depends on the cardiovascular centers located in the medulla oblongata. This cluster of neurons responds to changes in blood pressure as well as blood concentrations of oxygen, carbon dioxide, and other factors such as pH The kidneys provide a hormonal mechanism for the regulation of blood pressure by managing blood volume.

Describe the major functions of the heart

The heart is an organ that pumps blood throughout the body supplies oxygen and nutrients to the tissues and removes carbon dioxide and other waste

Describe the physical characteristics of blood including the pH, viscosity, volume and colors.

The pH of blood is 7.35 -> 7.45 Blood has a thick viscosity. The volume of blood is 55% plasma to 45% formed elements and there is 46 L of blood in the body. The colors of the erythrocytes are red, the color of leukocytes are white, and the plasma is yellow.

Name the major types of blood vessels an outline the pathway of blood follows as it travels through the arteries, arterials, capillaries, venules, and veins.

There are five main types of blood vessels there are arteries that carry blood away from the heart, arterials, capillaries which are the site of gas exchange, Daniels and veins which carry blood to the heart.

Identify the sources of ATP used by cardiac muscle.

These energy needs are met through mitochondria, myoglobins, and rich blood supply from the coronary arteries

Describe the developmental formation of white blood cells also called leukocytes.

They start as a Myeloid stem cell -> monocyte or Myeloid stem cell -> lymphoid cell -> B cell, T cell, or a NK Cell

Name three major functions of blood.

Transportation, regulation, and protection. The blood transports gases, nutrients, hormones and waste. It regulates your pH, body temperature and osmotic pressure. The blood also protects by clotting, containing white blood cells and carrying proteins.

List the type of antigen or antigens and the type of antibody or antibodies present in each ABO blood type.

Type a blood has antigen A and anti-B antibodies. Type B blood has only antigen B and anti-A antibodies. Type AB blood has antigens A and B with no antibodies. Type O blood has no antigens with both A and B antibodies.

Compare the generation of action potentials in cardiomyocytes to that of skeletal muscle muscle fibers.

Unlike the action potential in skeletal muscle cells, the cardiac action potential is not initiated by nervous activity. Instead, it arises from a group of specialized cells, that have automatic action potential generation capability

Describe the role of vitamin K in the clotting process.

Vitamin K is used to make clotting factors II, IV, IX & X

Name the major components of plasma.

Water and solutes. The solute's include albumin, globulins, and fibrinogen. The solute also include electrolytes, nutrients, enzymes, hormones, gases and waste products.

3 Primary mechanisms involved in Hemostasis when a hemorrhage occurs

1.) VASCULAR SPASM- Smooth muscle in artery or arteriole wall contracts. 2.) PLATELET PLUG FORMATION- platelets stick to damaged parts of a damaged blood vessel and accumulate in large numbers. 3.) BLOOD CLOTTING

1.)Explain the particular importance of bulk flow in capillary exchange and discuss the following regarding flow: A.)the difference between filtration and reabsorption, B.)pressures that favor filtration like blood hydrostatic pressure and interstitial fluid asthmatic pressure, C.)pressures of favor reabsorption like colloid osmotic pressure and interstitial fluid hydrostatic pressure, D.)calculation and interpretation of net filtration pressure, E.)and Starlings Law of the capillaries

1.)Bulk flow is more important for the regulation of relative volumes of blood and interstitial fluid. A.)Filtration is going from the capillaries to move into interstitial fluid and reabsorption is when things move from the interstitial fluid into the capillaries. B.)Blood hydrostatic pressure (BHP) is generated by pumping actions in the heart. Interstitial fluid osmotic pressure (IFOP) is generated by solutes in the interstitial fluid. C.)Blood colloid osmotic pressure (BCOP) promotes reabsorption, due to the presence of blood plasma proteins to large to cross walls, avg is 28mmHg. Interstitial fluid hydrostatic pressure (IFHP) is close to 3 mmHg D.) NFP=(BHP+IFOP)-(BCOP+IFHP) E.)Nearly as much reabsorbed as filtered.

how to calculate the time of one complete cardiac cycle

60(seconds) / HR = Cardiac Cycle

Describe how the wall of the heart is constructed including the following layers: epicardium, myocardium, and endocardium.

Epicardium (outside) is visceral pericardium that has a smooth slippery texture. Myocardium (middle)- 95% of the heart is cardiac muscle.Endocardium (inside) is smooth lining for chambers of the heart, valves and continuous with lining of the large blood vessels.

Discuss the following regarding veins: a. Compare the wall of the vein to a wall of an artery. B. Compare lumen of a vein to lumen of an artery. C. Role in blood pressure. D. Valves. E. Vascular (venous) sinus.

A.) The walls of veins have the same three layers as the arteries. Although all the layers are present, there is less smooth muscle and connective tissue. This makes the walls of veins thinner than those of arteries, which is related to the fact that blood in the veins has less pressure than in the arteries. B.) Veins are generally larger in diameter, carry more blood volume and have thinner walls in proportion to their lumen. Arteries are smaller, have thicker walls in proportion to their lumen and carry blood under higher pressure than veins. C.)The contraction of skeletal muscles surrounding a vein compresses the blood and increases the pressure in that area D.)valves which fold in on the tunica interna and they aid and venous return by preventing backflow E.)Venous sinus, in human anatomy, any of the channels of a branching complex sinus network that lies between layers of the dura mater, the outermost covering of the brain, and functions to collect oxygen-depleted blood.

Distinguish between blood types and blood groups.

ABO blood groups are based on A and B antigens. Blood Types are based on Rh factors

Define arrhythmia and describe different types of heart arrhythmias that result from defects in the conduction system. Includes these terms bradycardia, tachycardia, first, second, and third degree heart block, flutter, and fibrillation

An arrhythmia is an abnormal rate of muscle contractions within the heart. Bradycardia is an abnormally slow heartbeat. Tachycardia is an abnormally rapid heartbeat. Fibrillation is muscular twitching. A flutter is a type of heart rhythm disorder in which the hearts upper chambers of the atria beat too quickly. When you have a heart block there's interference with the electrical signals that usually move from the Airdrie at Yardley to the ventricles these are in three different levels first which is the least severe second degree and there is a third- degree which is the most severe.

Describe the role of Anastomoses in collateral circulation.

Anastomosis is the union of the branches of two or more arteries supplying the same body region. It provides alternate routes which is called collateral circulation.

Define anemia. Give five examples of anemia and the medical cause of each one.

Anemia is a deficiency of red blood cells. Polycythemia is an increase concentration of hemoglobin in the blood. Pernicious anemia is a deficiency in production of red blood cells through a lack of vitamin B12. Leukopenia is a reduction in the number of white blood cells. Thrombocytopenia is the deficiency of platelets in blood.

Explain the role of surface antigens on red blood cells in determining blood groups.

Antigens stimulate an immune response which will protect a person from the wrong blood.

Describe the role of arterials in regulation of blood flow from the arteries into the capillaries, including the function of precapillary sphincter's.

Arterials are abundant microscopic vessels. A metarteriole has precapillary sphincters which monitor blood flow into the capillary.

Define blood flow and describe four factors that influence blood flow such as blood pressure, vascular resistance, venous return, and velocity of blood flow.

Blood flow refers to the movement of blood through the vessels from arteries to the capillaries and then into the veins. blood pressure increases and blood flow decreases. Vascular resistance is the resistance that must be overcome to push blood through the circulatory system and create flow. Venous return (VR) is the flow of blood back to the heart. The rate, or velocity, of blood flow varies inversely with the total cross-sectional area of the blood vessels. As the total cross-sectional area of the vessels increases, the velocity of flow decreases.

Describe the chambers of the heart including the blood vessels and valves associated with each chamber

Blood flows through the right atrium and through the tricuspid valve into the right ventricle and up and out into the lungs and blood gets pumped back in through the left atrium through the mitral valve/bicuspid valve and into the left ventricle through the aortic valve and out into the aorta.

Explain how blood pressure is measured. Include definitions of the following: sphygmomanometer systolic blood pressure and diastolic blood pressure Korotkoff sounds and pulse pressure.

Blood pressure is the force that blood exerts against a vessel wall. It's measured at a brachial artery of the arm using a sphygmomanometer and listen for Korotkoff sounds. Systolic pressure is peak arterial blood pressure taken during ventricular contraction or ventricular systole. Diastolic pressure is the minimum arterial blood pressure taken during ventricular relaxation or diastole between heartbeats.

Define capillary exchange and describe the three methods by which capillary exchange occurs which will include diffusion, transcytosis and bulk flow.

Capillary exchange refers to the exchange of material from the blood into the tissues in the capillary. Diffusion, the most widely-used mechanism, allows the flow of small molecules across capillaries. Transcytosis is the mechanism whereby large, lipid-insoluble substances cross the capillary membranes. Bulk flow is a passive process in which a large number of ions, molecules, or particles in a fluid route together in the same direction.

Discuss the following regarding capillaries: explain how the composition of capillary walls differ from that of other blood vessels. Micro circulation. Capillary beds. Three types of capillaries : the continuous, the fenestrated, and sinusoids.

Capillary walls are thin enough to exchange gases such as gas between blood and interstitial fluid. They go through something called micro circulation which is when the flow from the matter cheerio through capillaries and into post capillaries annual. The capillary beds arise from a single met arterial. There are three types of capillaries: the first type is a continuous capillary, which is when an endothelial cell membrane forms a continuous tube. A fenestrated capillary has fenestrations or pores, such as in the kidneys in small intestines. sinusoid capillaries are wider and more winding, usually they have large fenestrations and you can find them in bone marrow, the spleen and liver.

Describe how cardiac action potential's propagate through the auto rhythmic fibers that make up the conduction system of the heart. Include the following in your explanation SA node, AV node, AV bundle, and right and left bundle branches, Purkinje fibers.

Cardiac action potential is a brief change in voltage across the cell membrane of heart cells the action potential passes along the cell membrane causing the cell to contract. The SA node fires and excitation spreads through the atrial myocardium. Then the AV node fires and excitation spreads down the AV bundle and then the Purkinje fibers distribute excitation through the ventricular myocardium

Describe clot retraction.

Clot retraction is the shrinking of a blood clot over a number of days.

Briefly describe coronary circulation and its major vessels.

Coronary circulation is the circulation of blood in the blood vessels that supply the heart muscle. Coronary arteries supply oxygenated blood to the heart muscle and cardiac veins drain away the blood once it has been deoxygenated.

Describe the stages depolarization, plateau, repolarization, and the roles of ions.

Depolarization - The cells of the heart will depolarize without an outside stimulus Plateau - plateau phase of the cardiac action potential. Membrane permeability to calcium increases during this phase, maintaining depolarization and prolonging the action potential. Repolarization - termination of the action potential then occurs, as potassium channels open, allowing K+ to leave the cell and causing the membrane potential to return to negative, this is known as repolarization

Explain negative feedback regulation of red blood cell formation.

During negative feedback control there is a drop in red blood cell count which causes kidney hypoxemia. This causes the kidneys to produce erythropoietin, which stimulates the bone marrow. The red blood cells increase within 3 to 4 days.

Explain: fetal circulation. include placenta, umbilical cord, ductus venousus, foraman ovale, and ductus arteriosus.

During pregnancy, the fetal circulatory system works differently than after birth: The fetus is connected by the umbilical cord to the placenta. This is the organ that develops and implants in the mother's uterus during pregnancy. Through the blood vessels in the umbilical cord, the fetus gets all needed nutrition and oxygen. The fetus gets life support from the mother through the placenta. Waste products and carbon dioxide from the fetus are sent back through the umbilical cord and placenta to the mother's circulation to be removed. The shunt that bypasses the lungs is called the foramen ovale. This shunt moves blood from the right atrium of the heart to the left atrium. The ductus arteriosus moves blood from the pulmonary artery to the aorta. ... Most of this blood is sent through the ductus venosus.

Explain how platelets differ structurally and functionally from the other formed elements.

Each platelet fragment is enclosed in a piece of plasma membrane. Disc shaped w/no nucleus. Helps stop blood loss by forming a platelet plug. Granules contain blood clotting chemicals.

Define edema and relay edema to bulk flow.

Edema is a condition characterized by an excess of watery fluid collecting in the cavities or tissues of the body.

Explain how the intrinsic pathway and the X transit pathway differ, include the role of tissue factor.

Extrinsic means that something is coming from outside where is intrinsic means that something is coming from the inside. Tissue factor or thromboplastin leaks into the blood from cells outside or extrinsic to blood vessels and initiates the formation of Prothrombinase.

Describe the structure and functions of the pericardium: fibrous pericardium, serous pericardium, parietal and visceral layers, pericardial cavity, and the pericardial fluid

Fibrous pericardium is tough, dense irregular connective tissue that prevents over stretching, protection, anchorage. Serous pericardium is thinner, more delicate membrane and has a double layer. The parietal layer is fused to the fibrous pericardium and the visceral layer also called the epicardium. Pericardial fluid reduces friction and is secreted into the pericardial cavity.

What is the difference between granular and agranular white blood cells? What are the different types of white blood cells?

Granular means that there are many granuals. The white blood cells that are granular are neutrophils, eosinophils, and basophils. Agranular means that there are little to no granules within the cell. The two white blood cells that are agranular are lymphocytes and monocytes.

List and explain the major factors that regulate heart rate.

Heart rate is controlled by the two branches of the autonomic (involuntary) nervous system. The sympathetic nervous system (SNS) and the parasympathetic nervous system (PNS). The sympathetic nervous system (SNS) releases the hormones (catecholamines - epinephrine and norepinephrine) to accelerate the heart rate.

What is the structure and role of hemoglobin?

Hemoglobin is an iron containing protein that transports oxygen to the tissues. GLOBIN has four polypeptide chains. HEME with an iron in each of those chains

Describe the medical cause of hemolytic disease of the newborn and explain the role of agglutination and hemolysis in the disease process.

Hemolytic disease of the newborn happens if blood from an Rh+ fetus contacts Rh- mother during birth, anti-Rh antibodies will be made. This affects the second Rh+ baby. It can cause agglutination and hemolysis. Treatment is anti-Rh antibodies after every pregnancy.

Define hemopoiesis. Describe the formation of blood cells and include pluripotent stem cells, myeloid stem cells and lymphoid stem cells.

Hemopoiesis is defined as the formation of blood cells. Blood cells form from pluripotent stem cells in red bone marrow. Myeloid stem cells give rise to red blood cells, platelets, monocytes, neutrophils, eosinophils and basophils. Lymphoid stem cells give rise to lymphocytes.

Describe the common pathway in the blood clotting process and include the role of the following molecules: prothrombin, thrombin, fibrinogen and fibrin.

In the common pathway, prothrombinase converts prothrombin into thrombin. Thrombin converts to fibrinogen into fibrin, forming the threads of a clot.

What are the specific functions of each type of white blood cell?

Neutrophils are active phagocytes and respond quickest to tissue damage by bacteria. Eosinophils leave capillaries and enter tissue fluid. They release histamine usually due to allergies and parasites. Basophils leave capillaries and at the sites of information release granules containing heparin and histamine..

Considering both ABO and Rh, predict which blood types are compatible and what happens when the incorrect ABO or RH blood type is transfused.

O+ can receive O+ and O- A+ can receive O+, O-, A+,A- B+ can receive O+,O-, B+, B- AB+ can receive O+,O-, A+, A-, B+, B-, AB+, AB- O- can receive O- A- can receive O-, A- B- can receive O-, B- AB- Can receive O-, A-, B-, AB- Agglutination will happen if the incorrect blood is transfused. This means that the blood will clump up.

Define and explain the three major factors that regulate stroke volume including preload contractility and afterload.

Preload is the degree of stretch on the heart before it contracts. The Frank starling law of the heart is that the more the heart fills with blood during diastole, the greater the force of the contraction during systole. The next factor is called contractility and this the strength of the contraction that is given in any preload and the third factor is called afterload this is the pressure that must be over calm before a semi lunar valve can open.

Explain: Systemic Circulation Pulmonary Circulation and Hepatic Portal System

Systemic circulation carries oxygenated blood from the left ventricle, through the arteries, to the capillaries in the tissues of the body. The pulmonary circulation is the portion of the circulatory system which carries deoxygenated blood away from the right ventricle, to the lungs, and returns oxygenated blood to the left atrium and ventricle of the heart. The hepatic portal system is the system of veins comprising the hepatic portal vein and its tributaries. It is responsible for directing blood from the region of the gastrointestinal tract between the esophagus and rectum

Identify four major circulatory pathways in the body, explain their purpose

The Heart: keeps the circulatory system working at all times. Arteries: carry oxygen-rich blood away from the heart and where it needs to go. Veins: carry deoxygenated blood to the heart where it is directed to the lungs to receive oxygen. Blood: the transport media of nearly everything within the body. It transports hormones, nutrients, oxygen, antibodies, and other important things needed to keep the body healthy.

Describe the three major stages in the blood clotting process.

The first stage of the blood clotting process as a vascular spasm The second stage is the platelet plug formation The third and final step is blood clotting or coagulation.

Describe the location of the heart

The heart is located in the thoracic cavity in the mediastinum

What are the major components of the cardiovascular system?

The major components of the cardiovascular system are connected tissue, blood plasma and formed elements.