Chapter 18 - The Circulatory System: Blood
What Leukocyte is present when fighting a parasite?
Eosinophils
What are the most abundant and critical formed elements?
Erythrocytes
What is the most abundant formed element?
Erythrocytes
___ are the only human cells that carry out anaerobic fermentation indefinitely.
Erythrocytes
At what point do hemophiliacs have a problem?
Factor VIII (because they lack this factor)
What is the prothetic group of hemoglobin?
Fe
Which type of dietary Iron can the stomach absorb?
Fe2+
Which major class of plasma proteins is absent from plasma serum?
Fibrinogen
Iron Metabolism
Figure 18.7
2.5% of adults hemoglobin is form ___.
HbA2
What happens to HbS at low O2 concentrations?
HbS does not bind O2 very well; it forms a gel and the sickled erythrocytes are sticky and agglutinate
How could a disease such as liver cancer or hepatitis result in impaired blood clotting?
It damages the liver, the producer of plasma proteins, and plasma proteins are key factors in the clotting process.
___ discovered blood types A, B, and O
Karl Landsteiner (he did not find AB)
What is the least abundant formed element?
Leukocytes
What is a reason for Leukocytes retaining their nucleus and organelles?
Leukocytes must synthesize proteins in order to carry out their functions
How do Leukocytes differ from Erythrocytes?
Leukocytes retain their nucleus and organelles (rough ER, ribosomes, Goli complex)
What Leukocyte is present when fighting cancer cells?
Lymphocytes
What is the second most abundant Leukocyte?
Lymphocytes
Which two Leukocytes are antigen-presenting cells?
Lymphocytes and Monocytes
What Leukocyte turns into a macrophage once out of the blood stream?
Monocytes
What are the largest WBCs seen on a blood slide?
Monocytes
How do you inhibit clotting?
Na binds up Ca (Ca is very important in coagulation)
What is the most abundant Leukocyte?
Neutrophils
What type of blood is the most common in the US?
O
hypoxemia
O2 deficiency in the blood
What is the second most abundant formed element?
Platelets (platelets are so small they contribute less than WBCs to blood volume)
___ is the most abundant plasma solute by weight.
Protein
Whole blood is more viscous than water because of its
RBC
Living at elevated climates can change a person's ___.
RBC count
Erythrocyte Homeostasis
RBC count drops → kidneys detect this drop → increase EPO output → 3-4 days later, RBC count begins to rise and reverse the hypoxemia that started the process
Endurance-trained athletes tend to have higher ___.
RBC counts
A ___ or ___ deficiency can cause blood to flow too easily.
RBC or Protein
Where do most megokaryocytes live?
RBM adjacent to blood-filled spaces /sinusoids/ lined with simple squamous epithelium called endothelium
What can be given to the mother to combat this reaction?
Rh immune globulin (RhoGAM and Gamulin Rh) • the immune globulin binds to fetal RBC Ag so they cannot stimulate the mothers immune system to produce anti-D
Major Proteins of the Blood Plasma
Table 18.3
Causes of Anemia
Table 18.4
Where do Lymphocytes go to mature if they do not stay in the RBM?
Thymus • mature lymphocytes from both locations then colonize the spleen, lymph nodes, and other lymphoid organs and tissues
T/F: There are other blood groups.
True: MN, Duffy, Kell, Kidd, and Lewis groups. (can be used in identifying paternal and criminal cases)
leukocytosis
a WBC count above 10,000
thalassemia
a blood disorder involving less than normal amounts of an oxygen-carrying protein
embolus
a clot that travels in the bloodstream
What type of cell can all formed elements trace their origin back to?
a common type of *hemopoietic stem cell (HSC)* found in the bone marrow • multipotent stem cells/ pluripotent stem cells
leukopenia
a count below the normal WBC count (5,000-10,000 WBCs/uL)
hemophilia
a family of hereditary diseases characterized by deficiencies in one clotting factor or another (predominately in male)
megakaryocyte
a gigantic cell, visible to the naked eye, with huge multi lobed nucleus and multiple sets of chromosomes
Injury to smooth muscle of the blood vessel itself causes:
a longer-lasting vasoconstriction, and platelets releasing serotonin (vasoconstrictor)
centrifuge
a machine that spins and separates blood into layers (ranging from least dense to most)
What do erythrocytes and platelets lack that leukocytes have?
a nucleus
Fibrinogen
a precursor to /fibrin/
gastroferritin
a protein produced by the stomach; binds Fe2+ and transports it to the small intestines
Which type of leukemia has found the most treatment and cure?
acute lymphoblastic leukemia
clot retraction
after a clot has formed, spinous pseudopods of the platelets adhere to stands of fibrin and contract-pulling on the fibrin threads and drawing the edges of the broken vessel together (like coin purse)
What is the smallest and most abundant plasma protein?
albumin
Another name for anti-A is?
alpha agglutinin
Copper is transported in the blood by ___.
an alpha globulin called /ceruloplasmin/
the *heme* group binds an O2 to:
an iron atom (Fe) at its center
Because they have no mitochondria-RBCs must rely on ___ to produce ATP
anaerobic fermentation-which prevents them from consuming the O2 they must carry to other tissues
a deficiency in either RBCs or hemoglobin
anemia
A person's ABO type can be determined using:
anti-A and anti-B serum
Rh blood type is testes by using?
anti-D reagent
Antibodies bind to antigens and mark them, another method of antibody action is agglutination, reputation of this process produces large ___.
antigen-antibody complexes
blod types are based on:
antigens and antibodies
The liver binds surplus Fe to a protein called ___, forming an Fe storage complex called ___.
apoferritin ; ferritin
People who are heterozygous for HbS
are carriers for sickle-cell disease
pernicious anemia
autoimmune disease in which antibodies destroy stomach tissue, causing B12 deficiency
Antibodies of the ABO group are produced mainly in response to:
bacteria that inhabit the intestines
Another name for anti-B is?
beta agglutinin
biliverdin and bilirubin are collectively known as ___.
bile pigments
___ & ___ require continual replacement
blood & blood plasma
pulmonary embolism
blood clots trapped in the lungs
What shears off proplatelets into platelets?
blood flow
myeloid hemopoiesis
blood formation in the bone marrow and lymphatic organs
lymphoid hemopoiesis
blood formation in the lymphatic organs
What stimulates early erythropoiesis and increases the number of reticulocytes circulating in the blood?
blood loss
The matrix of blood is ___.
blood plasma
A bleeding injury should be ___ rather than ___.
blotted, wiped
leukemia
cancer of the hemopoietic tissue that normally drastically increases WBC count and their precursors
formed elements
cells and cell fragments - membrane enclosed bodies with a definite structure visible under the microscope • RBC's • WBC's • Platlets
The ratio of formed elements to blood plasma can be seen by using a ___.
centrifuge
hemostasis
cessation of bleeding
Small Lymphocytes are most common seen in ___.
circulating blood
blood plasma
clear, light yellow fluid; also known as blood's matrix
thrombus
clot
procoagulants
clotting factors
coagulation
clotting of the blood
What is the last but most effective defense against bleeding?
coagulation
CFU's have receptors for ___.
colony-stimulating factors (CSFs) • mature lymphocytes and macrophages secrete serveral CSFs in response to infections; each CSF stimulates a different WBC type to develop
aplastic anemia is caused by:
complete cessation of erythropoiesis caused by complete failure or destruction of the myeloid tissue • leads to tissue necrosis & blackening of skin
antigens
complex molecules that are genetically unique to each individual (except identical twins)- they occur of the surface of all cells are help dustings self from non-self
plasma cells
connective tissue cells that are descended from white blood cells called B lymphocytes
What does to stomach acid have to do to Fe3+?
convert it to Fe2+
kallikrein
converts the inactivated protein /plasminogen/ into *plasmin* a fibrin-dissolving enzyme that breaks up the clot
polycythemia
dangerous excess of RBCs
What is responsible for the creamy color of pus?
dead neutrophils
What is more useful than a WBC count?
differential WBC count
Why are erythrocytes caved in at the center
differing opinions: • shape maximizes ratio of cell surface area to volume (promotes the quick transfer of O2 to all of the hemoglobin in the cell) • allows for smooth laminar flow in larger b.v. without turbulence • easiest, most stable shape for the cell and its cytoplasm to relax to when the nucleus is removed
An enlarge and tender spleen may indicate:
diseases in which RBCs are rapidly breaking down
primary polycythemia (polycythemia vera)
due to cancer or the erythropoietic lone of the red bone marrow • can result in a RBC count as high as 11 million RBCs/uL & hematocrit as high as 80%
Who is most likely to be anemic?
elderly
What is one example where hypoxemia cannot be corrected by erythropoiesis?
emphysema, where less lung tissue is available to oxygenate the blood
carbonic anhydrase
enzyme that catalyzes the reaction *CO2 + H2O ↹ H2CO3* • plays a role in gas transport and pH balance
Other plasma proteins are ___ involved in the ___ process.
enzymes, clotting process
Eosinophils are stained with ___.
eosin
erythropoiesis
erythrocyte production • takes 3-5 days
People who are homozygous for HbS
exhibit sickle-cell disease
HbF binds O2 more tightly than HbA, enabling the fetus to:
extract O2 from the mother's bloodstream
What pathway to coagulation is shorter and faster?
extrinsic mechanism (hemophiliacs break up tissue by rubbing to increase)
What form of hemoglobin do fetuses produce?
fetal hemoglobin (HbF)
Medium and large Lymphocytes are usually seen in ___.
fibrous connective tissue and only occasionally in circulating blood.
allergens
foreign antigens that trigger allergies
ABO blood group
formed by blood types A, B, AB, and O
What is suspended in blood plasma?
formed elements
platelets are not cells but:
fragment of marrow cells called /megakaryocytes/
platlets
fragments tons from certain bone marrow cells
What is the general function of Leukocytes?
give protection against infections and other diseases
What is the procedure for reducing the risk of a transfusion reaction?
giving packed RBCs with minimum plasma
hemoglobin consists of 4 protein chains called ___
globins • two alpha chains (141 amino acids long) • two beta chains (146 amino acids long)
The antigens are ___.
glycolipids-membrane phospholipids with short carbohydrate chains bonded to them
Normal levels of men vs. women:
hematocrit: *♂* (42-52%) ; *♀*(37-48%) hemoglobin concentration: *♂* (13-18 g/dL) ; *♀*(12-16 g/dL) RBC count: *♂* (4.6-6.2 million RBCs/uL) ; *♀*(4.2-5.4 million RBCs/uL)
Sickle-cell disease is caused by a recessive allele that modifies ___.
hemoglobin
CO2 binds to the:
hemoglobin moeity rather than the heme
megakaryoblasts
hemopoietic stem cells that produce receptors for the hormone /thrombopoietin/ - cells committed to producing platelets
After birth, what one cell type is the starting point for all hemopoiesis?
hemopoietic stemWhich major class of plasma proteins is absent from plasma serum? cell (HSC)
Sickle-cell disease and thalassemia are:
hereditary hemoglobin defects
When the body detects an antigen of foreign origin it activates an:
immune response-consisting partly of plasma cells secreting proteins called antibodies
Eosinophils are abundant:
in mucous membranes of the respiratory, digestive, and lower urinary tracts
the principle dangers of polycythemia are:
increased blood volume, pressure, and viscosity
extrinsic mechanisms
initiated by clotting factors released by damaged blood vessel and perivascular tissues - these factors come from sources external to the blood
B12 defiance also causes anemia and occurs when glands of the stomach fail to produce a substance called ___ that the small intestines needs to absorb the vitamin.
intrinsic factor
In what way does hemoglobin exemplify a quaternary protein structure?
it is the arrangement of more than one protein molecule in a multi-subunit complex (because we call a single polypeptide chain a protein if it can function on its own)
If blood osmolarity is too high:
it may absorb too much water
IF blood osmolarity is too low:
it may cause water retention in the tissues and swelling called /edematous/
A high level of bilirubin in the blood causes ___.
jaundice
factor XII catalyzes the formation of a plasma enzyme called ___.
kallikrein
anemia often results from?
kidney failure
What organ has influence over RBC production?
kidneys
hemophilia A
lack of factor IX (anti hemophiliac factor B)
classical hemophilia A
lack of factor VIII (anti hemophiliac factor A)
hemophilia C
lack of factor XI - autosomal and not sex-linked
blood is considered ___.
liquid connective tissue
All clotting factors come from where?
liver
Most procoagulants are proteins produced by the ___.
liver
The ___ produces every plasma protein except gamma globulins.
liver
What organ releases Fe into the blood when it is needed?
liver, using stored Fe in ferritin
proplatelets
long tendrils that megakaryocytes sprout - protrude through the endothelium into the blood of the sinusoid
Where do most proplatelets get broken down?
lungs
lymphocytes are also produced in:
lymphatic tissues and organs-especially the thymus, tonsils, lymph nodes, spleen, and mucous membranes
hematomas
masses of clotted blood in tissue
The megakaryoblast duplicates its DNA repeatedly without undergoing nuclear of cytoplasmic division resulting in a ___.
megakaryocyte
Basophils are stained with ___.
methylene blue
We see Rh+/- incompatibilities mostly in:
mothers who are Rh- carrying an Rh+ baby; can cause *hemolytic disease of the newborn (HDN)* or *erythroblastosis fetalis* (these diseases can also be contributed to incompatible blood types between the mother and her fetus)
RBC count is maintained in a classical ___.
negative feedback loop
ABO type has ___ effect of Rh type.
no
All WBCs have lysosomes called ___ in their cytoplasm.
nonspecific (azurophilic) granules
Contrasting to the ABO group, anti-D antibodies are:
not normally present in the blood; they form only in Rh- people exposed to Rh+ blood
RBCs loose their ___ & ___ during maturation
nucleus & organelles
How does Sickle-cell hemoglobin (HbS) differ from regular hemoglobin?
on the 6th amino acid on the beta chain, where HbA has glutamic acid, HbS has valine
sodium is for important than any other solute for the ___ of the blood.
osmolarity
hematocrit
percentage of blood volume composed of erythrocytes
hematocrit (packed cell volume, PCV)
percentage of whole blood volume composed of RBCs
Where do gamma globulins come from?
plasma cells
blood types and transfusion compatibility are influenced by interactions between:
plasma proteins and erythrocytes
Thrombin also activates:
plasmin - and plasmic indirectly promotes the formation of more kallikrein
thrombocytopenia
platelet deficiency
platelets and endothelial cells secrete a mitotic stimulant named ___.
platlet-derived growth factor (PDGF)
Sickle-Cell disease is a prime example of ___.
pleiotrophy - the occurrence of multiple phenotypic effects from a change in a single gene
a RBC excess
polycythemia
secondary polycythemia
polycythemia from all other cases • characterized by RBC count as high as 6-8 million RBCs/uL
Neutrophils are also called ___ because of their varied nuclear shape.
polymorphonuclear leukocytes (PMNs)
Both platelet plug formation and coagulation are examples of ___.
positive feedback cycles
anticoagulants
prevent clotting
cell clusters called /blood islands/ produce:
primitive stem cells that migrate into the embryo proper and colonize the bone marrow, liver, spleen, and thymus
What normally coats endothelium and is a platelet repellent?
prostacyclin
colloid osmotic pressure (COP)
protein contribution to blood osmotic pressure
Plasma is more viscous than water because of its
proteins
When activated, platelets for ___ and are capable of ameboid movement.
pseudopods
The blood viscosity changing can make the blood flow too easily or too sluggish which can:
put a strain on the heart-leading to serious cardiovascular effects
procoagulants are always present in the blood but in its inactive form, when one factor activates it causes a ___.
reaction cascade
erythrocytes are also known as ___.
red blood cells (RBC)
What produces all seven kinds of formed elements?
red bone marrow
Where are granulocytes and monocytes stored until they are needed?
red bone marrow
hemoglobin
red pigment that gives RBC's their name and color; known for its role in *O2 transport, CO2 transport, and buffering of blood pH*
As leukemia proliferates they:
replace normal bone marrow causing a deficiency of normal granulocytes, erythrocytes, and platelets
Rh blood group is named for ___ and focuses on Antigen _.
rhesus monkeys; Antigen D
eosinophilia
rise in Eosinophil count
neutrophilia
rise in Neutrophil count
reaction cascade
series of reactions
Infants with HDN are:
severely anemic-as the fetal hemopoietic tissue responds to the need for more RBCs-erythroblasts (immature RBCs) enter the blood stream and provide no help
In most cases of bleeding extrinsic and intrinsic mechanisms work ___.
simultaneously
___ ions constitute about 90% of the plasma cations.
sodium
colony-forming units (CFUs)
some HSC's go on to form these cells that are destine to produce one or another class of formed elements
What is called the "erythrocyte graveyard" because of its small, narrow channels that trap, break up, and destroy RBCs?
spleen
Where are platelets stored in the body?
spleen
multipotent stem cells/ pluripotent stem cells
stem cells destined to develop into multiple mature cell types
fibrin
sticky protein that forms the framework of a blood clot
platlet-derived growth factor (PDGF)
stimulates fibroblasts and smooth muscle cells to multiply and repair the damaged blood vessel
hemopoietic tissues
terraces that produce blood cells
thrombosis
the abnormal clotting of blood in an unbroken blood vessel
RBC count and hemoglobin concentration are important clinical data because they determine ___.
the amount of O2 the blood can carry
the transfer of fluids between the bloodstream and tissues depends on:
the balance between the filtration of fluid from the capillary and its reabsortion by osmosis
hypoplastic anemia is caused by:
the decline in erythropoiesis
fibrinolysis
the dissolution of a clot; achieved by a small cascade reaction with a positive feedback component
opportunistic infection
the establishment of a pathogenic organism that usually is unharmful to people with healthy immune systems
serum
the fluid remaining when the blood clots and the solids are removed
one's ABO type is determined by
the hereditary presence or absence of antigens A and B on the RBCs
vascular spasm
the most immediate protection against blood loss - a prompt constriction of the broken vessel • enjury → stimulates pain receptors → cause vessels to constrict • lasts long enough for the other 2 mechanisms to come into play
Anti-D does not appear instantly but causes a problem in:
the person's second contact with Rh+ blood; the anti-D agglutinates the Rh+ blood
hemopoiesis
the production of blood, especially its formed elements
thrombopoiesis
the production of platelets (a division of hemopoiesis)
leukopoiesis
the production of white blood cells
viscosity
the resistance of a fluid to flow, resulting from the cohesion of its particles (thickness or stickiness of a fluid)
hemolysis
the rupture of RBCs; releases hemoglobin, leaving empty plasma membranes
hematology
the study of blood
What are people with high blood pressure often advised to limit?
their sodium intake
the terms universal donor (AB) and universal recipient (O) are outdated because:
these types can still react with certain blood types and agglutinate
A person is considered Rh-positive (Rh+) if?
they have D antigens (genotype DD or Dd)
A person is considered Rh-negative (Rh-) if?
they lack D antigens (genotype dd)
Platelets are occasionally called ___.
thrombocytes
infarction
tissue death
What is the objective of coagulation?
to convert plasma protein fibrinogen into fibrin, a sticky protein that adheres to the walls of vessels
osmolarity
total military of dissolves particles that cannot pass through the blood vessel wall
nitrogenous waste
toxic end products catabolism • most abundant is /urea/ • normally excreted by the kidneys
Fe2+ is absorbed into the blood in the small intestines, here it binds to a plasma protein called ___.
transferrin
A mismatch of blood is called a ___.
transfusion reaction-the agglutinated RBCs block small blood vessels, homeless, and release their hemoglobin-which can cause blockages
thromboembolism
traveling blood clots - results in pulmonary failure (more likely to occur in veins)
After Fe2+ binds to transferrin it:
travels to the bone marrow, liver, and other tissues
bacteria converts bilirubin into ___.
urobilinogen, responsible for the brown color of feces
Another hemoglobin breakdown pigment, ___, produces the yellow color of urine.
urochrome
intrinsic mechanisms
uses factors only found within the blood
Lymphocytes, responsible to long-term immunity, survive ___.
weeks to decades-leave the bloodstream for the tissues and eventually end up in the lymphatic system
leukocytes are also known as ___.
white blood cells (WBC)
the first hemopoietic tissues of the human embryo form the ___.
yolk sac • also the source of cells that produce sperm and egg
The Pathways to Coagulation
• *thromboplastins (factor III)* : comes from surrounding tissues • Factor XII coverts Factor XI to its active form • *Factor X *: both extrinsic and extrinsic pathways arrive at this factor • Factor V : positive feedback loop • *thrombin* : converts fibrinogen to fibrin
What are other nutritional requirements for erythropoiesis?
• B12 & folic acid - for rapid cell division and DNA synthesis • Vitamin C & Cu - cofactors for some enzymes that synthesize hemoglobin
formed element classifications:
• Erythrocytes • Platlets • Leukocytes Granulocytes - Neutrophils - Basophils - Eosinophils Agranulocytes - Lymphocytes - Monocytes
Blood types result from actions between ___ on the surface of the RBCs and ___ in the blood plasma.
• antigens called *agglutinogens* • antibodies called *agglutinins*
Erythrocyte Death and Disposal
• as an erythrocyte ages and its membrane proteins (especially spectrin) deteriorate, the membrane becomes fragile • without a nucleus the RBC cannot synthesize new spectrin
Stages of erythropoiesis
• begins with a hemopoietic stem cell (HSC) → erythrocyte colony-forming unit (ECFU) : which has receptors for /erythropoietin (EPO)/ (a hormone secreted by the kidneys) • EPO stimulates the ECFU to transform into an /erythroblast (normoblast)/ : erythroblasts multiply and synthesize hemoglobin • when hemoglobin synthesis is complete → nucleus shrivels and discharges from cell : the cell is now called a /reticulocyte/ (named for the temporary network/reticulum composed of ribosome clusters/polyribosomes) • reticulocytes leave the bone marrow → enter the circulating blood, in a day or two the last of the polyribosomes disintegrate and disappear and the cell is a mature erythrocyte
Stages of Leukopoiesis:
• begins with hemopoietic stem cells (HSCs) → differentiate into district types of colony-forming units (CFUs) and go on to produce following cell lines: 1. Myeloblasts: differentiate into three types of granulocytes (neutrophils, eosinophils, and basophils) 2. Monoblasts: lead to monocytes 3. Lymphoblasts: produce lymphocyte type
Transportation Function:
• blood carries O2 from the lungs to body's tissue, picks up CO2 from those tissues and carries it to lungs for removal • picks up nutrients from digestive tract and delivers to all of body's tissues • carries metabolic waste to kidneys for removal • carries hormones from endocrine cells to target organs • transforms variety of stem cells from Bone Marrow and etc organs to tissues where they lodge and mature
hypoxemia has many causes:
• blood loss • low O2 in atmosphere • formerly lazy person takes up exercise
Protection Function:
• blood plays several roles in inflammation, a mechanism for limiting the speed of infection • WBCs destroy MO and cancer cells • Ab & etc blood proteins neutralize toxins and help destroy pathogens • Platlets secrete factors that initiate blood clotting and etc processes for minimizing blood loss
Different things use Fe for different reasons:
• bone marrow: hemoglobin synthesis • muscles: to make O2 storage protein /myoglobulin/ • used to make electron-transport molecules /cytochromes/
Regulation Function:
• by absorbing/giving off fluid, capillaries help to stabilize fluid distribution in the body • by buffering acids & bases, blood proteins help stabilize pH of ECF • shifts in blood flow help to regulate body temp by routing blood to skin for heat loss (or) retaining it deeper in the body for conservation
Plasma proteins play a variety of roles in:
• clotting • defense • transport of other solutes (Fe, Cu, lipids, hydrophobic hormones)
secondary polycythemia can result from:
• dehydration • smoking • air pollution • emphysema • high altitude • excessive aerobic exercise
plasma also transportas nutrients absorbed by the digestive tract:
• glucose • amino acids • fats • cholesterol • phospholipids • vitamins • minerals ---- • dissolved O2 • Co2 • Nitrogen
The plasma membrane of a mature RBC consists of:
• glycolipids on outer surface (determine a person's blood type) • two cytoskeletal proteins on its inner surface /spectrin/ and /actin/ (give the membrane resilience and durability
The cardiovascular system refers only to the:
• heart • blood vessels
The circulatory system consists of:
• heart • blood vessels • blood
The cytoplasm of a RBC consists of:
• hemoglobin • carbonic anhydrase
leukocytosis usually indicates:
• infection • allergy • dehydration • emotional disturbances
leukopenia is a result of:
• lead, mercury, or arsenic poisoning • measles, mumps, chicen pox • influenza • AIDS
The ___ and ___ stop producing blood cells around the third trimester, but the spleen produces ___ for life.
• liver & spleen • lymphocytes
Platlets have a complex internal structure that includes:
• lysosomes • mitochondria • microtubules • microfilaments • granules filled with platelet secretions • system of channels that open onto their surfaces called *open canalicular system* (have no nuclei)
Leukemia classifications
• myeloid: uncontrolled granulocyte production • lymphoid: uncontrolled lymphocyte production • acute: short term • chronic: long term
the blood transports:
• nutrients • wastes • hormones • O2
HDN can be treated by:
• phototherapy • exchange transfusion
Prevention of inappropriate Clotting
• platelet repulsion: platlets do not adhere to prostacyclin coated endothelium • dilution: thrombin forms spontaneously in blood plasm but is diluted quickly by blood flow • anticoagulants: suppresses thrombin formation (ex. antithrombin:secreted by the liver & heparin:secreted by basophils & mast cells)
Platelet function:
• secrete vasoconstrictors, chemicals that stimulate spasmodic constriction of broken vessels and thereby help to reduce blood loss. • stick together to form temporary platelet plugs that seal small breaks in injured blood vessels. • secrete procoagulants, or clotting factors, which promote blood clotting. • initiate the formation of a clot-dissolving enzyme that dissolves blood clots that have outlasted their usefulness. • secrete chemicals that attract neutrophils and monocytes to sites of inflammation. • internalize and destroy bacteria. • secrete growth factors that stimulate mitosis in fibroblasts and smooth muscle and thereby help to maintain and repair blood vessels.
Albumin
• smallest & most abundant plasma protein • transports various solutes • buffers pH of plasma • contributes to 2 physical properties of blood: *viscosity* & *osmolarity* • its changes can effect *blood volume, pressure, & flow*
The osmolarity of the blood is a product mainly of its:
• sodium ions • proteins • erythrocytes
Function of the circulatory system:
• transport • protection • regulation
platelet plug formation
• vessel breaks → collagen fibers to its walls are exposed to blood → platelets stick to the collagen or other rough surfaces & other platelets (using pseudopods) → the mass of platelets thus formed is called a platelet plug (may reduce or stop minor bleeding)
Albumin contributes to two physical properties of blood, ___ & ___.
• viscosity • osmolarity
sodium has a major influence on blood ___ & ___.
• volume • pressure
Changes in Albumin can effect blood ___, ___, & ___.
• volume • pressure • flow
Plasma is a complet mixture of:
• water • proteins • nutrients • electrolytes • nitrogenous waste • hormones • gases
As platelets aggregate they undergo ___.
*degranulation* - the exocytosis of their cytoplasmic granules and release of factors that promote hemostasis: • serotonin (vasoconstrictor) • adenosine diphosphate (ADP) - attracts more platelets • thromboxane A2 - an eicosanoid that promotes platelet aggregation, degranulation, and vasoconstriction
each chain is conjugated with a nonprotein moiety called the ___.
*heme* group
nutritional anemia's most common form is ___.
*iron-deficency anemia* - characterized by small, pale erythrocytes
Young Neutrophils have undivided nucleus and are called ___.
/band cells/ or /stab cells/
Each heme can carry _ molecule of O2, therefor the hemoglobin molecule as a whole can transport up to _ O2
1, 4
3 major categories of plasma proteins:
1. Albumin 2. Globulins 3. Fibrinogen
2 forms of dietary Iron:
1. Fe3+ 2. Fe2+
Different hemoglobin forms:
1. adult hemoglobin (HbA) • two alpha chains • two beta chains 2. HbA2 • two alpha chains • two delta chains 3. fetal hemoglobin (HbF) • two alpha chains • two gamma chains
3 reasons the values of hematocrit, hemoglobin concentration, and RBC count are lower in women than in men:
1. androgens stimulate RBC production; men have higher androgen levels than women 2. women at reproductive age have periodic menstrual losses 3. hematocrit is inversely prop. to % of body fat; women have more body fat in men blood also clots faster and the skin has fewer blood vessels
What are the two reaction pathways to coagulation?
1. extrinsic mechanisms 2. intrinsic mechanisms
3 of the most common measurements are:
1. hematocrit 2. hemoglobin concentration 3. RBC count
The causes of anemia fall into 3 categories:
1. inadequate erythropoiesis or hemoglobin synthesis 2. *hemorrhagic anemia*: from bleeding 3. *hemolytic anemia*: from RBC destruction
2 principle functions of Erythrocytes:
1. pick up O2 from lungs and deliver it to tissues 2. pick up CO2 from tissues and unload it in the lungs
erythropoiesis involves 4 major developments:
1. reduction in cell size 2. increase in cell number 3. synthesis of hemoglobin 4. loss of the nucleus and other organelles
3 potential consequences of anemia:
1. tissue suffers hypoxia (oxygen deprivation) - individual is lethargic & short of breath, skin is pallid because of hemoglobin deficiency - can cause necrosis of brain, heart, and kidney tissues 2. blood osmolarity is reduced - more fluid transfers from b.s. to ICF causing edema 3. blood viscosity is reduced - heart beats faster, causing later heart failure
3 hemostatic mechanisms:
1. vascular spasm 2. platelet plug formation 3. blood clotting • platelets play a role in all 3
Each antibody molecule has ___ binding spots.
10
Monocytes travel in the blood ___ and then migrate into tissue and transform into macrophages where they live ___.
10-20 hrs; as long as a year
Disposing of hemoglobin
1st: macrophages separate the heme from the globin → hydrolyze the globin into free amino acids to be used for energy-releasing catabolism or recycled for protein synthesis 2nd: macrophage removes the Fe and releases it into the blood → where it combines with transferrins and is used or stored in the same way as dietary Fe 3rd: macrophage converts the rest of the heme into a greenish pigment *biliverdin* → further converts it to a yellow-greenish pigment *bilirubin* 4th: macrophage releases bilirubin and it binds to albumin in the blood plasma 5th: liver removes bilirubin from albumin and secretes it into bile
Antibodies of the ABO group begin to appear in the plasma ___ after birth.
2-8 months
mean count of Platelets
250,000/μL
Globulins
3 subclasses: 1. alpha(a) 2. beta(β) 3. gamma(γ) • play roles in: *solute transport, clotting, & immunity*
mean count of Erythrocytes
4,500,000/μL
Adults generally have _ - _ liters of blood.
4-6 liters
Granulocytes circulate in the blood ___ and then migrate into tissue where they live another ___.
4-8 hrs; 4-5 days
mean count of Leukocytes
5,000 - 10,000/μL
Platelets live ___ in the circulating blood.
5-6 days
There are _ kinds of formed elements:
7
Antibodies of the ABO group reach their maximum concentration between ___ years of age and then slowly decline for the rest of one's life.
8-10
What type of blood is the rarest in the US?
AB
Basophils
Appearance • nucleus large and U- to S- shaped; normally pale and absurd from view • coarse, abundant, dark violet specific granules in cytoplasm • 1% of WBC Differential count • relatively stable • increase in chicken pox, sinusitis, diabetes mellitus, myxedema, and polycythemia Function • secrete histamine (vasodilator) • secrete heparin (anticoagulant)
Eosinophils
Appearance • nucleus normally has 2 large lobes connected by thing strand • large orange-pink specific granules in the cytoplasm • 3% of WBC Differential count • fluctuates greatly from night-day, seasonal, & phases of menstruation • *increases in parasitic infections*, allergens, collagen diseases, and diseases of spleen and CNS Function • phagocytizes Ag-Ab complexes, allergens, inflammatory chemicals • releases enzymes that weaken/destroy parasites
Monocytes
Appearance • nucleus ovoid, kidney shaped, or horse shaped; violet • abundant cytoplasm with sparse, fine, nonspecific granules • sometimes very large with stellate or polygonal shapes • 6% of WBC Differential count increase in viral infection and inflammation Function • *differentiate into macrophages* • phagocytize pathogens, dead neutrophils, and debris of dead cells • present Antigens to activate other cells of immune system
Lymphocytes
Appearance • nucleus round, ovoid, or slightly dimpled on one side, of uniform or mottled dark violet color • in small lymphocytes the nucleus takes up almost the whole cell • in large lymphocytes the cytoplasm is more abundant (can be mistaken for monocyte) • 25% of WBC Differential count • increase in diverse infections and *immune response* Function • several function classes: indistinguishable under light microscopy • destroy cancer cells, cells with infected viruses, and foreign cells • present Antigens to activate other cells of immune system • coordinate actions of other immune cells • secrete Antibodies • serve in Immune memory
Neutrophils
Appearance • nucleus usually 3-5 lobes in S- or C- shape • fine reddish to violet specific granules in cytoplasm • 65% of WBC Differential Count • increases in bacterial infections Function • phagocytize bacteria • release lysosomes & antimicrobial chemicals
What is the rarest WBC and also of all the formed elements?
Basophils
Why does Sickle-cell disease exist?
Because many people in Africa die from malaria, sickle-cell carriers are immune from malaria and HbS is fatal to the malaria parasites
Explain why the hemoglobin concentration could appear deceptively higher in a patient who is dehydrated?
Because the O2 per dL of blood would appear high but that is only because the amount of fluid has gone down; therefore the blood is only more concentrated because of the lack of fluid the hemoglobin should be suspended in
