The blood
What are the steps of hemostasis?
1) Vasoconstriction 2) Temporary platelet plug (primary hemostasis) 3) Coagulation (secondary Hemostasis) 4) Fibrinolysis: dissolves clot and restores function 5) Regeneration & repair
If the anti-A antibody causes the blood to coagulate, which antigen would be present on the blood cells?
A
If your bone marrow is producing an elevated number of red blood cells, what happens to your hematocrit?
A person may experience dizziness and headaches, which can be a sign of the condition polycythemia.
(a) Prostacyclin (b) Plasmin (c) ADP d) Fibrin e) Thrombin f) Factor X g) Factor XII H) Factor XIII
A) Inhibits platelet aggregation B) Fibrinolytic enzyme C) Causes platelets to aggregate in positive-feedback fashion D) Forms meshwork of the clot E) Activates fibrinogen F) activates prothrombin/ activated by tissue thromboplastin G) First factor activated in intrinsic clotting pathway H) Stabilizes the clot
What are the three main parts of the formation of a platelet plug?
ADHESION, ACTIVATION and AGGREGATION
What do activated platelets release?
ADP, serotonin, thromboxane A2
What are lymphoid tissues?
Are lymphocyte containing tissues such as the lymph nodes and tonsils
What kind of globulin are the coagulation factors?
Beta
How does hemoglobin bind to oxygen?
Can combine reversibly with one molecule of O2 --> can pick up four O2 passengers in the lungs. Because O2 is poorly soluble in the plasma, 98.5% of the O2 carried in the blood is bound to hemoglobin
What is primary polycythemia and what causes it?
Caused by a tumor-like condition of the bone marrow in which erythropoiesis proceeds at an excessive, uncontrolled rate instead of being subject to the normal erythropoietin regulatory mechanism
What is the Rhesus system?
Classifies blood as Rh-positive or Rh-negative.
What is the role of thrombin?
Converts fibrinogen to fibrin Activates the factor XIII to stabilize the fibrin net FAcilitates its own formation (positive feedback) Enhances platelet aggregation--> essential to clotting process
What are some characteristics of neutrophils?
Cytoplasm granules with lysosomal enzymes and bactericides (hydrogen peroxide & superoxide) Phagocyticelevated in bacterial infections multi-lobed nuclei (3-5 lobes)
What does plasma consist of?
Erythrocytes (RBCs), leukocytes (WBCs) and platelets (thrombocytes)
What are the major steps of erythropoiesis?
Erythrocytes are derived in the red bone marrow from pluripotent stem cells that give rise to all the types of blood cells. Myeloid stem cells are partially differentiated cells that give rise to erythrocytes and several other types of blood cells. Nucleated erythroblasts are committed to becoming mature erythrocytes. These cells extrude their nucleus and organelles, making more room for hemoglobin. Reticulocytes are immature red blood cells that contain organelle (mostly ribosome) remnants. Mature erythrocytes are released into the abundant capillaries in the bone marrow.
How does EPO work?
Erythropoietin acts on erythrocyte forerunners, stimulating their proliferation and maturation into mature erythrocytes that are released into the blood
Hemoglobin can carry only O2 true or false?
False
White blood cells spend most of their time in the blood. (True or false?)
False
What are T lymphocytes?
HELPER T CELLS: T lymphocytes that orchestrates cellular immunity by direct contact with other immune cells and by releasing chemical called lymphokines: also helps mediate the humoral response by interacting with B cells. SUPPRESSOR T CELLS: regulate T lymphocytes that suppress the immune system. CYTOTOXIC (killer) T CELLS: effector T cell that directly kills foreign cells.
What is a special aspect of hematopoietic stem cells?
Have the ability to differentiate themselves into erythrocytes, leukocytes and platelets
What is neutrophilia?
Helps the defense and indicates the infection
How is erythropoiesis controlled?
Hormonally (EPO) from the kidneys
What is a possible diagnosis for patients with chest pain?
Increased ESR in myocardial infarction, normal in angina (ischemia)
Which of the following is not directly triggered by exposed collagen in an injured vessel? a. initial vascular spasm b. platelet aggregation c. activation of the clotting cascade d. activation of plasminogen
Initial vascular spasm
What does exposed collagen do?
Initiates platelet aggregation
What happens when there is an increased erythropoietic activity?
It elevates the number of circulating RBCs, thereby increasing O2-carrying capacity of the blood and restoring O2 delivery to the tissues to normal
If your bone marrow is producing an elevated number of red blood cells, whats happens to your hematocrit?
It increases
What is the benefit of the secretion of PF3 from aggregated platelets do?
It is essential for the clotting cascade that in turn enhances further platelet aggregation
The hormone erythropoietin stimulates red blood cell production in the red bone marrow. Where in the body is erythropoietin produced?
Kidney
An increased white blood cell count is indicative of which disease?
Leukemia
Most clotting factors are synthesized in the
Liver
The type of leukocyte produced primarily in lymphoid tissue is....
Lymphocytes
What are the sub categories of mononuclear agranulocytes?
Lymphocytes and Monocytes
What is the erythrocyte sedimentation rate test?
Measures the erythrocyte sedimentation rate in a vertical, stationary pipette during the first hour (or even the second hour) after blood sampling
Platelets are formed from what type of cell?
Megakaryocytes
What are normal values of hematocrit in adults?
Men: 41 - 53%, Women: 36 - 46%
Since only a small part of total lymphocytes are in transit in the blood stream what happens to the rest?
Most, continually recycle among the blood, lymph and lymphoid tissues
Does a person with type O blood have A or B antigens on the red blood cells?
Neither
Which of the following white blood cells is capable of phagocytosis? A) Lymphocytes B) Basophils C) Neutrophils D) Erythrocytes
Neutrophils
What are the subcategories of polymorphonuclear granulocytes?
Neutrophils, basophils and eosinphils
Female patients with acute abdominal pain could possibly have?
Normal ESR in the 1st 24 hours of acute appendicitis but elevated in the early stages of acute pelvic inflammatory disease or ectopic pregnancy
Why is hemoglobulin important in erythrocytes?
O2 transport while contributing significantly to CO2 transport and the pH-buffering capacity of blood helps deliver the O2 it is carrying.
What is thromboembolism?
Obstruction of a blood vessel by a blood clot that has become dislodged from another site in the circulation.
How is a platelet plug formed?
Once the platelets are activated, they become sticky and adhere to the inner lining of the injured blood vessel and stick together. The plug diminishes bleeding at the injured site. The plug is invaded by activated blood-clotting factors and evolve into a strong blood clot
What diseases cause an increase in ESR?
Polycythemia Congestive heart failure Chronic obstructive pulmonary disease At high altitudes
What is the intrinsic pathway?
Precipitates clotting within damaged vessels and clotting of blood samples in test tubes
What is the Roudeaux arrangement?
Production of fibrinogen and hemoglobin is increased and they cause the red blood cells to accumulate, that is, to be stacked, forming a column
What are lymphocytes?
Provide immune defense against targets for which they are specifically programmed - B-lymphocytes - T-lymphocytes
What is the extrinsic pathway?
Provides a tissue factor and then uses factro VIIa and VII to create the prthrombinase complex in the common pathway
What would happen to red blood cells if the haem group were removed from haemoglobin?
Red blood cells would not be able to bind oxygen.
What is the clotting cascade?
Series of steps involving 12 plasma clotting factors that lead to final conversion of fibrinogen into a stabilized fibrin mesh
How are leukocytes produced?
Stimulate by chemical messengers, which can act either as paracrines or hormones, are glycoproteins that fall into two families of hematopoietic factors, interleukins and colony-stimulating factors, or CSFs afre named for the leukocytes population they stimulate
What is a platelet plug?
The aggregation of platelets around the breakage to prevent blood loss
What is the ABO system?
The erythrocytes of people with type A blood contain A antigens, those with type B blood contain B antigens, those with type AB blood have both A and B antigens, and those with type O blood do not have any A or B red blood cell surface antigens.
What is hematocrit?
The ratio of the volume of red blood cells to the total volume of blood
What is the Rhesus factor?
The rhesus (RhD) antigen determines whether people are RhD positive (carry the RhD antigen) or RhD negative (absence of RhD antigen). Antibodies may develop in response to this antigen.
In abnormal conditions (bleeding) what happens to erythropoietin?
There is the release of reticulocytes into the circulation to quickly restore the needs of the body
Which of the following statements about erythrocytes is correct? a) They fight infection. b) They clot blood. c) They lack a nucleus. d) They are produced in the spleen.
They lack a nucleus
What is a special characteristics of platelets?
They lack nuclei but have organelles and cytosolic enzyme systems for generating energy and synthesizing secretory products, which they store in numerous granules dispersed throughout the cytosol
What is polycythemia?
Too many RBCs - Primary - Secondary
Which of the following is not a function of plasma proteins? a. facilitating retention of fluid in the blood vessels b. playing an important role in blood clotting c. transporting water-insoluble substances in the blood d. transporting O2 in the blood e. serving as antibodies f. contributing to the buffering capacity of the blood
Transporting O2 in the blood
What activates the intrinsic pathway?
When factor XII (Hageman factor) is activated by coming into contact with either exposed collagen in an injured vessel or a foreign surface such as a glass test tube
When does an elevated hematocrit occur?
When the body loses fluid but not erythrocytes, as in dehydration accompanying heavy sweating or profuse diarrhea
What is anemia?
a decrease in the oxygen-carrying ability of the blood
What is an important role of the platelet plug?
a)The actin-myosin complex within the aggregated platelets contracts to compact and strengthen the original loose plug b)The plug releases several powerful vasoconstrictors that induce profound constriction of the affected vessel to reinforce the initial vascular spasm c)The plug releases other chemicals that enhance blood coagulation
What is sickle cell disease?
abnormal hemoglobin: red blood cells are crescent shaped.
What is cell-mediated immunity?
an immune response that does not involve antibodies, but rather involves the activation of phagocytes, antigen-specific cytotoxic T-lymphocytes, and the release of various cytokines in response to an antigen.
What are platelets (Thrombocytes)?
are not whole cells but small cell fragments shed from the outer edges of extraordinarily large bone marrow-bound cells
What are the characteristics of Eosinophils?
bilobed nucleus moderate allergic reactions deep red granules in acid stain
What are the 2 main categories of leukocytes?
granulocytes and agranulocytes
Characteristics of the Intrinsic pathway
longer cascade --> slower but stronger and more efficient
How are platelets produced?
through a process called thrombopoiesis from precursor cells named megakaryocytes
How does blood help the defense of elements in the body?
- Antibodies production - Coagulation
What are plasma protiens?
- Are dispersed as a colloid - Partially responsible for plasma's capacity to buffer changes in pH -
What is blood?
- Living fluid tissue, composed of a wide variety of constituents and dissolved chemicals (carbohydrates, proteins, hormones, and gases: O2, CO2, N - Means of mass transport of materials over long distances between cells and extracellular environment
Where is the bone marrow located and what does it contain for hematopoiesis?
- Located in the epiphyses of long bones such as the humerus and femur - Contains undifferentiated stem cells
How does blood help the regulation of elements in the body?
- Maintainance of acid-base balance (pH) - Maintainance of temperature (thermoregulation) - Maintainance of H2O balance
What do each of ingredients of blood contribute as a function?
- Plasma: H2O transport, hormones electrolytes, antibodies, nutrients, metabolism byproducts, plasma proteins, coagulation factors - WBCs: defense - Platelets: hemostasis - Erythrocytes: transport of O2
What prevents innaproopitate clot formation?
- Platelet-repellent property of the endothelium, - Anticoagulant factors (Serpins and APC proteins) - Fibrinolysis cascade that dissolves blood clots after they are formed, - Fluidity of normal blood flow also helps dilute the small amount of thrombin that forms spontaneously
What are some main aspects of anemia?
- Reduced rate of erythropoiesis - Large erythrocyte loss - Decreased amount of hemoglobin in red blood cells
What is the lymphatic system?
- The network of vessels through which lymph drains from the tissues into the blood - The waste from the body is collected through the lymph vessels, it is filtered in the lymph nodes (lymphatic and defense system) and returns the lymph clean to the circulatory system (superior vena cava).
What do the factors of hematocrit depend on?
- The number of red blood cells - The average volume of blood cells - Plasma volume
How does blood help the transfer of elements in the body?
- Tranfer of O2 from the lungs to the tissues - Transfer of CO2 from the tissues to the lungs - Transfer of nutrients (digestive system to tissues) - Transfer of metabolic byproducts to the kidneys for excretion
What is netosis?
- unique form of cell death - NET: neutrophil extracellular traps - neutrophils kill microbes by their poisonous webs - neutrophils commit suicide and expel content in toxic RNA web - type of immunogenic cell death (not programmed)
What are the three main parts of the immune system?
1) Defends against invading disease-producing microorganisms (viruses and bacteria) 2) Functions as s "clean up" crew that removes worn-out cells and tissue debris, paving the way for wound healing and tissue repair 3) Identifies and destroys cancer
What are the steps of controlling erythropoiesis?
1) Kidneys detect reduced O2-carrying capacity of blood. Developing erythrocytes in red bone marrow 2) When less O2 is delivered to the kidneys, they secrete erythropoietin into blood. 3) Erythropoietin stimulates erythropoiesis by red bone marrow. 4) Additional circulating erythrocytes increase O2-carrying capacity of blood. 5) Increased O2-carrying capacity relieves initial stimulus that triggered erythropoietin secretion.
What factors affect ESR?
1) Number of red blood cells 2) Shape of red blood cells- macrocytosis of red blood cells increases ESR while microcytosis decreases ESR 3) Plasma Proteins: directly proportional to a) the amount of fibrinogen b) the amount of α, β, γ globin, inversely proportional to albumin 4) The amount of cholesterol in the blood: decreasing the amount of cholesterol causes an increase in ESR
What are the 6 types of anemia?
1) Nutritional anemia (eg iron deficiency anemia) 2) Malignant anemia (inability to absorb B12 from the digestive tract- ) 3) Aplastic anemia (insufficiency of marrow to produce red blood cells) 4) Renal anemia (affects erythropoietin production - stimulus of erythropoiesis) 5) Hemorrhagic anemia (losing a lot of blood) 6) Hemolytic anemia (rupture of red blood cells by external factors)
What is von Willebrand factor?
A plasma protein secreted by megakaryocytes, platelets and endothelial cells which adheres to the exposed collagen of the underlying endothelium of the damaged vessel
What is inappropriate clot formation?
An abnormal intravascular clot attached to a vessel wall is called thrombus and freely floating clots are known as emboli
What are the two circulatory systems that make up the human body?
The cardiovascular and lymphatic
Erythrocytes, leukocytes, and platelets all originate from the same undifferentiated stem cells. (True or false?)
True
What is a hemogloulin?
Two part molecule (1) the globin portion, a protein made up of four highly folded polypeptide chains (2) four iron- containing, nonprotein groups known as heme groups, each of which is bound to one of the polypeptides
What is hematopoiesis?
blood cell formation by hematopoietic stem cells in the bone marrow
Despite the constant conversion of fibrinogen into fibrin throughout the vasculature.... what happens?
clots do not develop
What is neutropenia?
decrease in neutrophils
What is secondary polycythemia?
erythropoietin-induced adaptive mechanism to improve the blood's O2-carrying capacity in response to a prolonged reduction in O2 delivery to the tissues. It occurs normally in people living at high altitudes, where less O2 is available in the air, or in people for whom O2 delivery to the tissues is impaired by chronic lung disease or cardiac failure.
What are white blood cells?
mobile units of the body's immune defense system which destroys or neutralizes materials that are "foreign" to the "normal self"
What are B lymphocytes?
produce antibodies which circulate in the blood and are responsible for antibody-mediated, or humoral immunity
What is the tissue plasminogen activator (tPA)?
produces a low level of plasmin activation in the absence of clotting- used to get rid of clots in heart attacks and strokes
What is erythropoiesis?
production of red blood cells
How does hemoglobin act as a buffer?
when CO2 enters a cell, it reacts with H2O (catalyzed by carbonic anhydrase) to form H2CO3, which decomposes into HCO3 and H+. Hemoglobin picks up the H+.
•Will the platelet plug continue to develop and expand? If yes, for how long?
•ADP released by the activated platelets stimulates the release of Prostacyclin and Nitric Oxide from the adjacent normal endothelium •Both these chemicals strongly inhibit platelet aggregation, thus the plug is limited to the defect and does not spread to the nearby healthy vascular tissue